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<1>
Accession Number
2040342206
Title
Efficacy and safety of prothrombin complex concentrate versus frozen
plasma in cardiac surgery: a systematic review and meta-analysis with
trial sequential analysis.
Source
British Journal of Anaesthesia. 135(5) (pp 1359-1362), 2025. Date of
Publication: 01 Nov 2025.
Author
Shalabi L.; Ibrahim A.; Zreigh S.; Tawfik A.M.; Shalabi S.; Rifai M.;
Legrand M.
Institution
(Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Ibrahim, Tawfik) Faculty of Medicine, Alexandria University, Alexandria,
Egypt
(Zreigh) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara,
Turkey
(Shalabi) College of Pharmacy, Gharyan University, Gharyan, Libyan Arab
Jamahiriya
(Rifai) Faculty of Medicine, Menoufia University, Shebin El Kom, Egypt
(Legrand) Department of Anesthesia and Perioperative Care, University of
California, San Francisco, CA, United States
Publisher
Elsevier Ltd

<2>
Accession Number
2032350869
Title
Use of standard Del Nido cardioplegia for the intracardiac repair of
tetralogy of Fallot: A systematic review and meta-analysis of randomized
controlled trials.
Source
Health Sciences Review. 11 (no pagination), 2024. Article Number: 100179.
Date of Publication: 01 Jun 2024.
Author
Usmani S.U.R.; Hasan S.U.; Ahmed S.H.; Pervez N.; Zia A.; Chen Q.; Gill
G.; Rowe G.; Alvi S.; Zubair M.M.
Institution
(Usmani, Hasan, Pervez, Zia) Department of Surgery, Dow University of
Health Sciences, Baba-e-Urdu Rd, Karachi, Pakistan
(Ahmed) Division of Plastic and Reconstructive Surgery, Department of
Surgery, University of Florida, Gainesville, FL, United States
(Chen, Gill, Rowe) Department of Cardiac Surgery, Cedars-Sinai Hospital,
8700 Beverly Blvd, Los Angeles, CA, United States
(Alvi) Tufts Medical Centre, 800 Washington St, Boston, MA, United States
(Zubair) Department of Pediatric Cardiac Surgery, C.S. Mott Children's
Hospital, University of Michigan Health, 1540 E Hospital Dr, Ann Arbor,
MI, United States
Publisher
Elsevier Ltd
Abstract
This meta-analysis compares the efficacy of the standard Del Nido
cardioplegia with other agents during intra-cardiac tetralogy of Fallot
repair. Meta-analysis was performed on studies comparing standard Del Nido
cardioplegia with other types of cardioplegia. Outcomes were pooled using
inverse variance and random effects analysis models to calculate the
standardized mean difference (SMD) and odds ratio (OR). The SMD for ICU
length of stay, duration of mechanical ventilation, and time taken for the
heart to return to normal rhythm were -0.06 (P = 0.67), -0.21 (P = 0.06),
and 0.23 (P = 0.48), respectively. The OR for the incidence of
postoperative arrhythmias was 0.65 (P = 0.32). The standardized mean
differences for twenty-four-hour post-operative IL-6, TNF-alpha, and cTnI
levels were 0.29 (P = 0.16), -0.27 (P = 0.01), and -0.60 (P = 0.01),
respectively. Del Nido cardioplegia is protective on the myocardium, with
lower levels of inflammatory cytokines 24 h post-operation and a
significantly reduced incidence of post-operative
arrhythmias. Copyright © 2024

<3>
Accession Number
2034838898
Title
Saline-based modified del Nido cardioplegia versus multidose St. Thomas
cardioplegia in canine mitral valve repair: A randomized controlled trial.
Source
Veterinary Surgery. 54(7) (pp 1366-1377), 2025. Date of Publication: 01
Oct 2025.
Author
Kurogochi K.; Takahashi A.; Nii Y.; Chen A.; Nishiyama M.; Furusato S.;
Sugiya H.; Uechi M.
Institution
(Kurogochi, Takahashi, Nii, Chen, Nishiyama, Furusato, Sugiya, Uechi)
JASMINE Veterinary Cardiovascular Medical Center, Yokohama, Japan
(Kurogochi) Department of Clinical Sciences, North Carolina State
University, College of Veterinary Medicine, Raleigh, NC, United States
(Furusato) Department of Health Data Science, Yokohama City University,
Yokohama, Japan
Publisher
John Wiley and Sons Inc
Abstract
Objective: To compare the utility of a saline-based modified del Nido
(mDN) cardioplegia solution with a conventional institutional technique
(multidose St. Thomas blood cardioplegia) for mitral valve repair (MVR) in
dogs. Study design: Prospective, randomized, open-label trial. Animals:
Forty client-owned dogs with myxomatous mitral valve disease (stage B2 and
C) eligible for MVR were divided into control and modified mDN groups.
 Method(s): Cardioplegia was induced in the control group using 50%
blood containing St. Thomas solution every 10 min. In the mDN group, a
cardioplegia solution containing 20% blood was administered once or when
required. As the primary outcome, serum cardiac troponin I levels were
compared 12 h postoperatively between the groups. The other clinical
findings were evaluated as secondary outcomes. Result(s): Troponin
levels 12 h after surgery were a median of 27.8 ng/mL (interquartile
range, 15.1-43.2) in the control group and 19.4 ng/mL (15.2-33.6) in the
mDN group (p =.478). The sinus rhythm recovery time following aortic
cross-clamp removal was 362 s (103-995) in the control group and 60 s
(44-605) in the mDN group (p =.027). The total amount of crystalloid
cardioplegia solution required was 12.6 mL/kg (11.3-15.0) in the control
group and 23.6 mL/kg (18.0-35.1) in the mDN group (p <.001).
 Conclusion(s): Cardiac troponin I levels did not show differences
between the groups. The saline-based mDN cardioplegia facilitated earlier
sinus rhythm recovery. Clinical significance: Saline-based mDN
cardioplegia may be a viable alternative for canine MVR. Copyright
© 2025 Japan Animal Specialty Medical Institute Inc. Veterinary
Surgery published by Wiley Periodicals LLC on behalf of American College
of Veterinary Surgeons.

<4>
Accession Number
2039873174
Title
Left atrial appendage occlusion in patients with atrial fibrillation and
previous Intracranial Hemorrhage or Cerebral Amyloid Angiopathy: A
systematic review and meta-analysis.
Source
International Journal of Stroke. 20(9) (pp 1049-1059), 2025. Date of
Publication: 01 Oct 2025.
Author
Mavridis T.; Archontakis-Barakakis P.; Chlorogiannis D.-D.; Charidimou A.
Institution
(Mavridis) Department of Neurology, Tallaght University Hospital (TUH),
The Adelaide and Meath Hospital, Dublin, Incorporating the National
Children's Hospital (AMNCH), Dublin, Ireland
(Archontakis-Barakakis) Redington-Fairview General Hospital, Skowhegan,
ME, United States
(Chlorogiannis) Department of Radiology, Brigham and Women's Hospital,
Harvard Medical School, Boston, MA, United States
(Charidimou) Department of Neurology, Boston University Medical Center,
Boston University School of Medicine, Boston, MA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Patients with atrial fibrillation (AF) on oral anticoagulation
(OAC) who have a history of intracranial hemorrhage (ICrH) or cerebral
amyloid angiopathy (CAA) have an elevated risk of ICrH recurrence. Left
atrial appendage occlusion (LAAO) has emerged as a potential alternative
to OAC for stroke prevention in high-bleeding-risk AF patients. Small
observational studies suggest that LAAO may be safe and feasible in
patients with ICrH, when using single or dual antiplatelet therapy or
short-term OAC post-procedure, though data remain limited. This systematic
review and meta-analysis aims to consolidate evidence on the safety and
efficacy of LAAO in patients with prior ICrH or CAA. Method(s): We
conducted a systematic review and meta-analysis examining the safety and
efficacy of LAAO in patients with non-valvular AF and prior ICrH and/or
CAA. PubMed/MEDLINE and EMBASE (via Scopus) databases were systematically
searched from inception until 29 February 2024. Eligible studies included
randomized control trials, observational studies, and case series (10
participants) reporting stroke events in patients with AF and previous
history of ICrH and/or CAA undergoing LAAO. Pooled incidence rates (IRs)
with corresponding 95% confidence intervals (CIs) were calculated for
primary outcomes (post-procedural ischemic stroke and recurrent ICrH) and
secondary outcomes. Result(s): Fourteen studies including 1235
patients met inclusion criteria. The pooled average follow-up period was
17.1 months. The pooled IRs for ischemic stroke, recurrent ICrH, and major
hemorrhage were 2% (95% CI: 1-3%, I2 = 2%), 2% (95% CI: 0.4-3%,
I2 = 45%) and 3% (95% CI: 1-5%, I2 = 54%),
respectively. In prespecified subgroup analyses of studies focusing on
patients with intraparenchymal hemorrhage and/or CAA, pooled IRs for
ischemic stroke, recurrent ICrH, and major hemorrhage IR of 4% (95% CI:
1-8%), 4% (95% CI: 0.4-10%) and 6% (95% CI: 3-12%), respectively.
 Conclusion(s): LAAO may be a safe and effective treatment for
selected AF patients with a history of ICrH and/or CAA, but the quality of
evidence is poor. Future randomized controlled trials are essential to
validate LAAO's efficacy and long-term safety. Copyright © 2025
World Stroke Organization

<5>
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.

<6>
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

<7>
Accession Number
2035548834
Title
Parvovirus B19-associated myocarditis in children: A systematic review of
clinical features, management and outcomes.
Source
European Journal of Clinical Investigation. 55(11) (no pagination), 2025.
Article Number: e70102. Date of Publication: 01 Nov 2025.
Author
Veronese G.; Colombo G.; Garascia A.; Adorisio R.; Bonanomi E.; Ammirati
E.
Institution
(Veronese, Bonanomi) Pediatric Intensive Care Unit, ASST Papa Giovanni
XXIII, Bergamo, Italy
(Veronese) Department of Cardiothoracic Surgery, Heart and Vascular
Centre, Maastricht University Medical Centre, Maastricht, Netherlands
(Colombo, Garascia, Ammirati) De Gasperis Cardio Center, Niguarda
Hospital, Milan, Italy
(Adorisio) Heart Failure, Transplant and Mechanical Assist Device Unit,
IRCCS Bambino Gesu Children's Hospital, Rome, Italy
(Ammirati) University of Milan-Bicocca, School of Medicine and Surgery,
Monza, Italy
Publisher
John Wiley and Sons Inc
Abstract
Background: Parvovirus B19 (PVB19) has emerged as a relevant etiologic
agent of paediatric myocarditis, particularly during recent
epidemiological surges in Europe and the United States. Despite increasing
recognition, current knowledge remains fragmented, and standardised
diagnostic and therapeutic strategies are lacking. Method(s): We
conducted a systematic review of the literature up to May 2025, including
40 studies encompassing 53 individual case reports, 107 patients from
registry-based cohorts, and 4 tissue-based investigations. Result(s):
Clinical presentation was frequently fulminant, with cardiogenic shock,
severe left ventricular dysfunction, and need for mechanical circulatory
support in up to 47% of cases. Mortality rates ranged from 10% to 30%,
with heart transplantation rates varying between 5% and 42% across
cohorts. Diagnosis relied primarily on blood polymerase chain reaction
(PCR), while serology showed limited diagnostic utility. Histological
confirmation via endomyocardial biopsy (EMB) was variably applied across
studies, and myocardial viral load quantification was reported in only one
study. Case series and cohort studies confirmed early age of onset (median
16-24 months), respiratory or gastrointestinal prodromes, and poor
outcomes in fulminant presentations. Tissue-based studies revealed high
myocardial PVB19 loads in acute myocarditis, particularly in infants, but
also demonstrated viral persistence in asymptomatic individuals,
complicating causal inference. Immunomodulatory therapy was administered
in up to 58% of cases, although its clinical impact remains uncertain due
to heterogeneity in treatment protocols. No antiviral treatments have been
evaluated to date. Conclusion(s): These findings highlight the need
for standardised diagnostic criteria incorporating PCR, serology, imaging,
and, where appropriate, EMB and viral load assessment. Given recent
epidemiologic surges and high morbidity, prospective multicentre studies
and surveillance efforts are urgently required to refine clinical
algorithms and improve outcomes in paediatric PVB19
myocarditis. Copyright © 2025 The Author(s). European Journal of
Clinical Investigation published by John Wiley & Sons Ltd on behalf of
Stichting European Society for Clinical Investigation Journal Foundation.

<8>
Accession Number
2034828621
Title
A randomized controlled trial on the impact of anesthetic agents on renal
function in cardiac surgery with cardiopulmonary bypass.
Source
Molecular and Cellular Biochemistry. 480(10) (pp 5399-5410), 2025. Date of
Publication: 01 Oct 2025.
Author
Fan T.; Zhao Z.; Liu J.; Ma W.; Tian J.; Ma G.
Institution
(Fan, Zhao, Liu, Ma, Tian, Ma) The First Affiliated Hospital of Xinxiang
Medical University, Henan, China
Publisher
Springer
Abstract
Acute kidney injury (AKI) is a frequent and severe problem following heart
surgery, particularly in procedures involving cardiopulmonary bypass
(CPB). This research investigates the Randomized Controlled Trial (RCT) on
the impact of agents of anesthetic on renal function in patients receiving
elective cardiac surgery and CPB, comparing propofol-based and volatile
anesthetic-based regimens. A sum of 61 patients was randomly assigned into
two regions: one receiving a propofol-based regimen and the other, a
volatile anesthetic regimen, both combined with opioid analgesia. Renal
function was assessed preoperatively and postoperatively at 24 and 48 h
using serum creatinine and cystatin C levels. Perioperative inflammatory
markers were deliberate to evaluate inflammation-mediated renal impairment
multivariate logistic regression identified risk factors for AKI, and
independent t-tests compared renal function parameters between regimens.
Patients receiving propofol exhibited significantly lower rates of AKI
(p<0.05) and reduced inflammatory marker levels associated to the volatile
anesthetic regimen. These results present that propofol anesthesia
provides a protecting influence on renal function, likely due to its
anti-inflammatory properties. The research emphasizes the necessity of
choosing the right anesthetic for postoperative kidney outcomes by
tailoring anesthetic regimens to mitigate AKI risk in high-risk
populations. Propofol's protective role against AKI offers potential
clinical value, particularly in cardiac surgeries requiring CPB. Further
investigation with bigger cohorts and continued follow-up are necessary
for verifying these findings and exploring their broader applicability in
cardiac anesthesia. Copyright © The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<9>
Accession Number
2040987574
Title
Cardiopulmonary bypass-mediated lung ischemia-reperfusion injury: A
protective role of sitaxentan.
Source
Journal of International Medical Research. 53(10) (no pagination), 2025.
Article Number: 03000605251383318. Date of Publication: 01 Oct 2025.
Author
Wang Z.; Zhan R.; Mo L.; Zhang Y.; Chen Y.; Liu L.; Bai Y.
Institution
(Wang, Mo, Zhang, Chen, Liu, Bai) Department of Anesthesiology, the
Affiliated Hospital, Southwest Medical University, China
(Wang, Mo, Bai) Anesthesiology and Critical Care Medicine Key Laboratory
of Luzhou, China
(Zhan) Department of Anesthesiology, Gulin People's Hospital, China
Publisher
SAGE Publications Ltd
Abstract
Background: Cardiopulmonary bypass is widely used in cardiac surgery but
often leads to lung ischemia-reperfusion injury, a major cause of
morbidity and mortality. Despite advances in critical care, effective
prevention remains challenging. Sitaxentan, a selective endothelin
receptor antagonist, has shown protective effects in ischemia-reperfusion
models, suggesting its potential in mitigating lung ischemia-reperfusion
injury. This study investigated the efficacy of sitaxentan in reducing
lung ischemia-reperfusion injury during cardiopulmonary bypass.
 Method(s): Twenty-four female beagles were divided into sham,
cardiopulmonary bypass, and endothelin receptor antagonist
(sitaxentan-treated) groups. Hemodynamics, arterial blood gas, lung damage
scores, wet/dry ratio, and levels of various biomarkers were evaluated.
 Result(s): Lung damage scores in the endothelin receptor antagonist
group were lower than those in the cardiopulmonary bypass group but higher
than those in the sham group (P < 0.05). The wet/dry ratio was lowest
in the sham group and higher in the cardiopulmonary bypass group than that
in the endothelin receptor antagonist group (P < 0.05). Caspase-3 and
hypoxia inducible factor-1alpha levels were intermediate in the endothelin
receptor antagonist group compared with those in the cardiopulmonary
bypass and sham groups (P < 0.05). In contrast,
phosphorylated-endothelial nitric oxide synthase, phosphorylated protein
kinase B, tumor necrosis factor-alpha, and interleukin-6 levels were
higher in the endothelin receptor antagonist group than in the
cardiopulmonary bypass and sham groups (P < 0.05). Malondialdehyde
level was higher and superoxide dismutase level was lower in the
cardiopulmonary bypass and endothelin receptor antagonist groups than in
the sham group (P < 0.05). Conclusion(s): Sitaxentan may offer a
novel therapeutic approach to attenuate lung ischemia-reperfusion injury
in clinical settings by regulating the hypoxia inducible
factor-1alpha/phosphorylated protein kinase B/phosphorylated-endothelial
nitric oxide synthase pathway. Copyright © The Author(s) 2025.
Creative Commons Non Commercial CC BY-NC: This article is distributed
under the terms of the Creative Commons Attribution-NonCommercial 4.0
License (https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access pages
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<10>
Accession Number
2031580208
Title
Minimally invasive versus conventional sternotomy for aortic valve
replacement: A systematic review and meta-analysis.
Source
Clinical Medicine, Journal of the Royal College of Physicians of London.
23(Supplement 6) (pp 58-59), 2023. Date of Publication: 01 Nov 2023.
Author
Mohamed A.; Negida A.; Shaboub A.
Institution
(Mohamed, Shaboub) Ain Shams University, Cairo, Egypt
(Negida) Harvard Medical School, Cambridge, United States
Publisher
Elsevier B.V.

<11>
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.

<12>
Accession Number
2040933409
Title
Pharmacoinvasive strategy versus fibrinolytic therapy alone in adults with
ST-elevation myocardial infarction: A systematic review and meta-analysis.
Source
PLOS ONE. 20(10 October) (no pagination), 2025. Article Number: e0334309.
Date of Publication: 01 Oct 2025.
Author
Soriano-Moreno D.R.; Tuco K.G.; Delgado Flores C.J.; Flores-Lovon K.;
Ccami-Bernal F.; Quijano-Escate R.; Lopez-Rojas L.M.; Goicochea-Lugo S.
Institution
(Soriano-Moreno, Tuco) Unidad de Investigacion Clinica y Epidemiologica,
Escuela de Medicina, Universidad Peruana Union, Lima, Peru
(Delgado Flores) Carrera de Farmacia y Bioquimica, Facultad de Ciencias de
la Salud, Universidad Cientifica del Sur, Lima, Peru
(Flores-Lovon, Ccami-Bernal) Facultad de Medicina, Universidad Nacional de
San Agustin de Arequipa, Arequipa, Peru
(Quijano-Escate) Sociedad Cientifica de Estudiantes de Medicina de Ica,
Universidad Nacional San Luis Gonzaga, Ica, Peru
(Lopez-Rojas) Hospital Nacional Alberto Sabogal, EsSalud, Callao, Peru
(Goicochea-Lugo) Unidad de Investigacion para la Generacion y Sintesis de
Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
Publisher
Public Library of Science
Abstract
Objective To compare the pharmacoinvasive strategy (PS) versus
fibrinolysis alone in adults with ST-segment elevation myocardial
infarction. Methods We searched PubMed/MEDLINE, Web of Science, Embase,
and Cochrane Library from inception until January 17th, 2025. The review
protocol was registered in PROSPERO (CRD42022309130). We included
randomized controlled trials (RCTs), assessed risk of bias with the
Cochrane Risk of Bias 1.0 tool, and calculated pooled relative risks and
mean differences. We used GRADE's minimally contextualized approach to
determine the certainty of the evidence. Results We found 7 RCTs (n=3053).
The PS, compared to fibrinolysis alone, may have an important reduction on
mortality (3.3% vs 3.9%; -5 per 1000; 95% CI: -16 to +10); and has an
important reduction on reinfarction (2.6% vs 4.4%; -19 per 1000; 95% CI:
-27 to -6), revascularization (9.0% vs 26.8%; -169 per 1000; 95% CI: -220
to -64), and recurrent ischemia (1.2% vs 5.7%; -46 per 1000; 95% CI: -52
to -27) at 30 days follow up. Similar results were found at longest follow
up for the outcomes mentioned. PS probably has an important reduction on
mean hospital stay length at longest follow up (-2.47 days; 95% CI: -4.17
to -0.78) and may reduce cardiac failure and cardiogenic shock at 30 days,
but the evidence is very uncertain. PS has trivial or no effect on major
bleeding (4.6% vs 5.0%; -4 per 1000; 95% CI: -17 to +13) and may have an
important reduction on stroke (0.7% vs 1.3%; -6 per 1000: 95 CI: -10 to
+2). Conclusions The PS has an important reduction on reinfarction,
revascularization, and recurrent ischemia; probably has an important
reduction on mean hospital stay length; and may have an important
reduction of mortality and stroke. Also, PS may reduce cardiac failure and
cardiogenic shock, but the evidence is very uncertain. The risk of major
bleeding did not increase. Copyright © 2025 Soriano-Moreno 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.

<13>
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.

<14>
[Use Link to view the full text]
Accession Number
2040070927
Title
Transfusion of Amustaline/Glutathione Pathogen-Reduced Red Blood Cells in
Cardiac Surgery - A Randomized Phase III Clinical Trial.
Source
Anesthesiology. (no pagination), 2025. Article Number:
10.1097/ALN.0000000000005716. Date of Publication: 2025.
Author
Sekela M.E.; Snyder E.L.; Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.;
Beaver T.M.; Pelletier J.P.R.; Gorham J.D.; Mcneil J.S.; Sniecinski R.M.;
Pearl R.G.; Nuttall G.A.; Sarode R.; Reece T.B.; Benjamin R.J.; Kaplan A.;
Davenport R.D.; Ipe T.S.; Benharash P.; Lopez-Plaza I.; Sadler P.; Reik
R.; Gammon R.R.; Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.;
Varrone J.
Institution
(Sekela) Gill Heart Institute University of Kentucky, Lexington, KY,
United States
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Welsby) Duke University Medical Center, Durham, NC, United States
(Toyoda) Temple University Hospital, Philadelphia, PA, United States
(Alsammak) Temple University Health System, Philadelphia, PA, United
States
(Sodha) Rhode Island Hospital, Providence, RI, United States
(Beaver) University of Florida, Gainesville, FL, United States
(Pelletier) University of Florida, Gainesville, FL, United States
(Gorham) University of Virginia Health System, Charlottesville, VA, United
States
(Mcneil) University of Virginia Health System, Charlottesville, VA, United
States
(Sniecinski) Emory University, Atlanta, GA, United States
(Pearl) Stanford University, Stanford, CA, United States
(Nuttall) Mayo Clinic, Rochester, MN, United States
(Sarode) University of Texas Southwestern Medical Center, Southwestern,
Dallas, TX, United States
(Reece) University of Colorado Hospital, Denver, CO, United States
(Benjamin) Chief Medical Officer, Cerus Corporation, Concord, CA, United
States
(Pearl) Stanford University School of Medicine, Stanford, CA, United
States
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Davenport) University of Michigan, Ann Arbor, MI, United States
(Ipe) Our Blood Institute, Oklahoma City, OK, United States
(Benharash) UCLA, Los Angeles, CA, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, MI, United States
(Sadler) Central California Blood Center, Fresno, CA, United States
(Reik) OneBlood, Orlando, FL, United States
(Gammon) OneBlood, Orlando, FL, United States
(Pitman) Cerus Corporation, Concord, CA, United States
(Liu) Cerus Corporation, Concord, CA, United States
(Bentow) Cerus Corporation, Concord, CA, United States
(Corash) Cerus Corporation, Concord, CA, United States
(Mufti) Cerus Corporation, Concord, CA, United States
(Varrone) Clinical Operations, Cerus Corporation, Concord, CA, United
States
(Pelletier) Shands UF Blood Bank, United States
(Pearl) Perioperative and Pain Medicine, United States
(Kaplan) Vitalant, Pittsburgh, PA, United States
(Davenport) Blood Bank, Cytopathology and Transfusion Medicine, United
States
(Ipe) University of Arkansas for Medical Sciences, Little Rock, AR, United
States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: Transfusion has a persistent low risk of
transfusion-transmitted infection and transfusion-associated
graft-versus-host disease that may be addressed using pathogen-reduction.
The Red Cell Pathogen Inactivation (ReCePI) trial tested whether
amustaline/glutathione pathogen-reduced Red Cells are non-inferior to
conventional transfusions for support of acute surgical blood loss.
 Method(s): A Phase III, double-blinded, non-inferiority trial
randomized cardiac or thoracic-aorta surgery patients with increased risk
of Red Cell transfusion to receive pathogen-reduced or conventional Red
Cells during and for seven days post-surgery. The primary endpoint was the
proportion of patients with acute kidney injury (AKI) defined as an
increase from baseline of >=0.3 mg/dL serum creatinine within 48 hours of
surgery. Non-inferiority was claimed if the upper bound 95%C.I. of the
treatment difference was less than half (50%) of the observed conventional
arm incidence. Adverse events and treatment-emergent Red Cell antibodies
were assessed for 28 and 75-days, respectively. Result(s): Five
hundred eighty-one subjects were randomized and 321 (55%) transfused with
study Red Cells. Transfused subjects in both arms had similar baseline
demographics, medical histories, hemoglobin levels and surgical
procedures. Hemoglobin Day 3 nadir levels (8.6g/dL [7.8-9.2]
pathogen-reduced; 8.4g/dL [7.8-9.3] conventional arm, P=0.52) were
comparable. Incidence of AKI by 48 hours was 46/157 (29.3%) in the
pathogen-reduced, and 45/161 (28.0%) in the conventional arm (treatment
difference 0.7%, 95%C.I. -8.9, 10.4%, non-inferiority margin 14.0%,
P=0.001 for non-inferiority). AKI within 7 days by KDIGO staging criteria
was not different (59/159 [37.1%] pathogen-reduced; 55/162 [34.0%]
conventional arm; p=0.53) but stage III was more common in the
pathogen-reduced arm (pathogen-reduced 15/159 [9.4%]; conventional arm
7/162 [4.3%], p=0.075). Five of 159 (3.1%) pathogen-reduced Red Cell
recipients developed specific, low-titer antibodies without evidence of
hemolysis. Conclusion(s): The incidence of AKI in recipients of
pathogen-reduced Red Cells was non-inferior to conventional Red Cell
transfusion. Treatment-emergent antibodies were uncommon and not
clinically significant. Copyright © 2025 The Author(s). Published
by Wolters Kluwer Health, Inc., on behalf of the American Society of
Anesthesiologists.

<15>
Accession Number
2035811924
Title
MitraClip Versus Surgery for Secondary Mitral Regurgitation: A Systematic
Review and Updated Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2675-2685),
2025. Date of Publication: 01 Oct 2025.
Author
Pinilla J.; Jaramillo S.; Gallo Ruelas M.; Samaniego M.; Baral B.; Nava
N.; Queiroz I.; R. Farias F.; Garot P.
Institution
(Pinilla) CES University, School of Medicine, Medellin, Colombia
(Jaramillo) Facultad de Ciencias Biomedicas, Universidad Austral, Buenos
Aires, Pilar, Argentina
(Gallo Ruelas) Instituto de Investigacion Nutricional, Lima, Peru
(Samaniego, Nava) Universidad Autonoma Metropolitana, Mexico City, Mexico
(Baral) Birat Medical College and Teaching Hospital, Biratnagar, Nepal
(Queiroz) Department of Medicine, Catholic University of Pernambuco,
Brazil
(R. Farias) Federal University of Parana, Curitiba, Brazil
(Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques
Cartier, Massy, Ramsay-Sante, France
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal management of secondary mitral regurgitation (MR)
remains uncertain, with surgical and percutaneous approaches offering
alternative treatment strategies. Aim(s): To compare percutaneous
repair with mitral transcatheter edge-to-edge repair (M-TEER) using
MitraClip and surgical intervention in patients with secondary MR.
 Method(s): We systematically searched PubMed, Embase, and Cochrane
for studies comparing M-TEER using MitraClip with surgery in secondary MR,
reporting outcomes of interest. Risk ratios (RR) with 95% confidence
intervals (CI) were pooled using a random-effects model in R software.
Heterogeneity was assessed with I2 statistics. Result(s): A total of
11 studies (two randomized controlled trials and nine observational
studies) comprising 1605 patients were included. The mean age was 69
years. Among them, 906 (57.7%) underwent MitraClip. Mean follow-up was
24.7 months (minimum: 6 months). The rate of MR grade <= 2+ at follow-up
was lower in the MitraClip group compared to surgery (RR: 0.86, 95% CI:
0.78 to 0.95, p < 0.01). No significant differences were observed in
all-cause mortality (RR: 1.18, 95% CI: 0.93 to 1.49, p = 0.16),
cardiovascular mortality (RR: 1.42, 95% CI: 0.54 to 3.68, p = 0.47), heart
failure hospitalizations (RR: 1.55, 95% CI: 0.79 to 3.04, p = 0.20), or
NYHA class I/II at follow-up (RR: 0.92, 95% CI: 0.83 to 1.01, p = 0.08).
 Conclusion(s): Although patients undergoing MitraClip exhibited a
lower rate of residual MR <= 2+ at follow-up compared to those treated
surgically, this did not translate into higher rates of clinical outcomes,
including all-cause mortality, cardiovascular mortality, heart failure
hospitalizations, or impaired functional status (NYHA
classification). Copyright © 2025 Wiley Periodicals LLC.

<16>
Accession Number
2036806304
Title
Liposomal Bupivacaine in Ultrasound-Guided Paravertebral Block Reduces
Opioid Consumption and Accelerates Recovery After Thoracic Surgery: A
Randomized Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 9137-9149), 2025. Date of
Publication: 2025.
Author
Wang L.-L.; Zhu Y.; Hui L.-Y.; Zhang X.; He J.-S.; Zhang N.-L.; Dong Y.;
Feng W.
Institution
(Wang, Zhu, Zhang, He, Feng) Department of Anesthesiology, The Affiliated
Hospital of Qingdao University, Shandong Province, Qingdao, China
(Wang, Hui, Zhang) Neuropsychiatry Research Institute, The Affiliated
Hospital of Qingdao University, Qingdao University, Shandong Province,
Qingdao, China
(Dong) Neuropsychiatry Research Institute, The Affiliated Hospital of
Qingdao University, Qingdao University, Shandong Province, Qingdao, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Liposomal bupivacaine (LB) can provide prolonged analgesia,
which may reduce patients' opioid consumption, improve comfort, and
facilitate recovery. Looser tissue and lower vascularity in the
paravertebral space may facilitate LB diffusion and duration, so we
investigated the effects of LB in multimodal analgesia after thoracic
surgery with paravertebral block. Method(s): In this single-center,
double-blind, randomized, parallel-controlled trial, 102 patients
undergoing elective thoracoscopic surgery were randomized 1:1 to thoracic
paravertebral block with LB (6.67 mg/mL) or ropivacaine hydrochloride (RH;
0.33%). The primary outcome was opioid consumption within 72 h
postoperatively. Secondary outcomes included pain ratings at 6, 12, 24,
48, and 72 h postoperatively; rescue analgesia; time to first ambulation
and defecation; post-anesthesia care unit and hospital length of stay; and
adverse events. Result(s): One patient was excluded due to block
failure, leaving 101 patients (LB group, n = 51; RH group, n = 50). LB
significantly reduced 72-h opioid consumption compared to RH (difference =
-181.4 mg; 95% CI: -232.8, -130.0 mg; P < 0.001), and fewer patients in
the LB group required rescue analgesia compared to the RH group (OR: 0.33;
95% CI: 0.13, 0.82; P < 0.05). Pain scores at 24 h were lower in the LB
group than RH group (difference = -0.44; 95% CI: -0.84, -0.04; P < 0.05),
with no differences at other timepoints. The LB group had shorter time to
first ambulation than the RH group [median time (IQR): 20 (18-24) h vs 26
(22-32) h; HR: 3.81; 95% CI: 2.32, 6.19; P < 0.001] and shorter time to
defecation [median time (IQR): 56 (42-65) h vs 72 (57-80) h; HR: 3.98; 95%
CI: 2.46, 6.44; P < 0.001]. Conclusion(s): Ultrasound-guided
paravertebral block with LB may reduce postoperative opioid consumption
and enhance recovery in patients undergoing thoracic surgery. Trial
Registration: Chinese Clinical Trials Registry Platform (chictr.org.cn):
ChiCTR2400091217. Copyright © 2025 Wang et al.

<17>
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.

<18>
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.

<19>
Accession Number
2035571626
Title
Prognostic Benefit of the Target Vessel in Revascularization of Chronic
Total Occluded Coronary Arteries: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2300-2310),
2025. Date of Publication: 01 Oct 2025.
Author
Skov E.; Hansen E.K.; Mogensen L.J.-H.; Christiansen E.H.; Holck E.N.
Institution
(Skov, Hansen, Mogensen, Christiansen, Holck) Department of Cardiology,
Aarhus University Hospital, Aarhus, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Background: Previous data have implied that percutaneous coronary
intervention (PCI) of chronic total occlusions (CTO) is dependent on
target vessel. This systematic review and meta-analysis aimed to
investigate if the benefit of CTO revascularization with PCI is dependent
on the target vessel. Method(s): A comprehensive search of multiple
databases was conducted to identify studies investigating CTO patients
undergoing PCI in the left anterior descending artery (LAD), right
coronary artery (RCA), or left circumflex artery (LCX). Outcomes for
patients with successful CTO PCI were compared with those who did not
undergo PCI stratified on target vessel. The primary outcome was all-cause
mortality, while secondary outcomes included major adverse cardiac events
(MACE) and cardiac death (CD). Result(s): Twenty observational
studies were included after screening of 3053 studies. Successful CTO PCI
was associated with a lower risk of all-cause mortality for LAD (Hazard
ratio [HR]: 0.51 [0.42, 0.62], p < 0.05, I2 = 0%) and LCX (HR:
0.63 [0.41, 0.97], p < 0.05, I2 = 40%) than no
revascularization. The risk of MACE was only signficantly reduced after
successful CTO PCI for LAD lesions (HR: 0.55 [0.47, 0.64], p < 0.05, I2 =
0%), but not for LCX (HR: 0.52 [0.10, 2.62], p = 0.43, I2 = 73%) or RCA
(HR: 0.65 [0.19, 2.28], p = 0.50, I2 = 83%). Conclusion(s):
Successful CTO PCI in the LAD was consistently associated with lower
all-cause mortality, MACE, and CD compared to non-revascularization, while
results were variable for RCA and LCX. These findings emphasize the need
for further randomized trials to clarify prognostic differences based on
the target vessel. Copyright © 2025 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<20>
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.

<21>
Accession Number
2034824174
Title
Dexmedetomidine as a Ropivacaine Adjuvant in a Thoracic Paravertebral
Block Combined With an Erector Spinae Plane Block for Improving Early
Quality of Recovery After Transapical Transcatheter Aortic Valve
Implantation.
Source
Kaohsiung Journal of Medical Sciences. 41(10) (no pagination), 2025.
Article Number: e70058. Date of Publication: 01 Oct 2025.
Author
Dong G.-L.; Qiu R.-E.; Xu C.-Z.
Institution
(Dong, Qiu, Xu) Department of Anesthesiology, The Quzhou Affiliated
Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou,
China
Publisher
John Wiley and Sons Inc
Abstract
The study aimed to investigate the effectiveness of dexmedetomidine (Dex)
as an adjuvant for ropivacaine in a thoracic paravertebral block (TPVB)
combined with an erector spinae plane block (ESPB) for improving early
quality of recovery and postoperative pain after transapical transcatheter
aortic valve implantation (TAVI). A total of 89 patients who were
scheduled to undergo transapical TAVI under general anesthesia were
allocated into Group RS and Group RD by using a computer-generated
random-number list. Group RS (n = 45) received 35 mL of 0.5% ropivacaine
with 5 mL of a normal saline mixture in TPVB combined with ESPB and Group
RD (n = 44) received 35 mL of 0.5% ropivacaine with 1 mug/kg Dex in 5 mL
of normal saline. The RD group exhibited significantly higher global
QoR-15 scores with lower visual analog scale (VAS) scores at 12 and 24 h
postoperatively than the RS group. The RD group needed fewer press times
of PCIA than the RS group. The postoperative sufentanil consumption was
significantly less in the RD group than that in the RS group. A longer
time to first use of flurbiprofen with less remedial doses of flurbiprofen
consumption within 48 h postoperatively was required for the RD group than
that for the RS group. The two groups did not differ in the incidence of
side effects. The findings of the study suggest that adding Dex to
ropivacaine in TPVB combined with ESPB is effective in improving early
quality of recovery and alleviating postoperative pain for patients
undergoing transapical TAVI under general anesthesia. Copyright ©
2025 The Author(s). The Kaohsiung Journal of Medical Sciences published by
John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical
University.

<22>
Accession Number
2035597474
Title
Inflammatory Markers and Contrast-Induced Nephropathy Risk: A
Meta-Analysis of NLR and PLR in ACS Patients Undergoing Percutaneous
Coronary Intervention.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2361-2373),
2025. Date of Publication: 01 Oct 2025.
Author
AlHammouri H.M.; Mustafa O.; Mash'al N.; Suwan S.; Al-Rababa'h M.; Turk
A.Z.; Toubasi A.
Institution
(AlHammouri, Mustafa, Mash'al, Suwan, Al-Rababa'h, Toubasi) Faculty of
Medicine, University of Jordan, Amman, Jordan
(Mustafa) Department of Neurology, Vanderbilt University Medical Center,
Nashville, TN, United States
(Turk) Saint Luke's Hospital, University of Missouri-Kansas City, Kansas
City, MO, United States
(Toubasi) Department of Neurology, Neuroimaging Unit, Neuroimmunology
Devision, Vanderbilt University Medical Center, Nashville, TN, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: Contrast-induced nephropathy (CIN) is a serious complication
after percutaneous coronary intervention (PCI), especially in acute
coronary syndrome (ACS) patients. While risk factors are known, predicting
CIN remains difficult. New biomarkers like the neutrophil-to-lymphocyte
ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are gaining attention
as potential predictors due to their links with inflammation and
coagulation. Aim(s): This meta-analysis examines whether NLR and PLR
can predict CIN risk in PCI patients with ACS, aiming to clarify their
diagnostic value. Method(s): We analyzed data from 25 studies with
25,505 patients, looking at the link between preprocedural NLR and PLR and
CIN risk. We calculated odds ratios (OR), sensitivity, specificity, and
area under the curve (AUC) values to assess diagnostic accuracy.
 Result(s): A total of 25,505 patients from 25 studies were included.
Elevated preprocedural NLR and PLR were significantly associated with
increased CIN risk. In the ACS population, 15 studies demonstrated that
NLR was significantly associated with increased odds of CIN, with a pooled
OR of 1.21 (95% confidence interval (CI): 1.12 to 1.30, p < 0.001).
Receiver operating characteristic analysis showed moderate sensitivity
(72%), specificity (60%), and an AUC of 71%. Similar trends were observed
in ST-segment elevation myocardial infarction (STEMI). The non-STEMI
(NSTEMI) subgroup showed a stronger association, with a pooled OR of 2.03
(95% CI: 1.13 to 3.65, p = 0.02), moderate to good diagnostic accuracy
(AUC 79%), and higher sensitivity (77%) and specificity (73%). For PLR,
significant associations with CIN were found in the ACS population (OR:
1.16, 95% CI: 1.04 to 1.30, p = 0.007), with moderate diagnostic accuracy
(AUC: 0.67, 95% CI: 0.61 to 0.73). In the STEMI population, PLR was also
significantly associated with CIN (OR: 1.34, 95% CI: 1.14 to 1.57, p <
0.001), but diagnostic accuracy was lower (AUC: 0.66, 95% CI: 0.59 to
0.74). Limited data from the NSTEMI population showed a moderate
association (AUC: 0.68, 95% CI: 0.64 to 0.72), indicating fair diagnostic
accuracy. Conclusion(s): Preprocedural NLR and PLR are simple,
cost-effective biomarkers for predicting CIN risk in ACS, especially among
NSTEMI patients undergoing PCI. These markers can facilitate earlier
identification of high-risk patients and enable targeted preventive
strategies. However, their moderate diagnostic performance highlights the
need for the development of more specific and sensitive
biomarkers. Copyright © 2025 Wiley Periodicals LLC.

<23>
Accession Number
2039972487
Title
Ultrasound Guided Versus Conventional Closure Device Deployment Following
Transfemoral Endovascular Procedures: A Systematic Review and
Meta-analysis.
Source
European Journal of Vascular and Endovascular Surgery. 70(4) (pp 469-479),
2025. Date of Publication: 01 Oct 2025.
Author
Kalaja I.; Smeets R.R.; Wegner M.; Macherey-Meyer S.; Heyne S.;
Espinola-Klein C.; Mees B.M.E.; Meertens M.M.
Institution
(Kalaja, Espinola-Klein, Meertens) Department for Cardiology III -
Angiology, University Medical Centre of the Johannes Gutenberg-University,
Mainz, Germany
(Smeets) Department of Vascular Surgery, Slingeland Hospital, Doetinchem,
Netherlands
(Smeets, Mees) Department of Vascular Surgery, Maastricht University
Medical Centre, Maastricht, Netherlands
(Wegner) Department of Vascular and Endovascular Surgery, Faculty of
Medicine, University Hospital Cologne, University of Cologne, Cologne,
Germany
(Macherey-Meyer, Heyne, Meertens) Clinic III for Internal Medicine,
University of Cologne, Faculty of Medicine and University Hospital
Cologne, Cologne, Germany
Publisher
W.B. Saunders Ltd
Abstract
Objective: Femoral access site complications influence short term survival
and outcomes in patients undergoing endovascular procedures. While
ultrasound guided puncture is a reliable method to reduce such
complications, ultrasound guidance is rarely used for closure device
deployment. Data Sources: Web of Science, PubMed, and the Cochrane
Library. Review Methods: A systematic literature search was conducted to
assess the safety and efficacy of ultrasound guided vascular closure
device deployment compared with vascular closure device deployment without
ultrasound guidance, referred to as conventional closure. All studies
reporting on ultrasound guided closure in transfemoral arterial
interventions were eligible, and those directly comparing ultrasound
guided with conventional closure were included in the meta-analysis.
 Result(s): Overall, 2 738 patients receiving ultrasound guided
closure were included: 1 025 for introducer sheaths measuring 12 F or
larger and 1 713 for introducer sheaths smaller than 12 F. The incidence
of access complications was 5.7% (range 0.8 - 21.6%) for large sheath
procedures and 2.6% (range 0.9 - 4.7%) for small sheath procedures. The
meta-analysis, which included 2 339 patients who received ultrasound
guided closure and 1 175 who underwent conventional closure, showed that
ultrasound guided closure was associated with reduced access site
complications compared with conventional closure (odds ratio [OR] 0.49,
95% confidence interval [CI] 0.37 - 0.65; p < .001). This was consistently
seen both for small sheath (OR 0.45, 95% CI 0.28 - 0.75; p = .002) and
large sheath procedures (OR 0.50, 95% CI 0.37 - 0.71; p < .001), but with
a low certainty of evidence in the Grading of Recommendations Assessment,
Development, and Evaluation (GRADE) analysis. Conclusion(s):
Ultrasound guided vessel closure of the femoral artery appeared to be
associated with a lower rate of overall access site complications compared
with conventional closure techniques. Therefore, ultrasound guided closure
might offer the potential to increase procedural and patient safety in
percutaneous arterial access. Copyright © 2025 The Authors

<24>
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.

<25>
Accession Number
648228430
Title
Intravenous Versus Inhaled Milrinone in Patients with Known Pulmonary
Hypertension Undergoing Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Annals of cardiac anaesthesia. 28(4) (pp 364-378), 2025. Date of
Publication: 01 Oct 2025.
Author
Kavanagh T.; Kilpatrick T.; Hardy B.; Lee S.; Seavill M.; Lau C.-W.M.;
Bullard S.; Green S.; Cadd M.
Institution
(Kavanagh, Kilpatrick, Lee, Lau, Bullard, Green, Cadd) Anaesthetic
Department, Royal Sussex County Hospital, University Hospitals Sussex,
United Kingdom
(Hardy) Department of Cardiothoracic Anesthesia and the Cardiovascular
Intensive Care Unit, Auckland City Hospital, Auckland, New Zealand
(Seavill) Anaesthetic Department, Conquest Hospital, East Sussex
Healthcare Trust, United Kingdom
Abstract
To summarize the evidence on the hemodynamic effects and vasopressor
requirements of adult patients with known pulmonary hypertension (PH)
undergoing cardiac surgery treated with intravenous and inhaled milrinone.
A total of 400 patients in 5 prospective (4 RCT) studies were included for
pooled analysis. There was no significant difference in the primary
outcome; mean pulmonary artery pressure (MPAP) between groups (MD: -4.80,
95% CI -10.57 to 0.98). Inhaled milrinone was associated with a greater
systemic vascular resistance index (SVRI) (MD: 259.21, 95% CI 168.70 to
349.72) and reduction in pulmonary capillary wedge pressure (MD: -4.64,
95% CI -5.47 to -3.81). There were no observable differences in mean
arterial pressure, pulmonary vascular resistance, cardiac index, or
central venous pressure. All studies included were assessed to be
moderate/some concern risk of bias. Inhaled milrinone has not been shown
to have a significant beneficial effect on MPAP and SVR when compared to
intravenous milrinone in patients with known PH undergoing cardiac
surgery. However, it has shown some benefits in maintaining MAP and
improving oxygenation in this patient cohort. The study is limited by the
bias of the included studies and the variability of inhaled drug dosage
and administration timing, further well-powered randomized controlled
trials are required. Copyright © 2025 Annals of Cardiac
Anaesthesia.

<26>
Accession Number
2035738903
Title
Tricuspid Transcatheter Edge-to-Edge Repair Versus Medical Management for
Tricuspid Regurgitation: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(4) (pp 2579-2589),
2025. Date of Publication: 01 Oct 2025.
Author
Kritya M.; Kharsa C.; Samimi S.; Sella G.; Aoun J.; Faza N.N.; Little
S.H.; Reardon M.J.; Atkins M.D.; Zoghbi W.; Kleiman N.S.; Goel S.S.
Institution
(Kritya, Kharsa, Sella, Aoun, Faza, Little, Zoghbi, Kleiman, Goel)
Department of Cardiology, Houston Methodist DeBakey Heart & Vascular
Center, Houston, TX, United States
(Samimi) Section of Cardiology, Baylor College of Medicine, Michael E
DeBakey VA Medical Center, Houston, TX, United States
(Reardon, Atkins) Department of Cardiovascular Surgery, Houston Methodist
DeBakey Heart & Vascular Center, Houston, TX, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Severe tricuspid regurgitation (TR) is associated with poor
prognosis, and guideline-directed medical therapy (GDMT) alone has limited
efficacy. Transcatheter edge-to-edge repair (T-TEER) has emerged as a
promising therapeutic option, but its impact on clinical outcomes remains
debated. Aim(s): Evaluation of the efficacy and safety of T-TEER
compared to GDMT. Method(s): PubMed, EMBASE and Cochrane Central were
searched for clinical trials and observational studies through February
2025, for studies comparing the clinical outcomes of T-TEER to GDMT. The
outcomes assessed were all-cause mortality, heart failure hospitalization
(HFH), cardiovascular mortality, residual TR, NYHA class improvement,
stroke and new permanent pacemaker (PPM) implantation. Random-effects
models were used to calculate pooled risk ratios (RR) or hazard ratios
(HR) with corresponding 95% confidence intervals (CI). Heterogeneity was
assessed using the I2 statistic. Subgroup analysis was done
based on study design. Result(s): Seven studies with 4220 patients
were included. T-TEER was associated with a significant reduction in
mortality (HR: 0.79; 95% CI: 0.64-0.98; p = 0.03) and HFH (HR: 0.69; 95%
CI: 0.53-0.91; p < 0.01) compared to GDMT. No difference was observed in
cardiovascular mortality (RR: 0.96; 95% CI: 0.37-2.52) or stroke (RR:
1.06; 95% CI: 0.32-3.56). T-TEER significantly improved TR severity (RR:
9.12; 95% CI:4.43-18.77; p < 0.001) and reduction in NYHA functional class
(RR: 2.37; 95% CI: 1.15-4.88; p = 0.019), without increasing the risk of
new PPM implantation (RR: 1.83; 95% CI: 0.80-4.21; p = 0.153).
 Conclusion(s): T-TEER is associated with improved survival, a lower
risk of HFH, higher reduction in NYHA class and effective TR severity
reduction without significantly increasing the risk of stroke or the need
for PPM implantation. Further studies would be needed to identify optimal
patient subgroup based on disease severity and clinical
phenotype. Copyright © 2025 Wiley Periodicals LLC.

<27>
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.

<28>
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.

<29>
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.

<30>
Accession Number
2035395968
Title
Rationale and design of the randomized 'early ventricular assist
device'-Trial (VAD-DZHK3).
Source
ESC Heart Failure. 12(5) (pp 3731-3740), 2025. Date of Publication: 01 Oct
2025.
Author
Knosalla C.; Farber G.; Rieth A.J.; Wachter R.; Placzek M.; Albert W.;
Hasenfuss G.; Falk V.; Friede T.
Institution
(Knosalla, Albert, Falk) Department of Cardiothoracic and Vascular
Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany
(Knosalla, Albert, Falk) Charite - Universitatsmedizin Berlin, corporate
member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin,
Berlin, Germany
(Knosalla, Albert, Falk) German Center for Cardiovascular Research (DZHK),
partner site Berlin, Berlin, Germany
(Knosalla) Department of Thoracic and Cardiovascular Surgery Saarland,
University Medical Center and Saarland University, Homburg, Germany
(Farber) Department of Cardiothoracic Surgery, University Hospital Jena,
Friedrich Schiller University of Jena, Jena, Germany
(Rieth) Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad
Nauheim, Germany
(Rieth) German Center for Cardiovascular Research (DZHK), partner site
Rhine-Main, Frankfurt am Main, Germany
(Wachter) Department of Cardiology, University Hospital Leipzig, Leipzig,
Germany
(Wachter, Hasenfus) Clinic for Cardiology and Pneumology, Heart Research
Center, University Medical Center Gottingen, Gottingen, Germany
(Wachter, Hasenfus, Falk) Department of Health Science and Technology, ETH
Zurich, Zurich, Switzerland
(Placzek, Friede) German Center for Cardiovascular Research (DZHK),
partner site Gottingen, Gottingen, Germany
(Placzek, Friede) Department of Medical Statistics, University Medical
Center Gottingen, Gottingen, Germany
Publisher
John Wiley and Sons Inc
Abstract
Aims: Bridge to transplantation (BTT) with durable, continuous-flow left
ventricular assist devices (LVAD) of patients is a well-established
treatment concept in patients awaiting heart transplantation (HTx).
However, the role of elective LVAD implantation in patients with less
advanced HF, but increased risk of decompensation remains uncertain.
 Methods and Results: The VAD-DZHK3 trial is an
investigator-initiated, randomized controlled trial designed to assess
whether an early strategy of elective LVAD implantation improves outcomes
compared with a conventional approach involving optimal medical therapy
and delayed device implantation only after clinical deterioration.
Eligible patients are those with end-stage HF listed for cardiac
transplantation. This is an event-driven study, that is, the study is
completed once 120 events of the primary composite endpoint have been
observed and all patients have at least 1 year of follow-up unless they
died earlier. Patients meeting inclusion criteria who decline
randomization are enrolled in a parallel observational registry reflecting
standard care. The primary efficacy endpoint is survival free from high
urgent cardiac transplantation, disabling stroke and HF hospitalizations
(including emergency room HF visits >6 h). Conclusion(s): The
VAD-DZHK3 trial will provide guidance on the optimal timing and patient
selection for LVAD implantation in heart transplant candidates,
potentially redefining current standards of care. Copyright ©
2025 The Author(s). ESC Heart Failure published by John Wiley & Sons Ltd
on behalf of European Society of Cardiology.

<31>
Accession Number
2040880254
Title
Technique, safety, efficacy, and optimal drug volume for erector spinae
plane block in neonatal and infant cardiac surgery: A single-center
experience with 295 cases.
Source
Annals of Pediatric Cardiology. 18(3) (pp 252-258), 2025. Date of
Publication: 01 May 2025.
Author
Gopalakrishnan R.M.; Ramachandran M.A.; Gutjahr G.; Leeladharan S.P.;
Sudhakar A.; Kumar R.K.
Institution
(Gopalakrishnan, Leeladharan) Department of Paediatric Cardiac
Anaesthesiology and Intensive Care, Amrita Institute of Medical Sciences,
Kerala, Kochi, India
(Ramachandran) Department of Respiratory Therapy, Amrita Institute of
Medical Sciences, Kerala, Kochi, India
(Gutjahr) Department of Health Sciences Research, Amrita Institute of
Medical Sciences, Kerala, Kochi, India
(Sudhakar, Kumar) Department of Paediatric Cardiology, Amrita Institute of
Medical Sciences, Kerala, Kochi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: The erector spinae plane block (ESPB) is an emerging
regional anesthesia technique gaining popularity for perioperative pain
management in pediatric cardiac surgery. However, limited data exist on
the feasibility, safety, hemodynamic stability, and efficacy of ESPB in
neonates and infants undergoing cardiac procedures. This study aimed to
evaluate the procedural safety, optimal drug volume, and its impact on
ventilation duration, intensive care unit (ICU) length of stay (LOS), and
opioid consumption in neonates and infants undergoing complex heart
surgeries. Method(s): Conducted at a tertiary pediatric cardiac
center in Southern India from January 2021 to June 2023, this study
included 295 infants (<=1 year) who received ESPB. These patients were
compared with an equal number of neonates and infants who underwent
cardiac surgery before ESPB implementation. Data were retrospectively
reviewed from the International Quality Improvement Collaborative for
Congenital Heart Disease and hospital records. Result(s): No
procedure-related complications or intraoperative hemodynamic instability
were observed in the ESPB group. The modified technique was easily
administered, requiring 1 ml/kg for each hemithorax to achieve effective
analgesia. The ESPB group showed significantly lower cumulative opioid
consumption (400 [100-400] mug) compared to the pre-ESPB group (600
[250-600] mug). In addition, the duration of invasive mechanical
ventilation was shorter (20 [11-43] h vs. 23 [16-43] h), and ICU LOS was
reduced (72 [48-120] h vs. 96 [72-168] h). Conclusion(s): ESPB is a
safe, feasible, and effective option for perioperative analgesia in
neonates and infants undergoing cardiac surgery. Administering a volume of
1 ml/kg on each thorax provides optimal analgesia, reducing opioid use,
invasive ventilation duration, and ICU LOS. Copyright © 2025
Wolters Kluwer Medknow Publications. All rights reserved.

<32>
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)

<33>
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.

<34>
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.

<35>
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

<36>
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

<37>
Accession Number
2040996758
Title
Respiratory Reactivation of Herpes Simplex Virus-1 Following Cardiac
Surgery in Immunocompetent Individuals.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Asiller O.O.; Fresilli S.; Damiani D.; Della Peruta M.; Prati P.;
Franceschini G.; Farinaccio A.; Moresco M.; Ajello V.
Institution
(Asiller) Department of Anesthesia and Intensive Care, Ankara University
Faculty of Medicine, Ankara, Turkey
(Fresilli, Damiani, Della Peruta) Department of Anesthesia and Intensive
Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Prati, Franceschini, Farinaccio, Moresco, Ajello) Department of
Cardiothoracic Anesthesia, Tor Vergata University Hospital, Rome, Italy
Publisher
W.B. Saunders
Abstract
Objective: Herpes simplex virus type 1 reactivation is common in
immunocompromised patients. Its frequency and clinical significance as a
cause of pneumonia in immunocompetent patients, particularly following
cardiac surgery, remain poorly defined. This review synthesizes all the
evidence on the frequency, pathophysiology, and clinical impact of herpes
simplex virus reactivation in immunocompetent patients following cardiac
surgery. Design(s): Systematic review. Setting(s): Studies
conducted in cardiac surgery. Participant(s): Immunocompetent adults
with suspected or confirmed herpes simplex virus pneumonia after cardiac
surgery. Measurements and Main Results: Medical databases were
searched from inception to June 4, 2025. Studies reporting immunocompetent
adults with suspected and/or confirmed herpes simplex virus pneumonia
post-cardiac surgery were included. Twenty studies (published in the
period 1983-2025), including 112 patients with pneumonia and herpes
simplex virus reactivation after cardiac surgery, were identified.
Bronchoalveolar lavage was used as a diagnostic tool in 79% of cases. The
use of antiviral treatment (predominantly acyclovir) was reported in 42 of
78 patients (53%). All-cause mortality was 14 of 30 patients (46%).
 Conclusion(s): Herpes simplex virus reactivation after cardiac
surgery is not frequently reported, but mortality approaches 50%. This
underscores the need for heightened awareness and targeted testing in
nonresponding pneumonias, potentially improving outcomes. Even if patients
often die with the herpes simplex virus reactivation complicating other
severe conditions, the frequency with which herpes simplex virus
reactivation itself is the primary cause of death remains uncertain.
Diagnosis relied mainly on polymerase chain reaction, and early antiviral
treatment was frequently administered. Increased clinical awareness and
further research are warranted to standardize diagnosis and optimize
management. Copyright © 2025 Elsevier Inc.

<38>
Accession Number
2040984359
Title
TCT-872 Comparison of Myval Versus SAPIEN Transcatheter Heart Valves in
Severe Aortic Stenosis: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B378-B379), 2025. Date of Publication: 28 Oct 2025.
Author
Khan M.H.; Ali J.; Rehman W.U.; Ahmad H.; Khan S.; Kassahun M.; Nawaz A.;
Waqar Younas H.M.; Abuelazm M.; Hassan M.B.; Naeem A.; Afridi L.; Khan U.
Institution
(Khan) Saidu Medical College, Pakistan., Swat, Swat, Pakistan
(Ali, Afridi) Saint Peter's University Hospital, New Brunswick, New
Jersey, United States
(Rehman) Saidu Teaching Hospital/Saidu Medical College, Swat, Pakistan
(Ahmad) Shaikh Khalifa Bin Zayed Al Nahyan Medical and Dental College,
Lahore, Pakistan
(Khan) KTH, Peshawar, Pakistan
(Kassahun) Marian University, Indiana, Indiana, United States
(Nawaz) Pakistan Atomic Energy Commision Hospital Islamabd, Islamabad,
Pakistan
(Waqar Younas) Weiss Memorial Hospital, Chicago, Illinois, United States
(Abuelazm) Tanta University, Tanta, Egypt
(Hassan) Saidu Medical College, LOWER DIR, Pakistan
(Naeem) St. Francis Hospital and Heart Centre, Roslyn, New York, United
States
(Khan) University of Maryland School of Medicine, Baltimore, Maryland,
United States
Publisher
Elsevier Inc.
Abstract
Background: Severe aortic stenosis is associated with morbidity and
mortality, requiring valve replacement. Bioprosthetic values are
exclusively used during transcatheter aortic valve replacement (TAVR/TAVI)
that includes the Myval and SAPIEN series. This meta-analysis compares the
clinical outcomes of Myval vs. SAPIEN THVs in patients undergoing TAVR.
 Method(s): A systematic search was conducted across PubMed, CENTRAL,
Web of Science, Scopus, and Embase until April 2025. Pooled data were
reported using the risk ratio (RR) for dichotomous outcomes and the mean
difference (MD) for continuous outcomes, along with a 95% confidence
interval (CI). This study is registered with PROSPERO ID: CRD420251104268.
 Result(s): Six studies were included in the final analysis. No
significant difference observed between both groups in device success rate
(RR 1.08, [95% CI 0.97, 1.21]) and all-cause mortality (RR 1.12, [95% CI
0.59, 2.15]). However, the Myval THV was associated with a significantly
lower risk of moderate-to-severe prosthesis mismatch (RR 0.65, [95% CI
0.52, 0.80]) and lower mean trans valvular gradient (SMD - 0.48, [95% CI -
0.74, -0.23]). Similarly, Myval showed a significantly reduced risk of
first-degree block compared to the SAPIEN series (RR 0.13, [95% CI 0.03,
0.55]) (Fig. 1). [Formula presented] Conclusion(s): Patients with
severe AS, the Myval THV series demonstrated superior hemodynamic
performance and a lower risk of conduction abnormalities compared to the
SAPIEN series, without compromising device success or short-term
mortality. These findings suggest Myval may offer clinical advantages in
selected patient populations. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<39>
Accession Number
2040984017
Title
TCT-1152 Incidence and Severity of Paravalvular Leak Following
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B492-B493), 2025. Date of Publication: 28 Oct 2025.
Author
Amaanullah M.; Reddy Chityala R.S.; Biswas S.; Bharia U.; Seeram D.V.N.R.;
Patel R.; Shah H.; Yadav A.; Talukdar A.; Bhosale S.
Institution
(Amaanullah) Dr B R Ambedkar Medical College, Karnataka, Bengaluru, India
(Reddy Chityala) Kamineni Institute of Medical Sciences, Telangana,
Hyderabad, India
(Biswas) Ivano-Frankivsk National Medical University, Ivano-Frankivsk,
Ukraine, Ukraine
(Bharia) Lokmanya Tilak Municipal Medical College and General Hospital,
Sion, Maharashtra, Mumbai, India
(Seeram) Gandhi Medical College, Telangana, Hyderabad, India
(Patel) GMERS Medical College & General Hospital, Gujarat, Himmatnagar,
India
(Shah) New York Medical College, Denville, New Jersey, United States
(Yadav) Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, New
Delhi, India
(Talukdar) Bharati Vidyapeeth Medical College, Maharashtra, Pune, India
(Bhosale) Government Medical College and Hospital, Maharashtra,
Chandrapur, India
Publisher
Elsevier Inc.
Abstract
Background: Paravalvular leak (PVL) is a recognized complication of TAVR,
associated with adverse outcomes; however, its incidence across valve
types remains undefined. Method(s): We conducted a systematic review
and meta-analysis of studies published between January 2016 and May 2025
that reported moderate-to-severe PVL following TAVR. Comprehensive
searches were performed in MEDLINE, Embase.com, PubMed, Cochrane CENTRAL,
Scopus, and ClinicalTrials.gov. Only full-text published studies in
English were included. Eligible studies comprised randomized controlled
trials, cohort studies, and registries enrolling adult patients (>=18
years). Data were pooled using a random-effects model, and heterogeneity
was assessed with the I2 statistic. Subgroup analyses were
conducted based on valve type. Result(s): A total of 56 studies
involving 18,785 patients were included. The pooled incidence of
moderate-to-severe PVL was 4.3% (95% CI: 3.4%-5.5%), with substantial
heterogeneity (I2 = 91.9%, p < 0.0001). Among newer-generation
balloon-expandable valves, SAPIEN 3 had the lowest PVL rate at 3.5%,
followed by SAPIEN 3 Ultra at 4.2%. Among self-expanding valves, Portico
had a pooled incidence of 6.2%, Evolut R/PRO 7.3%, and Evolut R 8.8%.
Older-generation valves showed higher PVL rates: SAPIEN XT (8.1%) and
CoreValve (17.6%). [Formula presented] Conclusion(s): In this
meta-analysis of over 18,000 TAVR recipients, moderate-to-severe PVL
incidence has decreased substantially with newer valve generations. SAPIEN
3 and SAPIEN 3 Ultra demonstrated the lowest rates, emphasizing the impact
of technological advancements in valve design on clinical outcomes.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<40>
Accession Number
2040984157
Title
TCT-759 Use of Amiodarone for Prevention of New-Onset Atrial Fibrillation
after Transcatheter Aortic Valve Replacement: PAF-TAVR Randomized Clinical
Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B331), 2025. Date of Publication: 28 Oct 2025.
Author
Tirado-Conte G.; Anguita-Gamez M.; Oteo Dominguez J.F.; Regueiro A.;
Rivero F.; Amat-Santos I.; Alfonso F.; Gonzalez I.C.; Escaned J.; Gonzalo
N.; Nombela-Franco L.
Institution
(Tirado-Conte) Cardiovascular Institute. Hospital Clinico San Carlos,
IdISSC, Madrid, Spain
(Anguita-Gamez) Hospital Clinico San Carlos, Madrid, Spain
(Oteo Dominguez) Hospital Universitario Puerta De Hierro., Las Rozas De
Madrid, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
(Rivero, Alfonso) Hospital Universitario de La Princesa, Madrid, Spain
(Amat-Santos) University Clinic Hospital of Valladolid, Valladolid, Spain
(Gonzalez) University Hospital of Salamanca, Salamanca, Spain
(Escaned) Hospital CliA-nico San Carlos, Madrid, Spain
(Gonzalo, Nombela-Franco) Hospital Clinico San Carlos, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: New-onset atrial fibrillation (NOAF) is a frequent
complication after transcatheter aortic valve replacement (TAVR) and has
been linked to worse short- and long-term outcomes. We evaluated whether
peri-procedural amiodarone reduces the incidence of NOAF after TAVR in
patients without prior history of atrial fibrillation. Method(s): In
this prospective, multicenter, randomized, double-blind trial, 109
patients without previous atrial fibrillation scheduled for TAVR across 6
hospitals were assigned to oral amiodarone or placebo from 6 days before
to 6 days after the procedure. The treatment consisted of oral amiodarone
200 mg three times daily (600 mg/day) for 6 days before TAVR, followed by
200 mg twice daily (400 mg/day) for 6 days after the procedure. Continuous
rhythm monitoring was performed using a 60-day textile Holter. The primary
endpoint was NOAF within 30 days. Secondary endpoints included NOAF at 60
days, AF burden, and a composite of death, stroke, or
major/life-threatening bleeding at 1 year. Result(s): A total of 52
patients received amiodarone and 57 received placebo. Baseline
characteristics, procedural outcomes, and in-hospital complications were
similar between groups. At 30 days, NOAF occurred in 4/52 patients (7.7%)
in the amiodarone group versus 7/57 (12.3%) in the placebo group (p =
0.53; RR 0.63, 95% CI 0.19-2.02). At 60 days, NOAF was observed in 8
(14.6%) and 7 (14.0%) patients in the amiodarone and placebo groups,
respectively. One-year event-free survival was comparable (93.8% vs
87.8%). Permanent pacemaker implantation rates were also similar between
groups (15.4% vs 17.5%). Conclusion(s): The PAF-TAVR trial found that
peri-procedural amiodarone did not significantly reduce the incidence of
NOAF following TAVR. Event-free survival and pacemaker implantation rates
were similar between groups. While the findings suggest a possible trend
toward benefit, the trial was not powered to definitively assess this
hypothesis. Larger trials with robust sample sizes-particularly in
patients at elevated risk for AF-are needed to more clearly define the
role of amiodarone in this setting. Categories: STRUCTURAL: Valvular
Disease and Intervention: Aortic Copyright © 2025

<41>
Accession Number
2040985015
Title
TCT-1187 Perioperative Outcomes in Patients Undergoing Transcatheter
Aortic Valve Replacement With Concomitant Mitral Regurgitation Revealing
Improving Mitral Regurgitation: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B507), 2025. Date of Publication: 28 Oct 2025.
Author
Amani-Beni R.; Darouei B.; Rad M.R.; Dabaghi G.G.; Eshraghi R.; Bahrami
A.; Amini-Salehi E.; Hashemi S.M.; Mazaheri-Tehrani S.; Movahed M.R.
Institution
(Amani-Beni, Rad, Dabaghi) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Isfahan, Iran, Islamic Republic of
(Darouei) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran,
Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Iran., Tehran,
Rasht, Iran, Islamic Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Movahed) University of Arizona Sarver Heart Center, Tucson, Arizona,
United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is widely
performed in high-risk patients with severe aortic stenosis. However, the
effects of baseline concomitant mitral regurgitation (MR) on perioperative
outcomes remain unclear. This study evaluated the impact of concomitant MR
severity on short-term TAVR outcomes. Method(s): A systematic search
of six electronic databases was conducted. Studies that stratified
patients based on MR severity (MR >=2 vs. <2 or MR >=3 vs. <3) and
reported perioperative outcomes, including short-term mortality,
in-hospital mortality, acute kidney injury (AKI), pacemaker implantation,
bleeding, vascular complications, and MR improvement (up to one week and
one month were eligible. Result(s): Data from 26 studies (32,453
patients) demonstrated that patients with baseline moderate-to-severe MR
(MR >=2) had a 49% (95% confidence interval (CI): 1.32-1.70) increased
risk of short-term mortality, a 41% (95% CI: 1.22-1.63) higher risk of
in-hospital mortality, and a 38% (95% CI: 1.17-1.62) higher risk of AKI
than those with none-to-mild MR (MR<2). Patients with an MR >=3 had an
even greater 72% (95% CI: 1.37-2.16) increase in short-term mortality. No
significant differences were observed in pacemaker implantation, bleeding,
or vascular complications between groups. Additionally, after TAVR, MR
improved in 36% of patients by at least one grade within one week,
increasing to 44% by one month. In TAVR patients, MR >=2 was associated
with significantly higher early mortality and AKI risk, underscoring the
need for a comprehensive perioperative risk assessment. Future studies
should examine the differential impact of functional and degenerative MR.
 Conclusion(s): This meta-analysis found that the presence of
concomitant moderate-to-severe disease (MR >=2) was significantly
associated with an increased risk of 30-day mortality, in-hospital
mortality, and AKI in patients undergoing TAVR. The stratified analysis
revealed that patients with MR >=3 face an even higher risk of short-term
mortality compared to those with MR >= 2. By contrast, no significant
association was found between MR severity and bleeding, vascular
complications, or pacemaker implantation. Categories: STRUCTURAL: Valvular
Disease and Intervention: Aortic Copyright © 2025

<42>
Accession Number
2040984353
Title
TCT-1219 Comparing Valve-in-Valve Versus Redo-Surgical Aortic Valve
Replacement: A Systematic Review and Meta-Analysis of Propensity
Score-Matched Studies: The ViV Procedure Revealed Lower In-Hospital
Mortality and Reduced AF Risk Compared to Redo-SAVR.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B523), 2025. Date of Publication: 28 Oct 2025.
Author
Eshraghi R.; Pirmoradian P.; Bahrami A.; Rafiei N.; Ebrahimi P.; Shahid
F.; Soleimani H.; Hosseini K.; Amini-Salehi E.; Movahed M.R.
Institution
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Pirmoradian, Rafiei) Isfahan University of Medical Sciences, Isfahan,
Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Kashan, Iran, Islamic Republic of
(Ebrahimi) Cardiology Department, University Hospitals Birmingham NHS
Foundation Trust, Birmingham, United Kingdom
(Shahid) Queen Elizabeth Hospital, Birmingham, United Kingdom
(Soleimani, Hosseini) Tehran University of Medical Sciences, Tehran, Iran,
Tehran, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Tehran, Rasht, Iran,
Islamic Republic of
(Movahed) University of Arizona Sarver Heart Center, Tucson, Arizona,
United States
Publisher
Elsevier Inc.
Abstract
Background: Valve-in-valve (ViV) procedure has emerged as an option for
patients with failed bioprosthetic heart valves, particularly patients
with high risk of mortality, but concerns regarding early and long-term
outcomes compared to redo-surgical aortic valve replacement (Redo-SAVR).
This study aims to compare short-term and long-term outcomes using
propensity score-matched studies. Method(s): This systematic review
and meta-analysis adhered to the PRISMA guidelines. A comprehensive search
was conducted in PubMed, Scopus, Web of Science, and EMBASE from inception
to march 2025. The primary outcome was mortality and secondary outcomes
included atrial fibrillation (AF), readmission, need for permanent
pacemaker implantation (PPI), stroke, and hospital stay. The deaths after
two years of intervention was considered as long-term mortality. R program
was used to analyze the risk ratio (RR) and mean difference (MD). We used
ROBINS-I for quality assessment of the studies. Result(s): Total of
15 propensity score-matched studies with a population of 18,781 patients
were included, comprising 9,063 patients who underwent Redo-SAVR and 9,718
who received ViV. In-hospital mortality was significantly higher for
Redo-SAVR patients (RR = 2.74, 95% CI: 2.05-3.66). Likewise, in-hospital
risk of AKI was higher for Redo-SAVR patients (RR = 2.42, 95% CI:
1.43-4.10). In one-month mortality, the difference was statistically
insignificant favoring ViV (RR= 1.41, 95% CI: 0.73, 2.75). In-hospital and
one-month AF was significantly higher in Redo-SAVR (RR = 4.06, 95% CI:
2.18-7.55 and RR = 2.94, 95% CI: 1.14-7.58). In addition, there was no
significant difference in one-month PPI risk, re-admissions, or stroke (P
> 0.05). With the mean follow-up of 3.71 +/-1.33, long-term follow-up
revealed non-significant mortality trend favoring Redo-SAVR (RR = 0.81,
95% CI: 0.64, 1.02). Conclusion(s): The ViV procedure offers lower
in-hospital mortality and reduced AF risk compared to Redo-SAVR. ViV may
be preferable for high-risk patients in the short term, but long-term
benefits are comparable to Redo-SAVR. Further studies with prolonged
follow-up are required to better understand the long-term effects of ViV.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<43>
Accession Number
2040984028
Title
TCT-1189 The Impact of Concomitant Mitral Regurgitation on Cardiovascular
Events and Mortality After Transcatheter Aortic Valve Replacement: A
Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B508), 2025. Date of Publication: 28 Oct 2025.
Author
Amani-Beni R.; Bahrami A.; Dabaghi G.G.; Rad M.R.; Darouei B.; Eshraghi
R.; Hashemi S.M.; Mazaheri-Tehrani S.; Amini-Salehi E.; Movahed M.R.
Institution
(Amani-Beni, Dabaghi, Rad) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Kashan, Iran, Islamic Republic of
(Darouei) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran,
Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Amini-Salehi) Guilan University of Medical Sciences, Iran., Tehran,
Rasht, Iran, Islamic Republic of
(Movahed) University of Arizona Sarver Heart Center, TUCSON, Arizona,
United States
Publisher
Elsevier Inc.
Abstract
Background: Many patients undergoing transcatheter aortic valve
replacement (TAVR) have concomitant mitral regurgitation (MR), yet the
prognostic impact of MR severity remains uncertain. This meta-analysis
evaluated the association between baseline MR severity, cardiovascular
outcomes, and mortality after TAVR. Method(s): A comprehensive search
of related databases was conducted. Eligible studies included adult
patients undergoing TAVR with stratified MR severity (MR >=2 or MR >=3)
and reported post-TAVR clinical outcomes. Meta-analyses were performed
using hazard ratios (HRs) and odds ratios (ORs). Subgroups based on
follow-up duration, leave-one-out sensitivity, and meta-regression
analyses on hypertension, female sex, Society of Thoracic Surgeons (STS)
score, transfemoral access, and prior cardiac surgery were also conducted.
 Result(s): Forty-five studies (n = 68,241 patients) were included. MR
>=2 was associated with increased long-term mortality (HR: 1.42; 95% CI:
1.29-1.56) and cardiovascular mortality (OR: 2.18; 95% CI: 1.09-4.35), but
not with stroke, transient ischemic attack, myocardial infarction (MI), or
heart failure hospitalization. MR >=3 conferred an even higher risk for
long-term mortality (OR: 1.82; 95% CI: 1.33-2.48) and rehospitalization
(OR: 1.51; 95% CI: 1.20-1.89), but not with rehospitalization and MI.
Subgroup analysis showed that the mortality risk for both MR >=2 and MR
>=3 was more pronounced in the short term (<12 months) and attenuated with
longer follow-up. MR improvement occurred in 41% of patients within <1
year post-TAVR, declining to 15% at >1 year. Conclusion(s): Baseline
moderate-to-severe MR (MR >=2) predicts long-term and cardiovascular
mortality after TAVR, especially severe MR (>=3). While no consistent
associations were found with non-fatal outcomes such as stroke, TIA, MI,
or heart failure hospitalization, the prognostic impact of MR appears to
be predominantly mortality-centered. The findings underscore the
importance of integrating MR severity into preprocedural risk assessment.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<44>
Accession Number
2040984057
Title
TCT-136 Calcium Density by Coronary CT: A Novel Predictor of Stent
Underexpansion.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B62-B63), 2025. Date of Publication: 28 Oct 2025.
Author
Collet C.; Tajima A.; Mizukami T.; Sakai K.; Arai T.; Ikeda K.; Stalikas
N.; Norgaard B.; Engstroem T.; Leipsic J.; Stefanini G.; Bagnall A.; Ko B.
Institution
(Collet) AZORG, Aalst, Belgium
(Tajima, Arai) Cardiovascular Research Center Aalst, Aalst, Belgium
(Mizukami) Showa University School of Medicine, Tokyo, Tokyo, Japan
(Sakai) Showa University School of Medicine, Tokyo, Japan
(Ikeda) Cardiovascular Center Aalst, AZORG, Aalst, Belgium
(Stalikas) Aalst Cardiovascular Centre, Aalst, Belgium
(Norgaard) Aarhus University Hospital, Arhus, Denmark
(Engstroem) The Heart Centre, University of Copenhagen, Copenhagen,
Denmark
(Leipsic) St. Paul's Hospital, Vancouver, British Columbia, Canada
(Stefanini) Humanitas University, Milan, Milan, Italy
(Bagnall) Freeman Hospital, Newcastle upon Tyne, United Kingdom
(Ko) Monash Heart, Clayton, Victoria, Australia
Publisher
Elsevier Inc.
Abstract
Background: Coronary artery calcium has traditionally been quantified by
morphologic features such as arc, thickness, and length, which are known
to influence stent expansion. Coronary computed tomography angiography
(CCTA) enables non-invasive visualization of these features and also
reflects structural rigidity through quantitative analysis of calcium
density using Hounsfield Units (HU). We hypothesized that CT-derived
calcium density is associated with stent expansion and provides
incremental prognostic value beyond conventional morphological
descriptors. Study Methods: In this prospective, randomized, core-lab
controlled trial, patients with obstructive coronary artery disease (CAD)
and low fractional flow reserve derived from CT (FFRCT) were randomized to
CT-guided or IVUS-guided PCI. This analysis included patients in the
IVUS-guided PCI arm with moderate to severe calcification (defined as
calcium arc >=90degree). Patients with prior coronary artery bypass
grafting (CABG), left main disease, or who underwent advanced calcium
modification (e.g., atherectomy or lithotripsy) were excluded. Coronary
calcium was analyzed from CCTA by voxel clustering within 5-mm vessel
segments to derive a normalized Calcium Density Index (CDI), ranging from
0 to 1, with higher values indicating denser calcium. The optimal CDI
cutoff to predict stent underexpansion was determined using receiver
operating characteristic (ROC) curve analysis. Stent underexpansion was
defined as minimal stent area (MSA) <5.5 mm2. Result(s):
Among 549 patients randomized to IVUS-guided PCI, 169 had moderate to
severe calcification, of which 139 had complete CCTA and IVUS data for
analysis. The mean age was 65.0 +/- 7.7 years; 79% were male and 25% had
diabetes. The LAD was the target vessel in 76% of cases. CCTA-derived
calcium metrics included arc 204 +/- 88.6degree, thickness 1.76 +/- 0.42
mm, and length 16.0 +/- 11.5 mm. The mean CDI was 0.41 +/- 0.18. The mean
stent length was 40 +/- 20 mm and mean diameter 3.1 +/- 0.4 mm. Post-PCI,
the mean MSA was 6.4 +/- 1.9 mm2 and mean stent expansion was
69 +/- 15%. Patients with high CDI (>=0.44) exhibited significantly
greater overall calcium burden compared to those with lower CDI, including
larger calcium arc (226 +/- 88.5degree vs. 190 +/- 86.4degree, p=0.02),
increased thickness (1.9 +/- 0.4 mm vs. 1.7 +/- 0.4 mm, p<0.001), longer
calcium length (21.9 +/- 11.4 mm vs. 12.2 +/- 9.8 mm, p<0.001), higher
volume (105 +/- 82 mm3 vs. 52 +/- 50 mm3, p<0.001),
and higher peak HU (1621 +/- 285 HU vs. 1319 +/- 375 HU, p<0.001).
Procedural outcomes were less favorable in the high CDI group, with
significantly smaller MSA (5.99 +/- 1.81 mm2 vs. 6.73 +/- 1.82
mm2, p=0.02) and lower stent expansion (66 +/- 14% vs. 72 +/-
15%, p=0.02). In multivariable regression analysis, CDI remained the only
independent predictor of stent underexpansion (p=0.027).
 Conclusion(s): In patients with moderate to severe calcification
undergoing PCI, the CT-derived Calcium Density Index is an independent
predictor of stent underexpansion, outperforming traditional calcium
metrics such as arc, thickness, and length. These findings support the use
of calcium density as a novel biomarker to guide lesion preparation
strategies and optimize stent outcomes in complex PCI. Copyright
© 2025

<45>
Accession Number
2040984231
Title
TCT-1103 Transcatheter vs. Surgical Replacement of Degenerated
Bioprosthetic Aortic Valve Over Time: Findings from a Meta-Analysis of
Propensity-Score-Matched Studies.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B471), 2025. Date of Publication: 28 Oct 2025.
Author
Ebrahimi P.; Namazi M.J.; Rezasoltani M.; Ramezani P.; Namin S.M.; Sarmad
A.; Akbari T.; Khezrpour A.; Ahmed R.; Mandegar M.H.; Upadhyaya S.; Shahid
F.
Institution
(Ebrahimi) Cardiology Department, University Hospitals Birmingham NHS
Foundation Trust, Birmingham, United Kingdom
(Namazi) Department of Radiation Oncology, Mayo Clinic, Rochester,
Minnesota, USA, Rochester, Minnesota, United States
(Rezasoltani) Mayo Clinic, Rochester, Minnesota, Rochester, Minnesota,
United States
(Ramezani) Tehran Azad University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Namin) Rajaei Cardiovascular Medical and Research Center, Tehran, Iran,
Islamic Republic of
(Sarmad) Department of Health Information Management, School of Allied
Medicine, Tehran University of Medical Sciences, Tehran, Tehran, Iran,
Islamic Republic of
(Akbari) Shahid Beheshti University of Medical Science, Sharjah, United
Arab Emirates
(Khezrpour) Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Mandegar) Shariati Hospital, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Upadhyaya) Department of Cardiology, University Hospital Birmingham,
Birmingham, United Kingdom
(Shahid) Queen Elizabeth Hospital, Birmingham, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Valve-in-valve transcatheter aortic valve replacement
(ViV-TAVR) is increasingly used as an alternative to redo surgical aortic
valve replacement (Redo-SAVR) for failed bioprosthetic valves. While early
safety advantages favor ViV-TAVR, its long-term durability remains
debated. This systematic review and meta-analysis aimed to evaluate how
survival outcomes of ViV-TAVR versus Redo-SAVR evolve, using only
propensity score-matched data. Method(s): A systematic search of
PubMed, Scopus, and Cochrane Central was conducted for studies comparing
ViV-TAVR and Redo-SAVR with propensity score matching. Two reviewers
independently performed screening, data extraction, and risk-of-bias
assessment using the ROBINS-I tool. A random-effects meta-analysis with
inverse variance weighting was used to pool time-specific mortality data.
Short-term (30-day), intermediate (1-year), and long-term (>=2-year)
survival outcomes were analyzed separately to evaluate temporal trends in
relative performance. Heterogeneity was assessed using I2 and
publication bias using Egger's test. Result(s): Fourteen
propensity-matched studies (n=13,944) were included. At 30 days, ViV-TAVR
showed lower mortality than Redo-SAVR (RR 0.66; 95% CI: 0.53-0.83;
I2 = 0%). One-year survival was similar between groups.
However, long-term analysis showed higher mortality with ViV-TAVR beyond 2
years. The pooled long-term risk ratio favored redo-SAVR (RR, 1.35; 95%
CI, 0.94-1.93; I2 = 94.4%). Subgroup analysis revealed
significantly higher mortality with ViV-TAVR at 5 years (RR 1.63; 95% CI:
1.05-2.53) and 8 years (RR 2.08; 95% CI: 1.39-3.12), with a significant
subgroup effect (P = 0.0002), highlighting a time-dependent reversal in
outcomes. Conclusion(s): The comparative effectiveness of ViV-TAVR
and Redo-SAVR is time-dependent. ViV-TAVR offers lower early mortality but
loses this advantage beyond 1-2 years, with Redo-SAVR demonstrating
superior long-term survival. These findings emphasize the importance of
considering expected longevity when selecting a reintervention strategy
and support greater caution in choosing ViV-TAVR for patients with longer
life expectancy. A randomized trial with extended echocardiographic and
clinical follow-up is warranted. Categories: STRUCTURAL: Valvular Disease
and Intervention: Aortic Copyright © 2025

<46>
Accession Number
2040984023
Title
TCT-937 Short-term and Long-term forecasting of clinical events in the
Multivessel TALENT Trial with de novo three vessel coronary artery disease
population.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B400-B401), 2025. Date of Publication: 28 Oct 2025.
Author
Onuma Y.; Revaiah P.C.; Oshima A.; Wlodarczak A.; Mollmann H.; Moreno R.;
Dziarmaga M.; Sabate M.; Legutko J.; Silvestri M.; Choudhury A.; Oner A.;
Sharif F.; Biscaglia S.; Kochman J.; Wykrzykowska J.; Lesiak M.; Amat
Santos I.J.; Kumar A.; Meneveau N.; Landt M.; Magro M.; Zaman A.;
Veerasamy M.; Tarantini G.; Farah B.; O'Kane P.; Gomez Hospital J.A.;
Schmitz T.; Gallagher S.; Anderson R.A.; Achenbach S.; McNeice A.; Lauten
A.; Van Belle E.; Bartus S.; Wacinski P.; Devadathan S.; Oemrawsingh R.;
Lattuca B.; Morgan K.; Sharar H.A.; Ochala A.; Rudolph T.; Gil R.; Kennedy
M.; Fores J.S.; Esposito G.; Gurav A.; Miyashita K.; Tobe A.; Sunny S.;
Bheolain G.N.; Chinhenzva A.; Tsai T.-Y.; Serruys P.
Institution
(Onuma, Oshima, Gurav, Miyashita, Tobe, Bheolain, Chinhenzva, Serruys)
University of Galway, Galway, Galway, Ireland
(Revaiah) University of Galway, Galway, Galway, Ireland
(Wlodarczak) Copper Health Center, Lubin, Poland
(Mollmann) St. Johannes Hospital Dortmund, Dortmand, Germany
(Moreno) University Hospital La Paz, Madrid, Spain
(Dziarmaga) Poznan University of Medical Sciences, Poznan, Poland
(Sabate) Hospital Clinic of Barcelona, Barcelona, Spain
(Legutko) Saint John Paul II Hospital, Krakow, Poland
(Silvestri) Clinique Axium, Aix En Provence, France
(Choudhury) Morriston Hospital, Swansea, United Kingdom
(Oner) Universitatsmedizin Rostock, Rostock, Germany
(Sharif) Galway Regional Hospital, Galway, Galway, Ireland
(Biscaglia) Azienda Ospedaliero-Universitaria di Ferrara, Ferrara,
Ferrara, Italy
(Kochman) Medical University of Warsaw, Warsaw, Poland
(Wykrzykowska) University Medical Center Groningen, Groningen, Netherlands
(Lesiak) Dept. of Cardiology, Medical University, Poznan, Poland
(Amat Santos) Hospital Clinico De Valladolid, Madrid, Spain
(Kumar) Royal Albert Edward Infirmary, Wigan and Leigh Teaching Hospitals
NHS Foundation, Wigan, Wrightington, United Kingdom
(Meneveau) Besancon University Hospital, Besancon, France
(Landt) Heart Center Segeberger Kliniken GmbH, Bad Segeberg, Germany
(Magro) Elisabeth-Tweesteden Ziekenhuis, Tilburg, Netherlands
(Zaman) Freeman Hospital, Newcastle upon Tyne, United Kingdom
(Veerasamy) Leeds Teaching Hospital, Leeds, United Kingdom
(Tarantini) Department of Cardiac, Thoracic and Vascular Science,
University of Padova, Padova, Padua, Italy
(Farah) Clinique Pasteur, Toulouse, France
(O'Kane) Bournemouth Hospital, Bournemouth, United Kingdom
(Gomez Hospital) Hu Bellvitge, Barcelona, Spain
(Schmitz) Contilia Heart Center, Essen, Germany
(Gallagher) University Hospital of Wales, Cardiff, United Kingdom
(Anderson) University Hospital of Wales, Caerdydd, United Kingdom
(Achenbach) Friedrich-Alexander-Universitaet, Erlangen, Germany
(McNeice) Royal Victoria Hospital, Belfast, United Kingdom
(Lauten) Dep. of General & Interventional Cardiology & Rhythmology,
Erfurt, Germany
(Van Belle) Lille University, Lille Cedex, France
(Bartus) University Hospital, Krakow, Poland
(Wacinski) Clinical Department of Interventional Cardiology, Medical
University of Lublin, Lublin, Poland
(Devadathan) NHS, Truro, United Kingdom
(Oemrawsingh) Amphia Ziekenhuis, Breda, Netherlands
(Lattuca) Cardiology Department, Nimes University Hospital, Nimes, Nimes,
France
(Morgan) Sheffield Teaching Hospitals, Sheffield, United Kingdom
(Sharar) Heidelberg University Hospital, Heidelberg, Germany
(Ochala) University Hospital, Katowice, Poland
(Rudolph) Heart & Diabetes Center NRW, Bad Oeynhausen, Germany
(Gil) National Medical Institute of the Ministry of Interior, and
Administration Warsaw, Warsaw, Poland
(Kennedy) Beaumont Hospital, Dublin, Dublin, Ireland
(Fores) Hospital Clinico De Valencia, Valencia, Spain
(Esposito) Department of Advanced Biomedical Sciences, University Federico
II, Naples, Napoli, Italy
(Sunny) University of Galway, Ireland, Galway, Ireland
(Tsai) Department of Cardiology, School of Medicine, University of Galway,
Galway, Ireland, Cardiology Department, Galway University Hospital,
Galway, Ireland., Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background: Accurate prognostication in patients with three-vessel CAD
(3VD) is critical for guiding treatment decisions and setting realistic
expectations. Informing patients about their prognosis supports shared
decision-making, helping them understand the risks and benefits of options
like coronary artery bypass grafting (CABG) or percutaneous coronary
intervention (PCI). To predict outcomes of the randomized Multivessel
TALENT trial (NCT04390672) in patients with de novo three-vessel disease,
and to subsequently validate and recalibrate both short-term and long-term
prognostic models for future application. Method(s): The Multivessel
TALENT trial is a prospective, multicenter, randomized controlled study
comparing outcomes between Supraflex Cruz and SYNERGY drug-eluting stents
(DES) in 1,550 patients with de novo three-vessel disease (3VD) without
left main involvement. Patients were treated according to SYNTAX Score II
recommendations and Heart Team decisions, incorporating functional
assessment (QFR), IVUS/OCT-guided optimization, contemporary chronic total
occlusion techniques, and guideline-directed medical therapy. Following
completion of enrolment, the updated logistic SYNTAX score, SYNTAX Score
II, and SYNTAX Score 2020 were prospectively applied to estimate 2-, 4-,
5-, and 10-year mortality and 5-year MACCE. Ninety-five percent prediction
intervals (PIs) for mortality and MACCE were calculated using bootstrap
resampling (10,000 iterations). Result(s): For the overall cohort,
predicted 2-, 4-, 5-, and 10-year mortality, 5-year MACCE, and 2-year VOCE
were 4.09% (PI 3.8-4.5), 10.8% (PI 10.3-11.3), 16.0% (PI 15.4-16.6), 31.8%
(PI 30.8-32.8), 22.7% (PI 22.0-23.3), and 6.1% (PI 5.8-6.3) respectively.
 Conclusion(s): In the large-scale Multivessel TALENT trial, short-
and long-term prediction models were successfully applied to estimate
clinical outcomes. The accuracy of these mortality predictions will be
validated against actual individual outcome data as follow-up progresses
in the coming years, and the models will be recalibrated if necessary.
Categories: CORONARY: Stents: Drug-Eluting and Bare Metal Copyright
© 2025

<47>
Accession Number
2040983290
Title
TCT-657 Incidence of Infective Endocarditis Following Surgical and
Transcatheter Mitral Valve Replacement: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B286), 2025. Date of Publication: 28 Oct 2025.
Author
Vibhishanan J.; Zorman M.; Malik B.; Coronelli M.; Kumar A.; Hampshire J.;
Heylen K.; Choksey A.; Eastwick-Jones K.; Dawkins S.; Newton J.; Cahill T.
Institution
(Vibhishanan, Coronelli, Hampshire) Oxford Heart Centre, Oxford University
Hospitals, Oxford, United Kingdom
(Zorman) Mayo Clinic Rochester, Rochester, Minnesota, United States
(Malik) King's College University, London, United Kingdom
(Kumar) Mayo Clinic, MN, Oxford, Rochester, United Kingdom
(Heylen) University of Cambridge, Cambridge, United Kingdom
(Choksey, Dawkins, Cahill) Oxford University Hospitals, Oxford, United
Kingdom
(Eastwick-Jones) Oxford University, Oxford, United Kingdom
(Newton) John Radcliffe Hospital, UK, Oxford, Oxford, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Infective endocarditis (IE) is a potentially life-threatening
complication of bioprosthetic valve replacement. The relative incidence of
IE following bioprosthetic surgical mitral valve replacement (SMVR) versus
transcatheter mitral valve replacement (TMVR) is understudied.
 Method(s): A literature search of Medline, Embase, and Cochrane
Library (Jan 2000-Jan 2024) identified 4581 studies. 43 studies including
7987 patients were included in the analysis. Pooled IE incidence rates
were derived using random-effects models, using meta-regression to adjust
for subgroup differences. Result(s): 3105 patients underwent TMVR,
with mean age 71.3 years, and mean follow-up 0.9 years. 51.3% (1593/3105)
were male and 26.5% (770/2909) had diabetes mellitus (DM). 4872 patients
underwent SMVR, with a mean age 61.4 years, and mean follow-up 5.2 years.
35.7% (427/1195) were male and 17.9% (131/731) had DM. 222 IE events
occurred over a total follow-up of 28,015 patient-years. Overall incidence
of IE following TMVR or SMVR was 2.0 (95% CI 1.3-3.1) events per
100-patient-years. Incidence of IE following TMVR was 3.2 (95% CI 2.0-5.1)
events per 100-patient-years, compared to 1.1 (95% CI 0.5-2.3) events per
100-patient-years after SMVR (p=0.016). After adjustment for age the
incidence of IE following TMVR remained significantly higher than SMVR,
with an incidence rate ratio of 5.28 (95% CI 1.5-19.1), p=0.011. [Formula
presented] Conclusion(s): The incidence of IE is significantly higher
after TMVR than after bioprosthetic SMVR. Factors which may underlie this
difference, including patient, procedural and valve risk factors, merit
further research focus. Categories: STRUCTURAL: Valvular Disease and
Intervention: Mitral Copyright © 2025

<48>
Accession Number
2040983765
Title
TCT-640 Diabetes, Glucose Dysregulation, and Inflammatory Biomarkers as
Predictors of Mortality and Adverse Events Following Transcatheter Aortic
Valve Implantation: A Systematic Review and Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B278-B279), 2025. Date of Publication: 28 Oct 2025.
Author
Ebrahimi P.; Ramezani P.; Namin S.M.; Namazi M.J.; Ahmed R.; Rezasoltani
M.; Akbari T.; Eshraghi R.; Kachela Y.; Diwan T.; Myers J.; Khan M.;
Giocondo Costa S.S.; Upadhyaya S.; Soleimani H.; Mandegar M.H.; Naderi F.;
Shahid F.
Institution
(Ebrahimi) Cardiology Department, University Hospitals Birmingham NHS
Foundation Trust, Birmingham, United Kingdom
(Ramezani) Tehran Azad University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Namin) Rajaei Cardiovascular Medical and Research Center, Tehran, Iran,
Islamic Republic of
(Namazi) Department of Radiation Oncology, Mayo Clinic, Rochester,
Minnesota, USA, Rochester, Minnesota, United States
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Rezasoltani) Mayo Clinic, Rochester, Minnesota, Rochester, Minnesota,
United States
(Akbari) Shahid Beheshti University of Medical Science, Sharjah, United
Arab Emirates
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Kachela, Diwan, Myers, Khan) Aston University, Birmingham, United Kingdom
(Giocondo Costa, Shahid) Queen Elizabeth Hospital, Birmingham, United
Kingdom
(Upadhyaya) Department of Cardiology, University Hospital Birmingham,
Birmingham, United Kingdom
(Soleimani) Tehran University of Medical Sciences, Tehran, Iran, Tehran,
Iran, Islamic Republic of
(Mandegar) Shariati Hospital, Tehran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Naderi) School of Medicine, Shahrekord University of Medical Sciences,
Shahrekord, Iran, Islamic Republic of
Publisher
Elsevier Inc.
Abstract
Background: Diabetes mellitus (DM) and glucose dysregulation are prevalent
among patients with severe aortic stenosis undergoing transcatheter aortic
valve implantation (TAVI). Their prognostic significance remains
incompletely understood, particularly in relation to short- and long-term
mortality and inflammatory risk profiles. The objective of this study is
to evaluate the association of diabetes, insulin treatment, and
inflammatory biomarkers with mortality and adverse cardiovascular (CV)
outcomes following TAVI. Method(s): We conducted a systematic review
and meta-analysis of 15 studies involving 276,419 patients (98,420 with
DM, 177,999 without) undergoing TAVI. Data were extracted on short- and
long-term mortality, CV risk profiles, and inflammatory markers. Subgroup
analysis was performed comparing insulin-treated diabetes (ITDM) with
oral-treated diabetes (OTDM). Risk ratios (RR) with 95% confidence
intervals (CI) were calculated using random-effects models. Heterogeneity
was assessed using I2 statistics. The prognostic value of
inflammatory biomarkers, especially C-reactive protein (CRP), was also
examined. Result(s): DM patients were younger (MD: -2.9 years;
p<0.0001), had higher rates of hypertension (84.6%), dyslipidemia (73.1%),
CKD (55.3%), and CAD (57.4%) (all p<0.0001). Pooled 30-day mortality
showed a non-significant 11% increase in DM patients (RR 1.11; 95% CI
0.92-1.35; I2=36.7%). ITDM showed a 51% relative increase vs.
OTDM (RR 1.51; 95% CI 0.76-3.22; not significant). Long-term mortality
(1-2 years) was 33% more in DM (RR 1.33; 95% CI 0.99-1.89;
I2=64.1%). CRP independently predicted mortality (adjusted HR
1.019 per 1 mg/L increase; 95% CI 1.01-1.03; p=0.003). No consistent
associations were found for WBC or IL-6. Conclusion(s):
Diabetes-particularly insulin-treated-was associated with a trend toward
higher early and late mortality following TAVI, though results did not
reach statistical significance. Diabetic patients had greater comorbidity
burdens despite younger age. CRP emerged as a reliable inflammatory
biomarker predicting long-term mortality. These findings highlight the
need for individualized risk assessment and tailored post-TAVI
surveillance in patients with glucose dysregulation. Categories:
ENDOVASCULAR: Diseases of the Aorta and Intervention Copyright ©
2025

<49>
Accession Number
2040984445
Title
TCT-420 Predictive Value of Coronary CT-derived Plaque and FFR Analysis in
Patients with Peripheral Artery Disease and No Known Coronary Disease.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B184-B185), 2025. Date of Publication: 28 Oct 2025.
Author
Erglis A.; Latkovskis G.; Kumsars I.; Narbute I.; Stradins P.; Krievins
D.; Zellans E.; Jegere S.
Institution
(Erglis) University of Latvia, Pauls Stradins Clinical University
Hospital, Latvia, Riga, Latvia
(Latkovskis) Pauls Stradins Clinical Hospital, Riga, Latvia
(Kumsars) P.Stradins University Hospital, Riga, Latvia
(Narbute) Pauls Stradins Clinical University Hospital, University of
Latvia, Latvia, Riga, Latvia
(Stradins) Pauls Stradins Clinical University Hospital, Latvian Centre of
Cardiology, Latvia, Riga, Latvia
(Krievins) University of Latvia, Riga, Latvia
(Zellans) Pauls Stradins Clinical University Hospital, Riga, Latvia
(Jegere) RigaLatvia
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing peripheral vascular procedures have poor
long-term survival due to CAD which is often asymptomatic and undiagnosed.
This study aims to determine if CT-derived plaque and FFR analysis can
predict long-term mortality following elective vascular surgery.
 Method(s): Vascular surgery patients with no cardiac history or
symptoms were enrolled in a prospective, IRB-approved study of coronary CT
angiography to evaluate cardiac risk. This study included 191 vascular
surgery patients with off-site FDA-approved atherosclerotic plaque and
CTFFR analysis. All patients received guideline-directed optimal medical
therapy with no elective coronary revascularization. The primary endpoint
was all-cause death at 5 years with univariate Cox regression analysis.
 Result(s): Baseline cardiac evaluation in 191 patients (age 67+/-9
yrs, 70% men) revealed median Total Plaque Volume (TPV)=454 [IQR=199-977]
mm3. During 5-year follow-up 48 patients (25%) died and 143
(75%) survived. TPV was twofold higher in non-survivors (801
[IQR=387-1358] vs 392 [IQR=128-764] mm3, p<0.001) with similar
increases in calcified (p<0.001), low attenuation (p=0.003), and
noncalcified plaque (p<0.001). TPV>454 mm3, CTFFR<=0.80 and
both combined were associated with increased mortality (p<0.001).
CTFFR>0.80 with TPV<454 mm3 was associated with 89% 5-year
survival (Figure). [Formula presented] Conclusion(s): In PAD patients
with no known CAD, CT-derived total plaque volume added to CTFFR is a
strong indicator of long-term mortality. CT plaque features may identify
high-risk patients who may benefit from aggressive preventive treatment.
Categories: IMAGING AND PHYSIOLOGY: Invasive and Non-Invasive
Angiography Copyright © 2025

<50>
Accession Number
2040605293
Title
Comparison of perioperative analgesic efficacy between serratus anterior
plane block and thoracic paravertebral block in adult patients undergoing
thoracic and breast surgeries: a systematic review and meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 493. Date
of Publication: 01 Dec 2025.
Author
Wang J.; Li T.
Institution
(Wang, Li) Department of Anesthesiology, Yuncheng Central Hospital
Affiliated to Shanxi Medical University, No. 3690, Hedong East Street,
Yanhu District, Shanxi Province, Yuncheng, China
Publisher
BioMed Central Ltd
Abstract
Background: Serratus anterior plane block (SAPB) and thoracic
paravertebral block (TPVB) are widely used regional anesthesia techniques
for postoperative analgesia and are generally considered safe and
effective. However, the comparative efficacy remains inconclusive. This
systematic review and meta-analysis of randomized controlled trials (RCTs)
aims to evaluate the perioperative analgesic efficacy of SAPB versus TPVB
in adult patients undergoing thoracic and breast surgeries.
 Method(s): A comprehensive literature search was conducted in PubMed,
EMBASE, Web of Science, Cochrane library, ClinicalTrial.gov, and Google
Scholar up to February 28, 2025. Primary outcomes included time to first
analgesic request (TFAR), 24-h total analgesic consumption (TAC)
postoperatively, and 24-h postoperative pain scores at rest. Secondary
outcomes comprised pain scores at various postoperative timepoints,
intraoperative fentanyl consumption, length of hospital stay, patient
satisfaction with analgesia, and incidence of complications. A
random-effect model was applied for the meta-analysis. Result(s):
Twenty-eight 28 RCTs comprising 1796 patients were included. No
significant differences were found between SAPB and TPVB in TFAR (mean
difference [MD] = -0.68 h, 95% confidence interval [CI]: -1.55 to 0.18, P
= 0.122), 24-h pain scores at rest (MD = 0.14, 95%CI: -0.14 to 0.42, P =
0.334), other postoperative pain scores, length of hospital stay, patient
satisfaction, or incidence of postoperative nausea and vomiting (risk
ratio [RR] = 0.87, 95%CI: 0.63 to 1.20, P = 0.310). Despite statistically
significant, the difference of 24-h TAC comparing SAPB to TPVB (MD = 1.73
mg intravenous morphine equivalents, 95%CI: 0.54 to 2.92, P = 0.005) did
not exceed the minimal clinically important difference (MCID) of 10 mg.
SAPB also resulted in greater intraoperative fentanyl consumption (MD =
13.85 mcg, 95%CI: 3.86 to 23.84, P = 0.007) but a significantly lower
incidence of hypotension (RR = 0.39, 95%CI: 0.20 to 0.76, P = 0.006).
Subgroup analyses showed that TPVB provided superior, but non-clinically
significant, opioid-sparing benefits in thoracic procedures (3.38 mg) and
when compared to superficial SAPB (3.11 mg). Conclusion(s): SAPB
offers comparable analgesic efficacy to TPVB, with a more favorable safety
profile but slightly higher opioid consumption. However, the increased
opioid use does not exceed the MCID. Therefore, SAPB is a clinically
effective and safe alternative to TPVB for perioperative regional
analgesia in thoracic and breast surgeries. Copyright © The
Author(s) 2025.

<51>
Accession Number
2040985124
Title
TCT-300 Ticagrelor Removal to Reduce Bleeding after Urgent CABG: Registry
and Individual Patient-level Meta-analysis of Observational Data.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B133-B134), 2025. Date of Publication: 28 Oct 2025.
Author
Thielmann M.; Schoerghuber M.; Kuenzer T.; Storey R.; Hassan K.; Dalen M.;
Meyar A.; Schlachtenberge G.; Panholzer B.; Voetsch A.; Bernardi M.; de
Somer F.; Marczin N.; Donovan T.; Tircoveanu R.; Mayer C.; Prats J.; Wendt
D.; Deliargyris E.; Schmoeckel M.; Berghold A.
Institution
(Thielmann) Department of Thoracic- and Cardiovascular Surgery, Westgerman
Heart & Vascular Center Essen, Essen, Germany
(Schoerghuber) Division of Anaesthesiology and Intensive Care Medicine 2,
Medical University of Graz, Graz, Austria
(Kuenzer) Institute for Medical Informatics, Statistics and Documentation,
Medical University of Graz, Graz, Austria
(Storey) University of Sheffield, Sheffield, United Kingdom
(Hassan) Department of Cardiac Surgery, Asklepios Klinik St. Georg,
Hamburg, Germany
(Dalen) Karolinska Institute, Stockholm, Sweden
(Meyar) Department of Cardiac Surgery, University Hospital Heidelberg,
Heidelberg, Germany
(Schlachtenberge) Department of Thoracic Surgery, Hildegardis Hospital
Cologne, Cologne, Germany
(Panholzer) Department for Cardiac Surgery, UKSH Campus Kiel, Kiel,
Germany
(Voetsch) Department of Cardiovascular and Endovascular Surgery,
Paracelsus Medical University, Salzburg, Austria
(Bernardi) Cardiac Thoracic Vascular Anesthesia and Intensive Care
Medicine, Medical University of Vienna, Vienna, Austria
(de Somer) Heart Centre, University Hospital Ghent, Ghent, Belgium
(Marczin) Division of Anaesthesia, Pain Medicine and Intensive Care,
Imperial College London, Royal Brompton & Harefield Hospitals, Guy's & St.
Thomas' NHS, London, United Kingdom
(Donovan) Krankenhaus der Barmherzigen Bruder Trier, Trier, Germany
(Tircoveanu) Department of Anesthesiology, Saint-Luc University Hospital,
Catholic University of Louvain, Brussels, Belgium
(Mayer) Division of Cardiac Surgery, Medical University of Graz, Graz,
Austria
(Prats) Elysis LLC, Carlisle, Massachusetts, United States
(Wendt) CytoSorbents Corp, Berlin, Germany
(Deliargyris) Cytosorbents, Princeton, New Jersey, United States
(Schmoeckel) Dept. Cardiac Surgery, Munchen, Germany
(Berghold) Institute for Medical Informatics, Statistics and
Documentation, Medical University of Graz, Graz, Austria
Publisher
Elsevier Inc.
Abstract
Background: Patients undergoing CABG <3 days from their last ticagrelor
dose are at increased risk of severe perioperative bleeding. A novel
hemoadsorption device capable of intraoperative ticagrelor removal may
help mitigate this elevated risk. Method(s): Bleeding after urgent
CABG <3 days from last ticagrelor dose was evaluated in 2 groups according
to device use. Group 1 (CABG + Device, n=150) included patients from the
International Safe and Timely Antithrombotic Removal (STAR) registry, and
Group 2 (CABG No Device, n=389) from a meta-analysis of 4 observational
studies. Individual patient level data were compared for the primary
outcome of Bleeding Academic Research Consortium (BARC)-4 bleeding. The
propensity score, based on ten clinical and operative variables, was used
for inverse probability of treatment weighting (IPTW). Result(s):
Values are reported for G1 followed by G2. Age and sex were similar
between groups (65 vs. 67 years, p=0.13 and 79.2% vs. 82.8% male, p=0.09).
Time from last ticagrelor dose to CABG was also comparable (0.89 vs 1.0
days, p=0.11). EuroSCORE-II was higher in G1 (3.0% vs. 2.7%, p=0.04).
Crude BARC-4 rates were lower in G1 with 12.7% vs 34.2% in G2 and remained
lower after IPTW adjustment (OR 0.26, 95%CI: 0.16, 0.40; p<0.001). 30-day
mortality was not significantly different (4.0% vs. 7.4%, p=0.82), while
the composite of BARC-4 or 30-day mortality was significantly lower in G1
(OR: 0.33; 95%CI: 0.20, 0.53; p<0.001). Conclusion(s): BARC-4
bleeding occurs in about one third of patients on ticagrelor undergoing
CABG before completion of the recommended washout period. Intraoperative
use of a novel hemoadsorption device to remove ticagrelor significantly
reduces BARC-4 bleeding. Prospective, randomized studies are needed to
validate these findings. Categories: CORONARY: Cardiac and Coronary Artery
Surgery and Hybrid Revascularization Copyright © 2025

<52>
Accession Number
2040985117
Title
TCT-851 TAVR Versus Surveillance in Patients with Moderate Aortic Stenosis
and Heart Failure: A Crossover-Censored Analysis of the TAVR UNLOAD Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B369-B370), 2025. Date of Publication: 28 Oct 2025.
Author
von Stein P.; Redfors B.; Snyder C.; Spitzer E.; Pibarot P.; Bax J.;
Kobayashi Y.; Abu-Much A.; Regan K.; Popma A.; Cohen D.; Elmariah S.; Alu
M.; Leon M.; Van Mieghem N.
Institution
(von Stein) CRF, New York, New York, United States
(Redfors, Kobayashi, Alu) Cardiovascular Research Foundation, New York,
New York, United States
(Snyder, Regan) Cardiovascular Research Foundation, Brooklyn, New York,
United States
(Spitzer) Rotterdam, Cardialysis, Netherlands
(Pibarot) Quebec Heart and Lung Institute, Quebec, Quebec, Canada
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Abu-Much) Columbia University Irving Medical Center, New York, New York,
United States
(Popma) CRF Clinical Trials Center, New York, New York, United States
(Cohen) St. Francis Hospital, New York, New York, United States
(Elmariah) University of California San Francisco, San Francisco,
California, United States
(Leon) Newyork-Presbyterian Columbia University Irving Medical Center, New
York, New York, United States
(Van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has transformed
the management of severe aortic stenosis (AS). Less is known about the
management of moderate AS, particularly in the context of heart failure
with reduced ejection fraction (HFrEF). The TAVR UNLOAD trial showed no
overall benefit of TAVR vs. clinical AS surveillance (CASS). However, a
substantial proportion of CASS patients ultimately crossed over to TAVR.
We evaluated outcomes censoring CASS patients at crossover and examined
baseline predictors of crossover. Method(s): TAVR UNLOAD was an
international, randomized controlled trial enrolling HFrEF patients with
moderate AS eligible for transfemoral TAVR. From 01/2017-12/2022,
participants were randomized 1:1 to TAVR or CASS. The hierarchical primary
endpoint comprised all-cause death, disabling stroke, HF
hospitalization/equivalents, and change in Kansas City Cardiomyopathy
Questionnaire Overall Summary Score (KCCQ-OSS). Analyses were performed
through 1 year and longest follow-up, censoring CASS patients at
crossover. Multivariable logistic regression models were constructed to
identify predictors of crossover. Result(s): A total of 178 patients
(mean age 77.4 +/- 9.2 years; 20.8% women; 55.6% NYHA class >=III) were
randomized to TAVR (n=89) or CASS (n=89). Through 1 year, 19 CASS patients
(21.4%) crossed over to TAVR (median 177 days [96- 214]). The 1-year
crossover-censored win ratio favored TAVR (Figure). Older age (OR 1.10 per
year [95% CI: 1.01-1.22]; p=0.043) and history of angina pectoris (OR 3.52
[95% CI: 1.11-11.51]; p=0.033) independently predicted crossover. Through
longest follow-up (median 690 days [380-1,015]), 39 CASS patients (43.8%)
crossed over (median 393 days [182- 606]). The crossover-censored win
ratio again favored TAVR (Figure). Lower STS score (OR 0.75 per %-point
[95% CI: 0.58-0.91]; p=0.001), smaller aortic valve area (OR 0.76 per 0.1
cm2 [95% CI: 0.57-0.99]; p=0.053), higher KCCQ-OSS (OR 1.24 per
10-points [0.97-1.61]; p=0.095), and atrial fibrillation (OR 5.28 [95% CI;
1.7-19.14]; p=0.006) independently predicted crossover.
 Conclusion(s): In TAVR UNLOAD, TAVR was associated with a significant
benefit over CASS in HFrEF patients with moderate AS when CASS patients
were censored at crossover, both through 1 year and longest follow-up.
Nearly half of CASS patients ultimately underwent TAVR, with predominantly
clinical rather than echocardiographic factors predicting crossover. These
findings suggest that patients with moderate AS and HFrEF may derive
clinical benefit from TAVR; however, a larger confirmatory trial is needed
to establish its role in this population. [Formula
presented] Copyright © 2025

<53>
Accession Number
2040984360
Title
TCT-1178 Safety and Efficacy of Supra-Annular Versus Intra- Annular Self
Expanding Valves in Patients Undergoing Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B503-B504), 2025. Date of Publication: 28 Oct 2025.
Author
Burhan M.; Hussain F.; Shafiq S.; Saeed H.; Khalid S.; Ali S.; Shabbir
M.R.; Awais M.; Khan S.A.; Ahsan M.; Majeed U.; Niaz A.; Le Huu A.
Institution
(Burhan, Hussain, Shafiq) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Saeed) Rawalpindi Medical University, Pakistan, Islamabad, Rawalpindi,
Pakistan
(Khalid, Niaz) Oklahoma Heart Hospital, Oklahoma City, Oklahoma, United
States
(Ali) Oklahoma Heart Hospital, Abrazo Arizona Heart Hospital, Scottsdale,
Arizona, United States
(Shabbir) Marshfield Clinic Health System, Marshfield, Wisconsin, United
States
(Awais, Majeed) Allama Iqbal Medical College, Lahore, Pakistan
(Khan) Allama Iqbal Medical College Lahore Pakistan, Oklahoma, Oklahoma,
United States
(Ahsan) King Edward Medical University Lahore, Oklahoma City, Oklahoma,
United States
(Le Huu) Oklahoma Heart Hospital, Moore, Oklahoma, United States
Publisher
Elsevier Inc.
Abstract
Background: Supra-annular and intra-annular self-expanding valves (SEVs)
differ in leaflet position and flow dynamics, potentially influencing
clinical and hemodynamic outcomes. This meta-analysis compares the safety
and efficacy of these SEV types in patients undergoing transcatheter
aortic valve replacement (TAVR). Method(s): We conducted a
comprehensive search across multiple databases to identify studies
comparing supra-annular SEVs (Evolut, Acurate) with intra-annular SEVs
(Portico) in patients undergoing TAVR. Dichotomous outcomes were pooled as
odds ratios (ORs) with 95% confidence intervals (CIs). All analyses were
performed in R (v4.4.1), with statistical significance set at p < 0.05.
 Result(s): Eight studies comprising 8,383 patients were included.
Supra-annular SEVs were associated with significantly lower rates of
pacemaker implantation [OR: 0.76; (0.61-0.95); p=0.015], any
prosthesis-patient mismatch (PPM) [OR: 0.46; (0.31-0.67); p<0.001], severe
PPM [OR: 0.46; (0.27-0.79); p=0.005], and myocardial infarction (MI) [OR:
0.43; (0.21-0.89); p=0.024] compared to intra-annular SEVs. Minor bleeding
was significantly lower with intra-annular SEVs [OR: 1.76; (1.02-3.05);
p=0.042]. Rates of acute kidney injury (AKI), cardiovascular mortality,
major bleeding, and vascular complications were comparable between groups.
[Formula presented] Conclusion(s): Supra-annular SEVs are linked to
lower rates of pacemaker implantation, MI, and PPM, but higher minor
bleeding compared to intra-annular SEVs. Other outcomes were similar.
Large randomized trials are needed to confirm these findings. Categories:
STRUCTURAL: Valvular Disease and Intervention: Aortic Copyright ©
2025

<54>
Accession Number
2040982859
Title
TCT-386 Optical Coherence Tomography Guided Treatment of the Distal Left
Main Bifurcation - an OCTOBER trial substudy.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B170-B171), 2025. Date of Publication: 28 Oct 2025.
Author
Holck E.; Andreasen L.; Neghabat O.; Laanmets P.; Spratt J.; Bennett J.;
Biscaglia S.; Walsh S.; O'Kane P.; Henareh L.; Chowdhary S.; Grikis K.;
Lonborg J.; Odenstedt J.; Heigert M.; Christiansen E.
Institution
(Holck, Andreasen) Aarhus University Hospital, Aarhus N, Denmark
(Neghabat) Aarhus University Hospital, Aarhus C, Denmark
(Laanmets) North-Estonia Medical Centre Foundation, Estonia, Tallinn,
Estonia
(Spratt) St George's, University of London, London, United Kingdom
(Bennett) University Hospitals Leuven, Leuven, Belgium
(Biscaglia) Azienda Ospedaliero-Universitaria di Ferrara, Ferrara,
Ferrara, Italy
(Walsh) Royal Victoria Hospital, Belfast, United Kingdom
(O'Kane) Bournemouth Hospital, Bournemouth, United Kingdom
(Henareh) Karolinska Unidersity Hospital, Stockholm, Sweden
(Chowdhary) Manchester Foundation Trust, Altrincham, United Kingdom
(Grikis) Pauls Stradins Clinical University Hospital, Latvia, Kekava,
Latvia
(Lonborg) Copenhagen University Hospital, Copenhagen, Denmark
(Odenstedt) Sahlgrenska University Hospital, Gothenburg, Sweden
(Heigert) University Hospital Trondheim, Norway, Trondheim, Norway
(Christiansen) Aarhus University Hospital, Aarhus, Skejby, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous coronary intervention (PCI) of the distal left
main coronary artery (LMCA) bifurcation is inferior to coronary artery
bypass grafting (CABG). The impact of optical coherence tomography (OCT)
guiding is unknown. Method(s): In the OCTOBER (OCT Optimized
Bifurcation Event Reduction) trial, 1201 patients with true bifurcation
lesions were randomized 1:1 to OCT or angiographic guided stent
implantation. This study is a sub analysis of patients with true
bifurcation lesions in the distal LMCA. The randomization in the main
trial was stratified for LMCA lesions. The primary end point was
difference in a composite major adverse cardiac events (MACE) comprising
cardiac death, target-lesion myocardial infarction (MI), and
ischemia-driven target-lesion revascularization at a median follow-up two
years after randomization. Key-secondary end point in this study was MACE
excluding procedural MI (PMI) and quantitative OCT analysis.
 Result(s): In the intention-to-treat population, 227 patients were
treated for a true LMCA bifurcation lesion (angiographic: 116, OCT: 111).
The mean age was 70.1+/-9.2 in the angiography group and 72.2+/-10.0 in
the OCT group. At a median two-years follow-up the difference in MACE was
HR (95%CI) 0.78 (0.39;1.51) and for MACE without PMI it was 0.68
(0.30;1.51) with the angiographic group as reference (figure 1). Complete
quantitative OCT analysis was feasible in 102/111 patients and is
presented at TCT 2025. [Formula presented] Conclusion(s): OCT guiding
of the LMCA bifurcation did not significantly improve prognosis compared
with angiographic guidance. However, a trend favouring OCT guidance was
observed. Categories: IMAGING AND PHYSIOLOGY: Imaging:
Intracoronary Copyright © 2025

<55>
Accession Number
2041117357
Title
Does Autologous Platelet-Rich Plasma Improve Blood Conservation and
Postoperative Outcomes in Acute Type A Aortic Dissection Surgery? A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Santos K.; Oya K.; Umibe T.; Patel N.; Abo T.; Sakai W.; Plonek T.
Institution
(Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia
(Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum
Twente, Enschede, Netherlands
(Oya, Umibe, Abo, Sakai) Department of Surgery, National Center for Global
Health and Medicine, Tokyo, Japan
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate whether autologous platelet-rich plasma (aPRP)
improves blood conservation and postoperative outcomes in emergency
surgery for acute type A aortic dissection (ATAAD). Design(s):
Systematic review and meta-analysis of randomized controlled trials and
observational studies. Setting(s): Cardiac surgery centers from
multiple institutions. Participant(s): Six studies comprising 2,150
adult patients undergoing ATAAD repair, of whom 906 (42.1%) received
intraoperative aPRP. Intervention(s): Use of intraoperative aPRP
versus no aPRP during ATAAD repair. Measurements and Main Results:
Primary outcomes included reoperation for bleeding and allogeneic blood
product transfusion volumes. Secondary outcomes were mechanical
ventilation duration, hospital stay, and postoperative complications. aPRP
was associated with significantly shorter mechanical ventilation time (MD
-13.8 hours; 95% CI -23.9 to -3.7; p = 0.008), lower incidence of
prolonged ventilation (OR 0.3; 95% CI 0.2 to 0.7; p = 0.004), reduced
reoperation rates (OR 0.4; 95% CI 0.2 to 0.7; p = 0.005), and decreased
platelet (MD -2.2 units; 95% CI -3.5 to -0.9; p = 0.001) and
cryoprecipitate use (MD -1.9 units; 95% CI -3.0 to -0.8; p < 0.001). No
differences were observed in mortality, hospital stay, or rates of
neurological or renal complications. Subgroup analysis of randomized
controlled trial and propensity-matched data confirmed several of these
findings and additionally showed reduced plasma transfusion volumes.
 Conclusion(s): In ATAAD surgery, aPRP may reduce transfusion needs,
reoperations, and ventilation duration without increasing adverse
outcomes. Given that most evidence is observational, high-quality
randomized trials are needed to confirm these findings. Copyright
© 2025 Elsevier Inc.

<56>
Accession Number
2041115178
Title
Controversies in valvular heart disease: insights from cardiac imaging.
Source
Trends in Cardiovascular Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
van der Bijl P.; Ajmone Marsan N.; Bax J.J.
Institution
(van der Bijl, Ajmone Marsan, Bax) Department of Cardiology, Leiden
University Medical Centre, Leiden, Netherlands
(van der Bijl) SAEndovascular, Netcare Kuils River Hospital, Cape Town,
South Africa
Publisher
Elsevier Inc.
Abstract
Numerous controversies still exist in the diagnosis and management of
valvular heart disease, for example, the benefit of treating moderate
aortic stenosis (AS) or asymptomatic, severe AS and the appropriate
selection criteria for transcatheter edge-to-edge mitral valve repair.
While numerous imaging parameters have been linked to the risk of sudden
cardiac death in mitral valve prolapse, their relative merits are unknown
and this is a challenging population to risk-stratify. No large,
randomized data exist to guide selection of patients for transcatheter
repair of tricuspid regurgitation or valve intervention in severe
pulmonary regurgitation. Multimodality cardiac imaging provides unique
insights into these important questions. Copyright © 2025 The
Author(s)

<57>
Accession Number
2040972314
Title
iHEART trial: study protocol for a German multicentre randomised
controlled trial on the feasibility and acceptance of an internet-based
preoperative intervention to optimise patient expectations and improve
outcomes after heart surgery.
Source
BMJ Open. 15(9) (no pagination), 2025. Article Number: e092482. Date of
Publication: 17 Sep 2025.
Author
Compere V.N.; Balci S.; Heinz C.; Schade-Brittinger C.; Rastan A.J.;
Salzmann-Djufri M.; Niemann B.; Boening A.; Choi Y.-H.; Zarski A.-C.;
Laferton J.; Euteneuer F.; Rief W.; Salzmann S.
Institution
(Compere, Balci, Rief, Salzmann) Division of Clinical Psychology and
Psychotherapy, University of Marburg, Marburg, Germany
(Heinz, Schade-Brittinger) Coordinating Center for Clinical Trials (KKS),
University of Marburg, Marburg, Germany
(Rastan) Department for Cardiovascular Surgery, Heart Center, University
Hospital of Giessen and Marburg, Marburg, Germany
(Salzmann-Djufri, Niemann, Boening) Department for Cardiovascular Surgery,
University Hospital Giessen, Giessen, Germany
(Choi) Department of Cardiac Surgery, Department of Cardiology, Department
for Heart Surgery, Kerckhoff Clinic Heart Centrum, Bad Nauheim, Germany
(Zarski) Department of Clinical Psychology, Division of eHealth in
Clinical Psychology, University of Marburg, Marburg, Germany
(Laferton) Institute for Mental Health and Behavioral Medicine, Department
of Medicine, HMU Health and Medical University Potsdam GmbH, Potsdam,
Germany
(Euteneuer) MSB Medical School Berlin GmbH, Department of Psychology,
Clinical Psychology and Psychotherapy, Berlin, Germany
(Salzmann) HMU Health and Medical University Erfurt GmbH, Erfurt, Germany
Publisher
BMJ Publishing Group
Abstract
Introduction Treatment expectations are a key mechanism of placebo effects
in clinical trials. In a previous study (PSY-HEART-I), preoperative
expectation optimisation improved quality of life 6months postcardiac
surgery. However, barriers such as travel distance, staffing shortages and
COVID-19 limited participation. This study evaluates the feasibility and
acceptability of iEXPECT, a brief internet-based intervention designed to
optimise expectations before heart surgery. Methods and analysis In this
three-arm, multicentre randomised controlled trial, 160 patients
undergoing elective coronary artery bypass graft surgery are randomised
to: (a) standard of care (SOC); (b) SOC plus iEXPECT with phone-based
guidance (iEXPECT enhanced) or (c) SOC plus iEXPECT with email-based
guidance (iEXPECT limited). The intervention includes four 20min online
modules addressing surgical benefits, side effects and coping strategies.
Modules are accompanied by personalised guidance provided through feedback
on each module via email or telephone (three before surgery, three booster
sessions at 6, 12 and 18 weeks postsurgery). Assessments occur at baseline
(5-21 days before surgery), preoperatively (day before surgery), 7days
postsurgery and 6 months later. Primary feasibility outcomes include
recruitment (>=1 participant/week/centre), retention (>=49% completing
6-month follow-up including biomarkers) and engagement (>=75% completing
>=1 presurgery module). Acceptability is measured by self-reported
enjoyment, usefulness and impact, with acceptance defined as mean scores
>3.4 (5-point Likert scale) and CSQ-I ratings. Secondary outcomes include
psychological measures, inflammatory markers and heart rate variability.
Ethics and dissemination Ethical approval was granted by the Ethics
Committees of Philipps University Marburg (AZ 229/23 BO) and the
University of Giessen (AZ 186/23). All participants provide written
informed consent. Results will be shared via publications, conferences and
public outreach with relevant consumer advocacy groups. Trial registration
number DRKS00033284. Copyright © Author(s) (or their employer(s))
2025. Re-use permitted under CC BY. Published by BMJ Group.

<58>
Accession Number
2040983280
Title
TCT-966 A Multicenter Randomized Clinical Trial of Hemodynamic Support
with a Novel Percutaneous Left Ventricular Assist Device Versus VA-ECMO in
High-Risk PCI Patients with Severely Reduced LVEF: 30-Day Results of the
PERSIST III Study.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B412-B413), 2025. Date of Publication: 28 Oct 2025.
Author
Fang Z.; Zhang Z.; Zhang B.; Ma J.; Li H.; Chen Y.; Zhao G.; Ge J.
Institution
(Fang, Li) Zhongshan Hospital, Fudan University, Shanghai, Shanghai, China
(Zhang) , (UTC +08:00), Shanghai, China
(Zhang) Zhongshan Hospital Fudan University, Shanghai, China, Shanghai,
Shanghai, Shanghai, China
(Ma) Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital,
Fudan University, Shanghai, Shanghai, China
(Chen) Chinese PLA General Hospital, Beijing, Beijing, China
(Zhao, Ge) Department of Cardiology, Zhongshan Hospital, Fudan University,
Shanghai, Shanghai, China
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous mechanical circulatory support (pMCS) devices
such as venoarterial extracorporeal membrane oxygenation (VA-ECMO) are
selectively used to provide hemodynamic support in patients undergoing
high-risk percutaneous coronary intervention (HR-PCI). SynFlow 3.0 is a
novel percutaneous left ventricular assist device featuring an axial flow
pump capable of delivering forward blood flow up to 3.5 L/min. Currently,
no clinical trials have directly compared percutaneous left ventricular
assist devices and VA-ECMO in HR-PCI patients. Method(s): The PERSIST
III trial was a prospective, multicenter, randomized controlled clinical
trial enrolling patients with three-vessel disease, unprotected left main
coronary artery disease, or last patent conduit, and severely reduced left
ventricular function (LVEF <= 35%). Eligible patients undergoing
nonemergent PCI were randomized to receive either SynFlow 3.0 or VA-ECMO
support during the procedure. The primary endpoint was the incidence of
30-day major adverse events (MAE), defined as any of: all-cause death,
myocardial infarction, stroke/TIA, repeat revascularization, MCS-ARC 3-5
bleeding, acute kidney injury, cardiopulmonary
resuscitation/cardioversion, cardiac surgery/limb ischemia, or serious
device-related complications. Result(s): In the modified
intention-to-treat (mITT) population, 222 patients from 19 centers in
China were enrolled between September 2024 and April 2025 and randomized
to SynFlow 3.0 (n = 109) or VA-ECMO (n = 113) support. Hemodynamic
instability during the procedure occurred in one patient in each group.
The primary endpoint did not differ significantly between groups: 7.3% for
SynFlow 3.0 versus 10.6% for VA-ECMO (P = 0.393) in the mITT population,
and 7.4% versus 10.6% (P = 0.405) in the per-protocol population.
 Conclusion(s): The incidence of 30-day MAE was not significantly
different between VA-ECMO and SynFlow 3.0 support groups, although
numerically fewer events occurred with SynFlow 3.0. These findings suggest
that SynFlow 3.0 may be a safe and effective alternative for hemodynamic
support in HR-PCI. Categories: CORONARY: Complex and Higher Risk
Procedures for Indicated Patients (CHIP) Copyright © 2025

<59>
Accession Number
2040985579
Title
TCT-1188 Patients With Moderate-to-Severe Baseline MR Before TAVR Showed
Greater Pronounced Improvements in Specific Echocardiographic Parameters
Related to LV Function and Geometry After TAVR: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B507-B508), 2025. Date of Publication: 28 Oct 2025.
Author
Darouei B.; Amani-Beni R.; Rad M.R.; Dabaghi G.G.; Eshraghi R.; Bahrami
A.; Amini-Salehi E.; Hashemi S.M.; Mazaheri-Tehrani S.; Movahed M.R.
Institution
(Darouei) Isfahan Cardiovascular Research Center, Cardiovascular Research
Institute, Isfahan University of Medical Sciences, Isfahan, Isfahan, Iran,
Islamic Republic of
(Amani-Beni, Rad, Dabaghi) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Iran., Tehran,
Rasht, Iran, Islamic Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Bandar Abbas, Iran, Islamic Republic of
(Mazaheri-Tehrani) Child Growth and Development Research Center, Research
Institute for Primordial Prevention of Non-Communicable Disease, Isfahan
University of Medical Sciences, Isfahan, Isfahan, Iran, Islamic Republic
of
(Movahed) University of Arizona Sarver Heart Center, TUCSON, Arizona,
United States
Publisher
Elsevier Inc.
Abstract
Background: Mitral regurgitation (MR) commonly coexists with aortic
stenosis (AS) and is a potential risk factor influencing outcomes
following transcatheter aortic valve replacement (TAVR). This
meta-analysis aimed to evaluate the mean changes in key echocardiographic
parameters before and after TAVR and to compare these changes between
patients with moderate-to-severe MR (MR >=2) and those with none-to-mild
MR (MR <2). Method(s): A comprehensive literature search was
conducted using six electronic databases. We included studies that
evaluated patients undergoing TAVR, classified them based on baseline MR
grade >=2 (moderate/severe MR) or MR grade <2 (none/mild MR), and reported
the mean difference (MD) in echocardiographic parameters before and after
TAVR in both groups. The primary outcomes included changes in ejection
fraction (EF), LV end-diastolic volume (LVEDV) index, LV end-systolic
volume (LVESV) index, LV end-diastolic diameter (LVEDD), LV end-systolic
diameter (LVESD), aortic valve area (AVA), and the mean aortic gradient.
Pooled MDs were analyzed using a random-effects model. Result(s):
Thirteen studies with 7,163 patients were included, of which 2,376 had an
MR >=2. The MR <2 and MR >=2 groups experienced significant improvements
in AVA and reductions in mean aortic gradient, LVEDV index, LVESV index,
LVEDD, and LVESD. Compared to MR <2 patients, those with MR >=2 exhibited
significantly greater improvements in EF (MD = 2.03; 95% CI: 0.81, 3.24),
LVEDV index (MD = -5.55; 95% CI: -7.85, -3.26), LVESV index (MD = -5.43;
95% CI: -7.28, -3.58), LVESD (MD = -2.23; 95% CI: -3.71, -0.26), and mean
aortic gradient (MD = 1.43; 95% CI: 0.79, 2.07). However, the changes in
LVEDD and AVA were not significantly different between the groups.
 Conclusion(s): These findings suggest that patients with
moderate-to-severe baseline MR before TAVR showed greater pronounced
improvements in specific echocardiographic parameters related to LV
function and geometry, particularly in LVEF, LVEDV index, LVESV index, and
LVESD, compared to those with none-to-mild MR. Categories: STRUCTURAL:
Valvular Disease and Intervention: Aortic Copyright © 2025

<60>
Accession Number
2040983652
Title
TCT-678 Coronary Angiography, Intravascular Imaging, and Coronary
Physiology for Guiding of Coronary Revascularization: a Systematic Review
and Network Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B295), 2025. Date of Publication: 28 Oct 2025.
Author
Occhipinti G.; Laudani C.; Sanchez J.S.; Abdul-Jawad Altisent O.; Freixa
X.; Regueiro A.
Institution
(Occhipinti) Hospital Clinic De Barcelona, Barcelona, Spain
(Laudani) Policlinico Hospital, University of Catania, Catania, Catania,
Italy
(Sanchez) Hospital La Fe, Valencia (Spain), Valencia, Spain
(Abdul-Jawad Altisent) Germans Trias i Pujol University Hospital,
Badalona, Spain
(Freixa) Hospital Clinic, Barcelona, Spain
(Regueiro) Hospital Clinic Barcelona, Barcelona, Spain
Publisher
Elsevier Inc.
Abstract
Background: Guidance of percutaneous coronary intervention (PCI) has
traditionally relied on invasive coronary angiography (ICA), which offers
limited anatomical information and lacks functional assessment.
Intravascular imaging (IVI) and coronary physiology (CF) have emerged as
complementary strategies aimed at overcoming these limitations. The
comparative efficacy of these modalities in guiding coronary
revascularization remains uncertain. Method(s): A systematic review
and network meta-analysis of 53 randomized trials (42,258 patients, 83,797
patient-years) was conducted to evaluate ICA-, IVI-, and CF-guided
revascularization. Co-primary outcomes were major adverse cardiovascular
events (MACE) and target lesion revascularization (TLR). Secondary
outcomes included all-cause and cardiovascular death, myocardial
infarction (MI), ischemia-driven TLR, target vessel revascularization
(TVR), target vessel MI, stroke, and stent thrombosis. Frequentist
random-effects models were used. Treatment ranking was estimated using
surface under the cumulative ranking curve (SUCRA). Sensitivity and
meta-regression analyses were performed. Result(s): IVI- and
CF-guided strategies significantly reduced MACE versus ICA (incidence rate
ratio [IRR] 0.68, 95% CI 0.60-0.77; IRR 0.85, 95% CI 0.74-0.97,
respectively). IVI also reduced MACE compared to CF (IRR 0.80, 95% CI
0.68-0.95). IVI-guided PCI lowered cardiovascular death (IRR 0.57, 95% CI
0.44-0.74), MI (IRR 0.78, 95% CI 0.67-0.91), TLR, ID-TLR, TVR, and stent
thrombosis versus ICA, and reduced cardiovascular death versus CF.
CF-guided PCI reduced MI versus ICA (IRR 0.79, 95% CI 0.66-0.94) but not
TLR. Among single strategies, IVUS and OCT showed consistent benefit, with
IVUS ranked highest for MACE reduction. Results remained robust in
sensitivity and subgroup analyses, with low heterogeneity and no
inconsistency. Conclusion(s): Compared with ICA, both IVI- and
CF-guided revascularization improve clinical outcomes, with IVI offering
broader ischemic protection and superior procedural optimization. Future
integration of anatomical and physiological assessment may further enhance
precision in PCI. Categories: IMAGING AND PHYSIOLOGY: Invasive and
Non-Invasive Angiography Copyright © 2025

<61>
Accession Number
2040985538
Title
TCT-216 Outcomes based on the completeness of revascularization in
patients with three-vessel coronary artery disease: The FAME 3 Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B95-B96), 2025. Date of Publication: 28 Oct 2025.
Author
Otsuki H.; Takahashi K.; Kobayashi Y.; Zimmermann F.; Minten L.; Takahashi
T.; Yeung A.; Fearon W.
Institution
(Otsuki) Stanford University, California, Tokyo, Japan
(Takahashi) Stanford University, Stanford, California, United States
(Kobayashi) NewYork-Presbyterian/Weill Cornell Medical Center, Brooklyn,
New York, United States
(Zimmermann) Catharina Hospital Eindoven, Eindhoven, Netherlands
(Minten) UZ Leuven, Leuven, Belgium
(Takahashi) Jacobi Medical Center, Bronx, New York, United States
(Yeung) Stanford University School of Medicine, Stanford, California,
United States
(Fearon) Stanford Healtchare, Stanford, California, United States
Publisher
Elsevier Inc.
Abstract
Background: The impact of the completeness of revascularization after
fractional flow reserve (FFR)-guided percutaneous coronary intervention
(PCI) in patients with three-vessel coronary artery disease (3VD) amenable
to PCI or coronary artery bypass grafting (CABG) is unknown.
 Method(s): The FAME 3 trial is a multicenter, international,
randomized study comparing FFR-guided PCI with CABG in patients with
angiographic 3VD. Completeness of revascularization after PCI was
quantified using the residual functional SYNTAX score (rFSS), calculated
by subtracting FFR-negative deferred lesions from the residual anatomic
SYNTAX score. The primary endpoint of a composite of death, myocardial
infarction (MI), or stroke at 5 years was assessed according to the rFSS
(rFSS 0-8, rFSS>8) and compared with outcomes after CABG. Result(s):
Of the 757 patients randomized to FFR-guided PCI, the rFSS was analyzed by
the core laboratory in 84% (n=627). Of these, 63% had rFSS 0-8 and 37% had
rFSS >8. Compared with the CABG group, patients with rFSS 0-8 had a
similar risk of death, MI, or stroke at 5 years (13% vs. 14%, adjusted
Hazard ratio[HR]:0.91, 95% confidence interval[CI]:0.6-1.3, p=0.60),
whereas those with rFSS >8 had significantly worse outcomes (20% vs. 14%,
adjusted HR:1.48, 95%CI: 1.03-2.14, p=0.04) (Figure). [Formula presented]
 Conclusion(s): In the FAME 3 trial, 63% of patients achieved an rFSS
0-8 after FFR-guided PCI, with outcomes comparable to those seen with
CABG. Categories: IMAGING AND PHYSIOLOGY: Physiologic Lesion
Assessment Copyright © 2025

<62>
Accession Number
2040983699
Title
TCT-314 Post-Ligation Cardiac Syndrome Following Surgical vs.
Transcatheter PDA Closure in Preterm Infants: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B138-B139), 2025. Date of Publication: 28 Oct 2025.
Author
Lang C.; de Andrade Garcia A.; Algarin R.S.; Shehan T.M.; Enriquez S.T.
Institution
(Lang) Universidad Austral, Buenos Aires, Argentina
(de Andrade Garcia) Faculdade Sao Leopoldo Mandic, Sao Paulo, Sao Paulo,
Brazil
(Algarin) Universidad Simon Bolivar, Barranquilla, Colombia
(Shehan) Gulf 7 Pediatric Disaster Network, Texas, Texas, United States
(Enriquez) Hospital de especialidades Santa Margarita, Portoviejo, Ecuador
Publisher
Elsevier Inc.
Abstract
Background: Patent Ductus Arteriosus (PDA) is a common cardiovascular
condition in preterm infants. After failed medical management, surgical
ligation is typically performed. However, it carries a known risk of
Post-Ligation Cardiac Syndrome (PLCS), defined as the need for hemodynamic
and respiratory support within 24 hours of closure. Transcatheter closure
has emerged as a less invasive alternative; yet the incidence of PLCS
remains uncertain. We conducted a systematic review and meta-analysis to
compare the incidence of PLCS in preterm infants with hemodynamically
significant PDA undergoing surgical versus transcatheter closure.
 Method(s): PubMed, Cochrane, Embase and Scopus databases were
systematically searched for studies comparing surgical ligations and
transcatheter closure in premature infants with hemodynamically
significant PDA. Data from five retrospective studies were pooled for
meta-analysis. The primary outcomes were post-ligation cardiac syndrome
and all-cause mortality. Result(s): A total of 378 preterm infants
were included across five studies. Compared to those who underwent
surgical ligation, infants in the transcatheter closure group had a higher
mean gestational age (26.2 vs. 25.4 weeks) and birth weight (1172 g vs.
847 g). For the primary outcome, the pooled analysis showed no
statistically significant difference in PLCS incidence (RR 0.33; 95% CI
0.09-1.13; p= 0.08). [Formula presented] Conclusion(s): Our findings
suggest that transcatheter closure is associated with similar rates of
PLCS compared to surgical ligation, despite differences in baseline
characteristics. Further research is warranted to confirm these results.
Categories: STRUCTURAL: Congenital and Other Structural Heart
Disease Copyright © 2025

<63>
Accession Number
2041079702
Title
Evidence from a Bayesian reanalysis of the iPROVE-OLV study: is it time to
update our prior assumptions regarding neuromuscular block and reversal?.
Source
British Journal of Anaesthesia. 135(5) (pp 1391-1393), 2025. Date of
Publication: 01 Nov 2025.
Author
Colquhoun D.A.; Blobner M.
Institution
(Colquhoun) Department of Anesthesiology, University of Michigan Medical
School, Ann Arbor, NI, United States
(Blobner) Department of Anaesthesiology and Intensive Care Medicine,
Faculty of Medicine, University of Ulm, Ulm, Germany
Publisher
Elsevier Ltd
Abstract
In a Bayesian secondary analysis of a subset of 698 patients in the
iPROVE-OLV study, Mazzinari and colleagues report evidence of benefit for
the use of neuromuscular monitoring and reversal under a range of prior
assumptions (i.e. assumptions of probability of benefit or harm). This is
a secondary analysis of the iPROVE-OLV study, a 1308-patient RCT of
individualised PEEP and postoperative high-flow nasal cannula oxygen in
patients undergoing thoracic surgery. However, detailed information on
monitoring modalities and reversal agent dosage, which could impact
practice, were not available for analysis. Recent practice guidelines,
published by both European and American professional societies have
supported routine use of quantitative neuromuscular block and reversal.
Practice surveys and observational analyses that predate these guidelines
suggest that a significant gap between real world and
guideline-recommended practice exists. Copyright © 2025 British
Journal of Anaesthesia

<64>
Accession Number
2040985061
Title
TCT-133 Shockwave Balloon or Atherectomy with Rotablation in Calcified
Coronary Artery Lesions: Primary Results of the SONAR Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B61), 2025. Date of Publication: 28 Oct 2025.
Author
Bennett J.; Ameloot K.; Palmers P.-J.; Colletti G.; Ungureanu C.; de
Hemptinne Q.; Lesizza P.; Van Mieghem N.; Vandeloo B.; De Wilde W.;
Vanhaverbeke M.; Gach O.; Coussement P.; Castaldi G.; Minten L.;
Vanoverbeke L.; Dens J.
Institution
(Bennett, Vanoverbeke) University Hospitals Leuven, Leuven, Belgium
(Ameloot) Zonhoven, Zol, Belgium
(Palmers) CHC Liege, Hasselt, Belgium
(Colletti) Clinique St. Joseph, Arlon, Belgium
(Ungureanu) Jolimont, Jolimont, Belgium
(de Hemptinne) CHU Saint-Pierre, Brussels, Belgium
(Lesizza, Minten) UZ Leuven, Leuven, Belgium
(Van Mieghem) Erasmus University Medical Center, Rotterdam, Netherlands
(Vandeloo) Cardiovascular Center, Universitair Ziekenhuis Brussel (UZB),
Vrije Universiteit Brussel (VUB), Hasselt, Belgium
(De Wilde) Imelda Ziekenhuis Bonheiden, Bonheiden, Belgium
(Vanhaverbeke) AZ Delta, Roeselare, Belgium
(Gach) CHC Montlegia Liege, Liege, Belgium
(Coussement) BruggeBelgium
(Castaldi) ZOL Genk, Genk, Belgium
(Dens) Ziekenhuis Oost Limburg, Genk, Belgium
Publisher
Elsevier Inc.
Abstract
Background: Coronary calcification negatively effects the safety and
efficacy of percutaneous coronary intervention (PCI). In particular,
coronary artery calcification is associated with frequent peri-procedural
myocardial infarction (PPMI) which is associated with poorer clinical
outcomes. Method(s): The ShOckwave ballooN or Atherectomy with
Rotablation in calcified coronary artery lesions (SONAR) study is an
investigator-initiated, prospective, randomized, international,
multicenter trial (NCT05208749) comparing lesion preparation strategy with
either shockwave intravascular lithotripsy(IVL) or rotational
atherectomy(RA) before DES implantation. Using web-based randomization
platform, 170 patients with angiographic moderate to severe calcified
lesions, suitable for IVL and RA and crossable with a >=2.5 non-compliant
balloon, were randomized to IVLS or RA. High sensitivity Troponin T,
Creatine Kinase (CK) and CK-MB (creatine kinase myocardial band) were
measured prior to PCI and at 8,16 and 24 hours. The primary endpoint is
difference in rate of PPMI between treatment groups. Secondary endpoints
include rate of periprocedural microvascular dysfunction (PPMD),
periprocedural myocardial injury, technical and procedural success, 30-day
and 1-year major adverse clinical events, and descriptive study of IMR
measurements in calcified lesions. Result(s): Between February 2022
and July 2025, 170 patients were randomized to either IVLS (n=85) or RA
(n=85) in 12 centers in Belgium and the Netherlands. Patients were 73.9
+/- 9.0 years old, 81.7% presented with chronic coronary syndrome, 74.0%
of patients were male, 30.6% were diabetic and 43.9% had previous PCI
and/or CABG. The left main/proximal LAD was the target lesion in 24.6% of
cases, physiological evaluation was performed in 12.9% of cases, and
intracoronary imaging in 21% of cases. Data analysis is underway, and the
primary endpoint will be available for first-time presentation.
 Conclusion(s): The SONAR trial is the first randomized trial
comparing the incidence of PPMI between 2 contemporary calcium
modification strategies in patients with calcified coronary lesions.
Furthermore, for the first time, the incidence of PPMD after Shockwave IVL
and RA will be evaluated. Categories: CORONARY: Coronary Atherectomy,
Plaque Modification, Lithotripsy, Thrombectomy, Cutting/Scoring
Balloons Copyright © 2025

<65>
Accession Number
2040984198
Title
TCT-30 Comparative Meta-Analysis of LVOTO Prevention Techniques in TMVR: A
Subgroup Evaluation of Hemodynamic and Clinical Outcomes.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B18), 2025. Date of Publication: 28 Oct 2025.
Author
Algzhawi Y.; Matar H.; Hammad O.; Aletaywi A.
Institution
(Algzhawi) Jordan University of Science and Technology, Irbid, Jordan
(Matar) Faculty of Medicine, Jordan University of Science and Technology,
Irbid, Jordan
(Hammad, Aletaywi) Jordan University of Science and Technology, Amman,
Jordan
Publisher
Elsevier Inc.
Abstract
Background: Left ventricular outflow tract obstruction (LVOTO) remains a
key challenge in transcatheter mitral valve replacement (TMVR). Multiple
anatomical strategies have been proposed, yet their comparative
effectiveness remains unclear. The aim of this meta-analysis is to assess
the effectiveness and safety of anatomical LVOTO prevention techniques
prior to TMVR. Method(s): Data from 19 studies (n = 263) were
analyzed. Median-reported values were converted to mean +/- SD using
Hozo/Wan methods. Outcomes were pooled via random-effects meta-analysis by
technique: alcohol septal ablation (ASA), Laceration of the Anterior
Mitral leaflet to Prevent Outflow Obstruction (LAMPOON), Bioprosthetic or
Native Aortic Scallop Intentional Laceration (BATMAN), Mitral chordal
laceration (MitraCut), and the DETROIT technique. Result(s): Peak
Gradient (n = 168): ASA (n = 82) and LAMPOON (n = 86) showed significant
post-TMVR increases (SMD = 1.35 [0.08-2.62], I2 = 93.4%; and
1.11 [0.54-1.68], I2 = 63.4%, respectively). ASA had greater
heterogeneity but consistent effect direction. Neo-LVOT (n = 79): ASA
significantly expanded neo-LVOT area (SMD = 1.84 [0.85-2.83],
I2 = 77.9%). Comparison with other techniques was limited by
data. Mean Gradient (n = 148): LAMPOON (SMD = 1.09 [0.49-1.68],
I2 = 58.1%) and BATMAN (2.37 [0.28-4.46]) showed consistent
increases. ASA (SMD = 0.81 [-0.95-2.58], I2 = 96.0%) was
non-significant with high variability. 1-Year Mortality: ASA (n = 133) =
8%, LAMPOON (n = 119) = 11%, BATMAN (n = 7) = 24%. ASA and LAMPOON had
moderate heterogeneity; sample sizes for BATMAN and MitraCut were limited.
LVOTO Prevention: LAMPOON (n = 120): 91% success (95% CI: 79-97%,
I2 = 36.3%); BATMAN (n = 8): 83% (50-96%, I2 = 0%);
ASA (n = 88): 84% (32-98%, I2 = 83.8%). Sensitivity analysis
(excluding Wang et al.) raised ASA to 94% (87-97%) with no heterogeneity
(I2 = 0%). Conclusion(s): LAMPOON demonstrates consistent
efficacy. ASA, after outlier exclusion, shows robustness. BATMAN appears
promising but lacks sufficient data. DETROIT and MitraCut remain
inconclusive. Despite these findings, limited sample sizes highlight the
need for larger, well-designed studies to develop a standardized protocol
for LVOTO prevention in TMVR. Categories: STRUCTURAL: Valvular Disease and
Intervention: Mitral Copyright © 2025

<66>
Accession Number
2040605286
Title
Efficacy and safety of tranexamic acid in cardiac surgery: a systematic
review and network meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 503. Date
of Publication: 01 Dec 2025.
Author
Pan X.; Tang M.; Xu Z.; Yu H.; Huang J.; Liang P.
Institution
(Pan, Xu, Yu, Liang) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Tang) West China School of Medicine, Sichuan University, Chengdu, China
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
(Liang) Day Surgery Center, General Practice Medical Center, West China
Hospital, Sichuan University, No.37 Guoxue, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Tranexamic acid (TXA) is recommended for reducing blood loss
and transfusion in cardiac surgery. However, there are concerns regarding
the safety profile of TXA, especially its proconvulsant effects. We
conducted this study to investigate the efficacy and safety of tranexamic
acid in cardiac surgery. Method(s): We searched PubMed, Embase and
Cochrane Central Register of Controlled Trials from inception to December
11, 2024. Randomised controlled trials assessed the hemostatic effects of
TXA in cardiac surgery were included. Two authors independently selected
studies and assessed the quality of eligible trials. The main endpoints
were red blood cell transfusion and thrombotic outcomes. The results were
calculated with pairwise and network meta-analysis. Result(s): Data
was provided by 18,141 participants from 64 trials. High-dose continuous
(OR: 0.38, 95%CI: [0.31, 0.47]), low-dose continuous (OR: 0.44, 95%CI:
[0.34, 0.56]), high-dose single (OR: 0.50, 95%CI: [0.43, 0.57]), and
low-dose single (OR: 0.52, 95%CI: [0.40, 0.67]) TXA significantly reduce
the rate of red blood cell transfusion. Furthermore, in high-risk
patients, high-dose continuous administration further reduces transfusion
risk compared to low-dose continuous administration (OR: 1.22, 95%CI:
[1.01, 1.75]). Topical TXA does not significantly reduce the rate of red
blood cell transfusion (OR: 0.80, 95%CI: [0.60, 1.07]); conversely, it is
associated with a higher rate of red blood cell transfusion compared to
intravenous administration. Both intravenous and topical TXA
administration reduce postoperative blood loss. High-dose continuous
administration further reduces the risk of reoperation (OR: 1.70, 95%CI:
[1.03, 2.80]) and the need for fresh frozen plasma transfusion (OR: 1.33,
95%CI: [1.01, 1.74]) compared to low-dose continuous administration.
Neither intravenous nor topical TXA increases the incidence of
postoperative thrombotic complications. High-dose single administration is
associated with a significantly increased risk of postoperative seizures
(OR: 6.66, 95%CI: [1.85, 24.02]). Conclusion(s): This meta-analysis
further confirms that intravenous TXA administration, regardless of dose
or administration regimen, significantly reduces postoperative blood loss
and red blood cell transfusions in adult cardiac surgery, without
increasing the incidence of serious adverse events except for seizures.
Future studies should incorporate patient-specific factors, comorbidities,
and bleeding risks to determine the optimal TXA dosing strategy that
balances risks and benefits. Trial registration: Our prespecified protocol
was registered with PROSPERO (CRD42022380404). Copyright © The
Author(s) 2025.

<67>
Accession Number
2040985314
Title
TCT-758 Lp(a) and Oxidized Phospholipids as Predictors of Bioprosthetic
Valve Dysfunction Following Transcatheter Aortic Valve Implantation.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B330-B331), 2025. Date of Publication: 28 Oct 2025.
Author
Giuliani C.; Zanuttini A.; Avvedimento M.; Nuche J.; Pasos J.F.; Tastet
L.; Beaudoin J.; Cote N.; Beaupre F.; Poulin A.; Paradis J.-M.; Clavel
M.-A.; Arsenault B.; Capoulade R.; Rodes-Cabau J.; Tsimikas S.; Pibarot P.
Institution
(Giuliani, Zanuttini, Beaupre) Institut Universitaire De Cardiologie Et De
Pneumologie De Quebec (IUCPQ), Quebec, Quebec, Canada
(Avvedimento) Institut Universitaire De Cardiologie Et De Pneumologie De
Quebec, Canada, Quebec, Quebec, Canada
(Nuche) Hospital Universitario 12 De Octubre, Madrid, Spain
(Pasos) ABC Medical Center, Federal District, Mexico City, Mexico
(Tastet) University of California San Francisco, Quebec, Quebec, Canada
(Beaudoin) Quebec Heart & Lung Insitute, Quebec, Quebec, Canada
(Cote) IUCPQ, Quebec, Quebec, Canada
(Poulin, Paradis, Rodes-Cabau, Pibarot) Quebec Heart and Lung Institute,
Quebec, Quebec, Canada
(Clavel) Institut Universitaire de Cardiologie et de Pneumologie de Quebec
(IUCPQ), Quebec, Quebec, Canada
(Arsenault) Institut universitaire de cardiologie et de pneumologie de
Quebec (IUCPQ), Quebec, Quebec, Canada
(Capoulade) Nantes University, Nantes University Hospital, Nantes, France
(Tsimikas) University of California San Diego, San Diego, California,
United States
Publisher
Elsevier Inc.
Abstract
Background: Lp(a) and OxPL are involved in the initiation and progression
of aortic stenosis (AS). Their association with VARC-3 criteria for
bioprosthetic valve dysfunction (BVD) after 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.
 Method(s): This analysis included 210 patients with severe AS treated
with TAVI between 2017 and 2020, enrolled at IUCPQ 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. Result(s): 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 (15 [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. Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<68>
Accession Number
2040984006
Title
TCT-301 Long-Term Outcomes after Deferred Coronary Artery Bypass Grafting.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B134), 2025. Date of Publication: 28 Oct 2025.
Author
Troan J.; Thuesen A.L.; Christiansen E.; Eftekhari A.; Havndrup O.; Modrau
I.; Riber L.; Andreasen J.; Jensen S.E.; Siig J.; Isse Y.; Junker A.;
Mortensen P.E.; Jensen L.
Institution
(Troan, Jensen) Department of Cardiology, Odense University Hospital,
Odense, Denmark
(Thuesen) Odense University Hospital, Odense C, Denmark
(Christiansen) Aarhus University Hospital, Aarhus, Skejby, Denmark
(Eftekhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Havndrup) Roskilde Sygehus, Roskilde, Denmark
(Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus
University Hospital, Aarhus, Denmark
(Riber) Odense, Ouh, Denmark
(Andreasen) Department of Cardiothoracic Surgery, Aalborg University
Hospital, Aalborg, Denmark
(Jensen) Aalborg University Hospital, Aalborg, Denmark
(Siig) Department of Cardiology, Aalborg University Hospital, Aalborg,
Denmark
(Isse) Department of Cardiology, Zealand University Hospital, Roskilde,
Denmark
(Junker, Mortensen) Odense University Hospital, Odense, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Fractional flow reserve (FFR)-guided coronary artery bypass
grafting (CABG) reduces the need for grafts and may improve graft patency
in patients undergoing CABG. However, in the "Fractional Flow Reserve
Versus Angiography Randomization for Graft Optimization" (FARGO) trial,
FFR was reduced significantly after 6 months in deferred lesions. The aim
of this study was to investigate the long-term outcomes after FFR-guided
CABG compared to angiography-guided CABG. Method(s): In this
multicenter randomized clinical trial, 100 patients were randomized to
FFR-guided or angiography-guided CABG. Patients underwent follow-up
coronary angiography after six months, and FFR of deferred vessels.
Long-term clinical follow-up was performed in all patients for
revascularization, myocardial infarction (MI), stroke and death.
 Result(s): FFR of deferred vessel was significantly reduced from
baseline to 6 months follow-up 0.88 (IQR 0.84, 0.94) vs. 0.83 (IQR 0.78,
0.89), p=0.01. After a median follow-up of 8.8 years (IQR 8.3, 9.3),
patients in the FFR-guided group had numerically, but not statistically
significant, more long-term revascularization compared to the
angiography-guided group, 24% vs. 12%, log-rank test p=0.10. In the
FFR-guided group, 12 (24%) patients had revascularization of which 5 (10%)
were of a deferred vessel, and in the angiography-guided group, 6 (12%)
patients had revascularization. Among the 24 deferred lesions, 4 (17%)
were revascularized within the first year. Revascularization was
numerically higher 0-1 year in the FFR-guided group (9 [18%] vs. 3 [6%],
log-rank test p=0.06), whereas from 1 year to end of follow-up the rates
were similar (3 [6%] vs. 3 [6%], log-rank test p=0.85). Among the
FFR-guided group vs. the angiography-guided group MI (6 [12%]) vs. (3
[6%]), log-rank test p=0.26, death (10 [20%] vs. (7 [14%], log-rank test
p=0.36 (in both groups 3 of the deaths were cardiac) and stroke (6 [12%])
vs. (6 [12%]), log-rank test=0.93) did not differ significantly.
 Conclusion(s): Long-term revascularization did not differ among
FFR-guided compared to angiography-guided CABG despite a mid term FFR
reduction in lesions with FFR deferred grafting. Categories: CORONARY:
Cardiac and Coronary Artery Surgery and Hybrid
Revascularization Copyright © 2025

<69>
Accession Number
2040983798
Title
TCT-713 Outcomes of Left Atrial Appendage Occlusion vs. Direct Oral
Anticoagulants in Atrial Fibrillation: A Systematic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B311-B312), 2025. Date of Publication: 28 Oct 2025.
Author
Rashwan R.; Mohamed A.; Kholeif Z.; Elnashar M.; Tahhan I.S.; Elnady M.;
Khalafallah M.; Ghonima M.; Afify R.; Elkasaby H.; Mustafa A.; Barsoom R.;
Elalfy A.; Goldsweig A.
Institution
(Rashwan) Lincoln Medical Center, Bronx, New York, United States
(Mohamed, Ghonima, Afify) Faculty of Medicine, Tanta University, Tanta,
Egypt, Egypt
(Kholeif) Baptist Hospital of South East Texas, Beaumont, Texas, United
States
(Elnashar) University of Arkansas for Medical Sciences, Little Rock,
Arkansas, United States
(Tahhan) Wellington Regional Medical Center, Palm Beach, Florida, United
States
(Elnady) Faculty of Medicine, Kafr Elsheikh University, Lombard, Egypt
(Khalafallah) Alexandria University, Alexandria, Egypt
(Elkasaby) Faculty of Medicine, Newgiza University, Giza, Tanta, Egypt
(Mustafa) University of Arkansas For Medical Sciences, Little Rock,
Arkansas, United States
(Barsoom, Elalfy) Mayo Clinic, Jacksonville, Florida, United States
(Goldsweig) Baystate Medical Center, Springfield, Massachusetts, United
States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage occlusion (LAAO) is indicated for stroke
risk reduction in patients with atrial fibrillation (AF) and a reason to
seek an alternative to oral anticoagulation. Initial studies compared LAAO
to warfarin. Direct oral anticoagulants (DOACs) have become the standard
of care for AF, but comprehensive data comparing LAAO vs. DOACs are
lacking. Method(s): A systematic search was conducted to identify
studies comparing LAAO vs. DOACs. Outcomes assessed included ischemic
stroke + transient ischemic attack (TIA), systemic embolism, major
bleeding, hemorrhagic stroke, cardiovascular mortality, and all-cause
mortality. Random-effects models were used to estimate risk ratios (RRs)
with corresponding confidence intervals (CIs). Result(s): Eleven
studies, comprising a total of 18,203 patients, met the inclusion
criteria. Compared to DOACs, LAAO was associated with a statistically
significant reduction in ischemic stroke/TIA (RR 0.85, 95% CI 0.78-0.93)
and systemic embolism (RR 0.65, 95% CI 0.49-0.86). No statistically
significant differences were observed in rates of major bleeding,
hemorrhagic stroke, cardiovascular mortality, or all-cause mortality (p=
0.33, 0.13, 0.60, 0.08, respectively). [Formula presented]
 Conclusion(s): This meta-analysis found that LAAO reduced the risk of
ischemic stroke/TIA and systemic embolism compared to DOACs, with no
significant differences in major bleeding, hemorrhagic stroke,
cardiovascular mortality, or all-cause mortality. Thus, LAAO may be
favored over DOACs in patients with AF and a reason to seek an alternative
to oral anticoagulation. Categories: STRUCTURAL: Left Atrial Appendage
Exclusion Copyright © 2025

<70>
Accession Number
2040605979
Title
Bibliometric analysis reveals global thymoma research trends
collaborations and emerging frontiers from 2010 to 2024.
Source
Discover Oncology. 16(1) (no pagination), 2025. Article Number: 1867. Date
of Publication: 01 Dec 2025.
Author
Yu Z.; Li Y.-H.; Han Q.; Wang X.-P.; Yu X.-T.; Cui J.; Gao X.; Yang X.-G.;
Yu L.
Institution
(Yu, Yu, Cui, Gao, Yang, Yu) Department of Thoracic Surgery, Beijing
Tongren Hospital, Capital Medical University, No.2 Xihuan Road, Daxing
District, Beijing, China
(Li, Han, Wang) The Fourth Clinical School of Capital Medical University,
Beijing, China
Publisher
Springer Science and Business Media B.V.
Abstract
Objective: To map global thymoma research trends (2010-2024) through
bibliometric analysis. Method(s): Analysis of 2,078 publications from
Web of Science/PubMed using Bibliometrix, VOSviewer, and CiteSpace.
Metrics included productivity (countries/institutions/authors), thematic
evolution, collaboration networks, and citation impact. Result(s):
The analysis reveals a steady increase (6.2% CAGR) in the volume of
thymoma-related publications over the past decade. Key journals included
Journal of Thoracic Oncology and Annals of Thoracic Surgery. Prolific
authors like Marx Alexander (25 publications) and institutions such as
Fudan University (67 publications) dominated the field. Keyword analysis
revealed sustained focus on "myasthenia gravis," "surgery," and
"thymectomy," with emerging interest in "immunotherapy" and "molecular
biology." High-impact articles addressed autoimmune associations and novel
therapies (e.g., sunitinib). Global collaboration networks highlighted
strong partnerships among the U.S., Europe, and Asia, though logistical
and policy barriers may have limited China's broader international
engagement. Conclusion(s): Thymoma research has evolved toward
molecular and therapeutic innovation, emphasizing immunotherapy and
precision medicine. Despite growth, geographical disparities and
understudied areas (e.g., long-term outcomes) persist. Future efforts
should prioritize multidisciplinary collaboration, biomarker discovery,
and multicenter trials to optimize clinical strategies. Copyright
© The Author(s) 2025.

<71>
Accession Number
2040984160
Title
TCT-1101 Transcatheter Versus Surgical Aortic Valve Replacement in Heart
Failure with Reduced Ejection Fraction: A Meta-Analysis of Randomized and
Propensity-Score Studies.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B470), 2025. Date of Publication: 28 Oct 2025.
Author
Emara A.; Gadelmawla A.F.; Emara M.; Shubietah A.; Elgendy M.; Ali M.;
Megaly M.
Institution
(Emara) Faculty of Medicine, Al-Azhar University, Cairo, Cairo, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt.,
Menoufia, Egypt
(Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shubietah) Advocate Illinois Masonic Medical Center, Chicago, Illinois,
United States
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Ali) Health Education Services/ Crestwood Medical Center, Huntsville,
Alabama, United States
(Megaly) Ascension St John Medical Center-Tulsa, Tulsa, Oklahoma, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) and surgical
aortic valve replacement (SAVR) are both viable options for patients with
aortic stenosis (AS) and heart failure with reduced ejection fraction
(HFrEF) (EF <=50%). However, the optimal approach in this high-risk
population remains unclear. Method(s): PubMed, Scopus, Web of
Science, and Cochrane Central were searched up to May 2025 for studies
comparing TAVR versus SAVR in patients with AS and HFrEF. The primary
outcomes were short-term and long-term all-cause mortality. A
random-effects model was used to calculate risk ratios (RR) and mean
differences (MD) with 95% confidence intervals (CI). Result(s): One
randomized controlled trial and three propensity-score matched studies
including 1,947 patients (980 TAVR, 967 SAVR) were included. TAVR was
associated with significantly lower short-term mortality compared to SAVR
(4.38% vs 8.79%; RR 0.52; 95% CI 0.36-0.75; P < 0.05). However, TAVR
showed higher rates of major vascular complications (RR 7.14; 95% CI
2.7-18.88), PPI (RR 2.45; 95% CI 1.44-4.18), and mild Aortic
regurgitations (AR) (RR 2.23; 95% CI 1.59-3.39). No significant
differences were found in long-term mortality, stroke, MI, moderate to
severe AR, or ICU stay. TAVR was associated with a significantly shorter
hospital stay (MD -5.06 days; 95% CI -8.30 to -1.82). [Formula presented]
 Conclusion(s): TAVR in AS patients with HFrEF was associated with
lower short-term mortality and shorter hospital stay than SAVR, but with
higher risks of vascular complications, pacemaker implantation, and mild
AR. TAVR may be a favorable option with individualized risk assessment.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<72>
Accession Number
2041078176
Title
Disparities while listing for orthotopic heart transplantation: A
systematic review and meta-analysis.
Source
Transplantation Reviews. 39(4) (no pagination), 2025. Article Number:
100968. Date of Publication: 01 Dec 2025.
Author
Phutinart S.; Thamthanaruk A.; Siranart N.; Chuanchai W.; Sowalertrat W.;
Chumpangern Y.; Pajareya P.
Institution
(Phutinart, Thamthanaruk, Chuanchai, Pajareya) Faculty of Medicine, King
Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok,
Thailand
(Siranart) Department of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, MN, United States
(Sowalertrat) Department of Radiology, Prince of Songkhla University,
Bangkok, Thailand
(Chumpangern) Faculty of Medicine, Siriraj Hospital, Mahidol University,
Bangkok, Thailand
Publisher
Elsevier Inc.
Abstract
Background: Disparities in orthotopic heart transplant (OHT) listing exist
due to race, gender, insurance access, socioeconomic status (SES) and
access to healthcare. This study aims to investigate the impact of these
factors on the inequities encountered within the pre-transplantation
process. Method(s): Literature search was conducted up to July 2024,
focusing on disparities in organ transplant outcomes. The primary endpoint
was the recipient acceptance rate. Secondary endpoints were donor
acceptance, waitlist urgency (status 1, 1A, or 1A exception), waitlist
mortality (death while on the list), and waitlist duration (time from
listing to transplantation). Result(s): A total of 40 studies
involving 506,459 patients at listing for OHT were included. Disparities
in education level, gender, and insurance were not associated with
recipient acceptance rate. However, black patients have a significantly
lower recipient acceptance rate compared to the white patients (HR 0.86,
95 % CI: 0.84-0.89, I2 = 15.8 %). For waitlist urgency, black
patients were more likely to be listed for status 1 (OR 1.24, 95 % CI:
1.11-1.39, I2 = 85.2 %). For waitlist mortality, there was no
significant association with race, gender, insurance, income and education
level, but the introduction of the 2018 policy led to a significantly
lower waitlist mortality (HR 0.61, 95 % CI: 0.52-0.72, I2 = 0.0
%). Conclusion(s): Race remains a primary determinant of inequity in
transplant access. Addressing racial disparity is crucial for achieving
equitable access to care for all patients with end-stage heart
disease. Copyright © 2025 The Authors

<73>
Accession Number
2040984128
Title
TCT-321 Cerebral Embolic Protection Devices in Transcatheter Aortic Valve
Replacement: A Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B142), 2025. Date of Publication: 28 Oct 2025.
Author
Emara A.; Ali M.; Azim A.A.; Diaa A.; Emara M.; Shubietah A.; Ellebedy M.;
Elgendy M.; Megaly M.
Institution
(Emara) Faculty of Medicine, Al-Azhar University, Cairo, Cairo, Egypt
(Ali) Health Education Services/ Crestwood Medical Center, Huntsville,
Alabama, United States
(Azim) Faculty of Medicine, Assiut University, Assiut, Assiut, Egypt
(Diaa, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shubietah) Advocate Illinois Masonic Medical Center, Chicago, Illinois,
United States
(Ellebedy) Faculty of Medicine, Sohag University, Elbalyana, Egypt
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Megaly) Ascension St John Medical Center-Tulsa, Tulsa, Oklahoma, United
States
Publisher
Elsevier Inc.
Abstract
Background: Stroke is a major complication following TAVR. Cerebral
embolic protection devices (CEPDs) are designed to reduce embolic events,
but their clinical benefit remains uncertain. Our objective was to
evaluate the impact of cerebral embolic protection devices (CEPDs) on
stroke and related outcomes in patients undergoing transcatheter aortic
valve replacement (TAVR) through a meta-analysis of randomized controlled
trials (RCTs). Method(s): A systematic search of PubMed, Scopus,
Cochrane Central, and Web of Science was conducted up to June 2025. RCTs
comparing TAVR with and without CEPDs were included. The primary outcome
was overall stroke at 2-5 days and 30 days. Data were pooled using a
random-effects model, and results were reported as risk ratios (RRs) with
95% confidence intervals (CIs). Result(s): Eight RCTs with 11,623
patients were included. CEPDs significantly reduced disabling stroke at
2-5 days (RR 0.47, 95% CI 0.22-0.99; p = 0.05), but had no significant
effect on overall stroke at 2-5 or 30 days. CEPDs also did not reduce
disabling stroke at 30 days, non-disabling stroke at 2-5 or 30 days,
life-threatening or disabling bleeding, all-cause mortality at 2-5, 30, or
90 days, or major vascular complications (all p > 0.05). [Formula
presented] Conclusion(s): CEPDs may modestly reduce disabling stroke
risk in the immediate post-TAVR period (2-5 days) but do not significantly
impact overall stroke, mortality, or bleeding. Further large-scale trials
are warranted to confirm the clinical benefit and cost-effectiveness of
routine CEPD use. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<74>
Accession Number
2040983411
Title
TCT-1119 Direct Comparison of Early Survival Following Urgent
Transcatheter Aortic Valve Implantation Versus Balloon Aortic
Valvuloplasty: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B478), 2025. Date of Publication: 28 Oct 2025.
Author
Dimitriadis K.; Pyrpyris N.; Dri E.; Antonopoulos A.; Aznaouridis K.;
Aggeli K.; Tsioufis C.
Institution
(Dimitriadis) Hippokration Hospital, Athens, Athens, Greece
(Pyrpyris) University of Athens, Athens, Greece
(Dri) G.H.A Hippokration, Athens, Greece
(Antonopoulos) First Cardiology Department, School of Medicine,
Hippokration General Hospital, National and Kapodistrian University of
Athens, Vas. Sofias 114, 11528, Athens, Athens, Greece
(Aznaouridis) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration General Hospital,
Athens, Athens, Greece
(Aggeli) 1st Cardiology dpt, University of Athens, Hippokrateion Hospital,
Athens, Greece
(Tsioufis) First Department of Cardiology, School of Medicine, National
and Kapodistrian University of Athens, Hippokration General Hospital,
Athens, Greece, Athens, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve implantation (TAVI) is increasingly
performed in the urgent setting for patients presenting with aortic
stenosis (AS) and related cardiogenic shock or acute decompensated heart
failure (HF), in order to acutely improve patient hemodynamics and enhance
patient outcomes. Despite TAVI is most frequently preferred over
transcatheter balloon aortic valvuloplasty (BAV), there are limited
studies directly comparing the safety and efficacy of the two
interventions. Therefore, the aim of this systematic review and
meta-analysis is to compare urgent TAVI and BAV in regard to early
post-interventional mortality. Method(s): We performed a systematic
search in 3 different databases (MEDLINE/PubMed, Web of Science and
Scopus). After selecting all appropriate studies according to the
Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines, a random effect meta-analysis was performed.
 Result(s): A total of 6 studies and 21,020 individuals were included
in the analysis (TAVI: 10,597; BAV: 10,423). The most common indication
for urgent TAVI or BAV was cardiogenic shock, followed by acute
decompensated HF. In regards to in-hospital mortality, TAVI was associated
with significantly reduced mortality compared to BAV [Risk Ratio(RR):
0.53; 95% Confidence Interval (95%CI): 0.39-0.71], while a trend towards
reduced mortality with TAVI was also noted in 30 days, despite remaining
borderline non-significant (RR: 0.53; 95%CI: 0.26-1.05).
 Conclusion(s): This systematic review and meta-analysis shows that,
in the setting of urgent interventions for AS, TAVI is associated with
improved survival compared to BAV, especially in short-term follow-up
after the procedure. Considering the limited number of studies, the
observational nature of the included data and the absence of reporting of
other major adverse events or procedural complications, more research,
directly comparing TAVI with BAV, is needed in order to investigate the
benefit of urgent interventions. Categories: STRUCTURAL: Valvular Disease
and Intervention: Aortic Copyright © 2025

<75>
Accession Number
2040488880
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: 2025.
Author
Elezbawy B.; Abaza N.; Fasseeh M.; Elshahawy R.; S. Mahmoud 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, S. Mahmoud, 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
Publisher
Taylor and Francis Ltd.
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. Copyright © 2025 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<76>
Accession Number
2041001750
Title
Left atrial appendage occlusion plus oral anticoagulation in stroke
patients despite ongoing anticoagulation: rationale and design of the
ADD-LAAO clinical trial.
Source
REC: Interventional Cardiology. 7(3) (pp 140-145), 2025. Date of
Publication: 01 Jul 2025.
Author
Amaro S.; Cruz-Gonzalez I.; Estevez-Loureiro R.; Millan X.; Nombela-Franco
L.; Gomez-Hospital J.; Flores-Umanzor E.; Lopez-Mesonero L.; Macineiras
J.; Prats-Sanchez L.; Simal P.; Cardona P.; Teruel L.; Cepas-Guillen P.;
Arzamendi D.; Freixa X.
Institution
(Amaro) Departamento de Neurologia, Hospital Clinic de Barcelona,
Barcelona, Spain
(Cruz-Gonzalez) Departamento de Cardiologia, Hospital Universitario de
Salamanca, Salamanca, Spain
(Estevez-Loureiro) Departamento de Cardiologia, Hospital Universitario
Alvaro Cunqueiro, Pontevedra, Vigo, Spain
(Millan, Arzamendi) Departamento de Cardiologia, Hospital de la Santa Creu
i Sant Pau, Barcelona, Spain
(Nombela-Franco) Departamento de Cardiologia, Hospital Clinico San Carlos,
Madrid, Spain
(Gomez-Hospital, Teruel) Departamento de Cardiologia, Hospital
Universitari de Bellvitge, Barcelona, Spain
(Flores-Umanzor, Cepas-Guillen, Freixa) Departamento de Cardiologia,
Hospital Clinic de Barcelona, Barcelona, Spain
(Lopez-Mesonero) Departamento de Neurologia, Hospital Universitario de
Salamanca, Salamanca, Spain
(Macineiras) Departamento de Neurologia, Hospital Universitario Alvaro
Cunqueiro, Vigo, Spain
(Prats-Sanchez) Departamento de Neurologia, Hospital de la Santa Creu i
Sant Pau, Barcelona, Spain
(Simal) Departamento de Neurologia, Hospital Clinico San Carlos, Madrid,
Spain
(Cardona) Departamento de Neurologia, Hospital Universitari de Bellvitge,
Barcelona, Spain
Publisher
Sociedad Espanola de Cardiologia
Abstract
Introduction and objectives: The prevalence of atrial fibrillation and the
number of patients experiencing ischemic strokes despite oral
anticoagulation (OAC) are both on the rise, which presents a significant
challenge due to the absence of clear and uniform treatment
recommendations for these patients. To date, there is no formal
combination merging into a high anticoagulant efficacy profile while
keeping a low bleeding risk. Transcatheter left atrial appendage occlusion
(LAAO) in combination with OAC might provide a balance between safety and
efficacy. The objective of this study is to evaluate whether, in ischemic
stroke patients, despite anticoagulation, the combination of LAAO plus
long-term anticoagulation-direct oral anticoagulants or vitamin K
antagonist when indicated-is associated with a lower rate of recurrent
cardioembolic events at 12 months vs the optimal medical therapy
recommended by the neurologist. Method(s): A total of 380 patients
with ischemic stroke despite OAC will be included. Patients will be
randomized on a 1:1 ratio to receive the optimal medical therapy (control)
or the combination of LAAO plus OAC or OAC. The primary endpoint of the
study will be the occurrence of a cardioembolic event-ischemic stroke or
arterial peripheral embolism-within the first 12 months after inclusion.
 Conclusion(s): This study is one of the first randomized clinical
trials to compare the LAAO plus OAC combination and optimal medical
therapy in patients who have experienced ischemic strokes despite being on
OAC. If results confirm the superiority of LAAO plus OAC, it could lead to
a paradigm shift in treatment guidelines for these patients. Copyright
© 2025 Sociedad Espanola de Cardiologia. Publicado por Permanyer
Publications. Este es un articulo open access bajo la licencia CC BY-NC-ND
4.0.

<77>
Accession Number
2040534007
Title
Association between pre-operative sodium-glucose cotransporter-2 inhibitor
use and postoperative outcomes: a propensity score-matched analysis of the
TriNetX database.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
Wu H.-L.; Chen J.-T.; Cata J.P.; Hsieh C.-H.; Cherng Y.-G.; Tai Y.-H.
Institution
(Wu) School of Medicine, National Yang Ming Chiao Tung University, Taipei,
Taiwan (Republic of China)
(Wu) Department of Anaesthesiology, Taipei Veterans General Hospital,
Taipei, Taiwan (Republic of China)
(Chen, Cherng, Tai) Department of Anaesthesiology, School of Medicine,
College of Medicine, Taipei Medical University, Taipei, Taiwan (Republic
of China)
(Chen, Cherng, Tai) Department of Anaesthesiology, Shuang Ho Hospital,
Taipei Medical University, New Taipei City, Taiwan (Republic of China)
(Cata) Department of Anaesthesiology and Perioperative Medicine, The
University of Texas MD Anderson Cancer Center, Houston, TX, United States
(Hsieh) Division of Endocrinology and Metabolism, Department of Internal
Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan (Republic of
China)
Publisher
John Wiley and Sons Inc
Abstract
Introduction: While sodium-glucose cotransporter-2 inhibitors offer
cardiovascular and renal benefits, their peri-operative safety and effect
profile remain unclear. This study aimed to evaluate the association
between pre-operative sodium-glucose cotransporter-2 inhibitor use and
postoperative adverse events in patients with type 2 diabetes mellitus.
 Method(s): This nationwide propensity-score matched cohort study
utilised the TriNetX database to analyse data from patients with type 2
diabetes mellitus who underwent surgery in the USA. Patients were
categorised based on whether they had received a prescription for
sodium-glucose cotransporter-2 inhibitors 90 days before surgery. The
primary outcome was 30-day all-cause mortality. Secondary outcomes
included the incidence of major adverse cardiovascular events; acute
kidney injury; and diabetic ketoacidosis. Result(s): In 98,118
matched pairs, 30-day all-cause mortality was significantly lower in
patients in the sodium-glucose cotransporter-2 inhibitor group compared
with those in the control group (RR 0.61, 95%CI 0.55-0.67, p < 0.001).
Patients receiving sodium-glucose cotransporter-2 inhibitor treatment also
showed lower risks of major adverse cardiovascular events (RR 0.89, 95%CI
0.86-0.91); acute kidney injury (RR 0.71, 95%CI 0.69-0.74); and diabetic
ketoacidosis (RR 0.31, 95%CI 0.18-0.540) (p < 0.001 for all comparisons).
Subgroup analyses revealed a more pronounced reduction in mortality among
females, patients living with obesity or proteinuria, and those undergoing
cardiovascular surgery. Discussion(s): Our study showed a
significantly reduced risk of postoperative mortality and morbidity
associated with pre-operative sodium-glucose cotransporter-2 inhibitor use
in patients with type 2 diabetes mellitus, including a notably lower rate
of diabetic ketoacidosis, contrary to previous concerns. Randomised
controlled trials are warranted to validate these findings. Copyright
© 2025 Association of Anaesthetists.

<78>
Accession Number
648834955
Title
Cardiac geometry alterations following bariatric surgery in severely obese
adolescents: a one-year follow-up study of a randomised controlled trial.
Source
Cardiology in the young. (pp 1-7), 2025. Date of Publication: 15 Oct
2025.
Author
Talib A.; Roebroek Y.; Paulus G.; de Boom F.; Winkens B.; Bouvy N.; van
Heurn E.
Institution
(Talib, Roebroek, Paulus, de Boom, Bouvy, van Heurn) Department of
Surgery, https://ror.org/02jz4aj89Maastricht University Medical Center,
Maastricht, Netherlands
(Talib, Roebroek, Paulus, de Boom, Bouvy, van Heurn) NUTRIM School for
Nutrition and Translational Research in Metabolism,
https://ror.org/02jz4aj89Maastricht University, Maastricht, Netherlands
(Roebroek) Department of General Surgery, Maxima Medical Center,
Veldhoven, Netherlands
(Paulus) Department of General Surgery, Spaarne Gasthuis, Hoofddorp,
Netherlands
(Winkens) Department of Methodology and Statistics, CAPHRI Care and Public
Health Research Institute, Maastricht University, Maastricht, Netherlands
(Bouvy, van Heurn) Department of Surgery, Leiden University Medical
Center, Leiden, Netherlands
Abstract
BACKGROUND: Severe obesity in adolescents is a public health crisis of
increasing concern. Cardiac maladaptation, such as left ventricular
hypertrophy, increases the risk of future cardiovascular disease. This
study aims to evaluate the impact of weight loss surgery on cardiac
geometry in morbidly obese adolescents. METHOD(S): A single-centre,
randomised controlled trial titled comparing laparoscopic adjustable
gastric banding with multidisciplinary lifestyle intervention against a
control group with multidisciplinary lifestyle intervention alone. The
trial included severely obese adolescents aged 14-16 who had not responded
to a minimum of 12 months of multidisciplinary lifestyle intervention. The
primary outcome measured was the percentage change in total body weight
one year after surgery. Left ventricular geometry was evaluated
ultrasonographically before and one year after bariatric surgery.
 RESULT(S): In the intervention and control group, a total of 10 and 8
patients received both the baseline and follow-up ultrasonographic
examination. BMI significantly decreased in the intervention group
compared to the control group (-6.75; 95% CI: -10.28 - -3.23). Moreover,
left ventricular mass index (-8.21; 95% CI: -15.43 - -0.98) and relative
left ventricular wall thickness (-0.04; 95% CI: -0.07 - 0.00)
significantly decreased within the intervention group, reflecting
amelioration of adverse remodelling, albeit without statistically
significant intervention effect when compared to the control group.
 CONCLUSION(S): Significant weight loss through bariatric surgery may
improve left ventricular geometry in severely obese adolescents. These
findings support the potential of bariatric surgery not only for reducing
weight loss but also for improving cardiac health.

<79>
Accession Number
2040474793
Title
Risk prediction models for permanent pacemaker implantation following
transcatheter aortic valve replacement: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1563597. Date of Publication: 2025.
Author
Mao Y.; Liu Q.; Fan H.; He W.; Ouyang X.; Wang X.; Li E.; Qiu L.; Dong H.
Institution
(Mao, Fan, He, Ouyang, Wang, Qiu, Dong) Department of Nursing, Xianyang
Central Hospital, Xianyang, China
(Liu) Department of Orthopedic Surgery, Xianyang Central Hospital,
Xianyang, China
(Li) Interventional Operating Room, Xianyang Central Hospital, Xianyang,
China
Publisher
Frontiers Media SA
Abstract
Objective: To systematically evaluate the methodological quality and
predictive performance of risk prediction models for permanent pacemaker
implantation (PPMI) following transcatheter aortic valve replacement
(TAVR), identify key predictive factors, and assess the risk of bias and
clinical applicability of these models. Method(s): A comprehensive
search was conducted across multiple databases, including PubMed, Web of
Science, The Cochrane Library, Embase, Cumulative Index to Nursing and
Allied Health Literature (CINAHL), China National Knowledge Infrastructure
(CNKI), Wanfang Database, China Science and Technology Journal Database
(VIP), and SinoMed. The search included all records from database
inception to January 1, 2025. Two independent researchers screened studies
and extracted relevant data. Result(s): A total of 11 studies were
included, covering 11 risk prediction models with sample sizes ranging
from 184-35,410. The incidence of PPMI after TAVR varied between 7.3% and
31.0%. Frequently identified predictors (present in at least two studies)
included right bundle branch block (RBBB), self-expandable valves, PR
interval, QRS interval, and atrioventricular block (AVB). All models
reported the area under the receiver operating characteristic curve
(AUROC), ranging from 0.660-0.916, with seven studies providing
calibration metrics. Internal validation was performed in three studies,
while one study included both internal and external validation. Ten
studies were assessed as having a high risk of bias, primarily due to
deficiencies in data analysis. The pooled AUROC for the nine validated
models was 0.76 (95% confidence interval: 0.72-0.80), indicating moderate
discriminatory ability. Conclusion(s): Existing risk prediction
models for PPMI after TAVR demonstrate moderate predictive performance but
are limited by a high risk of bias, as assessed using the Prediction Model
Risk of Bias Assessment Tool (PROBAST). Future research should focus on
developing more robust models through larger sample sizes, rigorous
methodologies, and multi-center external validation. Systematic Review
Registration: The protocol for this study is registered with
https://www.crd.york.ac.uk/PROSPERO/view/CRD42025629869, PROSPERO
CRD42025629869. Copyright 2025 Mao, Liu, Fan, He, Ouyang, Wang, Li,
Qiu and Dong.

<80>
Accession Number
2040550457
Title
Redefining Aortic Valve Replacement: The Transition from Open Surgery to
Transcatheter Innovation.
Source
Journal of Clinical Medicine. 14(19) (no pagination), 2025. Article
Number: 6761. Date of Publication: 01 Oct 2025.
Author
Lodge F.; Soliman F.; Kandula V.; Tagliafierro M.; Pirelli L.
Institution
(Lodge, Soliman, Kandula, Tagliafierro, Pirelli) Division of
Cardiothoracic Surgery, Department of Surgery, Columbia University Irving
Medical Center, New York, NY, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Aortic valve replacement (AVR) has evolved dramatically, transitioning
from open surgery to minimally invasive and transcatheter approaches. This
review examines the historical and technological advancements in AVR,
focusing on the evolution of mechanical and bioprosthetic valves,
valve-sparing techniques, and the Ross procedure. Mechanical valves offer
superior durability but require lifelong anticoagulation, while
bioprosthetic valves avoid this need at the expense of long-term
durability. Transcatheter aortic valve replacement (TAVR), originally
reserved for high-risk patients, is now used across all risk profiles due
to growing evidence of safety and efficacy from major trials like PARTNER
and Core Valve. Despite its benefits, TAVR presents some challenges,
including paravalvular leak, pacemaker implantation, and uncertain
long-term durability, especially in younger patients. Valve-in-valve
techniques, novel valve designs, and anti-calcification treatments offer
promising solutions. Looking forward, the integration of artificial
intelligence and personalized procedural planning will play a key role in
optimizing outcomes. As AVR technology advances, careful patient selection
and a multidisciplinary approach remain essential to guiding
individualized treatment decisions. Copyright © 2025 by the
authors.

<81>
Accession Number
2040515803
Title
Contemporary Outcomes of Ventricular Tachycardia Ablation in Left
Ventricular Assist Device Therapy: A Meta-Analysis.
Source
Journal of Cardiovascular Electrophysiology. (no pagination), 2025. Date
of Publication: 2025.
Author
Barrera N.; Kushnir Y.; Solorzano M.; Gallegos-Koyner F.; Lynch P.T.;
Queiroga F.; Giorgi J.; Brigido A.R.D.; de Carvalho G.D.; Chelu M.G.;
Colombo P.C.; D'Avila A.
Institution
(Barrera, Colombo) Division of Cardiology, Columbia University College of
Physicians and Surgeons, New York Presbyterian Hospital, New York, NY,
United States
(Kushnir, Solorzano, Gallegos-Koyner) Department of Medicine, SBH Health
System, New York, NY, United States
(Lynch, Chelu) Department of Medicine (Division of Cardiology), Baylor
College of Medicine, Houston, TX, United States
(Queiroga) Deparment of Medicine, Emory University School of Medicine,
Atlanta, GA, United States
(Giorgi) Division of Cardiology, Sirio Libanes Hospital, Sao Paulo, Sao
Paulo, Brazil
(Brigido) Division of Cardiology, Heart Institute (InCor), Hospital das
Clinicas, Faculty of Medicine, Sao Paulo, Sao Paulo, Brazil
(de Carvalho) Division of Cardiac Arrhythmias and Electrophysiology, Dante
Pazzanese Institute of Cardiology, Sao Paulo, Brazil
(Chelu) Cardiovascular Research Institute, Houston, TX, United States
(Chelu) Division of Cardiology, Texas Heart Institute at Baylor College of
Medicine and Baylor St. Luke's Medical Center, Houston, TX, United States
(D'Avila) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background and Objective: Ventricular arrhythmias (VAs) remain a pervasive
and deadly arrhythmia in patients with left ventricular assist devices
(LVADs). Catheter ablation has emerged as a treatment option for
refractory VAs, yet evidence in the era of the HeartMate 3 (HM3) remains
limited. This review aims to synthesize contemporary evidence for VA
ablation in LVAD recipients. Method(s): A systematic review was
performed across major electronic databases. The primary efficacy outcome
was the recurrence of ventricular tachycardia (VT), and the primary safety
outcome was the rate of procedural complications. The secondary outcomes
were inability to induce any VT, all-cause mortality at 12 months,
orthotropic heart transplantation (OHT). Sub-analyses were performed for
patients with HM3 LVADs. Result(s): Twenty-seven studies encompassing
300 LVAD recipients undergoing 325 VT ablations, after a mean follow-up of
327 +/- 175 days post VT ablation, VT recurred in 38% (95% CI, 28% to 49%)
of cases and the complication rate was 8% (95% CI, 1.6% to 15.7%). VT was
non-inducible in 61% of cases. One-year all-cause mortality was 26%, and
16% had OHT. Among HM3 recipients, electromagnetic interference (EMI)
occurred in 51%, and no cases of device thrombosis were reported; one
stroke was observed. Conclusion(s): Catheter ablation is a safe and
feasible treatment for refractory VAs in LVAD patients as evidenced by low
complication rates and reasonable acute success. Yet, the persistence of
considerable VT recurrence and all-cause mortality reflects the clinical
complexity of this population. Procedural challenges include mapping
limitations caused by EMI, particularly in the HM3 era. Copyright
© 2025 Wiley Periodicals LLC.

<82>
Accession Number
2040550668
Title
Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation in
the Acute Care Setting: A Narrative Review.
Source
Journal of Clinical Medicine. 14(19) (no pagination), 2025. Article
Number: 6835. Date of Publication: 01 Oct 2025.
Author
Fellahi J.-L.; Fischer M.-O.; Ruste M.; Jacquet-Lagreze M.
Institution
(Fellahi, Ruste, Jacquet-Lagreze) Service d'Anesthesie Reanimation,
Hopital Universitaire Louis Pradel, Hospices Civils de Lyon, 59 Boulevard
Pinel, Lyon, France
(Fellahi, Ruste, Jacquet-Lagreze) Laboratoire CarMeN, Inserm UMR 1060,
Universite Claude Bernard Lyon 1, Lyon, France
(Fischer) Institut Aquitain du Coeur, Clinique Saint-Augustin, ELSAN,
Bordeaux, France
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
New-onset postoperative atrial fibrillation (POAF) is common after cardiac
and major noncardiac surgery and significantly associated with short- and
long-term adverse events. Multiple management strategies have been
described but the lack of evidence from large randomized controlled trials
and the lack of consensus regarding best practices has led to major
variations in practice patterns. Considering on the one hand its serious
adverse effects and complex drug interactions, and on the other hand
discrepancies among recent international guidelines, the indications of
amiodarone to both prevent and treat POAF should be reserved to patients
at high risk of POAF only, or patients with hemodynamic instability and/or
severely reduced left ventricular ejection fraction. Perioperative
optimization of oral and intravenous cardio-selective beta-blockers to
prevent POAF, and control heart rate when POAF occurs with a rapid
ventricular response is the recommended first-line strategy,
simultaneously with the treatment of associated factors. Given their
efficient and safe profile, ultra-short-acting intravenous beta-blockers
like esmolol or landiolol could be preferentially used in acute care
patients. Besides waiting for the results of ongoing RCTs in cardiac and
noncardiac surgery, the use of oral anticoagulation in patients with POAF
should take into account the individualized thromboembolic/hemorrhagic
risk ratio. Copyright © 2025 by the authors.

<83>
Accession Number
648829516
Title
Impact of metabolic and bariatric surgery on heart rate variability: a
systematic review and meta-analysis.
Source
Updates in surgery. (no pagination), 2025. Date of Publication: 14 Oct
2025.
Author
Jamialahmadi T.; Abdalla M.A.; Mirhadi E.; Almahmeed W.; Sukhorukov V.N.;
Virani S.; Eid A.H.; Sahebkar A.
Institution
(Jamialahmadi) Pharmaceutical Research Center, Pharmaceutical Technology
Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Abdalla) Hull York Medical School, University of Hull, Hull, United
Kingdom
(Mirhadi) School of Pharmacy, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Almahmeed) Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu
Dhabi, United Arab Emirates
(Sukhorukov) Institute of General Pathology and Pathophysiology, 8
Baltiiskaya Street, Moscow, Russian Federation
(Virani) Aga Khan University, Karachi, Pakistan
(Eid) Department of Basic Medical Sciences, College of Medicine, QU
Health, Qatar University, Doha, Qatar
(Sahebkar) Center for Global Health Research, Saveetha Medical College and
Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha
University, Chennai, India
(Sahebkar) Biotechnology Research Center, Pharmaceutical Technology
Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Sahebkar) Applied Biomedical Research Center, Basic Sciences Research
Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
Abstract
Obesity is associated with autonomic nervous system (ANS) dysfunction,
characterized by increased sympathetic activity, and reduced
parasympathetic tone, which together contribute to elevated cardiovascular
risk. Heart rate variability (HRV), a key marker of ANS function, is often
reduced in individuals with obesity. Metabolic and bariatric surgery (MBS)
is an effective intervention for severe obesity; however, its impact on
HRV remains unclear. A systematic review and meta-analysis were conducted
in accordance with PRISMA guidelines. Literature searches were performed
in PubMed, Scopus, Embase, Google Scholar, and Web of Science. Studies
evaluating HRV before and after MBS were included. Meta-analysis was
carried out using Comprehensive Meta-Analysis (CMA) version 4 software.
Eleven studies comprising 322 patients were included. MBS significantly
improved HRV (weighted mean difference: 12.011; 95% CI: 6.984-17.038; p <
0.001). Meta-regression demonstrated a positive correlation between BMI
reduction and HRV improvement (slope: 1.553; 95% CI: 0.203-2.903; p =
0.024). HRV improvements were observed at both short-term (< 6 months) and
long-term (>= 6 months) follow-up. Roux-en-Y gastric bypass (RYGB)
produced greater HRV improvements compared with sleeve gastrectomy (SG).
MBS significantly enhances HRV, suggesting partial reversal of
obesity-related ANS dysfunction. The observed association between weight
loss and HRV improvement highlights MBS as a promising cardiometabolic
intervention. Copyright © 2025. Italian Society of Surgery (SIC).

<84>
Accession Number
2040984235
Title
TCT-295 Surgical Left Atrial Appendage Occlusion During Cardiac Surgery in
Atrial Fibrillation: A Contemporary Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B130-B131), 2025. Date of Publication: 28 Oct 2025.
Author
Bahar A.R.; Khoury I.; Hamza M.; Jahan S.; Jawadi M.H.; Bahar Y.; Guntha
M.; Razzaq S.; Alraies M.C.
Institution
(Bahar, Guntha) Wayne State University School of Medicine, Detroit,
Michigan, United States
(Khoury, Bahar) Wayne State University, Detroit, Michigan, United States
(Hamza) Guthrie Medical Group, Cortland, New York, United States
(Jahan) Valley Health System, Las Vegas, Nevada, United States
(Jawadi) Detroit Medical Center/Wayne State University, Dearborn Heights,
Michigan, United States
(Razzaq) Detroit Medical Center/Wayne State University, Detroit, Michigan,
United States
(Alraies) Detroit Medical Center, Detroit, Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage occlusion (LAAO) is a promising stroke
prevention strategy in atrial fibrillation (AF) patients undergoing
cardiac surgery. We conducted a comprehensive evaluation of its safety and
effectiveness by synthesizing data from randomized trials and
observational studies. Method(s): This meta-analysis of 20 studies
(12 observational, 8 RCTs) including 215,181 patients (2005-2024)
estimated pooled odds ratios using fixed- and random-effects models.
Heterogeneity, publication bias, and sensitivity analyses followed PRISMA
guidelines. Result(s): LAAO significantly reduced ischemic stroke,
systemic embolism, hemorrhagic stroke, silent infarcts, and cardiac death.
All-cause mortality was reduced with a fixed-effects model but not with
random-effects due to heterogeneity. No differences were seen in MI,
peripheral ischemia, or major bleeding. Sensitivity and cumulative
analyses confirmed the ischemic stroke findings, with no outcome variation
by study design or publication year. [Formula presented]
 Conclusion(s): LAAO during cardiac surgery is associated with a
significant reduction in thromboembolic events, without increasing the
risk of major complications. These findings support the role of LAAO as a
safe and effective adjunctive intervention in appropriately selected
patients with AF. Further high-quality, prospective studies are warranted
to confirm these benefits and inform guideline-directed practice.
Categories: STRUCTURAL: Left Atrial Appendage Exclusion Copyright
© 2025

<85>
Accession Number
2040983702
Title
TCT-1145 Self-Expanding vs. Balloon-Expandable TAVR in Small Aortic
Annuli: A Meta-Analysis of Clinical and Hemodynamic Outcomes.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B489), 2025. Date of Publication: 28 Oct 2025.
Author
Abdelrahman A.; Elkholy M.; Ahmed K.; Omara G.; Arce J.; Al-Muhaisen R.;
Altujjar M.; Leon M.B.; Beohar N.
Institution
(Abdelrahman) Mount Sinai Medical Center at Miami Beach / Columbia
University, Miami Beach, Florida, United States
(Elkholy) Detroit Medical Center, Wayne State University, Detroit,
Michigan, United States
(Ahmed) Menoufia University Faculty of Medicine, Menoufia, Egypt
(Omara) Nasser Institute Hospital for Research and Treatment, Menoufia,
Egypt
(Arce) Mount Sinai Medical Center, Miami Beach, Florida, United States
(Al-Muhaisen) Mount Sinai Medical Center, Miami, Florida, United States
(Altujjar) Mount Sinai Medical Center, North Bay Village, Florida, United
States
(Leon) Columbia University Medical Center, New York, New York, United
States
(Beohar) Columbia University Division of Cardiology at Mount Sinai Medical
Center, Miami Beach, Florida, United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal transcatheter aortic valve replacement (TAVR)
strategy for patients with a small aortic annulus (SAA), a common and
challenging anatomy, remains debated. We performed a meta-analysis
comparing outcomes between self-expanding (SEV) and balloon-expandable
(BEV) valves in this high-risk population. Method(s): A systematic
review and meta-analysis of randomized and observational studies comparing
SEV and BEV in SAA was conducted. Data were pooled for key clinical and
hemodynamic endpoints. The analysis included a total of 4,638 patients
across 10 studies. Result(s): SEV showed better hemodynamics, with
significantly lower mean transvalvular gradients (Mean Difference -5.61
mmHg, 95% CI -6.56 to -4.66) and a 59% relative risk reduction in severe
prosthesis-patient mismatch (RR 0.41, CI 0.30-0.56). However, it showed
higher risks of 30-day permanent pacemaker implantation (RR 1.67, CI
1.21-2.30), >=moderate paravalvular leak (RR 4.67, CI 2.65-8.23), and a
signal for disabling stroke in two studies (RR 14.48, CI 2.89-72.54). The
hemodynamic advantages did not translate into a statistically significant
survival benefit. At 1-year, all-cause mortality showed a non-significant
trend favoring SEV (RR 0.78, CI 0.60-1.01) [Formula presented]
 Conclusion(s): In patients with SAA, SEV provides better hemodynamics
but at the cost of increased procedural complications. The absence of a
definitive mortality benefit at 1 year highlights a critical trade-off.
Valve selection must be personalized, carefully weighing the long-term
benefits of improved hemodynamics against immediate procedural risks.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<86>
Accession Number
2040983361
Title
TCT-1113 Transcatheter versus Surgical Aortic-Valve Replacement in Women
with High versus Low Gradient Severe Aortic Stenosis: A Substudy of the
RHEIA Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B475), 2025. Date of Publication: 28 Oct 2025.
Author
Alperi A.; Silva I.; Zanuttini A.; Theron A.; Giuliani C.; Dahou A.; Hecht
S.; Bax J.; Bonaros N.; Windecker S.; Messika-Zeitoun D.; Mares J.;
Wesselink W.; Rakova R.; Bramlage P.; Tchetche D.; Eltchaninoff H.;
Pibarot P.
Institution
(Alperi) University of Laval Quebec, Laval, Quebec, Canada
(Silva) Hospital Universitario Central de Asturias, Oviedo, Spain
(Zanuttini, Giuliani) Institut Universitaire De Cardiologie Et De
Pneumologie De Quebec (IUCPQ), Quebec, Quebec, Canada
(Theron) La Timone Hospital, Marseille, France
(Dahou) Geisinger Medical College, Wilkes Barre, Pennsylvania, United
States
(Hecht) Institut universitaire de cardiologie et de pneumologie de Quebec
(IUCPQ), Quebec, Quebec, Canada
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Bonaros) Medical University of Innsbruck, Innsbruck, Austria
(Windecker) Cardiovascular Center Bern, Bern, Switzerland
(Messika-Zeitoun) University of Ottawa Heart Institute, Ottawa, Ontario,
Canada
(Mares) Institute for Clinical and Experimental Medicine, Prague, Czechia
(Wesselink) Edwards Lifesciences, Irvine, California, United States
(Rakova) Prague 8, Edwards Lifesciences, Czechia
(Bramlage) IPPMed, Cloppenburg, Germany
(Tchetche) Clinique Pasteur Toulouse, Toulouse Cedex 3, France
(Eltchaninoff) University Hospital of Rouen, Rouen, France
(Pibarot) Quebec Heart and Lung Institute, Quebec, Quebec, Canada
Publisher
Elsevier Inc.
Abstract
Background and Aims: In the Randomized researcH in womEn all comers wIth
Aortic stenosis (RHEIA) trial, the incidence of the primary composite
end-point of death, stroke, or rehospitalization at one year was lower
with transcatheter aortic valve implantation (TAVI) than with surgical
aortic valve replacement (SAVR). Low-gradient aortic stenosis (LGAS) is
associated with worse clinical outcomes compared to high-gradient AS
(HGAS) and the prevalence of this entity is higher in women. The objective
of this post-hoc analysis was to compare the outcomes of TAVI vs. SAVR in
women with low vs. high gradient AS. Method(s): In the RHEIA trial,
443 women were enrolled across 48 European centers and randomized 1:1 to
transfemoral TAVI with a balloon-expandable valve or to SAVR. Of these,
420 received treatment as assigned. For this analysis, 299 women with
complete baseline echocardiographic data were included. Primary composite
end point was death, stroke, or (valve, procedure or heart failure
related) rehospitalization at one year. HGAS was defined as mean gradient
at baseline >= 40 mmHg and LGAS < 40 mmHg. Result(s): HGAS was
present in 72.9% and LGAS in 27.1% of the women included in this analysis.
Among the 81 patients with LGAS, 9.6% presented with classical low-flow
(reduced LV ejection fraction < 50%), 16.4% with paradoxical low-flow
(LVEF>= 50% and stroke volume index < 35 ml/m2), and 74% with
normal-flow LGAS pattern (LVEF>= 50% and stroke volume index >= 35
ml/m2). Kaplan-Meier estimates of the primary end point event
rates at one year were 7.7% in the TAVI group and 15.5% in the SAVR group
(HR=0.48, 95%CI: 0.24 to 0.97; p=0.035). The rate of the primary endpoint
was not statistically different (p=0.24) in LGAS (14.8%) vs. HGAS (10.1%),
irrespective of treatment group. In women with HGAS, the rate of the
primary endpoint was 12.7% with surgery vs. 7.9% with TAVI (p=0.25),
whereas in those with LGAS, the rate was higher with surgery vs. TAVI
(23.1 vs. 7.1%; p=0.05). There was no significant interaction (p=0.35)
between treatment group (TAVI vs. SAVR) and gradient group (LGAS vs. HGAS)
with respect to effect on the primary clinical outcome.
 Conclusion(s): Among women with severe aortic stenosis, LGAS is
present in about one quarter of patients and is associated with preserved
LVEF and normal flow in the vast majority. Overall results of the RHEIA
trial showed that TAVI is superior to surgery in women with severe AS with
regards to the composite of mortality, stroke or rehospitalization at 1
year. According to the results of the present analysis, this superiority
of TAVI appears to be maintained in the subset of patients with LGAS.
These results therefore suggest that TAVI may be preferable to surgery in
women with severe AS, irrespective of their gradient status: i.e. HGAS or
LGAS. Copyright © 2025

<87>
Accession Number
2040983353
Title
Meta-analysis of the Self-Expanding Navitor Valve: Midterm Outcomes Across
Contemporary Studies.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B6-B7), 2025. Date of Publication: 28 Oct 2025.
Author
Samimi S.; Kharsa C.; Kritya M.; Faza N.; Zaid S.; Little S.; Kleiman N.;
Reardon M.; Goel S.
Institution
(Samimi) Baylor College of Medicine, Houston, Texas, United States
(Kharsa) Houston Methodist Hospital, Houston, Texas, United States
(Kritya) Houston Methodist Research Institute, Houston, Texas, United
States
(Faza, Kleiman, Reardon, Goel) Houston Methodist Debakey Heart & Vascular
Center, Houston, Texas, United States
(Zaid) Baylor College of Medicine; Michael E. DeBakey VA Medical Center,
Houston, Texas, United States
(Little) Houston Methodiest DeBakey Heart & Vascular Center, Houston,
Texas, United States
Publisher
Elsevier Inc.
Abstract
Background: The Navitor valve is a next-generation, self-expanding
transcatheter heart valve with an active outer fabric cuff (NaviSeal)
designed to mitigate paravalvular leak (PVL). We performed a meta-analysis
to assess clinical outcomes following TAVR with the Navitor.
 Method(s): A systematic literature search was conducted through June
2025 to identify studies reporting 30-day or 1-year outcomes with Navitor.
Eligible studies enrolled adult patients undergoing TAVR with Navitor and
reported relevant safety and efficacy endpoints, including: technical
success, all-cause mortality, stroke, major vascular and bleeding
complications, permanent pacemaker implantation (PPI), and PVL >=
moderate. Pooled event rates and 95% CIs were calculated using
random-effects models. Heterogeneity was assessed using I2 and
tau2. Result(s): Twelve studies comprising 6,717 patients
were included. Technical success was achieved in 97% (95% CI: 95-98%). At
30 days, pooled all-cause mortality was 2% (95% CI: 1-3%), stroke 2% (95%
CI: 1-2%), major vascular complications 1% (95% CI: 1-2%), and PVL >=
moderate 2% (95% CI: 1-4%). PPI occurred in 16% (95% CI: 12-21%). At
1-year, all-cause mortality was 7% (95% CI: 2-15%), PPI 20% (95% CI:
17-25%), and PVL >= moderate remained low at 1% (95% CI: 0-3%). [Formula
presented] Conclusion(s): High procedural success and low rates of
PVL at 30 days and 1 year were achieved following TAVR with the Navitor
valve. However, PPI rates remain elevated. Continued real-world experience
will help further define clinical outcomes with the Navitor. Categories:
STRUCTURAL: Valvular Disease and Intervention: Aortic Copyright ©
2025

<88>
Accession Number
2040982906
Title
TCT-21 Utility of Cerebral Embolic Protection in Transcaval Transcatheter
Aortic Valve Replacement.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B15), 2025. Date of Publication: 28 Oct 2025.
Author
Andrews T.; Coombe V.; Patel R.; Lee J.; Dawdy J.; Zweig B.; Villablanca
P.; O'Neill B.; Frisoli T.; Gonzalez P.E.
Institution
(Andrews, Coombe) Henry Ford Health, Detroit, Michigan, United States
(Patel) Wayne State University School of Medicine, Detroit, Michigan,
United States
(Lee) Henry Ford Heart and Vascular Institute, Detroit, Michigan, United
States
(Dawdy, Zweig, Villablanca, Frisoli) Henry Ford Hospital, Detroit,
Michigan, United States
(O'Neill) Wayne State University, Detroit, Michigan, United States
(Gonzalez) Henry Ford, Detroit, Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: The utility of cerebral embolic protection (CEP) during
alternative access TAVR is unclear. This study examines stroke rate in
transcaval TAVR performed with and without CEP. Method(s): This is a
retrospective cohort study of 196 patients who underwent successful
transcaval TAVR at Henry Ford Hospital from 2013-2025. Baseline
characteristics and CEP use were obtained through review of electronic
medical records. Peri-procedural stroke was confirmed with cerebral
imaging. Result(s): Among 198 patients, 75 (37.9%) were male, with a
mean age of 78.1 +/- 9.3 years and an average STS mortality score of 7.39
+/- 11.6. A history of prior stroke was present in 18 patients (9.09%).
The overall post-TAVR stroke rate in the cohort was 2.02%. Stroke occurred
in 1 of 59 patients (1.69%) who received CEP and 3 of 139 patients (2.16%)
without CEP. CEP was associated with a nonsignificant reduction in stroke
risk (RR 0.78; 95% CI, 0.08-7.49; p=1.00). The observed rate of
periprocedural stroke in this cohort was not significantly different from
contemporary standard access TAVR (RR 1.30; p=0.56). [Formula presented]
 Conclusion(s): CEP use was associated with a nonsignificant reduction
in stroke risk, with event rates comparable to those reported in larger
transfemoral studies and meta-analyses. The event rate did not differ
significantly from contemporary rates for standard access TAVR. While
limited by sample size and event frequency, this study represents, to our
knowledge, the largest single-center description of stroke rate following
transcaval TAVR. Larger studies are needed to better define the role of
CEP in alternative access TAVR. Categories: ENDOVASCULAR: Stroke, Stroke
Prevention, Carotid Intervention Copyright © 2025

<89>
Accession Number
2040985080
Title
TCT-721 Single- vs Double Perclose-Proglide Device Strategy for Access
Site Closure of Transcatheter Aortic Valve Replacement: A Systematic
Review and Meta-Analysis of Updated Evidence.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B315), 2025. Date of Publication: 28 Oct 2025.
Author
Burhan M.; Siddiqui M.R.; Tauqir M.; Basit J.; Tabassum S.; Shehada W.;
Khoury I.; Mir J.; Usman M.; Alraies M.C.
Institution
(Burhan, Siddiqui, Basit) Rawalpindi Medical University, Rawalpindi,
Pakistan
(Tauqir) Rawalpindi Medical University, RAWALPINDI, Pakistan
(Tabassum) The Wright Center for Graduate Medical Education, Scranton,
Pennsylvania, United States
(Shehada) Islamic University of Gaza, London, United Kingdom
(Khoury) Wayne State University, Detroit, Michigan, United States
(Mir) University of Missouri, Columbia, Missouri, United States
(Usman) University of Wisconsin Madison, Madison, Wisconsin, United States
(Alraies) Detroit Medical Center, Detroit, Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: Vascular complications during transcatheter aortic valve
replacement (TAVR) have declined tremendously due to use of suture-based
devices. Perclose Proglide (PP) is the most used vascular closure device.
While double Perclose technique is used in most centers, recent studies
indicate that single Perclose technique may be advantageous in terms of
cost and fewer complications. Method(s): We conducted comprehensive
search across databases to identify articles comparing single PP with
double PP in patients undergoing TAVR. Odds ratios were pooled along with
their 95% confidence intervals (CIs). A random effects model assessed
heterogeneity between studies using R software. Result(s): A total of
six observational studies with 2224 patients (1125 in single PP; 1099 in
double PP) were included in final analysis. Our meta-analysis showed that
major bleeding [OR: 0.57; (0.35 - 0.94); p = 0.029], major vascular [OR:
0.52; (0.33 - 0.81); p-value = 0.004], minor vascular [OR: 0.4; (0.23 -
0.69); p-value = 0.001] complications and arterial dissection [OR: 0.2;
(0.08 - 0.49); p-value < 0.001] were significantly decreased in single PP
group as compared to double PP. All-cause mortality, minor bleeding,
residual stenosis and procedural success were comparable between the two
groups. Conclusion(s): Single PP is associated with decreased major
bleeding and vascular complications and arterial dissection as compared to
double PP with comparable residual stenosis and procedural success.
Randomized controlled trials are warranted to confirm our findings.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<90>
Accession Number
2040982949
Title
Win Ratio Analysis of 1-Year Outcomes in the LANDMARK Trial: Myval vs
Contemporary THVs (Sapien or Evolut) in Patients with Symptomatic Severe
Aortic Stenosis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B6), 2025. Date of Publication: 28 Oct 2025.
Author
Tobe A.; van Royen N.; Amat-Santos I.; Hudec M.; Bunc M.; Ijsselmuiden A.;
Rosseel L.; Thakkar A.; Pomar J.L.; Baumbach A.; Onuma Y.; Serruys P.
Institution
(Tobe, Onuma, Serruys) University of Galway, Galway, Galway, Ireland
(van Royen) Radboud University Medical Center, Nijmegen, Netherlands
(Amat-Santos) University Clinic Hospital of Valladolid, Valladolid, Spain
(Hudec) SUSCCH, A.S., Banska Bystrica, Slovakia
(Bunc) University Medical Center Ljubljana, Ljubljana, Slovenia
(Ijsselmuiden) Maastricht University Medical Center/Zuyderland Hospital,
Maastricht, Netherlands
(Rosseel) Algemeen Stedelijk Ziekenhuis, Aalst, Belgium
(Thakkar) Meril Life Sciences Pvt. Ltd., Gujarat, Vapi, India
(Pomar) The Cardiovascular Institute Hospital Clinic & University of
Barcelona, BARCELONA, Spain
(Baumbach) Queen Mary University of London and Barts Heart Centre, London,
United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: The LANDMARK trial demonstrated the non-inferiority of the
Myval transcatheter heart valve (THV) series versus the contemporary
standard THVs (Sapien and Evolut) at 1 year based on the conventional
time-to-first event analysis. Method(s): LANDMARK is a multicenter,
randomized, open-label, non-inferiority trial enrolling 768 patients with
severe symptomatic native aortic stenosis across 16 countries. Patients
were randomized 1:1 to Myval arm (n=384) or contemporary THV arm (n=384).
A hierarchical composite endpoint was analyzed using the win ratio method:
(1) all-cause death, (2) disabling stroke, (3) non-disabling stroke, and
(4) procedure- or valve-related hospitalization. Outcomes were compared
across 147,456 (384x384) unmatched patient pairs. Death and stroke were
analyzed by time-to-first-event (later = winner), and hospitalization by
the total number of events (fewer = winner). An extended analysis included
quality-of-life (QoL) outcomes. Result(s): The primary win ratio was
1.02 (95% CI: 0.68-1.51; p=0.94), with 17,870 wins for Myval and 17,599
for contemporary THVs. Mortality wins were balanced; contemporary THVs had
numerically more wins for disabling stroke, while Myval had numerically
more wins for non-disabling stroke and hospitalization (Figure). The
extended endpoint including QoL yielded a win ratio of 1.13 (95% CI:
0.82-1.55; p=0.45). [Formula presented] Conclusion(s): This win ratio
analysis confirmed comparable 1-year hierarchical outcomes between Myval
THV series and contemporary THV series, supporting their clinical
equivalence. Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<91>
Accession Number
2040982913
Title
TCT-1166 Transcatheter Aortic Valve Implantation in a Hospital Without
On-Site Cardiac Surgery - The First Italian Single-Center Experience.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B498-B499), 2025. Date of Publication: 28 Oct 2025.
Author
Mancini G.; Iorio E.; Basile E.; Martimucci M.; Scarcia M.; Xhelo A.;
Casamassima V.; Guida P.; Paradies V.; Grimaldi M.
Institution
(Mancini) "Miulli" Hospital, Acquaviva delle Fonti, Bari, Italy
(Iorio, Martimucci, Scarcia, Xhelo, Casamassima, Guida, Grimaldi) Ente
Ecclesiastico Ospedale Generale Regionale "F. Miulli", Acquaviva delle
Fonti, Bari, Italy
(Basile) Ospedale "Miulli", Acquaviva Delle Fonti, Bari, Italy
(Paradies) Maasstad Ziekenhuis, Rotterdam, Netherlands
Publisher
Elsevier Inc.
Abstract
Background: As indications for TAVI continue to expand, the risk of
complications is declining, driven by enhanced operator expertise,
improved procedural planning, and the introduction of repositionable TAVI
systems. Recent large-scale registry data suggest that prolonged waiting
times for TAVI are linked to increased mortality rates. Current guidelines
recommend performing TAVI in hospitals with on-site CS, yet conversion to
emergency cardiac surgery (ECS) is a very rare event (<0.5%) and
associated with highmortality rate, regardless of surgical intervention.
This study presents data from the first Italian single-center experience
of TAVI performed without on-site CS. Method(s): This retrospective,
single-center study analyzed 186 consecutive patients undergoing TAVI at a
hospital without on-site CS. Each case was reviewed by a Heart Team, and
all procedures were conducted with surgical backup available. Key
demographic, echocardiographic and procedural data were prospectively
collected with routine follow-ups at 30 days and 1 year and annually up to
5 years. Clinical endpoints were evaluated according to the Valve Academic
Research Consortium (VARC) 3 definitions. Result(s): Mean age was
82+/-6 years with a mean STS score of 7+/-6. VARC3 device success and
early safety were 98.9% and 97.8%. Conversion to emergency cardiac surgery
was required in 2 cases (1.1%). In-hospital mortality was 1.6%, all deaths
were non valve-related. Major cardiac complications (3 pericardial
tamponade and 1 left ventricle perforation) occurred in 4 patients (2.2%),
and mostly (75%) managed percutaneously. At 30-day and 1-year follow-up,
the mortality rate was respectively 2.2% and 15.6%. The median longest
follow-up was 24 months and showed a survival rate of 82.7%.
 Conclusion(s): In our extensive single center experience, TAVI
performed without on-site CS but with availability of surgical "back-up"
was associated with high rates of device success and early safety. Future
randomized controlled trials are needed to demonstrate these results.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<92>
Accession Number
2040984286
Title
TCT-708 Comparative Effectiveness of AMPLATZER Amulet vs Watchman FLX for
LAA Closure: A Systematic Review and Meta-analysis of RCTs with Updated
SWISS-APERO & Amulet IDE Outcomes.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B309-B310), 2025. Date of Publication: 28 Oct 2025.
Author
Afzal M.A.; Abdullah M.; Khalid N.; Romero J.; Ozgur S.; Ahmad A.; Abbasi
S.; Moore M.; Sharma N.; Tiyyagura S.; Shamoon F.
Institution
(Afzal, Ozgur, Tiyyagura) St Joseph's University Medical Center, Paterson,
New Jersey, United States
(Abdullah) Department of Internal Medicine, HCA Florida Oak Hill Hospital,
Brooksville, FL, USA, Brooksville, Florida, United States
(Khalid) NewYork Presbyterian Brooklyn Methodist Hospital, Brooklyn, New
York, United States
(Romero) St Joseph University Medical Center, Elizabeth, New Jersey,
United States
(Ahmad) St Joseph's University Hospital, Union, New Jersey, United States
(Abbasi, Sharma) HCA Florida Oak Hill Hospital, Brooksville, Florida,
United States
(Moore) HCA Florida Oak Hill Hospital, Brooksville, FL, Brooksville,
Florida, United States
(Shamoon) St. Joseph's Regional Medical Center, Paterson, New Jersey,
United States
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous left-atrial-appendage occlusion (LAAO) is an
accepted alternative to long-term anticoagulation for stroke prevention in
non-valvular atrial fibrillation. Two contemporary devices now dominate
practice: the dual-seal Amplatzer Amulet and the single-seal Watchman FLX.
Long-term follow-up from the pivotal Amulet IDE trial and the updated
SWISS-APERO trial has created a timely opportunity to reassess the
comparative effectiveness of these second-generation implants.
 Method(s): PubMed, EMBASE, Cochrane, and ClinicalTrials.gov were
searched for RCTs comparing Amulet with Watchman FLX. After screening
Pooled odds ratios (ORs) with 95 % confidence intervals (CIs) were
calculated using a random-effects model in RevMan 5.3. Result(s):
Three trials encompassing 2105 participants met inclusion criteria.
Compared with Watchman FLX, Amulet showed similar all-cause mortality and
major bleeding. Numerical reductions did not reach statistical
significance for ischemic cerebrovascular events and systemic embolism.
Amulet significantly reduced large peridevice leaks and showed a
favourable, though non-significant, trend toward device-related thrombi.
[Formula presented] Conclusion(s): In this meta-analysis, Amulet and
Watchman FLX provide comparable protection against ischemic events,
mortality and major bleeding. Amulet achieves superior anatomic sealing
with roughly 54 % fewer clinically significant peridevice leaks. These
findings support individualized device selection based on
left-atrial-appendage anatomy and highlight the need for larger
head-to-head trials or patient-level meta-analyses to confirm potential
clinical advantages. Categories: STRUCTURAL: Left Atrial Appendage
Exclusion Copyright © 2025

<93>
Accession Number
2040984013
Title
TCT-871 Comparative Outcomes of Myval Versus Contemporary Transcatheter
Heart Valves: A Meta-Analysis of Randomized Controlled Trials and
Propensity Score-Matched Studies.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B377-B378), 2025. Date of Publication: 28 Oct 2025.
Author
Alcantara R.; Oliveira V.; Zawam Y.; Tartuce L.; Tartuce Filho P.R.
Institution
(Alcantara) Hospital Sao Judas Tadeu/Oliveira-MG, Oliveira, Minas Gerais,
Brazil
(Oliveira) Federal University of Goias, Goiania, Goias, Brazil
(Zawam) Ohio University, Portsmouth, Ohio, United States
(Tartuce) ICRI, Rio Verde, Goias, Brazil
(Tartuce Filho) Unknown, Rio Verde, Brazil
Publisher
Elsevier Inc.
Abstract
Background: Myval is a balloon-expandable transcatheter valve with growing
clinical adoption. However, its comparative safety and efficacy remain
uncertain. We conducted a meta-analysis to evaluate clinical outcomes of
Myval versus contemporary transcatheter heart valves (THVs) in patients
undergoing transcatheter aortic valve implantation (TAVI). Method(s):
PubMed, Embase, and Cochrane were searched to identify randomized and
propensity score macthed studies comparing the Myval valve versus
contemporary heart valves (CHVs) in patients undergoing transcatheter
aortic valve implantation (TAVI). Risk ratios (RRs) and 95% confidence
intervals (CIs) were calculated using a Mantel-Haenszel random-effects
model. All analyses were performed using R version 4.5.0. Result(s):
This meta-analysis comprised 5 studies with a total of 2,421 patients, of
whom 1,169 were randomized to receive Myval. Compared to other
transcatheter heart valves, Myval demonstrated no significant differences
in 30-day mortality (RR 1.04; 95% CI 0.57-1.88; P=0.909), 1-year mortality
(RR 0.91; 95% CI 0.59-1.40; P=0.655), stroke (RR 1.02; 95% CI 0.62-1.65;
P=0.951), moderate or severe aortic regurgitation (RR 1.02; 95% CI
0.62-1.65; P=0.951), permanent pacemaker implantation (RR 0.72; 95% CI
0.38-1.38; P=0.322), or procedural success (RR 1.01; 95% CI 0.99-1.04;
P=0.327). [Formula presented] Conclusion(s): Myval demonstrated
comparable safety and efficacy to established transcatheter heart valves,
with no significant differences observed in mortality, stroke, aortic
regurgitation, permanent pacemaker implantation, or procedural success.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<94>
Accession Number
648833450
Title
Comparison of perioperative analgesic efficacy between serratus anterior
plane block and thoracic paravertebral block in adult patients undergoing
thoracic and breast surgeries: a systematic review and meta-analysis.
Source
BMC anesthesiology. 25(1) (pp 493), 2025. Date of Publication: 14 Oct
2025.
Author
Wang J.; Li T.
Institution
(Wang) Department of Anesthesiology, Yuncheng Central Hospital Affiliated
to Shanxi Medical University, No. 3690, Hedong East StreetShanxi Province,
Yuncheng, China
(Li) Department of Anesthesiology, Yuncheng Central Hospital Affiliated to
Shanxi Medical University, No. 3690, Hedong East StreetShanxi Province,
Yuncheng, China
Abstract
BACKGROUND: Serratus anterior plane block (SAPB) and thoracic
paravertebral block (TPVB) are widely used regional anesthesia techniques
for postoperative analgesia and are generally considered safe and
effective. However, the comparative efficacy remains inconclusive. This
systematic review and meta-analysis of randomized controlled trials (RCTs)
aims to evaluate the perioperative analgesic efficacy of SAPB versus TPVB
in adult patients undergoing thoracic and breast surgeries.
 METHOD(S): A comprehensive literature search was conducted in PubMed,
EMBASE, Web of Science, Cochrane library, ClinicalTrial.gov, and Google
Scholar up to February 28, 2025. Primary outcomes included time to first
analgesic request (TFAR), 24-h total analgesic consumption (TAC)
postoperatively, and 24-h postoperative pain scores at rest. Secondary
outcomes comprised pain scores at various postoperative timepoints,
intraoperative fentanyl consumption, length of hospital stay, patient
satisfaction with analgesia, and incidence of complications. A
random-effect model was applied for the meta-analysis. RESULT(S):
Twenty-eight 28 RCTs comprising 1796 patients were included. No
significant differences were found between SAPB and TPVB in TFAR (mean
difference [MD] = -0.68 h, 95% confidence interval [CI]: -1.55 to 0.18, P
= 0.122), 24-h pain scores at rest (MD = 0.14, 95%CI: -0.14 to 0.42, P =
0.334), other postoperative pain scores, length of hospital stay, patient
satisfaction, or incidence of postoperative nausea and vomiting (risk
ratio [RR] = 0.87, 95%CI: 0.63 to 1.20, P = 0.310). Despite statistically
significant, the difference of 24-h TAC comparing SAPB to TPVB (MD = 1.73
mg intravenous morphine equivalents, 95%CI: 0.54 to 2.92, P = 0.005) did
not exceed the minimal clinically important difference (MCID) of 10 mg.
SAPB also resulted in greater intraoperative fentanyl consumption (MD =
13.85 mcg, 95%CI: 3.86 to 23.84, P = 0.007) but a significantly lower
incidence of hypotension (RR = 0.39, 95%CI: 0.20 to 0.76, P = 0.006).
Subgroup analyses showed that TPVB provided superior, but non-clinically
significant, opioid-sparing benefits in thoracic procedures (3.38 mg) and
when compared to superficial SAPB (3.11 mg). CONCLUSION(S): SAPB
offers comparable analgesic efficacy to TPVB, with a more favorable safety
profile but slightly higher opioid consumption. However, the increased
opioid use does not exceed the MCID. Therefore, SAPB is a clinically
effective and safe alternative to TPVB for perioperative regional
analgesia in thoracic and breast surgeries. Copyright © 2025. The
Author(s).

<95>
Accession Number
648832858
Title
Efficacy and safety of tranexamic acid in cardiac surgery: a systematic
review and network meta-analysis.
Source
BMC anesthesiology. 25(1) (pp 503), 2025. Date of Publication: 14 Oct
2025.
Author
Pan X.; Tang M.; Xu Z.; Yu H.; Huang J.; Liang P.
Institution
(Pan, Xu, Yu, Liang) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Tang) West China School of Medicine, Sichuan University, Chengdu, China
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
(Liang) Day Surgery Center, General Practice Medical Center, West China
Hospital, Sichuan University, Chengdu, China

<96>
Accession Number
2040985010
Title
TCT-711 Outcomes of Left Atrial Appendage Closure vs. Oral Anticoagulation
Following Catheter Ablation in Older and Younger Patients: A Sub-analysis
of the OPTION Clinical Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B310-B311), 2025. Date of Publication: 28 Oct 2025.
Author
Nair D.; DeVille J.; Issa Z.; Jaber W.; Mansour M.; Reddy V.; Tondo C.;
Natale A.; Philips K.; Boersma L.; Healey J.; Doshi R.; Leger K.; Christen
T.; Sutton B.; Wazni O.
Institution
(Nair) St. Bernards Med Center & Arrhythmia Research Group, Jonesboro,
Arkansas, United States
(DeVille) Baylor Scott & White Heart Hospital, Plano, Texas, United States
(Issa) St. John's Hospital, Springfield, Illinois, United States
(Jaber) Cleveland Clinic, Cleveland, Ohio, United States
(Mansour) MGH, Boston, Massachusetts, United States
(Reddy) Mount Sinai Heart Health System, New York City, New York, United
States
(Tondo) Centro Cardiologico Monzino, Milano, Milan, Italy
(Natale) Texas Cardiac Arrhythmia Research, Austin, Texas, United States
(Philips) Greenslopes Private Hospital, Brisbane, Queensland, Australia
(Boersma) St. Antonius Hospital, Nieuwegein, Netherlands
(Healey) McMaster University, Ontario, Ontario, Canada
(Doshi) Scottsdale Healthcare, Scottsdale, Arizona, United States
(Leger, Christen) Boston Scientific, Marlborough, Massachusetts, United
States
(Sutton) Boston Scientific, Arden Hills, Minnesota, United States
(Wazni) Cleveland Clinic Foundation, Cleveland, United States
Publisher
Elsevier Inc.
Abstract
Background: The OPTION randomized clinical trial demonstrated that, in
patients who had a prior ablation, left atrial appendage closure (LAAC)
was associated with a lower risk of non-procedural bleeding and
non-inferiority to oral anticoagulation (OAC) for a composite 3-year event
rate of death, stroke, or systemic embolism. This sub-analysis evaluates
outcomes in patients older than 75 years and in patients aged 75 years or
younger. Method(s): Patients undergoing catheter ablation for AF were
randomly assigned to receive LAAC or OAC. The primary efficacy endpoint
was a composite of all-cause death, stroke, or systemic embolism at 3
years and the primary safety endpoint was non-procedural major or
clinically-relevant non-major bleeding through 3 years. The secondary
safety endpoint was major bleeding (procedural or non-procedural) through
3 years. Age sub-groups were defined according to age reported at
baseline. Result(s): Among 1600 enrolled patients, 22.5% were >75
years and 77.5% were <= 75. Mean ages in the older patient group were
78.5+/-2.7 and 78.5+/-2.5, and in the younger group, 66.9+/-6.1 and
66.9+/-7.0 for LAAC and OAC, respectively. The rate of patients on OAC at
3 years in the older group was 14.5% (24/166) in the LAAC arm and 88.9%
(128/144) in the OAC arm. In the younger group OAC usage rates at 3 years
were 8.8% (48/548) and 83.7% (448/535) for LAAC and OAC arms,
respectively. Primary and secondary endpoint rates and individual clinical
event rates are shown in Table 1. [Formula presented] Conclusion(s):
In both age groups, LAAC was non-inferior to OAC with respect to primary
efficacy. Patients aged 75 years or younger appear to benefit from
superior safety (bleeding) with LAAC compared to OAC. Among patients older
than 75 years, there were no differences in safety event rates (bleeding)
between LAAC and OAC, potentially driven by a substantial proportion of
patients in the LAAC arm still on OAC at the end of follow-up. Categories:
STRUCTURAL: Left Atrial Appendage Exclusion Copyright © 2025

<97>
Accession Number
2040983038
Title
TCT-23 Cerebral Embolic Protection During TAVR: An Updated Frequentist and
Bayesian Meta-Analysis of Randomized Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B15-B16), 2025. Date of Publication: 28 Oct 2025.
Author
Bolaji O.; Nor M.; Bandaru R.R.; Jahan S.; Adabale O.; Dodoo S.; Kapadia
S.; Spilias N.; Ibebuogu U.
Institution
(Bolaji) Memorial Sloan Kettering Cancer Center, New York, New York,
United States
(Nor) Stamford Hospital, Stamford, Connecticut, United States
(Bandaru) USF Morsani College of Medicine/HCA Florida Citrus Hospital,
Inverness, Florida, United States
(Jahan) Valley Health System, Las Vegas, Nevada, United States
(Adabale) University of Colorado, Health Parkview Medical Center, Pueblo,
Colorado, United States
(Dodoo) University of Tennessee Health Science Center, Memphis, Tennessee,
United States
(Kapadia) Cleveland Clinic, Cleveland, Ohio, United States
(Spilias) University of Miami Miller School of Medicine, Miami, Florida,
United States
(Ibebuogu) Division of Cardiovascular Diseases, Department of Medicine,
University of Tennessee Health Science Center, Memphis, Memphis,
Tennessee, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has
revolutionized the management of severe aortic stenosis, but stroke
remains one of its most devastating complications, with rates consistently
reported at 2-5%. Cerebral embolic protection (CEP) devices were developed
to reduce embolic events during TAVR, however evidence regarding efficacy
remains inconclusive. Method(s): We searched databases for trials
comparing CEP devices for TAVR. 9 trials involving 11,708 patients were
included. The primary outcome was all strokes(AS); secondary outcomes
included disabling stroke(DS), non-disabling stroke(NDS), and all-cause
mortality(ACM). Both frequentist(FT) and Bayesian(BN) meta-analytic
approaches were employed. Result(s): In the FT meta-analysis, CEP
demonstrated a non-significant 8% reduction in all strokes (RR 0.92; 95%
CI, 0.73-1.15; p=0.393) with no heterogeneity (I2=0.0%). The BN
analysis indicated a 71.5% probability that CEP reduces all stroke risk.
CEP was associated with a 39% reduction in disabling stroke (RR 0.61; 95%
CI, 0.15-2.47; p=0.267) with moderate heterogeneity (I2=46.2%),
while BN analysis revealed an 86.5% probability of benefit. For NDS and
ACM, neither approach demonstrated benefit from CEP. [Formula presented]
 Conclusion(s): We demonstrates that while CEP devices do not
significantly reduce overall stroke risk, they are associated with a
probable reduction in DS. The differential effect on stroke subtypes
highlights the mechanistic complexity of periprocedural cerebrovascular
events. These findings support consideration of CEP devices, particularly
in high-risk patients. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<98>
Accession Number
2040982905
Title
TCT-200 Association between the Occurrence of Coronary In-Stent Restenosis
in Post-Renal Transplant Recipients and Adverse Cardiovascular Events.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B87), 2025. Date of Publication: 28 Oct 2025.
Author
Rana A.; Sawalha K.; Fugere B.; Alhwarat B.; Spraggins R.; Bruich L.;
Sivakumar K.; Shaw-Devine A.; Tayal B.; Uretsky B.; Al'Aref S.
Institution
(Rana) Central Arkansas Health Care System, Little Rock, Arkansas, United
States
(Sawalha, Fugere, Alhwarat, Bruich, Sivakumar, Shaw-Devine, Al'Aref)
University of Arkansas for Medical Sciences, Little Rock, Arkansas, United
States
(Spraggins, Tayal) UAMS, Little Rock, Arkansas, United States
(Uretsky) CAVHS/UAMS, Little Rock, Arkansas, United States
Publisher
Elsevier Inc.
Abstract
Background: In kidney transplant recipients (KTR), a history of
percutaneous coronary intervention (PCI) is common, yet the impact of
subsequent in-stent restenosis (ISR) on post-transplant outcomes remains
unclear. This study evaluates the prognostic significance of ISR after
kidney transplantation by comparing clinical outcomes between individuals
with prior PCI who develop ISR post-transplant and those who do not.
 Method(s): This study utilized data from the US Collaborative Network
in TriNetX, focusing on post-renal transplant (PRT) patients with and
without ISR who had undergone PCI prior to transplantation. We performed
1:1 propensity score matching (PSM) for demographics, CABG, PCI, DM,
immunosuppressants, antilipidemic agents, and antiplatelet therapies. The
primary outcome was a composite of all-cause death, acute myocardial
infarction (MI), heart failure (HF), and stroke, while the secondary
outcomes were the individual components of the primary outcome. Outcomes
were analyzed in relation to ISR in Kaplan-Meier (KM) analysis as
percentages survival at 8.2-years follow-up period and Cox regression with
hazard ratios (HR), with significance set at P < 0.05. Result(s):
Baseline characteristics of 373 patients per PSM in each group are shown
in Table 1. Significant differences were observed in the primary composite
outcome between the ISR vs no ISR group, 24.2% vs 47.9% [HR 1.70, 95% CI
1.50-1.93, p=0.01]. PRT patients with ISR vs no ISR had a higher risk of
all-cause death (35.7% vs 45.7%, HR 1.71, 95% CI 1.41-2.06, p=0.01), acute
MI (57.8% vs 74.4%, HR 1.76, 95% CI 1.49-2.08, p=0.01) and HF (29.1% vs
60.2%, HR 1.69, 95% CI 1.49-1.94, p=0.01). No significant differences were
observed in stroke (HR 1.20, 95% CI 0.86-1.68, p=0.29). [Formula
presented] Conclusion(s): In KTR with prior PCI, post-transplant ISR
is associated with higher risks of mortality, acute MI and HF, warranting
intensified cardioprotective therapy. Categories: IMAGING AND PHYSIOLOGY:
Invasive and Non-Invasive Angiography Copyright © 2025

<99>
Accession Number
2040985071
Title
TCT-1110 Transcatheter Versus Surgical Aortic-Valve Replacement in
Pulmonary-Hypertension Patients: A Systematic Review and Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B474), 2025. Date of Publication: 28 Oct 2025.
Author
Leal D.; Guillen M.; Cedeno F.; Jordan-Torres M.; Castro C.; German J.
Institution
(Leal) Universidad Catolica De Santiago De Guayaquil, Guayaquil, Ecuador
(Guillen) Universidad Catolica de Santiago de Guayaquil, Samborondon,
Ecuador
(Cedeno, Jordan-Torres) Universidad Catolica de Santiago de Guayaquil,
Guayaquil, Ecuador
(Castro) Universidad Rafael Landivar, Alta Verapaz, Guatemala
(German) Hospital Clinica Kennedy, Guayaquil, Ecuador
Publisher
Elsevier Inc.
Abstract
Background: Pulmonary hypertension (PH) complicates roughly one fifth of
severe aortic-stenosis (AS) cases and magnifies peri-operative risk.
Whether transcatheter aortic-valve replacement (TAVR) confers clinical
benefit over surgical AVR (SAVR) in this setting remains uncertain and
directly influences heart-team strategy. This meta-analysis aimed to
compare the incidence of postoperative adverse events between TAVR and
SAVR in patients with severe AS and PH. Method(s): A systematic
search was conducted through June 25, 2025, to identify studies comparing
TAVR and SAVR in adults with severe AS plus invasively or
echocardiographically confirmed PH. Three observational cohort studies
(n=36,920 patients) met inclusion criteria; two provided
propensity-score-matched (PSM) datasets (n=4,333 patients). Postoperative
stroke, major bleeding, permanent pacemaker implantation (PPM), and
in-hospital all-cause mortality were the outcomes analyzed. Pooled risk
ratios (RRs, 95% CI) were calculated using random-effects models;
identical analyses were conducted in PSM subsets. Result(s): Of 313
records screened, three observational cohorts were eligible for inclusion.
Stroke rates were comparable between TAVR and SAVR (RR 1.09; 95%CI
[0.94,1.27]; p=0.25). TAVR reduced major bleeding (RR 0.48; 95%CI
[0.41,0.55]; p<0.001), but increased PPM (RR 1.20; 95%CI [1.12,1.29];
p<0.001) and in-hospital mortality (RR 1.20; 95%CI [1.02,1.42]; p=0.03).
In PSM analysis, results were directionally consistent: stroke remained
neutral (RR 1.10; 95%CI [0.50,2.42]; p=0.82); bleeding reduction persisted
(RR 0.45; 95%CI [0.38,0.54]; p<0.001); PPM increase was non significant
(RR 1.18; 95%CI [0.96,1.44]; p=0.11); and in-hospital mortality difference
attenuated (RR 1.11; 95%CI [0.79,1.56]; p=0.55). Conclusion(s): In
patients with severe AS and concomitant PH, TAVR consistently reduces
major postoperative bleeding but is accompanied by higher rates of
permanent pacemaker implantation and increased mortality during
hospitalization when compared to SAVR, whereas stroke incidence remains
comparable. These findings underscore the need for individualized,
decision-making and contemporary randomized trials to guide valve strategy
in this high-risk population. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<100>
Accession Number
2040983692
Title
TCT-846 Early Transcatheter Aortic Valve Replacement Versus Medical
Therapy for moderate Aortic Stenosis in Patients With Heart Failure With
Reduced Ejection Fraction: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B367-B368), 2025. Date of Publication: 28 Oct 2025.
Author
Abdelrahman A.; Elkholy M.; Manasrah N.; Al-Muhaisen R.; Ahmed K.; Omara
G.; Badr S.
Institution
(Abdelrahman) Mount Sinai Medical Center at Miami Beach / Columbia
University, Miami Beach, Florida, United States
(Elkholy) Detroit Medical Center, Wayne State University, Detroit,
Michigan, United States
(Manasrah) Medical College of Georgia, Augusta, Georgia, United States
(Al-Muhaisen) Mount Sinai Medical Center, Miami, Florida, United States
(Ahmed) Menoufia University Faculty of Medicine, Menoufia, Egypt
(Omara) Nasser Institute Hospital for Research and Treatment, Menoufia,
Egypt
(Badr) Advocate Aurora St. Luke'S Hospital, Springfield, Illinois, United
States
Publisher
Elsevier Inc.
Abstract
Background: The optimal management of patients with non severe aortic
stenosis (AS) and concomitant heart failure with reduced ejection fraction
(HFrEF) remains debated. The evidence comparing early intervention with
transcatheter aortic valve replacement (TAVR) against conservative medical
therapy is conflicting. Method(s): We conducted a systematic review
and meta-analysis of studies comparing TAVR with medical therapy or
clinical surveillance in patients with modertae AS and HFrEF (defined as
[LVEF] <50%). Major electronic databases were searched for randomized
controlled trials (RCTs) and observational studies. Result(s): Pooled
data from one RCT and two observational studies, encompassing a total of
1587 patients, showed that early TAVR was associated with a significant
reduction in all-cause mortality compared to medical therapy (HR: 0.53;
95%[CI]: 0.41 to 0.70; P < 0.001). Significant heterogeneity was observed
across the studies (I2 = 68%, P=0.04), due to discrepancy
between the neutral results of the single RCT (HR: 0.98) and the survival
benefit reported in the observational studies (HR: 0.43 and 0.39). Risk of
bias was judged to be high in the observational studies due to potential
confounding, while the RCT had concerns related to being underpowered and
having a high crossover rate. [Formula presented] Conclusion(s): This
meta-analysis suggests a possible survival benefit of early TAVR in
patients with moderate AS and HFrEF, though the evidence is largely
observational and prone to bias. Conflicting results from the only RCT
highlight ongoing clinical uncertainty, with definitive answers pending
results from larger trials. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<101>
Accession Number
2040982927
Title
TCT-366 Long-Term Clinical Outcomes of CABG Vs PCI for Multivessel and
Left-Main Coronary Artery Disease: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B161), 2025. Date of Publication: 28 Oct 2025.
Author
Saleem M.; Tariq M.; Brar A.; Usman A.; Mudassar M.; Ibrahim S.; Abdalla
A.; Butt S.; Ismail A.; Bajwa M.S.; Zaitoun A.
Institution
(Saleem) Hurley Medical Center, Grand Blanc, Michigan, United States
(Tariq) Health Education Services, Tuscon, Tuscon, Arizona, United States
(Brar, Usman, Abdalla) Hurley Medical Center, Flint, Michigan, United
States
(Mudassar, Ibrahim) Mayo Hospital, Lahore, Lahore, Pakistan
(Butt) Mayo Hospital, LAHORE, Pakistan
(Ismail) King Edward Medical University, Lahore, Pakistan
(Bajwa) JFK University Medical Center HMH, Edison, New Jersey, United
States
(Zaitoun) Covenant Heart Specialists, Grand Blanc, Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: Current guidelines favor Coronary Artery Bypass Graft Surgery
(CABG) over Percutaneous Coronary Intervention (PCI) for multi-vessel
(MVD) and left main coronary artery disease (LM-CAD) due to better
outcomes. However, the FAME-3 trial suggests similar long-term results
between PCI and CABG for triple-vessel disease. To explore this
discrepancy, we conducted a systematic review and meta-analysis of
Randomized Controlled Trials comparing CABG and PCI with DES, assessing
differences in mortality, target vessel revascularization, and major
adverse cardiovascular and cerebrovascular events (MACCE) over at least 3
years. Method(s): RCTs comparing CABG with PCI, reporting outcomes on
at least 3 years (36 months) of follow-up, were included. The primary
outcome assessed was all-cause mortality, while secondary outcomes
consisted of target vessel revascularization (TVR) and MACCE. We also
performed subgroup analysis based on the type of coronary artery disease
(LM-CAD or MVD) and SYNTAX scores. Result(s): CABG did not show any
significant benefit in terms of all-cause mortality when compared to PCI
for either LM-CAD or MVD (RR: 0.90, 95% CI: 0.78, 1.04). It had a lower
risk of mortality in patients with SYNTAX <23 and a lower risk of MACCE
(RR: 0.75, 95% CI: 0.70, 0.81) and TVR (RR: 0.50, 95% CI: 0.38, 0.66)
across all subgroups regardless of the SYNTAX score. [Formula presented]
 Conclusion(s): While no major mortality difference was noted between
CABG and PCI, the risk of MACCE and TVR was lower with CABG in both LM-CAD
and MVCAD across all SYNTAX scores. This should be discussed at length
with patients, as it may impact decision-making. Categories: CORONARY:
Cardiac and Coronary Artery Surgery and Hybrid
Revascularization Copyright © 2025

<102>
Accession Number
2040985466
Title
TCT-710 Plug It or Drug It? Left Atrial Appendage Occlusion vs Direct
Acting oral Anticoagulants: A Propensity Matched Real World Analysis of
5-year Outcomes for patients with Atrial Fibrillation.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B310), 2025. Date of Publication: 28 Oct 2025.
Author
Aggarwal P.; Tuli A.; Slifer D.; Gunani M.
Institution
(Aggarwal, Slifer) Allegheny Health Network, Pittsburgh, Pennsylvania,
United States
(Tuli) Allegheny General Hospital, Washington, District of Columbia,
United States
(Gunani) Allegheny General Hospital, Pittsburgh, Michigan, United States
Publisher
Elsevier Inc.
Abstract
Background: Left atrial appendage occlusion (LAAO) offers a device-based
alternative to direct oral anticoagulants (DOACs) for stroke prevention in
atrial fibrillation (AF). Trials like PRAGUE-17 and PROTECT-AF show LAAO
is non-inferior to DOACs for preventing stroke, with lower rates of major
bleeding, especially intracranial hemorrhage. Meta-analyses confirm these
findings, and ESC and AHA/ACC guidelines now support LAAO in select
high-risk patients. However, real-world comparative outcomes and usage
patterns remain underexplored. The question to answer is- does one
strategy confer obvious risk or harm in equal risk patients.
 Method(s): Using retrospective pooled data from the TriNetX US
databse from 2010-2020, we identified adults in the United States with AF
treated with either LAAO or DOACs. Cohorts were propensity matched for
demographics, co-morbid conditions, and cardiovascular medications.
Primary endpoints at 30 days were stroke, bleeding, and all-cause
mortality. Additionally, we also measured vascular emboli and
hospitalizations in addition to the above, at the 5-year mark.
 Result(s): Our propensity matched analysis compared two cohorts of
16,459 patients each. At the 30-day mark, we observed a statistically
significant difference in incident stroke (RR 0.478, 95% Cl 0.329-0.694,
p<0.0001), all-cause mortality (RR 0.185, 95% CI 0. 148-0.233), favoring
LAAO use. At the 5-year mark, we noted statistically significant
differences in incident bleeding (GI/Intracranial/unspecified) (RR 0.913,
95% CI 0.849-0.982, p 0.0146) and mortality (RR 0.676, 95% CI 0.647-0.705,
p<0.0001) favoring LAAO use over DOACs. However, we also noted a higher
risk of vascular emboli (RR 1.234, 95% CI 1.121-1.357, P<0.0001) with LAAO
use. Conclusion(s): In this real-world analysis, LAAO was associated
with lower rates of stroke and mortality at 30 days, and reduced mortality
and bleeding at 5 years. These findings reinforce current ESC and AHA/ACC
guideline support for LAAO in high-risk NVAF patients and fill critical
gaps in long-term outcome data. As randomized trials remain limited in
duration and scope, our results highlight the value of real-world evidence
to inform future prospective studies and guide patient selection.
Categories: STRUCTURAL: Left Atrial Appendage Exclusion Copyright
© 2025

<103>
Accession Number
2040985485
Title
TCT-379 Systematic two-stent versus provisional stenting in patients with
true coronary artery bifurcation lesions: A pooled individual
patient-level meta-analysis of randomized trials (DKCRUSH X trial).
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B167), 2025. Date of Publication: 28 Oct 2025.
Author
Chen S.-L.
Institution
(Chen) Nanjing First Hospital of Nanjing Medical University, Jiangsu,
Nanjing, China
Publisher
Elsevier Inc.
Abstract
Background: This IPD meta-analysis aims to summarize long-term evidence
comparing provisional stenting with upfront two-stent techniques in
patients with true coronary bifurcation lesions. Method(s): A
systematic review and individual patient data (IPD)-level meta-analysis of
randomized trials with centrally adjudicated endpoints was conducted to
assess the efficacy and safety of provisional stenting versus upfront
two-stent approaches in patients with true coronary bifurcation lesions
undergoing percutaneous coronary intervention with drug-eluting stent. We
searched randomized trials comparing provisional stenting with systematic
two-stent techniques were searched in Ovid MEDLINE, Embase, and two
websites (www.tctmd.com and www.escardio.org) from database inception up
to September 28, 2024. The risk of bias was evaluated using the revised
Cochrane risk-of-bias tool. All patients were prospectively followed and
the last case was completed for at least 6 years. The primary endpoint,
re-evaluated by an independent clinical event committee, was target lesion
failure (TLF) - a composite of cardiac death, target vessel myocardial
infarction, or clinically driven target lesion revascularization, at the
end of follow-up by November 8, 2024. Result(s): A total of 6225
citations were screened. Of these, four trials that randomized patients to
provisional stenting or upfront two-stent techniques were included. Among
1573 patients in the intention-to-treat population, TLF at 6 years
occurred in 144 (Kaplan-Meier estimate 18.2%) in the upfront two-stent
group and 193 (Kaplan-Meier estimate 24.7%) in the provisional stenting
group (HR 0.71 [95% CI 0.57-0.89]; p=0.0022, tau2=0.00, I2=0%),
which was consistent with unadjusted and per-protocol analyses. In
patients with complex coronary bifurcation lesions, TLF occurred in 88
(Kaplan-Meier estimate 19.6%) in the two-stent group and 115 (Kaplan-Meier
estimate 27.6%) in the provisional stenting group (HR 0.68 [95% CI
0.52-0.90]; p=0.0066). Conclusion(s): This study provides robust
evidence that upfront two-stent techniques, particularly double kissing
crush stenting, are associated with a significant reduction in TLF over a
6-year follow-up period compared with provisional stenting. Categories:
CORONARY: Stents: Drug-Eluting and Bare Metal Copyright © 2025

<104>
Accession Number
2041013755
Title
Comparison of Pre-incisional Ultrasound-guided vs. Post-incisional
Surgeon-administered Parasternal Blocks for Analgesia in Pediatric
Congenital Cardiac Surgery: A Randomized Controlled Trial.
Source
Bali Journal of Anesthesiology. 9(3) (pp 136-142), 2025. Date of
Publication: 01 Jul 2025.
Author
Ahmed I.M.E.; Atia A.M.A.; Saad F.O.A.; Mohamed A.A.-K.; Ahmed M.A.A.
Institution
(Ahmed, Atia, Saad, Mohamed, Ahmed) Department of Anesthesia and Intensive
Care, Faculty of Medicine, Assiut University, Assiut, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Effective perioperative pain management in pediatric cardiac
surgery remains challenging due to the complex nature of sternotomy pain
and chest drain-related discomfort. This study compared the analgesic
efficacy and intraoperative hemodynamic effects of ultrasound-guided
pre-incisional parasternal intercostal fascial plane block with
surgeon-administered post-incisional parasternal block (PSB) in children
undergoing congenital heart surgery. Material(s) and Method(s): In
this randomized, double-blind controlled trial, 80 children aged 2-12
years with non-cyanotic congenital heart defects undergoing elective
open-heart surgery with cardiopulmonary bypass were randomized to receive
either PIFP (Group P) or surgeon-administered post-incisional PSB (Group
S). The primary outcome was time to first rescue analgesia
post-extubation. Secondary outcomes included intraoperative fentanyl
consumption, hemodynamic parameters, postoperative pain scores using the
modified objective pain score (MOPS), total nalbuphine consumption, and
intensive care unit (ICU) length of stay. Result(s): Eighty children
were randomized equally into two groups. Intraoperative fentanyl
consumption was significantly lower in Group P (120 [110, 182.5] microg)
compared to Group S (175 [164, 210] microg; P < 0.001). Time to first
rescue analgesia post-extubation was similar between groups (20 [20-24]
vs. 20 [16-24] h, P = 0.125). Postoperative nalbuphine consumption (P =
0.114), MOPS (P > 0.05 across multiple time points), and length of ICU
stay (P = 0.32) were also comparable. Conclusion(s): Pre-incisional
ultrasound-guided PSB reduces intraoperative opioid consumption and
improves hemodynamic stability without affecting postoperative analgesic
outcomes compared to surgeon-administered post-incisional block. Both
techniques provide effective analgesia in pediatric cardiac
surgery. Copyright © 2025 Bali Journal of Anesthesiology.

<105>
Accession Number
2040983012
Title
TCT-764 Impact of Sodium- Glucose Cotransporter 2 Inhibitors on Outcomes
of Transcatheter Aortic Valve Replacement: Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B333), 2025. Date of Publication: 28 Oct 2025.
Author
Mir J.; Yadav R.; Hamza M.; Sattar Z.; Dani S.
Institution
(Mir) University of Missouri, Columbia, Missouri, United States
(Yadav) Midwestern University GME/Verde Valley Medical Center, Cottonwood,
Arizona, United States
(Hamza) Guthrie Medical Group, Cortland, New York, United States
(Sattar) University of Kansas Medical Center, USA, Kansas, Arkansas,
United States
(Dani) Lahey Hospital and Medical Center, Burlington, Massachusetts,
United States
Publisher
Elsevier Inc.
Abstract
Background: The combination of sodium-glucose cotransporter-2 (SGLT2)
inhibitors and transcatheter aortic valve replacement (TAVR) has garnered
attention for its potential to improve cardiovascular outcomes in patients
with aortic stenosis (AS), however there is a paucity of data evaluating
the impact of SGLT2i on clinical outcomes following TAVR. Method(s):
A total of 54 studies were identified through a systematic search of
PubMed and Embase databases up to May 2025. Two studies- one RCT and one
retrospective cohort study-met the predefined inclusion criteria and were
included in the final analysis. The primary outcomes were all-cause
mortality, CV mortality, HF-related hospitalization, and a composite
primary outcome comprising all-cause mortality and HF-related
hospitalization. Using the Mantel-Haenszel method, a random-effects model
was employed to calculate RRs with corresponding 95% confidence intervals
(CIs) for statistical significance. Higgins' I2 was used to analyze
heterogeneity. Result(s): Two studies involving 1533 patients were
included. The pooled analysis demonstrated SGLT2i post-TAVR showed no
significant improvement in all-cause mortality (RR: 0.39; p=0.25),
CV-related mortality (RR: 0.48; p=0.22), primary composite outcome (RR:
0.39; p =0.13), however showed positive trends in favor of HF-related
hospitalizations (RR: 0.50 p =0.06) though not statistically significant.
[Formula presented] Conclusion(s): Although SGLT2i did not
demonstrate statistically significant reductions in mortality or
hospitalization following TAVR, the observed favorable trends across HF
and other key clinical outcomes are noteworthy. Categories: STRUCTURAL:
Valvular Disease and Intervention: Aortic Copyright © 2025

<106>
Accession Number
2040985367
Title
TCT-726 Coronary Obstruction Following Transcatheter Aortic Valve
Replacement Using CoreValve or Evolut in Native Aortic Stenosis: A
Systematic Review.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B316-B317), 2025. Date of Publication: 28 Oct 2025.
Author
Omori A.; Taniguchi T.; Toyota T.; Tabata H.; Takiguchi H.; Shirai S.;
Furukawa Y.
Institution
(Omori, Taniguchi, Toyota, Furukawa) Kobe City Medical Center General
Hospital, Kobe, Japan
(Tabata) Izumi Regional Medical Center, Kagoshima, Japan
(Takiguchi) Kokura Memorial Hospital, Kokurakita-ku, Japan
(Shirai) Kokura Memorial Hospital, Kitakyushu, Japan
Publisher
Elsevier Inc.
Abstract
Background: Coronary obstruction after transcatheter aortic valve
replacement (TAVR) is a rare but life-threatening complication,
particularly in self-expanding valves. Data on mechanisms and management
remain limited. Method(s): A systematic review and pooled analysis of
published case reports was conducted for publications from March 2007 to
January 2025. 33 publications describing 39 cases with coronary
obstruction after TAVR with CoreValve or Evolut for native aortic stenosis
were included. Result(s): The mean age was 82.6+/-6.4 years, with 92%
being women. Coronary obstruction was more common with the 26-mm valve (32
cases), followed by the 29-mm (6 cases) and the 23-mm (1 case). Acute
coronary syndrome occurred in 82%, and 33% required mechanical circulation
support. Coronary obstruction was most common on the left side (85%).
Percutaneous bail-out interventions were commonly performed in acute or
early (<=7 days) obstruction, whereas surgical treatment was more
frequently required in late (>7 days) obstruction (45% versus 11%,
P=0.02). Displacement of calcified native valve leaflets to coronary ostia
was more common in acute or early obstruction, while high implantation,
sinus sequestration, and endothelialization were more prevalent in late
obstruction. In 26-mm valve, its near-cylindrical shape in the lower half
may contribute to obstruction, particularly in cases of a low coronary
ostia height or narrow sinus of Valsalva. [Formula presented]
 Conclusion(s): Coronary obstruction following TAVR with CoreValve or
Evolut occurred frequently with the 26-mm valve. Both anatomical and
procedural factors critically contributed to its development. Categories:
STRUCTURAL: Valvular Disease and Intervention: Aortic Copyright ©
2025

<107>
Accession Number
2040985564
Title
TCT-1106 Long-term Clinical and Angiographic outcomes with Transcatheter
versus Surgical Aortic Valve Replacement in the low and intermediate risk
population; An Updated meta-analysis of Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B472-B473), 2025. Date of Publication: 28 Oct 2025.
Author
Saleem M.; Tariq M.; Brar A.; Usman A.; Mudassar M.; Ibrahim S.; Abdalla
A.; Ismail A.; Butt S.; Bajwa M.S.; Jutt U.
Institution
(Saleem) Hurley Medical Center, Grand Blanc, Michigan, United States
(Tariq) Health Education Services, Tuscon, Tuscon, Arizona, United States
(Brar, Usman, Abdalla) Hurley Medical Center, Flint, Michigan, United
States
(Mudassar, Ibrahim) Mayo Hospital, Lahore, Lahore, Pakistan
(Ismail) King Edward Medical University, Lahore, Pakistan
(Butt) Mayo Hospital, LAHORE, Pakistan
(Bajwa) JFK University Medical Center HMH, Edison, New Jersey, United
States
(Jutt) Mayo Hospital, Lahore, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic valve replacement (TAVR) is preferred
over surgical aortic valve replacement (SAVR) in patients at a high risk
of morbidity or mortality from surgery. However, surgery is still
preferred in younger and healthier patients with severe aortic stenosis,
although recent trials support comparable efficacy and safety of TAVR even
in low-risk patients. Method(s): An intention-to-treat analysis was
conducted to construct a forest plot. The Primary clinical outcome was the
relative risk (RR) of All-cause Mortality, and the secondary outcome was
the RR of stroke at follow-up. Angiographic outcomes were measured in
terms of the Mean Difference (MD) in Effective Orifice Area (EOA) and the
RR of Paravalvular leakage (PVL). Subgroup analysis was performed for the
clinical outcomes at a 5-year follow-up as well. Result(s): No
difference was seen between the two groups in terms of the RR of mortality
(RR: 0.92, 95% CI: 0.75, 1.12) as well as stroke (RR: 1.05, 95% CI: 0.81,
1.35) in both the low and intermediate risk patients and patients <80
years old. No statistically significant difference was found in the EOA;
however, sensitivity analysis showed improved EOA with TAVR (MD: 0.11, 95%
CI: 0.04, 0.18) TAVR was associated with an increased risk of PVL (RR:
5.54, 95% CI: 3.04, 10.10) 5-year follow-up did not show any significant
difference in risk of Mortality (RR: 0.97, 95% CI: 0.86, 1.11) or stroke
(RR: 1.05, 95% CI: 0.89, 1.25) [Formula presented] Conclusion(s):
TAVR is angiographically comparable and clinically as safe and effective
as SAVR in low-risk patients, even at longer follow-up durations.
Categories: ENDOVASCULAR: Diseases of the Aorta and
Intervention Copyright © 2025

<108>
Accession Number
2040982623
Title
TCT-600 Comparative Imaging Strategies in Structural Heart Interventions:
A Systematic Review of 3D/4D Intracardiac Echocardiography Versus
Transesophageal Echocardiography.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B260-B261), 2025. Date of Publication: 28 Oct 2025.
Author
Bilal A.; Kumar A.; Nor M.; Abu-Jazar D.; Dimala C.A.; Shalaby M.;
Narayanan A.
Institution
(Bilal, Kumar, Dimala) The University of Texas Medical Branch, Galveston,
Texas, United States
(Nor) Stamford Hospital, Stamford, Connecticut, United States
(Abu-Jazar, Narayanan) University of Texas Medical Branch, Galveston,
Texas, United States
(Shalaby) University of Texas- Medical Branch, Galveston, Texas, United
States
Publisher
Elsevier Inc.
Abstract
Background: Transesophageal echocardiography (TEE) is the conventional
imaging modality for structural heart interventions but often requires
general anesthesia and has procedural limitations. Emerging evidence
suggests that 3D or 4D intracardiac echocardiography (ICE) may offer
comparable imaging with procedural advantages. Method(s): A
systematic search of PubMed, Embase, Scopus, and Cochrane Library
(inception to June 12, 2025) identified studies comparing 3D/4D ICE and
TEE in structural heart interventions. Inclusion required adult patients
and reporting of procedural or clinical outcomes. Result(s): Of 31
screened studies, 3 met full criteria (n=266). Hussain et al. randomized
135 left atrial appendage occlusion (LAAO) patients to 4D ICE (n=110)
under conscious sedation or TEE (n=25) under general anesthesia. Lab time
was significantly shorter with 4D ICE (68+/-23 vs. 117+/-34 min, p<0.001).
No differences were seen in procedural time (31+/-17 vs. 36+/-15 min),
fluoroscopy (11+/-5 vs. 12+/-5 min), or contrast volume (64+/-35 vs.
68+/-36 mL). Stroke, device embolization, pericardial effusion, and
mortality rates were similar at 45 days and 6 months. Adams et al.
randomized 121 patients undergoing LAAO and found 4D ICE was associated
with shorter procedures (median 35 vs. 43 min, p<0.01), reduced contrast
volume (20 vs. 30 mL, p=0.04), and a trend towards lower fluoroscopy time
(9 vs. 11 min, p=0.06); implantation success was 100% in both groups, with
no peri-device leaks >5 mm. Biroli et al. evaluated 10 high-risk
Transcatheter Edge-to-Edge Repair for Tricuspid Valve Regurgitation (TEER)
patients, where 4D ICE enabled full procedural guidance with fewer
artifacts, strong spatial resolution, and excellent image quality. Key
measurements, including EROA and vena contracta width, demonstrated close
agreement with TEE. All procedures were completed successfully under
conscious sedation, without complications or conversion to general
anesthesia. Conclusion(s): Across structural interventions, 4D/3D ICE
offers comparable imaging to TEE with shorter procedural times, reduced
contrast use, and the advantage of conscious sedation. It is a safe,
efficient alternative for structural interventions in appropriately
selected patients. Categories: STRUCTURAL: Electrophysiology Copyright
© 2025

<109>
Accession Number
2040500455
Title
Efficacy and safety of continuation vs. interruption of anticoagulation
during transcatheter aortic valve implantation: A systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 25(1) (no pagination), 2025. Article Number:
734. Date of Publication: 01 Dec 2025.
Author
Adamu U.G.; Badianyama M.; Patel A.; Mutyaba A.; Tsabedze N.
Institution
(Adamu, Badianyama, Patel, Mutyaba, Tsabedze) Division of Cardiology,
Department of Internal Medicine, School of Clinical Medicine, Faculty of
Health Sciences, University of the Witwatersrand, York Road, Johannesburg,
Parktown, South Africa
Publisher
BioMed Central Ltd
Abstract
Background: The appropriate periprocedural management of oral
anticoagulation in transcatheter aortic valve implantation (TAVI) patients
who require long-term anticoagulation remains controversial.
 Purpose(s): This systematic review and meta-analysis compare the
efficacy and safety of periprocedural continuation versus interruption of
anticoagulation in patients undergoing TAVI with an indication for
long-term anticoagulation. Method(s): We searched PubMed, Embase, and
Cochrane Central databases to identify relevant articles. We included both
observational and randomized controlled trials. Data were analysed using
random-effects model to calculate the odds ratio (OR) with 95% confidence
intervals (CIs). A p <.05 was considered statistically significant.
 Result(s): Four studies comprising 3,144 patients, with
anticoagulation continued in 1,500 (47.7%) patients were included. There
were no difference between periprocedural continuation and interruption of
anticoagulation in the incidence of composite outcomes (OR: 0.84; 95% CI:
0.64-1.10; p =.19), major bleeding (OR: 0.98; 95% CI: 0.57-1.68; p =.95),
major vascular complications (OR: 0.93; 95% CI: 0.72-1.20; p =.60), and
myocardial infarction (MI) (OR: 0.60; 95% CI: 0.20-1.77; p =.36). However,
the incidence of stroke was significantly lower in the continuation group
(OR: 0.61; 95% CI: 0.39-0.94; p =.03). The incidence of blood transfusion
was not significantly different between the continuation and interruption
groups (OR: 0.86; 95% CI: 0.42-1.77; p =.68). Conclusion(s): In this
meta-analysis comparing periprocedural continuation of anticoagulation to
interruption of therapy in patients undergoing TAVI with concomitant
indications for long-term anticoagulation, continuation of anticoagulation
was associated with a lower incidence of stroke without increasing the
risk of bleeding. These findings suggest a potentially favourable safety
profile in favour of continuation of anticoagulant therapy, they should be
interpreted with caution and validated in larger and well-designed
randomised trials. The review protocol was prospectively registered with
the International Prospective Register of Systematic Reviews (PROSPERO),
registration number (CRD42024607149). Copyright © The Author(s)
2025.

<110>
Accession Number
2040985029
Title
TCT-230 Clinical Efficacy of Cerebral Embolism Protection Devices During
Transcatheter Aortic Valve Implantation: A Systematic Review and
Meta-analysis of RCTs with Recent Evidence from PROTECT-TAVI.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B101-B102), 2025. Date of Publication: 28 Oct 2025.
Author
Afzal M.A.; Khalid N.; Abdullah M.; Ashkar H.; Ahmad A.; Shamoon Y.;
Munshi H.; Abbasi S.; Sharma N.; Moore M.; Shamoon F.
Institution
(Afzal) St Joseph's University Medical Center, Paterson, New Jersey,
United States
(Khalid) NewYork Presbyterian Brooklyn Methodist Hospital, Brooklyn, New
York, United States
(Abdullah) Department of Internal Medicine, HCA Florida Oak Hill Hospital,
Brooksville, FL, USA, Brooksville, Florida, United States
(Ashkar, Shamoon) St Joseph University Medical Center, Paterson, New
Jersey, United States
(Ahmad) St Joseph's University Hospital, Union, New Jersey, United States
(Munshi) St. Joseph's University Medical Center US, Paterson, New Jersey,
United States
(Abbasi, Sharma) HCA Florida Oak Hill Hospital, Brooksville, Florida,
United States
(Moore) HCA Florida Oak Hill Hospital, Brooksville, FL, Brooksville,
Florida, United States
(Shamoon) St. Joseph's Regional Medical Center, Paterson, New Jersey,
United States
Publisher
Elsevier Inc.
Abstract
Background: Periprocedural stroke is one of the most serious complications
of transcatheter aortic valve implantation(TAVI). Cerebral embolic
protection devices(CEPDs) are intended to trap debris released during
valve deployment, yet earlier randomized trials were small and produced
mixed results. The 7,635-patient PROTECT TAVI study tripled the total
randomized evidence, offering a timely chance to re-examine CEPD efficacy.
We evaluated whether routine CPED use during TAVI lowers rates of clinical
stroke, disabling stroke, and all-cause mortality. Method(s): PubMed,
EMBASE, Cochrane, and ClinicalTrials.gov were searched from inception to
July 2025 for RCTs comparing CEPD-assisted with unprotected TAVI. After
screening the Pooled effects were calculated in Rev Man 5.3 with a
random-effects model and expressed as odds ratios(OR) with 95 % confidence
intervals(CI). Result(s): Eight trials, including PROTECT TAVI,
enrolled 11,561 participants (5,930 CEPD; 5,631 control). CEPD use did not
reduce the odds of 30-day stroke of any type, disabling stroke and
all-cause mortality. No significant differences were found for acute
kidney injury, life-threatening bleeding, or major vascular or access-site
complications. Sensitivity and subgroup analyses supported the findings.
[Formula presented] Conclusion(s): Across eight randomized trials,
routine CEPD use during TAVI did not lessen any stroke, disabling stroke,
or early mortality and provided no safety benefit. Current evidence does
not support universal CEPD adoption in contemporary TAVI practice. Larger
or risk-stratified studies are required to determine whether specific
patient groups might benefit. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<111>
Accession Number
2040515808
Title
Efficacy and Safety of Colchicine for Secondary Prevention of
Cardiovascular Disease: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Ahmed M.; Fahim M.A.A.; Humayun M.; Sajid B.; Ahmad S.; Asghar M.S.
Institution
(Ahmed) Department of Internal Medicine, Shaheed Mohtarma Benazir Bhutto
Medical College Lyari, Karachi, Pakistan
(Fahim, Humayun) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Sajid) Department of Internal Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Ahmad) Department of Internal Medicine, Aga Khan University and Hospital,
Karachi, Pakistan
(Asghar) AdventHealth, Altamonte Springs, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Colchicine may reduce cardiovascular events in coronary artery disease
(CAD) through its anti-inflammatory effects. PubMed, Scopus, and Cochrane
Library were searched from inception to May 10, 2025, for randomized
controlled trials (RCTs) comparing colchicine with placebo or usual care
in patients with CAD. Eligible trials had >= 30 days of colchicine use and
reported cardiovascular outcomes. The primary outcome was major adverse
cardiovascular events (MACE). Secondary outcomes included extended MACE
(eMACE), myocardial infarction (MI), stroke, all-cause mortality,
cardiovascular mortality, coronary revascularization, gastrointestinal
events, infection, myalgia, arrhythmia, cancer, alopecia, and treatment
discontinuation. Random-effects models were used to calculate risk ratios
with 95% CIs. Heterogeneity was assessed using the I2 statistic, and
meta-regression analysis was conducted to explore heterogeneity and
potential effect modifiers. Eleven studies included 19,618 patients with
9814 and 9804 patients in the colchicine and control groups, respectively.
The colchicine group was significantly associated with a lower rate of
MACE compared to the control group (RR = 0.73, 95% CI = 0.59-0.92, p =
0.006; I2 = 44%). From the secondary outcomes, eMACE (RR = 0.66, 95% CI =
0.52-0.85; p = 0.001; I2 = 73%), MI (RR = 0.82, 95% CI = 0.70-0.96, p =
0.01), and coronary revascularization (RR = 0.60, 95% CI = 0.41-0.87, p =
0.007) were found to be significantly lower in the colchicine group. All
the other secondary outcomes did not reach statistical significance.
Meta-regression analysis for MACE showed a statistically significant
association with diabetes (coefficient: -0.0778, p = 0.0013), indicating a
potential modifying effect. Other covariates, including mean age,
hypertension, smoking, and prior revascularization, did not demonstrate
statistically significant associations. Colchicine reduces MACE, MI, and
revascularization in CAD patients, supporting its use for secondary
prevention. Copyright © 2025 Wiley Periodicals LLC.

<112>
Accession Number
2040983973
Title
TCT-444 Explaining the Machine: A Review of Real-Time AI Tools and
Interpretability in Interventional Cardiology (2020-2025).
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B195), 2025. Date of Publication: 28 Oct 2025.
Author
Upadhyayula S.; N A.C.; Pothugunta R.
Institution
(Upadhyayula, N, Pothugunta) Kempegowda Institute of Medical Sciences,
Karnataka, Bangalore, India
Publisher
Elsevier Inc.
Abstract
Background: Real-time artificial intelligence (AI) is increasingly
integrated into interventional cardiology to enhance imaging, navigation,
and decision-making during PCI, TAVR, and EP procedures. Yet, limited
transparency in algorithm behavior hinders clinical trust. This review
evaluates existing real-time AI systems and their approaches to
interpretability. Method(s): Following PRISMA 2020 guidelines, we
conducted a systematic review of studies from January 2020 to July 2025
using PubMed, IEEE Xplore, Embase, and arXiv. Included studies implemented
AI intra-procedurally and described any form of model explainability.
Exclusion criteria were offline-only, diagnostic-only, or non-cardiac
applications. Extracted data included procedure type, AI task, model type,
imaging modality, latency, interpretability methods, and validation
details. Result(s): We identified 19 distinct intraoperative AI task
types across PCI (e.g., QCA, FFR, IVUS/OCT), structural heart procedures
(e.g., valve sizing, deployment tracking), electrophysiology (e.g., rotor
mapping, substrate classification), and device therapy (e.g., lead
placement). These spanned 2020-2025 human studies and described over 30
models, including CNNs, RNNs, transformers, and physics-based simulators.
Model performance was strong: QCA F1 = 0.96, IVUS/OCT Dice up to 0.97,
ablation AUC = 0.94, LAA sizing accuracy 90.2%. Explainability tools
(Grad-CAM, SHAP, LIME) appeared in 5 studies. Most validations were
retrospective; 1 RCT (FLASH) and 2 CE-marked tools (FEops, VX1) were
found. FDA-cleared intraop AI tools remain rare (e.g., Ultreon, CorPath).
[Formula presented] Conclusion(s): Real-time AI in the cath lab shows
promise for procedural support but often lacks built-in transparency. Most
solutions rely on post hoc saliency maps rather than intrinsic
explainability. Greater emphasis on interpretable, validated AI is
essential for safe clinical integration. Categories: PRECLINICAL: Cath Lab
of the Future Copyright © 2025

<113>
Accession Number
2040983621
Title
TCT-297 Association between Colchicine and Postoperative Atrial
Fibrillation in Patients with Cardiac Surgery: A Meta-analysis of
Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B132), 2025. Date of Publication: 28 Oct 2025.
Author
Jaiswal V.; Hanif M.; Mashkoor Y.; Ahmed A.; Patel N.; Rajak K.; Qamar A.
Institution
(Jaiswal) Section of Interventional Cardiology; Endeavor Health
(NorthShore University HealthSystem), Glenview, IL, Chicago, Illinois,
United States
(Hanif) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, USA, New York, New York, United States
(Mashkoor) Dow Medical College, Karachi, Pakistan
(Ahmed) Section of Interventional Cardiology, Endeavor Health (Northshore
University Health System), Chicago, Illinois, United States
(Patel) Newyork Medical College, Saint Mary and Saint Clare Hospital,
Parsipanny, New Jersey, United States
(Rajak) University of Missouri, Columbia, Missouri, United States
(Qamar) Endeavor Health (NorthShore University Health System), Glenview,
Illinois, United States
Publisher
Elsevier Inc.
Abstract
Background: Colchicine has been shown to reduce inflammation and adverse
cardiovascular events. However, evidence from clinical trials were mixed
in the prevention of postoperative atrial fibrillation (POAF) among
patients with cardiac surgery. We sought to evaluate the association
between colchicine and POAF among cardiac surgery patients.
 Method(s): We conducted a systematic literature search on electronic
database for relevant studies from their inception until July 15, 2025.
Randomized trials with colchicine as an intervention and placebo, in
cardiac surgery patients were included. Risk ratios (RR) and 95%
confidence intervals (CI) were pooled using a random-effect model, and a
p-value of <0.05 was considered statistically significant. Result(s):
Nice RCTs with 2,005 patients (990 in the colchicine group and 1,015 in
the placebo group) were included in the analysis. Pooled analysis shows
that compared with placebo, the colchicine group of patients had a
significantly lower risk of POAF (RR, 0.69(95%CI: 0.55-0.85), p<0.001).
However, the risk of permanent pacemaker implantation (PPM) (RR, 1.34
(94%CI: 0.09-20.08), all-cause mortality (RR, 0.81(95%CI: 0.36-1.83) was
comparable between both groups. Risk of stroke was nonsignificantly higher
among the colchicine group (RR, 2.69(95%CI: 0.50-14.59). [Formula
presented] Conclusion(s): This meta-analysis of nine randomized
controlled trials shows that colchicine reduces the risk of postoperative
atrial fibrillation. However, colchicine does not significantly impact
permanent pacemaker implantation, all-cause mortality, or stroke risk,
though a non-significant increase in stroke risk was noted. Categories:
CORONARY: Pharmacology/Pharmacotherapy Copyright © 2025

<114>
Accession Number
2040985286
Title
TCT-322 Routine Use of Cerebral Embolic Protection Devices During
Transcatheter Aortic Valve Replacement: A Meta-Analysis of Randomized
Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B142-B143), 2025. Date of Publication: 28 Oct 2025.
Author
Alam Kayani A.M.; Umar M.F.; Rashid M.A.; Garcia A.; Lemus-Zamora R.E.;
Akram A.S.; Ilyas H.
Institution
(Alam Kayani) Adventhealth Tampa, Tampa, Florida, United States
(Umar, Rashid) AdventHealth Tampa, Tampa, Florida, United States
(Garcia, Lemus-Zamora) Indiana University School of Medicine,
Indianapolis, Indiana, United States
(Akram) King Edward Medical University, LAHORE, Pakistan
(Ilyas) Florida Atlantic University, Boynton Beach, Florida, United States
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter Aortic Valve Replacement (TAVR) is increasingly
being used for severe aortic stenosis; however, embolization of
intraprocedural debris remains a concern as it can lead to debilitating
strokes. Cerebral embolic protection devices (CEPDs) have been developed
to mitigate this risk but their clinical utility remains uncertain. This
study aims to evaluate the efficacy of CEPDs in reducing the risk of
stroke and mortality during TAVR. Method(s): PubMed, Web of Science,
and Cochrane databases were searched until July 2, 2025. Outcomes measured
included risk of all-cause stroke, disabling stroke, and all-cause
mortality. These were reported as risk ratio (RR) using a random effects
model with 95% confidence intervals (CI). Result(s): A total of 8
studies with 11,511 patients (mean age 81, 45% male) were selected. There
was no difference between CEPDs and control for the risk of all-cause
stroke (RR=0.87 [95% CI: 0.67, 1.11], p=0.26) [A], disabling stroke
(RR=0.76 [95% CI: 0.45, 1.28], p=0.3) [B], and all-cause mortality
(RR=1.11 [95% CI: 0.72, 1.71], p=0.64) [C]. [Formula presented]
 Conclusion(s): The use of CEPDs during TAVR was not associated with a
reduction in risk of all-cause stroke, disabling stroke, and all-cause
mortality. These findings suggest a limited clinical benefit of routine
utilization of CEPDs during TAVR and underscores the importance of further
studies to identify patients who may derive greater benefit from this
approach. Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<115>
Accession Number
2040985359
Title
TCT-1111 Clinical Outcomes After Transcatheter Versus Surgical Aortic
Valve Replacement in Women: Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B474), 2025. Date of Publication: 28 Oct 2025.
Author
Singh Lnu P.; Gaderaju A.; Shah A.; Singh P.; Vaghela P.; Bhagala P.
Institution
(Singh Lnu) Tufts University School of Medicine, Boston, Massachusetts,
United States
(Gaderaju) University of Michigan Health Sparrow, Michigan, Michigan,
United States
(Shah) Smt. N.H.L Municipal Medical College, Gujarat, Ahmedabad, India
(Singh) Smt N.H.L Municipal Medical College, Gujarat, Ahmedabad, India
(Vaghela) GMERS Medical College, Gotri, Vadodara, Gujarat, Vadodara, India
(Bhagala) Grodno State Medical University, Gujarat, Ahmedabad, India
Publisher
Elsevier Inc.
Abstract
Background: Sex-specific outcomes after aortic valve replacement (AVR) are
underexplored despite recognized anatomic and physiologic differences. We
conducted a meta-analysis of 1-year clinical outcomes in women undergoing
transcatheter AVR (TAVR) versus mechanical and bioprosthetic surgical AVR
(SAVR), pooling data from seven studies (approximately 16 000 women),
including randomized trials and the SWEDEHEART registry, to inform
sex-tailored therapeutic strategies and guideline development.
 Method(s): Female-specific event and sample-size data were extracted
for 1-year all-cause mortality, total stroke, myocardial infarction (MI),
cardiac-cause mortality, non-cardiac mortality, and major bleeding.
Random-effects DerSimonian-Laird models generated pooled risk ratios (RR)
with 95 % confidence intervals (CI) and I2 heterogeneity
statistics. Sensitivity analyses assessed the influence of large cohort
studies. Result(s): At 1 year, women receiving TAVR experienced a
non-significant reduction in overall mortality (RR 0.86; 95 % CI
0.65-1.13; I2 66 %) and a significant 21 % lower stroke risk
(RR 0.79; 95 % CI 0.71-0.88; I2 0 %). MI rates were similar (RR
0.95; 95 % CI 0.50-1.80; I2 48 %). Cardiac-cause mortality was
35 % lower with TAVR (RR 0.65; 95 % CI 0.59-0.71; I2 0 %), and
non-cardiac mortality was 24 % lower (RR 0.76; 95 % CI 0.66-0.87;
I2 1.5 %). Major bleeding did not differ significantly (RR
1.06; 95 % CI 0.75-1.49; I2 85 %). Conclusion(s): In women
with severe aortic stenosis, TAVR provides sustained 1-year reductions in
stroke and both cardiac and non-cardiac mortality compared with SAVR,
without increased major bleeding. Overall mortality and MI remain
uncertain due to moderate heterogeneity. These results support
preferential consideration of TAVR in female patients and underscore the
need for dedicated, long-term randomized trials and registries focused on
sex-specific outcomes to refine guideline recommendations. Categories:
STRUCTURAL: Valvular Disease and Intervention: Aortic Copyright ©
2025

<116>
Accession Number
2040983338
Title
TCT-750 Guideline-Directed Medical Therapy for Heart Failure after
Transcatheter Edge-to-Edge Mitral Valve Repair - A Frequentist and
Bayesian Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B326-B327), 2025. Date of Publication: 28 Oct 2025.
Author
Hariyanto J.; Meeus R.; Udoh K.; Suruagy-Motta R.; Rovari G.
Institution
(Hariyanto) Universitas Pelita Harapan, Tangerang, Indonesia
(Meeus) KU Leuven, Leuven, Belgium
(Udoh) Baton Rouge General, Baton Rouge, Louisiana, United States
(Suruagy-Motta) Cesmac University Center, Alagoas, Maceio, Brazil
(Rovari) Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil
Publisher
Elsevier Inc.
Abstract
Background: Transcatheter edge-to-edge repair is a treatment option for
high-risk patients with secondary MR and long-term outcomes depend on
adherence to guideline-directed medical therapy. This study examines
outcomes in studies comparing triple vs non-triple GDMT after TEER.
 Method(s): We searched PubMed, Scopus, and Cochrane for studies
comparing triple GDMT (beta-blocker, renin-angiotensin system inhibitor,
and mineralocorticoid receptor antagonist) vs non-triple therapy (no GDMT,
<=2 agents, or low-dose/untitrated) after TEER. The primary outcome was
1-year all-cause mortality. Analyses were performed using RStudio with
random-effects and Bayesian meta-analysis models with noninformative
priors. Result(s): Four studies with 6,174 patients were included.
All studies included LVEF <50%, mostly with hypertension, DM, CKD, AF, or
prior MI. Age (~71-74) and sex (66-73% male) were similar. GDMT use
varied, with limited representation of high-risk groups (renal
dysfunction, RV impairment, residual MR post-TEER). Triple GDMT showed no
clear 1-year benefit (RR 0.82; 95% CI 0.36-1.86; P=0.413), but reduced
2-year mortality (RR 0.87; 95% CI 0.80-0.96; P=0.004). Benefit seen in
MR<2+ (RR 0.82; 95% CI 0.69-0.98; P=0.025; I2=0%; PI
0.56-1.20), not in MR>=2+ (RR 0.82; 95% CI 0.36-1.86; P=0.413;
I2=73.2%; PI 0.18-3.78). Bayesian analysis showed modest 1-year
benefit (log RR -0.20; 95% CrI -0.60-0.14; tau=0.26), sustained at 2 years
(log RR -0.18; 95% CrI -0.60-0.14; tau=0.16). Bayesian analysis supported
triple GDMT in MR <2+ (posterior log RR -0.210; 95% CrI -0.420 - -0.005;
tau = 0.130), with low heterogeneity. In MR >=2+, the effect was uncertain
(posterior log RR -0.081; 95% CrI -2.15 - 1.80) with high heterogeneity
(tau = 0.36; I2 = 83.2%), reflecting possibility of no
treatment effect. Conclusion(s): Triple GDMT may improve long-term
survival after TEER, particularly in patients with residual MR <2+. While
findings were consistent in this subgroup, the benefit in MR >=2+ remains
uncertain. These underscore the need for individualized care and further
studies on post-TEER management strategies. Categories: STRUCTURAL: Heart
Failure Copyright © 2025

<117>
Accession Number
2040983210
Title
TCT-78 Quantitative Flow Ratio versus Fractional Flow Reserve for Coronary
Revascularization Guidance: 2-Year Follow-up of the FAVOR III Europe
Trial.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B38), 2025. Date of Publication: 28 Oct 2025.
Author
Andersen B.; Holm N.; Sejr-Hansen M.; Maillard L.; Erriquez A.; Ramunddal
T.; Stahli B.; Guiducci V.; Mogensen L.; Westra J.; Escaned J.;
Christiansen E.
Institution
(Andersen) Deparment of Cardiology, Aarhus University Hospital, Aarhus N,
Denmark
(Holm) Aarhus University Hospital, Aarhus N, Denmark
(Sejr-Hansen, Mogensen) Aarhus University Hospital, Aarhus, Denmark
(Maillard) GCS ES Axium Rambot, Aix En Provence, France
(Erriquez) Cardiovascular institute, Azienda ospedaliero-universitaria di
Ferrara, Cona (FE), Venice, Italy
(Ramunddal) Sahlgrenska University Hospital, Gothenburg, Sweden
(Stahli) University Hospital Zurich, Zurich, Switzerland
(Guiducci) Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Modena, Italy
(Westra) Aarhus University Hospital, Skejby, Viborg, Denmark
(Escaned) Hospital Clinico San Carlos, Madrid, Spain
(Christiansen) Aarhus University Hospital, Skejby, Aarhus, Denmark
Publisher
Elsevier Inc.
Abstract
Background: Quantitative flow ratio (QFR) is an angiography-based method
for estimating fractional flow reserve (FFR). The European Society of
Cardiology (ESC) recommends QFR for functional assessment of intermediate
coronary stenoses in patients with chronic coronary syndrome. However, the
FAVOR III Europe trial showed that QFR increased the fraction of patients
requiring revascularization and that QFR was inferior to FFR in terms of
1-year clinical outcomes. Here we report the final 2-year clinical
outcomes of FAVOR III Europe. Method(s): Quantitative flow ratio
(QFR) is an angiography-based method for estimating fractional flow
reserve (FFR). The European Society of Cardiology (ESC) recommends QFR for
functional assessment of intermediate coronary stenoses in patients with
chronic coronary syndrome. However, the FAVOR III Europe trial showed that
QFR increased the fraction of patients requiring revascularization and
that QFR was inferior to FFR in terms of 1-year clinical outcomes. Here we
report the final 2-year clinical outcomes of FAVOR III Europe.
 Method(s): FAVOR III Europe was a multicenter, randomized,
open-label, non-inferiority trial. A total of 2,000 patients were
randomized to undergo QFR- or FFR-guided revascularization for
intermediate coronary artery stenoses. Endpoints assessed at the 2-year
follow-up include the composite of major adverse cardiac events (MACE) and
its individual components of death, myocardial infarction, and unplanned
revascularization. Rates of MACE are compared for superiority by Cox
regression analysis in the intention-to-treat population. Clinical
endpoint adjudication is performed by an independent clinical endpoint
committee blinded to study allocation. Result(s): The final 2-year
results of the FAVOR III Europe trial are ready for presentation at TCT
2025. Conclusion(s): Discussion: The primary report of the FAVOR III
Europe trial identified major safety and efficacy problems with QFR. The
2-year follow-up results may add important data for the ongoing clinical
validation of QFR. Categories: IMAGING AND PHYSIOLOGY: Physiologic Lesion
Assessment Copyright © 2025

<118>
Accession Number
2040985492
Title
TCT-854 Dimensionless Index as a Prognostic Marker in Aortic Stenosis With
Preserved Ejection Fraction: A Systematic Review and Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B371), 2025. Date of Publication: 28 Oct 2025.
Author
Shah H.; Kashif H.; Patel K.; Patel N.; Ganesan A.; Kumar N.; Zainab A.;
Jeoffrey R.; Vallabhajosyula S.
Institution
(Shah) New York Medical College, Denville, New Jersey, United States
(Kashif, Zainab, Jeoffrey) Dow University of Health Sciences, Karachi,
Pakistan
(Patel) New York Medical College, St. Mary's General Hospital, St. Clare
Health, Parsipanny, New Jersey, United States
(Patel) Newyork Medical College, Saint Mary and Saint Clare Hospital,
Parsipanny, New Jersey, United States
(Ganesan, Kumar) St. Mary's General Hospital, St. Claire Health, Denville,
New Jersey, United States
(Vallabhajosyula) Warren Alpert Medical School of Brown University /
Lifespan Cardiovascular Institute, Providence, Rhode Island, United States
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis (AS) is a common valvopathy in North America
and Europe, leading to cardiovascular morbidity and mortality. The
Dimensionless Index (DI) represents the ratio of LVOT time velocity
integral to aortic jet time velocity integral. Literature suggests that DI
<= 0.25 is associated with increased mortality in aortic stenosis with
preserved ejection fraction. This meta-analysis evaluated existing
literature on Dimensionless Index application in patients with aortic
stenosis and preserved ejection fraction, analyzing outcomes in patients
with DI <= 0.25 compared to DI >= 0.25. Method(s): An electronic
literature search was conducted across PubMed, Cochrane, EMBASE, Scopus,
and Google Scholar from inception to July 10th, 2025. Articles evaluating
outcomes in patients with AS and preserved ejection fraction were
included. Data analysis used Review Manager version 5.4 with a
random-effects model. The primary endpoint was overall mortality.
 Result(s): Four observational studies comprising 11,391 patients were
analyzed. Hazard ratios with 95% confidence intervals comparing mortality
outcomes in patients with DI <= 0.25 vs DI >= 0.25 were pooled. DI <= 0.25
was associated with greater mortality [HR: 1.73, CI (1.37-2.20), P <
0.00001]. Conclusion(s): The Dimensionless Index is useful for
assessing risk and mortality in patients with AS and preserved EF.
Patients with DI <= 0.25 have a higher death risk and may benefit from
aortic valve replacement. Further studies exploring low flow vs normal
flow are warranted. Categories: STRUCTURAL: Imaging: Aortic Copyright
© 2025

<119>
Accession Number
2040983225
Title
TCT-765 Renin-Angiotensin Inhibition Following TAVR: A Fresh Look at Old
Allies - An Updated Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B333), 2025. Date of Publication: 28 Oct 2025.
Author
Oliveira V.; Barbosa L.; Antonio de Sousa P.; Akabane M.A.; de Paiva A.;
Lima A.P.; Bertoli E.D.; Farias C.A.; Moreira H.; Tartuce Filho P.R.;
Tartuce L.
Institution
(Oliveira) Federal University of Goias, Goiania, Goias, Brazil
(Barbosa) Federal Univresity of Minas Gerais, Belo Horizonte, Minas
Gerais, Brazil
(Antonio de Sousa) Federal University of Uberlandia, Uberlandia, Minas
Gerais, Brazil
(Akabane) Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais,
Brazil
(de Paiva) University of Campinas, Campinas, Sao Paulo, Brazil
(Lima) University of Rio Verde, Rio Verde, Goias, Brazil
(Bertoli) Hospital e Maternidade Marieta Konder Bornhausen, Itajai, Santa
Catarina, Brazil
(Farias) 9th of July University, Sao Paulo, Sao Paulo, Brazil
(Moreira) Universidade Federal de Goias - UFG, Goias, Goiania, Brazil
(Tartuce Filho) Unknown, Rio Verde, Brazil
(Tartuce) ICRI, Rio Verde, Goias, Brazil
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis leads to left ventricular remodeling,
hypertrophy, and fibrosis, increasing the risk of heart failure.
Renin-angiotensin system (RAS) inhibitors may mitigate these adverse
effects and improve clinical outcomes. Despite advancements in
transcatheter aortic valve replacement (TAVR), substantial mortality,
heart failure readmissions, and other complications persist. This study
aimed to evaluate the impact of RAS inhibitor therapy following TAVR on
clinical outcomes. Method(s): We conducted a systematic review and
meta-analysis following the Cochrane Handbook for Systematic Reviews of
Interventions and PRISMA guidelines. A comprehensive search of PubMed,
Embase, and Cochrane was performed to identify studies comparing RAS
inhibitor (RASi) use versus non-use in patients undergoing TAVR for aortic
stenosis. Risk ratios (RRs) and 95% confidence intervals (CIs) were
calculated using a Mantel-Haenszel random-effects model. Heterogeneity was
assessed using Higgins' I2 statistics, with statistical
significance set at P<0.05. All analyses were performed using R version
4.5.0. Result(s): A total of 11 studies comprising 34,987 patients
were included. Among these, 16,593 patients received RASi therapy, and
16,687 (47.7%) were female. The mean age ranged from 79.1 to 84.4 years.
RASi use following TAVR was associated with significantly lower midterm
all-cause mortality (RR 0.70; 95% CI 0.61-0.80; P<0.001), cardiovascular
mortality (RR 0.67; 95% CI 0.59-0.76; P<0.001), and heart failure
readmission (RR 0.86; 95% CI 0.79-0.93; P=0.001) compared to non-users.
The risk of myocardial infarction (RR 1.11; 95% CI 0.75-1.66; P=0.61) was
similar between groups. Conclusion(s): RASi therapy following TAVR is
associated with improved outcomes, including reduced all-cause mortality,
cardiovascular mortality, and heart failure readmission, without
increasing the risk of myocardial infarction. Further randomized
controlled trials are needed to confirm these findings and guide clinical
practice. Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<120>
Accession Number
2040982635
Title
TCT-768 SGLT2 Inhibitors in Patients Undergoing Transcatheter Aortic Valve
Replacement: A Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B334-B335), 2025. Date of Publication: 28 Oct 2025.
Author
Shah S.; Trube J.; Sze C.-H.; Hyun S.; Johnson T.; Singh S.; Daneii P.;
Khan S.; Massaro J.; Sabina M.
Institution
(Shah, Trube, Sze, Johnson, Singh, Daneii, Khan, Sabina) Lakeland Regional
Health Medical Center, Lakeland, Florida, United States
(Hyun, Massaro) Lakeland Regional Health, Lakeland, Florida, United States
Publisher
Elsevier Inc.
Abstract
Background: Aortic stenosis is a common valvular disease in older adults,
causing significant morbidity and heart failure even after transcatheter
aortic valve implantation (TAVI). Untreated moderate to severe AS carries
a 4-year mortality of 45.7%. While SGLT2 inhibitors improve outcomes in
heart failure, evidence in TAVI patients is limited. This meta-analysis
examines two recent studies on SGLT2 inhibitors and post-TAVI outcomes.
 Method(s): A systematic search of PubMed, Embase, and
ClinicalTrials.gov (April 28, 2025) identified randomized and
observational studies comparing TAVR patients treated with versus without
SGLT2 inhibitors. Outcomes included all-cause mortality, heart failure
hospitalization, cardiovascular mortality, and their composite. Risk
ratios were pooled using a random-effects model, with heterogeneity
assessed by I2. Result(s): This analysis of one randomized
trial and one observational study found no significant reduction in
all-cause mortality (RR 0.48, 95% CI 0.13-1.72; p=0.26), cardiovascular
death (RR 0.53, 95% CI 0.19-1.48; p=0.22), or the composite of
cardiovascular death and heart failure hospitalization (RR 0.52, 95% CI
0.24-1.10; p=0.08). Heart failure hospitalizations were significantly
reduced (RR 0.56, 95% CI 0.32-0.99; p=0.05). [Formula presented]
 Conclusion(s): SGLT2 inhibitors did not significantly reduce
all-cause mortality, cardiovascular death, or the composite of
cardiovascular death and heart failure hospitalization, but were
associated with a 44% reduction in heart failure hospitalizations.
Substantial heterogeneity between the randomized trial and observational
study limits definitive conclusions. Categories: STRUCTURAL: Heart
Failure Copyright © 2025

<121>
Accession Number
2040985473
Title
TCT-661 Comparing Recurrence of Infective Endocarditis and Other Outcomes
in Patients Undergoing Bioprosthetic vs. Mechanical Aortic Valve
Replacement: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B288), 2025. Date of Publication: 28 Oct 2025.
Author
Sharma V.; Kumar H.; Wulandari P.; Kolade V.
Institution
(Sharma, Kolade) Guthrie/Robert Packer Hospital, Sayre, Pennsylvania,
United States
(Kumar) Dow University of Health Sciences, Karachi, Pakistan
(Wulandari) The Guthrie Clinic/Robert Packer Hospital, Sayre,
Pennsylvania, United States
Publisher
Elsevier Inc.
Abstract
Background: The choice between bioprosthetic and mechanical aortic valve
replacement (AVR) in patients with infective endocarditis (IE) remains
debatable. This meta-analysis examines the comparative outcomes of these
two valve types, focusing on recurrence, survival, and comorbidities.
 Method(s): A systematic review and meta-analysis compared
bioprosthetic and mechanical AVR in infective endocarditis, evaluating IE
recurrence and long-term survival as primary outcomes, and stroke, major
bleeding, and reoperation as secondary outcomes, with a random-effects
model used to calculate HRs, RRs, and CIs. Result(s): A total of 4
studies comprising 1,098 patients were included. Mechanical valves showed
a significantly lower recurrence rate of IE compared to bioprosthetic
valves (HR 0.268, p = 0.039). Long-term survival was improved in patients
receiving mechanical valves (HR 0.546, p = 0.025), with time-dependent
analyses favoring mechanical prostheses. The incidence of ischemic stroke
was lower in the mechanical valve group (8.3% vs. 16.8% at 5 years). No
significant difference was found in major bleeding rates between the two
groups. However, mechanical valves demonstrated a lower reoperation rate
over long-term follow-up. [Formula presented] Conclusion(s):
Mechanical aortic valves are linked with a decreased recurrence of IE,
higher long-term mortality, and reduced stroke risk compared to
bioprosthetic valves. Despite these advantages, bioprosthetic valve usage
is rising, probably due to anticoagulation concerns. Further study is
required to analyze patient selection criteria and the functioning of
newer-generation bioprosthetic valves. Categories: STRUCTURAL: Valvular
Disease and Intervention: Aortic Copyright © 2025

<122>
Accession Number
2040982983
Title
TCT-828 Transcatheter Mitral Valve Edge-to-Edge Repair for Central vs
Noncentral Degenerative Mitral Regurgitation: A Systemic Review and
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B359), 2025. Date of Publication: 28 Oct 2025.
Author
Gill O.A.; Omais M.; Pathak P.; Tahir M.U.; Tanvir T.A.; Ashraf S.; Gibson
C.M.
Institution
(Gill) King Edward Medical University Lahore, Lahore, Pakistan
(Omais) Mayo Hospital Lahore, Lahore, Pakistan
(Pathak) North Alabama Medical Center, Muscle Shoals, Alabama, United
States
(Tahir) King Edward Medical University, Lahore, Lahore, Pakistan
(Tanvir) Dar-ul-Sehat Hospital, Karachi, Karachi, Pakistan
(Ashraf) Allied Hospital, Faisalabad, Pakistan
(Gibson) Beth Israel Deaconess Medical Center, Boston, Massachusetts,
United States
Publisher
Elsevier Inc.
Abstract
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) was
previously indicated solely for central degenerative mitral regurgitation
(DMR) lesions, but recent strides in technology have resulted in favorable
outcomes in non-central DMR patients. This meta-analysis aims to compare
procedural and follow-up outcomes between central and non-central DMR
patients. Method(s): PubMed, Embase, Cochrane, and Scopus databases
were searched until June 2025. Studies comparing TEER for central and
non-central DMR were included. Pooled effect sizes for dichotomous
outcomes were calculated using Odds Ratios (OR) with 95% confidence
intervals (CI). Heterogeneity was assessed using I2, and all
analyses were performed using random-effects model in RevMan 5.4.
 Result(s): The procedural outcomes included procedural success
(OR=1.20, 95% CI: 0.38-3.74, p=0.76; I=0%), which was comparable between
central and non-central DMR patients, as were procedural complications
(OR=1.02, 95% CI= 0.39-2.67, p=0.96; I=0%) and requirement of >1 clips
(OR=1.00, 95% CI= 0.41-2.43, p=1.00; I=59%). Among the follow-up outcomes,
all-cause mortality (OR=1.00, 95% CI= 0.17-5.95, p=1.00; I=51%),
proportion of patients achieving MR grade 0-1 (OR= 0.55, 95% CI: 0.15 to
2.03, p=0.37; I=52%), proportion of patients achieving New York Heart
Association (NYHA) Class I (OR=0.63, 95% CI= 0.26-1.50, p=0.30; I=5%) and
incidence of heart failure-related readmission (OR=1.35, 95% CI=
0.32-5.68, p=0.68; I=0%) were pooled, with no statistically significant
differences between both groups. Conclusion(s): There were no
differences between the groups in procedural and follow-up outcomes.
M-TEER was equally effective in achieving MR grade 0-1 and NYHA Class I in
both groups. However, randomized controlled trials (RCTs) including larger
sample sizes are required to generate conclusive evidence. Categories:
STRUCTURAL: Valvular Disease and Intervention: Mitral Copyright ©
2025

<123>
Accession Number
2040982653
Title
TCT-1209 Percutaneous Coronary Intervention versus Coronary Artery Bypass
Grafting in Non-ST-segment elevation Acute Coronary Syndrome: An Updated
Meta-analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B518), 2025. Date of Publication: 28 Oct 2025.
Author
Elnaggar K.; Hafez A.; Alkowatli H.; Sells T.; Mocanu M.
Institution
(Elnaggar, Sells, Mocanu) Detroit Medical Center Huron Valley Sinai,
Commerce Township, Michigan, United States
(Hafez) Mayo Clinic, Phoenix, Arizona, United States
(Alkowatli) HCA Blake Hospital, Bradenton, Florida, United States
Publisher
Elsevier Inc.
Abstract
Background: Percutaneous coronary intervention (PCI) and coronary artery
bypass grafting (CABG) are widely utilized revascularization modalities.
However, debates remain on the favourable revascularization approach for
managing non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
 Method(s): Four databases were searched up to May 2025 to include
randomized controlled trials (RCTs), prospective cohorts (PCs) and
retrospective cohorts (RCs) evaluating PCI compared to CABG in patients
presenting with NSTE-ACS. Outcomes encompassed all-cause mortality, major
adverse cardiovascular events (MACE), stroke and the need for
revascularization. Categorical variables were analyzed as a risk ratio
(R.R.) with a 95% confidence interval (C.I.) through a Der Simonian-Laird
random-effect meta-analysis model. Result(s): 17 studies encompassing
39,846 patients constituted this meta-analysis. Pooled analysis and
estimates from PCs and RCTs revealed comparable estimates of all-cause
mortality and MACE between PCI and CABG. In contrast, RCs showed higher
mortality (R.R. = 1.45, 95% C.I. [1.27, 1.67], p = 0.001) and MACE (R.R. =
1.51, 95% C.I. [1.23, 1.84], p = 0.001) rates with PCI relative to CABG.
Although PCI showed a significant reduction in strokes compared to CABG,
there was a higher incidence of revascularization within patients
receiving PCI. [Formula presented] Conclusion(s): Comparable rates of
all-cause mortality and MACE were seen between PCI and CABG in NSTE-ACS
management. While RCs favored CABG, PCs and RCTs showed no significant
differences. PCI demonstrated superior stroke prevention but increased
revascularization requirements. Categories: CORONARY: Acute Coronary
Syndromes Copyright © 2025

<124>
Accession Number
2040983291
Title
TCT-934 What is Standard of Care? Qualitative Analysis of PCI Peer
Reviews.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B399), 2025. Date of Publication: 28 Oct 2025.
Author
Subramaniam A.; Dimitri D.S.; Stein E.; Simons C.; Doll J.
Institution
(Subramaniam, Dimitri, Stein, Doll) University of Washington, Seattle,
Washington, United States
(Simons) VA Puget Sound Health Care System, Seattle, Washington, United
States
Publisher
Elsevier Inc.
Abstract
Background: Case-based peer review is used by hospital systems for quality
improvement and to assess physician competency to perform percutaneous
coronary intervention (PCI). However, reviewers may disagree about whether
cases meet the standard of care. Method(s): We recruited 10 operators
from the Veterans Administration to review 65 cases such that each case
was evaluated by two independent reviewers in a blinded fashion. Each case
was rated across 6 care domains (Appropriateness, Lesion Suitability,
Strategy, Technical Performance, Outcome, and Documentation). Reviewers
also determined whether the standard of care was met. Comments were
solicited for each care domain. Each comment was reviewed and coded for
substantive and critical feedback. We reviewed 129 substantive and 117
critical comments. Comments were considered substantive if feedback was
meaningful for practice improvement, and critical if feedback was
judgmental or unfavorable of the care provided. Additionally, thematic
analysis was performed to identify case characteristics that reviewers
found important in their assessment of standard of care. Result(s):
The most likely domain to elicit critical feedback was "strategy".
Substantive and critical feedback was common for all cases, irrespective
of whether it was rated outside the standard of care. For cases rated
outside the standard of care, we identified several themes in the
reviewers' comments: 1) preference for medical therapy or cardiac surgery
instead of PCI. 2) recommendation for intravascular imaging or more
aggressive lesion preparation. 3) inadequate documentation, and 4) poor
complication management. In cases with discordant standard of care
decisions (19/65), both reviewers typically identified the same issues,
but differed in their assessment of severity. Conclusion(s):
Case-based peer review generated substantial critical feedback that may be
used for quality improvement, but reviewers often disagreed about the
standard of care. These qualitative findings support peer review as an
important tool, but raise concerns about the ability of peers to reliably
assess whether PCI operators meet the standard of care. Categories:
PRECLINICAL: Quality, Guidelines, Appropriateness Criteria,
Cost-Effectiveness, and Public Health Issues Copyright © 2025

<125>
Accession Number
2040984371
Title
TCT-227 Routine Cerebral Embolic Protection During Transcatheter Aortic
Valve Replacement: A Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B100), 2025. Date of Publication: 28 Oct 2025.
Author
Ismayl M.; Mufarrih M.; Eleid M.; Rihal C.; Guerrero M.
Institution
(Ismayl, Mufarrih, Eleid, Rihal) Mayo Clinic, Rochester, Minnesota, United
States
(Guerrero) Mayo Clinic Rochester, Rochester, Minnesota, United States
Publisher
Elsevier Inc.
Abstract
Background: Periprocedural stroke remains a key concern with trasncatheter
aortic valve replacement (TAVR). We conducted a meta-analysis of
randomized controlled trials (RCTs) to assess the effectiveness and safety
of routine cerebral embolic protection (CEP) use. Method(s): A
systematic search of PubMed, EMBASE, and ClinicalTrials.gov was conducted
from inception to May 22, 2025, to identify RCTs comparing CEP vs.
standard care during TAVR. The primary outcome was stroke (including
disabling and nondisabling strokes). Secondary outcomes included disabling
stroke, all-cause mortality, new ischemic lesions on post-TAVR brain
magnetic resonance imaging (MRI), major vascular complications,
life-threatening bleeding, and acute kidney injury. Risk ratios (RRs) were
pooled using a random-effects model. Result(s): A total of 9 RCTs
encompassing 11,641 patients (5,970 with CEP and 5,671 without) were
included. CEP use did not significantly reduce the risk of stroke (RR
0.91; 95% CI 0.73-1.14; p=0.41), disabling stroke (RR 0.80; 95% CI
0.57-1.12; p=0.19), or new ischemic lesions on MRI (RR 0.98; 95% CI
0.91-1.06; p=0.64). There were no significant differences in mortality or
safety outcomes between the CEP and control groups. Subgroup analyses
based on the type of CEP device showed no significant differences in
outcomes between the 2 groups, regardless of device type. [Formula
presented] Conclusion(s): Routine CEP use during TAVR was not
associated with reductions in stroke, disabling stroke, or mortality.
Future studies are warranted to identify subgroups that may benefit from
selective CEP use and to evaluate the efficacy of next-generation devices.
Categories: STRUCTURAL: Valvular Disease and Intervention:
Aortic Copyright © 2025

<126>
Accession Number
2040983023
Title
TCT-220 Real-world Utilization of PASCAL Precision System in non-A2P2
Degenerative Mitral Regurgitation.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B97), 2025. Date of Publication: 28 Oct 2025.
Author
Ramanathan P.K.; Makkar R.; Waggoner T.; Latib A.; Kipperman R.; Hanson
I.; Sinha A.; Chakravarty T.; Sharma R.; Depta J.; Castellanos J.; Kodali
S.; Krishnaswamy A.; Whisenant B.; Menees D.; Lim S.; Gilani F.; Sanchez
C.; Gheewala N.; Garcia S.; Gada H.; Kapadia S.; Shah P.; Renard B.;
Theodos G.; Yaryura R.; Gardner B.; Steinberg D.; Gnall E.; Kaddissi G.;
Chhatriwalla A.; Frangieh A.H.; Eleid M.; Genereux P.; Saxon J.;
Villablanca P.; Matar F.; Agarwal H.; Chetcuti S.; Frisoli T.; Zahr F.
Institution
(Ramanathan) Promedica Toledo Hospital, Toledo, Ohio, United States
(Makkar) Cedars-Sinai Medical Center, Beverly Hills, California, United
States
(Waggoner) US Heart & Vascular/Tucson Medical Center, Tucson, Arizona,
United States
(Latib) Montefiore Medical Center, New York, New York, United States
(Kipperman) Gagnon Cardiovascular Institute, Morristown Medical Center,
Atlantic Health System, Morristown, New Jersey, United States
(Hanson) Corewell Health William Beaumont University Hospital, Royal Oak,
Michigan, United States
(Sinha) Indiana University, Carmel, Indiana, United States
(Chakravarty) Cedars-Sinai Medical Center, Los Angeles, California, United
States
(Sharma) Stanford University, Palo Alto, California, United States
(Depta) Medical College of Wisconsin, Milwaukee, Wisconsin, United States
(Castellanos) Our Lady of The Lake Regional Medical Ce, Baton Rouge,
Louisiana, United States
(Kodali) Newyork-Presbyterian Columbia University Irving Medical Center,
New York, New York, United States
(Krishnaswamy) Cleveland Clinic Foundation, Cleveland, Ohio, United States
(Whisenant) Intermountain Medical Center Heart Institute, Salt Lake City,
Utah, United States
(Menees) University of Michigan, Ann Arbor, Michigan, United States
(Lim) Centre for Heart Valve Innovation, University of British Columbia,
Vancouver, British Columbia, Canada
(Gilani) Catholic Medical Center, Londonderry, New Hampshire, United
States
(Sanchez) Ohiohealth Riverside Methodist Hospital, Columbus, Ohio, United
States
(Gheewala) Pima Heart and Vascular/Tucson Medical Center, Tucson, Arizona,
United States
(Garcia) The Christ Hospital, Cincinnati, Ohio, United States
(Gada) UPMC Pinnacle, Harrisburg, Pennsylvania, United States
(Kapadia) Cleveland Clinic, Cleveland, Ohio, United States
(Shah) Brigham and Women's Hospital, Boston, Massachusetts, United States
(Renard) Beaumont Health System, Royal Oak, Michigan, United States
(Theodos) BJCMG Cardiology at Missouri Baptist Med, Saint Louis, Missouri,
United States
(Yaryura) Sarasota Memorial Hospital, Sarasota, Florida, United States
(Gardner) Intermountain Healthcare, Saint George, Utah, United States
(Steinberg) Medical University of South Carolina, Charleston, South
Carolina, United States
(Gnall) Lankenau Medical Center, Wynnewood, Pennsylvania, United States
(Kaddissi) The Heart House, Moorestown, New Jersey, United States
(Chhatriwalla) Saint Luke's Mid America Heart Institute, Kansas City,
Missouri, United States
(Frangieh) University of California Irvine, Orange, California, United
States
(Eleid) Mayo Clinic, Rochester, Minnesota, United States
(Genereux) Morristown Medical Center, Morristown, New Jersey, United
States
(Saxon) University of Virginia, Charlottesville, Virginia, United States
(Villablanca, Frisoli) Henry Ford Hospital, Detroit, Michigan, United
States
(Matar) University of South Florida, Tampa, Florida, United States
(Agarwal) Omaha VAMC and Creighton University Med Ctr, Omaha, Nebraska,
United States
(Chetcuti) University of Michigan Health Center, Ann Arbor, Michigan,
United States
(Zahr) Oregon Health & Science University, Portland, Oregon, United States
Publisher
Elsevier Inc.
Abstract
Background: Mitral valve transcatheter edge-to-edge repair (M-TEER) has
historically been considered more challenging in the commissural regions
of the mitral valve (A1P1, A3P3) compared to central regions (A2P2). Data
on outcomes with contemporary M-TEER by implant location are limited.
 Method(s): Degenerative mitral regurgitation (DMR) patients treated
with the PASCAL Precision system between Sep 2022-Oct 2024 using a single
PASCAL or PASCAL Ace implant were analyzed by device location (A2P2 vs
non-A2P2) from the STS/ACC TVT Registry. Procedural, clinical, and
echocardiographic outcomes to 30 days were assessed. All outcomes were
site-reported. Result(s): The study comprised 1207 patients
categorized into two groups: patients with a single implant at A2P2
(n=977) and those with a single implant at non-A2P2 position (n=230).
Patients in the A2P2 group were younger, majority female, had lower
incidence of flail leaflet, and a higher incidence of heart failure
hospitalization (HFH) and leaflet calcification. There were no aborted
procedures in either group, and successful device implantation was
achieved in a high proportion of patients, 98.2% in the A2P2 group vs.
97.0% in the non-A2P2 group (P=0.299). Procedure duration was shorter in
the A2P2 group (77.0 min) vs. non-A2P2 group (86.0 min) (P=0.053). The
PASCAL Ace implant was used more frequently in the non-A2P2 group (87.4%)
compared to A2P2 group (67.0%) (P<0.001). At 30 days, the incidence of
adverse events was low and comparable in both the A2P2 and non-A2P2 groups
[mortality: 1.9% vs. 2.6%; mitral valve reintervention: 0.3% vs. 0%; HFH:
1.6% vs. 3.0%; single leaflet device attachment (SLDA): 0.1% vs. 0.4%; all
P>0.05]. MR reduction at 30 days was similar in the A2P2 vs non-A2P2
groups (P=0.997) with MR<=2+ and MR<=1+ rates of 94.9% vs. 95.8% and 72.0%
vs. 74.3%, respectively. Conclusion(s): In a real-world setting, DMR
patients treated with the PASCAL Precision system in both commissural and
non-commissural implant locations experienced high survival, significant
MR reduction and low incidence of adverse events, including SLDA, HFH and
mitral valve reintervention at 30 days. Categories: STRUCTURAL: Valvular
Disease and Intervention: Mitral Copyright © 2025

<127>
Accession Number
2040985547
Title
TCT-339 Target Vessel-Specific Prognosis After Successful vs Failed
Chronic Total Occlusion Percutaneous Coronary Intervention: A
Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B149-B150), 2025. Date of Publication: 28 Oct 2025.
Author
Hariyanto J.; Udoh K.; Rovari G.; Ashraf H.
Institution
(Hariyanto) Universitas Pelita Harapan, Tangerang, Indonesia
(Udoh) Baton Rouge General, Baton Rouge, Louisiana, United States
(Rovari) Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil
(Ashraf) Rawalpindi Medical University, Rawalpindi, Pakistan
Publisher
Elsevier Inc.
Abstract
Background: While chronic total occlusion (CTO) PCI offers benefits,
outcomes may vary by target vessel. This study evaluates successful vs
failed CTO PCI across LAD, LCX, and RCA. Method(s): We systematically
searched PubMed, Scopus, and Cochrane for studies comparing failed vs
successful CTO PCI. Random-effects models estimated risk ratios (RRs);
subgroup analyses were based on target vessel. Result(s): Five
studies (n = 2,594; 710 failed, 1,884 successful) were included. RCA was
most common, LAD (33-44%). Success rates ranged from ~71% to >90%.
Failures were mostly LAD; patients were older with more comorbidities
(prior MI, CABG, multivessel disease) At 1 year, failed PCI was linked to
higher all-cause mortality (RR 1.63; 95% CI 1.39-1.91), with risk in LAD
(RR 2.46; 1.05-5.78) and RCA (RR 1.62; 1.24-2.12), but not LCX (RR 1.20;
0.82-1.75; P = 0.23). At 2 years, mortality remained higher (RR 1.47;
1.08-2.01), driven by LAD (RR 2.00; 1.20-3.33) and RCA (RR 1.40;
1.04-1.90), not LCX (RR 0.88; 0.68-1.16; P = 0.008). At 5 years, no
significant difference (RR 1.12; 0.90-1.40) in LAD (RR 1.24; 0.84-1.84),
LCX (RR 0.92; 0.82-1.04), or RCA (RR 1.18; 0.70-1.99; P = 0.26) Two-year
cardiovascular mortality was higher (RR 1.85; 1.35-2.55), with risk in LAD
(RR 1.77; 1.19-2.64), numerical increase in RCA (RR 1.91; 0.96-3.80), and
uncertainty in LCX (RR 2.21; 0.47-10.50; P = 0.95) [Formula presented]
 Conclusion(s): Failed CTO PCI increases short- and mid-term mortality
in LAD and RCA, but risk fades by 5 years. This highlights the importance
of success, especially in LAD, and support vessel-specific strategies.
Categories: CORONARY: Complex and Higher Risk Procedures for Indicated
Patients (CHIP) Copyright © 2025

<128>
Accession Number
2040983318
Title
TCT-1097 Five-Year Mortality After Surgical vs. Transcatheter Valve
Replacement in Low-Flow, Low-Gradient Aortic Stenosis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B468), 2025. Date of Publication: 28 Oct 2025.
Author
Jacquemyn X.; Ganduboina R.; Ogami T.; Hasan I.; Ferdinand F.;
Serna-Gallegos D.; Kliner D.; Toma C.; Makani A.; West D.
Institution
(Jacquemyn, Hasan, Ferdinand, Toma) University of Pittsburgh Medical
Center, Pittsburgh, Pennsylvania, United States
(Ganduboina) NRI Institute of Medical Sciences, Andhra Pradesh,
Visakhapatnam, India
(Ogami) University of Pittsburgh Medical Center, Erie, Pennsylvania,
United States
(Serna-Gallegos, Kliner, West) UPMC, Pittsburgh, Pennsylvania, United
States
(Makani) University of Pittsburgh Medical Center, Gibsonia, Pennsylvania,
United States
Publisher
Elsevier Inc.
Abstract
Background: The optimal approach to aortic valve replacement in patients
with low-flow, low-gradient (LFLG) aortic stenosis (AS) remains debated,
particularly regarding long-term outcomes of surgical (SAVR) versus
transcatheter (TAVR) valve replacement. Method(s): We conducted a
study-level meta-analysis using reconstructed individual time-to-event
data of studies published between 2015 and 2025. The primary endpoint was
5-year all-cause mortality. Analyses included both unadjusted and adjusted
cohorts, with the latter incorporating propensity score matching or
inverse probability of treatment weighting to account for baseline
differences. A conventional random-effects model and Cox frailty models
were used. Sensitivity analyses included leave-one-out procedures to
assess the robustness of the findings. Result(s): Five studies met
inclusion criteria, comprising 1,905 patients with LFLG AS: 618 (32.4%)
underwent SAVR and 1,287 (67.6%) underwent TAVR. In the unadjusted
analysis, TAVR was associated with significantly higher 5-year mortality
compared to SAVR (HR 1.41 [95% CI, 1.16-1.71]; P < 0.001). This
association remained consistent in adjusted analyses (HR 1.43 [95% CI,
1.19-1.71]; P < 0.001) (Figure). Sensitivity analyses confirmed robustness
of results, with leave-one-out HRs ranging from 1.30 to 1.96 with P<0.05.
[Formula presented] Conclusion(s): In patients with LFLG AS, SAVR
demonstrates superior long-term survival compared to TAVR. These findings
could support the preferential use of SAVR in appropriately selected
patients, especially those with acceptable surgical risk and life
expectancy beyond the short term. Categories: STRUCTURAL: Valvular Disease
and Intervention: Aortic Copyright © 2025

<129>
Accession Number
2040983433
Title
TCT-43 Catheter Ablation with Left Atrial Appendage Occlusion vs. Isolated
Ablation: A Meta-Analysis of Efficacy and Safety Outcomes.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B23), 2025. Date of Publication: 28 Oct 2025.
Author
Duhan S.; Kurpad K.P.; Keisham B.; Mehta S.; Kanakadandi U.; Mongwa M.
Institution
(Duhan) Carle Foundation Hospital/ Carle Illinois College of Medicine/
University of Illinois Urbana-Champaign, Urbana, Illinois, United States
(Kurpad) Carle Foundation Hospital, University of Illinois Urbana
Champaign, Champaign, Illinois, United States
(Keisham) Sinai Center for Thrombosis Research, Shandong, Weifang, China
(Mehta) Carle Foundation Hospital, Urbana, Illinois, United States
(Kanakadandi) Carle Foundation Hospital, Champaign, Illinois, United
States
(Mongwa) Cale Foundation Hospital, Urbana, Illinois, United States
Publisher
Elsevier Inc.
Abstract
Background: The combination of left atrial appendage occlusion (LAAO) with
atrial fibrillation (AF) catheter ablation (CA) has emerged as a strategy
to address arrhythmia control and thromboembolic risk. However, the
effectiveness and safety of CA + LAAO remain uncertain. Method(s):
Pubmed, Cochrane, and Scopus were systematically searched for studies
comparing CA+LAAO with CA alone, with at least one outcome of interest.
Random-effect models were used to calculate pooled risk ratios (RR) or
mean differences (MD) with 95% confidence intervals (CI). Result(s):
Ten studies (three RCTs and seven observational studies) encompassing
3,566 patients (1,805 LAAO+CA and 1,761 CA) were analyzed (Figure).
Arrhythmia Recurrence: No significant difference was observed between
combined therapy and ablation alone (RR: 1.05; 95% CI: 0.87-1.26; P=0.63;
I2=39%) (8 studies). Stroke or Systemic Embolism: The incidence
was not significantly different (RR: 0.84; 95% CI: 0.47-1.51; P = 0.56;
I2 = 0%) (7 studies). Major Complications: Rates were similar
between groups (RR: 0.82; 95% CI: 0.52-1.28; P = 0.38; I2 = 0%)
(7 studies). Procedural Time: Combined ablation+LAAO significantly
increased procedural duration (MD: 41.80 minutes; 95% CI: 30.26-53.35;
P<0.00001; I2=51%) (3 studies). [Formula presented]
 Conclusion(s): CA+LAAO does not significantly impact arrhythmia
recurrence, stroke/systemic embolism, or major complications compared to
CA alone, but is associated with longer procedural times. These findings
support the procedural safety of LAAO+CA without compromising clinical
outcomes, though the increased time burden should be considered in
clinical decision-making. Categories: STRUCTURAL:
Electrophysiology Copyright © 2025

<130>
Accession Number
2040985083
Title
TCT-838 Natural History and Outcomes of Early Aortic Valve Replacement
versus Conservative Management in Patients with Asymptomatic Severe Aortic
Stenosis: A Meta-Analysis.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B363-B364), 2025. Date of Publication: 28 Oct 2025.
Author
Huang J.; Ellis J.; Wang D.; Joseph E.; Connolly J.; Hasan R.; Rahman F.
Institution
(Huang) University of California, San Francisco, San Francisco,
California, United States
(Ellis, Wang, Joseph) Johns Hopkins School of Medicine, Baltimore,
Maryland, United States
(Connolly) Johns Hopkins Hospital, Baltimore, Maryland, United States
(Hasan) Johns Hopkins University, Baltimore, Maryland, United States
(Rahman) John Hopkins University, Baltimore, Maryland, United States
Publisher
Elsevier Inc.
Abstract
Background: For patients with asymptomatic severe aortic stenosis (AS),
optimal timing of aortic valve replacement (AVR) remains under debate.
Here, we examine the natural history of asymptomatic severe AS and the
impact of AVR versus conservative treatment on clinical outcomes.
 Method(s): PubMed, Embase, Cochrane, and Web Of Science were searched
in December 2024 for studies comparing patients with asymptomatic severe
AS receiving AVR versus conservative treatment. Random-effects
meta-analysis was performed. Result(s): Four RCTs and 8 observational
studies were included (3364 patients; 47% early AVR). Data from 7 of these
studies were pooled to explore the natural history of asymptomatic severe
AS (1620 patients, mean follow-up 5.6 years [5 studies], median follow-up
4.1 years [2 studies]), revealing that 710 (44%) patients developed
symptoms and 319 patients underwent AVR while asymptomatic. Of the 591
patients who remained asymptomatic and under conservative treatment, 194
died (33%). Across all 12 studies, AVR was associated with lower all-cause
mortality (relative risk (RR) 0.49 [95% confidence interval 0.32-0.73],
P<0.001), cardiovascular (CV) mortality (RR 0.52 [0.35-0.76], P<0.001),
and heart failure (HF) hospitalization (RR 0.37 [0.14-0.99], P=0.047).
[Formula presented] Conclusion(s): Within 6 years, nearly half of all
patients with asymptomatic severe AS developed symptoms, and one-third of
asymptomatic patients managed conservatively died. AVR was associated with
reduced all-cause mortality, CV mortality, and HF hospitalization. This
suggests that pre-symptom AVR may be appropriate for all patients with
asymptomatic severe AS. Categories: STRUCTURAL: Valvular Disease and
Intervention: Aortic Copyright © 2025

<131>
Accession Number
2040985044
Title
TCT-756 Sodium-Glucose Co-Transporter 2 Inhibitors and Clinical Outcomes
After Transcatheter Aortic Valve Implantation in Patients with Severe
Aortic Stenosis: Findings from the TriNetX Database.
Source
Journal of the American College of Cardiology. Conference: Transcatheter
Cardiovascular Therapeutics. San Francisco United States. 86(17
Supplement) (pp B329-B330), 2025. Date of Publication: 28 Oct 2025.
Author
Jaiswal V.; Ahmed A.; Hirji S.; Fonarow G.; Mishkel G.; Qamar A.;
Ricciardi M.
Institution
(Jaiswal) Section of Interventional Cardiology; Endeavor Health
(NorthShore University HealthSystem), Glenview, IL, Chicago, Illinois,
United States
(Ahmed) Section of Interventional Cardiology, Endeavor Health (Northshore
University Health System), Chicago, Illinois, United States
(Hirji) Brigham and Women's Hospital, Allston, Massachusetts, United
States
(Fonarow) UCLA, Los Angeles, California, United States
(Mishkel) Northshore University Health System, Chicago, Illinois, United
States
(Qamar) Endeavor Health (NorthShore University Health System), Glenview,
Illinois, United States
(Ricciardi) Section of Interventional Cardiology, Endeavor Health
(NorthShore University Health System), Glenview, Illinois, United States
Publisher
Elsevier Inc.
Abstract
Background: While sodium-glucose cotransporter-2 inhibitors (SGLT2i) have
demonstrated cardiorenal protective effects in heart failure (HF)
patients, their effectiveness in patients undergoing transcatheter aortic
valve implantation (TAVI) is not well-established. We aimed to evaluate
the association between SGLT2i use and clinical outcomes in patients
treated with TAVI. Method(s): The TriNeTX Global research database
was used to identify patients who underwent TAVI between 1st January 2014
and 30th April 2024. Patients were then categorized into two groups based
on SGLT2i usage. Covariates were balanced using 1:1 propensity
score-matched (PSM) analysis, and risk ratios (RR) were used to compare
outcomes. Result(s): After PSM, the study cohort included 3,526
patients in each of the two groups. At 1-month follow-up, SGLT2i use was
associated with significantly lower risk of acute myocardial infarction
(AMI) (RR, 0.44 (0.27-0.71), and MACE (RR, 0.59 (0.41-0.87), but not
all-cause mortality (ACM) (RR, 0.99 (0.72-1.39), ischemic stroke (RR,
0.70(0.37-1.33) and hemorrhagic stroke (RR, 1.00 (0.42-2.41) when compared
with control group. However, at 1-year follow-up, SGLT2i use significantly
decreased the risk of ACM (RR, 0.86 (0.76-0.98), AMI (RR, 0.76
(0.59-0.97), ischemic stroke (RR, 0.76 (0.58-0.99), hemorrhagic stroke
(RR, 0.41 (0.20-0.82) and MACE (RR, 0.81 (0.67-0.98). [Formula presented]
 Conclusion(s): SGLT2i use in patients post-TAVI is associated with
significantly lower mortality and cardiovascular events at 1-year
follow-up. However, no significant diffrence between SGLT2i use and
short-term mortality and stroke benefits were noted. Categories:
STRUCTURAL: Valvular Disease and Intervention: Aortic Copyright ©
2025

<132>
Accession Number
2041039063
Title
Impact of propofol or sevoflurane on the renoprotective effect of remote
ischaemic preconditioning in cardiac surgery: the HypnoRenalRIP randomised
clinical trial.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Zarbock A.; Schone L.M.; Kellum J.A.; Gerss J.; Weiss R.; Booke H.;
Meersch M.
Institution
(Zarbock, Schone, Weiss, Booke, Meersch) Department of Anaesthesiology,
Intensive Care Medicine and Pain Medicine, University Hospital Munster,
Munster, Germany
(Zarbock) Department of Anesthesiology, Critical Care and Pain Medicine,
The University of Texas Health Science Center at Houston, Houston, TX,
United States
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Gerss) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
Elsevier Ltd
Abstract
Background: Remote ischaemic preconditioning (RIPC) might reduce acute
kidney injury after cardiac surgery. Protective effects appear to be
restricted to patients with early and transient increases in two cell
cycle arrest markers, tissue inhibitor of metalloproteinases-2 (TIMP-2)
and insulin-like growth factor-binding protein 7 (IGFBP7), in urine.
Studies suggest that propofol can attenuate the preconditioning effect on
the myocardium. This study investigated whether propofol diminishes the
renoprotective effect associated with the early transient increases in
TIMP-2 and IGFBP7. Method(s): This was a single-centre, prospective
randomised double-blind 2x2 factorial clinical trial of high-risk patients
undergoing cardiac surgery. Patients were randomised to receive either
propofol+sham-RIPC, propofol+RIPC, sevoflurane+sham-RIPC, or
sevoflurane+RIPC. The primary outcome measure was the change in the
product of urinary concentrations of TIMP-2 and IGFBP7 ([TIMP-2].[IGFBP7])
from before to after the intervention. Result(s): We enrolled 160
participants in the trial (propofol+sham-RIPC: n=20, propofol+RIPC: n=60,
sevoflurane+sham-RIPC: n=20, sevoflurane+RIPC: n=60). The median change in
[TIMP-2].[IGFBP7] as an indicator of response to RIPC was greater in
participants receiving sevoflurane (0.070; interquartile range, -0.120 to
0.418) compared with those receiving propofol (-0.015; interquartile
range, -0.138 to 0.068; P=0.022). Conversely, elevated [TIMP-2].[IGFBP7]
as a sign of renal stress in response to surgery was detected in all
groups except for sevoflurane+RIPC (P=0.001). There were no statistically
significant differences in patient-centred outcomes between groups.
 Conclusion(s): Transient increases in [TIMP-2].[IGFBP7] induced by
RIPC, which were associated with renoprotective effects, were only seen
with sevoflurane anaesthesia, but not when propofol was used. The
association of biomarker concentrations and choice of anaesthetic agent
suggests that propofol can attenuate the renoprotective effects of remote
ischaemic preconditioning. Clinical trial registration:
DRKS00014989 Copyright © 2025 The Author(s)

<133>
Accession Number
2041016656
Title
Autograft reinforcement in the Ross procedure: A systematic review and
patient-level meta-analysis.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2025.
Date of Publication: 2025.
Author
Mylonas K.S.; Zoupas I.; Sarantou S.; Kourampi I.; Meintanopoulos A.S.;
Iliopoulos D.C.; Stavridis G.T.; Avgerinos D.V.; LaPar D.J.
Institution
(Mylonas, Stavridis, Avgerinos) Department of Cardiac Surgery, Onassis
Cardiac Surgery Center, Athens, Greece
(Zoupas, Sarantou, Kourampi, Meintanopoulos) Cardiothoracic and Vascular
Surgery Working Group, Society of Junior Doctors, Athens, Greece
(Zoupas, Iliopoulos) 4th Department of Cardiac Surgery, Hygeia Hospital,
Athens, Greece
(Zoupas, LaPar) Department of Pediatric and Congenital Heart Surgery,
Children's Heart Institute, Memorial Hermann Children's Hospital,
University of Texas Health Science Center at Houston, McGovern Medical
School, Houston, Tex, United States
(Meintanopoulos) Global Health - Disaster Medicine, National and
Kapodistrian University of Athens, Athens, Greece
(Iliopoulos) Department of Cardiovascular Surgery, University of Texas
Health Science Center at Houston, McGovern Medical School, Houston, Tex,
United States
(Iliopoulos) Division of Cardiac Surgery, National and Kapodistrian
University of Athens, Athens, Greece
Publisher
Elsevier Inc.
Abstract
Background: The Ross procedure is a well-established option for aortic
valve replacement, although progressive autograft dilation remains a
significant long-term complication. Although several reinforcement
techniques have been proposed to address this issue, their effectiveness
has yet to be rigorously evaluated. Method(s): A Preferred Reporting
Items for Systematic reviews and Meta-Analyses-compliant search was
conducted for studies involving reinforced Ross and nonreinforced Ross
procedures. Meta-analysis with individual patient data assessed survival
and freedom from autograft reoperation rates. Subgroup analyses were
conducted for the various reinforcement methods. Result(s): Sixteen
cohort studies comprising 2514 patients with the reinforced Ross procedure
and 595 patients with the nonreinforced Ross procedure were included.
Preoperative and perioperative characteristics were comparable between
groups. Individual patient data analysis of comparative studies
demonstrated superior survival in the reinforced Ross group, with 5-, 10-,
and 15-year survivals of 100%, 98.8%, and 98.8% compared with 95.0%,
93.7%, and 82.6%, respectively, in the nonreinforced group (hazard ratio,
11.9, P = .016). Likewise, freedom from autograft reoperation at 5, 10,
and 15 years was 96.4%, 94.2%, and 86.6% in the reinforced Ross group
versus 95.8%, 87.6%, and 77.7% in the nonreinforced group, respectively
(hazard ratio, 2.06, P < .001). Subgroup analysis showed comparable
outcomes across different reinforcement techniques. Conclusion(s):
Reinforced Ross procedures are associated with improved survival and
freedom from autograft reoperation rates compared with unsupported
pulmonary autografts. Copyright © 2025 The American Association
for Thoracic Surgery

<134>
Accession Number
2040499637
Title
Long-Term Outcomes and Complications of Pulmonary Valve Replacement: A
Meta-Analysis of Mechanical Versus Biological Prostheses.
Source
Pediatric Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Vahidshahi K.; Mofidi S.A.; Oraee S.; Ghafourian K.; Firouzabadi S.R.;
Mohammadi I.; Soltani S.M.; Shayesteh H.; Dastjerdi P.; Ghotbi N.;
Abdollahi M.; Meysami A.; Mesdaghi M.; Fatahi S.
Institution
(Vahidshahi) Modarres Teaching Hospital, Pediatric cardiology ward, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Vahidshahi, Mesdaghi, Fatahi) Research and Intervention Academic
leadership (HATAM), Clinical Research Development Center, Mofid Children's
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Mofidi, Oraee, Ghafourian, Firouzabadi, Mohammadi, Soltani) School of
Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Shayesteh) Student Research Committee, Islamic Azad University, Mashhad
Branch, Mashhad, Iran, Islamic Republic of
(Dastjerdi) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Ghotbi) Faculty of Medicine, Tehran Medical Sciences, Islamic Azad
University, Tehran, Iran, Islamic Republic of
(Abdollahi) Medical Student, Shiraz University of Medical Sciences,
Shiraz, Iran, Islamic Republic of
(Meysami) Medical Student, Tehran University of Medical Science, Tehran,
Iran, Islamic Republic of
(Mesdaghi) Department of Immunology and Allergy, Mofid Children's
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Fatahi) Department of Clinical Nutrition and Dietetics, Faculty of
Nutrition and Food Technology, Shahid Beheshti University of Medical
Sciences, Tehran, Iran, Islamic Republic of
Publisher
Springer
Abstract
This meta-analysis exclusively examines pulmonary valve replacement (PVR)
outcomes in congenital heart disease (CHD) patients. CHD affects nearly 1%
of live births globally, with a significant subset eventually requiring
PVR due to valve dysfunction following primary repair procedures. Choosing
between mechanical and biological valves is challenging, as both have
significant limitations, including thrombosis, bleeding, degradation, and
the need for reoperations. This study systematically evaluates the
long-term outcomes and complications of PVR options to provide
evidence-based guidance. Its goal is to optimize care and improve outcomes
for pediatric CHD patients. This systematic review and meta-analysis
followed PRISMA guidelines to compare outcomes and complications of
mechanical versus biological PVR in congenital heart disease patients. A
comprehensive search was conducted in PubMed, World of Science, and
Scopus, screening studies based on defined inclusion and exclusion
criteria. Data extraction and analysis were performed independently by two
reviewers, with pooled prevalence rates calculated using a random-effects
model. Ethical approval was not required as only published data were
analyzed. This meta-analysis included 158 studies with a marked imbalance
between valve types: 145 biological PVR studies (20,499 patients) versus
only 13 mechanical PVR studies (1060 patients) from 7178 screened
articles. This 19:1 patient ratio reflects the clinical rarity of
mechanical PVR in CHD patients. For biological PVR, valve dysfunction
rates increased over time: 4% at 1 year, 8% at 2-3 years, 12% at 4-6
years, 31% at 7-10 years, and 27% at 15-20 years. Reintervention rates
also rose: 3% at 1 year, 7% at 2-3 years, 12% at 4-6 years, 29% at 7-10
years, and 43% at 15-20 years. Redo-PVR rates followed a similar trend: 2%
at 1 year, 4% at 2-3 years, 8% at 4-6 years, 22% at 7-10 years, and 26% at
15-20 years. Mortality rates remained stable: 4% at 1-3 years, 6% at 4-6
years, and 6% at 15-20 years. Complications included arrhythmias (5%),
infective endocarditis (3%), and overall complications (11%). For
mechanical PVR, valve dysfunction was 4%, reoperation 6%, and redo-PVR 5%.
Thrombosis occurred in 9%, bleeding in 4%, and mortality was 1%.
Mechanical valves showed lower reintervention rates but higher thrombosis
risks compared to biological valves. PVR shows low long-term mortality and
complication rates for both mechanical and biological valves, though
mechanical valves reduce redo-PVR but increase thrombosis and bleeding
risks. The limited mechanical PVR data necessitates cautious
interpretation due to small sample sizes and potential selection bias.
Future research should explore outcomes across diverse patients, CHD
types, and implantation methods. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2025.

<135>
Accession Number
648822306
Title
Dexmedetomidine Improves Inflammatory Stress and Hemodynamic in Patients
Undergoing Open Heart Surgery via Interleukin-13: A Randomized,
Double-Blind, Controlled, Clinical Trial.
Source
Annals of cardiac anaesthesia. 28(4) (pp 401-409), 2025. Date of
Publication: 01 Oct 2025.
Author
Hatemi B.M.J.; Enayati A.; Ghorbani S.; Tahmasebi F.; Aljadayel H.A.;
Jabbari A.; Movafegh A.
Institution
(Hatemi) Ischemic Disorders Research Center, Golestan University of
Medical Sciences, International Campus, Gorgan, Iran, Islamic Republic of
(Hatemi) Anesthesia Techniques Department, College of Health and Medical
Techniques, Al-Mustaqbal University, Babylon, Iraq
(Enayati, Tahmasebi, Aljadayel, Jabbari) Ischemic Disorders Research
Center, Jorjani Clinical Sciences Research Institute, Golestan, Iran,
Islamic Republic of
(Ghorbani) Cancer Research Center, Golestan University of Medical
Sciences, Gorgan, Iran, Islamic Republic of
(Jabbari) Department of Anesthesiology and Critical Care Medicine,
Golestan University of Medical Sciences, Gorgan, Iran, Islamic Republic of
(Movafegh) Department of Anesthesiology, School of Medicine faculty,
Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of
Abstract
BACKGROUND: Few studies have explored the anti-inflammatory effects of
drugs in cardiac surgery. Dexmedetomidine (Dex), a centrally acting
alpha-agonist, is believed to possess anti-inflammatory properties. We
conducted a randomized, double-blind, controlled trial to assess the
anti-inflammatory effects of Dex in patients undergoing open-heart surgery
with cardiopulmonary bypass. METHOD(S): Adult eligible patients
undergoing cardiac surgery with cardiopulmonary bypass were randomly
assigned to receive either standard anesthetics or De x 0.5 mug/kg/h in
addition to anesthetics in a single-center, randomized, double-blinded
study. The primary outcome was the change in inflammatory mediators () in
plasma 24 hours postsurgery compared with baseline, measured by ELISA.
Secondary outcomes are defined as changes in hemodynamic and biological
markers, recovery time, and Dex's safety. RESULT(S): In total, 80
patients were included in the control and Dex groups. The Dex group
increased IL-13 levels as anti-inflammatory cytokines, while it was
decreased in the control group. Dex reduced the levels of interleukin
(IL)-6 (P = 0.777) and IL-18 (P = 0.895) at the 24 hours postsurgery, with
no statically significant difference against the control group. Both
groups did not increase the levels of IL-1beta and TNF-alpha regards to
baseline (P = 0.812 and P = 0.420, respectively); however, this increase
was lower in the Dex group for TNF-alpha and slightly higher for IL-1beta.
Dex provided better hemodynamic and repository stability. In addition, the
incidence of common events including hypotension, bradycardia, and
tachycardia was higher in the control group than in Dex.
 CONCLUSION(S): We found that administering Dex at the onset of
anesthesia and during cardiopulmonary bypass reduces inflammatory factors,
promotes hemodynamic stability, and enhances patient safety. It may offer
significant benefits for those undergoing open heart
surgery. Copyright © 2025 Annals of Cardiac Anaesthesia.

<136>
Accession Number
2040496160
Title
Efficacy of clopidogrel monotherapy versus aspirin monotherapy after
percutaneous coronary intervention.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2025. Date of
Publication: 2025.
Author
Waqas S.A.; Imran Z.; Bilal A.R.; Ahmed S.; Gaba H.; Chew N.W.S.; Greene
S.J.; Khan M.S.
Institution
(Waqas, Imran) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Bilal, Gaba) Department of Medicine, Ziauddin Medical College, Karachi,
Pakistan
(Ahmed) Department of Medicine, Fatima Memorial Hospital College of
Medicine and Dentistry, Lahore, Pakistan
(Chew) Department of Cardiology, National University Heart Centre,
National University Health System, Singapore, Singapore
(Chew) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore, Singapore
(Greene) Duke Clinical Research Institute, Durham, NC, United States
(Greene) Division of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Khan) Baylor College of Medicine, Temple, TX, United States
(Khan) Baylor Scott and White Heart Hospital, Plano, TX, United States
(Khan) Baylor Scott and White Research Institute, Baylor Scott and White
Health, Dallas, TX, United States
Publisher
Springer
Abstract
Following percutaneous coronary intervention (PCI), dual antiplatelet
therapy (DAPT) is standard to reduce thrombotic complications. However,
the optimal monotherapy after DAPT remains debated. Clopidogrel may offer
better protection than aspirin. We conducted a systematic review and
meta-analysis of randomized controlled trials (RCTs) comparing clopidogrel
versus aspirin monotherapy after DAPT in PCI patients. Searches were
performed in MEDLINE, Embase, Scopus, CENTRAL, and ClinicalTrials.gov up
to April 12, 2025. Outcomes included stroke, myocardial infarction (MI),
all-cause mortality, and cardiovascular (CV) death. Hazard ratios (HRs)
were pooled using random-effects models. Four RCTs comprising 19,554
patients (clopidogrel: 9,846; aspirin: 9,708) were included. Clopidogrel
was associated with a significantly lower risk of stroke (HR: 0.69; 95%
CI: 0.51-0.94; p = 0.02; I2 = 28%) and MI (HR: 0.71; 95% CI: 0.51-0.99; p
= 0.05; I2 = 48%) compared with aspirin. There was no significant
difference between clopidogrel and aspirin in terms of all-cause mortality
(HR: 0.99; 95% CI: 0.78-1.25; p = 0.92; I2 = 55%), CV death (HR: 0.87; 95%
CI: 0.70-1.08; p = 0.22; I2 = 0%), coronary revascularization (HR: 0.95;
95% CI: 0.83-1.09; p = 0.44; I2 = 0%), major bleeding (HR: 0.97; 95% CI:
0.70-1.35; p = 0.87; I2 = 57%), or stent thrombosis (HR: 0.66; 95% CI:
0.38-1.15; p = 0.15; I2 = 0%). Clopidogrel monotherapy post-DAPT after PCI
reduces stroke and MI risk compared to aspirin, without increasing
mortality or bleeding. These findings support clopidogrel as a favorable
alternative for monotherapy. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2025.

<137>
Accession Number
648823653
Title
Modified Del Nido Versus Custodiol Cardioplegia for Myocardial Protection
in Adult Patients Undergoing Cardiac Surgery; A Prospective Randomized
Double-Blinded Clinical Trial.
Source
Annals of cardiac anaesthesia. 28(4) (pp 451-458), 2025. Date of
Publication: 01 Oct 2025.
Author
Abdelhady M.A.; Goda A.S.; Sayed Gomaa M.S.; Hamed M.A.; Hassan A.A.S.M.
Institution
(Abdelhady, Goda, Hamed, Hassan) Departments of Anesthesiology, Fayoum
University, Egypt
(Sayed Gomaa) Department of Internal and Acute Medicine, Faculty of
Medicine, Fayoum University, Egypt
Abstract
BACKGROUND: Cardioplegia is essential for myocardial protection. Modified
Del Nido and Custodiol cardioplegia have been successfully used; however,
a limited number of clinical trials compared both solutions. Our objective
was to evaluate the effectiveness of Modified Del Nido cardioplegia
against Custodiol in protecting the myocardium in adult patients having
open heart surgery. METHOD(S): In this prospective randomized
double-blinded clinical trial, fifty-eight adult patients registered for
elective open heart surgery at Fayoum University hospitals, Fayoum, Egypt,
between February 2022 and November 2023, have enrolled. Patients were
randomized to receive either a Modified Del Nido cardioplegia solution
(MDN group) (n = 29) or Custodiol cardioplegia (C group) (n = 29). The
primary outcome was Troponin I (microg/L) measured 24 h after surgery.
 RESULT(S): Both groups had comparable demographics. Troponin I was
much lower in the MDN group (median = 2.9, IQR = 2.7-3.2) than in the C
group (median = 3.6, IQR = 3.1-4.1) 24 h after surgery. Similarly, there
were substantial differences in CK-MB between the two groups 24 h
postoperatively. The MDN group had better results in terms of time taken
for cardiac arrest, the incidence of ventricular fibrillation upon
cross-removal, and the percentage of patients requiring inotropes. The MDN
group shows notably reduced hospital length of stay (LOS), intensive care
unit length of stay (ICU LOS), and weaning from mechanical ventilation
times. CONCLUSION(S): Adult cardiac surgery may be performed safely
and successfully using Modified Del Nido cardioplegia in comparison to
Custodiol cardioplegia. Copyright © 2025 Annals of Cardiac
Anaesthesia.

<138>
Accession Number
2041002440
Title
Prevalence and Associated Factors of Postoperative Fever in Pediatric
Congenital Heart Surgery: A Systematic Review.
Source
International Cardiovascular Research Journal. 19(1) (no pagination),
2025. Article Number: e161516. Date of Publication: 01 Dec 2025.
Author
Nabavi S.S.; Behbahani S.M.S.; Shahandashti F.J.; Toloueitabar Y.;
Hamedpour H.; Gholizadeh B.; Moradi-Joo E.
Institution
(Nabavi) Department of General Surgery, Imam Khomeini Hospital, Golestan
Hospital, School of Medicine, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Behbahani) Ayatollah Taleghani Hospital, Shahid Beheshti Hospital, School
of Medicine, Abadan University of Medical Sciences, Abadan, Iran, Islamic
Republic of
(Shahandashti, Toloueitabar) Shaheed Rajaie Cardiovascular Medical and
Research Center, Tehran, Iran, Islamic Republic of
(Hamedpour) Department of Nursing-Midwifery, Islamic Azad University of
Ahwaz, Ahwaz, Iran, Islamic Republic of
(Gholizadeh) Department of Cardiac Surgery, Atherosclerosis Research
Center, Golestan Hospital, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Moradi-Joo) Abadan University of Medical Sciences, Abadan, Iran, Islamic
Republic of
Publisher
Brieflands
Abstract
Context: Post-operative fever in pediatric congenital heart surgery is a
common and challenging complication that can affect recovery,
hospitalization duration, and healthcare costs. Objective(s): This
systematic review aimed to investigate the prevalence, associated factors,
and management approaches of this condition. Data Sources: A
comprehensive search was conducted across Persian (SID, Magiran,
IranMedex) and English (PubMed, Scopus, Web of Science) databases. Search
keywords included "Post-operative fever", "Congenital heart surgery", and
their Persian equivalents. Study Selection: Out of 860 identified
articles, 25 studies were selected for the final analysis after screening.
The quality of the articles was assessed using the Critical Appraisal
Skills Programme (CASP) and AMSTAR tools. Data Extraction: Data were
analyzed using RevMan software. Result(s): The prevalence of
post-operative fever in pediatric congenital heart surgeries ranged from
10% to 25%, influenced by factors such as surgery duration, the complexity
of congenital defects, patients' nutritional status, and quality of care.
More complex and prolonged surgeries showed higher rates of fever.
Additionally, biomarkers such as C-reactive protein (CRP) and
procalcitonin (PCT) were identified as predictive tools for fever risk.
Effective management through the use of prophylactic antibiotics, proper
nutrition, and close monitoring of patient conditions helped reduce the
incidence of this complication. Fever-related outcomes, such as prolonged
hospital stays and elevated healthcare costs, were frequently observed.
 Conclusion(s): This study highlights the need for multifaceted
management of post-operative fever in pediatric congenital heart
surgeries. Reducing surgery duration, standardizing management protocols,
and improving care quality can help decrease its prevalence. Furthermore,
developing comprehensive research in resource-limited areas is recommended
to enhance treatment quality and mitigate the negative outcomes of
fever. Copyright © 2025, Nabavi et al.

<139>
Accession Number
2036810214
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) (no pagination), 2025. Article
Number: 668. Date of Publication: 01 Nov 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,
2201 - Nova Ribeirania, Sao Paulo, Ribeirao Preto, Brazil
(Carpi, Luchese) Hospital de Clinicas de Porto Alegre (HCPA), Rio Grande
Do Sul, Porto Alegre, Brazil
(da Silva) Department of Medicine, Federal University of Para (UFPA),
Para, Belem, Brazil
(Carneiro) Pontifical Catholic University of Parana (PUCPR), Parana,
Curitiba, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
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. (Table presented.) Copyright ©
The Author(s), under exclusive licence to Springer-Verlag GmbH Germany,
part of Springer Nature 2025.

<140>
Accession Number
648822862
Title
Glucose Variability IN Diabetic Patients Receiving DEXmedetomidine During
Off-Pump Coronary Artery Bypass Grafting: GV-IN-DEX, A Randomised
Controlled Trial.
Source
Annals of cardiac anaesthesia. 28(4) (pp 432-438), 2025. Date of
Publication: 01 Oct 2025.
Author
Goel K.; Kohli J.K.; Shri I.; Kalaiselvan J.; Sharma L.K.; Avinash R.
Institution
(Goel, Kohli, Kalaiselvan, Avinash) Department of Cardiac Anesthesia, Atal
Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New
Delhi, India
(Shri) Department of Anesthesia, Atal Bihari Vajpayee Institute of Medical
Sciences and Dr. RML Hospital, New Delhi, India
(Sharma) Department of Biochemistry, Atal Bihari Vajpayee Institute of
Medical Sciences and Dr. RML Hospital, New Delhi, India
Abstract
INTRODUCTION: Diabetes mellitus (DM) is a complex carbohydrate metabolic
disorder with increased levels of inflammation. Stress response to cardiac
surgery manifests as a major neuroendocrine and cytokine response leading
to increased levels of inflammation and subsequent hyperglycemia,
contributing to significant cardiovascular morbidity and mortality. To
mitigate these effects in patients undergoing off-pump coronary artery
bypass grafting (OPCABG), our study focused on using dexmedetomidine
infusion hypothesizing decreased stress response and thereby improved
glucose variability (GV). METHOD(S): Patients were randomized into
two groups: group D (dexmedetomidine) was administered the drug at 0.5
microg/kg/h, and group C (control) was administered an equivalent amount
of saline. Preinduction C-reactive protein (CRP) and interleukin-6 (IL-6)
levels were sent, and perioperative GV and mean insulin requirement were
recorded in 24 h. Postoperatively, samples were sent and recorded for IL-6
and CRP levels at 12 and 24 h. The primary objective of our study was to
assess the effect of injection dexmedetomidine on blood GV with secondary
objectives being the assessment of the level of IL-6 and CRP at
preinduction (0 h) and at 12 and 24 h postoperatively and comparison of
mean insulin requirement between the groups. RESULT(S): Eighty-nine
diabetic patients were enrolled in this study, among which 21 were
excluded. Sixty-eight patients, with 34 patients in each group, were
selected for analysis. There was a significant difference between the two
groups in terms of GV (P = 0.042) (16.44 +/- 4.63 vs. 14.38 +/- 3.45),
mean insulin requirements (U/h) (P = 0.001) (1.38 +/- 0.63 vs. 0.88 +/-
0.59), CRP (mg/dL) (12 h) (P = 0.012) (2.6 +/- 2.83 vs. 1.51 +/- 1.13, and
CRP (mg/dL) (24 h) (P = <0.001) (16.71 +/- 6.45 vs. 10.19 +/- 4.56). IL-6
was comparable in both groups at all points. CONCLUSION(S): Patients
receiving intraoperative dexmedetomidine infusion during OPCABG
demonstrated improved GV leading to a reduction in insulin requirements
and reduced CRP levels at 12 and 24 h postoperatively. We may incorporate
dexmedetomidine in our routine clinical practice to ameliorate stress
response in these patients. Copyright © 2025 Annals of Cardiac
Anaesthesia.

<141>
Accession Number
648824650
Title
Comparison of Epidural Analgesic Efficacy of Direct Thoracic versus
Caudally Inserted Catheter Positioned in Thoracic Space in Children
Undergoing Cardiac Surgery.
Source
Annals of cardiac anaesthesia. 28(4) (pp 439-444), 2025. Date of
Publication: 01 Oct 2025.
Author
Sharma V.K.; Vaishnavi A.
Institution
(Sharma) Department of Cardiac Anaesthesia, Dr. D. Y. Patil Medical
College Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth ,(Deemed
to be University), Pune, Maharashtra, India
Abstract
INTRODUCTION: Effective pain management during paediatric cardiac surgery
is essential to prevent complications such as metabolic, neuroendocrine,
and immunological disturbances. Thoracic epidural anesthesia (TEA) offers
significant benefits in terms of pain relief and postoperative recovery.
However, its application in children is challenging due to the risk of
dural puncture and nerve injury. This study compares the efficacy of two
techniques: direct thoracic space insertion and caudal-to-thoracic space
catheter placement for TEA in pediatric cardiac surgery. MATERIALS AND
METHODS: This prospective, randomized study was conducted at a tertiary
center with 40 children undergoing elective cardiac surgery. Participants
were randomized into two groups: Group A (Direct Thoracic Space) and Group
B (Caudal-to-Thoracic Space). Epidural catheter insertion was followed by
a bolus of bupivacaine and morphine, and continuous infusion for
postoperative pain control. Hemodynamic parameters, Face, Legs, Activity,
Cry, Consolability (FLACC) scores for pain, and analgesic requirements
were monitored. RESULT(S): Both groups exhibited similar hemodynamic
responses, with statistically significant differences in systolic blood
pressure at 60 and 72 h (P < 0.05) favoring the Direct Thoracic group.
Postoperative pain control, assessed using FLACC scores, was marginally
better in Group A, but differences were not statistically significant. No
major complications were observed. DISCUSSION(S): While both methods
provided comparable analgesia and hemodynamic stability, the direct
thoracic approach was slightly more effective in pain management. The
caudal to thoracic method remains technically simpler and more accessible,
making it a viable alternative. CONCLUSION(S): Both techniques
provide effective analgesia, with no major complications. The caudal to
thoracic approach offers a safer, simpler alternative to direct thoracic
catheter placement in pediatric cardiac surgery. Copyright © 2025
Annals of Cardiac Anaesthesia.

<142>
Accession Number
648812869
Title
Full Heparin Reversal With Protamine After Transcatheter Aortic Valve
Replacement: a Systematic Review and Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 09 Oct 2025.
Author
Silva J.P.M.R.J.; Nogueira B.V.; Mussolini M.C.B.; Bisneto O.I.M.; Gomes
W.F.
Institution
(Silva) Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
(Nogueira) University of Sao Paulo, Sao Paulo, Brazil
(Mussolini) School of Medicine of Araraquara, Araraquara, Brazil
(Bisneto) Federal University of Campina Grande, Cajazeiras, Brazil
(Gomes) INC Hospital, Curitiba, Brazil; Faculdades Pequeno Principe,
Curitiba, Brazil; Irmandade da Santa Casa de Misericordia de Curitiba,
Curitiba, Brazil
Abstract
Protamine sulfate is widely used to reverse unfractionated heparin during
transfemoral transcatheter aortic valve replacement (TAVR), but the
optimal reversal strategy remains uncertain. We conducted a systematic
review and meta-analysis of randomized controlled trials and observational
studies comparing full heparin reversal (1 mg protamine per 100 units
heparin) with partial or no reversal in transfemoral TAVR. The primary
outcome was a composite of all-cause mortality, major bleeding, and major
vascular complications, defined according to VARC-3 criteria, while
secondary outcomes included each component of the composite and stroke.
Five studies (two randomized trials, three cohort studies) involving 3,089
patients were included. Full-dose protamine significantly reduced the
composite outcome (RR 0.46, 95% CI 0.36-0.60), driven by reductions in
major bleeding (RR 0.41, 95% CI 0.28-0.59) and major vascular
complications (RR 0.44, 95% CI 0.30-0.65). No excess risk was observed for
all-cause mortality (RR 0.94, 95% CI 0.65-1.36) or stroke (RR 0.67, 95% CI
0.40-1.12). Leave-one-out and subgroup analyses confirmed the robustness
of these findings, and no evidence of publication bias was identified. In
conclusion, full heparin reversal with protamine during TAVR is associated
with lower bleeding and vascular complications without increasing
thromboembolic risk, supporting its use as a bleeding-avoidance
strategy. Copyright © 2025 Elsevier Inc. All rights reserved.

<143>
Accession Number
648808410
Title
Effectiveness of the Preschool Children eHealth Cardiac Rehabilitation
Program After Congenital Heart Surgery: A Randomised Controlled Trial.
Source
Journal of advanced nursing. (no pagination), 2025. Date of Publication:
10 Oct 2025.
Author
Luo W.; Chen L.; Cai X.; Yang Z.; Deng H.; Xu Y.; Hickey P.; Zhang Y.
Institution
(Luo, Yang, Deng) Department of Nursing, Shanghai Children's Medical
Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
(Luo, Chen, Cai) Department of Thoracic and Cardiovascular Surgery,
Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong
University, Shanghai, China
(Xu) Department of Rehabilitation, Shanghai Children's Medical Center,
School of Medicine, Shanghai Jiao Tong University, Shanghai, China
(Hickey) Cardiovascular, Boston Children's Hospital, Boston, MA, United
States
(Zhang) Editorial Department of Journal of Shanghai Jiao Tong University
(Medical Science), Shanghai, China
Abstract
AIM(S): To develop the Preschool Children eHealth Cardiac Rehabilitation
programme based on the Interaction Model of Client Health Behaviour, and
to evaluate its effects on children after congenital heart surgery.
DESIGN: A parallel two-arm randomised controlled trial was conducted.
 METHOD(S): A total of 84 participants were recruited from July 2022
to June 2023 and randomly assigned to either the intervention group (n =
40) or control group (n = 44). The intervention group participated in a
3-month eHealth Cardiac Rehabilitation programme, while the control group
received routine care. Outcomes were measured at baseline, 3 months post
baseline (intervention endpoint), and 6 months post baseline. Eighty
participants completed the study. RESULT(S): Compared to the
intervention group, the control group demonstrated significantly worse
outcomes at both 3 and 6 months, including a higher risk of heart failure,
lower left ventricular ejection fraction scores, and shorter 6-min walk
distance tests. The intervention group engaged in significantly more
vigorous physical activity. Significant between group differences were
also observed in parental knowledge, attitudes, behaviours and trust
levels. Additionally, the proportion of parents experiencing anxiety
decreased significantly more in the intervention group by 6 months post
baseline. CONCLUSION(S): This pioneering eHealth programme transforms
home-based rehabilitation for preschool children with congenital heart
disease, addressing a critical gap in accessible and long-term paediatric
cardiac rehabilitation care. IMPLICATIONS FOR THE PROFESSION AND/OR
PATIENT CARE: The use of eHealth programmes is valuable for improving
paediatric cardiac rehabilitation by empowering parents, enhancing care
continuity, and reducing barriers to accessing specialised services in
paediatric care, especially in areas with limited medical resources.
IMPACT: This study establishes the first validated eHealth framework for
family-centred cardiac rehabilitation in preschool children following
congenital heart surgery, addressing the critically low uptake of
previously home-based rehabilitation. It also provides clinicians with a
scalable solution for delivering care in underserved regions lacking
access to specialised cardiac services. REPORTING METHOD: This study
adhered to the CONSORT checklist guidelines for reporting randomised
controlled trials. PATIENT OR PUBLIC CONTRIBUTION: This study did not
include patient or public involvement in its design, conduct, or
reporting. TRIAL AND PROTOCOL REGISTRATION: This study was a randomised
controlled clinical trial. The research protocol was registered with the
China Clinical Trial Registration Center (registration number:
ChiCTR2200062022;
https://www.chictr.org.cn/showproj.html?proj=174261). Copyright ©
2025 John Wiley & Sons Ltd.

<144>
Accession Number
2036166070
Title
The safety and efficacy of intravenous administration of tranexamic acid
in off-pump coronary artery bypass grafting: a systematic review and
meta-analysis.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1643712.
Date of Publication: 2025.
Author
Zou Z.-Y.; Song J.-R.; Zhang Q.-H.; Huang X.-J.; Yao Y.-T.
Institution
(Zou, Song, Huang) Fuwai Yunnan Hospital, Chinese Academy of Medical
Sciences, Affiliated Cardiovascular Hospital of Kunming Medical
University, Yunnan, Kunming, China
(Zhang) Department of Anesthesiology, Qujing Maternal and Child
Health-care Hospital, Yunnan, Qujing, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College, Chinese Academy of
Medical Sciences, Beijing, China
(Yao) Department of Anesthesiology, Critical Care and Pain Medicine,
Center of Outcomes Research, University of Texas, Houston, TX, United
States
(Yao) Outcomes Research Consortium, Houston, TX, United States
Publisher
Frontiers Media SA
Abstract
Study objective: To assess the efficacy and safety of tranexamic acid
(TXA) on off-pump coronary artery bypass (OPCAB) surgery. Design(s):
Meta-analysis. Method(s): Relevant trials were identified by
computerized searches of PUBMED, Cochrane Library, EMBASE, OVID, China
National Knowledge Infrastructure (CNKI), Wanfang Data and VIP Data till
Aug 8th, 2025, were searched using search terms "Tranexamic acid,"
"coronary artery bypass grafting," "off-pump," "randomized controlled
trial" database search was updated on Aug 10th, 2025. Primary outcomes
included intraoperative and postoperative bleeding. Result(s):
Nineteen randomized controlled trials were finally included in the current
study. Intravenous TXA reduced intraoperative and postoperative bleeding
volume (including 2, 4, 6, and 24-h postoperative bleeding). It also
decreased the rate and volume of red blood cell (RBC) and fresh frozen
plasma (FFP) transfusions, with no effect on reoperation rates due to
postoperative bleeding. At 24 h postoperatively, TXA increased platelet
counts, hemoglobin concentrations, and prothrombin time (PT), while
decreasing activated partial thromboplastin time (APTT), fibrinogen
levels, and D-dimer concentrations. Importantly, TXA did not elevate the
risk of postoperative complications (e.g., mortality, myocardial
infarction, cerebrovascular accidents, thrombotic events) and had no
impact on levels of CK-MB, creatinine, interleukin-6, or lengths of
intensive care unit (ICU) and hospital stays. Conclusion(s):
Intravenous TXA is effective in reducing perioperative bleeding and
transfusion requirements in OPCAB without increasing the risk of major
postoperative complications, supporting its clinical utility in this
setting. More well-designed and adequately powered RCTs are needed to
confirm this further. Copyright © 2025 Zou, Song, Zhang, Huang
and Yao.

<145>
Accession Number
2040952560
Title
Outcomes of No-Touch Vs Conventionally Harvested Saphenous Veins for
Coronary Artery Bypass Surgery: A Meta-Analysis of Randomized Trials.
Source
European Journal of Cardio-thoracic Surgery. 67(9) (no pagination), 2025.
Article Number: ezaf297. Date of Publication: 01 Sep 2025.
Author
Sandner S.; Hirofuji A.; Mantaj P.; Di Franco A.; Rahouma M.; Gregg A.;
Krieger K.; Demetres M.; Gaudino M.
Institution
(Sandner, Hirofuji, Mantaj, Di Franco, Rahouma, Gregg, Krieger, Demetres,
Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Sandner, Mantaj) Department of Cardiac and Thoracic Aortic Surgery,
Medical University of Vienna, Vienna, Austria
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The no-touch (NT) technique for saphenous vein (SV) harvesting
in coronary artery bypass surgery preserves perivascular tissue and has
been proposed to improve vein graft patency compared to conventional (CON)
harvesting. However, recent large randomized clinical trials (RCTs) have
reported conflicting results. We performed a meta-analysis of all
available RCTs comparing graft patency and clinical outcomes between NT-SV
and CON-SV harvesting techniques. Method(s): A systematic review was
conducted through May 9, 2025 to identify RCTs with systematic imaging
follow-up comparing the NT-SV and CON-SV. The primary outcome was graft
failure. Secondary outcomes included mortality, major adverse cardiac
events (MACE; composite of mortality, myocardial infarction, or repeat
revascularization), and leg wound complications. Outcomes were pooled
using inverse variance random and fixed effects models. Result(s):
Eight RCTs involving 4286 patients (NT-SV: 2155; CON-SV: 2131) were
analysed. NT-SV was associated with a significantly lower incidence of
graft failure than CON-SV (incidence rate ratio [IRR], 0.70; 95%
confidence interval [CI] 0.60-0.82; P<.001) at a weighted mean follow-up
of 3.7 years; this result was solid in multiple sensitivity analyses.
Mortality (IRR, 1.03; 95% CI, 0.72-1.47, P=.87) and MACE (IRR, 0.89; 95%
CI, 0.67-1.18; P=.42) were similar between groups. NT-SV was associated
with a higher incidence of leg wound complications (IRR, 1.73; 95% CI,
1.32-2.27; P<.001). Conclusion(s): The NT-SV harvesting technique was
associated with a significant reduction in graft failure and an increased
risk of wound complications compared to the CON-SV. Further research is
warranted to evaluate clinical NT-SV outcomes, and strategies are needed
to mitigate NT-SV harvest-site complications. Copyright © The
Author(s) 2025. Published by Oxford University Press on behalf of the
European Association for Cardio-Thoracic Surgery. All rights reserved.

<146>
Accession Number
2041001538
Title
Worsening tricuspid regurgitation after mitral valve surgery: a
meta-analysis and meta-regression.
Source
International Journal of Cardiology. 443 (no pagination), 2026. Article
Number: 133931. Date of Publication: 15 Jan 2026.
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
(Hirsh-Raccah) Division of Clinical Pharmacy, Institute for Drug Research,
School of Pharmacy, Faculty of Medicine, Hebrew University of Jerusalem,
Jerusalem, Israel
Publisher
Elsevier Ireland Ltd
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 Elsevier B.V.

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