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<1>
Accession Number
2042230635
Title
Sex does not influence outcomes in valvular heart surgery due to infective
endocarditis: A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 34(1) (pp 82-91), 2026. Date of
Publication: 01 Jan 2026.
Author
Zeb R.; Sharma S.; Abdullah R.; Patel M.; Nallamotu S.; Veintemilla-Burgos
F.; Kovil Thangam B.M.; Sai B.A.; Kaur G.
Institution
(Zeb) Army Medical College, Rawalpindi, Pakistan
(Sharma) Riga Stradins University, Riga, Latvia
(Abdullah) Foundation University Medical College, Islamabad, Pakistan
(Patel) NHL Municipal Medical College, Gujarat, Ahmedabad, India
(Nallamotu) Kasturba Medical College, Karnataka, Manipal, India
(Veintemilla-Burgos) Universidad Catolica de Santiago de Guayaquil,
Guayaquil, Ecuador
(Kovil Thangam) Spartan Health Sciences University, Vieux Fort, Saint
Lucia
(Sai) Kamineni Academy of Medical Sciences and Research, Telangana,
Hyderabad, India
(Kaur) American University of Antigua School of Medicine, Osbourn, Antigua
and Barbuda
Publisher
SAGE Publications Inc.
Abstract
This systematic review and meta-analysis aimed to evaluate sex-based
differences in surgical outcomes among patients with infective
endocarditis (IE). A comprehensive search of three major medical databases
identified ten studies encompassing 16,763 patients who underwent valvular
surgery for IE. Of these, 70.8% were male (n = 11,873), and 29.2% were
female (n = 4890). Female patients were generally older at the time of
surgery. The most common causative pathogen was Staphylococcus aureus
(28.4%), followed by Streptococcus (22.5%) and Enterococcus (4.1%).
Females demonstrated lower aortic valve involvement (risk ratio [RR]:
0.80, 95% confidence interval [CI]: 0.67-0.96) but higher mitral valve
involvement (RR: 1.30, 95% CI: 1.17-1.45, p < 0.001). They also had a
reduced prevalence of Streptococcus (RR: 0.89, 95% CI: 0.81-0.98, p =
0.02) and Enterococcus (RR: 0.71, 95% CI: 0.62-0.82, p = 0.03) infections
and a lower risk of abscess formation (RR: 0.87, 95% CI: 0.76-0.99, p =
0.03) compared to males. There was a significant difference in the
in-hospital mortality between female and male patients (RR: 1.30, 95% CI:
1.04-1.61, p = 0.02). No significant sex-related differences were observed
in the duration of hospitalization. However, significant sex-related
differences were observed in the incidence of postoperative stroke (RR:
1.10, 95% CI: 1.02-1.20, p = 0.02). In summary, female patients undergoing
surgery for IE face a higher risk of both in-hospital mortality and
postoperative stroke compared to males, underscoring clinically meaningful
sex-based disparities in short-term surgical outcomes. These findings
emphasize the need for further studies to clarify these observations.
(PROSPERO Registration: CRD42024602013). Copyright © The
Author(s) 2025

<2>
Accession Number
2042454016
Title
Efficacy and safety of off-pump versus on-pump coronary artery bypass
grafting in chronic obstructive pulmonary disease patients: A systematic
review and meta-analysis.
Source
Revista Portuguesa de Cardiologia. 45(1) (pp 25-36), 2026. Date of
Publication: 01 Jan 2026.
Author
Hassan D.; Zehra Manjee K.; Umar T.P.; Al Diab Al Azzawi M.; Elshenawy S.;
Ahmed Khan W.; Rayyan Ahmed S.; Sohaib Khan M.; Amjad M.; Adel Mohammed Y.
Institution
(Hassan, Zehra Manjee, Ahmed Khan, Rayyan Ahmed, Sohaib Khan, Amjad)
Faculty of Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Umar) Division of Surgery and Interventional Science, Faculty of Medical
Sciences, University College London, London, United Kingdom
(Al Diab Al Azzawi) Faculty of Medicine, The National Ribat University,
Khartoum, Sudan
(Elshenawy) Faculty of Medicine Alexandria University, Alexandria, Egypt
(Adel Mohammed) Faculty of Medicine, Assiut University, Assiut, Egypt
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Introduction and objectives: Patients with chronic obstructive pulmonary
disease (COPD) undergoing coronary artery bypass grafting (CABG) face
significant perioperative risks. The choice between off-pump and on-pump
CABG techniques can impact clinical outcomes, particularly related to
pulmonary function and postoperative recovery. This meta-analysis aims to
evaluate the clinical efficacy and safety of off-pump versus on-pump CABG
in patients with COPD. Method(s): A comprehensive search of medical
databases including PubMed and Google Scholar was conducted to identify
relevant studies comparing off-pump and on-pump CABG in COPD patients. The
main outcomes included postoperative respiratory complications, mortality
rates, length of hospital stay, and overall recovery. Results were pooled
as relative risks (RR) or mean differences (MD) with 95% confidence
intervals (CI). Result(s): A total of seven studies (two randomized
controlled trials (RCTs), one sub-study from a previous RCT, and four
observational studies) comprising 1071 patients were included in the
analysis. While postoperative respiratory complications were lower in the
off-pump group, the difference was not statistically significant. However,
off-pump CABG was significantly associated with reduced mortality (RR
0.21; 95% CI: [0.08, 0.54], p=0.001), shorter hospital stays (MD=-2.34;
95% CI: [-4.51, -0.17], p=0.03), reduced need for mechanical ventilatory
support (MD=-4.73; 95% CI: [-6.17, -3.29], p<0.00001), and lower incidence
of low cardiac output (RR=0.43, 95% CI [0.19, 0.99], p=0.05).
 Conclusion(s): Off-pump CABG provides significant benefits over
on-pump CABG in COPD patients by reducing mortality, hospital stay
duration, the need for mechanical ventilatory support, and low cardiac
output. The observed reduction in postoperative respiratory complications,
although not statistically significant, may indicate potential clinical
benefits of off-pump CABG. Further large-scale RCTs are needed to confirm
these findings. Copyright © 2025 Sociedade Portuguesa de
Cardiologia

<3>
Accession Number
2042004818
Title
The effect of remimazolam versus conventional anesthesia on postoperative
delirium in frail patients: a prospective, controlled cohort study.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1684779.
Date of Publication: 2025.
Author
Yang Y.; Sun Z.; Wu J.; Huang L.; Ma S.
Institution
(Yang, Sun, Wu, Huang, Ma) Department of Anesthesiology, The Second
Hospital of Hebei Medical University, Shijiazhuang, China
Publisher
Frontiers Media SA
Abstract
Background: Frail elderly patients are at high risk for postoperative
delirium (POD), a serious complication associated with poor outcomes. The
choice of anesthetic agent may represent a modifiable risk factor. This
study aimed to compare the effect of anesthesia involving remimazolam
versus conventional general anesthesia without remimazolam on the
incidence of POD in this vulnerable population. Method(s): We
enrolled frail elderly patients (defined as Clinical Frailty Scale >= 5)
scheduled for elective non-cardiac surgery. Patients received either
anesthesia involving remimazolam (R group, n = 301) or conventional
general anesthesia without remimazolam (C group, n = 305), based on the
attending anesthesiologist's clinical decision. The primary outcome was
the incidence of POD within the first three postoperative days, assessed
by trained, blinded researchers using the 3-min Confusion Assessment
Method (3D-CAM). Secondary outcomes included postoperative recovery
quality (agitation, sleep, pain) and intraoperative safety parameters.
 Result(s): Between June 2024 and June 2025, a total of 606 patients
were enrolled and analyzed (R group: n = 301; C group: n = 305). The
overall incidence of POD was significantly lower in the R group (119/301,
39.5%) compared to the C group (143/305, 46.9%) (Relative Risk 0.84; 95%
CI 0.71-0.99; P = 0.038). The remimazolam group also experienced less
emergence agitation and, by postoperative day 3, reported significantly
better sleep quality and lower pain scores (P < 0.01). A multivariate
logistic regression identified the use of remimazolam as an independent
protective factor against POD (Adjusted Odds Ratio 0.68, 95% CI 0.47-0.98,
P = 0.041), while advanced age and longer anesthesia duration were
independent risk factors. Conclusion(s): In this cohort of frail
elderly patients, the use of remimazolam for general anesthesia was
associated with a lower incidence of postoperative delirium compared to
conventional anesthesia. This choice represents a promising, modifiable
strategy for improving neurological outcomes in this high-risk
group. Copyright © 2025 Yang, Sun, Wu, Huang and Ma.

<4>
Accession Number
2042047463
Title
Optimization in long-term survival after multiple arterial grafting in
coronary artery bypass: A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 34(1) (pp 67-81), 2026. Date of
Publication: 01 Jan 2026.
Author
Abdillah A.H.; Sofian A.; Agustian A.H.; Fadhilah A.; Fatharani A.
Institution
(Abdillah, Agustian) Faculty of Medicine, Universitas Sumatera Utara,
Medan, Indonesia
(Sofian) Department of Thoracic and Cardiovascular Surgery, Pertamina
Pusat Hospital, South Jakarta, Indonesia
(Fadhilah) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
(Fatharani) Faculty of Medicine and Life Sciences, King's College London,
London, United Kingdom
Publisher
SAGE Publications Inc.
Abstract
Introduction: Surgical revascularization through coronary artery bypass is
a widely accepted approach for treating diseases affecting multiple
coronary vessels. While the standard approach uses a single arterial graft
combined with vein grafts, using numerous arterial grafts may improve
long-term outcomes. Although supported by observational data and guideline
recommendations, the broader adoption of multiple arterial grafting has
been limited due to a lack of definitive randomized trial evidence and
uncertainties in specific patient subgroups. Method(s): A systematic
review and meta-analysis were conducted to compare long-term survival in
patients receiving multiple versus single arterial grafts during coronary
artery bypass surgery. Twenty-seven studies (including one randomized
trial) involving more than one million patients were included. The primary
outcome was long-term all-cause mortality. Hazard ratios with 95%
confidence intervals were pooled using a random-effects model. Subgroup
analyses were performed based on age, sex, diabetes status, graft conduit
type, extent of arterial revascularization, and left ventricular function.
Meta-regression examined the impact of patient characteristics.
 Result(s): Multiple arterial grafting was associated with a
significant reduction in long-term mortality compared to single arterial
grafting. The pooled hazard ratio indicated an approximate 20% relative
reduction in mortality. This survival benefit was consistent across all
evaluated subgroups. Meta-regression did not identify any patient
characteristic that significantly altered the benefit of multiple arterial
grafting. No significant publication bias was detected.
 Conclusion(s): Multiple arterial grafting is associated with improved
long-term survival in coronary artery bypass surgery. These findings
support the broader implementation of this strategy in suitable patients
while emphasizing the need for individualized surgical
decision-making. Copyright © The Author(s) 2025. This article is
distributed under the terms of the Creative Commons Attribution 4.0
License (https://creativecommons.org/licenses/by/4.0/) which permits any
use, reproduction and distribution of the work without further permission
provided the original work is attributed as specified on the SAGE and Open
Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

<5>
Accession Number
2041982079
Title
Fetal cardiac rhabdomyomas susceptible to prenatal treatment with mTOR
inhibitors: literature review and proposal of a prenatal management
algorithm.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1711774.
Date of Publication: 2025.
Author
Martinez-Garcia A.; Tirado-Aguilar O.A.; Acevedo-Gallegos S.;
Gallardo-Gaona J.M.; Velazquez-Torres B.; Ramirez-Calvo J.A.;
Camarena-Cabrera D.M.A.; Rodriguez-Sibaja M.J.; Lumbreras-Marquez M.I.;
Copado-Mendoza Y.
Institution
(Martinez-Garcia, Tirado-Aguilar, Acevedo-Gallegos, Gallardo-Gaona,
Velazquez-Torres, Ramirez-Calvo, Camarena-Cabrera, Rodriguez-Sibaja,
Lumbreras-Marquez, Copado-Mendoza) Maternal Fetal Medicine Department,
Instituto Nacional de Perinatologia Isidro Espinosa de los Reyes, Mexico
City, Mexico
(Martinez-Garcia, Copado-Mendoza) Fetal Cardiology Clinic, Instituto
Nacional de Perinatologia Isidro Espinosa de los Reyes, Mexico City,
Mexico
(Lumbreras-Marquez) Bioinformatics and Biostatistics Department, Instituto
Nacional de Perinatologia Isidro Espinosa de los Reyes, Mexico City,
Mexico
(Lumbreras-Marquez) Epidemiology and Public Health Department, Universidad
Panamericana School of Medicine, Mexico City, Mexico
Publisher
Frontiers Media SA
Abstract
Certain types of fetal cardiac rhabdomyomas can lead to severe
complications, including intrauterine death, yet no specific criteria have
been established for the prenatal use of pharmacological therapies to
mitigate the impact of rhabdomyomas. We conducted a narrative review of
case reports and case series published between January 1, 2000, and
February 28, 2025, identified through PubMed, Scopus, Web of Science, and
Google Scholar, describing the prenatal use of mammalian target of
rapamycin inhibitors in this context. Thirteen studies reporting on 15
fetuses were included. Five fetuses (33.3%) had a single rhabdomyoma, and
10 (66.6%) had multiple lesions. Prenatal genetic testing for Tuberous
Sclerosis Complex was performed in 9 cases (60%): 1 with a TSC1 mutation,
7 with TSC2 mutations, and 1 negative. Sirolimus was the most frequently
used inhibitor (86.6%), while everolimus was used in 2 cases (13.3%). The
main indication for treatment was progressive tumor growth causing outflow
obstruction and/or hemodynamic compromise, including reduced cardiac
output, arrhythmias, and fetal hydrops. Therapy was initiated at a median
of 30.0weeks (IQR 26.7-33.1) and completed at 38.0weeks (IQR 36-39). All
reports documented tumor reduction and improved cardiac function, though
regrowth occurred in 5 cases (33.3%) after discontinuation. No fetal or
neonatal deaths were reported, and none required postnatal cardiac surgery
before discharge. Based on these findings, we proposed echocardiographic
criteria to identify suitable candidates, including inflow/outflow tract
obstruction, severe atrioventricular valve insufficiency, tachyarrhythmia,
impaired cardiac function, or hydrops, and developed a structured prenatal
management algorithm. Prenatal therapy with mTOR inhibitors, therefore,
appears to improve fetal cardiac function by reducing tumor burden and may
contribute to better perinatal outcomes, although validation in future
studies is required. TSC1: urn:lsid:hgnc.org: HGNC:12362 TSC2:
urn:lsid:hgnc.org: HGNC:12363 Sirolimus: urn:lsid:ebi.ac.uk:chebi:9168
Everolimus: urn:lsid:ebi.ac.uk:chebi:68478. Copyright © 2025
Martinez-Garcia, Tirado-Aguilar, Acevedo-Gallegos, Gallardo-Gaona,
Velazquez-Torres, Ramirez-Calvo, Camarena-Cabrera, Rodriguez-Sibaja,
Lumbreras-Marquez and Copado-Mendoza.

<6>
Accession Number
2042128717
Title
A PROSPECTIVE RANDOMIZED CONTROL STUDY BETWEEN INTRAVENOUS CLONIDINE AND
DEXMEDETOMIDINE AS PREMEDICATION FOR INDUCED HYPOTENSION IN FUNCTIONAL
ENDOSCOPIC SINUS SURGERY.
Source
International Journal of Academic Medicine and Pharmacy. 7(5) (pp
404-408), 2025. Date of Publication: 01 Jan 2025.
Author
Kavitharani K.; Anitha K.; Elavarasan D.; Akila K.
Institution
(Kavitharani, Elavarasan, Akila) Senior Assistant Professor, Department of
Anaesthesiology, KAPV Government Medical College, Tamilnadu, Trichy, India
(Anitha) Associate Professor, Department of Anaesthesiology, Government
Medical College, Tamilnadu, Ariyalur, India
Publisher
Society for Healthcare and Research Development
Abstract
Background: Functional Endoscopic Sinus Surgery (FESS) often requires a
bloodless field to optimise visibility. Controlled hypotension with
alpha-2 agonists, such as clonidine and dexmedetomidine, is commonly used
to achieve this. Objective(s): To compare the efficacy of intravenous
clonidine and dexmedetomidine as premedication for induced hypotension in
adult patients undergoing FESS, evaluating surgical field quality, surgeon
satisfaction, patient recovery, and adverse effects. Material(s) and
Method(s): Sixty ASA I/II patients scheduled for FESS were randomly
allocated to two groups. Group A received intravenous dexmedetomidine (1
mug/kg), and Group B received intravenous clonidine (2 mug/kg), both
administered 15 min before induction. The intraoperative mean arterial
pressure was maintained between 50 and 70 mmHg using isoflurane titration.
The parameters assessed included the Fromme-Boezaart surgical field score,
heart rate, blood pressure, isoflurane requirements, sedation scores, and
awakening time. Result(s): Both groups were comparable in terms of
demographic characteristics. Group A showed a significantly better
Fromme-Boezaart score (1.8 +/- 0.66 vs. 2.43 +/- 0.68), shorter awakening
time (5.23 +/- 1.33 min vs. 8.6 +/- 1.67 min), and reduced isoflurane
requirement. Heart rates were similar during surgery, except for
post-extubation, where Group A had higher rates. The mean arterial and
diastolic pressures were significantly lower in Group A, whereas the
systolic pressures were comparable. No adverse reactions were reported.
 Conclusion(s): Intravenous dexmedetomidine provided more effective
hypotensive anaesthesia than clonidine, enhancing surgical field quality,
reducing anaesthetic requirements, and improving recovery profile.
Dexmedetomidine may be preferred as premedication for induced hypotension
in FESS, with good safety and surgeon satisfaction. Copyright ©
(2025), (Society for Healthcare and Research Development). All rights
reserved.

<7>
Accession Number
2040299145
Title
Cardiac prehabilitation: Is there a role in cardiac surgery.
Source
Best Practice and Research: Clinical Anaesthesiology. 39(2) (pp 147-156),
2025. Date of Publication: 01 Jun 2025.
Author
Di Giambattista C.; Buyck K.; Shepherd S.
Institution
(Di Giambattista, Buyck, Shepherd) Department of Anaesthesia and Intensive
Care Medicine, St. Bartholomew's Hospital, West Smithfield, London, United
Kingdom
Publisher
Bailliere Tindall Ltd
Abstract
Background: Cardiac surgery presents significant perioperative risks,
particularly for high-risk populations such as elderly and frail patients.
Prehabilitation, a preoperative strategy focusing on patient optimization,
has emerged as a promising intervention to enhance recovery and reduce
complications. Objective(s): This review explores the evidence
supporting prehabilitation programs, which integrate exercise, nutritional
optimization, psychological support, and patient education to improve
cardiac surgical outcomes. Method(s): A review of current literature
highlights the benefits, challenges, and emerging multidisciplinary
approaches in cardiac prehabilitation, including inspiratory muscle
training and tailored nutritional support. Result(s): While
prehabilitation is well-established in other surgical specialties, its
implementation in cardiac surgery remains limited due to protocol
heterogeneity, time constraints, and patient-specific factors. Early data
suggest improved recovery, reduced hospital stays, and better
perioperative outcomes. Conclusion(s): Standardized prehabilitation
protocols and additional research are necessary to improve patient
selection, increase adherence, and assess long-term effects. With around
one million cardiac surgeries conducted worldwide annually, incorporating
structured prehabilitation programs may enhance patient outcomes and
refine perioperative care. Copyright © 2025 Elsevier Ltd. All
rights are reserved, including those for text and data mining, AI
training, and similar technologies.

<8>
Accession Number
2042410008
Title
Efficacy and safety of rivaroxaban in neonatal catheter-related
thrombosis: a single-center retrospective study of 122 cases.
Source
PeerJ. 13 (no pagination), 2025. Article Number: e20375. Date of
Publication: 20 Nov 2025.
Author
Zhang R.; Chen G.; Cai W.H.; Yang B.; Lin Y.F.; Zhan T.H.
Institution
(Zhang, Cai, Yang, Zhan) Fujian Maternity and Child Health Hospital,
College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics,
Fujian Medical University, Fujian, Fuzhou, China
(Chen) Zhongshan Hospital (Xiamen), Fudan University, Xiamen, China
(Cai, Yang, Lin, Zhan) Fujian Key Laboratory of Women and Children's
Critical Diseases Research (Fujian Maternity and Child Health Hospital),
Fujian, Fuzhou, China
(Lin) Fujian Children's Hospital (Fujian Branch of Shanghai Children's
Medical Center), College of Clinical Medicine for Obstetrics & Gynecology
and Pediatrics, Fujian Medical University, Fujian, Fuzhou, China
(Lin) Clinical Research Center for Pediatric Neurodevelopmental Disease of
Fujian Province, Fujian, Fuzhou, China
Publisher
PeerJ Inc.
Abstract
Background. To systematically evaluate the clinical efficacy of
rivaroxaban in treating neonatal catheter-related thrombosis (CRT) and
analyze risk factors affecting treatment outcomes. Methods. Clinical data
of 122 neonatal CRT patients treated with rivaroxaban from March 2022 to
October 2024 at Fujian Provincial Maternal and Child Health Hospital were
retrospectively analyzed. The primary outcome was the complete thrombus
resolution rate. Multivariate logistic regression was used to analyze risk
factors affecting treatment efficacy. Results. Among 122 patients, the
complete thrombus resolution rate was 71.31% (87/122) after 6 weeks of
anticoagulation, which significantly increased to 88.52% (108/122) after
extending to 3 months (p < 0:01). Multivariate logistic regression
analysis showed that chemotherapy (OR D 5.48, 95% CI [1.04-28.73], P <
0:05) and difficult catheter placement (OR D 12.53, 95% CI [3.13-50.22], P
< 0:05) were independent risk factors reducing the likelihood of complete
thrombus resolution at 3 months. No anticoagulation-related bleeding or
other complications were observed during the study period, though the
sample size and follow-up period may limit the detection of rare events.
Conclusion. Retrospective data suggest that rivaroxaban is safe and
effective in treating neonatal catheter-related thrombosis, with a higher
complete thrombus resolution rate observed at 3 months compared to 6 weeks
of anticoagulation therapy. Chemotherapy and difficult catheter placement
were identified as independent risk factors affecting treatment efficacy.
These findings, derived from a single-center retrospective study, require
validation through multi-center, prospective, randomized controlled
trials. Copyright © 2025 Zhang et al.

<9>
Accession Number
2041656873
Title
Effects of Dexmedetomidine on Outcomes After Cardiac Surgery (DOCS): a
randomised double-blind, placebo-controlled trial.
Source
British Journal of Anaesthesia. 136(1) (pp 55-64), 2026. Date of
Publication: 01 Jan 2026.
Author
Lei C.; Zheng Z.; Han J.; Zhai W.; Li C.; Hou L.; Yu S.; Liu J.; Xu X.;
Wang S.; Guo X.; Zhang T.; Zhou J.; Zou J.; Tian Y.; Chi X.; Qiu L.; Xu
M.; Zhang X.; Huang W.; Chen Y.; Yan M.; Wang H.; Xia J.; Wang L.; Liu H.;
Dong H.
Institution
(Lei, Zheng, Wang, Hou, Dong) Department of Anesthesiology and
Perioperative Medicine, Xijing Hospital, the Fourth Military Medical
University, Shaanxi, Xi'an, China
(Lei, Zheng, Wang) Key Laboratory of Anesthesiology, Ministry of Education
of China, Xi'an, China
(Lei, Zheng, Dong) Anesthesia Clinical Research Center, (ACRC) Xijing
Hospital, Fourth Military Medical University, Xi'an, China
(Han, Zhai, Xia, Wang) Department of Anesthesiology, Tianjin Chest
Hospital, Tianjin, China
(Li) Department of Medical Statistics, School of Preventive Medicine,
Fourth Military Medical University, Shaanxi, Xi'an, China
(Yu, Liu, Xu) Department of Cardiovascular Surgery, Xijing Hospital, the
Fourth Military Medical University, Shaanxi, Xi'an, China
(Wang, Guo) Department of Anesthesiology, Guangdong People's Hospital,
Guangdong, Guangzhou, China
(Zhang, Zhou, Zou) Department of Anesthesiology, General Hospital of
Shenyang Military Region, Liaoning, Shenyang, China
(Tian, Chi) Department of Anesthesiology, Wuhan Tongji Hospital, Tongji
Medical College Huazhong University of Science and Technology, Hubei,
Wuhan, China
(Qiu) Department of Anesthesiology, Henan People's Hospital, Henan,
Zhengzhou, China
(Xu, Zhang) Department of Anesthesiology, Shanghai Chest Hospital,
Shanghai, China
(Huang, Chen) Department of Anesthesiology, First Affiliated Hospital, Sun
Yat-sen University, Guangdong, Guangzhou, China
(Yan, Wang) Department of Anesthesiology, the Second Affiliated Hospital
of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health System, Sacramento, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Organ dysfunction after cardiac surgery may be reduced by
dexmedetomidine. We evaluated whether perioperative dexmedetomidine
reduces complications after cardiac surgery with cardiopulmonary bypass.
 Method(s): In this randomised, double-blind, placebo-controlled trial
conducted in nine Chinese hospitals, adults scheduled for cardiac surgery
with cardiopulmonary bypass were randomly assigned to receive i.v.
dexmedetomidine (0.4 mug kg-1 h-1) or saline
(placebo) for 12 h after the induction of anaesthesia. The co-primary
outcomes were in-hospital mortality and major complications after surgery
(including stroke, myocardial infarction, heart block, cardiac arrest),
analysed by intention-to-treat. Secondary outcomes included individual
complications. Result(s): A total of 1073 participants (46% female;
mean age: 54 yr [range: 47-63 yr]) completed the study after
randomisation. Major complications occurred in 161/536 (30%) participants
who received dexmedetomidine, compared with 169/537 (32%) who received
saline (relative risk: 0.93 [95% confidence interval: 0.72-1.21]; P=0.66).
In addition, 10/536 (1.9%) participants who received dexmedetomidine died
in hospital, compared with 15/537 (2.8%) participants who received saline
(odds ratio: 0.66 [95% confidence interval: 0.29-1.49]; P=0.32). Major
complications, other than heart block, did not differ between participants
who received dexmedetomidine, compared with participants who received
saline. Safety outcomes and process measures did not differ between
participants allocated to dexmedetomidine or saline. Conclusion(s):
Perioperative use of dexmedetomidine did not reduce death, complications,
or both in adults undergoing cardiopulmonary bypass-assisted cardiac
surgery. Clinical trial registration: ClinicalTrials.gov
(NCT02237495). Copyright © 2025 British Journal of Anaesthesia

<10>
Accession Number
2040378528
Title
Pleural drain placement following lung resection in children: A
prospective observational study of the Western Pediatric Surgery Research
Consortium.
Source
Journal of Pediatric Surgery. 61(1) (no pagination), 2026. Article Number:
162541. Date of Publication: 01 Jan 2026.
Author
Kahan A.M.; Kelley-Quon L.I.; Acker S.N.; Vincent S.; Chao S.D.;
Nepomuceno H.; Lee J.H.; Padilla B.E.; Patwardhan U.M.; Gollin G.; Ignacio
R.C.; Fialkowski E.A.; Fowler K.L.; Cairo S.B.; Munar D.; Pandya S.R.;
Russell K.W.; Fenton S.J.; Lee S.L.; Rothstein D.H.
Institution
(Kahan, Russell, Fenton) Department of Surgery, Division of Pediatric
Surgery, University of Utah, Salt Lake City, UT, United States
(Kelley-Quon) Division of Pediatric Surgery, Children's Hospital Los
Angeles, Department of Surgery, Keck School of Medicine of University of
Southern California, Los Angeles, CA, United States
(Acker, Vincent) Department of Pediatric Surgery, University of Colorado
School of Medicine, Children's Hospital Colorado, Aurora, CO, United
States
(Chao, Nepomuceno) Division of Pediatric Surgery, Stanford Children's
Hospital, Palo Alto, CA, United States
(Lee, Padilla) Division of Pediatric Surgery, Phoenix Children's Hospital,
University of Arizona College of Medicine, Phoenix, AZ, United States
(Patwardhan, Gollin, Ignacio) Division of Pediatric Surgery, Department of
Surgery, University of California San Diego, Rady Children's Hospital, San
Diego, CA, United States
(Fialkowski, Fowler) Division of Pediatric Surgery, Doernbecher Children's
Hospital, Oregon Health and Science University, Portland, OR, United
States
(Cairo, Munar) Department of Surgery, University of California San
Francisco School of Medicine, CA, United States
(Pandya) Department of Pediatric General and Thoracic Surgery, University
of Texas Southwestern, Dallas, TX, United States
(Lee, Rothstein) Department of Pediatric General and Thoracic Surgery,
Seattle Children's Hospital, Seattle, WA, United States
(Cairo, Munar) Division of Pediatric Surgery, University of California San
Francisco Benioff Children's Hospitals, San Francisco, CA, United States
Publisher
W.B. Saunders
Abstract
Purpose: Pleural drains are used routinely after thoracic surgery in
children despite evidence that drainage is not always necessary. The
purpose of this study was to assess the necessity of intraoperative drain
placement after resectional lung surgery in children, provide a
contemporary characterization of the use of pleural drains, and evaluate
the utility of intraoperative air leak testing. Method(s): A
multi-institutional prospective cohort study was performed at 10
free-standing children's hospitals in the United States from 2023 to 2024.
Patients <=18 years old who underwent open or thoracoscopic wedge
resection or lobectomy were included. Patients undergoing operation for
spontaneous pneumothorax or trauma, those on extra-corporeal life support,
those undergoing bi-lobectomy or pneumonectomy, and those undergoing
reoperation in the affected hemithorax were excluded. Operative
parameters, intra-operative air leak, length of post-operative drain
placement, and number of post-operative chest x-rays were evaluated using
bivariate comparisons. Result(s): Among 229 patients (58% male,
median age 12.3 years [IQR 5-16]), 113 (49%) underwent wedge resection and
the remaining 116 (51%) underwent lobectomy. 201 patients (87.8%) had a
pleural drain vs 28 (12.2%) without. Air leak testing was performed for
198 children: among those with a negative leak test (168, 73.4%), 144
(85.7%) had a pleural drain placed. Of the 90 children undergoing wedge
resection with air leak test results available, 78 (87%) had a negative
leak test and 57 (73%) of those patients still received pleural drainage.
None of the 28 cases initially without pleural drainage required
post-operative insertion of a pleural drain. Children with pleural
drainage had significantly more post-operative chest x-rays compared to
those without (median 5 vs 2, p < 0.001), and a significantly longer
post-operative length of stay (median 3 vs 1 days, p < 0.001).
 Conclusion(s): Pleural drain placement after lung resection in
pediatric patients is routine but may not be necessary. Patients with
pleural drain incur significantly higher postoperative radiation exposure
compared to those without. Randomized control trials of pleural drainage
after resectional lung surgery are needed to examine further if the
routine use of pleural drainage is necessary. Level of Evidence:
III. Copyright © 2025 The Author(s)

<11>
Accession Number
2042393331
Title
Conscious Sedation Versus General Anesthesia for Percutaneous Left Atrial
Appendage Occlusion: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2026.
Date of Publication: 2026.
Author
Jain H.; Passey S.; Jain J.; Soni K.; Pushparaji B.; Ahmed R.; Jhand A.S.;
Khera S.; Goldsweig A.M.
Institution
(Jain) Department of Internal Medicine, All India Institute of Medical
Sciences, Jodhpur, India
(Passey) Department of Internal Medicine, University of Connecticut Health
Center, Farmington, CT, United States
(Jain) Department of Internal Medicine, Allegheny General Hospital, Drexel
University School of Medicine, Pittsburgh, PA, United States
(Soni) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY, United States
(Pushparaji) Division of Cardiovascular Medicine, Department of Medicine,
MetroHealth Medical Center, Cleveland, Ohio, United States
(Ahmed) Department of Cardiology, National Heart and Lung Institute,
Imperial College London, London, United Kingdom
(Jhand) Department of Cardiovascular Medicine, Heart and Vascular
Institute, Geisinger Medical Center, Danville, PA, United States
(Khera) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York City, NY, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, Massachusetts, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Percutaneous left atrial appendage occlusion (LAAO) has
traditionally been performed under general anesthesia (GA) to maintain
patient comfort and immobility, especially in the setting of
transesophageal echocardiography. Aim(s): We aimed to compare the
safety and efficacy of conscious sedation (CS) compared to GA for LAAO,
concurrent with the expansion of intracardiac echocardiography guidance.
 Method(s): A systematic search of the PubMed, Embase, Cochrane
Central, and Scopus databases was conducted through December 2024 for
studies comparing CS versus GA for LAAO. For outcomes of procedural
complications and characteristics, random-effects models were used to
calculate the mean difference (MD), odds ratio (OR), and risk ratio (RR)
effect estimates with 95% confidence intervals (CIs). Result(s): Four
studies with 1540 patients undergoing LAAO were included (CS = 678, GA =
862). CS was associated with significantly shorter total procedural time
[MD -11.95 min; 95% CI -19.52 to -2.78; p = 0.009] and a lower volume of
contrast media [MD -31.90 mL; 95% CI -56.72 to -7.08; p = 0.01]. No
significant differences were noted for total fluoroscopy time, total
length of hospital stay, device success, all-cause mortality,
cardiovascular mortality, stroke, device-related thrombus, and peri-device
leak > 5 mm. Conclusion(s): Percutaneous LAAO using CS allows for
faster procedures and lower contrast media volumes compared to GA without
compromising device success and clinical outcomes. Randomized studies with
longer follow-ups are necessary to understand the long-term outcomes of
percutaneous LAAO using CS. Copyright © 2026 Wiley Periodicals
LLC.

<12>
Accession Number
649781275
Title
Echocardiographic Results of Transcatheter Versus Surgical Aortic Valve
Replacement in Women With Severe Aortic Stenosis: The RHEIA Trial.
Source
Journal of the American Heart Association. 15(1) (pp e047196), 2026. Date
of Publication: 06 Jan 2026.
Author
Silva I.; Alperi A.; Hecht S.; Zanuttini A.; Theron A.; Giuliani C.;
Camacho B.; Dahou A.; Mares J.; Bax J.; Bonaros N.; Windecker S.;
Messika-Zeitoun D.; Wesselink W.; Rakova R.; Bramlage P.; Tchetche D.;
Eltchaninoff H.; Pibarot P.
Institution
(Silva, Alperi, Rakova) Department of Cardiology, Hospital Universitario
Central de Asturias Instituto de Investigacion Sanitaria del Principado de
Asturias Oviedo Spain, Spain
(Silva, Alperi, Hecht, Zanuttini, Theron, Giuliani, Rakova, Pibarot)
Quebec Heart & Lung Institute Laval University Quebec City Quebec Canada,
Canada
(Theron) Department of Cardiology, Assistance Publique Hopitaux de
Marseille Marseille France, France
(Camacho) Interventional Cardiology Hospital Arnau de Vilanova Lerida
Spain, Spain
(Dahou) Division of Cardiovascular Imaging, St. Francis Hospital and Heart
Center, Catholic Health New York NY
(Dahou) Division of Cardiology Massachusetts General Hospital/Harvard
Medical School Boston MA
(Mares) Department of Data Science Institute for Clinical and Experimental
Medicine Prague Czech Republic, Czechia
(Bax) Department of Cardiology Leiden University Medical Center Leiden The
Netherlands, Netherlands
(Bonaros) Department of Cardiac Surgery Medical University of Innsbruck
Innsbruck Austria, Austria
(Windecker) Department of Cardiology, Inselspital University Hospital of
Bern University of Bern Bern Switzerland, Switzerland
(Messika-Zeitoun) Division of Cardiology University of Ottawa Heart
Institute Ottawa ON Canada, Canada
(Wesselink) Edwards Lifesciences Prague Prague Czech Republic, Czechia
(Bramlage) Institute for Pharmacology and Preventive Medicine Cloppenburg
Cloppenburg Germany, Germany
(Tchetche) Clinique Pasteur Toulouse France
(Eltchaninoff) Department of Cardiology Univ Rouen Normandie, INSERM
U1096, France
Abstract
BACKGROUND: In the RHEIA (Randomized Research in Women All Comers With
Aortic Stenosis) trial, the incidence of the primary end point of death,
stroke, or rehospitalization at 1 year was lower with transcatheter aortic
valve implantation (TAVI) than with surgical aortic valve replacement. The
objective of this substudy was to compare echocardiographic findings in
women with severe aortic stenosis following surgical aortic valve
replacement or TAVI. METHOD(S): At 48 European centers, 443 women
underwent randomization 1:1, and 420 were treated as randomized.
Echocardiograms were available in 356 patients and were analyzed by a core
laboratory. RESULT(S): Rates of or greater moderate paravalvular
regurgitation was low (<1%) and similar between groups. At 30 days, TAVI
was associated with higher mean transprosthetic gradient and smaller
aortic valve area, but the rate of severe patient-prosthesis mismatch (3.0
versus 2.6%; P=1) was low and not different between groups. Valve
hemodynamics were stable at 1 year. The rate of residual left ventricular
hypertrophy (45.3 versus 28.6%; P=0.004) at 1 year was significantly
higher with TAVI, whereas the rate of right ventricular systolic
dysfunction (14.5 versus 40.7%; P<0.001) and evolution of cardiac damage
stage (improved in 21.8 versus 18.1%; worsened in 16.8 versus 47.0%;
P=0.001) were better with TAVI. CONCLUSION(S): Among women with
severe aortic stenosis, both TAVI and surgical aortic valve replacement
achieve excellent valve hemodynamic results with low and similar rates of
moderate or greater paravalvular regurgitation or severe
patient-prosthesis mismatch. Surgical aortic valve replacement was
associated with lower gradients and more pronounced regression of left
ventricular hypertrophy, whereas TAVI was associated with better right
ventricular systolic function and evolution of cardiac damage stage.
REGISTRATION: URL: https://clinicaltrials.gov/study/NCT04160130; Unique
Identifier: NCT04160130.

<13>
Accession Number
2042264034
Title
Transradial vs transfemoral secondary access outcomes in transcatheter
aortic valve replacement: an updated systematic review and meta-analysis.
Source
Egyptian Heart Journal. 77(1) (no pagination), 2025. Article Number: 113.
Date of Publication: 01 Dec 2025.
Author
Shaikh R.H.; Fatima E.; Jamshed M.M.; Ishfaq H.; Lukan A.; Inam H.;
Ibrahim M.B.; Shaka H.
Institution
(Ishfaq, Shaikh, Fatima, Jamshed) Medical College, Aga Khan University,
Karachi, Pakistan
(Ishfaq) Northwest Health-Porter, Valparaiso, United States
(Lukan) Advocate Illinois Masonic Medical Center, Chicago, United States
(Inam) Department of Cardiothoracic Surgery, Aga Khan University Hospital,
Karachi, Pakistan
(Ibrahim, Shaka) John H. Stroger, Jr. Hospital of Cook County, Chicago,
United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Transcatheter aortic valve replacement (TAVR) is a minimally
invasive procedure with associated risks that are influenced by the choice
of secondary vascular access used. The impact of transradial secondary
access (TRSA) compared to transfemoral secondary access (TFSA) on adverse
events remains uncertain. Therefore, we conducted an updated meta-analysis
to compare procedural complications between TRSA and TFSA in TAVR.
 Method(s): We systematically searched PubMed, Scopus, and the
Cochrane Library for studies comparing TRSA and TFSA in patients
undergoing TAVR. The primary endpoints were 30-day rates of each of the
following: access-related bleeding, access-related vascular complications,
stroke/transient ischemic attack (TIA), myocardial infarction (MI), acute
kidney injury (AKI stage III or higher), and all-cause mortality.
Leave-one-out sensitivity analyses and subgroup analyses stratified by
primary access route were performed to assess the consistency of the
findings. Result(s): Seven studies with 6327 patients were included,
comprising of six observational studies and one randomized controlled
trial TRSA was associated with significantly lower odds of mortality (OR
0.55, 95% CI [0.39, 0.78], p = 0.0007), stroke/TIA (OR 0.58, 95% CI [0.39,
0.87], p = 0.009), major/life-threatening bleeding (OR 0.50, 95% CI [0.30,
0.83], p = 0.008), and major vascular complications (OR 0.59, 95% CI
[0.41, 0.85], p = 0.004). Additionally, we stratified outcomes for
patients undergoing transfemoral primary access (TFPA) to determine
whether the primary access route influences results. The transradial group
demonstrated significantly lower odds of 30-day all-cause mortality (OR
0.49, 95% CI [0.28, 0.87], p = 0.01), and 30-day minor bleeding (OR 0.48,
95% CI [0.27, 0.86], p = 0.01). Conclusion(s): Key limitations
included predominance of non-randomized studies and high heterogeneity in
some outcomes. In patients undergoing TAVR, TRSA is associated with
significantly lower complications compared to TFSA, suggesting it may be a
superior alternative. Copyright © The Author(s) 2025.

<14>
Accession Number
649579333
Title
Paradoxical Normal-Flow Aortic Stenosis Despite Reduced Left Ventricular
Ejection Fraction: Insights From the Randomized COMPARE-TAVI 1 Trial.
Source
Journal of the American Heart Association. 15(1) (pp e045521), 2026. Date
of Publication: 06 Jan 2026.
Author
Ravn E.J.; Christiansen U.; Nissen H.; Povlsen J.A.; Alcaraz Frederiksen
C.; Hvitfelt Poulsen S.; Clavel M.-A.; Carter-Storch R.; Fur C.B.; Thim
T.; Freeman P.; Uttenthal F.; Christiansen E.H.; Terkelsen C.J.; Dahl J.S.
Institution
(Ravn, Nissen, Clavel, Carter-Storch, Dahl) Department of Cardiology
Odense University Hospital Odense Denmark, Denmark
(Christiansen, Freeman, Uttenthal) Department of Cardiology Aalborg
University Hospital Aalborg Denmark, Denmark
(Povlsen, Alcaraz Frederiksen, Hvitfelt Poulsen, Fur, Thim, Christiansen,
Terkelsen) Department of Cardiology Aarhus University Hospital Aarhus
Denmark, Denmark
(Hvitfelt Poulsen, Terkelsen) Department of Clinical Medicine Aarhus
University Hospital Aarhus Denmark, Denmark
(Dahl) Department of Clinical Research University of Southern Denmark
Odense Denmark, Denmark
(Dahl) Department of Cardiovascular Medicine Mayo Clinic Rochester MN USA
Abstract
BACKGROUND: The hemodynamic profile and remodeling patterns of paradoxical
low-flow, low-gradient aortic stenosis are well understood. However, some
patients with severe aortic stenosis exhibit eccentric remodeling with
enlarged left ventricular cavities, enabling a normal flow, low ejection
fraction (NF-LEF) phenotype. We assessed the prevalence, hemodynamic
characteristics, and post-transcatheter aortic valve implantation outcomes
of NF-LEF. METHOD(S): In this substudy of the COMPARE-TAVI 1 trial,
979 patients undergoing transfemoral transcatheter aortic valve
implantation were stratified by left ventricular ejection fraction (LVEF)
(< or >=50%) and stroke volume index (< or >=35 mL/m2) into 4 groups:
normal flow, normal LVEF, NF-LEF, low flow, normal ejection fraction, and
low flow, low ejection fraction. RESULT(S): NF-LEF was observed in
10.7% of patients. Reduced LVEF was associated with previous myocardial
infarction, pacemakers, New York Heart Association class >2, atrial
fibrillation, moderate or worse mitral regurgitation, and larger left
ventricular cavities (P<0.001) with eccentric hypertrophy (P=0.004).
Compared with low-flow, low-ejection fraction, patients with NF-LEF more
frequently had moderate or worse aortic regurgitation (P=0.007), whereas
low flow, low ejection fraction showed poorer diastolic indices,
suggesting diastolic dysfunction with high left ventricular filling
pressures. Patients with low flow, normal ejection fraction were the most
symptomatic and showed less improvement in 6-minute walk distance at 1
year compared with normal flow, normal ejection fraction. During
follow-up, both low-flow groups demonstrated significant increases in
stroke volume index (P<0.001), whereas LVEF also improved among patients
with reduced LVEF (P<0.001). CONCLUSION(S): NF-LEF is a prevalent
aortic stenosis phenotype characterized by preserved flow despite reduced
LVEF, likely driven by eccentric remodeling with moderate or worse aortic
regurgitation and more favorable diastolic properties, with similar
survival and time-to-event outcomes across phenotypes after transcatheter
aortic valve implantation at long-term follow-up. Despite higher
comorbidity burdens, patients with NF-LEF showed functional and clinical
improvements comparable with normal flow, normal ejection fraction,
indicating a severe aortic stenosis phenotype.

<15>
Accession Number
2042612647
Title
Prognostic Value of Speckle-tracking Echocardiography in Assessing
Outcomes of Transcatheter Edge-to-edge Repair for Mitral Regurgitation.
Source
Journal of Cardiovascular Echography. 35(4) (pp 336-343), 2025. Date of
Publication: 01 Oct 2025.
Author
Taherkhani A.; Zarinfar Y.; Khaheshi I.
Institution
(Taherkhani, Zarinfar) School of Medicine, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Khaheshi) Cardiovascular Research Center, Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Khaheshi) Echocardiography Fellowship Program, Division of Cardiology,
Vancouver General Hospital, University of British Columbia, Vancouver,
Canada
Publisher
Wolters Kluwer Medknow Publications
Abstract
Mitral regurgitation (MR) is a valvular heart disease with high morbidity
and mortality. Transcatheter edge-to-edge repair (TEER) presents a viable
treatment option for severe MR in high-risk surgical patients. This review
aims to assess the prognostic significance of speckle-tracking
echocardiography (STE) in predicting outcomes after TEER and its potential
role in patient management. A systematic literature review was done on
PubMed for studies until November 2024. The search incorporated keywords
of STE and TEER, including original research on STE's predictive value in
TEER patients. Studies concerning surgical mitral valve repair or
unrelated imaging techniques were excluded. Twenty-nine articles were
included, indicating that STE metrics, especially global longitudinal
strain (GLS), correlate with clinical outcomes like heart failure
progression and mortality. Baseline GLS was determined as predictive of
hospitalization and mortality, while post-TEER GLS improvements were
associated with better functional capacity. Furthermore, left atrial
function metrics were significant in predicting arrhythmia recurrence.
This study highlights the utility of STE in predicting outcomes for TEER
patients. While findings are encouraging, additional research is essential
to elucidate the long-term effects of TEER on cardiac function, thereby
enhancing patient selection and management approaches. This review
highlights the relevance of STE in prognosticating outcomes for patients
undergoing TEER. Further investigations are essential to clarify the
long-term repercussions of TEER on cardiac functionality, thereby refining
patient selection and management strategies. Copyright © 2025
Journal of Cardiovascular Echography.

<16>
Accession Number
2042008358
Title
The relevance of acute kidney injury in dehydrated children.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1698954. Date of Publication: 2025.
Author
Ruzgiene D.; Virsilas E.; Jankauskiene A.
Institution
(Ruzgiene, Virsilas, Jankauskiene) Clinic of Children's Diseases,
Institute of Clinical Medicine, Faculty of Medicine, Vilnius University,
Vilnius, Lithuania
Publisher
Frontiers Media SA
Abstract
Introduction: Dehydration is the leading cause of acute kidney injury in
children, yet its true burden and clinical relevance in the general
pediatric population remain poorly characterized. The majority of existing
research on pediatric acute kidney injury primarily focuses on cases
occurring after cardiac surgery or in critically ill children, leaving
dehydration-associated AKI understudied. Method(s): A PRISMA-guided
systematic search of PubMed and EBSCO databases was conducted to identify
studies published from 2010 to 2025 investigating pediatric acute kidney
injury due to dehydration. The risk of bias was assessed using the
Newcastle-Ottawa Scale for observational studies and the modified Cochrane
Collaboration Risk of Bias 2.0 tool for randomized controlled trials.
Outcomes examined included incidence, severity, short-term and long-term
effects of acute kidney injury, and risk factors. Result(s): Out of
2,251 records, 31 studies met the inclusion criteria. Most were cohort or
case-control studies of good quality, while one randomized controlled
trial was identified as having a low risk of bias. The incidence of acute
kidney injury varied widely, with higher rates observed among younger
children. Hypovolemia, sepsis and shock were key risk factors for the
development of acute kidney injury. Stage I acute kidney injury was the
most commonly reported stage. Short-term outcomes included kidney
recovery, mortality, and hospitalization metrics; long-term data were
scarce, primarily focusing on kidney function preservation.
 Conclusion(s): Prerenal acute kidney injury dominates in high-risk
pediatric settings. Most pediatric acute kidney injury cases appear to be
unifactorial in origin. Further long-term follow-up studies are necessary
to better understand the enduring effects of acute kidney injury in
children and its potential progression to chronic kidney
disease. Copyright 2025 Ruzgiene, Virsilas and Jankauskiene.

<17>
Accession Number
2042425153
Title
Effects of different noninvasive oxygenation strategies in critically ill
adults after extubation: An umbrella review of meta-analyses.
Source
Respiratory Medicine. 250 (no pagination), 2025. Article Number: 108526.
Date of Publication: 01 Dec 2025.
Author
Xu Y.; Yang S.; Liu C.; Zhang J.; Ding M.
Institution
(Xu, Yang, Liu, Zhang, Ding) Department of Medicine Intensive Care Unit,
Shandong Provincial Hospital Affiliated to Shandong First Medical
University, Jinan, China
Publisher
W.B. Saunders Ltd
Abstract
Purpose: To synthesize meta-analyses evaluating noninvasive oxygenation
including high-flow nasal cannula (HFNC), non-invasive ventilation (NIV),
combined in critically ill adults post-extubation, guiding clinical
practice. Method(s): Methodological quality was evaluated using the
AMSTAR-2 tool for systematic reviews, while the certainty of evidence was
appraised using the GRADE system. Data from existing meta-analyses were
analyzed using Stata, with descriptive summaries. Outcomes included
reintubation, mortality, respiratory failure, escalation needs, comfort,
and length of hospital stay (LOS). Result(s): Among 22 studies, HFNC
and NIV reduced reintubation vs. conventional oxygen therapy (COT) (HFNC:
ES = 0.51, 95 %CI: 0.45, 0.58; NIV: ES = 0.57, 95 %CI: 0.51, 0.65), with
combined therapy showing greater benefit. NIV lowered ICU/hospital
mortality (ICU: ES = 0.54, 95 %CI: 0.41, 0.70; hospital: ES = 0.73, 95
%CI: 0.62, 0.84), while HFNC did not. HFNC or NIV reduced the incidence of
respiratory failure (HFNC: ES = 0.55, 95 %CI: 0.43, 0.69; NIV: ES = 0.53,
95 %CI: 0.38, 0.75) and escalation of respiratory support (HFNC: ES =
0.51, 95 %CI: 0.41, 0.64), though NIV was associated with greater
discomfort (NIV: ES = 13.88, 95 %CI: 6.44, 29.90). No significant
differences were found in ICU or hospital LOS for most comparisons.
 Conclusion(s): HFNC, NIV, and their combination significantly may
reduce reintubation risk in post-extubation critically ill adults, with
NIV additionally lowering mortality but causing more discomfort. The
evidence suggests while HFNC reduces respiratory failure and escalation
needs versus COT, neither HFNC nor NIV alone shows superior efficacy over
the other, and neither affects LOS. Future research should focus on
high-risk groups and combination vs. monotherapy
comparisons. Copyright © 2025 Elsevier Ltd. All rights are
reserved, including those for text and data mining, AI training, and
similar technologies.

<18>
Accession Number
2034207377
Title
Geranylgeranylacetone as Prevention for Postoperative Atrial Fibrillation
(GENIALITY).
Source
Cardiovascular Drugs and Therapy. 39(6) (pp 1589-1595), 2025. Date of
Publication: 01 Dec 2025.
Author
S. Ramos K.; Nassiri S.; Wijdeveld L.F.J.; van der Palen R.L.; Kuipers
M.F.; Hills M.T.; Slijkerman P.; van Raalte D.H.; Handoko M.L.; de Groot
N.M.S.; Grewal N.; Klautz R.J.M.; Eringa E.C.; Brundel B.J.J.M.
Institution
(S. Ramos, Wijdeveld, van der Palen, Eringa, Brundel) Amsterdam
Cardiovascular Sciences, Heart Failure and Arrhythmias, Amsterdam
University Medical Center, Location Vrije Universiteit Amsterdam, De
Boelelaan 1117, Physiology, Netherlands
(Nassiri, Handoko) Department of Cardiology, Amsterdam University Medical
Center, Amsterdam, Netherlands
(Kuipers) AFIP Foundation, Amsterdam, Netherlands
(Hills) Stopafib.Org, American Foundation for Women'S Health, Decatur, TX,
United States
(Slijkerman) Innovation Exchange Amsterdam, Amsterdam University Medical
Center, Amsterdam, Netherlands
(van Raalte) Diabetes Center, Department of Internal Medicine, Amsterdam
University Medical Center, Amsterdam, Netherlands
(de Groot) Department of Cardiology, Erasmus Medical Center, Rotterdam,
Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Grewal, Klautz) Department of Cardiothoracic Surgery, Leiden University
Medical Center, Leiden, Netherlands
(Eringa) Department of Physiology, Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
Publisher
Springer
Abstract
Purpose: Abstract: Interestingly, 30-50% of patients undergoing elective
cardiothoracic surgery develop postoperative AF (PoAF). Unfortunately,
preventive PoAF therapy is still suboptimal. In our previous studies, we
showed that oral Geranylgeranylacetone (GGA) administration increased
cardioprotective heat shock protein (HSP) protecting against AF onset and
progression in clinically relevant animal model studies. Method(s):
The GENIALITY study is a phase II single-center, double-blind,
placebo-controlled randomized trial comparing the efficacy of GGA in
preventing PoAF. Participants (N = 146) are adult patients, without any
registered history of AF, undergoing elective open-heart surgery for
valvular disease, coronary artery bypass grafting, or concomitant, and are
allocated with ratio 1:1 in treatment or placebo groups. Daily
administration of 300 mg of GGA or placebo starts 5 days before until 3
days after surgery. Cardiac rhythm will be monitored using a Holter
monitoring post-surgery until hospital discharge. Additionally, blood
samples, right atrial appendage tissue, and epicardial adipose tissue will
be collected to assess proteostasis levels. Result(s): The primary
endpoint is the assessment of PoAF incidence in the GGA group compared to
the placebo group. Secondary endpoints include the evaluation of HSP
levels through biochemical analysis in both blood and atrial tissue.
 Conclusion(s): The GENIALITY study aims to reduce PoAF incidence in
the GGA group compared to the placebo group. Herewith, we expect to obtain
proof of concept for a beneficial effect of GGA in preventing PoAF in
patients undergoing cardiothoracic surgery. Trial Registration: Clinical
Trial Information System (CTIS) registry: 2024-514743-28-00. Authorized on
September 30th 2024. Copyright © The Author(s) 2025.

<19>
Accession Number
2038419593
Title
Successful Prevention of Intrapericardial Adhesions After Central
Extracorporeal Life Support Implantation by Synthetic Polyethylene
Glycols-Based "BAX602": Outcomes of a Multicenter Randomized Comparative
Study.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S22), 2025. Date of Publication: 01 Apr 2025.
Author
Fukushima S.; Tonai K.; Ushijima T.; Kinoshita O.; Shiose A.; Ono M.;
Fujita T.
Institution
(Fukushima) Adult Cardiac Surgery, National Cerebral and Cardiovascular
Center, Suita, Japan
(Tonai) National Cerebral and Cardiovascular Center, Suita, Japan
(Ushijima, Shiose) Kyushu University Hospital, Fukuoka, Japan
(Kinoshita) Saitama Medical University International Medical Center,
Hidaka, Japan
(Ono) The University of Tokyo Hospital, Tokyo, Japan
(Fujita) Cardiovascular Surgery, Institute of Science Tokyo, Tokyo, Japan
Publisher
Elsevier Inc.
Abstract
Purpose: Intrapericardial adhesions are risk of any cardiac surgical
procedures. The study purpose was to evaluate effects of BAX602, known as
COSEAL, spray over cardiac surface on prevention of intrapericardial
adhesions in patients undergoing extracorporeal life support (ECLS)
implantation by central cannulation via median sternotomy. Method(s):
This study was an investigator-initiated, multicenter, two-arm,
open-label, randomized trial, with a total of 30 cases being enrolled,
registered in UMIN Clinical Trials Registry (000038998). The cases were
assigned to have BAX602 sprayed over the cardiac surface or no treatment
before the sternum approximation in the central ECLS implantation surgery
for cardiogenic shock. The primary outcome measure was the severity of
intrapericardial adhesions, which was evaluated by at the redo sternotomy
surgery performed in 2 weeks or later after the primary ECLS surgery.
 Result(s): The primary outcome was evaluated in 26 cases (13 each
group). The total score of the adhesion severity, which was the sum of
four-grade adhesion score, raging 0 to 3, in the five predefined
intrapericardial sites, was 3.5+/-2.4 in the BAX602 group, which was
significantly smaller than that of 12.1+/-2.7 in the control group
(P<0.0001). In addition, the total number of adhesions with dense/vascular
or cohesive adhesions, which was graded as 2 or 3, across all five sites
was significantly smaller in the BAX602 group than that in the control
group (p<0.0001). Moreover, time of adhesiolysis in the redo surgery was
significant shorter in the BAX602 group than that of the control group.
There was no significant difference in the safety assessment between the
two groups. Conclusion(s): BAX602 spray over cardiac surface was
effective in preventing intrapericardial adhesions after central ECLS
implantation, suggesting that potentially redo sternotomy
surgery-requiring cases, such as bridge-to-transplant candidates, would
benefit from BAX602 spray in the primary cardiac surgery. Copyright
© 2025

<20>
Accession Number
2038421099
Title
Evaluating Postoperative Outcomes of Heart Transplant Recipients from
Active COVID19 Positive and Negative Donors Using Induction Therapy.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S403-S404), 2025. Date of Publication: 01 Apr 2025.
Author
Mohamed M.
Institution
(Mohamed) University of Connecticut School of Medicine, Farmington, CT,
United States
Publisher
Elsevier Inc.
Abstract
Purpose: A recent meta-analysis of the UNOS database has revealed
increased long-term all-cause mortality in heart transplant recipients
from COVID-19 positive donors, raising concerns over appropriate
immunosuppression strategies. Studies suggest that Anti-thymocyte globulin
(ATG) induction may offer a mortality benefit. This study aims to compare
patient outcomes between induction and maintenance immunotherapy in
managing heart transplant recipients of COVID-19 positive donors using
UNOS data. Method(s): We retrospectively analyzed all adult patients
(age >= 18 years) that are included in the UNOS database who underwent
heart transplantation between 2020 and 2024. Patients with prior
transplants, unknown COVID-19 status, and multiple organ transplants were
excluded. We assessed the impact of induction therapy that included an IL2
receptor antagonist and ATG compared to that of maintenance therapy in a
chi-squared analysis. All-cause mortality was the primary outcome measure.
 Result(s): 5793 patients were included in the final analysis. No
significant differences were found in demographics between those using
induction and maintenance therapy except in education status and gender (p
< .0001). A total of 2039 (35.2%) patients with known covid status
received induction therapy and 2441(64.8%) received maintenance therapy.
In both maintenance and induction therapy groups, COVID positive followed
up less than COVID negative patients (p = < .00001). In the Induction
therapy group, COVID positive were more likely to have a failed graft than
COVID negative patients (P = 0.01605). There was no difference in
mortality status or hospitalizations due to infection at a follow-up of 12
months. Conclusion(s): Our results showed no difference in mortality
or number of hospitalizations between HTx patients using induction and
maintenance therapy. Despite these results, HTx recipients of COVID
positive donors were interestingly less likely to follow up at 6 and 12
months compared to HTx recipients of COVID negative donors. Additionally,
HTx recipients of COVID positive donors were more likely to have graft
failures at 12 months follow up compared to HTx recipients of COVID
negative donors in the induction therapy group. We conclude that there is
no indication that induction therapy confers a mortality benefit over
maintenance therapy. Copyright © 2025

<21>
Accession Number
2038419438
Title
Utility of Cell Mediated Immunity Assay T-SPOT.CMV to Predict Likelihood
of Post-Prophylaxis Infection in Seropositive for Cytomegalovirus Heart
Transplant Recipients.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S46-S47), 2025. Date of Publication: 01 Apr 2025.
Author
Garcia-Romero E.; Diez-Lopez C.; Bestard O.; Trenado V.D.; Garcia-Cosio
M.; Ortiz-Bautista C.; Perez F.H.; Couto-Mallon D.; Gonzalez-Vilches F.;
Hernandez-Ruiz C.; Lopez-Lopez L.; Trillo A.G.; Molina M.G.; Vilalta L.R.;
Caballero S.I.; Casassas L.D.; Sabe N.; Gonzalez-Costello J.
Institution
(Garcia-Romero, Diez-Lopez) Department of Cardiology. Bioheart Group
(IDIBELL). Ciber Cardiovascular Group (CIBER-CV), Bellvitge University
Hospital, Barcelona, Spain
(Bestard, Casassas) Nephrology, Vall d'Hebron University Hospital,
Barcelona, Spain
(Trenado) Cardiology, La Fe University Hospital, Valencia, Spain
(Garcia-Cosio) Cardiology, 12 Octubre University Hospital, Madrid, Spain
(Ortiz-Bautista) Cardiology, Gregorio Maranon University Hospital, Madrid,
Spain
(Perez) Cardiology, Hospital Univ, Puerta De Hierro, Madrid, Spain
(Couto-Mallon) Cardiology, A Coruna University Hospital Complex, A Coruna,
Spain
(Gonzalez-Vilches) Cardiology, Marques de Valdecilla University Hospital,
Santander, Spain
(Hernandez-Ruiz) Cardiology, Valladolid University Hospital, Valladolid,
Spain
(Lopez-Lopez) Cardiology, Santa Creu i Sant Pau Hospital, Barcelona, Spain
(Trillo) Cardiology, Virgen del Rocio University Hospital, Sevilla, Spain
(Molina) Cardiology, Virgen de la Arrixaca University Hospital, Murcia,
Spain
(Vilalta, Caballero) Cardiology, Bellvitge University Hospital, Barcelona,
Spain
(Sabe) Infectious Diseases, Bellvitge University Hospital, Barcelona,
Spain
(Gonzalez-Costello) Department of Cardiology. Bioheart Group (IDIBELL).
Ciber Cardiovascular Group (CIBER-CV), Bellvitge Hospital, Barcelona,
Spain
Publisher
Elsevier Inc.
Abstract
Purpose: Use of Cell mediated immunity (CMI) assays in heart transplant
(HT) recipients has considerable potential to improve risk stratification
for CMV, allowing individualization of patient management around the
timing of infection prophylaxis. Using data from the ELISPOT-TC trial, we
have attempted to determine utility of T-SPOT.CMV to predict likehood of
post-prophylaxis infection. Method(s): This is a multicenter,
randomized, open-label, controlled phase IV trial, with a non-inferiority
design. Seropositive for CMV HT recipients have been randomly assigned
(2:1) to group 1: preventive strategy based on post-transplant CMI
(patients with low CMI will receive valganciclovir for 3 months and
patients with high CMI will be treated with pre-emptive therapy); or group
2: Standard of care, universal prophylaxis for 3 months. 190 patients from
11 Spanish hospitals have been included. Per protocol analysis have been
carried out. Result(s): Amongst all patients included in the trial,
86% presented a low CMI 10 days post-HT and 58% maintained a low CMI three
months post-HT. Mean CMV-specific CMI against either IE-1 or pp65 was not
different between control and experimental group at three months post-HT.
Patients with a low CMI three months post-HT received more inotropic
treatment, more long-term mechanical circulatory support and presented a
higher rate of mechanical ventilation before HT. A slightly higher rate of
infection prior to HT was also observed. Basiliximab was used as induction
therapy in 75% of these patients. No significant differences were found in
the cumulative incidences of CMV infection, CMV infection requiring
treatment or CMV disease from the third month post-HT between patients
with a low CMI vs high CMI at three months post-HT. Conclusion(s):
Cell mediated immunity assay T-SPOT.CMV does not predict risk of
post-prophylaxis infection at 3 months in CMV seropositive HT recipients
[Formula presented] Copyright © 2025

<22>
Accession Number
2038419803
Title
Targeting Inflammation and Alloimmunity in Heart Transplant Recipients
with Tocilizumab: Preliminary Results of the "All in Heart" Randomized
Clinical Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S17), 2025. Date of Publication: 01 Apr 2025.
Author
Kobashigawa J.; Heeger P.; Bridges N.D.; Morrison Y.; Bagiella E.; Arroyo
L.; Hall S.; Kao A.; Lewis G.; Patel J.; Starling R.; Stehlik J.; Madsen
J.C.
Institution
(Kobashigawa, Patel) Cedars-Sinai Smidt Heart Institute, Los Angeles, CA,
United States
(Heeger) Cedars-Sinai Medical Center, Los Angeles, CA, United States
(Bridges, Morrison) National Institutes of Health, Bethesda, MD, United
States
(Bagiella) Mount Sinai, New York, NY, United States
(Arroyo) Tampa General Hospital, Tampa, FL, United States
(Hall) Baylor University Medical Center, Dallas, TX, United States
(Kao) St. Luke's Cardiovascular Consultants, Inc., Kansas City, MO, United
States
(Lewis, Madsen) Massachusetts General Hospital, Boston, MA, United States
(Starling) Cleveland Clinic, Cleveland, OH, United States
(Stehlik) University of Utah, Salt Lake City, UT, United States
Publisher
Elsevier Inc.
Abstract
Purpose: IL-6 signaling blockade using tocilizumab has emerged as an
exciting and effective new therapy in the field of autoimmunity. The
purpose of this multicenter double blind randomized clinical trial is to
compare the efficacy of standard of care triple maintenance
immunosuppression plus tocilizumab treatment versus standard of care
triple maintenance immunosuppression plus placebo on outcomes as defined
by a composite 1 year post-transplant endpoint of a) detection of
donor-specific antibodies (DSA), b) acute cellular rejection (ACR), c)
antibody mediated rejection (AMR), d) hemodynamic compromise (HDC)
rejection in absence of biopsy or histological rejection, e) death, and f)
re-transplantation. Method(s): 151 patients from 17 heart transplant
centers in the United States were randomized 1:1 to either standard of
care triple maintenance immunosuppression plus tocilizumab or standard of
care triple maintenance immunosuppression plus placebo. Study therapy
(tocilizumab/placebo) was administered within the first 72 hours and at
week 4, week 8, month 3, month 4 and month 5 post-transplant. Patients
were followed for 12 months. Endpoints: The primary endpoint is a
composite incidence of first occurrence of the following events: any
detection of de novo donor-specific antibodies (dnDSA), acute cellular
rejection (ACR) > ISHLT 2R rejection, antibody mediated rejection (AMR) >
ISHLT AMR 1, hemodynamic compromise rejection in the absence of a biopsy
or histological rejection, death or re-transplantation. Hemodynamic
compromise-rejection was defined as follows: a) ejection fraction of <40%
or a 20% decrease from baseline, and the need for inotropic agents, or b)
fractional shortening of <20% or a 25% decrease from baseline, and the
need for inotropic agents, plus c) the need for inotropic agents due to a
cardiac index (CI) <2.0 L/min/m2 or a 25% decrease from baseline.
Exploratory mechanistic endpoints were also assessed. Preliminary results
will be presented at the time of presentation. Exploratory mechanistic
endpoints will be reported separately. Copyright © 2025

<23>
Accession Number
2038419024
Title
Developing a Psychological Prehabilitation Programme for Prospective Adult
Heart Transplant Recipients.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S320-S321), 2025. Date of Publication: 01 Apr 2025.
Author
Sharp J.
Institution
(Sharp) Psychology, NHS Golden Jubilee, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation is the treatment of choice for selected
patients with advanced heart failure who have limiting symptoms despite
optimal conventional treatment and evidence of a poor prognosis. The
limited number of available donor hearts restricts this treatment to a
small fraction of potential recipients and demands that the scarce
resource of a donor heart is allocated to patients most able and likely to
benefit. Psychological factors influence health behaviours predictive of
post-operative morbidity, mortality and length of hospital stay.
Prehabilitation aims to optimise patients physiologically, nutritionally,
and psychologically prior to surgery. To date, only three studies have
investigated the benefits of prehabilitation for adult heart transplant
candidates and, of these, only one featured a psychological intervention.
We aimed to investigate the feasibility of investigating the efficacy of a
structured psychology-led support programme delivered between decision to
list for transplant and the heart transplant procedure. Method(s):
The current study was early phase research to establish processes to
inform a larger scale RCT. A cohort study was use with the intention to
study recruitment, randomisation, treatment, administration of outcome
measures, and acceptability of the intervention. This feasibility study
assessed uncertainties in relation to the potential of a larger study
including consideration of participants' perspective on the acceptability
of the intervention, willingness to participate, and appropriateness of
key components. Result(s): The study will report on outcomes
including:* Acceptability of the intervention to the users * Uptake and
adherence to the intervention * Ways to ensure representative recruitment
and engagement * The choice of primary outcomes and their characteristics
* Follow-up rates, response rates to questionnaires, adherence rates *
Practicality of delivering the intervention in the proposed setting
Conclusion The study will report on the uptake, acceptability and
feasibility of routinely delivered psychologically informed
prehabilitation and how the current findings will informed the design of a
larger trial to assessing intervention efficacy to confirm indications of
prehabilitation for prospective heart transplant recipients. Copyright
© 2025

<24>
Accession Number
2038420551
Title
Glomerular Filtration Rate Evolution in Post-Heart Transplant Patients
Using SGLT2 Inhibitors.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S638), 2025. Date of Publication: 01 Apr 2025.
Author
Guazzelli D.L.; Sguario R.M.; Macaciel J.; Carbonera A.; Treib T.C.;
Mendonca R.R.; Faria V.S.; Marcondes-Braga F.; Seguro L.; Aulicino G.;
Mangini S.; Avila M.; Campos I.W.; Bacal F.
Institution
(Guazzelli, Sguario, Macaciel, Carbonera, Treib, Mendonca, Faria,
Marcondes-Braga, Seguro, Aulicino, Mangini, Avila, Campos, Bacal) Heart
Institute (InCor), Hospital das Clinicas, Universidade de Sao Paulo, Sao
Paulo, Brazil
Publisher
Elsevier Inc.
Abstract
Purpose: SGLT-2 inhibitors (SGLT-2i), initially developed for
glucose-lowering, have shown renal benefits in high-risk T2D populations,
reducing cardiovascular mortality. SGLT-2i may benefit T2D patients
post-HT by lowering kidney risks, but data are limited since many studies
exclude immunosuppressed patients.The aim of this study was to describe
the HT patients with T2D in use of SGLT2i, focusing on its effect on
glomerular filtration rate (GFR) and hemoglobin A1c (HbA1c) after HT.
 Method(s): A retrospective cohort analysis evaluated HT patients
(2013-2023). T2D patients on SGLT-2i were analyzed using medical records
and the Redcap database. GFR (via CKD-EPI) was assessed before starting
medication and at 2, 4, 6, and 12 months post-initiation. HbA1c levels and
adverse events were also tracked. Result(s): Among 490 HT patients,
290 had T2D, and 37 used SGLT-2i during follow-up. The majority of
diabetic patients on SGLT2i were male (63%), had media of HbA1c 7.2 +/-
1.14 (SD). Metformin was used by 71%, gliclazide by 26%, and insulin by
36%. Regarding GRF, the media before treatment initiation was 52.55 +/-
22.52 (SD). During 1-year follow up, GFR curve showed an initial decrease
during the first two months of medication use, followed by an increase in
subsequent months (Figure 1). The evolution of the GFR over time
demonstrated a trend similar to previous studies on non-transplant
populations using SGLT2 inhibitors.The glycemic control was also reported
and there was a reduction in hemoglobin A1c of 0.5% compared to baseline
after one year of SGLT2 inhibitor use. (Figure 2)In terms of adverse
events, only three patients discontinued medication due to recurrent
GUTIs. Conclusion(s): This small retrospective cohort suggests
potential renal and glycemic benefits from SGLT-2i in post-HT T2D
patients, with a favorable safety profile. However, this study only
provides preliminary insights into the use of SGLT2i in HT patients.
Randomized controlled trials are needed to confirm the safety and efficacy
of SGLT-2i in this population. [Formula presented] Copyright ©
2025

<25>
Accession Number
2038420908
Title
Initial Analysis of Immune Phenotypes in Heart Transplant Recipients of
the ALL IN HEART (Tocilizumab) Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S384-S385), 2025. Date of Publication: 01 Apr 2025.
Author
Jain R.; Garcia B.; Mortensen E.; Falk B.; Kobashigawa J.; Madsen J.C.;
Heeger P.
Institution
(Jain, Garcia, Mortensen, Falk, Kobashigawa, Heeger) Cedars-Sinai Medical
Center, Los Angeles, CA, United States
(Madsen) Massachusetts General Hospital, Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Outcomes after heart transplant (Tx) are suboptimal. We
hypothesize that early post-transplant inflammation and other downstream
effects of interleukin-6 (IL-6) contribute to graft injury and survival.
The ALL IN HEART trial is a randomized, blinded, placebo-controlled
multicenter study testing the hypothesis that a 5-month course of
tocilizumab (anti-IL-6 receptor, IL6R) plus standard 3-drug
immunosuppression will improve Tx outcomes. The trial enrolled 135
subjects to be followed for 1 year. Herein, we report immune phenotypes of
a subset of 38 subjects to assess the potential immunological effects of
the study drug. Method(s): Peripheral blood samples from subjects
were collected at 1 week, 1-, 3-, 6- and 12-months post-Tx. As IL-6
signaling induces liver production of C-reactive protein (CRP) we analyzed
serum CRP levels in each subject. We also analyzed serum levels of 25
cytokines/chemokines by Luminex and quantified T cell subsets by flow
cytometry. Result(s): Analysis of 1-mo post-Tx CRP levels in the 38
subjects segregated them into 2 groups - high CRP (Group 1, mean CRP
9205.1 ng/mL, n=17) and low CRP (Group 2, mean CRP 179.7 ng/mL, n=21, p <
0.0001). Serum cytokine analyses showed lower TNFalpha and higher IL-10 in
Group 2 at 1 wk and 1 mo, respectively, without statistical differences
noted for most other cytokines. Flow cytometry analyses showed
significantly higher ratios of regulatory T cells (Tregs)
(CD4+CD25+CD3+CD127lo) / IL-17 producing T cells (Th17)
(CD4+CXCR3-CCR6+CXCR5+PD1+) in Group 2 (95% CI of difference 15.7, 154.3,
p = 0.02), during the initial 6 post-Tx months, without differences in
other T cell subsets (Figure 1). Conclusion(s): These data suggest
that IL6R blockade can promote a favorable immunoregulatory phenotype in
heart Tx recipients, but complete analyses of all study subjects and
unblinding of the data will be required to make definitive conclusions.
Whether and how these immune phenotypes associate with study endpoints
will be reported as the data become available. [Formula
presented] Copyright © 2025

<26>
Accession Number
2038420987
Title
Evolocumab Reduces Progression of Cardiac Allograft Vasculopathy in Heart
Transplant Recipients with Increased Intimal Thickness at Baseline: A
Post-HOC Analysis of the EVOLVD Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S18-S19), 2025. Date of Publication: 01 Apr 2025.
Author
Arora S.; Gullestad L.; Lemstrom K.; Gustafsson F.; Eiskjaer H.; Karason
K.; Gjesdal G.; Pentikainen M.; Lommi J.; Gude E.; Andreassen A.;
Clemmensen T.; Christiansen E.H.; Bjorkelund E.; Broch K.
Institution
(Arora, Gullestad, Gude, Andreassen, Bjorkelund, Broch) Oslo University
Hospital, Oslo, Norway
(Lemstrom) University of Helsinki, Helsinki, Finland
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Eiskjaer, Clemmensen, Christiansen) Aarhus University Hospital, Aarhus,
Denmark
(Karason) Transplant Institute, Sahlgrenska University Hospital,
Sahlgrenska, Sweden
(Gjesdal) Lund University Hospital, Lunde, Sweden
(Pentikainen, Lommi) Helsinki University Hospital, Helsinki, Finland
Publisher
Elsevier Inc.
Abstract
Purpose: Cardiac allograft vasculopathy (CAV) is a leading cause of
morbidity and mortality in heart transplant (HTx) recipients. The EVOLVD
trial demonstrated that evolocumab, a PCSK9 inhibitor, significantly
reduced low-density lipoprotein (LDL) cholesterol but did not reduce
maximal intimal thickness (MIT) or percent atheroma volume (PAV) overall.
This post-hoc analysis evaluated CAV progression based on baseline MIT and
PAV to assess evolocumab's efficacy across different levels of disease
severity. Method(s): The EVOLVD trial enrolled 128 HTx recipients
from Nordic transplant centers between June 2019 and May 2022. Four to
eight weeks post-HTx, patients were randomized to monthly subcutaneous
injections of evolocumab 420 mg or placebo. Baseline MIT and PAV were
measured using intracoronary ultrasound. The primary outcomes were MIT and
PAV at 12 months, analyzed with ANCOVA, adjusting for baseline values.
Matched coronary ultrasound images were available for 56 patients
allocated to evolocumab and 54 patients allocated to placebo.
 Result(s): In patients with baseline MIT above the median, mean CAV
progression was 0.02 +/- 0.07 mm in the evolocumab group versus 0.07 +/-
0.08 mm in the placebo group (adjusted mean difference: 0.05 mm, p =
0.015). In patients with baseline MIT below the median, progression was
0.04 +/- 0.04 mm with evolocumab versus 0.02 +/- 0.03 mm with placebo
(adjusted mean difference: -0.02 mm, p = 0.184). Patients with baseline
PAV above the median had a mean increase of 0.77% +/- 2.35% in the
evolocumab group versus 2.63% +/- 2.55% in the placebo group (adjusted
mean difference: 1.86%, p = 0.014). In patients with baseline PAV below
the median, the increase was 1.94% +/- 2.86% with evolocumab versus 1.17%
+/- 1.58% with placebo (adjusted mean difference: -0.77%, p = 0.256).
 Conclusion(s): Twelve months of evolocumab treatment reduced CAV
progression in patients with elevated baseline MIT and PAV. In patients
with less disease at baseline, progression was minimal and not
significantly different between groups. These findings suggest that
baseline MIT and PAV may help identify HTx recipients most likely to
benefit from PCSK9 inhibition. Further research is needed to confirm these
results and inform personalized treatment strategies. Copyright ©
2025

<27>
Accession Number
2038421290
Title
Norepinephrine Donor Support and Outcomes in Heart Transplantation: A
Single-Center Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S509-S510), 2025. Date of Publication: 01 Apr 2025.
Author
Parigino D.; Giovannico L.; Fischetti G.; Savino L.; Mazzone F.; Leo C.;
Cristiano G.; Bari N.D.; Padalino M.; Bottio T.
Institution
(Parigino, Fischetti, Savino, Mazzone, Leo, Cristiano, Bari, Padalino,
Bottio) University of Bari, Bari, Italy
(Giovannico) Cardiac Surgery Unit - University Hospital Bari, Bari, Italy
Publisher
Elsevier Inc.
Abstract
Purpose: The growing disparity between available donor hearts and patients
on the waiting list has led to increased use of donors with extended
criteria. Donors requiring high-dose catecholamine support, especially
norepinephrine (NE), are often considered with caution. This study aims to
evaluate the impact of high-dose NE donor support on post-transplant
outcomes in HTx recipients in our transplant center. Method(s): We
retrospectively analyzed 109 HTx recipients transplanted between June 2022
and September 2024 in Bari. The dataset was stratified based on NE dose
administered to donors prior to procurement, dividing into three groups:
Group 1: 0 mcg/kg/min, Group 2: 0.01 to 0.2 mcg/kg/min, Group 3: >0.2
mcg/kg/min. Primary outcome measures included overall survival, 30-day and
1-year mortality, incidence of primary graft dysfunction (PGD), and other
secondary outcomes such as prolonged ICU stay, ventilatory support, and
renal replacement therapy. Statistical analyses were performed using a
multivariate Cox proportional hazards models. Result(s): Out of 109
patients, 11 received hearts without NE support, while 89,9 % received
hearts supported with NE (Group 2 and 3). No significant differences in
overall survival were observed across the groups (Group 2 vs 1: HR 1,11;
Group 3 vs 1: HR 0,98; p = 0,656). Similarly, 30-day and 1-year mortality
rates did not differ significantly between the groups. However, a higher
incidence of prolonged ICU stay was observed in Groups 2 and 3 compared to
Group 1 (p = 0,005). Conclusion(s): Our findings align with previous
studies: use of NE-supported donor hearts, even at high doses, does not
compromise recipient outcomes, provided careful donor selection. The
higher incidence of prolonged ICU stays observed may reflect the severity
of donors' pre-procurement conditions rather than the direct effect of NE
on organs. Cautiously expanding the criteria for donor heart acceptance to
include those supported by higher-dose vasoconstrictors could potentially
increase the available donor pool without compromising recipient survival
outcomes. In conclusion, the data from this analysis suggest that
high-dose NE donor support is not associated with increased mortality or
severe complications in heart transplant recipients. With appropriate
donor selection, these organs may safely contribute to addressing the
shortage of donor hearts for transplantation. Copyright © 2025

<28>
Accession Number
2038419002
Title
Cytomegalovirus Specific Cell Mediated Immunity in Cytomegalovirus
Seropositive Heart Transplant Recipients According to the Serological
Status of the Donor.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S415-S416), 2025. Date of Publication: 01 Apr 2025.
Author
Garcia-Romero E.; Diez-Lopez C.; Bestard O.; Trenado V.D.; Garcia-Cosio
M.; Ortiz-Bautista C.; Perez F.H.; Couto-Mallon D.; Gonzalez-Vilches F.;
Hernandez-Ruiz C.; Lopez-Lopez L.; Trillo A.G.; Molina M.G.; Vilalta L.R.;
Caballero S.I.; Casassas L.D.; Sabe N.; Gonzalez-Costello J.
Institution
(Garcia-Romero, Diez-Lopez, Gonzalez-Costello) Department of Cardiology.
Bioheart Group (IDIBELL). Ciber Cardiovascular Group (CIBER-CV), Bellvitge
University Hospital, Barcelona, Spain
(Bestard, Casassas) Nephrology, Vall d'Hebron University Hospital,
Barcelona, Spain
(Trenado) La Fe University Hospital, Valencia, Spain
(Garcia-Cosio) 12 Octubre University Hospital, Madrid, Spain
(Ortiz-Bautista) Cardiology, Gregorio Maranon University Hospital, Madrid,
Spain
(Perez) Cardiology, Puerta de Hierro University Hospital, Madrid, Spain
(Couto-Mallon) Cardiology, A Coruna University Hospital Complex, A Coruna,
Spain
(Gonzalez-Vilches) Cardiology, Marques de Valdecilla University Hospital,
Santander, Spain
(Hernandez-Ruiz) Cardiology, Valladolid University Hospital, Valladolid,
Spain
(Lopez-Lopez) Cardiology, Santa Creu i Sant Pau Hospital, Barcelona, Spain
(Trillo) Cardiology, Virgen del Rocio University Hospital, Sevilla, Spain
(Molina) Cardiology, Virgen de la Arrixaca University Hospital, Murcia,
Spain
(Vilalta, Caballero) Cardiology, Bellvitge University Hospital, Barcelona,
Spain
(Sabe) Infectious Diseases, Bellvitge University Hospital, Barcelona,
Spain
Publisher
Elsevier Inc.
Abstract
Purpose: Improving risk stratification for Cytomegalovirus (CMV) infection
in heart transplant (HT) patients using cell mediated immunity (CMI)
assays is needed to guide preventive strategies. This pre-specified
secondary analysis from the ELISPOT-TC trial aimed to evaluate the utility
of CMV-specific ELISPOT post-HT according to the CMV serological status of
the donor. Method(s): The ELISPOT-TC was a multicenter, randomized,
controlled phase IV trial, with a non-inferiority design. CMV seropositive
HT recipients were randomly assigned (2:1) to preventive strategy based on
10 days post-transplant CMI (patients with low CMI received valgancyclovir
for 3 months and those with high CMI were treated with pre-emptive
therapy); or Universal prophylaxis with Valgancyclovir for 3 months. 190
patients were included. Per protocol analysis have been previously
published. Result(s): Amongst all patients included, 68 % were D+/R+
and 25 % were D-/R+. About 80% received basiliximab. D+/R+ patients
received more inotropes, had a higher rate of short-term mechanical
circulatory support and infection prior to HT. Mean CMI against IE-1 or
pp65 was not different between both groups at none of the time points
(pre-HT, 10 days post-HT and 3 months post-HT). Amongst D+/R+ patients,
85% and 62% had low CMI at 10 days and 3 months post-HT vs 90% and 52%,
respectively in the D-/R+ group. Despite no significant differences
according to the ELISPOT assay, a higher risk of CMV infection and CMV
infection requiring treatment during the first year post-HT was observed
in the D+/R+ group (57% vs 38% HR 1.8 [1.06-3.07] and 36% vs 12% HR 3.36
[1.32-8.53]). Conclusion(s): Approximately 90% of CMV seropositive HT
patients present low CMV-specific CMI 10 days post-HT, regardless of the
serological status of the donor. However, an increased risk of CMV
infection and CMV infection requiring treatment has been observed amongst
D+/R+ patients, with no difference in the rate of CMV disease. [Formula
presented] Copyright © 2025

<29>
Accession Number
2038419004
Title
Exploring Mobile Health Technologies to Promote Medication Adherence in
Pediatric Heart Transplant Recipients: A Scoping Review.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S320), 2025. Date of Publication: 01 Apr 2025.
Author
Killian M.; Brumm S.; Mayewski S.; Gupta D.
Institution
(Killian, Brumm, Mayewski) Florida State University, Tallahassee, FL,
United States
(Gupta) UF College of Medicine, Gainesville, FL, United States
Publisher
Elsevier Inc.
Abstract
Purpose: The purpose of this scoping review was to examine the existing
research literature on the use of mobile health (mHealth) technologies in
promoting medication adherence among pediatric transplant recipients. This
review identified the range of mHealth interventions, assess their
effectiveness, and highlight current knowledge gaps to guide future
research in this area. Method(s): A comprehensive scoping review was
conducted using the PRISMA-ScR framework to systematically identify and
evaluate literature on mHealth technologies and medication adherence in
pediatric transplant patients. Multiple databases, including PubMed,
PsycINFO, CINAHL, and Cochrane Library, were searched using a combination
of keywords such as "mHealth," "mobile health," "medication adherence,"
"transplant," and "pediatric." Studies on mHealth interventions like
mobile apps, text messaging services, and other digital health tools were
included. Data extraction focused on study designs, sample
characteristics, outcomes, and the reported impact of these technologies.
 Result(s): The literature indicated that mHealth technologies,
including smartphone applications and SMS-based reminders, have the
potential to significantly enhance medication adherence in pediatric heart
transplant recipients. Mobile apps with customizable reminders,
gamification elements, educational content, and real-time tracking can
actively engage patients. Text messaging interventions may provide
motivational and behavioral support, offering regular prompts that help
address barriers like forgetfulness. Despite these promising findings,
current research is limited in evaluating the long-term sustainability of
these interventions and overall impact on outcomes, such as graft
survival, hospitalizations, and quality of life. Conclusion(s): This
scoping review demonstrates that mHealth technologies represent a strategy
for promoting medication adherence in pediatric heart transplant
recipients. The findings underscore the potential benefits of
personalized, accessible, and engaging digital tools in fostering better
adherence behaviors. However, there is a need for further research to
explore the long-term effects and integration of these technologies into
routine healthcare settings to support adherence and improve
post-transplant outcomes. Copyright © 2025

<30>
Accession Number
2040605286
Title
Efficacy and safety of tranexamic acid in cardiac surgery: a systematic
review and network meta-analysis.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 503. Date
of Publication: 14 Oct 2025.
Author
Pan X.; Tang M.; Xu Z.; Yu H.; Huang J.; Liang P.
Institution
(Pan, Xu, Yu, Liang) Department of Anesthesiology, West China Hospital,
Sichuan University, Chengdu, China
(Tang) West China School of Medicine, Sichuan University, Chengdu, China
(Huang) Department of Anesthesiology & Perioperative Medicine, University
of Louisville, Louisville, KY, United States
(Liang) Day Surgery Center, General Practice Medical Center, West China
Hospital, Sichuan University, No.37 Guoxue, Chengdu, China
Publisher
BioMed Central Ltd
Abstract
Background: Tranexamic acid (TXA) is recommended for reducing blood loss
and transfusion in cardiac surgery. However, there are concerns regarding
the safety profile of TXA, especially its proconvulsant effects. We
conducted this study to investigate the efficacy and safety of tranexamic
acid in cardiac surgery. Method(s): We searched PubMed, Embase and
Cochrane Central Register of Controlled Trials from inception to December
11, 2024. Randomised controlled trials assessed the hemostatic effects of
TXA in cardiac surgery were included. Two authors independently selected
studies and assessed the quality of eligible trials. The main endpoints
were red blood cell transfusion and thrombotic outcomes. The results were
calculated with pairwise and network meta-analysis. Result(s): Data
was provided by 18,141 participants from 64 trials. High-dose continuous
(OR: 0.38, 95%CI: [0.31, 0.47]), low-dose continuous (OR: 0.44, 95%CI:
[0.34, 0.56]), high-dose single (OR: 0.50, 95%CI: [0.43, 0.57]), and
low-dose single (OR: 0.52, 95%CI: [0.40, 0.67]) TXA significantly reduce
the rate of red blood cell transfusion. Furthermore, in high-risk
patients, high-dose continuous administration further reduces transfusion
risk compared to low-dose continuous administration (OR: 1.22, 95%CI:
[1.01, 1.75]). Topical TXA does not significantly reduce the rate of red
blood cell transfusion (OR: 0.80, 95%CI: [0.60, 1.07]); conversely, it is
associated with a higher rate of red blood cell transfusion compared to
intravenous administration. Both intravenous and topical TXA
administration reduce postoperative blood loss. High-dose continuous
administration further reduces the risk of reoperation (OR: 1.70, 95%CI:
[1.03, 2.80]) and the need for fresh frozen plasma transfusion (OR: 1.33,
95%CI: [1.01, 1.74]) compared to low-dose continuous administration.
Neither intravenous nor topical TXA increases the incidence of
postoperative thrombotic complications. High-dose single administration is
associated with a significantly increased risk of postoperative seizures
(OR: 6.66, 95%CI: [1.85, 24.02]). Conclusion(s): This meta-analysis
further confirms that intravenous TXA administration, regardless of dose
or administration regimen, significantly reduces postoperative blood loss
and red blood cell transfusions in adult cardiac surgery, without
increasing the incidence of serious adverse events except for seizures.
Future studies should incorporate patient-specific factors, comorbidities,
and bleeding risks to determine the optimal TXA dosing strategy that
balances risks and benefits. Trial registration: Our prespecified protocol
was registered with PROSPERO (CRD42022380404). Copyright © The
Author(s) 2025.

<31>
Accession Number
2022297808
Title
Effect of Decompressive Craniectomy with Stepwise Decompression of the
Intracranial Compartment on Postoperative Neurologic Function,
Hemodynamics, and Glasgow Outcome Scale Score of Patients with Severe
Traumatic Brain Injury.
Source
Journal of Neurological Surgery, Part A: Central European Neurosurgery.
84(6) (pp 536-541), 2023. Date of Publication: 01 Nov 2023.
Author
Wu H.; Jiang B.; Yan X.; Zhan C.; Dai W.; Yu G.
Institution
(Wu, Jiang, Yan, Zhan, Dai, Yu) Department of Neurosurgery, Quzhou
Affiliated Hospital of Wenzhou Medical University, Quzhou People's
Hospital, Zhejiang Province, Quzhou, China
Publisher
Georg Thieme Verlag
Abstract
Background: We assess the effects of standard decompressive craniectomy
with stepwise decompression of the intracranial compartment on the
postoperative neurologic function, hemodynamics, and Glasgow Outcome Scale
(GOS) score of patients with severe traumatic brain injury (sTBI).
 Method(s): One hundred sTBI patients admitted from July 2017 to
February 2019 were enrolled and randomly divided into step and standard
groups (n = 50) using a random number table. The standard group received
traditional standard decompression during surgery, while the step group
underwent multistep decompression during surgery. Heart rate (HR),
systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean
arterial pressure (MAP) were measured immediately after surgery (T0), 3
hours after surgery (T1), 6 hours after surgery (T2), and 12 hours after
surgery (T3). The postoperative Glasgow Coma Scale (GCS) score, neurologic
function deficit score, and GOS score were evaluated. Result(s):
After treatment, the excellent/good rate of neurologic function
improvement and GCS and GOS scores of the step group significantly
exceeded those of the standard group (p < 0.05). Compared with the
standard group, the HR, SBP, DBP, and MAP decreased significantly in the
step group at T1, T2, and T3 (p < 0.05). Conclusion(s): Standard
decompressive craniectomy under multistep decompression can markedly
improve the neurologic function, hemodynamics, and prognosis of
patients. Copyright © 2022. Thieme. All rights reserved.

<32>
Accession Number
2035796594
Title
Long-term Survival in Elderly Patients after Coronary Artery Bypass
Grafting Compared to the Age-matched General Population: A Meta-analysis
of Reconstructed Time-to-Event Data.
Source
Thoracic and Cardiovascular Surgeon. 74(1) (pp 1-7), 2026. Date of
Publication: 01 Jan 2026.
Author
Kirov H.; Caldonazo T.; Toshmatov S.; Tasoudis P.; Mukharyamov M.; Diab
M.; Doenst T.
Institution
(Kirov, Caldonazo, Toshmatov, Mukharyamov, Diab, Doenst) Department of
Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany
(Tasoudis) Division of Cardiothoracic Surgery, University of North
Carolina, Chapel Hill, NC, United States
Publisher
Georg Thieme Verlag
Abstract
Background Coronary artery disease (CAD) limits life expectancy compared
to the general population. Myocardial infarctions (MIs) are the primary
cause of death. The incidence of MI increases progressively with age and
most MI deaths occur in the population older than 70 years. Coronary
artery bypass grafting (CABG) may prevent the occurrence of new MIs by
bypassing most CAD lesions, providing downstream collateralization to the
diseased vessel, and consequently prolonging survival. We systematically
assessed the survival-improving potential of CABG by comparing elderly
CABG patients to the age-matched general population. Methods Three
databases were assessed. The primary and single outcome was long-term
all-cause mortality. Time-to-event data of the individual studies were
extracted and reconstructed in an overall survival curve. As a sensitivity
analysis, summary hazard ratios (HRs) and 95% confidence intervals (CIs)
for all individual studies were pooled and meta-analytically addressed.
The control group was based on the age-matched general population of each
individual study. Results From 1,352 records, 4 studies (4,045 patients)
were included in the analysis. Elderly patients (>70 years) who underwent
CABG had a significantly lower risk of death in the follow-up compared to
the general age-matched population in the overall survival analysis (HR:
0.88; 95% CI: 0.83, 0.94; p < 0.001: mean follow-up was 7 years).
Conclusion Elderly patients who undergo CABG appear to have significantly
better long-term survival compared to the age-matched general population.
This advantage becomes visible after the first year and underscores the
life-prolonging effect of bypass surgery, which may eliminate the expected
reduction in life expectancy through CAD. Copyright © 2024.
Thieme. All rights reserved.

<33>
Accession Number
2041093676
Title
Effectiveness and safety of low-dose intraoperative tranexamic acid in
cardiac surgery: a retrospective before-and-after study.
Source
BMC Anesthesiology. 25(1) (no pagination), 2025. Article Number: 550. Date
of Publication: 07 Nov 2025.
Author
Chung J.; Kim I.J.; Ju J.-W.; Hong C.-H.; Cho Y.J.; Jeon Y.; Nam K.
Institution
(Chung, Kim, Ju, Hong, Cho, Jeon, Nam) Department of Anesthesiology and
Pain Medicine, Seoul National University Hospital, Seoul National
University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, South
Korea
Publisher
BioMed Central Ltd
Abstract
Background: Tranexamic acid (TXA) is widely used to reduce perioperative
bleeding and transfusion requirements; however, its optimal dosing,
efficacy, and safety remain uncertain, particularly in cardiac surgery
patients. Method(s): This single-center, retrospective
before-and-after study consecutively included adult patients who underwent
cardiac and/or thoracic aortic surgery with cardiopulmonary bypass between
2011 and 2024. Patients were categorized into the before-TXA and after-TXA
groups based on the implementation of a routine intraoperative low-dose
TXA protocol in December 2017. This protocol included a loading dose (5
mg/kg) drawn from a 500 mg ampoule and administered at anesthesia
induction, with the remaining dose added to the CPB priming volume. A
maintenance infusion was administered at 5 mg/kg/h throughout surgery. The
primary outcome was chest tube output during the first 12 h after surgery.
Secondary safety outcomes included thrombotic complications and
postoperative seizures. Outcomes were compared using interrupted time
series analysis after stabilized inverse probability of treatment
weighting. Result(s): A total of 4,425 patients were analyzed (2,131
in the before-TXA group and 2,294 in the after-TXA group). The median
(interquartile range) chest tube output during the first 12 h
postoperatively was 480 mL (270-860 mL) in the before-TXA group and 400 mL
(230-710 mL) in the after-TXA group. In the interrupted time series
analysis, the intercept of log-transformed monthly chest tube output
significantly decreased after TXA implementation (beta<inf>2</inf> =
-0.285; 95% confidence interval, -0.392 to -0.178). There was no
significant increase in thrombotic complications or postoperative seizures
following intraoperative TXA implementation. Conclusion(s): The
routine implementation of low-dose intraoperative TXA in cardiac surgery
was associated with a significant reduction in bleeding after cardiac
surgery, without an increased risk of thrombotic complications or
seizures. Copyright © The Author(s) 2025.

<34>
Accession Number
2040566307
Title
Bleomycin for Malignant Pericardial Effusion: A Systematic Review of
Efficacy and Adverse Events.
Source
Journal of Cardiovascular Pharmacology. 86(4) (pp 330-336), 2025. Date of
Publication: 25 Nov 2025.
Author
Siahaan P.P.; Kurniawan R.B.; Saputra P.B.T.; Arnindita J.N.; Savitri
C.G.; Andira L.H.; Meitavany E.N.; Putranto J.N.E.; Alkaff F.F.
Institution
(Siahaan, Kurniawan) Faculty of Medicine, Universitas Airlangga, Surabaya,
Indonesia
(Saputra, Arnindita, Savitri, Andira, Putranto) Department of Cardiology
and Vascular Medicine, Faculty of Medicine, Universitas Airlangga
(Saputra, Arnindita, Savitri, Andira, Putranto) Department of Cardiology
and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya,
Indonesia
(Meitavany) School of Biomedical Engineering and Imaging Sciences (BMEIS),
King's College London, London, United Kingdom
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, University of Groningen, Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
Lippincott Williams and Wilkins
Abstract
Abstract: - Malignant pericardial effusion (MPE) is a progressive fluid
accumulation in the pericardial space that can lead to pericardial
tamponade. Despite the high recurrence rate associated with
pericardiocentesis, it remains the mainstay therapy. Bleomycin has emerged
as an intrapericardial sclerosing therapy that may reduce recurrence and
improve patients' quality of life. This systematic review aimed to assess
the efficacy and safety profile of bleomycin instillation in patients with
MPE. An exhaustive search was conducted in PubMed, Web of Science, Scopus,
ProQuest, EBSCO, and ClinicalTrials.gov databases. Eligible studies
included MPE patients as participants who were treated with
intrapericardial bleomycin, reporting the patients' outcomes and using
English in the full text. Individual studies were assessed for quality
using the Newcastle-Ottawa Scales for cohort studies and the Jadad Scale
for trial studies. Eight studies were included in this systematic review
involving 242 MPE patients treated with bleomycin. Bleomycin demonstrated
lower recurrence rates than other sclerosing agents, with only <=5% of
patients requiring repeated drainage because of recurrence. Bleomycin
treatment resulted in 3.5 days less hospitalization compared with
doxycycline. Bleomycin is also safe to use, with reported less severe pain
compared with other treatment agents for MPE, such as doxycycline and
pericardiocentesis. Bleomycin may benefit patients by reducing recurrence
rates and improving patients' quality of life. Moreover, it is safe and
has low rates of adverse events after the instillation. Copyright
© 2025

<35>
Accession Number
2041122940
Title
Conversion to Cardiac Surgery During Elective and Urgent Transcatheter
Aortic Valve Implantation: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 210-220),
2026. Date of Publication: 01 Jan 2026.
Author
Ktenopoulos N.; Apostolos A.; Chlorogiannis D.-D.; Kachrimanidis I.;
Vlachakis P.; Sagris M.; Theodoropoulou T.; Drakopoulou M.; Synetos A.;
Latsios G.; Aggeli C.; Tsioufis K.; Toutouzas K.
Institution
(Ktenopoulos, Apostolos, Kachrimanidis, Vlachakis, Sagris, Theodoropoulou,
Drakopoulou, Synetos, Latsios, Aggeli, Tsioufis, Toutouzas) First
Department of Cardiology, Hippokration General Hospital of Athens,
National and Kapodistrian University of Athens, Athens, Greece
(Ktenopoulos, Apostolos, Kachrimanidis, Vlachakis, Sagris, Theodoropoulou,
Drakopoulou, Synetos, Latsios, Aggeli, Tsioufis, Toutouzas) Unit of
Structural Heart Diseases, First Department of Cardiology, Medical School,
Hippocration General Hospital of Athens, National and Kapodistrian
University of Athens, Athens, Greece
(Chlorogiannis) Department of Radiology, Brigham and Women's Hospital,
Boston, MA, United States
Publisher
John Wiley and Sons Inc
Abstract
Transcatheter aortic valve implantation (TAVI) has become an established
treatment for severe aortic stenosis. However, the need for unplanned
conversion to cardiac surgery (CS) during TAVI remains an infrequent but
critical event. It is unclear whether this risk is higher in patients
undergoing urgent procedures. We conducted a systematic review and
meta-analysis to compare the incidence of unplanned conversion to CS
between patients undergoing urgent versus elective TAVI. A systematic
search of PubMed, SCOPUS, and Cochrane databases was performed to identify
eligible studies. The primary outcome was the rate of unplanned conversion
to CS. Secondary outcomes included mortality, device success, vascular
complications, device embolization, acute kidney injury (AKI), stroke,
permanent pacemaker implantation (PPI), moderate-or-severe paravalvular
regurgitation (PVL), need for second valve implantation, bleeding, and
duration of hospitalization. Seven studies comprising 71,909 patients were
analyzed; 5108 underwent urgent TAVI and 66,801 underwent elective TAVI.
No significant difference in conversion to CS was observed between the
groups (RR: 0.89; 95% CI: 0.65-1.22). Device success rates were similar
(RR: 0.99; 95% CI: 0.97-1.00). Urgent TAVI was associated with prolonged
hospitalization (mean difference: 7.75 days; 95% CI: 4.06-11.45) and
increased AKI risk (RR: 2.20; 95% CI: 1.53-3.16). Vascular complications,
device embolization, stroke, PPI, PVL, second valve implantation, and
major bleeding rates were comparable between the groups. Urgent TAVI is
not associated with an increased risk of unplanned conversion to surgery.
The observed higher AKI rates and longer hospital stay suggest that
patient-related factors beyond procedural urgency may contribute to
adverse outcomes. Copyright © 2025 The Author(s). Catheterization
and Cardiovascular Interventions published by Wiley Periodicals LLC.

<36>
Accession Number
2042444816
Title
Effects of pre-and post-operative active cycle of breathing technique as
an add-on to routine chest physical therapy on respiratory parameters in
coronary artery bypass graft patients.
Source
Anaesthesia, Pain and Intensive Care. 29(8) (pp 962-970), 2025. Date of
Publication: 01 Nov 2025.
Author
Bukhari S.; Ashraf H.S.; Abbas Z.U.; Zulfiqar N.; Nawaz M.A.; Sharif Z.
Institution
(Bukhari) Department of Physical Therapy, The University of Faisalabad,
Faisalabad, Pakistan
(Ashraf, Zulfiqar) Department of Physical Therapy, University of Lahore,
Lahore, Pakistan
(Abbas, Nawaz) Department of Physical Therapy, Sehat Medical Complex,
Hanjarwal, Lahore, Pakistan
(Sharif) Department of Physical Therapy, Superior University, Lahore,
Pakistan
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & Objective: When someone has coronary artery disease, surgeons
may perform a coronary artery bypass graft (CABG) to create a new route
for blood to reach the narrowed heart arteries. CABG procedures may
increase the risk of patients having pulmonary issues after surgery. The
usefulness of active cycle of breathing technique (ACBT) in patients who
undergo CABG to lower the risk of lung problems has not been widely
recognized or experienced in Pakistan. Therefore, the purpose was to
determine the effects of pre and postoperative ACBT on oxygen saturation
(SpO2), arterial blood gas (ABG), and respiratory rate (RR) after coronary
artery bypass graft surgery (CABG). Methodology: The randomized controlled
trial took place from March to May 2024 at the Faisalabad Institute of
Cardiology (FIC) in Faisalabad. The elected 72 patients both men and women
of ages 35 to 65 were randomized using lottery method to place equal
numbers of participants in each group (n = 36 each). ACBT was applied in
addition to routine chest physical therapy in the intervention group,
while the control group received only routine chest therapy. Both patient
groups had their arterial blood gases (ABG), oxygen saturation (SpO) and
respiratory rate (RR) checked at baseline and upto five days after surgery
(daily). Result(s): There were significant differences between the
groups for RR, SpO and PaCO over all the postoperative days (p < 0.001).
Nevertheless, there was no noticeable difference in PaO on Day 3 (P =
0.977), in HCO on Day 3 (P = 0.145) and 4 (P = 0.84), nor in pH on Days 2
(P = 0.158) and 3 (P = 0.017). SpO in the control group was 95 (95-96) at
the start, climbed to 99 (98-99.4) on Day 1, then dropped to 95 (95-96) by
Day 5. RR went up to 28 (27.25-30) on Day 5. For the intervention group,
the SpO went from 95 (95-96.75) at the beginning to 99 (98.25-100) by Day
5 and the RR was reduced from 30 (19-31) on Day 1 down to 22 (20-24) on
Day 5. Within the control group, SpO went down to 81% and RR went up to 36
+/- 3.75 on Day 3 which indicates the respiratory system had not returned
to normal as fast as the intervention group. Conclusion(s): The
findings of our study suggest that 'active cycle of breathing technique'
is more effective than the routine chest physical therapy alone for
improving hemodynamic and respiratory parameters including ABG, RR, and
SpO2 after CABG. Abbreviations: ABG: arterial blood gas, ACBT: Active
cycle breathing technique, CABG: Coronary artery bypass graft, RR:
respiratory rate. Copyright © 2025, Faculty of Anaesthesia, Pain
and Intensive Care, AFMS. All rights reserved.

<37>
Accession Number
2030550707
Title
Off-pump Versus On-pump Coronary Artery Bypass Grafting in Diabetic
patients: A Meta-analysis of Observational Studies with a Propensity-Score
Analysis.
Source
Cardiovascular Drugs and Therapy. 39(6) (pp 1365-1374), 2025. Date of
Publication: 01 Dec 2025.
Author
Ren Q.; Li G.; Chu T.; Liu Q.; Huang Y.; Liu K.; Pan J.; Wu Z.
Institution
(Ren, Li, Chu, Liu, Huang, Liu, Pan, Wu) Department of Cardiac Surgery,
First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
(Ren, Li, Chu, Liu, Huang, Liu, Pan, Wu) NHC Key Laboratory of Assisted
Circulation, Sun Yat-Sen University, Guangzhou, China
Publisher
Springer
Abstract
Purpose: The debate between off-pump coronary artery bypass grafting
(OPCAB) and on-pump coronary artery bypass grafting (ONCAB) in diabetic
patients remains. This meta-analysis aimed to investigate outcomes after
OPCAB versus ONCAB for patients with diabetes. Method(s): Literature
research was conducted up to December 2023 using Ovid Medline, EMBASE, and
the Cochrane Library. Eligible studies were observational studies with a
propensity-score analysis of OPCAB versus ONCAB. The primary outcomes were
early mortality and mid-term survival. The secondary outcomes were
cerebrovascular accidents, reoperation for bleeding, incomplete
revascularization, myocardial infarction, low cardiac output, and renal
replacement therapy. Result(s): Our research identified seven
observational studies with a propensity-score analysis enrolling 13,085
patients. There was no significant difference between OPCAB and ONCAB for
early mortality, mid-term survival, myocardial infarction, low cardiac
output, and renal replacement therapy. OPCAB was associated with a lower
risk of cerebrovascular accidents (OR 0.43; 95% CI, 0.24-0.76, P = 0.004)
and reoperation for bleeding (OR 0.60; 95% CI, 0.41-0.88, P = 0.009).
However, OPCAB was associated with a higher risk of incomplete
revascularization (OR 2.07; 95% CI, 1.60-2.68, P < 0.00001).
 Conclusion(s): Among patients with diabetes, no difference in early
mortality and mid-term survival was observed. However, OPCAB was
associated with a lower incidence of morbidity, including cerebrovascular
accidents and reoperation for bleeding. Copyright © The Author(s)
2024.

<38>
[Use Link to view the full text]
Accession Number
2040070927
Title
Transfusion of Amustaline/Glutathione Pathogen-reduced Red Blood Cells in
Cardiac Surgery: A Randomized Phase 3 Clinical Trial.
Source
Anesthesiology. 143(5) (pp 1196-1210), 2025. Date of Publication: 01 Nov
2025.
Author
Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.; Beaver T.M.; Pelletier
J.P.R.; Gorham J.D.; McNeil J.S.; Sniecinski R.M.; Pearl R.G.; Nuttall
G.A.; Sarode R.; Reece T.B.; Benjamin R.J.; Kaplan A.; Davenport R.D.; Ipe
T.S.; Benharash P.; Lopez-Plaza I.; Sadler P.; Reik R.; Gammon R.R.;
Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.; Varrone J.
Institution
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
and Vitalant, Pittsburgh, Pennsylvania, United States
(Davenport) University of Michigan, Ann Arbor, Michigan., United States
(Ipe) Our Blood Institute, Oklahoma City, Oklahoma, United States
(Benharash) UCLA, Los Angeles, California, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, Michigan., United States
(Sadler) Central California Blood Center, Fresno, California, United
States
(Reik, Gammon) OneBlood, Orlando, Florida, United States
(Pitman, Pitman, Liu, Liu, Bentow, Bentow, Corash, Corash, Mufti, Mufti,
Varrone, Varrone) Cerus Corporation, Concord, California, United States
(Reece) Department of Surgery, Gill Heart Institute, University of
Kentucky, Lexington, Kentucky, United States
(Benjamin) Department of Laboratory Medicine, Yale University School of
Medicine, New Haven, Connecticut, United States
(Welsby) Department of Anesthesiology and Critical Care, Duke University
Medical Center, Durham, North Carolina, United States
(Toyoda) Department of Surgery, Temple University Hospital, Philadelphia,
Pennsylvania, United States
(Alsammak) Temple University Health System, Philadelphia, Pennsylvania,
United States
(Sodha) Department of Cardiothoracic Surgery, Rhode Island Hospital,
Providence, Rhode Island, United States
(Beaver) Department of Cardiovascular Surgery, University of Florida,
Gainesville, Florida, United States
(Pelletier) Department of Transfusion Services, University of Florida,
Gainesville, Florida, United States
(Gorham) Department of Pathology, University of Virginia Health System,
Charlottesville, Virginia, United States
(McNeil) Department of Anesthesiology, University of Virginia Health
System, Charlottesville, Virginia, United States
(Sniecinski) Department of Anesthesiology, Emory University, Atlanta,
Georgia
(Pearl) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, California, United States
(Nuttall) Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota,
United States
(Sarode) Department of Pathology, University of Texas Southwestern Medical
Center, Southwestern, Dallas, Texas, United States
(Reece) Department of Cardiothoracic Surgery, University of Colorado
Hospital, Denver, Colorado, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Transfusion has a persistent low risk of
transfusion-transmitted infection and transfusion-associated
graft-versus-host disease that may be addressed using pathogen reduction.
The Red Cell Pathogen Inactivation (ReCePI) trial tested whether
amustaline/glutathione pathogen-reduced red cells are noninferior to
conventional transfusions for support of acute surgical blood loss.
 Method(s): - A phase 3, double-blinded, noninferiority trial
randomized cardiac or thoracic-aorta surgery patients with increased risk
of red cell transfusion to receive pathogen-reduced or conventional red
cells during and for 7 days postsurgery. The primary endpoint was the
proportion of patients with acute kidney injury (AKI), which is defined as
an increase from baseline of greater than or equal to 0.3 mg/dl serum
creatinine within 48 h of surgery. Noninferiority was claimed if the upper
bound 95% CI of the treatment difference was less than half (50%) of the
observed conventional arm incidence. Adverse events and treatment-emergent
red cell antibodies were assessed for 28 and 75 days, respectively.
 Result(s): - A total of 581 subjects were randomized, and 321 (55%)
were transfused with study red cells. Transfused subjects in both arms had
similar baseline demographics, medical histories, hemoglobin levels, and
surgical procedures. Hemoglobin day 3 nadir levels (8.6 g/dl [7.8 to 9.2]
in the pathogen-reduced arm; 8.4 g/dl [7.8 to 9.3] in the conventional
arm; P = 0.52) were comparable. Incidence of AKI by 48 h was 46 of 157
(29.3%) in the pathogen-reduced arm and 45 of 161 (28.0%) in the
conventional arm (treatment difference, 0.7%; 95% CI, -8.9 to 10.4%;
noninferiority margin, 14.0%; P = 0.001 for noninferiority). AKI within 7
days by Kidney Disease Improving Global Outcomes staging criteria was not
different (59 of 159 [37.1%] in the pathogen-reduced arm; 55 of 162
[34.0%] in the conventional arm; P = 0.53), but stage III was more common
in the pathogen-reduced arm (pathogen-reduced arm, 15 of 159 [9.4%];
conventional arm, 7 of 162 [4.3%]; P = 0.075). Of 159 pathogen-reduced red
cell recipients, 5 (3.1%) developed specific, low-titer antibodies without
evidence of hemolysis. Conclusion(s): - The incidence of AKI in
recipients of pathogen-reduced red cells was noninferior to conventional
red cell transfusion. Treatment-emergent antibodies were uncommon and not
clinically significant. Copyright © 2025

<39>
Accession Number
2042208477
Title
New Adhesive Composite Barrier in Pediatric Cardiac Surgery: A Pilot
Clinical Study.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
5363678. Date of Publication: 2025.
Author
Egunov O.A.; Mikheeva E.R.; Stepanov I.V.; Grishin A.S.; Boshchenko A.A.
Institution
(Egunov, Stepanov, Boshchenko) Cardiology Research Insitute, Tomsk
National Research Medical Center, Tomsk, Russian Federation
(Mikheeva) Lobachevsky State University of Nizhny Novgorod, Nizhny
Novgorod, Russian Federation
(Grishin) Helsnet NTI Infrastructure Center, St. Petersburg, Russian
Federation
Publisher
John Wiley and Sons Inc
Abstract
Objectives: This study aims to assess the effectiveness of a new adhesive
composite barrier for preventing scars between the sternum and the
intracardiac structures. Method(s): A pilot, prospective,
single-center, randomized controlled study encompassing neonates with
ventricular septal defect who received staged correction between January
and September 2024. Patients (n = 20) were divided into two groups. After
pulmonary artery banding, the study group (n = 10) had the new adhesive
composite barrier implanted in the pericardium before the sternum was
closed (n = 10). The control group (n = 10) had no barrier. After 3-6
months, all patients had complete correction of the ventricular septal
defect, and the barrier was explanted in the study group. We recorded
palliative procedure duration and continuously monitored clinical data and
resternotomy duration. The histological severity of fibrosis and
inflammatory reaction was assessed in the study group. Result(s): No
patients died during the study. The palliative procedure duration, length
of stay in the ICU, and length of hospitalization did not differ between
the groups. During complete correction, the severity of the adhesion
process was estimated in both groups and made up 1.6 +/- 0.6 points in the
study group and 2.3 +/- 0.6 points (p < 0.04) in the control group. The
length of hospital stay after VSD repair was the same (p = 0.84). The
overall degree of fibrotic changes was lower in the study group: 1.9 +/-
0.3 points as compared to 2.3 +/- 0.4 (p = 0.049) in the control group.
 Conclusion(s): The new adhesive composite Reperen-based barriers were
easily separated from the surrounding tissues without adhering to the
sternum or intracardiac structures and demonstrate high potential when
used as adhesion barriers in cardiac surgery. Copyright © 2025
Oleg A. Egunov et al. Journal of Cardiac Surgery published by John Wiley &
Sons Ltd.

<40>
Accession Number
2041335348
Title
Emergency Department Visits Following Transcatheter Cardiac Interventions:
A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 369-382),
2026. Date of Publication: 01 Jan 2026.
Author
Best N.G.; Talla M.; Rafiee F.; Balakumar S.; Moses A.; Akseer S.; Lee
D.S.; Horlick E.M.; Huszti E.; Abrahamyan L.
Institution
(Best, Talla, Rafiee, Akseer, Lee, Huszti, Abrahamyan) Institute of Health
Policy, Management and Evaluation (IHPME), University of Toronto, Toronto,
ON, Canada
(Best, Talla, Rafiee, Akseer, Lee, Abrahamyan) Toronto General Hospital
Research Institute, University Health Network, Toronto, ON, Canada
(Balakumar) Department of Human Biology, University of Toronto, Toronto,
ON, Canada
(Moses) Faculty of Health Sciences, Queens University, Kingston, ON,
Canada
(Lee, Abrahamyan) Institute for Clinical Evaluative Science, Toronto, ON,
Canada
(Lee, Horlick) Peter Munk Cardiac Centre, University Health Network,
Toronto, ON, Canada
(Huszti) Biostatistics Department, University Health Network, Toronto, ON,
Canada
Publisher
John Wiley and Sons Inc
Abstract
While hospital readmission is the most common health system performance
metric after transcatheter cardiac interventions, emergency department
(ED) visits are rarely evaluated. We aimed to synthesize the incidence,
causes, predictors, costs, and outcomes of ED visits following
transcatheter procedures in patients undergoing percutaneous coronary
interventions (PCI), atrial septal defect (ASD) closures, patent foramen
ovale (PFO) closures, and transcatheter aortic valve interventions (TAVI).
Embase and Medline databases were searched from January 01, 2004, to July
25, 2024. We descriptively summarized ED visit outcomes for all studies
and, when relevant, performed a meta-analysis to obtain a pooled mean
cumulative incidence for 30-day ED visits following intervention. Nineteen
studies met the eligibility criteria, nine of which were subsequently
meta-analyzed. The incidence of 30-day ED visits in individual studies
ranged from 2.8% to 22% for PCI patients, 4% to 15.3% for TAVI patients,
and 16.9% to 19.5% for ASD/PFO patients. The pooled mean cumulative
incidence of 30-day ED visits was 9% (95% CI: 3%-18%) for PCI patients and
12% (95% CI: 9%-15%) for TAVI patients. A high degree of between-study
heterogeneity was found in the meta-analysis of these outcomes. Based on
limited reporting, risk factors associated with ED visits varied by
procedure and included factors such as urgency of procedure, length of
stay, sex, age, and dementia. The incidence and predictors of ED visits
post-transcatheter cardiac interventions were noteworthy yet highly
variable and inconsistently reported. Further research into the risk
factors that contribute to ED visits is needed to capture the burden of
this outcome. Copyright © 2025 Wiley Periodicals LLC.

<41>
Accession Number
2038419983
Title
Outcomes After DCD Cardiac Transplantation: An International, Multicentre
Retrospective Study.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S23), 2025. Date of Publication: 01 Apr 2025.
Author
Louca J.O.; Ochsner M.; Bhagra S.; Shah A.; Schlendorf K.; Lima B.; Wang
C.C.; Siddiqi H.; Irshad A.; Schroder J.; Casalinova S.; Milano C.; Khush
K.; Skoda A.; Luikart H.; Ashley E.; Moazami N.; James L.; Dar O.;
Konicoff M.; Urban M.; Um J.; Castleberry A.; Hoffman J.; Park S.; Cain
M.; Fetten K.; Meyer D.; Xu A.; Gonzalez-Vilchez F.; Dominguez-Gil B.;
Royo-Villanova M.; Garrido I.; Brouckaert J.; Rega F.; Tchana-Sato V.;
Berman M.; Bae J.; Sinha S.; Pettit S.; Messer S.; Large S.
Institution
(Louca, Ochsner, Sinha) University of Cambridge, Cambridge, United Kingdom
(Bhagra, Pettit, Large) Royal Papworth Hospital, Cambridge, United Kingdom
(Shah, Schlendorf, Lima, Wang, Siddiqi, Irshad) Vanderbilt University
Medical Center, Nashville, TN, United States
(Schroder, Casalinova, Milano) Duke University Medical Center, Durham, NC,
United States
(Khush, Skoda, Ashley) Stanford University, Palo Alto, CA, United States
(Luikart) Stanford, Stanford University, Palo Alto, CA, United States
(Moazami, James) NYU Langone Health, New York, NY, United States
(Dar, Konicoff) Harefield Hospital, London, United Kingdom
(Urban) UNMC, Omaha, NE, United States
(Um, Castleberry) University of Nebraska, Omaha, NE, United States
(Hoffman) University of Colorado School of Medicine, Boulder, CO, United
States
(Park, Cain) University of Colorado, Anschutz Medical Center, Aurora, CO,
United States
(Fetten, Meyer, Xu) Baylor Scott and White Health, Baylor University
Medical Center, Dallas, TX, United States
(Gonzalez-Vilchez) Hosp Marques de Valdecilla, Santander, Spain
(Dominguez-Gil) Organizacion Nacional de Trasplantes, Madrid, Spain
(Royo-Villanova, Garrido) Hospital Universitario Virgen de la Arrixaca,
Murcia, Murcia, Spain
(Brouckaert, Rega) University Hospitals Leuven, Leuven, Belgium
(Tchana-Sato) CHU Liege, Liege, Belgium
(Berman, Bae) Royal Papworth Hospital, Cambridge, United Kingdom
(Messer) Golden Jubilee National Hospital, Glasgow, United Kingdom
Publisher
Elsevier Inc.
Abstract
Purpose: Donation after circulatory determination of death (DCD) has been
shown to be a safe and effective method of increasing the size of the
potential donor pool. The DCD heart is ischaemic and requires a period of
resuscitative reperfusion which can take place either in the donor (known
as thoraco-abdominal normothermic regional perfusion - taNRP) or outside
the donor known as direct procurement and preservation (DPP). This study
aimed to compare the outcomes of DCD heart transplantation across Europe
and the US to identify whether there are any significant differences in
recipient outcomes between taNRP and DPP. Method(s): This was a
retrospective observational study across Europe and the US. It included 20
heart transplant centres across Belgium, Spain, the UK and the US. All
participants who had undergone a DCD heart transplant at participating
centres from the start of their respective programmes until 1st
January 2023 were included. The censor date for the study was
1st January 2024 to ensure at least one year of follow up data
on all participating patients. This study included 504 DCD cases from 28th
February 2015 - 1st Jan 2023. 223 patients received hearts that had been
procured with taNRP. 281 patients received hearts that were procured by
DPP. Result(s): The data demonstrate a similar one-year and
three-year survival between taNRP and DPP heart recipients (0.91 vs 0.88
p= 0.16, 0.85 vs 0.78 p=0.1). The taNRP group had a significantly reduced
need for mechanical circulatory support (MCS) post transplant compared to
the DPP group (7.6% vs 19.2% p < 0.001) and a significantly lower rate of
acute rejection requiring treatment in the first year (13% vs 25%
p<0.001). The taNRP group also had a higher ejection fraction at 1-month
(63.8% vs 57.5%, p<0.001)and 1-year (61% vs 57.5%, p<0.001) post
transplant. Conclusion(s): This international, retrospective study
demonstrated that taNRP is associated with a lower need for mechanical
circulatory support and acute rejection requiring treatment. There is a
need for a randomised control trial to definitively confirm these results.
These results are significant as mechanical support is associated with
significant financial cost and morbidity. The significance of higher rates
of acute rejection in the DPP group are not yet known. Copyright
© 2025

<42>
Accession Number
2038421386
Title
Intravascular Ultrasound (IVUS) Assessment of Cardiac Allograft
Vasculopathy in the TEAMMATE Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S347), 2025. Date of Publication: 01 Apr 2025.
Author
Bock M.J.; Auerbach S.R.; Kuhn M.A.; Lu M.; Sleeper L.A.; Miyamoto S.D.;
Pietra B.A.; Almond C.S.; Daly K.P.; Investigators F.T.T.T.
Institution
(Bock) Pediatric Cardiology, Rady Children's Hospital / UC San Diego, San
Diego, CA, United States
(Auerbach, Miyamoto) Pediatric Cardiology, Children's Hospital Colorado,
Denver, CO, United States
(Kuhn) Pediatric Cardiology, Loma Linda University, Loma Linda, CA, United
States
(Lu, Sleeper, Daly, Investigators) Cardiology, Boston Children's Hospital,
Boston, MA, United States
(Pietra) Pediatric Cardiology, University of Florida Congenital Heart
Center, Gainesville, FL, United States
(Almond) Pediatric Cardiology, Stanford University, Palo Alto, CA, United
States
Publisher
Elsevier Inc.
Abstract
Purpose: Intravascular ultrasound (IVUS) is used to evaluate for cardiac
allograft vasculopathy (CAV) early after heart transplant (HTX). IVUS
evidence suggests an improved freedom from CAV in those receiving
proliferation signal inhibitors (PSI), such as everolimus, compared to
other regimens. We sought to evaluate differences in CAV as assessed by
IVUS at 12, 24, and 36 months post-HTX in pediatric HTX recipients
receiving low-dose tacrolimus with everolimus (TAC-EVL) and usual-dose
tacrolimus with mycophenolate (TAC-MMF). Additionally, we sought to
evaluate differences in the assessment of CAV by IVUS as compared with
coronary angiography. Method(s): We evaluated differences in and
changes to mean maximal intimal thickness (MIT), and Stanford IVUS
Classification (SIC) between those randomized to TAC-EVL or TAC-MMF at 12,
24, and 36 months after HTX in the TEAMMATE Trial using basic comparison
statistics and mixed effects regression models. We also evaluated
differences in CAV grading by IVUS as compared to coronary angiography at
these timepoints using Spearman correlation. Result(s): Of the 211
subjects in the TEAMMATE Trial, 21 underwent 45 CAV evaluations via IVUS.
13 subjects were randomized to TAC-MMF, while 8 subjects were randomized
to TAC-EVL. 17 studies were in TAC-EVL subjects and 28 were in TAC-MMF
subjects. 7 subjects underwent testing at two time points and 8 had
testing at all three time points. Mean (SD) MIT was 0.3 mm (0.2) for
TAC-EVL and 0.2 mm (0.1) for TAC-MMF and was not different between groups
(p=0.44) or between different time points (p=0.16-0.90). SIC was abnormal
(class 2-3) in 35% of TAC-EVL and 37% of TAC-MMF studies (p=0.91). Mixed
effects modeling did not suggest a difference in MIT (p=0.42) or SIC
(p=0.85) between groups. There were also no changes over time
(p=0.16-0.69). 3 subjects had abnormal angiography (2 in TAC-EVL group and
1 in TAC-MMF group). One subject in each group had grade 3 CAV by
angiography; corresponding SICs were class 1 for the TAC-EVL subject and
class 2 for the TAC-MMF subject. Spearman correlation between IVUS SIC and
angiography grade was R=0.3 (p=0.08). Conclusion(s): In this small
subset of TEAMMATE Trial subjects undergoing CAV evaluation with IVUS, no
differences in MIT or SIC were observed over time or between
immunosuppressive regimens over the 30-month trial period. Also,
correlation between IVUS and angiography was modest at best. Copyright
© 2025

<43>
Accession Number
2038419877
Title
Outcomes After Heart Transplantation from Donors After Circulatory Death
versus Brain Death: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S157-S158), 2025. Date of Publication: 01 Apr 2025.
Author
Picado-Loaiza S.; Morgado Ferreira R.O.; Luiz L.; Chanda V.; Rivera A.;
Amador Y.; Fuentes R.A.
Institution
(Picado-Loaiza) Cardiovascular Surgery, Caja Costarricense del Seguro
Social, San Jose, Costa Rica
(Morgado Ferreira) Federal University of Santa Catarina, Florianopolis,
Brazil
(Luiz) Universidade da Regiao de Joinville, Santa Catarina, Brazil
(Chanda) Johns Hopkins University, Maryland, MD, United States
(Rivera) Nove de Julho University, Sao Bernardo do Campo, Brazil
(Amador) Kingston Health Science Center, Toronto, ON, Canada
(Fuentes) Robert Bosch Hospital, Stuttgart, Germany
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) is the definitive treatment for
patients with end-stage heart failure. Traditionally, HTs have relied on
donation after brain death (DBD). However, the growing disparity between
the number of available donor heart and the waitlist for HT has led to the
exploration of donation after circulatory death (DCD) as a potential
alternative. We performed a systematic review and meta-analysis comparing
DCD versus DBD in patients undergoing HT. Method(s): We
systematically searched PubMed, Embase, and Cochrane databases for studies
comparing clinical outcomes in patients undergoing HT with donor hearts
from DCD versus DBD. Statistical analyses included pooled risk ratios (RR)
for binary outcomes and mean differences (MD) for continuous outcomes,
both with 95% confidence intervals (CI). Random-effects models were
employed for all endpoints. All analyses were conducted using R version
4.2.3. Result(s): This meta-analysis included 1 randomized controlled
trial and 10 observational studies. There was no significant difference
between groups in mortality at 1 (RR 0.65; 95% CI 0.28-1.53; p=0.32), 6
(RR 0.67; 95% CI 0.30-1.51; p=0.33), and 12 months (RR 0.96; 95% CI
0.68-1.36; p=0.81). No significant difference occurred in need for
extracorporeal membrane oxygenation (ECMO) (RR 0.84; 95% CI 0.36-1.95;
p=0.68) and intraaortic balloon pump (IABP) (1.29; 0.93-1.72; p=0.13). ICU
and hospital length of stay (LOS) were similar between groups (MD 0.85
days; -0.22-1.91; p=0.12; and MD 0.77 days; -2.20-0.67; p=0.29,
respectively).The DBD group showed a significantly lower incidence of
primary graft dysfunction (PGD) (RR 2.10; 95% CI 1.06-1.95; p=0.033) and
need for dialysis or hemofiltration (RR 1.31; 95% CI 1.04-1.64; p=0.023).
 Conclusion(s): There were no statistically significant differences in
mortality outcomes, hospital and ICU LOS, ECMO use, and IABP. DCD
recipients have a higher risk of PGD and dialysis or hemofiltration.
[Formula presented] Copyright © 2025

<44>
Accession Number
2038420370
Title
Significance of Artificial Intelligence in Predicting 1-year Post-Heart
Transplant Mortality in Children: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S234-S235), 2025. Date of Publication: 01 Apr 2025.
Author
Das B.; Ansari M.; Deshpande S.
Institution
(Das) Pediatrics, University of Mississippi Medical Center, Jackson, MS,
United States
(Ansari) Data Science, University of Mississippi Medical Center, Jackson,
MS, United States
(Deshpande) Pediatrics, Children's National Hospital, George Washington
University, Washington D.C., WA, United States
Publisher
Elsevier Inc.
Abstract
Purpose: Heart transplantation (HT) is a life-saving procedure for
children with end-stage heart failure (HF). Despite advancements in
long-term outcomes, 1-year post-HT mortality remains high. Artificial
intelligence (AI) has significantly improved risk stratification by
utilizing a broader set of variables in adult donor-recipient pairs. This
study aims to systematically review and perform a meta-analysis of
published studies on AI's role in predicting 1-year post-HT mortality in
children. Method(s): We searched the Embase, PubMed, and Scopus
databases for literature on AI's use in predicting 1-year post-HT
mortality in children. The Quality Assessment of Diagnostic Accuracy
Studies 2 criteria assessed each study's quality and risk bias. We used a
random-effects model to account for study heterogeneity to enhance the
prediction of 1-year post-HT mortality in children. Sensitivity,
specificity, and diagnostic odds ratio measures were calculated using a
proportional logit transformation and analyzed with the DerSimonian-Laird
method for random effects. Heterogeneity was quantified using the I2
statistic. We reported both fixed-effect (common effect model) and
random-effects model results for comparison. Result(s): Four studies,
including 26,855 subjects, were analyzed. All studies were conducted at
different intervals using pediatric patient cohorts from the UNOS
database. Using the random-effects model, the pooled sensitivity for
predicting 1-year post-HT mortality was 0.86 (95% CI 0.70 - 0.95),
specificity was 0.92 (95% CI 0.83 - 0.97), and the diagnostic odds ratio
was 75.99 (9.75 - 592.09) (Figure). However, significant heterogeneity was
observed between studies, indicated by a Higgins I2 value of 99-100%.
 Conclusion(s): AI can enhance the prediction of 1-year
post-transplant mortality in children. However, there is considerable
heterogeneity among AI algorithms, necessitating improvements in study
quality and design. [Formula presented] Copyright © 2025

<45>
Accession Number
2038419829
Title
Prognostic Significance of Cardiopulmonary Exercise Testing in HFrEF: A
Meta-Analysis of Peak VO2 and VE/VCO2 Slope.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S623), 2025. Date of Publication: 01 Apr 2025.
Author
Younis A.K.; Hatamleh M.; Dabbah Y.; Aloqaili T.; Shdaifat A.; Al-Qalqili
L.; Bani-Khaled F.; Albdour K.; Turk A.
Institution
(Younis, Hatamleh, Dabbah, Aloqaili, Shdaifat, Al-Qalqili, Bani-Khaled,
Albdour) The University of Jordan, Amman, Jordan
(Turk) The Advanced Heart Diseases Center, Amman, Jordan
Publisher
Elsevier Inc.
Abstract
Purpose: This study evaluates the prognostic value of Peak VO2 and VE/VCO2
slope in patients with heart failure with reduced ejection fraction
(HFrEF). By synthesizing evidence from multiple studies, it aims to
determine the utility of these cardiopulmonary exercise testing (CPET)
metrics in guiding clinical decision-making and enhancing risk
stratification strategies. Method(s): A systematic search was
conducted using PubMed, Cochrane, Web of Science, and Scopus for studies
evaluating CPET metrics in adults (>=18 years) diagnosed with HFrEF. The
search was completed on September 25, 2023. We included cohort studies,
case-control studies, and randomized controlled trials. The primary
outcomes analyzed were mortality, hospitalization, LVAD implantation, and
heart transplantation. The QUIPS tool was employed to assess the risk of
bias. A random-effects meta-analysis was performed to calculate pooled
hazard ratios (HR) and 95% confidence intervals (CI). Result(s): Our
search identified 2,670 studies, with 31 selected after full-text
screening. Of these, 15 studies were excluded due to ineligibility. An
analysis of 16 studies involving 14,580 patients found that each 1
mL/kg/min increase in Peak VO2 was associated with an 18% reduction in
adverse outcomes (HR: 0.82; 95% CI: 0.77-0.87)(Fig.1). Additionally, 13
studies comprising 13,405 patients demonstrated that each 1-unit increase
in VE/VCO2 slope was associated with a 16% increase in risk (HR: 1.16; 95%
CI: 1.07-1.25) (Fig.2). Conclusion(s): Peak VO2 and VE/VCO2 slope are
robust prognostic markers in HFrEF, providing valuable insights for
clinical management and patient risk stratification. These findings
underscore the importance of incorporating CPET metrics into routine
practice to optimize patient care and outcomes. [Formula
presented] Copyright © 2025

<46>
Accession Number
2038420671
Title
Long-Term Outcomes in Patients with Fulminant Myocarditis Supported with
Extracorporeal Membrane Oxygenation Surviving to Hospital Discharge.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S268), 2025. Date of Publication: 01 Apr 2025.
Author
Lambadaris M.; Vishram-Nielsen J.; Okumura T.; Chen Y.; Cheng A.; Sun H.;
Loforte A.; Asaumi Y.; Sawada K.; Huang M.; Lee W.C.; Fux T.; Pozzi M.;
Ross H.; Gustafsson F.; Moller-Sorensen H.; Okumura M.; Ariza-Sole A.;
Senechal M.; Turgeon P.; Martinez-Selles M.; Hernandez-Perez F.J.; Lorusso
R.; Billia F.; Alba A.
Institution
(Lambadaris) Cardiology, Toronto General Hospital, University Health
Network, Toronto, ON, Canada
(Vishram-Nielsen) Roskilde Hospital, Roskilde, Denmark
(Okumura) Cardiology, Nagoya University Graduate School of Medicine,
Nagoya, Japan
(Chen, Cheng) Division of Infectious Diseases, Department of Internal
Medicine, National Taiwan University Hospital, Taipei, Taiwan (Republic of
China)
(Sun) National Taiwan University Hospital, Tapei, Taiwan (Republic of
China)
(Loforte) Cardiac Surgery, University of Turin, S. Orsola University
Hospital, Turin, Italy
(Asaumi, Sawada) National Cerebral and Cardiovascular Center, Osaka, Japan
(Huang) Cardiothoracic Surgery, National Heart Centre Singapore,
Singapore, Singapore
(Lee) Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan (Republic
of China)
(Fux) Perioperative Medicine and Intensive Care; Physiology and
Pharmacology, Karolinska Institute, Stockholm, Sweden
(Pozzi) Louis Pradel Cardiologic Hospital, Lyon, France
(Ross) Peter Munk Cardiac Centre, Toronto General Hospital, Toronto, ON,
Canada
(Gustafsson) Rigshospitalet, Copenhagen, Denmark
(Moller-Sorensen) Rigshospitalet, University Hospital of Copenhagen,
Copenhagen, Denmark
(Okumura) Osaka Toneyama Medical Center, Japan
(Ariza-Sole) Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet
de Llobregat, Barcelona, Spain
(Senechal) Laval University, Quebec, QC, Canada
(Turgeon) Institut Universitaire de Cardiologie et Pneumologie de Quebec,
Quebec, QC, Canada
(Martinez-Selles) Cardiology, Hospital General Universitario Gregorio
Maranon, Madrid, Spain
(Hernandez-Perez) Hospital Universitario Puerta de Hierro Majadahonda,
Madrid, Spain
(Lorusso) Maastricht University Medical Center, Maastricht, Netherlands
(Billia) University Health Network, Toronto, ON, Canada
(Alba) Toronto General Hospital, Toronto, ON, Canada
Publisher
Elsevier Inc.
Abstract
Purpose: Fulminant myocarditis (FM) is a morbid disease that can progress
rapidly to refractory cardiogenic shock requiring venoarterial
extracorporeal membrane oxygenation (V-A ECMO). This study aimed to
identify long term outcomes in patients with FM who were successfully
weaned from V-A ECMO and discharged without durable mechanical circulatory
support or heart transplantation (HTx). Method(s): This is a
retrospective analysis of patient level data of studies identified in a
recent systematic review published by our centre on adult patients with FM
supported with V-A ECMO. Among the 16 centres that participated (440
patients), we included patients who survived to hospital discharge to
evaluate long-term mortality and need for HTx or left ventricular assist
device (LVAD). Using a univariable Cox regression model, we also evaluated
the association between LVEF at discharge with long-term mortality, HTx or
LVAD. Result(s): Of the 440 patients with FM on V-A ECMO support, 113
were discharged without LVAD or HTx. Average age was 43.4 +/- 16.7 years,
42% were male, 26% required CPR pre-ECMO and the average LVEF was 23 +/-
11.9% prior to V-A ECMO cannulation. During a median follow-up of 4.4
years (IQR 1.6-7.9), there were 3 deaths, 1 HTx and 1 LVAD. The composite
risk of death, LVAD or HTx at 1 year was 3.0% and 6.9% at 5 years. Of the
113 patients, 106 had documented LVEF at discharge. By univariate
analysis, LVEF <50% (n=37, 2 deaths) in comparison to LVEF >50% (n=69, 1
LVAD, 1 death) was not associated with increased risk of the composite end
point of death, HTx or mortality (HR 2.9, 95%CI 0.19-42.9).
 Conclusion(s): Our study suggests low long-term mortality or need for
advanced therapy among patients with FM requiring V-A ECMO who survived to
hospital discharge. We did not find an increased risk of the composite
endpoint regardless of LVEF at the time of discharge. Copyright ©
2025

<47>
Accession Number
2038420444
Title
Circulating Donor-Derived Cell-Free DNA as a Marker for Rejection After
Heart Transplantation: A Systematic Review and Meta-Analysis.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S649), 2025. Date of Publication: 01 Apr 2025.
Author
Brignoli K.; Xourgia E.; Martinelli M.; Hunziker Munsch L.; Schnegg B.
Institution
(Brignoli, Xourgia, Martinelli, Hunziker Munsch, Schnegg) Cardiology,
Inselspital, University of Bern, Bern, Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: Post-transplant management requires careful monitoring for
cellular (ACR) and antiBody-mediated acute rejection (AMR). Due to the
costs and risks of endomyocardial biopsy (EMB), interest in non-invasive
screening methods is increasing. We performed a meta-analysis to evaluate
the use of donor-derived cell-free DNA (ddcfDNA) as a screening tool for
rejection. Method(s): We included studies presenting data on ddcfDNA
in transplant patients experiencing acute rejection. The primary outcomes
of the meta-analysis were ddcfDNA for ACR ISHLT>=1, ISHLT>=2 and pAMR>=1
compared with no-rejection patients (NR). We pooled the diagnostic
accuracy metrics of the studies. Random effect models were used. We
pre-registered the meta-analysis on PROSPERO (CRD42024583998).
 Result(s): ddcfDNA was increased both in ISHLT>=2R and pAMR >= 1 (SMD
1.98, 95% CI 1.03 to 2.93, p<0.00001; 7 studies; 3647 EMBs), and ISHLT>=1R
(SMD 0.23, 95% CI 0.15 to 0.32, p<0.00001; 5 studies; 2335 EMBs) versus
NR. The results persisted in the sensitivity analysis for low risk-of bias
studies. The ddcfDNA test yielded a pooled sensitivity of 0.776 (95% CI:
0.562 to 0.903), a false positive rate (FPR) of 0.223 (95% CI: 0.141 to
0.333) and an area under the curve of 0.839 for ISHLT>=2R and/or pAMR>=1
and a sensitivity of 0.740 (95% CI: 0.614 to 0.836), FPR of 0.222 (95% CI:
0.158 to 0.301) and AUC of 0.826 for ISHLT>=1R. Conclusion(s):
ddcfDNA shows promise as a non-invasive screening tool for acute
rejection, with good diagnostic performance for both mild and severe
rejection cases and could provide a non-invasive alternative to EMBs for
transplant monitoring. [Formula presented] [Formula
presented] Copyright © 2025

<48>
Accession Number
2038420611
Title
Hypothermic Oxygenated Perfusion of the Donor Heart in Heart
Transplantation: The One Year Outcome from a Randomized, Controlled,
Open-Label, Multicenter Clinical Trial.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S49), 2025. Date of Publication: 01 Apr 2025.
Author
Rega F.; Lebreton G.; Para M.; Michel S.; Schramm R.; Begot E.;
Vandendriessche K.; Kamla C.; Gerosa G.; Berman M.; Boeken U.; Clark S.;
Ranasinghe A.; Ius F.; Forteza A.; Pivodic A.; Hennig F.; Guenther S.;
Zuckermann A.; Knosalla C.; Dellgren G.; Wallinder A.
Institution
(Rega, Vandendriessche) Cardiac Surgery, University Hospitals Leuven,
Leuven, Belgium
(Lebreton, Begot) Cardiac Surgery Department, Pitie-Salpetriere Hospital,
APHP, Sorbonne University, Paris, France
(Para) Department of Cardiovascular Surgery and Transplantation, Bichat
Hospital, Universite Paris Cite, Paris, France
(Michel, Kamla) Clinic of Cardiac Surgery, Ludwig-Maximilians-University
of Munich, Munich, Germany
(Schramm, Guenther) Clinic for Thoracic and Cardiovascular Surgery, Heart
and Diabetes Center North Rhine Westfalia, Ruhr-University Bochum, Bad
Oeynhausen, Germany
(Gerosa) Department of Cardiac, Thoracic, Vascular Sciences and Public
Health, University of Padua, Padua, Italy
(Berman) Cadiothoracic Surgery, Royal Papworth Hospital NHS Foundation
Trust, Cambridge, United Kingdom
(Boeken) Department of Cardiac Surgery, Heinrich Heine University,
Dusseldorf, Germany
(Clark) Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne,
United Kingdom
(Ranasinghe) Cardiac Surgery, Queen Elizabeth Hospital, University
Hospitals Birminghem NHS Trust, Birmingham, United Kingdom
(Ius) Department of Cardiothoracic, Transplant and Vascular Surgery,
Hannover Medical School, Hannover, Germany
(Forteza) Department of Cardiac Surgery, Puerta de Hierro Majadahonda
University Hospital, Madrid, Spain
(Pivodic) APNC, Moldnal, Sweden
(Hennig, Knosalla) Department of Cardiothoracic and Vascular Surgery,
Deutsches Herzzentrum der Charite, Berlin, Germany
(Zuckermann) Department of Cardiac Surgery, Medical University of Vienna,
Vienna, Austria
(Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Wallinder) XVIVO Perfusion, Gothenburg, Sweden
Publisher
Elsevier Inc.
Abstract
Purpose: A recent randomized, controlled, open-label, multicenter clinical
trial demonstrated beneficial short-term effects of hypothermic oxygenated
machine perfusion (HOPE) on donor hearts. The one-year outcomes from this
trial are now available. Method(s): A multicenter, open-label RCT
with superiority design across 15 transplant centers in eight European
countries. Adult candidates for heart transplantation were included. For
HOPE a portable machine perfusion system (XVIVO Perfusion) was used and
for the control group ischemic static cold storage (SCS). 30-day outcomes
were previously reported. This analysis includes the first 12-month follow
up for the modified intention to treat population. Result(s):
Patients were enrolled between November 2019 and May 2023. The 30 day
survival was 96% in both study groups. Between day 30 and 12-months, 4
patients died in the HOPE group and 10 patients in the SCS group,
resulting in an overall 12-month survival rate of 92% and 86%. No
retransplantation occurred. Biopsy verified acute cellular rejection >
grade 1, was reported in 14% of patients in the HOPE group and 13% of
patients in the SCS group during the first 12 months. There were a total
of 14 and 20 adverse allograft rejection events in the HOPE and SCS group
respectively. Cardiac allograft vasculopathy (CAV) was diagnosed in 4 HOPE
patients, 2 of whom were transplanted with donors heart with known
non-significant coronary stenosis, and in 2 SCS patients. Major adverse
cardiac transplant events affected 26% of HOPE patients and 41% of SCS
patients (p = 0.019). Conclusion(s): This is the first RCT that has
demonstrated a reduction in PGD after heart transplantation. The 61% risk
reduction of PGD, appears to be reflected in the 12-month survival and
reduction in major transplant complications. Our findings support the
concept that HOPE mitigates graft injury, leading to improved patient
outcomes. Follow-up will continue for five years post-transplant. *
p-value from log-rank test. **2 patients with donor hearts with non-sign
coronary stenosis pre-TX [Formula presented] Copyright © 2025

<49>
Accession Number
2038419378
Title
Speckle-Tracking Echocardiography of Left and Right Ventricle and Acute
Cellular Rejection in Orthotropic Heart Transplantation.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S651), 2025. Date of Publication: 01 Apr 2025.
Author
Xourgia E.; Brignoli K.; Linder O.; Neagoe A.; Capek L.; Bruno J.;
Strickler E.; Bakula A.; Pavlicek M.; Furholz M.; Muster C.; Malagutti P.;
Martinelli M.; Munsch L.H.; Schnegg B.
Institution
(Xourgia, Neagoe, Capek, Bruno, Strickler, Bakula, Pavlicek, Furholz,
Muster, Malagutti, Martinelli, Munsch, Schnegg) Cardiology, Inselspital,
University of Bern, Bern, Switzerland
(Brignoli, Linder) Internal Medicine, Burgerspital Solothurn, Solothurn,
Switzerland
Publisher
Elsevier Inc.
Abstract
Purpose: After cardiac transplantation, steering of immunosuppression
requires active search for acute cellular rejection (ACR). Given the costs
and potential complications of endomyocardial biopsy (EMB), there is
growing interest in the use of non-invasive screening. Thus, we conducted
a systematic review and meta-analysis to evaluate speckle-tracking
echocardiography as a screening method for ACR. Method(s): We
searched PubMed and gray literature for studies presenting data on speckle
tracking echocardiography in transplant patients experiencing ACR. The
primary outcomes of the meta-analysis were left and right ventricular
global longitudinal strain. We used random effects models for all
analyses. We pre-registered the meta-analysis with PROSPERO
(CRD42024508654). Result(s): Both left (LVGLS, MD -1.96, 95% CI -2.85
to -1.07, p<0.0001; 16 studies; 2274 EMBs), and right (RVGLS, MD -2.90,
95% CI -4.03 to -1.76, p<0.00001; 5 studies; 1254 EMBs), global
ventricular longitudinal strain were lower among patients without ACR.
Left circumferential strain (LVCS, MD -2.83, 95% CI -5.30 to -0.36,
p=0.02; 10 studies; 1069 EMBs) was also lower among patients without ACR,
while left radial strain (LVRS, p=0.05; 6 studies; 885 EMBs),
circumferential (p=0.11; 3 studies; 186 EMBs) and longitudinal strain
rates (p=0.05; 4 studies; 406 EMBs) were similar between groups. RVFWS was
increased in ACR (MD -2.64, 95% CI -4.72 to -0.56, p=0.01; 6 studies; 1188
EMBs). In the subgroup analysis of first post-transplant year versus
various follow-up times, no difference was observed (Chi2=0.44,
p=0.51). The change of LVGLS from baseline over time until the rejection
event or follow-up censoring was greater in ACR (MD -2.43, 95% CI -4.82 to
-0.05, p=0.045). Conclusion(s): Myocardial strain measured by speckle
tracking echocardiography appears affected in ACR and could potentially be
used as a rule-out strategy for early rejection, leading to a reduction of
routine biopsies in heart transplant follow-up. [Formula
presented] Copyright © 2025

<50>
Accession Number
2038420456
Title
A Novel Mechanical Perfusion Transportation Device (Organ Angel) in a Pig
Model.
Source
Journal of Heart and Lung Transplantation. Conference: ISHLT 45th Annual
Meeting and Scientific Sessions. Boston United States. 44(4 Supplement)
(pp S665), 2025. Date of Publication: 01 Apr 2025.
Author
Besanko J.E.; Ou R.; Edwards J.R.; Worthington M.G.; Beltrame J.; Toby C.
Institution
(Besanko) Department of Cardiothoracic Surgery, Royal Adelaide Hospital,
Adelaide, Australia
(Ou) Cardiothoracic Surgery, Baker Insitute, Melbourne, Australia
(Edwards, Worthington) Cardiothoracic Surgery, Royal Adelaide Hospital,
Adelaide, Australia
(Beltrame) Cardiology, Queen Eliazbeth Hospital, Adelaide, Australia
(Toby) Transplant, Royal Adelaide Hospital, Adelaiade, Australia
Publisher
Elsevier Inc.
Abstract
Purpose: Evidence from randomised human and experimental trials indicate
that the results of heart transplantation improve with the use of
perfusion of donor hearts. The two devices currently approved for this
purpose are large and expensive, often requiring a charter aircraft.
Recently an Australian team has developed a small, portable oxygenated
hypothermic perfusion device which weighs 16kg, operates from batteries
and fits in a standard economy domestic airline seat. This device has been
subjected to validation in a randomised trial in a porcine model.
 Method(s): 12 porcine hearts were randomised to perfusion with the
Organ Angel device (n=6) or cooling in an ice slurry (n=6) for 6 hours.
After warming and reversal of cardioplegia cardiac function was assessed
on a working heart reanimation circuit for 2 hours. Samples were taken for
electron microscopy and biochemical studies. Result(s): The
mechanical perfusion device demonstrated superior preservation compared to
cold storage in terms of cardiac performance (Cardiac output) p=0.01 on
the bench bypass circuit, electron microscopy, and biochemical normality.
 Conclusion(s): These preliminary studies demonstrate early
indications of superiority to cold storage preservation in terms of
cardiac performance electron microscopy and biochemical normality. Thus
this machine provides an alternative to cold storage preservation and
potentially other mechanical perfusion devices. After further studies this
new device could have a role to play in the transport of donor hearts in
Australia and abroad. Copyright © 2025

<51>
Accession Number
2041694505
Title
Age-Stratified Effect of Rivaroxaban Monotherapy for Atrial Fibrillation
in Stable Coronary Artery Disease: A Post Hoc Analysis of the AFIRE
Randomized Clinical Trial.
Source
JAMA Cardiology. 10(10) (pp 990-999), 2025. Date of Publication: 08 Oct
2025.
Author
Yamaguchi J.; Arashi H.; Hagiwara N.; Yasuda S.; Kaikita K.; Akao M.; Ako
J.; Matoba T.; Nakamura M.; Miyauchi K.; Matsui K.; Nakamura A.; Tamiya
E.; Yamamoto T.; Suetake S.; Noguchi T.; Nakamura S.; Kojima J.; Yamaguchi
H.; Suwa S.; Yasu T.; Nakajima A.; Yamada T.; Arai H.; Hata Y.; Sakanashi
T.; Tateishi H.; Nakayama T.; Nozaki Y.; Okumura Y.; Tokue M.; Kuroki N.;
Maruyama Y.; Suzuki H.; Nishida Y.; Ajioka M.; Yumoto K.; Shimizu S.;
Shimomura H.; Takeda T.; Oshiro K.; Sugishita N.; Shibata Y.; Otonari T.;
Shimizu M.; Kihara H.; Ogawa H.; Ono A.; Hazama M.; Tsukahara K.; Haruta
S.; Haruna T.; Ito M.; Fujii K.; Atsuchi N.; Sata M.; Wakeyama T.; Hasebe
N.; Kobayasi Y.; Osato K.; Hironaga K.; Naganuma Y.; Anzaki K.; Okazaki
S.; Nakagawa Y.; Tokuhiro K.; Tanaka K.; Momose T.; Fukushima Y.; Kametani
R.; Kawamitsu K.; Saito Y.; Akashi S.; Kumagai K.; Eshima K.; Tobaru T.;
Seo T.; Okuhara K.; Kozuma K.; Ikari Y.; Takahashi T.; Oiwa K.; Michishita
I.; Fujikura H.; Momomura S.; Yamamoto Y.; Otomo K.; Matsubara T.; Tashiro
H.; Inoue T.; Ishihara M.; Shiojima I.; Tachibana E.; Sumii K.; Yamamoto
N.; Omura N.; Takahashi N.; Morita Y.; Watanabe K.; Fujinaga H.; Maruyama
M.; Oka T.; Shirayama T.; Amano T.; Fukui K.; Ando K.; Oshima S.; Kagiyama
S.; Teragawa H.; Yuge M.; Ono S.; Koga T.; Fujiu K.; Kuwabara M.; Oya Y.;
Yumoto Y.; Kuji N.; Ikemura M.; Kario K.; Chatani K.; Sato K.; Miyagi H.;
Murakami M.; Saito K.; Hoshiga M.; Sato S.; Kubo N.; Sakamoto Y.; Ashida
K.; Sakamoto H.; Murasaki S.; Uehara H.; Akasaka T.; Oba Y.; Nakahara S.;
Hanaoka Y.; Nishimiya T.; Tsunoda R.; Onuma Y.; Higuchi S.; Tani A.; Wada
A.; Kato M.; Obata H.; Higuchi Y.; Endo T.; Kato R.; Matsunaga T.;
Matsuoka T.; Noguchi H.; Usui M.; Hayashi T.; Otsuji Y.; Osaki T.; Zaizen
H.; Yoshihara H.; Kadota K.; Hirose T.; Miyazawa T.; Mori A.; Takano M.;
Shimizu W.; Wake M.; Oriso S.; Yoshiyama M.; Kakinoki S.; Nishioka T.;
Ozaki T.; Nomoto K.; Seki K.; Kawai K.; Ozaki Y.; Miura S.; Kawasaki M.;
Funada R.; Dote K.; Okamoto S.; Owada T.; Doke T.; Matsumura T.; Kubo T.;
Horiuchi M.; Nagano T.; Takaishi A.; Yamamoto M.; Nakashima H.; Murozono
Y.; Munemasa M.; Sakata Y.; Inoue N.; Ota T.; Hamano Y.; Abe N.; Tsubokura
T.; Goto M.; Kubota I.; Yano M.; Umetani K.; Date T.; Morimoto H.; Noda
T.; Goto S.; Hibi K.; Nakano A.; Hiramitsu S.; Kihara Y.; Sugi M.; Shiba
N.; Izumi D.; Sato T.; Ajiki K.; Oishi M.; Kiryu M.; Ko T.; Ando H.;
Miyazaki S.; Kinugawa T.; Otake H.; Kitaoka H.; Tayama S.; Hirata Y.;
Honda S.; Manita M.; Ishii Y.; Oka H.; Nanba Y.; Nishino M.; Sakamoto T.;
Saito T.; Sakai H.; Ichikawa M.; Namiuchi S.; Matsui T.; Inoue K.;
Komiyama N.; Akashi Y.; Matsumura A.; Nakamura Y.; Komaru T.; Hosokawa T.;
Chikamori T.; Tanaka H.; Suzuki A.; Arasaki O.; Aonuma K.; Wakasa Y.;
Yoshizawa T.; Sugano T.; Yokota N.; Kakutani A.; Suzuki T.; Abe Y.;
Kataoka T.; Okayama H.; Yokoi H.; Chin K.; Hasegawa K.; Tomita H.; Honzyo
H.; Kawai H.; Morino Y.; Tsujiyama S.; Yoshimura M.; Hamasaki S.; Niijima
Y.; Aoyama T.; Mizuno Y.; Maki A.; Tanabe K.; Murohara T.; Nakamura T.;
Naomi S.; Matsumoto N.; Minamino T.; Sairenji H.; Miyamoto N.; Arikawa M.;
Ito H.; Matsuura Y.; Hata S.; Nakatsu Y.; Onodera T.; Kato T.; Amano H.;
Tokutake E.; Kasao M.; Moriguchi M.; Yamamoto K.; Tsuji M.; Yamamoto H.;
Yanbe Y.; Iwasawa T.; Suzuki M.; Mori H.; Shibahashi E.; Takita M.; Kimura
K.
Institution
(Yamaguchi, Arashi, Hagiwara) Department of Cardiology, Tokyo Women's
Medical University, Tokyo, Japan
(Yasuda) Department of Cardiovascular Medicine, Tohoku University,
Graduate School of Medicine, Miyagi, Japan
(Yasuda) National Cerebral and Cardiovascular Center, Osaka, Japan
(Kaikita) Department of Cardiovascular Medicine, Graduate School of
Medical Sciences, Kumamoto University, Kumamoto, Japan
(Kaikita) Division of Cardiovascular Medicine and Nephrology, Department
of Internal Medicine, Faculty of Medicine, University of Miyazaki,
Miyazaki, Japan
(Akao) Department of Cardiology, National Hospital Organization, Kyoto
Medical Center, Kyoto, Japan
(Ako) Department of Cardiovascular Medicine, Kitasato University, School
of Medicine, Kanagawa, Japan
(Matoba) Department of Cardiovascular Medicine, Faculty of Medical
Sciences, Kyushu University, Fukuoka, Japan
(Nakamura) Division of Cardiovascular Medicine, Toho University, Ohashi
Medical Center, Tokyo, Japan
(Miyauchi) Department of Cardiovascular Medicine, Juntendo Tokyo Koto
Geriatric Medical Center, Tokyo, Japan
(Matsui) Department of General Medicine and Primary Care, Kumamoto
University Hospital, Kumamoto, Japan
(Ogawa) Kumamoto University, Kumamoto, Japan
(Nakamura) Iwate Prefectural Central Hospital, Japan
(Tamiya) Koto Hospital, Japan
(Yamamoto) Hokkaido Cardiovascular Hospital, Japan
(Suetake) Kaetsu Hospital, Japan
(Noguchi) National Cerebral and Cardiovascular Center, Japan
(Nakamura) Hitoyoshi Medhical Center, Japan
(Matsumura) Kameda Medical Center, Japan
(Kojima) Kojima Clinic, Japan
(Yamaguchi) Hiroshi YamaguchI Clinic, Japan
(Suwa) Juntendo University Shizuoka Hospital, Japan
(Yasu) Dokkyo Medhical University Nikko Medical Center, Japan
(Nakajima) New Tokyo Hospital, Japan
(Yamada) Osaka General Medical Center, Japan
(Arai) Kanoya Heart Center, Japan
(Hata) Minamino Cardiovascular Hospital, Japan
(Sakanashi) Sakanashi Heart Clinic, Japan
(Tateishi) Koyo Newtown Hospital, Japan
(Nakayama) Nakayama Clinic, Japan
(Nozaki) Hokkokinen Hospital, Japan
(Okumura) Nihon University Itabashi Hospital, Japan
(Tokue) Toho University Medical Center Ohashi Hospital, Japan
(Kuroki) Tokyo Metropolitan Bokutoh Hospital, Japan
(Maruyama) Iwatsuki-minami Hospital, Japan
(Suzuki) Showa University Fujigaoka Hospital, Japan
(Nishida) Kouseikai Takai Hospital, Japan
(Ajioka) Tosei General Hospital, Japan
(Yumoto) Yokohama Rosai Hospital, Japan
(Shimizu) Mashiko Hospital, Japan
(Aoyama) Fukui Prefectural Hospital, Japan
(Shimomura) Fukuoka Tokushukai Hospital, Japan
(Takeda) Koto Memorial Hospital, Japan
(Oshiro) Ohama Dai-ichi Hospital, Japan
(Sugishita) Sugishita Clinic, Japan
(Shibata) Miyazaki Medical Association Hospital, Japan
(Otonari) Otonari Clinic, Japan
(Shimizu) International Goodwill Hospital, Japan
(Kihara) Kihara Cardiovascular Clinic, Japan
(Ogawa) Kitaakita Municipal Hospital, Japan
(Ono) Medical Corporation Shoikai Kasai Shoikai Hospital, Japan
(Hazama) Nijigaoka Hospital, Japan
(Tsukahara) Fujisawa City Hospital, Japan
(Haruta) Fukuyama Cardiovascular Hospital, Japan
(Haruna) Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
(Ito) Mie University Hospital, Japan
(Fujii) Sakurabashi Watanabe Hospital, Japan
(Atsuchi) Tenyokai Central Clinic, Japan
(Sata) Tokushima University Hospital, Japan
(Wakeyama) Tokuyama Central Hospital, Japan
(Hasebe) Asahikawa Medical University Hospital, Japan
(Kobayasi) Chiba University Hospita, Japan
(Osato) Fukui CardioVascular Center, Japan
(Hironaga) Fukuoka City Hospital, Japan
(Naganuma) Hachinohe Red Cross Hospital, Japan
(Anzaki) Izumi Regional Medical Center, Japan
(Okazaki) Juntendo University Hospital, Japan
(Nakagawa) Kawanishi City Hospital, Japan
(Tokuhiro) Misato Central General Hospital, Japan
(Tanaka) Miyoshi Central Hospital, Japan
(Momose) Nagano Matsushiro General Hospital, Japan
(Fukushima) Nagatsuda Kosei General Hospital, Japan
(Kametani) Nagoya Tokushukai General Hospital, Japan
(Kawamitsu) Nanbu Tokushukai Hospital, Japan
(Saito) Nara Medical University, Japan
(Akashi) National Hospital Organization Hamada Medical Center, Japan
(Kumagai) Odawara Cardiovascular Hospital, Japan
(Eshima) Saga-Ken Medical Centre Koseikan, Japan
(Tobaru) Sakakibara Heart Institute, Japan
(Seo) Seo Heart Clinic, Japan
(Okuhara) Shobara Red Cross Hospital, Japan
(Kozuma) Teikyo University Hospital, Japan
(Ikari) Tokai University Hospital, Japan
(Takahashi) Tokyo Saiseikai Central Hospital, Japan
(Oiwa) Yokohama Chuo Hospital, Japan
(Michishita) Yokohama Sakae Kyosai Hospital, Japan
(Fujikura) Fujikura Clnic, Japan
(Momomura) Jichi Medical University Saitama Medical Center, Japan
(Yamamoto) Kansai Medical University Medical Center, Japan
(Otomo) Ome Municipal Hospital, Japan
(Matsubara) Shinrakuen Hospital, Japan
(Tashiro) St.Mary's Hospital, Japan
(Inoue) Dokkyo Medical University Hospital, Japan
(Ishihara) Hyogo College of Medicine College Hospital, Japan
(Shiojima) Kansai Medical University Hospital, Japan
(Tachibana) Kawaguchi Municipal Medical Center, Japan
(Sumii) MAZDA Hospital, Japan
(Yamamoto) Miyazaki Prefectural Nobeoka Hospita, Japan
(Omura) Nakata Clinic, Japan
(Nakamura) National Hospital Organization Kyushu Medical Center, Japan
(Takahashi) Oita University Hospital, Japan
(Morita) SAGAMIHARA NATIONAL HOSPITAL, Japan
(Watanabe) Saiseikai Matsuyama Hospital, Japan
(Fujinaga) Tokushima Prefectural Central Hospital, Japan
(Maruyama) Toyama Prefectural Central Hospital, Japan
(Oka) Tsuyama Chuo Hospital, Japan
(Shirayama) University Hospital, Kyoto Prefectural University of Medicine,
Japan
(Amano) Aichi Medical University Hospital, Japan
(Fukui) Kanagawa Cardiovascular and Respiratory Center, Japan
(Ando) Kokura Memorial Hospital, Japan
(Oshima) Kumamoto Chuo Hospital, Japan
(Kagiyama) Kyushu Central Hospital of the Mutual Aid Association of
Public, Japan
(Teragawa) Medical Corporation JR Hiroshima Hospital, Japan
(Yuge) Odawara Municipal Hospital, Japan
(Ono) Saiseikai Yamaguchi Hospita, Japan
(Koga) Steel Memorial Yawata Hospital, Japan
(Fujiu) The University of Tokyo Hospital, Japan
(Kuwabara) Toranomon Hospital, Japan
(Oya) University of the Ryukyus Hospital, Japan
(Yumoto) Fuji Hospital, Japan
(Kuji) Good Heart Clinic, Japan
(Ikemura) Ikemura Medical Clinic, Japan
(Kario) Jichi Medical University Hospital, Japan
(Chatani) Kawasaki Municipal Tama Hospital, Japan
(Sato) Kumamoto City Hospital, Japan
(Miyagi) Miyagi Clinic, Japan
(Murakami) Murakami Clinic, Japan
(Saito) Nishiarai Heart Center Hospital, Japan
(Hoshiga) Osaka Medical College Hospital, Japan
(Sato) Saiseikai Imabari Hospital, Japan
(Kubo) Saitama Medhical Center, Japan
(Sakamoto) Sakamoto Cardiovascular Clinic, Japan
(Ashida) Seirei Yokohama Hospital, Japan
(Sakamoto) Shizuoka Prefectural Hospital, Japan
(Murasaki) Tama-Hokubu Medical Center, Japan
(Uehara) Urasoe General Hospital, Japan
(Akasaka) Wakayama Medical University Hospital, Japan
(Oba) Chihaya Hospital, Japan
(Nakahara) Dokkyo Medical University Saitama Medical Center, Japan
(Hanaoka) Hanaoka Cardiovascular Clinic, Japan
(Nishimiya) Japanese Red Cross Asahikawa Hospital, Japan
(Tsunoda) Japanese Red Cross Kumamoto Hospital, Japan
(Onuma) JR Sapporo Hospital, Japan
(Higuchi) Kamiamakusa General Hospital, Japan
(Tani) Kano General Hospital, Japan
(Wada) Kusatsu General Hospital, Japan
(Kato) Mie Heart Center, Japan
(Obata) National Hospital Organization Obihiro Hospital, Japan
(Higuchi) Osaka Police Hospital, Japan
(Endo) Saiseikai Yokohamashi Nanbu Hospital, Japan
(Kato) Saitama Medical University International Medical Center, Japan
(Matsunaga) Suizenji Tohya Hospital, Japan
(Matsuoka) Uji Tokushukai Medical Center, Japan
(Noguchi) Fukuoka Wajiro Hospital, Japan
(Usui) Hamanomachi Hospital, Japan
(Hayashi) Hayashi Medical Clinic, Japan
(Otsuji) Hospital of the University of Occupational and Environmental
Health, Japan
(Osaki) Iwate Prefectual Kuji Hospital, Japan
(Zaizen) JA Oita Koseiren TsurumiI Hospital, Japan
(Yoshihara) JA Toride Medical Center, Japan
(Kadota) Kurashiki Central Hospital, Japan
(Hirose) Minamata City Hospital & Medical Center, Japan
(Miyazawa) Miyazawa Heart Clinic, Japan
(Mori) National Hospital Organization Iwakuni Clinical Center, Japan
(Takano) Nippon Medical School Chiba Hokusoh Hospital, Japan
(Shimizu) Nippon Medical School Hospital, Japan
(Wake) Okinawa Prefectural Chubu Hospital, Japan
(Oriso) Oriso Internal Medicine & Cardiology Clinic, Japan
(Yoshiyama) Osaka City University Hospital, Japan
(Kakinoki) Otaru Kyokai Hospital, Japan
(Nishioka) Saitama-Medhical Center, Japan
(Ozaki) Sapporo Orthopaedics and Cardiovascular Hospital, Japan
(Nomoto) Tokyo Rinkai Hospital, Japan
(Seki) Yamaguchi Rosai Hospital, Japan
(Kawai) Chikamori Hospital, Japan
(Ozaki) Fujita Health University Hospital, Japan
(Miura) Fukuoka University Hospital, Japan
(Kawasaki) Gifu University Hospital, Japan
(Funada) Gunma University Hospital, Japan
(Dote) Hiroshima City Asa Citizens Hospital, Japan
(Okamoto) Iwasaki Hospital, Japan
(Owada) Japanese Red Cross Society Fukushima Hospital, Japan
(Doke) Kohka Public Hospital, Japan
(Matsumura) Kumamoto Rosai Hospital, Japan
(Kubo) Japanese Red Cross Matsuyama Hospital, Japan
(Horiuchi) Medical Association Sugimura Hospital, Japan
(Nagano) Iwasa Hospital Iwasa Maternity, Japan
(Takaishi) Mitoyo General Hospital, Japan
(Yamamoto) National Center for Global Health and Medicine, Japan
(Nakashima) National Hospital Organization Kagoshima Medical Center, Japan
(Murozono) Japanese Red Cross Oita Hospital, Japan
(Munemasa) National Hospital Organization Okayama Medical Center, Japan
(Sakata) Osaka University Hospital, Japan
(Inoue) Sendai Kousei Hospital, Japan
(Ota) Takanohara Central Hospital, Japan
(Hamano) Tawaramachi Hamano Hospital, Japan
(Abe) Tokyo Medical University Ibaraki Medical Center, Japan
(Tsubokura) Tsubokura Cardiovascular Clinic, Japan
(Goto) Watanabe Hospital, Japan
(Kubota) Yamagata University Hospital, Japan
(Yano) Yamaguchi University Hospital, Japan
(Umetani) Yamanashi Prefectural Central Hospital, Japan
(Date) Date Naika Clinic, Japan
(Morimoto) Fukagawa Municipal Hospital, Japan
(Noda) Gifu Prefectural General Medical Center, Japan
(Goto) Goto Clinic, Japan
(Hibi) Gumyoji Eye Heart Clinic, Japan
(Nakano) Hikone Municipal Hospital, Japan
(Hiramitsu) Hiramitsu Heart Clinic, Japan
(Kihara) Hiroshima University Hospital, Japan
(Sugi) Imaki City Medical Center, Japan
(Shiba) International University of Health and Welfare Hospital, Japan
(Izumi) Japanese Red Cross Ise Hospital, Japan
(Sato) Japanese Red Cross Okayama Hospital, Japan
(Ajiki) JR Tokyo General Hospital, Japan
(Oishi) Kagoshima University Hospital, Japan
(Kiryu) Kanagawa Cardiovascular Medicine, Japan
(Ko) Kashima Heart Clinic, Japan
(Ando) Keiai Hospital, Japan
(Miyazaki) Kindai University Hospital, Japan
(Kinugawa) Kinugawa Cardiology Clinic, Japan
(Otake) Kobe University Hospital, Japan
(Kitaoka) Kochi Medical School Hospital, Japan
(Tayama) JCHO Kumamoto General Hospital, Japan
(Hirata) Kumamoto Regional Medical Center, Japan
(Honda) Minami Municipal National Insurance Hospital, Japan
(Manita) Naha City Hospital, Japan
(Ishii) Ogikubo Hospital, Japan
(Oka) Oka Clinic, Japan
(Nanba) Okayama Rosai Hospital, Japan
(Nishino) Osaka Rosai Hospital, Japan
(Sakamoto) Saiseikai Kumamoto Hospital, Japan
(Saito) Saito Clinic, Japan
(Sakai) Sakai Clinic, Japan
(Ichikawa) Sekishindo Hospital, Japan
(Namiuchi) Sendai Open Hospital, Japan
(Matsui) JCHO Shiga Hospital, Japan
(Inoue) South Miyagi Medical Center, Japan
(Komiyama) St. Luke's International Hospital, Japan
(Akashi) St. Marianna University School of Medicine Hospital, Japan
(Matsumura) Awa Regional Medical Center, Japan
(Nakamura) Takeda General Hospital, Japan
(Komaru) Tohoku Medical and Pharmaceutical University Hospital, Japan
(Hosokawa) Tokyo Haert Center, Japan
(Chikamori) Tokyo Medical University Hospital, Japan
(Tanaka) Tokyo Metropolitan Tama Medical Center, Japan
(Suzuki) JCHO Tokyo Yamate Medical Center, Japan
(Arasaki) Tomishiro Central Hospital, Japan
(Aonuma) University of Tsukuba Hospital, Japan
(Wakasa) Wakasa Medical Clinic, Japan
(Yoshizawa) Yamato Municipal Hospital, Japan
(Sugano) Yokohama City University Hospital, Japan
(Yokota) Yokota Naika, Japan
(Kakutani) Yoshinoawa Medical Center, Japan
(Suzuki) Aizawa Hospital, Japan
(Abe) Akeno Clinic, Japan
(Kataoka) Bellland General Hospital, Japan
(Okayama) Ehime Prefectural Central Hospital, Japan
(Yokoi) Fukuoka Sanno Hospital, Japan
(Chin) Hakuai Clinic, Japan
(Hasegawa) Hasegawa Outpatients Clinic for Cardiovascular Disease, Japan
(Tomita) Hirosaki University Hospital, Japan
(Honzyo) Honzyo Medical Hospital, Japan
(Kawai) Hyogo Brain and Heart CenterAt Himeji, Japan
(Yamamoto) Iida Municipal Hospital, Japan
(Morino) Iwate Medical University Hospital, Japan
(Tsujiyama) JA Hiroshima General Hospital, Japan
(Yoshimura) The Jikei University Hospital, Japan
(Hamasaki) Kagoshima City Hospital, Japan
(Niijima) Kan-etsu Chu-oh Hospital, Japan
(Aoyama) Kizawa Memorial Hospital, Japan
(Mizuno) Kumamoto Kinoh Hospital, Japan
(Maki) Maki Clinic, Japan
(Tanabe) Mitsui Memorial Hospital, Japan
(Murohara) Nagoya University Hospital, Japan
(Nakamura) Nakamura Clinic, Japan
(Naomi) Naomi Medicinal Clinic, Japan
(Matsumoto) Nihon University Hospital, Japan
(Minamino) Niigata University Medical & Dental Hospital, Japan
(Sairenji) Nishiyama Ichou Jyunkanki Geka Clinic, Japan
(Miyamoto) NTT-East Sapporo Hospital, Japan
(Arikawa) National Hospital Organization Oita Medical Center, Japan
(Ito) Okayama University Hospital, Japan
(Matsuura) Sakaemachi Clinic, Japan
(Hata) Sasebo City General Hospital, Japan
(Nakatsu) Shioda Memorial Hospital, Japan
(Onodera) Shizuoka City Shizuoka Hospital, Japan
(Kato) National Hospital Organization Tochigi Medical Center, Japan
(Amano) Toho University Omori Medical Center, Japan
(Tokutake) Tokutake Clinic, Japan
(Kasao) Tokyo Metropolitan Police Hospital, Japan
(Moriguchi) Toshiba Rinkan Hospital, Japan
(Yamamoto) Tottori University Hospital, Japan
(Tsuji) Tsuji Internal Medicine and Cardiology and Dental Clinic, Japan
(Yamamoto) Yamamoto Clinic, Japan
(Yanbe) Yokohama General Hospital, Japan
(Iwasawa) Yokohama General Hospital Uwamachi, Japan
(Suzuki) Yokohama Minami Kyousai Hospital, Japan
(Mori) Yokohama Sotetsu Building Clinic, Japan
(Shibahashi) Tokyo Women's Medical University, Japan
(Takita) Mebix, Japan
(Kimura) Yokohama City University Medical Center, Japan
Publisher
American Medical Association
Abstract
Importance: Antithrombotic therapy is crucial for older patients with
coronary artery disease (CAD) and atrial fibrillation (AF) who are at a
high risk of bleeding and thrombotic events. Objective(s): To examine
the age-stratified effects of rivaroxaban monotherapy compared with those
of rivaroxaban plus antiplatelet agent combination therapy. Design,
Setting, and Participant(s): This was a post hoc secondary analysis of the
Atrial Fibrillation and Ischemic Events With Rivaroxaban in Patients With
Stable Coronary Artery Disease (AFIRE) open-label randomized clinical
trial. This was a multicenter study conducted in Japan from February 23,
2015, to July 31, 2018. Patients with AF and stable CAD who had undergone
percutaneous coronary intervention or coronary artery bypass grafting 1 or
more years earlier or who had angiographically confirmed CAD that did not
require revascularization were enrolled. Participants were stratified into
4 groups by age (<70 years, 70-74 years, 75-79 years, and >=80 years).
Study data were analyzed from August 2024 to July 2025.
 Intervention(s): Rivaroxaban monotherapy or rivaroxaban plus
antiplatelet agent therapy. Main Outcomes and Measures: The primary
efficacy end point was a major adverse cardiovascular event, defined as a
composite of stroke, systemic embolism, myocardial infarction, unstable
angina requiring revascularization, or death from any cause. The primary
safety end point was major bleeding. Result(s): This study included a
total of 2215 participants (mean [SD] age, 74.3 [8.2] years; 1751 male
[79.1%]). The incidence of primary efficacy end points per patient-year
for rivaroxaban monotherapy vs rivaroxaban plus antiplatelet agent therapy
was 3.2% vs 4.3% (<70 years), 3.2% vs 2.8% (70-74 years), 3.8% vs 5.3%
(75-79 years), and 6.2% vs 10.3% (>=80 years). The hazard ratios were 0.74
(95% CI, 0.40-1.37) for those younger than 70 years, 1.16 (95% CI,
0.55-2.45) for those aged 70 to 74 years, 0.72 (95% CI, 0.41-1.26) for
those aged 75 to 79 years, and 0.61 (95% CI, 0.40-0.93) for those 80 years
and older (P for interaction =.51). For the primary safety end points, the
incidence was 0.5% vs 2.3% (<70 years), 2.2% vs 2.4% (70-74 years), 1.1%
vs 2.1% (75-79 years), and 2.9% vs 4.3% (>=80 years). The hazard ratios
were 0.23 (95% CI, 0.06-0.79) for those younger than 70 years, 0.91 (95%
CI, 0.39-2.15) for those aged 70 to 74 years, 0.52 (95% CI, 0.19-1.42) for
those aged 75 to 79 years, and 0.67 (95% CI, 0.35-1.27) for those 80 years
and older (P for interaction =.33). Conclusions and Relevance:
Results of this post hoc analysis of the AFIRE randomized clinical trial
reveal that rivaroxaban monotherapy reduced the risk of major
cardiovascular events and major bleeding across the broad range of age in
patients with AF and stable CAD. Possible age-related differences in
trends, with more pronounced efficacy in older patients and more
pronounced safety in younger patients, should be considered as hypothesis
generating and require further research. Copyright © 2025
American Medical Association.

<52>
Accession Number
2032930320
Title
Comparisons of Risk Scores for Infective Endocarditis Surgery: A
Meta-Analysis.
Source
Angiology. 77(2) (pp 176-185), 2026. Date of Publication: 01 Feb 2026.
Author
Agrawal A.; Arockiam A.D.; Dahdah J.E.; Honnekeri B.; Schleicher M.;
Shekhar S.; Haroun E.; Witten J.; Majid M.; Pettersson G.; Griffin B.;
Unai S.; Wang T.K.M.
Institution
(Agrawal, Arockiam, Dahdah, Honnekeri, Shekhar, Haroun, Majid, Griffin,
Wang) Section of Cardiovascular Imaging, Department of Cardiovascular
Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
(Schleicher) Floyd D. Loop Alumni Library, Cleveland Clinic, Cleveland,
OH, United States
(Witten, Pettersson, Unai) Department of Thoracic and Cardiovascular
Surgery, Heart, Vascular, and Thoracic Institute, Cleveland Clinic,
Cleveland, OH, United States
Publisher
SAGE Publications Inc.
Abstract
While multiple scoring systems exist to predict mortality in cardiac
surgery, their utility in infective endocarditis (IE) remains uncertain,
prompting this study to compare their prognostic accuracy. We conducted a
comprehensive review using Ovid Medline, Embase, and Cochrane Central
Register of Controlled Trials. Data were pooled using Open-Meta[Analyst]
software, and calibration analysis was performed with Review Manager 5.4.
Among 620 articles identified, 570 were screened, leading to 15 included
studies. Twelve risk scores were analyzed for operative mortality
discrimination in IE surgery, with the area under the curve (AUC) ranging
from 0.64 to 0.83. Among the IE-specific risk scores, AUCs (95% confidence
interval) were highest for ANCLA (Anemia, NYHA class IV, critical state,
large intracardiac destruction, surgery on thoracic aorta) 0.838
(0.803-0.873), AEPEI (Association pour l'Etude et la Prevention de
l'Endocadite Infectieuse) 0.764 (0.726-0.802), RISK-E (Risk Endocarditis)
(0.752 (0.662-0.842) and APORTEI (Analisis de los factores PROnosticos en
el Tratamiento quirurgico de la Endocarditis Infecciosa) 0.750
(0.726-0.774) scores. Regarding traditional risk scores, EuroSCORE II
performed at 0.750 (0.725-0.775) but underestimated mortality compared
with EuroSCORE I in calibration analysis. In conclusion, EuroSCORE II and
several endocarditis-specific scores had moderate discrimination (AUC >
0.75) in predicting mortality after IE surgery. Copyright ©The
Author(s) 2025

<53>
Accession Number
2042512752
Title
Effect of Dexmedetomidine on Pulmonary Artery Pressure: A Systematic
Review.
Source
Archives of Anesthesiology and Critical Care. 12(1) (pp 90-96), 2026. Date
of Publication: 2026.
Author
Hashemidoust A.; Moharreri M.; Namaee P.; Attar A.S.; Moradi A.
Institution
(Hashemidoust, Namaee, Attar) Department of Anesthesiology, Mashhad
University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Moharreri, Moradi) Clinical Research Development Unit, Ghaem Hospital,
Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of
(Moradi) Orthopedic Research Center, Mashhad University of Medical
Sciences, Mashhad, Iran, Islamic Republic of
Publisher
Tehran University of Medical Sciences
Abstract
Background: Dexmedetomidine, a selective alpha2-adrenergic receptor
agonist, is widely used for sedation and analgesia in critically ill
pediatric patients. Its dose-dependent modulation of pre- and postsynaptic
receptors induces sympatholysis and vascular effects. While systemic
hemodynamic impacts are well-documented, its influence on pulmonary artery
pressure (PAP) remains underexplored. This systematic review evaluates
dexmedetomidine's effects on PAP. Method(s): This systematic review
analyzes studies from databases including SID, IranMedex, Magiran, Google
Scholar, Cochrane, Scopus, and Web of Science (2005-2024). Keywords such
as "dexmedetomidine," "pulmonary artery pressure," and "pulmonary effects"
identified cross-sectional studies assessing PAP changes. Fifteen
high-quality articles met inclusion criteria. Result(s):
Dexmedetomidine's effects on PAP seem inconsistent. Animal studies have
reported both increased PAP with intravenous administration and no
significant changes. Paradoxically, some models demonstrated PAP reduction
in hypertensive states via suppressed vascular contraction. Human studies
have observed transient PAP elevation after bolus dosing, though loading
doses have shown no sustained pulmonary vascular effects. Preoperative
administration reduced pulmonary vascular resistance and mean arterial
pressure. Secondary pulmonary outcomes included improved oxygenation and
lung mechanics in restrictive lung disease, though benefits were not
universal. Conclusion(s): Dexmedetomidine exhibits variable PAP
modulation, with evidence suggesting transient pressure spikes after bolus
doses but neutral or beneficial effects in controlled administrations.
Animal-human discrepancies highlight physiological differences,
necessitating further clinical research. Beyond hemodynamics,
dexmedetomidine may enhance oxygenation and ventilation-perfusion matching
while mitigating pulmonary inflammation, though inconsistent oxygenation
outcomes underscore context-dependent variability. These findings
emphasize cautious dosing in pulmonary hypertension and identify gaps for
future human trials to clarify its role in cardiopulmonary
management. Copyright © 2026 Tehran University of Medical
Sciences.

<54>
Accession Number
2040919230
Title
Long-Term Durability of Balloon-Expandable Versus Self-Expanding
Transcatheter Aortic Valves: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 48-60), 2026.
Date of Publication: 01 Jan 2026.
Author
Continisio S.; Munafo A.R.; Montonati C.; Terzi R.; Boldi E.; Ielasi A.;
Montalto C.; Soriano F.; Oreglia J.A.; Marco F.D.; Silvestro A.; Fabris
T.; Ho E.; Saia F.; Tarantini G.; Godino C.; Maisano F.; Tang G.H.L.;
Latib A.; Scotti A.
Institution
(Continisio, Boldi, Silvestro) Division of Cardiology, Clinica S. Rocco di
Franciacorta, Brescia, Italy
(Munafo, Montalto, Soriano, Oreglia) De Gasperis Cardio Center,
Interventional Cardiology Unit, Niguarda Hospital, Milan, Italy
(Montonati, Ielasi) Division of Cardiology, IRCCS Hospital
Galeazzi-Sant'Ambrogio, Milan, Italy
(Terzi, Marco) Department of Cardiology, Monzino Cardiology Center, Milan,
Italy
(Montalto) School of Medicine and Surgery, University of Milano-Bicocca,
Milan, Italy
(Fabris, Tarantini) Department of Cardiac, Thoracic and Vascular Sciences
and Public Health, University of Padova, Padua, Italy
(Ho, Latib, Scotti) Montefiore-Einstein Center for Heart and Vascular
Care, Montefiore Medical Center, Albert Einstein College of Medicine,
Bronx, NY, United States
(Saia) Cardiology Unit, Cardio-Thoraco-Vascular Department, IRCCS
University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy
(Godino, Maisano) Heart Valve Center, Cardio-Thoracic-Vascular Department,
IRCCS San Raffaele Scientific Institute, Milan, Italy
(Tang) Department of Cardiovascular Surgery, Mount Sinai Health System,
New York, NY, United States
(Latib) Division of Cardiology, University of Cape Town, Cape Town, South
Africa
Publisher
John Wiley and Sons Inc
Abstract
Background: Transcatheter aortic valve replacement (TAVR) for aortic
stenosis (AS) is increasingly performed in younger patients with long life
expectancy. However, limited data exist on the durability of transcatheter
heart valves (THVs). Aim(s): The aim of the present work is to
compare the long-term durability of balloon-expandable (BEV) and
self-expanding (SEV) THVs after TAVR. Method(s): Electronic databases
were searched up to May 2025 for studies reporting on the long-term
durability of THVs in patients undergoing TAVR with a minimum follow-up of
5 years. Pooled odds ratios (ORs) with 95% confidence interval (CI) were
used as summary statistics and were calculated using a random-effects
model. Co-primary endpoints were moderate and severe structural valve
deterioration (SVD) and the occurrence of all-cause bioprosthetic valve
failure (BVF). All-cause death was the secondary endpoint. Result(s):
A total of 22 studies and 12,131 patients undergoing TAVR were included:
52.5% of patients (n = 6362) received BEV, 47.5% (n = 5769) SEV. An
old-generation THV was used in 84.5% of cases. At a median follow-up of 7
(5-8.3) years, the overall pooled estimates of moderate/severe SVD and BVF
were 7% (5-9) and 4% (3-5), respectively. Patients treated with a BEV
experienced a higher rate of SVD (OR: 2.09; 95% CI: 1.58-2.75; p < 0.001)
and BVF (OR: 1.61; 95% CI: 1.10-2.36; p = 0.014); no difference was
observed in terms of all-cause death. Conclusion(s): At long-term
follow-up after TAVR, patients receiving a BEV experienced higher rates of
moderate/severe SVD and of BVF compared to those having a SEV. However, no
significant differences between the two THV designs were observed on the
clinical endpoint of all-cause death. Copyright © 2025 Wiley
Periodicals LLC.

<55>
Accession Number
2041514566
Title
Low dose of landiolol does not prevent postoperative atrial fibrillation
after cardiac surgery in non-Asian patients: a multicentre randomised
study.
Source
British Journal of Anaesthesia. 136(1) (pp 65-73), 2026. Date of
Publication: 01 Jan 2026.
Author
Amour J.; Naudin C.; Besnard A.; Merzoug M.; Laverdure F.; Frossard B.;
Morichau-Beauchant T.; Geri G.; Squara P.
Institution
(Amour, Besnard, Laverdure, Frossard) Department of Cardiac
Anaesthesiology and Intensive Care Medicine, Institute of Perfusion,
Intensive Care Medicine and Anaesthesiology (IPRA), Hopital Prive Jacques
Cartier-Ramsay Sante, Massy, France
(Naudin, Merzoug, Geri, Squara) Department of Cardiology and Intensive
Care Medicine-Groupe Hospitalier Prive Ambroise Pare-Hartmann,
Neuilly-Sur-Seine, France
(Morichau-Beauchant) Department of Intensive Care Medicine, Centre
Cardiologique du Nord, Saint Denis, France
Publisher
Elsevier Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) affects 30% of
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Beta-blockers are the first-line agents recommended for POAF prevention.
Landiolol, an ultra-short-acting, highly selective beta-1-blocker, has
been shown to be effective in reducing POAF in Asian patients at a low
dose of 2 mug kg-1 min-1. The aim of this study was
to evaluate the effect of a low dose of landiolol for the prevention of
POAF in non-Asian patients after cardiac surgery. Method(s): This
multicentre, double-blind, randomised, placebo-controlled superiority
trial was conducted from January 2021 to July 2023 at three hospitals in
France. Participants were non-Asians >=65 yr undergoing elective cardiac
surgery with CPB and a left ventricular ejection fraction >=40%. Treatment
was started in the ICU and continued for up to 24 h, after which oral
beta-blockers were administered. The primary endpoint was the incidence of
POAF while in the ICU, analysed by intention to treat. Secondary outcomes
included in-hospital and 30-day POAF, ICU and hospital length of stay, and
safety outcomes. Result(s): A total of 318 participants (mean age: 71
[range: 68-76] yr; 21.4% female) were randomised. POAF in ICU occurred in
51/160 (31.9%) participants who received placebo, compared with 47/158
(29.8%) who received a low-dose landiolol infusion (relative risk: 0.93
[95% confidence interval, 0.67-1.30]; P=0.77). No differences were
observed in secondary endpoints, including in-hospital POAF and safety
outcomes. Conclusion(s): In non-Asian patients undergoing cardiac
surgery with CPB, a low-dose 24-h infusion of landiolol, used as a bridge
to oral beta-blockers, did not reduce the incidence of postoperative
atrial fibrillation. Clinical trial registration: ClinicalTrials.gov
(NCT04607122). Copyright © 2025 British Journal of Anaesthesia

<56>
Accession Number
2042068534
Title
MicroRNA and DNA Methylation Adaptation Mechanism to Endurance Training in
Cardiovascular Disease: A Systematic Review.
Source
Cardiogenetics. 15(4) (no pagination), 2025. Article Number: 28. Date of
Publication: 01 Dec 2025.
Author
Delhez J.; Ougier J.; de Araujo F.X.; de Abreu R.M.; Corbellini C.
Institution
(Delhez, Ougier, de Abreu, Corbellini) Department of Health, LUNEX
University of Applied Sciences, 50, Avenue du Parc des Sports,
Differdange, Luxembourg
(de Araujo) Department of Gymnastics and Health, Universidade Federal de
Pelotas (Federal University of Pelotas), Pelotas, Brazil
(de Abreu, Corbellini) Luxembourg Health & Sport Sciences Research
Institute A.s.b.l., 50, Avenue du Parc des Sports, Differdange, Luxembourg
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Regular endurance training induces physiological changes in
cardiac structure and function. The precise epigenetic mechanisms by which
cardiovascular adaptations are mediated are still unclear. This review
seeks to clarify the role of epigenetic regulation in exercise-induced
cardiovascular adaptation. Method(s): This systematic review was
conducted in accordance with the PRISMA guidelines up to 30 April 2025,
using the databases PubMed, VHL, and LILACS Plus. Studies were included if
they focused on microRNA expression and DNA methylation in individuals
with cardiovascular disease who underwent endurance training.
 Result(s): Six articles, including 384 participants with heart
failure, coronary artery disease, and hypertension, were included in the
final analysis. Changes in DNA methylation and microRNA expression of
specific genes involved in cardiovascular structural and functional
adaptation were observed. Significant improvements were found in body
composition, VO<inf>2peak</inf>, systolic and diastolic blood pressure,
and left ventricular function and structure. Conclusion(s): Endurance
training has a positive impact on epigenetic mechanisms related to
cardiovascular structural and functional adaptation. A clear causal link
between epigenetic modifications and clinical outcomes remains to be
established. Copyright © 2025 by the authors.

<57>
Accession Number
2042293146
Title
Lipid-lowering therapies to target cardiac allograft vasculopathy after
heart transplantation: Current evidence and future directions.
Source
Journal of Clinical Lipidology. (no pagination), 2026. Date of
Publication: 2026.
Author
Mansoor T.; Ismayl M.; Virani S.S.; Nambi V.; Misra A.; Jia X.; Fudim M.;
Greene S.J.; Sperling L.; Parikh S.; Rifai M.A.; Koshy S.K.G.; Abramov D.;
Minhas A.M.K.
Institution
(Mansoor, Koshy) Department of Internal Medicine, Western Michigan
University Homer Stryker M.D., School of Medicine (Drs Mansoor and Koshy),
Kalamazoo, MI, United States
(Ismayl) Department of Cardiology, Mayo Clinic (Dr Ismayl), Rochester, MN,
United States
(Virani) Department of Medicine, Aga Khan University (Dr Virani), Karachi,
Pakistan
(Virani) Department of Population Health, Aga Khan University (Dr Virani),
Nairobi, Kenya
(Nambi, Misra, Jia, Minhas) Department of Medicine, Section of Cardiology,
Baylor College of Medicine (Drs Nambi, Misra, Jia, and Minhas), Houston,
TX, United States
(Fudim, Greene) Division of Cardiology, Duke University Medical Center
(Drs Fudim, Greene), Durham, NC, United States
(Sperling) Division of Cardiology, Department of Medicine, Emory Clinical
Cardiovascular Research Institute (Dr Sperling), Atlanta, GA, United
States
(Parikh) Division of Cardiology, Henry Ford Hospital (Dr Parikh), Detroit,
MI, United States
(Rifai) Department of Cardiology, Houston Methodist DeBakey Heart and
Vascular Center (Dr Rifai), Houston, TX, United States
(Koshy) Department of Cardiology, Borgess Hospital (Dr Koshy), Kalamazoo,
MI, United States
(Abramov) Division of Cardiology, Department of Medicine, Loma Linda
University Health (Dr Abramov), Loma Linda, CA, United States
Publisher
Elsevier Ltd
Abstract
BACKGROUND Heart transplantation represents an increasingly utilized
procedure for end-stage heart failure patients. CURRENT EVIDENCE Cardiac
allograft vasculopathy (CAV) is a post-transplant complication of
pathological vasculature remodeling and remains an important cause for
long-term graft failure and mortality. Current preventive strategies for
CAV include optimization of vascular risk factors and pharmacotherapy with
statins and immunosuppressants. CONCLUSION Despite demonstrated
post-transplant mortality benefit and reduction in CAV with statins, the
role of other pharmacotherapies on CAV reduction through LDL-C lowering
remains less established. This review explores established evidence as
well as evolving pathways for LDL-C lowering strategies to prevent
CAV. Copyright © 2025. Published by Elsevier Inc.

<58>
Accession Number
2042284940
Title
Protocol for a randomized controlled trial for comparison of self- and
balloon-expandable valves in patients with Ascending Aortic Dilation
Undergoing Transcatheter Aortic Valve Replacement (AAD-CHOICE).
Source
Trials. 27(1) (no pagination), 2026. Article Number: 1. Date of
Publication: 01 Dec 2026.
Author
An K.; Zhang F.; Ouyang W.; Li S.; Pan X.
Institution
(An, Zhang, Ouyang, Li, Pan) Department of Structural Heart Disease,
National Center for Cardiovascular Disease, China & Fuwai Hospital,
Chinese Academy of Medical Sciences & Peking Union Medical College, No.
167 North Lishi Rd, Xicheng District, Beijing, China
(An, Zhang, Ouyang, Li, Pan) National Health Commission Key Laboratory of
Cardiovascular Regeneration Medicine, Beijing, China
(An, Zhang, Ouyang, Li, Pan) Key Laboratory of Innovative Cardiovascular
Devices, Chinese Academy of Medical Sciences, Beijing, China
(An, Zhang, Ouyang, Li, Pan) National Clinical Research Center for
Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical
Sciences, Beijing, China
(An, Zhang, Ouyang, Li, Pan) State Key Laboratory of Cardiovscular
Disease, Beijing, China
(Li) Department of Structural Heart Disease, Fuwai Hospital Chinese
Academy of Medical Sciences Shenzhen, Shenzhen, China
(Ouyang, Pan) Department of Structural Heart Disease, Fuwai Yunnan
Cardiovascular Hospital, Kunming Medical University, Kunming, China
Publisher
BioMed Central Ltd
Abstract
Background: Self-expandable valves (SEVs) and balloon-expandable valves
(BEVs) are the most widely used transcatheter heart valves. In patients
with ascending aortic dilation (AAD) who undergo transcatheter aortic
valve replacement (TAVR), comparison of two type of valves is lacking.
 Method(s): The AAD-CHOICE trial is a multi-center, randomized
controlled, open-label study. The trial will randomly assign 100 patients
with AAD (ascending aortic diameter >= 45 mm) who undergo TAVR in 1:1
ratio to either SEV group or BEV group. Participants will be followed for
a minimum of 1 year. The primary end point is device success, 30-day
all-cause mortality and 30-day adverse aortic events. The key secondary
end point is 1-year all-cause mortality, 1-year cardiovascular mortality,
adverse aortic events, major adverse cardiovascular and cerebrovascular
events, and aortic expansion rate >= 3 mm/year. Discussion(s): The
study will provide evidence regarding the performance of SEVs and BEVs in
patients with AAD who undergo TAVR. Trial registration: ClinicalTrials.gov
NCT06009588. Registered on August 12, 2023. Copyright © The
Author(s) 2025.

<59>
Accession Number
2041334423
Title
Novel Wire-Assisted Mitral Commissurotomy Reduces Valve Crossing Time
Compared to Inoue-Balloon Technique of Treating Mitral Stenosis,
Randomized Controlled Trial (CROSSVal).
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 297-303),
2026. Date of Publication: 01 Jan 2026.
Author
Oljira C.F.; Packer E.J.S.; Dalen H.; Omdal T.R.; Haaverstad R.; Petros
A.; Yadeta D.; Loha E.; Dolven T.; Flade H.M.; Skagseth A.; Bogale N.
Institution
(Oljira, Petros, Yadeta) Cardiology Department, Addis Ababa University,
College of Health Sciences, School of Medicine, Addis Ababa, Ethiopia
(Packer, Omdal, Haaverstad, Bogale) Department of Heart Disease, Haukeland
University Hospital, Bergen, Norway
(Dalen, Flade) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Dalen) Clinic of Cardiology, St. Olavs Hospital, Trondheim University
Hospital, Trondheim, Norway
(Dalen) Department of Medicine, Levanger Hospital, Nord-Trondelag Hospital
Trust, Levanger, Norway
(Haaverstad, Loha, Bogale) University of Bergen, Bergen, Norway
(Dolven) Department of Anesthesia and Intensive Care, Haukeland University
Hospital, Bergen, Norway
(Flade) Clinic of Anesthesia and Intensive Care, St. Olavs Hospital,
Trondheim University Hospital, Trondheim, Norway
(Skagseth) University Hospital of North Norway, Tromso, Norway
Publisher
John Wiley and Sons Inc
Abstract
Background: Percutaneous mitral commissurotomy (PMC) of mitral stenosis is
routinely performed by the Inoue balloon technique (IBT) which may be
challenging with respect to valvular crossing. Using a novel wire-assisted
method (WAM) may improve feasibility and time efficiency. Aim(s): In
a randomized clinical trial, we compared the feasibility and time
consumption by WAM and IBT. Method(s): Twenty mitral stenosis
patients with a Wilkins score <=10 were randomized 1:1 to IBT (n = 11) or
WAM (n = 9). All procedures were performed under general anesthesia and
optimized by in-field and transesophageal echocardiographic guiding. The
IBT balloon catheter was inserted over the coiled wire, and the stylet was
used to advance it to the mitral valve, while WAM was performed by
advancing a commercially available balloon over a stiff coiled wire placed
in the left ventricle. 1st endpoint was time from interatrial septal
puncture to balloon inflation, and 2nd outcomes were failure to double
mitral valve area or severe mitral regurgitation. Result(s): Mean +/-
SD age was 28 +/- 7 years (80% women) with all in NYHA class II or III.
Symptom duration was median (IQR) 7 (4.8) years, Wilkins score was 8.8 +/-
0.9, and mitral inflow gradient was 15.6 +/- 4.6 mmHg. Procedural time
(1st endpoint) was 14.4 +/- 3.4 min and 21.8 +/- 8.3 min in WAM and IBT,
respectively (p = 0.020). Three patients in each group did not double the
valve area by PMC, and no procedure was complicated by severe mitral
regurgitation. Conclusion(s): WAM significantly reduced the time from
interatrial septal crossing to first balloon inflation during equally
optimized PMC in severe mitral stenosis patients compared to
IBT. Copyright © 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<60>
Accession Number
2031011308
Title
Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants
Compared with Vitamin K Antagonists in Patients with Atrial Fibrillation
and Type 2 Valvular Heart Disease: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Drugs and Therapy. 39(6) (pp 1375-1386), 2025. Date of
Publication: 01 Dec 2025.
Author
Liang X.; Liu S.; Ji L.; Ma F.; Song G.; Li F.; Liu G.
Institution
(Liang, Liu, Ji, Ma, Song, Li, Liu) Department of Cardiology, The First
Hospital of Hebei Medical University, Hebei, Shijiazhuang, China
(Liu) Hebei Key Laboratory of Cardiac Injury Repair Mechanism Study,
Hebei, Shijiazhuang, China
(Liu) Hebei Key Laboratory of Heart and Metabolism, Hebei, Shijiazhuang,
China
(Liu) Hebei Engineering Research Center of Intelligent Medical Clinical
Application, Hebei, Shijiazhuang, China
(Liu) Hebei International Joint Research Center for Structural Heart
Disease, Hebei, Shijiazhuang, China
Publisher
Springer
Abstract
Purpose: This meta-analysis aimed to evaluate the efficacy and safety of
non-vitamin K antagonist oral anticoagulants (NOACs) compared with vitamin
K antagonists (VKAs) in patients with atrial fibrillation (AF) and type 2
valvular heart disease (VHD). Method(s): We searched the PubMed,
LILACS, and MEDLINE databases to retrieve, randomized controlled trials
(RCTs) comparing NOACs and VKAs in patients with AF and type 2 VHD,
excluding mitral stenosis (moderate to severe, of rheumatic origin) or
mechanical heart valves. The efficacy outcomes assessed were stroke and
systemic embolism (SE), while safety outcomes included major bleeding and
intracranial hemorrhage (ICH). Result(s): Seven RCTs, including
16,070 patients with AF and type 2 VHD, were included. NOACs reduced the
risk of stroke/SE (relative risk [RR], 0.75; 95% confidence interval [CI],
0.64-0.89; P = 0.0005), with no significant difference in major bleeding
(RR, 0.88; 95% CI, 0.64-1.21; P = 0.43). The risk of ICH was reduced with
NOACs (RR, 0.46; 95% CI, 0.27-0.77; P = 0.003). For patients with AF and
bioprosthetic heart valve (five trials, 2805 patients), stroke/SE risks
(RR, 0.65, 95% CI, 0.44-0.96) with NOACs were superior to VKAs. Major
bleeding risks without ENVISAGE TAVI AF trial (RR, 0.53; 95% CI,
0.30-0.94; P = 0.03) with NOACs were superior to VKAs. The risks of ICH
(RR, 0.61; 95% CI 0.34-1.09; P = 0.09) with NOACs were comparable to VKAs.
 Conclusion(s): NOACs demonstrate efficacy and safety in patients with
AF and type 2 VHD and reduce the risk of stroke/SE and ICH when compared
with those with VKAs. Copyright © The Author(s) 2024.

<61>
Accession Number
2041086293
Title
Immediate and Midterm Efficacy and Safety of Intravascular Lithotripsy for
Calcified In-Stent Restenosis: A Systematic Review and Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 173-186),
2026. Date of Publication: 01 Jan 2026.
Author
Eri R.R.; Zahrani S.; Andriono P.; Silalahi T.D.A.
Institution
(Eri, Andriono) Abdi Waluyo Hospital, Jakarta, Indonesia
(Eri) Gatot Soebroto Army Central Hospital, Jakarta, Indonesia
(Zahrani) Faculty of Medicine, Universitas Indonesia, West Java, Indonesia
(Silalahi) Faculty of Medicine, Universitas Prima Indonesia, West Java,
Indonesia
Publisher
John Wiley and Sons Inc
Abstract
Background: In-stent restenosis (ISR) remains a major challenge in
coronary revascularization, especially in lesions with heavy
calcification, where recurrence rates are high. The lack of data on newer
treatment options often creates dilemmas for both physicians and patients.
Intravascular lithotripsy (IVL) is a relatively new technique that has
shown promise in managing calcified ISR. This meta-analysis aims to
evaluate the procedural success and clinical outcomes of IVL in this
setting. Method(s): Following PRISMA 2020 guidelines, a systematic
search was conducted on PubMed, ScienceDirect, and SCOPUS. Studies
reporting procedural success and major adverse cardiovascular events
(MACE) of IVL for calcified ISR during follow-up were included. The
Newcastle-Ottawa Scale was used to assess study quality. Data analysis was
performed using RevMan 5.4.0 and SPSS v25. Result(s): Five studies
with a total of 207 patients and 212 lesions treated were analyzed. Acute
procedural success was 85% (95% CI 0.76-0.91, I2 = 42.0%). At 1-year
follow-up, major adverse cardiac events (MACE) included myocardial
infarction (MI) in 6% of patients (95% CI 0.02-0.16, I2 = 52.5%), target
lesion revascularization in 13% (95% CI 0.08-0.20, I2 = 45.8%), and
cardiac death in 4% (95% CI 0.02-0.08, I2 = 0.0%). The rate of
periprocedural MI was 1.5% (95% CI 0.01-0.05, I2 = 0.0%), while
no reflow phenomenon was 0.5% (95% CI 0.01-0.06, I2 = 0.0%),
with no other procedural complication occured. The overall incidence of
MACE was 16% (95% CI 0.07-0.33, I2 = 69.8%). Conclusion(s): IVL shows
potential as a treatment option for for calcified-ISR, demonstrating high
acute procedural success and acceptable 1-year clinical outcomes. The
1-year TLR (13%) and MACE (16%) rates compare favorably with historical
data for non-IVL strategies. Further large-scale, controlled studies with
longer follow-up are needed to further validate its long-term safety and
effectiveness. Copyright © 2025 Wiley Periodicals LLC.

<62>
Accession Number
2033337287
Title
Pericardiocentesis Versus Surgical Pericardiotomy for Malignant
Pericardial Effusion: A Systematic Review and Meta-Analysis.
Source
Indian Journal of Surgical Oncology. 16(6) (pp 1403-1412), 2025. Date of
Publication: 01 Dec 2025.
Author
da Nobrega Oliveira R.E.N.; de Andrade Pontual Peres C.; Oliveira A.C.;
Onyeji P.; Kemczenski F.
Institution
(da Nobrega Oliveira) Departament of Thoracic Surgery, Barretos Cancer
Hospital, Street Antenor Duarte Vilela, 1331 - Dr. Paulo Prata, SP,
Barretos, Brazil
(de Andrade Pontual Peres) University of Pernambuco, Recife, Brazil
(Oliveira) Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
(Onyeji) All Saints University, Goodwill, Dominica
(Kemczenski) University of Joinville'S Region, Joinville, Brazil
Publisher
Springer
Abstract
To compare the effectiveness and safety of pericardiocentesis versus
surgical pericardiotomy in managing malignant pericardial effusion (MPE).
We searched PubMed, Embase, and Cochrane databases for studies comparing
pericardiocentesis with surgical pericardial window in patients with MPE.
We computed mean differences (MDs) for continuous endpoints and odds
ratios (ORs) for binary outcomes, with 95% confidence intervals (CIs).
Trial registry: International Prospective Register of Systematic Reviews;
N: CRD42024572468. A total of 12 studies comprising 3,721 patients were
included in this meta-analysis. There was a significant increase in
re-accumulation of pericardial effusion in patients undergoing
pericardiocentesis (OR 3.81; 95% CI 1.99-7.31). However, there were no
significant difference between groups for in-hospital mortality (OR 0.99;
95% CI 0.68-1.46), bleeding (OR 0.05; 95% CI 0.00-2.18), atrial
fibrillation (OR 0.50; 95% CI 0.05-5.12), paradoxical hemodynamic
instability (OR 0.67; 95% CI 0.32-1.38), and length of stay (MD -0.93; 95%
CI -6.17, 4.31). Significant heterogeneity was observed in the length of
hospital stay outcome (I2 = 79%). Additionally, the included
studies had a moderate risk of bias. Pericardiocentesis was associated
with an increase in re-accumulation of pericardial effusion compared with
surgical pericardial window in patients with MPE. However, there was no
significant difference between groups for in-hospital mortality, bleeding,
atrial fibrillation, paradoxical hemodynamic instability, and length of
stay. Copyright © The Author(s), under exclusive licence to
Indian Association of Surgical Oncology 2025.

<63>
Accession Number
2042277118
Title
Efficacy of prehabilitation interventions on exercise capacity of patients
undergoing major abdominal and cardiothoracic surgery: A systematic review
and network meta-analysis of randomized controlled trials.
Source
Journal of Clinical Anesthesia. 109 (no pagination), 2026. Article Number:
112112. Date of Publication: 01 Feb 2026.
Author
Priego-Jimenez S.; Priego Jimenez P.; Lopez-Gonzalez M.; Lorenzo-Garcia
P.; Contreras-Molina M.; Alvarez-Bueno C.
Institution
(Priego-Jimenez) Hospital Universitario de Cuenca, Camino de El T,
erminillo s/n, 16003 Cuenca, Spain
(Priego-Jimenez, Lopez-Gonzalez, Lorenzo-Garcia, Contreras-Molina,
Alvarez-Bueno) Centro de Estudios Socio-Sanitarios, Grupo de investigacion
Age-ABC, Universidad de Castilla-La Mancha, Edificio Melchor Cano, Campus
Universitario, s/n, Cuenca, Spain
(Priego-Jimenez, Lopez-Gonzalez, Lorenzo-Garcia, Contreras-Molina) Grupo
de Investigacion Age-ABC, Instituto de Investigacion Sanitaria de
Castilla-La Mancha (IDISCAM), 45004, Toledo, Spain
(Priego Jimenez) Servicio de Cirugia General y del Aparato Digestivo,
Hospital Universitario La Paz, Madrid, Spain
(Lorenzo-Garcia) Centro de Fisioterapia FISANA, Orgaz, Toledo, Spain
(Contreras-Molina) Servicio de Salud de Castilla-La Mancha, Albacete,
Spain
(Alvarez-Bueno) Facultad de Ciencias de la Salud, Universidad Autonoma de
Chile, Talca, Chile
Publisher
Elsevier Inc.
Abstract
Background Prehabilitation has reported improvements in exercise capacity,
as measured by the six-minute walking test (6MWT), in people undergoing
major abdominal and cardiothoracic surgery, although there is no evidence
about which component of prehabilitation is most effective for improving
exercise capacity. Methods A network meta-analysis (NMA) was performed to
determine the effects of different components of prehabilitation on
exercise capacity in people undergoing major abdominal or cardiothoracic
surgery. A literature search was performed from baseline to September
2025. Randomized controlled trials on the effectiveness of prehabilitation
programs on exercise capacity presurgery and recovery postsurgery were
included. We assessed the risk of bias via the Cochrane risk of bias (RoB
2.0) tool and the quality of the evidence via the Grading of
Recommendations, Assessment, Development, and Evaluation (GRADE) tool.
Pairwise meta-analyses and NMAs were performed for direct and indirect
evidence. Results Thirty-eight studies were included in this NMA. The
effects associated with improvements in exercise capacity presurgery
scores were greatest for the moderate-intensity exercise group versus
control group (Effect size [ES]: 0.93 95 % CI: 0.46, 1.40), followed by
the multimodal group (exercise+ nutrition + psychological intervention)
versus the control group (ES: 0.50, 95 % CI: 0.15, 0.86). The effects
associated with 6MWT recovery postsurgery score were greatest for the
exercise+ nutrition group versus the control group (ES: 1.08, 95 % CI:
0.00, 2.16), followed by the moderate-intensity exercise group versus the
control group (ES: 0.55, 95 % CI: 0.08, 1.01), and the multimodal group
versus the control group (ES: 0.35, 95 % CI: 0.03, 0.68). Conclusions
Moderate-intensity exercise, followed by multimodal exercise, should be
considered the most effective strategy for improving exercise capacity in
people undergoing major abdominal and cardiothoracic surgery. Exercise
plus nutrition is the most effective intervention to improve 6MWT recovery
postsurgery, followed by moderate-intensity exercise and multimodal
interventions. Owing to the importance of this outcome, as a predictor of
both postsurgical complications and recovery capacity after surgery, it is
essential to know the most effective intervention to improve
it. Copyright © 2025 Elsevier Inc.

<64>
Accession Number
2040584992
Title
Defining the Learning Curve in Minimally Invasive Cardiac Surgery: A
Systematic Review and Meta-Analysis.
Source
Annals of Thoracic Surgery. 121(2) (pp 480-490), 2026. Date of
Publication: 01 Feb 2026.
Author
Elsebaie A.; Boutros C.S.; Awad A.K.; Sanad M.; Pelletier M.; Abu-Omar Y.;
El-Diasty M.
Institution
(Elsebaie) Faculty of Health Sciences, Department of Medicine, Queen's
University, Kingston, ON, Canada
(Boutros, Awad, Pelletier, Abu-Omar, El-Diasty) Cardiac Surgery
Department, Harrington Heart and Vascular Institute, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
(Awad) Faculty of Medicine, Ain-Shams University, Cairo, Egypt
(Sanad) Cardiothoracic Surgery Department, Mansoura University, Mansoura,
Egypt
(El-Diasty) Department of Biomedical and Molecular Sciences, Queen's
University, Kingston, ON, Canada
Publisher
Elsevier Inc.
Abstract
Background Minimally invasive cardiac surgery (MICS) has become a popular
approach due to its potential benefits, such as improved cosmesis, faster
recovery, shorter hospital stays, and cost-effectiveness, compared with
traditional median sternotomy. However, there have been some concerns
regarding procedural efficiency and surgical outcomes, especially in the
early phase of the learning curve of these procedures. Methods In March
2025, a systematic review was conducted using MEDLINE, Embase, the
Cochrane Library and Google Scholar databases to identify potential
studies that quantitively assessed the learning curve in MICS using
predefined metrics based on surgical times and/or clinical outcomes.
Results There were 28 studies involving 13,257 patients that met the
inclusion criteria, most of which were retrospective, focusing on 3 types
of MICS: minimally invasive mitral valve surgery, aortic valve
replacement, and coronary artery bypass grafting. The learning curve was
assessed using arbitrary (split-group) and nonarbitrary (cumulative sum)
methods. Common perioperative metrics included operative, cardiopulmonary
bypass, aortic cross-clamp times, and postoperative complications. The
reported number of cases needed to overcome the learning curve varied
widely, ranging from 23 to 125 cases (mean, 39 cases [for repair] and 78
[for replacement]) for minimally invasive valve surgery, 40 to 138 cases
(mean, 93 cases) for minimally invasive aortic valve replacement, and 16
to 100 cases (mean, 40 cases) for minimally invasive coronary artery
bypass grafting. Conclusions Differences in surgical process and
postoperative outcomes suggest a learning curve in MICS, although stable
morbidity and mortality rates indicate the safe adoption of these
procedures with appropriate training. Nonetheless, significant
heterogeneity across studies prevents precise learning curve
characterization, highlighting the need for standardized, multivariable
assessment frameworks. Copyright © 2026 The Authors.

<65>
Accession Number
2041791589
Title
Beyond Technical Feasibility in Complex Percutaneous Coronary
Intervention: Lessons From the PROCTOR Trial on Equipoise, Evidence, and
Dogma.
Source
Journal of the American College of Cardiology. 87(3) (pp 283-285), 2026.
Date of Publication: 27 Jan 2026.
Author
Ahmad Y.; Reddy R.K.; Yeh R.W.
Institution
(Ahmad) Division of Cardiology, University of California-San Francisco,
San Francisco, CA, United States
(Reddy) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Yeh) Cardiology Division, Beth Israel Deaconess Medical Center, Boston,
MA, United States
Publisher
Elsevier Inc.

<66>
Accession Number
2042661739
Title
Efficacy of rhomboid intercostal block for postoperative analgesia in
patients undergoing breast surgery: A systematic review and meta-analysis.
Source
Indian Journal of Anaesthesia. 70(1) (pp 53-67), 2026. Date of
Publication: 01 Jan 2026.
Author
Sandhya M.K.; Desai T.; Podder S.; Shetty S.R.; Siva M.
Institution
(Sandhya) Department of Anaesthesiology, Dayananda Sagar University,
Chandramma Dayananda Sagar Institute of Medical Education and Research,
Bangalore South, Karnataka, Harohalli, India
(Desai) Department of Anaesthesiology, Belagavi Institute of Medical
Sciences, Karnataka, Belagavi, India
(Podder) Department of Anaesthesiology, Kasturba Medical College, Manipal
Academy of Higher Education, Karnataka, Manipal, India
(Shetty) Department of Anaesthesiology, Kanachur Institute of Medical
Sciences, Karnataka, Mangalore, India
(Siva) Department of Community Medicine, Dayananda Sagar University,
Chandramma Dayananda Sagar Institute of Medical Education and Research,
Bangalore South, Karnataka, Harohalli, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: The rhomboid intercostal plane block (RIB) is a
regional anaesthesia technique that has shown promising results in breast
and thoracic surgeries. This systematic review and meta-analysis evaluated
the efficacy and safety of RIB in breast surgery. Method(s): The
study was conducted as per PRISMA guidelines and registered in PROSPERO
(CRD420251089477). Randomised controlled studies in which RIB was compared
with other regional blocks or a control group for postoperative analgesia
in breast surgeries were included in this study. Databases searched
included PubMed, EMBASE, the Cochrane Library, Web of Science, Directory
of Open Access Journals, and Google Scholar. The primary outcome was 24 h
opioid consumption; secondary outcomes were duration of analgesia, pain
scores, and complications. Data extraction and Risk of Bias assessment
were performed independently by two reviewers. Continuous data were pooled
as mean difference (MD) and dichotomous data as risk ratio with 95%
confidence intervals (CIs). Analyses were conducted using Python
(v3.11.13) and RevMan (v5.4). Result(s): Ten randomised controlled
trials (n = 777) were included in this meta-analysis. The risk of bias was
low in 70% of studies, and none were at high risk. RIB reduced 24 h opioid
consumption compared to control (no block) (SMD: -3.68; 95% CI: 5.13,
2.23; P < 0.00001) and serratus anterior plane block (SAPB) (SMD: -0.93;
95% CI: 1.65, -0.21; P = 0.01). There was no difference between RIB and
pectoral nerve block or erector spinae plane block in terms of
postoperative analgesic consumption. The duration of analgesia was
significantly longer with the rhomboid intercostal block (RIB) compared to
no block (MD: 8.84 h; 95% CI: 8.02, 9.66; P < 0.00001). The duration of
analgesia was comparable between RIB and SAPB. Meta-analysis of
postoperative pain scores was not feasible due to the limited number of
studies. No block-related complications were reported in any of the
studies. RIB reduced postoperative nausea and vomiting compared to control
(no block), but not significantly when compared to other blocks.
 Conclusion(s): RIB, as part of multimodal analgesia, significantly
reduces opioid consumption compared with no block. RIB is a safe and
effective alternative to established regional anaesthesia techniques for
postoperative analgesia in breast surgeries. Copyright © 2026
Indian Journal of Anaesthesia.

<67>
Accession Number
2042403385
Title
CNS Outcomes in Patients with Frailty Undergoing Coronary Artery Bypass
Grafting and Heart Valve Surgical Procedures.
Source
Journal of Cellular and Molecular Anesthesia. 10(4) (no pagination), 2025.
Article Number: e168011. Date of Publication: 01 Dec 2025.
Author
Baniani M.; Alibeigi P.; Dabbagh A.; Tafti M.F.; Talebian N.; Shokri P.
Institution
(Baniani, Alibeigi, Dabbagh) Anesthesiology Research Center, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tafti, Talebian, Shokri) Student Research Committee, School of Medicine,
Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Talebian) Preventative Gynecology Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Context: Frailty, which is common among elderly patients undergoing
cardiac surgery, is associated with an increased risk of adverse central
nervous system (CNS) outcomes, including stroke, delirium, and other
cerebrovascular complications. Objective(s): This meta-analysis aimed
to clarify the impact of frailty on these outcomes in patients undergoing
coronary artery bypass grafting (CABG) and heart valve surgeries.
 Method(s): We performed a systematic search in PubMed, Scopus, and
Web of Science for studies published up to October 2024 that reported CNS
outcomes according to frailty status. Pooled effect sizes and odds ratios
(ORs) for stroke, delirium, transient ischemic attack (TIA), and
cerebrovascular complications were calculated. Result(s): Across 19
studies comprising 2,357,446 patients, frail patients exhibited
significantly higher rates of CNS events (5.05%) compared to non-frail
patients (1.81%, P < 0.05). Stroke and delirium were notably more common
in frail patients, with delirium showing an OR of 3.94. No significant
difference was observed for TIA, but cerebrovascular complications were
more frequent in frail patients. Outcomes differed by surgery type, with
higher rates observed after heart valve procedures compared to CABG.
 Conclusion(s): Frailty is strongly associated with increased CNS
complications in cardiac surgery patients, underscoring the importance of
routine frailty assessments and tailored care strategies. Copyright
© 2025, Baniani et al.

<68>
Accession Number
2041953105
Title
Targeting Kinesiophobia After Thoracic Surgery with an Integrated
Protection Motivation and Exposure Intervention: A Randomized Controlled
Trial.
Source
Journal of Pain Research. 18 (pp 6911-6920), 2025. Date of Publication:
2025.
Author
Peng J.; Luo Y.; Feng L.; Xiao J.; Feng F.; Zheng Y.; Bao L.; Yang S.; Wu
X.
Institution
(Peng) Department of Respiratory and Critical Care Medicine, Wuhan Fourth
Hospital, Hubei Province, Wuhan, China
(Luo, Feng, Xiao, Feng, Zheng, Wu) Department of Thoracic Surgery, Union
Hospital, Tongji Medical College, Huazhong University of Science and
Technology, Wuhan, China
(Bao, Yang) Department of Nursing, Union Hospital, Tongji Medical College,
Huazhong University of Science and Technology, Wuhan, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Kinesiophobia is a significant barrier to recovery after
thoracic surgery. We aimed to determine the efficacy of an integrated
intervention combining Protection Motivation Theory (PMT) and exposure
therapy for reducing kinesiophobia and improving postoperative outcomes.
 Method(s): In this single-center, randomized, double-blind,
controlled trial, we enrolled 144 patients with kinesiophobia (Tampa Scale
for Kinesiophobia [TSK-17-C] score >=37) following thoracoscopic pulmonary
surgery. Participants were randomized 1:1 to receive either a structured
PMT-based psychological and graded exposure-behavioral intervention on
postoperative day 1 (POD1) (experimental group, n=72) or routine care with
standard pain education (control group, n=72). The primary outcome was the
TSK-17-C score on POD3. Result(s): The experimental group exhibited a
significantly lower adjusted mean TSK-17-C score on POD3 compared to the
control group (28.26 vs 36.13, respectively; adjusted mean difference,
-7.86; 95% CI, -8.37 to -7.35; P <0.001). The intervention also led to a
more improved pain trajectory (P=0.048 for time-by-group interaction) and
superior cough capacity on POD3 (P <0.001). The intervention was safe and
well-tolerated. Conclusion(s): An integrated psychological-behavioral
intervention combining PMT and exposure therapy effectively reduces
kinesiophobia, alleviates pain, and improves cough capacity in the early
postoperative period for patients undergoing thoracic surgery. This
nurse-led protocol provides a non-pharmacological approach that may
enhance recovery and help mitigate the "pain-fear-avoidance"
cycle. Copyright © 2025 Peng et al.

<69>
Accession Number
2042230490
Title
Effects of Remimazolam on Perioperative Inflammatory Response and
Neurocognitive Disorders in Elderly Patients Undergoing Video-Assisted
Thoracic Surgery: A Randomized Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 11951-11963), 2025. Date of
Publication: 2025.
Author
Hu J.; Huang Y.; Li J.; Yang J.; Pan P.; Xiang S.; Ding Y.; Yang P.; Liu
C.
Institution
(Hu, Huang, Li, Yang, Pan, Yang, Liu) Department of Anesthesiology,
Chongqing University Three Gorges Hospital, Wanzhou, Chongqing, China
(Xiang, Ding) Department of Thoracic Surgery, Chongqing University Three
Gorges Hospital, Wanzhou, Chongqing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: The systemic inflammatory response triggered by video-assisted
thoracic surgery (VATS) is associated with the risk of perioperative
neurocognitive disorders (PND). Remimazolam, a newer benzodiazepine
anesthetic, has unknown anti-inflammatory properties and uncertain effects
on elderly patients. This study investigated the effects of remimazolam on
postoperative inflammation and neurocognitive disorders in elderly
patients undergoing VATS. Patients and Methods: Ninety-two patients
aged 60 years or older scheduled for VATS were randomized to receive
either remimazolam (induction: 0.25 mg/kg; maintenance: 0.5-1.5 mg/kg/h)
or propofol (induction: 2 mg/kg; maintenance: 4-6 mg/kg/h). The primary
outcome was the serum C-reactive protein concentration at 24 h
postoperatively. Secondary outcomes included the incidence of PND,
assessed using the 3-Minute Diagnostic Confusion Assessment Method and the
Mini-Mental State Examination on postoperative days 1, 3, 5, and 7.
Exploratory outcomes included inflammatory cells (leucocytes and
neutrophil counts), cytokines (IL-6, TNF-alpha, S100beta), stress markers,
and the systemic inflammatory response index. Other measures comprised
hemodynamic parameters, anesthesia parameters, and potential adverse
events. Result(s): All 92 patients completed the intention-to-treat
analysis. At 24h postoperation, the remimazolam group showed significantly
higher CRP, IL-6, leukocyte counts, neutrophil counts, and systemic
inflammatory response index than the propofol group. No differences were
found in TNF-alpha, S100beta, or PND incidence (8.7% vs 6.5%). Stress
marker levels were comparable between groups at all time points.
Additionally, the remimazolam group demonstrated shorter anesthesia
awakening time (P<0.001), with reduced incidence of hypotension (P <0.001)
and injection pain (P = 0.015). Conclusion(s): Although remimazolam
is less effective than propofol in suppressing the early postoperative
inflammatory response in elderly patients undergoing VATS, it did not
increase the risk of PND or infection. It has significant advantages in
hemodynamic stability, facilitates faster recovery, and reduces injection
pain, establishing it as a preferred anesthetic option for geriatric VATS,
though its inflammatory mechanisms require clarification. Copyright
© 2025 Hu et al.

<70>
Accession Number
2040475548
Title
The Impact of Perioperative Hemodynamic and Blood Pressure Variability in
Outcomes and Mortality: A Comprehensive Systematic Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 347-354),
2026. Date of Publication: 01 Jan 2026.
Author
Saputra P.B.T.; Widiarti W.; Siahaan P.P.; Putra R.M.; Kriswidyatomo P.;
Faizah N.N.; Alkaff F.F.
Institution
(Saputra) Specialist Study Program of Cardiology and Vascular Medicine,
Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
(Saputra) Department of Cardiology and Vascular Medicine, Dr. Soetomo
General Academic Hospital, East Java, Surabaya, Indonesia
(Widiarti, Siahaan) Faculty of Medicine, Universitas Airlangga, East Java,
Surabaya, Indonesia
(Putra) Department of Cardiology and Vascular Medicine, Faculty of
Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia
(Putra) Universitas Airlangga Hospital, East Java, Surabaya, Indonesia
(Kriswidyatomo) Department of Anesthesiology and Reanimation, Faculty of
Medicine, Universitas Airlangga - Universitas Airlangga Hospital, East
Java, Surabaya, Indonesia
(Faizah) Division of Cardiovascular Medicine, of Medicine, Kobe
University, Kobe, Japan
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University of Groningen, University Medical Center Groningen, Groningen,
Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga,
East Java, Surabaya, Indonesia
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the impact of perioperative blood pressure
variability (BPV) on cardiovascular outcomes and mortality in cardiac
surgery patients. Method(s): Literature searches were performed
across scientific databases up to December 31, 2024. Studies reporting
perioperative BPV in patients undergoing cardiac surgery and its
association with mortality and clinical outcomes were included.
 Result(s): Fifteen studies with 16,407 patients were included.
Increased BPV was significantly associated with higher rates of 30-day
mortality, acute kidney injury (AKI), prolonged intensive care unit stay,
and cognitive dysfunction. Among patients with fewer comorbidities and
perioperative risk, 30-day mortality ranged from 0.2% to 0.5%, while in
patients with higher risk, it increased from 42.4% to 60.7% (p < 0.001).
Elevated BPV was linked to a 23.2% higher risk of AKI per unit increase in
blood pressure (BP) standard deviation (SD) and a 15% increased incidence
of postoperative delirium. The findings emphasize the critical need for
precise perioperative BP control, with advanced metrics like BP
fragmentation providing valuable insights into patient risk.
 Conclusion(s): Perioperative BPV appears to be a crucial factor
influencing postoperative outcomes in cardiac surgery patients. Effective
management of BPV may help reduce complications and improve patient
outcomes, highlighting the potential benefits of tailored hemodynamic
strategies. However, further research is needed to establish standardized
BPV thresholds and optimal management approaches. Copyright ©
2025 The Authors

<71>
Accession Number
2042626685
Title
Minimally invasive coronary artery bypass grafting (MINI-CABG): Protocol
for a pilot randomized controlled trial comparing minimally invasive
versus conventional coronary surgery.
Source
PLOS ONE. 20(12 December) (no pagination), 2025. Article Number: e0337829.
Date of Publication: 01 Dec 2025.
Author
Dallan L.R.P.; Lisboa L.A.F.; Dallan L.A.O.; Mejia O.A.V.; Filho A.F.N.;
Doenst T.; Babliak O.; Sampedro G.A.O.; Jatene F.B.
Institution
(Dallan, Lisboa, Dallan, Mejia, Filho, Jatene) Instituto do Coracao,
Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao
Paulo, Sao Paulo, Brazil
(Doenst) Cardiothoracic Surgery Department, University Hospital Jena,
Friedrich Schiller University, Jena, Germany
(Babliak) Cardiac Surgery Department, Cardiac Surgery Center, Dobrobut
Medical Network, Kyiv, Ukraine
(Sampedro) Department of Surgery, Grupo Hospitalario Kennedy, Guayaquil,
Ecuador
Publisher
Public Library of Science
Abstract
Introduction Coronary artery bypass grafting (CABG) via sternotomy remains
the standard of care for multivessel coronary disease. Minimally invasive
cardiac surgery for coronary artery bypass grafting (MICS-CABG) is an
evolving technique with the potential to reduce surgical trauma and
promote faster recovery without compromising outcomes. This protocol
describes a pilot randomized controlled trial comparing MICS-CABG and
conventional CABG in multivessel patients in a high-volume tertiary
center. Methods and analysis This is a single-center, prospective,
randomized controlled pilot trial. A total of 100 patients with
multivessel coronary artery disease will be randomized (1:1) to undergo
either conventional CABG via median sternotomy or MICS-CABG through a left
anterior thoracotomy. The sample size of 100 patients (50 per group) was
defined based on feasibility and statistical precision. This allows
estimation of an expected 8% major adverse cardiovascular and
cerebrovascular events (MACCE) rate with a 95% confidence interval
half-width of +/-5% in each group. These data will inform sample size
calculations for a future phase III trial. The primary outcomes are safety
and feasibility. Feasibility will be assessed by the successful completion
of the planned minimally invasive coronary revascularization strategy.
Safety will be evaluated through the occurrence of MACCE within 30 days
postoperatively. Secondary outcomes include operative time, mechanical
ventilation time, conversion rate to sternotomy, bleeding volume, atrial
fibrillation, postoperative ICU and hospital length of stay, and
patient-reported quality of life (EQ-5D-5L) 6 months postoperatively. The
trial is ongoing at this moment. Ethics and dissemination The protocol was
approved by the Institutional Research Ethics Committee under que number
CAAE: 54175921.8.0000.0068. Results will be disseminated through
peer-reviewed publications and scientific conferences. Copyright
© 2025 Palma Dallan et al. This is an open access article distributed
under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided
the original author and source are credited.

<72>
Accession Number
2042064107
Title
Regional Cerebral Oxygen Saturation and Risk of Delirium: A Systematic
Review and Meta-Analysis.
Source
Diseases. 13(12) (no pagination), 2025. Article Number: 383. Date of
Publication: 01 Dec 2025.
Author
Rochina-Rodriguez B.; Martinez-Arnau F.M.; Perez-Ros P.
Institution
(Rochina-Rodriguez, Perez-Ros) Department of Nursing, Faculty of Nursing
and Podiatry, Universitat de Valencia, Menendez Pelayo 19, Valencia, Spain
(Martinez-Arnau) Department of Physiotherapy, Universitat de Valencia,
Gasco Oliag 5, Valencia, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Delirium onset is associated with increased comorbidity and
mortality. Identifying reliable delirium biomarkers remains challenging.
Regional cerebral oxygen saturation (rSO<inf>2</inf>) offers an objective,
easily obtainable measure suitable for hospital monitoring.
 Objective(s): We aimed to analyse the relationship between regional
cerebral oxygen saturation (rSO<inf>2</inf>) values obtained by
near-infrared spectroscopy (NIRS) and the subsequent development of
delirium. Method(s): Studies eligible for inclusion in our systematic
review evaluated rSO<inf>2</inf> values obtained by NIRS or a used a
similar method to study hospitalised patients aged 18 years or older, some
of whom subsequently developed delirium. We searched MEDLINE, Scopus and
Web of Science without restrictions to 24 March 2024. Two review authors
independently assessed the methodological quality of the included studies
using Joanna Briggs Institute Critical Appraisal tools. Using a
random-effects model in RevMan v 5.4.0 (Cochrane Collaboration, Oxford,
UK), we analysed baseline and minimum rSO<inf>2</inf> values. Results were
presented as means and mean differences (MDs) with their 95% confidence
intervals (CIs). We followed PRISMA guidelines and registered our review
protocol in PROSPERO (CRD42024523573). Results (or Findings): We included
22 studies (20 in the meta-analysis) published between 2009 and 2024 and
involving 5757 participants. The delirium group had a lower mean baseline
rSO<inf>2</inf> value (62.47%, 95% CI 58.40 to 66.55) compared with the
non-delirium group (64.24%, 95% CI 61.33 to 67.15). Meta-analysis of
effect estimates confirmed this result (MD -2.92%, 95% CI -4.38 to -1.47).
The MD between the delirium and non-delirium group was larger among
patients assessed with the INVOS device and patients who underwent cardiac
surgery. Studies that analysed baseline values according to sensor
location showed a larger MD in rSO<inf>2</inf> values obtained via a
right-sided sensor. Conclusion(s): Our results show lower baseline
and minimum rSO<inf>2</inf> in hospitalised patients who subsequently
developed delirium. The difference varies according to the type of surgery
and type of NIRS monitor. Copyright © 2025 by the authors.

<73>
Accession Number
2042466001
Title
Combined regional anesthetic techniques enhance postoperative recovery
after cardiac surgery: a randomized controlled trial.
Source
Postgraduate Medical Journal. 102(1203) (pp 56-62), 2026. Date of
Publication: 01 Jan 2026.
Author
Dou D.; Wang L.; Yuan S.; Jia Y.; Yan F.
Institution
(Dou, Wang, Yuan, Jia, Yan) Department of Anesthesiology, State Key
Laboratory of Cardiovascular Disease, Fuwai Hospital, National Centre for
Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union
Medical College, No. 167 BeilishiRd, Xicheng District, Beijing, China
Publisher
Oxford University Press
Abstract
Background Regional anesthetic techniques are applied in cardiac surgery
to improve postoperative pain and accelerate recovery. Pecto-intercostal
fascial block (PIFB) combined with rectus sheath block (RSB) has been
proved to provide ideal analgesia for cardiac surgery, but the effects of
combing regional anesthetic techniques on postoperative recovery are
uncertain. Methods This is a prospective and randomized controlled trial
at Fuwai Hospital from 1 June 2024 to 3 July 2024. Eighty patients
undergoing elective cardiac surgery via cardiopulmonary bypass were
randomized at a 1:1 ratio to be allocated in the intervention group (PIFB
combined with RSB) or control group (without regional blocks). The primary
outcome was the global score of the 15-item quality of recovery (QoR-15)
questionnaire at 24 h after surgery. Secondary outcomes included QoR-15 at
72 h, postoperative pain scores, time to extubation, length of stay,
medical expenses in hospital and postoperative morbidities. Results The
QoR-15 global score at 24 h after cardiac surgery was 122.35+/-6.71 in the
intervention group vs 115.30+/-5.90 in the control group (P<.001). The
proportion of patients experiencing better quality of recovery
(Qor-15>=118) was higher in the intervention group (77.5% vs 55%, P=.033).
Postoperative pain scores were 1.90+/-0.18 in the intervention group
compared to 2.95+/-0.99 in the control group (P=.027) at 24 h. Time to
extubation was earlier in the intervention group (274.40+/-98.36 vs
741.28+/-93.82 min, P<.001). There were no statistically differences in
Qor-15 at 72 h and other recovery outcomes. Conclusion The administration
of PIFB combined with RSB could improve quality of recovery and relieve
postoperative pain for patients following cardiac surgery. Copyright
© The Author(s) 2025. Published by Oxford University Press on behalf
of the Fellowship of Postgraduate Medicine. All rights reserved.

<74>
Accession Number
2042283295
Title
The Role of Colchicine in the Prevention of Postoperative Atrial
Fibrillation: Mechanisms, Efficacy, and Future Directions.
Source
SN Comprehensive Clinical Medicine. 8(1) (no pagination), 2026. Article
Number: 3. Date of Publication: 01 Dec 2026.
Author
Ogieuhi I.J.; Ajekiigbe V.O.; Anthony C.S.; Abiodun C.A.; Kolo-Manma K.;
Aghasili C.C.; Ayokunle F.T.; Ajayi J.O.; Akinmeji O.; Adeyemi B.A.;
Tetteh E.B.
Institution
(Ogieuhi, Adeyemi) Northwestern Medicine McHenry Hospital, McHenry, IL,
United States
(Ajekiigbe, Kolo-Manma) Ladoke Akintola University of Technology,
Ogbomosho, Nigeria
(Anthony) University of Calabar, Calabar, Nigeria
(Abiodun) Department of Global Health, African Cancer Institute,
Stellenbosch University, Cape Town, South Africa
(Aghasili) Geisinger Wyoming Valley Medical Centre, Wilkes Barre, PA,
United States
(Ayokunle) Bowen University Teaching Hospital, Ogbomosho, Nigeria
(Ajayi) Kharkiv National Medical University, Kharkiv, Ukraine
(Akinmeji) Olabisi Onabanjo University, Ogun State, Ago-Iwoye, Nigeria
(Tetteh) Sinai Hospital of Baltimore, Baltimore, MD, United States
Publisher
Springer Nature
Abstract
Introduction: Postoperative atrial fibrillation (POAF) is a pathological
condition observed commonly among patients who underwent cardiac
surgeries. It has been associated with increased hospital stay length,
healthcare costs, morbidity, and mortality. Recent studies have evaluated
colchicine's innate role as an anti-inflammatory in preventing POAF. This
is due to its ability to reduce the remodeling of the atrial walls. In
this review, we focus on the proposed mechanisms, efficacy, and future
directions in preventing POAF with colchicine. Methodology: This study
incorporated six (6) randomized controlled trials and three (3) systematic
reviews and meta-analyses of randomized controlled trials of varying
sample sizes involving individuals with cardiovascular comorbidities such
as diabetes, coronary artery disease, and hypertension after carefully
searching the data available on colchicine's efficacy in POAF.
 Result(s): The reviewed randomized controlled trials found the
following-three (3) studies found that colchicine significantly reduced
POAF compared to placebo; two (2) studies found that colchicine reduced
the occurrence of POAF, but the findings were not statistically
significant; and one study found no change between the treatment group and
placebo. Aside from reducing POAF incidence in patients treated with
colchicine, it was observed in the studies that patients noted improved
quality of life and reduced hospital stay. Additionally, patients reported
adverse effects such as increased rates of infections and gastrointestinal
side effects such as diarrhea. This review also conducted a comparative
analysis of colchicine with conventional therapies such as beta-blockers
and amiodarone, and it was noted that colchicine can serve as a
supplementary option. Conclusion(s): Large-scale studies with larger
sample sizes and more extensive clinical trials must be conducted to
prospectively scrutinize colchicine's definite role in POAF and its
application in a more diverse population of patients. Copyright ©
The Author(s), under exclusive licence to Springer Nature Switzerland AG
2026.

<75>
Accession Number
2041953540
Title
Effects of Intravenous Subanesthetic-Dose Esketamine on Early
Postoperative Pain in Elderly Patients Undergoing Thoracoscopic Lung
Surgery: A Randomized Double-Blind Controlled Trial.
Source
Drug Design, Development and Therapy. 19 (pp 11289-11305), 2025. Date of
Publication: 2025.
Author
Zhao H.; Liu Z.; Zhang Y.; Liu M.; Ning Y.; Gao D.; Hui K.; Ji Q.; Zhang
L.
Institution
(Zhao, Liu, Zhang, Liu, Ning, Gao, Hui, Ji, Zhang) Department of
Anesthesiology, Nanjing Jinling Hospital, Affiliated Hospital of Medical
School, Nanjing University, Nanjing, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Thoracic surgery is one of the postoperative surgical procedures
with the most severe pain. This study aimed to assess whether
intraoperative subanesthetic esketamine could reduce the proportion of
elderly patients experiencing moderate-to-severe pain following
thoracoscopic lung resection. Patients and Methods: A total of 136
elderly patients undergoing thoracoscopic pulmonary surgery were randomly
assigned to two groups: the esketamine group (0.25 mg/kg loading, 0.25
mg/kg/h infusion) and the control group (received normal saline). The
primary outcome was the proportion of patients experiencing
moderate-to-severe pain on the first postoperative day (POD1), defined as
a Numerical Rating Scale (NRS) pain score >=4 during coughing. The
secondary outcomes were the postoperative Athens Insomnia Scale (AIS),
Hospital Anxiety and Depression Scale (HADS) scores, opioid consumption,
hemodynamics, and adverse events. Result(s): The primary outcome
incidence was lower in the esketamine group (51.5% [35/68]) than in the
control group (69.1% [47/68]; relative risk [RR], 0.75; 95% confidence
interval [CI], 0.56-0.99; P = 0.035). The proportion of patients with
moderate-to-severe pain in the esketamine group decreased by 25.5%. The
analysis revealed an absolute risk reduction (ARR) of 17.6% and a number
needed to treat (NNT) of 5.7 (rounded to 6). The incidence of
postoperative sleep disturbance (PSD) on POD1 (23.5% vs 44.1%; RR, 0.53;
95% CI, 0.32-0.88; P = 0.011) is lower in patients who receive esketamine.
Compared to the control group, the esketamine group demonstrated lower
HADS scores and reduced opioid consumption, without significant
differences in hemodynamic parameters or an increased incidence of
neuropsychiatric adverse events. Conclusion(s): This study
demonstrated that intraoperative subanesthetic esketamine reduced the
proportion of moderate-to-severe pain in elderly patients after
thoracoscopic surgery, decreased the incidence of sleep disturbances,
improved anxiety and depression scores, and lowered opioid consumption,
without increasing neuropsychiatric adverse events. Copyright ©
2025 Zhao et al.

<76>
Accession Number
2041745371
Title
High-Flow Nasal Oxygenation During Sedation for Transcatheter Aortic Valve
Replacement: The HIGH-OXY-TAVR Randomised-Controlled Trial.
Source
Journal of Clinical Medicine. 14(23) (no pagination), 2025. Article
Number: 8347. Date of Publication: 01 Dec 2025.
Author
Gimenez-Mila M.; Manzano-Valls A.; Abdul-Jawad O.; Arguis M.J.; Brugaletta
S.; Carnaval T.; Carretero M.J.; Flores-Umanzor E.; Freixa X.; Ibanez C.;
Italiano S.; Lopez-Baamonde M.; Martinez-Otero S.; Matute P.; Pozo M.;
Navarro-Ripoll R.; Perdomo J.M.; Regueiro A.; Rovira I.; Vega F.J.; Videla
S.; Sabate M.
Institution
(Gimenez-Mila, Manzano-Valls, Arguis, Carretero, Ibanez, Italiano,
Lopez-Baamonde, Martinez-Otero, Matute, Pozo, Navarro-Ripoll, Perdomo,
Rovira, Vega) Department of Anaesthesia and Intensive Care, Hospital
Clinic of Barcelona, Barcelona, Spain
(Gimenez-Mila, Arguis, Navarro-Ripoll, Sabate) Institut d'Investigacio
August Pi I Sunyer (IDIBAPS), Barcelona, Spain
(Manzano-Valls, Sabate) Facultat de Medicina i Ciencies de La Salut,
Universitat de Barcelona (UB), c. Casanova, Barcelona, Spain
(Abdul-Jawad, Brugaletta, Flores-Umanzor, Freixa, Regueiro, Sabate)
Cardiology Department, Hospital Clinic, Universitat de Barcelona,
Barcelona, Spain
(Carnaval) Pharmacology Unit, Department of Pathology and Experimental
Therapeutics, School of Medicine and Health Sciences, IDIBELL, University
of Barcelona, L'Hospitalet de Llobregat, Spain
(Videla) Clinical Research Support Area, Clinical Pharmacology Department,
Hospital Universitari Germans Trias i Pujol, Badalona, Spain
(Videla) Department of Pharmacology, Therapeutics and Toxicology,
Autonomous University of Barcelona, Bellaterra, Spain
(Sabate) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares (CIBERCV), Madrid, Spain
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Data on high flow nasal oxygenation (HFNO) efficacy in hypoxia
prevention in transcatheter aortic valve replacement (TAVR) are
conflictive. We aimed to determine the benefit of HFNO in preventing the
occurrence of desaturations during TAVR. Method(s): An
investigator-initiated, proof of concept, single-centre, randomised, and
controlled trial on 132 adult patients who were scheduled to undergo
transfemoral TAVR was conducted. Patients were randomised (1:1) to HFNO
(H-group) with a flow rate of 50 L min-1 and FiO<inf>2</inf>
0.6 or standard of care oxygen therapy (S-group). The primary endpoint was
the number of patients with a desaturation episode (SpO<inf>2</inf> < 93%)
for >10 s during TAVR. Secondary outcomes included arterial partial
pressure of oxygen (pO<inf>2</inf>) 45 min from sedation start and changes
in glomerular filtration rate from baseline to 12 h post-procedure.
 Result(s): Between 23 November and 24 July, a per-protocol analysis
was performed in a total of 125 patients (H-group n = 64; S- group n = 61;
49 females). The number of patients with any desaturation episode was
significantly lower in the H-group [13/64 (20%, 95% CI: 12-32%)] than in
the S-group [31/61 (51%, 95% CI: 39-63%), RR: 0.39 (95%CI: 0.23-0.68)]. At
45 min, mean (SD) pO<inf>2</inf> was higher in the H-group (24(9.8) kPa
vs. 16.7(7.5) kPa; p < 0.005). A significant improvement in delta median
(IQR) difference on glomerular filtration rate was observed in the H-group
[1.6(-1-7.9) mL min-1 1.73 m-2] with respect to the
S-group [0.2(-6.1-3.1) mL min-1 1.73 m-2; p-value:
0.013]. Conclusion(s): This trial demonstrated that HFNO provides a
better oxygenation pattern than standard oxygen therapy during TAVR.
Larger studies focusing on long-term clinical outcomes are warranted to
evaluate the benefit of HFNO during sedation for TAVR
procedures. Copyright © 2025 by the authors.

<77>
Accession Number
2042276617
Title
Tricuspid valve disease: updates on diagnostic imaging and intervention.
Source
Nature Reviews Cardiology. (no pagination), 2026. Date of Publication:
2026.
Author
Grapsa J.; Zancanaro E.; Rommel K.P.; Weber L.; Coisne A.;
Estevez-Loureiro R.; Delgado V.; Sitges M.; Enriquez-Sarano M.; Praz F.;
Fam N.; Cristell N.; Latib A.; Piazza N.; Lurz P.; Modine T.; Hausleiter
J.; Hahn R.T.; Leon M.B.; Granada J.F.
Institution
(Grapsa, Zancanaro) Heart and Vascular Institute, Brigham and Women's
Hospital, Mass General Brigham, Harvard Medical School, Boston, MA, United
States
(Zancanaro, Rommel) Department of Cardiac and Vascular Surgery, University
of Mainz, Faculty of Medicine and University Hospital Mainz, Mainz,
Germany
(Zancanaro) Department of Cardiac Surgery, San Raffaele Hospital, Milan,
Italy
(Weber, Modine) Hopital Cardiologique du Haut-Leveque, CHU de Bordeaux,
Bordeaux, France
(Weber) Department of Cardiology, Kantonsspital St. Gallen, St. Gallen,
Switzerland
(Coisne) University of Lille, Inserm, CHU Lille, Institut Pasteur de
Lille, Lille, France
(Estevez-Loureiro) Department of Cardiology, University Hospital Alvaro
Cunqueiro, Vigo, Spain
(Delgado) Heart Institute, Department of Cardiology, Germans Trias i Pujol
University Hospital, Barcelona, Spain
(Sitges) Cardiovascular Institute, Hospital Clinic, Universitat de
Barcelona, Barcelona, Spain
(Enriquez-Sarano) Minneapolis Heart Institute, Minneapolis, MN, United
States
(Praz) Universitatsklinik Fur Kardiologie, Inselspital Bern, Bern,
Switzerland
(Fam) St. Micheal's Hospital, Toronto, ON, Canada
(Cristell, Hahn, Granada) Cardiovascular Research Foundation, New York,
NY, United States
(Latib) Montefiore-Einstein Center for Heart and Vascular Care, Montefiore
Medical Center, Albert Einstein College of Medicine, New York, NY, United
States
(Piazza) McGill University Health Centre, Montreal, QC, Canada
(Lurz) Department of Cardiology, University Medical Center Mainz, Mainz,
Germany
(Hausleiter) Medizinische Klinik und Poliklinik I, LMU Klinikum, LMU
Munchen, Munich, Germany
(Hausleiter) German Center for Cardiovascular Research (DZHK), Partner
Site Munich Heart Alliance, Munich, Germany
(Hahn, Leon) NewYork-Presbyterian/Columbia University Medical Center, New
York, NY, United States
Publisher
Nature Research
Abstract
Tricuspid regurgitation is associated with an increased risk of
hospitalization and death. Many patients with severe tricuspid
regurgitation are unable to undergo surgical intervention owing to
prohibitive technical or clinical risk. The past two decades has seen an
outburst of technological advances in the field of transcatheter tricuspid
technologies, with numerous randomized, controlled trials assessing the
safety and efficacy of various repair and replacement therapies for
tricuspid regurgitation. However, crucial knowledge gaps persist,
particularly in areas such as patient selection, anatomical eligibility
and the haemodynamic effects of device implantation. In this Review, we
outline the anatomical features of the tricuspid valve and the
haemodynamic consequences of tricuspid regurgitation, and we summarize the
imaging modalities used for diagnosis and management. Furthermore, we
detail the current guideline-directed medical therapy for tricuspid
regurgitation, as well as valve repair and replacement surgical procedures
being tested in clinical trials. Finally, we highlight future
technological innovations that promise to optimize diagnosis, patient
selection and the device development process. Copyright ©
Springer Nature Limited 2026.

<78>
Accession Number
2042272231
Title
The health effects of diaphragmatic breathing: A systematic review.
Source
Complementary Therapies in Medicine. 96 (no pagination), 2026. Article
Number: 103317. Date of Publication: 01 Mar 2026.
Author
Kwon C.-Y.; Won J.; Lee B.
Institution
(Kwon) Department of Oriental Neuropsychiatry, Dong-eui University College
of Korean Medicine, 52-57, Yangjeong-ro, Busanjin-gu, Busan, South Korea
(Kwon) Anti-Aging Research Center, Dong-Eui University, 52-57,
Yangjeong-ro, Busanjin-gu, Busan, South Korea
(Won) Department of Meridian and Acupoint, College of Korean Medicine,
Dong-eui University, 52-57, Yangjeong-ro, Busanjin-gu, Busan, South Korea
(Lee) KM Science Research Division, Korea Institute of Oriental Medicine,
1672, Yuseong-daero, Yuseong-gu, Daejeon, South Korea
Publisher
Elsevier Ltd
Abstract
Background Diaphragmatic breathing (DB) is widely used clinically, but a
comprehensive synthesis of randomized controlled trial (RCT) evidence on
its health effects is lacking. This systematic review evaluated the health
effects of DB interventions in adults based on RCT evidence. Methods Six
electronic databases were searched through January 2025 for RCTs comparing
DB to control conditions in adults. Two reviewers independently selected
studies, extracted data, and assessed risk of bias (Cochrane RoB 2). A
narrative synthesis was performed due to substantial heterogeneity across
studies. Results We included 48 RCTs. DB protocols were highly
heterogeneous, with parameters varying widely in breathing frequency (2-10
breaths/min), session duration (3-45 min), and total duration (single
session to 12 weeks). Methodological quality was a significant concern
(only 2.12 % of outcomes low risk of bias). Consistent benefits were found
for gastroesophageal reflux disease (GERD) (including reduced medication
use), anxiety, post-COVID-19 syndrome, and gestational diabetes). In
healthy adults, DB showed acute cardiovascular benefits. However, evidence
was inconsistent for chronic obstructive pulmonary disease, and DB was
less effective than standard care after cardiac surgery. Safety was
underreported (18.75 % of studies), but no serious adverse events were
noted. Conclusions DB is a promising complementary therapy for specific
conditions, including GERD, but the evidence base is constrained by
methodologically weak and heterogeneous primary studies. Future research
requires rigorous, standardized trial designs to establish its clinical
value. Despite these limitations, DB is a low-cost, accessible, and
apparently safe intervention for select conditions. Copyright ©
2026 The Authors.

<79>
Accession Number
2042260196
Title
Effects of RBT-1 on the Occurrence of Postoperative Complications in
Patients Undergoing Cardiac Surgery.
Source
Journal of Cardiac Surgery. 2025(1) (no pagination), 2025. Article Number:
5324660. Date of Publication: 2025.
Author
Mack C.A.; Jessen M.E.; Shaw A.D.; Ruiz S.; Wang C.; Snapinn S.; Singh B.;
Lamy A.
Institution
(Mack) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New
York, NY, United States
(Jessen) Department of Cardiovascular and Thoracic Surgery, University of
Texas Southwestern Medical Center, Dallas, TX, United States
(Shaw) Department of Intensive Care and Resuscitation, Cleveland Clinic,
Cleveland, OH, United States
(Ruiz, Singh) Renibus Therapeutics, Inc, Southlake, TX, United States
(Wang) Pharma Data Associates, LLC, Piscataway, NJ, United States
(Snapinn) Seattle-Quilcene Biostatistics, LLC, Seattle, WA, United States
(Lamy) Department of Perioperative Medicine and Surgery, Population Health
Research Institute, Hamilton, ON, Canada
Publisher
John Wiley and Sons Inc
Abstract
Objectives: Approximately two-thirds of patients undergoing cardiac
surgery experience postoperative complications, which may lead to
significant clinical consequences. RBT-1, an investigational drug with
anti-inflammatory and antioxidant properties, elicits a preconditioning
response and was shown to improve clinical outcomes when administered
within 24-48 hours prior to surgery (modified intention-to-treat
population). The current post hoc analysis evaluated the efficacy of RBT-1
in reducing postoperative complications in the entire study population
without excluding patients based on when surgery occurred relative to
study drug administration. Method(s): A total of 135 patients were
randomized to receive a single infusion of RBT-1 (n = 91) or placebo (n =
44) at least 1 day before undergoing nonemergent coronary artery bypass
graft (CABG) and/or heart valve surgery on cardiopulmonary bypass (CPB)
and were followed for 90 days postsurgery. Clinical outcomes assessed
included ventilator time, intensive care unit (ICU) and hospital length of
stay (LOS), cardiopulmonary readmission, and other clinical events of
interest. Result(s): In this analysis, RBT-1 reduced ventilator time,
ICU, and hospital LOS by 0.98 days (NS), 2.59 days (p = 0.026), and 1.35
days (NS), respectively, compared with placebo. The incidence of 30-day
cardiopulmonary readmission was significantly reduced by RBT-1 (4.6% vs.
17.5%, placebo; p = 0.035). Additionally, RBT-1 showed a trend in
reductions in several clinical events of interest, including anemia,
atrial fibrillation, and fluid overload. Conclusion(s): Trends in
improved clinical outcomes were seen with RBT-1 treatment in this post hoc
analysis that included all patients enrolled in a Phase 2 clinical study
regardless of surgery delay beyond 2 days posttreatment. A Phase 3 study
is underway to confirm these improved clinical outcomes in a larger study
population. Trial Registration: ClinicalTrials.gov identifier:
NCT06021457. Copyright © 2025 Charles A. Mack et al. Journal of
Cardiac Surgery published by John Wiley & Sons Ltd.

<80>
Accession Number
2042623472
Title
Comparative Evaluation of Epidural Dexmedetomidine Versus Fentanyl as
Adjuvants to Bupivacaine in Thoracic Surgery: A Randomized Controlled
Trial.
Source
Bali Journal of Anesthesiology. 9(4) (pp 224-229), 2025. Date of
Publication: 01 Oct 2025.
Author
Mohamed M.A.; Soliman M.G.; El Ashmawi H.S.E.D.; Muhareb R.S.; Tawadros
P.Z.
Institution
(Mohamed, Soliman, El Ashmawi, Muhareb, Tawadros) Department of
Anesthesiology, Surgical Intensive Care and Pain Medicine, Faculty of
Medicine, Cairo University, Cairo, Egypt
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Thoracic surgery is associated with significant postoperative
pain, often managed with epidural analgesia. This study compared the
analgesic efficacy, sedation profile, opioid-sparing effect, and patient
satisfaction of epidural dexmedetomidine versus fentanyl when used as
adjuvants to bupivacaine. Method(s): In this prospective, randomised,
double-blind trial, 50 patients undergoing elective thoracotomy were
allocated equally into two groups. Group A received epidural
dexmedetomidine (50 mug) with 0.125% bupivacaine, while Group B received
fentanyl (50 mug) with 0.125% bupivacaine. Primary outcomes included
postoperative analgesic requirements and sedation scores. Secondary
outcomes included haemodynamic parameters, numeric rating scale (NRS) for
pain, and patient satisfaction over 24 h postoperatively. Result(s):
Baseline characteristics were comparable between groups. Mean arterial
pressure and heart rate decreased significantly from baseline in both
groups; however, the heart rate remained lower in the dexmedetomidine
group throughout the intraoperative period (P < 0.05). Postoperatively,
the dexmedetomidine group required significantly less morphine (0.08 +/-
0.4 mg vs 0.88 +/- 1.8 mg, P = 0.047) and exhibited lower NRS scores (P =
0.001). Sedation scores were significantly higher with dexmedetomidine (P
= 0.001), and patient satisfaction was markedly improved (P = 0.001). Side
effect incidence was comparable, with no significant increase in
hypotension, nausea, or vomiting. Conclusion(s): Dexmedetomidine,
when used as an epidural adjuvant to bupivacaine in thoracic surgery,
provides superior sedation and analgesia with reduced opioid use and
improved patient satisfaction, without increasing adverse effects. It
represents a valuable alternative to fentanyl in thoracic epidural
analgesia. Copyright © 2025 Bali Journal of Anesthesiology.

<81>
Accession Number
2042273449
Title
The effect of online education on cardiovascular intensive care nurses'
self-efficacy in blood transfusion: A randomized controlled trial
conducted in Turkey.
Source
Transfusion and Apheresis Science. 65(1) (no pagination), 2026. Article
Number: 104306. Date of Publication: 01 Feb 2026.
Author
Songul A.; Bahar A.
Institution
(Songul) Istanbul Kartal Kosuyolu Yuksek Ihtisas Education nd Research
Hospital, Istanbul, Turkey
(Bahar) Cankiri Karatekin University, Faculty of Health Sciences,
Department of Nursing, Fundamentals of Nursing, Cankiri, Turkey
Publisher
Elsevier Ltd
Abstract
Abstact Objective Safe transfusion of blood and blood products is a
critical and complex process in cardiovascular surgical intensive care
units. This study aimed to determine nurses' self-efficacy in safe blood
transfusion and to examine the effect of a structured online training
program. Method This randomized controlled study included 90 nurses
working in a cardiovascular surgical intensive care unit of a training and
research hospital. The intervention group (n = 45) received a 40-minute
theoretical and practical online training on safe blood transfusion, while
the control group (n = 45) received no training. Data were collected using
a Personal Information Form and the Self-Efficacy Scale for Safe Blood and
Blood Product Transfusion for Nurses. Analyses were performed with
independent-samples t-tests and one-way ANOVA, with a significance level
of p ' 0.05. Results The post-test mean score of the intervention group
(215.22 +/- 10.17) was significantly higher than that of the control group
(197.11 +/- 24.47) (p ' 0.05). All sub-dimensions-knowledge, procedural
skills, and transfusion safety confidence-showed significant improvement
in the intervention group. Nurses with higher education levels and younger
age demonstrated greater improvements in self-efficacy scores. Discussion
The structured online training was effective in increasing nurses'
self-efficacy for safe transfusion practices. Demographic factors
influenced the learning outcomes. Conclusion Structured online training
programs improve the knowledge, skills, and confidence of cardiovascular
intensive care nurses. It is recommended that such programs be conducted
regularly and tailored to demographic differences. Copyright ©
2026 Elsevier Ltd.

<82>
Accession Number
2042285746
Title
Effect of dexmedetomidine on postoperative mortality and prognosis: a
systematic review and meta-analysis of randomized controlled trials.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 4. Date
of Publication: 01 Dec 2026.
Author
Xu Z.; Wang D.; Sun H.; Zhang W.; Li S.; Su N.; Chen Y.; Jiang C.; Bi C.
Institution
(Xu, Wang, Sun, Li, Su, Chen, Jiang, Bi) Department of Anesthesiology,
Central Hospital of Dalian University of Technology, Liaoning, Dalian,
China
(Zhang) Department of Anesthesiology, Zhoukou Central Hospital, Henan,
Zhoukou, China
Publisher
BioMed Central Ltd
Abstract
Objective: This meta-analysis aimed to systematically evaluate the impact
of intraoperative dexmedetomidine (DEX) on postoperative mortality and
clinical outcomes in surgical patients, addressing existing controversies
in the literature. Method(s): We conducted a systematic review of
randomized controlled trials (RCTs) from PubMed, Embase and Cochrane
Library (inception to October 8, 2024; PROSPERO: CRD42024583524). Included
studies compared intraoperative DEX against controls (placebo/active
comparators) in adults undergoing general anesthesia. Primary outcome was
mortality; secondary outcomes included postoperative delirium (POD),
ICU/hospital stay, mechanical ventilation duration, and safety endpoints.
Risk ratios (RR) or mean differences (MD) with 95% confidence intervals
(CI) were pooled using fixed/random-effects models. Result(s): This
meta-analysis included 17 randomized controlled trials (RCTs). In cardiac
surgery patients, DEX significantly reduced all-cause mortality (RR 0.39,
95% CI 0.18-0.85; P = 0.02) and in-hospital mortality (RR 0.23, 95% CI
0.08-0.70; P = 0.01), but not 30-day mortality. In non-cardiac surgery
patients, DEX did not significantly reduce all-cause, 30-day, or
in-hospital mortality. DEX decreased the incidence of POD in both cardiac
(RR 0.61, 95% CI 0.46-0.82; P = 0.001) and non-cardiac surgery patients
(RR 0.56, 95% CI 0.36-0.87; P = 0.01). For other outcomes, significant
reductions in hospital stay, ICU stay, and mechanical ventilation duration
were primarily observed in the cardiac surgery subgroup. Safety analysis
indicated there was no significant difference in intraoperative
bradycardia or hypotension between groups. Conclusion(s):
Dexmedetomidine use in cardiac surgery significantly reduces all-cause and
in-hospital mortality, shortens hospital length of stay, decreases ICU
stay duration, and reduces mechanical ventilation requirements. However,
its impact on 30-day mortality is not significant. Additionally, the drug
consistently demonstrates a preventive effect on postoperative delirium
across different surgical types.Clinicians must carefully weigh the
benefits of this medication against the potential risk of transient
hemodynamic instability. Copyright © The Author(s) 2025.

<83>
Accession Number
2041734354
Title
Thoracoscopy-Guided vs. Ultrasound-Guided Paravertebral Block in
Thoracoscopic Surgery: A Non-Inferiority Randomized Trial.
Source
Journal of Clinical Medicine. 14(23) (no pagination), 2025. Article
Number: 8493. Date of Publication: 01 Dec 2025.
Author
Hong S.B.; Hyun K.; Choi H.
Institution
(Hong) Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's
Hospital, College of Medicine, The Catholic University of Korea, Seoul,
South Korea
(Hyun) Department of Thoracic and Cardiovascular Surgery, St. Vincent's
Hospital, College of Medicine, The Catholic University of Korea, Seoul,
South Korea
(Choi) Department of Anesthesiology and Pain Medicine, Seoul St. Mary's
Hospital, College of Medicine, The Catholic University of Korea, Seoul,
South Korea
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Thoracic paravertebral block (TPVB) is an established
component of multimodal analgesia and enhanced recovery pathways following
thoracoscopic lung resection. A surgeon-performed, thoracoscopy-guided
approach has been proposed to improve intraoperative workflow, but
high-quality comparative data are limited. Method(s): In this
single-center, randomized, non-inferiority trial, adult patients
undergoing thoracoscopic lobectomy or segmentectomy received either
thoracoscopy-guided TPBV (T-TPVB) conducted by surgeons or
ultrasound-guided TPBV (U-TPVB) conducted by anesthesiologists. Blocks
were performed at the end of surgery at the T4 and T7 vertebra levels,
using 10 mL of 0.5% ropivacaine per level. The primary outcome was dynamic
pain during coughing at 1-6 h postoperatively (visual analog scale, VAS).
Secondary outcomes included resting/dynamic pain scores, opioid
consumption over 48 h, block-related complications, and procedural time.
 Result(s): Seventy-three patients were included in the
intention-to-treat analysis. Mean dynamic VAS scores at 1-6 h were 3.3
(T-TPVB) and 3.1 (U-TPVB), with a mean difference of 0.2 (95% CI: -0.3 to
0.7), meeting the non-inferiority criterion (margin 0.9). Secondary
outcomes, including pain trajectories and opioid consumption, were
comparable between groups. Procedural time was significantly shorter in
the T-TPVB group, with no differences in complication rates.
 Conclusion(s): Surgeon-performed thoracoscopy-guided TPVB was
non-inferior to the standard ultrasound-guided technique for early
postoperative pain after thoracoscopic lung resection. Both methods
provided comparable analgesic efficacy and safety profiles, while T-TPVB
significantly reduced procedural time. This approach may support
streamlined perioperative workflows and optimize enhanced recovery
protocols in thoracic surgery. (Trial registration number,
KCT0006471). Copyright © 2025 by the authors.

<84>
Accession Number
2042069597
Title
Efficacy and Safety of Drug and Device Strategies for Stroke Prevention in
Atrial Fibrillation After Intracranial Hemorrhage: A Bayesian Network
Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 12(12) (no pagination),
2025. Article Number: 464. Date of Publication: 01 Dec 2025.
Author
Qi F.; Yang Y.; Wang L.; Weng S.; Wu Q.; Liu Y.; Hu Z.; Chen L.; Wang Y.
Institution
(Qi, Yang, Wang, Weng, Wu, Liu, Hu, Chen, Wang) Department of Cardiology,
Beijing Anzhen Hospital, Capital Medical University, Beijing, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
(1) Background: Whether anticoagulation can be resumed in atrial
fibrillation (AF) combined with intracranial hemorrhage (ICH), and which
anticoagulation modality is used with better efficacy and safety, is
unknown. (2) Method: Randomized controlled trials (RCTs) and observational
studies on relevant topics were included by searching five databases:
PubMed, EMBASE, EBSCO, Cochrane Central Register of Controlled Trial and
ClinicalTrials. Bayesian network meta-analysis was performed to analyze
the effect of oral anticoagulant (OAC), new oral anticoagulant (NOAC),
warfarin, antiplatelet, left atrial appendage occlusion (LAAO) and no
therapy in patients with AF after intracranial hemorrhage. (3) Results: We
included 16 studies involving 25,483 patients. Compared with no
antithrombotic therapy, the risk of thromboembolism and all-cause
mortality were both reduced with OAC (OR: 0.38, 95% CI: 0.21-0.67; OR:
0.45, 95% CI: 0.25-0.8) and LAAO (OR: 0.11, 95% CI: 0.01-0.76; OR: 0.11,
95% CI: 0.01-0.88), and there was no increased risk of recurrent
intracranial hemorrhage. Regarding thromboembolism, OAC (OR: 0.28, 95% CI:
0.11-0.69) was superior to antiplatelet therapy, and antiplatelet therapy
(OR: 12.59, 95% CI: 1.57-133.50) was associated with a higher risk of
thromboembolism than LAAO. There were no significant differences in
recurrent intracranial hemorrhage between the interventions. LAAO appeared
to be the best option for reducing thromboembolism (SUCRA: 0.96),
recurrent intracranial hemorrhage (SUCRA: 0.75) and all-cause mortality
(SUCRA: 0.94). (4) Conclusion(s): Based on this network
meta-analysis, we hypothesize that LAAO has the highest likelihood of
reducing the risk of thromboembolism and recurrent intracranial
hemorrhage, as well as all-cause mortality in patients with AF after
intracranial hemorrhage, followed by OAC. Copyright © 2025 by the
authors.

<85>
Accession Number
2041945057
Title
Coronary artery bypass grafting versus percutaneous coronary intervention
outcomes among patients with acute coronary syndrome and unprotected left
main coronary artery disease: a meta-analysis with a reconstructed
time-to-event analysis.
Source
Expert Review of Cardiovascular Therapy. 24(1) (pp 57-69), 2026. Date of
Publication: 2026.
Author
Elbahloul M.A.; Gadelmawla A.F.; Ali A.H.G.; Awad A.K.; Elazab A.; Mansour
A.; Mohamed A.N.; Sarhan H.; Elgendy I.Y.
Institution
(Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Kafr
El-Shaikh, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Ali) Institute of Medicine, National Research Mordovia State University,
Saransk, Russian Federation
(Awad) Department of Cardiothoracic Surgery, Ain-Shams University, Cairo,
Egypt
(Elazab) Faculty of Medicine, South Valley University, Qena, Egypt
(Mansour) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Mohamed) Department of Internal Medicine, Cleveland Clinic, Cleveland,
OH, United States
(Mohamed) Department of Internal Medicine, Charleston Area Medical Center
(CAMC), Charleston, WV, United States
(Sarhan) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Elgendy) Division of Cardiovascular Medicine, Gill Heart and Vascular
Institute, University of Kentucky, Lexington, KY, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Patients with an unprotected left main coronary artery
(ULMCA) presenting with acute coronary syndrome (ACS) were
underrepresented in randomized trials. We aimed to compare the outcomes of
coronary artery bypass grafting (CABG) and percutaneous coronary
intervention (PCI) in these patients. Method(s): Electronic databases
were searched for studies comparing CABG vs PCI for patients with ULMCA
presenting with ACS. The primary outcome was all-cause mortality. The
outcomes were reported using a risk ratio (RR) and 95% confidence interval
(CI) using random-effect model. Result(s): A total of 7 studies with
4033 patients were included. There was no difference in the incidence of
all-cause mortality between CABG and PCI. CABG was associated with a trend
toward a higher incidence of stroke in short-term, but with lower rates of
lower target vessel revascularization, and target lesion revascularization
during long-term follow-up. Conclusion(s): CABG and PCI were
associated with comparable long-term mortality among patients with ULMCA
who presented with ACS. However, CABG was associated with a lower
incidence of MI and revascularization but a trend toward a higher
incidence of stroke. These findings could help with informed
decision-making among patients with ULMCA presenting with ACS.
Registration: The protocol was registered on PROSPERO
(CRD420251034578). Copyright © 2025 Informa UK Limited, trading
as Taylor & Francis Group.

<86>
Accession Number
2042285744
Title
Quality of early recovery after ultrasound-guided serratus plane block for
transapical transcatheter aortic valve implantation surgery under general
anesthesia: a single-center randomized controlled trial.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 1. Date
of Publication: 01 Dec 2026.
Author
Xiao C.; Jing S.; Yang G.; Chen F.; Yang M.; Cao L.; Tan Y.; Lin G.; Li H.
Institution
(Xiao, Jing, Yang, Chen, Yang, Cao, Tan, Lin, Li) Department of
Anesthesiology, Second Affiliated Hospital of Army Medical University,
PLA, No. 83 Xinqiao Road, Chongqing, Shapingba, China
Publisher
BioMed Central Ltd
Abstract
Background: Regional anesthesia techniques, including the serratus
anterior plane block (SAPB), reduce postoperative pain after minimally
invasive cardiac surgery. However, the evidence regarding its impact on
transapical transcatheter aortic valve replacement (TA-TAVR) is limited,
and data specifically exploring its effectiveness on patient-centric
outcomes are lacking. Method(s): We conducted a single-center
randomized controlled trial comparing the efficacy of ultrasound-guided
SAPB with ropivacaine 0.5% (40 ml) with no block for patients undergoing
TA-TAVR. The primary outcome was 24-hour Quality of Recovery-40 (QoR-40)
score. Secondary outcomes included QoR-40 at 48 h, pain scores, opioid
consumption, and complications. Result(s): A total of 66 participants
were included in the analysis. The median QoR-40 [IQR] at 24 h was higher
in SAPB group (n = 32) compared with the no block group (n = 34): 180.5
(171.25-183) VS 172 (165.25-179), p = 0.006. At 48 h, scores were 185.5
(182-189) vs. 183.5 (178.5-187), p = 0.048. Although these differences
were statistically significant, they did not reach the minimum clinically
important difference (MCID) of 6.3. Early postoperative analgesia was
superior in the SAPB group, with lower resting/coughing NRS scores at 6
and 12 h (median difference 1, P < 0.001). However, there were no
intergroup differences in opioid consumption or the need for rescue
analgesia. Conclusion(s): As part of multimodal analgesia for
TA-TAVR, SAPB improved early postoperative analgesia but did not enhance
the multidimensional quality of early recovery, as measured by the QoR-40
score. Further studies are warranted. Trial registration:
ChiCTR2300068584. Registered 24 February 2023.
https://www.chictr.org.cn/bin/project/edit? pid=184719. Copyright
© The Author(s) 2025.

<87>
Accession Number
2042623465
Title
Dissecting the Albumin Assumption: Can Albumin Reduce Acute Kidney Injury
after Cardiac Surgery Compared with Crystalloids? A Systematic Review and
Meta-analysis.
Source
Bali Journal of Anesthesiology. 9(4) (pp 209-217), 2025. Date of
Publication: 01 Oct 2025.
Author
Gemawan T.; Setiawan P.; Erisadana R.N.
Institution
(Gemawan, Setiawan) Department of Anesthesiology and Reanimation,
Airlangga University, Dr. Soetomo General Academic Hospital, Surabaya,
Indonesia
(Gemawan) Department of Anesthesiology and Intensive Care, Dr. Soebandi
General Academic Hospital, Jember, Indonesia
(Erisadana) University of Jember, Department of Faculty of Medicine,
Jember, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Introduction: Acute kidney injury (AKI) is a common and serious
complication after cardiac surgery. Albumin has been proposed as a
superior fluid for perioperative management compared to crystalloids. We
aimed to evaluate whether albumin reduces the incidence of AKI compared to
crystalloid solutions in patients undergoing cardiac surgery. The need for
renal replacement therapy (RRT) was assessed as a secondary outcome.
 Material(s) and Method(s): A systematic search was performed on
PubMed, ScienceDirect, and Scopus. Eligible studies were randomized
controlled trials (RCTs) comparing albumin to crystalloids in adult or
pediatric cardiac surgery patients and reporting AKI based on standardized
criteria. Risk of bias (RoB) was assessed using the Cochrane RoB 2.0 tool.
Meta-analysis was performed, calculating risk ratios (RRs) with 95%
confidence intervals (CIs) and applying random- or fixed-effects models
depending on heterogeneity. Result(s): Six RCTs, including 2465
patients, were analyzed. No significant difference in AKI incidence was
found between albumin and crystalloid groups (RR: 0.97, 95% CI: 0.79-1.18,
P = 0.74). Subgroup analysis showed no benefit when albumin was used as a
priming solution (RR: 1.06, 95% CI: 0.79-1.43), while a benefit was
observed in off-pump surgery in a single study. No significant difference
in RRT requirement was observed (RR: 1.75, 95% CI: 0.52-5.97, P = 0.37).
 Conclusion(s): This meta-analysis provides no evidence that albumin
reduces the incidence of AKI, compared to crystalloids in cardiac surgery.
Crystalloids remain an appropriate first-line choice, while future
large-scale RCTs are needed to clarify whether certain patient subgroups
may benefit from albumin. Copyright © 2025 Bali Journal of
Anesthesiology.

<88>
Accession Number
2042275821
Title
Safety and Efficacy of Cerebral Embolic Protection Device During
Transcatheter Aortic Valve Implantation: An Updated Systematic Review and
Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2026.
Date of Publication: 2026.
Author
de Pontes V.B.; Jaramillo S.; Trevisan T.; Huntermann R.; de Sousa
P.A.M.G.; Silva L.D.D.; Clemente M.R.C.; Garot P.; Gomes W.F.
Institution
(de Pontes, Trevisan) University Centre of Associated Colleges for
Education, Sao Joao da, Boa Vista, Brazil
(Jaramillo) Universidad Austral, Pilar, Argentina
(Huntermann) University Center for the Development of Alto Vale, Rio do
Sul, Brazil
(de Sousa) University of Sao Paulo Medical School, Sao Paulo, Brazil
(Silva) Federal University of Uberlandia, Uberlandia, Brazil
(Clemente) Faculdade de Medicina de Petropolis, Petropolis, Brazil
(Garot) Institut Cardiovasculaire Paris-Sud, Hopital Jacques Cartier,
Ramsay-Sante, Massy, France
(Gomes) Hospital INC, Curitiba, Brazil
(Gomes) Faculdades Pequeno Principe, Curitiba, Brazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Cerebral embolic protection (CEP) devices may mitigate the
risk of embolization and stroke during transcatheter aortic-valve
implantation (TAVI), yet their safety and efficacy remain debated.
 Aim(s): To evaluate the safety and efficacy of CEP during TAVI.
 Method(s): We conducted a systematic search of PubMed, Embase, and
the Cochrane Library from inception through April 2025 for randomized
controlled trials (RCTs) and observational studies comparing TAVI
performed with versus without the Sentinel CEP device. Pooled risk ratios
(RRs), odds ratios (ORs), and 95% confidence intervals (CIs) were
calculated using a random-effects model. Result(s): Seventeen studies
(4 RCTs and 13 observational cohorts) involving 752,164 patients were
included; among them, 86,916 (11.5%) received the Sentinel device. CEP use
was associated with significantly lower rates of early stroke (within 72
h; RR 0.61; 95% CI 0.40-0.94), any stroke (RR 0.78; 95% CI 0.65-0.94),
30-day stroke (RR 0.47; 95% CI 0.26-0.85), disabling stroke (RR 0.49; 95%
CI 0.29-0.84), and all-cause mortality (RR 0.66; 95% CI 0.49-0.89). No
significant differences were observed in transient major vascular
complications, bleeding events, or acute kidney injury (AKI). In the
analysis restricted to RCTs, stroke and mortality outcomes were similar
between groups, with no significant differences across safety endpoints.
In prespecified subgroup analyses, patients with bicuspid aortic valves
derived no significant benefit from CEP (OR O.80; 95% CI 0.40-1.61),
whereas those with prior stroke experienced a reduced risk of recurrent
stroke (RR 0.61; 95% CI 0.45-0.82). Conclusion(s): This meta-analysis
suggests that the Sentinel CEP device is associated with lower risks of
stroke and mortality following TAVI, without increasing the incidence of
vascular complications, bleeding, or AKI. Copyright © 2026 Wiley
Periodicals LLC.

<89>
Accession Number
2041941755
Title
Prioritizing surgical ablation for atrial fibrillation during coronary
artery bypass grafting: new evidence, old debate.
Source
Expert Review of Cardiovascular Therapy. 24(1) (pp 5-13), 2026. Date of
Publication: 2026.
Author
Erez E.; Squiers J.J.; Dorton C.W.; Banwait J.; Gasparini A.; Mack M.;
DiMaio J.M.; Schaffer J.M.
Institution
(Erez, Dorton, Banwait, Mack, DiMaio) Baylor Scott & White Research
Institute, Dallas, TX, United States
(Squiers, DiMaio, Schaffer) Department of Cardiothoracic Surgery, Baylor
Scott & White the Heart Hospital, Plano, TX, United States
(Gasparini) Red Door Analytics AB, Stockholm, Sweden
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Atrial fibrillation (AF) affects 10-20% of patients
undergoing coronary artery bypass grafting (CABG) and is associated with
increased postoperative morbidity and mortality. Although studies support
the safety and effectiveness of surgical ablation (SA), and guidelines
recommend its use during CABG for patients with preexisting AF, clinical
adoption remains limited. Areas covered: In this review, we outline
current guideline recommendations, evaluate the evidence base, highlight
recent analyses, and examine persistent barriers to the adoption of SA
during CABG, informed by studies identified through searches of PubMed and
Google Scholar. Expert opinion: Small randomized studies demonstrate that
SA restores sinus rhythm following CABG, while observational studies
suggest rhythm restoration improves survival and reduces thromboembolic
events. Recent national database analyses have lent further support,
finding an association between SA and long-term survival. Analytic
approaches included analysis by treatment type using propensity-score risk
adjustment and, more recently, using surgeon frequency of SA as an
instrumental variable. However, concerns about unmeasured confounding,
sparse rhythm follow-up, and limited lesion-set granularity undermine
confidence and contribute to underuse. A randomized trial comparing
long-term outcomes between pulmonary vein isolation, left atrial, and
bi-atrial lesion sets is critically needed to guide optimal implementation
of SA during CABG. Copyright © 2025 Informa UK Limited, trading
as Taylor & Francis Group.

<90>
Accession Number
2042200777
Title
Chest wall motion symmetry during breathing - a systematic review with
meta-analysis providing normative value in healthy subjects.
Source
Respiratory Medicine and Research. 89 (no pagination), 2026. Article
Number: 101244. Date of Publication: 01 May 2026.
Author
Gaillard L.; Stubbe L.; Riquet D.; Houel N.
Institution
(Gaillard, Riquet, Houel) Universite de Reims Champagne-Ardenne, PSMS,
Reims, France
(Gaillard, Stubbe, Riquet) Ecole Superieure d'Osteopathie - Paris,
ESO-Paris Recherche, Champs-sur-Marne, France
(Stubbe) CIAMS, Universite Paris-Saclay, Orsay Cedex, France
(Stubbe) CIAMS, Universite d'Orleans, Orleans, France
Publisher
Elsevier Masson s.r.l.
Abstract
Background The physical examination of the respiratory system looks for
evidence of asymmetrical breathing motion that is considered as
pathologic. Optoelectronic plethysmography (OEP) is a non-invasive technic
that uses motion capture to measure breathing volumes. Objective The aim
of this systematic review is to research the progress made using OEP with
a segmentation allowing the comparison of left and right parts of total
and compartmental chest wall motion both in pathology and healthy
condition. Methods Systematic research was conducted using Pubmed,
ScienceDirect, Scopus and Cochrane databases. A meta-analysis was
performed on the relative contribution of the right side to the total and
compartmental chest wall motion in healthy subjects during quiet
breathing. Results Twenty studies met the inclusion criteria. OEP
accurately diagnosed pathologies that would typically be diagnosed through
invasive procedures. OEP is suitable for the assessment of the effects of
thoracic surgeries and pulmonary rehabilitation. The meta-analysis results
show that the total chest wall motion is symmetrical with the right side
contributing 50.00% ([49.24: 50.76], p < 0.05). Compartmental chest wall
motion is affected by slight asymmetries. The right part of the pulmonary
rib cage (RCP) accounts for 51.02% ([49.56 : 52.47], p < 0.05) of the RCP
motion. The right part of the abdominal rib cage and the abdomen
compensate with a contribution of 49.25% ([47.74 : 50.77], p < 0.05 and
49.33% ([48.34 : 50.32], p < 0.05) respectively. Conclusion OEP's ability
to compare left and right sides of chest wall motion during breathing is
relevant to diagnose and to follow-up pathologies causing breathing
asymmetries. Copyright © 2025 The Author(s).

<91>
Accession Number
2042578392
Title
Heart Transplantation: Immunological Challenges Revisited.
Source
Current Cardiology Reviews. 22(2) (no pagination), 2026. Date of
Publication: 2026.
Author
Assadiasl S.; Safdel S.; Gheitasi M.; Nicknam M.H.
Institution
(Assadiasl, Safdel, Nicknam) Molecular Immunology Research Center, Tehran
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Assadiasl) Iranian Tissue Bank and Research Center, Tehran University of
Medical Science, Tehran, Iran, Islamic Republic of
(Gheitasi) Department of Immunology, School of Medicine, Kerman University
of Medical Sciences, Kerman, Iran, Islamic Republic of
(Nicknam) Department of Immunology, School of Medicine, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Bentham Science Publishers
Abstract
Introduction: Immunologic responses to cardiac allografts initiate before
transplantation during brain-dead organ procurement and might persist for
years after transplantation, culminating in chronic allograft dysfunction.
Despite remarkable advances in post-transplant care and immunosuppressive
agents, acute cellular and antibody-mediated rejections as well as chronic
allograft vasculopathy significantly affect cardiac allograft and patient
survival. Method(s): Herein, recent findings of the molecular
mechanisms involved in the inflammatory responses before and after heart
transplantation, including brain death donor inflammation, acute cellular
rejection, antibody-mediated rejection, and chronic allograft dysfunction,
have been summarized, along with novel therapeutic approaches for their
treatment. Finally, recent developments in prognostic and diagnostic
biomarkers for immunological complications have been provided, with an
overview of the most promising biomarkers to date. Results and Discussion:
Due to the recent developments in the description of molecular mechanisms
involved in the immunopathogenesis of cardiac allograft rejection, some
immune cells, proinflammatory cytokines, and adhesion molecules have been
proposed as therapeutic targets for the prevention or treatment of
alloimmune responses. In addition, several molecules derived from graft
tissue or immune cells, e.g. natriuretic peptides, cardiac troponins,
exosomal products, microRNAs, and donor-derived cell-free DNA, have been
suggested as potential biomarkers for the prediction or diagnosis of
cardiac transplant rejection. Conclusion(s): Considering the need to
design non-invasive, low-cost tests for early diagnosis of post-transplant
complications and convenient follow-up of the cardiac transplant
recipients, peripheral blood biomarkers could be appropriate candidates
for this purpose. Copyright 2026, © Bentham Science Publishers

<92>
Accession Number
2042578368
Title
Alirocumab versus Evolocumab on Cardiovascular Outcomes: A Systematic
Review and Meta-analysis.
Source
Current Cardiology Reviews. 22(1) (no pagination), 2026. Date of
Publication: 2026.
Author
Cleto A.S.; Schirlo J.M.; Machozeki J.; Martins C.M.
Institution
(Cleto, Schirlo, Machozeki, Martins) Department of Medicine, State
University of Ponta Grossa, Ponta Grossa, Brazil
Publisher
Bentham Science Publishers
Abstract
Introduction: The PCSK9 enzyme is present mainly in the liver and is
responsible for the degradation of LDL-C receptors. Currently, there are
some drugs that inhibit this enzyme, such as alirocumab and evolocumab.
Consequently, these drugs reduce serum LDL-C levels. Therefore, a
systematic review and a meta-analysis were carried out in order to compare
alirocumab against evolocumab in reducing cardiovascular outcomes.
 Method(s): This systematic review was carried out in accordance with
PRISMA and was registered in PROSPERO (CRD42024573217). The following
databases were searched on July, 9, 2024: PubMed, Web of Science and
Scopus. Randomized clinical trials with a control group were included and
meta-analyses were performed to assess relative risk (RR). The random
effects model was used in heterogeneous samples. The articles were
distributed into 2 subgroups: use of alirocumab and evolocumab.
 Result(s): Initially, 2,213 articles were found, of which 6 were
included. In total, 62,119 patients participated. The RR values were
significant for alirocumab in the following outcomes: myocardial
infarction (MI) 0.85 (95% CI 0.77-0.93), stroke 0.75 (95% CI 0.60-0.94)
and hospitalization for unstable angina 0.58 (95% CI 0.39-0.86), while for
evolocumab they were significant for MI 0.75 (95% CI 0.68-0.83) and
coronary revascularization 0.81 (95 CI % 0.75-0.88). There was a
statistically significant difference between the drugs for hospitalization
for unstable angina (p=0.02). Discussion(s): This study highlights
the benefits of PCSK9 inhibitors, especially alirocumab, in reducing major
cardiovascular events. Alirocumab significantly lowered hospitalizations
for unstable angina, with a 42% reduction, and showed favorable outcomes
in reducing myocardial infarction, coronary revascularization, and stroke.
These reductions are clinically meaningful, as they lower morbidity,
improve patient quality of life, and reduce healthcare costs. Both
alirocumab and evolocumab are effective and safe, offering important
therapeutic options for high-risk cardiovascular patients.
 Conclusion(s): The use of alirocumab is preferable if the focus is to
avoid hospitalizations for unstable angina or stroke, while evolocumab may
be an option if one wants to avoid coronary revascularization. Both drugs
are effective in reducing cardiovascular outcomes, but alirocumab was
superior to evolocumab. Copyright 2026, Bentham Science Publishers

<93>
Accession Number
2041621246
Title
I want to get better; I don't want to just stay at home: a theory-driven
qualitative exploration of participation in a home-based lung cancer
exercise clinical trial.
Source
Supportive Care in Cancer. 34(1) (no pagination), 2026. Article Number: 2.
Date of Publication: 01 Jan 2026.
Author
Whish-Wilson G.A.; Edbrooke L.; Krishnasamy M.; Visentin E.; Kinnersly E.;
Mitchell R.; Granger C.L.; Parry S.M.
Institution
(Whish-Wilson, Edbrooke, Visentin, Kinnersly, Granger, Parry) Department
of Physiotherapy, School of Health Sciences, The University of Melbourne,
161 Barry Street, Parkville, VIC, Australia
(Edbrooke, Krishnasamy) Department of Health Services Research, Peter
MacCallum Cancer Centre, 305 Grattan Street, Melbourne, VIC, Australia
(Krishnasamy) Department of Nursing, School of Health Sciences, The
University of Melbourne, 161 Barry Street, Parkville, VIC, Australia
(Visentin, Kinnersly, Mitchell, Granger, Parry) Department of
Physiotherapy, The Royal Melbourne Hospital, 300 Grattan Street,
Parkville, VIC, Australia
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: We conducted a multi-site randomised controlled trial (RCT) of
home-based exercise and self-management for patients after lung cancer
surgery, which improved the intervention group's exercise capacity and
self-efficacy and objectively measured physical function. We conducted
this qualitative evaluation of the RCT to explore participants'
experiences of the program and understand factors influencing
participation, behaviour change, and acceptability. Method(s): A
qualitative study nested within an RCT (ACTRN12617001283369), informed by
the Theoretical Domains Framework (TDF) and Theoretical Framework of
Acceptability (TFA). The intervention group participated in a 12-week
postoperative remotely delivered exercise and self-management program.
Following intervention maturation, consecutive intervention participants
participated in individual, semi-structured telephone interviews at
program discharge. Interviews were audio recorded, transcribed verbatim,
cross-checked, and analysed using directed content analysis.
 Result(s): Twenty-one participants took part in interviews (88% of
those approached). Thirty-three themes were developed from the qualitative
data and mapped to TDF and TFA domains. Key TDF domains driving behaviour
change included reinforcement, skills, and social influences. Examples of
exercise enablers included regular physiotherapy phone consultations and
activity tracking tools. Barriers to exercise included symptoms, poor
weather, and competing priorities. Perceived effectiveness was a key TFA
domain driving intervention acceptability. Most participants felt the
program improved their physical health, exercise self-efficacy and
capacity, and physical activity levels. Minor areas for improving
acceptability included increased flexibility/tailoring and exercise
supervision/demonstration. Conclusion(s): The program was acceptable
to participants and facilitated meaningful behaviour change. Qualitative
findings aligned with quantitative RCT findings, particularly regarding
improvements to exercise self-efficacy and capacity at program discharge.
Trial registration: Australian New Zealand Clinical Trials Registry
(http://anzctr.org.au). Registered on 06/09/2017.
Identifier:ACTRN12617001283369. Copyright © The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2025.

<94>
Accession Number
2042168513
Title
Obstructive Coronary Artery Disease and Health Status in Transcatheter
Aortic Valve Replacement: A Post Hoc Analysis of the SCOPE I Randomized
Clinical Trial.
Source
JAMA Network Open. 8(12) (no pagination), 2025. Article Number: e2547111.
Date of Publication: 2025.
Author
Tomii D.; Lanz J.; Thiele H.; Heg D.; Kim W.-K.; Joner M.; Mollmann H.;
Burgdorf C.; Linke A.; Redwood S.; Hilker M.; Conradi L.; Kerber S.; Thilo
C.; Toggweiler S.; Walther T.; Prendergast B.; Windecker S.; Pilgrim T.
Institution
(Tomii, Lanz, Windecker, Pilgrim) Department of Cardiology, Bern
University Hospital, University of Bern, Inselspital, Bern, Switzerland
(Thiele) Heart Centre Leipzig, Leipzig University, Leipzig, Germany
(Heg) Department of Clinical Research, University of Bern, Bern,
Switzerland
(Kim) Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad
Nauheim, Germany
(Joner) German Heart Centre, Technical University of Munich, Munich,
Germany
(Mollmann) Department of Internal Medicine I, St-Johannes-Hospital,
Dortmund, Germany
(Burgdorf) Heart and Vascular Centre, Bad Bevensen, Germany
(Linke) Department of Internal Medicine and Cardiology, Heart Centre
Dresden, Technische Universitat Dresden, Dresden, Germany
(Redwood, Prendergast) Department of Cardiology, St Thomas' Hospital,
Cleveland Clinic London, London, United Kingdom
(Hilker) Department of Cardiothoracic Surgery, University Medical Centre,
Regensburg, Germany
(Conradi) Department of Cardiovascular Surgery, University Heart Centre
Hamburg, Hamburg, Germany
(Kerber) Department of Cardiology, Cardiovascular Centre Bad Neustadt, Bad
Neustadt, Germany
(Thilo) Department of Internal Medicine I, RoMed Klinikum Rosenheim,
Rosenheim, Germany
(Toggweiler) Heart Center Lucerne, Luzerner Kantonsspital, Lucerne,
Switzerland
(Walther) Department of Cardiac, Thoracic and Thoracic Vascular Surgery,
University Hospital Frankfurt, Frankfurt, Germany
Publisher
American Medical Association
Abstract
IMPORTANCE Aortic stenosis (AS) and obstructive coronary artery disease
(CAD) often coexist, yet the impact of obstructive CAD on clinical and
patient-reported outcomes in patients undergoing transcatheter aortic
valve replacement (TAVR) remains a subject of ongoing debate. OBJECTIVES
To investigate the association of obstructive CAD with clinical outcomes
and health status among patients with symptomatic severe AS undergoing
TAVR. DESIGN, SETTING, AND PARTICIPANTS This post hoc analysis of the
investigator-initiated, multicenter SCOPE I (Safety and Efficacy of the
Symetis ACURATE Neo/TF Compared to the Edwards SAPIEN 3 Bioprosthesis for
Transcatheter Aortic Valve Implantation by Transfemoral Approach)
randomized clinical trial was conducted at 20 tertiary heart centers in
Europe from February 8, 2017, to February 2, 2019, with follow-up through
3 years. Data were analyzed from February 17 through August 13, 2025.
EXPOSURE Presence vs absence of obstructive CAD, defined as greater than
50% stenosis in at least 1 major epicardial coronary vessel. MAIN OUTCOMES
AND MEASURES Parameters of interest included vital and patient-reported
disease-specific health status (Kansas City Cardiomyopathy Questionnaire
[KCCQ] scores, ranging from 0 to 100, with higher numbers indicating
better health status), and clinical efficacy according to Valve Academic
Research Consortium (VARC)-3 definitions. Analyses were conducted using
the as treated population. RESULTS Of 732 patients with symptomatic severe
AS undergoing TAVR (mean [SD] age, 82 [4] years; 416 [56.8%] female),
obstructive CAD was identified in 373 (51.0%), 144 (38.6%) of whom
underwent elective percutaneous coronary intervention (PCI) during the
periprocedural period. At 3 years after TAVR, there were no statistically
significant differences in patient-reported health status (eg, median
[IQR] baseline overall KCCQ scores with CAD, 54.2 [40.3-69.8] vs without
CAD, 55.2 [38.5-72.9] and at 3-year follow-up with CAD, 79.7 [64.4-90.6]
vs without CAD, 82.3 [68.2-91.7]), mortality (all-cause death: 88 of 373
[24.7%] vs 76 of 359 [22.3%], adjusted hazard ratio, [HR], 0.97 [95% CI,
0.66-1.43]; cardiovascular death: 59 of 373 [17.6%] vs 51 of 359 [15.5%],
adjusted HR, 0.87 [95% CI, 0.54-1.42]), and clinical efficacy of TAVR (163
of 313 [52.1%] vs 159 of 298 [53.4%]; adjusted risk ratio, 1.10 [95% CI,
0.92-1.32]) between patients with vs without obstructive CAD. Having (vs
not having) obstructive CAD was associated with a numerically albeit not
statistically significantly higher risk of myocardial infarction (18 of
372 [5.5%] vs 3 of 359 [1.1%]; adjusted HR, 3.83 [95% CI, 0.96-15.31]).
Periprocedural PCI among patients with obstructive CAD did not improve
clinical outcomes, patient-reported health status, nor the integrated end
points of clinical outcomes and quality of life measures. CONCLUSIONS AND
RELEVANCE In this post hoc analysis of SCOPE I, patients with obstructive
CAD who underwent TAVR had no statistically significant differences in
survival, patient-reported health status, or VARC-3 clinical efficacy
compared with patients without CAD through 3 years of follow-up. Findings
suggest that a tailored approach may be essential in the treatment of TAVR
candidates with severe AS and CAD. Copyright © 2025 Tomii D et
al.

<95>
Accession Number
2042753568
Title
Botulinum Toxin Type A for Refractory Neuropathic Pain After Cervicotomy
and Thoracotomy: A Case Report.
Source
Toxicon. Conference: TOXINS 2026 8th International Conference. Madrid
Spain. 271(Supplement 1) (no pagination), 2026. Article Number: 108849.
Date of Publication: 01 Mar 2026.
Author
Rocha E.; Sumita C.; Nishizawa L.
Institution
(Rocha, Sumita, Nishizawa) Irmandade da Santa Casa de Misericordia de Sao
Paulo, Sao Paulo, Brazil
Publisher
Elsevier Ltd
Abstract
Introduction: Neuropathic pain following extensive cervical and thoracic
surgeries is uncommon but can significantly impair quality of life.
Postoperative complex regional pain syndrome (CRPS) may develop and often
proves refractory to standard pharmacologic therapies. Botulinum
neurotoxin type A (BoNT-A) has emerged as a promising therapeutic
alternative for focal neuropathic pain due to its peripheral and central
antinociceptive effects.1-3 Objective: To report the clinical
outcome of a patient with refractory postoperative neuropathic pain
successfully treated with BoNT-A. Method(s): A 63-year-old woman
underwent cervicotomy and left thoracotomy in 2014 for drainage of a deep
neck abscess of tonsillar origin, with bilateral vessel ligation. She
developed chronic neuropathic pain, edema, and facial dysfunction,
requiring speech therapy for rehabilitation. At initial physiatry
evaluation (February 2024), she reported burning and stabbing pain at the
cervical scar (Douleur Neuropathique 4 [DN4] = 4; Visual Analog Scale
[VAS] = 9/10) and perioral lesions due to left lip inversion. Physical
examination revealed a fibrotic, painful scar with dysesthesia and
allodynia. Pharmacologic management with gabapentin, pregabalin,
duloxetine, tramadol, and amitriptyline yielded minimal improvement. In
August 2024, BoNT-A (abobotulinumtoxinA; Dysport) was administered via
mesotherapy (4 U per point, 15 points; total, 60 U) along the cervical
scar. Result(s): At 1-month follow-up, the patient reported a 70%
reduction in pain intensity (VAS 2/10; DN4 = 3) along with improved
cervical mobility, mood, and function. Subsequent BoNT-A injections every
3 months maintained consistent analgesic and functional benefits, with no
adverse effects observed. Conclusion(s): BoNT-A may represent an
effective and safe option for managing refractory postoperative
neuropathic pain with CRPS features. Integrated into a multidisciplinary
rehabilitation program, it can lead to sustained pain relief, functional
recovery, and improved quality of life in complex surgical cases.
Keywords: Botulinum toxin; Cervicotomy; Complex regional pain syndrome;
Dysport; Neuropathic pain; Rehabilitation References 1. Ranoux D, Attal N,
Morain F, Bouhassira D. botulinum toxin type A induces direct analgesic
effects in chronic neuropathic pain. Ann Neurol. 2008;64(3):274-283. 2.
Intiso D, Santamato A, Di Rienzo F, Tolfa M, Russo M, Cisari C, Paoloni M.
botulinum toxin type A for the treatment of neuropathic pain in
neuro-rehabilitation. Toxins (Basel). 20doi:10.3390/toxins7072454 3. Li X,
Yang H, Chen X, Zhang T, Li Y, Xu L. Efficacy and Safety of Botulinum
Toxin A for Chronic Peripheral Neuropathic Pain: A systematic review and
meta-analysis of randomized controlled trials. Pain Physician.
2022;25(2):E233-E247. Copyright © 2025

<96>
Accession Number
2042738661
Title
Laryngeal mask airway combined with visual bronchial blocker versus
double-lumen tube for lung isolation in video-assisted thoracoscopic
surgery: a protocol for a multicentre randomised controlled trial.
Source
BMJ Open. 15(12) (no pagination), 2025. Article Number: e110539. Date of
Publication: 30 Dec 2025.
Author
Zhang Y.; Li T.; Wei J.; Bao R.; Lv X.; Wang J.-F.; Wu J.
Institution
(Zhang, Wu) Department of Anesthesiology, Shanghai Chest Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, Shanghai,
China
(Zhang) Shanghai Xuhui Central Hospital, Shanghai, Shanghai, China
(Li) Shanghai Chest Hospital of Shanghai Jiao Tong University School of
Medicine, Shanghai, Shanghai, China
(Wei) Department of Anesthesiology, Shanghai Pulmonary Hospital, School of
Medicine,Tongji University, Shanghai, China
(Bao, Wang) Changhai Hospital, Shanghai, China
(Lv) Tongji University Affiliated Shanghai Pulmonary Hospital, Shanghai,
China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative sore throat and hoarseness are common
complications following lung isolation with double-lumen tubes (DLTs) in
video-assisted thoracoscopic surgery (VATS). Laryngeal mask airway (LMA)
combined with a visual bronchial blocker (VBB) may reduce airway trauma
while maintaining effective lung isolation. Methods and analysis This is a
prospective, randomised, controlled, single-blind, multicentre clinical
trial conducted at three major thoracic surgery centres in Shanghai,
China. A total of 270 patients aged >=18 years scheduled for elective VATS
anatomical lung resection will be randomly allocated 1:1 to either the VBB
group (n=135) using LMA combined with VBB or the DLT group (n=135) using
conventional DLT (see Consolidated Standards of Reporting Trials diagram).
The primary outcome is the incidence of sore throat and hoarseness at 24
hours postoperatively. Secondary outcomes include sore throat and
hoarseness at 1 and 48 hours, intraoperative device performance, lung
collapse quality, intubation time, haemodynamic changes, emergence
quality, device-related complications and hospital length of stay. Ethics
and dissemination The study protocol was approved by the Ethics Committee
of Shanghai Chest Hospital (KS24042). Results will be disseminated through
peer-reviewed publications and conference presentations. Copyright
© Author(s) (or their employer(s)) 2025. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ
Group.

<97>
Accession Number
649846583
Title
Comparison of a mean arterial pressure alarm to the hypotension prediction
index in preventing intraoperative hypotension in elective moderate- to
high-risk non-cardiac surgical patients: a study protocol for a blinded,
parallel, randomized controlled trial with a non-inferiority framework.
Source
Trials. (no pagination), 2026. Date of Publication: 08 Jan 2026.
Author
Mulder M.P.; Florax A.A.; Harmannij-Markusse M.; Fresiello L.; Donker
D.W.; Potters J.-W.
Institution
(Mulder, Florax, Fresiello, Donker, Potters) Cardiovascular and
Respiratory Physiology, TechMed Centre, University of Twente, Enschede,
Netherlands
(Florax, Potters) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(Harmannij-Markusse) Technical Medicine, University of Twente, Enschede,
Netherlands
(Donker) Intensive Care Center, University Medical Center Utrecht,
Utrecht, Netherlands
Abstract
BACKGROUND: Intraoperative hypotension is common in surgical patients and
associated with an increased risk for acute kidney injury, myocardial
injury, and 30-day mortality. To predict hypotension and thereby promote
proactive blood pressure management, a machine learning algorithm was
developed: the Hypotension Prediction Index (HPI). In clinical trials, it
proved to prevent hypotension. However, a recent observational study found
that the performance of the HPI in predicting hypotension up to 15 min in
advance was virtually identical to that of the concurrent mean arterial
pressure (MAP). This indicates that the added value of the HPI above
continuous MAP monitoring may be limited. It is hypothesized that the
effect of preventing intraoperative hypotension triggered by a MAP
threshold of 70-75 mmHg is comparable to clinical care triggered by an HPI
alarm. METHOD(S): This is a monocentral, blinded, randomized
controlled clinical trial, conducted in the Netherlands. Adult patients
undergoing moderate- or high-risk elective non-cardiac surgery requiring
continuous blood pressure monitoring aiming for a MAP of >=65 mmHg are
eligible for inclusion. A total of 142 participants is randomized into two
groups: in the HPI group, the monitor alarms when the HPI value exceeds
85, whereas in the MAP group, it alarms when the MAP value drops below 72
mmHg. The monitor screen is partly covered to blind treating clinicians
for the study group allocation. The primary outcome measure is the area
under the threshold of hypotension (defined as MAP < 65 mmHg for at least
1 min) during surgery. Secondary objectives are the incidence and severity
of intraoperative hypotension and hypertension, cumulative doses of
administered medication and fluids, incidence of acute kidney injury and
myocardial injury, length of hospital stay, and 30-day mortality after
surgery. DISCUSSION(S): The decision to initiate treatment upon an
alarm is left at the discretion of the attending clinicians; if deemed
appropriate, they can also choose to ignore the alarms. Consequently,
clinical interventions could vary between participants and groups.
Contrarily, early treatment could lead to overtreatment. TRIAL
REGISTRATION: Overview of Medical research in the Netherlands (OMON),
NL-OMON53215, registered on 20-09-2023, last updated on 30-01-2025,
https://onderzoekmetmensen.nl/nl/trial/53215. Copyright © 2025.
The Author(s).

<98>
Accession Number
649850705
Title
Retrospective evaluation of vitamin D dosing regimen used in the double
blind, placebo controlled half-year clinical trial (reinforce-d) based on
calcidiol concentration monitoring.
Source
International Journal of Clinical Pharmacy. Conference: 51st ESCP
Symposium on Clinical Pharmacy. Aberdeen United Kingdom. 46(1) (pp
305-306), 2024. Date of Publication: 01 Feb 2024.
Author
Cerny D.; Cecrle M.; Halacova M.; Sedlackova E.
Institution
(Cerny) Department of Clinical Pharmacy, Hospital Rudolf and Stefanie,
Benesov, Czechia
(Cerny) Department of Clinical Pharmacy, Liberec Regional Hospital,
Liberec, Czechia
(Cerny, Cecrle) Institute of Pharmacology, 1st Faculty of Medicine,
Charles University in Prague, Czechia
(Cecrle) Insitute of Toxicology, General Teaching Hospital in Prague,
Czechia
(Halacova) Department of Clinical Pharmacy, Hospital Na Homolce, Prague,
Czechia
(Sedlackova) Department of Cardiac Surgery, Hospital Na Homolce, Prague,
Czechia
(Sedlackova) Department of Infectology, Hospital Usti Nad Labem, Usti nad
Labem, Czechia
Publisher
Dustri-Verlag Dr. Karl Feistle
Abstract
Background and objective: Vitamin D belongs to the most cited vitamins
today due to its positive biological effects. Human beeings and some
animals are capable to syntetize vitamin D3 (cholecalcif-erol) in the
skin. However this intrinsic synthesis is very variable depending on body
weight, age, season, geographical locality, area of sun exposition etc..
and also there is an intake of vitamin D from the food. To check up the
deposits of vitamin D in the body, we measure mainly calcidiol blood
concentration, because calcidiol is a metabolic interproduct of all
pathways of vitamin D metabolism. Although theoptimal calcidiol target
level is still not clearly established, generally, patients with a
calcidiol concentration under 75 nmol/l are considered as people with
deficit who should be supplemented additionaly by drug formulations
containing vitamin D. There are many different supplemetation regimens,
mainly based on level of calcidiol deficit. Primary objective of our work
was to verify, if our vitamin D3 dosing regimen is optimal. The
verification was based on measuring an initial and target calcidiol
concentration during our 6-months lasting clinical trial REINFORCE-D
concepted as placebo controlled, double blind, randomized, monocentric
clinical trial for patients with vitamin D hypovitaminosis undergoing
cardiac surgery procedure. Method(s): Our data was collected from
September 2016 till December 2020 in one center. A total of 216 trial
subjects were recruited, but just 141 were albe to finish the trial. All
the patients who fulfilled the inclusion criteria were randomized and
divided to six groups according to their initial calcidiol concentration.
Patient whose cal-cidiol concentration was under 25 nmol/l received 20 000
IU of cholecalciferol solution or placebo, patients under 50 nmol/l
received 12,500 IU and patients under 75 nmol/l received just 5000 IU per
week.Main outcome measures: In each subject in the trial, we measured the
initial and target calcidiol concentration using the
radioimunno-analytical assay. Result(s): Our pilot study randomized
together 141 subjects: 69 patients in placebo group and 72 patients in
cholecalciferol group. An amount of 32.9% subjects reached a level of 80
nmol/L, even though they were included in the placebo arm. On the other
hand, 33.8% of subjects were not able to achieve the target calcidiol
concentration even though they were originally randomized in
cholecalciferol group. Despite of these facts, statistically significant
difference in placebo and cholecalciferol group was demonstrated between
those who were and who were not able to achieve the target calcidiol
concentration (p < 0.001). As for the safety data, only 4 patients did not
tolerate our dosing regimen due to mild gastrointestinal disorders, where
3 of them were from cholecalciferol group and 1 of them was from placebo
group. Conclusion(s): We can assume that our supplementary
cholecalciferol regimens were proposed successfully, well tolerated by
patients. Dosing once a week supported by reminding SMSes each week has
been considered as an effective tool increasing a patient adherence to
treatment in the clinical trial.

<99>
Accession Number
2042731991
Title
Clinical outcomes following invasive cardiovascular interventions in frail
populations: a systematic review and meta-analysis.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 12(1) (pp
95-104), 2026. Date of Publication: 01 Jan 2026.
Author
Jiang H.; Wong J.J.; Li L.-J.; Gao F.; Wykrzykowska J.J.; Ho K.W.;
Takahashi S.; Lee K.S.; Kong W.K.F.; Poh K.K.; Tan R.-S.; Koh A.S.
Institution
(Jiang, Wong, Gao, Ho, Tan, Koh) Department of Cardiology, National Heart
Centre Singapore, 5 Hospital Drive, Singapore, Singapore
(Li) Yong Loo Lin School of Medicine, National University of Singapore,
Global Centre for Asian Women's Health (GloW), Singapore, Singapore
(Li) Department of O&G, Yong Loo Lin School of Medicine, National
University of Singapore, Singapore, Singapore
(Li) Bia-Echo Asia Centre for Reproductive Longevity and Equality (ACRLE),
Yong Loo Lin School of Medicine, National University of Singapore,
Singapore, Singapore
(Li) Institute for Human Development & Potential (iHDP), Agency for
Science, Technology & Research (A*STAR), Singapore, Singapore
(Gao, Ho, Tan, Koh) Duke-National University of Singapore Medical School,
Singapore, Singapore
(Wykrzykowska) Cardiology Department, University Medical Center Groningen,
Groningen, Netherlands
(Takahashi) Department of Cardiology, Shonan Oiso Hospital, Kanagawa 259,
Oiso, Japan
(Lee) Department of Cardiology, Mayo Clinic Arizona, AZ, United States
(Kong, Poh) Department of Medicine, Yong Loo Lin School of Medicine,
National University of Singapore, Singapore, Singapore
(Kong, Poh) Department of Cardiology, National University Heart Centre
Singapore, Singapore, Singapore
Publisher
Oxford University Press
Abstract
Frailty is highly prevalent in cardiovascular disease and associates with
poor clinical outcomes. Several cardiovascular conditions benefit from
invasive interventions, but the impact of these procedures in frail
patients remains unclear. We thus performed a systematic review and
meta-analysis to summarize evidence and quantify the pooled effect of
clinical outcomes of invasive cardiovascular interventions among frail vs.
non-frail patients. Systematic search of two electronic databases from
January 2015 to April 2025 was performed including all randomized
controlled trials (RCTs) and prospective cohort studies examining outcomes
of invasive cardiovascular interventions stratified by frailty. Outcomes
included all-cause mortality, hospitalizations, and other adverse
outcomes. Risk ratios (RRs) and their 95% confidence intervals (CI) were
assessed using random-effects models. Thirty-one studies (10 RCTs, 21
prospective, 3 retrospective studies) with a total of 27 534 participants
were included. Compared with non-frail patients, frail patients after
cardiovascular procedures were at higher risks of all-cause mortality (RR
3.14, 95% CI: 2.29-4.30), and hospitalizations (RR 1.88, 95% CI:
1.29-2.73). Frail patients undergoing transcatheter aortic-valve
implantation and percutaneous mitral-valve interventions did not have
significant increased mortality risks compared with non-frail patients (P
> 0.05). Pre-frailty predicted lower mortality risks amongst patients
undergoing transcatheter vs. surgical aortic valve replacement (HR 0.78,
95% CI: 0.67-0.92). Frail patients with non-ST elevation myocardial
infarction derived similar mortality benefits from an invasive vs.
conservative approach (HR 1.13, 95% CI: 0.64-2.01). In conclusion, frailty
prognosticates adverse outcomes following invasive cardiovascular
interventions and influences treatment efficacy, highlighting its
significance in treatment selection Copyright © The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved.

<100>
Accession Number
2042745910
Title
Left main revascularisation: Study of two techniques; angioplasty and
bypass surgery.
Source
Archives of Cardiovascular Diseases. Conference: Archives of
Cardiovascular Diseases. Paris France. 119(1 Supplement) (pp S18-S19),
2026. Date of Publication: 01 Jan 2026.
Author
Garci O.; Boudiche S.; Mourali M.S.
Institution
(Garci) Service de cardiologie La Rabta, faculte de medecine de Tunis,
Tunis, Tunisia
(Boudiche, Mourali) Service de cardiologie, hopital La Rabta, Tunis,
Tunisia
Publisher
Elsevier Masson s.r.l.
Abstract
Introduction: Several randomized clinical trials have shown that
percutaneous coronary intervention in unprotected left main coronary
artery is an efficient approach, paving the way for remarkable changes in
recent guidelines. Objective(s): To evaluate short and long-term
clinical outcomes following percutaneous interventions and coronary artery
bypass grafting in left main disease. Method(s): From 2012 to 2018,
consecutive patients with unprotected left main disease treated by
percutaneous intervention or bypass grafting were included in this
registry after excluding highly instable patients namely revascularization
in the settings of ST elevation myocardial infarction or cardiogenic
shock. A sub-study to get in line with landmark randomized trials design
with propensity score analysis in order to adjust for baseline differences
in overall cohort was performed to compare the two techniques in this
real-world registry. Result(s): During study period, 308 patients
were included: 159 vs. 149 in percutaneous and surgical groups
respectively (Fig. 1). During in-hospital stay, major adverse
cerebrovascular and cardiac events occurred in 1.9% vs. 12.1%, P = 0.001.
Difference was driven by in-hospital deaths 1.3% vs. 10.1%, P = 0.001. At
median follow-up of 48 months, major adverse cardio and cerebrovascular
events occurred in 28.9% vs. 36.2%, P = 0.077. Components of major events
were as follows: all-cause deaths 15.7% vs. 24.8%, P = 0.027; cardiac
deaths 10.7% vs. 17.4%, P = 0.047; myocardial infarction 8.2% vs. 5.3%, P
= 0.496; Cerebrovascular accidents 1.3% vs. 3.3%, P = 0.21 and
ischemia-driven target vessel revascularization 13.8% vs. 8.0%, P = 0.106.
89 matched pairs were identified for propensity matching score after
excluding patients with left ventricle ejection fraction <= 30%, eGFR <=
30 mL/min and SYNTAX score >= 33 and any bare metal stent use. At median
follow-up of 42 months there was a significant difference in favor of
percutaneous coronary interventions in terms of all-cause death (Hazard
Ratio: 0.3, 95% CI [0.1-0.8]; P = 0.004) and cardiac death (Hazard Ratio:
0.1, 95% CI [0.1-0.5]; P = 0.001). Conclusion(s): In-hospital
mortality after bypass grafting for unprotected left main disease was the
major difference when comparing this real-world registry with landmark
randomized clinical trials supporting current guidelines. Copyright
© 2025

<101>
Accession Number
2042776611
Title
Surgical Myectomy with Anterior Mitral Leaflet Extension Versus Isolated
Myectomy in Patients with Hypertrophic Obstructive Cardiomyopathy.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of
Publication: 2026.
Author
Heeringa T.J.P.; Hoogewerf M.; Hegeman R.; Wylick D.V.; Stecher D.; Cramer
M.J.; De Zan G.; Koop Y.; Meijer R.C.A.; Zuithoff N.P.A.; Harst P.V.D.;
Guglielmo M.; Vaartjes I.; Mokhles M.M.; Van Der Kaaij N.P.
Institution
(Heeringa, Hoogewerf, Wylick, Meijer, Mokhles, Van Der Kaaij) Department
of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht,
Netherlands
(Hegeman) Department of Cardiothoracic Surgery, St Antonius Hospital,
Nieuwegein, Utrecht, Netherlands
(Hegeman) Department of Cardiothoracic Surgery, Amsterdam University
Medical Centres, Amsterdam, Netherlands
(Stecher) Department of Cardiothoracic Surgery, Medical Centre Leeuwarden,
Leeuwarden, Netherlands
(Cramer, De Zan, Harst, Guglielmo) Department of Cardiology, University
Medical Centre Utrecht, Utrecht, Netherlands
(Koop, Zuithoff, Vaartjes) Department of Cardiovascular Epidemiology,
Julius Center for Health Sciences and Primary Care, Utrecht, Netherlands
Publisher
Georg Thieme Verlag
Abstract
Background This study evaluated the echocardiographic parameters and
complication rates of surgical myectomy with concomitant anterior mitral
leaflet extension (SM + AMLE) and isolated SM in hypertrophic obstructive
cardiomyopathy (HOCM) patients. Methods All HOCM patients undergoing SM +
AMLE (2006-2015) and isolated SM (2015-2020) in our centre were analysed.
The primary outcome was left ventricular outflow tract (LVOT)-gradient and
surgical reoperation (SM/mitral surgery). Secondary outcomes were aortic
cross-clamping (ACC) time, iatrogenic ventricular septal defect (VSD), and
mortality at 30-day and 3-year follow-up. Mixed-effects models assessed
postoperative changes in LVOT-gradient measurements over time until a
3-year follow-up. Results This cohort (n = 59) consisted of 34 (58%) SM +
AMLE and 25 (42%) isolated SM procedures. There were 32 (54%) males and 27
(46%) females with a mean age of 55 +/- 13 years at the time of the
intervention. Postoperatively, no differences were observed over time in
the median LVOT-gradient (p = 0.34). In the SM + AMLE group, 6% (n = 2)
required surgical reoperation (due to patch dehiscence) versus 0% in the
SM group. In the SM + AMLE group, the ACC time was significantly higher
(86 minutes [interquartile range [IQR]: 74-103]) than in the isolated SM
group (48 minutes [IQR: 39-57]; p < 001). In both groups, the VSD
complication rate was 0%, and neither procedure led to death at 3-year
follow-up. Conclusion HOCM-patients who underwent SM + AMLE had comparable
clinical and echocardiographic outcomes to patients who underwent isolated
SM. This suggests that increasing procedural complexity may not improve
outcomes. However, given potential confounding, this should be interpreted
with caution, future prospective randomised controlled trials are
necessary. Copyright © 2026. The Author(s).

<102>
Accession Number
2042800251
Title
The role of biomarkers in the preoperative evaluation of cardiac surgical
patients - A narrative review.
Source
Best Practice and Research: Clinical Anaesthesiology. 39(2) (pp 90-94),
2025. Date of Publication: 01 Jun 2025.
Author
Coverdale G.; Camilleri M.; Patteril M.
Institution
(Coverdale) Anaesthesia and Intensive Care Medicine - Queen Elizabeth
Hospital, University Hospitals Birmingham, United Kingdom
(Camilleri) Anaesthesia - University Hospital Coventry and Warwickshire,
United Kingdom
(Patteril) Cardiothoracic Anaesthesia - University Hospital Coventry and
Warwickshire, United Kingdom
Publisher
Bailliere Tindall Ltd
Abstract
Background: Biomarkers play a crucial role in the preoperative assessment
for cardiac surgery, aiding in risk stratification and evaluating comorbid
diseases. Objective(s): This narrative review summarizes current
evidence on preoperative biomarkers in cardiac surgery and their role for
risk stratification in international guidelines. Method(s): A review
of relevant literature was conducted to assess the prognostic value of
various biomarkers, including their integration into established risk
scoring systems. Result(s): Among cardiac biomarkers, brain
natriuretic peptide (BNP) has been found to independently predict outcomes
and may enhance prognostic accuracy when combined with scoring systems
such as the Society of Thoracic Surgeons (STS) and Euroscore calculators.
Additionally, several biomarkers related to comorbid diseases demonstrate
independent associations with postoperative outcomes, some of which are
already included in these scoring systems. Biomarkers such as glycosylated
haemoglobin, C-reactive protein (CRP), and albumin levels are strongly
linked to surgical outcomes and may aid perioperative optimization.
Emerging evidence suggests that novel biomarkers, including inflammatory
cytokines, may provide predictive value for specific complications.
 Conclusion(s): Biomarkers are an essential component of preoperative
assessment and risk stratification in cardiac surgery. Further research is
needed to refine biomarker-based predictive models to enhance
postoperative morbidity and mortality risk assessment. Copyright
© 2025 Elsevier Ltd. All rights are reserved, including those for
text and data mining, AI training, and similar technologies.

<103>
Accession Number
2042788134
Title
Sutureless versus transcatheter aortic valve replacement in patients with
aortic stenosis: An updated meta-analysis of short- and mid-term outcomes
with trial sequential analysis.
Source
International Journal of Cardiology. 447 (no pagination), 2026. Article
Number: 134116. Date of Publication: 15 Mar 2026.
Author
Obi O.; Ayesha A.; Lajczak P.; Hageen A.W.; Hamza M.; Erzinger G.; Khan
M.; Nweze U.; Eltawansy S.
Institution
(Obi) New York Institute of Technology College of Osteopathic Medicine,
Northern Blvd Old Westbury, United States
(Ayesha) Shifa College of Medicine, Islamabad, Pakistan
(Lajczak) Medical University of Silesia Katowice, Poland
(Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt
(Hamza) Saidu Medical College, Swat, Pakistan
(Erzinger) University of the Region of Joinville (Univille), Joinville,
Brazil
(Khan) Bacha Khan Medical College, Mardan, Pakistan
(Nweze) Kaiser Permanente, Fontana Medical Center, Fontana, United States
(Eltawansy) Jersey Shore University Medical Center, Neptune, United States
Publisher
Elsevier Ireland Ltd
Abstract
Background: The efficacy and safety of a novel aortic valve replacement
treatment (SAVR) technique, sutureless aortic valve replacement (SU-AVR),
compared to transcatheter aortic valve replacement (TAVR) in the treatment
of aortic stenosis, is unclear in short and mid-term outcomes due to
limited data. Method(s): PubMed, Scopus, Embase, Web of Science, and
the Cochrane Library were systematically searched for studies comparing
SU-AVR with TAVR. Risk ratios (RR) with 95 % confidence intervals (CIs)
were computed for binary outcomes. Trial sequential analysis (TSA) was
performed to assess whether the results in our meta-analysis were
conclusive. Result(s): This systematic review and meta-analysis
included 22 observational studies of symptomatic patients. When comparing
SU-AVR to TAVR, similar risk of in-hospital mortality (RR 0.67, 95 % CI
0.37-1.24, p = 0.20, I2 = 15.1 %) and two-year mortality (RR
0.73, 95 % CI 0.39-1.37, p = 0.32, I2 = 61.5 %) were noted.
However, SU-AVR was associated with significantly lower 30-day mortality
(RR 0.46, 95 % CI 0.28-0.75, p = 0.002, I2 = 0.9 %), total
number of valvular leakages (RR 0.13, 95 % CI 0.05-0.32, p < 0.00,
I2 = 59.5 %), and one-year mortality (RR 0.51, 95 % CI
0.32-0.80, p = 0.003, I2 = 0.0 %). In the TSA analysis, 30-day
mortality, one-year mortality, and total leakage rate showed true-positive
results in the method. The two-year mortality rate yielded false-negative
results due to the too low required information size. Conclusion(s):
In patients with aortic stenosis, SU-AVR was associated with similar
in-hospital mortality and two-year mortality rates compared with TAVR;
however, it was associated with significantly lower 30-day mortality,
total number of valvular leakages, and one-year mortality
rates. Copyright © 2025 Elsevier B.V.

<104>
Accession Number
649853690
Title
Negative Pressure Wound Therapy in Patients Undergoing Open Thoracic and
Abdominal Surgery: A Systematic Review and Meta-Analysis of Randomised
Trials.
Source
British Journal of Surgery. Conference: AUGIS Annual Scientific Meeting.
Glasgow United Kingdom. 112(Supplement17) (pp xvii28), 2025. Date of
Publication: 01 Dec 2025.
Author
Lakha A.; Neves S.; Alemour Y.; McGivern H.; Gordon-Weeks A.
Institution
(Lakha, Gordon-Weeks) University of Oxford, Oxford, United Kingdom
(Lakha, Neves, Gordon-Weeks) Oxford University Hospitals NHS Foundation
Trust, Oxford, United Kingdom
(Alemour) Al-Azhar University- Gaza, Gaza, Palestine
(Alemour) Sorbonne University, Paris, France
(McGivern) Bodleian Healthcare Libraries, University of Oxford, Oxford,
United Kingdom
Publisher
Oxford University Press
Abstract
Aim: Around 30,000 patients undergo emergency laparotomy in the United
Kingdom each year, and a similar number of patients undergo open thoracic
surgery. These incisions provide surgical access for major thoracic and
abdominal surgery, such as oesophagectomy, or pancreaticoduodenectomy.
Closure of these wounds may be aided by the use of negative pressure wound
therapy (NPWT). Theoretically, this technology aims to reduce wound
complications. This systematic review and meta-analysis aims to assess the
benefit of NPWT in patients undergoing major open thoracic/abdominal
surgery. Method(s): A literature search of was carried out in March
2025, and titles and abstracts were screened against our pre-defined
inclusion criteria. Summary statistics for outcomes of interest underwent
meta-analyses to a confidence interval (CI) of 95% and are presented as
Forest Plots for Odds Ratio (OR) or mean difference (MD). Result(s):
13,320 patients across 46 randomised trials in abdominal/ thoracic surgery
were included for analysis. When limited to abdominal surgery, negative
pressure wound therapy reduces surgical site infections (OR=0.51,
95%CI:0.41-0.63). Length of hospital stay was shorter in patients
receiving NPWT (MD=-1.21 days, 95%CI:-1.61 - -0.80). Sub-group analyses
limited to only PICO or only Prevena-type NPWT showed that both reduced
SSI. There was no difference in organ/space infection, fascial dehiscence
or re-operation. Conclusion(s): There appears to be benefit to use of
NPWT in patients undergoing major open abdominal surgery, in either the
emergency or elective setting, for the prevention of SSI. Clinically
relevant wound complications such as fascial dehiscence, return to
theatre, or organ/ deep infection were similar across both groups.

<105>
Accession Number
649833432
Title
Inclusion of Retracted Studies in a Systematic Review and Meta-Analysis of
Prophylactic Dexmedetomidine and Postoperative Junctional Ectopic
Tachycardia in Pediatric Cardiac Surgery Patients.
Source
Paediatric anaesthesia. (no pagination), 2026. Date of Publication: 07
Jan 2026.
Author
Feinstein M.M.; Levy R.J.; Ing C.
Institution
(Feinstein, Levy, Ing) Department of Anesthesiology, Columbia University
Vagelos College of Physicians and Surgeons, NY, United States
(Ing) Department of Epidemiology, Mailman School of Public Health, NY,
United States

<106>
Accession Number
649851871
Title
Influence of Early Removal of the Urinary Catheter on Postoperative
Urinary Retention after Abdominal and Thoracic Surgery with Continuous
Thoracic Epidural Analgesia.
Source
European Surgery - Acta Chirurgica Austriaca. Conference: 18th European
Colorectal Congress. St. Gallen Switzerland. 56(2 Supplement) (pp S140),
2024. Date of Publication: 01 Nov 2024.
Author
Alwali A.; Schafmayer C.; Grambow E.
Institution
(Alwali, Schafmayer) Department of General,Visceral, Thoracic, Vascular
and Transplant Surgery, University Medical Center Rostock, Rostock,
Germany
(Grambow) Department of Cardiovascular and Thoracic Surgery, University of
Goettingen Medical Center, Goettingen, Germany
Publisher
Springer Medizin
Abstract
Background/Aim: Postoperative urinary retention (POUR) is frequently
reported as a common complication under epidural analgesia (EA), often
requiring the use of a transurethral urinary catheter. Reports regarding
the early removal of the urinary catheter and the occurrence of POUR under
EA are inconsistent in the literature. Only a few randomized studies
addressing the same question have been published so far. This study aimed
to investigate whether the early removal of a urinary catheter after
abdominal and thoracic surgeries under continuous thoracic epidural
analgesia is safe. Method(s): In a prospective randomized study, 81
patients who underwent abdominal and thoracic surgeries and received
postoperative thoracic EA were examined. The urinary catheter was removed
within 48 h after surgery in the early removal group (ERG) (n = 43) and
after the discontinuation of EA in the standard group (SG) (n = 38). All
patients in the ERG still had ongoing thoracic EA at the time of catheter
removal. The primary endpoint was the incidence of POUR after catheter
removal in relation to epidural analgesia. The secondary endpoint was the
occurrence of postoperative catheter-associated urinary tract infections
(CA- UTI) and patient comfort. POUR was defined as a post-void residual
volume of more than 400 ml, determined sonographically 6 h after catheter
removal if spontaneous bladder emptying was not possible. Patient comfort
was quantified by the daily documentation of pain scores on the visual
analog scale by the pain management team. Study registration number (AZ
A2018-0220). Result(s): One patient (2.3%) in the ERG compared to one
patient in the SG (2.6%) developed POUR. No statistically significant
difference in the occurrence of POUR between the ERG and SG was found (p =
0.644). Four patients (10.6%, p = 0.04) were diagnosed with CA- UTI in the
SG compared to 0% in the ERG. Regarding postoperative pain and patient
comfort, a significant difference in favor of the ERG was found during the
postoperative period (p = 0.0314). Conclusion(s): The early removal
of the urinary catheter under EA is safely feasible in patients with a low
risk of POUR, without increasing the risk of POUR or urinary tract
infections.

<107>
[Use Link to view the full text]
Accession Number
649836022
Title
Baduanjin sequential therapy's effects on quality of life and cardiac
function in post-cardiac surgery heart disease patients: A systematic
review.
Source
Medicine. 105(1) (pp e46855), 2026. Date of Publication: 02 Jan 2026.
Author
Liu X.; Hao X.; Zhang W.; Zhang F.; Liu H.
Institution
(Liu) Department of Cardiovascular Surgery, Linfen Central Hospital,
Linfen, Shanxi, China
Abstract
BACKGROUND: This study aimed to objectively evaluate the effects of
Baduanjin exercise on the quality of life and cardiac function in patients
with cardiovascular heart disease after cardiac surgery. METHOD(S):
Pubmed, Embase, Cochrane, Web of science, Chinese National Knowledge
Infrastructure, Wanfang and Sinomed were searched from the date of their
inception until March 5th, 2024 using medical subject headings terms and
keywords. The primary outcomes were the quality of life and cardiac
function. The quality of life was assessed using Short Form-36, the
Seattle Angina Questionnaire, 6-min walk test and adverse events. The
cardiac function was evaluated using the 6-min walking test. For
statistical analysis, standardized mean difference or odds ratio and 95%
confidence intervals were calculated using Stata 14.0. RESULT(S):
Baduanjin exercise demonstrated significant enhancements in quality of
life across all Short Form-36 subitems. Meta-analyses revealed
improvements in Seattle Angina Questionnaire scores related to physical
limitation and stable angina pectoris. The incidence of adverse events
decreased with Baduanjin exercise, and cardiac function, as indicated by
left ventricular ejection fraction, showed significant improvement.
 CONCLUSION(S): Baduanjin exercise is a safe, feasible, and acceptable
intervention that can improve the quality of life and cardiac function in
patients with cardiovascular heart disease after cardiac surgery. However,
more studies with rigorous research designs are needed to assist in the
rehabilitation of such patients. Copyright © 2026 the Author(s).
Published by Wolters Kluwer Health, Inc.

<108>
Accession Number
2042682655
Title
External oblique intercostal plane block: A scoping review of anatomy,
techniques, and clinical applications.
Source
Indian Journal of Anaesthesia. 70(1) (pp 157-176), 2026. Date of
Publication: 01 Jan 2026.
Author
Thakore S.; Mistry T.; Nair A.S.; Kaasat A.
Institution
(Thakore, Kaasat) Department of Anaesthesiology, Ananta Institute of
Medical Sciences, Rajasthan, Udaipur, India
(Mistry) Department of Anaesthesiology and Perioperative Care, Ganga
Medical Centre and Hospitals Pvt Ltd, Tamil Nadu, Coimbatore, India
(Nair) Department of Anaesthesiology, Ibra Hospital, Ibra, Oman
Publisher
Wolters Kluwer Medknow Publications
Abstract
The external oblique intercostal plane block (EOIPB) is a novel,
ultrasound guided regional anaesthesia technique targeting the fascial
plane between the external oblique and external intercostal muscle. This
scoping review aimed to comprehensively map current evidence on EOIPB,
covering its anatomical basis, techniques, clinical applications,
efficacy, and safety. Following the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses extension for Scoping Reviews
guidelines, a systematic search of PubMed, Scopus, and Cochrane databases
was conducted for articles published between January 2019 and July 2025.
Eligible studies encompassed clinical trials, observational studies, case
series, case reports, cadaveric investigations, and relevant clinical
correspondences involving EOIPB for surgical or chronic pain related
indications. Forty-two studies involving 1610 patients were included, with
EOIPB performed in 765 cases. The block was most commonly administered at
the sixth rib between the midclavicular and anterior axillary lines using
an in-plane sagittal approach, providing consistent T6-T10 dermatomal
coverage. EOIPB demonstrated opioid-sparing effects, lower pain scores,
and improved recovery across various surgical settings. It was found to be
comparable or superior to other regional techniques, such as the
transversus abdominis plane block, erector spinae plane block, and wound
infiltration. Catheter-based EOIPB facilitated prolonged analgesia and
proved useful within enhanced recovery after surgery protocols. Reported
complication rates were low. Overall, EOIPB is a promising regional
anaesthesia technique, offering safe, effective, and versatile analgesia
for upper abdominal and lower thoracic surgeries. Further high-quality
comparative studies and standardisation of techniques are warranted to
establish its definitive role in perioperative care. Copyright ©
2026 Indian Journal of Anaesthesia.

<109>
Accession Number
649826199
Title
Transcatheter and Surgical Aortic Valve Implantation in the Management of
Aortic Stenosis between 2010 and 2022: A French Nationwide Study.
Source
Pharmacoepidemiology and Drug Safety. Conference: 2024 ISPE Annual
Meeting. Berlin Germany. 33(Supplement 2) (no pagination), 2024. Date of
Publication: 01 Nov 2024.
Author
Havet A.; Testud A.; L'Hospital A.; Payet C.; De Gevigney G.; Chavanis N.;
Viprey M.; Armoiry X.
Institution
(Havet, Testud, Viprey) Research on Healthcare Performance (RESHAPE),
INSERM U1290, Universite Claude Bernard Lyon 1, Lyon, France
(L'Hospital, Payet) Research on Healthcare Performance (RESHAPE), INSERM
U1290, Universite Claude Bernard Lyon 1, Lyon, France, Hospices Civils de
Lyon, Health Data Department, Lyon, France
(De Gevigney) Department of Cardiology, Hopital Louis-Pradel, Hospices
Civils de Lyon, Lyon, France
(Chavanis) Department of Cardiac Surgery, Centre Medico-Chirurgical Leon
Blum, Villeurbanne, France
(Armoiry) UMR CNRS 5510 MATEIS, Pharmacy Department, Hopital
Edouard-Herriot, Lyon, France
Publisher
John Wiley and Sons Ltd
Abstract
Background: Since 2010, with the publication of European guidelines and
randomized controlled trials (RCT), the management of aortic stenosis (AS)
has been revolutionised by the emergence of transcatheter aortic valve
implantation (TAVI) not only in patients contraindicated to surgical
aortic valve replacement (SAVR) but also to patients with lower surgical
risk. Objective(s): To describe the trends for AS management type in
French TAVI-eligible facilities between 2010 and 2022, and the possible
impact of European guidelines and RCT on these trends. Method(s): A
cohort study was conducted from the National Health Data System (SNDS).
Patients aged 18 and over, hospitalized for AS and undergoing a first TAVI
or SAVR between 2010 and 2022 were included. Patient characteristics (age,
sex, Charlson comorbidities index [CCI]), and TAVI valve characteristics
(self-expanding vs. balloon-expandable, and manufacturer name), and
30-days complications (critical care stays, myocardial infarction [MI],
stroke, pacemaker implantation [PI], mortality) and valve-in- valve
procedures rate were described. To assess the effect of guidelines and RCT
on the evolution of AS management, 2010-2015, 2016-2018 and 2019-2022
periods were distinguished. Result(s): We identified 255,453 adults,
including 43.0% with TAVI. The number of SAVR was stable to 2015 then
decreased from 11,579 in 2016-8123 in 2022, while the number of TAVI
increased sharply (1,389 in 2010-16,770 in 2022). The mean age ranged from
71.8 years between 2010 and 2015-67.8 years between 2019-2022 in SAVR
group and remained stable in TAVI group at 82.4 years. The percentage of
men increased from 49.0% between 2010-2015- 53.5% between 2019 and 2022 in
TAVI group and from 63.6% to 71.6% in SAVR group. The mean CCI decreased
from 4.1 between 2010 and 2015-3.8 between 2019 and 2022 in TAVI group,
and was stable in SAVR group at 3.2. Balloon-expandable TAVI valves were
mainly used (2010-2015: 65.1%; 2019-2022: 62.8%), and the market share
between Edwards, Medtronic, Boston and Abbott was respectively 62.5%,
34.4%, 2.0% and 1.1%. Within 30 days post-implantation, for TAVI and SAVR
groups respectively, the percentage of critical care stays ranged from
15.0% between 2010-2015- 6.1% between 2019 and 2022 and from 46.4% to
53.4%, the percentage of PI ranged from 16.6% between 2010-2015- 18.3%
between 2019 and 2022 and from 5.3% to 5.2% and the percentages of MI,
stroke and death tended to decrease in two groups (<= 1.1%, <= 2.9%, and
<= 3.1%, respectively). Few valve-in- valve procedures occurred (TAVI: <=
0.4%; SAVR: <= 2.2%). Conclusion(s): This study provides
comprehensive results over 13 years on the AS management type and patient
profile. A EuroSCORE proxy is being developed to define patients' surgical
risk and compare clinical outcomes according to the AS management type.

<110>
Accession Number
2042353720
Title
Left atrial appendage closure in patients with hereditary hemorrhagic
telangiectasia and atrial fibrillation: a prospective study and systematic
review.
Source
European Journal of Internal Medicine. (no pagination), 2026. Article
Number: 106695. Date of Publication: 2026.
Author
R T.-I.; L T.; Ma S.-C.; P C.; B V.; E G.; P P.; S M.-L.; A I.; E A.; A
P.; J G.-L.; J R.; A R.-M.
Institution
(R, Ma, P, B, P, S, A, E, A, J, A) HHT Unit. Internal Medicine Department.
Hospital Universitari Bellvitge, Barcelona, Spain
(R, P, B, P, S, A, A) Internal Medicine Department. Hospital Universitari
Bellvitge, Barcelona, Spain
(R, P, B, A, A, J, A) Bellvitge Biomedical Research Institute (IDIBELL),
Barcelona, Spain
(R, A) Faculty of Medicine and Health Sciences. Universitat de Barcelona,
Barcelona, Spain
(L, Ma, J) Cardiology Department. Hospital Universitari de Bellvitge,
Barcelona, Spain
(E) Cytology and Hematology Laboratory, Anatomic Pathology Department,
Hospital Universitari de Bellvitge, Barcelona, Spain
(E) Angioradiology Unit, Radiology Department. Hospital Universitari de
Bellvitge, Barcelona, Spain
(A) Otorhinolaringology Department. Hospital Universitari Bellvitge,
Barcelona, Spain
(J) Pneumology Department. Hospital Universitari de Bellvitge, Barcelona,
Spain
Publisher
Elsevier B.V.
Abstract
Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant
vascular disease with a high risk of iron deficiency anemia secondary to
epistaxis and gastrointestinal bleeding. Atrial fibrillation (AF) is
associated with a high risk of ischemic stroke and oral anticoagulation
therapy is indicated for its prevention. Percutaneous left atrial
appendage closure (LAAC) is recommended to prevent stroke in patients with
AF and high risk of bleeding such as HHT patients. However, double
antiplatelet therapy at first, followed by long-term single antiplatelet
therapy, is also recommended after the procedure to prevent device-related
thrombus (DRT), which most HHT patients cannot tolerate. This prospective
observational study describes 36 HHT patients with AF, 23 of whom
underwent LAAC. To prevent DRT, simple antiplatelet therapy was indicated
for 3 months if tolerated. In addition, a systematic review on LAAC in HHT
patients was performed to compare our results with what has been
previously reported. A total of 57 HHT patients with AF and LAAC were
analysed. Although only 12.3% tolerated long-term simple antiplatelet
therapy, none presented DRT during follow-up. Three ischemic events were
reported but only one of them appears to be partially related to AF in a
patient with significant leakage peri-device. In conclusion, percutaneous
LAAC is a safe and potentially effective strategy for preventing ischemic
stroke in HHT patients with AF. A simplified and personalized antiplatelet
regimen was not associated with DRT or ischemic events. Copyright
© 2025. Published by Elsevier B.V.

<111>
Accession Number
2042203920
Title
Triglyceride-glucose index as a novel predictor of major adverse
cardiovascular events in patients with coronary revascularization: a
meta-analysis of cohort studies.
Source
Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2607796.
Date of Publication: 2026.
Author
Zhang C.; Li M.; Liu L.; Zhong Y.; Xie Y.; Liao B.; Feng J.; Deng L.
Institution
(Zhang, Li, Liu, Zhong, Feng, Deng) Department of Cardiology, The
Affiliated Hospital of Southwest Medical University, Stem Cell Immunity
and Regeneration Key Laboratory of Luzhou, Luzhou, China
(Xie) School of Rehabilitation, Capital Medical University, Beijing, China
(Xie) Department of Rehabilitation Medicine, Affiliated Hospital of North
Sichuan Medical College, Sichuan, China
(Liao) Department of Cardiovascular Surgery, The Affiliated Hospital of
Southwest Medical University, Metabolic Vascular Diseases Key Laboratory
of Sichuan Province, Luzhou, China
(Deng) Department of Rheumatology, The Affiliated Hospital of Southwest
Medical University, Luzhou, China
Publisher
Taylor and Francis Ltd.
Abstract
Background: The triglyceride-glucose index (TyG) has gained attention as
an alternative indicator for assessing insulin resistance (IR). The
purpose of this study was to comprehensively summarize the correlation
between the TyG index and cardiovascular events in patients with coronary
revascularization. Method(s): PubMed, Web of Science, Embase, and The
Cochrane Library databases were searched to find relevant literature on
the prognostic assessment of TyG index in patients undergoing coronary
artery revascularization. Utilize the risk ratio (RR) and its 95%
confidence interval (CI) as the standard for assessing the correlation
between TyG and major adverse cardiovascular events (MACEs) in patients
undergoing coronary artery revascularization. Conduct sensitivity analysis
and subgroup analysis to detect the sources of heterogeneity and assess
the stability of the results. Result(s): A total of 12 studies
involving 9,973 participants were included. The results of the study
indicate that a high TyG index was related to the major adverse
cardiovascular event in patients undergoing coronary artery
revascularization (RR:2.0,95%CI: 1.71-2.35, I2=76.2%, p <
0.0001). Subgroup analysis reveals that the probability of MACEs occurring
in patients with high TyG index is higher than in those with low TyG index
after two different coronary artery revascularization procedures: CABG
group (RR:2.10, 95%CI:1.80-2.45, I2 = 20.9%, p = 0.0001). PCI group:
(RR:1.94, 95%CI:1.54-2.46, I2 = 84.2%, p < 0.00001). Additionally, we also
demonstrated the prognostic value of the TyG index in all-cause
mortality(p = 0.003), non-fatal myocardial infarction(p = 0.003),
non-fatal stroke(p < 0.0001) and repeat revascularization(p < 0.0001).
 Conclusion(s): Higher TyG index may be independently associated with
higher incidence of MACEs in patients with coronary
revascularization. Copyright © 2025 The Author(s). Published by
Informa UK Limited, trading as Taylor & Francis Group.

<112>
Accession Number
2042370593
Title
Auricular Vagus Nerve Stimulation Reduces Postoperative Delirium After
Major Non-Cardiac Surgery in Elderly Patients.
Source
Clinical Interventions in Aging. 21 (pp 1-12), 2025. Date of Publication:
2025.
Author
Shi J.; Gao D.; Hu X.; Zhang Y.; Guo T.; Mao Q.; Liu Q.; Ji M.
Institution
(Shi, Hu, Zhang, Guo, Mao, Ji) Department of Anesthesiology, The Second
Affiliated Hospital of Nanjing Medical University, Nanjing, China
(Shi, Zhang, Mao) Department of Anesthesiology, Jiangsu Province Academy
of Traditional Chinese Medicine, Nanjing, China
(Gao) Department of Anesthesiology, Jinling Hospital, Nanjing University
School of Medicine, Nanjing, China
(Liu) Department of Anesthesiology, Xishan People's Hospital of Wuxi City,
Wuxi, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Postoperative delirium (POD) is a prevalent and devastating
complication in elderly patients undergoing major surgery, marked by
substantial increases in morbidity, mortality, and long-term cognitive
decline. However, treatment and prevention methods are limited.
Accumulating evidence suggests that vagus nerve stimulation effectively
enhances cognitive function. Objective(s): To evaluate the efficacy
of transcutaneous auricular vagus nerve stimulation (taVNS) on POD in
elderly patients undergoing major non-cardiac surgery. Method(s):
Patients aged >=65 years scheduled for major non-cardiac surgery were
randomly assigned to either the active taVNS group or the sham taVNS
group, with stimulation targeting the cymba conchae or earlobe,
respectively. In both groups, stimulation was initiated 5 minutes prior to
anesthesia induction and continued until the end of surgery. The only
difference between the two groups was the stimulation site. The primary
outcome was the incidence of POD during the first 3 postoperative days.
 Result(s): A total of 150 patients (median age, 73 years; 96 women
[64%]) completed this trial. The incident POD risk was 12% (n = 9) vs
25.3% (n = 19) in active-taVNS and sham-taVNS groups, respectively
(relative risk, 0.47; 95% CI, 0.23-0.98; P = 0.036). The mediation
analysis revealed that postoperative sleep quality played a significant
mediating role in the effect of taVNS on POD (z = -2.30, P = 0.02).
 Conclusion(s): In this study, taVNS reduces the incidence of POD in
elderly patients undergoing major non-cardiac surgery, possibly by
improving postoperative sleep quality. We suggest that this non-invasive
neuromodulation technique could be considered as a potential preventive
strategy for POD. Further validation in future large-scale randomized
controlled trials is warranted. Copyright © 2026 Shi et al.

<113>
Accession Number
2042763765
Title
Coronary artery disease in patients undergoing transcatheter aortic valve
replacement: Current evidence and future directions.
Source
American Heart Journal Plus: Cardiology Research and Practice. 62 (no
pagination), 2026. Article Number: 100710. Date of Publication: 01 Feb
2026.
Author
Wehbeh B.E.D.; Al Sakan M.; Francis J.; Ghazal R.; Alam S.; Sawaya F.
Institution
(Wehbeh, Alam, Sawaya) Department of Internal Medicine, American
University of Beirut Medical Center, Beirut, Lebanon
(Al Sakan, Francis, Alam) Department of Cardiology, American University of
Beirut Medical Center, Beirut, Lebanon
(Ghazal) Department of Internal Medicine, Henry Ford Health, Detroit, MI,
United States
(Ghazal) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
MN, United States
(Sawaya) Structural Heart and Valve Division, American University of
Beirut Medical Center, Beirut, Lebanon
Publisher
Elsevier Inc.
Abstract
Coronary artery disease (CAD) coexists frequently with aortic stenosis
(AS), and the optimal management of CAD in patients undergoing
transcatheter aortic valve replacement (TAVR) remains incompletely defined
due to limited and heterogeneous evidence. This review aims to integrate
the current evidence on the epidemiology and shared pathophysiology of CAD
and AS, summarize the diagnostic algorithms for CAD in the TAVR
population, and evaluates revascularization strategies with a focus on the
timing of percutaneous coronary intervention relative to valve
replacement. Current evidence suggests that while routine PCI in TAVR
candidates for stable CAD may offer limited benefit, revascularization in
patients with complex CAD or high anatomical burden may improve outcomes.
This review further characterizes the incidence, proposed mechanisms, and
prognostic significance of post-TAVR coronary events and outlines emerging
strategies to optimize ischemic and procedural outcomes in this high-risk
cohort. Copyright © 2025 The Authors

<114>
Accession Number
2042682664
Title
Comparison of local anaesthetic versus saline erector spinae plane block
for perioperative opioid consumption and postoperative pain in open
posterior spine surgeries - A randomised controlled trial.
Source
Indian Journal of Anaesthesia. 70(1) (pp 251-258), 2026. Date of
Publication: 01 Jan 2026.
Author
Mahendranath M.; Shwethashri K.R.; Uppar A.; Chakrabarti D.; Sriganesh K.
Institution
(Mahendranath) Department of Anaesthesiology, SAKRA World Hospital,
Karnataka, Bengaluru, India
(Shwethashri, Chakrabarti, Sriganesh) Department of Neuroanaesthesia and
Neurocritical Care, NIMHANS, Karnataka, Bengaluru, India
(Uppar) Department of Neurosurgery, SAKRA World Hospital, Karnataka,
Bengaluru, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative pain is common after spine surgeries.
Studies involving lumbar surgeries noted that erector spinae plane block
(ESPB) decreased postoperative pain and opioid consumption. Studies
evaluating ESPB for cervical and thoracic spine surgeries are lacking. The
primary objective was to compare intraoperative opioid consumption and
postoperative pain in patients receiving local anaesthetic (LA)-ESPB
versus saline-ESPB for all level spine surgeries. Method(s): This
randomised controlled study comparing LA-ESPB versus saline-ESPB was
conducted over 27 months after patient consent, ethics approval, and trial
registration in patients undergoing cervical, thoracic, and lumbar spine
surgeries. Randomisation was done using a computer-generated random number
table, and allocation was performed centrally for concealment.
Anaesthesiologists, patients, outcome assessors, and data analysts were
blinded to interventions. Bilateral ESPB was performed after
administration of GA in the prone position at the midpoint of the planned
surgical incision level. A maximum of 40 mL of solution, either
bupivacaine 0.25% or saline, was used for ESPB. Pain was assessed using a
numerical rating scale (NRS) score. Secondary outcomes were rescue
analgesia requirements, sleep, satisfaction, adverse events, chronic pain,
and return to work. Result(s): Data were analysed for 198 patients
(LA-ESPB = 98, saline-ESPB = 100). There was no difference between the
groups for primary and secondary outcomes. The intraoperative and
postoperative opioid consumption was similar (P = 0.052 and 0.164,
respectively). There was no difference in immediate postoperative NRS
score (P = 0.880), at 24 h (P = 0.509), and at 48 h (P = 0.270). Rescue
analgesia requirements, sleep, satisfaction, adverse events, chronic pain,
and return to work were similar. Conclusion(s): We did not observe
differences in postoperative pain and perioperative analgesia consumption
between LA-ESPB and saline-ESPB groups in patients undergoing all-level
spine surgeries. Copyright © 2026 Indian Journal of Anaesthesia.

<115>
Accession Number
649808712
Title
Management of anaesthesia transfemoral transcatheter aortic valve
implantation: an Italian interdisciplinary consensus statement.
Source
British journal of anaesthesia. (no pagination), 2026. Date of
Publication: 02 Jan 2026.
Author
Ajello V.; Fresilli S.; D'Amico F.; Franceschini G.; Aloisio T.; Gottin
L.; Baiocchi M.; Guarracino F.; Bertini P.; Napodano M.; D'Amora M.;
Panascia E.; Meani P.; Weltert L.; Monaco F.; Pieri M.; Sangalli F.;
Santonocito C.; Silvetti S.; Landoni G.; Ranucci M.; Scolletta S.;
Paternoster G.
Institution
(Ajello, Franceschini) Department of Cardiothoracic Anaesthesia,
University Hospital Tor Vergata, Rome, Italy
(Fresilli, D'Amico) Department of Anaesthesia and Intensive Care, IRCCS
San Raffaele Scientific Institute, Milan, Italy
(Aloisio, Ranucci) Department of Cardiac Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
(Gottin) Unit of Cardiothoracic and Vascular Intensive Care Verona
Hospital and University Trust, Department of Surgery, Dentistry and
Paediatrics and Gynaecology, University of Verona, Verona, Italy
(Baiocchi) Cardiothoracic and Vascular Anaesthesia and Intensive Care,
IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
(Guarracino) Department of Cardiothoracic and Vascular Anaesthesia and
Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Bertini) Department of Anaesthesia and Intensive Care Medicine, Casa di
Cura Privata San Rossore, Pisa, Italy
(Napodano) Cardiologia Interventistica. Dipartimento
Cardio-Toraco-Vascolare, Azienda Ospedale Universita di Padova, Padua,
Italy
(D'Amora) Department of Cardiac, Thoracic, Vascular Anaesthesia,
University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno,
Italy
(Panascia, Santonocito) Anaesthesia and Critical Care Medicine III - CAST,
Policlinico University Hospital, Catania, Italy
(Meani) Cardio-Thoracic and Vascular Anaesthesia and Intensive Care, ASST
Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Weltert) Heart Surgery Department, Saint Camillus International
University for Health Sciences, Rome, Italy
(Monaco) Departement of Medical and Surgical Sciences (DIMEC)Alma Mater
Studiorum - University of Bologna, Italy; Cardiothoracic and Vascular
Anesthesia and Intensive Care IRCCS Azienda Ospedaliero-Universitaria
Sant'Orsola, BolognaVia Massarenti, 940138 Bologna, Italy
(Pieri, Landoni) Department of Anaesthesia and Intensive Care, IRCCS San
Raffaele Scientific Institute, Milan, Italy; School of Medicine,
Vita-Salute San Raffaele University, Milan, Italy
(Sangalli) Department of Anaesthesia and Intensive Care, University of
Milano-Bicocca, Vimercate, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS- IRCCS Cardiovascular Network, Italy
(Scolletta) Department of Medical Science, Surgery, Neurosciences,
Urgency-Emergency Anesthesia and Intensive Care Unit, University Hospital
of Siena, Siena, Italy
(Paternoster) Department of Health Sciences, Anaesthesia and ICU, School
of Medicine, University of Basilicata San Carlo Hospital, Potenza, Italy
Abstract
BACKGROUND: Transfemoral transcatheter aortic valve implantation (TAVI) is
a minimally invasive treatment for patients with severe aortic stenosis
who are at elevated surgical risk. Despite widespread use, optimal
periprocedural anaesthetic management remains highly variable, and
evidence-based guidance is lacking. METHOD(S): An interdisciplinary
panel of Italian experts in anaesthesiology, cardiology, and cardiac
surgery conducted a systematic review of the literature and used the
RAND/UCLA Appropriateness Method to evaluate 1032 clinical scenarios
across a range of risk profiles and comorbid conditions. Ratings were
conducted over three rounds, including a moderated in-person meeting to
refine and discuss appropriateness scores. RESULT(S): A minimally
invasive approach, local anaesthesia alone, and conscious sedation were
judged appropriate across most clinical scenarios. Invasive monitoring,
such as placement of an additional arterial catheter or a central venous
catheter, was recommended only in selected high-risk patients. Several
approaches or interventions were consistently rated inappropriate across
all evaluated scenarios, including nurse-administered anaesthesia,
pulmonary artery catheterisation, and cardiac output monitoring using
pulse wave analysis. Other approaches, such as general anaesthesia and
deep sedation, were considered inappropriate in most cases but retained
uncertainty in select clinical contexts. Several recommendations were
rated as necessary to define a minimum standard of care.
 CONCLUSION(S): This Italian consensus statement provides practical,
expert-driven recommendations to standardise anaesthetic care for
transfemoral TAVI. While many recommendations reached strong consensus,
areas of uncertainty remain, underscoring the need for further clinical
research. Patient-centred, individualised decision-making remains
essential, guided by institutional experience and procedural
complexity. Copyright © 2025 British Journal of Anaesthesia.
Published by Elsevier Ltd. All rights reserved.

<116>
Accession Number
649811609
Title
Effect of Anti-Obesity Treatments on Heart Rate Variability: Review of a
20 Years Evolution.
Source
Obesity. Conference: 42nd Annual Meeting of the Obesity Society at
Obesityweek. San Antonio, TX United States. 32(Supplement 1) (pp 180),
2024. Date of Publication: 01 Nov 2024.
Author
Bedin-Pochini A.; Facanha J.; Carvalho J.; De Oliveira J.M.P.; Rodrigues
C.; Toledo D.; Giorelli G.
Institution
(Bedin-Pochini, Toledo) Sao PauloBrazil
(Facanha, Carvalho) FortalezaBrazil
(De Oliveira) CampinasBrazil
(Rodrigues) JoinvilleBrazil
(Giorelli) Rio de JaneiroBrazil
Publisher
John Wiley and Sons Inc
Abstract
Background: Heart rate variability (HRV) analyzes the fluctuations in
heartbeat timing, providing a window into the autonomic nervous system's
(ANS) activity and balance. Research suggests HRV can be an indicator of
overall health, with lower variability associated with increased risk of
mortality and preceding the development of various health conditions.
Studies further demonstrate an inverse relationship between HRV and weight
gain/obesity. Method(s): A search was performed in Pubmed database
using the following strategy: (("Anti-Obesity Agents" OR "Anti-Obesity
Agents" OR "Bariatric Surgery") AND "Heart Rate") and 319 articles were
selected. A filter was applied to include articles in the last 20 years
(May, 2004 to May, 2024) in humans, retrieving 185 articles. Based on
their titles and abstracts, 19 were considered relevant. One was excluded
because the full text was not accessible online. Result(s): Three
RCTs evaluated GLP-1 agonists' effects on HRV using 5-minute ECG
recordings. Exenatide (acute, 1 week) increased the LF/HF ratio (median:
0.6, [-0.3 to-3.2]; p < 0.05), while liraglutide (12 weeks) showed no
significant impact on HRV (p > 0.05). Twelve observational studies 6 to 12
months after bariatric surgery consistently reported a positive impact on
HRV (p<0.05). Two studies showed further improvement in HRV for patients
who exercised(aerobic exercise) after surgery. Findings were mixed in
sibutramine. One observational study showed increased HRV with weight
loss, but another showed no change despite weight loss. A separate
case-control study found no improvement in HRV using 24-hour Holter
monitoring. Conclusion(s): Most studies only assess HRV for short
periods, and longer evaluations are needed since some treatments may have
fluctuating effects. Overall, more research is necessary, and wearable
devices could be valuable tools for continuous HRV monitoring.

<117>
Accession Number
649808330
Title
A pilot randomized controlled trial to test the feasibility of a mobile
health (mHealth) self-help intervention for adults after cardiac surgery.
Source
European journal of cardiovascular nursing. (no pagination), 2026. Date
of Publication: 04 Jan 2026.
Author
Wynne R.; Nolte J.; Angel J.; Moore A.; Campbell T.; Ferguson C.
Institution
(Wynne) Centre for Quality & Patient Safety in the Institute for Health
Transformation, School of Nursing & Midwifery, Deakin University, Geelong,
Australia
(Wynne) Western Health-Deakin Partnership, Western Centre for Research &
Education, Majorca Street, St Albans, VIC 3021, Australia
(Nolte, Angel) Department of Cardiothoracic Surgery, Royal Melbourne
Hospital, Grattan Street, Parkville, VIC, Australia
(Moore, Campbell) St Kilda Road, Melbourne, VIC, Australia
(Ferguson) School of Nursing, Faculty of Science, Medicine & Health,
University of Wollongong, NSW, Wollongong, Australia
Abstract
AIMS: To determine feasibility, acceptability and test protocol integrity,
for testing a mobile health (mHealth) intervention focused on enhancing
self-management after adult cardiac surgery. Secondary aims were to assess
the effect of the intervention on 30-day readmission, quality of life, and
knowledge, skill and confidence for self-help. METHODS AND RESULTS: A
parallel-group, pilot randomized controlled trial was conducted in a major
metropolitan publicly funded health service. Adult elective cardiac
surgery patients discharged home within 30-days, able to understand spoken
English, and use a smartphone, tablet or computer were eligible for
inclusion. The mHealth intervention comprised patient narrative videos,
and on-line resources focused on diagnosis, preparing for surgery, and
immediate, and ongoing recovery. From August 2021 until the 23rd of
December 2022, there were 341/516 elective cardiac surgery cases. Of 70
(20.5%) eligible patients, 61 (87.1%) participated. The mHealth
intervention was accessed by 27 (84.4%) participants. When accessed, the
intervention was feasible and acceptable for patients, there were no
protocol violations. There was high viewing of content related to
diagnosis, surgery and looking forward, compared with programmes related
to rehabilitation. Readmission rates did not differ between groups.
Participants taking action to manage their health in the intervention
group incrementally increased from baseline to 90-day follow-up.
 CONCLUSION(S): The effect of patient narratives on patient activation
warrants testing in an adequately powered randomized controlled trial.
While the uptake of the mHealth intervention was modest, trends in actions
for self-help and rate of 30-day readmission imply the intervention is
potentially effective in improving self-help management. REGISTRATION: The
Australian and New Zealand Clinical Trials Registry:
ACTRN12621000082808. Copyright © The Author(s) 2026. Published by
Oxford University Press on behalf of the European Society of Cardiology.

<118>
Accession Number
2042502909
Title
Multimodal diagnostic imaging for early mitral valve disease: integration
of current and emerging modalities-a narrative review.
Source
Cardiovascular Diagnosis and Therapy. 15(6) (pp 1212-1226), 2025. Date of
Publication: 31 Dec 2025.
Author
AlRahimi J.S.
Institution
(AlRahimi) Department of Cardiology, King Abdulaziz Medical City, Ministry
of National Guard Health Affairs, King Abdullah International Medical
Research Center, College of Medicine, King Saud bin Abdulaziz University
for Health Sciences, Jeddah, Saudi Arabia
Publisher
AME Publishing Company
Abstract
Background and Objective: Mitral valve disease (MVD) is a major
contributor to global cardiovascular morbidity and mortality. Early
identification is critical to prevent progression to heart failure, atrial
fibrillation, and irreversible myocardial remodeling. Existing reviews
have largely focused on advanced MVD, individual imaging modalities, or
guideline summaries, with limited emphasis on early, asymptomatic disease,
quantitative diagnostic thresholds, comparative multimodal imaging, and
recent innovations. This narrative review uniquely synthesizes evidence
published between 2020 and 2025 to provide an updated, modality-integrated
overview of early-stage MVD, emphasizing emerging technologies, global
accessibility considerations, and a practical multimodal diagnostic
framework. Method(s): A comprehensive literature search was conducted
using PubMed, Scopus, and Google Scholar from January 2020 to August 2025.
Original studies, meta-analyses, high-quality narrative or
state-of-the-art reviews, and consensus statements addressing early
diagnosis of MVD were included. Non-English publications, case reports,
and studies focusing exclusively on advanced disease were excluded. Study
selection and data extraction were performed by the author, and
alternative available versions were retrieved when full texts were
unavailable. Key Content and Findings: Echocardiography remains the
cornerstone of early MVD assessment due to its accessibility, dynamic
evaluation capabilities, and cost-effectiveness. Cardiac magnetic
resonance (CMR) offers high precision for quantifying regurgitant volume,
myocardial fibrosis, and early remodeling. Computed tomography (CT)
provides superior spatial resolution for anatomical assessment and
preprocedural planning, while positron emission tomography (PET)
contributes metabolic and inflammatory insights, especially in prosthetic
valve disease. Emerging innovations, such as artificial intelligence (AI),
machine learning (ML), fusion imaging, and four-dimensional (4D) flow CMR,
enhance diagnostic precision and prognostication. In resource-limited
settings, strategies including tele-echocardiography, portable ultrasound,
and global training initiatives are improving accessibility. Integration
of imaging with clinical, functional, and patient-reported outcomes
promotes a holistic, patient-centered approach. Conclusion(s):
Advances in multimodal cardiovascular imaging are transforming early MVD
detection and management. A patient-centered, AI-enhanced imaging
strategy, incorporating echocardiography, CMR, CT, and PET, can
significantly improve diagnostic accuracy, optimize intervention timing,
and enhance long-term outcomes. Broader implementation of telemedicine,
standardized training, and cost-effective imaging technologies will be
essential for equitable global adoption. Copyright © AME
Publishing Company.

<119>
Accession Number
2042542489
Title
Techniques for harvesting the saphenous vein in coronary artery bypass
grafting: a network systematic review and meta-analysis.
Source
Open Heart. 12(2) (no pagination), 2025. Article Number: e003728. Date of
Publication: 18 Dec 2025.
Author
Liu C.; Zhang M.-X.; Guan X.-L.; Jia S.-H.; Tang W.-J.; Wang X.-L.; Jiang
W.-J.; Zhang H.-J.
Institution
(Liu, Guan, Jia, Tang, Wang, Jiang, Zhang) Department of Cardiovascular
Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing,
China
(Liu, Guan, Jia, Tang, Wang, Jiang, Zhang) Beijing Laboratory of
Cardiovascular Precision Medicine, Beijing Municipal Education Commission,
Beijing, China
(Liu, Guan, Jia, Tang, Wang, Jiang, Zhang) Ministry of Education, Key Lab
of Medical Engineering for Cardiovascular Disease, Beijing, China
(Zhang) Department of Epidemiology and Biostatistics, School of Public
Health, Peking University Health Science Center, Peking University,
Beijing, China
Publisher
BMJ Publishing Group
Abstract
Objective The optimal technique for harvesting the saphenous vein (SVG) in
coronary artery bypass grafting (CABG) remains undetermined. This study
aimed to assess the efficacy of open vein harvesting (OVH), endoscopic
vein harvesting (EVH) and no-touch vein harvesting (NT) in CABG using a
network meta-analysis of randomised controlled trials (RCTs). Methods RCTs
evaluating the outcomes in patients undergoing CABG with the SVG using
OVH, EVH or NT were identified through a systematic search of PubMed, Web
of Science and the Cochrane Central Registry up to August 2025. The
outcomes analysed included graft failure, graft occlusion, mortality,
revascularisation, myocardial infarction (MI) and leg wound infection
rates. Results Data from 26 RCTs involving 7254 patients meeting the
inclusion criteria were analysed. The network meta-analysis indicated that
the graft failure rate in the NT group was significantly lower than in the
OVH group (relative risk (RR) 0.62; 95% CI 0.40 to 0.96) and the EVH group
(RR 0.41; 95%CI 0.21 to 0.80). The graft occlusion rate in the NT group
was significantly lower than in the OVH group (RR 0.66, 95%CI 0.52 to
0.84). However, the leg wound infection rate in the NT group was the
highest. No significant differences were observed in mortality,
revascularisation and MI rates among the three groups. Conclusion NT was
associated with lower graft failure and graft occlusion rates, yet it had
higher leg wound infection rates, while mortality, revascularisation and
MI rates remained comparable among the three techniques. These findings
require cautious interpretation, and it is important to balance harvest
site complications and the desirability of long-term graft
patency. Copyright © Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY. Published by BMJ Group.

<120>
Accession Number
2042525805
Title
A comparative study between ultrasound guided serratus anterior block and
erector spinae block for perioperative analgesia in children undergoing
upper thoracic surgeries: A randomized trial.
Source
Journal of Anaesthesiology Clinical Pharmacology. 42(1) (pp 56-61), 2026.
Date of Publication: 01 Jan 2026.
Author
Arora K.; Reena; Rath A.; Pandey A.R.; Singh A.P.; Sharma K.
Institution
(Arora) Department of Anaesthesiology, Asian Institute of Medical
Sciences, Haryana, Faridabad, India
(Reena, Rath, Pandey, Singh) Department of Anaesthesiology, Critical Care
and Pain Management, Uttar Pradesh, Varanasi, India
(Sharma) Department of Paediatric Surgery, IMS-BHU, Uttar Pradesh,
Varanasi, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Post-operative pain has always been neglected in
children. It is only recently that the issue is being given the
much-needed consideration. Even today, the literature is sparse for
paediatric post-thoracotomy pain management modalities. In this era of
ultrasound guided (USG) regional blocks, serratus anterior plane block
(SAPB) and erector spinae plane block (ESPB) seem to offer promising
results. We aimed to compare the ESPB with SAPB in patients undergoing
open thoracotomy. Material(s) and Method(s): Sixty paediatric
patients of age 5-14 years, scheduled to undergo open thoracotomies, were
divided into two groups: Group S (SAPB) and group E (ESPB). Each group
received 0.5 ml/kg of 0.25% bupivacaine under USG blocks. The primary
outcome of the study was to compare the postoperative pain scores using
the Wong-Baker Faces scale. The secondary outcomes were to compare
cumulative fentanyl consumption, time to initiation of chest
physiotherapy, and duration of hospital stays. Result(s): The Faces
score was significantly lower in Group E compared to Group S at 8 h, 12 h,
16 h, 20 h, and 24 h (P < 0.05). The mean cumulative fentanyl requirement
in Group S was higher than in Group E (P = 0.002). Time to initiate chest
physiotherapy and duration of hospital stays were both significantly
shorter in Group E (P < 0.05). Conclusion(s): ESPB is superior to
SAPB in terms of providing better pain control and reduced opioid
requirements in children post-thoracotomy. Copyright © 2025
Journal of Anaesthesiology Clinical Pharmacology.

<121>
Accession Number
649812301
Title
Randomized Evaluation of Heart Graft Preservation: Comparative Effects of
Optimized Static Cold Storage, Hypothermic and Normothermic Machine
Perfusion, and Colchicine Pretreatment on Ischemia-Reperfusion Injury in a
porcine model.
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2025. Date of Publication: 30 Dec 2025.
Author
Ughetto A.; Delmas C.; Benezech L.; Battistella P.; Gaudard P.; Molina A.;
Andre G.; Maamar S.; Guihaire J.; Audo R.; Martinez C.; Guilbeau-Frugier
C.; Roland D.; Herman F.; Lacampagne A.; Roubille F.
Institution
(Ughetto, Gaudard, Andre) PhyMedExp, University of Montpellier, CNRS,
INSERM, CHU Montpellier, France; Department of Anesthesiology and Critical
Care Medicine, Arnaud de Villeneuve Hospital, CHU Montpellier, University
of Montpellier, Montpellier, France
(Delmas) Intensive Cardiac Care Unit, Cardiology department, Rangueil
University Hospital, Toulouse, France / Toulouse University, Toulouse,
France; REICATRA (Recherche et Enseignement en Insuffisance Cardiaque
Avancee Transplantation et Assistance), Institut Saint Jacques, CHU de
Toulouse, France
(Benezech) PhyMedExp, University of Montpellier, CNRS, INSERM, CHU
Montpellier, France; Intensive Cardiac Care Unit, Cardiology department,
Rangueil University Hospital, Toulouse, France / Toulouse University,
Toulouse, France
(Battistella, Roubille) PhyMedExp, University of Montpellier, CNRS,
INSERM, CHU Montpellier, France; Cardiology department, CHU de
Montpellier, University of Montpellier, Montpellier, France
(Molina, Maamar, Roland) PhyMedExp, University of Montpellier, CNRS,
INSERM, CHU Montpellier, France; Cardio-thoracic and Vascular Surgery
department, CHU de Montpellier, University of Montpellier, Montpellier,
France
(Guihaire) Adult Cardiac Surgery and Transplantation, Marie Lanelongue
Hospital, Paris Saclay University
(Audo, Martinez, Lacampagne) PhyMedExp, University of Montpellier, CNRS,
INSERM, CHU Montpellier, France
(Guilbeau-Frugier) Institute of Metabolic and Cardiovascular Diseases
(I2MC), 31432 Toulouse CEDEX 4, France
(Herman) Clinical Research and Epidemiology Unit, La Colombiere University
Hospital, Montpellier, France
Abstract
BACKGROUND: Heart transplantation remains limited by ischemia-reperfusion
injury (IRI). Optimizing graft preservation and modulating inflammation
may improve early graft quality. We compared optimized static cold storage
(SCS), hypothermic machine perfusion (HMP), and normothermic machine
perfusion (NMP), and evaluated colchicine pretreatment as an adjunct
anti-inflammatory strategy. METHOD(S): Thirty-six pigs were
randomized to colchicine or placebo (n=18 each) and subsequently assigned
to SCS, HMP, or NMP (n=12 per group). After 4 hours of preservation, all
hearts underwent 1 hour of normothermic reperfusion. Myocardial injury,
lactate extraction, systemic cytokines, and histological assessments were
performed. Mixed-effects models accounting for repeated measures and
treatment-preservation interactions were used for all longitudinal
analyses. RESULT(S): HMP was associated with lower H-FABP levels than
SCS (beta -92.6; 95% CI -183 to -2.6; p=0.04), while NMP showed no
difference. Troponin I release was significantly higher in NMP versus SCS
(beta 97.9; 95% CI 63.4-132; p<0.001). Lactate extraction was greater with
HMP compared with SCS (beta 10.2; 95% CI -0.2 to 20.6; p=0.05), with no
difference for NMP. Preservation modality strongly influenced
inflammation: IL-6 (beta 3.72; p<0.001) and TNF-alpha (beta 0.25; p=0.003)
were markedly increased in NMP, whereas IL-10 was reduced in HMP versus
SCS (beta -0.38; p<0.001). Colchicine had no significant effect on any
biomarker. Oxidative stress proteins, apoptosis markers, and histological
injury scores did not differ across preservation modalities or treatment
groups. CONCLUSION(S): In this randomized large-animal model,
hypothermic preservation (SCS, HMP) provides superior metabolic and
inflammatory profiles compared with NMP. Colchicine did not confer
additional benefit under these conditions. Copyright © 2025.
Published by Elsevier Inc.

<122>
Accession Number
649820956
Title
Effect of intraoperative ventilation strategy on postoperative pulmonary
complications in thoracic surgery under general anesthesia: a
meta-analysis.
Source
Journal of cardiothoracic surgery. (no pagination), 2026. Date of
Publication: 04 Jan 2026.
Author
Wang Y.; Ouyang F.; Ding Z.; Xu L.; Wang J.; Chen Z.; Zhang L.
Institution
(Wang, Xu, Wang, Zhang) Department of Anesthesiology, Wuhan No.1 Hospital,
No. 215, Qiaokou District, Wuhan, China
(Ouyang) Department of Anesthesiology, Thrid People's Hospital of Hubei
Province, Wuhan, China
(Ding) Department of Painology, Wuhan No.1 Hospital, Wuhan, China
(Chen) Department of Anesthesiology, Wuhan No.1 Hospital, No. 215, Qiaokou
District, Wuhan, China

<123>
Accession Number
649822374
Title
Exploring the role of fathers' preoperative preparation in reducing
anxiety and enhancing self-efficacy before pediatric open-heart surgery.
Source
BMC psychology. (no pagination), 2026. Date of Publication: 05 Jan 2026.
Author
Zamani R.; Khoshab H.; Shirinabadi Farahani A.; Nourian M.; Nasiri M.;
Najafi K.; Valadkhani S.
Institution
(Zamani, Nourian, Nasiri, Valadkhani) Shahid Beheshti University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Khoshab, Najafi) Bam University of Medical Sciences, Bam, Iran, Islamic
Republic of
(Shirinabadi Farahani) Shahid Beheshti University of Medical Sciences,
Tehran, Iran, Islamic Republic of
Abstract
INTRODUCTION: Parents of children undergoing cardiac surgery face
significant anxiety. This study evaluated a preoperative preparation
program for fathers of children (aged 3-7 years) having open-heart
surgery. METHOD(S): In this semi-experimental study, 60 fathers were
randomly assigned to an intervention group (n = 30) receiving structured
preparation (hospital tours, group counseling, education) or a control
group (n = 30) receiving standard care. Anxiety and self-efficacy were
measured using the VAS-A and PSAM at three timepoints. RESULT(S):
Preoperative preparation significantly reduced fathers' anxiety (mean
difference: -2.1 points; 95% CI - 3.4 to - 0.8, p = 0.002) and increased
self-efficacy (+ 8.7 points, 95% CI 5.2 to 12.1; p < 0.001) compared to
controls. These improvements persisted through discharge (p < 0.05).
Structured interventions, including education and hospital tours,
effectively alleviated paternal distress while enhancing confidence during
their child's cardiac surgery. CONCLUSION(S): Preoperative
preparation for fathers, including education about their child's condition
and treatment, significantly reduces anxiety and enhances self-efficacy.
These interventions alleviate psychological distress and improve coping
strategies, demonstrating the value of targeted support for fathers of
children undergoing cardiac surgery. Copyright © 2026. The
Author(s).

<124>
Accession Number
649808924
Title
Autologous atrial appendage micrografts transplanted during coronary
artery bypass surgery: design of the AAMS2 randomized, double-blinded, and
placebo-controlled trial.
Source
Trials. (no pagination), 2026. Date of Publication: 02 Jan 2026.
Author
Sikorski V.; Nummi A.; Kuuva A.; Wilkman E.; Rajala H.; Stewart J.;
Junttila J.; Lindgren K.; Kervinen K.; Teittinen K.; Kohonen K.; Oksaharju
K.; Okkonen M.; Holmstrom M.; Lehtinen M.; Mulari S.; Taskinen P.; Simonen
P.; Karvonen P.; Kastell P.; Karja-Koskenkari P.; Kandolin R.; Kesavuori
R.; Kaarlenkaski S.; Vaara S.; Dahlbacka S.; Syrjala S.; Syvaranta S.;
Juvonen T.; Erkinaro T.; Makela T.; Karjalainen P.; Kankuri E.; Vento A.;
Nykanen A.
Institution
(Sikorski, Mulari, Kankuri) Faculty of Medicine, Department of
Pharmacology, University of Helsinki, Helsinki, Finland
(Nummi, Teittinen, Kohonen, Oksaharju, Lehtinen, Mulari, Dahlbacka,
Syrjala, Juvonen, Vento, Nykanen) Department of Cardiothoracic Surgery,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, P.O. Box 340 ,Haartmaninkatu 4, Helsinki, Finland
(Kuuva) HelsinkiFinland
(Wilkman) Department of Anesthesiology, Intensive Care and Pain Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Rajala, Stewart, Simonen, Kandolin, Karjalainen) Division of Cardiology,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, Helsinki, Finland
(Junttila, Lindgren, Karja-Koskenkari) Division of Cardiology, Department
of Internal Medicine, Oulu University Hospital, Oulu, Finland
(Kervinen) Heart Unit, Oulu University Hospital, Oulu, Finland
(Okkonen, Karvonen, Kastell, Kaarlenkaski) Research Unit of Internal
Medicine, Medical Research Center Oulu, University of Oulu and University
Hospital of Oulu, Oulu, Finland
(Holmstrom, Kesavuori, Vaara, Syvaranta) Radiology, HUS Diagnostic Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Taskinen) Department of Cardiothoracic Surgery, University of Oulu, Oulu
University Hospital, Oulu, Finland
(Erkinaro) Research Group of Anesthesiology, Medical Research Center Oulu,
Oulu University Hospital and University of Oulu, Oulu, Finland
(Makela) Anesthesia and Intensive Care, Research Unit of Surgery,
University of Oulu and Medical Research Center, Oulu, Finland
Abstract
BACKGROUND: The AAMS open-label clinical study demonstrated the safety and
feasibility of epicardial transplantation of autologous right atrial
appendage micrografts (AAMs) during coronary artery bypass grafting (CABG)
surgery. The study also provided the first indications of therapeutic
efficacy of the AAMs, as delivered within an extracellular matrix patch,
to reduce ischemic scar and increase viable ventricular wall thickness. To
further evaluate the initial beneficial effects observed in the AAMS
study, we designed the randomized, double-blinded, and placebo-controlled
AAMS2 trial. Focusing on patients with ischemic heart disease (IHD) and
myocardial scar, the AAMS2 trial aims to generate state-of-the-art
structural and functional imaging data of the myocardium treated with an
AAMs-patch during CABG. METHOD(S): The AAMS2 trial recruits IHD
patients who are set to undergo non-urgent CABG and present with an
ischemic myocardial scar in preoperative cardiac magnetic resonance
imaging (CMRI) with late gadolinium enhancement. Patients are randomized
(1:1) to receive a collagen-based matrix patch (Hemopatch), with or
without AAMs, epicardially onto the scar border. The primary endpoint,
assessed by CMRI preoperatively and at 6 months post-operative follow-up,
focuses on the left ventricle scar mass. The secondary endpoints center on
the change in scar mass by the AAMs-patch site and evaluation of therapy
safety and feasibility as well as its effects on myocardial structure and
function by echocardiography. Change in blood N-terminal-pro-BNP levels in
the timeframe is the co-primary endpoint. DISCUSSION(S): Data from
the AAMS2 trial provides the first randomized, blinded, and
placebo-controlled evaluation of efficacy on epicardial AAMs
transplantation for ischemic myocardial scar. This data will pave the road
towards rational design of larger AAMs therapeutic efficacy-addressing
trial(s). TRIAL REGISTRATION: ClinicalTrials.gov, NCT05632432, registered
30 November 2022,
https://clinicaltrials.gov/study/NCT05632432. Copyright © 2026.
The Author(s).

<125>
Accession Number
2042561179
Title
Heart transplantation for mitochondrial cardiomyopathy and associated
metabolic syndromes: Case series and systematic literature review.
Source
Global Cardiology Science and Practice. 2025(5) (no pagination), 2025.
Date of Publication: 01 Jan 2025.
Author
Mokhtassi S.S.; Bulut H.I.; Salmasi Y.; Khoshbin E.
Institution
(Mokhtassi, Bulut, Salmasi, Khoshbin) Harefield Hospital, Royal Brompton,
and Harefield as part of Guys and St Thomas NHS Trust, London, United
Kingdom
(Mokhtassi) St George's University Hospitals NHS Foundation Trust, London,
United Kingdom
(Salmasi, Khoshbin) National Heart & Lung Institute, Imperial College,
London, United Kingdom
(Salmasi) Hammersmith Hospital as part of Imperial College Healthcare NHS
Trust, London, United Kingdom
Publisher
HBKU Press
Abstract
Introduction: Mitochondrial diseases (MtDs) are a diverse group of
inherited metabolic disorders that frequently involve the heart, leading
to progressive cardiomyopathy and heart failure. In advanced stages,
transplantation may be the only life-saving option, though its role
remains poorly defined due to the rarity and complexity of these
syndromes. This review examines the outcomes of heart transplantation in
patients with MtD and reports two additional cases from our centre. These
represent the first known transplants for maternally-inherited diabetes
and deafness (MIDD) and for a homoplasmic m.4300 mutation syndrome.
Methodology: We systematically searched Medline, Embase, Cochrane Library,
and Web of Science from inception to May 2025 using MeSH and free-text
terms for heart transplantation and mitochondrial disease. Studies with
original patient data and genetically or clinically confirmed
mitochondrial disease were included. Screening, synthesis, and quality
appraisal followed PRISMA 2020 and Joanna Briggs Institute (JBI)
guidelines for case reports and series. Result(s): Sixteen
publications describing 27 patients met inclusion criteria. Most were
single-case reports or small series, predominantly involving MELAS,
Kearns-Sayre, or Friedreich's ataxia. Short-term post-transplant survival
was excellent (100%, 95% CI 86-100) at median two-year follow-up.
Neurological or metabolic complications, including stroke-like episodes,
occurred in approximately 10% of cases. Our two patients with MIDD and
homoplasmic m.4300 mutation achieved stable graft function and complete
neurological recovery at 12 and 24 months, respectively.
 Conclusion(s): Heart transplantation can be effective for carefully
selected patients with mitochondrial cardiomyopathy. Successful outcomes
require meticulous perioperative metabolic management, neurological
monitoring, and multidisciplinary coordination. Broader, collaborative
studies are needed to refine patient selection criteria and establish
structured long-term follow-up protocols. Copyright © (2025),
(HBKU Press). All rights reserved.

<126>
Accession Number
2042560030
Title
One-year versus three-year outcomes of DK-Crush versus Culotte for left
main bifurcation lesions: A systematic review and meta-analysis of RCTs.
Source
Global Cardiology Science and Practice. 2025(5) (pp 1-23), 2025. Date of
Publication: 01 Jan 2025.
Author
Adji A.S.; Komalasari I.; Saisa D.; Billah A.; Nadhifa; Saputra A.D.;
David D.; Oktaviano Y.H.
Institution
(Adji, Komalasari, Nadhifa) Hang Tuah University, Surabaya, Indonesia
(Saisa) Faculty of Medicine, Indonesia University, Jakarta, Indonesia
(Billah, David) Faculty of Medicine, Udayana University, Bali, Indonesia
(Saputra) Faculty of Medicine, University of Jember, Jember, Indonesia
(Oktaviano) Department of Cardiology and Vascular Medicine, Airlangga
University, Surabaya, Indonesia
Publisher
HBKU Press
Abstract
Background: The long-term comparative effectiveness of the Double Kissing
(DK) Crush and Culotte stenting techniques for left main bifurcation
lesions (LMBLs) remains a subject of clinical debate. This meta-analysis
aimed to evaluate and compare the one-year and three-year clinical
outcomes of the DK Crush and Culotte techniques in patients with LMBLs.
 Method(s): A systematic search was performed in PubMed, MEDLINE,
Cochrane, ScienceDirect, and Google Scholar databases up to June 2025.
Three randomized controlled trials (RCTs) comprising 1,188 patients with
LMBLs were included. Pooled risk ratios (RRs) with 95% confidence
intervals (CIs) were calculated using the Mantel-Haenszel fixed-effects
model to assess one- and three-year outcomes, including target vessel
revascularization (TVR), major adverse cardiac events (MACE), myocardial
infarction (MI), cardiac death (CD), and coronary artery bypass grafting
(CABG). Result(s): Across all studies, DK Crush demonstrated
significantly improved outcomes compared with the Culotte technique for
several endpoints. At the one-year follow-up, DK Crush was associated with
a significantly lower rate of target vessel revascularization (RR = 0.42,
95% CI: 0.24-0.75, p = 0.003) and major adverse cardiac events (RR = 0.45,
95% CI: 0.29-0.71, p = 0.0006). There were no significant differences
between the two techniques in cardiac death (RR = 0.83, 95% CI: 0.32-2.12,
p = 0.70), myocardial infarction (RR = 0.60, 95% CI: 0.26-1.39, p = 0.24),
or coronary artery bypass grafting (RR = 2.42, 95% CI: 0.43-13.69, p =
0.32). At the three-year follow-up, DK Crush maintained its superiority,
showing significantly reduced rates of TVR (RR = 0.37, 95% CI: 0.24-0.58,
p < 0.0001), MACE (RR = 0.47, 95% CI: 0.34-0.65, p < 0.0001), and MI (RR =
0.43, 95% CI: 0.21-0.89, p = 0.02). However, no statistically significant
differences were observed in cardiac death (RR = 0.81, 95% CI: 0.45-1.46,
p = 0.47) or CABG (RR = 2.25, 95% CI: 0.46-11.03, p = 0.32).
 Conclusion(s): The DK Crush technique demonstrated superior clinical
efficacy compared with the Culotte technique, with significantly lower
rates of TVR, MACE, and MI at both one and three years. Although no
significant differences were observed in cardiac death or CABG, DK Crush
appeared to provide more favorable long-term vessel patency and reduced
risk of repeat revascularization. Further large-scale randomized trials
are warranted to validate these findings and strengthen the evidence
supporting DK Crush as the preferred strategy for complex left main
bifurcation lesions. Copyright © (2025), (HBKU Press). All rights
reserved.

<127>
Accession Number
2041816283
Title
Updated evidence on peri-operative neutrophil-to-lymphocyte ratio in
cardiac surgery: A dual analysis of prognostic and diagnostic value for
post-operative atrial fibrillation.
Source
Heart Rhythm. (no pagination), 2026. Date of Publication: 2026.
Author
Awad M.K.A.; Ali A.E.; Mazroua M.S.; Ali K.; Awad R.K.; Mohamed T.R.;
Abdelmaksoud M.; Hashim M.A.; Nikollari R.; Vardas P.N.; Abu-Daya H.
Institution
(Awad, Mohamed, Abdelmaksoud) Division of Critical Care, Department of
Anesthesia and Critical Care, Faculty of Medicine, Ain Shams University,
Cairo, Egypt
(Ali) Department of Internal Medicine, Crestwood Medical Center,
Huntsville, AL, United States
(Mazroua) Department of Surgery, University of Pittsburgh, Pittsburgh, PA,
United States
(Ali) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United
States
(Awad) Department of Critical Care, Cairo University, Cairo, Egypt
(Hashim) Department of Internal Medicine, Mercy St. Vincent Medical
Center, Toledo, OH, United States
(Nikollari) Department of Internal Medicine, St. Barnabas Hospital Health
System, Bronx, NY, United States
(Vardas) Division of Cardiothoracic Surgery, University of Alabama,
Birmingham Heersink School of Medicine, Birmingham, AL, United States
(Abu-Daya) Division of Cardiovascular Disease, Department of Medicine,
University of Alabama, Birmingham Heersink School of Medicine, Birmingham,
AL, United States
Publisher
Elsevier B.V.
Abstract
Background Post-operative atrial fibrillation (POAF) is a frequent
complication after cardiac surgery, increasing morbidity. The
neutrophil-to-lymphocyte ratio (NLR), a simple marker of systemic
inflammation, has been studied as a predictor. Objective We aimed to
assess the association between NLR and new-onset POAF. Methods We
systematically searched PubMed, Scopus, Web of Science, and Embase through
June 2025 for studies reporting pre-operative or post-operative NLR and
incidence of POAF in adult cardiac surgery patients. Diagnostic test
accuracy (DTA) was assessed to evaluate the predictive performance of
pre-operative NLR for POAF, using pooled sensitivity, specificity, and
likelihood ratios. Subgroup analyses and meta-regression were conducted to
explore sources of heterogeneity. Results 32 studies (20,056 patients)
were included. In 27 studies excluding pre-operative atrial fibrillation
(13,630 patients), POAF was associated with significantly higher
pre-operative NLR (standardized mean difference [SMD] = 0.51; 95%
confidence interval [CI]: 0.34-0.67; P <.001; I2 = 94.0%). Post-operative
NLR was also elevated in POAF patients (SMD = 0.30; 95% CI: 0.13-0.47; P
<.001; I2 = 70.7%). Among 4 studies including patients with prior atrial
fibrillation (6364 patients), no significant association was observed (SMD
= 0.04; P =.21). DTA analysis of 12 studies showed pooled sensitivity of
0.52, specificity of 0.71, and diagnostic odds ratio of 3.74 (area under
the curve [AUC] = 0.713), indicating moderate diagnostic accuracy.
Conclusion Elevated NLR is associated with increased risk of POAF.
Distinguishing new-onset POAF and accounting for surgical type are
essential when evaluating NLR as a predictive biomarker. Copyright
© 2025 Heart Rhythm Society.

<128>
Accession Number
2042032442
Title
Efficacy and Safety of Anti-Reflux Mucosal Ablation in Proton Pump
Inhibitors Refractory Gastroesophageal Reflux Disease: A Systematic Review
and Meta-Analysis.
Source
American Journal of Gastroenterology. Conference: 2025 ACG Annual Meeting.
Phoenix United States. 120(10 Supplement 2) (pp S485-S485), 2025. Date of
Publication: 01 Oct 2025.
Author
Chaudhary A.J.; Ul Abideen Z.; Waseem M.H.; Aimen S.; Ramzan N.U.H.;
Shahid H.; Shahzil M.; Bin Hameed U.; Zafar S.; Piraka C.; Ginnebaugh B.
Publisher
Lippincott Williams and Wilkins
Abstract
Introduction: Gastroesophageal reflux disease (GERD) refractory to the
Proton pump inhibitors (PPI) poses a serious clinical challenge. New
endoscopic minimally invasive procedures, causing cardiac remodeling, have
emerged. This meta-analysis aimed to evaluate the efficacy and safety of
the less invasive approach called Anti-reflux mucosal ablation (ARMA) in
GERD. Method(s): Electronic databases including PubMed, Cochrane
Central and ScienceDirect were searched from inception till January 2025.
This review followed the PRISMA (Preferred Reporting Items for Systematic
Reviews and Meta-Analyses) guidelines. The pooled analysis was performed
using a random effects model in R version 4.2.3 employing the "metaprop"
package. The primary and secondary outcomes of interest were clinical
success rate at short-term (<1 year) and long-term (>=1 year) follow-ups,
adverse events, dysphagia requiring dilation and Gastroesophageal reflux
disease health-related quality of life (GERD-HRQL) score. The quality
assessment was done by the Newcastle Ottawa Scale. Publication bias was
assessed visually through funnel plots. Result(s): Five studies
encompassing a total of 294 patients were included in this meta-analysis.
The pooled clinical success rates at short and long follow-ups were 72%
(95% CI:[56-84%]; I2 = 70.8%) and 73% (95% CI:[19-97%];
I2 = 0%) respectively. The pooled adverse effects were 18% (95%
CI:[4-54%]; I2 = 91.6%). Among these adverse effects, the
dysphagia requiring dilation was 13% (95% CI:[7-22%]; I2 = 0%).
 Conclusion(s): This meta-analysis showed that ARMA has a high
clinical success rate along with low incidence of adverse effects implying
that it is a safe and effective minimally invasive endoscopic treatment
modality for GERD resistant to PPI. Copyright 2025 by The American
College of Gastroenterology

<129>
Accession Number
649805389
Title
Patient-Reported Outcomes Using Win Ratio Analysis: A Post Hoc Analysis
From The Randomized ENVISAGE-TAVI AF Trial.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 30 Dec 2025.
Author
Hengstenberg C.; Van Mieghem N.M.; Wang R.; Liao W.; Shi L.; Guo S.; Chen
C.; Ye X.; Dangas G.; Unverdorben M.
Institution
(Hengstenberg) Division of Cardiology, Department of Internal Medicine II,
Vienna General Hospital, Medical University of Vienna, Vienna, Austria
(Van Mieghem) Department of Cardiology, Cardiovascular Institute,
Thoraxcenter, Erasmus University Medical Center, Rotterdam, Netherlands
(Wang, Chen, Ye, Unverdorben) Daiichi Sankyo, Inc., Basking Ridge, NJ,
United States
(Liao, Shi, Guo) Evidera, PPD clinical research business of Thermo Fisher
Scientific, Waltham, MA, United States
(Dangas) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, USA; National and Kapodistrian University of
Athens, School of Medicine, Athens, Greece
Abstract
The previous report on patient-reported outcome (PRO) findings of the
ENVISAGE-TAVI AF (NCT02943785) trial demonstrated improved patient
experience for edoxaban vs vitamin K antagonists (VKAs). This post hoc
analysis aimed to provide insights on the PRO findings of ENVISAGE-TAVI AF
using a win ratio (WR) approach to understand key drivers of treatment
differences. This analysis included patients who received edoxaban or VKAs
and had evaluable Perception of Anticoagulant Treatment Questionnaire 2
(PACT-Q2) assessments from ENVISAGE-TAVI AF. The PACT-Q2 assesses
treatment convenience (13 items) and satisfaction (7 items). PACT-Q2 data
at months 3 and 12 were analyzed using the WR. Patient-to-patient pairs
(one from each group) were compared based on predefined outcome rules; a
"win," "loss," or "tie" was determined for edoxaban in each pairwise
comparison. The WR (95% confidence interval [CI]) for edoxaban was
calculated as the total number of pairs with a win divided by that of
pairs with a loss. WR >1 indicates a more favorable patient experience for
edoxaban vs VKAs. Edoxaban was associated with a higher probability of
improved overall treatment convenience and satisfaction compared with VKAs
at months 3 (WR [95% CI], 1.87 [1.58-2.22]) and 12 (WR [95% CI], 2.01
[1.70-2.38]). This difference was driven by 18 of 20 PACT-Q2 items,
showing a significantly higher probability of meaningfully better outcomes
with edoxaban. In conclusion, this WR analysis demonstrated that
meaningfully better treatment convenience and satisfaction were more
likely with edoxaban than with VKAs in patients with AF after
transcatheter aortic valve replacement. Copyright © 2025.
Published by Elsevier Inc.

<130>
Accession Number
2042354340
Title
Interpreting fractional flow reserve-guided percutaneous coronary
intervention vs coronary artery bypass grafting outcomes.
Source
World Journal of Cardiology. 17(11) (no pagination), 2025. Article Number:
113225. Date of Publication: 26 Nov 2025.
Author
Liu H.-R.; Weng J.-L.
Institution
(Liu) Department of Research, Yinuo Bio company, Tianjin, China
(Weng) Department of Pathology, The Second Affiliated Hospital of
Guangzhou Medical University, Guangdong Province, Guangzhou, China
Publisher
Baishideng Publishing Group Inc
Abstract
Kataveni et al's meta-analysis offers an important contemporary synthesis
of randomized evidence comparing fractional flow reserve-guided
percutaneous coronary intervention and coronary artery bypass grafting
(CABG) in multivessel coronary artery disease (CAD). The pooled analysis
found no significant difference in all-cause mortality or stroke, yet CABG
was superior in reducing myocar-dial infarction, major adverse cardiac
events, and repeat revascularization. These results confirm CABG's
durability even in the era of physiological lesion assessment and
second-generation drug-eluting stents. From a traditional Chinese medicine
(TCM) perspective, multivessel CAD corresponds to syndromes such as "heart
vessel obstruction" and "Qi and blood stagnation", in which local blockage
is compounded by systemic imbalance. While revascularization addresses the
structural impediment to blood flow, TCM approaches, including herbal
medicine, acupuncture, and lifestyle therapy, aim to improve
microcirculation, reduce inflammation, and support recovery, potentially
mitigating recurrent ischemic events. This commentary argues that future
research should integrate optimal revascularization strategies with
rigorously evaluated TCM interventions to address both the anatomical and
systemic dimensions of CAD and improve long-term patient
outcomes. Copyright ©The Author(s) 2025. Published by Baishideng
Publishing Group Inc. All rights reserved

<131>
Accession Number
649806481
Title
Concomitant Tricuspid Annuloplasty During Degenerative Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 30 Dec 2025.
Author
Jacquemyn X.; Rohit G.; Sa M.P.; Bonatti J.; Hasan I.; Ogami T.; Verbelen
T.; Verbrugghe P.; Rega F.; Sultan I.
Institution
(Jacquemyn) UPMC Heart and Vascular Institute, University of Pittsburgh
Medical Center, Pittsburgh, Pennsylvania, USA; Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh,
Pennsylvania, USA; Department of Cardiac Surgery, University Hospitals
Leuven and Department of Cardiovascular Sciences, KU Leuven - University
of Leuven, Leuven, Belgium
(Rohit) Division of Cardiology, Cedar-Sinai Medical Center, Los Angeles,
CA, United States
(Sa) Cleveland Clinic Florida, Weston, FL, United States
(Bonatti, Hasan, Ogami, Sultan) UPMC Heart and Vascular Institute,
University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA;
Department of Cardiothoracic Surgery, University of Pittsburgh,
Pittsburgh, Pennsylvania, USA
(Verbelen, Verbrugghe, Rega) Department of Cardiac Surgery, University
Hospitals Leuven and Department of Cardiovascular Sciences, KU Leuven -
University of Leuven, Leuven, Belgium
Abstract
Tricuspid regurgitation (TR) is common among patients undergoing surgery
for degenerative mitral regurgitation (DMR) and is associated with adverse
outcomes. The role of concomitant tricuspid annuloplasty (TA) during
mitral valve repair (MVr) remains controversial. To address this, we
performed a systematic review and meta-analysis of randomized and
observational studies published up to November 2024, comparing isolated
MVr versus MVr with concomitant TA in patients with DMR (CRD42024627505).
Reconstructed Kaplan-Meier time-to-event data were analyzed using Cox
frailty models to evaluate survival, TR progression, and permanent
pacemaker (PPM) implantation. Sensitivity analyses included randomized or
propensity-matched cohorts. A total of five studies, including 3,123
patients, were analyzed. Early (1-year) and long-term (up to 15 years)
survival were comparable between isolated MVr and concomitant TA (97.3%
vs. 96.9%, HR: 1.25, 95% CI: 0.76-2.08, p=0.381 and 72.2% vs 79.7%, HR:
1.28, 95% CI: 0.96-1.72, p=0.092, respectively). Concomitant TA
significantly reduced the risk of >=moderate TR progression (HR: 0.34, 95%
CI: 0.17-0.70, p=0.003). However, PPM implantation was higher with TA
during the perioperative period (7.4% vs 1.1%, HR 5.76, 95% CI 3.13-10.59)
and remained elevated at 2 years. Sensitivity analyses confirmed these
findings. In conclusion, in patients undergoing MVr for DMR, concomitant
TA effectively prevents TR progression without compromising survival but
is associated with increased PPM implantation. These results support a
selective, guideline-directed approach to TA based on patient- and
disease-specific risk factors. Copyright © 2025 The Author(s).
Published by Elsevier Inc. All rights reserved.

<132>
Accession Number
2042172257
Title
Ethical considerations and multidisciplinary care for pediatric patients
with hypoplastic left heart syndrome: a narrative review with a systematic
search.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2025. Article
Number: 1641337. Date of Publication: 2025.
Author
Zeleznik M.; Groselj U.; Fister P.
Institution
(Zeleznik) Department of Neonatology, University Children's Hospital,
University Medical Centre Ljubljana, Ljubljana, Slovenia
(Groselj) Department of Endocrinology, Diabetes and Metabolism, University
Children's Hospital, University Medical Centre Ljubljana, Ljubljana,
Slovenia
(Groselj) Department of Medical Ethics, Faculty of Medicine, University of
Ljubljana, Ljubljana, Slovenia
(Groselj, Fister) Department of Pediatrics, Faculty of Medicine,
University of Ljubljana, Ljubljana, Slovenia
(Groselj, Fister) National Medical Ethics Committee, Minister of Health,
Ljubljana, Slovenia
(Fister) Department of Pediatric Critical Care, University Children's
Hospital, University Medical Centre Ljubljana, Ljubljana, Slovenia
Publisher
Frontiers Media SA
Abstract
Background: Hypoplastic left heart syndrome (HLHS) was a fatal congenital
heart defect (CHD) until the 1980s. Introduction of the Norwood procedure
and subsequent Fontan operation significantly improved survival by
creating a single-ventricle circulation. Due to the high mortality
associated with the Norwood operation, neonatal orthotopic heart
transplantation emerged as an alternative, despite challenges such as
lifelong immunosuppressive treatment and uncertain longevity of
transplanted hearts. Method(s): A narrative review with a systematic
literature search was conducted in the PubMed, following PRISMA guidelines
and included studies of ethical and medical considerations,
decision-making, counseling and treatment planning in children with HLHS.
In addition, we manually screened reference lists to identify further
relevant literature. We aimed to explore: how do ethical considerations
and decision-making processes influence the management and outcomes of
fetuses and neonates with HLHS and their families across prenatal,
postnatal, and long-term care? Results: Of the 115 studies, 56 met the
inclusion criteria. Early diagnosis through prenatal fetal ultrasound has
markedly improved survival rates by enabling better parental awareness,
counseling, and decision-making. Managing HLHS requires urgent, extensive,
and costly medical interventions, with outcomes influenced by the
healthcare system's expertise, the experience of cardiologists and
surgeons, ethical, legal, and religious considerations of the parents and
medical team. The prenatal phase is crucial for optimal management, with
advanced fetal ultrasound facilitating early detection. Postnatal care
involves a multidisciplinary approach, including stage palliation
physiology/surgery tailored to each patient. Despite surgical
advancements, HLHS patients face higher morbidity and mortality rates than
other patients with CHDs, with long-term survival and quality of life
remaining key concerns. Ethical considerations play a significant role in
the management of HLHS, encompassing the autonomy of families, the best
medical interests of the child, societal, and cultural factors.
Decision-making must balance full disclosure with sensitivity to parents'
values and beliefs. Conclusion(s): Management of HLHS involves
multidisciplinary approach with complex medical and ethical
considerations, but the current literature lacks high-quality studies or
consensus guidelines on ethical decision-making. Therefore, the influence
of ethical considerations on clinical management and patient care remains
unclear, highlighting the need for further research. Copyright 2025
Zeleznik, Groselj and Fister.

<133>
Accession Number
2042583841
Title
Surgery versus conservative management for severe pectus excavatum
(RESTORE): protocol for a multicentre, randomised, controlled superiority
trial.
Source
BMJ Open. 15(12) (no pagination), 2025. Article Number: e113818. Date of
Publication: 24 Dec 2025.
Author
Maier R.; Dunning J.; Wason J.; Chadwick T.; Bryant A.; Fernandez-Garcia
C.; Vale L.; Danjoux G.R.; Wallace G.; Levett-Renton A.; Naidu B.; Pryor
C.; McCulloch P.; Thursfield R.; Wyllie J.; Chang L.; Marsay L.; Akowuah
E.
Institution
(Maier, Chang, Marsay, Akowuah) Academic Cardiovascular Unit, South Tees
Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
(Maier, Wason, Chadwick, Bryant, Fernandez-Garcia) Population Health
Sciences Institute, Newcastle University, Newcastle upon Tyne, United
Kingdom
(Dunning, Danjoux, Levett-Renton, Wyllie) South Tees Hospitals NHS
Foundation Trust, Middlesbrough, United Kingdom
(Vale) Global Health Economics Centre, London School of Hygiene & Tropical
Medicine, London, United Kingdom
(Danjoux) North Yorkshire Academic Alliance of Perioperative Medicine,
York, United Kingdom
(Wallace) North Tees and Hartlepool NHS Foundation Trust, Hartlepool,
United Kingdom
(Naidu) University of Birmingham, Birmingham, United Kingdom
(Pryor) SalfordUnited Kingdom
(McCulloch) University of Oxford, Oxford, United Kingdom
(Thursfield) Newcastle University, Translational and Clinical Research
Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Severe pectus excavatum (PE) may impair cardiopulmonary and
physical function. The effectiveness of surgical treatment to correct PE
and restore physical function is widely debated due to a lack of
high-quality comparative evidence. The RESTORE trial aims to determine the
clinical and cost-effectiveness of corrective surgery for severe PE
compared with conservative management for the first time in a randomised
controlled trial (RCT). Methods and analysis RESTORE is a pragmatic,
multicentre, RCT with an embedded observational cohort. 200 participants
aged >=12 years with severe PE will be recruited at around 12 National
Health Service cardiothoracic surgical centres in England. Participants
will be randomised 1:1 to receive either surgery within 3 months of
randomisation (intervention arm) or no surgery until after the primary
outcome measurement at 1 year (comparator arm). The primary outcome is
change in physical functioning from baseline to 1year as measured by the
Short Form Health Survey (SF-36v2) physical function score. The primary
economic outcome is cost-effectiveness. The key secondary outcome is
change in % predicted VO<inf>2peak</inf> at 1year measured by
cardiopulmonary exercise test (CPET). Outcomes will be assessed at 1year
post-randomisation in the comparator arm and 1year post-surgery in the
intervention arm. The primary analyses will be undertaken on an
intention-to-treat population using a linear mixed-effects model, adjusted
for stratification variables via a binary covariate. Other secondary
outcomes will include change from baseline of cardiopulmonary function
(CPET and spirometry), health-related quality of life using the EuroQol 5
Dimension 5 Level (EQ-5D-5L) and SF-36v2 questionnaires, Hospital Anxiety
and Depression Scale and disease specific symptoms (Phoenix Comprehensive
Assessment for Pectus Excavatum Symptoms and Pectus Excavatum Evaluation
Questionnaire). Adverse events, complications from surgery and operative
technical success (Haller and Compression Indices from preoperative and
postoperative CT scans) will also be assessed. Health economic analysis
will estimate the incremental cost per quality adjusted life year at
1year. Ethics and dissemination The trial was approved by East of Scotland
Research and Ethics Service (24/ES/0034). Participants who are >=16 years
of age will be required to provide written informed consent. For
participants <16 years of age who are not judged to be Gillick competent,
written assent and written informed consent from a parent/guardian will be
required. Results will be submitted for publication in peer-reviewed
journals and shared with participants, clinicians and
commissioners. Copyright © Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY. Published by BMJ Group.

<134>
Accession Number
2042192771
Title
The fascial plane blocks in the upper arm surgery and trauma: A narrative
review.
Source
Journal of Clinical Anesthesia. 109 (no pagination), 2026. Article Number:
112115. Date of Publication: 01 Feb 2026.
Author
Marrone F.; Sbucafratta L.; Fusco P.
Institution
(Marrone, Sbucafratta) Unit of Anesthesia and Intensive Care, Santo
Spirito Hospital, Rome, Italy
(Fusco) Unit of Anesthesia and Intensive Care, SS Filippo and Nicola
Hospital, L'Aquila, Avezzano, Italy
Publisher
Elsevier Inc.
Abstract
Fascial plane blocks are becoming popular as useful and safe methods to
provide pain relief. While their use in thoracic and abdominal surgery is
well known, their application in upper arm surgery and trauma is
underscored. This review explores research from the last 10 years focusing
the use of fascial plane blocks to relieve pain after surgery or trauma in
the upper limb. Studies include randomized controlled trials,
observational studies, and case reports. They look at techniques like the
cervical and high-thoracic erector spinae plane (ESP) block, the
clavipectoral fascia plane (CFP) block, the superior posterior serratus
intercostal plane (SPSIP) block, and periarticular approaches like the
pericapsular (PENG) shoulder block. The high-thoracic ESP block provided
pain relief and was often given with a continuous catheter infusion. The
research shows that there is a tendency toward combining fascial blocks
with each other or with peripheral nerve blocks to cover more area and cut
down on the use of opioids. Even if the results are promising, there
aren't many randomized trials in the literature, thus data are still
mostly low-quality level. Risk of potential complications, such as local
anesthetic systemic toxicity (LAST) or unintentional dissemination to
important anatomical areas, exists although not reported. This study shows
how fascial plane blocks in upper limb surgery are changing and recommends
for more high-quality research to find out when they are best used, how
safe they are, and how well they may work. Copyright © 2025
Elsevier Inc.

<135>
Accession Number
2042593477
Title
3-dimensional reconstruction and mixed reality in thoracic surgery: a
narrative review and user guide.
Source
Journal of Thoracic Disease. 17(12) (pp 11402-11419), 2025. Date of
Publication: 31 Dec 2025.
Author
Pohlman A.; Hallare J.; Facktor M.A.; Abdelsattar Z.M.
Institution
(Pohlman, Hallare, Abdelsattar) Stritch School of Medicine, Loyola
University Chicago, Maywood, IL, United States
(Pohlman, Hallare, Abdelsattar) Department of Cardiovascular and Thoracic
Surgery, Loyola University Medical Center, Maywood, IL, United States
(Pohlman) Department of Surgery, University of Illinois Chicago, Chicago,
IL, United States
(Hallare) Department of Surgery, Loyola University Medical Center,
Maywood, IL, United States
(Facktor) Department of Thoracic Surgery, Geisinger Health System,
Danville, PA, United States
(Abdelsattar) Department of Surgery, Edward Hines Jr VA Hospital, US
Department of Veterans Affairs, Hines, IL, United States
Publisher
AME Publishing Company
Abstract
Background and Objective: 3-dimensional (3D) reconstruction techniques,
including physical forms such as 3D printing, and virtual forms such as
virtual and augmented reality (VR/AR), are gaining popularity. Multiple
platforms have received regulatory approval and many more are being
developed for use in thoracic surgery. However, uptake of these
technologies has been slow, likely owing to poor understanding, unclear
guidance on implementation, and associated costs. In this context, we aim
to provide a review of the existing literature on 3D reconstruction in
thoracic surgery, while also forming a guide for thoracic surgeons.
 Method(s): We searched PubMed using MeSH term "thoracic surgery"
combined individually with "augmented reality", "virtual reality", and "3D
reconstruction". We limited the search to the last 15 years [2010-2025]
with results totaling 287 publications. We identified the highest impact
articles involving each of these technologies. We also searched the Food
and Drug Administration (FDA) website and identified 510k-approved VR and
AR technologies with the potential for use in thoracic surgery. Key
Content and Findings: We broke up our findings into four main sections:
(I) how these models are created; (II) indications for use in thoracic
surgery; (III) models that are currently available; and (IV) surgeons'
perceptions and limitations. These models are typically built from
traditional imaging, such as computed tomography scans, segmented into
individual structures either manually or via artificial intelligence, and
then placed into a file compatible with either projection on VR/AR
headsets or a 3D printer. These models can then be used in a variety of
ways in thoracic surgery, such as training, preoperative planning,
intra-operative guidance, or creation of 3D-printed prostheses. Currently,
the primary limitations are varying accuracy of models, available evidence
for use, uptake by surgeons, and cost of the technology.
 Conclusion(s): 3D reconstruction and mixed reality platforms are an
important development with many uses within thoracic surgery. Further
study into their development, use, and safety will be vital in the coming
years. Surgeons should understand these uses and limitations prior to
implementation into practice. Copyright © AME Publishing Company.

<136>
Accession Number
2042578687
Title
Evaluation and treatment of infective endocarditis in children and
adolescents with underlying CHD: a Paediatric Acute Care Cardiology
Collaborative Clinical Practice Guideline.
Source
Cardiology in the Young. (no pagination), 2025. Date of Publication:
2025.
Author
Aldrich J.B.; Madsen N.; Armstrong A.K.; Burns J.; Collins M.; Coward C.;
Davila S.Z.; Dimas V.; Erdmann A.; Fatemi Y.; Goldstein B.H.; Harahsheh
A.S.; Khan S.; Kipps A.; Kwon M.H.; Lyman E.; Maples H.; Merklinger S.L.;
Sganga D.; Stang C.; Subramanyan R.K.; Vaikunth S.; Gal D.
Institution
(Aldrich, Armstrong) The Heart Center, Nationwide Children's Hospital,
Columbus, OH, United States
(Aldrich, Armstrong) Department of Pediatrics, The Ohio State University,
Columbus, OH, United States
(Madsen) University of Texas Southwestern Medical Center, Dallas, TX,
United States
(Burns) Division of Infectious Diseases, Department of Pediatrics,
Stanford University School of Medicine, Stanford, CA, United States
(Collins) LexingtonKYUnited States
(Coward) Children's Healthcare of Atlanta Heart Center-Cardiac Intensive
Care Unit, Atlanta, GA, United States
(Davila) Department of Pediatrics, Divisions of Critical Care Medicine and
Infectious Diseases, University of Texas-Southwestern, Dallas, TX, United
States
(Dimas) Medical City Children's Hospital, Dallas, TX, United States
(Erdmann) Division of Cardiology, Department of Pediatrics, American
Family Children's Hospital, University of Wisconsin School of Medicine and
Public Health, Madison, WI, United States
(Fatemi) Division of Infectious Diseases, Seattle Children's Hospital,
Seattle, WA, United States
(Fatemi) Department of Pediatrics, University of Washington School of
Medicine, Seattle, WA, United States
(Goldstein) Heart Institute, University of Pittsburgh Medical Center
Children's Hospital of Pittsburgh, Pittsburgh, PA, United States
(Goldstein) Department of Pediatrics, University of Pittsburgh School of
Medicine, Pittsburgh, PA, United States
(Harahsheh, Khan) Children's National Hospital, Division of Pediatric
Cardiology, Department of Pediatrics, The George Washington University
School of Medicine and Health Sciences, Washington, DC, United States
(Kipps) Division of Cardiology, Department of Pediatrics, Stanford
University School of Medicine, Stanford, CA, United States
(Kwon) Boston Children s Hospital, Department of Cardiac Surgery, Harvard
Medical School, Boston, MA, United States
(Lyman) Grant Morrow III MD Medical Library, Nationwide Children s
Hospital, Columbus, OH, United States
(Maples) Department of Pharmacy Practice, University of Arkansas for
Medical Sciences College of Pharmacy, Little Rock, AR, United States
(Maples) Pharmacy Department, Quality & Safety Division, Arkansas Children
s Hospital, Little Rock, AR, United States
(Merklinger) Labatt Family Heart Center, The Hospital for Sick Children,
Toronto, ON, Canada
(Sganga) Boston Children s Hospital, Department of Cardiology, Department
of Pediatrics, Harvard Medical School, Boston, MA, United States
(Stang) Department of Patient Services, Division of Pharmacy, Cincinnati
Children s Hospital Medical Center, Cincinnati, OH, United States
(Subramanyan) Criss Heart Center, Children s Nebraska, Department of
Surgery, University of Nebraska Medical Center, Omaha, NE, United States
(Vaikunth) Division of Cardiovascular Medicine, Department of Medicine,
Hospital of the University of Pennsylvania, Philadelphia, PA, United
States
(Vaikunth) Division of Cardiology, Department of Pediatrics, Children s
Hospital of Philadelphia, Philadelphia, PA, United States
(Gal) Children s Hospital of Los Angeles, Division of Pediatric
Cardiology, Department of Pediatrics, Keck School of Medicine, Los
Angeles, CA, United States
Publisher
Cambridge University Press
Abstract
Background: Infective endocarditis is a leading cause of morbidity and
mortality in children and adolescents with underlying CHD. Appropriate
diagnostic workup and management in the inpatient setting can be
challenging in this patient population due to the spectrum of disease
complexity and the dynamic nature of the field. Therefore, the Paediatric
Acute Care Cardiology Collaborative has undertaken the creation of this
clinical practice guideline. Method(s): A panel of paediatric
cardiologists, infectious disease specialists, intensivists, advanced
practice practitioners, pharmacists, cardiothoracic surgeons, and a
dentist was convened. The literature was systematically reviewed for
relevant articles on the management of infective endocarditis in patients
with CHD. Using the modified Delphi technique, recommendations were
generated and put through iterative Delphi rounds to achieve consensus for
inclusion. Result(s): Based on 127 articles that met the inclusion
criteria, 82 recommendations were generated, 50 of which achieved
consensus for inclusion and are included in this guideline. They address
risk factors specific to CHD lesion type and prior interventions including
implanted material, diagnostic considerations, management strategies, and
recommendations on counselling other healthcare providers, patients, and
families. Of the 50 consensus recommendations, 36 are strong
recommendations, though 20 have low or very low quality of evidence.
 Conclusion(s): A central theme in this guideline is that an
individual's specific CHD lesion and prior interventions must be carefully
considered for risk stratification, diagnostic approach, and management.
While most are strong recommendations, many are supported by low quality
of evidence, emphasising the need for further research in this
subject. Copyright © The Author(s), 2025.

<137>
Accession Number
649775984
Title
The impact of near-infrared spectroscopy-based intraoperative management
on neurocognitive outcomes in adults undergoing cardiac surgery: A
systematic review and meta-Analysis.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists
Society Annual Meeting, CAS 2024. Victoria, BC Canada. 71(2 Supplement 2)
(pp S396-S397), 2024. Date of Publication: 01 Jul 2024.
Author
Abdali T.; Connelly E.; Shen M.; Spence J.
Institution
(Abdali, Connelly) Department of Anesthesia, McMaster University,
Hamilton, ON, Canada
(Shen) Michael G. Degroote School of Medicine, Hamilton, ON, Canada
(Spence) Departments of Anesthesia, Critical Care, and Health Research
Methods, Evaluation, and Impact, McMaster University, Hamilton, ON, Canada
(Spence) Population Health Research Institute, McMaster University,
Hamilton, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Adverse neurocognitive outcomes are common after adult
cardiac surgery, with postoperative cognitive decline (POCD) ranging from
30-80% at discharge. Based on the premise that adverse neurologic outcomes
are caused by focal or global cerebral hypoxia, near-infrared spectroscopy
(NIRS) guided anesthetic delivery may be used to prevent adverse
postoperative neurologic outcomes. We undertook a systematic review and
meta-Analysis of RCTs to describe the effect of NIRS-guided intraoperative
management on postoperative neurocognitive outcomes and mortality in
adults undergoing cardiac surgery on cardiopulmonary bypass. METHODS We
searched CENTRAL, CINAHL, EMBASE, MEDLINE, PsycInfo, and Web of Science
from inception until 31 October 2023 for randomized controlled trials
(RCTs) evaluating the effect of NIRS-guided intraoperative management vs
standard care (no NIRS or blinded NIRS monitoring) in adults undergoing
cardiac surgery on cardiopulmonary bypass. Pairs of reviewers screened
titles and abstracts and full texts, and independently extracted data
which were combined using a random-effects model. We evaluated the
outcomes of POCD, delirium, stroke, and mortality. We assessed the risk of
bias of included trials using a modified version of the Cochrane Risk of
Bias tool, and evaluated the overall quality of evidence for each outcome
using the Grading of Recommendations, Assessment, Development and
Evaluation (GRADE) approach. RESULTS We included 16 RCTs (n = 2,560); 6/16
were judged to be at high risk of bias, primarily because of inadequate
reporting. NIRS-guided intraoperative management decreased the incidence
of short-Term adverse neurocognitive outcomes, including POCD (n = 796;
risk ratio [RR], 0.65; 95% confidence interval [CI], 0.42 to 0.99; I2 =
64.9%; very low-quality evidence) and delirium (n = 1,197; RR, 0.74; 95%
CI, 0.57 to 0.98; I2 = 7.9%; low quality evidence). NIRS guided management
did not however lead to a higher mean MMSE score in the early
postoperative period (n = 301; mean difference [MD], 1.72; 95% CI,-0.02 to
3.46; I2 = 89.6%; very low-quality evidence) or from 6-12 weeks
postoperatively (n = 222; MD, 0.14; 95% CI,-1.54 to 1.83; I2 = 83.9%; very
low-quality evidence). NIRS guided management also did not reduce the risk
of stroke (n = 1,657; RR, 0.89; 95% CI, 0.42 to 1.91; I2 = 6.0%; low
quality evidence) or mortality (n = 1,438; RR, 0.84; 95% CI, 0.47 to 1.52;
I2 = 0.0%; low-quality evidence). DISCUSSION We identified low to very-low
quality evidence that NIRS guided intraoperative management reduces the
risk of short-Term postoperative cognitive decline and delirium, but does
not decrease the risk of stroke or mortality. More rigorous evidence is
required to clarify the role of NIRS-guided intraoperative management for
preventing adverse neurocognitive outcomes in adults undergoing cardiac
surgery on cardiopulmonary bypass.

<138>
Accession Number
649776346
Title
Adherence to, and barriers and facilitators of, prehabilitation for adult
surgical patients: A systematic review.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists
Society Annual Meeting, CAS 2024. Victoria, BC Canada. 71(2 Supplement 2)
(pp S355-S357), 2024. Date of Publication: 01 Jul 2024.
Author
Berrio-Valencia M.; Hutton B.; Chitiva I.; Wolfe D.; Lalu M.; Boet S.;
Gillis C.; McIsaac D.I.
Institution
(Berrio-Valencia, Chitiva, Lalu, Boet, McIsaac) Departments of
Anesthesiology and Pain Medicine, University of Ottawa and Ottawa
Hospital, Ottawa, ON, Canada
(Hutton, Wolfe, Lalu, Boet, McIsaac) Ottawa Hospital Research Institute,
Ottawa, ON, Canada
(Wolfe) Department of Surgery, University of Ottawa, Ottawa, ON, Canada
(Gillis) Department of Human Nutrition, McGill University, Montreal, QC,
Canada
(McIsaac) ICES, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Prehabilitation is a uni-or multimodal intervention that aims
to increase patients' reserves before surgery to improve postoperative
recovery. Low certainty evidence suggests that prehabilitation
interventions may improve outcomes,1 but a key barrier to prehabilitation
effectiveness is poor intervention adherence. In fact, several recent low
risk of bias trials show large benefits from prehabilitation in adherent
participants, but no impact across all participants because of low
adherence.2-4 While some reviews have identified predictors of, and
barriers and facilitators to, exercise adherence, data specific to
prehabilitation and multicomponent (e.g., exercise, nutrition,
psychocognitive) interventions are lacking. Therefore, we undertook a
systematic review: 1) to estimate prehabilitation adherence overall and by
intervention component, 2) to describe how adherence is measured, 3) to
identify predictors of adherence, and 4) to identify barriers and
facilitators to adherence as reported in randomized trials of
prehabilitation in adult surgical patients. METHODS Ethical review was not
required for this prespecified substudy of a larger review focused on
comparative efficacy of prehabilitation components. Our protocol was
directly informed using integrated knowledge translation methods that
engaged diverse partners. Best practices were used for duplicate
title/abstract and full text review, applied using a peer-reviewed search
strategy in seven biomedical databases without language restrictions
(inception to February 2023). Studies of adult, surgical patients
participants randomized to a prehabilitation program for >= 7 days before
elective surgery and that reported a measure of adherence were included.
Data were extracted in duplicate from included studies, and authors were
contacted to recover missing data. Adherence was extracted as reported
(continuous measure of proportion of prehabilitation completed, or as a
binary indicator of meeting a certain threshold of participation).
Descriptive statistics of included studies, measures of adherence, and
median [interquartile range (IQR)] for adherence were calculated across
all studies and for each prehabilitation component. Barriers and
facilitators to adherence were identified with supporting text, and were
inductively coded into themes by two authors. Themes were deductively
organized per the Theoretical Domains Framework (TDF). An ongoing
metaregression analysis will estimate the association of pre-specified
patient, procedural and program features with adherence. RESULTS We
screened 5,498 titles and included 106 studies (n = 4,640), 43% underwent
general, 23% orthopedic, and 19% thoracic surgery. Median adherence as a
proportion of prehabilitation completed was 92% [IQR, 82-97] and 83% [IQR,
64-92] using threshold definitions. Nutritional adherence was 89% [IQR,
79-94] and exercise was 76% [IQR, 58-90]. Definitions used to measure
adherence were heterogeneous. We identified four barrier themes: 1) Health
conditions (acute and chronic medical issues, gastrointestinal
intolerance); 2) Personal factors (anxiety, time constraints, competing
commitments); 3) Social influences (lack of social support, social roles);
and 4) Logistical issues (lack of access to transport, supervision,
supplements and information technology). Six facilitator themes included:
1) Supervision (by physiotherapist/dietician); 2) Homebased training; 3)
Personalization (individualized program, variety); 4) Access to resources
(program materials, equipment, supplements and information technology); 5)
Supporting program engagement (coaching, motivation); and 6) Presence of
social support (training with relatives/support person) (TDF domains,
Table). DISCUSSION Prehabilitation adherence is variable across trials, as
are metrics used to quantify adherence. To improve reporting and
interpretation of prehabilitation evidence, the field should establish
common metrics and approaches to adherence measurement. To increase
prehabilitation efficacy through improved adherence, TDF-informed barriers
and facilitators identified in our review could be linked to
evidence-based strategies using the related Behaviour Change Matrix (e.g.,
use of incentives and self-monitoring to overcome Beliefs about
capabilities.5 Promisingly, many factors identified as barriers had their
counter condition identified as a facilitator (e.g., lack of supervision
as barrier, presence of supervision as facilitator).

<139>
Accession Number
649775912
Title
Preoperative depression and health-related quality of life following
cardiac surgery: A systematic narrative review.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists
Society Annual Meeting, CAS 2024. Victoria, BC Canada. 71(2 Supplement 2)
(pp S386-S387), 2024. Date of Publication: 01 Jul 2024.
Author
Xue Y.; Diep C.; Lee S.; Xiao M.; Pivetta B.; Wijeysundera D.N.; Ladha
K.S.; Sussman D.
Institution
(Xue, Lee) Temerty Faculty of Medicine, University of Toronto, Toronto,
ON, Canada
(Diep, Xiao, Pivetta, Wijeysundera, Ladha, Sussman) Department of
Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON,
Canada
(Diep, Wijeysundera) Institute of Health Policy, Management and
Evaluation, Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Wijeysundera, Ladha, Sussman) Department of Anesthesia, Unity Health
Toronto, Toronto, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Depression is highly prevalent among adults undergoing
cardiac surgery with estimates ranging from 19-37%.1 Preoperative
depression is known to confer an increased risk for adverse clinical
outcomes following cardiac surgery including infection, cardiac
complications, rehospitalization, and mortality.2 Depression may also be a
predictor of various patient-reported outcomes such as health-related
quality of life (HRQoL), which is an important indicator of patient
satisfaction and surgical success.3 Nevertheless, the association between
preoperative depression and HRQoL after cardiac surgery in adults has not
yet been thoroughly reviewed. METHODS This systematic review searched
Medline, Embase, CENTRAL, and PsychINFO for studies examining adults
undergoing cardiac surgery that reported the association between
preoperative depression and postoperative HRQoL outcomes. Articles were
screened by two independent reviewers, and data from eligible studies were
extracted using a standardized collection form. We collected data on study
and participant characteristics, depression measure, HRQoL measure, and
statistical estimates related to the association between preoperative
depression and HRQoL outcomes at any time after cardiac surgery. A
narrative synthesis was only performed on the most commonly reported HRQoL
measure, the Short Form 36 (SF-36) and its derivative scales, given
significant heterogeneity in study design across included studies. RESULTS
Four thousand, five hundred and fifty-four patients from 11 studies
reported outcomes from SF-36 or derivative scales. Seven studies reported
adjusted estimates between preoperative depression and SF-36 summary
scores up to one year: physical component score (PCS) and/or mental
component score (MCS). Preoperative depression was associated with lower
MCS and less MCS improvement in five studies. One study reported increased
odds of MCS improvement. Depression was associated with a lower
postoperative PCS and less PCS improvement in one study and two studies,
respectively. Four studies reported no impact of depression on PCS.
Additionally, three studies reported adjusted estimates with SF-36's
subscale scores up to six months. Depression was negatively associated
with 'energy/fatigue' and 'general health' scores in these studies.
Depression was also negatively associated with 'social functioning' and
'role limitations because of emotional health,' but not 'emotional
wellbeing' at six months. DISCUSSION This review highlights the
detrimental and independent impact of preoperative depression on HRQoL up
to one year following cardiac surgery, especially the mental or
psychologic domain. Depression also had a negative impact on
self-perceived energy, health, and general functioning (e.g., social,
occupational, and daily activities) at six months. Nevertheless,
heterogeneity of the included studies precluded meta-Analyses. Further
work is needed to quantify the impact of preoperative depression on
patient-reported outcomes including HRQoL after cardiac surgery. A better
understanding of these relationships will inform tailored patient
counseling and the development of perioperative mental health screening
and management protocols in this population.

<140>
Accession Number
649772339
Title
TREATMENT OF SEVERE THROMBOSIS EVENT IN A POSTCARDIOVASCULAR- INTERVENTION
PATIENT EXACERBATED HEPARIN-INDUCED THROMBOCYTOPENIA.
Source
Journal of General Internal Medicine. Conference: 2024 Annual Meeting of
the Society of General Internal Medicine. Boston, MA United States.
39(Supplement 2) (pp S395-S396), 2024. Date of Publication: 01 Jun 2024.
Author
Nguyen T.; Seth N.; Khan S.
Institution
(Nguyen, Seth, Khan) Baylor College of Medicine, Houston, TX, United
States
Publisher
Springer
Abstract
CASE: The patient is a 66-year-old man with congenital chest wall
deformity, hypertension, hyperlipidemia, and peripheral vascular disease
who presented for a robotic coronary artery bypass graft (CABG) surgery.
20,000 units of unfractionated heparin (UFH) were used for intraprocedural
anticoagulation. The patient's platelet count was 132 K/muL on the day of
CABG and 213 K/muL at discharge (6 days after CABG). Three days after
discharge, the patient was readmitted due to left lower extremity pain and
swelling. Venous ultrasound with Doppler of the left leg showed acute
thrombosis and total obstruction of the common femoral, profunda femoral,
femoral, popliteal, posterior tibial, and peroneal veins. His platelet
count at that time (9 days after CABG) was 139 K/muL. The decision was
made to start an UFH drip. That evening, the patient developed an acute
pulmonary embolus (PE) in the left main pulmonary artery. The following
day (10 days after CABG), his platelets count dropped to 71 K/muL.
Hematology was then consulted for concern for heparin-induced
thrombocytopenia (HIT) with a 4T score of 6 indicating high probability of
HIT (~64%). UFH drip was discontinued, and the patient was started on a
bivalirudin drip. Heparin antibody was strongly positive at 2.954 OD and
confirmed with a serotonin release assay. The patient then underwent left
femoral vein thrombectomy and an incision and drainage of a hematoma in
the left femoral groin. He was bridged to warfarin at discharge.
IMPACT/DISCUSSION: Cardiovascular patients are at higher risk of HIT due
to exposure to UFH during both procedure and post-procedural prophylaxis.
The incidence of HIT following cardiac surgery is reported between 0.7 to
2% and is associated with higher incidence of thrombotic and embolic
complications (Gurbuz et al, 2005). In our case, the timing of onset (9
days after procedure) and extent of thrombosis could point to the
diagnosis of HIT occurring post-cardiovascular-intervention. The delay in
diagnosis and the mistake of starting an UFH drip in a patient with high
risk of HIT might have exacerbated the patient's HIT complications,
resulting in his subsequent acute PE. In a systematic review and
meta-analysis involving 3068 patients with suspected HIT, the negative
predictive value of a low 4T score (<4) was 99.8% (95% CI, 0.970-1.000)
(Cuker et al, 2012). Therefore, given its ease of use and extremely high
utility in excluding HIT, there should be a low threshold for providers to
use the 4T score to guide their management for patients with high risks of
HIT. CONCLUSION(S): This case highlights the importance to keep HIT
on the differential diagnoses in a patient with thrombosis who has
recently been exposed to UFH. In such cases, extreme cautions must be used
in the selection of anticoagulation as the choice of anticoagulant could
further worsen the patient's condition. Utilization of triaging tools such
as the 4T score and prompt consultation with hematology can make a
life-saving difference for patient care.

<141>
Accession Number
649776212
Title
Incidence and relative risk of delirium after major surgery for patients
with preoperative depression: A systematic review and meta-Analysis.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists
Society Annual Meeting, CAS 2024. Victoria, BC Canada. 71(2 Supplement 2)
(pp S460-S462), 2024. Date of Publication: 01 Jul 2024.
Author
Patel K.; Diep C.; Petricca J.; Daza J.; Lee S.; Xue Y.; Kremic L.; Xiao
M.; Pivetta B.; Wijeysundera D.N.; Ladha K.S.
Institution
(Patel) Cummings School of Medicine, University of Calgary, Calgary, AB,
Canada
(Diep, Xiao, Pivetta, Wijeysundera, Ladha) Department of Anesthesiology
and Pain Medicine, University of Toronto, Toronto, ON, Canada
(Diep, Daza, Wijeysundera, Ladha) Institute of Health Policy, Management
and Evaluation, Dalla Lana School of Public Health, University of Toronto,
Toronto, ON, Canada
(Petricca, Lee, Xue, Kremic) Temerty Faculty of Medicine, University of
Toronto, Toronto, ON, Canada
(Daza) Division of General Surgery, Department of Surgery, University of
Toronto, Toronto, ON, Canada
(Wijeysundera, Ladha) Department of Anesthesia, Unity Health Toronto,
Toronto, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Delirium is associated with a 2-to 5-fold increased
likelihood of experiencing major postoperative complications.1,2 It can
lead to functional decline, higher health care expenses, long-Term
cognitive dysfunction, and greater mortality.3,4 Hospitalized patients
with a history of depression or clinically significant depressed symptoms
have an increased risk of experiencing delirium. While the incidence of
delirium after cardiac surgery for patients with preoperative depression
was assessed,5 a general estimate is lacking for adults undergoing various
surgeries. We conducted a systematic review and meta-Analysis to estimate
the incidence and unadjusted relative risk (or relative odds) of
postoperative delirium for all adults with preoperative depression
undergoing a broad range of surgical procedures. METHODS Medline (OVID),
Embase (OVID), Cochrane Controlled Register of Trials (CENTRAL), and
PsycINFO databases were searched from inception to 30 June 2023. Studies
included defined depression as formal pre-existing diagnosis, or the
presence of clinically significant depressive symptoms assessed through
patient-reported tools before surgery. Multilevel random effects
meta-Analyses were used to estimate the pooled incidence and relative risk
of delirium. Subgroup analyses was conducted to identify important
moderators of pooled estimates among various study-level covariates such
as country of study, study design, inclusion of only older adults (>= 65
yr), inclusion of only cardiac surgery procedures, inclusion of
nonelective procedures, and use of formal instruments. The quality of the
studies was assessed using the Risk of Bias in Non-Randomised
Studies-Exposure tool. The quality of evidence for our study objectives
was assessed using the Grading of Recommendations Assessment, Development,
and Evaluation criteria, modified for observational studies. RESULTS
Forty-Two studies (n = 4,664,051) were included in this review. The
prevalence of postoperative delirium for patients with preoperative
depression was 29% (95% confidence interval [CI], 17 to 43%; I2 = 99.0%),
compared with 15% (95% CI, 6 to 28%); I2 = 99.8%) in patients without
preoperative depression. The overall incidence in the combined cohorts was
21% (95% CI, 11 to 33%; I2 = 99.8%). Patients with preoperative depression
had a 1.91-fold increased risk of delirium (95% CI, 1.68 to 2.17; I2 =
42.0%) compared with those patients without preoperative depression.
Study-level covariates such as country of study, study design, inclusion
of only adults, inclusion of only cardiac surgery, inclusion of only
nonelective procedures, and use of validated instruments were all found to
have a significant moderating effect in bivariate metaregression models.
Publication bias seemed to be present amongst the pooled studies. The
certainty of evidence was "moderate" for the pooled incidence and "high"
for the unadjusted relative risk between preoperative depression and
postoperative delirium. DISCUSSION Patients with a preoperative history of
depression or clinically significant depressive symptoms have a greater
risk of developing post-operative delirium after surgery. Considering the
frequency of preoperative depression and the significant complications
associated with postopera tive delirium,4,5 greater attention in screening
may allow for better informed risk assessment and discussions with
patients. Future efforts should focus on developing and testing risk
mitigation strategies for surgical patients with psychiatric
comorbidities.

<142>
Accession Number
649772013
Title
PROSTHETIC VALVE ENDOCARDITIS IN PATIENTS UNDERGOING TAVR: A
STATE-OF-THE-ART SYSTEMATIC REVIEW.
Source
Journal of General Internal Medicine. Conference: 2024 Annual Meeting of
the Society of General Internal Medicine. Boston, MA United States.
39(Supplement 2) (pp S830), 2024. Date of Publication: 01 Jun 2024.
Author
Hum A.; Shah V.; Shabani J.; Gonzalez A.; Lo S.; Baur A.; Song D.
Institution
(Hum, Shah, Shabani, Lo, Baur, Song) Icahn School of Medicine, Mount Sinai
Department of Medicine, New York, NY, United States
(Gonzalez) Mount Sinai Health System, New York, NY, United States
Publisher
Springer
Abstract
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is currently the
dominant form of aortic valve replacement in America.Infective
endocarditis (IE) post TAVR is a complication that is not well studied in
the literature. Diagnosis of post-TAVR IE is often complicated and delayed
recognition of this disease process can lead to dire consequences. This is
the first systematic review with more than 100,000 patients for IE post
TAVR. The goal of this study is to better understand the incidence, common
pathogens, and complications of this disease process. METHOD(S):
Databases were queried with various keyword combinations to find
applicable articles. The following keywords were used: infective
endocarditis, prosthetic valve endocarditis, and transcatheter aortic
valve replacement. RESULT(S): A total of 21 studies were included in
the final analysis with a total of 176,288 patients that underwent TAVR of
which 1.22% (n=2340) of the patients had IE post-TAVR. The mean age of
patients with IE post TAVR was 77.3 years old with 58.5% being males. The
most common comorbidities included diabetes (n=611, 26.11%), chronic
obstructive pulmonary disease (n=456, 19.48%) and history of previous
stroke ( n=184, 7.9%). Twelve studies reported the use of antibiotics for
prophylaxis, with beta-lactams being the most commonly used. The most
common presenting symptom was fever (n=800, 34.19%). Twenty studies
reported the type of bacteria isolated in cultures; all the studies
reported finding enterococcus species (n= 415, 18%) and staphylococcus
species (n= 656, 28.03%); whereas, streptococcus species (n= 171, 7.30%)
was isolated in sixteen of the studies. Post-TAVR IE led to further
complications including heart failure (n=405, 17.30%), acute kidney injury
(n= 370, 15.81%), septic shock (n=264,11.3%) and stroke (n= 98, 4.2%).
Among patients with IE, the length of hospital stay was noted to be 15
days and the overall mortality rate was estimated to be 24%.
 CONCLUSION(S): Incidence of IE post-TAVR is low but is associated
with higher rates of mortality and morbidity. Thus it is important and
reasonable to have a low threshold to consider infective endocarditis as a
complication post-TAVR. Delay in treatment can lead to severe consequences
for the patient. IE post-TAVR is not well studied and deserves more
dedicated research as this procedure is becoming more popular and common.

<143>
Accession Number
649775963
Title
Incidence of spinal hematoma in cardiac surgery after spinal anesthetic: A
systematic review.
Source
Canadian Journal of Anesthesia. Conference: Canadian Anesthesiologists
Society Annual Meeting, CAS 2024. Victoria, BC Canada. 71(2 Supplement 2)
(pp S264-S267), 2024. Date of Publication: 01 Jul 2024.
Author
Boni P.K.; Arya V.K.; Sondekoppam R.; Subramaniam K.; Rajmohan R.; Rana
M.; Srinivas C.; Iyer R.; Karuppiah A.; Subramani S.; Nayyar P.; Pillai
P.; Negi S.; Kumar B.; Jackson S.; Rabbani R.; McConnell B.
Institution
(Boni, Arya) Department of Anesthesiology, Perioperative and Pain
Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Sondekoppam, Subramani) Department of Anesthesia, University of Iowa,
Iowa City, IA, United States
(Subramaniam) Department of Anesthesia, University of Pittsburgh,
Pittsburgh, PA, United States
(Rajmohan) Department of Anesthesiology, Pharmacology and Therapeutics,
University of British Columbia, Vancouver, BC, Canada
(Rana, Srinivas) Department of Anesthesia, Toronto General Hospital,
University Health Network, University of Toronto, Toronto, ON, Canada
(Iyer) Children's Hospital of Philadelphia, University of Pennsylvania
Perelman School of Medicine, Philadelphia, PA, United States
(Karuppiah) Department of Anesthesiology, Virginia Common-wealth
University School of Medicine, Richmond, VA, United States
(Nayyar) Department of Anesthesia, Donald and Barbara Zucker School of
Medicine, Northshore University Hospital, Manhasset, NY, United States
(Pillai) Department of Anaesthesiology, Austin Health, University of
Melbourne, Heidelberg, VIC, Australia
(Negi, Kumar) Department of Anaesthesiology and Intensive Care, Advanced
Cardiac Center, PGIMER-Chandigarh, India
(Jackson) Max Rady College of Medicine, University of Manitoba, Winnipeg,
MB, Canada
(Rabbani) Department of Community Health Sciences, George and Fay Yee
Centre for Healthcare Innovation, University of Manitoba, Winnipeg, MB,
Canada
(McConnell) Department of Biology and Optometry and Vision Science,
University of Waterloo Library, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Spinal anesthesia in cardiac surgery is a technique with many
potential benefits including improved postoperative analgesia, hemodynamic
stability from denervation of the surgical site, positive myocardial
oxygen balance due to hypodynamic circulation and decrease of the stress
response.1-3 One reason for hesitancy of further investigating this
technique is the risk of spinal hematoma. Incidence of spinal hematoma in
cardiac surgery after spinal anesthesia was projected as 1:3600 by Ho et
al. in the year 2000.4 This study was a retrospective review with limited
data. This information is utilized by the American Society of Regional
Anesthesia (ASRA) to formulate the guidelines which are utilized by
anesthetists to have risk benefit discussions with patients regarding
spinal anesthesia.5 The objective of this study was to collect an
up-Todate data set to project the incidence of spinal hematoma in patients
undergoing cardiac surgery who receive spinals as part of their anesthetic
plan, and full dose heparinization afterwards. METHODS A retrospective
systematic literature review looking at all cases of spinal anesthesia in
cardiac surgery. We formulated a search strategy with our librarian and
searched MEDLINE, Embase and Cochrane Central Register of Controlled
Trials (CENTRAL) through the Ovid platform to identify studies, case
reports or case series looking at patients who have received spinal
anesthesia during cardiac surgery and any spinal hematoma case reports.
This review is conducted according to guidelines enumerated in the
Methodological Expectations of Cochrane Intervention Reviews (MECIR) and
reported according to the Preferred Reporting Items for Systematic Reviews
and Meta-Analysis (PRISMA). With the help of international collaborators,
two reviewers were utilized, and a third reviewer was used for dispute
resolution. We assessed the number of cardiac surgeries conducted with
spinal anesthesia and how many spinal hematomas have been documented,
compared to how many cardiac surgeries were conducted with spinal
anesthesia without spinal hematoma. This information was used to
extrapolate the risk of spinal hematoma in cardiac surgery using both the
Hanley and Lippman-Hand probability method to estimate the maximum risk,
which was previously used by Ho et al., and weighted proportion. We
reviewed American Society of Anesthesiologists (ASA) closed claims the
claims in the Canadian Medical Protective Association. RESULTS We reviewed
416 full text articles, of which 286 were excluded. The remaining 130
studies were included. We found 23,782 spinal anesthetics conducted in
cardiac surgery patients with zero spinal hematomas identified. This is
13,782 more cases than the previous incidence prediction. Maximum risk was
determined to be 1 in 7,927 using the Hanley et al. approximation. This
cuts the risk estimate nearly in half of what was previously predicted. We
also reviewed the ASA closed claims which looked at 97 cases of spinal
hematoma after spinal anesthesia. None of these cases were from cardiac
surgery. There were zero cases of spinal hematoma after spinal anesthesia
in cardiac surgery from the Canadian Medical Protective Association.
DISCUSSION We found more than double the number of spinal's have been
conducted in cardiac surgery since the initial risk evaluation conducted
by Ho et al., with no reported incidence of spinal hematoma. This provides
practitioners and patients with more confidence to include spinal
anesthesia in their cardiac anesthetic plans and further study this
technique. This risk is similar to other groups of patients, particularly
vascular patients where spinal is used routinely. To address limitations
with our study design, we approached closed claims bodies to further
delineate the safety profile of spinal anesthesia in cardiac surgery.

<144>
Accession Number
2042607921
Title
Stress Cardiac Magnetic Resonance Ischemia Burden and Cardiovascular
Events: Post-Hoc Analysis From the ISCHEMIA Trial.
Source
JACC: Cardiovascular Imaging. (no pagination), 2026. Date of Publication:
2026.
Author
Kwong R.Y.; Heydari B.; Abbasi S.; Mongeon F.-P.; Marcotte F.; Friedrich
M.; Shaw L.J.; Xu Y.; Anthopolos R.; Bekeredjian R.; Monti L.;
Selvanayagam J.; Lesiak M.; Picard M.H.; Berman D.S.; Bangalore S.;
Spertus J.A.; Stone G.W.; Boden W.E.; Min J.; Mancini G.B.J.; Leipsic J.;
Budoff M.; Hague C.; Hochman J.S.; Maron D.J.; Reynolds H.R.
Institution
(Kwong, Heydari) Department of Medicine, Cardiovascular Division, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Abbasi) Amegen, Thousand Oaks, CA, United States
(Mongeon) Department of Specialized Medicine, Division of Non-Invasive
Cardiology, Montreal Heart Institute, Montreal, QC, Canada
(Marcotte) Mayo Clinic, Phoenix, AZ, United States
(Friedrich) Department of Specialized Medicine, Division of Non-Invasive
Cardiology, Montreal Heart Institute, Universite de Montreal, Montreal,
QC, Canada
(Shaw) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Xu, Anthopolos) NYU Grossman School of Medicine, New York, NY, United
States
(Bekeredjian) Robert Bosch Medical Center, Stuttgart, Germany
(Monti) Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
(Selvanayagam) Flinders Medical Centre, Adelaide, SA, Australia
(Lesiak) University Hospital of the Lords Transfiguration, Poznan, Poland
(Picard) Department of Medicine, Cardiovascular Division, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
(Berman) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Bangalore) Duke Clinical Research Institute, Durham, NC, United States
(Spertus) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Spertus) University of Missouri-Kansas City's Healthcare Institute for
Innovations in Quality, Kansas City, MO, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Boden) VA New England Healthcare System, Bedford, MA, United States
(Min, Hague) Cleerly Inc, New York, NY, United States
(Mancini, Leipsic) University of British Columbia, Vancouver, BC, Canada
(Budoff) Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA,
United States
(Hochman, Reynolds) Cardiovascular Clinical Research Center, Leon H.
Charney Division of Cardiology, Department of Medicine, NYU Grossman
School of Medicine, New York, NY, United States
(Maron) Department of Medicine, Stanford University School of Medicine,
Stanford, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Research comparing the prognostic value of stress cardiac
magnetic resonance (CMR) to other stress modalities in patients with
coronary disease is limited. Objective(s): The authors compared the
prognostic value of stress CMR vs alternative testing by either
single-photon emission computed tomography or stress echocardiography
(SPECT/echo) in the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial. Method(s):
CMR vs SPECT/echo was compared in 3,909 patients randomized in ISCHEMIA
after sites' interpretation of moderate to severe ischemia. Ischemia and
infarct extent, measured by either CMR or SPECT/echo, were each associated
with the trial's primary outcome of cardiovascular death, nonfatal
myocardial infarction (MI), or hospitalization for unstable angina, heart
failure, or resuscitated cardiac arrest, at a median follow-up of 3.37
years (Q1-Q3: 2.20-4.56 years). Result(s): Compared with SPECT/echo
(n = 5,627), CMR participants (n = 313) were not different in key
demographic factors but were more likely to have severe ischemia (57% vs
38%; P < 0.001) and to be randomized (n = 257, 82%, vs n = 3,652, 65%; P <
0.001). Ischemia severity (no/mild, moderate, severe) by CMR core
laboratory was associated with cumulative 4-year event rates of all
trial-specific endpoints, including the primary outcome (P = 0.042),
cardiovascular death/MI (P = 0.041), and nonfatal MI (P = 0.03), but
SPECT/echo ischemia severity was not. No/mild, moderate, and severe
ischemia by CMR were associated with 0%, 14%, and 23% 4-year primary
outcome rates, respectively, compared with 18%, 15%, and 16%, by
SPECT/echo. After adjustment for age, estimated glomerular filtration
rate, and diabetes, the association between ischemia extent and the
primary endpoint differed by imaging modality, with each additional
ischemic segment on CMR associated with a 13% increase in hazard
(interaction P = 0.02). In participants assigned to initial conservative
management who had no/mild ischemia on imaging, 4-year rates of invasive
referral and coronary revascularization were lower in the CMR than
SPECT/echo group (16.7% and 0%, respectively, for CMR; and 31% and 13.3%,
respectively, for SPECT/echo). Conclusion(s): Ischemia severity by
CMR had a stronger association with all ISCHEMIA trial endpoints compared
with SPECT/echo. Copyright © 2025 American College of Cardiology
Foundation

<145>
Accession Number
649792146
Title
Postoperative Atrial Fibrillation in Patients Undergoing Non-Cardiac
Surgery.
Source
The American journal of cardiology. (no pagination), 2025. Date of
Publication: 29 Dec 2025.
Author
Roozbehi K.; Semirani-Nezhad D.; Soleimani H.; Soltani P.; Saeidi S.;
Farahvash Y.; Nikoohemmat M.; Bahiraie P.; Tayebi S.; Lakkireddy D.;
Mattumpuram J.; Hosseini K.
Institution
(Roozbehi, Semirani-Nezhad, Soleimani, Soltani, Saeidi, Farahvash,
Bahiraie) Cardiovascular Diseases Research Institute, Tehran University of
Medical Sciences, Tehran, Iran; Tehran Heart Center, Cardiovascular
Diseases Research Institute, Tehran University of Medical Sciences,
Tehran, Iran
(Nikoohemmat) Research Institute for Endocrine Sciences, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Tayebi) Centre for Clinical Research Sormland, Uppsala University, Sweden
(Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation,
Overland Park, KS, United States
(Mattumpuram) Division of Cardiology, University of Louisville School of
Medicine, Louisville, KY, United States
(Hosseini) Tehran Heart Center, Cardiovascular Diseases Research
Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic
Republic of
Abstract
BACKGROUND: Postoperative atrial fibrillation (POAF) occurs in
approximately 5-10% of patients undergoing non-cardiac surgery, yet its
long-term impact compared to patients without POAF (nPOAF) remains
uncertain. This study aimed to assess the incidence of cardiovascular
outcomes in patients with new-onset POAF. METHOD(S): A systematic
search of PubMed, EMBASE, and Scopus up to August 2025 identified studies
including adults who developed AF within the first postoperative week.
Outcomes analyzed were AF recurrence, cardiac-related hospitalization,
stroke, and all-cause mortality. Pooled analyses were performed using
random-effects models, reconstructed time-to-event data, and Restricted
Mean Survival Time (RMST). RESULT(S): A total of 14 studies
comprising 3,622,824 patients were included, with 61,305 experiencing
POAF. Compared to nPOAF patients, POAF was associated with significantly
higher risks of stroke at one year (HR 2.34, 95% CI 1.46-3.21),
in-hospital mortality (HR 3.29, 95% CI 2.90-3.67), and one-year mortality
(HR 1.64, 95% CI 1.56-1.71). The cumulative incidence of hospitalization
or stroke was greater in the POAF group (HR 1.75, 95% CI 1.18-2.61).
Time-to-event analysis showed frequent AF recurrence within days of
surgery, with risk persisting over one year. RMST analysis indicated that
POAF patients experienced hospitalization or stroke an average of 14.77
days earlier than nPOAF patients during follow-up. CONCLUSION(S):
New-onset POAF after non-cardiac surgery is strongly associated with
increased risks of stroke, mortality, and recurrent hospitalization. These
findings underscore the importance of early recognition and management,
and highlight the need for further research into preventive and
therapeutic strategies, including the role of
anticoagulation. Copyright © 2025. Published by Elsevier Inc.

<146>
Accession Number
2042069577
Title
Left Atrial Appendage Closure Versus Oral Anticoagulants in Atrial
Fibrillation: A Systematic Review and Meta-Analysis.
Source
Journal of Cardiovascular Development and Disease. 12(12) (no pagination),
2025. Article Number: 483. Date of Publication: 01 Dec 2025.
Author
Wang C.; Zhu D.; Nan J.; Zhang D.
Institution
(Wang, Zhu, Nan, Zhang) Department of Cardiology, The Second Affiliated
Hospital, School of Medicine, Zhejiang University, Hangzhou, China
(Wang, Zhu, Nan, Zhang) State Key Laboratory of Transvascular Implantation
Devices, Hangzhou, China
(Wang, Zhu, Nan, Zhang) Heart Regeneration and Repair Key Laboratory of
Zhejiang Province, Hangzhou, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Left atrial appendage (LAA) closure is an alternative to oral
anticoagulants (OAC) for stroke prevention in atrial fibrillation (AF),
but comparative evidence remains inconsistent. This study systematically
evaluates the efficacy and safety of LAA closure versus OAC in AF
patients. Method(s): We systematically searched PubMed, EmBase,
Cochrane Library, and Web of Science for randomized controlled trials
(RCTs) and propensity score-matched (PSM) studies published up to 30
September 2025. Treatment effects were estimated using relative risks (RR)
with 95% confidence intervals (CI), and a random-effects model was applied
for all analyses. Result(s): Fifteen studies (17,116 AF patients)
were included, comprising 4 RCTs, 3 prospective PSM studies, and 8
retrospective PSM studies. Compared with OAC, LAA closure significantly
reduced the composite endpoint (RR: 0.79; 95% CI: 0.66-0.95; p = 0.010),
all-cause mortality (RR: 0.58; 95% CI: 0.49-0.69; p < 0.001), and
cardiovascular mortality (RR: 0.55; 95% CI: 0.44-0.67; p < 0.001). Risks
of any stroke (RR: 1.06; 95% CI: 0.86-1.31; p = 0.555), ischemic stroke
(RR: 1.00; 95% CI: 0.85-1.17; p = 0.972), hemorrhagic stroke (RR: 0.96;
95% CI: 0.54-1.70; p = 0.879), and major bleeding (RR: 0.84; 95% CI:
0.67-1.04; p = 0.112) were not significantly different between groups.
 Conclusion(s): In AF patients, LAA closure significantly reduces
mortality and a composite clinical endpoint compared to OAC, with similar
risks of stroke and major bleeding. It is a favorable alternative for
patients unsuitable for long-term anticoagulation. Copyright ©
2025 by the authors.

<147>
Accession Number
2042268981
Title
Clinical Outcomes Following Transcatheter Tricuspid Valve Replacement - A
Meta-Analysis.
Source
Structural Heart. 9(11) (no pagination), 2025. Article Number: 100721.
Date of Publication: 01 Nov 2025.
Author
Hatab T.; Badwan O.; Alkhatib R.; Rosenzveig A.; Kritya M.; Massad F.;
Mirzai S.; Harb S.; Reed G.; Krishnaswamy A.; Puri R.; Kapadia S.R.
Institution
(Hatab, Alkhatib, Rosenzveig, Massad) Department of Internal Medicine,
Cleveland Clinic, Cleveland, OH, United States
(Badwan, Harb, Reed, Krishnaswamy, Puri, Kapadia) Department of
Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute,
Cleveland Clinic, Cleveland, OH, United States
(Kritya) Houston Methodist DeBakey Heart & Vascular Center, Houston, TX,
United States
(Mirzai) Department of Cardiovascular Medicine, Wake Forest Health,
Winston-Salem, NC, United States
Publisher
Cardiovascular Research Foundation
Abstract
Background Tricuspid regurgitation (TR) is associated with substantial
morbidity and mortality, yet it remains an undertreated entity.
Transcatheter tricuspid valve replacement (TTVR) has emerged as a
promising therapeutic option, with multiple novel systems demonstrating
early safety and efficacy. The objective of this study is to
systematically review and synthesize the clinical outcomes of
transcatheter heart valve systems. Methods A systematic search of PubMed,
Embase, and Cochrane databases was conducted from database inception
through March 31, 2025. Eligible studies included adult patients
undergoing TTVR for severe or torrential TR, reporting at least one
clinical outcome. Pooled event rates were calculated using a
random-effects model. Subgroup analyses were performed by valve type, and
meta-regression explored potential sources of heterogeneity. Results
Twenty studies comprising 1017 patients were included. The mean age was 73
+/- 9 years, and 71.2% were female. The weighted in-hospital and 30-day
mortality were 1.37 and 2.49%, respectively. New permanent pacemaker
implantation occurred in 7.98%, with highest rates observed in EVOQUE
recipients (11.64%). Only 3% of patients had greater than or equal to
severe TR at follow-up, and only 12% remained in New York Heart
Association functional class III/IV. Subgroup analysis revealed lower
in-hospital and 30-day mortality with EVOQUE but higher permanent
pacemaker implantation compared to other valves. Conclusions TTVR is a
feasible and safe intervention for patients with severe TR, providing
significant functional improvement and TR reduction. Robust, longer-term
randomized controlled trials with standardized outcome reporting and
clinical endpoints are urgently needed to define durable clinical benefit
and guide optimal device selection for patients with severe
TR. Copyright © 2025 The Authors.

<148>
Accession Number
2042210644
Title
Efficacy and safety of anticoagulant therapy for hypoattenuated leaflet
thickening Post-TAVR: A systematic review and meta-analysis.
Source
Journal of Thrombosis and Thrombolysis. (no pagination), 2025. Date of
Publication: 2025.
Author
Tudella G.C.N.; Fagundes C.S.; De Conto T.; Marques M.D.; Chemello D.
Institution
(Tudella, Fagundes, De Conto) Department of Medicine, Federal University
of Santa Maria, RS, Santa Maria, Brazil
(Marques, Chemello) Department of Clinical Medicine, Federal University of
Santa Maria, RS, Santa Maria, Brazil
Publisher
Springer
Abstract
Hypoattenuated leaflet thickening (HALT), a subclinical form of valve
thrombosis, is a common finding after transcatheter aortic valve
replacement (TAVR). While anticoagulant therapy has been associated with
HALT resolution, the efficacy and safety of this approach remain
uncertain. To evaluate the effectiveness and safety of oral anticoagulant
(OAC) therapy in resolving HALT after TAVR. A systematic review and
meta-analysis was performed in accordance with PRISMA guidelines and
registered in PROSPERO (CRD420251045514). Studies including adult TAVR
patients with imaging-confirmed HALT treated with anticoagulants were
included. Outcomes assessed included HALT resolution, valve dysfunction,
and major bleeding. Risk of bias was assessed using the ROBINS-I tool, and
certainty of evidence was evaluated via GRADE. Summary estimates were
calculated using a random-effects model. Nine observational studies
involving 369 patients were included, with a follow-up ranging from 78 to
217.6 days, and ranging from 5 days to 9.6 months of interval between TAVR
and imaging. The overall pooled HALT resolution rate in imaging follow-up
was 90% (95% CI: 0.84-0.95; I2 = 15.0%). Otherwise, when discontinuation
of OAC had a recurrence rate of 69% (95% CI: 0.49-0.84, I2=0). The
bleeding event proportion was 0.05 (95% CI: 0.01-0.18, I2 = 0.0%).
Sensitivity analyses excluding influential studies suggest the robustness
of findings. Anticoagulant therapy is associated with high rates of HALT
resolution and appears superior to antiplatelet therapy. These findings
support the role of anticoagulation in selected post-TAVR patients with
HALT, though randomized trials are needed to confirm efficacy and assess
bleeding risk. Copyright © The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2025.

<149>
Accession Number
2042253092
Title
The impact of red blood cell storage duration on clinical outcomes in
pediatric cardiac surgery: a systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1649610. Date of Publication: 2025.
Author
Jin X.; Zhang Q.; Sun Y.; Dong Z.; Jin W.
Institution
(Jin, Zhang, Jin) Department of Pain, Yanbian University Hospital, Jilin,
Yanji, China
(Sun) Department of Anatomy, School of Medicine, Yanbian University,
Jilin, Yanji, China
(Dong) Department of General Surgery II, Affiliated Hospital of Beihua
University, Jilin, Jilin City, China
Publisher
Frontiers Media SA
Abstract
Background: The impact of red blood cell (RBC) storage duration during
cardiopulmonary bypass (CPB) priming in pediatric cardiac surgery remains
unclear. Objective(s): To evaluate whether RBC storage time affects
perioperative outcomes in children undergoing cardiac surgery.
 Method(s): We performed a systematic review and meta-analysis of
studies comparing fresh vs. longer-stored RBCs for CPB priming in
pediatric patients. Databases searched included PubMed, EMBASE, Cochrane
Library, and Web of Science (through May 2025). Primary outcomes were
mortality, infection/sepsis, respiratory complications, and multiple organ
dysfunction syndrome (MODS); secondary outcomes included mechanical
ventilation duration, ICU stay, and intraoperative lactate levels.
 Result(s): Ten studies (including one randomized controlled trial)
were included. No significant differences were found between groups in any
primary or secondary outcomes, except for a slightly shorter ICU stay in
the fresh RBC group (mean difference = -1.08 days), with high
heterogeneity. Conclusion(s): RBCs stored within standard durations
appear safe for CPB priming in pediatric cardiac surgery. These findings
support current transfusion practices and underscore the need for further
high-quality randomized trials. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1015198,
PROSPERO CRD420251015198. Copyright 2025 Jin, Zhang, Sun, Dong and
Jin.

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