EPICORE Embase Updates: December 2025

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<1>
Accession Number
2041639211
Title
A systematic review of frailty changes following solid organ
transplantation: Is it all about the frailty tool?.
Source
Transplantation Reviews. 40(1) (no pagination), 2026. Article Number:
100969. Date of Publication: 01 Jan 2026.
Author
Li K.; Payne T.; Francis R.; Hubbard R.E.; Gordon E.H.
Institution
(Li, Payne, Francis, Hubbard, Gordon) Centre for Health Services Research,
Faculty of Health, Medicine and Behavioural Sciences, The University of
Queensland, Brisbane, Australia
(Francis) Department of Kidney & Transplant Service, Princess Alexandra
Hospital, Brisbane, QLD, Australia
(Hubbard, Gordon) Department of General and Geriatric Medicine, Princess
Alexandra Hospital, Brisbane, Australia
(Hubbard, Gordon) The Australian Frailty Network, The University of
Queensland, Brisbane, Australia
Publisher
Elsevier Inc.
Abstract
Introduction: Frailty is increasingly recognized among patients with
advanced organ disease (AOD). Solid organ transplantation (SOT) improves
survival rates of patients with AOD and also impacts frailty status.
However, there is considerable heterogeneity in frailty changes post-SOT
reported in the literature. This study aims to determine whether the type
of frailty tool contributes to heterogeneity in frailty outcomes after
transplantation. Method(s): We searched PubMed, Embase, MEDLINE,
Scopus, and Web of Science up to 1 August 2025 for studies assessing
frailty before and after SOT in adults. Frailty tools were classified as
phenotypic or deficit accumulation tools. Meta-analyses were conducted on
baseline prevalence and changes in prevalence, with subgroup analyses by
tool type and organ type. Narrative synthesis described changes in frailty
scores, state transitions, and domain-specific outcomes across early,
intermediate, and late post-transplant stages. Result(s): Forteen
studies (n = 3443) were included. Overall, phenotypic tools consistently
captured reductions in frailty prevalence during the intermediate stage
(6-12 months) post-transplant (mean difference, MD: -0.09; 95 % CI: -0.12
to -0.07; I2 = 0 %). In contrast, studies using deficit
accumulation tools showed inconsistent results with high heterogeneity
(MD: -0.19; 95 % CI: -1.18 to 0.79; I2 = 96.9 %). The
organ-specific subgroup analysis revealed substantial heterogeneity within
organ groups. Improvements in frailty scores and transitions to non-frail
states were more frequently observed with the phenotypic tools with
physical domains such as grip strength and activity improvement, while
some deficit accumulation tools demonstrated deterioration.
 Conclusion(s): Phenotypic frailty tools consistently detect
improvements during intermediate post-SOT recovery, while deficit
accumulation tools yield variable findings, highlighting the importance of
appropriate frailty tool choice. Copyright © 2025

<2>
Accession Number
2041620928
Title
High-dose intravenous iron significantly reduces the risk of red blood
cell transfusion and improves postoperative hemoglobin levels after
cardiac surgery: A systematic review of randomized controlled trials.
Source
PLOS ONE. 20(11 November) (no pagination), 2025. Article Number: e0336773.
Date of Publication: 01 Nov 2025.
Author
Wang L.; Ma C.H.; Yang S.Y.; Zhang Z.G.
Institution
(Wang, Ma, Yang, Zhang) Department of Cardiac Surgery, The Affiliated
Hospital of Guizhou Medical University, Guizhou Province, Guiyang, China
Publisher
Public Library of Science
Abstract
Background High-dose intravenous iron supplementation offers substantial
hematologic protective benefits in clinical practice; however, its
efficacy in enhancing blood protection during cardiac surgery remains
uncertain. The present study aimed to investigate the effects and safety
of high-dose intravenous iron as an optimal blood management strategy for
patients undergoing cardiac procedures. Methods Major databases, including
PubMed, Embase, and Cochrane, were searched on June 20, 2025, for
randomized controlled trials (RCTs) comparing red blood cell transfusion
rates in adult patients undergoing high-dose intravenous iron
supplementation versus those receiving control therapy (placebo) following
cardiac surgery. The secondary outcome measures included postoperative
hemoglobin levels, length of hospital stay, and incidence of adverse
events. Results Seven RCTs involving 975 subjects were identified in the
database search. Compared with the control group (placebo), high-dose
intravenous iron significantly decreased the rate of postoperative red
blood cell transfusion among patients undergoing cardiac surgery (risk
ratio 0.69, 95% confidence interval [CI] 0.52-0.91, P=0.009,
I2=61%, n=975, certainty of evidence: moderate). Furthermore,
one week or more following surgery, administration of high-dose
intravenous iron resulted in a significant increase in postoperative
hemoglobin levels (mean difference 0.71, 95% CI 0.41 to 1.01, P < 0.00001,
n = 907, I2 = 63%, certainty of evidence: moderate).
Significant differences between the groups were not observed for the other
outcome measures, including mortality, infection rates, and cardiovascular
events. Conclusions High-dose intravenous iron supplementation during the
perioperative period of cardiac surgery significantly reduces the risk of
red blood cell transfusion and enhances postoperative hemoglobin levels.
Although the present study demonstrated a favorable safety profile for
intravenous iron administration, the limitations of the present
meta-analysis necessitate continued vigilance regarding potential
drug-related risks associated with intravenous iron therapy. Systematic
review protocol: CRD420251069827 (PROSPERO). Copyright © 2025
Wang et al. This is an open access article distributed under the terms of
the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author
and source are credited.

<3>
Accession Number
2041626929
Title
Effect Of Breathing Exercises On Postoperative Recovery After Cardiac
Surgery.
Source
Vascular and Endovascular Review. 8(9 S) (pp 254-261), 2025. Date of
Publication: 2025.
Author
Bhojak N.; Mathew R.; Khan A.; Gupta P.; Rao M.; Tabassum F.; Naqvi S.;
Rajauria G.
Institution
(Bhojak) GCRC, Govt Dungar College (NAAC 'A' Grade), MGS University,
Bikaner, India
(Mathew) Dayanand Sagar University, College of Pharmaceutical Sciences,
Devarakaggalahalli, Harohalli, Kanakapura Road, South District, Bengaluru,
India
(Khan) Department of Pharmaceutics, ERA College of Pharmacy, ERA
University, Sarfarazganj, Uttar Pradesh, Lucknow, India
(Gupta) Career Point School of Pharmacy, Career Point University,
Rajasthan, Kota, India
(Rao) GokulAyurvedic College, Gokul Global University, Near SujanpurPatia,
GJ SH 41, Gujarat, Sidhpur, India
(Tabassum) Department of Nursing, Alghad International Colleges of Applied
Medical Sciences, Al-Ghuwaila Agricultural Plans, Najran, Saudi Arabia
(Naqvi) Physiotherapy MGH Mahatma Gandhi Physiotherapy College MGUMST
Sitapura, Rajasthan, Jaipur, India
(Rajauria) Institute of Pharmacy and Paramedical Sciences, Dr.
BhimraoAmbedkar University, Agra, India
Publisher
SCARLET PUBLISHING SOLUTIONS
Abstract
Cardiac surgery is frequently associated with postoperative pulmonary
complications, prolonged hospitalization, and delayed recovery. Breathing
exercises, including diaphragmatic breathing, incentive spirometry, and
pursed-lip breathing, have been shown to enhance lung expansion, improve
oxygenation, and accelerate rehabilitation in postoperative patients. The
present study aimed to evaluate the effect of structured breathing
exercises on postoperative recovery outcomes among cardiac surgery
patients. A randomized controlled approach was employed, with patients
divided into two groups: those receiving conventional postoperative care
and those receiving an additional breathing exercise program. Recovery was
assessed using parameters such as pulmonary function tests, oxygen
saturation, incidence of pulmonary complications, duration of hospital
stay, and patient-reported quality of life. Findings revealed that
patients in the intervention group demonstrated significantly improved
pulmonary function, reduced incidence of complications, shorter
hospitalization, and better subjective recovery outcomes compared to the
control group. This suggests that incorporation of simple, non-invasive
breathing exercises into postoperative care may contribute substantially
to improved recovery following cardiac surgery. Copyright © 2025
SCARLET PUBLISHING SOLUTIONS. All rights reserved.

<4>
Accession Number
2041282072
Title
Septal Myectomy in Pediatric Obstructive Hypertrophic Cardiomyopathy: A
Systematic Review and Meta-analysis.
Source
Pediatric Cardiology. (no pagination), 2025. Date of Publication: 2025.
Author
Cappellaro A.P.; de Almeida L.F.C.; Gismondi R.A.O.C.; Ayala R.; Thet
M.S.; Dearani J.A.
Institution
(Cappellaro) Centro Universitario Mauricio de Nassau de Barreiras,
Barreiras, Brazil
(de Almeida) Department of Medical Sciences, Universidade Federal
Fluminense, Niteroi, Brazil
(Gismondi) Department of Cardiology, Universidade Federal Fluminense,
Niteroi, Brazil
(Ayala) Cardiovascular Surgery Department, Robert Bosch Hospital,
Stuttgart, Germany
(Thet) Department of Surgery & Cancer, Imperial College London, South
Kensington, United Kingdom
(Dearani) Department of Cardiovascular Surgery, Mayo Clinic, Rochester,
MN, United States
Publisher
Springer
Abstract
Evidence regarding outcomes of septal myectomy in pediatric patients with
obstructive hypertrophic cardiomyopathy (HOCM) remains limited. This
meta-analysis aimed to assess surgical outcomes and long-term survival in
this population. A systematic review was conducted using PubMed, Embase,
Scopus, and Cochrane databases to identify studies evaluating septal
myectomy in pediatric patients with obstructive HCM. Eight clinical trials
comprising a total of 490 pediatric patients met the inclusion criteria.
Among children undergoing septal myectomy for HOCM, the pooled early and
late mortality rates were 3.3% and 8.5%, respectively. Concomitant mitral
valve repair was performed in 7.3% of patients. Rates of complete
atrioventricular block and permanent pacemaker implantation were 9.9% and
5.1%, respectively. The mean durations of intensive care and hospital stay
were 34.6 h and 12.9 days. Postoperative wound infection and reoperation
occurred in 3.4% and 6.4% of cases. Echocardiographic assessments
demonstrated a marked reduction in LVOT gradient (from 86.9 to 16.2 mmHg)
with preserved left ventricular ejection fraction. Mitral regurgitation
decreased from 49.8 to 6.4%, and systolic anterior motion from 84.9 to
19.9%. Septal myectomy in pediatric patients with HOCM is a safe and
effective procedure, associated with favorable survival and substantial
symptomatic and hemodynamic improvement. However, results must be
interpreted cautiously due to moderate-quality retrospective
data. Copyright © The Author(s) 2025.

<5>
Accession Number
2040694216
Title
Outcomes of Left Atrial Appendage Patency After Device Closure Detected by
Cardiac CT: A Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 18(12) (pp 1348-1359), 2025. Date of
Publication: 01 Dec 2025.
Author
Jacquemyn X.; Sa M.P.; Korsholm K.; Nielsen-Kudsk J.E.; Iriart X.; Saw J.;
Alkhouli M.; Jain S.; Bittencourt M.S.; Sultan I.
Institution
(Jacquemyn, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh, Pittsburgh, PA, United States
(Jacquemyn, Jain, Sultan) UPMC Heart and Vascular Institute, University of
Pittsburgh Medical Center, Pittsburgh, PA, United States
(Sa) Cleveland Clinic Florida, Weston, FL, United States
(Korsholm, Nielsen-Kudsk) Department of Cardiology, Aarhus University
Hospital, Skejby, Denmark
(Iriart) Department of Pediatric and Adult Congenital Cardiology, Hopital
Cardiologique du Haut-Leveque, CHU de Bordeaux, Bordeaux-Pessac, France
(Saw) Division of Interventional Cardiology, Vancouver General Hospital
and the University of British Columbia, Vancouver, BC, Canada
(Alkhouli) Department of Cardiology, Mayo Clinic School of Medicine
Rochester, MN, United States
(Bittencourt) Department of Medicine and Radiology University of
Pittsburgh, Pittsburgh, United States
Publisher
Elsevier Inc.
Abstract
Background: Residual leaks are common after left atrial appendage
occlusion (LAAO). Objective(s): The authors aimed to systematically
evaluate the prognostic implications of residual left atrial appendage
(LAA) patency and peridevice leaks (PDLs) detected by cardiac computed
tomography (CT) following LAAO. Method(s): The authors used
traditional meta-analytical methods and a Bayesian framework to assess the
probability of increased risks associated with these residual leaks.
 Result(s): Seventeen studies encompassing 2,036 patients met the
inclusion criteria. During follow-up, the presence of any LAA patency was
significantly associated with an almost 2-fold increased OR of
thromboembolism (pooled OR: 1.87, 95% CI: 1.08-3.24), corresponding to 28
(95% CI: 3-68) additional events per 1,000 patients. Although PDL showed a
similar trend, it was not significantly associated with increased
thromboembolism risk (pooled OR: 1.50, 95% CI: 0.85-2.65). For
thromboembolism with LAA patency, under a noninformative prior, the mean
logOR was 0.59 (95% credible interval [Crl]: 0.06-1.15), and translated
median OR of 1.87 (95% CrI: 1.06-3.14) and a mean absolute risk difference
(ARD) of 2.8% (95% CrI: 0.2%-6.8%). The posterior probability of ARD >0%
was 98.5%. For any PDL, the mean logOR was 0.38 (95% CrI: -0.22 to 0.95),
with a median OR of 1.53 (95% CrI: 0.80-2.59) and mean ARD of 1.9% (95%
CrI: -0.7% to 5.4%). The posterior probability of ARD >0% was 89.8%.
 Conclusion(s): LAA patency and PDL identified by CT may be associated
with an increased risk of thromboembolism. These findings indicate that
residual leaks detected by CT may be clinically significant and should not
be regarded as benign. Copyright © 2025 The Authors

<6>
Accession Number
2041561096
Title
Efficacy of transcutaneous electrical acupoint stimulation for the
treatment of gastrointestinal dysfunction in patients after cardiac
surgery with cardiopulmonary bypass: study protocol for a superiority,
single-centre, single-blind, randomised controlled clinical trial.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e108309. Date of
Publication: 04 Nov 2025.
Author
Liao Y.; Gao Q.; Chen Y.; Li H.; Wang J.; Zheng F.; Lin S.
Institution
(Liao, Gao, Chen, Li, Wang, Zheng, Lin) Department of Cardiovascular
Surgery, Southern Medical University Nanfang Hospital, Guangzhou, China
Publisher
BMJ Publishing Group
Abstract
Objective Gastrointestinal dysfunction is one of the most frequent
complications in patients after cardiac surgery with cardiopulmonary
bypass (CPB). It can seriously affect the patient's quality of life,
increase the length of hospitalisation and in severe cases trigger cardiac
arrest. This single-centre randomised controlled study aims to investigate
whether transcutaneous electrical acupoint stimulation (TEAS) can
effectively relieve gastrointestinal discomfort and improve the quality of
life of patients after cardiac surgery. Methods and analysis A total of
426 patients after cardiac surgery with CPB will be randomly assigned to
the control group or intervention group (1:1 ratio) to receive either
acupressure or TEAS for 3 days. The patients will be recruited from the
Department of Cardiovascular Surgery of Nanfang Hospital. The primary
outcome is the time of the first postoperative anal defecation, the
secondary outcomes include the first postoperative anal exsufflation time,
the number of bowel sounds, the proportion of postoperative laxatives used
in the two groups, abdominal girth, stool frequency per day and length of
postoperative hospital stay. Ethics and dissemination The procedures have
been approved by the Guangdong Regional Medical Ethics Committee of
Nanfang Hospital (NFEC-2023-404) and conformed to the Declaration of
Helsinki. Written informed consent will be obtained from all the
participants. Results will be disseminated through workshops,
peer-reviewed publications and conferences. Copyright © Author(s)
(or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<7>
Accession Number
2038843419
Title
Outcomes After Donation After Circulatory Determination of Death Cardiac
Transplantation.
Source
JACC: Heart Failure. 13(12) (no pagination), 2025. Article Number: 102473.
Date of Publication: 01 Dec 2025.
Author
Louca J.O.; Ochsner M.; Bhagra S.; Shah A.; Schlendorf K.; Lima B.; Wang
C.C.; Siddiqi H.; Irshad A.; Schroder J.; Casalinova S.; Milano C.; Khush
K.; Skoda A.; Luikart H.; Ashley E.; Moazami N.; James L.; Dar O.;
Konicoff M.; Urban M.; Um J.; Castleberry A.; Hoffman J.R.H.; Park S.Y.;
Cain M.T.; Fetten K.; Meyer D.; Xu A.; Gonzalez-Vilchez F.; Dominguez-Gil
B.; Royo-Villanova M.; Garrido I.; Brouckaert J.; Rega F.; Tchana-Sato V.;
Berman M.; Bae J.; Sinha S.; Pettit S.; Messer S.; Large S.
Institution
(Louca, Sinha) University of Cambridge, Cambridge Stem Cell Institute,
Cambridge, United Kingdom
(Louca, Ochsner, Bhagra, Berman, Bae, Pettit, Large) Royal Papworth
Hospital, Cambridge, United Kingdom
(Louca) University of Oxford, Nuffield Department of Population Health,
Oxford, United Kingdom
(Ochsner) LMU University Hospital, Munich, Germany
(Shah, Schlendorf, Lima, Wang, Siddiqi, Irshad) Vanderbilt University
Medical Center, Nashville, TN, United States
(Schroder, Casalinova, Milano) Duke University Medical Center, Durham, NC,
United States
(Khush, Skoda, Luikart, Ashley) Stanford University, Palo Alto, CA, United
States
(Moazami, James) NYU Langone Health, New York, NY, United States
(Dar, Konicoff) Harefield Hospital (a division of Guys and St Thomas' NHS
Foundation Trust), London, United Kingdom
(Dar) School of Cardiovascular Medicine and Sciences Kings College London,
United Kingdom
(Urban, Um, Castleberry) Univeristy of Nebraska, Medical Center, Omaha,
NE, United States
(Hoffman, Park, Cain) University of Colorado, Anschutz Medical Center,
Aurora, CO, United States
(Fetten, Meyer, Xu) Baylor Scott and White Health, Baylor University
Medical Center, Dallas, TX, United States
(Gonzalez-Vilchez) Hosp Marques de Valdecilla, Santander, Spain
(Dominguez-Gil) Organizacion Nacional de Trasplantes, Madrid, Spain
(Royo-Villanova, Garrido) Hospital Universitario Virgen de la Arrixaca,
Murcia, Spain
(Brouckaert, Rega) University Hospitals Leuven, Leuven, Belgium
(Tchana-Sato) CHU Liege, Liege, Belgium
(Messer) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background As donation after circulatory determination of death (DCD)
heart transplantation (HT) becomes more widely adopted, there is a need to
establish the most clinically effective method of organ procurement.
Objectives This international, multicenter study compares outcomes of DCD
HT across Europe and the United States between recipients whose donor
hearts were retrieved using thoraco-abdominal normothermic regional
perfusion (taNRP) with those whose hearts were recovered using direct
procurement and perfusion (DPP). Methods This was a retrospective
observational study across 22 heart transplant centers in Belgium, Spain,
the United Kingdom, and the United States. This study included all
patients undergoing DCD HT at participating centers, from the start of
each center's DCD program through January 1, 2023. DCD HT with recovery
using either taNRP or DPP were compared with one another. Posttransplant
outcomes included: 1) survival at 1 year; 2) incidence of severe primary
graft dysfunction (PGD); and 3) episodes of treated, biopsy-proven
acute-cellular rejection (ACR) in the first year following
transplantation. Results A total of 504 DCD HTs took place in the study
period. Survival at 1 year was similar for taNRP and DPP recipients (91%
vs 88%; P = 0.100). taNRP recipients had a lower rate of severe PGD (7.6%
vs 19.2%; P < 0.001) and fewer episodes of biopsy-proven, ACR requiring
treatment in the first year post-transplantation (13% vs 25%; P < 0.001).
Conclusions In an international study of DCD HT, recipients of hearts
retrieved by taNRP technique had lower rates of severe PGD and fewer
episodes of biopsy-proven ACR in the first year when compared with those
retrieved by using DPP. These results should be further investigated with
randomized control trials. Copyright © 2025 The Authors.

<8>
Accession Number
2041511034
Title
Assessing the impact of a semi-structured intraoperative anaesthesia
handoff cognitive aid on surgical patient outcomes: study protocol for a
cluster randomised trial.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e110401. Date of
Publication: 04 Nov 2025.
Author
Samost-Williams A.; Green C.E.; Kao L.S.; Sridhar S.; Sessler D.I.; Turan
A.; Thomas E.J.
Institution
(Samost-Williams, Sridhar, Sessler, Turan) The University of Texas Health
Science Center at Houston, Houston, TX, United States
(Samost-Williams, Sessler, Turan) Center for Outcomes Research, Houston,
TX, United States
(Green) Psychiatry and Pediatrics, The University of Texas Health Science
Center at Houston, Houston, TX, United States
(Kao) Center for Surgical Trials and Evidence-based Practice, The
University of Texas Health Science Center, Surgery, Houston, TX, United
States
(Thomas) University of Texas, Health Scince Center, Houston, TX, United
States
Publisher
BMJ Publishing Group
Abstract
Introduction Intraoperative anaesthesia handoffs represent a risk point in
the care of surgical patients. Although often necessary to prevent
fatigue, improve vigilance and optimise operational efficiency, critical
information can be lost, potentially leading to postoperative
complications. Structured handoffs can increase the transfer of knowledge
during intraoperative anaesthesia handoffs, improving their quality. We
therefore propose to test the primary hypothesis that a semi-structured
intraoperative anaesthesia handoff cognitive aid reduces the number of
serious 30-day complications in surgical patients. Methods and analysis We
will enrol adults having non-cardiac surgery who are scheduled to have an
intraoperative anaesthesia handoff for operational reasons. We plan a
cluster randomised trial (enrolling over 18 months, anticipated sample
size approximately 4500 patients) that will compare the Epic Electronic
Health Record intraoperative anaesthesia handoff cognitive aid to routine
handoffs. Our primary outcome will be the number of serious postoperative
complications within 30 days. Our secondary outcomes will be: (1) the
number of minor complications; and (2) the duration of postoperative
hospitalisation. Bayesian analysis with generalised linear multilevel
modelling will be used to estimate the effect of structured handoffs on
the primary and secondary outcomes. Ethics and dissemination This study
has been approved by the local institutional review board with a waiver of
informed consent. Results will be disseminated in the medical literature
with de-identified data available on request. Copyright ©
Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<9>
Accession Number
2041693484
Title
Comparative Study of Different Minimally Invasive Aortic Valve Replacement
Techniques: A Systematic Review and Network Meta-Analysis.
Source
Interdisciplinary Cardiovascular and Thoracic Surgery. 40(11) (no
pagination), 2025. Article Number: ivaf244. Date of Publication: 01 Nov
2025.
Author
Husen T.F.; Vidya A.P.; Heuts S.; Prasetyo A.; Nugroho A.K.Z.; Lorusso R.;
Bidar E.; Maesen B.; Sardari Nia P.
Institution
(Husen, Heuts, Lorusso, Bidar, Maesen, Sardari Nia) Department of
Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University
Medical Centre, Maastricht, Netherlands
(Husen, Vidya, Nugroho) Faculty of Medicine, University of Indonesia,
Jakarta, Indonesia
(Husen, Heuts, Lorusso, Bidar, Maesen, Sardari Nia) Maastricht University,
Cardiovascular Research Institute Maastricht (CARIM), Maastricht,
Netherlands
(Prasetyo) Faculty of Medicine, University Atma Jaya, Jakarta, Indonesia
Publisher
Oxford University Press
Abstract
Objectives: This investigation aimed to compare different minimally
invasive techniques, namely, mini-sternotomy (MS), mini-thoracotomy (MT),
and totally thoracoscopic (TT) approaches for the surgical treatment of
aortic valve disease, emphasizing their respective benefits and
limitations to guide clinical decision-making. Method(s): A
systematic search was conducted in Medline, Web of Science, Scopus, Wiley
Online Library, Google Scholar, and ProQuest. Studies were appraised using
the Newcastle-Ottawa Scale. A frequentist network meta-analysis (NMA) with
a random-effects model was employed to give reflective ranks and compare
outcomes across techniques. Treatment ranking was based on p-scores, with
MS as the reference. Higher p-scores indicate greater certainty of
superiority over competing interventions. The primary outcome was
mortality. Result(s): Twenty-five observational studies (n=34 573
patients) were included. Mortality did not differ between techniques
(p-score: MS [0.85] ~ MT [0.34] ~ TT [0.31]). TT had longer
cardiopulmonary bypass (mean difference [MD]: 41.04 [95% CI, 10.98-71.10])
and cross-clamp times (MD: 30.31 [95% CI, 5.81-54.80]) but offered the
shortest intensive care unit (ICU) length of stay (p-score: TT [0.98] > MT
[0.51] > MS [0.01]; MD: -16.00 [95% CI, -26.62 to -5.38]), reduced
hospital stay (MD: -2.07 [95% CI, -3.77 to -0.37]), and fewer
complications, including neurological events (odds ratio: 1.79 [95% CI,
1.03-3.13]), blood loss (MD: 208.85 mL [95% CI, 102.29-315.40]) compared
to MS. MT showed similar outcomes to MS, except for longer operative times
(MD: 29.84 [95% CI, 8.35-51.32]) and shorter ICU stays (MD: -5.88 [95% CI,
-11.10 to -0.67]). Conclusion(s): TT may offer advantages such as
shorter hospital stays, reduced neurological complications, and less
bleeding as compared to MS, although it is associated with longer
operative times. However, as all included studies were observational, the
findings should be interpreted with caution, and further NMA including
only randomized trials is warranted. Copyright © The Author(s)
2025. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery.

<10>
Accession Number
2019013771
Title
Retraction:Association between sarcoidosis and cardiovascular Outcomes: A
systematic review and Meta-analysis.
Source
IJC Heart and Vasculature. 41 (no pagination), 2022. Article Number:
101073. Date of Publication: 01 Aug 2022.
Author
Jaiswal V.; Peng Ang S.; Sarfraz Z.; Butey S.; Vinod Khandait H.; Song D.;
Ee Chia J.; Maroo D.; Hanif M.; Ghanim M.; Chand R.; Biswas M.
Institution
(Jaiswal) AMA School Of Medicine, Makati, Philippines
(Peng Ang) Department of Internal Medicine, Rutgers Health/Community
Medical Center, NJ, United States
(Sarfraz) Fatima Jinnah Medical University, Lahore, Pakistan
(Butey) Indira Gandhi Government Medical College, Nagpur, India
(Vinod Khandait, Chand) Department of Internal Medicine, Trinitas Regional
Medical Center, Elizabeth, NJ, United States
(Song) Department of Internal Medicine, Icahn School of Medicine at Mount
Sinai Hospital, NY, United States
(Ee Chia) School of Medicine, International Medical University, Kuala
Lumpur, Malaysia
(Maroo) Maulana Azad Medical College, New Delhi, India
(Hanif) Department of Internal Medicine, Suny Upstate Medical University,
NY, United States
(Ghanim) Henry Ford Healthcare System, Detroit, MI, United States
(Biswas) General Cardiology and Advanced Heart Failure, Wellspan
Cardiology, Lancaster, PA, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: Sarcoidosis is a chronic inflammatory disorder of unknown
etiology associated with high morbidity and mortality. Its association
with cardiovascular outcomes is under-documented. Aim(s): The aim of
this study was to assess the adverse cardiovascular outcomes in patients
with sarcoidosis compared with that of non-sarcoidosis. Methodology:
Online databases including PubMed, Embase and Scopus were queried from
inception until March 2022. The outcomes assessed included all-cause
mortality (ACM) and incidence of ventricular tachycardia (VT), heart
failure (HF) and atrial arrhythmias (AA). Result(s): A total of 6
studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354
Non-Sarcoidosis) were included in this analysis. The pooled prevalence of
sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47
years. The most common comorbidities were hypertension (12.7% vs 12.5%),
and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of
primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17
to 3.08; p = 0.01) was significantly increased in sarcoidosis patients.
The pooled analysis of secondary endpoints showed that the incidence of VT
(RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02
to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01)
were significantly higher with sarcoidosis respectively compared to
non-sarcoidosis. Conclusion(s): Incidence of VT, HF and AA was
significantly higher in patients with CS. Clinicians should be aware of
these adverse cardiovascular events associated with
sarcoidosis. Copyright © 2022 The Authors

<11>
Accession Number
2041678427
Title
Transcatheter Aortic Valve Implantation (TAVI) Versus Surgical Valve
Replacement on Clinical Outcomes in Patients with Aortic Stenosis.
Source
Arquivos Brasileiros de Cardiologia. 122(10) (no pagination), 2025.
Article Number: e20240295. Date of Publication: 2025.
Author
Cordeiro A.L.L.; de Souza Goncalves E.; de Santana R.M.; dos Santos T.S.M.
Institution
(Cordeiro, de Souza Goncalves, de Santana, dos Santos) Centro
Universitario de Excelencia, BA, Feira de Santana, Brazil
(Cordeiro) Escola Bahiana de Medicina e Saude Publica, BA, Salvador,
Brazil
Publisher
Sociedade Brasileira de Cardiologia
Abstract
Aortic stenosis (AS) is one of the most prevalent valve lesions, and
transcatheter aortic valve replacement (TAVI) has emerged as an
alternative to surgical aortic valve replacement (SAVR). TAVI is a
minimally invasive procedure that has proven to be a safer option in
several aspects. The objective is to review the impact of TAVI compared to
surgical aortic valve replacement on mortality, postoperative
complications, hospitalization, and quality of life in patients with AS. A
systematic review was conducted using the PICO strategy, with searches in
the PubMed, Central, and LILACS databases, employing the following
descriptors: aortic stenosis, hospitalization, mortality, clinical trial,
transcatheter aortic valve implantation, quality of life, postoperative
complications, combined with the Boolean operators "AND" and "OR." A total
of 29 articles were found after reading the titles and abstracts. Of
these, nine showed lower mortality in patients undergoing TAVI, while
three reported lower mortality in the SAVR group. Eight articles had
similar findings regarding complications, with six showing a lower
incidence of postoperative complications in TAVI and three in SAVR.
Additionally, three articles showed better quality of life in TAVI
patients, while one study indicated a shorter hospital stay for TAVI
patients. In all studies, the patients analyzed were over 70 years old.
TAVI reduced mortality compared to SAVR in patients with AS. Furthermore,
TAVI was associated with a reduction in hospital stay and improvement in
quality of life. Regarding postoperative complications, the results
indicated that TAVI tends to have a lower complication rate, although
variations exist between studies. Copyright © 2025 Sociedade
Brasileira de Cardiologia. All rights reserved.

<12>
Accession Number
2039833138
Title
Cardiac CT and PET for Surveillance of Heart Transplant Recipients:
Systematic Review and Bayesian Meta-Analysis.
Source
JACC: Cardiovascular Imaging. 18(12) (pp 1330-1344), 2025. Date of
Publication: 01 Dec 2025.
Author
Sayed A.; Nayfeh M.; Alahdab F.; Al Rifai M.; Abramov D.; Fudim M.;
Moayedi Y.; Yousefzai R.; Al-Mallah M.H.
Institution
(Sayed, Alahdab, Al Rifai, Yousefzai, Al-Mallah) Houston Methodist DeBakey
Heart and Vascular Center, Houston, TX, United States
(Sayed) Ain Shams University, Faculty of Medicine, Cairo, Egypt
(Sayed) Rochester General Hospital, Rochester, NY, United States
(Nayfeh) Vanderbilt University School of Medicine, Nashville, TN, United
States
(Alahdab) University of Missouri, Columbia, MO, United States
(Abramov) Lomda Linda University Medical Center, Loma Linda, CA, United
States
(Fudim) Duke Clinical Research Institute, NC, United States
(Fudim) Duke University School of Medicine, Durham, NC, United States
(Moayedi) Ted Rogers Centre of Excellence in Heart Research, Peter Munk
Cardiac Centre, University Health Network, Toronto, ON, Canada
(Moayedi) Ajmera Transplant Centre, University Health Network, Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: For noninvasive surveillance of cardiac allograft vasculopathy
(CAV), cardiac computed tomography (cardiac computed tomography [CT]) and
positron emission tomography (PET) received a Class IIa recommendation by
the 2023 ISHLT (International Society for Heart and Lung Transplantation)
guidelines. However, implementation has lagged behind because of concerns
about their ability to rule out disease and stratify risk.
 Objective(s): The purpose of this study was to define the diagnostic
and prognostic ability of PET and cardiac CT in cardiac transplant
recipients. Method(s): Electronic databases were searched for studies
evaluating CT or PET for their diagnostic (for detecting angiographic CAV)
and prognostic (for predicting major adverse cardiovascular outcomes)
value. Sensitivity and specificity were pooled using Bayesian bivariate
binormal-normal models with random-effects. HRs were pooled using Bayesian
normal random-effects models. Result(s): In total, 44 studies (32 CT
and 12 PET) enrolling 3,049 patients were included. Coronary computed
tomography angiography (CTA) showed high sensitivity (97.6%; 95% credible
interval [CrI]: 93.7%-99.1%) and specificity (82.3%; 95% CrI: 75.3%-88.3%)
for detecting any CAV. Coronary CTA also showed high sensitivity (92.6%;
95% CrI: 86.2%-96.2%) and specificity (92.6%; 95% CrI: 89.8%-94.9%) for
significant CAV. The PET CAV algorithm for detecting significant CAV
showed good sensitivity (83.9%; 95% CrI: 69.1%-92.4%) and specificity
(89.6%; 95% CrI: 82.2%-94.2%). PET-derived parameters including myocardial
flow reserve, stress myocardial blood flow, PET CAV score, and summed
stress score, predicted future major adverse cardiovascular outcomes.
 Conclusion(s): Both coronary CTA and PET can rule out significant
CAV; however, at higher pretest probabilities, coronary CTA may be
preferrable. Multiple PET-derived parameters may have prognostic value,
whereas there is insufficient evidence for the long-term prognostic value
of CT. Copyright © 2025 American College of Cardiology Foundation

<13>
Accession Number
2039162524
Title
Perioperative Normoxia vs Hyperoxia in Neonates With Cyanotic Heart
Disease Undergoing Cardiac Surgery: A Randomized Controlled Trial.
Source
Annals of Thoracic Surgery. 120(5) (pp 898-906), 2025. Date of
Publication: 01 Nov 2025.
Author
Sznycer-Taub N.; Peng Y.-W.; Yu S.; Batazzi A.; Les A.; Lowery R.;
Griffith K.; Sturmer D.; Ohye R.G.; Russell M.W.; Pasquali S.K.; Charpie
J.
Institution
(Sznycer-Taub, Peng, Yu, Batazzi, Lowery, Russell, Pasquali, Charpie)
Division of Pediatric Cardiology, Department of Pediatrics, University of
Michigan, Ann Arbor, MI, United States
(Les, Griffith, Sturmer) Department of Perfusion, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
(Ohye) Section of Pediatric Cardiovascular Surgery, Department of Cardiac
Surgery, University of Michigan, Ann Arbor, MI, United States
Publisher
Elsevier Inc.
Abstract
Background Exposure to supraphysiologic levels of oxygen has been
associated with end-organ damage and worse outcomes across multiple
populations related to oxidative stress and inflammation. There is limited
evidence to guide practice in children undergoing surgery with
cardiopulmonary bypass, including neonates with cyanotic congenital heart
disease, who are particularly vulnerable to oxidative stress due to
immature and depleted antioxidant defenses. Methods We conducted a
randomized trial of perioperative normoxia (goal PaO<inf>2</inf> 60-100 mm
Hg during cardiopulmonary bypass and for the first 24 hours) vs hyperoxia
(goal PaO<inf>2</inf> 200-300 mm Hg during cardiopulmonary bypass)
exclusively in cyanotic neonates to examine feasibility, systemic
oxidative stress response, and safety. The primary outcome was a serum
measure of oxidative stress: thiobarbituric acid reactive substances.
Additional biomarkers and clinical outcomes were collected. Results
Twenty-nine neonates (median age, 5 days) were enrolled. Mean
PaO<inf>2</inf> in the normoxia arm (n = 15) during cardiopulmonary bypass
was 106 +/- 27 mm Hg (vs hyperoxia 256 +/- 29 mm Hg, P < .0001). Mean
postoperative thiobarbituric acid reactive substances expressed as
fold-change from baseline was lower in the normoxia arm at 2 hours (1.21
+/- 0.26 vs 1.93 +/- 0.63), 6 hours (1.09 +/- 0.25 vs 1.77 +/- 0.7), and
24 hours (0.96 +/- 0.16 vs 1.41 +/- 0.29); all P < .01. Other biomarkers
of oxidative stress were significantly lower in the normoxia arm (all time
points P < .01). Safety outcomes including in-hospital mortality and
morbidities were similar between arms. Conclusions Controlled normoxia
during cardiopulmonary bypass in cyanotic neonates is feasible, safe, and
associated with significant improvement in measures of oxidative stress.
These data are critical in informing larger-scale studies of end-organ
injury and clinical outcomes. Copyright © 2025 The Society of
Thoracic Surgeons.

<14>
Accession Number
2041229371
Title
Effect of Qishen Yiqi Dripping Pill on Clinical Outcomes in Patients with
Ischemic Heart Failure: A Post-Hoc Analysis of the CACT-IHF Randomized
Trial.
Source
Drug Design, Development and Therapy. 19 (pp 10163-10174), 2025. Date of
Publication: 2025.
Author
Zhou Z.; Wang S.; Du Y.; Zhao Z.; Bi Y.; Su Q.; Hou Y.; Wang X.; Mao J.
Institution
(Zhou, Wang, Du, Zhao, Bi, Su, Hou, Wang, Mao) Cardiovascular Department,
First Teaching Hospital of Tianjin University of Traditional Chinese
Medicine, National Clinical Research Center for Chinese Medicine
Acupuncture and Moxibustion, No. 88 Changling Road, Xiqing District,
Tianjin, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to evaluate whether the effect of Qishen Yiqi
dropping pills (QSYQ) on the clinical outcome of patients with chronic
ischemic heart failure (IHF) is related to the history of
revascularization. Patients and Methods: An exploratory post-hoc
analysis was conducted using data from the CACT-IHF trial, a multicenter,
randomized, double-blind, placebo-controlled study involving 640 patients
with chronic IHF. Participants were randomized to receive either QSYQ or
placebo for a duration of 6 months in addition to standard therapy, with a
minimum follow-up period of 12 months. Result(s): Among 638 patients
(319 QSYQ, 319 placebo) in modified Intention-to-Treat (mITT) population
(patients receive at least one trial drug or placebo treatment after
randomization), 54.5% had prior revascularization. In the revascularized
subgroup, QSYQ significantly reduced the risk of major adverse cardiac
events (MACEs) (HR: 0.55, 95% CI: 0.36 to 0.82; P=0.003), second composite
endpoint (HR: 0.60, 95% CI: 0.39 to 0.92; P=0.02) and hospitalization for
heart failure (HHF) (HR: 0.57, 95% CI: 0.36 to 0.91; P=0.018) compared to
placebo, while no significant difference was observed in
non-revascularized patients. A significant interaction between
revascularization and QSYQ treatment was noted (Pinteraction=0.009). It is
suggested that the effect of QSYQ on the outcome of IHF patients is
related to the history of revascularization. Adverse event rates were
similar between groups. Conclusion(s): QSYQ reduces MACEs risk in
revascularized chronic IHF patients without increasing adverse events,
suggesting its potential as a safe and effective adjunct therapy.
Registration: Clinical Trial Registry Identifier:
NCT01555320. Copyright © 2025 Zhou et al.

<15>
Accession Number
2040476182
Title
Effects of Volatile Sedation Versus Propofol on Time to Extubation in the
Intensive Care Unit After Cardiac Surgery: A Systematic Review and
Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3576-3588),
2025. Date of Publication: 01 Dec 2025.
Author
Garo M.L.; Rinaldi P.; Galderisi A.; Di Folco M.; Ruggiero A.; Mattei A.;
Schiavoni L.; Nasso G.; Pascarella G.; Chello M.; Lusini M.; Cataldo R.;
Carassiti M.; Agro F.E.; Strumia A.
Institution
(Garo, Rinaldi, Galderisi, Di Folco, Ruggiero, Mattei, Schiavoni,
Pascarella, Cataldo, Carassiti, Agro, Strumia) Anesthesia and Intensive
Care Research Unit, Campus Bio-Medico University, Rome, Italy
(Rinaldi) Department of Anesthesiology, Unit of Emergency Anesthesia, Burn
Intensive Care and Poison Control Center, AORN Antonio Cardarelli, Naples,
Italy
(Mattei, Schiavoni, Pascarella, Cataldo, Carassiti, Agro, Strumia)
Anesthesia and Intensive Care Operative Unit, Fondazione Policlinico
Universitario Campus Bio-Medico, Rome, Italy
(Nasso) Anthea Hospital, GVM Care & Research, Bari, Italy
(Chello, Lusini) Research Unit of Cardiac Surgery, Department of
Cardiovascular Surgery, Campus Bio-Medico University, Rome, Italy
(Chello, Lusini) Operative Unit of Cardiac Surgery, Fondazione Policlinico
Universitario Campus Bio-Medico, Rome, Italy
Publisher
W.B. Saunders
Abstract
Background: Optimal sedation management is critical in the postoperative
care of cardiac surgery patients admitted to the intensive care unit
(ICU), where sedative choice may influence respiratory, hemodynamic, and
recovery outcomes. Propofol is the most widely used sedative, but volatile
anesthetics are gaining interest due to their pharmacologic advantages.
This systematic review and meta-analysis was designed to compare volatile
anesthetics with propofol for ICU sedation after cardiac surgery, focusing
on time to extubation as the primary outcome, and ICU and hospital length
of stay, hemodynamic support, and postoperative complications as secondary
outcomes. Method(s): PubMed, Web of Science, and Scopus were searched
from July to October 2024 without language or date restrictions. Eligible
studies were randomized controlled trials comparing volatile anesthetics
with propofol for postoperative ICU sedation in adult cardiac surgery
patients. Studies without extractable data were excluded. Risk of bias was
assessed using the Cochrane risk-of-bias 2.0 tool. Meta-analyses were
performed using random-effects models. Result(s): Five randomized
controlled trials involving 384 patients were included. Sedation with
volatile anesthetics significantly reduced time to extubation compared
with propofol (weighted mean difference [WMD] = -55 minutes, 95% CI -93 to
-17, p < 0.001), although heterogeneity was high (I2 = 95.9%, tau2 =
1,731.95, p < 0.001). No significant differences were observed for ICU
(WMD = -4.26 hours, 95% CI: -17.07 to 8.55, I2 = 89.9%,
t2 = 143.76, z = -0.65, p = 0.51) or hospital (WMD = -1.94
days, 95% CI: -4.17 to 0.30, I2 = 65.1%, t2 = 2.53)
length of stay. Secondary outcomes (use of vasopressors and/or positive
inotropes, postoperative atrial fibrillation, and nausea and/or vomiting)
were inconsistently reported and showed no clear pattern.
 Discussion(s): Volatile anesthetics reduce extubation time compared
with propofol in adult cardiac surgery patients sedated in the ICU.
However, evidence on secondary outcomes remains inconclusive due to
limited and heterogeneous data. Copyright © 2025 Elsevier Inc.

<16>
Accession Number
2041279109
Title
Dabigatran-based versus warfarin-based triple antithrombotic regimen with
a 1-month intensification after coronary stenting in patients with
nonvalvular atrial fibrillation (COACH-AF PCI).
Source
BMC Medicine. 23(1) (no pagination), 2025. Article Number: 643. Date of
Publication: 01 Dec 2025.
Author
Liang M.; Jin J.; Zhao R.; Li H.; Chen S.; Liu L.; Xu P.; Wang W.; Cheng
X.; Chen X.; Tao L.; Zhang Q.; Yang M.; Zeng C.; Li L.; Zheng Y.; Chen H.;
Guo J.; Zhong Z.; Bi Y.; Cheng B.; Zhou Y.; Wang H.; Zhang Y.; Qiu M.;
Zhang P.; Zhang J.; Wang Z.; Li Y.; Han Y.
Institution
(Liang, Zhang, Zhang, Qiu, Zhang, Zhang, Wang, Li, Han) National Key
Laboratory of Frigid Zone Cardiovascular Disease and Department of
Cardiology, General Hospital of Northern Theatre Command, Liaoning,
Shenyang, China
(Jin) Department of Cardiology, Xinqiao Hospital of Third Military Medical
University, Chongqing, China
(Zhao) Department of Cardiology, Baotou Central Hospital, Inner Mongolia,
Baotou, China
(Li) Department of Cardiology, Daqing Oilfield General Hospital,
Heilongjiang, Daqing, China
(Chen) Department of Cardiology, Nanjing First Hospital, Jiangsu, Nanjing,
China
(Liu, Xu) Department of Cardiology, The Second Affiliated Hospital of
Shenyang Medical College, Liaoning, Shenyang, China
(Wang) Department of Cardiology, Teda International Cardiovascular
Hospital, Tianjin, China
(Cheng) Department of Cardiology, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Hubei, Wuhan, China
(Chen) Department of Cardiology, Peking University International Hospital,
Beijing, China
(Tao) Department of Cardiology, First Affiliated Hospital of Air Force
Military Medical University, Shaanxi, Xi'an, China
(Zhang) Department of Cardiology, Shanghai Oriental Hospital, Shanghai,
China
(Yang) Department of Cardiology, Yingkou Central Hospital, Liaoning,
Yingkou, China
(Zeng) Department of Cardiology, Daping Hospital, Third Military Medical
University, Chongqing, China
(Li) Department of Cardiology, Guangzhou Red Cross Hospital, Guangdong,
Guangzhou, China
(Zheng) Department of Cardiology, Anshan Central Hospital, Liaoning,
Anshan, China
(Chen) Department of Cardiology, Peking University People's Hospital,
Beijing, China
(Guo) Department of Cardiology, The Luhe Hospital Affiliated With Capital
Medical University, Beijing, China
(Zhong) Department of Cardiology, Meizhou People's Hospital, Guangdong,
Meizhou, China
(Bi) Department of Cardiology, The First Affiliated Hospital of Harbin
Medical University, Heilongjiang, Harbin, China
(Cheng) Department of Cardiology, Sichuan Provincial People's Hospital,
Sichuan, Chengdu, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing Institute of Heart Lung and Blood Vessel Disease,
Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic
Disease, Clinical Center for Coronary Heart Disease, Capital Medical
University, Beijing, China
(Wang) Department of Cardiology, Liuzhou Workers Hospital, Guangxi Zhuang
Autonomous Region, Liuzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: To assess the safety and efficacy of dabigatran-based triple
antithrombotic (TAT) regimen in patients after percutaneous coronary
intervention (PCI) with atrial fibrillation (AF). Method(s): A
multicenter, open-label, randomized controlled trial across 50 Chinese
hospitals enrolled nonvalvular AF patients after coronary stenting.
Participants were randomly assigned to receive dabigatran (110 mg
twice/daily) or warfarin-based TAT regimen (dabigatran or warfarin with
aspirin and clopidogrel) for 1 month and then convert to dual
antithrombotic therapy (dabigatran or warfarin with clopidogrel) for 6
months. The primary safety endpoint was the first occurrence of clinically
relevant bleeding (BARC types 2-5). Secondary endpoints included net
adverse clinical events (NACEs) and major or clinically relevant non-major
bleeding (CRNB). And the efficacy endpoint was the major adverse cardiac
and cerebral events (MACCEs). Result(s): The study was terminated
early due to COVID-19 impacting recruitment. A total of 540 patients were
enrolled. BARC types 2-5 bleeding occurred in 8.0% and 4.3% of patients in
warfarin and dabigatran groups, respectively (HR 0.54; 95% CI 0.26-1.09; P
= 0.0861). And total bleeding events (BARC 1-5) were 20.5% and 9.4% (HR
0.44; 95% CI 0.27-0.70; P = 0.0005). Dabigatran showed a lower total
bleeding risk than warfarin, with similar risks for BARC types 2-5
bleeding, NACEs, CRNB, major bleeding, and MACCEs. Conclusion(s):
Among AF patients underwent PCI, the dabigatran-based TAT regimen did not
significantly reduce the rate of BARC types 2-5 bleeding at 6 months
compared with warfarin-based regimen, although the power of the study to
find a difference was low due to early termination (COACH-PCI,
NCT03536611, https://clinicaltrials.gov/show/NCT03536611). Copyright
© The Author(s) 2025.

<17>
Accession Number
2040980752
Title
Dual antiplatelet therapy after percutaneous coronary intervention
according to bleeding risk (HOST-BR): an open-label, multicentre,
randomised clinical trial.
Source
The Lancet. 406(10516) (pp 2244-2256), 2025. Date of Publication: 08 Nov
2025.
Author
Park K.W.; Han J.-K.; Hwang D.; Yang H.-M.; Park S.; Kang T.S.; Koh J.-S.;
Bang D.W.; Yoon H.-J.; Kim H.-S.; Kang J.; Lim Y.-H.; Lee S.R.; Choi Y.J.;
Ahn H.-S.; Hwang K.-K.; Kim B.G.; Jeong J.-O.; Ahn J.-H.; Rhew J.Y.; Jang
J.Y.; Park H.; Kang T.-S.; Koh J.S.; Park K.-T.; Bang D.-W.; Goh C.-W.;
Yoon H.J.; Jo S.-H.; Ki Y.-J.; Kim Y.H.; Park M.-W.; Yang T.-H.; Hong
S.J.; Park S.-H.; Kwon S.-W.; Han G.-R.; Chae I.-H.; Han S.H.; Lee N.; Cho
J.-M.; Ahn S.-K.; Kim S.-Y.; Lee H.-C.; Lee S.-J.; Seo S.-M.; Oh J.-H.;
Kang S.H.; Heo J.H.; Rha S.-W.; Woo J.S.; Kim S.; Kim S.-H.; Shin E.-S.;
Kim C.-H.; Park W.J.; Lee C.-H.; Her S.-H.; Jeon D.-S.; Lee K.-S.; Lee
S.-U.; Kim U.
Institution
(Kang, Park, Han, Hwang, Yang, Park, Kim, Kim, Kang, Lim, Lee, Choi, Ahn,
Hwang, Kim, Jeong, Ahn, Rhew, Jang, Park, Kang, Koh, Park, Bang, Goh,
Yoon, Jo, Ki, Kim, Park, Yang, Hong, Park, Kwon, Han, Chae, Han, Lee, Cho,
Ahn, Kim, Lee, Lee, Seo, Oh, Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim,
Park, Lee, Her, Jeon, Lee, Lee, Kim) Seoul National University Hospital,
Seoul, South Korea
(Kang, Park, Han, Hwang, Yang, Park, Kim, Kim, Kang, Lim, Lee, Choi, Ahn,
Hwang, Kim, Jeong, Ahn, Rhew, Jang, Park, Kang, Koh, Park, Bang, Goh,
Yoon, Jo, Ki, Kim, Park, Yang, Hong, Park, Kwon, Han, Chae, Han, Lee, Cho,
Ahn, Kim, Lee, Lee, Seo, Oh, Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim,
Park, Lee, Her, Jeon, Lee, Lee, Kim) Seoul National University College of
Medicine, Seoul, South Korea
(Ahn, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Uijeongbu St Mary's Hospital, Seoul, South Korea
(Hwang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew,
Jang, Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang,
Hong, Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh,
Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee,
Kim) Chungbuk National University Hospital, Cheongju, South Korea
(Kim, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Sanggye Paik Hospital, Seoul, South Korea
(Jeong, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew,
Jang, Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang,
Hong, Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh,
Kang, Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee,
Kim) Chungnam National University Hospital, Daejeon, South Korea
(Ahn, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gyeongsang National University Changwon Hospital, Changwon, South Korea
(Rhew, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Presbyterian Medical Center, Jeonju, South Korea
(Park, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gangneung Asan Hospital, Gangneung, South Korea
(Kang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Dankook University Hospital, Cheonan, South Korea
(Koh, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Gyeongsang National University Hospital, Jinju, South Korea
(Park, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Chung-Ang University Hospital, Seoul, South Korea
(Bang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Soonchunhyang University Seoul Hospital, Seoul, South Korea
(Goh, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Ewha Womans University Seoul Hospital, Seoul, South Korea
(Yoon, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Keimyung University Dongsan Hospital, Daegu, South Korea
(Jo, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Hallym University Sacred Heart Hospital, Anyang, South Korea
(Jang, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
National Health Insurance Service Ilsan Hospital, Goyang, South Korea
(Choi, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Sejong General Hospital, Bucheon, South Korea
(Lee, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Jeonbuk National University Hospital, Jeonju, South Korea
(Lim, Kim, Kang, Lim, Lee, Choi, Ahn, Hwang, Kim, Jeong, Ahn, Rhew, Jang,
Park, Kang, Koh, Park, Bang, Goh, Yoon, Jo, Ki, Kim, Park, Yang, Hong,
Park, Kwon, Han, Chae, Han, Lee, Cho, Ahn, Kim, Lee, Lee, Seo, Oh, Kang,
Heo, Rha, Woo, Kim, Kim, Shin, Kim, Park, Lee, Her, Jeon, Lee, Lee, Kim)
Hanyang University Seoul Hospital, Seoul, South Korea
Publisher
Elsevier B.V.
Abstract
Background The optimal duration of dual antiplatelet therapy (DAPT) after
coronary stenting according to bleeding risk is not well established. We
aimed to evaluate the optimal duration of DAPT after coronary stenting
according to bleeding risk. Methods In this open-label, multicentre,
randomised clinical trial, patients aged 19 years and older who received
percutaneous coronary intervention with a drug-eluting stent at 50
high-volume cardiology centres in South Korea were stratified into high
bleeding risk (HBR) or non-HBR strata, according to Academic Research
Consortium for High Bleeding Risk criteria. Patients in the HBR stratum
were randomly assigned (1:1) to 1-month or 3-month DAPT, and those in the
non-HBR stratum were randomly assigned (1:1) to 3-month or 12-month DAPT.
The three coprimary endpoints were net adverse clinical events (all-cause
death, myocardial infarction, stent thrombosis, stroke, or major
bleeding), major adverse cardiac or cerebral events (cardiovascular death,
myocardial infarction, definite or probable stent thrombosis, or ischaemic
stroke), and any actionable non-surgical bleeding at 1 year after
randomisation. Primary endpoints were assessed in hierarchical order in
the intention-to-treat population. This study is registered with
cris.nih.go.kr, KCT0005356, and ClinicalTrials.gov , NCT05631769 , and is
complete. Findings From July 24, 2020, to Sept 25, 2023, 4897 patients
were enrolled (1598 in the HBR stratum and 3299 in the non-HBR stratum).
In the HBR stratum, 1-month compared with 3-month DAPT did not reach
non-inferiority for net adverse clinical events (144 [18.4%] of 798 vs 110
[14.0%] of 800 patients; hazard ratio [HR] 1.337 [95% CI 1.043-1.713];
p=0.82 for non-inferiority). Major adverse cardiac or cerebral events
occurred in 74 (9.8%) patients in the 1-month DAPT group and 44 (5.8%) in
the 3-month group; bleeding occurred in 105 (13.8%) patients in the
1-month group and 122 (15.8%) in the 3-month group. In the non-HBR
stratum, 3-month was non-inferior to 12-month DAPT regarding net adverse
clinical events (47 [2.9%] of 1649 vs 72 [4.4%] of 1650 patients; HR 0.657
[0.455-0.949]; p<0.0001 for non-inferiority) and major adverse cardiac or
cerebral events (36 [2.2%] vs 37 [2.3%]; HR 0.984 [0.622-1.558]; p=0.0082
for non-inferiority), and superior for bleeding (120 [7.4%] vs 190
[11.7%]; HR 0.631 [0.502-0.793]; p<0.0001). Interpretation In east Asian
patients with HBR, 1-month DAPT did not reach non-inferiority to 3-month
DAPT for net adverse clinical events. In patients without HBR, 3-month
DAPT was non-inferior to 12-month DAPT regarding net adverse clinical
events and major adverse cardiac or cerebral events, and superior for
bleeding. Funding Medtronic and Abbott. Copyright © 2025 Elsevier
Ltd.

<18>
Accession Number
612844581
Title
Retraction:Interposed abdominal compression-cardiopulmonary resuscitation
after cardiac surgery.
Source
Interactive cardiovascular and thoracic surgery. 19(6) (pp 985-989), 2014.
Date of Publication: 01 Dec 2014.
Author
Li J.; Wang J.; Li T.
Institution
(Li) Cardiovascular Center of Hainan Medical College, Affiliated Hospital
of Hainan Medical College, Haikou, China
(Wang) Cardiovascular Center of Hainan Medical College, Affiliated
Hospital of Hainan Medical College, Haikou, China
(Li) Cardiovascular Center of Hainan Medical College, Affiliated Hospital
of Hainan Medical College, Haikou, China
Abstract
OBJECTIVES: The management of cardiac arrest after cardiac surgery differs
from the management of cardiac arrest under other circumstances. In other
studies, interposed abdominal compression-cardiopulmonary resuscitation
(IAC-CPR) resulted in a better outcome compared with conventional CPR. The
aim of the present study was to determine the feasibility, safety and
efficacy of IAC-CPR compared with conventional CPR in patients with
cardiac arrest after cardiac surgery.
METHODS: Data on all cardiac surgical patients who suffered a sudden
cardiac arrest during the first 24 h after surgery were collected
prospectively. Cardiac arrest was defined as the cessation of cardiac
mechanical activity with the absence of a palpable central pulse, apnoea
and unresponsiveness, including ventricular fibrillation, asystole and
pulseless electrical activity. Forty patients were randomized to either
conventional CPR (n = 21) or IAC-CPR (n = 19). IAC-CPR was initially
performed by compressing the abdomen midway between the xiphoid and the
umbilicus during the relaxation phase of chest compression. If spontaneous
circulation was not restored after 10-15 min, the surgical team would
immediately proceed to resternotomy. The endpoints of the study were
safety, return of spontaneous circulation (ROSC) >5 min, survival to
hospital discharge and survival for 6 months.
RESULTS: With IAC-CPR, there were more patients in terms of ROSC, survival
to hospital discharge, survival for 6 months and fewer CPR-related
injuries compared with patients who underwent conventional CPR.
CONCLUSIONS: IAC-CPR is feasible and safe and may be advantageous in cases
of cardiac arrest after cardiac surgery. Copyright © The Author
2014. Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<19>
Accession Number
2040468170
Title
Erector Spinae Plane Block Versus Retrolaminar Block for Perioperative
Analgesia in Pediatric Cardiac Surgery: A Randomized, Double-blinded,
Noninferiority Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3455-3464),
2025. Date of Publication: 01 Dec 2025.
Author
Gopalakrishnan R.M.; Shinde N.; Meghalakshmi A.R.; Gutjahr G.;
Krishnakumar M.; Leeladharan S.P.; Thomas D.; Padmanabhan S.; Krishnakumar
R.
Institution
(Gopalakrishnan, Padmanabhan) Department of Pediatric Cardiac Anesthesia
and Intensive Care, Amrita Institute of Medical Sciences and Research
Centre, Kerala, Kochi, India
(Shinde, Meghalakshmi, Leeladharan, Thomas) Department of Cardiac
Anesthesia, Amrita Institute of Medical Sciences and Research Centre,
Kerala, Kochi, India
(Gutjahr, Krishnakumar) Department of Health Science Research, Amrita
Institute of Medical Sciences and Research Centre, Kerala, Kochi, India
(Krishnakumar) Department of Pediatric Cardiology, Amrita Institute of
Medical Sciences and Research Centre, Kerala, Kochi, India
Publisher
W.B. Saunders
Abstract
Objective: To compare the efficacy and safety of retrolaminar block (RLB)
with erector spinae plane block (ESPB) for perioperative analgesia in
pediatric cardiac surgery. Design(s): Prospective, randomized,
double-blinded, controlled, noninferiority trial. Setting(s): A
pediatric cardiac surgical unit at a tertiary care referral center in
South India. Participant(s): Children aged between 1 day and 18 years
who were scheduled for elective cardiac surgery (Risk adjustment for
congenital heart surgery categories 1-6) were enrolled in the study. A
total of 298 patients were randomly assigned to receive either an ESPB or
RLB, with 149 patients in each group. Intervention(s): Myofascial
blocks were performed by one of four anesthesiologists, each administering
either ESPB or RLB under ultrasound guidance according to the assigned
group. The treating anesthesiologist and intensive care unit (ICU)
intensivist were blinded to group allocation. Measurements and Main
Results: This study compared RLB, a safer and less commonly used posterior
myofascial block, with ESPB, a widely adopted technique with few reported
complications, to establish the noninferiority of RLB. The primary outcome
was hemodynamic response to surgical incision, defined as a greater than
10% rise in heart rate. Secondary outcomes included block administration
time; intraoperative inhalational anesthetic; dexmedetomidine and opioid
use; postoperative pain and sedation scores at 2, 6, and 12 hours; and ICU
outcomes such as duration of mechanical ventilation, ICU length of stay,
reintubation rate, and cost of ventilator disposables and oxygen. The
groups were comparable in baseline characteristics. A rise in heart rate
of more than 10% was observed in 46% of patients in the ESPB group and 50%
in the RLB group (p = 0.3). Intraoperative drug consumption, pain and
sedation scores, as well as ICU outcomes, were similar between the groups.
 Conclusion(s): RLB is noninferior to ESPB in pediatric cardiac
surgery, providing comparable analgesic efficacy, safety, and
postoperative recovery outcomes. Copyright © 2025 Elsevier Inc.

<20>
Accession Number
2041140787
Title
Effect of Nebulized Dexmedetomidine on Postoperative Nausea and Vomiting
in Female Patients Undergoing Radical Thoracoscopic Lung Cancer Resection:
A Single-Center Randomized Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 10061-10073), 2025. Date of
Publication: 2025.
Author
Liu X.; Zhu H.; Zhao Y.; Yang Y.; Li B.; Wei W.; Wei L.; Zhang J.; Zhang
W.
Institution
(Liu, Li, Zhang, Zhang) Department of Anesthesiology and Perioperative
Medicine, Henan Provincial People's Hospital, Henan, Zhengzhou, China
(Zhu) Department of Anesthesiology, The First Affiliated Hospital of Henan
University of Chinese Medicine, Zhengzhou, China
(Zhao, Yang) Department of Anesthesiology and Perioperative Medicine,
Henan University People's Hospital, Henan Provincial People's Hospital,
Zhengzhou, China
(Wei, Wei) Department of Thoracic Surgery, Henan Provincial People's
Hospital, Zhengzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to investigate the effect of nebulized
dexmedetomidine on postoperative nausea and vomiting (PONV) in female
patients undergoing radical thoracoscopic lung cancer resection.
 Patients and Methods: Patients were enrolled and randomized into the
nebulized dexmedetomidine group (Dex group) and the normal saline group
(NS group). The primary outcome was the overall incidence of PONV within
48 hours postoperatively. Secondary outcomes included the incidence and
grade of PONV at multiple postoperative time points (T1: during PACU stay;
T2: from PACU discharge to 8 hours postoperatively; T3: 8-16 hours
postoperatively; T4: 16-24 hours postoperatively; T5: 24-32 hours
postoperatively; T6: 32-40 hours postoperatively; T7: 40-48 hours
postoperatively), postoperative sore throat (POST), Visual Analogue Scale
(VAS) scores at the above time points, use of rescue analgesics and
antiemetics, Quality of Recovery 15-item scale (QoR-15) scores et al.
 Result(s): A total of 64 eligible patients were enrolled, with 57
completing the study. There was no statistically significant difference in
the overall incidence of PONV within 48 hours postoperatively between two
groups. However, the incidence of PONV and POST in the Dex group was
significantly lower than that in the NS group at T2. The area under the
curve of VAS in the Dex group was significantly lower than that in the NS
group within 24 hours and 48 hours postoperatively. The Dex group had a
significantly lower rate of rescue analgesic use and higher postoperative
QoR-15 scores within 48 hours postoperatively compared with the NS group.
 Conclusion(s): Nebulized inhalation of 1 mug/kg dexmedetomidine
preoperatively can reduce the incidence of early postoperative PONV,
enhance postoperative analgesia, alleviate postoperative sore throat, and
improve postoperative recovery quality in female patients undergoing
radical lung cancer surgery. Trial Number and Registry Url: Registration
number, ChiCTR2400086070;
https://www.chictr.org.cn/bin/project/edit?pid=235076. Copyright
© 2025 Liu et al.

<21>
Accession Number
2041530047
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) (no pagination), 2025.
Article Number: e043448. Date of Publication: 23 Oct 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.; Berg
J.M.T.
Institution
(van Bergeijk, Venema, van der Werf, van den Heuvel, Voors, Wykrzykowska)
Department of Cardiology, University of Groningen, University Medical
Center Groningen, Netherlands
(Overduin, van Ginkel, Berg) Department of Cardiology, St. Antonius
Hospital, Nieuwegein, Netherlands
(Berg) Cardiovascular Research Institute Maastricht (CARIM), Netherlands
Publisher
American Heart Association Inc.
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.
 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 30days, stratified by OAC regimen and type, and sex.
 RESULT(S): After 30days 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).
 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. Copyright © 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-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited,
the use is non-commercial and no modifications or adaptations are made.

<22>
Accession Number
2041636771
Title
Design and rationale of the artificial intelligent dialogue System
assisted comprehensive Management of secondary prevention Among post
coronary aRtery bypass graft patienTs (SMART): protocol for a randomised
controlled trial for postcoronary artery bypass grafting management.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e106447. Date of
Publication: 11 Nov 2025.
Author
Lei L.; Li J.; Zhang L.; Yuan X.; Diao X.; Qi L.; Wang Y.; Du W.; Zhao W.;
Hu S.
Institution
(Lei, Li, Zhang, Hu) National Clinical Research Center for Cardiovascular
Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences, Peking Union Medical College,
Beijing, China
(Yuan, Hu) Department of Surgery, Fuwai Hospital, National Center for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, Beijing, China
(Diao, Qi, Wang, Zhao) Information Center, Fuwai Hospital, Chinese Academy
of Medical Sciences, Peking Union Medical College, Beijing, China
(Du) Mianyang Central Hospital, School of Medicine, University of
Electronic Science and Technology of China, Mianyang, China
Publisher
BMJ Publishing Group
Abstract
Introduction Cardiovascular risk factor management (ie, hypertension,
dyslipidaemia and diabetes) in post-coronary artery bypass grafting (CABG)
patients is suboptimal, with a high prevalence and low control rate due to
various barriers, including a lack of self-management awareness and
inadequate healthcare resources. Artificial intelligence (AI)
interventions are promising for improving lifestyle management and
secondary prevention; however, their effectiveness in post-CABG patients
remains unclear. We aimed to describe the protocol of the artificial
intelligence dialogue system-assisted comprehensive management of
secondary prevention among post-coronary artery bypass graft patients
(SMART) assessing the efficacy and safety of an AI-based dialogue system,
namely 'Smart Family Doctor', on blood pressure, lipids and glucose
control. Methods and analysis The SMART study is an open-label,
parallel-group, randomised controlled trial. 536 post-CABG patients with
uncontrolled hypertension, diabetes or dyslipidaemia are 1:1 randomly
assigned to either the health manager or the intervention group with the
implementation of the 'Smart Family Doctor' and followed up for 6 months
postoperatively. The 'Smart Family Doctor' runs on the WeChat service
platform, which includes an AI-based dialogue system of individual
intelligent questions and answers, physiological indicators monitoring,
medication reminders and automated message sending. Data on physical
examinations, biological samples and self-management behaviour will be
collected at baseline, 3 and 6 months after randomisation. The primary
outcome was the change from baseline to 6-month follow-up in
cardiovascular risk factors (hypertension, dyslipidaemia and diabetes)
control rates. For the primary analysis, we will use generalised
mixed-effects models to compare the control rate at the 6-month follow-up
between the intervention and control groups, accounting for study sites as
random effects. Ethics and dissemination The study was registered at
http://www.clinicaltrials.gov (NCT06615609). The central ethics committee
of Fuwai Hospital approved the SMART trial (2024-2410). All collaborating
sites obtained local approval or accepted central ethics approval. The
findings of this study will be disseminated through peer-reviewed
publications, presentations at national and international conferences, and
potentially public engagement initiatives. Copyright © Author(s)
(or their employer(s)) 2025. Re-use permitted under CC BY-NC. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<23>
Accession Number
2041693186
Title
Natural history of asymptomatic moderate or severe aortic regurgitation: A
systematic review and meta-analysis.
Source
Heart. (no pagination), 2025. Article Number: heartjnl-2025-326643. Date
of Publication: 2025.
Author
Naser J.A.; Massad F.; Al-Abcha A.; Gerberi D.; Pislaru S.V.; Nkomo V.T.;
Thaden J.J.; Wang Z.; Cavalcante J.L.; Pellikka P.A.; Michelena H.I.;
Enriquez-Sarano M.
Institution
(Naser, Massad, Al-Abcha, Gerberi) Mayo Clinic, Rochester, MN, United
States
(Pislaru, Pellikka) Cardiovascular Diseases, Mayo Clinic, Rochester, MN,
United States
(Nkomo, Enriquez-Sarano) Cardiovascular Diseases and Internal Medicine,
Mayo Clinic College of Medicine, Rochester, MN, United States
(Thaden, Michelena) Department of Cardiovascular Medicine, Mayo Clinic,
Rochester, MN, United States
(Wang) Health Sciences Research, Mayo Clinic, Rochester, MN, United States
(Cavalcante) Minneapolis Heart Institute Foundation, Minneapolis, MN,
United States
Publisher
BMJ Publishing Group
Abstract
Background The natural history of asymptomatic moderate or severe aortic
regurgitation (AR) remains uncertain, with conflicting reports about its
progression and surgical timing. We aimed to quantify adverse outcomes
under conservative management and evaluate the association of aortic valve
replacement/repair (AVR) with mortality. Methods Systematic searches
(inception-July 2025) identified cohort studies of asymptomatic
moderate/severe AR. Random-effects models estimated pooled incidence rates
of adverse events; fixed-effects models were used for hazard ratios (HRs)
of AVR vs conservative management. Results Twenty-seven studies (4720
patients; mean age 49 years; mean follow-up 3.9 years) were included.
Pooled incidence rates per 100 person-years were 1.75 (95% CI 1.27 to
2.41) for all-cause mortality, 1.29 for cardiac death, 0.29 for sudden
death, 4.30 for new symptoms and 7.01 for AVR. Asymptomatic low left
ventricular ejection fraction occurred in only 0.9 per 100 person-years.
Mortality rates were more than double those of the general population
across age groups - 2.45 (1.90 to 3.18) per 100 person-years for cohorts
with mean age >=50 years versus 0.59 (0.29 to 1.21) for younger cohorts.
Early AVR was associated with lower mortality (pooled HR 0.33; 95% CI 0.30
to 0.37). Conclusion Asymptomatic moderate/severe AR carries significant
excess mortality irrespective of age, contradicting its historically
benign reputation. Given the rarity of asymptomatic LV dysfunction,
earlier intervention guided by more sensitive markers of LV damage may
improve outcomes, although heterogeneity and study quality warrant
cautious interpretation. PROSPERO registration number
CRD42024522683. Copyright © Author(s) (or their employer(s))
2025.

<24>
Accession Number
2041676948
Title
Stroke Mechanism and Severity After Left Atrial Appendage Occlusion
Insights From the LAAOS III Randomized Clinical Trial.
Source
JAMA Neurology. (no pagination), 2026. Date of Publication: 2026.
Author
Katsanos A.H.; Whitlock R.P.; Belley-Cote E.P.; Brady K.; Wang A.;
Srivastava A.; Jacquin G.; Weiss V.; Volny O.; Sramek M.; Peeters A.;
Marto J.P.; Wrona P.; Tsolaki A.; Li L.; Nucera A.; Mikulik R.; Perera K.;
Catanese L.; Shoamanesh A.; Sharma M.
Institution
(Katsanos, Whitlock, Belley-Cote, Brady, Wang, Perera, Catanese,
Shoamanesh, Sharma) Population Health Research Institute, Hamilton Health
Sciences, Hamilton, ON, Canada
(Katsanos, Srivastava, Perera, Catanese, Shoamanesh, Sharma) Division of
Neurology, Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Belley-Cote) Divisions of Cardiology and Critical Care, Department of
Medicine, McMaster University, Hamilton, ON, Canada
(Jacquin) Universite de Montreal, Faculte de Medecine, Departement de
Neurosciences, Montreal, QC, Canada
(Weiss, Mikulik) Department of Neurology, St. Anne's University Hospital,
Masaryk University, Brno, Czechia
(Weiss, Mikulik) Department of Neurology, Tomas Bata Hospital, Zlin,
Czechia
(Volny) University of Ostrava Faculty of Medicine, Department of Clinical
Neurosciences, Ostrava, Czechia
(Sramek) Department of Neurology, Military University Hospital Prague,
Prague, Czechia
(Peeters) Department of Neurology, Cliniques Universitaires Saint Luc,
UCLouvain, Brussels, Belgium
(Marto) Department of Neurology, Centro Hospitalar Lisboa Ocidental,
Lisbon, Portugal
(Wrona) Department of Neurology, Jagiellonian University Medical College,
Krakow, Poland
(Tsolaki) First Department of Neurology, Medical School, Faculty of Health
Sciences, Aristotle University of Thessaloniki, Macedonia, Greece
(Li) Wolfson Centre for Prevention of Stroke and Dementia, Nuffield
Department of Clinical Neurosciences, Oxford University, United Kingdom
(Nucera) Neurovascular Treatment Unit, Spaziani Hospital, Frosinone, Italy
Publisher
American Medical Association
Abstract
IMPORTANCE In the Left Atrial Appendage Occlusion Study III (LAAOS III),
surgical occlusion of the LAA during cardiac surgery for patients with
known history of atrial fibrillation (AF) substantially reduced the risk
of stroke. OBJECTIVE To assess the impact of LAAO on ischemic stroke
subtype and outcome. DESIGN, SETTING, AND PARTICIPANTS This was a post hoc
exploratory analysis of the LAAOS III randomized clinical trial. Data were
adjudicated from June 28, 2023, to November 29, 2023, and the main
analyses took place from December 18, 2023, to April 29, 2024. The LAAOS
III trial recruited participants from 105 centers in 27 countries between
July 2012 and October 2018. Patients with AF and a
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of at least 2 undergoing cardiac
surgery for other indications were included in the analysis. INTERVENTIONS
Surgical LAAO plus standard care vs standard care alone. MAIN OUTCOMES AND
MEASURES For strokes occurring during the trial, the functional outcome as
measured by the modified Rankin Scale (mRS) score at day 7 or discharge,
mortality, the presence of cortical infarcts, and the occurrence of
infarcts of presumed cardioembolic origin were examined. RESULTS Of 4811
participants in the LAAOS III trial followed up for 3.8 years, 273 had a
first ischemic stroke. The mean (SD) age of participants at the time of
the first ischemic stroke was 75 (7) years, 104 were female (38%), and 169
were male (62%). Participants allocated to receive LAAO had reduced
(common odds ratio [OR], 0.80; 95% CI, 0.65-0.99) mRS scores at 7 days or
discharge and a lower risk for mortality at 30 days (16.5% vs 20.1%;
hazard ratio [HR], 0.55; 95% CI, 0.31-0.97) after a stroke event.
Participants allocated to LAAO had fewer cortical infarcts on neuroimaging
(46.2% vs 61.3%; difference in proportions: -15.2%; 95% CI, -26.7% to
-3.7%), as well as a lower proportion of ischemic strokes of presumed
cardioembolic etiology when compared with ischemic strokes in the no-LAAO
group (42.9% vs 57.9%; difference in proportions: -15.1%; 95% CI, -26.5%
to -3.7%). CONCLUSIONS AND RELEVANCE This study found that LAAO in
patients with AF undergoing cardiac surgery was associated with a
decreased risk of presumed cardioembolic stroke, reduced disability, and
mortality from stroke. These findings underscore the benefit of LAAO for
patients with AF undergoing cardiac surgery. Copyright © 2026
Katsanos AH et al.

<25>
Accession Number
2041694075
Title
Physiology-Guided Complete Revascularization in Older Patients With
Myocardial Infarction: Three-Year Outcomes of a Randomized Clinical Trial.
Source
JAMA Cardiology. 10(11) (pp 1130-1137), 2025. Date of Publication: 12 Nov
2025.
Author
Biscaglia S.; Erriquez A.; Guiducci V.; Escaned J.; Moreno R.; Lanzilotti
V.; Santarelli A.; Cerrato E.; Sacchetta G.; Menozzi A.; Amat-Santos I.;
Diez Gil J.L.; Ruozzi M.; Barbierato M.; Fileti L.; Picchi A.; Pavasini
R.; Cimaglia P.; Colaiori I.; Casella G.; Menozzi M.; Cavazza C.; Caretta
G.; Scarsini R.; D'Amico G.; Vadala G.; Pilato G.; Moscarella E.; Tebaldi
M.; Campo G.
Institution
(Biscaglia, Erriquez, Pavasini, Cimaglia, Campo) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
(Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, SMaria Nuova
Hospital, Reggio Emilia, Italy
(Escaned) Hospital Clinico San Carlos IDISCC, Complutense University of
Madrid, Madrid, Spain
(Moreno) Centro de Investigacion Biomedica en Red en Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
(Lanzilotti, Casella) Cardiology Unit, Ospedale Maggiore, Largo Nigrisoli
2, Bologna, Italy
(Santarelli) Cardiology Unit, Bufalini Hospital, Cesena, Italy
(Cerrato) Interventional Cardiology Unit, San Luigi Gonzaga University
Hospital, Rivoli Infermi Hospital ASLTO3, Orbassano, Rivoli, Turin, Italy
(Sacchetta) Cardiology Unit, Umberto I Hospital, ASP Siracusa, Siracusa,
Italy
(Menozzi, Caretta) S.C. Cardiologia, Ospedale Sant'Andrea, ASL5 Liguria,
La Spezia, Italy
(Amat-Santos) Department of Cardiology, Centro de Investigacion Biomedica
en Red en Enfermedades Cardiovasculares (CIBERCV), Hospital Clinico
Universitario, Valladolid, Spain
(Diez Gil) Department of Cardiology, Centro de Investigation Biomedica end
Red en Enfermedades Cardiovasculares, HUniversitario y Politecnico La Fe,
Valencia, Spain
(Ruozzi) Cardiology Unit, Ospedale Civile di Baggiovara, Baggiovara,
Modena, Italy
(Barbierato, D'Amico) Cardiology Unit, Ospedale Dell'Angelo, Mestre, Italy
(Fileti) Department of Cardiology, SMaria delle Croci Hospital, Ravenna,
Italy
(Picchi) Cardiovascular Department, Azienda USL Toscana SudEst,
Misericordia Hospital, Grosseto, Italy
(Colaiori) Cardiology Unit, Ospedale Santa Maria Goretti, Latina, Italy
(Menozzi, Cavazza) Cardiovascular Department, Infermi Hospital, Rimini,
Italy
(Scarsini) Division of Cardiology, Department of Medicina, University of
Verona, Verona, Italy
(Vadala) Department of Health Promotion, Mother and Child Care, Internal
Medicine and Medical Specialties (ProMISE), University of Palermo,
Palermo, Italy
(Pilato) Department of Interventional Cardiology, San Giovanni Di Dio
Hospital, Agrigento, Italy
(Moscarella) Department of Translational Medical Sciences, University of
Campania "Luigi Vanvitelli,", Caserta, Italy
(Tebaldi) Cardiology Unit, Infermi Hospital, AUSL Romagna, Faenza, Italy
(Moreno) Instituto de Investigacion Hospital La Paz (IDIPAZ), University
Hospital La Paz, Madrid, Spain
(Moscarella) Division of Clinical Cardiology, A.O.R.N "Sant'Anna e San
Sebastiano,", Caserta, Italy
Publisher
American Medical Association
Abstract
Importance: Complete revascularization in older patients with myocardial
infarction (MI) and multivessel disease has been shown to reduce
cardiovascular death and MI at 1 year. However, the durability of this
benefit over longer follow-up periods has been questioned by recent
studies. Objective(s): To determine whether the benefit of
physiology-guided complete treatment, compared with culprit-only
treatment, is sustained at 3 years in older patients with MI and
multivessel disease. Design, Setting, and Participant(s): This
randomized clinical trial, Functional Assessment in Elderly MI Patients
With Multivessel Disease (FIRE), was an investigator-initiated,
multicenter, prospective, superiority trial conducted at 34 centers across
3 countries from July 18, 2019, to October 25, 2021. Participants were
patients with MI (either ST segment or non-ST segment elevated) and
multivessel disease who were hospitalized after successful treatment of
the culprit lesion. Major exclusion criteria included a nonculprit lesion
in the left main coronary artery and unclear identification of the culprit
lesion. Data analysis was performed from March to May 2025.
 Intervention(s): Culprit-only treatment or physiology-guided complete
revascularization of nonculprit lesions. Main Outcomes and Measures:
The primary outcome was a patient-oriented composite end point of death,
MI, stroke, or ischemia-driven revascularization. Secondary end points
included a composite of cardiovascular death or MI and rate of heart
failure hospitalizations. Result(s): Among 1445 patients enrolled in
the trial, the median (IQR) age was 80 (77-84) years; 917 patients were
male (63.5%) and 528 female (36.5%). At 3 years, the primary outcome
occurred in 165 patients (22.9%) in the physiology-guided complete
revascularization group and 216 patients (29.8%) in the culprit-only group
(hazard ratio [HR], 0.72; 95% CI, 0.58-0.88; P =.002). The key secondary
outcome of cardiovascular death or MI occurred in a significantly lower
number of patients in the physiology-guided complete revascularization
group (92 patients [12.8%]) compared with the culprit-only group (132
patients [18.2%]; HR, 0.66; 95% CI, 0.50-0.88; P =.004). Hospitalizations
for heart failure were more frequent in the culprit-only group compared
with the physiology-guided complete group (143 [19.7%] vs 103 [14.3%]; HR,
0.73; 95% CI, 0.54-0.97; P =.03). Conclusions and Relevance: In
patients 75 years or older with MI and multivessel disease, the benefit of
physiology-guided complete revascularization over culprit-lesion-only
treatment was sustained at 3 years. Copyright © 2025 American
Medical Association. All rights reserved.

<26>
Accession Number
2040742623
Title
The Impact of Prothrombin Complex Concentrate Versus Fresh Frozen Plasma
for Hemorrhage Management in Cardiac Surgery: A Systematic Review and
Meta-analysis of Randomized Clinical Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3333-3337),
2025. Date of Publication: 01 Dec 2025.
Author
Grillo I.T.C.; Katsuyama E.; Aguiar C.C.; Passos F.S.; Costa B.S.; Treml
R.E.; Ehler J.; Kirov H.; Doenst T.; Caldonazo T.
Institution
(Grillo, Aguiar) Department of Medicine, University of Buenos Aires,
Buenos Aires, Argentina
(Katsuyama) Department of Medicine, ABC School of Medicine University
Center, Sao Paulo, Brazil
(Passos) Department of Thoracic Surgery, Mater Dei Hospital, Salvador,
Brazil
(Costa) Department of Medicine, Nove de Julho University, Bauru, Brazil
(Treml) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University School of Medicine, CA, United States
(Ehler) Department of Anesthesiology and Intensive Care Medicine, Jena
University Hospital, Jena, Germany
(Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery, Jena
University Hospital, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
Publisher
W.B. Saunders
Abstract
Objective: To clarify the efficacy and safety endpoints, comparing
prothrombin complex concentrate (PCC) versus fresh frozen plasma (FFP) for
hemorrhage management in cardiac surgery. Design(s): Systematic
review and meta-analysis of randomized clinical trials (RCTs).
 Setting(s): Tertiary care. Participant(s): Adult patients who
developed hemorrhage related to coagulation factor deficiency during
cardiac surgery. Intervention(s): PCC or FFP for hemorrhage
management in cardiac surgery. Measurements and Main Results: A
systematic search was conducted in PubMed, Embase, and Cochrane Library
and identified RCTs comparing PCC with FFP for hemorrhage management in
cardiac surgery. The primary outcome was postintervention hemoglobin
levels. Secondary outcomes included 30-day mortality, transfusion
requirements, adverse events, postintervention international normalized
ratio, and reoperation rates. Categorical values were analyzed using risk
ratios with 95% confidence intervals (CIs), whereas continuous values were
compared using the mean difference and standardized mean difference with
95% CIs. Statistical analyses were conducted using R software, version
4.4.2. Four RCTs (671 patients) were included, with 343 (51.1%) patients
receiving PCC. PCC was associated with higher postintervention hemoglobin
levels (mean difference 1.17 g/dL, 95% CI 0.93-1.41, p < 0.01). Compared
with FFP, the PCC group required fewer red blood cell transfusions at 24
hours, had reduced use of recombinant factor VII, and demonstrated
improved postintervention international normalized ratio.
 Conclusion(s): In patients undergoing cardiac surgery with
significant bleeding, PCC was associated with higher postintervention
hemoglobin levels and reduced transfusion needs compared with FFP, without
an increase in adverse events. Copyright © 2025 The Authors

<27>
Accession Number
2040584638
Title
TIVA vs Volatile Anesthesia in CABG Surgery: Effects on Inflammatory and
Cognitive Outcomes.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3306-3312),
2025. Date of Publication: 01 Dec 2025.
Author
Garg V.; Patel G.; Mandal B.; Kahlon S.; Puri G.D.; Kst S.; Rawat A.
Institution
(Garg, Patel, Mandal, Kahlon, Puri) Department of Anesthesia and Intensive
Care, Postgraduate Institute of Medical Education and Research (PGIMER),
Chandigarh, India
(Kst) Department of Cardiovascular and Thoracic Surgery, Postgraduate
Institute of Medical Education and Research (PGIMER), Chandigarh, India
(Rawat) Pediatric Allergy and Immunology Unit, Postgraduate Institute of
Medical Education and Research (PGIMER), Chandigarh, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the perioperative inflammatory response and early
neurocognitive outcomes in adult patients undergoing elective coronary
artery bypass grafting (CABG) under total intravenous anesthesia (TIVA)
versus volatile anesthesia. Design(s): Prospective, randomized
controlled trial. Setting(s): A tertiary care academic medical
center. Participant(s): Fifty adult patients aged 18 to 65 years
scheduled for elective on-pump CABG surgery. Intervention(s):
Patients were randomized to receive either propofol-based TIVA (Group P)
or sevoflurane-based volatile anesthesia (group S). Standardized surgical
and cardiopulmonary bypass protocols were followed in all patients.
 Measurements and Main Results: Serum interleukin-6 (IL-6) levels were
measured preoperatively and at 24 and 48 hours postoperatively. Secondary
outcomes included Mini-Mental State Examination scores, ventilation
duration, vasoactive-inotropic score, renal function, and intensive care
unit stay. IL-6 levels had increased significantly at 24 hours and
decreased by 48 hours in both groups, with no significant intergroup
difference at any time point. Mini-Mental State Examination scores at 24
and 48 hours were significantly higher in the TIVA group. TIVA was also
associated with shorter mechanical ventilation duration. VIS, cardiac
function, renal parameters, and intensive care unit stay duration were
comparable between groups. Conclusion(s): TIVA and volatile
anesthesia resulted in similar perioperative IL-6 responses in patients
undergoing CABG. However, TIVA was associated with better early
postoperative cognitive function and faster emergence from mechanical
ventilation. These findings suggest a potential neurocognitive benefit of
TIVA in this surgical population. Copyright © 2025 Elsevier Inc.

<28>
Accession Number
2037514673
Title
Bioprosthetic Valve Fracture for Transcatheter Aortic Valve-in-Valve
Replacement: A Systematic Literature Review.
Source
Annals of Thoracic Surgery. 120(5) (pp 817-825), 2025. Date of
Publication: 01 Nov 2025.
Author
Chopko T.C.; Afoke J.N.; Khan F.W.; Rowse P.G.
Institution
(Chopko) Department of Surgery, Mayo Clinic, Rochester, MN, United States
(Afoke, Khan, Rowse) Department of Cardiovascular Surgery, Mayo Clinic,
Rochester, MN, United States
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve-in-valve replacement presents a viable,
minimally invasive approach to replacing degraded bioprosthetic surgical
valves. The major drawback of this technique is poor hemodynamics in the
form of patient-prosthesis mismatch and high transvalvular gradients. This
is commonly attributable to the reduced valvular diameter from the
transcatheter heart valve fixed inside the degraded bioprosthesis.
Maximizing this diameter by bioprosthetic valve fracture occurs through a
noncompliant, high-pressure balloon to splay the degraded valve outward.
Despite its novelty, this has demonstrated improved hemodynamic outcomes
and optimal valvular expansion with slightly increased operative risk. In
this review, we highlight the technique of bioprosthetic valve fracture,
types of suitable balloons and valves, timing in relation to
valve-in-valve implantation, safety and efficacy, implications, and future
directions. Copyright © 2025 The Authors.

<29>
Accession Number
2040124339
Title
A Single-blind, Randomized Controlled Trial Comparing Postoperative
Analgesic Effects of Superficial and Deep Parasternal Intercostals Blocks
in Patients Undergoing Coronary Artery Bypass Grafting Surgery.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3426-3436),
2025. Date of Publication: 01 Dec 2025.
Author
Korkmaz Toker M.; Yazman S.; Altiparmak B.; Uysal A.I.; Harmandar B.
Institution
(Korkmaz Toker, Altiparmak) Department of Anesthesiology and Reanimation,
Mugla Sitki Kocman University, Mugla, Turkey
(Yazman, Harmandar) Department of Cardiovascular Surgery, Mugla Sitki
Kocman University, Mugla, Turkey
(Uysal) Department of Anesthesiology and Reanimation, Mugla Training and
Research Hospital, Mugla, Turkey
(Korkmaz Toker) Anesteziyoloji ve Reanimasyon A.D., Kotekli Mah, Mugla
Sitki Kocman Universitesi Tip Fakultesi, Merkez, Mugla, Turkey
Publisher
W.B. Saunders
Abstract
Objective: To compare the analgesic efficacy of anesthesiologist-performed
ultrasound-guided superficial parasternal intercostal plane block (SPIPB)
and surgeon-performed deep parasternal intercostal plane block (DPIPB) in
patients undergoing coronary artery bypass grafting (CABG) via median
sternotomy. Design(s): A prospective, randomized, single-blind
clinical trial. Setting(s): A single, tertiary care university
hospital. Participant(s): Seventy-five participants (aged 45-80
years, ASA III-IV) scheduled for elective isolated CABG surgery.
 Intervention(s): Participants were randomly assigned to the SPIPB,
DPIPB, or control groups. Regional blocks were performed either under
ultrasound guidance after sternal closure and sterilization of the
surgical site (SPIPB) or intraoperatively under direct vision (DPIPB).
Postoperative pain was managed with multimodal analgesia protocols.
 Measurements and Main Results: Outcomes included pain scores and
tramadol administration at the 1st, 4th, 12th, and 24th postoperative
hours, as well as after extubation. The cumulative 24-hour tramadol
administration (primary outcome) was significantly lower in the DPIPB
group (95 +/- 44 mg) compared with the SPIPB (141 +/- 58 mg) and control
groups (176 +/- 61 mg) (p < 0.001). Compared with the control group, the
DPIPB group had a significantly reduced likelihood of requiring high-dose
tramadol (odds ratio [OR]: 0.18, 95% confidence interval [CI]: 0.06-0.56,
p = 0.003). The SPIPB group showed an intermediate effect compared with
control (OR: 0.52, 95% CI: 0.23-1.18, p = 0.095). When directly compared,
DPIPB was associated with significantly lower tramadol use than SPIPB (OR:
0.34, 95% CI: 0.16-0.72, p < 0.001). Pain scores at all time points were
significantly lower in both block groups compared with control (p < 0.05),
with DPIPB showing the most pronounced effect. No block-related
complications were observed. Conclusion(s): Both parasternal
intercostal blocks improved postoperative analgesia compared with standard
care. The SPIPB was performed under ultrasound guidance, whereas the DPIPB
was applied under direct vision by the surgeon. The DPIPB demonstrated
superior opioid-sparing effects and improved dynamic pain control. These
findings support the use of parasternal fascial plane blocks, whether
performed under ultrasound guidance or direct vision, as effective
components of multimodal analgesia in cardiac surgery. Copyright
© 2025 Elsevier Inc.

<30>
Accession Number
2013196155
Title
Retraction:Effects of bilateral Pecto-intercostal Fascial Block for
perioperative pain management in patients undergoing open cardiac surgery:
a prospective randomized study.
Source
BMC Anesthesiology. 21(1) (no pagination), 2021. Article Number: 175. Date
of Publication: 01 Dec 2021.
Author
Zhang Y.; Gong H.; Zhan B.; Chen S.
Institution
(Zhang, Gong, Chen) Department of Anesthesiology, First Affiliated
Hospital of Nanchang University, 17 Yong wai zheng Street, Nanchang,
Jiangxi, China
(Zhan) Department of cardiology, The second Affiliated Hospital of
Nanchang University, NO.1 minde Street, Nanchang, Jiangxi, China
Publisher
BioMed Central Ltd
Abstract
Background: Open cardiac surgical patients may experience severe acute
poststernotomy pain. The ultrasound-guided Pecto-intercostal Fascial Block
(PIFB) can cover anterior branches of intercostal nerves from T2 to T6.
The aim of this study was to investigate the effect of bilateral PIFB in
patients undergoing open cardiac surgery. Method(s): A group of 108
patients were randomly allocated to either receive bilateral PIFB (PIFB
group) or no nerve block (SALI group). The primary endpoint was
postoperative pain. The secondary outcome measures included intraoperative
and postoperative sufentanil and parecoxib consumption, time to
extubation, time to first feces, length of stay in the ICU and the length
of hospital stay. Insulin, glucose, insulin resistance and interleukin
(IL)-6 at 1, 2, 3 days after surgery were mearsured. The homeostasis model
assessment (HOMA-IR) was used to measure perioperative insulin resistance.
 Result(s): The PIFB group reported significantly less sufentanil and
parecoxib consumption than the SALI group. Compared to the PIFB group, the
SALI group had higher Numerical Rating Scale (NRS) pain scores at 24 h
after operation both at rest and during coughing. The time to extubation,
length of stay in the ICU and length of hospital stay were significantly
decreased in the PIFB group compared with the SALI group. The PIFB group
had a lower insulin, glucose, IL-6, HOMA-IR level than the SALI group 3
days after surgery. Conclusion(s): Bilateral PIFB provides effective
analgesia and accelerates recovery in patients undergoing open cardiac
surgery. Trial registration: This study was registered in the Chinese
Clinical Trial Registry (ChiCTR 2000030609) on 08/03/2020. Copyright
© 2021, The Author(s).

<31>
Accession Number
2041530499
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) (no pagination), 2025.
Article Number: e038659. Date of Publication: 28 Oct 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
(Bacigalupi, Scorpiglione, Radico, Pizzicannella, Perfetti, Zimarino)
Cardiology Department, SS. Annunziata Hospital, Chieti, Italy
(Prendergast) Department of Cardiology, St Thomas' Hospital and Cleveland
Clinic London, London, United Kingdom
(Gallinoro) Division of University Cardiology, Milan, Italy
(Bartorelli) IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
(Bartorelli) Department of Biomedical and Clinical Sciences, University of
Milan, Italy
(Amat-Santos) Departamento de Cardiologia, Hospital Clinico Universitario
de Valladolid, Valladolid, Spain
(Amat-Santos) Instituto de Ciencias Del Corazon, Hospital Clinico
Universitario de Valladolid, Valladolid, Spain
(Barbanti) Universita degli Studi di Enna "Kore, ", Enna, Italy
(De Backer) Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
(Chiusolo) CardioThoracic and Vascular Department, Pisa University
Hospital, Pisa, Italy
(Van Mieghem) Department of Cardiology, Thoraxcenter, Erasmus University
Medical Center, Rotterdam, Netherlands
(Testa) Department of Cardiology, IRCCS Policlinico San Donato, Milan,
Italy
(Testa) "Vita e Salute" University, Milan, Italy
(Waksman) MedStar Washington Hospital Center, Washington, DC, United
States
(Pelliccia, Miraldi) Department of Cardiovascular Sciences, University
Sapienza, Rome, Italy
(Dangas) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
Publisher
American Heart Association Inc.
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. 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).
 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).
 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. Copyright © 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-NoDerivs License, which permits use and
distribution in any medium, provided the original work is properly cited,
the use is non-commercial and no modifications or adaptations are made.
JAHA is available at: www.ahajournals.org/journal/jaha

<32>
Accession Number
2040286516
Title
Effects of Preoperative Oral Carbohydrates on Insulin Resistance and
Postoperative Recovery in Diabetic Patients Undergoing Coronary Artery
Bypass Grafting: A Preliminary Prospective, Single-Blinded, Randomized
Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 39(12) (pp 3338-3349),
2025. Date of Publication: 01 Dec 2025.
Author
Zhang S.; He L.; Yu Y.; Yuan X.; Yang T.; Yan F.; Xu F.; Zhang Y.; Pan S.;
Zhang H.; Chen Z.; Xie L.; Wu R.; Feng W.; Yao Y.
Institution
(Zhang, Yuan, Yang, Xu, Zhang, Pan, Zhang, Xie, Feng) Department of
Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular
Diseases, Peking Union Medical College and Chinese Academy of Medical
Sciences, Beijing, China
(Yan, Yao) Department of Anesthesiology, Fuwai Hospital, National Center
for Cardiovascular Diseases, Peking Union Medical College and Chinese
Academy of Medical Sciences, Beijing, China
(Chen, Wu) The Department of Intensive Care Unit, Chinese Academy of
Medical Sciences and Peking Union Medical College, Fuwai Hospital,
Beijing, China
(He) Department of Anesthesiology, Fuwai Yunnan Hospital, Chinese Academy
of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical
University
(Yu) Department of Anesthesiology, Beijing Chao-Yang Hospital, Capital
Medical University, Beijing, China
(Yao) Center of Outcomes Research, Department of Anesthesiology, Critical
Care and Pain Medicine, University of Texas, Houston, TX, United States
(Yao) Outcomes Research Consortium, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Objective: Previous studies have demonstrated that preoperative oral
carbohydrates (CHO) can alleviate postoperative insulin resistance (IR)
and enhance recovery in non-diabetic patients undergoing cardiac surgery.
However, the potential benefits in diabetic patients remain unclear. This
study aimed to investigate the effects of preoperative CHO on IR and
postoperative recovery in diabetic patients undergoing off-pump coronary
artery bypass grafting (OPCAB). Design(s): A prospective,
single-center, single-blind, randomized controlled trial. Setting(s):
The study was conducted in the Adult Cardiac Surgery Ward 6 of a
large-volume cardiovascular center. Participant(s): A total of 62
consecutive diabetic patients scheduled for isolated OPCAB were
prospectively enrolled between July 8, 2022, and April 28, 2023.
Participants were randomized in a 1:1 ratio to the CHO group or the
control (CTRL) group using computer-generated random numbers.
 Intervention(s): Patients in the CHO group received 335 mL of a
carbohydrate drink containing 50 g of carbohydrates 8 to 12 hours before
surgery, while those in the CTRL group followed routine fasting protocols.
 Measurements and Main Results: The primary endpoint was postoperative
IR, assessed by the homeostasis model assessment. Secondary endpoints
included postoperative inflammatory markers and stress responses (e.g.,
serum cortisol levels), while exploratory endpoints focused on in-hospital
clinical outcomes. Baseline characteristics were comparable between
groups. CHO administration significantly reduced postoperative
inflammatory markers but did not significantly improve IR. Stress response
was attenuated in the CHO group, though the difference was not
statistically significant. Postoperative drainage was higher in the CHO
group, but no differences were observed in other clinical outcomes.
 Conclusion(s): Preoperative CHO may attenuate inflammatory and stress
responses without increasing perioperative risk in diabetic patients
undergoing OPCAB, although its effect IR remains uncertain. Copyright
© 2025 Elsevier Inc.

<33>
Accession Number
2040116202
Title
Meta-Analysis of Coronary Bypass Graft Patency Assessment With Invasive vs
Computed Tomographic Angiography.
Source
Annals of Thoracic Surgery. 120(6) (pp 1016-1027), 2025. Date of
Publication: 01 Dec 2025.
Author
Mantaj P.; Hirofuji A.; Dell'Aquila M.; Demetres M.; Gregg A.; Krieger K.;
Abdalla S.; Kennedy M.; Savic M.; Ahmadi-Hadad A.; Rossi C.S.; Soletti G.;
Nikolikj A.; Rahouma M.; Sandner S.; Gaudino M.
Institution
(Mantaj, Hirofuji, Dell'Aquila, Demetres, Gregg, Krieger, Abdalla, Rossi,
Soletti, Rahouma, Gaudino) Department of Cardiothoracic Surgery, Weill
Cornell Medicine, New York, NY, United States
(Mantaj) Department of Cardiac Surgery, Medical University of Graz, Graz,
Austria
(Dell'Aquila) Department of Cardiothoracic Surgery, Catharina Hospital,
Eindhoven, Netherlands
(Kennedy) University of Notre Dame, Notre Dame, IN, United States
(Savic) Johannes Kepler University, Linz, Austria
(Ahmadi-Hadad) Department of Cardiac Surgery, University of Naples
Federico II, Naples, Italy
(Nikolikj) Department of Cardiac Surgery, Acibadem Sistina Hospital,
Skopje, North Macedonia
(Sandner) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
Publisher
Elsevier Inc.
Abstract
Background Computed tomographic (CT) coronary angiography has emerged as a
noninvasive alternative for evaluating graft patency after coronary artery
bypass grafting (CABG), but there is ongoing debate regarding its
diagnostic performance compared with invasive coronary angiography,
particularly for arterial and composite grafts. Methods MEDLINE (Medical
Literature Analysis and Retrieval System Online), Embase, and Cochrane
databases were searched to identify studies comparing CT coronary
angiography with invasive coronary angiography for detection of graft
occlusion in patients who had undergone CABG. Outcomes included
sensitivity, specificity, positive predictive value, negative predictive
value, and diagnostic accuracy. Meta-regression explored key modifiers.
Pooled estimates were calculated using random-effects models, with
heterogeneity measured by I 2 . Results Fifty studies met
inclusion criteria, including 3449 patients (25% women). CT coronary
angiography sensitivity for graft occlusion was 0.96 (I 2 =
48%), specificity was 0.97 (I 2 = 46%), positive predictive
value was 0.94 (I 2 = 62%), negative predictive value was
0.98 (I 2 = 41%), and overall diagnostic accuracy was 0.97 (I
 2 = 58%). The pooled incidence rate of graft occlusion across
7506 included grafts was 0.08 per graft-year (95% CI, 0.06-0.10) using a
random-effects model and 0.07 per graft-year (95% CI, 0.07-0.08) using a
fixed-effects model. At meta-regression, study year, sample size,
beta-blocker use, number of slices, and time since surgery, but not type
and configuration of CABG grafts, were significantly associated with CT
coronary angiography sensitivity. Conclusions CT coronary angiography
detects CABG graft occlusion with a high degree of sensitivity and
specificity independently of graft type and configuration and can be used
for imaging of every type of CABG graft. Copyright © 2025 The
Society of Thoracic Surgeons.

<34>
Accession Number
2037326021
Title
Suture-based versus plug-based closure for large-bore arterial access: an
individual patient-level meta-analysis of randomised trials.
Source
EuroIntervention. 21(20) (pp e1222-e1233), 2025. Date of Publication: 20
Oct 2025.
Author
Dumpies O.; van Wiechen M.; Jobs A.; Abdelhafez A.; Loria J.R.D.; Richter
I.; Feistritzer H.-J.; Majunke N.; Noack T.; Desch S.; Thiele H.;
Dumonteil N.; Tchetche D.; Van Mieghem N.; Abdel-Wahab M.
Institution
(Dumpies, Jobs, Abdelhafez, Loria, Richter, Feistritzer, Majunke, Desch,
Thiele, Abdel-Wahab) Department of Cardiology, Heart Center Leipzig at
University of Leipzig, Leipzig, Germany
(van Wiechen, Van Mieghem) Department of Cardiology, Erasmus University
Medical Center, Rotterdam, Netherlands
(Noack) Department of Cardiac Surgery, Heart Center Leipzig at University
of Leipzig, Leipzig, Germany
(Dumonteil, Tchetche) Department of Cardiology, Clinique Pasteur,
Toulouse, France
Publisher
Europa Group
Abstract
BACKGROUND: Percutaneous large-bore arteriotomy closure devices are either
suture-or plug-based. The comparative efficacy and safety of both
techniques and optimal patient selection remain controversial. AIMS: We
aimed to conduct a patient-level meta-analysis of randomised trials
comparing suture-based ProGlide versus plug-based MANTA large-bore
vascular closure devices (VCDs). METHOD(S): We searched PubMed, the
Cochrane Central Register of Controlled Trials, and Google Scholar for
randomised controlled trials comparing vascular closure with the
ProGlide-based and the MANTA-based technique. The primary endpoint of this
analysis was access site-related vascular complications defined according
to the Valve Academic Research Consortium-3 criteria. RESULT(S): We
identified 2 trials that enrolled a total of 722 patients undergoing
transcatheter aortic valve implantation. The primary endpoint was
significantly less common after vascular closure with the ProGlide-based
technique (odds ratio [OR] 0.54, 95% confidence interval [CI]: 0.35-0.82).
Access site-related bleeding events were also less common with the
ProGlide-based technique (OR 0.41, 95% CI: 0.18-0.94). Prespecified
subgroup analyses did not reveal any subgroup favouring the plug-based
technique. Clinical outcomes with the MANTA-based technique were better in
larger-sized vessels. Patients who received the ProGlide-based technique
were less likely to undergo endovascular stenting or vascular surgery (OR
0.22, 95% CI: 0.06-0.79). CONCLUSION(S): In this patient-level
meta-analysis of randomised trials, the ProGlide-based technique for
large-bore arterial access was superior to the MANTA-based technique in
terms of vascular and bleeding complications. Copyright © Europa
Group 2025. All rights reserved.

<35>
Accession Number
2040588173
Title
Restrictive versus liberal oxygenation in patients undergoing
cardiopulmonary bypass-assisted heart surgery: a randomised controlled
trial.
Source
British Journal of Anaesthesia. 135(6) (pp 1618-1625), 2025. Date of
Publication: 01 Dec 2025.
Author
Wiberg S.; Moller C.H.; Kjaergaard J.; Mikkelsen A.D.; Sorensen H.-M.;
Kunkel J.B.; Olsen P.S.; Hofsten D.E.; Ravn J.; Ravn H.; Boesgaard S.;
Hassager C.; Kober L.; Nilsson J.C.
Institution
(Wiberg, Sorensen, Nilsson) Department of Cardiothoracic Anesthesiology
and Intensive Care, Copenhagen University Hospital Rigshospitalet,
Copenhagen, Denmark
(Wiberg, Kjaergaard, Mikkelsen, Kunkel, Hofsten, Boesgaard, Hassager,
Kober) Department of Cardiology, Copenhagen University Hospital
Rigshospitalet, Copenhagen, Denmark
(Wiberg, Kjaergaard, Hassager) Department of Clinical Medicine, Faculty of
Health Sciences, University of Copenhagen, Copenhagen, Denmark
(Moller, Olsen, Ravn) Department of Cardiothoracic Surgery, Copenhagen
University Hospital Rigshospitalet, Copenhagen, Denmark
(Ravn) Department of Anesthesiology and Intensive Care, Odense University
Hospital, Odense, Denmark
Publisher
Elsevier Ltd
Abstract
Background: Maintaining adequate oxygen delivery during cardiopulmonary
bypass (CPB)-assisted cardiac surgery is crucial, but hyperoxia has been
suggested to cause organ injury. We compared the effects of restrictive vs
liberal oxygenation during CPB and weaning from CPB on clinical outcomes
in cardiac surgery. Method(s): We conducted a single-centre, patient-
and assessor-blinded randomised trial on adults undergoing CPB-assisted
coronary artery bypass grafting, aortic valve replacement, or both.
Participants were randomly assigned (1:1) to restrictive
(FIO<inf>2</inf>=50%) or liberal (FIO<inf>2</inf>=100%) oxygen therapy
during and for the first hour after weaning from CPB. The primary
composite outcome was the time to death, stroke, renal failure requiring
dialysis, or new-onset or worsening heart failure during follow-up.
 Result(s): Among 1389 participants (mean age, 67 yr [range, 29-85
yr]; 17% female), randomisation to receive FIO<inf>2</inf> 50% resulted in
median PaO<inf>2</inf> levels of 19-23 kPa during CPB, compared with >60
kPa in participants receiving FIO<inf>2</inf> 100%. During a median
follow-up period of 5.9 yr (interquartile range, 2.5-8.3), 167/695 (24%)
participants in the restrictive oxygenation group and 168/694 (24%)
participants in the liberal oxygenation group met the primary endpoint
(hazard ratio, 1.01 [95% confidence interval, 0.8-1.3]; P=0.92). There was
no difference in adverse event rates between restrictive and liberal
oxygen therapy. Conclusion(s): Among patients undergoing elective or
urgent CPB-assisted coronary artery bypass grafting, aortic valve
replacement, or both, no significant differences were observed in
mortality, dialysis-dependent renal failure, stroke, or new-onset or
worsening heart failure between a restrictive oxygenation strategy
(FIO<inf>2</inf> 50%) and a liberal oxygenation strategy (FIO<inf>2</inf>
100%) during CPB and the subsequent weaning period. Clinical trial
registration: NCT02673931 Copyright © 2025 The Author(s)

<36>
Accession Number
2041250152
Title
Prehabilitation including psychological interventions reduces overall
postoperative complications following cancer surgery: a systematic review
and meta-analysis of randomised controlled trials.
Source
Supportive Care in Cancer. 33(12) (no pagination), 2025. Article Number:
1070. Date of Publication: 01 Dec 2025.
Author
Hirst N.; Solomon M.J.; McBride K.; Dhillon H.; Bai Z.; Alexander K.; Jeon
S.W.; Steffens D.
Institution
(Hirst, Solomon, Bai, Alexander, Jeon, Steffens) Surgical Outcomes
Research Centre (SOuRCe), Royal Prince Alfred Hospital, Missenden Road,
P.O. Box M157, Sydney, NSW, Australia
(Hirst, Solomon, McBride, Bai, Alexander, Jeon, Steffens) Faculty of
Medicine and Health, Central Clinical School, The University of Sydney,
Sydney, Australia
(Solomon) Department of Colorectal Surgery, Royal Prince Alfred Hospital,
Sydney, Australia
(Solomon, McBride, Steffens) Institute of Academic Surgery (IAS), Royal
Prince Alfred Hospital, Sydney, Australia
(Dhillon) Faculty of Science, School of Psychology, University of Sydney,
Sydney, NSW, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: This study aims to assess the effectiveness of psychological
prehabilitation in reducing postoperative complications and length of
hospital stay in patients undergoing cancer surgery. Method(s): A
comprehensive electronic search was conducted in CINAHL, Cochrane Library,
Medline, PsycINFO, AMED and Embase databases from inception to December
2023. Randomised controlled trials assessing the effectiveness of
psychological prehabilitation compared to control in patients undergoing
abdominal, pelvic, and/or thoracic cancer surgery were included. The
primary outcome measures were postoperative complications and length of
hospital stay. Two independent reviewers extracted relevant information
and assessed the risk of bias. Random-effect meta-analyses were used to
pool outcomes, and the quality of evidence was assessed using GRADE.
 Result(s): A total of 18 trials were identified (N = 1612) and 11 (N
= 923) analysed, including eight multimodal (N = 719), one bimodal (N =
90) and two unimodal (N = 189). There was high-quality evidence that
trials including psychological prehabilitation significantly reduced the
incidence of overall postoperative complications in all cancer types
included in the studies (relative risk: 0.73; 95% CI: 0.60 to 0.89) and
abdominal cancer subgroup (relative risk: 0.65; 95% CI: 0.48 to 0.88)
compared to control. Psychological prehabilitation was not effective in
reducing length of hospital stay (mean difference: - 0.78; 95% CI: - 1.72
to 0.17). Conclusion(s): Psychological prehabilitation appears
effective in reducing postoperative complications in cancer patients.
Future studies should investigate the optimal preoperative psychological
interventions according to individual cancer groups undergoing
surgery. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<37>
Accession Number
2035937261
Title
Infective endocarditis complicated by shock: a systematic review and
meta-analysis.
Source
Heart Failure Reviews. 30(6) (pp 1377-1395), 2025. Date of Publication: 01
Dec 2025.
Author
Piriianu-Masgras R.-B.; Mebazaa A.; Savarese G.; Stoica E.; Geavlete O.;
Ambrosy A.P.; Antohi E.-L.; Yilmaz M.B.; Radu R.-I.; Adamo M.; Davison
B.A.; Biegus J.; Cotter G.; Butler J.; Collins S.P.; Chioncel O.
Institution
(Piriianu-Masgras, Geavlete, Antohi, Radu, Chioncel) University of
Medicine and Pharmacy Carol Davila, 8 Eroii Sanitari Blvd, Bucharest,
Romania
(Mebazaa) Department of Anesthesia & Critical Care, Lariboisiere Hospital,
AP-HP, Paris, France
(Savarese) Division of Cardiology, Department of Medicine, Karolinska
Institutet, Stockholm, Sweden
(Stoica, Geavlete, Antohi, Radu, Chioncel) 1, Department of Cardiology,
Emergency Institute for Cardiovascular Diseases "C.C.Iliescu", 258 Fundeni
St, Bucharest, Romania
(Ambrosy) Department of Cardiology, Kaiser Permanente San Francisco
Medical Center, San Francisco, CA, United States
(Yilmaz) Department of Cardiology, Faculty of Medicine, Dokuz Eylul
University, Izmir, Turkey
(Adamo) Institute of Cardiology, ASST Spedali Civili, Brescia, Italy
(Davison, Cotter) UMR-S 942 (MASCOT), Universite Paris Cite, INSERM,
Paris, France
(Davison, Cotter) Momentum Research Inc, Durham, NC, United States
(Davison, Cotter) Heart Initiative, Durham, NC, United States
(Biegus) Department of Cardiology, Clinical Department of Intensive
Cardiac Care, Institute of Heart Diseases, Faculty of Medicine, Wroclaw
Medical University, Wroclaw, Poland
(Butler) Baylor Scott and White Research Institute, Dallas, TX, United
States
(Butler) University of Mississippi Medical Center, Jackson, MS, United
States
(Collins) Department of Emergency Medicine, Vanderbilt University Medical
Center, Nashville, TN, United States
(Mebazaa) Universite Paris Cite, Paris, France
(Ambrosy) Division of Research, Kaiser Permanente Northern California,
Oakland, CA, United States
(Ambrosy) Department of Health Systems Science, Kaiser Permanente Bernard
J. Tyson School of Medicine, Pasadena, CA, United States
(Adamo) Department of Medical and Surgical Specialties, Radiological
Sciences and Public Health, University of Brescia, Brescia, Italy
Publisher
Springer
Abstract
Abstract: Infective endocarditis (IE) complicated by septic or cardiogenic
shock is linked to a marked increase in morbidity and mortality rates.
This systematic review and meta-analysis sought to evaluate clinical
outcomes, identify prognostic factors, and assess the effects of valve
surgical intervention in patients with infective endocarditis complicated
by shock. Systematic searches were performed in PubMed, Cochrane Library,
and Google Scholar databases, following PRISMA and MOOSE guidelines.
Included were observational studies published from January 2015 to May
2025 that reported on adult patients with infective endocarditis
complicated by septic or cardiogenic shock. A random-effects model was
utilized for data synthesis (restricted maximum likelihood with
Hartung-Knapp adjustment), and meta-regression was conducted to assess
sources of heterogeneity. Seven observational studies were included (n =
183-255,838). In-hospital mortality among patients with shock was 62.3%
(95% CI 48.3-74.5%). Compared with IE without shock, the pooled odds ratio
for in-hospital mortality (HK-REML) was 5.83 (95% CI 1.35-25.23; 95%
prediction interval 0.26-129.69), with substantial heterogeneity
(I2 = 90.3%). Valve surgical intervention was associated with
reduced mortality, particularly in cardiogenic shock. Staphylococcus
aureus was the most common pathogen in available microbiological data.
Shock was frequently accompanied by acute kidney injury, neurological
complications, and multiorgan dysfunction. Infective endocarditis
complicated by shock carries an extremely poor prognosis, with pooled
mortality exceeding 60%. Prompt recognition of shock, timely initiation of
appropriate antimicrobial therapy, hemodynamic stabilization, and early
valve surgery are crucial to improve outcomes in this high-risk
population. Systematic review registration: PROSPERO:
CRD420250652570. Copyright © The Author(s) 2025.

<38>
Accession Number
2041172362
Title
Beyond Mortality: Textbook Outcome as a Novel Quality Metric in
Cardiothoracic Surgical Care.
Source
Journal of Clinical Medicine. 14(21) (no pagination), 2025. Article
Number: 7660. Date of Publication: 01 Nov 2025.
Author
Magouliotis D.E.; Androutsopoulou V.; Zotos P.-A.; Cioffi U.; Minervini
F.; Sicouri N.; Zacharoulis D.; Xanthopoulos A.; Scarci M.
Institution
(Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute
for Medical Research, Wynnewood, PA, United States
(Magouliotis, Androutsopoulou, Zotos) Department of Cardiothoracic
Surgery, University of Thessaly, Biopolis, Larissa, Greece
(Cioffi) Department of Surgery, University of Milan, Milan, Italy
(Minervini) Department of Thoracic Surgery, Luzern Kanton Hospital,
Luzern, Switzerland
(Sicouri) Department of Neuroscience Pittsburgh Campus, University of
Pittsburgh, Pittsburgh, PA, United States
(Zacharoulis) Department of Surgery, University of Thessaly, Biopolis,
Larissa, Greece
(Xanthopoulos) Department of Cardiology, University of Thessaly, Biopolis,
Larissa, Greece
(Scarci) Department of Cardiothoracic Surgery, Hammersmith Hospital,
Imperial College Healthcare, National Health Service (NHS) Trust, London,
United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: Textbook outcome (TO) is a multidimensional composite quality
metric that integrates several desirable short-term outcomes into a single
measure representing the "ideal" perioperative course. Unlike traditional
indicators that focus narrowly on mortality or single complications, TO
captures the complexity of cardiothoracic care, encompassing oncologic
adequacy, absence of major complications, avoidance of reintervention and
readmission, and timely discharge. Method(s): In this systematic
review, we synthesize evidence on the definition, incidence, determinants,
prognostic impact, and limitations of TO across cardiothoracic surgery
(lung and esophageal resections, lung transplantation, cardiac surgery,
and adult heart transplantation) in accordance with the PRISMA guidelines.
 Result(s): Reported achievement rates range from 24% to 66% in
thoracic series, 30% after Norwood palliation, 37-45% after adult heart
transplantation, and 52% in a contemporary national cohort of lung
transplantation, with wide between-center variability. Achieving TO is
consistently associated with improved overall and disease-free survival,
lower costs, and enhanced benchmarking. Determinants of failure include
inadequate lymph node dissection, prolonged operative time, advanced
comorbidity, pretransplant organ support, and socioeconomic disadvantage.
Heterogeneity of definitions, limited incorporation of patient-reported
outcomes, and equity concerns remain barriers to its successful use.
Outside transplantation, benchmarking of TO in adult cardiac procedures
(e.g., CABG/valve) remains limited and non-standardized.
 Conclusion(s): We argue for harmonized, procedure-specific core TO
sets aligned with widely available registry fields, integration of
equity-sensitive risk adjustment, and prospective validation. TO is poised
to become a cornerstone metric of quality assessment and improvement in
cardiothoracic surgery. Copyright © 2025 by the authors.

<39>
Accession Number
2010804677
Title
Granulomatosis With Polyangiitis (Wegener's Granulomatosis) Complicated by
Pericarditis: Our Experience of Two Cases and Comparative Review of
Literature.
Source
CASE. 5(2) (pp 126-136), 2021. Date of Publication: 01 Apr 2021.
Author
Ahmed T.; Meredith D.; Klein A.L.
Institution
(Ahmed, Meredith, Klein) Center for the Diagnosis and Treatment of
Pericardial Diseases, Heart, Vascular and Thoracic Institute, Cleveland
Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.

<40>
Accession Number
2041306551
Title
Effects of Preoperative Quetiapine on Postoperative Delirium in Coronary
Artery Bypass Graft Surgery Patients: A Randomized Double-blind Controlled
Trial.
Source
Caspian Journal of Neurological Sciences. 11(4) (pp 286-294), 2025. Date
of Publication: 2025.
Author
Imantalab V.; Sedighinejad A.; Karimi N.G.; Vahed L.K.; Zargarnataj S.S.;
Gholipour M.; Biazar G.
Institution
(Imantalab, Sedighinejad, Karimi, Biazar) Department of Anesthesiology,
Anesthesiology Research Center, Alzahra Hospital, Guilan University of
Medical Sciences, Rasht, Iran, Islamic Republic of
(Vahed) Department of Community Medicine, School of Medicine, Guilan
University of Medical Sciences, Rasht, Iran, Islamic Republic of
(Zargarnataj, Gholipour) Department of Cardiology, Healthy Heart Research
Center, School of Medicine, Heshmat Hospital, Guilan University of Medical
Sciences, Rasht, Iran, Islamic Republic of
Publisher
Guilan University of Medical Sciences
Abstract
Background: Coronary artery bypass graft (CABG) is a lifesaving surgery;
however, it can be accompanied by potential adverse events, such as
post-operative delirium (POD). Objective(s): The aim of this study
was to evaluate the effects of quetiapine on POD in patients undergoing
CABG. Material(s) and Method(s): This randomized clinical trial was
carried out from December 2023 to November 2024 in an academic center
affiliated with the Guilan University of Medical Sciences (GUMS). Eligible
patients were equally divided into two groups of quetiapine and control.
POD was assessed using the confusion assessment method (CAM) in the
intensive care unit (ICU) every 12 hours for two days postoperatively.
 Result(s): Data from 82 CABG patients were analyzed. No significant
difference was found between the two quetiapine and control groups
regarding patients' demographic data and surgery characteristics (P>0.05).
Two cases in the quetiapine group (4.87%) and four patients in the control
group (9.75%) developed POD, with no significant difference (P=0.675).
Comparing the onset time of delirium in the quetiapine (9.5+/-0.7) and
control (8.5+/-0.57) groups, no significant difference was observed
(P=0.135). There was no association between patients' co-morbidities
(P=0.675), American Society of Anesthesiologists (ASA) class (P=0.154),
age (P=0.648), body mass index (BMI) (P=0.468), and the occurrence of POD.
None of our cases showed serious adverse effects. Conclusion(s):
Quetiapine can be used safely in CABG patients with promising results,
despite the lack of statistical difference. In this regard, well-planned
trials with sufficient sample sizes and higher dosages are encouraged to
achieve practical results. Copyright © (2025), (Guilan University
of Medical Sciences). All rights reserved.

<41>
Accession Number
2037326016
Title
Impact of complete revascularisation in relation to left ventricular
function in patients with ST-segment elevation myocardial infarction and
multivessel disease: a post hoc analysis of the COMPLETE randomised trial.
Source
EuroIntervention. 21(20) (pp e1198-e1208), 2025. Date of Publication: 20
Oct 2025.
Author
Tiong D.; Pinilla-Echeverri N.; Wood D.A.; Mehran R.; Storey R.F.; Feldman
L.; Moreno R.; Rao S.; Cantor W.J.; Welsh R.; Bainey K.R.; Cohen E.A.;
Tsang M.B.; Sibbald M.; Natarajan M.K.; Wijesena D.; Mani T.; Nguyen H.;
Cairns J.A.; Mehta S.R.
Institution
(Tiong, Pinilla-Echeverri, Tsang, Sibbald, Natarajan, Mehta) McMaster
University and Hamilton Health Sciences, Hamilton, ON, Canada
(Pinilla-Echeverri, Wijesena, Mani, Nguyen, Mehta) Population Health
Research Institute, McMaster University and Hamilton Health Sciences,
Hamilton, ON, Canada
(Wood, Cairns) University of British Columbia, Vancouver, BC, Canada
(Mehran) The Zena A. Wiener Cardiovascular Institute, Icahn School of
Medicine at Mount Sinai, New York, NY, United States
(Storey) Division of Clinical Medicine, University of Sheffield,
Sheffield, United Kingdom
(Feldman) Universite Paris-Cite, INSERM U-1148, AP-HP, Hopital Bichat,
Paris, France
(Moreno) University Hospital La Paz, IdiPAZ, Madrid, Spain
(Moreno) Universidad Autonoma de Madrid, Madrid, Spain
(Rao) NYU Langone Health System, New York, NY, United States
(Cantor) Southlake Regional Health Centre, Toronto, ON, Canada
(Cantor) University of Toronto, Toronto, ON, Canada
(Welsh, Bainey) Mazankowski Alberta Heart Institute, University of
Alberta, Edmonton, AB, Canada
(Cohen) Sunnybrook Health Sciences Centre, University of Toronto, Toronto,
ON, Canada
Publisher
Europa Group
Abstract
BACKGROUND: The COMPLETE trial demonstrated a reduction in cardiovascular
(CV) death or new myocardial infarction (MI) after complete, rather than
culprit-only, revascularisation in patients with ST-segment elevation
myocardial infarction (STEMI) and multivessel disease (MVD). However, it
is unknown whether this benefit varies according to baseline left
ventricular ejection fraction (LVEF). AIMS: We aimed to determine the
effects of complete versus culprit-only revascularisation according to
LVEF. METHOD(S): Baseline LVEF was available for 2,214 of 4,041
randomised patients. The effect of both strategies on the first co-primary
outcome of CV death or new MI and the second co-primary outcome of CV
death, new MI, or ischaemia-driven revascularisation (IDR) was determined
within the prespecified LVEF ranges of <45% (N=660) and >=45% (N=1,554).
An analysis of clinical outcomes by LVEF according to thirds was also
conducted. RESULT(S): Patients with LVEF <45% experienced a
significantly higher incidence of the first co-primary outcome compared
with those with LVEF >=45% (4.2%/year vs 2.8%/year; hazard ratio [HR]
1.51, 95% confidence interval [CI]: 1.15-1.98; p=0.003). Compared with a
culprit-only strategy, complete revascularisation consistently reduced the
first co-primary outcome in patients with LVEF <45% (3.0%/year vs
5.5%/year; HR 0.55, 95% CI: 0.36-0.86) and those with LVEF >=45%
(2.4%/year vs 3.2%/year; HR 0.74, 95% CI: 0.52-1.04; interaction p=0.31).
Complete revascularisation also consistently reduced the second co-primary
outcome in patients with LVEF <45% (3.5%/year vs 7.3%/year; HR 0.49, 95%
CI: 0.33-0.74) and those with LVEF >=45% (2.7%/year vs 6.3%/year; HR 0.44,
95% CI: 0.33-0.60; interaction p=0.67). Consistent results were observed
for both co-primary outcomes when LVEF was further stratified into
categories of LVEF <=35%, 36-49% and >=50%. CONCLUSION(S): Among
patients presenting with STEMI and MVD, those with reduced LVEF are at
higher risk of ischaemic events than patients with preserved LVEF. There
is a consistent benefit of complete revascularisation regardless of
baseline LVEF. Copyright © Europa Group 2025. All rights
reserved.

<42>
Accession Number
2041244082
Title
Interventions to prevent postoperative neurocognitive complications: an
umbrella review of meta-analyses of randomised controlled trials.
Source
Anaesthesia. (no pagination), 2025. Date of Publication: 2025.
Author
D'Amico F.; Turi S.; Manazza M.; Lo Bianco G.; Monti G.; Zangrillo A.;
Landoni G.; Beretta L.
Institution
(D'Amico, Turi, Manazza, Lo Bianco, Monti, Zangrillo, Landoni, Beretta)
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Monti, Zangrillo, Landoni, Beretta) Vita-Salute San Raffaele University,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The certainty of the effectiveness of interventions to
manage postoperative neurocognitive complications remains unclear. The
objective of this umbrella review was to synthesise and evaluate the
evidence for interventions aimed at reducing the incidence of
peri-operative neurocognitive complications. Method(s): We searched
relevant databases from inception to 23 August 2025. We included
systematic reviews and meta-analyses of randomised trials evaluating
pharmacological and non-pharmacological interventions for the prevention
of postoperative neurocognitive complications in adult surgical
populations. Certainty of evidence for each intervention was assessed
using the GRADE framework. Methodological quality was appraised using
AMSTAR and the Ioannidis classification. Result(s): A total of 114
systematic reviews and meta-analyses, with data from 250,777 patients,
were included. Dexmedetomidine, cerebral monitoring, acupuncture, sleep
interventions, steroids, antipsychotics, peripheral nerve blocks,
esketamine and remimazolam were associated with reductions in
postoperative neurocognitive complications. Subgroup analyses indicated
that these interventions also showed potential benefits across
non-cardiac, orthopaedic and cardiac surgery. However, the overall
certainty of evidence for all these interventions was predominantly very
low. Discussion(s): A number of peri-operative interventions are
associated with a reduction in postoperative neurocognitive complications
but the certainty of evidence supporting these interventions to prevent is
very low. High-quality research is needed to advance the evidence base and
inform future clinical practice. Copyright © 2025 The Author(s).
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<43>
Accession Number
2041039063
Title
Impact of propofol or sevoflurane on the renoprotective effect of remote
ischaemic preconditioning in cardiac surgery: the HypnoRenalRIP randomised
clinical trial.
Source
British Journal of Anaesthesia. 135(6) (pp 1626-1634), 2025. Date of
Publication: 01 Dec 2025.
Author
Zarbock A.; Schone L.M.; Kellum J.A.; Gerss J.; Weiss R.; Booke H.;
Meersch M.
Institution
(Zarbock, Schone, Weiss, Booke, Meersch) Department of Anaesthesiology,
Intensive Care Medicine and Pain Medicine, University Hospital Munster,
Munster, Germany
(Zarbock) Department of Anesthesiology, Critical Care and Pain Medicine,
The University of Texas Health Science Center at Houston, Houston, TX,
United States
(Kellum) Center for Critical Care Nephrology, Department of Critical Care
Medicine, University of Pittsburgh, Pittsburgh, PA, United States
(Gerss) Institute of Biostatistics and Clinical Research, University of
Munster, Munster, Germany
Publisher
Elsevier Ltd
Abstract
Background: Remote ischaemic preconditioning (RIPC) might reduce acute
kidney injury after cardiac surgery. Protective effects appear to be
restricted to patients with early and transient increases in two cell
cycle arrest markers, tissue inhibitor of metalloproteinases-2 (TIMP-2)
and insulin-like growth factor-binding protein 7 (IGFBP7), in urine.
Studies suggest that propofol can attenuate the preconditioning effect on
the myocardium. This study investigated whether propofol diminishes the
renoprotective effect associated with the early transient increases in
TIMP-2 and IGFBP7. Method(s): This was a single-centre, prospective
randomised double-blind 2x2 factorial clinical trial of high-risk patients
undergoing cardiac surgery. Patients were randomised to receive either
propofol+sham-RIPC, propofol+RIPC, sevoflurane+sham-RIPC, or
sevoflurane+RIPC. The primary outcome measure was the change in the
product of urinary concentrations of TIMP-2 and IGFBP7 ([TIMP-2].[IGFBP7])
from before to after the intervention. Result(s): We enrolled 160
participants in the trial (propofol+sham-RIPC: n=20, propofol+RIPC: n=60,
sevoflurane+sham-RIPC: n=20, sevoflurane+RIPC: n=60). The median change in
[TIMP-2].[IGFBP7] as an indicator of response to RIPC was greater in
participants receiving sevoflurane (0.070; interquartile range, -0.120 to
0.418) compared with those receiving propofol (-0.015; interquartile
range, -0.138 to 0.068; P=0.022). Conversely, elevated [TIMP-2].[IGFBP7]
as a sign of renal stress in response to surgery was detected in all
groups except for sevoflurane+RIPC (P=0.001). There were no statistically
significant differences in patient-centred outcomes between groups.
 Conclusion(s): Transient increases in [TIMP-2].[IGFBP7] induced by
RIPC, which were associated with renoprotective effects, were only seen
with sevoflurane anaesthesia, but not when propofol was used. The
association of biomarker concentrations and choice of anaesthetic agent
suggests that propofol can attenuate the renoprotective effects of remote
ischaemic preconditioning. Clinical trial registration:
DRKS00014989 Copyright © 2025 The Author(s)

<44>
Accession Number
2036221090
Title
Direct Comparison of Urgent Transcatheter Aortic Valve Implantation and
Balloon Aortic Valvuloplasty: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 106(6) (pp 3378-3384),
2025. Date of Publication: 15 Nov 2025.
Author
Dimitriadis K.; Pyrpyris N.; Aznaouridis K.; Bonnet G.; Beneki E.;
Theofilis P.; Plaites A.; Antonopoulos A.; Chrysohoou C.; Tsioufis K.
Institution
(Dimitriadis, Pyrpyris, Aznaouridis, Beneki, Theofilis, Plaites,
Antonopoulos, Chrysohoou, Tsioufis) First Cardiology Department, School of
Medicine, Hippokration General Hospital, National and Kapodistrian
University of Athens, Athens, Greece
(Bonnet) Hopital Haut Leveque, Bordeaux, France
(Beneki) Department of Cardiology, Lausanne University Hospital, Lausanne,
Switzerland
Publisher
John Wiley and Sons Inc
Abstract
Objective: Aortic stenosis (AS) may complicate cardiogenic shock (CS) or
acute decompensated heart failure (ADHF) in a small but significant number
of patients. In such cases, urgent treatment is necessary to prevent
mortality and adverse outcomes. Transcatheter aortic valve implantation
(TAVI) and balloon aortic valvuloplasty (BAV) represent the main treatment
options, however, limited studies have compared them directly. Therefore,
this systematic review and meta-analysis aims to synthesize available
studies directly comparing urgent TAVI and BAV, in respect to reported
outcomes. Method(s): We systematically searched MEDLINE/PubMed,
Scopus and Web of Science for studies comparing outcomes in patients with
CS or ADHF undergoing urgent TAVI or BAV. Followingly, a meta-analysis of
all included studies was performed. Result(s): A total of six
studies, including 21,020 patients (10,597 patients undergoing TAVI and
10,423 patients undergoing BAV) were analyzed. Regarding in-hospital
mortality, it was found to be significantly lower in patients undergoing
urgent TAVI, compared to BAV (risk ratio [RR]: 0.53; 95% confidence
interval (CI): 0.32-0.87]. Moreover, urgent TAVI was also associated with
significantly lower all-cause mortality at 30-days follow up (RR 0.51, 95%
CI: 0.31-0.84). Conclusion(s): In this meta-analysis of
observational, retrospective studies including patients undergoing urgent
transcatheter interventions for acute AS, TAVI is associated with
significantly reduced in-hospital and 30-days mortality, in comparison to
BAV. More larger studies, reporting extended follow-up and adverse events'
rates, are needed to safely conclude regarding the benefit of urgent
interventions in the acute care. Copyright © 2025 The Author(s).
Catheterization and Cardiovascular Interventions published by Wiley
Periodicals LLC.

<45>
Accession Number
2035985928
Title
Expanding Access to Atrial Fibrillation Interventions: Patient Safety Must
Remain the Priority.
Source
Journal of Cardiovascular Electrophysiology. 36(11) (pp 2901-2902), 2025.
Date of Publication: 01 Nov 2025.
Author
Phillips K.P.
Institution
(Phillips) Greenslopes Private Hospital, Brisbane, Greenslopes, Australia
Publisher
John Wiley and Sons Inc

<46>
Accession Number
2041172818
Title
Giant Atrial Dilatation: Systematic Review of Reported Cases from the Last
Decade and an Illustrative Case with Dysphagia and Severe Dysphonia.
Source
Journal of Clinical Medicine. 14(21) (no pagination), 2025. Article
Number: 7832. Date of Publication: 01 Nov 2025.
Author
Streian C.G.; Munteanu I.-R.; Scuturoiu M.-A.; Cozlac A.-R.; Lascu A.;
Staicu R.-E.; Falnita L.-S.; Merce A.G.; Feier H.B.
Institution
(Streian, Feier) Department VI Cardiology-Cardiovascular Surgery Clinic,
"Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Streian, Munteanu, Scuturoiu, Cozlac, Lascu, Staicu, Falnita, Merce,
Feier) Institute for Cardiovascular Diseases of Timisoara, Clinic of
Cardiovascular Surgery, Gheorghe Adam Street, No. 13A, Timisoara, Romania
(Munteanu, Scuturoiu, Merce) Doctoral School Medicine-Pharmacy, "Victor
Babes" University of Medicine and Pharmacy, Timisoara, Romania
(Munteanu, Falnita, Merce, Feier) Advanced Research Center, Institute for
Cardiovascular Diseases of Timisoara, Timisoara, Romania
(Scuturoiu) NEUROPSY-COG Center for Cognitive Research in Neuropsychiatric
Pathology, Department of Neuroscience, "Victor Babes" University of
Medicine and Pharmacy, Timisoara, Romania
(Lascu) Department III of Functional Sciences, Discipline of
Pathophysiology, "Victor Babes" University of Medicine and Pharmacy,
Timisoara, Romania
(Lascu) Centre for Translational Research and Systems Medicine, "Victor
Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2,
Timisoara, Romania
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Giant atrial chambers are rare but clinically
important conditions, most often linked to rheumatic mitral valve disease,
though they may also occur in congenital or other acquired disorders.
Despite their low prevalence, they entail major hemodynamic,
arrhythmogenic, and extracardiac risks. This study aimed to review recent
evidence on giant atrial pathology-including giant left atrium (GLA),
giant right atrium (GRA), and atrial appendage aneurysms-and to illustrate
its relevance through cases of symptomatic extracardiac compression.
 Method(s): A PubMed search on 15 September 2025 using "giant atrium"
and limited to human, free full-text studies from the last 10 years
yielded 93 results. After screening, 21 reports describing 24 cases were
analyzed and compared with institutional experience. Result(s): GLA
is most often defined by an anteroposterior diameter >=6.5 cm or >=8 cm,
while criteria for GRA and appendage aneurysms remain inconsistent.
Reported complications include atrial fibrillation, thromboembolism, and
compression of mediastinal structures, with presentations such as
dysphagia or airway obstruction. While valve surgery alone may suffice,
many authors recommend concomitant atrial reduction or aneurysm resection
in symptomatic patients. Conclusion(s): Giant atrial pathology,
though uncommon, carries significant cardiac and extracardiac
implications. Management should be individualized, and awareness of
atypical manifestations is critical for timely diagnosis and
treatment. Copyright © 2025 by the authors.

<47>
Accession Number
2041633579
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. 67(11) (no pagination), 2025.
Article Number: ezaf382. Date of Publication: 01 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, Poznan, Poland
Publisher
European Association for Cardio-Thoracic Surgery
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 vs autologous blood patch pleurodesis in
managing postoperative air leak. Methods 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. Results 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 =. 033; 95% CI: 2.2% to 24.2%). The glucose group had a shorter
postoperative hospital stay (7 vs 9 days, P =. 036). Chest pain occurred
more frequently in the glucose group, but the difference was not
statistically significant (10.6% vs 4.8%, P =. 24). No major infectious
complications were observed. Residual air space occurrence and reoperation
rates were comparable. Conclusions Intrapleural 40% glucose solution
achieved a higher resolution rate of postoperative air leak compared to
autologous blood patch pleurodesis, with a comparable safety profile.
Clinical Registration Number NCT06936969
(ClinicalTrials.gov). Copyright © 2025 The Author(s). Published
by Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery.

<48>
Accession Number
2041602567
Title
The Effect of Parasternal Block on Postoperative Pain in Patients
Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled
Trial.
Source
Journal of Cellular and Molecular Anesthesia. 10(4) (no pagination), 2025.
Article Number: e166289. Date of Publication: 01 Dec 2025.
Author
Celik E.C.; Nil Kaan M.; Durmaz S.
Institution
(Celik) Department of Anesthesiology and Reanimation, Aydin Maternity and
Child Health Hospital, Aydin, Turkey
(Nil Kaan) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Adnan Menderes University, Aydin, Turkey
(Durmaz) Department of Cardiovascular Surgery, Faculty of Medicine, Adnan
Menderes University, Aydin, Turkey
Publisher
Brieflands
Abstract
Background and Objectives: This study aims to investigate the effects of
intraoperative parasternal block (PSB) on postoperative analgesia in
patients undergoing elective coronary artery bypass graft (CABG) surgery.
 Method(s): This prospective, randomized, double-blind study included
78 patients aged 30 - 80 years with an American Society of
Anesthesiologists (ASA) physical status III-IV, who were scheduled for
elective CABG surgery. Patients were randomly assigned into two groups:
The PSB group (n = 39), receiving a PSB with 0.25% bupivacaine, and the
saline group (n = 39), receiving a PSB with 0.9% NaCl. All patients were
administered a standard anesthesia protocol, and routine care and
analgesia practices during the postoperative period were not interfered
with. Patients in the intensive care unit (ICU) received intravenous
paracetamol every eight hours for analgesia. If postoperative 24-hour pain
scores in the ICU, assessed using the Behavioral Pain Scale (BPS) while
intubated and the Numeric Rating Scale (NRS) while extubated, exceeded
four, 1 mg/kg tramadol was administered. The timing and doses of the first
tramadol administration, as well as extubation times, ICU stay durations,
and discharge times, were recorded. Result(s): In the postoperative
period, BPS scores at the 8th hour and NRS scores at the 4th and 12th
hours were significantly lower in the PSB group than in the saline group
(P < 0.005). The average extubation time was 8.76 hours in the PSB group
and 14.76 hours in the saline group (P < 0.001). Among patients with pain
scores of four or higher, the total tramadol consumption in the PSB group
was 150 +/- 64.72 mg, with the first tramadol administration occurring at
17.26 +/- 4.78 hours. In the saline group, total tramadol consumption was
212.5 +/- 82.23 mg, and the first administration occurred at 12.35 +/-
5.75 hours. Conclusion(s): Our study demonstrated that PSB, as a
component of multimodal analgesia, improved postoperative analgesia levels
in CABG surgery. Therefore, we consider the PSB to be effective in pain
management following median sternotomy. Copyright © 2025,
Caglayan CELIK et al.

<49>
Accession Number
2041172175
Title
The Influence of Anesthesiologist Gender and Experience on Risk
Understanding and Anxiety Changes After Online Preoperative Patient
Education: A Sub-Analysis of the iPREDICT Randomized Controlled Trial.
Source
Journal of Clinical Medicine. 14(21) (no pagination), 2025. Article
Number: 7643. Date of Publication: 01 Nov 2025.
Author
Puskarevic A.; Ehrentraut H.; Kunsorg A.; Abulizi I.; Mayr A.; Jung M.;
Schillings M.; Temme C.; Putz A.; Coburn M.; Wittmann M.
Institution
(Puskarevic, Ehrentraut, Kunsorg, Jung, Schillings, Temme, Putz, Coburn,
Wittmann) Department of Anesthesiology and Intensive Care Medicine,
University Hospital Bonn, Bonn, Germany
(Abulizi, Mayr) Department of Medical Biometry and Statistics, University
of Marburg, Marburg, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Digital health technologies are increasingly
integrated into perioperative care to standardize information delivery and
improve patient empowerment. However, the overall effectiveness of
preoperative education depends not only on digital tools but also on
interpersonal factors, such as physician gender and clinical experience,
which may shape patients' perceptions and responses to digitally delivered
content. Method(s): Patients scheduled for elective surgery were
included in the iPREDICT randomized trial prior to their preoperative
anesthesia assessment. After preoperative anesthetic assessment, the
anesthesiologist documented the communication quality and the risks
explained. Patients completed a questionnaire to assess their knowledge of
anesthesia-related risks and whether the consultation alleviated their
fears. Result(s): A total of 275 included patients were consulted by
94 anesthesiologists, 65% of whom were female. Risk recall was mainly
determined by patient-related factors, with online education significantly
improving recall over time (beta = 1.24, p = 0.034). Anesthesiologists
with 1-4 years of clinical experience explained more risks than those with
<1 year of professional experience (beta = 2.30, p = 0.024). A reduction
in post-consultation anxiety was noted when the anesthetist was female
(beta = 0.21, p = 0.022). Communication was overall rated as good, with
higher ratings when anesthetists had more than 10 years of experience
(beta = 0.09, p = 0.049). Conclusion(s): Although we have shown with
the iPREDICT study (registered in the German CTS; DRKS00032514; on 21
August 2023) that online education improves patients' recall of
anesthesia-related risks, the current sub-analysis emphasizes that
interpersonal interactions remain essential for alleviating fears and
improving the quality of communication. Together, these findings
underscore the complementary roles of digital education and face-to-face
consultations in optimizing preoperative preparation. Copyright ©
2025 by the authors.

<50>
Accession Number
2041202452
Title
Which exercise modality is most effective for improving cardiac function
in patients with myocardial infarction? A network meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1623727. Date of Publication: 2025.
Author
Yu B.; Zhao L.; Huang L.; Zhang M.
Institution
(Yu, Zhang) School of Wushu, Shandong Sport University, Jinan, China
(Zhao) Traditional Sport Institute, Harbin Sport University, Harbin, China
(Huang) Zaoyang Children's Sports School, Zaoyang, China
Publisher
Frontiers Media SA
Abstract
Objective: This study aimed to compare the efficacy of different exercise
modalities on cardiac function in patients with myocardial infarction
(MI), providing evidence-based recommendations for optimal cardiac
rehabilitation programming. Method(s): We conducted a systematic
search of seven Chinese and English databases, including CNKI and Web of
Science, to identify eligible studies. A network meta-analysis based on
the frequency framework was performed using STATA 14.0. Result(s): A
total of 69 studies involving 5,044 participants were included. Compared
to the control group, all exercise interventions significantly improved
6-minute walk test (6MWT) scores in MI patients, with mean differences
(MDs) and 95% confidence intervals (CIs) ranging from 57.61 (34.87, 80.36)
for aerobic exercise (AE) to 144.38 (110.78, 177.98) for resistance
exercise (RE). All modalities enhanced left ventricular ejection fraction
(LVEF), with MDs (95% CI) from 4.75 (3.42, 6.09) for AE to 8.75 (5.72,
11.77) for RE. Except for AE, all interventions reduced left ventricular
end-diastolic diameter (LVEDD), with MDs (95% CI) from -4.01 (-6.42,
-1.59) for multi-component exercise training (MCET) to -6.40 (-9.24,
-3.56) for RE. All exercises improved left ventricular end-systolic
diameter (LVESD), with MDs (95% CI) from -1.89 (-3.27, -0.51) for AE to
-7.33 (-9.62, -5.03) for RE. RE consistently showed a high probability of
relatively high efficacy rankings across outcomes (SUCRA: 93.2-99.8).
 Conclusion(s): RE appeared to have a high probability of being a
highly effective single modality for improving post-MI cardiac function
and remodeling. MCET and mind-body training also offer notable advantages,
particularly in reducing ventricular size. Ultimately, rehabilitation
programs should be tailored by considering the modality-specific benefits,
patient's clinical profile, and functional capacity to optimize outcomes.
Systematic Review Registration: https://inplasy.com/inplasy-2024-11-0016/,
identifier INPLASY2024110016. Copyright 2025 Yu, Zhao, Huang and
Zhang.

<51>
Accession Number
2040174307
Title
From pioneering to innovation: A comprehensive review of acupuncture
anesthesia in cardiothoracic surgeries.
Source
Journal of Integrative Medicine. 23(6) (pp 623-629), 2025. Date of
Publication: 01 Nov 2025.
Author
Wu X.-D.; Wei X.-Q.; Chen T.-Y.; Zhou W.-X.; Wang K.; Zhou J.
Institution
(Wu, Wei, Wang, Zhou) Department of Clinical Research Institute of
Acupuncture and Anesthetic, Yueyang Hospital of Integrated Traditional
Chinese and Western Medicine, Shanghai University of Traditional Chinese
Medicine, Shanghai, China
(Wu, Zhou) Department of Intensive Care Unit, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Chen, Zhou) Department of Cardiothoracic Surgery, Yueyang Hospital of
Integrated Traditional Chinese and Western Medicine, Shanghai University
of Traditional Chinese Medicine, Shanghai, China
(Wang) Office of National Clinical Research Base of Traditional Chinese
Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western
Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai,
China
Publisher
Elsevier (Singapore) Pte Ltd
Abstract
The evolution of acupuncture anesthesia (AA) has spanned six decades.
Cardiothoracic surgery serves as a representative case study to illustrate
this evolution. Reflecting on its historical development, the use of AA in
cardiothoracic surgery has advanced from basic AA procedures in the 1960s
to combined acupuncture and drug anesthesia techniques in the early 1980s.
Since 2005, the innovative use of non-intubation AA combined anesthesia
has been implemented extensively in cardiothoracic surgery. As the medical
industry continues to evolve, the techniques applied in AA have expanded
to encompass the entire perioperative period in cardiothoracic surgery,
leading to the introduction of the concept of modern AA. The use of AA in
cardiothoracic surgery exemplifies the ongoing advances and integration of
traditional Chinese and Western medicine. Moving forward, it is imperative
to enhance the theoretical framework of AA through the execution of
rigorous multicenter clinical trials, to further strengthen the body of
evidence supporting evidence-based medicine, and to finally explore the
underlying mechanisms of AA. Please cite this article as: Wu XD, Wei XQ,
Chen TY, Zhou WX, Wang K, Zhou J. From pioneering to innovation: A
comprehensive review of acupuncture anesthesia in cardiothoracic
surgeries. J Integr Med . 2025; 23(6):623-629. Copyright © 2025
Shanghai Yueyang Hospital Affiliated to Shanghai University of Traditional
Chinese Medicine.

<52>
Accession Number
2019170814
Title
A Partially Randomized Patient Preference Trial to Assess the Quality of
Life and Patency Rate After Minimally Invasive Cardiac Surgery-Coronary
Artery Bypass Grafting: Design and Rationale of the MICS-CABG PRPP Trial.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 804217. Date of Publication: 25 Apr 2022.
Author
Gong Y.; Wang X.; Li N.; Fu Y.; Zheng H.; Zheng Y.; Zhan S.; Ling Y.
Institution
(Gong, Fu, Zheng, Zheng, Ling) Department of Cardiac Surgery, Peking
University Third Hospital, Beijing, China
(Wang, Li, Zhan) Research Center of Clinical Epidemiology, Peking
University Third Hospital, Beijing, China
(Zhan) Department of Epidemiology and Biostatistics, School of Public
Health, Peking University, Beijing, China
Publisher
Frontiers Media SA
Abstract
Background: Minimally invasive cardiac surgery-coronary artery bypass
grafting (MICS-CABG) has emerged as a safe alternative to standard cardiac
surgery. However, treatment preferences can decrease the generalizability
of RCT results to the clinical population (i.e., reduce external validity)
and influence adherence to the treatment protocol and study outcomes
(i.e., reduce internal validity). However, this has not yet been properly
investigated in randomized trials with consideration of treatment
preferences. Study Design: In this study, patients with a preference
will be allocated to treatment strategies accordingly, whereas only those
patients without a distinct preference will be randomized. The randomized
trial is a 248-patient controlled, randomized, investigator-blinded trial.
It is designed to compare whether treatment with MICS-CABG is beneficial
in comparison to CABG. This study is aimed to establish the superiority
hypothesis for the physical component summary (PCS) accompanied by the
non-inferiority hypothesis for overall graft patency. Patients with no
treatment preference will be randomized in a 1:1 fashion to one of the two
treatment arms. The primary efficacy endpoints are the PCS score at 30
days after surgery and the overall patency rate of the grafts within 14
days after surgery. Secondary outcome measures include the PCS score and
patency rate at different time points. Safety endpoints include major
adverse cardiac and cerebrovascular events, complications, bleeding, wound
infection, death, etc. Conclusion(s): This trial will address
essential questions of the efficacy and safety of MICS-CABG. The study
will also address the impact of patients' preferences on external validity
and internal validity. Copyright © 2022 Gong, Wang, Li, Fu,
Zheng, Zheng, Zhan and Ling.

<53>
Accession Number
2041656873
Title
Effects of Dexmedetomidine on Outcomes After Cardiac Surgery (DOCS): a
randomised double-blind, placebo-controlled trial.
Source
British Journal of Anaesthesia. (no pagination), 2025. Date of
Publication: 2025.
Author
Lei C.; Zheng Z.; Han J.; Zhai W.; Li C.; Hou L.; Yu S.; Liu J.; Xu X.;
Wang S.; Guo X.; Zhang T.; Zhou J.; Zou J.; Tian Y.; Chi X.; Qiu L.; Xu
M.; Zhang X.; Huang W.; Chen Y.; Yan M.; Wang H.; Xia J.; Wang L.; Liu H.;
Dong H.
Institution
(Lei, Zheng, Wang, Hou, Dong) Department of Anesthesiology and
Perioperative Medicine, Xijing Hospital, the Fourth Military Medical
University, Shaanxi, Xi'an, China
(Lei, Zheng, Wang) Key Laboratory of Anesthesiology, Ministry of Education
of China, Xi'an, China
(Lei, Zheng, Dong) Anesthesia Clinical Research Center, (ACRC) Xijing
Hospital, Fourth Military Medical University, Xi'an, China
(Han, Zhai, Xia, Wang) Department of Anesthesiology, Tianjin Chest
Hospital, Tianjin, China
(Li) Department of Medical Statistics, School of Preventive Medicine,
Fourth Military Medical University, Shaanxi, Xi'an, China
(Yu, Liu, Xu) Department of Cardiovascular Surgery, Xijing Hospital, the
Fourth Military Medical University, Shaanxi, Xi'an, China
(Wang, Guo) Department of Anesthesiology, Guangdong People's Hospital,
Guangdong, Guangzhou, China
(Zhang, Zhou, Zou) Department of Anesthesiology, General Hospital of
Shenyang Military Region, Liaoning, Shenyang, China
(Tian, Chi) Department of Anesthesiology, Wuhan Tongji Hospital, Tongji
Medical College Huazhong University of Science and Technology, Hubei,
Wuhan, China
(Qiu) Department of Anesthesiology, Henan People's Hospital, Henan,
Zhengzhou, China
(Xu, Zhang) Department of Anesthesiology, Shanghai Chest Hospital,
Shanghai, China
(Huang, Chen) Department of Anesthesiology, First Affiliated Hospital, Sun
Yat-sen University, Guangdong, Guangzhou, China
(Yan, Wang) Department of Anesthesiology, the Second Affiliated Hospital
of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health System, Sacramento, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Organ dysfunction after cardiac surgery may be reduced by
dexmedetomidine. We evaluated whether perioperative dexmedetomidine
reduces complications after cardiac surgery with cardiopulmonary bypass.
 Method(s): In this randomised, double-blind, placebo-controlled trial
conducted in nine Chinese hospitals, adults scheduled for cardiac surgery
with cardiopulmonary bypass were randomly assigned to receive i.v.
dexmedetomidine (0.4 mug kg-1 h-1) or saline
(placebo) for 12 h after the induction of anaesthesia. The co-primary
outcomes were in-hospital mortality and major complications after surgery
(including stroke, myocardial infarction, heart block, cardiac arrest),
analysed by intention-to-treat. Secondary outcomes included individual
complications. Result(s): A total of 1073 participants (46% female;
mean age: 54 yr [range: 47-63 yr]) completed the study after
randomisation. Major complications occurred in 161/536 (30%) participants
who received dexmedetomidine, compared with 169/537 (32%) who received
saline (relative risk: 0.93 [95% confidence interval: 0.72-1.21]; P=0.66).
In addition, 10/536 (1.9%) participants who received dexmedetomidine died
in hospital, compared with 15/537 (2.8%) participants who received saline
(odds ratio: 0.66 [95% confidence interval: 0.29-1.49]; P=0.32). Major
complications, other than heart block, did not differ between participants
who received dexmedetomidine, compared with participants who received
saline. Safety outcomes and process measures did not differ between
participants allocated to dexmedetomidine or saline. Conclusion(s):
Perioperative use of dexmedetomidine did not reduce death, complications,
or both in adults undergoing cardiopulmonary bypass-assisted cardiac
surgery. Clinical trial registration: ClinicalTrials.gov
(NCT02237495). Copyright © 2025 British Journal of Anaesthesia

<54>
Accession Number
2041232787
Title
Machine learning models for predicting postoperative delirium in
non-cardiac surgery patients - systematic review and meta-analysis.
Source
GeroScience. (no pagination), 2025. Date of Publication: 2025.
Author
Das O.; Tang L.Y.; Oh E.S.; Suarez J.; Theodore N.; Azad T.D.
Institution
(Das, Tang, Theodore, Azad) Department of Neurosurgery, Johns Hopkins
University School of Medicine, 1800 Orleans St, Baltimore, MD, United
States
(Oh) Division of Geriatric Medicine and Gerontology, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Suarez) Division of Neurosciences Critical Care, Departments of
Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Early diagnosis of post-operative delirium (POD) in the older surgical
population allows for timely interventions and reduces morbidities. Risk
prediction models (RPMs) utilizing machine learning have emerged as
promising tools to predict POD, but their performance and applicability in
clinical settings remain uncertain. This systematic review evaluates the
predictive accuracy and quality of RPMs for POD developed from 2014 to
2024 focusing on patients after non-cardiac surgery. PubMed and EMBASE
were systematically searched for studies that developed RPMs predicting
POD. Two authors independently screened 298 potential studies for
eligibility, and quality assessment was performed using the Prediction
model Risk of Bias Assessment Tool (PROBAST). Pooled performance metrics,
including AUROC, sensitivity, specificity, and precision, were calculated.
Twenty-two articles matched review criteria, with the majority employing
machine learning techniques such as gradient boosting and random forests.
The pooled AUROC was 0.82 (95% CI: 0.79-0.85), indicating moderate-to-high
predictive accuracy. Sensitivity, specificity, and precision were 0.78,
0.83, and 0.55, respectively. Studies utilizing more predictors and
complex model architectures did not show substantial increases in
performance compared to simpler models developed pre-2014. We demonstrated
that while newer RPMs for POD are more likely to be validated and utilize
advanced machine learning algorithms, their interpretability and clinical
applicability remain limited. ML models hold promise in reducing the
incidence of POD, but significant effort is needed to facilitate the
integration of these models into clinical practice. Future efforts should
focus on validating models externally, reducing false positive
predictions, and translating model predictions into clinical
actions. Copyright © The Author(s), under exclusive licence to
American Aging Association 2025.

<55>
Accession Number
2030244524
Title
Immediate Versus Staged Complete Revascularization in Patients Presenting
with Acute Coronary Syndrome and Multivessel Coronary Disease Without
Cardiac Shock: A Study-Level Meta-analysis of Randomized Controlled
Trials.
Source
Cardiovascular Drugs and Therapy. 39(5) (pp 1063-1074), 2025. Date of
Publication: 01 Oct 2025.
Author
Zhou Y.M.; Sun B.
Institution
(Zhou) Department of Emergency, The Fourth Affiliated Hospital of Nanjing
Medical University, Jiangsu, Nanjing, China
(Sun) Department of Cardiology, Tang Du Hospital, Air Force Medical
University, Shaanxi, Xi'An, China
Publisher
Springer
Abstract
Background: Achieving full revascularization via percutaneous coronary
intervention (PCI) may enhance the prognosis of individuals diagnosed with
acute coronary syndrome (ACS) and multivessel coronary disease (MVD). The
present work focused on investigating whether PCI should be performed
during staged or index procedures for non-culprit lesions. Method(s):
Electronic databases, such as PubMed, EMBASE, the Cochrane Library, and
Web of Science, were systematically explored to locate studies contrasting
immediate revascularization with staged complete revascularization for
patients who experienced ACS and MVD without cardiac shock. The outcome
measures comprised major adverse cardiovascular events (MACEs), all-cause
mortality, cardiovascular mortality, myocardial infarction (MI), stroke,
and unplanned ischemia-driven revascularization (UIDR). Result(s):
Nine randomized controlled trials involving 3550 patients, including 1780
who received immediate complete revascularization (ICR) and 1770 who
received staged complete revascularization (SCR), were included in the
analysis. The ICR group had lower MACEs (RR: 0.73, 95% CI: 0.61~0.87, P =
0.0004), MI (RR: 0.53, 95% CI: 0.37~0.77, P = 0.0008), and UIDR (RR: 0.64,
95% CI: 0.50~0.81, P = 0.0003) than did the SCR group. All-cause
mortality, CVD incidence, and stroke incidence did not significantly
differ between the two groups. According to our subgroup analyses based on
the time window of the SCR, the ICR group had significantly fewer MACEs
(RR: 0.70, 95% CI: 0.56~0.88, P = 0.003), MI (RR: 0.53, 95% CI: 0.37~0.77,
P = 0.0002), and UIDR (RR: 0.56, 95% CI: 0.40~0.77, P = 0.0004) than did
the subgroup of patients who were between discharge and 45 days.
 Conclusion(s): Compared with patients in the SCR group, patients in
the ICR group had decreased MACEs, MI, and UIDR, especially between
discharge and 45 days. All-cause mortality and CVD incidence were not
significantly different between the two groups. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<56>
Accession Number
2041141969
Title
Complications of total hip and knee arthroplasty in solid organ transplant
patients: a systematic review and meta-analysis.
Source
Arthroplasty. 7(1) (no pagination), 2025. Article Number: 56. Date of
Publication: 01 Dec 2025.
Author
Challoumas D.; Ramasubbu R.; Rooney E.; Paterson A.; Ali A.; Millar N.;
Jones B.
Institution
(Challoumas, Millar) School of Infection and Immunity, College of Medical,
Veterinary and Life Sciences, University of Glasgow, Glasgow, United
Kingdom
(Challoumas, Ramasubbu, Rooney, Paterson, Ali, Jones) Department of Trauma
& Orthopaedic Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: This systematic review and meta-analysis aimed to quantify
risks of complications associated with total hip and knee arthroplasty
(THA, TKA) in patients with solid organ transplants (SOT) compared to the
general population. Method(s): The study was pre-registered on
PROSPERO (CRD42023399043). Literature searches were performed looking for
comparative studies reporting postoperative complication data of THA or
TKA in patients with kidney, liver, pancreas, heart, or lung transplants
versus controls. Outcomes of interest included incidence of blood
transfusion, periprosthetic joint infection (PJI), periprosthetic
fracture, deep venous thrombosis (DVT), pulmonary embolism (PE),
mortality, hospital re-admission, and all-cause revision. The Newcastle
Ottawa scale was used to assess study quality, and the GRADE for certainty
of evidence. Result(s): A total of 13 studies participated in
meta-analyses (10 in THA, 3 in TKA). Compared to controls, SOT patients
(mixed data from all transplant types) had a significantly higher
incidence of blood transfusion [THA OR 1.57 (1.36-1.80), TKA OR 1.37
(1.15-1.63)], PJI [THA OR 1.78 (1.01-3.12), TKA 3.11 (1.16-8.35)], DVT
[THA OR 1.32 (1.04-1.66), TKA OR 1.56 (1.36-1.78)], and all-cause revision
[only TKA OR 1.37 (1.15-1.63)]. THA in kidney transplant patients was
associated with higher early mortality [OR 2.12 (1.38-3.25)] and 30-day
re-admission [OR 1.62 (1.31-2.00)] compared to the general population. SOT
was not associated with a higher incidence of post-operative PE after
either THA or TKA [OR 0.94 (0.66-1.34), OR 0.89 (0.55-1.43),
respectively]. The incidence of THA dislocation in mixed analyses with all
SOT types was not statistically significant despite the unfavourable OR
[1.62 (0.94-2.78)], but it was in the kidney and heart transplant subgroup
analyses (OR 1.41 (1.16-1.73), OR 2.17 (1.47-3.20), respectively). The
incidence of periprosthetic fracture was not higher in SOT patients
compared to controls in those undergoing a THA [OR 1.07 (0.84-1.36)], but
it was after a TKA [OR 1.79 (1.36-2.36)]. Conclusion(s): THA and TKA
are associated with an unfavourable complication profile in SOT patients
compared to the general population. Decisions for or against arthroplasty
surgery should be made on an individual basis with a multidisciplinary
approach. Copyright © The Author(s) 2025.

<57>
Accession Number
2030338356
Title
Efficacy and Safety of Edoxaban in Anticoagulant Therapy Early After
Surgical Bioprosthetic Valve Replacement: Rationale and Design of the
ENBALV Trial.
Source
Cardiovascular Drugs and Therapy. 39(5) (pp 1215-1221), 2025. Date of
Publication: 01 Oct 2025.
Author
Izumi C.; Amano M.; Fukushima S.; Yaku H.; Eishi K.; Sakaguchi T.; Minami
M.; Yamamoto H.; Onda K.; Omae K.
Institution
(Izumi, Amano) Department of Heart Failure and Transplant, National
Cerebral and Cardiovascular Center, 6-1 Kishibe Shimmachi, Suita-City,
Osaka, Japan
(Fukushima) Department of Cardiovascular Surgery, National Cerebral and
Cardiovascular Center, Suita, Japan
(Yaku) Department of Cardiovascular Surgery, Kyoto Prefectural University
of Medicine, Kyoto, Japan
(Eishi) Department of Cardiovascular Surgery, Hakujyuji Hospital, Fukuoka,
Japan
(Sakaguchi) Department of Cardiovascular Surgery, Hyogo Medical
University, Nishinomiya, Japan
(Minami, Yamamoto, Onda, Omae) Department of Data Science, National
Cerebral and Cardiovascular Center, Suita, Japan
Publisher
Springer
Abstract
Background and Purpose: Anticoagulant therapy with vitamin K antagonists
is recommended within 3 to 6 months after bioprosthetic valve replacement
to prevent thromboembolic events. However, data regarding whether direct
oral anticoagulants can be an alternative to warfarin in such patients are
limited. The purpose of this study is to compare the efficacy and safety
of edoxaban versus warfarin within 3 months after bioprosthetic valve
replacement. Method(s): The ENBALV trial is an
investigator-initiated, phase 3, randomized, open-label, multicenter
study. It involves patients aged 18 to 85 years undergoing bioprosthetic
valve replacement at the aortic and/or mitral position. They are
randomized 1:1 to receive either edoxaban or warfarin. Administration of
edoxaban or warfarin is to be continued for 12 weeks after surgery. The
primary outcome is the occurrence rate of stroke or systemic embolism at
12 weeks after surgery. The net clinical outcome is a composite of stroke,
systemic embolism, or major bleeding, which is included in the secondary
outcomes. Conclusion(s): The ENBALV trial demonstrates the efficacy
and safety of edoxaban compared with warfarin in patients early after
bioprosthetic valve replacement, including patients with sinus rhythm,
which will bring a significant benefit to patients in clinical practice.
Trial Registration: Japan Registry of Clinical Trials (jRCT) 2051210209.
30 Mar 2022
https://jrct.niph.go.jp/latest-detail/jRCT2051210209. Copyright ©
The Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2024.

<58>
Accession Number
2030181219
Title
Cardioprotection with Intralipid During Coronary Artery Bypass Grafting
Surgery on Cardiopulmonary Bypass: A Randomized Clinical Trial.
Source
Cardiovascular Drugs and Therapy. 39(5) (pp 1045-1052), 2025. Date of
Publication: 01 Oct 2025.
Author
Hadebe N.; Cour M.; Imamdin A.; Petersen T.; Pennel T.; Scherman J.;
Snowball J.; Ntsekhe M.; Zilla P.; Swanevelder J.; Lecour S.
Institution
(Hadebe, Cour, Imamdin, Petersen, Snowball, Lecour) Cardioprotection
Group, Faculty of Health Sciences, Cape Heart Institute, University of
Cape Town, Anzio Road, Observatory, Cape Town, South Africa
(Hadebe, Swanevelder) Department of Anaesthesia, Faculty of Health
Sciences, University of Cape Town, Cape Town, South Africa
(Pennel, Scherman, Zilla) Chris Barnard Division of Cardiothoracic
Surgery, University of Cape Town, Cape Town, South Africa
(Ntsekhe) Division of Cardiology, Faculty of Health Sciences, University
of Cape Town, Cape Town, South Africa
Publisher
Springer
Abstract
Purpose: Coronary artery bypass grafting (CABG) on cardiopulmonary bypass
(CPB) is associated with myocardial ischemia-reperfusion injury (IRI),
which may limit the benefit of the surgery. Both experimental and clinical
studies suggest that Intralipid, a lipid emulsion commonly used for
parenteral nutrition, can limit myocardial IRI. We therefore aimed to
investigate whether Intralipid administered at reperfusion can reduce
myocardial IRI in patients undergoing CABG on CPB. Method(s): We
conducted a randomized, double-blind, pilot trial in which 29 adult
patients scheduled for CABG were randomly assigned (on a 1:1 basis) to
receive either 1.5 ml/kg Intralipid 20% or Ringer's Lactate 3 min before
aortic cross unclamping. The primary endpoint was the 72-h area under the
curve (AUC) for troponin I. Result(s): Of the 29 patients randomized,
26 were included in the study (two withdrew consent and one was excluded
before surgery). The 72-h AUC for troponin I did not significantly differ
between the control and Intralipid group (546437 +/- 205518 versus 487561
+/- 115724 arbitrary units, respectively; P = 0.804). Other outcomes
(including 72-h AUC for CK-MB, C-reactive protein, need for
defibrillation, time to extubation, length of ICU and hospital stay, and
serious adverse events) were similar between the two groups.
 Conclusion(s): In patients undergoing CABG on CPB, Intralipid did not
limit myocardial IRI compared to placebo. Trial Registration:
ClinicalTrials.gov Identifier: NCT02807727 (registration date: 16 June
2016). Copyright © The Author(s) 2024.

<59>
Accession Number
2041657751
Title
The Efficacy of a Multidisciplinary Perianesthetic Management Bundle for
Alleviating Delirium After Thoracic Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Xu M.; Wu Y.; Wang R.; Luo C.; Chen J.; Yang J.
Institution
(Xu, Wu, Wang, Luo, Chen, Yang) Department of Anesthesiology, West China
Hospital, Sichuan University, Sichuan, Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative delirium significantly worsens surgery
prognosis. Here, the authors assessed the ability of comprehensive
perianesthetic management to reduce the risk of delirium after thoracic
surgery. Design(s): This was a prospective, randomized, single-blind
study. Setting(s): The study was conducted at a tertiary care
institution and university-level teaching hospital. Participant(s): A
total of 508 patients scheduled to undergo elective thoracic surgeries
with an expected anesthesia duration of at least 2 hours were enrolled.
 Intervention(s): All eligible participants received routine pre- and
postoperative nonpharmacologic interventions, and the intervention group
also received comprehensive perianesthetic management, including
perioperative pain control, rational medication, refined intraoperative
management, and cognitive training. Delirium was assessed using the
Confusion Assessment Method. Measurements and Main Results: Of the
508 randomized patients, 497 were included in the final analysis.
Postoperative delirium occurred in 9 of 247 patients (3.6%) in the
intervention group and in 23 of 250 patients (9.2%) in the control group.
Bundle perianesthetic management was associated with a significantly lower
risk of delirium, both in per-protocol analysis (relative risk 0.40, 95%
confidence interval 0.19-0.84, p = 0.012) and intention-to-treat analysis
(relative risk 0.39, 95% confidence interval 0.19-0.84, p = 0.011). No
significant differences were observed between the groups in terms of
delirium duration, postoperative pain, ability to perform activities of
daily living, hospitalization duration, or hospital-related costs.
 Conclusion(s): The findings support integrating this bundle into
perioperative pathways to reduce the risk of delirium after thoracic
surgery. Further studies are warranted to evaluate its feasibility,
generalizability, and safety in broader clinical settings. Copyright
© 2025 Elsevier Inc.

<60>
Accession Number
2041179776
Title
Evaluation of Saphenous Vein Graft Patency Using Wall Shear Stress and
Geometry Post Coronary Artery Bypass Graft Surgery.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
5602643. Date of Publication: 2025.
Author
Abdel Kader H.; Kyriazis P.G.; Punjabi P.P.
Institution
(Abdel Kader) Department of General Surgery, Royal Free London NHS
Foundation Trust, London, United Kingdom
(Kyriazis, Punjabi) Imperial College London, National Heart and Lung
Institute, London, United Kingdom
(Kyriazis, Punjabi) Department of Cardiothoracic Surgery, Imperial College
Healthcare NHS Trust, London, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Background: Saphenous vein grafts (SVGs) remain widely used in coronary
artery bypass grafting (CABG). This study examines the role of wall shear
stress (WSS) and graft geometry on SVG patency and evaluates the potential
of computational fluid dynamics (CFD) as an assessment tool post-CABG.
 Method(s): A systematic search was conducted in PubMed, Cochrane
Library, Scopus and EMBASE using the terms 'wall shear stress',
'geometry', 'computational fluid dynamics' and 'saphenous vein graft
patency'. From 374 articles, 82 met the inclusion criteria, focussing on
WSS and/or graft geometry in relation to SVG patency in coronary disease.
Studies limited to qualitative findings or animal models were excluded,
narrowing the selection to 64 eligible articles. Result(s): Adverse
WSS conditions were linked to pronounced intimal hyperplasia,
atherosclerosis and graft failure. Geometrical factors influencing SVG
patency included graft diameter, target coronary diameter (> 2.0 mm),
graft wall thickness (> 1.5 mm), curvature at the graft-host junction and
anastomotic angles exceeding 15-20degree. CFD-based evaluations of SVG
patency aligned with existing literature findings. Discussion(s): The
interplay between SVG patency, WSS and graft geometry is well documented.
CFD offers a promising modality for in-depth graft analysis by gauging
geometry and flow dynamics. By delivering objective information, CFD can
equip surgeons with the tools to optimise strategies and thereby enhance
CABG patient outcomes. Copyright © 2025 Hashem Abdel Kader et al.
Journal of Cardiac Surgery published by John Wiley & Sons Ltd.

<61>
Accession Number
2041586119
Title
Systematic Review of The Effect Of Preoperative Cardiac Biomarkers on The
Duration of Ventilator Use in Post-Operative Cabg Patients.
Source
Vascular and Endovascular Review. 8(3s) (pp 127-138), 2025. Date of
Publication: 2025.
Author
Pratiwi F.R.; Sembiring Y.E.; Setiawan P.
Institution
(Pratiwi, Sembiring) Department of Thoracic and Cardiovascular Surgery,
Faculty of Medicine, Airlangga University, Surabaya, Indonesia
(Pratiwi, Sembiring) Department of Thoracic, Cardiac and Vascular Surgery,
Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
(Setiawan) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga, Surabaya, Indonesia
(Setiawan) Department of Anesthesiology and Reanimation, Dr. Soetomo
General Academic Hospital, Surabaya, Indonesia
Publisher
SCARLET PUBLISHING SOLUTIONS
Abstract
Prolonged ventilator duration after coronary artery bypass grafting (CABG)
surgery is a critical issue in intensive care units (ICUs) as it can
increase the risk of complications, length of hospital stay, and
mortality. Several studies have shown that preoperative cardiac
biomarkers, such as NT-proBNP, troponin I/T, and C-reactive protein (CRP),
have the potential to be important predictors of ventilator duration, but
the results are mixed and have not been systematically integrated. This
study aims to comprehensively evaluate the existing evidence regarding the
effect of preoperative cardiac biomarkers on ventilator duration in
post-CABG patients. This study used a Systematic Literature Review method
with a search of articles in PubMed, Scopus, and Web of Science databases,
and followed the PRISMA guidelines for study selection. The results showed
that high preoperative levels of NT-proBNP, troponin I/T, and CRP were
consistently associated with longer ventilator requirements. Furthermore,
the integration of biomarkers with traditional clinical factors resulted
in a more accurate prediction of ventilation duration compared with
clinical factors alone. These findings underscore the importance of
preoperative cardiac biomarkers as predictive tools to assist in more
optimal planning of post-CABG patient management. Copyright ©
2025 SCARLET PUBLISHING SOLUTIONS. All rights reserved.

<62>
Accession Number
2040694954
Title
A Systematic Review of the Prognostic Value of Cardiopulmonary Exercise
Testing in Patients with Ischemic and Nonischemic Cardiomyopathy.
Source
CJC Open. 7(11) (pp 1441-1450), 2025. Date of Publication: 01 Nov 2025.
Author
Lowes H.; Brenner I.; Woodend K.; West S.; Sunner M.; Khehra B.;
Orchanian-Cheff A.; Rodriguez Arias J.J.; Foroutan F.; Fan C.P.S.;
Rodenas-Alesina E.; Posada J.D.; Ross H.J.; Moayedi Y.
Institution
(Lowes, Brenner, Woodend, West) Environmental and Life Sciences, Trent
University, Peterborough, ON, Canada
(Lowes, Sunner, Khehra, Orchanian-Cheff, Rodriguez Arias, Foroutan, Fan,
Rodenas-Alesina, Posada, Ross, Moayedi) Ted Rogers Centre for Heart
Research, Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
Publisher
Elsevier Inc.
Abstract
Background: The prognostic utility of cardiopulmonary exercise testing
(CPET) in heart failure (HF) is well established; however, whether optimal
CPET parameter thresholds differ across HF etiologies remains unclear.
This systematic review aimed to determine how CPET-derived parameters and
their prognostic threshold values differ, and their association with
adverse outcomes, in patients with ischemic vs nonischemic cardiomyopathy.
 Method(s): Eligible studies assessed adult HF patients and reported
outcomes of all-cause mortality, left ventricular assist device
implantation, heart transplantation, or hospitalization. CPET parameters
and associated threshold values were extracted, and risk of bias was
assessed using the Joanna Briggs Institute checklist for cohort studies.
 Result(s): Four studies comprising 491 ischemic and 218 nonischemic
HF patients were included. Peak oxygen consumption (pVO<inf>2</inf>) was
the only CPET parameter unanimously reported. In ischemic HF, the optimal
pVO<inf>2</inf> thresholds, in mL/kg/min, were <= 14.10 (hazard ratio [HR]
3.3; confidence interval [CI]: 1.9-5.8), <= 10.0 (HR 0.76; CI: 0.59-0.98),
<= 15.20, and <= 14.0 (used in one study as a guideline comparator),
yielding a mean threshold of <= 13.33 mL/kg/min ( +/- 2.28). In
nonischemic HF, optimal thresholds in mL/kg/min were <= 14.60 (HR 4.30
[CI: 2.10-8.90]) and <= 14.0, yielding a mean of <= 14.30 mL/kg/min ( +/-
0.42). Conclusion(s): Significant heterogeneity was present in study
design, patient populations, and CPET variables assessed. The few
consistently assessed prognostic thresholds were similar across HF
etiologies. Peak oxygen consumption (pVO<inf>2</inf>) remains a robust
prognostic marker in both ischemic and nonischemic cardiomyopathy.
Although patients with ischemic cardiomyopathy generally have worse
clinical profiles, this review suggests that no meaningful differences
occur in a few key CPET prognostic thresholds, namely pVO<inf>2</inf>,
across etiologies. These findings support continued use of established
guideline-recommended thresholds for risk stratification, irrespective of
HF subtype, but require further confirmation. Copyright © 2025
The Authors

<63>
Accession Number
2041584664
Title
Center-mediated Differences in Postoperative Acute Kidney Injury Rates: A
Post Hoc Analysis of the PROTECTION Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
Ranucci M.; Monaco F.; Bradic N.; Venditto M.; Neri G.; Barucco G.; Ti
L.K.; Porta S.; Baryshnikova E.; Pontillo D.; Silvetti S.; Federici F.;
Crescenzi G.; Cortegiani A.; Guarracino F.; Bove T.; Paternoster G.;
Anguissola M.
Institution
(Ranucci, Baryshnikova, Anguissola) Department of Cardiovascular
Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, San
Donato Milanese, Italy
(Monaco) Division of Cardiacthoracic and Vascular Anesthesia, IRCCS
Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital,
University of Bologna, Bologna, Italy
(Monaco) Department of Medical and Surgical Sciences, DIMEC, University of
Bologna, Bologna, Italy
(Bradic, Barucco, Pontillo) Clinic of Anesthesiology, Resuscitation and
Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia
(Bradic) University North, Department of Nursing, Varazdin, Croatia
(Venditto) Cardiac Anesthesia and ICU, AORN "Dei Colli," Monaldi Hospital,
Naples, Italy
(Neri) Anesthesia and Intensive care, Department of Medical and Surgical
Sciences, Magna Graecia University, Catanzaro, Italy
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Porta) S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine
Maurizio Umberto I di Torino, Turin, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS - IRCCS Cardiovascular Network, Genova,
Italy
(Federici) UOC Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria
Sant'Andrea, Rome, Italy
(Crescenzi) IRCCS Humanitas Research Hospital, Anestesia e Terapia
Intensiva Cardiochirurgica (TIC), Milan, Rozzano, Italy
(Cortegiani) Department of Precision Medicine in Medical, Surgical and
Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo,
Italy
(Guarracino) Azienda Ospedaliero Universitaria Pisana, Department of
Cardiothoracic Anaesthesia and Intensive Care, Pisa, Italy
(Bove) Department of Medicine, University of Udine, Udine, Italy
(Bove) Azienda Sanitaria Universitaria Friuli Centrale, Department of
Emergency "Santa Maria Della Misericordia", University Hospital of Udine,
Italy
(Paternoster) Department of Health Science School of Medicine, University
of Basilicata, Italy
(Paternoster) Anesthesia and ICU San Carlo Hospital, Potenza, Italy
Publisher
W.B. Saunders
Abstract
Objectives: The recently published PROTECTION trial (Intravenous Amino
Acid Therapy for Kidney Protection in Cardiac Surgery) demonstrated that,
in adult cardiac surgery patients, preoperative amino acid (AA)
administration has a protective effect on renal function. However, large
differences were observed within the participating centers. We aimed to
investigate whether such center effects would remove the impact of AA on
the prevention of cardiac surgery-associated acute kidney injury
(CSA-AKI). Design(s): A post hoc analysis of data from the PROTECTION
trial was performed. Setting(s): Multi-institutional data from
centers that participated in the PROTECTION trial. Participant(s):
Adult patients undergoing cardiac surgery enrolled in the PROTECTION
trial. Intervention(s): Two centers showed a significantly lower rate
of CSA-AKI with respect to the pooled rate in all centers (low-rate
centers) and 3 centers had a significantly higher rate (high-rate centers
[HR-C]). These centers were compared for preoperative and intraoperative
variables. Result(s): Patients in the HR-C were significantly (p =
0.001) older, with lower left ventricular ejection fraction and hemoglobin
values, a higher rate of class III and IV New York Heart Association
functional class, arterial hypertension, previous myocardial infarction,
diabetes, peripheral vascular disease, and more frequently received
myocardial revascularization. During surgery, patients in the HR-C group
had a longer aortic cross-clamp time, higher temperature on
cardiopulmonary bypass, and received diuretics and hemofiltration at a
lower rate. Additionally, a greater number of patients in the HR-C group
required norepinephrine. However, once corrected for such a center effect,
AA remained significantly independently associated with a reduction in
CSA-AKI (relative risk, 0.79). Conclusion(s): HR-Cs treated patients
with greater severity (unmodifiable risk factors) and received different
operative and perioperative management. Taking into account such center
effects, however, AA therapy remained independently associated with
CSA-AKI prevention. Copyright © 2025 Elsevier Inc.

<64>
Accession Number
2039599399
Title
Valve in valve transcatheter versus redo surgical replacement of a failing
surgical bioprosthetic aortic valve: An updated systematic review and
meta-analysis.
Source
Journal of Cardiology. 86(5) (pp 474-482), 2025. Date of Publication: 01
Nov 2025.
Author
Dimitriadis K.; Pyrpyris N.; Aznaouridis K.; Soulaidopoulos S.;
Koutsopoulos G.; Beneki E.; Tatakis F.; Adamopoulou E.; Tsioufis P.;
DeBiase C.; Milasinovic D.; De Backer O.; Vanhaverbeke M.; Aggeli K.;
Tsioufis K.
Institution
(Dimitriadis, Pyrpyris, Aznaouridis, Soulaidopoulos, Koutsopoulos, Beneki,
Tatakis, Adamopoulou, Tsioufis, Aggeli, Tsioufis) First Department of
Cardiology, School of Medicine, National and Kapodistrian University of
Athens, Hippokration General Hospital, Athens, Greece
(DeBiase) Clinique Pasteur, Toulouse, France
(Milasinovic) Department of Cardiology, University Clinical Center of
Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
(De Backer) The Heart Centre, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Vanhaverbeke) Department of Cardiology, AZ Delta, Roeselare, Belgium
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background With the aging population, degeneration of surgical aortic
valves is an important clinical scenario. Currently, in most European
countries, both redo surgery [redo-surgical aortic valve replacement
(SAVR)] and valve-in-valve transcatheter aortic valve implantation
(ViV-TAVI) are established alternatives for treating such patients. This
meta-analysis aims to compare redo-SAVR and ViV-TAVI for treating a
failing bioprosthetic aortic valve. Methods A systematic search was
performed from inception to June 2023. After selecting all appropriate
trials according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines, a random effect meta-analysis was performed.
Clinical and echocardiographic outcomes were compared among the groups.
Results Twenty-six studies with a total of population of 17,581 patients
were included [ViV-TAVI ( n = 9163) or redo-SAVR ( n = 8418]. ViV-TAVI was
associated with lower 30-day mortality (RR: 0.55; 95%CI: 0,47 to 0,66) and
1-year mortality (RR: 0.85; 95%CI: 0.75 to 0.96), major bleeding events
(RR: 0.58; 95%CI: 0.42-0.79), and a trend towards lower new pacemaker
implantations (RR: 0.70; 95%CI: 0.49-1.01) at 30 days. On the other hand,
ViV-TAVI resulted in a higher mean transprosthetic gradient and higher
rates of severe patient-prosthesis mismatch (RR: 1.64; 95%CI: 1.01 to
2.65) and paravalvular leak (RR: 2.44; 95%CI: 1.73-3.45) as compared to
redo-SAVR. No significant difference was observed in 30-day myocardial
infarction (RR: 0.90; 95%CI: 0.56 to 1.46) or stroke (RR: 0.77; 95%CI:0.55
to 1.06). Conclusion ViV-TAVI has a satisfying safety profile with better
short-term survival outcomes as compared to redo-SAVR. However, adequate
pre-procedural planning of VIV-TAVI cases is needed, in order to minimize
the risk of a suboptimal hemodynamic outcomes following
ViV-TAVI. Copyright © 2025 The Authors.

<65>
Accession Number
2040488880
Title
Incidence of staphylococcus aureus infections after surgical
interventions: a systematic review and meta-analysis.
Source
Expert Review of Anti-Infective Therapy. 23(10) (pp 1011-1029), 2025. Date
of Publication: 2025.
Author
Elezbawy B.; Abaza N.; Fasseeh M.; Elshahawy R.; S. Mahmoud Y.; Hendawy
H.; Konstantinov S.R.; Ruiz-Guinazu J.; Willame C.; Geurtsen J.; Poolman
J.; Voko Z.; Nagy D.; Zelei T.; Kovacs S.; Lohner S.
Institution
(Elezbawy) Semmelweis University Doctoral School, Budapest, Hungary
(Elezbawy, Abaza, Fasseeh, Elshahawy, S. Mahmoud, Hendawy) Syreon Middle
East, Alexandria, Egypt
(Konstantinov, Geurtsen, Poolman) Janssen Vaccines and Prevention B.V,
Leiden, Netherlands
(Ruiz-Guinazu, Willame) Janssen Research and Development, Beerse, Belgium
(Voko, Nagy, Zelei, Kovacs, Lohner) Syreon Research Institute, Budapest,
Hungary
(Voko, Nagy) Center for Health Technology Assessment, Semmelweis
University, Budapest, Hungary
(Lohner) Department of Public Health Medicine, University of Pecs Medical
School, Pecs, Hungary
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Postoperative Staphylococcus aureus (S. aureus) infections
are associated with increased morbidity and mortality. This systematic
review and meta-analysis aimed to summarize the incidence of postoperative
S. aureus infections. Method(s): We searched MEDLINE, CENTRAL, and
Embase (2008-2023) for studies reporting S. aureus infections after hip or
knee replacement, spinal surgery, craniotomy, coronary artery bypass
surgery (CABG), open colon surgery, abdominal hysterectomy, cesarean
section, peripheral vascular bypass, or elective plastic surgery in
selected developed countries were considered. We conducted meta-analysis
with a generalized linear mixed model and assessed risk of bias. This
study is registered with PROSPERO,CRD42023416876. Result(s): Data
from 224 studies indicated a cumulative incidence of deep S. aureus
infection after hip surgery 5.05 infections/1000 procedures (95% CI
3.29-7.74), 5.59 (95% CI 3.62-8.63) after knee surgery, 11.74 (95% CI
9.08-15.16) after spinal surgery, and 7.23 (95% CI 1.63-31.86) after CABG
surgery. S. aureus infections were associated with increased all-cause
mortality among CABG, hip, knee, and spinal surgeries. Patients cohorts
who received antibiotic prophylaxis and/or underwent decolonization
demonstrated lower incidence of S. aureus infections. Conclusion(s):
The incidence of S. aureus infections varies by procedure, with highest
rates seen after spinal surgeries and hysterectomies. Findings highlight
the importance of standardized prevention across surgical
settings. Copyright © 2025 The Author(s). Published by Informa UK
Limited, trading as Taylor & Francis Group.

<66>
Accession Number
2041562164
Title
Meta-analysis of the diagnostic accuracy of computed tomography
angiography compared with invasive coronary angiography in preoperative
cardiac surgery planning: a focus on valve surgery patients.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003768. Date of
Publication: 10 Nov 2025.
Author
Alwaheidi D.; Ehtesham A.; Azizi S.; Tbishat L.; Lateef Wani M.; Almulla
A.
Institution
(Alwaheidi, Ehtesham, Azizi, Lateef Wani, Almulla) Hamad Medical
Corporation, Doha, Qatar
(Tbishat) The University of Jordan, Amman Governorate, Amman, Jordan
Publisher
BMJ Publishing Group
Abstract
Objective To investigate the diagnostic performance of coronary CT
angiography (CCTA) for assessing significant coronary artery disease (CAD)
in patients referred for surgical aortic valve replacement or
transcatheter aortic valve implantation (TAVI)\transcatheter aortic valve
replacement (TAVR), with invasive coronary angiography (ICA) as the
reference standard. Methods We performed a meta-analysis of 28 studies to
compare CCTA with ICA for preoperative coronary evaluation. Studies were
stratified into two subgroups: the first consisting of those which
included only patients undergoing valve surgery (n=19) and the second
including TAVI or mixed (TAVI and surgical) populations (n=9).
Sensitivity, specificity, positive predictive value (PPV), negative
predictive value (NPV) and accuracy were recorded or determined, and a
summary diagnostic performance was obtained by a random effects model.
Pooled forest plots and summary receiver operating characteristic curves
were also analysed. Results The overall sensitivity of CCTA to diagnose
significant CAD varied between 18 studies, ranging from 85% to 94%; the
pooled sensitivity over all 28 studies was 91% (95% CI 88% to 93%) and the
specificity was 88% (95% CI 84% to 91%). The pooled PPV was 78% (95% CI
72% to 83%), while the NPV was 95% (95% CI 93% to 97%). The diagnostic
performance of the study was 89.8%. Conclusions CCTA is a trustworthy,
non-invasive diagnostic option to rule out significant CAD in patients
undergoing valve surgery. Its high specificity in surgical candidates
favours its use as a 'gatekeeper' to ICA with a potential reduction in
unnecessary invasive surgery. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<67>
Accession Number
2035839133
Title
Risk of acute kidney injury following intravenous iodinated contrast
exposure among pediatric population: a narrative review.
Source
Pediatric Radiology. 55(12) (pp 2518-2530), 2025. Date of Publication: 01
Nov 2025.
Author
Salah Ayad Mohamed N.; Waleed Abdullah Alkharji F.; Fuad Ghareeb M.;
Aljabr A.
Institution
(Salah Ayad Mohamed, Waleed Abdullah Alkharji, Fuad Ghareeb) College of
Medicine, AlMaarefa University, 71666, Riyadh, Saudi Arabia
(Aljabr) Altakassusi Alliance Medical, Riyadh, Saudi Arabia
Publisher
Springer Nature
Abstract
Contrast-induced acute kidney injury is a significant concern in pediatric
populations following the administration of intravenous iodinated contrast
media. This narrative review aims to systematically evaluate the
incidence, risk factors, and diagnostic criteria associated with
contrast-induced acute kidney injury in children, addressing the
variability in reported rates and the implications for clinical practice.
The rationale for this review stems from the need to clarify the
relationship between iodinated contrast media exposure and acute kidney
injury, particularly in high-risk pediatric patients, as existing
literature presents inconsistent findings. A comprehensive literature
search was conducted using PubMed, Scientific Direct, and Google Scholar
databases, focusing on studies published between 2020 and 2025 that
addressed contrast-induced acute kidney injury in children. The review
identified key messages, including that contrast-induced acute kidney
injury incidence ranges from 1.4-35%, influenced by factors such as
chronic kidney disease, estimated glomerular filtration rates, age, and
gender. The findings emphasize the need for standardized diagnostic
criteria and protocols to improve the assessment and management of
contrast-induced acute kidney injury in children. Additionally, there is a
gap in robust randomized controlled trials, highlighting the necessity for
future multicenter studies to explore novel biomarkers for early detection
and effective preventive strategies. This review advocates for a balanced
approach to using iodinated contrast media in pediatric patients while
aiming to prevent unnecessary exclusions from vital diagnostic
procedures. Copyright © The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2025.

<68>
Accession Number
2041562181
Title
Telematic intervention on frailty in patients undergoing TAVI. Design of
the TELE-FRAIL TAVI clinical trial.
Source
REC: Interventional Cardiology. 7(4) (pp 223-228), 2025. Date of
Publication: 01 Oct 2025.
Author
Bernal-Labrador E.; Romaguera R.; Garcia-Blas S.; Regueiro A.; Serra V.;
Asmarats L.; Tizon-Marcos H.; Agudelo V.; Scardino C.; Casanova-Sandoval
J.M.; Rodriguez-Gabella T.; Jimenez-Mendez C.; Perez-Rivera A.;
Robles-Gamboa C.; Ayesta A.; Diez-Villanueva P.; Raposeiras-Roubin S.;
Amat-Santos I.J.; Esteve-Pastor A.; Veiga-Fernandez G.; Anguita M.;
Marti-Sanchez D.; Martinez-Velilla N.; Cortes L.; Calvo E.; Asimbaya S.;
Formiga F.; Ariza-Sole A.
Institution
(Bernal-Labrador, Cortes) Hospital Universitari Germans Trias i Pujol,
Servicio de Cardiologia, Badalona, Barcelona, Spain
(Romaguera, Calvo, Asimbaya, Formiga, Ariza-Sole) Hospital Universitari de
Bellvitge, Servicio de Cardiologia, L'Hospitalet de Llobregat, Barcelona,
Spain
(Garcia-Blas) Hospital Clinico Universitario de Valencia, Servicio de
Cardiologia, Valencia, Spain
(Regueiro) Hospital Clinic de Barcelona, Servicio de Cardiologia,
Barcelona, Spain
(Serra) Hospital Universitari Vall d'Hebron, Servicio de Cardiologia,
Barcelona, Spain
(Asmarats) Hospital de la Santa Creu i Sant Pau, Servicio de Cardiologia,
Instituto de Investigacion Biomedica Sant Pau (IIB Sant Pau), Barcelona,
Spain
(Tizon-Marcos) Hospital del Mar, Servicio de Cardiologia, Barcelona, Spain
(Tizon-Marcos) Departament de Salut, Generalitat de Catalunya, Barcelona,
Spain
(Tizon-Marcos, Esteve-Pastor, Calvo) Centro de Investigacion Biomedica en
Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos
III, Madrid, Spain
(Agudelo) Hospital Universitari Josep Trueta, Servicio de Cardiologia,
Girona, Spain
(Scardino) Hospital Universitari Joan XXIII, Servicio de Cardiologia,
Tarragona, Spain
(Casanova-Sandoval) Hospital Arnau de Vilanova, Servicio de Cardiologia,
Lleida, Spain
(Rodriguez-Gabella) Hospital Son Espases, Servicio de Cardiologia, Palma
de Mallorca, Spain
(Jimenez-Mendez) Hospital Puerta del Mar, Servicio de Cardiologia, Cadiz,
Spain
(Perez-Rivera) Hospital Universitario de Burgos, Servicio de Cardiologia,
Burgos, Spain
(Robles-Gamboa) Hospital Universitario de Toledo, Servicio de Cardiologia,
Toledo, Spain
(Ayesta) Hospital Universitario Central de Asturias, Servicio de
Cardiologia, Asturias, Oviedo, Spain
(Diez-Villanueva) Hospital Universitario de La Princesa, Servicio de
Cardiologia, Madrid, Spain
(Raposeiras-Roubin) Hospital Alvaro Cunqueiro, Servicio de Cardiologia,
Pontevedra, Vigo, Spain
(Amat-Santos) Hospital Clinico de Valladolid, Servicio de Cardiologia,
Valladolid, Spain
(Esteve-Pastor) Hospital Virgen de la Arrixaca, Servicio de Cardiologia,
El Palmar, Murcia, Spain
(Veiga-Fernandez) Hospital Marques de Valdecilla, Servicio de Cardiologia,
Cantabria, Santander, Spain
(Anguita) Hospital Reina Sofia, Servicio de Cardiologia, Cordoba, Spain
(Marti-Sanchez) Hospital Gomez Ulla, Servicio de Cardiologia, Madrid,
Spain
(Martinez-Velilla) Hospital Universitario de Navarra, Servicio de
Cardiologia, Navarra, Pamplona, Spain
Publisher
Sociedad Espanola de Cardiologia
Abstract
Introduction and objectives: Although transcatheter aortic valve
implantation (TAVI) is the first-line therapy for aortic stenosis (AS),
its benefit could be lower (or even disappear) in frail patients. Physical
exercise and nutritional support programs are recommended to address
frailty. Data on the application of telemedicine strategies in this
context is scarce. The objective of this study is to analyze, in older
patients with AS undergoing TAVI, the effect of a telematic intervention
on the reversal of frailty vs standard of care. Method(s): We will be
conducting a randomized multicenter study including patients aged >= 75
years with severe AS (mean aortic gradient > 40 mmHg, or aortic valve area
< 0.8 8 cm2 on echocardiogram) with baseline frailty criteria
(Short Physical Performance Battery [SPPB] < 10 and FRAIL scale >= 3)
undergoing TAVI. Prior to discharge, patients will be randomized to a) a
telematic intervention within the first 3 months (nutritional support plus
supervised physical exercise plus health education); or b) standard of
care. The primary endpoint will be the percentage of patients with frailty
reversal (SPPB >= 10) at 3 months. The estimated sample size is 206
patients (103 in each arm). Conclusion(s): The hypothesis of this
study is that telematic intervention will allow a higher percentage of
frailty reversal at 3 months vs standard of care after TAVI. The results
of this study may provide novel information on this approach to frail
patients with AS undergoing TAVI. Copyright © 2025 Sociedad
Espanola de Cardiologia. Publicado por Permanyer Publications. Este es un
articulo open access bajo la licencia CC BY-NC-ND 4.0.

<69>
Accession Number
648793573
Title
Effect of Mobile Augmented Reality Counseling on Improving Shared
Decision-Making in Thoracic Surgery: Randomized Clinical Crossover Trial.
Source
JMIR mHealth and uHealth. 13 (pp e79632), 2025. Date of Publication: 13
Nov 2025.
Author
Chen Y.-S.; Hsu Y.-C.; Romalee W.; Wang D.-H.; Lai J.; Huang T.-W.; Lin
K.H.
Institution
(Chen) School of Medicine, National Defense Medical University, Taipei,
Taiwan (Republic of China)
(Chen) Taichung Armed Forces General Hospital, Taichung, Taiwan (Republic
of China)
(Chen, Huang, Lin) Division of Thoracic Surgery, Department of Surgery,
Tri-Service General Hospital, National Defense Medical University, Taipei,
Taiwan (Republic of China)
(Hsu, Romalee, Wang) College of Dentistry, National Yang Ming Chiao Tung
University, Taipei, Taiwan (Republic of China)
(Hsu, Wang) Oral Medicine Innovation Center (OMIC), National Yang Ming
Chiao Tung University, Taipei, Taiwan (Republic of China)
(Romalee) Department of Community Dentistry & Gerodontology, Faculty of
Dentistry, Thammasat University, Pathum Thani, Thailand
(Wang) Research Center for Intelligent Sensor Device, National Yang Ming
Chiao Tung University, Taipei, Taiwan (Republic of China)
(Lai) Tri-Service General Hospital, National Defense Medical University,
Taipei, Taiwan (Republic of China)
Abstract
BACKGROUND: Augmented reality (AR) superimposes virtual objects onto a
real-world environment, allowing users to interact in real time. As AR has
become widely used, its integration into smartphones or tablets has
enabled mobile augmented reality (MAR) experiences. AR has been adopted in
many industries, and the literature has highlighted its applications in
academic and clinical settings, particularly in enhancing visualization,
communication, and learning. OBJECTIVE(S): This study investigated
the potential of MAR as a mobile health tool to enhance shared
decision-making (SDM) in thoracic surgery by increasing patient
understanding and engagement during medical consultations. METHOD(S):
A randomized crossover clinical trial was conducted at the Tri-Service
General Hospital in Taiwan. Participants scheduled for thoracic surgery
were enrolled and randomized in a crossover design. The MAR intervention
incorporated patient-specific 3D anatomical models that were reconstructed
from computed tomography imaging to facilitate understanding and support
SDM. The impact of each counseling approach on SDM was evaluated using
postintervention questionnaires. RESULT(S): A total of 47
participants were enrolled in this study. After analyzing the data, we
found that patients in the MAR group showed significantly higher scores
compared to those in the traditional counseling group (P<.001) during the
SDM process. Moreover, patients reported higher satisfaction levels and
found the visual objects helpful for understanding tumor location and
surgical procedures. CONCLUSION(S): This study demonstrated that MAR
counseling significantly enhanced patients' comprehension of thoracic
conditions and increased their active engagement in the SDM process
(P<.001). The integration of patient-specific 3D anatomical models into
MAR technology provided an intuitive method for critical medical
information. This digital approach not only enhanced personalization in
medical communication but also reinforced patient education about their
health care conditions. These findings suggest that MAR counseling
represents a promising approach for promoting patient-centered care in
thoracic surgery and has potential applications across various clinical
domains. TRIAL REGISTRATION: ClinicalTrials.gov NCT07062393;
https://clinicaltrials.gov/study/NCT07062393. Copyright
©Ying-Shian Chen, Yi-Chen Hsu, Worachate Romalee, Ding-Han Wang,
Jennifer Lai, Tsai-Wang Huang, Kuan Hsun Lin. Originally published in JMIR
mHealth and uHealth (https://mhealth.jmir.org), 13.11.2025.

<70>
Accession Number
2041559729
Title
Postoperative antithrombotic therapy after coronary artery bypass grafting
combined with coronary endarterectomy (PATH-CARE): study protocol for a
randomised controlled clinical trial.
Source
BMJ Open. 15(11) (no pagination), 2025. Article Number: e104950. Date of
Publication: 09 Nov 2025.
Author
Tiemuerniyazi X.; Yang Z.; Yang E.; He L.; Chen L.; Huang S.; Nan Y.; Song
Y.; Xu F.; Yuan X.; Hu Z.; Zhao W.; Feng W.
Institution
(Tiemuerniyazi, Yang, He, Chen, Huang, Nan, Song, Xu, Yuan, Hu, Zhao,
Feng) Department of Cardiovascular Surgery, Chinese Academy of Medical
Sciences, Peking Union Medical College Fuwai Hospital, Beijing, China
(Yang) Department of Cardiovascular Surgery, Fuwai Yunnan Cardiovascular
Hospital, Yunnan, Kunming, China
Publisher
BMJ Publishing Group
Abstract
Introduction Coronary endarterectomy (CE) combined with coronary artery
bypass grafting (CABG) has been associated with poor graft patency, which
might be attributed to the activation of coagulation cascade caused by the
exposure of the subendothelial tissue to the blood stream, which could
necessitate anticoagulation therapy. However, the optimal antithrombotic
therapy after CE+CABG remains unclear. Methods and analysis The PATH-CARE
is a double-centre, two-armed, blinded to outcome assessed, randomised
controlled trial, aimed to determine the optimal antithrombotic therapy
after CE+CABG. A total of 202 patients are expected to be recruited.
Patients will be randomly assigned in a 1:1 ratio to the control (dual
antiplatelet therapy (AT) group) and the intervention (dual AT+warfarin
(ATW) group). Patients in the AT group will receive aspirin plus
clopidogrel for 1 year, while patients in the ATW group receive aspirin
plus clopidogrel for 1 year with extra warfarin therapy for the first 3
months postoperatively. All patients will receive life-long aspirin
treatment after the first year. All of the patients will be required to
complete a 6-month follow-up. The primary endpoint is the patency of
CE-targeted coronary grafts, assessed through coronary CT angiography or
coronary angiography. Secondary outcomes include the occurrence of major
adverse cardiovascular and cerebrovascular events and bleeding events.
Ethics approval and dissemination This study was approved by the
Institutional Review Board of Fuwai Hospital (No.: 2022-1849), and Yunnan
Fuwai Cardiovascular Hospital (No.: 2023-048-01). Findings of this trial
will be disseminated via peer-reviewed research papers and academic
conference presentations. Copyright © Author(s) (or their
employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use.
See rights and permissions. Published by BMJ Group.

<71>
Accession Number
2040665136
Title
Fetal Surgery for Congenital Heart Diseases: A Systematic Review and
Single-Arm Meta-analysis.
Source
Advances in Therapy. 42(12) (pp 6150-6162), 2025. Date of Publication: 01
Dec 2025.
Author
de Azevedo Teixeira L.K.; Provinciatto H.; Callado G.Y.; de Oliveira
Nieblas C.; Granese R.; Araujo Junior E.
Institution
(de Azevedo Teixeira, de Oliveira Nieblas, Araujo Junior) Discipline of
Woman Health, Municipal University of Sao Caetano do Sul (USCS), SP, Sao
Caetano do Sul, Brazil
(Provinciatto, Araujo Junior) Department of Obstetrics, Paulista School of
Medicine, Federal University of Sao Paulo (EPM-UNIFESP), Sao Paulo, Brazil
(Callado) Department of Woman Health, Albert Einstein Israelite College of
Health Sciences, Albert Einstein Israelite Hospital, SP, Sao Paulo, Brazil
(Granese) Department of Biomedical and Dental Sciences and
Morphofunctional Imaging, "G. Martino" University Hospital, Messina, Italy
Publisher
Adis
Abstract
Introduction: Congenital heart diseases (CHD) are the most common
congenital anomalies, and fetal cardiac interventions (FCI) have been
developed to improve perinatal outcomes. We aimed to conduct a systematic
review and meta-analysis of observational studies to evaluate the effects
of FCI on CHD. Method(s): We searched PubMed/Medline, Embase, and the
Cochrane Central Register of Controlled Trials from inception to April
2025 without language restrictions. References of included studies and
prior reviews were also screened. The protocol was registered in the
International Prospective Register of Systematic Reviews (PROSPERO; ID
CRD42024599628). Eligible studies included observational cohorts
evaluating intrauterine procedures for CHD. Data were synthesized using
random effects models in RStudio (version 4.2.2), and study quality was
assessed with the Newcastle-Ottawa Quality Assessment Form for Cohort
Studies (NOS). Result(s): Twelve studies including 485 fetuses with
CHD were analyzed. The pooled overall survival rate after fetal cardiac
intervention was 57.4% (95% confidence interval [CI] 39.8-73.3), with
survival ranging from 20.0% to 90.2% across studies. The pooled perinatal
mortality rate was 31.5% (95% CI 21.0-44.2), with estimates ranging from
9.8% to 66.7%. Substantial heterogeneity was observed for both outcomes
(I2 > 75%). Conclusion(s): FCI for CHD are associated with
moderate overall survival but substantial perinatal mortality.
Standardized protocols, refined patient selection, and multicenter
collaboration are needed to improve outcomes and guide clinical
decision-making. Copyright © The Author(s) 2025.

<72>
Accession Number
649168858
Title
Colchicine for the secondary prevention of cardiovascular events.
Source
The Cochrane database of systematic reviews. 11 (pp CD014808), 2025. Date
of Publication: 13 Nov 2025.
Author
Ebrahimi F.; Ebrahimi R.; Beer M.; Schonenberger C.M.; Ewald H.; Briel M.;
Janiaud P.; Hirt J.; Hemkens L.G.
Institution
(Ebrahimi) Department of Gastroenterology and Hepatology, University
Digestive Health Care Center Basel - Clarunis, Basel, Switzerland
(Ebrahimi) Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden
(Ebrahimi) Division of Cardiology, Department of Internal Medicine B,
Greifswald, University Medicine Greifswald, Germany
(Ebrahimi) Zentrum fur Kardiologie, Pratteln, Switzerland
(Beer, Janiaud, Hirt, Hemkens) Pragmatic Evidence Lab, Research Center for
Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University of
Basel and University Hospital Basel, Basel, Switzerland
(Schonenberger, Briel) CLEAR Methods Center, Division of Clinical
Epidemiology, Department of Clinical Research, University Hospital Basel,
Basel, Switzerland
(Schonenberger, Briel) University of Basel, Basel, Switzerland
(Ewald) University Medical Library, University of Basel, Basel,
Switzerland
(Janiaud, Hemkens) Department of Clinical Research, Faculty of Medicine,
University of Bern, Bern, Switzerland
(Hirt) Department of Health, Eastern Switzerland University of Applied
Sciences, St Gallen, Switzerland
(Hirt) Institute of Health and Nursing Science, Medical Faculty, Martin
Luther University Halle-Wittenberg, Halle (Saale), Germany
(Hemkens) Meta-Research Innovation Center at Stanford (METRICS), Stanford
University, Stanford, CA, United States
(Hemkens) Meta-Research Innovation Center Berlin (METRIC-B), Berlin
Institute of Health, Berlin, Germany
Abstract
RATIONALE: People with cardiovascular disease are at risk of recurrent
major adverse cardiovascular events, and chronic low-grade inflammation
may be a major underlying factor. Treatment with low-dose colchicine has
been proposed for the secondary prevention of cardiovascular events in
individuals at high cardiovascular risk. A previous Cochrane review showed
considerable uncertainty regarding the benefits and harms of this
approach. OBJECTIVE(S): To evaluate the benefits and harms of
low-dose colchicine in the prevention of cardiovascular events in adults
with a history of stable CVD or following myocardial infarction or stroke.
 SEARCH METHOD(S): We conducted a comprehensive search of the
literature until February 2025 using Cochrane Central Register of
Controlled Trials (CENTRAL), MEDLINE, EMBASE, the drugs@FDA database,
references of key papers, and references of included studies. ELIGIBILITY
CRITERIA: Randomised controlled trials (RCTs) comparing the use of
low-dose colchicine for a minimum of six months versus any control
intervention in patients of any age with cardiovascular disease (i.e.
history of stable cardiovascular disease, previous myocardial infarction
or stroke). OUTCOME(S): Our critical outcomes were all-cause
mortality, myocardial infarction, and serious adverse events. Our
important outcomes were cardiovascular mortality, stroke, all-cause
hospitalisations, coronary revascularisation (percutaneous coronary
intervention (PCI)/angioplasty or coronary artery bypass graft (CABG)),
quality of life, and gastrointestinal adverse events (i.e. diarrhoea,
nausea, abdominal pain, or vomiting). RISK OF BIAS: Two authors
independently assessed the risk of bias using the Cochrane RoB2 tool.
SYNTHESIS METHODS: We conducted meta-analyses using the random-effects
model. We generated forest plots to facilitate visualisation of the data.
We did not perform any subgroup analysis. We used GRADE to assess the
certainty of evidence for all critical outcomes and for cardiovascular
mortality, stroke, and coronary revascularisation. This was carried out by
two review authors working independently. INCLUDED STUDIES: We included 12
studies involving 22,983 randomised participants. The follow-up in the
studies ranged from 6 to 80 months. Overall, 11,524 participants were
assigned to low-dose colchicine treatment and 11,459 were assigned to a
control intervention, which constituted either usual care plus placebo or
usual care only. The doses of colchicine used were 0.5 mg once or twice
daily. At baseline, the mean age of participants ranged from 57 to 74
years. Most participants (79.4%) were male. SYNTHESIS OF RESULTS: There is
high-certainty evidence that low-dose colchicine treatment reduces the
risk of myocardial infarction, with a risk ratio (RR) of 0.74 (95%
confidence interval (CI) 0.57 to 0.96; 22,153 participants, 8 studies; I2
= 51%), yielding an absolute risk reduction of 9 fewer events (95% CI 16
fewer to 2 fewer) per 1000 patients, when the myocardial infarction rate
is about 4% (36 events per 1000 patients) in the control group. There is
also high-certainty evidence that low-dose colchicine reduces the risk of
stroke with a RR of 0.67 (95% CI 0.47 to 0.95; 22,483 participants, 10
studies; I2 = 40%), yielding an absolute risk reduction of 8 fewer events
(95% CI 12 fewer to 1 fewer) per 1000 patients, when the stroke rate is
about 2% (22 events per 1000 patients) in the control group. There is
high-certainty evidence that the use of low-dose colchicine does not
increase the rate of serious adverse events (RR 0.98, 95% CI 0.94 to 1.02;
15,677 participants, 4 studies; I2 = 0%). However, gastrointestinal
adverse events were more common under treatment with colchicine (RR 1.68,
95% CI 1.11 to 2.57; 22,185 participants, 10 studies; I2 = 91%). For all
other outcomes assessed, the evidence is of moderate certainty. Colchicine
probably results in little to no difference in all-cause mortality (RR
1.01, 95% CI 0.84 to 1.21; 22,747 participants, 10 studies; I2 = 1%;
moderate-certainty evidence), in cardiovascular mortality (RR 0.94, 95% CI
0.73 to 1.22; 22,271 participants; 8 studies; I2 = 13%; moderate-certainty
evidence), and coronary revascularisation (RR 0.83, 95% CI 0.64 to 1.08;
13,705 participants, 5 studies; I2 = 40%; moderate-certainty evidence).
There is no evidence about the benefits or harms of colchicine on
quality-of-life or on the risk of all-cause hospitalisation. AUTHORS'
 CONCLUSION(S): People with cardiovascular disease using low-dose
colchicine as secondary prevention for at least six months benefit from
reduced rates of myocardial infarction and stroke, without an increase in
serious adverse events. Moderate-certainty evidence did not show a benefit
from low-dose colchicine for the risk of mortality (i.e. all-cause and
cardiovascular mortality) or coronary revascularisation rates. Colchicine
use was associated with an increased risk of gastrointestinal adverse
events, which were typically described as mild and transient in nature.
Additional studies are warranted to investigate the benefits and harms of
low-dose colchicine in relevant subgroups and in specific indications,
such as long-term use in individuals with stable coronary artery disease
versus limited-time use following acute coronary syndrome. FUNDING: Review
author FE was supported by the Margot und Erich Goldschmidt & Peter Rene
Jacobson Foundation. Review author CMS was supported by the Janggen Pohn
Foundation and the Swiss National Science Foundation (MD-PhD grant Number:
323530_221860). REGISTRATION: This review is based on its protocol, which
is available via DOI 10.1002/14651858.CD014808, and a previous review,
which is available via DOI 10.1002/14651858.CD011047.pub2. Copyright
© 2025 The Cochrane Collaboration. Published by John Wiley & Sons,
Ltd.

<73>
Accession Number
2036992043
Title
New imaging modalities have the potential to expand appropriate
indications for percutaneous coronary interventions.
Source
American Journal of the Medical Sciences. Conference: 2025 Southern
Regional Meeting. InterContinental Hotel, New Orleans United States.
369(Supplement 1) (pp S106-S107), 2025. Date of Publication: 01 Feb 2025.
Author
Keesee J.M.; Shah V.
Institution
(Keesee, Shah) Grand Strand Medical Center/Mercer University, Murrells
Inlet, SC, United States
Publisher
Elsevier B.V.
Abstract
Purpose: Percutaneous coronary intervention (PCI) has long been compared
to surgical revascularization: coronary artery bypass graft (CABG), and
optimized medical therapy for management of coronary artery disease. To
date, generating quality studies summarizing indications for PCI vs
surgical revascularization vs medical therapy has remained difficult
largely due to advancing treatment options and procedural technique. The
purpose of this abstract is to examine new data indicating expanded
indications for PCI and compare current practices including the use of new
periprocedural imaging modalities and how this may influence indications
for PCI. Method(s): This review article summarizes both quantitative
and qualitative data obtained from meta-analysis, systematic reviews, case
control studies, and the Prevent Trial to look at the indications for PCI,
and how changing technologies may influence additional future appropriate
indications for PCI. Result(s): 2021 guidelines provided by the
American Heart Association and American College of Cardiology indicate
that assessment of lesion significance to guide revascularization with PCI
should be done based on the use of Fractional Flow Reserve (FFR) or
Instantaneous Wave-Free Ratio (iFR) with patients having FFR value greater
than 0.8 or an iFR value of greater than 0.89, recommended against
undergoing PCI with a Class 1A recommendation. Use of intravascular
ulstrasound (IVUS) and optical coherent tomography (OCT) however, was
given a class 2a recommendation. Since the release of the 2021 guidelines
multiple new studies have been released comparing outcomes utilizing new
imaging modalities including OCT, intravascular ultrasound (IVUS),
near-infrared spectroscopy (NIRS), and ultrasound elastography. Studies
have demonstrated superiority in terms of outcomes when utilizing IVUS,
OCT, or Hybrid IVUS-OCT in conjunction with FFR compared to FFR alone.
Additionally, use of intravascular imaging has demonstrated a reduction in
unnecessary stent placement. One recent study, The PREVENT Trial, showed
PCI of non-FFR positive plaques angiographically >50% with vulnerable
imaging features reduces ischemia driven revascularization rate and
improves all cause mortality at 2 years compared with optimized medical
therapy alone. Conclusion(s): Indications for PCI is a rapidly
changing field in large part due to lack of quality studies and
development of new techniques and technology such as intravascular imaging
and improved medical therapies. Recent data indicates that utilization of
intravascular imaging such as IVUS and OCT may prove helpful as adjunctive
tools to delineate appropriate PCI strategies and improve outcomes in
patients undergoing revascularization. Copyright © 2025 Southern
Society for Clinical Investigation. Published by Elsevier Inc. All rights
are reserved, including those for text and data mining, AI training, and
similar technologies.. All rights reserved.

<74>
Accession Number
649199615
Title
COMPLETE OR INCOMPLETE REVASCULARIZATION AND INCIDENCE OF HEART FAILURE IN
PATIENTS WITH ACUTE CORONARY SYNDROME AND MULTIVESSEL DISEASE. A
SUB-ANALYSIS OF THE CORALYS REGISTRY.
Source
Giornale Italiano di Cardiologia. Conference: 43.Congresso Nazionale GISE.
Milan Italy. 23(10 Supplement 1) (pp e11), 2022. Date of Publication: 01
Oct 2022.
Author
Bruno F.; Marengo G.; De Filippo O.; Wanha W.; Leonardi S.; Rubin S.R.;
Fabris E.; Truffa A.; Huczek Z.; Gaibazzi N.; Ielasi A.; Cortese B.; Nunez
Gil I.; Ugo F.; Bianco M.; Barbieri L.; Marchini F.; Desperak P.; Montalto
C.; Mancone M.; Morici N.; Scaglione M.; Tuttolomondo D.; Sardella G.;
Gasior M.; Gallone G.; Campo G.; Wojakowski W.; Essi E.A.; Sinagra G.; De
Ferrari G.M.; D'Ascenzo F.
Institution
(Bruno, Marengo, De Filippo, Gallone, De Ferrari, D'Ascenzo) Cardiology,
Department of Medical Sciences, Citta della Salute e della Scienza di
Torino Hospital, University of Turin, Turin, Italy
(Wanha, Desperak, Gasior, Wojakowski) Department of Cardiology and
Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
(Leonardi, Montalto) Coronary Care Unit, Fondazione IRCCS Policlinico San
Matteo, Italy
(Rubin, Essi) Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
(Fabris, Sinagra) Cardiovascular Department, Azienda Sanitaria
Universitaria Giuliano Isontina, University of Trieste, Trieste, Italy
(Truffa, Scaglione) Division of Cardiology, Ospedale Cardinal G. Massaia,
Asti, Italy
(Huczek) 1st Department of Cardiology, Medical University of Warsaw,
Warszawa, Poland
(Gaibazzi, Tuttolomondo) Cardiology Department, Parma University Hospital,
Parma, Italy
(Ielasi) UO Cardiologia Clinica ed Interventistica, Istituto Clinico
Sant'Ambrogio, Milan, Italy
(Cortese) Cardiovascular Research Team, San Carlo Clinic, Milano, Italy
(Nunez Gil) Cardiovascular Institute, Hospital Clinico San Carlos, Madrid,
Spain
(Ugo) Department of Cardiology, Sant'Andrea Hospital, Vercelli, Italy
(Bianco) Division of Cardiology, San Luigi Gonzaga University Hospital,
Orbassano, Turin, Italy
(Barbieri) Division of Cardiology, Fondazione IRCCS Ca' Granda Ospedale
Maggiore Policlinico, Milan, Italy
(Marchini, Campo) Cardiovascular Institute, Azienda Ospedaliero
Universitaria di Ferrara, Cona (FE), Italy
(Mancone, Sardella) Dipartimento di Scienze Cliniche Internistiche,
Anestesiologiche e Cardiovascolari, Sapienza Universita di Roma, Roma,
Italy
(Morici) IRCCS S. Maria Nascente, Fondazione Don Carlo Gnocchi ONLUS,
Milan, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. Protective role of complete revascularization towards
development of HF after ACS remains to be elucidated. The main aim of this
subanalysis of the CORALYS registry is to evaluate the impact of CR on
adverse outcome at follow-up, including heart failure hospitalization in
patients with ACS and multivessel coronary artery disease undergoing PCI.
Methods. Consecutive ACS patients with multivessel disease from the
CORALYS registry were analyzed. Incidence of first hospitalization for HF
or CV death was the primary endpoint, while the single component and
all-cause death were the secondary ones. Patients were stratified
according to completeness of coronary revascularization. Results. Out of
14699 patients in the CORALYS registry, 5054 presented with multivessel
disease. 1473 (29.2%) underwent CR, while 3581 (70.8%) did not. Over 5
years follow-up, CR was associated with a reduced incidence of the primary
endpoint of HF hospitalization or CV death (adjusted HR 0.66, 95% CI
0.51-0.85), first HF hospitalization (adjusted HR 0.67, 95% CI 0.49-0.90)
along with all-cause death and CV death alone (adjusted HR 0.74, 95% CI
0.56-0.97 for all-cause death; and adjusted HR 0.56, 95% CI 0.38-0.84 for
CV death). The results were consistent also in the propensity-score
matching population and in IPTW analysis. The benefit of CR was consistent
across ACS presentations (HR 0.59, 95% CI 0.39-0.89 for STEMI and HR 0.71,
95% CI 0.50-0.99 for NSTE-ACS) and in patients with LVEF >40% (HR 0.52;
95% CI 0.37- 0.72), while no benefit was observed in patients with LVEF
<=40% (HR 0.77; 95% CI 0.37-1.10, p for interaction 0.04). Conclusions. In
patients with ACS (both STEMI and NSTE-ACS) and multivessel disease, CR
reduced the risk of the primary endpoint of first hospitalization for HF
and CV death, as well as first HF hospitalization, CV and overall death.
When feasible, CR should be performed in all patients with ACS to reduce
the incidence of HF and death at follow-up.

<75>
[Use Link to view the full text]
Accession Number
649208989
Title
Comparison of the Efficacy and Safety of Tranexamic Acid Versus
Aminocaproic Acid for Bleeding Prevention in Adult Surgical Patients
Undergoing Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 18 Nov
2025.
Author
Behrendt H.A.; Reinert J.P.
Institution
(Behrendt) Department of Pharmacy Practice, The University of Toledo
College of Pharmacy and Pharmaceutical Sciences, Toledo, OH
Abstract
The objective of this endeavor was to analyze current evidence comparing
tranexamic acid (TXA) with aminocaproic acid (EACA) to determine their
relative efficacy and safety in adult patients undergoing cardiopulmonary
bypass (CPB). A systematic review and meta-analysis were conducted
utilizing the Preferred Reporting Items for Systematic Reviews and
Meta-Analyses methodology to assess randomized controlled trials comparing
TXA with EACA in adult CPB. Studies were excluded if not randomized, did
not directly compare TXA with EACA, or did not involve the adult CPB
population. The primary efficacy endpoint was total blood loss in 24 hours
(mL). Safety endpoints included the most commonly reported adverse events.
The secondary efficacy endpoint was total units of packed red blood cells
transfused (units). Nine randomized controlled trials were included. TXA
had a statistically significant reduction in 24-hour blood loss compared
with EACA [-0.21 (CI, -0.36 to -0.06), P = 0.0070]. TXA also had a
statistically significant reduction in total packed red blood cells
infused [-0.30 (CI -0.50 to -0.11), P = 0.0025]. There was no significant
difference in neurological [1.48 (0.92-2.38), P = 0.9843], renal [0.99
(0.85-1.15), P = 0.2274], cardiac [1.08 (0.88-1.32), P = 0.2068], or
thrombotic [1.00 (0.39-2.58), P = 0.4450] events. With synthesized
evidence supporting TXA, this review can help guide practitioners to make
informed recommendations regarding periprocedural care to minimize blood
loss and maximize resource use. This analysis and review supports the
preferential use of TXA over EACA in adults undergoing CPB. Copyright
© 2025 Wolters Kluwer Health, Inc. All rights reserved.

<76>
Accession Number
649195510
Title
The influence of prosthetic heart valves on the patient's quality of life.
Source
Archives of the Balkan Medical Union. Conference: 38th Balkan Medical
Week. Bucharest Romania. 60(Supplement 1) (pp S18), 2025. Date of
Publication: 01 Jun 2025.
Author
Chiriloae R.A.; Mazur-Nicorici L.
Institution
(Chiriloae) University of Medicine and Pharmacy Nicolae Testemitanu,
Chisinau, Moldova
(Mazur-Nicorici) Department of Internal Medicine, Discipline of
Cardiology, University of Medicine and Pharmacy Nicolae Testemitanu,
Chisinau, Moldova
Publisher
Balkan Medical Union
Abstract
Introduction: Heart valve diseases represent a significant public health
concern, often necessitating surgical valve replacement. Biological
prostheses are favored due to their advantage of eliminating the need for
long-term anticoagulation. Assessing their impact on patients' quality of
life remains a critical aspect of clinical evaluation. The objective of
the study was to evaluate the influence of prosthetic heart valves on the
quality of patients' life. Material(s) and Method(s): There were
analyzed 109 clinical trials and meta-analyses published between
2020-2025, using Google Academic, ScienceDirect and PubMed. The keywords
used were: Aortic valve stenosis, prosthetic valves, quality of life,
intraoperative and postoperative complications. Result(s): The
studies demonstrate a notable enhancement in the functional capacity of
patients following prosthetic valve implantation, accompanied by a
reduction in heart failure symptoms. Individuals with biological valves
experience a superior quality of life in the short term and a diminished
risk of anticoagulation-related complications. Advances in implantation
techniques have effectively minimized several postoperative risks.
 Conclusion(s): The selection of a biological prosthesis should be
tailored to the patient's individual needs and clinical profile. While the
risk of valvular degeneration remains a concern, studies indicate a
significant improvement in quality of life following the procedure.

<77>
Accession Number
649199624
Title
SINGLE VERSUS DUAL ANTIPLATELET THERAPY FOLLOWING PERCUTANEOUS LEFT ATRIAL
APPENDAGE CLOSURE - A SYSTEMATIC REVIEW AND META-ANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 43.Congresso Nazionale GISE.
Milan Italy. 23(10 Supplement 1) (pp e48), 2022. Date of Publication: 01
Oct 2022.
Author
Continisio S.; Montonati C.; Angelini F.; Cardaioli F.; Scotti A.;
Sciarretta T.; Zuccarelli V.; Masiero G.; Fabris T.; Fraccaro C.; Napodano
M.; Fovino L.N.; Tarantini G.
Institution
(Continisio, Montonati, Cardaioli, Scotti, Sciarretta, Zuccarelli,
Masiero, Fabris, Fraccaro, Napodano, Fovino, Tarantini) Department of
Cardiac, Thoracic, Vascular Sciences and Public Health, University of
Padua, Italy
(Angelini) Department of Medical Sciences, University of Turin - Citta
della Salute e della Scienza, Italy
(Scotti) Montefiore-Einstein Center for Heart and Vascular Care,
Montefiore Medical Center, United States
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Background. Atrial fibrillation (AF) is the most important cause of
cardioembolic stroke worldwide and most of stroke-causing clot derives
from the left atrial appendage (LAA). In the last few years, transcatheter
LAA occlusion (LAAO) has become a plausible alternative to oral
anticoagulation therapy (OAT) for AF patients with absolute
contraindications to anticoagulation therapy. Although post-procedure
antiplatelet therapy represents the only possible strategy in this subset,
few data are currently available about the best antiplatelet regimen. The
aim of this study was to assess clinical outcomes among patients treated
with single antiplatelet therapy (SAPT) and dual antiplatelet therapy
(DAPT) after LAAO. Methods. Published studies comparing single versus dual
antiplatelet regimens following LAAO were systematically searched and
screened. The outcomes of interest were ischemic stroke, major bleeding
and device-related thrombus (DRT). Random-effect meta-analysis was
performed comparing outcomes in both groups. The moderator effect of
baseline characteristics on outcomes were evaluated by univariate
metaregression analysis. Results. A total of 14 observational studies with
2931 patients treated with antiplatelet therapy (SAPT, n = 961; DAPT, n =
1970) after LAAO were included. The main indication to perform LAAO in the
overall population was previous bleeding during anticoagulation. In the
overall cohort, mean age was 74.4 +/- 8.6 years, while mean CHA2DS2-VASC
and HAS-BLED scores were 4.3 +/- 1.5 and 3.0 +/- 1.1, respectively. At a
weighted mean follow-up of 10.3 +/- 9.2 months, there were no
significative difference in the occurrence of stroke (RR 1.27; 95% CI 0.53
to 2.03; p=0.60), major bleeding (RR 1.18; 95% CI 0.52 to 2.69; p=0.70)
and DRT (RR 1.30; 95% CI 0.73 to 2.31; p=0.38) comparing SAPT versus DAPT
after LAAO. The occurrence of the composite outcome was also similar
between groups (7.5% vs. 7.1%, respectively; RR 1.16; 95% CI 0.50 to 2.71;
p=0.73). Conclusions. In patients treated with SAPT or DAPT after
percutaneous LAAO there were no differences with regards to stroke, major
bleeding, and DRT.

<78>
Accession Number
649199285
Title
AORTIC VALVE CALCIFICATION PATTERNS ON CT SCAN AND HEMODYNAMIC PERFORMANCE
OF THE SELF-EXPANDING INTRAANNULAR TRANSCATHETER PORTICO PROSTHESIS VALVE.
Source
Giornale Italiano di Cardiologia. Conference: 43.Congresso Nazionale GISE.
Milan Italy. 23(10 Supplement 1) (pp e55), 2022. Date of Publication: 01
Oct 2022.
Author
Viscusi M.M.; Nusca A.; Circhetta S.; Nobile E.; Bernardini F.; De
Filippis A.; Paolucci L.; Mangiacapra F.; Ricottini E.; Melfi R.; Rinaldi
R.; Gallo P.; Cocco N.; Grigioni F.; Ussia G.P.
Institution
(Viscusi, Nusca, Circhetta, Nobile, Bernardini, De Filippis, Paolucci,
Mangiacapra, Ricottini, Melfi, Rinaldi, Gallo, Cocco, Grigioni, Ussia)
Campus Bio-Medico, Roma, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction. The burden of native aortic valve calcification (AVC)
represents a negative prognostic factor in patients undergoing
transcatheter aortic valve implantation (TAVI). Recent randomized clinical
trials comparing commercially available self-expanding (SE) supraannular
and balloon-expandable (BE) devices with second-generation SE
intra-annular devices demonstrated the clinical non-inferiority of the
latter in terms of procedural success. However, no current data are
available in vivo regarding the potential impact of the above-mentioned
calcification patterns on SE intra-annular device performance and clinical
outcomes. Purpose. To evaluate the potential impact of different AVC
patterns on SE intra-annular device performance in a consecutive cohort of
patients undergoing TAVI. Methods. This is an observational,
non-randomized, prospective, singlecenter study preliminarily enrolling 53
consecutive patients who underwent TAVI with a SE intra-annular device
(Portico - Abbott Structural Heart, St Paul, MN, USA) between 2019 and
2022 at our department. All patients underwent transthoracic
echocardiography, contrast-enhanced multidetector row computed tomography
(MDCT) with volumetric calcium score and coronary angiography before TAVI.
Patients with bicuspid aortic valve and previous surgical aortic valve
replacement eligible for valve-in-valve TAVI were excluded. AVC and left
ventricle outflow tract (LVOT) calcification (up to 15 mm below the basal
annular plane) were quantified in the contrast images by using a
Hounsfield unit threshold of 850. Results. Patients undergoing pacemaker
implantation post-TAVI (19% of the overall study population) because of
the occurrence of third degree atrio-ventricular block or advanced
atrio-ventricular block (implantation depth described as
ventricular/aortic stent extension ratio: 27.77+/-6.9%) had higher
calcification extension on all aortic cusps compared with those that did
not show this complication (overall AVA calcium score 270.6+/-409.6 vs
158.1+/-137.1, p=0.146; p significance of 0.048, 0.181 and 0.346 for left
cusp- LCC, right cusp - RCC- and non-coronary cusp-NCC, respectively).
Severe LVOT calcification was also associated with a higher incidence of
AV conduction abnormalities (37.9+/-44.5 vs 13.4+/-39.0 of patients
without AV defects, p=0.045). Moreover, post-procedural moderate/severe
aortic regurgitation occurred more frequently in patients with LCC
calcification (183.7+/-87.0 vs 64.2+/-99.6, p=0.018) and RCC calcification
(188.7+/-149.5 vs 58.7+/-120.8, p=0.019) rather than those with NCC or
LVOT calcification. Conclusions. Preliminary results of our observational
registry highlight the potential impact of AVC patterns on the occurrence
of aortic regurgitation and pacemaker implantation after a SE
intra-annular device implantation. A larger sample size is needed to
better understand the impact of calcium patterns on each single outcome in
order to identify patients at higher risk and to early manage these
complications, improving long-term outcomes.

<79>
Accession Number
2041697709
Title
The internal mammary artery - use as a free graft in coronary artery
bypass grafting - evidence, technical considerations and controversies.
Source
Perfusion (United Kingdom). (no pagination), 2025. Date of Publication:
2025.
Author
Navaratnarajah M.; Al-Zubaidi F.I.; Raja S.G.
Institution
(Navaratnarajah) Department of Cardiac Surgery, St Thomas Hospital,
London, United Kingdom
(Al-Zubaidi) Department of Cardiac Surgery, John Radcliffe Hospital,
Oxford, United Kingdom
(Raja) Department of Cardiac Surgery, Harefield Hospital, Middlesex,
United Kingdom
Publisher
SAGE Publications Ltd
Abstract
Background: In-situ internal mammary artery (IMA) grafting remains the
gold standard in coronary artery bypass grafting (CABG), particularly for
left anterior descending artery revascularisation. However, the role of
free-IMA grafts-especially free right IMA (RIMA) and select cases of free
left IMA (LIMA)-has expanded in response to anatomical and technical
constraints. This narrative review synthesises current evidence on
free-IMA use during CABG. Method(s): A structured literature search
was conducted using PubMed (1946-2025) and Embase (1974-2025),
supplemented by Web of Science, Google Scholar, and thesis repositories.
Studies were included if they reported outcomes related to free-IMA
grafting, regardless of pump status or harvesting technique. Of 74
eligible studies, 9 chosen studies specifically reported free-RIMA
outcomes and were analysed in detail. Result(s): Free-RIMA grafting
demonstrated excellent long-term patency (up to 96%) and favourable
survival outcomes when used as composite or direct aorto-coronary grafts.
Multi-arterial grafting (MAG) and total arterial grafting (TAG) strategies
incorporating free-IMA conduits were associated with reduced major adverse
cardiac events (MACE) and improved freedom from repeat revascularisation.
Despite these benefits, uptake of free-IMA techniques remains low in
Europe and North America, often limited by institutional preferences and
operator experience. Conclusion(s): Current evidence supports the
selective use of free-IMA grafts in CABG, particularly when in-situ
deployment is not feasible. Prospective studies are needed to validate
long-term outcomes beyond 10 years, compare free-IMA with radial artery
grafts, and define optimal arterial configurations for durable
revascularisation. Copyright © The Author(s) 2025. This article
is distributed under the terms of the Creative Commons Attribution 4.0
License (https://creativecommons.org/licenses/by/4.0/) which permits any
use, reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<80>
Accession Number
2041192686
Title
Modern anticoagulation strategies in cardiovascular surgery: nonvitamin K
antagonist oral anticoagulants versus warfarin after aortic bioprosthetic
valve replacement.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2025. Date of
Publication: 2025.
Author
Chaudhri M.; Mahrizi A.D.A.; Nadeem S.A.; Canal A.; Rajendran P.; Rapelli
V.R.; Gill H.; Haroon B.; Shahzad A.; Acquah F.; Kaunzinger C.; Albert C.;
Raza M.R.
Institution
(Chaudhri, Acquah, Kaunzinger, Raza) Hackensack Meridian Ocean University
Medical Center, Brick Township, NJ, United States
(Mahrizi, Haroon) Faculty of Medicine and Surgery, University of Malta,
Msida, Malta
(Nadeem) Drexel University, Philadelphia, PA, United States
(Canal, Rapelli, Gill) Rowan-Virtua School of Osteopathic Medicine,
Stratford, NJ, United States
(Rajendran) Hackensack Meridian School of Medicine, Hackensack, NJ, United
States
(Shahzad) Saint Barnabas Hospital, Bronx, NY, United States
(Albert) Robert Wood Johnson University Hospital, New Brunswick, NJ,
United States
(Chaudhri) Department of Medicine, Hackensack Meridian Ocean University
Medical Center, Brick, NJ, United States
Publisher
Springer
Abstract
The optimal postaortic valve replacement (AVR) anticoagulation strategy
remains poorly defined, particularly when comparing nonvitamin K
antagonist oral anticoagulants (NOACs) versus warfarin. This systematic
review and meta-analysis aimed to evaluate the safety and efficacy of
NOACs compared with warfarin in these patients. Our study was registered
on PROSPERO (ID CRD420251028998). A search of the PubMed, EMBASE, and
Cochrane databases was conducted on April 9, 2025, for studies published
between 2015 and 2025 that compared NOACs to warfarin after aortic
bioprosthetic valve replacement. Inclusion criteria included randomized
controlled trials (RCTs) and observational studies reporting
thromboembolic events, major bleeding, and mortality with at least 6
months of follow-up. Studies on mechanical valves, case reports, and
publications that could not be translated into English were excluded. Data
extraction was conducted based on study design, patient demographics,
clinical outcomes, and effect sizes, expressed as hazard ratios (HRs) with
95% confidence intervals (CIs) using a random effects model. Risk of bias
was assessed using the ROBINS-I tool. Seventeen studies (n = 93,510
participants) were included. NOACs were associated with an HR of 0.91 for
thromboembolic events (95% CI: 0.76-1.09) and a pooled HR of 1.22 for
major bleeding (95% CI: 0.88-1.68). Several studies have suggested a trend
toward lower all-cause mortality and major bleeding with NOACs,
particularly in patients with lower bleeding risk. In patients undergoing
aortic bioprosthetic valve replacement, NOACs show similar efficacy and
safety to warfarin for preventing thromboembolic events and major
bleeding. However, anticoagulation decisions should be individualized, and
larger RCTs are needed to determine the optimal approach. Copyright
© The Author(s) 2025.

<81>
Accession Number
2036992026
Title
Endocarditis secondary to neisseria elongata: what do we know so far? A
scoping review.
Source
American Journal of the Medical Sciences. Conference: 2025 Southern
Regional Meeting. InterContinental Hotel, New Orleans United States.
369(Supplement 1) (pp S108), 2025. Date of Publication: 01 Feb 2025.
Author
Tariq H.; Ashraf D.; Hassan F.; Kamran F.; Khosa M.; Khosa W.; Shaikh J.;
Naguib T.
Institution
(Tariq, Shaikh, Naguib) Texas Tech University Health Sciences Center,
Amarillo, TX, United States
(Ashraf, Kamran) Foundation University Medical College, Islamabad,
Pakistan
(Hassan) Allama Iqbal Medical College, Lahore, Pakistan
(Khosa, Khosa) Quetta Institute of Medical Sciences, Quetta, Pakistan
Publisher
Elsevier B.V.
Abstract
Purpose: Most instances of endocarditis typically result from infections
caused by gram-positive bacteria such as Streptococci, Staphylococci, and
Enterococci. Nevertheless, Neisseria elongata, once considered an oral
commensal, has been documented for its pathogenicity causing endocarditis,
among other infections. Isolating the organism proves to be a diagnostic
challenge. A high index of suspicion may be required to initiate early
medical and surgical management to prevent the development of
complications. This study serves as a scoping review of Neisseria
elongata-induced endocarditis and its management to study available
evidence and knowledge gaps in the published literature. Method(s): A
scoping review was done according to PRISMA guidelines. An extensive
literature search was conducted using eight databases, including PubMed,
Web of Science, EBSCO, Science Direct, Cochrane, Scopus, Medline Plus,
Hinari, and PMC. Articles published between the years 1993-2022, including
case reports, case series, cohort studies, retrospective studies, or
systematic reviews/meta-analyses relevant to our research question, were
included. The screening was done using the web-based screening tool
Rayyan. Result(s): Twenty-nine case reports, one literature review,
and one original article met our inclusion criteria with a total of 32
articles. The most used diagnostic modalities were physical examination,
laboratory investigations, blood cultures, and transesophageal
echocardiography. The most common clinical findings included elevated
Creactive protein in 43.8%, elevated leukocyte count in 46.9%, murmur
presenting in 62.5% of patients, positive blood cultures in 87.5%, and
vegetation on echocardiography in 93.8%. Vegetation were most commonly
present on the mitral valve in 47% of patients (n = 15), while other
valves accounted for the following numbers: Aortic valve 34% (n = 11),
prosthetic valve 6.25% (n = 2), tricuspid valve 3.1% (n = 1). Treatment
usually involves a standard set of antibiotics. Conclusion(s):
Endocarditis secondary to Neisseria elongata showed a generally good
prognosis when treated with beta-lactam antibiotics, with the majority
requiring no surgical intervention and full recovery post antibiotics.
Early diagnosis and initiation of antibiotics are important to prevent
complications. Copyright © 2025 Southern Society for Clinical
Investigation. Published by Elsevier Inc. All rights are reserved,
including those for text and data mining, AI training, and similar
technologies.. All rights reserved.

<82>
[Use Link to view the full text]
Accession Number
649202011
Title
Individualized Flow-Controlled versus Pressure-Controlled Ventilation in
Cardiac Surgery: A Randomized Controlled Trial.
Source
Anesthesiology. (no pagination), 2025. Date of Publication: 17 Nov 2025.
Author
Becker S.; Kurz C.T.; Schnitzler R.; Geppert J.; Wichelhaus L.-M.; Denz
R.; Poepping J.; Rembecki M.; Berres D.M.; Strauch J.T.; Bates D.G.;
Erdoes G.; Timmesfeld N.; Zahn P.K.
Institution
(Becker, Kurz, Schnitzler, Geppert, Wichelhaus, Poepping, Rembecki, Zahn)
Department of Anesthesiology, Intensive Care and Pain Medicine, BG
University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Kurz) Department of Cardiac Anesthesiology and Intensive Care Medicine,
Berlin, Germany
(Denz, Timmesfeld) Department of Medical Informatics, Biometry and
Epidemiology, Ruhr University Bochum, Bochum, Germany
(Berres, Strauch) Department of Cardiothoracic Surgery, BG University
Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Bates) School of Engineering, University of Warwick, Coventry, United
Kingdom
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital,
University of Bern, University Hospital Bern, Bern, Switzerland
Abstract
BACKGROUND: Patients undergoing on-pump cardiac surgery are at high risk
for perioperative lung injury and a hyper-inflammatory state associated
with postoperative complications. We investigated the hypothesis that
Flow-Controlled Ventilation (FCV) reduces the inflammatory stimulus
compared to conventional Pressure-Controlled Ventilation (PCV) in this
patient cohort. FCV has the unique feature of controlling airway flows
during inspiration and expiration and the potential to reduce mechanical
power of invasive ventilation. METHOD(S): In this single-center
randomized controlled trial, 140 adult patients undergoing cardiac surgery
with cardiopulmonary bypass were allocated 1:1 to FCV or PCV from Aug 10,
2020, to Nov 16, 2022. Participants received perioperatively either
individualized FCV with a compliance-guided positive end-expiratory
pressure (PEEP) and a compliance-guided driving pressure (DELTAP) or PCV
with a compliance-guided PEEP and DELTAP for tidal volumes of 6-8 ml/kg
predicted body weight. Postoperative plasmatic interleukin 8 (IL-8) levels
six hours after cardiopulmonary bypass were defined as the primary
endpoint. Explorative secondary outcomes included incidences of
postoperative pulmonary and extrapulmonary complications, and hospital
length of stay. RESULT(S): Median postoperative IL-8 levels did not
differ significantly between FCV and PCV (FCV 3.08 vs. PCV 3.60, beta
coefficient 0.08 pg/ml, 95% CI -0.17 to 0.33; P = 0.573). DELTAP values
and tidal volumes were higher in the FCV group, but FCV yielded lower
respiratory rates and minute volumes required for normocapnia. As a
result, the FCV approach reduced the perioperatively applied mechanical
power by 55%. After FCV, incidences of single postoperative pulmonary
complications (e.g. confirmed pneumonia, moderate and severe hypoxemia)
and any postoperative extrapulmonary complication were lower, and the
hospital stay shorter. CONCLUSION(S): FCV did not reduce plasmatic
IL-8 levels at the predefined timepoint six hours after cardiopulmonary
bypass. However, the reduction of mechanical power during individualized
FCV application and the findings of the explorative secondary study
outcomes justify future trials. Copyright © 2025 The Author(s).
Published by Wolters Kluwer Health, Inc., on behalf of the American
Society of Anesthesiologists.

<83>
Accession Number
2041298250
Title
Comparison in trends and outcomes of multiple vs. single arterial coronary
bypass graft surgery.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1661006. Date of Publication: 2025.
Author
Ding Q.; Li H.; Cheng X.; Ge M.; Zhou Q.
Institution
(Ding, Li, Cheng, Ge, Zhou) Department of Cardio-Thoracic Surgery, Nanjing
Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical
School, Nanjing, China
(Cheng) Department of Cardio-Thoracic Surgery, Nanjing Drum Tower
Hospital, Clinical College of Nanjing University of Chinese Medicine,
Nanjing, China
Publisher
Frontiers Media SA
Abstract
Objective: Multiple arterial grafting (MAG) has been suggested to confer
long-term survival benefits for patients undergoing coronary artery bypass
grafting (CABG), yet its short-term benefits remain uncertain. This study
aims to analyze the impact of MAG on in-hospital outcomes and identify
potential risk factors. Method(s): A retrospective analysis was
conducted from all patients who underwent CABG surgery in our development
from January 2022 to December 2024. A generalized mixed-effects model and
sensitivity analysis were employed to evaluate the influence of the type
of CABG bypass graft on in-hospital major adverse cardiac and
cerebrovascular events (MACCEs), postoperative dialysis, intra-aortic
balloon pump (IABP) use, re-thoracotomy for bleeding and sternal wound
infection (SWI). Result(s): A total of 960 patients were included in
this study. Patients who received MAG surgeries had more coronary artery
lesions observed preoperatively. Compared with patients who underwent
single arterial grafting (SAG), those who received MAG surgery did not
show significant differences in the incidence of in-hospital MACCEs,
postoperative dialysis, IABP use, re-thoracotomy or SWI. Interestingly,
good left ventricular function was associated with a reduced occurrence of
postoperative dialysis, MACCEs, and IABP application. Chronic renal
insufficiency emerged as a risk predictor of major in-hospital adverse
events. Conclusion(s): This single-center study did not find
significant differences in short-term outcomes between MAG and SAG groups.
However, caution should be exercised when applying these findings to other
clinical environments and patient populations. Further multi-center,
prospective randomized controlled trials (RCTs) are needed to validate and
extend our results. Copyright 2025 Ding, Li, Cheng, Ge and Zhou.

<84>
Accession Number
2041694759
Title
Transcatheter or Surgical Treatment of Patients With Aortic Stenosis at
Low to Intermediate Risk: An Individual Participant Data Meta-Analysis.
Source
JAMA Cardiology. 10(11) (pp 1175-1185), 2025. Date of Publication: 12 Nov
2025.
Author
Ludwig S.; Klimek M.; Bay B.; Blankenberg S.; Granada J.F.; Hildick-Smith
D.; Hudson J.; Jorgensen T.Ho.; Leon M.B.; Magnussen C.; Thiele H.;
Horsted Thyregod H.G.; Wendler O.; De Backer O.; Toff W.D.; Ziegler A.;
Seiffert M.
Institution
(Ludwig, Bay, Blankenberg, Magnussen, Ziegler) Department of Cardiology,
University Heart and Vascular Center Hamburg, University Medical Center
Hamburg-Eppendorf, Hamburg, Germany
(Ludwig, Bay, Blankenberg, Magnussen, Ziegler) Centre for Population
Health Innovation, University Heart and Vascular Center Hamburg,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Ludwig, Bay, Blankenberg, Magnussen, Thiele, Seiffert) German Centre for
Cardiovascular Research Partner Site North, Hamburg, Germany
(Ludwig, Granada, Leon) Cardiovascular Research Foundation, New York,
United States
(Klimek, Blankenberg, Ziegler) Cardio-CARE, Medizincampus Davos, Davos,
Switzerland
(Hildick-Smith) Sussex Cardiac Centre, Brighton and Sussex University
Hospitals National Health Service Trust, Brighton, United Kingdom
(Hudson) Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen,
United Kingdom
(Jorgensen, Horsted Thyregod, De Backer) Rigshospitalet, Copenhagen,
Denmark
(Leon) NewYork-Presbyterian Hospital, Columbia University Irving Medical
Center, New York, United States
(Thiele) Department of Cardiology, Heart Center Leipzig at Leipzig
University, Leipzig Heart Science, Leipzig, Germany
(Wendler) Cleveland Clinic, London, United Kingdom
(Toff) Department of Cardiovascular Sciences, University of Leicester,
Leicester, United Kingdom
(Toff) National Institute for Health Research Biomedical Research Centre,
Glenfield Hospital, Leicester, United Kingdom
(Ziegler) School of Mathematics, Statistics and Computer Science,
University of KwaZulu-Natal, Pietermaritzburg, South Africa
(Seiffert) Department of Cardiology and Angiology, BG University Hospital
Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
Publisher
American Medical Association
Abstract
Importance: Mounting evidence suggests transcatheter aortic valve
implantation (TAVI) as preferred treatment for patients at low to
intermediate surgical risk. However, limitations in study design and
statistical power raise concerns about the generalizability of individual
randomized clinical trials (RCTs) comparing TAVI and surgical aortic valve
replacement (SAVR) to routine clinical practice. Objective(s): To
compare 1-year outcomes of TAVI vs SAVR in patients with severe
symptomatic aortic stenosis at low to intermediate surgical risk applying
a 2-stage individual participant data (IPD) and aggregate meta-analyses.
 Data Sources: MEDLINE databases were searched for RCTs comparing TAVI
and SAVR in patients with aortic stenosis until June 15, 2025. Study
Selection: RCTs were selected comparing TAVI vs SAVR in patients with
severe symptomatic aortic stenosis at low or intermediate surgical risk
with 1-year follow-up. Data Extraction and Synthesis: IPD were obtained
from all investigator-initiated RCTs (DEDICATE, NOTION, NOTION-2, and UK
TAVI) and analyzed in 1- and 2-stage IPD meta-analyses. An overall
meta-analysis was performed by adding aggregate data from
industry-sponsored RCTs. Main Outcomes and Measures: The primary end
point was all-cause death or any stroke 1 year after randomization.
Secondary end points included all-cause death, any stroke, disabling
stroke, cardiovascular death, rehospitalization for cardiovascular cause,
myocardial infarction, new-onset atrial fibrillation, new permanent
pacemaker implantation, and aortic valve reintervention. Result(s):
The IPD meta-analysis included 4 RCTs comprising 2873 patients (mean [SD]
age, 76.7 [5.5] years; 805 [56.1%] male) at low to intermediate surgical
risk randomly assigned to TAVI (n = 1439) or SAVR (n = 1434). At 1 year,
the hazard ratio (HR) for the primary end point for TAVI compared to SAVR
was 0.73 (95% CI, 0.56-0.95) in the 1-stage and 0.79 (95% CI, 0.49-1.27)
in the 2-stage IPD meta-analysis. In the 2-stage overall meta-analysis the
HR for the primary end point was 0.76 (95% CI, 0.60-0.97).
 Conclusions and Relevance: In this IPD meta-analysis of 4 RCTs, and
an overall meta-analysis of 8 RCTs of patients with severe symptomatic AS
at low to intermediate risk, TAVI was associated with a reduction in the
1-year incidence of all-cause death or any stroke. These findings
emphasize TAVI as alternative option in patients at low to intermediate
risk. Long-term follow-up is warranted to evaluate sustainability of these
findings. Copyright © 2025 American Medical Association.

<85>
Accession Number
2041303293
Title
Right ventricular function assessment following transcatheter aortic valve
implantation/replacement (TAVI/TAVR): a systematic review and
meta-analysis comparing speckle tracking and conventional
echocardiographic approaches.
Source
Journal of Echocardiography. (no pagination), 2025. Date of Publication:
2025.
Author
Goudarzi E.; Aghajani S.; Ebrahimi N.; Akarzadeh D.; Javadi M.; Layegh
Mirhosseyni S.S.; Zarinfar Y.; Khaheshi I.
Institution
(Goudarzi, Aghajani, Ebrahimi, Zarinfar) School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Akarzadeh) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Javadi) Department of Medicine, Faculty of Medicine, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Layegh Mirhosseyni) Department of Medicine, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Goudarzi, Khaheshi) Cardiovascular Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khaheshi) Echocardiography Fellowship Program, Division of Cardiology,
Vancouver General Hospital, University of British Columbia, Vancouver,
Canada
Publisher
Springer
Abstract
This study evaluates alterations in right ventricular strains using
speckle-tracking echocardiography (STE) following transcatheter aortic
valve implantation/replacement (TAVI/TAVR) and compares these alterations
with conventional echocardiographic measurements. A systematic search
identified studies assessing RVFWLS and RVGLS via STE pre- and
post-TAVI/TAVR. Secondary outcomes included LVEF, TAPSE, FAC, and LVGLS
changes. Echocardiographic parameters of TAVI/TAVR patients were compared
to those of SAVR patients. Subgroup analyses were based on follow-up
duration (<= 1 month vs. >1 month). Meta-regression examined associations
between baseline LVEF, RV strain parameters, and AVA with RV strain
changes. Risk of bias assessments, sensitivity analyses, and publication
bias evaluations ensured result robustness. Thirteen studies comprising
1,399 patients were analyzed. RVFWLS significantly improved post-TAVI/TAVR
(MD = 1.57, SMD = 0.23, p < 0.001). RVGLS showed minor improvement (SMD =
0.09, p = 0.028). LVGLS exhibited considerable improvement (MD = 1.14, SMD
= 0.27, p < 0.001). RVFWLS demonstrated the most improvement among all
parameters at follow-up > 1 month, whereas within the first month, LVGLS
showed greater improvement than RVFWLS. (SMD = 0.30, MD = 1.98, p <
0.001). Lower AVA was associated with greater RVFWLS improvement
(coefficient= -0.11, p = 0.08). Among the echocardiographic parameters,
only RVFWLS and LVGLS showed consistent improvement after TAVI/TAVR.
RVFWLS demonstrated the greatest improvement beyond 1 month of follow-up,
whereas LVGLS showed the largest early improvement within the first month.
In contrast, changes in RVGLS, LVEF, TAPSE, and FAC were generally
small.Keywords: speckle-tracking echocardiography, echocardiography,
transcatheter aortic valve implantation, transcatheter aortic valve
replacement, right ventricle. Copyright © Japanese Society of
Echocardiography 2025.

<86>
Accession Number
2041658013
Title
Effects of intraoperative higher versus lower positive end-expiratory
pressure during one-lung ventilation for thoracic surgery on postoperative
pulmonary complications (PROTHOR): a multicentre, international,
randomised, controlled, phase 3 trial.
Source
The Lancet Respiratory Medicine. (no pagination), 2025. Date of
Publication: 2025.
Author
Abbenhuis J.; Abdulmomen A.; Abdyli A.; Abu Elyazed M.M.; Aguirre Puig P.;
Akbudak I.H.; Aksu C.; Alagoz A.; Alhamdi M.; Almadhati S.; Altorki N.K.;
Aragon Alvarez S.; Arun O.; Azizoglu M.; Baar W.; Balde D.; Balla B.;
Balli Seker M.; Basheer M.; Bauer W.O.; Bence J.; Bernardi M.H.; Bigatello
L.M.; Bignami E.; Bluth T.; Bonney I.; Bouhemad B.; Bradic N.; Brescianini
L.; Bruthans J.; Bulte C.S.E.; Cadar G.; Cakmak G.; Cali P.; Cantatore
L.P.; Chai X.; Chang Y.-T.; Chen J.; Christofaki M.; Cinnella G.; Coelho
Sanches L.; Constantin A.; Contreras V.; Corsi L.; da Silva E.; Defosse
J.; Deluca R.; Diaper J.; Didden L.; Dimitriou E.; do Nascimento Junior
P.; Domi R.; Dorfinger L.; dos Reis Falcao L.F.; Douradinho C.; Drnovsek
Globokar M.; Duran F.M.; Eldawlatly A.; El-Gendy H.M.; Elmazny M.I.;
Elsherif S.-E.I.; Emara M.M.; Enriquez de los Santos S.T.; Farnell-Ward
S.; Ferrufino R.; Gama de Abreu M.; Gao L.; Geyik D.; Gnezda D.; Goeden
S.; Gorjup K.; Granell Gil M.; Guido Guerra R.E.; Guimaraes de Castro
Pereira M.; Guinot P.-G.; Guven A.; Hager H.; Han L.; Hatipoglu Z.;
Hayashi M.; Hell J.; Hofland J.; Hollmann M.W.; Hu J.; Hudacek K.; Huti
G.; Ilic M.; Jankovic R.J.; Jegarl A.; Jimenez Andujar M.-J.; Jin D.;
Kammerer T.; Karadza V.; Kawagoe I.; Kiran Paudel S.I.; Kiss T.; Koch T.;
Kolaric N.; Koning N.J.; Kostopanagiotou K.; Kostroglou A.; Kovac P.;
Kramer T.; Krassler J.; Kreft T.; Kumrular Y.; Kuut M.; Lan L.; Li P.-C.;
Li X.-F.; Li L.-T.; Licker M.; Liu Y.; Longo F.; Loop T.; Lopez-Baamonde
M.; Luise S.; Luo W.; Lv H.; Macias Jimenez M.D.L.A.; Magalhaes D.D.;
Martuscelli M.; Mavko A.; Meco B.C.; Mermer H.A.; Miao C.; Michalek P.;
Mills G.H.; Minana Aragon E.; Mirabella L.; Molyneux M.; Montrano L.;
Mosqueira L.; Mourisse J.; Murrell M.T.; Navarro-Ripoll R.; Negru F.;
Neskovic V.; Nikolic M.; Norberto de la Vega J.A.; Noto A.; Nyktari V.;
Orhan Sungur M.; Ozdemir L.; Ozolina A.; Ozturk T.; Pace M.C.; Pagnussatt
Neto E.; Paloczi B.; Papaioannou A.; Papamichail K.; Patroniti N.; Pektas
Y.; Pereira Matalobos D.; Persec J.; Petrovic S.; Pirc D.; Plismanis G.;
Prata Amendola C.; Prazetina M.; Radovic N.; Rauseo M.; Richter T.; Rivera
Vallejo L.; Rodriguez Ruiz J.J.; Rondovic G.; Rosser J.; Sanchez Garcia
F.J.; Sansone P.; Saracoglu A.; Saracoglu K.T.; Sazak H.; Scharffenberg
M.; Schiavoni L.; Schilling T.; Sediq A.; Semmelmann A.; Senturk N.M.;
Sertac Bingul E.; Sertcakacilar G.; Sfika E.; Shelley B.; Shin S.H.;
Sidiropoulou T.; Silva-Jr J.M.; Socci L.; Socorro T.; Soulioti E.; Spadaro
S.; Spicek-Macan J.; Spray D.; Stamenkovic D.; Stefanakis G.; Stoica R.;
Stojanovic M.; Stopora P.; Sungur Z.; Svareniece-Karjaka E.; Szamos K.;
Tanase N.-V.; Tanriverdi C.; Tempel F.; Terwindt L.E.; Theilen R.; Tipura
D.; Tire Y.; Tomaselli E.; Tsuguie Onari N.; Tunc M.; Turhan O.; Turktan
M.; Ugliola D.; Ulugol H.; Vegh T.; Vetrugno L.; Vitali C.; Volta C.A.;
von Dossow V.; Voyagis G.; Vukovic R.; Vukovic A.Z.; Waeschle R.M.; Wall
D.; Wang H.; Wang D.; Winroth D.; Wittenstein J.; Wu Q.; Xu P.; Yaldir O.;
Yamansavci Sirzai E.; Yang X.; Yapici D.; Yildirim O.; Yildirim Guclu C.;
Yu H.; Yuksel Tanriverdi S.; Zarbock A.; Zeba S.; Zhang Y.; Zhang X.;
Zhang Z.; Zhang J.; Zhang G.-W.; Zhong J.; Ziemann S.
Publisher
Elsevier Ltd
Abstract
Background: The effect of higher positive end-expiratory pressure (PEEP)
and recruitment manoeuvres aimed at lung expansion as compared with lower
PEEP without recruitment manoeuvres aimed at permissive atelectasis on
postoperative pulmonary complications (PPCs) in patients undergoing
one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to
determine the contribution of an intraoperative lung expansion strategy to
preventing PPCs. Method(s): In this multicentre, randomised,
controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in
28 countries, we enrolled adult patients (aged >=18 years) with a BMI of
less than 35 kg/m2 who were scheduled for open thoracic or
video-assisted thoracoscopic surgery under general anaesthesia requiring
one-lung ventilation with a double-lumen tube, with a planned operative
time of more than 60 min, and an expected duration of one-lung ventilation
longer than that of two-lung ventilation. Patients were randomly assigned
(1:1), using permuted blocks of random size (4, 6, and 8) and stratified
by study site, to receive one-lung ventilation with either a higher PEEP
of 10 cm H<inf>2</inf>O and periodic lung recruitment manoeuvres (high
PEEP group) or a lower PEEP of 5 cm H<inf>2</inf>O without routine
recruitment manoeuvres (low PEEP group). All patients received protective
tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation
and 7 mL/kg predicted body weight during two-lung ventilation.
Postoperative assessors were masked to treatment allocation. The primary
outcome was a composite of PPCs during the first 5 postoperative days,
including aspiration pneumonia, moderate or severe respiratory failure,
acute respiratory distress syndrome (ARDS), pulmonary infection,
atelectasis, cardiopulmonary oedema, pleural effusion, non-operative
pneumothorax, pulmonary infiltrates, prolonged air leak, purulent
pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified
intention-to-treat analysis was performed, with patients analysed
according to their assigned treatment group, except in cases of withdrawal
of informed consent, cancellation of surgery, and or loss to follow-up.
This trial is registered with ClinicalTrials.gov (NCT02963025) and is
completed. Finding(s): Between Jan 3, 2017, and Feb 12, 2024, 2200
patients were randomly allocated: 1099 to the high PEEP group and 1101 to
the low PEEP group. 43 patients in the high PEEP group and 33 in the low
PEEP group were excluded from the modified intention-to-treat analysis
after randomisation. The primary outcome occurred in 555 (53.6%) of 1036
patients in the high PEEP group and 592 (56.4%) of 1049 patients in the
low PEEP group (absolute risk difference -2.68 percentage points [95% CI
-6.36 to 1.01]; p=0.155). Intraoperative complications occurred in 484
(49.8%) of 972 patients in the high PEEP group and in 305 (31.3%) of 974
patients in the low PEEP group (absolute risk difference 18.09 percentage
points [95% CI 14.41-21.77]), among which hypotension (360 [37.3%] of 966
patients in the high PEEP group vs 140 [14.3%] of 978 in the low PEEP
group) and new arrhythmias (89 [9.9%] of 899 vs 37 [3.9%] of 956) were
more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres
were more frequent in the low PEEP group (29 [3.3%] of 888 vs 86 [8.8%] of
982). The proportions of patients with extrapulmonary postoperative
complications (110 [10.6%] of 1036 vs 107 [10.2%] of 1049 patients), and
the numbers of adverse events (209 vs 204 events), did not differ between
groups. Interpretation(s): In patients with a BMI of less than 35
kg/m2 undergoing thoracic surgery, one-lung ventilation using
higher PEEP with recruitment manoeuvres, compared with lower PEEP without
recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative
lung expansion or permissive atelectasis should take the individual
gas-exchange and haemodynamic conditions into account, which might vary
during the intraoperative period. Funding(s): Clinical Trials Network
of the European Society of Anaesthesiology and Intensive Care; Department
of Anaesthesiology and Intensive Care, University Hospital Carl Gustav
Carus, Technische Universitat Dresden (Dresden, Germany); Conselho
Nacional de Desenvolvimento Cientifico e Tecnologico (Brasilia, Brazil);
and the Association of Anaesthetists of GB and Ireland. Copyright
© 2025 Elsevier Ltd

<87>
Accession Number
2041658879
Title
Ketamine in Cardiac Surgery: A Systematic Review and Meta-Analysis of
Effects on Inflammatory Markers and Clinical Outcomes.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2025.
Date of Publication: 2025.
Author
de Lima e Souza P.F.; Neto M.M.C.; Paz M.C.; Ponte R.V.
Institution
(de Lima e Souza) Department of Anesthesiology, Federal University of
Ceara, Fortaleza, Brazil
(Neto, Paz) School of Medicine, State University of Ceara, Fortaleza,
Brazil
(Ponte) Department of Surgery, University of Fortaleza, Fortaleza, Brazil
Publisher
W.B. Saunders
Abstract
Cardiac surgery triggers a systemic inflammatory response, especially when
cardiopulmonary bypass (CPB) is used, which may contribute to
postoperative complications. Ketamine, an NMDA receptor antagonist, has
shown anti-inflammatory potential by inhibiting nuclear factor kappa B and
reducing cytokine release, but its perioperative immunomodulatory effects
remain unclear. This systematic review and meta-analysis assessed
randomized controlled trials (RCTs) comparing intraoperative ketamine to
placebo in cardiac surgery. The primary outcome was interleukin (IL)-6
level; secondary outcomes included C-reactive protein (CRP) level,
intensive care unit (ICU) length of stay, mechanical ventilation duration,
and transfusion requirements. Eight RCTs, including a total of 377
patients, were included in the analysis. Ketamine did not significantly
reduce IL-6 levels at 24 hours postoperatively (standardized mean
difference [SMD], -0.96; 95% confidence interval [CI], -2.56 to 0.65; I2 =
96%), although a significant decrease was observed in off-pump procedures
(mean difference [MD], -59.57 pg/mL; I2 = 0%). IL-6 levels measured
immediately after CPB and CRP levels immediately after surgery also were
reduced, but findings were limited by high heterogeneity. No significant
differences were observed in ICU length of stay (MD, -0.10 days),
ventilation time (MD, -0.86 hours), or transfusion rates (risk ratio,
1.01). The certainty of the evidence was rated low to moderate owing to
imprecision and inconsistency. Although ketamine's immunomodulatory
effects were observed in selected subgroups, they did not translate into
improved clinical outcomes. Current evidence does not support the routine
use of ketamine for inflammation control in cardiac surgery, although its
effect in off-pump procedures warrants further research. Copyright
© 2025 Elsevier Inc.

<88>
Accession Number
649171832
Title
Five-year outcomes of transcatheter versus surgical aortic valve
replacement in women: A systematic review and meta-analysis.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 14 Nov 2025.
Author
Wolf S.E.M.; Kucera J.A.; Gregg A.C.; Di Franco A.; Rahouma M.; Redfors
B.; Reardon M.; Pineda A.M.; Gaca J.A.; Zwischenberger B.A.
Institution
(Wolf, Kucera, Gaca, Zwischenberger) Division of Cardiothoracic Surgery,
Department of Surgery, Duke University Medical Center, Durham, NC, United
States
(Gregg, Di Franco, Rahouma, Redfors) Department of Cardiothoracic Surgery,
Weill Cornell Medicine, New York, NY, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Sweden
(Reardon) Department of Cardiovascular Surgery, Houston Methodist
Hospital, Houston, TX, United States
(Pineda) Division of Cardiology, Duke University Medical Center, Durham,
NC, United States
Abstract
OBJECTIVES: Women patients with aortic stenosis (AS) exhibit distinct
anatomic and physiologic features that may influence outcomes after valve
replacement. While transcatheter aortic valve replacement (TAVR) has shown
early advantages over surgical aortic valve replacement (SAVR) in women,
long-term sex-specific outcomes remain unclear. To evaluate outcomes at 5
years comparing TAVR versus SAVR a systematic review and meta-analysis was
performed. METHOD(S): A systematic literature review was conducted,
identifying all randomized controlled trials (RCTs) comparing TAVR with
SAVR which included women with completed 5-year follow-up. The primary
outcome was the composite of all-cause mortality or disabling stroke.
Meta-analysis was performed using both random-effects and fixed-effect
models. The study protocol was registered in PROSPERO (CRD420251004394).
 RESULT(S): Six RCTs were included with a total of 3,094 women (1,587
TAVR and 1,507 SAVR). Overall, no significant difference was observed in
the primary outcome between TAVR and SAVR (Incidence Rate Ratios [IRR]
1.00, 95% Confidence Interval [CI]: 0.88-1.13, p = 0.98). Meta-regression
did not find any association between key clinical covariates and the
primary outcome. Trial sequential analysis demonstrated that the extracted
sample size met the required information size, but a definitive treatment
effect was not confirmed. CONCLUSION(S): While TAVR shows an
advantage over SAVR at 1-year follow-up in women, all-cause mortality or
disabling stroke are similar in TAVR and SAVR at 5 years. Future studies
must include sex-disaggregated reporting of both primary and secondary
outcomes in order to comprehensively weigh risks and benefits of each
intervention and inform personalized treatment strategies. CLINICAL
REGISTRATION NUMBER: The study protocol was registered in PROSPERO
(CRD420251004394). Copyright © The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site-for
further informat

<89>
Accession Number
2041648509
Title
Evaluation of natriuresis-guided depletion after cardiac surgery: Protocol
for a single-centre, open-label, randomised controlled trial - The EASY-CS
study.
Source
BMJ Open. 15(10) (no pagination), 2025. Article Number: e108600. Date of
Publication: 06 Oct 2025.
Author
Beyls C.; Mollet N.; Gibert L.; Huette P.; Khamari M.; Meynier J.;
Abou-Arab O.; Mahjoub Y.
Institution
(Beyls, Mollet, Abou-Arab, Mahjoub) Chu Amiens-Picardie Pole Coeur Thorax
Vaisseaux, Amiens, France
(Gibert, Huette, Khamari) Centre Hospitalier Universitaire
Amiens-Picardie, Hauts-de-France, Amiens, France
(Meynier) Amiens-Picardy University Hospital, Hauts-de-France, Amiens,
France
Publisher
BMJ Publishing Group
Abstract
Introduction Fluid overload (FO) is a common complication following
cardiac surgery with cardiopulmonary bypass (CPB) and is associated with
increased morbidity and mortality. Loop diuretics, particularly
furosemide, are widely used to promote sodium and water excretion, but
their postoperative use remains largely empirical. International
guidelines recommend early assessment of diuretic response using spot
urinary sodium concentration, traditionally measured by automated
laboratory analysers. Recent advances now enable bedside measurement of
natriuresis using point-of-care (POC) urinary sodium sensors. This trial
aims to determine whether real-time bedside natriuresis monitoring using a
POC device can guide safer and more effective diuretic strategies in the
postoperative management of FO. Materials and methods The EASY-CS trial is
a prospective, single-centre, open-label, randomised controlled trial
designed to evaluate whether a natriuresis-guided furosemide titration
protocol improves diuresis within 48 hours following cardiac surgery with
CPB. A total of 102 adult patients undergoing elective cardiac surgery
with CPB and requiring postoperative intravenous (IV) furosemide for FO
will be randomised in a 1:1 ratio to either standard care (n=51;
furosemide titration based on clinical judgement) or a natriuresis-guided
arm (n=51), in which furosemide dosing is adjusted according to urinary
sodium concentration. All patients will receive an initial 20 mg dose of
IV furosemide. In the intervention group, urinary sodium will be measured
every 6 hours using a POC sodium sensor (LAQUAtwin Na + metre, Horiba,
Japan). If the spot urinary sodium is <70 mmol/L, the furosemide dose will
be doubled at the next administration, up to a maximum of 200 mg per
bolus. The primary endpoint is cumulative urine output at 48 hours
post-randomisation. Secondary outcomes include urinary sodium
concentration and urine output at 24 hours, natriuresis at 48 hours, and
the venous excess ultrasound score at 48 hours, as determined by
transthoracic echocardiography. The study will also assess total loop
diuretic dose administered, cumulative fluid balance over 48 hours and the
incidence of postoperative complications at day 30, including
cardiovascular, renal, respiratory and gastrointestinal events. Safety
endpoints include the presence of hypotension, hypokalaemia or acute
kidney injury before each diuretic administration. Randomisation will be
stratified by EuroSCORE II (<4% vs >=4%) and baseline serum creatinine
(<100 vs>=100 mumol/L). Recruitment has not yet started. Ethics and
dissemination Ethical approval has been obtained from the Institutional
Review Board (IRB) of Amiens University hospital (IRB-ID: 2025-A00925-44).
The study's results will be disseminated through peer-reviewed
publications and presentations at national and international conferences.
Trial registration number ClinicalTrials.gov Identifier:
NCT07077772. Copyright © Author(s) (or their employer(s)) 2025.

<90>
Accession Number
649172421
Title
Evidence for a clinically meaningful effect of no-touch harvesting
technique on vein graft patency - A Bayesian reanalysis of the SWEDEGRAFT
trial.
Source
European journal of cardio-thoracic surgery : official journal of the
European Association for Cardio-thoracic Surgery. (no pagination), 2025.
Date of Publication: 14 Nov 2025.
Author
Sartipy U.; Heuts S.; James S.K.
Institution
(Sartipy) Department of Cardiothoracic Surgery, Karolinska University
Hospital, Stockholm, Sweden
(Sartipy) Department of Molecular Medicine and Surgery, Karolinska
Institutet, Stockholm, Sweden
(Heuts) Department of Cardiothoracic Surgery, Maastricht University
Medical Centre, Maastricht, Netherlands
(Heuts) Cardiovascular Research Institute Maastricht (CARIM), Maastricht
University, Maastricht, Netherlands
(James) Uppsala Clinical Research Center, Uppsala University, Uppsala,
Sweden
(James) Department of Medical Sciences, Uppsala University Hospital,
Cardiology, Uppsala, Sweden

<91>
[Use Link to view the full text]
Accession Number
649172259
Title
Comparative Estimation of Long-Term Graft Patency Rates After Isolated
Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis.
Source
Cardiology in review. (no pagination), 2025. Date of Publication: 14 Nov
2025.
Author
Fredericks T.; Nasher N.; Pritting C.D.; Rahimov D.; Saxena A.; Slota P.;
Ahmad D.; Saran N.; Stulak J.M.; Tchantchaleishvili V.
Institution
(Fredericks, Nasher, Pritting, Rahimov, Saxena, Slota, Ahmad,
Tchantchaleishvili) From the Department of Cardiac Surgery, Thomas
Jefferson University, Philadelphia, PA, United States
(Ahmad) Department of Cardiothoracic Surgery, University of Pittsburgh
Medical Center, Pittsburgh, PA, United States
(Saran, Stulak) Department of Cardiac Surgery, Mayo Clinic, Rochester, MN,
United States
Abstract
We sought to characterize the long-term patency of various graft types in
patients undergoing coronary artery bypass grafting. A comprehensive
literature search identified 139 studies including 56,827 patients who
underwent isolated coronary artery bypass grafting surgery. The mean
patient age was 62 years (95% confidence interval: 60-63), and 80% (95%
confidence interval: 79-82) were male. Patency outcomes were analyzed for
each graft type, and parametric extrapolation was performed based on mean
patency and mean follow-up time per conduit. The left internal mammary
artery (LIMA) demonstrated the highest mean patency at 96% with a mean
follow-up of 3.2 years, followed by the right internal mammary artery
(RIMA) at 94% (2.8 years), gastroepiploic artery (GEA) at 93% (1.7 years),
and radial artery (RA) at 89% (3.7 years). The saphenous vein graft had
the lowest mean patency at 82% with a mean follow-up of 3.5 years.
Extrapolated 20-year patency rates were 77% for LIMA, 64% for RIMA, 54%
for RA, 42% for GEA, and 33% for saphenous vein graft. Arterial grafts
demonstrated superior long-term patency compared to vein grafts. LIMA
remains the primary conduit of choice, while RIMA, followed by RA and GEA,
may be appropriate secondary arterial conduits depending on
patient-specific factors. Vein grafts had the poorest long-term
patency. Copyright © 2025 Wolters Kluwer Health, Inc. All rights
reserved.

<92>
Accession Number
2041238671
Title
Outcomes of Early vs Delayed Aortic Valve Replacement.
Source
JACC: Cardiovascular Interventions. 18(22) (pp 2761-2773), 2025. Date of
Publication: 24 Nov 2025.
Author
Genereux P.; Schwartz A.; Pibarot P.; Lindman B.R.; Cohen D.J.; Oldemeyer
J.B.; Fearon W.F.; Babaliaros V.; Daniels D.; Chhatriwalla A.K.; Suradi
H.S.; Shah P.B.; Szerlip M.; Mack M.J.; Dahle T.; Goel K.; O'Neill W.W.;
Davidson C.J.; Makkar R.R.; Sheth T.; Williams M.; Russo M.J.; Guerrero
M.; McCabe J.; Leipsic J.; Zhao Y.; Hahn R.T.; Blanke P.; Leon M.B.
Institution
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Schwartz, Cohen, Hahn, Leon) Columbia University Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Pibarot) Department of Cardiology, Quebec Heart and Lung Institute, Laval
University, Quebec City, QC, Canada
(Lindman) Structural Heart and Valve Center, Vanderbilt University Medical
Center, Nashville, TN, United States
(Lindman, Goel) Division of Cardiovascular Medicine, Vanderbilt University
Medical Center, Nashville, TN, United States
(Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United
States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Oldemeyer) University of Colorado Health, Loveland, CO, United States
(Fearon) Interventional Cardiology Section, Division of Cardiovascular
Medicine, Department of Medicine, Stanford University School of Medicine,
Stanford, CA, United States
(Babaliaros) Emory School of Medicine, Atlanta, GA, United States
(Daniels) Division of Cardiology, California Pacific Medical Center, San
Francisco, CA, United States
(Chhatriwalla) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Suradi) Division of Cardiology, Rush University Medical Center, Chicago,
IL, United States
(Shah) Division of Cardiovascular Medicine, Brigham and Women's Hospital,
Boston, MA, United States
(Szerlip, Mack) Baylor Scott & White Heart Hospital, Plano, TX, United
States
(Dahle) CentraCare Heart & Vascular Center, St. Cloud, MN, United States
(O'Neill) Center for Structural Heart Disease, Henry Ford Health System,
Detroit, MI, United States
(Davidson) Northwestern University Feinberg School of Medicine, Chicago,
IL, United States
(Makkar) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles,
CA, United States
(Sheth) Population Health Research Institute, McMaster University and
Hamilton Health Sciences, Hamilton, ON, Canada
(Williams) New York University Langone Medical Center, New York, NY,
United States
(Russo) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Guerrero) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(McCabe) Division of Cardiology, University of Washington, Seattle, WA,
United States
(Leipsic, Blanke) St. Paul's Hospital and University of British Columbia,
Vancouver, BC, Canada
(Zhao) Edwards Lifesciences, Irvine, CA, United States
Publisher
Elsevier Inc.
Abstract
Background For patients with asymptomatic, severe aortic stenosis (AS),
the EARLY TAVR (Evaluation of TAVR Compared to Surveillance for Patients
With Asymptomatic Severe Aortic Stenosis) trial demonstrated that early
transcatheter aortic valve replacement (TAVR) was superior to clinical
surveillance (CS) with respect to the primary endpoint in the
intention-to-treat population. Objectives The aim of this study was to
compare postprocedural outcomes in the valve implant population. Methods
The valve implant population comprised patients randomized to early TAVR
who underwent the procedure and those randomized to CS who underwent
delayed aortic valve replacement (AVR). The impact of the clinical
presentation at time of delayed AVR was also assessed as progressive valve
syndrome (eg, NYHA functional class II) vs acute valve syndrome (AVS; eg,
NYHA functional class III or IV, syncope). The primary outcome was the
composite of death, stroke, or heart failure hospitalization 2 years
postprocedure. Results Across 75 sites, 97.6% of early TAVR patients (444
of 455) underwent the index procedure, and 87.0% of CS patients (388 of
446) underwent delayed AVR through 5 years; 39.2% presented with AVS and
58.5% with progressive valve syndrome (median time to delayed AVR 11.1
months). Early TAVR demonstrated a benefit compared with delayed AVR for
the primary composite (adjusted HR [aHR]: 0.61; 95% CI: 0.38-0.99; P =
0.045). When examined by clinical presentation, delayed AVR with AVS was
significantly associated with worse outcomes compared with early TAVR
(aHR: 2.12; 95% CI: 1.19-3.78; P = 0.01), driven largely by stroke (aHR:
2.92; 95% CI: 1.26-6.76; P = 0.01). Conclusions Among patients with
asymptomatic, severe AS, delayed AVR with AVS is associated with higher
rates of death, stroke, or heart failure hospitalization compared with
early TAVR, highlighting a benefit for early TAVR before symptoms develop
given the unpredictability of AS progression. (Evaluation of TAVR Compared
to Surveillance for Patients With Asymptomatic Severe Aortic Stenosis
[EARLY TAVR]; NCT03042104 ) Copyright © 2025 American College of
Cardiology Foundation.

<93>
Accession Number
649145774
Title
PHYSIOLOGY-GUIDED COMPLETE REVASCULARIZATION in OLDER PATIENTS with
MYOCARDIAL INFARCTION and COMPLEX NON-CULPRIT LESION: A FIRE TRIAL
SUBANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: GISE 2025 National Congress.
Milan Italy. 26(10 Supplement 1) (pp e1), 2025. Date of Publication: 01
Oct 2025.
Author
Sarti A.; Erriquez A.; Passo B.D.; Casella G.; Guiducci V.; Moreno R.;
Escaned J.; Marchini F.; Cocco M.; Maria Verardi F.; Clo S.; Caglioni S.;
Farina J.; Barbato E.; Campo G.; Biscaglia S.
Institution
(Sarti, Erriquez, Passo, Campo, Biscaglia) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
(Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy
(Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio
Emilia, Italy
(Moreno) Hospital Universitario la Paz, Madrid, Spain
(Escaned) Hospital Clinico San Carlos, Madrid, Spain
(Marchini, Cocco, Maria Verardi, Clo, Caglioni, Farina) Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
(Barbato) Sapienza University of Rome, Roma, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction The Functional Assessment in Elderly MI Patients With
Multivessel Disease (FIRE) randomized clinical trial showed that
physiology-guided complete revascularization was superior as compared to
culprit-only strategy in older (>=75 years) with multivessel disease
patients admitted to hospital for myocardial infarction (MI). Older MI
patients tend to have more complex coronary artery disease (CAD) as
compared to younger ones. Accordingly, it would be interesting to
understand if the benefit of physiology-guided complete revascularization
was consistent across simple and complex CAD. The aim of the present
analysis is to investigate if the benefit of physiology-guided complete
revascularization vs a culprit only strategy was consistent in patients
with complex non-culprit lesion (NCL). Methods This was a sub-analysis of
the Functional Assessment in Elderly MI Patients With Multivessel Disease
(FIRE) randomized clinical trial data. FIRE was an investigator-initiated,
open-label, multicenter trial. Patients 75 years or older with MI and
multivessel disease were enrolled at 34 European centers from July 2019
through October 2021. Patients were randomized to receive either
physiology-guided complete or culprit-only revascularization. For the
scope of the present analysis, patients were divided into patients having
at least one NCL meeting CHIP criteria vs others. CHIP criteria of
interest were: angiographic heavy calcification, true bifurcation lesions
involving side-branches >2.5mm, in-stent restenosis, long-lesions
(estimated stent length > 28mm), being left main disease and chronic total
occlusion exclusion criteria. The primary endpoint was the 3-year
occurrence of all-cause mortality, stroke, reinfarction or ischemia-driven
revascularization. Secondary endpoints were the singular components of the
primary endpoint. Results Among 1445 patients, 641 (44%) patients had at
least one NCL meeting CHIP criteria. At univariate analysis patients with
complex NCL were at higher risk for the primary end point (hazard ratio
[HR], 1.29; 95% Cl, 1.05-1.58; p = 0.013), cardiovascular death or MI (HR,
1.41; 95% CI, 1.07-1.85; p = 0.013), MI or ischemia-driven coronary
revascularization at 3 years [(HR, 2.37; 95% CI, 1.47-3.82; p < 0.001),
(HR, 2.26; 95% CI, 1.45-3.51; p < 0.001) respectively]. After adjustment
for potential confounding factors, patients with at least one complex NCL
remained at higher risk of MI and ischemia-driven coronary
revascularization at 3 years. No signal of interaction was noted between
revascularization strategy and presence of at least one complex NCL for
the primary endpoint. On the contrary, we observed significant interaction
between randomization arm and complex NCL in terms of secondary endpoint
MI and ischemia-driven revascularization. Physiology-guided complete
revascularization as compared with culprit-only strategy reduced the risk
of MI at 3 years significantly only in patient with complex NCL (p for
interaction 0.021). Physiology-guided complete revascularization as
compared with culprit-only strategy reduced the risk of ischemia-driven
coronary revascularization at 3 years significantly in patient with
complex NCL (p for interaction 0.0002). Conclusions Complex coronary
anatomy status is frequent among older patients with Ml, significantly
increasing the likelihood of adverse events. Physiology guided complete
revascularization emerges as an effective strategy, in comparison with
culprit-only revascularization, for mitigating adverse events in patients
having NCL meeting CHIP criteria, in particular reducing MI and
ischemia-driven coronary revascularization.

<94>
Accession Number
2041209413
Title
Left Atrial Appendage Occlusion Using the Amplatzer Amulet Device in
High-Risk Patients With Atrial Fibrillation Undergoing Transcatheter
Aortic Valve Intervention: A Randomized Pilot Study.
Source
Structural Heart. 9(12) (no pagination), 2025. Article Number: 100735.
Date of Publication: 01 Dec 2025.
Author
Jakob P.; Heinz P.; Gong Y.; Chen M.; Binder R.K.; Held U.; Taramasso M.;
Paneni F.; Schuetz P.; Haager P.K.; Kasel M.; Pedrazzini G.; Windecker S.;
Moccetti M.; Pilgrim T.; Luscher T.F.; Stahli B.E.; Nietlispach F.
Institution
(Jakob, Gong, Chen, Paneni, Kasel, Stahli) Department of Cardiology,
University Heart Center, University Hospital Zurich and the Center for
Translational and Experimental Cardiology (CTEC), University of Zurich,
Zurich, Switzerland
(Heinz, Held) Department of Biostatistics at Epidemiology, Biostatistics
and Prevention Institute, University of Zurich, Zurich, Switzerland
(Binder) Department of Cardiology and Intensive Care, Klinikum Wels, Wels,
Austria
(Taramasso) Clinic of Cardiac Surgery, HerzZentrum Hirslanden Zurich,
Zurich, Switzerland
(Schuetz) Division of General Internal and Emergency Medicine, Medical
University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
(Haager) HOCH Cantonal Hospital St. Gallen, Department of Cardiology, St.
Gallen, Switzerland
(Pedrazzini, Moccetti) Cardiology Department, Cardiocentro Ticino, Lugano,
Switzerland
(Windecker, Pilgrim) Department of Cardiology, Inselspital, University of
Bern, Bern, Switzerland
(Luscher) Center for Molecular Cardiology, University of Zurich,
Schlieren, Switzerland
(Luscher) Royal Brompton and Harefield Hospitals and King's College and
Imperial College, London, United Kingdom
(Nietlispach) Cardiovascular Center Zurich, Heart Center im Park, Zurich,
Switzerland
Publisher
Cardiovascular Research Foundation
Abstract
Background Patients with severe aortic stenosis and atrial fibrillation
(AF) undergoing transcatheter aortic valve intervention (TAVI) are at
increased risk of bleeding and cerebrovascular events. This
investigator-initiated, randomized, multicenter, open-label pilot study
assessed left atrial appendage occlusion (LAAO) in patients with AF
undergoing TAVI. Methods Patients were randomly assigned to LAAO (TAVI +
LAAO) or standard medical therapy (SMT) (TAVI + SMT). The primary endpoint
was a composite of cerebrovascular events, peripheral embolism,
life-threatening/disabling/major bleeding, or cardiovascular mortality at
1 year. A sensitivity analysis was performed in the per-protocol
population. Results Eighty-one patients (Society of Thoracic Surgeons
score: 9.0% +/- 5.4%) were enrolled. The primary endpoint occurred in 13
patients (33%) in the TAVI + LAAO group and in 15 patients (37%) in the
TAVI + SMT group (adjusted odds ratio [OR], 0.87; 95% CI: 0.32-2.29, p =
0.77). Bleeding rates were comparable between TAVI + LAAO (13%) and TAVI +
SMT (17%), with absent nonprocedural bleeding in the TAVI + LAAO group and
5 gastrointestinal bleedings in TAVI + SMT, and cerebrovascular events did
not significantly differ between groups (10% in TAVI + LAAO vs. 2.4% in
TAVI + SMT). In the per-protocol analysis, occurrence of the primary
endpoint was comparable between groups (adjusted OR, 0.55; 95% CI:
0.18-1.56, p = 0.27) with cerebrovascular events in 5.6% and 2.4%, and
bleeding events in 8.3% and 17% for TAVI + LAAO and TAVI + SMT,
respectively. Conclusions This pilot study suggests that among high-risk
patients with AF undergoing TAVI, a strategy of a combined procedure with
LAAO and early cessation of oral anticoagulation overall showed similar
rates of the primary end point as compared to a single TAVI procedure
(NCT03088098). Copyright © 2025 .

<95>
[Use Link to view the full text]
Accession Number
649142136
Title
Airway management in thoracic anesthesia in the light of the guidelines of
EACTAIC-thoracic group: what is next?.
Source
Current opinion in anaesthesiology. (no pagination), 2025. Date of
Publication: 22 Oct 2025.
Author
Granell Gil M.; Martinez Plumed R.
Institution
(Granell Gil) Surgery Department, University of Valencia, Consorcio
Hospital General Universitario of Valencia, Valencia, Spain
Abstract
PURPOSE OF REVIEW: This article reviews the latest literature and
discusses future guidance on airway management in thoracic surgery. RECENT
FINDINGS: It has been recommended for the preoperative assessment to use
validated scales such as the Airway Risk Index combined with tools for
predicting difficult lung isolation, especially in patients with chronic
obstructive pulmonary disease, endobronchial tumors, or tracheal
pathology. Preoperative imaging plays a crucial role in predicting and
planning lung isolation in thoracic anesthesia, with computed tomography
(e.g. three-dimensional reconstructions and virtual bronchoscopy) being
very useful for identifying airway abnormalities and guiding the selection
of appropriate lung isolation devices. One of the most reliable methods to
achieve lung collapse with a bronchial blocker is the apnea-disconnection
for improvate nonventilated lung collapse. Recent studies suggest that the
adoption of videolaryngoscopes in thoracic surgery procedures involving
double-lumen endotracheal intubation may enhance patient safety and
outcomes by reducing the incidence of malpositioned tubes. In addition,
the development of double-lumen tubes with integrated cameras enables
real-time visualization of tube positioning, a growing trend that may
partially replace conventional bronchoscopy. SUMMARY: The field of airway
management is constantly evolving, with new technologies and techniques
emerging regularly, improving patient safety, reducing the risk of
complications, and enhancing surgical conditions. Copyright ©
2025 Wolters Kluwer Health, Inc. All rights reserved.

<96>
Accession Number
649142706
Title
Identifying Paediatric Populations with Increased Risk for Oropharyngeal
Dysphagia in Acute and Critical Care Settings: A Scoping Review.
Source
Dysphagia. Conference: 33rd Meeting of the Dysphagia Research Society.
Philadelphia, PA United States. 40(Supplement 1) (pp S19-S20), 2025. Date
of Publication: 01 Oct 2025.
Author
Grunke C.; Marshall J.; Miles A.; Carrigg B.; Ward E.C.
Institution
(Grunke, Marshall, Ward) University of Queensland, Brisbane, Australia
(Marshall) Children's Health Queensland, Brisbane, Australia
(Miles) University of Auckland, New Zealand
(Carrigg) Royal Children's Hospital, Melbourne, Australia
(Ward) Centre for Functioning and Health Research (CFAHR), Brisbane,
Australia
Publisher
Springer
Abstract
Purpose: Oropharyngeal dysphagia is commonly observed in hospitalised
children. Despite this, clarity regarding its prevalence is required to
direct service needs in this area. This scoping review reports prevalence
of oropharyngeal dysphagia amongst paediatric populations admitted to
acute and/or critical care wards, following an acute illness, medical or
surgical intervention. It also explores characteristics associated with
increased oropharyngeal dysphagia risk in these settings. Method(s):
Five electronic databases (EMBASE, Cinahl, Cochrane, PubMed, Scopus) were
searched. Studies identified for inclusion involved children (0-16 years)
in acute or critical care settings where prevalence data for new onset or
worsening oropharyngeal dysphagia was reported. Peer reviewed journal
articles including systematic reviews were included. Data was extracted
and synthesised using a purpose-designed extraction tool. Result(s):
A total of 7,522 studies were screened after duplicate removal and 67
studies met criteria. The most researched populations included congenital
heart disease surgeries, posterior fossa tumour resections, stroke, and
post-extubation dysphagia. Populations with the highest documented
oropharyngeal dysphagia prevalence were children after posterior fossa
tumour resection with a new tracheostomy, children using nasal continuous
positive airway pressure, and children following ischemic stroke.
Characteristics significantly associated with oropharyngeal dysphagia were
younger age, lower weight, longer intubation, upper/middle airway
dysfunction (e.g., vocal fold paresis), and presence of additional
comorbidities (e.g., congenital/neurological conditions).
 Conclusion(s): This review presents synthesised prevalence data for
children in acute and critical care settings with new onset or worsening
oropharyngeal dysphagia. It highlights the broad nature of oropharyngeal
dysphagia in hospitalised children and the need for more rigorous research
into characteristics associated with increased risk to better support
screening and early identification of oropharyngeal dysphagia in these
settings.

<97>
Accession Number
2041613608
Title
Percutaneous femoral access closure and prognosis following transcatheter
aortic valve replacement: A systematic review and meta-analysis.
Source
Journal of Vascular Access. (no pagination), 2025. Date of Publication:
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
Publisher
SAGE Publications Ltd
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.
 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.
 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). 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. Copyright ©
The Author(s) 2025. This article is distributed under the terms of the
Creative Commons Attribution-NonCommercial 4.0 License
(https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access pages
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<98>
Accession Number
649142568
Title
Comparing the Incidence and Extent of Post-Induction Hypotension between
Titration and Conventional Induction with Propofol TCI in Adults
Undergoing Non-Cardiac Surgery-a Retrospective Cohort Study.
Source
Swiss Medical Weekly. Conference: Swiss Society for Anaesthesiology and
Perioperative Medicine, SSAPM and the Swiss Association for Anaesthesia
Care, SIGA/FSIA. Lausanne Switzerland. 155(Supplement 292) (pp 4S), 2025.
Date of Publication: 01 Oct 2025.
Author
Gaberdiel A.P.; Zabret P.; Steiner L.A.; Lohri M.D.; Dell-Kuster S.
Institution
(Gaberdiel, Zabret, Steiner, Lohri, Dell-Kuster) Clinic for
Anaesthesiology, University Hospital Basel, Basel, Switzerland
(Gaberdiel, Steiner, Lohri, Dell-Kuster) University of Basel, Basel,
Switzerland
(Gaberdiel, Steiner, Lohri, Dell-Kuster) Department of Clinical Research,
University Hospital Basel, Basel, Switzerland
(Dell-Kuster) Epidemiology, Biostatistics and Prevention Institute,
University of Zurich, Zurich, Switzerland
Publisher
SMW supporting association
Abstract
Background: Hypotension is the most common side effect of propofol and is
more pronounced at high plasma concentra-tions, particularly in elderly
patients. The aim of this study was to investigate whether this side
effect can be reduced through individualised drug titration.
 Method(s): This retrospective cohort study included patients
un-dergoing planned, non-cardiac surgery at the University Hospi-tal Basel
from February 2022 to December 2024. Both groups used target-controlled
infusion (TCI) for propofol (Schnider model) and for remifentanil (Minto
model). The titrated group received an anaesthesia induction with a
stepwise increase of the propofol target effect site concentration (Cet)
by 0.5-1(2) ug/ml until loss of consciousness, whereas the conventional
group received a high starting Cet of 4-8 ug/ml. To create a balanced
dataset, surgical disciplines were frequency-matched between the two
groups. Using a two-sample t-test, the area under the individual
pre-induction threshold of the mean arte-rial pressure (MAP) as well as
the MAPs maximum decrease were compared between both groups as a primary
and first secondary endpoint, respectively. The final multivariable
re-gression analysis still needs to be performed. Preliminary Results: In
this preliminary analysis of 345 patients, 168 (49%) received a titrated
and 177 (51%) a conventional an-aesthesia induction. Most baseline
characteristics such as age, with a median of 54 years (IQR: 41-68) in the
titration group and 53 years (IQR: 38-64) in the conventional group as
well as BMI, gender and cardiovascular comorbidities were comparable.
However, there were fewer ASA II and more ASA III patients in the
titration group (83 (49%) and 71 (42%)) than in the conven-tional group
(110 (62%) and 54 (31%)). In the still unadjusted analysis, the area under
the threshold of the MAP was found to have significantly decreased in the
titration group with a mean difference (SD) of 68.0 (30.3) mmHg*min
(95%-CI: 8.4 to 127.6 mmHg*min; p = 0.025). However, the maximum decrease
of the MAP was found to be only insignificantly smaller in the titrated
group with a mean difference (SD) of 1.5 (1.3) mmHg (95%-CI:-1.0 to 3.9
mmHg, p = 0.241). Additionally, fewer patients re-ceived vasoactive drugs
in the titration group 69 (41%) than in the conventional group 79 (45%).
 Conclusion(s): The titration approach resulted in a reduction of the
area under the threshold of the MAP and thereby is a prom-ising
alternative to conventional induction techniques.

<99>
Accession Number
649145852
Title
OMEGA LAA OCCLUDER for TINY LEFT ATRIAL APPENDAGES: A EUROPEAN MULTICENTER
CASE SERIES.
Source
Giornale Italiano di Cardiologia. Conference: GISE 2025 National Congress.
Milan Italy. 26(10 Supplement 1) (pp e31), 2025. Date of Publication: 01
Oct 2025.
Author
Tumminello G.; Barbieri L.; Federico Mallardi G.P.; Pellegrini D.;
Sacchetta D.; Guarracini S.; Piccaluga E.; Fassini G.; Cereda A.; Colombo
F.; Gobbi C.; Mircoli L.; Ruscica M.; Carugo S.
Institution
(Tumminello, Barbieri, Federico Mallardi, Colombo, Gobbi, Mircoli, Carugo)
Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca'
Granda Ospedale Maggiore Policlinico, Milano, Italy
(Pellegrini) Cardiology Division, IRCCS Ospedale Galeazzi sant'Ambrogio,
milano, Italy
(Sacchetta) Department of Cardiology, Asl 03 Abruzzo, Pescara, Italy
(Guarracini) Department of Cardiology, Pierangeli Hospital, Pescara, Italy
(Piccaluga) Cardiology i, 'A.de Gasperis' Department, Niguarda Ca' Granda
Hospital, milano, Italy
(Fassini) Dept. of Clinical Electrophysiology Cardiac Pacing Heart Rhythm
Center at Monzino Cardiac Center, Irccs, milano, Italy
(Cereda) Asst Santi Paolo e Carlo, Milano, Italy
(Ruscica) Department of Pharmacological and Biomolecular Sciences rodolfo
Paoletti, Universita Degli Studi di Milano, Milano, Italy
(Carugo) Department of Clinical Sciences and Community Health, Universita
Degli Studi di Milano, Milano, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction: Left atrial appendage (LAA) occlusion is an interventional
technique used to prevent ischemic strokes in patients with atrial
fibrillation and a contraindication for oral anticoagulation. Current left
atrial appendage occlusion devices do not fit all anatomical variations of
the left atrial appendage. The Omega left atrial appendage occluder is a
highly conformable device, which can occlude LAAs with a minimum landing
zone diameter as small as 10.5 mm. Our registry aimed to determine if very
small LAAs, with a landing zone <10.5 mm, which is below the recommended
size for most LAA occluders, including Omega, can be safely closed.
 Method(s): This multicentre retrospective registry involved 10
patients from seven European centres between May 2023 and July 2024. All
patients had atrial fibrillation with an indication for left atrial
appendage occlusion and a minimum LAA diameter less than 10.5 mm. The
primary endpoint was to assess the safety and efficacy of the procedure,
while secondary endpoints included complete left atrial appendage closure,
absence of embolization, and incidence of stroke during follow-up.
 Result(s): The Omega device was successfully implanted, without
complications, and achieved complete left atrial appendage closure without
significant peri-device leak in all patients. No events occurred within 7
days post implant. Similarly, at an average follow-up of 130 +/- 69 days,
there were no device embolization, thrombosis, thromboembolic events,
major bleedings or deaths. Conclusion(s): The registry suggest that
Omega left atrial appendage occluder may be safely and effectively
utilized in patients with very small left atrial appendages, offering a
viable alternative for stroke prevention in atrial fibrillation; further
prospective, randomized, controlled studies are needed to confirm and
support these data.

<100>
Accession Number
2041613640
Title
Operative outcomes following robotic-assisted and conventional minimally
invasive mitral valve surgery: A meta-analysis of propensity-matched
studies.
Source
Asian Cardiovascular and Thoracic Annals. (no pagination), 2025. Article
Number: 02184923251394563. Date of Publication: 2025.
Author
Santos K.; Consoli L.; de Oliveira L.G.A.M.; Donaldy W.; Plonek T.
Institution
(Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum
Twente, Enschede, Netherlands
(Santos) School of Medicine, New Vision University, Tbilisi, Georgia
(Consoli, de Oliveira) Federal University of Bahia, Salvador, Brazil
(Donaldy) New York City Health and Hospitals, New York City, NY, United
States
Publisher
SAGE Publications Inc.
Abstract
Background: Robotic-assisted mitral valve surgery (RAMVS) has emerged as
an alternative to conventional minimally invasive mitral valve surgery
(MIMVS). However, previous studies have been limited by small sample
sizes, heterogeneous techniques and reliance on unmatched or indirectly
compared cohorts, resulting in inconclusive evidence. This meta-analysis
focuses exclusively on propensity-matched studies to provide a more robust
comparison of RAMVS and MIMVS. Method(s): A comprehensive literature
search was performed to identify propensity-matched studies comparing
RAMVS and MIMVS. Pooled odds ratios (ORs) and mean differences (MDs) with
95% confidence intervals (CIs) were calculated using RevMan 8.13.0.
Subgroup analyses, including mitral valve repair only, non-isolated mitral
valve surgery and MIMVS via right minithoracotomy, were conducted to
explore heterogeneity. Result(s): Eight studies comprising 3352
patients were included, with 1578 (47.1%) undergoing RAMVS. The RAMVS was
associated with a shorter hospital stay (MD -1.8 days; 95% CI -3.0 to
-0.5; p = 0.006) but significantly longer cardiopulmonary bypass time (MD
21.8 min; 95% CI 0.8-42.9; p = 0.04), and higher odds of conversion to
sternotomy (OR 2.9; 95% CI 1.6-5.4; p = 0.0007) and re-exploration for
bleeding (OR 1.86; 95% CI 1.1-3.2; p = 0.02). Intensive care unit stay,
operative time and postoperative complications were comparable. All
subgroup analyses consistently showed higher conversion rates with RAMVS.
 Conclusion(s): The RAMVS offers potential recovery benefits but at
the cost of greater intraoperative complexity. Careful patient selection
and technical expertise are essential to maximise outcomes. Copyright
© The Author(s) 2025

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