EPICORE Embase Updates: 2026

Total documents retrieved: 152 Results Generated From: Embase <1980 to 2026 Week 30> Embase Weekly Updates (updates since 2026-07-17) - (152 records) <1> Accession Number 2046150005 Title Postoperative pericardial effusion on routine echocardiography: A review of incidence, progression, and management: To dissolve or to be resolved. Source Netherlands Heart Journal. 34(7-8) (pp 254-264), 2026. Date of Publication: 01 Aug 2026. Author van Dinter S.; Wollersheim L.; Li W.; Donders R.; van Royen N.; Dieker H.-J.; Verhagen A. Institution (van Dinter, Li, Verhagen) Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Wollersheim) Department of Cardiothoracic Surgery, Frisius Medical Center, Leeuwarden, Netherlands (Donders) Department for Health Evidence, Section Biostatistics, Radboud Institute of Health Sciences, Radboud University Medical Center, Nijmegen, Netherlands (van Royen, Dieker) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands Publisher Bohn Stafleu van Loghum Abstract Postoperative pericardial effusion (PPE) is a common finding after cardiac surgery, with reported incidences ranging widely from 2% to 85%. While most effusions resolve spontaneously, a subset progresses to cardiac tamponade requiring urgent intervention. This systematic review evaluated the true incidence of PPE and PPE-related reinterventions based on routine echocardiographic screening, and explored temporal evolution, symptomatology, and perioperative risk factors. A comprehensive search of Embase, PubMed, and Web of Science through May 2025 identified 26 eligible studies including 8,495 patients. Data extraction followed PRISMA guidelines and quality assessment with the JBI checklist. Random-effects meta-analysis demonstrated a pooled PPE incidence of 36% (95% confidence interval (CI) 25-49%), whereas only 3% (95% CI 2-4%) required reintervention, ranging from 2% after CABG to 6% after aortic surgery. Large effusions (> 2 cm) were associated with a substantially higher likelihood of intervention (54% [14-90%]), although spontaneous resolution remained common. Preventive strategies such as posterior pericardiotomy and posterior chest tube placement significantly reduced both PPE incidence and reintervention rates. Despite these findings, interpretation is limited by substantial heterogeneity in study design, definitions, and follow-up protocols. Standardized definitions, structured echocardiographic follow-up, and prospective studies are needed to improve risk stratification and guide clinical decision-making. Copyright © The Author(s) 2026. <2> Accession Number 2046501984 Title Perioperative Management: HeartMate 3 Left Ventricular Assist Devices in Non-Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2544-2556), 2026. Date of Publication: 01 Aug 2026. Author O'Callaghan L.; Walsh D.; Mulligan D.; Merdad M.; Luk A.; Billia F.; Rao V.; Wasowicz M.; Griffin M.; Efrimescu C. Institution (O'Callaghan, Walsh, Mulligan, Griffin, Efrimescu) Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland (Merdad, Luk, Billia, Rao, Wasowicz) Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, Canada (Luk, Billia, Rao, Wasowicz) University of Toronto, Toronto, Canada (Griffin) School of Medicine, University College Dublin, Dublin, Ireland Publisher W.B. Saunders Abstract The HeartMate 3 (HM3) left ventricular assist device is currently the most widely used left ventricular assist device worldwide. Advances in technology have enabled its use both as a bridge to transplant and as destination therapy. The HM3's fully magnetically levitated rotor, wider blood flow pathways, and artificial pulse technology have significantly improved hemocompatibility and reduced the incidence of pump thrombosis, stroke, and gastrointestinal bleeding. As a result, the HM3 offers greater durability and fewer complications than its predecessors. With the growing disparity between organ availability and transplant demand, anesthesiologists are increasingly likely to encounter patients supported by HM3 devices in both cardiac and non-cardiac surgical settings. A thorough understanding of the HM3's function, physiological implications, and potential perioperative complications is essential for safe anesthetic management. This narrative review explores the underlying physical principles of the HM3, key technical parameters necessary for monitoring device function, and perioperative management strategies. Topics include multidisciplinary team coordination, anesthetic approach and monitoring, relevant cardiac physiology, and the management of common emergencies. Although cardiac anesthesiologists are ideally suited to manage these complex cases, this may not always be possible. Therefore, it is imperative that all anesthesiologists, particularly those practicing in mechanical circulatory support centers-develop a comprehensive understanding of the HM3 system. Copyright © 2026 <3> Accession Number 2044198298 Title Early Versus Late Extubation After Pediatric Cardiac Surgery: A Systematic Review and Meta-analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2571-2580), 2026. Date of Publication: 01 Aug 2026. Author Alkhatip A.A.A.M.M.; Mills K.E.; Akram A.; Farag E.; Hamza M.K.; Abdelkader M.; Bahr M.; ELEmady M.F.M.; Hosny H.; Sallam A.; Farag A.M.G.; Wagih M. Institution (Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom (Alkhatip, Farag, Abdelkader, Bahr) Department of Anesthesia, Pain Management and Surgical Intensive Care, Beni-Suef University Hospital and Faculty of Medicine, Beni Suef University, Beni Suef, Egypt (Mills) Department of Science and Technology, University of Canberra, Canberra, ACT, Australia (Akram) Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan (Hamza, ELEmady, Hosny, Wagih) Department of Anesthesia, Kasr Al Ainy Faculty of Medicine and Cairo University Hospitals, Cairo University, Cairo, Egypt (Hosny) Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, United Kingdom (Sallam) Department of Anaesthesia, St. Vincent's University Hospital, Dublin, Ireland (Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City, Makkah Mukarramah, Saudi Arabia Publisher W.B. Saunders Abstract Early extubation after pediatric cardiac surgery has been increasingly adopted as part of fast-track and enhanced recovery pathways, but its association with postoperative outcomes remains uncertain. The authors conducted a systematic review and meta-analysis of studies comparing early extubation (defined as extubation in the operating room or within 24 hours postoperatively) versus delayed extubation after pediatric cardiac surgery. Electronic databases were searched from inception through April 2024. Random-effects models were used to pool effect estimates for mortality, reintubation, and length-of-stay outcomes. Prespecified subgroup and sensitivity analyses were performed. Twenty-eight studies, including 37,995 children, were analyzed. Early extubation was associated with lower in-hospital mortality (odds ratio, 0.19; 95% confidence interval, 0.14-0.25); however, absolute mortality rates were low, and this association was vulnerable to confounding by indication and preferential selection of clinically stable patients for early extubation. Early extubation was also associated with lower reintubation rates and shorter intensive care unit and hospital lengths of stay. Associations were more consistent among older children than among neonates. In this predominantly observational evidence base, early extubation should be interpreted primarily as a marker of patient stability and institutional practice rather than a proven intervention that reduces mortality. Given the low to very low certainty of evidence, these findings are hypothesis-generating and may inform quality-improvement initiatives and future prospective studies, rather than definitive clinical guidance. Copyright © 2026 Elsevier Inc. <4> Accession Number 2047402647 Title Dexmedetomidine for the prevention of postoperative atrial fibrillation: A systematic review and meta-analysis. Source Journal of International Medical Research. 54(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Chen Y.-J.; Xu S.-S.; Shen Q.-H.; Yu D.-H. Institution (Chen) Department of Anesthesiology, Sir Run Run Shaw Hospital Affiliated with the Zhejiang University, China (Xu, Shen, Yu) Department of Anesthesiology, Affiliated Hospital of Jiaxing University, China Publisher SAGE Publications Ltd Abstract Objective: Postoperative atrial fibrillation, a prevalent complication following cardiac surgery, significantly increases patient morbidity and healthcare expenditures. Although dexmedetomidine has been proposed as a potential strategy to mitigate the risk of postoperative atrial fibrillation risk, existing evidence from randomized controlled trials has shown conflicting results. Method(s): To evaluate the efficacy of perioperative dexmedetomidine in adult cardiac surgery patients, we conducted a systematic search across four major electronic databases: (a) PubMed; (b) Embase; (c) the Cochrane Library; and (d) Web of Science. Our search sought all relevant randomized controlled trials on this specific intervention and patient population. We utilized random-effects models to synthesize treatment effects, expressed as risk ratios with 95% confidence intervals. Furthermore, trial sequential analysis and the Grading of Recommendations Assessment, Development, and Evaluation framework were applied to determine the robustness and certainty of the evidence, respectively. Result(s): Our analysis included 22 randomized controlled trials, involving a total of 4063 patients. Dexmedetomidine administration significantly lowered the risk of postoperative atrial fibrillation risk compared with control groups (risk ratio 0.80, 95% confidence interval: 0.70-0.93; I2 = 28%). Subgroup analysis specifically indicated a significant reduction in postoperative atrial fibrillation risk in placebo-controlled trials, while no notable difference was observed when dexmedetomidine was compared with other active sedative agents. In addition, dexmedetomidine was associated with a reduced risk of postoperative delirium (risk ratio 0.62, 95% confidence interval: 0.44-0.87; I2 = 56%). Conclusion(s): Perioperative dexmedetomidine appears to reduce the risk of both postoperative atrial fibrillation risk and delirium in adult cardiac surgery patients, particularly compared with placebo. However, its efficacy relative to alternative active prophylactic agents remains unclear, necessitating rigorous comparative effectiveness trials. Copyright © The Author(s) 2026. 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 page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <5> Accession Number 2047105843 Title Contemporary approach and key considerations to asymptomatic aortic stenosis treatment. Source Expert Review of Cardiovascular Therapy. 24(7) (pp 569-576), 2026. Date of Publication: 2026. Author Banovic M.; Iung B. Institution (Banovic) Belgrade Medical School, University of Belgrade, Belgrade, Serbia (Banovic) Cardiology Department, University Clinical Center of Serbia, Belgrade, Serbia (Iung) Cardiology Department, Bichat Hospital, APHP, INSERM LVTS1148, Universite Paris-Cite, Paris, France Publisher Taylor and Francis Ltd. Abstract Introduction: Aortic stenosis (AS) is the most common and the deadliest valvular disease. The treatment of asymptomatic patients with severe AS remains a subject of investigation. Recently, ESC/EACTS guidelines for valvular diseases introduced a new indication for the treatment of asymptomatic low-risk patients with isolated high-gradient severe AS, as an alternative to clinical surveillance Area covered: This paper attempts to provide a rational, clinically oriented and evidence-based approach to the treatment of asymptomatic patients with high-gradient severe AS without additional adverse factors such as decrease in left ventricular systolic function or increase in natriuretic peptides. We searched for original and review papers through the PubMed database using the keywords: aortic stenosis, asymptomatic, risk stratification and intervention, without limiting the time period of the analyzed papers Expert opinion: The latest ESC/EACTS recommendations for the treatment of asymptomatic AS should be considered adequate. Considering differences in patient characteristics and heterogeneous treatment modalities, as well as differences in institutional-level outcomes, the optimal intervention strategy still needs clarification. Ongoing trials in asymptomatic patients with severe AS should provide significant new evidence. The diverse array of therapeutic options emphasizes the need for TAVI vs. SAVR randomized trial in middle-aged asymptomatic patients. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <6> Accession Number 2047189892 Title A Randomized Controlled Trial Comparing the TruSteer and FXD Double Curve Delivery Systems for Left Atrial Appendage Occlusion With the Watchman FLX Pro Device-The GUIDE-LAAO Study. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Taieb P.; Frazzetto M.; Teixeira P.S.; Filby S.J. Institution (Taieb, Frazzetto, Teixeira, Filby) Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Taieb) Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel Publisher John Wiley and Sons Inc Abstract Background: Deflectable delivery systems have been introduced to enhance coaxial alignment and procedural efficacy during left atrial appendage occlusion (LAAO), yet randomized comparisons with conventional fixed-curve systems are lacking. Aim(s): The GUIDE-LAAO trial evaluated whether the TruSteer deflectable delivery system is non-inferior to the FXD Double Curve (FXD DC) delivery system for procedural success in patients undergoing LAAO with the Watchman FLX Pro device. Method(s): In this prospective, randomized, all-comers trial, 50 patients with non-valvular atrial fibrillation undergoing LAAO were assigned 1:1 to TruSteer (n = 25) or FXD DC (n = 25). The primary endpoint was procedural success, defined as successful device implantation without major procedural or periprocedural complications. Secondary endpoints included technical success, device success, procedural efficiency, and safety outcomes. Result(s): Procedural success occurred in 100% of TruSteer-treated patients and 84% of FXD DC-treated patients (risk difference 16%; 95% confidence interval -6.9% to 34.7%), meeting criteria for non-inferiority; superiority was not demonstrated (p = 0.11). Technical and device success were 100% with TruSteer and 92% with FXD DC. Procedural time (34.6 +/- 7.1 vs. 36.5 +/- 13.0 min), fluoroscopy time (22.3 +/- 4.4 vs. 22.1 +/- 7.2 min), and contrast volume (34.5 +/- 12.1 vs. 36.8 +/- 13.5 mL) were similar. Periprocedural complications occurred in 4% and 16%, respectively, with no deaths or strokes. Conclusion(s): In this first randomized comparison of LAAO delivery systems, TruSteer was non-inferior to a standard fixed-curve system, with comparable efficiency and safety in an unselected population. These findings provide randomized evidence supporting deflectable delivery technology in contemporary LAAO practice and inform future studies in anatomically complex subsets. Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. <7> Accession Number 2047198918 Title Current Advances and Navigating the Complexities of SVG-PCI. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Attachaipanich T.; Virk H.U.H.; Khawaja M.; Alam M.; Krittanawong C. Institution (Attachaipanich) Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States (Virk) Division of Cardiovascular Disease, Case Western Reserve University, Cleveland, OH, United States (Khawaja) Department of Cardiology, Emory University, Atlanta, GA, United States (Alam) Texas Heart Institute and Baylor College of Medicine, Houston, TX, United States (Krittanawong) HumanX, DE, United States Publisher John Wiley and Sons Inc Abstract Saphenous vein graft (SVG) percutaneous coronary intervention (PCI) remains technically challenging and clinically high risk due to the friable, thrombus-rich nature of SVG lesions, which predispose to distal embolization, no-reflow, and periprocedural myocardial infarction (MI). The role of embolic protection devices in contemporary practice remains unclear. Although early randomized trials demonstrated significant reductions in periprocedural MI and no-reflow, contemporary observational studies and meta-analyses have not shown consistent clinical benefit. Similarly, while intracoronary imaging modalities provide detailed plaque characterization, their clinical application in guiding SVG-PCI remains unclear. Revascularization after prior coronary artery bypass grafting (CABG) requires individualized, multidisciplinary decision-making. Factors favoring PCI include a patent left internal mammary artery (IMA)-left anterior descending artery graft and suitable coronary anatomy, whereas redo-CABG may be preferred in patients with multiple failing grafts or complex anatomy in which an IMA conduit can be used. Although guidelines have historically favored native-vessel PCI when feasible, the only randomized trial comparing SVG-PCI with native-vessel PCI in a contemporary setting demonstrated that SVG-PCI may offer superior outcomes in certain patient populations, particularly when native coronary disease is complex, and the chronic total occlusion burden is high. Predictors of adverse outcomes have been identified across patient-, lesion-, and procedure-related characteristics; however, their integration into clinical decision-making is limited by the lack of validated risk-stratification tools. Future randomized studies in the contemporary PCI era are needed. Additionally, the integration of imaging technologies, together with artificial intelligence and machine-learning-enhanced risk prediction models, may help individualize patient selection and optimize procedural strategy. Copyright © 2026 Wiley Periodicals LLC. <8> Accession Number 2047104668 Title Approaches to transcatheter aortic valve replacement failure: is more focus on prevention required?. Source Expert Review of Cardiovascular Therapy. 24(7) (pp 593-607), 2026. Date of Publication: 2026. Author Androutsopoulou V.; Xanthopoulos A.; Zotos P.-A.; Athanasiou T.; Brecher V.; Magouliotis D.E. Institution (Androutsopoulou, Zotos) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Xanthopoulos) Department of Cardiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Brecher, Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Transcatheter aortic valve replacement (TAVR) has transformed the management of severe aortic stenosis across all surgical risk strata. As its use expands to younger, lower-risk patients, the durability of transcatheter heart valves and the clinical consequences of prosthetic failure have become critically important. Despite a growing literature on reintervention strategies, systematic prevention of TAVR failure remains comparatively underemphasized. Areas covered: We searched PubMed and the Cochrane Library (2000-2026, English language) for studies on TAVR failure and its prevention. This review examines the mechanisms of TAVR failure, including structural valve deterioration, paravalvular leak, prosthesis-patient mismatch, subclinical leaflet thrombosis, valve endocarditis, and device migration; appraises current management, including valve-in-valve TAVR, redo surgical aortic valve replacement, and medical therapy; and reviews prevention strategies spanning patient selection, procedural optimization, antithrombotic management, structural surveillance, coronary access preservation, and lifetime planning. Expert opinion: The evidence base has focused disproportionately on reintervention rather than prevention. Greater emphasis on structured lifetime management planning at index TAVR, individualized antithrombotic strategies, and evidence-based surveillance is needed. Several proposed measures, however, including routine anticoagulation for subclinical leaflet thrombosis and routine CT or artificial-intelligence-based surveillance, are not yet supported by outcome data and require prospective validation. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <9> [Use Link to view the full text] Accession Number 2046440364 Title Comparison of Intensive Versus Conventional Glycemic Control Targets: An Updated Systematic Review and Meta-Analysis of the 2024 Society of Critical Care Medicine Guidelines on Glycemic Control for Critically Ill Adults. Source Critical Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Sirimaturos M.; Honarmand K.; Long M.T.; Preiser J.-C.; Nagpal A.D.; Agus M.S.D.; Aldouhan J.; Bircher N.G.; Carpenter D.L.; Dearness K.; Farrington E.A.; Freire A.X.; Hirshberg E.L.; Irving S.Y.; Krinsley J.S.; Lanspa M.J.; Prager R.; Srinivasan V.; Umpierrez G.E.; Wax S.P.; Jacobi J. Institution (Sirimaturos) System Critical Care Pharmacy Services Leader, Houston Methodist Hospital, Houston, TX, United States (Honarmand) Division of Critical Care, Department of Medicine, Mackenzie Health, Vaughan, ON, Canada (Honarmand) GUIDE Canada, McMaster University, Hamilton, ON, Canada (Long) Department of Anesthesiology, Division of Critical Care, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States (Preiser) Department of Internal Medicine, Erasme University Hospital, Brussels, Belgium (Nagpal) Division of Cardiac Surgery and Critical Care Western, London Health Sciences Centre, London, ON, Canada (Agus) Harvard Medical School and Division Chief, Medical Critical Care, Boston Children's Hospital, Boston, MA, United States (Aldouhan) King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia (Bircher) Department of Nurse Anesthesia, School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States (Carpenter) Emory Critical Care Center, Atlanta, GA, United States (Dearness) HamiltonONCanada (Farrington) Pediatric Critical Care Pharmacist, New Hanover Regional Medical Center, Wilmington, NC, United States (Freire) Pulmonary Critical Care and Sleep Medicine at the University of Tennessee Health Science Center, Memphis, TN, United States (Hirshberg) Adult and Pediatric Critical Care Specialist, University of Utah School of Medicine, Salt Lake City, UT, United States (Irving) Department of Nursing and Clinical Care Services-Critical Care, University of Pennsylvania School of Nursing, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Krinsley) Emeritus, Vagelos Columbia University College of Physicians and Surgeons, Stamford Hospital, Stamford, CT, United States (Lanspa) Division of Critical Care, Intermountain Medical Center, Salt Lake City, UT, United States (Prager) Division of Critical Care, Western University, London, United Kingdom (Srinivasan) Departments of Anesthesiology, Critical Care and Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States (Srinivasan) Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Umpierrez) School of Medicine, Emory University, Atlanta, GA, United States (Wax) Queen's University, Kingston, ON, Canada (Jacobi) LebanonINUnited States Publisher Lippincott Williams and Wilkins Abstract Objectives: - To perform an updated systematic review and meta-analysis of the efficacy and safety of intensive (INT) vs. conventional (CONV) blood glucose (BG) targets for critically ill adults on insulin infusions. Data Sources: - We conducted a comprehensive search of Embase and OVID Medline databases from inception to October 16, 2023. We manually excluded studies published before 2000 due to potential lack of relevance as glycemic control in the ICU was not routinely practiced before 2000. Study Selection: - We included randomized controlled trials (RCTs) evaluating adult, critically ill patients on insulin infusions comparing INT vs. CONV targets for efficacy and safety outcomes. Data Extraction: - Data were screened and extracted with accuracy confirmed by a second reviewer. Study methodological characteristics, patient population, interventions, and outcome data were recorded. Studies without numerical outcomes were summarized as text statements. Data Synthesis: - Forty-five RCTs were included involving 32, 215 patients. No differences were seen between INT and CONV targets for hospital mortality or ICU mortality. INT targets were associated with lower ICU length of stay (LOS), infections, and critical illness polyneuropathy (CIP); however, INT targets demonstrated a 3.6-fold higher risk of severe hypoglycemia. Most of the studies with significant differences contained serious inconsistencies or risk of bias. In the subgroup analyses, INT targets demonstrated favorable neurologic outcomes in neurologic ICU patients, lower ICU LOS in mixed ICU patients, and lower ICU mortality in the cardiac surgery subgroup. Conclusion(s): - INT BG targets demonstrated mild to moderate improvements in several important morbidity secondary outcomes, including LOS, infections, and CIP, but were associated with a 3.6-fold higher risk of severe hypoglycemia. No differences were seen in ICU or hospital mortality. INT targets should not be routinely used over CONV targets when trying to minimize hypoglycemia as a marker of patient safety. However, as stated in the Society of Critical Care Medicine guidelines, a lower target within the INT range (110-140 mg/dL; 6.1-7.8 mmol/L) may be considered acceptable in select centers where the risk of hypoglycemia is documented to be negligible based on routine assessment and with the use of optimized glycemic management protocols. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. <10> Accession Number 2047152262 Title Topography and functional connectivity analysis of heart surgery-associated brain lesions: a literature review. Source Neurological Sciences. 47(8) (no pagination), 2026. Article Number: 611. Date of Publication: 01 Aug 2026. Author Marcolongo F.; Guariglia C.; Tessari G.; Tropea A.; Volterrani M.; Alves P.N. Institution (Marcolongo, Guariglia, Tessari, Tropea) Psychology Department, Sapienza University of Rome, Rome, Italy (Marcolongo, Volterrani) Cardiopulmonary Department, IRCCS San Raffaele, Rome, Italy (Volterrani) Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University, Rome, Italy (Alves) Laboratorio de Estudos de Linguagem, Centro de Estudos Egas Moniz, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal (Alves) Servico de Neurologia, Departamento de Neurociencias E Saude Mental, Hospital de Santa Maria, ULSSM, Lisboa, Portugal Publisher Springer-Verlag Italia s.r.l. Abstract Background: Cardiac surgery is a major therapeutic advancement but remains associated with neurological complications, including ischemic stroke and postoperative cognitive decline. Compared with stroke of other etiologies, ischemic brain injury following cardiac surgery may involve distinct vascular territories and functional networks, potentially influencing its characteristic cognitive profile. Method(s): We performed a systematic review of case reports describing ischemic brain lesions occurring after cardiac surgery in adults with available neuroimaging data. Lesions were manually traced onto a standard brain atlas and compared with ischemic stroke lesions from the ATLAS database, matched for hemispheric involvement. Lesion topography was analyzed at the arterial territory and voxel levels. Lesion network mapping was conducted using normative resting-state functional connectivity data to identify patterns of functional disconnection. Permutation-based statistical analyses were applied, with correction for multiple comparisons and lesion volume included as a covariate. Result(s): Nineteen articles met the inclusion criteria, yielding 20 cases of post-cardiac surgery ischemic lesions. Compared with stroke controls, these lesions more frequently involved posterior arterial territories, particularly the occipital branches of the posterior cerebral arteries and posterior thalamic regions. Lesion network mapping revealed a distinct pattern of functional disconnection in the occipital lobes, posterior thalamus (including the pulvinar), and medial frontal cortex. Conclusion(s): Our results suggest that ischemia associated with cardiac surgery may preferentially involve posterior arterial territories and be associated with distinct patterns of functional disconnection involving the occipital lobe, the pulvinar, and the medial frontal cortex. Copyright © Fondazione Societa Italiana di Neurologia 2026. <11> Accession Number 2047087674 Title Machine learning model predicts acute kidney injury in pediatric patients after cardiac surgery: a systematic review and meta-analysis. Source BMC Nephrology. 27(1) (no pagination), 2026. Article Number: 400. Date of Publication: 01 Dec 2026. Author Fan X.; Zhuang J.; Xiong Z.; Chen Z.; Yang N.; Li T. Institution (Li) Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China (Fan, Zhuang, Xiong, Chen, Yang) Department of Nursing, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Fan, Zhuang) School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China Publisher BioMed Central Ltd Abstract Background: Acute kidney injury (AKI) is a common complication following pediatric cardiac surgery, frequently leading to poor outcomes and even death in severe cases. Early prevention remains the primary intervention strategy. Studies have developed prediction models to identify at-risk children at an early stage. This study systematically evaluate existing AKI prediction models to support their clinical utility and future refinement. Method(s): PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang and SinoMed were searched from inception to 31 December, 2024. The search of references from included studies, as well as the manual search, extended until November 30, 2025. Literature searching, screening, and data extraction were done by two authors. Quality evaluation according to prediction model risk of bias assessment tool (PROBAST). Area under the receiver operating characteristic curve (AUROC) was pooled using a random-effects model to summarize the overall performance of existing models, exploring sources of heterogeneity of performance through subgroup analysis and meta-regression. Sensitivity analysis and Egger's method were used to analyze the stability of the included studies and to identify publication bias. This study was registered with PROSPERO (CRD42024593112) and reported following the Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis: Checklist for Systematic Reviews and Meta-Analysis (TRIPOD-SRMA). Result(s): A total of 2189 studies were screened which represented the total number of studies retrieved from the database search, the search of references from included studies, and the manual search. Nineteen studies were included in this review. Included studies differed in study design, AKI definition, predictor screening, model development and validation and model performance. The overall pooled AUROC was 0.850 (95% CI, 0.810-0.890), but all studies were evaluated as high risk of bias using the PROBAST. Heterogeneity in model performance was high, and study design and development methods were identified as possible sources of heterogeneity in pooled AUROC. Included studies were stable and free of publication bias. Conclusion(s): This systematic review suggested that machine learning models for predicting postoperative AKI in pediatric cardiac surgery indicated good discriminative ability. However, the high risk of bias across all included studies and the significant heterogeneity in model performance indicated that the reported performance may be overestimated. The high heterogeneity observed highlights the substantial variability in model performance, which is likely driven by differences in study design and development methods. The clinical utility of these models was currently limited due to the lack of external validation in most studies and the methodological limitations identified. Future research must incorporate rigorous study design, transparent reporting based on the TRIPOD guidelines, and external validation to develop prediction models with clinical utility. Copyright © The Author(s) 2026. <12> Accession Number 2045456044 Title Hemodynamic Response to Intubation With 4 Different Laryngoscopes in Coronary Artery Bypass Graft Surgery: A Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2332-2340), 2026. Date of Publication: 01 Aug 2026. Author Mermer H.A.; Yildiz M.; Tutar M.S.; Yazar M.A.; Kozanhan B. Institution (Mermer, Yildiz, Tutar, Yazar, Kozanhan) Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkey (Yazar) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To evaluate whether different laryngoscope types influence the hemodynamic stress response to tracheal intubation in adult patients undergoing elective coronary artery bypass graft (CABG) surgery. Design(s): Prospective, randomized, controlled clinical trial. Setting(s): University-affiliated tertiary care hospital. Participant(s): A total of 112 adult patients scheduled for elective CABG surgery with no anticipated difficult airway. Intervention(s): Patients were randomly assigned to tracheal intubation using a Macintosh laryngoscope, C-MAC videolaryngoscope, EzVision videolaryngoscope, or McGrath videolaryngoscope under a standardized deep anesthesia protocol. Measurements and Main Results: Hemodynamic parameters were recorded at predefined time points. The primary outcome was the hemodynamic stress response as changes in mean arterial pressure (DELTAMAP) and heart rate (DELTAHR) between measurements obtained after anesthesia induction but before neuromuscular blockade (T2) and those obtained 1 minute after tracheal intubation (T4). Mean DELTAMAP values were 20.8 +/- 19.4 mmHg in the Macintosh group, 26.3 +/- 13.6 mmHg in the C-MAC group, 21.8 +/- 12.4 mmHg in the EzVision group, and 28.4 +/- 11.9 mmHg in the McGrath group (p = 0.168). Corresponding DELTAHR values were 7.4 +/- 8.2 bpm, 6.1 +/- 10.6 bpm, 8.6 +/- 16.4 bpm, and 7.5 +/- 7.7 bpm, respectively (p = 0.844). When hemodynamic stress response was defined as an increase of >=10 mmHg in MAP and/or >=10 beats per minute in heart rate, its incidence was 28.5%, 37.0%, 42.8%, and 42.8% in the Macintosh, C-MAC, EzVision, and McGrath groups, respectively (p = 0.653). Intubation time differed significantly among the groups (median [interquartile range]: 15 [11-18], 19 [12-22], 22 [15-28], and 16 [12-19] seconds, respectively; p < 0.001), whereas intubation success rates and complication profiles were similar across groups. Conclusion(s): Videolaryngoscopes conferred no hemodynamic advantage over direct laryngoscopy during intubation in deeply anesthetized patients undergoing CABG. Adequate anesthesia depth and pharmacologic modulation likely play a more prominent role than device type in blunting intubation stress. Copyright © 2026 Elsevier Inc. <13> Accession Number 2047431614 Title Perioperative mortality in pediatric non-cardiac surgery in Ethiopia: a systematic review and meta-analysis. Source Perioperative Medicine. 15(1) (no pagination), 2026. Article Number: 63. Date of Publication: 01 Dec 2026. Author Zegeye S.T.; Dejen E.T.; Nega M.H.; Admassie B.M. Institution (Zegeye, Dejen, Nega, Admassie) Bahir Dar University, Bahir Dar, Ethiopia Publisher BioMed Central Ltd Abstract Background: Perioperative mortality in children continues to be a major concern, with rates significantly exceeding those observed in adults. This issue remains despite improvements in anesthesia, surgical, and perioperative management. The aim of this systematic review and meta-analysis is to generate evidence regarding perioperative pediatric mortality in Ethiopia. Method(s): This systematic review was conducted in strict adherence to the PRISMA 2020 guidelines. A thorough literature search was undertaken to identify published and unpublished English-language studies. Electronic databases, including PubMed, African Journals Online, Cochrane Library, and CINAHL, were systematically searched to capture relevant studies for inclusion. The methodological quality of the selected studies was appraised using the Joanna Briggs Institute critical appraisal tools. Data analysis was performed using Stata version 17, whereby the pooled incidence of perioperative pediatric mortality was calculated, and potential predictors were examined. Result(s): A total of 23 studies, comprising 7,059 participants, were included in this analysis. The pooled incidence of perioperative pediatric mortality was found to be 15.81% (95%CI: 11.82-19.79). Factors significantly associated with elevated perioperative pediatric mortality included neonatal surgery (pOR = 8.65; 95%CI: 4.06-18.45), pediatric trauma surgery (pOR = 8.07; 95%CI: 4.66-13.98), delayed presentation and surgical intervention following the onset of disease (pOR = 4.41; 95%CI: 2.02-9.62), prolonged hospital stays (pOR = 3.46; 95%CI: 2.10-5.68), and emergency surgery (pOR = 2.35; 95%CI: 1.80-3.08). Conclusion(s): The meta-analysis indicates that perioperative pediatric mortality in Ethiopia is elevated. Significant factors include pediatric trauma surgery, emergency surgery, delayed presentation and intervention following disease onset, prolonged hospital stay, and neonatal surgery. Copyright © The Author(s) 2026. <14> Accession Number 2046474123 Title Left Atrial Appendage Closure versus Oral Anticoagulants in Patients with Atrial Fibrillation: Systematic Review. Source Clinical and Applied Thrombosis/Hemostasis. 32 (no pagination), 2026. Article Number: 10760296261459709. Date of Publication: 01 Jan 2026. Author Liu H.; Li Z.; Chen X.; Zhou J. Institution (Liu, Li) Department of Cardiology, Heyuan People's Hospital, Heyuan, China (Chen) Department of Cardiology, Heyuan People's Hospital, The First Clinical College of Guangdong Medical University, Heyuan, China (Zhou) Department of Critical Care Medicine, Heyuan People's Hospital, Heyuan, China Publisher SAGE Publications Inc. Abstract Background: Oral anticoagulants (OACs) remain the standard strategy for stroke prevention in atrial fibrillation (AF) but are limited by bleeding risk, intolerance, and long-term adherence challenges. Left atrial appendage closure (LAAC) has emerged as a catheter-based alternative for thromboembolic prevention in non-valvular AF. This systematic review evaluated the comparative efficacy and safety of LAAC versus OAC therapy in patients with AF. Method(s): PubMed and Embase were systematically searched for randomized controlled trials (RCTs) comparing percutaneous LAAC with OACs, including direct oral anticoagulants (DOACs) and warfarin, in patients with AF. Result(s): Four pivotal randomized trials (PROTECT AF, PREVAIL, PRAGUE-17, and OPTION) were included. Compared with DOAC therapy, LAAC demonstrated non-inferiority for the composite endpoint of all-cause death, stroke, or systemic embolism in OPTION and for the primary composite outcome in PRAGUE-17. LAAC was associated with significantly lower non-procedural bleeding compared with DOACs in OPTION and PRAGUE-17. Compared with warfarin, LAAC achieved non-inferiority for ischemic stroke or systemic embolism beyond 7 days after randomization in PREVAIL and reduced long-term cardiovascular mortality in PROTECT AF. Procedure-related complications declined with increasing operator experience. Conclusion(s): LAAC provides non-inferior thromboembolic protection compared with OAC therapy while reducing long-term bleeding events in selected patients with AF. LAAC represents an important alternative for patients at elevated bleeding risk or with contraindications to long-term anticoagulation. Copyright © The Author(s) 2026. 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). <15> Accession Number 2047218016 Title The effects of menopausal hormone therapy on cardiovascular disease, cancer, cognition and depression in younger women: A systematic review. Source JRSM Open. 17(6) (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Bencivenga P.A.; Fort N.; Fugh-Berman A.; Scialli A.R. Institution (Bencivenga, Fort, Fugh-Berman, Scialli) Department of Pharmacology and Physiology, Georgetown University Medical Center, Washington, DC, United States Publisher SAGE Publications Inc. Abstract Objective: The Women's Health Initiative (WHI), a randomized controlled trial, found no overall health benefit of menopausal hormone therapy. Our objective was to evaluate the hypothesis that initiating hormonal therapy prior to age 60 or within a few years after the last menstrual period provides health benefits in menopausal women. Design(s): A search was conducted in MEDLINE, Scopus, and ClinicalTrials.gov from inception until August 26, 2025. Randomized controlled trials in which at least one arm was a pharmaceutical oestrogen and one arm was a placebo were included. We required studies to present clinical health outcomes. Setting(s): Systematic review Participants: Menopausal women age 60 or younger or within a short time of the last menstrual period, as defined by individual study authors. Main Outcome Measure(s): Studies were categorized based on primary endpoints, namely cardiovascular disease, cancer, depression, and cognition. Risk of bias was assessed using a standard tool. The reliability of conclusions was assessed using the core GRADE method. Result(s): Thirty-one papers, reporting on seventeen randomized controlled trials, met eligibility criteria. Menopausal hormone therapy in young menopausal women was not shown to have beneficial effects on cardiovascular disease, cancer, depression, or cognition with the exception of some cardiovascular endpoints in women on oestrogen alone in the WHI, a finding not confirmed in other randomized controlled trials and not confirmed in women with vasomotor symptoms. Conclusion(s): Menopausal hormone therapy in young menopausal women has not been shown in randomized controlled trials to have beneficial effects on cardiovascular disease, cancer, depression, or cognition. Copyright © 2026 The Author(s). 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 page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <16> Accession Number 2033208430 Title Comparison of Propofol-Based Total Intravenous Anesthesia versus Volatile Anesthesia with Sevoflurane for Postoperative Delirium in Adult Coronary Artery Bypass Grafting Surgery: A Prospective Randomized Single-Blinded Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 38(9) (pp 1932-1940), 2024. Date of Publication: 01 Sep 2024. Author Varsha A.V.; Unnikrishnan K.P.; Saravana Babu M.S.; Raman S.P.; Koshy T. Institution (Varsha, Unnikrishnan, Saravana Babu, Raman, Koshy) Cardiothoracic and Vascular Anaesthesiology Division, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India Publisher W.B. Saunders Abstract Objectives: To compare the incidence of delirium and early (at 1 week) postoperative cognitive dysfunction (POCD) between propofol-based total intravenous anesthesia (TIVA) and volatile anesthesia with sevoflurane in adult patients undergoing elective coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB). Design(s): This was a prospective randomized single-blinded study. Setting(s): The study was conducted at a single institution, the Sree Chitra Tirunal Institute for Medical Sciences and Technology, a tertiary care institution and university-level teaching hospital. Participant(s): Seventy-two patients undergoing elective CABG under CPB participated in this study. Intervention(s): This study was conducted on 72 adult patients (>18 years) undergoing elective CABG under CPB who were randomized to receive propofol or sevoflurane. Anesthetic depth was monitored to maintain the bispectral index between 40 and 60. Delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit. Early POCD was diagnosed when there was a reduction of >2 points in the Montreal Cognitive Assessment score compared to baseline. Cerebral oximetry changes using near-infrared spectroscopy (NIRS), atheroma grades, and intraoperative variables were compared between the 2 groups. Measurements & Main Results: Seventy-two patients were randomized to receive propofol (n = 36) or sevoflurane (n = 36). The mean patient age was 59.4 +/- 8.6 years. The baseline and intraoperative variables, including atheroma grades, NIRS values, hemoglobin, glycemic control, and oxygenation, were comparable in the 2 groups. Fifteen patients (21.7%) patients developed delirium, and 31 patients (44.9%) had early POCD. The incidence of delirium was higher with sevoflurane (n = 12; 34.2%) compared to propofol (n = 3; 8.8%) (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.13-2.62; p = 0.027)*. POCD was higher with sevoflurane (n = 20; 57.1%) compared to propofol (n = 11; 32.3%) (OR, 1.63; 95% CI, 1.01-2.62; p = 0.038)*. In patients aged >65 years, delirium was higher with sevoflurane (7/11; 63.6%) compared to propofol (1/7; 14.2%) (p = 0.03)*. Conclusion(s): Propofol-based TIVA was associated with a lower incidence of delirium and POCD compared to sevoflurane in this cohort of patients undergoing CABG under CPB. Large-scale, multicenter randomized trials with longer follow-up are needed to substantiate the clinical relevance of this observation. Copyright © 2024 <17> Accession Number 2047158448 Title Protection against postoperative atrial fibrillation via antiplatelet aggregation induced by remote ischemic preconditioning during off-pump coronary artery bypass grafting. Source Basic Research in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Jiang Q.; Zheng Y.; Huang K.; Du J.; Yang Z.; Hu S. Institution (Jiang, Huang) Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China (Jiang, Zheng) School of Medicine, University of Electronic Science and Technology, Chengdu, China (Jiang) Ultrasound Medicine and Computational Cardiology Key Laboratory of Sichuan Province, Chengdu, China (Du) Department of Operating Room, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, Chengdu, China (Yang) The Key Laboratory for Human Disease Gene Study of Sichuan Province, Department of Laboratory Medicine, Sichuan Provincial People's Hospital, Chengdu, China (Hu) Department of Cardiac Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Jiang) No.32, West Second Section First Ring Road, Chengdu, China Publisher Springer Science and Business Media Deutschland GmbH Abstract Off-pump coronary artery bypass grafting (OPCABG) is associated with increased platelet aggregation and a higher incidence of postoperative atrial fibrillation (POAF). Remote ischemic preconditioning (RIPC) has been reported as a promising intervention to mitigate these adverse outcomes. Consecutive patients with cytochrome P450 family 2 subfamily C member 19 (CYP2C19) loss-of-function (LOF) genotype who underwent isolated OPCABG were randomly assigned to receive intermittent ischemia-reperfusion applied to the arm (RIPC group) or not intervention (control group). RIPC was performed after induction of anesthesia using three cycles of 5-min inflation separated by 5-min deflation. The primary outcome was the cumulative incidence of POAF within the first postoperative week, assessed by the intention-to-treat analysis. Secondary outcomes included POAF burden, biochemical indicators, and clinical trajectory. Among the 220 patients available for the primary endpoint analysis, POAF occurred in 27 of 109 patients (24.8%) in the RIPC group versus 46 of 111 patients (41.4%) in the control group (hazard ratio [HR]: 0.542, 95% confidence interval [CI]: 0.342 to 0.858; P = 0.01). The RIPC group also showed significantly lower values than the control group for AF burden (5.1% [IQR 2.3-11.3%] vs. 8.3% [IQR 4.1-19.1%]; P = 0.019), arachidonic acid- and adenosine diphosphate-stimulated platelet aggregation, inflammatory and prothrombotic index, and intensive care unit length of stay. In CYP2C19 LoF carriers, administration of RIPC favorably reduced the incidence and burden of POAF within 1 week after OPCABG, attenuated platelet aggregation and systemic inflammation, and shortened the duration of intensive care unit stay. Copyright © Springer-Verlag GmbH Germany, part of Springer Nature 2026. <18> Accession Number 2046436285 Title The Society of Thoracic Surgeons 2026 Clinical Practice Guidelines for the Prevention and Treatment of New-Onset Postoperative Atrial Fibrillation After Cardiac Surgery. Source Annals of Thoracic Surgery. 122(2) (pp 255-277), 2026. Date of Publication: 01 Aug 2026. Author Chatterjee S.; Grant M.C.; Hui D.S.; Schwann T.A.; Alexander J.H.; Gaudino M.F.L.; Mack C.A.; Malaisrie S.C.; Merritt H.; Sood P.; Wyler von Ballmoos M.; Schena S. Institution (Chatterjee) Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States (Chatterjee) The Texas Heart Institute at Baylor College of Medicine, Houston, TX, United States (Grant) Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States (Hui) Department of Cardiothoracic Surgery, Joe and Teresa R. Lozano Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX, United States (Schwann) Division of Cardiac Surgery, Department of Surgery, Corewell Health East, Royal Oak, MI, United States (Alexander) Division of Cardiology, Duke Clinical Research Institute, Duke Health, Durham, NC, United States (Gaudino, Mack) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Malaisrie) Division of Cardiac Surgery, Bluhm Cardiovascular Institute, Northwestern University, Chicago, IL, United States (Merritt) Cardiothoracic Surgery, Nebraska Methodist Hospital, Omaha, NE, United States (Sood) The Society of Thoracic Surgeons, Chicago, IL, United States (Wyler von Ballmoos) Department of Cardiovascular and Thoracic Surgery, Texas Health Fort Worth, Fort Worth, TX, United States (Schena) Division of Cardiothoracic Surgery, Medical College of Wisconsin, Milwaukee, WI, United States Publisher Elsevier Inc. Abstract Background Postoperative atrial fibrillation (POAF) is the most frequent complication after cardiac surgery and is associated with greater morbidity, mortality, length of stay, and cost. Multiple pharmacologic and procedural strategies exist for POAF prevention and treatment, yet practice variation persists. The Society of Thoracic Surgeons (STS) Workforce on Evidence-Based Surgery convened a multidisciplinary writing group to synthesize contemporary evidence and develop guideline recommendations for preventing and treating new-onset POAF after cardiac surgery. Methods In 2025, the group used the Population, Intervention, Comparison, Outcome framework to formulate clinical questions spanning preoperative, intraoperative, and postoperative domains. Following standardized STS methodology, evidence from randomized controlled trials and observational studies was reviewed, and recommendations were graded by Class of Recommendation and Level of Evidence. Results The group developed 15 recommendations: 8 addressing preventive strategies, 3 intraoperative techniques, and 4 postoperative treatments. Two Class I recommendations addressed perioperative oral amiodarone and rhythm cardioversion for hemodynamically unstable POAF. Two Class IIa recommendations supported posterior pericardiotomy and perioperative beta-blockers. Eight Class IIb recommendations reflected areas of uncertainty and limited data. Three Class III recommendations addressed therapies without demonstrated benefit. Conclusions Levels of Evidence vary across interventions, and high-quality data remain limited for POAF after cardiac surgery. Pharmacologic studies often lack granularity in dose and timing, and intraoperative maneuvers continue to evolve. Individualized risk assessment remains essential given therapy-related adverse effects. The 2026 STS guidelines provide the most comprehensive recommendations focused on POAF after cardiac surgery, offering a framework to standardize care and highlight future investigational priorities. Copyright © 2026 The Society of Thoracic Surgeons. <19> Accession Number 2046687355 Title Computational modelling for personalized transcatheter aortic valve replacement planning: a systematic review of complications and decision support. Source Frontiers in Digital Health. 8 (no pagination), 2026. Article Number: 1832926. Date of Publication: 04 Jun 2026. Author Rauseo E.; Bevis L.; Chen X.; Petersen S.E.; Mathur A.; Slabaugh G.G.; Roney C.H. Institution (Rauseo, Petersen, Slabaugh) William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom (Rauseo, Petersen, Mathur) Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom (Rauseo, Bevis, Chen, Slabaugh, Roney) Digital Environment Research Institute, Queen Mary University of London, London, United Kingdom (Bevis, Slabaugh, Roney) School of Engineering and Materials Science, Queen Mary University of London, London, United Kingdom (Chen) Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Petersen, Mathur) NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom (Mathur) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Slabaugh) The British Library, John Dodson House, Alan Turing Institute, London, United Kingdom Publisher Frontiers Media SA Abstract Patient-specific digital simulation is emerging as a tool to support personalized planning of transcatheter aortic valve replacement (TAVR), particularly as the procedure expands to younger, lower-risk patients, and more complex anatomies. Despite procedural advances, complications such as paravalvular leak, conduction disturbances, coronary obstruction, and aortic injury remain important determinants of outcome. Current pre-procedural planning relies heavily on computed tomography-based anatomical assessment, which is indispensable but largely static and cannot fully capture dynamic device-tissue interactions, and haemodynamic mechanisms underlying many procedural events. Computational modelling derived from patient-specific imaging can extend this assessment by simulating valve deployment, device-tissue contact, and flow, offering mechanistic insight and potential support for individualized procedural decision-making. This systematic review evaluates modelling approaches addressing TAVR complications and procedural planning, including high-risk scenarios such as bicuspid valves and valve-in-valve procedures. Across the literature, modelling enables patient-specific simulations and exploration of procedural strategies that may reduce complication risk. However, clinical translation remains limited by small study populations, heterogeneous methodologies, limited patient-specific validation, and lack of integration into routine workflows. Future progress will require validation against clinically meaningful endpoints, scalable digital infrastructure, and close collaboration between clinicians and engineers to incorporate simulation outputs into routine Heart Team decision-making. Copyright © 2026 Rauseo, Bevis, Chen, Petersen, Mathur, Slabaugh and Roney. <20> Accession Number 2044082163 Title Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Heart Transplant Recipients: A Systematic Review and Meta-analyses. Source American Journal of Cardiovascular Drugs. 26(4) (pp 419-433), 2026. Date of Publication: 01 Jul 2026. Author Cahuapaza-Gutierrez N.L.; Calderon-Hernandez C.C.; Umeres-Bravo M.M.; Villavicencio-Escudero T.V. Institution (Cahuapaza-Gutierrez, Calderon-Hernandez, Villavicencio-Escudero) Universidad Cientifica del Sur, Lima, Peru (Cahuapaza-Gutierrez, Calderon-Hernandez, Umeres-Bravo) Cardiology Research Department, N y C-Center of Research and Medical Excellence (CRME), Lima, Peru (Umeres-Bravo) Facultad de Ciencias de la Salud, Carrera de Medicina, Universidad de Aquino Bolivia, Cochabamba, Bolivia Publisher Adis Abstract Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have demonstrated efficacy and safety in patients with type 2 diabetes mellitus, chronic kidney disease, and heart failure. However, their effects in heart transplant recipients, a population with high cardiovascular risk, remain poorly understood. Method(s): Clinical trials and observational studies were included. A systematic search was conducted in PubMed, Scopus, EMBASE, and Web of Science. Mean differences (MD) were calculated for continuous outcomes and risk ratios (RR) for binary outcomes, both with 95% confidence intervals (CI). Analyses were performed using RevMan version 5.4.1. Result(s): Five retrospective cohort studies including 1512 heart transplant recipients (312 SGLT2i users and 1200 controls) were analyzed. SGLT2i use was not associated with significant changes in renal function (MD in eGFR: 3.96 mL/min/1.73 m2; 95% CI: - 2.33 to 10.26; p = 0.22) or glycemic control (MD in HbA1c: - 0.20%; 95% CI: - 0.73 to 0.34; p = 0.47). Mortality was comparable between groups (RR: 0.64; 95% CI: 0.29-1.40; p = 0.26), with no significant increase in urinary tract infections (RR: 1.40; 95% CI: 0.25-7.72; p = 0.70). However, SGLT2i use was associated with significant reductions in body mass index (MD: - 0.90 kg/m2; 95% CI: - 1.67 to - 0.14; p = 0.02) and systolic blood pressure (MD: - 4.69 mmHg; 95% CI: - 7.27 to - 2.12; p < 0.001). Conclusion(s): In heart transplant recipients, the use of SGLT2 inhibitors was not associated with significant improvements in renal function or glycemic control and did not increase mortality or the incidence of urinary tract infections. However, SGLT2 inhibitor therapy was associated with significant reductions in body mass index and systolic blood pressure, suggesting a potential cardiometabolic benefit in this high-risk population. Given that hypertension and obesity are well-established cardiovascular risk factors and that hypertension, in particular, is a common complication among heart transplant recipients, these blood pressure and weight-lowering effects may be clinically meaningful. Systematic Review Registration: PROSPERO CRD420251057335. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <21> Accession Number 2043340493 Title The impact of acute normovolemic hemodilution on blood transfusions in cardiac surgery: a GRADE-assessed systematic review and meta-analysis of 30 randomized controlled trials with trial sequential analysis. Source Naunyn-Schmiedeberg's Archives of Pharmacology. 399(8) (pp 11035-11054), 2026. Date of Publication: 01 May 2026. Author Alam U.; Rath S.; Ansab M.; Khattak F.; Siddiqui H.T.; Burhan M.; Moiz A.; Sabir V.; Afridi Z.A.K. Institution (Alam, Khattak, Sabir, Afridi) Khyber Medical College, Peshawar, Pakistan (Rath) All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India (Ansab) Services Institute of Medical Sciences, Lahore, Pakistan (Siddiqui) Jinnah Sindh Medical University, Karachi, Pakistan (Burhan) Dow University of Health Sciences, Sindh, Karachi, Pakistan (Moiz) Bacha Khan Medical College, Mardan, Pakistan Publisher Springer Science and Business Media Deutschland GmbH Abstract Acute normovolemic hemodilution (ANH) is an intraoperative blood conservation technique that involves removing a portion of the patient's blood after anesthesia induction and replacing it with fluids to maintain normovolemia. The purpose of this systematic review and meta-analysis was to assess the efficacy and safety of ANH in reducing transfusion requirements and improving hemorrhagic outcomes in adult cardiac surgery patients. Studies were identified through systematic searches of PubMed, Embase, and Cochrane Central databases. Effect estimates were calculated using random-effects models, with heterogeneity assessed using the I2 statistic. Trial sequential analysis (TSA) was employed to evaluate the robustness of cumulative evidence. randomized controlled trials (RCTs) involving 4473 patients were included for further analysis. ANH was associated with a 27% relative reduction in the incidence of allogeneic blood transfusions (RR = 0.73, 95% CI = 0.60 to 0.88; p = 0.0008) and a decrease in the volume of allogeneic red blood cell units transfused (MD = - 0.75 units, 95% CI = - 1.41 to - 0.08; p = 0.020). Fresh frozen plasma transfusion requirements were also significantly reduced (MD = - 0.21 units, 95% CI = - 0.39 to - 0.03; p = 0.0248), along with total blood loss (MD = - 64.35 mL, 95% CI = - 114.57 to - 14.13; p = 0.012). However, chest tube drainage, surgical revision, and stroke incidence showed no significant differences between ANH and usual care. This meta-analysis demonstrates that ANH significantly reduces the need for allogeneic blood transfusions and improves outcomes such as red blood cell and fresh frozen plasma usage during cardiac surgery. The findings highlight ANH's potential as an effective blood conservation strategy, though variability in outcomes and heterogeneity warrant further high-quality research to optimize its application in contemporary cardiac surgical practices. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <22> [Use Link to view the full text] Accession Number 2045858323 Title Major adverse cardiovascular events after liver transplantation: A call for a shared definition. Source Liver Transplantation. Publish Ahead of Print (no pagination), 2026. Date of Publication: 11 May 2026. Author Biolato M.; Pedicino D. Institution (Biolato) Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy (Pedicino) Department of Cardiovascular Medicine, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli 8, Rome, Italy Publisher Lippincott Williams and Wilkins Abstract Cardiovascular complications are a leading cause of morbidity and mortality after liver transplantation. Major Adverse Cardiovascular Events (MACE) are increasingly used as composite endpoints in both clinical trials and observational studies; however, definitions are highly variable, limiting comparability. Liver transplant recipients present unique pathophysiological features and perioperative risks that are not adequately captured by standard cardiovascular frameworks. We conducted a systematic review of 49 studies reporting MACE after liver transplantation, including randomized trials, prospective and retrospective cohort studies, and registry-based analyses. Data on study design, follow-up, MACE definitions, and the components included in composite endpoints were extracted and analyzed descriptively. None of the studies applied the classical three-point MACE definition (non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death). Components included in composite endpoints varied widely: myocardial infarction and heart failure were reported in 78% of studies, stroke in 68%, arrhythmias in 35%, and cardiac death in 35%. Pulmonary embolism was inconsistently included. Heart failure and arrhythmias accounted for a substantial proportion of events, whereas ischemic events represented a minority. Based on event frequency, pathophysiology, and prognostic relevance, we propose that post-transplant MACE include coronary artery disease (defined as myocardial infarction, unstable angina requiring hospitalization, or coronary revascularization, including elective procedures), stroke, heart failure requiring hospitalization, clinically significant arrhythmias (including perioperative events within 30 d of transplantation), cardiac arrest, and cardiovascular death. All non-fatal components should require cardiovascular hospitalization. Pulmonary embolism should be excluded. This definition represents the authors' proposal and requires further consensus and formal validation. A structured international process, ideally using Delphi methodology and a position paper endorsed by transplant societies, could provide a reference framework for future studies, improving comparability, risk stratification, and clinical management of liver transplant recipients. Copyright © 2026 American Association for the Study of Liver Diseases. <23> Accession Number 2046592674 Title Risk prediction models for postoperative atrial fibrillation in patients with lung cancer: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1779009. Date of Publication: 2026. Author Yang F.; Sun T.; Shang Y.; Chen Y.; Wu J.; Shang X. Institution (Yang, Sun) Medicine School of Lishui University, Zhejiang, Lishui, China (Shang) Changchun Humanities and Sciences College, Changchun, China (Chen) Department of Otorhinolaryngology, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China (Wu) Department of Hepatology and Infectious Diseases, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China (Shang) Department of Nursing, Lishui Hospital of Wenzhou Medical University, The First Affiliated Hospital of Lishui University, Lishui People's Hospital, Zhejiang, Lishui, China Publisher Frontiers Media SA Abstract Background - Postoperative atrial fibrillation (POAF) is a common and clinically significant complication following lung cancer surgery, associated with increased morbidity and mortality. Although numerous prediction models have been developed to estimate POAF risk, their overall performance and methodological quality remain unclear. Methods - A systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines, and the protocol was registered with PROSPERO (CRD42025115874). Chinese and English databases were searched from their inception until 30 May 2024. Studies that developed or validated prediction models for postoperative atrial fibrillation (POAF) in patients with surgically treated lung cancer were included. Data were extracted using the CHARMS checklist and the risk of bias was assessed using PROBAST. A random-effects meta-analysis was performed to pool the discriminative performance of the eligible models, using the area under the curve (AUC). Results - Six studies were included. Most models were developed using logistic regression, with age, sex, cardiovascular comorbidities and surgical factors being the most common predictors. Reported area under the curve (AUC) values ranged from 0.72 to 0.89. The pooled AUC was 0.79 (95% CI: 0.71-0.87), which indicates good overall discrimination. However, substantial heterogeneity was observed (I 2 = 98.7%). Subgroup analysis with consistent outcome definitions showed reduced heterogeneity. All studies were judged to have a high overall risk of bias. Conclusions - Current POAF prediction models for lung cancer patients show acceptable discriminative ability but are limited by methodological weaknesses and lack of external validation, restricting their clinical applicability. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251158742, identifier CRD420251158742. Copyright © 2026 Yang, Sun, Shang, Chen, Wu and Shang. <24> Accession Number 2047543105 Title Ventilator-derived Versus Standard Rapid Shallow Breathing Index for Weaning Assessment: A Systematic Review. Source In Vivo. 40(4) (pp 1872-1883), 2026. Date of Publication: 01 Jul 2026. Author Lay Y.-Y.; Chuang Y.-T.; Pai S.-C.; Lin C.-S.; Feng J.-Y.; Chen T.-A. Institution (Lay, Lin) Department of Critical Care Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan (Republic of China) (Lay, Feng, Chen) Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan (Republic of China) (Chuang, Chen) Surgical Intensive Care Unit, Department of Nursing, Show Chwan Memorial Hospital, Changhua, Taiwan (Republic of China) (Pai) Division of Respiratory Therapy, Department of Chest Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan (Republic of China) (Lin) Department of Chest Medicine, Show Chwan Memorial Hospital, Changhua, Taiwan (Republic of China) (Feng) Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan (Republic of China) Publisher International Institute of Anticancer Research Abstract Background/Aim: The rapid shallow breathing index (RSBI) is widely used to assess readiness for liberation from mechanical ventilation. With advances in ventilator technology, RSBI is increasingly obtained directly from ventilator displays. However, differences in measurement conditions and ventilator settings may influence RSBI values and their clinical interpretation, particularly in relation to established cutoff thresholds. This systematic review aimed to evaluate differences between ventilator-derived and conventional RSBI measurements and their clinical implications. Material(s) and Method(s): A systematic literature search was conducted in PubMed and Ovid for studies published up to February 24, 2026. Studies were included if they compared ventilator-derived RSBI with standard measurements in mechanically ventilated adult patients. Data on study design, measurement strategies, and outcomes were extracted and qualitatively synthesized. Result(s): A total of 11 prospective studies involving 824 patients were included. Most studies reported lower RSBI values under ventilatory support, particularly with pressure support ventilation (PSV) or continuous positive airway pressure (CPAP), compared with measurements obtained during unsupported spontaneous breathing. However, some studies reported higher or variable RSBI values depending on ventilator algorithms and measurement techniques. Despite these differences, moderate to good correlations were observed between ventilator-derived and conventional RSBI measurements. Additional factors, including trigger sensitivity and base flow, were found to influence RSBI values, whereas changes in FiO_2 had minimal impact. Conclusion(s): Ventilator-derived RSBI provides a practical alternative for assessing weaning readiness, but values may differ from conventional measurements depending on ventilatory support and measurement conditions. The traditional cutoff of 105 breaths/min/l remains appropriate for unsupported breathing, whereas lower thresholds may be required when RSBI is obtained from ventilators. Careful interpretation is necessary, and further studies are needed to establish standardized measurement approaches and optimal cutoff values. Copyright © 2026 The Author(s). Published by the International Institute of Anticancer Research. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproductionin any medium, provided the original work is properly cited. <25> Accession Number 2046714386 Title The impact of inspiratory muscle training on pulmonary function recovery and pulmonary complications in patients undergoing cardiothoracic surgery: a systematic review and meta-analysis. Source Frontiers in Physiology. 17 (no pagination), 2026. Article Number: 1761926. Date of Publication: 01 Jun 2026. Author Ge Y.; Zhang M.; Gan Y. Institution (Ge) Department of Thoracic Surgery, Linping Campus, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (Zhang) Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Gan) Department of Infection Control, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China Publisher Frontiers Media SA Abstract Objective - To quantify the effects of inspiratory muscle training (IMT) on pulmonary function (PF) recovery and postoperative pulmonary complications (PPCs) including pneumonia and atelectasis in patients undergoing cardiothoracic surgery through systematic evaluation and meta-analysis, providing an evidence-based basis for perioperative respiratory management. Methods - PubMed, Embase, Cochrane Library, and Web of Science were systematically searched until May 2025, with 7 randomized controlled trials (RCTs) involving 507 adult patients who underwent cardiothoracic surgery retrieved (the study of transcatheter aortic-valve replacement was excluded due to heterogeneous surgical characteristics). The quality of the literature was evaluated using the Cochrane Risk-of-Bias Tool (RoB 2.0). A meta-analysis was conducted using RevMan 5.4 software to compare the differences in predefined outcome measures: forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the pneumonia incidence between the IMT and control groups. Results - The meta-analysis showed that the IMT group had a higher FEV1 than the control group [mean difference (MD)=0.80 L, 95% confidence interval (CI): 0.09-1.52, P = 0.03], with clinically relevant improvements. Similarly, FVC was better in the IMT group (MD = 0.64 L, 95% CI: 0.11-1.17, P = 0.03), also representing a clinically meaningful benefit. However, there was no difference in FEV1/FVC ratio between the two groups (P = 0.15). The IMT group performed better in the 6-minute walk test (6MWT) (MD = 47.89 m, 95% CI: 1.28-94.51, P = 0.04), indicating improved functional capacity. Regarding PPCs, the incidence of postoperative pneumonia [odds ratio (OR)=0.18, 95% CI: 0.06-0.57, P = 0.004] and atelectasis (OR = 0.37, 95% CI: 0.17-0.81, P = 0.01) in the IMT group were lower than those in the control group. Conclusion - IMT can effectively improve PF and reduce the risk of PPCs in patients undergoing cardiothoracic surgery by enhancing the strength and endurance of inspiratory muscles. Copyright © 2026 Ge, Zhang and Gan. <26> Accession Number 2045747094 Title Two-Lung Ventilation Attenuates Systemic Inflammatory and Oxidative Stress Responses During Thoracic Surgery: A Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2457-2465), 2026. Date of Publication: 01 Aug 2026. Author Ballester E.; Frandoloso M.; Mendes R.A.; Helene M.K.; Ballester M.E.; Effting P.S.; Dominguini D.; Ritter C.; Rocco P.R.M.; Dal-Pizzol F. Institution (Ballester, Effting, Dominguini, Ritter, Dal-Pizzol) Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Santa Catarina, Criciuma, Brazil (Ballester, Frandoloso, Mendes, Ballester) Department of Thoracic Surgery, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Helene) Department of Anesthesiology, Arquidiocesano Consul Carlos Renaux Hospital, Santa Catarina, Brusque, Brazil (Rocco) Laboratory of Pulmonary Investigation, Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Ritter, Rocco, Dal-Pizzol) National Science and Technology Institute for Precision Critical Care Medicine - INCT PCCM, Criciuma, Brazil Publisher W.B. Saunders Abstract Objective: To evaluate whether two-lung ventilation (TLV) attenuates perioperative inflammatory and oxidative responses compared with one-lung ventilation (OLV). Design(s): A randomized, open-label clinical trial. Setting(s): Thoracic Surgery Department of a general hospital in Southern Brazil. Participant(s): Forty adults (age >=18 years) undergoing thoracic surgery between July and November 2023 were enrolled. Exclusion criteria included pregnancy, preoperative mechanical ventilation, American Society of Anesthesiologists class IV status, inability to place a double-lumen tube, and prior lung resection. Intervention(s): Patients were randomized to receive OLV or TLV during surgery. Measurements & Main Results: Bronchoalveolar lavage (BAL) fluid from the operated and nonoperated lungs and plasma samples were collected preoperatively and postoperatively. Cytokines (interleukin [IL]-6, IL-1beta, IL-8, IL-4, IL-10, and tumor necrosis factor alpha) and oxidative stress markers (thiobarbituric acid reactive substances, protein carbonyls, and DCFH-DA [2',7'-dichlorodihydrofluorescein diacetate]) were quantified. Group-by-time effects were analyzed using generalized mixed-effects models adjusted for age, sex, and surgical duration. BAL fluid cytokine levels, including the primary outcome, IL-6 (p = 0.57), did not differ between groups. However, TLV was associated with reduced postoperative IL-1beta (p = 0.04) and oxidative damage (p = 0.02) in the operated lung. Systemically, TLV markedly attenuated inflammatory and oxidative responses, with lower circulating cytokines and oxidative stress markers and significant group-by-time interactions for multiple mediators. Conclusion(s): Although TLV did not modify local IL-6 concentrations, it consistently dampened systemic inflammatory and oxidative activation induced by thoracic surgery, supporting its potential as a protective perioperative ventilatory strategy. Copyright © 2026 The Author(s) <27> Accession Number 2043741549 Title Anticoagulation for Pregnant Individuals With Mechanical Heart Valves: A Methodologic Review of Systematic Reviews. Source Canadian Journal of Cardiology. 42(7) (pp 1580-1593), 2026. Date of Publication: 01 Jul 2026. Author Ashraf R.; Clarfield L.; Sayfi S.; Keepanasseril A.; Bhatia K.; Shehata N.; Shah P.S.; Hwang M.; Giannarakos A.; Brignardello-Petersen R.; Beyene J.; D'Souza R. Institution (Ashraf, Sayfi, D'Souza) Department of Obstetrics and Gynaecology, McMaster University, Hamilton, ON, Canada (Ashraf, Sayfi, Brignardello-Petersen, Beyene, D'Souza) Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada (Ashraf, Clarfield, D'Souza) Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada (Keepanasseril) Department of Obstetrics and Gynaecology, Jawaharlal Institute of Postgraduate Medical Education & Research, Dhanvantri Nagar, Pondicherry, India (Bhatia) Department of Anaesthesiology, St. Mary's Hospital, University of Manchester, Manchester, United Kingdom (Shehata) Department of Medicine, Mount Sinai Hospital, Toronto, ON, Canada (Shehata) Department of Laboratory Medicine and Pathobiology, Mount Sinai Hospital, Toronto, ON, Canada (Shah) Department of Pediatrics, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada (Hwang, Giannarakos) Library & Knowledge Services, Trillium Health Partners, Mississauga, ON, Canada Publisher Elsevier Inc. Abstract In this study we aimed to describe methodologic variations in systematic reviews (SRs) that estimated clinical outcomes with different anticoagulant strategies for pregnant individuals with mechanical heart valves (MHVs), and present the most reliable risk estimates. We identified eligible SRs through a search involving 8 databases and critically appraised: 1) study quality using A MeaSurement Tool to Assess systematic Reviews (AMSTAR 2); 2) search strategies using Peer Review of Electronic Search Strategies (PRESS) guidelines and operationalized criteria of SR searches; and 3) meta-analytic approaches using a self-designed checklist. We determined most reliable estimates for clinical outcomes using an algorithm considering AMSTAR 2 scores, quality of search strategy, and recency of publication. Of the 12 eligible SRs, most (9 of 12) were of critically low quality based on AMSTAR 2. Of the 4 SRs that published search strategies, 3 were of low quality based on PRESS guidelines. Meta-analytic approaches varied widely. The most reliable risk estimates with vitamin K antagonists were 0.9% (95% confidence interval [CI] 0.1%-1.6%) for maternal mortality, 2.7% (1.4%-4.0%) for thromboembolism, 35.5% (19.8%-51.2%) for fetal loss, and 2.0% (0.3%-3.7%) for congenital anomalies. These risks with sequential therapy were 2.0% (0.8%-3.1%), 5.8% (3.8%-7.7%), 20.1% (14.4%-25.7%), and 1.4% (0.3%-2.5%), and with low-molecular-weight heparin they were 2.9% (0.2%-5.7%), 8.7% (3.9%-13.4%), 8.0% (2.0%-13.9%), and 0.0% (0.0), respectively. SRs on anticoagulation for pregnant individuals with MHVs demonstrated considerable heterogeneity in terms of study quality, search strategies, and meta-analytical approaches. The risk estimates provided could inform shared decision-making and clinical practice guidelines. Copyright © 2026 The Authors. <28> Accession Number 2039794249 Title Tracheobronchial Replacement: A Systematic Review. Source JAMA Surgery. 160(8) (pp 912-919), 2025. Date of Publication: 13 Aug 2025. Author Martinod E.; Radu D.M.; Onorati I.; Chapalain X.; Santos Portela A.M.; Peretti M.; Freynet O.; Uzunhan Y.; Chouahnia K.; Duchemann B.; Juvin C.; Lebreton G.; Rouard H.; Van Der Meersch G.; Galvaing G.; Chadeyras J.-B.; Tronc F.; Kuczma P.; Tresallet C.; Venissac N.; Beloucif S.; Huet O.; Vicaut E. Institution (Martinod, Radu, Onorati, Santos Portela, Peretti) Chirurgie Thoracique et Vasculaire, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, Assistance Publique-Hopitaux de Paris (AP-HP), Bobigny, France (Martinod, Radu, Onorati) Hypoxie et Poumon, Faculte de Medecine SMBH, Inserm UMR1272, Universite Sorbonne Paris Nord, Bobigny, France (Martinod, Radu, Onorati) Laboratoire de Recherche Bio-chirurgicale, Fondation Alain Carpentier, Hopital Europeen Georges Pompidou, AP-HP, Universite Paris Cite, Paris, France (Onorati, Rouard) Banque des Tissus, AP-HP, EFS Ile de France, Ivry-sur-Seine, France (Chapalain) Anesthesie-Reanimation, UFR de medecine, Centre Hospitalier Universitaire de Brest, Universite de Bretagne occidentale, Brest, France (Freynet, Uzunhan) Pneumologie, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France (Chouahnia, Duchemann) Oncologie, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France (Juvin, Lebreton) Chirurgie Cardiaque, Hopital La Pitie-Salpetriere, AP-HP, Sorbonne Universite, Paris, France (Van Der Meersch) Medecine Intensive Reanimation, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France (Galvaing, Chadeyras) Service de Chirurgie Thoracique et Endocrinienne, Centre Jean Perrin, Clermont-Ferrand, France (Tronc) Chirurgie Thoracique, Hopitaux Universitaires de Lyon, Lyon, France (Kuczma, Tresallet) Chirurgie Digestive et Endocrinienne, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France (Venissac) Chirurgie Thoracique, Hopitaux Universitaires de Lille, Lille, France (Beloucif) Anesthesie-Reanimation, Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, Bobigny, France (Huet) Hopital Avicenne, Hopitaux Universitaires Paris Seine-Saint-Denis, AP-HP, UFR de medecine, Universite de Bretagne occidentale, Brest, Bobigny, France (Vicaut) Unite de Recherche Clinique, Hopitaux Saint Louis-Lariboisiere-Fernand Widal, AP-HP, Universite Paris Cite, Paris, France Publisher American Medical Association Abstract Importance: Tracheobronchial replacement remains a surgical and biological challenge despite several decades of experimental and clinical research. Objective(s): To compile a comprehensive state-of-the-science review examining the current indications, techniques, and outcomes of tracheobronchial replacement in human patients. Evidence Review: A systematic review of the literature was conducted on July 1, 2024, to identify studies examining tracheobronchial replacement. This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines and the PRISMA 2020 statement. We selected the following 3 databases: (1) PubMed via the US National Library of Medicine's PubMed.gov; (2) Embase via Elsevier's Embase.com; and (3) the Cochrane Central Register of Controlled Trials (CENTER) via Wiley's Cochrane Library. An additional search was performed using the following clinical trials registers: the World Health Organization's International Clinical Trials Registry Platform and ClinicalTrials.gov, provided by the US National Library of Medicine. Finding(s): The initial search produced 6043 results, with a total of 126 publications included in the final review. Only 1 prospective cohort study and 1 registry, both concerning the use of cryopreserved aortic allografts, were identified. Most publications were case reports and series. From July 1, 2002, to July 1, 2024, a total of 137 cases of tracheobronchial replacement were published. Tracheobronchial replacement was indicated for extensive neoplastic tumors (108 cases [78.8%]) or benign stenoses (29 cases [21.2%]). The most common malignancies were thyroid cancers and adenoid cystic carcinomas. The most frequent resections involved the upper half of the trachea, with reconstructions using muscle flaps, or, most notably, cryopreserved aortic allografts, which have shown promising outcomes and have become the most widely used method since 2022. In the only available registry, the 30-day postoperative mortality and morbidity rates were 2.9% and 22.9%, respectively. Long-term follow-up showed that mortality was related to local recurrences and metastases in patients with cancer. Conclusions and Relevance: This systematic review indicates that extensive malignant lesions are the primary indication for tracheobronchial replacement, with cryopreserved aortic allografts being the only scientifically evaluated surgical technique. Postoperative outcomes were comparable to other major thoracic surgical procedures, while long-term results depended on the underlying disease, especially in cancer cases. Copyright © 2025 American Medical Association. All rights reserved. <29> Accession Number 2047459672 Title A scoping review of the evidence supporting antiarrhythmic use after paediatric cardiac surgery. Source Cardiology in the Young. (no pagination), 2026. Date of Publication: 2026. Author Sullenger R.D.; Kohlmann T.; Kilborn A.G.; Commander S.J.; Foote H.P.; Zimmerman K.O.; Hill K.D.; Hornik C.; Thompson E.J. Institution (Sullenger, Kohlmann) Duke University School of Medicine, Durham, NC, United States (Kohlmann, Kilborn, Commander, Foote, Zimmerman, Hill, Hornik, Thompson) Duke Clinical Research Institute, Durham, NC, United States (Foote, Zimmerman, Hill, Hornik, Thompson) Duke University School of Medicine, Duke University Medical Center, Durham, NC, United States Publisher Cambridge University Press Abstract Background: Arrhythmias after paediatric cardiac surgery occur frequently and contribute to postoperative morbidity and mortality. There is limited literature assessing the safety and efficacy of common antiarrhythmics administered in this population. Method(s): We systematically searched PubMed and EMBASE for literature on antiarrhythmic use in children <18 years of age after cardiac surgery from 2000 to 2024. Two reviewers independently screened abstracts and then reviewed full-text manuscripts to determine eligibility. Result(s): We identified 28 studies of 3,752 patients across 11 different antiarrhythmics: flecainide, procainamide, esmolol, landiolol, propranolol, amiodarone, sotalol, dexmedetomidine, digoxin, ivabradine, and magnesium. Most studies were small, with 17 enrolling fewer than 100 children. Only eight studies were randomised, 16 were retrospective, 12 were prospective, and one was multicenter. Safety and efficacy endpoints varied widely, limiting our ability to combine data for metaanalysis. Overall, evidence supporting the use of these drugs in children after cardiac surgery was limited. Conclusion(s): Although antiarrhythmics are commonly used in children after cardiac surgery, randomised trials with standardised endpoints to guide choice of therapy are lacking. Pragmatic trials to generate real-world data should be considered to further evaluate the safety and efficacy of various antiarrhythmics in this population. Copyright © The Author(s), 2026. Published by Cambridge University Press. <30> Accession Number 2047262037 Title The Plantaris Tendon in Surgery: A Scoping Review of Reconstructive Roles Beyond Orthopedics. Source Journal of Surgical Research. 325 (pp 668-675), 2026. Date of Publication: 01 Sep 2026. Author Davidson A.M.; Chi A.; Gonzalez G.; Papp D.F. Institution (Davidson, Chi, Gonzalez, Papp) Department of Orthopaedic Surgery, Florida International University, Baptist Health South Florida, Miami, Florida, United States Publisher Academic Press Inc. Abstract Introduction: The plantaris tendon, a slender and often vestigial structure of the posterior leg, has long been recognized in orthopedic surgery for its favorable properties as an autograft. However, its role beyond musculoskeletal applications remains under characterized. This scoping review synthesizes the existing literature on the surgical use of the plantaris tendon in nonorthopedic procedures, highlighting patterns, outcomes, and evidence gaps across clinical specialties. Method(s): Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, a systematic search of PubMed, Scopus, and Embase was conducted from inception through final search date. Studies were eligible if they described nonorthopedic surgical applications of the plantaris tendon or muscle and reported procedural detail or outcomes. Data were extracted using a standardized charting form and summarized narratively by surgical domain. Result(s): Ten studies met inclusion criteria, encompassing facial reanimation, ophthalmic surgery, hand reconstruction, cardiac valve repair, visceral grafting, and cadaveric feasibility assessments. The most common use was static suspension for facial paralysis, with 55 patients undergoing tendon sling procedures and reporting improved symmetry and oral competence. In comparative studies, plantaris tendon grafts showed superior lip excursion versus alternative techniques. Experimental data supported tendon viability for esophageal grafting and cardiac repair. Across studies, the plantaris was favored for its length, tensile strength, and low donor site morbidity. Outcome reporting varied and was most robust in facial applications. Conclusion(s): The plantaris tendon demonstrates promising versatility in reconstructive and experimental surgery beyond orthopedics. Despite encouraging results, the literature remains sparse and heterogeneous. Broader adoption may benefit from greater anatomical familiarity, standardized outcomes, and further comparative studies. Copyright © 2026 Elsevier Inc. <31> Accession Number 2046315793 Title Con: Viscoelastic Testing Should Not Be Used Routinely but Selectively in Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(8) (pp 2613-2616), 2026. Date of Publication: 01 Aug 2026. Author Cameron M.; Awad T. Institution (Cameron) Department of Anesthesia, McGill University, Montreal, Canada (Awad) Department of Anesthesiology and Critical Care Medicine, University of Chicago, Chicago, IL, United States (Cameron) Department of Anesthesia, Jewish General Hospital, Canada Publisher W.B. Saunders Abstract Viscoelastic testing (VET) has become an important tool in cardiac surgery, particularly within bleeding management algorithms. However, evidence supporting its benefits largely pertains to patients with active bleeding rather than its use in all cases. VET does not reliably predict bleeding or transfusion requirements when performed preoperatively, and its indiscriminate application may lead to unnecessary blood product administration and increased costs. Randomized trials and meta-analyses consistently show that VET improves outcomes when integrated into structured blood management algorithms after bleeding is clinically evident. Established clinical predictors and standard laboratory tests remain effective for assessing bleeding risk, and recent expert guidelines explicitly discourage routine VET for all cardiac surgery patients. Selective use of VET in patients with suspected coagulopathy preserves its clinical benefits, minimizes harm, and aligns with evidence-based practice. Copyright © 2026 Elsevier Inc. <32> Accession Number 2044213022 Title Efficacy of oral sucrose for preterm infants undergoing point-of-care lung ultrasound: a randomized assessor-blinded controlled trial. Source European Journal of Pediatrics. 185(4) (no pagination), 2026. Article Number: 212. Date of Publication: 01 Apr 2026. Author Elkhouli M.; Mohsen N.; Elhanafy T.; Ibrahim J.; Lee S.; Cheng C.; Taddio A.; Shah V.; Mohamed A. Institution (Elkhouli) Scarborough Health Network, Toronto, ON, Canada (Elkhouli, Shah, Mohamed) Department of Paediatrics, University of Toronto, Toronto, ON, Canada (Mohsen) Department of Pediatrics, Mansoura University, Mansoura, Egypt (Elhanafy, Ibrahim, Lee, Cheng, Shah, Mohamed) Department of Paediatrics, Mount Sinai Hospital, 600 University Avenue, Toronto, ON, Canada (Taddio) Lesile Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada (Cheng) Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, United Kingdom Publisher Springer Science and Business Media Deutschland GmbH Abstract Although lung ultrasound (LUS) is considered non-invasive in nature, handling and probe pressure may provoke pain and transient physiological changes in preterm infants. The aim of this study was to determine whether oral sucrose combined with a pacifier reduces procedural pain and stress in preterm infants undergoing bedside LUS. A two-arm randomized controlled trial was conducted between November 2020 and January 2023. Preterm infants undergoing LUS were randomized to receive either oral sucrose-plus-pacifier or pacifier-alone, administered 2 min before the scan. Pain was evaluated using the premature infant pain profile (PIPP) at four time points: baseline (30 s before intervention), 30 s into scanning, midpoint of the scan, and 30 s post-procedure. Physiological parameters (heart rate, oxygen saturation, and apneic episodes) and duration of the procedure were recorded. Group differences in PIPP scores were analyzed using repeated-measures ANOVA. Out of 60 infants enrolled, 30 infants were randomized in each group with data available on 29 infants in the sucrose-plus-pacifier group and 27 in the pacifier-alone group. Baseline demographics and clinical characteristics were comparable between groups. No statistically significant differences were observed in PIPP scores and physiological parameters at any time point between groups. Repeated-measures ANOVA showed a significant change in PIPP scores across procedural phases (p < 0.0001), with no differences between groups (p = 0.16) or group-by-phase interaction, indicating similar PIPP score trajectories in both groups (p = 0.21). Conclusion(s): Among preterm infants, sucrose did not add benefit to pacifier-alone for reducing procedural pain and stress during lung ultrasound. Trial registration: NCT05717088. (Table presented.) Copyright © Crown 2026. <33> Accession Number 2045328038 Title Management algorithm for pulmonary vein stenosis: An evaluation of available surgical data. Source Heart Rhythm O2. 7(7) (pp 1353-1360), 2026. Date of Publication: 01 Jul 2026. Author Bauer J.; Chorazy K.; Schwarz S.; Taghavi S.; Aigner C.; Vetchy V.; Gerges C.; Lang I.; Moser B. Institution (Bauer, Chorazy, Schwarz, Taghavi, Aigner, Moser) Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria (Vetchy) Department of Biomedical Imaging and Guided Therapy, Medical University of Vienna/General Hospital Vienna, Vienna, Austria (Gerges, Lang) Division of Cardiology, Department of Internal Medicine II, Vienna General Hospital, Medical University of Vienna, Vienna, Austria (Bauer, Chorazy, Schwarz, Taghavi, Aigner, Moser) Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria Publisher Elsevier B.V. Abstract Background Pulmonary vein stenosis (PVS) is a rare complication after radiofrequency ablation for patients with atrial fibrillation. However, the impact of a high-grade stenosis on a patient's hemodynamic situation and quality of life can be severe. Percutaneous balloon angioplasty or stent implantation are interventional treatment options for severe and symptomatic PVS. Owing to significant postinterventional restenosis rates, the management of PVS remains challenging, and the investigation of other options, such as surgical correction, is warranted. Objectives In this study, a structured literature review on surgical treatment strategies for PVS was performed. Based on these findings and multidisciplinary clinical experience, we developed a pragmatic management algorithm to guide individualized treatment decisions for patients with severe or recurrent PVS. Methods A literature review was conducted using PubMed, following the population, intervention, comparison, and outcome framework. A treatment algorithm was designed as a decision flowchart. Results The literature search identified 7 publications on cardiothoracic surgical techniques for the treatment of PVS, describing 11 cases. Although the most common surgical approach was pericardial patchplasty, sutureless techniques and a combination of operations, including endarterectomy, bypass, widening plasty after stent implantation, suturing the vein directly to the left auricle, or the use of pulmonary homograft tissue, were also described in the literature. Conclusion Managing PVS is challenging, especially in cases of restenosis. These patients should be discussed in a multidisciplinary setting, including cardiology, radiology, and thoracic surgery. We propose a treatment algorithm that may aid in individual decision making and serve as a starting point for future discussions. Copyright © 2026 Heart Rhythm Society. <34> Accession Number 2042483106 Title Aortic Valve Replacement for Severe Asymptomatic Aortic Stenosis-A Systemic Review and Bayesian Meta-analysis. Source Canadian Journal of Cardiology. 42(7) (pp 1469-1477), 2026. Date of Publication: 01 Jul 2026. Author Brophy J.M. Institution (Brophy) Research Institute of McGill University Health Centre, Centre for Health Outcomes Research, Montreal, QC, Canada Publisher Elsevier Inc. Abstract Background Previous meta-analyses have concluded that early aortic valve replacement (AVR) is associated with reduced cardiovascular events compared to clinical surveillance (CS) for severe asymptomatic aortic stenosis (AS). However, individual patient data (IPD) was not used and the possibility of biases not considered. Methods A systematic review of randomized clinical trials (RCTs) whose primary outcome was mortality and unplanned cardiac hospitalization. IPD data was reconstructed, permitting calculation of time varying risks. Bayesian analyses, with vague priors, were performed for each trial and combined in a meta-analysis. Results Four RCTs were identified. The pooled average long-term primary outcome was hazard ratio (HR) 0.52 (95% credible interval (CrI) 0.25 - 0.93) and the predicted HR for the next study was HR 0.52 (95% CrI 0.13 - 1.87) with increased uncertainty from between study heterogeneity. Only the EARLY_TAVR trial showed improved outcomes in year one (HR 0.33, 95% CrI 0.24 - 0.46), driven by a 142% increase in the crossover rate compared to previous trials. A one-year landmark analysis, that eliminates possible early unblinding bias, showed no long term AVR benefit for any individual study or for the pooled result (RR 0.59, 95% CI 0.20 - 1.40). Conclusions One-year landmark analysis showed no definitive longer-term benefit for early AVR compared to CS in asymptomatic AS. The EARLY_TAVR benefit is possibly the result of performance bias. Further research is required before early AVR for asymptomatic severe AS can become the new standard of care. Copyright © 2025 Canadian Cardiovascular Society. <35> Accession Number 2041907894 Title Clinical outcomes of transcatheter pulmonary valve replacement versus surgical pulmonary valve replacement: A meta-analysis. Source Cardiovascular Revascularization Medicine. 88 (pp 81-83), 2026. Date of Publication: 01 Jul 2026. Author Ahmed H.; Ismayl M.; El-Shaer A.; Aboeata A.; Goldsweig A.M. Institution (Ahmed, El-Shaer) Department of Medicine, Division of Internal Medicine, Creighton University School of Medicine, Omaha, NE, United States (Ismayl) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Aboeata) Department of Medicine, Division of Cardiovascular Disease, Creighton University School of Medicine, Omaha, NE, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, United States Publisher Elsevier Inc. <36> Accession Number 2046079871 Title Incidence and predictors of postoperative atrial fibrillation following coronary artery bypass graft surgery: a meta-analysis of 207 studies. Source Acta Cardiologica. 81(5) (pp 731-740), 2026. Date of Publication: 2026. Author Farzaneh A.; Zameni N.; Masoum A.; Karamian A. Institution (Farzaneh) School of Medicine, Department of Cardiology, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of (Zameni) Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic of (Masoum) Faculty of Medicine, Mashhad Islamic Azad University, Mashhad, Iran, Islamic Republic of (Karamian) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Taylor and Francis Ltd. Abstract Background: Postoperative atrial fibrillation (POAF) is one of the most common tachyarrhythmias after coronary artery bypass graft (CABG) surgery. This study aimed to determine the overall incidence and predictors of POAF after CABG surgery through a systematic review of existing research findings. Method(s): The protocol of this study was registered in PROSPERO (CRD420251023423) and written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result(s): 207 articles with a total sample size of 180,223 participants were included in our meta-analysis. The overall incidence of POAF following CABG surgery was 24% (95% CI 23%-26%). Increased age and male gender were associated with higher odds of developing POAF (ORs of 1.06 and 1.28, respectively, p < 0.01). Comorbidities, including congestive heart failure (CHF), hypertension, COPD, renal failure, and chronic kidney disease (CKD), were shown to be predictors of POAF. Those who do not use beta-blocker or have withdrawn from it were more likely to experience POAF (OR = 2.26, 95% CI 1.35-3.78, p < 0.01). Preoperative use of statins significantly reduced the odds of POAF (OR = 0.57, 95% CI 0.42-0.78, p < 0.01). On-pump surgery, grafting >= 3 vessels, longer length of stay in hospital, use of intra-aortic balloon pump (IABP), prolonged cross-clamp time, use of inotropic medications, and higher left atrial volume index (LAVI), and LA diameter were also predictors of POAF. Higher preoperative left ventricular ejection fraction (LVEF) was another factor that was associated with lower odds of developing POAF. Conclusion(s): Recognising the risk factors for POAF helps us to identify high-risk patients to provide better preventive measures and management strategies for POAF after CABG. Copyright © 2026 Belgian Society of Cardiology. <37> Accession Number 2047287983 Title Effects of integrated inspiratory-expiratory muscle training within hybrid cardiac rehabilitation following cardiac surgery: A randomized controlled study. Source Respiratory Medicine. 261 (no pagination), 2026. Article Number: 109018. Date of Publication: 01 Sep 2026. Author Eksi B.U.; Cilbir C.E.; Ucgun H.; Ertan Harputlu O.; Aslan G.K.; Ezelsoy M.; Ugurlucan M.; Sagbas L.E.; Akinci B. Institution (Eksi) Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Cilbir) Health Institutes of Turkey, Institute of Public Health and Chronic Diseases, Ankara, Turkey (Ucgun) Istanbul Atlas University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Ertan Harputlu) Istanbul Kent University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation (English), Istanbul, Turkey (Aslan) Istanbul University-Cerrahpasa, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation, Istanbul, Turkey (Ezelsoy) Koc University Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Ugurlucan) Liv Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Sagbas) Florence Nightingale Hospital, Division of Cardiovascular Surgery, Istanbul, Turkey (Akinci) Biruni University, Faculty of Health Sciences, Division of Physiotherapy and Rehabilitation (English), Istanbul, Turkey Publisher W.B. Saunders Ltd Abstract Background: Cardiac surgery may reduce pulmonary function, respiratory muscle strength, and functional capacity after surgery. Respiratory muscle training (RMT) is recommended in cardiac rehabilitation; however, evidence regarding RMT within HCR remains limited. Objective(s): To evaluate the effects of adding RMT to an HCR program following cardiac surgery in a randomized controlled trial. Method(s): In this randomized controlled trial, 20 patients were randomized to HCR (n = 10) or HCR + RMT (n = 10). Rehabilitation started in postoperative week 1 and continued for 8 weeks. Both groups received HCR, while the HCR + RMT group performed combined inspiratory and expiratory muscle training. Primary outcomes were pulmonary function, respiratory muscle strength, and 6-min walk distance. Secondary outcomes included quality of life, physical activity, usability, feasibility, and satisfaction. Result(s): Twenty participants completed the study, with 100% retention and attendance in both groups and no adverse events. At postoperative week 1, respiratory and functional parameters declined in both groups. By week 8, 6-min walk distance increased by 49.5 m in the HCR group and 55.5 m in the HCR + RMT group. Duke Activity Status Index scores improved by 5.25 and 4.95 points, respectively, while Minnesota Living with Heart Failure Questionnaire scores decreased by 7-9 points. No significant between-group differences were found for any outcome (all p > 0.05). Conclusion(s): Adding RMT to HCR is feasible, safe, and well accepted. Both interventions improved respiratory function, respiratory muscle strength, functional capacity, physical activity, and quality of life. Although no additional short-term benefit was observed with RMT, it may be considered complementary to HCR programs. Clinical trial registration number: NCT06258681. Copyright © 2026 Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <38> Accession Number 2047287633 Title Effect of the ligament of Marshall excision during minimally invasive cardiac surgery-coronary artery bypass grafting (MICS-CABG) on the prevention of postoperative new-onset atrial fibrillation (LOMEX-AF): study protocol for a randomised controlled trial. Source BMJ Open. 16(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Song J.; Wang J.; Wang X.; Fu Y.; Yang W.; Yang H.; Gong Y.; Meng L.; Ding T.; Rui L.; Feng H.; Zhao J.; Zheng H.; Zhan S.; Ling Y. Institution (Song, Fu, Yang, Yang, Gong, Meng, Ding, Rui, Zhao, Zheng, Ling) Department of Cardiac Surgery, Peking University Third Hospital, Beijing, China (Wang) Department of Epidemiology, Chinese Academy of Medical Sciences Fuwai Hospital, Beijing, China (Wang, Zhan) Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China (Feng, Zheng) Cardiac Intensive Care Unit, Peking University Third Hospital, Beijing, China Publisher BMJ Publishing Group Abstract Introduction: Postoperative atrial fibrillation (POAF) remains one of the most common complications following coronary artery bypass grafting (CABG), including minimally invasive cardiac surgery-CABG (MICS-CABG). The ligament of Marshall (LOM), containing myocardial fibres and rich autonomic innervation, has been implicated in atrial arrhythmogenesis. Despite evidence that catheter ablation targeting the LOM or surgical interruption during conventional CABG can be effective, prophylactic surgical excision of the LOM during MICS-CABG has not been evaluated in randomised controlled trials (RCTs). Methods and analysis: The Ligament of Marshall Excision for the Prevention of Postoperative New-Onset Atrial Fibrillation (LOMEX-AF) trial is a single-centre, prospective, triple-blind (participants, outcome assessors, statisticians) RCT. Adults 30-80 years scheduled for elective MICS-CABG who meet inclusion/exclusion criteria will be randomised to Standard MICS-CABG with posterior left pericardiotomy (control) or the same procedure plus excision of a segment of the LOM (intervention). Resected tissue will be fixed for histopathology. Primary Outcome: new-onset POAF during index hospitalisation defined as atrial fibrillation or atrial flutter lasting >=30 s detected by ECG/telemetry. Secondary outcomes include frequency and duration of episodes, need for Class I/III antiarrhythmics or electrical cardioversion, intensive care unit and hospital length of stay, mechanical ventilation time and reoperation for bleeding. Sample size: 340 per arm (n=680 total) to detect a 50% relative reduction from an estimated 17% control event rate with 90% power, two-sided alpha=0.05, allowing 5% attrition. Primary analysis: intention-to-treat; categorical comparisons by chi2 or Fisher exact test; continuous variables by t-test or Mann-Whitney U as appropriate; analyses performed in R. Ethics and dissemination: The study has been approved by the institutional ethics committee of Peking University Third Hospital, Beijing, China (IRB00006761-M20250847. 11 October 2025). Written informed consent will be obtained from all participants before enrolment. The trial will be conducted in accordance with the Declaration of Helsinki, Good Clinical Practice principles and applicable national regulations. The findings will be disseminated through publication in peer-reviewed journals and presentation at academic conferences. Trial registration number: ChiCTR2500110913. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <39> Accession Number 2047415629 Title Predictors of Procedural and Clinical Outcomes Following Transcatheter Tricuspid Edge-to-Edge Repair. Source JACC: Cardiovascular Interventions. 19(10) (pp 1195-1209), 2026. Date of Publication: 25 May 2026. Author Gibson W.; Wunderlich N.C.; Alranini I.; Karaduman B.D.; Al Asmar M.; Buithieu J.; Chetrit M.; de Varennes B.; Drullinsky D.; Fam N.P.; Kedhi E.; Lachapelle K.; Modine T.; Mousavi N.; Mylotte D.; Prendergast B.; Spaziano M.; Theriault-Lauzier P.; Stephan von Bardeleben R.; Zgheib A.; Martucci G.; Piazza N. Institution (Gibson, Alranini, Al Asmar, Buithieu, Chetrit, de Varennes, Drullinsky, Kedhi, Lachapelle, Mousavi, Spaziano, Zgheib, Martucci, Piazza) Division of Cardiology, Department of Medicine, Glen Hospital, McGill University Health Center, Montreal, QC, Canada (Wunderlich) Asklepios Klinik Langen, Langen, Germany (Karaduman) Health Sciences University, Ankara Bilkent City Hospital, Ankara, Turkey (Fam) St. Michael's Hospital/University of Toronto, Toronto, ON, Canada (Modine) CHU Bordeaux, Hopital Cardiologique Haut-Leveque, Pessac, France (Mylotte) Department of Cardiology, University Hospital Galway, Galway, Ireland (Prendergast) Cleveland Clinic London and St. Thomas' Hospital, London, United Kingdom (Theriault-Lauzier) Ottawa Heart Institute, Ottawa, ON, Canada (Stephan von Bardeleben) University Medical Center Mainz, Mainz, Germany Publisher Elsevier Inc. Abstract Tricuspid transcatheter edge-to-edge repair alleviates symptoms, but survival benefit remains inconsistent. The authors conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant systematic review and meta-analysis ( CRD42024600438 ) to identify multivariable predictors of procedural success and adverse outcomes. PubMed, Scopus, the Cochrane Library, and Google Scholar were searched (from January 2008 to March 2025) for adjusted predictors of mortality, heart failure hospitalization, major adverse cardiovascular events, and procedural success. Random-effects meta-analysis was performed when >=2 independent cohorts reported comparable estimates. Fifty-nine studies met the inclusion criteria. Baseline tricuspid regurgitation severity (OR: 2.50; 95% CI: 1.33-4.71), nonanteroseptal jet location (OR: 2.46; 95% CI: 1.08-5.60), and increasing coaptation gap (HR: 1.19 per mm; 95% CI: 1.07-1.33) predicted residual tricuspid regurgitation. Residual tricuspid regurgitation >=3+ was the only predictor suitable for pooled synthesis across endpoints and was associated with all-cause mortality (HR: 2.19; 95% CI: 1.60-3.00) and major adverse cardiovascular events (HR: 1.84; 95% CI: 1.37-2.48) ( I 2 = 0%-2%.) Renal dysfunction, impaired right ventricular function and remodeling, pulmonary hypertension, and right ventricular-pulmonary arterial uncoupling reflect advanced disease substrate and demonstrated consistent associations with adverse outcomes. Among surgical risk models, the European System for Cardiac Operative Risk Evaluation II score showed limited discrimination, whereas the TRI-SCORE performed better; tricuspid transcatheter edge-to-edge repair-specific clinical models remain limited, and validated procedural prediction models are emerging. Limited data suggest that an intermediate disease profile may derive the greatest benefit, but this finding is confined to single-registry analyses. Further work is required to define optimal disease-stage thresholds and develop integrated risk models incorporating procedural outcome predictors. Copyright © 2026 . <40> Accession Number 2047250584 Title Long-Term Mobile-Based Glycemic Intervention for Secondary Prevention in Patients With Diabetes Undergoing Surgical Revascularization: Multicenter Randomized Controlled Trial. Source Journal of Medical Internet Research. 28 (no pagination), 2026. Article Number: e72226. Date of Publication: 2026. Author Song Y.; Nan Y.; Tiemuerniyazi X.; Yang Z.; Zhang S.; Li X.; Feng W. Institution (Song, Nan, Tiemuerniyazi, Yang, Zhang, Feng) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Fuwai Hospital, Beijing, China (Li) National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China Publisher JMIR Publications Inc. Abstract Background: Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in low- and middle-income countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. Mobile health tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce. Objective(s): This study aimed to evaluate the significance of mobile health tools in long-term glycemic management for post-CABG patients with comorbid diabetes mellitus. Method(s): GUIDEME (glycemic control using mini program-based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management) is a multicenter, open-label, closed-user group, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into 2 groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-sized health education and medication reminders through a smartphone app during the 6 months after discharge. The primary end point was a change in glycosylated hemoglobin (HbA<inf>1c</inf>) from baseline to 6 months. Result(s): Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had 6-month HbA<inf>1c</inf> results available. Although only 79 (14.9%) patients in the intervention group were defined as active users, a greater reduction of HbA<inf>1c</inf> in the intervention group was observed (adjusted between-group mean difference -0.13, 95% CI -0.25 to -0.01; P=.04). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P=.04). There was no difference between the 2 groups regarding the secondary end points. Conclusion(s): Health education and medication reminders based on smartphone app achieved a statistically significant but modest between-group difference in HbA<inf>1c</inf>, the clinical relevance of which remains uncertain. Copyright © Yangwu Song, Yifeng Nan, Xieraili Tiemuerniyazi, Ziang Yang, Shicheng Zhang, Xi Li, Wei Feng. <41> Accession Number 2046743989 Title Enterococcal Infections in Left Ventricular Assist Device Recipients: Two Clinical Cases and Systematic Review. Source Pathogens. 15(6) (no pagination), 2026. Article Number: 626. Date of Publication: 01 Jun 2026. Author Gay C.; Ramos-Merino L.; Sandoval E.; Couto-Mallon D.; Perissinotti A.; Garcia-Vieites M.; Barge-Caballero E.; Farrero M.; Hernandez-Meneses M.; Crespo-Lerio M.G. Institution (Gay, Hernandez-Meneses) Department of Infectious Diseases, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Ramos-Merino) Department of Infectious Diseases, Hospital Universitario A Coruna, A Coruna, Spain (Sandoval) Department of Cardiovascular Surgery, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Couto-Mallon, Barge-Caballero, Crespo-Lerio) Cardiology Department, Hospital Universitario A Coruna, CIBERCV, A Coruna, Spain (Perissinotti) Department of Nuclear Medicine, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain (Perissinotti) Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Instituto de Salud Carlos III (ISCIII), Barcelona, Spain (Garcia-Vieites) Department of Cardiovascular Surgery, Hospital Universitario A Coruna, A Coruna, Spain (Farrero) Heart Failure Unit, Cardiology Department, Hospital Clinic de Barcelona-IDIBAPS, University of Barcelona, Barcelona, Spain Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Infections remain a major complication in patients with left ventricular assist devices (LVADs). Enterococcal infections are increasingly recognized and are therapeutically challenging because of antimicrobial tolerance, biofilm formation on prosthetic material, and the frequent impossibility of device removal. Objective and method: We report two clinical cases of Enterococcus faecalis LVAD infection and a PRISMA-based systematic review of cases published between 1996 and 2025 that were identified through PubMed/MEDLINE. Primary outcomes were clinical cure, relapse or recurrence, mortality, and device removal. Results were synthesized descriptively. Result(s): Seventeen cases were analyzed, including 15 previously reported cases and two new cases. E. faecalis accounted for 47% of infections, Enterococcus faecium for 29%, and Enterococcus spp. without species identification for 24%. Bacteremia was the most common presentation, occurring in 76%, whereas LVAD-associated endocarditis occurred in 18%. Driveline or pocket involvement was reported in 41%. Suppressive antimicrobial therapy (SAT) was used in 29%, often as a bridge to heart transplantation. Cultures from explanted LVAD components were positive in 47% of cases despite prolonged antimicrobial therapy. Recurrence or relapse and overall mortality each occurred in 18% of patients. Conclusion(s): Enterococcal LVAD infections may be associated with microbiological persistence despite prolonged therapy. SAT may help control infection in selected patients and bridge to heart transplantation when device removal is not feasible. Copyright © 2026 by the authors. <42> Accession Number 2047063373 Title Intracardiac Echocardiography Versus Transesophageal Echocardiography for Guidance of Atrial Fibrillation Ablation: A Systematic Review and Meta-Analysis of Procedural Safety and Efficacy. Source Echocardiography. 43(7) (no pagination), 2026. Article Number: e70543. Date of Publication: 01 Jul 2026. Author Kanniyan A.S.; Mohammed O.; Wadhwa A.; Koduri S.S.P.; Fatima N.; Gowda D.S.; Romero-Acero L.M.; Nanna M.; Kutty S. Institution (Kanniyan, Mohammed) Government Medical College, Kerala, Kozhikode, India (Wadhwa) Shri Atal Bihari Vajpayee Medical College and Research Institute, Bangalore, India (Koduri) JSS Medical College, Mysore, India (Fatima) Ayaan Institute of Medical Sciences, Telangana, Hyderabad, India (Gowda) Hassan Institute of Medical Sciences, Karnataka, Hassan, India (Romero-Acero, Nanna) Cardiac Care and Vascular Medicine, Albert Einstein College of Medicine, New York City, NY, United States (Kutty) BayCare Health System, Clearwater, FL, United States Publisher John Wiley and Sons Inc Abstract Purpose: Transesophageal echocardiography (TEE) is the standard periprocedural imaging modality for atrial fibrillation (AF) catheter ablation but carries the burden of esophageal instrumentation, frequent deep sedation, and logistical constraints. Intracardiac echocardiography (ICE) is a growing alternative, yet comparative evidence had not been systematically synthesized. This systematic review and meta-analysis compared ICE and TEE as periprocedural imaging strategies in adults undergoing AF catheter ablation, focusing on safety and procedural efficiency. Method(s): A search of PubMed, Embase, CENTRAL, and Web of Science identified six eligible studies (five cohort studies and one multicenter randomized controlled trial) enrolling 4760 participants (ICE n = 2616; TEE n = 2144). Peto odds ratios (OR) were used for dichotomous safety outcomes and mean differences (MD) with random-effects models for continuous outcomes; certainty of evidence was graded using GRADE. Result(s): ICE was not associated with significant differences in periprocedural complications, including cardiac tamponade (Peto OR 0.67, 95% CI 0.33-1.36), stroke/TIA/thromboembolism (0.81, 0.36-1.78), vascular complications (1.22, 0.70-2.13), or bleeding (0.50, 0.22-1.12). Total procedure duration did not differ (MD -7.11 min, 95% CI -18.82 to 4.61). ICE was associated with shorter fluoroscopy time (MD -4.17 min, -6.07 to -2.26), though this was attenuated after excluding studies with combined left atrial appendage occlusion. Certainty of evidence was low to very low; the absence of significant differences reflects imprecision rather than demonstrated equivalence and should be regarded as hypothesis-generating. Conclusion(s): Within these limitations, ICE may be a reasonable alternative to TEE in appropriately selected patients at centers with established ICE expertise. PROSPERO: CRD420251239269. Copyright © 2026 Wiley Periodicals LLC. <43> Accession Number 2047375228 Title An Insight Into a Potential Antithrombin-Independent Mechanism of Inadequate Heparin Response in Neonates and Infants Undergoing Pediatric Cardiac Surgery: An Exploratory Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Swangwong S.; Sullivan K.; Malm E.; Kim S.; Faraoni D.; Odegard K.; Yuki K. Institution (Swangwong, Sullivan, Malm, Kim, Faraoni, Odegard, Yuki) Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States (Swangwong, Faraoni, Odegard, Yuki) Department of Anaesthesia, Harvard Medical School, Boston, MA, United States (Swangwong) Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Yuki) Department of Immunology, Harvard Medical School, Broad Institute of MIT and Harvard, Cambridge, MA, United States Publisher W.B. Saunders Abstract Objectives: Inadequate heparin response is frequently observed in neonates and young infants. While low antithrombin level is considered to be the primary cause, the existing literature suggests that it is not necessarily responsible. However, granular coagulation factor profiling data are rather limited. Design(s): Prospective, single-center study. Setting(s): Tertiary academic hospital in the United States. Participant(s): Total of 30 neonates and infants who underwent cardiac surgery with cardiopulmonary bypass between May 31, 2022, and February 22, 2023. Intervention(s): None. Measurements and Main Results: Comparison between the heparin response group and the inadequate heparin response group demonstrated that antithrombin levels were comparable. However, levels of another thrombin inhibitor, alpha<inf>2</inf>-macroglobulin, and coagulation factor adjunct protein S were significantly lower in the inadequate heparin response group. Conclusion(s): Lower alpha<inf>2</inf>-macroglobulin and protein S levels may be at least partly responsible for inadequate heparin response in the study cohort. Copyright © 2026 Elsevier Inc. <44> Accession Number 2047511840 Title Angiography-derived physiology versus pressure wire-based fractional flow reserve for coronary revascularization guidance: A systematic review and meta-analysis. Source JRSM Cardiovascular Disease. 15 (no pagination), 2026. Article Number: 20480040261469414. Date of Publication: 01 Jan 2026. Author Shah M.M.; Fatima S.; Khachatryan M.; Angela I.C.; Arshad U.; St. Jacques J.; Agha N.; Hashmi H.; Malombe B.A.; Ayaz Z.; Khawar M.M.H.; Khawar M. Institution (Shah) Department of Medicine, GMERS Medical College and Hospital, Gujarat, Patan, India (Fatima) Department of Medicine, Dow Medical College, Karachi, Pakistan (Khachatryan) Department of Medicine, Fanarjyan Clinic, Yerevan, Armenia (Angela) Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria (Arshad, Khawar) Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan (St. Jacques) Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica (Agha) Department of Medicine, Foundation University Medical College, Islamabad, Pakistan (Hashmi) Department of Medicine, Aga Khan University, Karachi, Pakistan (Malombe) Department of Pathology, Catholic University of Health and Allied Science (CUHAS)-Bugando, Mwanza, Tanzania (Ayaz) Department of Medicine, Khyber Medical University, Peshawar, Pakistan (Khawar) Department of Medicine, King Edward Medical University, Lahore, Pakistan Publisher SAGE Publications Ltd Abstract Background: Pressure-wire-based fractional flow reserve (FFR) is the gold standard for physiological assessment of intermediate coronary stenoses but remains underutilized owing to procedural complexity, cost, and the need for hyperemic agents. Angiography-derived physiology (ADP) platforms offer a wire-free, adenosine-free alternative. This systematic review and meta-analysis compared the clinical outcomes of ADP-guided versus FFR-guided revascularization in patients with coronary artery disease. Method(s): Comprehensive searches were performed in PubMed, Embase, ScienceDirect, and Cochrane CENTRAL from inception to April 2026. Dichotomous outcomes were pooled as risk ratios (RRs) with 95% confidence intervals using random-effects models and robustness was checked with trial sequential analysis (TSA). Result(s): Three multicenter randomized controlled trials involving 6165 patients were included. There was no significant difference in the primary composite endpoint (RR: 1.14, 95% CI: 0.85-1.54; p = 0.37; I2 = 57%), all-cause mortality (RR: 1.08, 95% CI: 0.75-1.56; p = .68), cardiac death (RR: 0.89, 95% CI: 0.53-1.49; p = .66), and any myocardial infarction (RR: 1.14, 95% CI: 0.66-1.98; p = .64) between ADP-guided and pressure-wire-based FFR-guided strategies. Clinically indicated revascularization was significantly higher with ADP (RR: 1.12, 95% CI: 1.05-1.20; p = .005; I2 = 0%). Trial sequential analysis confirmed that the accumulated evidence was sufficient to conclude no clinically meaningful difference in composite outcome. Conclusion(s): ADP-guided revascularization achieves broadly comparable clinical outcomes to pressure-wire-based FFR. Although ADP offers procedural advantages, certain platforms were associated with modestly higher revascularization rates. These findings support ADP as a practical alternative to conventional FFR in selected patients. Copyright © The Author(s) 2026 <45> Accession Number 2033537213 Title Outcomes associated with postoperative cognitive dysfunction: a systematic review and meta-analysis. Source Age and Ageing. 53(7) (no pagination), 2024. Article Number: afae160. Date of Publication: 01 Jul 2024. Author Suraarunsumrit P.; Srinonprasert V.; Kongmalai T.; Suratewat S.; Chaikledkaew U.; Rattanasiri S.; McKay G.; Attia J.; Thakkinstian A. Institution (Suraarunsumrit, Srinonprasert, Kongmalai, Chaikledkaew, Thakkinstian) Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand (Suraarunsumrit, Srinonprasert) Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Suraarunsumrit, Srinonprasert, Kongmalai) Siriraj Health Policy Unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Kongmalai) Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Suratewat) Department of Emergency Medicine, Yanhee Hospital, Bangkok, Thailand (Chaikledkaew) Social Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand (Rattanasiri, Thakkinstian) Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand (McKay) Centre for Public Health, School of Medicine, Dentistry, and Biomedical Sciences, Queen's University Belfast, Belfast, United Kingdom (Attia) School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia Publisher Oxford University Press Abstract Background: Postoperative cognitive dysfunction (POCD) manifests as a subtle decline in cognition, potentially leading to unfavourable postoperative outcomes. We explored the impact of POCD on physical function, length of hospital stay (LOS), dementia and mortality outcomes. Method(s): PubMed and Scopus were searched until May 2023. All studies of major surgical patients that assessed POCD and outcomes of interest were included. POCD effects were stratified by surgery type (cardiac and noncardiac) and time of POCD assessment (<30 and >=30 days postsurgery). Result(s): Of 2316 studies, 20 met the inclusion criteria. POCD was not associated with functional decline postsurgery. Patients who experienced POCD postcardiac surgery had an increased relative risk (RR) of death of 2.04 [(95% CI: 1.18, 3.50); I2 = 0.00%]. Sensitivity analyses showed associations with intermediate-term mortality among noncardiac surgical patients, with an RR of 1.84 [(95% CI: 1.26, 2.71); I2 = 0.00%]. Patients who developed POCD <30 days postcardiac and noncardiac surgeries experienced longer LOS than those who did not [mean difference (MD) = 1.37 days (95% CI: 0.35, 2.39); I2 = 92.38% and MD = 1.94 days (95% CI: 0.48, 3.40); I2 = 83.29%, respectively]. Postoperative delirium (POD) may contribute to the heterogeneity observed, but limited data were reported within the studies included. Conclusion(s): Patients undergoing cardiac and noncardiac surgeries who developed POCD <30 days postsurgery had poorer outcomes and an increased risk of premature death. Early recognition of perioperative neurocognitive disorders in at-risk patients may enable early intervention. However, POD may confound our findings, with further studies necessary to disentangle the effects of POD from POCD on clinical outcomes. Copyright © The Author(s) 2024. <46> Accession Number 2046395954 Title Effects of digoxin in modern heart failure treatment: Rationale and design of the DIG-Mod HF trial. Source Revista Portuguesa de Cardiologia. 45(7) (pp 393-400), 2026. Date of Publication: 01 Jul 2026. Author Valentim Goncalves A.; Cardim N.; Fiarresga A.; Pereira-da-Silva T.; Ilhao-Moreira R.; Galrinho A.; Rio P.; Carvalheiro R.; Ferreira F.; Lopes J.; Marques Antunes M.; Selas M.; Viana B.; Domingues L.; Cruz Ferreira R. Institution (Valentim Goncalves, Fiarresga, Pereira-da-Silva, Ilhao-Moreira, Galrinho, Rio, Carvalheiro, Ferreira, Lopes, Marques Antunes, Selas, Viana, Cruz Ferreira) Departamento de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitario de Lisboa Central. Centro Clinico Academico de Lisboa, Lisboa, Portugal (Valentim Goncalves, Cardim, Fiarresga, Pereira-da-Silva) NOVA Medical School, Centro Clinico Academico de Lisboa, Lisboa, Portugal (Valentim Goncalves, Cardim, Rio) Hospital CUF Descobertas, Lisboa, Portugal (Domingues) NOVA Clinical Research Unit - NOVA CRU, NOVA Medical School, Lisboa, Portugal Publisher Sociedade Portuguesa de Cardiologia Abstract Aims: Even though it is the oldest heart failure (HF) medication still in use, digoxin has not been evaluated alongside the updated algorithm for treating HF with reduced ejection fraction patients. This could help explain the low use of digoxin in recent HF studies. The main objective is to assess the effectiveness of digoxin in functional capacity and cardiac function when combined with modern HF therapy. Method(s): An interventional, open-label, randomised, crossover trial among adults with chronic Heart Failure and reduced ejection fraction (<=45%) was designed to allocate 50 patients for 24 weeks in each arm (48 weeks of study). The arms are daily intake of digoxin 0.125 mg plus standard of care versus standard of care alone. Both patients with sinus rhythm and atrial fibrillation were enrolled. At the end of each 24-week arm, patients will undergo the co-primary outcome measurement of the peak oxygen consumption, evaluated through cardiopulmonary exercise test, and the global work index, measured by transthoracic echocardiography. Key secondary outcome includes a safety composite of death, need for urgent heart transplantation or mechanical assist device, total hospitalizations and sustained ventricular arrhythmias. The study completed recruitment in April 2025 and will complete follow up in March 2026. Conclusion(s): The use of digoxin could be significantly affected by evidence that it still has a considerable effect on functional capacity and cardiac function in HF patients. EU CT Number: 2024-513448-26-00. Copyright © 2026 Sociedade Portuguesa de Cardiologia <47> Accession Number 2046955596 Title Perioperative Transfusion Trigger Score Versus Restrictive Transfusion in Older Non-Cardiac Surgery Patients: A Multicenter Randomized Controlled Trial. Source Journal of the American Geriatrics Society. (no pagination), 2026. Date of Publication: 2026. Author Liang S.; Bai L.; Yang G.; Chen Z.; Wei Y.; Lv Y.; Huang Z.; Huang Y.; Lu K. Institution (Liang, Bai, Yang, Chen, Wei, Wei, Lv, Huang, Lu) Department of Anesthesiology, The Third Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China (Liang, Bai, Yang, Chen, Wei, Wei, Lv, Huang, Lu) Department of Anesthesiology, The Second Naning People's Hospital, Guangxi, Nanning, China (Huang) Department of Anesthesiology, Affiliated Hospital of Youjiang Medical University for Nationalities, Guangxi, Baise, China Publisher John Wiley and Sons Inc Abstract Background: Restrictive transfusion (Hb < 7 g/dL) is recommended for most perioperative patients, but the optimal threshold for those with cardiovascular disease or Hb 7-10 g/dL remains uncertain. The Perioperative Transfusion Trigger Score (POTTS), which integrates adrenaline requirement, FiO<inf>2</inf>, temperature, and angina history, may standardize decisions and safely reduce transfusions in older non-cardiac surgery patients. Method(s): This multicenter RCT in two Chinese hospitals randomized patients >= 60 years undergoing non-cardiac surgery 1:1 to POTTS or control. POTTS = 6 plus points for adrenaline, FiO<inf>2</inf> (to maintain SpO<inf>2</inf> >= 95%), core temperature, and angina; transfusion when Hb < POTTS. Control followed 2012 AABB guideline (Hb < 7 always transfuse; > 10 not; 7-10 physician discretion). Primary Outcome: proportion receiving allogeneic RBC transfusion during perioperative period (ITT population). Result(s): 253 patients (mean age 72.3 years; 67.6% women) were randomized (May 2023-Sept 2025). Baseline Hb similar (median 9.60 vs. 9.50 g/dL). In ITT, transfusion required in 24.00% (30/125) of POTTS vs. 35.94% (46/128) of control (p = 0.038). Transfusion volume did not differ significantly (median 2.50 vs. 3.00 units, p = 0.520). Overall complication rates: 12.80% vs. 8.59% (p = 0.279); one death in control group (0.85%). No significant differences in specific complications. Conclusion(s): In patients >= 60 years undergoing non-cardiac surgery, POTTS-guided transfusion significantly reduced the proportion of patients transfused without increasing complications. Trial Registration: This study was registered at http://www.chictr.org.cn (#ChiCTR2300071739). Copyright © 2026 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society. <48> Accession Number 2040742594 Title Safety and effectiveness of contraception among women with solid organ transplants: An updated systematic review. Source Contraception. 159 (no pagination), 2026. Article Number: 111205. Date of Publication: 01 Jul 2026. Author Baker C.C.; Suresh T.; Nguyen A.T.; Curtis K.M.; Tepper N.K.; Whiteman M.K. Institution (Baker, Suresh, Nguyen, Curtis, Tepper, Whiteman) Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, United States (Baker) Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, United States Publisher Elsevier Inc. Abstract Objective: To update a previous systematic review on contraceptive safety and effectiveness among women with solid organ transplants. Study design: We searched multiple databases from inception through December 7, 2022, for studies of any design that examined contraceptive safety and effectiveness for any contraceptive method among women with solid organ transplants. We extracted data from included articles; for studies that were not case series/reports, we assessed risk of bias and determined certainty of evidence. Result(s): Twenty-six articles satisfied inclusion criteria, 11 cohort studies and 15 case series/reports. Among the 11 cohort studies, most had moderate or high risk of bias. For levonorgestrel intrauterine devices (LNG-IUDs), four non-comparative cohort studies of women with transplants (total n = 55) observed no pregnancies and no pelvic infections. One comparative cohort study (n = 16) suggested similar LNG-IUD effectiveness between women with and without transplants, based on uterine histologic and inflammatory markers. Another comparative cohort study found no unwanted pregnancies among 178 IUD users (type unspecified) with kidney transplants. For non-IUD hormonal contraception, one comparative cohort study (n = 48) found no differences in transplant-related safety outcomes or pregnancy rates for etonogestrel implant use compared with no hormonal contraception; another (n = 126 with kidney transplant) observed fewer unwanted pregnancies among oral contraceptive users (11.8%) compared with non-users (59.8%). Four non-comparative cohort studies of combined hormonal contraception users (total n = 76) observed no clinically meaningful safety outcomes and no pregnancies. Conclusion(s): Very low certainty evidence does not suggest adverse safety or effectiveness outcomes among LNG-IUD and non-IUD hormonal contraception users with solid organ transplant. Implications: While limited, this evidence can be used by health care providers and women with solid organ transplants in counseling and shared decision-making about contraception. Further studies are needed to address concerns about contraceptive use among women with transplants, such as the risk of thrombosis and other cardiovascular risks with hormonal contraceptive use. Copyright © 2025 Elsevier Inc. <49> Accession Number 2040764849 Title A Bayesian meta-analysis of transcatheter versus surgical aortic valve replacement in patients with small aortic annulus. Source Cardiovascular Revascularization Medicine. 87 (pp 16-24), 2026. Date of Publication: 01 Jun 2026. Author Oliveira V.M.R.; Nishikubo M.E.P.; Antunes A.G.O.; Barbosa L.M.; de Sousa P.A.; Lopes L.; Tartuce L.P.; Rassi D.D.C.; Moreira H.G. Institution (Oliveira, Nishikubo, Antunes, Rassi, Moreira) Department of Medicine, Federal University of Goias, Goiania, Brazil (Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil (de Sousa) Department of Medicine, Federal University of Uberlandia, Uberlandia, Brazil (Lopes) Johns Hopkins Bloomberg School of Public Health, Baltimore, United States (Tartuce) Instituto de Cardiologia e Radiologia Intervencionista de Rio Verde, Rio Verde, Brazil (Moreira) Einstein Hospital Israelita, Sao Paulo, Brazil Publisher Elsevier Inc. Abstract Background Small aortic annulus (SAA) is associated to suboptimal results after aortic valve replacement. The optimal treatment for aortic disease in SAA remains unclear. Methods We conducted a systematic review and Bayesian random-effects meta-analysis to compare transcatheter (TAVR) versus surgical aortic valve replacement (SAVR) in patients with small aortic annulus. A comprehensive search of PubMed, Scopus, and Cochrane Library was performed through May 2024. Binary outcomes were synthesized using a binomial-normal hierarchical model to estimate posterior distributions of log odds ratios (log OR) and corresponding 95 % credible intervals (CrIs). Posterior probabilities of treatment effects were calculated to assess the certainty of benefit or harm. All statistical analyses were performed using R version 4.5.0. Results Nine studies comprising 2548 patients (50.9 % TAVR) were included. TAVR was associated with reduced risk of severe patient-prosthesis mismatch (OR 0.47; 95 % CrI 0.31-0.72; posterior probability of benefit 99.8 %) and moderate mismatch (OR 0.56; 95 % CrI 0.40-0.79; posterior probability 99.7 %). In contrast, SAVR was associated with lower risk of moderate/severe aortic regurgitation (OR 4.74; 95 % CrI 2.43-9.27; posterior probability of harm with TAVR 98.1 %) and permanent pacemaker implantation (OR 2.66; 95 % CrI 1.69-4.20; posterior probability of harm with TAVR 98.5 %). No meaningful differences were observed for stroke at 30 days (OR 1.51; 95 % CrI 0.69-3.36) or all-cause mortality at 1 year (OR 0.78; 95 % CrI 0.51-1.17). Conclusions TAVR is superior to SAVR regarding severe and moderate PPM in SAA patients. SAVR is associated with lower risk of aortic regurgitation and new pacemaker implant, with no significant differences in mortality and stroke. Copyright © 2025 Elsevier Inc. <50> Accession Number 2047267363 Title Valve-Specific Comparative Effectiveness of Direct Oral Anticoagulants Versus Vitamin K Antagonists After Surgical Valve Procedures in Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Gamarra-Valverde N.N.; Loaiza S.P.; Asif M.; Silva R.; Melo G.; Dandamudi M.; Delgado D.; Batista P.G.; Chilon J.; Giorgi J.M.; Barbagelata A. Institution (Gamarra-Valverde) Universidad Peruana Cayetano Heredia, Facultad de Medicina Alberto Hurtado, Lima, Peru (Gamarra-Valverde) Division of Internal Medicine, Universidad de Costa Rica, San Jose, Costa Rica (Asif) Division of Internal Medicine, Alfaisal University, Riyadh, Saudi Arabia (Silva) Division of Internal Medicine, Universidade Federal do Ceara, Ceara, Brazil (Melo) Division of Internal Medicine, Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, Sao Paulo, Brazil (Dandamudi) Department of Heart Failure, Division of Cardiology, Montefiore Einstein Hospital, New Rochelle, NY, United States (Delgado, Chilon) Division of Internal Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru (Loaiza, Batista) Division of Internal Medicine, Federal University of Paraiba, Joao Pessoa, Brazil (Giorgi) Division of Internal Medicine, Hospital Sirio-Libanes, Sao Paulo, Brazil (Giorgi) Division of Internal Medicine, Hospital Albert Einstein, Sao Paulo, Brazil (Barbagelata) Division of Internal Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina (Barbagelata) Division of Cardiology, Duke University, Durham, NC, United States Publisher Lippincott Williams and Wilkins Abstract Anticoagulation after left-sided bioprosthetic valve replacement or mitral valve repair in patients with atrial fibrillation (AF) remains uncertain, as decisions must balance prevention of thromboembolism against bleeding risk in a heterogeneous postoperative population. Although vitamin K antagonists (VKAs) have long been the standard of care, expanding real-world use of direct oral anticoagulants (DOACs) has created an urgent need to define their comparative effectiveness and safety in this setting. We performed a systematic review and meta-analysis of randomized and observational studies comparing DOACs with VKAs in patients with AF after surgical left-sided bioprosthetic valve replacement or mitral valve repair. The primary outcome was ischemic stroke; secondary outcomes included composite thromboembolic events, major bleeding, and all-cause mortality. Pooled risk ratios were estimated using random-effects models, with prespecified subgroup and sensitivity analyses to explore clinical heterogeneity. Fourteen studies including 15, 877 patients met inclusion criteria. Compared with VKAs, DOACs were associated with a lower observed risk of ischemic stroke, although this finding was largely driven by patients with aortic bioprosthetic valves. Across analyses, heterogeneity was moderate, and no significant differences were observed for composite thromboembolic events, major bleeding, or all-cause mortality. These findings suggest that DOACs may be a reasonable alternative to VKAs in selected patients with AF after surgical valve intervention. However, the dependence of treatment effect on valve type underscores that left-sided valve populations should not be treated as clinically interchangeable. Anticoagulation decisions should be individualized, integrating valve position, surgical substrate, thromboembolic risk, bleeding risk, and the strength of available evidence. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <51> Accession Number 651133255 Title Efficacy and safety of perioperative magnesium on postoperative pain in adult patients undergoing cardiothoracic surgeries- a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 07 May 2026. Author Swetha R.K.; Gayathri B.; Haridoss M.; Kuppuraman D.; Karthikeyan S. Institution (Swetha, Kuppuraman) Department of Anesthesiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Gayathri) Department of Anesthesiology, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Haridoss) Division of Medical Research, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India (Karthikeyan) Division of Medical Research, SRM Medical College Hospital and Research Centre, Faculty of Medicine and Health Sciences, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu, India Abstract BACKGROUND: Cardiothoracic surgeries such as CABG, valve replacement, and thoracotomy are associated with significant postoperative pain, for which opioids remain the primary treatment despite notable adverse effects and tolerance. Magnesium, an NMDA receptor antagonist with analgesic and cardioprotective properties, has been suggested as a perioperative adjuvant to improve pain control. This systematic review and meta-analysis examined the efficacy and safety of perioperative magnesium for postoperative pain relief in adult cardiothoracic surgery patients. METHOD(S): The review followed PRISMA guidelines and was registered with PROSPERO (CRD420251049449). A search was conducted in PubMed, EMBASE, Scopus, and CENTRAL up to 14 May 2025 for randomized controlled trials comparing perioperative magnesium with placebo or other analgesics in adult patients undergoing cardiothoracic surgery. Pain scores, opioid consumption (MME), time to rescue analgesia, length of hospital stay, and adverse events were analyzed. Random-effects meta-analyses were performed using R Studio (v4.3.2) with mean difference (MD) or risk ratio (RR) and 95% confidence intervals (CI). RESULT(S): Ten RCTs involving 1,140 participants were included. Magnesium significantly reduced pain intensity compared with placebo at 24 h postoperatively (MD - 0.85, 95% CI: -1.53 to - 0.16), although the effect did not reach the minimal clinically important difference. No significant differences were observed when magnesium was compared with active analgesics. For all other outcomes, including opioid consumption (MME), time to first rescue analgesia, and length of hospital stay, no significant differences were found in pooled analyses versus either placebo or other analgesics. Heterogeneity was substantial across most outcomes (I2 > 75%), and no major adverse events were reported. CONCLUSION(S): Perioperative magnesium shows small and safe analgesic effects after cardiothoracic surgery, but the clinical relevance remains uncertain due to substantial heterogeneity and variable dosing. Further robust trials are needed to define its efficacy and optimal use. Copyright © 2026. The Author(s). <52> [Use Link to view the full text] Accession Number 650778282 Title Angiography-Based Physiology to Guide Coronary Revascularization. Source The New England journal of medicine. 395(1) (pp 20-31), 2026. Date of Publication: 02 Jul 2026. Author Daemen J.; van der Eijk J.A.; Barbierato M.; Byrne R.A.; Canova P.; De Maria G.L.; Van Belle E.; Amat-Santos I.; Mangieri A.; Hovasse T.; Sabate M.; Margey R.; Biscaglia S.; Rivero F.; D'Amario D.; Abdelwahed Y.S.; Oemrawsingh R.M.; Moreno R.; Cockburn J.; Testa L.; de Vries T.; Landmesser U.; Banning A.P.; Tijssen J.G.P.; Spitzer E. Institution (Daemen, van der Eijk) Department of Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands (Barbierato) Department of Cardiology, Ospedale dell'Angelo-ULSS 3 Serenissima, Mestre, Italy (Byrne) Department of Cardiology, Mater Private Network, Dublin, United States (Byrne) Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, United States (Byrne) School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, United States (Canova) Department of Cardiology, Ospedale Papa Giovanni XXIII, Bergamo, Italy (De Maria, Banning) Oxford Heart Centre, John Radcliffe, Oxford University Hospitals, National Health Service Foundation Trust, Oxford, United Kingdom (Van Belle) Department of Cardiology, Centre Hospitalier Universitaire Lille, Lille, France (Van Belle) Department of Interventional Cardiology for Coronary Valves and Structural Heart Diseases, INSERM, Institut Pasteur de Lille, European Genomic Institute for Diabetes, Universite de Lille, Lille, France (Amat-Santos) Department of Cardiology, Hospital Clinico Universitario Valladolid, Valladolid, Spain (Mangieri) Department of Cardiology, IRCCS Humanitas Research Hospital, Milan, United States (Hovasse) Department of Cardiology, Institut Cardiovasculaire Paris Sud, Hopital Jacques Cartier, Massy, France (Sabate) Cardiology Department, Cardiovascular Institute, Hospital Clinic, Institut d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona, Centro de Investigacion Biomedica en Red Enfermedades Cardiovaculares (CIBER-CV), Barcelona, Philippines (Margey) Department of Cardiology, Mater Private Cork, Cork, Ireland (Biscaglia) Department of Cardiology, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy (Rivero) Department of Cardiology, Instituto de Investigacion Sanitaria Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain (D'Amario) Dipartimento di Medicina Translazionale, Universita del Piemonte Orientale, Novara, Italy (D'Amario) Department of Cardiology, Ospedale Maggiore della Carita, Novara, Italy (Abdelwahed, Landmesser) Department of Cardiology, Angiology, Intensive Care Medicine, Charite-Universitatsmedizin Berlin, Berlin, Germany (Abdelwahed) Deutsches Zentrum fur Herz-Kreislauf-Forschung, Partner Site Berlin, Berlin, Germany (Oemrawsingh) Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, Netherlands (Moreno) Department of Cardiology, La Paz Hospital, Madrid, Spain (Cockburn) Department of Cardiology, Royal Sussex County Hospital, Brighton, United Kingdom (Testa) Coronary Revascularization Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy (de Vries, Spitzer) Cardialysis, Rotterdam, Netherlands (Banning) National Institute for Health and Care Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom (Tijssen) Amsterdam University Medical Centers, Department of Cardiology, Amsterdam, United States (Spitzer) European Cardiovascular Research Institute, Rotterdam, Netherlands Abstract BACKGROUND: Current society guidelines recommend physiological assessment of intermediate coronary lesions to guide revascularization. Data regarding revascularization guided by vessel fractional flow reserve (vFFR), derived from three-dimensional quantitative coronary angiography without the need for a pressure wire or hyperemic agent, as compared with pressure-wire-based fractional flow reserve (FFR), are lacking. METHOD(S): We conducted an international, open-label, randomized, noninferiority trial at 37 sites in Europe. Patients with intermediate coronary-artery lesions (diameter stenosis of 30 to 80%) who presented with chronic or acute coronary syndromes were randomly assigned in a 1:1 ratio to undergo either vFFR-guided or FFR-guided revascularization of the intermediate coronary-artery lesions. The primary end point was a composite of death from any cause, any myocardial infarction, or any revascularization at 1 year. The noninferiority margin was 3.0 percentage points. RESULT(S): The primary end point was assessed in 1116 patients in the vFFR group and 1095 in the FFR group. The mean age of the patients was 67 years, 24.3% were women, 18.7% presented with an acute coronary syndrome, and 26.6% had diabetes mellitus. At 1 year, a primary end-point event had occurred in 80 patients (Kaplan-Meier estimate, 7.5%) in the vFFR group and in 79 patients (Kaplan-Meier estimate, 7.5%) in the FFR group (risk difference, -0.02 percentage points; 95% confidence interval, -2.25 to 2.21; P = 0.004 for noninferiority). The incidence of serious adverse events appeared to be similar in the two groups. CONCLUSION(S): Among patients with intermediate coronary lesions, vFFR-guided revascularization was noninferior to FFR-guided revascularization with respect to a composite of death, myocardial infarction, or revascularization at 1 year. (Funded by Pie Medical Imaging and Siemens Healthineers; FAST III ClinicalTrials.gov number, NCT04931771.). Copyright © 2026 Massachusetts Medical Society. <53> [Use Link to view the full text] Accession Number 2043620788 Title Artificial intelligence in cardiothoracic monitoring and echocardiography. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (no pagination), 2026. Date of Publication: 03 Dec 2025. Author Bryant J.M.; Jelly C.A.; Kertai M.D. Institution (Bryant, Jelly, Kertai) Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of review - This review describes the recent advancements of artificial intelligence (AI) in cardiothoracic anesthesia monitoring. Recent findings - The application of AI in cardiothoracic anesthesia monitoring has potential to affect all phases of perioperative care - from preoperative testing and risk stratification to postoperative evaluation and advances in echocardiography image acquisition and interpretation. While these developments are promising, they remain in the early stages of clinical integration and validation. Summary - Advances in machine learning and natural language processing are expected to play an increasingly significant role in the monitoring and management of cardiothoracic surgery patients. As these technologies evolve, they hold the potential to enhance the precision, efficiency, and personalization of care. However, as AI becomes more integrated into clinical decision-making, it is imperative that care models remain grounded in the core principles of patient-centeredness and safety. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <54> Accession Number 2047367082 Title Patient overlap and the validity of SGLT2 inhibitor benefits after TAVI: a critique of recent meta-analytical findings. Source European Journal of Clinical Pharmacology. 82(8) (no pagination), 2026. Article Number: 201. Date of Publication: 01 Aug 2026. Author Mohamed A.A. Institution (Mohamed) Faculty of Medicine, Zagazig University, Zagazig, Egypt Publisher Springer Science and Business Media Deutschland GmbH <55> Accession Number 2043741684 Title Incidence and Predictors of Pacemaker Implantation Post-Transcatheter Aortic Valve Replacement in Patients with Pre-existing Right Bundle-Branch Block. Source Canadian Journal of Cardiology. 42(7) (pp 1559-1574), 2026. Date of Publication: 01 Jul 2026. Author Prabhu R.; Rao K.; Ciofani J.L.; Litkouhi P.N.; Baer A.; Hansen P.; Bhindi R. Institution (Prabhu, Rao, Ciofani, Litkouhi, Hansen, Bhindi) Department of Cardiology, Royal North Shore Hospital, Sydney, Australia (Rao, Ciofani, Litkouhi, Hansen, Bhindi) School of Medicine, University of Sydney, Australia (Ciofani) Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom (Baer) Department of Cardiology, North Shore Private Hospital, Sydney, Australia Publisher Elsevier Inc. Abstract Background Pre-existing right bundle branch block (RBBB) is the leading predictor of permanent pacemaker implantation (PPI) following transcatheter aortic valve implantation (TAVI). The applicability of conventional PPI predictors in this high-risk subgroup remains unclear. This review evaluates PPI incidence and associated predictors in TAVI patients with pre-existing RBBB. Methods A systematic review of PubMed, Scopus, Embase, and Web of Science identified studies reporting PPI incidence and predictors in RBBB patients undergoing TAVI. Studies not addressing RBBB-specific factors were excluded. Pooled PPI incidence was calculated, and a qualitative narrative synthesis of predictors was performed. Results Of 2269 identified references, 22 studies with 429,342 patients met the inclusion criteria. Within the RBBB cohort, the mean age was 81.6 +/- 7.4 years, with 64.2% being male, and 23.7% having atrial fibrillation. Balloon-expandable valves were used in 69.8% of cases, and the transfemoral approach in 88.6%. The pooled PPI incidence was 37% across 17 studies. Substantial interstudy heterogeneity necessitated further analysis among 13 studies reporting consistent 30-day follow-up, which yielded 39% incidence. PPI predictors in the RBBB cohort encompassed demographic, anatomic, electrophysiological, and procedural domains. Conclusions Patients with baseline RBBB have significantly higher post-TAVI PPI rates. Identifying RBBB specific predictors could facilitate individualized procedural planning and risk stratification. This review reinforces how both traditional (eg, implantation depth) and nontraditional (eg, female sex, myocardial fibrosis, calcium volume, and distribution) factors have an amplified role in predicting PPI risk, emphasizing the need for further research in this subgroup to improve risk stratification and reduce PPI incidence. Registration: PROSPERO CRD420251057657. Copyright © 2026 . <56> Accession Number 2044946820 Title Economic impact of disposable versus reusable instruments in minimally invasive surgery: a systematic review. Source Surgical Endoscopy. 40(5) (pp 3683-3697), 2026. Date of Publication: 01 May 2026. Author Greve P.J.W.; Rahimi M.; Daams F.; Greve J.W.M.; Bonjer J.H.; Horeman T.; Schijven M.P. Institution (Greve, Rahimi, Daams, Bonjer, Schijven) Dept. of Surgery, Amsterdam UMC Location, De Boelelaan 1117, Amsterdam, Netherlands (Greve, Schijven) Amsterdam Gastroenterology and Metabolism, Amsterdam, Netherlands (Greve, Schijven) Amsterdam Public Health, Digital Health, Amsterdam, Netherlands (Greve, Rahimi, Horeman) Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands (Greve) Maastricht NUTRIM - Institute of Nutrition and Translational Research in Metabolism, Maastricht, Netherlands (Rahimi, Daams, Bonjer) Cancer Center Amsterdam, Amsterdam, Netherlands (Greve, Rahimi, Daams, Bonjer) Science Hub for ASC Research and Education (SHARE), Amsterdam Skills Centre for Health Sciences (ASC), Amsterdam, Netherlands Publisher Springer Abstract Objective: To systematically evaluate the economic impact of disposable versus reusable instruments in minimally invasive surgery (MIS), and to summarize the limited available evidence on environmental impact. Background(s): The increasing use of disposable instruments in MIS has raised concerns regarding healthcare costs and environmental sustainability. While reusable instruments may reduce per-procedure costs and waste, their economic and environmental performance is influenced by procedure type, workflow, and reprocessing requirements. Evidence integrating these factors across surgical specialties remains limited. Method(s): A systematic review was conducted in accordance with PRISMA guidelines. Studies published since 2014 comparing disposable and reusable instruments in MIS were identified using predefined PICOS criteria. Data extraction focused on cost components, including instrument costs, sterilization, operating room time, and total procedural costs. Environmental outcomes were recorded when available. Result(s): Nine studies encompassing 4,724 procedures across multiple surgical specialties met inclusion criteria. In general surgery, reusable instruments were consistently associated with lower per-procedure costs, with reported savings ranging from $16 to $388. In selected subspecialties, including gynecology, thoracic surgery, and spinal surgery, disposable instruments were associated with reduced operative time, indirectly lowering total costs in specific settings. Only one included study directly assessed environmental impact, providing limited, low-level evidence that reusable instruments may confer environmental benefit primarily when used repeatedly. Conclusion(s): Reusable instruments appear to be associated with lower per-procedure costs in general surgery, while disposable instruments may offer context-specific economic advantages in selected subspecialties. Conclusions regarding environmental impact are limited by the scarcity of primary data. Future studies incorporating standardized cost definitions and robust environmental assessments, including life-cycle analyses, are needed to support evidence-based and sustainable instrument selection in MIS. Copyright © The Author(s) 2026. <57> Accession Number 2041671046 Title Thoracic pedicle Subtraction osteotomies: a systematic review of indications, correction magnitudes, and safety profile. Source European Spine Journal. 35(5) (pp 2275-2289), 2026. Date of Publication: 01 May 2026. Author Hoang R.; Cowman A.W.; Jin H.; Tummala P.; Liu L.; Song J.; Theologis A.A. Institution (Hoang, Cowman, Jin, Tummala, Liu) University of California - Irvine, Irvine, United States (Song) Icahn School of Medicine at Mount Sinai, New York, United States (Theologis) University of California - San Francisco, San Francisco, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Thoracic pedicle subtraction osteotomies (T-PSO) are used to correct severe primary and revision thoracic spinal deformities. While lumbar PSOs are well established, literature describing the efficacy and safety of T-PSOs remains limited. This systematic review aims to characterize indications, correction magnitudes, and complications associated with T-PSO. Method(s): A systematic review was conducted across PubMed, Web of Science, and Scopus in accordance with PRISMA guidelines. Studies were included if they reported outcomes specific to T-PSO in either primary or revision surgeries. Surgical correction characteristics, thoracic region sub-analyses, and adverse events were summarized. Result(s): Data were extracted from 52 studies, including 38 case reports/series and 14 retrospective chart reviews. Among 404 T-PSO patients, 167 patients had the level of procedure reported. Most procedures were single-level osteotomies (n = 161, 96.4%), with the most frequent levels at T11 and T12. The most common indications for T-PSO based on thoracic region were postoperative kyphosis (n = 15, 32.6%) for the upper thoracic spine, thoracic kyphosis (n = 3, 37.5%) alongside thoracic kyphoscoliosis (n = 3, 37.5%) for the middle thoracic spine, and thoracolumbar kyphosis (n = 54, 50.5%) for the lower thoracic spine. Mean magnitude of thoracic kyphosis correction was 25.8degree and correction at the T-PSO level was 25.5degree. Adverse events occurred in 48.5% of patients, including structural complications (22.5%), instrumentation failures (11.8%), infections (10.8%), and neurologic deficits (9.8%). Three deaths were reported. Complication rates were similar between primary and revision procedures. Conclusion(s): T-PSO achieves meaningful sagittal plane correction in appropriately selected patients with severe and/or rigid primary and revision thoracic spinal deformities. However, high complication rates emphasize the importance of careful patient selection and surgical planning. Standardization of outcome reporting is critical to optimize future clinical guidance. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2025. <58> Accession Number 2047346341 Title Comparison of the Efficacy of Ciprofol and Propofol for Rapid Sequence Induction and Intubation in Elective Non-Cardiac Surgery: A Prospective, Randomized, Non-Inferiority Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 614980. Date of Publication: 2026. Author Lin Y.; Wang C.; Wu J.; Liu J.; Liu M.; Miao C.; Liang C. Institution (Lin, Wu, Wang, Wu, Liu, Liu, Miao, Liang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Background: Rapid sequence induction and intubation (RSII) requires an agent that provides excellent intubating conditions with minimal hemodynamic disturbance. Propofol is standard but often causes hypotension. We compared the novel agent ciprofol with propofol for RSII in adult patients scheduled for elective non-cardiac surgery. Method(s): In this prospective, randomized, double-blind, non-inferiority trial, 170 adult patients scheduled for elective non-cardiac surgery were allocated to receive intravenous ciprofol (0.4 mg/kg, n = 85) or propofol (2.0 mg/kg, n = 85) for induction, with remifentanil and rocuronium. The non-inferiority margin was set at -10% for the primary outcome. The primary outcome was the proportion of patients with excellent intubation conditions (Viby-Mogensen scale). Secondary outcomes included incidence of hypotension, induction success rate, time to loss of consciousness (LOC), bispectral index (BIS) values, and pain on injection. Result(s): Excellent intubation conditions were achieved in 96.5% (82/85) of the ciprofol group and 95.3% (81/85) of the propofol group (difference 1.2%, 95% CI: -4.4% to 6.7%). The lower limit of the 95% CI exceeded the prespecified non-inferiority margin of -10%. The per-protocol analysis confirmed non-inferiority (difference 1.2%, 95% CI -4.2% to 6.7%). The incidence of post-induction hypotension was significantly lower in the ciprofol group (15.3% vs 43.5%; RR 0.35, 95% CI 0.20 to 0.61; P < 0.001). No patient reported injection pain with ciprofol, compared to 68.2% with propofol (P < 0.001). Time to LOC and induction success rates were similar between groups. Conclusion(s): In adult patients undergoing elective non-cardiac surgery under a standardized RSI protocol, ciprofol 0.4 mg/kg provided intubating conditions non-inferior to propofol 2.0 mg/kg and was associated with less post-induction hypotension and injection pain. Further studies are needed in emergency, critically ill, and high-risk RSI populations. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2500095742). Copyright © 2026 Lin et al. <59> Accession Number 2046969659 Title Outcomes of donation after circulatory death heart transplant using normothermic regional perfusion: a systematic review and meta-analysis. Source Journal of Artificial Organs. 29(3) (no pagination), 2026. Article Number: 41. Date of Publication: 01 Sep 2026. Author He M.; Zhang X.; Li H.; Zhang Y.; Zhao Q.; Wu X.; Li Y.; Pei W. Institution (He, Zhang, Li, Zhang, Zhao, Wu, Li, Pei) Lanzhou University, Lanzhou, China (He, Zhang, Li, Zhang, Zhao, Wu, Li, Pei) Department of Cardiac Surgery, Lanzhou University Second Hospital, Lanzhou University, No. 80 Cuiyingmen, Chengguan District, Lanzhou, China Publisher Springer Abstract This systematic review and meta-analysis aim to synthesize evidence comparing normothermic regional perfusion (NRP) and direct procurement and perfusion (DPP) in donation after circulatory death (DCD) heart transplantation, providing evidence-based guidance for optimizing donor heart procurement and transplantation protocols. A systematic literature review was conducted following PRISMA guidelines. PubMed, Embase, the Cochrane Library, and the International Clinical Trials Registry Platform were systematically searched. Two reviewers independently applied eligibility criteria, evaluated quality, and extracted data. The primary outcome was the 30-day survival rate. The 30-day survival rates for NRP and DPP patients were 96.58% and 94.79%, respectively (odds ratio [OR]: 1.52, 95% confidence interval [CI] 1.06-2.17, P = 0.02). Severe primary graft dysfunction (PGD) rates for NRP and DPP patients were 7.90% and 14.03%, respectively (P = 0.002), while the combined rate of none/mild PGD was 86.36% and 85.84% for each group. The cumulative postoperative extracorporeal membrane oxygenation rate for NRP patients was 6.54%, compared to 17.18% for DPP patients (P = 0.0001). The postoperative intra-aortic balloon pump rate for NRP patients was 9.09%, compared to 17.78% for DPP patients (P = 0.35). NRP patients had a higher likelihood of being discharged home than DPP patients (P = 0.36), while NRP patients had a lower likelihood of being discharged from the intensive care unit than DPP patients (P = 0.71). NRP was associated with higher 30-day survival, which is a promising clinical approach in the application of DCD donor hearts. Copyright © The Author(s), under exclusive licence to the Japanese Society for Artificial Organs 2026. <60> Accession Number 2038356516 Title Enhanced Recovery After Surgery (ERAS) in Gynecological Procedures. Source International Journal of Clinical Obstetrics and Gynaecology. 10(3) (pp 909-913), 2026. Date of Publication: 01 May 2026. Author Sharma A.D.; Shaboo S.; Solanki S.; Rohini; Maini S. Institution (Sharma, Shaboo, Solanki, Rohini, Maini) Department of Anaesthesia, Noida International Institute of Medical Sciences (NIIMS), Yamuna Expressway, Gautam Budh Nagar, Uttar Pradesh, India Publisher Integrated Publishers Abstract Enhanced Recovery After Surgery (ERAS) protocols represent a multimodal, evidence-based perioperative care pathway designed to minimise surgical stress, accelerate physiological recovery, and reduce postoperative morbidity. Despite proven efficacy in colorectal and cardiac surgery, their systematic adoption in gynaecological procedures remains limited and inconsistently studied. This prospective, randomised controlled study evaluated the clinical effectiveness of a structured ERAS protocol versus conventional perioperative care in 120 women undergoing elective gynaecological surgeries-including total abdominal hysterectomy, laparoscopic myomectomy, and staging laparotomy-at a tertiary care academic centre over a 12-month period. Patients were randomly assigned to either the ERAS group (n = 60) or the standard care group (n = 60). Primary outcomes included length of hospital stay, postoperative pain scores (Numerical Rating Scale), time to first oral intake, and time to ambulation. Secondary outcomes encompassed intraoperative haemodynamic stability, anaesthetic drug consumption, postoperative nausea and vomiting (PONV) incidence, and overall patient satisfaction. The ERAS cohort demonstrated a statistically significant reduction in mean length of hospital stay (2.8 +/- 0.6 days vs. 4.9 +/- 0.9 days; p < 0.001), lower NRS pain scores at 24 hours (3.1 +/- 0.7 vs. 5.4 +/- 1.1; p < 0.001), earlier return to oral feeding (6.2 +/- 1.4 hours vs. 18.7 +/- 3.2 hours; p < 0.001), and reduced PONV incidence (18.3% vs. 41.7%; p = 0.006). Patient satisfaction was significantly higher in the ERAS group (92% vs. 63%; p < 0.001). These findings affirm that ERAS protocols are safe, effective, and feasible in the gynaecological surgical setting, yielding measurable improvements in clinical and patient-reported outcomes. Routine implementation of ERAS in gynaecological care is strongly recommended. Copyright © Gynaecology Journal. <61> Accession Number 2039379151 Title Intercostal or Paravertebral Block vs Thoracic Epidural in Lung Surgery: A Randomized Noninferiority Trial. Source JAMA Surgery. 160(8) (pp 855-864), 2025. Date of Publication: 13 Aug 2025. Author Spaans L.N.; Dijkgraaf M.G.W.; Susa D.; De Loos E.R.; Mourisse J.M.J.; Bouwman R.A.; Verhagen A.F.T.M.; Van Den Broek F.J.C.; Meijer P.; Kuut M.; Hanneman N.; Bousema J.; Franssen A.; Brokx H.; Van Duyn E.; Potters J.-W.; Van Den Broek R.; Van Brakel T.; Rijna H.; Boom A.; Noyez V.; Hendriks J.M.H.; Yogeswaran S.K.; Dickhoff C.; Van Dorp M. Institution (Spaans, Van Den Broek) Department of Surgery, Maxima Medical Center, Veldhoven, Netherlands (Spaans, Dijkgraaf) Amsterdam UMC location University of Amsterdam, Epidemiology and Data Science, Amsterdam, Netherlands (Dijkgraaf) Amsterdam Public Health, Methodology, Amsterdam, Netherlands (Susa, Brokx) Department of Surgery, Bravis Hospital, Bergen op Zoom, Roosendaal, Netherlands (De Loos, Franssen) Division of General Thoracic Surgery, Department of Surgery, Zuyderland Medical Center, Heerlen, Netherlands (Mourisse, Kuut) Department of Anesthesia, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen, Netherlands (Bouwman, Van Den Broek) Department of Anesthesiology and Pain Medicine, Catharina Hospital, Eindhoven, Netherlands (Bouwman) Department of Electrical Engineering, Signal Processing Systems, Eindhoven Technical University, Eindhoven, Netherlands (Verhagen) Department of Cardio-thoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands (Meijer) Department of Anaesthesiology, Maxima Medical Center, Veldhoven, Netherlands (Hanneman, Bousema) Department of Surgery, Ikazia Hospital, Rotterdam, Netherlands (Van Duyn) Department of Surgery, Medisch Spectrum Twente, Enschede, Netherlands (Potters) Department of Anesthesiology, Medisch Spectrum Twente, Enschede, Netherlands (Van Brakel) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands (Rijna) Department of Surgery, Spaarne Gasthuis, Hoofddorp, Netherlands (Boom) Department of Anesthesiology, Spaarne Gasthuis, Hoofddorp, Netherlands (Noyez) Department of Surgery, Algemeen Ziekenhuis Sint-Maarten, Mechelen, Belgium (Hendriks, Yogeswaran) Department of Vascular and Thoracic Surgery, Antwerp University Hospital, Antwerp, Belgium (Dickhoff, Van Dorp) Department of Cardiothoracic Surgery, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, Netherlands Publisher American Medical Association Abstract Importance: Effective pain control after thoracic surgery is crucial for enhanced recovery. While thoracic epidural analgesia (TEA) traditionally ensures optimal analgesia, its adverse effects conflict with the principles of enhanced recovery after thoracic surgery. High-quality randomized data regarding less invasive alternative locoregional techniques are lacking. Objective(s): To evaluate the efficacy of continuous paravertebral block (PVB) and a single-shot intercostal nerve block (ICNB) as alternatives to TEA. Design, Setting, and Participant(s): This randomized clinical trial compared PVB and ICNB vs TEA (1:1:1) in patients undergoing thoracoscopic anatomical lung resection at 11 hospitals in the Netherlands and Belgium, enrolled from March 5, 2021, to September 5, 2023. The study used a noninferiority design for pain and a superiority design for quality of recovery (QoR). Intervention(s): Continuous PVB and single-shot ICNB. Main Outcomes and Measures: Primary outcomes were pain, defined as mean proportion of pain scores 4 or greater during postoperative days (POD) 0 through 2 (noninferiority margin for the upper limit [UL] 1-sided 98.65% CI, 17.5%), and QoR, assessed with the QoR-15 questionnaire at POD 1 and 2. Secondary measures included opioid consumption, mobilization, complications, and hospitalization. Result(s): A total of 450 patients were randomized, with 389 included in the intention-to-treat (ITT) analysis (mean [SD] age, 66 [9] years; 208 female patients [54%] and 181 male [46%]). Of these 389 patients, 131 received TEA, 134 received PVB, and 124 received ICNB. The mean proportions of pain scores 4 or greater were 20.7% (95% CI, 16.5%-24.9%) for TEA, 35.5% (95% CI, 30.1%-40.8%) for PVB, and 29.5% (95% CI, 24.6%-34.4%) for ICNB. While PVB was inferior to TEA regarding pain (ITT: UL, 22.4%; analysis per-protocol [PP]: UL, 23.1%), ICNB was noninferior to TEA (ITT: UL, 16.1%; PP: UL, 17.0%). The mean (SD) QoR-15 scores were similar across groups: 104.96 (20.47) for TEA, 106.06 (17.94; P =.641) for PVB (P =.64 for that comparison), and 106.85 (21.11) for ICNB (P =.47 for that comparison). Both ICNB and PVB significantly reduced opioid consumption and enhanced mobility compared with TEA, with no significant differences in complications. Hospitalization was shorter in the ICNB group. Conclusions and Relevance: After thoracoscopic anatomical lung resection, only ICNB provides noninferior pain relief compared with TEA. ICNB emerges as an alternative to TEA, although risks and benefits should be weighed for optimal personalized pain control. Copyright © 2025 American Medical Association. All rights reserved. <62> Accession Number 2047012736 Title Does gabapentin add value to multimodal analgesia in thoracic surgery? A procedure-specific meta-analysis. Source Pain Management. (no pagination), 2026. Date of Publication: 2026. Author Lemos Gonzalez G.; Felippe V.A.; Wegner B.F.M.; Minetto Wegner G.R.; Lopes de Mattos I.L.; Souza do Nascimento T.; Area Leao Barreto L.; Alves Bersot C.D.; Nhuch F.; Lessa M.A. Institution (Lemos Gonzalez, Lopes de Mattos) Department of Anesthesia, Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil (Felippe) Department of Anesthesia, National Cancer Institute - INCA, Rio de Janeiro, Brazil (Wegner) College of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil (Minetto Wegner) College of Medicine, Federal University of Fronteira Sul, Rio Grande do Sul, Brazil (Souza do Nascimento, Lessa) Department of Anesthesia, University of Iowa Carver College of Medicine, University of Iowa, Iowa City, IA, United States (Area Leao Barreto) College of Medicine, Federal University of Ceara, Ceara, Brazil (Alves Bersot) Paulista School of Medicine, EPM-UNIFESP, Sao Paulo, Brazil (Nhuch) Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States Publisher Taylor and Francis Ltd. Abstract Aims: Thoracic surgery is associated with severe acute and chronic pain, high opioid use, and other adverse outcomes. Gabapentin is commonly used perioperatively, but its effectiveness remains uncertain. This systematic review and meta-analysis evaluated the efficacy and safety of perioperative gabapentin versus placebo after thoracic surgery. Patients and Methods: Cochrane, Embase, PubMed, and Web of Science were searched through 29 August 2025 for randomized controlled trials comparing gabapentin with placebo in adults undergoing thoracic surgery. The primary outcome was pain at 24 hours. Secondary outcomes included pain at other time points, opioid consumption, chronic pain, and adverse events. Data were pooled using random-effects models. Result(s) and Conclusion(s): Six trials including 748 patients were analyzed. Gabapentin had no significant effect on rest pain at 24 hours (MD -0.13; 95% CI -1.17 to 0.91). A non-significant trend toward worse cough-evoked pain at 24 hours was observed with gabapentin (MD 0.53; 95% CI 0.00 to 1.07). Gabapentin also did not significantly affect opioid consumption, pain chronification, or adverse events such as nausea, sedation, or delirium. Based on low-certainty evidence, perioperative gabapentin does not appear to provide meaningful benefit after thoracic surgery. Protocol Registration: The www.crd.york.ac.uk/prospero identifier is CRD420251136259. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <63> Accession Number 2044528346 Title Effect of Subcutaneous Versus Topical Nitroglycerin on the Radial Artery Dimensions in Pediatric Patients Undergoing Surgery: A Randomized Non-inferiority Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(7) (pp 2053-2060), 2026. Date of Publication: 01 Jul 2026. Author Verma C.; Mahajan V.; Ganesan R.; Biswas I.; Mathew P.J.; Mandal B. Institution (Verma, Mahajan, Ganesan, Biswas, Mathew, Mandal) Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India Publisher W.B. Saunders Abstract Objectives: To compare the changes in radial artery dimensions produced by subcutaneous nitroglycerin (NTG) versus a topical NTG patch in pediatric patients. Design(s): Randomized controlled non-inferiority trial. Setting(s): Pediatric and cardiac operating rooms at a tertiary care hospital. Participant(s): Forty-five children aged 2 to 8 years undergoing surgery requiring radial arterial catheterization for hemodynamic monitoring or blood gas sampling. Intervention(s): Patients were randomized to receive either subcutaneous NTG (5 microg/kg diluted in 0.5 mL of saline solution, administered under ultrasound guidance) or a topical NTG patch (Releasing approximately 200 microg/h) applied over the radial artery 30 minutes before induction. Radial artery dimensions were measured ultrasonographically at baseline and after NTG administration. Measurements and Main Results: The increase in post-intervention vertical diameter in the topical NTG group met the predefined criterion for non-inferiority when compared with the subcutaneous NTG group (non-inferiority margin, -0.3 mm). Compared with subcutaneous NTG, topical NTG produced a significantly greater percentage increase in vertical diameter (0.45% +/- 11.76% v 15.6% +/- 16.18%, p = 0.002), horizontal diameter (3.53% +/- 16.01% v 19.72% +/- 16.42%, p = 0.001), and cross-sectional area (3.6% +/- 18.02% v 38.29% +/- 26.65%, p < 0.001). Subcutaneous NTG resulted in a markedly greater increase in radial artery depth when compared with topical NTG (84.35% +/- 47.09% v -0.37% +/- 15.8%, p < 0.001). The first-attempt cannulation success rate was lower in the subcutaneous NTG group (81.8% v 100%, p = 0.049). No NTG-related adverse events or significant hemodynamic changes were observed in either group. Conclusion(s): Topical NTG was statistically non-inferior to subcutaneous NTG in increasing the radial artery vertical diameter. Although the absolute post-intervention dimensions were similar between groups-likely influenced by the slightly smaller baseline arterial dimensions in the topical NTG group-the topical application produced larger percentage increases from baseline and did not cause the depth increase observed with subcutaneous NTG. Copyright © 2026 Elsevier Inc. <64> [Use Link to view the full text] Accession Number 2043620841 Title Will prothrombin complex concentrate replace plasma in cardiac surgical bleeding in North America?. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (no pagination), 2026. Date of Publication: 04 Dec 2025. Author Bartoszko J.; Gabarin N.; Tanaka K.; Callum J. Institution (Bartoszko) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Canada (Bartoszko) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Canada (Bartoszko) Departments of Anesthesiology and Pain Medicine, Canada (Gabarin) Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Tanaka) Department of Anesthesiology, University of Oklahoma Health, Oklahoma City, OK, United States (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher Lippincott Williams and Wilkins Abstract Purpose of review - There is increasing interest in four-factor prothrombin complex concentrate (4F-PCC) for treatment of acquired coagulopathic bleeding in cardiac surgery. Plasma, traditionally the treatment of choice, has a different composition compared with 4F-PCC. This review summarizes the current evidence. Recent findings - Because of its rapid reconstitution at the bedside and small administration volume, the use of 4F-PCC over plasma is rising - particularly with new clinical trial evidence suggesting 4F-PCC has efficacy and safety advantages. This is reinforced by mechanistic evidence supporting the role of 4F-PCC in normalizing or improving thrombin generation, an important aspect of secondary hemostasis often impacted in cardiac surgery. Four randomized controlled trials contribute to the human evidence base for the use of 4F-PCC in cardiac surgery. FARES-II, the largest study to date, demonstrated that 4F-PCC has improved hemostatic efficacy and a superior safety profile compared with plasma. Three additional studies are underway to confirm these findings. Summary - The use of 4F-PCC for the treatment of coagulopathic bleeding in cardiac surgery is supported by high-quality clinical evidence. Several unanswered questions remain regarding sex- and race-specific efficacy, the mechanism through which 4F-PCC may reduce serious adverse events, and its use in procedures that were under-represented in existing clinical trials. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <65> Accession Number 2046821355 Title Clinical Impact of MeltDose Technology Extended-Release Tacrolimus (LCPT) in Solid Organ Transplantation: A Systematic Review. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 613201. Date of Publication: 2026. Author Almalki B.A. Institution (Almalki) Department of Pharmacy Practice, College of Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia Publisher Dove Medical Press Ltd Abstract Tacrolimus is a narrow-therapeutic-index immunosuppressant whose clinical performance is XREnvarsus XR), an extended-release tacrolimus formulation, was developed to enhance dissolution, improve bioavailability, and reduce pharmacokinetic variability. This systematic review evaluated the clinical and translational impact of LCPT compared with immediate-release tacrolimus (IR-Tac) across solid-organ transplantation. A systematic search of PubMed/MEDLINE and Google Scholar was conducted from database inception through October 2025. Owing to heterogeneity in study populations, designs, and outcome reporting, a quantitative meta-analysis was not performed, and findings were synthesized qualitatively. Of 351 identified records, 326 underwent screening, and six studies met inclusion criteria. The primary outcome was biopsy-proven acute rejection (BPAR); secondary outcomes included graft survival, mortality, renal function, metabolic complications, adverse events, and tacrolimus trough concentrations. Across studies, LCPT demonstrated clinical efficacy comparable to IR-Tac. In de novo kidney transplantation, BPAR rates were similar (13.1% vs 13.5%), with comparable graft survival and mortality. In heart transplantation, LCPT maintained noninferior outcomes (BPAR 15% vs 10%). In conversion settings, rejection rates remained comparable. LCPT consistently achieved therapeutic trough concentrations with approximately 20-30% lower total daily doses, reflecting enhanced bioavailability attributable to MeltDose technology. These findings support LCPT as a formulation-driven optimization of tacrolimus delivery. While pharmacokinetic advantages are evident, their translation into superior long-term clinical outcomes remains to be fully established. Copyright © 2026 Almalki. <66> [Use Link to view the full text] Accession Number 2045462723 Title Management and outcomes of post-myocardial infarction left ventricular pseudoaneurysm: A case-level systematic review. Source Critical Pathways in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Karimanasseri C.; Rahimov D.; Sankisa D.; Nasher N.; Mustafa M.; Allimulla A.; Vizzeswarapu S.; Plestis K.A.; Entwistle J.W.; Bavaria J.E.; Tchantchaleishvili V. Institution (Karimanasseri, Sankisa, Mustafa, Allimulla, Vizzeswarapu) Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States (Rahimov, Nasher, Plestis, Entwistle, Bavaria, Tchantchaleishvili) Department of Cardiac Surgery, Thomas Jefferson University, Philadelphia, PA, United States Publisher Lippincott Williams and Wilkins Abstract Left ventricular pseudoaneurysm (LVPA) is a rare mechanical complication of acute myocardial infarction (MI) associated with significant mortality. Given the paucity of available data in the literature, we sought to pool existing evidence to better understand the current management strategies and outcomes. Electronic search was performed in February 2025 to identify all studies reporting management of post-MI LVPA. A total of 158 reports, with a total of 159 patients were included. Patient-level data were extracted for analysis. A total of 159 patients were included in the analysis. The median age was 65 years [Interquartile range (IQR), 57-75], and 70% (106/159) of patients were male. The most frequent site of MI was inferior wall (31.4%, 49/156) and the most common method of MI management was thrombolysis (49%, 64/131). The median time from MI to presentation signs/symptoms of LVPA was 21 days [IQR, 0-152]. The most common LVPA location was the anterior/apical wall (27.7%, 44/159). Sixty-six percent of patients (105/159) underwent surgical repair, while 22% of patients (35/159) were managed medically and 5.7% (9/159) of patients underwent transcatheter repair. In-hospital/30-day mortality was 10% (16/159), with operative mortality after surgical repair of 4.8% (5/105). Mortality from reoperative surgery was 18.8% (3/16) as opposed to 2.2% (2/89) in patients without redo sternotomy (p = 0.004). Periprocedural mortality among patients treated with transcatheter intervention occurred in a single case (11.1%), involving a patient with prior coronary artery bypass grafting. At a median follow-up of 6 months [IQR, 1-12], overall survival was 86.1% (137/159). Surgery remains the standard therapy of LVPA, with acceptable operative risk, however, re-operative sternotomy carries higher surgical risk. In carefully selected patients, percutaneous repair may serve as a viable alternative to surgery. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <67> Accession Number 2047133538 Title Impact of Social Support on Patient-Reported Outcomes in Cardiothoracic Surgery: A Systematic Review. Source Journal of Surgical Research. 325 (pp 576-586), 2026. Date of Publication: 01 Sep 2026. Author Adebayo O.W.; Ansari M.; Naeem W.; Brooks C.; D'Alise L.; Khan A.A.; Westrick J.C.; Juarez L.; Casanova T.; Alex G.C.; Geissen N.M.; Liptay M.J.; Seder C.W. Institution (Adebayo, Ansari, Naeem, D'Alise, Casanova, Alex, Geissen, Liptay, Seder) Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, Illinois, United States (Brooks) College of Medicine, University of Illinois Chicago, Chicago, Illinois, United States (Khan) Washington University, Department of General Surgery, St. Louis, Missouri, United States (Westrick, Juarez) Rush University Medical Center Library, Chicago, Illinois, United States Publisher Academic Press Inc. Abstract Introduction: Disparities in cardiothoracic surgery recovery outcomes highlight the need to understand the impact of social determinants, such as social support, on patient-reported outcomes (PROs). This systematic review synthesizes evidence on the relationship between social support and PROs following cardiothoracic surgery. Method(s): Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched PubMed/MEDLINE, Embase, CINAHL, and Cochrane CENTRAL. Three reviewers screened studies independently, with a fourth resolving conflicts. Included studies examined adult cardiothoracic surgery patients and assessed the association between social support and at least one PRO domain: physical functioning, mental health, symptom burden, or health-related quality of life. Result(s): Thirty-one studies (N = 10,920) met the inclusion criteria. Only 26.1% of participants were women, and 10.5% were racial minorities. Most studies found that emotional, informational, tangible, and physical support were positively associated with improved PROs, including better mental health, physical recovery, and lower symptom burden. However, women received less support and reported greater anxiety, fatigue, and depression. Racial and ethnic minorities were underrepresented, and no studies directly compared outcomes across racial/ethnic subgroups. Conclusion(s): Social support is associated with improved PROs following cardiothoracic surgery, yet key disparities persist. Women and racial minorities remain underrepresented in this literature, and their outcomes are poorly characterized. Future research should focus on inclusive study designs and targeted interventions to enhance support and improve outcomes for underserved populations. Copyright © 2026 Elsevier Inc. <68> Accession Number 2047210374 Title Comment: Topical Use of Tranexamic Acid in Cardiac Surgery: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of Publication: 2026. Author Umair Shah S.; Akbar H.; Hatim Hussain S.; Muhammad Momin S. Institution (Umair Shah, Akbar, Hatim Hussain, Muhammad Momin) Department of Medicine, Nowshera Medical College, Khyber Pakhtunkhwa, Nowshera, Pakistan Publisher Georg Thieme Verlag <69> Accession Number 2046749120 Title Clinical Features of Adult Patients with Isolated Pulmonary Valve Endocarditis: A Systematic Review. Source Microorganisms. 14(6) (no pagination), 2026. Article Number: 1208. Date of Publication: 01 Jun 2026. Author Cuervo G.; Chesdachai S.; Hindy J.-R.; Gerberi D.; DeSimone C.V.; Deshmukh A.J.; Miro J.M.; El Sabbagh A.; DeSimone D.C.; Baddour L.M. Institution (Cuervo, Miro) Infectious Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Cuervo, Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Cuervo, Chesdachai, Hindy, DeSimone, Baddour) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Chesdachai, DeSimone, Deshmukh, DeSimone, Baddour) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Gerberi) Department of Library Services, Mayo Clinic, Rochester, MN, United States (Miro) Reial Academia de Medicina de Catalunya, Barcelona, Spain (El Sabbagh) Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Isolated pulmonary valve endocarditis (PV-IE) is a rare condition. Its epidemiology, clinical profile, and management remain poorly characterized. A systematic review was conducted to provide a contemporary characterization (2020-2025) of adult cases with isolated PV-IE. Individuals with previous cardiac surgeries, cardiac implantable electronic devices (CIEDs), or long-term venous catheters were excluded. Of 1902 citations identified, 72 studies were selected with 79 eligible cases, mostly case reports. Patients were predominantly male (78.5%) with a median age of 43 years. Congenital heart disease (CHD) and injection drug use (IDU) were risk factors in 30.4% and 27.8% of cases, respectively, while 41.8% had neither (No-CHD/IDU group). Staphylococcus aureus was the leading pathogen (39%), followed by streptococci (16.5%) and Enterococcus faecalis (8.9%). Vegetations were large (median, 19.5 mm), and pulmonary septic emboli highly prevalent (~93% of cases). More than half (54.4%) of patients underwent surgery. Hospital mortality was low (7.6%). Differences across risk factor subgroups were observed, with higher median age in No-CHD/IDU patients and more staphylococcal etiology in patients with IDU, although treatment approaches and mortality did not differ. This review highlights distinct characteristics and the overall favorable short-term prognosis of isolated PV-IE, underscoring the need for larger, systematically collected datasets. Copyright © 2026 by the authors. <70> Accession Number 2045733673 Title Effect of Intraoperative Regional Anesthesia on Postoperative Outcomes in Pediatric Cardiac Surgery-A Systematic Review of Randomized Controlled Trials. Source Paediatric Anaesthesia. 36(8) (pp 899-907), 2026. Date of Publication: 01 Aug 2026. Author Hiisivuori K.; Salmi H.; Kontinen V.K.; Kuitunen I. Institution (Hiisivuori, Salmi, Kontinen) Department of Anesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland (Hiisivuori, Salmi) Pediatric Research Centre, University of Helsinki, Helsinki, Finland (Kontinen) Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland (Kuitunen) Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Publisher John Wiley and Sons Inc Abstract Objective: To conduct a meta-analysis of postoperative outcomes following the use of regional anesthesia in pediatric cardiac surgery. Data Sources: We searched PubMed (MEDLINE), Web of Science, CINAHL, CENTRAL, and Scopus in December 2024 (PROSPERO: CRD420025635423; registered January 2025). Study Selection: Two authors screened search results. We included parallel-grouped randomized controlled trials (RCT) regardless of blinding. Studies comparing adjuvant regional anesthesia (excluding neuraxial anesthesia) with general anesthesia in pediatric patients (0-17 years) having cardiac surgery via midline sternotomy were included. Data Extraction: Two authors independently extracted the data and assessed risk of bias. The main outcome measures were pain relief using any documented pain score and duration of mechanical ventilation. Other outcome measures sought were postoperative opioid consumption, time to first rescue analgesia, time in pediatric intensive care unit (PICU), length of hospital stay, complications, and patient satisfaction. Data Synthesis: We identified 15 RCTs with 1055 participants for the analysis. Pain scores were lower during the first 24 h postoperatively, with Modified Objective Pain Scale (MOPS) mean difference (MD) being 0.76 less (MD -0.76; CI -1.19 to -0.32). Duration of mechanical ventilation was 48 min shorter in the regional anesthesia group (MD -48; CI -60 to -36). Postoperative cumulative opioid consumption (morphine equivalents) was 0.21 mg/kg lower (MD -0.21; CI -0.30 to -0.11). No complications related to regional anesthesia were reported. Conclusion(s): Our meta-analysis demonstrates that regional anesthesia in pediatric cardiac surgery reduces postoperative pain, as measured by pain scores and postoperative opioid consumption, leads to shorter mechanical ventilation and PICU stays. Copyright © 2026 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd. <71> Accession Number 651028985 Title Perioperative management of pulmonary arterial hypertension in children undergoing congenital heart surgery: a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 25 Apr 2026. Author Ikwuanusi E.; Rajah T.; Scandrett K.; Asamane E.A.; Volpi S. Institution (Ikwuanusi) University Hospitals Birmingham, Birmingham, United Kingdom (Rajah) Birmingham Medical School, University of Birmingham, Birmingham, United Kingdom (Scandrett) University of Birmingham, Birmingham, United Kingdom (Asamane) School of Medicine, Keele University, Keele, Newcastle, ST5 5BG, UK (Volpi) Department of Cardiac Surgery, St. Thomas' Hospital London, London, United Kingdom Abstract BACKGROUND: Children with pre-existing pulmonary arterial hypertension (PAH) undergoing surgery for congenital heart disease (CHD) are at an increased risk of morbidity and mortality, primarily due to complications associated with increased pulmonary arterial pressures. Despite the clinical significance of this risk, no comprehensive review of perioperative strategies to manage pre-existing PAH in paediatric CHD patients undergoing cardiac surgery exists. This systematic review aims to address this gap. METHOD(S): A comprehensive systematic literature search was conducted on Scopus, Medline, Embase, PubMed, Cochrane Library and grey literature; studies were screened using eligibility criteria. Data was extracted using a pre-tested standard form and the methodological quality appraised using the RoB 2 tool. A meta-analysis was used to analyse, summarise, and interpret the extracted data. RESULT(S): Ten randomised controlled studies were included in this review, comprising 520 patients, ages ranged from 0.21 to 13.8 years across 6 countries. All studies reported a greater decrease in postoperative mean pulmonary arterial pressure (mPAP) in the intervention groups compared to the control groups. Although perioperative management did not significantly reduce postoperative PAP (pooled mean difference, -0.44; 95% CI: -4.62-3.73; I2 = 88.73%), their use resulted in statistically significant decreases in mean ICU stays (pooled mean difference, -1.08; 95% CI: -1.90-0.25, p-value = 0.01; I2 = 86.21%) and ventilation times (pooled mean difference, -13.29; 95% CI: -25.78 -0.80, p - value = 0.04; I2 = 97.47%) compared to controls. Sildenafil was the most used intervention, with a significantly greater reduction in PAP compared to other management strategies (pooled mean difference, -6.27; 95% CI: -8.982- -3.57, p-value < 0.001; I2 = 49.84%). Among studies reporting pulmonary hypertensive crises and mortality, the prevalence of pulmonary hypertensive crises was 6.18% in the control group versus 3.43% in the treatment group. Mortality rates were 1.27% in the control group and 0.54% in the treatment group, respectively. CONCLUSION(S): PAH Perioperative management strategies yielded no reductions in postoperative mPAP, but significantly reduced other key clinical outcomes including mean ICU stay and ventilation times in children undergoing cardiac surgery for CHD. Integrating perioperative interventions in the management of PAH may improve overall clinical outcomes, despite minimal impact on mPAP. <72> Accession Number 2043990022 Title Cocoa flavanol supplementation and prevention of cardiovascular disease: a novel analysis of the COSMOS randomized trial using "win ratio". Source European Journal of Epidemiology. 41(5) (pp 599-609), 2026. Date of Publication: 01 May 2026. Author Ogata S.; Manson J.E.; Rist P.M.; Hamaya R.; Aragaki A.K.; Allison M.; Haring B.; Martin L.W.; Nishimura K.; Clar A.; Sesso H.D. Institution (Ogata, Nishimura) Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan (Manson, Rist, Hamaya, Clar, Sesso) Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States (Manson, Rist, Hamaya, Sesso) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Aragaki) Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States (Allison) Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States (Haring) Department of Medicine III, Saarland University, Saarland, Homburg, Germany (Martin) Division of Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, United States Publisher Springer Science and Business Media B.V. Abstract Cocoa flavanols may reduce cardiovascular disease (CVD) risk, yet large randomized trials remain inconclusive. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) suggested a modest, nonsignificant benefit using Cox models, which do not account for event severity in composite outcomes. To address this, we applied generalized pairwise comparison (GPC), or "win ratio" (WR), to assess cocoa flavanols versus placebo on hierarchical CVD outcomes among healthy older US adults. This secondary analysis of COSMOS, a randomized, placebo-controlled, 2 x 2 factorial trial of cocoa extract and multivitamins for preventing CVD and cancer, included 21,442 adults (women >= 65, men >= 60 years) followed for a median of 3.6 years. The primary outcome was a hierarchical composite of total CVD, prioritizing: fatal CVD, non-fatal myocardial infarction (MI), non-fatal stroke, coronary revascularization, carotid surgery, peripheral artery surgery, and hospitalized unstable angina. Analyses followed the intention-to-treat principle. GPC estimated WRs and net treatment benefits (NTBs) for cocoa flavanols versus placebo. GPC analyses showed cocoa flavanol wins of 3.41% and placebo wins of 2.87%, yielding a reciprocal WR of 0.84 (95% CI 0.72-0.99) and negative NTBs of - 0.54% (- 1.04 to - 0.03), p = 0.037. Sensitivity analyses prioritizing stroke over MI produced similar findings. By contrast, Cox regression of the same composite yielded a nonsignificant hazard ratio of 0.90 (95% CI 0.79-1.03), suggesting standard time-to-first-event models underestimated benefit. GPC "WR" analyses showed cocoa flavanols significantly reduced CVD events by accounting for event severity in the composite CVD outcome, whereas Cox regression marginally missed these effects. Copyright © Springer Nature B.V. 2026. <73> Accession Number 2047384537 Title Noninvasive Cardiac Output Monitoring Combined With Critical Care Ultrasound for Postoperative Volume Management in Cardiac Surgery Patients: A Randomized Controlled Trial. Source Journal of Surgical Research. 326 (pp 53-63), 2026. Date of Publication: 01 Oct 2026. Author Xu Y.; Zhang L.; Pan X.; Jiang Y.; Lv J. Institution (Xu, Zhang, Pan, Jiang, Lv) Department of Critical Care Medicine, Tongji University East Hospital, Shanghai, China, China Publisher Academic Press Inc. Abstract Introduction: Postoperative hemodynamic instability and low cardiac output syndrome are common complications following cardiac surgery. Conventional volume management guided by central venous pressure and mean arterial pressure has well-documented limitations. Noninvasive cardiac output monitoring (NICOM) and critical care ultrasound (CCUS) provide complementary, real-time hemodynamic and volumetric assessments. This randomized controlled trial evaluated whether NICOM+CCUS-guided fluid management improves clinical outcomes in cardiac surgery patients with postoperative hemodynamic instability. Material(s) and Method(s): In this single-center, parallel-group randomized controlled trial conducted at Tongji University East Hospital (January-December 2024), 86 adults (>=18 y) with postoperative hemodynamic instability cardiac index (CI) < 2.5 L/min/m2 plus >=1 of: lactate >2 mmol/L or norepinephrine >0.05 mug/kg/min after cardiac surgery were randomized 1:1 (control n = 43, observation n = 43) to conventional monitoring (central venous pressure/mean arterial pressure-guided) or NICOM+CCUS-guided management. Eighty-one patients (control n = 40, observation n = 41) completed analysis. Primary outcomes: extubation time category (<24 h, 24-48 h, >48 h), left ventricular ejection fraction (LVEF), and brain natriuretic peptide at intensive care unit (ICU) discharge. Secondary Outcomes: lactate normalization time (<2 mmol/L), 24-h urine output, net fluid balance, acute heart failure incidence, intra-aortic balloon pump use, mechanical ventilation duration, and ICU length of stay. Categorical variables were analyzed using chi2/Fisher's exact tests; continuous variables were analyzed using t-test/Mann-Whitney U-test after Shapiro-Wilk normality testing. Within-group changes were assessed using paired t-test/Wilcoxon test. Significance: P < 0.05 (two-sided). Result(s): Baseline characteristics were balanced (P > 0.05). The observation group had higher 24-h extubation rates 92.7% versus 60.0%; odds ratio 7.96 (95% CI 2.14-29.63), P < 0.001 and greater LVEF improvement median DELTA6.7% (95% CI 3.2-10.2), P < 0.001 versus control at discharge. The greater LVEF improvement in the observation group was accompanied by lower net fluid balance, earlier lactate normalization, and reduced diuretic use, suggesting that optimized volume status and improved oxygen delivery contributed to enhanced myocardial recovery. Brain natriuretic peptide reduction was more pronounced DELTA-104.0 +/- 68.2 versus -58.8 +/- 62.1 pg/mL; P = 0.031. Secondary outcomes favored the observation group: lactate normalization 16.2 +/- 8.5 versus 28.3 +/- 11.4 h; mean difference (MD) -12.1 h (95% CI -16.7 to -7.5), P < 0.001, urine output 4846.7 +/- 1653.4 versus 4086.5 +/- 1113.8 mL; MD 760.2 mL (95% CI 148.6-1371.8), P = 0.015, net fluid balance 101.4 +/- 32.3 versus 347.6 +/- 64.2 mL; MD -246.2 mL (95% CI -278.5 to -214.0), P < 0.001, acute heart failure 4.8% versus 17.5%; odds ratio 0.24 (95% CI 0.05-1.17), P = 0.045, mechanical ventilation 15.1 +/- 9.3 versus 27.3 +/- 11.5 h; MD -12.2 h (95% CI -16.9 to -7.5), P < 0.001, and ICU stay 31.1 +/- 13.3 versus 42.5 +/- 13.1 h; MD -11.4 h (95% CI -17.4 to -5.4), P < 0.001. Conclusion(s): NICOM+CCUS-guided fluid management significantly improved hemodynamic stability, cardiac recovery, and resource utilization compared to conventional monitoring. This noninvasive strategy reduced fluid overload and complications in high-risk cardiac surgery patients. Multicenter trials enrolling a broader range of cardiac surgical procedures with long-term follow-up are warranted. Copyright © 2026 Elsevier Inc. <74> Accession Number 2045835881 Title Hybrid Suture- and Plug-Based Closure Versus Dual Suture Devices in Transfemoral Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(7) (no pagination), 2026. Article Number: 105339. Date of Publication: 01 Jul 2026. Author Moeez A.; Shah S.W.; Huma S.; Salma Shabbar Banatwala U.E.; Ali A.; Khattak L.Z.; Bacha Z.; Khan A.; Shaid F.; Azeem T.; Razzaq S.; Khan M.W.Z.; Ikram J.; Ullah F.; Shaban M. Institution (Moeez) Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan (Shah, Huma, Ali, Bacha, Khan, Shaid, Azeem) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Salma Shabbar Banatwala) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Khattak, Ullah) Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan (Razzaq) Department of Medicine, Poonch Medical College, Rawalkot, Pakistan (Khan) Department of Internal Medicine, AdventHealth Orlando, Orlando, FL, United States (Ikram, Shaban) Cardiovascular Medicine, Department, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier B.V. Abstract Background Effective vascular closure is crucial in transfemoral transcatheter aortic valve replacement (TAVR) to minimize access-related complications. Although dual suture-based closure is widely used, a hybrid approach combining suture- and plug-based vascular closure devices (VCD) has gained increasing attention. This meta-analysis compared these 2 strategies in terms of vascular outcomes and procedural success. Methods A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched through January 2025 for studies comparing suture-plus-plug-based vs suture-based VCD in TAVR patients. Primary outcomes were major and minor vascular complications, bleeding events, VCD failure, and unplanned interventions. Risk ratios (RRs) with 95% CIs were calculated. Results Six studies involving 2308 patients were included. The suture-plus-plug-based approach significantly reduced major vascular complications (RR, 0.50; P = .001), minor vascular complications (RR, 0.58; P < .00001), and VCD failure (RR, 0.26; P < .00001) compared with suture-based closure alone. No significant differences were observed in major ( P = .30) or minor bleeding ( P = .47). Unplanned interventions were less frequent with the hybrid approach, but the difference was not statistically significant (RR, 0.68; P = .19). Conclusions The combination of suture- and plug-based closure devices in transfemoral TAVR provides superior vascular outcomes and lower device failure rates without increasing bleeding risk. These findings support the hybrid approach as a safe and effective strategy, although further randomized controlled trials are warranted to confirm long-term outcomes. Copyright © 2026 The Author(s). <75> Accession Number 2046866323 Title Surgical Repair of the Aortic Valve in Children: A State-of-the-Art Systematic Review. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 6691434. Date of Publication: 2026. Author Semyashkin A.; Sandica A.; Gherta L.; Ben Mime L. Institution (Semyashkin) Department of Pediatric Cardiac Surgery and Congenital Heart Defects, Klinikum Stuttgart, Stuttgart, Germany (Sandica, Gherta, Ben Mime) Ruhr University Bochum, University Hospital Herz- und Diabeteszentrum NRW, Center for Congenital Heart Defects and Pediatric Heart Center, Pediatric Heart Surgery, Bad Oeynhausen, Germany (Sandica, Gherta, Ben Mime) Bielefeld University, Medical School OWL, Bad Oeynhausen, Germany Publisher John Wiley and Sons Inc Abstract Aortic valve repair in children remains an important strategy to preserve native valve tissue, avoid prosthetic valve replacement, and accommodate somatic growth. However, outcomes vary substantially across repair techniques, valve morphologies, and patient subgroups. We performed a systematic review with quantitative synthesis of outcomes to provide a contemporary overview of surgical strategies and long-term results of pediatric aortic valve repair. PubMed/MEDLINE, Embase, Scopus, and the Cochrane Library were searched for studies published between January 2000 and January 2026 reporting outcomes of surgical aortic valve repair in patients aged <= 18 years. Thirty-four studies, including 2684 children, were analyzed. Repair strategies included commissurotomy, leaflet plication, cusp extension or tricuspidization, annuloplasty-based techniques, pericardial leaflet reconstruction, and aortic valve neocuspidization. Early mortality after pediatric aortic valve repair was low overall (1.3%; 95% confidence interval [CI]: 0.7%-2.1%) but higher in neonates and infants. Long-term durability differed by technique and underlying pathology. Autologous pericardial cusp extension and tricuspidization demonstrated favorable long-term durability in selected patients, with freedom from reoperation approaching 75% at 15 years in some series. Valve neocuspidization was associated with excellent early hemodynamics and no early mortality in the included studies, but currently available pediatric data suggest less certain mid-term durability, with estimated freedom from reintervention of 44% at 10 years; however, interpretation is limited by small sample sizes and relatively short follow-up. Younger age at repair and the use of treated xenograft material were associated with increased risk of reintervention. Pediatric aortic valve repair provides low operative mortality and favorable valve preservation in carefully selected patients, but outcomes depend strongly on patient age, valve morphology, surgical technique, and institutional experience. Pooled estimates should be interpreted cautiously in view of substantial clinical heterogeneity. Surgical decision-making should remain individualized and lesion-specific, with a strong emphasis on valve preservation whenever feasible. Copyright © 2026 Andrey Semyashkin et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <76> Accession Number 650777117 Title Impact of FloTrac/EV1000-guided intraoperative hemodynamic optimization on postoperative outcomes in cardiac valve surgery: a randomized controlled trial. Source Scientific reports. 16(1) (no pagination), 2026. Date of Publication: 29 Mar 2026. Author Tribuddharat S.; Ratanasuwan P.; Sathitkarnmanee T.; Chaimala N.; Polsena L.; Mantruad P. Institution (Tribuddharat, Ratanasuwan, Sathitkarnmanee) Department of Anesthesiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand (Chaimala, Polsena) Faculty of Medicine, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand (Mantruad) Queen Sirikit Heart Center of the Northeast, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand Abstract Cardiac valve surgery is associated with significant postoperative morbidity and mortality. This study evaluated the impact of intraoperative hemodynamic optimization using FloTrac/EV1000 on postoperative outcomes in patients undergoing cardiac valve surgery. In this single-center, prospective, randomized controlled trial, 82 patients undergoing elective cardiac valve surgery were randomly allocated to either FloTrac/EV1000 management (EV1000 group, n = 42) or conventional management (Control group, n = 40). The primary outcome was ICU length of stay. Secondary outcomes included mechanical ventilation duration, hospital length of stay, vasoactive drug requirements, fluid balance, and postoperative complications. The EV1000 group had significantly shorter ICU (30.2%) and hospital (13.6%) stay (p = 0.007 and 0.047, respectively) compared to the Control group. The EV1000 group required more vasoactive drugs during pre-bypass (p = 0.018) but fewer before ICU transfer (p = 0.003) and during their ICU stay (p < 0.05). The incidence of postoperative ventricular fibrillation (0 vs. 15.0%, p = 0.011), bradycardia (11.9 vs. 35.0%, p = 0.016), atrial fibrillation with rapid ventricular response (14.3 vs. 25.0%, p = 0.032), acute respiratory distress syndrome (0 vs. 5.0%, p = 0.045), and acute kidney injury (0 vs. 5.0%, p = 0.045) was lower in the EV1000 group. Goal-directed hemodynamic management using FloTrac/EV1000 monitoring in cardiac valve surgery was associated with shorter ICU and hospital length of stay, reduced postoperative vasoactive drug requirements, and fewer postoperative complications compared with conventional management. Whether this benefit derives from the monitoring technology, the structured hemodynamic algorithm, or their combination warrants confirmation in future multicenter trials.Trial registration: NCT04292951 (The full date of first registration on https://ClinicalTrials.gov : March 1, 2020). <77> Accession Number 651030626 Title Screening rates and geographical disparities shape venous thromboembolism risk after cardiac surgery: a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 25 Apr 2026. Author Chang R.; Xu Z.; Li W.; Liu X.; Shen Y.; Wang Y.; Mao Q.; Wang W.; Yang X. Institution (Chang, Xu, Li, Liu, Shen) Department of Cardiology, Shenzhen Longhua District Central Hospital, Shenzhen, Guangdong, China (Xu) Medical College, Research Center for High Altitude Medicine in Qinghai University, Xining, Qinghai, China (Wang) Department of Medicine, Beijing Zhongwei Medical Research Center, Biological and Translational Medicine, Beijing, China (Mao, Wang) Department of Biology, Oasis Road Research Center, Watertown, MA, United States (Yang) Department of Cardiology, Deyang People's Hospital, China Abstract INTRODUCTION: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), is a serious complication following cardiac surgery. Despite existing investigations, the true incidence rates and risk factors remain incompletely defined. METHOD(S): We systematically searched PubMed, Cochrane, Embase, and Web of Science databases, incorporating 21 eligible studies (n = 794,662). A random-effects model was applied to perform a meta-analysis assessing the incidence of VTE and associated risk factors after cardiac surgery. RESULT(S): The pooled incidence of VTE after cardiac surgery was 10.2% (95% CI: 7.6%-13.1%), with incidences of DVT and PE reported at 10.6% (95% CI: 7.6%-14.0%) and 1.6% (95% CI: 0.8%-2.6%), respectively based on random-effects models. Subgroup analyses revealed lower VTE rates in studies conducted in the Americas than in those from Eurasia (6.5% vs. 19.3%). Studies using antithrombotic prophylaxis, including combined therapy (19.6%) or pharmacological prophylaxis alone (23.2%), also showed lower VTE rates than studies without prophylaxis, although these differences were not statistically significant. Studies employing universal screening (100% screening rate) detected significantly higher VTE rates compared with those without (23.1% vs. 3.9%). CONCLUSION(S): In conclusion, VTE incidence after cardiac surgery remains high, but reported rates are heavily influenced by screening intensity. The clinical significance of screen-detected events is uncertain. Future research should distinguish asymptomatic from symptomatic VTE and evaluate the cost-effectiveness of targeted versus universal screening. <78> Accession Number 650807781 Title Comparison of mixed reality and computed tomography-guided preoperative hook-wire localization for pulmonary nodules in video-assisted thoracoscopic surgery: a noninferiority randomized clinical trial. Source Scientific reports. 16(1) (no pagination), 2026. Date of Publication: 02 Apr 2026. Author Qi W.; Zhou J.; Xin N. Institution (Qi, Xin) Department of Thoracic Surgery, 960th Hospital of People's Liberation Army, Jinan, China (Zhou) Department of Special Operations, 960th Hospital of People's Liberation Army, Jinan, China (Xin) Shandong Second Medical University, Jinan, China Abstract Preoperative localization of pulmonary nodules is critical for video-assisted thoracoscopic surgery (VATS). Traditional Computed Tomography (CT)-guided localization has limitations, including radiation exposure and procedural complexity. Mixed Reality (MR)-guided localization offers a promising alternative, potentially improving accuracy, efficiency, and safety. To compare the accuracy, efficiency, and safety of MR-guided versus CT-guided preoperative localization for pulmonary nodules in VATS through a noninferiority randomized trial. This prospective, single-center, noninferiority randomized clinical trial enrolled 90 patients with small pulmonary nodules. Patients were randomized to either MR-guided or CT-guided localization groups. The primary outcome was localization accuracy, measured by deviation from the target nodule. Secondary outcomes included procedural duration, insertion attempts, radiation exposure, complications, and surgical outcomes. Intention-to-treat (ITT) and per-protocol (PP) analyses were both performed. The MR-guided group demonstrated significantly higher localization accuracy, with smaller total deviation (5.50 mm vs. 6.84 mm, p = 0.04) and vertical deviation (p = 0.04). Procedural duration (3.98 min vs. 10.73 min, p < 0.001) and insertion attempts (1.05 vs. 2.28, p < 0.001) were significantly reduced in the MR-guided group. Radiation exposure was also lower, with fewer CT scans and reduced dose length product and effective dose (p < 0.001). Complication rates, including pneumothorax and hemorrhage, were slightly lower in the MR-guided group but not statistically significant. Surgical outcomes were comparable between groups. MR-guided localization met the noninferiority criteria to CT-guided localization in terms of localization accuracy and overall safety, and showed exploratory clinical benefits with notably improved procedural efficiency and reduced radiation exposure. These findings support its potential as a safe and effective alternative for preoperative pulmonary nodule localization in thoracic surgery. <79> Accession Number 650919955 Title Impact of tight blood glucose control on atrial fibrillation in critically ill patients receiving early parenteral nutrition: an individual patient data meta-analysis of two large randomized controlled trials. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 15 Apr 2026. Author De Troy E.; Gunst J.; Wouters P.J.; Van den Berghe G.; Dauwe D. Institution (De Troy, Gunst, Wouters, Van den Berghe, Dauwe) Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium Abstract BACKGROUND: Atrial fibrillation often occurs during critical illness. Tight glucose control with insulin (TGC) is known to reduce inflammation and oxidative stress and may alter atrial metabolism, which, together, could affect atrial fibrillation pathogenesis. Our group has previously shown that TGC reduced morbidity and mortality in a mixed medical/surgical critically ill patient population receiving early parenteral nutrition as part of the contemporary standard of care. We here hypothesized that TGC reduces atrial fibrillation in the intensive care unit (ICU). METHOD(S): In this individual patient data meta-analysis of 2 randomized controlled trials (performed 2000-2001 and 2002-2005), we investigated the impact of TGC with insulin (targeting blood glucose 80-110 mg/dL) in comparison with tolerating hyperglycemia to 215 mg/dL (liberal glucose control [LGC]) on atrial fibrillation in mixed surgical (n = 1548) and medical (n = 1200) ICU patients admitted to a quaternary-care university hospital. Atrial fibrillation was further classified as new-onset or recurrent/persistent pre-existing atrial fibrillation. The primary endpoint was the impact of TGC on atrial fibrillation in ICU, determined via multivariable logistic regression analysis after adjusting for relevant baseline patient characteristics. Prespecified subgroup analyses were performed for patients with a history of diabetes mellitus, pre-existing atrial fibrillation, overall surgical admission, admission after cardiac surgery and for patients with an ICU-stay longer than 5 days, after assessing treatment heterogeneity via determination of interaction p-values. RESULT(S): Atrial fibrillation in ICU occurred in 845/2639 patients (32.0%), 65.9% of which was new-onset atrial fibrillation. TGC had no impact on atrial fibrillation in ICU (adjusted OR 0.92 [0.77-1.11])(P = 0.40). TGC also did not affect new-onset atrial fibrillation (adjusted OR 0.92 [0.75-1.12])(P = 0.39). There was no treatment heterogeneity present for the pre-defined subgroups except for the subgroup of patients with history of diabetes mellitus (n = 390), in which atrial fibrillation was documented for 66/199 patients in the TGC-group (33.2%) and 80/191 patients in the LGC-group (41.9%), interaction P = 0.045). Atrial fibrillation in ICU was strongly associated with worse outcome. CONCLUSION(S): TGC in the context of early use of parenteral nutrition did not reduce atrial fibrillation during ICU-stay in this large mixed medical-surgical ICU cohort. A possible exception was noted for patients with a history of diabetes mellitus. <80> Accession Number 650992664 Title Short- and long-term outcomes of david versus bentall procedures in acute type a aortic dissection: a meta-analysis with reconstructed individual patient data for time-to-event analysis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 22 Apr 2026. Author Santos K.; Habiyambere G.I.; Bartolozzi H.; Obi O.S.; Carvalho P.E.P.; Madera D.; Plonek T. Institution (Santos) New Vision University School of Medicine, Tbilisi, Georgia (Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum Twente, Enschede, Netherlands (Habiyambere) University of Global Health Equity, Butaro campus, Rwanda (Bartolozzi) Trakia University, Stara Zagora, Bulgaria (Obi) New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, NY, United States (Carvalho) Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, United States (Madera) Department of Vascular Surgery Pasteur Hospital, Montevideo, Uruguay Abstract BACKGROUND: Acute Type A Aortic Dissection (ATAAD) involving the aortic root is managed with either the Bentall or valve-sparing David procedure, but the optimal approach remains debated. Prior meta-analyses are limited by outdated cohorts, indirect comparisons, and high heterogeneity. We conducted an updated meta-analysis of recent studies (2020-2025) comparing David and Bentall procedures, incorporating reconstructed individual patient data to assess long-term survival. METHOD(S): A systematic search identified studies directly comparing the David and Bentall procedures in ATAAD. Statistical analyses were performed using RevMan 8.13.0, reporting odds ratios (OR) and mean differences (MD) with 95% confidence intervals (CI), and heterogeneity assess via I2 statistic. Time-to-event data were reconstructed from Kaplan-Meier curves using digitisation and the IPDfromKM algorithm, with pooled hazard ratios calculated using a Cox frailty model. RESULT(S): Seven studies comprising 1,666 patients were included, of whom 432 (25.9%) underwent the David procedure. Compared to the Bentall procedure, the David technique was associated with significantly lower odds of mortality [OR 0.47; 95% CI 0.31-0.71; p = 0.004], shorter hospital stay [MD - 3.81 days; 95% CI - 6.80 to - 0.82; p = 0.03], reduced blood loss [MD - 33.45 mL; 95% CI - 65.24 to - 1.65; p = 0.05] and lower odds of atrial fibrillation [OR 0.42; 95% CI 0.27-0.64; p = 0.02], acute kidney injury (AKI) [OR 0.50; 95% CI 0.32-0.79; p = 0.003], and prolonged mechanical ventilation [OR 0.60; 95% CI 0.49-0.75; p = 0.02]; all with I2 = 0%. Long-term analysis showed a 62% reduction in mortality risk with David [HR 0.38; 95% CI 0.28 to 0.52; p < 0.001], with consistently lower 10-year mortality on reconstructed Kaplan-Meier curves. CONCLUSION(S): The David procedure demonstrated favourable outcomes compared to the Bentall procedure in ATAAD patients, including significantly lower mortality, shorter hospital stays, and reduced incidence of AKI, AF, prolonged ventilation, and long-term survival. These findings suggest the David technique as a safe, effective, and durable alternative to the Bentall procedure. However, the potential for selection bias remains considerable, as the David procedure is often reserved for younger, haemodynamically stable patients with favourable anatomy. <81> Accession Number 651003445 Title Frailty and postoperative complications in elderly patients undergoing cardiac surgery: a systematic review and meta-analysis. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 24 Apr 2026. Author Zhang X.; Li Y.; Zhang L.; Xiao Y.; Huang H.; Feng F.; Chen J.; Wang S.; Chen X.; Wang L. Institution (Zhang, Chen, Chen) Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, China (Zhang, Zhang, Xiao, Wang) Faculty of Medicine, Macau University of Science and Technology, SAR, Macau, China (Li, Wang) Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Huang) Department of Nursing, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (Feng) College of Public health, Zhengzhou University, Zhengzhou, Henan, China Abstract BACKGROUND: Frailty prevalence is high in elderly, especially those experiencing surgical operation. Identifying high-risk individuals who planned to receive surgery becomes imperative. OBJECTIVE(S): Current evidence from observational studies suggesting the specific impact of frailty on cardiac surgery remains ambiguous, the systematic review and meta-analysis aimed to consolidate existing data to evaluate the impact of frailty on outcomes in elderly patients undergoing cardiac surgery. METHOD(S): Searches were conducted in PubMed, Web of Science, Cochrane, and Wanfang database from inception to May 31, 2025, and the review was subsequently updated to February 17, 2026. The primary outcomes were all-cause mortality after cardiac surgery, atrial fibrillation (AF), delirium, and stroke. Secondary outcomes included other related complications including acute kidney injury (AKI), infection, pulmonary complications, bleeding, rehospitalization, nonhome discharge, length of intensive care unit (ICU) stay, length of hospital stay (LOS). RESULT(S): Twenty-five studies were incorporated into the meta-analyses, involving 20 original studies and five database studies. The results showed that mortality among frail elderly patients undergoing cardiac surgeries was higher than non-frail counterparts both in original studies [risk ratio (RR) 3.63; 95% confidence interval (CI), 2.78-4.72; I2= 19%; P < 0.001] and database studies (RR 3.84; 95% CI, 3.63-4.06; I = 74%; P < 0.001). The risks of AF, delirium, stroke were higher in frail elderly patients: AF (OR 1.30; 95% CI: 1.03 - 1.65; I2 = 0%; P = 0.03), delirium (OR 2.08; 95% CI: 1.53 - 2.81; I2 = 40%; P < 0.001), stroke (OR 2.81; 95% CI: 2.08 - 3.81; I2 = 0%; P < 0.001). Frailty was significantly associated with increased risks of other postoperative complications in older patients after cardiac surgeries. Subgroup analyses indicated that database studies performed comparably to original studies in predicting postoperative complications, yet demonstrated significant heterogeneity in reporting outcomes. CONCLUSION(S): Our study underscores the pivotal impact of frailty on mortality, AF, delirium, stroke and other complications in the elderly patients undergoing cardiac surgeries. The results advocate for the incorporation of frailty assessments into the preoperative evaluation process. REGISTRATION INFORMATION: Registered in the International Prospective Register of Systematic Reviews (CRD420251115942). <82> Accession Number 651020383 Title Trans-catheter versus open surgical aortic valve replacement in severe symptomatic aortic stenosis. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 24 Apr 2026. Author Eltaweel M.F.; Elsokkary I.N.; Badawi M.W.; Mohamed Adas A.Y.; Alherazi A.; Yossif M.A.W.; Ibrahim G.K.; Ramadan A.; Albatrek H.; Khalil I.M. Institution (Eltaweel) Department of Cardiothoracic surgery, Faculty of Medicine, Menoufia University, Egypt (Elsokkary, Badawi, Ibrahim) Department of Cardiothoracic surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Mohamed Adas) Department of Cardiothoracic surgery, Faculty of Medicine, Beni Seuf University, Egypt (Alherazi) Department of Cardiothoracic surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt (Yossif) Department of Cardiothoracic surgery, Faculty of Medicine, Al-Azhar Assiut University, Egypt (Yossif) Department of Cardiovascular & Thoracic surgery, Faculty of Medicine, Al-Azhar University, Egypt (Ramadan, Albatrek) Department of Cardiac surgery, National Heart Institute, Cairo, Egypt (Khalil) Department of Cardiothoracic surgery, Faculty of Medicine, Menoufia University, Egypt Abstract OBJECTIVES: The objectives of this study were: (1) to compare the incidence of effective orifice area (EOA) after either the trans-catheter and surgical aortic valve replacement (SAVR); and (2) to assess the impact of EOA on life style modifications and mortality recorded after either surgical or trans-catheter aortic valve replacement. Trans-catheter aortic valve replacement (TAVR) has emerged as a valid alternative to SAVR in selected patients. It appears important to implement preventive strategies to avoid prosthesis failure without increasing operative risk. METHOD(S): A case series of 148 consecutive patients from January 2023 to January 2025 with severe aortic valve stenosis. The patients were randomized into two groups as trans-catheter aortic valve replacement (TAVR as group A) and surgical aortic valve replacement (SAVR as group B). The Echocardiography was done pre- and postoperatively, plus scales of life activities in the follow-up period (6 months and one year). RESULT(S): In this study, a total of 148 patients were studied to determine the outcomes of patients who underwent either trans-catheter or surgical aortic valve replacement in terms of demographic, operative, and postoperative variables. There were significant improvement in Echo findings after 6 months and one year. In the other side, there were no significant differences comparing both groups according to quality of life parameters. CONCLUSION(S): In patients with severe aortic stenosis and high surgical risk, EOA is good indicator for the success of SAVR than TAVR. TAVR may be preferable to SAVR in patients with better life style modifications. <83> Accession Number 2047447057 Title Comparing outcomes of TAVI and SAVR in low or intermediate risk symptomatic severe aortic stenosis: A systematic review and meta-analysis. Source Open Medicine (Poland). 21(1) (no pagination), 2026. Article Number: 20261466. Date of Publication: 01 Jan 2026. Author Rashid K.; Hasan A.; Javaid M.; Ansar F.; Khan Y.; Kazmi M.H.; Farid T.; Waheed F.; Ali L.; Ali Saleh S.; Akbar R.A.; Waheed M.A. Institution (Rashid) North Cumbria Integrated Care Nhs Foundation Trust, Carlisle, United Kingdom (Hasan) University of Minnesota, Minneapolis, MN, United States (Javaid) Oxford University Hospitals, Oxford, United Kingdom (Ansar) Alkhidmat Raazi Hospital, Rawalpindi, Pakistan (Khan) Institute of Kidney Disease, Peshawar, Pakistan (Kazmi) Sunderland Royal Hospital, Sunderland, United Kingdom (Farid) Ninewell Hospital, Dundee, United Kingdom (Waheed) Hayatabad Medical Complex, Peshawar, Pakistan (Ali) Nowshera Medical College, Peshawar, Pakistan (Ali Saleh, Akbar) Hamad General Hospital, Doha, Qatar (Waheed) Hamad General Hospital, Qatar University, Doha, Qatar Publisher Walter de Gruyter GmbH Abstract Objectives: To compare the mortality and clinical outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with low- or intermediate-risk symptomatic severe aortic stenosis through an updated systematic review and meta-analysis of randomized controlled trials. Method(s): This systematic review was performed using PubMed, Medline, Embase, and Cochrane databases for RCTS between 2017 and 2024 which evaluated mortality outcomes in patients with low to intermediate risk AS who received TAVI vs. SAVR. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random effects models. Result(s): TAVI showed a numerically lower but statistically insignificant mortality risk compared to SAVR (RR: 0.88, 95% CI: 0.62-1.25, p=0.49). TAVI was associated with a higher risk of PPM insertion (RR: 2.19, 95% CI: 1.55-3.16, p<0.001, i2: 80%), aortic valve re-intervention (RR: 2.51, 95% CI: 1.40-4.51, p<0.001; I2=0%), new-onset bundle branch block (RR: 2.10, 95% CI: 1.21-3.67, p<0.01; I2=84%), and vascular site complications (RR: 4.77, 95% CI: 2.11-10.81, p<0.001; I2=62%). Atrial fibrillation incidence was lower with TAVI (RR: 0.29, 95% CI: 0.23-0.38, p<0.001; I2=73). There was no significant difference in the rates of post-procedural myocardial infarction, stroke and endocarditis between TAVI and SAVR. Conclusion(s): TAVI has mortality outcomes comparable to SAVR in low to intermediate risk patients. TAVI offers advantages in atrial fibrillation reduction, but is associated with increased risk of PPM insertion, vascular complications, new-onset bundle branch block, aortic valve re-intervention. Individualized treatment decisions remain important for optimizing outcomes in low to intermediate risk patients. Prospero registration number: CRD42024547882. Copyright © 2026 the author(s), published by De Gruyter, Berlin/Boston. <84> Accession Number 650992340 Title Restrictive versus liberal red blood cell transfusion strategies for cardiac surgery: a systematic review and meta-analysis of randomized controlled trials. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 22 Apr 2026. Author Shao J.; Zhang Y.; Lin W.; Yan M.; Cai X.; Luo Z.; Yu W.; Xu J. Institution (Shao, Zhang, Lin, Yan, Cai, Cai, Luo, Yu, Xu) School of Medical, Southeast University, 87 Dingjiaqiao Rd, Nanjing, China (Shao, Zhang, Lin, Yan, Cai, Cai, Luo, Yu, Xu) Department of Critical Care Medicine, Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China Abstract BACKGROUND: The equivalence of transfusion-related outcomes between restrictive and liberal red blood cell (RBC) transfusion strategies after cardiac surgery remains to be determined. This review provides an overview of the impact of restrictive RBC transfusion strategies compared with liberal transfusion strategies on the transfusion-related outcomes of postcardiac surgery patients. METHOD(S): Studies in MEDLINE, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases until March 2025 were searched. Studies compared the effects of restrictive RBC transfusion strategies with liberal transfusion strategies in postcardiac surgery patients were eligible. Two reviewers extracted data independently. Data including sample size, characteristics of patients, intervention and outcomes were extracted. Primary outcome was respiratory complications. Subgroup analyses were conducted by time of follow-up and Euroscore I. Review Manager 5.4 was used to evaluate the risk of bias and data. Random errors were evaluated by trial sequential analysis (TSA). RESULT(S): Of the 4293 records identified, 13 studies compared restrictive versus liberal transfusion strategies, including 9,267 patients receiving restrictive transfusion (49.98%) and 9,275 receiving liberal transfusion (50.02%). There was no significant difference in respiratory complications between the restrictive transfusion group and the liberal transfusion group (risk ratio [RR] 1.07; 95% confidence interval [CI] 0.90-1.26; P = 0.44), but we found a statistically significant for gastrointestinal complications (RR 1.99; 95% CI 1.05-3.77; P = 0.04) and units of RBC transfusions (mean deviation [MD] -0.70; 95% CI -0.96--0.43, P < 0.00001). Different transfusion strategies had no statistically significant effect on other transfusion-related outcomes. Subgroup analyses for mortality indicated that patients with low Euroscore I risk preferred restrictive transfusion (RR 1.72; 95% CI 1.16-2.57; P = 0.007). The TSA indicated insufficient number of trials and evidence to support firm conclusions. CONCLUSION(S): There are no significant differences in the risk of respiratory complications between restrictive and liberal transfusion strategies. However, the restrictive transfusion strategy is associated with an increased risk of gastrointestinal complications and a lower number of RBC transfusion units in patients undergoing cardiac surgery. Additionally, restrictive transfusion may reduce mortality in patients with low Euroscore I risk. Clinically, these findings support an individualized transfusion approach, in which restrictive strategies may be appropriate for selected low-risk patients, while transfusion decisions in higher-risk patients should carefully balance potential gastrointestinal risks against the benefits of blood conservation. <85> Accession Number 650151181 Title Cerebral oximetry-guided anaesthesia and postoperative delirium in elderly patients undergoing off-pump coronary artery bypass grafting: a randomized controlled trial. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 03 Feb 2026. Author Tian L.; Wang H.; Jia Y.; Guo J.; Shan J.; Zhou H.; Zhao W.; Yuan S. Institution (Tian, Wang, Jia, Guo, Shan) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, China (Zhou) Department of Intensive Care Unit, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Zhao) Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Yuan) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, National Clinical Research Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, Xicheng District, Beijing, China Abstract INTRODUCTION: While cerebral oximetry monitoring has been reported to reduce neurological dysfunction and hospital stay after cardiac surgery, its effect on postoperative delirium (POD) during off-pump coronary artery bypass grafting (CABG) remains underexplored. This study examines whether using cerebral oximetry to guide anaesthesia can reduce POD in patients aged >= 65 years undergoing off-pump CABG. METHODS : This single-center, randomized trial enrolled 200 patients scheduled for off-pump CABG. Participants were randomly assigned (1:1) to either the intervention or control group using sealed envelopes prior to anaesthesia. In the intervention group, cerebral oxygen saturation was continuously monitored by cerebral oximetry. A desaturation event (a drop > 20% from baseline or an absolute regional cerebral oxygen saturation < 55% at either probe) triggered predefined intervention strategies. In the control group, cerebral oximetry data were blinded to clinicians, and patients received standard anaesthetic care. The primary outcome was the incidence of POD during the first 7 days after surgery. Secondary outcomes included the incidence of postoperative acute kidney injury and myocardial infarction, mechanical ventilation duration, intensive care unit (ICU) and hospital stay, and in-hospital mortality. RESULTS : A total of 200 patients were randomized and included in the final analysis. Delirium occurred in 14 patients (14.0%) in the intervention group versus 24 (24.0%) in the control group within the first 7 postoperative days (P = 0.104). Subgroup analysis showed a significantly lower incidence of delirium in older patients ( > 70 years) in the intervention group compared to the controls [5/47 (10.6%) vs. 11/31 (35.5%); P = 0.011], suggesting a possible interaction between cerebral oximetry-guided anaesthesia and advanced age. ICU and hospital stays were also markedly shorter in the intervention group. CONCLUSION : Cerebral oximetry-guided anaesthesia did not significantly reduce POD in patients aged >= 65 years undergoing off-pump CABG; exploratory analyses suggested a numeric reduction in those > 70 years. However, this observation requires prospective validation in a larger, adequately powered trial. TRIAL REGISTRATION: ChiCTR2300068537 (Chinese Clinical Trial Registry), registered 22/02/2023. <86> Accession Number 2038287491 Title Pharmacist-integrated early screening for postoperative complications in pediatric cardiac surgery: Evidence synthesis and derivation of the pediatric early complication score. Source Pharmacy Practice. 24(2) (no pagination), 2026. Article Number: 3598. Date of Publication: 01 Apr 2026. Author Chidnok W.; Wienghirun J.; Lin C.; Poowaruttanawiwit P. Institution (Chidnok) Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand (Chidnok) Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand (Wienghirun, Lin, Poowaruttanawiwit) Medical and Pharmaceutical Innovation Research and Development Unit, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand (Poowaruttanawiwit) Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand Publisher Grupo de Investigacion en Atencion Farmaceutica Abstract Background: Early postoperative complications remain a major determinant of morbidity and mortality in pediatric cardiac surgery despite improved survival. Conventional risk systems such as Risk Adjustment for Congenital Heart Surgery (RACHS) and Risk Adjusted Surgical Complexity Hierarchy (RASCH) focus on procedural complexity and mortality rather than real-time complication prediction. Objective(s): This systematic review and meta-analysis aimed to quantify the pooled incidence and predictors of early postoperative complications and to derive a concise, evidence-based Pediatric Early Complication Score (PECS) to support early screening and pharmacist-integrated care. Method(s): Eligible studies enrolled patients <18 years undergoing congenital heart surgery and reported extractable complication incidences or predictor-adjusted effects. Data were pooled using random-effects meta-analysis with prespecified thresholds (e.g., cardiopulmonary bypass [CPB] >=120 minutes, C-reactive protein [CRP] >118 mg/L). Internal validity was reinforced by preregistration, standardized definitions, duplicate assessment, adjusted-effect preference, and ROBINS-I/RoB2 risk-of-bias tools. Result(s): Across 13 observational studies (n=25,000) and two randomized trials, higher operative complexity (RACHS 3-6 or RASCH-2 >=4), prolonged CPB exposure, neonatal age (<=60 days), and elevated CRP/D-dimer were consistently associated with approximately threefold higher early-complication risk (pooled adjusted effect =2.8, 95% CI 2.03-3.88, I2=23%). These reproducible predictors were transformed into integer points (4, 2, 2, 2, 1 respectively) to form the PECS, which stratifies patients into low (0-3), moderate (4-6), and high (>=7) risk tiers via a logistic probability link. Conclusion(s): The PECS offers a transparent, internally valid, and clinically tractable bedside tool integrating surgical complexity, CPB duration, age, and inflammatory response to predict early postoperative complications. Its pragmatic design supports pharmacist-led, prevention-focused care and warrants multicenter calibration and external validation. Copyright © the Authors. <87> Accession Number 650813209 Title The combined use of HA380 hemoperfusion in cardiopulmonary bypass alleviates postoperative inflammatory response and organ dysfunction following cardiac surgery. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 03 Apr 2026. Author Li L.; Li J.; Li H.; Wang S.; Chen C.; Zhang B. Institution (Li, Li, Li, Wang, Chen) Fuyang Hospital Affiliated to Anhui Medical University, Fuyang, China (Zhang) Fuyang Hospital Affiliated to Anhui Medical University, Fuyang, China Abstract OBJECTIVE: To evaluate the efficacy of the HA380 hemoperfusion device in attenuating systemic inflammatory response during cardiopulmonary bypass (CPB)-assisted cardiac surgery and its influence on perioperative clinical outcomes. METHOD(S): This trial enrolled 65 patients who underwent elective cardiac surgery with CPB. Patients were randomly divided into two groups: the experimental group (HP group, n = 34) used the HA380 hemoperfusion device throughout CPB; the control group (n = 31) underwent conventional CPB only. Serum levels of IL-1beta, IL-6, IL-8, IL-10, TNF-alpha, and CRP were measured at: preoperatively (T0), immediately postoperatively (T1), 24 h (T2) and 48 h (T3) post-surgery. Surgical data, postoperative ICU indicators (duration of intubation, vasoactive-inotropic score [VIS], drainage volume, urine output, ICU stay duration), and first-day postoperative blood routine, liver and kidney function, and coagulation indicators were recorded. Differences between the two groups were compared. RESULT(S): There were no statistical differences in baseline data between the two groups (P > 0.05). Inflammatory factor analysis showed that serum levels of IL-1beta, IL-6, IL-8, and IL-10 in the HP group were significantly lower than the control group (P < 0.05) at T1 and T2. However, no significant differences were observed in TNF-alpha and CRP levels between the two groups at any time point (P > 0.05). Regarding clinical indicators, the HP group exhibited a lower VIS on postoperative day 1 (P < 0.05); significant reductions in levels of white blood cells, neutrophils, ALT, urea, and creatinine were observed than the control group (P < 0.05). ICU intubation time, drainage volume, and urine output on the first postoperative day, ICU stay duration, hemoglobin, platelet, bilirubin, and other indicators showed no intergroup differences (P > 0.05). CONCLUSION(S): The combined application of the HA380 blood perfusion device during CPB-assisted cardiac surgery effectively clears medium molecular weight inflammatory mediators (IL-1beta, IL-6, IL-8, IL-10), significantly reduces early postoperative systemic inflammatory response, and helps improve early postoperative hemodynamic stability (reducing the need for vasoactive drugs) and short-term liver and kidney function indicators. However, no significant reduction was observed in ICU mechanical ventilation time and ICU stay duration. HA380 demonstrates promise as an adjunct anti-inflammatory therapy, though its long-term benefits and impact on postoperative recovery optimization require further investigation. <88> Accession Number 2047425394 Title A Comparative Study between General Anesthesia versus Sedation by Dexmedetomidine and Ketamine with Local Infiltration for Percutaneous Transcatheter Closure of Atrial Septal Defect in Pediatric Patients. Source International Journal of Drug Delivery Technology. 16(67 Supplement) (pp 897-904), 2026. Date of Publication: 2026. Author Mashal A.E.; Darwish J.M.; Yousef A.A.E.; Okab M.E.; Shaban S.E. Institution (Mashal, Darwish, Yousef, Okab, Shaban) Anesthesia, Intensive Care and Pain Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background A cardiac condition known as atrial septal defect (ASD) is characterized by an inadequate closure of the communication between the right and left atria. This work aimed to compare between general anesthesia (GA) versus sedation with dexmedetomidine and ketamine with local infiltration at the catheter insertion site in pediatric patients undergoing transcutaneous closure of ASD on hemodynamic changes. Methods This prospective randomized study involved sixty pediatric cases scheduled for elective ASD closure who were selected from Tanta University Hospitals. All cases were randomly classified into 2 equal groups: Group A (GA group): Received general anesthesia (GA). Group B (local anesthesia group): Received local anesthesia. Results The incidence of emergency agitation was significantly lower in group B (LA) than group A (GA) (P < 0.001). The recovery time was significantly decreased in group B (LA group) than group A (GA group) (P value < 0.001). Vomiting and nausea were significantly increased in group A (GA group) than group B (LA group) (P = 0.037, 0.003). Conclusions Both GA and sedation with dexmedetomidine and ketamine with local infiltration were comparable in maintaining hemodynamics regarding heart rate, mean blood pressure, left ventricular function, and respiration and oxygen saturation at the catheter insertion site in pediatric patients undergoing transcutaneous closure of ASD. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <89> Accession Number 2047576478 Title Artificial intelligence and biomarker-driven prediction of post-coronary artery bypass grafting atrial fibrillation: Integrating clinical, genomic, and metabolic insights. Source Heart Rhythm O2. (no pagination), 2026. Date of Publication: 2026. Author Ghani M.U.; Prasad A.; Nagarajan J.S.; Patel D.T.; Desai R.; Gnanaguruparan S.; Chatterjee S. Institution (Ghani) Department of Internal Medicine, Central Michigan University, Mt. Pleasant, MI, United States (Prasad) Department of Anesthesiology and Perioperative Medicine, MD Anderson Cancer Center, Houston, TX, United States (Nagarajan) Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States (Patel) Department of Medicine, Mercy Catholic Medical Center, Darby, PA, United States (Desai) Independent Researcher, Outcomes Research, Atlanta, GA, United States (Gnanaguruparan) Division of Cardiology, Christiana Hospital, Newark, DE, United States (Chatterjee) Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, United States Publisher Elsevier B.V. Abstract Background Postoperative atrial fibrillation (POAF) remains one of the most frequent and consequential complications after coronary artery bypass grafting, occurring in 15%-30% of patients and contributing to increased morbidity, prolonged hospitalization, and higher long-term mortality. Despite decades of investigation, traditional risk models have shown limited predictive accuracy owing to the multifactorial nature of POAF. Objective This review synthesizes the emerging evidence from recent studies applying artificial intelligence (AI) and machine learning (ML) approaches for POAF prediction, with focus on clinical, biochemical, genomic, and molecular dimensions. Methods We conducted a structured narrative review of PubMed/MEDLINE, Embase, and Google Scholar for studies evaluating AI and ML-based prediction of POAF following isolated coronary artery bypass grafting published from January 2020 through 2025. Search terms included POAF, coronary artery bypass grafting, ML, AI, pharmacogenomics, and biomarkers. A total of 9 studies met inclusion criteria and were synthesized narratively given the heterogeneity in study designs and outcomes. Results Across studies, modern algorithms demonstrate areas under the curve receiver operating characteristic between 0.80 and 0.93, with performance exceeding that reported for traditional clinical risk scores. However, external validation, model calibration, and biases remain to be fully addressed before clinical translation is considered. Conclusion The convergence of interpretable AI, metabolic and genetic biomarkers, and clinical data offers a promising path toward individualized risk stratification and targeted postoperative management. Copyright © 2026 Heart Rhythm Society. <90> Accession Number 651690588 Title Risk stratified effect of beta-blockers after myocardial infarction in patients without heart failure: A substudy of the BETAMI-DANBLOCK trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii117-ii118), 2026. Article Number: zwag249.076. Date of Publication: 01 Jun 2026. Author Caglar H.; Holmager T.; Kristensen A.; Atar D.; Munkhaugen J.; Prescott E. Institution (Caglar, Holmager, Kristensen, Prescott) Bispebjerg Hospital, Department of Cardiology, Copenhagen, Denmark (Atar) Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway (Munkhaugen) Drammen Hospital, Department of Medicine, Drammen, Norway Publisher Oxford University Press Abstract Background: Recent meta-analyses show that beta-blockers benefit patients with mildly reduced left ventricular ejection fraction (LVEF) after myocardial infarction (MI), but not those with preserved LVEF. Whether simple clinical risk factors can identify patients who derive greater absolute benefit remains unknown. Purpose(s): To assess whether the clinical effect of long-term beta-blocker therapy after MI differs across baseline risk strata defined by a modified Thrombolysis in Myocardial Infarction Risk Score for Secondary Prevention (TRS-2P) Methods: This was a substudy of the BETAMI-DANBLOCK trial, which randomized patients with recent MI and LVEF >40% to long-term beta-blocker or no beta-blocker therapy. A modified TRS-2P score (0-8 points) was constructed by excluding current smoking and incorporating mildly reduced LVEF (41-49%). Patients were categorized as low- (0 points), intermediate- (1-2 points), or high-risk (>=3 points). The primary endpoint was a composite of all-cause mortality, MI, unplanned coronary revascularization, ischemic stroke, heart failure, or malignant ventricular arrhythmia. The secondary endpoint was recurrent MI. Within each TRS-2P strata the effect of beta-blocker was estimated using Cox proportional hazard model and Fine-Gray subdistribution hazard model. Three-year absolute risk reduction (ARR) and number needed to treat (NNT) were estimated for each TRS-2P stratum using the total trial hazard ratio (HR) applied to stratum-specific cumulative incidences derived from Kaplan-Meier estimates Results: Among the 5,558 patients included in the analysis, 38.4% were low-, 52.8% intermediate-, and 8.8% high-risk. Event rates increased stepwise across risk strata (2.96, 4.58, and 11.05 per 100 person-years, respectively). Relative treatment effects were consistent in low-risk (HR 0.88, 95% CI 0.67-1.13), intermediate-risk (HR 0.81, 95% CI 0.67-0.97), and high-risk patients (HR 0.88, 95% CI 0.63-1.20). Absolute benefit increased with risk strata: 3-year ARR was 1.4% (NNT 72) in low-risk-, 2.1% (NNT 47) in intermediate-risk-, and 3.6% (NNT 28) in high-risk patients. Recurrent MI demonstrated the same pattern, with greater absolute benefit in the higher-risk strata. Conclusion(s): The modified TRS-2P score showed clear prognostic ability, and the absolute benefit of beta-blockers increased with baseline risk despite similar relative effects. These findings support the use of simple clinical risk stratification to guide long-term beta-blocker therapy after MI. (Figure Presented) <91> Accession Number 2047503866 Title Current status of various types of ICG contrast imaging in pediatric thoracic surgery. Source Surgery Today. (no pagination), 2026. Date of Publication: 2026. Author Takazawa S.; Konishi K.-I.; Fujiogi M.; Fujishiro J. Institution (Takazawa, Fujiogi, Fujishiro) Department of Pediatric Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan (Konishi) Department of Pediatric Surgery, Japanese Red Cross Medical Center, 4-1-22 Hiroo, Shibuya-ku, Tokyo, Japan Publisher Springer Abstract Indocyanine green (ICG) fluorescence imaging is an emerging intraoperative navigation tool. However, its application in pediatric thoracic surgery remains to be elucidated. This review evaluates the current status and clinical utility of ICG-based imaging techniques in the field. A narrative review of studies published between January 2015 and February 2026 was conducted using PubMed, Web of Science, and Cochrane Library. Relevant original articles, reviews, and case reports were included. Data were analyzed by focusing on indications, administration methods, and clinical outcomes. Additionally, representative cases of chylothorax and congenital pulmonary airway malformations from our institution were included. Thirty-eight studies were included in this meta-analysis. ICG imaging enables real-time visualization of lymphatic leakage in chylothorax, rapid identification of intersegmental planes in pulmonary resections, and ventilation-based lesion delineation using inhaled ICG. It also supports fistula localization and perfusion assessment in patients with esophageal diseases. In oncology, ICG shows high sensitivity for detecting hepatoblastoma lung metastases, although its specificity is limited. ICG fluorescence imaging improves intraoperative visualization and precision during pediatric thoracic surgery. However, current evidence remains limited, and further standardization and prospective validation are required. Copyright © The Author(s) 2026. <92> Accession Number 651696843 Title Prosthesis-patient mismatch with intra-annular self-expanding valves: an analysis of the PORTICO IDE trial. Source EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 22(13) (pp e741-e747), 2026. Date of Publication: 06 Jul 2026. Author Fontana G.P.; Waksman R.; Salemi A.; Cohen M.; Abernethy W.; Hermiller J.; Baker C.; Montarello J.; Kleiman N.; Sondergaard L.; Gnall E.; Rodriguez R.; Gada H.; Brinkman W.; Weissman N.J.; Mahoney P.; Makkar R. Institution (Fontana) Cardiovascular Institute, HCA Los Robles Health System, Thousand Oaks, CA, United States (Waksman, Weissman) MedStar Washington Hospital Center, Washington, D.C., USA (Salemi, Cohen) Newark Beth Israel, Newark, NJ, United States (Abernethy) Mission Health & Hospitals, Asheville, NC, United States (Hermiller) St. Vincent Hospital, Carmel, IN, United States (Baker) USC University Hospital, Los Angeles, CA, United States (Montarello) St. Andrew's Hospital, Adelaide, Australia (Kleiman) Houston Methodist Hospital, Houston, TX, United States (Sondergaard) Rigshospitalet, Copenhagen, Denmark (Sondergaard) Abbott, Santa Clara, CA, USA (Gnall, Rodriguez) Lankenau Institute for Medical Research, Penn Wynne, PA, United States (Gada) Pinnacle Health System, Pittsburgh, PA, United States (Brinkman) Heart Hospital Baylor Scott and White, Plano, TX, United States (Weissman) MedStar Health Research Institute, Columbia, MD, United States (Mahoney) East Carolina Heart Institute, Greenville, NC, United States (Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States Abstract BACKGROUND: Aortic valve replacement in small aortic annuli is associated with an increased risk of impaired haemodynamics. AIMS: We sought to evaluate haemodynamic outcomes and prosthesis-patient mismatch (PPM) in aortic stenosis (AS) patients treated with Portico, Evolut, and SAPIEN 3 transcatheter aortic valves (TAVs) in small (diameter <=23 mm) and large (diameter >23 mm) aortic annuli. METHOD(S): PORTICO IDE was a prospective, multicentre, international, premarket randomised controlled trial comparing Portico to Evolut and SAPIEN 3 TAVs. An independent core laboratory evaluated the mean transvalvular pressure gradient (MG) and the effective orifice area (EOA), and PPM was calculated based on the core lab results. RESULT(S): A total of 675 patients with severe AS at high or extreme surgical risk were included (Portico: 362 patients; Evolut: 109; SAPIEN 3: 204). At 30 days, the EOA and rates of severe PPM in small aortic annuli were similar between Portico and Evolut (EOA 1.65 cm2 vs 1.78 cm2; p=0.09; PPM 3.3% vs 3.0%; p=1.0) with a higher MG (8.5 mmHg vs 6.9 mmHg; p=0.034) for Portico. No significant differences were observed between Portico and Evolut for large aortic annuli (MG 8.3 mmHg vs 7.4 mmHg; p=0.069; EOA 1.93 cm2 vs 2.02 cm2; p=0.18; PPM 5.4% vs 3.2%; p=0.83). Portico was superior to SAPIEN 3 in both small (MG 8.5 mmHg vs 13.7 mmHg; p<0.0001; EOA 1.65 cm2 vs 1.40 cm2; p<0.0001; PPM 3.3% vs 26.3%; p<0.0001) and large annuli (MG 8.3 mmHg vs 10.9 mmHg; p<0.0001; EOA 1.93 cm2 vs 1.67 cm2; p<0.0001; PPM 5.4% vs 10.9%; p=0.0014). At 5 years, the rate of structural valve deterioration in patients with small aortic annuli was significantly lower in patients treated with Portico (2.2%) versus SAPIEN 3 (13.9%; p=0.03). CONCLUSION(S): Haemodynamic performance was similar for the intra-annular Portico and supra-annular Evolut. Portico haemodynamics outperformed the balloon-expandable SAPIEN 3 for PPM and mean gradient in both small and large aortic annuli. <93> Accession Number 651697958 Title Baseline peak VO2 and treatment effect consistency of perioperative rehabilitation in cardiac valve surgery: an exploratory subgroup analysis of the PORT trial. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 06 Jul 2026. Author Wang R.; Huang Z.; Jiang Z.; Bai B.; Chang J.; Zhu J.; Lin K.; Ma H. Institution (Wang, Zhu, Ma) School of Medicine South China University of Technology, Guangzhou, China (Wang, Bai, Zhu, Ma) Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, No. 106, Yuexiu District, Zhongshan Second Road, Guangzhou, Guangdong, China (Huang) Department of Traditional Chinese Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China (Jiang) Department of Cardiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China (Bai) Third Affiliated Hospital of Zhengzhou Universit, Third Affiliated Clinical Medical College of Zhengzhou University, Zhengzhou, China (Chang) Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Lin) Zhongshan Hospital of Traditional Chinese Medicine, West District, No. 3 Kangxin Road, Zhongshan, Guangdong, China Abstract BACKGROUND: In the PORT trial (Perioperative Rehabilitation in Patients Undergoing Elective Cardiac Valve Surgery: A Randomised Controlled Trial), a short-term multidomain perioperative rehabilitation programme was associated with a reduced incidence of postoperative pneumonia in patients undergoing elective cardiac valve surgery. Whether baseline peak oxygen consumption (peak VO2), a marker of cardiorespiratory reserve, modifies the effect of this intervention remains uncertain. OBJECTIVE(S): To evaluate whether the association between perioperative rehabilitation and postoperative outcomes differs according to baseline peak VO2 (<= 20 vs. > 20 mL.kg-1.min-1). METHOD(S): This exploratory subgroup analysis included 702 participants from the PORT trial who underwent preoperative cardiopulmonary exercise testing. Patients were stratified by baseline peak VO2 and randomized to perioperative rehabilitation-comprising education, inspiratory muscle training, active cycle of breathing techniques, and early mobilization-or usual care. The primary endpoint was a composite of in-hospital all-cause mortality, postoperative pulmonary complications (PPCs), and prolonged hospitalization (> 7 days). Logistic and Cox regression models adjusted for prespecified covariates were used to estimate treatment effects within peak VO2 strata, and treatment-by-peak VO2 interactions were tested. RESULT(S): Of 702 participants, 202 (29%) had peak VO2 >20 and 500 (71%) had peak VO2 <=20 mL.kg-1.min-1. The composite primary endpoint did not differ significantly between rehabilitation and usual care in either stratum (interaction P = 0.62). Perioperative rehabilitation was associated with a lower incidence of postoperative pneumonia in both peak VO2 >20 mL.kg-1.min-1 (adjusted OR 0.30; 95% CI 0.13-0.71) and <= 20 mL.kg-1.min-1 (adjusted OR 0.65; 95% CI 0.47-0.90), with no significant interaction between peak VO2 category and treatment effect (P for interaction = 0.12). No significant effect modification was observed for other outcomes, including SICU stay, total hospitalization duration, or 3-month mortality. CONCLUSION(S): In this exploratory analysis of the PORT trial, the reduction in postoperative pneumonia associated with short-term perioperative rehabilitation was consistent across strata of baseline peak VO2. These findings suggest that the pneumonia benefit of respiratory-focused perioperative rehabilitation may not depend on baseline cardiorespiratory fitness, although adequately powered studies are required to definitively assess effect modification. Although the observed reduction in pneumonia was statistically significant and biologically plausible, it arose from a secondary exploratory analysis without adjustment for multiple comparisons and should therefore be interpreted with caution. Copyright © 2026. The Author(s). <94> Accession Number 651690117 Title Integrating combined inspiratory and expiratory muscle training into hybrid cardiac rehabilitation after cardiac surgery: a randomized controlled trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii346-ii347), 2026. Article Number: zwag249.222. Date of Publication: 01 Jun 2026. Author Ulker Eksi B.; Akinci B.; Ezelsoy M.; Ugurlucan M.; Emirza Cilbir C.; Ucgun H.; Ertan Harputlu O.; Kuran Aslan G. Institution (Ulker Eksi) Istanbul Galata University, Department of Therapy and Rehabilitation Physiotherapy Program, Istanbul, Turkey (Akinci) Biruni University, Faculty of Health Sciences, Istanbul, Turkey (Ezelsoy) Koc University Hospital, Istanbul, Turkey (Ugurlucan) Biruni University Hospital, Istanbul, Turkey (Emirza Cilbir) Health Institutes of Turkiye, Institute of Public Health and Chronic Diseases, Ankara, Turkey (Ucgun) Istanbul Atlas University, Faculty of Health Science, Istanbul, Turkey (Ertan Harputlu, Kuran Aslan) Istanbul University Cerrahpasa, Istanbul, Turkey Publisher Oxford University Press Abstract Introduction: Hybrid cardiac rehabilitation (HCR) enhances accessibility and adherence through the combination of in-person and remote sessions. Previous research suggests that incorporating inspiratory and expiratory respiratory muscle training (RMT) into HCR may help mitigate postoperative reductions in respiratory muscle strength and lung volumes. Purpose(s): This study aims to evaluate the effects of a combined HCR program including inspiratory and expiratory RMT on respiratory function, respiratory muscle strength, functional capacity, and quality of life in individuals after cardiac surgery. Method(s): Twenty participants were randomly assigned to the HCR or HCR+RMT group. The eight-week HCR program included two weeks of supervised in-person sessions and six weeks of real-time remotely supervised sessions. Respiratory function (FEV<inf>1</inf>, FVC), respiratory muscle strength (MIP, MEP), and functional capacity (6-minute walk distance) were assessed at three time points: preoperatively, postoperative week 1, and postoperative week 8. Physical activity level (Duke Activity Status Index, DASI) and quality of life (Minnesota Living with Heart Failure Questionnaire, MLHFQ) were evaluated only at preoperative assessment and postoperative week 8. In both groups, respiratory exercises were included as part of the HCR program. In the HCR+RMT group, the program included combined inspiratory and expiratory muscle training using a device set at 40-60% of maximal inspiratory and expiratory pressures. Result(s): The results are summarized in Table 1 and Table 2. At postoperative week 1, decreases were observed in respiratory function, respiratory muscle strength, and functional capacity in both groups compared with preoperative values. By postoperative week 8, all of these parameters demonstrated significant within-group increases relative to baseline (p<0.05). Physical activity level and quality of life scores also showed significant improvements at postoperative week 8, and marked increases were noted in VO<inf>2</inf>peak and MET levels (p<0.001). No significant between-group differences or groupxtime interaction effects were identified for any of the measured outcomes (p>0.05). Conclusion(s): In this study, both HCR and HCR+RMT resulted in similar improvements in respiratory function, respiratory muscle strength, functional capacity, physical activity level, and quality of life. Within the current protocol, both approaches appear to yield similar short-term benefits, supporting the clinical applicability of combined respiratory training as part of comprehensive HCR after cardiac surgery. (Table Presented) <95> Accession Number 2047601085 Title Superiority of Fibrinogen Concentrate Versus Cryoprecipitate for Treatment of Bleeding in Cardiac Surgery Patients: A Secondary Analysis of the FIBRES Randomized Clinical Trial Stratified by Surgical Risk. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Bartoszko J.; Karkouti K.; Callum J.L. Institution (Bartoszko, Karkouti) Department of Anesthesia and Pain Management, University Health Network, Sinai Health, Women's College Hospital, University of Toronto, Toronto, ON, Canada (Bartoszko, Karkouti) Peter Munk Cardiac Centre and Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada (Bartoszko, Karkouti) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Callum) Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre and Queen's University, Kingston, ON, Canada Publisher W.B. Saunders Abstract Objectives: To explore the superiority of fibrinogen concentrate (FC) versus cryoprecipitate for bleeding after cardiac surgery. Design(s): Secondary analysis of the FIBRES randomized trial. Setting(s): Eleven Canadian hospitals, February 2017-November 2018. Participant(s): Adult cardiac surgery patients experiencing significant postbypass bleeding and acquired hypofibrinogenemia (fibrinogen <2.0 g/L or FIBTEM A10 <10 mm). Intervention(s): FC (4 g) or cryoprecipitate (10 units) dosed within 24 hours after cardiopulmonary bypass as needed. Measurements and Main Results: In total, 735 patients (372 FC, 363 cryoprecipitate) were included in the primary analysis (median age 64 years, 30% women). The primary endpoint was cumulative blood components (red cells, platelets, plasma) administered within 24 hours postbypass. Superiority was assessed using deviance-scaled Poisson regression. FC was superior to cryoprecipitate in the a priori-defined, well-balanced subgroups of non-critically ill patients (n = 634, 86% of population; mean 13.6 versus 16.2 units, mean ratio 0.84 [95% CI 0.73, 0.96]; p = 0.01) and elective surgery patients (n = 466, 63% of population; 11.7 versus 14.4 units, 0.81 [0.69, 0.96]; p = 0.02). In elective surgery patients, adverse events (relative risk 0.85 [0.75, 0.97]; p = 0.02) and serious adverse events (0.71 [0.52, 0.99]; p = 0.04) were less frequent with FC. Conclusion(s): FC showed superior hemostatic efficacy to cryoprecipitate in the prespecified subgroups of elective cardiac surgery patients and patients who were not in a critical state before surgery, representing the large majority of patients with bleeding postbypass. FC may also offer safety advantages over cryoprecipitate. Copyright © 2026 The Author(s) <96> Accession Number 651696692 Title Left atrial appendage closure with the AnchorMan or Watchman devices: 12-month results of the SAFE-PROTECT randomised trial. Source EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 22(13) (pp e720-e729), 2026. Date of Publication: 06 Jul 2026. Author Wang B.; Cai H.; Wu Y.; Chen M.; Wang C.; Jiang X.; Tao S.; Zhong Z.; Zeng J.; Wang F.; Ning Z.; Yuan Z.; He J.; Francese D.P.; Lansky A.J.; He B.; Chu H.; Of The Safe-Protect Investigators O.B. Institution (Wang, Chu) Arrhythmia Center, First Affiliated Hospital of Ningbo University, Ningbo, China (Cai) Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China (Wu) Department of Cardiology, Second Affiliated Hospital of Nanchang, Nanchang, China (Chen) Department of Cardiology, Central Hospital of Wuhan, Wuhan, China (Wang) Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Jiang) Department of Cardiology, Zhuhai People's Hospital, Zhuhai, China (Tao) Department of Cardiology, Second People's Hospital of Yunnan Province, Kunming, China (Zhong) Department of Cardiology, Meizhou People's Hospital, Meizhou, China (Zeng) Department of Cardiology, Sichuan Provincial People's Hospital, Chengdu, China (Wang) Department of Cardiology, Henan Provincial Chest Hospital, Zhengzhou, China (Ning) Department of Cardiology, Shanghai Pudong New District Zhoupu Hospital, Shanghai, China (Yuan) Department of Cardiology, First Affiliated Hospital of Xi'an Jiao Tong University, Xi'an, China (He) Department of Cardiology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Francese, Lansky) Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States (He) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China Abstract BACKGROUND: Percutaneous closure of the left atrial appendage (LAA) is an alternative to chronic oral anticoagulation to reduce stroke risk in patients with non-valvular atrial fibrillation (AF). AIMS: The SAFE-PROTECT trial was designed to evaluate the safety and efficacy of the AnchorMan, a novel LAA closure device, compared with the Watchman 2.5 device for patients with AF at high risk of ischaemic stroke. METHOD(S): SAFE-PROTECT was a multicentre, open-label, non-inferiority trial of patients with non-valvular AF at high risk of ischaemic stroke, randomised 1:1 to LAA closure with the AnchorMan or the Watchman device. The 12-month primary endpoint was clinical success (freedom from ischaemic/haemorrhagic stroke, systemic embolism, cardiovascular or unexplained death); the secondary efficacy endpoint was echocardiography-defined LAA occlusion (peridevice leak <5 mm) at 12 months. RESULT(S): A total of 216 patients were randomised to either an AnchorMan (n=108) or to a Watchman (n=108) device. The AnchorMan was non-inferior to Watchman for the primary endpoint (98.1% vs 98.1%;p>0.99; difference -0.3; 95% confidence interval [CI]: -3.9 to 3.5; pnon-inferiority=0.0004) and the powered secondary efficacy endpoint of LAA closure (100% vs 100%; difference 0%; 95% CI: -3.60 to 3.50; pnon-inferiority=not applicable). The rates of all-cause death, stroke, major bleeding, and device-related complications were low and similar between groups. CONCLUSION(S): Among patients with non-valvular AF at high risk of ischaemic stroke, the AnchorMan device met its prespecified non-inferiority primary clinical success and secondary LAA occlusion endpoints compared with the Watchman 2.5 device. CLINICALTRIALS: gov: NCT04479722. <97> Accession Number 651690398 Title Clinical efficacy of a digital therapeutic for cardiac rehabilitation: a multicenter randomized controlled trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii703-ii704), 2026. Article Number: zwag249.454. Date of Publication: 01 Jun 2026. Author Song J.; Kim C.; Lee J.W.; Bang M.H.; Choi H.E.; Kim S.H.; Jun S.M.; Yoo J.Y.; Cho H.Y. Institution (Song, Kim, Kim) Inje University, Sanggye Paik Hospital, Department of Rehabilitation Medicine, Seoul, South Korea (Lee, Bang, Jun, Yoo, Cho) NHIS Ilsan Hospital, Department of Rehabilitation Medicine, Goyang, South Korea (Choi) Haeundae Paik Hospital, Department of Rehabilitation Medicine, Busan, South Korea Publisher Oxford University Press Abstract Objectives: Cardiac rehabilitation (CR) is an evidence-based, multidisciplinary intervention that reduces mortality and improves functional recovery. Despite these benefits, participation rates remain suboptimal, largely due to limited accessibility and insufficient patient engagement inherent to traditional center-based CR models. Digital therapeutics, integrating mobile technologies, wearable sensors, and telemonitoring, have recently emerged as a promising strategy to overcome these barriers of center-based CR. This study aimed to evaluate the clinical efficacy of home-based CR supported by a novel digital therapeutic system. Design(s): Patients with cardiovascular disease who were eligible for CR and had recently undergone revascularization or cardiac surgery were randomized to either the intervention or control group. The intervention group used a chest-worn Holter electrocardiogram device for heart-rate monitoring during exercise, along with a digital therapeutic software that provided personalized exercise prescriptions based on home-based evaluations and offered real-time monitoring and feedback through a mobile application. The control group received education to perform exercise independently without HR monitoring. All participants were instructed to perform high-intensity interval training (six cycles of 3-minute high and 3-minute low intensity) three times per week for 12 weeks. The primary outcome was peak oxygen uptake (peak VO<inf>2</inf>); secondary outcomes included quality of life, physical activity index, and depression score. Result(s): 87 patients (42 intervention, 45 control) completed 3-month follow-up. Peak VO<inf>2</inf> significantly increased in the intervention group (27.0 +/- 5.0 to 29.2 +/- 5.0 mL/kg/min, P < 0.001) but not in the control group (28.5 +/- 5.1 to 29.1 +/- 5.3, P = 0.245). Consistently, the intervention group exhibited a significantly greater improvement in peak VO<inf>2</inf> compared to the control group (2.3 +/- 2.7 vs 0.6 +/- 3.3, P = 0.009). After adjustment for age, sex, and baseline peak VO<inf>2</inf>, the adjusted mean peak VO<inf>2</inf> at 3 months was 30.0 (95% CI, 29.1-30.8) in the intervention group and 28.4 (95% CI, 27.6-29.3) in the control group (P = 0.015 by analysis of covariance). Regarding secondary outcomes, within-group analysis revealed a significant improvement in the Korean Activity Scale/Index in the intervention group (64.5 +/- 15.0 to 68.0 +/- 11.4, P = 0.043), whereas no meaningful change occurred in the control group. Conclusion(s): Home-based CR supported by digital therapeutics which integrates real-time heart-rate monitoring, remote patient supervision, and individualized exercise prescription, resulted in a significant improvement in exercise capacity compared to conventional self-directed exercise. These findings underscore the potential of digital, home-based CR to enhance overall program effectiveness and extend access to patients who are unable to participate in traditional center-based rehabilitation. (Figure Presented) <98> Accession Number 651689669 Title Stronger start: dual-mode training boost functional outcome in early phase 2 cardiac rehabilitation after heart valve surgery. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii513), 2026. Article Number: zwag249.339. Date of Publication: 01 Jun 2026. Author Siagian T.W.; Ramandika E.; Ambari A.M.; Radi B.; Dwiputra B. Institution (Siagian) Regional General Hospital H. Abdul Manan Simatupang, Kisaran, Indonesia (Ramandika) Faculty of Medicine University of Indonesia, Departement of Cardiology and Vascular Medicine, Jakarta Barat, Indonesia (Ambari, Radi, Dwiputra) National Cardiovascular Center Harapan Kita, Division of Cardiovascular Prevention and Rehabillitation, Jakarta, Indonesia Publisher Oxford University Press Abstract Background: Cardiac rehabilitation integrating aerobic and resistance training has demonstrated efficacy in enhancing short-term functional capacity in patients following valve surgery. Combined aerobic and resistance exercises targeting upper and lower extremities are considered safe and effective in improving exercise capacity, muscle strength, and quality of life in patients post-heart valve surgery. Aim(s): This study aimed to evaluate the impact of early phase 2 cardiac rehabilitation with combined aerobic and resistance training compared to aerobic training alone on functional outcomes in patients post-open heart valve surgery. Method(s): In a prospective randomized controlled trial, 89 patients (2 weeks to 1 month post-surgery) were assigned to either an intervention group (n=46, supervised combined aerobic and resistance training for 4 weeks, 12 sessions) or a control group (n=43, aerobic training alone). Primary endpoints included the Six-Minute Walk Test (6MWT), Five Sit-to-Stand Test (5STS), handgrip strength, and quality of life assessed by the Kansas City Cardiomyopathy Questionnaire (KCCQ). Statistical analyses included descriptive statistics, independent t-tests, and paired t-tests. Result(s): At baseline, no significant differences were observed between the intervention and control groups for 6MWT (p = 0.153) or 5STS (p = 0.683). At post-intervention, the intervention group exhibited significantly better performance in the 6MWT (466.39 +/- 54.02 vs. 440.12 +/- 41.95 m, p = 0.013) and 5STS (7.56 +/- 1.38 vs. 9.20 +/- 1.83 s, p < 0.001). Paired t-tests revealed significant improvements in both groups (p < 0.001), with greater gains in the intervention group (6MWT: +87.91 m vs. +78.95 m; 5STS: 3.42 s vs. 2.00 s). There were no significant between-group differences in post-intervention handgrip strength (p = 0.179) or in the average quality-of-life score measured using the KCCQ (p = 0.375). Conclusion(s): Early phase 2 cardiac rehabilitation with combined aerobic and resistance training significantly enhances functional capacity (6MWT, 5STS)compared to aerobic training alone in patients post-heart valve surgery. These findings support the safety and efficacy of combined exercise regimens in improving physical function <99> Accession Number 651697749 Title Efficacy and safety of CETP inhibitors in patients with atherosclerotic cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. Source Journal of cardiovascular pharmacology. (no pagination), 2026. Date of Publication: 06 Jul 2026. Author Milan R.R.; Jimenez Castellanos M.S.; Doniz Viveros A.D.; Yusufzai M.O.; Chiong Espinoza E.E.; Estela Fernandez C.A.; Machado D.A.; Abbas M.S.; Sah H.; Altamirano A.A.; Mahajan K. Institution (Milan) Universidad Autonoma Metropolitana, Departamento de Atencion a la Salud, Unidad Xochimilco, Ciudad de Mexico, Mexico (Jimenez Castellanos) Universidad Autonoma de Chiapas, Facultad de Medicina Humana, Chiapas, Mexico (Doniz Viveros) Universidad La Salle, Facultad Mexicana de Medicina, Departamento de Medicina y Salud, Ciudad de Mexico, Mexico (Yusufzai) Bacha Khan Medical College, Mardan, Pakistan (Chiong Espinoza) Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru (Estela Fernandez) Universidad Cientifica del Sur, Lima, Peru (Machado) Universidad Catolica, Santa Cruz, Bolivia (Abbas) Goma Medical College, Khyber Medical University, Peshawar, Pakistan (Sah) Doctor of Medicine, Bahcesehir University Medical Park Goztepe, Istanbul, Turkey (Altamirano) Research Professor, Universidad Autonoma Metropolitana, Departamento de Atencion a la Salud, Unidad Xochimilco, Ciudad de Mexico, Mexico (Mahajan) Director Cardiology, Himachal Heart Institute Mandi, India Abstract Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death globally. Cholesteryl ester transfer protein (CETP) inhibitors have been proposed as a novel strategy for cardiovascular risk reduction, yet evidence remains inconsistent. PubMed, Embase and Scopus were searched for Randomized Controlled Trials (RCTs) comparing CETP inhibitors to placebo in patients with ASCVD. Random-effects models were used to pool risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Heterogeneity was assessed using I2 statistics. Statistical analysis was performed using R software version 4.3.3. We included 5 RCTs involving 62,565 participants, of whom 31,698 (50.7%) received CETP inhibitors. Compared to placebo, CETP inhibitors showed no significant reduction in death from coronary heart disease (RR 0.91; 95% CI: 0.82 to 1.01), unplanned coronary revascularization (RR 0.91; 95% CI: 0.79 to 1.05), non-fatal myocardial infarction (RR 0.94; 95% CI: 0.87 to 1.02) and stroke (RR 1.02; 95% CI 0.93 to 1.12). Also, no excess risk of adverse events was observed (RR 1.00; 95% CI: 0.99 to 1.02). Conversely, HDL-C (MD + 130.82%; 95% CI: 121.49 to 140.15), LDL-C (MD -32.68%; 95% CI: -40.73 to -24.63), ApoA1 (MD +45.04%; 95% CI: 40.51 to 49.57) and Apo B (MD -17.26%; 95% CI: -20.51 to -14.00) showed significant improvement. CETP inhibitors produce substantial lipid modifications but do not reduce major adverse cardiovascular events, underscoring the limitations of surrogate lipid markers and the need for outcome-based validation of lipid-modifying therapies. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <100> Accession Number 651697574 Title Viability testing for guiding revascularization in ischemic cardiomyopathy. Source Current opinion in cardiology. (no pagination), 2026. Date of Publication: 07 Jul 2026. Author Li K.Y.; Dhingra N.K.; Patel R.; Kalra S.; Rabi A. Institution (Li, Dhingra, Rabi) Division of Cardiovascular Surgery (Patel, Kalra) Division of Cardiology, Toronto General Hospital, University Health Network, Toronto, ON, Canada Abstract PURPOSE OF REVIEW: Myocardial viability testing has traditionally been used to guide revascularization decisions in ischemic cardiomyopathy on the assumption that identifying dysfunctional but viable myocardium predicts functional recovery and improved survival following revascularization. Recent trials have challenged this assumption, highlighting the need to re-evaluate the clinical role of viability testing in the context of contemporary revascularization strategies and modern guideline-directed medical therapy. RECENT FINDINGS: The STICH trial and its extended follow-up demonstrated that CABG improves long-term survival independently of viability status and independently of whether ejection fraction improves, challenging the mechanistic assumption of viability-guided revascularization. REVIVED-BCIS2 showed that PCI may not improve survival benefit, even in patients selected with demonstrated viability. A prespecified imaging substudy of REVIVED identified scar burden, rather than the presence of viable myocardium, as the strongest independent predictor of adverse outcomes, reframing the prognostic question from the detection of viable tissue toward the quantification of irreversible myocardial loss. SUMMARY: Viability should be reconceptualized as a continuous spectrum rather than a binary construct. Scar quantification, particularly through late gadolinium enhancement cardiac magnetic resonance (CMR), may offer greater prognostic utility than viability detection alone. A prospective randomized trial integrating contemporary imaging with modern guideline-directed medical therapy is needed to resolve the clinical role of viability-guided revascularization. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <101> Accession Number 2047544436 Title Lessons learned from the feasibility phase of the REvascularization CHoices Among Under-Represented Groups Evaluation (RECHARGE) trial program. Source American Heart Journal. 301 (no pagination), 2026. Article Number: 107515. Date of Publication: 01 Nov 2026. Author Gaudino M.; Stone G.W.; Puskas J.; Krieger K.; Redfors B.; Bagiella E.; Gelijns A.; Bhatt D.L.; Sandner S.; Barman N.; Bozinovski J.; Gee P.; Haider A.; Hafiz A.M.; Jolly S.S.; Li D.; Mack C.; Madani M.M.; Mahmud E.; Pineda A.M.; Masoudi F.A.; Mazzaferri E.; Monroe R.; Nicholson W.; Pocock S.J.; Sachdeva R.; Yong C.; Zwischenberger B.A.; Yancy C.; Creber R.M.; Spertus J. Institution (Gaudino, Krieger) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Puskas) Division of Cardiac Surgery, Emory University, Atlanta, GA, United States (Redfors) Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, United States (Redfors) Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden (Redfors) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Bagiella, Gelijns, Li) Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Sandner) Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria (Barman) Division of Cardiology, Mount Sinai Morningside, New York, NY, United States (Bozinovski, Mazzaferri) The Ohio State University Wexner Medical Center, Columbus, OH, United States (Gee) Healthcare Consultant/Patient Advocate, iAdvocate, North Chesterfield, VA, United States (Haider, Mack) NewYork-Presbyterian Queens, New York, NY, United States (Hafiz) Division of Cardiology, Southern Illinois University School of Medicine, IL, United States (Jolly) Population Health Research Institute, McMaster University, Hamilton, ON, Canada (Madani, Mahmud) Sulpizio Cardiovascular Center, UC San Diego, San Diego, CA, United States (Pineda, Zwischenberger) Duke University Medical Center, Durham, NC, United States (Masoudi) Ascension Clinical Research Institute, St Louis, MO, United States (Monroe) BOOST - Better Outcomes Optimal Scientific Therapies, Washington, DC, United States (Monroe) Heart Failure Society of America Advocacy Committee, Charlotte, NC, United States (Nicholson) Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States (Pocock) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Sachdeva) Division of Cardiology, Atlanta VA Medical Center, Decatur, GA, United States (Yong) Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States (Yong) Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States (Yancy) Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States (Creber) Columbia University School of Nursing, New York, NY, United States (Spertus) University of Missouri - Kansas City's Healthcare Institute for Innovations in Quality and Saint Luke's Mid America Heart Institute, Saint Luke's Hospital, Kansas City, MO, United States Publisher Elsevier Inc. Abstract Background The REvascularization CHoices Among Under-Represented Groups Evaluation (RECHARGE) program is enrolling 1200 women, Black and Hispanic patients, in 2 parallel randomized trials of percutaneous coronary intervention vs coronary artery bypass grafting. Methods Funded by a phased Patient-Centered Outcomes Research Institute award, the pilot phase was designed to assess the feasibility of enrolling groups historically under-represented and challenging to enroll in prior revascularization trials, evaluate willingness of patients to accept randomization, refine patient and stakeholder engagement, and scale site infrastructure and data collection across diverse centers. We report key insights from the pilot phase. Results Physician and patient treatment preferences, often shaped by prior experience and evidence not directly applicable to these cohorts, were the main reasons eligible patients were not randomized. Many sites also lacked consistent multidisciplinary Heart Team processes for coronary disease, requiring new workflows to establish equipoise between percutaneous coronary intervention and coronary artery bypass grafting. Successful recruitment required intentional trust-building and tailored patient-facing materials, while engagement of non-academic centers demanded added financial, educational, and start-up support. During the 2-year pilot phase, 91 US and 17 Canadian sites were selected, and 65 were activated. Median activation time was 10.8 months (Interquartile range [IQR] 9.1-13.6). The pilot enrollment goal of 60 participants was exceeded, with 141 patients randomized within 13 months at a mean rate of 0.27 patients/site/month, prompting expansion to up to 150 sites for the full program. Conclusion The lessons learned from the pilot phase of the REvascularization CHoices Among Under-Represented Groups Evaluation program can inform the design and implementation of future randomized trials seeking to enroll traditionally under-represented populations. Trial Registration REvascularization CHoices Among Under-Represented Groups Evaluation: The RECHARGE Trial; NCT06399705 (RECHARGE:M) and NCT06399692 (RECHARGE:W). Copyright © 2026 Elsevier Inc. <102> Accession Number 651689872 Title Improving preventive cardiology in congenital heart disease: lessons from the QUALIREHAB trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii487), 2026. Article Number: zwag249.318. Date of Publication: 01 Jun 2026. Author Andrianoely M.A.; Audie M.A.; Guillaumont S.G.; Venna A.V.; Rheault M.R.; Desir A.D.; Amedro P.A. Institution (Andrianoely) INSERM 1045, IHU LIRYC, Pessac, France (Audie) Bordeaux University Hospital, Pediatric and Congenital Cardiology Department, Pessac, France (Guillaumont) Montpellier University Hospital, Pediatric and Congenital Cardiology Department, Montpellier, France (Venna, Rheault, Desir, Amedro) Children's National Hospital, Heart and Lung Center, Washington, United States Publisher Oxford University Press Abstract Background: Medical advances have reduced morbidity and mortality in congenital heart disease (CHD); however, maximum oxygen uptake (VO2max) and ventilatory anaerobic threshold (VAT), decline more rapidly in CHD patients compared to the general population, impairing cardiopulmonary fitness and health-related quality of life (HRQoL) (1,2). The QUALIREHAB randomized controlled trial showed positive effects of a hybrid cardiac rehabilitation program on physical health, mental health and HRQoL in youth with CHD (Amedro et al., Eur Heart J, 2024) (3). We analyzed parameters associated with the intervention's magnitude. Method(s): A post-hoc analysis was conducted using data from e-Case Report Forms, medical records and interviews with pediatric cardiologists, specialist nurses, adapted physical activity educators and psychologists. Efficacy was defined as a 3.5 mL/kg/min increase in VO2max at 3 or 12 months a 4.3-point increase in HRQoL questionnaire. The parameters associated with poorer outcomes were evaluated using multivariate analysis. Result(s): Data from 70 participants (intervention group) and 10 professionals were analyzed. Analyses found that the moderate intensity of exercise training (VAT interval training) could have been exceeded in most patients and a one-hour cycloergometer was too long. Many patients and professionals expressed a need for more playful sessions and less center-based reinforcement sessions (adherence: 88% for home-based and 77% for center-based). The intervention had a positive effect on mental health (-2.4 points in depression and -2.3 points in anxiety outcomes), but patients expressed the importance to involve their relatives. Parameters associated with lower efficacy included: cardiac surgery or catheterization for VO2max change at 3 months (AUC = 0.79), low VAT and female gender for VO2max change at 12 months (AUC = 0.83), and low VAT for HRQoL change at 12 months (AUC = 0.69). Conclusion(s): QUALIREHAB showed positive results but could benefit from a more tailored rehabilitation approach to maximize intervention magnitude, particularly for female patients, with high-intensity, playful activities, home-based sessions and stronger mental health support <103> Accession Number 651699230 Title Effect of KinesioTaping on Pain at Thoracic Tube Sites After CABG: A Randomized Study. Source The Thoracic and cardiovascular surgeon. (no pagination), 2026. Date of Publication: 06 Jul 2026. Author Yilmaz U.; Ersoy G.G.; Ayabakan Eski N.; Tekin K.A.; Bektas O.; Tozlu Yilmaz E. Institution (Yilmaz) TC Saglik Bakanligi Sancaktepe Sehit Prof Dr Ilhan Varank Egitim ve Arastirma Hastanesi, Istanbul, Turkey (Ersoy, Ayabakan Eski) Kastamonu Universitesi, Kastamonu, Turkey (Tekin) TC Saglik Bakanligi Kosuyolu Yuksek Ihtisas Egitim ve Arastirma Hastanesi, Istanbul, Turkey (Bektas) Kastamonu Training and Research Hospital, Department of Physical Therapy and Rehabilitation, kastamonu, Turkey (Tozlu Yilmaz) Kastamonu Universitesi Tip Fakultesi, Kastamonu, Turkey Abstract BACKGROUND: Pain from chest tubes significantly contributes to postoperative discomfort and opioid use after coronary artery bypass grafting (CABG). Nonpharmacological interventions at drain sites may aid recovery and reduce opioid exposure. METHOD(S): This randomized, controlled study involved 100 adult patients undergoing elective CABG, randomized 1:1 to receive kinesio taping (n = 50) or serve as controls (n = 50). Kinesio tape was applied around mediastinal and thoracic drain sites before extubation, avoiding the incision.Both groups received standard analgesia with paracetamol and tramadol as rescue analgesia.Pain was measured using a visual analog scale (VAS) immediately after extubation and at 24 and 72 hours postoperatively. Opioid requirements, ICU stay, hospital stay, and complications were documented. RESULT(S): VAS scores at extubation were similar (4.00 +/- 1.25 vs 3.86 +/- 0.90; p = .678). Kinesio taping patients had significantly lower VAS scores at 24 hours (3.76 +/- 1.36 vs 5.52 +/- 1.20; p < .001) and 72 hours (2.60 +/- 0.82 vs 4.18 +/- 0.83; p < .001). Fewer patients in the kinesio taping group required opioid rescue (24% vs 62%; p < .001). The ICU stay was shorter with kinesio taping (2.90 +/- 0.58 vs 3.42 +/- 0.86 days; p = .001), while hospital stay and infection rates were similar. CONCLUSION(S): Kinesio taping around drain sites post-CABG reduces pain, opioid needs, and ICU stay. This safe approach may enhance early postoperative pain management after cardiac surgery. Copyright Thieme. All rights reserved. <104> Accession Number 2047507855 Title Effect of transcutaneous auricular vagus nerve stimulation on postoperative pain in patients undergoing thoracoscopic partial lung resection: a randomized, double-blind, controlled clinical trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2703358. Date of Publication: 2026. Author Yuan M.; Lv S.-J.; Wu M.-R.; Lu Y.-C.; Zhang M.-H.; He J.-H. Institution (Yuan, Lv, Zhang, He) Department of Anesthesiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu, Nanjing, China (Wu, Lu, He) School of Anesthesiology, Xuzhou Medical University, Jiangsu, Xuzhou, China Publisher Taylor and Francis Ltd. Abstract Background: Postoperative pain after thoracic surgery remains common and challenging. Transcutaneous auricular vagus nerve stimulation (taVNS) is a noninvasive neuromodulation technique with potential analgesic effects. This study aimed to evaluate the efficacy and safety of taVNS for postoperative pain management in patients undergoing thoracoscopic partial lung resection. Method(s): Adults undergoing thoracoscopic partial lung resection were randomized to active or sham taVNS. The primary outcome was cough pain intensity at 48h post-surgery, assessed by Numeric Rating Scale (NRS). Secondary outcomes included cough pain at 24h and 72h, resting pain, moderate-to-severe pain incidence, opioid consumption, quality of recovery, postoperative pulmonary complications, chest tube duration, hospital stay, postoperative nausea/vomiting, and adverse events. Result(s): Among 119 analyzed patients (active n = 60, sham n = 59), active taVNS reduced cough pain scores at 24h, 48h, and 72h postoperatively, as well as resting pain (p < 0.05). It also lowered the incidence of moderate-to-severe cough pain at 24h and 48h, reduced cumulative postoperative opioid use at 24h and 72h, and decreased rescue analgesia on postoperative day 3 (p < 0.05). Active taVNS was associated with a lower incidence of postoperative pneumothorax (p < 0.05). No serious adverse events occurred. Conclusion(s): Perioperative taVNS was associated with a modest analgesic benefit and reduced postoperative opioid requirements after thoracoscopic partial lung resection. The observed reduction in postoperative pneumothorax requires cautious interpretation, and further multicenter trials are needed to determine its clinical utility. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <105> Accession Number 651690052 Title Validating national registry data for randomised trials: comparison of adjudicated and registry-derived cardiovascular outcomes in the BETAMI-DANBLOCK trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii738-ii739), 2026. Article Number: zwag249.475. Date of Publication: 01 Jun 2026. Author Holmager T.; Kristensen A.; Fagerland M.; Atar D.; Olsen M.; Bakken A.; Munkhaugen J.; Prescott E. Institution (Holmager, Kristensen, Prescott) Bispebjerg Hospital, Dept of Cardiology, Copenhagen, Denmark (Fagerland) Oslo University Hospital, Oslo Centre for Biostatistics & Epidemiology (OCBE), Oslo, Norway (Atar, Bakken) Oslo University Hospital Ulleval, Department of Cardiology, Oslo, Norway (Olsen) Holbaek Hospital, Department of Internal Medicine 1, Holbaek, Denmark (Munkhaugen) Vestre Viken Hospital Trust, Department of Medicine, Drammen, Norway Publisher Oxford University Press Abstract Background: Registry-based randomised clinical trials are increasingly dependent on registry-derived outcomes, providing advantages in feasibility and data capture. However, registry data may introduce bias through misclassification or incomplete information. In the BETAMI-DANBLOCK trial, we compared registry-based cardiovascular events with and without adjudication, using information from national registries, electronic health records, and patient reports. Purpose(s): To investigate whether registry-based endpoints can substitute adjudicated endpoints without materially altering trial results. Method(s): BETAMI-DANBLOCK enrolled 5,574 patients with myocardial infarction (MI) and a left ventricular ejection fraction >=40% from 2018 through 2024. Patients were randomised to beta-blocker therapy or no beta-blocker therapy. The primary endpoint events (death, MI, ischemic stroke, heart failure, unplanned coronary revascularisation, and ventricular arrhythmias) were identified from the Danish and Norwegian national patient registries, self-reported questionnaires, and medical records. All registry-identified events, except death, underwent blinded adjudication. We compared events with and without adjudication by calculating incidence rates and hazard ratios (HRs) for beta-blocker treatment versus controls. Result(s): National registries had almost complete capture of events when compared to site-reporting. In total, 75% of the primary endpoint events identified through the registries were confirmed by adjudication. The confirmation rate was lower during the first six months and varied by event type (from 92% for ischemic stroke to 45% for unplanned coronary revascularisations). The incidence rate of the primary endpoint was 6.23 per 100 person-years using registry data without adjudication and 4.43 with adjudication. Estimated treatment effects were consistent for the primary endpoint (0.88, 95% confidence interval (CI): 0.78-0.98 without adjudication and 0.85, 95% CI: 0.75-0.98 with adjudication), with no apparent differences across event types. Conclusion(s): Registry data provide treatment effect estimates comparable to those obtained from adjudicated data in BETAMI-DANBLOCK. However, adjudication substantially reduced the total number of endpoint events and event-specific misclassification was a limitation, particularly during the first months after the index event. (Figure Presented) <106> Accession Number 2047575330 Title Prognostic Value of Frailty in Aortic Surgery: A Systematic Review and Meta-Analysis Comparing Frailty Assessment Tools. Source Annals of Vascular Surgery. 132 (pp 200-213), 2026. Date of Publication: 01 Nov 2026. Author Coutinho M.L.; Delgado L.M.; Torres I.O.; Rocha-Neves J.; Zerati A.E.; D'Oria M.; Leao P.P. Institution (Coutinho, Torres, Zerati, Leao) Department of Vascular Surgery, Hospital das Clinicas FMUSP, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil (Delgado) Department of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Rocha-Neves) Faculty of Medicine of the University of Porto, Unity of Anatomy, Department of Biomedicine, Portugal (D'Oria) Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, Trieste, Italy Publisher Elsevier Inc. Abstract Background Frailty is increasingly recognized as an important determinant of outcomes after aortic vascular surgery, but assessment methods vary substantially and the optimal tool for risk stratification remains uncertain. This systematic review and meta-analysis evaluated the prognostic value of preoperative frailty and compared the predictive performance of different frailty instruments in aortic surgery. Methods PubMed, Embase, and Cochrane Library were searched from inception to April 27, 2026. Eligible studies included patients undergoing open, endovascular, or hybrid aortic procedures involving abdominal, thoracic, thoracoabdominal, arch, and proximal aortic diseases, including aneurysms and dissections, assessed frailty preoperatively, and reported postoperative outcomes. Results Thirty studies comprising 419,459 patients were included. Frailty was associated with higher early mortality (odds ratio [OR] 2.20; 95% confidence interval [CI] 1.54-3.14) and late mortality (hazard ratio 2.18; 95% CI 1.64-2.90). Frail patients also had increased risks of major complications (OR 2.52; 95% CI 1.22-5.19), acute kidney injury (OR 1.64; 95% CI 1.34-2.02), and nonhome discharge (OR 5.50; 95% CI 3.05-9.92). Associations were consistent across surgical approaches and aortic segments. Judgment-based or phenotype-like tools yielded higher effect estimates than deficit-accumulation indices, although differences were not statistically significant; among index-based tools, Modified Frailty Index (mFI)-11 outperformed mFI-5. Conclusion Preoperative frailty strongly predicts mortality, morbidity, and loss of functional independence after open, endovascular, and hybrid aortic surgery across different aortic segments and pathologies, including aneurysmal and dissecting aortic disease. Routine frailty assessment may improve risk stratification and perioperative decision-making. Copyright © 2026 The Author(s). <107> Accession Number 651689860 Title Cardiac prehabilitation: who declines participation and why? a single-centre analysis of recruitment barriers in the PRECOVERY trial. Source European Journal of Preventive Cardiology. Conference: ESC Preventive Cardiology 2026. Ljubljana Slovenia. 33(Supplement 2) (pp ii646-ii647), 2026. Article Number: zwag249.419. Date of Publication: 01 Jun 2026. Author Kaumkoetter S.; Schmidt T.; Von Arnim C.; Steinmetz C.; Heinemann S.; Sadlonova M.; Kutschka I.; Remppis B.; Reiss N. Institution (Kaumkoetter, Reiss) Schuechtermann-Clinic, Bad Rothenfelde, Germany (Schmidt) German Sports University Cologne, Cologne, Germany (Von Arnim, Steinmetz, Heinemann, Sadlonova, Kutschka) University Medical Center of Gottingen (UMG), Goettingen, Germany (Remppis) Cardiovascular Centre Bad Bevensen, Bad Bevensen, Germany Publisher Oxford University Press Abstract Background: The PRECOVERY trial investigates the effectiveness of a standardised, multimodal prehabilitation programme for older adults prior to elective cardiac procedures, with the long-term aim of integrating this pathway into routine care. Recruiting suitable patients remains challenging. Identifying and understanding barriers to participation are crucial to optimising recruitment strategies and facilitating the wider implementation of multimodal prehabilitation. This single-centre analysis examined the reasons why eligible patients declined participation in the PRECOVERY trial despite potential benefits. Method(s): PRECOVERY is a randomised, controlled, longitudinal, multicentre trial enrolling patients aged >=65 years scheduled for elective cardiac procedures. The intervention group receives a two-week multimodal prehabilitation programme. The primary endpoints are quality of life and 12-month mortality. For this analysis, recruitment data from 147 eligible patients were retrospectively evaluated. Initial contact was made via telephone by a member of the study team; interested patients subsequently received written study information by post. Recruitment outcomes were analysed using continuously collected screening data. Reasons for non-participation were recorded and categorised as follows: (1) medical advice against participation; (2) lack of interest; (3) imminent surgery not to be postponed; (4) caregiving or other private commitments; and (5) other reasons. Result(s): Over a 14-month period, the overall recruitment rate was 28% (41 of 147 screened patients). Participation rates did not differ significantly by gender or referring department (p > 0.05). The mean age of enrolled patients was 73.1 +/- 5.1 years, while the mean age of non-enrolled patients was 75.6 +/- 5.8 years. A significant association was observed for age, with participation rates of 39% among patients aged <=75 years and 16% among those aged >75 years (p = 0.004) (Fig. 1). Logistic regression analysis revealed that patients aged <75 years were significantly more likely to decline participation due to "imminent surgery" (odds ratio [OR] 4.6; p = 0.04). A further significant association was observed between the category "imminent surgery" and patients referred from cardiac surgery (OR 11.8; p = 0.03) (Fig. 2). Conclusion(s): Recruitment to multimodal prehabilitation programmes is impeded by medical concerns, lack of interest, scheduling constraints, and private obligations, particularly among younger patients and those referred from cardiac surgery. Understanding these barriers is vital to improve recruitment strategies and enable the integration of prehabilitation into routine care. Analysis of participation patterns revealed a significant association with age, with higher enrolment among patients aged <=75 years. These findings highlight the importance of demographic factors in designing targeted recruitment strategies for prehabilitation programmes. (Figure Presented) <108> Accession Number 2047692590 Title The Pediatric Cardiac Extubation Readiness Framework: An Evidence-Derived Translational Framework for Structured Extubation Assessment Following Pediatric Cardiac Surgery. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Alkhatip A.A.A.M.M.; Mills K.E.; Akram A.; Farag E.; Hamza M.K.; Abdelkader M.; Bahr M.; ELEmady M.F.M.; Hosny H.; Sallam A.; Farag A.M.G.; Wagih M.; Naguib A. Institution (Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital, Birmingham, United Kingdom (Alkhatip, Farag, Abdelkader, Bahr) Department of Anesthesia, Pain Management and Surgical Intensive Care, Beni-Suef University Hospital and Faculty of Medicine, Beni Suef University, Beni Suef, Egypt (Mills) Department of Science and Technology, University of Canberra, Canberra, Australia (Akram) Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan (Hamza, ELEmady, Hosny, Wagih, Naguib) Department of Anesthesia, Kasr Al Ainy Faculty of Medicine and Cairo University Hospitals, Cairo University, Cairo, Egypt (Hosny) Department of Cardiothoracic Anaesthesia and Intensive Care Medicine, Freeman Hospital, Newcastle upon Tyne Foundation Trust, Newcastle upon Tyne, United Kingdom (Sallam) Department of Anaesthesia, St. Vincent's University Hospital, Dublin, Ireland (Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City, Makkah al-Mukarramah, Saudi Arabia Publisher W.B. Saunders Abstract This Special Article aimed to develop an evidence-derived translational framework for structured assessment of readiness for early extubation following pediatric cardiac surgery, informed by a previously published systematic review and meta-analysis. Framework development was based on secondary synthesis of aggregated study-level data from pediatric cardiac surgical populations across multiple institutions; no clinical intervention was performed. Extracted study-level data, subgroup findings, sensitivity analyses, and predefined clinical interpretability criteria were used. Candidate variables associated with extubation timing and postoperative outcomes were mapped into clinically coherent domains according to recurrent representation within the evidence base, biological plausibility, and applicability to routine multidisciplinary assessment. The Pediatric Cardiac Extubation Readiness Framework (PCERF) was revised into a 2-layer translational framework. Layer 1 comprises age, weight, procedural complexity, cardiopulmonary stability, and peri-extubation pathway factors. Layer 2 comprises mandatory non-scored clinical safety modifiers intended to identify physiological states that may independently preclude consideration of early extubation. The numerical score structure, weight categories, equal weighting, and readiness bands are illustrative prototype framework components rather than statistically optimized or outcome-derived thresholds. PCERF is a hypothesis-generating translational framework intended to support structured multidisciplinary assessment of extubation readiness following pediatric cardiac surgery. It is not a validated prediction model and requires prospective multicenter evaluation before clinical implementation. Copyright © 2026 Elsevier Inc. <109> Accession Number 2047692640 Title Heparin Dose-Response Curve for Heparin Dose Determination During Cardiopulmonary Bypass for Pediatric Cardiac Surgery: A Prospective Randomized Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Gokhale P.; Hasija S.; Choudhury A.; B S.G.; Yadav M.; Chauhan S. Institution (Gokhale, Hasija, Choudhury, Chauhan) Department of Cardiac Anaesthesia and Critical Care, AIIMS, New Delhi, India (B, Yadav) Department of Cardiothoracic and Vascular Surgery, AIIMS, New Delhi, India Publisher W.B. Saunders Abstract Objectives: To determine whether individualized heparin dosing guided by a heparin dose-response (HDR) curve is noninferior to conventional weight-based dosing in achieving target activated clotting time (ACT) of >=480 seconds before cardiopulmonary bypass (CPB) and to compare total heparin and protamine requirements, postoperative blood loss, and transfusion needs in children younger than 14 years undergoing cardiac surgery with cardiopulmonary bypass support. Design(s): Single-center, prospective, double-blinded, randomized controlled trial. Setting(s): Cardiothoracic operating theaters and intensive care unit of a tertiary care hospital in India. Participant(s): Pediatric (<14 years) patients undergoing elective cardiac surgery with CPB support. Intervention(s): The HDR group received an initial test dose of 100 IU/kg of heparin, and an individualized ACT dose-response curve was constructed to determine the dose required to target an ACT of 480 seconds. Controls received standard 400 IU/kg of heparin. Protamine was given post-CPB per protocol in both groups. Measurements and Main Results: In this noninferiority trial, HDR-guided anticoagulation was assessed against conventional weight-based dosing for first-pass attainment of ACT >=480 seconds before CPB. Target ACT was achieved in 72.2% (26/36) of HDR patients versus 83.3% (30/36) of controls (p = 0.396). Although HDR was associated with lower heparin exposure (260 v 420 IU/kg; p < 0.001) and protamine use (4.1 v 4.8 mg/kg; p = 0.002), as well as reduced 24-hour blood loss (5.2 v 6.5 mL/kg; p = 0.03) and packed red blood cell transfusion (6.8 v 8.2 mL/kg; p = 0.04), it did not demonstrate superior first-attempt ACT attainment. Conclusion(s): HDR-guided heparinization reduced heparin and protamine exposure and was associated with less bleeding and transfusion, but it did not improve first-pass ACT attainment. Because ACT is an imperfect surrogate for anticoagulant adequacy in children on CPB, these findings should be interpreted as ACT-guided dosing data rather than proof of equivalent anticoagulation. Larger multicenter studies with mechanistic and clinical endpoints are needed to confirm these results. Copyright © 2026 Elsevier Inc. <110> Accession Number 2047626279 Title Enhanced Recovery After Cardiac Surgery: A Bibliometric Analysis With Emphasis on Perioperative and Anesthetic Practice. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Huang S.; Chao M.; Zhao X.-S.; Liu K.-X.; Gao S.-S.; Yao Y.-T. Institution (Huang, Zhao, Liu, Gao, Yao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Huang, Zhao, Liu, Gao, Yao) The Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Chao, Yao) Center of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Chao, Yao) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To systematically characterize the global research landscape and emerging trends of enhanced recovery after cardiac surgery (ERACS). Design(s): Bibliometric analysis. Data Source: Publications were retrieved from the Web of Science Core Collection database, a comprehensive repository of peer-reviewed international literature. Study Selection: A total of 725 publications related to ERACS published between 1979 and 2026 were included. Intervention(s): Not applicable. Measurements and Main Results: Annual publication output increased markedly after 2015, indicating growing interest in ERACS. The United States and Canada were the leading contributors in both productivity and academic influence. Co-occurrence and clustering analyses identified major research themes, including minimally invasive cardiac surgery, multimodal analgesia, perioperative management, and postoperative complications. Temporal keyword analysis demonstrated a transition from early extubation strategies toward comprehensive perioperative care pathways. Despite this expansion, high-quality randomized evidence remains limited. Conclusion(s): This bibliometric analysis provides a comprehensive overview of the evolving research landscape of ERACS. The field is rapidly expanding and shifting toward integrated perioperative care models. However, further high-quality studies are required to strengthen the evidence base and support clinical implementation. Copyright © 2026 Elsevier Inc. <111> Accession Number 2047691138 Title Comparison of Paravertebral Block and Serratus Posterior Superior Intercostal Plane Block for Postoperative Analgesia After Video-Assisted Thoracoscopic Surgery: A Prospective, Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Manici M.; Sincer Y.; Yaylak D.; Sogut M.S.; Darcin K.; Kalyoncu I.; Ozer K.B.; Tanju S.; Gurkan Y. Institution (Manici, Sincer, Yaylak, Sogut, Darcin, Kalyoncu, Gurkan) Department of Anaesthesiology and Reanimation, Koc University Hospital, Istanbul, Turkey (Ozer, Tanju) Department of Thoracic Surgery, Koc University Hospital, Istanbul, Turkey Publisher W.B. Saunders Abstract Objectives: To compare the analgesic efficacy of serratus posterior superior intercostal plane block (SPSIPB) versus thoracic paravertebral block (TPVB) in patients undergoing video-assisted thoracoscopic surgery (VATS), with a focus on postoperative opioid consumption and pain scores. Design(s): A prospective, randomized, controlled, single-center clinical trial. Setting(s): A tertiary university hospital. Participant(s): Sixty adult patients aged 18 to 80 years scheduled for elective VATS. Participants were randomized in a 1:1 ratio to receive either SPSIPB (n = 30) or TPVB (n = 30). Baseline characteristics were comparable between groups. Intervention(s): Prior to induction of general anesthesia, patients received either ultrasound-guided SPSIPB or TPVB using 30 mL of 0.25% bupivacaine. Measurements and Main Results: The primary outcome was cumulative 24-hour postoperative opioid consumption, expressed as oral morphine equivalents. Secondary outcomes included numeric rating scale (NRS, 0-10) for pain scores and the incidence of opioid-related adverse effects at 1, 3, 6, 12, and 24 hours after surgery. Twenty-four-hour opioid use was not significantly different between SPSIPB and TPVB (66.8 +/- 29.4 mg v 77.2 +/- 40.0 mg; mean difference -10.4 mg; 95% CI, -36.1 to 15.3; p = 0.439). No significant differences were seen in pain scores or opioid-related side effects at any assessed time point (p > 0.05). Conclusion(s): SPSIPB and TPVB were associated with similar postoperative opioid consumption, pain scores, and the incidence of adverse effects following VATS. Given its potentially simpler application, SPSIPB may serve as an effective alternative regional analgesic technique in thoracic surgery. Copyright © 2026 Elsevier Inc. <112> Accession Number 2047638505 Title Fractional Flow Reserve-Guided Versus Coronary Angiography Alone for Guiding Coronary Artery Bypass Grafting: A Meta-Analysis of Randomized Trials. Source American Journal of Cardiology. 273 (pp 150-153), 2026. Date of Publication: 15 Aug 2026. Author Abbas O.F.; Emara A.; Almarfadi A.; Haddad R.; Atta K.; Elbenawi H.; Zordok M.; Elgendy I.Y. Institution (Abbas, Emara) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Almarfadi) Department of Medicine, Ferhat Abbas University of Setif, Setif, Algeria (Haddad) Faculty of Medicine, October 6 University, Giza, Egypt (Atta) Institute of Medicine, National Research Mordovia State University, Saransk, Russian Federation (Elbenawi) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Zordok) Department of Cardiovascular Medicine, Baylor Scott & White, The Heart Hospital Plano, Plano, TX, United States (Elgendy) Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, KY, United States Publisher Elsevier Inc. Abstract Coronary artery bypass grafting (CABG) has been traditionally guided by coronary angiography, although angiographic severity may not accurately reflect the physiological significance of coronary lesions. Fractional flow reserve (FFR) improves outcomes in percutaneous coronary intervention, but its role in guiding CABG remains uncertain. We conducted a meta-analysis of randomized controlled trials (RCTs) comparing FFR-guided versus angiography-guided CABG. Electronic databases were systematically searched from inception to April 2026. Outcomes included all-cause death, myocardial infarction (MI), and stroke. Random-effects models were used to calculate pooled risk ratios (RRs) with 95% confidence intervals (CIs). Three RCTs including 1,061 patients were analyzed, with 533 patients assigned to FFR-guided CABG. During a mean follow-up of 15 months, FFR-guided CABG was associated with a significantly lower risk of MI compared with angiography-guided CABG (RR 0.48, 95% CI 0.26 to 0.89; p = 0.01). There were no statistically significant differences in all-cause death (RR 0.74, 95% CI 0.52 to 1.07; p = 0.10) or stroke (RR 1.60, 95% CI 0.94 to 2.74; p = 0.08). Risk of bias was low across all included trials. In conclusion, FFR-guided CABG was associated with a reduced incidence of MI compared with angiography-guided CABG, without significant differences in all-cause death or stroke. Larger trials with longer follow-up are needed to further define the role of physiology-guided surgical revascularization. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <113> Accession Number 2047679317 Title Practice-changing updates in the perioperative medicine literature of 2025. Source American Journal of Medicine. (no pagination), 2026. Date of Publication: 2026. Author Silbert R.E.; Bartlett M.A.; Devalapalli A.P.; Dinh C.A.; Mauck K.F.; Regan D.W.; Sanchez J.J.; Stephenson C.R.; Khambaty M. Institution (Silbert, Bartlett, Mauck, Stephenson) Division of General Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, United States (Devalapalli, Dinh, Regan, Sanchez, Khambaty) Division of Hospital Internal Medicine, Department of Medicine, Mayo Clinic and Mayo Clinic College of Medicine, Rochester, MN, United States Publisher Elsevier Inc. Abstract A wealth of new literature is published annually in the growing field of perioperative medicine. The most noteworthy publications are often hard to find as they are spread over a variety of journals. We have undertaken a multi-database literature search from January to December of 2025 to identify the most impactful perioperative articles from the past year. We included original research articles, systematic reviews, meta-analyses, and guidelines. We excluded abstracts, case reports, letters, or literature pertaining to cardiovascular surgery, pediatrics, and obstetrics. Two authors reviewed each reference using the Distiller SR systematic review software (Evidence Partners Inc., Ottawa, Ontario, Canada). A modified Delphi technique was used to narrow down to seven of the most impactful publications and another eight tabular summaries. The purpose of this review is to highlight new literature to improve perioperative outcomes for patients. Copyright © 2026 Elsevier Inc. <114> Accession Number 651684544 Title Prognostic Value of the Meta-Analysis Global Group in Chronic Heart Failure Risk Score in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair. Source Journal of the American Heart Association. (pp e048383), 2026. Date of Publication: 03 Jul 2026. Author Nishimura Y.; Asami M.; Horiuchi Y.; Tanaka J.; Taniwaki M.; Komiyama K.; Yuzawa H.; Tanabe K.; Yamamoto M.; Kubo S.; Saji M.; Izumi Y.; Sugiura A.; Shimura T.; Enta Y.; Shirai S.; Izumo M.; Mizuno S.; Watanabe Y.; Amaki M.; Kodama K.; Otsuki H.; Naganuma T.; Bota H.; Ohno Y.; Yamawaki M.; Ueno H.; Nakazawa G.; Hachinohe D.; Otsuka T.; Hayashida K. Institution (Nishimura, Asami, Horiuchi, Tanaka, Taniwaki, Komiyama, Yuzawa, Tanabe) Division of Cardiology Mitsui Memorial Hospital Tokyo Japan, Japan (Yamamoto) Department of Cardiology Toyohashi Heart Center Toyohashi Japan, Japan (Kubo) Department of Cardiology Kurashiki Central Hospital Kurashiki Japan, Japan (Saji, Izumi) Department of Cardiology Sakakibara Heart Institute Tokyo Japan, Japan (Saji) Division of Cardiovascular Medicine, Department of Internal Medicine Toho University Faculty of Medicine Tokyo Japan, Japan (Sugiura) Department of Cardiology Nagoya Heart Center Nagoya Japan, Japan (Shimura) Department of Cardiology Gifu Heart Center Gifu Japan, Japan (Enta) Department of Cardiology Sendai Kosei Hospital Sendai Japan, Japan (Shirai) Division of Cardiology Kokura Memorial Hospital Kitakyushu Japan, Japan (Izumo) Division of Cardiology St. Marianna University School of Medicine Hospital Kawasaki Japan, Japan (Mizuno) Department of Cardiology Shonan Kamakura General Hospital Kamakura Kanagawa Japan, Japan (Watanabe) Department of Cardiology Teikyo University School of Medicine Tokyo Japan, Japan (Amaki) Department of Cardiology National Cerebral and Cardiovascular Center Suita Japan, Japan (Kodama) Division of Cardiology Saiseikai Kumamoto Hospital Cardiovascular Center Kumamoto Japan, Japan (Otsuki) Department of Cardiology Tokyo Women's Medical University Tokyo Japan, Japan (Naganuma) Department of Cardiology New Tokyo Hospital Chiba Japan, Japan (Bota) Department of Cardiology Sapporo Higashi Tokushukai Hospital Sapporo Japan, Japan (Ohno) Department of Cardiology Tokai University School of Medicine Isehara Japan, Japan (Yamawaki) Department of Cardiology Saiseikai Yokohama City Eastern Hospital Yokohama Kanagawa Japan, Japan (Ueno) Second Department of Internal Medicine Toyama University Hospital Toyama Japan, Japan (Nakazawa) Department of Cardiology Kindai University Faculty of Medicine Osaka Japan, Japan (Hachinohe) Cardiovascular Medicine, Sapporo Heart Center Sapporo Cardiovascular Clinic Sapporo Japan, Japan (Otsuka) Department of Hygiene and Public Health Nippon Medical School Tokyo Japan, Japan (Hayashida) Department of Cardiology Keio University School of Medicine Tokyo Japan, Japan Abstract BACKGROUND: The prognostic value of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in patients undergoing mitral valve transcatheter edge-to-edge repair (M-TEER) remains unclear. This study evaluated the MAGGIC score to predict outcomes after M-TEER in patients with functional (FMR) or degenerative mitral regurgitation (DMR) and compared its performance with conventional surgical and M-TEER-specific risk models. METHOD(S): We analyzed 3609 patients (FMR, 71%; DMR, 29%) who underwent M-TEER in the OCEAN (Optimized Catheter Valvular Intervention)-Mitral registry. Patients were stratified into MAGGIC score tertiles. The primary outcome was all-cause death at 1 and 3 years. Secondary outcomes included cardiovascular death. Predictive performance was compared with Society of Thoracic Surgeons score, European System for Cardiac Operative Risk Evaluation II, MitraScore, and COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) score. RESULT(S): The median age was 81 years, 55.3% were men, and median MAGGIC score was 30. In the FMR cohort, patients in tertile 3 had higher risks of all-cause death (1 year: adjusted hazard ratio [HRadj], 4.15 [95% CI, 2.34-7.36]; 3 years: HRadj, 1.83 [95% CI, 1.22-2.77]) and cardiovascular death (1 year: HRadj, 2.31 [95% CI, 1.56-3.43]; 3 years: HRadj, 1.61 [95% CI, 1.13-2.31]). In the DMR cohort, tertile 3 was associated with higher all-cause death (1 year: HRadj, 2.84 [95% CI, 1.18-6.86]; 3 years: HRadj, 2.25 [95% CI, 1.07-4.73]) and cardiovascular death at 3 years (HRadj, 3.49 [95% CI, 1.23-9.84]). The MAGGIC score demonstrated comparable or superior discrimination on the basis of the concordance index. CONCLUSION(S): The MAGGIC score independently predicted 1- and 3-year all-cause death after M-TEER in both FMR and DMR cohorts and cardiovascular death in the FMR cohort and at 3 years in the DMR cohort. It demonstrated comparable or superior predictive performance to conventional surgical and M-TEER-specific risk models. <115> Accession Number 651677577 Title Coronary artery bypass grafting based on computed tomography-derived fractional flow reserve versus angiography: Early results. Source The Annals of thoracic surgery. (no pagination), 2026. Date of Publication: 02 Jul 2026. Author Kim M.-S.; Ryu A.-J.; Kim J.W.; Lee C.H.; Hwang S.W.; Kim K.-B. Institution (Kim) Cardiovascular Center, Myongji Hospital, Gyeonggido, Republic of Korea; Hanyang University College of Medicine, Seoul, Republic of Korea (Ryu) SeoulSouth Korea (Kim, Lee, Hwang, Kim) Cardiovascular Center, Myongji Hospital, Gyeonggido, South Korea Abstract BACKGROUND: This randomized trial was designed to compare 1-yearoutcomes in patients who received revascularization based on computed tomography-derived fractional flow reserve(CT-FFR) versus quantitative coronary angiography(QCA). In this early analysis, early angiographic and clinical outcomes were compared. METHOD(S): A total of 106 patients were randomized to undergo coronary artery bypass grafting based on CT-FFR(CT-FFR group,N=53) or QCA(QCA group,N=53). Complete revascularization was achieved for coronary arteries with CT-FFR <=0.78(CT-FFR group) or those with QCA stenosis(>70% stenosis for left; >=90% stenosis for right coronary artery territories)(QCA group).. Angiography was performed at median 1[1,1] postoperative day in all patients. Angiographic findings of graft flow were categorized as perfectly patent, competitive(bidirectionally or unidirectionally competitive), or occluded. RESULT(S): There were no differences in patient characteristics between the 2 groups. The average number of revascularized coronary arteries per patient were 3.7+/-0.8 in the CT-FFR group and 3.5+/-0.7 in the QCA group(P=0.089). The median difference in expected anastomosis sites was 2[1,3]. There were no operative mortality and no differences in morbidities between the 2 groups. The number of perfectly patent, bidirectionally competitive, and unidirectionally competitive grafts were 167(85.2%),10(5.1%), and 19(9.7%),respectively, in the CT-FFR group(n=196);133(72.7%),23(12.6%), and 27(14.8%),respectively, in the QCA group(n=183). There was a significant difference in the number of perfectly patent grafts between the 2 groups(p=0.007). CONCLUSION(S): The average number of distal anastomoses was similar between the two groups. However, the number of competitive grafts was significantly reduced in the CT-FFR group compared to the QCA group. Copyright © 2026. Published by Elsevier Inc. <116> Accession Number 651680714 Title The effectiveness of perioperative respiratory muscle exercise in elderly cardiac surgery patients: a randomized controlled trial. Source Archives of physical medicine and rehabilitation. (no pagination), 2026. Date of Publication: 04 Jul 2026. Author Wang Q.; Shao J.; Peng Y.; Li S.; Chen L.; Lin Y. Institution (Wang) Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Department of Intensive Care Unity, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; School of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian China (Shao, Peng) Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China (Li) Department of Cardiovascular Surgery, Fujian Medical University, Fujian China, Fuzhou, China (Chen) Department of Cardiovascular Surgery, Fujian Medical University, Fujian China., Fuzhou, China (Lin) Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, Fujian, China; Department of Cardiovascular Surgery, Fujian Medical University, Fuzhou, Fujian China. Electronic address: fjxhyjl@163.com Abstract OBJECTIVE: This study aimed to evaluate the impact of perioperative respiratory muscle training on respiratory muscle strength, pulmonary function, functional capacity and prognostic outcomes in patients undergoing surgery. DESIGN: A randomized controlled trial. SETTING(S): Cardiac surgery ward and cardiac surgery intensive care unit of a tertiary Grade A hospital in Fuzhou, China. PARTICIPANTS: Eighty-two participants. INTERVENTIONS: Perioperative respiratory muscle exercise. MAIN OUTCOME MEASURES: Eighty-two patients were randomly assigned to either the intervention group (n = 42), who performed perioperative respiratory muscle training, or the control group (n = 40). Patients completed one session per day from admission to discharge (except during mechanical ventilation). Respiratory muscle strength was assessed upon admission, the day before surgery, on the third day post-intensive care unit transfer, and at discharge. Each patient underwent a lung function test, six-minute walk test, self-efficacy for exercise scale, anxiety and depression test, and quality of life questionnaire, before and after intervention. RESULT(S): The intervention group showed significantly greater improvements in maximal inspiratory pressure (57.69 +/- 10.85 cmH2O vs. 48.28 +/- 10.30 cmH2O), pulmonary function, functional capacity, postoperative pulmonary complications (38.1% vs. 65.0%), inspiratory muscle weakness (42.9% vs. 85.0%), duration of mechanical ventilation and intensive care unit stay, level of anxiety and depression, quality of life, and length of post-operative hospitalization. Additionally, the incidence of postoperative pulmonary (9.5% vs. 22.5%) and re-hospitalization within six months (9.5% vs. 17.5%) was reduced, though not statistically significant. CONCLUSION(S): Perioperative respiratory muscle training could contribute to improved respiratory muscle strength, pulmonary function, functional capacity, prognostic outcome, and quality of life in elderly cardiac surgery patients. Continuous activation of the respiratory muscles could provide multiple benefits for these individuals. Copyright © 2026. Published by Elsevier Inc. <117> Accession Number 2047607360 Title Colchicine in coronary heart disease: from inflammatory biology to secondary prevention. Source Clinical and Experimental Rheumatology. 44 (pp 1306-1311), 2026. Date of Publication: 14 Jul 2026. Author Imazio M. Institution (Imazio) Department of Medicine, University of Udine, and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, Udine, Italy Publisher Clinical and Experimental Rheumatology S.A.S. Abstract Inflammation is now recognised as a central mechanism in atherosclerosis and its clinical complications, shifting coronary heart disease management beyond exclusive lipid lowering and antithrombotic therapy. In this setting, colchicine is a potential low-cost anti-inflammatory candidate for cardiovascular prevention. While the CANTOS trial provided proof of principle that targeting inflammation can reduce recurrent cardiovascular events independently of lipid lowering, randomised colchicine trials such as COLCOT and LoDoCo2 showed reductions in major adverse cardiovascular events in patients with recent myocardial infarction and chronic coronary disease, respectively. Later meta-analyses generally confirmed benefit for major adverse cardiovascular events, myocardial infarction, stroke, and coronary revascularisation, although without a consistent mortality reduction and with gastrointestinal intolerance as the most common adverse effect. This review summarises the biological rationale, clinical trial evidence, safety profile, practical use, limitations, and current place of colchicine in coronary heart disease highlighting that colchicine is a real available cheap option for secondary prevention at least in chronic coronary syndromes. © Copyright CLINICAL AND EXPERIMENTAL RHEUMATOLOGY 2026. <118> Accession Number 2047595294 Title From fast track to ultrafast track extubation in cardiac surgery: a systematic review. Source Minerva Anestesiologica. 92(6) (pp 588-600), 2026. Date of Publication: 01 Jun 2026. Author Silvetti S.; Fresilli S.; Abelardo D.; Ajello V.; Aloisio T.; Capuano P.; Guarracino F.; Labanca R.; Landoni G.; Lobdell K.W.; Meani P.; Pieri M.; Ranucci M.; Sepolvere G.; Toscano A.; Scolletta S.; Stoppe C.; Weltert L.; Zarbock A.; Paternoster G. Institution (Silvetti) Department of Cardioanesthesia and Intensive Care, Cardiovascular Network, IRCCS Ospedale Policlinico San Martino, Genoa, Italy (Fresilli, Labanca, Landoni, Pieri) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Abelardo) Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy (Ajello) Department of Cardiac Anesthesia, Tor Vergata University Hospital, Rome, Italy (Aloisio, Ranucci) Department of Cardio-Thoraco-Vascular Anesthesia and Intensive Therapy, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (Capuano) IRCCS ISMETT, Palermo, Italy (Capuano) UPMC Italy, Palermo, Italy (Guarracino) Department of Medical,, Oral and Biotechnological Sciences "Gabriele d'Annunzio" University, Chieti, Italy (Landoni, Pieri) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Lobdell) Sanger Heart and Vascular Institute, Advocate Health, Charlotte, NC, United States (Meani) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Sepolvere) Intensive Care Unit, Department of Anesthesia and Cardiac Surgery, San Michele Hospital, Caserta, Italy (Toscano) Department of Anesthesia and Intensive Care, ASL TO4, Ivrea Hospital, Ivrea, Turin, Italy (Scolletta) Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy (Stoppe) Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Stoppe, Zarbock) UTHealth, Center for Outcomes Research, Department of Anesthesiology, Houston, TX, United States (Weltert) Saint Camillus International University for Health Science, Rome, Italy (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Paternoster) Department of Health Science, Anesthesia and Intensive Care Unit, San Carlo Hospital, University of Basilicata, Potenza, Italy Publisher Edizioni Minerva Medica Abstract BACKGROUND: This study aimed to evaluate interventions that facilitate rapid extubation in adult cardiac surgery patients, defined as extubation within six hours, three hours, or one hour post-surgery. Early extubation is a critical component of enhanced recovery pathways in cardiac surgery and plays an essential role in improving patient outcomes. Several strategies have been investigated, including the use of locoregional anesthesia techniques, dexmedetomidine, and adaptive support ventilation. METHOD(S): A systematic review of randomized controlled trials (RCTs) was conducted, searching the Medline, Central, and Embase databases from January 2015 to May 2025. Studies were included if they compared interventions for rapid extubation and achieved extubation within at least one study group for more than 75% of patients. Fifty-seven trials were included in the review. RESULT(S): Out of the 57 trials, 42 studies reported extubation within six to three hours post-surgery. These results were predominantly associated with locoregional anesthesia techniques, particularly fascial blocks, as well as dexmedetomidine use and adaptive support ventilation. Eleven studies reported extubation within three hours and one hour, with the majority of these trials also involving fascial blocks. Among the 57 studies, four focused specifically on ultrafast track strategies. Notably, only one study assessing the erector spinae plane block achieved extubation within one hour in over 75% of patients, with a median extubation time of 10 minutes (range 10-120 minutes), compared to 60 minutes (range 10-225 minutes) in the control group (P=0.06). CONCLUSION(S): While ultrafast extubation is currently limited to select patients, it appears to be safe and effective when carefully applied. The study supports the use of various interventions for facilitating rapid extubation and highlights the importance of individualized patient selection. Further high-quality trials are needed to identify the most effective combinations of these interventions and to standardize protocols for broader clinical practice. Copyright © 2025 EDIZIONI MINERVA MEDICA. <119> Accession Number 651680135 Title The Effect of Preoperative Hydration on Cardiac Surgery-Associated Acute Kidney Injury. Source Brazilian journal of cardiovascular surgery. 41(2) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Karakoc A.Z.; Ozcan E.; Akardere O.F.; Cevirme D.; Zengin A.; Sunar H. Institution (Karakoc) Sehit Prof. Dr. Ilhan Varank Sancaktepe Research and Training Hospital Department of Cardiovascular Surgery Istanbul Turkiye Department of Cardiovascular Surgery, Sehit Prof. Dr. Ilhan Varank Sancaktepe Research and Training Hospital, Istanbul, Turkey (Ozcan, Akardere, Sunar) Kartal Kosuyolu Heart Research and Training Hospital Department of Cardiovascular Surgery Istanbul Turkiye Department of Cardiovascular Surgery, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey (Cevirme) Istinye University Faculty of Medicine Department of Cardiovascular Surgery Istanbul Turkiye Department of Cardiovascular Surgery, Istinye University Faculty of Medicine, Istanbul, Turkey (Zengin) Fatih Gebze State Hospital Department of Cardiovascular Surgery Kocaeli Turkiye Department of Cardiovascular Surgery, Fatih Gebze State Hospital, Kocaeli, Turkey Abstract OBJECTIVE: The aim of this study was to determine the effect of preoperative intravenous saline hydration on postoperative renal functions and the prevention of acute kidney injury subsequent to open-heart surgery. METHOD(S): Our investigation was designed as a prospective, randomized, and controlled single-center trial. We included 110 patients with basal renal functions that were not disrupted and who were undergoing cardiac surgery from October to December 2020. The first group (control) had fluid restriction for 12 hours prior to surgery (n = 55), and the second group (case) was hydrated with 0.9% normal saline for 12 hours before surgery (n = 55). RESULT(S): In the hydration group, creatinine values dropped below the preoperative values (P = 0.008) and the glomerular filtration rate values rose above the preoperative levels (P = 0.003). The early-term mortality rates were 0% for the hydration group and 5.45% for the control group (n = 3). Besides, in the hydration group, the glomerular filtration rate values on the 30th day and 360th day after surgery increased to levels even higher than those recorded preoperatively. CONCLUSION(S): As a result of much effort, we showed that preoperative hydration can prevent severe cardiac surgery-associated acute kidney injury and related in-hospital mortality. <120> Accession Number 651663397 Title Percutaneous Coronary Intervention Prior to Transcatheter Aortic Valve Implantation: A Bayesian Meta-Analysis of Randomized Controlled Trials. Source The Canadian journal of cardiology. (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Batista P.G.; Albino Dos Santos Silva R.R.; Malik M.; Gaelzer G.C.; Montenegro M.V.; Fischer Bacca C.O.; Giorgi J. Institution (Batista) Federal University of Paraiba, Joao Pessoa, Paraiba, Brazil (Albino Dos Santos Silva) Federal University of Ceara, Fortaleza, Ceara, Brazil (Malik) Beth Israel Deaconess Medical Center, Boston, MA, United States (Gaelzer) Pontifical Catholic University of Parana, Curitiba, Parana, Brazil (Montenegro) University of Pernambuco, Recife, Pernambuco, Brazil (Fischer Bacca) University Center for the Development of Alto Vale, Rio do Sul, Santa Catarina, Brazil (Giorgi) Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil; Albert Einstein Hospital, Sao Paulo, Sao Paulo, Brazil Abstract BACKGROUND: The optimal management of concomitant coronary artery disease (CAD) during transcatheter aortic valve implantation (TAVI) remains controversial due to conflicting data from randomized controlled trials (RCTs). METHOD(S): A systematic review and Bayesian meta-analysis of RCTs (through April 2026) compared pre-TAVI percutaneous coronary intervention (PCI) versus conservative management in TAVI patients with CAD. Effect measures were risk ratios (RRs) with 95% credible intervals (CrIs) using a Bayesian random-effects model. RESULT(S): Three RCTs involving 1,156 patients were included, with 579 (50%) randomized to pre-TAVI PCI. No evidence of benefit was observed for myocardial infarction (RR, 0.83; 95% CrI, 0.44 to 1.60), all-cause mortality (RR, 0.92; 95% CrI, 0.62 to 1.35), acute kidney injury (RR, 1.01; 95% CrI, 0.41 to 2.73), rehospitalization (RR, 1.08; 95% CrI, 0.67 to 1.75), cardiovascular death (RR, 0.74; 95% CrI, 0.44 to 1.24) or stroke (RR, 0.71; 95% CrI, 0.42 to 1.20). Although pre-TAVI PCI was associated with fewer subsequent revascularizations (RR, 0.27; 95% CrI, 0.11 to 0.66), this outcome is vulnerable to ascertainment and treatment bias. Conversely, point estimates favored conservative management for major bleeding (RR, 1.57; 95% CrI, 0.96 to 2.57). CONCLUSION(S): Pre-TAVI PCI yielded no hard clinical benefits and likely increased major bleeding risk. While it reduced subsequent revascularizations, a soft, clinician-driven endpoint, this did not improve hospital-free survival. These findings strongly support a selective, lesion-guided approach over routine intervention. Copyright © 2026. Published by Elsevier Inc. <121> Accession Number 2047435870 Title Suitability of sedative usage in patients undergoing cardiovascular surgery. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Martin N.J.; Brinkman H.M.; Ellis S.; Nabzdyk C.G.S.; Ortoleva J.P.; Wittwer E.D.; D'Andria Ursoleo J.; Wieruszewski P.M.; Monaco F. Institution (Martin, Brinkman, Wieruszewski) Department of Pharmacy, Mayo Clinic, Rochester, MN, United States (Ellis) Department of Anesthesiology, University of California San Diego, San Diego, CA, United States (Nabzdyk, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States (Ortoleva) Department of Anesthesiology, Boston Medical Center, Boston, MA, United States (D'Andria Ursoleo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Monaco) Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Publisher Taylor and Francis Ltd. Abstract Introduction: The provision of optimal anesthesia care is essential to the safe conduct of cardiac surgery. Nevertheless, evidence regarding ideal choices for anesthetic induction and maintenance remain conflicting. Individualized regimens balancing the patient's cardiac pathology and the expected hemodynamic perturbations from the anesthetics are likely optimal, underscoring the rationale for this review of contemporary anesthetic strategies in cardiac surgery. Areas covered: Descriptions of cardiac surgery trends and advancements that necessitate concomitant anesthesia, including the challenges with the provision of anesthesia in these patients were introduced. Induction and maintenance anesthesia considerations are discussed next, along with individual medication-specific commentary on volatile anesthetics, propofol, benzodiazepines, barbiturates, ketamine, etomidate, opioids, dexmedetomidine, and remimazolam. PubMed/MEDLINE, EMBASE, and Google Scholar were searched without date restriction through April 2026. Expert opinion: An optimal blanket anesthetic strategy for patients undergoing cardiac surgery remains elusive. Thoughtful combinations of multiple agents considering the patient's physiology, anticipated hemodynamic perturbations, and type and length of surgery are likely to continue to dominate practice. Novel agents, like remimazolam, may prove especially fruitful for patients given their unique properties, but more evidence is needed to prove impact on patient outcomes for this, and other agents in combination. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <122> Accession Number 2047448158 Title Transbronchial Lung Cryobiopsy and Awake Video-Assisted Thoracic Surgery in Interstitial Lung Disease: Complementary Roles in a Stepwise Diagnostic Approach. Source Diagnostics. 16(13) (no pagination), 2026. Article Number: 2095. Date of Publication: 01 Jul 2026. Author Masi U.; Sanduzzi Zamparelli A.; Sanduzzi Zamparelli S. Institution (Masi) Interventional Pulmonology Unit, A. Cardarelli Hospital, Naples, Italy (Sanduzzi Zamparelli) Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, Italy (Sanduzzi Zamparelli) UNESCO Chair for Health Education and Sustainable Development, University of Naples "Federico II", Naples, Italy (Sanduzzi Zamparelli) ERN Lung, Frankfurt am Main, Germany (Sanduzzi Zamparelli) Division of Pneumology and Semi-Intensive Respiratory Therapy, A. Cardarelli Hospital, Naples, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract The diagnostic evaluation of interstitial lung diseases (ILDs) remains challenging when clinical assessment and imaging findings are inconclusive. Although surgical lung biopsy has traditionally represented the diagnostic gold standard, its invasiveness and perioperative risks limit its applicability, particularly in patients with advanced disease or impaired respiratory reserve. This review aims to examine the evolving roles of transbronchial lung cryobiopsy (TBLC) and awake video-assisted thoracoscopic surgery (Awake VATS) within contemporary diagnostic pathways for ILD. A narrative review of the current literature was performed, focusing on studies evaluating the diagnostic performance, safety profiles, clinical indications, and complementary integration of TBLC and Awake VATS in patients with suspected ILD. Evidence from multidisciplinary ILD referral centers and recent guideline recommendations was critically analyzed. TBLC has progressively emerged as an appropriate first-line histological procedure in many ILD centers, providing a pooled diagnostic yield of approximately 80% with an acceptable safety profile. Awake VATS has refined the surgical approach by preserving spontaneous ventilation while maintaining high diagnostic accuracy. Current evidence suggests that these techniques should be considered complementary rather than competitive. A TBLC-first strategy, followed by selective surgical escalation when endoscopic sampling is non-diagnostic or insufficient, appears to achieve diagnostic accuracy comparable to upfront surgical biopsy while reducing complications, length of hospital stay, and overall patient burden. The choice between Awake VATS and conventional surgical biopsy should be individualized according to patient characteristics, institutional expertise, and available resources. TBLC and Awake VATS represent complementary tools within a multidisciplinary, personalized, and risk-adapted diagnostic framework for ILD. Their integrated use enables optimization of diagnostic accuracy while minimizing procedural invasiveness and improving patient safety, supporting a stratified approach to histological assessment in contemporary clinical practice. Copyright © 2026 by the authors. <123> Accession Number 651658875 Title 'Aspirin versus ticagrelor for the management after coronary revascularization - a systematic review and meta-analysis of randomised trials'. Source BMC cardiovascular disorders. (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Regmi D.R.; Regmi S.; Upreti S.; Gautam N. Institution (Regmi) Nepalese Army Institute of Health Sciences (NAIHS), Kathmandu, Nepal (Regmi, Upreti) Tribhuvan University Teaching Hospital, Kathmandu, Nepal (Gautam) Gulmi Durbar Basic Hospital, Gulmi, Nepal Abstract OBJECTIVE: To compare the efficacy and safety of ticagrelor monotherapy versus aspirin monotherapy in patients with coronary artery disease undergoing coronary revascularization. METHOD(S): We conducted a systematic review and meta-analysis of RCTs comparing ticagrelor monotherapy with aspirin monotherapy after PCI or CABG. MEDLINE, Embase, Cochrane Central, Scopus, ClinicalTrials.gov and Google Scholar were searched up to 19th January 2026. The primary outcome was major adverse cardiovascular events (MACE), a composite of all-cause mortality, myocardial infarction and stroke. Secondary outcomes included all-cause mortality, myocardial infarction, stroke, major bleeding, repeat revascularization and stent thrombosis. Risk ratios (RRs) with 95% CIs were pooled using a random-effects model with restricted maximum likelihood estimation and Knapp-Hartung adjustment. RESULT(S): Five randomised trials involving 25,994 participants were included, of whom 12,998 received ticagrelor monotherapy and 12,996 received aspirin monotherapy. Ticagrelor monotherapy was associated with a significantly lower risk of MACE than aspirin monotherapy (RR 0.86, 95% CI 0.78 to 0.95; p = 0.012; I2 = 0%). All-cause mortality was also reduced with ticagrelor (RR 0.86, 95% CI 0.77 to 0.97; p = 0.023; I2 = 0%). No significant differences were observed for myocardial infarction (RR 0.87, 95% CI 0.70 to 1.07; p = 0.138; I2 = 0%), stroke (RR 1.01, 95% CI 0.85 to 1.19; p = 0.913; I2=0%), major bleeding (RR 1.00, 95% CI 0.84 to 1.20; p = 0.976; I2 = 0%), repeat revascularization (RR 0.89, 95% CI 0.58 to 1.37; p = 0.452; I2 = 45.8%) or stent thrombosis (RR 0.88, 95% CI 0.20 to 3.90; p = 0.481; I2 = 0%). CONCLUSION(S): Ticagrelor monotherapy was associated with a potential reduction in MACE and all-cause mortality compared with aspirin monotherapy after coronary revascularisation, without increasing major bleeding. However, these findings were driven primarily by PCI trials, particularly the GLOBAL LEADERS and GLASSY trial program, and should be interpreted cautiously because PCI and CABG populations were analyzed together. TRIAL REGISTRATRION: CRD420261286239. Copyright © 2026. The Author(s). <124> Accession Number 2047461398 Title Prediction Models for Postoperative Atrial Fibrillation After Cardiac Surgery: A Systematic Review and Critical Appraisal. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 5255. Date of Publication: 01 Jul 2026. Author Tuesta B.L.; Alberca-Naira Y.; Leon-Rodriguez J.A.; Rodriguez-Pratto J.; Andrade-Saavedra J.D.; Calderon-Chilet F.J.; Sarmiento-Maldonado C.A.; Rivera-Lozada O.; Bonilla-Asalde C.; Barboza J.J. Institution (Tuesta) Departamento de Cardiologia, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru (Alberca-Naira) Escuela de Medicina, Universidad Nacional de Piura, Piura, Peru (Leon-Rodriguez) Universidad Cesar Vallejo, Trujillo, Peru (Rodriguez-Pratto) Facultad de Medicina, Universidad Del Norte, Barranquilla, Colombia (Andrade-Saavedra) Facultad de Medicina Humana, Universidad Privada Antenor Orrego, Trujillo, Peru (Calderon-Chilet) Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru (Sarmiento-Maldonado) Escuela Superior de Medicina, Instituto Politecnico Nacional, Mexico City, Mexico (Rivera-Lozada, Bonilla-Asalde, Barboza) Escuela de Medicina, Universidad Senor de Sipan, Chiclayo, Peru Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Postoperative atrial fibrillation (POAF) is a frequent complication after cardiac surgery and is associated with increased morbidity, prolonged hospitalization, and higher healthcare costs. Numerous multivariable prediction models have been developed to estimate individual risk; however, their methodological robustness, validation status, and clinical transportability remain uncertain. This systematic review aimed to critically evaluate the methodological quality, validation strategies, and predictive performance of multivariable prediction models developed to estimate the risk of postoperative atrial fibrillation (POAF) after cardiac surgery. Method(s): In accordance with PRISMA 2020 guidelines, we conducted a comprehensive search of PubMed, Scopus, Web of Science, and Embase from inception to July 2025. Studies that developed or externally validated multivariable prediction models for POAF in adult patients undergoing cardiac surgery were eligible. Data extraction was performed using the CHARMS checklist, and methodological quality was assessed with PROBAST. Model performance was summarized descriptively, focusing on discrimination (C-statistic/AUC), calibration reporting, and validation strategies. Result(s): A total of 39 studies were included. Most models were based on logistic regression, whereas a minority employed Cox regression or machine learning techniques. Reported discrimination ranged from 0.60 to 0.98, demonstrating substantial heterogeneity in predictive performance. Calibration was inconsistently reported. Six studies performed external validation. According to PROBAST, 32 of 39 studies (82%) were rated at high risk of bias, predominantly within the analysis domain due to inadequate handling of overfitting, insufficient events-per-variable ratios, and limited validation procedures. Conclusion(s): Existing prediction models for POAF show variable discrimination but are frequently limited by high risk of bias, inadequate validation, and incomplete calibration assessment, thereby restricting their clinical applicability. Future research should prioritize rigorous external validation, transparent reporting in accordance with TRIPOD recommendations, and methodological strategies that enhance model generalizability and transportability across diverse surgical populations. Copyright © 2026 by the authors. <125> Accession Number 651659778 Title Extracorporeal Membrane Oxygenation as a Preoperative Bridge for Infective Endocarditis: A Case Report and Review. Source ASAIO journal (American Society for Artificial Internal Organs : 1992). (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Chen Y.; Liang S.; Xu S.; Huang J.; Hao J.; Li C. Institution (Chen, Liang, Xu, Huang, Li) From the Department of Critical Care Medicine, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China (Hao) Department of Emergency Medicine, Shenzhen Hospital, Shanghai University of Traditional Chinese Medicine, Shenzhen, China Abstract Infective endocarditis (IE) complicated by refractory cardiopulmonary failure carries high mortality, and standardized protocols for extracorporeal membrane oxygenation (ECMO) are lacking. We report a 31 year old male with fulminant IE, severe aortic regurgitation, acute respiratory distress syndrome (ARDS), and refractory cardiogenic shock who was initially supported with venovenous (VV) ECMO for isolated respiratory failure. Due to progressive hemodynamic deterioration, configuration was converted to veno-arterial (VA) ECMO, followed by emergency aortic valve replacement and targeted antimicrobial therapy. The patient achieved successful decannulation and discharge. To contextualize this case, we conducted a systematic literature review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying 21 additional cases (2000-2025), forming a 22-patient cohort. Pooled analysis demonstrated an overall in-hospital survival rate of 81.8% (18/22) with ECMO bridging. Surgical treatment significantly improved survival compared with conservative management (94.4% vs. 25%). These findings suggest that ECMO is a feasible bridge-to-surgery strategy for IE with refractory cardiopulmonary failure. However, given the significant risk of publication bias inherent to case report data, we propose a hypothesis-generating management algorithm emphasizing individualized mode selection and early surgical source control, rather than definitive clinical guidelines. Large-scale prospective studies are required for validation. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASAIO. <126> Accession Number 2047498941 Title Bayesian Reanalysis of Revascularization Strategies for Left Main Disease: Coronary Artery Bypass Grafting vs Percutaneous Intervention. Source Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication: 2026. Author Li Z.; Larson J.; Vervoort D.; Rakhshan S.; Servito M.; Tam D.Y.; Liu K.; Fremes S.E. Institution (Li) Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada (Li, Vervoort, Rakhshan, Tam, Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, ON, Canada (Larson) Toronto Metropolitan University, Toronto, ON, Canada (Vervoort, Servito, Liu, Fremes) Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada (Rakhshan) Western University, London, ON, Canada (Servito) Division of Cardiac Surgery, University of Manitoba, Manitoba, Winnipeg, Canada (Tam, Fremes) Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Background The preferred revascularization strategy for left main disease between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) remains controversial, given discordant conclusions from randomized and observational evidence for mortality. Accordingly, we performed a bayesian reanalysis of the meta-analysis by Sabatine and coworkers to assess the probability of effectiveness using different assumptions. Methods Data were extracted from the meta-analysis of 4 trials by Sabatine and coworkers. The primary outcome was all-cause mortality; secondary outcomes included myocardial infarction, stroke, repeated revascularization, and composite outcomes. Bayesian methods estimated 5-year hazard ratios and absolute risk reductions using priors ranging from no prior preference to data-informed assumptions. Results For all-cause mortality, bayesian analysis indicated a higher probability of lower mortality with CABG, exceeding 80% across priors. Under the minimally informative prior, the hazard ratio was 1.1 (95% credible interval, 0.91-1.33), and the absolute risk reduction was 0.88% (95% credible interval: -0.92% to 2.76%). Under the downweighted historical prior, the hazard ratio was 1.40 (1.25-1.56) and the absolute risk reduction 4.61% (3.06%-6.11%). CABG also showed highly probable benefits for myocardial infarction, repeated revascularization, and composite outcomes. Conversely, stroke favored PCI (hazard ratio, 0.83 [0.58-1.19]; absolute risk reduction -0.40% [-1.40% to 0.62%]). Conclusions This reanalysis suggests a higher probability that CABG is associated with reduced mortality, myocardial infarction, repeated revascularization, and composite outcomes, whereas PCI offers a lower risk of stroke. Interpretation of mortality was prior dependent, whereas other outcomes were largely prior agnostic. Copyright © 2026 The Authors. <127> Accession Number 2047594957 Title Artificial Intelligence for Predicting Perioperative Outcomes in Cardiac Surgery: A Systematic Review. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Ha J.; Vohra H.A. Institution (Ha, Vohra) University of Bristol, United Kingdom Publisher SAGE Publications Ltd Abstract Objective: Cardiac surgery carries a significant risk of complications and mortality. Artificial intelligence (AI), particularly machine learning (ML), is increasingly being explored to enhance perioperative risk prediction and support clinical decision-making. This systematic review evaluates the clinical applications, predictive performance, and limitations of AI models in cardiac surgery. Method(s): PubMed and Embase were searched for studies published between January 2020 and July 2025. Of 939 records identified, 178 studies met the inclusion criteria following screening and full-text review. Included studies applied AI to predict clinical outcomes in patients undergoing cardiac surgery. Key outcomes assessed were model performance metrics and their clinical utility. Result(s): Among the 178 included studies, 114 (64%) were conducted in the United States or China. Most studies (n = 168, 94%) used retrospective designs and focused on adult populations. Random forest (n = 82, 46%), logistic regression (n = 82, 46%), and eXtreme Gradient Boosting (n = 70, 39%) were the most frequently used algorithms. AI applications primarily targeted the prediction of postoperative complications (n = 102, 57%) and mortality (n = 70, 39%), with common outcomes including acute kidney injury and stroke. ML models consistently outperformed traditional clinical risk scores (n = 39). SHapley Additive exPlanations was the most common interpretability method (n = 66, 37%). Only 26% of studies included external validation, and just 19% adhered to TRIPOD guidelines. Conclusion(s): AI models demonstrate superior predictive performance in cardiac surgery compared with traditional risk scores, but concerns regarding validation, transparency, and generalizability must be addressed to enable implementation. Copyright © The Author(s) 2026. 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). <128> Accession Number 2047462324 Title Modern Era in Personalized Medicine of Dual Antiplatelet Therapy After Myocardial Revascularization. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 4870. Date of Publication: 01 Jul 2026. Author Dehghan A.; Javadi N.; Allaqaband S.Q.; Jan M.F. Institution (Dehghan) Department of Surgery, Washington University in St. Louis, St. Louis, MO, United States (Javadi, Allaqaband, Jan) Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Aurora Health Care, Milwaukee, WI, United States (Allaqaband, Jan) Department of Cardiovascular Medicine, Atrium Health Wake Forest Baptist Medical Center, Winston-Salem, NC, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor remains the cornerstone of antithrombotic management after myocardial revascularization. However, the traditional "one-size-fits-all" approach to DAPT duration and intensity fails to account for marked interindividual variability in drug response-driven by genetic polymorphisms, notably CYP2C19 variants like CYP2C19*2, which reach a frequency of up to 75% in specific groups like the Melanesian population-comorbidities such as diabetes and chronic kidney disease, and dynamic clinical factors including age and concomitant medications. We examine the current landscape of precision medicine tools for individualizing DAPT, including platelet function testing, point-of-care genotyping, validated clinical risk scores, and emerging artificial intelligence (AI)-based predictive models. Evidence from landmark trials is synthesized to evaluate escalation, de-escalation, and duration-tailoring strategies within the ischemic-bleeding trade-off framework. Special populations requiring individualized approaches are reviewed, including patients with atrial fibrillation, the elderly, and those requiring urgent noncardiac surgery with perioperative bridging. Future directions, including multi-omics integration, novel antiplatelet agents, and AI-driven clinical decision support systems, are also explored. As a narrative review, conclusions should be interpreted as reflective of current evidence synthesis rather than systematic-review-grade evidence, given the absence of formal risk-of-bias scoring or meta-analytic pooling. Personalized DAPT guided by complementary genetic and phenotypic testing, integrated with dynamic risk stratification, offers a paradigm shift from empiric therapy toward precision-guided antithrombotic management with the potential to simultaneously reduce ischemic and bleeding complications. Copyright © 2026 by the authors. <129> Accession Number 2047593230 Title Oral anticoagulation and left atrial appendage closure in dialysis atrial fibrillation: between stroke prevention and bleeding hazard. Source Clinical Kidney Journal. 19(7) (no pagination), 2026. Article Number: sfag217. Date of Publication: 01 Jul 2026. Author Genovesi S.; Kuno T.; Floege J.; Zoccali C. Institution (Genovesi) Istituto Auxologico Italiano, IRCCS, Milan, Italy (Genovesi) School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Floege) Department of Nephrology and Immunology, RWTH Aachen University Hospital, Aachen, Germany (Zoccali) Associazione Ipertensione, Trapianto Renale (IPNET), Reggio Cal, Italy (Zoccali) Institute of Biology and Molecular Genetics, Ariano Irpino, Italy (Zoccali) Renal Research Institute, NY, United States Publisher Oxford University Press Abstract Atrial fibrillation (AF) is frequent in dialysis patients and associates with a substantial increase in stroke, cardiovascular events, and mortality, yet the net clinical benefit of oral anticoagulation (OAC) in this setting remains uncertain. Dialysis patients were excluded from pivotal vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) trials, and observational data are conflicting. The PRO position argues that in carefully selected patients with very high thromboembolic risk and acceptable bleeding risk, thromboembolic prophylaxis-pharmacological with OAC or non-pharmacological with left atrial appendage closure (LAAC)-can reduce stroke and possibly mortality. This view is supported by several cohort studies suggesting lower ischemic events and improved survival when OAC is maintained, and international normalized ratio control is good, and by emerging data that LAAC may offer similar stroke protection with less bleeding and lower mortality than OAC or no prophylaxis. The CON position stresses that many large studies show no clear stroke reduction and consistently higher major bleeding with warfarin versus no OAC, that small randomized controlled trials of DOACs versus VKAs reveal very high absolute bleeding without clear efficacy gains, and that VKAs may aggravate vascular calcification. Both positions agree on the need for individualized, shared decision-making and for adequately powered randomized trials comparing OAC and LAAC with no specific therapy in dialysis AF. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com <130> Accession Number 2047461090 Title Optimizing Lung Collapse During One-Lung Ventilation: Physiological Mechanisms and Clinical Strategies: A Narrative Review. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 5078. Date of Publication: 01 Jul 2026. Author Byun S.-H. Institution (Byun) Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Effective thoracic surgery requires timely, predictable operative lung collapse. During one-lung ventilation (OLV), lung collapse is not merely a mechanical consequence of nonventilated lumen opening but a phase-dependent physiological process. Rapid phase I collapse is driven by elastic recoil and passive gas venting, whereas slower phase II collapse depends on residual alveolar gas absorption. Communication between the operative-side airway and the atmosphere before pleural opening may permit tidal gas movement, ambient air entrainment, and nitrogen re-entry during the closed-chest period, delaying subsequent absorption collapse. This narrative review reorganizes lung collapse strategies, including denitrogenation, operative-side airway occlusion, preemptive OLV, disconnection, bronchial suction, and the open-clamp airway technique, according to timing and physiological target. Before pleural opening, alveolar nitrogen should be reduced and ambient air entrainment prevented. Around the pleural opening, airway patency and brief suspension of positive-pressure ventilation may preserve elastic recoil venting. During OLV maintenance, re-clamping or limiting atmospheric communication may support residual gas absorption. This phase-based framework interprets recent clinical findings as interventions acting before, during, and after pleural opening. This may help clinicians select strategies according to the lung isolation device, oxygenation reserve, and surgical environment, although standardized endpoints and component-level validation remain necessary. Copyright © 2026 by the author. <131> Accession Number 2047464945 Title Antithrombotic Strategies After Complex Percutaneous Coronary Intervention. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 5196. Date of Publication: 01 Jul 2026. Author Ueki Y.; Kuwahara K. Institution (Ueki, Kuwahara) Department of Cardiovascular Medicine, Shinshu University Hospital, Nagano, Japan Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Complex percutaneous coronary intervention (PCI) represents a growing proportion of contemporary coronary revascularization, driven by aging populations, increasing comorbidity burden, and advances in interventional techniques. Complex PCI encompasses a spectrum of anatomically and procedurally challenging lesions, including left main disease, bifurcation lesions requiring two-stent strategies, chronic total occlusions, long stent lengths, severe calcification requiring atherectomy, and multivessel revascularization. Antithrombotic therapy, comprising antiplatelet and anticoagulant agents, is essential for preventing stent thrombosis and other ischemic events in both the early and long-term phases after PCI. While antithrombotic therapy mitigates ischemic risks associated with complex PCI, these patients frequently carry a high bleeding risk, thus making the choice of antithrombotic regimen challenging. Recent guideline recommendations emphasize balancing ischemic and bleeding risks rather than relying solely on procedural complexity. This review synthesizes contemporary evidence, guideline recommendations, and clinical considerations for antithrombotic therapy after complex PCI. Copyright © 2026 by the authors. <132> Accession Number 2047461671 Title Effects of Combined Pectoserratus and Pecto-Intercostal Fascial Plane Blocks for Cardiac Surgery via Median Sternotomy: A Randomized Controlled Trial. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 4946. Date of Publication: 01 Jul 2026. Author Kim B.; Jeon Y.-G.; So J.H.; Hong S.; Park J.-H. Institution (Kim, Jeon, So, Park) Department of Anesthesiology and Pain Medicine, Wonju College of Medicine, Yonsei University, Wonju, South Korea (Hong) Department of Cardiovascular Surgery, Wonju College of Medicine, Yonsei University, Wonju, South Korea Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Ultrasound-guided fascial plane blocks have emerged as opioid-sparing analgesic strategies for cardiac surgery; however, evidence regarding combined block techniques remains limited. This randomized controlled trial evaluated the analgesic efficacy of combined pectoserratus plane block (PSPB) and pecto-intercostal fascial plane block (PIFB) in patients undergoing cardiac surgery via median sternotomy. Method(s): Sixty-two adult patients undergoing cardiac surgery via median sternotomy were randomized to either a block group receiving bilateral PSPB and PIFB after anesthetic induction or a control group receiving conventional analgesia alone. The primary outcome was postoperative visual analog scale (VAS) pain score at 6, 12, 24, and 48 h after surgery. Secondary outcomes included Korean version of Quality of Recovery-15 (QoR-15K) scores, total opioid consumption, rescue analgesic dose, time to first rescue analgesia, extubation time, intensive care unit (ICU) stay, hospital stay, and the incidence of postoperative nausea and vomiting. Result(s): Fifty-four patients were included in the final analysis. Postoperative VAS scores did not differ significantly between groups after Bonferroni correction for repeated measurements. No significant overall between-group effect was observed in repeated-measures ANOVA. ICU stay was statistically shorter in the block group, although the absolute difference was small and of uncertain clinical relevance. No significant differences were observed in the remaining secondary outcomes. Conclusion(s): Combined PSPB and PIFB did not reduce postoperative pain or improve recovery outcomes after cardiac surgery via median sternotomy. Early postoperative pain scores were numerically higher in the block group, although these differences were not statistically significant after correction for multiple comparisons. The incremental analgesic benefit of combined fascial plane blocks may therefore be limited in this clinical setting. Copyright © 2026 by the authors. <133> Accession Number 2047384835 Title Residual Angina Following Complete Revascularization in the ISCHEMIA Trial: Frequency, Clinical Characteristics, Health Status, and Cardiovascular Outcomes. Source Journal of the American Heart Association. 15(10) (no pagination), 2026. Article Number: e047355. Date of Publication: 2026. Author Singh A.; Brown D.L.; Jones P.G.; Fu Z.; Reynolds H.R.; Boden W.E.; O'Brien S.M.; Mavromatis K.; Poh K.K.; Ali Z.; Stone G.W.; Bangalore S.; Spertus J.A.; Maron D.J.; Hochman J.S. Institution (Singh, Brown) Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States (Jones, Fu, Spertus) University of Missouri, Kansas City's Healthcare Institute for Innovations in Quality, Saint Luke's Mid America Heart Institute, Kansas City, MO, United States (Reynolds, Bangalore, Hochman) Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology,, Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States (Boden) VA New England Healthcare System, Boston, MA, United States (O'Brien) Duke Clinical Research Institute, Durham, NC, United States (Mavromatis) Atlanta VA Healthcare System, Atlanta, GA, United States (Mavromatis) Emory University School of Medicine, Atlanta, GA, United States (Poh) National University Heart Center Singapore, the Yong Loo Lin School of Medicine, National University of Singapore, Singapore (Ali) Department of Cardiology, St Francis Hospital and Heart Center, Roslyn, NY, United States (Ali) Cardiovascular Research Foundation, New York, NY, United States (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Maron) Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States Publisher American Heart Association Inc. Abstract BACKGROUND: The frequency of residual angina and its impact on health status and death following anatomic complete revascularization in symptomatic patients with chronic coronary disease are unknown. METHOD(S): Data were analyzed from ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial participants randomized to invasive management with baseline angina (Seattle Angina Questionnaire Angina Frequency score <100), no prior coronary artery bypass graft surgery, and anatomic complete revascularization within 90days of randomization. The primary outcome was frequency of residual angina after revascularization, defined as a Seattle Angina Questionnaire Angina Frequency score <100 within 6months of randomization. Secondary outcomes included 6-month health status and medication use and 5-year all-cause and cardiovascular death. RESULT(S): Among 2588 participants randomized to invasive management, 1442 (56%) had baseline angina and no prior coronary artery bypass graft surgery; 1034 underwent revascularization within 90days, and 436 achieved anatomic complete revascularization. Of these, 184 (42.2%) had residual angina within 6 months. Baseline characteristics were similar between those with and without residual angina. Percutaneous coronary intervention was more common than coronary artery bypass graft surgery in those with residual angina (88% versus 80%, P=0.03). At 6 months, residual angina participants reported lower quality of life (Seattle Angina Questionnaire Quality of Life: 70+/-20 versus 83+/-20, P<0.001), greater physical limitation (Seattle Angina Questionnaire Physical Limitation: 84+/-20 versus 95+/-11, P<0.001), more dyspnea (Rose Dyspnea Scale score: 1+/-1.3 versus 0.4+/-0.8, P<0.001), and more antianginal medication use (P=0.006). Five-year all-cause and cardiovascular death did not differ significantly between groups. CONCLUSION(S): Residual angina is common (>40%) following anatomic complete revascularization for chronic coronary disease and is associated with reduced quality of life and greater antianginal medication use but no increase in death. REGISTRATION: Unique Identifier: NCT01471522. Copyright © 2026 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. <134> Accession Number 2038389269 Title Remifentanil versus Fentanyl impact on Ejection Fraction and Troponin in Off-Pump Cardiac Surgery. Source Baghdad Journal of Biochemistry and Applied Biological Sciences. 7(2) (pp 169-176), 2026. Date of Publication: 01 Apr 2026. Author Ibrahim Z.Y.; Mohammad H.N.; Mustafa M.H. Institution (Ibrahim, Mohammad, Mustafa) Department of Anesthesia Sciences, College of Health Sciences, University of Duhok, Duhok, Iraq Publisher Al-Nahrain University College of Medicine Abstract Background: Remifentanil is structurally synthesized from fentanyl. It offers markedly superior analgesic effects compared to fentanyl and reaches peak efficacy within minutes after parenteral dosing (1). This study compared the effects of fentanyl and remifentanil on ejection fraction (EF) and troponin I measurement during elective off-pump coronary artery bypass graft (OPCABG) surgery. Method(s): Seventy-two patients, aged 35-75 years, were included. Parameters recorded include arterial oxygen saturation (SaO<inf>2</inf>), heart rate (HR), invasive blood pressure (IBP), and EF. Baseline IBP was recorded before any surgical or anesthetic interventions. In addition, a baseline blood sample was collected for troponin I measurement. Before anesthesia induction, all patients received 100% oxygen for at least 3 minutes, followed by intravenous midazolam 0.06 mg/kg, propofol 1.3 mg/kg, rocuronium 1.2 mg/kg, and sevoflurane 0.5 MAC. Patients were then randomly assigned to one of the two groups (randomization was done using patient numbering: odd-numbered patients were assigned to Group R (remifentanil group), and evennumbered patients to Group F (fentanyl group); Group R received 0.5 mug/kg remifentanil over 1 minute for induction and 0.1-1 mug/kg/hour for maintenance. Meanwhile, Group F received 5 mug/kg fentanyl over 1 minute for induction and 0.1-1 mug/kg/hour for maintenance. Data were analyzed using SPSS version 23 (IBM Corp., USA). Normality was assessed with the Kolmogorov-Smirnov and Shapiro-Wilk tests. Normally distributed data were expressed as mean +/- SD and nonnormally distributed data as median (IQR). EF and serum troponin were analyzed using the Friedman and Wilcoxon signed-rank tests, respectively, and group comparisons were performed using the Mann-Whitney U test. A p-value < 0.05 was considered statistically significant. Result(s): Group R showed a median preoperative EF of 55% (IQR 0.110, MR 29.23), while Group F had 58% (IQR 0.113, MR 1.77). The overall median preoperative EF was 56% (IQR 0.100), with no significant difference between groups (p=0.567). Intraoperatively, Group R demonstrated a higher median EF of 60% (IQR 0.12, MR 37.33) compared with 52% (IQR 0.10, MR 23.67) in Group F. The overall intraoperative EF was 52% (IQR 0.10), with a statistically significant difference (p=0.002). The p-value of 0.001 indicates a highly statistically significant difference in serum troponin I levels from preoperative to 24 hours post intensive care unit (ICU) admission for both R and F groups. The p-value of 0.024 indicates a highly statistically significant difference in serum troponin I levels between Group R and Group F, with Group R having a higher median 24 hours post ICU admission troponin. Conclusion(s): Both opioids provided safe and effective anesthesia for OPCABG. However, remifentanil was associated with superior intraoperative EF, suggesting greater compatibility with fast-track anesthesia and enhanced postoperative recovery, on the other side, remifentanil demonstrated higher serum troponin levels compared with fentanyl. Copyright © 2026 the Authors. <135> Accession Number 651658898 Title Effects of remimazolam vs. propofol on plasma neurofilament light chain and postoperative delirium in frail elderly patients undergoing major non-cardiac surgery: a prospective, randomized, assessor-blinded controlled trial. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 30 Jun 2026. Author He X.-Y.; Zhang S.-H.; Xie L.; Bao J.-T.; An M.-Z.; Li Z.-P.; Zhou Q.-H.; Jia X.-Y. Institution (He, Xie, Bao) Anesthesia Medicine, Zhejiang Chinese Medical University, Hangzhou city, Zhejiang Province, China (He, Zhang, Xie, Bao, An, Li, Jia) Department of Anesthesiology and Pain Medicine, Jiaxing First Hospital, No. 1882, Zhonghuan South Road ,Zhejiang Province, China (Zhou) Department of Anesthesiology and Pain Medicine, Second Affiliated Hospital of Jiaxing University, 1518 North Ring City Road ,Zhejiang Province, China Abstract BACKGROUND: The relationship between remimazolam administration and early neurological complications, particularly postoperative delirium (POD), in elderly patients undergoing major non-cardiac surgery remains unclear. Plasma neurofilament light chain (NfL) is a potential biomarker for central nervous injury. This study aims to compare the effects of remimazolam and propofol on postoperative plasma NfL concentrations and the incidence of POD in frail elderly patients undergoing major non-cardiac surgery. METHOD(S): This was a single-center randomized controlled trial on frail patients who underwent non-cardiac surgery. Participants were randomized to receive either Remimazolam (Group R) or Propofol (Group P) for induction and maintenance of general anesthesia, with all other anesthetic management standardized. The primary outcome was plasma NfL concentration on postoperative day 1, and the incidence of POD was assessed as a key clinical secondary endpoint. The secondary endpoint encompassed the incidence of hypotension during the anesthesia induction, as well as the time-weighted average of the area under the curve below the baseline for mean arterial pressure (AUB-MAP). RESULT(S): A total of 123 patients were enrolled. No significant differences were observed in plasma NfL concentrations on postoperative day 1 between Group R and Group P (123.3[83.6-198.2] vs. 149.0[102.0-226.6], pg/ml, P = 0.186, respectively); and similarly, no differences in POD were found between Group R and Group P (6/62[9.7%] vs. 7/61[11.5%], unadjusted odds ratio 0.827, 95% CI 0.261-2.62, P = 0.746). In the secondary outcomes, the incidence of hypotension during the anesthesia induction in Group R was significantly decreased (3[4.8%] vs. 19[31.3%], P < 0.001). And the time-weighted average of AUB-MAP in Group R was higher than Group P (-21.3 +/- 10.7 vs. -25.4 +/- 9.6, mmHg, P = 0.03). CONCLUSION(S): In frail elderly patients undergoing major non-cardiac surgery, remimazolam group shows no significant difference from propofol in plasma NfL levels or POD incidence on the first day. Due to its advantage in maintaining hemodynamic stability, remimazolam may be a safer anesthetic option for frail patients sensitive to hemodynamic changes. TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2400093862. Copyright © 2026. The Author(s). <136> Accession Number 2047458941 Title Complete Dacron reinforcement of Ross autograft does not increase neoaortic valve regurgitation: A systematic review and meta-analysis. Source JTCVS Techniques. (no pagination), 2026. Article Number: 102490. Date of Publication: 2026. Author Wahba A.; Elmezayen Z.W.; Elbahy O.; Elshabrawi M.N.; Ehmidat M.; Said S.M. Institution (Wahba) Department of Cardiothoracic Surgery, Port Said University, Port Said, Egypt (Wahba, Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Westchester Medical Center and Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, United States (Elmezayen) Department of Surgery, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Elbahy, Elshabrawi) Department of Surgery, Port Said University, Port Said, Egypt (Ehmidat) Department of Surgery, Alexandria University, Alexandria, Egypt (Said) Department of Cardiothoracic Surgery, Alexandria University, Alexandria, Egypt Publisher Elsevier Inc. Abstract Objective The Ross procedure offers superior hemodynamics and growth potential for patients with unrepairable aortic valve disease, but pulmonary autograft dilation and progressive neoaortic valve regurgitation remain key limitations. Complete autograft reinforcement with Dacron has been proposed to enhance structural stability and prevent dilation. However, concerns persist regarding potential autograft distortion, impaired leaflet coaptation, and increased valve regurgitation. This systematic review and meta-analysis compares clinical outcomes of fully Dacron-supported versus unsupported or partially supported autografts in the Ross procedure. Methods A comprehensive literature search of PubMed, Web of Science, Cochrane, and Scopus databases was conducted from inception through March 30, 2026. Five retrospective comparative cohort studies including a total of 526 patients met inclusion criteria. Outcomes evaluated were early mortality (<=30 days), overall survival, freedom from autograft reoperation, and incidence of moderate or greater neoaortic valve regurgitation. Pooled risk ratios (RRs) with 95% CIs were calculated using random-effects meta-analysis. Results No significant differences were observed between fully supported and unsupported/partially supported groups for early mortality (RR, 2.52; 95% CI, 0.28-22.51; P = .41, I 2 = 0%), overall survival (RR, 0.99; 95% CI, 0.97-1.00], P = .14, I 2 = 0%), freedom from autograft reoperation (RR, 0.90; 95% CI, 0.76-1.07], P = .25, I 2 = 79.1%), or incidence of moderate or greater neoaortic valve regurgitation (RR, 2.00; 95% CI, 0.39-10.25; P = .41, I 2 = 73.5%). Conclusions Complete Dacron reinforcement of the pulmonary autograft does not increase the risk of neoaortic valve regurgitation or adversely affect clinical outcomes compared with unsupported or partially supported autografts. This technique offers a viable strategy to improve autograft durability and may enable the Ross procedure's application in patients previously deemed suboptimal candidates. Surgical technique should be tailored to individual patient profiles and institutional expertise, rather than standardized adoption of one technique. Copyright © 2026 The Author(s). <137> Accession Number 2047430649 Title Ultrasound-guided double-lumen tube size selection improves intubation success and postoperative airway outcomes in thoracic surgery: a randomized controlled study. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1865696. Date of Publication: 01 Jul 2026. Author Duran M.; Zengin S.U.; Ergun M.O. Institution (Duran, Zengin, Ergun) Department of Anesthesiology and Reanimation, Marmara University Pendik Training and Research Hospital, Kadikoy, Turkey Publisher Frontiers Media SA Abstract Background - Appropriate double-lumen tube (DLT) size selection is crucial for safe and effective one-lung ventilation in thoracic surgery. Conventional selection based on sex and height does not account for individual airway variability. This study evaluated whether ultrasound-guided DLT size selection improves intubation success and postoperative airway outcomes. Methods - In this prospective randomized controlled study, 70 patients undergoing thoracic surgery who required one-lung ventilation were assigned to either a conventional group (DLT size based on sex and height) or an ultrasound group (DLT size based on tracheal diameter measured by ultrasound at the suprasternal notch). The primary outcome was the incidence of postoperative sore throat at 24 h. Secondary outcomes included postoperative cough, first-attempt intubation success, number of attempts, surgeon-rated lung collapse satisfaction, and intraoperative respiratory parameters. Results - Postoperative sore throat was significantly lower in the ultrasound group compared to the conventional group (8.6% vs. 37.1%, p = 0.004). Postoperative cough was also reduced (8.6% vs. 40.0%, p = 0.002). First-attempt intubation success was higher in the ultrasound group (97.1% vs. 62.9%, p = 0.001). Additionally, peak airway pressure was lower, and dynamic compliance was higher in the ultrasound group (p = 0.002 and p < 0.001, respectively). Surgeon satisfaction was significantly improved (p = 0.005). Conclusion - Ultrasound-guided DLT size selection improves intubation success, reduces postoperative airway complications, and enhances ventilatory parameters. This approach may provide a simple and effective method for optimizing airway management in thoracic surgery. Copyright © 2026 Duran, Zengin and Ergun. <138> Accession Number 651647399 Title Pulmonary artery catheters or central venous catheters for cardiac surgery: the PUMA Pilot randomised clinical trial. Source Anaesthesia. (no pagination), 2026. Date of Publication: 28 Jun 2026. Author Perry L.A.; Segal R.; Larobina M.; Bellomo R.; Smith J.A.; Sin J.; Danial K.; McLean A.R.D.; Rong L.Q.; Gaudino M.; Schwann T.; Palumbo M.; O'Halloran L.; Chee B.; Patel J.; Silvers A.; Bennetts J.; Marasco S.; Coulson T.G.; Royse A.; See E.; Miles L.F. Institution (Perry, Sin, Danial, Chee, Patel) Victorian Cardiac Anaesthesia Research Laboratory, Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, VIC, Australia (Perry, Sin, Danial, Palumbo, O'Halloran, Chee, Patel, Silvers) Department of Anaesthesia and Perioperative Medicine, Victorian Heart Hospital, Melbourne, VIC, Australia (Perry, Coulson, See, Miles) Department of Critical Care, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia (Segal) Department of Anaesthesia and Pain Management, Royal Melbourne Hospital, Melbourne, VIC, Australia (Larobina, Smith, Bennetts) Department of Cardiothoracic Surgery, Victorian Heart Hospital, Monash Health, Melbourne, VIC, Australia (Smith, Marasco) Department of Surgery, School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, Australia (McLean) Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia (McLean) MISCH (Methods and Implementation Support for Clinical Health) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia (Rong) Department of Anesthesiology, Weill Cornell Medicine, New York, NY, USA (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, USA (Schwann) Department of Cardiovascular Surgery, Corewell Health, Royal Oak, MI, United States (Marasco) Cardiothoracic Unit, The Alfred, Melbourne, VIC, Australia (Coulson) Department of Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Royse) Department of Cardiothoracic Surgery, Royal Melbourne Hospital, Melbourne, VIC, Australia (Royse) Department of Surgery, University of Melbourne, Melbourne, VIC, Australia (See) Departments of Intensive Care and Nephrology, Royal Melbourne Hospital, Melbourne, VIC, Australia (Miles) Department of Anaesthesia, Austin Health, Melbourne, VIC, Australia Abstract INTRODUCTION: Pulmonary artery catheters are used widely in cardiac surgery despite observed associations with worse outcomes and guidelines that recommend against their routine use. No adequately powered randomised trials are available. METHOD(S): The PUMA Pilot was a multicentre, randomised, parallel assignment, open-label, pilot and feasibility trial conducted at three tertiary cardiac surgery centres. Eligible patients were adults undergoing coronary artery bypass grafting, aortic valve replacement or surgery on the aortic root or ascending aorta with or without aortic valve replacement, with a predicted surgical mortality of < 2%. Patients were allocated randomly to receive a pulmonary artery catheter or a central venous catheter inserted immediately before surgery. The primary feasibility outcome was protocol compliance, defined as receiving the assigned intervention without crossover. Secondary feasibility outcomes were eligibility rate; recruitment proportion and rate; data completeness; and rate of clinician refusal. RESULT(S): We screened 480 patients and 206 (43%) were eligible; 150/203 (74%) approached provided informed consent. Three of 206 (1%) eligible patients were not included due to clinician refusal. Of 149 patients who were randomised, 76 were assigned to the pulmonary artery catheter group and 73 to the central venous catheter group. For the primary feasibility outcome, 147 patients (99%) received the allocated intervention. Data were complete for 144 (97%) patients. Median (IQR [range]) days alive and at home at 30 days was 23.7 (21.9-24.7 [7.0-26.0]) in the pulmonary artery catheter group and 22.9 (20.8-23.9 [8.6-25.8]) in the central venous catheter group. Acute kidney injury occurred in 26/76 (34%) patients in the pulmonary artery catheter group and 14/73 (19%) in the central venous catheter group. DISCUSSION(S): A randomised trial of pulmonary artery catheters compared with central venous catheters in low-risk cardiac surgery is feasible. Such a trial would address significant practice variability and inform international guidelines. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <139> Accession Number 2047563540 Title Pharmacological Strategies for Postoperative Pain Control in Patients Undergoing Cardiac Surgery: A Mixed Methods Systematic Review of Clinical Efficacy, Opioid Consumption, Patient Experience, and Nursing Care. Source Journal of Pharmacy and Bioallied Sciences. 18(3) (pp 157-159), 2026. Date of Publication: 01 Jul 2026. Author Rajendran S.; Kuppusamy K.; Jayakumar S. Institution (Rajendran) Department of Medical Surgical Nursing, Vinayaka Mission's College of Nursing, Vinayaka Mission's Research Foundation (DU), Karaikal, Puducherry, Tamil Nadu, Salem, India (Kuppusamy) Department of Child Health Nursing, Vinayaka Mission's College of Nursing, Vinayaka Mission's Research Foundation (DU), Karaikal, Puducherry, Tamil Nadu, Salem, India (Jayakumar) Department of Mental Health (Psychiatric) Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Kerala, Kochi, India Publisher Wolters Kluwer Medknow Publications Abstract Postoperative pain following cardiac surgery remains a major challenge that can delay recovery, increase opioid use, and hinder rehabilitation. This systematic review evaluated mixed methods evidence on pharmacological pain management strategies and their integration with nursing care in adult patients undergoing cardiac surgery. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Google Scholar was conducted from database inception to December 2025 following PRISMA 2020 guidelines. Four mixed methods studies met the inclusion criteria. Pharmacological interventions included opioids, paracetamol, nonsteroidal anti-inflammatory drugs, gabapentinoids, ketamine, dexmedetomidine, and multimodal analgesic regimens. These approaches were associated with reduced postoperative pain, 15-38% lower opioid consumption, shorter intensive care unit stays, and improved rehabilitation. Qualitative findings emphasized patients' concerns regarding opioid dependence and sedation while highlighting the importance of nurse-led education and individualized pain assessment. Overall, multimodal opioid-sparing analgesic strategies integrated with patient-centered nursing care appear to enhance postoperative recovery after cardiac surgery, although further high-quality mixed methods research is required to strengthen the evidence. Copyright © 2026 Journal of Pharmacy and Bioallied Sciences. <140> Accession Number 2047383647 Title The Impact of Insulin Glargine on Blood Glucose Control during On-Pump Beating Coronary Artery Bypass Surgery in Diabetic Patients: A Single-Blind Randomized Controlled Trial. Source Archives of Anesthesiology and Critical Care. 12(4) (pp 362-369), 2026. Date of Publication: 01 Jul 2026. Author Ganjali R.; Kahrom M.; Bijari F.; Tabari M.; Firoozjah A.G.; Sheybani S. Institution (Ganjali) Clinical Research Development Unit, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Kahrom) Department of Cardiovascular Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Bijari, Tabari, Sheybani) Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Firoozjah) Department of Cardiac Intensive Care, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of Publisher Tehran University of Medical Sciences Abstract Background: Diabetes mellitus in subjects of coronary artery bypass grafting (CABG) surgery is associated with increased morbidity and mortality. Therefore, in recent years, glycemic monitoring and control have been the focus of clinical research. This study aimed to determine the impact of insulin glargine on the management of blood glucose during the perioperative period of on-pump coronary artery bypass graft in diabetic patients. Method(s): In a randomized clinical trial, 80 patients with type 2 diabetes, candidates for elective CABG with a cardiopulmonary pump, were randomly separated into two groups. The intervention group received 0.2 units/kg of insulin glargine 2 hours before induction of anesthesia plus usual care. The control group received usual care. Usual care included injection of regular insulin before, during, and after surgery in accordance with a changed Van den Berghe code. Blood glucose (BG) level, ICU and hospital length of stay (LOS), creatinine, white blood cell count (WBC), and postoperative complications, including infection and dehiscence, were evaluated between two groups. Result(s): The BG of patients upon entrance (p=0.04), 16 (p=0.01), 20 (p=0.01), and 24 (p=0.01) hours after admission to the ICU was significantly lower in the intervention than in the control group. There was a significant difference in the average BG levels at different times (p<0.001), so the highest and lowest BG levels were observed 4 and 20 hours after ICU administration in the intervention group and 4 hours and immediately after ICU admission in the control group. Average creatinine (p=0.01), regular insulin used until the end of the first day after surgery (p=0.01), ICU length of stay (LOS) (p=0.009), and hospital LOS (p=0.001) were significantly lower in the intervention group than the controls. Conclusion(s): Insulin glargine plus regular insulin is able to maintain BG at a controlled level up to 24 hours after surgery. It also showed significant control over postoperative complications. This study revealed the therapeutic effectiveness of both insulin glargine and regular insulin in achieving adequate BG control for type 2 diabetes patients during the critical postoperative period of on-pump CABG. Copyright © 2026 Tehran University of Medical Sciences. <141> Accession Number 2047448840 Title Coronary Artery Anomalies Revisited: Description of the Types, Pathophysiology and Treatment Options Based on Latest Guidelines. Source Journal of Clinical Medicine. 15(13) (no pagination), 2026. Article Number: 4959. Date of Publication: 01 Jul 2026. Author Genoud A.; Portugal I.; Murith N.; Deux J.-F.; Sologashvili T.; Huber C.; Cikirikcioglu M. Institution (Genoud, Portugal, Murith, Deux, Sologashvili, Huber, Cikirikcioglu) Faculty of Medicine, University of Geneva, Geneva, Switzerland (Murith, Sologashvili, Huber, Cikirikcioglu) Cardiovascular Surgery Division, Department of Surgery, University Hospitals of Geneva, Geneva, Switzerland (Deux) Radiology Division, Department of Diagnostic, University Hospitals of Geneva, Geneva, Switzerland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Coronary artery anomalies (CAAs) are a rare but clinically significant group of congenital abnormalities that are associated with myocardial ischaemia, malignant arrhythmias and sudden cardiac death, particularly in young people and athletes. Despite increasing recognition of these conditions and advances in cardiovascular imaging, there are still significant challenges regarding their classification, risk stratification and management, particularly with respect to surgical indications. This review provides a comprehensive overview of the current evidence on the classification, pathophysiology, diagnosis and management of CAAs, with a particular focus on surgical decision-making and contemporary guideline recommendations. A systematic literature search was conducted up to February 2025 using PubMed and Google Scholar. Priority was given to international guidelines, consensus statements, systematic reviews, meta-analyses and large observational studies. CAAs encompass a broad spectrum of anatomical variants and clinical presentations. Among these, anomalies of coronary origin are the most extensively studied. Surgical management is well established for coronary arteries arising from the pulmonary artery, particularly for anomalous left coronary artery from the pulmonary artery (ALCAPA). Substantial advances have also been made in the diagnosis, risk stratification, and treatment of anomalous aortic origin of a coronary artery (AAOCA), which has become a major focus of contemporary guideline recommendations. For patients with AAOCA, surgical correction, including unroofing, coronary reimplantation or coronary artery bypass grafting, is recommended for individuals with symptoms and/or high-risk anatomical features. In contrast, the diagnosis and management of myocardial bridging, coronary artery fistulas, and coronary artery ectasia remain controversial, with considerable variability in the indications for medical, percutaneous, and surgical treatment. The management of CAAs is an evolving field. While there is consensus for a limited number of anomalies, most cases still require individualised decision-making. It is essential to develop standardised diagnostic frameworks, improved risk stratification tools and outcome-based management criteria. A multidisciplinary, evidence-based approach involving cardiologists, cardiac imagers, interventional cardiologists and cardiac surgeons is crucial in order to optimise patient outcomes and reduce the risk of adverse cardiovascular events, including sudden cardiac death. Copyright © 2026 by the authors. <142> Accession Number 2047445674 Title The management of sternal mediastinitis in heart and lung transplant patients: An 8-year experience and application of reconstructive algorithm. Source Journal of Plastic, Reconstructive and Aesthetic Surgery. 120 (pp 39-50), 2026. Date of Publication: 01 Sep 2026. Author Fu E.B.; Zubler C.; Gkouma A.; Ibrahim A.; Anikin V.; Osman M.; Khoshbin E.; Nikkhah D. Institution (Fu, Nikkhah) University College London Medical School, Division of Surgery and Interventional Science, United Kingdom (Zubler, Ibrahim, Nikkhah) Department of Plastic Surgery, Royal Free Hospital, Pond St, London, United Kingdom (Zubler) Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, Freiburgstrasse 18, Bern, Switzerland (Gkouma, Anikin, Osman, Khoshbin, Nikkhah) Department of Cardiothoracic and Transplant Surgery, Royal Brompton and Harefield Hospital, Hill End Rd, Harefield, Uxbridge, London, United Kingdom Publisher Churchill Livingstone Abstract Background Sternal mediastinitis, the most severe form of deep sternal wound infection (DSWI), following heart and lung transplantation is uncommon but associated with substantial morbidity. Chronic immunosuppression, complex microbiological profiles and altered chest wall anatomy pose distinct reconstructive challenges. We present our experience from our tertiary transplant centre and evaluate the applicability of our reconstructive algorithm in this population. Methods A retrospective review was conducted of all heart and lung transplant recipients who were surgically managed for DSWI at a tertiary cardiothoracic transplant centre between June 2017 and December 2025. Demographic data, microbiology, operative details, reconstructive interventions and outcomes were analysed. A PRISMA-compliant systematic review was performed alongside. Results Ten patients were identified (7 lung and 3 heart transplant recipients). Median time from transplant to DSWI diagnosis was 95 (4-1486) days. Following diagnosis, median time to definitive reconstruction was 90 (32-722) days, during which patients underwent a median of 4 (1-10) debridements and received prolonged antimicrobial therapy. Negative pressure wound therapy was used for a median of 42.5 days (8-122 days; n=9). Median DSWI-related length of stay was 147 (62-321) days. Reconstructive strategy was guided by previous incision type: reverse abdominoplasty predominated following clamshell thoracotomy (5/7), whereas bilateral pectoralis major advancement flaps were most employed following median sternotomy (2/3). All patients were successfully discharged. There was no perioperative mortality. Conclusion Transplant-associated DSWI is characterised by prolonged treatment courses and complex microbiology. Aggressive source control within a multidisciplinary framework, combined with considered reconstructive planning, facilitates durable results and successful discharge in this high-risk population. Copyright © 2026 The Author(s). <143> Accession Number 2047406388 Title The Effectiveness of Perioperative Intravenous Lidocaine for Postoperative Analgesia in Video-Assisted Thoracic Surgery: A Systematic Review and Meta-Analysis. Source Journal of Pain Research. 19 (no pagination), 2026. Article Number: 616585. Date of Publication: 2026. Author Liu J.; Zhong B.; Huang X.; Lei S.; Liu H.; Deng W.; Liu W.; Fan M. Institution (Liu, Zhong, Huang, Lei, Liu, Deng, Liu, Fan) Department of Anesthesiology, Nanfang Hospital, Southern Medical University, 1838 Guangzhou Avenue North, Guangzhou, China (Fan) Department of Rheumatology, Nanfang Hospital, Southern Medical University, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Background: Acute pain after video-assisted thoracic surgery (VATS) remains a significant challenge. While intravenous lidocaine is increasingly used for analgesia, its efficacy for VATS remains uncertain. This meta-analysis aimed to evaluate the impact of perioperative intravenous lidocaine on postoperative pain in patients undergoing VATS. Method(s): We systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Chinese databases (CNKI, WANFANG, SinoMed) from inception to December 31, 2025, for randomized controlled trials (RCTs) comparing intravenous lidocaine with placebo saline in adults undergoing VATS. Primary outcomes were static and dynamic pain scores. Secondary outcomes included opioid consumption, quality of recovery (QoR), postoperative nausea and vomiting (PONV), gastrointestinal recovery, postoperative pulmonary complications (PPCs), and length of hospital stay. Data were pooled using random-effects models. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Result(s): Sixteen RCTs involving 1045 patients were included. Compared with placebo, intravenous lidocaine significantly reduced static pain scores at 6-8 h (MD -0.61 cm, 95% CI [-0.99, -0.24]), 24 h (MD -0.48 cm, 95% CI [-0.79, -0.17]), and 48 h (MD -0.31 cm, 95% CI [-0.48, -0.14]), as well as dynamic pain scores at the corresponding time points. However, the magnitude of pain reduction did not reach the predefined threshold for clinical importance (>=1 cm), and prediction intervals crossed the line of no effect for all pain outcomes. Intravenous lidocaine was also associated with reduced postoperative opioid consumption and improved QoR, although neither effect reached established minimal clinically important difference (MCID) thresholds. Additionally, lidocaine reduced PONV and accelerated gastrointestinal recovery. No significant effects were observed on PPCs or lidocaine-related adverse events, and it slightly prolonged the length of hospital stay. The certainty of evidence ranged from very low to moderate. Conclusion(s): Although perioperative intravenous lidocaine infusion was associated with statistically significant improvements in postoperative pain and several recovery-related outcomes following VATS, the magnitude of benefit in pain, opioid consumption, and QoR did not consistently reach established thresholds for clinical importance. The certainty of evidence was generally low, and substantial heterogeneity was observed across studies. The overall clinical benefit of perioperative intravenous lidocaine remains uncertain and should be interpreted with caution. Copyright © 2026 Liu et al. <144> Accession Number 2046590760 Title Effect of remote ischaemic preconditioning on acute kidney injury after heart transplantation (RIPCAT): A randomised controlled feasibility trial. Source European Journal of Anaesthesiology. (no pagination), 2026. Date of Publication: 2026. Author M'Pembele R.; Jagdfeld J.D.; Henning L.S.; Huhn R.; Lurati Buse G.; Boeken U.; Roth S. Institution (M'Pembele, Jagdfeld, Henning, Huhn, Lurati Buse, Roth) From the Department of Anaesthesiology, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany (Huhn) Department of Anaesthesiology, Kerckhoff Heart and Lung Centre, Bad Nauheim, Germany (Boeken) Department of Cardiac Surgery, Medical Faculty and University Hospital Duesseldorf, Heinrich-Heine-University Duesseldorf, Germany Publisher Lippincott Williams and Wilkins <145> Accession Number 2046634217 Title Critical Appraisal of "Continued versus Interrupted Oral Anticoagulation During Transcatheter Aortic Valve Replacement in Patients with Atrial Fibrillation: A Meta-Analysis". Source American Journal of Therapeutics. (no pagination), 2026. Date of Publication: 2026. Author Tahir M.; Akhtar I.; Javaid M.H. Institution (Tahir, Akhtar) Department of Medicine, Ayub Medical College, Abbottabad, Pakistan (Javaid) Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan Publisher Lippincott Williams and Wilkins <146> Accession Number 2038347141 Title Iatrogenic Injury to the Left Circumflex Artery during Mitral Valve Surgery: A Narrative Review. Source Journal of Pioneering Medical Sciences. 15(6) (pp 77-85), 2026. Date of Publication: 01 Jun 2026. Author Krishna G.; Narayanaswamy A.G.; Ramrao V.; Vijayaraghavan R. Institution (Krishna) Department of Anatomy, Saveetha Institute of Medical and Technical Sciences, Tamil Nadu, Chennai, India (Narayanaswamy) Department of Cardiology, Saveetha Institute of Medical and Technical Sciences, Tamil Nadu, Chennai, India (Ramrao) Department of Cardiothoracic Surgery Rajarajeshwari Medical College and Hospital, Bengaluru, India (Vijayaraghavan) DRD, SIMATS, Tamil Nadu, Chennai, India Publisher Journal of Pioneering Medical Sciences Abstract Iatrogenic injury to the left circumflex artery (LCx) during mitral valve surgery is an uncommon but potentially catastrophic complication because of the artery's close relationship to the posterior mitral annulus, especially near the P1-A1 region. This review summarizes the available evidence on anatomical risk factors, mechanisms of injury, diagnosis, prevention and management. A structured literature search was performed using major electronic databases and studies relevant to LCx injury associated with mitral valve surgery were screened according to predefined inclusion criteria, with priority given to clinical studies, systematic reviews and case series published in English. The risk appears greater in patients with left-dominant coronary circulation, a small annulus-to-artery distance, annular calcification, reoperative surgery, minimally invasive approaches and complex rheumatic or degenerative mitral pathology. Clinical recognition may be challenging because ischemia can present intraoperatively or postoperatively with new regional wall motion abnormalities, electrocardiographic changes, hemodynamic instability or delayed heart failure symptoms. Current evidence suggests that preoperative coronary CT angiography and three-dimensional transoesophageal echocardiography, combined with meticulous intraoperative attention to annular anatomy and suture depth, may reduce the likelihood of preventable injury in selected patients. Management depends on the mechanism and timing of diagnosis and may include immediate suture revision, surgical revascularization, urgent percutaneous coronary intervention or hybrid approaches. Although the available literature indicates that imaging-based planning, surgical precision, multidisciplinary awareness and timely revascularization are associated with improved outcomes, the evidence remains limited, highlighting the need for larger prospective studies and standardized reporting. Copyright © 2026 the Author(s). <147> [Use Link to view the full text] Accession Number 2045808612 Title Evaluation of clinical impact of ultra fast-track versus conventional extubation in patients undergoing nonemergency cardiac surgery: 'CARDU-FAST': A randomised clinical trial. Source European Journal of Anaesthesiology. Publish Ahead of Print (no pagination), 2026. Date of Publication: 28 Apr 2026. Author Cruces L.M.; Alcazar M.C.; Sial R.L.B.; Vizcayno M.L.; Martin R.S.; Camargo D.P.; Carnicer J.C.; Mercadal L.A.; Morenza A.A.; Lacruz F.R.; Fernandez P.C.; Molano M.A.G.; Torron J.M.M.; Chavez M.B.S.; Castellanos L.C.M. Institution (Cruces, Alcazar, Camargo, Carnicer, Lacruz, Fernandez, Molano, Torron, Chavez, Castellanos) Department of Cardiac Surgery, Spain (Sial, Vizcayno, Martin, Mercadal, Morenza) Department of Anaesthesiology, Hospital Clinico San Carlos, Madrid, Spain Publisher Lippincott Williams and Wilkins Abstract BACKGROUND - Immediate extubation in the operating theatre (Ultra Fast-Track, UFT), compared with early extubation in the intensive care unit (ICU) (Fast-Track, FT), has been proposed as a strategy to improve postoperative recovery after cardiac surgery. However, its effect on major clinical outcomes remains unclear. OBJECTIVE - To compare the risk of a composite outcome including perioperative all-cause mortality, respiratory complications, and acute kidney injury between UFT and FT in patients undergoing major nonemergency cardiac surgery. DESIGN - Single-centre, randomised clinical trial conducted between February 2023 and November 2024. SETTING - A tertiary cardiovascular centre with standardised perioperative and anaesthetic management. PARTICIPANTS - A total of 612 adult patients undergoing major cardiac surgery were randomised to UFT (n = 306) or FT (n = 306). INTERVENTION - Patients in the UFT group were extubated in the operating theatre, whereas patients in the FT group underwent early extubation in the ICU. MAIN OUTCOMES AND MEASURES - The primary endpoint was a composite outcome of all-cause mortality, respiratory complications (prolonged intubation >24 h, reintubation, pneumonia), and stage III acute kidney injury (AKIN III). RESULTS - The primary composite endpoint occurred in 6.5% of patients in the UFT group and 10.1% in the FT group, with no statistically significant difference (P = 0.105). Compared with FT, UFT was associated with shorter ICU and hospital length of stay, lower rates of prolonged intubation (2.0 versus 7.5%; P = 0.001), reduced need for noninvasive ventilation (5.6 versus 11.1%; P = 0.013), fewer reoperations for bleeding (2.6 versus 6.9%; P = 0.013) and a lower incidence of postoperative low cardiac output syndrome. CONCLUSIONS - Although UFT did not significantly reduce the primary composite outcome in the intention-to-treat (ITT) analysis, it was not associated with an increased risk of adverse events but was associated with improvements in several secondary outcomes. These findings suggest potential benefits of UFT in carefully selected cardiac surgery patients. TRIAL REGISTRATION - Evaluation of clinical impact of UFT versus conventional extubation in patients undergoing cardiac surgery. CARDU-FAST clinical trial. ClinicalTrials.gov Identifier: NCT05706857. Copyright © 2026 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited. <148> Accession Number 2047527849 Title Advanced organ protection strategies in aortic arch surgery: A narrative review. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Husen T.F.; Lotfalla A.; Schreurs R.; Korver E.; Verheule S.; Schurgers L.; Jacobs M.; Lorusso R.; Heuts S.; Bidar E. Institution (Husen, Lotfalla, Schreurs, Korver, Lorusso, Heuts, Bidar) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Husen) Faculty of Medicine, University of Indonesia, Jakarta, Indonesia (Lotfalla, Schreurs, Korver, Verheule, Schurgers, Jacobs, Lorusso, Heuts, Bidar) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands (Jacobs) Department of Vascular Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands Publisher SAGE Publications Ltd Abstract Objective: Aortic arch surgery remains a complex procedure associated with significant morbidity and mortality. This review aims to provide insights into the current concepts and evidence regarding organ protection during this procedure. Method(s): A non-systematic approach was used to identify relevant literature across three databases. Inclusion criteria comprised case reports/series, observational cohorts, or randomized controlled trials investigating perfusion strategies and other factors that influence clinical outcomes in aortic arch surgery, as well as experimental studies and key reviews pertinent to the topic. Result(s): Although hypothermic circulatory arrest (HCA) remains the current gold standard, interest in using higher temperatures in aortic arch surgery is increasing. To enable this, cerebral, myocardial, and visceral protection remain crucial, prompting the development of several strategies to facilitate higher-temperature surgery. A growing body of predominantly observational, single-center evidence has explored warmer, continuous multi-organ perfusion strategies. These emerging approaches have been associated with favorable outcomes in selected cohorts but have not been validated against the guideline-concordant standard. Conclusion(s): Advancements in cardiopulmonary bypass and perfusion techniques have driven an evolving interest in continuous normothermic organ perfusion as an emerging strategy rather than an established alternative to HCA in selected cases. Continuous normothermic multi-organ perfusion represents an intriguing and potentially important direction, but its adoption should remain selective until comparative clinical evidence becomes stronger. Copyright © The Author(s) 2026. 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). <149> Accession Number 2047447447 Title Extended and Repeated Cytoreductive Surgery in Recurrent Uterine Leiomyosarcoma: A Narrative Review. Source Cancers. 18(13) (no pagination), 2026. Article Number: 2061. Date of Publication: 01 Jul 2026. Author Maccio A.; Neri M.; Vallerino V.; Nemolato S.; Pusceddu E.; Sole G.; Ferrari P.A. Institution (Maccio, Neri, Vallerino) Department of Obstetrics and Gynecology and Gynecological Oncology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, Cagliari, Italy (Maccio, Neri, Vallerino, Sole, Ferrari) Department of Oncological Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, Cagliari, Italy (Nemolato) Unit of Anatomic Pathology, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, Cagliari, Italy (Pusceddu) Anesthesia and Intensive Care Unit, Liver Transplantation Center, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, Cagliari, Italy (Ferrari) Department of Thoracic Surgery, Azienda di Rilievo Nazionale ed Alta Specializzazione "G. Brotzu", Piazza A. Ricchi 1, Cagliari, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Recurrent uterine leiomyosarcoma (ULMS) frequently poses a surgical question because systemic options remain limited and recurrence patterns are heterogeneous. We reviewed the published evidence on repeated and extended cytoreductive surgery for recurrent ULMS, focusing on selection criteria, operative boundaries, and the role of multivisceral, thoracic, and peritoneal-directed procedures. Method(s): This narrative review synthesizes peer-reviewed literature on surgically managed recurrent or metastatic ULMS, prioritizing contemporary guidelines, retrospective cohorts, pooled analyses, selected systematic reviews when directly relevant to the surgical question, and published illustrative reports. The search covered records available from database inception through 14 May 2026 and used PubMed/MEDLINE, Web of Science Core Collection, Scopus, Google Scholar, selected publisher databases, and citation-linked records. No new patient-level or institution-specific clinical data are presented. Result(s): The available evidence is entirely retrospective and strongly affected by selection bias, yet it consistently suggests that the best outcomes are observed when complete gross resection is feasible. Across published series, favorable features include isolated or limited recurrence, longer time to relapse, compartmentalized disease, lung-only metastases, and preserved performance status. Contemporary reports also show that repeat surgery may evolve into extensive multivisceral procedures involving bowel resection, upper-abdominal dissection, urinary tract reconstruction, diaphragmatic resection, and thoracic surgery. Peritoneal-directed CRS/HIPEC-type strategies remain supported mainly by small heterogeneous studies and a ULMS-specific systematic review, reinforcing feasibility but not routine use. Published illustrative reports confirm that serial metastasectomies can occasionally support prolonged survival in exceptional patients, but they cannot establish effectiveness. Conclusion(s): In highly selected patients, repeated and even extensive cytoreductive surgery may remain a rational disease-control strategy for recurrent ULMS. The central unmet need is not proof that surgery can work in exceptional cases, but better criteria to identify who benefits from iterative resection and when escalation to multivisceral or thoracoabdominal surgery is justified. Copyright © 2026 by the authors. <150> Accession Number 2046550242 Title Comparable Assessment of Perioperative and Postoperative Outcomes in Open Versus Endoscopic Radial Artery Harvest for Patients Undergoing CABG: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Meghwar S.; Parvez A.; Abbasi S.U.A.M.; Fatima M.; Kumar D.; Lohano G.; Hashmi M.U.H.; Jabeen L.; Sahil F.; Singh K. Institution (Meghwar) Department of Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Parvez) Department of Internal Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan (Abbasi) Department of Internal Medicine, Allama Iqbal Medical College, Jinnah Hospital, Lahore, Pakistan (Fatima) Department of Internal Medicine, People's University of Medical and Health Sciences for Women-Nawabshah, Sindh, Pakistan (Kumar, Jabeen) Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan (Hashmi) Department of Internal Medicine, Nishtar Medical University, Multan, Pakistan (Sahil) Department of Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Meghwar, Lohano, Singh) Nursing & Midwifery Research Department, Hamad Medical Corporation, Doha, Qatar Publisher Lippincott Williams and Wilkins Abstract Coronary artery bypass grafting (CABG) is the standard treatment for multivessel coronary disease. The radial artery (RA) is commonly used because of its good long-term outcomes. RA can be harvested using either endoscopic or open techniques, but the optimal method remains unclear. This systematic review and meta-analysis compares outcomes between both approaches in CABG procedures. This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Embase, Cochrane Library, and Scopus were searched up to January 2026 for randomized controlled trials comparing endoscopic versus open RA harvesting in CABG. Data were analyzed using a random-effects model in R (version 4.5.2), with risk of bias 2 used for bias assessment. Outcomes assessed included wound and neurological complications, along with graft patency, mortality, and reoperation. Pooled analysis showed a significant reduction in wound infections (risk ratio, 0.58; P = 0.03) and neurological complications (risk ratio, 0.47; P < 0.0001) with endoscopic compared with conventional open harvesting, with consistent results across various follow-up periods. Graft patency showed similar results in both groups (P = 0.49), with no significant differences in reoperation (P = 0.33), in-hospital/30-day mortality (P = 0.47), or length of hospital stay (P = 0.16). However, endoscopic harvesting showed a significant increase in harvest time compared with open harvesting (mean difference, 11.44 minutes; P = 0.04), with no significant differences in aortic clamp time (P = 0.96). Endoscopic RA harvesting in CABG surgery showed significantly reduced wound infections and neurological complications without affecting graft patency or short-term outcomes. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <151> Accession Number 651639184 Title A randomized controlled study on the effects of the T-REX Twente (Thoracic Surgical Rehabilitation Experts Twente) sternal precautions on quality of life and physical activity levels in cardiac surgery patients, compared to standard care in patients following a median sternotomy: the study protocol. Source Trials. (no pagination), 2026. Date of Publication: 27 Jun 2026. Author Wielens N.; Roerdink K.; Lynch W.; Esau L.; van der Palen J.; Halfwerk F.R. Institution (Wielens, Roerdink, Lynch, Halfwerk) Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Esau) Department of Physiotherapy, Foothills Medical Centre, Alberta Health Services, Calgary, Canada (van der Palen) Department of Epidemiology, Medisch Spectrum Twente, Enschede, Netherlands (van der Palen) Section Cognition, Data and Education, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands (Halfwerk) Cardiac Surgery Innovations Lab, Department of Biomechanical Engineering, University of Twente, Enschede, Netherlands Abstract BACKGROUND: In 2023, a majority (86%) of open-heart surgeries was performed at Thorax Centrum Twente (TCT) via a full median sternotomy. Currently, there is no consensus on postoperative sternal precautions following full median sternotomy. Research from the USA and Canada suggests that existing restrictive sternal precautions may not be necessary. More lenient sternal precautions, such as the "Keep Your Move in the Tube" principle, have shown positive outcomes, with no significant complications. Patients following this approach experienced fewer mobility issues and reported improved quality of life and reduced anxiety. This study explores the potential benefits of fewer restrictions, which could reduce patient anxiety and lead to fewer follow-up visits. This study aims to determine whether the Thoracic Surgical Rehabilitation Experts Twente (T-REX Twente) sternal precautions have a small positive effect on the Modified MacNew Quality of Life after Myocardial Infarction questionnaire (QLMI-2), physical activity, and reduction of movement-related anxiety in patients after full median sternotomy, compared to standard restrictive sternal precautions. It also assesses whether the T-REX sternal precautions result in no negative effects on pain, wound healing, or postoperative complications. METHOD(S): This prospective, randomized, controlled, single-blind study will include adult patients undergoing full median sternotomy at TCT between June 2024 and June 2026, all participating in outpatient cardiac rehabilitation. Exclusion criteria include intensive care unit stays over 72 h, delirium, dementia, severe cognitive impairments, language barriers, or treatment by an external referring cardiologist. The control group will adhere to current restrictive sternal precautions, whereas those in the intervention group will follow the T-REX sternal precautions, which allow lifting, pushing, or pulling as long as arm movement remains within a defined "tube." The primary endpoint is the change in QLMI-2 from baseline (T0) to start of phase II cardiac rehabilitation (T4). DISCUSSION(S): The T-REX Twente sternal precautions may improve quality of life, physical activity, and reduce movement-related anxiety, supporting the idea that less restrictive postoperative sternal precautions can enhance patient outcomes. TRIAL REGISTRATION: CCMO Trial Register NL78107.100.23, registered on 29 February 2024. CLINICALTRIALS: gov: NCT06115759. Copyright © 2026. The Author(s). <152> Accession Number 2046658726 Title Headless Pacemaker in Bradyarrhythmia After Transcatheter Aortic Valve Replacement: A Meta-Analysis. Source Cardiology in Review. Publish Ahead of Print (no pagination), 2026. Date of Publication: 19 Jun 2026. Author Pajareya P.; Chuanchai W.; Laohasurayotin K.; Siranart N.; Phutinart S.; Tokavanich N.; Prasitlumkum N.; Chokesuwattanaskul R. Institution (Pajareya, Chuanchai, Laohasurayotin, Siranart, Phutinart, Chokesuwattanaskul) Division of Cardiovascular Medicine, Center of Excellence in Arrhythmia Research, Cardiac Center, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok, Thailand (Tokavanich) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Prasitlumkum) Department of Cardiology, Electrophysiology Section, Pali Momi, Hawaii Pacific Health, Hawaii, HI, United States Publisher Lippincott Williams and Wilkins Abstract Leadless pacemaker (LPM) offers a favorable safety profile for bradyarrhythmia, especially in patients at high risk for infection from transvenous pacemaker (TPM). However, its use for bradyarrhythmia after transcatheter aortic valve replacement (TAVR) remains unexplored. We conducted a systematic search from the inception of PubMed to November 2025. Eligible studies included adults who received a pacemaker after TAVR. Primary endpoints were overall complications and device-related complications. Secondary endpoints included all-cause mortality, device-related mortality, hospitalization for heart failure, procedure time, fluoroscopy time, and length of stay after pacemaker implantation. We included a total of 11 studies involving 11, 750 patients who underwent TAVR (1243 with LPM and 10, 507 with TPM). None of the patients in the LPM group experienced device-related complications, with significantly lower rates compared to the TPM group [adjusted hazard ratio (aHR) 0.35, 95% confidence interval (CI): 0.13-0.97; I2 = 0%]. Similarly, no device-related mortality was observed in the LPM group. All-cause mortality and hospitalization for heart failure were comparable between the LPM and TPM groups (aHR 1.02, 95% CI, 0.05-20.68; I2 = 25% and aHR 0.87, 95% CI, 0.24-3.17; I2 = 0%, respectively). The feasibility of LPM was also similar to TPM in terms of procedural time (MD -28.66 minutes, 95% CI, -92.36 to 35.03; I2 = 11%), fluoroscopy time (MD -1.36 minutes, 95% CI, -6.30 to 3.59; I2 = 0%), and length of stay (MD -0.53 days, 95% CI, -1.33 to 0.27; I2 = 6%). In conclusion, LPM could serve as a first-line pacing strategy in bradyarrhythmia post-TAVR due to its safer profile with comparable efficacy and feasibility to TPM. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved.

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