EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2042297298
Title
1-Year Outcomes of Novel Balloon-Expandable vs Contemporary Transcatheter
Heart Valves in Severe Aortic Stenosis: The LANDMARK Trial.
Source
Journal of the American College of Cardiology. 87(4) (pp 362-381), 2026.
Date of Publication: 03 Feb 2026.
Author
Serruys P.W.; Tobe A.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.;
Van den Branden B.J.L.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.;
Ninios V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; De
Sousa Almeida M.; van Belle E.; Linke A.; Ielasi A.; Montorfano M.;
Webster M.; Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.;
Angeras O.; Kim W.-K.; Rothe J.; Abdel-Wahab M.; Kristic I.; Peral V.;
Garg S.; Tsai T.-Y.; Thakkar A.; Chandra U.; Smits P.C.; Morice M.-C.;
Onuma Y.; Kraaijeveld A.O.; Oliveira A.; Cervone A.; Cosenza A.; Nagy A.;
Ioannidis A.; Marvaki A.; Kisiczki A.; Ferencz A.B.; Ansari A.; Belini B.;
Baladron C.; Delhaye C.; Valina C.; Vella C.; Czimbalmos C.; Sjoholm D.;
Pellegrini D.; Siqueira D.; van Ginkel D.J.; Westermann D.; Mesa D.; Della
Togna D.; Chen E.; Unic E.; Nedjat F.D.R.; Woitek F.; Russo F.; Vincent
F.; Ereliadou F.; Pontana F.; Versteeg G.; Papadopoulos G.; Gallo I.;
Rudez I.; Ninios I.; Hadzibegovic I.; Jurin I.; Ambrozic J.; Hommel J.;
Vos J.; Novoa Medina J.M.; Brito J.; ten Berg J.M.; Franke K.; Timmers L.;
Koliastasis L.; Molnar L.; Ohe L.N.; Ferri L.A.; Testa L.; Liptak L.;
Vitez L.; Boukantar M.; Fish M.; Belo Costa M.; Ancona M.B.; Drakopoulou
M.; Pellicano M.; Garcia-Gomez M.; Meuwissen M.; Czerny M.; Renker M.;
Tespili M.; van Gameren M.; Dickinson M.G.; Kosowski M.; Uelskaja M.;
Sustersic M.; Ferenc M.; Bechiri M.; Mouden M.; Bercar M.; Zeleznikova M.;
AlChay M.; Mokhles M.M.; Barbe M.; Scientist B.; Diab N.; Brambilla N.;
Bharti N.; Stens N.; Pavlovic N.; Ktenopoulos N.; Loffelhardt N.; Mangner
N.; Katsaros O.; Allahyari P.; Poliacikova P.; Ennezat P.-V.; van der
Harst P.; Kubler P.; Gallet R.; Holc P.; Petursson P.; Prasad R.; Leonora
R.; Papp R.; Teles R.C.; Bramer S.; Joshi S.; Gjorgjievska S.; Bakhtari
S.; Manola S.; Porouchani S.; Andreen S.; Campillo S.; Ojeda S.; Evangelou
S.; Haussig S.; Jaiswal S.; Delamain T.R.B.; Rodriguez Gabella T.; Pamart
T.; Dessing T.C.; Denimal T.; Sipic T.; Quevedo Nelson V.; Bhatt V.;
Balmette V.; Postma W.; Patil Y.; Baumbach A.
Institution
(Serruys, Tobe, Tsai, Onuma) Department of Cardiology, School of Medicine,
University of Galway, Galway, Ireland
(van Royen) Department of Cardiology, Radboud University Hospital,
Nijmegen, Netherlands
(Amat-Santos) Centro de Investigacion Biomedica en Red de Enfermedades
Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain
(Amat-Santos) Department of Cardiology, Hospital Clinico Universitario de
Valladolid, Valladolid, Spain
(Hudec) Department of Acute Cardiology, Middle-Slovak Institute of
Cardiovascular Diseases, Banska Bystrica, Slovakia
(Bunc) Department of Cardiology, University Medical Centre Ljubljana,
Ljubljana, Slovenia
(Van den Branden) Department of Cardiology, Amphia Hospital, Breda,
Netherlands
(Laanmets) Department of Invasive Cardiology, North Estonia Medical
Centre, Tallinn, Estonia
(Unic) Department of Cardiac and Transplant Surgery, University Hospital
Dubrava, Zagreb, Croatia
(Merkely) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
(Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands
(Ninios) Department of Cardiology, European Interbalkan Medical Center,
Thessaloniki, Greece
(Protasiewicz) Department of Cardiology, Institute of Heart Diseases,
Wroclaw Medical University, Wroclaw, Poland
(Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein,
Netherlands
(Martin) Department of Interventional Cardiology, University Hospital of
Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain
(Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao
Paulo, Brazil
(De Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon,
Lisbon, Portugal
(van Belle) Department of Interventional Cardiology, Lille University,
Lille, France
(Linke) Department of Internal Medicine and Cardiology, University Clinic,
Heart Center Dresden, University of Technology Dresden, Dresden, Germany
(Ielasi) Department of Interventional Cardiology, IRCCS Ospedale Galeazzi
Sant'Ambrogio, Milan, Italy
(Montorfano) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
(Webster) Department of Cardiology, Auckland City Hospital, Auckland, New
Zealand
(Toutouzas) Department of Cardiology, Hippokration Hospital, Athens,
Greece
(Teiger) Department of Interventional Cardiology, Henri Mondor University
Hospital, Creteil, France
(Bedogni) Department of Clinical Cardiology, San Donato Hospital, Milan,
Italy
(Voskuil) Department of Cardiology, University Medical Center Utrecht,
Utrecht, Netherlands
(Pan) Department of Cardiology, University Hospital Reina Sofia,
University of Cordoba, IMIBIC, Centro de Investigacion Biomedica en Red de
Enfermedades Cardiovasculares, Cordoba, Spain
(Angeras) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Angeras) Department of Molecular and Clinical Medicine, Institute of
Medicine, University of Gothenburg, Gothenburg, Sweden
(Kim) Department of Cardiology and Angiology, University of Giessen and
Marburg, Giesen, Germany
(Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim,
Germany
(Rothe) Department of Cardiology and Angiology, Campus Bad Krozingen,
University Heart Center-University of Freiburg, Bad Krozingen, Germany
(Rothe) Faculty of Medicine, University of Freiburg, Freiburg, Germany
(Abdel-Wahab) Department of Structural Heart Disease/Cardiology, Heart
Center Leipzig at Leipzig University, Leipzig, Germany
(Kristic) Department of Cardiology, University Hospital of Split, Split,
Croatia
(Peral) Department of Cardiology University Hospital Son Espases, Health
Research Institute of the Balearic Islands, Palma de Mallorca, Spain
(Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn,
United Kingdom
(Garg) School of Medicine, University of Central Lancashire, Preston,
United Kingdom
(Thakkar, Chandra) Department of Clinical Research, Meril Life Sciences
Pvt Ltd, Vapi, India
(Smits, Morice) Cardiovascular European Research Center, Massy, France
(Morice) Institut Cardiovasculaire Paris Sud, Hopital Prive Jacques
Cartier, Massy, France
(Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey
Research Institute, Queen Mary University of London and Barts Heart
Centre, London, United Kingdom
(Baumbach) Cleveland Clinic, London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: In the LANDMARK trial, the Myval balloon-expandable
transcatheter heart valve (THV) series was noninferior to the most
commonly used contemporary SAPIEN and Evolut Series THVs for the 30-day
early safety endpoint in participants with symptomatic severe native
aortic stenosis. <br/>Objective(s): The current report from the LANDMARK
trial describes clinical outcomes, hemodynamic performances, and quality
of life at 1 year. <br/>Method(s): This open-label, noninferiority trial
enrolled 768 participants across 31 hospitals in Europe, New Zealand, and
Brazil. Participants were randomly assigned (1:1) to receive either a
Myval THV series or a contemporary THV (SAPIEN or Evolut series). The
composite endpoint at 1 year included all-cause mortality, all strokes,
and procedure- or valve-related hospitalizations. Clinical efficacy was
defined as freedom from the composite endpoint. As recommended in Valve
Academic Research Consortium-3, the previous composite endpoint combined
with the assessment of quality of life at baseline and 1 year with the
12-Item Short Form Health Survey was reported as an extended composite
endpoint. The noninferiority hypothesis was prespecified for the
assessment of the primary endpoint at 30 days. Considering the specific
1-year composite endpoints of Valve Academic Research Consortium-3 and the
event rate of 27.23% derived from recent studies, an a posteriori
descriptive and exploratory noninferiority hypothesis was introduced with
a noninferiority margin of 10.89%. The analysis was performed in the
intention-to-treat population. <br/>Result(s): The mean age was 80 years,
48% were women, and the median Society of Thoracic Surgeons Predicted Risk
of Mortality score was 2.6%. There was no significant difference in the
Kaplan-Meier estimates of freedom from the composite endpoint at 365 days
(Myval THV 87.0% vs contemporary THVs 86.9%). The Myval THV series was
noninferior to the contemporary THVs for the composite endpoint
(difference: -0.1%; 1-sided 95% CI: 3.9%; P<inf>noninferiority</inf> <
0.0001). Similarly, there were no significant differences in freedom from
the extended composite endpoint (80.5% vs 77.3%; difference: 3.2%; 95% CI:
-2.9% to 9.2%; P = 0.33). <br/>Conclusion(s): In the treatment of
symptomatic severe native aortic stenosis, the clinical and hemodynamic
outcomes of the Myval THV series were comparable to those of contemporary
THVs for the 1-year composite of all-cause mortality, all strokes, or
procedure- or valve-related hospitalizations. (LANDMARK Trial: a
Randomised Controlled Trial of Myval THV [LANDMARK];
NCT04275726)<br/>Copyright &#xa9; 2026 The Authors

<2>
Accession Number
2035833154
Title
Intravenous methadone for pain management in cardiac surgery: a randomised
controlled trial with plasma concentration analysis*.
Source
Anaesthesia. 81(1) (pp 51-61), 2026. Date of Publication: 01 Jan 2026.
Author
Wong H.M.K.; Lai V.K.W.; Chiu S.L.C.; Wong W.T.; Wo S.K.; Zuo J.Z.; Liu
X.; Wong R.H.L.; Ho K.M.
Institution
(Wong, Chiu, Wong, Liu, Ho) Department of Anaesthesia and Intensive Care,
The Chinese University of Hong Kong, Hong Kong
(Lai) Child Health Evaluative Sciences, The Hospital for Sick Children
Research Institute, Toronto, ON, Canada
(Wo, Zuo) School of Pharmacy, Faculty of Medicine, The Chinese University
of Hong Kong, Hong Kong
(Wong) Division of Cardiothoracic Surgery, Department of Surgery, Prince
of Wales Hospital, New Territories, Hong Kong
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative pain after cardiac surgery remains significant
despite the administration of opioids. Methadone may improve pain control
and decrease the need for postoperative opioids. Randomised controlled
trials, however, are limited and the effects of cardiopulmonary bypass on
methadone pharmacokinetics are unclear. The aims of this study were to
compare methadone and morphine in cardiac surgery, measuring methadone
concentrations and correlating them with pain control. <br/>Method(s):
Patients undergoing cardiac surgery that required cardiopulmonary bypass
were allocated randomly to receive either 0.2 mg.kg^-1 methadone
or 0.2 mg.kg^-1 morphine (based on actual body weight, maximum
20 mg for both drugs). Postoperative pain was assessed at 15 min and 8 h,
12 h, 24 h, 48 h and 72 h after tracheal extubation, by analysis of
morphine consumption and pain scores. Opioid-related adverse events were
evaluated. Postoperative blood samples were collected for 96 h to measure
plasma methadone concentrations. <br/>Result(s): In total, 80 patients
were analysed (40 allocated to the methadone group, 40 allocated to the
morphine group). Patients allocated to the methadone group had
significantly reduced 24-h and total postoperative morphine requirements
compared to those allocated to the morphine group (median (IQR [range]) 9
(5-16 [0-40]) mg vs. 24 (17-43 [4-54]) mg (p < 0.001) at 24 h and 35
(23-52 [5-66]) mg vs. 11 (7-20 [0-44]) mg (p < 0.001) total). Patients
allocated to the methadone group had lower pain scores at rest (beta
-2.24, standard error 0.49, p < 0.001) and on coughing (beta -2.16,
standard error 0.50, p < 0.001). There was no difference in the incidence
of opioid-related adverse effects between the two groups. Plasma methadone
concentration decreased during cardiopulmonary bypass but remained above
the minimum effective analgesic concentration for approximately 24 h after
administration (mean (SD) 51 (24.7) ng.ml^-1 at baseline to 30
(10.7) ng.ml^-1 at 24 h). <br/>Discussion(s): Intra-operative
methadone reduces postoperative analgesia requirements without increasing
the incidence of opioid-related adverse events.<br/>Copyright &#xa9; 2025
The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of
Association of Anaesthetists.

<3>
[Use Link to view the full text]
Accession Number
2042841111
Title
Ticagrelor and Aspirin or Aspirin Alone after Coronary Surgery for Acute
Coronary Syndrome.
Source
New England Journal of Medicine. 393(23) (pp 2313-2323), 2025. Date of
Publication: 11 Dec 2025.
Author
Krogstad L.-E.M.; Jeppsson A.; James S.; Moller C.H.; Malm C.J.; Dalen M.;
Vanky F.; Modrau I.S.; Andersen K.; Anttila V.; Atroshchenko G.V.; Barbu
M.; Dreifaldt M.; El-Akkawi A.I.; Friberg O.; Gudbjartsson T.; Gunn J.;
Haaverstad R.; Halonen J.; Hansson E.C.; Holm J.; Husso A.; Juvonen T.;
Jakobsen O.; Jideus L.; Johannesson E.; Holmdahl A.J.; Jonsson K.; Kolseth
S.M.; Krasniqi L.; Makela T.; Mennander A.; Mohagen Krogstad L.-E.; Rafiq
S.; Raivio P.; Riber L.; Tahir A.; Thorsen C.; Tonnessen T.; Wahba A.;
Zindovic I.; Pivodic A.; Nielsen S.J.; Erlinge D.; Alfredsson J.; Sartipy
U.
Institution
(Jeppsson, Malm, Hansson, Jonsson, Nielsen, Jeppsson, Malm, Jonsson,
Nielsen) Department of Cardiothoracic Surgery, Sahlgrenska University
Hospital, Gothenburg, Sweden
(Jeppsson, Malm, Hansson, Jonsson, Nielsen, Jeppsson, Malm, Jonsson,
Nielsen) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(James, James) Depart-ment of Medical Sciences, Cardiology, Uppsala
University, Uppsala, Sweden
(Moller, Rafiq, Moller, Rafiq) Department of Cardiothoracic Surgery,
University Hospital, Copenhagen, Denmark
(Dalen, Sartipy, Dalen, Sartipy) Department of Cardiothoracic Surgery,
Karolinska University Hospital, Stockholm, Sweden
(Dalen, Sartipy, Dalen, Sartipy) De-partment of Molecular Medicine and
Surgery, Karolinska Institutet, Stockholm, Sweden
(Vanky, Holm, Vanky, Holm) Department of Cardiothoracic and Vascular
Surgery, Linkoping University Hospital, Linkoping, Sweden
(Vanky, Holm, Vanky, Holm) Department of Health, Medicine, and Caring
Sciences, Unit of Cardiovascular Medicine, Linkoping University,
Linkoping, Sweden
(Modrau, El-Akkawi, Modrau, El-Akkawi) Department of Cardiothoracic and
Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
(Modrau, El-Akkawi, Modrau, El-Akkawi) Department of Clinical Medicine,
Aarhus University, Aarhus, Denmark
(Andersen, Andersen) De-partment of Cardiology, Landspitali University
Hospital, Reykjavik, Iceland
(Andersen, Gudbjartsson, Andersen, Gudbjartsson) Faculty of Medicine,
University of Iceland, Reykjavik, Iceland
(Anttila, Anttila) Heart Center, Turku University Hospital, University of
Turku, Turku, Finland
(Atroshchenko, Atroshchenko) Department of Cardiothoracic Surgery, Aalborg
University Hospital, Aalborg, Denmark
(Barbu, Thorsen, Barbu, Thorsen) Department of Cardiology and
Cardiothoracic Surgery, Blekinge Hospital, Karlskrona, Sweden
(Dreifaldt, Friberg, Dreifaldt, Friberg) Department of Cardiothoracic and
Vascular Surgery, Orebro University Hospital, Orebro, Sweden
(Dreifaldt, Friberg, Dreifaldt, Friberg) Faculty of Medicine and Health,
Orebro University, Orebro, Sweden
(Gudbjartsson, Gudbjartsson) Department of Cardiothoracic Surgery,
Landspitali University Hospital, Reykjavik, Iceland
(Gunn, Gunn) Department of Emergency Services, Turku University Hospital,
University of Turku, Turku, Finland
(Haaverstad, Kolseth, Haaverstad, Kolseth) Department of Heart Disease,
Haukeland University Hospital, Bergen, Norway
(Halonen, Husso, Halonen, Husso) Department of Cardiac Surgery, Heart
Center, Kuopio University Hospital, Kuopio, Finland
(Halonen, Halonen) University of Eastern Finland, Kuopio, Finland
(Juvonen, Raivio, Juvonen, Raivio) Department of Cardiac Surgery, Heart
and Lung Center, Helsinki University Hospital, University of Helsinki,
Helsinki, Finland
(Jakobsen, Jakobsen) Department of Clinical Medicine, Arctic University of
Norway, Tromso, Norway
(Jakobsen, Jakobsen) Department of Cardiothoracic and Vascular Surgery,
University Hospital of North Norway, Tromso, Norway
(Jideus, Jideus) Department of Cardiothoracic Surgery, Uppsala University
Hospital, Uppsala, Sweden
(Johannesson, Zindovic, Johannesson, Zindovic) Department of
Cardiothoracic Surgery, Skane University Hospital, Lund, Sweden
(Johannesson, Zindovic, Johannesson, Zindovic) Department of Clinical
Sciences, Lund University, Lund, Sweden
(Holmdahl) Department of Cardiothoracic Surgery, Umea University Hospital,
Umea, Sweden
(Holmdahl) Department of Public Health and Clinical Medicine, Medical
Faculty, Umea University, Umea, Sweden
(Krasniqi, Riber, Krasniqi, Riber) Department of Cardiac, Vascular, and
Thoracic Surgery, Odense University Hospital, Odense, Denmark
(Krasniqi, Riber, Krasniqi, Riber) Department of Clinical Research,
University of Southern Denmark, Odense, Denmark
(Makela, Makela) Research Unit of Translational Medicine, Medical Research
Center Oulu, Oulu University Hospital, Oulu, Finland
(Makela, Makela) Department of Cardiothoracic Surgery, Oulu University
Hospital, Oulu, Finland
(Mennander, Mennander) Tampere University Heart Hospital, Tampere, Finland
(Mennander, Mennander) Tampere University, Tampere, Finland
(Krogstad, Wahba, Mohagen Krogstad, Wahba) Department of Cardio-Thoracic
Surgery, St. Olav's University Hospital, Trondheim, Norway
(Tahir, Tonnessen, Tahir, Tonnessen) Department of Cardiothoracic Surgery,
Oslo University Hospital, Oslo, Norway
(Tahir, Tonnessen, Tahir, Tonnessen) University of Oslo, Oslo, Norway
(Wahba, Wahba) Department of Circulation and Medical Imaging, Norwegian
University of Science and Technology, Trondheim, Norway
(Pivodic, Pivodic) APNC Sweden, Molndal, Sweden
(Pivodic, Pivodic) Center for Person-Centered Care, Sahlgrenska Academy,
University of Gothenburg, Gothenburg, Sweden
(Erlinge, Erlinge) Department of Cardiology, Clinical Sciences, Lund
University, Lund, Sweden
(Alfredsson, Alfredsson) Department of Health, Medicine, and Caring
Sciences, Linkoping University, Linkoping, Sweden
(Alfredsson, Alfredsson) Department of Cardiology, Linkoping University,
Linkoping, Sweden
Publisher
Massachussetts Medical Society
Abstract
BACKGROUND Patients benefit from antiplatelet therapy after
coronary-artery bypass grafting (CABG) for an acute coronary syndrome.
Whether the addition of ticagrelor to aspirin, as compared with aspirin
alone, further reduces the risk of adverse cardiovascular outcomes is
unclear. METHODS In this open-label, registry-based, clinical trial
conducted at 22 Nordic cardiothoracic surgery centers, we randomly
assigned patients in a 1:1 ratio to receive either ticagrelor plus aspirin
or aspirin alone for 1 year after CABG for an acute coronary syndrome. The
primary outcome was a composite of death, myocardial infarction, stroke,
or repeat revascularization, evaluated at 1 year. A key secondary outcome
was net adverse clinical events, defined as a primary-outcome event or
major bleeding. RESULTS A total of 2201 patients were randomly assigned to
receive ticagrelor plus aspirin (1104 patients) or aspirin alone (1097
patients). The mean age of the patients was 66 years, and 14.4% were
women. A primary-outcome event occurred in 53 patients (4.8%) in the
ticagrelor-plus-aspirin group and 50 (4.6%) in the aspirin-alone group
(hazard ratio, 1.06; 95% confidence interval [CI], 0.72 to 1.56; P=0.77).
Net adverse clinical events occurred in 9.1% of patients in the
ticagrelor-plus-aspirin group and 6.4% in the aspirin-alone group (hazard
ratio, 1.45; 95% CI, 1.07 to 1.97). Major bleeding occurred in 4.9% of
patients in the ticagrelor-plus-aspirin group and 2.0% in the
aspirin-alone group (hazard ratio, 2.50; 95% CI, 1.52 to 4.11).
CONCLUSIONS Among patients who underwent CABG for an acute coronary
syndrome, ticagrelor plus aspirin did not result in a lower incidence of
death, myocardial infarction, stroke, or repeat coronary revascularization
than aspirin alone at 1 year. (Funded by the Swedish Research Council and
others; TACSI ClinicalTrials.gov number, NCT03560310; EudraCT number,
2017-001499-43; EU Clinical Trials number,
2023-508551-40-00.).<br/>Copyright &#xa9; 2025 Massachusetts Medical
Society.

<4>
Accession Number
2042867028
Title
Beta-blocker therapy after myocardial infarction with preserved LVEF
(>=50%): a systematic review and Bayesian meta-analysis with time-to-event
reconstruction.
Source
American Heart Journal Plus: Cardiology Research and Practice. 62 (no
pagination), 2026. Article Number: 100706. Date of Publication: 01 Feb
2026.
Author
Al-Shammari A.S.; Kurmasha Y.H.; Islam M.R.; Hammadeh B.M.; Khaleel N.I.;
Hamed B.M.; Altaii H.; Jena N.; Gerdes J.; Sokos G.; Daggubati R.; Sattar
Y.; Refaat M.
Institution
(Al-Shammari, Jena, Gerdes, Sokos, Daggubati, Sattar) Department of
Cardiology, West Virginia University, Camden Clark Medical Center,
Parkersburg, WV, United States
(Kurmasha) Department of Internal Medicine, College of Medicine,
University of Kufa, Najaf, Iraq
(Islam) Department of Internal Medicine, Shaheed Suhrawardy Medical
College Hospital, Dhaka, Bangladesh
(Hammadeh) Department of Internal Medicine, Faculty of Medicine, Al-Balqa'
Applied University, Salt, Jordan
(Khaleel) Department of Cardiovascular Medicine, Ibn Al-Bitar Specialized
Center for Cardiac Surgery, Baghdad, Iraq
(Hamed) Department of Internal Medicine, Faculty of Medicine, Al-Azhar
University, Cairo, Egypt
(Altaii) Department of Cardiology, Aultman Deuble Heart & Vascular
Hospital, Aultman Health System, Canton, OH, United States
(Refaat) Division of Cardiovascular Medicine, American University of
Beirut Medical Center, Beirut, Lebanon
(Al-Shammari) Department of Internal Medicine, College of Medicine,
University of Baghdad, Baghdad, Iraq
Publisher
Elsevier Inc.
Abstract
Background: The role of beta-blockers in MI with preserved LVEF (>=50%)
remains unclear. This Bayesian meta-analysis assessed their effect on
mortality and major cardiovascular outcomes. <br/>Method(s): A systematic
search was performed in PubMed, Embase, and Scopus from database inception
to September 2025 for studies assessing BB use in post-MI patients with
preserved LVEF. All-cause mortality was the primary outcome. A Bayesian
random-effects model was applied using the bayesmeta package in RStudio,
with effect sizes expressed as risk ratios (RRs) and 95% credible
intervals (CrIs). Between-study heterogeneity was assessed through
posterior tau estimates. Time-to-event outcomes were analyzed using
reconstructed individual patient data from published Kaplan-Meier curves.
<br/>Result(s): Six studies, including 17,068 patients, met the inclusion
criteria. BB therapy was associated with a posterior risk ratio (RR 0.79;
95% CrI 0.55-1.06) suggesting a possible reduction in all-cause mortality;
however, the credible interval included the null, indicating uncertainty
in the magnitude or direction of effect. The posterior estimates for
cardiovascular death (RR 0.84; 95% CrI 0.55-1.23), stroke (RR 0.92; 95%
CrI 0.58-1.49), myocardial infarction (RR 1.04; 95% CrI 0.80-1.40), heart
failure (RR 0.84; 95% CrI 0.55-1.23), MACE (RR 1.09; 95% CrI 0.76-1.51),
and unplanned revascularization (RR 1.06; 95% CrI 0.75-1.48) also showed
wide credible intervals overlapping 1.0, reflecting uncertainty in
potential treatment effects. Heterogeneity across outcomes was generally
low to moderate. In time-to-event analyses, the frequentist stratified
model showed a statistically significant survival benefit with
beta-blockers (HR 0.87; 95% CI 0.81-0.92), whereas the Bayesian model
indicated a similar trend, but the credible interval (HR 0.60; 95% CrI
0.26-1.41) included the null, suggesting no strong evidence of effect.
<br/>Conclusion(s): beta-blockers were not associated with a clear
reduction in all-cause mortality or other outcomes, as credible intervals
included the null. Large, randomized trials are needed to define their
long-term role in this population.<br/>Copyright &#xa9; 2025

<5>
Accession Number
2041658013
Title
Effects of intraoperative higher versus lower positive end-expiratory
pressure during one-lung ventilation for thoracic surgery on postoperative
pulmonary complications (PROTHOR): a multicentre, international,
randomised, controlled, phase 3 trial.
Source
The Lancet Respiratory Medicine. 14(1) (pp 17-28), 2026. Date of
Publication: 01 Jan 2026.
Author
Cohen E.; El Tahan M.R.; Gregoretti C.; Hachenberg T.; Nandor M.;
Nisnevitch-Savarese Z.; Rossaint R.; Severgnini P.; Szegedi L.L.; Tamas
V.; Vazquez de Anda G.F.; Waheedullah K.; Schultz M.J.; Serpa Neto A.;
Abbenhuis J.; Abdulmomen A.; Abdyli A.; Abu Elyazed M.M.; Aguirre Puig P.;
Akbudak I.H.; Aksu C.; Alagoz A.; Alhamdi M.; Almadhati S.; Altorki N.K.;
Aragon Alvarez S.; Arun O.; Azizoglu M.; Baar W.; Balde D.; Balla B.;
Balli Seker M.; Basheer M.; Bauer W.O.; Bence J.; Bernardi M.H.; Bigatello
L.M.; Bignami E.; Bluth T.; Bonney I.; Bouhemad B.; Bradic N.; Brescianini
L.; Bruthans J.; Bulte C.S.E.; Cadar G.; Cakmak G.; Cali P.; Cantatore
L.P.; Chai X.; Chang Y.-T.; Chen J.; Christofaki M.; Cinnella G.; Coelho
Sanches L.; Constantin A.; Contreras V.; Corsi L.; da Silva E.; Defosse
J.; Deluca R.; Diaper J.; Didden L.; Dimitriou E.; do Nascimento Junior
P.; Domi R.; Dorfinger L.; dos Reis Falcao L.F.; Douradinho C.; Drnovsek
Globokar M.; Duran F.M.; Eldawlatly A.; El-Gendy H.M.; Elmazny M.I.;
Elsherif S.-E.I.; Emara M.M.; Enriquez de los Santos S.T.; Farnell-Ward
S.; Ferrufino R.; Gama de Abreu M.; Gao L.; Geyik D.; Gnezda D.; Goeden
S.; Gorjup K.; Granell Gil M.; Guido Guerra R.E.; Guimaraes de Castro
Pereira M.; Guinot P.-G.; Guven A.; Hager H.; Han L.; Hatipoglu Z.;
Hayashi M.; Hell J.; Hofland J.; Hollmann M.W.; Hu J.; Hudacek K.; Huti
G.; Ilic M.; Jankovic R.J.; Jegarl A.; Jimenez Andujar M.-J.; Jin D.;
Kammerer T.; Karadza V.; Kawagoe I.; Kiran Paudel S.I.; Kiss T.; Koch T.;
Kolaric N.; Koning N.J.; Kostopanagiotou K.; Kostroglou A.; Kovac P.;
Kramer T.; Krassler J.; Kreft T.; Kumrular Y.; Kuut M.; Lan L.; Li P.-C.;
Li X.-F.; Li L.-T.; Licker M.; Liu Y.; Longo F.; Loop T.; Lopez-Baamonde
M.; Luise S.; Luo W.; Lv H.; Macias Jimenez M.D.L.A.; Magalhaes D.D.;
Martuscelli M.; Mavko A.; Meco B.C.; Mermer H.A.; Miao C.; Michalek P.;
Mills G.H.; Minana Aragon E.; Mirabella L.; Molyneux M.; Montrano L.;
Mosqueira L.; Mourisse J.; Murrell M.T.; Navarro-Ripoll R.; Negru F.;
Neskovic V.; Nikolic M.; Norberto de la Vega J.A.; Noto A.; Nyktari V.;
Orhan Sungur M.; Ozdemir L.; Ozolina A.; Ozturk T.; Pace M.C.; Pagnussatt
Neto E.; Paloczi B.; Papaioannou A.; Papamichail K.; Patroniti N.; Pektas
Y.; Pereira Matalobos D.; Persec J.; Petrovic S.; Pirc D.; Plismanis G.;
Prata Amendola C.; Prazetina M.; Radovic N.; Rauseo M.; Richter T.; Rivera
Vallejo L.; Rodriguez Ruiz J.J.; Rondovic G.; Rosser J.; Sanchez Garcia
F.J.; Sansone P.; Saracoglu A.; Saracoglu K.T.; Sazak H.; Scharffenberg
M.; Schiavoni L.; Schilling T.; Sediq A.; Semmelmann A.; Senturk N.M.;
Sertac Bingul E.; Sertcakacilar G.; Sfika E.; Shelley B.; Shin S.H.;
Sidiropoulou T.; Silva-Jr J.M.; Socci L.; Socorro T.; Soulioti E.; Spadaro
S.; Spicek-Macan J.; Spray D.; Stamenkovic D.; Stefanakis G.; Stoica R.;
Stojanovic M.; Stopora P.; Sungur Z.; Svareniece-Karjaka E.; Szamos K.;
Tanase N.-V.; Tanriverdi C.; Tempel F.; Terwindt L.E.; Theilen R.; Tipura
D.; Tire Y.; Tomaselli E.; Tsuguie Onari N.; Tunc M.; Turhan O.; Turktan
M.; Ugliola D.; Ulugol H.; Vegh T.; Vetrugno L.; Vitali C.; Volta C.A.;
von Dossow V.; Voyagis G.; Vukovic R.; Vukovic A.Z.; Waeschle R.M.; Wall
D.; Wang H.; Wang D.; Winroth D.; Wittenstein J.; Wu Q.; Xu P.; Yaldir O.;
Yamansavci Sirzai E.; Yang X.; Yapici D.; Yildirim O.; Yildirim Guclu C.;
Yu H.; Yuksel Tanriverdi S.; Zarbock A.; Zeba S.; Zhang Y.; Zhang X.;
Zhang Z.; Zhang J.; Zhang G.-W.; Zhong J.; Ziemann S.
Institution
(Wittenstein, Kiss, Gama de Abreu) Department of Anesthesiology and
Intensive Care Medicine, Pulmonary Engineering Group, Faculty of Medicine
and University Hospital Carl Gustav Carus, Dresden University of
Technology, Dresden, Germany
(Senturk) Department of Anesthesiology, Istanbul Medical Faculty, Istanbul
University, Istanbul, Turkey
(Senturk) Department of Anesthesiology and Reanimation, School of
Medicine, Acibadem University, Istanbul, Turkey
(Kiss) Department of Anesthesiology, Intensive-,Pain- and Palliative Care
Medicine, Radebeul Hospital, Academic hospital of the Technische
Universitat Dresden, Germany
(Schultz) Department of Intensive Care, Academic Medical Center,
University of Amsterdam, Amsterdam, Netherlands
(Serpa Neto) Department of Intensive Care, Austin Hospital, Melbourne,
VIC, Australia
(Serpa Neto) Department of Critical Care, Melbourne Medical School,
University of Melbourne, Austin Hospital, Melbourne, VIC, Australia
(Serpa Neto) Department of Critical Care Medicine, Hospital Israelita
Albert Einstein, Sao Paulo, Brazil
(Gama de Abreu) Division of Intensive Care and Resuscitation, Department
of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic,
Cleveland, OH, United States
(Gama de Abreu) Outcomes Research Consortium, Department of
Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Elsevier Ltd
Abstract
Background: The effect of higher positive end-expiratory pressure (PEEP)
and recruitment manoeuvres aimed at lung expansion as compared with lower
PEEP without recruitment manoeuvres aimed at permissive atelectasis on
postoperative pulmonary complications (PPCs) in patients undergoing
one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to
determine the contribution of an intraoperative lung expansion strategy to
preventing PPCs. <br/>Method(s): In this multicentre, randomised,
controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in
28 countries, we enrolled adult patients (aged >=18 years) with a BMI of
less than 35 kg/m² who were scheduled for open thoracic or
video-assisted thoracoscopic surgery under general anaesthesia requiring
one-lung ventilation with a double-lumen tube, with a planned operative
time of more than 60 min, and an expected duration of one-lung ventilation
longer than that of two-lung ventilation. Patients were randomly assigned
(1:1), using permuted blocks of random size (4, 6, and 8) and stratified
by study site, to receive one-lung ventilation with either a higher PEEP
of 10 cm H<inf>2</inf>O and periodic lung recruitment manoeuvres (high
PEEP group) or a lower PEEP of 5 cm H<inf>2</inf>O without routine
recruitment manoeuvres (low PEEP group). All patients received protective
tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation
and 7 mL/kg predicted body weight during two-lung ventilation.
Postoperative assessors were masked to treatment allocation. The primary
outcome was a composite of PPCs during the first 5 postoperative days,
including aspiration pneumonia, moderate or severe respiratory failure,
acute respiratory distress syndrome (ARDS), pulmonary infection,
atelectasis, cardiopulmonary oedema, pleural effusion, non-operative
pneumothorax, pulmonary infiltrates, prolonged air leak, purulent
pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified
intention-to-treat analysis was performed, with patients analysed
according to their assigned treatment group, except in cases of withdrawal
of informed consent, cancellation of surgery, and or loss to follow-up.
This trial is registered with ClinicalTrials.gov (NCT02963025) and is
completed. <br/>Finding(s): Between Jan 3, 2017, and Feb 12, 2024, 2200
patients were randomly allocated: 1099 to the high PEEP group and 1101 to
the low PEEP group. 43 patients in the high PEEP group and 33 in the low
PEEP group were excluded from the modified intention-to-treat analysis
after randomisation. The primary outcome occurred in 555 (53.6%) of 1036
patients in the high PEEP group and 592 (56.4%) of 1049 patients in the
low PEEP group (absolute risk difference -2.68 percentage points [95% CI
-6.36 to 1.01]; p=0.155). Intraoperative complications occurred in 484
(49.8%) of 972 patients in the high PEEP group and in 305 (31.3%) of 974
patients in the low PEEP group (absolute risk difference 18.09 percentage
points [95% CI 14.41-21.77]), among which hypotension (360 [37.3%] of 966
patients in the high PEEP group vs 140 [14.3%] of 978 in the low PEEP
group) and new arrhythmias (89 [9.9%] of 899 vs 37 [3.9%] of 956) were
more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres
were more frequent in the low PEEP group (29 [3.3%] of 888 vs 86 [8.8%] of
982). The proportions of patients with extrapulmonary postoperative
complications (110 [10.6%] of 1036 vs 107 [10.2%] of 1049 patients), and
the numbers of adverse events (209 vs 204 events), did not differ between
groups. <br/>Interpretation(s): In patients with a BMI of less than 35
kg/m² undergoing thoracic surgery, one-lung ventilation using
higher PEEP with recruitment manoeuvres, compared with lower PEEP without
recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative
lung expansion or permissive atelectasis should take the individual
gas-exchange and haemodynamic conditions into account, which might vary
during the intraoperative period. <br/>Funding(s): Clinical Trials Network
of the European Society of Anaesthesiology and Intensive Care; Department
of Anaesthesiology and Intensive Care, University Hospital Carl Gustav
Carus, Technische Universitat Dresden (Dresden, Germany); Conselho
Nacional de Desenvolvimento Cientifico e Tecnologico (Brasilia, Brazil);
and the Association of Anaesthetists of GB and Ireland.<br/>Copyright
&#xa9; 2025 Elsevier Ltd

<6>
Accession Number
2035943213
Title
Effect of peri-operative pharmacological interventions on postoperative
delirium in patients having cardiac surgery: a systematic review and
Bayesian network meta-analysis.
Source
Anaesthesia. 81(2) (pp 274-287), 2026. Date of Publication: 01 Feb 2026.
Author
Queiroz I.; Barbosa L.M.; Gallo Ruelas M.; Araujo B.; Defante M.L.R.;
Tavares A.H.; Florencio de Mesquita C.; Pimentel T.; Ximenes Mendes B.;
Ferreira Felix I.; Rivera A.; Oliva Morgado Ferreira R.; de Oliveira H.M.;
Righetto B.B.; Smischney N.J.; Tong G.; Ma D.
Institution
(Queiroz) Department of Medicine, APAMI Hospital, Vitoria de Santo Antao,
Brazil
(Barbosa) Department of Medicine, Federal University of Minas Gerais, Belo
Horizonte, Brazil
(Gallo Ruelas) Department of Nutrition Sciences, Instituto de
Investigacion Nutricional, Lima, Peru
(Araujo, Rivera) Department of Medicine, Nove de Julho University, Sao
Bernardo do Campo, Brazil
(Defante) Department of Medicine, Redentor University Center, Rio de
Janeiro, Brazil
(Tavares) Department of Medicine, University of Pernambuco, Recife, Brazil
(Florencio de Mesquita, Pimentel) Department of Medicine, Federal
University of Pernambuco, Recife, Brazil
(Ximenes Mendes) Department of Medicine, Unichristus, Fortaleza, Brazil
(Ferreira Felix, Smischney) Department of Medicine, Mayo Clinic,
Rochester, MN, United States
(Oliva Morgado Ferreira) Department of Medicine, Federal University of
Santa Catarina, Florianopolis, Brazil
(de Oliveira) Department of Medicine, Federal University of Mato Grosso,
Sinop, Brazil
(Righetto) Department of Medicine, University Positivo, Valinhos, Brazil
(Tong) Department of Medicine, Yale School of Medicine, New Haven, CT,
United States
(Tong) Department of Statistics, Yale School of Public Health, New Haven,
CT, United States
(Ma) Department of Anesthesiology, Zhejiang University School of Medicine
Children's Hospital, Hangzhou, China
(Ma) Department of Anaesthetics, Imperial College London Chelsea and
Westminster Hospital, London, United Kingdom
(Ma) Department of Anesthesiology, The First Affiliated Hospital of Ningbo
University, Ningbo, China
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Postoperative delirium is a common complication following
cardiac surgery. Despite its known impact on patient outcomes, effective
preventative strategies remain elusive. We aimed to perform a
comprehensive Bayesian network meta-analysis of randomised controlled
trials assessing the effect of pharmacological interventions on the
incidence of postoperative delirium. <br/>Method(s): Databases were
searched from inception to September 2024. Our search was updated in
January 2025. Eligible studies included randomised controlled trials
reporting the incidence of postoperative delirium in patients having
cardiac surgery treated with pharmacological interventions. Bayesian
models were used to estimate risk ratios (RR) and mean differences with
95%CrI through Markov chain Monte Carlo. Interventions were ranked using
the surface under the cumulative ranking curve. Sensitivity analyses and
grading of recommendations, assessment, development and evaluation
assessment were conducted to evaluate the robustness and certainty of
evidence. <br/>Result(s): Seventy-nine randomised controlled trials
comprising 24,827 patients were included, with 29 pharmacological
interventions compared. Dexmedetomidine combined with melatonin was the
most effective intervention, reducing the incidence of postoperative
delirium compared with placebo (risk ratio 0.31, 95%CrI 0.13-0.69; low
certainty). Dexmedetomidine with melatonin also significantly decreased
intensive care unit stay (2.4 days, 95%CrI -3.50-1.10) and hospital stay
(1.32 days, 95%CrI -2.09 to -0.57). Other interventions, including
ketamine and risperidone, showed potential efficacy but with low or very
low certainty of evidence. <br/>Discussion(s): We identified
dexmedetomidine with melatonin as the most effective pharmacological
strategy for preventing postoperative delirium following cardiac surgery.
Whilst these findings highlight potential benefits, the low certainty of
evidence underscores the need for more high-quality primary
evidence.<br/>Copyright &#xa9; 2025 The Author(s). Anaesthesia published
by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.

<7>
Accession Number
2041584664
Title
Center-mediated Differences in Postoperative Acute Kidney Injury Rates: A
Post Hoc Analysis of the PROTECTION Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 179-186),
2026. Date of Publication: 01 Jan 2026.
Author
Ranucci M.; Monaco F.; Bradic N.; Venditto M.; Neri G.; Barucco G.; Ti
L.K.; Porta S.; Baryshnikova E.; Pontillo D.; Silvetti S.; Federici F.;
Crescenzi G.; Cortegiani A.; Guarracino F.; Bove T.; Paternoster G.;
Anguissola M.
Institution
(Ranucci, Baryshnikova, Anguissola) Department of Cardiovascular
Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, San
Donato Milanese, Italy
(Monaco) Division of Cardiacthoracic and Vascular Anesthesia, IRCCS
Azienda Ospedaliero-Universitaria di Bologna, S. Orsola Hospital,
University of Bologna, Bologna, Italy
(Monaco) Department of Medical and Surgical Sciences, DIMEC, University of
Bologna, Bologna, Italy
(Bradic, Barucco, Pontillo) Clinic of Anesthesiology, Resuscitation and
Intensive Medicine, University Hospital Dubrava, Zagreb, Croatia
(Bradic) University North, Department of Nursing, Varazdin, Croatia
(Venditto) Cardiac Anesthesia and ICU, AORN "Dei Colli," Monaldi Hospital,
Naples, Italy
(Neri) Anesthesia and Intensive care, Department of Medical and Surgical
Sciences, Magna Graecia University, Catanzaro, Italy
(Ti) Department of Anaesthesia, National University Hospital, Singapore
(Porta) S.C. Anestesia e Rianimazione Cardiovascolare, A.O. Ordine
Maurizio Umberto I di Torino, Turin, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS - IRCCS Cardiovascular Network, Genova,
Italy
(Federici) UOC Anestesia e Rianimazione, Azienda Ospedaliero-Universitaria
Sant'Andrea, Rome, Italy
(Crescenzi) IRCCS Humanitas Research Hospital, Anestesia e Terapia
Intensiva Cardiochirurgica (TIC), Milan, Rozzano, Italy
(Cortegiani) Department of Precision Medicine in Medical, Surgical and
Critical Care Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy
(Cortegiani) Department of Anesthesia Analgesia Intensive Care and
Emergency, University Hospital Policlinico 'Paolo Giaccone', Palermo,
Italy
(Guarracino) Azienda Ospedaliero Universitaria Pisana, Department of
Cardiothoracic Anaesthesia and Intensive Care, Pisa, Italy
(Bove) Department of Medicine, University of Udine, Udine, Italy
(Bove) Azienda Sanitaria Universitaria Friuli Centrale, Department of
Emergency "Santa Maria Della Misericordia", University Hospital of Udine,
Italy
(Paternoster) Department of Health Science School of Medicine, University
of Basilicata, Italy
(Paternoster) Anesthesia and ICU San Carlo Hospital, Potenza, Italy
Publisher
W.B. Saunders
Abstract
Objectives: The recently published PROTECTION trial (Intravenous Amino
Acid Therapy for Kidney Protection in Cardiac Surgery) demonstrated that,
in adult cardiac surgery patients, preoperative amino acid (AA)
administration has a protective effect on renal function. However, large
differences were observed within the participating centers. We aimed to
investigate whether such center effects would remove the impact of AA on
the prevention of cardiac surgery-associated acute kidney injury
(CSA-AKI). <br/>Design(s): A post hoc analysis of data from the PROTECTION
trial was performed. <br/>Setting(s): Multi-institutional data from
centers that participated in the PROTECTION trial. <br/>Participant(s):
Adult patients undergoing cardiac surgery enrolled in the PROTECTION
trial. <br/>Intervention(s): Two centers showed a significantly lower rate
of CSA-AKI with respect to the pooled rate in all centers (low-rate
centers) and 3 centers had a significantly higher rate (high-rate centers
[HR-C]). These centers were compared for preoperative and intraoperative
variables. <br/>Result(s): Patients in the HR-C were significantly (p =
0.001) older, with lower left ventricular ejection fraction and hemoglobin
values, a higher rate of class III and IV New York Heart Association
functional class, arterial hypertension, previous myocardial infarction,
diabetes, peripheral vascular disease, and more frequently received
myocardial revascularization. During surgery, patients in the HR-C group
had a longer aortic cross-clamp time, higher temperature on
cardiopulmonary bypass, and received diuretics and hemofiltration at a
lower rate. Additionally, a greater number of patients in the HR-C group
required norepinephrine. However, once corrected for such a center effect,
AA remained significantly independently associated with a reduction in
CSA-AKI (relative risk, 0.79). <br/>Conclusion(s): HR-Cs treated patients
with greater severity (unmodifiable risk factors) and received different
operative and perioperative management. Taking into account such center
effects, however, AA therapy remained independently associated with
CSA-AKI prevention.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<8>
[Use Link to view the full text]
Accession Number
2038618098
Title
Combined Heart and Liver Transplantation in the Failing Fontan: Systematic
Review and Single-arm Meta-analysis.
Source
Transplantation. 109(11) (pp 1783-1791), 2025. Date of Publication: 01 Nov
2025.
Author
Karlinski Vizentin V.; Antunes V.; Ferreira Felix I.; Florencio de
Mesquita C.; Bulhoes E.; Ameduri R.K.; Johnson J.N.
Institution
(Karlinski Vizentin) Cardiovascular Diseases Department, Mayo Clinic,
Rochester, MN
(Antunes) Medicine Department, Federal University of Health Sciences of
Porto Alegre, Porto Alegre, Brazil
(Ferreira Felix) Internal Medicine Department, Mayo Clinic, Rochester, MN
(Florencio de Mesquita) Federal University of Pernambuco, Recife, Brazil
(Bulhoes) Medicine Department, Faculty of Higher Superior of the Amazon
Reunida, Redencao, Brazil
(Ameduri, Johnson) Pediatric Cardiology Department, Mayo Clinic,
Rochester, MN
Publisher
Lippincott Williams and Wilkins
Abstract
Background. - The Fontan procedure has transformed the management of
congenital heart defects characterized by single ventricle physiology, yet
it predisposes individuals to Fontan-associated liver disease. Combined
heart and liver transplantation (CHLT) emerges as a therapeutic option,
but evidence of its efficacy and safety remains limited. This study aimed
to comprehensively evaluate CHLT in Fontan patients, focusing on patient
characteristics, perioperative outcomes, and posttransplant morbidity and
mortality. Methods. - Following Preferred Reporting Items for Systematic
Reviews and Meta-analyses guidelines, a systematic search of PubMed,
Embase, and the Cochrane Central Register of Controlled Trials was
conducted. Studies meeting the intervention of CHLT in Fontan patients
were included, and data were collected and synthesized using proportion
meta-analysis techniques. Statistical analysis was carried out using R
software. Results. - Four studies met inclusion criteria, comprising 67
Fontan patients undergoing CHLT. All included studies were observational
retrospective cohorts performed in the United States. The 1-y survival
rate post-CHLT was 88% (95% confidence interval [CI], 70%-98%). Liver
graft rejection rates were low, 4% (95% CI, 0%-22%), and no heart graft
rejection greater than mild was reported. Postoperative complications
included acute kidney injury 75% (95% CI, 50%-93%), temporary dialysis 27%
(95% CI, 9%-51%), neurologic events 7% (95% CI, 0%-26%), infection 23%
(95% CI, 3%-55%), and unplanned medical procedures 40% (95% CI, 23%-59%).
Conclusions. - CHLT in Fontan patients demonstrates promising survival
rates, but graft rejection and postoperative complications pose
challenges. The rate of renal complications is particularly notable and
requires further evaluation. Future research should prioritize comparative
different management strategies and long-term follow-up to refine
protocols and optimize outcomes.<br/>Copyright &#xa9; 2025

<9>
Accession Number
2031895367
Title
Bifurcated Endografts for the Treatment of Aortoiliac Disease a Systematic
Review and Individual Patient Data (IPD) Meta-Analysis.
Source
Journal of Endovascular Therapy. 33(1) (pp 88-95), 2026. Date of
Publication: 01 Feb 2026.
Author
Manaki V.; Bontinis V.; Bontinis A.; Giannopoulos A.; Kontes I.; Ktenidis
K.
Institution
(Manaki, Bontinis, Bontinis, Giannopoulos, Kontes, Ktenidis) Department of
Vascular Surgery, AHEPA University General Hospital, Aristotle University
of Thessaloniki, Thessaloniki, Greece
Publisher
SAGE Publications Inc.
Abstract
Background: This review aimed to assess the efficacy and safety of
bifurcated endografts in the treatment of aortoiliac disease (AOID).
<br/>Method(s): A systematic search on PubMed, Scopus, and Web of Science
was performed. The primary endpoint was primary patency, whereas secondary
endpoints included reintervention, technical, clinical success, and
overall postoperative complications. <br/>Result(s): Ten studies with a
total of 365 patients were included in this review. Most included studies
used the AFX unibody endograft, one study the Excluder endograft, and one
the Powerlink endograft. The majority of included patients displayed
TransAtlantic InterSociety Consensus (TASC) D aortoiliac lesions (56.1%
205/365). The pooled primary patency estimates at 12, 24, and 36 months
were 93.93% (95% confidence interval [CI]: 87.7-100), 91.46% (95% CI:
84.6-98.8), and 90.25% (95% CI: 82.6-98.6), respectively. The mean primary
patency time was 85.74 months (95% CI: 71.99-86.88). The pooled freedom
from reintervention estimates at 12, 24, and 36 months were 91.94% (95%
CI: 81.4-100), 91.03% (95% CI: 79.8-100), and 91.03% (95% CI: 79.8-100),
respectively. The pooled estimates of major complications (rupture, graft
thrombosis, amputation) were 11.12% (95% CI, 0.05%-3.03%), 3.76%
(0.32%-9.45%), and 0.38% (0%-2.59%), whereas the pooled estimates for
minor complications (hematoma, groin infection, dissection) and overall
mortality were 5.27% (95% CI, 1.11%-11.38%), 6.93% (95% CI, 2.94%-12.16%),
2.19% (95% CI, 0.06%-6.14%), and1.57% (95% CI, 0.13-3.97), respectively.
Technical and clinical success estimates were 99.92% (95% CI: 98.86%-100%)
and 99.47% (95% CI: 94.92%-100%), respectively. <br/>Conclusion(s): The
application of bifurcated endografts may present a safe and viable option
in the treatment of AOID, with preliminary results indicating promising
primary patency outcomes. However, the definitive assessment of their
efficacy and safety will be better determined through long-term follow-up
studies and high-quality randomized controlled trials, which are essential
to substantiate these initial findings. Clinical Impact: Bifurcated
endograft application may be a safe and viable alternative for high-risk
patients with complex AOID TASC C and D lesions with encouraging primary
patency outcomes potentially comparable to those of open surgery.
Non-negligible postoperative complication rates were also noted.
High-quality randomized controlled trials and studies comparing CERAB,
kissing stenting, and the use bifurcated endografts for the treatment of
AOID is necessary to draw more definite conclusions.<br/>Copyright &#xa9;
The Author(s) 2024

<10>
Accession Number
2042612166
Title
Ambulatory management of primary spontaneous pneumothorax in the emergency
department: EFFI-PNO protocol - a multicentre, cluster-controlled,
stepped-wedge, randomised interventional study.
Source
BMJ Open. 15(12) (no pagination), 2025. Article Number: e106739. Date of
Publication: 24 Dec 2025.
Author
Kepka S.; Wilme V.; Duracinsky M.; Matau C.; Nze Ossima A.; Gil Jardine
C.; Le Borgne P.; Marjanovic N.; Marx T.; Ohana M.; Peyrony O.; Philippon
A.-L.; Viglino D.; Chenou A.; Clere-Jehl R.; Bilbault P.; Durand-Zaleski
I.; Sauleau E.A.
Institution
(Kepka, Wilme, Le Borgne, Chenou, Clere-Jehl, Bilbault) Emergency
department, University Hospital Centre Strasbourg, Strasbourg, France
(Kepka, Wilme, Sauleau) ICube, Grand Est, Illkirch, France
(Duracinsky, Nze Ossima, Durand-Zaleski) URCEco, AP-HP, Paris, France
(Matau) Pneumologie Unit, University Hospital Centre Strasbourg,
Strasbourg, France
(Gil Jardine) Department of Emergency, University Hospital Centre
Bordeaux, Bordeaux, France
(Gil Jardine) Injury Epidemiology Trauma and Occupation Team, ISPED,
Bordeaux, France
(Le Borgne) Nanomedecine regenerative, UMR 1260, Universite de Strasbourg
CRBS, UNISTRA, Strasbourg, France
(Marjanovic) Department of Emergency Medicine, CHU de Poitiers, Poitiers,
France
(Marx) CHU de Besancon, Besancon, France
(Ohana) Radiology unit, University Hospitals Strasbourg, Strasbourg,
France
(Peyrony) Emergency Department Saint Louis, AP-HP, Paris, France
(Philippon) Department of Emergency, Hopital Pitie-Salpetriere, Paris,
France
(Viglino) Department of Emergency, Centre Hospitalier Universitaire
Grenoble Alpes, Grenoble, France
(Viglino) Grenoble-Alpes University Hospital, Grenoble, France
(Durand-Zaleski) University of Paris, Paris, France
(Sauleau) GMRC, University Hospital Centre Strasbourg, Strasbourg, France
Publisher
BMJ Publishing Group
Abstract
Introduction For large primary spontaneous pneumothorax (PSP), drainage or
simple aspiration are the two first-line treatment options. Outpatient
ambulatory strategies have a success rate of almost 80% with few
complications. New French recommendations suggest that an outpatient
strategy should be preferred if an appropriate care network is in place.
However, establishing this care network remains the main obstacle to the
use of this strategy. Thus, outpatient management of PSP remains rare,
which is neither optimal for the patient, with a likely impact on quality
of life (QOL) and satisfaction with care, nor for the healthcare system,
with increased costs. We hypothesise that outpatient treatment of PSP
compared with usual inpatient management could improve quality of care and
represent a more efficient, generalisable and sustainable strategy.
Methods and analysis In this multicentre, cluster-controlled, randomised
interventional study with stepped wedge implementation, patients aged
18-50 presenting to the emergency department (ED) with a first episode of
large PSP will be enrolled in seven university hospitals in France. The
main objective of this study is to evaluate the impact on changes in QOL
of an ambulatory strategy for the management of large PSP in the ED
compared with usual inpatient management. The primary outcome is the
difference in QOL as measured by SF-36 score, between drain placement and
6 months. Clinical criteria (pulmonary expansion at 6 days, pain,
dyspnoea, complications, recurrence), perceived quality of care
(satisfaction, patient preference, anxiety) and ease of implementation of
the care pathway will also be assessed. A cost-utility analysis will be
carried out to evaluate the incremental cost-utility ratio at 1 year,
defined as the difference in costs divided by the difference in utility
estimated by the EQ-5D scores. Ethics and dissemination Ethics approval
has been obtained by the Comite de Protection des Personnes Nord Ouest III
Ndegree 2024-36. Study findings will be disseminated by publication in a
high-impact international journal. Results will be presented at national
and international emergency healthcare meetings, and participating
patients notified of the main conclusions.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2025. Published by BMJ Group.

<11>
Accession Number
2042545408
Title
Analysis of prognostic factors for esophageal cancer after radical
resection and the applica-tion value of machine learning prediction model.
Source
Chinese Journal of Digestive Surgery. 24(10) (pp 1305-1317), 2025. Date of
Publication: 20 Oct 2025.
Author
Zhao Y.; Zhang S.; Li H.; Ma Y.; Zhang Z.; Li Z.; Liu J.; Tian H.; Tian Y.
Institution
(Zhao, Zhang, Li, Ma, Li, Liu, Tian, Tian) Department of Thoracic Surgery,
Qilu Hospital of Shandong University, Jinan, China
(Zhang) Shandong Provincial Qianfoshan Hospital, Jinan, China
Publisher
Chinese Medical Journals Publishing House Co.Ltd
Abstract
Objective: To investigate the prognostic factors for esophageal cancer
after radical resection and the application value of machine learning
prediction model. <br/>Method(s): The retrospective cohort study was
conducted. The clinicopatholigical data of 406 esophageal cancer patients
who were admitted to Qilu Hospital of Shandong University from January
2018 to March 2022 were collected. There were 357 males and 49 females,
aged (64+/-8)years. All patients underwent radical resection of esophageal
cancer. The 406 patients were randomly divided into a training set of 285
cases and a validation set of 121 cases at a 7:3 ratio based on a random
number table. The training set was used to construct prediction model, and
the validation set was used to validate prediction model. Patients were
divided into high-risk group and low-risk group based on risk scores.
Observation indicators: (1) follow-up of patients and analysis of
influencing factors for prognosis; (2) construction and validation of
machine learning prediction models. Comparison of measurement data with
normal distribution between groups was conducted using the independent
sample t test. Comparison of measurement data with skewed distribution
between groups was conducted using the Mann-Whitney U test. Comparison of
count data between groups was conducted using the chi-square test.
Comparison of ordinal data between groups was conducted using the rank sum
test. The Kaplan-Meier method was used to calculate survival rate and plot
survival curve, and the Log-rank test was used for survival analysis. The
Cox proportional hazard regression model was used for univariate and
multivariate analyses. Independent influencing factors were included, and
data processing, machine learning model construction, and visualization
were performed using R packages including random survival forest (RSF),
gradient boosting machine (GBM), least absolute shrinkage and selection
operator Cox regression (LASSO-Cox), Cox proportional hazards model
boosting (CoxBoost), survival support vector machine (survivalsvm),
extreme gradient boosting (XGBoost), supervised principal component
analysis (SuperPC), and Cox partial least squares regression (plsRcox).
Receiver operating characteristic (ROC) curves were drawn, and
sensitivity, specificity, and area under the curve (AUC) were calculated.
The Delong test was used to assess the differences in AUC among different
models in the training set, and the time-dependent ROC was used to compare
the predictive performance of different models. Calibration curves were
used to evaluate model accuracy, and decision curve analysis (DCA) was
used to evaluate overall net benefit. <br/>Result(s): (1) Follow-up of
patients and analysis of influencing factors for prognosis. All 406
patients were followed up postoperatively for 28(range, 6-36)months, with
1- and 3-year overall survival rate of 86.5% and 40.9%, respectively. The
285 patients in the training set were followed up postoperatively for
30(range, 6-36)months, with 1- and 3-year overall survival rate of 85.1%
and 35.5%, respectively. The 121 patients in the validation set were
followed up postoperatively for 25(range, 6-36)months, with 1- and 3-year
overall survival rate of 87.0% and 43.2%, respectively. There was no
significant difference in postoperative overall survival rate between the
training set and the validation set (chi²=3.20, P>0.05).
Results of multivariate analysis showed that left thoracic surgical
approach, preopera-tive neutrophil count, vascular invasion, perineural
invasion, pathological T2-4 stage, pathological N2-3 stage, and
postoperative pneumonia were independent risk factors affecting
postoperative survival of 285 patients in the training set (hazard
ratio=1.466, 1.037, 1.482, 1.549, 5.268, 7.727, 22.202, 2.539, 2.686,
1.425, 95% confidence interval as 1.026-2.096, 1.003-1.073, 1.008-2.179,
1.105-2.170, 1.201-23.099, 1.833-32.576, 4.734-104.128, 1.577-4.087,
1.631-4.422, 1.018-1.994, P<0.05). (2) Construction and validation of
machine learning prediction models. Independent risk factors affecting
postoperative survival were included to construct RSF, GBM, LASSO-Cox,
CoxBoost, survivalsvm, XGBoost, SuperPC, and plsRcox machine learning
prediction models. Results of Delong test showed that there were
significant differences in the AUC of RSF and GBM from the other six
models (P<0.05). Results of time-dependent ROC curve showed that all 8
machine learning predic-tion models had good discriminative ability in the
training cohort, among which the RSF machine learning prediction model had
the best predictive performance. Results of calibration curve showed that
the RSF machine learning prediction model fitted well for predicting
postoperative 1-, 2-, and 3-year overall survival in the training cohort,
with high consistency with actual results. Results of decision curve
analysis showed that within a threshold range of 0-0.80, the RSF machine
learning prediction model provided a better overall net benefit. Further
analysis showed that in the validation set, the AUC of RSF machine
learning prediction model for postoperative 1-, 2-, and 3-year survival
prediction were 0.786 (95% confidence interval as 0.609-0.962), 0.774 (95%
confidence interval as 0.676-0.873), and 0.750 (95% confidence interval as
0.652-0.848), respectively. Results of calibration curve showed that the
RSF machine learning prediction model fitted well for predicting
postopera-tive 1-, 2-, and 3-year overall survival in the validation set,
with high consistency with actual results. In the training set, the
optimal cutoff value of the RSF machine learning prediction model risk
score was 11.7. Patients with risk score >=11.7 were classified as the
high-risk group, and those with risk score <11.7 as the low-risk group.
The median survival times of the two groups were 18.0 months and >36.0
months, respectively, showing a significant difference between them
(chi2=73.30, P<0.05). In the validation set, the optimal cutoff value of
the RSF machine learning prediction model risk score was 11.7. Patients
with risk score >=11.7 were classified as the high-risk group, and those
with risk score<11.7 as the low-risk group. The median survival times of
the two groups were 17.0 months and>36.0 months for the high-risk and
low-risk groups, respectively, showing a significant difference between
them (chi2=35.20, P<0.05). <br/>Conclusion(s): Left thoracic surgical
approach, preoperative neutrophil count, vascular invasion, perineural
invasion, pathological T2-4 stage, pathological N2-3 stage, and
postoperative pneumonia are independent risk factors affecting survival of
esophageal cancer patients after radical resection. The RSF machine
learning prediction model constructed based on these factors can
effectively distinguish the survival prognosis of high-risk and low-risk
patients.<br/>Copyright 2025 Chinese Medical Association

<12>
Accession Number
2042463954
Title
Adherence to Accelerometer Use in Older Adults Undergoing mHealth Cardiac
Rehabilitation: Secondary Analysis of a Randomized Clinical Trial.
Source
Journal of Medical Internet Research. 27 (no pagination), 2025. Article
Number: e8052. Date of Publication: 2025.
Author
Barua S.; Upadhyay D.; Pena S.; McConnell R.; Varghese A.; Adhikari S.;
LeRoy E.; Schoenthaler A.; Dodson J.A.
Institution
(Barua, Upadhyay) Division of Precision Medicine, Department of Medicine,
New York University Grossman School of Medicine, New York, NY, United
States
(Pena, McConnell, Varghese, Dodson) Leon H Charney Division of Cardiology,
Department of Medicine, New York University Grossman School of Medicine,
New York, NY, United States
(Adhikari, Schoenthaler, Dodson) Department of Population Health, New York
University Grossman School of Medicine, New York, NY, United States
(LeRoy) Rusk Department of Rehabilitation Medicine, New York University
Grossman School of Medicine, New York, NY, United States
Publisher
JMIR Publications Inc.
Abstract
Background: Wearable accelerometers, which continuously record physical
activity metrics, are commonly used in mobile health-enabled cardiac
rehabilitation (mHealth-CR). The association between adherence to
accelerometer use during mHealth-CR and improvement in clinical outcomes,
such as functional capacity, is understudied. The emergence of artificial
intelligence (AI) technology provides novel opportunities to investigate
accelerometry use patterns in relation to mHealth-CR outcomes.
<br/>Objective(s): In this study, we sought to use an AI clustering
framework to identify distinct behavioral phenotypes of adherence to
accelerometer use. We then aimed to quantify the association of these
adherence phenotypes with functional capacity improvements in older adults
undergoing mHealth-CR. <br/>Method(s): We analyzed data from the RESILIENT
(Rehabilitation at Home Using Mobile Health in Older Adults After
Hospitalization for Ischemic Heart Disease) trial, the largest randomized
clinical study to date comparing mHealth-CR versus usual care in older
adults (aged >=65 years). Intervention arm participants were instructed to
wear a Fitbit accelerometer for the 3-month study duration. Adherence to
accelerometer use was quantified as overall adherence (percentage of days
worn) via k-means clustering AI-derived measures and compared with changes
in 6-minute walk distance (6-MWD), adjusted for demographic and clinical
covariates. <br/>Result(s): Among 271 participants with a mean age of 71
years (SD 8), of whom 198 (73%) were male, accelerometers were worn for an
average of 76 days (95% confidence limits 73,78) over 3 months. Adjusted
analyses showed a weak association between days of wear and improvement in
6-MWD, with every 30 additional days associated with an 11-meter
improvement (P=.08). Our k-means clustering framework identified adherence
phenotypes at two resolutions: low resolution (k=2 clusters) and high
resolution (k=8 clusters). The consistently high adherence cluster trended
toward a 24.6-meter improvement in 6-MWD compared to the low and declining
adherence clusters (n=39; 95% CI 0.7-49.9; P=.06). The 8-cluster
phenotyping revealed a richer set of adherence patterns, with the
consistently high adherence cluster in this analysis having a 38.5-meter
(95% CI 2.2-74.7; P=.04) improvement in 6-MWD than the low adherence
cluster, as well as greater average daily steps over the 3-month
intervention (mean 7518, SD 3415 vs mean 4800, SD 2920 steps; P=.008).
<br/>Conclusion(s): A time-series AI clustering framework identified a
range of behavioral phenotypes representing different degrees of adherence
to accelerometer use. Regression analysis identified a weak association
between the higher adherence phenotype and functional capacity improvement
in older adults undergoing mHealth-CR. Our AI-derived accelerometry
adherence phenotypes may offer a new approach to tailor mHealth-CR
regimens to individual patients, potentially leading to better outcomes in
this high-risk population.<br/>Copyright &#xa9;Souptik Barua, Dhairya
Upadhyay, Stephanie Pena, Riley McConnell, Ashwini Varghese, Samrachana
Adhikari, Erik LeRoy, Antoinette Schoenthaler, John A Dodson.

<13>
Accession Number
2035976126
Title
Challenges to the Claimed Safety and Feasibility of Atrial Fibrillation
Ablation and Left Atrial Appendage Occlusion Without Onsite Cardiothoracic
Surgery.
Source
Journal of Cardiovascular Electrophysiology. 37(1) (pp 203-204), 2026.
Date of Publication: 01 Jan 2026.
Author
Sohail S.; Ahmed N.; Rana M.A.; Abbas M.H.; Riaz M.S.
Institution
(Sohail, Ahmed, Rana, Abbas) King Edward Medical University, Lahore,
Pakistan
(Riaz) International University of Kyrgyzstan, Bishkek, Kyrgyztan
Publisher
John Wiley and Sons Inc

<14>
Accession Number
2042679722
Title
Breakthrough outflow tract unlocking: modified transapical
balloon-assisted transseptal mitral annuloplasty for high-risk mitral
valve-in-ring patients.
Source
European Heart Journal. 47(1) (pp 133), 2026. Date of Publication: 01 Jan
2026.
Author
Li Y.; Wei L.; Zhang C.
Institution
(Li, Wei, Zhang) Department of Cardiovascular Surgery, First Affiliated
Hospital of Anhui Medical University, Anhui Medical University, Hefei,
China
Publisher
Oxford University Press

<15>
Accession Number
2042504812
Title
Corticosteroid Use and Atrial Fibrillation: Exploring Underlying
Mechanisms, FAERS Disproportionality Analysis, and a Meta-Analysis of
Clinical Studies.
Source
Cardiovascular Toxicology. 26(1) (no pagination), 2026. Article Number:
14. Date of Publication: 01 Jan 2026.
Author
Hardi H.; Barinda A.J.; Vidya A.P.; Utama K.E.; Mahata L.E.
Institution
(Hardi, Mahata) Clinical Pharmacology Specialist Study Program, Faculty of
Medicine, Universitas Indonesia, Jakarta, Indonesia
(Barinda) Department of Pharmacology and Therapeutics, Faculty of
Medicine, Universitas Indonesia, Jakarta, Indonesia
(Barinda) Metabolic, Cardiovascular, and Aging Cluster, Medical Education
and Research Institute (IMERI), Faculty of Medicine, Universitas
Indonesia, Jakarta, Indonesia
(Vidya, Utama) Faculty of Medicine, Universitas Indonesia, Jakarta,
Indonesia
(Mahata) Department of Pharmacology and Therapy, Faculty of Medicine,
Universitas Andalas, West Sumatra, Indonesia
Publisher
Springer
Abstract
Steroids are known to have proarrhythmogenic properties, even though they
have been demonstrated to lower the incidence of atrial fibrillation
following heart surgery. According to the American Heart Association
(AHA), this negative impact was still inconsistent. Therefore, this study
aims to elucidate the association between corticosteroid usage and atrial
fibrillation.This systematic review employed the keywords
"corticosteroids" and "atrial fibrillation," collected from PubMed,
Scopus, Web of Science, and Google Scholar. Meta-analysis was performed
using a random effects model through Mantel-Haenszel analysis.
Disproportionality analysis and Bayesian analysis were conducted utilizing
the United States Food and Drug Administration (FDA) Adverse Event
Reporting System (FAERS) datasets. A narrative review was conducted to
obtain mechanistic insights into corticosteroid-induced atrial
fibrillation. The meta-analysis of 23 studies involving 679,330
individuals indicated that exogenous steroids elevated the risk of atrial
fibrillation by 1.74 times (95% CI = 1.55 to 1.96, p < 0.0001).
Intravenous, oral, and inhaled corticosteroids elevated the risk of atrial
fibrillation by 2.02, 1.95, and 1.67 times, respectively. The risk of
atrial fibrillation was elevated with the administration of
corticosteroids at higher doses and for longer durations.
Disproportionality analysis from FAERS indicated that some corticosteroids
exhibited a significant reported odds ratio (ROR). Corticosteroids can
induce mechanical and electrical remodeling of cardiomyocytes, as well as
cardiomyocyte senescence, cardiac hypertrophy, hypertension, and diabetes
mellitus, all of which may collectively increase susceptibility to atrial
fibrillation. Corticosteroids might increase the risk of atrial
fibrillation in a dose- and duration-dependent fashion. Inflammation
should be regarded as a confounding factor in this
conclusion.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2026.

<16>
[Use Link to view the full text]
Accession Number
2038786493
Title
Pharmacokinetics and Pharmacodynamics of Analgesic and Anesthetic Drugs in
Patients During Cardiac Surgery With Cardiopulmonary Bypass: A Narrative
Review.
Source
Anesthesia and Analgesia. 142(1) (pp 5-14), 2026. Date of Publication: 01
Jan 2026.
Author
Beukers A.; Breel J.; van den Brom C.; Saatpoor A.; Kluin J.; Eleveld D.;
Hollmann M.; Hermanns H.; Eberl S.
Institution
(Beukers, Breel, van den Brom, Hollmann, Hermanns, Eberl) From the
Department of Anesthesiology, Amsterdam UMC, Amsterdam, Netherlands
(van den Brom) Department of Intensive Care Medicine, Amsterdam UMC,
Amsterdam, Netherlands
(Saatpoor) Faculty of Medicine, University of Amsterdam, Amsterdam,
Netherlands
(Kluin) Department of Cardiothoracic Surgery, Erasmus MC, Erasmus
University Rotterdam, Rotterdam, Netherlands
(Eleveld) Department of Anesthesiology, UMC Groningen, Rijksuniversiteit
Groningen, Groningen, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
Cardiopulmonary bypass (CPB) impacts pharmacokinetics and -dynamics of
drugs used during cardiac surgery. These alterations can lead to changes
in drug efficacy resulting in under- or overdosing. This review summarizes
current knowledge on the effects of CPB on commonly used intraoperative
and continuously administered anesthetics and analgesics. Out of 197
articles initially identified, 22 were included in the final review. The
breakdown of studies by main topic was as follows: propofol (9 articles),
sevoflurane (4), remifentanil (3), isoflurane (2), fentanyl (2), and
sufentanil (2), and alfentanil (1). The initiation of CPB typically
results in hemodilution and hypothermia, leading to a decrease in total
plasma concentration combined with an increase in unbound plasma
concentrations. This phenomenon has varying implications for different
drugs: For propofol and sevoflurane, lower doses may be required during
CPB to achieve the same anesthetic effect. Fentanyl and sufentanil plasma
concentrations decrease by 25% on average at CPB initiation due to an
increased volume of distribution, followed by an increase during CPB, with
sufentanil, showing an almost 50% increase post-CPB. This implies that an
additional bolus before CPB initiation should be considered, followed by a
reduction of the maintenance dose to prevent prolonged sedation.
Remifentanil plasma concentration decreases at CPB initiation, which
implies that higher initial- or adjusted maintenance dose should be
considered in normothermic patients. However, under hypothermic
conditions, infusion rates should be decreased by 30% for every 5degreeC
decrease in temperature. Alfentanils, total plasma concentration decreases
during CPB, while its free fraction remains unaltered, indicating that no
further adjustments are necessary. Target-controlled infusion (TCI) models
for propofol (Schnider, Marsh, and PGIMER [Postgraduate Institute of
Medical Education and Research]) and remifentanil (Minto) were found to be
inaccurate in the context of CPB. Based on the included studies, the use
of these pharmacokinetic models is not recommended. In conclusion, dosing
inaccuracies resulting in adverse events in on-pump cardiac surgery
underscore the importance of understanding the pharmacokinetics and
-dynamics of anesthetic and analgesic drugs during CPB. The clinical
implication of the altered drug responses after CPB remains challenging in
this high-risk population. Key takeaways include the necessity of
considering patient-specific factors, utilizing objective monitoring
tools, and recognizing potential drug alterations due to
CPB.<br/>Copyright &#xa9; 2025 The Author(s). Published by Wolters Kluwer
Health, Inc. on behalf of the International Anesthesia Research Society.

<17>
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. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2026 Indian Journal of Anaesthesia.

<18>
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.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2025. Re-use permitted under CC
BY-NC. No commercial re-use. See rights and permissions. Published by BMJ
Group.

<19>
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.<br/>Copyright &#xa9; 2025 The Authors.

<20>
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. <br/>Objective(s): To evaluate whether RBC storage time affects
perioperative outcomes in children undergoing cardiac surgery.
<br/>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.
<br/>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. <br/>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.<br/>Copyright 2025 Jin, Zhang, Sun, Dong and
Jin.

<21>
Accession Number
2041916590
Title
Lack of impact of adjunctive lipid-modifying therapy in the CLEAR Outcomes
trial.
Source
Journal of Clinical Lipidology. 20(1) (pp 196-199), 2026. Date of
Publication: 01 Jan 2026.
Author
Menon V.; Bloedon L.; Li N.; Lincoff A.M.; Nicholls S.J.; Powell H.A.;
Nissen S.E.
Institution
(Menon, Lincoff, Nissen) Cleveland Clinic, Cleveland, OH, United States
(Bloedon, Li, Powell) Esperion Therapeutics, Ann Arbor, MI, United States
(Nicholls) Monash University, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
BACKGROUND Bempedoic acid is a prodrug that reduces circulating
low-density lipoprotein (LDL) cholesterol levels by inhibiting the liver
enzyme adenosine triphosphate-citrate lyase. Treatment of statin
intolerant patients with bempedoic acid was associated with a
significantly reduced risk of the primary composite endpoint
(cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or
coronary revascularization) in the CLEAR (Cholesterol Lowering via
Bempedoic Acid, an ACL-Inhibiting Regimen) Outcomes Trial. OBJECTIVE To
evaluate impact of additional lipid modifying therapy (LMT) on the primary
composite endpoint of the CLEAR Outcomes Trial. RESULTS Utilization of
adjunctive LMT was observed in 1749 (12.5%) enrolled patients. The most
common adjunctive LMTs reported were statins (4.0% vs 6.5%), ezetimibe
(2.7% vs 5.5%), and proprotein convertase subtilisin/kexin type 9
inhibitors (2.8% vs 4.4%) in the bempedoic acid and placebo groups,
respectively. The majority of first MACE-4 events (92.9% of events in
bempedoic acid and 90.9% of events in placebo) preceded the initiation of
adjunctive LMT. When censored at the time of initiating adjunctive LMT,
primary event reduction was observed in favor of bempedoic acid compared
to placebo (hazard ratio [HR]: 0.86 [95% CI, 0.77-0.94]) which was similar
to the reduction noted with bempedoic acid in the overall trial (HR of
0.87 [95% CI, 0.79-0.96], P = .004). CONCLUSIONS The utilization of
additional LMT following randomization had no impact on the observed
results of the CLEAR Outcomes trial.<br/>Copyright &#xa9; 2025. Published
by Elsevier Inc.

<22>
Accession Number
2041876236
Title
Left atrial appendage occlusion vs standard of care in high stroke risk
atrial fibrillation patients ineligible for anticoagulation: COMPARE-LAAO.
Source
Netherlands Heart Journal. 34(1) (pp 18-26), 2026. Date of Publication: 01
Jan 2026.
Author
Aarnink E.W.; Huijboom M.F.M.; van der Kley F.; Folkeringa R.; de Groot
J.R.; van der Voort P.H.; Blaauw Y.; Chaldoupi M.; Stevenhagen J.;
Vlachojannis G.J.; van Mieghem N.M.; Swaans M.J.; van Dijk V.F.; Dijkgraaf
M.G.; van Dijk E.J.; Tijssen J.G.P.; Boersma L.V.A.
Institution
(Aarnink, Huijboom, Swaans, van Dijk, Boersma) Department of Cardiology,
St. Antonius Hospital, Nieuwegein, Netherlands
(van der Kley) Department of Cardiology, Leiden University Medical Center,
Leiden, Netherlands
(Folkeringa) Department of Cardiology, Medical Center Leeuwarden,
Leeuwarden, Netherlands
(de Groot, Boersma) Department of Cardiology, Amsterdam University Medical
Center, location AMC, Amsterdam, Netherlands
(van der Voort) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Blaauw) Department of Cardiology, University Medical Center Groningen,
Groningen, Netherlands
(Chaldoupi) Department of Cardiology, Maastricht University Medical
Center, Maastricht, Netherlands
(Stevenhagen) Department of Cardiology, Medical Spectrum Twente, Enschede,
Netherlands
(Vlachojannis) Department of Cardiology, University Medical Center
Utrecht, Utrecht, Netherlands
(van Mieghem) Department of Cardiology, Erasmus University Medical Center,
Rotterdam, Netherlands
(Dijkgraaf) Department of Epidemiology and Data Science, Location AMC,
Amsterdam University Medical Center, Amsterdam, Netherlands
(van Dijk) Department of Neurology, Radboud University Medical Center,
Nijmegen, Netherlands
(Tijssen) Department of Cardiology, Clinical Epidemiology & Biostatistics,
Amsterdam University Medical Center, Amsterdam, Netherlands
(van Dijk) Department of Neurology, University Medical Center Utrecht,
Utrecht, Netherlands
Publisher
Bohn Stafleu van Loghum
Abstract
Introduction: The left atrial appendage is the dominant source of
cardioembolic stroke in patients with atrial fibrillation (AF).
Contemporary guidelines recommend considering left atrial appendage
occlusion (LAAO) in AF patients contraindicated to oral anticoagulation
therapy (OAC), but randomized controlled trial (RCT) data for this
subpopulation are lacking. <br/>Method(s): COMPARE LAAO was designed as an
event-driven, multicenter, prospective, randomized, open, blinded endpoint
(PROBE) trial that randomized AF patients with an increased thromboembolic
risk and a contraindication to OAC 2:1 to LAAO or standard-of-care (SOC).
The co-primary endpoints comprised 1) time to first occurrence of
ischemic/hemorrhagic/undetermined stroke and 2) time to first occurrence
of all-cause stroke/TIA/SE. The trial aimed to enroll 609 patients.
<br/>Result(s): After randomization of 69 patients, the trial was
terminated prematurely by the sponsor due to a slow inclusion rate.
Results are discussed briefly without formal statistical testing.
All-cause stroke occurred in 7/48 and 2/21 patients randomized to LAAO and
SOC, respectively. According to the as-treated principle, all-cause stroke
occurred in 5/41 and 4/28 patients treated with LAAO and SOC. The
composite of all-cause stroke/TIA/SE occurred in 10/48 and 4/21 patients
randomized to and 8/41 and 6/28 patients treated with LAAO and SOC.
<br/>Conclusion(s): Insufficient statistical power of COMPARE LAAO impedes
drawing any conclusions. Among other factors, the loss of perceived
clinical equipoise among physicians proved problematic for successful
trial completion. Conducting an RCT on LAAO vs SOC in OAC-ineligible
patients appears infeasible globally, which threatens to preclude
reimbursement in the Netherlands for these patients that have no proven
alternative.<br/>Copyright &#xa9; The Author(s) 2025.

<23>
Accession Number
648523963
Title
Management of asymptomatic severe aortic stenosis: a systematic review and
meta-analysis of randomized controlled trials.
Source
Minerva cardiology and angiology. 73(6) (pp 778-786), 2025. Date of
Publication: 01 Dec 2025.
Author
Johnson N.; Anil S.; Craig N.J.; Shah B.N.; Ring L.; Tsampasian V.;
Vassiliou V.S.
Institution
(Johnson, Anil, Tsampasian) Norwich Medical School, Bob Champion Research
and Education, Norwich, United Kingdom
(Craig) British Heart Foundation Centre of Research Excellence, University
of Edinburgh, Edinburgh, United Kingdom
(Craig) Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh,
United Kingdom
(Shah) Department of Cardiology, Wessex Cardiac Centre, Southampton,
United Kingdom
(Ring) West Suffolk Hospital, Bury St. Edmunds, United Kingdom
(Tsampasian, Vassiliou) Norfolk and Norwich University Hospital, Norwich,
United Kingdom
(Vassiliou) Norwich Medical School, Bob Champion Research and Education,
Norwich, United Kingdom
Abstract
INTRODUCTION: Whilst aortic stenosis remains the most prevalent valvular
abnormality, the management of asymptomatic severe aortic stenosis remains
a clinical challenge. Recently, two randomised-controlled trials (RCTs) -
EVOLVED (Early Intervention in Patients With Asymptomatic Severe Aortic
Stenosis and Myocardial Fibrosis) and Early TAVR (Transcatheter
Aortic-Valve Replacement for Asymptomatic Severe Aortic Stenosis) - have
been published, alongside an extended follow-up from the AVATAR (Aortic
Valve Replacement Versus Conservative Treatment in Asymptomatic Severe
Aortic Stenosis) study. EVIDENCE ACQUISITION: In response, we conducted a
systematic review of PubMed, Ovid, and Cochrane databases, identifying
RCTs up to October 29, 2024, that compared early intervention with
conventional management. EVIDENCE SYNTHESIS: Four studies met the
inclusion criteria, with a combined total of 1427 patients across the
trials. Meta-analysis of the primary endpoints across these studies
demonstrated a benefit with early intervention (HR=0.50, 95% CI:
0.35-0.73). However, we did not find mortality and cardiac mortality to
show significant reductions (HR=0.68, 95% CI: 0.40-1.18 and HR=0.66, 95%
CI: 0.33-1.29, respectively). Crucially, stroke outcomes were improved
with early intervention (HR=0.60, 95% CI: 0.38-0.95), as were unplanned
hospitalizations (HR=0.40, 95% CI: 0.30-0.53). <br/>CONCLUSION(S): These
findings confirm the safety of early intervention and suggest a reduction
in stroke incidence, although no significant benefits were observed in
overall or cardiac mortality; results which can help to guide shared
decision-making with patients and prevent adverse health outcomes.

<24>
Accession Number
2042176932
Title
Randomized clinical trial between two sedation protocols during
transcatheter aortic valve replacement procedures: Ketamine and Propofol
versus Remifentanil and Dexmedetomidine.
Source
Journal of Clinical Anesthesia. 109 (no pagination), 2026. Article Number:
112116. Date of Publication: 01 Feb 2026.
Author
Castellari A.; Lucchelli M.; Gomarasca M.; Salice V.; Orsenigo F.; Moro
Salihovic B.; Mondin F.; Castiglioni C.; Calzolari A.; Mistraletti G.
Institution
(Castellari, Lucchelli, Gomarasca, Salice, Orsenigo, Moro Salihovic,
Mondin, Castiglioni, Calzolari, Mistraletti) S.C. Rianimazione e Anestesia
Legnano, ASST Ovest Milanese, Legnano, Italy
(Mistraletti) Dipartimento di Fisiopatologia Medico-chirurgica e dei
Trapianti, Universita degli Studi di Milano, Italy
Publisher
Elsevier Inc.
Abstract
Objectives To compare efficacy and safety of two different sedation
protocols during Transcatheter Aortic Valve Replacement (TAVR); Ketamine
and Propofol (KETOFOL) versus Remifentanil and Dexmedetomidine (REMIDEX).
Design Monocentric, prospective, randomized and controlled trial. Setting
University hospital. Participants 231 patients were enrolled in the trial.
198 patients were included in the final analysis. Interventions Patients
enrolled underwent procedural sedation according to one of the two
possible drug combinations, KETOFOL vs REMIDEX, assigned through
randomization. During the procedure intervention times and clinical
parameters were recorded. After the procedure incidence of postoperative
adverse events were recorded. Measurements and main results REMIDEX group
showed a higher trend in the raw incidence of respiratory acidosis (67.7 %
vs 54.3 %). The correlation was confirmed in the multivariate logistic
regression analysis, with an increased risk of developing respiratory
acidosis in the REMIDEX group (OR 1.864 %, 95 % CI 1.014-3.427). Patients
in the REMIDEX group showed significantly longer induction times. REMIDEX
group required a greater number of pharmacological adjustments, had a
higher incidence of intraoperative agitation, and more episodes of
desaturation. No other differences were observed in any of the other
intraoperative or postoperative safety indicators. Conclusions Both
protocols showed a low and comparable incidence of cardiovascular adverse
events and postoperative complications such as POD and POCD. KETOFOL
protocol appears to offer greater sedative stability and seems to be more
protective regarding the incidence of respiratory adverse
events.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<25>
Accession Number
2041647463
Title
Should we unfasten our patients? A meta-analysis of randomized trials on
fasting prior to cardiac catheterization procedures.
Source
Clinical Research in Cardiology. 115(1) (pp 169-173), 2026. Date of
Publication: 01 Jan 2026.
Author
Vargas K.G.; Karthikesan D.; Huber K.; Bekfani T.; Parco C.; Lin Y.; Wolff
G.
Institution
(Vargas, Parco, Lin, Wolff) Clinic of Cardiology, Klinikum Ibbenburen,
Grose Strase 41, Ibbenburen, Germany
(Karthikesan) Department of Cardiology, Hospital Sultanah Bahiyah, Alor
Setar, Malaysia
(Huber) Austrian Heart Foundation, Vienna, Austria
(Huber) Ludwig Boltzmann Institute for Cardiovascular Research, Vienna,
Austria
(Vargas, Bekfani) Department of Internal Medicine, Division of Cardiology
and Angiology, University Hospital Magdeburg, Magdeburg, Germany
Publisher
Springer Science and Business Media Deutschland GmbH

<26>
Accession Number
2042800317
Title
Cardiovascular point-of-care ultrasound: A comprehensive guide to bedside
echocardiography.
Source
Best Practice and Research: Clinical Anaesthesiology. 39(4) (pp 321-337),
2025. Date of Publication: 01 Dec 2025.
Author
Bouchez S.
Institution
(Bouchez) Department of Anesthesiology and Intensive Care, AZORG, Aalst,
Belgium
Publisher
Bailliere Tindall Ltd
Abstract
Point-of-care ultrasound (POCUS) has greatly transformed bedside patient
care by enabling clinicians to conduct rapid, non-invasive evaluations of
cardiac structure and function. This review presents a systematic approach
to structural and functional cardiac assessment using POCUS, with an
emphasis on left and right ventricular dimensions and function, preload
and volume responsiveness, and valvular assessment. The echocardiographic
measurements that can be readily performed at the bedside are discussed.
This review also emphasizes the vital role of POCUS in identifying
life-threatening conditions, such as pericardial effusion and tamponade,
acute pulmonary embolism, cardiogenic shock due to left ventricular
failure, hypovolemic shock, and aortic stenosis. Finally, the importance
of clinician training in cardiac POCUS is highlighted, with a focus on
standardized methods, structured training programs, and developing
clinician competencies.<br/>Copyright &#xa9; 2025 Elsevier Ltd. All rights
are reserved, including those for text and data mining, AI training, and
similar technologies.

<27>
Accession Number
2042593319
Title
Association between platelet-to-lymphocyte ratio and prognosis in patients
receiving coronary artery bypass grafting: a meta-analysis.
Source
Journal of Thoracic Disease. 17(12) (pp 10820-10834), 2025. Date of
Publication: 31 Dec 2025.
Author
Li Z.; Su H.; Li C.
Institution
(Li, Su, Li) College of Basic Medicine, Army Medical University,
Chongqing, China
(Li) College of Basic Medicine, Army Medical University, No. 30 Gaotan Yan
Zhengjie, Shapingba District, Chongqing, China
Publisher
AME Publishing Company
Abstract
Background: Emerging evidence indicates a possible relation of the
platelet-to-lymphocyte ratio (PLR) to clinical outcomes in the coronary
artery disease (CAD) population receiving coronary artery bypass grafting
(CABG). However, current findings remain inconclusive and inconsistent.
Our study examines the prognostic value of PLR in CAD patients undergoing
CABG. <br/>Method(s): PubMed, Embase, Web of Science, as well as Cochrane
Library, were thoroughly retrieved until April 15, 2025. Data for
categorical and continuous variables were merged separately using odds
ratio (OR), 95% confidence interval (CI), and standardized mean difference
(SMD). In addition, the result stability was rated, and possible sources
of heterogeneity were identified via sensitivity and subgroup analyses.
<br/>Result(s): Twenty-seven studies were encompassed, comprising nine
cohort studies and eighteen case-control studies, with an aggregate sample
size of 17,120 patients. Meta-analysis of categorical data revealed that
elevated PLR was notably linked to an elevated incidence of postoperative
atrial fibrillation (POAF) (OR =1.02, 95% CI: 1.01-1.02; P<0.001),
all-cause mortality (ACM) (OR =1.69, 95% CI: 1.04-2.74; P=0.03), and
delirium (OR =1.05, 95% CI: 1.03-1.07; P<0.001). Statistically significant
relations were noted between PLR and acute kidney injury (AKI) (OR =1.04,
95% CI: 0.97-1.11; P=0.30) or saphenous vein graft disease (SVGD) (OR
=1.34, 95% CI: 0.81-2.20; P=0.25). For continuous variables, elevated PLR
values were associated with a greater likelihood of POAF, AKI, ACM, and
SVGD; however, no significant correlations were found with delirium or
other adverse events. Subgroup analyses suggested that the predictive
value of PLR for POAF was influenced by study design, patient age,
geographic location, and PLR cutoff values, while region and time of PLR
measurement affected its prognostic significance for AKI.
<br/>Conclusion(s): An elevated PLR correlated with a potential risk of
POAF, AKI, ACM, delirium, and SVGD in the CAD population undergoing CABG.
PLR may be a valuable and accessible biomarker for prognostic assessment
in this patient population, thereby aiding clinical decision-making in the
context of surgical management of CAD.<br/>Copyright &#xa9; AME Publishing
Company.

<28>
Accession Number
2036469162
Title
Robotic-assisted thoracic surgery versus video-assisted thoracic surgery
for patients undergoing lung resection: a systematic review and
meta-analysis of randomized controlled trials.
Source
General Thoracic and Cardiovascular Surgery. 74(1) (pp 1-10), 2026. Date
of Publication: 01 Jan 2026.
Author
Lamas F.M.; Lech G.E.; Maboni L.R.; Silveira P.A.Z.; da Silva P.B.E.;
Alberti A.M.; Loss N.V.; Camargo S.M.; Soder S.A.
Institution
(Lamas, Maboni, Silveira, da Silva, Alberti, Loss) Universidade Federal de
Ciencias da Saude de Porto Alegre (UFCSPA), 245 Sarmento Leite Street, RS,
Porto Alegre, Brazil
(Lech) Pontificia Universidade Catolica Do Rio Grande Do Sul (PUC-RS),
6681 Ipiranga Ave, RS, Porto Alegre, Brazil
(Camargo, Soder) Department of Thoracic Surgery, Santa Casa de Porto
Alegre, 295 Professor Annes Dias Street, RS, Porto Alegre, Brazil
Publisher
Springer
Abstract
Background: Minimally invasive techniques have mostly replaced open
thoracotomy for lung resection, yet their comparative benefits remain
unclear. We performed a systematic review and meta-analysis to evaluate
clinical outcomes associated with robot-assisted (RATS) and video-assisted
thoracic surgery (VATS). <br/>Method(s): We searched PubMed, Embase, and
Cochrane Central for randomized controlled trials (RCTs) comparing RATS to
VATS in patients undergoing lung resection. Primary outcomes were
conversion to thoracotomy and overall complications. Risk ratios (RR) and
mean differences (MD) were used for categorical and continuous outcomes,
respectively, considering as significant p-values < 0.05. Trial sequential
analysis was also conducted. <br/>Result(s): We included five RCTs
comprising 712 patients, of whom 338 (47.5%) underwent RATS, and 374
(52.5%) underwent VATS. No differences were found between groups in
conversion to thoracotomy (RR 0.65; 95% CI 0.36-1.20; p = 0.17) and
overall complications (RR 0.91; 95% CI 0.69-1.21; p = 0.49). RATS
presented a higher number of lymph node stations resected (p < 0.00001)
and a shorter length of hospital stay after performing sensitivity
analysis (p < 0.00001). There were no differences between RATS and VATS in
any of the other secondary outcomes. <br/>Conclusion(s): Our study results
reassure the safety and potential benefits associated with RATS lung
resections, demonstrating a significantly higher number of lymph node
stations resected and a possible trend toward shorter hospital stays, with
similar rates of complications and conversion in comparison to
VATS.<br/>Copyright &#xa9; The Author(s), under exclusive licence to The
Japanese Association for Thoracic Surgery 2025.

<29>
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.<br/>Copyright &#xa9; 2025 The Author(s). Catheterization
and Cardiovascular Interventions published by Wiley Periodicals LLC.

<30>
Accession Number
2042519464
Title
Continuous furosemide does not prevent cardiopulmonary bypass-related
acute kidney injury in minimally invasive cardiac surgery: the randomized
furosemide trial.
Source
Journal of Extra-Corporeal Technology. 57(4) (pp 209-217), 2025. Date of
Publication: 01 Dec 2025.
Author
Takeichi T.; Morimoto Y.; Yamada A.; Tanaka T.; Fujiwara K.; Sato M.; Toma
R.; Mitsui K.; Sugita T.; Yamada H.; Gan K.
Institution
(Takeichi, Tanaka, Fujiwara, Mitsui, Sugita, Yamada) Department of
Clinical Engineering, Kitaharima Medical Center, 926-250, Ichiba-cho, Ono,
Japan
(Morimoto, Yamada, Sato, Toma, Gan) Cardiovascular Surgery, Kitaharima
Medical Center, 926-250, Ichiba-cho, Hyogo, Ono-shi, Japan
Publisher
EDP Sciences
Abstract
Objectives: This study aimed to assess whether continuous furosemide
administration during cardiopulmonary bypass (CPB) in minimally invasive
cardiac surgery (MICS) reduces the incidence of cardiac surgery-associated
acute kidney injury (AKI). <br/>Method(s): A total of 100 patients
undergoing MICS with CPB were randomly assigned to receive either
continuous furosemide infusion or no continuous furosemide during CPB. The
primary endpoint was the incidence of AKI. Secondary endpoints included
the cardiac surgery-associated neutrophil gelatinase-associated lipocalin
(CSA-NGAL) score, urine output within 12 h postoperatively, postoperative
furosemide dose requirements, red blood cell transfusion volume,
PaO<inf>2</inf>/FiO<inf>2</inf> ratio, duration of mechanical ventilation,
length of stay in the intensive care unit (ICU) and hospital, and
in-hospital mortality. <br/>Result(s): AKI occurred in 8 patients (16%) in
the continuous furosemide group and in 6 patients (12%) in the
non-continuous group (relative risk, 0.72; 95% CI, 0.23-2.23). Among the
secondary endpoints, urine output within the first 3 h postoperatively and
the PaO<inf>2</inf>/FiO<inf>2</inf> ratio were significantly higher in the
continuous furosemide group. However, subgroup analyses revealed no
significant differences between the two groups. <br/>Conclusion(s):
Continuous furosemide administration during CPB did not effectively reduce
the incidence of AKI. However, it was associated with a significant
increase in postoperative urine output and an improvement in the
PaO<inf>2</inf>/FiO<inf>2</inf> ratio.<br/>Copyright &#xa9; The Author(s),
published by EDP Sciences, 2025.

<31>
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. <br/>Objective(s): To examine
the age-stratified effects of rivaroxaban monotherapy compared with those
of rivaroxaban plus antiplatelet agent combination therapy. <br/>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.
<br/>Intervention(s): Rivaroxaban monotherapy or rivaroxaban plus
antiplatelet agent therapy. <br/>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. <br/>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). <br/>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.<br/>Copyright &#xa9; 2025
American Medical Association.

<32>
Accession Number
2030837434
Title
Six-Year Outcomes of Total Arch Replacement vs Debranching With TEVAR for
Aortic Arch Pathologies: Meta-Analysis of Kaplan-Meier-Derived Data From
Propensity Score-Matched Studies.
Source
Journal of Endovascular Therapy. 33(1) (pp 494-504), 2026. Date of
Publication: 01 Feb 2026.
Author
Sa M.P.; Iyanna N.; Jacquemyn X.; Brown J.A.; Yousef S.; Ahmad D.; Singh
M.J.; Serna-Gallegos D.; Sultan I.
Institution
(Sa, Iyanna, Brown, Yousef, Ahmad, Singh, Serna-Gallegos, Sultan) UPMC
Heart and Vascular Institute, University of Pittsburgh Medical Center,
Pittsburgh, PA, United States
(Sa, Iyanna, Brown, Yousef, Ahmad, Serna-Gallegos, Sultan) Department of
Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United
States
(Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven,
Belgium
(Singh) Division of Vascular Surgery, University of Pittsburgh,
Pittsburgh, PA, United States
Publisher
SAGE Publications Inc.
Abstract
Background: Total arch replacement (TAR) and debranching plus thoracic
endovascular aortic repair (TEVAR) serve as significant therapeutic
options for aortic arch pathologies. It remains unclear whether one of
these approaches should be considered preferable. Our study aimed to
compare the long-term outcomes of these 2 approaches. <br/>Method(s): We
carried out a pooled meta-analysis of time-to-event data extracted from
studies published by December 2023. Eligibility criteria included
populations with any aortic arch pathology who underwent debranching plus
TEVAR or TAR, propensity score-matched (PSM) studies
(prospective/retrospective; single-center/multicentric), and the outcomes
included follow-up for overall survival/mortality and/or reinterventions.
<br/>Result(s): Eleven PSM studies met our eligibility criteria, including
a total of 1142 patients (571 matched pairs). We did not observe any
statistically significant difference in the risk of all-cause death
between the groups (hazard ratio [HR]=1.20, 95% confidence interval
[CI]=0.91-1.56, p=0.202), but patients who underwent TAR had a
significantly lower risk of late aortic reinterventions compared with
patients who underwent debranching plus TEVAR (HR=0.38, 95% CI=0.23-0.64,
p<0.001). Our meta-regression analyses for all-cause mortality identified
statistically significant coefficients for age (coefficient=-0.047;
p=0.012) and type A aortic dissections (coefficient=0.012; p=0.010).
<br/>Conclusion(s): Debranching plus TEVAR and TAR demonstrate no
statistically significant differences in terms of survival in patients
with aortic arch pathologies, but TAR is associated with lower risk of
late aortic reinterventions over time. Although older patients may benefit
more from debranching plus TEVAR rather than from TAR, patients with
dissections may benefit more from TAR. Clinical Impact: Although the 2
strategies seem to be equally valuable in terms of survival, total aortic
arch replacement (when compared with debranching plus TEVAR to treat
patients with aortic arch pathologies) is associated with reduction of
late aortic reinterventions over time in patients with and without aortic
dissections. However, we should consider debranching plus TEVAR in older
patients as it is associated with lower risk of death in this population.
The novelty of our study lies in the fact that, instead of comparing
study-level effect estimates, we analyzed the outcomes with reconstructed
time-to-event data. This offered us the opportunity of performing our
analyses with a mathematically appropriate model which consider events and
time; however, these findings might be under the influence of treatment
allocation bias.<br/>Copyright &#xa9; The Author(s) 2024

<33>
Accession Number
2042514150
Title
Cardiac Allograft Vasculopathy in Heart Transplantation From Circulatory
Death Donors: A Systematic Review and Meta-Analysis.
Source
Clinical Transplantation. 40(1) (no pagination), 2026. Article Number:
e70435. Date of Publication: 01 Jan 2026.
Author
Safdar W.; Chan M.A.G.; D'Angelo L.; Kumar A.; Patel S.R.; Saeed O.;
Goldstein D.J.; Jorde U.P.; Madan S.
Institution
(Safdar) Department of Internal Medicine, Montefiore Medical Center,
Albert Einstein College of Medicine, Bronx, NY, United States
(Chan) Division of Cardiology, New York-Presbyterian, Queens, Flushing,
NY, United States
(D'Angelo, Saeed, Jorde, Madan) Division of Cardiology, Montefiore Medical
Center, Albert Einstein College of Medicine, Bronx, NY, United States
(Kumar) Albert Einstein College of Medicine, Bronx, NY, United States
(Patel) Division of Cardiology, North Shore University Hospital, Zucker
School of Medicine at Hofstra, Manhasset, NY, United States
(Goldstein) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center, Albert Einstein College of Medicine, Bronx, NY, United
States
Publisher
John Wiley and Sons Inc
Abstract
Background: Cardiac allograft vasculopathy (CAV) remains a major cause of
long-term morbidity and mortality after heart transplantation (HT). With
the growing use of donation after circulatory death (DCD) donors, it is
crucial to assess the incidence of CAV in this population. <br/>Method(s):
We conducted a systematic review and meta-analysis of studies published
between January 2010 and December 2024. comparing 1-year CAV incidence and
1-year mortality between DCD and donation after brain death (DBD) HT
recipients. Odds ratios (OR) with 95% confidence intervals (CI) were
pooled using fixed and random-effects models. <br/>Result(s): Four studies
met inclusion criteria, comprising 951 HTs (576 DBD and 375 DCD). Of
these, 594 HTs contributed to the CAV analysis and 914 to the mortality
analysis. Pooled analysis demonstrated no significant difference in 1-year
CAV incidence between DCD and DBD recipients (OR = 0.71, 95% CI:
0.43-1.17, p = 0.17). Similarly, no difference was observed in 1-year
mortality (OR = 0.87, 95% CI: 0.48-1.58, p = 0.66). <br/>Conclusion(s):
DCD and DBD-HT recipients demonstrated comparable 1-year CAV incidence and
mortality. These findings support the continued and expanded use of DCD
donors to address the ongoing shortage of suitable donor
hearts.<br/>Copyright &#xa9; 2026 John Wiley & Sons A/S. Published by John
Wiley & Sons Ltd.

<34>
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.<br/>Copyright &#xa9;
2026 Indian Journal of Anaesthesia.

<35>
Accession Number
2040997424
Title
A Novel Propyl Gallate-Based Paclitaxel-Coated Balloon for the Side Branch
Treatment in Coronary Bifurcation Lesions.
Source
Catheterization and Cardiovascular Interventions. 107(1) (pp 91-100),
2026. Date of Publication: 01 Jan 2026.
Author
Yao Z.; Zhou Y.; Yin J.; Wu Y.; Shen L.; Lu H.; Ma J.; Qian J.; Huang Z.;
Ge J.
Institution
(Yao, Yin, Wu, Shen, Lu, Ma, Qian, Huang, Ge) Department of Cardiology,
Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan
University, Shanghai, China
(Yao, Zhou, Yin, Wu, Shen, Lu, Ma, Qian, Huang, Ge) National Clinical
Research Center for Interventional Medicine, Shanghai, China
(Yao, Zhou, Yin, Wu, Shen, Lu, Ma, Qian, Huang, Ge) State Key Laboratory
of Cardiovascular Diseases, Zhongshan Hospital, Fudan University,
Shanghai, China
(Yao, Zhou, Yin, Wu, Shen, Lu, Ma, Qian, Huang, Ge) Key Laboratory of
Viral Heart Diseases, Chinese Academy of Medical Sciences, Shanghai, China
(Yao, Zhou, Yin, Wu, Shen, Lu, Ma, Qian, Huang, Ge) NHC Key Laboratory of
Ischemic Heart Diseases, Shanghai, China
(Zhou) Department of Cardiology, Shanghai Geriatric Medical Center,
Zhongshan Hospital, Shanghai Institute of Cardiovascular Diseases, Fudan
University, Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
Background: Drug-coated balloons are emerging as an important approach for
the treatment of coronary bifurcation lesions (CBL). <br/>Aim(s): This
study aimed to evaluate the efficacy and safety of a novel
paclitaxel-coated balloon (PCB), which used propyl gallate (PG) as the
excipient, in treating the side branch of de novo CBL. <br/>Method(s): In
this multicenter, randomized, non-inferiority trial, 236 patients across
17 centers were 1:1 randomized to the PG-based PCB or iohexol-based PCB
groups. After stent deployment in the main vessel, the side branch was
dilated with the allocated PCB. Angiographic follow-up was planned at 9
months and clinical follow-up at 12 months. The primary endpoint was
diameter stenosis (DS) in the side branch during the angiographic
follow-up. <br/>Result(s): DS in the side branch was 21.3 +/- 23.8% in the
PG group versus 21.7 +/- 24.3% in the control group (p = 0.198). After
adjustment for centers, the difference of DS between the PG group and the
control group was -0.11% (95% confidence interval, -6.84% to 6.62%),
meeting the prespecified non-inferiority margin of 7%. Clinical outcomes
at 12 months were comparable between groups. <br/>Conclusion(s): The
PG-based PCB demonstrated non-inferior efficacy and safety in comparison
with the iohexol-based PCB for side branch treatment in de novo CBL. The
PG-based PCB could be used as a therapeutic alternative in CBL
revascularization.<br/>Copyright &#xa9; 2025 Wiley Periodicals LLC.

<36>
Accession Number
2042580543
Title
Withdrawal of Spironolactone for Heart Failure With Improved Ejection
Fraction: An Open-Label, Pilot, Randomized Controlled Trial (With-HF
Trial).
Source
Korean Circulation Journal. 55(12) (pp 1077-1089), 2025. Date of
Publication: 01 Dec 2025.
Author
Hyun J.; Lee S.-A.; Lee S.E.; Hong J.A.; Kim M.-S.; Kim J.-J.
Institution
(Hyun, Lee, Lee, Kim, Kim) Division of Cardiology, Department of Internal
Medicine, Asan Medical Center, University of Ulsan College of Medicine,
Seoul, South Korea
(Hong) Department of Thoracic and Cardiovascular Surgery, Asan Medical
Center, University of Ulsan College of Medicine, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Background and Objectives: The optimal strategy for the maintenance or
discontinuation of evidence-based medication is unclear in heart failure
(HF) patients with improved left ventricular ejection fraction (LVEF). We
tested the feasibility and safety of withdrawing mineralocorticoid
receptor antagonists (MRAs) in this population. <br/>Method(s): This is an
open-label, prospective, randomized controlled pilot trial including HF
patients whose LVEF improved from <=35% to >=50% after guideline-directed
medical therapy. While testing withdrawal of MRA, other medications were
maintained. The primary endpoint was the proportion of patients showing
deteriorations in LVEF by >=10% at 6-month follow-up. The secondary
endpoints were numerical changes in echocardiographic parameters, changes
in blood natriuretic peptide levels, and adverse clinical events relevant
to HF. <br/>Result(s): We randomly assigned 62 HF patients with improved
LVEF to the withdrawal or continuation groups. Two (6.7%) patients in the
withdrawal group and one (3.2%) patient in the continuation group showed
deterioration in LVEF by >=10% at 6 months; one of the 2 patients in the
withdrawal group who showed a decline in LVEF had LVEF of less than 50% at
follow-up. Re-initiation of MRA did not occur in any patients. Compared
with baseline, echocardiographic parameters, including LV end-diastolic
volume index, global longitudinal strain, and natriuretic peptides, were
similar at follow-up in both groups. <br/>Conclusion(s): MRA withdrawal
was associated with a low risk of significant deterioration of cardiac
function in HF patients with improved LVEF of >=50%. MRA withdrawal may be
feasible and safe in this population.<br/>Copyright &#xa9; 2025. The
Korean Society of Cardiology.

<37>
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. <br/>Aim(s): In
a randomized clinical trial, we compared the feasibility and time
consumption by WAM and IBT. <br/>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. <br/>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. <br/>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.<br/>Copyright &#xa9; 2025 The Author(s). Catheterization and
Cardiovascular Interventions published by Wiley Periodicals LLC.

<38>
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. <br/>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. <br/>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.<br/>Copyright 2025
Zeleznik, Groselj and Fister.

<39>
[Use Link to view the full text]
Accession Number
2040338363
Title
Accelerometer-Measured Physical Activity After Mitral Valve Surgery: An
Analysis of the UK Mini Mitral Randomized Controlled Trial.
Source
Circulation. 152(17) (pp 1234-1245), 2025. Date of Publication: 2025.
Author
Wagnild J.M.; Bayliss C.; Maier R.H.; Ogundimu E.; Zacharias J.; Akowuah
E.F.
Institution
(Wagnild) Department of Anthropology (J.M.W.), Durham University, United
Kingdom
(Ogundimu) Department of Mathematical Sciences (E.O.), Durham University,
United Kingdom
(Bayliss, Akowuah) Department of Cardiac Surgery, James Cook University
Hospital, South Tees Hospitals National Health Service Foundation Trust,
Middlesbrough, United Kingdom
(Maier, Akowuah) Academic Cardiovascular Unit, James Cook University
Hospital, South Tees Hospitals National Health Service Foundation Trust,
Middlesbrough, United Kingdom
(Maier) Population Health Sciences Institute, Newcastle University, United
Kingdom
(Akowuah) Translational and Clinical Research Institute (E.F.A.),
Newcastle University, United Kingdom
(Zacharias) Lancashire Cardiac Centre, Blackpool Teaching Hospitals
National Health Service Foundation Trust, Blackpool, United Kingdom
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - Wearable accelerometer devices measure free-living physical
activity and sleep without relying on self-reports. Their utility to
measure and compare recovery of physical function after cardiac surgery
procedures has not been previously studied in the setting of a randomized
controlled trial. <br/>METHOD(S): - Data were collected during the UK
(United Kingdom) Mini Mitral trial, in which patients were randomized to
undergo either a sternotomy or a minimally invasive thoracoscopically
guided right minithoracotomy procedure (Mini) for mitral valve repair.
This is a secondary analysis of the trial data using a different primary
end point. Patients wore a wrist-worn triaxial accelerometer on their
nondominant wrist for 24 hours over a 7-day period before surgery and at
6, 12, 18, 24, 38, and 52 weeks after surgery. Accelerometer outcomes
included the change from baseline to 52 weeks in total activity counts and
time spent in moderate-to-vigorous physical activity, light physical
activity, and sedentary time. Time spent asleep and sleep efficiency were
also captured. Accelerometry data were processed and analyzed by
researchers blinded to the surgical approach. <br/>RESULT(S): - A total of
230 patients (115 in each trial arm) provided valid accelerometry data.
There were significant differences between arms in total activity counts;
the mean difference was 26 744 (95% CI, 9085-44 403; P=0.003) at 6 weeks
and 26 060 (95% CI, 6971-45 149; P=0.008) at 18 weeks, both favoring Mini.
Time spent in moderate-to-vigorous physical activity also favored the Mini
arm at 6 and 18 weeks, with mean differences of 15 (95% CI, 5.7-24;
P=0.001) and 9.9 (95% CI, 0.31-20; P=0.043) minutes per day, respectively.
Those in the Mini arm also had significantly lower sedentary time (at 12,
18, and 24 weeks) and spent more time in light physical activity (at 18
weeks) than those in the sternotomy arm. There were no differences in
sleep duration between arms at any time point, although those in the Mini
arm had higher sleep efficiency than those in the sternotomy arm at 12
weeks. <br/>CONCLUSION(S): - This analysis from the UK Mini Mitral trial
suggests that wearable accelerometer devices can be used to compare
recovery after surgical procedures. The data support an overall decline
from baseline activity to 52 weeks in patients undergoing a sternotomy and
an earlier recovery of physical activity after a minimally invasive
thoracoscopically guided right minithoracotomy approach.<br/>Copyright
&#xa9; 2025

<40>
Accession Number
2042207466
Title
Cardioprotective therapies for ST-elevation myocardial infarction: the
emerging role of thyroid hormone: a narrative review.
Source
Frontiers in Endocrinology. 16 (no pagination), 2025. Article Number:
1696749. Date of Publication: 2025.
Author
Grigoriou K.; Karakasis P.; Lamprou V.; Michas G.; Pamporis K.; Trikas A.;
Pantos C.; Mourouzis I.
Institution
(Grigoriou, Pamporis, Trikas, Pantos, Mourouzis) Department of
Pharmacology, University of Athens, Athens, Greece
(Karakasis) Second Department of Cardiology, Hippokration General
Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
(Lamprou) Manchester Heart Centre, Manchester Royal Infirmary, Manchester
University National Health Service (NHS) Foundation Trust, Manchester,
United Kingdom
(Michas, Trikas) Department of Cardiology, Evangelismos General Hospital
of Athens, Athens, Greece
Publisher
Frontiers Media SA
Abstract
The mortality rates and the incidence of cardiac remodeling and subsequent
heart failure remain high, despite ongoing advancements in the management
of patients with ST-segment elevation myocardial infarction (STEMI). Most
of the adjunctive therapies aiming to further reduce myocardial infarction
(MI) size have failed to apply in daily clinical practice. In this
context, new promising therapeutic approaches aiming to enhance myocardial
salvage have emerged. Recent studies have suggested that thyroid hormone
(TH) may have regenerative effects on ischemic myocardium. Immediate
treatment with TH appears to trigger repair and the regeneration process
in the injured myocardium, especially in patients with large infarct
sizes. The aim of this narrative review is to summarize the most recent
advances in the use of TH for salvaging ischemic myocardium following
STEMI and place it among the most promising cardioprotective therapies.
Emphasis is placed on preclinical and clinical data that highlight the
favorable effects of TH in enhancing myocardial recovery and improving
outcomes after acute myocardial ischemia.<br/>Copyright &#xa9; 2025
Grigoriou, Karakasis, Lamprou, Michas, Pamporis, Trikas, Pantos and
Mourouzis.

<41>
Accession Number
2033036350
Title
Biomarkers predicting postoperative adverse outcomes in children with
congenital heart disease: a systematic review and meta-analysis.
Source
Frontiers in Pediatrics. 13 (no pagination), 2025. Article Number:
1508329. Date of Publication: 2025.
Author
Zhou S.; Liu L.; Jin X.; Dorikun D.; Ma S.
Institution
(Zhou, Jin, Dorikun, Ma) Pediatric Cardiothoracic Surgery, First
Affiliated Hospital of Xinjiang Medical University, Urumqi, China
(Zhou) College of Pediatrics, Xinjiang Medical University, Urumqi, China
(Liu) Hematology Department, First Affiliated Hospital of Xinjiang Medical
University, Urumqi, China
Publisher
Frontiers Media SA
Abstract
Objective: To statistically analyze biomarkers predicting postoperative
outcomes in children with congenital heart disease (CHD). <br/>Method(s):
PubMed, Embase, Cochrane Library, and Web of Science were performed to
search up to February 2024. The measured outcomes were biomarkers,
mortality, length of hospital stay, complication rates, and infection
rates. Adults with CHD were excluded. Standard deviation or odds ratio
(OR) with 95% confidence interval (95% CI) were extracted. A
random-effects model synthesized SMDs or ORs with 95% CIs. Sensitivity
analysis investigated heterogeneity, and Egger's test assessed publication
bias. <br/>Result(s): Seventeen eligible articles were included, the
biomarkers involved include serum lactate, NT-Pro BNP, PaO2, serum
creatinine, C1-INH activity, ST2, serum chloride concentration, GH,
glycemia, cTOI, NLR, serum albumin, and glucose levels, with 2,888
patients who underwent surgery(modified Norwood procedure, arterial switch
procedure, biventricular repair etc.). Serum lactate was higher in the
postoperative death group (SMD: 1.18, 95% CI: 0.59-1.77). Lower
postoperative N-terminal pro-B-type natriuretic peptide (NT-pro BNP)
levels were associated with lower mortality (OR: 0.23, 95% CI: 0.08-0.68)
and shorter mechanical ventilation time (OR: 0.40, 95% CI: 0.18-0.90).
Higher serum albumin levels were associated with longer hospital stays
(OR: 3.12, 95% CI: 1.66-5.84). Significant heterogeneity was found in
serum creatinine, B-type natriuretic peptide (BNP), serum lactate, and
NT-Pro BNP. Publication bias was detected in some studies.
<br/>Conclusion(s): Serum lactate, NT-Pro BNP, and serum albumin are
reliable biomarkers for predicting adverse outcomes in children with CHD
after surgery. Systematic Review Registration: PROSPERO
[CRD42024512753].<br/>Copyright 2025 Zhou, Liu, Jin, Dorikun and Ma.

<42>
Accession Number
2041169077
Title
Role of multimodality imaging in cardiac implantable electronic devices
related infection and infective endocarditis.
Source
Expert Review of Medical Devices. 23(1) (pp 47-58), 2026. Date of
Publication: 2026.
Author
Khayata M.; Goff Z.; Gordon S.; Callahan T.; Elgharably H.; Unai S.; Xu B.
Institution
(Khayata) Robert and Suzanne Tomsich Department of Cardiovascular
Medicine, Sydell and Arnold Family Heart, Vascular, and Thoracic
Institute, Cleveland Clinic, Cleveland, OH, United States
(Goff, Xu) Section of Cardiovascular Imaging, Robert and Suzanne Tomsich
Department of Cardiovascular Medicine, Sydell and Arnold Family Heart,
Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United
States
(Gordon) Department of Infectious Diseases, Cleveland Clinic, Cleveland,
OH, United States
(Callahan) Section of Pacing and Electrophysiology, Robert and Suzanne
Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Family
Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
(Elgharably, Unai) Department of Thoracic and Cardiovascular Surgery,
Sydell and Arnold Family Heart, Vascular, and Thoracic Institute,
Cleveland Clinic, Cleveland, OH, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Infective endocarditis (IE) is a serious and increasingly
recognized condition, associated with significant morbidity and mortality.
The diagnosis of IE is more challenging in patients with implanted cardiac
devices such as cardiac implantable electronic devices, left ventricular
assist devices, and left atrial appendage occlusion devices. Areas
covered: This review focuses on the contemporary roles and applications of
multi-modality imaging in the evaluation of patients with cardiac
implantable electronic devices related infection and IE. The role of
multi-modality imaging in the diagnosis of patients with native or
prosthetic valve IE is beyond the scope of this review. A literature
search of the PubMed database was performed between 1 June 2024, and 30
June 2025. Relevant articles on the subjects of 'infective endocarditis,'
'multi-modality imaging,' and 'implanted cardiac devices' were utilized in
our review. Expert opinion: The growing utilization of cardiac implanted
electronic devices (CIED) demands improvement in the detection of
CIED-related infections. Contemporary guidelines have considered utilizing
multimodality imaging to diagnose IE. The incremental value of
multimodality imaging remains to be rigorously examined. Large
observational studies from tertiary centers might serve as the starting
point toward building a strong evidence base.<br/>Copyright &#xa9; 2025
Informa UK Limited, trading as Taylor & Francis Group.

<43>
Accession Number
2041609883
Title
Cerebral embolic protection devices in transcatheter aortic valve
implantation: a systematic review and meta-analysis of randomized
controlled trials.
Source
Expert Review of Medical Devices. 23(1) (pp 59-68), 2026. Date of
Publication: 2026.
Author
Waseem M.H.; ul Abideen Z.; Cheema A.H.; Osama M.; Javed Khan H.; Farid
R.; Rehman N.; Aimen S.; Thada P.K.
Institution
(Waseem) Department of Medicine, Allama Iqbal Medical College, Lahore,
Pakistan
(ul Abideen, Javed Khan) Department of Medicine, King Edward Medical
University, Lahore, Pakistan
(Cheema) Department of Medicine, UT Southwestern Medical Center, Dallas,
TX, United States
(Osama) Department of Medicine, Hayatabad Medical Complex Peshawar,
Peshawar, Pakistan
(Farid) Department of Medicine, Jinnah Sindh Medical University, Karachi,
Pakistan
(Rehman) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Aimen) Department of Medicine, Quetta Institute of Medical Sciences,
Quetta, Pakistan
(Thada) Department of Medicine, Sotang Primary Hospital, Sotang, Nepal
Publisher
Taylor and Francis Ltd.
Abstract
Background: This meta-analysis aimed to assess the efficacy and safety of
cerebral embolic protection devices (CEPDs) in patients undergoing
transcatheter aortic valve implantation (TAVI). <br/>Method(s): PubMed,
Cochrane Central, and ScienceDirect were searched till April 2025. Risk
ratios (RRs) with 95% confidence intervals (CIs) were pooled under a
random-effects model using Review Manager. The Cochrane risk of bias (RoB
2.0) tool was used for quality assessment. Funnel plots were assessed for
publication bias. <br/>Result(s): Eight randomized controlled trials,
including 11,632 patients undergoing TAVI, were analyzed. Use of CEPDs
showed a non-significant reduction in all strokes (RR 0.92, 95% CI:
0.74-1.15, p = 0.48) and disabling stroke (RR 0.80, 95% CI: 0.57-1.12, p =
0.18). There was no significant difference in all-cause mortality (RR
1.09, 95% CI: 0.71-1.67, p = 0.70), acute kidney injury (AKI) (RR 0.96,
95% CI: 0.44-2.11, p = 0.93), disabling bleeding (RR 0.96, 95% CI:
0.28-3.31; p = 0.94) and major vascular complications (RR 1.25, 95% CI:
0.56-2.78, p = 0.59). <br/>Conclusion(s): CEPD did not significantly
reduce the incidence of ischemic lesions or neurocognitive decline.
Current evidence does not support a statistically significant clinical
benefit of CEPD use during TAVI. While trends suggest a potential
reduction in stroke, larger trials are needed to establish the
significance of these results.<br/>Copyright &#xa9; 2025 Informa UK
Limited, trading as Taylor & Francis Group.

<44>
Accession Number
2042399656
Title
Predisposing Factors for Chronic Post-Surgical Pain After Thoracic
Surgery: A Scoping Review with Quantitative Synthesis.
Source
Journal of Pain Research. 19 (pp 1-13), 2026. Date of Publication: 2026.
Author
Bonilla Sierra P.; Celi M.A.; Suarez Burneo C.
Institution
(Bonilla Sierra, Celi, Suarez Burneo) Department of Health Sciences,
Universidad Tecnica Particular de Loja (UTPL), Loja, Ecuador
Publisher
Dove Medical Press Ltd
Abstract
Background: Chronic post-surgical pain (CPSP) is a frequent complication
after thoracic and cardiothoracic surgery; however, reported risk factors
remain heterogeneous and inconsistent. <br/>Objective(s): To map and
synthesize the factors associated with CPSP after thoracic and cardiac
surgery and to determine the strength of evidence supporting each
predictor category. <br/>Method(s): An exploratory review was conducted
following PRISMA-ScR guidelines. Searches were performed in PubMed,
Scopus, and Web of Science, identifying 20 eligible studies. A
complementary qualitative synthesis was undertaken: statistically
significant p-values (p < 0.05) were extracted, and predictors were
categorized by evidence strength (strong, moderate, limited/inconsistent).
<br/>Result(s): Severe acute postoperative pain during the first
postoperative days emerged as the strongest and most reproducible
predictor of CPSP across designs and populations. Psychological distress,
particularly anxiety, depression, and catastrophizing, also showed strong
and consistent associations. Moderate evidence supported the influence of
young age, female sex, low BMI, and pre-existing chronic pain. Surgical
determinants such as operative duration, minimally invasive approaches,
tissue trauma, and postoperative complications showed variable
associations, as did anesthetic factors, especially high intraoperative
remifentanil doses. Evidence for single-dose S-ketamine and regional
blocks was limited or inconsistent. Preliminary findings related to
inflammatory cytokines, microRNA phenotypes, and geriatric prediction
models suggest additional biological contributors but remain exploratory.
<br/>Conclusion(s): CPSP after thoracic and cardiothoracic surgery results
from interacting nociceptive, psychological, procedural, and biological
factors. Although heterogeneity across studies requires cautious
interpretation, this synthesis highlights early postoperative pain control
and psychological vulnerability screening as priority strategies in
perioperative care, and underscores the need for standardized,
prospective, biomarker-informed research.<br/>Copyright &#xa9; 2026
Bonilla Sierra et al.

<45>
Accession Number
2042683073
Title
Use of intranasal insulin on postoperative delirium: A systematic review
and meta-analysis of randomised controlled trials.
Source
Indian Journal of Anaesthesia. 70(1) (pp 92-101), 2026. Date of
Publication: 01 Jan 2026.
Author
Ng K.T.; Lim W.E.; Teoh W.Y.; Abidin M.F.B.Z.
Institution
(Ng) Department of Anaesthesia, University of Malaya Medical Centre, Kuala
Lumpur, Malaysia
(Lim) Department of Anaesthesia, University of Glasgow, United Kingdom
(Teoh) Department of Medicine, University of Malaya Medical Centre, Kuala
Lumpur, Malaysia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Postoperative delirium remains a major concern among
adult patients undergoing surgery. Intranasal insulin is believed to
reduce postoperative delirium in adults. However, its efficacy and safety
profile remain unclear. The primary objective was to examine the effects
of intranasal insulin on the incidence of postoperative delirium.
Secondary outcomes include serum concentration of Tissue Necrosis
Factor-alpha (TNF-alpha), Interleukin-6 (IL-6), C-Reactive Protein (CRP),
haemostasis model assessment - insulin (HOMA-IR), and serum glucose.
<br/>Method(s): All randomised controlled trials (RCTs) were searched in
the databases of CENTRAL, EMBASE, and MEDLINE until January 2025. Case
reports, case series, letters to the editor, and conference abstracts were
excluded. We used Revman Version 5.4 to calculate the fixed-effects and
random-effects models to report the primary and secondary outcomes by
using the odds ratio (OR) and mean difference (MD), respectively, with a
95% confidence interval (CI). This review included a Grading of
Recommendations Assessment, Development and Evaluation analysis on the
quality of evidence for all measured outcomes. <br/>Result(s): Seven
studies with a total of 739 patients were included in this systematic
review. In comparison to intranasal saline, intranasal insulin
significantly reduced the incidence of postoperative delirium among adults
undergoing surgery (OR: 0.37, 95% CI: 0.22, 0.63). Its administration was
also associated with a statistical decrease in the serum concentration of
TNF-alpha (MD: -3.10, 95% CI: -4.42, -1.78), serum concentration of IL-6
(MD: -3.86, 95% CI: -5.92, -1.80), and serum concentration of CRP (MD:
-1.71, 95% CI: -3.38, -0.04). However, no statistical differences were
observed in the HOMA-IR and serum glucose. <br/>Conclusion(s): This
meta-analysis highlighted the promising application of intranasal insulin
in reducing the incidence of postoperative delirium, serum concentration
of TNF-alpha, IL-6, and CRP in adult patients undergoing surgery. However,
a high degree of heterogeneity and limited sample size warrant future
adequately powered studies to confirm our findings.<br/>Copyright &#xa9;
2026 Indian Journal of Anaesthesia.

<46>
Accession Number
2042013085
Title
Early vs Late Staged PCI After Subintimal Tracking and Re-Entry for
Chronic Total Occlusions: A Randomized Trial.
Source
Journal of the American College of Cardiology. 87(3) (pp 286-293), 2026.
Date of Publication: 27 Jan 2026.
Author
Azzalini L.; Kearney K.; Salisbury A.C.; Stone N.; Gosch K.L.; Jones P.G.;
Spertus J.A.; Pershad A.; Nicholson W.; Lombardi W.; Wyman R.M.; Davies
R.; Grantham J.A.; Hirai T.
Institution
(Azzalini, Kearney, Lombardi) Division of Cardiology, Department of
Medicine, University of Washington, Seattle, WA, United States
(Salisbury, Stone, Gosch, Jones, Spertus, Grantham) Saint Luke's Mid
America Heart Institute, Kansas City, MO, United States
(Salisbury, Grantham) University of Missouri Kansas City, Kansas City, MO,
United States
(Stone, Gosch, Jones, Spertus) University of Missouri-Kansas City's
Healthcare Institute for Innovations in Quality, Kansas City, MO, United
States
(Pershad) Dignity Health & Chandler Regional Medical Center, Chandler, AZ,
United States
(Nicholson) Emory University, Atlanta, GA, United States
(Wyman) Torrance Medical Center, Torrance, CA, United States
(Davies) Wellspan Health, York, PA, United States
(Hirai) Gifu Heart Center, Gifu, Japan
(Hirai) Division of Cardiology University of Missouri, MO, United States
Publisher
Elsevier Inc.
Abstract
Background: Subintimal tracking and re-entry (STAR) with staged stenting
may increase the success and safety of chronic total occlusion (CTO)
percutaneous coronary intervention (PCI) when used as a bailout strategy.
The optimal timing for staged stenting is unknown. <br/>Objective(s): In
this study, the authors sought to evaluate the timing of staged PCI after
STAR by randomizing to an earlier (5-7 weeks) or later (12-14 weeks)
timeframe. <br/>Method(s): Patients undergoing CTO PCI with the use of
STAR (n = 150) were randomized at 6 centers to early or late staged PCI.
The primary endpoint was partial technical success of the staged
procedure, defined as TIMI flow grade 2-3 with <30% residual stenosis into
at least 1 >=2.5 mm distal branch. Study outcomes were compared between
groups with the use of chi-square and Fisher exact tests. <br/>Result(s):
Seventy-three patients were randomized to the early group and 77 to the
late group. The mean Japanese-CTO score was 2.9 +/- 1.1. Differences in
the primary endpoint between the early group and the late group did not
reach statistical significance (83.6% vs 71.4%; P = 0.08). TIMI flow grade
2-3 in the target vessel at the start of staged procedure was higher in
the early group (64.4% vs 44.2%; P = 0.012; P = 0.048 after adjustment).
<br/>Conclusion(s): Among patients undergoing STAR with deferred stenting
after an unsuccessful index CTO PCI attempt, the partial technical success
rate of staged procedures was high. Although vessel patency was higher at
the start of early staged procedures, there were no statistically
significant differences for partial technical success of the staged
procedure with early or late treatment. (STAR and Deferred Stenting Study
[STAR]; NCT05089864)<br/>Copyright &#xa9; 2026 American College of
Cardiology Foundation

<47>
Accession Number
2042265217
Title
Clinical efficacy and mechanisms of transcutaneous auricular vagus nerve
stimulation targeting the gut-brain axis for postoperative complications
of aortic dissection: study protocol for a randomized controlled trial.
Source
Frontiers in Medicine. 12 (no pagination), 2025. Article Number: 1692356.
Date of Publication: 2025.
Author
Ning B.; Yang L.; Wei Y.; Luo C.; Zheng F.; Ge T.; Ou H.; Wang C.; Hu J.;
Zhao Q.; Bo J.; Wang K.; Zhang Z.; Chen H.; Zou R.; Fan X.; Peng J.
Institution
(Ning, Yang, Ge, Wang, Hu, Zhao, Bo, Zou, Fan) The Second Clinical Medical
College, Guangzhou University of Chinese Medicine, Guangzhou, China
(Wei) The Fourth Clinical Medical College, Guangzhou University of Chinese
Medicine, Shenzhen, China
(Luo) Clinical Medical College, Chengdu University of Traditional Chinese
Medicine, Chengdu, China
(Zheng, Ou, Wang, Zou, Fan, Peng) Guangdong Provincial Hospital of Chinese
Medicine, The Second Affiliated Hospital of Guangzhou University of
Chinese Medicine, Guangzhou, China
(Wang, Zhang, Chen) The First Clinical Medical College, Shaanxi University
of Chinese Medicine, Xianyang, China
(Zou, Fan) State Key Laboratory of Traditional Chinese Medicine Syndrome,
State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong
Provincial Key Laboratory of TCM Emergency Research, Guangzhou, China
Publisher
Frontiers Media SA
Abstract
Background: Aortic dissection (AD) is a life-threatening cardiovascular
emergency characterized by rapid onset and high mortality. While surgery
intervention, the primary treatment, improves short-term survival, it
frequently leads to postoperative complications including systemic
inflammatory response syndrome, gastrointestinal dysfunction, and
anxiety/depression. These complications may be exacerbated by
dysregulation of the gut-brain axis (GBA). Transcutaneous auricular vagus
nerve stimulation (taVNS) is a non-invasive neuromodulation technique
known to exert anti-inflammatory, prokinetic, and neuroregulatory effects
in various conditions; however, its application for managing postoperative
complications in AD remains unexplored. This study aims to evaluate the
efficacy and safety of taVNS in regulating the GBA among postoperative AD
patients through a randomized controlled trial. <br/>Method(s): This is a
single-center, randomized, investigator-blinded, sham-controlled
randomized controlled trial. A total of 50 patients aged 18-75 years with
postoperative Stanford Type A or B AD will be enrolled and randomly
assigned in a 1:1 ratio to either the active taVNS group or the sham
control group. Both groups will receive standard postoperative care. The
experimental group will additionally receive active taVNS targeting the
vagus nerve-innervated auricular area (15 Hz, 200 mus pulse width), while
the control group will receive sham stimulation at a non-vagus innervated
site without electrical current. The intervention will be administered for
30 min, twice daily, over 7 consecutive days, with follow-up assessments
continuing until 24 weeks post-surgery. Primary outcomes include changes
in gut microbiota diversity/abundance and brain function (assessed via
functional near-infrared spectroscopy). Secondary outcomes encompass
inflammatory markers, plasma neurotransmitter levels, intestinal function
recovery, and relevant psychometric scale scores. Safety will be monitored
through vital signs, laboratory tests, and recording of any adverse
events. <br/>Discussion(s): This study is the first to innovatively
integrate taVNS with the GBA theory, investigating its multi-target
mechanisms through a comprehensive set of biomarkers and clinical
endpoints. If proven effective, taVNS could offer a safe and
cost-effective non-pharmacological adjunctive therapy for managing
postoperative complications in AD. Furthermore, the findings have the
potential to elucidate the role of the GBA in the recovery trajectory of
patients following major cardiovascular surgery. Trial Registration:
Chinese Clinical Trial Registry (ChiCTR, http://www.chictr.org.cn), No.
ChiCTR2500102345, Date: May 13, 2025.<br/>Copyright &#xa9; 2025 Ning,
Yang, Wei, Luo, Zheng, Ge, Ou, Wang, Hu, Zhao, Bo, Wang, Zhang, Chen, Zou,
Fan and Peng.

<48>
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). <br/>Aim(s): The aim of the present work is to
compare the long-term durability of balloon-expandable (BEV) and
self-expanding (SEV) THVs after TAVR. <br/>Method(s): Electronic databases
were searched up to May 2025 for studies reporting on the long-term
durability of THVs in patients undergoing TAVR with a minimum follow-up of
5 years. Pooled odds ratios (ORs) with 95% confidence interval (CI) were
used as summary statistics and were calculated using a random-effects
model. Co-primary endpoints were moderate and severe structural valve
deterioration (SVD) and the occurrence of all-cause bioprosthetic valve
failure (BVF). All-cause death was the secondary endpoint. <br/>Result(s):
A total of 22 studies and 12,131 patients undergoing TAVR were included:
52.5% of patients (n = 6362) received BEV, 47.5% (n = 5769) SEV. An
old-generation THV was used in 84.5% of cases. At a median follow-up of 7
(5-8.3) years, the overall pooled estimates of moderate/severe SVD and BVF
were 7% (5-9) and 4% (3-5), respectively. Patients treated with a BEV
experienced a higher rate of SVD (OR: 2.09; 95% CI: 1.58-2.75; p < 0.001)
and BVF (OR: 1.61; 95% CI: 1.10-2.36; p = 0.014); no difference was
observed in terms of all-cause death. <br/>Conclusion(s): At long-term
follow-up after TAVR, patients receiving a BEV experienced higher rates of
moderate/severe SVD and of BVF compared to those having a SEV. However, no
significant differences between the two THV designs were observed on the
clinical endpoint of all-cause death.<br/>Copyright &#xa9; 2025 Wiley
Periodicals LLC.

<49>
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.<br/>Copyright &#xa9;The
Author(s) 2025

<50>
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.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2025.
Re-use permitted under CC BY. Published by BMJ Group.

<51>
Accession Number
2042851037
Title
Combined Inhaled Pulmonary Vasodilators in Cardiac Surgery: A Scoping
Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Soto L.; Lareau A.; Ducharme M.-P.; Elmi-Sarabi M.; Jarry S.; Couture E.;
Beaubien-Souligny W.; Huard K.; Lepage M.-A.; Denault A.
Institution
(Soto, Lareau, Ducharme, Elmi-Sarabi, Jarry, Denault) Department of
Anesthesiology, Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Couture) Department of Anesthesiology and Department of Medicine,
Division of Intensive Care Medicine, Institut Universitaire de Cardiologie
et de Pneumologie de Quebec, Universite Laval, Quebec City, Canada
(Beaubien-Souligny) Department of Nephrology, Centre Hospitalier de
l'Universite de Montreal, Montreal, Canada
(Huard) Universite de Montreal, Montreal, Canada
(Lepage) Department of Anesthesiology and Critical Care Medicine, Division
of Critical Care Medicine, CHU de Quebec-Universite Laval, Quebec City,
Canada
Publisher
W.B. Saunders
Abstract
Pulmonary hypertension is a risk factor for increased morbidity and
mortality in cardiac surgery. The use of a combination of inhaled
vasodilator agents could have an improved effect on pulmonary vascular
resistance in the perioperative cardiac surgery setting without causing
the systemic side effect of hypotension observed with intravenous agents.
There is currently limited evidence regarding the use of combination
therapy for pulmonary hypertension in the context of cardiac surgery. A
scoping review was conducted to retrieve relevant literature on the use of
a combination of inhaled vasodilator agents in the treatment of pulmonary
hypertension and/or right ventricular dysfunction in adults and children
undergoing cardiac surgery. The authors searched MEDLINE, Embase, and the
Cochrane Central Register of Controlled Trials from inception to April
2025 for relevant articles. They identified 23 studies including 432
patients. The combined inhaled therapies reported in the literature are
nitric oxide or milrinone combined with prostacyclin analogues. Of the 23
studies, 18 reported a hemodynamic benefit of the drugs in decreasing
pulmonary hypertension and improving right ventricular function. Decreased
intraoperative and postoperative vasopressor and/or inotropic use also was
observed. Moreover, the impact on clinical outcomes, such as difficulty in
weaning from cardiopulmonary bypass and length of intensive care unit
stay, showed conflicting results. No study has reported an impact on
mortality, length of hospital stay, or other intraoperative or
postoperative complications. Combined therapies are promising therapeutic
alternatives for the management of pulmonary hypertension and/or right
ventricular dysfunction in cardiac surgery, but more studies are required
to determine their systemic effects and impact on clinical
outcomes.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<52>
Accession Number
2042731960
Title
Letter to the Editor: 'The prognostic role of cardiac biomarkers in
periprocedural myocardial infarction following coronary artery bypass
grafting'.
Source
European Heart Journal - Quality of Care and Clinical Outcomes. 12(1) (pp
156), 2026. Date of Publication: 01 Jan 2026.
Author
Paolucci L.; Mangiacapra F.
Institution
(Paolucci, Mangiacapra) Research Unit of Cardiovascular Science,
Department of Medicine and Surgery, Universita Campus Bio-Medico di Roma,
Rome, Italy
(Paolucci, Mangiacapra) Fondazione Policlinico Universitario Campus
Bio-Medico, Interventional Cardiology Unit, Rome, Italy
Publisher
Oxford University Press

<53>
Accession Number
2042787439
Title
A step back in time, or a call to action? Revisiting cardiology-unit
access in modern acute myocardial infarction treatment.
Source
International Journal of Cardiology. 448 (no pagination), 2026. Article
Number: 134144. Date of Publication: 01 Apr 2026.
Author
Honda S.; Noguchi T.
Institution
(Honda, Noguchi) Department of Cardiovascular Medicine, National Cerebral
and Cardiovascular Center, Osaka, Japan
Publisher
Elsevier Ireland Ltd

<54>
Accession Number
2035827902
Title
Surgical Management of Substernal Goiters: A Systematic Review and
Meta-Analysis.
Source
Laryngoscope. 136(2) (pp 575-585), 2026. Date of Publication: 01 Feb 2026.
Author
Cheung M.H.; Walker A.M.; Nguyen S.A.; Butehorn H.; Albergotti W.G.
Institution
(Cheung, Walker, Nguyen, Butehorn, Albergotti) Medical University of South
Carolina, Department of Otolaryngology-Head and Neck Surgery, Charleston,
SC, United States
(Cheung) SUNY Upstate Medical University, School of Medicine, Syracuse,
NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Objective: Defining indication for intervention in substernal goiter, and
secondarily define when thoracic intervention may be required. <br/>Data
Sources: PubMed, Scopus, CINAHL. <br/>Method(s): A systematic review and
meta-analysis were performed on studies employing thyroidectomy for
substernal goiters. Meta-analysis of continuous measures, proportions, and
comparison of weighted proportions was performed for patient
characteristics, symptoms, and outcomes. <br/>Result(s): Data from 102
studies were included, with a total study population of 15,719 patients
undergoing substernal thyroidectomies. Criteria for classifying substernal
goiter were heterogeneous across studies, with a plurality (21/102)
defining diagnosis by > 50% of the goiter mass located below the thoracic
inlet. There was a female predominance at 67% (CI 64.2-69.9) with a mean
age of 58 years old (10-94). Most common preoperative symptoms were a
described "neck mass" (71.1%, CI 57.6-82.9) and overall compressive
symptoms (64.8%, CI 52.4-76.2). 27.6% (CI 22.4-33.1) of the population
remained asymptomatic. On radiologic imaging, tracheal deviation and
compression were identified in 60.6% (CI 52.5-68.5) and 48.6% (CI
37.6-59.6) of the population, respectively. Cervical approach alone was
performed in 88.7% (CI 86.0-91.1) of the population, while 10.4% (CI
8.2-12.8) required additional thoracic intervention. Malignancy was
moderate and seen in 12.4% (CI 10.4-14.6) of cases. <br/>Conclusion(s):
Results highlight the indication for substernal surgery is largely due to
the presence of clinical symptoms or compressive findings on imaging;
however, over a quarter of the population is asymptomatic and over 50% are
without compressive findings on imaging. When surgery is undertaken, a
cervical approach is often adequate, suggesting that only a minority of
the population may require thoracic intervention.<br/>Copyright &#xa9;
2025 The Author(s). The Laryngoscope published by Wiley Periodicals LLC on
behalf of The American Laryngological, Rhinological and Otological
Society, Inc.

<55>
Accession Number
2042850998
Title
Bibliometric Analysis of Research on Chinese Heart Transplantation
Technology under the Background of Innovative Development in Organ
Donation and Transplantation.
Source
Transplantation Proceedings. (no pagination), 2026. Date of Publication:
2026.
Author
Long Y.; Zhao Z.; Xie X.; Wu Q.
Institution
(Long) Library of Fujian Normal University, Fuzhou, China
(Long) Intellectual Property Information Service Center of Fujian Normal
University, Fuzhou, China
(Long) Industrial Intelligence Research Institute of Fuzhou University,
Fuzhou, China
(Zhao) School of Public Administration & Law, Fujian Agriculture and
Forestry University, Fujian Province, Fuzhou City, China
(Xie) Medical Administration Department, Fujian Medical University Union
Hospital, Fujian, Fuzhou, China
(Wu) Education Department, Fujian Medical University Union Hospital,
Fujian, Fuzhou, China
Publisher
Elsevier Inc.
Abstract
Objectives: This study examined and systematically summarized the current
research status and characteristics of trends in heart transplantation,
emphasizing innovative developments in organ donation and transplantation
in China. <br/>Method(s): A bibliometric analysis and information
visualization were conducted utilizing the literature from the China
National Knowledge Infrastructure database from 2015 to 2024. This
analysis examines the research status of heart transplantation,
concentrating on the number of published documents, ratio of funded
papers, authorship of publications, scientific research institutions of
the published papers, and relevant keywords. <br/>Result(s): The annual
average number of papers published on heart transplantation was
consistently at 169.30. The publications mainly originated from Fuwai
Hospital, Chinese Academy of Medical Sciences & Peking Union Medical
College, as well as Union Hospital of Tongji Medical College of Huazhong
University. The majority of papers were published in Organ
Transplantation. The primary research hotspots focused on pre-operative
evaluation and prognosis of heart transplantation, experimental studies
involving rats and mice, immune tolerance related to heart
transplantation, and cardiac xenotransplantation. <br/>Conclusion(s): In
the past decade, research on heart transplantation has shown consistency.
Research predominantly occurs within universities and their affiliated
medical institutions, with minimal collaboration among research
institutions; research hotspots span multiple fields, incorporating both
clinical and basic research.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<56>
Accession Number
2041584323
Title
Catheter Ablation vs Sotalol or Amiodarone for Ventricular Tachycardia: A
Substudy of the VANISH2 Trial.
Source
Journal of the American College of Cardiology. 87(2) (pp 157-168), 2026.
Date of Publication: 20 Jan 2026.
Author
Nery P.B.; Wells G.A.; Tang A.S.L.; Parkash R.; Stevenson W.; Healey J.S.;
Gula L.; Nair G.M.; Essebag V.; Rivard L.; Deyell M.W.; Sarrazin J.-F.;
Amit G.; Roux J.-F.; AbdelWahab A.; Lane C.; Samuel M.; Sandila N.; Sapp
J.L.
Institution
(Nery, Wells, Nair) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Tang, Gula) Western University, London, ON, Canada
(Parkash, AbdelWahab, Samuel, Sapp) QEII Health Sciences Centre, Dalhousie
University, Halifax, NS, Canada
(Stevenson) Vanderbilt University Medical Centre, Nashville, TN, United
States
(Healey) Population Health Research Institute, Hamilton, ON, Canada
(Essebag) McGill University Health Centre, Montreal, QC, Canada
(Rivard) Montreal Heart Institute, Montreal, QC, Canada
(Deyell) University of British Columbia, Vancouver, BC, Canada
(Sarrazin) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Quebec City, QC, Canada
(Amit) Hamilton Health Sciences Centre, Hamilton, ON, Canada
(Roux) Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC,
Canada
(Lane) Kelowna General Hospital, Kelowna, BC, Canada
(Samuel) Mario Lemieux Center for Heart Rhythm Care, Allegheny Health
Network, Drexel University, Pittsburgh, PA, United States
(Sandila) Research Methods Unit, Nova Scotia Health, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background: In the VANISH2 multicenter randomized trial comparing catheter
ablation to antiarrhythmic drugs (AADs) for patients with prior myocardial
infarction and ventricular tachycardia (VT), randomization was stratified
by drug eligibility based on clinical criteria. <br/>Objective(s): The
objective of this prespecified substudy was to compare the outcomes of
catheter ablation vs AAD according to drug eligibility stratum.
<br/>Method(s): Patients were considered eligible to be allocated to
sotalol vs ablation if they met all the following criteria: estimated
glomerular filtration rate >=30 mL/min, NYHA functional class I-II, left
ventricular ejection fraction >=20%, qualifying arrhythmia was not VT
storm, and no history of torsades de pointes or QT interval prolongation.
All other patients were eligible to be randomly allocated to amiodarone vs
ablation. The primary endpoint was a composite of death, appropriate
implantable cardioverter-defibrillator shock, VT storm, or treated
sustained VT below the detection limit of the implantable
cardioverter-defibrillator >14-days postrandomization. Secondary endpoints
included safety and the individual components of the primary endpoint. In
this analysis, the primary and secondary outcomes for catheter ablation
are compared with those for sotalol and to amiodarone separately.
<br/>Result(s): A total of 416 patients (199 in sotalol and 217 in
amiodarone strata) were followed for a median of 4.3 years. In the sotalol
stratum, a primary endpoint occurred in 44 of 95 patients (46%) assigned
to catheter ablation and in 62 of 104 (59%) assigned to sotalol (HR: 0.64;
95% CI: 0.43-0.94; P = 0.02). In the amiodarone stratum, a primary
endpoint occurred in 59 of 108 (55%) patients assigned to ablation and 67
of 109 (61%) assigned to AAD (HR: 0.86; 95% CI: 0.61-1.22; P = NS). In the
sotalol stratum, sustained VT below detection occurred in 2 of 95 (2.1%)
patients randomized to ablation and 18 of 104 (17.3%) assigned to sotalol
(HR: 0.12; 95% CI: 0.03-0.5; P = 0.004). In the amiodarone stratum it
occurred in 7 of 108 (6.5%) randomized to ablation and 17 of 109 (15.6%)
assigned to amiodarone (HR: 0.41; 95% CI: 0.17-0.99; P = 0.048). In the
amiodarone stratum, patients allocated to drug therapy had a 3-fold
increase in noncardiac death (5.6% vs 16.5%), a 2-fold increase in
respiratory failure (4.6% vs 11.0%), a 50% increase in heart failure
hospitalization (19.4% vs 31.2%), a 65% increase in sepsis (5.6% vs 9.2%),
a 3-fold increase in pneumonia (3.7% vs 11.9%), and 4.6% incidence of
pulmonary fibrosis/infiltrate (vs 0%), when compared with patients
allocated to ablation. <br/>Conclusion(s): In the sotalol-eligible
patients, ablation led to lower risk of the primary composite endpoint. In
the amiodarone-eligible group, efficacy outcomes were comparable between
ablation and amiodarone. Adverse events were more marked among patients
randomized to amiodarone (Antiarrhythmics or Ablation for Ventricular
Tachycardia 2 [VANISH2]; NCT02830360).<br/>Copyright &#xa9; 2026 The
Authors

<57>
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<br/>Copyright &#xa9; The Author(s)
2025. Published by Oxford University Press on behalf of the European
Society of Cardiology. All rights reserved.

<58>
Accession Number
2041657751
Title
The Efficacy of a Multidisciplinary Perianesthetic Management Bundle for
Alleviating Delirium After Thoracic Surgery: A Randomized Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 290-299),
2026. Date of Publication: 01 Jan 2026.
Author
Xu M.; Wu Y.; Wang R.; Luo C.; Chen J.; Yang J.
Institution
(Xu, Wu, Wang, Luo, Chen, Yang) Department of Anesthesiology, West China
Hospital, Sichuan University, Sichuan, Chengdu, China
Publisher
W.B. Saunders
Abstract
Objectives: Postoperative delirium significantly worsens surgery
prognosis. Here, the authors assessed the ability of comprehensive
perianesthetic management to reduce the risk of delirium after thoracic
surgery. <br/>Design(s): This was a prospective, randomized, single-blind
study. <br/>Setting(s): The study was conducted at a tertiary care
institution and university-level teaching hospital. <br/>Participant(s): A
total of 508 patients scheduled to undergo elective thoracic surgeries
with an expected anesthesia duration of at least 2 hours were enrolled.
<br/>Intervention(s): All eligible participants received routine pre- and
postoperative nonpharmacologic interventions, and the intervention group
also received comprehensive perianesthetic management, including
perioperative pain control, rational medication, refined intraoperative
management, and cognitive training. Delirium was assessed using the
Confusion Assessment Method. <br/>Measurements and Main Results: Of the
508 randomized patients, 497 were included in the final analysis.
Postoperative delirium occurred in 9 of 247 patients (3.6%) in the
intervention group and in 23 of 250 patients (9.2%) in the control group.
Bundle perianesthetic management was associated with a significantly lower
risk of delirium, both in per-protocol analysis (relative risk 0.40, 95%
confidence interval 0.19-0.84, p = 0.012) and intention-to-treat analysis
(relative risk 0.39, 95% confidence interval 0.19-0.84, p = 0.011). No
significant differences were observed between the groups in terms of
delirium duration, postoperative pain, ability to perform activities of
daily living, hospitalization duration, or hospital-related costs.
<br/>Conclusion(s): The findings support integrating this bundle into
perioperative pathways to reduce the risk of delirium after thoracic
surgery. Further studies are warranted to evaluate its feasibility,
generalizability, and safety in broader clinical settings.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<59>
Accession Number
2041117357
Title
Does Autologous Platelet-Rich Plasma Improve Blood Conservation and
Postoperative Outcomes in Acute Type A Aortic Dissection Surgery? A
Systematic Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 49-57), 2026.
Date of Publication: 01 Jan 2026.
Author
Santos K.; Oya K.; Umibe T.; Patel N.; Abo T.; Sakai W.; Plonek T.
Institution
(Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia
(Santos, Plonek) Department of Cardiothoracic Surgery, Medisch Spectrum
Twente, Enschede, Netherlands
(Oya, Umibe, Abo, Sakai) Department of Surgery, National Center for Global
Health and Medicine, Tokyo, Japan
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate whether autologous platelet-rich plasma (aPRP)
improves blood conservation and postoperative outcomes in emergency
surgery for acute type A aortic dissection (ATAAD). <br/>Design(s):
Systematic review and meta-analysis of randomized controlled trials and
observational studies. <br/>Setting(s): Cardiac surgery centers from
multiple institutions. <br/>Participant(s): Six studies comprising 2,150
adult patients undergoing ATAAD repair, of whom 906 (42.1%) received
intraoperative aPRP. <br/>Intervention(s): Use of intraoperative aPRP
versus no aPRP during ATAAD repair. <br/>Measurements and Main Results:
Primary outcomes included reoperation for bleeding and allogeneic blood
product transfusion volumes. Secondary outcomes were mechanical
ventilation duration, hospital stay, and postoperative complications. aPRP
was associated with significantly shorter mechanical ventilation time (MD
-13.8 hours; 95% CI -23.9 to -3.7; p = 0.008), lower incidence of
prolonged ventilation (OR 0.3; 95% CI 0.2 to 0.7; p = 0.004), reduced
reoperation rates (OR 0.4; 95% CI 0.2 to 0.7; p = 0.005), and decreased
platelet (MD -2.2 units; 95% CI -3.5 to -0.9; p = 0.001) and
cryoprecipitate use (MD -1.9 units; 95% CI -3.0 to -0.8; p < 0.001). No
differences were observed in mortality, hospital stay, or rates of
neurological or renal complications. Subgroup analysis of randomized
controlled trial and propensity-matched data confirmed several of these
findings and additionally showed reduced plasma transfusion volumes.
<br/>Conclusion(s): In ATAAD surgery, aPRP may reduce transfusion needs,
reoperations, and ventilation duration without increasing adverse
outcomes. Given that most evidence is observational, high-quality
randomized trials are needed to confirm these findings.<br/>Copyright
&#xa9; 2025 Elsevier Inc.

<60>
Accession Number
2039975343
Title
Effects of Individualized Positive End-Expiratory Pressure on Patients
Undergoing One-Lung Ventilation During Thoracic Surgery: A Systematic
Review and Meta-Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 364-371),
2026. Date of Publication: 01 Jan 2026.
Author
Sun X.; Gao Y.; Jin X.; Lin W.
Institution
(Sun, Jin, Lin) Department of Anesthesiology, The First Affiliated
Hospital, Zhejiang University School of Medicine, Zhejiang, China
(Gao) Department of Anesthesiology, The Second Affiliated Hospital,
Zhejiang University School of Medicine, Zhejiang, China
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the impact of individualized positive
end-expiratory pressure (PEEP) versus fixed PEEP on postoperative
pulmonary complications (PPCs), intraoperative oxygenation, and
respiratory mechanics in thoracic surgery. One-lung ventilation (OLV)
poses potential risks of PPCs. PEEP may mitigate lung injury, but the
optimal PEEP level remains uncertain. <br/>Method(s): We searched PubMed,
Embase, Web of Science, and Cochrane for randomized controlled trials
(RCTs) comparing individualized PEEP versus fixed PEEP during OLV
published up to December 2024. The primary outcome was the occurrence of
overall PPCs during hospitalization. Secondary outcomes included
postoperative hypoxemia, atelectasis, pneumonia, acute respiratory
distress syndrome (ARDS), intraoperative oxygenation, dynamic compliance,
driving pressure, and hospital length of stay. Risk ratios (RRs) and mean
differences were calculated using the DerSimonian-Laird method. Study
quality was evaluated using the Cochrane Risk of Bias tool version 2 for
RCTs trials. Trial sequential analysis (TSA) was used to assess result
reliability. <br/>Result(s): Six RCTs (with a total of 1,844 patients)
were included, with 5 studies (1,814 patients) reporting PPCs.
Individualized PEEP did not significantly reduce overall PPCs (RR, 0.78;
95% confidence interval, 0.59-1.03; p = 0.08), hypoxemia, pneumonia, or
atelectasis; however, it reduced postoperative ARDS and improved
intraoperative oxygenation and lung compliance. TSA revealed that the
current sample size of 1,814 in PPCs was below the required 3,660, and
that the z-curve did not cross the TSA monitoring boundaries.
<br/>Conclusion(s): Individualized PEEP in thoracic surgery may improve
intraoperative oxygenation, pulmonary mechanics, and reduce postoperative
ARDS but does not significantly lower overall PPCs. Overall, the quality
of the evidence is low and inconclusive, and further investigation is
warranted.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<61>
Accession Number
2040473207
Title
The Effects of Nonpharmacological Interventions on Sleep Quality in
Cardiac Surgical Patients: A Prospective Randomised Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 229-234),
2026. Date of Publication: 01 Jan 2026.
Author
Gayatri A.; Panidapu N.; Neema P.K.; Madathil T.; Poduval D.; Palamattam
D.J.; Varma P.K.
Institution
(Gayatri, Panidapu, Neema, Madathil, Poduval, Palamattam) Department of
Cardiac Anesthesia & Critical Care, Amrita Institute of Medical Sciences,
Kochi, India
(Varma) Department of Cardiac Surgery, Amrita Institute of Medical
Sciences, Kochi, India
Publisher
W.B. Saunders
Abstract
Objectives: The primary objective of the current study was to evaluate
whether the use of eye masks and ear plugs improves postoperative sleep
quality in patients undergoing cardiac surgery. The secondary objectives
include the evaluation of nonpharmacological interventions on daytime
sleepiness, opioid consumption, and postoperative complications Design:
Prospective, randomized, controlled, parallel-group study. Participants
and setting: The study was conducted in 100 adult patients undergoing
elective cardiac surgery in a quaternary care hospital.
<br/>Intervention(s): The intervention group received ear plugs and an eye
mask from 10:00 PM to 6:00 AM. The quality of sleep was assessed on the
morning of the next day using the Richards-Campbell Sleep Questionnaire.
<br/>Measurements and Main Results: The intervention group had
significantly higher Richards-Campbell Sleep Questionnaire scores (78 v
62; p < 0.05) and a significant reduction in daytime sleepiness (30% v
62%; p < 0.05) and opioid consumption (7.35 mg v 12.75 mg; p < 0.05). The
incidence of postoperative atrial fibrillation, delirium, and length of
stay in the intensive care unit were comparable between the groups.
<br/>Conclusion(s): Eye masks and ear plugs improve the quality of sleep
and reduce daytime sleepiness and opioid consumption in patients
undergoing cardiac surgery.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<62>
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.<br/>Copyright &#xa9; 2025 Informa UK Limited, trading
as Taylor & Francis Group.

<63>
Accession Number
2041286638
Title
Combination of Serratus Anterior and Deep Parasternal Intercostal Plane
Blocks versus Erector Spinae Plane Block for Acute Pain Management After
Cardiac Surgery: A Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 256-265),
2026. Date of Publication: 01 Jan 2026.
Author
Aydin M.E.; Karapinar Y.E.; Medetoglu Koksal E.N.; Yilmaz M.A.; Yayik
A.M.; Celik E.C.; Oral Ahiskalioglu E.; Erkut B.; Ahiskalioglu A.
Institution
(Aydin, Karapinar, Yilmaz, Yayik, Celik, Oral Ahiskalioglu, Ahiskalioglu)
Department of Anesthesiology and Reanimation, Ataturk University School of
Medicine, Erzurum, Turkey
(Medetoglu Koksal) Department of Anesthesiology and Reanimation,
University of Health Sciences, Erzurum City Hospital, Erzurum, Turkey
(Erkut) Department of Cardiovascular Surgery, Ataturk University School of
Medicine, Erzurum, Turkey
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the analgesic efficacy of bilateral erector spinae
plane block (ESPB) versus the combination of deep parasternal intercostal
plane block (DPIPB) and serratus anterior plane block (SAPB) for managing
acute pain after cardiac surgery. <br/>Design(s): Prospective, randomized,
assessor-blinded controlled trial Setting: A single institution, an
academic university hospital Participants: Sixty patients scheduled for
elective on-pump cardiac surgery through median sternotomy Interventions:
Patients were allocated at random into 2 groups: bilateral ESPB (n = 30)
and combined DPIPB and SAPB (n = 30). <br/>Measurements and Main Results:
The primary outcome was postoperative opioid consumption over the first 24
hours. Secondary outcomes included pain scores at rest and during
coughing, rescue analgesia requirements, and opioid-related adverse
effects. Cumulative opioid consumption was significantly lower in the ESPB
group compared to the DPIPB+SAPB group (mean, 330.00 +/- 206.82 microg v
464.17 +/- 232.74 microg; p = 0.022). No significant differences were
observed in pain scores at the sternotomy or drain sites at rest or during
coughing at any time point (p > 0.05). Additionally, there were no
significant differences in rescue analgesic requirements or opioid-related
side effects between the 2 groups (p > 0.05). <br/>Conclusion(s): In
patients undergoing open-heart surgery through median sternotomy,
bilateral ESPB provided more effective opioid-sparing analgesia compared
to the combined DPIPB+SAPB technique, despite similar subjective pain
scores and side effect profiles. These findings support the broader
dermatomal spread and prolonged efficacy of ESPB, although both techniques
appear to be clinically effective as components of multimodal analgesia
strategies.<br/>Copyright &#xa9; 2025

<64>
Accession Number
2042409072
Title
Impact of intravenous infusion of lidocaine on intrapulmonary shunt and
postoperative cognitive function in patients undergoing one-lung
ventilation.
Source
Advances in Clinical and Experimental Medicine. 34(7) (pp 1139-1144),
2025. Date of Publication: 01 Jul 2025.
Author
Yang D.; Yang Q.; Wang Y.; Liu F.; Xing Z.; Li S.; Zhang J.
Institution
(Yang, Yang, Wang, Liu, Xing, Zhang) Department of Anesthesiology,
Affiliated Hospital of Yangzhou University, China
(Li) Department of Anesthesiology, First People's Hospital Affiliated to
Shanghai Jiaotong University, China
Publisher
Wroclaw Medical University
Abstract
Background. Intravenous infusion of lidocaine as an anesthesia adjuvant
can improve patient outcomes, but its impact on intrapulmonary shunt
during one-lung ventilation (OLV) has not been clarified. Objectives. To
determine the effect of intravenous lidocaine infusion on intrapulmonary
shunt during OLV and postoperative cognitive function in video-assisted
thoracoscopic surgery (VATS). Materials and methods. Sixty patients who
underwent OLV for thoracic surgery were randomized to receive intravenous
infusion of lidocaine (lidocaine group, n = 30) or normal saline (control
group, n = 30) for anesthesia induction. Arterial and venous blood gases
were measured during two-lung ventilation and at 15 and 30 min after OLV
(OLV + 15 and OLV + 30). The Mini-Mental State Examination was
administered before the surgery and at postoperative 12 months to assess
patient cognitive function. Results. No significant difference was found
in intrapulmonary shunt fraction (Qs/Qt) between the lidocaine group and
the control group at OLV + 15 (p = 0.493) and OLV + 30 (p = 0.754). The
lidocaine group used significantly lower doses of propofol and
remifentanil compared to the control group (both p < 0.001). Furthermore,
no significant difference was observed in the incidence of postoperative
cognitive dysfunction between the lidocaine group and the control group at
1 year post-operation (3.3% vs 6.7%, p = 0.554). Conclusions. Intravenous
lidocaine administered in VATS had no significant impact on intrapulmonary
shunt during OLV or postoperative cognitive function. However, it
significantly reduced the doses of anesthetics used during the
surgery.<br/>&#xa9; Copyright by Author(s). This is an article distributed
under the terms of the Creative Commons Attribution 3.0 Unported (CC BY
3.0) (https://creativecommons.org/licenses/by/3.0/)

<65>
Accession Number
2041374815
Title
Total Intravenous Versus Volatile Anesthesia in Pediatric Cardiac Surgery:
Inflammatory Response and Early Recovery Profiles.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 162-169),
2026. Date of Publication: 01 Jan 2026.
Author
Patel G.; Mandal B.; Kahlon S.; Garg V.; Puri G.D.; Kst S.; Rawat A.
Institution
(Patel, Mandal, Kahlon, Garg, Puri) Department of Anesthesia and Intensive
Care, Postgraduate Institute of Medical Education and Research (PGIMER),
Chandigarh, India
(Kst) Department of Cardiovascular and Thoracic Surgery, Postgraduate
Institute of Medical Education and Research (PGIMER), Chandigarh, India
(Rawat) Pediatric Allergy and Immunology Unit, Postgraduate Institute of
Medical Education and Research (PGIMER), Chandigarh, India
Publisher
W.B. Saunders
Abstract
Objectives: To compare the effects of total intravenous anesthesia (TIVA)
versus volatile anesthesia on systemic inflammation and early
postoperative cognitive recovery in pediatric patients undergoing cardiac
surgery with cardiopulmonary bypass. <br/>Design(s): Prospective,
randomized controlled trial. <br/>Setting(s): A tertiary care center
specializing in pediatric cardiac surgery. <br/>Participant(s): Fifty
children aged 1 to 12 years undergoing elective open heart surgery
requiring cardiopulmonary bypass. <br/>Intervention(s): Participants were
randomized to receive either propofol-based TIVA or sevoflurane-based
volatile anesthesia. All patients were managed under standardized
protocols for intraoperative monitoring and postoperative intensive care
unit care. <br/>Measurements and Main Results: The primary outcome was the
interleukin-6 concentration measured at baseline, 6 hours, and 24 hours
postoperatively. Interleukin-6 levels increased significantly in both
groups but showed no difference between groups at any time point.
Secondary outcomes included Mini-Mental State Examination (MMSE) scores
and duration of mechanical ventilation. Cognitive recovery was assessed in
34 children aged 4 years and older using a pediatric-adapted MMSE. At 24
hours post extubation, the mean MMSE scores were significantly higher in
the TIVA group (23.7 +/- 2.1) than in the volatile group (15.1 +/- 3.0; p
< 0.01), and the difference persisted at 48 hours (27.2 +/- 1.4 vs 23.6
+/- 2.8; p < 0.05). Ventilation duration was also shorter in the TIVA
group (12.4 +/- 3.2 hours vs 20.0 +/- 4.6 hours; p = 0.045).
<br/>Conclusion(s): Interleukin-6 responses, the primary outcome, were
comparable between groups. However, TIVA was associated with higher early
MMSE scores and shorter ventilation duration, suggesting potential
neuroprotective benefits.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<66>
Accession Number
2041921143
Title
The impact of operating room teamwork on patients outcomes: A systematic
review.
Source
Current Problems in Surgery. 74 (no pagination), 2026. Article Number:
101946. Date of Publication: 01 Jan 2026.
Author
Moreal C.; Mecozzi I.; Giacomini V.; Dentice S.; Magro G.; Dussi G.;
Chiappinotto S.; Palese A.
Institution
(Moreal, Mecozzi, Giacomini, Dentice, Magro, Dussi, Chiappinotto, Palese)
Department of Medicine, University of Udine, Udine, Italy
Publisher
Elsevier Inc.

<67>
Accession Number
2042578783
Title
Comparison of Short-term and Standard Duration Dual Antiplatelet Therapy
in Elderly Patients: A Pooled Analysis of Five Korean Randomized Clinical
Trials.
Source
Korean Circulation Journal. 55(12) (pp 1125-1137), 2025. Date of
Publication: 01 Dec 2025.
Author
Jin I.T.; Kim Y.; Heo S.-J.; Lee Y.-J.; Lee S.-J.; Hong S.-J.; Ahn C.-M.;
Kim J.-S.; Cho D.-K.; Ko Y.-G.; Choi D.; Hong M.-K.; Kim B.-K.
Institution
(Jin, Lee, Lee, Hong, Ahn, Kim, Ko, Choi, Hong, Kim) Division of
Cardiology, Severance Cardiovascular Hospital, Yonsei University College
of Medicine, Seoul, South Korea
(Kim, Cho) Division of Cardiology, Yongin Severance Hospital, Yonsei
University College of Medicine, Yongin, South Korea
(Heo) Division of Biostatics, Department of Biomedical Systems
Informatics, Yonsei University College of Medicine, Seoul, South Korea
Publisher
Korean Society of Cardiology
Abstract
Backgrounds and Objectives: Data on the optimal duration of dual
antiplatelet therapy (DAPT) by age in patients undergoing percutaneous
coronary intervention (PCI) are limited. This study assessed clinical
outcomes based on age groups and DAPT duration, focusing on patients aged
>=75 years. <br/>Method(s): We analyzed data from 10,487 patients across 5
Korean randomized trials examining the impact of DAPT durations on
clinical outcomes after drug-eluting stent implantation. Patients were
categorized into 2 groups: >=75 years (n=1,571) and <75 years (n=8,916).
Each group was further stratified into short-term DAPT (1-6 months) and
standard DAPT (12 months). The primary outcome was major bleeding within
12 months of PCI. Major adverse cardiovascular and cerebrovascular events
(MACCE) and net adverse clinical events (NACE), a composite of MACCE and
major bleeding, were also compared. <br/>Result(s): Patients aged >=75 had
a higher risk of major bleeding and MACCE than those aged <75. In patients
aged >=75, standard DAPT was associated with a higher risk of major
bleeding than short-term DAPT (hazard ratio [HR], 2.34; 95% confidence
interval [CI], 1.17-4.68; p=0.016). In patients aged <75 years, the risk
was comparable (HR, 1.45; 95% CI, 1.00-2.10; p=0.053), with no significant
interaction between groups (p=0.207). The risks of MACCE and NACE did not
differ significantly between DAPT strategies or age groups.
<br/>Conclusion(s): Standard DAPT strategy may increase bleeding risk in
elderly patients without reducing ischemic events, despite no significant
age-treatment interaction. Trial Registration: ClinicalTrials.gov
Identifier: NCT01145079 (RESET), NCT01308281 (IVUS-XPL), NCT01752894
(DETECT-OCT), NCT02494895 (TICO), NCT02513810
(One-Month-DAPT).<br/>Copyright &#xa9; 2025. The Korean Society of
Cardiology.

<68>
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. <br/>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. <br/>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. <br/>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).<br/>Copyright &#xa9; 2025 Informa UK Limited, trading
as Taylor & Francis Group.

<69>
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. <br/>Objective(s): To evaluate the efficacy
of transcutaneous auricular vagus nerve stimulation (taVNS) on POD in
elderly patients undergoing major non-cardiac surgery. <br/>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.
<br/>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).
<br/>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.<br/>Copyright &#xa9; 2026 Shi et al.

<70>
[Use Link to view the full text]
Accession Number
2042073778
Title
Efficacy of incentive spirometer and diaphragmatic breathing exercise on
the alteration of arterial blood gas measures in patients after coronary
artery bypass grafting: A randomized comparative trial.
Source
Medicine (United States). 104(44) (pp e45538), 2025. Date of Publication:
31 Oct 2025.
Author
Shaphe M.A.; Ali T.; Pandey S.K.; Iqbal A.; Kashoo F.Z.; Alajam R.A.; Khan
M.H.; Alghadir A.H.
Institution
(Shaphe) Department of Physical Therapy, College of Nursing and Health
Sciences, Jazan University, Jazan, Saudi Arabia
(Ali) Department of Physical Therapy, Peerless Hospitex Hospital &
Research Center, Kolkata, India
(Pandey) Department of Cardiothoracic and Vascular Surgery, Batra Hospital
& Medical Research Center, New Delhi, India
(Iqbal) Rehabilitation Research Chair, Department of Rehabilitation
Sciences, College of Applied Medical Sciences, King Saud University,
Riyadh, Saudi Arabia
(Kashoo) Department of Physical Therapy & Health Rehabilitation, College
of Applied Medical Science, Majmaah University, Majmaah, Saudi Arabia
(Alajam) Department of Physical Therapy, College of Nursing and Health
Sciences, Jazan University, Jazan, Saudi Arabia
(Khan) Department of Diagnostic Radiology, College of Nursing and Health
Sciences, Jazan University, Jazan, Saudi Arabia
(Alghadir) Rehabilitation Research Chair, Department of Rehabilitation
Sciences, College of Applied Medical Sciences, King Saud University,
Riyadh, Saudi Arabia
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - The incidence of lung-related issues after undergoing
coronary artery bypass graft (CABG) surgery is notably significant.
Initiating lung exercises soon after heart surgery plays a crucial role in
averting these issues. The purpose of this research was to examine how the
use of an incentive spirometer (IS) and diaphragmatic breathing exercises
(DBE) impacts changes in arterial blood gas (ABG) levels. <br/>Method(s):
- The study was based on a 2-arm, parallel-group, randomized comparative
design. In this study, 30 individuals who had CABG surgery were selected
based on specific criteria and randomly divided into the IS group and the
DBE group. Each group received targeted chest physiotherapy; the IS Group
had an IS, and the DBE Group had DBE. Key ABG parameters, such as blood
pH, partial pressure of arterial oxygen (PaO2), and partial pressure of
arterial carbon dioxide (PaCO2), were evaluated using an ABG analyzer.
Measurements were taken initially on the first day after extubation and
then again on the second day post-extubation. All statistical analyses
were conducted with a maintained significance threshold of 95%.
<br/>Result(s): - The results showed no significant differences
between-group and within-group comparisons for PH, PaO2, and PaCO2
outcomes. However, the IS group patients showed a trend in the increase in
PaO2 levels and a decrease in PaCO2 levels compared to those in the DBE
group. <br/>Conclusion(s): - Despite not revealing statistically
significant differences in the alteration of ABG measures between groups,
the current study observed minimal improvements in ABG measures in the IS
Group compared to the DBE Group. Therefore, this study suggests that, in
addition to conventional chest physiotherapy, using an IS might be
superior to DBE in altering ABG measures in patients with post-CABG.
Nonetheless, we may use both intervention and conventional chest
physiotherapy postoperatively as a prophylactic regime.<br/>Copyright
&#xa9; 2025

<71>
Accession Number
2040489627
Title
Efficacy and Safety of Pulmonary Vasodilator and Inodilator Drugs in
Congenital Heart Disease Surgery: A Systematic Review and Network
Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(1) (pp 333-346),
2026. Date of Publication: 01 Jan 2026.
Author
Ollosu M.; Tripodi V.F.; Aresu C.; Ledda G.; Manai F.; Marini C.; Musu M.;
Ippolito M.; Cortegiani A.; Finco G.; Sardo S.
Institution
(Ollosu, Aresu, Ledda, Manai, Marini, Musu, Finco, Sardo) Department of
Medical Sciences and Public Health, University of Cagliari, Monserrato,
Italy
(Tripodi) Anesthesia and Intensive Care, Human Pathology Department,
"Gaetano Martino" University Hospital, Messina, Italy
(Ippolito, Cortegiani) Department of Anesthesia, Analgesia, Intensive Care
and Emergency, University Hospital Policlinico Paolo Giaccone, Palermo,
Italy
(Ippolito, Cortegiani) Department of Precision Medicine in Medical,
Surgical and Critical Care (Me.Pre.C.C.), University of Palermo, Italy
Publisher
W.B. Saunders
Abstract
Background: Perioperative management of congenital heart disease (CHD)
surgery presents a unique challenge due to significant pathophysiological
alterations, with pulmonary hypertension contributing substantially to
morbidity and mortality. Although pulmonary vasodilators and inodilators
are commonly used, evidence of their efficacy and safety remains limited.
<br/>Objective(s): To evaluate the effectiveness and safety of
vasodilators and inodilators in pediatric patients undergoing CHD surgery.
<br/>Design(s): Systematic review with network meta-analysis. <br/>Data
Sources: PubMed, CENTRAL, and Embase. Eligibility Criteria: We included
single- or double-blind, parallel-group, randomized controlled trials
comparing the perioperative use of vasodilators and inodilators in
pediatric CHD surgery. We selected only English-language studies. We
excluded crossover, non randomized trials and trials comparing the same
drugs in all study arms. <br/>Result(s): We included 28 randomized
controlled trials involving 3118 patients. Intravenous levosimendan ranked
highest in decreasing postoperative mortality, although the effect was not
statistically significant. Intravenous sildenafil and inhaled nitric oxide
(NO) significantly reduced the duration of mechanical ventilation, and
inhaled NO also significantly shortened the length of intensive care unit
stay. Inhaled iloprost, NO, and enteral sildenafil reduced mean pulmonary
artery pressure. No intervention significantly affected the incidence of
acute kidney injury. <br/>Conclusion(s): Vasodilators and inodilators did
not significantly decrease perioperative mortality in pediatric CHD. Some
agents, such as intravenous sildenafil and inhaled NO, demonstrated modest
benefits of questionable clinical significance regarding duration of
mechanical ventilation, intensive care unit stay, and pulmonary pressure.
The results are limited by small sample sizes, study heterogeneity,
variability in standard care, and risk of bias, requiring cautious
interpretation. Registration: CRD42024552531.<br/>Copyright &#xa9; 2025
The Authors

<72>
Accession Number
2042354632
Title
Posterior pericardiotomy: An effective strategy for reducing post-coronary
artery bypass grafting complications, with considerations for pleural
effusion risk.
Source
World Journal of Cardiology. 17(10) (pp 1-10), 2025. Article Number:
110793. Date of Publication: 26 Oct 2025.
Author
Khawar M.; Shah S.A.; Khan A.; Waseem A.; Saeed H.; Fatima A.; Saifullah
M.; Mehdi A.M.; Qadeer A.; Khawar M.M.H.
Institution
(Khawar, Shah, Waseem, Saeed, Saifullah) Department of Medicine, King
Edward Medical University, Punjab, Lahore, Pakistan
(Khan, Fatima) Department of Medicine, Nishtar Medical University And
Hospital, Punjab, Multan, Pakistan
(Mehdi) Department of Medicine, International School of Medicine,
International University of Kyrgyzstan, Bishkek, Kyrgyztan
(Qadeer) Department of Medicine, Mayo Clinic Phoenix, Arizona City, AZ,
United States
(Khawar) Department of Medicine, Services Institute of Medical Sciences,
Punjab, Lahore, Pakistan
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND Postoperative complications such as atrial fibrillation and
pericardial effusion are frequent after coronary artery bypass grafting
(CABG), contributing to increased morbidity and prolonged hospital stays.
Posterior pericardiotomy (PP), a surgical technique involving incision of
the posterior pericardium to allow drainage, has been suggested as a
preventive measure. However, its overall efficacy and safety profile,
including potential risks like pleural effusion, require comprehensive
evaluation amid varying study qualities. We hypothesized that PP reduces
key post-CABG complications compared to standard care. AIM To determine
the efficacy of PP in reducing postoperative complications following CABG.
METHODS This systematic review and meta-analysis included randomized
controlled trials (RCTs) from PubMed, Cochrane, ClinicalTrials.gov, and
Ovid, comparing PP vs no PP in adult CABG patients. Studies were conducted
in tertiary care hospital settings. Twenty RCTs with 5331 participants
were selected based on predefined inclusion criteria. The intervention
involved intraoperative PP. Primary outcome was postoperative atrial
fibrillation (POAF); secondary outcomes included effusions, tamponade,
hospital/intensive care unit stay, and bleeding revisions. Risk ratios
(RRs), mean differences, and 95% confidence intervals (CIs) were
calculated using random-effects models; heterogeneity assessed via
I² statistic. RESULTS Twenty RCTs analyzed 5331 patients (2665
with PP vs 2666 without). PP significantly lowered POAF (10% vs 21%; RR =
0.48, 95%CI: 0.36-0.65, P < 0.00001; I² = 70%), cardiac
tamponade (0.5% vs 3%; RR = 0.16, 95%CI: 0.08-0.34, P < 0.00001;
I² = 0%), early pericardial effusion (2% vs 6%; RR = 0.31,
95%CI: 0.14-0.68, P = 0.004; I² = 96%), and late pericardial
effusion (1% vs 9%; RR = 0.11, 95%CI: 0.05-0.21, P < 0.00001;
I² = 0%). Hospital stay decreased (mean difference = -1.23
days, 95%CI: -1.87 to -0.59, P = 0.0002; I² = 85%). Pleural
effusion risk increased (25% vs 17%; RR = 1.46, 95%CI: 1.21-1.76, P <
0.0001; I² = 0%). No significant effects on mortality (RR =
0.92, 95%CI: 0.48-1.76, P = 0.80; I² = 0%), intensive care unit
stay, or bleeding revisions. CONCLUSION PP effectively reduces POAF,
pericardial effusions, tamponade, and hospital stay in CABG patients,
though it increases pleural effusion risk and shows heterogeneity in some
outcomes.<br/>Copyright &#xa9;The Author(s) 2025.

<73>
Accession Number
2042661890
Title
Critique on "determining the optimal timing for tetralogy of Fallot
management: A meta-analysis of neonatal versus postneonatal repairs".
Source
Annals of Pediatric Cardiology. 18(4) (pp 414-415), 2025. Date of
Publication: 01 Jul 2025.
Author
Shahzad Z.
Institution
(Shahzad) Fatima Jinnah Medical University, Lahore, Pakistan
Publisher
Wolters Kluwer Medknow Publications

<74>
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.<br/>Copyright
&#xa9; 2025. Published by Elsevier B.V.

<75>
Accession Number
649436821
Title
Effect of perioperative oral care on postoperative pneumonia in thoracic
surgery patients: a systematic review and meta-analysis.
Source
Scientific reports. 16(1) (pp 951), 2025. Date of Publication: 05 Dec
2025.
Author
Duan L.; Li D.; Li Z.; Luo W.; Chu X.
Institution
(Duan, Li, Luo) School of Nursing, Chengdu University of Traditional
Chinese Medicine, Chengdu, China
(Li) Department of Thoracic Surgery, Suining Central Hospital, China
(Chu) Department of Nursing, Hospital of Chengdu University of Traditional
Chinese Medicine, Sichuan Province, No. 39 ,Shi-Er-Qiao Road, Chengdu,
China
Abstract
Postoperative pneumonia (POP) is a prevalent and serious complication
following thoracic surgery, substantially increasing morbidity, mortality,
and healthcare expenditures. The aim of this study was to evaluate the
efficacy of perioperative oral care (POC) in reducing the incidence of
POP. A comprehensive literature search was conducted across the Cochrane
Library, Web of Science, PubMed, and Embase from their inception through
September 26, 2024. We included all observational studies and randomized
controlled trials (RCTs) that assessed the impact of POC on POP reduction.
A total of 25 studies, involving 52,227 patients (24,964 in the POC group
and 27,263 in the control group), were included in the final analysis,
comprising 9 RCTs and 16 observational studies. The incidence of POP was
2,887 cases (11.6%) in the POC group, compared with 3,438 cases (12.6%) in
the control group. The meta-analysis revealed that POC was associated with
a significantly reduced incidence of POP in patients undergoing thoracic
surgery (RR, 0.54; 95% CI, 0.44-0.67; p < 0.001; I2 = 72%). In conclusion,
POC significantly reduces the incidence of POP in thoracic surgery
patients, and its integration into perioperative protocols may improve
clinical outcomes.<br/>Copyright &#xa9; 2025. The Author(s).

<76>
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. <br/>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. <br/>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%). <br/>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.<br/>Copyright &#xa9; 2025 Wiley Periodicals LLC.

<77>
Accession Number
2034340509
Title
Atrial fibrillation and ischemic stroke in cancer: the latest scientific
evidence, current management, and future directions.
Source
Journal of Thrombosis and Thrombolysis. 58(8) (pp 1081-1094), 2025. Date
of Publication: 01 Dec 2025.
Author
Seth L.; Stabellini N.; Doss S.; Patel V.; Shah V.; Lip G.; Dent S.;
Fradley M.G.; Kober L.; Guha A.
Institution
(Seth, Stabellini, Doss, Patel, Shah, Guha) Department of Medicine,
Division of Cardiology, Medical College of Georgia at Augusta University,
Augusta, GA, United States
(Stabellini) Department of Hematology-Oncology, University Hospitals
Seidman Cancer Center, Cleveland, OH, United States
(Lip) Liverpool Centre for Cardiovascular Science at University of
Liverpool, Liverpool John Moores University and Liverpool Heart & Chest
Hospital, Liverpool, United Kingdom
(Lip) Danish Center for Health Services Research, Department of Clinical
Medicine, Aalborg University, Aalborg, Denmark
(Lip) Department of Cardiology, Lipidology and Internal Medicine with
Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok,
Poland
(Dent) Wilmot Cancer Center, Department of Medicine, University of
Rochester, Rochester, NY, United States
(Fradley) Thalheimer Center for Cardio-Oncology, Division of Cardiology,
Department of Medicine Perelman School of Medicine, University of
Pennsylvania, Philadelphia, PA, United States
(Kober) Department of Cardiology, Rigshospitalet, Copenhagen University
Hospital, Copenhagen, Denmark
(Guha) Cardio-Oncology Program, Department of Medicine, Cardiology
Division, Medical College of Georgia at Augusta University, Augusta, GA,
United States
Publisher
Springer
Abstract
Atrial fibrillation is the most common cardiac arrhythmia and is a major
risk factor for ischemic stroke. Atrial fibrillation and ischemic stroke
are major cardiovascular complications in cancer patients, who have a
higher burden and worse outcomes than the general population. Clinical
risk stratification scores for stroke and bleeding, commonly used in the
general population to estimate thromboembolic and bleeding risk,
respectively, are less well validated in cancer patients, who have
historically been excluded in clinical trials. There is a lack of
consensus opinion on how to effectively risk-stratify cancer patients
based on the currently available tools and a need for cancer-specific
scores that offer a tailored approach to each patient in order to more
effectively stratify ischemic stroke and bleeding risk in this cohort of
patients. Cancer-mediated physiologic changes and adverse effects of
antineoplastic therapy have been implicated as etiologies of the increased
risk for both atrial fibrillation and ischemic stroke. Risk stratifying
scores such as CHA<inf>2</inf>DS<inf>2</inf>-VASc and HAS-BLED, commonly
used in the general population, are less well validated in cancer
patients. There is a need for cancer-specific scores that can more
effectively stratify ischemic stroke and bleeding risk in cancer patients,
although given the heterogeneity of cancers, whether a "one score fits
all" is uncertain.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<78>
[Use Link to view the full text]
Accession Number
2042067838
Title
Percutaneous left atrial appendage closure for stroke prevention in atrial
fibrillation: who should receive it in current clinical practice?.
Source
Current Opinion in Cardiology. 41((1 Pt c)) (no pagination), 2026. Date of
Publication: 01 Jan 2026.
Author
d'Entremont M.-A.; Healy J.S.; Jolly S.S.
Institution
(d'Entremont, Healy, Jolly) Population Health Research Institute, McMaster
University, Hamilton, Canada
(d'Entremont, Healy, Jolly) Hamilton Health Sciences, Hamilton, Ontario,
Canada
(d'Entremont) Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke,
Quebec, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review Although oral anticoagulation (OAC) remains the
cornerstone therapy for stroke prevention in atrial fibrillation, several
limitations, such as noncompliance and bleeding, limit its effectiveness.
Percutaneous left atrial appendage closure (pLAAC) has emerged as a
promising therapy. We will review current and potential indications for
pLAAC and knowledge gaps. Recent findings Current guidelines recommend
pLAAC for patients who have atrial fibrillation at moderate to high risk
of stroke with a high risk of bleeding or who have a contraindication for
OAC. pLAAC is being investigated as a potential therapeutic option for the
following patient populations: end-stage renal disease, after atrial
fibrillation ablation, and in combination with OAC in patients with a high
risk of breakthrough stroke or in patients with prior stroke on OAC. The
Left Atrial Appendage Occlusion Study IV (LAAOS-IV) (n = 4000) is a
randomized trial that will determine the role of pLAAC and OAC compared to
OAC alone in preventing ischemic stroke or systemic embolism. Summary
pLAAC has a growing role in patients with atrial fibrillation with
moderate to high stroke risk and contraindication to OAC. Multiple
randomized trials are currently underway in different patient populations,
which may expand the role of pLAAC.<br/>Copyright &#xa9; 2025 Wolters
Kluwer Health, Inc. All rights reserved.

<79>
Accession Number
2042855681
Title
Contemporary outcomes of lower extremity vein bypass for chronic
limb-threatening ischemia based on a post hoc comparison of the BEST-CLI
and PREVENT III multicenter prospective randomized controlled trials.
Source
Journal of Vascular Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Hussain M.A.; Khan A.A.; Menard M.T.; Conte M.S.; Vouyouka A.G.; Doros G.;
Strong M.B.; Kalish J.A.; Chew D.; Gasper W.J.; Tan T.-W.; Darling R.C.;
LaMuraglia G.; Rosenfield K.; Farber A.; Schanzer A.
Institution
(Hussain, Menard, Strong) Division of Vascular and Endovascular Surgery,
Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United
States
(Hussain) Center for Surgery and Public Health, Brigham and Women's
Hospital, Boston, MA, United States
(Khan) Warren Alpert Medical School of Brown University, Providence, RI,
United States
(Conte, Gasper) Division of Vascular & Endovascular Surgery, University of
California, San Francisco, CA, United States
(Vouyouka) Division of Vascular Surgery, The Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(Doros) Department of Biostatistics, Boston University School of Public
Health, Boston, MA, United States
(Kalish, Farber) Division of Vascular & Endovascular Surgery, Department
of Surgery, Boston University Chobanian & Avedisian School of Medicine,
Boston Medical Center, Boston, MA, United States
(Chew) Division of Vascular Surgery, Iowa Heart Center, West Des Moines,
IA, United States
(Tan) Department of Vascular Surgery, University of Southern California,
Los Angeles, CA, United States
(Darling) Division of Vascular Surgery, Albany Medical Center Hospital,
Albany, NY, United States
(LaMuraglia, Rosenfield) Division of Vascular & Endovascular Surgery,
Massachusetts General Hospital, Boston, MA, United States
(Schanzer) Division of Vascular Surgery, UMass Chan Medical School,
Boston, MA, United States
Publisher
Elsevier Inc.
Abstract
Background: BEST-CLI (Best Endovascular vs Best Surgical Therapy in
Patients with Chronic Limb-Threatening Ischemia [CLTI]) demonstrated the
superiority of single-segment great saphenous vein bypass over
endovascular treatment for patients with CLTI who were candidates for both
treatment strategies. However, with the rise of endovascular techniques
and the subsequent decrease in the number of vein bypass procedures being
performed, concerns have emerged regarding the continued ability to
perform surgical bypass safely and effectively. This study aimed to
evaluate whether outcomes after lower extremity infrainguinal vein bypass
for CLTI have changed over the past two decades by comparing data from two
major randomized controlled trials: BEST-CLI and PREVENT III (Project or
Ex-Vivo vein graft Engineering via Transfection III). <br/>Method(s): This
post hoc comparative analysis included patients with CLTI who underwent
lower extremity infrainguinal vein bypass in the multicenter, prospective
BEST-CLI (2014-2019) and PREVENT III (2001-2003) trials. The primary
outcome was a composite of major adverse limb event (MALE) or death at 1
year. Secondary outcomes included perioperative (30-day) rates of major
adverse cardiovascular event (MACE) and MALE. Multivariable Cox and
logistic regression models were used for 1-year and 30-day outcomes,
respectively, to compare outcomes between the two cohorts; confirmatory
analyses were conducted using propensity score methods. <br/>Result(s): In
total, 2114 patients underwent infrainguinal vein bypass for CLTI (710
BEST-CLI and 1404 PREVENT III). The mean patient age was 67.9 +/- 11.0
years; 32.8% were female. Patients in BEST-CLI had higher use rates of
aspirin, statins, and single segment great saphenous vein conduit. The
primary end point of 1-year MALE or death was lower in BEST-CLI (21.0%)
compared with PREVENT III (37.8%) (adjusted hazard ratio [HR], 0.50; 95%
confidence interval [CI], 0.40-0.62; P < .0001)-this observation was
consistent across predefined subgroups and in confirmatory analyses using
propensity score methods. Major reinterventions (new bypass, surgical
revision, thrombectomy, or endovascular intervention for graft occlusion)
at 1 year were also lower in BEST-CLI (7.2% vs 18.4%; adjusted HR, 0.40;
95% CI, 0.28-0.57; P < .0001), although rates of any reinterventions were
similar (25.8% vs 29.3%; adjusted HR, 0.90; 95% CI, 0.72-1.14; P = .39).
Perioperative major cardiovascular and limb events were significantly
lower in BEST-CLI: MACE (4.1% vs 7.8%; adjusted OR 0.47; 95% CI,
0.28-0.79; P = .005) and MALE (2.7% vs 6.3%; adjusted OR 0.44; 95% CI,
0.24-0.82; P = .009). <br/>Conclusion(s): Over the past two decades,
outcomes after lower extremity infrainguinal vein bypass for CLTI have
improved significantly. These advances likely reflect a combination of
broad improvements in cardiovascular risk management, surgical techniques,
and postoperative care for CLTI patients.<br/>Copyright &#xa9; 2025
Society for Vascular Surgery

<80>
Accession Number
2042533548
Title
Clinical outcomes off-pump comparing on-pump coronary artery bypass
surgery in diabetic patients: updated systematic review and meta-analysis.
Source
Acta Diabetologica. (no pagination), 2026. Date of Publication: 2026.
Author
Elmozugi T.; Khelifa H.; Badr A.; Harfoush M.K.; Shehata M.; Alganadi R.;
Ziada A.; Hegazy I.; Ali O.M.; Albaoni H.K.; Otmani Z.; Al Swayah M.B.
Institution
(Elmozugi) Faculty of Medicine, Benghazi University, Benghazi, Libyan Arab
Jamahiriya
(Khelifa) Faculty of Medicine, University of Oran, 1 Ahmed Ben Bella, Es
Senia, Algeria
(Badr) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Harfoush) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Shehata, Alganadi) Faculty of Medicine, Modern University for Technology
and Information, Cairo, Egypt
(Ziada) Faculty of Medicine, Tanta University, Tanta, Egypt
(Hegazy, Ali) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Albaoni) Jordan University of Science & Technology, Ar-Ramtha, Jordan
(Otmani) Faculty of Medicine, Mouloud Mammeri University, Tizi Ouzou,
Algeria
(Al Swayah) Faculty of Medicine, Tripoli University, Tripoli, Libyan Arab
Jamahiriya
Publisher
Springer-Verlag Italia s.r.l.
Abstract
Background: Patients with diabetes mellitus are at high risk for coronary
artery disease and frequently undergo coronary artery bypass grafting
(CABG). Off-pump CABG (OPCAB) has been proposed to reduce perioperative
complications compared with on-pump CABG (ONCAB), but long-term outcomes
remain uncertain. <br/>Method(s): We conducted a systematic review and
meta-analysis in accordance with PRISMA 2020 and Cochrane guidelines. Five
databases were searched through May 2025 for randomized trials and
observational cohorts comparing OPCAB and ONCAB in adults with diabetes.
Risk of bias was assessed using RoB-2 and ROBINS-I, and evidence quality
was graded with GRADE. <br/>Result(s): Seventeen studies were included. No
significant differences were observed in 30-day (RR = 0.82, 95% CI:
0.51-1.31; I2 = 64%), 1-year (RR = 0.93, 95% CI: 0.56-1.55; I2 = 65.6%),
or 5-year mortality (RR = 1.09, 95% CI: 0.78-1.53; I2 = 58.8%). Randomized
data suggested a possible increase in late mortality with OPCAB. OPCAB was
associated with lower rates of cerebrovascular events, pulmonary
complications, reoperation for bleeding, prolonged ventilation, and
intensive care unit stay. No differences were found in myocardial
infarction, renal failure, atrial fibrillation, or sternal wound
infection. Incomplete revascularization occurred more frequently with
OPCAB (RR = 1.96, 95% CI: 1.28-3.0). <br/>Conclusion(s): In diabetic
patients undergoing CABG, OPCAB may reduce postoperative morbidity without
altering overall survival. These findings underscore the need to balance
perioperative benefits against potential long-term risks when selecting
the surgical approach.<br/>Copyright &#xa9; Associazione Medici
Diabetologi / Association of Diabetologists (AMD), Societa Italiana di
Diabetologia / Italian Society of Diabetology (SID) 2026.

<81>
[Use Link to view the full text]
Accession Number
2042619478
Title
Five-Year Clinical Outcomes and Durability of a Self-Expanding
Transcatheter Heart Valve With Intra-Annular Leaflets.
Source
Circulation: Cardiovascular Interventions. 18(12) (pp e015430), 2025. Date
of Publication: 01 Dec 2025.
Author
Puri R.; Thiele H.; Fichtlscherer S.; Westermann D.; Makkar R.; Waksman
R.; Hakmi S.; Sondergaard L.; Groh M.; Montarello J.K.; Kempfert J.; Yong
G.; Bedogni F.; Maisano F.; Worthley S.G.; Rodes-Cabau J.; Fontana G.P.;
Mollmann H.
Institution
(Puri) Cleveland Clinic, OH (R.P.)
(Thiele) Heart Center Leipzig at Leipzig University, Germany (H.T.)
(Fichtlscherer) University Heart and Vascular Center Frankfurt and Bad
Segeberg, Germany (S.F.)
(Westermann) University Heart Center, University of Freiburg, Germany
(D.W.)
(Makkar) Cedars-Sinai Medical Center, Los Angeles, CA (R.M.)
(Waksman) MedStar Washington Hospital Center (R.W.).
(Hakmi) Asklepios Klinik St. Georg, Germany (S.H.)
(Sondergaard) Abbott Structural Heart, Santa Clara, CA (L.S.)
(Groh) Asheville Heart, NC (M.G.)
(Montarello) Royal Adelaide Hospital, Australia (J.K.M.)
(Kempfert) German Heart Institute Berlin, Germany (J.K.)
(Yong) Advara Heart Care, Hollywood Medical Centre, Australia (G.Y.)
(Bedogni) IRCCS Policlinico San Donato, Italy (F.B.)
(Maisano) IRCCS Ospedale San Raffaele, Italy (F.M.)
(Worthley) St. Andrew's Hospital, Australia (S.G.W.)
(Rodes-Cabau) Quebec Heart & Lung Institute, Canada (J.R.-C.)
(Fontana) Cardiovascular Institute of the HCA Los Robles Health System,
Thousand Oaks, CA (G.P.F.)
(Mollmann) St.-Johannes-Hospital Dortmund, Germany (H.M.)
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - There is a paucity of data regarding the longer-term
durability of transcatheter heart valves. This analysis aimed to describe
the 5-year clinical outcomes and valve durability for patients treated
with the Portico transcatheter heart valves across 3 studies harmonized in
their prospective enrollment, inclusion/exclusion criteria, centralized
independent core laboratory echocardiographic analysis, and independent
clinical events committee adjudication. <br/>METHOD(S): - Patient-level
data from the PORTICO IDE randomized controlled trial, the PORTICO I
postmarket study, and the PORTICO continued access protocol were pooled
using a random-effects meta-analysis model. All 3 studies collected
follow-up data at discharge, 30 days, and annually through 5 years.
Adverse events and pooled echocardiographic data were assessed using Valve
Academic Research Consortium-2 definitions. Durability definitions were
adapted from Valve Academic Research Consortium-3 and European Association
of Percutaneous Cardiovascular Interventions/European Society of
Cardiology/European Association for Cardio-Thoracic Surgery consensus
guidelines. <br/>RESULT(S): - A total of 1464 patients with severe
symptomatic aortic stenosis and high or extreme surgical risk were
included. Median age was 83 years, 61.7% were women, and the median
Society of Thoracic Surgeons score was 4.9%. At 5 years, all-cause
mortality and stroke rates were 49.4% and 12.3%, respectively.
Transvalvular gradient and effective orifice area at 5 years were 6.2 mm
Hg and 1.83 cm², respectively, with paravalvular leak
>=moderate severity occurring in 1.9%. The 5-year bioprosthetic valve
failure rate was 2.7%, including a 0.7% valve-related death rate and a
2.0% valve reintervention rate, but no patients with severe hemodynamic
structural valve deterioration. Moderate hemodynamic structural valve
deterioration occurred in 0.9% of the patients at 5 years. Hemodynamic
performance and transcatheter heart valve durability remained stable
irrespective of annular size. <br/>CONCLUSION(S): - The use of the Portico
transcatheter heart valve system in patients at high or extreme surgical
risk demonstrated favorable clinical outcomes and hemodynamic performance
with low transvalvular gradients and greater than mild paravalvular leak.
Furthermore, bioprosthetic valve failure rates were low with no incidence
of severe hemodynamic structural valve deterioration at 5 years,
irrespective of annular size. REGISTRATION: - URL:
https://www.clinicaltrials.gov; Unique identifier: NCT02000115 and
NCT01802788.<br/>Copyright &#xa9; 2025

<82>
[Use Link to view the full text]
Accession Number
2042947198
Title
Medical Management and Revascularization for Asymptomatic Carotid
Stenosis.
Source
New England Journal of Medicine. 394(3) (pp 219-231), 2026. Date of
Publication: 15 Jan 2026.
Author
Brott T.G.; Howard G.; Lal B.K.; Voeks J.H.; Turan T.N.; Roubin G.S.;
Lazar R.M.; Brown R.D.; Huston J.; Edwards L.J.; Jones M.; Clark W.M.;
Chamorro A.; Llull L.; Mena-Hurtado C.; Heck D.; Marshall R.S.; Howard
V.J.; Moore W.S.; Barrett K.M.; Demaerschalk B.M.; Sangha N.; Aronow H.;
Foster M.; Sternbergh W.C.; Shawl F.; Lanzino G.; Rapp J.; Tran H.S.;
Ecker R.; Mackey A.; Ali V.; Given C.; Teal P.; Kashyap V.S.; Mukherjee
D.; Harrigan M.; Silverman S.; Koopmann M.; Wadley V.G.; Zhang Y.; Rhodes
J.D.; Chaturvedi S.; Meschia J.F.
Institution
(Brott, Barrett, Meschia) Department of Neurology, Mayo Clinic,
Jacksonville, FL, United States
(Howard, Edwards, Zhang, Rhodes) Department of Biostatistics, University
of Alabama at Birmingham, Birmingham, United States
(Lal) Department of Surgery, University of Maryland, Baltimore, United
States
(Voeks, Turan) Department of Neurology, Medical University of South
Carolina, Charleston, United States
(Roubin) CREST-2 Executive Committee, Jackson, WY, United States
(Lazar) Department of Neurology, University of Alabama at Birmingham,
Birmingham, United States
(Brown) Department of Neurology, Mayo Clinic, Rochester, MN, United States
(Huston) Department of Radiology, Mayo Clinic, Rochester, MN, United
States
(Jones) Department of Cardiology, Baptist Health Lexington, Lexington, KY,
United States
(Clark) Department of Neurology, Oregon Health and Science University,
Portland, United States
(Chamorro, Llull) Department of Neurology, Hospital Clinic Barcelona,
Barcelona, Spain
(Mena-Hurtado) Department of Cardiovascular Medicine, Yale University, New
Haven, CT, United States
(Heck) Department of Radiology, Novant Health, Winston-Salem, NC, United
States
(Marshall) Department of Neurology, Columbia University Irving Medical
Center, New York, United States
(Howard) Department of Epidemiology, University of Alabama at Birmingham,
Birmingham, United States
(Moore) Department of Surgery, University of California, Los Angeles, Los
Angeles, United States
(Demaerschalk) Department of Neurology, Mayo Clinic, Scottsdale, AZ,
United States
(Sangha) Department of Neurology, Kaiser Permanente Los Angeles Medical
Center, Los Angeles, United States
(Aronow) Division of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, United States
(Foster) Department of Interventional Cardiology, Tennova Healthcare
Turkey Creek Medical Center, Knoxville, TN, United States
(Sternbergh) Department of Vascular Surgery, Ochsner Health, New Orleans,
United States
(Shawl) Department of Interventional Cardiology, White Oak Medical Center,
Silver Spring, MD, United States
(Lanzino) Department of Neurosurgery, Mayo Clinic, Rochester, MN, United
States
(Rapp) Department of Surgery, University of California, San Francisco, San
Francisco, United States
(Tran) Department of Vascular Surgery, Deaconess Heart Group, Newburgh,
IN, United States
(Ecker) Department of Neurological Surgery, MaineHealth Neurosurgery and
Spine, Scarborough, ME, United States
(Mackey) Department of Neurology, Centre Hospitalier Universitaire de
Quebec, Universite Laval, Quebec, QC, Canada
(Ali) First Coast Cardiovascular Institute, Jacksonville, FL, United
States
(Given) Department of Neuroradiology, Baptist Health Lexington, Lexington,
KY, United States
(Teal) Department of Neurology, Vancouver General Hospital, Vancouver, BC,
Canada
(Kashyap) Department of Vascular Surgery, Corewell Health, Grand Rapids,
MI, United States
(Mukherjee) Department of Vascular Surgery, Inova Fairfax Hospital, Falls
Church, VA, United States
(Harrigan) Department of Neurosurgery, University of Alabama at
Birmingham, Birmingham, United States
(Silverman) Department of Neurology, Massachusetts General Hospital,
Boston, United States
(Koopmann) Department of Vascular Surgery, Oregon Health and Science
University, Portland, United States
(Wadley) Department of Medicine, University of Alabama at Birmingham,
Birmingham, United States
(Chaturvedi) Department of Neurology, University of Maryland, Baltimore,
United States
Publisher
Massachussetts Medical Society
Abstract
Background Improvements in medical therapy, carotid-artery stenting, and
carotid endarterectomy call into question the preferred management of
asymptomatic carotid stenosis. Whether adding revascularization to
intensive medical management would provide greater benefit than intensive
medical management alone is unclear. Methods We conducted two parallel,
observer-blinded clinical trials that enrolled patients with high-grade
(>=70%) asymptomatic carotid stenosis across 155 centers in five
countries. The stenting trial compared intensive medical management alone
(medical-therapy group) with carotid-artery stenting plus intensive
medical management (stenting group); the endarterectomy trial compared
intensive medical management alone (medical-therapy group) with carotid
endarterectomy plus intensive medical management (endarterectomy group).
The primary outcome was a composite of any stroke or death, assessed from
randomization to 44 days, or ipsilateral ischemic stroke, assessed during
the remaining follow-up period up to 4 years. Results A total of 1245
patients underwent randomization in the stenting trial and 1240 in the
endarterectomy trial. In the stenting trial, the 4-year incidence of
primary-outcome events was 6.0% (95% confidence interval [CI], 3.8 to 8.3)
in the medical-therapy group and 2.8% (95% CI, 1.5 to 4.3) in the stenting
group (P=0.02 for the absolute difference). In the endarterectomy trial,
the 4-year incidence of primary-outcome events was 5.3% (95% CI, 3.3 to
7.4) in the medical-therapy group and 3.7% (95% CI, 2.1 to 5.5) in the
endarterectomy group (P=0.24 for the absolute difference). From day 0 to
44, in the stenting trial, no strokes or deaths occurred in the
medical-therapy group and seven strokes and one death occurred in the
stenting group; in the endarterectomy trial, three strokes occurred in the
medical-therapy group and nine strokes occurred in the endarterectomy
group. Conclusions Among patients with high-grade stenosis without recent
symptoms, the addition of stenting led to a lower risk of a composite of
perioperative stroke or death or ipsilateral stroke within 4 years than
intensive medical management alone. Carotid endarterectomy did not lead to
a significant benefit. (Funded by the National Institute of Neurological
Disorders and Stroke and others; CREST-2 ClinicalTrials.gov number,
NCT02089217).<br/>Copyright &#xa9; 2025 Massachusetts Medical Society.

<83>
[Use Link to view the full text]
Accession Number
2042078624
Title
Left ventricular functional recovery after complex high-risk indicated
percutaneous coronary intervention supported with microaxial flow pump.
Source
Journal of Cardiovascular Medicine. 26(10) (pp 575-581), 2025. Date of
Publication: 01 Oct 2025.
Author
Lombardi M.; Chiabrando J.G.; Ameri P.; Canepa M.; Gonzalo N.; Escaned J.;
Porto I.; Vergallo R.
Institution
(Lombardi, Ameri, Canepa, Porto, Vergallo) Department of Internal Medicine
and Medical Specialties (DIMI), University of Genoa, Genoa, Italy
(Lombardi, Gonzalo, Escaned) Hospital Clinico San Carlos IDISSC and
CIBER-CV, Complutense University of Madrid, Spain
(Chiabrando) UOSD Ospedale Barone Romeo, Patti, Italy
(Ameri, Canepa, Porto, Vergallo) Cardiothoracic and Vascular Department
(DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy
Publisher
Lippincott Williams and Wilkins
Abstract
Background - The potential clinical benefit of complex high-risk indicated
percutaneous coronary intervention (CHIP-PCI) remains uncertain. Temporary
mechanical circulatory support with a microaxial flow pump allows the
performance of protected PCI, potentially reducing peri-procedural
myocardial injury and enabling a more complete myocardial
revascularization. Whether this reflects an improvement in left
ventricular (LV) function after PCI remains uncertain. Methods - We
conducted a systematic literature search in PubMed/MEDLINE, Scopus and
CENTRAL and performed a one-group meta-analysis using pre- and post-PCI LV
ejection fraction (LVEF) data from randomized and observational studies
evaluating microaxial flow pump use in CHIP-PCI. The primary outcome was
the mean difference (MD) in LVEF between follow-up and baseline. Results -
Nine studies involving 2370 patients were included, with a weighted
follow-up period of 154.6 days. Overall, 67.4% of patients had chronic
coronary syndrome as the clinical presentation, with a mean SYNTAX score
of 32.8 and a mean baseline LVEF of 29.5%. CHIP-PCI assisted by a
microaxial flow pump was associated with a significant improvement in LVEF
during follow-up (MD, +6.70%; 95% confidence interval, 4.49 to 8.91, P =
0.0001). Conclusions - Microaxial flow pump-supported CHIP-PCI was
associated with significant LVEF increase at follow-up, suggesting its
potential beneficial role in LV functional recovery after myocardial
revascularization in CHIP patients.<br/>Copyright &#xa9; 2025

<84>
Accession Number
2042867991
Title
Accuracy of a point-of-care CoaguChek test versus standard laboratory
coagulation monitoring in cardiac surgery involving cardiopulmonary
bypass: randomized clinical trial.
Source
Brazilian Journal of Anesthesiology (English Edition). 76(2) (no
pagination), 2026. Article Number: 844714. Date of Publication: 01 Mar
2026.
Author
Mendonca F.T.; Matos S.H.D.; Moreira L.G.; Pereira I.L.; Dino L.L.; Braga
M.B.; Dias G.H.D.S.
Institution
(Mendonca, Matos, Moreira, Pereira, Dino, Braga, Dias) Hospital de Base do
Distrito Federal, Departamento de Anestesiologia, DF, Brasilia, Brazil
Publisher
Elsevier Editora Ltda
Abstract
Background: Intraoperative coagulopathies are common in complex surgeries,
and timely coagulation monitoring is crucial. We assessed the accuracy of
the point-of-care CoaguChek XS test against standard laboratory
measurements in patients undergoing cardiac surgery with Cardiopulmonary
Bypass (CPB). <br/>Method(s): We conducted a single-center, diagnostic
accuracy study to assess the coagulation profile of 50 participants before
and after CPB. The index test was the CoaguChek XS device and the
reference test was the standard laboratory assay. The primary outcome was
the accuracy of the CoaguChek device in measuring the International
Normalized Ratio (INR). We pre-specified a tolerance range of +/- 0.5 INR
units. Secondary outcomes included accuracy in measuring prothrombin time
and prothrombin activity. <br/>Result(s): We included 50 patients
undergoing cardiac surgery with CPB between October 2023 and January 2024.
The mean (standard deviation) age was 59.2 (12.3) years, and 32
participants (64%) were male. For INR values, Lin's coefficient was 0.72
(95% CI: 0.60-0.82) pre-CPB and 0.66 (95% CI: 0.50-0.77) post-CPB, both
indicating good agreement. In the pre-CPB period, on average, the index
test readings exceeded reference readings by 0.045 INR units (95% CI:
0.030-0.059, p < 0.001), while in post-CPB period, index readings were, on
average, 0.064 INR units lower (95% CI: -0.09 to -0.04, p < 0.001).
Although statistically significant differences were observed, they fell
within predefined tolerance range and were considered clinically
irrelevant. Analyses of secondary outcomes were consistent with the
primary outcome findings. <br/>Conclusion(s): In patients undergoing
cardiac surgery with cardiopulmonary bypass, CoaguChek XS provided results
comparable to standard laboratory coagulation monitoring, both pre-and
post-cardiopulmonary bypass. Research Board Approval: Plataforma Brasil
CAAE 70266023.8.0000.5553. Clinical Trials Registration:
(https://clinicaltrials.gov/study/NCT06037720) NCT06037720,
14/09/2023.<br/>Copyright &#xa9; 2025

<85>
Accession Number
2042910521
Title
Pressure Monitoring-Augmented Long-Axis In-Plane Versus Long-Axis In-Plane
Alone for Ultrasound-Guided Radial Artery Catheterization in Elderly
Patients Undergoing Coronary Artery Bypass Grafting: A Randomized
Prospective Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Lu Y.; Yuan Z.; He W.; Song X.; Teng S.
Institution
(Lu, Yuan, He, Song, Teng) Department of Anesthesiology, First Hospital of
Jilin University, Changchun, China
Publisher
W.B. Saunders
Abstract
Objectives: Radial artery catheterization is challenging in patients with
poor vascular conditions, particularly those with severe atherosclerotic
changes. The long-axis in-plane ultrasound technique provides full
visualization and reduces the risk of posterior vessel wall injury;
however, its precision is compromised by slice-thickness artifacts
inherent to ultrasound beam physics. The authors hypothesized that
combining pressure monitoring with ultrasound-guided long-axis in-plane
catheterization would improve first-attempt success by mitigating
ultrasound beam-thickness artifacts. <br/>Design(s): Single-center
prospective randomized controlled study. <br/>Setting(s): Tertiary
academic cardiac hospital. <br/>Participant(s): One hundred eight elderly
patients scheduled for coronary artery bypass grafting were enrolled, with
54 patients allocated to each study group. Nine junior anesthesiologists
performed the procedures after standardized training.
<br/>Intervention(s): Patients were randomly assigned to 2 groups:
pressure monitoring combined with ultrasound-guided long-axis in-plane
catheterization (intervention group) and long-axis in-plane
ultrasound-guided catheterization alone (control group). <br/>Measurements
and Main Results: The primary outcome was the first-attempt success rate;
secondary outcomes included procedural time, overall success rate, number
of attempts, and complication rate. The intervention group showed a higher
first-attempt success rate (74.07% [40 of 54] v 53.70% [29 of 54];
difference, 20.37% [95% confidence interval, 4.2%-36.5%], p = 0.028) and a
shorter median procedural time (48.15 seconds [interquartile range,
40.95-116.73 seconds] v 62.05 seconds [interquartile range, 46.08-165.68
seconds]; p = 0.024). Fewer attempts were needed in the intervention group
(p = 0.039). No significant differences were observed in overall success
rate (90.74% [49 of 54] v 81.48% [44 of 54], p = 0.164) or hematoma rate
(5.56% [3 of 54] v 9.26% [5 of 54], p = 0.462), and arterial thrombosis
did not occur in either group. <br/>Conclusion(s): Pressure monitoring
combined with ultrasound-guided long-axis in-plane catheterization is an
improved technique. In this study, it helped junior operators achieve
higher success rates of radial artery catheterization in elderly patients
undergoing coronary artery bypass grafting compared with the conventional
long-axis in-plane technique.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<86>
Accession Number
2042931324
Title
Proactive Management and Treatment of Aortic Stenosis: An International
Expert Perspective.
Source
Journal of the American College of Cardiology. 87(4) (pp 414-438), 2026.
Date of Publication: 03 Feb 2026.
Author
Cook C.M.; Pibarot P.; Tarantini G.; Genereux P.; Delgado V.; Hayashida
K.; Parma R.; Kaneko T.; Rudolph T.K.; Cavalcante J.L.; Wood D.A.; Bax
J.J.; Pilgrim T.; Saia F.; Vemulapalli S.; Pellikka P.A.; Iung B.; Guibone
K.; Dweck M.R.; Eltchaninoff H.; Ailawadi G.; Lam S.C.-C.; Poon K.;
Unbehaun A.; Schwartz A.; Joner M.; Prendergast B.; Mack M.; Hahn R.T.;
Windecker S.; Leon M.B.; Lindman B.R.
Institution
(Cook) The Essexcardiothoracic Centre, Basildon University Hospital,
Basildon, United Kingdom
(Cook) Anglia Ruskin University, Chlemsford, United Kingdom
(Pibarot) Department of Cardiology, Institut Universitaire de Cardiologie
et de Pneumologie de Quebec Universite Laval/Quebec Heart & Lung Institute
- Laval University, Quebec City, Quebec, Canada
(Tarantini) Department of Cardiac, Thoracic and Vascular and Public
Health, University of Padua, Padua, Italy
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Delgado) Heart Institute, Cardiovascular Imaging Unit, Hospital
University Germans Trias i Pujol, Badalona, Spain and Centre of
Comparative Medicine and Bioimaging, Research Institute Germans Trias i
Pujol, Badalona, Spain
(Hayashida) Department of Cardiology, Keio University School of Medicine,
Tokyo, Japan
(Parma) Department of Cardiology and Structural Heart Diseases, Medical
University of Silesia, Katowice, Poland
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St
Louis, St Louis, MO, United States
(Rudolph) Department of General and Interventional Cardiology/Angiology,
Heart and Diabetes Center Nordrhine Westfalia, Bad Oeynhausen,
Ruhr-University, Bad Oeynhausen, Germany
(Cavalcante) Allina Health Minneapolis Heart Institute, Minneapolis, MN,
United States
(Wood) Dilawri Cardiovascular Institute, University of British Columbia,
Vancouver, BC, Canada
(Bax) Leiden University Medical Center, Leiden, Netherlands
(Pilgrim, Windecker) Department of Cardiology, Bern University Hospital,
Inselspital, University of Bern, Bern, Switzerland
(Saia) Interventional Cardiology Unit, IRCCS University Hospital of
Bologna, Policlinico St Orsola, Bologna, Italy
(Vemulapalli) Duke University School of Medicine, Duke Clinical Research
Institute, Duke-Margolis Institute for Health Policy, Durham, NC, United
States
(Pellikka) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Iung) Bichat Hospital, APHP and INSERM LVTS 1148, Universite Paris Cite,
Paris, France
(Guibone) Beth Israel Deaconess Medical Center, Boston, MA, United States
(Dweck) BHF Centre for Cardiovascular Science, University of Edinburgh,
Edinburgh, United Kingdom
(Eltchaninoff) University of Rouen Normandy, Inserm U1096, CHU Rouen,
Department of Cardiology, Rouen, France
(Ailawadi) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Lam) Division of Cardiology, Department of Medicine, Queen Mary Hospital,
Hong Kong SAR, China
(Poon) University of Queensland, The Prince Charles Hospital, Brisbane,
QLD, Australia
(Unbehaun) Deutsches Herzzentrum der Charite, Department of Cardiothoracic
and Vascular Surgery, Berlin, Germany
(Unbehaun) Charite-Universitatsmedizin Berlin, corporate member of Freie
Universitat Berlin and Humboldt-Universitat zu Berlin, Berlin, Germany
(Schwartz, Hahn, Leon) Columbia University Medical
Center/NewYork-Presbyterian Hospital, New York, NY, United States
(Joner) Department of Cardiology, TUM University Hospital German Heart
Center, Munich, Germany and DZHK (German Center for Cardiovascular
Research), Partner Site Munich Heart Alliance, Munich, Germany
(Prendergast) Cleveland Clinic London and St Thomas' Hospital, London,
United Kingdom
(Mack) Baylor Scott & White Health, Dallas, TX, United States
(Lindman) Structural Heart and Valve Center, Cardiovascular Division,
Vanderbilt University Medical Center, Nashville, TN, United States
Publisher
Elsevier Inc.
Abstract
The 2025 European Society of Cardiology/European Association for
Cardio-Thoracic Surgery guidelines mark a pivotal change, challenging the
paradigm of symptom-driven watchful waiting, and supporting earlier
treatment in many patients with asymptomatic severe aortic stenosis.
Building on this foundation, this international expert perspective
advocates a comprehensive, proactive management strategy and offers
clinicians a contemporary operational framework for managing severe aortic
stenosis. Key evidence-based elements include early referral to the
multidisciplinary Heart Valve Team, streamlined evaluation, upstream
testing, prompt aortic valve replacement in many asymptomatic patients,
more urgent treatment for symptomatic patients, and structured
surveillance involving close working relationships between the referring
clinician and Heart Valve Team when intervention is deferred. This
proactive evidence-based model aims to improve timeliness, efficiency, and
equity of care, thereby reducing preventable morbidity and mortality and
improving long-term outcomes.<br/>Copyright &#xa9; 2026 American College
of Cardiology Foundation

<87>
Accession Number
649909486
Title
Impact of Public Debate on Health Technology Assessment Based Decisions:
Brazilian Case of Left Atrial Appendage Closure in the Supplementary
Health Sector.
Source
International Journal of Technology Assessment in Health Care. Conference:
HTAi 2025 Annual Meeting. Buenos Aires Argentina. 41(Supplement 1) (pp
S73), 2025. Date of Publication: 01 Dec 2025.
Author
Antonio M.; Tortele H.; Pereira A.; Conto M.
Publisher
Cambridge University Press
Abstract
Introduction Atrial fibrillation (AF) has a high economic burden for the
healthcare system. Due to the emboligenic profile of AF, stroke prevention
with oral anticoagulants (OAC) is usually recommended. For patients with
AF at risk of bleeding who are contraindicated for OAC,
non-pharmacological thromboembolism prevention therapies such as left
atrial appendage closure (LAAC) is recommended. We aimed to incorporate
the LAAC procedure into the Brazilian Supplementary Health Sector (SHS).
Methods A scientific technical opinion (STO) including a literature review
and economic and budget impact analysis was submitted to the National
Supplementary Health Agency (ANS). The STO was technically evaluated and a
health technology assessment based ANS decision rite was followed. The
rite was composed of an applicant defense meeting, publication of an ANS
critical report, a preliminary decision, public consultation, a public
hearing, presentation of the public consultation results, and a final
decision. Applicants could participate in the defense meeting and all
stages of public participation. Results Arguing insufficient randomized
controlled trials specifically addressing the OAC-contraindicated AF
population and some concerns regarding the economic modeling, ANS
preliminary decision was unfavorable to the incorporation. The ANS full
critical report was published and received extensive responses from the
applicants in the public consultation, which received 919 contributions.
The main points addressed during public debates, including the public
hearing were the ethical implications of allocating OAC-contraindicated
patients to an OAC treatment arm; the lack of treatment available for this
population in the Brazilian SHS; the importance of real-world evidence;
the impact of stroke on patients, families, and society; and
clarifications on the economic model. After considering all the
contributions, the ANS reversed its verdict. Conclusions The LAAC
procedure has been available in the Brazilian SHS since 1 July 2024. The
ANS' final favorable decision was only possible thanks to the broad space
for public debate made available during the ANS decision rite, added to
extensive popular engagement throughout the process.

<88>
Accession Number
649910191
Title
Hospital-Based Health Technology Assessment: Evaluating Skirted Aortic
Valves for Transcatheter Aortic Valve Implantation.
Source
International Journal of Technology Assessment in Health Care. Conference:
HTAi 2025 Annual Meeting. Buenos Aires Argentina. 41(Supplement 1) (pp
S43), 2025. Date of Publication: 01 Dec 2025.
Author
Filiniuk O.; Kostiuk I.; Lyaskovskyi T.; Nikulina V.; Hryshchenko V.;
Ditkivskyi I.; Voloshyn D.; Yakovets V.; Babenko M.; Kosyachenko K.; Sucu
R.; Sampietro-Colom L.
Publisher
Cambridge University Press
Abstract
Introduction Aortic valves for transcatheter aortic valve implantation
(TAVI) vary in design. Traditional models without a skirt, used at the
Amosov National Institute of Cardiovascular Surgery, have notable
disadvantages. This study conducted a hospital-based health technology
assessment (HB-HTA) to evaluate the feasibility of implementing skirted
aortic valves to optimize resource utilization within the facility.
Methods The Amosov National Institute of Cardiovascular Surgery of the
National Academy of Medical Sciences of Ukraine (the Institute) conducted
this project as part of a national pilot to introduce health technology
assessment (HTA) in hospitals. The institute formed a multidisciplinary
team of specialists with clearly defined roles and responsibilities. The
team relied on Ukrainian methodological guidelines for implementing HTA in
hospitals that were approved in 2023 and were derived from recommendations
from Adopting Hospital-Based Health Technology Assessment (AdHopHTA) and
the Danish Centre for Evaluation and Health Technology Assessment. Results
The analysis of clinical effectiveness and safety showed that aortic
valves with a skirt have advantages over those without a skirt for aortic
valve replacement in patients with aortic stenosis. A systematic review of
literature from PubMed and the Cochrane Library found reduced rates of
paravalvular leakage (10 to 20%) and complications with skirted valves,
minimizing the need for corrective interventions and further monitoring.
Budget impact analysis revealed that using skirted valves reduced cost
overruns and optimized resource use. Transitioning to this model required
no structural changes and offered significant strategic and economic
benefits. Conclusions Considering the clinical efficacy, safety, and
economic feasibility of aortic valves with a skirt, their introduction
into the Institute's practice is highly justified. These valves offer the
potential to enhance long-term treatment outcomes, reduce the incidence of
complications such as paravalvular leakage, and optimize resource
utilization. This implementation represents a strategic step toward
improving patient care and healthcare efficiency.

<89>
Accession Number
2042515087
Title
Comparative efficacy of chest wall fascial plane blocks for cardiac
surgery via median sternotomy: a network meta-analysis.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 25. Date
of Publication: 01 Dec 2026.
Author
Bu Y.; Savir S.; Saeed S.; Sharkey A.; Robitaille M.; Mahmood F.; Matyal
R.; Khabbaz K.
Institution
(Bu, Savir, Saeed, Sharkey, Robitaille, Mahmood, Matyal) Department of
Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical
Center, Harvard Medical School, Boston, MA, United States
(Khabbaz) Department of Cardiac Surgery, Beth Israel Deaconess Medical
Center, Harvard Medical School, 1 Deaconess Rd, West Campus, Boston, MA,
United States
Publisher
BioMed Central Ltd
Abstract
Background: To quantitatively evaluate and compare the relative efficacy
of different chest wall fascial plane blocks in cardiac surgery via median
sternotomy. <br/>Method(s): This study was conducted according to the
Preferred Reporting Items for Systematic Review and Meta-Analyses for
Network Meta-Analyses (PRISMA-NMA) utilizing a frequentist network
meta-analysis (NMA) method. Conclusions were drawn using a minimally
contextualized framework of the GRADE (Grading of Recommendations
Assessment, Development and Evaluation) approach. <br/>Result(s):
Twenty-four randomized controlled trials were retrieved from four
databases. A total of 1366 adult patients were included, of whom 789
(57.8%) received one of five chest wall fascial plane block modalities.
The primary outcome was 24-hour postoperative opioid consumption
(converted as intravenous morphine in mg, n = 1159). With moderate
confidence, erector spinae plane block (ESPB) plus patient-controlled
analgesia (PCA) was more efficacious in reducing 24-hour postoperative
intravenous morphine than PCA alone (Rank based on SUCRA = 1). Secondary
outcomes included postoperative mechanical ventilation time and pain
assessment scores (0, 12, and 24 h after extubation) with 1186, 664, 1054,
and 958 patients analyzed, respectively. Network meta-regression results
across primary or secondary outcomes suggested that local anesthetic type
and volume, injection timing, and a continuous block feature may
contribute to the relative efficacy of chest wall fascial plane blocks.
<br/>Conclusion(s): ESPB plus PCA was found to be more efficacious in
decreasing postoperative opioid requirements for adults undergoing cardiac
surgery via median sternotomy, with moderate confidence in the current
evidence. Modifying the current fascial plane block protocols may be the
direction of future clinical studies. Trial registration: PROSPERO
identifier CRD42022345047.<br/>Copyright &#xa9; The Author(s) 2025.

<90>
Accession Number
2042494002
Title
A pilot trial of long-distance shipped, extended- and cold-stored
platelets in 100% plasma for cardiothoracic surgical bleeding.
Source
Transfusion. (no pagination), 2026. Date of Publication: 2026.
Author
Stolla M.; Bailey S.L.; Chauhan A.; Byrne D.A.; Ting L.; Klotz P.; Pulido
J.N.; Lehr E.J.; Youssef S.; Lawrence J.; Limanek A.; Alcorn K.; Ryan P.;
Stout D.M.
Institution
(Stolla, Bailey, Chauhan, Byrne, Klotz) Bloodworks Northwest Research
Institute, Seattle, WA, United States
(Stolla, Alcorn) Bloodworks Northwest, Medical Services Division, Seattle,
WA, United States
(Stolla) Department of Medicine, Division of Hematology and Oncology,
University of Washington, Seattle, WA, United States
(Stolla) Department of Laboratory Medicine and Pathology, University of
Washington, Seattle, WA, United States
(Stolla) Clinical Research Division, Fred Hutch Cancer Institute, Seattle,
WA, United States
(Ting, Lawrence, Limanek) Stasys Medical Corporation, Seattle, WA, United
States
(Pulido, Stout) Department of Critical Care, Division of Cardiac
Anesthesiology, US Anesthesia Partners, Swedish Medical Center, Cherry
Hill Campus, Seattle, WA, United States
(Lehr, Youssef, Ryan) Swedish Medical Center, Swedish Cardiac Surgery,
Seattle, WA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: In this pilot trial, we tested the feasibility of conducting a
randomized controlled trial in cardiac surgery patients using extended-,
100% plasma-, cold-stored, and long-distance-shipped platelets (CSPs).
Study Design and Methods: We conducted a single center, controlled,
double-blind pilot study in adult patients undergoing elective redo or
complex cardiothoracic surgery. Patients were allocated in a week-based
block randomization scheme to receive either room temperature-stored
platelets (RTPs) or CSPs shipped from a Texas-based blood center and
stored between 10 and 14 days. The primary outcome was defined as the
feasibility of recruitment and accrual. Several other secondary endpoints
were assessed. All platelet units were screened for aggregates using RTP
release criteria. <br/>Result(s): In a post-hoc "as treated" analysis, 15
patients received RTPs, and 9 received CSPs (including 3 who received
both). We found that most CSPs (58%) were not usable for transfusion due
to the presence of aggregates. This resulted in an excess of subjects
receiving RTPs; consequently, the final nine transfused participants were
allocated to receive CSPs without randomization. We accrued 0.7 evaluable
subjects/month of active enrollment, which was below our desired primary
outcome feasibility target of >=1.2. One death within 28 days occurred in
the RTP transfusion group, while none occurred in the CSPs group. In vitro
testing yielded contradictory results. <br/>Conclusion(s): Due to slow
recruitment and the abundance of aggregates in CSPs, this pilot trial does
not support the feasibility of the study protocol.<br/>Copyright &#xa9;
2026 AABB.

<91>
Accession Number
649916423
Title
Cognitive Outcomes in Randomized Controlled Trials of Coronary Artery
Bypass Graft Surgery From 2005 to 2025: A Systematic Review.
Source
Journal of the American Heart Association. (pp e041946), 2026. Date of
Publication: 14 Jan 2026.
Author
Srivatsa S.; Sujanthan S.; Paleczny S.; Ripsman D.A.; de Rivera S.N.;
Dimagli A.; Taghdiri F.; Cheng P.-S.; Lou W.; Farkouh M.E.; Fremes S.E.;
Gaudino M.F.; Rabin J.; Razzouk L.; Owen A.M.; Creber R.M.; Swartz R.H.
Institution
(Srivatsa) Department of Medicine University of North Carolina School of
Medicine Chapel Hill North Carolina USA
(Sujanthan, Rabin, Swartz) Department of Medicine (Neurology) Hurvitz
Brain Sciences Program, Sunnybrook HSC, Institute of Medical Sciences,
University of Toronto Toronto Ontario Canada, Canada
(Paleczny) Department of Neuroscience Schulich School of Medicine and
Dentistry, Western University London Ontario Canada
(Ripsman) Department of Medicine (Neurology) University of British
Columbia Vancouver British Columbia Canada, Canada
(de Rivera, Creber) Columbia University School of Nursing, Columbia
University Irving Medical Center New York NY USA
(Dimagli) Department of Surgery Columbia University Irving Medical Center
New York NY USA
(Taghdiri) Division of Neurology, Department of medicine University of
Toronto Toronto Ontario Canada, Canada
(Cheng) Biostatistics Division Dalla Lana School of Public Health,
University of Toronto Toronto Ontario Canada, Canada
(Lou) Dalla Lana School of Public Health University of Toronto Toronto
Ontario Canada, Canada
(Farkouh) Academic Affairs, Cedars-Sinai Health System Los Angeles CA USA
(Fremes) Division of Cardiac Surgery, Schulich Heart Centre, Sunnybrook
HSC, Department of Surgery Institute of Medical Sciences, Institute of
Health Policy Management and Evaluation, University of Toronto Toronto
Ontario Canada, Canada
(Gaudino) Department of Cardio-thoracic Surgery Cornell Medicine New York
NY USA
(Rabin) Harquail Centre for Neuromodulation, Sunnybrook Research Institute
Toronto ON M4N 3M5 Canada, Canada
(Razzouk) Department of Interventional Cardiology, Leon H. Charney
Division of Cardiology New York University Grossman School of Medicine New
York NY USA
(Owen) Department of Physiology and Pharmacology and Department of
Psychology Western University London Ontario Canada
Abstract
BACKGROUND: Cognitive decline after coronary artery bypass graft (CABG) is
common and affects morbidity, mortality, and quality of life. We
systematically reviewed randomized CABG trial control arms to characterize
cognitive assessments, testing frequency, attrition, and ability to detect
perioperative change. <br/>METHOD(S): We searched MEDLINE, Embase,
Cochrane Library, and PsycINFO for randomized controlled trials of CABG
surgery that included at least one arm of patients solely undergoing CABG
and that reported at least one objective cognitive assessment, from
January 2005 to February 2025. Trials with mixed cardiac surgery or only
subjective measures were excluded. We summarized task frequency, cognitive
domains, and attrition. For tasks assessed preoperatively and
postoperatively in >=3 trials, we reported control group means and SDs.
Risk of bias was assessed using the Cochrane Risk of Bias tool among 6
bias domains. This study was supported by NIH-R01NS123639. <br/>RESULT(S):
Of 3494 screened studies, 2284 were CABG trials, and only 71 (3.1%)
reported cognitive evaluation. These involved 15 925 patients (79% men;
mean age, 64.2 years; median follow-up, 90 days) and used 145 unique
cognitive tasks, with the Trail Making Test Part B (40 of 71; 56.3%) and
Part A (38 of 71; 53.5%) being the most frequently administered. Among 7
tasks with sufficient data, none detected preoperative to postoperative
changes. Attrition rates averaged 18.9%, with a broad range of 0 to 62%.
<br/>CONCLUSION(S): Cognitive assessment is uncommon in CABG trials, and
commonly used tests rarely detect change. Heterogeneity precluded
meta-analysis, and high attrition raises concerns about selection and
survivorship bias. To evaluate cognitive impact after CABG, trials need
standardized, sensitive assessment strategies resilient to attrition and
feasible for broad deployment.

<92>
Accession Number
2042517224
Title
Is the superior septal approach a safe alternative to conventional left
atriotomy for mitral valve surgery? Evidence from a systematic review and
meta-analysis.
Source
BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number:
29. Date of Publication: 01 Dec 2026.
Author
Maali A.; Hausmann H.; Flieger R.; Moawad M.H.E.D.; Ismail M.; Elettreby
A.M.; Abdul-Hafez H.A.; Bisht O.
Institution
(Maali, Hausmann, Flieger, Ismail, Bisht) Evangelisches Herzzentrum
Coswig, Lerchefeld 1, Coswig, Germany
(Moawad) Alexandria Main University Hospital, Alexandria, Egypt
(Moawad) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Elettreby) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health
Sciences, An-Najah National University, Nablus, Palestine
Publisher
BioMed Central Ltd
Abstract
Background: The superior septal approach (SSA) was developed to improve
mitral valve exposure during surgery, particularly in patients with
complex anatomy. However, concerns regarding prolonged operative times and
rhythm disturbances have limited its widespread adoption. This systematic
review and meta-analysis aimed to compare SSA with conventional left
atriotomy (CLA) in terms of perioperative outcomes, complications, rhythm
disturbances, and mortality. <br/>Method(s): A systematic search of
PubMed, Scopus, and Web of Science was performed up to August 2025
according to PRISMA guidelines. Outcomes assessed included postoperative
cardiac rhythm outcomes (primary outcomes), perioperative metrics
(secondary outcomes) -including pacemaker implantation, cardiopulmonary
bypass (CPB) and cross-clamp times, intensive care unit (ICU) stay, and
hospital stay, and complications (safety outcomes). Pooled risk ratios
(RR) and mean differences (MD) with 95% confidence intervals (CI) were
calculated using a random-effects model. <br/>Result(s): A total of 12
cohort studies were included. Postoperative sinus rhythm (RR = 0.86, 95%
CI 0.71-1.04) and atrial fibrillation (AF) (RR = 1.12, 95% CI 0.83-1.49)
did not differ between SSA and CLA; junctional rhythm and complete
atrioventricular block (AVB) were also comparable. Within-group (pre-post)
analyses showed sinus rhythm increased after both techniques, more with
SSA (RR = 1.36) than CLA (RR = 1.20), while AF changes were
non-significant. Meta-regression indicated more recent publication year
and higher repair (vs. replacement) proportion were associated with
greater sinus rhythm benefit favoring SSA. Secondary outcomes were similar
overall; pacemaker implantation was borderline higher after SSA and became
significant in sensitivity analysis. Safety endpoints were also comparable
between approaches. <br/>Conclusion(s): The SSA provides equivalent
perioperative efficiency and clinical safety compared with CLA in mitral
valve surgery. Concerns about rhythm disturbances and operative burden are
not supported by pooled evidence, suggesting that SSA remains a safe and
valuable option, particularly in cases requiring enhanced exposure.
Further high-quality prospective studies are warranted to define long-term
outcomes and refine patient selection.<br/>Copyright &#xa9; The Author(s)
2025.

<93>
Accession Number
2042493009
Title
Extremity Function After Transfemoral Transcatheter Aortic Valve
Implantation: A TAVI XS Sub-Study.
Source
Catheterization and Cardiovascular Interventions. (no pagination), 2026.
Date of Publication: 2026.
Author
Versteeg G.A.A.; Rooijakkers M.J.P.; Hemelrijk K.I.; Vlaar P.J.; Overduin
D.C.; van Wely M.H.; Aarts H.M.; van Ginkel D.-J.; Stens N.A.; van Nunen
L.X.; van Geuns R.J.; van Garsse L.A.F.M.; Geuzebroek G.S.C.; Verkroost
M.W.A.; Cetinyurek-Yavuz A.; Heijmen R.H.; Thijssen D.H.J.; ten Berg J.M.;
Tonino P.A.L.; Delewi R.; van Royen N.
Institution
(Versteeg, Rooijakkers, van Wely, Stens, van Nunen, van Geuns, van Royen)
Department of Cardiology, Radboud University Medical Center, Nijmegen,
Netherlands
(Hemelrijk, Aarts, Delewi) Department of Cardiology, Amsterdam UMC,
Amsterdam, Netherlands
(Vlaar, Tonino) Department of Cardiology, Catharina Hospital, Eindhoven,
Netherlands
(Overduin, van Ginkel, ten Berg) Department of Cardiology, St. Antonius
Hospital, Nieuwegein, Netherlands
(Stens, Thijssen) Department of Medical Biosciences, Radboud University
Medical Center, Nijmegen, Netherlands
(van Garsse, Geuzebroek, Verkroost, Heijmen) Department of Cardiothoracic
Surgery, Radboud University Medical Center, Nijmegen, Netherlands
(Cetinyurek-Yavuz) Department of IQ Health, Section Biostatistics, Radboud
University Medical Center, Nijmegen, Netherlands
(Thijssen) Liverpool Centre for Cardiovascular Science, Liverpool John
Moores University and Liverpool Heart & Chest Hospital, University of
Liverpool, Liverpool, United Kingdom
(ten Berg) Cardiovascular Research Institute Maastricht (CARIM),
Maastricht, Netherlands
Publisher
John Wiley and Sons Inc
Abstract
Background: Physical decline after transcatheter aortic valve implantation
(TAVI) is associated with worse outcomes. However, data on post-TAVI
extremity function are limited. This sub-study of the TAVI XS trial aimed
to assess extremity function after transfemoral TAVI, evaluate functional
decline, compare outcomes between upper-and lower-extremity secondary
access approaches and identify predictors of functional decline after
TAVI. <br/>Method(s): The TAVI XS was a randomized clinical trial
comparing upper- and lower-extremity secondary access during TAVI.
Patients were assessed for extremity function at baseline and at 30 days
using the Lower Extremity Function Scale (higher score indicating better
function) and the Quick Disabilities of the Arm, Shoulder, and Hand
questionnaire (higher score indicating worse function). <br/>Result(s):
Lower-extremity (45.0 [IQR 35.0-57.0] to 52.0 [39.0-63.0]; p < 0.001), and
upper-extremity function (11.4 [2.3-25.0] to 6.8 [0-22.7]; p = 0.003)
improved after TAVI. Relevant decline in lower-extremity function occurred
in 20 (8.4%) patients, and in upper-extremity function in 19 (8.0%)
patients. No differences in post-TAVI function were observed between
upper- or lower-extremity secondary access (lower-extremity: 10.1% vs.
6.7%; p = 0.35, upper-extremity: 7.6% vs. 8.4%; p = 0.81). Predictors (OR
[95% CI]) of clinically relevant decline were baseline use of dual
antiplatelet therapy/oral anticoagulants (4.17 [1.39-12.49]; p = 0.01) for
lower-extremity function and multiple punctures (4.05 [1.46-11.24]; p =
0.007) for upper-extremity function. Age inversely affected lower- (0.92
[0.85-0.99/year]; p = 0.02) and upper-extremity function (0.93
[0.86-0.99/year]; p = 0.04). <br/>Conclusion(s): The incidence of
clinically relevant decline in extremity function after TAVI is low. No
differences in reported extremity function were observed between the
upper- and lower-extremity secondary access approach. Predictors of
decline were antithrombotic therapy and multiple punctures. Trial
Registration: ClinicalTrials.gov identifier: NCT05672823.<br/>Copyright
&#xa9; 2026 The Author(s). Catheterization and Cardiovascular
Interventions published by Wiley Periodicals LLC.

<94>
Accession Number
2042483106
Title
Aortic Valve Replacement for Severe Asymptomatic Aortic Stenosis-A
Systemic Review and Bayesian Meta-analysis.
Source
Canadian Journal of Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Brophy J.M.
Institution
(Brophy) Research Institute of McGill University Health Centre, Centre for
Health Outcomes Research, Montreal, QC, Canada
Publisher
Elsevier Inc.
Abstract
Background Previous meta-analyses have concluded that early aortic valve
replacement (AVR) is associated with reduced cardiovascular events
compared to clinical surveillance (CS) for severe asymptomatic aortic
stenosis (AS). However, individual patient data (IPD) was not used and the
possibility of biases not considered. Methods A systematic review of
randomized clinical trials (RCTs) whose primary outcome was mortality and
unplanned cardiac hospitalization. IPD data was reconstructed, permitting
calculation of time varying risks. Bayesian analyses, with vague priors,
were performed for each trial and combined in a meta-analysis. Results
Four RCTs were identified. The pooled average long-term primary outcome
was hazard ratio (HR) 0.52 (95% credible interval (CrI) 0.25 - 0.93) and
the predicted HR for the next study was HR 0.52 (95% CrI 0.13 - 1.87) with
increased uncertainty from between study heterogeneity. Only the
EARLY_TAVR trial showed improved outcomes in year one (HR 0.33, 95% CrI
0.24 - 0.46), driven by a 142% increase in the crossover rate compared to
previous trials. A one-year landmark analysis, that eliminates possible
early unblinding bias, showed no long term AVR benefit for any individual
study or for the pooled result (RR 0.59, 95% CI 0.20 - 1.40). Conclusions
One-year landmark analysis showed no definitive longer-term benefit for
early AVR compared to CS in asymptomatic AS. The EARLY_TAVR benefit is
possibly the result of performance bias. Further research is required
before early AVR for asymptomatic severe AS can become the new standard of
care.<br/>Copyright &#xa9; 2025 Canadian Cardiovascular Society.

<95>
Accession Number
2041718975
Title
Bilateral renal artery embolism following trauma: A case report and
systematic review.
Source
Medicine (United States). 104(45) (pp e45723), 2025. Date of Publication:
07 Nov 2025.
Author
Tang J.; He L.; Xu Y.-A.; Zhang Q.; Chao S.; Liu Y.
Institution
(Tang, Zhang, Chao) Department of Thyroid and Breast Surgery, Nanxishan
Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
(Tang, Chao) School of Clinical Medicine, Guilin Medical University,
Guilin, China
(He) Department of Emergency Medicine, Nanxishan Hospital of Guangxi
Zhuang Autonomous Region, Guilin, China
(Xu) Department of Emergency Medicine, The Second Affiliated Hospital
Zhejiang University School of Medicine, Hangzhou, China
(Liu) Department of Hospital Office, Guangxi Orthopaedic Hospital,
Nanning, China
Publisher
Lippincott Williams and Wilkins
Abstract
Rationale: - Post-traumatic renal artery embolism (RAE) represents a rare
vascular emergency with diagnostic challenges due to its nonspecific
presentation. This study aims to enhance clinical recognition through a
comprehensive analysis of a bilateral RAE case and contemporary management
strategies. Patient concerns: - A 23-year-old male was admitted to the
Emergency Department of the Second Affiliated Hospital, Zhejiang
University School of Medicine, with acute chest and back pain and
disturbance of consciousness following blunt abdominal trauma. Diagnoses:
- The diagnostic workup included contrast-enhanced computed tomography
angiography and serum biomarkers. <br/>Intervention(s): - Upon admission
to the Emergency Intensive Care Unit, the patient underwent immediate
continuous renal replacement therapy, vasoactive drugs, fluid replacement,
alkalization of urine, and symptomatic treatment. After the patient's
condition improved, the spinal surgery performed thoracic vertebra
reduction and internal fixation surgery. <br/>Outcome(s): - Serial renal
function monitoring demonstrated complete functional recovery. Lessons: -
In the evaluation of post-traumatic abdominal pain, RAE should be
systematically considered in the differential diagnosis following
exclusion of acute surgical abdomen.<br/>Copyright &#xa9; 2025

<96>
Accession Number
649898301
Title
Early and late mortality in paediatric aortic valve replacement: A
systematic review with meta analysis.
Source
Critical Public Health. Conference: 17th Excellence in Pediatrics
Conference. Paris France. 35(Supplement 1) (pp 71-72), 2025. Date of
Publication: 2025.
Author
Siddiqui I.; Patel U.; Butt H.; Farid A.; Lodi A.; Khan H.
Institution
(Siddiqui, Khan) St George's University Hospitals NHS Foundation Trust,
United Kingdom
(Patel) Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation
Trust, United Kingdom
(Butt) Bolton Foundation Trust, United Kingdom
(Farid) South London and Maudsley NHS Foundation Trust, United Kingdom
(Lodi) Horton General Hospital, Oxford University Hospitals Foundation
Trust, United Kingdom
Publisher
Routledge
Abstract
Introduction: Aortic valve replacement (AVR) in paediatric populations is
associated with significant considerations. These include the valve having
to grow alongside the patient, the valve degrading over time, and a
mechanical valve prosthesis requiring long-term anticoagulation. All of
these have significant risks, contributing to a decrease in survival time
and the need for reoperations. Due to this, aortic valve repair can be
seen as an option to mitigate these drawbacks, preserving the native
valve. However, repair is not always feasible; in such cases, replacement
will need to be considered. There are now several options available to
replace a native aortic valve. Traditionally, paediatric AVRis associated
with substantial mortality rates, with the Ross procedure preferred due to
a survival benefit. <br/>Aim(s): Often, the choice of procedure is due to
surgical preference. Transcatheter Aortic Valve Insertion, which has been
well established for several years in adults has now started to be
implemented into paediatric populations. The main aim of this study is to
compare the early and late mortality, and infective endocarditis risk
between different types of studies, to aid clinicians with decision
making. <br/>Methods and Results: The initial phase of the study required
a systematic review of published literature reporting mortality following
paediatric AVR(maximum age <21), published between 1/1/1990 and 1/1/2025.
Publications reporting outcomes after paediatric Ross, bioprosthetic AVR,
homograft AVR, mechanical AVR, and TAVI were included. Due to similarities
in surgical technique, bioprosthetic, homograft and mechanical AVRwere
classed as Surgical AVR. The early (<30 day) and long term (within
follow-up) data for mortality was extracted. In total 13 retrospective
cohort studies were included, from which there were 18 cohorts which were
compared. Out of these 18 cohorts, eight were related to the Ross
procedure, three to Surgical AVRand one to TAVI. The average age between
the procedures varied as well, with the Ross procedure being used across
age groups, with a range of 10.5 years compared to 8.1 of Surgical AVR,
likely because of the propensity for the autograft and homograft to grow
with the patient. The Ross procedure demonstrated an early mortality of
3.46% (CI 95%: 0.88-6.05%), compared to 13.42% (3.80-23.04%) for Surgical
AVRand 0% for the single TAVI cohort. Comparatively, the Ross procedure
also demonstrated a reduced follow-up mortality of 6.93% (2.39-11.48%),
compared to 26.58% (10.80-42.37%) Surgical AVR. The sole TAVI cohort
demonstrated a similar follow-up mortality to that of the Ross procedure,
at 6.25%. <br/>Conclusion(s): Paediatric AVR, regardless of procedure, is
associated with a significant mortality risk; with the choice of procedure
being associated with surgical preference alongside valve selection based
on patient factors. Despite this, the Ross procedure demonstrated a
sustained survival benefit. Alongside this, the emergence of TAVI
procedures demonstrates a promising, less invasive alternative; however,
this is demonstrated in a single cohort, and further research would need
to be done to properly evaluate its long-term use.

<97>
Accession Number
649901119
Title
ACC/AHA vs ESC/EACT Guidelines on valvular heart disease: EJPC Guideline
comparison review.
Source
European journal of preventive cardiology. (no pagination), 2026. Date of
Publication: 12 Jan 2026.
Author
Debski M.; Tsampasian V.; Zacharias J.; Ring L.; Vassiliou V.S.
Institution
(Debski, Tsampasian, Vassiliou) Norwich Medical School, University of East
Anglia, Norwich Research Park, Norwich, United Kingdom
(Debski, Tsampasian, Vassiliou) Department of Cardiology, Norfolk and
Norwich University Hospital, Colney Lane, Norwich, United Kingdom
(Zacharias) Department of Cardiothoracic Surgery, Lancashire Cardiac
Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Whinney Heys
Road, Blackpool, United Kingdom
(Ring) Department of Cardiology, West Suffolk Hospital, Hardwick Lane,
Bury St Edmunds, United Kingdom
Abstract
Valvular heart disease poses persistent challenges for clinical
decision-making, and international guidelines provide essential frameworks
for its management. The American College of Cardiology/American Heart
Association last issued a full update in 2020 and an expert consensus on
tricuspid regurgitation in 2025. The European Society of
Cardiology/European Association for Cardio-Thoracic Surgery released their
updated guidelines in 2025. Although there is broad alignment in
principles of intervention, prosthesis choice, and the role of Heart
Teams, the European document incorporates substantial new trial evidence.
Key areas of divergence include thresholds for earlier intervention in
aortic stenosis and regurgitation, expanded recommendations for
transcatheter edge-to-edge repair and mitral replacement, formal
integration of tricuspid repair and transcatheter therapies, evolving
strategies for coronary assessment in transcatheter aortic valve
implantation, and sex-specific considerations. This review highlights
consistencies, discrepancies, and priorities for future
research.<br/>Copyright &#xa9; The Author(s) 2026. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<98>
Accession Number
649914156
Title
Wide variability in studies reporting on digital education interventions
for patients undergoing cardiac procedures: A patient-commissioned mixed
methods systematic review.
Source
Heart & lung : the journal of critical care. 78 (pp 102702), 2026. Date of
Publication: 12 Jan 2026.
Author
Wells R.; Boulos L.; Gray M.; Keeping S.E.; Devereaux E.J.; Brauer-Chapin
T.; Hariharan A.; Fera G.; DeCoste K.; Hickey M.; Johnson C.; Rubenstein
D.; Hirsch G.M.; Gainer R.; Curran J.A.
Institution
(Wells, Rubenstein) Patient Partner, Patient Advisors Network, 43 Dorval
Road, Toronto, ON, Canada
(Boulos, Hariharan) Strengthening Transitions in Care Lab, IWK Health,
5850/5980 University Avenue, Halifax, NS, Canada
(Gray, Devereaux, Fera, DeCoste) Faculty of Health, Dalhousie University,
5869 University Avenue ,P.O. Box 15000, Halifax, NS, Canada
(Keeping, Curran) Strengthening Transitions in Care Lab, IWK Health,
5850/5980 University Avenue, Halifax, Nova Scotia, Canada, B3K 6R8; School
of Nursing, Dalhousie University, 5869 University Avenue, P.O. Box 15000,
Halifax, Nova Scotia, Canada, B3H 4R2
(Brauer-Chapin, Hirsch, Gainer) Division of Cardiac Surgery & Research and
Innovation, Periop/Surgical Services, Nova Scotia Health, 1796 Summer St,
Halifax, NS, Canada
(Hickey) Implementation Science Team, Nova Scotia Health, 90 Lovett Lake
Court, Halifax, NS, Canada
(Johnson) Strengthening Transitions in Care Lab, IWK Health, 5850/5980
University Avenue, Halifax, Nova Scotia, Canada, B3K 6R8; School of
Communication Sciences and Disorders, Dalhousie University, 5869
University Avenue, P.O. Box 15000, Halifax, Nova Scotia, Canada, B3H 4R2
Abstract
BACKGROUND: Although cardiac rehabilitation is widely acknowledged as the
gold standard for improved outcomes in cardiac procedures, it remains
underutilized. Digital education tools have the potential to improve
access and adherence to cardiac rehabilitation. <br/>OBJECTIVE(S): The
primary objective of this review is to determine the impact of digital
education interventions for patients undergoing cardiac procedures on
patient-level and health system-level outcomes. <br/>METHOD(S):
Conceptualized by a patient partner, a mixed methods systematic review was
conducted using JBI methodology. MEDLINE, Embase, CINAHL, and Scopus were
searched. Studies were included if they reported on a digital education
intervention for adult patients preparing for or recovering from cardiac
procedures, and if they reported primary outcomes related to healthcare
utilization, learning/knowledge, and/or patient-level health.
Interventions were mapped onto the WHO taxonomy of Digital Health
Interventions for Persons. <br/>RESULT(S): 41 studies were included, and
most reported a positive effect across several outcome categories:
knowledge; behavior, attitude, and self-efficacy; physiological;
healthcare utilization; mental health; quality of life; physical function
and activity; and other. Considerable variation in outcomes, measurement
instruments, and intervention characteristics hindered meta-analysis and
made it challenging to draw broad conclusions. <br/>CONCLUSION(S):
Overall, interventions included in this review resulted in a positive
effect on a wide range of outcomes. However, most studies did not report
the use of an educational theory or underlying framework, leading to wide
variability in intervention design and implementation. Future developers
should consider using an educational framework to design and evaluate
digital interventions. Additionally, engaging patients and knowledge users
as co-designers could increase relevance, acceptability, and
uptake.<br/>Crown Copyright &#xa9; 2025. Published by Elsevier Inc. All
rights reserved.

<99>
Accession Number
2042911453
Title
The Preventive Role of Posterior Pericardial Window in the Complications
Following Coronary Artery Bypass Grafting.
Source
Journal of Cardiovascular Disease Research. 11(10) (pp 264-272), 2020.
Date of Publication: 2020.
Author
Amin S.; Mahmoud G.M.; Omar I.
Institution
(Amin) Cardiothoracic Surgery Department, Faculty of Medicine, Cairo
University, Cairo, Egypt
(Mahmoud, Omar) Cardiothoracic Surgery Department, Faculty of Medicine,
Beni-Suef University, Beni-Suef, Egypt
Publisher
EManuscript Technologies
Abstract
Background: Open-heart surgeries are considered complex procedures because
of their high potential risks and postoperative complications. The
complications of coronary artery bypass grafting (CABG) surgery remain a
burden resulting in morbidity, mortality, and decreased quality of life
(QoL). <br/>Objective(s): This research objected to assessing the
preventive role of posterior pericardial window (PPW) in the complications
following CABG. <br/>Method(s): This prospective randomized
case-controlled clinical research involved 100 patients who underwent
CABG. Patients were equally distributed into two groups: Group A (n=50):
in which a PPW was performed and Group B (n=50): the control group in
which the pericardium was not opened. Postoperative complications as
atrial fibrillation (AF), pericardial and pleural effusion, tamponade, and
total drainage volume were recorded. <br/>Result(s): The total drainage
during the 1^st 24 h and the onset of postoperative atrial
fibrillation (POAF) were significantly greater in group B compared to
group A (P value <0.001 and 0.028 respectively). Although tamponade,
re-exploration, early pericardial effusion (PE), and bibasilar atelectasis
were higher in group B than group A, the difference was not significant.
The ICU and hospital stay duration was significantly prolonged in group B
than group A (P value <0.001). <br/>Conclusion(s): The PPW procedure is
simple, easy to perform and reduces the incidence of serious complications
following CABG with economic efficiency concerning reducing the hospital
stay duration.<br/>Copyright &#xa9; 2020 EManuscript Technologies. All
rights reserved.

<100>
Accession Number
2042855880
Title
Multicentre Study of Diaphragm Pacing in High-Risk Cardiac Surgery to
Decrease Postoperative Mechanical Ventilation.
Source
European Journal of Cardio-thoracic Surgery. 68(1) (no pagination), 2026.
Article Number: ezaf472. Date of Publication: 01 Jan 2026.
Author
David C.-H.; Vourc'h M.; Guimbretiere G.; Mugniot A.; Lacoste P.; Cadiet
J.; Rozec B.; Arora R.; Pelletier M.; Sabik J.; Onders R.
Institution
(David, Guimbretiere, Mugniot, Lacoste) Nantes Universite, CHU Nantes,
Service de Chirurgie Thoracique et Cardiovasculaire, l'Institut du thorax,
Nantes, France
(Vourc'h, Cadiet, Rozec) Nantes Universite, CHU Nantes, Service
d'Anesthesie-Reanimation, Hopital Laennec, Nantes, France
(Arora, Sabik, Onders) Department of Surgery, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
(Pelletier) Division of Cardiac Surgery, Heart and Vascular Center, Yale
New Haven Hospital, Yale School of Medicine, New Haven, CT, United States
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: Prolonged mechanical ventilation after cardiac surgery occurs
in 15% of patients and significantly increases morbidity and mortality. We
investigated the potential benefits of diaphragm pacing following cardiac
surgeries to decrease ventilator burden. <br/>Method(s): A randomized
controlled pilot study was conducted at 2 centres using diaphragm pacing
in patients undergoing open cardiac surgery by median sternotomy. Enrolled
patients had at least one pre-identified high-risk criterion for requiring
prolonged ventilation. Diaphragm pacing was initiated postoperatively.
<br/>Result(s): Sixty-six patients were randomized into Standard of Care
(34) and Treatment (32) groups. This study provides evidence that
diaphragm pacing may reduce mechanical ventilation time and improve
weaning success prior to 24 hours post-operatively. Treated patients had a
total of 246 hours of mechanical ventilation compared to 670 hours for the
standard of care group. Treatment group patients were more likely to be
successfully weaned at 12 hours post-operatively, 83% compared to 65%,
which represented an 18% absolute and 52% relative risk reduction. For the
subset of 14 Treatment and 19 Standard of Care patients that required
ventilation beyond 6 hours, those receiving diaphragm pacing had a reduced
median time on ventilation: 8.3 hours (95% CI 7.1-12.5) compared to 16.8
hours (95% CI 8.1-23.4). <br/>Conclusion(s): Diaphragm pacing may reduce
the time on mechanical ventilation following cardiac surgery in patients
at risk of prolonged ventilation. These results will inform the design of
a prospective, pivotal, randomized controlled trial to assess the ability
of diaphragm pacing to reduce ventilator burden in high-risk cardiac
surgery patients.<br/>Copyright &#xa9; The Author(s) 2025. Published by
Oxford University Press on behalf of the European Association for
Cardio-Thoracic Surgery. All rights reserved.

<101>
[Use Link to view the full text]
Accession Number
649915175
Title
Impaired endotoxin inactivation, rather than gut translocation, is
associated with organ injury in cardiac surgery with cardiopulmonary
bypass: An ancilliary analysis of a randomised control trial.
Source
European journal of anaesthesiology. (no pagination), 2026. Date of
Publication: 14 Jan 2026.
Author
Nguyen M.; Alvarez M.; Evezard C.; Ibrahima A.; Huette P.; Mahjoub Y.;
Pais-De-Barros J.-P.; Bouhemad B.; Masson D.; Gautier T.; Guinot P.-G.;
Abou-Arab O.
Institution
(Nguyen) From the Department of Anesthesiology and Intensive Care, Dijon
Universite Hospital (MN, CE, BB, PGG), the Universite Bourgogne Europe,
Dijon, France (MN, BB, DM, PPG), the Centre for Translational and
Molecular Medicine (CTM), INSERM UMR1231, Lipness Team, Dijon (MN, MA,
JPPde B, BB, DM, TG, PGG), the Department of Anesthesiology and Intensive
Care, Amiens Universite Hospital (AI, PH, YM, OAA), the Department of
Anesthesiology and Intensive Care, Pauchet sante, Clinique Victor Pauchet,
Amiens (PH), the DiviOmics Facility, UMS 58 BioSanD, Universite de
Bourgogne (JPPdeB), the Laboratory of Clinical Chemistry, Dijon Universite
Hospital, Dijon, France (DM)
Abstract
BACKGROUNDS: In patients with cardiac surgery under cardiopulmonary bypass
(CPB), postoperative inflammation is a driver of adverse outcomes.
Endotoxaemia is one of the factors thought to trigger this inflammatory
response. The mechanism behind high endotoxin activity (increased
translocation vs. reduced inactivation capacity) has never been elucidated
and may imply different therapeutic candidates. <br/>OBJECTIVE(S): We
aimed to evaluate, in patients with cardiac surgery with prolonged CPB,
mechanisms and consequences of endotoxaemia and the efficacy of
haemo-adsorption to reduce the endotoxin burden. DESIGN: Ancillary
analysis of a randomised controlled trial. Patients scheduled for cardiac
surgery with prolonged CPB were assigned to receive either intra-operative
haemo-adsorption or standard of care. Endotoxin mass and activity were
measured before surgery, at the end of CPB, 6, 24 and 48 h after the end
of surgery. SETTING: Operating room, Amiens University Hospital. PATIENTS:
Adults scheduled for cardiac surgery under CPB with an expected CPB time
more than 90 min. INTERVENTION: Patients were randomised to receive either
haemo-adsorption or standard care during CPB. MAIN OUTCOME MEASURES:
Endotoxin activity. <br/>RESULT(S): Two hundred and ninety-five samples
from 66 patients were analysed. Following CPB, we observed a reduction in
endotoxin mass accompanied by a relative increase in endotoxin activity.
High postoperative endotoxin activity was associated with intra-operative
dobutamine requirement, increased postoperative inflammatory biomarkers
and organ injury. Endotoxin plasma concentration and activity were not
lower in patients treated with haemo-adsoprtion. <br/>CONCLUSION(S): The
capacity of individuals to inactivate endotoxin rather than raw endotoxin
mass (i.e. Quantity) seemed to be a determinant of endotoxin noxious
effect in cardiac surgery and CBP. Haemo-adsorption was not associated
with a reduction of endotoxin plasma mass or activity in patients with
cardiac surgery under CPB. TRIAL REGISTRATION: ClinicalTrials.gov,
NCT04201119NCT04201119.<br/>Copyright &#xa9; 2026 European Society of
Anaesthesiology and Intensive Care. Unauthorized reproduction of this
article is prohibited.

<102>
[Use Link to view the full text]
Accession Number
2042429935
Title
Individualized Flow-Controlled versus Pressure-Controlled Ventilation in
Cardiac Surgery: A Randomized Controlled Trial.
Source
Anesthesiology. Publish Ahead of Print (no pagination), 2025. Date of
Publication: 01 Jan 2025.
Author
Becker S.; Kurz C.T.; Schnitzler R.; Geppert J.; Wichelhaus L.-M.; Denz
R.; Poepping J.; Rembecki M.; Berres D.M.; Strauch J.T.; Bates D.G.;
Erdoes G.; Timmesfeld N.; Zahn P.K.
Institution
(Becker, Kurz, Schnitzler, Geppert, Wichelhaus, Poepping, Rembecki, Zahn)
Department of Anesthesiology, Intensive Care and Pain Medicine, BG
University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Kurz) Department of Cardiac Anesthesiology and Intensive Care Medicine,
Deutsches Herzzentrum der Charite, Berlin, Germany
(Denz, Timmesfeld) Department of Medical Informatics, Biometry and
Epidemiology, Ruhr University Bochum, Bochum, Germany
(Berres, Strauch) Department of Cardiothoracic Surgery, BG University
Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany
(Bates) School of Engineering, University of Warwick, Coventry, United
Kingdom
(Erdoes) Department of Anesthesiology and Pain Medicine, Inselspital,
University Hospital Bern, University of Bern, Bern, Switzerland
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Patients undergoing on-pump cardiac surgery are at high risk
for perioperative lung injury and a hyper-inflammatory state associated
with postoperative complications. We investigated the hypothesis that
Flow-Controlled Ventilation (FCV) reduces the inflammatory stimulus
compared to conventional Pressure-Controlled Ventilation (PCV) in this
patient cohort. FCV has the unique feature of controlling airway flows
during inspiration and expiration and the potential to reduce mechanical
power of invasive ventilation. <br/>Method(s): - In this single-center
randomized controlled trial, 140 adult patients undergoing cardiac surgery
with cardiopulmonary bypass were allocated 1:1 to FCV or PCV from Aug 10,
2020, to Nov 16, 2022. Participants received perioperatively either
individualized FCV with a compliance-guided positive end-expiratory
pressure (PEEP) and a compliance-guided driving pressure (DELTAP) or PCV
with a compliance-guided PEEP and DELTAP for tidal volumes of 6-8 ml/kg
predicted body weight. Postoperative plasmatic interleukin 8 (IL-8) levels
six hours after cardiopulmonary bypass were defined as the primary
endpoint. Explorative secondary outcomes included incidences of
postoperative pulmonary and extrapulmonary complications, and hospital
length of stay. <br/>Result(s): - Median postoperative IL-8 levels did not
differ significantly between FCV and PCV (FCV 3.08 vs. PCV 3.60, beta
coefficient 0.08 pg/ml, 95% CI -0.17 to 0.33; P = 0.573). DELTAP values
and tidal volumes were higher in the FCV group, but FCV yielded lower
respiratory rates and minute volumes required for normocapnia. As a
result, the FCV approach reduced the perioperatively applied mechanical
power by 55%. After FCV, incidences of single postoperative pulmonary
complications (e.g. confirmed pneumonia, moderate and severe hypoxemia)
and any postoperative extrapulmonary complication were lower, and the
hospital stay shorter. <br/>Conclusion(s): - FCV did not reduce plasmatic
IL-8 levels at the predefined timepoint six hours after cardiopulmonary
bypass. However, the reduction of mechanical power during individualized
FCV application and the findings of the explorative secondary study
outcomes justify future trials.<br/>Copyright &#xa9; 2025

<103>
Accession Number
2042499510
Title
Fasting Versus Non-fasting Protocols Before Cardiac Catheterization
Procedures: A Meta-analysis of Clinical Trials.
Source
Journal of the Society for Cardiovascular Angiography and Interventions.
(no pagination), 2026. Article Number: 104161. Date of Publication: 2026.
Author
Bhat V.; Kumar A.; Georgy I.; Kalra A.
Institution
(Bhat, Kalra) Division of Cardiology, Department of Medicine, SUNY Upstate
Medical University, Syracuse, NY, United States
(Kumar) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN,
United States
(Georgy) Department of Medicine, University of Minnesota Medical School,
Minneapolis, MN, United States
Publisher
Elsevier B.V.
Abstract
Background Recent trials suggest that liberalizing oral intake prior to
cardiac catheterization procedures improves patient satisfaction and is as
safe as the traditional practice of "nothing by mouth." We aimed to
compare the outcomes of fasting and nonfasting protocols before such
procedures. Methods We searched PubMed and Cochrane Library until May 1,
2025, for clinical trials comparing fasting and nonfasting protocols for a
variety of cardiac catheterization procedures. Outcomes of interest were
all-cause mortality, aspiration, hypoglycemia, hyperglycemia,
nausea/vomiting, contrast-induced nephropathy, and hypotension. Risk
ratios (RR) with 95% CI were calculated using the inverse variance method,
and quality was assessed using the Cochrane Risk of Bias 2.0 tool. Results
We included 9 trials comparing fasting and nonfasting protocols, with a
total sample of 3646 patients. We found no significant differences between
the 2 groups for mortality (RR, 1.36; 95% CI, 0.55-3.36; I ² =
0%, chi² P = .78), aspiration (RR, 2.14; 95% CI, 0.28-16.53; I
² = 0; chi² P = .44), nausea/vomiting (RR, 0%; 95%
CI, 0.62-1.53; I ² = 0%; chi² P = .74), or other
outcomes. Patient satisfaction was greater in the nonfasting group in most
trials, although heterogenous reporting precluded quantitative synthesis.
Eight of the included studies had low risk of bias or some concerns.
Conclusions We found that the nonfasting group had similar risk of
complications as the fasting group, lending support to liberalizing oral
intake prior to these procedures. Our findings provide impetus for
standardized, evidence-based protocols in cardiac
catheterization.<br/>Copyright &#xa9; 2025 The Author(s).

<104>
Accession Number
2042931322
Title
LANDMARK Device or More of the Same?.
Source
Journal of the American College of Cardiology. 87(4) (pp 382-384), 2026.
Date of Publication: 03 Feb 2026.
Author
Waksman R.; Waksman O.; Ha E.T.; Phichaphop A.
Institution
(Waksman, Waksman, Ha, Phichaphop) Section of Interventional Cardiology,
MedStar Washington Hospital Center, Washington, DC, United States
Publisher
Elsevier Inc.

<105>
[Use Link to view the full text]
Accession Number
2042618220
Title
Sodium-Glucose Cotransporter-2 Inhibitors Following Transcatheter Aortic
Valve Replacement: A Meta-Analysis.
Source
Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date
of Publication: 2025.
Author
Jain H.; Soni K.; Jain J.; Goyal A.; Passey S.; Goldsweig A.M.
Institution
(Jain) From the Department of Medicine, All India Institute of Medical
Sciences, Jodhpur, India
(Soni) Department of Internal Medicine, SUNY Upstate Medical University,
Syracuse, NY
(Jain) Department of Internal Medicine, Allegheny General Hospital,
Pittsburgh, PA
(Goyal) Department of Internal Medicine, Cleveland Clinic Foundation,
Cleveland, OH
(Passey) Department of Internal Medicine, University of Connecticut Health
Center, Farmington, CT
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA
Publisher
Lippincott Williams and Wilkins
Abstract
Sodium-glucose cotransporter-2 inhibitors (SGLT2is) reduce heart failure
(HF)-associated admissions; however, the data on patients with aortic
stenosis following transcatheter aortic valve replacement (TAVR) is
limited. This systematic review and meta-analysis compares clinical
outcomes in patients with and without SGLT2i following TAVR. Major
electronic databases were systematically searched through April 2025 for
studies evaluating SGLT2i following TAVR. Risk ratios (RR) with 95%
confidence intervals (CI) were pooled using a random-effects model. A P
value of <=0.05 was considered statistically significant. Two studies with
1534 patients undergoing TAVR (679: SGLT2i; 855: no SGLT2i) were included.
SGLT2i therapy led to a significant reduction in HF hospitalization (RR:
0.56; 95% CI: 0.32-0.99; P = 0.05); however, no differences in all-cause
(RR: 0.48; 95% CI: 0.13-1.72; P = 0.26) and cardiovascular mortality (RR:
0.53; 95% CI: 0.19-1.48; P = 0.22) were noted. SGLT2i are associated with
a statistically and clinically significant reduction in HF
hospitalization; however, no reduction in mortality was observed following
TAVR. Further randomized controlled trials are warranted to support future
guideline recommendations regarding SGLT2i following TAVR.<br/>Copyright
&#xa9; 2025

<106>
[Use Link to view the full text]
Accession Number
2042910915
Title
Less Is More for Bleeding Management Algorithms in Cardiac Surgery: A
Network Meta-Analysis and Meta-Regression of Randomized Studies.
Source
Anesthesia and Analgesia. (no pagination), 2025. Date of Publication:
2025.
Author
Barbaria A.; Baryshnikova E.; Anguissola M.; Landi G.; Aloisio T.;
Casalino S.; Ranucci M.
Institution
(Barbaria, Baryshnikova, Anguissola, Aloisio, Casalino, Ranucci) From the
Department of Cardiovascular Anesthesia and Intensive Care, I.R.C.C.S.
Policlinico San Donato, Milan, Italy
(Landi) Department of Cardiothoracic Surgery, Heart and Vascular Centre,
Maastricht University Medical Centre, Maastricht, Netherlands
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - Major bleeding after cardiac surgery is still a relatively
common complication, requiring red blood cell (RBC) transfusions and use
of procoagulants. The existing guidelines recommend a bleeding management
based on viscoelastic tests and bleeding management algorithms (BMA).
However, there are different BMAs with different trigger values prompting
the use of different procoagulants; consequently, based on these trigger
values, a BMA can be more or less liberal in the use of drugs and blood
derivates aimed to control bleeding. At present, no studies have
investigated the effectiveness of liberal versus restrictive BMAs in
limiting the risk of RBC transfusion. <br/>METHOD(S): - In this study, we
performed 2 network meta-analyses and a meta-regression of randomized and
nonrandomized (before and after) studies where a BMA was applied. Based on
the trigger values prompting the use of procoagulants (fresh frozen
plasma, platelet concentrate, fibrinogen concentrate, prothrombin complex
concentrate, recombinant activated factors), we have adjudicated the
various BMAs to a restrictive or liberal group, and we compared the
effectiveness of restrictive versus liberal BMAs in limiting RBC
transfusions. Additionally, the consumption of procoagulants was compared
between the 2 groups. <br/>RESULT(S): - Both restrictive and liberal BMAs
were superior to conventional strategies in limiting RBC transfusions
(rate and units). Restrictive BMAs were more effective than liberal BMAs
in terms of RBC units transfused (mean difference -0.43 units, 95%
confidence interval [CI], -0.80 to -0.07, P = .020). The RBC transfusion
rate was tested after correction for potential confounders (complexity of
surgery and hematocrit trigger for RBC transfusion) with a meta-regression
RBC transfusion rate was significantly lower in restrictive versus liberal
BMAs (odds ratio 0.728, 95% CI 0.569-0.932, P = .012). The use of any kind
of procoagulants was significantly (P = .001) lower in restrictive versus
liberal BMAs. <br/>CONCLUSION(S): - Overall, viscoelastic test-based BMAs
are superior to conventional strategies in limiting RBC transfusions in
the presence of major bleeding; however, a restrictive strategy of
procoagulant administration is superior to a liberal strategy in terms of
RBC transfusion containment. Liberal BMAs are associated with a
significantly higher use of procoagulants without any benefit in terms of
RBC transfusions; therefore, in terms of cost/benefit ratio, restrictive
BMAs should be preferred.<br/>Copyright &#xa9; 2025

<107>
Accession Number
2042970550
Title
Ultrasound-Guided Transverse Thoracic Muscle Plane Block (TTMPB) for
Post-Sternotomy Pain: A Randomised Controlled Trial.
Source
Malaysian Journal of Medical Sciences. 32(6) (pp 165-175), 2025. Date of
Publication: 31 Dec 2025.
Author
Gill N.S.; Mokhtar A.M.; Abidin H.Z.; Eu C.S.; Zahari Y.; Hassan M.H.
Institution
(Gill, Mokhtar, Abidin, Eu, Zahari, Hassan) Department of Anaesthesiology
and Intensive Care, School of Medical Sciences, Universiti Sains Malaysia,
Health Campus, Kelantan, Malaysia
(Hassan) Department of Anaesthesiology and Intensive Care, National Heart
Institute, Kuala Lumpur, Malaysia
(Gill) Department of Anaesthesiology and Intensive Care, Hospital Sultan
Idris Shah, Serdang, Selangor, Malaysia
Publisher
Penerbit Universiti Sains Malaysia
Abstract
Background: Poorly controlled acute surgical pain after cardiac surgery
results from extensive tissue injuries and associated with high pain
intensity and leading to chronic pain and excessive opioid use. The aim is
to analyse the pain scores, patient controlled analgesia (PCA) fentanyl
requirement and spirometry values in Transverse Thoracic Muscle Plane
Block (TTMPB) vs. conventional opioid strategy in patients who underwent
cardiac sternotomy surgeries. <br/>Method(s): This is a randomised
controlled trial involving 40 adult patients who underwent elective
cardiac surgery with sternotomy, receiving either TTMPB (B, n = 20) or
control (A, n = 20). We measured mean pain scores at rest and on movement
postextubation using the Visual Analogue Scale (VAS), mean PCA fentanyl
consumption, and incentive spirometry volume at 0, 3, 6, 12, 18, 24, and
48 h postextubation. Analysis was done using the repeated measure ANOVA.
<br/>Result(s): At rest, there was a significant reduction in pain score
across different time points observed between both groups (F [6, 228] =
3.180, P < 0.05). On movement, a significant interaction between the TTMPB
treatment and pain score at movement across different time points (F [6,
228] = 2.249, P < 0.001) was shown. There was also a significant reduction
in PCA fentanyl consumption across different time points (F [6, 228] =
2.080, P < 0.05). Similar outcomes were also observed in spirometry volume
changes across time points between the two study groups (F [6, 228] =
10.855, P < 0.001). <br/>Conclusion(s): The administration of the TTMPB
resulted in significantly reduced pain scores at rest and movement,
reduced the mean PCA fentanyl consumption and showed better incentive
spirometry volume postextubation compared to the control group. This study
supports TTMPB as efficient postoperative analgesia for post-cardiac
surgery.<br/>Copyright &#xa9; Penerbit Universiti Sains Malaysia, 2025.

<108>
Accession Number
649885123
Title
Reduction in ischaemic events with icosapent ethyl in patients with
diabetes and prior CABG: REDUCE-IT diabetes-prior CABG.
Source
Diabetologia. Conference: 60th EASD Annual Meeting of the European
Association for the Study of Diabetes. Madrid Spain. 67(Supplement 1) (pp
S69), 2024. Date of Publication: 01 Sep 2024.
Author
Verma S.; Bhatt D.L.; Steg P.G.; Miller M.; Brinton E.A.; Jacobson T.A.;
Ketchum S.B.; Lira Pineda A.; Mueller-Wieland D.; Tardif J.-C.; Ballantyne
C.M.
Institution
(Verma) Cardiac Surgery, St. Michael's Hospital, Toronto, ON, Canada
(Bhatt) Mount Sinai Fuster Heart Hospital, New York, NY, United States
(Steg) Universite Paris-Cite, AP-HP, INSERM, Paris, France
(Miller) Univ. of Pennsylvania School of Medicine, Philadelphia, PA,
United States
(Brinton) Utah Lipid Center, Salt Lake City, UT, United States
(Jacobson) Emory Univ. School of Medicine, Atlanta, GA, United States
(Ketchum, Lira Pineda) Amarin Pharma Inc., Bridgewater, NJ, United States
(Mueller-Wieland) RWTH Univ. Hospital Aachen, Aachen, Germany
(Tardif) Montreal Heart Institute, Montreal, QC, Canada
(Ballantyne) Baylor College of Medicine, Houston, TX, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and aims: Patients with diabetes mellitus (DM) are at high
cardiovascular (CV) risk. Atherosclerotic cardiovascular disease (ASCVD)
is the principal cause of mortality among these patients. Significant
residual ischemic risk remains after coronary artery bypass grafting
(CABG) surgery. The effect of icosapent ethyl (IPE) on CV risk in patients
with DM and history of CABG at baseline is unknown. <br/>Material(s) and
Method(s): In REDUCE-IT (Reduction of Cardiovascular Events With Icosapent
Ethyl-Intervention Trial), a multicenter, placebo (PBO)-controlled,
double-blind trial, statin-treated patients with controlled
LDL-cholesterol and mild to moderate hypertriglyceridemia were randomized
to 4 g daily IPE or PBO. They experienced a 25% reduction in risk of a
primary efficacy endpoint (composite of CV death, myocardial infarction,
stroke, coronary revascularization, or hospitalization for unstable
angina) and a 26% reduction in risk of a key secondary efficacy endpoint
(composite of CV death, myocardial infarction, or stroke) compared with
PBO. This post hoc analysis reports on the subgroup of patients with DM
and CABG history at baseline. <br/>Result(s): Of 8179 patients randomized
in REDUCE-IT, 5785 (70.7%) had established ASCVD, of whom 2401 (41.5%) had
baseline DM. Of these, 799 (33.3%) had history of CABG, with 387 patients
randomized to IPE and 412 to PBO. In the PBO arm, patients with history of
CABG had numerically higher rates of ischemic events vs those without
history of CABG. Randomization to IPE was associated with a significant
reduction in the primary endpoint (HR 0.72; 95% CI 0.56-0.93; P=0.01) and
in the key secondary endpoint (HR 0.59; 95% CI 0.43-0.80; P=0.0007)
compared with PBO. Absolute risk reduction was 7.9% and 9.4% in first
events with a number needed to treat of 13 and 11 for the primary and key
secondary endpoints, respectively, during median follow-up of 4.6 years
(Figure). Patients with established ASCVD and DM but without history of
CABG experienced comparable risk reductions. In patients with established
ASCVD, DM and history of CABG, hospitalizations for atrial fibrillation or
flutter occurred in 5.4% (IPE) and 3.4% (PBO) of patients (P=0.24).
Serious bleeding events occurred in 4.9% (IPE) and in 4.4% (PBO) of
patients (P=0.74). <br/>Conclusion(s): In REDUCE-IT patients with history
of DM and CABG at baseline, IPE treatment was associated with significant
reductions in ischemic events.

<109>
Accession Number
649884694
Title
Effectiveness of real-time continuous glucose monitoring (Dexcom G6) among
cardiac surgery patients: a randomised controlled trial.
Source
Diabetologia. Conference: 60th EASD Annual Meeting of the European
Association for the Study of Diabetes. Madrid Spain. 67(Supplement 1) (pp
S391-S392), 2024. Date of Publication: 01 Sep 2024.
Author
Moon S.-J.; Kim M.-S.; Lee H.-E.; Lee Y.-W.; Lee S.-J.; Chung E.-S.; Park
C.-Y.
Institution
(Moon, Lee, Park) Endocrinology, Kangbuk Samsung Hospital, Sungkyunkwan
University, Seoul, South Korea
(Kim, Lee, Lee, Chung) Thoracic and Cardiovascular Surgery, Kangbuk
Samsung Hospital, Sungkyunkwan University, Seoul, South Korea
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and aims: Studies assessing the in-hospital use of real-time
continuous glucose monitoring (RT-CGM) among surgical patients are rare.
This study aimed to evaluate the efficacy of RT-CGM in cardiac surgery
patients. <br/>Material(s) and Method(s): In this single-center,
randomized, prospective study, participants were randomly assigned to an
RT-CGM group and a control group one day after cardiac surgery. Patients
with diabetes or prediabetes were enrolled based on a 75g oral glucose
tolerance test performed before surgery. Glycemic control in the RT-CGM
group was managed with Dexcom G6, and in the control group with
point-of-care blood glucose monitoring and blinded CGM. The primary
outcome was time in target range (TIR) of 100-180 mg/dL of sensor glucose
for 7 days starting one day after surgery. Key secondary outcomes included
TIR of 70-180 mg/dL, time in tight target range (TTIR), time below range
(TBR), coefficient of variance (CV), mean glucose, and length of hospital
stay (LOS). Diabetes or prediabetes status was stratified at randomization
and adjusted in the ANCOVA model. <br/>Result(s): Among 54 randomized
participants, 52 subjects (27 in the RTCGM group, and 25 in the control
group) completed the study. The mean age was 63.8+/-10.8 years, A1c
6.3+/-1.3%, and BMI 25.5+/-3.4 kg/m2, with 31 (59.6%) patients having
diabetes and 21 (40.4%) having prediabetes. The TIR of 100-180 mg/dL for 7
days after surgery was 74.7+/-12.0% and 71.6+/-17.8% in the RT-CGM and
control groups, respectively, without a statistically significant
difference (adjusted difference: 3.0% [95% CI, -4.2 to 10.2], p=0.379).
However, the TIR of 70-180 mg/dL showed a significant difference, with
83.8+/-10.6% in the RT-CGM group vs. 75.8+/-18.9% in the control group
(adjusted difference: 7.9% [95% CI, 0.6 to 15.3], p=0.036). TTIR of
100-140 mg/dL and 70-140 mg/dL were also better in the RT-CGM group
(adjusted differences: 9.8% [95% CI, 1.3 to 18.4], p=0.026, and 14.8% [95%
CI, 4.9 to 24.6], p=0.004, respectively). CV and mean glucose
significantly improved in the RT-CGM group (adjusted differences: 3.1%
[95%CI, 0.2 to 5.9], p=0.034, and -14.6 mg/ dL [-23.9 to -5.3], p=0.003,
respectively). No differences were seen in TBR at 70 mg/dL and 54 mg/dL,
and LOS. <br/>Conclusion(s): In patients with diabetes and prediabetes
undergoing cardiac surgery, the postoperative in-hospital application of
RT-CGM proved to be an effective and safe strategy for glucose management.

<110>
Accession Number
649880481
Title
Exploring the Potential of AI and Augmented Reality in Cardiovascular
Disease Management: A Narrative Review.
Source
Current cardiology reviews. (no pagination), 2026. Date of Publication:
07 Jan 2026.
Author
Khan A.M.; Villalobos A.; Kakadiya A.D.; Kaur H.; Tabassum S.; Faisal
A.M.; Pardeshi R.; Shah D.; Ponnada S.C.; Patel K.
Institution
(Khan) OSF Saint Francis Medical Centre, Peoria, IL, United States
(Villalobos) Ponce Health Sciences University, United States
(Kakadiya) GMERS Medical College & Hospital, Sola, Ahmedabad, India
(Kaur) Government Medical College, Patiala, India
(Tabassum) Dr. V.R.K Women's Medical College, Telangana, India
(Faisal) Danylo Halytsky Lviv National Medical University (Ukraine), Lviv,
India
(Pardeshi) GCS Medical College, Hospital and Research Center, Ahmedabad,
India
(Shah) B.J Medical College, Ahmedabad, India
(Ponnada) Great Eastern Medical School and Hospital, Srikakulam, India
(Patel) Government Medical College, Surat, India
Abstract
INTRODUCTION: Cardiovascular diseases remain a leading cause of morbidity
and mortality worldwide, with their rising incidence demanding a shift
toward more personalized treatment approaches. Artificial intelligence
(AI) and augmented reality (AR) are two newly evolving technologies that
have found extensive usage in the field of cardiovascular medicine and
surgery. AI-based models involve machine learning and deep learning neural
networks. These primarily form the basis of prediction models, allowing
the prediction of risk, survival, and risk stratification of patients.
<br/>METHOD(S): A literature search was conducted using PubMed and Google
Scholar, and it included studies published between 2003 and 2024. Articles
were selected based on clinical relevance and applicability to
cardiovascular disease management using artificial intelligence (AI) and
AR. Keywords used included "cardiovascular disease," "artificial
intelligence," "augmented reality," "diagnostic imaging," and "risk
prediction." Studies were screened manually for inclusion based on the
title and abstract review, followed by full-text evaluation for relevance
and quality. <br/>RESULT(S): This narrative review highlights how
artificial intelligence (AI) and augmented reality (AR) are increasingly
being applied in cardiovascular disease management. Despite recent
studies, there remains a lack of proper evaluation of these models'
efficacy, and therefore multiple large-scale trials are needed.
<br/>DISCUSSION(S): Networks such as Convolutional Neural Networks (CNNs)
and Natural Language Processing (NLP) have been used to improve image
interpretation and documentation processes. <br/>CONCLUSION(S): Further
and larger studies are needed to test the efficacy and safety of these
models. This narrative review summarizes recent findings in AI and AR and
offers perspectives on future research.<br/>Copyright&#xa9; Bentham
Science Publishers; For any queries, please email at
epub@benthamscience.net.

<111>
Accession Number
2042423304
Title
Asymptomatic Aortic Regurgitation: Evolving Imaging Markers and
Contemporary Intervention Strategies.
Source
Journal of Clinical Medicine. 15(1) (no pagination), 2026. Article Number:
339. Date of Publication: 01 Jan 2026.
Author
Tsai C.-M.; Lai K.-Y.; Su Y.-C.; Wu C.-H.; Tsai C.H.H.; Singh S.; Yang
L.-T.
Institution
(Tsai) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN,
United States
(Lai, Wu) Department of Internal Medicine, National Taiwan University
Hospital, Taipei, Taiwan (Republic of China)
(Su, Yang) College of Medicine, National Taiwan University, Taipei, Taiwan
(Republic of China)
(Tsai) Department of Surgery, National Taiwan University Hospital, Taipei,
Taiwan (Republic of China)
(Singh) Department of Internal Medicine, Reading Hospital, West Reading,
PA, United States
(Yang) Division of Cardiology, Department of Internal Medicine, National
Taiwan University Hospital, Taipei, Taiwan (Republic of China)
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Asymptomatic aortic regurgitation (AR) has traditionally been managed
conservatively until symptom onset or overt left ventricular systolic
dysfunction. However, adverse myocardial remodeling-detected by myocardial
strain, volumetric cardiac magnetic resonance, and fibrosis imaging-often
precedes current guideline thresholds for interventions and may be
irreversible. Advances in multimodal imaging now enable earlier risk
stratification beyond conventional metrics. In parallel, intervention
strategies are evolving, including valve repair, valve-sparing root
replacement, Ross procedure, and transcatheter aortic valve replacement in
selected high-risk patients. This narrative review summarizes contemporary
advances in imaging and intervention for asymptomatic AR, while critically
appraising current evidentiary and technical limitations that constrain
earlier intervention. The review is based on a narrative synthesis of the
contemporary literature, drawing from recent clinical studies, imaging
advances, and guideline documents rather than a systematic evidence
search.<br/>Copyright &#xa9; 2026 by the authors.

<112>
Accession Number
2042423496
Title
Innovations in Diagnosis and Treatment of Coronary Artery Disease.
Source
Diagnostics. 16(1) (no pagination), 2026. Article Number: 98. Date of
Publication: 01 Jan 2026.
Author
Agamy S.; Zaghloul S.; Khan Z.; Shahin A.; Kishk R.; Smman A.; Candilio L.
Institution
(Agamy) Cardiology Department, University Hospitals Birmingham, Hartlands
Hospital, Birmingham, United Kingdom
(Zaghloul) Cardiology Department, Royal Berkshire Hospital, Reading,
United Kingdom
(Khan) Bart's Heart Centre, London and Queen Mary University, London,
United Kingdom
(Shahin) Cardiology Department, Hampshire Hospitals NHS Foundation Trust,
Basingstoke, United Kingdom
(Kishk, Smman, Candilio) Cardiology Department, Royal Free London NHS
Foundation Trust, London, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Coronary artery disease (CAD) remains a significant health
challenge, placing a heavy burden on people and healthcare systems
worldwide. <br/>Objective(s): This narrative review aims to provide a
comprehensive overview of recent advancements in the diagnosis,
intervention, and pharmacological management of CAD, with a focus on
emerging technologies shaping its future. <br/>Method(s): This is a
narrative review that synthesises information from diverse sources,
including clinical trials, systematic reviews, meta-analyses, and
preclinical studies, to provide a comprehensive overview of the current
landscape and emerging trends in CAD management. The literature included
in this review was sourced from original research articles and review
papers published between January 2010 and December 2025. <br/>Result(s):
Early detection has been transformed by non-invasive imaging, such as
PCAT, and the addition of invasive and non-invasive FFR technology enables
quicker and more accurate diagnoses. Biomarkers, such as high-sensitivity
troponin, have further improved the precision of acute coronary syndrome
detection, enhancing early intervention. In interventional cardiology,
new-generation drug-eluting stents (DESs) have lowered restenosis rates,
whereas robotic-assisted percutaneous coronary intervention (PCI) offers
precision and reduced operator radiation exposure. Furthermore, the
efficacy of drug-coated balloons (DCBs) has been established in the
management of in-stent restenosis, and their application in de novo
coronary lesions and bifurcation anatomy remains promising. Looking ahead,
nanomedicine promises targeted plaque reduction and vascular repair, while
3D-bioprinted blood vessels offer durable, biocompatible grafts for
surgical applications. Pharmacological developments, including modern
cholesterol-lowering drugs, have also been crucial in achieving
cholesterol targets. <br/>Conclusion(s): Despite significant advancements
in diagnosis, intervention, and pharmacotherapy, several critical
challenges remain, including the need for validated biomarkers and imaging
modalities to identify vulnerable atheroma before symptoms arise.
Continued research is essential to improve patient outcomes and address
the global burden of CAD.<br/>Copyright &#xa9; 2025 by the authors.

<113>
Accession Number
649881773
Title
The evaluation of early topical lidocaine patches in and outside ICU
mechanically ventilated patients.
Source
Neurocritical Care. Conference: 5th Regional Neurocritical Care Meeting in
the Middle East and Africa. Dubai . 41(2) (pp 701-702), 2024. Date of
Publication: 01 Oct 2024.
Author
Agzamov A.; Harbi H.A.; Almutairi L.H.
Institution
(Agzamov, Harbi, Almutairi) Department of Anesthesiology, Al Sabah
Hospital, Intensive care unit, Kuwait
Publisher
Springer
Abstract
Introduction The lidocaine patches, applied over the chest of the lungs
fields in mechanically ventilated (MV) in the intensive care unit (ICU)
patients and MV patients outside the ICU have been suggested as a method
of transdermal drug delivery to improve respiratory function, reduce
opioid consumption, and consequently, reduce pulmonary complications. The
aim of this clinical study was to investigate and to establish whether a
definitive clinical study of topical lidocaine patches in MV in the ICU
and MV patients outside the ICU is feasible. Methods We had a clinical
study patch in 820 MV patients in the ICU and 880 MV patients outside the
ICU, aged 60-96 years, who were divided into two groups: lidocaine patches
and a control (without lidocaine patches), in addition to standard
clinical management or standard clinical management alone. Results
Lidocaine patches (700 mg) were applied immediately in ICU patients and
patients outside the ICU and continued daily for 7-14 days or until
discharge. A total of 850 patients were included in the lidocaine group;
850 patients were included in the control group. Mean visual analog scores
for pain did not differ between the groups (lidocaine, 2; control, 6; p
&gt; 0.01). Lengths of stay for groups (cardiothoracic ICU: lidocaine,
4.08 days; control, 9.11 days; p &gt; 0.05; hospital: lidocaine, 12.26
days; control, 46.91 days; p &gt; 0.001). Clinical outcomes, such as early
liberation from MV were three times more in the lidocaine group than in
control group; 30-day pulmonary complications four times less in patients
in the lidocaine group than those in the control group. Conclusions The
topically applied lidocaine patches in MV patients inside and outside the
ICU targeted peripheral nociceptive pathways while minimizing absorption
into the plasma, which leads to potential systemic adverse effects. Our
study has found 5% lidocaine patches to be effective and well tolerated
for the treatment of MV patients inside and outside the ICU, with a
minimal risk of toxicity or drug-drug interactions.

<114>
Accession Number
649884226
Title
Empagliflozin limits AKI incidence and severity following cardiac surgery:
an open-label phase IV randomised pilot study.
Source
Diabetologia. Conference: 60th EASD Annual Meeting of the European
Association for the Study of Diabetes. Madrid Spain. 67(Supplement 1) (pp
S343-S344), 2024. Date of Publication: 01 Sep 2024.
Author
Snel L.I.P.; Oosterom M.J.P.; Rampanelli E.; Lankedava Y.; Plummer M.P.;
Preckel B.; Hermanides J.; van Raalte D.; Hulst A.
Institution
(Snel, Oosterom, Preckel, Hermanides, Hulst) Anaesthesiology, Amsterdam
University Medical Center, Amsterdam, Netherlands
(Rampanelli) Experimental Vascular Medicine, Amsterdam University Medical
Center, Amsterdam, Netherlands
(Lankedava) Translational Cardiovascular and Renal Research Group, The
Florey, Melbourne, Australia
(Plummer) Discipline of Acute Care Medicine, The University of Adelaide,
Adelaide, Australia
(van Raalte) Internal Medicine, Amsterdam University Medical Center,
Amsterdam, Netherlands
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and aims: Cardiac surgery-associated acute kidney injury
(CSA-AKI) is a common postoperative complication. Currently, no effective
preventative strategies exist to mitigate CSA-AKI. Sodiumglucose
transporter-2 (SGLT2) inhibitors reduced acute kidney injury (AKI)
incidence in large, randomized placebo-controlled, cardiovascular and
kidney outcome trials conducted in patients with chronic kidney disease.
We hypothesized that perioperative SGLT2 inhibition could also reduce
CSA-AKI. <br/>Material(s) and Method(s): In this open-label phase IV,
randomized, parallel-group, pilot study, adult patients undergoing
elective cardiac surgery with cardiopulmonary bypass were randomized to
receive the SGLT2 inhibitor, empagliflozin (10 mg; oral), once daily three
days prior to surgery and continued to two days after surgery compared
with standard-of-care. Biomarkers for acute kidney injury (AKI), including
serum and urinary neutrophil gelatinase-associated lipocalin (NGAL), serum
and urinary kidney injury molecule-1 (KIM-1), and serum hypoxia-inducible
factor-1alpha (HIF-1alpha) were measured. Additional outcomes included AKI
incidence according to Kidney Disease: Improving Global Outcomes (KDIGO)
criteria as well as metabolic parameters, including ketone body
concentrations and glycemic control. <br/>Result(s): Between March 2022
and April 2023, 55 patients were included (sex: 73% male, age: 66 +/- 10
years, BMI: 28 +/- 4 kg/m2, empagliflozin n = 25, control n = 30) in the
intention-to-treat analysis. Empagliflozin significantly reduced the
incidence of AKI (20% vs 66.7%; absolute difference 46.7%, 95% CI, -69.7 -
-23.6; P=.001). Following surgery, urinary NGAL, and KIM-1 were found to
increase in both arms, whereas a significant increment in serum HIF-1alpha
after surgery was solely observed in the control group. We observed no
between-group differences in the incidence of (euglycemic) ketoacidosis or
hypoglycemic events. <br/>Conclusion(s): Perioperative SGLT2 inhibition,
compared with standard of care, significantly reduced the incidence of
CSA-AKI. These findings warrant validation in large-scale, double-blind,
placebo-controlled, randomized trials.

<115>
Accession Number
649887630
Title
Right ventricular function after mitral valve surgery: Insights from the
United Kingdom Mini Mitral study.
Source
The Annals of thoracic surgery. (no pagination), 2026. Date of
Publication: 07 Jan 2026.
Author
Bayliss C.; Wagnild J.; Maier R.; Ogundimu E.; Graham R.; Zacharias J.;
Deshpandhe R.; Akowuah E.
Institution
(Bayliss, Graham) Department of Cardiac Surgery, James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, United
Kingdom
(Wagnild) Department of Anthropology, Durham University, Durham, United
Kingdom
(Maier) Academic Cardiovascular Unit, James Cook University Hospital,
South Tees Hospitals NHS Foundation Trust, Middlesborough, United Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
(Zacharias) Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS
Foundation Trust, Blackpool, United Kingdom
(Deshpandhe) Cardiac Care Group, King's College Hospital, London, United
Kingdom
(Akowuah) Department of Cardiac Surgery, the James Cook University
Hospital, South Tees Hospitals NHS Foundation Trust, Middlesbrough, UK;
Academic Cardiovascular Unit, James Cook University Hospital, South Tees
Hospitals NHS Foundation Trust, Middlesborough, UK; Newcastle University
Translational and Clinical Research Institute
Abstract
BACKGROUND: Right ventricular (RV) function is frequently reduced
following cardiac surgery, with persistent impairment associated with
increased mortality. This study aimed to compare RV function following
mitral valve repair via right minithoracotomy versus sternotomy.
<br/>METHOD(S): In the UK Mini Mitral Trial, patients were randomized to
mitral valve repair via right minithoracotomy (small lateral pericardial
incision) or sternotomy. Prespecified secondary outcomes included
assessment of cardiac function via blinded echocardiography
pre-operatively, at early (12 weeks) and late (52 weeks) time points. RV
function was assessed via tricuspid annular plane systolic excursion
(TAPSE). RV to pulmonary artery coupling was determined by the TAPSE to
systolic pulmonary artery pressure ratio. <br/>RESULT(S): Of 330 patients
randomized, 224 had suitable echocardiographic data for analysis. Baseline
demographic, clinical, and echocardiographic data were comparable between
groups. Cross-clamp and bypass times were significantly longer in the
minithoracotomy group. At 12 weeks, there was a significant reduction in
TAPSE from baseline in both groups (TAPSE minithoracotomy -7.52mm, 95%
confidence interval (CI) -8.52 - -6.53, P<0.001, versus sternotomy
-8.75mm, -9.80 - -7.71, P<0.001), which recovered, however not to
pre-operative levels by 52 weeks. The degree of RV impairment was
significantly less in the minithoracotomy group at both early (between
group difference in TAPSE 1.47mm, 95% CI 0.37 - 2.56, P=0.009) and late
time points (1.37mm, 95% CI 0.29 - 2.45, P=0.013). <br/>CONCLUSION(S):
Despite longer cross-clamp and bypass times, mitral valve repair via
minithoracotomy, was superior to sternotomy at preserving RV function
(measured by TAPSE), at 12 weeks and one year.<br/>Copyright &#xa9; 2026.
Published by Elsevier Inc.

<116>
Accession Number
649884164
Title
SYNCHRONIZETM-CVOT: study design of a phase 3, randomised, event-driven,
CV outcome trial of survodutide in adults living with overweight or
obesity, and CVD, CKD or with risk factors for CVD.
Source
Diabetologia. Conference: 60th EASD Annual Meeting of the European
Association for the Study of Diabetes. Madrid Spain. 67(Supplement 1) (pp
S340), 2024. Date of Publication: 01 Sep 2024.
Author
Kosiborod M.N.; Wharton S.; Le Roux C.; Platz E.; Brueckmann M.;
Jastreboff A.M.; Ajaz Hussain S.; Pedersen S.D.; Unseld A.; Startseva E.;
Kaplan L.M.
Institution
(Kosiborod) St Luke's Mid America Heart Inst., Uni. of Missouri-Kansas
City, Kansas City, MO, United States
(Wharton) McMaster Uni., Toronto, ON, Canada
(Le Roux) St Vincent's Uni. Hospital, University College Dublin School of
Medicine, Dublin, Ireland
(Platz) Cardiovascular Division, Brigham & Women's Hospital, Harvard
Medical School, Boston, MA, United States
(Brueckmann, Ajaz Hussain, Startseva) Boehringer Ingelheim International
GmbH, Ingelheim, Germany
(Jastreboff) Section of Endocrinology (Internal Medicine & Pediatrics),
Yale Obesity Research Center (Y-Weight), Yale School of Medicine, New
Haven, CT, United States
(Pedersen) C-ENDO Diabetes and Endocrinology Clinic, University of
Calgary, Calgary, AB, Canada
(Unseld) Boehringer Ingelheim Pharma GmbH & Co. KG, Biberach, Germany
(Kaplan) Section of Obesity Med., Center for Digestive Health, Geisel
School of Medicine at Dartmouth, Hanover, NH, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background and aims: GLP-1 receptor agonists have been shown to reduce
risk of adverse CV events in individuals with T2D and established ASCVD or
elevated CV risk, and in those living with obesity and established ASCVD
(but no CVD or T2D). Survodutide is a glucagon/ GLP-1 receptor dual
agonist in clinical development for the treatment of overweight or
obesity, and has demonstrated up to 18.7% mean body weight reduction after
46 weeks on (actual) treatment in a phase 2 trial. There is currently no
evidence regarding the CV effects of glucagon/ GLP-1 receptor dual agonism
in people with overweight or obesity. <br/>Material(s) and Method(s):
SYNCHRONIZETM-CVOT is a phase 3 trial (in approx. 36 countries/600 sites)
that is investigating the effects of survodutide once weekly vs placebo
(PBO) on CV events in participants (with or without T2D) with: i) BMI >=27
kg/m2 with established CVD (including HF, CAD, and cerebrovascular or
peripheral arterial disease) and/or >=2 weight-related complications or
risk factors for CVD, or ii) BMI >=30 kg/ m2 with established CVD or CKD
and/or >=2 weight-related complications or risk factors for CVD at
baseline. Approx. 4935 participants (including around 600 with HF) will be
randomised 1:1:1 to once-weekly s.c. injections of survodutide at target
doses of 3.6 mg, 6.0 mg, or PBO as an adjunct to standard of care for CV
risk reduction, and lifestyle modifications. Primary endpoint is time to
first occurrence of any of the adjudicated components of a 5P-MACE
composite consisting of: CV death, non-fatal stroke, non-fatal MI,
ischaemia-related coronary revascularisation, or HF event (including
hospitalisation for HF, emergency department, urgent care, or urgent
outpatient HF visit). <br/>Result(s): This trial is event-driven and is
planned to continue until >=189 participants experience an
adjudication-confirmed component of 5P-MACE and until approximately 3600
participants have been treated for >=1 year. Primary objective is to show
non-inferiority of survodutide (pooled) vs PBO on 5P-MACE. Key secondary
objectives include superiority of survodutide vs PBO for absolute change
from baseline to Week 72 in KCCQ-TSS in participants with HF at baseline,
and superiority of survodutide (pooled) vs PBO on 5P-MACE. Safety and
tolerability of survodutide will be assessed based on the occurrence of
treatment-emergent adverse events. <br/>Conclusion(s): Results from
SYNCHRONIZETM-CVOT will provide important insights into the CV effects of
survodutide in people with overweight or obesity at high CV risk.

<117>
Accession Number
2042381898
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: 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, New York, NY, United States
(Ing) Department of Epidemiology, Mailman School of Public Health, New
York, NY, United States
Publisher
John Wiley and Sons Inc

<118>
Accession Number
2042447186
Title
Long-term outcome of patients undergoing pacemaker implantation after
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. (no pagination), 2026. Date
of Publication: 2026.
Author
Veraar C.; Lamm G.; Merl L.; Fischer-Hammerschmied A.; Granner M.; Will
M.; Schwarz K.; Kammerlander A.; Mascherbauer J.
Institution
(Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Karl
Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Strase 30,
Krems, Austria
(Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Division of
Internal Medicine 3, University Hospital St. Polten, Dunant- Platz 1, St.
Polten, Austria
(Fischer-Hammerschmied) Department of Anesthesiology, Intensive Care
Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular
Anesthesia and Intensive Care Medicine, Medical University of Vienna,
Vienna, Austria
(Kammerlander) Department of Cardiology, Medical University of Vienna,
Vienna, Austria
Publisher
Springer
Abstract
The long-term prognostic relevance of permanent pacemaker (PM)
implantation after transcatheter aortic valve implantation (TAVI) remains
uncertain. We performed a meta-analysis to evaluate its association with
all-cause mortality beyond five years. Following MOOSE recommendations,
PubMed and Embase were searched through September 2025 for studies
reporting long-term outcomes after TAVI, including hazard ratios (HRs)
comparing patients with and without new PM implantation. Pooled HRs were
calculated using random-effects models with restricted maximum likelihood
estimation and Hartung-Knapp adjustment. Heterogeneity was quantified
using I2, and robustness was tested by leave-one-out procedures and
alternative model estimators. Random-effects meta-regression examined
whether study-level covariates modified the association. Seven
observational studies comprising 59 635 patients were included, of whom 11
325 (19%) received a new PM within 30 days after TAVI. Follow-up ranged
from 60 to 120 months. PM implantation was associated with higher
long-term all-cause mortality {pooled HR 1.13 (95% CI 1.07-1.19); I2 =
0%}. Leave-one-out analyses confirmed stability (HR 1.11-1.13), and
funnel-plot inspection revealed no asymmetry. None of the examined
covariates-female sex, diabetes, atrial fibrillation, conduction
disturbances, coronary artery disease, or left-ventricular ejection
fraction-significantly affected the association (beta range - 0.018 to +
0.024; exp(beta) 0.98-1.02; all p > 0.10). Across seven contemporary
registries, PM implantation after TAVI was consistently linked to a modest
increase in long-term mortality, independent of baseline comorbidities,
emphasizing the need for conduction-preserving implantation and
physiologic pacing strategies.<br/>Copyright &#xa9; The Author(s) 2026.

<119>
Accession Number
2042423114
Title
Impact of Prehabilitation Components on Oxygen Uptake of People Undergoing
Major Abdominal and Cardiothoracic Surgery: A Network Meta-Analysis of
Randomized Controlled Trials.
Source
Journal of Clinical Medicine. 15(1) (no pagination), 2026. Article Number:
175. Date of Publication: 01 Jan 2026.
Author
Priego-Jimenez S.; Priego-Jimenez P.; Lopez-Gonzalez M.; Martinez-Rodrigo
A.; Lopez-Requena A.; Alvarez-Bueno C.
Institution
(Priego-Jimenez) Hospital Universitario de Cuenca, Cuenca, Spain
(Priego-Jimenez, Lopez-Gonzalez, Lopez-Requena, Alvarez-Bueno) Center for
Socio-Health Studies (CESS), Age-ABC Research Group, University of
Castilla-La Mancha, Cuenca, Spain
(Priego-Jimenez, Lopez-Gonzalez) Age-ABC Research Group, Health Research
Institute of Castilla-La Mancha (IDISCAM), Toledo, Spain
(Priego-Jimenez) Department of General and Digestive Surgery, Hospital
Universitario La Paz, Madrid, Spain
(Martinez-Rodrigo) COMETA Research Group, Informatics Systems Department,
University of Castilla-La Mancha, Cuenca, Spain
(Alvarez-Bueno) Facultad de Ciencias de la Salud, Universidad Autonoma de
Chile, Talca, Chile
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Patient preoperative cardiorespiratory physical
fitness measured by maximal oxygen consumption (VO2max) is highly relevant
to postoperative outcomes, with low VO2max associated with a greater
symptom burden and a greater prevalence of long-term treatment-related
cardiovascular disease risk factors in patients undergoing surgery. A
network meta-analysis (NMA) was conducted to determine the effects of
different components of prehabilitation, including exercise, nutrition,
psychological intervention, and different combinations of the
aforementioned interventions, on oxygen consumption in people undergoing
major abdominal or cardiothoracic surgery. <br/>Method(s): A literature
search was conducted from inception to December 2025. Randomized
controlled trials on the effectiveness of prehabilitation programmes on
pre-surgery VO2max were included. The risk of bias was assessed via the
Cochrane risk of bias (RoB 2.0) tool, and the quality of evidence was
assessed via the Grading of Recommendations, Assessment, Development, and
Evaluation (GRADE) tool. Pairwise meta-analyses and NMAs were conducted
for direct and indirect evidence. <br/>Result(s): Fourteen studies were
included in this NMA. The highest effect (ES) for VO2max scores was for
the exercise group versus the control group (ES: 0.44; 95% CI: 0.11,
0.78). When exercise was categorized according to intensity, the highest
effect was for high-intensity interval training (HIIT) versus the control
(ES: 0.51; 95% CI: 0.04, 0.97). <br/>Conclusion(s): Exercise HIIT should
be considered the most effective strategy for improving exercise capacity
in patients undergoing major abdominal or cardiothoracic surgery. Given
the importance of VO2 as a predictor of morbidity, mortality, and the
potential occurrence of adverse events after the procedure in surgical
patients, it is essential to include its measurement in future studies to
estimate both the risk of procedures and the effect of prehabilitation
programmes.<br/>Copyright &#xa9; 2025 by the authors.

<120>
Accession Number
2042766503
Title
Non-amyloid specific treatment for transthyretin cardiac amyloidosis: a
clinical consensus statement of the ESC Heart Failure Association.
Source
European Heart Journal. 47(1) (pp 22-36), 2026. Date of Publication: 01
Jan 2026.
Author
Garcia-Pavia P.; Gonzalez-Lopez E.; Anderson L.J.; Cappelli F.; Damy T.;
Fontana M.; Gonzalez-Costello J.; Jurcut R.; Lairez O.; van der Meer P.;
Merlo M.; Perlini S.; Bayes-Genis A.
Institution
(Garcia-Pavia, Gonzalez-Lopez) Department of Cardiology, Hospital
Universitario Puerta de Hierro Majadahonda, IDIPHISA, GUARD-HEART ERN,
Manuel de Falla, 2, Madrid, Spain
(Garcia-Pavia, Gonzalez-Lopez, Bayes-Genis) CIBER Cardiovascular,
Instituto de Salud Carlos III, Madrid, Spain
(Garcia-Pavia) Centro Nacional de Investigaciones Cardiovasculares (CNIC),
C. de Melchor Fernandez Almagro, 3, Fuencarral-El Pardo, Madrid, Spain
(Anderson) Cardiology Clinical Academic Group, St George's Hospital,
London, United Kingdom
(Cappelli) Tuscan Regional Amyloidosis Centre, Careggi University
Hospital, Florence, Italy
(Damy) Referral Center for Cardiac Amyloidosis, Department of Cardiology,
APHP CHU Henri Mondor Creteil and Reseau Amylose and Filiere Cardiogen,
GUARD-HEART ERN, Paris, France
(Fontana) National Amyloidosis Centre, UCL, Division of Medicine, Royal
Free Hospital, London, United Kingdom
(Gonzalez-Costello) Department of Cardiology, Hospital Universitario de
Bellvitge, Hospitalet de Llobregat, Barcelona, Spain
(Gonzalez-Costello) Bio-Heart, Instituto de Investigacion Biomedica de
Bellvitge, Barcelona, Spain
(Jurcut) University of Medicine and Pharmacy 'Carol Davila', Bucharest,
Romania
(Jurcut) Expert Center for Rare Cardiovascular Diseases, Emergency
Institute for Cardiovascular Diseases 'Prof.dr.C.C.Iliescu', GUARD-HEART
ERN, Bucharest, Romania
(Lairez) Toulouse University, HealthAge University Hospital Institute,
Toulouse, France
(van der Meer) Experimental Cardiology University Medical Center,
Groningen, Netherlands
(Merlo) Cardiothoracovascular Department, Azienda Sanitaria Universitaria
Giuliano Isontina (ASUGI), GUARD-HEART ERN, Trieste, Italy
(Merlo) Center for Diagnosis and Treatment of Cardiomyopathies,
Cardiovascular Department, Azienda Sanitaria Universitaria
Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy
(Perlini) Department of Internal Medicine, Emergency Medicine and
Amyloidosis Research and Treatment Center, IRCCS Policlinico San Matteo
Foundation, Universita degli Studi, Pavia, Italy
(Bayes-Genis) l'Institut del Cor. Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Bayes-Genis) Department of Medicine, Universitat Autonoma de Barcelona,
Barcelona, Spain
Publisher
Oxford University Press
Abstract
This clinical consensus statement, developed by the Heart Failure
Association of the European Society of Cardiology, offers a detailed
review of the non-specific management of transthyretin amyloid
cardiomyopathy (ATTR-CM). This progressive and often fatal condition is
increasingly recognized as a major contributor to heart failure. This
document provides advice on symptom management and enhancing quality of
life, with a focus on volume management, neurohormonal modulation, and
tailored use of diuretics and other supportive therapies that address the
distinct pathophysiology of ATTR-CM. It also explores advanced treatment
modalities such as heart transplantation and mechanical circulatory
support, which play crucial roles in managing advanced stages of the
disease. Furthermore, it addresses the management of aortic stenosis in
the context of ATTR-CM, advising transcatheter aortic valve replacement as
the preferred treatment for these patients. The advice provided in this
document relies primarily on expert opinion and retrospective studies due
to a notable lack of randomized clinical trials, which underscores a
critical research gap and the pressing need for evidence-based treatment
protocols.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology. All
rights reserved.

<121>
Accession Number
2042714077
Title
A Comparative Study of Ticagrelor and Clopidogrel in Patients Undergoing
Elective Coronary Stenting.
Source
Pakistan Journal of Medical and Health Sciences. 17(12) (pp 682-685),
2023. Date of Publication: 01 Jan 2023.
Author
Farooq U.; Anum H.; Akhtar M.N.; Ul Haq E.; Farooqui K.S.; Uroos I.
Institution
(Farooq, Anum, Akhtar) Department of Cardiology, Rehmatul Lil Alameen
Institute of Cardiology, Lahore, Pakistan
(Ul Haq, Uroos) Department of Cardiology, National Institute of
Cardiovascular Diseases, Karachi, Pakistan
(Farooqui) National Institute of Cardiovascular Diseases, Karachi,
Pakistan
Publisher
Lahore Medical And Dental College
Abstract
Background: Ticagrelor and clopidogrel are widely used P2Y12 inhibitors
for patients undergoing percutaneous coronary intervention. While
ticagrelor offers faster and more consistent platelet inhibition, its
comparative benefit over clopidogrel in elective coronary stenting remains
uncertain, especially in local populations. This study evaluated the
short-term ischemic and safety outcomes of ticagrelor versus clopidogrel
in patients undergoing elective coronary stenting. <br/>Method(s): A
prospective comparative study was conducted at Rehmatul Lil Alameen
Institute of Cardiology, Lahore, from January to July 2023. Sixty adults
scheduled for elective PCI with drug-eluting stent implantation were
enrolled and allocated equally to ticagrelor or clopidogrel, each combined
with aspirin. The primary endpoint was 30-day major adverse cardiovascular
events including all-cause death, non-fatal myocardial infarction, and
ischemia-driven target vessel revascularization. Secondary endpoints
included stent thrombosis and safety outcomes such as BARC >=2 bleeding,
access-site complications, dyspnea, and bradyarrhythmias. Analyses were
performed using intention-to-treat principles. <br/>Result(s): Baseline
demographic and clinical characteristics were comparable between groups.
Procedural characteristics, including radial access (91.7 percentage) and
procedural success (100 percentage), were similar. At 30 days, major
adverse cardiovascular events were lower with ticagrelor compared to
clopidogrel (3.3 percentage vs 16.7 percentage, p=0.19). Non-fatal MI (10
percentage) and stent thrombosis (6.7 percentage) occurred only among
clopidogrel users. Ticagrelor had higher but non-significant rates of BARC
>=2 bleeding (13.3 percentage vs 3.3 percentage, p=0.35) and dyspnea (20
percentage vs 3.3 percentage, p=0.10). No BARC 3-5 bleeding occurred in
either group. Hospital stay and DAPT adherence were similar between
groups. <br/>Conclusion(s): Ticagrelor demonstrated a trend toward fewer
ischemic complications, including absence of stent thrombosis, without a
statistically significant increase in major bleeding at 30 days. Although
the study was limited by its small sample size, findings suggest that
ticagrelor may offer clinically meaningful ischemic protection in elective
PCI settings. Larger multicenter trials are required to clarify the
optimal P2Y12 strategy in stable coronary intervention
populations.<br/>Copyright &#xa9; (2026). All right reserved.

<122>
Accession Number
2042858793
Title
Management of anaesthesia for transfemoral transcatheter aortic valve
implantation: an Italian interdisciplinary consensus statement.
Source
British Journal of Anaesthesia. (no pagination), 2026. Date of
Publication: 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, Pieri, Landoni) 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, and 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
(Sangalli) Department of Anaesthesia and Intensive Care, ASST Brianza,
University of Milano-Bicocca, Vimercate, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS- IRCCS Cardiovascular Network, Italy
(Pieri, Landoni) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Scolletta) Department of Medical Science, Surgery, and 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
(Monaco) Departement of Medical and Surgical Sciences (DIMEC)Alma Mater
Studiorum - University of Bologna, Italy
(Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care IRCCS
Azienda Ospedaliero-Universitaria Sant'Orsola, BolognaVia Massarenti,
Bologna, Italy
Publisher
Elsevier Ltd
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. <br/>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. <br/>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.
<br/>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.<br/>Copyright &#xa9; 2025 British Journal of Anaesthesia

<123>
[Use Link to view the full text]
Accession Number
649889704
Title
The impact of anesthetic modality and cardiopulmonary bypass flow type on
intraoperative intraocular pressure during coronary artery bypass
grafting: A prospective, randomized controlled trial.
Source
Medicine. 105(2) (pp e47110), 2026. Date of Publication: 09 Jan 2026.
Author
Ucak D.; Ulku H.S.; Ciloglu E.; Badak T.O.
Institution
(Ucak, Ulku) Department of Anesthesiology and Reanimation, University of
Health Sciences Adana City Training and Research Hospital, Adana, Turkey
(Ciloglu) Department of Ophthalmology, Adana Sevgi Eye Center Hospital,
Adana, Turkey
(Badak) Department of Cardiovascular Surgery, University of Health
Sciences Adana City Training and Research Hospital, Adana, Turkey
Abstract
Intraocular pressure (IOP) is an indirect marker of ocular perfusion and
is critical during coronary artery bypass grafting (CABG) due to potential
hemodynamic instability. The combined effects of anesthetic modality
(sevoflurane vs propofol-based total intravenous anesthesia [TIVA]) and
cardiopulmonary bypass (CPB) flow type (pulsatile vs nonpulsatile) on
intraoperative IOP during CABG are not well established. This prospective,
randomized controlled trial included 160 patients undergoing CABG,
randomized into four groups (n = 40 each): Sevoflurane + pulsatile CPB
(SP), sevoflurane + nonpulsatile CPB (SN), TIVA + pulsatile CPB (TP), and
TIVA + nonpulsatile CPB (TN). Patients with preexisting ocular conditions
were excluded. IOP was measured using a Tono-Pen Avia at four time points:
before induction, after induction, after CPB initiation, and at the end of
surgery. Statistical analysis included one-way analysis of variance, Tukey
post hoc testing, and chi-square tests. Baseline characteristics and IOP
values were comparable across groups. After induction, the TIVA groups (TP
and TN) showed a significant reduction in IOP (mean difference -3.5 mm Hg;
P < .001) compared with the sevoflurane groups. Upon CPB initiation, IOP
increased in all groups, most prominently in the SN group (P < .01).
Pulsatile flow was associated with significantly lower IOP values than
nonpulsatile flow (P < .01), irrespective of anesthetic modality. The TP
group exhibited the most stable IOP profile throughout surgery (P < .05).
No acute glaucoma or serious ocular complications were observed.
Propofol-based TIVA produced a greater reduction in IOP after induction,
and pulsatile CPB contributed to a more stable intraoperative IOP profile
during CABG compared with sevoflurane anesthesia and nonpulsatile CPB,
respectively. Although IOP fluctuations remained within subclinical
limits, these findings suggest that TIVA combined with pulsatile CPB may
offer advantages in maintaining ocular hemodynamic stability, particularly
in high-risk patients.<br/>Copyright &#xa9; 2026 the Author(s). Published
by Wolters Kluwer Health, Inc.

<124>
Accession Number
649861802
Title
Liraglutide Rapid Effects on Glucose and Adipose Tissue during and after
CABG.
Source
Diabetes. Conference: 84th scientific sessions 2024. Orlando, FL United
States. 73(Supplement 1) (no pagination), 2024. Date of Publication: 01
Jun 2024.
Author
Iacobellis G.; Frasca D.
Institution
(Iacobellis, Frasca) MiamiFLUnited States
Publisher
American Diabetes Association Inc.
Abstract
Introduction: Optimization of glucose control during coronary artery
by-pass grafting (CABG) is a major goal to reduce intra and post-op
morbidity and mortality in subjects with coronary artery disease (CAD) and
type 2 diabetes (T2DM). Glucagon like peptide-1 receptor analogs
(GLP-1RAs) reduce cardiovascular risk. However, the short-term effects of
GLP1RA on intra and post CABG metabolic control is unknown.
<br/>Objective(s): was to evaluate if pre-operative treatment with
liraglutide can improve intra and post CABG glucose and metabolic control
Methods: This was a 12-week randomized, double-blind, placebo-controlled
interventional study in 38 patients with T2DM and CAD with an acceptable
glycemic control (HbA1c <8%) who required elective CABG. Subjects were
started on either liraglutide or placebo in addition to current treatment
for a minimum of 4 up to 12 weeks prior to CABG. Fat samples were
collected during CABG; blood and clinical data were obtained before
starting either liraglutide or placebo, intra-op and 1-month post-op.
<br/>Result(s): The two groups were very homogenous prior to the CABG.
Patients who were randomized to liraglutide had significantly better
intra-op glucose control during the CABG than those on placebo (146+/-21
vs 160+/-21 mg/dl, p<0.01). BMI and body weight significantly decreased at
1- month post-op when compared to baseline in patients who were randomized
to liraglutide (from 32.7+/-6 to 30.5+/-5 kg/m2; from 214+/-39 to 208+/-38
lbs p< 0.05 for both), whereas placebo had no significant BMI or body
weight changes. Post-op HbA1c improved in both liraglutide and placebo
group (from 6.9 to 5.9% and from 7.2 to 6.1% respectively, p<0.01).
Coronary epicardial fat (EAT) inflammatory transcriptome was significantly
different than subcutaneous fat (p<0.01). <br/>Conclusion(s): This RCT
shows for the first time that short-term pre-CABG liraglutide induces
significant beneficial cardio-metabolic effects, such as better intra- and
post-operative glucose control, EAT changes and post-operative weight
loss.

<125>
Accession Number
649866592
Title
Comparative efficacy of schroth and core training for early postoperative
recovery in adolescent idiopathic scoliosis: A single blind randomized
controlled trial.
Source
PloS one. 21(1) (pp e0340585), 2026. Date of Publication: 2026.
Author
Meng F.; Li K.; Wang W.; Yang R.; Wang C.; Zhao Z.; Chen M.; Ao L.
Institution
(Meng, Li, Yang, Wang, Chen, Ao) School of Rehabilitation, Kunming Medical
University, Kunming, Yunnan, China
(Li) Department of Rehabilitation, Kunming Municipal Hospital of
Traditional Chinese Medicine, Kunming, Yunnan, China
(Wang) College of Mechanical and Electrical Engineering, Harbin
Engineering University, Harbin, Heilongjiang, China
(Zhao) Department of Orthopaedics, Second Affiliated Hospital of Kunming
Medical University, Kunming, China
Abstract
BACKGROUND: To evaluate the clinical efficacy of Schroth exercises
combined with core training versus core training alone on early trunk
balance optimization and functional recovery in adolescent idiopathic
scoliosis (AIS) patients following selective thoracic fusion surgery.
<br/>METHOD(S): This single-blinded randomized controlled trial enrolled
46 AIS patients with Lenke1 type configuration who underwent selective
thoracic posterior spinal fusion at the Orthopedics Department of the
Second Affiliated Hospital of Kunming Medical University. Participants
were randomly assigned to either the Schroth exercise combined Core
Training (SCT, n = 23) or Core training group (CT, n = 23). The SCT group
received Schroth three-dimensional (3D) scoliosis-specific exercises
combined with core stabilization training: during the initial 3
postoperative months, they performed core exercises, rotational angular
breathing, and daily postural management; during the subsequent 3 months,
they engaged in Schroth 3D corrective exercises targeting surgical
correction outcomes. The CT group exclusively performed core stabilization
training throughout the 6-month postoperative period. Both groups received
40-minute intervention sessions three to four times weekly from discharge
to 6 months postoperatively. Assessments were conducted at four time
points: preoperatively, at the discharge (postoperative day 7), and at 3
and 6 months postoperatively. Spinal radiographic parameters, paraspinal
muscle surface electromyography, core muscle strength and endurance, and
SRS-22 questionnaire data were analyzed to evaluate early clinical
efficacy across three domains: body structure/function, activities, and
participation in surgically treated AIS patients. <br/>RESULT(S): Analysis
of the primary radiographic outcomes revealed no significant time-by-group
interactions. However, the SCT group demonstrated superior overall
improvement in pelvic balance compared to the CT group (Group main effect:
p = 0.032). For secondary exploratory outcomes, significant interactions
were observed for trunk extensor endurance and SRS-22 self-image (p <
0.01), with the SCT group showing greater improvement than the CT group
specifically at the 6-month follow-up (p < 0.05). In unadjusted
exploratory comparisons, trunk flexor endurance was also better in the SCT
group at 6 months (p = 0.046). No other significant between-group
differences were found. <br/>CONCLUSION(S): Compared with isolated core
stabilization training, Schroth 3D scoliosis-specific exercises combined
with core training demonstrate superior efficacy in improving early
postoperative muscular function, pelvic symmetry, and self-image.
Nevertheless, comparable effects were observed between both rehabilitation
protocols regarding early postoperative Cobb angles of major and minor
curves, convex-concave paraspinal muscle balance restoration, pain
alleviation, and psychological status improvement.<br/>Copyright: &#xa9;
2026 Meng 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.

<126>
Accession Number
649850545
Title
The Effect of Continuous Glucose Monitoring on Postoperative Glucose
Control in People with Type 2 Diabetes Mellitus Undergoing Coronary Artery
Bypass Grafting-A Randomized Clinical Trial.
Source
Diabetes. Conference: 84th scientific sessions 2024. Orlando, FL United
States. 73(Supplement 1) (no pagination), 2024. Date of Publication: 01
Jun 2024.
Author
Son H.; Sohn S.H.; Kim H.A.; Choe H.J.; Lee H.; Jung H.S.; Cho Y.M.; Park
K.S.; Hwang H.Y.; Kwak S.H.
Institution
(Son, Sohn, Kim, Choe, Lee, Jung, Cho, Park, Hwang, Kwak) SeoulSouth Korea
Publisher
American Diabetes Association Inc.
Abstract
Introduction & Objective: Effective glycemic control following cardiac
surgery improves overall clinical outcomes, and continuous glucose
monitoring (CGM) is a valuable tool in achieving this objective. We
investigated the effect of CGM on postoperative glycemic control in
patients with diabetes after coronary artery bypass grafting (CABG).
<br/>Method(s): In this randomized clinical trial involving adults with
type 2 diabetes undergoing CABG, all participants utilized real-time CGM
(Dexcom G6) after scheduled CABG, and received a basal bolus insulin
regimen. The subjects were randomly assigned to either a test group
utilizing CGM for glycemic control, or a control group with blinded CGM
measures, relying on point-of-care measures. The primary outcome was the
percentage of time in range (TIR) of blood glucose between 70-180 mg/dL,
as measured by CGM. <br/>Result(s): Of total 96 subjects, 49 were in the
test group and 47 in the control group. CGM was applied for 5.9 +/- 2.0
days. Participants had a mean age of 68.9 +/- 9.3 years, and baseline
glycated hemoglobin was 7.2 +/- 0.9 %. The least squares (LS) mean +/-
standard error of TIR was 58.9 +/- 2.7%, 50.2 +/- 2.8% in the test and
control group, respectively. TIR was significantly higher in the test
group than in the control group when adjusted with age, sex, body mass
index, and baseline glycated hemoglobin (LS mean difference, 8.3%; 95%
confidence interval, 0.4-16.3; p=0.041). Time above range and mean glucose
levels were also significantly lower in the test group than in the control
group. No differences in time below range, coefficient of variation, and
hypoglycemic event rate were observed between the two groups.
<br/>Conclusion(s): In this randomized clinical trial, Dexcom G6 CGM has
enhanced glycemic control without increasing the risk of hypoglycemia.
Given the benefits of effective glycemic control on perioperative
outcomes, CGM may be helpful in managing type 2 diabetes after CABG.

<127>
Accession Number
649862939
Title
Prognostic value of CT-derived myocardium-related parameters in patients
with aortic stenosis: A systematic review and meta-analysis.
Source
Insights into Imaging. Conference: European Congress of Radiology, ECR
2024. Vienna Austria. 15(Supplement 2) (pp 48), 2024. Date of Publication:
01 Sep 2024.
Author
He X.; Li Y.; Lu X.; Nan J.; Cao L.; Wang Y.; Wang G.; Chen Z.
Institution
(He, Li, Wang, Lu, Nan, Cao, Wang, Chen) Lan Zhou cityChina
(Wang) ShanghaiChina
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: The aim of this study was to investigate the prognostic value of
CTderived myocardium-related parameters in patients with severe aortic
stenosis (AS) who have undergone aortic valve replacement (AVR). Methods
or Backround: Four databases (PubMed, Web of Science, Embase, and
Cochrane) were searched to identify studies investigating the prognostic
performance of CT-derived myocardium-related parameters in patients with
AS. A random effects model for meta-analysis was conducted to calculate
pooled hazard ratios (HR) and 95% confidence intervals (CI) in order to
assess the prognostic value. The I2 statistic was used to assess
heterogeneity. Results or Findings: In this analysis, ten studies were
identified, six of which involved 662 patients reporting CT-derived
extracellular volume fraction (ECV), and four studies, including 1244
patients reporting CT-derived left ventricular global longitudinal strain
(LVGLS). The meta-analysis revealed that ECV, whether considered as a
dichotomous variable (pooled HR: 4.12, 95% CI: 2.76-6.15, I2 =0%, P<
0.001), or as a continuous variable (pooled HR: 1.15, 95% CI: 1.05-1.25,
I2 =74%, P=0.002), and LVGLS, whether considered as a dichotomous variable
(pooled HR: 1.70, 95% CI: 1.31-2.19, I2 =0%, P< 0.001) or a continuous
variable (pooled HR: 1.07, 95% CI: 1.05-1.10, I2=0%, P< 0.001) were all
significant predictors for all-cause mortality in patients with AS after
AVR. <br/>Conclusion(s): This study has demonstrated the significant
prognostic value of pre-AVR CT-derived ECV and LVGLS, both as dichotomous
and continuous variables, in predicting all-cause mortality in patients
with AS. These findings enhance our understanding of the pathophysiology
of AS and assist in optimizing the timing of AVR.