EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
648979354
Title
Dedicated Versus Conventional Devices in Patients With Pure Native Aortic
Regurgitation: A Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 14(21) (pp e038659), 2025. Date
of Publication: 04 Nov 2025.
Author
Bacigalupi E.; Scorpiglione L.; Prendergast B.D.; Radico F.; Gallinoro E.;
Bartorelli A.L.; Amat-Santos I.; Barbanti M.; De Backer O.; Latib A.;
Pizzicannella J.; Chiusolo S.; Van Mieghem N.M.; Perfetti M.; Testa L.;
Waksman R.; Pelliccia F.; Miraldi F.; Dangas G.; Zimarino M.
Institution
(Bacigalupi, Scorpiglione, Pizzicannella, Zimarino) Department of
Neuroscience, Imaging and Clinical Sciences "G. D'Annunzio" University of
Chieti-Pescara Chieti Italy, Italy
(Bacigalupi, Scorpiglione, Radico, Pizzicannella, Perfetti, Zimarino)
Cardiology Department SS. Annunziata Hospital Chieti Italy, Italy
(Prendergast) Department of Cardiology St Thomas' Hospital and Cleveland
Clinic London London United Kingdom, United Kingdom
(Gallinoro) Division of University Cardiology IRCCS Ospedale
Galeazzi-Sant'Ambrogio Milan Italy, Italy
(Bartorelli) IRCCS Ospedale Galeazzi-Sant'Ambrogio Milan Italy, Italy
(Bartorelli) Department of Biomedical and Clinical Sciences University of
Milan Italy, Italy
(Amat-Santos) Departamento de Cardiologia Hospital Clinico Universitario
de Valladolid Valladolid Spain, Spain
(Amat-Santos) Instituto de Ciencias Del Corazon Hospital Clinico
Universitario de Valladolid Valladolid Spain, Spain
(Barbanti) Universita degli Studi di Enna "Kore, Italy
(De Backer) Rigshospitalet Copenhagen University Hospital Copenhagen
Denmark, Denmark
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center Albert Einstein College of Medicine Bronx New York USA
(Chiusolo) Cardio-Thoracic and Vascular Department Pisa University
Hospital Pisa Italy, Italy
(Van Mieghem) Department of Cardiology, Thoraxcenter Erasmus University
Medical Center Rotterdam The Netherlands, Netherlands
(Testa) Department of Cardiology IRCCS Policlinico San Donato Milan Italy,
Italy
(Testa) "Vita e Salute" University Milan Italy, Italy
(Waksman) MedStar Washington Hospital Center Washington DC USA
(Pelliccia, Miraldi) Department of Cardiovascular Sciences University
Sapienza Rome Italy, Italy
(Dangas) Zena and Michael A. Wiener Cardiovascular Institute Icahn School
of Medicine at Mount Sinai New York New York USA
Abstract
BACKGROUND: Surgical aortic valve replacement is the gold standard for
treating pure native aortic regurgitation. However, many patients have
unacceptable surgical risk. Increasing evidence supports the use of
transcatheter aortic valve replacement in this subset. This metanalysis
aims to evaluate transcatheter aortic valve replacement efficacy in pure
native aortic regurgitation. <br/>METHOD(S): We systematically searched
MEDLINE/PubMed, Embase, the Cochrane Database, Google Scholar,
ClinicalTrials.gov, and major cardiology conference abstracts from
inception to April 1, 2024, and included 19 observational studies with
>=20 patients with pure native aortic regurgitation undergoing
transcatheter aortic valve replacement. The primary end point was 30-day
all-cause mortality; secondary end points were device success, valve
migration, and 1-year all-cause mortality. Pooled estimates were
calculated using random-effects meta-analysis. Risk of bias was assessed
using the Newcastle-Ottawa Scale and publication bias with funnel plots
and Egger's test. The study protocol was registered in International
Prospective Register of Systematic Reviews (CRD42024534117).
<br/>RESULT(S): The pooled 30-day mortality was 8.7% (95% CI, 5.8%-10.7%),
and decreased from first (16.9% [95% CI, 13.2%-18.9%]) to second
generation (7.2% [95% CI, 6.1%-9.2%]) and dedicated devices (4.7% [95% CI,
1.8%-8.9%; P<0.0001]). Overall device success was 84.1% (95% CI,
78.0%-88.9%), improving from first (63.1% [95% CI, 52.0%-72.5%]) to second
generation (86.3% [95% CI, 80.1%-90.4%]) and dedicated devices (93.0% [95%
CI, 86.2%-97.3%]; P<0.00001). Valve migration occurred in 7.8% (95% CI,
5.0%-11.7%) of cases, decreasing from first (19.0% [95% CI, 15.2%-24.7%])
to second generation (6.9% [95% CI, 3.7%-10.0%]) and dedicated devices
(3.0% [95% CI, 1.3%-5.6%]; P<0.00001). Overall 1-year mortality was 14.0%
(95% CI, 10.1%-19.9%) and decreased from first (27.2% [95% CI,
15.4%-43.2%]) to second generation (12.7% [95% CI, 8.8%-18.9%]) and
dedicated devices (8.7% [95% CI, 3.5%-16.7%]; P<0.0001).
<br/>CONCLUSION(S): Although the observational design, lack of
patient-level data, device heterogeneity, and potential publication bias
limit definitive conclusions, transcatheter aortic valve replacement using
dedicated devices may be considered a safe and effective therapeutic
option for patients with pure native aortic regurgitation and unacceptable
risk for surgery. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero/;
Unique identifier: CRD42024534117.

<2>
Accession Number
2035520101
Title
Features and Prognosis of Patients With Retroperitoneal Fibrosis
Developing Fibrosing Mediastinitis: Case-Control Study and Systematic
Review.
Source
ACR Open Rheumatology. 7(8) (no pagination), 2025. Article Number: e70065.
Date of Publication: 01 Aug 2025.
Author
Ding Y.; Li Z.; Liu S.; Li M.; Ren Y.; Xu K.-F.; Luo C.; Pan C.; Gao H.
Institution
(Ding) Department of Research and Education, Peking University
International Hospital, Beijing, China
(Ding, Gao) Peking University Eighth Clinical Medical School, Beijing,
China
(Li, Pan) Center for Intelligent Medicine Research, Greater Bay Area
Institute of Precision Medicine (Guangzhou), School of Life Sciences,
Fudan University, Guangzhou, China
(Liu) Department of Retroperitoneal Tumor Surgery, Peking University
International Hospital, Beijing, China
(Li) Department of Pulmonary and Critical Care Medicine, Peking University
International Hospital, Beijing, China
(Ren) Department of Pathology, Peking University International Hospital,
Beijing, China
(Xu) Department of Pulmonary and Critical Care Medicine, Peking Union
Medical College Hospital, Chinese Academy of Medical Sciences, Beijing,
China
(Luo) Department of General Surgery, Peking University People's Hospital,
Beijing, China
(Pan) Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong
Kong University of Science and Technology, Guangzhou, China
(Gao) Department of Rheumatology and Immunology, Peking University
International Hospital, Beijing, China
Publisher
John Wiley and Sons Inc
Abstract
Objective: Retroperitoneal fibrosis (RPF) complicated by mediastinal
fibrosis (MF) is rare but fatal. We aimed to explore the features and
indicators of poor prognosis for the population of those affected.
<br/>Method(s): Patients with idiopathic RPF were recruited in Peking
University International Hospital. Literature related to RPF with MF was
searched from PubMed, Web of Science, and Embase until September 2024.
Systematic review and case-control studies were conducted. <br/>Result(s):
One patient with RPF and MF from our center and nine cases identified
through literature search formed the study group. The remaining 51
patients with RPF who did not have MF were enrolled as the control group.
Patients with RPF and MF were more likely to present specific symptoms,
including emaciation (30% vs 2%), fever (20% vs 0), pericardial effusion
(30% vs 0), pleurisy (20% vs 0) and dyspnea (40% vs 0) (all P < 0.05).
Hyperglobulinemia (elevated IgG levels) was also more predominant in the
study group, whereas low back pain (20% vs 56.9%, P = 0.043) was less
prevalent. Four of 10 patients in the study group died, but none died in
the control group. A second case-control study was performed among
patients with RPF and MF, with the three patients who died of fibrosis
disease as the study group and the surviving six patients as the control
group. It was found that pleural effusions (100% versus 16.7%, P = 0.048)
and the absence of glucocorticoid treatment were risk factors for death in
patients with RPF and MF. <br/>Conclusion(s): RPF with MF has specific
clinical features and poor prognosis. Early detection and
glucocorticoids-based treatment could improve the outcome.<br/>Copyright
&#xa9; 2025 The Author(s). ACR Open Rheumatology published by Wiley
Periodicals LLC on behalf of American College of Rheumatology.

<3>
Accession Number
2036781533
Title
Repurposing colchicine for reduction of residual inflammatory risk in type
1 diabetes: Design and rationale of the REC1TE trial.
Source
Diabetes, Obesity and Metabolism. 27(12) (pp 6884-6893), 2025. Date of
Publication: 01 Dec 2025.
Author
Mathiesen D.S.; Hansen J.V.; Hock A.; Nielsen C.K.; Pedersen M.G.;
Kristensen P.L.; Andersen H.U.; Aarestrup M.L.; Forman J.L.; Bagger J.I.;
Dejgaard T.F.; Knop F.K.; Johansen N.J.; Lund A.B.
Institution
(Mathiesen, Hansen, Hock, Nielsen, Pedersen, Bagger, Dejgaard, Knop,
Johansen, Lund) Center for Clinical Metabolic Research, Herlev and
Gentofte Hospital, University of Copenhagen, Hellerup, Denmark
(Kristensen, Dejgaard) Department of Endocrinology and Nephrology, North
Zealand University Hospital, Hillerod, Denmark
(Kristensen, Knop, Lund) Department of Clinical Medicine, Faculty of
Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
(Andersen, Aarestrup, Bagger, Lund) Steno Diabetes Center Copenhagen,
Herlev, Denmark
(Forman) Section of Biostatistics, Department of Public Health, Faculty of
Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
Publisher
John Wiley and Sons Inc
Abstract
Aims: Compared to people without diabetes, individuals with type 1
diabetes have a several-fold increased risk of cardiovascular (CV)
morbidity and mortality despite guideline-recommended management of
traditional risk factors; so-called residual CV risk. Systemic low-grade
inflammation has emerged as an independent risk factor for CV events with
residual inflammatory risk referring to the increased risk conferred by
inflammation when all other risk factors are well-treated. Several
clinical trials in individuals without type 1 diabetes have demonstrated
improved CV outcomes when targeting residual inflammatory risk with
anti-inflammatory therapies, of which especially low-dose colchicine has
shown promise and has been approved by the FDA for atherosclerotic CV
disease (CVD) prevention. <br/>Material(s) and Method(s): This trial is an
investigator-initiated, randomised, double-blind, placebo-controlled phase
2b trial evaluating low-dose colchicine (0.5 mg/day) in individuals with
type 1 diabetes, established or high risk of atherosclerotic CVD and
residual inflammatory risk (defined as two consecutive measurements of
high-sensitivity C-reactive protein (hsCRP) >=2 mg/L). A total of 102
participants have been included in the trial and randomly assigned to
colchicine or placebo (1:1) for up to 52 weeks in addition to standard of
care. The primary endpoint is the difference in hsCRP at week 26.
Recruitment began August 2023 and last patient last visit is expected in
February 2026. <br/>Result(s) and Conclusion(s): Here, we present the
protocol for a study designed to evaluate the efficacy of low-dose
colchicine on residual inflammatory risk in individuals with type 1
diabetes.<br/>Copyright &#xa9; 2025 The Author(s). Diabetes, Obesity and
Metabolism published by John Wiley & Sons Ltd.

<4>
Accession Number
2041308093
Title
Clinical and hemodynamic effect of intravenous calcium administration in
cardiac surgery: A systematic review.
Source
Heart and Lung. 75 (pp 329-336), 2026. Date of Publication: 01 Jan 2026.
Author
Belletti A.; Boboshko V.; Piazza E.; Crusi M.C.; Zaraca L.; Toth K.;
Asiller O.O.; Landoni G.; Monaco F.; Zangrillo A.; Lomivorotov V.
Institution
(Belletti, Piazza, Crusi, Zaraca, Asiller, Landoni, Monaco, Zangrillo)
Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Boboshko) Department of Anesthesiology and Intensive Care, E. Meshalkin
National Medical Research Center, Novosibirsk, Russian Federation
(Landoni, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Toth) Department of Surgery, Transplantation and Gastroenterology,
Semmelweis University, Budapest, Hungary
(Asiller) Department of Anesthesia and Intensive Care, Ankara University
Faculty of Medicine, Ankara, Turkey
(Lomivorotov) Department of Anesthesiology and Perioperative Medicine,
Penn State Milton S. Hershey Medical Center, Penn State College of
Medicine, Hershey, PA, United States
Publisher
Elsevier Inc.
Abstract
Background: Intravenous calcium is frequently administered in cardiac
surgery patients to improve hemodynamics. <br/>Objective(s): To assess
safety and efficacy of intravenous calcium administration in this
population. <br/>Method(s): We conducted a systematic review (with
meta-analysis of hemodynamic data) and searched PubMed and Scopus up to
March 15th, 2025. All studies investigating intravenous calcium
administration in patients undergoing cardiac surgery were considered.
Animal studies and studies investigating oral calcium administration were
excluded. We abstracted data on study design, sample size, setting,
calcium formulation, dose and timing of administration. Primary outcome
was all-cause mortality. Secondary outcomes included rate of myocardial
ischemia, postoperative release of cardiac necrosis biomarkers, adverse
events, and hemodynamic data. Only data from randomized controlled trials
(RCTs) were included in the quantitative analysis. <br/>Result(s):
Twenty-two studies were selected (nine RCTs, eight pediatric studies, ten
including a control group), with a total sample size of 1278 patients (809
receiving calcium). The most common formulation was calcium chloride. Most
studies followed up patients for <60 min. Only one non-RCT study with a
control group reported mortality data (4/66 [6.1 %] calcium group vs 8/69
[11.6 %] control group). Intravenous calcium transiently increases mean
arterial pressure (MAP) and reduces heart rate, with effects fading within
10-20 min. Calcium administration may blunt hemodynamic response to
catecholamines <br/>Conclusion(s): There is no data on the effects of
intravenous calcium on major clinical outcomes in patients undergoing
cardiac surgery. Calcium may transiently improve MAP and reduce heart
rate. Large RCTs are needed to assess the effects of calcium on clinically
relevant endpoints. Review Registration: International Prospective
Register of Systematic Reviews (PROSPERO), n.
CRD420250282624<br/>Copyright &#xa9; 2025 Elsevier Inc.

<5>
Accession Number
2041435487
Title
Sternal Complications After Clamshell Surgery for (Heart-)Lung
Transplantation-A Systematic Literature Review.
Source
European Journal of Cardio-thoracic Surgery. 67(11) (no pagination), 2025.
Article Number: ezaf318. Date of Publication: 01 Nov 2025.
Author
Klei D.S.; Sabaoglu R.; Mokhles M.M.; De Heer L.M.; Van Wessem K.J.P.
Institution
(Klei, Van Wessem) Department of Trauma Surgery, University Medical Centre
Utrecht, Utrecht, Netherlands
(Sabaoglu, Mokhles, De Heer) Department of Cardiothoracic Surgery,
University Medical Centre Utrecht, Utrecht, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Bilateral transverse thoracosternotomy ("clamshell") is widely
used for (heart-)lung transplantations, but postoperative sternal
complications are a significant challenge. The primary objective of this
systematic review was to evaluate the prevalence of sternal complications
after clamshell surgery in (heart-)lung transplantation patients.
<br/>Method(s): A systematic literature review was conducted. On April 4,
2025, PubMed and Embase databases were searched. Original studies
reporting sternal complications after clamshell surgery in adults for
bilateral lung or heart-lung transplantation were included. Studies
including <10 patients were excluded. Study quality was assessed using the
National Institutes of Health assessment tool. The total and range of
sternal complication prevalence was provided. Meta-analysis of sternal
complication prevalence was not performed due to significant heterogeneity
across studies. <br/>Result(s): The database searches yielded 945 eligible
articles. Eighteen studies were included, including 828 patients who
underwent a total of 830 bilateral lung or heart-lung transplantations
through clamshell surgery. All included studies were cohort studies with
poor (n=15), fair (n=1), or good (n=2) quality. In total, 286 sternal
complications were reported (0.34 event per clamshell surgery; range 0.02
to 1.35 in individual studies) and 90 sternal reoperations were conducted
(0.14 reoperation per clamshell surgery; range 0.02 to 0.29 in individual
studies). <br/>Conclusion(s): Despite limitations in study quality and
heterogeneity, this review highlights the high prevalence and relevance of
sternal complications following clamshell surgery for (heart-)lung
transplantation. Future studies should focus on patient selection, risk
stratification, development of modified sternal closure techniques, and
implementation of alternative surgical approaches to (heart-)lung
transplantation.<br/>Copyright &#xa9; The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<6>
Accession Number
2037294125
Title
Application Effects of Single-Lumen Endotracheal Tube Intubation for
General Anesthesia in Totally Thoracoscopic Cardiac Surgery.
Source
Brazilian Journal of Cardiovascular Surgery. 40(5) (no pagination), 2025.
Article Number: e20240339. Date of Publication: 2025.
Author
Yi X.; Wang L.
Institution
(Yi) Second Operating Room, The First Hospital of Jilin University, Jilin,
Changchun, China
(Wang) Department of Cardiac Surgery, The First Hospital of Jilin
University, Jilin, Changchun, China
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: The rapid advancement of medical technology has enabled the
application of single-lumen endotracheal tube (SLET) incubation anesthesia
in thoracoscopic surgeries for thoracic diseases, demonstrating promising
results. This study aims to explore the application of extracorporeal
circulation (ECC) and combined intravenous-inhalation anesthesia (CIIA)
with SLET intubation in totally thoracoscopic cardiac surgery (TTCS).
<br/>Method(s): In this single-center, double-blind, randomized controlled
trial, we assessed primary outcomes, including intraoperative metrics and
postoperative conditions. Secondary outcomes included the number of
patients achieving spontaneous resuscitation and those requiring
extracorporeal defibrillation after opening the ascending aorta,
alertness/sedation scores five minutes post-extubation, and incidence of
postoperative complications. <br/>Result(s): The observation group showed
shorter durations in the anesthesia recovery room, intensive care unit
retention, extubation, eye-opening time, and postoperative hospital stay
compared to the control group (t = 5.913, 8.820, 7.792, 6.904, 11.140; all
P < 0.001) and had higher proportion of patients with an
alertness/sedation score of five (43/109, 39.45%) and rate of spontaneous
resuscitation after opening the ascending aorta (97/109, 88.99%) compared
to the control group ([8/109, 34%], [84/109, 77.06%]). In contrast, the
rate of external electrical defibrillation (12/109, 11.01%) and the
incidence of postoperative complications (2/109, 1.83%) were lower than in
the control group ([25/109, 22.94%], [10/109, 9.17%]) (chi² =
31.350, 5.501, 5.644; all P < 0.05). <br/>Conclusion(s): Maintaining
oxygen saturation in thoracoscopic surgery requires effective cooperation
of anesthesia and ECC. The combined use of ECC and CIIA with SLET
intubation in TTCS is a safe, effective approach that warrants broader
clinical application.<br/>Copyright &#xa9; 2025, Sociedade Brasileira de
Cirurgia Cardiovascular. All rights reserved.

<7>
Accession Number
2037294651
Title
Effects of Perioperative Recombinant Human Brain Natriuretic Peptide in
Patients Undergoing Cardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 26(9) (no pagination), 2025. Article
Number: 36423. Date of Publication: 01 Sep 2025.
Author
Shao J.; Wang L.; Shao C.; Wang Y.; Li J.; Luo J.; Du Z.; Hou X.
Institution
(Shao, Wang, Shao, Wang, Li, Du, Hou) Center for Cardiac Intensive Care,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
(Luo) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
Publisher
IMR Press Limited
Abstract
Background: Clinical trials have demonstrated the efficacy of recombinant
human brain natriuretic peptide (rhBNP) in managing acute decompensated
heart failure. Moreover, since rhBNP performs roles in hemodynamic
regulation, neurohormonal balance, and renal function, rhBNP
administration could benefit cardiac surgery patients. We conducted a
systematic review and meta-analysis to evaluate the impact of
perioperative rhBNP in cardiac surgery patients. <br/>Method(s): We
conducted a comprehensive search of the MEDLINE, Em-base, the Cochrane
Library, CNKI, and WANFANG databases from January 1, 2007, until December
31, 2023, identifying randomized controlled trials (RCTs) that examined
the use of rhBNP during cardiac surgery. We estimated the treatment
effects of perioperative rhBNP administration using a random-effects
meta-analysis. The primary cardiovascular endpoint was the change in left
ventricular ejection fraction (LVEF) meanwhile, renal function was
assessed using the 24-hour urine output, changes in estimated glomerular
filtration rate (eGFR), and serum creatinine (SCr) levels. Additional
parameters included pulmonary artery pressure (PAP), adverse event (AE)
incidence, respiratory support duration, ICU length of stay (ICU LOS),
hospital length of stay (hospital LOS), and tumor necrosis factor-alpha
(TNF-alpha) levels. <br/>Result(s): Our meta-analysis included 38 RCTs
encompassing 2280 patients. The use of rhBNP in the periop-erative period
significantly enhanced LVEF compared to the control group (mean difference
= 3.13 (95% CI [1.88, 4.37] p < 0.00001). Additionally, rhBNP
administration was associated with a significant increase in the 24-hour
urine volume (mean difference = 401.42, 95% CI [253.06, 549.77] p <
0.00001) and an improvement in eGFR (mean difference = 13.94, 95% CI
[5.57, 22.31] p = 0.001). Mean-while, perioperative administration of
rhBNP significantly reduced SCr levels (mean difference = -14.55, 95% CI
[-22.04, -7.06] p < 0.0001). In addition, rhBNP significantly decreased
PAP, the incidence of AEs, the duration of respiratory support, ICU LOS,
hospital LOS, and TNF-alpha levels. <br/>Conclusion(s): These findings
underscore the potential benefits of rhBNP as a perioperative treatment in
patients undergoing cardiac surgery.<br/>Copyright &#xa9; 2025 The
Author(s).

<8>
Accession Number
2041157397
Title
Veno-pulmonary extracorporeal membrane oxygenation for concomitant right
ventricular and respiratory support: A systematic review of utilization
patterns and outcomes.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251389383. Date of Publication: 2025.
Author
Nasher N.; Mounzer M.; Mallur K.; Fayek F.B.; Rahimov D.; Rame J.E.;
Alvarez R.J.; Entwistle J.W.; Rajagopal K.; Hoopes C.W.;
Tchantchaleishvili V.
Institution
(Nasher, Rahimov, Entwistle, Rajagopal, Hoopes, Tchantchaleishvili)
Department of Cardiac Surgery, Thomas Jefferson University Hospital,
Philadelphia, PA, United States
(Mounzer, Mallur, Fayek) Sidney Kimmel Medical College, Thomas Jefferson
University, Philadelphia, PA, United States
(Rame, Alvarez) Division of Cardiology, Department of Medicine, Thomas
Jefferson University Hospital, Philadelphia, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Background: Veno-pulmonary artery extracorporeal membrane oxygenation (V-P
ECMO) is a configuration of extracorporeal life support (ECLS) for
patients with isolated or predominantly right ventricular (RV) failure and
inadequate gas exchange due to severe respiratory failure. We aimed to
systematically review the existing literature to better understand its
utilization patterns and associated outcomes. <br/>Method(s): The
electronic search identified all studies reporting the characteristics and
outcomes of V-P ECMO use in adult patients. Patient-level data for 110
patients from 60 case reports and case series were extracted and analyzed.
<br/>Result(s): The median patient age was 45 [IQR, 32-56] years, and 63%
were male. Patients most commonly presented with moderate to severe RV
dysfunction (90%), along with acute hypoxic respiratory failure (64%) and
severe pulmonary hypertension (23%). On presentation, 85% of patients were
placed on ventilatory support for a median duration of 13 [5-32] days. V-P
ECMO was initiated in the setting of a primary cardiorespiratory pathology
in 75% of cases, and major chest surgery in 25% of cases. A percutaneous
dual-lumen cannula was used in 64% of cases, of which 29% required an
additional cannula. The median duration of V-P ECMO support was 12 [7-31]
days. Overall, 42% of patients recovered, 26% underwent lung
transplantation, and 9% underwent heart transplantation. In-hospital
mortality was 22%. At a median follow-up time of 81 [44-181] days, overall
survival was 75%. <br/>Conclusion(s): V-P ECMO can be utilized in place of
traditional ECLS strategies with favorable outcomes across various
settings.<br/>Copyright &#xa9; The Author(s) 2025

<9>
Accession Number
648929527
Title
Sex Differences in Transcatheter Aortic Valve Implantation Outcomes in
Patients on Oral Anticoagulants: A Popular PAUSE TAVI SubAnalysis.
Source
Journal of the American Heart Association. 14(21) (pp e043448), 2025. Date
of Publication: 04 Nov 2025.
Author
van Bergeijk K.H.; Overduin D.C.; Venema C.S.; van Ginkel D.J.; van der
Werf H.W.; van den Heuvel A.F.M.; Voors A.A.; Wykrzykowska J.J.; Ten Berg
J.M.
Institution
(van Bergeijk, Venema, van der Werf, van den Heuvel, Voors, Wykrzykowska)
Department of Cardiology University of Groningen, University Medical
Center Groningen the Netherlands, Netherlands
(Overduin, van Ginkel, Ten Berg) Department of Cardiology St. Antonius
Hospital Nieuwegein the Netherlands, Netherlands
(Ten Berg) Cardiovascular Research Institute Maastricht (CARIM) the
Netherlands, Netherlands
Abstract
BACKGROUND: Many patients undergoing transcatheter aortic valve
implantation (TAVI) have an indication for oral anticoagulation (OAC). Our
aim was to study sex differences in outcomes after TAVI, depending on the
type and regimen of vitamin K antagonist versus direct OAC.
<br/>METHOD(S): The Popular PAUSE TAVI (Periprocedural Continuation Versus
Interruption of Oral Anticoagulant Drugs During Transcatheter Aortic Valve
Implantation) was a randomized clinical trial to compare outcomes between
patients who continued or interrupted OAC during TAVI. The outcomes of
interest in this subanalysis were a combination of cardiovascular
mortality, stroke, myocardial infarction, major vascular complications or
major bleeding at 30 days, stratified by OAC regimen and type, and sex.
<br/>RESULT(S): After 30 days of follow-up, 44/296 (14.9%) women reached
the combined end point, compared with 90/562 men (16.0%), P=0.732. There
were no statistically significant differences between sexes in outcomes,
irrespective of the continued or interrupted OAC regimen. Women on vitamin
K antagonist had a numerically higher combined event rate (21.7%) compared
with women using direct OAC (13.1%), although not statistically
significant (P=0.146), similarly for major vascular complications (15%
versus 7.2% in women on vitamin K antagonist and direct OAC respectively
[P=0.255]). The interaction between sex and type of OAC for the combined
end point lost significance after correcting for OAC indication and
randomization, among others (unadjusted: P=0.037, adjusted=0.090).
<br/>CONCLUSION(S): After a 30-day follow-up of patients undergoing TAVI
on OAC, there were no statistically significant differences in outcomes
between sexes, independent of interrupted or continued management.
Although women treated with vitamin K antagonist had numerically more
events than those with direct OAC and an interaction between sex and type
of OAC was present, this interaction lost significance after adjustment
for other factors. REGISTRATION:
https://clinicaltrials.gov/study/NCT04437303; Unique Identifier:
NCT044373030.

<10>
Accession Number
2041371179
Title
Effects of Remote Ischaemic Pre-conditioning in Patients undergoing
Off-pump Coronary Artery Bypass Grafting Procedure: A Randomised
Controlled Study.
Source
Journal of Clinical and Diagnostic Research. 19(11) (pp UC38-UC42), 2025.
Date of Publication: 01 Nov 2025.
Author
Rajkumar S.; Iswarya S.; Gayathri B.
Institution
(Rajkumar) Department of Anaesthesia, AIIMS, Tamil Nadu, Madurai, India
(Iswarya) Department of Anaesthesia, SRM Medical College Hospital and
Research Centre, Tamil Nadu, Chengalpattu, India
(Gayathri) Department of Anaesthesia, SRM Medical College Hospital and
Research Centre, Tamil Nadu, Chengalpattu, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Remote Ischaemic Pre-conditioning (RIPC) is a simple, non
invasive, cost-effective intervention using brief cycles of limb
ischaemia/reperfusion that may reduce Peri-operative Myocardial Injury
(PMI) in patients undergoing Coronary Artery Bypass Grafting (CABG)
surgery. <br/>Aim(s): To study the effects of remote ischaemic
pre-conditioning in cardiac patients undergoing off-pump CABG procedure.
<br/>Material(s) and Method(s): A double-blinded, randomised controlled
study was conducted at the Department of Anaesthesiology, SRM Medical
College Hospital and Research Centre, Tamil Nadu, India from November 2023
to July 2024. Among a total of 140 patients, 69 patients received RIPC
(group A), and 71 patients were free of RIPC (group B). Total of 134
patients were included for final analysis. Preoperatively, the patient's
routine laboratory investigations, including cardiac Troponin I (cTnI),
were measured. cTnI is the primary endpoint used here to assess PMI.
Post-procedure, the patient's cTnI level as well as the renal function
tests were evaluated at 24, 48, and 72 hours (hrs). Secondary endpoints
included short-term clinical outcomes. The Student's t-test, and Pearson's
Chi-squared test were used, and p-values<0.05 were considered
statistically significant. <br/>Result(s): The groups were comparable
concerning demographic data and baseline haemodynamic parameters. Compared
with the control group B at 24, 48, and 72 hrs, the cTnI was shown to be
lower in the RIPC group throughout the trial (1.66+/-2.02, 2.52+/-1.92,
2.34+/-1.85, p-value: 0.001, 0.001, and 0.001, respectively). Acute renal
injury was measured by comparing serum creatinine levels at 24, 48, and 72
hours, which were lower in the RIPC group A (1.07+/-0.44, 1.06+/-0.48,
1.08+/-0.48, p values: 0.001, 0.001, and 0.001, respectively). Conversely,
the RIPC group remained a shorter stay in the Intensive Care Unit (ICU)
(p-value <0.0001). <br/>Conclusion(s): Remote ischaemic pre-conditioning
in off-pump CABG procedure has been shown to reduce the severity of
peri-operative myocardial injury, as evidenced by lower cTnI levels at 24,
48, and 72 hrs post-intervention. RIPC also reduced the incidence of acute
kidney injury, resulting in consistently lower serum creatinine levels.
Additionally, patients in the RIPC group had a significantly shorter ICU,
suggesting improved postoperative recovery.<br/>Copyright &#xa9; 2025 JCDR
Research and Publications Pvt Ltd. All rights reserved.

<11>
Accession Number
2041273117
Title
No-touch versus conventional saphenous vein harvesting technique in
coronary artery bypass grafting: A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 33(8-9) (pp 281-291), 2025. Date
of Publication: 01 Nov 2025.
Author
Harta I.K.A.P.; Pertiwi P.F.K.; Sudarma I.W.; Yasa K.P.
Institution
(Harta, Sudarma, Yasa) Cardiothoracic and Vascular Surgery Division,
Department of Surgery, Faculty of Medicine, Udayana University, Bali,
Indonesia/Prof. Dr I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
(Pertiwi) Faculty of Medicine, Udayana University, Bali, Indonesia/Prof.
Dr I.G.N.G. Ngoerah General Hospital, Bali, Indonesia
Publisher
SAGE Publications Inc.
Abstract
Background: The saphenous vein graft (SVG) remains widely used in coronary
artery bypass grafting (CABG). The no-touch (NT) technique offers
atraumatic procedures in vein harvesting. Its effectiveness is still
compared to conventional (CON) methods. <br/>Method(s): We conducted a
systematic review using electronic databases, focusing on studies that
compared the NT and CON techniques in CABG. The primary outcomes assessed
were major adverse cardiac and cerebrovascular events (MACCE), graft
patency, and leg complications. Kaplan-Meier estimates and the Cox
proportional hazards model were used to analyze MACCE-free survival. This
study has been registered on PROSPERO(CRD42024553619). <br/>Result(s): A
total of seven studies, including three randomized controlled trials and
four prospective cohort studies, encompassing 3859 patients, were included
in the analysis. The NT technique showed significantly higher overall
graft patency (OR 1.59; 95% CI 1.18-2.15; p < 0.001; I²= 49%),
especially in the right coronary artery (OR 1.63; 95% CI 1.25-2.13; p <
0.001; I²= 0%). However, the NT technique had a higher
incidence of leg complications (OR 2.49; 95% CI 1.73-3.60; p < 0.001;
I²= 10%). No significant difference in 3-year MACCE-free
survival (log-rank p = 0.47). <br/>Conclusion(s): The NT SVG harvesting
technique has the potential to improve patency rates, especially when
utilized as a conduit to the right coronary artery
territory.<br/>Copyright &#xa9; The Author(s) 2025

<12>
Accession Number
2041015362
Title
Semaglutide reduces cardiovascular events in type 2 diabetes: a systematic
review and meta-analysis highlighting enhanced benefits in chronic kidney
disease.
Source
European Journal of Medical Research. 30(1) (no pagination), 2025. Article
Number: 1059. Date of Publication: 01 Dec 2025.
Author
Yao Y.; Liu N.; Chen S.; Sun M.; Guo Y.
Institution
(Yao, Liu, Chen, Sun, Guo) Xi'an International Medical Center Hospital
Affiliated to Northwest University, Xi'an, China
Publisher
BioMed Central Ltd
Abstract
Background: Cardiovascular disease (CVD) disproportionately affects type 2
diabetes (T2D) patients with chronic kidney disease (CKD). Although
semaglutide shows cardiometabolic benefits, its efficacy across CVD
endpoints and high-risk CKD subgroups remains underexplored.
<br/>Method(s): We systematically reviewed PubMed, Embase, Cochrane, Web
of Science (through September 2025) for randomized trials and
observational studies evaluating oral semaglutide versus placebo in T2D.
Data synthesis employed hazard ratios (HRs) and mean differences (MDs)
with 95% confidence intervals (CIs). <br/>Result(s): Across 17 studies (n
= 40, 632 patients), semaglutide significantly reduced the risk of
cardiovascular (CV) death by 23% [HR 0.77, 95% CI (0.68, 0.88)], major
adverse cardiovascular events (MACE) by 18% [HR 0.82, 95% CI (0.75,
0.90)], expanded MACE by 22% [HR 0.78, 95% CI (0.70, 0.85)], nonfatal
myocardial infarction (MI) by 18% [HR 0.82, 95% CI (0.68, 0.92)], and
nonfatal stroke by 32% [HR 0.68, 95% CI (0.56, 0.83)]. The reductions in
CV events were most pronounced in T2D patients with CKD (24-37% risk
reduction vs. 13-35% in T2D alone or with CVD). Semaglutide also
significantly improved modifiable CV risk factors, reducing
systolic/diastolic blood pressure (SBP/DBP) decreased by 8.02/3.71 mmHg,
and low-density Lipoprotein (LDL) decreased by 12.62 mg/dL, while
increasing high-density lipoprotein (HDL) by 1.44 mg/dL. However,
semaglutide had no significant effect on estimated glomerular filtration
rate (eGFR) and urinary albumin-to-creatinine ratio (UACR).
<br/>Conclusion(s): Semaglutide confers robust cardiovascular protection
in T2D, with amplified benefits in patients with comorbid CKD. It confers
a collective advantage by simultaneously addressing multiple risk factors
including blood pressure and lipoprotein, positioning it as a
comprehensive treatment strategy for high-risk populations. This analysis
is the first to synthesize evidence across CKD subgroups, supporting
prioritizing semaglutide in T2D patients with CKD. Further research should
clarify mechanisms underlying CKD-specific benefits and refine
risk-stratified treatment algorithms.<br/>Copyright &#xa9; The Author(s)
2025.

<13>
Accession Number
2041397908
Title
Intensive Blood Pressure Control in Older Patients With Hypertension:
6-Year Results of the STEP Trial.
Source
Journal of the American College of Cardiology. 86(17) (pp 1421-1433),
2025. Date of Publication: 28 Oct 2025.
Author
Song Q.; Peng X.; Bai J.; Yang R.; Ling Q.; Chen S.; Ji Y.; Dong X.; Wang
X.; Wu S.; Wang T.-D.; Yu X.; Liu H.; Ren J.; Zhou X.; Chen R.; Yang L.;
Yang J.; Tian G.; Zhang H.; Zhao D.; Chen F.; Li D.; Yu J.; Zhang J.; Yang
Z.; Zhang W.; Cai J.
Institution
(Song, Peng, Bai, Yang, Ling, Yang, Cai) Hypertension Center, Beijing
Anzhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung, and Blood Vessel Diseases, Beijing, China
(Song, Peng, Ling, Chen, Ji, Dong, Wang, Zhang) Hypertension Center, Fuwai
Hospital, State Key Laboratory of Cardiovascular Disease, National Center
for Cardiovascular Diseases, Peking Union Medical College, Chinese Academy
of Medical Sciences, Beijing, China
(Wu) Department of Cardiology, Kailuan General Hospital, Tangshan, China
(Wang) Cardiovascular Center and Division of Cardiology, College of
Medicine, National Taiwan University, Taipei, Taiwan (Republic of China)
(Yu) Internal Medicine Department, Benxi Railway Hospital, Benxi, China
(Liu) Department of Cardiology, Zhoukou City Central Hospital, Zhoukou,
China
(Ren) Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of
Medical Sciences, Taiyuan, China
(Zhou) Department of Cardiology, Renmin Hospital of Wuhan University,
Wuhan, China
(Chen) Department of Cardiology, Zhenjiang First People's Hospital,
Zhenjiang, China
(Yang) Department of Geriatric Medicine, Yan'an Hospital Affiliated to
Kunming Medical University, Kunming, China
(Yang) Hypertension Department, The People's Hospital of Ji Xian District,
Tianjin, China
(Tian) Department of Cardiology, First Affiliated Hospital, Xian Jiaotong
University, Xi'an, China
(Zhang) General Ward Department, Hospital of Shunyi District, Beijing,
China
(Zhao) Department of Cardiology, First Affiliated Hospital of Harbin
Medical University, Harbin, China
(Chen) Cardiac Care Center, The First People's Hospital of Yinchuan,
Yinchuan, China
(Li) Department of Cardiology, Wuxiang County People's Hospital, Changzhi,
China
(Yu) Department of Cardiology, Lanzhou University Second Hospital,
Lanzhou, China
(Zhang) Department of Cardiology, First Hospital of Shanxi Medical
University, Taiyuan, China
Publisher
Elsevier Inc.
Abstract
Background: The STEP (Strategy of Blood Pressure Intervention in the
Elderly Hypertensive Patients) trial showed that intensive systolic blood
pressure (SBP) control reduced cardiovascular risk. <br/>Objective(s):
Study investigators conducted an extended follow-up of the STEP trial to
determine the longer-term effects of intensive blood pressure (BP)
control. <br/>Method(s): In this randomized controlled trial, 8,511
patients with hypertension were randomly assigned to the intensive
treatment group, with an SBP target of 110 mm Hg to <130 mm Hg, or the
standard treatment group, with an SBP target of 130 mm Hg to <150 mm Hg.
After the original trial ended, all surviving patients, either in the
standard group or the intensive treatment group previously, received
intensive treatment in the extended period, referred to as the delayed
intensive treatment group or the sustained intensive treatment group. The
primary outcome was a composite of stroke, acute coronary syndrome, acute
decompensated heart failure, coronary revascularization, atrial
fibrillation, or death resulting from cardiovascular causes. The Fine-Gray
subdistribution hazard model was used to estimate the HR between the 2
groups, and g-formula methods were initiated to compare overall primary
outcome risks with intensive treatment initiated from randomization and
initiated every year after randomization. <br/>Result(s): After a median
follow-up of 6.11 years, the mean SBP was 127.9 mm Hg in the sustained
intensive treatment group and 129.5 mm Hg in the delayed intensive
treatment group. The incidence rate of primary outcome was 1.12% per year
in the sustained intensive treatment group, compared with 1.33% per year
in the delayed intensive treatment group (HR: 0.82; 95% CI: 0.71-0.96). No
difference in safety event rates between the 2 groups was observed except
for hypotension, which occurred more frequently in the sustained intensive
treatment group. Furthermore, analyses using the parametric g-formula
showed that compared with the standard BP treatment, intensive treatment
initiating from randomization (0 month) yielded the greatest benefit
(relative risk [RR]: 0.83; 95% CI: 0.70-0.96), with an attenuated
cardiovascular benefit for later initiation from 12 months (RR: 0.88; 95%
CI: 0.76-0.99). <br/>Conclusion(s): Our results suggested that sustained
intensive BP control could benefit patients with hypertension compared
with delayed intensive treatment in the longer-term follow-up. The earlier
intensive treatment is initiated after the hypertension diagnosis, the
greater the cardiovascular benefits will be. (Strategy of Blood Pressure
Intervention in the Elderly Hypertensive Patients [STEP];
NCT03015311)<br/>Copyright &#xa9; 2025 The Authors

<14>
Accession Number
2041371178
Title
Normal Saline versus Balanced Salt Solution in Diabetic Patients
Undergoing Elective Surgery with Spinal Anaesthesia: A Randomised Control
Study.
Source
Journal of Clinical and Diagnostic Research. 19(11) (pp UC22-UC27), 2025.
Date of Publication: 01 Nov 2025.
Author
Yadav P.; Meena S.; Gehlaut P.; Seelwal D.; Chhikara M.
Institution
(Yadav, Seelwal, Chhikara) Department of Anaesthesiology and Critical
Care, Pt. BDS PGIMS, Haryana, Rohtak, India
(Meena) Department of Anaesthesiology and Critical Care, Pt. BDS PGIMS,
Haryana, Rohtak, India
(Gehlaut) Department of Anaesthesiology and Critical Care, Pt. BDS PGIMS,
Haryana, Rohtak, India
Publisher
JCDR Research and Publications Pvt Ltd
Abstract
Introduction: Perioperative fluid management is of utmost importance in
diabetic patients posted for surgery. Despite availability of a plethora
of intravenous fluids, Normal Saline (NS) is still most commonly used in
diabetic patients for perioprative fluid therapy. <br/>Aim(s): The present
study was designed to compare NS with plasmalyte to study their effects on
blood sugar, serum electrolytes, lactate levels and blood pH in diabetes
mellitus patients undergoing elective surgery under subarachnoid block.
<br/>Material(s) and Method(s): The present double blinded randomised
control study was carried out in the department of anaesthesiology and
critical care at a Pt BDS PGIMS, Rohtak, Haryana, India, between November
2022 - April 2024. Seventy patients of age 30-85 years, with diabetes
mellitus, American Society of Anaesthesiologists (ASA) class II scheduled
for elective surgery under sub-arachnoid block were enrolled in a
randomised controlled trial and randomly divided into two groups; Group A
received NS and Group B received plasmalyte as intravenous fluid. Rest of
the anaesthesia protocol was uniformly standardised in all the patients.
Venous blood sample were drawn preoperatively, at one hour and six hours
after the start of surgery for the measurement of blood sugar, serum
sodium, potassium, chloride, serum lactate and pH. Recorded data was
analysed with t-tests and Chi-square tests. <br/>Result(s): Mean age was
60.66+/-13.56 years in NS group and 64.80+/-12.52 years in plasmalyte
group. Serum lactate levels were comparable in preoperative (mean value
1.34+/-6.57 mmol\L in NS group and 1.14+/-0.48 mmol/L in plasmalyte group;
p-value 0.12) and postoperative period at six hours time point (mean value
of lactate (mmol/L) in Group A (NS) was 1.33+/-0.61 mmol/L in NS group and
1.17+/-0.38 mmol/L in plasmalyte group; p-value 0.18), but lactate levels
were significantly lower in plasmalyte group (1.05+/-0.32) than in NS
group (1.29+/-0.56) in intraoperative period with p-value of 0.03. Serum
electrolytes, blood pH and glucose levels were comparable at preoperative,
intraoperative and postoperative in both groups. <br/>Conclusion(s): The
present study results conclude that both plasmalyte and NS are comparable
in maintaining blood sugar, serum electrolytes and blood pH
perioperatively in patients with well optimised type II diabetes mellitus.
However, plasmalyte is a promising alternative to 0.9% NS in terms of
maintenance of lactate levels in diabetic patients.<br/>Copyright &#xa9;
2025 JCDR Research and Publications Pvt Ltd. All rights reserved.

<15>
Accession Number
2032044382
Title
Cardiogenic Necrotizing Enterocolitis in Infants with Congenital Heart
Disease: A Systematic Review and Meta-analysis.
Source
Pediatric Cardiology. 46(8) (pp 2429-2442), 2025. Date of Publication: 01
Dec 2025.
Author
Asztalos I.B.; Hill S.N.; Nash D.B.; Schachtner S.K.; Palm K.J.
Institution
(Hill, Schachtner) Division of Cardiology, Department of Pediatrics,
Children's Hospital of Philadelphia and University of Pennsylvania
Perelman School of Medicine, 3401 Civic Center Blvd, Philadelphia, PA,
United States
(Nash) Division of Cardiology, Department of Pediatrics, Children's
Hospital Colorado, University of Colorado Denver, 13123 E 16th Ave,
Anschutz Medical Campus, Aurora, CO, United States
(Palm) Clinical Nutrition, Cardiac Center, Children's Hospital of
Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, United States
(Asztalos) Division of Cardiology, Department of Pediatrics, Children's
Hospital of Philadelphia and University of Pennsylvania Perelman School of
Medicine, 3401 Civic Center Blvd, 8NW85, Philadelphia, PA, United States
Publisher
Springer
Abstract
Necrotizing enterocolitis (NEC) is a known cause of morbidity and
mortality in infants with congenital heart disease (CHD), but reports
about the burden of cardiogenic NEC frequently conflict. To synthesize the
extant literature on the incidence, risk factors, and prognosis of NEC in
patients with CHD. Medline, Cochrane, and EMBASE were searched from 1946
through 2023 for studies of NEC in infants 0-12 months of age with CHD.
Risk of bias was assessed with validated tools for incidence and risk
factors. Pooled estimates were meta-analyzed by risk of bias or
synthesized without meta-analysis. Eighty-six studies with a total of
67,924 participants were included. The incidence of cardiogenic NEC was
7.1% (95% CI 4.7-10.5%) in term infants and 13.0% (10.2-16.5%) in low
birthweight preterm infants. NEC required surgery in 0.8% (0.5-1.1%) of
term and 2.7% (2.0-3.7%) of premature infants, respectively. Only
gestational age and birth weight were consistently associated with risk of
NEC. Restricting pooled estimates to studies of moderate or low risk of
bias significantly reduced the number of studies included. Necrotizing
enterocolitis is a common cause of morbidity in infants with CHD, but
additional research is needed to determine which infants are at highest
risk of developing NEC and would benefit most from a change in management.
This systematic review and meta-analysis was conducted according to a
prespecified protocol registered at the Prospective Register of Systematic
Reviews (CRD42021282114).<br/>Copyright &#xa9; The Author(s) 2024.

<16>
Accession Number
2040988918
Title
Surgical compared to percutaneous repair of aortic coarctation in the
pediatric population: a protocol for a systematic review and meta-analysis
update.
Source
Systematic Reviews. 14(1) (no pagination), 2025. Article Number: 211. Date
of Publication: 01 Dec 2025.
Author
Perez-Ariza V.; Delgado-Perez M.P.; Prada S.A.; Maldonado-Escalante J.;
Maldonado-Canon K.
Institution
(Perez-Ariza, Delgado-Perez, Maldonado-Escalante) School of Medicine,
Universidad de los Andes, Bogota, Colombia
(Perez-Ariza, Prada, Maldonado-Escalante, Maldonado-Canon) Grupo de
Investigacion en Cirugia Cardiovascular, Department of Surgery, Clinica
Universitaria Colombia, Bogota, Colombia
(Maldonado-Escalante) Cardiovascular Surgery Section, Department of
Surgery, Clinica Universitaria Colombia, Bogota, Colombia
(Maldonado-Escalante) Cardiovascular Surgery Section, Department of
Surgery, Fundacion Santa Fe de Bogota, Bogota, Colombia
Publisher
BioMed Central Ltd
Abstract
Background: Native coarctation of the aorta (CoA) accounts for 6-8% of
congenital heart defects and poses significant morbidity and mortality
risks if untreated. By incorporating the most recent evidence, focusing on
the pediatric population, this protocol outlines the planned approach for
a systematic review and meta-analysis update that will compare the
long-term safety and effectiveness of surgical repair, balloon
angioplasty, and stenting in CoA patients. <br/>Method(s): Following
PRISMA guidelines, a systematic review and meta-analysis will be
conducted. Electronic databases, including Scopus, LILACS, MEDLINE,
CENTRAL, EMBASE, IBECS, OpenGrey, and major trial registries, will be
searched for comparative studies of stent versus surgery and of balloon
angioplasty versus surgery. Randomized control trials and observational
studies focused on pediatric patients will be eligible. Two independent
reviewers will screen the titles and abstracts based on predefined
eligibility criteria, and two will assess the full texts of relevant
studies. Quality assessment will be done with the Cochrane Risk of Bias
tool for RCTs and the Newcastle-Ottawa Scale for observational studies.
Pre-planned analyses, including quantitative and sensitivity analyses, are
detailed within this protocol. R Studio will be used to analyze the data.
The strength of the body of evidence will be assessed using GRADE.
<br/>Discussion(s): Despite recent advances in surgical and percutaneous
techniques for CoA, there remains uncertainty on the best strategy for
achieving long-term safety and effectiveness of treatment, particularly in
the pediatric population. This study's comprehensive comparative outcomes
analysis will help bridge these gaps and inform clinical decision-making.
Systematic review registration: PROSPERO CRD42024549170. Registered on May
20th 2024.<br/>Copyright &#xa9; The Author(s) 2025.

<17>
Accession Number
2040937339
Title
Treatment effects of fibrinogen concentrates vs. cryoprecipitate for
correcting hypofibrinogenemia in cardiac surgery patients: a systematic
review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1671405. Date of Publication: 2025.
Author
Chen Y.; Yang W.; Zhao C.; Wang F.; Ren P.; Liu X.; Cao T.; Ji S.; Chen
L.; Kang D.
Institution
(Chen) Clinical Trial Center, West China Hospital, Sichuan University,
Sichuan, Chengdu, China
(Yang, Ji, Kang) Center of Biostatistics, Design, Measurement and
Evaluation (CBDME), West China Hospital, Sichuan University, Sichuan,
Chengdu, China
(Zhao, Kang) Department of Evidence-based Medicine and Clinical
Epidemiology, West China Hospital, Sichuan University, Chengdu, China
(Wang) State Key Laboratory of Biotherapy, West China Hospital, Sichuan
University, Chengdu, China
(Ren) Department of Pulmonary and Critical Care Medicine State Key
Laboratory of Respiratory Health and Multimorbidity, Targeted Tracer
Research and Development Laboratory, Med-X Center for Manufacturing,
Frontiers Science Center for Disease-related Molecular Network, West China
Hospital, West China School of Medicine, Sichuan University, Chengdu,
China
(Liu) Editorial Department of Chinese Journal of Clinical Thoracic and
Cardiovascular Surgery, Medical Publisher, West China Hospital, Sichuan
University, West China, Chengdu, China
(Cao) Department of Hematology, The Second Hospital & Clinical Medical
School, Lanzhou University, Gansu, Lanzhou, China
(Chen) Department of Neurology, West China Hospital, Joint Research
Institution of Altitude Health, Sichuan University, Chengdu, China
Publisher
Frontiers Media SA
Abstract
Background: Hypofibrinogenemia in cardiac surgery increases bleeding risk,
but the efficacy and safety of fibrinogen concentrate vs. cryoprecipitate
remain unclear. This meta-analysis compares the patient-important outcomes
associated with the use of fibrinogen concentrate vs. cryoprecipitate for
the management of acquired hypofibrinogenemia in cardiac surgery.
<br/>Method(s): Medline, Embase, Cochrane Library, and Transfusion
Evidence Library were searched from their inception until June 2024.
Eligible studies included randomized clinical trials (RCTs). Effect
estimates were synthesized using risk ratios (RR) and standardized mean
differences (SMD), along with their corresponding 95% confidence intervals
(CIs). <br/>Result(s): We analyzed 4 RCTs (945 participants: 823 adults,
122 children) comparing fibrinogen concentrate with cryoprecipitate
undergoing cardiac surgery. Meta-analysis showed no difference in
mortality (RR = 1.25, 95% CI: 0.79-1.96; moderate GRADE), blood loss (SMD
= -0.14, 95% CI: -0.46-0.18), transfusion rates (blood cells: RR = 0.98,
0.77-1.26; platelets: RR = 0.17, 0.02-1.40; fresh frozen plasma: RR =
0.48, 0.16-1.45; cryoprecipitate: RR = 1.02, 0.58-1.81), infections (RR =
0.91, 0.64-1.28), volume overload (RR = 1.95, 0.18-21.34), transfusion
reactions (RR = 0.98, 0.06-15.54), or postoperative thrombosis (RR = 0.76,
0.47-1.22). No allergic reactions were reported. Subgroup analysis
revealed substantial heterogeneity (I² = 0% to 98%) in most
outcome measures between adults and children. Using the GRADE criteria, we
assessed the quality of the evidence for mortality as moderate, whereas
the quality of evidence for other outcomes was judged to be low.
<br/>Conclusion(s): For patients undergoing cardiac surgery who experience
clinically significant bleeding and hypofibrinogenemia, the available
trial data provide moderate evidence that fibrinogen concentrate, compared
to cryoprecipitate, does not increase the short-term risk of all-cause
mortality. However, for the rate of transfusion of allogeneic or
individual blood components, and adverse events, the existing evidence is
of low certainty. Given the relatively small sample size, the group of
children may not be representative of all children. Systematic Review
Registration: (https://www.who.int/clinical-trials-registry-platform),
identifier CRD42023421670.<br/>Copyright 2025 Chen, Yang, Zhao, Wang, Ren,
Liu, Cao, Ji, Chen and Kang.

<18>
Accession Number
2037294056
Title
Study Design Update of the Off-pump versus On-pump Coronary Artery Bypass
Grafting in Frail Patients: FRAGILE Trial.
Source
Brazilian Journal of Cardiovascular Surgery. 40(5) (no pagination), 2025.
Article Number: e20250199. Date of Publication: 01 Sep 2025.
Author
Mejia O.A.V.; de Freitas F.L.; Meneghini B.; Deininger M.O.; Segalote R.;
Consentino F.; Guerrieri M.; Hueb A.C.; Ribas F.; Castro R.M.; Dallan
L.R.P.; e Silva P.G.M.B.; Lopes R.D.; Lisboa L.A.F.; Puskas J.; Jatene
F.B.
Institution
(Mejia, de Freitas, Meneghini, Dallan, Lisboa, Jatene) Instituto do
Coracao do Hospital das Clinicas da Faculdade de Medicina da Universidade
de Sao Paulo (InCor-HCFMUSP), Sao Paulo, Sao Paulo, Brazil
(Deininger) Hospital Alberto Urquiza Wanderley, Unimed, Joao Pessoa,
Paraiba, Brazil
(Segalote, Consentino) Instituto Nacional de Cardiologia (INC), Rio de
Janeiro, Rio de Janeiro, Brazil
(Guerrieri, Hueb) Hospital das Clinicas Samuel Libanio, Minas Gerais,
Pouso Alegre, Brazil
(Ribas, Castro) Hospital Beneficencia Portuguesa de Sao Paulo, Sao Paulo,
Sao Paulo, Brazil
(e Silva, Lopes) Brazilian Clinical Research Institute, Sao Paulo, Sao
Paulo, Brazil
(Lopes) Duke University Medical Center, Durham, NC, United States
(Puskas) Emory University Hospital Midtown, Atlanta, GA, United States
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
The Off-pump versus On-pump Coronary Artery Bypass Grafting in Frail
Patients (FRAGILE Trial) is a multicenter, randomized controlled trial
comparing off-pump and on-pump coronary artery bypass grafting in frail or
pre-frail patients undergoing coronary artery bypass grafting. This
manuscript presents an update to the FRAGILE Trial study design, detailing
protocol modifications made in response to the time gap between the
study's conception and its actual implementation These changes were
implemented early in the trial and were formally approved by the Ethics
Committee, ensuring the scientific and ethical integrity of the study and
reinforcing its relevance to address a gap in a vulnerable patient
population.<br/>Copyright &#xa9; 2025, Sociedade Brasileira de Cirurgia
Cardiovascular. All rights reserved.

<19>
Accession Number
2035953194
Title
Mitral Transcatheter Edge-to-Edge Repair in Symptomatic Hypertrophic
Cardiomyopathy: A Systematic Review.
Source
Catheterization and Cardiovascular Interventions. 106(5) (pp 2831-2838),
2025. Date of Publication: 01 Nov 2025.
Author
Ahmed A.; Webber F.; Perumalla H.S.; Abid S.; Baniowda M.; Arango J.; Dyal
M.D.
Institution
(Ahmed, Abid) Department of Internal Medicine, Yale University School of
Medicine, Bridgeport Hospital, Bridgeport, CT, United States
(Webber) Department of Cardiovascular Medicine, University of Miami, Coral
Gables, FL, United States
(Perumalla, Baniowda) Department of Internal Medicine, UMKC University,
Kansas City, MO, United States
(Arango) Department Cardiovascular Diseases, Yale University School of
Medicine, Bridgeport Hospital, Bridgeport, CT, United States
(Dyal) Department Interventional Cardiology, University of Miami, Coral
Gables, FL, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Hypertrophic cardiomyopathy (HCM) with left ventricular
outflow tract (LVOT) obstruction poses significant clinical challenges.
Although septal reduction therapy (SRT) is the first treatment strategy
after medical therapy, mitral transcatheter edge-to-edge repair (M-TEER)
has been reported in the emerging literature to alleviate the LVOT
obstruction related to mitral regurgitation (MR) and systolic anterior
motion (SAM). <br/>Aim(s): In this article, we aim to evaluate the
efficacy and safety of M-TEER in managing symptomatic HCM. <br/>Method(s):
We conducted a systematic review according to Cochrane Handbook and the
PRISMA statement. We comprehensively searched Embase, PubMed, and Scopus
from inception to September 5, 2024, to identify case reports where
symptomatic HCM were managed by M-TEER. The data extracted included
patient demographics, procedural details, hemodynamics, and outcomes.
<br/>Result(s): We identified 20 patients in the literature with
symptomatic HCM who underwent M-TEER. The average age was 73.06 +/- 13.81
years, predominantly male, 60%. All patients had evidence of intermittent
LVOT obstruction, MR, and SAM. NYHA III-IV was the presenting symptom in
95% of the patients. M-TEER was performed in all patients, resulting in a
significant improvement in the LVOT gradient from 68.9 +/- 34.4 to 12.35
+/- 9.6 mmHg, an average improvement in MR grade of 2.68, and a mean
improvement in NYHA class of two. Nineteen patients had successful
procedures, underscoring the potential of M-TEER in treating symptomatic
HCM, while one patient succumbed to cardiogenic shock. <br/>Conclusion(s):
M-TEER appears to be viable and safe for managing symptomatic HCM due to
LVOT obstruction secondary to MR and SAM in patients where SRT is deemed
unsuitable. However, more evidence in a larger scale is required to
demonstrate its long-term efficacy and outcomes.<br/>Copyright &#xa9; 2025
Wiley Periodicals LLC.

<20>
Accession Number
2039155744
Title
Machine learning approaches for cardiovascular disease prediction: A
review.
Source
Archives of Cardiovascular Diseases. 118(10) (pp 554-562), 2025. Date of
Publication: 01 Oct 2025.
Author
Wan S.; Wan F.; Dai X.-J.
Institution
(Wan, Dai) Department of Radiology, The Second Affiliated Hospital,
Jiangxi Medical College, Nanchang University, Nanchang, China
(Wan, Dai) Jiangxi Provincial Key Laboratory of Intelligent Medical
Imaging, Nanchang, China
(Wan, Wan) Department of Electrical and Computer Engineering, Faculty of
Science and Technology, University of Macau, Taipa, Macao
Publisher
Elsevier Masson s.r.l.
Abstract
Cardiovascular disease is a leading cause of death worldwide and is
associated with significant morbidity and mortality. The use of artificial
intelligence techniques, particularly machine learning algorithms, has
emerged as a transformative approach for enhancing early diagnostic
accuracy of disease compared with conventional diagnostic methods. This
systematic review examines three core aspects: (1) comparative analysis of
current machine learning algorithms in early diagnosis of cardiovascular
disease, (2) operational frameworks for clinical implementation, and (3)
critical evaluation of regulatory compliance and ethical implications. It
summarizes recent advancements in machine learning-based heart disease
prediction, outlines a typical workflow for applying machine learning in
clinical settings, and discusses the regulatory and ethical challenges
associated with its implementation. Finally, this review explores
potential directions for future research in this rapidly evolving
field.<br/>Copyright &#xa9; 2025 Elsevier Masson SAS.

<21>
Accession Number
2041435606
Title
Hybrid procedures in the management of hypoplastic left heart syndrome: a
systematic review.
Source
Cardiology in the Young. (no pagination), 2025. Date of Publication:
2025.
Author
Labartkava N.
Institution
(Labartkava) University of Bergamo, Italy
Publisher
Cambridge University Press
Abstract
Background/Objectives: Hypoplastic left heart syndrome is considered one
of the most severe CHDs and occurs in approximately 2-3% of all CHD cases.
Hybrid procedures have been introduced as an alternative to traditional
surgical techniques, such as the Norwood procedure, particularly for
neonates at high risk. Although hybrid approaches claim to reduce surgical
risks and improve recovery, little is known regarding their comparative
effectiveness and safety. This review aims to describe the contribution of
hybrid procedures in hypoplastic left heart syndrome management regarding
survival rates, postoperative complications, and quality of life, through
recovery outcomes and long-term results, in light of conventional surgical
techniques. <br/>Method(s): A systematic review was carried out following
the PRISMA guidelines. Data were retrieved from PubMed, Scopus, Web of
Science, and Cochrane Library. The search articles were published from
January 2014 to November 2024. Inclusion was focused on paediatric
patients diagnosed with hypoplastic left heart syndrome and studies
comparing hybrid procedures versus traditional surgical methods. All
screening, data extraction, and quality assessment were done by two
independent reviewers. <br/>Result(s): This review analysed data from 11
studies comprising 934 neonates with hypoplastic left heart syndrome, of
whom 371 underwent hybrid procedures (HP) and 563 received the Norwood
procedure. The findings demonstrated that both approaches achieved
comparable survival rates at 1, 3, and 5 years. Hybrid procedures were
linked to slightly earlier interventions (standardised mean difference =
-0.10, 95% confidence interval: -0.61 to 0.41, p = 0.77) and were favored
for highrisk neonates due to reduced invasiveness. However, hybrid
procedures showed a higher rate of interstage events (risk ratio = 0.81),
95% confidence interval: -0.62 to 2.25, p = 0.09) and higher rates of
pulmonary artery stenosis requiring reinterventions (30% vs. 18% for
Norwood). Norwood procedures were associated with fewer reinterventions
and lower interstage event rates, highlighting their effectiveness for
stable patients. <br/>Conclusion(s): Hybrid procedures offer a practical
alternative to the Norwood procedure, especially for high-risk neonates.
Although both approaches show similar long-term survival rates, hybrid
procedures are associated with a higher risk of complications, including
increased interstage mortality. These challenges highlight the need for
continued advancements to refine hybrid techniques and to improve
long-term outcomes. This review emphasises the critical role of tailored
patient selection and calls for further research to enhance hybrid
procedure protocols and optimise their effectiveness for specific patient
populations.<br/>Copyright &#xa9; The Author(s), 2025. Published by
Cambridge University Press.

<22>
Accession Number
2040938972
Title
Systemic davunetide provides sex-specific neuroprotection during Coronary
Artery Bypass Grafting (CABG).
Source
Translational Psychiatry. 15(1) (no pagination), 2025. Article Number:
454. Date of Publication: 01 Dec 2025.
Author
Gozes I.; Blatt J.; Guz L.S.
Institution
(Gozes, Blatt, Guz) The Elton Laboratory for Molecular Neuroendocrinology,
Department of Human Molecular Genetics and Biochemistry, Gray Faculty of
Medical and Health Sciences, Gray School of Medical Sciences, Sagol School
of Neuroscience and Adams Super Center for Brain Studies, Tel Aviv
University, Tel Aviv, Israel
Publisher
Springer Nature
Abstract
Coronary artery bypass grafting (CABG) is a surgical procedure commonly
employed to treat severe coronary artery disease by improving blood flow
to the heart. Despite its effectiveness, CABG is an open-heart surgery
associated with potential complications, including cognitive decline, a
currently unmet need. Discovered in our laboratory, activity-dependent
neuroprotective protein (ADNP) is essential for brain formation as well as
heart development and embryogenesis and the ADNP-derived investigational
drug, davunetide, ameliorates partly ADNP-linked deficiencies.
Specifically, davunetide was found to be efficacious in a rat pre-clinical
model of ischemic stroke, a potential unwanted side effect of CABG, which
may lead to a neurodegenerative process, culminating in cognitive
dysfunction. Here, leveraging acute administration of intravenous
davunetide (AL-208, ClinicalTrials.gov ID NCT00404014), we implicated, for
the first time, a differential drug metabolism/bioavailability between men
and women, with a potential dose-dependent accumulation in men and an
opposite decline/no concentration change in women over time. These
findings, while requiring caution due to the small cohort size, were
linked with an apparent protection against brain cell death/disease
progression by davunetide (AL-208) neuroprotective effects
(neuron-specific enolase - NSE blood content). In men, also for the first
time under these circumstances, neuroprotection was coupled to cognitive
function increases in the treated group versus placebo, reaching healthy
control levels in the Verbal Paired Associates II test, emphasizing the
importance of sex-specific brain medicine.<br/>Copyright &#xa9; The
Author(s) 2025.

<23>
Accession Number
2036003856
Title
Efficacy of Cerebral Embolic Protection Device in Transcatheter Aortic
Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(5) (pp 2996-3007),
2025. Date of Publication: 01 Nov 2025.
Author
Shahid S.; Kasbati M.; Adawi S.O.; Ishtiaq S.; Osama M.; Shah S.M.A.;
Saifullah M.; Ali S.; Ahmed R.; Ch I.A.; Khalid S.; Tahirkheli N.K.
Institution
(Shahid) Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
(Kasbati) Dow University of Health Sciences, Karachi, Pakistan
(Adawi) Al-Quds University, Jerusalem, Palestine
(Ishtiaq) Rawalpindi Medical University, Rawalpindi, Pakistan
(Osama) Hayatabad Medical Complex, Peshawar, Pakistan
(Shah, Saifullah) King Edward Medical University, Lahore, Pakistan
(Ali, Khalid, Tahirkheli) Oklahoma Heart Hospital, Oklahoma City, OK,
United States
(Ahmed) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Ch) South Oklahoma Heart Research, Oklahoma City, OK, United States
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve replacement (TAVR) is widely used to treat
severe aortic stenosis; however, periprocedural stroke remains a
significant concern. This systematic review and meta-analysis evaluate
whether the use of cerebral embolic protection devices (CEPDs) during TAVR
reduces the risk of stroke and other complications. To conduct a network
meta-analysis of relevant trials to assess the efficacy of CEPDs currently
used in TAVR. PubMed, Embase, and Scopus were systematically searched
through April 2025 to identify studies comparing TAVR performed with and
without CEPDs. Primary outcomes included stroke, all-cause mortality,
major bleeding, and major vascular complications. Data were analyzed using
RevMan (Version 5.4.1). A random-effects model was used for all analyses,
applying the Mantel-Haenszel method for dichotomous outcomes, reported as
risk ratios with 95% confidence intervals. Funnel plots were used to
assess publication bias. Twenty-four studies (9 randomized controlled
trials and 15 observational studies), including a total of 437,487
patients (59,274 with CEPD and 384,213 without), were included in the
analysis. The mean patient age was 80 years, and 46.4% were female.
Compared to patients undergoing TAVR without protection, those receiving
CEPDs had significantly lower risks of stroke (RR = 0.70; 95% CI:
0.60-0.82; p < 0.0001), all-cause mortality (RR = 0.69; 95% CI: 0.50-0.93;
p = 0.02), disabling stroke (RR = 0.44; 95% CI: 0.26-0.75; p = 0.003),
acute kidney injury (RR = 0.84; 95% CI: 0.79-0.89; p < 0.00001), and
30-day readmission (RR = 0.75; 95% CI: 0.60-0.95; p = 0.02). A reduction
in major bleeding was also observed (RR = 0.83; 95% CI: 0.59-1.17),
although this did not reach statistical significance (p = 0.29). No
significant differences were found between groups in terms of major
vascular complications, transient ischemic attack (TIA), new pacemaker
implantation, or delirium. The use of CEPDs during TAVR is associated with
reduced risks of stroke, disabling stroke, acute kidney injury, and 30-day
readmission. However, discrepancies between randomized and observational
studies warrant cautious interpretation. Further research is needed to
clarify the benefits and evaluate the cost-effectiveness of CEPD
implementation in routine clinical practice.<br/>Copyright &#xa9; 2025 The
Author(s). Catheterization and Cardiovascular Interventions published by
Wiley Periodicals LLC.

<24>
Accession Number
2037294061
Title
Impact of Right Atrial Appendage Ligation vs. Repair on Serum Atrial
Natriuretic Peptide, Brain Natriuretic Peptide, and Atrial Fibrillation
following Coronary Artery Bypass Grafting.
Source
Brazilian Journal of Cardiovascular Surgery. 40(5) (no pagination), 2025.
Article Number: e20210574. Date of Publication: 01 Sep 2025.
Author
Can M.F.; Sicim H.; Selcuk I.; Selcuk U.N.; Temizkan V.
Institution
(Can) Department of Cardiovascular Surgery, Adana Cukurova State Hospital,
Adana, Turkey
(Sicim) Department of Cardiovascular Surgery, Kirklareli Training and
Research Hospital, Kirklareli, Turkey
(Selcuk, Temizkan) Department of Cardiovascular Surgery, Sultan Abdulhamid
Han Training and Research Hospital, Istanbul, Turkey
(Selcuk) Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic
and Cardiovascular Training and Research Hospital, Istanbul, Turkey
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Objective: In this study, we aimed to compare the levels of serum atrial
natriuretic peptide (ANP) and brain natriuretic peptide (BNP) with
ligation and primary repair of right atrial appendage after venous
decannulation procedure in isolated coronary artery bypass grafting (CABG)
and their relationship with postoperative atrial fibrillation (POAF).
<br/>Method(s): In this prospective randomized study, 38 patients who
underwent isolated CABG in Haydarpasa Training Hospital between March 2015
and November 2015 were included. Patients were divided into two groups
whose atrial appendage were ligated (group A) or primary repaired (group
B) after right atrial appendage decannulation. Both groups were evaluated
in terms of perioperative serum ANP/BNP levels and POAF incidence. ANP/BNP
levels were measured by taking blood samples through the central venous
catheter on the preoperative day and postoperative days 1 and 3.
<br/>Result(s): While six POAF incidents were observed in group A, there
were none in group B. There was no statistical difference between the
groups (P > 0.05) in the evaluation of ANP/ BNP levels. POAF rate in group
A was statistically significantly higher than in group B (P < 0.05).
<br/>Conclusion(s): No significant difference in perioperative ANP/BNP
levels was observed between the two groups. Also, no correlation between
ANP/BNP levels and POAF were detected. Development of POAF significantly
increased in group A. Therefore, we advocate that the prevalence of atrial
fibrillation might be reduced in patients who had undergone right atrial
repair with primary repair method.<br/>Copyright &#xa9; 2025, Sociedade
Brasileira de Cirurgia Cardiovascular. All rights reserved.

<25>
Accession Number
2037277323
Title
Comparison of ventilation and blood oxygenation changes in non-intubated
versus intubated anesthesia for video-assisted thoracic surgery.
Source
Anaesthesia, Pain and Intensive Care. 29(7) (pp 670-678), 2025. Date of
Publication: 01 Oct 2025.
Author
Diep T.K.; Lu P.H.; Kinh N.Q.; Thuy L.Q.; Hung D.D.
Institution
(Diep, Kinh, Thuy) VNU University of Medicine & Pharmacy, Thach That
district, Hanoi, Vietnam
(Lu) Viet Duc University Hospital, 40 Trang Thi str, Ha Noi, Vietnam
(Hung) Hanoi Medical University, Hanoi, Vietnam
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: Thoracic surgery is almost always performed under
general anesthesia (GA) with controlled ventilation through an
endotracheal tube (ETT). This study aimed to compare intraoperative
ventilation, blood oxygenation parameters between non-intubated
video-assisted thoracic surgery (NI-VATS) using a laryngeal mask airway
(LMA) with spontaneous/pressure support ventilation (PSV) versus
controlled ventilation through ETT with one-lung ventilation (OLV).
Methodology: 100 patients (ASA I-III) undergoing VATS were randomized into
two groups of 50 each: NI-VATS group, to receive spontaneous/pressure
support ventilation (PSV) through an LMA of a suitable size, and I-VATS
group, to receive controlled ventilation through ETT with OLV. Key
ventilation parameters and oxygenation parameters were monitored and
compared. <br/>Result(s): I-VATS group had significantly higher tidal
volume and minute ventilation. Conversely, NI-VATS group exhibited
significantly lower Ppeak during both two-lung (4.06 +/- 1.74 cmH2O vs.
24.18 +/- 3.94 cmH2O, P < 0.001) and one-lung ventilation (5.36 +/- 1.66
cmH2O vs. 30.42 +/- 5.46 cmH2O, P < 0.001). NI-VATS group had higher peak
EtCO2 (48.56 +/- 4.11 mmHg vs. 40.96 +/- 4.71 mmHg, P < 0.001) and PaCO2
during OLV (46.84 +/- 6.90 mmHg vs. 38.54 +/- 7.48 mmHg, P < 0.001).
Regarding oxygenation, NI-VATS group required significantly lower highest
FiO2 (P < 0.001) yet maintained higher lowest SpO2 (P < 0.001). During
OLV, NI-VATS showed higher PaO2 (P < 0.001), a superior PaO2/FiO2 ratio (P
< 0.001), and a lower AaDO2 (P < 0.001). <br/>Conclusion(s): NI-VATS
demonstrated advantages in oxygenation efficiency, requiring lower FiO2
while maintaining better SpO2 and gas exchange during OLV, alongside
significantly lower airway pressures.<br/>Copyright &#xa9; 2025, Faculty
of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

<26>
[Use Link to view the full text]
Accession Number
2041345407
Title
Digitoxin in Patients with Heart Failure and Reduced Ejection Fraction.
Source
New England Journal of Medicine. 393(12) (pp 1155-1165), 2025. Date of
Publication: 25 Sep 2025.
Author
Bavendiek U.; Grosshennig A.; Schwab J.; Berliner D.; Rieth A.; Maier
L.S.; Gaspar T.; Thomas N.H.; Liu X.; Schallhorn S.; Angelini E.; Soltani
S.; Rathje F.; Sandu M.-A.; Geller W.; Hambrecht R.; Zdravkovic M.;
Philipp S.; Kosevic D.; Nickenig G.; Scheiber D.; Winkler S.; Becher P.M.;
Lurz P.; Hulsmann M.; Wiesner S.; Schroder C.; Neuhaus B.; Seltmann A.;
von der Leyen H.; Veltmann C.; Stork S.; Bohm M.; Koch A.; Bauersachs J.
Institution
(Bavendiek, Berliner, Schallhorn, Angelini, Soltani, Rathje, Sandu,
Geller, Veltmann, Bauersachs) Department of Cardiology and Angiology,
Hannover Medical School, Hannover, Germany
(Groshennig, Thomas, Liu, Wiesner, Koch) Institute for Biostatistics,
Hannover Medical School, Hannover, Germany
(Schwab) Department of Cardiology, Paracelsus Medical University,
Nuremberg, Germany
(Schwab) MVZ Kardiologie, Klinikum Neumarkt, Neumarkt, Germany
(Rieth) Department of Cardiology, Kerckhoff-Klinik, Bad Nauheim, Germany
(Maier) Department for Internal Medicine II, University Hospital
Regensburg, Regensburg, Germany
(Gaspar) Department of Internal and Cardiovascular Medicine, Herzzentrum
Dresden, University Clinic, Technische Universitat Dresden, Dresden,
Germany
(Gaspar) Department of Cardiology, Angiology and Internal Intensive Care
Medicine, Medical Clinic 2, Stadtisches Klinikum Dresden, Dresden, Germany
(Hambrecht) Department of Internal Medicine II, Cardiology, Angiology and
Intensive Care Medicine, Klinikum Links der Weser, Bremen, Germany
(Zdravkovic) Clinic for Internal Medicine, University Clinical Hospital
Center Bezanijska Kosa, Faculty of Medicine, University of Belgrade,
Belgrade, Serbia
(Philipp) Department of Internal Medicine, Cardiology and Intensive Care
Medicine, Elbeklinikum Stade, Stade, Germany
(Kosevic) Institute for Cardiovascular Diseases Dedinje, Department of
Cardiology, Belgrade, Serbia
(Nickenig) Department of Cardiology, Angiology and Pneumology, Internal
Medicine II, University Hospital Bonn, Bonn, Germany
(Scheiber) Division of Cardiology, Pulmonology and Vascular Medicine,
University Hospital Dusseldorf, Heinrich-Heine University Dusseldorf,
Medical Faculty, Dusseldorf, Germany
(Winkler) Department of Internal Medicine, BG Klinikum Unfallkrankenhaus
Berlin, Berlin, Germany
(Becher) Department of Cardiology, University Heart and Vascular Center
Hamburg, Hamburg, Germany
(Becher) German Center of Cardiovascular Research, Partner Site
Hamburg/Kiel/Lubeck, Hamburg, Germany
(Becher) Department of Clinical Science and Education, Sodersjukhuset,
Karolinska Institutet, Stockholm, Sweden
(Lurz) University Medical Center Mainz, Center of Cardiology, Johannes
Gutenberg University, Mainz, Germany
(Hulsmann) Universitatsklinik fur Innere Medizin II, Abteilung
Kardiologie, Medizinische Universitat Wien, Vienna, Austria
(Schroder) Institute of Clinical Pharmacology, Hannover Medical School,
Hannover, Germany
(Neuhaus, Seltmann) Center for Clinical Trials, Hannover Medical School,
Hannover, Germany
(von der Leyen) Orgenesis, Germantown, MD, United States
(von der Leyen) Hannover Medical School, Hannover, Germany
(Veltmann) Center for Electrophysiology Bremen, Bremen, Germany
(Stork) Department of Clinical Research and Epidemiology, Comprehensive
Heart Failure Center Wurzburg, University Hospital Wurzburg, Wurzburg,
Germany
(Stork) Department of Internal Medicine I, University Hospital Wurzburg,
Wurzburg, Germany
(Bohm) Klinik fur Innere Medizin III, HOMICAREM (Homburg Institute for
Car-diorenalmetabolic Medicine), Universitatsklinikum des Saarlandes,
Saarland University, Homburg, Germany
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND The therapeutic efficacy of the cardiac glycoside digitoxin in
patients with heart failure and reduced ejection fraction is not
established. METHODS In this international, double-blind,
placebo-controlled trial, we randomly assigned patients with chronic heart
failure who had a left ventricular ejection fraction of 40% or less and a
New York Heart Association (NYHA) functional class of III or IV or a left
ventricular ejection fraction of 30% or less and an NYHA functional class
of II in a 1:1 ratio to receive digitoxin (at a starting dose of 0.07 mg
once daily) or matching placebo in addition to guideline-directed medical
therapy. The primary outcome was a composite of death from any cause or
hospital admission for worsening heart failure, whichever occurred first.
RESULTS Among 1240 patients who underwent randomization, 1212 fulfilled
the criteria for inclusion in the modified intention-to-treat population:
613 patients in the digitoxin group and 599 in the placebo group. Over a
median follow-up of 36 months, a primary-outcome event occurred in 242
patients (39.5%) in the digitoxin group and 264 (44.1%) in the placebo
group (hazard ratio for death or first hospital admission for worsening
heart failure, 0.82; 95% confidence interval [CI], 0.69 to 0.98; P=0.03).
Death from any cause occurred in 167 patients (27.2%) in the digitoxin
group and 177 (29.5%) in the placebo group (hazard ratio, 0.86; 95% CI,
0.69 to 1.07). A first hospital admission for worsening heart failure
occurred in 172 patients (28.1%) in the digitoxin group and 182 (30.4%) in
the placebo group (hazard ratio, 0.85; 95% CI, 0.69 to 1.05). At least one
serious adverse event occurred in 29 patients (4.7%) in the digitoxin
group and 17 (2.8%) in the placebo group. CONCLUSIONS Treatment with
digitoxin led to a lower combined risk of death from any cause or hospital
admission for worsening heart failure than placebo among patients with
heart failure and reduced ejection fraction who received
guideline-directed medical therapy.<br/>Copyright &#xa9; 2025
Massachusetts Medical Society.

<27>
Accession Number
2039345221
Title
The Safety and Feasibility of Same-Day Discharge for Patients Undergoing
Transcatheter Aortic Valve Replacement: A Systematic Review and
Meta-analysis.
Source
Canadian Journal of Cardiology. 41(10) (pp 1902-1914), 2025. Date of
Publication: 01 Oct 2025.
Author
Litkouhi P.N.; Rao K.; Baer A.; Hansen P.S.; Bhindi R.
Institution
(Litkouhi, Rao, Baer, Hansen, Bhindi) Department of Cardiology, Royal
North Shore Hospital, St Leonards, Australia
(Litkouhi, Rao, Hansen, Bhindi) School of Medicine, University of Sydney,
Camperdown, Australia
Publisher
Elsevier Inc.
Abstract
Background Next-day discharge (NDD) after transcatheter aortic valve
replacement (TAVR) has been shown to be safe in appropriately selected
patients and has been implemented into clinical practice. As the demand
for TAVR grows, improving its accessibility is crucial. Several studies
have trialled same-day discharge (SDD) after TAVR, but a review has not
been performed. Methods Five databases were searched. Baseline
demographics, study characteristics and the assessment criteria used to
determine eligibility for SDD were extracted and compared. Proportional
meta-analysis was used to compare post-TAVI outcomes between SDD and NDD
patients. Results Six studies were included from 1734 screened articles.
Of 3519 patients, 318 (9.0%) underwent SDD (mean age 78.2 +/- 8.7 years,
59.3% male). Balloon-expandable valves were used in 91.6% of cases, and
self-expanding valves in the remaining 8.4%. Patients that underwent SDD
experienced lower rates of mortality (OR 0.104, 95% CI 0.015-0.998),
all-cause readmission (OR 0.194, 95% CI 0.052-0.717), cardiovascular
readmissions (OR 0.155, 95% CI 0.026-0.971), and new pacemaker requirement
(OR 0.167, 95% CI 0.028-0.995) at 30 days after TAVR compared with
patients that underwent NDD. There was no difference in rates of stroke
(OR 0.407, 95% CI 0.015-16.694) or major vascular complications (0.0% vs
0.0%). Conclusions Current evidence supports the safety and feasibility of
SDD after elective transfemoral TAVR in appropriately selected patients.
Heterogeneity between eligibility criteria used to select patients for
SDD, especially related to conduction disease, poses a barrier to
implementation. Further research on self-expanding valves is
needed.<br/>Copyright &#xa9; 2025 Canadian Cardiovascular Society.

<28>
Accession Number
2041391130
Title
Impact of Diabetes Mellitus on 5-year Outcomes After PCI with a
Polymer-Free Drug-Coated Stent or a Biodegradable Polymer Ultra-Thin Strut
Stent.
Source
American Journal of Cardiology. 257 (pp 159-167), 2025. Date of
Publication: 15 Dec 2025.
Author
Hansen K.N.; Christiansen E.H.; Ellert-Gregersen J.; Eftekhari A.;
Jakobsen L.; Veien K.T.; Freeman P.; Jensen R.V.; Noori M.; Stottrup N.B.;
Lassen J.F.; Troan J.; Maeng M.; Terkelsen C.J.; Raungaard B.; Kahlert J.;
Junker A.; Jensen L.O.
Institution
(Hansen, Ellert-Gregersen, Veien, Noori, Lassen, Troan, Junker, Jensen)
Department of Cardiology, Odense University Hospital, Odense, Denmark
(Christiansen, Jakobsen, Jensen, Stottrup, Maeng, Terkelsen) Department of
Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Eftekhari, Freeman, Raungaard) Department of Cardiology, Aalborg
University Hospital, Aalborg, Denmark
(Maeng) Department of Clinical Medicine, Health, Aarhus University,
Aarhus, Denmark
(Kahlert) Department of Clinical Epidemiology, Aarhus University Hospital,
Aarhus, Denmark
Publisher
Elsevier Inc.
Abstract
Diabetes mellitus (DM) is a known risk factor for cardiac events in
patients undergoing percutaneous coronary intervention (PCI). It remains
unclear whether specific stent types improve long-term outcomes in this
population. This substudy of the Scandinavian Organization for Randomized
Trials with Clinical Outcome (SORT OUT) IX trial compared long-term
outcomes in patients with DM with either the polymer-free biolimus
A9-coated BioFreedom stent (BF-BES) or the ultra-thin strut, biodegradable
polymer sirolimus-eluting Orsiro stent (O-SES). SORTOUT IX was a
randomized, noninferiority trial allocating patients to BF-BES or O-SES.
The primary endpoints was target lesion failure (TLF), consisting of
cardiac death, target lesion-related myocardial infarction (MI), and
target lesion revascularization (TLR), and stent thrombosis within 5 years
in patients with DM. Among 3,151 patients enrolled, 607 (19.3%) had DM
(BF-BES: 304; O-SES: 303). At 5 year, TLF was higher for patients with DM
than those without DM (19.9% vs 11.4%, rate ratio (RR) 1.48; 95%
confidence interval (CI) 1.15 to 1.91). In patients with DM, TLF was
similar between BF-BES and O-SES (21.7% vs 18.2%; RR 1.11; 95% CI; 0.76 to
1.62). Rates of cardiac death, TLR and stent thrombosis did not differ
significantly. In-stent restenosis was higher for BF-BES within 1 year
(4.6% vs 1.0%; RR 4.20; 95% CI 1.20 to 14.7), but not after 5 years (5.9%
vs 10.2%; RR 1.56; 95% CI 0.85 to 2.85). In patient with DM undergoing
PCI, rates of TLF, cardiac death, target MI, TLR and stent thrombosis did
not differ between BF-BES and O-SES after 5 years.<br/>Copyright &#xa9;
2025 The Authors

<29>
Accession Number
2041391321
Title
Network Meta-Analysis of Axillary, Femoral, and Central Arterial
Cannulation in Minimally Invasive Cardiac Surgery.
Source
American Journal of Cardiology. 257 (pp 168-177), 2025. Date of
Publication: 15 Dec 2025.
Author
Comanici M.; Khoshdel N.; Farmidi A.A.; Ayaz G.; Sabashnikov A.; Bhudia
S.K.; Bahrami T.; Raja S.G.
Institution
(Comanici, Khoshdel, Farmidi, Ayaz, Sabashnikov, Bhudia, Bahrami, Raja)
Department of Cardiac Surgery, Harefield Hospital, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
The optimal arterial cannulation site in minimally invasive cardiac
surgery (MICS) remains debated. While axillary, femoral, and central
approaches each offer distinct advantages, no prior network meta-analysis
has compared all 3. We conducted a Bayesian network meta-analysis of 11
retrospective studies including 11,353 patients to evaluate their impact
on postoperative outcomes. The analysis examined mortality, stroke, acute
kidney injury (AKI), aortic dissection, atrial fibrillation, reoperation
for bleeding, and length of stay, reporting odds ratios (ORs) with 95%
credible intervals (CrIs) and ranking strategies using Surface under the
cumulative ranking curve (SUCRA) probabilities. Central cannulation was
associated with the lowest odds of stroke and aortic dissection, whereas
axillary cannulation carried significantly higher odds of stroke compared
with central (OR 4.66; 95% CrI 1.60 to 17.08) and ranked lowest across
most outcomes. Femoral cannulation demonstrated favorable trends in
in-hospital mortality (OR 0.61; 95% CrI 0.13 to 1.69 vs central) and AKI
(OR 0.65; 95% CrI 0.35 to 1.19), although not statistically significant.
SUCRA rankings identified central as most favorable for neurologic and
vascular complications, and femoral as strongest for mortality and renal
outcomes. In conclusion, central cannulation may provide the most balanced
risk profile in MICS, particularly in minimizing neurologic and vascular
events, while femoral cannulation remains a valid alternative in patients
without significant aortic disease. Axillary cannulation, despite its
theoretical benefits, was associated with higher complication rates and
warrants further prospective evaluation.<br/>Copyright &#xa9; 2025
Elsevier Inc.

<30>
[Use Link to view the full text]
Accession Number
2041344593
Title
Aspirin in Patients with Chronic Coronary Syndrome Receiving Oral
Anticoagulation.
Source
New England Journal of Medicine. 393(16) (pp 1578-1588), 2025. Date of
Publication: 23 Oct 2025.
Author
Lemesle G.; Didier R.; Steg P.G.; Simon T.; Montalescot G.; Danchin N.;
Bauters C.; Blanchard D.; Bouleti C.; Angoulvant D.; Andrieu S.; Vanzetto
G.; Kerneis M.; Decalf V.; Puymirat E.; Mottier D.; Diallo A.; Vicaut E.;
Gilard M.; Cayla G.
Institution
(Lemesle, Bauters) Heart and Lung Institute, University Hospital of Lille,
Centre Hospitalier Universitaire (CHU) Lille, Lille, France
(Lemesle) Institut Pasteur de Lille, INSERM Unite 1011, Lille, France
(Lemesle, Bauters) Universite de Lille, Lille, France
(Lemesle, Steg, Simon, Danchin) French Alliance for Cardiovascular Trials,
Paris, France
(Didier, Gilard) Cardiology Department, CHU Brest, Brest, France
(Didier, Mottier, Gilard) INSERM Unite Mixte de Recherche (UMR) 1304,
Groupe d'Etudes Tumeurs et Biotherapies Oncologiques (GETBO), Brest,
France
(Didier, Mottier, Gilard) University of Brest, Brest, France
(Steg, Puymirat) Universite Paris-Cite, Paris, France
(Steg, Simon) INSERM Unite 1148, Paris, France
(Steg) Assistance Publique-Hopitaux de Paris (AP-HP), Hopital Bichat,
Paris, France
(Simon, Montalescot) Sorbonne Universite, Paris, France
(Simon, Diallo, Vicaut) Unite de Recherche Clinique de l'Est Parisien
(UR-CEST), Paris, France
(Simon) Department of Clinical Pharmacology, AP-HP, Hopital Saint Antoine,
Paris, France
(Montalescot, Kerneis) AP-HP, Hopital Pitie-Salpetriere, Paris, France
(Montalescot) INSERM Unite 1166, Paris, France
(Montalescot, Diallo, Vicaut, Cayla) ACTION Group, Paris, France
(Danchin) Department of Cardiology, Saint Joseph Hospital, Paris, France
(Bauters) INSERM Unite 1167, Lille, France
(Blanchard, Puymirat) Department of Cardiology, AP-HP, Hopital Europeen
Georges Pompidou, Paris, France
(Bouleti) University of Poitiers, Clinical Investigation Center, INSERM
1402, Poitiers, France
(Bouleti) Department of Cardiology, University Hospital of Poitiers,
Poitiers, France
(Angoulvant) Cardiology Department, Hopital Trousseau, Centre Hospitalier
Regional Universitaire de Tours, Tours, France
(Angoulvant) INSERM Unite 1327, ISCHEMIA "Membrane Signalling and
Inflammation in Reperfusion Injuries, Tours, France
(Angoulvant) Universite de Tours, Tours, France
(Andrieu) Department of Cardiology, Hopital Henri-Duffaut, Avignon, France
(Vanzetto) Department of Cardiology, Grenoble University Hospital, La
Tronche, France
(Decalf) Department of Cardiology and Cardiovascular Diseases, Hopital
NOVO, Pontoise, France
(Puymirat) Paris Cardiovascular Research Center (PARCC), Paris, France
(Mottier) Departe-ment de Medecine Interne et Pneumologie, CHU Brest,
Brest, France
(Mottier) French Clinical Research Infrastructure Network IN-NOVTE
(Investigation Network on Venous Thromboembolism), Saint Etienne, France
(Diallo, Vicaut) AP-HP, Hopital Fernand Widal, Paris, France
(Diallo, Vicaut) Statistique, Analyse, et Modelisation Multidisciplinaire,
Paris, France
(Diallo, Vicaut) Universite Paris 1 Pantheon Sorbonne, Paris, France
(Cayla) Service de Cardiologie, CHU de Nimes, Nimes, France
(Cayla) Universite de Montpellier, Montpellier, France
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND The appropriate antithrombotic regimen for patients with
chronic coronary syndrome who are at high atherothrombotic risk and
receiving long-term oral anticoagulation remains unknown. METHODS We
conducted a multicenter, double-blind, randomized, placebo-controlled
trial in France involving patients with chronic coronary syndrome who had
undergone a previous stent implantation (>6 months before enrollment) and
were at high atherothrombotic risk and currently receiving long-term oral
anticoagulation. The patients were randomly assigned in a 1:1 ratio to
receive aspirin (100 mg once daily) or placebo; all the patients continued
to receive their current oral anticoagulation therapy. The primary
efficacy outcome was a composite of cardiovascular death, myocardial
infarction, stroke, systemic embolism, coronary revascularization, or
acute limb ischemia. The key safety outcome was major bleeding. RESULTS A
total of 872 patients underwent randomization; 433 were assigned to the
aspirin group, and 439 to the placebo group. The trial was stopped early
at the advice of the independent data and safety monitoring board after a
median follow-up of 2.2 years because of an excess of deaths from any
cause in the aspirin group. A primary efficacy outcome event occurred in
73 patients (16.9%) in the aspirin group and in 53 patients (12.1%) in the
placebo group (adjusted hazard ratio, 1.53; 95% confidence interval [CI],
1.07 to 2.18; P=0.02). Death from any cause occurred in 58 patients
(13.4%) in the aspirin group and in 37 (8.4%) in the placebo group
(adjusted hazard ratio, 1.72; 95% CI, 1.14 to 2.58; P=0.01). Major
bleeding occurred in 44 patients (10.2%) in the aspirin group and in 15
patients (3.4%) in the placebo group (adjusted hazard ratio, 3.35; 95% CI,
1.87 to 6.00; P<0.001). A total of 467 and 395 serious adverse events were
reported in the aspirin group and placebo group, respectively. CONCLUSIONS
Among patients with chronic coronary syndrome at high atherothrombotic
risk who were receiving an oral anticoagulant, the addition of aspirin led
to a higher risk of cardiovascular death, myocardial infarction, stroke,
systemic embolism, coronary revascularization, or acute limb ischemia than
placebo, as well as higher risks of death from any cause and major
bleeding.<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<31>
Accession Number
2040783499
Title
Dextran vs. Crystalloid Priming Solution in Cardiac Surgery: A Randomized
Trial on Acute Kidney Injury.
Source
Acta Anaesthesiologica Scandinavica. 70(1) (no pagination), 2026. Article
Number: e70139. Date of Publication: 01 Jan 2026.
Author
Juvakka O.; Wallinder A.; Moller-Sorensen P.H.; Matschke K.; Jeppsson A.;
Lannemyr L.
Institution
(Juvakka, Lannemyr) Department of Anesthesiology and Intensive Care
Medicine, Institute of Clinical Sciences at the Sahlgrenska Academy,
University of Gothenburg, Sweden
(Juvakka, Lannemyr) Department of Cardiothoracic Anaesthesia, Sahlgrenska
University Hospital, Gothenburg, Sweden
(Wallinder) XVIVO Perfusion, Gothenburg, Sweden
(Moller-Sorensen) Department of Cardiothoracic Anesthesiology,
Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
(Matschke) Klinik fur Herzchirurgie, Herzzentrum Dresden GmbH, Dresden,
Germany
(Jeppsson) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Jeppsson) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
Publisher
John Wiley and Sons Inc
Abstract
Background: Acute kidney injury (AKI) is a frequent complication following
cardiac surgery involving cardiopulmonary bypass (CPB). This is partly
attributable to crystalloid-based priming solutions causing both hemolysis
and loss of oncotic pressure with tissue edema. While colloids like
albumin and starches have not shown clear benefits, pilot studies using
dextran-based priming reported improved oncotic pressure, reduced
hemolysis, and lower levels of a renal injury marker, suggesting potential
renal protective effects. <br/>Objective(s): We hypothesized that a
dextran-based priming solution can reduce the incidence of postoperative
AKI in high-risk patients undergoing cardiac surgery with CPB.
<br/>Method(s): In this randomized, controlled, double-blinded,
multicenter trial, adult patients with a calculated postoperative AKI risk
of >= 50% were assigned to receive either a dextran or a crystalloid-based
CPB priming solution. The primary outcome was the incidence of AKI within
96 h postoperatively. Secondary outcomes included perioperative hemolysis,
net fluid balance, and the need for postoperative renal replacement
therapy. <br/>Result(s): The trial was terminated early due to slow
enrolment, with 101 of the planned 366 patients recruited. A total of 92
patients were included in the final analysis (43 in the dextran group, 49
in the control group). Postoperative AKI occurred in 81% and 53% of
patients in the dextran and control groups, respectively (risk ratio 1.53,
95% confidence interval 1.15-2.06, p = 0.004). The dextran group
demonstrated lower intraoperative hemolysis and a more favorable net fluid
balance. Postoperative renal replacement therapy was required in 7% of the
dextran group and 4% of the control group (p = 0.66). No significant
differences in adverse events were observed between the groups.
<br/>Conclusion(s): In high-risk patients undergoing cardiac surgery with
CPB, the use of a dextran-based priming solution was associated with a
significantly increased risk of postoperative AKI. Editorial Comment: This
randomized multicenter trial compared dextran to a crystalloid-based
priming solution during cardiopulmonary bypass in participants with
elevated risk of acute kidney injury. While the trial had to be terminated
due to slow enrolment after about a third of planned cases were included,
acute kidney injury was significantly more common in the dextran group,
contrary to the primary hypothesis of the study. The study highlights the
complexity and logistical challenges of conducting randomized treatment
protocols for cardiopulmonary bypass, but at the same time highlights the
importance of conducting such studies. Trial Registration:
ClinicalTrials.gov identifier: NCT04293744.<br/>Copyright &#xa9; 2025 The
Author(s). Acta Anaesthesiologica Scandinavica published by John Wiley &
Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

<32>
Accession Number
2041004958
Title
Inclusion and reporting by age, sex, and ethnicity in clinical studies of
high-risk medical devices approved in the European Union.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 11(7) (pp
962-968), 2025. Date of Publication: 01 Nov 2025.
Author
Coughlan J.J.; Byrne R.A.; Siontis G.C.M.; McGovern L.; Durand R.; Lubbeke
A.; Bano A.; Fraser A.G.
Institution
(Coughlan, Byrne, McGovern, Durand) Department of Cardiology,
Cardiovascular Research Institute (CVRI) Dublin, Mater Private Network,
Eccles Street 73, Dublin, Ireland
(Coughlan, Byrne) School of Pharmacy and Biomolecular Sciences, RCSI
University of Medicine and Health Sciences, 123 St Stephen's Green,
Dublin, Ireland
(Siontis) Department of Cardiology, Bern University Hospital, University
of Bern, Freiburgstrasse 18, Bern, Switzerland
(Lubbeke) Division of Orthopedic Surgery & Traumatology, Geneva University
Hospitals, University of Geneva, Rue Gabrielle-Perret-Gentil 4, Geneve,
Switzerland
(Lubbeke) Botnar Research Centre, Nuffield Department of Orthopaedics,
Rheumatology and Musculoskeletal Sciences, University of Oxford, Old Rd,
Headington, Oxford, United Kingdom
(Bano) Institute of Social and Preventive Medicine, University of Bern,
Mittelstrasse 43, Bern, Switzerland
(Fraser) Department of Cardiology, University Hospital of Wales, Heath
Park Way, Cardiff, United Kingdom
Publisher
Oxford University Press
Abstract
Introduction Adequate inclusion and representation of patients in clinical
studies is critical for the generalizability of research findings. The aim
of this analysis was to determine inclusion and reporting by age, sex, and
ethnicity in clinical studies of high-risk medical devices (orthopaedic,
diabetes, and cardiovascular) approved in the European Union. Methods This
is an analysis of data from three co-ordinated systematic reviews of
clinical evidence for high-risk medical devices. This analysis includes
641 studies, reporting on more than 1.9 million patients treated with
high-risk orthopaedic, diabetes, and cardiovascular medical devices. The
main outcomes were the proportions of studies providing data on the age,
sex, and ethnicity of participants, and the performance of stratified
analyses based on these factors. Results The majority (>90%) of studies in
all three device categories (orthopaedics, diabetes, and cardiovascular)
provided data on the age and sex of participants, but only a minority
(<10%) provided information on ethnicity. Female patients comprised over
half of the patients in the included orthopaedic and diabetes device
studies, but <40% of patients in the included cardiovascular device
studies (P < 0.001). A minority of studies performed analyses stratified
by age (14.6%) or sex (10.4%), although those were more frequently
reported in randomized studies. Conclusions Almost all studies in this
analysis provided demographic data on age and sex, but only a small
minority had analysed whether these factors had any impact on device
performance. Very few studies provided information on the ethnicity of
study participants. Cardiovascular device studies enrolled a lower
proportion of female patients in comparison to orthopaedic and diabetes
device studies. Study registration Cardiovascular device systematic
review: PROSPERO (CRD42022308593). Diabetes device systematic review:
PROSPERO (CRD42022366871). Orthopaedic device systematic review: open
science framework (https://osf.io/6gmyx).<br/>Copyright &#xa9; 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Society of Cardiology.

<33>
Accession Number
2032623449
Title
A Meta-Analysis of Mitral Surgery in Patients Undergoing Surgery for
Anomalous Left Coronary Artery: When to Perform Repair?.
Source
Pediatric Cardiology. 46(8) (pp 2531-2541), 2025. Date of Publication: 01
Dec 2025.
Author
Brancaccio G.; Chinali M.; Dionisi S.; Trezzi M.; Esposito C.; Iacobelli
R.; Miraldi F.; Labriola V.; Alessia R.; Francesco B.; D'Inzeo V.; Perri
G.; Butera G.; Galletti L.
Institution
(Brancaccio, Trezzi, Labriola, Alessia, Francesco, D'Inzeo, Perri,
Galletti) Pediatric Cardiac Surgery Unit, Bambino Gesu Children's
Hospital, IRCCS, Rome, Italy
(Chinali, Esposito, Iacobelli, Butera) Pediatric Cardiology Unit, Bambino
Gesu Children's Hospital, IRCCS, Rome, Italy
(Dionisi, Miraldi) Department of Cardiac Surgery, University "La Sapienza"
of Rome, Rome, Italy
(Labriola, Francesco) Department of Cardiac Surgery, University of "Tor
Vergata", Rome, Italy
Publisher
Springer
Abstract
The present study is the first meta-analysis comparing long-term outcomes
in patients undergoing correction for anomalous left coronary artery
(ALCAPA) regarding concomitant mitral valve surgery. A systematic
literature review was conducted to identify all relevant studies with
comparative data on mitral valve surgery performed during surgery for
ALCAPA correction. Predefined primary end points included mortality and
mitral valve (re)operation. Echocardiographic outcomes were assessed when
available (including severity of mitral regurgitation). Fifty-three
relevant retrospective studies with comparative data for ALCAPA patients
with concomitant mitral valve surgery were identified from the existing
literature. The study population included 3,851 patients, of whom 55% were
girls. The mean age at surgery was 6 months [0-99 months]. The mean
follow-up after surgery was 22.7 years [6.3-37.2]. Among patients with
available echocardiographic data at the time of ALCAPA correction, 283 had
no mitral regurgitation (13%), 642 had mild mitral regurgitation (30%),
756 had moderate mitral regurgitation (36%), and 437 had severe mitral
regurgitation (21%). A subgroup of patients who underwent mitral valve
surgery (yMVS; n = 753; 19.5% of the total population) was identified. A
total of 228 patients died during follow-up (5.9%), with no differences
among patients who underwent vs those who did not undergo mitral valve
concomitant surgery at baseline (p = ns). Among the 1,536 patients with
available follow-up echocardiographic data, 519 had no mitral
regurgitation (34%), 663 had mild mitral regurgitation (43%), 268 had
moderate mitral regurgitation (17%), and 86 had severe mitral
regurgitation (6%). Overall, during follow-up, 91 patients underwent
mitral valve surgery (first MVS for 20 pts and reintervention for 71 pts,
representing a 10% reintervention rate). In regression analysis, we found
no association between the mean age at first surgery and the need for
reoperation (p = 0.458). Mitral valve surgery is performed in about 20% of
patients undergoing ALCAPA correction. Indications for MVS vary among
centers, although the severity of MV regurgitation was the most common
criterion (more than 50% of the yMVS group). Of yMVS patients,
approximately 10% underwent a second MVS during follow-up, regardless of
age at first surgery. Overall, long-term mortality in these patients is
over 5%, with no evident impact related to concomitant MV
surgery.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2024.

<34>
Accession Number
2031423383
Title
Nebulized Budesonide Prevents Airway Inflammation in Children with High
Total IgE Levels After Open Heart Surgery with Cardiopulmonary Bypass: A
Prospective Randomized Controlled Trial.
Source
Pediatric Cardiology. 46(8) (pp 2291-2302), 2025. Date of Publication: 01
Dec 2025.
Author
Zhu L.; Li C.; Gong X.; Xu Z.; Zhang H.
Institution
(Zhu, Li, Gong, Xu) Cardiac Intensive Care Unit, Department of
Cardiovascular and Thoracic Surgery, Shanghai Children's Medical Center,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Zhang) Department of Cardiovascular and Thoracic Surgery, Shanghai
Children's Medical Center, Shanghai Jiao Tong University School of
Medicine, Shanghai, China
Publisher
Springer
Abstract
Cardiopulmonary bypass (CPB) is a crucial technique used to repair
congenital heart defects (CHD); however, it may induce inflammatory
response, leading to airway inflammation and need for prolonged mechanical
ventilation. In this study, we aimed to evaluate the effect of budesonide
nebulization in children with high serum total immunoglobulin E (tIgE)
levels undergoing surgical repair of CHD via CPB. We conducted a
randomized, single-center, controlled trial at a tertiary teaching
hospital. One-hundred and one children with high tIgE were enrolled and
randomized into the budesonide nebulization group (BUD group, n = 50) or
the normal saline nebulization group (NS group, n = 51) between January
2020 and December 2020. Budesonide or normal saline was administered
through a vibrating mesh nebulizer during mechanical ventilation every 8
h. Blood and bronchoalveolar lavage fluid (BALF) samples were examined and
data on airway mechanics and clinical outcomes were recorded. IL-6 and
IL-8 levels in the blood and BALF samples significantly increased after
CPB in both groups. Budesonide inhalation reduced IL-6 and IL-8 levels in
the blood and BALF samples in children with high tIgE (P < 0.05). The mean
airway pressure, PCO<inf>2</inf>, and oxygen index in the BUD group were
significantly lower than those in the NS group after the first inhalation
dose and persisted until almost 24 h after surgery. The peak inspiratory
pressure and drive pressure were lower in the BUD group than in the NS
group at nearly 24 h after surgery, with no significant difference at
other time points. Additionally, the duration of mechanical ventilation,
number of noninvasive ventilations after extubation, and number of
patients using aerosol-inhaled bronchodilators after CICU in the BUD group
were significantly lower than those in the NS group (P < 0.05). Children
with high preoperative tIgE levels are at risk of airway inflammation
after cardiopulmonary bypass. Inhaling budesonide during postoperative
mechanical ventilation can reduce the intensity of inflammatory reactions,
shorten the duration of mechanical ventilation, reduce airway pressure and
the utilization of NIV after extubation.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<35>
Accession Number
2036180195
Title
Intraoperative Ventilatory Strategies in Patients Undergoing
Video-Assisted Thoracic Surgery: A Narrative Review.
Source
Advances in Therapy. 42(11) (pp 5427-5450), 2025. Date of Publication: 01
Nov 2025.
Author
Coppola S.; Pastene B.; Fratti I.; Senturk M.; Emre Demirel E.; Leone M.;
Chiumello D.A.
Institution
(Coppola, Chiumello) Department of Anesthesia and Intensive Care, ASST
Santi Paolo e Carlo, San Paolo University Hospital, Via Di Rudini 9,
Milan, Italy
(Pastene, Leone) Department of Anesthesiology and Intensive Care Unit,
Hospital Nord, Aix Marseille University, Assistance Publique Hopitaux
Universitaires de Marseille, Marseille, France
(Coppola, Fratti, Chiumello) Department of Health Sciences, University of
Milan, Milan, Italy
(Senturk) School of Medicine, Department of Anesthesiology and Intensive
Care, Acibadem University, Istanbul, Turkey
(Emre Demirel) Istanbul Medical Faculty, Department of Anesthesiology and
Reanimation, Istanbul University, Istanbul, Turkey
(Chiumello) Coordinated Research Center on Respiratory Failure, University
of Milan, Milan, Italy
Publisher
Adis
Abstract
Video-assisted thoracic surgery (VATS) and robotic-assisted thoracic
surgery (RATS) are commonly used in thoracic surgery, yet postoperative
complications still occur in up to 10% of the patients. The aim of our
narrative review was to summarize the best available evidence on
mechanical ventilation settings, particularly with regard positive
end-expiratory pressure (PEEP) selection, tidal volume (VT) and
ventilation mode, as well as the feasibility of two-lung ventilation in
patients undergoing thoracic surgery using VATS or RATS techniques. We
searched the MEDLINE/PubMed database using the terms "VATS" or "RATS" and
"ventilation" between 1 January 2007 and 1 February 2025. Publications
were screened by title or abstract. We discussed studies according to
their methodological quality, ventilation mode, as well as the feasibility
of two-lung ventilation in patients undergoing thoracic surgery using VATS
or RATS techniques. In patients receiving one-lung ventilation (OLV), the
application of a protective lung ventilation using an intermediate VT
ranged between 5 and 8 ml (mL) of predicted body weight (PBW) and a PEEP
of 5-8 cmH<inf>2</inf>O was not found to be associated with a lower
incidence of postoperative pulmonary complications and improved hospital
outcomes. Titrating PEEP based on mechanical properties appears to enhance
perioperative oxygenation and ventilatory mechanics and to reduce
postoperative pneumonia. However, no conclusions can be drawn regarding
ventilation modes, because only few studies have compared the same low VT
using different pressure versus volume control modes. The feasibility of
two-lung ventilation during specific thoracic surgery procedures has
recently been positively evaluated, with no differences in postoperative
complications found. The level of evidence for the ventilatory settings in
patients undergoing VATS or RATS remains low. In conclusion, large
randomized controlled trials (RCTs) are needed to determine whether
certain intraoperative ventilatory strategies can reduce postoperative
pulmonary complications (PPCs) in patients.<br/>Copyright &#xa9; The
Author(s) 2025.

<36>
Accession Number
2040873554
Title
Effect of pressure-controlled ventilation-volume guaranteed mode on
intraoperative respiratory mechanics, oxygenation and postoperative
pulmonary complications: a systematic review and network meta-analysis.
Source
Annals of Medicine. 57(1) (no pagination), 2025. Article Number: 2579790.
Date of Publication: 2025.
Author
Liu Z.; Liu W.; Zhao P.; Ma Z.; Li Y.
Institution
(Liu, Ma, Li) Department of Anesthesiology, Gansu Provincial Hospital,
Lanzhou, China
(Liu) Department of Anesthesiology, Liangzhou Hospital, Wuwei, China
(Zhao) Department of Pharmacology, Gansu Provincial Hospital, Lanzhou,
China
Publisher
Taylor and Francis Ltd.
Abstract
Background: Ventilation strategies during general anesthesia are crucial
for optimizing respiratory mechanics, ensuring adequate oxygenation, and
minimizing postoperative pulmonary complications (PPCs) in surgical
patients. This systematic review and network meta-analysis (NMA) aim to
evaluate the effect of pressure controlled volume guaranteed ventilation
(PCV-VG) in patients undergoing non-cardiothoracic surgery.
<br/>Method(s): We selected randomized controlled trials (RCTs) to explore
the effect of PCV-VG mode on intraoperative respiratory mechanics,
oxygenation and PPCs in surgical patients published in English by
searching PubMed, Embase, Web of Science, and the Cochrane from inception
to May 2025. The primary outcome was dynamic lung compliance (Cdyn).
<br/>Result(s): Fourteen studies with 2263 patients were included.
Compared to volume-controlled ventilation (VCV), PCV-VG had higher Cdyn
and lower airway peak pressure (Ppeak). For tidal volume (Vt), partial
pressure of carbon dioxide in arterial blood (PaCO<inf>2</inf>), partial
pressure of oxygen in arterial blood (PaO<inf>2</inf>), oxygenation index
(OI), airway mean pressure (Pmean), and PPCs, there were no significant
difference among pressure-controlled ventilation (PCV), VCV, and PCV-VG.
Compared to VCV, PCV-VG did not significantly affect the values of
potential of hydrogen (pH) and partial pressure of end-tidal carbon
dioxide (PetCO<inf>2</inf>). The subgroup analysis only showed that PCV
had higher Cdyn than VCV in prone position. <br/>Conclusion(s): PCV-VG was
superior to VCV in Cdyn and Ppeak, PCV only achieved higher Cdyn than VCV
for prone position. The three modes did not differ in Vt, Pmean,
PetCO<inf>2,</inf> pH, PaCO<inf>2</inf>, PaO<inf>2</inf>, OI, and PPCs for
patients undergoing non-cardiothoracic surgery.<br/>Copyright &#xa9; 2025
The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<37>
Accession Number
2040996785
Title
The effects of whole foods and dietary patterns on flow-mediated dilation:
a systematic review and meta-analysis of randomized controlled trials.
Source
American Journal of Clinical Nutrition. 122(5) (pp 1204-1232), 2025. Date
of Publication: 01 Nov 2025.
Author
Trinquet N.M.; Kellow N.J.; Eviana R.; Williamson G.; Dordevic A.L.
Institution
(Trinquet, Kellow, Eviana, Williamson, Dordevic) Department of Nutrition,
Dietetics and Food, School of Clinical Sciences, Faculty of Medicine
Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
(Trinquet, Eviana, Williamson, Dordevic) Victorian Heart Institute, Monash
University, Clayton, VIC, Australia
(Williamson) School of Biological Sciences, Queen's University, Belfast,
United Kingdom
Publisher
Elsevier B.V.
Abstract
Background: Diet is a key modifiable risk factor for cardiovascular
diseases (CVDs), which remain the leading cause of death worldwide.
Impaired endothelial function is an early predictor of CVD and an
important risk marker to determine the impact of dietary interventions.
<br/>Objective(s): A systematic review with meta-analyses was conducted to
determine the effects of whole foods and dietary patterns on endothelial
function in adults. <br/>Method(s): Eligible studies were randomized
controlled trials investigating the effects of whole foods or dietary
patterns for >=28 d on endothelial function in adults, measured as fasting
brachial artery flow--mediated dilation (FMD). Meta-analyses and
meta-regression analyses were performed in order to explore the effects of
whole foods and dietary interventions on FMD. Grading of Recommendations
Assessment, Development and Evaluation (GRADE) and risk of bias and
publication bias assessments were performed. <br/>Result(s): There were
133 studies included: 102 whole food interventions comparing 14 food
groups and 31 dietary interventions comparing 11 diet patterns. The
following interventions consistently showed improvement in FMD (i.e.,
improved endothelial function) across the studies: fruits {mean difference
(MD): 0.86%; [95% confidence interval (CI): 0.16%, 1.55%]}, vegetables
(MD: 1.37%; 95% CI: 0.34%, 2.40%), soy (MD: 1.58%; 95% CI: 0.32%, 2.83%),
nuts and seeds (MD: 1.39%; 95% CI: 0.17%, 2.60%), cocoa (MD: 1.68%; 95%
CI: 0.08%, 3.29%), tea (MD: 3.22%; 95% CI: 2.01%, 4.42%), and the
Mediterranean diet (MD: 2.32%; 95% CI: 1.86%, 2.78%), with tea showing the
greatest improvement in FMD. Weight loss interventions showed no change in
FMD with weight loss of <10% body weight. The GRADE certainty of evidence
ranged from moderate to low. <br/>Conclusion(s): The systematic review
provides evidence that fruits, vegetables, soy, nuts and seeds, cocoa, and
tea, as well as following a Mediterranean diet are the most effective
dietary strategies for improving endothelial function as measured by FMD.
However, findings should be interpreted with caution owing to
moderate-to-low certainty of evidence and some concerns or high risk of
bias in many cases. This systematic review was registered at PROSPERO as
CRD42023453352.<br/>Copyright &#xa9; 2025 The Author(s)

<38>
Accession Number
2040914499
Title
AI-supported non-invasive measurement for intraoperative hypotension
reduction in major Orthopedic and trauma surgery-study protocol for a
randomized clinical trial.
Source
Trials. 26(1) (no pagination), 2025. Article Number: 455. Date of
Publication: 01 Dec 2025.
Author
Habicher M.; Kleymann R.; Shakkour K.; Holstein N.; Koch C.; Markmann M.;
Schneck E.; Sander M.
Institution
(Habicher, Kleymann, Shakkour, Holstein, Koch, Markmann, Schneck, Sander)
Department of Anesthesiology, Intensive Care Medicine and Pain Therapy,
Justus Liebig University of Giessen, University Hospital of Giessen &
Marburg, Rudolf-Buchheim-Street 7, Giessen, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension (IOH) is a common complication in
non-cardiac surgeries, with significant impacts on postoperative outcomes
such as acute kidney injury (AKI), myocardial injury after non-cardiac
surgery (MINS), and postoperative cognitive dysfunction (delirium).
Traditional non-invasive blood pressure monitoring often results in blind
gaps through the discontinuous measurement, potentially missing critical
hypotensive events. This study investigates the efficacy of a
non-invasive, continuous AI-supported technology using the Hypotension
Prediction Index (HPI) system, designed to predict and mitigate IOH, in
reducing the incidence and severity of IOH and related complications in
major orthopedic and trauma surgeries. Methods/design: This monocentric,
randomized, prospective interventional trial will be conducted at the
University Hospital Giessen. The study will include patients aged 45 years
and older undergoing major orthopedic or trauma surgeries. Participants
will be randomized into two groups: an intervention group receiving
hemodynamic management using the ClearSight system in combination with a
HPI-based treatment algorithm and a control group receiving standard care.
The patients from the standard group also receive continuous cardiac
output monitoring; however, this will be blinded to the anesthesiologist,
to ensure the comparability of the measured hemodynamic parameters. The
primary endpoint is the incidence, duration and severity of IOH, which is
defined as MAP < 65 mmHg for at least one minute and which is calculated
as the area under MAP < 65 mmHg and the time-weighted average (TWA) of MAP
< 65 mmHg. Secondary endpoints include the occurrence of postoperative AKI
(measured by KDIGO criteria), MINS (measured by high-sensitivity troponin
I assays), and postoperative delirium. The study aims to recruit 150
patients, accounting for potential dropouts, to provide sufficient power
to detect differences in the primary and secondary endpoints.
<br/>Conclusion(s): This study aims to demonstrate improved intraoperative
hemodynamic stability, with a reduction of hypotension and a reduced
incidence of postoperative complications, potentially setting a new
standard for non-invasive continuous monitoring in orthopedic and trauma
patients. Trial registration: ClinicalTrials.gov NCT06291714. Registered
on 4 March 2024.<br/>Copyright &#xa9; The Author(s) 2025.

<39>
Accession Number
2039377367
Title
Impact of Metabolic Surgery on Cardiovascular Disease Outcomes.
Source
Canadian Journal of Cardiology. 41(9) (pp 1794-1808), 2025. Date of
Publication: 01 Sep 2025.
Author
Piche M.-E.; Poirier P.; Wong J.A.
Institution
(Piche) Institut Universitaire de Cardiologie et de Pneumologie de Quebec,
Universite Laval, Quebec City, Quebec, Canada
(Piche, Poirier) Faculty of Medicine, Laval University, Quebec City,
Quebec, Canada
(Poirier) Faculty of Pharmacy, Laval University, Quebec City, Quebec,
Canada
(Wong) Division of Cardiology, Department of Medicine, McMaster
University, Hamilton, ON, Canada
(Wong) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
Publisher
Elsevier Inc.
Abstract
Obesity is strongly associated with a range of cardiovascular conditions,
including coronary artery disease, heart failure, atrial fibrillation, and
stroke. Metabolic surgery has emerged as one of the most effective
interventions for individuals with severe obesity, not only by promoting
substantial and durable weight loss but also by improving cardiovascular
risk factors and outcomes. Cardiovascular benefits may also be mediated
via weight-independent mechanisms involving insulin sensitivity,
gastrointestinal hormones, bile acid dynamics, and gut microbiome.
Long-term cohort studies have documented that metabolic surgery is
associated with a reduction in all-cause mortality and major adverse
cardiovascular events in this population. In this narrative review we
examine the role of metabolic surgery in the prevention and management of
cardiovascular disease associated with severe obesity. It provides an
overview of the most common metabolic surgery procedures, including sleeve
gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with
duodenal switch, as well as newer procedures like single-anastomosis
duodenal switch. We also evaluate the impact of these interventions on key
cardiovascular risk factors, such as type 2 diabetes, hypertension,
dyslipidemia, and obstructive sleep apnea, as well as their effects on
cardiac structure and function. Metabolic surgery is associated with
reductions in all-cause mortality and cardiovascular events, including
myocardial infarction and heart failure, especially in individuals with
obesity and pre-existing cardiovascular disease. The current evidence
supporting the link between metabolic surgery and cardiovascular outcomes
is reviewed. Notably, randomized trials specifically focusing on
cardiovascular outcomes after metabolic surgery are lacking, which
highlights an important knowledge gap and the crucial need for these
studies. Addressing this gap is essential for guiding future clinical
practice and optimizing patient care.<br/>Copyright &#xa9; 2025 Canadian
Cardiovascular Society

<40>
Accession Number
2037294077
Title
History and Application of Mechanical Assist Devices as a Bridge to Heart
Transplant: A Review and Perspectives in Brazil.
Source
Brazilian Journal of Cardiovascular Surgery. 40(6) (no pagination), 2025.
Article Number: e20250906. Date of Publication: 01 Oct 2025.
Author
Perazzo A.; Gaiotto F.A.; Steffen S.P.; Gaspar S.F.D.; Faria V.S.;
Ferreira R.C.S.; Carbonera A.; Guazzelli D.L.; Gamboa J.A.R.; Ideal L.F.;
Gomes H.L.; Filho A.T.G.F.; Fernandes A.L.; Campos L.H.; Steffen C.L.;
Limongi C.; Varjao R.L.; Avila M.S.; Seguro L.F.B.C.; Mangini S.;
Marcondes-Braga F.G.; Aulicino G.B.; de Campos I.W.; Santos R.H.B.; Filho
D.D.L.; Kowalewski M.; Ronco D.; Matteucci M.; Meani P.; Russo C.F.; Di
Mauro M.; Mariani S.; Loforte A.; Wiedmann D.; Bacal F.; Whitman G.;
Punjabi P.; Lorusso R.; Jatene F.B.
Institution
(Perazzo, Gaiotto, Steffen, Gaspar, Faria, Ferreira, Carbonera, Guazzelli,
Gamboa, Steffen, Avila, Seguro, Mangini, Marcondes-Braga, Aulicino, de
Campos, Santos, Filho, Bacal, Jatene) Nucleo de Transplante do Instituto
do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, AP, Sao Paulo, Brazil
(Perazzo, Gaiotto, Steffen, Gaspar, Ideal, Gomes, Filho, Fernandes,
Varjao, Santos, Filho, Jatene) Departamento de Cirurgia Cardiovascular do
Instituto do Coracao do Hospital das Clinicas da Faculdade de Medicina da
Universidade de Sao Paulo, SP, Sao Paulo, Brazil
(Perazzo, Kowalewski, Ronco, Matteucci, Meani, Di Mauro, Mariani, Lorusso)
Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht
University Medical Centre (MUMC), Cardiovascular Research Centre
Maastricht (CARIM), Maastricht, Netherlands
(Campos) Faculdade Israelita de Ciencias da Saude Albert Einstein
(FICSAE), SP, Sao Paulo, Brazil
(Limongi) Departamento de Cirurgia Cardiovascular, Santa Casa de Curitiba,
PR, Curitiba, Brazil
(Kowalewski) Department of Cardiac Surgery and Transplantology, National
Medical Institute of the Ministry of Interior and Administration,
Varsovia, Poland
(Mariani) Cardiac Surgery Unit, Fondazione IRCCS San Gerardo dei Tintori,
Monza, Italy
(Ronco, Russo) Cardiac Surgery and Heart Transplant Unit, Cardiac Thoracic
and Vascular Department, Niguarda Hospital, Milao, Italy
(Meani) Cardiothoracic and vascular Anestesia and Intensive Care, ASST
Grande Ospedale Metropolitano, Niguarda, Milao, Italy
(Loforte) Mechanical Circulatory Support Program, University of Turin,
Turin, Italy
(Wiedmann) Cardiac Surgery and Mechanical Circulatory Support Department,
University of Wien, Wien, Austria
(Whitman) Cardiovascular Surgery Department, Johns Hopkins School of
Medicine Faculty, Baltimore, United States
(Punjabi) Cardiothoracic Surgery Department, Imperial College London,
National Heart and Lung Institute, Londres, United Kingdom
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Mechanical circulatory support (MCS) devices have evolved
significantly over the past decades and play a vital role in managing
end-stage heart failure, especially as a bridge to heart transplantation.
From the pioneering heart-lung machines to third-generation ventricular
assist devices (VADs), MCS technology has advanced to provide more
durable, efficient, and safer options for both short-and long-term
support. This review outlines the historical development of mechanical
assist devices, the types of available supports - ranging from
intra-aortic balloon pumps and extracorporeal membrane oxygenation to
implantable devices like HeartMate 3 - and their clinical indications and
complications. Special attention is given to right ventricular
dysfunction, thromboembolic and hemorrhagic complications, and infections,
which remain major challenges in the management of patients with MCS
devices. In Brazil, despite the growing evidence supporting MCS in
critically ill patients, access remains limited due to financial and
systemic constraints. The review explores the current landscape of device
availability in the country, national guidelines, cost-effectiveness data,
and the impact of recent changes in transplant allocation criteria that
prioritize patients receiving mechanical support. Notably, the approval of
long-term VADs for destination therapy in the public health system in 2024
marks a significant milestone. This review offers a comprehensive
perspective on MCS utilization, highlighting both global advances and
Brazil-specific challenges. By identifying gaps in access and proposing
future directions, it advocates for expanded use of these life-saving
technologies to improve survival and quality of life in advanced heart
failure patients.<br/>Copyright &#xa9; 2025, Sociedade Brasileira de
Cirurgia Cardiovascular. All rights reserved.

<41>
Accession Number
2041310747
Title
Impact of aortic root abscess on outcomes in infective endocarditis and
predictors of in-hospital mortality: A meta-analysis.
Source
Heart and Lung. 75 (pp 337-346), 2026. Date of Publication: 01 Jan 2026.
Author
Emara A.; Emara M.; Aldemerdash M.A.; Hemmeda L.; Gadelmawla A.F.; Saber
A.; Ellebedy M.; Zordok M.; Harris K.M.; Bapat V.N.; Beckmann E.; Brilakis
E.S.; Megaly M.
Institution
(Emara, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Aldemerdash, Ellebedy) Faculty of Medicine, Sohag University, Sohag,
Egypt
(Hemmeda) Faculty of Medicine, University of Khartoum, Khartoum, Sudan
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Saber) Department of Cardiology, Minia University Hospital, Minya, Egypt
(Zordok) Department of Medicine, Catholic Medical Center, Manchester, NH,
United States
(Harris, Bapat, Beckmann, Brilakis) Minneapolis Heart Institute, Abbott
Northwestern Hospital, Minneapolis, MN, United States
(Megaly) Ascension St John Heart and Vascular Center, Tulsa, OK, United
States
Publisher
Elsevier Inc.
Abstract
Background: Aortic root abscess (ARA) is a severe and life-threatening
complication of infective endocarditis (IE), often requiring urgent
surgical intervention. However, data on surgical outcomes and predictors
of mortality in this population are limited. <br/>Objective(s): We
conducted a systematic review and meta-analysis to evaluate postoperative
outcomes and identify predictors of in-hospital mortality in patients with
IE complicated by ARA. <br/>Method(s): A comprehensive search of PubMed,
Web of Science, Scopus, and Embase was performed through February 2025 for
studies comparing surgical outcomes in patients with IE with versus
without ARA. Risk ratios (RR) were used for dichotomous outcomes and mean
differences (MD) for continuous outcomes, both with 95 % confidence
intervals (CI). <br/>Result(s): Eight observational studies comprising
2266 patients (637 with ARA, 1629 without ARA) were included. ARA was
significantly associated with higher in-hospital mortality (15.7 % vs.
12.8 %; RR 1.65, 95 % CI 1.28-2.13, P = 0.0001), late mortality (21.4 %
vs. 20.2 %; RR 1.44, 95 % CI 1.16-1.79, P = 0.001), and IE recurrence
(10.6 % vs. 4.8 %; RR 2.15, 95 % CI 1.29-3.59, P = 0.003). No significant
difference in heart failure incidence was found (RR 1.02, 95 % CI
0.86-1.21, P = 0.82). Renal failure (OR 3.22, 95 % CI 1.37-7.60) and
Staphylococcus aureus infection (OR 3.30, 95 % CI 1.50-7.26) were
independently associated with higher in-hospital mortality.
<br/>Conclusion(s): ARA in patients undergoing surgery for IE is
associated with worse outcomes, including higher in-hospital and late
mortality and greater IE recurrence. Renal failure and S. aureus infection
are significant mortality predictors.<br/>Copyright &#xa9; 2025 Elsevier
Inc.

<42>
Accession Number
2039602194
Title
Impact of olive oil consumption on surgical outcomes in patients
undergoing open heart surgery: a randomized clinical trial.
Source
Journal of Complementary and Integrative Medicine. 22(3) (pp 522-529),
2025. Date of Publication: 01 Sep 2025.
Author
Bahrami R.; Ebadi A.; Saeid Y.; Farzam S.S.; Gomrokchian E.; Moayed M.S.
Institution
(Bahrami) Student Research Committee, Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Ebadi, Saeid, Moayed) Nursing Care Research Center, Clinical Sciences
Institute, Faculty of Nursing, Baqiyatallah University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Farzam) Department of Cardiology, School of Medicine Bu Ali Sina,
Teaching Hospital Qazvin, University of Medical Sciences, Qazvin, Iran,
Islamic Republic of
(Gomrokchian) Teaching Hospital Qazvin University of Medical Sciences,
Qazvin, Iran, Islamic Republic of
Publisher
Walter de Gruyter GmbH
Abstract
Introduction: The incidence of post-surgery outcomes, such as pain and
constipation, in patients undergoing coronary artery bypass surgery can
impact the healing process and the quality of life of patients. This study
aimed to investigate the effect of olive oil consumption on pain and
constipation in adult coronary bypass surgery patients. <br/>Method(s): A
randomized controlled trial in Qazvin, Iran (2022-2023) assigned 110
patients scheduled for coronary artery bypass surgery to two groups using
four-block randomization. In the intervention group, patients received 30
cc of extra virgin olive oil daily with food from the day before the
operation to 30 days after. The control group received usual care. Pain
and constipation levels were measured before and after surgery and up to
30 days post-surgery using the visual pain scale (VAS) and Bristol stool
form scale (BSFS). <br/>Result(s): With similar background variables
between the two groups, the results indicated that the average pain and
constipation scores in the intervention group decreased more than in the
control group (p-value < 0.05). <br/>Conclusion(s): Based on the study's
findings and the positive impact of olive oil consumption on reducing pain
and constipation, incorporating olive oil into the diet of heart surgery
patients is recommended.<br/>Copyright &#xa9; 2025 Walter de Gruyter GmbH,
Berlin/Boston.

<43>
Accession Number
2041271040
Title
Early Aortic Valve Replacement of Asymptomatic Severe Aortic Stenosis: A
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of the American Heart Association. 14(16) (no pagination), 2025.
Article Number: e041283. Date of Publication: 20 Aug 2025.
Author
Song Q.; Liu R.; Yang K.; Tu X.; Tan H.; Fan C.; Li X.
Institution
(Song, Liu, Tu, Tan, Fan) Department of Cardiovascular Surgery, The Second
Xiangya Hospital, China
(Yang) Department of Plastic and Aesthetic(Burn) Surgery, Second Xiangya
Hospital, China
(Li) Hunan Key Laboratory of Joint Degeneration and Injury, Xiangya
Hospital, Central South University, Changsha, China
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Asymptomatic severe aortic stenosis may lead to the
progression to both symptoms and adverse outcomes if left untreated. The
appropriate timing of intervention for these patients remains
controversial, and any decision requires careful assessment.
<br/>METHOD(S): We searched PubMed, Web of Science, EMBASE, and Cochrane
Library for randomized controlled trials comparing early aortic valve
replacement with conservative management in asymptomatic patients with
severe aortic stenosis until December 2024. The primary efficacy outcome
was a composite of all-cause mortality, hospitalization for cardiovascular
causes, stroke, and myocardial infarction. We expressed outcome data as
risk ratios (RRs) with 95% CIs. <br/>RESULT(S): We included 4 randomized
controlled trials involving 1427 patients. Early aortic valve replacement
significantly reduced the incidence of the composite outcome when compared
with conservative management (29.2% versus 53.7%; RR, 0.56 [95% CI,
0.49-0.64]; I²=60%). Significant reductions were also detected
in all-cause mortality (10.0% versus 13.7%; RR, 0.74 [95% CI, 0.55-0.99];
I²=58%), hospitalization for cardiovascular causes (14.6%
versus 32.5%; RR, 0.48 [95% CI, 0.39-0.58]; I²=26%), and stroke
(4.5% versus 7.2% RR, 0.62 [95% CI, 0.40-0.95]; I²=0%). No
significant difference was observed in cardiac-specific mortality (8.3%
versus 16% RR, 0.68 [95% CI, 0.40-1.16]; I²=65%) and myocardial
infarction (0.6% versus 4.6%; RR, 0.21 [95% CI, 0.04-1.19];
I²=0%). <br/>CONCLUSION(S): Our meta-analysis of randomized
controlled trials showed that among patients with asymptomatic severe
aortic stenosis, a strategy of early aortic valve interventions was
superior to conservative treatments in reducing the primary composite
outcome of all-cause mortality, hospitalization for cardiovascular causes,
stroke, and myocardial infarction. However, significant differences in the
rates of cardiac-specific mortality were not apparent.<br/>Copyright
&#xa9; 2025 The Author(s). Published on behalf of the American Heart
Association, Inc., by Wiley. This is an open access article under the
terms of the Creative Commons Attribution License, which permits use,
distribution and reproduction in any medium, provided the original work is
properly cited. JAHA is available at: www.ahajournals.org/journal/jaha

<44>
Accession Number
2037294641
Title
Lipoprotein(a) as a Predictor of Cardiovascular Risk in Acute Coronary
Syndrome Patients Undergoing Percutaneous Coronary Intervention: A
Systematic Review.
Source
Reviews in Cardiovascular Medicine. 26(9) (no pagination), 2025. Article
Number: 42784. Date of Publication: 01 Sep 2025.
Author
Mojahedi A.; Chen O.; Skopicki H.A.; Rahman T.; Sadeghian A.
Institution
(Mojahedi) Department of Internal Medicine, Stony Brook University
Hospital, Stony Brook, NY, United States
(Chen, Skopicki, Rahman) Division of Cardiology, Stony Brook University
Hospital, Stony Brook, NY, United States
(Sadeghian) School of Medicine, Zabol University of Medical Sciences,
Sistan and Baluchestan, Zabol, Iran, Islamic Republic of
Publisher
IMR Press Limited
Abstract
Background: Despite advancements in treatment, coronary artery disease
(CAD) remains a significant global health concern. Although lipoprotein(a)
[Lp(a)] is recognized as a crucial cardiovascular risk factor associated
with increased risk, the prognostic value of using Lp(a) levels in
patients with acute coronary syndrome (ACS) who have undergone
percutaneous coronary intervention (PCI) remains debatable. This review
aimed to investigate the association between Lp(a) levels and recurrent
ischemic events in patients with ACS undergoing PCI. <br/>Method(s): This
systematic review included studies with individuals aged >=18 years
diagnosed with ACS who underwent PCI and had Lp(a) measurements. The
included studies were sourced from the PubMed database, with a focus on
articles published between January 2020 and January 2025. Keywords related
to Lp(a) and cardiovascular diseases were used in the search. Data
extraction involved a review of titles and abstracts followed by quality
assessment using the QUADAS-2 tool. <br/>Result(s): The final analysis
included 10 studies with a combined population of 20,896 patients from
diverse regions, including Japan, India, Egypt, China, and South Korea.
Key findings indicate that elevated Lp(a) levels are significantly
associated with adverse cardiovascular outcomes, including myocardial
infarction and mortality, both in hospital and during long-term follow-up.
<br/>Conclusion(s): This review highlights Lp(a) as a critical biomarker
for predicting recurrent cardiovascular events in ACS patients post-PCI.
The consistent correlation between elevated Lp(a) levels and adverse
outcomes underscores the necessity of routine monitoring and targeted
management of Lp(a) to mitigate residual cardiovascular
risk.<br/>Copyright &#xa9; 2025 The Author(s). Published by IMR Press.

<45>
Accession Number
2040629239
Title
Efficacy and Safety of Direct Oral Anticoagulants in Patients After Heart
Valve Replacement or Repair: A Systematic Review and Network
Meta-Analysis.
Source
Clinical Therapeutics. 47(11) (pp 1061-1068), 2025. Date of Publication:
01 Nov 2025.
Author
Gao W.; Zhang Z.; Jia P.; Dong L.; Li R.; Xu J.; Zhang J.; Chen W.
Institution
(Gao, Zhang, Jia, Dong, Li, Xu, Zhang, Chen) Third Hospital of Shanxi
Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical
Sciences, Tongji Shanxi Hospital, Taiyuan, China
(Zhang, Jia, Dong, Chen) School of Pharmacy, Shanxi Medical University,
Taiyuan, China
Publisher
Elsevier Inc.
Abstract
Purpose: The optimal anticoagulation strategy following bioprosthetic
heart valve replacement or valve repair remains controversial. Therefore,
we conducted a meta-analysis to compare the efficacy and safety of direct
oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in patients
with heart valve disease. <br/>Method(s): We searched PubMed, Cochrane
Library, Embase, Web of Science, CNKI, and Wanfang for clinical studies
comparing DOACs and VKAs in patients following bioprosthetic heart valve
replacement or repair, up to November 1, 2023. The meta-analysis was
conducted using RevMan 5.3 and Stata 17.0. <br/>Finding(s): Thirty-three
studies involving 59,660 individuals were included in the meta-analysis.
Compared with VKAs, DOACs may reduce the risk of stroke or systemic
embolism (risk ratios [RR] = 0.83, 95% confidence interval [CI] 0.75-0.93,
P = 0.0007) and major bleeding (RR = 0.76, 95% CI 0.62-0.94, P = 0.009),
while the risks of all-cause death and intracranial bleeding were similar.
DOACs may increase the risk of gastrointestinal bleeding (RR = 1.42, 95%
CI 1.04-1.95, P = 0.03). Twelve studies (4,789 patients) were included in
a network meta-analysis. Indirect comparisons suggested rivaroxaban
appears most favorable in reducing stroke or systemic embolism and major
bleeding, though based on indirect evidence. Implications: In patients
following bioprosthetic heart valve replacement or repair, DOACs may
reduce the risk of stroke or systemic embolism and major bleeding, but may
increase gastrointestinal bleeding compared with VKAs. Among DOACs,
rivaroxaban appears to be the optimal choice. These findings should be
interpreted cautiously due to limited RCT evidence and incomplete
drug-specific reporting.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<46>
Accession Number
614951242
Title
Randomized Evaluation of the Effects of Anacetrapib through
Lipid-modification (REVEAL)-A large-scale, randomized, placebo-controlled
trial of the clinical effects of anacetrapib among people with established
vascular disease: Trial design, recruitment, and baseline characteristics.
Source
American Heart Journal. 187 (pp 182-190), 2017. Date of Publication: 01
May 2017.
Author
Bowman L.; Chen F.; Sammons E.; Stevens W.; Valdes-Marquez E.; Wiviott S.;
Cannon C.P.; Braunwald E.; Collins R.; Landray M.J.; Hopewell J.C.; Jiang
L.; Armitage J.; Haynes R.; Maggioni A.P.; Ertl G.; Angermann C.E.;
Pedersen T.; Goto S.; Teramoto T.; Gray A.; Mihaylova B.; Baigent C.;
Barter P.; Chen Y.; Chen Z.; Tobert J.; Sleight P.; Blaustein R.; DeLucca
P.; Mitchel Y.; van Leijenhorst G.; Sandercock P.; DeMets D.; Kjekshus J.;
Neuberger J.; Tonkin A.; Emberson J.; Granger C.; Colhoun H.; Wallendszus
K.
Institution
(Bowman, Chen, Sammons, Hopewell, Wallendszus, Stevens, Valdes-Marquez,
Wiviott, Cannon, Braunwald, Collins) REVEAL Central Coordinating Office,
Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield
Department of Population Health, University of Oxford, United Kingdom
Publisher
Mosby Inc. (E-mail: customerservice@mosby.com)
Abstract
Patients with prior vascular disease remain at high risk for
cardiovascular events despite intensive statin-based treatment. Inhibition
of cholesteryl ester transfer protein by anacetrapib reduces low-density
lipoprotein (LDL) cholesterol by around 25% to 40% and more than doubles
high-density lipoprotein (HDL) cholesterol. However, it is not known if
these apparently favorable lipid changes translate into reductions in
cardiovascular events. Methods The REVEAL study is a randomized,
double-blind, placebo-controlled clinical trial that is assessing the
efficacy and safety of adding anacetrapib to effective LDL-lowering
treatment with atorvastatin for an average of at least 4 years among
patients with preexisting atherosclerotic vascular disease. The primary
assessment is an intention-to-treat comparison among all randomized
participants of the effects of allocation to anacetrapib on major coronary
events (defined as the occurrence of coronary death, myocardial
infarction, or coronary revascularization). Results Between August 2011
and October 2013, 30,449 individuals in Europe, North America, and China
were randomized to receive anacetrapib 100 mg daily or matching placebo.
Mean (SD) age was 67 (8) years, 84% were male, 88% had a history of
coronary heart disease, 22% had cerebrovascular disease, and 37% had
diabetes mellitus. At the randomization visit (after at least 8 weeks on a
protocol-defined atorvastatin regimen), mean plasma LDL cholesterol was 61
(15) mg/dL and HDL cholesterol was 40 (10) mg/dL. Interpretation The
REVEAL trial will provide a robust evaluation of the clinical efficacy and
safety of adding anacetrapib to an effective statin regimen. Results are
anticipated in 2017.<br/>Copyright &#xa9; 2017 The Authors

<47>
Accession Number
2040654017
Title
Development and initial content validation of a new version of the damage
index in thrombotic antiphospholipid syndrome (DIAPSV2).
Source
Lupus. 34(13) (pp 1334-1346), 2025. Date of Publication: 01 Nov 2025.
Author
Goycochea Robles M.V.; Garcia G.M.; Mendoza Pinto C.; Mercado C.M.;
Martinez Martinez L.A.; Medina San Millan P.; Guzman Vazquez S.; Perez
Ruiz A.A.; Amigo M.-C.
Institution
(Goycochea Robles) Facultad de Medicina, Universidad Nacional Autonoma de
Mexico, Mexico City, Mexico
(Garcia) Unidad de Investigacion en Medicina Traslacional en Enfermedades
Hematooncologicas, Hospital de Especialidades Centro Medico La Raza Centro
Medico La Raza, Instituto Mexicano del Seguro Social, Mexico City, Mexico
(Mendoza Pinto) Hospital de Especialidades, UMAE-Centro Medico Nacional,
Manuel Avila Camacho, Centro de Investigacion Biomedica de Oriente,
Puebla, Mexico
(Mercado) Rheumatology Department, Centro Medico ISSEMYN Toluca Edo Mex,
Estado de Mexico, Toluca, Mexico
(Martinez Martinez) Rheumatology Departament, Instituto Nacional de
Cardiologia Ignacio Chavez, Secretaria de Salud, Mexico City, Mexico
(Medina San Millan) Rheumatology Departament, Hospital Juarez de Mexico
Secretaria de Salud, Mexico City, Mexico
(Guzman Vazquez) HS Estudios Farmacoeconomicos, Mexico City, Mexico
(Perez Ruiz) Rheumatology Department, Instituto Nacional de Neurologia y
Neurocirugia, Secretaria de Salud, Mexico City, Mexico
(Amigo) Rheumatology Department, Centro Medico ABC. Coordinator of
Antiphospholipid Study Group of Mexican College of Rheumatology, Mexico
City, Mexico
Publisher
SAGE Publications Ltd
Abstract
Background: Antiphospholipid syndrome (APS) is the most common acquired
hypercoagulable disorder characterized mainly by thrombotic events and
obstetric morbidity. Quantifying chronic damage caused by APS is crucial
for patient management. The original Damage Index for Thrombotic APS
(DIAPS) was developed to address this need, but required updates to
improve its comprehensiveness and specificity. <br/>Objective(s): To
report the initial content validation process of a new version of the
damage index: DIAPSv2. <br/>Method(s): A modified Delphi panel was
conducted in two stages. Stage 1 involved a systematic scoping review of
DIAPS studies, with data extracted from questionnaires and confirmed by
the leading committee. These questionnaires identified items from the
original instrument that needed modification, elimination, or replacement
with new candidate items. Stage 2 employed the modified Delphi method over
three rounds, considering expert panelists' opinions to select concepts
for inclusion in DIAPSv2. <br/>Result(s): In Stage 1, evidence supported
the validity of the original DIAPS but highlighted missing conditions
reflecting chronic damage, such as alveolar hemorrhage and significant
bleeding due to anticoagulation therapy. In Stage 2, participants from
different working groups reached a consensus to evaluate 41 of the 67
items that the leading committee proposed for accurately measuring chronic
damage in APS. A final consensus included 32 items. Definitions of all
items were updated according to specialists' input and international
recommendations for each domain. <br/>Conclusion(s): A collaborative and
multidisciplinary consensus-based approach developed a new version of the
damage index, comprising 11 domains and 32 items (an update from 10
domains and 38 items in the original version). DIAPSv2 offers a more
specific tool for evaluating irreversible damage in patients with
thrombotic APS.<br/>Copyright &#xa9; The Author(s) 2025

<48>
Accession Number
2034205200
Title
Etomidate vs Ketamine-Propofol for Induction of Anesthesia in Coronary
Artery Bypass Grafting: An Updated Systematic Review and Meta-Analysis.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(4) (pp 246-257),
2025. Date of Publication: 01 Dec 2025.
Author
Kumar N.; Bardia A.; Fitzsimons M.G.; Essandoh M.; Mitchell J.; Falkson
S.R.; Dalia A.; Tang J.; Sawyer T.R.; Iyer M.H.
Institution
(Kumar, Bardia, Fitzsimons, Falkson, Dalia) Department of Anesthesia,
Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Essandoh, Tang, Iyer) Department of Anesthesiology, The Ohio State
University Wexner Medical Center, Columbus, OH, United States
(Mitchell) Department of Anesthesiology and Perioperative Medicine,
University of California Los Angeles, Los Angeles, CA, United States
(Sawyer) Central Michigan University College of Medicine, Mt. Pleasant,
MI, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Etomidate has minimal cardiovascular depressant effects at the
cost of endogenous cortisol production suppression, whereas propofol has
vasodilatory and myocardial depressant properties, which may be poorly
tolerated in the cardiac surgical population. To offset the undesirable
effects of propofol, ketamine can be co-administered to harness its
cardiac stimulatory properties. Though etomidate is a more cardio-stable
induction agent than propofol, its superiority over the combination of
propofol and ketamine-colloquially known as "ketofol"-remains
controversial. <br/>Method(s): United States National Library of Medicine
Database (MEDLINE) and Excerpta Medica Database (EMBASE) were searched for
randomized controlled trials published since 2010 comparing etomidate and
ketofol relative to propofol alone for induction of general anesthesia for
coronary artery bypass grafting (CABG). Key data collected included
post-induction nadir mean arterial pressure (MAP), heart rate, cardiac
index, systemic vascular resistance (SVR), and serum cortisol levels at 24
hours postoperatively. Variables were compared by calculating a weighted
mean difference (WMD) [95% confidence interval (CI)]. <br/>Result(s): This
analysis included 15 studies (1125 patients). Anesthetic induction with
etomidate was associated with a higher nadir MAP and SVR compared to
ketofol during the peri-induction period by WMD 4.77 mmHg [95% CI 0.31,
9.23, P = 0.04] and 42.22 dynes/cm⁵[95% CI 0.49-83.94, P =
0.05]. However, there was no difference in the frequency of needed boluses
of vasopressors or fluids for peri-induction hypotension.
<br/>Conclusion(s): Though etomidate appears to provide a superior
hemodynamic profile compared to ketofol, both agents require similar
degrees of clinical response to hypotension during the induction of CABG
surgery patients.<br/>Copyright &#xa9; The Author(s) 2025

<49>
Accession Number
2035310142
Title
Resveratrol improves lipid profile and recovers heart function in
postoperative CABG patients.
Source
Molecular and Cellular Biochemistry. 480(11) (pp 5793-5803), 2025. Date of
Publication: 01 Nov 2025.
Author
Ahmadi P.; Akbarzadeh S.; Alizadeh M.; Mohammadi N.; Mahmoodi M.; Amini
A.; Netticadan T.; Rezaei M.; Movahed A.
Institution
(Ahmadi, Mohammadi) Bushehr University of Medical Sciences, Bushehr, Iran,
Islamic Republic of
(Akbarzadeh, Alizadeh, Movahed) Department of Clinical Biochemistry,
Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr,
Iran, Islamic Republic of
(Mahmoodi) Department of Biostatistics and Epidemiology, Addiction and
Lifestyle Research Center, Bushehr University of Medical Sciences,
Bushehr, Iran, Islamic Republic of
(Amini) Department of Internal Medicine, Faculty of Medicine, Bushehr
University of Medical Sciences, Bushehr, Iran, Islamic Republic of
(Netticadan) Canadian Centre for Agri-Food Research in Health and
Medicine, Winnipeg, Canada
(Rezaei) Department of Cardiovascular Surgery, Faculty of Medicine,
Bushehr University of Medical Sciences, Bushehr, Iran, Islamic Republic of
Publisher
Springer
Abstract
Cardiovascular diseases (CVD), especially coronary artery disease (CAD),
are among the most important causes of mortality in the world. Coronary
artery bypass grafting (CABG) is a standard treatment for this disease,
but it may be associated with complications in the postoperative period.
This study investigated the effect of resveratrol (RES), a potent
antioxidant and anti-inflammatory molecule, on cardiovascular indices and
oxidative stress in patients after CABG surgery. This randomized,
double-blind, placebo-controlled trial was carried out at the Bushehr
Heart Center in Bushehr, Iran. A total of 60 patients undergoing CABG were
randomly assigned in equal numbers to either the intervention group or the
control group. The intervention group received RES capsules for 60 days,
and the control group received a placebo for the same duration.
Cardiovascular function and biochemical parameters, including lipid
profile, cardiac enzymes, and markers of oxidative stress and
inflammation, were measured at the beginning and end of the intervention.
Compared to the control group, RES intake significantly reduced systolic
blood pressure (SBP), triglyceride (TG), total cholesterol (TC),
low-density lipoprotein (LDL), and improved ejection fraction (EF).
Although decreases in cardiac enzymes, including creatine phosphokinase
(CPK) and lactate dehydrogenase (LDH), were observed in the RES group,
these changes were not statistically significant. Also, the two groups
showed no significant differences in diastolic blood pressure (DBP), HDL,
or oxidative stress markers. RES supplementation protects patients after
CABG by improving cardiovascular function and lipid profiles. Trial
registration: IRCT20111119008129N12, first trial registration date:
2022-06-18.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<50>
Accession Number
2041189524
Title
Prehabilitation of frail elderly PAtients undergoing majoR surgEry at HOME
(PREPARE-HOME): a superiority parallel-group randomised controlled trial
protocol evaluating smart wearable enhanced prehabilitation versus usual
care.
Source
BMJ Open. 15(10) (no pagination), 2025. Article Number: e094986. Date of
Publication: 23 Oct 2025.
Author
Leong Y.H.; Tay V.Y.J.; Yang X.; Tan C.J.; Au-Yong P.-S.; Sim J.L.X.; Ng
R.R.G.; Ong M.E.H.; Tan B.P.Y.; Abdullah H.R.; Ke Y.
Institution
(Leong, Tay, Yang, Au-Yong, Sim, Ng, Tan, Ke) Singapore General Hospital,
Singapore
(Tan) Department of Physiotherapy, Singapore General Hospital, Singapore
(Ong) Duke-NUS, Singapore
(Abdullah) Department of Anesthesiology, Singapore General Hospital,
Singapore
Publisher
BMJ Publishing Group
Abstract
Introduction Frailty is a key predictor of adverse surgical outcomes in
older adults, contributing to increased postoperative complications,
prolonged hospitalisation and delayed recovery. Prehabilitation-targeting
improvements in physical function before surgery-can mitigate these risks.
However, traditional programmes often face low adherence due to logistical
barriers. Integrating smart wearable devices into tele-supervised,
home-based prehabilitation may enhance adherence, engagement and clinical
outcomes. This trial protocol describes the PREhabilitation of frail
elderly PAtients undergoing majoR surgEry at HOME study with the objective
to evaluate the effectiveness of a wearable-enhanced, tele-supervised
prehabilitation programme (swSEP) versus standard care (unsupervised
prehabilitation, uSEP) on improving preoperative functional capacity and
postoperative outcomes in frail older adults undergoing major elective
surgery. Methods and analysis This single-centre, prospective, randomised
controlled trial will enrol 190 patients aged >=65 years scheduled for
major elective, non-cardiac surgery at Singapore General Hospital.
Participants with frailty (Edmonton Frail Scale >=6) will be randomised
1:1 to either the swSEP group (tele-supervised exercise with Fitbit
Inspire 3 monitoring) or the uSEP group (standard physiotherapy education,
exercise booklet and inspiratory muscle training if maximal inspiratory
pressure <100 cm HO). The primary outcome is change in 6min walk test
distance from baseline to 1-3days presurgery. Secondary outcomes include
30s sit-to-stand test, handgrip strength, postoperative complications (per
American College of Surgeons National Surgical Quality Improvement
Program), hospital length of stay, readmissions, five-level version of the
EuroQol five-dimensional questionnaire (EQ-5D-5L) and adherence. Data will
be analysed using t-tests, analysis of covariance, logistic regression and
Cox models, with stratification by baseline nutritional status. Ethics and
dissemination Approved by the SingHealth Institutional Review Board (CIRB
Ref: 2024/2242). Trial registered on ClinicalTrials.gov (NCT06633614).
Results will be disseminated via peer-reviewed publications and academic
conferences. Contact: irb@singhealth.com.sg<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<51>
Accession Number
2040861244
Title
Functional Roles of the Complement Immune System in Cardiac Inflammation
and Hypertrophy.
Source
International Journal of Molecular Sciences. 26(20) (no pagination), 2025.
Article Number: 9931. Date of Publication: 01 Oct 2025.
Author
Hok K.D.; Rich H.E.; Shadid A.; Gunamalai L.; Weng-Mills T.; Thandavarayan
R.A.; Banda N.K.; Doursout M.-F.; Restrepo M.I.; Shivshankar P.
Institution
(Hok, Rich, Shadid, Shivshankar) Center for Metabolic and Degenerative
Diseases, The Brown Foundation Institute of Molecular Medicine for
Prevention of Human Diseases, UTHealth-McGovern Medical School, Houston,
TX, United States
(Gunamalai) Center for Human Genetics, The Brown Foundation Institute of
Molecular Medicine for Prevention of Human Diseases, UTHealth-McGovern
Medical School, Houston, TX, United States
(Weng-Mills) Department of Biochemistry and Molecular Biology,
UTHealth-McGovern Medical School, Houston, TX, United States
(Thandavarayan) Department of Cardiology, DeBakey Heart & Vascular Center,
Houston Methodist Weill Cornell Medical College, Houston, TX, United
States
(Banda) Division of Rheumatology-Department of Medicine, School of
Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO,
United States
(Doursout) Department of Anesthesiology, UTHealth-McGovern Medical School,
Houston, TX, United States
(Restrepo) VA-San Antonio Geriatric Research Education and Clinical Center
(GRECC), South Texas Veterans Health Care System Audie L. Murphy Division,
UTHealth San Antonio, San Antonio, TX, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac inflammation and hypertrophy develop as a pathologic response to
an array of insults, such as myocardial infarctions, chronic systemic
hypertension, and valvular defects. Due to the high prevalence of such
conditions, there is an increasing need to prevent and halt cardiac
hypertrophy. Because cardiac damage and subsequent remodeling can lead to
arrhythmias, heart failure, and even sudden cardiac death, inhibition of
cardiac hypertrophy is key to reducing cardiovascular-related mortality.
The immune system is the driving force behind inflammatory reactions. All
three pathways of complement system activation-classical, lectin, and
alternative-are implicated in developing cardiac damage, inflammation, and
hypertrophy due to infectious and non-infectious causes, autoimmune
diseases, genetic polymorphisms, and forms of complement dysregulation. Of
interest in this review is the role of the complement system, a collection
of soluble and membrane-bound proteins that mediate inflammatory processes
through interactions with signaling molecules and immune cells. This
review comprehensively discusses the roles of these complement pathways in
contagious, chronic inflammatory, genetic, and metabolic diseases. An
overview of the completed and terminated clinical trials aimed at
preventing cardiovascular mortality by targeting various aspects of the
complement system and inflammatory reaction is included. Most current
treatments for cardiac inflammation and remodeling primarily target the
renin-angiotensin-aldosterone system (RAAS), which prevents further
remodeling by reducing myocardial workload. However, moving forward, there
may be a place for emerging anti-complement therapeutics, which impair the
inflammatory response that generates hypertrophy itself.<br/>Copyright
&#xa9; 2025 by the authors.

<52>
Accession Number
2041420751
Title
Cerebral embolic protection devices in transcatheter aortic valve
implantation: An updated meta-analysis of randomized controlled trials.
Source
Indian Heart Journal. (no pagination), 2025. Date of Publication: 2025.
Author
Mansouri E.S.; Queiroga F.; Ghasemi M.; Barbosa L.M.; Pinilla J.; Faizan
M.A.; Ardebili S.F.Z.; Jena N.; Gomes W.
Institution
(Mansouri) Department of Internal Medicine, Ziaeian Hospital, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Queiroga) Department of Medicine, Emory University, Atlanta, United
States
(Ghasemi) Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Pinilla) CES University, School of Medicine, Medellin, Colombia
(Faizan) Gomal Medical College, Khyber Medical University, Peshawar,
Pakistan
(Ardebili) Charles University, Faculty of Medicine in Hradec Kralove,
Czechia
(Jena) Department of Interventional Cardiology, Marshall University,
Huntington, WV, United States
(Gomes) INC Hospital, Department of Interventional Cardiology, Curitiba,
Brazil
Publisher
Elsevier B.V.
Abstract
Background: Cerebral embolic protection devices (CEPD) have been designed
to prevent embolization to the cerebral circulation during transcatheter
aortic valve replacement (TAVR). However, the efficacy and safety of CEPD
in stroke prevention in TAVR remains uncertain. <br/>Method(s): PubMed,
Embase, and Cochrane Library were searched for randomized controlled
trials (RCTs) comparing CEPD vs. control for patients undergoing TAVR.
Risk ratios (RR) with 95 % confidence intervals (CI) were pooled with a
random-effects model. <br/>Result(s): Our meta-analysis included eight
RCTs with 11,596 patients, of whom 5946 (51 %) were randomized to the CEPD
group. There was no significant difference in the incidence of any stroke
(3.51 % vs. 3.64 %; RR 0.91; 95 % CI 0.75-1.1; p = 0.33; I² = 0
%) between groups. Similarly, CEPD did not significantly reduce the
incidence of all-cause mortality (0.82 % vs. 0.67 %; RR 1.13; 95 % CI
0.74-1.74; p = 0.57; I² = 0 %) <br/>Conclusion(s): Among
patients undergoing TAVR, CEPD did not significantly reduce stroke
incidence or all-cause mortality.<br/>Copyright &#xa9; 2025 Cardiological
Society of India

<53>
Accession Number
2040508036
Title
Beating Heart Versus Arrested Heart for Isolated Tricuspid Valve Surgery:
A Kaplan-Meier-Derived Meta-Analysis.
Source
Innovations: Technology and Techniques in Cardiothoracic and Vascular
Surgery. 20(5) (pp 442-451), 2025. Date of Publication: 01 Sep 2025.
Author
Baudo M.; Sicouri S.; Yamashita Y.; Magouliotis D.; Cabrucci F.; Ramlawi
B.
Institution
(Baudo, Sicouri, Yamashita, Magouliotis, Cabrucci, Ramlawi) Department of
Cardiac Surgery Research, Lankenau Institute for Medical Research, Main
Line Health, Wynnewood, PA, United States
(Yamashita, Ramlawi) Department of Cardiac Surgery, Lankenau Heart
Institute, Main Line Health, Wynnewood, PA, United States
Publisher
SAGE Publications Ltd
Abstract
Objective: The aim of the current study was to analyze the clinical and
surgical outcomes of patients undergoing isolated tricuspid valve surgery
(ITVS) from the available literature. It currently remains uncertain
whether arrested heart (AH) surgery has superior postoperative outcomes
over beating heart (BH) for ITVS. <br/>Method(s): A systematic review and
meta-analysis were conducted by searching PubMed, ScienceDirect, Scopus,
DOAJ, SciELO, and Cochrane databases from 2000 until November 2024. The
protocol was registered with the International Prospective Register of
Systematic Reviews under the PROSPERO registration number CRD42024622618.
<br/>Result(s): A total of 22 studies met the inclusion criteria. These
studies were published between 2012 and 2023 and included a combined total
of 1,627 patients, with 1,053 in the BH group and 574 in the AH group. The
present analysis showed that patients undergoing BH surgery were generally
more comorbid and more frequently underwent minimally invasive procedures
as compared with patients undergoing AH surgery. The BH and AH groups
reported no significant differences in postoperative outcomes. At
follow-up, BH was associated with higher recurrent >2+ tricuspid
regurgitation rates (P = 0.048), but this did not affect late survival
(hazard ratio [HR] = 0.90, 95% confidence interval [CI]: 0.68 to 1.19, P =
0.457) or reintervention for TV (HR = 1.18, 95% CI: 0.61 to 2.29, P =
0.622) rates. <br/>Conclusion(s): A consensus between BH and AH for ITVS
is still lacking. However, BH ITVS procedures appear to be the preferred
surgeon choice for higher-risk patients. At follow-up, the BH group showed
higher rates of recurrent tricuspid regurgitation >2+, without affecting
late survival or rates of TV reintervention.<br/>Copyright &#xa9; The
Author(s) 2025

<54>
Accession Number
2040632337
Title
The effectiveness of music on pain during heel blood collection in
premature infants: A randomized controlled trial.
Source
Infant Behavior and Development. 81 (no pagination), 2025. Article Number:
102157. Date of Publication: 01 Dec 2025.
Author
Dogan P.; Karakul A.; Engur D.; Oncel M.Y.
Institution
(Dogan) Izmir Katip Celebi University, Faculty of Health Science,
Department of Pediatric Nursing, Izmir, Turkey
(Karakul) Tarsus University, Faculty of Health Sciences, Department of
Nursing, Mersin, Turkey
(Engur) Izmir S.B.U Tepecik Teaching and Research Hospital, Izmir, Turkey
(Oncel) Izmir Buca Seyfi Demirsoy Teaching and Research Hospital, Izmir,
Turkey
Publisher
Elsevier Ltd
Abstract
Newborns are exposed to pain during heel blood collection. The experience
of pain in newborns can lead to both physiological and behavioral changes.
The aim of this study was examine the effect of music (classical music and
lullaby) on pain during the heel blood collection in premature infants.
This single blind randomized controlled study was conducted between
October, 2022 and April, 2023 in the Neonatal Intensive Care Unit at a
university hospital. A total of 60 premature infants were randomly
allocated to three groups: the Control Group, the Classical Music Group,
and the Lullaby Group. Pain, oxygenation saturation levels, heart rate and
respiratory rate were measured before, during, after the heel blood
collection procedure. There were no statistically significant differences
in the demographic data of the infants in the classical music, lullaby,
and control groups. After heel blood collection procedure, pain levels,
heart rate and respiratory rate of premature infants in the lullaby groups
measurement were lower than the classical and control group. No
significant difference was found in terms of oxygen saturation between the
groups. In premature infants, in the lullaby group listening to during
heel blood collection was more effective in reducing pain compared to the
control group and classical music. This indicates lullaby can potentially
be an effective method in alleviating pain during heel blood
collection.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<55>
Accession Number
2041196869
Title
Collaborative couple-based management using King's theory improves health
behaviours after percutaneous coronary intervention for coronary artery
disease: randomized controlled trial.
Source
European Journal of Cardiovascular Nursing. 24(7) (pp 1052-1064), 2025.
Date of Publication: 01 Nov 2025.
Author
Yang Q.; Ma H.; Huang J.; Liu X.; Wang Y.; Li Z.; Cheng Y.; Wu Q.; Hu K.;
Liu J.; Qiu W.; Chao Y.; Lyu Q.
Institution
(Yang, Ma, Wang, Li, Cheng, Wu, Hu, Liu, Lyu) School of Nursing, Jinan
University, No. 601 Huangpu Avenue West, Tianhe District, Guangdong
Province, Guangzhou, China
(Huang) Department of Cardiology, Dongguan People's Hospital, No. 3 South
Wandao Road, Xinguyong Community, Wanjiang District, Guangdong Province,
Dongguan, China
(Liu) School of Nursing and Health Sciences, Hong Kong Metropolitan
University, Jockey Club Institute of Healthcare, 1 Sheung Shing Street, Ho
Man Tin, Kowloon, Hong Kong
(Qiu) Department of Cardiology, The First Affiliated Hospital of Jinan
University, No. 613 West Huangpu Avenue, Tianhe District, Guangdong
Province, Guangzhou, China
(Chao) Division of Nursing Science, Rutgers School of Nursing, Ackerson
Hall, Rm. 360, 180 University Avenue, Newark, NJ, United States
Publisher
Oxford University Press
Abstract
Aims To explore the impact of a collaborative management for couples based
on KING's Goal Attainment Theory on the health outcomes of
post-percutaneous coronary intervention (PCI) patients with coronary heart
disease (CHD). Methods and results This RCT involved 194 eligible
patients, randomly assigned to either a control group (CG) or an
intervention group (IG). The CG received routine care and follow-up, while
the IG received KING's Theory-based couple-focused case management in
addition to routine care. The intervention comprised pre- and
post-discharge sessions, containing dyadic goal-setting and dyadic health
management strategies, fostering collaborative decision-making between the
patient and their spouse. Outcomes were measured at T0 (2 days
post-stabilisation), 1 and 3 months post-discharge. The mean age of the
participants was 61.3 (SD = 12.0) years. Baseline data were similar in
both groups. The intervention significantly improved chronic disease
management self-efficacy (beta = 1.175), medication adherence (beta =
0.834), healthy diet adherence (beta = 1.127), exercise adherence (beta =
1.206), and was associated with the improvements of total cholesterol
(beta = -0.293), triglycerides (beta = -0.280), and low-density
lipoprotein (beta = -0.229). All P < 0.05. However, the difference in
high-density lipoprotein levels (beta = -0.012), the rate of
revascularization, recurrent angina pectoris, in-stent restenosis, and
left ventricular ejection fraction (Z = -0.667) between the groups was not
significant, all P > 0.05. Conclusion The collaborative management for
couples based on KING's Goal Attainment Theory significantly improved
self-efficacy and adherence to lifestyle changes of post-PCI patients with
CHD, and was associated with the improvements of the lipid profiles.
Future studies could investigate the cost-effectiveness and long-term
impact of this theory-based intervention. Registration Chinese Clinical
Trial Registry (ChiCTR): ChiCTR2400085183.<br/>Copyright &#xa9; The
Author(s) 2025. Published by Oxford University Press on behalf of the
European Society of Cardiology. All rights reserved.

<56>
Accession Number
2034368011
Title
Combined Use of Dexmedetomidine and Hydrocortisone to Prevent New-Onset
Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery: A
Randomized Clinical Trial.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. 29(4) (pp 284-290),
2025. Date of Publication: 01 Dec 2025.
Author
Alhadidy M.A.; Alansary A.M.; Elghareeb S.H.
Institution
(Alhadidy, Alansary, Elghareeb) Department of Anesthesiology, ICU and Pain
Management, Ain Shams University, Cairo, Egypt
Publisher
SAGE Publications Inc.
Abstract
Objective: Postoperative atrial fibrillation (POAF) occurs in 20%-40% of
patients following coronary artery bypass grafting (CABG), contributing to
significant morbidity. POAF is linked to elevated catecholamines,
oxidative stress, and inflammatory mediators. Dexmedetomidine, a centrally
acting alpha-2 agonist with sympatholytic and anti-inflammatory effects,
and hydrocortisone, which suppresses inflammatory mediators, may reduce
the incidence of POAF. <br/>Method(s): A prospective, double-blind
randomized controlled trial was conducted on 248 patients undergoing
elective on-pump CABG at Ain Shams University Hospital. Patients were
randomized into 2 groups: the Treatment Group received dexmedetomidine and
hydrocortisone, and the Placebo Group received standard care. The primary
endpoint was the occurrence of POAF within 7 days postoperatively.
<br/>Result(s): All 248 patients (124 per group) completed the study. The
combined use of dexmedetomidine and hydrocortisone reduced POAF incidence
(4.8% vs 12.9%). ICU and hospital length of stay were also shorter in the
Treatment Group (2.77 +/- 1.12 vs 3.16 +/- 1.34 days, P = .012, and 6.63
+/- 1.56 vs 7.11 +/- 2 days, P = .035, respectively). No differences in
hypotension, bradycardia, or wound infections were observed.
Hyperglycemia, defined as blood glucose >180 mg/dl, occurred in 8.1% of
the Treatment Group and 6.5% of the Placebo Group. <br/>Conclusion(s):
Combining dexmedetomidine and hydrocortisone effectively reduces POAF
incidence after CABG, with manageable side effects. Multicenter trials are
warranted to confirm these findings. Date and Number of IRB Approval and
Clinical Trial Registry Number. Ain Shams University Protocol Record
(FMASU R 261/2022), ClinicalTrials.gov Identifier:
NCT05674253.<br/>Copyright &#xa9; The Author(s) 2025

<57>
Accession Number
2032339271
Title
Cost Effectiveness of Catheter Ablation Versus Antiarrhythmic Drugs for
Atrial Fibrillation: A Systematic Review and Meta-analysis.
Source
American Journal of Cardiovascular Drugs. 25(2) (pp 169-189), 2025. Date
of Publication: 01 Mar 2025.
Author
Wattanasukchai L.; Bubphan T.; Thavorncharoensap M.; Youngkong S.;
Chaikledkaew U.; Thakkinstian A.
Institution
(Wattanasukchai) Clinical Epidemiology Unit, Faculty of Medicine, Khon
Kean University, Khon Kaen, Thailand
(Bubphan) Cardiology Unit, Department of Internal Medicine, Udon Thani
Hospital, Udon Thani, Thailand
(Thavorncharoensap, Youngkong, Chaikledkaew, Thakkinstian) Mahidol
University Health Technology Assessment (MUHTA) Graduate Program, Mahidol
University, Bangkok, Thailand
(Thavorncharoensap, Youngkong, Chaikledkaew) Social and Administrative
Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol
University, Bangkok, Thailand
(Thakkinstian) Department of Clinical Epidemiology and Biostatistics,
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok,
Thailand
Publisher
Adis
Abstract
Background Atrial fibrillation (AF) is the most prevalent cardiac
arrhythmia and is associated with substantial morbidity and mortality.
Current international guidelines recommend antiarrhythmic drugs or
catheter ablation (CA) as rhythm-control strategies for AF. This study
aimed to comprehensively assess economic evaluations (EEs) of the
treatment of AF by country income level. Methods Seven electronic
databases were systematically searched for EE literature until March 30,
2024, with no constraints on time or language. Two independent reviewers
selected the studies, extracted the data, and assessed the quality of the
data. Full EEs comparing CA with antiarrhythmic drugs for rhythm-control
treatment were included; surgical or rate-control treat-ments were
excluded. The quality of the included articles was assessed using the
ECOBIAS checklist. Costs were converted to purchasing power parity US
dollars for 2023. A random-effects meta-analysis was applied to pool
incremental net benefit (INB) based on a heterogeneity test and its degree
(I²> 25% or Cochran's Q test < 0.1). We also explored
heterogeneity and potential publication bias and conducted sensitivity and
subgroup analyses. Results In total, 27 studies across nine countries were
eligible, predominantly from high-income countries (n = 25), with a
smaller subset from upper-middle-income countries (n = 2). Because of the
heterogeneity among the studies, a random-effects model was selected over
a fixed-effects model to pool INBs. Most studies (n = 21) favored CA as
the cost-effective inter-vention, yielding an INB of $US23,796 (95%
confidence interval [CI] 15,341-32,251) in high-income countries. However,
heterogeneity was substantial (I²= 99.67%). In
upper-middle-income countries, the estimated INB was $US18,330 (95% CI -
11,900-48,526). The publication bias results showed no evidence of
asymmetrical funnel plots. Conclusion In this meta-analysis, CA emerged as
a cost-effective rhythm-control treatment for AF when compared with
antiarrhythmic drugs, particularly in high-income countries. However,
economic evidence for upper-middle-income countries is lacking, and no
primary evaluations were found for low-middle-income and low-income
countries. Further EEs are necessary to expand the understanding of AF
treatment globally.<br/>Copyright &#xa9; The Author(s) 2024.

<58>
Accession Number
2041363478
Title
Intranasal Dexmedetomidine vs. Oral Midazolam in Pediatric Emergence
Agitation Management Following Anesthesia; A Double Blind Randomized
Clinical Trial.
Source
Archives of Academic Emergency Medicine. 13(1) (no pagination), 2025.
Article Number: e66. Date of Publication: 01 Sep 2025.
Author
Mahdavi N.S.; Jafari F.; Shojaei F.S.; Razavi S.S.; Mortazavi M.; Mahdavi
A.R.
Institution
(Mahdavi, Jafari, Shojaei, Razavi, Mortazavi, Mahdavi) Department of
Anesthesiology, Mofid Children's Hospital, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Shaheed Beheshti University of Medical Sciences and Health Services
Abstract
Introduction: Emergence agitation (EA) occurs shortly after emergence from
anesthesia in pediatric patients causing disorientation, restlessness, and
non-purposeful movement. This study aimed to compare intranasal
dexmedetomidine (DEX) and oral midazolam in managing EA in pediatric
patients scheduled for neurosurgical procedures. <br/>Method(s): This
double-blinded randomized clinical trial was conducted on 50 pediatric
patients who underwent neurosurgical procedure in an educational hospital
between March and June 2024. One group received intranasal DEX (2 mcg/kg)
and other group received oral midazolam (1 mg/kg of midazolam) before
induction of anesthesia. The rate of EA as well as vital signs changes
were compared between the two groups using statistical analysis.
<br/>Result(s): 50 participants were enrolled in the study and randomly
divided to DEX and midazolam groups (25 participants in each group). The
two groups were similar regarding age (p = 0.538); sex (p = 0.417);
pre-operation heart rate (p = 0.675); systolic (p = 0.226) and diastolic
(p = 0.753) blood pressure; and pre-operative mean arterial blood pressure
(p = 0.634). Among all participants, 13 (26.00%) patients showed signs of
EA after extubation (2 patients (8.00%) in DEX group and 11 (44.00%)
patients in midazolam group; p = 0.004). Regrading vital signs, only the
decrease in heart rate after extubation in the DEX group was significantly
greater than that observed in the midazolam group (-9.28+/-12.88 vs.
-2.48+/-8.23, respectively; p = 0.0310). The number needed to treat (NNT),
relative risk reduction (RRR), and absolute risk reduction (ARR) of using
intranasal DEX in management of EA were 2.77 (95%confidence interval (CI):
1.72-7.19), 81.8% (95%CI: 26.0%-95.5%), and 36.0% (95%CI: 13.9%-58.1%)
respectively. <br/>Conclusion(s): Intranasal DEX compare to oral midazolam
demonstrated superior efficacy in managing postoperative EA in pediatric
patients.<br/>Copyright &#xa9; 2025 Shaheed Beheshti University of Medical
Sciences and Health Services. All rights reserved.

<59>
Accession Number
2031305675
Title
Electronic Health Record Alert With Heart Failure Risk and Sodium Glucose
Cotransporter 2 Inhibitor Prescriptions in Diabetes: A Randomized Clinical
Trial.
Source
Journal of Diabetes Science and Technology. 19(6) (pp 1496-1504), 2025.
Date of Publication: 01 Nov 2025.
Author
Segar M.W.; Patel K.V.; Keshvani N.; Kannan V.; Willett D.; Klonoff D.C.;
Pandey A.
Institution
(Segar) Department of Cardiology, The Texas Heart Institute, Houston, TX,
United States
(Patel) Department of Cardiology, Houston Methodist DeBakey Heart &
Vascular Center, Houston, TX, United States
(Keshvani, Willett, Pandey) Division of Cardiology, Department of Internal
Medicine, The University of Texas Southwestern Medical Center, Dallas, TX,
United States
(Kannan) Department of Health System Information Resources (Clinical
Informatics), The University of Texas Southwestern Medical Center, Dallas,
TX, United States
(Klonoff) Diabetes Research Institute, Mills-Peninsula Medical Center, San
Mateo, CA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Sodium glucose cotransporter 2 inhibitors (SGLT2i) prevent
heart failure (HF) in patients with type 2 diabetes mellitus (T2DM) but
prescription rates are low. The effect of an electronic health record
(EHR) alert notifying providers of patients' estimated risk of developing
HF on SGTL2i prescriptions is unknown. <br/>Method(s): This was a
pragmatic, randomized clinical trial that compared an EHR alert and usual
care among patients with T2DM and no history of HF or SGLT2i use at a
single center. The EHR alert notified providers of their patient's HF risk
and recommended HF prevention strategies. Randomization was performed at
the provider level across general and subspecialty internal medicine as
well as family medicine outpatient clinics. The primary outcome was
proportion of SGLT2i prescriptions within 30 days. Proportion of
natriuretic peptide (NP) tests within 90 days was also assessed.
<br/>Result(s): A total of 1524 patients (median age 75 years, 45% women,
23% Black) were enrolled between September 28, 2021, and April 29, 2022
from 189 outpatient clinics. SGLT2i were prescribed to 1.2% (9/780) of
patients in the EHR alert group and 0% (0/744) of those in the usual care
group (P value = 0.009). Natriuretic peptide testing was performed within
90 days among 10.8% (84/780) of patients in the EHR alert group and 7.3%
(54/744) of patients in the usual care group (P value = 0.02).
<br/>Conclusion(s): In a single-center trial with low overall SGLT2i use,
an EHR alert incorporating HF risk information significantly increased
SGLT2i prescriptions and NP testing although the absolute rates were
low.<br/>Copyright &#xa9; 2024 Diabetes Technology Society

<60>
Accession Number
2041326554
Title
The Effect of Normothermia and Moderate Hypothermia Cardiopulmonary Bypass
on Early Clinical Outcomes in Low-Risk Pediatrics Undergoing Congenital
Heart Defects Surgery.
Source
Innovative Journal of Pediatrics. 35(3) (no pagination), 2025. Article
Number: e159576. Date of Publication: 01 Jun 2025.
Author
Namdar S.; Zirak N.; Sistani M.N.; Khozani E.S.; Maleki M.H.; Yaghubi M.
Institution
(Namdar) Department of Extra-Corporeal Circulation (ECC), Imam Reza
Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic
Republic of
(Zirak) Department of Anesthesiology, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Sistani) Pediatric and Congenital Cardiology Division, Department of
Pediatric, Faculty of Medicine, Mashhad University of Medical Sciences,
Mashhad, Iran, Islamic Republic of
(Khozani) Faculty of Nursing and Midwifery, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
(Maleki) Department of Cardiac Surgery, Imam Reza Hospital, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Yaghubi) Department of Extra-Corporeal Circulation (ECC), Razavi
Hospital, Imam Reza International University, Mashhad, Iran, Islamic
Republic of
Publisher
Brieflands
Abstract
Background: The optimal temperature strategy during cardiopulmonary bypass
(CPB) remains a topic of debate. <br/>Objective(s): This study
investigates the effects of normothermia and moderate hypothermia during
CPB on early clinical outcomes in congenital heart defect surgery.
<br/>Method(s): In this prospective, randomized cohort study, 120 patients
with congenital heart defects classified as risk adjustment for congenital
heart surgery (RACHS) I-II were enrolled. The participants were divided
into two groups: Sixty patients underwent normothermic CPB, and 60
underwent moderate hypothermic CPB. The primary clinical outcomes assessed
were the vasoactive inotropic score (VIS), weaning time from mechanical
ventilation, and lengths of ICU and hospital stays. Statistical analyses
were conducted using SPSS software version 26.0, with a significance level
set at P < 0.05. <br/>Result(s): The analysis of primary outcomes revealed
that patients in the normothermic group had significantly lower VIS,
shorter ICU stays, and reduced weaning times from mechanical ventilation
compared to the moderate hypothermic group (P < 0.001). Additionally,
other clinical outcomes, including CPB time (P < 0.001), glomerular
filtration rate (GFR) at 24 hours post-ICU admission (P = 0.024), thoracic
blood loss (P < 0.001), blood product transfusion requirements (P <
0.001), and several hematologic laboratory findings (P < 0.05),
demonstrated statistically significant differences between the two groups.
<br/>Conclusion(s): Based on the clinical outcomes observed in this study,
a normothermic CPB strategy appears to be optimal for low-risk pediatric
patients undergoing congenital heart disease surgery.<br/>Copyright &#xa9;
2025, Namdar et al.

<61>
Accession Number
2040819198
Title
Beyond Conventional Meta-Analysis: A Meta-Learning Model to Predict
Cohort-Level Mortality After Transcatheter Aortic Valve Replacement
(TAVR).
Source
Journal of Cardiovascular Development and Disease. 12(10) (no pagination),
2025. Article Number: 376. Date of Publication: 01 Oct 2025.
Author
Liscano Y.; Martinez Guevara D.; Urriago-Osorio G.A.; Quintana J.
Institution
(Liscano, Martinez Guevara) Grupo de Investigacion en Salud Integral
(GISI), Department of Health, Universidad Santiago de Cali, Cali, Colombia
(Urriago-Osorio, Quintana) Internal Medicine Specialization Program,
Department of Health, Universidad Santiago de Cali, Cali, Colombia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Context and Objective: Post-Transcatheter Aortic Valve Replacement (TAVR)
mortality exhibits extreme heterogeneity that conventional meta-analyses
fail to explain, limiting the clinical utility of evidence synthesis and
hindering accurate prognostic assessment. This study evaluated whether
meta-learning, using aggregate data from the literature, can predict
cohort-level mortality and identify its determinants, overcoming the
limitations of traditional methods to provide a clearer understanding of
the factors driving TAVR outcomes. <br/>Method(s): A systematic review
following PRISMA guidelines was conducted across five databases.
Methodological quality was assessed with standardized tools (Risk of Bias
2, Newcastle-Ottawa Scale, Risk of Bias in Non-randomized Studies of
Exposure). After performing conventional meta-analyses and
meta-regressions, multiple machine learning models were trained using
study-level characteristics as predictors. Advanced optimization with
regularization and ensemble techniques was applied to develop a final,
optimized model. <br/>Result(s): Fifty-eight studies, encompassing over
533,000 patients, were included. Traditional meta-analysis confirmed
extreme heterogeneity (I² = 76.7% in Random Clinical Trials,
96.8% in observational studies), with no explanatory power via
meta-regression. The initial AdaBoost model achieved R² =
0.191, outperforming 17 alternative algorithms. Advanced optimization
developed a Blend_Optimized model that explained 65.3% of the variability
(R² = 0.653), marking a substantial 46 percentage-point
increase. Interpretability analysis identified four dominant predictors:
Society of Thoracic Surgeons Predicted Risk of Operative Mortality
(R² = 0.300), Recruitment Year (R² = 0.212), %
Transfemoral (R² = 0.201), and % Diabetes (R² =
0.175), revealing a potent temporal gradient reflecting the evolution of
medical practice. <br/>Conclusion(s): Meta-learning significantly
surpasses traditional methods in extracting systematic signals from
heterogeneous evidence. This study demonstrates that, in addition to
patient risk factors, a significant temporal gradient models technological
evolution and learning curves. The methodology transforms seemingly
unexplained heterogeneity into clinically interpretable patterns,
demonstrating the potential of meta-learning as a complementary tool for
evidence synthesis in interventional cardiology and opening avenues for
applications in other complex cardiovascular fields. Important Limitation:
This model predicts cohort-level outcomes and should not be used for
individual risk assessment.<br/>Copyright &#xa9; 2025 by the authors.

<62>
Accession Number
2041374815
Title
Total Intravenous Versus Volatile Anesthesia in Pediatric Cardiac Surgery:
Inflammatory Response and Early Recovery Profiles.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Patel G.; Mandal B.; Kahlon S.; Garg V.; Puri G.D.; Kst S.; Rawat A.
Institution
(Patel, Mandal, Kahlon, Garg, Puri) Department of Anesthesia and Intensive
Care, Postgraduate Institute of Medical Education and Research (PGIMER),
Chandigarh, India
(Kst) Department of Cardiovascular and Thoracic Surgery, Postgraduate
Institute of Medical Education and Research (PGIMER), Chandigarh, India
(Rawat) Pediatric Allergy and Immunology Unit, Postgraduate Institute of
Medical Education and Research (PGIMER), Chandigarh, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the effects of total intravenous anesthesia (TIVA)
versus volatile anesthesia on systemic inflammation and early
postoperative cognitive recovery in pediatric patients undergoing cardiac
surgery with cardiopulmonary bypass. <br/>Design(s): Prospective,
randomized controlled trial. <br/>Setting(s): A tertiary care center
specializing in pediatric cardiac surgery. <br/>Participant(s): Fifty
children aged 1 to 12 years undergoing elective open heart surgery
requiring cardiopulmonary bypass. <br/>Intervention(s): Participants were
randomized to receive either propofol-based TIVA or sevoflurane-based
volatile anesthesia. All patients were managed under standardized
protocols for intraoperative monitoring and postoperative intensive care
unit care. <br/>Measurements and Main Results: The primary outcome was the
interleukin-6 concentration measured at baseline, 6 hours, and 24 hours
postoperatively. Interleukin-6 levels increased significantly in both
groups but showed no difference between groups at any time point.
Secondary outcomes included Mini-Mental State Examination (MMSE) scores
and duration of mechanical ventilation. Cognitive recovery was assessed in
34 children aged 4 years and older using a pediatric-adapted MMSE. At 24
hours post extubation, the mean MMSE scores were significantly higher in
the TIVA group (23.7 +/- 2.1) than in the volatile group (15.1 +/- 3.0; p
< 0.01), and the difference persisted at 48 hours (27.2 +/- 1.4 vs 23.6
+/- 2.8; p < 0.05). Ventilation duration was also shorter in the TIVA
group (12.4 +/- 3.2 hours vs 20.0 +/- 4.6 hours; p = 0.045).
<br/>Conclusion(s): Interleukin-6 responses, the primary outcome, were
comparable between groups. However, TIVA was associated with higher early
MMSE scores and shorter ventilation duration, suggesting potential
neuroprotective benefits.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<63>
Accession Number
2040871493
Title
Efficacy and safety of echinocandins combined with
Trimethoprim-Sulfamethoxazole as first-line treatment for Pneumocystis
pneumonia in HIV-infected and non-HIV-infected patients.
Source
BMC Infectious Diseases. 25(1) (no pagination), 2025. Article Number:
1443. Date of Publication: 01 Dec 2025.
Author
Xie J.; Gao A.; Zhang W.; Zhao D.; Liu W.
Institution
(Xie, Gao, Zhang, Zhao, Liu) Department of Pharmacy, Beijing YouAn
Hospital, Capital Medical University, No. 8 Xitoutiao, Youanmenwai,
Fengtai District, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Pneumocystis pneumonia (PCP) is a life-threatening infection
in both HIV- infected and non-HIV-infected immunocompromised patients.
Although Trimethoprim-Sulfamethoxazole (TMP/SMX) combined with
echinocandins has been used clinically, whether this combination is
superior to TMP/SMX monotherapy as first-line treatment remains
inconclusive. This systematic review and meta-analysis aimed to evaluate
the efficacy and safety of TMP/SMX plus echinocandins versus TMP/SMX alone
in treating PCP. The protocol of this study was registered at the
PROSPERO, with registration number CRD420251008762. <br/>Method(s): We
systematically searched PubMed, Embase, Cochrane Library, and Web of
Science for studies published before February 28, 2025. Included studies
involved patients with confirmed PCP infection receiving either TMP/SMX
plus echinocandins or TMP/SMX monotherapy. The primary outcome was
all-cause in-hospital mortality. Secondary outcomes included overall
positive response rate and adverse events (AEs). <br/>Result(s): Seven
studies involving 1963 patients were included. Combination therapy was
associated with significantly lower mortality in HIV-infected patients (OR
= 0.44, 95% CI: 0.28-0.70, p = 0.0005), but not in non-HIV-infected
patients (OR = 1.00, 95% CI: 0.57-1.76, p = 0.99). The treatment response
rate was higher with combination therapy in both HIV-infected and
non-HIV-infected patients (OR = 2.29, 95% CI: 1.61-3.28, p < 0.00001). The
positive response rate was significantly higher in non-HIV-infected
(67.54%, 154/228) than in HIV-infected patients (59.00%, 236/400; p <
0.05). No serious AEs were reported in the combination therapy groups.
<br/>Conclusion(s): The combination of echinocandins with TMP/SMX may
reduce mortality in HIV-infected patients with PCP, but does not appear
necessary in non-HIV populations. Due to geographical and demographic
limitations, these findings should be applied in conjunction with clinical
context.<br/>Copyright &#xa9; The Author(s) 2025.

<64>
Accession Number
2040919658
Title
European Journal of Heart Failure expert consensus statement on
transcatheter treatment of mitral regurgitation in heart failure.
Source
European Journal of Heart Failure. (no pagination), 2025. Date of
Publication: 2025.
Author
Iliadis C.; Adamo M.; Rudolph V.; Karam N.; von Bardeleben R.S.; Anker
S.D.; Delgado V.; Hausleiter J.; Kempton H.; Metra M.; Bohm M.; Baldus S.
Institution
(Iliadis, Baldus) Department of Internal Medicine III, Faculty of Medicine
and University Hospital Cologne, University of Cologne, and Center for
Cardiovascular Medicine (CCMABCD), partner site Cologne, Cologne, Germany
(Adamo, Metra) Cardiology, ASST Spedali Civili, Department of Medical and
Surgical Specialties, Radiological Sciences, and Public Health, University
of Brescia, Brescia, Italy
(Rudolph) General and Interventional Cardiology, Heart and Diabetes Centre
NRW, University Hospital of the Ruhr-University Bochum, Medical Faculty
OWL, Bad Oeynhausen, Germany
(Karam) Department of Cardiology, European Hospital Georges Pompidou and
Paris Cardiovascular Research Centre (INSERM U970), Paris, France
(von Bardeleben) Department of Cardiology, University Medical Centre
Mainz, Mainz, Germany
(Anker) Department of Cardiology (CVK) of German Heart Centre Charite;
German Centre for Cardiovascular Research (DZHK) partner site Berlin,
Charite Universitatsmedizin, Berlin, Germany
(Delgado) Cardiovascular Imaging Section, Department of Cardiology, Heart
Institute, University Hospital Germans Trias i Pujol, Badalona, Spain
(Hausleiter, Kempton) Medizinische Klinik und Poliklinik I, LMU-Klinikum,
LMU Munchen, Munich, Germany
(Hausleiter) German Centre for Cardiovascular Research (DZHK), partner
site Munich Heart Alliance, Munich, Germany
(Bohm) Department of Cardiology, Angiology and Internal Intensive Care,
University Hospital of Saarland, Saarland University, Homburg, Germany
Publisher
John Wiley and Sons Ltd
Abstract
Secondary mitral regurgitation (SMR) is highly prevalent in patients with
heart failure (HF), associated with poor prognosis, and its treatment is
typically preceded by implementing pharmacotherapy for HF as well as
cardiac resynchronization therapy. Given the increase in experience and
important technological iterations, transcatheter mitral valve repair has
witnessed increasing safety and efficacy. Recently, two randomized
controlled trials extended the level of evidence for this intervention in
patients with SMR: RESHAPE-HF2 randomized patients with less severe SMR to
either medical therapy alone versus adjunct transcatheter repair, whereas
the MATTERHORN trial compared surgical therapy with transcatheter mitral
valve repair in patients with SMR and increased risk for surgery. These
two trials have a potential impact on the indications of transcatheter
repair. Here we discuss updated indications for transcatheter mitral valve
therapy across the different subtypes of SMR, revisit the current body of
evidence for transcatheter mitral valve repair and classify this technique
into the current treatment hierarchy of SMR in patients with
HF.<br/>Copyright &#xa9; 2025 The Author(s). European Journal of Heart
Failure published by John Wiley & Sons Ltd on behalf of European Society
of Cardiology.

<65>
Accession Number
2041269848
Title
Left atrial appendage occlusion in patients with end-stage renal disease:
an individual patient-level meta-analysis.
Source
Europace. 27(10) (no pagination), 2025. Article Number: euaf198. Date of
Publication: 01 Oct 2025.
Author
Rodriguez-Riascos J.F.; Vemulapalli H.S.; Akin I.; Areiza L.A.; Della
Rocca D.G.; Eitel I.; Fink T.; Genovesi S.; Kefer J.; Zweiker D.;
Prajapati P.; Srivathsan K.
Institution
(Rodriguez-Riascos, Vemulapalli, Prajapati, Srivathsan) Division of
Cardiovascular Diseases, Mayo Clinic, 5777 East Mayo Boulevard, Phoenix,
AZ, United States
(Akin) Department of Invasive Cardiology and Electrophysiology, University
Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University,
First Department of Medicine, Cardiovascular Research, Mannheim, Germany
(Areiza) Department of Invasive Cardiology, Hospital Universitario Mayor,
Mederi, Bogota, Colombia
(Della Rocca) Texas Cardiac Arrhythmia Institute, St.David's Medical
Center, Austin, TX, United States
(Della Rocca) Heart Rhythm Management Centre, Universitair Ziekenhuis
Brussel-Vrije Universiteit Brussel, European Reference Network
Guard-Heart, Jette, Brussels, Belgium
(Eitel) Department of Cardiology, Angiology and Intensive Care
Medicine-Division of Electrophysiology, University Heart Center Lubeck,
Lubeck, Germany
(Fink) Clinic for Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr
University Bochum, Bad Oeynhausen, Germany
(Genovesi) School of Medicine and Surgery, Nephrology Clinic, University
of Milano-Bicocca, Milan, Italy
(Genovesi) Istituto Auxologico Italiano, IRCCS, Milan, Italy
(Kefer) Division of Cardiology, Cliniques Universitaires Saint-Luc et Pole
de Recherche Cardiovasculaire, Universite Catholique de Louvain
(UCLouvain), Institut de Recherche Experimentale et Clinique, (IREC),
Brussels, Belgium
(Zweiker) Department of Cardiology, Medical University of Graz, Graz,
Austria
(Zweiker) Third Medical Department for Cardiology and Intensive Care,
Clinic Ottakring, Vienna, Austria
Publisher
Oxford University Press
Abstract
Aims Patients with end-stage renal disease (ESRD) and atrial fibrillation
present a challenge for thromboembolic prevention, given their elevated
risks of both thromboembolism and bleeding. Anticoagulants carry a higher
bleeding risk in this population without clear evidence of thromboembolic
benefit. This study aims to define the role of left atrial appendage
occlusion (LAAO) as a preventive strategy for patients with ESRD. Methods
and results A systematic literature review was conducted to identify
studies reporting outcomes in patients with ESRD who underwent LAAO.
Meta-analyses of aggregate and individual patient data were performed to
evaluate acute and long-term outcomes and compare them with those of
patients without ESRD. Seventeen studies reporting data from 24 127
patients, including 1047 with ESRD, were included. Procedural
complications were more common in patients with ESRD (RR 2.23; P = 0.02),
with a pooled rate of 4% (95% CI, 1-9%). There was no significant
difference in thromboembolic event rates during follow-up between the
groups (IRR 1.44; P = 0.16), but major bleeding incidence was higher among
patients with ESRD (IRR 1.84; P < 0.01). Individual patient-level data
from seven studies comprising 4745 patients (268 with ESRD) were obtained
and analysed. Similarly, there was no significant association between ESRD
and stroke/TIA incidence (HR, 1.22; 95% CI, 0.66-2.26), but major bleeding
was higher on patients with ESRD (HR, 1.65; 95% CI, 1.01-2.69). Conclusion
LAAO represents a feasible option for thromboembolic prevention in
patients with ESRD, although these patients have an increased risk of
complications and bleeding.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<66>
Accession Number
2041351853
Title
Quality indicators in pediatric cardiopulmonary bypass: Current
perspectives and future directions.
Source
Perfusion (United Kingdom). (no pagination), 2025. Article Number:
02676591251393364. Date of Publication: 2025.
Author
Yoneyama F.; Van Dyke T.R.; Brenes J.
Institution
(Yoneyama, Brenes) Department of Congenital Heart Surgery, Baylor College
of Medicine, Texas Children's Hospital, Austin, TX, United States
(Van Dyke) Department of Perfusion, Texas Children's Hospital, Austin, TX,
United States
Publisher
SAGE Publications Ltd
Abstract
Introduction: Cardiopulmonary bypass (CPB) plays a central role in
pediatric cardiac surgery, yet standardized quality indicators (QIs)
specific to pediatric practice remain underutilized across institutions.
<br/>Method(s): A comprehensive review of literature from 2010 to 2025 was
conducted using PubMed, Embase, and the Cochrane Library. Eligible studies
included randomized trials, observational research, and meta-analyses.
<br/>Result(s): DO<inf>2</inf>i > 340 mL/min/m²in neonates and
>400 mL/min/m²in infants was associated with a lower risk of
acute kidney injury (AKI). Lactate >3 mmol/L predicted major morbidity,
while MAP >40-45 mmHg correlated with adequate perfusion. Maintaining Hct
>=25% and a fluid balance within +/-5% of baseline also supported improved
postoperative outcomes. The integration of real-time multimodal
monitoring, including NIRS and venous oxygen metrics, enhances
individualized perfusion management. <br/>Conclusion(s): Adopting and
standardizing QIs in pediatric CPB supports early detection of inadequate
perfusion and enhances surgical safety. A structured, multimodal QI
framework can facilitate institutional benchmarking, improve patient
outcomes, and guide future innovation in pediatric perfusion
practices.<br/>Copyright &#xa9; The Author(s) 2025

<67>
Accession Number
2041197094
Title
From frailty to function after cardiac surgery: a call for nurse-led
holistic innovation.
Source
European Journal of Cardiovascular Nursing. 24(7) (pp 1097-1098), 2025.
Date of Publication: 01 Nov 2025.
Author
Bueser T.; Chen R.
Institution
(Bueser) Florence Nightingale Faculty of Nursing, Midwifery & Palliative
Care, King's College London, James Clerk Maxwell Building, 57 Waterloo
Road, London, United Kingdom
(Bueser) South East Genomic Medicine Service Alliance, Guy's and St
Thomas' Hospital NHS Foundation Trust, Westminster Bridge Road, London,
United Kingdom
(Chen) Monash Victorian Heart Institute, Monash University, 631 Blackburn
Road, Clayton, VIC, Australia
(Chen) Monash Nursing and Midwifery, Monash University, 10 Chancellors
Walk, Wellington Road, Clayton, VIC, Australia
Publisher
Oxford University Press

<68>
Accession Number
2040919230
Title
Long-Term Durability of Balloon-Expandable Versus Self-Expanding
Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2025.
Date of Publication: 2025.
Author
Continisio S.; Munafo A.R.; Montonati C.; Terzi R.; Boldi E.; Ielasi A.;
Montalto C.; Soriano F.; Oreglia J.A.; Marco F.D.; Silvestro A.; Fabris
T.; Ho E.; Saia F.; Tarantini G.; Godino C.; Maisano F.; Tang G.H.L.;
Latib A.; Scotti A.
Institution
(Continisio, Boldi, Silvestro) Division of Cardiology, Clinica S. Rocco di
Franciacorta, Brescia, Italy
(Munafo, Montalto, Soriano, Oreglia) De Gasperis Cardio Center,
Interventional Cardiology Unit, Niguarda Hospital, Milan, Italy
(Montonati, Ielasi) Division of Cardiology, IRCCS Hospital
Galeazzi-Sant'Ambrogio, Milan, Italy
(Terzi, Marco) Department of Cardiology, Monzino Cardiology Center, Milan,
Italy
(Montalto) School of Medicine and Surgery, University of Milano-Bicocca,
Milan, Italy
(Fabris, Tarantini) Department of Cardiac, Thoracic and Vascular Sciences
and Public Health, University of Padova, Padua, Italy
(Ho, Latib, Scotti) Montefiore-Einstein Center for Heart and Vascular
Care, Montefiore Medical Center, Albert Einstein College of Medicine,
Bronx, NY, United States
(Saia) Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS
University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy
(Godino, Maisano) Heart Valve Center, Cardio-Thoracic-Vascular Department,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Latib) Division of Cardiology, University of Cape Town, Cape Town, South
Africa
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) for aortic
stenosis (AS) is increasingly performed in younger patients with long life
expectancy. However, limited data exist on the durability of transcatheter
heart valves (THVs). <br/>Aim(s): The aim of the present work is to
compare the long-term durability of balloon-expandable (BEV) and
self-expanding (SEV) THVs after TAVR. <br/>Method(s): Electronic databases
were searched up to May 2025 for studies reporting on the long-term
durability of THVs in patients undergoing TAVR with a minimum follow-up of
5 years. Pooled odds ratios (ORs) with 95% confidence interval (CI) were
used as summary statistics and were calculated using a random-effects
model. Co-primary endpoints were moderate and severe structural valve
deterioration (SVD) and the occurrence of all-cause bioprosthetic valve
failure (BVF). All-cause death was the secondary endpoint. <br/>Result(s):
A total of 22 studies and 12,131 patients undergoing TAVR were included:
52.5% of patients (n = 6362) received BEV, 47.5% (n = 5769) SEV. An
old-generation THV was used in 84.5% of cases. At a median follow-up of 7
(5-8.3) years, the overall pooled estimates of moderate/severe SVD and BVF
were 7% (5-9) and 4% (3-5), respectively. Patients treated with a BEV
experienced a higher rate of SVD (OR: 2.09; 95% CI: 1.58-2.75; p < 0.001)
and BVF (OR: 1.61; 95% CI: 1.10-2.36; p = 0.014); no difference was
observed in terms of all-cause death. <br/>Conclusion(s): At long-term
follow-up after TAVR, patients receiving a BEV experienced higher rates of
moderate/severe SVD and of BVF compared to those having a SEV. However, no
significant differences between the two THV designs were observed on the
clinical endpoint of all-cause death.<br/>Copyright &#xa9; 2025 Wiley
Periodicals LLC.

<69>
Accession Number
649063438
Title
The Effect of the 5A Self-management Model on Treatment Adherence and
Self-care in Patients Undergoing Coronary Artery Bypass Graft Surgery:
Protocol Study.
Source
International Cardiovascular Research Journal. Conference: 16th Middle
East Cardiovascular Congress (MECC), 9th Congress of Clinical Cases in
Complex Cardiovascular Therapeutics (CCCCT) and 4th Student Conference
from Prevention to Intervention. Dubai . 19(Supplement 1) (pp 11), 2025.
Date of Publication: 01 Jul 2025.
Author
Tajizadegan F.; Shahriari M.; Dehkordi L.M.; Hosseini M.
Institution
(Tajizadegan, Shahriari, Dehkordi, Hosseini) 1School of Nursing and
Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2Department of Medical-Surgical Nursing, School of Nursing and Midwifery,
Isfahan University of Medical Sciences, Isfahan, Iran 3Department of
Medical-Surgical Nursing, School of Nursing and Midwifery, Isfahan
University of Medical Sciences, Isfahan, Iran 4Department Epidemiology and
Biostatistics, School of Health and Statistics, Isfahan University of
Medical Sciences, Isfahan, Iran
Publisher
Brieflands
Abstract
Background: Coronary artery bypass grafting (CABG) is recognized as one of
the most effective treatments for coronary artery disease (CAD). However,
the long-term success of CABG depends on the extent of patients' adherence
to treatment and self-care practices. Utilizing patient-centered
self-management programs may be effective in improving adherence to
treatment and self-care by fostering desirable behaviors.
<br/>Objective(s): This study aims to investigate the impact of the 5A
self-management model on treatment adherence and self-care among patients
undergoing Coronary Artery Bypass Grafting at Shahid Chamran Hospital.
<br/>Method(s): This study will be a two-group randomized clinical trial
conducted on 60 patients undergoing CABG surgery at Shahid Chamran
Hospital in Isfahan. Patients will be selected based on inclusion criteria
and then randomly assigned to either the intervention group or the control
group, with 30 patients in each group. The intervention group will receive
a self-management program based on the 5A model, which includes the stages
of assess, advise, agree, assist, and arrange, over a period of two
months. The control group will receive routine care. Data will be
collected using demographic information forms and the standard adherence
to treatment questionnaire by Madanloo, as well as a self-care
questionnaire for patients undergoing CABG. Data analysis will be
performed using descriptive and inferential statistics with SPSS software
version 26. <br/>Result(s): XX <br/>Conclusion(s): It is expected that by
employing a suitable educational model, such as the 5A model, appropriate
strategies can be implemented to enhance patient engagement in self-care
and promote treatment adherence among individuals who have undergone
coronary artery bypass graft surgery. Such approaches can yield beneficial
outcomes for both the patient and their family, as well as for the
healthcare delivery system.

<70>
Accession Number
2041514566
Title
Low dose of landiolol does not prevent postoperative atrial fibrillation
after cardiac surgery in non-Asian patients: a multicentre randomised
study.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Amour J.; Naudin C.; Besnard A.; Merzoug M.; Laverdure F.; Frossard B.;
Morichau-Beauchant T.; Geri G.; Squara P.
Institution
(Amour, Besnard, Laverdure, Frossard) Department of Cardiac
Anaesthesiology and Intensive Care Medicine, Institute of Perfusion,
Intensive Care Medicine and Anaesthesiology (IPRA), Hopital Prive Jacques
Cartier-Ramsay Sante, Massy, France
(Naudin, Merzoug, Geri, Squara) Department of Cardiology and Intensive
Care Medicine-Groupe Hospitalier Prive Ambroise Pare-Hartmann,
Neuilly-Sur-Seine, France
(Morichau-Beauchant) Department of Intensive Care Medicine, Centre
Cardiologique du Nord, Saint Denis, France
Publisher
Elsevier Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) affects 30% of
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Beta-blockers are the first-line agents recommended for POAF prevention.
Landiolol, an ultra-short-acting, highly selective beta-1-blocker, has
been shown to be effective in reducing POAF in Asian patients at a low
dose of 2 mug kg^-1 min^-1. The aim of this study was
to evaluate the effect of a low dose of landiolol for the prevention of
POAF in non-Asian patients after cardiac surgery. <br/>Method(s): This
multicentre, double-blind, randomised, placebo-controlled superiority
trial was conducted from January 2021 to July 2023 at three hospitals in
France. Participants were non-Asians >=65 yr undergoing elective cardiac
surgery with CPB and a left ventricular ejection fraction >=40%. Treatment
was started in the ICU and continued for up to 24 h, after which oral
beta-blockers were administered. The primary endpoint was the incidence of
POAF while in the ICU, analysed by intention to treat. Secondary outcomes
included in-hospital and 30-day POAF, ICU and hospital length of stay, and
safety outcomes. <br/>Result(s): A total of 318 participants (mean age: 71
[range: 68-76] yr; 21.4% female) were randomised. POAF in ICU occurred in
51/160 (31.9%) participants who received placebo, compared with 47/158
(29.8%) who received a low-dose landiolol infusion (relative risk: 0.93
[95% confidence interval, 0.67-1.30]; P=0.77). No differences were
observed in secondary endpoints, including in-hospital POAF and safety
outcomes. <br/>Conclusion(s): In non-Asian patients undergoing cardiac
surgery with CPB, a low-dose 24-h infusion of landiolol, used as a bridge
to oral beta-blockers, did not reduce the incidence of postoperative
atrial fibrillation. Clinical trial registration: ClinicalTrials.gov
(NCT04607122).<br/>Copyright &#xa9; 2025 British Journal of Anaesthesia

<71>
Accession Number
2041488720
Title
Prevalence and clinical impact of baseline atherosclerotic vascular
disease in patients undergoing transcatheter aortic valve implantation: A
meta-analysis.
Source
International Journal of Cardiology. 444 (no pagination), 2026. Article
Number: 134004. Date of Publication: 01 Feb 2026.
Author
Papazoglou A.S.; Tsiartas E.; Kyriakoulis K.G.; Moysidis D.V.; Daios S.;
Anastasiou V.; Kamperidis V.; Ziakas A.; Fragakis N.; Vassilikos V.;
Giannakoulas G.
Institution
(Papazoglou) Athens Naval Hospital, Athens, Greece
(Tsiartas) Royal Devon & Exeter Hospital, Royal Devon University
Healthcare NHS Foundation Trust, Exeter, United Kingdom
(Kyriakoulis) National and Kapodistrian University of Athens, School of
Medicine, Athens, Greece
(Moysidis) School of Medicine, Aristotle University of Thessaloniki,
Thessaloniki, Greece
(Daios, Anastasiou, Kamperidis, Ziakas, Giannakoulas) First Department of
Cardiology, AHEPA University Hospital of Thessaloniki, Thessaloniki,
Greece
(Fragakis) Second Department of Cardiology, Hippokrateion Hospital of
Thessaloniki, Thessaloniki, Greece
(Vassilikos) Third Department of Cardiology, Hippokrateion Hospital of
Thessaloniki, Thessaloniki, Greece
Publisher
Elsevier Ireland Ltd
Abstract
Background: Degenerative aortic valve disease and atherosclerotic vascular
disease (ASCVD) frequently coexist. ASCVD may impact pre-procedural
planning and patient outcomes. <br/>Aim(s): To systematically quantify the
prevalence and prognostic significance of prior coronary artery disease
(CAD), peripheral artery disease (PAD), and cerebrovascular event (CVE) in
patients undergoing transcatheter aortic valve implantation (TAVI).
<br/>Method(s): A systematic literature search was conducted to identify
studies reporting the prevalence of baseline ASCVD in patients undergoing
TAVI. Meta-analyses were conducted to synthesize 1) the prevalence of
pre-existing CAD, PAD and CVE in patients undergoing TAVI and 2) the
prognostic effects of these comorbidities for post-TAVI mortality.
<br/>Result(s): A total of 43 studies (14 randomized) fulfilled the
inclusion criteria encompassing a total of 732,895 patients undergoing
TAVI (51 % males, pooled mean age of 81.2 years and Society of Thoracic
Surgeons' score of 5.3). Of these, 48 % (42-55 %) had pre-existing CAD, 16
% (13-20 %) had PAD, and 11 % (9-12 %) had suffered a prior CVE. The
baseline presence of CAD, PAD and CVE was independently linked with worse
prognosis. Significant heterogeneity was observed among included studies,
partially explained by differences in sample size, geographical location,
and baseline patient characteristics. <br/>Conclusion(s): This aggregate
meta-analysis of large-scale studies yielded a high prevalence of ASCVD in
patients undergoing TAVI. Every second patient had CAD, every sixth
patient had PAD and 1 out of 10 had CVE. The presence of each comorbidity
increased independently the risk of long-term mortality. These findings
can help navigate pre-procedural planning, resource allocation, and
ultimately optimize overall TAVI outcomes.<br/>Copyright &#xa9; 2025
Elsevier B.V.

<72>
Accession Number
2041463974
Title
Arrhythmogenic cardiomyopathy diagnosis and management: a systematic
review of clinical practice guidelines and recommendations with insights
for future research.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 11(7) (pp
1033-1069), 2025. Date of Publication: 01 Nov 2025.
Author
Iezzi L.; Sorella A.; Galanti K.; Gallina S.; Chahal A.A.; Bauce B.;
Cipriani A.; Providencia R.; Lopes L.R.; Ricci F.; Khanji M.Y.
Institution
(Iezzi, Sorella, Galanti, Gallina, Ricci) Department of Neuroscience,
Imaging and Clinical Sciences, G. D'Annunzio University of Chieti-Pescara,
Chieti, Italy
(Gallina, Ricci) University Cardiology Division, Heart Department, SS.
Annunziata Polyclinic, Chieti, Italy
(Gallina, Ricci) Institute for Advanced Biomedical Technologies, G.
D'Annunzio University of Chieti-Pescara, Via Luigi Polacchi, 11, Chieti,
Italy
(Chahal, Providencia, Lopes, Khanji) Barts Heart Centre, St. Bartholomew's
Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom
(Chahal) Center for Inherited Cardiovascular Diseases, Department of
Cardiology, WellSpan Health, 30 Monument Rd, York, PA, United States
(Chahal, Khanji) William Harvey Research Institute, NIHR Barts Biomedical
Centre, Queen Mary University of London, Charterhouse Square, London,
United Kingdom
(Chahal) Department of Cardiovascular Medicine, Mayo Clinic, 200 First
Str, SW, Rochester, MN, United States
(Bauce, Cipriani) Department of Cardiac, Thoracic and Vascular Sciences,
University of Padua, Via Giustiniani, 2, Padua, Italy
(Lopes) Institute of Cardiovascular Science, University College London,
London, United Kingdom
(Khanji) Department of Cardiology, Newham University Hospital, Barts
Health NHS Trust, London, United Kingdom
Publisher
Oxford University Press
Abstract
Arrhythmogenic cardiomyopathy (ACM) is addressed in international
guidelines and expert consensus statements. To assist clinicians in their
routine practice and support decision-making, we performed a systematic
review of the most relevant guidelines and recommendations for ACM
diagnosis and management. Our search, covering MEDLINE, EMBASE, and
resources from scientific societies over the last 10 years, identified two
guidelines and three consensus statements that met rigorous inclusion
criteria for detailed analysis. In the examined documents, key areas of
agreement included the critical role of cardiac imaging for initial
diagnosis and ongoing monitoring, genetic testing in index patients,
ventricular arrhythmia management, catheter ablation indications, heart
failure treatment strategies, and exercise recommendations. However,
significant differences were found in definitions and diagnostic criteria
for ACM, interpretation of phenocopies, management of family members, and
criteria for implantable cardioverter defibrillator implantation.
Additional discrepancies emerged regarding the role of multidisciplinary
teams, non-cardiac surgical considerations, atrial fibrillation
management, and reproductive issues. Crucially, there remain considerable
gaps in evidence, especially in areas such as the management and follow-up
of patients with potential or borderline ACM diagnoses, as well as the
care of their relatives. The clinical implications of genetic findings,
along with the clinical management of left-dominant, biventricular
phenotypes, and hot phases of disease, are also insufficiently addressed.
Furthermore, a critical shortfall is the lack of externally validated risk
assessment tools to guide clinical decision-making. Bridging these gaps
could help guiding future research and guideline development towards
improving patient outcomes.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Society of
Cardiology.

<73>
Accession Number
2040701327
Title
The organ protective effects of penehyclidine hydrochloride (PHC) in
patients undergoing cardiac surgery: a systematic review and
meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 516. Date
of Publication: 01 Dec 2025.
Author
Tian L.; Guo J.; Yao Y.
Institution
(Tian, Guo, Yao) Department of Anesthesiology, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Yao) Center of Outcomes Research, Department of Anesthesiology, Critical
Care and Pain Medicine, University of Texas, Houston, TX, United States
(Yao) Outcomes research Consortium, Houston, TX, United States
Publisher
BioMed Central Ltd
Abstract
Background: As a novel selective anticholinergic drug, penehyclidine
hydrochloride (PHC) provided the potential to protect organs by inhibiting
the inflammatory response, attenuating oxidative stress, and alleviating
ischemia / reperfusion injury. This study aimed to evaluate the organ
protective effects of PHC in patients undergoing cardiac surgery.
<br/>Method(s): Six electronic databases were searched systematically for
randomized-controlled trials (RCTs) published April 30th 2025 that
explored the application of PHC on cardiac surgical patients. Primary
outcomes of interest included the biomarkers and variables of major organs
(e.g. heart, lung, gastrointestinal tract and immune system) injury.
Secondary outcomes of interest included the mechanical ventilation
duration and hospital length of stay (LOS). Mean difference (MD) with 95%
confidence interval (CI) or odds ratios (OR) with 95% CI were employed to
analyze the data. <br/>Result(s): A total of 37 RCTs with 1929 cardiac
surgical patients (PHC group, 1043 patients; Control group, 886 patients)
were included. The current study demonstrated that the adult patients in
PHC group had lower cardiac troponin I (cTnI) [MD: -1.70, 95%CI: -2.63 to
-0.77, P = 0.0003, with heterogeneity (P < 0.00001)] and creatine kinase
(CK)-MB levels on post-operative day (POD)-1 after cardiac surgery, while
the pediatric patients had lower cardiac troponin T (cTnT) (MD: -0.10,
95%CI: -0.12 to -0.09, P < 0.00001, without heterogeneity) in PHC group on
POD-1. The levels of interleukin (IL)-6 and tumor necrosis factor
(TNF)-alpha were significantly lower in both adult and pediatric patients
of PHC group on POD-1. The incidence of postoperative pulmonary infection
was significantly reduced in the PHC group, and the duration of mechanical
ventilation and hospital LOS were shortened in adult patients.
<br/>Conclusion(s): This meta-analysis demonstrated that PHC could provide
myocardial protection and suppress the inflammatory response in patients
undergoing cardiac surgery, thereby potentially facilitating rapid
recovery. Clinical trial number: PROSPERO registration number
CRD42020183260.<br/>Copyright &#xa9; The Author(s) 2025.

<74>
Accession Number
2041494420
Title
Full Heparin Reversal With Protamine After Transcatheter Aortic Valve
Replacement: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 258 (pp 239-246), 2026. Date of
Publication: 01 Jan 2026.
Author
Silva J.P.M.R.J.; Nogueira B.V.; Mussolini M.C.B.; Bisneto O.I.D.M.; Gomes
W.F.
Institution
(Silva) Department of Medicine, Federal University of Rio de Janeiro, Rio
de Janeiro, Brazil
(Nogueira) Department of Medicine, University of Sao Paulo, Sao Paulo,
Brazil
(Mussolini) Department of Medicine, School of Medicine of Araraquara,
Araraquara, Brazil
(Bisneto) Department of Medicine, Federal University of Campina Grande,
Cajazeiras, Brazil
(Gomes) Department of Interventional Cardiology, INC Hospital, Curitiba,
Brazil
(Gomes) Department of Internal Medicine, Faculdades Pequeno Principe,
Curitiba, Brazil
(Gomes) Department of Interventional Cardiology, Irmandade da Santa Casa
de Misericordia de Curitiba, Curitiba, Brazil
Publisher
Elsevier Inc.
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.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<75>
Accession Number
2040961749
Title
Perioperative tight glucose control regimens for preventing surgical site
infections following cardiac surgery-a systematic review and metanalysis
of randomized controlled trials.
Source
Journal of Clinical Anesthesia. 108 (no pagination), 2026. Article Number:
112051. Date of Publication: 01 Jan 2026.
Author
Sun Y.; Wen Z.; Ren Y.; Hua Z.
Institution
(Sun, Ren, Hua) Department of Anesthesiology, Beijing Hospital, National
Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing, China
(Wen) Medical school, Jiamusi University, Heilongjiang, Jiamusi, China
Publisher
Elsevier Inc.
Abstract
Background Perioperative hyperglycemia is common during cardiac surgery
and has been linked to an increased risk of surgical site infections
(SSIs). However, the benefits of perioperative tight glucose control (TGC)
remain debated, largely due to concerns about hypoglycemia. This
systematic review assessed the effects and safety of TGC on SSIs in adults
undergoing cardiac surgery. Methods We searched MEDLINE, Embase, and
Cochrane databases for randomized controlled trials (RCTs) comparing TGC
(upper blood glucose target <=150 mg/dL or 8.3 mmol/L) with conventional
glucose management in adults undergoing cardiac surgery. The primary
outcome was incidence of SSIs. Secondary outcomes included hypoglycemia,
length of intensive care unit (ICU) stay, incidence of neurological
deficits and all-cause mortality within 30 days after surgery. The
certainty of evidence was evaluated using the GRADE approach. Results
Twenty-six RCTs including 17,990 participants were analyzed. TGC compared
with control group was associated with reducing the risk of SSIs (risk
ratio [RR]: 0.53; 95 % confidence interval [CI]: 0.42-0.68; I²
= 0 %; low certainty evidence), particularly when initiated at the start
of surgery (RR: 0.50, 95 %CI: 0.39-0.66, I² = 0; low certainty
evidence) but not postoperatively (RR = 0.80, 95 % CI: 0.39-1.66;
I² = 0; very low certainty evidence). TGC also shortened ICU
stay by 7.03 h compared to the control group (95 % CI: -10.83 to -3.22;
very low certainty evidence), though heterogeneity was considerable
(I² = 92 %). However, TGC was associated with a higher risk of
hypoglycemia (RR: 3.14; 95 % CI: 2.37-4.16; I² = 0; moderate
certainty evidence). No significant effects were observed on neurological
deficits or all-cause mortality. Conclusion This systematic review of the
available evidence suggests that perioperative TGC, particularly when
initiated at the start of surgery, may reduce the risk of SSIs following
cardiac surgery. However, it increases the risk of hypoglycemia and does
not significantly impact neurological outcomes and all-cause
mortality.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<76>
Accession Number
649065273
Title
Comparison of 40% glucose solution and autologous blood patch pleurodesis
for the treatment of postoperative air leak after lung resections: A
prospective randomized controlled study.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 04 Nov 2025.
Author
Skrzypczak P.J.; Dobiecki T.; Rozmiarek M.; Gabryel P.; Kasprzyk M.;
Piwkowski C.
Institution
(Skrzypczak, Dobiecki, Rozmiarek, Gabryel, Kasprzyk, Piwkowski) Department
of Thoracic Surgery, Poznan University of Medical Sciences, 62
Szamarzewskiego St, Poznan, Poland
Abstract
OBJECTIVES: Postoperative air leak is among the most common complications
in thoracic surgery. Current management strategies are often suboptimal.
Intrapleural administration of a glucose solution has emerged as a novel
therapeutic approach; however, its clinical value has not been thoroughly
investigated. This study aimed to compare the effectiveness of
intrapleural 40% glucose solution versus autologous blood patch
pleurodesis in managing postoperative air leak. <br/>METHOD(S): This
prospective, randomized, controlled study enrolled patients who underwent
anatomical lung resections (segmentectomy, lobectomy, or bilobectomy) at
the Department of Thoracic Surgery, Poznan University of Medical Sciences,
between November 2023 and December 2024. Patients with postoperative air
leak were randomized to receive either 40% glucose (study group) or
autologous blood (control group). The primary end-point was cessation of
postoperative air leak. Secondary end-points included incidence of
residual air space, chest pain, and reoperation. <br/>RESULT(S): A total
of 110 patients were included: 47 in the glucose group and 63 in the blood
group. Glucose administration resulted in a higher rate of postoperative
air leak resolution (95.7% vs 82.5%, p = 0.033; 95% CI: 2.2% to 24.2%).
The glucose group had a shorter postoperative hospital stay(7 vs 9 days, p
= 0.036). Chest pain occurred more frequently in the glucose group, but
the difference was not statistically significant(10.6% vs 4.8%, p = 0.24).
No major infectious complications were observed. Residual air space
occurence and reoperation rates were comparable. <br/>CONCLUSION(S):
Intrapleural 40% glucose solution achieved a higher resolution rate of
postoperative air leak compared to autologous blood patch pleurodesis,
with a comparable safety profile.<br/>Copyright &#xa9; The Author(s) 2025.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<77>
Accession Number
649069533
Title
Effect of Propofol on Metabolic Acidosis in Patients Undergoing Cardiac
Surgery With Cardiopulmonary Bypass.
Source
Asian journal of anesthesiology. 62(4) (pp 216-226), 2024. Date of
Publication: 03 Dec 2024.
Author
Lam V.T.; Ly N.M.
Institution
(Lam) Department of Anesthesiology and Pain Management, Vinmec Times City
International Hospital, Hanoi, Vietnam
(Ly) Department of Anesthesia and Resuscitation, 108 Military Central
Hospital, Hanoi, Vietnam
Abstract
BACKGROUND: Propofol has been associated with metabolic acidosis in case
reports. However, the results of studies in patients undergoing
non-cardiac surgery are controversial. On the other hand, there have been
no randomized controlled studies addressing this issue in patients
undergoing cardiac surgery with cardiopulmonary bypass (CPB). In this
study, we investigated whether propofol was associated with metabolic
acidosis in patients undergoing cardiac surgery with CPB. <br/>METHOD(S):
Forty patients undergoing cardiac surgery with CPB were randomly assigned
to receive total anesthesia with propofol (intervention group) or
sevoflurane (control group), respectively. Except for this, the anesthetic
and surgical management was the same in all patients. The primary outcomes
were the changes in arterial blood pH, base excess, HCO_3^-, and lactate
levels during surgery. The secondary outcomes included serum aspartate
transaminase (AST), alanine transaminase (ALT), urea, and creatinine
levels, as well as the proportion of patients with increased liver enzymes
and kidney damage at the end of surgery, and the proportion of patients
with arrhythmia during surgery. <br/>RESULT(S): The rate of metabolic
acidosis with high lactate at the end of surgery in the propofol group
(intervention group) was statistically higher than that in the sevoflurane
group (control group). Nevertheless, no difference in serum AST, ALT,
urea, and creatinine levels between the two groups, and the proportions of
patients with increased liver enzymes and kidney damage at the end of
surgery, as well as the proportion of patients with arrhythmia during
surgery. <br/>CONCLUSION(S): Total anesthesia with propofol was associated
with metabolic acidosis but did not significantly affect increased liver
enzymes, kidney damage, and arrhythmias when compared with the control
group in patients undergoing cardiac surgery with CPB.

<78>
Accession Number
2041290411
Title
Perioperative Management of Hepatectomy in Patients with Fontan-Associated
Liver Disease: A Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 40th
EACTAIC Annual Congress 2025. Valencia Spain. 39(12 Supplement) (pp 5-6),
2025. Date of Publication: 01 Dec 2025.
Author
Minote T.; Yonezawa H.; Kinoshita M.; Tanaka K.
Institution
(Minote, Kinoshita) Department of Anesthesiology, Tokushima University
Hospital, Tokushima, Japan
(Yonezawa, Tanaka) Department of Anesthesiology, Institute of Biomedical
Sciences, Tokushima University Graduate School, Tokushima, Japan
Publisher
W.B. Saunders
Abstract
Objective: The Fontan procedure is a palliative surgery for complex
congenital heart defects characterized by single-ventricle physiology.
Advances in surgical techniques have improved outcomes, with 30-year
survival rates now exceeding 80%. This increased longevity has led to the
emergence of chronic complications, including Fontan-Associated Liver
Disease (FALD). Among these, hepatocellular carcinoma (HCC) represents a
particularly severe manifestation, with a rising number of reported cases.
While hepatectomy remains the most curative treatment for HCC, unique
Fontan physiology presents specific challenges for liver resection beyond
those of routine non-cardiac surgery. This systematic review aimed to
synthesize the current literature on hepatectomy in patients with Fontan
circulation, focusing on perioperative strategies and clinical outcomes.
Design and method: The study protocol was prospectively registered
(PROSPERO, CRD420251025106). A comprehensive literature search was
conducted across PubMed, Scopus, the Cochrane Library, Google Scholar,
ICHUSHI, and CiNii Research. Eligible studies included full-text
reports-such as case reports, case series, and original
articles-describing clinical cases of hepatectomy in patients with Fontan
circulation. We excluded studies without full-text availability,
theoretical articles lacking patient cases. Literature screening and data
extraction were independently performed by at least two reviewers. The
methodological quality of each study was assessed using the tool developed
by Murad et al. <br/>Result(s) and Conclusion(s): A total of 29 articles
describing 32 cases of hepatectomy in Fontan patients were included. The
mean patient age was 28.8 years (range: 12-45), and the mean interval
since the Fontan procedure was 23.6 years (range: 10.7-40). Underlying
congenital heart conditions included single ventricle in 11 cases (34.4%),
tricuspid atresia in 11 cases (34.4%), double outlet right ventricle in 5
cases (15.6%), transposition of the great arteries in 3 cases (9.4%), and
others in 2 cases (6.3%). Cardiac function was normal to mildly impaired,
and valve regurgitation was generally mild. Arrhythmias, when present,
were well controlled with catheter ablation or pacemaker therapy. Most
patients had preoperative central venous pressure (CVP) levels below 15
mmHg. Laparoscopic hepatectomy was performed in 17 cases (53.1%), while
the remaining 15 cases (46.9%) underwent open surgery. Intraoperative
management strategies consistently emphasized maintaining CVP near
preoperative levels to balance the dual needs of pulmonary circulation and
surgical hemostasis. Key strategies included pharmacologic interventions
(e.g., phosphodiesterase inhibitors, nitroglycerin, inhaled nitric oxide),
reverse Trendelenburg positioning, approximately 5 cmH2O positive
end-expiratory pressure, and careful fluid management. In laparoscopy,
insufflation pressures were kept below 10 mmHg to avoid exceeding CVP.
Most reports noted stable hemodynamics during the Pringle maneuver.
Intraoperative blood loss ranged from minimal to 4,100 mL. No
perioperative mortality was reported, although pleural effusion and
ascites were frequent postoperative complications, typically managed with
diuretics or therapeutic thoracentesis. Favorable surgical outcomes across
all reported cases were supported by stable preoperative cardiac function
and a well-compensated Fontan circulation, together with appropriately
tailored intraoperative management to maintain pulmonary flow. Both open
and laparoscopic hepatectomy appear feasible and safe when patients are
appropriately selected. Nevertheless, current evidence remains limited,
highlighting the need for further clinical experience in this complex and
expanding patient population.<br/>Copyright &#xa9; 2025

<79>
Accession Number
2041271377
Title
Antithrombotic Monotherapy or Combination Therapy for Atrial Fibrillation
in Stable Coronary Artery Disease: A Meta-Analysis of Randomized Trials.
Source
Journal of the American Heart Association. 14(20) (pp 1-10), 2025. Article
Number: e041422. Date of Publication: 21 Oct 2025.
Author
Reddy K.; Koeckerling D.; Lip Y.H.; Howard J.P.; Ahmad Y.
Institution
(Reddy, Howard) National Heart and Lung Institute, Imperial College
London, London, United Kingdom
Nuffield Department of Population Health, University of Oxford, Oxford,
United Kingdom
(Koeckerling) Department of Cardiology, Angiology and Respiratory
Medicine,Heidelberg University Hospital, Heidelberg, Germany
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John MooresUniversity and Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
(Ahmad) Division of Cardiology, University of California, San Francisco,
CA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: In patients with atrial fibrillation and stable coronary
artery disease, guidelines recommend oral anticoagulation monotherapy
after periods on dual antithrombotic therapy. These recommendations are
based on evidence from prematurely terminated randomized controlled trials
that were underpowered for bleeding and mortality end points. New data are
available, so we conducted a systematic review and meta-analysis to pool
the totality of randomized evidence. <br/>METHOD(S): This investigation
was preregistered on International Prospective Register of Systematic
Reviews (CRD42024590457). Systematic searches and data extraction were
performed independently and in duplicate for randomized controlled trials
enrolling patients with atrial fibrillation and stable coronary artery
disease that reported clinical end points. The prespecified coprimary end
points were major bleeding and all-cause death. Prespecified secondary
outcomes included all bleeding, cardiovascular death, noncardiovascular
death, myocardial infarction, stroke, the composite of net adverse
cardiovascular events and coronary revascularization. End point data were
pooled using fixed and random effect models, to generate hazard ratios
(HR) and relative risks and corresponding 95% CIs. <br/>RESULT(S): Four
randomized controlled trials enrolling 4092 patients were eligible, with
2049 randomized to monotherapy and 2043 randomized to dual therapy.
Monotherapy reduced the hazard of major bleeding by 41% (HR, 0.59 [95% CI,
0.44-0.79], P<0.001, I2=29%). There was no statistically significant
difference in hazard of all-cause death (HR, 0.89 [95% CI, 0.45-1.74],
P=0.73, I2=72%), or other secondary outcomes. <br/>CONCLUSION(S): In
patients with stable coronary artery disease and atrial fibrillation, oral
anticoagulation monotherapy reduces major bleeding compared with dual
antithrombotic therapy. There were no significant differences in all-cause
and cardiovascular death, myocardial infarction, stroke, adverse
cardiovascular events, and coronary revascularization.<br/>Copyright
&#xa9; 2025 The Author(s). Published on behalf of the American Heart
Association, Inc., by Wiley. This is an open access article under the
terms of the Creative Commons Attribution-NonCommercial License, which
permits use, distribution and reproduction in any medium, provided the
original work is properly cited and is not used for commercial purposes.

<80>
Accession Number
2041290213
Title
Effect of Esketamine on Perioperative Negative Mood in Patients Undergoing
Cardiac Valve Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 40th
EACTAIC Annual Congress 2025. Valencia Spain. 39(12 Supplement) (pp 8-9),
2025. Date of Publication: 01 Dec 2025.
Author
Zhang Z.; Hao X.; Mi W.; Tong L.
Institution
(Zhang, Hao, Mi, Tong) Chinese PLA General Hospital, Beijing, China
Publisher
W.B. Saunders
Abstract
Objective: Perioperative negative mood, including depression and anxiety
symptoms, are common for patients undergoing cardiac valve surgery and
adversely affect their prognosis. The study was designed to explore the
effects of esketamine on perioperative negative mood in patients who
underwent cardiac valve surgery and its potential mechanism. Design and
method: This randomized, double blind, parallel-group clinical trial
recruited 142 adults undergoing cardiac valve surgery at 3 Chinese
hospitals from September 2024 to March 2025. Patients were randomly
assigned 1:1 to the esketamine and control groups. Patients were randomly
assigned 1:1 to the esketamine (n = 71) and control (n = 71) groups. Those
in the esketamine group received a single intravenous injection of 0.3
mg/kg of esketamine administered before anesthesia induction. Patients in
the control group received an equivalent volume of saline. The primary
outcomes were prevalence of depression symptoms and anxiety symptoms at
postoperative day 7, diagnosed using the Hospital Anxiety and Depression
Scale (HADS). Secondary outcomes included depression symptoms and anxiety
symptoms at postoperative day 30 using the HADS, delirium within
postoperative 7 days according to the 3-minute confusion assessment method
(CAM) or the confusion assessment method for the intensive care unit
(CAM-ICU), postoperative pain using the Numeric Rating Scale at
postoperative day 7 and 30, postoperative nausea and vomiting using the
Visual Analog Scale, the Insomnia Severity Index (ISI) score at
postoperative day 7 and 30, and the quality of recovery (QoR-15) score at
postoperative day 7 and 30. Exploratory outcomes included serum biomarker
levels (CRP, IL-6, S100beta, BDNF, acetylcholine, and norepinephrine) at 5
time points during the perioperative period. Safety evaluations included
adverse events at postoperative day 7, and 30. <br/>Result(s) and
Conclusion(s): A total of 142 patients were enrolled and randomised. The
prevalence of depression symptoms and anxiety symptoms were significantly
lower among patients given esketamine compared with controls (depression:
32.8%[22 of 71] vs 7.5%[5 of 71]; P <0.001; anxiety: 37.3%[25 of 71] vs
11.9%[8 of 71]; P <0.001) on postoperative day 7. And the incidence of
delirium within 7 days after surgery was significantly reduced in the
esketamine group. In addition, on postoperative day 7, the NRS score with
movement, and QoR-15 score in the esketamine group decreased. However,
there were no differences between the groups in the incidence of
depression symptoms and anxiety symptoms or in other scores at
postoperative day 30. The esketamine group had lower CRP, IL-6, S100beta
levels, and higher BDNF levels postoperatively, while serum acetylcholine
and norepinephrine were not significantly different. The overall incidence
of adverse events within 7 d after surgery were higher in the esketamine
group. Among patients undergoing cardiac valve surgery, a single dose of
esketamine reduced the incidence of depression symptoms and anxiety
symptoms at postoperative day 7, while simultaneously improving
multidimensional short-term prognosis. This may be related to its
reduction in the production of pro-inflammatory and brain injury related
factors, while promoting the generation of BDNF. But there is no
improvement in the long-term prognosis.<br/>Copyright &#xa9; 2025

<81>
Accession Number
2041481456
Title
Predicting procedural outcomes in transcatheter aortic valve implantation:
a scoping review of numerical patient-specific simulations.
Source
Progress in Biomedical Engineering. 8(1) (no pagination), 2026. Article
Number: 012001. Date of Publication: 01 Mar 2026.
Author
Grossi B.; Perri L.M.; Raona V.; Cozzi O.; Migliavacca F.; Condorelli G.;
Stefanini G.; Luraghi G.
Institution
(Grossi, Cozzi, Condorelli, Stefanini) IRCCS Humanitas Research Hospital,
Via Alessandro Manzoni 56, Rozzano, Milan, Italy
(Grossi, Perri, Raona, Migliavacca, Luraghi) Department of Chemistry,
Materials and Chemical Engineering, Politecnico di Milano, Piazza L. da
Vinci 32, Milan, Italy
(Grossi, Raona, Cozzi, Condorelli, Stefanini) Department of Biomedical
Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve
Emanuele, Milan, Italy
(Migliavacca) Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico,
Milan, Italy
Publisher
Institute of Physics
Abstract
Transcatheter aortic valve implantation (TAVI)-related post-operative
complications remain significant clinical challenges, and current
in-silico simulations fall short in predicting them accurately, limiting
their clinical applicability. This scoping review evaluates the state of
the art in TAVI computational modeling, identifying methodological gaps
and proposing directions for refinement to enhance translational impact.
Following PRISMA-ScR guidelines, 40 studies were included, with data
extracted and summarized by evaluated outcomes. A quality assessment was
performed using a 14-item rubric. Most studies focused on predicting
paravalvular leak (65%) and conduction disturbances (20%). This review
reveals substantial heterogeneity in modeling approaches, with limited
standardization and varying degrees of validation. To improve clinical
relevance, future efforts should prioritize model standardization,
rigorous validation following ASME V&V guidelines, increased automation,
and improved interpretability for clinical users. By ensuring robustness,
efficiency, and clinical accessibility, in-silico models could transform
TAVI outcome prediction and support personalized treatment planning,
ultimately enhancing care standards in structural heart
interventions.<br/>Copyright &#xa9; 2025 The Author(s). Published by IOP
Publishing Ltd.

<82>
Accession Number
2041461886
Title
High-Intensity Statin versus Upfront Equivalent-Dose Combination of
Moderate-Intensity Statin with Ezetimibe Following Acute Myocardial
Infarction (ROSUZET-AMI): protocol of a multicentre, open-label,
randomised non-inferiority trial.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e104127. Date of
Publication: 01 Nov 2025.
Author
Choo E.H.; Kim C.J.; Hwang B.-H.; Lee K.Y.; Oh G.C.; Lim S.; Choi I.J.;
Kim D.-B.; Kwon O.S.; Lee S.; Choi Y.; Park C.-S.; Park M.-W.; Kim H.-Y.;
Lee H.C.; Kang T.S.; Sung J.K.; Woo S.-I.; Park H.S.; Yun K.H.; Chang K.
Institution
(Choo, Hwang, Lee, Oh, Choi, Chang) Seoul St.Mary's Hospital, The Catholic
University of Korea, Seoul, South Korea
(Kim, Lim) Uijeongbu St.Mary's Hospital, The Catholic University of Korea,
Uijeongbu, South Korea
(Choi) Incheon St. Mary's Hospital, The Catholic University of Korea,
Incheon, South Korea
(Kim, Kim) Bucheon St. Mary's Hospital, The Catholic University of Korea,
Bucheon, South Korea
(Kwon) Eunpyeong St.Mary's Hospital, The Catholic University of Korea,
Seoul, South Korea
(Lee) St. Vincent Hospital, The Catholic University of Korea, Suwon, South
Korea
(Park) Yeouido St. Mary's Hospital, The Catholic University of Korea,
Seoul, South Korea
(Park) Daejeon St.Mary's Hospital, The Catholic University of Korea,
Daejeon, South Korea
(Lee) Pusan National University Hospital, Busan, South Korea
(Kang) Dankook University Hospital, Cheonan-si, South Korea
(Sung) Andong Medical Group Hospital, Andong, South Korea
(Woo) Inha University Hospital, Incheon, South Korea
(Park) Kyungpook National University Hospital, Daegu, South Korea
(Yun) Wonkwang University Hospital, Iksan-si, South Korea
Publisher
BMJ Publishing Group
Abstract
Introduction High-intensity statin therapy is recommended as a first-line
strategy for lowering lowdensity lipoprotein cholesterol (LDL-C) levels in
patients with acute myocardial infarction (AMI). A combination of
moderate-intensity statin and ezetimibe at an equivalent dose to
high-intensity statin may achieve similar LDL-C reduction with fewer side
effects. This study evaluates the long-term efficacy and safety of this
approach, initiated following AMI, compared with high-intensity statin
monotherapy. Methods and analysis The ROSUZET-AMI trial is a multicentre,
prospective, open-label, randomised, non-inferiority trial. Patients with
AMI who underwent percutaneous coronary intervention were randomised 1:1
to receive either moderate-intensity statin with ezetimibe (rosuvastatin
5mg with ezetimibe 10mg) or high-intensity statin monotherapy
(rosuvastatin 20mg). The primary endpoint is the composite of
cardiovascular death, major coronary events (non-fatal myocardial
infarction, documented unstable angina requiring hospitalisation and all
coronary revascularisation events occurring at least 30 days after
randomisation), or non-fatal stroke. Ethics and dissemination Ethics
approval for this study was obtained from the Institutional Review Board
of Seoul St. Mary's Hospital (No. 2020-0424-0003). Informed consent is
obtained from every participant before randomisation. The results of this
study will be submitted for publication in international peer-reviewed
journals, and the key findings will be presented at international
scientific conferences.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<83>
Accession Number
649056476
Title
Perioperative tight glucose control regimens for preventing surgical site
infections following cardiac surgery-a systematic review and metanalysis
of randomized controlled trials.
Source
Journal of clinical anesthesia. 108 (pp 112051), 2025. Date of
Publication: 03 Nov 2025.
Author
Sun Y.; Wen Z.; Ren Y.; Hua Z.
Institution
(Sun, Ren, Hua) Department of Anesthesiology, Beijing Hospital, National
Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of
Medical Sciences, Beijing, China
(Wen) Medical school, Jiamusi University, Jiamusi, Heilongjiang, China
Abstract
BACKGROUND: Perioperative hyperglycemia is common during cardiac surgery
and has been linked to an increased risk of surgical site infections
(SSIs). However, the benefits of perioperative tight glucose control (TGC)
remain debated, largely due to concerns about hypoglycemia. This
systematic review assessed the effects and safety of TGC on SSIs in adults
undergoing cardiac surgery. <br/>METHOD(S): We searched MEDLINE, Embase,
and Cochrane databases for randomized controlled trials (RCTs) comparing
TGC (upper blood glucose target <=150 mg/dL or 8.3 mmol/L) with
conventional glucose management in adults undergoing cardiac surgery. The
primary outcome was incidence of SSIs. Secondary outcomes included
hypoglycemia, length of intensive care unit (ICU) stay, incidence of
neurological deficits and all-cause mortality within 30 days after
surgery. The certainty of evidence was evaluated using the GRADE approach.
<br/>RESULT(S): Twenty-six RCTs including 17,990 participants were
analyzed. TGC compared with control group was associated with reducing the
risk of SSIs (risk ratio [RR]: 0.53; 95 % confidence interval [CI]:
0.42-0.68; I2 = 0 %; low certainty evidence), particularly when initiated
at the start of surgery (RR: 0.50, 95 %CI: 0.39-0.66, I2 = 0; low
certainty evidence) but not postoperatively (RR = 0.80, 95 % CI:
0.39-1.66; I2 = 0; very low certainty evidence). TGC also shortened ICU
stay by 7.03 h compared to the control group (95 % CI: -10.83 to -3.22;
very low certainty evidence), though heterogeneity was considerable (I2 =
92 %). However, TGC was associated with a higher risk of hypoglycemia (RR:
3.14; 95 % CI: 2.37-4.16; I2 = 0; moderate certainty evidence). No
significant effects were observed on neurological deficits or all-cause
mortality. <br/>CONCLUSION(S): This systematic review of the available
evidence suggests that perioperative TGC, particularly when initiated at
the start of surgery, may reduce the risk of SSIs following cardiac
surgery. However, it increases the risk of hypoglycemia and does not
significantly impact neurological outcomes and all-cause
mortality.<br/>Copyright &#xa9; 2025. Published by Elsevier Inc.

<84>
Accession Number
649057514
Title
Percutaneous femoral access closure and prognosis following transcatheter
aortic valve replacement: A systematic review and meta-analysis.
Source
The journal of vascular access. (pp 11297298251389645), 2025. Date of
Publication: 05 Nov 2025.
Author
Simonetti F.; Cassese S.; Rheude T.; Alvarez-Covarrubias H.; Pellegrini
C.; Kastrati A.; Joner M.; Xhepa E.
Institution
(Simonetti, Cassese, Rheude, Alvarez-Covarrubias, Pellegrini, Kastrati,
Joner, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum
Deutsches Herzzentrum, Technical University of Munich, Munich, Germany
(Simonetti) Department of Advanced Biomedical Sciences, University of
Naples Federico II, Naples, Italy
(Kastrati, Joner) DZHK (German Centre for Cardiovascular Research),
partner site Munich Heart Alliance, Munich, Germany
Abstract
BACKGROUND: The impact of different percutaneous femoral access closure
strategies on mortality and bleeding after transcatheter aortic valve
replacement (TAVR) has been less studied. The aim of this study is to
investigate whether different percutaneous femoral access closure
strategies might affect systemic outcomes in patients undergoing TAVR.
<br/>METHOD(S): In this systematic review and meta-analysis, randomized
trials comparing a suture-based closure (suture group) with a plug-based
or suture/plug-based closure (control group) for hemostasis of the femoral
access in patients undergoing TAVR were included. The primary endpoint of
the study was all-cause death. Secondary endpoints included any bleeding
(defined according Valve Academic Research Consortium (VARC) criteria) and
unplanned endovascular or surgical repair at the access site. All
endpoints were calculated at the longest available follow-up.
<br/>RESULT(S): Four studies with a total of 1429 TAVR patients
(suture-based group, n = 707; control group, n = 722) were available for
quantitative synthesis. There was no statistically significant difference
in all-cause death in patients who underwent TAVR with suture-based
closure compared to the control group (risk ratio-RR = 1.04, 95%
confidence interval-CI 0.60-1.82; p = 0.83). Similarly, there was no
statistically significant difference between treatment groups for any
bleeding and unplanned endovascular or surgical repair at the access site.
However, there was a significant treatment effect for VARC bleeding type 2
associated with the use of a plug-based or suture/plug-based closure in
the control group (p for interaction = 0.01). <br/>CONCLUSION(S): In the
context of contemporary TAVR procedures, percutaneous closure of the
femoral access using any suture or plug-based strategy has no impact on
hard clinical outcomes such as death from any cause.

<85>
Accession Number
2040996585
Title
Stent thrombosis: a contemporary guide to definitions, risk factors, and
management.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1622235. Date of Publication: 2025.
Author
Flowers A.; Evenhuis B.; Gabanic B.; Weiss A.; Eisenberg S.; Siddiqui R.;
Rizwan A.; Riaz I.; Hassan Virk H.U.; Alam M.; Khawaja M.; Strauss M.;
Krittanawong C.
Institution
(Flowers, Evenhuis, Gabanic, Weiss, Eisenberg) Department of Internal
Medicine, Emory University, Atlanta, GA, United States
(Siddiqui) School of Medicine, University of Mississippi Medical Center,
Jackson, MS, United States
(Rizwan) Departmemnt of Internal Medicine, Baylor College of Medicine,
Houston, TX, United States
(Riaz) Department of Internal Medicine, Mobile Infirmary Medical Center,
Mobile, AL, United States
(Hassan Virk) Harrington Heart & Vascular Institute, Case Western Reserve
University, University Hospitals Cleveland Medical Center, Cleveland, OH,
United States
(Alam) Department of Cardiology, Texas Heart Institute and Baylor College
of Medicine, Houston, TX, United States
(Khawaja) Department of Cardiology, Emory University, Atlanta, GA, United
States
(Strauss) Department of Cardiology I- Coronary and Periphal Vascular
Disease, Heart Failure Medicine, University Hospital Muenster, Muenster,
Cardiol, Germany
(Krittanawong) HumanX, Delaware, DE, United States
Publisher
Frontiers Media SA
Abstract
Stent thrombosis remains a major complication following percutaneous
coronary intervention, with significant morbidity and mortality
implications. Despite advancements in drug-eluting stents and optimized
pharmacotherapy, real-world registry data indicate that definite or
probable stent thrombosis occurs in approximately 0.5% of percutaneous
coronary intervention cases, with a 30-day mortality rate approaching 25%
and a long-term risk exceeding 30% at 10 years. Stent thrombosis is
classified based on timing into acute, subacute, late, and very late
thrombosis, with subacute and very late stent thrombosis being the most
prevalent. Clinical consequences include myocardial infarction, emergent
revascularization, and heightened cardiovascular risk, necessitating
timely recognition and intervention. Risk factors include patient
characteristics, procedural variables, and lesion complexity, with
recurrent stent thrombosis remaining a notable concern. This review
explores the definitions, classifications, pathophysiology, and risk
factors for stent thrombosis while discussing current strategies for
prevention and management. Additionally, advancements in stent technology
and pharmacologic interventions are examined, underscoring the need for a
multidisciplinary approach to mitigate stent thrombosis incidence and
improve patient outcomes.<br/>Copyright 2025 Flowers, Evenhuis, Gabanic,
Weiss, Eisenberg, Siddiqui, Rizwan, Riaz, Hassan Virk, Alam, Khawaja,
Strauss and Krittanawong.

<86>
Accession Number
2041420213
Title
PCI of Native Coronary Artery vs Saphenous Vein Graft After Prior Bypass
Surgery: A Multicenter, Randomized Trial.
Source
Journal of the American College of Cardiology. (no pagination), 2025.
Date of Publication: 2025.
Author
Schumacher S.P.; Bom M.J.; Verouden N.J.; Henriques J.P.; Viscusi M.M.;
van Geuns R.-J.M.; Heestermans A.A.C.M.; Knaapen P.; Scholzel B.E.;
Teeuwen K.; Kraaijeveld A.O.; Dens J.; Haine S.E.F.; Spratt J.C.; Murphy
C.; Agostoni P.; Opolski M.P.; Hofma S.H.; van Kuijk J.-P.; van Geuns
R.-J.; Bennett J.; Nap A.; Delewi R.; Simao Henriques J.P.; de Winter
R.W.; Hoek R.; Vegting I.; Oemrawsingh R.M.; den Hollander J.; van Meel
J.; Steerneman-Geurts F.; van Leur L.; van Doleweerd M.; Harasic M.;
Schogt J.; den Adel S.; Griffioen A.; Swijsen C.; Brosens N.; Deruyter P.;
van Roey S.; Sookhoo V.; McCart E.; Wolny R.; Sprengers R.W.; Walsh S.J.;
Hanratty C.G.; Twisk J.W.R.; Koch K.T.; Wykrzykowska J.J.; Rahmam M.S.;
Smits P.C.; Tijssen J.G.P.; ten Berg J.M.; Lemkes J.S.; Wilgenhof A.;
Viscusi M.; Dirksen M.T.
Institution
(de Winter, Hoek, Vegting, Schumacher, Bom, Verouden, Henriques, Delewi,
Nap, Knaapen) Department of Cardiology, Heart Center Amsterdam, Amsterdam
UMC, Amsterdam, Netherlands
(Walsh) Department of Cardiology, Belfast Health and Social Care Trust,
Royal Victoria Hospital, Belfast, United Kingdom
(Hanratty) Heart and Vascular Centre, Mater Private Day Hospital, Dublin,
Ireland
(Sprengers) Department of Radiology and Nuclear Medicine, Amsterdam UMC,
Amsterdam, Netherlands
(Twisk) Department of Epidemiology and Data Science, Amsterdam UMC,
Amsterdam, Netherlands
(Wilgenhof) Cardiovascular Center Aalst, Onze-Lieve-Vrouwenziekenhuis,
Aalst, Belgium
(Viscusi) Department of Advanced Biomedical Sciences, University of Naples
Federico II, Naples, Italy
(Teeuwen) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Opolski, Wolny) Department of Interventional Cardiology and Angiology,
National Institute of Cardiology, Warsaw, Poland
(Agostoni) HartCentrum Ziekenhuis Aan de Stroom (ZAS) Middelheim, Antwerp,
Belgium
(van Kuijk) Department of Cardiology, St Antonius Ziekenhuis, Nieuwegein,
Netherlands
(Scholzel) Department of Cardiology, Amphia Ziekenhuis, Breda, Netherlands
(Kraaijeveld) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(van Geuns) Department of Cardiology, Radboud University Medical Center,
Nijmegen, Netherlands
(Dirksen, Heestermans) Department of Cardiology, Noordwest
Ziekenhuisgroep, Alkmaar, Netherlands
(Dens) Department of Cardiology, Ziekenhuis Oost Limburg, Genk, Belgium
(Bennett) Department of Cardiovascular Medicine, University Hospital
Leuven, Leuven, Belgium
(Haine) Department of Cardiology, Antwerp University Hospital and
University of Antwerp, Antwerp, Belgium
(Spratt) Department of Cardiology, St George's University Hospital NHS
Trust, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: In patients with prior coronary artery bypass grafting (CABG)
presenting with graft failure, current guidelines recommend percutaneous
coronary intervention (PCI) of the bypassed native coronary artery over
PCI of the bypass graft. However, this recommendation relies solely on
observational data. <br/>Objective(s): This study compared clinical
outcomes between a strategy of native vessel PCI with saphenous vein graft
(SVG) PCI in post-CABG patients presenting with SVG failure.
<br/>Method(s): The multicenter, randomized PROCTOR (Percutaneous Coronary
Intervention of Native Coronary Artery versus Saphenous Vein Graft in
Patients with Prior Coronary Artery Bypass Graft Surgery) trial included
patients with significant SVG stenosis and a heart team-defined clinical
indication for revascularization. Patients were randomly assigned (1:1) to
either a strategy of native vessel PCI or SVG PCI using an interactive
web-based randomization platform. The trial was conducted across 14
centers in Europe. We report the occurrence of major adverse cardiac
events at 1 year following the index PCI, defined as the composite of
all-cause mortality, nonfatal target coronary territory myocardial
infarction (MI), or clinically driven target coronary territory
revascularization, analyzed on an intention-to-treat basis. The trial is
registered with ClinicalTrials.gov (NCT03805048), and long-term follow-up
is ongoing. <br/>Result(s): Between January 2019 and December 2023, 220
patients (mean age 73 +/- 7 years; 84% men [185/220 patients]) were
randomized to a strategy of native vessel PCI (n = 108) or SVG PCI (n =
112). At 1 year, major adverse cardiac events occurred in 37 patients
(34%) in the native vessel PCI group and 21 patients (19%) in the SVG PCI
group (HR: 2.14; 95% CI: 1.25-3.65; P = 0.006). There was no significant
difference in all-cause mortality (HR: 1.59; 95% CI: 0.45-5.64; P =
0.472), whereas both nonfatal target coronary territory MI (HR: 2.12; 95%
CI: 1.08-4.17; P = 0.029) and clinically driven target coronary territory
revascularization (HR: 2.19; 95% CI: 1.02-4.72; P = 0.044) occurred more
frequently in patients assigned to native vessel PCI. The incidence of
PCI-related MI was 13% in the native vessel PCI group and 1% in the SVG
PCI group (HR: 14.85; 95% CI: 1.95-112.96; P = 0.009). <br/>Conclusion(s):
In the randomized PROCTOR trial, SVG PCI was associated with improved
1-year clinical outcomes compared with native vessel PCI, primarily driven
by lower rates of PCI-related MI and clinically driven target coronary
territory revascularization.<br/>Copyright &#xa9; 2025

<87>
Accession Number
2041290380
Title
Preventing postoperative delirium by BIS-guided depth of anesthesia during
cardiac surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. Conference: 40th
EACTAIC Annual Congress 2025. Valencia Spain. 39(12 Supplement) (pp
83-84), 2025. Date of Publication: 01 Dec 2025.
Author
Martinova B.; Bakalivanov L.; Mitrev B.
Institution
(Martinova, Bakalivanov, Mitrev) National Cardiology Hospital Department
of cardiac anesthesia and intensive care unit, Sofia, Bulgaria
Publisher
W.B. Saunders
Abstract
Objective: Postoperative delirium (POD) in cardiac intensive care unit is
a multifactorial neuropsychiatric syndrome reflecting acute brain
dysfunction and disturbances in consciousness and attention affecting all
age groups with incidence from 9 to 73%. Prevention and diagnosis of POD
are challenging. Pathophysiology and risk factors for the development of
POD are heterogeneous. Risk factors may be divided into predisposing and
precipitating; modifiable and non-modifiable; preoperative, intraoperative
and postoperative factors. Intraoperative risk factors in cardiac surgery
are not yet fully understood. Surgical interventions with cardiopulmonary
bypass (CPB) are performed under general anesthesia. Data on the influence
of anesthesia on occurrence of POD delirium are contradictory. There is
conflicting evidence in the literature that anesthesia seems to have a
less clear effect on the development of POD. Depth of anesthesia is a
modifiable risk factor. This study investigate the association between the
depth of anesthesia and occurrence of POD in elderly patients undergoing
cardiac surgery with CPB. Design and method: This is a single-center
prospective study. A total of 120 patients aged 65 years or older with
ejection fraction over 35%, without significant carotid stenoses, without
a history of alcohol/drug abuse or depression/cognitive decline,
undergoing valvular, coronary or combined surgical intervention with with
general balanced inhalation anesthesia with Sevoflurane and monitoring of
the depth of anesthesia using the BIS index data were included in the
study. Patients were randomly divided into two groups: one with a target
BIS of 40 (deeper anesthesia) and the other with a BIS of 60 (lighter
anesthesia) during all major stages of the surgery. Patients were assessed
for delirium from the first to the fifth postoperative day by applying the
Confusion Assessment Method for intensive care unit by a physician every
12 hours. Statistical data processing was performed using the SPSS v22.0
software and Chi Square test. <br/>Result(s) and Conclusion(s): The
results show that out of a total of 120 patients, 49 (40.8%) had POD, and
the remaining 71 (59.2%) did not have POD. Of those with POD, 36 (30.0%)
were from the group with a target BIS40, and 13 (10.8%) were from the
group of patients with a target BIS60. Chi-Square Test shows that there is
a relationship between BIS (depth of anesthesia) and the occurrence of
delirium. This conclusion is supported by the characteristic Pearson
Chi-Square = 18.247, which has a significance level of Asymp. Sig.
(2-sided) = 0.000 < alpha =0.05. The results show that out of 49 patients
with POD, 22 (18.3%) had hypoactive delirium, and 27 (22.5%) had
hyperactive delirium. In the group of patients with hypoactive delirium,
those with BIS40 predominated - they were 15 (12.5%), while in the group
with BIS60 there were only 7 patients (5.8%). In the group of patients
with hyperactive delirium, those with BIS40 also predominated - they were
21 (17.5%), while in the group with BIS60 there were only 6 patients
(5.0%). In conclusion maintaining a lighter level of anesthesia (BIS near
60) may reduce the occurrence of POD after cardiac surgery. Level of
anesthesia influences the type of POD.<br/>Copyright &#xa9; 2025

<88>
Accession Number
2041445142
Title
Infective endocarditis meets native vertebral osteomyelitis: a mortality
perspective.
Source
Journal of Bone and Joint Infection. 10(6) (pp 425-435), 2025. Date of
Publication: 05 Nov 2025.
Author
Borgonovo F.; Petri F.; Matsuo T.; Igwilo-Alaneme R.; Alavi M.S.A.;
Mahmoud O.K.; Zein S.E.; Passerini M.; Murad M.H.; DeSimone D.C.; Nassr
A.; Tande A.J.; Gori A.; Berbari E.F.
Institution
(Borgonovo, Petri, Passerini, Gori) Department of Infectious Diseases,
ASST Fatebenefratelli Sacco, "L. Sacco" University Hospital, Milan, Italy
(Borgonovo, Petri, Matsuo, Igwilo-Alaneme, Mahmoud, Zein, Murad, DeSimone,
Tande, Berbari) Division of Public Health, Infectious Diseases and
Occupational Medicine, Department of Medicine, Mayo Clinic College of
Medicine and Science, Mayo Clinic, Rochester, MN, United States
(Alavi) Faculty of Medicine, Ahvaz Jundishapur University of Medical
Sciences, Ahvaz, Iran, Islamic Republic of
(Passerini, Gori) Department of Pathophysiology and Transplantation,
University of Milan, Milan, Italy
(Murad) Evidence-Based Practice Center, Mayo Clinic, Rochester, MN, United
States
(Nassr) Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN,
United States
(Gori) Centre for Multidisciplinary Research in Health Science (MACH),
University of Milan, Milan, Italy
Publisher
Copernicus Publications
Abstract
Background: Native vertebral osteomyelitis and infective endocarditis (NVO
+ IE) are increasingly recognized as overlapping entities, sharing common
risk factors (e.g., advanced age, immunosuppression) and similar pathogen
profiles, most commonly Staphylococcus aureus and streptococci. Concurrent
infection presents unique diagnostic and therapeutic challenges, leading
to uncertainty regarding clinical outcomes and mortality. Therefore, we
aimed to systematically evaluate the combined mortality associated with
concomitant NVO + IE and to summarize the available clinical
characteristics from published studies. <br/>Method(s): A systematic
review was conducted following the PRISMA framework. The databases
searched included MEDLINE, Embase, Cochrane Library, and Scopus from 1970
to October 2023. Studies were included if they involved at least 10 adult
patients diagnosed with NVO and IE and provided mortality data. Two
reviewers independently screened the references, extracted the data, and
evaluated the methodological quality using a dedicated tool. A
random-effects meta-analysis was performed to aggregate in-hospital,
1-month, 1-year, and 3-year mortality rates. <br/>Result(s): A total of 16
studies (12 retrospective, 3 prospective, 1 mixed) were included,
involving 641 patients (mean age 67.1 years) with NVO + IE. In-hospital
mortality was 14.0 % (95 % CI: 10.0 %-20.0 %). At 1 month, mortality was
9.0 % (95 % CI: 5.0 %-17.0 %), rising to 18.0 % (95 % CI: 13.0 %-24.0 %)
by 1 year and 16.0 % (95 % CI: 3.0 %-50.0 %) by 3 years. Significant
between-study heterogeneity was observed (I² range: 3 %-70 %).
Common co-morbidities included diabetes mellitus (23.7 %), chronic renal
failure (15.0 %), and immunosuppression (15.0 %). Streptococci (31.5 %),
S. aureus (25.2 %), and enterococci (17.7 %) were the primary pathogens.
Cardiac valve surgery and spinal surgery were reported in 47.5 % and 29.9
% of patients, respectively. A subgroup analysis on 1-month mortality
showed that S. aureus predominance was associated with a significantly
higher mortality compared to streptococci. Certainty in the estimates was
low due to imprecision and methodological limitations. <br/>Conclusion(s):
Concomitant NVO + IE is associated with substantial mortality, especially
for S. aureus, underscoring the need for earlier diagnosis, coordinated
multidisciplinary management, and standardized treatment protocols. Future
prospective, high-quality studies are needed to clarify optimal strategies
for diagnostic workup and surgical intervention for this complex clinical
scenario.<br/>Copyright &#xa9; Author(s) 2025.

<89>
Accession Number
649035051
Title
Routine versus selective protamine administration to reduce bleeding after
TAVI: Rationale and Design of the POPular ACE TAVI trial.
Source
American heart journal. (pp 107296), 2025. Date of Publication: 31 Oct
2025.
Author
Overduin D.C.; van Ginkel D.J.; Dubois C.; Lesizza P.; Broeze G.M.;
Montero-Cabezas J.M.; Rosseel L.; van der Kley F.; van Nuland P.J.; Smits
T.P.; Hemelrijk K.I.; Aarts H.M.; Rensing B.J.W.M.; Timmers L.; Swaans
M.J.; Sonker U.; Veenstra L.; van 't Hof A.W.J.; Peper J.; Tijssen J.G.P.;
Delewi R.; Vriesendorp P.A.; Ten Berg J.M.
Institution
(Overduin, van Ginkel, van Nuland, Smits, Rensing, Timmers, Swaans,
Sonker, Peper) Department of Cardiology, St. Antonius Hospital,
Nieuwegein, Netherlands
(Dubois, Lesizza) Department of Cardiovascular Medicine, University
Hospital Leuven, Leuven, Belgium
(Broeze, Hemelrijk, Aarts, Tijssen, Delewi) Department of Cardiology,
Amsterdam, Netherlands
(Montero-Cabezas, van der Kley) Department of Cardiology, Leiden
University Medical Center, Leiden, Netherlands
(Rosseel) Department of Cardiology, Aalst, Belgium
(Veenstra, van 't Hof, Vriesendorp) Department of Cardiology, Maastricht
University Medical Center, Maastricht, The Netherlands; Cardiovascular
Research Institute Maastricht (CARIM), Maastricht, The Netherlands
(Ten Berg) Department of Cardiology, St. Antonius Hospital, Nieuwegein,
The Netherlands; Department of Cardiology, Maastricht University Medical
Center, Maastricht, The Netherlands; Cardiovascular Research Institute
Maastricht (CARIM), Maastricht, The Netherlands. Electronic address:
jurtenberg@gmail.com
Abstract
BACKGROUND: Unfractionated heparin is routinely used during transcatheter
aortic valve implantation (TAVI) to reduce catheter thrombosis and
thromboembolism. Protamine reverses the effect of heparin and may lower
bleeding risk, but it can also trigger severe allergic reactions. Robust
data on the safety and efficacy of routine protamine administration after
TAVI is lacking. <br/>METHOD(S): The 'Routine Versus Selective Protamine
Administration to Reduce Bleeding Complications After Transcatheter Aortic
Valve Implantation (POPular ACE TAVI)' is an investigator-initiated,
multicenter, double-blind, placebo-controlled, randomized clinical trial.
A total of 1000 patients will be randomized 1:1 to routine versus
selective protamine administration, stratified by study site and
antithrombotic therapy. Primary and secondary outcomes are defined
according to the Valve Academic Research Consortium-3 (VARC-3) criteria.
The primary outcome is a composite of all-cause mortality and clinically
relevant bleeding (type 1-4) within 30 days after TAVI. Ranked secondary
outcomes include clinically relevant bleeding; major, life-threatening or
fatal bleeding (type 2-4); major vascular complications; cardiovascular
mortality; and all-cause mortality. Safety outcomes include anaphylaxis
and thromboembolic events defined as the composite of myocardial
infarction, ischemic stroke, transient ischemic attack, or non-cerebral
distal embolization. Recruitment began in November 2023 and will continue
until 1000 patients are randomized. The trial will end after 30-day
follow-up of the last patient. <br/>CONCLUSION(S): The POPular ACE TAVI
trial (NCT05774691) will evaluate whether routine protamine administration
reduces all-cause mortality or clinically relevant bleeding after TAVI
compared with selective use.<br/>Copyright &#xa9; 2025. Published by
Elsevier Inc.

<90>
[Use Link to view the full text]
Accession Number
649037224
Title
Radial artery occlusion after cardiac catheterization and impact of
anticoagulation as medical treatment: a meta-analysis.
Source
Coronary artery disease. (no pagination), 2025. Date of Publication: 03
Nov 2025.
Author
Didagelos M.; Papazoglou A.S.; Moysidis D.V.; Pagiantza A.; Afendoulis D.;
Kakderis C.; Daios S.; Anastasiou V.; Theodoropoulos K.C.; Kouparanis A.;
Kartalis A.; Kamperidis V.; Kassimis G.; Ziakas A.
Institution
(Didagelos, Pagiantza, Kakderis, Daios, Anastasiou, Theodoropoulos,
Kouparanis, Kamperidis, Ziakas) First Cardiology Department, AHEPA
University General Hospital
(Papazoglou) Cardiology Department, Athens Naval Hospital, Athens, United
States
(Moysidis, Pagiantza) Cardiology Department, 424 General Military
Hospital, Thessaloniki, Greece
(Afendoulis, Kartalis) Cardiology Department, General Hospital of Chios
'Skylitseio'
(Kassimis) Second Department of Cardiology, Hippokration Hospital,
Thessaloniki, Greece
Abstract
BACKGROUND: Radial artery occlusion (RAO) is one of the most common
complications associated with transradial access in cardiac
catheterization procedures. To date there are no standardized protocols,
and only a few studies have evaluated the use of anticoagulation for RAO
treatment. The current meta-analysis aimed to assess the impact of various
anticoagulation strategies on RAO treatment after cardiac catheterization
via the transradial route. <br/>METHOD(S): Literature search was performed
in PubMed, Web of Science, and CENTRAL databases, from inception until
September 2024. The primary outcome of this study was the incidence of
radial artery recanalization. The secondary outcomes were the incidence of
any bleeding events and symptom resolution during patient follow-up.
<br/>RESULT(S): A total of six studies with 398 patients were included in
the analysis. Patients with RAO under anticoagulation had a sevenfold
increased chance of radial artery recanalization [pooled odds ratio (pOR)
= 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there
was no statistically significant difference between patients receiving and
not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41].
Regarding bleeding events, no pooled data could be extracted; however, no
major bleeding events were reported in any study. <br/>CONCLUSION(S): This
meta-analysis provides compelling evidence that anticoagulation therapy
significantly improves radial artery recanalization rates in patients with
RAO without increasing the risk of major bleeding events; however, its
effect on symptom resolution remains limited, suggesting the need for a
comprehensive approach to RAO management.<br/>Copyright &#xa9; 2025
Wolters Kluwer Health, Inc. All rights reserved.

<91>
Accession Number
649039129
Title
Myval versus Contemporary Valves in Patients Undergoing Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
Anatolian journal of cardiology. (no pagination), 2025. Date of
Publication: 03 Nov 2025.
Author
Mansuri Z.; Rajith G.; Taikadan T.; Ashraf H.; Ayesha A.; Cavalcante
L.F.F.
Institution
(Mansuri) Department of Cardiology, Gujarat Cancer Society Medical College
and Research Centre, Ahmedabad, India
(Rajith) All India Institute of Medical Sciences, Guwahati, India
(Taikadan) Calicut Medical College, Government Medical College, Kozhikode,
India
(Ashraf) Rawalpindi Medical University, Rawalpindi, Pakistan
(Ayesha) Shifa College of Medicine, Islamabad, Pakistan
(Cavalcante) Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo-SP,
Brazil
Abstract
BACKGROUND: Myval is a balloon-expandable valve (BEV) used in
transcatheter aortic valve implantation (TAVI) with distinguished
features. Data comparing Myval with contemporary transcatheter heart
valves (THVs) is limited. The authors performed a meta-analysis of studies
comparing Myval with contemporary THVs (Sapien series and Evolut series).
<br/>METHOD(S): The authors searched PubMed, EMBASE, and Cochrane
databases. The primary composite endpoint of early safety (freedom from
death and major complications) and other outcomes were extracted as
defined by the Valve Academic Research Consortium 3 (VARC 3). The authors
computed risk ratios (RRs) with 95% CIs using a Mantel-Haenszel method
with a random-effects model with Review Manager (Cochrane Collaboration).
<br/>RESULT(S): Six studies with 2084 patients were included. Myval had
better early safety at 30 days as per VARC 3 (RR 1.12; 95% CI: 1.02-1.22;
P = .01) and lower need for permanent pacemaker implantation (PPI) (RR
0.62; 95% CI: 0.45-0.86; P = .004). Other outcomes were comparable in both
groups. Vis-a-vis Evolut, Myval had better 30-day device success and lower
rates of moderate or severe paravalvular leak (PVL) in addition to better
early safety and lower need for PPI. Subgroup analyses of Myval with
Sapien showed non-inferiority of Myval. <br/>CONCLUSION(S): Myval showed
better safety and lower need for PPI and may become a promising
alternative for concurrent THVs.

<92>
Accession Number
649034799
Title
Rationale and design of REAC-TAVI 2: single antiplatelet treatment with
ticagrelor versus aspirin after transcatheter aortic valve implantation.
Source
American heart journal. (pp 107293), 2025. Date of Publication: 31 Oct
2025.
Author
Hemelrijk K.; Jimenez-Diaz V.A.; Vilchez J.P.; Oteo J.F.; Gomez-Blazquez
I.; Sabate M.; Vilalta V.; Jofresa A.B.; Asmarats L.; Amat-Santos I.J.;
Tello-Montoliu A.; de la Torre J.M.; Flores X.; Gheorghe L.; Peral V.;
Munoz-Garcia A.J.; Alfonso F.; Tirado-Conte G.; Brugaletta S.; Veiga G.;
Rodriguez-Gabella T.; Regueiro A.; De Lara J.G.; Valle-Fernandez R.D.;
Nodar J.M.R.; Mazuecos J.J.; Pan M.; Baz J.A.; Fernandez J.F.D.; Guerreiro
C.; Jorge E.; Silva M.T.; Marques J.S.; Rodrigues I.; Neves D.; Braga
J.P.; Testa L.; Costa G.; Stefanini G.; Pesarini G.; Sisinni A.; Capodanno
D.; Ribichini F.; Salvadores P.J.; Delewi R.; Angiolillo D.J.;
Garcia-Garcia H.M.; Iniguez A.; Nombela-Franco L.
Institution
(Hemelrijk) Cardiovascular Institute, Hospital Clinico San Carlos,
Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos
(IdISSC), Madrid, Spain; Heart Center, Amsterdam UMC, University of
Amsterdam, Amsterdam, the Netherlands
(Jimenez-Diaz) Department of Cardiology, Hospital Alvaro Cunqueiro,
University Hospital of Vigo, Vigo, Spain
(Vilchez) Hospital Universitario y Politecnico la Fe de Valencia,
Valencia, Spain
(Oteo) Hospital Universitario Puerta de Hierro-Majadahonda, Spain
(Gomez-Blazquez) Department of Cardiology, Hospital Universitario 12 de
Octubre. Instituto de Investigacion Sanitaria Hospital 12 de Octubre
(imas12), Madrid, Spain
(Sabate, Brugaletta, Regueiro) Department of Cardiology. Cardiovascular
Institute, Hospital Clinic of Barcelona, Institut d'Investigacions
Biomediques August Pi i Sunyer (IDIBAPS); CIBER-CV, Spain
(Vilalta) Department of Interventional Cardiology, Germans Trias i Pujol
University Hospital, Badalona, Spain
(Jofresa) Servicio de Cardiologia, Consorcio Hospital General
Universitario de Valencia
(Asmarats) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Amat-Santos) Instituto de Ciencias del Corazon (ICICOR), Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Tello-Montoliu, De Lara) Servicio de Cardiologia. Hospital Universitario
Virgen de la Arrixaca, Murcia, Spain
(de la Torre, Veiga) Servicio de Cardiologia. Hospital Universitario
Marques de Valdecilla, IDIVAL, Santander, Spain
(Flores) Hospital Universitario de A Coruna, Spain
(Gheorghe) Department of Cardiology, Hospital Universitario Puerta del
Mar, Cadiz, Spain
(Peral, Rodriguez-Gabella) Hospital Universitario de Son Espases,
Mallorca, Spain
(Munoz-Garcia) Hospital Universitario Virgen de la Victoria, Malaga, Spain
(Alfonso) Department of Cardiology. Hospital Universitario de la Princesa.
CIBER-CV. IIS-IP. Universidad Autonoma de Madrid. Madrid. Spain, Spain
(Tirado-Conte) Cardiovascular Institute, Hospital Clinico San Carlos,
Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos
(IdISSC), Madrid, Spain
(Valle-Fernandez) Department of Cardiology. Asturias Central University
Hospital, Oviedo, Spain
(Nodar) Department of Cardiology. Hospital General Universitario de
Alicante, Instituto de Investigacion Sanitaria y Biomedica de Alicante
ISABIAL, Alicante, Spain
(Mazuecos) Complejo Hospitalario Universitario Albacete, Albacete, Spain
(Pan) Department of Cardiology. Hospital Universitario Reina Sofia,
IMIBIC, Cordoba, Spain
(Baz, Salvadores, Delewi, Iniguez) Department of Cardiology, Hospital
Alvaro Cunqueiro, University Hospital of Vigo, Vigo, Spain
(Fernandez) Department of Cardiology. Hospital Universitario Virgen del
Rocio. Sevilla, Spain
(Guerreiro, Braga) Department of Cardiology, Vila Nova de Gaia/Espinho
Hospital Center, Vila Nova de Gaia, Portugal
(Jorge) Department of Cardiology, Hospitais da Universidade de Coimbra,
Centro Hospitalar e Universitario de Coimbra, Coimbra, Portugal
(Silva) Department of Cardiology, Centro Hospitalar Sao Joao, EPE, Porto,
Portugal
(Marques) Department of Cardiology, ULS Santa Maria Hospital, Lisbon,
Portugal
(Rodrigues) Cardiology Department, Hospital de Santa Marta, Centro
Hospitalar de Lisboa Central, Lisbon, Portugal
(Neves) Servico de Cardiologia, Hospital Espirito Santo, Evora, Portugal
(Testa, Sisinni) IRCCS Policlinico San Donato, San Donato Milanese, Milan,
Italy
(Costa, Capodanno) Division of Cardiology, University of Catania, Catania,
Italy
(Stefanini) Department of Biomedical Sciences, Humanitas University, Pieve
Emanuele, Milan, Italy. Cardio Center, IRCCS Humanitas Research Hospital,
Rozzano, Milan, Italy
(Pesarini, Ribichini) Division of Cardiology, Department of Medicine,
Verona University Hospital, Verona, Italy
(Angiolillo, Garcia-Garcia) Division of Cardiology, University of Florida
College of Medicine, Jacksonville, FL, United States
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos
(IdISSC), Madrid, Spain; Department of Interventional Cardiology at
MedStar Washington Hospital Center, Washington, DC. USA
Abstract
BACKGROUND: Patients undergoing transcatheter aortic valve implantation
(TAVI) frequently experience life-threatening ischemic and bleeding
complications. However, management of antithrombotic therapy after TAVI in
patients without oral anticoagulation (OAC), particularly in patients with
high burden for subsequent ischemic events, has limited evidence from
randomized controlled trials. <br/>METHOD(S): The REAC TAVI2 trial is a
prospective, multicenter, open-label, phase III randomized trial
(NCT05283356). A total of 1206 patients undergoing TAVI with high ischemic
risk (defined as concomitant coronary artery disease, diabetes mellitus or
peripheral vascular disease) will be randomized in a 1:1 ratio to single
antiplatelet therapy with aspirin (100mg once daily) or low-dose
ticagrelor (60mg twice daily). The primary endpoint is the incidence of a
net adverse clinical event (NACE) at 1-year after TAVI. NACE is defined as
a composite of all-cause mortality, cerebrovascular events, myocardial
infarction, progressive angina leading to emergency evaluation,
rehospitalization or new coronary angiogram, clinical valve thrombosis,
acute limb ischemia leading to hospitalization, and type 2, 3, or 5
bleeding. The secondary endpoint is the incidence of subclinical valve
thrombosis detected by hypo-attenuated leaflet thickening and reduced
leaflet motion at 3 and 12 months post-TAVI assessed by four-dimensional
computed tomography. SUMMARY: In patients undergoing TAVI without an
indication for OAC, there is a need for antiplatelet therapy that provides
protection against ischemic events without increasing bleeding,
particularly in the subset of patients at heightened risk of ischemic
events. The REAC-TAVI 2 is a randomized multicenter clinical trial
designed to study the effect of single antiplatelet therapy with aspirin
compared to low-dose ticagrelor on a composite outcome of all-cause
mortality, ischemic, and bleeding events after TAVI.<br/>Copyright &#xa9;
2025. Published by Elsevier Inc.

<93>
Accession Number
649037715
Title
Comfort-Focused Assessment and Patient-Reported Experience After Regional
versus General Anaesthesia: Post Hoc Analysis of a Cluster-Randomised
Trial.
Source
Anaesthesia, critical care & pain medicine. (pp 101660), 2025. Date of
Publication: 31 Oct 2025.
Author
Maurice-Szamburski A.; Rozier R.; Fusco N.; Meuret L.; Loundou A.; Auquier
P.; Beloeil H.
Institution
(Maurice-Szamburski) Department of Anesthesiology and Intensive Care
Medicine, Pasteur Nice University Hospital, Nice, France
(Rozier) Department of Anesthesiology and Intensive Care Medicine,
L'Archet Nice University Hospital, Nice, France
(Fusco) CHU Rennes, Anesthesia and Intensive Care Department, Rennes,
France; Private Hospital, Anesthesia Department, Saint-Gregoire, France;
Hypnosis Institute, Emergences Campus, F-35000 Rennes, France
(Meuret) CHU Rennes, Anesthesia and Intensive Care Department, CIC 1414,
Rennes, France
(Loundou, Auquier) Laboratoire de Sante Publique, 264 rue Saint Pierre,
Marseille, France
(Beloeil) University of Rennes, CHU Rennes, Inserm, OSS1242, CIC 1414,
Anesthesia and Intensive Care Department, Rennes, France
Abstract
INTRODUCTION: Postoperative pain management typically relies on numerical
(NRS) or analogue rating scales. However, exclusive focus on nociception
may overlook broader aspects of patient experience, especially under
regional anaesthesia (RA). This post hoc analysis of the COMFORT trial
(NCT05234216) examined whether replacing the NRS with a comfort-focused
scale affects patient-reported experience, opioid use, and related
outcomes. <br/>METHOD(S): We analysed data from a cluster-randomised trial
in 29 French centres. Adults undergoing elective non-cardiac surgery
managed in the post-anaesthesia care unit (PACU) were included. The
intervention (comfort scale) and comparator (pain NRS) were applied in the
PACU. Patient-reported experience was measured with the EVAN-G/LR scales,
self-completed on the ward/day-care unit >=4 hours postoperatively.
Participants were divided into RA and general anaesthesia subgroups.
<br/>RESULT(S): Of 885 randomised patients, 786 had evaluable EVAN data.
After regional anaesthesia (RA; n = 305), comfort-focused assessment was
associated with higher EVAN Pain (median 88 [IQR 75-94] vs. 75 [69-88]; p
= 0.034), Waiting (100 [75-100] vs. 75 [50-100]; p = 0.012), and Global
Index (81 [72-91] vs. 77 [68-90]; p = 0.044). After general anaesthesia
(GA; n=481), EVAN scores were similar between groups. Nefopam use was
lower with the comfort approach in RA (7% vs. 18%; p = 0.005). Antiemetic
use was lower with the comfort approach in GA. <br/>CONCLUSION(S):
Replacing the NRS with a comfort-focused approach did not improve global
patient experience after surgery. In patients receiving regional
anaesthesia, however, using a comfort scale was associated with better
patient-reported experience in the EVAN "Pain" dimension, while no benefit
was observed after general anaesthesia.<br/>Copyright &#xa9; 2025.
Published by Elsevier Masson SAS.

<94>
Accession Number
2040988435
Title
Cognitive Function Among Heart Transplant Recipients Before and After
Intravenous Iron Supplement for Iron Deficiency: Results From a
Randomized, Placebo-Controlled, Double-Blind Treatment Trial.
Source
Clinical Transplantation. 39(11) (no pagination), 2025. Article Number:
e70370. Date of Publication: 01 Nov 2025.
Author
Burker B.S.; Brautaset Englund K.V.; Myrdal Ostby C.; Andersson S.;
Gullestad L.; Broch K.
Institution
(Burker) Norwegian National Unit for Sensory Loss and Mental Health, Oslo
University Hospital, Oslo, Norway
(Burker, Brautaset Englund, Myrdal Ostby, Gullestad, Broch) Department of
Cardiology, Oslo University Hospital - Rikshospitalet, Oslo, Norway
(Brautaset Englund) Division of Medicine, Akershus University Hospital,
Lorenskog, Norway
(Andersson) Department of Psychology, University of Oslo, Oslo, Norway
(Gullestad) Institute of Clinical Medicine, University of Oslo, Oslo,
Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: Cognitive dysfunction after successful heart transplantation
(HTx) is not uncommon. Lower hemoglobin levels have previously been
associated with cognitive dysfunction in heart transplant recipients (HTx
recipients). In a randomized, placebo-controlled, double-blind treatment
trial, we assessed as a pre-specified secondary outcome whether a single
intravenous iron supplement for iron deficiency in HTx recipients resulted
in changes in cognitive function after 6 months. <br/>Method(s): In the
"Intravenous Iron Supplement for Iron Deficiency in Cardiac Transplant
Recipients" (IronIC) trial, we assessed cognitive function at baseline and
at 6-month follow-up with the following tests of the Cambridge
Neuropsychological Test Automated Battery: Reaction Time, Paired
Associates Learning, and Spatial Working Memory. Of 94 participants with
cognitive data at baseline and follow-up, 49 were randomized to the single
intravenous iron supplement, while 45 received placebo. <br/>Result(s):
Raw score changes from baseline to follow-up did not differ statistically
significantly between study groups (two measures of each test analyzed).
In the total sample, 27%-44% of participants performed at baseline at
least one standard deviation below the normative mean on measures of
memory and working memory/executive functions. Exploratory analyses
indicated that performance on measures of memory might decrease more than
expected with increasing age. <br/>Conclusion(s): A single intravenous
iron supplement for iron deficiency in HTx recipients did not result in
statistically significant cognitive changes after 6 months. The group as a
whole performed approximately half a standard deviation below the
normative mean on measures of memory and working memory/executive
functions. Regular cognitive screening after HTx is recommended. Clinical
Trial Registration: Trial Registration: ClinicalTrials.gov identifier:
NCT03662789.<br/>Copyright &#xa9; 2025 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<95>
Accession Number
2041445932
Title
Effect of Dexmedetomidine on Endothelial Glycocalyx in Patients Undergoing
Cardiac Surgery with Cardiopulmonary Bypass.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Fan Y.; Chen B.; Fang F.; Gao W.; Wu Q.; Wang W.; He G.
Institution
(Fan) Department of Anesthesiology, Women's Hospital School of Medicine
Zhejiang University, Zhejiang Province, Hangzhou, China
(Chen) Department of Anesthesiology, Taizhou Hospital of Zhejiang Province
affiliated to Wenzhou Medical University, Zhejiang, Linhai, China
(Fang) Department of Anaesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China
(Gao, Wu, Wang, He) Department of Anesthesiology, The First Affiliated
Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou, China
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the protective role of dexmedetomidine on
endothelial glycocalyx in cardiac surgery patients undergoing
cardiopulmonary bypass (CPB). <br/>Design(s): Randomized controlled trial.
<br/>Setting(s): Single-center study conducted from June 2022 to December
2022. <br/>Participant(s): Fifty-eight patients who underwent elective
valvular cardiac surgery with CPB. <br/>Intervention(s): Patients were
randomly assigned to either the dexmedetomidine group (n = 29) or the
saline group (n = 29), with infusion starting 10 minutes before anesthesia
induction and continuing throughout the maintenance phase.
<br/>Measurements and Main Results: Radial artery blood samples were
collected at 4 time points: T1, before anesthesia induction; T2, 5 minutes
after aortic unclamping; T3, 1 hour postoperatively; and T4, 24 hours
postoperatively. The primary endpoint was plasma syndecan-1 concentration,
and secondary endpoints were heparin sulfate and tumor necrosis
factor-alpha (TNF-alpha) levels, and long-term clinical outcomes. Compared
with controls, the dexmedetomidine group showed significantly less
glycocalyx shedding, an effect that persisted throughout CPB and recovery.
TNF-alpha levels were significantly lower at T2-T3, along with reduced
lactate levels on aortic unclamping. <br/>Conclusion(s): Dexmedetomidine
preserves endothelial glycocalyx integrity and attenuates systemic
inflammation in CPB patients.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<96>
Accession Number
2037294064
Title
Efficacy and Safety Profile of Low-Dose Tranexamic Acid Regimen in Cardiac
Surgery: A Meta-Analysis.
Source
Brazilian Journal of Cardiovascular Surgery. 40(5) (no pagination), 2025.
Article Number: e20240022. Date of Publication: 01 Sep 2025.
Author
Wardhana A.; Ghea C.; Nugroho A.; Kinasih N.C.P.; Nugroho J.
Institution
(Wardhana) Department of Anesthesiology, Faculty of Medicine, Universitas
Surabaya, East Java, Surabaya, Indonesia
(Ghea, Nugroho) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Airlangga University, Dr. Soetomo General Hospital, East Java,
Surabaya, Indonesia
(Nugroho, Kinasih) Faculty of Medicine, Public Health and Nursing, Gadjah
Mada University, Special Region of Yogyakarta, Yogyakarta, Indonesia
Publisher
Sociedade Brasileira de Cirurgia Cardiovascular
Abstract
Introduction: Various dosing regimens of tranexamic acid have been
reported to exhibit varying efficacy and safety profiles. Herein, we
conducted a meta-analysis to evaluate the efficacy and safety of low-dose
regimens in open-heart surgery. <br/>Method(s): Three databases were
systematically searched for randomized trials examining the bleeding
reduction effect of tranexamic acid in open-heart surgery. The pooled data
of the low-dose group was then compared with the control, high-dose, and
epsilon aminocaproic acid groups. The boundary between the low-and
high-dose groups was a bolus of 30 mg/kg followed by 16 mg/kg/hour.
<br/>Result(s): The meta-analysis included 81 studies. The low-dose
tranexamic acid regimen was associated with a decreased incidence of
reoperation (risk ratio: 0.52; 95% confidence interval: 0.39-0.69; high
quality of evidence), perioperative myocardial infarction (risk ratio:
0.64; 95% confidence interval: 0.43-0.95; high quality of evidence), the
amount of postoperative bleeding in 24 hours, and the need for transfusion
of packed red cells compared to control, without increasing the rates of
mortality, venous thromboembolism, or stroke. Compared with the high-dose
group, the low-dose group had a lower incidence of seizures and stroke.
The low-dose of tranexamic acid group also showed significantly reduced
postoperative bleeding; however, the cost of an increased risk of seizure
events was higher in the low-dose group than in the epsilon aminocaproic
acid group. <br/>Conclusion(s): Low-dose tranexamic acid effectively
reduced bleeding, the risk of reoperation, and myocardial infarction
without increasing the risk of adverse events.<br/>Copyright &#xa9; 2025,
Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.

<97>
Accession Number
649035738
Title
Efficacy and Safety of Very Low Achieved LDL-Cholesterol in Patients with
Prior Ischemic Stroke.
Source
Circulation. (no pagination), 2025. Date of Publication: 03 Nov 2025.
Author
Monguillon V.; Kelly P.; O'Donoghue M.L.; Park J.-G.; Bohula E.A.; Saver
J.L.; Atar D.; Keech A.C.; Sever P.S.; Wang H.; Paiva da Silva Lima G.;
Sabatine M.S.; Giugliano R.P.
Institution
(Monguillon, O'Donoghue, Park, Bohula, Sabatine, Giugliano) TIMI Study
Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Kelly) Mater Misericordiae University Hospital, Dublin, Ireland; School
of Medicine, University College Dublin, Dublin, Ireland; Health Research
Board Stroke Clinical Trials Network Ireland, Dublin, Ireland
(Saver) Department of Neurology and Comprehensive Stroke Center, David
Geffen School of Medicine at UCLA, Los Angeles, CA, United States
(Atar) Department of Cardiology, Oslo University Hospital Ulleval,
Institute of Clinical Medicine, University of Oslo, Oslo, Norway
(Keech) Sydney Medical School, National Health and Medical Research
Council Clinical Trials Centre, Australia
(Sever) National Heart and Lung Institute, Imperial College London, United
Kingdom
(Wang, Paiva da Silva Lima) Global Development, Amgen, Thousand Oaks, CA,
United States
Abstract
BACKGROUND: Patients with prior ischemic stroke are at high risk for
recurrent stroke and other major adverse cardiovascular events (MACE). The
benefits of achieving very low levels of low-density
lipoproteins-cholesterol (LDL-C) in such patients is unclear.
<br/>METHOD(S): We analyzed patients with prior ischemic stroke enrolled
in FOURIER, a randomized placebo-controlled trial studying evolocumab in
patients with stable atherosclerotic cardiovascular disease (median
follow-up 2.2 years), and through the open-label extension (FOURIER-OLE)
period (additional median follow-up 5 years), to examine the relationship
between achieved LDL-C and the long-term incidence of the primary endpoint
(cardiovascular death, myocardial infarction, stroke, hospitalization for
unstable angina or coronary revascularization) and stroke-related
endpoints. <br/>RESULT(S): The analysis included 5,291 patients with prior
ischemic stroke (more than 4 weeks old). A total of 666 (12.6%), 1410
(26.6%), 586 (11.1%), 508 (9.6%) and 2121 (40.1%) patients achieved LDL-C
values of <20, 20 to <40, 40 to <55, 55 to <70 and >=70 mg/dL,
respectively. The incidence of the primary endpoint, all stroke, and
ischemic stroke each decreased in a monotonic fashion with lower achieved
LDL-C levels on a continuous scale (Ptrend <0.001, 0.002 and 0.002,
respectively). Compared with patients with LDL-C >=70 mg/dL, those who
achieved levels <40 mg/dL had incidence rate ratios (IRRs) (95% CI) of
0.69 (0.57-0.84), 0.73 (0.53-0.99), and 0.75 (0.54-1.05) for the outcomes
of the primary endpoint, all stroke, and ischemic stroke, respectively.
Hemorrhagic strokes were infrequent and unrelated to achieved LDL-C
(Ptrend=0.85). <br/>CONCLUSION(S): In patients with prior ischemic stroke,
it appeared that the lower the LDL-C, down to levels below 40 mg/dL, the
lower the risk of MACE, including recurrent stroke, without a clear
increase in risk of hemorrhagic stroke. These findings support the concept
that more intensive LDL-C lowering in patients with prior ischemic stroke
may be warranted.

<98>
[Use Link to view the full text]
Accession Number
649038655
Title
Percutaneous left atrial appendage closure for stroke prevention in atrial
fibrillation: who should receive it in current clinical practice?.
Source
Current opinion in cardiology. (no pagination), 2025. Date of
Publication: 04 Nov 2025.
Author
d'Entremont M.-A.; Healy J.S.; Jolly S.S.
Institution
(d'Entremont, Healy, Jolly) Population Health Research Institute, McMaster
University, Hamilton, Bermuda
(d'Entremont, Healy, Jolly) Hamilton Health Sciences, Hamilton, Ontario
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke,
QC, Canada
Abstract
PURPOSE OF REVIEW: Although oral anticoagulation (OAC) remains the
cornerstone therapy for stroke prevention in atrial fibrillation, several
limitations, such as noncompliance and bleeding, limit its effectiveness.
Percutaneous left atrial appendage closure (pLAAC) has emerged as a
promising therapy. We will review current and potential indications for
pLAAC and knowledge gaps. RECENT FINDINGS: Current guidelines recommend
pLAAC for patients who have atrial fibrillation at moderate to high risk
of stroke with a high risk of bleeding or who have a contraindication for
OAC. pLAAC is being investigated as a potential therapeutic option for the
following patient populations: end-stage renal disease, after atrial
fibrillation ablation, and in combination with OAC in patients with a high
risk of breakthrough stroke or in patients with prior stroke on OAC. The
Left Atrial Appendage Occlusion Study IV (LAAOS-IV) (n = 4000) is a
randomized trial that will determine the role of pLAAC and OAC compared to
OAC alone in preventing ischemic stroke or systemic embolism. SUMMARY:
pLAAC has a growing role in patients with atrial fibrillation with
moderate to high stroke risk and contraindication to OAC. Multiple
randomized trials are currently underway in different patient populations,
which may expand the role of pLAAC.<br/>Copyright &#xa9; 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<99>
Accession Number
2040964193
Title
The overlooked challenge of perioperative hypertension: unveiling
pathophysiology and redefining management strategies.
Source
Current Medical Research and Opinion. (no pagination), 2025. Date of
Publication: 2025.
Author
Saputra P.B.T.; Widarti W.; Yolanda S.; Hidayat R.A.; Putra R.M.;
Kriswidyatomo P.; Faizah N.N.; Alkaff F.F.
Institution
(Saputra, Hidayat, Putra) Department of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Saputra, Hidayat, Putra) Department of Cardiology and Vascular Medicine,
Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
(Widarti) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Yolanda) Universitas Airlangga Hospital, Universitas Airlangga, Surabaya,
Indonesia
(Kriswidyatomo) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga-Universitas Airlangga Hospital, Surabaya,
Indonesia
(Faizah) Division of Cardiovascular Medicine, Graduate School of Medicine,
Kobe University, Kobe, Japan
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
Taylor and Francis Ltd.
Abstract
Hypertension, defined as systolic blood pressure (BP) >=140 mmHg or
diastolic BP >=90 mmHg, presents a significant challenge in perioperative
settings. Perioperative hypertension is highly prevalent, affecting 25% of
patients undergoing non-cardiac procedures and up to 80% of cardiac
surgeries. This review aims to provide an in-depth examination of
perioperative hypertension, emphasizing its impact on patient outcomes,
current management strategies, and the need for standardized guidelines.
Evidence from observational studies, clinical trials, and expert
guidelines is analyzed to highlight gaps and best practices in
perioperative BP control. A comprehensive literature review was conducted
using scientific databases. Studies examining the incidence,
complications, and management strategies of perioperative hypertension
were included. Perioperative hypertension significantly increases the risk
of adverse cardiovascular events, including myocardial infarction, stroke,
and renal failure, contributing to longer hospital stays and higher
healthcare costs. Patients with significant intraoperative systolic BP
elevations had markedly higher risks of adverse outcomes, including
approximately 1.5-fold higher mortality and a doubling of renal failure
risk. Additionally, hypertension is a leading cause of elective surgery
postponement. Despite its high prevalence, comprehensive management
guidelines remain inadequate, resulting in inconsistent BP control
strategies and suboptimal patient outcomes. The management of
perioperative hypertension requires a more standardized and evidence-based
approach. Current strategies emphasize individualized BP targets,
optimization of antihypertensive therapy, and intraoperative haemodynamic
stability. However, the lack of universally accepted guidelines hinders
effective BP management. Future research should focus on developing
standardized protocols to improve perioperative outcomes and reduce
complications related to hypertension.<br/>Copyright &#xa9; 2025 Informa
UK Limited, trading as Taylor & Francis Group.

<100>
Accession Number
649037094
Title
Comment on: "Effect of vitamin D on postoperative atrial fibrillation in
patients undergoing coronary artery bypass grafting: a systematic review
and meta-analysis".
Source
Minerva cardiology and angiology. (no pagination), 2025. Date of
Publication: 03 Nov 2025.
Author
Salazar Ore J.V.; Redzanova T.; Calderon Martinez E.
Institution
(Salazar Ore) Faculty of Medical Sciences, University of Buenos Aires,
Buenos Aires, Argentina
(Redzanova) Crimean State Medical University, Simferopol, Ukraine
(Calderon Martinez) Department of Internal Medicine, University of Texas
Health Science Center at Houston, Houston, TX, United States

<101>
Accession Number
649024776
Title
Integrating tactile simulation into thoracic surgery education: a Miller's
pyramid-Based study.
Source
BMC surgery. 25(1) (pp 514), 2025. Date of Publication: 31 Oct 2025.
Author
Liu G.; Yang F.; Zhou Z.; Jiang G.
Institution
(Liu, Yang, Zhou, Jiang) Department of Thoracic Surgery, Peking University
People's Hospital, No. 11 ,Xizhimen South Street, Xicheng District,
Beijing, China
(Liu, Yang, Zhou, Jiang) Institute of Advanced Clinical Medicine, Peking
University, Beijing, China
Abstract
Accurate intraoperative localization of pulmonary nodules remains a
significant challenge in video-assisted thoracoscopic surgery (VATS),
especially for small, deep, or subsolid lesions. This prospective cohort
study evaluated the impact of a simulation-based training program using
high-fidelity 3D-printed lung models on surgical trainees' spatial-tactile
localization skills. A total of 67 postgraduate year 1-2 trainees were
randomized into a lung model group (LMG) or a control group (CG). The
curriculum comprised four sequential phases aligned with Miller's Pyramid:
anatomical instruction, CT-to-anatomy mapping, thoracoscopic simulated
localization, and intraoperative localization. Participants in the LMG
achieved significantly higher scores in radiologic-anatomic mapping (6.94
+/- 1.07 vs. 5.82 +/- 1.07; p < 0.001) and simulated localization (2.09
+/- 0.71 vs. 1.45 +/- 0.87; p = 0.002). In clinical procedures, LMG
trainees had a higher localization success rate (68.97%) compared to CG
(66.67%), though not statistically significant (p = 0.877). Self-reported
confidence and satisfaction ratings consistently favored the LMG. These
findings suggest that anatomically realistic, simulation-based tactile
training enhances thoracic surgery trainees' ability to mentally integrate
radiologic data with intraoperative spatial reasoning. Incorporating such
structured modules into thoracic surgical education may improve operative
readiness and reduce reliance on adjunctive localization
technologies.<br/>Copyright &#xa9; 2025. The Author(s).

<102>
Accession Number
2041327732
Title
A Fine Balance: Anticoagulation for Non-Valvular Atrial Fibrillation After
Cerebral Amyloid Angiopathy-Related Intracranial Haemorrhage.
Source
Heart Lung and Circulation. (no pagination), 2025. Date of Publication:
2025.
Author
Turner D.; Kamadasala K.; McGarity B.
Institution
(Turner) Department of Cardiology, Royal Prince Alfred Hospital, Sydney
Local Health District, Sydney, NSW, Australia
(Turner, Kamadasala, McGarity) Department of Cardiology and General
Medicine Bathurst Base Hospital, Western New South Wales Local Health
District, Bathurst, NSW, Australia
(Turner, McGarity) Bathurst Clinical School, University of Western Sydney,
Bathurst, NSW, Australia
Publisher
Elsevier Ltd
Abstract
The management of anticoagulation in patients with non-valvular atrial
fibrillation at high risk of bleeding complications can be challenging.
One such group is elderly patients with previous intracranial haemorrhage
secondary to cerebral amyloid angiopathy (CAA-ICH). These patients have a
high rate of rebleeding, which can be predicted by features on cerebral
magnetic resonance imaging. Common bleeding risk calculators, such as the
HAS-BLED score, underestimate the bleeding event rate in patients with
CAA-ICH due to poor patient representation in validation studies.
Observational studies and subgroup analyses of small randomised controlled
trials have failed to show conclusive evidence of benefit or harm with
restarting anticoagulation after CAA-ICH. The results of larger, dedicated
randomised controlled trials are eagerly awaited. An alternative to
anticoagulation in patients with CAA-ICH and concomitant high ischaemic
stroke risk is left atrial appendage closure, which has been shown to be
effective in this subgroup. This narrative review will use a case to
discuss the currently available evidence on this important topic, given
our ageing population.<br/>Copyright &#xa9; 2025 The Author(s)

<103>
[Use Link to view the full text]
Accession Number
649028983
Title
Efficacy and safety of invasive versus noninvasive treatments in elderly
patients with non-ST-segment myocardial infarction: a systematic review
and meta-analysis.
Source
Coronary artery disease. (no pagination), 2025. Date of Publication: 30
Oct 2025.
Author
Malik S.; Mufaddal Z.Q.; Koskina L.; Siddiqui O.M.; Mansour M.; Nusrat K.;
Khan R.; Sohail M.U.; Farhan S.H.; Singh D.; Ali E.; Hameed I.
Institution
(Malik, Mufaddal, Siddiqui, Khan, Sohail, Farhan, Ali) Department of
Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Koskina, Mansour, Singh, Hameed) Department of Medicine, Medstar Health,
Baltimore, MD, United States
(Nusrat) Department of Medicine, University at Buffalo-Catholic Health
System, Buffalo, NY, United States
Abstract
BACKGROUND: Historically, the elderly population was underrepresented in
clinical trials evaluating the optimal treatment for non-ST-segment
elevation myocardial infarction (NSTEMI). Therefore, we aimed to compare
invasive versus noninvasive strategies for the management of NSTEMI in
older adults. <br/>METHOD(S): PubMed, SCOPUS, and Cochrane Central
Register of Controlled Trials were screened for studies evaluating medical
therapy or invasive revascularization in elderly patients with NSTEMI.
Following outcomes were extracted: all-cause mortality, cardiovascular
death, fatal or nonfatal MI, repeat coronary revascularization, major
adverse cardiovascular events (MACE), bleeding, stroke, noncardiovascular
death, and repeat hospitalization for heart failure. Data were pooled
using random-effects model to evaluate weighted mean differences and risk
ratios with 95% confidence intervals (CIs). This study is registered with
PROSPERO, CRD42024622236. <br/>RESULT(S): Seven studies (n = 2997
patients) were included. Patients treated with medical versus invasive
therapies showed no significant difference in all-cause mortality (risk
ratio: 1.05, 95% CI: 0.94-1.18, P = 0.37); however, invasive therapies
significantly decreased the risk of fatal or nonfatal MI (risk ratio:
0.75, 95% CI: 0.59-0.96, P = 0.02), repeat coronary revascularizations
(risk ratio: 0.29, 95% CI: 0.21-0.40, P < 0.00001), and risk of MACE (risk
ratio: 0.74, 95% CI: 0.61-0.89, P = 0.002). Lastly, invasive therapies
were associated with increased risk of bleeding. <br/>CONCLUSION(S):
Invasive therapy, in comparison to medical management, has reduced
incidence of fatal or nonfatal MI, MACE, and the need for
revascularization; however, no benefit was noted for all-cause and
cardiovascular mortality. Age-specific guidelines must be established for
the management of NSTEMI among older adults.<br/>Copyright &#xa9; 2025
Wolters Kluwer Health, Inc. All rights reserved.

<104>
Accession Number
2041330865
Title
Impact of intraoperatiVe moderAte positive end-expiratory pressure with
reCruitment mAnoeuvres versus low positive end-expiRatory pressure on
major postoperative pulMonary complications and death after on-pump
cardiac surgery in high-risk patients: the VACARM randomised clinical
trial-study protocol.
Source
BMJ Open. 15(10) (no pagination), 2025. Article Number: e104179. Date of
Publication: 29 Oct 2025.
Author
Demaure N.; Le Cunff J.; Duchene M.; Rozec B.; Espitalier F.; Cabon J.-M.;
Oilleau J.-F.; Guerci P.; Labaste F.; Abou-Arab O.; Guinot P.-G.; Duval
P.; Besnier E.; Flecher E.; Leroyer I.; Morcet J.; Fougerou-Leurent C.;
Mansour A.; Nesseler N.
Institution
(Demaure, Le Cunff) Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre
d'Investigation Clinique de Rennes), Department of Anesthesia and Critical
Care, Pontchaillou, Rennes University Hospital, Brittany, Rennes, France
(Duchene) Department of Anesthesia and Critical Care, University Hospital
Centre Nantes, Pays de la Loire, Nantes, France
(Rozec) Department of Anesthesia and Critical Care, Laennec Hospital,
University Hospital of Nantes and Nantes Universite, CHU Nantes, CNRS,
INSERM, l'Institut du Thorax, University Hospital Centre Nantes, Pays de
la Loire, Nantes, France
(Espitalier) Department of Anesthesia and Critical Care, Regional
University Hospital Centre Tours, Centre-Val de Loire, Tours, France
(Cabon) Department of Anesthesia and Critical Care, CHU de Brest,
Brittany, Brest, France
(Oilleau) Departement d'Anesthesie et Reanimation Chirurgicale, Brest
University Hospital Centre, Brittany, Brest, France
(Guerci) Department of Anesthesia and Critical Care, CHU de Nancy,
Lorraine, Nancy, France
(Labaste) Department of Anesthesia and Critical Care, University Hospital
of Toulouse, Toulouse, France
(Abou-Arab) Department of Anesthesia and Critical Care, Amiens-Picardy
University Hospital, Hauts-de-France, Amiens, France
(Guinot) Burgundy Franche-Comte University, Besancon, France
(Duval, Besnier) Department of Anesthesia and Critical Care, University
Hospital Centre Rouen, Normandy, Rouen, France
(Flecher) Cardiothoracic Surgery Unit, Centre Hospitalier Universitaire de
Rennes, Bretagne, Rennes, France
(Leroyer) Univ Rennes, CHU de Rennes, Department of Research and
Innovation, University Hospital of Rennes, Rennes University Hospital,
Brittany, Rennes, France
(Morcet) Inserm, CIC 1414 (Centre d'Investigation Clinique de Rennes),
Rennes University Hospital, Brittany, Rennes, France
(Fougerou-Leurent) Pharmacology, University Hospital Centre Rennes,
Rennes, France
(Fougerou-Leurent) CIC 1414, INSERM, Rennes, France
(Mansour) Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre
d'Investigation Clinique de Rennes), Inra, Inserm, Institut NUMECAN -
UMR_A 1341, UMR_S 1241, Department of Anesthesia and Critical Care,
Pontchaillou, University Hospital of Rennes, Rennes University Hospital,
Rennes, France
(Nesseler) Univ Rennes, CHU Rennes, Inserm, CIC 1414 (Centre
d'Investigation Clinique de Rennes), Inra, Inserm, Institut NUMECAN -
UMR_A 1341, UMR_S 1241, Department of Anesthesia and Critical Care,
Pontchaillou, Rennes University Hospital, Brittany, Rennes, France
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative pulmonary complications (PPCs) are common after
cardiac surgery and are associated with significant morbidity and
mortality. Lung-protective ventilation strategies have been proposed to
reduce PPCs, but the optimal level of positive end-expiratory pressure
(PEEP) and the use of alveolar recruitment manoeuvres (RMs) remain
controversial. Methods/analysis In this investigator-initiated,
multicentre, open, randomised, parallel-group, superiority clinical trial,
elective cardiac surgery patients at risk of PPCs will be assigned to one
of two intraoperative ventilation strategies: (1) an open-lung ventilation
strategy with protective ventilation, moderate PEEP and RMs or (2) a
standard protective ventilation with low PEEP and no RM. The primary
outcome will be a composite of prolonged (>24 hour) postoperative
mechanical ventilation, reintubation for any cause or hospital-acquired
pneumonia within 7 days of surgery, or death within 28 days of surgery.
Data will be analysed on an intention-to-treat basis. Ethics and
dissemination The VACARM (impact of intraoperatiVe moderAte positive
end-expiratory pressure with reCruitment mAnoeuvres versus low positive
end-expiRatory pressure on major postoperative pulMonary complications and
death after on-pump cardiac surgery in high-risk patients) trial has been
approved by an independent ethics committee for all study centres.
Recruitment began in July 2021. Results will be published in international
peer-reviewed medical journals.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<105>
Accession Number
648996113
Title
OPIOID-SPARING EFFECT OF DEXMEDETOMIDINE IN THE OPERATING ROOM: EVIDENCE
FROM RANDOMIZED TRIALS.
Source
Pain Practice. Conference: Algos 2025 International Symposium. Rodos
Greece. 25(Supplement 1) (no pagination), 2025. Date of Publication: 01
Sep 2025.
Author
Baltogianni I.V.; Sakkalis G.; Kapetanakis K.; Fragkou L.; Glavas A.
Institution
(Baltogianni, Sakkalis, Kapetanakis, Fragkou, Glavas) Anesthesiology
Department of General Hospital of Athens Elpis, Athens, Greece
Publisher
John Wiley and Sons Inc
Abstract
Background: Opioids remain the cornerstone of perioperative analgesia but
are associated with adverse effects such as nausea, vomiting, sedation,
ileus, and risk of dependency. Dexmedetomidine (DEX), a selective
alpha-adrenergic agonist with sedative and analgesic properties, is
increasingly used in multimodal protocols. We conducted a systematic
review and meta-analysis to evaluate the opioid-sparing effect of
intravenous dexmedetomidine in adult surgical patients. <br/>Method(s): A
systematic search of PubMed and trial registries identified randomized
controlled trials (RCTs) published between 2020 and 2025 evaluating
intravenous dexmedetomidine (IV DEX) in adult surgical patients. Inclusion
criteria were: (1) intraoperative IV DEX use, (2) comparison with placebo
or standard opioid-based regimens, and (3) reported postoperative opioid
consumption. Ten RCTs involving a total of approximately 1350 patients
were included. Mean differences (MD) in 24-h opioid consumption (converted
to morphine equivalents) were pooled using a fixed-effects model.
<br/>Result(s): Across diverse procedures-including laparoscopic,
orthopedic, thoracic, neurosurgical, bariatric, and cardiac surgeries- IV
DEX significantly reduced postoperative opioid consumption by a pooled
mean of 7.8 mg morphine equivalents (95% CI: 8.45 to 7.14; SE: 0.33).
Additional benefits included lower pain scores, reduced postoperative
nausea and vomiting (PONV), shorter time to mobilization, and in select
cases, improved sedation quality and reduced ventilator duration. No
serious adverse events were reported; mild bradycardia was the most common
side effect and was clinically manageable. <br/>Conclusion(s): Intravenous
dexmedetomidine provides a robust opioid-sparing effect and enhances
postoperative recovery in adult surgical patients. Its favorable safety
and efficacy profile support wider implementation in perioperative
protocols. Further large-scale trials are warranted to define optimal
dosing and evaluate long-term outcomes beyond 24 h.

<106>
Accession Number
649011205
Title
Mitral valve replacement versus conservative therapy in severe acute
ischemic mitral regurgitation: a 20 year series.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: Acute
Cardiovascular Care Congress 2025. Florence Italy. 14(Supplement 1) (pp
i261), 2025. Date of Publication: 01 Apr 2025.
Author
Romeo Arias Escarpulli R.A.E.; Eder Amaro Palomo E.J.A.P.J.; Ana Cristina
Maldonado May A.C.M.M.; Francisco Bolanos Prats F.B.P.; Raul Neri Bale
R.N.B.; Braiana Diaz Herrera B.D.H.; Eduardo Abner Malchan Garcia
E.A.M.G.; Hector Santos Alfaro H.S.A.; Rodrigo Gopar Nieto R.G.N.;
Alexandra Arias Mendoza A.A.M.; Diego Araiza Garaygordobil D.A.G.
Institution
(Romeo Arias Escarpulli, Eder Amaro Palomo, Ana Cristina Maldonado May,
Francisco Bolanos Prats, Raul Neri Bale, Braiana Diaz Herrera, Eduardo
Abner Malchan Garcia, Hector Santos Alfaro, Rodrigo Gopar Nieto, Alexandra
Arias Mendoza, Diego Araiza Garaygordobil) National Institute of
Cardiology Ignacio Chavez, Mexico City, Mexico
Publisher
Oxford University Press
Abstract
Background: Acute ischemic mitral regurgitation (aiMR) remains a serious
complication of acute coronary syndrome (ACS). Severe aiMR affects less
than 1% of ACS's cases, and is associated with increased mortality.
Surgical correction has been recommended as a potential treatment,
however, uncertainty exists in the optimal treatment. <br/>Purpose(s): The
aim of this study was to analyze short-term outcomes of MVR versus medical
therapy for severe aiMR secondary to acute myocardial infarction.
<br/>Method(s): We conducted a retrospective cohort study including adult
patients diagnosed with severe aiMR admitted to the coronary care unit at
from 2006 and 2024, who received either conservative therapy or MVR.
Mitral regurgitation severity was diagnosed following American Society of
Echocardiography guidelines. The primary endpoint was all-cause mortality.
For the analysis we used log-rank tests for survival analysis, depicted
results using Kaplan-Meier curves, and Cox regression to identify
independent predictors of outcomes, adjusted for age, sex, diabetes, and
Killip-Kimball classification. <br/>Result(s): Among 29,244 patients with
ACS included during the study period, 113 (0.38%) had severe aiMR (median
age: 62 years, SD 10; men: 66.37%) and constitute the analytical sample.
Of these, 75 (66.4%) received conservative therapy and 38 (33.6%)
underwent MVR. Severe aiMR was more common in ST-elevation myocardial
infarction (n=75, 66.3%) than Non-ST-elevation myocardial infarction
(n=38, 33.6%) and 94 patients (83.2%) did not receive reperfusion therapy.
Survival rates were 64% (48/75) for medical therapy and 71% (27/38) for
MVR, with no significant difference in a Kaplan-Meier curve analysis
(p=0.54). In a multivariate adjusted Cox regression model (adjusted by
age, sex, Killip-Kimball&diabetes) mitral valve replacement was not
significantly associated with a reduced risk of short term mortality (HR
1.73, 95% CI 0.72-4.62, p=0.19) compared with optimal medical therapy.
<br/>Conclusion(s): In the present real-world study, MVR was not
associated with and improved short-term mortality in severe aiMR patients
compared to conservative therapy, despite being the recommended treatment.
The absence of randomized clinical trials underscores the need for further
research.

<107>
Accession Number
649002098
Title
Open-lung ventilation versus no ventilation during cardiopulmonary bypass
in an innovative animal model of heart transplantation SM Colombo1.
Source
Critical Care. Conference: 43rd International Symposium on Intensive Care
and Emergency Medicine, ISICEM 2024. Brussels Belgium. 28(Supplement 1)
(no pagination), 2024. Date of Publication: 01 Mar 2024.
Author
Karnik V.; Rickards L.; See Hoe L.; Wildi K.; Passmore M.; Suen J.;
McGriffin D.; Fraser J.; Li Bassi G.
Institution
(Karnik, See Hoe, Wildi, Passmore, Suen, Fraser, Li Bassi) Critical Care
Research Group, Brisbane, Australia
(Rickards) Sunshine Coast Hospital, Sunshine Coast, Australia
(McGriffin) Alfred Hospital, Melbourne, Australia
Publisher
BioMed Central Ltd
Abstract
Introduction: Open-lung ventilation is a potential strategy to mitigate
acute respiratory failure following cardiac surgical procedures with
cardiopulmonary bypass (CPB), such as heart transplantation (HTx). We
conducted a randomized study in an innovative ovine model of HTx to
investigate whether open-lung ventilation during CPB reduces postoperative
lung damage and complications. <br/>Method(s): Eighteen sheep received HTx
either from brain dead (n = 9) or sham (no neurological injury) donors (n
= 9). During the period of CPB, ventilatory interventions were randomly
assigned: The OPENVENT group received low tidal volume ( VT) of 3 mL/kg
and positive end expiratory pressure (PEEP) of 8 cm of H20, while no
ventilation was provided in the NOVENT group, as per standard of care. The
recipient sheep were monitored for 6 h post-surgery. The primary outcome
was histological lung damage score at the end of study. Secondary outcomes
included pulmonary shunt, driving pressure, hemodynamics, and inflammatory
cell lung infiltration. <br/>Result(s): The OPENVENT group showed
significantly lower histological lung damage versus the NOVENT group
(Figure: 1.05 vs. 1.51, p < 0.001). Pulmonary shunt (19.2% vs. 32.1%, p =
0.0012) and driving pressure was reduced in the OPENVENT group (9.6 vs.
12.8 cm of H2O, p = 0.04). Finally, lungs in the OPENVENT group presented
lower neutrophil (5.25% vs. 7.97%, p < 0.001) and macrophage infiltrations
(11.1% vs. 19.6%, p < 0.001). No significant differences were observed in
hemodynamic parameters between groups. <br/>Conclusion(s): In an ovine
model of HTx, open-lung ventilation during CPB significantly reduced lung
histological injury and inflammatory cell infiltration. The study
highlights the value of an open-lung approach during CPB and emphasizes
the need of translating these findings to decrease risks of acute
respiratory failure in HTx patients.

<108>
[Use Link to view the full text]
Accession Number
649009932
Title
Sentinel Cerebral Embolic Protection in Patients with Transcatheter Aortic
Valve Replacement: A Meta-analysis of Randomized Controlled Trials and
Trial Sequential Analysis.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 15 Oct
2025.
Author
Joshi D.K.; Kirmani N.; Pinilia J.; Ratan P.; Majeed M.W.; Purohit A.;
Desai D.P.; Garg Y.; Maheta D.K.; Agrawal S.P.
Institution
(Joshi, Purohit) From the Department of Internal Medicine, Narendra Modi
Medical College and Sheth L.G. Hospital, Ahmedabad, India
(Kirmani) Department of Internal Medicine, Dow Medical College, Karachi,
Pakistan
(Pinilia) Department of Internal Medicine, School of Medicine, CES
University, Medellin, Colombia
(Ratan) Department of Internal Medicine, Patna Medical College, Patna,
India
(Majeed) Department of Internal Medicine, VMMC and Safdarjung Hospital,
New Delhi, India
(Desai) Department of Internal Medicine, B.J. Medical College, Ahmedabad,
India
(Garg) Department of Internal Medicine, North Knoxville Medical Center,
Powell, TN, United States
(Maheta) Department of Public Health, New York Medical College, Valhalla,
NY, United States
(Agrawal) Department of Internal Medicine, New York Medical
College/Landmark Medical Center, Woonsocket, RI, United States
Abstract
Transcatheter aortic valve replacement (TAVR) is widely used to treat
severe aortic stenosis, and stroke remains a serious complication. The
Sentinel cerebral embolic protection (CEP) device is designed to reduce
this risk. However, it is still unclear if it truly improves patient
outcomes. This meta-analysis evaluates whether the Sentinel device reduces
stroke, death, or neurological complications. We searched PubMed, Embase,
and Cochrane Central for randomized controlled trials comparing the use of
the Sentinel CEP versus no device in patients undergoing TAVR. Outcomes
included stroke within 72 hours, disabling stroke, any stroke, transient
ischemic attack, and mortality. Statistical analysis was performed using R
version 4.4.2. Heterogeneity was assessed using the I2 statistic. Five
randomized controlled trials with 11,006 patients were included; 50.0% (n
= 5502) received the CEP device and 50.0% (n = 5504) did not. Lower risk
of stroke within 72 hours was observed with Sentinel CEP, although the
difference was nonsignificant [2.3% vs 2.5%; risk ratio (RR): 0.88, 95%
confidence interval (CI): 0.69-1.12; P = 0.292; I2 = 0%]. No significant
difference was observed in the incidence of transient ischemic attack
between both groups (0.4% vs 0.3%; RR: 1.28, 95% CI: 0.66-2.50; P = 0.465;
I2 = 0%). All-cause mortality rates were comparable between both groups
(0.7% vs 0.7%; RR: 1.08, 95% CI: 0.69-1.69; P = 0.748; I2 = 0%). CEP
during TAVR was not associated with a significant reduction in
neurological or mortality outcomes, indicating no clear overall clinical
benefit in the studied population. Further studies are needed to determine
its potential role in selected high-risk patients.<br/>Copyright &#xa9;
2025 Wolters Kluwer Health, Inc. All rights reserved.

<109>
Accession Number
649013445
Title
The effect of Kangaroo care on vital signs in infants undergoing cardiac
surgery: A randomized controlled study.
Source
Journal of pediatric nursing. (no pagination), 2025. Date of Publication:
29 Oct 2025.
Author
Cengizli D.; Albayrak S.
Institution
(Cengizli) Gelisim University Faculty of Health Sciences, Nursing
Department, Istanbul, Turkey
(Albayrak) Istinye University Faculty of Health Sciences, Nursing
Department, Istanbul, Turkey
Abstract
BACKGROUND AND PURPOSE: This study aimed to determine the effect of
kangaroo care on vital signs in infants undergoing cardiac surgery. DESIGN
AND METHODS: This randomized controlled study was conducted in the
pediatrics cardiovascular surgery intensive care unit of a training
research hospital between December 2023 and March 2024. The sample
consisted of 60 infants who had undergone cardiac surgery, with 30
assigned to the experimental group and 30 to the control group. The
experimental group received kangaroo care during the procedure. Data was
collected via the Descriptive Information Form about sample
characteristics and the Vital Signs and Pain Recording Form. The data were
analyzed using descriptive statistics, Chi-square, independent sample
t-tests, ANOVA, and mixed effect model variance analysis. The study was
recorded in the Clinicaltrials.gov PRS system. <br/>RESULT(S): The
mixed-method comparison showed a high level of significance in the
intervention group regarding heart rate and respiratory rate reductions,
pain score reduction, and increased peripheral saturation levels in both
time and group measurements (p < 0.001). Additionally, the decrease in
systolic blood pressure in the intervention group was significant in the
group measurements (p < 0.001), whereas time-based comparisons showed no
significant changes in diastolic blood pressure (p > 0.05). Comparison of
changes in pre-test and post-test vital signs between the intervention and
control groups were significant, except for diastolic blood pressure (p <
0.05). <br/>CONCLUSION(S): The study demonstrated that post-surgical
kangaroo care in infants undergoing cardiac surgery reduced heart rate,
systolic arterial pressure, and respiratory rate, while increasing
peripheral saturation levels and decreasing pain scores. IMPLICATIONS FOR
PRACTICE: The integration of kangaroo care into post-cardiac surgery care
practices may lead to improvements in infants' vital signs and promote
relaxation through mother-infant skin-to-skin contact. This, in turn,
could potentially enhance family-centered care practices in cardiac
surgery units, and, in the future, improve the quality of care outcomes
for both mothers and infants.<br/>Copyright &#xa9; 2025 Elsevier Inc. All
rights reserved.

<110>
[Use Link to view the full text]
Accession Number
649010110
Title
Efficacy and Safety of Minimally Invasive Maze Versus Conventional Maze
for the Treatment of Atrial Fibrillation: A Meta-Analysis of Clinical
Outcomes.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 13 Oct
2025.
Author
Cheema S.; Ijaz H.; Faheem M.S.B.; Areeb-Ul-Haq M.; Hassan M.F.
Institution
(Cheema, Ijaz, Hassan) From the Department of Internal Medicine, King
Edward Medical University, Lahore, Pakistan
(Faheem) Department of Medicine and Surgery, Karachi Institute of Medical
Sciences, KIMS, Karachi, Pakistan
(Areeb-Ul-Haq) Department of Internal Medicine, Allama Iqbal Medical
College, Lahore, Pakistan
Abstract
The minimally invasive MAZE (mi-MAZE) procedure, a less invasive form of
conventional MAZE (c-MAZE) procedure developed by Dr. Randall Wolf, has
demonstrated promising outcomes in the treatment of atrial fibrillation.
We conducted a meta-analysis by searching PubMed, Embase, Cochrane, and
clinical trials databases. After screening 3771 studies, we included 7
studies, a total of 1486 patients, in our analysis. We analyzed
dichotomous and continuous outcomes, with 95% confidence intervals (CI),
using RevMan 5.4. Heterogeneity was calculated by I2 and chi2. P value
<0.05 was deemed significant. This meta-analysis included 7 cohort studies
involving 1486 patients. There was a significant decrease in length of
hospital stay (days) in the mi-MAZE group (mean difference (MD), -1.22,
95% CI, -1.36 to -1.08, I2 = 97%). At both 6 months and 12 months, sinus
rhythm maintenance in the mi-MAZE group was noninferior to the c-MAZE (6
months = odds ratio (OR), 1.48, 95% CI, 0.88-2.51, I2 = 0%, 12 months =
risk ratio (RR), 0.99, 95% CI, 0.94-1.03, I2 = 38). mi-MAZE was
noninferior to c-MAZE in the safety outcomes such as pneumonia (RR, 0.80,
95% CI, 0.46-1.41, I2 = 27%), stroke (RR, 0.54, 95% CI, 0.11-2.58), and
kidney injury (RR, 1.18; 95% CI, 0.38-3.64). In our meta-analysis, mi-MAZE
showed a reduction in the length of hospital stay. mi-MAZE was noninferior
to c-MAZE in efficacy and safety outcomes. These trends warrant
well-designed clinical trials to determine their clinical significance
further.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<111>
Accession Number
649011053
Title
The effect of early administration of colchicine in non
ST-segment-elevation myocardial infarction patients.
Source
European Heart Journal: Acute Cardiovascular Care. Conference: Acute
Cardiovascular Care Congress 2025. Florence Italy. 14(Supplement 1) (pp
i145), 2025. Date of Publication: 01 Apr 2025.
Author
Shengelia T.; Nadaraia K.-N.; Rigvava L.R.; Gordeladze N.G.; Rukhaia S.R.
Institution
(Shengelia, Nadaraia, Rigvava, Gordeladze, Rukhaia) Tbilisi state
university clinic VIvamedi, Clinical and interventional cardiology
department, Tbilisi, Georgia
Publisher
Oxford University Press
Abstract
Background: In re-perfused non ST-segment-elevation myocardial infarction,
inflammation is a major contributor to myocardial damage. One of these
medicines is colchicine, a well-known medication that has been used in
clinical practice for millennia to treat inflammation. Indeed, colchicine
has direct anti-inflammatory and pleiotropic effects, as well as possible
anti-arrhythmic, anti-fibrotic and anti-atherosclerotic properties all of
which are very relevant in this population. Colchicine effects in the
context of acute myocardial infarction were investigated in numerous
clinical studies. <br/>Purpose(s): We hypothesized that early
administration of the potent anti-inflammatory medication called
colchicine could improve outcomes with non-ST-segment-elevation myocardial
infarction. Our primary goal was to compare the primary effectiveness and
safety endpoints Methods: We conducted a randomized, double-blind trial
with patients enrolled within 1 day to 30 days following a myocardial
infarction. One group receives 2mg colchicine on the first day of MI
before PCI, while the second group receives colchicine after PCI for 30
days after myocardial infarction. The initial dose was 2 mg, which was
followed by 0.5 mg of colchicine once a day for one month. The primary
effectiveness endpoint was a composite of cardiovascular-related death,
resuscitated cardiac arrest, myocardial infarction, stroke, or urgent
hospitalization for angina requiring coronary revascularization. All-cause
mortality, Acute renal damage, bleeding, gastrointestinal events and
life-threatening arrhythmias were used to determine safety. The components
of the primary endpoint and safety, HS-CRP,6 min walk, EF were also
evaluated on a day 0, 1 and 3 month follow up visits from randomization.
<br/>Result(s): A total of 172 patients satisfied the inclusion criteria
and were randomized. One hundred patients were assigned to the early
treatment group, and 72 to the late treatment group. Colchicine
pre-treatment in NSTMI patients (Group 1) reduces the risk of
cardiovascular-related death, resuscitated cardiac arrest, myocardial
infarction, stroke, or urgent hospitalization for angina requiring
coronary revascularization, as well as the composite of adverse
cardiovascular events, Hs-CRP levels( P < 0.05). . The risk of adverse
gastrointestinal events were increased in both group, there was no
significant difference between them ( P < 0.05). . Also there was no
significant difference between groups in on all-cause mortality, or the
incidence of stroke (P < 0.05). . <br/>Conclusion(s): Early administration
of Colchicine lowers the risk of cardiovascular-related death,
resuscitated cardiac arrest, myocardial infarction, stroke, or urgent
hospitalization for angina requiring coronary revascularization (P <
0.05). Early administration no influence on the incidence of stroke, or
all-cause death.

<112>
Accession Number
648996191
Title
CRYOANALGESIA AND OPIOID CONSUMPTION ON POSTOPERATIVE PAIN IN THORACIC
SURGERY.
Source
Pain Practice. Conference: Algos 2025 International Symposium. Rodos
Greece. 25(Supplement 1) (no pagination), 2025. Date of Publication: 01
Sep 2025.
Author
Tyrovola N.; Mis M.; Markoulatou V.; Zachariadi M.; Papageorgiou E.;
Astropekaki Aik.; Dermitzaki E.; Vitoula K.; Karampinis I.; Athanassiadi
K.; Romana C.
Institution
(Tyrovola, Mis, Zachariadi, Markoulatou, Zachariadi, Papageorgiou,
Astropekaki, Dermitzaki, Vitoula, Romana) Departments of Anaesthesiology,
Evaggelismos General Hospital, Athens, Greece
(Karampinis, Athanassiadi) Departments of Thoracic Surgery, Evaggelismos
General Hospital, Athens, Greece
Publisher
John Wiley and Sons Inc
Abstract
The optimal approach to pain management after thoracic surgery remains
poorly defined. The purpose of this study was to examine the association
between intercostal nerve cryoanalgesia and postoperative opioid analgesic
requirements. <br/>Method(s): We conducted a single center retrospective
review of 30 patients who underwent open pulmonary lobectomy. The patients
received intercostal nerve cryoanalgesia (group I) n = 15 were compared
with standard opioid analgesia (group II) n = 15. All patients were
subjected to general anaesthesia with intubation with a double lumen tube
and mechanical ventilation. After induction of anaesthesia fentanyl 2-4
mcg/kg, propofol 3-5 mg/kg, ketamine 0.5 mg/kg, sevoflurane 1-1.5 mac were
administered and analgesia was maintained with fentanyl and remifentanil
as proper. Approximately 30 min before the end of the procedure morphine
100 mcg/kg was administered to the two groups. In the postoperative period
morphine was administered in regural intervals: boluses max 0.1 mg/kg
every 4 h, if visual analogue pain scale score (VAS) > 5. Patients
receiving cryoanalgesia intraoperatively were treated with the cryoflex
probe at 70degreeC for 2 min at 5 intercostal spaces encompassing the
location of the surgical incision. Complications of the cryolysis
procedure were defined as: neuropathetic specific pain described as
"burning" sensations in the operated area. Adverse reactions due to opioid
were: nausea, pruritus, breathing difficulties, dizziness, apnoea,
bradycardia, and decrease in SpO2 < 90%. Evaluation of acute pain
intensity in the first day after surgery, measurement every 4 h for 24 h
VAS (0-10), the total dose of morphine, the duration of iv opioid use - up
to which day after surgery, side effects of opioids, were recorded.
<br/>Result(s): The Wilcoxon rank -sum test demonstrated significantly
less inpatient opioid use for cryoanalgesia Group I, (50 mg vs. 150 mg
Group II, p < 0.001), cryoanalgesia lowered daily VAS score (4 to 7 Group
II p < 0.001), morphine use up to the 5th day to Group I/8th day. Group
II, no side effects of cryolysis were recorded and opioid side effects
were at 15% Gr.I/19% Gr.II. <br/>Discussion(s): Cryoanalgesia involves
freezing nerves, causing reversible neurolysis of the selected intercostal
nerves, which disrupt their ability to transmit pain signals. The
intensity and duration of the pain relief are increased depending on the
degree of neurolysis, which lasts to 6-10 months. <br/>Conclusion(s): Our
results suggest that intraoperative cryoanalgesia during thoracic surgery
is associated with lower inpatient opioid requirements and postoperative
pain. Favorable trends for improved pulmonary function and reduced opioid
use are benefits not easily achieved using other strategies.

<113>
Accession Number
649002092
Title
Mechanical ventilation strategy during cardiopulmonary bypass. Impact on
outcomes and pulmonary complications in the intensive care unit.
Source
Critical Care. Conference: 43rd International Symposium on Intensive Care
and Emergency Medicine, ISICEM 2024. Brussels Belgium. 28(Supplement 1)
(no pagination), 2024. Date of Publication: 01 Mar 2024.
Author
Vakhrushev I.; Li T.; Kuanyshbek A.; Tulegenov S.; Bukirova P.
Institution
(Vakhrushev, Li, Kuanyshbek, Tulegenov, Bukirova) National Research
Cardiac Surgery Center, Cicu, Astana, Kazakhstan
Publisher
BioMed Central Ltd
Abstract
Introduction: The immediate post-operative phase following cardiac surgery
is a delicate and difficult phase in which serious complications can
occur. One of the most dangerous complications is respiratory
insufficiency, which is aggravated by the restriction of chest movement,
haemodilution and non-physiological blood circulation during
cardiopulmonary bypass (CPB). The impact of mechanical ventilation
settings during CPB on the postoperative period is still debated.
<br/>Method(s): Prospective, randomised, controlled study at one centre.
Adult patients undergoing on-pump cardiac surgery (coronary artery bypass
grafting (CABG)) by sternotomy for coronary artery disease were included.
Patients were randomised into two groups-one group that received
mechanical ventilation and one group that did not receive ventilation
during CPB. The main endpoint was PaO2/ FiO2 as a marker for the quality
of ventilation and perfusion measured in the ICU in the immediate
postoperative period. Secondary endpoints were driving pressure, minute
ventilation and postoperative pulmonary complications such as atelectasis
and acute respiratory distress syndrome. Atelectasis was diagnosed using
the USI method. The patients in both groups were comparable with regard to
the primary parameters. <br/>Result(s): Fifty-two consecutive patients
were included, 25 and 27 in each group. No significant difference was
found in the PaO2/ FiO2 ratio in the groups (p = 0.06). A significant
difference was found in driving pressure 10.13 +/- 2.76 versus 8.75 +/-
3.1 cmH2O with p = 0.03. More complications such as acute respiratory
distress syndrome and USI signs of atelectasis (5 vs. 16) were observed in
the non-ventilated group. Results are shown in the Table.
<br/>Conclusion(s): Prolonged absence of mechanical ventilation during CPB
may lead to an increase in cases of atelectasis. Maintaining mechanical
ventilation during CPB may be beneficial for patients undergoing cardiac
surgery. Strategy of mechanical ventilation during CPB need in further
research.

<114>
[Use Link to view the full text]
Accession Number
649010589
Title
A Systematic Review of Aortic Valve Repair With Geometric Ring
Annuloplasty: Clinical Implications With a Meta-Analysis of Aortic
Insufficiency.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 15 Oct
2025.
Author
Tejada B.; Phillip A.F.; Fountos D.M.; Ali M.M.; Yibas K.; Sehgal V.
Institution
(Tejada, Fountos, Ali, Yibas, Sehgal) From the CUNY School of Medicine,
New York, NY
(Phillip) Washington University in St. Louis, St. Louis, MO, United States
Abstract
This systematic review aimed to consolidate current literature on the use,
outcomes, and clinical implications of Hemispherical Aortic Annuloplasty
Reconstructive Technology (HAART) geometric ring annuloplasty (GRAP) for
both tricuspid aortic valve and bicuspid aortic valve repair (AVr). A
systematic search of Pubmed, Embase, and Google Scholar (2015-2025)
following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines was conducted. Included studies involved adult
patients undergoing AVr with HAART rings and reporting follow-up aortic
insufficiency. Quality was assessed using Risk of Bias in Non-Randomized
Studies (ROBINS-I). Data on patient demographics, surgical details, aortic
insufficiency grade, mean aortic valve gradient, and reoperations were
extracted and analyzed. Nine studies (410 patients: 219 tricuspid valves
and 191 bicuspid valves) met the inclusion criteria. GRAP, often with
adjunctive procedures, significantly reduced aortic insufficiency in
tricuspid, bicuspid, and overall cohorts. Post repair gradients were
generally below 15 mm Hg. The overall reoperation rate was 5.37% (22
patients), with tricuspid aortic valve cohorts at 5.48% and bicuspid
aortic valve cohorts at 4.2%. Reasons included progressive aortic
insufficiency and ring-related issues. GRAP with the HAART system is an
effective AVr technique for tricuspid and bicuspid pathologies, showing
promising mid-term outcomes. Further long-term data are
needed.<br/>Copyright &#xa9; 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<115>
Accession Number
2040850867
Title
The Importance of Mentorship in Thoracic Surgery Residency.
Source
Journal of Clinical Medicine. 14(20) (no pagination), 2025. Article
Number: 7391. Date of Publication: 01 Oct 2025.
Author
Ciriaco P.
Institution
(Ciriaco) Department of Thoracic Surgery, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Effective mentorship is a critical component of thoracic
surgery training, fostering the acquisition of advanced clinical skills,
professional identity, and academic growth essential for the development
of future specialists. This perspective article examines the role of
mentorship in thoracic surgery training, with a particular focus on the
value perceived by residents. <br/>Method(s): The research was conducted
on Pubmed, using the following targeted search queries: 'mentorship and
thoracic residency' and 'thoracic surgery residents' satisfaction'. Only
studies published in English between 2015 and 2025 were included. Studies
lacking primary data on mentorship outcomes were excluded. <br/>Result(s):
Out of 286 studies initially identified, 25 fulfilled the inclusion
criteria. Five main thematic domains emerged: Impact and Effectiveness of
Mentorship (12 studies), Training Pathways and Workforce (13), Diversity,
Gender, and Equity (8), Resident Well-Being and Outcomes (4), and
Assessment Tools (1). Overlaps among domains were frequent, underscoring
the multifaceted role of mentorship in thoracic surgery training.
<br/>Conclusion(s): Mentorship is a key determinant of success in thoracic
surgical training, enhancing technical skills, clinical performance, and
academic productivity while protecting resident well-being. It also
promotes diversity, equity, and inclusion, supports workforce
sustainability, and strengthens professional development. Evidence
confirms that mentorship should be considered an essential component of
training curricula, with future efforts directed toward structured,
equitable, and measurable mentorship programs.<br/>Copyright &#xa9; 2025
by the author.

<116>
Accession Number
2041375770
Title
Transcatheter procedures for tricuspid regurgitation in advanced heart
failure: A systematic review.
Source
Trends in Cardiovascular Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Kourek C.; Sicouri S.; Magouliotis D.E.; Xanthopoulos A.; Ramlawi B.
Institution
(Kourek) Department of Cardiology, 417 Army Share Fund Hospital of Athens
(NIMTS), Athens, Greece
(Sicouri, Magouliotis, Ramlawi) Department of Cardiac Surgery Research,
Lankenau Institute for Medical Research, Wynnewood, PA, United States
(Xanthopoulos) Department of Cardiology, University Hospital of Larissa,
Larissa, Greece
(Ramlawi) Department of Cardiac Surgery, Lankenau Medical Center,
Wynnewood, PA, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid regurgitation (TR) in advanced heart failure (HF) is associated
with poor prognosis, functional decline, and increased morbidity. This
systematic review synthesizes current evidence of transcatheter device
tricuspid transcatheter approaches in advanced HF patients. A
comprehensive search of PubMed, Embase, Scopus, CINAHL, and the Cochrane
Library identified studies evaluating transcatheter procedures for
moderate-to-severe TR in advanced HF, and reporting procedural outcomes,
survival, and functional measures. A total of 37 studies encompassing
approximately 2,372 patients were included, spanning edge-to-edge repair
systems (TriClip, PASCAL), annuloplasty devices (Cardioband, Trialign,
TriCinch), transcatheter valve replacement (Evoque, LuX-Valve, NaviGate,
Intrepid), heterotopic caval valve implantation (TricValve, Tricento), and
leaflet spacers (FORMA). Most patients were in NYHA class III-IV with high
surgical risk scores. Across techniques, procedural success rates were
high, with consistent reductions in TR severity and improvements in NYHA
class, 6-minute walk distance, and quality-of-life scores. Edge-to-edge
repair was the most frequently studied, showing favorable safety and
symptom improvement. Mortality rates varied, with limited long-term
follow-up data. Transcatheter interventions for TR in advanced HF offer
promising improvements in symptoms, functional status, and quality of
life. Given patient and anatomical heterogeneity, an individualized
approach is essential.<br/>Copyright &#xa9; 2025 Elsevier Inc.