EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

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<1>
Accession Number
2042481201
Title
Immune Unresponsiveness to Cardiopulmonary Bypass Is Associated With
Unfavorable Outcome in Infants Requiring Cardiac Surgery.
Source
JACC: Basic to Translational Science. 11(1) (no pagination), 2026. Article
Number: 101450. Date of Publication: 01 Jan 2026.
Author
Chenouard A.; Petrier M.; Bridonneau C.; Andre E.; Davieau M.; Fourgeux
C.; Mancuso C.; Davidson J.; Broquet A.; Joram N.; Bourgoin P.; Gourain
V.; Poschmann J.; Jacqueline C.; Roquilly A.
Institution
(Chenouard, Joram, Bourgoin) CHU Nantes, Reanimation Pediatrique, Nantes,
France
(Chenouard, Petrier, Bridonneau, Andre, Fourgeux, Broquet, Gourain,
Poschmann, Jacqueline, Roquilly) Nantes Universite, CHU Nantes, INSERM,
Center for Research in Transplantation and Translational Immunology UMR
1064, Nantes, France
(Davieau, Broquet, Roquilly) CHU Nantes, INSERM, Nantes Universite,
Anesthesie Reanimation, Nantes, France
(Mancuso) Department of Biostatistics and Informatics, Colorado School of
Public Health, Aurora, CO, United States
(Davidson) Department of Pediatrics, University of Colorado School of
Medicine, Aurora, CO, United States
(Bourgoin) CHU Nantes, Departement d'anesthesie, Nantes, France
Publisher
Elsevier Inc.
Abstract
Cardiopulmonary bypass (CPB) induces a complex immune response which can
lead to complications after pediatric cardiac surgery. We hypothesized
that analyzing the whole blood transcriptomic response after cardiac
surgery with or without CPB in children would provide new insights into
the pathophysiological mechanisms of CPB-related postoperative
complications. In this study focusing on infants <=3 months of age
requiring CPB who are more likely to develop postoperative complications,
we defined an immune transcriptomic signature related to CPB. Among the
genes included in the CPB signature, we identified only 18 genes that were
differentially expressed after surgery in patients with a complicated
outcome. In contrast, more than 2,000 genes were differentially expressed
before and after the surgery in the uncomplicated group. We demonstrated
the predictive potential of the preoperative plasma TNFSF12 abundance to
identify patients at risk of CPB-induced complications, which was
confirmed in an external cohort.<br/>Copyright &#xa9; 2026 The Authors.

<2>
Accession Number
2043090850
Title
Concomitant Tricuspid Annuloplasty During Degenerative Mitral Valve
Repair: A Systematic Review and Meta-Analysis.
Source
American Journal of Cardiology. 262 (pp 68-74), 2026. Date of Publication:
01 Mar 2026.
Author
Jacquemyn X.; Rohit G.; Sa M.P.; Bonatti J.; Hasan I.; Ogami T.; Verbelen
T.; Verbrugghe P.; Rega F.; Sultan I.
Institution
(Jacquemyn, Bonatti, Hasan, Ogami, Sultan) UPMC Heart and Vascular
Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United
States
(Jacquemyn, Bonatti, Hasan, Ogami, Sultan) Department of Cardiothoracic
Surgery, University of Pittsburgh, Pittsburgh, PA, United States
(Jacquemyn, Verbelen, Verbrugghe, Rega) Department of Cardiac Surgery,
University Hospitals Leuven and Department of Cardiovascular Sciences, KU
Leuven - University of Leuven, Leuven, Belgium
(Rohit) Division of Cardiology, Cedar-Sinai Medical Center, Los Angeles,
California, United States
(Sa) Cleveland Clinic Florida, Weston, Florida, United States
Publisher
Elsevier Inc.
Abstract
Tricuspid regurgitation (TR) is common among patients undergoing surgery
for degenerative mitral regurgitation (DMR) and is associated with adverse
outcomes. The role of concomitant tricuspid annuloplasty (TA) during
mitral valve repair (MVr) remains controversial. To address this, we
performed a systematic review and meta-analysis of randomized and
observational studies published up to November 2024, comparing isolated
MVr versus MVr with concomitant TA in patients with DMR (CRD42024627505).
Reconstructed Kaplan-Meier time-to-event data were analyzed using Cox
frailty models to evaluate survival, TR progression, and permanent
pacemaker (PPM) implantation. Sensitivity analyses included randomized or
propensity-matched cohorts. A total of 5 studies, including 3,123
patients, were analyzed. Early (1-year) and long-term (up to 15 years)
survival were comparable between isolated MVr and concomitant TA (97.3%
vs. 96.9%, HR: 1.25, 95% CI: 0.76 to 2.08, p = 0.381 and 72.2% vs 79.7%,
HR: 1.28, 95% CI: 0.96 to 1.72, p = 0.092, respectively). Concomitant TA
significantly reduced the risk of >=moderate TR progression (HR: 0.34, 95%
CI: 0.17 to 0.70, p = 0.003). However, PPM implantation was higher with TA
during the perioperative period (7.4% vs 1.1%, HR 5.76, 95% CI 3.13 to
10.59) and remained elevated at 2 years. Sensitivity analyses confirmed
these findings. In conclusion, in patients undergoing MVr for DMR,
concomitant TA effectively prevents TR progression without compromising
survival but is associated with increased PPM implantation. These results
support a selective, guideline-directed approach to TA based on patient-
and disease-specific risk factors.<br/>Copyright &#xa9; 2025 The Author(s)

<3>
Accession Number
2042657898
Title
Surgical outcomes of congenital heart disease in African pediatric
populations: a systematic review.
Source
Egyptian Pediatric Association Gazette. 74(1) (no pagination), 2026.
Article Number: 7. Date of Publication: 01 Dec 2026.
Author
Anthony C.S.; Ogieuhi I.J.; Entonu A.I.; Bob-Ume N.C.; Akinmeji O.;
Chukwuneke O.M.; Akinmeji A.; Ajekiigbe V.O.; Agbo C.E.
Institution
(Anthony) University of Calabar, Calabar, Nigeria
(Ogieuhi) Northwestern Medicine McHenry Hospital, McHenry, United States
(Entonu) University of Ilorin, Ilorin, Nigeria
(Bob-Ume) All Saints University College of Medicine, Kingstown, Saint
Vincent and the Grenadines
(Akinmeji) Olabisi Onabanjo University, Sagamu, Nigeria
(Chukwuneke) BPP University, London, United Kingdom
(Akinmeji) New York Medical College, Valhalla, United States
(Ajekiigbe) Ladoke Akintola University of Technology, Ogbomoso, Nigeria
(Agbo) University of Nigeria, Nsukka, Nigeria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Congenital heart disease (CHD) is a major cause of child
morbidity and mortality across Africa. Despite increased recognition of
CHD as a significant public health challenge, surgical services remain
geographically and institutionally limited. Individual reports and studies
have shown widely varied surgical outcomes for pediatrics in Africa.
Hence, there is a need to obtain consolidated evidence on these outcomes
to guide policies. This study systematically analyzes the surgical
outcomes of CHD among African pediatric populations. <br/>Method(s): Using
the PRISMA guidelines, we searched databases including PubMed, Google
Scholar, Scopus, Web of Science, and AJOL. Boolean operators (AND, OR)
were used appropriately to combine the keywords. We then screened articles
for eligibility, ensuring that only studies with surgical interventions
comprising the pediatric African population were selected. <br/>Result(s):
A total of 2,843 records were screened, of which 18 eligible studies were
included. The median age of the included population ranged from about 2
years to 15 years. The postoperative mortality ranged from approximately
0% to 13%. In many cases, patients presented late, often with advanced
disease and comorbidities. The median hospital stay ranged from 7 to 19
days. Centers with locally trained cardiac surgeons had better survival
rates than those reliant solely on visiting international missions.
<br/>Conclusion(s): There are wide systemic inequities in terms of the
availability of surgical services and outcome measures such as mortality
and complications. There is a need to invest adequately in pediatric
cardiac programs to ensure the availability of highly-skilled local
cardiologists and adequate infrastructure.<br/>Copyright &#xa9; The
Author(s) 2026.

<4>
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.

<5>
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.

<6>
Accession Number
2041676948
Title
Stroke Mechanism and Severity After Left Atrial Appendage Occlusion:
Insights From the LAAOS III Randomized Clinical Trial.
Source
JAMA Neurology. 83(1) (pp 76-82), 2026. Date of Publication: 12 Jan 2026.
Author
Katsanos A.H.; Whitlock R.P.; Belley-Cote E.P.; Brady K.; Wang A.;
Srivastava A.; Jacquin G.; Weiss V.; Volny O.; Sramek M.; Peeters A.;
Marto J.P.; Wrona P.; Tsolaki A.; Li L.; Nucera A.; Mikulik R.; Perera K.;
Catanese L.; Shoamanesh A.; Sharma M.
Institution
(Katsanos, Whitlock, Belley-Cote, Brady, Wang, Perera, Catanese,
Shoamanesh, Sharma) Population Health Research Institute, Hamilton Health
Sciences, Hamilton, ON, Canada
(Katsanos, Srivastava, Perera, Catanese, Shoamanesh, Sharma) Department of
Medicine, McMaster University, Division of Neurology, Hamilton, ON, Canada
(Whitlock) Division of Cardiac Surgery, Department of Surgery, McMaster
University, Hamilton, ON, Canada
(Belley-Cote) Universite de Montreal, Faculte de Medecine, Departement de
Neurosciences, Montreal, QC, Canada
(Jacquin) Department of Neurology, Masaryk University, Tomas Bata
Hospital, St. Anne's University Hospital, Department of Neurology, Brno,
Zlin, Czechia
(Weiss, Mikulik) University of Ostrava, Faculty of Medicine, Department of
Clinical Neurosciences, Ostrava, Czechia
(Volny) Department of Neurology, Military University Hospital Prague,
Prague, Czechia
(Sramek) Department of Neurology, UCLouvain, Cliniques Universitaires
Saint Luc, Brussels, Belgium
(Peeters) Department of Neurology, Centro Hospitalar Lisboa Ocidental,
Lisbon, Portugal
(Marto) Department of Neurology, Jagiellonian University Medical College,
Krakow, Poland
(Wrona) First Department of Neurology, Medical School, Faculty of Health
Sciences, Aristotle University of Thessaloniki, Macedonia, Greece
(Tsolaki) Wolfson Centre for Prevention of Stroke and Dementia, Nuffield
Department of Clinical Neurosciences, Oxford University, United Kingdom
(Li) Neurovascular Treatment Unit, Spaziani Hospital, Frosinone, Italy
Publisher
American Medical Association
Abstract
Importance In the Left Atrial Appendage Occlusion Study III (LAAOS III),
surgical occlusion of the LAA during cardiac surgery for patients with
known history of atrial fibrillation (AF) substantially reduced the risk
of stroke. Objective To assess the impact of LAAO on ischemic stroke
subtype and outcome. Design, Setting, and Participants This was a post hoc
exploratory analysis of the LAAOS III randomized clinical trial. Data were
adjudicated from June 28, 2023, to November 29, 2023, and the main
analyses took place from December 18, 2023, to April 29, 2024. The LAAOS
III trial recruited participants from 105 centers in 27 countries between
July 2012 and October 2018. Patients with AF and a
CHA<inf>2</inf>DS<inf>2</inf>-VASc score of at least 2 undergoing cardiac
surgery for other indications were included in the analysis. Interventions
Surgical LAAO plus standard care vs standard care alone. Main Outcomes and
Measures For strokes occurring during the trial, the functional outcome as
measured by the modified Rankin Scale (mRS) score at day 7 or discharge,
mortality, the presence of cortical infarcts, and the occurrence of
infarcts of presumed cardioembolic origin were examined. Results Of 4811
participants in the LAAOS III trial followed up for 3.8 years, 273 had a
first ischemic stroke. The mean (SD) age of participants at the time of
the first ischemic stroke was 75 (7) years, 104 were female (38%), and 169
were male (62%). Participants allocated to receive LAAO had reduced
(common odds ratio [OR], 0.80; 95% CI, 0.65-0.99) mRS scores at 7 days or
discharge and a lower risk for mortality at 30 days (16.5% vs 20.1%;
hazard ratio [HR], 0.55; 95% CI, 0.31-0.97) after a stroke event.
Participants allocated to LAAO had fewer cortical infarcts on neuroimaging
(46.2% vs 61.3%; difference in proportions: -15.2%; 95% CI, -26.7% to
-3.7%), as well as a lower proportion of ischemic strokes of presumed
cardioembolic etiology when compared with ischemic strokes in the no-LAAO
group (42.9% vs 57.9%; difference in proportions: -15.1%; 95% CI, -26.5%
to -3.7%). Conclusions and Relevance This study found that LAAO in
patients with AF undergoing cardiac surgery was associated with a
decreased risk of presumed cardioembolic stroke, reduced disability, and
mortality from stroke. These findings underscore the benefit of LAAO for
patients with AF undergoing cardiac surgery. Trial Registration
ClinicalTrials.gov Identifier: NCT01561651<br/>Copyright &#xa9; 2026
Katsanos AH et al.

<7>
Accession Number
2042163911
Title
Tenecteplase vs Alteplase in Mechanical Prosthetic Heart Valve Thrombosisl
The TENET Randomized Clinical Trial.
Source
JAMA Cardiology. 11(1) (pp 84-88), 2026. Date of Publication: 14 Jan 2026.
Author
Sharma G.; Akkineni K.P.; Makkar N.; Shukla A.; Haldar P.; Velayoudam D.;
Kamal K.; Kumar S.; Naik N.; Roy A.; Singh S.; Seth S.; Bhatia R.
Institution
(Sharma, Akkineni, Makkar, Kamal, Naik, Roy, Singh, Seth) Department of
Cardiology, All India Institute of Medical Sciences, New Delhi, India
(Shukla) Centre for Integrative Medicine and Research, All India Institute
of Medical Sciences, New Delhi, India
(Haldar) Centre for Community Medicine, All India Institute of Medical
Sciences, New Delhi, India
(Velayoudam) All India Institute of Medical Sciences, Department of
Cardiothoracic & Vascular Surgery, New Delhi, India
(Kumar) Department of Cardiac Vascular Radiology & Endovascular
Interventions, All India Institute of Medical Sciences, New Delhi, India
(Bhatia) Department of Neurology, All India Institute of Medical Sciences,
New Delhi, India
Publisher
American Medical Association
Abstract
IMPORTANCE For patients presenting with symptomatic prosthetic valve
thrombosis (PVT) after mechanical heart valve replacement, thrombolytic
therapy with alteplase is accepted as a first-line therapeutic
alternative. The utility of tenecteplase compared with conventional
regimens remains unstudied, to the authors' knowledge, in this patient
population. OBJECTIVE To assess the relative safety and efficacy of
tenecteplase compared with standard infusions of alteplase in patients
with PVT. DESIGN, SETTING AND PARTICIPANTS This was an open-label,
parallel-group, non-inferiority randomized clinical trial among
consecutive adult patients presenting with obstructive PVT of a mechanical
prosthetic valve over the study period from October 2022 to August 2024 to
a single tertiary care center in India. INTERVENTIONS Patients received
thrombolytic therapy with a low-dose slow infusion alteplase or
weight-based bolus doses of tenecteplase. MAIN OUTCOMES AND MEASURES The
primary outcomes were to determine the rates of complete thrombolytic
success and the incidence of major complications. RESULTS A total of 83
patients (mean [SD] age, 39.6 [12.4] years, 42 male [50.6%]) were
randomized to receive alteplase (n = 43) or tenecteplase (n = 40). The
rates of the primary efficacy end point (complete thrombolytic success)
were significantly higher (risk ratio, 1.18; 95% CI, 1.03-1.39; P = .02
for noninferiority) in the tenecteplase group (39 patients [97.5%])
compared with the alteplase group (35 patients [81.5%]). Additionally,
patients treated with tenecteplase had higher rates of complete success
with the first administered dose and a shorter duration of hospital stay
(median [IQR], 4.1 [3.2-5.1] days vs 6.5 [4.3-9.2] days; P < .001). The
rates of major and minor adverse events were similar. CONCLUSIONS AND
RELEVANCE Tenecteplase may be a safe and effective alternative to
alteplase in patients presenting with obstructive PVT. Patients treated
with tenecteplase in our study had higher rates of complete thrombolytic
success and a shorter duration of hospital stay. Furthermore, the relative
ease of drug administration with tenecteplase may translate to greater
clinical benefit in a real-world setting.<br/>Copyright &#xa9; 2026
American Medical Association. All rights reserved, including those for
text and data mining, AI training, and similar technologies.

<8>
Accession Number
2042762534
Title
Perioperative multicomponent exercise rehabilitation for frail elderly
patients undergoing surgical procedures: A systematic review and
meta-analysis.
Source
Archives of Gerontology and Geriatrics. 143 (no pagination), 2026. Article
Number: 106127. Date of Publication: 01 Apr 2026.
Author
Xie X.; Lei L.; Zhan Y.; He C.
Institution
(Xie, He) Hunan Normal University, Changsha, China
(Xie, Lei) The Second Xiangya Hospital of Central South University,
Changsha, China
(Zhan) Hunan Provincial People's Hospital, Changsha, China
Publisher
Elsevier Ireland Ltd
Abstract
Background: Frailty among elderly patients undergoing surgical procedures
constitutes a notable risk factor for adverse postoperative outcomes.
Perioperative multicomponent exercise rehabilitation presents a promising
strategy; however, its overall efficacy is still uncertain. This
systematic review aimed to assess the effects of these programs on frail
elderly patients undergoing surgery. <br/>Method(s): A search was
conducted in MEDLINE, Embase, CINAHL, Cochrane CENTRAL, Web of Science,
and SPORTDiscus from inception to August 2025 for RCTs examining
perioperative (primarily prehabilitation) multicomponent exercise in
adults aged >= 65 with frailty. The JBI checklist was utilized to assess
the risk of bias, while evidence certainty was evaluated using the GRADE
system. <br/>Result(s): Out of 663 identified records, 10 RCTs involving
1146 patients were included. A meta-analysis indicated that exercise
significantly decreased postoperative complications (RR 0.72, 95% CI
0.58-0.87; high certainty) and enhanced functional capacity, evidenced by
a mean difference of 26.7 meters in the Six-Minute Walk Test (95% CI
16.1-37.3; high certainty). A modest yet noteworthy decrease in length of
stay (MD -0.51 days) and an enhancement in handgrip strength (MD 0.35 kg)
were observed. The impacts on quality of life, disability, frailty, and
readmission risk were determined to be non-significant, corroborated by
low-to-moderate certainty evidence. <br/>Conclusion(s): Perioperative
multicomponent exercise rehabilitation significantly decreases
complications and improves physical function in frail elderly patients
undergoing surgery. Nonetheless, its impact on wider geriatric syndromes
has yet to be established. Clinicians ought to implement these programs to
enhance core recovery outcomes, while future research should focus on
optimizing patient-centered benefits.<br/>Copyright &#xa9; 2025

<9>
Accession Number
2042654386
Title
Circumferential Ultrasonic Renal Denervation Targeting Main Renal Arteries
and Branches.
Source
JACC: Asia. 6(2) (pp 263-268), 2026. Date of Publication: 01 Feb 2026.
Author
Yao Z.; Ji M.; Wu Y.; Shen L.; Qian J.; Ge J.
Institution
(Yao, Ji, Wu, Shen, Qian, Ge) Department of Cardiology, Zhongshan
Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases,
Shanghai, China
(Yao, Ji, Wu, Shen, Qian, Ge) State Key Laboratory of Cardiovascular
Diseases, Zhongshan Hospital, Fudan University, China
(Yao, Ji, Wu, Shen, Qian, Ge) NHC Key Laboratory of Ischemic Heart
Diseases, China
(Yao, Ji, Wu, Shen, Qian, Ge) Key Laboratory of Viral Heart Diseases,
Chinese Academy of Medical Sciences, China
(Yao, Ji, Wu, Shen, Qian, Ge) National Clinical Research Center for
Interventional Medicine, Shanghai, China
Publisher
Elsevier Inc.
Abstract
This study assessed the feasibility and safety of ultrasound renal
denervation (uRDN) targeting both main and branch renal arteries to treat
uncontrolled hypertension. A circumferential uRDN system was evaluated in
a porcine model (n = 6) and a first-in-human study (n = 5). Endpoints
included the incidence of device-related adverse events and changes in
blood pressure. Preclinical studies revealed a favorable safety profile
and >97% reduction in renal norepinephrine levels. In the human study, all
procedures were technically successful without device-related adverse
events. At 2 and 6 months, 24-hour ambulatory systolic/diastolic blood
pressure decreased by 8.8 (95% CI: 0.98-16.62)/4.6 (95% CI: -1.83 to
11.03) mm Hg and 16 (95% CI: 1.18-30.82)/8 (95% CI: 0.76-15.24) mm Hg ,
respectively. These preliminary findings support the feasibility and
safety of this circumferential uRDN approach for uncontrolled
hypertension. (A Prospective Feasibility Trial Investigating the Use of
Hantong Medical uRDN System in Patients With Uncontrolled Hypertension
(Hammer HTN; ChiCTR2400093088 )<br/>Copyright &#xa9; 2026 The Authors.

<10>
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.

<11>
Accession Number
2043042375
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 January) (no pagination), 2026. Article Number: e0340585.
Date of Publication: 01 Jan 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, Yunnan, Kunming, China
(Li) Department of Rehabilitation, Kunming Municipal Hospital of
Traditional Chinese Medicine, Yunnan, Kunming, China
(Wang) College of Mechanical and Electrical Engineering, Harbin
Engineering University, Heilongjiang, Harbin, China
(Zhao) Department of Orthopaedics, The Second Affiliated Hospital of
Kunming Medical University, Kunming, China
Publisher
Public Library of Science
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. Methods 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. Results 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. Conclusion 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.

<12>
Accession Number
2037425825
Title
Efficacy and safety of mechanical thrombectomy in patients with acute
ischemic stroke and left ventricular assist device: review of the
literature and meta-analysis.
Source
Journal of NeuroInterventional Surgery. 18(2) (pp 339-347), 2026. Date of
Publication: 01 Feb 2026.
Author
Jazayeri S.B.; Al-Janabi O.M.; Alateya A.; Muhammad S.; Ghozy S.;
Rabinstein A.A.; Kadirvel R.; Kallmes D.F.
Institution
(Jazayeri) Tehran University of Medical Sciences, Sina Trauma and Surgery
Research Center, Tehran, Iran, Islamic Republic of
(Al-Janabi) Department of Neurology, Baptist Health Lexington, Lexington,
KY, United States
(Alateya) Royal College of Surgeons in Ireland, Busaiteen, Bahrain
(Muhammad) Department of Neurology, New York Medical College, Valhalla,
NY, United States
(Ghozy, Kadirvel, Kallmes) Department of Radiology, Mayo Clinic,
Rochester, MN, United States
(Ghozy, Kadirvel) Department of Neurologic Surgery, Mayo Clinic,
Rochester, MN, United States
(Rabinstein) Department of Neurology, Mayo Clinic, Rochester, MN, United
States
Publisher
BMJ Publishing Group
Abstract
Background Left ventricular assist devices (LVADs) are used as definitive
therapy or as a bridge to heart transplant in patients with advanced heart
failure. Thromboembolic complications such as acute ischemic stroke (AIS)
are common among patients with LVAD support. This study aims to evaluate
the current evidence on the efficacy and safety of mechanical thrombectomy
(MT) in patients with AIS due to large vessel occlusions (LVO) and
LVAD-support. Methods A comprehensive systematic review was conducted in
PubMed, Embase, and Scopus to find observational studies with reports of
>=5 MTs in adult patients with LVAD support (PROSPERO registration code
CRD42024597541). Rates of successful and complete reperfusion, favorable
functional outcomes at 90 days (modified Rankin Scale (mRS) 0-2 or equal
to pre-stroke mRS), mortality at 90 days, any intracerebral hemorrhage
(ICH) and symptomatic ICH (sICH) were pooled using generalized linear
mixed models. Results Eight studies were included with data from 51
patients and 62 MTs. The rate of successful reperfusion was 87.4% (95% CI
62.5% to 96.6%) and complete reperfusion rate was 57.3% (95% CI 35.1% to
76.9%). Rate of favorable functional recovery was 62.5% (95% CI 42.2% to
79.2%). Rate of sICH was 6.4% (95% CI 0.9% to 34.0%). Mortality rate was
16.7% (95% CI 7.1% to 34.7%). Between 25-40% of patients who were waiting
for a heart transplant before their stroke received a heart transplant
after MT. Conclusions MT for the emergent treatment of AIS in the setting
of LVAD is relatively safe and efficacious for achieving successful
reperfusion and good functional recovery.<br/>Copyright &#xa9; Author(s)
(or their employer(s)) 2026. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<13>
Accession Number
2042013065
Title
Sex Differences in Dilated Cardiomyopathy: Evidence Gaps and Future
Directions.
Source
Journal of the American College of Cardiology. 87(6) (pp 723-735), 2026.
Date of Publication: 17 Feb 2026.
Author
Stroeks S.L.V.M.; Oko-Osi S.; Arasu A.; Hirst J.E.; Tayal U.P.
Institution
(Stroeks) Department of Cardiology, Maastricht University, Cardiovascular
Research Institute Maastricht, Maastricht, Netherlands
(Stroeks) KU Leuven, Cardiovascular Sciences, Leuven, Belgium
(Stroeks) Department of Clinical Genetics, Maastricht University Medical
Center, Maastricht, Netherlands
(Stroeks) European Reference Network for Rare, Low Prevalence and Complex
Diseases of the Heart (ERN GUARD-Heart), Amsterdam, Netherlands
(Oko-Osi, Arasu, Tayal) National Heart Lung Institute, Imperial College
London, London, United Kingdom
(Oko-Osi, Arasu, Tayal) Royal Brompton & Harefield Hospitals, Guy's and St
Thomas' NHS Foundation Trust, London, United Kingdom
(Hirst) George Institute for Global Health, Imperial College London,
London, United Kingdom
Publisher
Elsevier Inc.
Abstract
Dilated cardiomyopathy (DCM), which affects 1 in 250 people, is a leading
global cause of heart failure and the most common indication for heart
transplantation. Evidence suggests that DCM is more prevalent in men, but
whether this reflects biological differences or underdiagnosis in women
remains uncertain. This review explores the impact of sex on DCM,
examining differences in epidemiology, etiology, clinical presentation,
treatment response, and outcomes. Women often present with less severe
cardiac phenotypes, including lower levels of fibrosis and better left
ventricular function, yet the long-term prognosis of DCM in women is less
clear. Through a systematic review and meta-analysis, we found that male
DCM patients with variants in PLN, DSP, and LMNA had higher arrhythmic
event rates compared with TTNtv and BAG3 carriers. In female patients with
DCM, those with RBM20, DSP, and PLN variants faced the highest arrhythmic
risk, and TTNtv carriers the lowest. PLN and LMNA variants had the highest
heart failure risk in both sexes, whereas BAG3, RBM20, and TTN variants
had lower heart failure rates in female compared with male carriers. These
findings highlight the influence of sex and genotype on clinical outcomes.
Current risk-stratification tools, such as those used for implantable
cardioverter-defibrillators, may undertreat women owing to reliance on
sex-neutral thresholds. We highlight the role of genetic, environmental,
and reproductive factors in shaping these disparities, including the
influence of pregnancy, pregnancy complications, and menopause. This
review identifies key gaps in knowledge and calls for expanded
representation of women in DCM studies and the development of sex-specific
risk models. Addressing these gaps is essential to improving outcomes and
advancing equitable personalized care for all DCM patients.<br/>Copyright
&#xa9; 2026 American College of Cardiology Foundation

<14>
Accession Number
2041110140
Title
Tongxinluo Adjunctive Therapy and 12-Month Cardiovascular Outcomes after
ST-Segment Elevation Myocardial Infarction: A Real-World Multicenter
Prospective Cohort Study.
Source
Chinese Journal of Integrative Medicine. 32(1) (pp 3-11), 2026. Date of
Publication: 01 Jan 2026.
Author
Yuan G.-Q.; Chang C.-C.; Yang L.-M.; Yang L.-B.; Xiao M.-T.; Wei X.-X.;
Kang X.-X.; Sun Y.-H.
Institution
(Yuan) Department of Cardiovascular Medicine, Hebei Yiling Hospital, Key
Laboratory of Collateral Disease Theory of the State Administration of
Traditional Chinese Medicine, Shijiazhuang, China
(Chang, Wei, Kang, Sun) Clinical Medical Research Center for Traditional
Chinese Medicine Cardiovascular Diseases of Hebei Province, Shijiazhuang,
China
(Yang, Yang, Xiao) State Key Laboratory for Innovation and Transformation
of Luobing Theory, Shijiazhuang, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Objective: To evaluate the efficacy and safety of Tongxinluo in improving
medium- and long-term prognosis of patients with ST-segment elevation
myocardial infarction (STEMI) in a real-world setting. <br/>Method(s):
This multicenter prospective cohort study enrolled STEMI patients from 122
certified chest pain centers in China. Participants were stratified into
exposure (n=1,598) and non-exposure (n=1,600) groups based on Tongxinluo
administration initiation before or within 24 h post-reperfusion. Both
groups received percutaneous coronary intervention (PCI) or thrombolysis
with guideline-based therapy. The primary endpoint was incidence of major
adverse cardiovascular and cerebrovascular events (MACCEs) at 12 months.
Secondary endpoints included the incidence of severe STEMI complications
at 30 days; MACCEs at 30 days and 6 months; composite endpoint events at 6
and 12 months; and all-cause mortality at 30 days, 6 months, and 12
months. <br/>Result(s): A total of 3,198 patients were included in the
primary analysis. The primary endpoint, MACCEs incidence at 12 months, was
significantly lower in the exposure group [40 (2.5%) vs. 106 (6.6%)],
driven by reductions in cardiac death and stroke. In the secondary
endpoint analysis, early risk reduction was pronounced at 30 days [MACCEs:
19 (1.2%) vs. 64 (4.0%)] and 6 months [MACCEs: 33 (2.1%) vs. 90 (5.6%)].
The exposure group exhibited 92% lower 30-day STEMI complications [16
(1.0%) vs. 210 (13.1%)], including reductions in cardiogenic shock, acute
heart failure, mechanical complications, and malignant arrhythmias.
Composite endpoint risks decreased by 65% at 6 months [36 (2.3%) vs. 104
(6.5%)] and 66% at 12 months [43 (2.7%) vs. 127 (7.9%)], with significant
heart failure readmission reductions and 89% lower severe bleeding risk.
More surprisingly, the risk of all-cause death at 30 days, 6 months, and 1
year was reduced by 71%, 61% and 59% in the exposure group.
<br/>Conclusion(s): Adjunctive Tongxinluo therapy demonstrated significant
improvement in 12-month cardiovascular outcomes with favorable safety
profile, suggesting potential benefits of integrating traditional Chinese
medicine with evidence-based STEMI management. (Registration No.
ChiCTR100054466)<br/>Copyright &#xa9; The Chinese Journal of Integrated
Traditional and Western Medicine Press and Springer-Verlag GmbH Germany,
part of Springer Nature 2025.

<15>
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. 58(1) (pp 1-8), 2026. Date of Publication: 01
Jan 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.

<16>
Accession Number
2042977076
Title
Head-to-head comparison of two paclitaxel-coated balloons for
femoropopliteal lesions: 3-year results from the BIOPACT RCT.
Source
Journal of Cardiovascular Surgery. 66(6) (pp 557-565), 2025. Date of
Publication: 01 Dec 2025.
Author
Peeters M.; Callaert J.; Lansink W.; Brodmann M.; Werner M.; Keirse K.;
Goueffic Y.; Verbist J.; Maene L.; Hendriks J.M.; Brunet J.; Ducasse E.;
Levent K.; Sauguet A.; Vernez E.; Deloose K.R.
Institution
(Peeters, Callaert, Deloose) Department of Vascular Surgery, AZ Sint
Blasius, Dendermonde, Belgium
(Lansink) Department of Thoracic and Vascular Surgery, Ziekenhuis
Oost-Limburg, Genk, Belgium
(Brodmann) Department of Angiology, Medical University of Graz, Graz,
Austria
(Werner) Department of Angiology, Hanusch Krankenhaus, Vienna, Austria
(Keirse) Department of Vascular Surgery, Regionaal Ziekenhuis Heilig Hart,
Tienen, Belgium
(Goueffic) Vascular and Endovascular Surgical Center, Groupe Hospitalier
Paris Saint Joseph, Paris, France
(Verbist) Department of Thoracic and Vascular Surgery, Imeldaziekenhuis,
Bonheiden, Belgium
(Maene) Department of Vascular and Thoracic Surgery, AZORG, Aalst, Belgium
(Hendriks) Department of Thoracic and Vascular Surgery, University
Hospital Antwerpen, Edegem, Belgium
(Brunet) Cardiovascular Department, Clinique Rhone Durance, Avignon,
France
(Ducasse) Department of Vascular Surgery, Hospital Center University
Bordeaux, Bordeaux, France
(Levent) Institute of Radiology and Nuclear Medicine, Stadtspital Triemli,
Zurich, Switzerland
(Sauguet) Clinique-Pasteur, Toulouse, France
(Vernez) iD3 Medical, Sint-Agatha-Berchem, Belgium
Publisher
Edizioni Minerva Medica
Abstract
Background: Over the past decade, drug-coated balloons (DCBs) delivering
paclitaxel have become widely used for the treatment of peripheral artery
disease (PAD). The safety and efficacy of various DCBs have been
extensively studied, but differences in device design and drug delivery
matrices may influence outcomes. The publication aim was to report
long-term safety and efficacy data of the Passeo-18 Lux DCB for the
treatment of symptomatic PAD due to stenosis, restenosis or occlusion of
the femoral and/or popliteal arteries. <br/>Method(s): Three hundred and
two patients were randomized 1:1 and assigned to the Passeo-18 Lux DCB
(study device) group or to the IN.PACT Admiral DCB (control device) group
for testing of noninferiority. An efficacy endpoint was freedom from
clinically-driven target lesion revascularization (CD-TLR) at 36 months.
In terms of safety, a composite endpoint of freedom from
device-/procedure-related death at 30 days post-index procedure, - major
target limb amputation and clinically-driven target vessel
revascularization (CD-TVR) at 36 months was investigated. <br/>Result(s):
At 36 months, freedom from CD-TLR-was achieved in 119 out of 128 patients
in the IN.PACT Admiral group (93.0%) and in 116 out of 127 patients in the
Passeo-18 Lux group (91.3%). The null hypothesis of inferiority was
rejected with a P value of 0.0095, confirming the non-inferiority of
Passeo-18 Lux compared to IN.PACT Admiral in terms of efficacy. Both
treatment groups demonstrated sustained clinical improvement, as shown by
the evolution of the Rutherford Clinical Category (RCC). At 36 months, the
mean change in target limb RCC class compared to baseline was -2.5 in both
groups, indicating comparable and significant clinical improvement over
time. <br/>Conclusion(s): The Passeo-18 Lux and the IN.PACT Admiral DCBs
demonstrate comparable results with excellent effectiveness and safety
through 36 months for femoropopliteal interventions.<br/>Copyright &#xa9;
2025 EDIZIONI MINERVA MEDICA.

<17>
Accession Number
2043085189
Title
Effects of exercise on the efficacy and adverse effects of
immunosuppressants: a systematic review and meta-analysis.
Source
Transplantation Reviews. 40(2) (no pagination), 2026. Article Number:
101001. Date of Publication: 01 Apr 2026.
Author
Etayo-Urtasun P.; Saez de Asteasu M.L.; Izquierdo M.
Institution
(Etayo-Urtasun, Saez de Asteasu, Izquierdo) Navarrabiomed, Hospital
Universitario de Navarra (HUN) - Universidad Publica de Navarra (UPNA),
IdiSNA, Pamplona, Spain
(Saez de Asteasu, Izquierdo) CIBER of Frailty and Healthy Aging
(CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
Publisher
Elsevier Inc.
Abstract
Background: Lifelong immunosuppression is the standard care after solid
organ transplantation; however, it is associated with a wide range of
adverse effects. Emerging evidence indicates that structured exercise may
help reduce these complications. Therefore, this review aimed to assess
the effects of exercise interventions on the side effects of
immunosuppressive treatment. <br/>Method(s): A systematic search was
conducted in PubMed, Web of Science, and Scopus following the PRISMA 2020
guidelines (PROSPERO CRD420251078616). Randomised controlled trials (RCTs)
examining post-transplant exercise interventions were included. Two
reviewers independently screened studies published since 2000 using the
PICOS framework and assessed their quality with the PEDro scale. Pooled
analyses employed random effects models. <br/>Result(s): Twenty-five RCTs
involving 560 participants were included. Exercise significantly increased
peak oxygen uptake (VO<inf>2</inf>peak; standardised mean difference [SMD]
= 0.749, 95% confidence interval [CI]: 0.225 to 1.274, p = 0.010) and
decreased body fat percentage (SMD = -0.509, 95% CI: -0.899 to -0.118, p =
0.022). No significant effects were observed on blood pressure, muscle
strength, or metabolism. Evidence on bone health and immunomodulatory
efficacy remains limited. <br/>Conclusion(s): Exercise may partially
mitigate adverse effects of immunosuppressants by improving
cardiorespiratory fitness and body composition. However, gaps still exist
regarding its impact on metabolic, skeletal, and immunological
effects.<br/>Copyright &#xa9; 2026 The Authors

<18>
Accession Number
2043143464
Title
Spontaneous Coronary Artery Dissection in Women.
Source
Reviews in Cardiovascular Medicine. 26(12) (no pagination), 2025. Article
Number: 44459. Date of Publication: 01 Dec 2025.
Author
Luca F.; Parrini I.; Chieffo A.
Institution
(Luca) Department of Cardiology, Grande Ospedale Metropolitano, Reggio
Calabria, Italy
(Parrini) Cardiology Unit, Koelliker Hospital, Torino, Italy
(Chieffo) Interventional Cardiology Unit, IRCCS San Raffaele Scientific
Institute, Milan, Italy
Publisher
IMR Press Limited

<19>
Accession Number
2042977181
Title
Natural history of unrepaired bicuspid aortic valve at diagnosis:
meta-analysis and reconstruction of time-to-event data.
Source
Journal of Cardiovascular Surgery. 66(6) (pp 517-524), 2025. Date of
Publication: 01 Dec 2025.
Author
Ogami T.; Yokoyama Y.; Sa M.P.; Takagi H.; Fukuhara S.; Sultan I.; Kuno T.
Institution
(Ogami, Sultan) Department of Cardiothoracic Surgery, University of
Pittsburgh Medical Center, PA, United States
(Ogami, Sultan) Heart and Vascular Institute, University of Pittsburgh
Medical Center, PA, United States
(Yokoyama, Fukuhara) Department of Cardiac Surgery, University of
Michigan, MI, Ann Arbor, United States
(Sa) Division of Cardiovascular Surgery, Heart, Vascular and Thoracic
Institute, Cleveland Clinic Florida, FL, Weston, United States
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, MA, Boston, United States
(Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center,
Harvard Medical School, MA, Boston, United States
Publisher
Edizioni Minerva Medica
Abstract
Introduction: While outcomes after surgical or transcatheter aortic valve
replacement between bicuspid aortic valve (BAV) and tricuspid aortic valve
have been reported, the natural history of unrepaired BAV is sparse in the
literature. <br/>Evidence Acquisition: The MEDLINE and EMBASE databases
were searched to identify relevant studies. The search was conducted
through February 2024. Time-to-event data was synthesized to reconstruct
survival curves. <br/>Evidence Synthesis: A total of 20 studies were
identified. Nine studies were included to reconstruct the Kaplan-Meier
survival curves, enrolling 5819 patients with BAV. Expected survival was
97.6+/-0.2%, 91.9+/-0.4%, 84.3+/-0.6%, and 76.0+/-0.9% at 1-, 5-, 10-, and
15-year, respectively. Long-term survival was similar between patients
with unrepaired BAV and the general population (HR 1.15, 95% CI: 0.86 to
1.55, I²=0). Five studies were included to synthesize freedom
from cardiac surgery, enrolling 2962 patients. Expected freedom cardiac
surgery were 88.5+/-0.6%, 82.1+/-0.7%, and 70.0+/-1.5% at 1, 5, and 10
years, respectively. The risk of thoracic aortic dissection was 0.06 per
100 patient years (95% CI: 0.01 to 0.12, I²=30%).
<br/>Conclusion(s): The estimated survival of patients with BAV was 91.9%
at 5 years and 84.3% at 10 years after the diagnosis. Survival of patients
with BAV may be comparable to that of the general population. The need for
an intervention to either aortic valve or thoracic aorta was 30% at 10
years.<br/>Copyright &#xa9; 2025 EDIZIONI MINERVA MEDICA.

<20>
Accession Number
2035937239
Title
Stent thrombosis in acute myocardial infarction in the era of
second-generation drug-eluting stent: incidence, prognosis, and historical
comparisons with previous stent era.
Source
Cardiovascular Intervention and Therapeutics. 41(1) (pp 56-65), 2026. Date
of Publication: 01 Jan 2026.
Author
Kirii Y.; Kurita T.; Kainuma H.; Yamaguchi K.; Mori H.; Yanagisawa M.;
Okazaki T.; Ikami A.; Fukuma T.; Ito H.; Kato T.; Ishiyama M.; Takasaki
A.; Sato Y.; Takamura T.; Dohi K.
Institution
(Kirii, Kurita, Ito, Ishiyama, Takasaki, Dohi) Department of Cardiology
and Nephrology, Mie University Graduate School of Medicine, 2-174
Edobashi, Tsu, Japan
(Kainuma) Department of Cardiology, Nagai Hospital, Tsu, Japan
(Yamaguchi) Department of Cardiology, Saiseikai Mastusaka General
Hospital, Matsusaka, Japan
(Mori) Department of Cardiology, Owase General Hospital, Owase, Japan
(Yanagisawa) Department of Cardiology, Kuwana City Medical Center, Kuwana,
Japan
(Okazaki) Department of Cardiology, Mie Chuo Medical Center, Tsu, Japan
(Ikami) Department of Cardiology, Suzuka Chuo General Hospital, Suzuka,
Japan
(Fukuma) Department of Cardiology, Nabari City Hospital, Nabari, Japan
(Kato) Department of Cardiology, Mie Prefectural General Medical Center,
Yokkaichi, Japan
(Sato) Department of Cardiology, Matsusaka Chuo General Hospital,
Matsusaka, Japan
(Takamura) Department of Cardiology, Ise Red Cross Hospital, Ise, Japan
Publisher
Springer
Abstract
Background: Stent thrombosis (ST) remains a serious complication after
percutaneous coronary intervention, leading to acute myocardial infarction
(AMI) in over 70% of cases. And it has been reported that the prognosis
for ST is worse than for de-novo AMI. While the use of second-generation
drug-eluting stents (G2-DES) has reduced ST incidence, ST remains a
concern, and its incidence and prognosis in the G2-DES era have not been
well studied. <br/>Aim(s): To evaluate the incidence and prognosis of AMI
due to ST in the G2-DES era compared with de-novo AMI. <br/>Method(s):
From January 2013 to November 2022, we analyzed 6273 consecutive AMI
patients from the Mie ACS Registry, including 78 ST and 6195 de-novo type
1 AMI (de-novo AMI) after exclusion of the other type of AMI. The primary
endpoint was all-cause mortality, and target lesion revascularization
(TLR) was the secondary endpoint. <br/>Result(s): ST occurred in 1.2% (n =
78) of AMI, predominantly as very late ST (79.5%, n = 62). Thirty-day
mortality was marginally lower in ST (2.6%) than de-novo AMI (6.7%, p =
0.16), with ST not being an independent predictor of 30-day mortality (HR
0.39, p = 0.19). However, ST patients had a higher 2-year TLR rate (21.4%
vs. 11.9%, p = 0.02), confirmed as an independent predictor (HR 2.03, p =
0.01). Compared to previous clinical data, the reduced incidence of ST and
the improved prognosis was observed. <br/>Conclusion(s): While ST-related
AMI prognosis has improved, with mortality comparable to de-novo AMI, the
higher TLR rate in ST patients persists, and an optimized
revascularization strategy is still needed.<br/>Copyright &#xa9; The
Author(s) under exclusive licence to Japanese Association of
Cardiovascular Intervention and Therapeutics 2025.

<21>
Accession Number
2042643225
Title
The predictive value of right ventricle speckle tracking echocardiography
in patients undergoing cardiac surgery, a systematic review and
meta-analysis.
Source
Cardiovascular Ultrasound. 24(1) (no pagination), 2026. Article Number: 4.
Date of Publication: 01 Dec 2026.
Author
Al-shammari A.S.; Al Sakini A.S.; Hasan M.T.; Islam M.R.; Shahzad M.;
Alsawadi R.A.; Lingamsetty S.S.P.; Ibrahim A.; Marsool M.D.; Elgebaly M.;
Masih R.
Institution
(Al-shammari, Al Sakini) College of Medicine, University of Baghdad,
Baghdad, Iraq
(Hasan) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Islam) Department of Internal Medicine, Shaheed Suhrawardy Medical
College Hospital, Dhaka, Bangladesh
(Shahzad) Department of Internal Medicine, Dow University of Health
Sciences, Karachi, Pakistan
(Alsawadi) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
(Lingamsetty) Department of Internal Medicine, Mamata Medical College,
Khammam, India
(Ibrahim) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Marsool) Research Fellow at Mayo clinic, Phoenix/Scottsdale, AZ, United
States
(Elgebaly) Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt
(Masih) Department of Cardiology, Minneapolis Heart Institute, MN, United
States
Publisher
BioMed Central Ltd
Abstract
Background: Right ventricular (RV) dysfunction is a critical predictor of
adverse outcomes in cardiac surgery patients. The assessment of right
ventricular global longitudinal strain (GLS) echo has emerged as a
promising tool for detecting early RV dysfunction. This meta-analysis
evaluates the predictive value of RV GLS in these patients.
<br/>Method(s): A comprehensive literature search was conducted. The
primary outcomes included pooled diagnostic performance measures,
including sensitivity, specificity, and the diagnostic odds ratio (DOR). A
multiple-cutoff model was employed to determine the optimal RV-GLS
threshold. <br/>Result(s): Ten observational studies involving 583
patients were included. RV-GLS demonstrated strong diagnostic accuracy,
with a pooled area under the summary receiver operating characteristic
curve (AUC) of 0.90 (95% CI: 0.82-1.00). The pooled DOR was 6.34 (95% CI:
3.20-12.57) with no heterogeneity (I2 = 0%). Sensitivity was 0.79 (95% CI:
0.69-0.86; I2 = 57.2%) and specificity was 0.78 (95% CI: 0.71-0.84; I2 =
20.8%). The risk of publication bias was low (LFK index = 0.6). A
multiple-threshold model identified - 15.25% as the optimal RV-GLS cutoff,
achieving balanced sensitivity and specificity of 0.7423.
<br/>Conclusion(s): RV-GLS demonstrates excellent predictive value for RV
dysfunction in cardiac surgery patients.<br/>Copyright &#xa9; The
Author(s) 2025.

<22>
Accession Number
2041514566
Title
Low dose of landiolol does not prevent postoperative atrial fibrillation
after cardiac surgery in non-Asian patients: a multicentre randomised
study.
Source
British Journal of Anaesthesia. 136(1) (pp 65-73), 2026. Date of
Publication: 01 Jan 2026.
Author
Amour J.; Naudin C.; Besnard A.; Merzoug M.; Laverdure F.; Frossard B.;
Morichau-Beauchant T.; Geri G.; Squara P.
Institution
(Amour, Besnard, Laverdure, Frossard) Department of Cardiac
Anaesthesiology and Intensive Care Medicine, Institute of Perfusion,
Intensive Care Medicine and Anaesthesiology (IPRA), Hopital Prive Jacques
Cartier-Ramsay Sante, Massy, France
(Naudin, Merzoug, Geri, Squara) Department of Cardiology and Intensive
Care Medicine-Groupe Hospitalier Prive Ambroise Pare-Hartmann,
Neuilly-Sur-Seine, France
(Morichau-Beauchant) Department of Intensive Care Medicine, Centre
Cardiologique du Nord, Saint Denis, France
Publisher
Elsevier Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) affects 30% of
patients undergoing cardiac surgery with cardiopulmonary bypass (CPB).
Beta-blockers are the first-line agents recommended for POAF prevention.
Landiolol, an ultra-short-acting, highly selective beta-1-blocker, has
been shown to be effective in reducing POAF in Asian patients at a low
dose of 2 mug kg^-1 min^-1. The aim of this study was
to evaluate the effect of a low dose of landiolol for the prevention of
POAF in non-Asian patients after cardiac surgery. <br/>Method(s): This
multicentre, double-blind, randomised, placebo-controlled superiority
trial was conducted from January 2021 to July 2023 at three hospitals in
France. Participants were non-Asians >=65 yr undergoing elective cardiac
surgery with CPB and a left ventricular ejection fraction >=40%. Treatment
was started in the ICU and continued for up to 24 h, after which oral
beta-blockers were administered. The primary endpoint was the incidence of
POAF while in the ICU, analysed by intention to treat. Secondary outcomes
included in-hospital and 30-day POAF, ICU and hospital length of stay, and
safety outcomes. <br/>Result(s): A total of 318 participants (mean age: 71
[range: 68-76] yr; 21.4% female) were randomised. POAF in ICU occurred in
51/160 (31.9%) participants who received placebo, compared with 47/158
(29.8%) who received a low-dose landiolol infusion (relative risk: 0.93
[95% confidence interval, 0.67-1.30]; P=0.77). No differences were
observed in secondary endpoints, including in-hospital POAF and safety
outcomes. <br/>Conclusion(s): In non-Asian patients undergoing cardiac
surgery with CPB, a low-dose 24-h infusion of landiolol, used as a bridge
to oral beta-blockers, did not reduce the incidence of postoperative
atrial fibrillation. Clinical trial registration: ClinicalTrials.gov
(NCT04607122).<br/>Copyright &#xa9; 2025 British Journal of Anaesthesia

<23>
Accession Number
2041546809
Title
Efficacy and Safety of Oral PCSK9 Inhibitor Enlicitide in Adults With
Heterozygous Familial Hypercholesterolemia: A Randomized Clinical Trial.
Source
JAMA. 335(2) (pp 129-139), 2026. Date of Publication: 13 Jan 2026.
Author
Ballantyne C.M.; Gellis L.; Tardif J.-C.; Banka P.; Navar A.M.; Asprusten
E.A.; Scott R.; Stroes E.S.G.; Froman S.; Mendizabal G.; Wang F.; Catapano
A.L.
Institution
(Ballantyne) Texas Heart Institute, Baylor College of Medicine, Houston,
TX, United States
(Gellis, Banka, Froman) Merck & Co, Inc, Rahway, NJ, United States
(Tardif) Montreal Heart Institute, Universite de Montreal, Montreal, QC,
Canada
(Navar) Department of Medicine, Division of Cardiology, University of
Texas Southwestern Medical Center, Dallas, United States
(Asprusten) Lipid Clinic, Oslo University Hospital, Oslo, Norway
(Scott) NZ Clinical Research, Christchurch, New Zealand
(Stroes) Department of Vascular Medicine, Amsterdam Cardiovascular
Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Mendizabal) MSD Argentina, Munro, Argentina
(Wang) MSD China, Beijing, China
(Catapano) University of Milan, Milan, Italy
(Catapano) IRCCS Multimedica, Milan, Italy
Publisher
American Medical Association
Abstract
Importance Persons with heterozygous familial hypercholesterolemia (HeFH)
are at increased risk of atherosclerotic cardiovascular disease due to
lifelong elevated levels of low-density lipoprotein cholesterol (LDL-C).
Many patients with HeFH do not achieve guideline-recommended LDL-C goals
with the currently available lipid-lowering therapies. Objective To
evaluate the efficacy of enlicitide decanoate (an oral proprotein
convertase subtilisin/kexin type 9 inhibitor) vs placebo in adults with
HeFH requiring further lowering of LDL-C levels despite use of statin
therapy. Design, Setting, and Participants This phase 3, randomized
clinical trial included persons aged 18 years or older with HeFH currently
using lipid-lowering therapy (taking at least a moderate- or
high-intensity statin) and either an LDL-C level of 55 mg/dL or greater
and a history of major atherosclerotic cardiovascular disease or an LDL-C
level of 70 mg/dL or greater without a history of major atherosclerotic
cardiovascular disease. The trial was conducted at 59 sites across 17
countries; the first participant was screened on August 8, 2023, and the
last follow-up visit occurred on April 7, 2025. Interventions Participants
were randomized (2:1) to 20 mg of enlicitide (n = 202) or placebo (n =
101) once daily for 52 weeks. Main Outcomes and Measures The primary
outcome was the mean percentage change in LDL-C level at week 24. The
secondary outcomes included the mean percentage change in LDL-C level at
week 52, the mean percentage change at week 24 in levels of
non-high-density lipoprotein cholesterol (non-HDL-C) and apolipoprotein B,
and the median percentage change at week 24 in lipoprotein(a). Results Of
the 303 participants (mean age, 52.4 [SD, 13.5] years; 51% were female)
randomized, 293 (96.7%) completed the trial. The mean LDL-C level was
119.0 mg/dL (SD, 41.0 mg/dL) at baseline, all had statin current use
(81.5% were taking a high-intensity statin), and 64.4% were taking
ezetimibe. The mean percentage change in LDL-C level at week 24 was -58.2%
in the enlicitide group vs 2.6% in the placebo group (between-group
difference, -59.4% [95% CI, -65.6% to -53.2%]; P <.001). The mean
percentage change in LDL-C level at week 52 was -55.3% in the enlicitide
group vs 8.7% in the placebo group (between-group difference, -61.5% [95%
CI, -69.4% to -53.7%]; P <.001). At week 24, the mean percentage change in
non-HDL-C level was -52.3% in the enlicitide group vs 2.1% in the placebo
group (between-group difference, -53.0% [95% CI, -58.5% to -47.4%]; P
<.001), the mean percentage change in apolipoprotein B level was -48.2% vs
1.8%, respectively (between-group difference, -49.1% [95% CI, -54.0% to
-44.3%]; P <.001), and the median percentage change in lipoprotein(a)
level was -24.7% vs -1.6% (between-group difference, -27.5% [95% CI,
-34.3% to -20.6%]; P <.001). The incidence of adverse events, serious
adverse events, and study discontinuation due to adverse events was
similar between groups. Conclusions Among adults with HeFH, treatment with
enlicitide was well tolerated and significantly reduced levels of LDL-C,
apolipoprotein B, non-HDL-C, and lipoprotein(a). Trial Registration
ClinicalTrials.gov Identifier: NCT05952869.<br/>Copyright &#xa9; 2026
American Medical Association. All rights reserved, including those for
text and data mining, AI training, and similar technologies. American
Medical Association.

<24>
Accession Number
2042307442
Title
Rationale, Design, and Baseline Clinical Characteristics of the
Ziltivekimab Cardiovascular Outcomes Trial: Interleukin-6 Inhibition and
Atherosclerotic Event Rate Reduction.
Source
JAMA Cardiology. 11(1) (pp 89-97), 2026. Date of Publication: 14 Jan 2026.
Author
Ridker P.M.; Baeres F.M.M.; Hveplund A.; Engelmann M.M.D.; Hovingh G.K.;
Lincoff A.M.; Marx N.; Navar A.M.; Sattar N.; Tuttle K.; Perkovic V.
Institution
(Ridker) Center for Cardiovascular Disease Prevention, Brigham and Women's
Hospital, Boston, MA, United States
(Ridker) Division of Cardiovascular Medicine, Brigham and Women's
Hospital, Boston, MA, United States
(Baeres, Hveplund, Engelmann, Hovingh) Novo Nordisk, Copenhagen, Denmark
(Lincoff) Department of Cardiovascular Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Marx) Department of Internal Medicine I, University Hospital RWTH Aachen,
Aachen, Germany
(Navar) Department of Medicine, UT Southwestern Medical Center, Dallas,
TX, United States
(Navar) JAMA Cardiology, United States
(Sattar) School of Cardiovascular and Metabolic Health, University of
Glasgow, Glasgow, United Kingdom
(Tuttle) Providence Medical Research Center, Providence Inland Northwest
Health, Spokane, WA, United States
(Perkovic) University of New South Wales Sydney, Sydney, NSW, Australia
Publisher
American Medical Association
Abstract
Importance Cardiovascular inflammation is a major determinant of
atherosclerotic disease, and inhibition of the central signaling cytokine,
interleukin 6 (IL-6), is a promising target for intervention. Patients
with chronic kidney disease (CKD) commonly have plasma elevations of
inflammatory biomarkers, such as high-sensitivity C-reactive protein
(hsCRP) and IL-6, and are at high risk for life-threatening
atherosclerotic events as well as loss of kidney function and might
therefore benefit from IL-6 inhibition. Observations The Ziltivekimab
Cardiovascular Outcomes Trial (ZEUS; NCT05021835) will determine the
safety and efficacy of IL-6 inhibition with ziltivekimab among patients
with atherosclerotic cardiovascular disease (ASCVD), CKD, and systemic
inflammation. ZEUS is a multinational, double-blind, placebo-controlled,
event-driven, randomized clinical trial inclusive of 6376 participants
with ASCVD, CKD, and an hsCRP level greater than or equal to 2 mg/L who
were randomized in a 1:1 fashion to receive either ziltivekimab, 15 mg,
administered subcutaneously every month or matching placebo. At
randomization, mean age was 69.5 years, 27.5% were female, 92.0% had
hypertension, 65.7% had diabetes, and 41.3% had heart failure. At
baseline, the mean estimated glomerular filtration rate (eGFR) was 44.5
mL/min/1.73 m², mean low-density lipoprotein cholesterol level
was 77.7 mg/dL, median hsCRP level was 4.5 mg/L, and median IL-6 level was
4.9 pg/mL. At enrollment, sodium-glucose cotransporter-2 inhibitors and
glucagon-like peptide-1 receptor agonists were being used by 36.8% and
11.3% of the cohort, respectively. The primary outcome is 3-point major
adverse cardiovascular events. Secondary cardiovascular outcomes include
(1) an expanded major adverse cardiovascular event outcome including
hospitalization for unstable angina requiring urgent coronary
revascularization, (2) hospitalizations for heart failure or urgent heart
failure visits or cardiovascular death, and (3) all-cause mortality. The
secondary kidney outcome is a composite of greater than 40% decline in
eGFR, eGFR less than 15 mL/min/1.73 m², dialysis, kidney
transplant, death from kidney disease, or cardiovascular death.
Conclusions and Relevance The ZEUS randomized clinical trial will formally
test the hypothesis that IL-6 inhibition with ziltivekimab will lower
incident cardiovascular event rates and potentially slow kidney decline
among participants with known ASCVD, CKD, and elevated hsCRP. If
successful, the ZEUS trial would provide a fully novel approach for
prevention of myocardial infarction, stroke, cardiovascular death, and
kidney function decline among high-risk patients with CKD.<br/>Copyright
&#xa9; 2026 American Medical Association. All rights reserved, including
those for text and data mining, AI training, and similar technologies.
American Medical Association.

<25>
[Use Link to view the full text]
Accession Number
2042617025
Title
Early valve intervention in asymptomatic patients with severe aortic
stenosis: a meta-analysis of randomized-controlled trials.
Source
Journal of Cardiovascular Medicine. 26(11) (pp 674-676), 2025. Date of
Publication: 01 Nov 2025.
Author
Di Pietro G.; Improta R.; Giordano E.; Birtolo L.I.; Colantonio R.;
Sardella G.; Mancone M.
Institution
(Di Pietro, Improta, Giordano, Birtolo, Colantonio, Sardella, Mancone)
Department of Clinical, Internal, Anesthesiology and Cardiovascular
Sciences, Umberto I Hospital, Sapienza University of Rome, Rome, Italy
Publisher
Lippincott Williams and Wilkins

<26>
Accession Number
2042454016
Title
Efficacy and safety of off-pump versus on-pump coronary artery bypass
grafting in chronic obstructive pulmonary disease patients: A systematic
review and meta-analysis.
Source
Revista Portuguesa de Cardiologia. 45(1) (pp 25-36), 2026. Date of
Publication: 01 Jan 2026.
Author
Hassan D.; Zehra Manjee K.; Umar T.P.; Al Diab Al Azzawi M.; Elshenawy S.;
Ahmed Khan W.; Rayyan Ahmed S.; Sohaib Khan M.; Amjad M.; Adel Mohammed Y.
Institution
(Hassan, Zehra Manjee, Ahmed Khan, Rayyan Ahmed, Sohaib Khan, Amjad)
Faculty of Medicine, Dow University of Health Sciences, Karachi, Pakistan
(Umar) Division of Surgery and Interventional Science, Faculty of Medical
Sciences, University College London, London, United Kingdom
(Al Diab Al Azzawi) Faculty of Medicine, The National Ribat University,
Khartoum, Sudan
(Elshenawy) Faculty of Medicine Alexandria University, Alexandria, Egypt
(Adel Mohammed) Faculty of Medicine, Assiut University, Assiut, Egypt
Publisher
Sociedade Portuguesa de Cardiologia
Abstract
Introduction and objectives: Patients with chronic obstructive pulmonary
disease (COPD) undergoing coronary artery bypass grafting (CABG) face
significant perioperative risks. The choice between off-pump and on-pump
CABG techniques can impact clinical outcomes, particularly related to
pulmonary function and postoperative recovery. This meta-analysis aims to
evaluate the clinical efficacy and safety of off-pump versus on-pump CABG
in patients with COPD. <br/>Method(s): A comprehensive search of medical
databases including PubMed and Google Scholar was conducted to identify
relevant studies comparing off-pump and on-pump CABG in COPD patients. The
main outcomes included postoperative respiratory complications, mortality
rates, length of hospital stay, and overall recovery. Results were pooled
as relative risks (RR) or mean differences (MD) with 95% confidence
intervals (CI). <br/>Result(s): A total of seven studies (two randomized
controlled trials (RCTs), one sub-study from a previous RCT, and four
observational studies) comprising 1071 patients were included in the
analysis. While postoperative respiratory complications were lower in the
off-pump group, the difference was not statistically significant. However,
off-pump CABG was significantly associated with reduced mortality (RR
0.21; 95% CI: [0.08, 0.54], p=0.001), shorter hospital stays (MD=-2.34;
95% CI: [-4.51, -0.17], p=0.03), reduced need for mechanical ventilatory
support (MD=-4.73; 95% CI: [-6.17, -3.29], p<0.00001), and lower incidence
of low cardiac output (RR=0.43, 95% CI [0.19, 0.99], p=0.05).
<br/>Conclusion(s): Off-pump CABG provides significant benefits over
on-pump CABG in COPD patients by reducing mortality, hospital stay
duration, the need for mechanical ventilatory support, and low cardiac
output. The observed reduction in postoperative respiratory complications,
although not statistically significant, may indicate potential clinical
benefits of off-pump CABG. Further large-scale RCTs are needed to confirm
these findings.<br/>Copyright &#xa9; 2025 Sociedade Portuguesa de
Cardiologia

<27>
Accession Number
2041656873
Title
Effects of Dexmedetomidine on Outcomes After Cardiac Surgery (DOCS): a
randomised double-blind, placebo-controlled trial.
Source
British Journal of Anaesthesia. 136(1) (pp 55-64), 2026. Date of
Publication: 01 Jan 2026.
Author
Lei C.; Zheng Z.; Han J.; Zhai W.; Li C.; Hou L.; Yu S.; Liu J.; Xu X.;
Wang S.; Guo X.; Zhang T.; Zhou J.; Zou J.; Tian Y.; Chi X.; Qiu L.; Xu
M.; Zhang X.; Huang W.; Chen Y.; Yan M.; Wang H.; Xia J.; Wang L.; Liu H.;
Dong H.
Institution
(Lei, Zheng, Wang, Hou, Dong) Department of Anesthesiology and
Perioperative Medicine, Xijing Hospital, the Fourth Military Medical
University, Shaanxi, Xi'an, China
(Lei, Zheng, Wang) Key Laboratory of Anesthesiology, Ministry of Education
of China, Xi'an, China
(Lei, Zheng, Dong) Anesthesia Clinical Research Center, (ACRC) Xijing
Hospital, Fourth Military Medical University, Xi'an, China
(Han, Zhai, Xia, Wang) Department of Anesthesiology, Tianjin Chest
Hospital, Tianjin, China
(Li) Department of Medical Statistics, School of Preventive Medicine,
Fourth Military Medical University, Shaanxi, Xi'an, China
(Yu, Liu, Xu) Department of Cardiovascular Surgery, Xijing Hospital, the
Fourth Military Medical University, Shaanxi, Xi'an, China
(Wang, Guo) Department of Anesthesiology, Guangdong People's Hospital,
Guangdong, Guangzhou, China
(Zhang, Zhou, Zou) Department of Anesthesiology, General Hospital of
Shenyang Military Region, Liaoning, Shenyang, China
(Tian, Chi) Department of Anesthesiology, Wuhan Tongji Hospital, Tongji
Medical College Huazhong University of Science and Technology, Hubei,
Wuhan, China
(Qiu) Department of Anesthesiology, Henan People's Hospital, Henan,
Zhengzhou, China
(Xu, Zhang) Department of Anesthesiology, Shanghai Chest Hospital,
Shanghai, China
(Huang, Chen) Department of Anesthesiology, First Affiliated Hospital, Sun
Yat-sen University, Guangdong, Guangzhou, China
(Yan, Wang) Department of Anesthesiology, the Second Affiliated Hospital
of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
(Liu) Department of Anesthesiology and Pain Medicine, University of
California Davis Health System, Sacramento, CA, United States
Publisher
Elsevier Ltd
Abstract
Background: Organ dysfunction after cardiac surgery may be reduced by
dexmedetomidine. We evaluated whether perioperative dexmedetomidine
reduces complications after cardiac surgery with cardiopulmonary bypass.
<br/>Method(s): In this randomised, double-blind, placebo-controlled trial
conducted in nine Chinese hospitals, adults scheduled for cardiac surgery
with cardiopulmonary bypass were randomly assigned to receive i.v.
dexmedetomidine (0.4 mug kg^-1 h^-1) or saline
(placebo) for 12 h after the induction of anaesthesia. The co-primary
outcomes were in-hospital mortality and major complications after surgery
(including stroke, myocardial infarction, heart block, cardiac arrest),
analysed by intention-to-treat. Secondary outcomes included individual
complications. <br/>Result(s): A total of 1073 participants (46% female;
mean age: 54 yr [range: 47-63 yr]) completed the study after
randomisation. Major complications occurred in 161/536 (30%) participants
who received dexmedetomidine, compared with 169/537 (32%) who received
saline (relative risk: 0.93 [95% confidence interval: 0.72-1.21]; P=0.66).
In addition, 10/536 (1.9%) participants who received dexmedetomidine died
in hospital, compared with 15/537 (2.8%) participants who received saline
(odds ratio: 0.66 [95% confidence interval: 0.29-1.49]; P=0.32). Major
complications, other than heart block, did not differ between participants
who received dexmedetomidine, compared with participants who received
saline. Safety outcomes and process measures did not differ between
participants allocated to dexmedetomidine or saline. <br/>Conclusion(s):
Perioperative use of dexmedetomidine did not reduce death, complications,
or both in adults undergoing cardiopulmonary bypass-assisted cardiac
surgery. Clinical trial registration: ClinicalTrials.gov
(NCT02237495).<br/>Copyright &#xa9; 2025 British Journal of Anaesthesia

<28>
Accession Number
2041655936
Title
Effect of optimising regional cerebral oxygenation on postoperative
morbidity and mortality: a systematic review and meta-analysis of
randomised controlled trials.
Source
British Journal of Anaesthesia. 136(1) (pp 446-449), 2026. Date of
Publication: 01 Jan 2026.
Author
Chen J.; Chen D.; Xu C.; Guo M.; Ji F.; Ma X.; Qin Y.; Sudhan N.; Peng K.
Institution
(Chen, Chen, Xu, Guo, Ji, Peng) Department of Anaesthesiology, First
Affiliated Hospital of Soochow University, Jiangsu, Suzhou, China
(Chen, Chen, Xu, Guo, Ji, Peng) Institute of Anaesthesiology, Soochow
University, Jiangsu, Suzhou, China
(Ma, Qin) Department of Anaesthesiology, Affiliated Hospital of Nantong
University, Medical School of Nantong University, Nantong, China
(Ma, Sudhan, Peng) Department of Anaesthesia and Intensive Care, Barking
Havering and Redbridge University Hospitals NHS Trust, Romford, United
Kingdom
Publisher
Elsevier Ltd

<29>
[Use Link to view the full text]
Accession Number
2042617144
Title
Balloon vs. self-expanding valves for transcatheter aortic valve
implantation in bicuspid aortic stenosis: a meta-analysis.
Source
Journal of Cardiovascular Medicine. 26(9) (pp 477-486), 2025. Date of
Publication: 01 Sep 2025.
Institution
Department of Internal Medicine, Faculty of Medicine, Siriraj Hospital,
Mahidol University, Bangkok, Thailand
Graduate School of Science, Osaka University, Osaka, Japan
Division of Rheumatology, Department of Internal Medicine, Faculty of
Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
Publisher
Lippincott Williams and Wilkins
Abstract
Aims - Bicuspid aortic valve (BAV) is a common congenital heart disease.
However, pivotal randomized trials of transcatheter aortic valve
replacement (TAVR) have excluded this population. There remains a lack of
consensus on the optimal choice between balloon-expandible valves (BEVs)
and self-expanding valves (SEVs) in this setting. This study aimed to
compare the efficacy and safety of BEVs vs. SEVs in patients with BAV
stenosis. Methods - A systematic search using four databases, including
PubMed, Embase, Web of Science, and Cochrane CENTRAL, was conducted from
inception to 26 November, 2024. Studies comparing the outcome of BEVs and
SEVs in patients with BAV stenosis were included. Results - Nineteen
studies comprising 3794 participants were included in this meta-analysis.
Procedural mortality did not differ significantly between BEVs and SEVs
[odds ratio (OR), 1.06; 95% confidence interval (95% CI) 0.42-2.69, P =
0.91]. Similarly, no differences were observed in all-cause mortality at 1
year or 3 years. BEVs were associated with a lower risk of permanent
pacemaker implantation (OR, 0.60; 95% CI 0.48-0.76, P < 0.01) and moderate
to severe paravalvular leakage (OR, 0.44; 95% CI 0.23-0.85, P = 0.01)
compared with SEVs. However, BEVs were associated with a higher risk of
annular rupture (OR, 2.80; 95% CI 1.05-7.49, P = 0.04). Conclusion - BEVs
and SEVs demonstrate similar survival outcomes from the procedural period
up to 3 years of follow-up. However, the risk profiles for specific
complications differ between the valve types. Valve selection for TAVR in
patients with BAV stenosis should be considered based on individual
anatomical characteristics and the associated risk of specific
complications.<br/>Copyright &#xa9;

<30>
Accession Number
2042316582
Title
Coronary computed tomography angiography versus invasive coronary
angiography for interventional triage in acute coronary syndrome: Design
of the randomized TRACTION trial.
Source
American Heart Journal. 294 (no pagination), 2026. Article Number: 107325.
Date of Publication: 01 Apr 2026.
Author
Sorgaard M.H.; Kristensen A.T.; Eskesen K.; Kofoed K.F.; Linde J.J.;
Kelbaek H.; Ottesen M.; Neland K.; Kragelund C.; Bertelsen M.L.N.; Hove
J.D.; Mork G.; Kristiansen O.P.; Engstrom T.; Lonborg J.T.; Kuhl J.T.;
Risom S.S.; Blanche P.; Olsen N.T.
Institution
(Sorgaard, Eskesen, Risom) Department of Cardiology, Herlev and Gentofte
Hospital, Herlev, Denmark
(Kristensen, Kofoed, Linde, Engstrom, Lonborg, Kuhl, Olsen) Department of
Cardiology, Rigshospitalet, Copenhagen, Denmark
(Kelbaek, Ottesen, Neland) Department of Cardiology, University Hospital
of Zealand, Roskilde, Roskilde, Denmark
(Kragelund, Bertelsen) Department of Cardiology, North Zealand Hospital,
Hilleroed, Denmark
(Hove) Department of Cardiology, Hvidovre Hospital, Hvidovre, Denmark
(Mork, Kristiansen) Department of Cardiology, Bispebjerg Hospital,
Copenhagen, Denmark
(Risom) Institute of Nursing and Nutrition, University College Copenhagen,
Copenhagen, Denmark
(Risom) Health and Medical Sciences, University of Copenhagen, Copenhagen,
Denmark
(Blanche) Section of Biostatistics, Department of Public Health,
Copenhagen University, Copenhagen, Denmark
Publisher
Elsevier Inc.
Abstract
Purpose In patients admitted with acute coronary syndrome, invasive
coronary angiography (ICA) is performed to determine which patients need
revascularization. Coronary computed tomography angiography (CCTA) offers
a widely available, non-invasive alternative that could reduce patient
discomfort, procedural risks, and healthcare costs. The current trial aims
to determine whether CCTA is noninferior to ICA in determining the
interventional strategy for patients admitted with non-ST elevation acute
coronary syndrome (NSTE-ACS)( Central Illustration ). Methods TRACTION
(Team-based Interventional Triage in Acute Coronary Syndrome Based on
Noninvasive Coronary Computed Tomography Angiography Versus Invasive
Coronary Angiography) is a multicenter, randomized, open-label,
noninferiority trial enrolling 2,300 patients. Patients hospitalized with
non-ST elevation myocardial infarction or unstable angina with ischemic
changes on ECG will be randomized 1:1 to CCTA vs ICA (standard of care).
In the CCTA group, a Coronary Team reviews the CCTA and clinical
information to determine the interventional strategy. The primary
composite endpoint is major adverse cardiac events at 1 year, comprised of
all-cause mortality, nonfatal myocardial infarction, hospitalization due
to refractory angina, or hospitalization due to heart failure. Secondary
outcomes include cardiovascular death, revascularization, symptom status,
procedure-related adverse events, and resource utilization. The trial is
designed to demonstrate noninferiority if the 95% confidence interval
excludes an absolute risk difference of the primary endpoint larger than
5%. Perspectives If CCTA is shown to be noninferior to ICA in patients
admitted with NSTE-ACS, CCTA could become the preferred management in a
large group of patients. This could result in fewer patients exposed to
invasive procedures and improved resource utilization. ClinicalTrials.gov
identifier: NCT06101862<br/>Copyright &#xa9; 2025 The Authors.

<31>
Accession Number
2040566307
Title
Bleomycin for Malignant Pericardial Effusion: A Systematic Review of
Efficacy and Adverse Events.
Source
Journal of Cardiovascular Pharmacology. 86(4) (pp 330-336), 2025. Date of
Publication: 25 Nov 2025.
Author
Siahaan P.P.; Kurniawan R.B.; Saputra P.B.T.; Arnindita J.N.; Savitri
C.G.; Andira L.H.; Meitavany E.N.; Putranto J.N.E.; Alkaff F.F.
Institution
(Siahaan, Kurniawan) Faculty of Medicine, Universitas Airlangga, Surabaya,
Indonesia
(Saputra, Arnindita, Savitri, Andira, Putranto) Department of Cardiology
and Vascular Medicine, Faculty of Medicine, Universitas Airlangga
(Saputra, Arnindita, Savitri, Andira, Putranto) Department of Cardiology
and Vascular Medicine, Dr. Soetomo General Academic Hospital, Surabaya,
Indonesia
(Meitavany) School of Biomedical Engineering and Imaging Sciences (BMEIS),
King's College London, London, United Kingdom
(Alkaff) Division of Nephrology, Department of Internal Medicine,
University Medical Center Groningen, University of Groningen, Netherlands
(Alkaff) Division of Pharmacology and Therapy, Department of Anatomy,
Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga,
Surabaya, Indonesia
Publisher
Lippincott Williams and Wilkins
Abstract
Abstract: - Malignant pericardial effusion (MPE) is a progressive fluid
accumulation in the pericardial space that can lead to pericardial
tamponade. Despite the high recurrence rate associated with
pericardiocentesis, it remains the mainstay therapy. Bleomycin has emerged
as an intrapericardial sclerosing therapy that may reduce recurrence and
improve patients' quality of life. This systematic review aimed to assess
the efficacy and safety profile of bleomycin instillation in patients with
MPE. An exhaustive search was conducted in PubMed, Web of Science, Scopus,
ProQuest, EBSCO, and ClinicalTrials.gov databases. Eligible studies
included MPE patients as participants who were treated with
intrapericardial bleomycin, reporting the patients' outcomes and using
English in the full text. Individual studies were assessed for quality
using the Newcastle-Ottawa Scales for cohort studies and the Jadad Scale
for trial studies. Eight studies were included in this systematic review
involving 242 MPE patients treated with bleomycin. Bleomycin demonstrated
lower recurrence rates than other sclerosing agents, with only <=5% of
patients requiring repeated drainage because of recurrence. Bleomycin
treatment resulted in 3.5 days less hospitalization compared with
doxycycline. Bleomycin is also safe to use, with reported less severe pain
compared with other treatment agents for MPE, such as doxycycline and
pericardiocentesis. Bleomycin may benefit patients by reducing recurrence
rates and improving patients' quality of life. Moreover, it is safe and
has low rates of adverse events after the instillation.<br/>Copyright
&#xa9; 2025

<32>
Accession Number
2042591294
Title
Sodium-Glucose Cotransporter 2 Inhibitors in Diabetic Solid Organ
Transplant Recipients: A Systematic Review and Meta-Analysis of
Comparative Studies.
Source
Journal of Diabetes Research. 2026(1) (no pagination), 2026. Article
Number: 8540354. Date of Publication: 2026.
Author
Geum M.J.; Oh K.S.; Ah Y.-M.
Institution
(Geum) Department of Pharmacy, Severance Hospital, Yonsei University
Health System, Seoul, South Korea
(Oh, Ah) College of Pharmacy, Yeungnam University, Gyeongsan, South Korea
Publisher
John Wiley and Sons Ltd
Abstract
Background: Solid organ transplant recipients with diabetes mellitus face
unique challenges in glycemic control, compounded by the metabolic effects
of immunosuppressants. Although sodium-glucose cotransporter 2 (SGLT2)
inhibitors are effective in diabetes, evidence for their use in transplant
recipients remains limited. We aimed to systematically review the efficacy
and safety of SGLT2 inhibitors in transplant recipients with diabetes.
<br/>Method(s): A systematic review and meta-analysis was conducted by
searching the MEDLINE, Embase, and Cochrane CENTRAL databases for studies
published before July 2025. Seventeen comparative studies involving 12,892
transplant recipients with diabetes were included. Efficacy and safety
data of SGLT2 inhibitors were extracted and analyzed. A random-effects
model was used to pool the results. <br/>Result(s): SGLT2 inhibitors led
to a significantly greater reduction in HbA1c (mean difference [MD]:
-0.59% and 95% confidence interval [CI]: -0.91 to -0.26) and body mass
index (MD: -0.82 kg/m² and 95% CI: -1.54 to -0.10) compared to
controls. The risks of dialysis (odds ratio [OR]: 0.50 and 95% CI:
0.31-0.79), major adverse cardiovascular events (OR: 0.29 and 95% CI:
0.22-0.38), heart failure (OR: 0.66 and 95% CI: 0.52-0.83), urinary tract
infection (OR: 0.45 and 95% CI: 0.22-0.92), graft rejection (OR: 0.73, 95%
and CI: 0.64-0.83), and all-cause mortality (OR: 0.40 and 95% CI:
0.27-0.59) were significantly lower in the SGLT2 inhibitor group.
<br/>Conclusion(s): SGLT2 inhibitors were associated with improved
glycemic control, weight reduction, and favorable trends in cardiovascular
outcomes among solid organ transplant recipients. Most safety outcomes,
including urinary tract infection and graft rejection, were comparable
between groups or more favorable in the SGLT2 inhibitor group,
particularly among kidney transplant recipients. These findings support
the use of SGLT2 inhibitors in this population. However, further
large-scale studies are warranted to validate these results and assess the
long-term effects across different transplant types.<br/>Copyright &#xa9;
2026 Min Jung Geum et al. Journal of Diabetes Research published by John
Wiley & Sons Ltd.

<33>
Accession Number
2042230635
Title
Sex does not influence outcomes in valvular heart surgery due to infective
endocarditis: A systematic review and meta-analysis.
Source
Asian Cardiovascular and Thoracic Annals. 34(1) (pp 82-91), 2026. Date of
Publication: 01 Jan 2026.
Author
Zeb R.; Sharma S.; Abdullah R.; Patel M.; Nallamotu S.; Veintemilla-Burgos
F.; Kovil Thangam B.M.; Sai B.A.; Kaur G.
Institution
(Zeb) Army Medical College, Rawalpindi, Pakistan
(Sharma) Riga Stradins University, Riga, Latvia
(Abdullah) Foundation University Medical College, Islamabad, Pakistan
(Patel) NHL Municipal Medical College, Gujarat, Ahmedabad, India
(Nallamotu) Kasturba Medical College, Karnataka, Manipal, India
(Veintemilla-Burgos) Universidad Catolica de Santiago de Guayaquil,
Guayaquil, Ecuador
(Kovil Thangam) Spartan Health Sciences University, Vieux Fort, Saint
Lucia
(Sai) Kamineni Academy of Medical Sciences and Research, Telangana,
Hyderabad, India
(Kaur) American University of Antigua School of Medicine, Osbourn, Antigua
and Barbuda
Publisher
SAGE Publications Inc.
Abstract
This systematic review and meta-analysis aimed to evaluate sex-based
differences in surgical outcomes among patients with infective
endocarditis (IE). A comprehensive search of three major medical databases
identified ten studies encompassing 16,763 patients who underwent valvular
surgery for IE. Of these, 70.8% were male (n = 11,873), and 29.2% were
female (n = 4890). Female patients were generally older at the time of
surgery. The most common causative pathogen was Staphylococcus aureus
(28.4%), followed by Streptococcus (22.5%) and Enterococcus (4.1%).
Females demonstrated lower aortic valve involvement (risk ratio [RR]:
0.80, 95% confidence interval [CI]: 0.67-0.96) but higher mitral valve
involvement (RR: 1.30, 95% CI: 1.17-1.45, p < 0.001). They also had a
reduced prevalence of Streptococcus (RR: 0.89, 95% CI: 0.81-0.98, p =
0.02) and Enterococcus (RR: 0.71, 95% CI: 0.62-0.82, p = 0.03) infections
and a lower risk of abscess formation (RR: 0.87, 95% CI: 0.76-0.99, p =
0.03) compared to males. There was a significant difference in the
in-hospital mortality between female and male patients (RR: 1.30, 95% CI:
1.04-1.61, p = 0.02). No significant sex-related differences were observed
in the duration of hospitalization. However, significant sex-related
differences were observed in the incidence of postoperative stroke (RR:
1.10, 95% CI: 1.02-1.20, p = 0.02). In summary, female patients undergoing
surgery for IE face a higher risk of both in-hospital mortality and
postoperative stroke compared to males, underscoring clinically meaningful
sex-based disparities in short-term surgical outcomes. These findings
emphasize the need for further studies to clarify these observations.
(PROSPERO Registration: CRD42024602013).<br/>Copyright &#xa9; The
Author(s) 2025

<34>
[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

<35>
Accession Number
2042592623
Title
Robotic-assisted tracheobronchoplasty for excessive central airway
collapse: a systematic review of clinical outcomes, safety, and functional
recovery.
Source
Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number:
181. Date of Publication: 01 Dec 2026.
Author
Hussein A.M.; Rackauskas M.; Vijayan K.; Mehta H.J.; Aladaileh M.
Institution
(Hussein) Faculty of Medicine, Al- Balqa' Applied University, Salt, Jordan
(Rackauskas, Aladaileh) Division of Thoracic Surgery, Department of
Surgery, University of Florida, Gainesville, FL, United States
(Vijayan, Mehta) Department of Medicine, Division of Pulmonary, Critical
Care and Sleep Medicine, University of Florida, Gainesville, FL, United
States
Publisher
Springer Nature
Abstract
Excessive central airway collapse (ECAC), encompassing
tracheobronchomalacia (TBM) and excessive dynamic airway collapse (EDAC),
is increasingly recognized as a debilitating condition with substantial
symptomatic and functional burden. Robotic-assisted tracheobronchoplasty
(R-TBP) has emerged as a minimally invasive alternative to open repair;
however, its collective clinical outcomes have not been systematically
synthesized. We conducted a systematic review of comparative and
non-comparative studies reporting outcomes of R-TBP, following PRISMA
guidelines (PROSPERO: CRD420251241127). A systematic search of PubMed,
Scopus, Cochrane, and Web of Science was performed through August 14,
2025. Outcomes included postoperative pulmonary function, functional
exercise capacity (6MWT), patient-reported outcome measures (PROMs),
perioperative parameters, and complications. Due to substantial
heterogeneity in outcome definitions, follow-up intervals, and reporting
standards, a quantitative meta-analysis was precluded, and a narrative
synthesis was performed. Risk of bias was assessed using ROBINS-I. Four
studies comprising 231 patients were included. Operative duration ranged
from 264 to 504 min. Postoperative recovery was rapid, characterized by
minimal ICU utilization (0 to 1.33 days) and a median hospital length of
stay of 2.33 to 5 days markedly shorter than historical open benchmarks.
Clinical efficacy was most pronounced in patient-reported outcomes:
studies consistently reported substantial quality-of-life improvements,
including SGRQ reductions of 11.6 to 36.7 points. Functional capacity also
showed improvement, with 6MWT distance increases ranging from 10.3 to 76.3
m. Conversely, pulmonary function outcomes were heterogeneous; while some
cohorts showed modest gains in predicted FEV1 (+ 1.7% to + 8%), others
demonstrated stabilization rather than significant improvement. Safety
profiles were acceptable, with major complications (Clavien-Dindo >= IIIa)
ranging from 14% to 21%. R-TBP represents a technically demanding yet
increasingly viable alternative to open surgery. The available data
consistently demonstrates clear benefits regarding postoperative recovery
and patient-reported quality of life, suggesting that symptomatic relief
outweighs the inconsistent spirometric improvements often seen in this
population. Current evidence positions R-TBP as a safe approach with
superior immediate recovery metrics compared to historical open standards.
While the certainty of evidence is limited by retrospective designs, the
consistency of the safety signal supports R-TBP's role in the surgical
armamentarium. Future comparative trials should prioritize
patient-reported outcomes and functional measures like the 6MWT over
static spirometry to accurately gauge efficacy.<br/>Copyright &#xa9; The
Author(s), under exclusive licence to Springer-Verlag London Ltd., part of
Springer Nature 2026.

<36>
[Use Link to view the full text]
Accession Number
2040070927
Title
Transfusion of Amustaline/Glutathione Pathogen-reduced Red Blood Cells in
Cardiac Surgery: A Randomized Phase 3 Clinical Trial.
Source
Anesthesiology. 143(5) (pp 1196-1210), 2025. Date of Publication: 01 Nov
2025.
Author
Welsby I.J.; Toyoda Y.; Alsammak M.; Sodha N.R.; Beaver T.M.; Pelletier
J.P.R.; Gorham J.D.; McNeil J.S.; Sniecinski R.M.; Pearl R.G.; Nuttall
G.A.; Sarode R.; Reece T.B.; Benjamin R.J.; Kaplan A.; Davenport R.D.; Ipe
T.S.; Benharash P.; Lopez-Plaza I.; Sadler P.; Reik R.; Gammon R.R.;
Pitman J.P.; Liu K.; Bentow S.; Corash L.; Mufti N.; Varrone J.
Institution
(Kaplan) University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
and Vitalant, Pittsburgh, Pennsylvania, United States
(Davenport) University of Michigan, Ann Arbor, Michigan., United States
(Ipe) Our Blood Institute, Oklahoma City, Oklahoma, United States
(Benharash) UCLA, Los Angeles, California, United States
(Lopez-Plaza) Henry Ford Hospital, Detroit, Michigan., United States
(Sadler) Central California Blood Center, Fresno, California, United
States
(Reik, Gammon) OneBlood, Orlando, Florida, United States
(Pitman, Pitman, Liu, Liu, Bentow, Bentow, Corash, Corash, Mufti, Mufti,
Varrone, Varrone) Cerus Corporation, Concord, California, United States
(Reece) Department of Surgery, Gill Heart Institute, University of
Kentucky, Lexington, Kentucky, United States
(Benjamin) Department of Laboratory Medicine, Yale University School of
Medicine, New Haven, Connecticut, United States
(Welsby) Department of Anesthesiology and Critical Care, Duke University
Medical Center, Durham, North Carolina, United States
(Toyoda) Department of Surgery, Temple University Hospital, Philadelphia,
Pennsylvania, United States
(Alsammak) Temple University Health System, Philadelphia, Pennsylvania,
United States
(Sodha) Department of Cardiothoracic Surgery, Rhode Island Hospital,
Providence, Rhode Island, United States
(Beaver) Department of Cardiovascular Surgery, University of Florida,
Gainesville, Florida, United States
(Pelletier) Department of Transfusion Services, University of Florida,
Gainesville, Florida, United States
(Gorham) Department of Pathology, University of Virginia Health System,
Charlottesville, Virginia, United States
(McNeil) Department of Anesthesiology, University of Virginia Health
System, Charlottesville, Virginia, United States
(Sniecinski) Department of Anesthesiology, Emory University, Atlanta,
Georgia
(Pearl) Department of Anesthesiology, Perioperative and Pain Medicine,
Stanford University, Stanford, California, United States
(Nuttall) Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota,
United States
(Sarode) Department of Pathology, University of Texas Southwestern Medical
Center, Southwestern, Dallas, Texas, United States
(Reece) Department of Cardiothoracic Surgery, University of Colorado
Hospital, Denver, Colorado, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Transfusion has a persistent low risk of
transfusion-transmitted infection and transfusion-associated
graft-versus-host disease that may be addressed using pathogen reduction.
The Red Cell Pathogen Inactivation (ReCePI) trial tested whether
amustaline/glutathione pathogen-reduced red cells are noninferior to
conventional transfusions for support of acute surgical blood loss.
<br/>Method(s): - A phase 3, double-blinded, noninferiority trial
randomized cardiac or thoracic-aorta surgery patients with increased risk
of red cell transfusion to receive pathogen-reduced or conventional red
cells during and for 7 days postsurgery. The primary endpoint was the
proportion of patients with acute kidney injury (AKI), which is defined as
an increase from baseline of greater than or equal to 0.3 mg/dl serum
creatinine within 48 h of surgery. Noninferiority was claimed if the upper
bound 95% CI of the treatment difference was less than half (50%) of the
observed conventional arm incidence. Adverse events and treatment-emergent
red cell antibodies were assessed for 28 and 75 days, respectively.
<br/>Result(s): - A total of 581 subjects were randomized, and 321 (55%)
were transfused with study red cells. Transfused subjects in both arms had
similar baseline demographics, medical histories, hemoglobin levels, and
surgical procedures. Hemoglobin day 3 nadir levels (8.6 g/dl [7.8 to 9.2]
in the pathogen-reduced arm; 8.4 g/dl [7.8 to 9.3] in the conventional
arm; P = 0.52) were comparable. Incidence of AKI by 48 h was 46 of 157
(29.3%) in the pathogen-reduced arm and 45 of 161 (28.0%) in the
conventional arm (treatment difference, 0.7%; 95% CI, -8.9 to 10.4%;
noninferiority margin, 14.0%; P = 0.001 for noninferiority). AKI within 7
days by Kidney Disease Improving Global Outcomes staging criteria was not
different (59 of 159 [37.1%] in the pathogen-reduced arm; 55 of 162
[34.0%] in the conventional arm; P = 0.53), but stage III was more common
in the pathogen-reduced arm (pathogen-reduced arm, 15 of 159 [9.4%];
conventional arm, 7 of 162 [4.3%]; P = 0.075). Of 159 pathogen-reduced red
cell recipients, 5 (3.1%) developed specific, low-titer antibodies without
evidence of hemolysis. <br/>Conclusion(s): - The incidence of AKI in
recipients of pathogen-reduced red cells was noninferior to conventional
red cell transfusion. Treatment-emergent antibodies were uncommon and not
clinically significant.<br/>Copyright &#xa9; 2025

<37>
[Use Link to view the full text]
Accession Number
2039608807
Title
The Dose-Response Relationship of Aerobic Exercise on Cardiorespiratory
Fitness in Cardiac Rehabilitation.
Source
Journal of Cardiopulmonary Rehabilitation and Prevention. 45(6) (pp
E53-E70), 2025. Date of Publication: 2025.
Author
Collins B.E.G.; Gordon B.A.; Wundersitz D.W.T.; Carey D.; Kingsley M.I.C.
Publisher
Lippincott Williams and Wilkins
Abstract
Objective: - To explore the incremental dose-response effect of aerobic
exercise-based cardiac rehabilitation programs (ExCRP) on
cardiorespiratory fitness in comparison to non-exercise controls among
people with coronary heart disease (CHD). Review Methods: - Medline,
CINAHL, Cochrane, SCOPUS, and SPORTDiscus were searched from January 1,
2000 until December 4, 2023. Articles were eligible for selection if they
satisfied the following criteria: randomized controlled studies assessing
change in cardiorespiratory fitness among people with CHD in non-exercise
and aerobic intervention groups, established peak oxygen uptake via
cardiopulmonary exercise test, minimum of 4-week program duration, and
reported frequency, intensity, and duration of prescribed exercise. The
study was prospectively registered (PROSPERO ID: CRD42021274924).
<br/>Summary: - Thirty-three studies, including 1901 participants were
included in the continuous dose-analysis. A significant difference in
cardiorespiratory fitness was identified between ExCRP and non-exercise
control that favored exercise by 3.4 (3.0-3.9)
mL.kg^-1.min^-1. No difference existed between
interval and continuous training when matched for exercise dose.
Dose-response analyses identified a significant increase in
cardiorespiratory fitness (3.4 [2.9-5.5]
mL.kg^-1.min^-1) associated with program completion,
with no additional benefit related to increased exercise dose. When
compared to non-exercise control, participating in ExCRP with a minimum
total program intervention dose of 2194 metabolic equivalent minutes
significantly improves cardiorespiratory fitness. However, no additional
benefit was discernible from higher exercise doses. Although the
recommended dose for ExCRP augments medical treatment and is sufficient to
improve cardiorespiratory fitness, it is likely that the narrow range in
prescribed exercise dose and variations in the fidelity of exercise
interventions limit interpretation.<br/>Copyright &#xa9; 2025

<38>
[Use Link to view the full text]
Accession Number
2041805144
Title
Pilot-Optimizing Transfusion Therapy in Critically Ill Children With
Anemia: A Pilot Multicenter Electronic Health Record-Enabled Randomized
Controlled Trial on Red Blood Cell Transfusion in Critically Ill Children.
Source
Pediatric Critical Care Medicine. 26(10) (pp e1218-e1230), 2025. Date of
Publication: 01 Oct 2025.
Author
Tucci M.; Sarfatti A.; Leteurtre S.; Du Pont-Thibodeau G.; Fontela P.; Ray
S.; Stanworth S.J.; Hebert P.C.; Roumeliotis N.; Sauthier M.; Spinella
P.C.; Ducruet T.; Jouvet P.; Masse B.; Robitaille N.; Trottier H.; Lacroix
J.
Institution
(Tucci, Du Pont-Thibodeau, Roumeliotis, Sauthier, Jouvet, Lacroix)
Pediatric Intensive Care Unit, CHU Sainte-Justine, Universite de Montreal,
Montreal, Canada
(Sarfatti) Paediatric Intensive Care Unit, Oxford University Hospitals NHS
Foundation Trust, Oxford, United Kingdom
(Leteurtre) Service de Reanimation et Soins Intensifs Pediatriques
Polyvalents, CHU Lille, Universite de Lille ULR 2694-METRICS: Evaluation
des technologies de sante et des pratiques medicales, Lille, France
(Fontela) Pediatric Intensive Care Unit, Montreal Children's Hospital,
McGill University, Montreal, QC, Canada
(Ray) Paediatric Intensive Care Unit, Great Ormond Street Children's
Hospital, London, United Kingdom
(Stanworth) NHS Blood and Transplant, Oxford University Hospitals, Oxford,
Department of Haematology, University of Oxford, Oxford, United Kingdom
(Hebert) Department of Medicine, Institut de recherche du Bruyere,
Universite d'Ottawa, Ottawa, ON, Canada
(Spinella) Department of Surgery and Department of Critical Care Medicine,
University of Pittsburgh, Pittsburgh, PA, United States
(Ducruet, Masse) Centre de soutien a la gestion et analyse de donnees
(CSGAD), Research Center, CHU Sainte-Justine, Montreal, QC, Canada
(Masse, Trottier) Hema-Quebec, Montreal, QC, Canada
(Robitaille) Division of Hematology-Oncology, Department of Pediatrics,
CHU Sainte-Justine, Universite de Montreal, Montreal, QC, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: - To evaluate the feasibility of conducting a large
international electronic health record-enabled randomized controlled trial
(RCT) designed to compare two strategies for RBC transfusion (RBCT) in
almost all anemic critically ill children, and the ability to support data
abstraction from electronic medical data monitoring systems (eMDMSs).
DESIGN: - Two-arm parallel design pilot RCT. SETTING: - Four
university-affiliated PICUs in Canada, France, and United Kingdom.
PATIENTS: - Non-cyanotic critically ill children with hemoglobin (Hb) less
than or equal to 9.5 g/dL. INTERVENTIONS: - Participants were randomly
allocated to a restrictive strategy (no RBCT if Hb >= 7.0 g/dL) or to
usual care (clinician discretion for RBCT). MEASUREMENTS AND MAIN RESULTS:
- Feasibility outcomes were recruitment, adherence, separation of pre-RBCT
Hb, and electronic data extraction from eMDMS. The proportion of patients
with Hb less than or equal to 9.5 g/dL who were eligible for consent to
participate in Pilot-Optimizing Transfusion Therapy in Critically Ill
Children With Anemia (P-OpTTICCA) was 83% (feasibility criterion: >= 80%).
We enrolled 120 patients, 63 in the restrictive and 57 in the usual care
arms. We reached the planned recruitment rate (>= 2 participants/wk in
sites with > 800 admissions/yr, >= 1 in other sites). The pre-RBCT Hb
concentration was 6.6 +/- 7 and 6.7 +/- 1.3 g/dL in the restrictive and
usual care arms, respectively (separation = 0.1 g/dL; desired difference
>= 1.0 g/dL). The pre-transfusion Hb concentration was greater than or
equal to 7.0 g/dL for 6 of 20 RBCT (30%) given to patients allocated to
the restrictive arm (success criterion for protocol adherence: < 20%).
There were two protocol deviations, but no protocol violation. Using
eMDMS, 87.7% of the 390 data elements in the case report form were
extracted and/or calculated electronically (success criterion: > 80%).
<br/>CONCLUSION(S): - P-OpTTICCA demonstrated the feasibility of
recruitment, adherence, and electronic data extraction, but we did not get
a good separation of pre-RBCT Hb. Future trials need to clearly define
transfusion Hb thresholds in both trial arms (NCT03871244).<br/>Copyright
&#xa9; 2025

<39>
Accession Number
2042530146
Title
Effect of Acupuncture-Assisted Anesthesia on Prevention of Postoperative
Nausea and Vomiting: A Meta-Analysis.
Source
Innovations in Acupuncture and Medicine. 19(1) (no pagination), 2026.
Article Number: 4. Date of Publication: 01 Dec 2026.
Author
Li D.; Xie X.; Huang C.; Shi S.
Institution
(Li, Xie, Huang, Shi) The First People's Hospital of Linping District,
Zhejiang Province, Hangzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: While conventional pharmacologic antiemetics have recognized
limitations, the evidence regarding acupuncture-assisted anesthesia (AAA)
for preventing postoperative nausea and vomiting (PONV) remains
inconsistent. This study specifically evaluates AAA as a standardized
perioperative protocol rather than isolated acupuncture interventions,
aiming to quantitatively assess its efficacy in PONV prevention.
<br/>Method(s): Major databases were systematically searched for all
relevant studies published up to March 2025. Only trials implementing AAA
as a structured component of anesthesia management were included. The
meta-analysis was conducted using RevMan 5.3 software. <br/>Result(s): A
total of seven randomised controlled clinical trials with 775 patients
were included, 389 in the AAA group and 386 in the control group.
Acupuncture-assisted anesthesia reduced the incidence of postoperative
nausea and vomiting (RR = 0.29, 95% CI 0.20-0.41; P < 0.00001;
I² = 7%). Although the low I² value indicates good
statistical homogeneity and strengthens the reliability of the pooled
results, the relatively small number of included studies and large effect
sizes compared to previous comprehensive reviews raise concerns. A more
detailed and critical analysis is needed to explore potential sources of
this discrepancy-such as differences in acupuncture techniques, surgical
types, or patient populations. The finding of reduced cough incidence is
noteworthy as it highlights the unique aspects of AAA in managing
anesthesia-related complications during induction and recovery. This
result distinguishes our study from other reviews that have not addressed
this outcome. However, given that this finding is based on only two
studies, the significance and limitations of this conclusion should be
rigorously discussed. AAA lowered cough incidence (RR = 0.71, 95% CI
0.52-0.97; P = 0.03; 2 studies, n = 162; I² = 0%) and reduced
postoperative pain (VAS score MD = - 1.20, 95% CI - 1.42 to - 0.98; P <
0.00001; 2 studies, n = 164; I² = 0%). For gastrointestinal
recovery, AAA accelerated first flatus time (MD = - 1.71 h, 95% CI - 2.56
to - 0.86; P < 0.0001) and first defecation time (MD = - 4.32 h, 95% CI -
6.21 to - 2.43; P < 0.00001), both from 2 studies (n = 284; I²
= 0% for both). <br/>Conclusion(s): Acupuncture-assisted anesthesia as a
standardized perioperative protocol can reduce postoperative nausea and
vomiting, cough, and pain while accelerated gastrointestinal recovery.
These findings provide specific guidance for integrating AAA into modern
anesthesia practice.<br/>Copyright &#xa9; The Author(s) 2026.

<40>
[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

<41>
[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

<42>
Accession Number
2042122876
Title
The PRINCE trial of remote ischaemic preconditioning in noncardiac surgery
to reduce myocardial injury: sign o' the times.
Source
British Journal of Anaesthesia. 136(2) (pp 475-480), 2026. Date of
Publication: 01 Feb 2026.
Author
Ackland G.L.; Pinto B.B.
Institution
(Ackland) Translational Medicine and Therapeutics, William Harvey Research
Institute, Queen Mary University of London, London, United Kingdom
(Pinto) Department of Anaesthesiology, Pharmacology, Intensive Care and
Emergency Medicine, Geneva University Hospitals, Geneva, Switzerland
Publisher
Elsevier Ltd
Abstract
The remote ischemic PReconditioning In Non-Cardiac surgEry (PRINCE) trial
was a multinational, double-blind trial in which 1213 patients undergoing
noncardiac surgical procedures were randomly assigned to receive remote
ischaemic preconditioning (RIPC) or sham-RIPC after general anaesthesia
and before surgery to reduce myocardial injury. Postoperative myocardial
injury, defined alone by postoperative high-sensitivity troponin above the
highest 99th percentile of reference values, occurred in 215/566 patients
(38.0%) in the RIPC group and in 223/596 patients (37.4%) in the sham-RIPC
group. The PRINCE trial adds to an apparently contradictory literature on
the role of RIPC in perioperative medicine. We discuss both trial-specific
and mechanistic reasons to explain these discrepancies, and we contend
that a role for RIPC in minimising organ injury as a result of noncardiac
surgery remains possible.<br/>Copyright &#xa9; 2025 British Journal of
Anaesthesia

<43>
Accession Number
649578752
Title
Chest tube removal after cardiac surgery in first vs. second
post-operative day: a systematic review and meta-analysis.
Source
Journal of cardiothoracic surgery. 21(1) (pp 33), 2025. Date of
Publication: 16 Dec 2025.
Author
Rakab M.S.; Awashra A.; Radwan N.; Shubietah A.; Maamoun A.; Mattar M.;
Manasrah A.; Ghanem A.; Elbaz A.; Emara A.; Abdul-Hafez H.A.
Institution
(Rakab, Radwan, Maamoun, Ghanem, Elbaz, Emara) Faculty of Medicine,
Mansoura University, Mansoura, Egypt
(Awashra) Department of Medicine, An Najah National University, Nablus,
Palestine
(Shubietah) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL, United States
(Mattar) Faculty of Medicine, Zagazig University, Zagazig, Egypt
(Manasrah) Department of Internal Medicine, United Health Services -
Wilson Medical Center, Johnson City, NY, United States
(Abdul-Hafez) Department of Medicine, An Najah National University,
Nablus, Palestine
(Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health
Sciences, An- Najah National University, Nablus, Palestine
Abstract
BACKGROUND: The optimal timing of chest tube removal after cardiac surgery
remains uncertain, with institutional practices varying widely. While
early removal may promote faster recovery, concerns persist regarding
potential complications such as fluid accumulation. This meta-analysis
compares early versus late chest tube removal and their effects on
clinical and procedural outcomes. <br/>METHOD(S): We searched Web of
Science, SCOPUS, PubMed, and Cochrane Central Register of Controlled
Trials until May 2025. Nine studies involving 8,557 patients were
included. Pooled risk ratios (RR) and mean differences (MD) with 95%
confidence intervals were calculated using either random-effects or
fixed-effects models. <br/>RESULT(S): Early chest tube removal was
associated with a significantly higher risk of pericardial effusion (RR
1.85, p = 0.0105), while pleural effusion showed an increasing trend with
marginally significant difference (RR 1.19, p = 0.0584). Hospital stay was
shorter in the early group (MD -1.00 days, p < 0.0001), yet ICU stay
showed no meaningful difference (MD -7.25 h, p = 0.217). Mortality rates
were comparable (RR 0.93, p = 0.8048). Similarly, no significant
differences were observed in postoperative infection (RR 0.85, p = 0.4403)
or atrial fibrillation rates (RR 1.01, p = 0.8649). <br/>CONCLUSION(S):
Early chest tube removal appears safe with respect to mortality,
infection, and atrial fibrillation, but is associated with a higher risk
of pericardial effusion; adoption should therefore be risk-stratified and
paired with post-removal surveillance.<br/>Copyright &#xa9; 2025. The
Author(s).

<44>
Accession Number
2041851054
Title
Ultrasound-guided thoracic paravertebral block versus erector spinae plane
block analgesia for cardiac surgery with median sternotomy: a
noninferiority randomised controlled trial.
Source
British Journal of Anaesthesia. 136(2) (pp 687-694), 2026. Date of
Publication: 01 Feb 2026.
Author
Montandrau O.; Kattou F.; Arana H.; Rekik M.; Ait Hamou N.; Weisslinger
S.-J.; Teil E.; Mekaouar S.; Bargaoui A.; Bouattour K.; Bey Boumezrag C.;
Lacombe J.-M.; Lebatard N.; Zannis K.; Beaussier M.
Institution
(Montandrau, Kattou, Arana, Rekik, Ait Hamou, Weisslinger, Bargaoui,
Bouattour, Beaussier) Department of Anaesthesia, Institut Mutualiste
Montsouris, Paris, France
(Teil, Mekaouar) Department of Intensive Care Unit, Institut Mutualiste
Montsouris, Paris, France
(Bey Boumezrag, Lacombe) Department of Clinical Research, Institut
Mutualiste Montsouris, Paris, France
(Lebatard, Zannis) Department of Cardiac Surgery, Institut Mutualiste
Montsouris, Paris, France
Publisher
Elsevier Ltd
Abstract
Background: Effective postoperative analgesia after cardiac surgery with
median sternotomy is essential to minimise complications and promote
recovery. Bilateral thoracic paravertebral block (TPVB) is an established
technique in cardiac surgery but carries potential risks. Erector spinae
plane block (ESPB) could offer a simpler and safer alternative.
<br/>Method(s): In this prospective, patient- and assessor-blinded,
noninferiority, randomised controlled trial, adults undergoing median
sternotomy for planned cardiac surgery were allocated to receive
ultrasound-guided single-shot ESPB or TPVB with 20 ml of ropivacaine
0.375% per side performed under general anaesthesia in the left lateral
decubitus position. The primary outcome was pain during forced expiration,
assessed using the numerical rating scale (NRS) at 6 h after surgery.
Secondary outcomes included opioid consumption and block-related adverse
events. <br/>Result(s): We enrolled 74 participants. At 6 h, mean (SD) NRS
pain scores were 3.5 (2.6) for ESPB and 3.0 (2.1) for TPVB (95% confidence
interval, -0.48 to 1.34). As the upper bound of the 95% confidence
interval exceeded the predefined margin of 1 NRS point, noninferiority of
ESPB could not be demonstrated. Opioid consumption, NRS pain scores at 24
and 48 h, and ICU or hospital length of stay were comparable between
groups. ESPB participants experienced more intraoperative hypertension
than TPVB participants. No serious block-related complications were
observed. <br/>Conclusion(s): ESPB did not demonstrate noninferiority to
TPVB for early dynamic analgesia after median sternotomy. Clinical trial
registration: NCT04546113.<br/>Copyright &#xa9; 2025 British Journal of
Anaesthesia

<45>
Accession Number
2042870911
Title
Ultrasound-guided unilateral thoracic paravertebral block for
postoperative analgesia in pediatric patients undergoing thoracoscopic
mediastinal tumor resection: a single-center randomized controlled trial.
Source
World Journal of Surgical Oncology. 24(1) (no pagination), 2026. Article
Number: 58. Date of Publication: 01 Dec 2026.
Author
Sun L.; Wu Z.; Wang F.; Gao Z.; Li L.; Liu H.; Liu G.; Li G.; Zhang J.
Institution
(Sun, Wang, Gao, Li, Liu, Liu, Li, Zhang) Department of Anesthesiology,
Beijing Children's Hospital, Capital Medical University, National Center
for Children's Health, Beijing, China
(Wu) Department of Science and Technology, Beijing Youan Hospital, Capital
Medical University, Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic paravertebral block (TPVB) has rarely been reported
for pediatric mediastinal tumor surgery. This study aimed to evaluate the
efficacy of unilateral TPVB for postoperative analgesia in children
undergoing thoracoscopic mediastinal tumor resection, providing a
potential option for multimodal analgesia in pediatric thoracic oncology
surgery. <br/>Method(s): Children aged 4 to 12 years scheduled for
thoracoscopic mediastinal tumor resection were enrolled and randomly
assigned to either the general anesthesia group (GA group) or the general
anesthesia combined with paravertebral block group (TPVB group).
Postoperative pain was assessed using the FLACC (Face, Legs, Activity,
Cry, Consolability) scale at 2, 4, 8, 12, and 24 h after surgery. The
primary outcome was the pain intensity, and secondary outcomes included
pain scores at rest and during activity, postoperative opioid consumption,
adverse events, and recovery quality. <br/>Result(s): Of the 120 patients
enrolled and randomized, 110 completed the study (GA group, n = 54; TPVB
group, n = 56).Results showed that the TPVB group had significantly lower
pain intensity compared to the general anesthesia group (1.8 +/- 0.3 vs.
2.2 +/- 0.3, p < 0.001). Pain scores at rest and during activity were
significantly reduced at 2, 4, and 8 h, and pain scores at rest remained
significantly lower at 12 h. Compared with the GA group, the TPVB group
had lower postoperative opioid consumption (0.2 [0.1-0.3] microg/kg vs.
0.3 [0.2-0.4] microg/kg, p = 0.024), a lower incidence of desaturation in
the post-anesthesia care unit (PACU) (2 [3.6%] vs. 12 [22.2%], p = 0.003),
shorter PACU stay (21 [15-27] min vs. 31 [25-35] min, p < 0.001), earlier
chest tube removal (3 [3-4] days vs. 4 [3-4] days, p = 0.013), and a
shorter hospital stay (5 [4-6] days vs. 6 [5-7] days, p < 0.001). There
were no significant differences in adverse events between the two groups.
<br/>Conclusion(s): Unilateral TPVB for pediatric mediastinal tumor
resection significantly reduces overall pain intensity within 24 h and
pain scores within the first 8 h postoperatively, decreases opioid
consumption during the first 24 h, and improves postoperative recovery.
Trial registration: Chinese Clinical Trial Registry ChiCTR2400083377,
registered 23 April 2024.<br/>Copyright &#xa9; The Author(s) 2025.

<46>
Accession Number
650061074
Title
Transcatheter aortic valve implantation in the immunosuppressed: A
systematic review and meta-analysis.
Source
Acta Cardiologica. Conference: Belgian Society of Cardiology 44th Annual
Congress. Brussels Belgium. 80(Supplement 2) (pp 52-53), 2025. Date of
Publication: 01 Feb 2025.
Author
Meeus R.; Dhondt P.; Hariyanto J.; Ashraf H.; Meeus N.
Institution
(Meeus, Dhondt, Meeus) University Hospitals Leuven, Leuven, Belgium
(Hariyanto) Universitas Pellita Harapan, Jakarta, Indonesia
(Ashraf) Rawalpindi Medical School, Rawalpindi, Pakistan
Publisher
Taylor and Francis Ltd.
Abstract
Background/introduction: Immunocompromised (IC) patients are at a higher
risk of adverse outcomes following traditionalCardiac surgery, and
transcatheter aortic valve implantation (TAVI) is often considered a
suitable alternative for treatingsevere aortic stenosis in this
population. However, despite the increasing use of TAVI, there is limited
and inconclusive dataregarding its safety and efficacy in IC patients.
Given the unique risks posed by immunosuppression, it is crucial to
betterunderstand the outcomes of TAVI in this vulnerable group.
<br/>Purpose(s): This meta-analysis aims to compare the outcomes of IC
patients undergoing TAVI to those ofnon-immunosuppressed patients.
<br/>Method(s): We searched PubMed, EMBASE, and Cochrane Central for
randomised controlled trials or observational studiescomparing IC and
non-IC patients undergoing TAVI. Primary outcomes were all-cause
mortality, major or life-threateningbleeding, and new pacemaker
implantation with at least 30-day follow-up. <br/>Result(s): Three
studies, including 1572 patients (mean age 81.1 years, 8.2% IC), were
analysed. IC patients had significantlyhigher all-cause mortality compared
to non-IC patients (Odds Ratio [OR] 2.30, 95% Confidence Interval [CI]
1.08-4.87,p = .030). There were no significant differences in major or
life -threatening bleeding (OR 1.14, 95% CI 0.37-3.47, p = .820) ornew
pacemaker implantation (OR 1.11, 95% CI 0.54-2.27, p = .773) between the
two groups.Conclusion(s): This meta-analysis shows that IC patients
undergoing TAVI have a significantly higher risk of all-cause mortality
compared to non-IC patients. However, rates of major or life-threatening
bleeding and new pacemaker implantation were similar. These findings
highlight the importance of careful risk assessment in IC patients
undergoing TAVI, and further studies are needed to explore long-term
outcomes in this population.

<47>
Accession Number
650079392
Title
Cost analyses in randomized trials on robot-assisted surgery: systematic
review.
Source
BJS open. 10(1) (no pagination), 2025. Date of Publication: 29 Dec 2025.
Author
Bosscha S.R.J.; Amiri R.; Jamaludin F.; Rovers M.; Besselink M.G.; van
Hilst J.
Institution
(Bosscha, Amiri, Jamaludin, Besselink, van Hilst) Department of Surgery,
Location University of Amsterdam, Amsterdam, Netherlands
(Bosscha, Amiri, Jamaludin, Besselink, van Hilst) Cancer Center Amsterdam,
Amsterdam, Netherlands
(Rovers) Department of Medical Imaging, Radboud University Medical Center,
Nijmegen, Netherlands
(van Hilst) Department of Surgery, OLVG, Amsterdam, Netherlands
Abstract
BACKGROUND: Robot-assisted surgery (RAS) is increasingly being used, yet
its cost-effectiveness remains debated. Cost analyses of RAS are therefore
essential but remain challenging. This systematic review evaluated the
quality of cost analyses in randomized clinical trials (RCTs) comparing
RAS with alternative surgical approaches. <br/>METHOD(S): A systematic
review was performed in PubMed, EMBASE, Cochrane Library, and Web of
Science from inception up to August 2025. RCTs were included if they
compared RAS with other approaches and conducted a cost analysis. Risk of
bias was assessed using the revised Cochrane Risk-of-Bias tool. The
methodological quality and comprehensiveness of cost analyses were
evaluated with the Economic Evaluation Bias Assessment Tool (ECOBIAS) and
Consolidated Health Economic Evaluation Reporting Standards (CHEERS)
checklist, respectively. Studies were evaluated for key structural and
component-specific costs of RAS. <br/>RESULT(S): Overall, 38 RCTs
involving 5832 patients were included. Most studies focused on general
surgical procedures (20 RCTs, 53%), followed by urology (7), gynaecology
(7), and cardiothoracic surgery (4). RAS was compared with laparoscopic
surgery in 23 RCTs, open surgery in 14 RCTs, and another robotic modality
in one RCT. Regarding bias, 10 RCTs (26%) were considered high risk, and
24 (63%) had some concerns. On average, RCTs met 5 of 11 ECOBIAS criteria
and 14 of 28 CHEERS items. Only 15 of 38 RCTs (39%) included key
structural costs of RAS, such as robot acquisition and maintenance,
whereas 12 of 38 RCTs (32%) provided a component-specific cost overview.
RAS was more expensive in 33 of 36 RCTs (92%). <br/>CONCLUSION(S):
Randomized trials comparing RAS with other surgical approaches rarely
perform adequate cost assessments and cost-effectiveness analyses. The
substantial risk of bias, methodological heterogeneity, and partial cost
reporting observed underline the need for uniform economic evaluation in
RCTs on RAS. Registration number: CRD42024520677
(https://www.crd.york.ac.uk/prospero/).<br/>Copyright &#xa9; The Author(s)
2026. Published by Oxford University Press on behalf of BJS Foundation
Ltd.

<48>
Accession Number
650071529
Title
Axillary Versus Sternotomy Access in Minimally Invasive Mitral Valve
Surgery: A Systematic Review and Meta-Analysis.
Source
Innovations (Philadelphia, Pa.). (pp 15569845251400765), 2026. Date of
Publication: 27 Jan 2026.
Author
Almehandi A.; Ramadhan M.; Ali Y.; Almhanedi A.; Al-Naseem A.O.; Gonnah
A.; Awad A.; Fischer J.; Kirov H.; Doenst T.; Nazer R.I.; Caldonazo T.
Institution
(Almehandi) Department of Cardiovascular Science, University College
London, United Kingdom
(Ramadhan, Almhanedi, Al-Naseem) Department of Surgery, Jaber Al Ahmad Al
Jaber Al Sabah Hospital, Surra, Al Asimah Governorate, Kuwait
(Ali) Faculty of Life Science and Medicine, Kings College London, United
Kingdom
(Gonnah) Imperial College Healthcare NHS Trust, London, United Kingdom
(Awad) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Fischer, Kirov, Doenst, Caldonazo) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, Germany
(Nazer) Department of Cardiac Science, King Fahad Cardiac Centre, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, USA
Abstract
OBJECTIVE: Minimally invasive cardiac surgery for mitral valve (MV)
disease is a rising strategy. Axillary access is linked to reduced pain
and faster recovery, but its efficacy and safety compared with median
sternotomy for MV surgery (MVS) remain unclear. We conducted a
meta-analysis comparing the clinical outcomes of MVS via axillary access
and median sternotomy. <br/>METHOD(S): Four databases were analyzed. The
primary endpoint was perioperative mortality. Secondary endpoints included
cardiopulmonary bypass (CPB) and cross-clamp times, rethoracotomy, wound
complications, mechanical ventilation duration, stroke, hospital and
intensive care unit (ICU) stay, and residual moderate mitral
regurgitation. A random-effects model was used. <br/>RESULT(S): We
included 2,129 patients from 4 studies, with 1,135 (53.3%) undergoing
axillary access. Perioperative mortality was comparable between approaches
(odds ratio [OR] = 0.34, 95% confidence interval [CI]: 0.09 to 1.23, P =
0.10). Axillary access was associated with longer CPB times (mean
difference [MD] = 16.38, 95% CI: 6.42 to 26.34, P = 0.001), fewer wound
complications (OR = 0.41, 95% CI: 0.21 to 0.80, P = 0.009), shorter
ventilation time (MD = -4.93, 95% CI: -8.79 to -1.08, P < 0.01), and
shorter hospital (MD = -0.78, 95% CI: -1.41 to -0.14, P = 0.02) and ICU
stays (MD = -10.84, 95% CI: -19.54 to -2.14, P = 0.01). No difference was
found in cross-clamp time, rethoracotomy, stroke, or residual mitral
regurgitation. <br/>CONCLUSION(S): Axillary access for MVS shows
comparable mortality to median sternotomy, with benefits in wound
complications, ventilation, and recovery but longer CPB times. Further
research is needed to confirm long-term safety and efficacy.

<49>
Accession Number
2042873561
Title
Sex-based differences in outcomes between male and female patients with
bicuspid aortic stenosis following transcatheter aortic valve replacement:
A meta-analysis.
Source
Precision Medical Sciences. (no pagination), 2026. Date of Publication:
2026.
Author
Khan M.H.A.; Khawar M.; Farooq A.U.; Khalid A.; Ahsan S.M.; Awan M.H.N.;
Nisar M.S.; Elahi A.; Faizan M.A.; Shahid I.; Ahmed A.M.; Haider F.;
Chhetri R.
Institution
(Khan, Ahsan, Elahi) Department of Medicine, Harlingen Medical Center,
Harlingen, TX, United States
(Khawar, Farooq, Awan, Nisar, Shahid, Ahmed) Department of Medicine, King
Edward Medical University, Punjab, Lahore, Pakistan
(Khalid) Department of Medicine, Rawalpindi Medical University, Punjab,
Rawalpindi, Pakistan
(Faizan) Gomal Medical College, Khyber Medical University, Khyber
Pakhtunkhwa, Peshawar, Pakistan
(Haider) Department of Medicine, Allama Iqbal Medical College, Punjab,
Lahore, Pakistan
(Chhetri) Department of Medicine, Nepalgunj Medical College, Kohalpur,
Nepal
Publisher
John Wiley and Sons Inc
Abstract
Bicuspid aortic valve (BAV) is a common congenital anomaly leading to
early aortic stenosis. Although transcatheter aortic valve replacement
(TAVR) offers a less invasive treatment for BAV stenosis, sex-specific
outcome data are scarce. This study evaluates clinical outcomes after TAVR
by sex in BAV patients. A systematic literature search was performed
across PubMed, ClinicalTrials.gov, and Cochrane CENTRAL to identify
relevant English-language randomized controlled trials and observational
studies. Risk ratios (RRs) with 95% confidence intervals (CIs) were
calculated using fixed- or random-effects models based on heterogeneity.
Statistical significance was set at p <.05, and heterogeneity was assessed
using the I² statistic. Analyses were performed with Review
Manager Version 5.3. Four observational studies comprising 7585 patients
met inclusion criteria. Males had a higher incidence of acute kidney
injury (AKI) (RR = 1.33; 95% CI: 1.13-1.57; p =.0008) and acute myocardial
infarction (MI) (RR = 2.18; 95% CI: 1.54-3.07; p =.00001), but a lower
risk of in-hospital mortality (RR = 0.71; 95% CI: 0.51-0.99; p =.04),
stroke (RR = 0.70; 95% CI: 0.50-0.95; p =.02), and bleeding (RR = 0.79;
95% CI: 0.63-0.98; p =.03) compared to females. No statistically
significant differences were observed in one-year mortality (RR = 1.08;
95% CI: 0.58-2.03; p =.81), 30-day mortality (RR = 1.18; 95% CI:
0.51-2.75; p =.69), or arrhythmia (RR = 0.83; 95% CI: 0.52-1.33; p =.45).
Males had increased risks of AKI and MI, while females experienced higher
in-hospital mortality, stroke, and bleeding. These findings, derived from
a limited number of retrospective observational studies, are
hypothesis-generating and highlight the need for sex-specific risk
stratification and further prospective research to confirm these patterns
and guide clinical practice.<br/>Copyright &#xa9; 2026 The Author(s).
Precision Medical Sciences published by John Wiley & Sons Australia, Ltd
on behalf of Nanjing Medical University Affiliated Cancer Hospital &
Jiangsu Cancer Hospital.

<50>
Accession Number
2043229573
Title
The PROTECT trial: Effect of titrated versus conventional induction of
general anaesthesia using a target-controlled infusion system on
haemodynamics in patients undergoing non-cardiac surgery - protocol for a
multicentre, expertise-based randomised controlled trial.
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e110452. Date of
Publication: 28 Jan 2026.
Author
Funk S.; Lohri M.D.; Lugli A.K.; Schindler C.; Wiencierz A.; Mnich K.;
Schlapfer M.; Gaberdiel A.P.; Puhan M.A.; Steiner L.A.; Gomes N.V.;
Dell-Kuster S.
Institution
(Funk, Lohri, Gaberdiel, Steiner, Gomes, Dell-Kuster) Department of Acute
Medicine, University Hospital Basel, Basel, Switzerland
(Funk, Lohri, Wiencierz, Gaberdiel, Steiner, Gomes, Dell-Kuster)
Department of Clinical Research, University of Basel, Basel, Switzerland
(Lohri) Intensive Care Unit, Department of Acute Medicine, University
Hospital Basel, Basel, Switzerland
(Lugli) Department of Anaesthesiology and Intensive Care, Kantonsspital
Baden, Baden, Switzerland
(Schindler) Swiss Tropical and Public Health Institute, Allschwil,
Switzerland
(Schindler) University of Basel, Basel, Switzerland
(Mnich) Department of Perioperative Medicine (Anaesthesiology, Intensive
Care Medicine, Pain Medicine and Prehospital Emergency Medicine),
Kantonsspital Olten, Olten, Switzerland
(Schlapfer) Department of Anaesthesiology, Kantonsspital Graubunden, Chur,
Switzerland
(Schlapfer) Institute of Anaesthesiology, University Hospital Zurich,
Zurich, Switzerland
(Schlapfer) Institute of Physiology, University of Zurich, Zurich,
Switzerland
(Puhan, Dell-Kuster) Epidemiology, Biostatistics and Prevention Institute,
University of Zurich, Zurich, Switzerland
(Gomes) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital NHS Foundation Trust, Cambridge, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Introduction Hypotension is a frequent complication after induction of
general anaesthesia leading to end-organ injury, for which elderly and
multimorbid patients are particularly susceptible. The extent of
hypotension depends, among other factors, on the dose and rate of propofol
administration. Target-controlled infusion systems are widely used to
administer short-acting anaesthetics such as propofol and remifentanil.
Commonly, induction is started with a fixed effect-site concentration.
Titration, an alternative method of induction using an incremental
augmentation of propofol, leads to a reduced induction dose and rate of
propofol. We hypothesise that the titration method improves haemodynamic
stability compared with conventional induction. Methods and analysis This
multicentre, expertise-based randomised controlled trial takes place at
four Swiss hospitals. Patients >=55 years of age undergoing non-cardiac
surgery under general anaesthesia using propofol target-controlled
infusion are randomised to either a conventional or a titrated anaesthesia
induction method. Patients, statisticians and, if resources allow, outcome
assessors will be blinded. The primary endpoint is the mean arterial
pressure under the individual baseline mean arterial pressure (area under
threshold) during the first 30 min after start of induction. Secondary
endpoints include the maximum deviation from baseline mean arterial
pressure, haemodynamic rescue methods, propofol consumption and
neurocognitive recovery after regaining consciousness. A total of 320
patients are required to have an 80% chance of observing superiority of
titration for the area under the threshold as significant at the 5% level,
assuming a true difference of 100 mm Hg*min. The area under threshold and
the maximum deviation will be compared between arms using mixed linear
regression models. Ethics and dissemination Ethical approval has been
obtained from all responsible ethics committees (BASEC2025-01007). The
results will be presented at international meetings and published in
peer-reviewed journals and may contribute to a change in clinical practice
for anaesthesia induction using target-controlled infusion systems with
propofol.<br/>Copyright &#xa9; Author(s) (or their employer(s)) 2026.
Re-use permitted under CC BY-NC. No commercial re-use. See rights and
permissions. Published by BMJ Group.

<51>
Accession Number
2043081312
Title
Antithrombotic Treatment After Valve-in-Valve, Valve-in-Ring, and
Valve-in-MAC Procedures: A Systematic Review and Meta-Analysis.
Source
Acta Medica Portuguesa. 38(9) (pp 528-537), 2025. Date of Publication: 01
Sep 2025.
Author
Terleira Batista G.; Costa G.; Delgado Silva J.; Goncalves L.
Institution
(Terleira Batista, Costa, Delgado Silva, Goncalves) Servico de
Cardiologia, Centro Hospitalar e Universitario de Coimbra, Coimbra,
Portugal
(Costa, Delgado Silva, Goncalves) Faculdade de Medicina, Universidade de
Coimbra, Coimbra, Portugal
(Costa, Delgado Silva, Goncalves) Coimbra Institute for Clinical and
Biomedical Research (iCBR), Coimbra, Portugal
Publisher
CELOM
Abstract
While antithrombotic therapy following transcatheter valve implantation
has been extensively studied in various clinical trials, there remains a
notable gap in evidence regarding the optimal approach following
valve-in-valve (ViV), valve-in-ring (ViR) and valve-in-mitral annular
calcification (ViMAC) procedures, warranting further assessment. This gap
is particularly concerning due to the apparent increased risk of
thrombosis associated with ViV interventions. The aim of this systematic
review was to explore the potential benefits of anticoagulation in ViV,
ViR, and ViMAC procedures. We searched PubMed, Embase, and the Cochrane
Central Register of Controlled Trials, as well as the grey literature, for
observational and interventional studies published until December 2023.
Trials were included if a comparative analysis between the two
antithrombotic strategies was feasible and excluded if patients under 18
years old were analysed. The primary efficacy endpoints were incidence of
clinical and total valve thrombosis (VT), major bleeding was the sole
safety primary endpoint. Additional analyses were performed regarding
valves in the mitral position and valve type. The risk of bias was
evaluated using the Newcastle-Ottawa scale. Data was assessed using the
Review Manager 5.4 software. A total of five observational and one case
series were included (n = 614 on anticoagulation and n = 468 on
antiplatelets), comprising a total of 1082 participants. Clinical VT rates
were 4.2% for all procedures, and patients on anticoagulants were
associated with a lower risk of clinical VT (1.1% vs 8.3%; OR: 0.18; 95%
CI: 0.07 - 0.42, I2: 0%) and total VT (1.3% vs 8.5%; OR: 0.16; 95% CI:
0.07 - 0.37, I2: 0%). Regarding bleeding events, the existing literature
did not provide adequate information to enable a thorough analysis. Our
study suggests a potential benefit of anticoagulation regimens to decrease
the high rates of VT following valve-in-valve, valve-in-ring and
valve-in-mitral annular calcification procedures. However, the lack of
randomized controlled trials and data on bleeding and mortality emphasises
the necessity for further research.<br/>Copyright &#xa9; Ordem dos Medicos
2025

<52>
Accession Number
2043151244
Title
Meta-Analysis of Dual Antiplatelet Therapy Versus Low-Dose Direct Oral
Anticoagulation After Left Atrial Appendage Occlusion.
Source
American Journal of Therapeutics. 32(3) (pp e312-e315), 2025. Date of
Publication: 2025.
Author
Singh S.; Bliden K.; Tantry U.S.; Gurbel P.A.; Kanjwal M.Y.; Lundgren S.W.
Institution
(Singh) Department of Medicine, Sinai Hospital of Baltimore, Baltimore, MD
(Bliden, Tantry) Sinai Center for Thrombosis Research, Sinai Hospital of
Baltimore, Baltimore, MD
(Gurbel, Kanjwal) Division of Cardiology, Sinai Hospital of Baltimore,
Baltimore, MD
(Lundgren) Division of Cardiology, University of Nebraska Medical Center,
Omaha, NE
Publisher
Lippincott Williams and Wilkins

<53>
Accession Number
2042831558
Title
Imaging and Clinical Outcomes with Sentinel Cerebral Embolic Protection
During TAVR: A Meta-Analysis of Randomized Trials with Trial Sequential
Analysis.
Source
Journal of Clinical Medicine. 15(2) (no pagination), 2026. Article Number:
914. Date of Publication: 01 Jan 2026.
Author
Pavan Lingamsetty S.S.; Kritya M.; Vatsavayi P.; Tera C.R.; Doma M.; Jitta
S.R.; Gudiwada M.C.V.B.; Jasti J.; Ramadan A.; Vedantam V.; Villablanca
P.A.; Goldsweig A.M.
Institution
(Pavan Lingamsetty) Beth Israel Deaconess Medical Center, Harvard Medical
School, Boston, MA, United States
(Kritya) Department of Structural Heart, Houston Methodist Research
Institute, Houston, TX, United States
(Vatsavayi, Tera, Vedantam) Department of Internal Medicine, East
Tennessee State University (ETSU) Quillen College of Medicine, Johnson
City, TN, United States
(Doma) Department of Cardiology, Massachusetts General Hospital, Boston,
MA, United States
(Jitta) Department of Internal Medicine, Mercy Health St. Louis, St.
Louis, MO, United States
(Gudiwada) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, United States
(Jasti) Department of Cardiology, Tower Health Reading Hospital, West
Reading, PA, United States
(Ramadan) Department of Internal Medicine, Boston Medical Center-Brighton
South, Boston, MA, United States
(Villablanca) Division of Cardiovascular Medicine, Henry Ford Hospital,
Detroit, MI, United States
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical
Center, Springfield, MA, United States
(Goldsweig) Division of Cardiology, University of Massachusetts-Baystate,
Springfield, MA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Stroke and subclinical cerebral ischemia remain important
neurological complications of transcatheter aortic valve replacement
(TAVR). The Sentinel cerebral embolic protection (CEP) device is designed
to capture embolic debris during TAVR, but its impact on clinical and
imaging outcomes remains incompletely characterized. <br/>Method(s):
PubMed, Embase, and Cochrane databases were systematically searched for
randomized controlled trials (RCTs) comparing Sentinel CEP versus no
protection when TAVR was performed. Outcomes of interest included all
stroke, disabling stroke, infarct volume by diffusion-weighted MRI in
protected and unprotected areas, all-cause mortality, acute kidney injury,
and major vascular complications. Risk ratios (RRs) and median differences
with 95% confidence intervals (CIs) were calculated using random-effects
models and trial sequential analysis (TSA) assessed evidence robustness.
<br/>Result(s): Four RCTs including 10,986 patients were analyzed.
Sentinel CEP did not significantly reduce clinical stroke (RR 0.88, 95% CI
0.69-1.12) or disabling stroke (RR 0.68, 95% CI 0.41-1.14). Pooled DW-MRI
data showed a significant reduction in new ischemic lesion volume within
Sentinel CEP-protected territories (difference in medians -75.7
mm³; 95% CI -130.4 to -21.0). Subgroup analyses in elderly,
female, and high-surgical-risk patients revealed no benefit with Sentinel
CEP. Additionally, TSA indicated that current data are underpowered for
definitive conclusions. <br/>Conclusion(s): The Sentinel CEP device during
TAVR did not significantly reduce clinical stroke but was associated with
lower MRI-detected ischemic lesion volumes compared with no protection.
Further adequately powered RCTs integrating clinical and imaging endpoints
are needed to define its role in neuroprotection during
TAVR.<br/>Copyright &#xa9; 2026 by the authors.

<54>
Accession Number
2042869470
Title
Local anesthesia alone versus with sedation for transcatheter aortic valve
implantation: a systematic review and meta-analysis.
Source
Clinical Research in Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Hendrianus H.; Lee S.Y.; Jeong Y.-H.; Won H.; Cho J.H.; Jo J.; Park K.T.;
Park G.T.; Cho E.J.; Ohlmann P.; Kim S.-W.
Institution
(Hendrianus, Lee, Jeong, Won, Cho, Park, Park, Cho, Kim) Department of
Internal Medicine, Chung-Ang University College of Medicine, Seoul, South
Korea
(Hendrianus, Lee, Jeong, Cho, Jo, Cho, Kim) Heart and Brain Hospital,
Chung-Ang University Medical Center, Gwangmyeong, South Korea
(Hendrianus) Division of Cardiology, Natuna General Hospital, Natuna,
Indonesia
(Jeong) Chung-Ang University Thrombosis and Biomarker Center, Chung-Ang
University Medical Center, Gwangmyeong, South Korea
(Won, Park, Park) Division of Cardiology, Chung-Ang University Hospital,
Seoul, South Korea
(Ohlmann) Department of Cardiovascular Medicine, Nouvel Hopital Civil,
Strasbourg University Hospital, Strasbourg, France
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: As minimalist transcatheter aortic valve implantation (TAVI)
programs continue to expand globally, significant practice variation
persists in anesthetic strategy. This meta-analysis directly compares the
safety and efficacy of local anesthesia alone (LA) versus local anesthesia
with sedation (LAS) for TAVI. <br/>Method(s): We systematically searched
PubMed, Embase, and the Cochrane Central Register of Controlled Trials
(CENTRAL) from inception through September 2025. Primary outcomes included
all-cause mortality, stroke, acute kidney injury (AKI), and >= moderate
paravalvular regurgitation (PVR). Secondary outcomes encompassed
procedural complications and efficiency metrics. Pooled risk ratios (RR)
and mean differences (MD) with 95% confidence intervals (CIs) were
calculated using random- or fixed-effects models. <br/>Result(s): Seven
studies (one randomized controlled trial, six observational) with 2,990
patients (LA: n = 1,229; LAS: n = 1,761) were included. We found no
significant differences between LA and LAS in all-cause mortality (RR
0.67, 95% CI 0.35-1.29, p = 0.23), stroke (RR 0.77, 95% CI 0.37-1.62, p =
0.49), AKI (RR 0.67, 95% CI 0.26-1.73, p = 0.41), or PVR (RR 1.03, 95% CI
0.63-1.69, p = 0.91). Rates of vascular complications, pacemaker
implantation, and major bleeding were also comparable. Procedural
efficiency metrics, including procedure time (MD 2.76 min, 95% CI
-2.70-8.21, p = 0.32) and hospital length of stay (MD -0.48 days, 95% CI
-1.16-0.19, p = 0.16), did not differ significantly between groups.
<br/>Conclusion(s): In patients undergoing transfemoral TAVI, a minimalist
approach using LA alone is non-inferior to LAS regarding short-term
safety, efficacy, and procedural efficiency. These findings suggest that
anesthetic strategy may be individualized based on patient-specific
factors and operator experience while maintaining comparable clinical
outcomes. Registration: PROSPERO CRD420251146705.<br/>Copyright &#xa9;
Springer-Verlag GmbH Germany, part of Springer Nature 2026.

<55>
Accession Number
650061077
Title
Improving atrial fbrillation or futter detection and management by
smartphone-based photoplethysmography rhythm monitoring following cardiac
surgery: A pragmatic randomized trial.
Source
Acta Cardiologica. Conference: Belgian Society of Cardiology 44th Annual
Congress. Brussels Belgium. 80(Supplement 2) (pp 4-5), 2025. Date of
Publication: 01 Feb 2025.
Author
Gruwez H.; De Melio N.; Vermunicht P.; Van Langenhoven L.; Desteghe L.;
Lamberigts M.; Nuyens D.; Van Herendael H.; Rodrigus I.; Van Kerrebroeck
C.; Vandervoort P.; Heidbuchel H.; Pison L.; Rega F.; Haemers P.
Institution
(Gruwez, Lamberigts, Rega, Haemers) UZ Leuven, Leuven, Belgium
(Gruwez, Nuyens, Van Herendael, Van Kerrebroeck, Vandervoort, Pison)
Ziekenhuis Oost-Limburg, Genk, Belgium
(De Melio) UHasselt, Hasselt, Belgium
(Vermunicht, Desteghe, Rodrigus, Heidbuchel) Universitair Ziekenhuis
Antwerpen, Antwerpen, Belgium
(Van Langenhoven) KU Leuven, Leuven, Belgium
Publisher
Taylor and Francis Ltd.
Abstract
Background/introduction: Atrial fibrillation (AF) or atrial flutter (AFL)
after cardiac surgery are common and associated with adverse outcomes. The
increased risk related to AF or AFL may extend beyond discharge.
<br/>Purpose(s): This study aims to determine whether photoplethysmography
(PPG)-based smartphone monitoring to detect AF or AFL after hospital
discharge following cardiac surgery improves AF management.
<br/>Method(s): The intervention group performed one-minute rhythm checks
three times daily using a smartphone-based PPG application during 6 weeks
after hospitalisation for cardiac surgery. The primary outcome involved AF
management interventions by independent physicians, including initiation
of oral anticoagulation (OAC), direct cardioversion and up-titration or
initiation of antiarrhythmic drugs. <br/>Result(s): The study included 450
patients (mean [SD] age, 64.1 [9.2] years; 96 women [21.3%]; 130 patients
with AF history [28.9%]; median [IQR] CHA2DS2-VASc score, 2 [1-3]), of
whom 238 were randomised to PPG-based monitoring and 212 to usual care.
AF/AFL was detected with PPG or electrocardiography in 44 patients (18.5%)
in the monitoring group and 4 patients (1.9%) in the usual care group (OR
11.8; 95%CI, 4.2-33.3; p<.001), these were new detections in respectively
22 patients (9.2%) and 1 patient (0.5%) (OR 21.3; 95%CI, 2.9-166.7; p =
.003). AF management interventions occurred in 24 patients (10.1%) in the
monitoring group compared to 5 patients (2.4%) in the usual care group
(odds ratio [OR]), 5.1; 95%CI, 1.8-14.4; p = .002). Conclusion(s): In
unselected patients discharged home following cardiac surgery, PPG-based
smartphone monitoring revealed significantly more AF/AFL which led to
significantly more optimisation of AF management.

<56>
Accession Number
2037627531
Title
Ultrasound guided internal jugular vein cannulation in pediatric patients:
a randomized controlled trial.
Source
Signa Vitae. 22(1) (pp 85-94), 2026. Date of Publication: 01 Jan 2026.
Author
Wang S.; Sun Y.; Chen X.; Chen W.; Wu P.; Cao J.; Tan Y.; Li Y.; Liu L.
Institution
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Department of
Anesthesiology, Children's Hospital of Chongqing Medical University,
Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) National Clinical Research
Center for Child Health and Disorders, Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Ministry of Education Key
Laboratory of Child Development and Disorders, Chongqing, China
(Wang, Sun, Chen, Chen, Wu, Cao, Tan, Li, Liu) Chongqing Key Laboratory of
Pediatric Metabolism and Inflammatory Diseases, Chongqing, China
Publisher
Pharmamed Mado Ltd
Abstract
Background: Central venous catheterization is essential for hemodynamic
monitoring and rapid fluid administration during pediatric surgeries, with
the internal jugular vein (IJV) being a preferred site for access.
However, ultrasound-guided IJV cannulation in pediatric patients remains
technically challenging. This study aimed to compare the efficacy and
safety of the modified dynamic needle tip positioning (MDNTP) technique
with the real-time biplane technique in pediatric patients.
<br/>Method(s): This prospective randomized controlled trial enrolled 88
children aged 0-6 years undergoing thoracic or cardiac surgery and
requiring IJV cannulation at Chongqing Children's Hospital (November 2023
to April 2024). Eleven anesthesiology residents received standardized
simulator-based training in both techniques. The patients were randomized
in a 1:1 ratio to either the MDNTP group (using a linear probe) or the
real-time biplane group (using a biplane probe). The primary outcomes were
the first-attempt success rate and cannulation time. Secondary outcomes
included overall success rate, number of puncture attempts, and incidence
of complications. The operators, outcome assessors, and statisticians were
blinded to group assignments. Statistical analyses were performed using
the Mann-Whitney U test and chi-square test. <br/>Result(s): The MDNTP
group demonstrated a higher first-attempt success rate (79.5% vs. 54.5%;
p=0.022) and shorter cannulation time (82.50 (55.50-115.50) vs. 108.00
(71.80-174.00) s; p=0.023) compared to the real-time biplane group, with
fewer required puncture attempts (p=0.015). Both groups achieved similar
overall success rates (97.7%) and demonstrated comparable safety profiles,
with one minor hematoma in the MDNTP group and none in the biplane group
(p=1.000). <br/>Conclusion(s): Residents performing ultrasound-guided IJV
cannulation in pediatric patients using the MDNTP technique had a
significantly higher first-attempt success rate and faster cannulation
compared to the real-time biplane technique, without compromising safety.
Clinical Trial Registration: ChiCTR2300077334.<br/>Copyright &#xa9; 2026
The Author(s).

<57>
Accession Number
2043261534
Title
Outcomes of robotic repair for the degenerative mitral valve: a systematic
review and meta-analysis.
Source
Annals of Cardiothoracic Surgery. 15(1) (no pagination), 2026. Article
Number: 1. Date of Publication: 01 Jan 2026.
Author
Eranki A.; Munir L.; Downes D.; Debs C.; Rajesh K.; Muston B.; Ng D.;
Wilson-Smith A.; Gupta A.; Misfeld M.
Institution
(Eranki) Department of Cardiothoracic Surgery, Royal Hobart Hospital,
Hobart, Australia
(Munir) School of Medicine and Dentistry, Griffith University, Gold Coast,
Australia
(Downes) School of Medicine, University of New England, Armidale,
Australia
(Debs) School of Medicine and Surgery, University of Sydney, Sydney,
Australia
(Rajesh) School of Medicine, University of New South Wales, Sydney,
Australia
(Muston, Misfeld) Department of Cardiothoracic Surgery, Royal Prince
Alfred Hospital, Sydney, Australia
(Ng) Department of Cardiothoracic Surgery, Westmead Hospital, Sydney,
Australia
(Wilson-Smith) School of Medicine, Macquarie University, Sydney, Australia
(Gupta) School of Medicine, University of Adelaide, Adelaide, Australia
(Gupta) Department of Cardiothoracic Surgery, John Hunter Hospital,
Newcastle, Australia
Publisher
AME Publishing Company
Abstract
Background: Robotic mitral valve repair (RMVr) provides a minimally
invasive option for degenerative mitral regurgitation (MR), yet durability
signals and patient outcomes remain heterogeneously reported. This current
systematic review and meta-analysis aims to summarize survival and freedom
from reoperation following RMVr in degenerative disease. <br/>Method(s):
Five databases were searched from inception through July 2025 for studies
reporting RMVr outcomes in degenerative disease. Cohorts with mixed
etiologies without separable data were excluded. Short-term mortality (<30
days) was the primary outcome, while mid- to long-term survival and
freedom from reoperation were presented using Kaplan-Meier curves.
Secondary endpoints included relevant morbidity outcomes and reoperation
rates. Meta-regression analysis examined associations between cohort size
and adverse outcomes and assessed temporal trends in RMVr technique.
<br/>Result(s): Following independent screening, 15 studies were selected,
including 11,432 patients. Pooled mean follow-up was 60.9 months
(clinical) and 20.0 months (echocardiographic). Kaplan-Meier overall
survival at 1, 3, 5 and 10 years was 98.9%, 98.7%, 97.4% and 92.3%,
respectively. At 1, 3 and 5 years, freedom from reoperation was 97.7%,
96.0% and 96.0%, while freedom from recurrent >=2+ MR was 98.3%, 95.8% and
95.8%. Pooled short-term (<30 days) mortality was 1.3% [95% confidence
interval (CI): 1.1-1.4%]. Postoperative morbidity was low, with
cerebrovascular accident (CVA) in 1.4% and acute kidney injury (AKI) in
1.3%. Reoperation for bleeding and valve dysfunction occurred in 2.3% and
2.2% of patients, respectively. Pooled mean intensive care unit (ICU) stay
was 1.2 days and hospital length of stay (LOS) was 6.0 days.
Meta-regression suggested increasing adoption of neochordae techniques
over time (P=0.015). Heterogeneity was high for several parameters,
reflecting differences in study design, surgeon experience, and follow-up
duration. <br/>Conclusion(s): In degenerative mitral disease, RMVr
demonstrates low short-term mortality and complications, with favorable
mid- to long-term durability, including high freedom from recurrent
moderate-to-severe MR and reoperation. These findings support RMVr as an
effective and durable surgical approach to degenerative mitral pathology,
underscoring the need for prospective, standardized studies with robust
echocardiographic follow-up and case-mix adjustment.<br/>Copyright &#xa9;
AME Publishing Company.

<58>
Accession Number
650048723
Title
Ultrasound-guided pecto-intercostal fascial plane block for chronic
postoperative pain after cardiac surgery via median sternotomy: study
protocol for a randomized controlled trial.
Source
Trials. (no pagination), 2026. Date of Publication: 26 Jan 2026.
Author
Yao J.; Shen F.; Chen Y.; Cai W.; Lu X.; Wang Z.; Li B.; Xie J.; Tan X.;
Sun J.
Institution
(Yao, Shen, Chen, Cai, Lu, Wang, Li, Xie, Tan, Sun) Department of
Anesthesiology & Key Laboratory of Clinical Science and Research, Zhongda
Hospital, Southeast University, Nanjing City, No. 87 DingjiaqiaoJiangsu
Province, China
Abstract
BACKGROUND: Median sternotomy As per our journal style, article titles
should not include capitalised letters unless these are proper
nouns/acronyms. We have therefore used the article title
"Ultrasound-guided Pecto-intercostal fascial plane block for chronic
postoperative pain after cardiac surgery via median sternotomy: study
protocol for a randomized controlled trial" as opposed to
"Ultrasound-guided Pecto-intercostal Fascial Plane Block for Chronic
Postoperative Pain after Cardiac Surgery via Median Sternotomy: study
protocol for a randomized controlled trial". Please check if this is
correct.remains the preferred incision technique for cardiac surgery.
Consequently, postoperative pain is a prevalent complication following
such procedures, potentially leading to delayed recovery and a diminished
quality of life for patients. The parasternal intercostal fascial plane
block (PIFPB) is a superficial regional anesthetic technique targeting the
interfacial plane between the pectoralis major and internal intercostal
muscles. Currently, no randomized controlled trials have evaluated the
impact of PIFPB on chronic pain following cardiac surgery via median
sternotomy. To address this knowledge gap, we conducted a prospective,
randomized, double-blind, placebo-controlled trial specifically designed
to evaluate the effect of preoperative PIFPB on chronic pain incidence in
patients undergoing median sternotomy for cardiac surgery. <br/>METHOD(S):
This study protocol has been approved by the Ethics Review Committee of
Zhongda Hospital, Southeast University. We plan to enroll 304 adult
patients scheduled for cardiac surgery via median sternotomy under general
anesthesia. Participants will be randomly allocated to one of two groups:
the PIFPB group will receive a single injection of 40 ml of 0.375%
ropivacaine hydrochloride administered, while the control group will
receive an equivalent volume of 0.9% saline placebo. The primary outcome
is the incidence of chronic pain at 3 months post-surgery.
<br/>DISCUSSION(S): This is a novel randomized controlled trial designed
to evaluate the impact of preoperative ultrasound-guided single
parasternal intercostal fascia plane block on the incidence of chronic
post-surgical pain (CPSP) in patients undergoing cardiac surgery via
median sternotomy. The study will comprehensively describe the severity of
postoperative acute and chronic pain, as well as associated clinical
outcomes, in this patient population. Our findings may provide a
foundation for optimizing analgesic strategies in cardiac surgery via
median thoracotomy, further elucidate the role of regional anesthesia in
postoperative chronic pain development, and ultimately improve
postoperative quality of life for these patients. TRIAL REGISTRATION: The
trial protocol was prospectively registered with the China Clinical Trial
Registry on June 16, 2025, (trial identifier:
ChiCTR2500104378).<br/>Copyright &#xa9; 2026. The Author(s).

<59>
Accession Number
2043205767
Title
Systematic review on the effect of sleep disorders on postoperative
cognitive dysfunction and other neurological outcomes in the elderly.
Source
Journal of the Neurological Sciences. Conference: The Soul of Neurological
Innovation. Seoul South Korea. 480(Supplement) (no pagination), 2025.
Article Number: 124415. Date of Publication: 01 Dec 2025.
Author
Abeykoon D.
Institution
(Abeykoon) University of Colombo, Faculty of Medicine, Colombo, Sri Lanka
Publisher
Elsevier B.V.
Abstract
Background and aims: Associated with prolonged recovery, longer hospital
stays, and increased mortality, postoperative cognitive dysfunction (POCD)
is a common complication in the elderly. Sleep disorders may exacerbate
these outcomes. The relationship between sleep disturbances and
neurological outcomes following surgery in the elderly was aimed to be
evaluated in this systematic review. <br/>Method(s): A systematic search
of PubMed and Cochrane Library databases (September 2019-September 2024)
identified studies assessing the impact of sleep disorders on
postoperative outcomes. of 423 records screened, 11 studies were included
according to PRISMA guidelines. Meta-analysis and thematic synthesis were
performed across 3764 patients (mean age: 68.4 years, SD 5.3).
<br/>Result(s): Sleep disturbances were identified in 791 of 3764 patients
(21.02 %), with affected individuals showing a 1.43-fold higher risk of
POCD (OR 1.43, 95 % CI: 1.11-1.82). The relative risk was 2.04 (95 % CI:
1.18-3.50; I2 = 0.00 %) after cardiac surgery and 1.84 (95 % CI:
1.26-2.71; I2 = 0.00 %) for non-cardiac procedures. Interventions such as
dexmedetomidine and music therapy reduced POCD incidence by up to 56.67 %
(from 27 % to 11.7 %, P < 0.05). Sleep quality was a consistent predictor
of cognitive decline, measured using the Pittsburgh Sleep Quality Index.
Heterogeneity (I2 = 83.29 %) was associated with surgical duration,
intraoperative hypotension, and baseline sleep quality <br/>Conclusion(s):
In elderly surgical patients, sleep disorders predict poorer neurological
outcomes. POCD risk may be reduced by early identification and targeted
sleep interventions. To clarify causation, further research is essential.
In this vulnerable population, integrating sleep management into
postoperative care may improve recovery.<br/>Copyright &#xa9; 2025
Elsevier B.V.

<60>
Accession Number
2042790324
Title
The TCRAT Technique (Total Coronary Revascularization via Left Anterior
Thoracotomy): Renaissance in Minimally Invasive On-Pump Multivessel
Coronary Artery Bypass Grafting?.
Source
Journal of Cardiovascular Development and Disease. 13(1) (no pagination),
2026. Article Number: 28. Date of Publication: 01 Jan 2026.
Author
Demianenko V.; Dorge H.; Sellin C.
Institution
(Demianenko, Dorge, Sellin) Department of Cardiothoracic Surgery,
Heart-Thorax Center, Klinikum Fulda, University Medicine Marburg, Campus
Fulda, Pacelliallee 4, Fulda, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Total Coronary Revascularization via left Anterior Thoracotomy (TCRAT)
represents a modern evolution of sternum-sparing, on-pump multivessel
coronary artery bypass grafting. In this review, we will summarize the
historical development, detail the surgical principles, and provide a
comprehensive overview of the clinical outcomes of TCRAT. The technique
combines cardiopulmonary bypass using peripheral arterial as well as
venous cannulation and cardioplegic cardiac arrest using transthoracic
aortic cross-clamping with surgical access through a left anterior
minithoracotomy. By applying special slinging and rotational maneuvers,
both a stable exposition of all coronary territories-in particular those
of the right and the circumflex coronary artery-and a quiet, bloodless
operating field enable complete anatomical revascularization and complex
coronary surgery procedures, including all variations in multiarterial
grafting in unselected patients. Data from all published clinical series
were integrated, and a weighted analysis of a total of 2282 patients was
performed. TCRAT proved to be very effective with regard to complete
anatomical revascularization and modern grafting strategies, and it showed
excellent perioperative safety in an all-comers population. Both the
30-day mortality and perioperative stroke incidence were distinctly below
1.0%. Data from mid-term follow-up, although rare so far, are promising
and compare well to those of the important RCTs. The TCRAT approach
eliminates sternal complications completely and accelerates recovery. As
an on-pump arrested-heart surgery, TCRAT inherently permits the
combination of minimally invasive multivessel CABG with a variety of other
cardiac operations, mainly the combination with valve procedures. The
integration of robotic and endoscopic assistance represents the next
evolutionary step. With its reproducibility and broad applicability, TCRAT
holds strong potential to become a standard routine technique in the field
of minimally invasive cardiac surgery.<br/>Copyright &#xa9; 2026 by the
authors.

<61>
Accession Number
650021935
Title
Transcatheter Aortic Valve Replacement for Mixed Aortic Valve Disease: An
Updated Meta-Analysis and Systematic Review.
Source
The American journal of the medical sciences. (no pagination), 2026. Date
of Publication: 22 Jan 2026.
Author
Kidess G.G.; Hamza M.; Basit J.; Alraiyes M.; Alraies M.C.
Institution
(Kidess) Wayne State University School of Medicine, Detroit, MI, United
States
(Hamza) Guthrie Medical Group, Cortland, NY, United States
(Basit) Rawalpindi Medical University, Rawalpindi, Pakistan
(Alraiyes) Detroit Medical Center, Wayne State University, Cardiovascular
Institute, Detroit, MI, United States
(Alraies) Detroit Medical Center, Wayne State University, Cardiovascular
Institute, Detroit, MI, United States
Abstract
BACKGROUND: Mixed aortic valve disease (MAVD) is defined by the presence
of concurrent aortic stenosis (AS) and aortic regurgitation (AR).
Transcatheter aortic valve replacement (TAVR) is effective in MAVD
patients with mortality rates comparable to pure aortic stenosis (PAS).
While most TAVR complications also occur at similar rates between the MAVD
and PAS populations, recent studies have shown conflicting results.
<br/>METHOD(S): A systematic literature review was conducted on PubMed and
Embase for studies on the outcomes of TAVR in MAVD from inception until
May 2024. Primary outcomes were short- and long-term mortality. Secondary
outcomes were paravalvular regurgitation (PVR), vascular and bleeding
complications, pacemaker implantation, and cerebrovascular complications.
A random-effects model was used to pool risk ratios (RR) and 95%
confidence intervals (CI). <br/>RESULT(S): Eleven observational studies,
including 133,558 patients, were included in the analysis. There were no
significant differences in primary endpoints (p>0.05). MAVD was associated
with a higher risk of paravalvular regurgitation (RR: 1.29, 95% CI:
1.07-1.55) and higher risk of vascular complications (RR: 1.20, 95% CI:
1.01-1.44). No significant differences were noted in other secondary
outcomes (p>0.05), although there was a nonsignificant trend towards a
decreased risk of cerebrovascular complications associated with TAVR in
MAVD patients. <br/>CONCLUSION(S): TAVR is an intervention with similar
mortality and complication risk in MAVD and PAS patients. Future research
is needed to further clarify the outcomes of TAVR in patients with MAVD,
especially regarding cerebrovascular complications, long-term mortality,
and the association of paravalvular regurgitation with
mortality.<br/>Copyright &#xa9; 2026. Published by Elsevier Inc.

<62>
Accession Number
2042789392
Title
Optimizing Temperature in Ex Situ Heart Perfusion: A Comparative Review of
Traditional and Novel Methods in Heart Transplantation.
Source
Journal of Cardiovascular Development and Disease. 13(1) (no pagination),
2026. Article Number: 25. Date of Publication: 01 Jan 2026.
Author
Georghiou P.; Georghiou G.P.; Amarelli C.; Berman M.
Institution
(Georghiou) Barts and The London School of Medicine and Dentistry, Queen
Mary University of London, Turner St, London, United Kingdom
(Georghiou) Engineering Department and INESC-TEC, University of
Tras-os-Montes e Alto Douro, Quinta de Prados, Vila Real, Portugal
(Amarelli) Department of Cardiac Surgery and Transplants, AORN dei Colli
Monaldi Hospital, Via Leonardo Bianchi, Naples, Italy
(Berman) Department of Transplantation, Royal Papworth Hospital, Papworth
Rd, Cambridge, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Heart transplantation is still the definitive therapy for end-stage heart
failure, yet the persistent shortage of suitable donor organs limits its
application. Traditionally, static cold storage (SCS) has served as an
effective standard preservation method, providing safe and adequate
protection for preservation times under four hours. Yet, the need to
extend this window and the specific metabolic requirements of donation
after circulatory death (DCD) hearts have prompted interest in machine
perfusion (MP) technologies. This literature review investigates the
influence of temperature in ex situ heart perfusion, comparing
normothermic (NMP), hypothermic (HMP), and subnormothermic (SNMP)
strategies. Evidence from experimental models and emerging clinical
studies suggests that MP can prolong preservation times, mitigate ischemic
injury, and enable real-time metabolic and viability assessment of donor
hearts prior to transplantation. These strategies represent a central
trade-off: NMP enables real-time functional assessment of the beating
heart, while HMP and SNMP approaches prioritize profound metabolic
suppression to mitigate ischemic injury. Nonetheless, current data are
limited by high costs, significant resource requirements, variability in
perfusion protocols, and the scarcity of randomized controlled trials,
particularly for HMP and SNMP. Standardization of methodologies, direct
comparative studies, and the adoption of a risk-stratified preservation
ecosystem are needed to clarify optimal temperature strategies. However,
recent clinical successes with hypothermic strategies in traditionally
normothermia-dependent donor types, such as DCD hearts, signal a potential
paradigm shift, challenging established value propositions and prompting a
critical re-evaluation of optimal preservation strategies.<br/>Copyright
&#xa9; 2026 by the authors.

<63>
Accession Number
2043087772
Title
Comments on "Dexmedetomidine administration is associated with small
haemodynamic changes in children undergoing cardiac procedures: a
systematic review and meta-analysis".
Source
Cardiology in the Young. (no pagination), 2026. Date of Publication:
2026.
Author
Sharma A.; Katkuri S.N.; Vadhithala V.; Kumar A.; Verma S.; Dedeepya D.
Institution
(Sharma) Department of Anatomy, School of Medical Sciences and Research,
Sharda University, Greater Noida, India
(Katkuri) Department of Community Medicine, Malla Reddy Institute of
Medical Sciences, Malla Reddy Vishwavidyapeeth, Telangana, Hyderabad,
India
(Vadhithala) Dr. D. Y. Patil Medical College, Dr. D. Y. Patil Vidyapeeth
(Deemed-to-be-University), Hospital and Research Centre, Maharashtra,
Pune, India
(Kumar) Faculty of Pharmaceutical Sciences, Graphic Era Hill University,
Dehradun, India
(Kumar) Centre for Promotion of Research, Graphic Era Deemed University,
Dehradun, India
(Verma) Department of Pharmaceutics, Pharmacy Institute, Noida Institute
of Engineering & Technology, Greater Noida, India
(Dedeepya) Saveetha Medical College and Hospital, Saveetha Institute of
Medical and Technical Sciences, Saveetha University, Chennai, India
Publisher
Cambridge University Press

<64>
Accession Number
2042694077
Title
Comparison of perioperative outcomes of minimally invasive and
conventional aortic root surgery in adult patients: a systematic review
and meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date
of Publication: 2026.
Author
Karadzha A.; Enginoev S.; Schaff H.V.; Suvorov A.; Mukharyaov M.; Babeshko
S.; Chekhoeva A.; Kadyraliev B.; Bogachev-Prokophiev A.
Institution
(Karadzha, Schaff) Department of Cardiovascular Surgery, 200 1st St SW,
Rochester, MN, United States
(Enginoev) Federal State Budgetary Institution <<Federal Center for
Cardiovascular Surgery>> of theMinistry of Health of the Russian
Federation, Astrakhan, Russian Federation
(Enginoev) Federal State Budgetary Educational Institution of Higher
Education "Astrakhan State Medical University" of the Ministry of Health
of the Russian Federation, Astrakhan, Russian Federation
(Suvorov) Institute of Personalized Cardiology of the Center for Digital
Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State
Medical University, Moscow, Russian Federation
(Mukharyaov) University Clinic Jena, Thuringia, Germany
(Mukharyaov) Kazan State Medical University, Kazan, Russian Federation
(Babeshko) Region Hospital #1, Krasnodar Region, Russian Federation
(Chekhoeva) Department of Cardiac Surgery, The University Hospital of
Dusseldorf, Dusseldorf, Germany
(Kadyraliev) S.G. Sukhanov Federal Center of Cardiovascular Surgery, E.A.
Vagner Perm State Medical, Perm, Russian Federation
(Bogachev-Prokophiev) Heart Valve Surgery Department, E. Meshalkin
National Medical Research Centre, Novosibirsk, Russian Federation
Publisher
Springer
Abstract
Introduction: Minimally invasive approaches have become a gold standard
for most cardiac surgery procedures, but their use in aortic root surgery
remains limited. Previous analyses suggested potential benefits of
minimally invasive aortic root surgery (MIARS) over conventional aortic
root surgery (CARS). This study aims to provide updated insights into
intraoperative and early postoperative outcomes between MIARS and CARS.
<br/>Method(s):. This systematic review and meta-analysis followed PRISMA
guidelines. Two-arm observational studies comparing MIARS and CARS were
included. The literature search was conducted using a mix of keywords and
standardized indexing terms in the eight sources up to December 16, 2024.
The risk of bias was assessed using ROBINS-I. <br/>Result(s): Twenty-one
studies comparing MIARS and CARS were included, resulting in 2908 MIARS
and 3,456 CARS patients. Minimally invasive approaches were associated
with shorter mechanical ventilation (-4.72 h; p <.001), ICU stay (-0.46
days; p <.001), hospital stay (-1.65 days; p <.001), reduced postoperative
bleeding (-0.82 units; p <.001), blood transfusion (-0.50 units; p <.001)
and atrial fibrillation rate (RR 0.73; p =.006). Safety outcomes,
including the risk of mortality, stroke, and renal failure, as well as
surgical procedure duration, reflected by aortic cross-clamp and
cardiopulmonary bypass times, were comparable between MIARS and CARS.
<br/>Conclusion(s): The use of minimally invasive approaches for aortic
root procedures may offer benefits over median sternotomy, including
shorter recovery times and reduced postoperative bleeding, without
compromising safety. However, the certainty of the available evidence
remains low.<br/>Copyright &#xa9; The Author(s), under exclusive licence
to The Japanese Association for Thoracic Surgery 2026.

<65>
Accession Number
650055599
Title
Comparing the Direct Oral Anticoagulants versus Vitamin K Antagonists in
Bioprosthetic Valves: A Systematic Review and Meta-Analysis of Randomized
Controlled Trials.
Source
Clinical and applied thrombosis/hemostasis : official journal of the
International Academy of Clinical and Applied Thrombosis/Hemostasis. 32
(pp 10760296251415375), 2026. Date of Publication: 01 Jan 2026.
Author
Waseem M.H.; Abideen Z.U.; Cheema A.H.; Farhan K.; Raja H.A.A.; Tahir
M.Z.; Saleem F.; Nadeem A.; Thada P.K.
Institution
(Waseem) Allama Iqbal Medical College, Lahore, Pakistan
(Abideen) King Edward Medical University, Lahore, Pakistan
(Cheema) University of Texas Southwestern, Dallas, TX, United States
(Farhan) Jinnah Sindh Medical University, Karachi, Pakistan
(Raja) Rawalpindi Medical University, Rawalpindi, Pakistan
(Tahir, Saleem, Nadeem) Punjab Medical College, Faisalabad, Pakistan
(Thada) Sotang Primary Hospital, Solukhumbu, Nepal
Abstract
BackgroundReplacing bioprosthetic valves is common but can cause
coagulation issues. This study assesses the safety and efficacy of Direct
oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in
bioprosthetic valve procedures.MethodsPubMed, Cochrane Central, and
ScienceDirect were searched till May 2025. The risk ratios (RRs) were
pooled with 95% confidence intervals (CIs) under the random effects model
using Review Manager software. The quality assessment was conducted using
the Cochrane risk of bias (RoB 2.0) tool.ResultsEight randomized
controlled trials involving 3863 patients were included in the
meta-analysis. DOACs were associated with a significant reduction in the
risk of stroke or systemic embolism compared with VKAs (RR = 0.48; 95%CI:
[0.26, 0.88]; p = .02). The rate of major bleeding was similar between the
DOACs and VKAs (RR = 0.92; 95%CI: [0.49, 1.72]; p = .79). There was no
significant difference in the incidence of any stroke between the two
groups (RR = 0.65; 95%CI: [0.32, 1.31]; p = .23). The occurrence of
clinically relevant non-major bleeding (RR = 1.17; 95%CI: [0.97, 1.40]; p
= .10), all-cause mortality (RR = 0.94; 95%CI: [0.75, 1.17]; p = .57), and
intracranial hemorrhage (ICH) (RR = 0.71; 95%CI: [0.40, 1.26]; p = .25)
were comparable between the groups.ConclusionDOACs seem safe after
bioprosthetic valve implantation, lowering the risk of stroke or systemic
embolism. However, rates of major bleeding, clinically relevant non-major
bleeding, any stroke, ICH, and all-cause mortality were comparable between
DOACs and VKAs.

<66>
Accession Number
2037632706
Title
The Largest Systematic Review of Left Atrial Appendage Aneurysms: A
Comprehensive Analysis of 216 Cases.
Source
Reviews in Cardiovascular Medicine. 26(12) (no pagination), 2025. Article
Number: 45129. Date of Publication: 01 Dec 2025.
Author
Mihali K.; Mausinbaev T.; Kreutz J.; Pasqualin G.; Chessa M.; Walsh K.P.;
McMahon C.J.; Bassareo P.P.
Institution
(Mihali, Mausinbaev, Kreutz) Department of Cardiology, Angiology, and
Intensive Care Medicine, University Hospital, Philipps-University of
Marburg, Marburg, Germany
(Pasqualin, Chessa) Adult Congenital Heart Disease (ACHD) Unit, IRCCS
Policlinico San Donato, San Donato Milanese, Italy
(Chessa) Department of Cardiology, Vita-Salute San Raffaele University,
Milan, Italy
(Walsh, McMahon, Bassareo) School of Medicine, University College of
Dublin, Dublin, Ireland
(Walsh, Bassareo) Department of Cardiology, Mater Misericordiae University
Hospital, Dublin, Ireland
(Walsh, McMahon, Bassareo) Department of Cardiology, Children's Health
Ireland at Crumlin, Dublin, Ireland
Publisher
IMR Press Limited
Abstract
Background: Left atrial appendage aneurysm (LAAA) is a rare cardiac
abnormality associated with thromboembolic events and arrhythmias. This
systematic review aimed to provide a comprehensive evaluation of
literature reports on the demographics, clinical presentation,
electrocardiographic and imaging findings, treatment, and outcomes of
patients with LAAA. <br/>Method(s): A literature search was conducted
using the PubMed, MEDLINE, and Scopus databases through September 2025.
Only case reports and series explicitly describing LAAA were included.
Extracted data included age, sex, clinical symptoms, electrocardiogram
(ECG) characteristics, imaging findings, associated cardiac abnormalities,
treatment modalities, and outcomes. <br/>Result(s): A total of 216 cases
were included. The mean age at diagnosis was 30.41 +/- 22.39 years, with a
slight predominance of males (50.5%). Symptoms included palpitations
(32.4%), dyspnoea (17.2%), and thromboembolic events (7.8%). Atrial
fibrillation and flutter were the most commonly detected arrhythmias.
Echocardiography was the most frequently used initial diagnostic tool,
with computed tomography (CT) and magnetic resonance imaging (MRI)
providing additional anatomical details. Chest X-rays often yielded
non-specific findings. The mean aneurysm diameter was 6.87 +/- 2.64 cm.
Surgical treatment, mainly aneurysm resection, was the most commonly used
approach (72.7%), while conservative and device-based therapies were
applied selectively. Concomitant cardiac anomalies were present in 13.7%
of cases and influenced case management. The mortality rate was 4.6%,
although significant morbidity was observed. Multivariate logistic
regression analysis revealed that atrial fibrillation/flutter was the sole
variable significantly linked with clot formation/embolism (p < 0.05).
<br/>Conclusion(s): LAAA is a rare, although clinically significant,
entity with variable presentation and management challenges. However,
early recognition and individualized treatment are essential. Further
research is needed to define standardized diagnostic criteria and
treatment guidelines.<br/>Copyright &#xa9; 2025 The Author(s).

<67>
[Use Link to view the full text]
Accession Number
2043043964
Title
Iatrogenic atrial septal defect following transcatheter edge-to-edge
mitral valve repair: A systematic review and meta-analysis.
Source
Medicine (United States). (pp 1-11), 2025. Article Number: e46486. Date
of Publication: 2025.
Author
Lei D.; Zhou C.; Zhou J.; Luo C.; Zheng B.
Institution
(Lei, Zhou) Department of Cardiac Surgery, Shaoxing People's Hospital,
Shaoxing, China
(Zhou) Department of Radiology, Shaoxing People's Hospital, Shaoxing,
China
(Luo, Zheng) Department of Cardiac Surgery, the First Affiliated Hospital
of Guangxi Medical University, Nanning, China
Publisher
Lippincott Williams and Wilkins
Abstract
Background: - Transcatheter edge-to-edge mitral valve repair (TEER)
requires transseptal access of the left atrium, which usually causes an
iatrogenic atrial septal defect (iASD). It is controversial that whether
these patients with iASD persistence will progress to a bad prognostic
state. So it's worthwhile to evaluate whether the procedure of TEER
induced iASD leads to development of a relevant interatrial shunt. This
systematic review and meta-analysis aimed to identify predictors of iASD
persistence in patients with mitral regurgitation (MR) undergoing TEER and
assess its effect on in-hospital outcomes and mortality. <br/>Method(s): -
In this systematic review and meta-analysis, we conducted a literature
search in various databases. Our investigation summarized data from
contemporary studies on the incidence of iASD following TEER for MR and
its association with clinical outcomes. <br/>Result(s): - 10 studies were
analyzed, possible predictors of risk factors for the persistence of iASD
after TEER seemed to be atrial fibrillation before surgery (OR 1.40; P =
.04), residual MR > 2⁺(OR 2.36; P = .001), residual tricuspid
regurgitation > mild(OR 1.52; P = .01), and prolonged fluoroscopic time(MD
[in minutes] 5.36; P = .007). Patients with iASD persistence after TEER
seemed to have a greater risk to suffer from right heart overload
reflecting from the enlarged right ventricle end-diastolic dimension
(RVEDD) (MD 3.27; P < .00001) and the enlarged diameter of the right
atrium (MD 4.41; P < .00001). Patients with iASD persistence after TEER
had a greater risk of heart failure rehospitalization (OR 2.71; P = .003).
<br/>Conclusion(s): - This systematic review and meta-analysis identified
several related predictors of iASD persistence, possibly leading to right
heart volume overload and a higher risk of heart failure
rehospitalization. In order to generalize our findings, larger clinical
studies in independent patient cohorts are necessary. What's more, there
is a need to perform a careful decision for interventional closure of an
iASD after TEER.<br/>Copyright &#xa9; 2025 the Author(s). Published by
Wolters Kluwer Health, Inc.

<68>
Accession Number
2043136227
Title
The Surgical Objective Structured Clinical Examination: A Literature
Review.
Source
Journal of Surgical Education. 83(4) (no pagination), 2026. Article
Number: 103856. Date of Publication: 01 Apr 2026.
Author
Charron B.P.; Norkum C.; Rasoulinejad P.; Singh S.; Beveridge T.; Morash
K.; Deweyert A.
Institution
(Charron, Rasoulinejad, Singh) Department of Orthopedic Surgery, Western
University, London, Canada
(Norkum, Beveridge, Deweyert) Department of Anatomy and Cell Biology,
Schulich School of Medicine and Dentistry, London, Canada
(Morash) Department of Orthopedic Surgery, Dalhousie University, Halifax,
Canada
Publisher
Elsevier Inc.
Abstract
Background: As competency-based medical education (CBME) gains prominence,
assessment tools that integrate both theoretical knowledge and technical
skill have become essential, particularly in surgical training.
Traditional tools such as the objective structured clinical examination
(OSCE) and the Objective Structured Assessment of Technical Skills (OSATS)
are limited in scope, prompting the development of the Surgical Objective
Structured Clinical Examination (S-OSCE). The S-OSCE integrates
knowledge-based and technical assessments to align with competency-based
medical education (CBME) goals, including those outlined in the CanMEDS
and ACGME frameworks. This review examines S-OSCE implementation and
highlights trends that can inform future assessment strategies in surgical
curricula. <br/>Method(s): A comprehensive literature search was conducted
across PubMed, Web of Science, and Scopus using defined keywords.
Inclusion criteria encompassed all surgical disciplines and study designs
that employed both theoretical and technical assessments. After screening
1101 articles, 16 studies were identified that met the inclusion criteria
for S-OSCEs. <br/>Result(s): The 16 studies spanned 6 specialties: general
surgery, orthopedics, obstetrics and gynecology, oral and maxillofacial
surgery, otolaryngology, and thoracic surgery. Most employed
multiple-choice or short-answer theoretical assessments (n=12) and
practical evaluations using OSATS or global rating scales (n=9).
Video-based assessments were increasingly incorporated to reduce evaluator
bias and logistical barriers. Canadian programs conducted the highest
proportion of studies (37.5%). <br/>Discussion(s): S-OSCEs show strong
potential to provide valid and reliable assessment of surgical competency.
However, widespread adoption is limited by logistical, financial, and
staffing constraints. Video-based formats offer a promising solution,
allowing asynchronous review and enhanced feedback while reducing costs
and time requirements. <br/>Conclusion(s): S-OSCEs offer a comprehensive
framework for evaluating surgical trainees across theoretical and
technical domains. Future research should focus on validating scalable
models, particularly those incorporating video-based assessment, to
support broader integration into surgical training programs.<br/>Copyright
&#xa9; 2026

<69>
Accession Number
2043220501
Title
The effect of postoperative back massage on pain, sleep outcomes and serum
cortisol after open-heart surgery: A randomized controlled trial.
Source
International Journal of Nursing Studies. 176 (no pagination), 2026.
Article Number: 105343. Date of Publication: 01 Apr 2026.
Author
Ozhanli Y.; Gunes A.; Akyuz N.; Uzun S.; Kurt M.; Omay O.; Sik B.Y.; Sahin
Institution
(Ozhanli, Sahin) Kocaeli University Faculty of Health Sciences, Umuttepe
Campus, Kocaeli, Izmit, Turkey
(Gunes) Istanbul Beykent University Faculty of Health Sciences, Beylikduzu
Campus, Istanbul, Beylikduzu, Turkey
(Akyuz) Istanbul University-Cerrahpasa Florence Nightingale Faculty of
Nursing, Abide-i Hurriyet Street, Istanbul, Sisli, Turkey
(Uzun, Kurt) Kocaeli University Research and Practice Hospital,
Cardiovascular Surgery Intensive Care, Umuttepe Campus, Kocaeli, Izmit,
Turkey
(Omay) Kocaeli University Faculty of Medicine, Cardiovascular Surgery
Department, Umuttepe Campus, Kocaeli, Izmit, Turkey
(Sik) Kocaeli University Faculty of Medicine, Biochemistry Department,
Umuttepe Campus, Kocaeli, Izmit, Turkey
Publisher
Elsevier Ltd
Abstract
Background: Massage is widely recognized as an effective
non-pharmacological intervention for reducing pain and anxiety after
cardiac surgery. However, its effects on sleep outcomes and biological
stress markers remain underexplored. <br/>Aim(s): To evaluate the impact
of back massage on postoperative pain, subjective and objective sleep
outcomes, and serum cortisol levels in patients undergoing open-heart
surgery. <br/>Method(s): A prospective randomized controlled trial was
conducted with 72 patients scheduled for elective open-heart surgery.
Participants were randomized (1:1) to an intervention group (back massage)
or a control group (routine care with light touch). The intervention
consisted of three standardized sessions (15-20 min each) on the first
postoperative day. Outcomes included pain (Numeric Rating Scale-Pain),
subjective sleep quality (Richard-Campbell Sleep Scale), objective sleep
duration (smartwatch measurement), and serum cortisol levels. Data were
analyzed using repeated-measures analysis of variance and Brunner-Langer
tests in a per-protocol population (n = 64). <br/>Result(s): Back massage
was associated with significantly longer total sleep duration (p = 0.037)
and greater reduction in pain scores, with significant group, time, and
group x time effects (p = 0.002, p < 0.001, p = 0.048). Cortisol levels
decreased over time in both groups (p < 0.001), but without significant
between-group differences. Subjective sleep quality improved in both
groups, and analgesic use declined, with no significant variation between
groups. No adverse events were observed. <br/>Conclusion(s): This
randomized controlled trial demonstrates that back massage is a safe and
feasible intervention after open-heart surgery, improving objectively
measured sleep duration and reducing pain. By incorporating objective
sleep measures and a biological stress marker (serum cortisol), this study
provides novel insights that extend beyond the traditionally reported
outcomes of pain and anxiety, supporting massage as a complementary
strategy within multimodal nursing care.<br/>Copyright &#xa9; 2026
Elsevier Ltd

<70>
Accession Number
2043177752
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, Vassiliou) 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
Publisher
Edizioni Minerva Medica
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. EVIDENCEACQUISITION: 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. EVIDENCESYNTHESIS: 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. (Cite
this article as: Johnson N, Anil S, Craig NJ, Shah BN, Ring L, Tsampasian
V, et al. Management of asymptomatic severe aortic stenosis: A systematic
review and meta-Analysis of randomized controlled trials. Minerva Cardiol
Angiol 2025;73:778-86. DOI: 10.23736/S2724-5683.25.06950-9)<br/>Copyright
&#xa9; 2025 EDIZIONIMINERVAMEDICA.

<71>
Accession Number
650030452
Title
Randomized, Sham-Controlled Trial of Intraoperative Ticagrelor Removal to
Reduce Perioperative Bleeding.
Source
The Journal of thoracic and cardiovascular surgery. (no pagination),
2026. Date of Publication: 23 Jan 2026.
Author
Mack M.J.; Whitlock R.; Chu M.W.A.; Taylor B.; Zias E.A.; Liu D.; Protos
A.N.; Rokkas C.; Pelletier M.; Choi D C.W.; Saha T.; Sellke F.W.;
Schneider D.J.; Thourani V.H.; Douketis J.; Mazer C.D.; Fan W.;
Deliargyris E.N.; Gibson C.M.
Institution
(Mack) Baylor Scott & White Health, Dallas, TX, United States
(Whitlock) Surgery, Population Health Research Institute, Hamilton, Canada
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, Canada
(Taylor) Division of Cardiac Surgery University of Maryland Medical
Center, Baltimore, MD, Liberia
(Zias) Department of Cardiothoracic Surgery, NYU Langone School of
Medicine, New York, NY
(Liu) Department of Cardiac Surgery, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Protos) Division of Cardiac Surgery. University of Mississippi Medical
Center, Jackson, MS, United States
(Rokkas) Division of Cardiac Surgery, University of Wisconsin, Madison,
WI, United States
(Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New
Haven, CT, United States
(Choi D) Division of Cardiothoracic Surgery, Virtua Health, Cherry Hill,
NJ, United States
(Saha) Division of Cardiac Anesthesia, Kingston General Hospital,
Kingston, Canada
(Sellke) Division of Cardiothoracic Surgery, Rhode Island Hospital,
Providence, RI, United States
(Schneider) Department of Medicine, Cardiovascular Research Institute,
University of Vermont, Burlington, VT, United States
(Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute,
Atlanta, GA, United States
(Douketis) Thrombosis and Atherosclerosis Research Institute, McMaster
University, Hamilton, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital, University of
Toronto, Toronto, Canada
(Fan, Deliargyris) CytoSorbents Corporation, Princeton, NJ, United States
(Gibson) Department of Medicine, Beth Israel Deaconess Medical Center and
Baim Institute, Boston MA, Israel
Abstract
OBJECTIVE: Patients on ticagrelor undergoing cardiac surgery before
completing guideline-recommended washout are at high risk for severe
bleeding. This study evaluated whether a novel drug removal device reduces
bleeding in patients operated within 2 days from ticagrelor
discontinuation. <br/>METHOD(S): Eligible patients were randomized 1:1 to
intraoperative DrugSorb-ATR or sham control. Primary safety endpoint was
adverse events at 30 days. Efficacy was assessed by composite endpoints
comprising bleeding events using Universal Definition of Perioperative
Bleeding (UDPB) and 24-hour chest tube drainage (CTD) in the overall and
isolated coronary artery bypass grafting (CABG) populations with a
hierarchical win ratio (WR) method. <br/>RESULT(S): 140 patients were
randomized, 132 had surgery and received a study device; 92% were isolated
CABG. Mean age was 65+/-5 years, 15% females. The primary safety endpoint
was met, with similar adverse events between groups. The primary efficacy
endpoint was not met in the overall or CABG populations (WR 1.07, 95% CI
0.72-1.58, p=0.748; WR 1.33, 95% CI 0.86-2.04, p=0.202 respectively). The
supplementary efficacy endpoint was met in the CABG population (WR 1.59,
95% CI 1.02-2.46, p=0.041) with significant reductions also shown in large
CTD bleeding events (p=0.016) and the composite of severe bleeding events
or CTD>=1L (p=0.041). The number needed to treat to prevent a severe bleed
was 6. <br/>CONCLUSION(S): Intraoperative use of DrugSorb-ATR is safe in
patients operated within 2 days of ticagrelor discontinuation. Although
the primary endpoint was not met in the overall population there were
significant reductions in severe bleeding events in the prespecified CABG
population.<br/>Copyright &#xa9; 2026. Published by Elsevier Inc.

<72>
Accession Number
650050338
Title
Renin-Angiotensin-Aldosterone System (RAAS) Antagonists in the
Perioperative Setting: An Updated Review.
Source
The American journal of medicine. (no pagination), 2026. Date of
Publication: 24 Jan 2026.
Author
Nahlawi R.; Majeed Z.; Motairek I.; Martyn T.; Alvarez P.; Jaber W.A.;
Auron M.
Institution
(Nahlawi) Case Western Reserve University School of Medicine, Cleveland,
OH, United States
(Majeed, Motairek) Department of Internal Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Martyn, Alvarez, Jaber) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Auron) Case Western Reserve University School of Medicine, Cleveland, OH;
Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH; Outcomes
Research Consortium, Houston, TX
Abstract
Renin-angiotensin-aldosterone system (RAAS) antagonists are essential in
managing heart failure, hypertension, chronic kidney disease, and
atherosclerotic cardiovascular disease. However, their perioperative use
remains controversial due to concerns about intraoperative hypotension and
vasoplegia. This review offers an updated synthesis of guideline
recommendations, mechanistic insights, and clinical trial evidence,
including POISE-3, STOP-OR-NOT, and SPACE, along with a practical
decision-making framework for internists. We examine the physiological
basis for holding or continuing RAAS antagonists amidst anesthetic
interactions, fluid shifts, and cardiovascular risks. Evidence indicates
that continuing RAAS antagonists until the day of surgery may raise the
risk of intraoperative hypotension but does not consistently worsen major
postoperative outcomes. Discontinuation might be suitable for patients
with low cardiovascular risk or those undergoing high-risk procedures. We
also discuss when and how to resume therapy, incorporate biomarkers like
NT-proBNP for risk stratification, and explore emerging approaches such as
ARNIs and pharmacogenomics. This review advocates for an individualized,
evidence-based approach to RAAS management across surgical
contexts.<br/>Copyright &#xa9; 2026 The Author(s). Published by Elsevier
Inc. All rights reserved.

<73>
Accession Number
2043206367
Title
Cerebral embolic protection devices and transcatheter aortic valve
implantation. Could stroke be avoided? A meta-analysis of 4091 patients.
Source
Journal of the Neurological Sciences. Conference: The Soul of Neurological
Innovation. Seoul South Korea. 480(Supplement) (no pagination), 2025.
Article Number: 124504. Date of Publication: 01 Dec 2025.
Author
Elkasaby M.H.; Balata M.; Gbreel M.
Institution
(Elkasaby) Faculty of Medicine, Al-Azhar University, Department of
Research, Cairo, Egypt
(Balata) University Hospital Bonn, Department of Internal Medicine and
Polyclinic II, Bonn, Germany
(Gbreel) Faculty of Medicine, October 6 University, Department of
Research, Giza, Egypt
Publisher
Elsevier B.V.
Abstract
Background and aims: Debris embolization during transcatheter aortic valve
implantation (TAVI) can result in stroke, adversely affecting patient
survival and quality of life. Cerebral embolic protection devices (CEPDs)
aim to reduce this risk, but their effectiveness remains uncertain.
<br/>Aim(s): To evaluate the impact of CEPDs on post-TAVI stroke risk from
day two onward and on neurocognitive outcomes. <br/>Method(s): A
systematic search of six databases (PubMed, Scopus, Web of Science,
Cochrane, Embase, and Ovid) was conducted up to January 20, 2023. Only
randomized controlled trials (RCTs) were included and assessed using the
Cochrane Risk of Bias tool. Risk ratios (RR) and mean differences (MD)
with 95 % confidence intervals (CI) were used based on outcome type.
<br/>Result(s): Seven RCTs involving 4091 patients met inclusion criteria.
All studies had low risk of bias. CEPDs significantly reduced the risk of
disabling stroke at 2-5 days post-TAVI (RR = 0.455, 95 % CI [0.214,
0.967], P = 0.041). No significant difference was observed at 30 days (RR
= 1.295, 95 % CI [0.373, 4.493], P = 0.684). Non-disabling stroke risk was
not significantly different at either 2-5 days (RR = 1.196, 95 % CI
[0.738, 1.938]) or 30 days (RR = 0.939, 95 % CI [0.528, 1.671]). There
were no significant differences in overall stroke, mortality, major
adverse cardiac and cerebrovascular events, acute kidney injury, or
vascular complications. No substantial heterogeneity was detected.
<br/>Conclusion(s): CEPDs may reduce early disabling stroke risk after
TAVI and appear to offer neurocognitive protection based on MoCA scores.
Further long-term studies are needed.<br/>Copyright &#xa9; 2025 Elsevier
B.V.

<74>
Accession Number
2042871188
Title
Impact of osteosarcopenia in older people on prognosis following major
surgery: a scoping review.
Source
PeerJ. 14 (no pagination), 2026. Article Number: e20527. Date of
Publication: 08 Jan 2026.
Author
Silva-Diaz Y.A.; Odar-Rojas C.; Pasten-Hidalgo W.; Gallegos-Chavez E.;
Barros-Osorio C.; Sepulveda-Loyola W.
Institution
(Silva-Diaz, Odar-Rojas) Instituto de Salud Integral Intercultural (ISI),
Facultad de Ciencias de la Salud (FACISA), Universidad Nacional Toribio
Rodriguez de Mendoza (UNTRM), Chachapoyas, Peru
(Silva-Diaz, Odar-Rojas) Grupo de Investigacion Plantas Medicinales y
Medicina Alternativa (PYMA), Centro de Investigacion Plantas Medicinales,
Terapias Alternativas y Comunidades Nativas y Rurales (CIPMAYCOM),
Instituto de Salud Integral Intercultural (ISI), Facultad de Ciencias de
la Salud (FACISA), Universidad Nacional Toribio Rodriguez de Mendoza
(UNTRM), Amazon, Peru
(Pasten-Hidalgo) Departamento de Kinesiologia, Facultad de Ciencias de la
Salud, Universidad de Atacama, Copiapo, Chile
(Gallegos-Chavez) Unidad de Cuidados Agudos, Hospital Dr. Sotero del Rio,
Programa de Especialidad de Geriatria USACH- Capredena, Santiago, Chile
(Gallegos-Chavez, Barros-Osorio, Sepulveda-Loyola) Grupo de Estudios del
Envejecimiento (GEE), Santiago, Santiago, Chile
(Barros-Osorio, Sepulveda-Loyola) Faculty of Health and Social Sciences,
Universidad de Las Americas, Region Metropolitana, Santiago, Chile
(Sepulveda-Loyola) Centro de Investigacion en Ciencias Biologicas y
Quimicas (CICBQ), Universidad de Las Americas (UDLA), Santiago, Chile
Publisher
PeerJ Inc.
Abstract
Purpose. This review aims to map the existing literature on the
prevalence, diagnostic criteria, and impact of osteosarcopenia on
postoperative clinical outcomes in older adults. Methods. The search for
this scoping review followed the PRISMA extension guidelines across five
databases (Medline, Scopus, Web of Science, Scielo, and PEDro) from their
inception until August 2025. Eligible studies included older adults with
osteosarcopenia who underwent major surgeries and reported clinical
outcomes. Additionally, data extraction covered three themes: study and
population characteristics; prevalence and impact of osteosarcopenia on
post-major surgery clinical outcomes; and diagnostic criteria for
osteosarcopenia. Results. A total of 164 studies were identified, of which
18 met the inclusion criteria, involving 3,235 participants aged between
60.7 and 83 years. The impact of osteosarcopenia varies depending on the
type of procedure: (1) in oncological surgeries, the prevalence ranged
from 12% to 44%, with reported complications including prolonged surgical
time and reduced survival; (2) in orthopedic surgeries, prevalence ranged
from 28% to 100%, with issues such as delayed recovery and increased
mortality; and (3) in cardiovascular and gastrointestinal surgeries, the
prevalence of osteosarcopenia ranged from 6.5% to 38.5%, associated with
delayed wound healing and higher infection rates. Diagnostic approaches to
osteosarcopenia showed substantial heterogeneity, most frequently relying
on skeletal muscle mass index and bone mineral density, but applying
different cutoff values. Conclusions. The prevalence of osteosarcopenia
differs across populations and surgical contexts. This syndrome represents
an important risk factor for adverse postoperative outcomes in older
adults undergoing major surgery. Furthermore, considerable variability
persists in the diagnostic criteria employed, underscoring the need for
standardized definitions to improve clinical applicability and
comparability across studies.<br/>Copyright &#xa9; (2026), (PeerJ Inc.).
All rights reserved.

<75>
Accession Number
2042788259
Title
Fast-Track Extubation After Cardiac Surgery: A Narrative Review.
Source
Journal of Cardiovascular Development and Disease. 13(1) (no pagination),
2026. Article Number: 6. Date of Publication: 01 Jan 2026.
Author
Christophides A.; DiMaria S.; Jacob S.A.; Feit A.; Oster J.; Bergese S.
Institution
(Christophides) Office of the Vice President of Medical Affairs, Northwell
Mather Hospital, Port Jefferson, NY, United States
(DiMaria, Jacob, Feit, Oster, Bergese) Department of Anesthesiology, Stony
Brook University Hospital, Stony Brook, NY, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Fast-track extubation has emerged as a vital component of Enhanced
Recovery After Surgery pathways, designed to optimize recovery and
resource utilization after cardiac surgery, contrasting with traditional
prolonged ventilation. This review explores the evidence supporting
fast-track extubation, detailing patient selection criteria based on
preoperative risk factors and functional status and outlining
perioperative management strategies. It synthesizes findings from various
studies, including randomized controlled trials, retrospective studies,
and meta-analyses, focusing on intraoperative techniques such as low-dose
opioids, neuromuscular blockade reversal, controlled cardiopulmonary
bypass duration, judicious inotrope use, and minimal transfusion,
alongside structured postoperative protocols emphasizing early sedative
weaning and spontaneous breathing trials. Results demonstrate that
fast-track extubation decreases intensive care unit stay, reduces costs
and ventilator-associated complications, with a safety comparable to
conventional care. Prolonged cardiopulmonary bypass time, dependency on
inotropes, and intraoperative blood transfusions are identified as
critical predictors of fast-track extubation failure. In conclusion, the
successful implementation of fast-track extubation protocols requires a
collaborative, multidisciplinary approach, proving essential for improving
patient outcomes, minimizing complications such as postoperative delirium,
and enhancing hospital efficiency in cardiac surgery. Further research
should aim to refine patient selection and standardize protocols across
healthcare systems.<br/>Copyright &#xa9; 2025 by the authors.

<76>
[Use Link to view the full text]
Accession Number
2042620745
Title
Short-Term Anticoagulation Versus Dual Antiplatelet Therapy for Preventing
Device Thrombosis Following Left Atrial Appendage Closure: The ANDES
Randomized Clinical Trial.
Source
Circulation. 152(25) (pp 1759-1768), 2025. Date of Publication: 23 Dec
2025.
Author
Rodes-Cabau J.; Nombela-Franco L.; Cruz-Gonzalez I.; Hibbert B.; Freixa
X.; Masson J.-B.; Ibrahim R.; Estevez-Loureiro R.; Millan X.; Kass M.;
Paradis J.-M.; Champagne J.; Salinas P.; Laffond A.; Abdel-Razek O.;
Labinaz M.; Cepas-Guillen P.; Arzamendi D.; Vidal-Cales P.; Pavesi M.;
Cote M.; O'Hara G.; Salaun E.
Institution
(Rodes-Cabau, Paradis, Champagne, Vidal-Cales, Cote, O'Hara, Salaun)
Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada
(Rodes-Cabau, Freixa, Cepas-Guillen) Clinic Barcelona, Barcelona, Spain
(J.R.-C., X.F., P.C.-G.)
(Rodes-Cabau, Pavesi) Barcelona Clinical Coordinating Center, Mon Clinic
Foundation, Barcelona, Spain
(Nombela-Franco, Salinas) Hospital Clinico San Carlos, Instituto de
Investigacion Sanitaria Hospital Clinico San Carlos, Madrid, Spain
(Cruz-Gonzalez, Laffond) Hospital Universitario de Salamanca, IBSAL, CIBER
CV, Salamanca, Spain
(Hibbert, Abdel-Razek, Labinaz) Ottawa Heart Institute, Ottawa, ON, Canada
(Masson) Centre Hospitalier Universitaire de Montreal, Montreal, QC,
Canada (J.-B.M.)
(Ibrahim) Montreal Heart Institute, Montreal, QC, Canada (R.I.)
(Estevez-Loureiro) Hospital Universitario Alvaro Cunqueiro, Vigo, Spain
(R.E.-L.)
(Millan, Arzamendi) Department of Cardiology, Hospital Universitari de la
Santa Creu i Sant Pau, IB Sant Pau, Barcelona, Spain
(Kass) Saint Boniface Hospital, Winnipeg, MB, Canada (M.K.)
(Hibbert) Department of Cardiovascular Diseases, Mayo Clinic, Rochester,
MN (B.H.)
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - The optimal antithrombotic treatment after transcatheter
left atrial appendage closure (LAAC) remains to be determined. The
objective of this trial was to compare anticoagulation and antiplatelet
therapy for preventing device-related thrombosis (DRT) after LAAC.
<br/>METHOD(S): - This was a prospective multicenter international
randomized trial comparing 2 different antithrombotic strategies for
preventing DRT after LAAC in patients with nonvalvular atrial
fibrillation. Patients were randomized (1:1) to receive direct oral
anticoagulants (DOACs) or dual antiplatelet therapy (DAPT;
aspirin+clopidogrel) for 60 days. Patients underwent transesophageal
echocardiography at 60 days, and the images were analyzed in a central
echocardiography laboratory by experienced echocardiographers blinded to
the allocated treatment. The primary outcome was DRT as determined by
transesophageal echocardiography 60 days after LAAC in patients receiving
the allocated treatment at the time of transesophageal echocardiography
(per-protocol analysis). The safety outcome included all-cause mortality,
stroke, bleeding, or site-reported DRT within 60 days after LAAC in all
randomized patients (intention-to-treat analysis). <br/>RESULT(S): - A
total of 510 patients (mean age 77+/-9 years, 35% women) were included
between October 2018 and May 2025, and 253 and 257 patients were
randomized to the DOAC and DAPT groups, respectively. Of these, 399
patients underwent transesophageal echocardiography and were receiving the
allocated treatment at 60 days after LAAC. The primary outcome occurred in
3 patients (1.5%) in the DOAC group compared with 8 patients (4.1%) in the
DAPT group (difference, -2.7% [95% CI, -6.0% to 0.6%]; P=0.110). The
safety outcome occurred in 52 patients (22.5%) in the DOAC group compared
with 82 patients (34.9%) in the DAPT group (difference, -12.4% [95% CI,
-20.6% to -4.2%]; P=0.003), and differences were mainly driven by a lower
rate of bleeding events in the DOAC group (44 patients [17.4%] versus 64
patients [24.9%]; difference, -7.5% [95% CI, -14.6% to -0.4%]; P=0.038).
<br/>CONCLUSION(S): - The use of DOACs after LAAC failed to reduce DRT
compared with DAPT, but it was associated with an improved safety profile.
The results of this study should be interpreted with caution because of
statistical power issues related to the narrower-than-expected
between-group differences and will need confirmation in future larger
studies. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique
identifier: NCT03568890.<br/>Copyright &#xa9; 2025

<77>
[Use Link to view the full text]
Accession Number
2043043604
Title
Association of Preoperative Frailty and Postoperative Outcomes in Older
Adults Undergoing Major Cardiac Procedures: A Systematic Review and
Meta-Analysis.
Source
Anesthesia and Analgesia. (pp 1-12), 2025. Date of Publication: 2025.
Author
Thangavelu V.; Bhatia O.; Hasija A.; Rajapakse N.; Yan E.; Saripella A.;
Englesakis M.; Chung F.
Institution
(Thangavelu, Bhatia, Rajapakse, Chung) Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Hasija) Michael G. DeGroote School of Medicine, McMaster University,
Hamilton, ON, Canada
(Yan, Saripella, Chung) Department of Anesthesia and Pain Management,
Toronto Western Hospital, University Health Network, University of
Toronto, Toronto, ON, Canada
(Yan) Postgraduate PhD Program, Institute of Medical Science, Temerty
Faculty of Medicine, University of Toronto, Toronto, ON, Canada
(Englesakis) Library & Information Services, Department of Anesthesia and
Pain Management, University Health Network, Toronto, ON, Canada
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - Frailty, characterized by reduced physiological resilience,
is a pivotal risk factor in older adults undergoing major cardiac
procedures. Although previous analyses have linked frailty to adverse
surgical outcomes, knowledge gaps persist due to methodological
inconsistency across frailty tools and limited synthesis of complications
such as delirium, infection, and renal dysfunction. The objective of this
systematic review and meta-analysis is to determine the prevalence of
preoperative frailty in older adults undergoing major cardiac procedures,
and assess its association with postoperative outcomes, including cardiac,
respiratory, renal, infectious, stroke, and bleeding complications,
postoperative delirium, hospital and intensive care unit (ICU) length of
stay, nonhome discharge, hospital readmission, and both 30-day and 1-year
mortality. <br/>METHOD(S): - A prespecified protocol was registered with
PROSPERO (CRD#42024574916), following Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines. MEDLINE, Embase,
and Cochrane databases were searched for English-language studies of
patients undergoing major cardiac procedures, including coronary artery
bypass grafting (CABG), aortic or mitral valve replacement or repair,
transcatheter aortic valve replacement (TAVR), or combined procedures.
Validated frailty instruments (eg, Fried Frailty Phenotype, Clinical
Frailty Scale) were required to determine preoperative frailty, along with
reporting at least 1 postoperative outcome. Noncardiac surgeries, minor
procedures, case reports, and reviews were excluded. Random-effects
meta-analyses generated odds ratio (OR) or standardized mean difference
(SMD) values with 95% confidence intervals (CI). <br/>RESULT(S): -
Nineteen studies (n = 11, 667; mean +/- SD age 71.9 +/- 8.1 years, 28%
female) met inclusion criteria, spanning North America, Europe, Asia, and
Oceania. The overall prevalence of preoperative frailty was 16.8%. Frailty
was significantly associated with delirium (OR, 4.11; 95% confidence
interval [CI], 2.00-8.45; P <.001), infection (OR, 3.72; 95% CI,
2.27-6.12; P <.001), renal complications (OR, 2.72; 95% CI, 2.05-3.60; P
<.001), and extended hospital (SMD, 0.69; 95% CI, 0.35-1.02; P <.001) and
ICU (SMD, 0.72; 95% CI, 0.51-0.94; P <.001) stays. Frailty increased the
odds of 30-day (OR, 3.58; 95% CI, 2.16-5.93; P <.001) and 1-year (OR,
2.25; 95% CI, 1.56-3.25; P <.001) mortality. <br/>CONCLUSION(S): - Frailty
affects nearly 1 in 5 older adults requiring major cardiac procedures.
Frailty was significantly associated with adverse postoperative outcomes,
including delirium, infections, renal complications, extended length of
stay, and mortality. As frailty is potentially modifiable, targeted
strategies-such as prehabilitation, nutritional optimization, and enhanced
perioperative monitoring-may improve outcomes. Incorporating routine
frailty screening into standard preoperative practice allows for earlier
identification of high-risk patients, efficient resource allocation, and
perioperative care planning.<br/>Copyright &#xa9; 2025 International
Anesthesia Research Society

<78>
Accession Number
2042825773
Title
Sex Disparities in Infective Endocarditis Presentation, Management and
Outcomes: A Systematic Review and Meta-Analysis.
Source
Diagnostics. 16(2) (no pagination), 2026. Article Number: 260. Date of
Publication: 01 Jan 2026.
Author
Jacobs H.; Arjomandi Rad A.; Izzat A.W.; Guida G.A.; Al-Zubaidi F.I.;
Verdichizzo D.; Abu Reish I.; Sayeed R.; Kourliouros A.
Institution
(Jacobs, Izzat, Guida) Department of Cardiothoracic Surgery, Bristol Heart
Institute, University Hospitals Bristol and Weston NHS Trust, Bristol,
United Kingdom
(Arjomandi Rad, Al-Zubaidi, Verdichizzo, Abu Reish, Sayeed, Kourliouros)
Department of Cardiothoracic Surgery, Oxford Heart Centre, Oxford
University Hospitals NHS Foundation Trust, Oxford, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Sex-based disparities in the presentation, management, and
outcomes of infective endocarditis (IE) remain insufficiently
characterized despite their growing recognition. This study systematically
evaluates current evidence on sex differences in the presentation,
treatment, and outcomes of IE. <br/>Method(s): A systematic review and
meta-analysis were conducted according to PRISMA and Cochrane guidelines.
EMBASE, MEDLINE, PubMed, the Cochrane Library, and Google Scholar were
searched up to October 2024. Twenty-four studies including 139,952
patients (79,698 men and 60,254 women) were analyzed. Primary outcomes
were mortality (in-hospital, 30-day, and 1-year), stroke, and treatment
modality (medical vs. surgical). Secondary outcomes included
complications, procedural characteristics, and hospital course.
<br/>Result(s): Men were younger at diagnosis and had higher rates of
substance abuse and coronary artery disease, while women more often had
hypertension, diabetes, chronic lung disease, and prior valvular
pathology. Men more frequently had aortic and prosthetic valve IE, whereas
women had mitral and tricuspid involvement. Men were about 65% more likely
to undergo surgery for infective endocarditis than women, while women were
predominantly managed medically. Men had lower in-hospital (OR 0.81, 95%
CI 0.72-0.92) and 1-year mortality (OR 0.76, 95% CI 0.61-0.94), though
30-day mortality did not differ significantly. Women experienced shorter
hospital stays but longer ICU admissions and more heart failure, whereas
men had more recurrent IE. <br/>Conclusion(s): Men underwent surgery more
often and had better short- and long-term survival. Women presented later,
with greater comorbidity and higher complication rates. Enhanced
recognition of sex-specific risk and equitable surgical referral may
improve IE outcomes.<br/>Copyright &#xa9; 2026 by the authors.

<79>
Accession Number
2042845288
Title
Wide variability in studies reporting on digital education interventions
for patients undergoing cardiac procedures: A patient-commissioned mixed
methods systematic review.
Source
Heart and Lung. 78 (no pagination), 2026. Article Number: 102702. Date of
Publication: 01 Jul 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, Keeping, Hariharan, Johnson, Curran) 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) School of Nursing, Dalhousie University, 5869 University
Avenue, P.O. Box 15000, Halifax, NS, Canada
(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) School of Communication Sciences and Disorders, Dalhousie
University, 5869 University Avenue, P.O. Box 15000, Halifax, NS, Canada
Publisher
Elsevier Inc.
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/>Copyright &#xa9; 2025

<80>
Accession Number
2042637595
Title
Subxiphoid Incisional Hernia Following Cardiac Procedures: A Narrative
Review.
Source
Journal of Abdominal Wall Surgery. 4 (no pagination), 2026. Article
Number: 15219. Date of Publication: 2026.
Author
Symeonidou E.; Gkoutziotis I.; Dinas S.; Totsi A.; Liaretidou E.; Damaskos
D.
Institution
(Symeonidou, Gkoutziotis, Totsi) School of Medicine, Aristotle University
of Thessaloniki, Thessaloniki, Greece
(Symeonidou) Department of General Surgery, Princess Royal University
Hospital, King's College Hospital, London, United Kingdom
(Gkoutziotis) 5th Department of Surgery, Ippokratio General Hospital,
Aristotle University of Thessaloniki, Thessaloniki, Greece
(Dinas, Totsi) Department of Surgery, Papageorgiou General Hospital,
Thessaloniki, Greece
(Liaretidou) 1st Department of Cardiac Surgery, Onassis Cardiac Surgery
Center, Athens, Greece
(Damaskos) Department of General Surgery, Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom
Publisher
Frontiers Media SA
Abstract
Introduction: Subxiphoid hernias are indeed an uncommon type of hernia
that tend to present in the caudal aspect of a sternotomy incision, which
typically enters the epigastrium. These patients have usually undergone
major cardiac surgeries, like heart transplant, coronary artery bypass
grafting (CABG), or cardiac valve replacement, representing a high-risk
group of patients. The purpose of the study is to identify risk factors,
prevention measures, and to explore different techniques for surgical
management, including whether minimal invasive surgery is superior than
the conventional open approach. <br/>Material(s) and Method(s): A
comprehensive search was performed on Pubmed, Sciencedirect, Scopus, and
Cochrane library. The search terms included "subxiphoid hernia" and "post
sternotomy hernia." Articles not in the English literature and duplicates
studies were excluded. Studies regarding epigastric hernias were also
excluded. All relevant articles published until 28th of February 2025 were
included. Relevant references from the identified articles were also
searched and included for review. <br/>Result(s): Particular care should
be given to recognizing patient-related risk factors, preventing surgical
site infections, and ensuring proper closure of the fascia. Regarding
surgical management, seventeen articles were identified with 442 patients
overall. 320 patients underwent open repair, while in 122 patients
laparoscopic approach was achieved. Intraperitoneal onlay mesh placement
was the most popular laparoscopic technique applied. Only 3 studies
provided comparable results between the two approaches. A significant
variety of techniques concerning both approaches was noticed in the
literature. <br/>Conclusion(s): Excellent knowledge of the anatomical and
physiological aspects of the subxiphoid region, and acknowledgement of
risk factors, are essential. Minimal invasive repair of subxiphoid hernias
is a feasible option, as long as defect closure and adequate mesh overlap
are achieved. There are not enough data still to prove the superiority of
the laparoscopic approach. Complex cases should be referred to experienced
hernia surgeons.<br/>Copyright &#xa9; 2026 Symeonidou, Gkoutziotis, Dinas,
Totsi, Liaretidou and Damaskos.

<81>
Accession Number
2043195580
Title
Minimally invasive versus conventional mitral valve surgery: a systematic
review and meta-analysis of randomised clinical trials.
Source
Open Heart. 13(1) (no pagination), 2026. Article Number: e003612. Date of
Publication: 27 Jan 2026.
Author
Spadini F.A.; Lira K.B.; Delvaux R.S.; Kopittke L.; Anschau F.; Ceron
R.O.; Rode J.; Rey R.A.W.; Almeida A.S.
Institution
(Spadini, Lira, Kopittke, Anschau, Almeida) Department of Education and
Research, Postgraduate Program in Technology Assessment for the Brazilian
National Health System, Conceicao Hospital Group, Porto Alegre, Brazil
(Spadini, Lira, Delvaux, Rode, Almeida) Department of Cardiovascular
Surgery, Postgraduate Program in Cardiovascular Surgery, Nossa Senhora da
Conceicao Hospital, Porto Alegre, Brazil
(Kopittke, Anschau, Almeida) Center for Health Technology Assessment,
Conceicao Hospital Group, Porto Alegre, Brazil
(Ceron, Rode, Rey, Almeida) Department of Cardiovascular Surgery, Nossa
Senhora da Conceicao Hospital, Porto Alegre, Brazil
Publisher
BMJ Publishing Group
Abstract
Background The benefits of minimally invasive mitral valve surgery (MIMVS)
compared with conventional approaches (CMVS, conventional mitral valve
surgery) remain controversial. We conducted a systematic review and
meta-analysis to evaluate the short-term benefits between these
approaches. Objective To evaluate the short-term benefits of MIMVS versus
CMVS in adults. Methods We searched PubMed/MEDLINE, EMBASE, Cochrane
Library, LILACS, SciELO, clinical trial registries and grey literature
using MeSH terms, without date or language restrictions. Randomised
clinical trials (RCTs) comparing MIMVS and CMVS in adults (>=18 years)
were included. Robotic, endovascular and redo procedures were excluded.
Two reviewers independently extracted data following Preferred Reporting
Items for Systematic reviews and Meta-Analyses guidelines. Risk of bias
was assessed with the Cochrane tool, and certainty of evidence with
Grading of Recommendations, Assessment, Development and Evaluation.
Meta-analyses used random-effects models. Primary outcomes were mortality,
acute kidney injury (AKI) and wound infection. Results Nine studies (1248
patients) from eight RCTs were included (686 CMVS, 562 MIMVS). MIMVS
showed no significant difference in mortality or AKI compared with CMVS.
There was a trend towards fewer wound infections (risk ratio=0.47;
95%CI=0.22 to 1.00) and shorter intensive care unit (ICU) stay (mean
difference=-0.71days; 95%CI=-1.47 to 0.04). MIMVS reduced reoperation for
bleeding (RR=0.24; 95%CI=0.06 to 0.92) and hospital stay (mean
difference=-1.83days; 95%CI=-3.03 to -0.64). Operative times were longer
with MIMVS, but without clinical impact. Stroke, myocardial infarction,
mechanical ventilation time and transfusion rates were similar. Most
studies had low risk of bias, with moderate to high certainty of evidence.
No heterogeneity was detected for primary outcomes. Conclusion MIMVS
enhances postoperative recovery through shorter hospital stays, fewer
reoperations for bleeding and a trend towards fewer wound infections and
shorter ICU stays compared with CMVS. Despite longer operative times, key
safety is comparable between techniques. The overall certainty of evidence
is high for most outcomes, supporting strong clinical recommendations in
favour of MIMVS. PROSPERO registration number
CRD42022321939.<br/>Copyright &#xa9; Author(s) (or their employer(s))
2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights
and permissions. Published by BMJ Group.

<82>
Accession Number
2042788245
Title
Bioresorbable Scaffolds for Coronary Revascularization: From Concept to
Clinical Maturity.
Source
Journal of Cardiovascular Development and Disease. 13(1) (no pagination),
2026. Article Number: 2. Date of Publication: 01 Jan 2026.
Author
Bourazana A.; Briasoulis A.; Kourek C.; Kuno T.; Leventis I.; Pantsios C.;
Androutsopoulou V.; Spiliopoulos K.; Giamouzis G.; Skoularigis J.;
Xanthopoulos A.
Institution
(Bourazana) Department of Cardiology, General Hospital of Larissa,
Larissa, Greece
(Briasoulis) Department of Cardiovascular Medicine, Section of Heart
Failure and Transplantation, University of Iowa, Iowa City, IA, United
States
(Kourek) Department of Cardiology, 417 Army Share Fund Hospital of Athens
(NIMTS), Athens, Greece
(Kuno) Division of Cardiology, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Leventis, Pantsios, Giamouzis, Skoularigis, Xanthopoulos) Department of
Cardiology, University Hospital of Larissa, Faculty of Medicine, School of
Health Sciences, University of Thessaly, Larissa, Greece
(Androutsopoulou, Spiliopoulos) Department of Cardiac Surgery, University
Hospital of Larissa, University of Thessaly, Larissa, Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Over the past decades, coronary revascularization has evolved dramatically
with the introduction of bioresorbable scaffolds (BRSs), designed to
provide temporary vessel support, elute antiproliferative drugs, and then
fully resorb, ideally restoring natural vasomotion and eliminating
long-term foreign-body reactions. Early enthusiasm for first-generation
polymeric devices, such as the Absorb bioresorbable vascular scaffold, was
tempered by increased rates of scaffold thrombosis and late adverse
events, largely attributed to thick struts, suboptimal implantation
techniques, and unpredictable degradation kinetics. Subsequent
developments in polymeric (e.g., MeRes-100, NeoVas) and metallic
magnesium-based scaffolds (e.g., Magmaris) have focused on thinner struts,
improved radial strength, and refined resorption profiles. Clinical trials
and meta-analyses, including ABSORB, AIDA, BIOSOLVE, and BIOSTEMI, reveal
that optimized procedural strategies, especially the "PSP" approach
(Prepare-Size-Post-dilate) and routine intravascular imaging,
substantially reduce thrombosis and restenosis rates, aligning outcomes
closer to those of contemporary drug-eluting stents (DESs). Nonetheless,
challenges persist regarding inflammatory responses to degradation
by-products, mechanical fragility in complex lesions, and patient
selection. Ongoing innovations include hybrid polymer-metal designs,
stimuli-responsive drug coatings, and AI-assisted imaging for precision
implantation. While early-generation BRSs demonstrated both promise and
pitfalls, next-generation platforms show steady progress toward achieving
the dual goals of transient scaffolding and long-term vessel restoration.
The current trajectory suggests that bioresorbable technology, supported
by optimized technique and material science, may soon fulfill its original
vision; offering safe, effective, and fully resorbable alternatives to
permanent metallic stents in coronary artery disease. This review provides
an updated synthesis of the design principles, clinical outcomes, and
procedural considerations of drug-eluting bioresorbable scaffolds (BRSs).
It integrates recent meta-analytic evidence and emerging insights on
device mechanics, including the influence of strut thickness on radial
strength and the potential role of non-invasive imaging in
pre-implantation planning. Special focus is given to magnesium-based
scaffolds and future directions in patient selection and implantation
strategy.<br/>Copyright &#xa9; 2025 by the authors.

<83>
Accession Number
2043152206
Title
Factors influencing the decision to accept or decline aortic valve
replacement for asymptomatic aortic stenosis: a nested longitudinal
qualitative substudy of the EASY-AS randomised trial.
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e106485. Date of
Publication: 22 Jan 2026.
Author
Allmark P.; Taylor B.; Tod A.M.; Ryan T.; Dweck M.; McCann G.P.; Singh A.
Institution
(Allmark, Taylor, Tod, Ryan) School of Allied Health Professions,
Pharmacy, Nursing and Midwifery, University of Sheffield, Sheffield,
United Kingdom
(Dweck) British Heart Foundation Centre of Research Excellence, Edinburgh
Heart Centre, Royal Infirmary of Edinburgh, University of Edinburgh,
Edinburgh, United Kingdom
(McCann, Singh) Department of Cardiovascular Sciences, University of
Leicester, Leicester National Institute for Health and Care Research
Biomedical Research Centre, Leicester British Heart Foundation Centre of
Research Excellence, Leicester, United Kingdom
Publisher
BMJ Publishing Group
Abstract
Objective To examine how patients and family members decide whether to
accept a highly invasive intervention (aortic valve replacement (AVR))
when their condition (aortic stenosis (AS)) is asymptomatic and its course
uncertain. Design Nested, longitudinal, qualitative substudy of an ongoing
randomised controlled trial (RCT) (NCT04204915) testing early intervention
(EI) versus watchful waiting (WW) in patients with asymptomatic severe AS.
Setting Six select UK sites of the RCT. Participants Select participants
of the RCT, their next-of-kin and some who declined RCT participation.
Results 73 interviews were conducted, with 41 participants. Few knew much
about AS before diagnosis. Uncertainty and the need for reliable
information regarding symptoms and progress was a significant problem.
While some expressed unease at a major intervention for an asymptomatic
condition, there were no outright objections to the idea. Those who
declined participation in the RCT did so for personal reasons, for
example, their home circumstances did not permit the required period of
recovery or they felt too old to risk intervention. Reasons for accepting
early intervention included the belief that the condition was serious and
likely to deteriorate, and so better to have the intervention before such
deterioration, as well as avoiding long waiting lists. Trusting
clinicians' judgement played a part in some decisions. Patients also
wanted choice in the type of intervention received. The longitudinal
interviews (n=32) showed satisfaction in the early intervention group
despite some problems in the the early recovery phase, especially for
those undergoing surgical AVR. Conclusions Where evidence supports major
intervention for an asymptomatic condition, patients are likely to accept
the offer, although personal circumstances play an important role in
decision-making. Where a condition is not well known to the public, such
as AS, patients rely on clinicians and other resources to help decide.
Liaison with patient groups in developing shared decision-making resources
may help with complex decisions.<br/>Copyright &#xa9; Author(s) (or their
employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.

<84>
Accession Number
2042684174
Title
Effects of rhomboid intercostal and sub-serratus plane block on
perioperative analgesic efficacy and diaphragm excursion in video-assisted
thoracic surgery: a prospective, randomized controlled trial.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 50. Date
of Publication: 01 Dec 2026.
Author
Zhao S.-F.; Chang Q.-Y.; Zheng Y.-R.; Qiu L.; Shen J.
Institution
(Zhao, Chang, Zheng, Qiu, Shen) Department of Anesthesiology, The Third
Affiliated Hospital of Soochow University, Jiangsu, Changzhou, China
(Chang, Zheng, Qiu, Shen) Department of Anesthesiology, Changzhou First
People's Hospital, Jiangsu, Changzhou, China
(Zhao) Department of Anesthesiology, Changzhou Fourth People's Hospital,
Jiangsu, Changzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Rhomboid intercostal and sub-serratus plane (RISS) block is a
novel nerve block technique that provides good analgesia, but overall
research is scarce. This study aimed to investigate the effect of
ultrasound-guided RISS block on postoperative analgesia and diaphragmatic
excursion (DE) after video-assisted thoracic surgery (VATS) for lung
cancer. <br/>Method(s): One hundred patients who underwent VATS lung
resection participated in this study and were randomized to a RISS group
(Group R) or a control group (Group C). Group R underwent
ultrasound-guided RISS block with 0.25% ropivacaine hydrochloride 0.5
ml/kg immediately after surgery. Group C was given standard general
anaesthesia, and patient-controlled intravenous analgesia (PCIA) was used
in the postoperative period in both groups. The visual analogue scores
(VAS) at rest and during movement at 2 hours(h), 24 h, and 48 h
postoperatively were used as the primary outcome measures. Secondary
outcomes included postoperative consumption of sufentanil; preoperative
and postoperative left and right-sided DE during calm and deep breathing,
and the occurrence of adverse effects such as postoperative nausea and
vomiting (PONV), dizziness, somnolence, puncture site infection, and
hematoma. <br/>Result(s): At 2 h, 24 h, and 48 h postoperatively, patients
in Group R had lower VAS scores at rest (median [Q1, Q3]: 1.00 [1.00,
1.00]; 1.00 [1.00, 1.00]; 0.00 [0.00, 1.00]) and during movement (2.00
[2.00, 3.00]; 2.00 [2.00, 2.00]; 2.00 [1.00, 2.00]) than those in Group C
(resting: 2.00 [2.00, 2.00]; 2.00 [2.00, 2.00]; 1.00 [1.00, 2.00];
movement: 3.00 [3.00, 4.00]; 3.00 [3.00, 4.00]; 3.00 [2.00, 4.00]) (all P
< 0.0001). Sufentanil consumption at 2 h, 24 h, and 48 h postoperatively
was also significantly lower in Group R (P = 0.0002, P < 0.0001, P <
0.0001). Preoperatively, no significant difference in DE existed between
the groups (P > 0.05). At 30 min post-extubation and 2 h and 24 h
postoperatively, during both calm and deep breathing on both sides, Group
R had significantly greater DE than Group C (P < 0.05). At 48 h
postoperatively, the right-sided DE during calm breathing showed no
significant difference between the groups. PONV incidences did not differ
significantly (P = 0.2662), and Group R had less dizziness, somnolence,
higher satisfaction post-surgery, and showed no cases of puncture site
infection or hematoma. <br/>Conclusion(s): Ultrasound-guided RISS block
can modestly reduce postoperative pain in patients undergoing VATS, with
clinically relevant benefits, and may help alleviate diaphragmatic
dysfunction caused by surgical or anesthetic factors. Trial registration:
The trial was registered at the China Clinical Trial Registry
(http://www.chictr.org.cn, ChiCTR2300070842) on 24/04/2023.<br/>Copyright
&#xa9; The Author(s) 2025.

<85>
Accession Number
2042644338
Title
Comparison of liposomal bupivacaine and bupivacaine hydrochloride
intercostal nerve blocks for postoperative analgesia after thoracic
surgery: a multicenter, randomized, three arms trial protocol.
Source
Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2612384.
Date of Publication: 2026.
Author
Huang J.; Wang L.; Wei S.; Xin Y.; Chang R.; Liu H.; Yang Y.; Song J.; Lv
X.
Institution
(Huang, Wang, Wei, Xin, Liu, Yang, Song, Lv) Department of Anesthesiology,
Shanghai Pulmonary Hospital, School of Medicine, Tongji University,
Shanghai, China
(Chang) Department of Medicine, Shanghai Pulmonary Hospital, School of
Medicine, Tongji University, China
(Wei) Outcomes Research Consortium, Houston, TX, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Whether intercostal nerve block can fully realize the
prolonged analgesic potential of liposomal bupivacaine remains uncertain.
This study aims to evaluate whether liposomal bupivacaine administered via
intercostal nerve block confers a long-acting analgesic advantage over
bupivacaine hydrochloride and no block within the postoperative 25-72 h
window. <br/>Patients and Methods: This is a multicenter, randomized,
parallel, three-arm controlled trial planning to enroll 210 patients
undergoing elective unilateral video-assisted thoracoscopic surgery. Using
center-stratified block randomization (1:1:1), patients will be allocated
at the end of surgery to receive an intercostal nerve block with liposomal
bupivacaine, bupivacaine hydrochloride, or no block. All patients will
follow a standardized general anesthesia and multimodal analgesia
protocol. The primary outcome is the area under the curve for pain scores
during the postoperative 25-72 h. Other outcomes include pain verbal
response scale at predefined time points, cumulative postoperative
morphine milligram equivalent consumption, sensory block recovery time,
15-item quality of recovery scale, postoperative nausea and vomiting,
postoperative pulmonary complications, length of hospital stay.
<br/>Discussion(s): This study prospectively evaluates the central
question of whether liposomal bupivacaine confers a clinically meaningful
long-acting analgesic advantage when used in the context of nerve block.
By focusing on the area under the curve of pain scores and incorporating
patient-centered outcomes such as opioid consumption and quality of
recovery, the study aims to generate high-quality, translatable evidence
to define the role of liposomal bupivacaine in thoracic surgery. Clinical
trial registration: Clinicaltrials.org, NCT07134660.<br/>Copyright &#xa9;
2026 The Author(s). Published by Informa UK Limited, trading as Taylor &
Francis Group.

<86>
Accession Number
2042664963
Title
The effectiveness and safety of oral anticoagulation therapy in patients
undergoing transcatheter aortic valve replacement: a systematic
review/meta-analysis.
Source
European Journal of Clinical Pharmacology. 82(2) (no pagination), 2026.
Article Number: 60. Date of Publication: 01 Feb 2026.
Author
Zhou Q.; Liu X.; Liu S.; Yang X.; Wu Y.; Tao Y.; Wei M.
Institution
(Zhou, Wu, Tao, Wei) Department of Clinical Pharmacy, Jinling Hospital,
Medical School of Nanjing University, Nanjing, China
(Liu) Faculty of Chinese Medicine, Jiangsu College of nursing, Huaian,
China
(Liu) Department of Cardiology, Jinling Hospital, Medical School of
Nanjing University, Nanjing, China
(Yang) Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated
Hospital of Nanjing University Medical School, Nanjing, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Patients undergoing transcatheter aortic valve replacement
(TAVR) often require anticoagulation therapy due to various comorbidities.
However, the decision to continue anticoagulation therapy during the TAVR
perioperative period and the optimal regimen for postoperative
anticoagulation therapy remain debatable. <br/>Method(s): We searched the
PubMed, EMBASE, MEDLINE, and Cochrane Library databases from their date of
establishment to September 2024. We evaluated the choice of
anticoagulation regimen in the TAVR perioperative and postoperative
period. The primary outcomes were stroke, major bleeding, all-cause death,
and net adverse clinical events (NACEs). The secondary outcomes were any
bleeding, life-threatening bleeding, thrombotic events, and cardiovascular
death. We conducted a meta-analysis with a RR and 95% CI. We performed
subgroup analyses based on the follow-up duration, study design, and
whether oral antiplatelet drugs (OAP) were used. <br/>Result(s): We
compared four studies with peri-procedural continuation or discontinuation
of oral anticoagulants (OACs). We did not observe a difference between the
two groups with major bleeding, stroke, all-cause death, and NACEs (P >
0.05). Seventeen studies compared the effects of direct oral
anticoagulants (DOACs) and vitamin K antagonists (VKAs) after TAVR. The
risk of NACEs (RR: 0.84, 95% CI :0.71-0.99, P = 0.04) and cardiovascular
death (RR: 0.78, 95% CI: 0.69-0.87, P < 0.0001) was significantly lower in
the DOACs than in the VKAs, but there were no statistically significant
differences between the two groups with other outcomes. In the subgroup
analysis, the beneficial effects of DOACs on NACEs were observed in the
early postoperative (P < 0.05). During the long-term follow-up time after
TAVR, DOACs had a lower risk of all-cause mortality and cardiovascular
death compared to VKAs (P < 0.05), but an increased risk of any bleeding
(P < 0.05). In RCTs, the risk of any bleeding owing to DOACs was higher (P
< 0.05). In cohort studies, DOACs led to lower NACEs and cardiovascular
death (P < 0.05). When administered in combination with OAP drugs, DOACs
posed a lower risk for cardiovascular death and all-cause death than VKAs
(P < 0.05). If not administered in combination with OAP drugs, DOACs posed
a lower risk for all-cause death (P < 0.05). <br/>Conclusion(s): In
patients undergoing TAVR with established indications for OACs,
periprocedural continuation of OACs may offer comparable clinical outcomes
to temporary discontinuation. Furthermore, DOACs after TAVR appear to be
associated with more favorable clinical outcomes than VKAs, although this
benefit must be weighed against a potentially increased risk of bleeding.
Further large-scale RCTs are warranted to validate these
findings.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer-Verlag GmbH Germany, part of Springer Nature 2026.

<87>
Accession Number
650018704
Title
Middle Meningeal Artery Embolisation in An Elderly Patient with Chronic
Subdural Haemorrhage and Embolic Stroke Secondary to Atrial Fibrillation.
Source
International Journal of Stroke. Conference: 19th UK Stroke Forum
Conference. Liverpool United Kingdom. 19(3 Supplement) (pp 9), 2024. Date
of Publication: 01 Dec 2024.
Author
Maero M.; Maguire F.; Byrne M.; Borg D.; Nicholson P.; Fearon P.
Institution
(Maero, Maguire, Byrne, Borg, Nicholson, Fearon) Beaumont Hospital,
Dublin, Ireland
Publisher
SAGE Publications Inc.
Abstract
Background and aims: Chronic subdural haematoma (cSDH) can be a
significant contraindication to anticoagulation and is more common in
older patients, who are also more likely to have co-morbidities including
atrial fibrillation (AF). Recent RCT evidence suggests that middle
meningeal artery (MMA) embolisation can significantly decrease the risk of
recurrent subdural bleeding, enabling anticoagulation for conditions like
AF. However, the treatment is not yet widely available. <br/>Method(s): We
describe a case of successful MMA embolisation in an elderly gentleman
with cSDH and embolic ischaemic stroke secondary to AF. <br/>Result(s): An
88 year old male, with known history of AF, hypertension and ischaemic
heart disease presented with a right hemianopia and corresponding subacute
left PCA infarct. Four months prior he had presented with SDH requiring
cessation of Apixaban and had further acute SDH whilst off all
antithrombotic. He had been deemed unsuitable for left atrial appendage
occlusion due to the short-term requirement for dual antiplatelet post
procedure. Successful MMA embolisation was performed as an inpatient. He
was commenced on Aspirin initially due to haemorrhagic transformation of
infarction. An early repeat CT brain at one month showed a slight
reduction in the size of the left SDH and no further acute bleeding. He
has since been restarted on Apixaban without complication.
<br/>Conclusion(s): MMA embolisation is a significant treatment advance
for elderly patients with cSDH to lower bleeding risk and enable treatment
with anticoagulation for AF to reduce risk of disabling stroke.
Neurointerventionalists should.

<88>
Accession Number
2042689151
Title
Right Ventricular Function After Mitral Valve Surgery: Insights From the
United Kingdom Mini Mitral Study.
Source
Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Bayliss C.; Wagnild J.; Maier R.; Ogundimu E.; Graham R.; Zacharias J.;
Deshpande R.; Akowuah E.
Institution
(Bayliss, Graham, Akowuah) Department of Cardiac Surgery, The James Cook
University Hospital, South Tees Hospitals NHS Foundation Trust,
Middlesbrough, United Kingdom
(Wagnild) Department of Anthropology, Durham University, Durham, United
Kingdom
(Maier, Akowuah) 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) The Lancashire Cardiac Centre, Blackpool Teaching Hospitals
NHS Foundation Trust, Blackpool, United Kingdom
(Deshpande) The Cardiac Care Group, King's College Hospital, London,
United Kingdom
(Akowuah) Translational and Clinical Research Institute, Newcastle
University, Newcastle upon Tyne, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background Right ventricular (RV) function is frequently reduced after
cardiac surgery, with persistent impairment associated with increased
mortality. This study aimed to compare RV function after mitral valve
repair through right minithoracotomy vs sternotomy. Methods In the UK Mini
Mitral trial, patients were randomized to mitral valve repair through
right minithoracotomy (small lateral pericardial incision) or sternotomy.
Prespecified secondary outcomes included assessment of cardiac function by
blinded echocardiography preoperatively and at early (12 weeks) and late
(52 weeks) time points. RV function was assessed by tricuspid annular
plane systolic excursion (TAPSE). RV to pulmonary artery coupling was
determined by the TAPSE to systolic pulmonary artery pressure ratio.
Results 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, -7.52 mm [95% CI, -8.52 to -6.53; P < .001], vs
sternotomy, -8.75 mm [95% CI, -9.80 to -7.71; P < .001]), which recovered,
but not to preoperative levels, by 52 weeks. The degree of RV impairment
was significantly less in the minithoracotomy group at both early
(between-group difference in TAPSE at 12 weeks, 1.47 mm [95% CI,
0.37-2.56; P = .009]) and late time points (between-group difference in
TAPSE at 52 weeks, 1.37 mm [95% CI, 0.29-2.45; P = .013]). Conclusions
Despite longer cross-clamp and bypass times, mitral valve repair through
minithoracotomy was superior to sternotomy at preserving RV function
(measured by TAPSE) at 12 weeks and 1 year.<br/>Copyright &#xa9; 2026 The
Society of Thoracic Surgeons.

<89>
Accession Number
2037632697
Title
Meta-Analysis of Durable Compared to Temporary Left Ventricular Assist
Devices Compared to Venoarterial Extracorporeal Membrane Oxygenation for
Bridging to Heart Transplantation or Treatment of Primary Graft
Dysfunction.
Source
Reviews in Cardiovascular Medicine. 26(12) (no pagination), 2025. Article
Number: 45064. Date of Publication: 01 Dec 2025.
Author
Saemann L.; Maier S.; Kohl M.; Simm A.; Szabo G.
Institution
(Saemann, Simm, Szabo) Department of Cardiac Surgery, University Hospital
Halle, Halle (Saale), Germany
(Maier) Department of Cardiac Surgery, University Hospital Freiburg,
Faculty of Medicine, University of Freiburg, Freiburg, Germany
(Kohl) Faculty III: Health, Medical Life Sciences, Furtwangen University
of Applied Sciences, Villingen-Schwenningen, Germany
(Szabo) Department of Cardiac Surgery, University Hospital Heidelberg,
Heidelberg, Germany
Publisher
IMR Press Limited
Abstract
Background: Patients bridged to heart transplantation (HTx) and patients
with primary graft dysfunction (PGD) after HTx are typically treated with
circulatory support. However, the survival of patients in both indications
might depend on the type of circulatory support. Thus, this meta-analysis
aimed to investigate the survival of HTx patients supported during
bridging with a durable left ventricular assist device (d-LVAD), a
temporary LVAD (t-LVAD), or venoarterial extracorporeal membrane
oxygenation (VA-ECMO). We also investigated the survival rate of patients
with PGD by type of circulatory support device. <br/>Method(s): We
performed a random-effects meta-analysis. <br/>Result(s): We included four
studies evaluating bridging to HTx (n=1678 patients) and three studies for
the PGD analysis (n=35 patients). The 1-year survival after HTx was
significantly higher in patients bridged with a t-LVAD (92.7%; 95%
confidence interval (CI): 89.2 to 95.6%; p=0.027) and with a d-LVAD
(86.8%; 95% CI: 75.8 to 94.8%; p=0.001) compared to VA-ECMO (71.6%; 95%
CI: 63.7 to 78.9%). The 30-day survival in patients with PGD and t-LVAD
was 100% (95% CI: 59.2-100%), while with PGD and VA-ECMO, survival was
92.4% (95% CI: 66 to 100%). <br/>Conclusion(s): Both d-LVAD and t-LVAD
bridging methods appear to have comparable 1-year survival rates, which
are higher than those after VA-ECMO bridging. Nonetheless, more
prospective clinical studies are needed to investigate outcomes after
using circulatory support devices for PGD after HTx. The PROSPERO
registration: CRD420251149065,
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251149065.<br/>Copyright
&#xa9; 2025 The Author(s).

<90>
Accession Number
2043181628
Title
The effects of a nurse-led smartphone-based intervention after coronary
artery bypass grafting: A randomised controlled trial.
Source
International Journal of Nursing Studies. 176 (no pagination), 2026.
Article Number: 105341. Date of Publication: 01 Apr 2026.
Author
Mahmoodi M.; Antikchi M.; Saeidinasab S.; Bakhshi F.
Institution
(Mahmoodi) Intensive Care Nursing, Department of Nursing, School of
Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran, Islamic Republic of
(Antikchi, Bakhshi) Research Center for Nursing and Midwifery Care,
Comprehensive Research Institute for Maternal and Child Health, Department
of Nursing, School of Nursing and Midwifery, Shahid Sadoughi University of
Medical Sciences, Yazd, Iran, Islamic Republic of
(Saeidinasab) Department of Nursing, School of Nursing and Midwifery,
Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic
Republic of
Publisher
Elsevier Ltd
Abstract
Background: Patients after coronary artery bypass grafting often face
suboptimal recovery, including pain, reduced quality of life, and
haemodynamic instability, worsened by limited self-care knowledge and
inadequate post-discharge support. Nurse-led smartphone-based
interventions may offer a scalable solution for resource-limited settings.
<br/>Objective(s): To evaluate the effects of a nurse-led,
smartphone-based educational and follow-up intervention on pain, quality
of life, and haemodynamic stability in patients undergoing elective
coronary artery bypass grafting. <br/>Design(s): Single-blind, randomized
controlled trial. <br/>Setting(s): A tertiary cardiac surgery center in
Shiraz, Iran, from July 2024 to April 2025. <br/>Participant(s):
Eighty-four adults undergoing elective coronary artery bypass grafting,
randomized (1:1) to intervention or control groups, with 80 completing the
study (40 per group). <br/>Method(s): The intervention group received a
three-phase programme: (1) pre-operative education via videos, messages,
and a face-to-face session; (2) in-hospital education and daily symptom
monitoring for pain and self-care; (3) 30-day post-discharge follow-up
with weekly nurse-led calls and real-time messaging. Controls received
standard care with one handout. Outcomes included pain (visual analog
scale), quality of life (SF-36 Health Survey), and hemodynamic indices
(blood pressure, heart rate). Pain and haemodynamic indices were assessed
at baseline, three times daily for four days in the general ward following
post-intensive care unit discharge (12 time points), and weekly
post-discharge (days 7, 14, 21, 30; 4 time points), totaling 17
assessments. Quality of life was assessed at baseline and 30 days
post-discharge. Data were analyzed using Mann-Whitney U tests, t-tests,
and repeated-measures analysis of variance. <br/>Result(s): The
intervention group had lower pain scores (in-hospital: 3.96 +/- 0.42 vs.
4.29 +/- 0.35, p < 0.001, d = - 0.85, 95% CI -0.50 to - 0.16;
post-discharge: 1.45 +/- 0.38 vs. 2.01 +/- 0.50, p < 0.001, d = - 1.26,
95% CI -0.76 to - 0.36) and reduced post-discharge blood pressure and
heart rate. Total quality of life scores showed no significant
between-group differences at 30 days (adjusted ANCOVA: adjusted mean
difference = 0.15, 95% CI - 1.27 to 1.57, p = 0.832), while the pain
domain improved significantly in the intervention group (p = 0.002, r = -
0.35). Group-by-time interactions were significant for pain and
haemodynamic outcomes (p < 0.05). <br/>Conclusion(s): This nurse-led,
smartphone-based intervention reduced pain, improved pain-related quality
of life, and stabilized haemodynamic parameters post-coronary artery
bypass grafting. Easily integrated into nursing practice, it supports
recovery in resource-limited settings and merits further study.
Registration: Registered at the Iranian Registry of Clinical Trials,
IRCT20240426061574N1, registered June 05, 2024,
https://irct.behdasht.gov.ir/search/result?query=IRCT20240426061574N1.
Social media abstract: Nurse-led smartphone intervention reduces pain and
stabilizes haemodynamics in post-coronary artery bypass grafting patients
over 30 days.<br/>Copyright &#xa9; 2026 Elsevier Ltd

<91>
Accession Number
650011012
Title
Anticipating stroke in patients undergoing transcatheter aortic valve
replacement.
Source
Expert review of medical devices. (no pagination), 2026. Date of
Publication: 22 Jan 2026.
Author
Hajj J.; Zalaquett Z.; Harb S.; Kapadia S.
Institution
(Hajj, Zalaquett, Harb, Kapadia) Department of Cardiovascular Medicine,
Heart, Vascular, Thoracic Institute, Cleveland Clinic, Cleveland, OH,
United States
Abstract
INTRODUCTION: Transcatheter aortic valve replacement (TAVR) has
transformed treatment of severe aortic stenosis, offering a less invasive
alternative to surgery. Despite advances, stroke remains a serious
complication, impacting morbidity, mortality, and long-term cognitive
function, thus the need for effective prevention strategies. AREAS
COVERED: Based on a targeted review of the PubMed literature, this review
addresses mechanisms and risk factors for stroke after TAVR and evaluates
current preventive approaches. Cerebral embolic protection devices
(CEPDs), particularly the Sentinel system, are discussed alongside other
devices. Antithrombotic strategies before, during, and after TAVR are also
reviewed, emphasizing the balance between thromboembolic protection and
bleeding risk in an elderly population. EXPERT OPINION: While some studies
suggest CEPDs may reduce stroke, randomized trials have not confirmed
broad and robust benefit, and high cost limits routine adoption. Future
work should focus on high-risk subgroups, device refinement, and
large-scale trials. For now, individualized antithrombotic therapy and
selective CEPD use remain central to stroke prevention in TAVR.

<92>
[Use Link to view the full text]
Accession Number
650012962
Title
The Effect of Reflexology on Anxiety in Patients Undergoing Open Heart
Surgery: Systematic Review and Meta-Analysis of Randomized Controlled
Trials.
Source
The journal of nursing research : JNR. (no pagination), 2026. Date of
Publication: 26 Jan 2026.
Author
Dagcan Sahin N.; Gorucu S.
Institution
(Dagcan Sahin) Nursing Department, Faculty of Health Sciences, Kutahya
Health Sciences University, Kutahya, Turkey
(Gorucu) Nursing Department, Faculty of Health Science, Akdeniz University
Kumluca, Antalya, Turkey
Abstract
BACKGROUND: Open-heart surgery is effective but may involve significant
postoperative complications and long recovery times that can be
exacerbated by patient anxiety. Nonpharmacological approaches such as
reflexology have gained attention in the field of medicine for their
ability to alleviate anxiety without significant side effects. PURPOSE:
This systematic review and meta-analysis were designed to determine the
effect of reflexology on anxiety in patients undergoing open-heart
surgery. <br/>METHOD(S): The PubMed, EBSCO (including MEDLINE and CINAHL),
OVID, Web of Science, and Cochrane databases were searched from May 15 to
July 15, 2024. Randomized controlled trials that evaluated patients who
had open-heart surgery were included in the analysis. Studies were
appraised using the Critical Appraisal Checklists for Randomized
Controlled Trials developed by the Joanna Briggs Institute (JBI). The
meta-analysis was conducted using the Comprehensive Meta-Analysis Version
2, and heterogeneity between studies was assessed using the chi2 test and
I2 statistic. The results were reported in line with the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses statement.
<br/>RESULT(S): Eight studies encompassing 485 patients were included in
the meta-analysis. All of the included studies used common measurement
times for anxiety and compared intervention groups with either standard
care or a placebo. In the meta-analysis performed using a random-effects
model, reflexology was found to significantly reduce anxiety (g=-1.49, 95%
confidence interval (CI)=[-2.35, -0.63], with a statistically significant
difference observed between the intervention and control groups (z=-3.41,
p=.001). However, the findings of the meta-analysis should be interpreted
with caution. <br/>CONCLUSION(S): Reflexology may be effective in reducing
anxiety in patients undergoing open-heart surgery. However, the
significant heterogeneity identified among the included studies indicates
variability among study conditions. Therefore, their outcomes should be
evaluated carefully. Reflexology may be used as an adjunct to standard
patient care. Additional studies with more homogeneous methodologies are
required to strengthen the evidence base for the efficacy of reflexology
in reducing anxiety in this vulnerable patient population.<br/>Copyright
&#xa9; 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on
behalf of the Taiwan Nurses Association.

<93>
Accession Number
2042751913
Title
Inclisiran in Dyslipidemia with High Residual Platelet Reactivity.
Source
Diseases. 14(1) (no pagination), 2026. Article Number: 30. Date of
Publication: 01 Jan 2026.
Author
Kapsultanova D.; Zhangelova S.; Nurmukhammad F.; Makasheva Z.; Sakhov O.;
Galkina T.; Rustamova F.; Akhmentayeva D.; Aubakirova B.
Institution
(Kapsultanova, Zhangelova, Sakhov, Rustamova, Akhmentayeva) Faculty of
Postgraduate Education, Asfendiyarov Kazakh National Medical University,
Almaty, Kazakhstan
(Nurmukhammad) Faculty of Postgraduate Medical Education, Hodja Ahmed
Yasawi International Kazakh-Turkish University, Turkestan, Kazakhstan
(Makasheva, Sakhov, Aubakirova) Department of Cardiology, City Cardiology
Center, Almaty, Kazakhstan
(Galkina) Department of Cardiology, Medical Center <<AMAST>>, Astana,
Kazakhstan
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: High residual platelet reactivity (HRPR) and persistent
dyslipidemia remain important unmet needs in cardiovascular risk
management, particularly in patients undergoing coronary
revascularization. Despite intensive lipid-lowering and antiplatelet
therapy, a substantial proportion of patients fail to reach recommended
low-density lipoprotein cholesterol (LDL-C) targets or exhibit inadequate
platelet inhibition. Inclisiran, a PCSK9-targeting small interfering RNA,
represents an emerging approach for long-term LDL-C reduction.
<br/>Method(s): A narrative review of the literature published between
2009 and 2025 was performed using PubMed, Scopus, Web of Science, and
MEDLINE. Studies evaluating the addition of inclisiran to standard
lipid-lowering therapy in patients with dyslipidemia and HRPR, assessed
using the VerifyNow assay, were included. Illustrative clinical cases from
Kazakhstan were analyzed to demonstrate real-world changes in LDL-C levels
and platelet reactivity following insufficient response to conventional
treatment. The review had a descriptive design. <br/>Result(s): Available
evidence indicates that a significant proportion of high- and
very-high-risk patients do not achieve LDL-C targets or are unable to
tolerate high-intensity statin therapy. Inclisiran consistently induces
sustained reductions in LDL-C and circulating PCSK9 levels. Emerging data
suggest a potential indirect modulation of platelet reactivity associated
with intensive lipid lowering. In patients at extreme cardiovascular
risk-including those after coronary artery bypass grafting (CABG) and with
long-standing multivessel coronary artery disease-inclisiran therapy was
associated with marked LDL-C reduction and a trend toward normalization of
platelet reactivity. <br/>Conclusion(s): Assessment of platelet function
using the VerifyNow assay may improve identification of residual
thrombotic risk in patients with advanced atherosclerotic disease.
Inclisiran appears to be a promising adjunctive therapy for dyslipidemic
patients with persistently elevated cardiovascular risk and HRPR despite
standard treatment. Further prospective studies are warranted to clarify
the relationship between intensive LDL-C lowering, platelet reactivity,
and clinical outcomes, and to optimize integrated lipid-lowering and
antiplatelet strategies.<br/>Copyright &#xa9; 2026 by the authors.

<94>
Accession Number
2037623505
Title
Efficacy and Safety of Transcatheter Mitral Valve Repair (MitraClip)
Compared to Medical Therapy and Surgery in Patients With Secondary Mitral
Regurgitation: A Systematic Review & Pairwise Meta-analysis.
Source
Journal of the Saudi Heart Association. 37(4) (no pagination), 2025.
Article Number: 52. Date of Publication: 2025.
Author
Younas S.; Rana A.; Beig M.F.A.; Sahu S.; Emanemua C.E.; Reshie A.A.;
Kaukab L.; Duggineni D.; Gokavarapu S.K.S.S.P.A.; Bhavani P.; Khan A.;
Fattal P.G.
Institution
(Younas) Department of Pharmacy, Punjab University College of Pharmacy,
Lahore, Pakistan
(Rana) Department of Internal Medicine, Armed Forces Medical College,
Pune, India
(Beig) Department of Internal Medicine, Community Based Medical College,
Bangladesh
(Sahu) Department of Internal Medicine, JJM Medical College, Devangere,
India
(Emanemua) Department of Internal Medicine, College of Medicine,
University of Benin, Edo State, Nigeria
(Reshie) Department of Internal Medicine, Government Medical College,
Srinagar, India
(Kaukab) Department of Internal Medicine, Deccan College of Medical
Sciences, India
(Duggineni) Department of Internal Medicine, Siddhartha Medical College,
India
(Gokavarapu) Department of Internal Medicine, Kamineni Academy of Medical
Sciences and Research Center, India
(Bhavani) Department of Internal Medicine, Atlantic University School of
Medicine, Saint Lucia
(Khan) Department of Cardiology, Central Michigan University, 1000
Houghton Avenue, Saginaw, MI, United States
(Fattal) Department of Cardiology, University of Michigan Health, 1015 S.
Washington, Saginaw, MI, United States
Publisher
Saudi Heart Association
Abstract
Background: Secondary mitral regurgitation (SMR) worsens outcomes in heart
failure. Transcatheter mitral valve repair (MitraClip/TMVr) is an
established alternative for patients who remain symptomatic on
guideline-directed medical therapy (GDMT), but comparative efficacy versus
GDMT and surgery has been debated. <br/>Method(s): We searched MEDLINE,
Embase, and Cochrane through February 2025. To avoid double counting,
quantitative syntheses used unique randomized controlled trials (RCTs)
only; RCT substudies informed qualitative context. Pairwise random-effects
meta-analyses compared MitraClip + GDMT vs GDMT and MitraClip vs surgery.
Primary outcomes were all-cause mortality and heart-failure
hospitalization (HFH). Secondary outcomes included quality of life (Kansas
City Cardiomyopathy Questionnaire (KCCQ), MR <= 2+, stroke/MI, and major
adverse events (MAE). Heterogeneity was explored with
I²/tau², leave-one-out, and prespecified sensitivity
analyses per Cochrane/JBI guidance. <br/>Result(s): Nineteen studies were
included, of which 5 unique Randomized Control Trials (RCTs) (n=1912
randomized) contributed to pooling. Versus GDMT, MitraClip reduced
mortality (RR 0.77, 95 % CI 0.63-0.95; I²=73 %) and (Heart
Failure Hospitalization) HFH (RR 0.76, 0.65-0.89; I²=90 %), and
improved KCCQ (MD +13.7 points, 6.6-20.7). Including all available
comparators across RCTs, mortality remained lower with MitraClip (RR 0.80,
0.65-1.00; p=0.047; I²=26 %). Versus surgery, MitraClip had
fewer 30-day MAE (Major Adverse events) (RR 0.29, 0.21-0.40;
I²=0 %), with no difference in 1-year mortality and similar MR
<= 2+ at ~1 year. Stroke/MI were comparable. Procedural success exceeded
96 %; partial clip detachment occurred in 1-2 %. <br/>Conclusion(s): In
contemporary RCTs, MitraClip on top of GDMT lowers mortality and HF
hospitalizations and improves quality of life in SMR. Compared with
surgery, TMVr offers a superior early safety profile with similar MR
reduction at ~1 year. These results support Heart-Team use of MitraClip
after optimized GDMT in anatomically suitable SMR, while reserving surgery
for selected scenarios.<br/>Copyright &#xa9; 2025 Saudi Heart Association.

<95>
Accession Number
649988873
Title
Cost-effectiveness of perioperative amino acid therapy as renal
protection.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Carrandi A.; Fagery M.; Losiggio R.; Pruna A.; Landoni G.; Bellomo R.;
Higgins A.
Institution
(Carrandi, Fagery, Bellomo, Higgins) Monash University, Australian and New
Zealand Intensive Care Research Centre, Melbourne, Australia
(Losiggio, Pruna, Landoni) IRCCS San Raffaele Scientific Institute,
Department of Anesthesia and Intensive Care, Milan, Italy
Publisher
BioMed Central Ltd
Abstract
Introduction: Acute kidney injury (AKI) frequently occurs after cardiac
surgery, and is independently linked to increased morbidity and mortality
[1,2]. A recent meta-Analysis found that intravenous amino acids (AA)
likely reduces the incidence of AKI in surgical patients [3], but their
cost-effectiveness remains unknown. We conducted an economic evaluation to
evaluate the cost-effectiveness of AA therapy versus placebo (as a proxy
for standard of care) among adult patients undergoing surgery.
<br/>Method(s): We conducted a cost-effectiveness analysis using a
decision analytical model to simulate and compare outcomes from a
healthcare payer perspective using an in-hospital time horizon. We used
costs and outcomes from the published literature to calculate the cost per
case of AKI avoided. The patient trajectory included intensive care unit
(ICU) stay (including renal replacement therapy), hospital ward stay, and
discharge or death. Costs did not include the surgical procedure cost. In
addition to length of stay, resource use included units of blood
transfused. Model parameters were extracted from the literature, and unit
costs were identified for Australia, China, Italy, United Kingdom, and the
United States (US). Costs were inflated using a GDP index and converted to
US Dollars 2022 using OECD power purchasing parity values [4].
Bootstrapping with repeated random sampling was used to establish the
expected total costs and 95% confidence intervals. <br/>Result(s): The use
of amino acids resulted in lower costs and fewer cases of AKI, resulting
in a dominant incremental cost-effectiveness ratio (Table) in all
countries compared to placebo. Length of ICU and ward stay and units of
FFP and RBCs had the greatest impact on the probability of
cost-effectiveness. <br/>Conclusion(s): Amino acids are cost-saving and
cost-effective regarding the avoidance of AKI cases among adult
perioperative patients.

<96>
Accession Number
649988585
Title
Close-loop control provides more protective modes and optimization of
diaphragm function than conventional weaning from MV in cardiac surgery
patients with BMI > 35 kg/m2.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Komnov R.; Eremenko A.; Alferova A.; Urbanov A.; Klyuzova P.; Gerasimenko
S.; Goncharova A.; Titov P.; Vasilyeva O.; Sorokina L.
Institution
(Komnov, Eremenko, Alferova, Urbanov, Klyuzova, Gerasimenko, Titov,
Vasilyeva, Sorokina) Petrovsky National Research Centre of Surgery,
Post-Cardiac Surgery Intensive Care Unit, Moscow, Russian Federation
(Goncharova) Petrovsky National Research Centre of Surgery, Laboratory,
Moscow, Russian Federation
Publisher
BioMed Central Ltd
Abstract
Introduction: The main goal of ventilation management is to discontinue
invasive ventilation as soon as possible, without delaying it too early or
too late, until the patient is ready. <br/>Method(s): In this randomized
controlled trial (NCT04973917) 32 adult cardio surgical patients with BMI
> 35 kg/m2 were included. In the postoperative period 16 of them were
ventilated using the INTELLiVENT-ASVR mode and then weaned with "Quick
Wean" option. Another 16 were ventilated using conventional ventilation
modes and weaned using Pressure Support Ventilation (PSV). Hamilton G5
ventilators were used. Care in both groups was standardized, except
management of mechanical ventilation. The primary goal of this part of the
study was to understand could we optimize diaphragmatic function by using
intellectual modes by considering airway occlusion pressure (P0.1), PS
level; Rapid Shallow Breathing Index (RSBI). <br/>Result(s): We have
obtained significant differences in the P0.1 level between groups (1.7
(1.4-2.3) (Intellivent ASVR) vs 1.5 (1-1.6) (PSV), p-0.03). Also PS (6
(5-6) vs 9 (8-9), p-0.0001) and PEEP (7 (7-8) vs 10 (8-10), p-0.0006)
level was significantly lower in the Intellivent group. The RSBI was lower
in the PSV group (34 (31-44) vs 28 (24-30), p = 0.04), but we connect it
with higher tidal volume level in the PSV group (8 (7.5-9) vs 10 (9-10), p
= 0.0004). There were no significant differences in the SpO<inf>2</inf>
and PaO<inf>2</inf>/ FiO<inf>2</inf> ratio, PaCO2 during weaning process
and after extubation of the trachea in the groups. In addition, there were
no significant differences in the number of cases of atelectasis,
diaphragm dysfunction, and the use of non-invasive ventilation (NIV)
between the groups (Table). <br/>Conclusion(s): Using intellectual modes
during the weaning process in patients with BMI > 35 kg/m2 allows for the
selection of the optimization pressure support and PEEP level, as well as
optimization of the diaphragm function. The evaluation of the potential
benefits of using based on ASV modes to optimize diaphragm function
requires further investigation.

<97>
Accession Number
2043062914
Title
A 2025 Update on Mitral Valve Disease-Focusing on Mitral Stenosis:
Quantification, Clinical Management, and Guideline Review.
Source
Annals of Clinical Cardiology. 7(2) (pp 64-79), 2025. Date of Publication:
01 Jul 2025.
Author
Alrashid E.A.; Alshammari M.G.; Aldalmani M.A.; Al Jarallah M.; Alansari
Y.E.; Dashti R.; Al Mulla K.; Al Roomi F.A.S.; Rajan R.
Institution
(Alrashid, Alshammari, Aldalmani) Department of Medicine, Faculty of
Medicine, Kuwait University, Kuwait
(Al Jarallah, Alansari, Dashti, Al Mulla, Al Roomi, Rajan) Department of
Cardiology, Sabah Al Ahmed Cardiac Centre, Al Amiri Hospital, Kuwait City,
Kuwait
Publisher
Wolters Kluwer Medknow Publications
Abstract
A comparison of the recommendations for the diagnosis and management of
mitral stenosis (MS), the major cause of valvular heart disease globally,
from the European Society of Cardiology/European Association to the
American College of Cardiology/American Heart Association 2020 guidelines.
We systematically reviewed and contrasted the guidelines on the diagnosis
and management of MS to appraise clinical judgment. A multimodel approach
includes transesophageal echocardiogram (TEE), transthoracic
echocardiogram (TTE), cardiac catheterization, exercise testing, and
transcatheter mitral valve repair or replacement/transcatheter mitral
valve implantation. Both guidelines agreed on medical therapy, which is
anticoagulation, which has been shown to reduce the thromboembolic events
in rheumatic MS. On the other hand, there was a subtle difference between
both guidelines in staging the severity of MS. In addition, there was a
disagreement regarding whether to perform a regular follow-up or to
perform surgery.<br/>Copyright &#xa9; 2026 Annals of Clinical Cardiology.

<98>
Accession Number
649988797
Title
Use of Acumen system with HPI for the prediction of hypotension in TAVI
patients: A randomized controlled clinical trial on 40 patients.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Rama J.; Russo A.; Alberini M.; Bergamini E.V.; Tomasella I.; Ceola
Graziadei M.; Zanin A.; Gottin L.
Institution
(Rama, Russo, Alberini, Bergamini, Tomasella, Ceola Graziadei, Zanin,
Gottin) AOUI Verona, Ospedale Civile Maggiore Borgo Trento,
Anesthesiology, Verona, Italy
Publisher
BioMed Central Ltd
Abstract
Introduction: The development of new technological tools, able to predict
the onset of an hypotensive event like hypotension prediction index (HPI),
seems to appear an attractive instrument for the management of hemodynamic
changes also in the field of catheter laboratory and, in particular, of
transcatheter aortic valve implantation (TAVI). The aim of the study is to
evaluate, through a non invasive hemodynamic monitoring system, the
efficacy of HPI as a tool to reduce intraoperative hypotension (IOH),
adverse events and 30-day complications in patients undergone TF TAVI
procedure. <br/>Method(s): Using the Acumen non invasive hemodynamic
monitoring system (Edwards Lifesciences, Irvine, CA), patients have been
divided into 2 groups: A control group in which the HPI algorithm has not
been applied; an intervention group with HPI application for the
management of hypotension. At the end of every single case, data have been
collected and stored in the Acumen analytics software. In the following 30
days we have evaluated the onset of complications: delirium, AKI, stroke,
new onset arrhythmias, myocardial infarction, heart failure, surgical and
valvular complications and all-cause mortality. <br/>Result(s): The total
mean MAP under 65 mmHg measured was higher in the intervention group and
the number of patients who have developed hypotensive events was lower in
this subgroup compared to the control one, although the total number of
IOH events was higher in intervention group. SVRI were statistically
higher in the study group (4350(813) vs 3290(910), p = 0.001), meanwhile
CI was lower in this subgroup (2.08 vs 1.74, p = 0.02). AKI was
statistically lower in the intervention group (p = 0.02), on the other
hand delirium was seen with lower prevalence in the control one (p =
0.04). <br/>Conclusion(s): The study has given us some encouraging
results, explaining the potential usefulness of predictive algorithms in
improving intraoperative hemodynamic management and reducing post
operatory complications such as AKI.

<99>
Accession Number
2042635250
Title
Effects of remote ischaemic preconditioning against acute kidney injury in
cardiac surgery patients: a randomized controlled trial.
Source
Perioperative Medicine. 15(1) (no pagination), 2026. Article Number: 9.
Date of Publication: 01 Dec 2026.
Author
Wang H.; Liao Q.; Huang Y.; Miao P.; Guo K.
Institution
(Wang, Liao, Huang, Miao, Guo) Department of Anesthesiology, Zhongshan
Hospital, Fudan University, Shanghai, China
(Wang, Liao, Guo) Shanghai Key Laboratory of Perioperative Stress and
Protection, Shanghai, China
(Guo) ShanghaiChina
Publisher
BioMed Central Ltd
Abstract
Background: Acute kidney injury (AKI) is a well-known, serious
complication of cardiac surgery that is associated with increased
morbidity and mortality. However, the effects of remote ischaemic
preconditioning (RIPC) on AKI after cardiac surgery have shown
inconsistent results. This study was conducted to evaluate the effects of
RIPC on AKI in patients undergoing cardiac surgery with cardiopulmonary
bypass (CPB). <br/>Method(s): In this single-centre, prospective,
randomized, double-blind, controlled trial, 240 patients undergoing
elective cardiac surgery were assessed for eligibility. 180 patients were
randomly assigned to either RIPC group or control (Con) group. Finally,
159 patients (79 to Con group and 80 to RIPC group) completed follow-up.
RIPC was performed on an upper limb with repeated 5-min inflation and
5-min deflation for three times. The primary outcome was the proportion of
AKI 48 h after surgery. Secondary outcomes included major clinical
short-term outcomes and the incidences of postoperative complications,
clinical diagnostic indicators serum creatinine (SCr), urinary novel
biomarkers IGFBP7 and TIMP-2. <br/>Result(s): The proportion of AKI in
RIPC group was significantly lower than Con group (Con versus RIPC: 26.6%
vs. 13.8%; P = 0.044). In addition, RIPC resulted in a smaller increase in
SCr levels 24 h (Con versus RIPC: 96.6 +/- 35.9 micromol/L vs. 86.2 +/-
24.9 micromol/L; P = 0.035) and 48 h (Con versus RIPC: 93.6 +/- 45.2
micromol/L vs. 75.8 +/- 30.8 micromol/L; P = 0.004) postoperatively. The
postoperative concentrations of urinary biomarkers such as IGFBP7 and
IGFBP7xTIMP-2 were lower in the RIPC group than in the Con group (P =
0.045 and 0.009, respectively). There were no significant differences in
short-term outcomes and postoperative complications. <br/>Conclusion(s):
In this trial, RIPC reduced the proportion of AKI and the amplitude of SCr
elevation 48 h postoperatively. RIPC may exert a certain renal protective
effect by enhancing renal recovery in the early postoperative stage. Trial
registration: ClinicalTrials.gov identifier: NCT04433468.<br/>Copyright
&#xa9; The Author(s) 2025.

<100>
Accession Number
649988552
Title
Preoperative carbohydrate loading reduces length of hospital stay compared
to fasting in patients undergoing major elective, non-cardiac surgery: A
systematic review and meta-Analysis.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Turan C.; Sebestyen A.R.; Szemere A.; Virag M.; Engh M.A.; Dembrovszky F.;
Ocskay K.; Szabo L.; Hegyi P.; Molnar Z.
Institution
(Turan, Molnar) Semmelweis University, Department of Anesthesiology and
Intensive Therapy, Budapest, Hungary
(Sebestyen, Szemere, Virag, Engh, Dembrovszky, Ocskay, Szabo, Hegyi)
Semmelweis University, Centre for Translational Medicine, Budapest,
Hungary
Publisher
BioMed Central Ltd
Abstract
Introduction: Although preoperative fasting is routinely scheduled before
elective non-cardiac surgeries with the goal of preventing
anesthesia-related complications, Enhanced Recovery After Surgery (ERAS)
Guidelines recommend preoperative carbohydrate loading to facilitate early
recovery and readiness to discharge, albeit with low level of evidence. We
investigated whether preoperative fasting reduces the length of hospital
stay. <br/>Method(s): We conducted a systematic search on the 15th of
October, 2021, in five databases (PubMed via Medline, Embase, Cochrane
Central, Web of Science, Scopus). We included only randomized controlled
trials (RCT) that compared preoperative carbohydrate loading (CHO) to
either fasting or placebo in elective non-cardiac surgeries. The main
outcome was the length of hospital stay. Risk of bias and level of
evidence certainty were assessed using RoB2 and GRADE assessment
respectively. A random-effects model was used in meta-Analysis, and
results were visualized in forest plots along with 95% confidence
intervals. <br/>Result(s): Systematic search and selection identified 55
RCTs. Preoperative carbohydrate loading was significantly effective in
reducing the length of hospital stay when compared to preoperative fasting
(mean difference:-1.71 days [95% CI:-3.04,-0.38]) (Figure). However,
meta-Analysis of RCTs comparing CHO to any kind of placebo did not show
this effect (mean difference:-0.01 days [95% CI:-0.16, 0.16]). The main
outcome had a low risk of bias, and moderate level of certainty.
<br/>Conclusion(s): This study shows that preoperative carbohydrate
loading significantly reduces length of hospital stay for patients
undergoing elective non-cardiac surgeries. CHO may have wide implications,
especially in cases where early achievement of recovery and readiness to
discharge are critical for improved hospital resource management.

<101>
[Use Link to view the full text]
Accession Number
2042450226
Title
Comparative effects of flow- versus volume-controlled one-lung ventilation
on gas exchange and respiratory system mechanics in thoracic surgery.
Source
European Journal of Anaesthesiology. Publish Ahead of Print (no
pagination), 2025. Date of Publication: 21 Nov 2025.
Author
Wittenstein J.; Kramer T.; Mutschke A.-K.; Huhle R.; Piorko S.; Dorfinger
L.; Tempel F.; Schweigert M.; Mauer R.; Koch T.; Schultz M.; Richter T.;
Krassler J.; Scharffenberg M.; Gama de Abreu M.
Institution
(Wittenstein, Kramer, Mutschke, Huhle, Piorko, Dorfinger, Tempel,
Schweigert, Koch, Richter) Pulmonary Engineering Group Dresden, Department
of Anaesthesiology and Intensive Care Medicine, TUD Dresden University of
Technology, Dresden, Germany
(Scharffenberg) The Department of Thoracic Surgery, University Hospital
Schleswig-Holstein, Luebeck, Germany
(Mauer) The Faculty of Medicine Carl Gustav Carus, Institute for Medical
Informatics and Biometry, Technische Universitat, Dresden, Germany
(Schultz) The Department of Intensive Care, Amsterdam UMC Location AMC,
1105 AZ Amsterdam, Netherlands
(Krassler) The Department of Anesthesiology, Thoracic Center Coswig,
Cowsig, Germany
(Gama de Abreu) The Division of Intensive Care and Resuscitation,
Department of Anesthesiology, Integrated Healthcare Institute, Cleveland
Clinic, Cleveland, OH, United States
(Gama de Abreu) The Outcomes Research Consortium, Department of
Anesthesiology, Integrated Healthcare Institute, Cleveland Clinic,
Cleveland, OH, United States
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND - The effect of flow-controlled ventilation (FCV) as compared
with volume-controlled ventilation (VCV) on oxygenation and respiratory
system mechanics in patients undergoing one-lung ventilation (OLV) is
unknown. OBJECTIVE - To test the hypothesis that FCV would improve
oxygenation and respiratory system mechanics compared with VCV during OLV.
DESIGN - Two-centre, two-arm, randomised controlled clinical trial SETTING
- University hospital and speciality hospital for pulmonary diseases in
Germany. PATIENTS - A total of 78 thoracic surgery patients undergoing OLV
for more than 30 min. INTERVENTIONS - Patients were randomly assigned to
OLV with FCV (n = 39), or VCV (n = 39). In both groups, OLV was conducted
with tidal volume of 5 ml kg-1, positive end-expiratory pressure of 5
cmH2O, respiratory rate to normocapnia, and inspiratory oxygen fraction of
1.0. MAIN OUTCOME MEASURES - The primary outcome was the arterial partial
pressure of oxygen (PaO2) 20 min after initiation of OLV. The secondary
outcomes included respiratory system mechanics, the need for rescue due to
hypoxaemia, and clinical outcome variables. RESULTS - The partial pressure
of arterial oxygen did not differ between FCV and VCV at 20 min after
starting OLV (PaO2: 24.8 +/- 14.8 kPa vs. 26.1 +/- 15.9 kPa, mean
difference -1.2 (95% confidence interval -8.2 to 5.7), P = 0.721), while
mechanical power was lower during FCV compared with VCV. Other variables
did not differ at any time thereafter, except for the compliance of the
respiratory system at end of surgery. The need for rescue manoeuvres due
to hypoxemia or hypercapnia during OLV did not differ between the groups.
The incidence of postoperative pulmonary and extrapulmonary complications,
as well as the number of hospital-free days at day 30 after surgery, did
not differ between FCV and VCV. CONCLUSIONS - Compared with VCV in
thoracic surgery patients, FCV did not improve oxygenation or respiratory
system mechanics during OLV, nor was it associated with improved
outcomes.<br/>Copyright &#xa9; 2025

<102>
Accession Number
649988525
Title
Lateral position as an alveolar recruitment maneuver in patients
immediately after cardiac surgery.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Melo J.L.; Santos Ac.C.; Costa As.C.; Amato Mb.P.
Institution
(Melo, Santos, Amato) Instituto Do Coracao da Faculdade de Medicina da
Universidade de Sao Paulo, Pulmonology, Sao Paulo, Brazil
(Costa) Instituto Do Coracao da Faculdade de Medicina da Universidade de
Sao Paulo, Physical Therapy, Sao Paulo, Brazil
Publisher
BioMed Central Ltd
Abstract
Introduction: Evidence suggests that lateral positioning can reduce lung
collapse [1]. This randomized clinical trial evaluates whether automated
lateral positioning can serve as an alveolar recruitment maneuver without
increasing positive airway pressure, the standard practice [2].
<br/>Method(s): Forty-seven patients in the immediate postoperative period
of cardiac surgery, under invasive mechanical ventilation and with a
PaO<inf>2</inf>/ FiO<inf>2</inf> ratio < 250 mmHg, were randomized into
two groups. The intervention group (IG) underwent 30. automated lateral
positioning, while the control group (CG) remained supine. Both groups
later received an alveolar recruitment maneuver (ARM), steps of 5
cmH<inf>2</inf>O, reaching a plateau pressure of 45 cmH<inf>2</inf>O. PEEP
levels were adjusted based on BMI, which were done based previous studies
[3]. For lateralization, PEEP was increased by 2 cmH<inf>2</inf>O to
protect the dependent lung. If needed, PEEP was further increased, with a
maximum cumulative increase of 4 cmH<inf>2</inf>O. Patients were monitored
via EIT and EV1000R to assess alveolar recruitment and hemodynamic
effects. <br/>Result(s): Median BMI-Adjusted PEEP was 14 [13-15]
cmH<inf>2</inf>O. As shown in the Figure, driving pressure and lung
collapse decreased significantly over time in the IG compared to the CG.
In the CG, these reductions occurred only after the ARM, whereas in the
IG, they were observed earlier during lateral positioning. No significant
hemodynamic changes were noted over time or between groups. Drops in
cardiac output and mean arterial pressure occurred only during the ARM but
were similar between groups. <br/>Conclusion(s): Lateral positioning at
30. demonstrates potential for alveolar recruitment with less hemodynamic
impact compared to ARM with increased positive airway pressure in patients
in the immediate postoperative period following cardiac surgery.

<103>
Accession Number
649988602
Title
Effect of sigh ventilation on postextubation hypoxemia after cardiac
surgery: A randomized clinical trial.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Wang Z.; Chen H.; Chen T.; Cheng Q.; Sun J.; Cao H.; Guo F.
Institution
(Wang, Chen, Cheng, Guo) Zhongda Hospital, School of Medicine, Southeast
University, Jiangsu Provincial Key Laboratory of Critical Care Medicine,
Department of Critical Care Medicine, Nanjing, China
(Chen) Liverpool School of Tropical Medicine, Global Health Trials Unit,
Liverpool, United Kingdom
(Sun) Zhongda Hospital, School of Medicine, Southeast University,
Department of Anesthesiology, Surgery and Pain Management, Nanjing, China
(Cao) Zhongda Hospital, School of Medicine, Southeast University,
Department of Cardiothoracic Surgery, Zhongda Hospital, Nanjing, China
Publisher
BioMed Central Ltd
Abstract
Introduction: Pulmonary atelectasis remains a frequent event after cardiac
surgery with surfactant alteration or depletion often preceding its
formation. The protective role of adding sigh breaths to conventional lung
protective ventilation among cardiac surgery patients is still uncertain.
<br/>Method(s): An accessor-blind randomized clinical trial of sigh
ventilation was conducted from February 2024 to August 2024 in a single
hospital in China. Patients aged over 18 years and planned to receive
cardiac surgery requiring CPB were included. Sigh ventilation (sigh
breaths plus lung protective ventilation) by producing plateau pressure of
35 cmH<inf>2</inf>O delivered once every 6 min. Conventional ventilation
including low tidal volume of 6-8 mL/kg PBW and PEEP set according to the
low PEEP/FiO<inf>2</inf> table. The primary outcome was time-weighted
average SpO<inf>2</inf>/ FiO<inf>2</inf> ratio during the 1st
postextubation hour. There were 10 secondary outcomes, including the
severity of postoperative pulmonary complications and use of HFNC or NIV
computed by postoperative day 7. <br/>Result(s): 192 patients were
enrolled. 96 patients randomized to the sigh ventilation group received
sigh breaths for a median duration of 12 h with an initial median sigh
volume of 1721 mL. The mean timeweighted average SpO<inf>2</inf>/
FiO<inf>2</inf> ratios were 380 in the sigh ventilation group and 338 in
the conventional ventilation group (MD 42.1; 95% CI 16.7-67.5; p = 0.0013)
(Table). By postoperative day 7, the severity of pulmonary complications
was lower in sigh ventilation group compared with the conventional
ventilation group with a common odds ratio for lower severity of 2.3 (95%
CI [1.3 to 4.2]; p = 0.005). The proportion of patients with use of HFNC
or NIV was lower in sigh ventilation group compared with conventional
ventilation group (MD-13.5%; 95% CI-23.2% to-3.9%; p = 0.007).
<br/>Conclusion(s): Among patients undergoing cardiac surgery, the
addition of sigh breaths significantly improved the SpO<inf>2</inf>/
FiO<inf>2</inf> ratios during the initial hour after extubation.

<104>
Accession Number
649988855
Title
Combination of urinary biomarkers can predict cardiac surgery-Associated
acute kidney injury: A systematic review and meta-Analysis.
Source
Critical Care. Conference: 44th International Symposium on Intensive Care
& Emergency Medicine. Brussels Belgium. 29(Supplement 1) (no pagination),
2025. Date of Publication: 01 Mar 2025.
Author
Kiss N.; Papp M.; Turan C.; Koi T.; Madach K.; Hegyi P.; Zubek L.; Molnar
Z.
Institution
(Kiss, Papp, Turan, Madach, Zubek, Molnar) Semmelweis University,
Department of Intensive Therapy, Budapest, Hungary
(Koi) Budapest University of Technology and Economics, Department of
Stochastics, Budapest, Hungary
(Hegyi) Semmelweis University, Centre for Translational Medicine,
Budapest, Hungary
Publisher
BioMed Central Ltd
Abstract
Introduction: Acute kidney injury (AKI) develops in 20-50% of patients
undergoing cardiac surgery (CS). We aimed to assess the predictive value
of urinary biomarkers (UBs) for predicting CS-Associated AKI.
<br/>Method(s): All clinical studies reporting on the diagnostic accuracy
of individual or combined UBs were eligible for inclusion. We searched
three databases (MEDLINE, EMBASE, and CENTRAL) without any filters or
restrictions on the 11th of November, 2022. Random and mixed effects
models were used for meta-Analysis. The main effect measure was the area
under the Receiver Operating Characteristics curve (AUC) with 95%
confidence intervals. Our primary outcome was thepredictive values of each
individual UB at different time point measurements to identify patients
developing acute kidney injury (KDIGO). As a secondary outcome, we
calculated the performance of combinations of UBs. <br/>Result(s): We
screened 10,763 records and included 89 articles (both randomized and
non-randomized studies) in the analysis. The predictive value of UBs
measured in the intraoperative and early postoperative period was at
maximum acceptable, with the highest AUCs of 0.74 [0.68, 0.81], 0.73
[0.65, 0.82] and 0.74 [0.72, 0.77] for predicting severe CS-Associated
AKI, respectively. To predict all stages of CS-Associated AKI, UBs
measured in the intraoperative and early postoperative period yielded AUCs
of 0.75 [0.67, 0.82] and 0.73 [0.54, 0.92]. To identify all cases and
severe cases of acute kidney injury, combinations of any two UB
measurements outperformed any single measurement with AUCs of 0.82 [0.75,
0.88] and 0.85 [0.79, 0.91] for all cases and severe cases, respectively.
Combining three or more biomarkers, however, did not improve the
predictive value. <br/>Conclusion(s): The combination of any two urinary
biomarker measurements leads to the highest accuracy for predicting
cardiac surgery-Associated acute kidney injury. Prompt and accurate
evaluation of CS-Associated AKI might lead to better patient outcomes.

<105>
Accession Number
649996787
Title
Left atrial appendage closure for atrial fibrillation patients at high
risk of gastrointestinal bleeding. An evidence-based multidisciplinary
review for gastroenterologists.
Source
Revista espanola de enfermedades digestivas. (no pagination), 2026. Date
of Publication: 22 Jan 2026.
Author
Sanz Segura P.; Jimeno Sanchez J.; Senzolo M.; Grygier M.; Bernal-Monterde
V.; Perez de Prado A.; Lip G.Y.H.; Camm A.J.
Institution
(Sanz Segura) Gastroenterology, Hospital Universitario Royo Villanova,
Spain
(Jimeno Sanchez) Interventional Cardiology Unit, Hospital Universitario
Miguel Servet, Spain
(Senzolo) Surgery, Oncology and Gastroenterology, University Hospital of
Padua, Italy
(Grygier) Cardiology, Poznan University Hospital, Poland
(Bernal-Monterde) Gastroenterology, Hospital Universitario Miguel Servet,
Spain
(Perez de Prado) Interventional Cardiology, Hospital Universitario de
Leon, Spain
(Lip) Liverpool Centre for Cardiovascular Science, Liverpool John Moores
University and Liverpool Heart and Chest Hospital, United Kingdom
(Camm) City and St. George's University of London, United Kingdom
Abstract
BACKGROUND: atrial fibrillation (AF) is the most prevalent cardiac
arrhythmia, constituting a significant risk factor for stroke and systemic
embolism. Oral anticoagulation (OAC) remains the primary strategy for
stroke prevention, however, a subset of patients must discontinue it due
to adverse events. Percutaneous left atrial appendage closure (LAAC)
involves the mechanical occlusion of the left atrial appendage, an
embryonic remnant in the left atrium of the heart where most thrombi form
in patients with AF. It offers an alternative to long-term OAC for stroke
prevention. <br/>METHOD(S): this article provides an overview of the LAAC
procedure, its indications, and the current evidence (including clinical
trials, meta-analyses, and real-world practice studies) regarding
gastrointestinal bleeding (GIB) secondary to OAC. <br/>RESULT(S): The
PROTECT-AF and PREVAIL RCTs included 1114 patients with non-valvular AF,
randomized 2:1 to LAAC or warfarin. Differences in major bleeding favoured
LAAC (HR 0.48; 95% CI: 0.32-0.71). In the PRAGUE-17 trial, LAAC was
non-inferior to DOAC in preventing major AF-related cardiovascular,
neurological and bleeding events among patients at high risk for stroke
and bleeding. In the long-term follow-up, the noninferiority of LAAC was
maintained after 4 years (annual rate of nonprocedural clinically relevant
bleeding, including GIB, was 7.42% for DOAC vs 3.76% for LAAC). In the
OPTION trial, LAAC reduced non-procedure-related major or clinically
relevant nonmajor bleeding at 36 months compared to OAC in patients
undergoing catheter-based AF ablation. In a real-world study about LAAC in
43 anticoagulated patients with previous GIB, hospitalization need, number
of endoscopic procedures, as well as iron intravenous doses and packed red
cells administered decreased after LAAC. In cirrhosis, LAAC appears to be
associated with an increased risk of complications (renal failure, cardiac
tamponade, GIB) and readmissions. <br/>CONCLUSION(S): LAAC offers a
treatment option for stroke prevention in AF patients in whom lifelong
anticoagulation is contraindicated due to recurrent GIB, chronic anaemia
or high bleeding risk. In cirrhotic patients, careful selection and shared
decision-making are critical due to its higher complications risk.