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<1>
Accession Number
647617968
Title
A Randomized Controlled Trial Comparison of Subcuticular Suture and
Adhesive Strip for Cosmetic Outcome in Median Sternotomy Closure in
Patient Undergoing Cardiac Surgery.
Source
Aesthetic plastic surgery. 50(1) (pp 421-434), 2026. Date of Publication:
01 Jan 2026.
Author
Songvasin S.; Winaikosol K.; Karunasumetta C.
Institution
(Songvasin, Karunasumetta) Cardiothoracic Surgery, Srinagarind Hospital
and Queen Sirikit Heart Center of the Northeast, Khon Kaen, Thailand
(Winaikosol) Plastic Surgery, Srinagarind Hospital, Khon Kaen, Thailand
(Karunasumetta) Division of Cardiothoracic Surgery, Faculty of Medicine,
Khon Kaen University, 123/2000 Mittraphap Road, Khon Kaen, Thailand
Abstract
BACKGROUND: The median sternotomy incision is a common approach in cardiac
surgery, often leading to noticeable scar formation that can impact
patients' quality of life. This study aims to compare outcomes between
subcuticular suture and adhesive strip (Steri-stripTM, 3M HealthCare)
closure techniques for median sternotomy incisions in cardiac surgery
patients. <br/>METHOD(S): In this prospective randomized controlled trial,
112 patients undergoing cardiac surgery (August 2020 to September 2021)
were assigned to either the adhesive strip or subcuticular suture group.
Wound assessments occurred on postoperative days 3, 7, and before
discharge, monitoring for infection and dehiscence. Follow-ups at 1-2
weeks, 3 months, and 6 months used scar scales, including Vancouver Scar
Scale (VSS), Manchester Scar Scale (MSS), and Patient and Observer Scar
Assessment Scale (POSAS). <br/>RESULT(S): Out of a total of 112 patients,
6 were excluded. All remaining patients were completely followed up. No
significant differences were observed in VSS, MSS, POSAS outcomes, or
wound complications during postoperative follow-ups. Adhesive strip
closure took 0.49 minutes, significantly less than 7.27 minutes for
subcuticular sutures (P < 0.001). Furthermore, the total cost of adhesive
strips was lower than the subcuticular suture group. <br/>CONCLUSION(S):
The adhesive strips application for skin closure of median sternotomy
wounds was found to be non-inferior to subcuticular sutures in terms of
clinical outcomes and postoperative wound complications. Additionally,
this approach resulted in reduced operative time and proved to be
cost-effective in hospital care. LEVEL OF EVIDENCE I: This journal
requires that authors assign a level of evidence to each article. For a
full description of these Evidence-Based Medicine ratings, please refer to
the Table of Contents or the online Instructions to Authors
www.springer.com/00266 .<br/>Copyright &#xa9; 2025. Crown.

<2>
Accession Number
2043242378
Title
Limb remote ischemic preconditioning attenuates biomarkers of acute lung
injury and inflammation during thoracoscopic lobectomy: a randomized
controlled trial.
Source
Clinics. 81 (no pagination), 2026. Article Number: 100883. Date of
Publication: 01 Jan 2026.
Author
Zhang W.; Zeng M.; Yang C.; Yang L.; Yang J.; Wang Y.; Xie H.; Wang L.;
Zhong M.; Hua F.; Liang W.
Institution
(Zeng, Xie, Wang, Zhong, Hua, Liang) Anesthesia & Surgery Center, The
First Affiliated Hospital of Gannan Medical University, Jiangxi, China
(Zhang, Yang, Wang, Wang, Zhong, Liang) Gannan Medical University,
Jiangxi, China
(Zhang) Hospital of Traditional Chinese Medicine of Zhongshan, Guangdong,
Zhongshan, China
(Yang) Fujian Maternity and Child Health Hospital College of Clinical
Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical
University, Fuzhou, China
(Yang) Academic Affairs Department, The First Affiliated Hospital of
Gannan Medical University, Jiangxi, China
(Hua) Department of Anesthesiology, The Second Affiliated Hospital of
Nanchang University, Jiangxi, China
Publisher
Universidade de Sao Paulo. Museu de Zoologia
Abstract
Background One-Lung Ventilation (OLV), though essential for thoracic
surgery, triggers inflammation and oxidative stress that may lead to Acute
Lung Injury (ALI). Remote Ischemic Preconditioning (RIPC) is a simple,
non-invasive intervention that may activate protective pathways and reduce
ischemia-reperfusion injury. This randomized controlled trial assessed
whether limb RIPC attenuates OLV-induced lung injury during thoracoscopic
lobectomy. Methods Fifty-four patients undergoing thoracoscopic lobectomy
with OLV were randomized to the RIPC (n = 27) or Control (NC, n = 27)
group. RIPC consisted of five cycles of 5-min ischemia and 5-min
reperfusion using a lower limb tourniquet before OLV. Blood samples were
collected at T0 (post-induction), T1 (30-min after OLV), T2 (90-min after
OLV), and T3 (30-min after resumption two-lung ventilation). The primary
endpoint was plasma CC16. Secondary endpoints included IL-6, MDA, arterial
blood gases, Intraoperative Oxygenation Indices (OI, RI,
A-aDO<inf>2</inf>, a/A), and hospital stay. Results Plasma CC16, IL-6, and
MDA levels were significantly lower in the RIPC group from T1 to T3 (all p
< 0.001). In contrast, oxygenation indices, blood gas parameters, and
hospital stay did not differ significantly between groups (all p > 0.05).
Conclusions Limb RIPC effectively reduced systemic markers of lung injury
(CC16), inflammation and oxidative stress during OLV but not in short-term
improvements in oxygenation or clinical recovery. These findings suggest
that RIPC confers molecular protection, with potential functional benefits
requiring longer follow-up or evaluation in high-risk populations. Larger
multicenter trials are warranted.<br/>Copyright &#xa9; 2026 HCFMUSP.

<3>
Accession Number
2043110211
Title
Efficacy and Safety of Ciprofol for Sedation in Critically Ill Patients
After Cardiac Surgery: A Single-Center, Prospective, Randomized Controlled
Trial.
Source
Drug Design, Development and Therapy. 20 (no pagination), 2026. Article
Number: 12475780. Date of Publication: 2026.
Author
Guo L.; Hong M.; Li P.; Du W.; Li Y.; Li J.
Institution
(Guo, Hong, Du, Li) The Xuzhou Clinical College of Xuzhou Medical
University, Jiangsu, Xuzhou, China
(Li, Li) Xuzhou Clinical College of Xuzhou Medical University, Xuzhou
Medical University, Jiangsu, Xuzhou, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to compare the efficacy and safety of ciprofol
and propofol for sedation in critically ill patients after cardiac
surgery. <br/>Patients and Methods: In this prospective, randomized
controlled trial, 123 patients undergoing coronary artery bypass grafting
(CABG) and/or valve surgery were randomly assigned to receive either
ciprofol (Group C) or propofol (Group P) for postoperative sedation in the
intensive care unit (ICU). Midazolam was administered if additional
sedation was required, and remifentanil was used for analgesia. Sedation
and analgesia were titrated to a target Richmond Agitation-Sedation Scale
(RASS) score of -2 to +1 and a Critical-Care Pain Observation Tool (CPOT)
score < 3. The primary endpoint was the mean sedation compliance rate,
defined as the percentage of RASS scores within the target range during
the initial 24 hours. Secondary endpoints included safety events,
extubation time, length of ICU stay, mortality, delirium incidence, and
postoperative recovery. <br/>Result(s): In the per-protocol (PP)
population, sedation compliance was 92.77% (Group C) and 94.30% (Group P).
Ciprofol showed non-inferior sedation to propofol in cardiac surgery
patients; the lower limit of the one-sided 95% confidence interval (CI)
for rate difference (RD) exceeded the -8% non-inferiority margin in both
PP and intention-to-treat (ITT) populations. The incidence of hypotension
was numerically lower in Group C (31.3% vs 40.7%; P = 0.276), with no
significant differences in other safety or secondary outcomes (all P >
0.05). <br/>Conclusion(s): In summary, ciprofol provides non-inferior
sedation efficacy and a comparable safety profile to propofol in
critically ill patients following cardiac surgery. A numerical trend
toward lower hypotension incidence was observed with ciprofol, which
warrants further validation in future studies.<br/>Copyright &#xa9; 2026
Guo et al.

<4>
Accession Number
2039520738
Title
Candida endocarditis: current perspectives on diagnosis and therapy.
Source
Clinical Microbiology and Infection. 32(3) (pp 382-388), 2026. Date of
Publication: 01 Mar 2026.
Author
Ben-Ami R.; Bassetti M.; Bouza E.; Kosman A.; Vena A.
Institution
(Ben-Ami, Kosman) Infectious Diseases Unit, Tel Aviv Sourasky Medical
Center, Tel Aviv, Israel
(Ben-Ami, Kosman) Gray Faculty of Medical and Health Sciences, Tel Aviv
University, Tel Aviv, Israel
(Bassetti, Vena) Department of Health Sciences, University of Genoa,
Genoa, Italy
(Bassetti, Vena) Clinical Infectious Diseases Unit, San Martino Polyclinic
Hospital-IRCCS, Genoa, Italy
(Bouza) Clinical Microbiology and Infectious Diseases, Hospital General
Universitario Gregorio Maranon, Madrid, Spain
(Bouza) Medicine Department, School of Medicine, Universidad Complutense
de Madrid (UCM), Madrid, Spain
(Bouza) CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid,
Spain
(Bouza) Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM),
Madrid, Spain
Publisher
Elsevier B.V.
Abstract
Background Candida infective endocarditis (CIE) is a rare but potentially
devastating condition. Although it accounts for only 1-1.5% of infective
endocarditis cases, CIE carries a high mortality rate (36-49%) and a
substantial risk of relapse. Despite advances in diagnostic and
therapeutic strategies, significant uncertainties persist regarding the
role and selection of imaging modalities and the most effective medical
and surgical management. Furthermore, the best follow-up strategy to
promptly detect recurrences in patients with a confirmed diagnosis remains
inadequately defined. Objectives This review explores the diagnosis and
management of CIE with a particular focus on: (a) optimal use of cardiac
imaging studies; (b) challenges associated with antifungal therapy; (c)
the limitations and real-world impact of surgical intervention; and (d)
strategies for long-term follow-up. Sources A comprehensive literature
search was conducted in PubMed using the terms Candida endocarditis,
fungal biomarkers, echocardiography, antifungal therapy, and surgical
management. Additional studies were identified through reference
screening. Only clinically relevant articles, as judged by the authors,
were included. Content Diagnosis remains difficult due to intermittently
negative blood cultures and limitations of standard endocarditis criteria.
Echocardiography is the primary diagnostic modality for patients with
candidaemia, and risk stratification to guide its use remains exploratory.
Novel diagnostic methods, including fungal biomarkers (1,3-beta-D-glucan),
molecular assays, and positron emission tomography/computed tomography,
may improve detection, but robust clinical data are lacking. Management
requires a multimodal approach, combining prolonged antifungal therapy
and, when feasible, surgical intervention. Echinocandins or liposomal
amphotericin B plus flucytosine are first-line treatments, with
fluconazole as a step-down option. Prosthetic valve infections often
require lifelong suppressive therapy due to high relapse rates.
Implications Given the high mortality and recurrence rates, early
multidisciplinary involvement is crucial. With emerging antifungal
resistance, antibiofilm strategies and next-generation antifungals are
needed to improve outcomes.<br/>Copyright &#xa9; 2025 European Society of
Clinical Microbiology and Infectious Diseases.

<5>
Accession Number
2043709904
Title
Comparison of Performance Characteristics of Flexible Bronchoscopy- or
Video Laryngoscopy-Assisted Insertion Versus Blind Insertion of
Transesophageal Echocardiography Probe in Adults Undergoing Cardiac
Surgery: A Randomized Controlled Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Das D.; Misra S.; Patra T.K.; Das P.K.; Mohanty S.
Institution
(Das, Patra) Department of Anesthesiology (Burn Centre), All India
Institute of Medical Sciences, Bhubaneswar, India
(Misra, Das) Department of Anesthesiology & Critical Care, All India
Institute of Medical Sciences, Bhubaneswar, India
(Mohanty) Department of Cardiothoracic & Vascular Surgery, All India
Institute of Medical Sciences, Bhubaneswar, India
Publisher
W.B. Saunders
Abstract
Objectives: The objective of this study was to compare visually assisted
techniques (flexible bronchoscope and video laryngoscope) versus blind
insertion of the transesophageal echocardiography (TEE) probe. The primary
objective was to evaluate the first-attempt success rate of probe
insertion. Secondary objectives were to evaluate the time required for
probe insertion, the number of attempts required for successful insertion,
hemodynamic perturbation immediately after and at 3 minutes after probe
insertion, operator satisfaction, and the incidence of complications
related to probe insertion. <br/>Design(s): A randomized controlled study.
<br/>Setting(s): A single-institution tertiary center.
<br/>Participant(s): One hundred thirty-five adult patients undergoing
elective cardiac surgery. <br/>Intervention(s): Patients were randomized
into 3 equal groups of 45 patients each: blind insertion of the TEE probe
(group B), video laryngoscopy-assisted insertion of the TEE probe (group
VL), and flexible bronchoscopy-assisted insertion of the TEE probe (group
FB). <br/>Measurements and Main Results: One hundred twenty-four patients
completed the study (group B, n = 42; group VL, n = 41; group FB, n = 41).
The first-attempt success rate was significantly better with visually
assisted techniques: 92.7% in group VL and 95.1% in group FB versus 78.6%
in group B (p = 0.042). Time to probe insertion was significantly longer
in group FB versus both groups VL and B (p = 0.001). The number of
attempts required for successful probe insertion was significantly lower
in the visually assisted groups (p = 0.01). The increases in heart rate
and mean arterial pressure were significantly lower in group FB versus
groups VL and B immediately following probe insertion and at 3 minutes.
However, there was no difference in hemodynamics between groups VL and B.
Operator satisfaction was comparable among the groups. The incidence of
complications such as blood at the tip of the probe was significantly
lower with visually guided techniques (p = 0.005), whereas the incidence
of probe-related injuries was comparable across the groups (p = 0.09).
<br/>Conclusion(s): Flexible bronchoscopy-assisted TEE probe insertion
provides similar performance characteristics to video
laryngoscopy-assisted insertion albeit with less hemodynamic perturbation
and is superior to blind insertion of the TEE probe.<br/>Copyright &#xa9;
2026

<6>
Accession Number
2041909523
Title
Residual Mitral Regurgitation After Transcatheter Edge-to-Edge Repair
Worsens Survival in Patients with Renal Dysfunction.
Source
CJC Open. 8(2) (pp 174-186), 2026. Date of Publication: 01 Feb 2026.
Author
Rottlander D.; Hausleiter J.; Schmitz T.; Bufe A.; Seyfarth M.; Beucher
H.; Ouarrak T.; Schneider S.; Boekstegers P.
Institution
(Rottlander, Bufe, Seyfarth, Boekstegers) Department of Cardiology,
Faculty of Health, Witten/Herdecke University, Witten, Germany
(Rottlander) Department of Cardiology, Krankenhaus Porz am Rhein, Cologne,
Germany
(Hausleiter) Department of Cardiology, Klinikum der Universitat Munchen,
Ludwig-Maximilians-Universitat, Munich, Germany
(Hausleiter) DZHK (German Center for Cardiovascular Research), Partner
Site Munich Heart Alliance, Munich, Germany
(Schmitz) Department of Cardiology, Elisabeth Krankenhaus, Essen, Germany
(Bufe) Department of Cardiology, Helios Clinic Krefeld, Krefeld, Germany
(Seyfarth) Department of Cardiology, University Hospital Helios Wuppertal,
Wuppertal, Germany
(Beucher) Department of Cardiology, Helios Klinikum Siegburg, Siegburg,
Germany
(Ouarrak, Schneider) Institut fur Herz-Infarkt Forschung, Ludwigshafen,
Germany
Publisher
Elsevier Inc.
Abstract
Background: Chronic kidney disease (CKD) and postprocedural acute kidney
injury (AKI) are predictors of survival after mitral transcatheter
edge-to-edge repair (TEER). This study aimed to assess the impact of
residual mitral regurgitation (MR) on 3-year mortality in patients with vs
without CKD or AKI. <br/>Method(s): Patients from the prospective,
multicentre MITRAClip PROgnosis (MITRA-PRO) registry (n = 1491) were
stratified by baseline estimated glomerular filtration rate (eGFR), into 3
groups: > 50, 30-50, and < 30 mL/min per 1.73 m². Residual MR
was quantified using the multimodal MitraScore(<=3, mild; >=4, relevant).
<br/>Result(s): Patients with eGFR < 30 had significantly higher 3-year
mortality (55.4%) compared to those with eGFR 30-50 (40.8%) and eGFR > 50
(27.7%, P < 0.001). Compared to patients with eGFR < 30, the adjusted
hazard ratio for mortality was 0.64 (95% confidence interval: 0.51-0.80, P
< 0.0001) in the eGFR 30-50 group, and 0.41 (95%confidence interval:
0.32-0.52, P < 0.0001) in the eGFR > 50 group. Relevant residual MR was
more frequent in the eGFR < 30 group (33.2%). The combination of relevant
residual MR and reduced baseline renal function was associated with worse
long-term survival after mitral TEER. Furthermore, the overall cohort was
divided into those with (i) no postprocedural AKI (n = 1381) and (ii)
postprocedural AKI (n = 105). Postprocedural AKI occurred in 7% of the
cohort and was linked to increased mortality (61.5% vs 35.8%, P < 0.001).
Patients with both AKI and relevant residual MR had the highest mortality
rate. <br/>Conclusion(s): Residual MR following TEER is a strong predictor
of long-term mortality, particularly in patients with CKD. Minimizing
residual MR may reduce postprocedural AKI and improve survival outcomes in
patients with CKD. Clinical Trial Registration:
DRKS00012288.<br/>Copyright &#xa9; 2025 The Authors

<7>
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.

<8>
[Use Link to view the full text]
Accession Number
648978914
Title
Transcatheter or Surgical Aortic-Valve Replacement in Low-Risk Patients at
7 Years.
Source
The New England journal of medicine. 394(8) (pp 773-783), 2026. Date of
Publication: 19 Feb 2026.
Author
Leon M.B.; Mack M.J.; Pibarot P.; Hahn R.T.; Thourani V.H.; Kodali S.H.;
Genereux P.; Kapadia S.R.; Cohen D.J.; Pocock S.J.; Zhang Y.; Szerlip M.;
Ternacle J.; Malaisrie S.C.; Herrmann H.C.; Szeto W.Y.; Russo M.J.;
Babaliaros V.; Nazif T.; Webb J.G.; Makkar R.R.
Institution
(Leon, Hahn, Kodali, Nazif) Columbia University Irving Medical Center, New
York-Presbyterian Hospital, NY, United States
(Leon, Hahn, Kodali, Cohen, Pocock, Nazif) Cardiovascular Research
Foundation, NY, United States
(Mack, Szerlip) Baylor Scott and White the Heart Hospital Plano, Plano,
TX, United States
(Pibarot) Laval University, Quebec, QC, Canada
(Thourani) Piedmont Heart Institute, Atlanta, United States
(Genereux) Gagnon Cardiovascular Institute, Morristown Medical Center,
Morristown, NJ, United States
(Kapadia) Cleveland Clinic, Cleveland, United States
(Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States
(Pocock) London School of Hygiene and Tropical Medicine, London, United
Kingdom
(Zhang) Edwards Lifesciences, Irvine, CA, United States
(Ternacle) Unite Medico-Chirurgicale des Valvulopathies, Hopital
Haut-Leveque, CHU Bordeaux, Pessac, France
(Malaisrie) Northwestern University, Chicago, Mexico
(Herrmann, Szeto) University of Pennsylvania, Philadelphia, United States
(Russo) Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ,
United States
(Babaliaros) Emory University, Atlanta, United States
(Webb) St. Paul's Hospital, University of British Columbia, Vancouver,
Canada
(Makkar) Cedars-Sinai Medical Center, Los Angeles, Mexico
Abstract
BACKGROUND: Five-year data from the PARTNER 3 trial showed that among
low-risk patients with severe, symptomatic aortic stenosis, outcomes were
similar among patients who had undergone transcatheter aortic-valve
replacement (TAVR) and those who had undergone surgical aortic-valve
replacement. Longer-term assessments of clinical outcomes and valve
durability are needed. <br/>METHOD(S): Patients were randomly assigned in
a 1:1 ratio to undergo transfemoral TAVR or surgery. The first primary end
point was a nonhierarchical composite of death, stroke, or
rehospitalization related to the procedure, the valve, or heart failure.
The second primary end point was a hierarchical composite of death,
disabling stroke, nondisabling stroke, and the number of rehospitalization
days related to the procedure, the valve, or heart failure, analyzed with
the use of a win ratio analysis. Clinical, echocardiographic,
valve-durability, and health-status end points were assessed through 7
years. <br/>RESULT(S): A total of 1000 patients underwent randomization.
In the analysis of the first primary end point, the Kaplan-Meier estimate
of the incidence of an end-point event was 34.6% with TAVR and 37.2% with
surgery (difference, -2.6 percentage points; 95% confidence interval [CI],
-9.0 to 3.7). The win ratio for the second primary end point was 1.04 (95%
CI, 0.84 to 1.30). In the TAVR and surgery groups, respectively, the
Kaplan-Meier estimates for the incidence of components of the first
primary end point were as follows: death, 19.5% and 16.8%; stroke, 8.5%
and 8.1%; and rehospitalization, 20.6% and 23.5%. The mean (+/-SD)
aortic-valve gradients assessed by echocardiography at 7 years were
13.1+/-8.5 mm Hg after TAVR and 12.1+/-6.3 mm Hg after surgery. The
percentage of bioprosthetic valves that failed was 6.9% in the TAVR group
and 7.5% in the surgery group. Patient-reported outcomes were similar in
the two groups. <br/>CONCLUSION(S): Among low-risk patients with severe,
symptomatic aortic stenosis, no significant differences with respect to
two primary composite end points involving death, stroke, and
rehospitalization were observed at 7 years between those who had undergone
TAVR and those who had undergone surgery. (Funded by Edwards Lifesciences;
PARTNER 3 ClinicalTrials.gov number, NCT02675114.).<br/>Copyright &#xa9;
2025 Massachusetts Medical Society.

<9>
Accession Number
2032774088
Title
Antiplatelet therapy after coronary artery bypass surgery: five year
follow-up of randomised DACAB trial.
Source
BMJ. 385 (no pagination), 2024. Date of Publication: 2024.
Author
Zhu Y.; Zhang W.; Dimagli A.; Han L.; Cheng Z.; Mei J.; Chen X.; Wang X.;
Zhou Y.; Xue Q.; Hu J.; Tang M.; Wang R.; Song Y.; Kang L.; Redfors B.;
Gaudino M.; Zhao Q.
Institution
(Zhu, Zhou, Kang, Zhao) Department of Cardiovascular Surgery, Ruijin
Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Zhang) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
(Dimagli, Gaudino) Department of Cardio-thoracic Surgery, Weill Cornell
Medicine, New York, NY, United States
(Han, Xue) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Naval Medical University (Shanghai Changhai Hospital),
Shanghai, China
(Cheng, Hu) Department of Cardiac Surgery, Heart Centre of Henan
Provincial People's Hospital, Central China Fuwai Hospital of Zhengzhou
University, Zhengzhou, China
(Mei, Tang) Department of Cardiothoracic Surgery, Xinhua Hospital Shanghai
Jiao Tong University School of Medicine, Shanghai, China
(Chen, Wang) Department of Cardiovascular Surgery, Nanjing First Hospital,
Nanjing Medical University, Nanjing, China
(Wang, Song) Department of Cardiovascular Surgery, Jiangsu Province
Hospital, Nanjing, China
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
Publisher
BMJ Publishing Group
Abstract
OBJECTIVE To assess the effect of different antiplatelet strategies on
clinical outcomes after coronary artery bypass grafting. DESIGN Five year
follow-up of randomised Different Antiplatelet Therapy Strategy After
Coronary Artery Bypass Grafting (DACAB) trial. SETTING Six tertiary
hospitals in China; enrolment between July 2014 and November 2015;
completion of five year follow-up from August 2019 to June 2021.
PARTICIPANTS 500 patients aged 18-80 years (including 91 (18.2%) women)
who had elective coronary artery bypass grafting surgery and completed the
DACAB trial. INTERVENTIONS Patients were randomised 1:1:1 to ticagrelor 90
mg twice daily plus aspirin 100 mg once daily (dual antiplatelet therapy;
n=168), ticagrelor monotherapy 90 mg twice daily (n=166), or aspirin
monotherapy 100 mg once daily (n=166) for one year after surgery. After
the first year, antiplatelet therapy was prescribed according to standard
of care by treating physicians. MAIN OUTCOME MEASURES The primary outcome
was major adverse cardiovascular events (a composite of all cause death,
myocardial infarction, stroke, and coronary revascularisation), analysed
using the intention-to-treat principle. Time-to-event analysis was used to
compare the risk between treatment groups. Multiple post hoc sensitivity
analyses examined the robustness of the findings. RESULTS Follow-up at
five years for major adverse cardiovascular events was completed for 477
(95.4%) of 500 patients; 148 patients had major adverse cardiovascular
events, including 39 in the dual antiplatelet therapy group, 54 in the
ticagrelor monotherapy group, and 55 in the aspirin monotherapy group.
Risk of major adverse cardiovascular events at five years was
significantly lower with dual antiplatelet therapy versus aspirin
monotherapy (22.6% v 29.9%; hazard ratio 0.65, 95% confidence interval
0.43 to 0.99; P=0.04) and versus ticagrelor monotherapy (22.6% v 32.9%;
0.66, 0.44 to 1.00; P=0.05). Results were consistent in all sensitivity
analyses. CONCLUSIONS Treatment with ticagrelor dual antiplatelet therapy
for one year after surgery reduced the risk of major adverse
cardiovascular events at five years after coronary artery bypass grafting
compared with aspirin monotherapy or ticagrelor monotherapy.<br/>Copyright
&#xa9; 2024 BMJ Publishing Group. All rights reserved.

<10>
Accession Number
2034671077
Title
Management of atrial fibrillation in older adults.
Source
BMJ. 386 (no pagination), 2024. Article Number: e076246. Date of
Publication: 2024.
Author
Parks A.L.; Frankel D.S.; Kim D.H.; Ko D.; Kramer D.B.; Lydston M.; Fang
M.C.; Shah S.J.
Institution
(Parks) University of Utah, Division of Hematology and Hematologic
Malignancies, Salt Lake City, UT, United States
(Frankel) Cardiovascular Division, Perelman School of Medicine, The
University of Pennsylvania, Philadelphia, PA, United States
(Kim, Ko) Hinda and Arthur Marcus Institute for Aging Research, Hebrew
SeniorLife, Harvard Medical School, Boston, MA, United States
(Ko) Richard A and Susan F Smith Center for Outcomes Research, Beth Israel
Deaconess Medical Center, Boston, MA, United States
(Ko) Boston Medical Center, Section of Cardiovascular Medicine, Boston,
MA, United States
(Kramer) Richard A and Susan F Smith Center for Outcomes Research, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(Lydston) Massachusetts General Hospital, Treadwell Virtual Library,
Boston, MA, United States
(Fang) University of California, San Francisco, Division of Hospital
Medicine, San Francisco, CA, United States
(Shah) Massachusetts General Hospital, Division of General Internal
Medicine, Center for Aging and Serious Illness, Harvard Medical School,
Boston, MA, United States
Publisher
BMJ Publishing Group
Abstract
Most people with atrial fibrillation are older adults, in whom atrial
fibrillation co-occurs with other chronic conditions, polypharmacy, and
geriatric syndromes such as frailty. Yet most randomized controlled trials
and expert guidelines use an age agnostic approach. Given the
heterogeneity of aging, these data may not be universally applicable
across the spectrum of older adults. This review synthesizes the available
evidence and applies rigorous principles of aging science. After
contextualizing the burden of comorbidities and geriatric syndromes in
people with atrial fibrillation, it applies an aging focused approach to
the pillars of atrial fibrillation management, describing screening for
atrial fibrillation, lifestyle interventions, symptoms and complications,
rate and rhythm control, coexisting heart failure, anticoagulation
therapy, and left atrial appendage occlusion devices. Throughout, a
framework is suggested that prioritizes patients' goals and applies
existing evidence to all older adults, whether atrial fibrillation is
their sole condition, one among many, or a bystander at the end of
life.<br/>Copyright &#xa9; Published by the BMJ Publishing Group Limited.

<11>
Accession Number
2037453363
Title
Benzodiazepine-Free Cardiac Anesthesia for Reduction of Postoperative
Delirium: A Cluster Randomized Crossover Trial.
Source
JAMA Surgery. 160(3) (pp 286-294), 2025. Date of Publication: 12 Mar 2025.
Author
Spence J.; Devereaux P.J.; Lee S.-F.; D'Aragon F.; Avidan M.S.; Whitlock
R.P.; Mazer C.D.; Rousseau-Saine N.; Rajamohan R.R.; Pryor K.O.; Klein R.;
Tan E.; Cameron M.J.; Di Sante E.; Deborba E.; Mustard M.E.; Couture E.J.;
Zamper R.P.C.; Law M.W.Y.; Djaiani G.; Saha T.; Choi S.; Hedlin P.;
Pikaluk D.R.; Lam W.; Deschamps A.; Ramasundarahettige C.F.; Vincent J.;
McIntyre W.F.; Oczkowski S.J.W.; Dulong B.J.; Beaver C.; Kloppenburg S.A.;
Lamy A.; Jacobsohn E.; Belley-Cote E.P.
Institution
(Spence, Devereaux, Lee, Whitlock, Di Sante, Deborba, Ramasundarahettige,
Vincent, McIntyre, Beaver, Kloppenburg, Lamy, Belley-Cote) Population
Health Research Institute, Hamilton, ON, Canada
(Spence) Department of Anesthesia and Critical Care, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Lee, Whitlock, Oczkowski, Belley-Cote) Department of
Health Research Methods, Evidence, and Impact, McMaster University,
Hamilton, ON, Canada
(Spence, Devereaux, Whitlock, McIntyre, Lamy, Belley-Cote) World Health
Research Trust, Hamilton, ON, Canada
(Devereaux, McIntyre, Lamy) Department of Medicine, Cardiology, McMaster
University, Hamilton, ON, Canada
(D'Aragon) Departement d'Anesthesiologie, Universite de Sherbrooke,
Sherbrooke, QC, Canada
(Avidan) Department of Anesthesia, Washington University, St Louis School
of Medicine, St Louis, MO, United States
(Whitlock) Department of Surgery, Cardiac Surgery, McMaster University,
Hamilton, ON, Canada
(Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St.
Michael's Hospital, Toronto, ON, Canada
(Mazer) Departments of Anesthesiology and Pain Medicine, Physiology, and
Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
(Rousseau-Saine, Deschamps) Departement d'Anesthesie, Institut de
Cardiologie de Montreal, Universite de Montreal, Montreal, QC, Canada
(Rajamohan) Department of Anesthesia, St Paul's Hospital, University of
British Columbia, Vancouver, BC, Canada
(Pryor) Department of Anesthesiology, Weill Cornell Medical College, New
York, NY, United States
(Klein) Department of Anesthesia, Vancouver General Hospital, University
of British Columbia, Vancouver, BC, Canada
(Tan, Dulong) Department of Anesthesia and Critical Care Medicine, Queen
Elizabeth II Health Sciences, Dalhousie University, Halifax, NS, Canada
(Cameron) Department of Anesthesia, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Mustard) St Michael's Hospital, Toronto, ON, Canada
(Couture) Institut Universitaire de Cardiologie et de Pneumologie de
Quebec, Universite Laval, Quebec, QC, Canada
(Zamper) Department of Anesthesia, University of Western Ontario, London,
ON, Canada
(Law) Department of Anesthesiology, Royal Columbian Hospital, Department
of Anesthesiology, Pharmacology & Therapeutics, University of British
Columbia, Vancouver, BC, Canada
(Djaiani, Choi) Department of Anesthesiology and Pain Medicine, University
of Toronto, Toronto, ON, Canada
(Saha) Department of Anesthesia, Queen's University, Kingston, ON, Canada
(Choi) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Hedlin, Pikaluk) Department of Anesthesia, University of Saskatchewan,
Saskatoon, SK, Canada
(Lam) Department of Anesthesia, University of Alberta, Mazankowski Alberta
Heart Institute, Edmonton, AB, Canada
(Oczkowski) Department of Medicine, Critical Care, McMaster University,
Hamilton, ON, Canada
(Lamy, Belley-Cote) Department of Medicine, Cardiology and Critical Care,
McMaster University, Hamilton, ON, Canada
(Jacobsohn) Departments of Anesthesia and Perioperative Medicine and
Medicine, Critical Care, University of Manitoba, Winnipeg, MB, Canada
Publisher
American Medical Association
Abstract
Importance: Delirium is common after cardiac surgery and associated with
adverse outcomes. Intraoperative benzodiazepines may increase
postoperative delirium but restricting intraoperative benzodiazepines has
not yet been evaluated in a randomized trial. <br/>Objective(s): To
determine whether an institutional policy of restricted intraoperative
benzodiazepine administration reduced the incidence of postoperative
delirium. <br/>Design, Setting, and Participant(s): This pragmatic,
multiperiod, patient- and assessor-blinded, cluster randomized crossover
trial took place at 20 North American cardiac surgical centers. All adults
undergoing open cardiac surgery at participating centers during the trial
period were included through a waiver of individual patient consent
between November 2019 and December 2022. <br/>Intervention(s):
Institutional policies of restrictive vs liberal intraoperative
benzodiazepine administration were compared. Hospitals (clusters) were
randomized to cross between the restricted and liberal benzodiazepine
policies 12 to 18 times over 4-week periods. <br/>Main Outcomes and
Measures: The primary outcome was the incidence of delirium within 72
hours of surgery as detected in routine clinical care, using either the
Confusion Assessment Method-Intensive Care Unit or the Intensive Care
Delirium Screening Checklist. Intraoperative awareness by patient report
was assessed as an adverse event. <br/>Result(s): During the trial, 19768
patients (mean [SD] age, 65 [12] years; 14528 [73.5%] male) underwent
cardiac surgery, 9827 during restricted benzodiazepine periods and 9941
during liberal benzodiazepine periods. During restricted periods,
clinicians adhered to assigned policy in 8928 patients (90.9%), compared
to 9268 patients (93.2%) during liberal periods. Delirium occurred in 1373
patients (14.0%) during restricted periods and 1485 (14.9%) during liberal
periods (adjusted odds ratio [aOR], 0.92; 95% CI, 0.84-1.01; P =.07). No
patient spontaneously reported intraoperative awareness. <br/>Conclusions
and Relevance: In intention-to-treat analyses, restricting benzodiazepines
during cardiac surgery did not reduce delirium incidence but was also not
associated with an increase in the incidence of patient-reported
intraoperative awareness. Given that smaller effect sizes cannot be ruled
out, restriction of benzodiazepines during cardiac surgery may be
considered. Research is required to determine whether restricting
intraoperative benzodiazepines at the patient level can reduce the
incidence of postoperative delirium. Trial Registration:
ClinicalTrials.gov Identifier: NCT03928236.<br/>Copyright &#xa9; 2025
American Medical Association. All rights reserved, including those for
text and data mining, AI training, and similar technologies.

<12>
Accession Number
2043730146
Title
Effect of Stellate Ganglion Block on Internal Mammary Artery Dynamics: A
Randomized Controlled Clinical Trial.
Source
Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination),
2026. Date of Publication: 2026.
Author
Aboelnile D.B.; Ghallab M.A.; Attia E.H.A.; Hawas A.Y.; Kamal Eldin F.
Institution
(Aboelnile, Ghallab, Attia, Hawas, Kamal Eldin) Department of Anesthesia,
Intensive Care and Pain Management, Faculty of Medicine, Ain Shams
University, Cairo, Egypt
Publisher
SAGE Publications Inc.
Abstract
The left internal mammary artery (LIMA) is commonly selected as the graft
of choice for coronary artery bypass procedures. Various pharmacological
agents have been used to enhance LIMA blood flow. Left stellate ganglion
block (LSGB) has been utilized to achieve sympathetic blockade, promote
vasodilation in the upper extremities, and manage refractory angina. This
randomized controlled clinical trial aimed to evaluate the effect of
preoperative LSGB on LIMA blood flow in patients undergoing elective
coronary artery bypass grafting (CABG). Seventy patients (aged 18-80
years, of both genders) scheduled for elective CABG were equally divided
into two groups: the LSGB group and the control group. Patients in the
intervention group received an ultrasound-guided LSGB using 8 mL of 0.25%
bupivacaine. Both groups received topical nitroglycerin during LIMA
harvesting. LIMA diameter was measured at baseline and again after an
equal time interval before the induction of anaesthesia. Additionally,
LIMA free flow after harvesting and mean graft flow were measured using a
transit time flow metre (TTFM). LIMA free blood flow was significantly
increased in the LSGB group (50.57 +/- 5.79 mL/min) compared to the
control group (46.86 +/- 8.32 mL/min), with a P-value = 0.034. Similarly,
the LIMA diameter was significantly greater in the LSGB group (2.38 +/-
0.17 mm) than in the control group (2.31 +/- 0.14 mm), with a P-value =
0.04, suggesting that preoperative LSGB significantly enhances LIMA blood
flow and diameter in patients undergoing CABG.<br/>Copyright &#xa9; The
Author(s) 2026

<13>
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.

<14>
Accession Number
2043559146
Title
Aspirin dosing after acute coronary syndrome with suspected aspirin
resistance: the ANDAMAN trial.
Source
European Heart Journal. 47(6) (pp 719-730), 2026. Date of Publication: 07
Feb 2026.
Author
Dillinger J.-G.; Pezel T.; Batias L.; Angoulvant D.; Goralski M.; Ferrari
E.; Cayla G.; Silvain J.; Gilard M.; Lemesle G.; Souteyrand G.; Lim P.;
Roubille F.; Georges J.-L.; Bal Dit Sollier C.; Petroni T.; Morel O.;
Delarche N.; Elbaz M.; Puymirat E.; Toupin S.; Montalescot G.; Drouet L.;
Vicaut E.; Henry P.; Victor A.; Loic B.; Anne B.-A.; Hakim B.; Farzin B.;
Nicolas B.; Eric B.-C.; Philippe B.; Didier C.; Frederic C.; Pierre C.;
Yves C.; Thomas C.; Francois D.; Jean Claude D.; Gregory D.; Pascal G.;
Marie H.-M.; Sonia H.-P.; Herve L.; Loic M.; Laurens M.-H.; Fabrice P.;
Francesca S.; Francois S.; Philippe Gabriel S.; Christophe T.; Olivier V.
Institution
(Dillinger, Pezel, Toupin, Henry) Department of Cardiology, Hopital
Lariboisiere, Assistance Publique-Hopitaux de Paris, Universite Paris
Cite, Inserm MASCOT - UMRS 942, 2 Rue Ambroise Pare, Paris, France
(Dillinger, Pezel, Toupin) MIRACL.ai Laboratory, Multimodality Imaging for
Research and Artificial Intelligence Core Laboratory, University Hospital
of Lariboisiere (AP-HP), Paris, France
(Dillinger, Bal Dit Sollier, Drouet) CREATIF, Centre de Reference et
d'Education des Antithrombotiques d'Ile de France, Hopital Lariboisiere,
Assistance Publique-Hopitaux de Paris, Paris, France
(Batias) Centre Hospitalier Metropole Savoie, Service de Cardiologie,
Place Lucien Biset, Chambery, France
(Angoulvant) Cardiology Department, CHU Tours, INSERM Unite 1327 ISCHEMIA,
Universite de Tours, Tours, France
(Goralski) Cardiology Department, CHU Orleans, Orleans, France
(Ferrari) Cardiology Department, Pasteur University Hospital, Nice, France
(Cayla) Cardiology Department, Nimes University Hospital, Montpellier
University, ACTION Study Group, Nimes, France
(Silvain, Montalescot) ACTION Study Group, Sorbonne Universite, INSERM
UMRS1166, Hopital Pitie-Salpetriere (AP-HP), Paris, France
(Gilard) Chest Diseases, CHU Brest, INSERM U1304, Univ Brest, Brest,
France
(Lemesle) Heart and Lung Institute, University Hospital of Lille, CHU
Lille, Lille, France
(Lemesle) Medical School, University of Lille, Lille, France
(Lemesle) Institut Pasteur of Lille, Inserm U1011-EGID, Lille, France
(Lemesle) FACT (French Alliance for Cardiovascular Trials), Paris, France
(Souteyrand) Institut Pascal, Therapies Guidees par l'Image, CNRS SIGMA
UCA UMR 6602, University Hospital Gabriel Montpied, Clermont-Ferrand,
France
(Lim) Service de Cardiologie, Univ Paris Est Creteil, INSERM, IMRB, AP-HP,
Hopital Universitaire Henri-Mondor, Creteil, France
(Roubille) PhyMedExp, Cardiology Department, Universite de Montpellier,
INSERM, CNRS, INI-CRT, CHU de Montpellier, Montpellier, France
(Georges) Service de Cardiologie, Cardiologie Interventionnelle, Centre
Hospitalier de Versailles, Hopital Andre Mignot, Le Chesnay-Rocquencourt,
France
(Petroni) Cardiology Department, Clinique Pont de Chaume, Montauban,
France
(Morel) Division of Cardiovascular Medicine, Nouvel Hopital Civil,
Strasbourg University Hospital, UR 3074 Translational CardioVascular
Medicine CRBS, Strasbourg, France
(Delarche) Cardiology Department, Hopital Francois Mitterrand, Pau, France
(Elbaz) Center for Clinical Investigation (CIC1436), CARDIOMET, Rangueil
University Hospital, Toulouse, France
(Puymirat) Department of Cardiology, Assistance Publique-Hopitaux de Paris
(AP-HP), Hopital Europeen Georges Pompidou, Paris, France
(Puymirat) Faculte de Sante, Universite Paris Cite, Paris, France
(Vicaut) Unite de Recherche Clinique, ACTION Group, Hopital Fernand Widal
(AP-HP), Paris, France
Publisher
Oxford University Press
Abstract
Background and Aims Despite current antithrombotic treatments, the
recurrence of ischaemic events remains high in patients with diabetes
mellitus (DM) or aspirin resistance after acute coronary syndrome (ACS).
Whether twice-daily aspirin dosing reduces major adverse cardiovascular
events (MACE) in this population remains unknown. Methods In this
prospective multicentre, randomized trial, patients with ACS and DM or
high-risk of aspirin resistance (HRAR) defined as: (i) an index event
occurring while on aspirin; (ii) body mass index >=27 kg/m²; or
(iii) increased waist circumference were assigned to receive
enteric-coated aspirin once daily (100 mg/day) or twice daily (100 mg
morning and evening). The primary outcome was MACE, a composite of any
death, myocardial infarction, stroke, urgent coronary revascularization,
stent thrombosis, or acute arterial thrombotic event assessed using a
time-to-first-event analysis. The main secondary outcome was major
bleeding (Bleeding Academic Research Consortium type 3-5). Results In
total, 2484 participants were enrolled (77.2% with DM, 55.5% with
ST-elevation segment myocardial infarction). The median follow-up duration
was 18 (interquartile range: 17.6-18.3) months. The primary outcome
occurred in 95 of 1228 participants (7.7%) in the twice-daily aspirin
group, and 110 of 1256 (8.8%) in the once-daily group (hazard ratio [HR]
0.90; 95% confidence interval [CI] 0.69-1.19; P =. 42). Major bleeding
rates were similar between the groups (1.9% vs 2.1%; HR 0.88; 95% CI
0.50-1.55). Conclusions In patients with ACS and DM or HRAR, twice-daily
aspirin did not significantly reduce the risk of MACE compared to
once-daily dosing. No significant difference was observed in major
bleeding between groups.<br/>Copyright &#xa9; 2025 The Author(s).
Published by Oxford University Press on behalf of the European Society of
Cardiology. All rights reserved.

<15>
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.

<16>
[Use Link to view the full text]
Accession Number
2043317577
Title
What's New in Musculoskeletal Infection.
Source
Journal of Bone and Joint Surgery. 107(22) (pp 2495-2503), 2025. Date of
Publication: 19 Nov 2025.
Author
Citak M.; Kose O.; Luo T.D.; Hoveidaei A.H.; Gehrke T.; Ekhtiari S.
Institution
(Citak, Gehrke) Department of Orthopaedic Surgery, Helios ENDO-Klinik,
Hamburg, Germany
(Kose) Department of Orthopedics and Traumatology, Antalya Education and
Research Hospital, University of Health Sciences, Antalya, Turkey
(Luo) Indiana Orthopedic Institute, Fort Wayne, Indiana
(Hoveidaei) International Center for Limb Lengthening, Rubin Institute for
Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
(Ekhtiari) Division of Orthopaedic Surgery, Department of Surgery,
McMaster University, Hamilton, Ontario, Canada
Publisher
Lippincott Williams and Wilkins

<17>
[Use Link to view the full text]
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

<18>
Accession Number
2042904919
Title
Prevalence and Risk Factors of Colorectal Cancer in Solid Organ Transplant
Recipients: A Systematic Review and Meta Analysis.
Source
Clinical Transplantation. 40(2) (no pagination), 2026. Article Number:
e70470. Date of Publication: 01 Feb 2026.
Author
Udaikumar J.; Achuta K.M.; Lella V.V.; Nimmagadda R.; Kuppili S.; Tummala
N.; Alsaqa M.; Bellamkonda A.; Sarwar R.
Institution
(Udaikumar) Department of Medicine, NYU Grossman School of Medicine, NY,
United States
(Achuta) Department of Internal Medicine, Garden City Hospital, Garden,
United States
(Lella, Kuppili) Konaseema Institute of Medical Sciences and Research
Foundation, Amalapuram, India
(Nimmagadda, Bellamkonda) Department of Medicine, One Brooklyn Health, NY,
United States
(Tummala) Department of Medicine, New York Medical College St. Mary's
General Hospital and Saint Clare's Health, NY, United States
(Alsaqa) Harvard Medical School Division of Gastroenterology and
Hepatology, Beth Isreal Deaconess Medical Center, Beth, United States
(Alsaqa) Department of Medicine, Saint Peter's University Hospital Rutgers
RWJMS, Saint Peter's, United States
(Sarwar) Division of Gastroenterology and Hepatology, NYU Grossman School
of Medicine, NY, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Solid organ transplant (SOT) recipients face increased
colorectal cancer (CRC) risk due to chronic immunosuppression and
comorbidities such as primary sclerosing cholangitis, inflammatory bowel
disease, and cystic fibrosis. Despite this elevated risk, CRC screening
and treatment guidelines specific to transplant recipients remain limited.
This systematic review and meta-analysis evaluated the prevalence,
clinical characteristics, risk factors, and outcomes of CRC in SOT
recipients. <br/>Method(s): A comprehensive search across major databases
identified studies reporting CRC incidence and outcomes in kidney, liver,
heart, and lung transplant recipients. Study quality was assessed using
validated risk-of-bias tools. Pooled estimates were calculated using a
random-effects model; heterogeneity and organ-specific subgroup analyses
were also conducted. <br/>Result(s): The pooled incidence of CRC in SOT
recipients was 0.95% (95% CI: 0.35%-1.55%). Incidence was highest in heart
transplant recipients (1.27%), followed by kidney (1.12%), lung (0.56%),
and liver (0.53%) recipients. The mean time to CRC diagnosis was 8.8 years
(95% CI: 5.94-11.82). A total of 41.13% of patients presented with stage
III/IV or metastatic disease, and right-sided tumors predominated
(46.34%). Surgical resection was performed in 62.74% of patients. The
mortality rate among CRC patients post-transplant was 61.13% (95% CI:
39.55%-82.7%). <br/>Conclusion(s): CRC in SOT recipients is associated
with increased incidence, delayed diagnosis, and poor prognosis. The
predominance of right-sided tumors and late-stage presentation underscore
the need for tailored screening and surveillance protocols. Future
clinical guidelines should incorporate organ-specific risk stratification
and long-term monitoring to optimize outcomes in this high-risk
population.<br/>Copyright &#xa9; 2026 John Wiley & Sons A/S. Published by
John Wiley & Sons Ltd.

<19>
Accession Number
2043244503
Title
McGrath videolaryngoscopy versus direct laryngoscopy for rapid sequence
intubation: A multicenter randomized clinical trial.
Source
Journal of Clinical Anesthesia. 110 (no pagination), 2026. Article Number:
112148. Date of Publication: 01 Mar 2026.
Author
Tire Y.; Sertcakacilar G.; Ekrami E.; Yazar M.A.; Oner A.A.; Orhan M.K.;
Ugural A.; Patterson W.M.; Zengin S.N.G.; Kilinc M.; Boyacioglu S.;
Cekmecelioglu B.T.; Kozanhan B.; Kurt R.
Institution
(Tire, Yazar, Oner, Orhan, Ugural, Kozanhan) Department of Anesthesiology
and Reanimation, Konya City Hospital, University of Health Sciences,
Konya, Turkey
(Sertcakacilar, Zengin, Kilinc, Boyacioglu) Department of Anesthesiology,
Bakirkoy Dr. Sadi Konuk Research and Education Hospital, Istanbul, Turkey
(Ekrami, Cekmecelioglu) Division of Multi-Specialty Anesthesiology,
Department of Anesthesiology & Pain Management, Cleveland Clinic,
Cleveland, OH, United States
(Patterson) Department of Quantitative Health Sciences, Cleveland Clinic,
Cleveland, OH, United States
(Kurt) Department of Anesthesia and Intensive Care Medicine,
Ordensklinikum Linz, Linz, Austria
(Tire, Sertcakacilar, Ekrami, Yazar, Cekmecelioglu, Kurt) OUTCOMES
RESEARCH Consortium, Houston, TX, United States
(Kurt) Karl Landsteiner Institute for perioperative medicine, Linz,
Austria
Publisher
Elsevier Inc.
Abstract
Background Videolaryngoscopy has been proposed to improve glottic
visualization and intubation success during rapid sequence intubation
(RSI). Evidence on the effectiveness of the McGrath videolaryngoscope in
this setting remains limited. Methods In this multicenter,
patient-blinded, randomized trial, 400 adults undergoing elective
non-cardiac surgery requiring RSI were assigned to McGrath
videolaryngoscopy (VL, n = 193) or direct laryngoscopy (DL, n = 201). The
primary outcome was glottic visualization using the modified
Cormack-Lehane (CL) classification. Secondary outcomes included
first-attempt intubation success, number of attempts, intubation failure,
and time to intubation. Safety outcomes included airway injury and
postoperative complications. Results Glottic visualization did not differ
significantly between groups (Grade 1 view: VL 46.6% vs DL 42.3%; OR 1.24,
95% CI 0.85-1.79; P = 0.26). First-attempt success was similar (VL 86.5%
vs DL 87.6%; P = 0.76). Intubation failure occurred in 1.6% of VL and 0.5%
of DL cases ( P = 0.29). Median time to intubation was longer with VL (35
s vs 30 s; HR 1.27; 95% CI 1.04-1.56; P = 0.016). Rates of airway trauma
and postoperative complications were low and comparable. Conclusions In
adult patients undergoing RSI, McGrath videolaryngoscopy did not improve
glottic visualization or first-pass intubation success compared with
direct laryngoscopy, and was associated with a modestly longer intubation
time. Adverse events were infrequent and similar. These findings suggest
that the routine use of McGrath for RSI may not confer clinical benefit in
low-risk elective surgical populations.<br/>Copyright &#xa9; 2026 Elsevier
Inc.

<20>
Accession Number
2043224421
Title
Invasive versus conservative management in infective endocarditis after
transcatheter aortic valve implantation: A systematic review and
meta-analysis.
Source
Current Problems in Cardiology. 51(5) (no pagination), 2026. Article
Number: 103264. Date of Publication: 01 May 2026.
Author
Theofilis P.; Dimitriadis K.; Pyrpyris N.; Karakasis P.; Dri E.; Beneki
E.; Vordoni A.; Tsioufis P.; Chatzi M.; Oikonomou E.; Aznaouridis K.;
Tsioufis K.
Institution
(Theofilis, Dimitriadis, Pyrpyris, Dri, Beneki, Vordoni, Tsioufis, Chatzi,
Aznaouridis, Tsioufis) Department of Cardiology, "Hippokration" General
Hospital of Athens, Athens, Greece
(Karakasis) Department of Cardiology, Ippokrateio General Hospital of
Thessaloniki, Thessaloniki, Greece
(Oikonomou) Department of Cardiology, Sotiria General Hospital, Athens,
Greece
Publisher
Elsevier Inc.
Abstract
Background Infective endocarditis after transcatheter aortic valve
implantation (TAVI-IE) is an uncommon but severe complication associated
with substantial morbidity and mortality. Therapeutic strategies vary
widely, since invasive management is often precluded by prohibitive risk
and conservative medical therapy may be linked to poorer outcomes.
Therefore, we aimed to compare outcomes between conservative and invasive
management in patients with TAVI-IE. Methods A systematic search of
PubMed, Scopus, and Web of Science identified comparative studies
evaluating conservative versus invasive treatment in TAVI-IE. The primary
endpoints were all-cause in-hospital and 1-year mortality. Pooled risk
ratios (RRs) with 95 % confidence intervals (CIs) were calculated using a
random-effects model. Heterogeneity was quantified with I2, publication
bias was assessed with Egger's test, and sensitivity analyses
(leave-one-out, GOSH plots) were performed. Results The search yielded
2,551 records; 15 studies met inclusion criteria for data extraction and
meta-analysis. No significant differences were observed between
conservative and invasive strategies for in-hospital mortality (RR 0.99,
95 % CI 0.80-1.24, p = 0.96; I2 = 0 % with p = 0.67) or 1-year mortality
(RR 1.03, 95 % CI 0.84-1.26; p = 0.81; I2 = 11.4 % with p = 0.33). There
was no evidence of publication bias (Egger's test: in-hospital, p = 0.07;
1-year, p = 0.54). Results were robust in sensitivity analyses.
Conclusions In patients with TAVI-IE, conservative and invasive treatments
were associated with comparable in-hospital and 1-year mortality. These
findings support individualized, multidisciplinary decision-making rather
than presuming a uniform advantage of either approach.<br/>Copyright
&#xa9; 2026. Published by Elsevier Inc.

<21>
Accession Number
2043730404
Title
Heart Failure Rate After Thoracic Endovascular Aortic Repair (TEVAR).
Source
Journal of Endovascular Therapy. (no pagination), 2026. Date of
Publication: 2026.
Author
Moula A.I.; Spanos K.; Xanthopoulos A.; Kouvelos G.; Parise O.; Gelsomino
S.; Giamouzis G.; Giannoukas A.
Institution
(Moula) Department of Surgery, "Achillopouleion" General Hospital, Volos,
Greece
(Spanos, Kouvelos, Giannoukas) Vascular Surgery Department, Faculty of
Medicine, School of Health Sciences, University of Thessaly, University
Hospital of Larissa, Larissa, Greece
(Xanthopoulos, Giamouzis) Department of Cardiology, University Hospital of
Larissa, Faculty of Medicine, University of Thessaly, Larissa, Greece
(Parise, Gelsomino) Cardiovascular Center, CARIM School for Cardiovascular
Disease, University Hospital Maastricht, University of Maastricht,
Maastricht, Netherlands
Publisher
SAGE Publications Inc.
Abstract
Thoracic endovascular aortic repair (TEVAR) is a minimally invasive
technique for the treatment of thoracic aortic aneurysms (TAA). We
hypothesized that alteration of blood hemodynamics in the thoracic aorta
caused by stent implantation can possibly lead to hypertension and reduced
coronary flow leading to the induction of heart failure (HF). The search
in PubMed, Web of Science, Scopus, and the Cochrane library for studies
containing data about the occurrence of HF after TEVAR resulted in 1231
articles of which 11 fulfilled the inclusion criteria. A meta-analysis was
undertaken with the raw incidence of HF post-implantation as the primary
endpoint. This occurred, in the first 30 days, to 684 out of 30,680 total
patients (2.23%), and the raw incidence rate of HF was 0.03 [0.02-0.04],
p<0.001. The random effects model was used because the examined studies
had significant heterogeneity (I²=99.999%,
tau²=3.905x10^-4, p<0.001. In addition, significant
publication bias was observed (Egger's test z=2.156, p=0.031). HF may
develop in 30 days post-TEVAR possibly because of the increased aortic
stiffness and the subsequent heamodynamic alterations which reduce the
coronary blood supply. Thus, it may be necessary to initiate early
pharmacological intervention while further research with randomized
controlled trials with longer follow-up is warranted for the evaluation of
the incidence of HF in the long term after TEVAR. Clinical Impact: Our
meta-analysis shows that heart failure (HF) can occur in approximately 3%
of patients within 30 days after TEVAR, indicating that HF is a clinically
relevant but often under-recognized complication. Increased aortic
stiffness and subsequent heamodynamic alterations which reduce the
coronary blood supply may contribute to the development of HF. Our
findings highlight the need for careful peri- and post-operative cardiac
monitoring, particularly in patients with pre-existing cardiovascular risk
and the need for hemodynamic optimization after stent-graft
implantation.<br/>Copyright &#xa9; The Author(s) 2026

<22>
Accession Number
2042993270
Title
Effects of ginseng berry saponins on cardiorespiratory fitness in patients
with SCAD: a randomized, double-blinded, placebo-controlled trial.
Source
Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number:
1724232. Date of Publication: 2026.
Author
Ge Y.; Huan N.; Sun J.; Chao T.; Zhao X.; Wang C.
Institution
(Ge) Beijing Shijitan Hospital affiliated with Capital Medical University,
Beijing, China
(Huan, Sun, Chao, Wang) Xiyuan Hospital, China Academy of Chinese Medical
Sciences, Beijing, China
(Zhao) Jilin Ji'an Yisheng Company, Jilin, China
Publisher
Frontiers Media SA
Abstract
Background: With the development of cardiac rehabilitation (CR), the
advantages of combined Chinese and Western medicine cardiac rehabilitation
for the treatment of stable coronary artery disease (SCAD) have become
increasingly prominent. <br/>Purpose(s): This study was aimed to evaluate
the effect of Zhenyuan capsule (a Chinese patented medicine consisting of
ginseng berry saponins extracted from the mature berry of Panax Ginseng)
on cardiorespiratory fitness (CRF) in patients with SCAD, and explore
possible potential candidate molecule. Study Design and Methods: Using a
randomized, double-blind, placebo-controlled trial design, 100 patients
with SCAD were enrolled and randomly divided into the group taking
Zhenyuan capsules (test group, n = 50) and the group taking placebo
(control group, n = 50). In both groups, patients were treated with
secondary prevention medication for CHD, with the addition of 2 capsules
of Zhenyuan capsule 3 times a day for 12 weeks in the test group and 2
capsules of placebo 3 times a day for 12 weeks in the control group, with
a follow-up of 1 month after the end of treatment. Subjects completed
symptom-limited maximal cardiopulmonary exercise test (CPET) on a bicycle
ergometer at 3 time points before enrollment, after 12 weeks of treatment,
and after 1 month of follow-up. The main outcome was the increase in
metabolic equivalent. <br/>Result(s): Both at anaerobic threshold (AT)
level and at maximal level, the results of between-group comparisons
showed that the test group was significantly better than that of the
control group after treatment (AT level: 0.58 +/- 0.89 Mets vs. 0.15 +/-
1.06 Mets; maximal level: 0.69 +/- 0.92 Mets vs. 0.19 +/- 0.93 Mets) (P <
0.05). No serious adverse events occurred in patients in both groups.
Serum proteomics studies suggested that insulin-like growth factor II
(IGF2) was downregulated in a minority of responders, potentially related
to cholesterol metabolism and the PI3K-Akt pathway. <br/>Conclusion(s):
Zhenyuan capsule can significantly improve the CRF of patients with SCAD,
and the downregulation of IGF2 observed in a minority of responders
suggests IGF2 may be a potential candidate molecule of interest associated
with cholesterol metabolism and the PI3K-Akt pathway. Clinical Trial
Registration: https://www.chictr.org.cn/showproj.html?proj=53361,
identifier ChiCTR2000032818.<br/>Copyright &#xa9; 2026 Ge, Huan, Sun,
Chao, Zhao and Wang.

<23>
Accession Number
2042966699
Title
The impact of thoracic paravertebral nerve block at different positions on
pain relief in patients undergoing single-port thoracoscopic partial lung
resection: study protocol for a randomized controlled trial.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 99. Date of
Publication: 01 Dec 2026.
Author
Zhu X.; Peng P.; Guo J.; Zhang L.; Zhong H.; Zhu J.; Xie H.
Institution
(Zhu, Peng, Guo, Zhang, Zhong, Zhu, Xie) Department of Anesthesiology, The
Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road,
Jiangsu, Suzhou, China
Publisher
BioMed Central Ltd
Abstract
Background: Despite the widespread adoption of uniportal video-assisted
thoracoscopic surgery (VATS), postoperative pain associated with this
procedure remains a significant concern. Effective postoperative analgesia
is essential for facilitating the recovery of patients undergoing thoracic
surgery. Thoracic paravertebral block (TPVB) is widely recognized as an
extremely effective method of analgesia in such surgeries. Our previous
study has demonstrated that the diffusion of local anesthetic during nerve
blocks is related to body position. Therefore, this study aimed to
evaluate the impact of thoracic paravertebral nerve block in various body
positions on the analgesic outcomes for patients undergoing single-port
thoracoscopic lung resection. <br/>Method(s): A randomized controlled
trial was conducted to assess the impact of different body positions
during thoracic paravertebral nerve blocks on the analgesic effect in
patients undergoing single-port thoracoscopic partial lung resection.
Patients scheduled for thoracoscopic lung resection will be included in
this study. Participants (n = 200) will undergo thoracic paravertebral
nerve block under ultrasound guidance. After the injection of the drug,
they will be placed in either a supine position or a lateral position with
the puncture side up. The NRS scores will be assessed at 1 h, 2 h, 8 h, 12
h, 24 h, and 48 h postoperatively. Postoperative opioid consumption,
rescue analgesia time and frequency, patient satisfaction, incidence of
adverse reactions, and length of hospital stay will also be recorded.
<br/>Discussion(s): This research project mainly aimed to investigate the
impact of different perioperative positions for thoracic paravertebral
nerve block on the analgesic effects in patients undergoing single-port
thoracoscopic lung resection. The results may provide important
implications for the development of effective analgesic strategies and
robust clinical evidence to support the recovery of patients undergoing
thoracic surgery. Trial registration: ClinicalTrials.gov NCT06789276.
Registered on 10 January 2025.<br/>Copyright &#xa9; The Author(s) 2026.

<24>
[Use Link to view the full text]
Accession Number
2039444702
Title
Evaluating Outcomes of Overexpanding Versus Conventional Sizing in
Transcatheter Aortic Valve Replacement for Borderline Aortic Annulus: A
Meta-Analysis.
Source
Critical Pathways in Cardiology. 24(4) (pp e0392), 2025. Date of
Publication: 01 Dec 2025.
Author
Mustafa A.; Kaple R.; Wei C.; Dudiy Y.; Yoon S.-H.; Wengrofsky P.; Jelnin
V.; Batsides G.; Spallone R.; Elmann E.; Anderson M.; Landers D.; Basman
C.
Institution
(Mustafa, Kaple, Dudiy, Yoon, Wengrofsky, Jelnin, Batsides, Spallone,
Elmann, Anderson, Landers, Basman) From the Department of Cardiology and
Cardiothoracic Surgery, Hackensack University Medical Center, NJ, United
States
(Mustafa, Wei) Department of Cardiology and Cardiothoracic Surgery,
Northwell Health, New York, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Approximately 20%-40% of patients that present for transcatheter aortic
valve replacement with a balloon-expandable transcatheter heart valve
(THV) fall into a borderline aortic annulus size (BAAS). There are
potential benefits to overexpanding an undersized THV (OE-THV) in such
cases that include reduced electrical disturbances and annular injury at
the expense of increased paravalvular leak (PVL). We conducted a
meta-analysis of data comparing conventional-sized versus OE-THV strategy
for BAAS and reviewed the literature for balloon-expandable-THV in such
cases. 9 nonrandomized studies that compared a conventional strategy to
OE-THV in patients with BAAS were included in our study. Our findings
suggest that there is no difference in mortality, stroke, mean gradient,
or significant PVL. There was a trend towards fewer pacemakers in patients
receiving an OE-THV. Borderline aortic annulus measurements are common in
patients undergoing transcatheter aortic valve replacement and there
appears to be equipoise between conventional sizing versus OE-THV. Future
detailed studies are required to evaluate short- and long-term outcomes
among strategies.<br/>Copyright &#xa9; 2025

<25>
Accession Number
2043640409
Title
The Effect of High-Dose Atorvastatin on Postoperative Troponin in Patients
Undergoing Non-Cardiac Surgery: A Triple-Blind Randomized Clinical Trial.
Source
Journal of Tehran University Heart Center. 20(4) (pp 276-284), 2025. Date
of Publication: 2025.
Author
Aminizadeh M.J.; Mousavi S.H.; Mosaed R.; Khoshfetrat M.; Arefizdeh R.;
Askari M.; Mohsenizade S.A.
Institution
(Aminizadeh, Mousavi, Khoshfetrat, Arefizdeh, Mohsenizade) Trauma and
Surgery Research Center, AJA University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Mosaed) Department of Clinical Pharmacy, School of Medicine, AJA
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Askari) Department of Internal Medicine, School of Medicine, AJA
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Tehran Heart Center
Abstract
Background: Cardiovascular complications account for a substantial
proportion of perioperative complications. This study aimed to evaluate
whether preoperative high-dose atorvastatin reduces postoperative changes
in serum high-sensitivity cardiac troponin (hs-cTn) concentrations in
patients at elevated cardiac risk undergoing noncardiac surgery.
<br/>Method(s): In this triple-blind, parallel-group, randomized
controlled trial, adults with a Revised Cardiac Risk Index (RCRI) of 1 or
greater scheduled for noncardiac surgery were randomized (1:1) to receive
atorvastatin 80 mg 24 hours preoperatively or placebo. The primary outcome
was the change in serum hs-cTn concentrations 24 hours after surgery.
Secondary outcomes included the incidence of major adverse cardiovascular
events (MACE) within 7 days after surgery, as well as cardiovascular
death, myocardial infarction, stroke, heart failure, arrhythmia, or
transient ischemic attack. <br/>Result(s): A total of 112 patients with
similar baseline characteristics were randomized and completed a 7-day
follow-up. Postoperative hs-cTn levels increased significantly in the
placebo group (P<0.001) but decreased in the statin group (P<0.001), with
a significant between-group difference favoring statin therapy (P<0.001).
Subgroup analyses by anesthesia type and prior statin use showed
consistent findings. MACE occurred in three patients (5.4%) in the statin
group and two patients (3.6%) in the placebo group (P=1.00).
<br/>Conclusion(s): Preoperative high-dose atorvastatin significantly
reduced postoperative hs-cTn levels, indicating a biochemical
cardioprotective effect, but it did not translate into a reduction of
short-term clinical cardiovascular events. Larger multicenter trials with
longer follow-up are required to determine whether troponin reduction
translates into improved clinical outcomes.<br/>Copyright &#xa9; 2025
Tehran University of Medical Sciences. Published by Tehran University of
Medical Sciences.

<26>
Accession Number
2043091798
Title
Commentary: Transcatheter aortic valve replacement in a quadricuspid
aortic valve: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2026. Article
Number: 1660716. Date of Publication: 2026.
Author
Ruzayqat R.S.H.
Institution
(Ruzayqat) Faculty of Medicine, Hebron University, Hebron, Palestine
Publisher
Frontiers Media SA

<27>
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.

<28>
Accession Number
2043244528
Title
The Effect of anesthesia depth monitoring on postoperative delirium in
elderly patients: A systematic review and meta-analysis.
Source
Current Problems in Surgery. 76 (no pagination), 2026. Article Number:
101985. Date of Publication: 01 Mar 2026.
Author
Bi Y.; Hu Y.
Institution
(Bi) Department of Anesthesiology, Shanghai Ninth People's Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Hu) Department of Nursing, Shanghai Ninth People's Hospital, Shanghai
Jiao Tong University School of Medicine, Shanghai, China
Publisher
Elsevier Inc.

<29>
[Use Link to view the full text]
Accession Number
2043177378
Title
Long-Term Outcomes of Synchronous Versus Staged Carotid Endarterectomy and
Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis.
Source
Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date
of Publication: 2025.
Author
Moawad M.H.E.D.; Alkhawaldeh I.M.; Karawya M.; Abushanap M.M.; Abualnadi
M.; Alkabi A.; Alhamouz L.H.A.; Alkhalili H.B.A.; Zaki M.S.A.; Alattar A.;
Serag I.; Abdul-Hafez H.A.; Gadelmawla A.F.; Abouzid M.; Bisht O.
Institution
(Moawad, Karawya) From the Alexandria Main University Hospital,
Alexandria, Egypt
(Moawad) Faculty of Medicine, Suez Canal University, Ismailia, Egypt
(Alkhawaldeh, Alkabi, Alhamouz) Faculty of Medicine, Mutah University,
Al-Karak, Jordan
(Abushanap, Abualnadi) Faculty of Medicine, Hashemite University, Zarqa,
Jordan
(Alkhalili) Prince Hamza Hospital, Hashemite University, Zarqa, Jordan
(Zaki) Department of Anatomy, College of Medicine, King Khalid University,
Abha, Saudi Arabia
(Alattar) King Abdullah Medical City, Makkah, Saudi Arabia
(Serag) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Abdul-Hafez) Department of Medicine, An-Najah National University, West
Bank, Nablus, Palestine
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Gadelmawla) Medical Research Group of Egypt (MRGE), Negida Academy,
Arlington, MA
(Abouzid) Department of Physical Pharmacy and Pharmacokinetics, Faculty of
Pharmacy, Poznan University of Medical Sciences, Poznan, Poland
(Bisht) Evangelisches Herzzentrum Coswig, Coswig (Anhalt), Germany
Publisher
Lippincott Williams and Wilkins
Abstract
The management of patients with concomitant coronary artery disease and
carotid artery stenosis undergoing coronary artery bypass grafting (CABG)
remains controversial. While synchronous carotid endarterectomy (CEA) with
CABG may reduce perioperative stroke, its long-term benefit compared with
staged procedures is unclear. This study systematically reviewed and
meta-analyzed long-term outcomes of synchronous versus staged CEA with
CABG. Following Preferred Reporting Items for Systematic Reviews and
Meta-Analyses guidelines, was searched up to July 2025. Eligible studies
included randomized controlled trials and cohort studies reporting
long-term outcomes after synchronous or staged CEA/CABG. Pooled risk ratio
(RR) with 95% confidence intervals (CIs) was calculated using a
random-effects model. Twenty-five studies, including 35, 781 patients,
were analyzed, of whom 6828 underwent synchronous and 28, 953 staged
procedures. Long-term mortality was significantly lower with staged
surgery (RR: 1.26, 95% CI: 1.15-1.37, P < 0.00001, I2 = 0%). No
significant differences were observed between synchronous and staged
approaches for stroke (RR: 1.16, 95% CI: 0.75-1.77), myocardial infarction
(MI) (RR: 0.83, 95% CI: 0.54-1.28), or major adverse cardiovascular events
(MACE) (RR: 0.99, 95% CI: 0.85-1.16). Among patients undergoing
synchronous CEA/CABG, pooled long-term incidences were 14.6% for
mortality, 6.2% for stroke, 5.0% for MI, and 17.5% for MACE. Long-term
stroke, MI, and MACE rates are broadly comparable between synchronous and
staged CEA with CABG. However, staged procedures appear to provide a
survival advantage, with significantly reduced long-term mortality.
Further multicenter randomized trials are warranted to confirm these
findings and optimize patient selection.<br/>Copyright &#xa9; 2025

<30>
Accession Number
2043541334
Title
Efficacy and Safety of Transarterial Retrograde Approach in Ventricular
Septal Defect Closure: A Systematic Review and Meta-Analysis.
Source
Anatolian Journal of Cardiology. 30(1) (pp 2-8), 2026. Date of
Publication: 01 Jan 2026.
Author
Ali H.H.A.; Sayed S.B.H.; Gafoon A.A.A.; Ali M.A.; Abdelrahman N.; Saad
K.; Suliman R.; Eltayeb E.A.I.; Attallah A.
Institution
(Ali, Sayed, Gafoon, Abdelrahman, Eltayeb) MichiganUnited States
(Ali) Saudi German Hospital, Madinah, Saudi Arabia
(Saad) Department of Internal Medicine, Corewell Health Dearborn Hospital,
Michigan, United States
(Suliman) Al Rumailah Hospital, Doha, Qatar
(Attallah) Batterjee Medical College, Jeddah, Saudi Arabia
Publisher
Turkish Society of Cardiology
Abstract
Background: Transcatheter closure approaches of ventricular septal defects
(VSDs) include anterograde through the right ventricle using an
arteriovenous loop and retrograde transarterial approach. This systematic
review assesses the outcomes and complications associated with
transcatheter closure of VSD through a retrograde approach.
<br/>Method(s): PubMed was searched for articles in English on retrograde
closure of VSD from 2006 to 2024. The pooled estimates of success and
complication rates were done by the random effects model. <br/>Result(s):
A total of 11 publications comprising 482 patients with variable types of
VSD were included in this analysis. The pooled estimate of success was
89.3% (95% CI: 0.84-0.93). The most common complication is residual shunt
pooled estimated is 7.1% (95% CI: 0.02-0.20). Others included valvular
lesions pooled estimate is 6.4% (95% CI: 0.02-0.14), arrhythmias pooled
estimate is 5.5% (95% CI: 0.02-0.12), conduction abnormalities pooled
estimate rate is 5.3% (95% CI: 0.01-0.13), and death pooled estimated rate
is 2.8% (95% CI: 0.08-0.07). <br/>Conclusion(s): This analysis suggests
that transcatheter retrograde closure of VSD is safe and effective with
promising results. The limitations of this study are difficulties in
analyzing the types of devices and VSDs individually. Clear inclusion and
exclusion criteria including the patient's age, weight, VSD type, and
other features must be considered before proceeding with this
approach.<br/>Copyright@Author(s) - Available online at
anatoljcardiol.com. Content of this journal is licensed under a Creative
Commons Attribution-NonCommercial 4.0 International License.
https://creativecommons.org/licenses/by-nc/4.0/

<31>
Accession Number
2042985142
Title
Comparison of a mean arterial pressure alarm to the hypotension prediction
index in preventing intraoperative hypotension in elective moderate- to
high-risk non-cardiac surgical patients: a study protocol for a blinded,
parallel, randomized controlled trial with a non-inferiority framework.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 104. Date of
Publication: 01 Dec 2026.
Author
Mulder M.P.; Florax A.A.; Harmannij-Markusse M.; Fresiello L.; Donker
D.W.; Potters J.-W.
Institution
(Mulder, Florax, Fresiello, Donker, Potters) Cardiovascular and
Respiratory Physiology, TechMed Centre, University of Twente, Enschede,
Netherlands
(Florax, Potters) Department of Anesthesiology, Medisch Spectrum Twente,
Enschede, Netherlands
(Harmannij-Markusse) Technical Medicine, University of Twente, Enschede,
Netherlands
(Donker) Intensive Care Center, University Medical Center Utrecht,
Utrecht, Netherlands
Publisher
BioMed Central Ltd
Abstract
Background: Intraoperative hypotension is common in surgical patients and
associated with an increased risk for acute kidney injury, myocardial
injury, and 30-day mortality. To predict hypotension and thereby promote
proactive blood pressure management, a machine learning algorithm was
developed: the Hypotension Prediction Index (HPI). In clinical trials, it
proved to prevent hypotension. However, a recent observational study found
that the performance of the HPI in predicting hypotension up to 15 min in
advance was virtually identical to that of the concurrent mean arterial
pressure (MAP). This indicates that the added value of the HPI above
continuous MAP monitoring may be limited. It is hypothesized that the
effect of preventing intraoperative hypotension triggered by a MAP
threshold of 70-75 mmHg is comparable to clinical care triggered by an HPI
alarm. <br/>Method(s): This is a monocentral, blinded, randomized
controlled clinical trial, conducted in the Netherlands. Adult patients
undergoing moderate- or high-risk elective non-cardiac surgery requiring
continuous blood pressure monitoring aiming for a MAP of >=65 mmHg are
eligible for inclusion. A total of 142 participants is randomized into two
groups: in the HPI group, the monitor alarms when the HPI value exceeds
85, whereas in the MAP group, it alarms when the MAP value drops below 72
mmHg. The monitor screen is partly covered to blind treating clinicians
for the study group allocation. The primary outcome measure is the area
under the threshold of hypotension (defined as MAP < 65 mmHg for at least
1 min) during surgery. Secondary objectives are the incidence and severity
of intraoperative hypotension and hypertension, cumulative doses of
administered medication and fluids, incidence of acute kidney injury and
myocardial injury, length of hospital stay, and 30-day mortality after
surgery. <br/>Discussion(s): The decision to initiate treatment upon an
alarm is left at the discretion of the attending clinicians; if deemed
appropriate, they can also choose to ignore the alarms. Consequently,
clinical interventions could vary between participants and groups.
Contrarily, early treatment could lead to overtreatment. Trial
registration: Overview of Medical research in the Netherlands (OMON),
NL-OMON53215, registered on 20-09-2023, last updated on 30-01-2025,
https://onderzoekmetmensen.nl/nl/trial/53215.<br/>Copyright &#xa9; The
Author(s) 2025.

<32>
Accession Number
2043239690
Title
Left and right myocardial ventricular energetics during cardioplegic
ischemic arrest and reperfusion in patients undergoing cardiac surgery.
Source
Journal of Molecular and Cellular Cardiology. 213 (pp 84-92), 2026. Date
of Publication: 01 Apr 2026.
Author
Moscarelli M.; Skeffington K.L.; Fudulu D.; Punjabi P.; Emanueli C.;
Fiorentino F.; Suleiman M.-S.; Angelini G.D.
Institution
(Moscarelli) Department of Cardiovascular Surgery, Maria Eleonora
Hospital, GVM Care&Research, Palermo, Italy
(Moscarelli) Imperial College London, Department of Surgery & Cancer -
Faculty of Medicine, London, United Kingdom
(Skeffington, Fudulu, Suleiman, Angelini) Department of Cardiac Surgery,
University Hospital Bristol NHS Trust, Bristol, United Kingdom
(Punjabi) Department of Cardiothoracic Surgery, Hammersmith Hospital,
Imperial College Healthcare NHS Trust, London, United Kingdom
(Emanueli) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Fiorentino) Leeds Institute of Clinical Trials Research, University of
Leeds, Leeds, United Kingdom
Publisher
Academic Press
Abstract
Background Effective myocardial protection during cardiac surgery is
essential, yet the differential metabolic stress of the left (LV) and
right ventricles (RV) to ischemia-reperfusion remains poorly
characterized. Methods This predefined substudy of a multicenter
randomized trial conducted in the United Kingdom (ISRCTN33084113)
evaluated remote ischemic preconditioning in patients undergoing coronary
artery bypass grafting (CABG) or aortic valve replacement (AVR). Paired LV
and RV biopsies were obtained before ischemia and after reperfusion.
High-performance liquid chromatography was used to quantify metabolite
concentrations and calculate markers of energetics. Cross-clamp time and
postoperative troponin levels were recorded. Results Eighty-nine patients
were included (CABG: n = 49; AVR: n = 40). Following ischemia-reperfusion,
LV exhibited greater decline in metabolites than the RV. In CABG, this
included larger sustained fall in ATP (-0.90 vs -0.13 mumol/mg, p =
0.0032) and glutamate (-4.22 vs -1.33 mumol/mg, p = 0.0009), alongside ADP
(-0.53 vs -0.20 mumol/mg, p = 0.0196), GTP (-0.04 vs -0.01 mumol/mg, p =
0.0160), and B-NAD (-0.15 vs -0.04 mumol/mg, p = 0.0137). Computed energy
charge decreased significantly in both ventricles (LV: p = 0.0002; RV: p =
0.010), but remained stable in AVR. ATP/AMP and ATP/ADP ratios declined
more in the LV, suggesting impaired energy buffering. There was no
significant correlation between cross-clamp time and changes in energy
charge in either the LV or RV. Troponin release correlated with ischemic
time in CABG, but EC decline did not. Conclusions The LV shows greater
depletion of myocardial metabolites than the RV following
ischemia-reperfusion, particularly in CABG patients. These findings
support ventricle-specific strategies to optimize myocardial
protection.<br/>Copyright &#xa9; 2026 The Authors.

<33>
Accession Number
2043170185
Title
Assessing the impact of transcatheter edge-to-edge repair on reverse
remodeling in secondary mitral regurgitation: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 12 (no pagination), 2026. Article
Number: 1714337. Date of Publication: 2026.
Author
Lichtfusz A.; Galdzytska N.; Gergo D.; Szabo B.; Hegyi P.; Molnar Z.;
Duray G.; Papp J.
Institution
(Lichtfusz, Galdzytska, Gergo, Szabo, Hegyi, Molnar, Duray, Papp) Centre
for Translational Medicine, Semmelweis University, Budapest, Hungary
(Lichtfusz, Duray, Papp) Department of Cardiology, Central Hospital of
Northern Pest - Military Hospital, Budapest, Hungary
(Lichtfusz) Department of Cardiac Surgery, Central Hospital of Northern
Pest - Military Hospital, Budapest, Hungary
(Gergo) Department of Pharmacognosy, Semmelweis University, Budapest,
Hungary
(Hegyi) Institute for Translational Medicine, Medical School, University
of Pecs, Pecs, Hungary
(Hegyi) Institute of Pancreatic Diseases, Semmelweis University, Budapest,
Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Semmelweis
University, Budapest, Hungary
(Molnar) Department of Anesthesiology and Intensive Therapy, Poznan
University of Medical Sciences, Poznan, Poland
(Duray) Heart and Vascular Center, Semmelweis University, Budapest,
Hungary
Publisher
Frontiers Media SA
Abstract
Background and aim: Transcatheter edge-to-edge repair (TEER) is a
minimally invasive approach to reduce secondary mitral regurgitation (SMR)
in patients with heart failure. However, there is limited evidence on its
effectiveness in achieving reverse remodeling. Our aim was to assess the
effects of TEER over time and to compare the effects of TEER plus GDMT vs.
GDMT alone on echocardiographic parameters. <br/>Method(s): A systematic
search of MEDLINE, EMBASE, and CENTRAL was conducted from inception to
November 16, 2023. Eligible studies included patients with SMR treated
with TEER and echocardiographic follow-ups. We evaluated changes in left
ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic
diameter (LVESD), left ventricular end-diastolic volume (LVEDV), left
ventricular end-systolic volume (LVESV), left atrial volume (LAV), left
ventricular ejection fraction (LVEF) and NTproBNP levels. <br/>Result(s):
Of 9,290 identified studies, 38 met inclusion criteria. After TEER,
statistically significant reductions were observed in LVEDD (-1.63 mm),
LVESD (-1.20 mm), LVEDV (-14.21 mL), and LVESV (-9.24 mL). Changes in LAV
(-5.70 mL) and LVEF (+1.10%) were not statistically or clinically
meaningful. NT-proBNP decreased substantially (-1,340 pg/mL). In
comparative analyses, TEER plus GDMT did not show statistically
significant differences vs. GDMT alone for any parameter, including LVEDD
(-1.02 mm), LVEDV (-11.98 mL), LVEF (-0.14%), and LVESV (-5.29 mL). TEER
reduced grade 3-4 MR from 99% to 9%. Systematic Review Registration:
identifier CRD42023483404. <br/>Conclusion(s): TEER results in
statistically significant but clinically small changes in
echocardiographic parameters, and no clear advantage over GDMT alone.
These findings should be interpreted with caution given the high
heterogeneity and low certainty of evidence. Further studies are needed to
define which SMR patient subgroups may derive meaningful
reverse-remodeling benefit from TEER. Systematic Review Registration:
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=483404,
PROSPERO CRD42023483404.<br/>Copyright 2026 Lichtfusz, Galdzytska, Gergo,
Szabo, Hegyi, Molnar, Duray and Papp.

<34>
Accession Number
2043298837
Title
Isometric exercise training in patients with heart failure with preserved
ejection fraction: a randomized controlled study.
Source
European Journal of Preventive Cardiology. 33(2) (pp 229-237), 2026. Date
of Publication: 01 Jan 2026.
Author
Edwards J.J.; Jalaludeen N.; Shanmugam N.; Ray R.; Jouhra F.; Cheriyan J.;
Guzik P.; Marciniak A.; Sharma R.; O'Driscoll J.M.
Institution
(Edwards, Shanmugam, Ray, Jouhra, Marciniak, Sharma, O'Driscoll)
Department of Cardiology, St George's University Hospitals, NHS Foundation
Trust, Blackshaw Road, Tooting, London, United Kingdom
(Edwards) Department of Applied Sport and Exercise Science, University of
East London, London, United Kingdom
(Jalaludeen, Cheriyan) Division of Experimental Medicine &
Immunotherapeutics, Department of Medicine, School of Clinical Medicine,
University of Cambridge, Cambridge, United Kingdom
(Jalaludeen, Cheriyan) Clinical Pharmacology Department, Cambridge
University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
(Cheriyan) Cambridge Clinical Trials Unit, Cambridge University Hospitals
NHS Foundation Trust, Cambridge, United Kingdom
(Guzik) University Centre for Sports and Medical Studies, Poznan
University of Medical Sciences, Poznan, Poland
(Guzik) Department of Cardiology-Intensive Therapy, Poznan University of
Medical Sciences, Poznan, Poland
(O'Driscoll) Diabetes Research Centre, College of Life Sciences,
University of Leicester, Leicester, United Kingdom
(O'Driscoll) Leicester Diabetes Centre, Leicester General Hospital,
University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Publisher
Oxford University Press
Abstract
Aims Heart failure with preserved ejection fraction (HFpEF) is a complex
clinical condition associated with poor health-related quality of life and
high mortality rates. Limited therapeutic options highlight the need for
innovative approaches. Isometric exercise training (IET) produces
cardiovascular benefits; however, the effects of IET in patients with
HFpEF have not yet been studied. This study aimed to determine the
feasibility of an IET programme and explore safety and efficacy outcomes
in patients with HFpEF. Methods and results Medically optimized HFpEF
participants were randomized to a 4-week IET intervention (n = 19) or
usual care (n = 19). Resting haemodynamics, cardiac function, and
patient-reported outcomes were measured before and after the intervention.
Global longitudinal strain (GLS) and left atrial reservoir strain (LAr)
were assessed using 2D speckle-tracking echocardiography. Patient-reported
outcomes were evaluated using the Kansas City Cardiomyopathy Questionnaire
(KCCQ-12). 33 (87%) participants completed the study. Isometric exercise
training produced significant reductions in resting systolic (-8.52 +/-
2.7 mmHg, P = 0.003), mean (-4.94 +/- 2 mmHg, P = 0.018), and diastolic
(-4.62 +/- 1.8 mmHg, P = 0.016) blood pressure, as well as total
peripheral resistance (270.4 +/- 75.4 dyne s cm^-5, P = 0.001)
compared to usual care. Additionally, significant improvements were
observed in GLS (2.18 +/- 0.7%, P = 0.005), LAr (4.59 +/- 1.7%, P =
0.012), LA stiffness index (-0.2 +/- 0.06), and the physical limitation
subscale of the KCCQ (10.27 +/- 4.56, P = 0.032) following IET. Conclusion
Isometric exercise training is a feasible and safe therapeutic
intervention for patients with HFpEF, with cardiovascular and quality of
life improvements. A larger-scale, multi-centre study is required to
confirm findings and establish the wider utility and long-term safety of
IET in HFpEF.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<35>
Accession Number
2043367292
Title
Operating room communication and teamwork: An observational pilot study
comparing objective and perceived collaboration.
Source
Surgery (United States). 192 (no pagination), 2026. Article Number:
109719. Date of Publication: 01 Apr 2026.
Author
Armstrong V.L.; Lu P.G.; Johnson E.R.; Butterfield R.D.; Deshpande A.;
Gill V.S.; Qu Y.; Boddu S.P.; Peters D.E.; Files J.A.; Stucky C.-C.H.
Institution
(Armstrong, Lu, Johnson, Deshpande, Gill, Qu, Boddu, Stucky) Department of
Surgical Oncology, Mayo Clinic Arizona, Phoenix, AZ, United States
(Butterfield) Department of Biostatistics, Mayo Clinic Arizona,
Scottsdale, AZ, United States
(Peters) Program in Professionalism and Values, Mayo Clinic, College of
Medicine and Science, Scottsdale, AZ, United States
(Files) Department of Medicine, Mayo Clinic Arizona, Scottsdale, AZ,
United States
Publisher
Elsevier Inc.
Abstract
Background: Patient safety in the operating room requires effective
teamwork and communication. The purpose of this observational pilot study
is to identify trends and potential biases of perceived communication
effectiveness and teamwork in the operating room, such that education and
interventions can be provided for improved teamwork, patient safety, and
workplace satisfaction. <br/>Method(s): Trained observers attended
randomly assigned surgical cases over a 3-month period to analyze
effectiveness of teamwork, communication, and leadership skills among
surgeon, anesthesia, and circulating/scrub nurse teams and complete
objective surveys. Subjective surveys were completed anonymously by every
member of the team to gauge perceived teamwork, cooperation, and
communication among those present. Results were analyzed using t test and
analysis of variance. <br/>Result(s): From 14 cases, 28 objective, and 97
subjective surveys were completed. There were no differences between
objective and subjective impressions by respondent age, gender, role, or
involvement. However, when the respondent and lead surgeon were the
opposite gender, the surgeon was rated less favorably in all categories.
Cases longer than 3 hours scored lower on all categories.
Circulating/scrub staff scored greatest on completion of checklist items
(P < .0001) and communication (P < .001) while surgeons scored highest on
teamwork (P < .0001) and leadership (P < .0001). <br/>Conclusion(s):
Gender and age were not factors leading to significant differences between
subjective and objective evaluations; however, attending surgeon gender
specifically and case duration were associated with subjective
communication and teamwork scores. These results identify opportunities
for education and training to reduce bias in the operating
room.<br/>Copyright &#xa9; 2025 Elsevier Inc. All rights are reserved.

<36>
Accession Number
2043360600
Title
Comparison of intravenous dexmedetomidine and intravenous dexamethasone
for prolongation of analgesia in supraclavicular brachial plexus block: A
prospective comparative study.
Source
International Journal of Clinical Obstetrics and Gynaecology. 10(1) (pp
569-575), 2026. Date of Publication: 01 Jan 2026.
Author
Hassan S.; Bashir R.; Abbas C.Z.
Publisher
Integrated Publishers
Abstract
Background: Supraclavicular brachial plexus block provides effective
anesthesia and postoperative analgesia for upper limb surgeries. Various
intravenous adjuvants have been evaluated to enhance the quality and
duration of analgesia. Dexmedetomidine and dexamethasone, when
administered intravenously, have shown promising analgesic effects;
however, comparative evidence remains limited. <br/>Method(s): This
prospective comparative study was conducted on 80 patients (ASA physical
status I-II), aged 18-60 years, undergoing elective unilateral upper limb
surgeries under ultrasound-guided supraclavicular brachial plexus block.
Patients were randomized into two equal groups (n = 40 each). Group DEXA
received intravenous dexamethasone 0.1 mg/kg, Group DEXMED received
intravenous dexmedetomidine 1 microg/kg. All patients received 20 mL of
0.5% ropivacaine for the block. The primary outcome was time to first
rescue analgesia. Secondary outcomes included onset and duration of
sensory and motor block, postoperative VAS scores, intra-operative
hemodynamic parameters, and adverse effects. <br/>Result(s): Demographic
variables and baseline characteristics were comparable between groups. The
onset of sensory block was 10.02+/-1.16 minutes in Group DEXA and
10.45+/-1.26 minutes in Group DEXMED (p = 0.121), while onset of motor
block was 15.35+/-1.21 minutes and 15.40+/-1.24 minutes, respectively (p =
0.855). The duration of sensory block was 443.12+/-53.73 minutes in Group
DEXA and 433.62+/-51.09 minutes in Group DEXMED (p = 0.422). Motor block
duration was 392.25+/-57.45 minutes and 378.62+/-52.99 minutes,
respectively (p = 0.274). The time to first rescue analgesia was
significantly longer in Group DEXA (504.12+/-55.81 minutes) compared to
Group DEXMED (496.25+/-47.78 minutes, p = 0.046). Postoperative VAS scores
were comparable between groups, with no pain reported up to 4 hours, mild
pain at 6 hours in all patients, and severe pain at 12 hours in 10.0%
(DEXA) and 12.5% (DEXMED) of patients. Intra-operative heart rate showed a
statistically significant reduction in the DEXMED group at 5, 15, and 20
minutes; however, systolic blood pressure, diastolic blood pressure, and
SpO2 remained comparable between groups. Adverse effects were minimal,
with bradycardia and hypotension observed only in the DEXMED group,
without statistical significance. <br/>Conclusion(s): Both intravenous
dexamethasone and dexmedetomidine are effective adjuvants for
supraclavicular brachial plexus block. Intravenous dexamethasone provided
a significantly longer duration of postoperative analgesia, while
dexmedetomidine was associated with greater intra-operative heart rate
reduction but maintained overall hemodynamic stability.<br/>Copyright
&#xa9; Gynaecology Journal.

<37>
[Use Link to view the full text]
Accession Number
2032793584
Title
Factors Associated With Coronary Angiography Performed Within 6 Months of
Randomization to the Conservative Strategy in the ISCHEMIA Trial.
Source
Circulation: Cardiovascular Interventions. 17(6) (pp 457-473), 2024. Date
of Publication: 01 Jun 2024.
Author
Spertus J.A.; Broderick S.; Rockhold F.W.; Demchenko E.; Grossman G.B.;
Stone G.W.; Mancini G.B.J.; Hochman J.S.; Boden W.E.; Mavromatis K.; Doan
J.; Linefsky J.; Lee R.; Patel R.; Miller T.; Cho S.Y.; Milbrandt S.;
Shelstad D.; Banerjee S.; Kamath P.; Tejani I.; Reynolds H.R.; Newman
J.D.; Bangalore S.; Phillips L.M.; Saric M.; Abdul-Nour K.; Schley A.;
Golden H.; Stone P.H.; Osseni H.; Wiyarand C.; Douglass P.; Pomeroy H.;
Craft A.; Harvey B.; Jang J.J.; Anaya O.; Yee G.; Goold P.; Weitz S.;
Giovannone S.; Pritchard L.; Arnold S.; Gans R.; O'Keefe J.H.; Kennedy P.;
Shapiro M.D.; Ganesan S.; Schlichting D.; Naher A.; Fein S.A.; Stewart
W.L.; Torosoff M.T.; Salmi K.M.; Lyubarova R.; Mookherjee S.; Drzymalski
K.; McFalls E.O.; Garcia S.A.; Bertog S.C.; Johnson D.K.; Siddiqui R.A.;
Herrmann R.R.; Ishani A.; Hansen R.A.; Khouri M.G.; Arges K.; LeFevre M.;
Tomfohr J.; Goldberg J.L.; Byrne K.A.; Zappernick T.; Goldweit R.; Canada
S.; Kakade M.; Mieses P.; Cohen R.A.; Mirrer B.; Navarro V.; Rantinella
M.; Rodriguez J.; Mancilla O.; Winchester D.E.; Stinson S.; Kronenberg M.;
Weyand T.; Crook S.C.; Heitner J.F.; Ho J.; Khan S.; Mohamed M.; Dauber
I.M.; Soltau M.R.; Rose D.K.; Wimmer R.J.; Siegel K.E.; Derbyshire S.;
Cannan C.; Dixon M.; Leonard G.; Sudarshan S.; Heard C.; Gabriel V.;
Desire S.; Mehta P.K.; McDaniel M.; Rashid F.; Lerakis S.; Asier S.;
Quyyumi A.; Patel K.; Wenger N.K.; Hedgepeth C.M.; Gillis J.; Hurlburt H.;
Manocchia M.; Rosen A.; Moore S.; Congdon E.; Sahul Z.; Brandt G.;
Marchelletta N.; Wippler K.; Leung S.; Reda H.; Ziada K.; Setty S.;
Halverson K.E.; Roraff C.; Thorsen J.; Barua R.S.; Ojajuni A.; Olurinde
O.; Surineni K.; Hage F.; Valaiyapathi B.; Davies J.E.; Leesar M.; Heo J.;
Iskandrian A.; Al Solaiman F.; Dajani K.; Kartje C.M.; El-Hajjar M.;
Mesropian P.D.; Sacco J.; Rawlins M.; McCandless B.; Thomson J.; Orgera
M.; Sidhu M.S.; Rogge M.C.; Arif I.; Bunke J.; Kerr H.; Unterbrink K.;
Fannon J.; Burman C.; Trejo J.F.; Dubin M.F.; Fletcher G.; Lane G.E.;
Neeson L.M.; Parikh P.P.; Pollak P.M.; Shapiro B.P.; Landolfo K.;
Gemignani A.; Beaudry S.; O'Rourke D.; Meadows J.L.; Tirado S.A.; Halliday
J.; Julian P.; Call J.T.; Lane S.M.; Stanford J.L.; Hannan J.; Bojar R.;
Arsenault P.; Kumar D.; Sigel P.; Mukai J.; Martin E.T.; Brooks M.;
Vorobiof G.; Douangvila L.; Gevorgyan R.; Moor-Man A.; Ranjbaran F.; Smith
B.; Ohmart C.; Kinlay S.; Hamburger R.J.; Rocco T.P.; Ly S.; Bhatt D.L.;
Quinn M.C.; Croce K.; Temiyasathit S.; Quin J.A.; Do J.; Anumpa J.; Tobin
D.; Zenati M.; Faxon D.P.; Rayos G.; Langdon J.; Bayer M.W.; Seedhom A.;
O'Malley A.; Sullenberger L.; Orvis E.; Kumkumian G.; Murphy M.; Greenberg
A.; Iraola M.; Sedlis S.P.; Maranan L.C.; Donnino R.M.; Lorin J.;
Tamis-Holland J.E.; Malinay A.; Kornberg R.; Leber R.; Saba S.; Edillo
C.P.; Lee M.W.; Small D.R.; Nona W.; Alexander P.B.; Rehman I.; Badami U.;
Ostrander A.; Wasmiller S.; Marzo K.; Drewes W.; Patel D.; Robbins I.H.;
Levite H.A.; White J.M.; Shetty S.; Hallam A.; Patel M.; Hamroff G.S.;
Spooner B.J.; Hollenweger L.M.; Little R.W.; Little H.; Zimbelman B.D.;
Little T.; Lui C.Y.; Eskelson N.A.; Smith B.R.; Vezina D.P.; Khor L.L.;
Abraham J.D.; Bull D.A.; McKellar S.H.; Booth D.; Taul Y.; Kotter J.;
Rodgers C.; Abdel-Latif A.; Isaacs J.; Bulkley V.; Hu B.; Kaneshiro R.;
Labovitz A.J.; Berlowitz M.; Kirby B.J.; Rogal P.; Tran N.N.; McFarren C.;
Jahrsdorfer C.; Matar F.; Caldeira C.; Maron D.J.; Rodriguez F.; Yunis R.;
Schnittger I.; Patro J.; Fearon W.F.; Deedwania P.; Vega A.; Reddy K.;
Sweeny J.; Bloise-Adames H.; Jimenez S.; Vrestil N.S.; Bhandari R.;
Spizzieri C.; Schade D.; Yost R.; Hochberg C.P.; Beardsley P.; Fine D.;
Salerno W.D.; Tancredi J.; Arakelian P.; Mathus S.; O'Neill D.; Wyman R.;
Burkhardt J.; Hosino S.; Lubyanaya O.A.; Salas J.D.; Zarka A.; Aguirre M.;
Shah A.V.; Dhawan M.; Parra D.; Tran T.; Haldis T.; Fowler-Lehman K.;
Spitzer N.; Riedberger C.; Weick C.; Kohn J.A.; Girotra S.; Drum C.;
Miller-Cox K.; Ollinger A.; Almousalli O.; Capasso-Gulve E.; Loehr A.M.;
Mosley M.; Krishnam M.S.; Heydari S.; Mil-Liken J.C.; Lundeen A.M.; Patel
P.M.; Karanjah E.; Seto A.H.; Marfori W.C.; Harley K.T.; Hernandez-Rangel
E.; Gibson M.A.; Singh P.; Allen B.J.; Coram R.; Webb A.M.; Fridell E.;
Wilson H.; Thomas S.; Kim A.; Schwartz R.G.; Wilmot P.; Chen W.; El
Shahawy M.; Stevens R.; Stafford J.; Black L.; Abernethy W.B.; Hull A.B.;
Lim O.J.; Tucker H.C.; Putnam N.C.; Hall L.L.; Cauthren T.; Tucker T.;
Zurick A.; Horton H.; Orga J.; Meyer T.M.; White J.R.; Morford R.G.;
Baumann C.; Rutkin B.; Seeratan V.; Bokhari S.; Jimenez M.; Sokol S.I.;
Schultz C.; Meisner J.; Russo J.; Hamzeh I.; Misra A.; Huda Z.; Wall M.;
Boan A.; De Rosen V.L.; Alam M.; Turner M.C.; Hinton C.R.; Mulhearn T.J.;
Good A.P.; Archer B.A.; Dionne J.S.; Allardyce C.A.; Sikora L.N.; Czerniak
J.H.; Mull J.A.; Ferguson E.; Laube F.; Shammas N.W.; Shammas G.A.;
Christensen L.; Park H.; Chilton R.; Hecht J.; Nguyen P.K.; Vo D.; Hirsch
J.; Jezior M.; Bindeman J.; Salkind S.; Desimone L.-A.; Gordon P.C.;
Felix-Stern L.; Crain T.; Gomes J.; Gordon C.; Stenberg R.; Mann A.;
McCreary T.; Pedalino R.P.; Cobos S.E.; Dwyer R.R.; Espinosa D.; Quiles
K.J.; Wiesel J.; Juang G.J.; Gopaul C.; Hultberg K.; Huk T.; Hussain A.;
Al-Amoodi M.; Zambrano Y.; Rodriguez S.M.; Milner T.; Wohns D.; Mulder A.;
Van Oosterhout S.; Lader E.W.; Meyer M.; Mumma M.; Clapp N.L.; Barrentine
H.; Dharmarajan L.; Jose J.M.; Manchery J.; McGarvey J.F.X.; McKinney V.;
Schwarz L.; Downes T.R.; Kaczkowski S.M.; Luckasen G.J.; Jaskowiak A.J.;
Klitch J.; Cheong B.; Dees D.; Potluri S.; Vasquez P.; Mastouri R.A.;
Breall J.A.; Hannemann E.L.; Revtyak G.E.; Foltz J.M.; Bazeley J.W.;
DeRosa E.; Jorgenson B.; Riestenberg-Smith J.; Giedd K.; Old W.; Bariciano
R.; Burt F.; Sokhon K.; Waldron J.; Mayon M.; Gopal D.; Valeti U.S.;
Peichel G.A.; Kobashigawa J.; Starks B.; Garcia L.; Thottam M.; Anand A.;
Govindan S.C.; Raj J.; Nair R.G.; Ravindran R.; Rajalekshmi V.S.;
Manjunath C.N.; Nataraj N.; Moorthy N.; Nayak S.; Manjunath S.C.;
Mylarappa M.; Narayanappa S.; Pandit N.; Bajaj S.; Nath R.K.; Yadav V.;
Mishra G.; Dwivedi S.K.; Tewari R.; Narain V.S.; Mishra M.; Chandra S.;
Patel S.; Wander G.S.; Tandon R.; Ralhan S.; Kaur B.; Aslam N.; Gupta S.;
Pharmacy B.; Goyal A.; Bhargava B.; Suvarna C.; Karthikeyan G.;
Ramakrishnan S.; Seth S.; Yadav R.; Singh S.; Roy A.; Parakh N.; Verma
S.K.; Narang R.; Mishra S.; Naik N.; Sharma G.; Choudhary S.K.; Patel C.;
Gulati G.; Sharma S.; Bahl V.K.; Mathew A.; Kurian B.M.; Punnoose E.;
Gadkari M.A.; Karwa S.R.; Gadage S.; Kolhe S.; Pillay T.U.; Satheesh S.;
Vindhya R.J.; Jain P.; Seth A.; Meharwal Z.S.; Mathur A.; Verma A.; Bhatia
M.; Sachdeva A.; Devi T.I.; Jungla N.; Rani K.M.; Menon R.; Reddy M.S.;
Oomman A.; Sidh R.R.; Mao R.; Ramakrishnan T.; Solomon H.; Francis R.;
Priya V.P.; Khan S.P.; Preethi K.; Kumar N.; Grant P.; Hande S.; Sonawane
P.; Kachru R.; Dubey A.; Rawat K.; Kumar A.V.K.; Ganapathi S.; Jayakumar
K.; Vineeth C.P.; Sivadasanpillai H.; Chacko M.; Sasidharan B.; Babu S.;
Kapilamoorthy T.R.; Christopher J.; Reddy S.; Polamuri P.; Rani M.; Kaul
U.; Arambam P.; Singh B.; Senior R.; Fox K.A.A.; Carruthers K.; Elghamaz
A.; Gurunathan S.; Karogiannis N.; Young G.M.; Shah B.N.; Kinsey C.;
Trimlett R.H.J.; Kavalakkat R.; Rubens M.B.; Evans J.; Nicol E.D.; Hassan
I.; Mittal T.K.; Hampson R.; Gamma R.A.; Williams S.; Holland K.; Swan K.;
de Belder M.A.; Atkinson B.; Thambyrajah J.; Nageh T.; Kunhunny S.; Davies
J.R.; Lindsay S.J.; Atkinson C.; Kurian J.; Krannila C.; Jamil H.; Vinod
M.; Raheem O.; Hoye A.; Chaytor L.; Cox L.; Morrow J.; Rowe K.; Donnelly
P.; Kelly S.; Valecka B.; Regan S.; Turnbull D.; Chauhan A.; Fleming C.;
Ghosh A.; Gratrix K.; Preston S.; Barr C.; Cartwright A.; Alfakih K.;
Knighton A.; Byrne J.; Martin K.; Webb I.; Henriksen P.; Flint L.;
Harrison J.; OKane P.; Lake-Man N.; Ljubez A.; de Silva R.; Conway D.S.G.;
Wright J.; Exley D.; Sirker A.A.; Andiapen M.; Richards A.J.; Hoole S.P.;
Wong L.; Witherow F.N.; Munro M.J.; Harbinson M.; McEvoy M.; Walsh S.; Bao
B.; Brown C.; Douglas H.; Luckie M.; Charles T.; Kolakaluri L.; Phillips
H.; Sobolewska J.; Morby L.; Hallett K.; Corbett C.; Winstanley L.;
Jeetley P.; Smit A.; Patel N.; Kotecha T.; Travill C.; Gent S.; Karimullah
I.; Hussain N.; Al-Bustami M.; Braganza D.; Haines F.; Taaffe J.;
Henderson R.; Burton J.; Pointon K.; Colton M.; Naik S.; King R.; Mathew
T.; Brown A.; Docherty A.; Berry C.; McCloy L.; Collison D.; Robb K.;
Roditi G.; Paterson C.; Crawford W.; Kelly J.; McGregor L.; Moriarty A.J.;
Mackin A.; Glover J.D.; Knight J.P.; Pradhan J.; Mikhail G.; Bose T.;
Francis D.P.; Dzavik V.; Proietti A.; Brousseau M.; Corfias M.; Blaise P.;
Harvey L.; Diaz A.; Rheault P.; Barrero M.; Gagne C.-E.; Alarie P.;
Pepin-Dubois Y.; Arcand L.; Costa R.; Roy I.; Sia Y.T.; Montpetit E.;
Lemay C.; Gisbert A.; Gervais P.; Rheault A.; Drouin K.; Phaneuf D.C.;
Bergeron C.; Gosselin G.; Shelley C.; Masson C.; Garg P.; Carr S.; Bone
C.; Chow B.J.W.; Moga E.; Hessian R.C.; Kourzenkova J.; Beanlands R.S.;
Walter O.; Davies R.F.; Bainey K.R.; Hogg N.; Welsh S.; Bagai A.; Wald R.;
Goodman S.; Graham J.J.; Peterson M.; Bello O.; Chow C.-M.; Abramson B.;
Cheema A.N.; Syed I.; Vakani M.T.; Hussain M.; Kushniriuk K.; Cha J.; Otis
J.; Otis R.; Howarth A.G.; Seib M.M.; Rivest S.M.; Sandonato R.; Chow J.;
Starovoytov A.; Uchida N.; Meadows N.; Uxa A.; Asif N.; Tavares S.;
Galiwango P.; Bozek B.; Kassam S.; Shier M.; Mukherjee A.; Larmand L.-A.;
Ricci A.J.; Janmohamed A.; Hart B.; Lam A.; Marucci J.; Tai S.; Mehta S.;
Brons S.; Beck C.; Wong G.; Etherington K.; Arumairajah T.; Udell J.;
Aprile M.; Karlsson S.; Webber S.; Genereux P.; Mercure C.; Hameed A.;
Aedy N.; Daba L.; Farquharson F.; Siddiqui A.; Lopes R.D.; Hueb W.;
Takiuti M.E.; Rezende P.C.; Silva E.E.R.; Hueb A.C.; Smanio P.E.P.;
Caetano L.P.; de Quadros A.S.; Kalil R.A.K.; Deiro A.P.; da Costa Vieira
J.L.; Muller A.M.; Grossmann G.; de Moraes M.A.P.; de Oliveira P.P.;
Ascoli B.M.; Bridi L.; Poletti S.Z.; Savaris S.; Vitola J.V.; Cerci R.J.;
Zier S.S.; Farias F.R.; Veiga V.; Fernandes M.M.; Marin-Neto J.A.; Schmidt
A.; de Oliveira Lima Filho M.; da Cunha D.F.; Oliveira R.M.; Chierice
J.R.A.; Polanczyk C.A.; Rucatti G.G.; Furtado M.V.; Igansi F.; Smidt L.F.;
Haeffner M.P.; Carvalho A.C.; Almeida V.; Pucci G.; de Souza G.S.; Lyra
F.; Alves A.R.; Almeida M.; dos Santos V.; Dracoulakis M.D.A.; Oliveira
N.S.; Lima R.G.S.D.; Figueiredo E.; Azevedo B.E.P.; Caramori P.R.; Santos
M.B.; Germann A.; Gomes V.; Homem R.; Magedanz E.; Tumelero R.; Laimer R.;
Tognon A.; Dall'Orto F.; Mesquita C.T.; Santos R.P.; Colafranseschi A.S.;
Oliveira A.C.; Carvalho L.A.; Palazzo I.C.; Sousa A.S.; da Silva E.E.R.;
de Barros e Silva P.G.M.; Okada M.Y.; de Padua Silva Baptista L.; Batista
A.P.; Rodrigues M.J.; Rabaca A.N.; de Resende M.V.C.; Saraiva J.F.; Trama
L.M.; de Souza Ormundo C.T.; Vicente C.; Costantini C.; Pinheiro C.; Komar
D.; Ruzyllo W.; Demkow M.; Pracon R.; Kepka C.; Teresinska A.; Walesiak
O.; Kryczka K.; Malinowska K.; Henzel J.; Solecki M.; Kaczmarska E.;
Mazurek T.; Maksym J.; Wojtera K.; Fojt A.; Szczerba E.; Drozdz J.;
Czarniak B.; Frach M.; Szymczyk K.; Niedzwiecka I.; Sobczak S.; Ciurus T.;
Jakubowski P.; Misztal-Teodorczyk M.; Teodorczyk D.; Swiderek M.; Fratczak
A.; Wojtala E.; Szkopiak M.; Lebioda P.; Wlodarczyk M.; Plachcinska A.;
Kusmierek J.; Miller M.; Marciniak H.; Wojtczak-Soska K.; Luczak K.;
Tarchalski T.; Cichocka-Radwan A.; Szwed H.; Karwowski J.; Szulczyk G.A.;
Witkowski A.; Kukula K.; Celinska-Spodar M.; Zalewska J.; Gajos G.; Bury
K.; Pruszczyk P.; Labyk A.; Roik M.; Szramowska A.; Zdonczyk O.;
Loboz-Grudzien K.; Jaroch J.; Sokalski L.; Brzezinska B.; Lesiak M.;
Lanocha M.; Reczuch K.W.; Kolodziej A.; Kalarus Z.; Swiatkowski A.; Szulik
M.; Musial W.J.; Marcinkiewicz-Siemion M.; Bockeria O.; Bockeria L.;
Petrosyan K.; Kudzoeva Z.; Trifonova T.; Aripova N.; Chernyavskiy A.M.;
Naryshkin I.A.; Kretov E.I.; Kuleshova A.; Grazhdankin I.O.; Malaev D.;
Bershtein L.L.; Sayganov S.A.; Subbotina I.; Kuzmina-Krutetskaya A.M.;
Gumerova V.; Zbyshevskaya E.V.; Katamadze N.O.; Demchenko E.A.; Nikolaeva
O.B.; Kozlov P.S.; Kozulin V.Y.; Lubinskaya E.I.; Lopez-Sendon J.L.;
Lopez-Sendon J.; Fernandez-Figares V.; Castro A.; Salicio E.R.; Guzman G.;
Galeote G.; Valbuena S.; Peteiro J.; Martinez-Ruiz M.D.; Perez-Fernandez
R.; Blanco-Calvo M.; Cuenca-Castillo J.J.; Alonso-Alvarez E.; Flores-Rios
X.; Garcia-Gonzalez P.; Prada-Delgado O.; Barge-Caballero G.; Juanatey
J.R.G.; Amigo J.S.; Bayarri M.S.; Nunez V.P.; Sanchez R.O.; Alvarez B.C.;
Gil C.P.; Monzonis A.M.; Sionis A.; Martinez A.F.; Perales M.V.; Padro
J.M.; Penaranda A.S.; Picart J.G.; Iglesias A.G.; Marimon X.G.-M.; Llado
G.P.; Costa F.C.; Miro V.; Igual B.; Diez J.L.; Calvillo P.; Ortuno F.M.;
Chavarri M.V.; Giner M.Q.; Montolliu A.T.; Aniorte A.I.R.; Bermudez E.P.;
Caravaca J.M.R.; De La Morena G.; Blancas M.G.; Canavate O.; Guerrero S.;
Riera S.; Luena J.E.C.; Lasala M.; Fernandez-Aviles F.; Lorenzo M.;
Sobrino O.; Vazquez A.; Jiang L.; Chen J.; Dong H.; He P.; Xia C.; Yang
J.; Zhong Q.; Wu Y.; Tian Y.; Li D.; Ma Y.; Yang Y.; Ma X.; Yu Z.; Zhao
Q.; Ji Z.; Li C.; Zhu B.; Yang X.; Chen M.; Chi H.; Zhang J.; Lin W.; Jing
R.; Liu J.; Zeng H.; Zhou Q.; Xu C.; Li Z.; Xiong L.; Fu X.; Gao D.; Jiang
D.; Leng R.; Yuan Q.; Zhang L.; Bai Z.; Li J.; Qi J.; Wang F.; Wang H.;
Yang B.; Yue Z.; Zhang Z.; Wang S.; Dong Y.; Mao J.; Zhang B.; Cheng G.;
Li X.; Yao X.; Zhong N.; Zhou N.; Huang Y.; Zhou P.; Fang X.; Su W.; Zeng
Q.; Kunwu Y.; Peng Y.; Su X.; Wang C.; Zhao Y.; Li Q.; Geng Y.; Wang Y.;
Nie S.-P.; Fan J.-Y.; Feng S.-T.; Wang X.; Yan Y.; Zhang H.-M.; Yu Q.; Chi
L.; Liu F.; Chen H.; Jiang J.; Li H.; Wang J.; Han Y.; Xu L.; Zhang S.;
Liu Z.; Chen G.; Hu R.; Perna G.P.; Pietrucci F.; Marini M.; Gabrielli G.;
Provasoli S.; Di Donato A.; Verna E.; Monti L.; Nardi B.; Di Chiara A.;
Pezzetta F.; Mortara A.; Casali V.; Galvani M.; Attanasio C.; Ottani F.;
Sicuro M.; Leone G.; Pisano F.; Bare C.; Calabro P.; Fimiani F.; Formisano
T.; Tarantini G.; Barioli A.; Cucchini U.; Ramani F.; Andres A.L.; Racca
E.; Rolfo F.; Goletto C.; Briguori C.; De Micco F.; Amati R.; Di Marco S.;
Vergoni W.; Tricoli M.; Russo A.; Villella M.; Fanelli R.; Poh K.-K.; Chai
P.; Lau T.; Loh J.P.; Tay E.L.; Teoh K.; Tan S.-Y.V.; Teo L.L.; Sia W.C.;
Ong C.-C.; Leong A.W.; Wong R.C.; Loh P.-H.; Kofidis T.; Chan W.X.; Chan
K.H.; Foo D.; Yan L.H.; Kong J.L.K.; Er C.M.; Jafary F.-H.H.; Chua T.;
Ismail N.; Kyaw M.T.; Yip D.; Doerr R.; Stumpf J.; Grahl D.; Matschke K.;
Guenther F.; Simonis G.; Bonin K.; Kadalie C.T.; Sechtem U.; Wenzelburger
I.; Ong P.; Gruensfelder S.; Schulze P.C.; Goebel B.; Lenk K.; Nickenig
G.; Sinning J.-M.; Weber M.; Werner N.; Schuchlenz H.; Steinmaurer G.;
Weikl S.; Lang I.M.; Winter M.-P.; Andric T.; Huber K.; Maximilian T.;
Gabriele J.-K.; Claudia W.; Bernhard J.; Florian E.; Keltai M.; Vertes A.;
Sebo J.; Davidovits Z.; Matics L.; Varga A.; Agoston G.; Fontos G.; Dekany
G.; Merkely B.; Bartykowszki A.; Maurovich-Horvat P.; Kerecsen G.; Jakal
A.; Hinic S.; Djokic J.; Zdravkovic M.; Mudrenovic V.; Crnokrak B.;
Beleslin B.D.; Boskovic N.N.; Djordjevic-Dikic A.D.; Petrovic M.T.; Giga
V.L.; Dobric M.R.; Stepanovic J.J.; Markovic Z.Z.; Mladenovic A.S.;
Cemerlic-Adjic N.; Velicki L.; Pupic L.; Davidovic G.; Simovic S.M.; Vucic
R.; Dekleva M.N.; Martinovic M.S.; Stevanovic G.; Stankovic G.; Dobric M.;
Apostolovic S.; Martinovic S.S.; Stanojevic D.; Escobedo J.; de
Jesus-Perez R.; Juarez B.; Baleon-Espinosa R.; Campos-Santaolalla A.S.;
Duran-Cortes E.; Flores-Palacios J.M.; Garcia-Rincon A.; Jimenez-Santos
M.; Penafiel J.V.; Ortega-Ramirez J.A.; Valdespino-Estrada A.; Rosas E.A.;
Brassetti M.F.C.; Anaya D.A.V.; Garcia M.P.; Juarez I.E.C.; Rovalo M.M.;
Rodriguez E.D.M.; Selvanayagam J.B.; Rankin J.; Murphy D.; Lee S.; Joseph
M.X.; Thomas P.; Thambar S.T.; Chaplin M.D.; Boer S.C.; Beltrame J.F.;
Stansborough J.K.; Black M.; Hillis G.S.; Bonner M.M.; Ireland K.F.;
Venn-Edmonds C.; Steg P.-G.; Thobois C.; Thuaire C.; Tachot E.; Dutoiu T.;
Laure C.; Vassaliere C.; Steg P.G.; Abergel H.; Juliard J.-M.; Fuentes A.;
Slama M.S.; Eliahou L.; Mahmoud R.E.; Dubourg O.; Michaud P.; Nicollet E.;
Hadjih S.; Goube P.; Brito P.; Barone-Rochette G.; Furber A.; Cornet C.;
Biere L.; Rautureau J.; Juceviciene A.; Kalibataite-Rutkauskiene I.;
Keinaite L.; Laucevicius A.; Laukyte M.; Celutkiene J.; Mikolaitiene G.;
Smigelskaite A.; Tamasauskiene I.; Urboniene A.; Kedhi E.; Timmer J.;
Bouwhuis I.; Hermanides R.; Nijmeijer L.; Kaplan E.; Riezebos R.K.; Samadi
P.; Schoep J.J.M.; van Dongen E.; Janzen E.M.; Niehe S.R.; Suryapranata
H.; Ahoud S.; van Vugt S.; Ramos R.; Cacela D.; Santana A.; Fiarresga A.;
Sousa L.; Marques H.; Patricio L.; Selas M.; Bernanrdes L.; Silva F.; Rio
P.; Freixo C.; Carvalho R.; Ferreira R.; Silva T.; Rodrigues I.; Modas P.;
Portugal G.; Fragata J.; Pinto F.J.; Cabrita I.Z.; Menezes M.N.; Rocha A.;
Lopes G.C.; Figueiras F.P.; Almeida A.G.; Coelho A.; Silva P.C.; Capinha
M.; Nobre A.; Caetano M.I.; Francisco A.R.; Silva S.; Ferreira N.; Lopes
R.L.; Diaz R.; Guzman L.; Tinnirello V.; Figal J.C.; Mungo M.N.; Mendiz
O.; Cortes C.; Favaloro R.R.; Alvarez C.; Garcia M.; Courtis J.; Godoy V.;
Zeballos G.; Schiavi L.; Actis M.V.; Rubio M.; Scaro G.; Devlin G.P.; Low
L.; Fisher R.; Scales J.; Abercrombie K.; Stewart R.A.H.; Howell L.;
Patten C.; Benatar J.; Kedev S.; Mitevska I.P.; Kostovska E.S.; Pejkov H.;
Held C.; Eggers K.; Frostfelt G.; Bjorklund C.; Johnston N.; Andreasson
M.; Olsowka M.; Essermark M.; Akerblom A.; Soveri I.; Aspberg J.; Persson
L.; Beyar R.; Nikolsky E.; Sharir T.; Harel O.; Elian D.; Kerner A.;
Bentzvi M.; Massalha S.; Helmer L.; Fukuda K.; Ueda I.; Kohsaka S.; Fujita
J.; Yasuda S.; Furukawa A.; Nagai T.; Otsuka F.; Nishimura S.; Nakano S.;
Goetschalckx K.; Robesyn V.; Van de Werf F.; Claes K.; Hung C.-L.; Yang
Y.-H.; Yun C.-H.; Hou C.J.-Y.; Kuo J.-Y.; Yeh H.-I.; Hung T.-C.; Li J.-Y.;
Chien C.-Y.; Tsai C.-T.; Liu C.-C.; Yu F.-C.; Lin Y.-H.; Lan W.-R.; Yen
C.-H.; Tsai J.-P.; Sung K.-T.; Ntsekhe M.; Pandie S.; Philander C.;
Viljoen C.A.; Mtana N.; De Andrade M.; Maggioni A.P.; Moccetti T.; Anesini
A.; Rossi M.G.; Maspoli S.; Mombelli M.; Abdelhamid M.; Talaat A.; Adel
A.; Kamal A.; Mahrous H.; El Kaffas S.; El Fishawy H.; Pop C.; Claudia M.;
Popescu B.A.; Ginghina C.; Rosca M.; Deleanu D.; Beladan C.C.; Iliescu
V.A.; Al-Mallah M.H.; Zahrani S.; Aljzeeri A.; Najm H.; Alghamdi A.; Ramos
W.E.M.; Davila M.A.M.; Kuanprasert S.; Prommintikul A.; Nawarawong W.;
Khwakhong S.; Woragidpoonpol S.; Chaiyasri A.; Tepsuwan T.; Mekara W.;
Taksaudom N.; Kulthawong S.; Rimsukcharoenchai C.; Amaritakomol A.;
Euathrongchit J.; Wannasopha Y.; Yamwong S.; Panpunuan P.; Sritara P.;
Aramcharoen S.; Meemuk K.; White H.D.; Alsweiler C.; Khairuddin A.;
Mokhtar N.S.; Hadi H.A.; Basri N.A.; Yahaya S.A.; Yusnida I.; Hashim H.;
Bugiardini R.
Institution
(Pracon, Ruzyllo) National Institute of Cardiology, Warsaw, Poland
(Spertus) Saint Luke's Mid America Heart Institute, University of
Missouri-Kansas City, Durham, NC, United States
(Broderick, Rockhold) Duke Clinical Research Institute, Durham, NC, United
States
(Bangalore, Newman, Reynolds, Hochman) Cardiovascular Clinical Research
Center, New York University Grossman School of Medicine, Durham, NC,
United States
(Rockhold) Department of Biostatistics and Bioinformatics, Duke University
School of Medicine, Durham, NC, United States
(Demchenko) Almazov National Medical Research Centre, Saint Petersburg,
Russian Federation
(Nageh) Southend University Hospital, United Kingdom
(Grossman) Moinhos de Vento Hospital, Porto Alegre, Brazil
(Grossman) Cardionuclear Clinic, Porto Alegre, Brazil
(Mavromatis) Emory University, Atlanta VA Healthcare System, GA, United
States
(Manjunath) Sri Jayadeva Institute of Cardiovascular Sciences and
Research, Bengaluru, India
(Smanio) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
(Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Mancini) Center for Cardiovascular Innovation, The University of British
Columbia, Vancouver, Canada
(Boden) VA New England Healthcare System, Boston University School of
Medicine, MA, United States
(Maron) Department of Medicine, Stanford University, CA, United States
(Boden, Mavromatis, Doan) Atlanta VA Medical Center, Decatur, GA, United
States
(Linefsky, Lee, Patel, Miller, Cho) Mayo Clinic, Rochester, MN, United
States
(Milbrandt, Shelstad, Banerjee, Kamath) V.A. North Texas Health Care
System, Dallas, TX, United States
(Tejani) NYU Langone Medical Center-Bellevue Hospital, New York, NY,
United States
(Reynolds, Newman, Bangalore, Donnino, Phillips, Saric, Abdul-Nour,
Schley) Henry Ford Health System, Detroit, MI, United States
(Golden, Stone, Osseni) Brigham & Women's Hospital, Harvard Medical
School, Boston, MA, United States
(Wiyarand, Douglass, Pomeroy, Craft, Harvey, Jang, Anaya) Kaiser
Permanente San Jose, San Jose, CA, United States
(Yee, Goold, Weitz, Giovannone) Cardiology Associates of Schenectady P.C.,
Schenectady, NY, United States
(Pritchard, Arnold, Gans) Saint Luke's Hospital, Kansas City, MO, United
States
(O'Keefe, Kennedy, Shapiro, Ganesan) Oregon Health & Science University,
Portland, OR, United States
(Schlichting, Naher) Albany Medical Center Hospital, Albany, NY, United
States
(Fein, Stewart, Torosoff, Salmi, Lyubarova, Mookherjee, Drzymalski,
McFalls) Minneapolis VAMC, Minneapolis, MN, United States
(Garcia, Bertog, Johnson, Siddiqui, Herrmann, Ishani, Hansen, Khouri,
Arges) Duke University Medical Center, Durham, NC, United States
(LeFevre, Tomfohr, Goldberg, Byrne) Louis Stokes Cleveland Veterans
Affairs Medical Center, Cleveland, OH, United States
(Zappernick, Goldweit, Canada) Englewood Hospital and Medical Center,
Englewood, NJ, United States
(Kakade) NYU-HHC Woodhull Hospital, Brooklyn, NY, United States
(Mieses, Cohen, Mirrer, Navarro, Rantinella, Rodriguez, Mancilla,
Winchester, Stinson) Malcom Randall VAMC, Gainesville, FL, United States
(Kronenberg, Weyand) Vanderbilt University Medical Center, Nashville, TN,
United States
(Rogal, Crook, McFarren, Heitner, Ho) New York -Presbyterian/Brooklyn
Methodist Hospital, Brooklyn, NY, United States
(Khan, Mohamed, Dauber, Soltau) South Denver Cardiology Associates, P.C.,
Littleton, CO, United States
(Rose, Wimmer, Siegel, Derbyshire, Cannan, Dixon) Providence Heart and
Vascular Institute, Portland, OR, United States
(Leonard, Sudarshan, Heard) Wichita Falls Heart Clinic, Wichita Falls, TX,
United States
(Gabriel, Desire, Mehta) Emory University, Atlanta, GA, United States
(McDaniel, Rashid, Lerakis, Asier, Quyyumi, Patel, Wenger, Hedgepeth,
Gillis) Kent Hospital, Warwick, RI, United States
(Hurlburt, Manocchia, Rosen, Moore, Congdon, Sahul, Brandt) Michigan
Heart, PC, Ypsilanti, MI, United States
(Marchelletta, Wippler, Booth, Taul) University of Kentucky, Lexington,
KY, United States
(Leung, Isaacs, Abdel-Latif, Bulkley, Reda, Rodgers, Ziada, Setty,
Halverson) Gundersen Lutheran Medical Center, La Crosse, WI, United States
(Roraff, Thorsen, Barua, Ojajuni) Kansas City VA Medical Center, Kansas
City, MO, United States
(Olurinde, Surineni, Hage, Valaiyapathi) UAB Vascular Biology and
Hypertension Program, Birmingham, AL, United States
(Caldeira, Davies, Leesar, Heo, Iskandrian, Al Solaiman, Singh, Dajani,
Kartje) Loyola University Medical Center, Maywood, IL, United States
(El-Hajjar) Samuel Stratton VA Medical Center of Albany NY, Albany, NY,
United States
(Mesropian, Sacco, Rawlins, McCandless, Thomson, Orgera, Sidhu, Rogge)
Cincinnati VA Medical Center, Cincinnati, OH, United States
(Arif, Bunke, Kerr, Unterbrink, Fannon, Burman, Trejo, Dubin) Mayo Clinic
Florida, Jacksonville, FL, United States
(Fletcher, Lane, Neeson, Parikh, Pollak, Shapiro, Landolfo, Gemignani,
Beaudry) VAMC-White River Junction, White River Junction, VT, United
States
(O'Rourke, Meadows, Tirado) VA Connecticut Healthcare System, West Haven,
CT, United States
(Halliday, Julian, Call, Lane) Winchester Cardiology and Vascular
Medicine, PC, Winchester, VA, United States
(Stanford, Hannan) Saint Vincent Hospital, Worcester Medical Center,
Worcester, MA, United States
(Bojar, Arsenault, Kumar, Sigel, Mukai, Martin, Brooks) Oklahoma Heart
Institute, Tulsa, OK, United States
(Vorobiof, Douangvila) Ronald Reagan UCLA Medical Center, Los Angeles, CA,
United States
(Gevorgyan, Moor-Man, Ranjbaran) University of Washington Medical Center,
Seattle, WA, United States
(Smith, Ohmart, Kinlay) VA Boston Healthcare System, West Roxbury, MA,
United States
(Hamburger, Rocco, Ly, Bhatt, Quinn, Croce, Temiyasathit, Quin, Do,
Anumpa, Tobin, Zenati, Faxon, Rayos, Langdon) Daytona Heart Group, Daytona
Beach, FL, United States
(Bayer, Seedhom, O'Malley) Capital Cardiology Associates, Albany, NY,
United States
(Sullenberger, Orvis, Kumkumian, Murphy) NIH Heart Center, Suburban
Hospital, Bethesda, MD, United States
(Greenberg, Iraola, Sedlis, Maranan) VA New York Harbor Health Care
System, New York, NY, United States
(Donnino, Lorin, Tamis-Holland, Malinay) Mount Sinai Saint Luke's
Hospital, Ridgewood, NJ, United States
(Kornberg, Leber, Saba, Edillo) Providence - Providence Park Hospital,
Southfield, MI, United States
(Lee, Small, Nona, Alexander, Rehman, Badami, Ostrander) Covenant Medical
Center, Inc., Saginaw, MI, United States
(Wasmiller, Marzo, Drewes) NYU Winthrop, Mineola, NY, United States
(Patel, Robbins) AtlantiCare Regional Medical Center, Pomona, NJ, United
States
(Levite, White, Shetty, Hallam, Patel, Hamroff, Spooner) NYP Medical
Medical Group Hudson Valley Cardiology, Cortlandt Manor, NY, United States
(Hollenweger, Little, Little) Houston Heart & Vascular Associates,
Houston, TX, United States
(Zimbelman, Little, Lui, Eskelson) Salt Lake City VA Medical Center, Salt
Lake City, UT, United States
(Smith, Vezina, Khor, Abraham, Bull, McKellar, Booth, Taul) Lexington VA
Medical Center, Lexington, KY, United States
(Kotter, Rodgers, Abdel-Latif, Isaacs, Bulkley, Hu, Kaneshiro) Palo Alto
Medical Foundation Research Institute, Palo Alto, CA, United States
(Labovitz) University of South Florida, Tampa, FL, United States
(Berlowitz, Kirby, Rogal, Tran, McFarren, Jahrsdorfer, Matar, Caldeira,
Maron) Stanford University School of Medicine, Stanford, CA, United States
(Rodriguez, Yunis, Schnittger, Patro, Fearon, Deedwania, Vega) UCSF -
Fresno Community Regional Medical Center, Fresno, CA, United States
(Reddy, Sweeny, Bloise-Adames) Icahn School of Medicine at Mount Sinai,
New York, NY, United States
(Jimenez, Vrestil, Bhandari, Spizzieri, Schade) Holy Spirit Hospital
Cardiovascular Institute, Camp Hill, PA, United States
(Yost, Hochberg, Beardsley) Boston Medical Center, Boston, MA, United
States
(Fine, Salerno, Tancredi) Hackensack University Medical Center, Saddle
Brook, NJ, United States
(Arakelian, Mathus, O'Neill, Wyman, Burkhardt) Torrance Memorial Medical
Center, Torrance, CA, United States
(Hosino, Lubyanaya) Coastal Heart Medical Group, Santa Ana, CA, United
States
(Salas, Zarka, Aguirre, Shah, Dhawan, Parra, Tran, Haldis, Weick) Sanford
Health, Fargo, ND, United States
(Fowler-Lehman, Spitzer, Riedberger, Weick, Kohn) NYU New York Medical
Associates, New York, NY, United States
(Cobos, Quiles, Girotra, Drum) University of Iowa Hospitals and Clinics,
Iowa City, IA, United States
(Miller-Cox, Ollinger, Almousalli, Capasso-Gulve) Advanced Heart Care
Group, Fairview Heights, IL, United States
(Loehr, Mosley, Krishnam, Heydari) University of California Irvine Medical
Center, Orange, CA, United States
(Mil-Liken, Lundeen, Patel, Karanjah, Seto, Marfori, Harley,
Hernandez-Rangel, Gibson, Singh, Allen, Coram, Webb) University of
Louisville, Louisville, KY, United States
(Fridell, Wilson, Thomas, Kim) University of Rochester, Rochester, NY,
United States
(Schwartz, Wilmot, Chen, El Shahawy, Stevens) Cardiovascular Center of
Sarasota, Sarasota, FL, United States
(Stafford, Black) University of Maryland Medical Center, Baltimore, MD,
United States
(Abernethy, Hull) Asheville Cardiology Associates, Asheville, NC, United
States
(Lim, Tucker, Putnam, Hall, Cauthren, Tucker, Zurick, Horton) Saint Thomas
Hospital, Nashville, TN, United States
(Orga, Meyer, White) Stroobants Cardiovascular Center, Lynchburg, VA,
United States
(Morford, Baumann, Rutkin, Seeratan) Northwell Health - Manhasset,
Manhasset, NY, United States
(Bokhari, Jimenez) Columbia University Medical Center, New York, NY,
United States
(Sokol, Schultz) Jacobi Medical Center, Bronx, NY, United States
(Meisner, Russo, Hamzeh) Baylor College of Medicine, Houston, TX, United
States
(Misra, Huda, Wall, Boan, De Rosen, Alam, Turner, Hinton) Cardiovascular
Specialists of Southwest Louisiana, Lake Charles, LA, United States
(Mulhearn, Good, Archer) Ohio Health Grant Medical Center, Columbus, OH,
United States
(Dionne, Allardyce, Sikora, Czerniak, Mull, Ferguson, Laube, Shammas,
Shammas) Midwest Cardiovascular Research Foundation, Davenport, IA, United
States
(Christensen, Park, Chilton, Hecht) Audie Murphy V.A., San Antonio, TX,
United States
(Nguyen, Vo) VA Palo Alto Healthcare System, Palo Alto, CA, United States
(Hirsch, Jezior, Bindeman) Walter Reed National Military Medical Center,
Bethesda, MD, United States
(Salkind, Espinosa) Miriam Hospital, Providence, RI, United States
(Desimone, Gordon, Felix-Stern, Crain, Gomes, Gordon, Stenberg, Mann)
Conemaugh Valley Memorial Hospital, Johnstown, PA, United States
(McCreary, Pedalino, Cobos) NYU-HHC Kings County Hospital Center,
Brooklyn, NY, United States
(Dwyer, Espinosa, Quiles, Wiesel) New York University - Langone
Cardiovascular Associates, Flushing, NY, United States
(Juang, Gopaul) Coney Island Hospital, Brooklyn, NY, United States
(Hultberg, Huk, Hussain, Al-Amoodi, Zambrano) Yuma Regional Medical
Center, Yuma, AZ, United States
(Rodriguez, Milner, Wohns, Mulder) Spectrum Health, Grand Rapids, MI,
United States
(Van Oosterhout, Lader, Meyer) Mid Valley Cardiology, Kingston, NY, United
States
(Mumma, Clapp) Sarasota Memorial Hospital, Sarasota, FL, United States
(Barrentine, Dharmarajan, Jose) NYU-HHC Lincoln Medical and Mental Health
Center, Bronx, NY, United States
(Manchery, McGarvey, McKinney) Doylestown Health Cardiology, Doylestown,
PA, United States
(Schwarz, Downes, Kaczkowski) Medical Center of the Rockies, Loveland, CO,
United States
(Luckasen, Jaskowiak, Klitch, Cheong, Dees) Baylor St. Luke's Medical
Center, Houston, TX, United States
(Potluri, Vasquez) Baylor Research Institute, Legacy Heart Center, Plano,
TX, United States
(Mastouri) Indiana University, Krannert Institute of Cardiology,
Indianapolis, IN, United States
(Breall, Hannemann, Revtyak, Foltz, Bazeley, Li, DeRosa) HealthEast Saint
Joseph's Hospital, St. Paul, MN, United States
(Jorgenson, Riestenberg-Smith, Giedd) Beth Israel Medical Center, New
York, NY, United States
(Old, Bariciano) Cardiovascular Associates, Ltd., Chesapeake, VA, United
States
(Burt) Saint Luke's Hospital and Health Network, Bethlehem, PA, United
States
(Sokhon, Waldron) Medicus Alliance Clinical Research Org., Inc., Sugar
land, TX, United States
(Mayon, Gopal) The Heart Hospital Baylor, Plano, TX, United States
(Valeti, Peichel) University of Minnesota, Minneapolis, MN, United States
(Kobashigawa, Starks) Cedars Sinai Medical Center, Beverly Hills, CA,
United States
(Garcia, Thottam, Bhargava, Anand) Government Medical College, Calicut,
India
(Govindan, Raj, Nair, Ravindran, Rajalekshmi, Manjunath, Nataraj) Sri
Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru,
India
(Moorthy, Nayak, Manjunath, Mylarappa, Narayanappa, Pandit, Bajaj) Dr Ram
Manohar Lohia Hospital, New Delhi, India
(Nath, Yadav, Mishra, Dwivedi, Tewari) King George's Medical University,
Department of Cardiology, Lucknow, India
(Narain, Mishra, Chandra, Patel, Singh, Wander) Hero DMC Heart Institute,
Dayanand Medical College and Hospital, Ludhiana, India
(Tandon, Ralhan, Kaur, Aslam, Gupta, Pharmacy, Goyal, Bhargava, Suvarna)
All India Institute of Medical Sciences, New Delhi, India
(Karthikeyan, Ramakrishnan, Seth, Yadav, Singh, Roy, Parakh, Verma,
Narang, Mishra, Naik, Sharma, Choudhary, Patel, Gulati, Sharma, Bahl,
Mathew, Kurian) MOSC Medical College Hospital, Kolenchery, India
(Punnoose, Gadkari, Karwa) KEM Hospital Pune, Pune, India
(Gadage, Kolhe, Pillay, Satheesh, Vindhya) Jawaharlal Institute of
Postgraduate Medical Education & Research (JIPMER), Pondicherry, India
(Jain) Fortis Escort Heart Institute, New Delhi, India
(Seth, Meharwal, Mathur, Verma, Kaul, Bhatia, Sachdeva, Devi, Jungla,
Christopher, Rani) Gurunanak CARE Hospital, Hyderabad, India
(Menon, Reddy, Kumar, Preethi, Oomman, Sidh) Apollo Research and
Innovation, Chennai, India
(Mao, Ramakrishnan, Solomon, Francis, Naik, Priya) Apollo Research &
Innovations, Hyderabad, India
(Khan, Christopher, Preethi) CARE Nampally, Hyderabad, India
(Kumar, Grant, Hande) Ruby Hall Clinic, Grant Medical Foundation, Pune,
India
(Sonawane, Kachru, Dubey) Fortis Healthcare Fl.t Lt. Rajan Dhall Hospital,
New Delhi, India
(Rawat, Kumar) Sree Chitra Tirunal Institute for Medical Sciences and
Technology, Trivandrum, India
(Ganapathi, Jayakumar, Vineeth, Sivadasanpillai, Chacko, Sasidharan, Babu,
Kapilamoorthy, Christopher, Reddy) CARE Hospital, Hyderabad, India
(Polamuri, Rani, Kaul, Arambam) Batra Hospital and Medical Research Centre
(BHMRC), New Delhi, India
(Singh, Senior, Fox, Young, Carruthers) Northwick Park Hospital Harrow,
Royal Brompton Hospital London, Harrow, United Kingdom
(Elghamaz, Gurunathan, Karogiannis, Young, Shah, Kinsey, Trimlett,
Kavalakkat, Rubens, Evans, Nicol, Hassan, Mittal, Hampson, Gamma,
Williams) Broomfield Hospital, Chelmsford, United Kingdom
(Holland, Swan, de Belder, Atkinson) The James Cook University Hospital,
Middlesbrough, Middlesbrough, United Kingdom
(Thambyrajah, Nageh, Kunhunny) Southend University Hospital, Westcliffe on
Sea, United Kingdom
(Davies, Lindsay, Atkinson) Bradford Royal Infirmary, Bradford, United
Kingdom
(Kurian, Krannila, Jamil, Vinod, Raheem, Hoye, Chaytor) The University of
Hull, Castle Hill Hospital, Cottingham, United Kingdom
(Cox, Morrow, Rowe, Donnelly, Kelly) South Eastern Health and Social Care,
Belfast, United Kingdom
(Valecka, Regan, Turnbull, Chauhan, Fleming) Blackpool Teaching Hospitals,
Blackpool, United Kingdom
(Ghosh, Gratrix, Preston, Barr, Cartwright) Russells Hall Hospital,
Dudley, United Kingdom
(Alfakih, Knighton) King's College NHS Foundation Hospital, London, United
Kingdom
(Byrne, Martin, Webb, Henriksen, Flint) Royal Infirmary of Edinburgh,
Edinburgh, United Kingdom
(Harrison, OKane, Lake-Man) Royal Bournemouth Hospital, Bourneouth, United
Kingdom
(Ljubez, de Silva) Bedford Hospital NHS Trust, Bedford, United Kingdom
(Conway, Wright) Pinderfields Hospital, Wakefield, United Kingdom
(Exley, Sirker, Andiapen) University College London Hospitals NHS
Foundation Trust, London, United Kingdom
(Richards) BartsHealth NHS Trust, United Kingdom
(Hoole, Wong) Papworth Hospital, Cambridge, United Kingdom
(Witherow, Munro) Dorset County Hospital, Dorchester, United Kingdom
(Johnston, Bao) Belfast Trust, Belfast, United Kingdom
(Harbinson, Bao, McEvoy, Walsh, Bao, Brown, Douglas, Luckie, Charles)
Central Manchester University Hospital, Manchester, United Kingdom
(Kolakaluri, Phillips, Sobolewska, Morby) The Pennine Acute Hospitals NHS
Trust, Oldham, United Kingdom
(Hallett, Corbett, Winstanley, Jeetley, Smit) Royal Free London NHS
Foundation Trust, London, United Kingdom
(Patel, Kotecha, Travill, Gent) Luton and Dunstable University Hospital
NHS FT, Luton, United Kingdom
(Karimullah, Hussain, Al-Bustami, Braganza, Haines) Peterborough City
Hospital, Peterborough, United Kingdom
(Taaffe, Henderson, Burton) Nottingham University Hospitals, Nottingham,
United Kingdom
(Pointon, Colton, Naik, King, Mathew, Brown) University of Glasgow,
Clydebank, United Kingdom
(Docherty, Berry, McCloy, Collison, Robb, Roditi, Paterson, Crawford,
Kelly, McGregor, Moriarty, Mackin) Cardiovascular Research Unit, Craigavon
Area Hospital, Craigavon, United Kingdom
(Glover, Knight) Hampshire Hospitals NHS Foundation Trust, Basingstoke,
United Kingdom
(Pradhan, Mikhail, Bose) Imperial College Healthcare NHS Trust, London,
United Kingdom
(Francis, Dzavik, Goodman, Gosselin, Proietti) Montreal Heart Institute,
Montreal, QC, Canada
(Brousseau, Corfias, Blaise, Harvey, Diaz) Centre Hospitalier de Regional
Trois-Rivieres, Trois-Rivieres, QC, Canada
(Rheault, Barrero, Gagne, Alarie, Pepin-Dubois, Arcand, Costa, Roy, Sia,
Montpetit, Lemay, Gisbert, Gervais, Rheault, Drouin) CISSSL - Hopital
Pierre-Le Gardeur, Terrebonne, QC, Canada
(Phaneuf, Bergeron, Gosselin, Shelley, Masson, Garg, Carr) London Health
Sciences Centre, London, ON, Canada
(Bone, Chow, Moga) University of Ottawa Heart Institute, Ottawa, ON,
Canada
(Hessian, Kourzenkova, Beanlands, Walter, Davies, Bainey, Hogg) University
of Alberta, Edmonton, AB, Canada
(Welsh, Cheema) St. Michael's Hospital, Toronto, ON, Canada
(Bagai, Wald, Goodman, Kushniriuk, Graham, Hussain, Peterson, Bello, Chow,
Abramson, Cheema, Syed) Dixie Medical Group, Mississauga, ON, Canada
(Vakani, Hussain, Kushniriuk, Cha, Otis) Dr James Cha, Oshawa, ON, Canada
(Otis, Howarth, Seib) University of Calgary, Calgary, AB, Canada
(Rivest, Sandonato, Wong, Chow) Vancouver General Hospital, Vancouver, BC,
Canada
(Starovoytov, Uchida, Meadows, Uxa, Asif) University Health Network,
Toronto, ON, Canada
(Tavares, Galiwango, Bozek) Scarborough Cardiology Research, Scarborough,
ON, Canada
(Kassam, Shier, Mukherjee, Larmand, Ricci, Janmohamed, Hart, Lam, Marucci)
West Lincoln Memorial Hospital East Grimsby, ON, Canada
(Tai, Mehta, Brons) Hamilton General Hospital, Hamilton, ON, Canada
(Beck, Wong, Etherington, Arumairajah, Udell, Aprile) Women's College
Hospital, Toronto, ON, Canada
(Karlsson, Webber, Genereux, Mercure) Centre Integre Universitaire de
Sante et de Services Sociaux du Montreal, Montreal, QC, Canada
(Hameed, Aedy) Saint Catharines General Hospital, Catharines, ON, Canada
(Daba, Farquharson) Northwest GTA Cardiovascular and Heart Rhythm Program,
Vaughan, ON, Canada
(Siddiqui, Carvalho, Lopes, Hueb, Takiuti) Heart Institute (InCor),
University of Sao Paulo, Sao Paulo, Brazil
(Rezende, Silva, Hueb, Smanio, Caetano) Instituto Dante Pazzanese de
Cardiologia, Sao Paulo, Brazil
(de Quadros) Instituto de Cardiologia de Porto Alegre, Porto Alegre,
Brazil
(Kalil, Deiro, da Costa Vieira, Muller, Grossmann, de Moraes, de Oliveira,
Ascoli, Bridi, Poletti, Savaris, Vitola) Quanta Diagnostico & Terapia,
Curitiba, Brazil
(Cerci, Zier, Farias, Veiga, Fernandes, Marin-Neto) Hospital das Clinicas
da Faculdade de Medicina de Ribeirao Preto, Universidade de Sao Paulo,
Ribeirao Preto, Brazil
(Schmidt, de Oliveira Lima Filho, da Cunha, Oliveira, Chierice, Polanczyk,
Rucatti) Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
(Furtado, Igansi, Smidt, Haeffner, Carvalho, Almeida) Unifesp - Hospital
Sao Paulo, Sao Paulo, Brazil
(Pucci, de Souza, Lyra, Alves, Almeida) Fundacao Bahiana de Cardilogia,
Salvador, Brazil
(dos Santos, Dracoulakis, Oliveira) Hospital da Bahia, Salvador, Brazil
(Lima, Figueiredo, Azevedo) Hospital Lifecenter, Belo Horizonte, Brazil
(Caramori, Santos) Hospital Sao Lucas da Pontificia Universidade Catolica
do Rio Grande do Sol, Porto Alegre, Brazil
(Germann, Gomes, Homem, Magedanz, Tumelero, Laimer) Hospital Sao Vicente
de Paulo Fundo, Brazil
(Tognon, Dall'Orto) Hospital Maternidade e Pronto Socorro Santa Lucia,
Pocos de Caldas, Brazil
(Mesquita, Santos) Hospital Pro-Cardiaco Botafogo, Brazil
(Colafranseschi, Oliveira, Carvalho, Palazzo, Sousa, da Silva) Hospital
TotalCor, Sao Paulo, Brazil
(de Barros e Silva, Okada, de Padua Silva Baptista, Batista, Rodrigues,
Rabaca, de Resende, Saraiva, Trama) Hospital Celso Pierro, Sao Paulo,
Brazil
(Silva, de Souza Ormundo, Vicente, Costantini, Pinheiro, Pracon) Hospital
Cardiologico Costantini, Curitiba, Brazil
(Komar, Ruzyllo, Szwed, Demkow, Pracon) Coronary and Structural Heart
Diseases Department, Institute of Cardiology, Warsaw, Poland
(Kepka, Teresinska, Walesiak, Kryczka, Malinowska, Henzel, Solecki,
Kaczmarska, Mazurek, Maksym) Medical University of Warsaw, Warszawa,
Poland
(Wojtera, Fojt, Szczerba, Drozdz) Cardiology Clinic, Medical University in
Lodz, Lodz, Poland
(Czarniak, Frach, Szymczyk, Niedzwiecka, Sobczak, Ciurus, Jakubowski,
Misztal-Teodorczyk, Teodorczyk, Swiderek, Fratczak, Wojtala, Szkopiak,
Lebioda, Wlodarczyk, Plachcinska, Kusmierek, Miller, Marciniak,
Wojtczak-Soska, Luczak, Tarchalski, Cichocka-Radwan, Szwed, Karwowski)
National Institute of Cardiology, Warsaw, Warsaw, Poland
(Szulczyk, Witkowski) Department of Interventional Cardiology & Angiology,
Institute of Cardiology, Warsaw, Poland
(Kukula, Celinska-Spodar, Zalewska, Gajos) Department of Coronary Disease,
John Paul II Hospital, Jagiellonian University Medical College, Krakow,
Poland
(Bury, Pruszczyk, Labyk) Department of Internal Medicine and Cardiology,
Infant Jesus Teaching Hospital, Medical University of Warsaw, Warszawa,
Poland
(Roik, Szramowska, Zdonczyk, Loboz-Grudzien, Jaroch) T.Marciniak Hospital,
Wroclaw, Poland
(Sokalski, Brzezinska, Lesiak) Szpital Kliniczny Przemienienia Panskiego,
Poznan, Poland
(Lanocha, Reczuch, Kolodziej) Military Hospital, Medical University,
Wroclaw, Poland
(Kalarus) Medical University of Silesia, School of Medicine, The Division
of Dentistry, Department of Cardiology, Congenital Heart Diseases and
Electrotherapy, Silesian Center for Heart Diseases, Zabrze, Poland
(Swiatkowski, Szulik, Musial, Marcinkiewicz-Siemion) University Hospital
in Bialystok, Bialystok, Poland
(Bockeria, Bockeria) National Medical Research Center for Cardiovascuar
Surgery, Moscow, Russian Federation
(Petrosyan, Kudzoeva, Trifonova, Aripova, Chernyavskiy, Naryshkin)
E.Meshalkin National Medical Research Center, The Ministry of Health of
the Russian Federation, Novosibirsk, Russian Federation
(Kretov, Kuleshova, Grazhdankin, Malaev, Bershtein) North-Western State
Medical University, Saint Petersburg, Russian Federation
(Sayganov, Subbotina, Kuzmina-Krutetskaya, Gumerova, Zbyshevskaya,
Katamadze, Demchenko, Nikolaeva) Federal Almazov North-West Medical
Research Centre, Saint Petersburg, Russian Federation
(Kozlov, Kozulin, Lubinskaya, Lopez-Sendon, Castro, Lopez-Sendon,
Fernandez-Figares) Hospital La Paz. IdiPaz, Madrid, Spain
(Castro, Salicio, Guzman, Galeote, Valbuena, Peteiro) Complexo
Hospitalario Universitario A Coruna (CHUAC) Sergas, Department of
Cardiology, INIBIC A Coruna. CIBER-CV., Universidad de A Coruna, A Coruna,
Spain
(Martinez-Ruiz, Perez-Fernandez, Blanco-Calvo, Cuenca-Castillo,
Alonso-Alvarez, Flores-Rios, Garcia-Gonzalez, Prada-Delgado,
Barge-Caballero, Juanatey, Amigo) Hospital Clinico Universitario de
Santiago, Santiago de Compostela, Spain
(Bayarri, Nunez, Sanchez, Alvarez, Gil, Monzonis, Sionis, Martinez)
Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
(Perales, Padro, Penaranda, Picart, Iglesias, Marimon, Llado, Costa, Miro,
Igual) Hospital Universitario y Politecnico La Fe, Valencia, Spain
(Diez, Calvillo, Ortuno) HUVA, Hospital Clinico Universitario Virgen De La
Arrixaca, Murcia, Spain
(Chavarri, Giner, Montolliu, Aniorte, Bermudez, Caravaca, De La Morena,
Blancas, Canavate) Hospital De Bellvitge, Barcelona, Spain
(Guerrero, Riera, Luena, Luena) Hospital Universitario Miguel Servet,
Zaragoza, Spain
(Lasala, Fernandez-Aviles, Lorenzo) Hospital General Universitario
Gregorio Maranon, Madrid, Spain
(Sobrino, Vazquez, Jiang, Chen, Dong) Guangdong General Hospital,
Guangzhou, China
(He, Xia, Yang, Zhong, Wu, Tian) Chinese Academy of Medical Sciences,
Fuwai Hospital, Beijing, China
(Li) First Affiliated Hospital of Xinjiang Medical University, Urumqi,
China
(Ma, Li, Yang, Ma, Yu, Zhao, Ji, Li) Tangshan Gongren Hospital, Tangshan,
China
(Zhang, Zhao, Zhu, Yang, Chen) Beijing Chao-yang Hospital, Capital Medical
University, Beijing, China
(Chi, Wang, Zhang, Lin, Jing) TEDA International Cardiovascular Hospital,
Tianjing, China
(Liu, Zeng, Zhou) Tongji Medical College, Wuhan, China
(Xu, Li, Li, Xiong, Fu, Gao) The First Affiliated Hospital of Zhengzhou
University, Zhengzhou, China
(Jiang, Leng, Wang, Yuan, Zhang, Yang, Bai) Shanxi Cardiovascular
Hospital, Taiyuan, China
(Li, Qi, Wang, Wang, Yang, Yue, Zhang, Wang, Dong) Qingdao Fuwai Hospital,
Qingdao, China
(Mao, Zhang, Cheng, Li) Shanxi Provincial People's Hospital, Xian, China
(Yao, Zhong, Zhou, Zhao, Huang) The Second Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Zhou, Fang, Su) Liangxiang Hospital, Beijing, Fangshan District, Beijing,
China
(Zeng, Kunwu) Wuhan Union Hospital, Tongji Medical College, Huazhong
Science and Tech University, Wuhan, China
(Peng, Su, Su, Wang) Wuhan Asia Heart Hospital, Wuhan, China
(Zhao, Li, Geng) Affiliated Hospital of Jining Medical University, Jining,
China
(Wang, Nie, Fan) Beijing Anzhen Hospital, Beijing, China
(Feng, Wang, Yan, Zhang, Yu, Chi) Affiliated Zhongshan Hospital of Dalian
University, Dalian, China
(Liu, Wang, Chen) The Second Affiliated Hospital Zhejiang University
School of Medicine, Hangzhou, China
(Jiang, Li, Wang, Han) Peking Union Medical College Hospital, Beijing,
China
(Xu, Zhang, Liu, Liu, Chen, Hu, Maggioni, Perna, Pietrucci) Cardiology and
CCU - Ospedali Riuniti Ancona, Ancona, Italy
(Marini, Gabrielli, Provasoli, Di Donato) Ospedale di Circolo e Fondazione
Macchi, Varese, Italy
(Verna, Monti) Humanitas Research Hospital, Rozzano (MI), Rozzano, Italy
(Nardi, Di Chiara, Pezzetta) Azienda Servizi Sanitaria n.3 Alto
Friuli-Collinare-Medio Friuli, Tolmezzo, Italy
(Mortara, Casali) Policlinico di Monza, Monza, MB, Monza, Italy
(Galvani, Attanasio) Ospedale "G.B. Morgagni - L. Pierantoni" Forli (AUSL
della Romagna), Forli, Italy
(Ottani, Sicuro, Leone) Ospedale Regionale Umberto Parini, Aosta, Italy
(Pisano, Bare, Calabro, Fimiani) AORN Dei Colli "V. Monaldi" UOC
Cardiologia Universita della Campania "L.Vanvitelli", Napoli, Italy
(Formisano, Tarantini, Barioli) University of Padua- Cardiology Clinic,
Padua, Italy
(Cucchini, Ramani, Andres, Racca, Rolfo) Azienda Ospedaliera S. Croce e
Carle, Cuneo, Italy
(Goletto, Briguori, De Micco) Clinica Mediterranea, Naples, Italy
(Amati, Di Marco) UO Cardiologia Ospedale SS Cosma e Damiano, Pescia,
Italy
(Vergoni, Tricoli, Russo, Villella) IRCCS "Casa Sollievo della
Sofferenza", San Giovanni Rotondo, Italy
(Fanelli, White, Alsweiler, Poh) National University Heart Center
Singapore, Singapore, Singapore
(Chai, Lau, Loh, Tay, Teoh, Tan, Teo, Sia, Ong, Leong, Wong, Loh, Kofidis,
Chan, Chan, Foo, Yan) Tan Tock Seng Hospital, Singapore, Singapore
(Kong, Er, Jafary, Chua, Ismail) National Heart Centre Singapore,
Singapore, Singapore
(Kyaw, Yip, Doerr) Praxisklinik Herz und Gefaesse, Dresden, Germany
(Stumpf, Grahl, Matschke, Guenther, Simonis, Bonin, Kadalie, Sechtem,
Wenzelburger) Robert-Bosch-Krankenhaus, Stuttgart, Germany
(Ong, Gruensfelder, Schulze) University Hospital Jena, Jena, Germany
(Goebel, Lenk, Nickenig, Sinning) Universitatsklinikum Bonn, Bonn, Germany
(Weber, Werner, Lang, Huber, Schuchlenz, Steinmaurer) LKH Graz West, Graz,
Austria
(Weikl, Lang, Winter) Medical University of Vienna, Department of
Cardiology, Vienna, Austria
(Andric) Wilhelminen Hospital Vienna, Vienna, Austria
(Huber, Maximilian, Gabriele, Claudia, Bernhard, Florian, Keltai, Vertes,
Sebo) Eszszk- Szent Istvan Hospital, Budapest, Hungary
(Davidovits, Matics, Varga, Agoston) University of Szeged, Szeged, Hungary
(Fontos, Dekany) George Gottsegen National Institute of Cardiology,
Budapest, Hungary
(Merkely, Bartykowszki) Heart and Vascular Center, Semmelweis University,
Budapest, Hungary
(Maurovich-Horvat, Kerecsen, Jakal) Military Hospital, Budapest, Budapest,
Hungary
(Hinic, Djokic) University Hospital Center Bezanijska Kosa, Belgrade,
Serbia
(Zdravkovic, Mudrenovic, Crnokrak, Beleslin) Faculty of Medicine,
University of Belgrade, Cardiology Clinic, Clinical Center of Serbia,
Belgrade, Serbia
(Boskovic, Djordjevic-Dikic, Petrovic, Giga, Dobric, Stepanovic, Markovic,
Mladenovic, Cemerlic-Adjic, Velicki) Institute of Cardiovascular Diseases
Vojvodina, Sremska Kamenica, Serbia
(Pupic, Davidovic, Simovic) Clinical Center Kragujevac, Kragujevac, Serbia
(Vucic, Dekleva, Martinovic) University Clinical Hospital Zvezdara,
Belgrade, Serbia
(Stevanovic, Stankovic, Dobric) Clinical Center of Serbia, Belgrade,
Serbia
(Apostolovic, Martinovic) Clinic for Cardiovascular Diseases, Clinical
Center Nis, Nis, Serbia
(Stanojevic, Escobedo, de Jesus-Perez, Juarez) Instituto Mexicano del
Seguro Social, Mexico
(Baleon-Espinosa, Campos-Santaolalla, Duran-Cortes, Flores-Palacios,
Garcia-Rincon, Jimenez-Santos, Penafiel, Ortega-Ramirez,
Valdespino-Estrada, Rosas, Brassetti, Selvanayagam) Instituto Nacional de
Cardiologia "Ignacio Chavez", Mexico City, Mexico
(Anaya, Garcia, Juarez, Rovalo, Rodriguez, Selvanayagam, Rankin, Murphy,
Lee) Flinders Medical Centre, Adelaide, Australia
(Joseph, Thomas, Thambar, Chaplin) John Hunter Hospital, New Lambton
Heights, Australia
(Boer, Beltrame, Stansborough) The Queen Elizabeth Hospital, Woodville
South, Australia
(Black, Hillis, Bonner) Royal Perth Hospital, Perth, Australia
(Ireland, Venn-Edmonds, Steg, Abergel, Juliard, Thobois) C.H. Louis
Pasteur, Chartres, France
(Thuaire, Tachot, Dutoiu, Laure, Vassaliere, Steg, Abergel) Bichat
Hospital, Paris, France
(Juliard, Fuentes, Slama, Eliahou) Antoine-Beclere Hospital, Clamart,
France
(Mahmoud, Dubourg) Ambroise Pare Hospital, Boulogne, France
(Michaud, Nicollet, Hadjih) Centre Hospitalier Sud Francilien,
Corbeil-Essonnes, France
(Goube, Brito, Barone-Rochette, Barone-Rochette) Grenoble University
Hospital, Grenoble, France
(Furber, Cornet) Centre Hospitalier Universitaire d'Angers, Angers, France
(Biere, Rautureau, Juceviciene) Vilnius University Hospital Santariskes
Clinic, Vilnius, Lithuania
(Kalibataite-Rutkauskiene, Keinaite, Laucevicius, Laukyte, Celutkiene,
Mikolaitiene, Smigelskaite, Tamasauskiene, Urboniene, Kedhi) Isala
Klinieken, Zwolle, Netherlands
(Timmer, Bouwhuis, Hermanides, Nijmeijer, Kaplan, Riezebos) Cardio
Research Hartcentrum OLVG, Amsterdam, Netherlands
(Samadi, Schoep, van Dongen, Janzen, Niehe, Suryapranata, Ahoud)
Radboudumc, Nijmegen, Netherlands
(van Vugt, Ramos) Hospital de Santa Marta, Lisbon, Portugal
(Cacela, Santana, Fiarresga, Sousa, Marques, Patricio, Selas, Bernanrdes,
Silva, Rio, Freixo, Carvalho, Ferreira, Silva, Rodrigues, Modas, Portugal,
Fragata, Pinto, Cabrita) Santa Maria University Hospital, Cardiology
Department, CHLN, Lisbon, Portugal
(Menezes, Rocha, Lopes, Figueiras, Almeida, Coelho, Silva, Capinha, Nobre,
Caetano, Francisco, Silva, Ferreira) Centro Hospitalar de Vila Nova de
Gaia/Espinho, EPE, Vila Nova de Gaia, Portugal
(Lopes, Diaz, Guzman, Tinnirello) Instituto Medico DAMIC, Cordoba,
Argentina
(Figal, Mungo) Fundacion Favaloro, Ciudad Autonoma de Buenos Aires,
Argentina
(Mendiz, Cortes, Favaloro, Alvarez, Garcia) Hospital Italiano Regional del
Sur Bahia Blanca, Bahia Blanca, Argentina
(Courtis, Godoy) Clinica Romagosa and Clinica De La Familia, Cordoba,
Spain
(Zeballos, Schiavi, Actis) Clinica Del Prado, Cordoba, Spain
(Rubio) Clinica Privada Velez Sarsfield, Cordoba, Spain
(Scaro, Devlin, Low) Waikato Hospital, Hamilton, New Zealand
(Fisher, Scales, Abercrombie, Stewart) Auckland City Hospital, Auckland,
New Zealand
(Howell, Patten, Benatar, Kedev, Held) University Clinic of Cardiology,
Skopje, North Macedonia
(Mitevska, Kostovska, Pejkov, Held) Uppsala University, Uppsala, Sweden
(Eggers, Frostfelt, Bjorklund, Johnston, Andreasson, Olsowka, Essermark,
Akerblom, Soveri, Aspberg, Persson, Sharir) Karolinska Institutet,
Danderyd Hospital, Stockholm, Sweden
(Beyar, Nikolsky, Sharir, Harel) Assuta Medical Centers, Tel-Aviv, Israel
(Elian, Kerner, Bentzvi) Rambam Medical Center, Haifa, Israel
(Massalha, Helmer, Kohsaka, Fukuda, Ueda) Keio University, Shinjuku-ku,
Japan
(Kohsaka, Fujita, Yasuda, Furukawa) National Cerebral and Cardiovascular
Center, Kanae Hirase, RN, -4, Suita-shi, Japan
(Nagai, Otsuka, Nishimura, Nakano) Saitama Medical University, Hidaka,
Japan
(Van de Werf, Goetschalckx, Robesyn) University Hospital Leuven, Leuven,
Belgium
(Van de Werf, Claes, Hung, Yang) Mackay Memorial Hospital, Taipei City,
Taiwan (Republic of China)
(Yun, Hou, Kuo, Yeh, Hung, Li, Chien, Tsai, Liu, Yu, Lin, Lan, Yen, Tsai,
Sung, Ntsekhe) Groote Schuur Hospital, University of Cape Town, Cape Town,
South Africa
(Pandie, Philander, Viljoen, Mtana, De Andrade, Maggioni, Moccetti,
Anesini) Cardiocentro, Lugano, Switzerland
(Rossi, Maspoli, Mombelli, Abdelhamid, Talaat) Cairo University, Cairo,
Egypt
(Adel, Kamal, Mahrous, El Kaffas, El Fishawy, Pop) Emergency County
Hospital Baia Mare, Bucharest, Romania
(Claudia, Popescu) Emergency Institute of Cardiovascular Diseases ''Prof.
Dr. C. C. Iliescu'', Bucharest, Romania
(Ginghina, Rosca, Deleanu, Beladan, Iliescu, Al-Mallah, Zahrani) King
AbdulAziz Cardiac Center, Central Province, Saudi Arabia
(Aljzeeri, Najm, Alghamdi, Ramos) Instituto Neuro Cardiovascular De Las
Americas, Mirafloes, Peru
(Davila, Kuanprasert) Maharaj Nakorn Chiang Mai Hospital, Chiang Mai,
Thailand
(Prommintikul, Nawarawong, Khwakhong, Woragidpoonpol, Chaiyasri, Tepsuwan,
Mekara, Taksaudom, Kulthawong, Rimsukcharoenchai, Amaritakomol,
Euathrongchit, Wannasopha, Yamwong, Panpunuan) Ramathibodi Hospital,
Bangkok, Thailand
(Sritara, Aramcharoen, Meemuk, White, Alsweiler, Khairuddin, Mokhtar)
Institut Jantung Negara, Kuala Lumpur, Malaysia
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: ISCHEMIA (International Study of Comparative Health
Effectiveness With Medical and Invasive Approaches) did not find an
overall reduction in cardiovascular events with an initial invasive versus
conservative management strategy in chronic coronary disease; however,
there were conservative strategy participants who underwent invasive
coronary angiography early postrandomization (within 6 months).
Identifying factors associated with angiography in conservative strategy
participants will inform clinical decision-making in patients with chronic
coronary disease. <br/>METHOD(S): Factors independently associated with
angiography performed within 6 months of randomization were identified
using Fine and Gray proportional subdistribution hazard models, including
demographics, region of randomization, medical history, risk factor
control, symptoms, ischemia severity, coronary anatomy based on
protocol-mandated coronary computed tomography angiography, and medication
use. <br/>RESULT(S): Among 2591 conservative strategy participants,
angiography within 6 months of randomization occurred in 8.7% (4.7% for a
suspected primary end point event, 1.6% for persistent symptoms, and 2.6%
due to protocol nonadherence) and was associated with the following
baseline characteristics: enrollment in Europe versus Asia (hazard ratio
[HR], 1.81 [95% CI, 1.14-2.86]), daily and weekly versus no angina (HR,
5.97 [95% CI, 2.78-12.86] and 2.63 [95% CI, 1.51-4.58], respectively),
poor to fair versus good to excellent health status (HR, 2.02 [95% CI,
1.23-3.32]) assessed with Seattle Angina Questionnaire, and new/more
frequent angina prerandomization (HR, 1.80 [95% CI, 1.34-2.40]). Baseline
low-density lipoprotein cholesterol <70 mg/dL was associated with a lower
risk of angiography (HR, 0.65 [95% CI, 0.46-0.91) but not baseline
ischemia severity nor the presence of multivessel or proximal left
anterior descending artery stenosis >70% on coronary computed tomography
angiography. <br/>CONCLUSION(S): Among ISCHEMIA participants randomized to
the conservative strategy, angiography within 6 months of randomization
was performed in <10% of patients. It was associated with frequent or
increasing baseline angina and poor quality of life but not with objective
markers of disease severity. Well-controlled baseline low-density
lipoprotein cholesterol was associated with a reduced likelihood of
angiography. These findings point to the importance of a comprehensive
assessment of symptoms and a review of guideline-directed medical therapy
goals when deciding the initial treatment strategy for chronic coronary
disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique
identifier: NCT01471522. GRAPHIC ABSTRACT: A graphic abstract is available
for this article.<br/>Copyright &#xa9; 2024 American Heart Association,
Inc.

<38>
Accession Number
2041714445
Title
Cerebral Embolic Protection Devices for the Prevention of Stroke in
Patients Undergoing Transcatheter Aortic Valve Implantation: An Updated
Meta-Analysis of Randomized Controlled Trials.
Source
Catheterization and Cardiovascular Interventions. 107(3) (pp 795-806),
2026. Date of Publication: 15 Feb 2026.
Author
Nazmy A.; Sobhy A.; Elshahat A.; Abdelaziz A.; Makhlouf E.; El-Nemr A.F.;
Hassanin M.S.; Atta K.; Shaban A.Y.; Nazmy M.; Kharbanda R.K.; Abdelazeem
B.; Mamas M.A.
Institution
(Nazmy, Sobhy, Elshahat, Abdelaziz, Makhlouf, El-Nemr, Hassanin, Atta,
Shaban, Nazmy, Abdelazeem) Medical Research Group of Egypt (MRGE), Negida
Academy, Arlington, MA, United States
(Nazmy, Sobhy, Nazmy) Faculty of Medicine, Kafr-Elsheikh University,
Kafr-Elsheikh, Egypt
(Elshahat, El-Nemr, Hassanin) Faculty of Medicine, Al-Azhar University,
Cairo, Egypt
(Abdelaziz) Division of Cardiology, Montefiore Health System/Albert
Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United
States
(Makhlouf) Department of Cardiology, Faculty of Medicine, Minia
University, Minia, Egypt
(Atta) Institute of Medicine, National Research Mordovia State University,
Saransk, Russian Federation
(Shaban) Department of Hematology and Oncology, Mayo Clinic, Rochester,
MN, United States
(Kharbanda) Division of Cardiovascular Medicine, Oxford University
Hospitals NHS Foundation Trust, Oxford, United Kingdom
(Abdelazeem) Department of Cardiology, West Virginia University,
Morgantown, WV, United States
(Mamas) Keele Cardiovascular Research Group, Centre for Prognosis
Research, Institute of Primary Care and Health Sciences, Keele University,
Stoke-on-Trent, United Kingdom
Publisher
John Wiley and Sons Inc
Abstract
Stroke remains one of the most devastating complications following
transcatheter aortic valve implantation (TAVI). Although cerebral embolic
protection devices (CEPDs) have emerged to mitigate patients' risks, their
impact on stroke risk, as well as other clinical and neurocognitive
outcomes after TAVI, remains uncertain. We aimed to assess whether CEPDs
alleviate stroke risks and neurocognitive outcomes after TAVI. We
systematically searched MEDLINE, Scopus, Web of Science (WOS), and the
Cochrane CENTRAL from inception until May 2025. We included randomized
controlled trials (RCTs) that assessed the effectiveness of CEPD compared
to the control group (no CEPD) in adult patients (> 18 years) undergoing
TAVI. The primary endpoint was the incidence of all-cause stroke. In
contrast, the secondary endpoints included disabling stroke, systemic
bleeding, transient ischemic attack (TIA), and major adverse
cardiovascular and cerebrovascular events (MACCE). Additionally, we
assessed neurological outcomes, including changes in the Montreal
Cognitive Assessment (MoCA) score, the National Institutes of Health
Stroke Scale (NIHSS) score, and the presence of new ischemic lesions. Nine
RCTs comprising 11,696 patients were included in the final analysis. The
use of CEPDs showed no statistical difference in reducing all-cause stroke
compared to the control group (OR = 0.91, 95% CI [0.73-1.15], p = 0.44).
Additionally, there was no significant difference in other studies'
secondary outcomes, including disabling stroke, MACCE, systemic bleeding,
or neurological outcomes, such as worsening NISSS, decline in MoCA score,
and the presence of new ischemic lesions. The use of CEPD during TAVI
showed no benefit in reducing the risks of all-cause stroke and other
neurological outcomes studied.<br/>Copyright &#xa9; 2025 Wiley Periodicals
LLC.

<39>
Accession Number
2043305212
Title
Ultrasound-guided measurement of cross-sectional area of dural sac to
titrate the dosage of local anaesthetic in geriatric orthopaedic surgery
under spinal anaesthesia: A prospective randomised study.
Source
Indian Journal of Anaesthesia. 70 (pp S42-S49), 2026. Date of Publication:
01 Jan 2026.
Author
Kaur K.; Bhatia V.; Vashishth S.; Kumar P.; Singh R.; Singh N.
Institution
(Kaur, Bhatia, Vashishth, Kumar, Singh) Department of Anaesthesiology and
Critical Care, Haryana, Rohtak, India
(Singh) Department of Orthopaedics, Haryana, Rohtak, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and Aims: Dural sac cross-sectional area (DSCSA)-based
intrathecal dosing aims to optimise block spread and improve haemodynamic
stability during spinal anaesthesia (SA). Ultrasound-guided DSCSA
measurement helps in local anaesthetic (LA) dose reduction compared with
conventional fixed-dose practice. The primary objective was to determine
LA dosage proportional to DSCSA reduction, while the secondary objectives
included comparison of block characteristics and intra-operative
haemodynamic parameters [heart rate and mean arterial pressure (HR and
MAP)] between the two approaches. <br/>Method(s): This prospective
randomised study included 60 American Society of Anesthesiologists I-III
patients aged >65 years undergoing orthopaedic surgery under SA. Patients
were allocated to an ultrasound-guided DSCSA-based dosing group (US, n =
30) or a control group (C, n = 30). In Group US, DSCSA was calculated from
ultrasound-measured dural sac diameter at L3-L4, and hyperbaric
bupivacaine dosing was individualised, while Group C received a fixed 11
mg dose. Sensory and motor block characteristics, HR, MAP, and surgical
duration were recorded. <br/>Result(s): Group US had a mean dural sac
diameter of 11.99 (0.76) mm and a DSCSA of 112.98 (13.42) mm2, resulting
in a mean calculated dose of 1.79 (0.14) mL. Both groups achieved a
maximum motor block score of 3. Group C showed significantly greater
reductions in HR, with more frequent bradycardia, and a significant
decrease in MAP between 10 and 30 minutes. Surgical duration was
comparable between the groups. <br/>Conclusion(s): Ultrasound-guided
DSCSA-based dosing improves haemodynamic stability and reduces bradycardia
and hypotension while maintaining comparable block quality to conventional
fixed-dose SA.<br/>Copyright &#xa9; 2026 Indian Journal of Anaesthesia.

<40>
Accession Number
2043194674
Title
Comparing TAVR + PCI vs. SAVR + CABG across short- and mid- to long-term
horizons in patients with severe aortic stenosis and concomitant CAD: a
systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article
Number: 1640906. Date of Publication: 2026.
Author
Fang X.; Zhang X.; Wei F.; Feng S.; Chen X.
Institution
(Fang, Wei, Feng, Chen) Department of Cardiology, Dazhou Second People's
Hospital, Sichuan, Dazhou, China
(Zhang) Department of Otorhinolaryngology Head and Neck Surgery, Dazhou
Second People's Hospital, Sichuan, Dazhou, China
Publisher
Frontiers Media SA
Abstract
Background: The optimal revascularization approach for intermediate- and
high-risk individuals with severe aortic stenosis (AS) and concomitant
coronary artery disease (CAD) remains uncertain, particularly regarding
the comparative short- and mid- to long-term outcomes of transcatheter
aortic valve replacement with percutaneous coronary intervention (TAVR +
PCI) vs. surgical aortic valve replacement with coronary artery bypass
grafting (SAVR + CABG). <br/>Method(s): A systematic search of major
databases was conducted up to March 2025 to identify studies comparing
TAVR + PCI vs. SAVR + CABG in this population. Meta-analyses were
performed using a random-effects model to estimate pooled odds ratios
(ORs) and 95% confidence intervals (CIs). Evidence quality was assessed
using the GRADE framework. <br/>Result(s): Thirteen studies comprising
53,869 patients were analyzed. Compared with SAVR + CABG, TAVR + PCI was
associated with lower 30-day risks of stroke, myocardial infarction, and
acute kidney injury, but higher permanent pacemaker implantation. No
differences were found in all-cause mortality, major vascular
complications, or major bleeding. In mid- to long-term follow-up (>=2
years), the TAVR + PCI group exhibited increased risks of all-cause
mortality, myocardial infarction, and repeat revascularization, with
similar stroke rates between strategies. Certainty of evidence ranged from
very low to moderate. <br/>Conclusion(s): In intermediate- and high-risk
patients with severe AS and concomitant CAD, TAVR + PCI appears to confer
short-term safety advantages but may be associated with less favorable
mid- to long-term outcomes compared with SAVR + CABG. These findings
support individualized revascularization strategies that balance early
procedural safety against longer-term risks and highlight the need for
further randomized trials with extended follow-up. Systematic Review
Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251000317,
PROSPERO CRD420251000317.<br/>Copyright 2026 Fang, Zhang, Wei, Feng and
Chen.

<41>
Accession Number
2036876769
Title
Successful cutaneous sensory blockade following single-injection and
double-injection techniques of ultrasound-guided superficial parasternal
intercostal plane block: a randomized clinical trial.
Source
Regional Anesthesia and Pain Medicine. 51(2) (pp 174-180), 2026. Date of
Publication: 01 Feb 2026.
Author
Samerchua A.; Sroiwong C.; Lapisatepun P.; Leurcharusmee P.; Pipanmekaporn
T.; Sukhupragarn W.; Boonsri S.; Bunchungmongkol N.; Pansuan K.; Phothikun
A.
Institution
(Samerchua, Sroiwong, Lapisatepun, Leurcharusmee, Pipanmekaporn,
Sukhupragarn, Boonsri, Bunchungmongkol, Pansuan) Faculty of Medicine,
Chiang Mai University, Chiang Mai, Thailand
Publisher
BMJ Publishing Group
Abstract
Background While superficial parasternal intercostal plane blocks can
improve analgesia after cardiac surgery, the optimal site and the number
of injections remain uncertain. This study aimed to compare the efficacy
of single versus double injections of superficial parasternal blocks,
hypothesizing that double injections would achieve superior cutaneous
sensory blockade. Methods 70 cardiac patients undergoing median sternotomy
were randomly assigned to receive either single or double injections of
superficial parasternal blocks bilaterally. Each patient received 40mL of
0.25% bupivacaine with epinephrine 5microg/mL and dexamethasone 10mg. The
single-injection group received 20mL/side at the third costal cartilage,
while the double-injection group received 10mL/injection at the second and
fourth costal cartilages. The primary outcome was a successful block,
defined as sensory loss in the T2-T6 dermatomes. Secondary outcomes
included sensory block of T1, T7, and T8 dermatomes, block-related
complications, intraoperative hemodynamics, postoperative pain intensity,
opioid consumption, and recovery quality. Results Double injections
achieved an overall higher success rate compared with the single-injection
technique (81% vs 51%, relative risk 1.6; 95%CI 1.2, 2.0; p<0.001).
Additionally, higher blockade percentages were observed in dermatomes T1
(83% vs 59%, p=0.003), T7 (67% vs 46%, p=0.017), and T8 (61% vs 39%,
p=0.011) with double injections. Other secondary outcomes did not differ
significantly between groups. Conclusions Compared with single injection,
double injections of superficial parasternal blocks provided more reliable
coverage of the T2-T6 dermatomes, crucial for median sternotomy. However,
no differences were observed in intraoperative hemodynamic effects or
postoperative pain control after cardiac surgery.<br/>Copyright &#xa9;
American Society of Regional Anesthesia & Pain Medicine 2026. No
commercial re-use. See rights and permissions. Published by BMJ Group.

<42>
Accession Number
2042967588
Title
Exercise-based cardiac rehabilitation after transcatheter aortic valve
replacement: a systematic review and meta-analysis of randomized
controlled trials.
Source
Future Cardiology. 22(2) (pp 155-166), 2026. Date of Publication: 2026.
Author
Khan U.; Abdelgalil M.S.; Khan M.H.; Ali J.; Majeed Z.; Amin A.M.; Nawaz
A.; Younas H.M.W.; Abuelazm M.; Aamir M.
Institution
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Abdelgalil) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Ali) Department of Medicine, Saint Peter's University Hospital, New
Brunswick, NJ, United States
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Younas) Department of Medicine, Weiss Memorial Hospital, Chicago, IL,
United States
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Aamir) Department of Cardiology, Lehigh Valley Health Network, Allentown,
PA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Many patients remain functionally limited after transcatheter
aortic valve replacement (TAVR) despite successful correction of aortic
stenosis. Exercise-based cardiac rehabilitation (EBCR) is effective in
other cardiac populations, but its benefits after TAVR remain uncertain.
This study evaluated the impact of EBCR on functional capacity, cardiac
function, quality of life, and safety outcomes in post-TAVR patients.
<br/>Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) published through February 2025 was conducted
using major databases. Outcomes were pooled using mean differences or risk
ratios with 95% confidence intervals. <br/>Result(s): Six RCTs with 272
patients were included. No significant difference was found between EBCR
and usual care for peak VO<inf>2</inf> change (MD: 1.46, 95% CI: [-0.16 to
3.08], p = 0.076) and six-minute walk distance (6MWD) change (MD: 18.72,
95% CI: [-2.24 to 39.68], p = 0.08). Similarly, no significant difference
was observed between EBCR and usual care for left ventricular ejection
fraction (LVEF) change (MD: 1.31, 95% CI: [-2.06 to 4.69], p = 0.45), and
aortic valve orifice area change (AVOA) (MD: -0.03, 95% CI: [-0.24 to
0.18], p = 0.78). <br/>Conclusion(s): EBCR did not significantly improve
outcomes after TAVR; however, near-significant trends in functional
capacity warrant further large-scale investigation. <br/>Protocol
Registration: PROSPERO ID CRD420250652719.<br/>Copyright &#xa9; 2026
Informa UK Limited, trading as Taylor & Francis Group.

<43>
[Use Link to view the full text]
Accession Number
2043177382
Title
Comparative Outcomes of Balloon-Expandable and Self-Expandable Valves in
Transcatheter Aortic Valve Replacement for Bicuspid Aortic Stenosis: A
Systematic Review and Meta-Analysis.
Source
Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date
of Publication: 2025.
Author
Bacha Z.; Rath S.; Qadri M.; Alam U.; Ali M.A.; Ahmad O.; Sajjad F.; Khan
K.; Noor H.; Javed J.; Henna F.; Tariq M.D.; Ghanim Al-Badri S.; Ahmed R.;
Ahmad H.; Fakhar M.; Mattumpuram J.
Institution
(Bacha, Alam, Ali, Ahmad, Sajjad, Khan, Noor) From the Department of
Medicine, Khyber Medical College, Peshawar, Pakistan
(Rath) Department of Medicine, All India Institute of Medical Sciences,
Bhubaneswar, Odisha, India
(Qadri, Javed) Department of Medicine, Jinnah Sindh Medical University,
Karachi, Pakistan
(Henna) Department of Medicine, Dubai Medical College for Girls, Dubai,
United Arab Emirates
(Tariq, Fakhar) Department of Medicine, Mary Washington Healthcare,
Fredericksburg, VA
(Ghanim Al-Badri) Department of Medicine, College of Medicine, University
of Warith Al-Anbiyaa, Karbala, Iraq
(Ahmed, Ahmad) Department of Cardiology, National Heart and Lung
Institute, Imperial College London, London, United Kingdom
(Mattumpuram) Department of Cardiology, University of Louisville School of
Medicine, Louisville, KY
Publisher
Lippincott Williams and Wilkins
Abstract
The comparative efficacy and safety of balloon-expandable valves (BEVs)
and self-expandable valves (SEVs) in transcatheter aortic valve
replacement for bicuspid aortic stenosis remain a topic of debate. This
systematic review and meta-analysis aim to synthesize available evidence
to guide clinical decision-making. A systematic search of PubMed, Embase,
and Web of Science was conducted. Risk ratios (RRs) and mean differences
were pooled using a random-effects model. Thirteen studies comprising 2174
patients were included. BEVs were associated with a significantly higher
risk of annulus rupture (RR = 3.00, 95% CI, 1.13-7.94, P = 0.03), while
procedural and 30-day mortality rates were comparable between BEVs and
SEVs. The need for new pacemaker implantation at 30 days was significantly
lower in the BEV group (RR = 0.64, 95% CI, 0.49-0.83, P = 0.0009).
Postdilation was reduced considerably with BEVs following sensitivity
analysis (RR = 0.35, 95% CI, 0.24-0.52, P < 0.0001). In summary, both BEVs
and SEVs demonstrated acceptable safety profiles, with BEVs carrying a
higher risk of annular rupture but potential advantages in device success
and postdilation rates. Large-scale randomized trials remain essential to
refine patient selection and procedural strategies.<br/>Copyright &#xa9;
2025

<44>
Accession Number
2041584408
Title
Propofol-supplemented cardioplegia: A multicenter blinded 3-group
randomized trial (Propofol for Myocardial Protection Trial 2: ProMPT2).
Source
Journal of Thoracic and Cardiovascular Surgery. 171(3) (pp 649-658), 2026.
Date of Publication: 01 Mar 2026.
Author
Angelini G.D.; Smartt H.J.M.; Joyce K.; Heys R.; Maishman R.; Culliford
L.; de Jesus S.E.; Fitzgerald B.M.; Suleiman M.S.; Punjabi P.; Nwaejike
N.; Downes R.; Gibbison B.; Rogers C.A.
Institution
(Angelini, Suleiman, Gibbison) Bristol Heart Institute, University of
Bristol, Bristol, United Kingdom
(Smartt, Joyce, Heys, Maishman, Culliford, de Jesus, Fitzgerald, Rogers)
Bristol Trials Centre, Bristol Medical School, University of Bristol,
Bristol, United Kingdom
(Punjabi) National Heart and Lung Institute, Imperial College London,
London, United Kingdom
(Punjabi) Hammersmith Hospital, Imperial College Healthcare NHS Trust,
London, United Kingdom
(Nwaejike) Wythenshawe Hospital, Manchester University NHS Foundation
Trust, Manchester, United Kingdom
(Downes) Perfusion Department, University Hospitals Bristol and Weston NHS
Foundation Trust, Bristol, United Kingdom
Publisher
Elsevier Inc.
Abstract
Objective: Coronary artery bypass grafting using cardiopulmonary bypass
and cardioplegic arrest is an effective treatment for coronary artery
disease. Research suggests supplementing the cardioplegia solution with
propofol may be cardioprotective. Our aim was to compare the safety and
efficacy of supplementing the cardioplegia solution with different doses
of propofol in adults undergoing first-time surgery. <br/>Method(s): A
blinded, parallel group randomized controlled trial conducted in 3
hospitals in the United Kingdom compared a cardioplegia solution
supplemented with high-dose propofol (concentration 12 mug/mL), low-dose
propofol (concentration 6 mug/mL), and placebo (saline). Primary outcome
was cardiac troponin T measurements over the first 48 hours after surgery.
Participants were followed for 12 months. <br/>Result(s): In total, 240
participants, median age 66 years, 90% male, were randomly allocated: 78
to high-dose propofol, 80 to low-dose propofol, and 82 to placebo. In
total, 239 participants were included in the primary analysis. Geometric
mean cardiac troponin release at 48 hours (95% confidence interval) was
145 ng/L (125-168), 162 ng/L (138-191), and 150 ng/L (125-180) in the
high-dose propofol, low-dose propofol, and placebo groups, respectively
(adjusted geometric mean ratio 1.06; 95% confidence interval, 0.97-1.15; P
= .20, for pairwise comparisons between high- and low-dose propofol and
between low-dose propofol and placebo). A total of 96 adverse events that
prolonged the hospital stay or were life-threatening were reported (33,
26, and 37 in the high-dose propofol, low-dose propofol, and placebo
groups, respectively), as well as 4 deaths (1 low-dose propofol group, 3
placebo group). <br/>Conclusion(s): Propofol supplementation of warm blood
cardioplegia at both the lower and higher concentrations is safe, but
there is no evidence to suggest either dose is
cardioprotective.<br/>Copyright &#xa9; 2025 The Authors

<45>
Accession Number
2042607921
Title
Stress Cardiac Magnetic Resonance Ischemia Burden and Cardiovascular
Events: Post-Hoc Analysis From the ISCHEMIA Trial.
Source
JACC: Cardiovascular Imaging. 19(3) (pp 326-341), 2026. Date of
Publication: 01 Mar 2026.
Author
Kwong R.Y.; Heydari B.; Abbasi S.; Mongeon F.-P.; Marcotte F.; Friedrich
M.; Shaw L.J.; Xu Y.; Anthopolos R.; Bekeredjian R.; Monti L.;
Selvanayagam J.; Lesiak M.; Picard M.H.; Berman D.S.; Bangalore S.;
Spertus J.A.; Stone G.W.; Boden W.E.; Min J.; Mancini G.B.J.; Leipsic J.;
Budoff M.; Hague C.; Hochman J.S.; Maron D.J.; Reynolds H.R.
Institution
(Kwong, Heydari) Department of Medicine, Cardiovascular Division, Brigham
and Women's Hospital, Harvard Medical School, Boston, MA, United States
(Abbasi) Amegen, Thousand Oaks, CA, United States
(Mongeon) Department of Specialized Medicine, Division of Non-Invasive
Cardiology, Montreal Heart Institute, Montreal, QC, Canada
(Marcotte) Mayo Clinic, Phoenix, AZ, United States
(Friedrich) Department of Specialized Medicine, Division of Non-Invasive
Cardiology, Montreal Heart Institute, Universite de Montreal, Montreal,
QC, Canada
(Shaw) Icahn School of Medicine at Mount Sinai, New York, NY, United
States
(Xu, Anthopolos) NYU Grossman School of Medicine, New York, NY, United
States
(Bekeredjian) Robert Bosch Medical Center, Stuttgart, Germany
(Monti) Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
(Selvanayagam) Flinders Medical Centre, Adelaide, SA, Australia
(Lesiak) University Hospital of the Lords Transfiguration, Poznan, Poland
(Picard) Department of Medicine, Cardiovascular Division, Massachusetts
General Hospital, Harvard Medical School, Boston, MA, United States
(Berman) Cedars Sinai Medical Center, Los Angeles, CA, United States
(Bangalore) Duke Clinical Research Institute, Durham, NC, United States
(Spertus) Saint Luke's Mid America Heart Institute, Kansas City, MO,
United States
(Spertus) University of Missouri-Kansas City's Healthcare Institute for
Innovations in Quality, Kansas City, MO, United States
(Stone) The Zena and Michael A. Wiener Cardiovascular Institute, Icahn
School of Medicine at Mount Sinai, New York, NY, United States
(Boden) VA New England Healthcare System, Bedford, MA, United States
(Min, Hague) Cleerly Inc, New York, NY, United States
(Mancini, Leipsic) University of British Columbia, Vancouver, BC, Canada
(Budoff) Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA,
United States
(Hochman, Reynolds) Cardiovascular Clinical Research Center, Leon H.
Charney Division of Cardiology, Department of Medicine, NYU Grossman
School of Medicine, New York, NY, United States
(Maron) Department of Medicine, Stanford University School of Medicine,
Stanford, CA, United States
Publisher
Elsevier Inc.
Abstract
Background: Research comparing the prognostic value of stress cardiac
magnetic resonance (CMR) to other stress modalities in patients with
coronary disease is limited. <br/>Objective(s): The authors compared the
prognostic value of stress CMR vs alternative testing by either
single-photon emission computed tomography or stress echocardiography
(SPECT/echo) in the ISCHEMIA (International Study of Comparative Health
Effectiveness with Medical and Invasive Approaches) trial. <br/>Method(s):
CMR vs SPECT/echo was compared in 3,909 patients randomized in ISCHEMIA
after sites' interpretation of moderate to severe ischemia. Ischemia and
infarct extent, measured by either CMR or SPECT/echo, were each associated
with the trial's primary outcome of cardiovascular death, nonfatal
myocardial infarction (MI), or hospitalization for unstable angina, heart
failure, or resuscitated cardiac arrest, at a median follow-up of 3.37
years (Q1-Q3: 2.20-4.56 years). <br/>Result(s): Compared with SPECT/echo
(n = 5,627), CMR participants (n = 313) were not different in key
demographic factors but were more likely to have severe ischemia (57% vs
38%; P < 0.001) and to be randomized (n = 257, 82%, vs n = 3,652, 65%; P <
0.001). Ischemia severity (no/mild, moderate, severe) by CMR core
laboratory was associated with cumulative 4-year event rates of all
trial-specific endpoints, including the primary outcome (P = 0.042),
cardiovascular death/MI (P = 0.041), and nonfatal MI (P = 0.03), but
SPECT/echo ischemia severity was not. No/mild, moderate, and severe
ischemia by CMR were associated with 0%, 14%, and 23% 4-year primary
outcome rates, respectively, compared with 18%, 15%, and 16%, by
SPECT/echo. After adjustment for age, estimated glomerular filtration
rate, and diabetes, the association between ischemia extent and the
primary endpoint differed by imaging modality, with each additional
ischemic segment on CMR associated with a 13% increase in hazard
(interaction P = 0.02). In participants assigned to initial conservative
management who had no/mild ischemia on imaging, 4-year rates of invasive
referral and coronary revascularization were lower in the CMR than
SPECT/echo group (16.7% and 0%, respectively, for CMR; and 31% and 13.3%,
respectively, for SPECT/echo). <br/>Conclusion(s): Ischemia severity by
CMR had a stronger association with all ISCHEMIA trial endpoints compared
with SPECT/echo. (International Study of Comparative Health Effectiveness
with Medical and Invasive Approaches [ISCHEMIA];
NCT01471522)<br/>Copyright &#xa9; 2026 American College of Cardiology
Foundation

<46>
Accession Number
2042172243
Title
Perioperative Multimodal General Anesthesia Focusing on Specific Central
Nervous System Targets Does Not Reduce Postoperative Interleukin-6 and
Neurofilament Light Levels in Patients Undergoing Cardiac Surgeries: A
Randomized Controlled Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(3) (pp 814-824),
2026. Date of Publication: 01 Mar 2026.
Author
Janga S.R.; Li M.H.; Kveraga K.; Ramachandran R.V.; Sharkey A.; Bose R.;
Sehgal S.; Brown E.N.; Subramaniam B.
Institution
(Janga, Li, Kveraga, Sharkey, Bose, Sehgal, Subramaniam) Department of
Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical
Center, Boston, MA, United States
(Ramachandran) Department of Anesthesiology and Pain Medicine, University
of Washington, Seattle, WA, United States
(Brown) Department of Anesthesia, Critical Care and Pain Medicine,
Massachusetts General Hospital, Boston, MA, United States
Publisher
W.B. Saunders
Abstract
Objectives: Interleukin-6 (IL-6) and neurofilament light chain (NFL) are
predictive biomarkers of postoperative delirium in patients undergoing
cardiac surgery. This study was designed to compare postoperative changes
in IL-6 and NFL between patients receiving multimodal general anesthesia
(MMGA) guided by electroencephalography (EEG) versus standard-of-care
anesthesia. <br/>Design(s): Randomized, controlled, investigator-blinded
clinical trial. <br/>Setting(s): A single-center, tertiary referral
hospital. <br/>Participant(s): Adults >=60 years old undergoing coronary
artery bypass grafting, valve, or combined procedures.
<br/>Intervention(s): MMGA included intraoperative EEG monitoring, total
intravenous anesthesia with propofol, remifentanil, ketamine,
dexmedetomidine, pecto-intercostal fascial block, and postoperative
pecto-intercostal fascial block. Controls received inhaled anesthetics and
intravenous fentanyl, without EEG guidance. <br/>Measurements and Main
Results: IL-6 and NFL were measured at baseline, postoperative day 1, and
postoperative day 2. EEG was recorded intraoperatively and
postoperatively. Cognition was assessed using the Confusion Assessment
Method and Montreal Cognitive Assessment up to 6 months. No significant
differences were observed in IL-6 or NFL levels at any time point.
Delirium incidence and long-term cognitive dysfunction were also similar.
However, burst suppression duration was significantly longer in the MMGA
group (mean = 4.83 minutes, standard deviation = 3.47) versus controls
(mean = 1.68 minutes, standard deviation = 2.2), particularly during and
after cardiopulmonary bypass in male patients. <br/>Conclusion(s): MMGA
did not reduce postoperative IL-6 or NFL levels, nor did it improve
neurocognitive outcomes, compared with standard of care. The higher burst
suppression in the MMGA group underscores the need for structured EEG
education among cardiac anesthesiologists. Future studies should explore
other EEG metrics and multimodal strategies for perioperative brain
protection.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<47>
Accession Number
2041905354
Title
Rationales Behind Physiology-Guided Revascularization.
Source
JACC: Cardiovascular Interventions. 19(4) (pp 422-434), 2026. Date of
Publication: 23 Feb 2026.
Author
Zhang R.; Wang H.-Y.; Song L.; Guan C.; Yin D.; Zhu C.; Feng L.; Jin Z.;
Yu B.; Fu G.; Zhou Y.; Wang J.; Chen Y.; Pu J.; Chen L.; Qu X.; Zhao Y.;
Wang Y.; Liu W.; Qiao S.; Tu S.; Wijns W.; Dou K.
Institution
(Zhang, Wang, Dou) Cardiometabolic Medicine Center, National Clinical
Research Center for Cardiovascular Diseases, Fuwai Hospital, National
Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences
and Peking Union Medical College, Beijing, China
(Zhang, Wang, Song, Yin, Zhu, Feng, Qiao, Dou) Department of Cardiology,
National Clinical Research Center for Cardiovascular Diseases, Fuwai
Hospital, National Center for Cardiovascular Diseases, Chinese Academy of
Medical Sciences and Peking Union Medical College, Beijing, China
(Zhang, Wang, Song, Yin, Zhu, Feng, Qiao, Dou) Coronary Heart Disease
Center, Fuwai Hospital, National Center for Cardiovascular Diseases,
Chinese Academy of Medical Sciences and Peking Union Medical College,
Beijing, China
(Zhang, Wang, Dou) State Key Laboratory of Cardiovascular Disease,
Beijing, China
(Song, Guan) Catheterization Laboratories, Fuwai Hospital, National Center
for Cardiovascular Diseases, Chinese Academy of Medical Sciences and
Peking Union Medical College, Beijing, China
(Jin) Department of Cardiology, Beijing Tiantan Hospital, Capital Medical
University, Beijing, China
(Yu) Department of Cardiology, Second Affiliated Hospital of Harbin
Medical University, Harbin, China
(Fu) Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Zhou) Department of Cardiology, Beijing Anzhen Hospital, Capital Medical
University, Beijing, China
(Wang) Department of Cardiology, Second Affiliated Hospital, Zhejiang
University School of Medicine, Hangzhou, China
(Chen) Department of Cardiology, Sixth Medical Centre, Chinese PLA General
Hospital, Beijing, China
(Pu) Department of Cardiology, Renji Hospital, School of Medicine,
Shanghai Jiao Tong University, Shanghai, China
(Chen) Department of Cardiology, Fujian Medical University Union Hospital,
Fuzhou, China
(Qu) Department of Cardiology, Huadong Hospital Affiliated to Fudan
University, Shanghai, China
(Zhao, Wang) Medical Research and Biometrics Center, National Center for
Cardiovascular Diseases, Beijing, China
(Liu) State Key Laboratory for Complex, Severe, and Rare Diseases, Peking
Union Medical College Hospital, Chinese Academy of Medical Sciences,
Beijing, China
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
(Wijns) The Lambe Institute for Translational Medicine and Curam,
University of Galway, Galway, Ireland
Publisher
Elsevier Inc.
Abstract
Background The optimization of a treatment plan developed on the basis of
coronary angiography alone is recognized as one of the underlying
rationales for the clinical benefits of physiology-guided percutaneous
coronary intervention (PCI). Objectives The aim of this study was to
investigate the diagnostic impact of quantitative flow ratio (QFR) through
a post hoc analysis of the multicenter randomized FAVOR (Comparison of
Quantitative Flow Ratio Guided and Angiography Guided Percutaneous
Intervention in Patients With Coronary Artery Disease) III China trial.
Methods In FAVOR III China, operators were required to declare all target
vessels intended for PCI before randomization (prerandomization declared
treatment plan). After randomization, the actual treatment strategy was
performed with online QFR or angiographic guidance (randomized
allocation). In this study, prerandomization treatment plan and
postrandomization treatment strategy were adjudicated using off-line QFR
by independent core laboratory to determine physiological concordance. The
primary outcome of interest for the present study was major adverse
cardiac events. Results Among 3,768 pooled patients with available
off-line QFR, 2,601 (69.0%) had prerandomization physiology-concordant
plans, proportions of which were comparable between the online QFR-guided
and angiography-guided groups (70.9% [1,340 of 1,891] vs 67.2% [1,261 of
1,877], standardized mean difference = 0.087). Physiological concordance
was reclassified in 447 (23.6%) and 87 (4.6%) patients with online QFR and
angiographic guidance, respectively, and a significant between-group
difference was identified in terms of achieving postrandomization
physiological concordance (92.3% vs 67.2%, standardized mean difference =
0.665). A significant interaction was identified between prerandomization
physiological concordance and randomized allocation for 2-year major
adverse cardiac events ( P for interaction = 0.002). Patients with older
age, multivessel disease, left circumflex or right coronary artery
involved, and lower SYNTAX (Synergy Between PCI With Taxus and Cardiac
Surgery) scores were found more likely to have prerandomization
physiological nonconcordance. Conclusions In the FAVOR III China trial,
approximately 30% of patients showed discrepancies between
angiography-based treatment plans and physiological ischemia. The
mechanistic insight underlying the benefits of QFR-guided PCI is
reclassification following online QFR guidance, which leads to a shift
from initially flawed plans toward physiology-concordant decisions. (The
FAVOR III China Study [FAVORIII]; NCT03656848 )<br/>Copyright &#xa9; 2026
American College of Cardiology Foundation.

<48>
Accession Number
2043137807
Title
Impact of frailty on postoperative delirium in ICU patients aged 65 and
older: a systematic review.
Source
BMJ Open. 16(1) (no pagination), 2026. Article Number: e108249. Date of
Publication: 22 Jan 2026.
Author
Schindele D.; McDonough J.; Muller-Wolff T.
Institution
(Schindele) Institute of Nursing Science and Practice, Paracelsus Medical
University, Salzburg, Austria
(Schindele, Muller-Wolff) Regionale Kliniken Holding RKH GmbH,
Ludwigsburg, Germany
(McDonough, Muller-Wolff) University of North Florida, Brooks College of
Health, Jacksonville, FL, United States
Publisher
BMJ Publishing Group
Abstract
Objectives The objective was to assess whether frailty is associated with
an increased risk of postoperative delirium (POD) in intensive care unit
(ICU) patients aged 65 years and older. Design A systematic review was
conducted in accordance with Preferred Reporting Items for Systematic
Review and Meta-Analysis guidelines. MEDLINE (via PubMed) and the Cochrane
Library were searched for studies published between August 2014 and
January 2025, assessing frailty with validated instruments and reporting
POD during ICU stay. While the search strategy was not limited to a
specific study design, only observational studies met the inclusion
criteria. Study quality was appraised using the NewcastleOttawa Scale
(NOS). Due to methodological heterogeneity, results were synthesised
narratively. Setting This review targeted the intensive care setting
specifically, including studies conducted in hospital-based ICUs in
various countries. Results Of 655 records, five studies (n=3045) met
inclusion criteria. Frailty prevalence ranged from 10% to 34.9%. Tools
used included the Fried Frailty Scale, modified Frailty Index (mFI), FRAIL
Scale (Fatigue, Resistance, Ambulation, Illnesses, and Loss of weight),
Comprehensive Assessment of Frailty and Edmonton Frailty Scale. Frail
patients had higher POD incidence and experienced more complications such
as acute kidney injury, prolonged mechanical ventilation and reoperation.
NOS scores ranged from 5 to 7, indicating moderate quality. Conclusion
Frailty appears to be associated with an increased risk of POD in ICU
patients aged 65 and older. Given the limited number and heterogeneity of
studies, further research is needed to validate this relationship and to
inform targeted prevention strategies in critical care.<br/>Copyright
&#xa9; Author(s) (or their employer(s)) 2026. Re-use permitted under CC
BY. Published by BMJ Group.

<49>
Accession Number
2043225157
Title
Analgesic efficacy of the subtransverse process interligamentary plane
block in thoracic surgery: A randomized, controlled, non-inferiority
trial.
Source
Journal of Clinical Anesthesia. 110 (no pagination), 2026. Article Number:
112149. Date of Publication: 01 Mar 2026.
Author
Wu W.; Liu Y.; Liu M.; Wu J.; He W.; Shi H.
Institution
(Wu, Liu, Liu, Wu, Shi) Department of Anesthesiology, Shanghai Pulmonary
Hospital, School of Medicine, Tongji University, Shanghai, China
(He) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, School
of Medicine, Tongji University, Shanghai, China
Publisher
Elsevier Inc.
Abstract
Background Clinical evidence on the analgesic efficacy of the
subtransverse process interligamentary plane (STIL) block after thoracic
surgery remains limited. This study aimed to compare the postoperative
analgesic efficacy of the STIL block versus the thoracic paravertebral
block (TPVB) in thoracic surgery. Methods This randomized, non-inferiority
trial enrolled patients undergoing video-assisted thoracoscopic surgery at
a large academic medical center in China. Patients were randomly assigned
(1:1) to receive either the STIL block or TPVB. Both groups received a
single-shot injection of 15 mL of 1% ropivacaine mixed with 2% lidocaine.
The primary outcome was pain intensity during deep inspiration within 48 h
postoperatively, assessed by the area under the curve (AUC) of the numeric
rating scale. A non-inferiority margin of 34 was predefined, and analyses
were performed in both intention-to-treat and per-protocol populations.
Results From February 1, 2023, to December 30, 2024, 114 eligible patients
(median age 58 years [IQR 49-61]; 54.0% female) were enrolled and randomly
assigned to receive either the STIL block ( n = 57) or the TPVB (n = 57).
Nine patients were excluded after randomisation, resulting in 105 patients
included in the per-protocol analysis. In the per-protocol population, the
48-h postoperative pain AUC during deep inspiration was 196.04 +/- 2.50
for the STIL group and 187.49 +/- 4.13 for the TPVB group (mean difference
= 8.59; 95% CI, -0.94 to 18.14). In the intention-to-treat population, the
values were 195.24 +/- 2.49 and 186.44 +/- 4.03, respectively (mean
difference = 9.12; 95% CI, -0.39 to 18.63), both within the predefined
noninferiority margin. No serious adverse events were observed in either
group. Conclusions This randomized clinical trial demonstrates that, in
the studied population, the subtransverse process interligamentary plane
block was non-inferior to the thoracic paravertebral block for
postoperative pain control after thoracic surgery, providing an effective
alternative for analgesia.<br/>Copyright &#xa9; 2026 Elsevier Inc.

<50>
Accession Number
2019390809
Title
RETRACTED: The Application of the Nurse-Led Sedation and Analgesia
Management in ICU after Heart Surgeries.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 7706172. Date of Publication: 2022.
Author
Lu R.; Song H.; Wang L.; Xiong H.; Chen Z.; Liu X.; Wang S.; Xie C.; Jia
P.
Institution
(Lu, Wang, Xiong, Chen) Department of SICU, Sichuan Academy of Medical
Sciences and Sichuan Provincial People's Hospital, School of Medicine,
University of Electronic Science and Technology of China, Sichuan,
Chengdu, China
(Lu, Wang, Chen, Xie, Jia) Chinese Academy of Sciences Sichuan
Translational Medicine Research Hospital, Sichuan, Chengdu, China
(Song) Department of Nursing, Sichuan Provincial People's Hospital and
QiongLai Hospital, Sch. of Med., Univ. of Electronic Science and
Technology of China, Chengdu, Sichuan Uestc.edu.cn, China
(Xiong) Department of Neurosurgery, Sichuan Academy of Medical Sciences
and Sichuan Provincial People's Hospital, School of Medicine, University
of Electronic Science and Technology of China, Sichuan, Chengdu, China
(Liu) Department of ICU, Deyang People's Hospital, Sichuan, Deyang, China
(Wang) School of Nursing, North Sichuan Medical College, Sichuan,
Nanchong, China
(Xie) Department of Nursing, Sichuan Academy of Medical Sciences and
Sichuan Provincial People's Hospital, School of Medicine, University of
Electronic Science and Technology of China, Sichuan, Chengdu, China
(Jia) Department of NICU, Sichuan Academy of Medical Sciences and Sichuan
Provincial People's Hospital, School of Medicine, University of Electronic
Science and Technology of China, Sichuan uestc.edu.cn, Chengdu, China
Publisher
Hindawi Limited
Abstract
Aim. Traditional sedation management consists of doctors adjusting the
dosage of sedative drugs or adding other drugs in combination according to
the evaluation of nurses; the nurses then execute the orders. The nurses'
passive execution in the process is not the ideal model for continuous
evaluation and observation of sedation. This study aims to investigate the
application and effects of nurse-provided procedural sedation and
analgesia for patients in intensive care unit. Methods. The experimental
group consisted of 354 heart surgery patients who received procedural
sedation and analgesia from nurses from November 2020 to August 2021. The
control group consisted of 301 patients who had had heart surgery and
received the traditional sedation management program from January to
October 2020. The differences in levels of the sedative effect, delirium,
and unplanned extubation of patients between these two groups were
compared. Results. There were no significant differences in baseline
characteristics between the two groups (P>0.05). It was found that both
insufficient sedation and excessive sedation decreased in the experimental
group when compared to the control group, while the appropriate proportion
of sedation increased (72.41% versus 37.98%); the difference was
statistically significant (P<0.05). The incidence of delirium was lower
for patients in the experimental group than for patients in the control
group (37.01% versus 66.45%); the difference was statistically significant
(P<0.05). The incidence of unplanned extubation caused by patient factors
was lower for the experimental group than for the control group, but the
difference was not statistically significant (P>0.05). Conclusion. The
programmed sedation scheme led by nurses can improve the sedation effect
and reduce the incidence of delirium. Implications for Practice. The
management team gives the sedative goal and establishes the standard
flowchart. The sedation management led by the nurse according to the goal
and flowchart is better than the traditional sedation
management.<br/>Copyright &#xa9; 2022 Rong Lu et al.

<51>
Accession Number
2014746627
Title
RETRACTED: Comparison of Efficacy and Safety of Recombinant Human
Prourokinase and Alteplase in the Treatment of STEMI and Analysis of
Influencing Factors of Efficacy.
Source
Evidence-based Complementary and Alternative Medicine. 2021 (no
pagination), 2021. Article Number: 6702965. Date of Publication: 2021.
Author
Liu Y.; Yang Y.; Li Y.; Peng X.
Institution
(Liu, Peng) Affiliated Nanhua Hospital, Department of Cardiology, Hengyang
Medical School, University of South China, Hunan, Hengyang, China
(Yang) Affiliated Nanhua Hospital, Department of Recovery from Anesthesia,
Hengyang Medical School, University of South China, Hunan, Hengyang, China
(Li) Affiliated Nanhua Hospital, Department of Nursing Teaching and
Research, Hengyang Medical School, University of South China, Hunan,
Hengyang, China
Publisher
Hindawi Limited
Abstract
Objective. To compare the efficacy and safety of recombinant human
prourokinase (rhPro-UK) and alteplase for thrombolytic therapy in acute
ST-segment elevation myocardial infarction (STEMI) and to analyze the
related factors affecting efficacy. Methods. From January 2017 to December
2019, 100 patients diagnosed with STEMI were selected and randomly divided
into the control group (n = 50) and the observation group (n = 50). Based
on conventional treatments, the control group was treated with alteplase,
and the observation group was treated with rhPro-UK, and both were treated
for 7 days. After treatment, the vascular recanalization, left ventricular
end-systolic diameter (LVESD), left ventricular end-diastolic diameter
(LVEDD), and left ventricular ejection fraction (LVEF) were compared. The
bleeding and major adverse cardiovascular events (MACE) were recorded in
both groups. According to the patient's vascular recanalization, it was
divided into two subgroups: recanalization group and occlusion group.
Multiple logistic regression models were used to analyze the related
factors that affect the efficacy. Results. The recanalization rate of the
observation group (96.00%) was higher than that of the control group
(84.00%) (P<0.05). After treatment, LVDs and LVEDD in both groups were
lower than those before treatment, and LVEF was higher than that before
treatment. The LVDs and LVEDD in the observation group were lower than
those in the control group, and the LVEF was higher than that in the
control group (P<0.05). The incidence of bleeding in the observation group
(2.00%) was lower than that in the control group (12.00%), and the
incidence of MACE (4.00%) was lower than that in the control group
(16.00%) (P<0.05). Univariate analysis showed that age, smoking history,
diabetes history, myocardial infarction history, infarct location, and
intravenous thrombolysis time were related to the efficacy after treatment
(P<0.05). Multivariate logistic analysis showed that age, history of
diabetes, vascular infarction site, and venous thrombolysis time were
independent influencing factors after treatment (P<0.05). Conclusion. Both
rhPro-UK and alteplase thrombolytic therapy can effectively recanalize
blood vessels and improve the cardiac function of patients with STEMI.
However, rhPro-UK has better effect than alteplase and is safer and worth
promoting. The curative effect is related to age, diabetes history,
vascular infarction site, and venous thrombolysis time.<br/>Copyright
&#xa9; 2021 Yizhou Liu et al.

<52>
Accession Number
2043536360
Title
Topical Versus Intravenous Tranexamic Acid in Cardiac Surgery: A
Meta-analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Motawea K.R.; Tanas Y.; Abouelenien M.; Pelletier M.; Abu-Omar Y.;
El-Diasty M.
Institution
(Motawea, Abu-Omar, El-Diasty) Cardiac Surgery Department, University
Hospitals Cleveland Medical Center, Cleveland, OH, United States
(Tanas) Houston Methodist Hospital, Weill Cornell Medical College,
Houston, TX, United States
(Abouelenien) Alexandria University, Alexandria, Egypt
(Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New
Haven, CT, United States
Publisher
W.B. Saunders
Abstract
Objectives: To compare the effectiveness and safety of topical versus
intravenous tranexamic acid (TXA) in patients undergoing cardiac surgery.
Design and Setting: A systematic review and meta-analysis were conducted
in compliance with the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses guidelines. PubMed, Web of Science, and Scopus databases
were searched for randomized controlled trials (RCTs) comparing topical
and intravenous TXA in cardiac surgery. <br/>Participant(s): Only RCTs
involving pediatric and/or adult patients undergoing cardiac surgery were
included. Six RCTs encompassing 3,577 patients (1,792 topical TXA; 1,785
intravenous TXA) met the inclusion criteria. <br/>Intervention(s): Topical
versus intravenous TXA administration in cardiac surgery.
<br/>Measurements and Main Results: Outcomes included postoperative blood
loss, hemoglobin levels, transfusion requirements, and clinical and safety
outcomes. The overall analysis revealed no significant difference in total
postoperative blood loss between the two groups (mean difference = -16.66,
95% confidence interval = -41.01 to 7.69, p = 0.18). Subgroup analysis
showed that topical TXA significantly reduced blood loss at 48 hours in
pediatric patients (mean difference = -8.63, 95% confidence interval =
-16.77 to -0.49, p = 0.04), but no significant difference was observed at
24 hours in adults. No significant differences were found in hemoglobin
level changes, transfusion requirements, or clinical outcomes. Safety
analyses showed comparable rates of mortality, reoperation, seizures,
infections, respiratory failure, intensive care unit length of stay, and
ventilation duration. <br/>Conclusion(s): The findings suggest that
topical and intravenous TXA demonstrate similar efficacy in reducing
perioperative bleeding in cardiac surgery, with no significant differences
in safety outcomes. However, topical TXA may have a delayed benefit in
pediatric patients. Larger, high-quality RCTs are warranted to confirm
these findings and to optimize TXA administration strategies in different
patient populations.<br/>Copyright &#xa9; 2026 Elsevier Inc.

<53>
Accession Number
2043204404
Title
Breathe poorly, recover worse? The impact of obstructive sleep apnea on
cardiac surgery outcomes - an updated systematic review and meta-analysis.
Source
Sleep and Breathing. 30(1) (no pagination), 2026. Article Number: 47. Date
of Publication: 01 Mar 2026.
Author
da Silva Ferreira M.; Oliveira de Amorim S.; Motta R.F.O.S.; Fayyat T.C.;
Pereira F.H.L.; Lima N.L.; Neto J.A.; Honorato M.M.
Institution
(da Silva Ferreira, Oliveira de Amorim, Pereira, Neto, Honorato) Faculty
of Medicine, University of the State of Para (UEPA), Para, Santarem,
Brazil
(Motta) Cesmac University Center, Alagoas, Maceio, Brazil
(Fayyat) Positivo University, Parana, Curitiba, Brazil
(Lima) Faculty of Medicine, Federal University of Santa Catarina, Santa
Catarina, Florianopolis, Brazil
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Purpose: We aimed to perform a systematic review and meta-analysis of
postoperative outcomes and the influence of obstructive sleep apnea (OSA)
in patients undergoing cardiac surgery. <br/>Method(s): We systematically
searched PubMed, Embase, Scopus, Cochrane Library and Web of Science for
eligible studies from inception to May 2025. We included randomized or
nonrandomized interventional studies comparing patients with versus
without OSA undergoing cardiac surgery. Risk ratios (RR) with 95%
confidence intervals (CI) were pooled with a random-effects model.
Statistical analysis was performed using RStudio 4.5.1. Heterogeneity was
assessed with I2 statistics. <br/>Result(s): A total of 2,642 studies were
screened, and 33 were fully reviewed. We included seventeen studies
involving 67,565 patients. Major adverse cardiac and cerebrovascular
events (RR: 1.66; 95% CI: 1.358-2.035; I2 = 0.0%) was significantly
increased in patients with OSA. The rates of all-cause mortality,
myocardial ischemia, postoperative atrial fibrillation, acute renal
failure, dialysis, pulmonary thromboembolism, tracheostomy, reintubation
and bleeding were similar in both groups. <br/>Conclusion(s): The presence
of OSA in patients undergoing cardiac surgery is associated with a
significantly higher risk of major adverse cardiac and cerebrovascular
events. However, definitive conclusions are hampered by significant
heterogeneity across studies, which is likely due to the inclusion of
nonrandomized studies, which underscores the need for further high-quality
research.<br/>Copyright &#xa9; The Author(s), under exclusive licence to
Springer Nature Switzerland AG 2026.

<54>
Accession Number
2043560385
Title
Thoracic paravertebral versus serratus anterior plane block in thoracic
surgery-a randomized trial.
Source
Signa Vitae. 22(2) (pp 47-54), 2026. Date of Publication: 01 Feb 2026.
Author
Yucal N.N.; Cardakozu T.; Cesur S.; Yorukoglu H.U.; Sezer H.F.; Elicora A.
Institution
(Yucal) Department of Anesthesiology and Reanimation, Basaksehir Cam &
Sakura City Hospital, Istanbul, Turkey
(Cardakozu, Cesur, Yorukoglu) Department of Anesthesiology and
Reanimation, Kocaeli University, Kocaeli, Turkey
(Sezer, Elicora) Department of Thoracic Surgery, Kocaeli University,
Kocaeli, Turkey
Publisher
Pharmamed Mado Ltd
Abstract
Background: Pain after thoracotomy is often severe and may lead to
postoperative complications. Although various regional anesthesia
techniques are used to manage thoracotomy pain, further evidence is needed
regarding the efficacy of the serratus anterior plane block (SAPB). This
randomized controlled study aimed to compare the postoperative analgesic
efficacy of ultrasound-guided single-injection thoracic paravertebral
block (TPVB) with deep SAPB in patients undergoing lung resection via
thoracotomy. <br/>Method(s): Sixty American Society of Anesthesiologists
(ASA) physical status I-III patients aged 18-75 years scheduled for
elective thoracotomy were randomized to receive either TPVB or SAPB using
20 mL of 0.5% bupivacaine. All patients received postoperative
patient-controlled intravenous morphine. Morphine consumption, visual
analogue score (VAS), postoperative nausea and vomiting (PONV), and
analgesia requirements were recorded at predetermined intervals. The
primary outcome was 24-hour postoperative opioid consumption. Secondary
outcomes included static and dynamic VAS pain scores, rescue analgesia
requirements, and complications. <br/>Result(s): Data from 58 patients
were analyzed. TPVB significantly reduced morphine consumption at all
measured time points (3, 6, 9, 12, and 24 hours). Total 24-hour opioid
consumption was lower in the TPVB group than in the SAPB group (8 mg vs.
14 mg p < 0.001). Rescue analgesia needs were higher in the SAPB group at
9th and 12th postoperative hours. TPVB also resulted in lower VAS scores
at multiple time points and lower (PONV). <br/>Conclusion(s): Compared to
SAPB, TPVB provided superior analgesia following thoracotomy, resulting in
lower opioid requirements, improved pain scores, and fewer opioid-related
side effects. Clinical Trial Registration: The study was retrospectively
registered with ClinicalTrials.gov (Registration No:
NCT06177652).<br/>Copyright &#xa9; 2026 The Author(s). Published by MRE
Press.

<55>
Accession Number
2043143399
Title
Azathioprine Increases the Risk of Non-Melanoma Skin Cancer Among Organ
Transplant Recipients; an Updated Systematic Review and Meta-Analysis.
Source
Cancer Reports. 9(2) (no pagination), 2026. Article Number: e70473. Date
of Publication: 01 Feb 2026.
Author
Salehi A.M.; Rezaei R.; Sadeghi A.; Omidi S.; Khazaei S.; Ebrahimi B.
Institution
(Salehi) Fetal and Pediatric Cardiovascular Research Center, Children's
Medical Center, Tehran University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Salehi, Rezaei, Sadeghi) Student Research Committee, Hamadan University
of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Omidi, Khazaei) Department of Epidemiology, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
(Ebrahimi) Department of Dermatology, School of Medicine, Hamadan
University of Medical Sciences, Hamadan, Iran, Islamic Republic of
Publisher
John Wiley and Sons Inc
Abstract
Background: Azathioprine (AZA) is a purine antimetabolite
immunosuppressant that prevents the body from rejecting transplanted
organs and is used in organ transplant recipients (OTRs). This study aimed
to conduct a meta-analysis to determine whether AZA usage has an increased
risk of skin cancer in OTRs. <br/>Method(s): To explore the association
between AZA usage and skin cancer through observational studies we
conducted a systematic search across PubMed, Scopus, and Web of Science
databases. A random effects model, subgroup analysis, and heterogeneity
assessment were used for meta-analysis. The quality of the included
studies was assessed using the Newcastle Ottawa scale checklist.
<br/>Result(s): A total of 27 studies with 21 405 patients were included
to the quantitative analysis. the overall summary estimate for
non-melanoma skin cancer (NMSC) risk in relation to AZA treatment
according Odds ratio (OR) estimates, relative risk (RR) estimates and
hazard ratio (HR) estimates were 1.83 (95% confidence interval (CI): 1.22,
2.75), 2.09 (CI: 1.41, 3.10), and 1.12 (CI: 0.93, 1.34), respectively.
There was a substantial heterogeneity between studies in all types of OR
estimates (I2 = 80.75%), RR estimates (I2 = 65.58%) and HR estimates (I2 =
54.63%). In the subgroup analysis, there was a significant increase in
squamous cell carcinoma (SCC) risk in all three estimate effects while
regarding basal cell carcinoma (BCC) none of them were significant.
<br/>Conclusion(s): Our findings indicate that OTRs treated with AZA are
at an increased risk for SCC and NMSC. Therefore, it is recommended to
prioritize monitoring for skin cancer in OTRs treated with
AZA.<br/>Copyright &#xa9; 2026 The Author(s). Cancer Reports published by
Wiley Periodicals LLC.

<56>
Accession Number
2020352702
Title
RETRACTED: Influences of Antithrombotic Elastic Socks Combined with Air
Pressure in Reducing Lower Extremity Deep Venous Thrombosis for Patients
Undergoing Cardiothoracic Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1338214. Date of Publication: 2022.
Author
Fu W.; Zhang Q.; Sun X.; Gu Y.
Institution
(Fu, Sun) Department of Thoracic Surgery, Affiliated Hospital of Nantong
University, Jiangsu, Nantong, China
(Zhang) Department of Cardiovascular Surgery, Affiliated Hospital of
Nantong University, Jiangsu, Nantong, China
(Gu) Department of Surgery, Affiliated Hospital of Nantong University,
Jiangsu, Nantong, China
Publisher
John Wiley and Sons Ltd
Abstract
This study was designed to investigate the application and therapeutic
effect of antithrombotic elastic socks combined with air pressure in the
prevention of lower extremity deep venous thrombosis in patients
undergoing cardiothoracic surgery. Sixty patients in cardiothoracic
surgery of our hospital from January 2019 to December 2020 were randomly
divided into a study group and control group. The control group was
treated with routine treatment intervention. Based on routine treatment
intervention, the study group was treated with antithrombotic elastic
socks combined with pneumatic treatment intervention. The activated
partial thromboplastin time (APTT), thrombin time (TT), femoral venous
blood flow velocity of both lower limbs, and the incidence of lower
extremity deep venous thrombosis (LEDVT), postoperative lower extremity
swelling, inflammatory factors, and satisfaction were measured. After
intervention, APTT (31.74+/-1.15 s) and TT (14.58+/-0.24 s) in the study
group were higher than those in the control group APTT (25.13+/-1.14 s)
and TT (12.14+/-0.23 s) (P<0.05). The left lower limb femoral vein blood
flow velocity and the right lower limb femoral vein blood flow velocity in
the study group were better than those in the control group (P<0.05). The
incidence of postoperative lower limb swelling and deep vein in the study
group was lower than that in the control group (P<0.05). Serum tumor
necrosis factor alpha and interleukin-6 concentrations in the study group
were lower than those in the control group (P<0.05). The satisfaction rate
of patients in the study group (93.33%) was significantly higher than that
in the control group (70.00%) (P<0.05). In conclusion, after
cardiothoracic surgery, antithrombotic elastic socks combined with air
pressure can significantly reduce the incidence of LEDVT by improving
patients' coagulation function, reducing inflammatory reaction. It is
worthy of popularization and application in relevant
surgery.<br/>Copyright &#xa9; 2022 Weihong Fu et al.

<57>
Accession Number
2043443813
Title
Sinotubular Stabilization in Isolated Tricuspid and Quadricuspid Aortic
Valve Repair.
Source
European Journal of Cardio-thoracic Surgery. 68(2) (no pagination), 2026.
Article Number: ezag056. Date of Publication: 01 Feb 2026.
Author
Ehrlich T.; Abeln K.B.; Froede L.; Zacek P.; Morgenthaler L.; Giebels C.;
Schafers H.-J.
Institution
(Ehrlich) Department of Cardiovascular Surgery and Heart Transplantation,
University Hospital of Nancy-Brabois, Vandoeuvre-les-Nancy, France
(Ehrlich, Abeln, Froede, Morgenthaler, Giebels) Department of
Cardiovascular Surgery, Saarland University Hospital, Saar, Homburg,
Germany
(Abeln, Schafers) Saarland University, Saarbrucken, Germany
(Zacek) Department of Cardiac Surgery, Faculty of Medicine, Charles
University, Hradec Kralove, Czechia
(Schafers) Department of Thoracic and Cardiovascular Surgery, Westpfalz
Klinikum, Kaiserslautern, Germany
(Schafers) Department of Cardiac Surgery, University Hospital Quironsalud,
Madrid, Spain
Publisher
European Association for Cardio-Thoracic Surgery

<58>
Accession Number
2018496226
Title
RETRACTED: Role of Aromatherapy as a Natural Complementary and Alternative
Therapy in Cardiovascular Disease: A Comprehensive Systematic Review.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 4543078. Date of Publication: 2022.
Author
Almohammed H.I.; A Alanazi N.; Maghrabi E.F.; A Alotaibi M.
Institution
(Almohammed) Department Of Basic Science, Faculty Of Medicine, Almaarefa
University, Riyadh, Saudi Arabia
(A Alanazi, Maghrabi) Faculty Of Medicine, University Science Malaysia
(USM), Kelantan, Kubang Kerian, Malaysia
(A Alotaibi) College Of Medicine, Imam Mohammad Ibn Saud Islamic
University, Riyadh, Saudi Arabia
Publisher
Hindawi Limited
Abstract
Background. The purpose of this study was a comprehensive review of
studies on the effect of aromatherapy with plant essential oils on the
improvement of some conditions, for example, anxiety, stress, sleep
quality, fatigue, and pain in people with cardiovascular disease.
Materials and Methods. We carried out this systematic review based on the
instructions of Preferred Reporting Items for Systematic Reviews and
Meta-Analyses (PRISMA). Ethical agreement was not necessary as main data
have not been collected. During March 2022, we searched the main English
databases, for example, Google Scholar, Web of Sciences, EMBASE, EBSCO,
ScienceDirect, Scopus, and PubMed/MEDLINE, with limitation to human
clinical trials. For this study, no time limit was applied for the
publication of articles. Results. Out of 1380 papers, 52 papers up to
March 2022 were eligible for review in this systematic review. Based on
the obtained results, the most widely used medicinal plants for
aromatherapy in patients with cardiovascular diseases were Lavandula
angustifolia (lavender, 55.7%), Rosa damascena (Damask rose, 11.5%), and
Mentha piperita (peppermint, 5.8%), respectively. Most studies have been
performed on the effect of aromatherapy on coronary angiography (21
papers, 40.4%), followed by artery bypass graft surgery (14 studies,
26.9%), and cardiac patients (5 studies, 9.6%). Most studies on the effect
of aromatherapy in cardiovascular diseases were performed on anxiety (31
papers, 59.6%), sleep quality (8 studies, 15.4%), and hemodynamic
parameters (6 studies, 11.5%), respectively. Conclusion. This study
systematically reviewed the effects of aromatherapy in patients with
cardiovascular diseases. The review of studies showed that lavender,
Damask rose, and peppermint are the most frequents plants used for
aromatherapy, whereas they significantly improved some illnesses and
conditions, especially anxiety and sleep quality. Therefore, it can be
concluded that cardiologist can used aromatherapy as a natural
complementary and alternative therapy particularly with lavender, Damask
rose, and peppermint to improve quality of life and some conditions such
as anxiety and sleep quality.<br/>Copyright &#xa9; 2022 Hamdan I
AlMohammed et al.

<59>
Accession Number
2041098938
Title
Anomalous left coronary artery from the pulmonary artery in adults: a
systematic review of clinical presentation, diagnosis, and outcomes.
Source
International Journal of Cardiovascular Imaging. 42(2) (pp 161-174), 2026.
Date of Publication: 01 Feb 2026.
Author
Suchodolski A.; Krolikowska M.; Kowal A.; Glowacki J.; Szulik M.
Institution
(Suchodolski, Szulik) Department of Cardiology and Electrotherapy,
Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze,
Medical University of Silesia, Marii Sklodowskiej-Curie 9 Zabrze,
Katowice, Poland
(Suchodolski) Doctoral School of the Medical University of Silesia in
Katowice, Katowice, Poland
(Krolikowska, Kowal) Student Research Group, Faculty of Medical Sciences
in Zabrze, Medical University of Silesia, Katowice, Poland
(Szulik) Collegium Medicum-Faculty of Medicine, Department of Medical and
Health Sciences, Faculty of Applied Sciences, Dabrowa Gornicza, Poland
(Glowacki) Computed Tomography Laboratory, Silesian Centre for Heart
Diseases, Zabrze, Poland
Publisher
Springer Science and Business Media B.V.
Abstract
Abnormal left coronary artery from the pulmonary artery (ALCAPA) is a rare
congenital coronary anomaly, occurring in approximately 1 in 300 000 live
births and accounting for roughly 0,5 per cent of all congenital heart
defects. Without surgical correction, in more than 90% of cases, the
defect leads to death in the first year of life. However, a small subgroup
of individuals survive into adulthood. In adults, it can manifest as
dyspnoea, angina, palpitations and eventually leads to heart failure,
arrhythmia and sudden cardiac death. We summarised 60 years of case
reports of ALCAPA syndrome in adults and identified 279 patients, the
majority of whom were women. In most cases, the diagnosis was based on
coronary angiography. The most common symptom was dyspnoea and the least
frequent were palpitations. Surgery was performed in 194 patients with a
mean age at surgery of 37,46 years. The aim of this study is to obtain
clinically relevant information that would be unattainable even in large
multicentre clinical trials, given the rarity of this anomaly. This is the
first review juxtaposing all ALCAPA cases in adults published in 60
years.<br/>Copyright &#xa9; The Author(s) 2025.

<60>
Accession Number
2043152985
Title
Preoperative Nutrition-Based Interventions in Children Undergoing Cardiac
Surgeries-A Systematic Review and Meta-Analysis.
Source
Nutrients. 18(3) (no pagination), 2026. Article Number: 544. Date of
Publication: 01 Feb 2026.
Author
Strozyk A.; Halicki P.; Kolodziej M.; Horvath A.; Buczynski M.; Pietrzak
R.
Institution
(Strozyk, Kolodziej, Horvath) Department of Pediatrics, Medical University
of Warsaw, Warsaw, Poland
(Halicki, Pietrzak) Department of Pediatric Cardiology and General
Pediatrics, Medical University of Warsaw, Warsaw, Poland
(Buczynski) Department of Cardiothoracic Surgery and Transplantology,
Medical University of Warsaw, Warsaw, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Objective: This systematic review aimed to evaluate the efficacy and
safety of preoperative nutrition-based interventions on pre-, intra-, and
postoperative outcomes in children undergoing cardiac surgical procedures.
<br/>Method(s): CENTRAL, MEDLINE, and EMBASE were systematically searched
for interventional and observational studies comparing any nutritional
preoperative intervention with a control or alternative strategy in
pediatric patients undergoing cardiac surgery, up to July 2025. The main
outcome was the postoperative length of stay in the intensive care unit
(ICU). The certainty of evidence was assessed using the GRADE approach.
<br/>Result(s): Nineteen studies were included (8 randomized controlled
trials [RCTs], 1 non-randomized trial, and 10 observational studies),
evaluating heterogeneous interventions or exposures, including fatty
acids, vitamin D supplementation, and structured preoperative nutritional
protocols. Two RCTs demonstrated shorter ICU and hospital stays with
extended preoperative nutritional support (2 weeks vs. 1 week; n = 40; and
1 month vs. no support; n = 80). Observational data indicated an
association between preoperative nutritional support and reduced hospital
length of stay (meta-analysis of four studies; n = 278), as well as fewer
days to achieve full enteral feeding postoperatively (meta-analysis of
three studies; n = 138). No significant difference in postoperative ICU
stay was observed between groups (meta-analysis of two studies; n = 175).
No intervention-related serious adverse events were reported. The overall
certainty of evidence was very low. <br/>Conclusion(s): This systematic
review provides very low-certainty evidence suggesting that preoperative
nutrition-based interventions in children undergoing cardiac surgery are
safe and may offer clinical benefits. Substantial heterogeneity across
studies underscores the need for well-designed trials and standardized
preoperative nutritional protocols. PROSPERO number:
CRD420251085196.<br/>Copyright &#xa9; 2026 by the authors.

<61>
Accession Number
2042093890
Title
The Effects of Tranexamic Acid on Renal Outcomes in Patients Undergoing
Cardiovascular Surgery: A Systematic Review and Meta-Analysis Compliant
With Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(3) (pp 844-854),
2026. Date of Publication: 01 Mar 2026.
Author
Zhang B.; He L.-X.; Yao Y.-T.
Institution
(Zhang) Department of Anesthesiology, Tianjin Union Medical Center,
Tianjin, China
(He) Department of Anesthesiology, Fuwai Yunnan Cardiovascular Hospital,
Kunming, China
(Yao) Department of Anesthesiology, Fuwai Hospital, National Center for
Cardiovascular Diseases, Peking Union Medical College and Chinese Academy
of Medical Sciences, Beijing, China
(Yao) Center of Outcomes Research, Department of Anesthesiology, Critical
Care and Pain Medicine, University of Texas, Houston, TX, United States
(Yao) Outcomes Research Consortium, Houston, TX, United States
Publisher
W.B. Saunders
Abstract
Objective: To assess how tranexamic acid (TXA) influences the renal
outcomes of cardiovascular surgical patients. <br/>Design(s): Systematic
review and meta-analysis of randomized controlled trials (RCTs).
<br/>Setting(s): The operating room. <br/>Participant(s): Cardiovascular
surgical patients. <br/>Intervention(s): TXA or placebo. <br/>Measurements
and Main Results: The primary outcome of interest included the incidence
of postoperative (PO) acute kidney injury (AKI). Secondary outcomes of
interest included PO-serum creatinine (SCr) levels, PO-blood urea nitrogen
(BUN) levels, intraoperative urine output volumes, the length of stay
(LOS) in the intensive care unit, the LOS in the hospital, and the 30-day
mortality rate postoperatively. A database search yielded 19 RCTs
including 6,450 patients, and 3,280 patients were allocated to the TXA
group and 3,170 to the control group (placebo). Meta-analysis suggested
that TXA did not influence the incidence of PO-AKI (4.2% v 4.3%; odds
ratio [OR], 0.96; 95% CI, 0.75-1.22; p = 0.72). Meta-analysis also
demonstrated that PO-SCr levels (weighted mean difference [WMD], 2.38; 95%
CI, -2.80 to 7.56; p = 0.37) and PO-BUN levels (WMD, -0.16; 95% CI, -0.92
to 0.61; p = 0.69) were comparable between the TXA group and the control
group, and that TXA did not influence PO-SCr and PO-BUN levels.
Additionally, TXA did not influence the incidence of patients' 30-day
mortality postoperatively (1.1% v 1.6%; OR, 0.71; 95% CI, 0.46 to 1.09; p
= 0.12). <br/>Conclusion(s): This current study suggested that TXA
administration did not influence renal outcomes in cardiovascular surgical
patients.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<62>
Accession Number
2043635049
Title
Operating Room Extubation After Cardiac Surgery: A Promising Practice, or
a Product of Selection Bias?.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Messinger C.J.; Hall E.; Smith M.R.; Mueller A.; Hou M.; Bloom J.;
Mehaffey C.; Gibson L.
Institution
(Messinger, Hall, Smith, Mueller, Mehaffey, Gibson) Division of Cardiac
Anesthesia, Department of Anesthesiology, Massachusetts General Hospital,
Mass General Brigham, Boston, MA, United States
(Hou, Bloom) Division of Cardiac Surgery, Department of Surgery,
Massachusetts General Hospital, Mass General Brigham, Boston, MA, United
States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the feasibility, safety, and early outcomes of a
standardized operating room extubation (ORE) protocol implemented for
elective cardiac surgery patients requiring cardiopulmonary bypass.
<br/>Design(s): A prospective observational cohort study with systematic
protocol implementation and data collection. <br/>Setting(s): A single
academic medical center. <br/>Participant(s): Six hundred twenty-eight
patients undergoing elective cardiac surgery with cardiopulmonary bypass
between November 2024 and June 2025. <br/>Intervention(s): Implementation
of a protocol requiring systematic consideration of ORE for all eligible
patients, with 171 patients (27%) receiving ORE and 457 patients receiving
conventional intensive care unit (ICU) extubation. <br/>Measurements and
Main Results: Primary outcomes included unadjusted ORE utilization rates,
reintubation rates, 30-day mortality, ICU length of stay, and hospital
length of stay. On average 28% of eligible cases were extubated each
month. Patients selected for ORE were relatively young (median age 62
years) with a low comorbidity burden. All ORE patients survived for 30
days. Reintubation occurred in 5 patients (2.9%). Median ICU stay was
shorter for ORE patients compared with the overall cohort (26 v 38 hours),
while median hospital stay was similar between groups (5 days).
<br/>Conclusion(s): A standardized ORE protocol demonstrated feasibility
and safety in selected cardiac surgery patients, with low reintubation
rates, zero 30-day mortality, and reduced ICU length of stay. However,
these encouraging outcomes likely reflect patient selection based on
clinical judgment and cannot establish comparative efficacy relative to
early ICU extubation. A multicenter randomized controlled trial is needed
to determine efficacy and define optimal patient populations for
ORE.<br/>Copyright &#xa9; 2026 Elsevier Inc.

<63>
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.

<64>
Accession Number
2043246530
Title
Impact of Sodium-Glucose Cotransporter 2 Inhibitors on Acute Kidney Injury
Post Off-Pump Coronary Artery Bypass Grafting: A Retrospective Cohort
Study and Meta-Analysis.
Source
Reviews in Cardiovascular Medicine. 27(1) (no pagination), 2026. Article
Number: 39400. Date of Publication: 2026.
Author
Zhou X.; Pan Y.; Hua K.; Yang X.
Institution
(Zhou, Pan, Hua, Yang) Department of Cardiovascular Surgery, Beijing
Anzhen Hospital, Capital Medical University, Beijing Institute of Heart,
Lung and Vessel Disease, Beijing, China
Publisher
IMR Press Limited
Abstract
Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, a novel
class of oral antihyperglycemic medications prescribed for type 2 diabetes
mellitus, play a beneficial role in slowing the progression of heart
failure. However, debate persists regarding the potential link of these
inhibitors to acute kidney injury (AKI) in specific clinical conditions.
<br/>Method(s): This study was a retrospective analysis of consecutive
patients receiving off-pump coronary artery bypass grafting (OPCABG) at
our institution between January 2018 and July 2023. A group of patients
who had been administered SGLT2 inhibitors was systematically compared
with non-users in a 1:3 ratio using propensity score matching. The
principal endpoint was postoperative AKI after OPCABG. In addition, we
performed a comprehensive meta-analysis of the associations between SGLT2
inhibitor therapy and AKI risk. The analytical approach combined
institutional data with aggregated findings from existing literature.
<br/>Result(s): The analysis encompassed 403 patients who administered
SGLT2 inhibitors and 1209 non-users. AKI developed in 54 cases (13.4%)
post-OPCABG among individuals who received SGLT2 inhibitors, compared to
373 cases (30.9%) in the control cohort. Statistical analysis demonstrated
significantly reduced AKI prevalence in the SGLT2 inhibitor cohort
compared to non-users (p < 0.001). The meta-analysis results confirmed a
protective association between SGLT2 inhibitor therapy and AKI risk
reduction (odds ratio (OR) = 0.525, 95% confidence interval (CI)
0.437-0.631 p < 0.001). <br/>Conclusion(s): In this study, SGLT2 inhibitor
administration was associated with a decreased incidence of postoperative
AKI in OPCABG patients. Clinical Trial Registration: NCT05888168,
https://clinicaltrials.gov/study/NCT05888168?cond=NCT05888168&rank=1.<br/>
Copyright &#xa9; 2026 The Author(s). Published by IMR Press.

<65>
Accession Number
2020659407
Title
RETRACTED: Meta-Resolve of Risk Factors for Nosocomial Infection in
Patients Undergoing Thoracic Surgery.
Source
Contrast Media and Molecular Imaging. 2022 (no pagination), 2022. Article
Number: 2836014. Date of Publication: 2022.
Author
Chen J.; Zhang W.; Yang D.
Institution
(Chen, Zhang, Yang) Department of Cardiothoracic Surgery, Chongqing
Emergency Medical Center, Chongqing University Central Hospital,
Chongqing, China
Publisher
Hindawi Limited
Abstract
As we all know, various complications may occur after surgery, and
postoperative bleeding and infection are the most common in clinical
practice. Postoperative infection mainly manifests as abdominal abscess,
peritonitis, and fungal infection. Thoracic surgery is a very common
clinical operation. It can directly deal with the relevant lesions, so a
better curative effect can usually be obtained. However, patients
undergoing thoracic surgery are generally more severely ill, with low
immune resistance, long duration, and complicated surgical treatment
process. Therefore, the probability of nosocomial infection is high, and
there are many risk factors for infection. After the occurrence of HAI, it
not only increases the suffering and economic burden of patients and the
workload of medical staff but also prolongs the hospitalization time of
patients, reduces the turnover rate of hospital beds, causes unnecessary
economic losses, and affects the social and economic benefits of
hospitals. Based on this, this paper proposes to analyze the risk factors
of nosocomial infection in patients undergoing thoracic surgery, so as to
provide a reference for the prevention or control of nosocomial infection.
This paper analyzes the actual situation of nosocomial infection in a city
hospital and then uses meta-analysis to determine the factors of
nosocomial infection from the perspective of relevant research literature.
Meta-analysis results show that patients older than 60 years have twice
the risk of postoperative infection compared with patients younger than 60
years.<br/>Copyright &#xa9; 2022 Junjian Chen et al.

<66>
Accession Number
2043624729
Title
Efficacy of Hemoadsorption in Cardiac Surgery with Cardiopulmonary Bypass:
A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Samaniego-Laguna M.A.; Queiroz I.; Pinilla J.; Ruelas M.G.; Piedra-Calle
C.A.; Giorgi J.; Katz J.N.
Institution
(Samaniego-Laguna) Universidad Autonoma Metropolitana, Mexico City, Mexico
(Queiroz) Department of Medicine, Catholic University of Pernambuco,
Brazil
(Pinilla) School of Medicine, CES University, Medellin, Colombia
(Ruelas) Instituto de Investigacion Nutricional, Lima, Peru
(Piedra-Calle) Hospital Universitario Son Espases, Palma de Mallorca,
Spain
(Giorgi) Hospital Sirio Libanes, Sao Paulo, Brazil
(Giorgi) Hospital Albert Einstein, Sao Paulo, Brazil
(Katz) Department of Medicine, NYU Grossman School of Medicine, New York,
NY, United States
(Katz) Cardiolog, y Department, Bellevue Hospital, New York, NY, United
States
Publisher
W.B. Saunders
Abstract
Objectives: To evaluate the efficacy of intraoperative hemoadsorption (HA)
during cardiopulmonary bypass (CPB) in reducing acute kidney injury (AKI)
and other major postoperative complications in patients undergoing cardiac
surgery. <br/>Design(s): Systematic review and meta-analysis of randomized
controlled trials (RCTs) conducted in accordance with PRISMA guidelines,
with a protocol registered in PROSPERO (CRD42025638656). <br/>Setting(s):
Multicountry, multi-institutional hospital-based studies of patients
undergoing cardiac surgery with CPB. <br/>Participant(s): A total of 1133
patients from 16 RCTs comparing CPB with versus without intraoperative HA.
<br/>Intervention(s): Intraoperative HA using sorbent-based devices (e.g.,
CytoSorb, oXiris, Jafron HA 380). Measurements and Main Result: Primary
outcomes included AKI incidence, renal replacement therapy requirement,
and mortality. Secondary outcomes included intensive care unit/hospital
length of stay, postoperative delirium, stroke, sepsis, and reoperation.
HA significantly reduced the incidence (RR 0.75; 95% CI 0.59-0.96; p =
0.020). No significant differences were observed for renal replacement
therapy (RR 0.64; p = 0.58) or mortality (RR 0.96; p = 0.861). No
significant effects were found for secondary outcomes. <br/>Conclusion(s):
Intraoperative HA during CPB reduces the risk of AKI but does not
significantly affect other major postoperative outcomes. Further studies
are needed to determine its clinical relevance and optimal patient
selection.<br/>Copyright &#xa9; 2026 Elsevier Inc.

<67>
Accession Number
2043213327
Title
Management of severe asymptomatic aortic stenosis: An updated overview.
Source
Archives of Cardiovascular Diseases. 119(1) (pp 39-49), 2026. Date of
Publication: 01 Jan 2026.
Author
Tribouilloy C.; Bohbot Y.; Rusinaru D.; Leborgne L.; Marechaux S.
Institution
(Tribouilloy, Bohbot, Rusinaru, Leborgne) Department of Cardiology, Amiens
University Hospital, Amiens, France
(Tribouilloy, Bohbot, Rusinaru, Leborgne) UR UPJV 7517, Jules-Verne
University of Picardie, Amiens, France
(Marechaux) Heart Valve Centre, Cardiology Department, GCS-Groupement des
Hopitaux de l'Institut Catholique de Lille/Lille Catholic Hospitals,
Lille, France
(Marechaux) ETHICS EA 7446, DataCoeur, Lille Catholic University, Lille,
France
Publisher
Elsevier Masson s.r.l.
Abstract
Aortic stenosis is the most frequent valvular heart disease in
industrialized countries, affecting about 10% of individuals aged > 75
years, with 2-4% presenting severe disease; nearly half of them are
asymptomatic. No medical therapy halts aortic stenosis progression, and
aortic valve replacement remains the only curative option. Managing
asymptomatic patients is challenging because of a persistent risk of
sudden death, and the potential for irreversible myocardial damage if
intervention is delayed, but also because aortic valve replacement carries
procedural risks and long-term prosthesis-related complications.
Functional assessment, especially exercise testing, is essential as it can
identify a substantial proportion of "falsely asymptomatic" patients who
will benefit from timely aortic valve replacement. Accurate assessment of
aortic stenosis severity is crucial, with echocardiography as the
cornerstone, although additional imaging modalities may be required in
selected cases. Modern risk stratification integrates markers of
subclinical myocardial dysfunction, haemodynamic compromise and procedural
risk. Although observational studies and randomized trials suggest that
early aortic valve replacement may reduce adverse events in selected
low-risk patients, results are heterogeneous and methodological concerns
remain. Meta-analyses have shown reductions in unplanned hospitalizations
but no clear survival benefit with early intervention. Current guidelines
recommend aortic valve replacement for classical indications, such as
symptom onset or reduced ejection fraction, and suggest early aortic valve
replacement only in carefully selected asymptomatic patients with low
procedural risk. Shared decision-making within a multidisciplinary heart
valve team remains essential, taking into account patient preferences,
co-morbidities, life expectancy and lifestyle. Close follow-up with
regular echocardiography and functional testing is critical to optimize
timing and outcomes.<br/>Copyright &#xa9; 2025 The Authors.

<68>
Accession Number
2043138873
Title
Understanding the learning curve in robotic-assisted cardiac surgery and
its application on curriculum development - systematic narrative review.
Source
Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number:
234. Date of Publication: 01 Dec 2026.
Author
EL-Gheryani M.; Sherif M.; Loubani M.
Institution
(EL-Gheryani) Clinical and Surgical Sciences Department, The University of
Edinburgh, Scotland, Edinburgh, United Kingdom
(Sherif, Loubani) Cardiothoracic Centre, Castle Hill Hospital, England,
Hull, United Kingdom
Publisher
Springer Nature
Abstract
Since robotic-assisted cardiac surgery was established, the adoption rate
was slow despite proven its efficacy and safety. Limited knowledge about
the learning curve (LC) has led to lacking recognised training programme
which in turn jeopardises patient safety and reduces the uptake rate. This
study aims to review current literature, identify any knowledge gaps and
quantify the LC. In addition, the study focuses on the application of LC
knowledge on the curriculum development which has not been covered in the
literature before. This systematic narrative review was conducted
according to PRISMA-20 guideline. Ovid MEDLINE, PubMed, EMBASE and SCOPUS
were searched from database inception to the 5th of February 2024.
Eligible articles were those assessing LC in robotic-assisted cardiac
surgery and reported in English. Among 24 studies which met the
eligibility criteria (Table 1), 12 studies are for robotic-assisted
coronary artery bypass, 9 for robotic-assisted mitral valve repair and 3
for robotic-assisted atrial septal defect repair. All studies were
observational. Reporting LC exhibited substantial heterogeneity in terms
of outcome variables and statistical analysis. None of the studies have
quantified the surgeons' previous experience. Finally, having structured
training programme is the most recommended method to mitigate the steep LC
while creating standardised reporting system has been advised to decrease
heterogeneity in the future studies. Current literature shows high
heterogeneity in defining LC which creates challenges in developing safe
curriculum. Nonetheless, adopting structured programme with good exposure
to simulation sessions are deemed effective approach to reduce LC and
improve patient safety.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag London Ltd., part of Springer Nature
2026.

<69>
Accession Number
2023176109
Title
RETRACTED: A Systematic Review and Meta-Analysis of Influences of Chronic
Kidney Disease on Patients after Percutaneous Coronary Intervention for
Chronic Total Occlusions.
Source
Computational and Mathematical Methods in Medicine. 2023 (no pagination),
2023. Article Number: 9450752. Date of Publication: 2023.
Author
Wu W.; Gao M.; Wu X.
Institution
(Wu, Gao, Wu) Department of Nephrology, Huzhou Central Hospital,
Affiliated Central Hospital Huzhou University, No. 1558, Sanhuan North
Road, Wuxing District, Zhejiang, Huzhou, China
Publisher
John Wiley and Sons Ltd
Abstract
Objective. Chronic kidney disease (CKD) is a clinical collective term for
kidney disease with glomerular filtration rate GFR<60 mL/min for more than
three months due to various factors and is usually associated with
coronary heart disease and is also an independent risk factor for coronary
heart disease. This study is aimed at systematically reviewing the
influence of CKD on the outcomes of patients after percutaneous coronary
intervention (PCI) for chronic total occlusions (CTOs). Methods. The
Cochrane Library, PubMed, Embase, China biomedical literature database
(SinoMed), China National Knowledge Infrastructure, and Wanfang database
were searched for case-control studies on the influence of CKD on outcomes
after PCI for CTOs. After screening the literature, extracting data, and
evaluating the quality of literature, RevMan 5.3 software was used for
meta-analysis. Results. There were 11 articles with a total of 558,440
patients included. Meta-analysis results indicated that left ventricular
ejection fraction (LVEF) level, diabetes, smoking, hypertension, coronary
artery bypass grafting, angiotensin converting enzyme inhibitor
(ACEI)/angiotensin receptor blocker (ARB), beta-blockers, age, and renal
insufficiency were the factors affecting outcomes after PCI for CTOs [risk
ratio and 95% confidence interval were: 0.88 (0.86, 0.90), 0.96 (0.95,
0.96), 0.76 (0.59, 0.98), 1.39 (0.89, 2.16), 0.73 (0.38, 1.40), 0.24
(0.02, 3.9), 0.78 (0.77, 0.79), 0.81 (0.80, 0.82), and 1.50 (0.47, 4.79)].
Conclusion. LVEF level, diabetes, smoking, hypertension, coronary artery
bypass grafting, ACEI/ARB, beta-blockers, age, renal insufficiency, etc.
are important risk factors for outcomes after PCI for CTOs. Controlling
these risk factors is of great significance for the prevention, treatment,
and prognosis of CKD.<br/>Copyright &#xa9; 2023 Weifei Wu et al.

<70>
Accession Number
2020663009
Title
RETRACTED: Meta-Analysis on the Anesthetic Effects of Remifentanil plus
Dexmedetomidine versus Remifentanil Alone in Cardiac Surgery.
Source
Computational and Mathematical Methods in Medicine. 2022 (no pagination),
2022. Article Number: 1077980. Date of Publication: 2022.
Author
Zeng X.-L.; Liao J.-H.; Zhong H.-S.; Yin X.-H.; Wang R.; Liang J.-P.;
Zhang Z.-S.
Institution
(Zeng, Yin, Wang) Department of Cardiology, Shenzhen University General
Hospital, Shenzhen, China
(Liao) Guangzhou Yujia Biotechnology Co., Ltd., Guangzhou, China
(Zhong) Cardiac Surgery Center, The First Affiliated Hospital of Gannan
Medical University, Jiangxi, China
(Liang) Department of Radiology, Shenzhen bao'An District Songgang
People's Hospital, Shenzhen, China
(Zhang) Department of Cardiology, Pingshan District People's Hospital of
Shenzhen, Pingshan General Hospital, Southern Medical University,
Guangdong, Shenzhen, China
Publisher
John Wiley and Sons Ltd
Abstract
In this study, we performed a meta-analysis to investigate the anesthesia
effects of remifentanil plus dexmedetomidine versus remifentanil alone in
cardiac surgery. Literature search was performed on PubMed, Web of
Science, Embase, China Knowledge Infrastructure, Wanfang Data, and other
databases for relevant literature published in English or Chinese before
October 2021. A total of 17 studies, consisting of 1350 patients, were
included in this study. Of these, 10 studies showed that remifentanil plus
dexmedetomidine had a good anesthesia effect in cardiac surgery (OR=3.61,
95% CI: 1.73, 7.52, P<0.001), and 8 studies showed that the Ramsay score
test of anesthesia (SMD=0.88; 95% CI: -0.77, 2.53; P<0.001) in the
experimental group was better than that in the control group. In addition,
changes in the hemodynamic heart rate (SMD=-0.74; 95% CI: -1.41, -0.07;
P<0.001) and mean arterial pressure (SMD=-0.18; 95% CI: -0.72, 0.36;
P<0.001) of the two groups of anesthesia were counted in 17 studies, which
also showed that the anesthesia effect of remifentanil plus
dexmedetomidine was good. Thus, remifentanil plus dexmedetomidine may be a
more promising option for cardiac surgery anesthesia than remifentanil
alone.<br/>Copyright &#xa9; 2022 Xiao-Lin Zeng et al.

<71>
Accession Number
2017404087
Title
RETRACTED: Prognostic Value of Creatine Phosphate and Inflammatory Markers
for Mitral Valve Replacement: A Systematic Review and Meta-Analysis.
Source
Applied Bionics and Biomechanics. 2022 (no pagination), 2022. Article
Number: 1132452. Date of Publication: 2022.
Author
Zhu Y.; Zou C.; Zhang J.; Chen L.; Jia Y.
Institution
(Zhu, Jia) Department of Cardiac Surgery, Shandong Provincial Hospital,
Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
(Zhu, Zou, Zhang, Chen, Jia) Department of Cardiac Surgery, Shandong
Provincial Hospital Affiliated to Shandong First Medical University,
Jinan, Shandong, China
Publisher
John Wiley and Sons Ltd
Abstract
Purpose. The prognosis of mitral valve replacement is an important
clinical issue and may produce unexpected mortality rates if not properly
addressed. The postoperative examination results have important prognostic
implications. This study was designed to determine the prognostic value of
phosphocreatine and inflammatory markers after mitral valve replacement.
Method. Comparison and analysis of the data obtained using SPSS software.
The computer retrieved PubMed, Science Citation Index (SCI), Embase, VIP,
CNKI, CBM, and Wanfang database and manually retrieved randomized
controlled trials (RCTs) published at home and abroad on the central
muscle protection role of creatine phosphate in heart valve replacement,
and the search period was established until February 2018. Two random
literature reviewers independently screened the literature and extracted
data, using Review Manager (RevMan) (Computer program), version 5.3 (The
Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, 2014).
RevMan software version 5.0 assesses the risk of bias for inclusion in
studies. The software performs a meta-analysis of the obtained data.
Results. Ten RCTs with a total of 464 participants were enrolled. The
meta-analysis results showed that (1) elevated creatine kinase levels
often predict a better prognosis after mitral valve replacement (RR=1.36,
95% CI: 1.22 to 1.52, P<0.00001), (2) the creatine kinase isoenzyme level
in the venous blood of the phosphocreatine group after 24 h of aortic
blocking was significantly lower than that in the control group
(SMD=-2.90, 95% CI: -5.19 to -0.60, P=0.01), and (3) Troponin I levels
were significantly lower in the intravenous creatine group than in the
control group 24 h after opening of the aortic block (SMD=-1.49, 95% CI:
-2.02 to -0.97,P<0.00001). Conclusions. Creatine phosphate and
inflammatory factor have good predictive value for the prognosis of mitral
valve replacement.<br/>Copyright &#xa9; 2022 Yanhui Zhu et al.

<72>
Accession Number
2021570254
Title
RETRACTED: Influence of Dexmedetomidine on Myocardial Injury in Patients
with Simultaneous Pancreas-Kidney Transplantation.
Source
Evidence-based Complementary and Alternative Medicine. 2022 (no
pagination), 2022. Article Number: 7196449. Date of Publication: 2022.
Author
Dong A.; Zhang Y.; Lu S.; Yu W.
Institution
(Dong, Lu, Yu) Tianjin First Center Hospital, Tianjin, China
(Zhang) First Teaching Hospital, Tianjin University of Traditional Chinese
Medicine, National Clinical Research Center for Chinese Medicine
Acupuncture and Moxibustion, Tianjin, China
Publisher
Hindawi Limited
Abstract
Background. Diabetes is one of the most common chronic diseases in the
world. End-stage renal disease (ESRD) caused by diabetes is the most
serious long-term complication. The main cause of death in patients with
simultaneous pancreas-kidney transplantation (SPKT) is cardiovascular
disease. Although dexmedetomidine (Dex) has unique advantages in heart
protection against ischaemic/reperfusion injury, few clinical studies have
been conducted on its cardioprotective effect in SPKT. This study aimed to
explore the influence of Dex on myocardial injury in patients undergoing
SPKT and to analyze its possible mechanism. Methods. A randomized
controlled trial (RCT) was performed from July 1, 2018 to December 1,
2020. Eighty patients, regardless of gender, scheduled for SPKT were
randomly allocated into a Dex group (D group) receiving Dex at a rate of 1
mug/kg for 10 minutes before anaesthesia induction and then continuous
infusion at 0.5 mug/kg/hour until the end of surgery and control group (C
group) receiving equivalent capacity of saline. Serum cardiac troponin I
(cTnI), creatine kinase isoenzyme (CK-MB), tumour necrosis factor-alpha
(TNF-alpha), and interleukin-6 (IL-6) were recorded at 5 minutes after
anaesthesia induction (baseline,T0), 5 minutes before renal arteriovenous
opening (T1), 30 minutes after renal arteriovenous opening (T2), 30
minutes after pancreatic related arteriovenous opening (T3), immediately
after surgery (T4), 4 hours after surgery (T5), and 24 hours after surgery
(T6). Adverse cardiovascular events were recorded during the perioperative
period. Changes in ECG S-T segments and T waves were monitored at T0-T6.
Myocardial infarction and percutaneous coronary intervention were recorded
with an average follow-up of one year. Results. Compared with T0,
TNF-alpha and IL-6 concentrations significantly increased at T1-T6 in the
C and D groups (P<0.05). IL-6 concentration increased significantly after
renal artery opening and reached the peak after the opening of pancreatic
blood vessels. Compared with the C group, TNF-alpha, and IL-6
concentrations were significantly reduced in group D at T2-T6 (P<0.05).
Compared with T0, cTnI and CK-MB concentrations were significantly
increased at T3-T6 in the C and D groups (P<0.05). cTnI and CK-MB
concentrations increased significantly after the opening of renal artery,
and reached the peak after the opening of pancreatic blood vessels.
Compared with the C group, cTnI and CK-MB concentrations were
significantly reduced in the D group at T3-T6 (P<0.05). There was no
significant difference in patient characteristics amongst groups,
including the proportion of intraoperative vasoactive drug use and adverse
cardiovascular events during the follow-up period. Heart rate, mean blood
pressure, central venous pressure, and cardiac output were not remarkably
different between the two groups at any time point. Conclusions.
Perioperative reperfusion could aggravate myocardial injury in SPKT. Dex
may be considered a way to reduce myocardial injury caused by inflammatory
action by decreasing the release of inflammatory factors. Trial
Registration Number: Chinese Clinical Trial Registry ID:
ChiCTR2200060084.<br/>Copyright &#xa9; 2022 Aili Dong et al.

<73>
Accession Number
2041527757
Title
Transfusion-related adverse events in patients with restrictive or liberal
transfusion strategy. An analysis of the MINT trial.
Source
Transfusion. 66(1) (pp 84-93), 2026. Date of Publication: 01 Jan 2026.
Author
Ghafghazi S.; Uhl L.; Herbert B.; Bertolet M.; Alexander J.H.; Goodman
S.G.; Raval J.; Roubille F.; Fordyce C.B.; Goldfarb M.; Bainey K.; de
Andrade P.B.; Senaratne J.; Bracey A.; Roswell R.O.; Lopes R.; Simon T.;
Steg G.; Brooks M.M.; Hebert P.C.; Carson J.L.; Triulizi D.J.
Institution
(Ghafghazi) Department of Medicine, Division of Cardiology, University of
Louisville, Louisville, KY, United States
(Uhl) Department of Pathology, Beth Israel Deaconess Medical Center,
Boston, MA, United States
(Uhl) Harvard Medical School, Boston, MA, United States
(Herbert, Bertolet, Brooks) Department of Epidemiology, School of Public
Health, University of Pittsburgh, Pittsburgh, PA, United States
(Herbert, Bertolet, Brooks) Department of Biostatistics, School of Public
Health, University of Pittsburgh, Pittsburgh, PA, United States
(Herbert, Bertolet, Brooks) School of Public Health, University of
Pittsburgh, Pittsburgh, PA, United States
(Alexander, Lopes) Duke Clinical Research Institute, Duke University,
Durham, NC, United States
(Goodman) St. Michael's Hospital, University of Toronto, Toronto, ON,
Canada
(Raval) Department of Pathology, University of Vermont School of Medicine,
Burlington, VT, United States
(Roubille) Cardiology Department, University of Montpellier, Montpellier,
France
(Fordyce) Division of Cardiology, Vancouver General Hospital and
University of British Columbia, Vancouver, BC, Canada
(Goldfarb) Division of Cardiology, Jewish General Hospital, McGill
University, Montreal, QC, Canada
(Bainey) Canadian VIGOUR Centre and BAIM Institute for Clinical Research,
University of Alberta/Mazankowski Alberta Heart Institute, Edmonton, AB,
Canada
(de Andrade) Brazilian Clinical Research Institute, Sao Paulo, Brazil
(Senaratne) Department Medicine, University of Alberta, Edmonton, AB,
Canada
(Bracey) Department of Pathology, Baylor College of Medicine, Houston, TX,
United States
(Roswell) Department of Science Education and Cardiology, Northwell
Health, Zucker School of Medicine at Hofstra/Northwell, NY, United States
(Simon, Steg) Hopital Saint Antoine, Sorbonne Universite, FACT (French
Alliance for Cardiovascular Trials), Paris, France
(Hebert) Buyere Research Institute, University of Ottawa, Ottawa, ON,
Canada
(Carson) Department of Medicine, Rutgers Robert Wood Johnson Medical
School, New Brunswick, NJ, United States
(Triulizi) Department of Pathology, Division of Transfusion Medicine,
University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The aim of this analysis was to quantify and compare the
frequency of transfusion-related adverse events (TRAE) in adult patients
with myocardial infarction transfused with a restrictive versus liberal
transfusion strategy from the Myocardial Ischemia and Transfusion (MINT)
trial. Study Design and Methods: Clinical sites reported TRAE. Major TRAE
were transfusion-related acute lung injury, transfusion-associated
circulatory overload, acute hemolytic transfusion reaction, anaphylactic
transfusion reaction, and transfusion-associated sepsis. TRAE rates per
transfusion arm per patient and per 100 units of red blood cells (RBC)
transfused were calculated. <br/>Result(s): There were nine site-reported
events in the restrictive transfusion arm and 49 events in the liberal
transfusion arm with an overall event rate of 0.51 in the restrictive
transfusion arm, and 2.80 in the liberal transfusion arm per 100 patients,
rate difference -2.29; 95% confidence interval [CI], -3.12,-1.44. The rate
of major TRAE was 0.51 in the restrictive arm and 1.99 in the liberal arm
per 100 patients, rate difference -1.48 (95% CI, -2.21, -0.74). When the
rates were normalized per 100 units of RBC transfused, the rate difference
of major TRAE was -0.08 (95% CI, -0.63, 0.46) and rate ratio was 0.90 (95%
CI, 0.43, 1.87). <br/>Conclusion(s): The rate of major TRAE was low,
albeit increased in the liberal transfusion arm proportional to the number
of RBC units transfused. The higher rate of major TRAE in the liberal arm
was not sufficient to offset the increased rates of myocardial infarction
or death at 30 days observed in patients assigned to the restrictive
transfusion arm.<br/>Copyright &#xa9; 2025 The Author(s). Transfusion
published by Wiley Periodicals LLC on behalf of AABB.

<74>
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.

<75>
Accession Number
2042963353
Title
A randomised controlled trial comparing of the efficacy and safety of left
lung isolation for minimally invasive direct coronary artery surgery using
video-imaging double-lumen endobronchial tube with a bronchial blocker
paced through a video-imaging single-lumen tracheal tube.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 83. Date
of Publication: 01 Dec 2026.
Author
Fang Y.; Wang M.; Liu T.; Han P.; Zhao M.; Deng Y.; Shi C.; Han B.; Zhang
J.; Li M.; Ling Y.; Guo X.; Zhou Y.; Han Y.
Institution
(Fang, Wang, Liu, Han, Zhao, Deng, Shi, Han, Zhang, Li, Guo, Zhou, Han)
Department of Anesthesiology, Peking University Third Hospital, Beijing,
China
(Ling) Department of Cardiac Surgery, Peking University Third Hospital,
Beijing, China
Publisher
BioMed Central Ltd
Abstract
Background and objectives: Minimally invasive coronary artery bypass
grafting (MIDCAB) requires effective left lung isolation, yet evidence
comparing video-imaging single-lumen tracheal tubes with bronchial
blockers (VSLT + BB) and video-imaging double-lumen endotracheal tubes
(VDLT) remains limited. This randomized controlled trial aimed to: (1)
quantitatively compare time efficiency for device placement and lung
isolation between VSLT + BB and VDLT; (2) evaluate perioperative airway
complications; and (3) assess differential impacts on postoperative
recovery, including postoperative sore throat, hoarseness, and Quality of
Recovery-15 (QoR-15) scores. <br/>Method(s): In this single-blind
randomized controlled trial, 97 MIDCAB patients were allocated to VSLT +
BB or VDLT groups. Primary outcomes were tube positioning time; secondary
outcomes included total intubation time, oxygenation parameters,
hemodynamic variables, and postoperative complications. <br/>Result(s):
VDLT exhibited shorter tube positioning time (128 +/- 37 vs. 159 +/- 58 s;
p < 0.001) but longer total intubation time (192 +/- 40 vs. 159 +/- 58 s;
p < 0.001). VSLT + BB demonstrated higher PaO at 10-min post-OLV (226.0
vs. 168.0 mmHg; p = 0.035) with lower airway pressures (p < 0.05).
Postoperative sore throat (33% vs. 13%; OR 2.84, 95% CI 1.04, 7.71; p =
0.018) and hoarseness at 48 h (55% vs. 31%; OR 2.45, 95% CI 1.08, 5.59; p
= 0.018) were higher with VDLT. Lung collapse quality, hypoxemia rates,
pulmonary complications, and QoR-15 scores showed no significant
differences (all p > 0.05). <br/>Conclusion(s): In MIDCAB surgery, VDLT
demonstrated significantly shorter tube positioning time compared with
VSLT + BB. However, VSLT + BB exhibited shorter total intubation time than
VDLT by avoiding postoperative tube exchange. Both techniques provided
clinically acceptable lung isolation with comparable lung collapse quality
and hypoxemia incidence. VSLT + BB exhibited lower airway pressures and
higher oxygenation indices during early OLV, whereas VDLT was associated
with higher rates of minor airway complications (sore throat, hoarseness).
No significant differences were observed in pulmonary complications,
hemodynamic stability, or recovery quality. Trial registration:
ChiCTR2300072124, 3/6/2023.<br/>Copyright &#xa9; The Author(s) 2026.

<76>
Accession Number
2036018406
Title
HTK Solution Cardioplegia in Pediatric Patients: A Meta-analysis.
Source
Thoracic and Cardiovascular Surgeon. 74(2) (pp 164-173), 2026. Date of
Publication: 01 Mar 2026.
Author
Galvao L.K.C.S.; De Farias Santos A.C.F.; Dos Santos N.P.; Zamora F.V.;
Biavatti B.B.V.; Salles J.P.C.E.A.; Mendonca H.S.
Institution
(Galvao, Zamora) Federal University of Minas Gerais Medicine School, Belo
Horizonte, Brazil
(De Farias Santos) Unicid, Sao Paulo, Brazil
(Dos Santos, Salles) Unirio, Rio de Janeiro, Brazil
(Biavatti) Unicamp, Campinas, Sao Paulo, Brazil
(Mendonca) Prevent Senior Private Health Operator, Sao Paulo, Brazil
Publisher
Georg Thieme Verlag
Abstract
Introduction Cardioplegia, a therapy designed to induce reversible cardiac
arrest, revolutionized cardiovascular surgery. Among the various
pharmacological approaches is the histidine-tryptophan-ketoglutarate (HTK)
solution. Despite numerous studies, no meta-analysis has investigated the
efficacy of the HTK solution in the pediatric population. Therefore, we
aim to conduct a meta-analysis comparing HTK and other cardioplegia
solutions in pediatric patients undergoing cardiovascular surgery. Methods
PubMed, Embase, and Cochrane databases were searched from inception
through April 2024. Endpoints were computed in odds ratios (OR) with 95%
confidence intervals (CI) for dichotomous variables, whereas continuous
variables were compared using mean differences (MD) with 95% CI. Results A
total of 11 studies comprising 1,349 patients were included, of whom 677
(50.19%) received HTK cardioplegia. The results were similar between
groups regarding mortality (OR 0.98; 95% CI 0.29, 3.29), length of
hospital stay (MD 0.32 days; 95% CI -0.88, 1.51), Mechanical ventilation
(MV) (MD -17.72 hours; 95% CI -51.29, 15.85), arrhythmias (OR 1.27; 95% CI
0.83, 1.95), and delayed sternal closure (OR 0.89; 95% 0.56, 1.43).
However, transfusion volume was lower in the HTK group (MD -452.39; 95% CI
-890.24, -14.53; p = 0.04). Conclusion The use of HTK solution was
demonstrated to be similar regarding its clinical efficacy to other
approaches for cardioplegia, and it may present advantages to patients
prone to hypervolemia.<br/>Copyright &#xa9; 2026 Georg Thieme Verlag. All
rights reserved.

<77>
Accession Number
2043534722
Title
Superficial Parasternal Intercostal Plane Block for Analgesia After
Cardiac Surgery: An Updated Meta-analysis of Randomized Controlled Trials
With Meta-regression and Trial Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Dost B.; Karapinar Y.E.; Turunc E.; Beldagli M.; Turan E.I.; De Cassai A.
Institution
(Dost, Turunc) Department of Anesthesiology and Reanimation, Ondokuz Mayis
University Faculty of Medicine, Samsun, Turkey
(Karapinar) Department of Anesthesiology and Reanimation, Istanbul
University-Cerrahpasa Faculty of Medicine, Istanbul, Turkey
(Beldagli) Department of Anesthesiology and Reanimation, Samsun Training
and Research Hospital, Samsun, Turkey
(Turan) Department of Anesthesiology and Reanimation, Health Science
University, Istanbul Kanuni Sultan Suleyman Education and Training
Hospital, Istanbul, Turkey
(De Cassai) Department of Medicine (DIMED), University of Padua, Padua,
Italy
(De Cassai) Institute of Anesthesia and Intensive Care Unit, University
Hospital of Padua, Padua, Italy
Publisher
W.B. Saunders
Abstract
Background: Effective postoperative pain control is essential for enhanced
recovery after cardiac surgery, yet optimal multimodal strategies continue
to evolve. The superficial parasternal intercostal plane (S-PIP) block has
been proposed as a simple and safe technique for median sternotomy
analgesia; however, current evidence remains fragmented, and its clinical
impact is unclear. <br/>Method(s): We conducted a systematic review and
meta-analysis of randomized controlled trials assessing the analgesic
efficacy and safety of the S-PIP block in adult cardiac surgery. PubMed,
Embase, CENTRAL, Web of Science, Scopus, ClinicalTrials.gov, and gray
literature were searched through September 2025. Trials comparing S-PIP
with standard or placebo analgesia were pooled using a random-effects
model. The primary outcome was 24-hour opioid use (morphine milligram
equivalents). Trial sequential analysis, meta-regression, and Grades of
Recommendation, Assessment, Development, and Evaluation were applied to
evaluate the robustness and certainty of evidence. <br/>Result(s):
Twenty-seven randomized controlled trials (1,760 patients) met the
inclusion criteria. S-PIP block significantly reduced 24-hour opioid use
compared with control (mean difference, -8.53 mg; 95% CI, -14.39 to
-2.68), although the reduction was below the minimal clinically important
difference and demonstrated substantial heterogeneity (I² =
98.1%). Trial sequential analysis confirmed statistical significance, but
the required sample size was not achieved. The block also lowered early
pain scores, reduced rescue analgesic use, and shortened extubation time
and intensive care unit stay. No meaningful differences were observed in
hospital stay, postoperative nausea and vomiting, or chronic postsurgical
pain. The certainty of the evidence ranged from moderate to very low.
<br/>Conclusion(s): S-PIP provides modest early analgesic benefits after
cardiac surgery. Further high-quality multicenter trials are required to
clarify its overall clinical value.<br/>Copyright &#xa9; 2026 Elsevier
Inc.

<78>
Accession Number
2041911209
Title
All-Venous Grafting and Very Long-Term Survival After Coronary Artery
Bypass Grafting.
Source
Annals of Thoracic Surgery. 121(3) (pp 560-570), 2026. Date of
Publication: 01 Mar 2026.
Author
Squiers J.J.; Shih E.; DiMaio J.M.; Banwait J.K.; Hale S.; Mack M.J.;
Schaffer J.M.
Institution
(Squiers, Shih, DiMaio, Mack, Schaffer) Department of Cardiothoracic
Surgery, Baylor Scott & White, The Heart Hospital, Plano, TX, United
States
(DiMaio, Banwait, Hale, Mack) Baylor Scott & White Research Institute,
Plano, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Observational studies of coronary artery bypass grafting (CABG)
have associated single-arterial grafting with superior outcomes compared
with all-venous grafting. Current guidelines assign single-arterial
grafting a class I recommendation. However, no adequately powered
randomized controlled trials were undertaken to confirm this benefit, and
very long-term data on outcomes of various conduit strategies from more
contemporary eras remain lacking. Methods This study retrospectively
analyzed Medicare beneficiaries who underwent CABG from 1999 to 2004, the
period immediately preceding the first publication of guidelines affording
single-arterial grafting a class I indication. The study compared survival
between beneficiaries undergoing all-venous grafting and those undergoing
single-arterial grafting by using restricted mean survival times (RMSTs).
Risk adjustment was performed for all available covariates by using
overlap propensity score weighting. Results Among 640,116 Medicare
beneficiaries, 101,120 (15.8%) underwent all-venous grafting and 538,996
(84.2%) underwent single-arterial grafting. Beneficiaries undergoing
all-venous grafting, vs single-arterial grafting, were noted to have worse
risk-adjusted operative survival (30-day RMST, 28.6 [95% CI: 28.6-28.7]
days vs 29.3 [95% CI: 29.2-29.3] days; difference, 0.73 [95% CI:
0.73-0.73] days; P < .001), short-term survival (1-year RMST, 324 [95% CI:
324-325] days vs 339 [95% CI: 338-339] days; difference, 14 [95% CI:
13-15] days; P < .001), and very long-term survival (20-year RMST, 8.34
[95% CI: 8.30-8.38] vs 9.55 [95% CI: 9.51-9.59] years; difference, 1.21
years; P < .001). Conclusions Medicare beneficiaries undergoing CABG with
all-venous grafting had inferior risk-adjusted survival compared with
patients receiving single-arterial grafting. These findings support
current multidisciplinary guideline recommendations offering a class I
indication for use of at least 1 arterial graft during CABG.<br/>Copyright
&#xa9; 2025 The Society of Thoracic Surgeons.

<79>
Accession Number
2039490983
Title
Evaluate psychological effects of prolonged fasting in patients undergoing
cardiac surgery.
Source
Cirugia Cardiovascular. 33(1) (pp 5-10), 2026. Date of Publication: 01 Jan
2026.
Author
Moreno Rodriguez J.; Lorenzo Diaz M.; Aranda Domene R.; Canovas Lopez
S.J.; March Salas M.; Alcaraz Garcia M.J.; Perez Morote J.; Sanchez Motos
R.; Amor Vigueras A.; Ponce de Leon Torralba M.; Aviles Alvizu J.M.;
Galindo Rueda M.D.M.; Clemente Murcia M.
Institution
(Moreno Rodriguez, Lorenzo Diaz, Aranda Domene, Canovas Lopez, March
Salas, Alcaraz Garcia, Perez Morote, Sanchez Motos, Amor Vigueras, Ponce
de Leon Torralba, Aviles Alvizu, Galindo Rueda, Clemente Murcia)
Cardiovascular Surgery, Murcian Institute of Biosanitary Research (IMIB),
Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
Publisher
Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE)
Abstract
Introduction: Comprehensive care of the cardiosurgical patient is
essential to optimize clinical results. In this context, preoperative
strategies play a key role, with accelerated recovery programs (ERAS)
being a promising alternative. <br/>Objective(s): To evaluate the
psychological and metabolic effects of prolonged fasting (>8h) in patients
undergoing elective cardiac surgery, comparing them with a group receiving
carbohydrate supplementation. Methodology: Quasi-experimental, prospective
and randomized study. Patients were assigned to two groups: (1)
Carbohydrate supplementation and (2) Prolonged fasting. Clinical
variables, capillary blood glucose, anxiety (Hamilton Scale), feeling of
hunger and thirst, perceived satisfaction and postoperative complications
were measured. <br/>Result(s): 58 patients were included. The intervention
group presented a lower sensation of hunger and thirst (p<0.001), as well
as a significant reduction in pre-surgical anxiety (p=0.003) compared to
the control group. Perceived satisfaction was also higher in the
intervention group (p=0.047). No significant differences were detected in
capillary blood glucose levels between the groups. Neither was a greater
need for insulin administration observed in either group. Regarding
postoperative complications, no significant differences were observed, nor
were there any cases of mortality attributable to the procedure.
<br/>Conclusion(s): Preoperative supplementation with carbohydrate-rich
fluids improves the patient experience in terms of anxiety and comfort,
without compromising metabolic stability or increasing the incidence of
postoperative complications. The findings found throughout the research
support the incorporation of this strategy into cardiac surgery protocols,
with the potential to optimize patient experience and outcomes.
Introduccion: La atencion integral del paciente cardioquirurgico es
fundamental para optimizar los resultados clinicos. En este contexto, las
estrategias preoperatorias desempenan un papel clave, siendo los programas
de recuperacion acelerada (ERAS) una alternativa prometedora. Objetivo:
Evaluar los efectos psicologicos y metabolicos del ayuno prolongado (>8
horas) en pacientes sometidos a cirugia cardiaca programada, comparandolos
con un grupo que recibe suplementacion con hidratos de carbono.
Metodologia: Estudio cuasiexperimental, prospectivo y aleatorizado. Los
pacientes fueron asignados a dos grupos: 1) Suplementacion con
carbohidratos y 2) Ayuno prolongado. Se midieron variables clinicas,
glucemia, ansiedad (Escala de Hamilton) y satisfaccion percibida.
Resultados: Se incluyeron 58 pacientes. El grupo de intervencion presento
menor sensacion de hambre y sed (p<0.001), asi como una reduccion
significativa de la ansiedad prequirurgica (p=0.003) en comparacion con el
grupo control. La satisfaccion percibida tambien fue mayor en el grupo de
intervencion (p=0,047). No se observaron diferencias significativas en las
complicaciones postoperatorias. Conclusiones: Los hallazgos encontrados a
lo largo de la investigacion respaldan la incorporacion de esta estrategia
en los protocolos de cirugia cardiaca, con el potencial de optimizar la
experiencia y los resultados del paciente.<br/>Copyright &#xa9; 2025
Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by
Elsevier Espana, S.L.U. This is an open access article under the CC
BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/

<80>
Accession Number
2041561397
Title
Amustaline/glutathione pathogen-reduced red cell hemoglobin utilization in
complex cardiac surgery: A post hoc analysis of the phase 3 ReCePI trial.
Source
Transfusion. 66(1) (pp 72-83), 2026. Date of Publication: 01 Jan 2026.
Author
Welsby I.J.; Sekela M.E.; Snyder E.L.; Gorham J.D.; McNeil J.S.; Liu K.;
Bentow S.; Gniadek T.; Corash L.; Mufti N.; Benjamin R.J.
Institution
(Welsby) Duke University Medical Center, Durham, NC, United States
(Sekela) Gill Heart Institute, University of Kentucky, Lexington, KY,
United States
(Snyder) Yale University School of Medicine, New Haven, CT, United States
(Gorham, McNeil) University of Virginia Health System, Charlottesville,
VA, United States
(Liu, Bentow, Gniadek, Corash, Mufti, Benjamin) Cerus Corporation,
Concord, CA, United States
Publisher
John Wiley and Sons Inc
Abstract
Background: The ReCePI randomized, controlled trial compared
amustaline/glutathione pathogen-reduced (PR) and conventional red blood
cell (RBC) transfusions in cardiac surgery. Study design and methods: We
performed a post-hoc analysis of hemoglobin (Hb) utilization and safety
outcomes. Hb content of study RBCs was measured at manufacture. Subject Hb
levels, estimated blood loss and blood product use were recorded during
and for 7 days post-surgery. Acute kidney injury (AKI) incidence was
graded over 7 days, and adverse events were assessed for 28 days.
<br/>Result(s): PR-RBCs contained 5.2% less Hb (mean [SD] Test 58.1 [6.5]
g; Control 61.5 [6.8] g Hb, p <.001) due to manufacturing volume losses.
Four hundred fifty-six PR- and 524 conventional RBCs were transfused to
159 Test and 162 Control subjects, respectively. Mean subject baseline and
post-surgery Hb levels, and blood loss were not different between groups.
Test subjects tended to require fewer total RBCs (3.5 [2.7] Test vs. 4.0
[3.5] Control, p =.08) resulting in 17.6% significantly less mean total Hb
transfused (Test 203.2 g; Control 246.8 g Hb, p =.01). The proportions of
subjects transfused with, and the number of platelet and cryoprecipitate
units transfused were not different. Test subjects received less plasma
(2.3 [1.8] units Test vs. 3.5 [3.8] Control, p =.03). Overall incidence of
adverse events and AKI were not clinically different. Imbalances in AKI
severity (Grade III Test 15/159 [9.4%]; Control 7/162 [4.3%], p =.07) may
suggest under-transfusion in the highest-risk Test subjects.
<br/>Discussion(s): Test patients required less transfused Hb than control
subjects to maintain equivalent daily hemoglobin levels following similar
blood loss.<br/>Copyright &#xa9; 2025 The Author(s). Transfusion published
by Wiley Periodicals LLC on behalf of AABB.

<81>
Accession Number
2042904298
Title
Effects of Preoperative Stellate Ganglion Block on Postoperative Sore
Throat and Hoarseness in Patients Undergoing Double-Lumen Endobronchial
Intubation: Protocol for a Prospective Randomized Controlled Trial.
Source
Journal of Pain Research. 19 (pp 1-11), 2026. Date of Publication: 2026.
Author
Chen Z.; Tan Y.; Cong P.; Jin Y.; Li N.
Institution
(Chen, Cong) Department of Anesthesiology, The Second Qilu Hospital,
Cheeloo College of Medicine, Shandong University, 247 Bei Yuan Street,
Shandong, Jinan, China
(Chen, Tan, Li) Department of Anesthesiology and Perioperative Medicine,
Shandong Public Health Clinical Center, Shandong University, 2999 Gangxing
West Road, Shandong, Jinan, China
(Jin) Department of Epidemiology and Biostatistics, School of Public
Health, Wannan Medical College/ Institute of Chronic Disease Prevention
and Control, Wuhu, China
(Jin) Department of Anesthesiology and Perioperative Medicine, Shandong
Public Health Clinical Center, Shandong University, Shandong, Jinan, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Postoperative sore throat (POST) is a common complication
after general anesthesia, especially following double-lumen endobronchial
tube (DLT) intubation in thoracic surgery, adversely affecting recovery.
Stellate ganglion block (SGB) modulates sympathetic tone and inflammation,
potentially reducing airway complications, but its efficacy for POST and
hoarseness after DLTs remains unclear. <br/>Objective(s): To evaluate the
impact of preoperative SGB on the incidence and severity of POST and
hoarseness in patients undergoing DLT intubation, and to explore its
effects on postoperative sleep, anxiety, depression, and hemodynamics.
<br/>Method(s): In this single-center, prospective, randomized controlled
trial, 124 patients scheduled for thoracic surgery with left DLT
intubation are to be included. Patients will be randomly assigned in a 1:1
ratio to the SGB group or the control group. Patients in the SGB group
will receive ultrasound-guided right SGB (5 mL of 0.5% ropivacaine)
approximately 30 minutes before anesthesia induction. In the control
group, ultrasound-guided scanning of the stellate ganglion will be
conducted without performing SGB, and local lubrication with 1% tetracaine
gel will be administered prior to intubation. The primary outcome is the
incidence of POST at 6 hours after surgery. <br/>Discussion(s): This trial
will determine whether SGB can effectively reduce POST and hoarseness
after DLT intubation, potentially offering a multimodal strategy to
improve postoperative recovery in thoracic surgery patients. Clinical
Trial Registration: Chinese Clinical Trial Registry
(ChiCTR2400092313).<br/>Copyright &#xa9; 2026 Chen et al.

<82>
Accession Number
2043206645
Title
Cardiovascular and renal outcomes of sodium-glucose cotransporter-2 versus
dipeptidyl peptidase-4 inhibitors in patients with type 2 diabetes
post-PCI: a meta-analysis of 14,511 patients.
Source
Diabetology and Metabolic Syndrome. 18(1) (no pagination), 2026. Article
Number: 63. Date of Publication: 01 Dec 2026.
Author
Badran A.S.; Gbreel M.I.; Tawfik A.M.; Balata M.
Institution
(Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Gbreel) Faculty of Medicine, October 6 University, Giza, Egypt
(Tawfik) Faculty of Medicine, Alexandria University, Alexandria, Egypt
(Balata) Department of Cardiology, University Hospital Rostock, Ernst-
Heydemann-Strase 6, Rostock, Germany
Publisher
BioMed Central Ltd
Abstract
Background: Patients with type 2 diabetes mellitus (T2DM) undergoing
percutaneous coronary intervention (PCI) are at high risk of adverse
cardiovascular and renal outcomes. While both sodium-glucose
cotransporter-2 inhibitors (SGLT-2i) and dipeptidyl peptidase-4 inhibitors
(DPP-4i) are widely used in this population, direct evidence comparing
their long-term efficacy and safety after PCI remains scarce. This
meta-analysis aimed to compare cardiovascular and renal outcomes between
SGLT-2i and DPP-4i in patients with T2DM post-PCI. <br/>Method(s): PubMed,
Web of Science, Scopus, and Cochrane CENTRAL were searched through June
2025. Primary outcomes were all-cause mortality, worsening renal function,
and heart failure. We included primary studies and assessed the quality of
studies using Newcastle Ottawa Scale. RevMan software was used to
calculate hazard ratios (HR) estimates and 95% confidence intervals (CI)
using the random-effects model. <br/>Result(s): We analyzed the outcomes
between SGLT-2i (n = 7,025 patients) and DPP-4i (n = 7,459 patients). The
mean age was 62.7 years, and 77.4% were males. SGLT-2i significantly
reduced all-cause mortality (HR = 0.65; 95% CI: 0.54-0.79; P < 0.001) and
the risk of worsening renal function (HR = 0.15; 95% CI: 0.09-0.26; P <
0.001). They also demonstrated a significant reduction in heart failure
events (HR = 0.59; 95% CI: 0.48-0.74; P < 0.001). For myocardial
infarction, a non-significant trend toward risk reduction with SGLT-2i was
observed (HR = 0.85; 95% CI: 0.72-1.02; P = 0.08). For cerebrovascular
accidents and the need for repeat revascularization (PCI/CABG), no
significant difference was observed. <br/>Conclusion(s): SGLT-2i
demonstrates more clinical benefits, and current evidence supports its
initiation over DPP-4i in T2DM patients after PCI.<br/>Copyright &#xa9;
The Author(s) 2026.

<83>
Accession Number
2035993112
Title
Treatment outcomes and safety profile of SGLT2 inhibitors versus GLP-1
agonists in type 2 diabetes mellitus: Systematic review of real-world
observational studies.
Source
Wiener Medizinische Wochenschrift. 176(1-2) (pp 45-59), 2026. Date of
Publication: 01 Feb 2026.
Author
Alam A.; Imran M.; ur Rehman Z.; Sahoo B.M.; Mahapatra M.K.
Institution
(Alam) Department of Pharmacognosy, College of Pharmacy, Prince Sattam Bin
Abdulaziz University, Al-Kharj, Saudi Arabia
(Imran) Department of Pharmaceutical Chemistry, College of Pharmacy,
Northern Border University, Rafha, Saudi Arabia
(Imran) Center for Health Research, Northern Border University, Arar,
Saudi Arabia
(ur Rehman) Health Research Centre, Jazan University, 114, Jazan, Saudi
Arabia
(ur Rehman) Department of Pharmaceutical Chemistry and Pharmacognosy,
Faculty of Pharmacy, Jazan University, 114, Jazan, Saudi Arabia
(Sahoo) School of Pharmacy and Life Sciences, Centurion University of
Technology & Management, Odisha, Jatni, India
(Mahapatra) Department of Pharmaceutical Chemistry, Kanak Manjari
Institute of Pharmaceutical Sciences, Odisha, Rourkela, India
Publisher
Springer
Abstract
Purpose: Several pharmacotherapies are available to treat type 2 diabetes
mellitus (T2DM) among which sodium-glucose cotransporter 2 inhibitors
(SGLT2is) and glucagon-like peptide 1 (GLP-1) receptor agonists are
significant. The current systematic review aims to critically evaluate
various clinical outcomes and safety profile of SGLT2is in comparison to
GLP-1 receptor agonists for the management of T2DM utilizing real-world
clinical data. <br/>Method(s): A total of 22,100 research articles were
extracted from several electronic databases including EMBASE, PubMed,
Clinicaltrials.gov, and Cochrane Library from January 2010 to September
2024. Preferred Reporting Items for Systematic Reviews and Meta-Analyses
(PRISMA) guidelines were followed to maintain consistency and transparency
in research. To obtain insights from the real-world clinical data,
observational studies were used for this review, excluding, randomized
controlled trials. <br/>Result(s): The pooled analysis showed that risk
ratio (RR) of heart failure and MACE (major cardiovascular events) or
revascularization, and odds ratio (OR) of renal outcomes were slightly
higher among SGLT2is (experimental) as compared to GLP-1 agonist
(control). In addition, the pooled analysis of hypoglycemic events and
all-cause mortalities favored SGLT2is as compared to GLP-1 agonist.
<br/>Conclusion(s): SGLT2is appear to be more effective in lowering
hospitalization for heart failure; GLP-1 medication appears to be safer
and more successful in treating MACE and improving renal outcomes.
Occurrence of hypoglycemic events and the rate of all-cause mortality were
found to be low in the SGLT2is group, which supported the clinical
implication of SGLT2is.<br/>Copyright &#xa9; Der/die Autor(en), exklusiv
lizenziert an Springer-Verlag GmbH Austria, ein Teil von Springer Nature
2025.

<84>
Accession Number
2043017354
Title
The impact of cerebral oxygen saturation monitoring on perioperative
neurocognitive disorders: a meta-analysis and economic analysis.
Source
Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1677218.
Date of Publication: 2026.
Author
Qin J.; Wang G.; Gu D.; Li J.; Zhang J.; Ge M.; He X.; Ma X.
Institution
(Qin, Wang, Ma) Department of Anesthesiology, Changzhi People's Hospital,
Changzhi, China
(Gu, Ge) Department of Otolaryngology, Changzhi People's Hospital,
Changzhi, China
(Li, He) Institute of Evidence-Based Medicine, Heping Hospital Affiliated
to Changzhi Medical College, Changzhi, China
(Zhang) Department of Pain Treatment, Changzhi People's Hospital,
Changzhi, China
Publisher
Frontiers Media SA
Abstract
Background: Inadequate intraoperative cerebral oxygen supply is one of the
inciting causes of postoperative cognitive disturbances. Numerous studies
have investigated the association between regional cerebral oxygen
saturation (rScO<inf>2</inf>) monitoring and postoperative cognitive
dysfunction. However, results are inconsistent, owing to differences in
surgery type, patient population, and monitoring protocols. Therefore, we
conducted a meta-analysis to comprehensively evaluate the association
between rScO<inf>2</inf> monitoring and the incidence of postoperative
neurocognitive disorders. <br/>Method(s): A comprehensive literature
search was conducted across multiple databases from their inception to
June 2025 to identify randomized controlled trials (RCTs) that compared
the impact of rScO<inf>2</inf> monitoring versus no monitoring on
cognitive function. The primary outcome was the incidence of perioperative
neurocognitive disorders (PNDs). Secondary outcomes were the incidences of
postoperative cognitive dysfunction (POCD) and postoperative delirium
(POD), as well as the economic indicators of the number needed to treat
(NNT) and cost-benefit ratio (CBR). <br/>Result(s): A total of 28 RCTs
were included. Overall, we found that intraoperative rScO<inf>2</inf>
monitoring significantly reduced the incidence risk of PND (relative risk
[RR]=0.47, 95% confidence interval [CI]: 0.41, 0.54), POCD (RR=0.47, 95%
CI: 0.39, 0.57), and POD (RR=0.45, 95% CI: 0.35, 0.57). Subgroup analyses
based on surgery type (cardiac, orthopedic, abdominal, and others)
demonstrated consistent protective effects of monitoring. Sensitivity
analyses using leave-one-out analysis, excluding Chinese-language
publications, low-quality studies, and studies with a baseline
rScO<inf>2</inf><80%, confirmed the robustness of results. The economic
evaluation showed that rScO<inf>2</inf> monitoring is both clinically
beneficial and cost-effective, as reflected in the low NNT values and
favorable CBRs, which indicated that the cost of prevention is
substantially lower than that of managing complications.
<br/>Conclusion(s): Intraoperative rScO<inf>2</inf> monitoring
significantly reduces the incidence of PND, including POCD and POD.
Consistent protective effects were observed across a wide range of surgery
types, demonstrating its broad clinical applicability. Furthermore, its
favorable cost-benefit profile demonstrated that the prevention of
neurocognitive complications has a substantially lower cost than the
estimated economic burden of managing these complications. Widespread
adoption of rScO<inf>2</inf> monitoring is recommended to improve
postoperative cognitive outcomes.<br/>Copyright &#xa9; 2026 Qin, Wang, Gu,
Li, Zhang, Ge, He and Ma.

<85>
Accession Number
2041910674
Title
A Standardized Remediation Approach for the Integrated Cardiothoracic
Surgery Trainee: Review of Current Paradigms and Suggested Strategies.
Source
Annals of Thoracic Surgery. 121(3) (pp 740-751), 2026. Date of
Publication: 01 Mar 2026.
Author
Hutson J.; Aggarwal R.; Robinson J.; Naselsky W.; Gicovi K.; Stewart S.
Institution
(Hutson, Aggarwal) Michigan State University College of Human Medicine,
East Lansing, MI, United States
(Robinson, Gicovi, Stewart) University of Maryland School of Medicine,
Baltimore, MD, United States
(Robinson, Gicovi, Stewart) Department of Surgery, University of Maryland,
Baltimore, MD, United States
(Naselsky) Houston Methodist, Houston, TX, United States
Publisher
Elsevier Inc.
Abstract
Background Effective remediation is essential for the success of residency
programs, yet integrated cardiothoracic (I6) surgery training lacks
standardized guidelines. Drawing from remediation practices in other
surgical subspecialties, this study evaluates existing strategies and
proposes a structured remediation framework tailored to I6 trainees.
Methods A systematic review examining remediation policies in surgical
residency programs was conducted through December 2024. Studies meeting
inclusion criteria were critically analyzed and key themes were
synthesized to inform a standardized approach for I6 trainees. Results Of
239 identified articles, 18 met inclusion criteria. Findings emphasized
the importance of regular assessments, structured performance evaluations,
and collaborative intervention strategies, including faculty mentorship
and success teams. Standardized remediation protocols, as seen in
neurosurgery and orthopedics, were instrumental in addressing competency
deficiencies through competency-based assessments and curriculum
refinements. Conclusions I6 training demands a multifaceted remediation
approach encompassing technical proficiency, clinical acumen, and
professional development. By integrating best practices from related
surgical fields, this study proposes a tailored, evidence-based
remediation framework to enhance surgical education and to support
struggling residents. Establishing a standardized remediation policy
across I6 programs can optimize training outcomes, ensuring competence and
preparedness of future cardiothoracic surgeons.<br/>Copyright &#xa9; 2025.
Published by Elsevier Inc.

<86>
Accession Number
2043533365
Title
Updated 5-year outcomes of transcatheter versus surgical aortic valve
replacement in patients with severe aortic stenosis at low- to
intermediate-surgical risk.
Source
Heart. (no pagination), 2026. Article Number: heartjnl-2025-327092. Date
of Publication: 2026.
Author
Marin-Cuartas M.; Kawczynski M.J.; de Waha S.; Kiefer P.; Falk V.; Siepe
M.; Bowdish M.E.; Akowuah E.; Verbrugghe P.; Oosterlinck W.; Klautz
R.J.M.; Lorusso R.; Bidar E.; Rahouma M.M.; Redfors B.; Biondi-Zoccai G.;
Bhatt D.L.; Gaudino M.; Borger M.A.; Heuts S.
Institution
(Marin-Cuartas, de Waha, Kiefer, Borger) University Department of Cardiac
Surgery, Leipzig Heart Centre University Hospital, SN, Leipzig, Germany
(Kawczynski, Lorusso, Bidar, Heuts) Department of Cardiothoracic Surgery,
Maastricht University Medical Centre, LI, Maastricht, Netherlands
(Kawczynski, Lorusso, Bidar, Heuts) Cardiovascular Research Institute
Maastricht (CARIM), Maastricht University, Maastricht, Netherlands
(de Waha) Department of Rhythmology, University Hospital Schleswig
Holstein, Kiel, Germany
(Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches
Herzzentrum der Charite (DHZC), Berlin, Germany
(Falk) Charite - Universitatsmedizin Berlin, Freie Universitat Berlin,
Humboldt-Universitat zu Berlin, Berlin, Germany
(Falk) DZHK (Deutsches Zentrum fur Herz-Kreislauf-Forschung), Partner Site
Berlin, Berlin, Germany
(Falk) Department of Health Science and Technology, Translational
Cardiovascular Technologies, ETH Zurich, Zurich, Switzerland
(Siepe) Department of Cardiac Surgery, Bern University Hospital, Bern,
Switzerland
(Bowdish) Department of Cardiac Surgery, Smidt Heart Institute, Los
Angeles, CA, United States
(Akowuah) James Cook University Hospital, Middlesbrough, United Kingdom
(Verbrugghe, Oosterlinck) Department of Cardiac Surgery, University
Hospitals Leuven, Leuven, Belgium
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
(Rahouma, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell
Medicine, New York City, NY, United States
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Molecular and Clinical Medicine, Gothenburg
University, Gothenburg, Sweden
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Biondi-Zoccai) Department of Medical-Surgical Sciences and
Biotechnologies, Sapienza University, Rome, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York City, NY, United States
Publisher
BMJ Publishing Group
Abstract
Objectives The comparative long-term safety and efficacy of transcatheter
aortic valve implantation (TAVI) versus surgical aortic valve replacement
(SAVR) remains under continued investigation, particularly in patients at
low- to intermediate-surgical risk. This study aims to synthesise and
update contemporary long-term TAVI versus SAVR data. Methods This study
comprised a systematic review and meta-analysis and employed a Bayesian
hierarchical design. Randomised controlled trials (RCTs) comparing TAVI to
SAVR in low-risk to intermediate-risk patients with at least 5-year
follow-up were included. The primary outcome was 5-year all-cause
mortality; secondary outcomes were the 5-year incidence of stroke and the
5-year incidence of the composite of mortality and stroke. Review methods
Time-to-event data were reconstructed. Relative risks (RRs) with 95%
credible intervals (CrIs) were estimated from reported 5-year event rates
using minimally informative priors. Sensitivity analyses were performed
using various meta-analytical models, and using conventional frequentist
random-effects and fixed-effects models for sensitivity purposes. Results
A total of six RCTs, enrolling 7249 low- to intermediate-risk patients
reported 5-year outcomes (TAVI n=3704, SAVR n=3545). The 5-year all-cause
mortality rate was 29.7% (28.2-31.2%, TAVI) and 27.6% (26.1-29.1%, SAVR).
The median RR for all-cause mortality was 1.12 (95% CrI 1.02-1.22,
heterogeneity tau²=0), with a 99.3% posterior probability that
SAVR is superior to TAVI for this endpoint. For stroke, the median RR was
1.13 (95% CrI 0.93-1.39, heterogeneity tau²=0.04), resulting in
an 88.0% posterior probability that SAVR outperformed TAVI for this
outcome. These results were consistent across conventional frequentist
random-effects and fixed-effects models employing p values (RR 1.13, 95%
CI 1.05 to 1.22, p=0.001, and RR 1.12, 95% CI 1.03 to 1.23, p=0.011,
respectively). There was no evidence for an interaction effect of surgical
risk category (p=0.470). Conclusion In this meta-analysis of RCTs, TAVI
resulted in a clinically relevant increase in all-cause mortality, and a
high probability of an increased risk of stroke, at 5 years of follow-up
in low-risk to intermediate-risk patients, when compared to
SAVR.<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.

<87>
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.

<88>
Accession Number
2033147397
Title
Serial Lactate in Clinical Medicine - A Narrative Review.
Source
Journal of Intensive Care Medicine. 41(3) (pp 175-185), 2026. Date of
Publication: 01 Mar 2026.
Author
Falter F.; Tisherman S.A.; Perrino A.C.; Kumar A.B.; Bush S.; Nordstrom
L.; Pathan N.; Liu R.; Mebazaa A.
Institution
(Falter) Department of Anaesthesia and Intensive Care, Royal Papworth
Hospital, Cambridge, United Kingdom
(Tisherman) Center for Critical Care and Trauma, University of Maryland
School of Medicine, Baltimore, United States
(Perrino) Department of Anesthesiology, Yale School of Medicine, New
Haven, United States
(Kumar) Department of Anesthesiology and Critical Care, Vanderbilt
University Medical Center, Nashville, United States
(Bush) Department of Emergency Medicine, Stephen Bush, Leeds Teaching
Hospitals, Leeds, United Kingdom
(Nordstrom) Department of Women's and Children's Health, Karolinska
University, Stockholm, Sweden
(Pathan) Department of Paediatrics, Cambridge University Hospitals,
Cambridge, United Kingdom
(Liu) Sutter Health, San Francisco, United States
(Mebazaa) Department of Anaesthesiology and Critical Care, Universite
Paris Cite, Paris, France
Publisher
SAGE Publications Inc.
Abstract
Background: Blood lactate is commonly used in clinical medicine as a
diagnostic, therapeutic and prognostic guide. Lactate's growing importance
in many disciplines of clinical medicine and academic enquiry is
underscored by the tenfold increase in publications over the past 10
years. Lactate monitoring is presently shifting from single to serial
measurements, offering a means of assessing response to therapy and to
guide treatment decisions. With the promise of wearable lactate sensors
and their potential integration in electronic patient records and early
warning scores, the utility of serial lactate measurement deserves closer
scrutiny. <br/>Method(s): Articles included in this review were identified
by searching MEDLINE, PubMed and EMBASE using the term "lactate" alone and
in combination with "serial", "point of care", "clearance", "prognosis"
and "clinical". Authors were assigned vetting of publications according to
their specialty (anesthesiology, intensive care, trauma, emergency
medicine, obstetrics, pediatrics and general hospital medicine). The
manuscript was assembled in multidisciplinary groups guided by underlying
pathology rather than hospital area. <br/>Finding(s): Lactate's clinical
utility as a dynamic parameter is increasingly recognized. Several
publications in the last year highlight the value of serial measurements
in guiding therapy. Outside acute clinical areas like the emergency room,
operating room or intensive care, obtaining lactate levels is often
fraught with difficulty and delays. <br/>Interpretation(s): Measuring
serial lactate and lactate clearance offers regular feedback on response
to therapy and patient status. Particularly on the ward, wearable devices
integrated in early warning scores via the hospital IT system are likely
to identify deteriorating patients earlier than having to rely on
observations by an often-overstretched nursing workforce.<br/>Copyright
&#xa9; The Author(s) 2025. This article is distributed under the terms of
the Creative Commons Attribution-NonCommercial 4.0 License
(https://creativecommons.org/licenses/by-nc/4.0/) which permits
non-commercial use, reproduction and distribution of the work without
further permission provided the original work is attributed as specified
on the SAGE and Open Access page
(https://us.sagepub.com/en-us/nam/open-access-at-sage).

<89>
Accession Number
2042950528
Title
Autologous atrial appendage micrografts transplanted during coronary
artery bypass surgery: design of the AAMS2 randomized, double-blinded, and
placebo-controlled trial.
Source
Trials. 27(1) (no pagination), 2026. Article Number: 97. Date of
Publication: 01 Dec 2026.
Author
Sikorski V.; Nummi A.; Kuuva A.; Wilkman E.; Rajala H.; Stewart J.;
Junttila J.; Lindgren K.; Kervinen K.; Teittinen K.; Kohonen K.; Oksaharju
K.; Okkonen M.; Holmstrom M.; Lehtinen M.; Mulari S.; Taskinen P.; Simonen
P.; Karvonen P.; Kastell P.; Karja-Koskenkari P.; Kandolin R.; Kesavuori
R.; Kaarlenkaski S.; Vaara S.; Dahlbacka S.; Syrjala S.; Syvaranta S.;
Juvonen T.; Erkinaro T.; Makela T.; Karjalainen P.; Kankuri E.; Vento A.;
Nykanen A.
Institution
(Sikorski, Mulari, Kankuri) Faculty of Medicine, Department of
Pharmacology, University of Helsinki, Helsinki, Finland
(Nummi, Teittinen, Kohonen, Oksaharju, Lehtinen, Mulari, Dahlbacka,
Syrjala, Juvonen, Vento, Nykanen) Department of Cardiothoracic Surgery,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, P.O. Box 340, Haartmaninkatu 4, Helsinki, Finland
(Kuuva) EpiHeart Oy, Helsinki, Finland
(Wilkman) Department of Anesthesiology, Intensive Care and Pain Medicine,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Rajala, Stewart, Simonen, Kandolin, Karjalainen) Division of Cardiology,
Heart and Lung Center, Helsinki University Hospital and University of
Helsinki, Helsinki, Finland
(Junttila, Lindgren, Karja-Koskenkari) Division of Cardiology, Department
of Internal Medicine, Oulu University Hospital, Oulu, Finland
(Kervinen) Heart Unit, Oulu University Hospital, Oulu, Finland
(Okkonen, Karvonen, Kastell, Kaarlenkaski) Research Unit of Internal
Medicine, Medical Research Center Oulu, University of Oulu and University
Hospital of Oulu, Oulu, Finland
(Holmstrom, Kesavuori, Vaara, Syvaranta) Radiology, HUS Diagnostic Center,
University of Helsinki and Helsinki University Hospital, Helsinki, Finland
(Taskinen) Department of Cardiothoracic Surgery, Oulu University Hospital,
University of Oulu, Oulu, Finland
(Erkinaro) Research Group of Anesthesiology, Medical Research Center Oulu,
Oulu University Hospital and University of Oulu, Oulu, Finland
(Makela) Anesthesia and Intensive Care, Research Unit of Surgery,
University of Oulu and Medical Research Center, Oulu, Finland
Publisher
BioMed Central Ltd
Abstract
Background: The AAMS open-label clinical study demonstrated the safety and
feasibility of epicardial transplantation of autologous right atrial
appendage micrografts (AAMs) during coronary artery bypass grafting (CABG)
surgery. The study also provided the first indications of therapeutic
efficacy of the AAMs, as delivered within an extracellular matrix patch,
to reduce ischemic scar and increase viable ventricular wall thickness. To
further evaluate the initial beneficial effects observed in the AAMS
study, we designed the randomized, double-blinded, and placebo-controlled
AAMS2 trial. Focusing on patients with ischemic heart disease (IHD) and
myocardial scar, the AAMS2 trial aims to generate state-of-the-art
structural and functional imaging data of the myocardium treated with an
AAMs-patch during CABG. <br/>Method(s): The AAMS2 trial recruits IHD
patients who are set to undergo non-urgent CABG and present with an
ischemic myocardial scar in preoperative cardiac magnetic resonance
imaging (CMRI) with late gadolinium enhancement. Patients are randomized
(1:1) to receive a collagen-based matrix patch (Hemopatch), with or
without AAMs, epicardially onto the scar border. The primary endpoint,
assessed by CMRI preoperatively and at 6 months post-operative follow-up,
focuses on the left ventricle scar mass. The secondary endpoints center on
the change in scar mass by the AAMs-patch site and evaluation of therapy
safety and feasibility as well as its effects on myocardial structure and
function by echocardiography. Change in blood N-terminal-pro-BNP levels in
the timeframe is the co-primary endpoint. <br/>Discussion(s): Data from
the AAMS2 trial provides the first randomized, blinded, and
placebo-controlled evaluation of efficacy on epicardial AAMs
transplantation for ischemic myocardial scar. This data will pave the road
towards rational design of larger AAMs therapeutic efficacy-addressing
trial(s). Trial registration: ClinicalTrials.gov, NCT05632432, registered
30 November 2022,
https://clinicaltrials.gov/study/NCT05632432.<br/>Copyright &#xa9; The
Author(s) 2026.

<90>
Accession Number
2042009449
Title
Evaluating Topical Antifibrinolytics in Cardiac Surgery: A Systematic
Review, Meta-Analysis, and Trial Sequential Analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(3) (pp 1024-1036),
2026. Date of Publication: 01 Mar 2026.
Author
Montoya-Beltran J.S.; Ramirez-Herrera L.; Pinilla J.L.; Herazo-Cubillos
A.; Pena-Blanco L.; Jimenez Ordonez A.F.
Institution
(Montoya-Beltran, Ramirez-Herrera, Pinilla, Herazo-Cubillos, Pena-Blanco)
Anesthesiology Research Group, Fundacion Cardioinfantil - Instituto de
Cardiologia, Bogota, Colombia
(Montoya-Beltran, Ramirez-Herrera, Herazo-Cubillos) Anesthesiology
Department, Fundacion Cardioinfantil - Instituto de Cardiologia, Bogota,
Colombia
(Montoya-Beltran, Ramirez-Herrera, Pinilla, Herazo-Cubillos, Pena-Blanco)
Universidad del Rosario, School of Medicine and Health Sciences, Bogota,
Colombia
(Jimenez Ordonez) Cardiovascular Surgery Department, Fundacion
Cardioinfantil - Instituto de Cardiologia, Bogota, Colombia
Publisher
W.B. Saunders
Abstract
Introduction: Lysine analog antifibrinolytics (LAAF) like tranexamic acid
(TXA) and aminocaproic acid (EACA) reduce intraoperative blood loss,
especially in cardiac surgery where bleeding risks are high. These LAAFs
inhibit fibrinolysis and have been proven to decrease bleeding and
transfusion volume. In cardiac surgery, frequent transfusions raise the
risk of infections, extend hospital stays and reoperations, and carry
higher morbidity and mortality. Current guidelines recommend intravenous
antifibrinolytics; however, the objective of this review was to determine
whether topical administration in cardiac surgery reduces blood loss, with
or without intravenous LAAF. <br/>Method(s): PubMed, Embase, MEDLINE,
Cochrane CENTRAL, and Clarivate WoS were searched from inception to August
31, 2024, for randomized controlled trials and observational studies
comparing topical TXA or EACA to placebo in cardiac surgery. Data
extraction was done independently, and RoB2/ROBINS-I was used for quality
assessment. A derSimmonian-Laird random-effects model was applied. Mean
differences were used for continuous outcomes, and OR/RR was used for
binary. I2 statistics measure heterogeneity. Sensitivity analysis and GOSH
plotting assessed heterogeneity; trial sequential analysis was performed.
The certainty of the evidence followed GRADE guidelines. <br/>Result(s):
The meta-analysis included 26 studies with 2,624 patients, 24 focused on
adults. Given the pragmatic approach to this meta-analysis, a wide variety
of surgical procedures were included, with coronary artery bypass grafting
and valvular procedures being the most prevalent. LAAF administration
reduced postoperative blood loss by 174 mL (MD -173.99, 95% CI -238.20 to
-109.78, p < 0.00001), and the effect remained constant through subgroup
analysis (coronary artery bypass grafting, high- v low-dose, dual-route
administration). No significant differences were found in transfusion
rates for packed red blood cells (PRBC) and platelets, though LAAF reduced
PRBC volume (MD -0.6 units, 95% CI -0.88 to -0.24, p = 0.00006) and fresh
frozen plasma requirements (RR 0.69, 95% CI: 0.5 to 0.95, p = 0.03). No
differences in hematological change scores or complication rates were
observed. The analysis showed high heterogeneity, but the overall effect
remained consistent. A trial sequential analysis suggests there is enough
data to confirm this effect. <br/>Conclusion(s): Topical LAAF
administration reduces postoperative blood loss up to 24 hours
postoperatively. Secondary analyses showed reductions in PRBC transfusion
volume and fresh frozen plasma transfusion rate, without increased
complications. Registration: PROSPERO CRD42024579777, August 27,
2024.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<91>
Accession Number
2043306678
Title
Early-Phase Exercise-Based Comprehensive Cardiac Rehabilitation Program
after Myocardial Infarction: A Randomized Controlled Trial.
Source
Acta Cardiologica Sinica. 42(1) (pp 33-46), 2026. Date of Publication: 01
Jan 2026.
Author
Aktan O.O.; Ozalevli S.; Dursun H.; Baskurt A.A.; Alpaydn A.O.; Kaya D.
Institution
(Aktan) Institute of Health Sciences, Turkey
(Ozalevli) Faculty of Physical Therapy and Rehabilitation, Turkey
(Dursun, Baskurt, Kaya) Department of Cardiology, Turkey
(Alpaydn) Department of Chest Diseases, Faculty of Medicine, Dokuz Eylul
University, Izmir, Turkey
Publisher
Republic of China Society of Cardiology
Abstract
Background: Myocardial infarction (MI) remains a leading cause of
mortality and morbidity worldwide. Cardiac rehabilitation (CR) is an
evidence-based intervention that improves cardiovascular outcomes;
however, the optimal timing and contents of CR remain unclear.
<br/>Objective(s): This study aimed to investigate the effects of an
early-phase, exercise-based supervised comprehensive CR program on
functional exercise capacity, grip strength, fatigue, sleep quality, and
health-related quality of life (HRQOL) in patients with MI.
<br/>Method(s): A randomized controlled trial was conducted involving 32
medically stable MI patients allocated to either an intervention or
control group. The intervention group received a two-phase supervised CR
program initiated within the first week post-MI, including inpatient and
outpatient aerobic, calisthenic, and strengthening exercises for eight
weeks. The control group received usual care. Primary and secondary
outcomes included the 6-minute walk distance (6MWD), 30-second
sit-to-stand test (30-sec STS), grip strength, fatigue (functional
assessment of chronic illness therapy [FACIT]-fatigue), sleep quality
(Pittsburgh Sleep Quality Index [PSQI]), and HRQOL (12-Item Short-Form
Questionnaire and MacNew Heart Disease Health-Related Quality of Life
Questionnaire). <br/>Result(s): Compared to the control group, the
intervention group showed significant improvements in 6MWD (mean
difference [MD] = 97.3 m, p < 0.001), 30-sec STS (MD = 3.1 repetitions, p
= 0.001), grip strength (MD = 5.7 kg, p = 0.04), FACIT-Fatigue score (MD =
8.8 points, p < 0.001), PSQI score (MD =-2.7 points, p < 0.001), and HRQOL
subdomains (p < 0.05). No adverse events were reported.
<br/>Conclusion(s): Early-phase supervised CR significantly enhanced
physical capacity, fatigue, sleep quality, and HRQOL in this cohort of MI
patients. Early initiation of structured CR should be considered in
clinical practice to promote faster recovery and improve long-term
outcomes following MI.<br/>Copyright &#xa9; 2026, Republic of China
Society of Cardiology. All rights reserved.

<92>
Accession Number
2041694784
Title
Effect of a Multifactorial Intervention on Retinopathy in People With Type
2 Diabetes: A Secondary Analysis of the J-DOIT3 Randomized Clinical Trial.
Source
JAMA Ophthalmology. 143(12) (pp 989-997), 2025. Date of Publication: 18
Dec 2025.
Author
Sasako T.; Ueki K.; Miyoshi K.; Miyake K.; Aoyama T.; Okazaki Y.; Ishizuka
N.; Yamauchi T.; Noda M.; Kadowaki T.
Institution
(Sasako, Miyoshi, Miyake, Aoyama, Yamauchi, Kadowaki) Department of
Diabetes and Metabolic Diseases, Graduate School of Medicine, The
University of Tokyo, Tokyo, Japan
(Ueki) Diabetes Research Center, Japan Institute for Health Security,
Tokyo, Japan
(Okazaki) Department of Metabolism and Endocrinology, Juntendo University
Graduate School of Medicine, Juntendo University, Tokyo, Japan
(Ishizuka) Center for Digital Transformation of Healthcare, Graduate
School of Medicine, Kyoto University, Kyoto, Japan
(Noda) Department of Diabetes, Metabolism and Endocrinology, Ichikawa
Hospital, International University of Health and Welfare, Chiba, Japan
(Noda) Department of Endocrinology and Diabetes, Saitama Medical
University, Saitama, Japan
(Kadowaki) Toranomon Hospital, Tokyo, Japan
Publisher
American Medical Association
Abstract
Importance Prevention of diabetic retinopathy is important to keep vision
and quality of life. Objective To examine the effects of an intensive
multifactorial intervention and hypoglycemia on retinopathy in people with
type 2 diabetes. Design, Setting, and Participants J-DOIT3 (Japan Diabetes
Optimal Integrated Treatment Study for 3 Major Risk Factors of
Cardiovascular Diseases) is a multicenter, open-label, parallel-group
randomized clinical trial that examined the efficacy of an intensified
multifactorial intervention on cardiovascular outcomes and mortality in
people with type 2 diabetes aged 45 to 69 years with hypertension and/or
dyslipidemia. The study was conducted at 81 sites in Japan from June 2006
to March 2009, and data analysis was performed from September 2018 to
August 2025. Interventions Participants were randomly assigned to
intensive therapy for glucose, blood pressure, and lipids or conventional
therapy and were followed up for a median duration of 8.5 years. Main
Outcomes and Measures This study is a secondary analysis of retinopathy
events of the secondary outcomes, composed of onset of retinopathy,
progression of retinopathy, and loss of vision likely due to retinopathy.
Results Among 2540 total participants (5080 eyes) randomly assigned to
intensive therapy or conventional therapy, mean (SD) age was 59.0 (6.3)
years, and 965 participants (38.0%) were female. Intensive therapy was
associated with a risk reduction in onset of retinopathy (hazard ratio
[HR], 0.83; 95% CI, 0.70-0.98; P =.03) but not with progression of
retinopathy (HR, 1.02; 95% CI, 0.70-1.49; P =.93). Hemoglobin
A<inf>1c</inf> (HbA<inf>1c</inf>) at 1 year after randomization was
associated with onset (HR, 1.31; 95% CI, 1.13-1.51; P <.001), even after
adjustment for baseline risk factors (ie, lower body mass index, longer
duration of diabetes, higher fasting plasma glucose, higher blood
pressure, and comorbid nephropathy), with no clear HbA<inf>1c</inf>
threshold observed. Moreover, compared with those without a hypoglycemic
episode during the intervention, the risk of onset was higher in those
with 0.5 hypoglycemic episodes per year or fewer (HR, 1.25; 95% CI,
1.02-1.53) and even higher in those with more than 1 hypoglycemic episode
per year (HR, 1.85; 95% CI, 1.39-2.47). Conclusions and Relevance This
secondary analysis of the J-DOIT3 randomized clinical trial shows that in
a randomized clinical trial setting, higher HbA<inf>1c</inf> and nonsevere
hypoglycemia are associated with higher risk of onset of retinopathy in
people with type 2 diabetes, even when good glycemic management, with a
very low incidence of severe hypoglycemia, is achieved, suggesting the
importance of strict glycemic management without any
hypoglycemia.<br/>Copyright &#xa9; 2025 Sasako T et al.

<93>
[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

<94>
Accession Number
2034451415
Title
Reexploring the STRESS Trial: Subgroup Postoperative Outcomes Following
Methylprednisolone for Infant Heart Surgery.
Source
Pediatric Cardiology. 47(3) (pp 1026-1034), 2026. Date of Publication: 01
Mar 2026.
Author
Sunthankar S.D.; Hill K.D.; Jacobs J.P.; Baldwin H.S.; Jacobs M.L.; Li
J.S.; Graham E.M.; Resheidat A.M.; Amula V.; Bleiweis M.S.; Wald E.L.;
Eghtesady P.; Scott J.P.; Anderson B.R.; Swartz M.F.; Benscoter A.;
Ravekes W.; Kannankeril P.J.
Institution
(Sunthankar, Baldwin, Kannankeril) Division of Pediatric Cardiology and
Center for Pediatric Precision Medicine, Department of Pediatrics,
Vanderbilt University Medical Center, 2220 Children's Way; Suite 5230,
Nashville, TN, United States
(Hill, Li) Division of Pediatric Cardiology, Duke University Medical
Center, Durham, NC, United States
(Jacobs, Bleiweis) Division of Cardiac Surgery, University of Florida,
Gainesville, FL, United States
(Jacobs) Division of Cardiac Surgery, Johns Hopkins School of Medicine,
Baltimore, MD, United States
(Graham) Division of Pediatric Cardiology, Medical University of South
Carolina, Charleston, SC, United States
(Resheidat) Division of Pediatric Cardiac Anesthesiology, Texas Children's
Hospital, Baylor College of Medicine, Houston, TX, United States
(Amula) Division of Critical Care, Department of Pediatrics, Primary
Children's Hospital, Salt Lake City, UT, United States
(Wald) Division of Pediatric Cardiology, Northwestern University Feinberg
School of Medicine, Chicago, IL, United States
(Eghtesady) Division of Cardiac Surgery, Washington University School of
Medicine, St. Louis, MO, United States
(Scott) Division of Pediatric Cardiology, Medical College of Wisconsin,
Madison, WI, United States
(Anderson) Division of Pediatric Cardiology, Icahn School of Medicine at
Mt Sinai, New York, NY, United States
(Swartz) Division of Cardiac Surgery, University of Rochester, Rochester,
NY, United States
(Benscoter) Division of Pediatric Cardiology, Cincinnati Children's
Hospital, Cincinnati, OH, United States
(Ravekes) Division of Pediatric Cardiology, Johns Hopkins School of
Medicine, Baltimore, MD, United States
Publisher
Springer
Abstract
Objective Assess the association between intraoperative methylprednisolone
and specific postoperative outcomes among subgroups undergoing infant
heart surgery. <br/>Design(s): Subpopulation analyses of The Steroids to
Reduce Systemic Inflammation after Infant Heart Surgery trial, a
double-blind randomized placebo-controlled trial. <br/>Setting(s): 24
congenital heart centers. <br/>Patient(s): Infants (< 1 year old)
undergoing heart surgery with cardiopulmonary bypass. Patients stratified
by Society of Thoracic Surgeons-European Association for Cardio-Thoracic
Surgery Congenital Heart Surgery (STAT) Mortality Category, age,
gestational age, and presence of chromosomal or syndromic diagnosis (CSD).
<br/>Intervention(s): Methylprednisolone (30 mg/kg) versus placebo
administered into cardiopulmonary bypass pump-priming fluid.
<br/>Measurements and Main Results: Outcomes included death, heart
transplantation, mechanical circulatory support, reinterventions, and
hospital length of stay. Ranked composite outcome (death, transplant, or
one of 13 major complications) was compared between placebo and
methylprednisolone for each subgroup using the win ratio.
Methylprednisolone did not reduce odds of death, transplant, or mechanical
circulatory support for any subgroup. Those receiving methylprednisolone
had fewer catheterization or surgical reinterventions after STAT Category
1-3 operations [OR 0.50 (0.29-0.86)]; and fewer reoperations for bleeding
among patients undergoing STAT Category 1-3 operations [OR 0.28
(0.09-0.87)], term infants [OR 0.30 (0.12-0.76)], and those without CSD
[OR 0.22 (0.07-0.68)]. Length of stay was no different between
methylprednisolone versus placebo. Those without chromosomal or syndromic
diagnosis demonstrated a favorable association for methylprednisolone [win
ratio 1.28 (1.01-1.61)] for the composite outcome. <br/>Conclusion(s):
Exploratory subpopulation analyses, although underpowered, suggest that
methylprednisolone is not associated with significant harm and may benefit
certain subpopulations<br/>Copyright &#xa9; The Author(s) 2025.

<95>
Accession Number
2038983222
Title
Review of minimally invasive coronary artery bypass grafting.
Source
European Journal of Cardio-thoracic Surgery. 67(5) (no pagination), 2025.
Article Number: ezaf160. Date of Publication: 01 May 2025.
Author
Walton A.J.; Pineda A.M.; Rogers L.; Davierwala P.M.; Zwischenberger B.A.
Institution
(Walton, Zwischenberger) Division of Cardiothoracic Surgery, Department of
Surgery, Duke University Medical Center, Durham, NC, United States
(Pineda) Division of Cardiology, Department of Medicine, Duke University
Medical Center, Durham, NC, United States
(Rogers, Davierwala) Division of Cardiovascular Surgery, Peter Munk
Cardiac Centre, Toronto General Hospital, University Health Network,
Toronto, ON, Canada
(Rogers, Davierwala) Department of Surgery, University of Toronto,
Toronto, ON, Canada
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
OBJECTIVES: Minimally invasive coronary artery bypass grafting (CABG),
defined broadly as surgical revascularization via any sternotomy-sparing
approach. Here, we provide an overview of minimally invasive CABG targeted
to cardiologists, cardiac surgeons and other clinicians involved in the
care of patients with coronary artery disease (CAD). <br/>METHOD(S): A
narrative review of the literature on minimally invasive CABG was
performed. <br/>RESULT(S): Minimally invasive CABG was first described
over 20 years ago, yet uptake has been slow and available data are
limited. The most common iteration of minimally invasive CABG is a
single-vessel CABG (left internal mammary artery to the left anterior
descending artery) performed without the cardiopulmonary bypass machine
via mini-thoracotomy. However, in patients with multivessel CAD, other
options include minimally invasive multivessel CABG and hybrid
revascularization (minimally invasive CABG with percutaneous coronary
intervention). Patient selection and preoperative planning are paramount.
Observational studies and small randomized controlled trials demonstrate
that minimally invasive CABG is associated with reduced rates of blood
transfusion, surgical site infections, lengths of intensive care unit and
hospital stays, and time to return to full activity with promising late
outcomes. Finally, we describe future areas for growth, including ongoing
clinical trials, gaps in evidence and pragmatic considerations for
surgeons interested in starting a minimally invasive CABG programme.
<br/>CONCLUSION(S): Minimally invasive CABG can expand the armamentarium
of revascularization techniques available for the ageing and increasingly
complex population of patients with CAD.<br/>Copyright &#xa9; 2025 The
Author(s). Published by Oxford University Press on behalf of the European
Association for Cardio-Thoracic Surgery. All rights reserved.

<96>
Accession Number
2036431434
Title
Efficacy and safety of left atrial appendage occlusion for atrial
fibrillation in patients with a history of prior intracranial hemorrhage:
a systematic review and meta-analysis of observational studies.
Source
Journal of Interventional Cardiac Electrophysiology. 69(2) (pp 285-295),
2026. Date of Publication: 01 Mar 2026.
Author
Hammad A.; Ahmad A.; Khalid N.; Munshi H.; Khraisat O.; Kumar V.; Muhammad
H.; Iyer A.; Ozgur S.; Dajani A.R.; Afzal A.; Patel S.; Tiyyagura S.;
Shamoon F.E.; Vasudev R.
Institution
(Hammad, Khraisat, Iyer, Ozgur, Dajani, Afzal) Department of Internal
Medicine, Englewood Hospital Medical Center, Englewood, NJ, United States
(Ahmad, Khalid, Munshi, Tiyyagura, Shamoon, Vasudev) Department of
Cardiology, St. Joseph's University Medical Center, Paterson, NJ, United
States
(Kumar) Department of Critical Care, George Washington University,
Washington, DC, United States
(Muhammad) Department of Cardiology, Newark Beth Israel Medical Center,
Newark, NJ, United States
(Patel) Rowan University School of Osteopathic Medicine, Glassboro, NJ,
United States
Publisher
Springer
Abstract
Background: Left atrial appendage occlusion (LAAO) is emerging as
alternative to anticoagulation in patients with nonvalvular atrial
fibrillation (AF) to reduce ischemic stroke risk, particularly in those at
high bleeding risk. <br/>Objective(s): Assess LAAO efficacy and safety in
patients with prior intracranial hemorrhage (ICH). <br/>Method(s):
Systematic review was performed using PubMed, Embase, and Cochrane Central
Register of Controlled Trials. Observational studies reporting outcomes of
percutaneous LAAO for AF thromboembolic stroke prophylaxis in patients
with prior ICH were included. Classic meta-analysis with risk ratios (RR)
for outcomes with control groups and proportions for outcomes without
controls were conducted. <br/>Result(s): A total of 19 observational
studies (13 retrospective and 6 prospective) involving 1671 patients met
the inclusion criteria. The mean CHADS-VASc score was 4.59 +/- 0.46, and
the mean HAS-BLED score was 3.66 +/- 0.56. The mean follow-up duration was
19.1 +/- 10.2 months, with follow-up ranging from 6 months to 3.7 years.
LAAO was successfully implanted in 99.3% of patients. Periprocedural
complications included ICH (0.4%), ischemic stroke (0.3%), pericardial
effusion/cardiac tamponade (1.3%), device embolization (0.5%), and
device-related thrombosis (0.1%). During follow-up, the incidence of ICH
was 1.9%, ischemic stroke/TIA 2.9%, device-related thrombosis 1.4%, and
all-cause mortality 3.3%. Using the CHADS-VASc score, LAAO significantly
reduced ischemic stroke risk (RR = 0.28, 95% CI 0.21-0.39). Similarly,
using the HAS-BLED score, bleeding events were reduced (RR = 0.61, 95% CI
0.44-0.84). <br/>Conclusion(s): LAAO is effective and relatively safe
treatment for reducing ischemic stroke risk in nonvalvular AF patients
with history of ICH.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer Science+Business Media, LLC, part of Springer Nature
2025.

<97>
Accession Number
2041683286
Title
Immune Modulation by Personalized vs Standard Prehabilitation Before Major
Surgery: A Randomized Clinical Trial.
Source
JAMA Surgery. 161(1) (pp 20-30), 2026. Date of Publication: 14 Jan 2026.
Author
Cambriel A.; Tsai A.; Choisy B.; Sabayev M.; Hedou J.; Shelton E.; Singh
K.; Amar J.; Badea V.; Bruckman S.; Ganio E.; Einhaus J.; Feyaerts D.;
Stelzer I.; Sato M.; Langeron O.; Bonham T.A.; Gaudilliere D.; Shelton A.;
Kin C.; Gaudilliere B.; Verdonk F.
Institution
(Cambriel, Tsai, Choisy, Sabayev, Hedou, Amar, Badea, Bruckman, Ganio,
Einhaus, Feyaerts, Stelzer, Sato, Bonham, Gaudilliere, Verdonk) Department
of Anesthesiology, Perioperative and Pain Medicine, Stanford University
School of Medicine, Stanford University, Stanford, CA, United States
(Cambriel, Verdonk) Department of Anesthesiology and Critical Care, DMU
DREAM, APHP, Hopital Saint Antoine, AP-HP, Paris, France
(Cambriel, Hedou, Verdonk) Centre de Recherche Saint-Antoine (CRSA),
Sorbonne Universite, UMRS_938, Inserm, Paris, France
(Tsai, Shelton, Singh, Gaudilliere, Shelton, Kin) Department of Surgery,
Stanford University School of Medicine, Stanford, CA, United States
(Choisy, Hedou) SurgeCare, SAS, Paris, France
(Sabayev) Institute of Computational and Mathematical Engineering,
Stanford University, Stanford, CA, United States
(Einhaus) Department of Pathology and Neuropathology, Comprehensive Cancer
Center Tubingen, University Hospital, Tubingen, Germany
(Stelzer) Department of Pathology, University of California, San Diego,La
Jolla, United States
(Langeron) Department of Anesthesiology and Critical Care, CHU Brest,
Brest, France
Publisher
American Medical Association
Abstract
Importance Prehabilitation programs are increasingly recognized for their
potential to improve surgical outcomes. However, their efficacy remains
debated, largely due to a lack of pathophysiologically driven
implementation and limited personalization. Objective To determine the
impact of personalized vs standard prehabilitation on preoperative
physical, cognitive, and immune function and postoperative outcomes.
Design, Setting, and Participants In this prospective, single-blinded,
randomized interventional trial conducted from June 2020 to September 2022
in a single academic medical center, 58 patients undergoing major elective
surgery were randomized to standard (n = 30) or personalized
prehabilitation (n = 28) using block randomization. Those with
contraindication to exercise, an American Society of Anesthesiologists
score 4 or higher, in palliative care, less than 14 days between screening
and surgery were excluded. Data were analyzed from April 2023 to May 2025.
Intervention The personalized group received 2 weekly one-on-one remote
coaching sessions tailored to individual progress in 4 domains (physical
activity, nutrition, cognitive training, and mindfulness), whereas the
standard group followed a paper-based program, including the same domains,
without individualized support. Main Outcomes and Measures Primary
clinical outcomes included cognitive assessments and physical performance
measures, including the wall squat test, timed-up-and-go test, and
6-minute walk test (6MWT). The primary immunological outcomes included
major innate and adaptive immune cell frequencies and intracellular
signaling responses measured using a 47-plex mass cytometry immunoassay.
Results Of 58 patients (median [IQR] age, 57 [45-67] years; 31 [57%]
female) enrolled, 54 completed the study (n = 27 per group). The
personalized group exhibited significant improvements in physical measures
(eg, median [IQR] 6MWT: 496 [340-619] minutes before prehab versus 546
[350-728] minutes after; P =.03) and fewer moderate-to-severe
postoperative complications (4 vs 11 Clavien-Dindo grade >1; P =.04).
Multivariable modeling identified profound and cell-type specific immune
alterations postprehabilitation compared to baseline (area under the
receiver operating characteristic curve [AUROC], 0.88; 0.79-0.97; P <.001;
leave-one-out cross-validation), including dampened phosphorylated protein
kinase R-like endoplasmic reticulum kinase 1/2 signaling in classical
monocytes and myeloid-derived suppressor cells after interleukin 2, 4, and
6 stimulation, and reduced phosphorylated cyclic adenosine monophosphate
response-element binding protein signaling in Th1 cells. In contrast, the
standard group showed only moderate clinical improvements and no immune
changes (AUROC = 0.63; 95% CI, 0.48-0.78; P =.12). Conclusions and
Relevance In this study, personalized prehabilitation significantly
altered the immunome before surgery, dampening inflammatory signaling
responses previously implicated in the pathophysiology of key surgical
outcomes, including surgical site infections and postoperative
neurocognitive decline. These changes were accompanied by improved
physical and cognitive function before surgery and decreased postoperative
complications. These findings support the use of personalized
prehabilitation and provide an avenue for biologically driven monitoring
of prehabilitation efficacy, and individual tailoring of programs to
optimize surgical readiness and recovery. Trial Registration
ClinicalTrials.gov Identifier: NCT04498208<br/>Copyright &#xa9; 2026
Cambriel A et al.

<98>
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

<99>
Accession Number
2040996758
Title
Respiratory Reactivation of Herpes Simplex Virus-1 Following Cardiac
Surgery in Immunocompetent Individuals.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(3) (pp 994-1002),
2026. Date of Publication: 01 Mar 2026.
Author
Asiller O.O.; Fresilli S.; Damiani D.; Della Peruta M.; Prati P.;
Franceschini G.; Farinaccio A.; Moresco M.; Ajello V.
Institution
(Asiller) Department of Anesthesia and Intensive Care, Ankara University
Faculty of Medicine, Ankara, Turkey
(Fresilli, Damiani, Della Peruta) Department of Anesthesia and Intensive
Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Prati, Franceschini, Farinaccio, Moresco, Ajello) Department of
Cardiothoracic Anesthesia, Tor Vergata University Hospital, Rome, Italy
Publisher
W.B. Saunders
Abstract
Objective: Herpes simplex virus type 1 reactivation is common in
immunocompromised patients. Its frequency and clinical significance as a
cause of pneumonia in immunocompetent patients, particularly following
cardiac surgery, remain poorly defined. This review synthesizes all the
evidence on the frequency, pathophysiology, and clinical impact of herpes
simplex virus reactivation in immunocompetent patients following cardiac
surgery. <br/>Design(s): Systematic review. <br/>Setting(s): Studies
conducted in cardiac surgery. <br/>Participant(s): Immunocompetent adults
with suspected or confirmed herpes simplex virus pneumonia after cardiac
surgery. <br/>Measurements and Main Results: Medical databases were
searched from inception to June 4, 2025. Studies reporting immunocompetent
adults with suspected and/or confirmed herpes simplex virus pneumonia
post-cardiac surgery were included. Twenty studies (published in the
period 1983-2025), including 112 patients with pneumonia and herpes
simplex virus reactivation after cardiac surgery, were identified.
Bronchoalveolar lavage was used as a diagnostic tool in 79% of cases. The
use of antiviral treatment (predominantly acyclovir) was reported in 42 of
78 patients (53%). All-cause mortality was 14 of 30 patients (46%).
<br/>Conclusion(s): Herpes simplex virus reactivation after cardiac
surgery is not frequently reported, but mortality approaches 50%. This
underscores the need for heightened awareness and targeted testing in
nonresponding pneumonias, potentially improving outcomes. Even if patients
often die with the herpes simplex virus reactivation complicating other
severe conditions, the frequency with which herpes simplex virus
reactivation itself is the primary cause of death remains uncertain.
Diagnosis relied mainly on polymerase chain reaction, and early antiviral
treatment was frequently administered. Increased clinical awareness and
further research are warranted to standardize diagnosis and optimize
management.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<100>
Accession Number
2042947683
Title
Comparative Effectiveness of Single-Dose Epidural Esketamine versus
Hydromorphone in Thoracic and Upper Abdominal Surgery: A Randomized Trial.
Source
Drug Design, Development and Therapy. 20 (pp 1-10), 2026. Date of
Publication: 2026.
Author
Song Y.; Wang C.; Huang N.; He H.; Hong W.; Wu J.; Yao M.; Miao C.; Liang
C.
Institution
(Song, Wang, Huang, He, Hong, Wu, Yao, Miao, Liang) Department of
Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: This study aimed to evaluate the effectiveness of a single
epidural dose of esketamine versus hydromorphone in patients undergoing
abdominal and thoracic surgeries. <br/>Patients and Methods: Patients
undergoing elective abdominal and thoracic surgery were randomly assigned
to receive either a single epidural injection of 15 mg esketamine (Group
E) or 0.5 mg hydromorphone (Group H) at the end of surgery. All patients
received intravenous patient-controlled analgesia postoperatively. The
primary outcome was hydromorphone consumption within 48 hours after
surgery. Secondary outcomes included time to first rescue analgesia,
hydromorphone consumption within 0-24, 24-48, and 48-72 hours, numerical
rating scale (NRS) pain scores, postoperative recovery scores, and
complications. <br/>Result(s): In total, 205 patients were enrolled, with
186 randomly assigned to either group E (n = 93) or group H (n = 93).
Hydromorphone consumption within 48 hours postoperatively was
significantly higher in group E than in group H. The time to first rescue
analgesia was significantly longer in group H compared to group E. Within
the first 24 hours postoperatively, patients in group E required more
hydromorphone than those in group H. No significant difference in
hydromorphone consumption between the two groups at 24-48 and 48-72 hours
postoperatively. The NRS scores during movement were significantly higher
in group E than in group H at 3 and 6 hours postoperatively.
<br/>Conclusion(s): Single-dose epidural esketamine for postoperative
analgesia resulted in higher hydromorphone consumption and a shorter time
to first rescue analgesia compared to hydromorphone.<br/>Copyright &#xa9;
2026 Song et al.

<101>
Accession Number
2041566940
Title
Impact of Concomitant Mitral Regurgitation on Cardiovascular Events and
Mortality After Transcatheter Aortic Valve Replacement: A Meta-Analysis.
Source
Catheterization and Cardiovascular Interventions. 107(2) (pp 577-592),
2026. Date of Publication: 01 Feb 2026.
Author
Darouei B.; Shafie D.; Amani-Beni R.; Elyasi Bakhtiari P.; Etemadi M.H.;
Bagherikaram S.; Eshraghi R.; Bahrami A.; Amini-Salehi E.; Hashemi S.M.;
Emami Meybodi M.; Movahed M.R.
Institution
(Darouei, Amani-Beni) Isfahan Cardiovascular Research Center,
Cardiovascular Research Institute, Isfahan University of Medical Sciences,
Isfahan, Iran, Islamic Republic of
(Shafie) Heart Failure Research Center, Cardiovascular Research Institute,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Elyasi Bakhtiari, Etemadi, Bagherikaram) Student Research Committee,
Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Health Research Center, Isfahan
University of Medical Sciences, Isfahan, Iran, Islamic Republic of
(Bahrami) Student Research Committee, Kashan University of Medical
Sciences, Kashan, Iran, Islamic Republic of
(Amini-Salehi) Guilan University of Medical Sciences, Rasht, Iran, Islamic
Republic of
(Hashemi) Cardiovascular Research Center, Hormozgan University of Medical
Sciences, Bandar Abbas, Iran, Islamic Republic of
(Emami Meybodi) Yazd Cardiovascular Research Center, Non-Communicable
Diseases Research Institute, Shahid Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
(Movahed) Department of Medicine, University of Arizona College of
Medicine, Tucson, AZ, United States
(Movahed) Department of Medicine, University of Arizona Sarver Heart
Center, Tucson, AZ, United States
Publisher
John Wiley and Sons Inc
Abstract
Mitral regurgitation (MR) is common in patients undergoing transcatheter
aortic valve replacement (TAVR). However, it is unclear how MR severity
affects prognosis. This meta-analysis evaluated the associations among
baseline MR severity, cardiovascular outcomes, and mortality after TAVR.
Eligible studies included adult patients undergoing TAVR with stratified
MR severity (MR >= 2 or MR >= 3) and reported the post-TAVR clinical
outcomes. Sensitivity analyses stratified by follow-up duration,
leave-one-out sensitivity, and meta-regression were also conducted.
Forty-two studies (n = 67,257 patients) were included. MR >= 2 was
associated with increased all-cause mortality during follow-up (> 30 days)
(hazard ratio [HR]: 1.40; 95% confidence interval [CI]: 1.26, 1.55) and
cardiovascular mortality (risk ratio [RR]: 1.80; 95% CI: 1.05, 3.08), but
not with stroke, transient ischemic attack, myocardial infarction (MI), or
heart failure hospitalization. MR >= 3 conferred an even higher risk of
all-cause mortality during follow-up (RR: 1.55; 95% CI: 1.24, 1.94) and
rehospitalization (RR: 1.40; 95% CI: 1.17, 1.67), but not for stroke and
MI. MR improvement occurred in 41% of patients within < 1-year post-TAVR,
declined to 15% at > 1-year post-TAVR. Baseline moderate-to-severe MR (MR
>= 2) predicts all-cause mortality during follow-up and cardiovascular
mortality after TAVR, particularly severe MR (MR >= 3). While no
consistent associations were found with nonfatal outcomes such as stroke,
TIA, MI, or heart failure hospitalization, the prognostic impact of MR
appears to be predominantly mortality-centered.<br/>Copyright &#xa9; 2025
Wiley Periodicals LLC.

<102>
[Use Link to view the full text]
Accession Number
2043150721
Title
Peri-Interventional Anesthesia Strategies for Transcatheter Aortic Valve
Implantation: A Multicenter, Randomized, Controlled, Noninferiority Trial.
Source
Circulation. 152(22) (pp 1526-1537), 2025. Date of Publication: 02 Dec
2025.
Author
Feistritzer H.-J.; Ender J.; Lauten P.; Rudolph T.K.; Rudolph V.; Geisler
T.; Massberg S.; Adam M.; Baldus S.; Sossalla S.; Joner M.; Mollmann H.;
Wolf A.; Kim W.-K.; Borger M.A.; Noack T.; Magunia H.; von Dossow V.;
Sander M.; Vigelius-Rauch U.; Feuerecker M.; Zakhary W.; Boening A.;
Bleiziffer S.; Hohenstein S.; Hoesler N.; Buske M.; Desch S.; Abdel-Wahab
M.; Thiele H.
Institution
(Feistritzer, Ender, Borger, Noack, Zakhary, Hoesler, Buske, Desch,
Abdel-Wahab, Thiele) Heart Center Leipzig at Leipzig University, Leipzig,
Germany
(Lauten, Baldus) Zentralklinik Bad Berka, Bad Berka, Germany
(Rudolph, Rudolph, Baldus, von Dossow) Heart and Diabetes Center NRW, Bad
Oeynhausen, Germany
(Geisler, Mollmann) University Hospital Tubingen, Tubingen, Germany
(Massberg, Feuerecker) Department of Medicine I, Ludwig Maximilian
University Munich, Munich, Germany
(Adam, Bleiziffer) Heart Center, University of Cologne, Cologne, Germany
(Sossalla, Kim, Sander, Vigelius-Rauch, Boening) University Hospital
Giessen, Giessen, Germany
(Joner) Department of Cardiology, German Heart Center Munich, Technical
University of Munich, Munich, Germany
(Magunia) Department of Cardiology, St.-Johannes Hospital Dortmund,
Dortmund, Germany
(Wolf) Heart Center Wuppertal, Witten-Herdecke University, Wuppertal,
Germany
(Hohenstein) Helios Health Institute, Leipzig, Germany
(Thiele) Leipzig Heart Science, Leipzig, Germany
Publisher
Lippincott Williams and Wilkins
Abstract
BACKGROUND: - Minimalist treatment strategies for transcatheter aortic
valve implantation have been widely adopted because of continued
procedural evolution, but large randomized trials are lacking. The
DOUBLE-CHOICE trial (Randomized Study Comparing Both Latest Generation
Self-Expanding Valves and a Minimalist Approach Versus Standard of Care in
Transcatheter Aortic Valve Implantation) evaluated the safety and efficacy
of a minimalist approach (MA) compared with the standard of care (SoC) for
transfemoral transcatheter aortic valve implantation. <br/>METHOD(S): - In
this investigator-initiated, 2x2 factorial, open-label, randomized,
multicenter, noninferiority trial, patients with symptomatic aortic
stenosis were included at 10 German sites. Patients were randomly assigned
to the MA, including isolated local anesthesia, versus the SoC using
conscious sedation. The primary end point was a composite of all-cause
mortality, vascular and bleeding complications, infection requiring
antibiotic therapy, and neurological events at 30 days. The noninferiority
of the MA compared with the SoC was tested in the intention-to-treat
population with an absolute noninferiority margin of -6% at an alpha level
of 0.05. <br/>RESULT(S): - Between July 11, 2022, and January 14, 2025,
752 patients were randomly assigned to the MA (n=377) and SoC (n=375). The
median age was 83 (interquartile range, 79-86) years, 439 (58.5%) patients
were women, and the median Society of Thoracic Surgeons risk score was
4.6% (interquartile range, 2.9-8.0). The primary end point occurred in 80
(22.9%) of 350 patients in the MA group and in 91 (25.8%) of 353 patients
in the SoC group (rate difference, 2.9%; lower boundary of the 1-sided 95%
CI, -2.4%; P for noninferiority=0.003; 2-sided 95% CI, -3.4 to 9.3; P for
difference=0.37). Patient-reported anxiety and stress levels during the
procedure were higher in the MA group. <br/>CONCLUSION(S): - The MA
including isolated local anesthesia was noninferior to the SoC with
conscious sedation, highlighting the safety and efficacy of the MA for
transcatheter aortic valve implantation. The burden of intraprocedural
pain and discomfort is potentially higher in the MA group. REGISTRATION: -
URL: https://www.clinicaltrials.gov; Unique identifier:
NCT05036018.<br/>Copyright &#xa9; 2025 American Heart Association, Inc.

<103>
Accession Number
2037038794
Title
A comparative cost analysis study of pulmonary robotic and video-assisted
lobectomy: results of a randomized controlled trial (BRAVO Study).
Source
Revista do Colegio Brasileiro de Cirurgioes. 52 (no pagination), 2025.
Article Number: e20253553. Date of Publication: 2025.
Author
Terra R.M.; Trindade J.R.M.; de Araujo P.H.X.N.; Lauricella L.L.; Zaidan
E.P.; Fernandes P.M.P.
Institution
(Terra, Trindade, de Araujo, Lauricella, Zaidan) Universidade de Sao
Paulo, Instituto do Cancer do Estado de Sao Paulo, Departamento de
Cirurgia Toracica, SP, Sao Paulo, Brazil
(Fernandes) Universidade de Sao Paulo Instituto do Coracao, Departamento
de Cirurgia Toracica, SP, Sao Paulo, Brazil
Publisher
Colegio Brasileiro de Cirurgioes
Abstract
Introduction: Robotic thoracic surgery has potential benefits, but the
cost is still considered a limiting factor for its wide dissemination in
most countries. <br/>Method(s): We compared the costs of robotic-assisted
(RATS) and video-assisted thoracic surgery (VATS) in the treatment of lung
cancer or pulmonary metastasis. Cost analysis was based on micro-costing
and individual cost analysis during surgical admission and frequency of
services (emergency service, clinic visits, imaging exams, chemotherapy
and radiotherapy, reoperation or additional procedures, rehospitalization,
and ICU stay) during postoperative 90-day follow-up. <br/>Result(s): A
total of 76 patients were included in this cost analysis (RATS=37,
VATS=39). Groups were equivalent in terms of age, gender, comorbidities,
and pre-operative status. Total costs of pulmonary lobectomy did not
differ between the RATS and VATS groups when considering cost of surgical
hospitalization and follow-up of up to 90 days. Mean individual cost per
patient in the RATS group was R$35,590.41 (+/-12,514.97) and R$41,066.98
(+/-25,891.04) in the VATS group, p=0.564. <br/>Conclusion(s): Robotic and
video-assisted thoracic surgery had similar costs, but longer follow-up
studies could be important to demonstrate RATS and VATS costs
differences.<br/>Copyright &#xa9; 2025, Colegio Brasileiro de Cirurgioes.
All rights reserved.

<104>
Accession Number
2041770098
Title
Evaluating Surgical Approaches in Early NSCLC: A Meta-Analysis of
Robot-Assisted and Video-Assisted Techniques.
Source
Annals of Surgical Oncology. 33(3) (pp 2123-2136), 2026. Date of
Publication: 01 Mar 2026.
Author
Khan W.; Ali T.; Bilal M.; Ahmad W.; Ali S.A.; Hashim A.; Khan A.Z.; Kumar
A.; Abdullah M.; Khan S.; Ahmed A.; Jawad M.
Institution
(Khan, Abdullah, Jawad) Dow Medical College, Dow University of Health
Sciences, Karachi, Pakistan
(Ali) Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi,
Pakistan
(Bilal) Peshawar Medical College, Peshawar, Pakistan
(Ahmad) King Edward Medical University, Lahore, Pakistan
(Ali) Bahria Medical College, Karachi, Pakistan
(Hashim, Khan) Al-Aleem Medical College, Lahore, Pakistan
(Kumar, Ahmed) Ziauddin Medical College, Ziauddin University, Karachi,
Pakistan
(Khan) Nishtar Medical College, Multan, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Lung cancer, especially non-small cell lung cancer (NSCLC), is
a leading cause of cancer death. Surgical resection is the primary
treatment for early-stage NSCLC. Video-assisted thoracoscopic surgery
(VATS) and robot-assisted thoracic surgery (RATS) are minimally invasive
options, with RATS offering better precision at higher costs. This
meta-analysis compared the perioperative outcomes of both techniques in
NSCLC. <br/>Method(s): A systematic search in PubMed, Web of Science, NLM,
CNKI, and Wanfang was conducted for RCTs published between 31 July 2021
and 31 December 2024. Primary outcomes included operation time, blood
loss, lymph node dissection, conversion to thoracotomy, chest drainage
time, and hospital stay. Statistical analyses were performed using RevMan
5.3, with heterogeneity assessed using the I² statistic. A p
value lower than 0.05 was considered significant. <br/>Result(s): Three
RCTs were analyzed. Blood loss showed no significant difference between
VATs and RATs (mean difference [MD], -33.00; 95% CI, -85.51 to 22.89; p =
0.07). Conversion to thoracotomy was comparable (MD, 0.69; 95% CI, 0.37 to
1.28; p = 0.24). Hospital stay did not differ significantly (MD, 0.13; 95%
CI, -0.58 to 0.84; p = 0.74). Operation time remained similar (MD, -4.63;
95% CI, -10.93 to 1.67; p = 0.15). The VATS procedure enabled
significantly greater lymph node dissection (MD, 1.83; 95% CI, 0.16 to
3.49; p = 0.03). Chest drainage duration showed no difference (MD, 0.00;
95% CI, -0.27 to 0.27; p = 1.00). <br/>Conclusion(s): In NSCLC, RATS and
VATS yield comparable outcomes, with RATS potentially reducing blood loss
and VATS allowing more lymph node dissection. Further high-quality RCTs
are needed to clarify the optimal approach for NSCLC.<br/>Copyright &#xa9;
Society of Surgical Oncology 2025.

<105>
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

<106>
Accession Number
2043103591
Title
Anatomical Variations of the Lung Lobes and Fissures: A Systematic Review
and Meta-Analysis.
Source
Clinical Anatomy. (no pagination), 2026. Date of Publication: 2026.
Author
Abdu S.M.; Ali S.Y.; Assefa E.M.; Muhaba E.S.
Institution
(Abdu, Assefa, Muhaba) School of Biomedical Sciences, College of Medicine
and Health Sciences, Wollo University, Dessie, Ethiopia
(Ali) School of Medicine, Institute of Health, Jigjiga University, Jijiga,
Ethiopia
Publisher
John Wiley and Sons Inc
Abstract
The lungs' fissural and lobar variations are clinically and anatomically
important, with direct implications for anatomists, radiologists, and
thoracic surgeons. Although standard anatomical textbooks commonly
describe fissures as complete, numerous studies have reported substantial
variability, including incomplete, absent, and accessory fissures. These
variations may complicate surgical procedures, affect disease spread, and
lead to misinterpretation of imaging findings. Therefore, quantifying the
prevalence of fissural and lobar variations is essential for accurate
clinical planning, reliable radiologic interpretation, and effective
anatomical education. A systematic search was conducted across PubMed,
Hinari, Crossref, and Google Scholar, as well as relevant anatomical
journals, in accordance with Evidence-Based Anatomy Workgroup
recommendations and reported following PRISMA 2020 guidelines. Eligible
anatomical studies were included, and study quality was assessed using a
standardized appraisal tool. Meta-analysis was performed using MetaXL with
a random-effects model to estimate the pooled prevalence and distribution
of lung variations. Among all evaluated lungs, anatomical variations were
observed in 42%, with 63% occurring on the right side. When assessed
independently, variations were present in 55% of right lungs and 33% of
left lungs. The right horizontal fissure was complete in 54%, incomplete
in 35%, and absent in 11%, while the right oblique fissure was complete in
77%. The left oblique fissure was complete in 72%, incomplete in 26%, and
absent in 2%. Accessory fissures were present in 14% of both right and
left lungs, most commonly the inferior accessory fissure on the right (6%)
and the left minor fissure on the left (8%). Lung fissural and lobar
variations occur in nearly half of individuals, with distinct right- and
left-sided patterns and variable completeness. Awareness of these
variations is essential for accurate anatomical understanding, surgical
planning, radiological interpretation, and minimizing complications in
thoracic procedures.<br/>Copyright &#xa9; 2026 American Association of
Clinical Anatomists and British Association of Clinical Anatomists.

<107>
Accession Number
2041445932
Title
Effect of Dexmedetomidine on Endothelial Glycocalyx in Patients Undergoing
Cardiac Surgery with Cardiopulmonary Bypass.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(3) (pp 805-813),
2026. Date of Publication: 01 Mar 2026.
Author
Fan Y.; Chen B.; Fang F.; Gao W.; Wu Q.; Wang W.; He G.
Institution
(Fan) Department of Anesthesiology, Women's Hospital School of Medicine
Zhejiang University, Zhejiang Province, Hangzhou, China
(Chen) Department of Anesthesiology, Taizhou Hospital of Zhejiang Province
affiliated to Wenzhou Medical University, Zhejiang, Linhai, China
(Fang) Department of Anaesthesiology, The First Affiliated Hospital,
Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China
(Gao, Wu, Wang, He) Department of Anesthesiology, The First Affiliated
Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou, China
Publisher
W.B. Saunders
Abstract
Objective: To evaluate the protective role of dexmedetomidine on
endothelial glycocalyx in cardiac surgery patients undergoing
cardiopulmonary bypass (CPB). <br/>Design(s): Randomized controlled trial.
<br/>Setting(s): Single-center study conducted from June 2022 to December
2022. <br/>Participant(s): Fifty-eight patients who underwent elective
valvular cardiac surgery with CPB. <br/>Intervention(s): Patients were
randomly assigned to either the dexmedetomidine group (n = 29) or the
saline group (n = 29), with infusion starting 10 minutes before anesthesia
induction and continuing throughout the maintenance phase.
<br/>Measurements and Main Results: Radial artery blood samples were
collected at 4 time points: T1, before anesthesia induction; T2, 5 minutes
after aortic unclamping; T3, 1 hour postoperatively; and T4, 24 hours
postoperatively. The primary endpoint was plasma syndecan-1 concentration,
and secondary endpoints were heparin sulfate and tumor necrosis
factor-alpha (TNF-alpha) levels, and long-term clinical outcomes. Compared
with controls, the dexmedetomidine group showed significantly less
glycocalyx shedding, an effect that persisted throughout CPB and recovery.
TNF-alpha levels were significantly lower at T2-T3, along with reduced
lactate levels on aortic unclamping. <br/>Conclusion(s): Dexmedetomidine
preserves endothelial glycocalyx integrity and attenuates systemic
inflammation in CPB patients.<br/>Copyright &#xa9; 2025 Elsevier Inc.

<108>
Accession Number
2037635783
Title
Perioperative Management of An Elderly with Coronary Artery Disease and
Aortic Stenosis Undergoing Emergency ORIF for Intertrochanteric Fracture.
Report of A Rare Case and Systematic Mini Review.
Source
International Journal of Health Sciences and Research. 16(1) (pp 227-242),
2026. Date of Publication: 01 Jan 2026.
Author
Datt V.; Dhingra S.; Datt D.; Khatri S.; Yadav S.; Sharma S.; Dahiya P.;
Kaushik P.; Singla R.; Yadav B.; Goel K.S.
Institution
(Datt, Dhingra, Khatri, Yadav, Dahiya, Kaushik, Singla, Yadav) Department
of Anaesthesiology and Intensive Care, India
(Sharma) Department of Orthopaedics, India
(Datt) Department of PSM, India
(Goel) Department of Surgery, SGT Medical College and University, Budhera,
Haryana, Gurugram, India
Publisher
Galore Knowledge Publication Pvt. Ltd.
Abstract
Aortic valve stenosis (AS) is the most common form of valvular heart
disease in the elderly population and often associated with significant
coronary artery disease (CAD), as both conditions have common risk
factors. Patients with untreated severe AS with concomitant coronary CAD
requiring a noncardiac surgery (NCS) is associated with worse prognosis
and higher risk for major adverse cardiovascular events (MACE). Patients
with symptomatic severe AS and significant CAD (>70% stenosis of any major
epicardial coronary vessel or >50% stenosis of the left main coronary
artery) have a higher risk profile because of a greater number of
cardiovascular risk factors and comorbidities, which can complicate their
management. Furthermore, such patients are at increased risk of
perioperative MI during cardiac and non-cardiac surgery. Recent guidelines
suggest surgical aortic valve replacement (AVR) or balloon aortic
valvotomy (BAV) or transcatheter aortic valve implantation (TAVI) for
severe AS and percutaneous coronary artery intervention (PCI) or coronary
artery bypass grafting (CABG)for the significant CAD before noncardiac
surgery for better outcome. However, mild to moderate asymptomatic AS
might proceed with NCS, but strict hemodynamic monitoring is recommended.
The unoperated patients of severe AS with CAD requiring NCS should be
managed by multidisciplinary approach and focus is to avoid the
hypotension/hypertension, tachycardia to prevent the MI, MACE and
mortality. The sinus rhythm and mean arterial pressure (>65 mmHg) should
be maintained with the use careful anaesthetic management and using
beta-blockers and phenylephrine or norepinephrine or vasopressin.
Untreated patients of AS with concomitant CAD requiring emergency lower
limb surgery can be managed safely under spinal anaesthesia with the
collaboration of multidisciplinary approach including cardiac
anaesthetist, cardiologist and surgeon. The aggressive hemodynamic
monitoring such as ECG, CVP/PAC, arterial catheter, and TEE and arterial
blood gas analysis in selected patients is most crucial for early
detections of hemodynamic deterioration, and their appropriate management
with fluid and vasoactive agents administration, and use of beta-blockers
or calcium channel blockers to control the tachycardia or even use of
mechanical circulatory support such as intra-aortic balloon counter
pulsations (IABP). We describe a successful perioperative management of a
challenging case of a 75 yrs-female, weighing 80Kg, a known post-PTCA
coronary artery disease with symptomatic severe aortic stenosis, who
developed left intertrochanteric fracture and required open reduction and
internal fixation (ORIF) with plating. The emergency surgery was performed
under spinal anaesthesia with heavy bupivacaine (0.5%),2 ml with fentanyl
(25 mcg) used in L4-5 space after obtaining an informed consent from the
relatives along with permission for the publication. A review of
literature on the CAD with severe symptomatic aortic stenosis requiring
emergency non-cardiac surgery will be discussed.<br/>Copyright &#xa9;
2026, Galore Knowledge Publication Pvt. Ltd.. All rights reserved.

<109>
Accession Number
2038319898
Title
Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic
Bleeding in Cardiac Surgery: The FARES-II Multicenter Randomized Clinical
Trial.
Source
JAMA. 333(20) (pp 1781-1792), 2025. Date of Publication: 27 May 2025.
Author
Karkouti K.; Callum J.L.; Bartoszko J.; Tanaka K.A.; Knaub S.; Brar S.;
Ghadimi K.; Rochon A.; Mullane D.; Couture E.J.; Lin Y.; Harle C.; Zeller
M.; Tran D.T.T.; Solomon C.; Rao V.; Law M.; Butt A.L.; Chen E.P.; Martins
M.R.; Saha T.; Shih A.W.; Vezina M.-C.; Moussa F.; Pereira Cezar Zamper
R.; Syed S.; Buyukdere H.; Werner S.; Grewal D.; Wong D.; Vandyck K.B.;
Tanzola R.; Hughes B.; Royer O.; Wong S.; Levy J.H.; Tran D.; Tanaka K.;
Lewis R.J.; Sellke F.; Cushing M.; Jones M.; Kowalski J.; Amaral J.;
Asmail S.; Thilagaratnam S.; Suthar P.; Azenabor M.; Cyr J.; Kucheryava
O.; Pascaru S.; Peer M.; Abrahamyan L.; Achen B.; Coley M.; Demers P.;
Devine D.; Flexman A.; Grocott H.; Lamarche Y.; de Souza C.M.; Payne D.;
Peterson M.; Scales D.; Sun T.; Tinmouth A.; Tomlinson G.; McCluskey S.;
Lieberman L.; Carroll J.; Firouzian S.; Liyanage N.; Poonawala H.; Selby
S.; Kabir R.; Oliver S.; Escorcia A.; Medic S.; Wong M.; Yan M.; Mozel M.;
Kaur R.; Randall R.; Bizovie K.; Buchko S.; Khakh S.; Gonzales R.A.;
Sutherland K.; Van Roekel J.; Babul A.; Lertnamvongwan R.; Monteiro L.;
Johnson P.; Okada H.; DuMerton D.; Tod R.; Smethurst B.; Jain S.; Scholey
A.; Sirosky-Yanyk A.; Stevens A.; Haider W.; Cisneros-Aguilera E.;
Belanger G.; Hutspardol S.; Lim S.; Mi J.; Kalar D.; Eang M.;
Lorenzana-Saldivar E.; Gupta A.; Jerath A.; Lau P.; D'Empaire P.P.; Armali
C.; Kaustov L.; Malkin A.; Colavecchia C.; Meirovich H.; Yang J.; Bergeron
A.; Laforge F.; Paradis K.; Gagne N.; Soleil M.; Dumont E.; Charest M.-E.;
Quantz M.; Mayer R.; Kinney J.; Fochesato L.-A.; Bai Y.; Jaffar I.;
Alhomsi N.; Guevarra J.; Jamula E.; Hsu W.C.; Drew A.; Rubens F.; Patel
D.; Tokessy M.; Watt E.; Arabi H.; Luciano K.; Pavenski K.; Moorehead A.;
Bisleri G.; Mazer D.; Kasimova K.
Institution
(Karkouti, Bartoszko, Grewal) Department of Anesthesia and Pain
Management, University Health Network, Sinai Health, Women's College
Hospital, University of Toronto, Toronto, ON, Canada
(Karkouti, Bartoszko, Rao, Grewal) Peter Munk Cardiac Centre, Toronto
General Hospital Research Institute, University Health Network, Toronto,
ON, Canada
(Karkouti, Bartoszko, Wong) Department of Anesthesiology and Pain
Medicine, University of Toronto, Toronto, ON, Canada
(Callum) Department of Pathology and Molecular Medicine, Kingston Health
Sciences Centre, Queen's University, Kingston, ON, Canada
(Callum) Sunnybrook Research Institute, Toronto, ON, Canada
(Tanaka, Butt, Vandyck) Department of Anesthesiology, University of
Oklahoma Health Sciences Center, Oklahoma City, United States
(Knaub, Solomon) Octapharma AG, Lachen, Switzerland
(Brar, Law) Department of Anesthesiology and Perioperative Medicine, Royal
Columbian Hospital, Vancouver, BC, Canada
(Brar, Law) University of British Columbia, Vancouver, Canada
(Ghadimi) Clinical Research Unit, Department of Anesthesiology & Critical
Care, Duke University Health System, Durham, NC, United States
(Rochon, Martins) Department of Anesthesia, University of Montreal,
Montreal Heart Institute, Montreal, QC, Canada
(Mullane, Hughes) Department of Anesthesiology, Pharmacology &
Therapeutics, University of British Columbia, Canada
(Mullane, Shih, Hughes, Hutspardol, Lim, Mi, Kalar, Eang) Vancouver
General Hospital, Vancouver, BC, Canada
(Couture, Vezina, Royer) Department of Anesthesiology, Quebec Heart and
Lung Institute, Laval University, Quebec, QC, Canada
(Lin) Precision Diagnostics and Therapeutics Program, Sunnybrook Health
Sciences Centre, Toronto, ON, Canada
(Lin) Department of Laboratory Medicine and Pathobiology, University of
Toronto, Toronto, ON, Canada
(Harle, Pereira Cezar Zamper) London Health Sciences Centre, London, ON,
Canada
(Harle) Schulich School of Medicine and Dentistry, Western University,
London, ON, Canada
(Zeller) Micheal G. DeGroote Centre for Transfusion Research, Department
of Medicine, McMaster University, Hamilton, ON, Canada
(Zeller) Canadian Blood Services, Ottawa, ON, Canada
(Tran) Division of Cardiac Anesthesiology and Critical Care, University of
Ottawa Heart Institute, Ottawa, ON, Canada
(Rao, Moussa) Department of Surgery, University of Toronto, Toronto, ON,
Canada
(Chen) Cardiothoracic Surgery Division, Department of Surgery, Duke
University Health System, Durham, NC, United States
(Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine,
Kingston Health Sciences Centre, Queen's University, Kingston, ON, Canada
(Ghadimi, Lorenzana-Saldivar) Duke University Health System, Durham, NC,
United States
(Moussa) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre,
Schulich Heart Centre, Toronto, ON, Canada
(Syed) Department of Anesthesia, McMaster University, Hamilton Health
Sciences Corporation, Hamilton, ON, Canada
(Syed) Department of Anesthesia, Oakville Trafalgar Memorial Hospital,
Oakville, ON, Canada
(Buyukdere) Division of Hematopathology and Transfusion Medicine,
University of Ottawa, Ottawa, ON, Canada
(Werner) Octapharma USA Inc, Paramus, NJ, United States
(Wong) Division of Cardiac Surgery, Royal Columbian Hospital, New
Westminster, BC, Canada
(Wong) Department of Surgery, University of British Columbia, Vancouver,
Canada
(Wong) Department of Anesthesia, Sunnybrook Health Sciences Centre,
Toronto, ON, Canada
(Levy) Department of Anesthesiology, Critical Care, and Surgery, Duke
University School of Medicine, Durham, NC, United States
(Bartoszko) Toronto General Hospital, Toronto, Canada
(Lin, Gupta, Jerath, Lau, D'Empaire, Armali, Kaustov, Malkin, Colavecchia,
Meirovich, Yang) Sunnybrook Health Sciences Centre, Toronto, ON, Canada
(Tran) University of Ottawa Heart Institute, Ottawa, Canada
(Saha, DuMerton, Tod, Smethurst, Jain, Scholey, Sirosky-Yanyk, Stevens)
Kingston Health Sciences Centre, Kingston, ON, Canada
(Johnson, Okada) Oklahoma Health Sciences Center, Oklahoma City, OK,
United States
(Quantz, Mayer, Kinney, Fochesato, Bai) University Hospital, London Health
Sciences Centre, London, ON, Canada
(Zeller) Hamilton General Hospital, Hamilton, Canada
(Brar) Royal Columbian Hospital, New Westminster, Canada
(Couture) Institut Universitaire de Cardiologie, Pneumologie de
Quebec-Universite Laval, QC, Canada
(Rochon, Haider, Cisneros-Aguilera, Bergeron, Belanger) Montreal Heart
Institute, Montreal, QC, Canada
(Tanaka) University of Oklahoma Health Sciences Center, Oklahoma City,
United States
(Lewis) Berry Consultants, LLC, Department of Emergency Medicine,
Harbor-UCLA Medical Center, Austin, TX, United States
(Sellke) Rhode Island Hospital and Brown Medical School, Providence, RI,
United States
(Cushing) Clinical Pathology and Laboratory Medicine, Weill Cornell
Medicine, New York City, NY, United States
(Jones, Kowalski) Ergomed GmbH Guildford, Surrey, United Kingdom
(Pavenski, Moorehead, Bisleri, Mazer, Kasimova) St. Michael's Hospital
(Unity Health Toronto), Toronto, ON, Canada
(Amaral, Asmail, Thilagaratnam, Suthar, Azenabor, Cyr, Kucheryava,
Pascaru) Ozmosis Research Inc., Toronto, ON, Canada
(Wong, Yan, Mozel, Kaur, Randall, Bizovie, Buchko, Khakh, Gonzales,
Sutherland, Van Roekel, Babul, Lertnamvongwan, Monteiro) Royal Columbian
Hospital, Fraser Health Authority, New Westminster, BC, Canada
(McCluskey, Lieberman, Carroll, Firouzian, Liyanage, Poonawala, Selby,
Kabir, Oliver, Escorcia, Medic) Toronto General Hospital, University
Health Network, Toronto, ON, Canada
(Rubens, Patel, Tokessy, Watt, Arabi, Luciano) Ottawa Heart Research
Institute, University of Ottawa, Ottawa, ON, Canada
(Jaffar, Alhomsi, Guevarra, Jamula, Hsu, Drew) McMaster University
(Hamilton Health Sciences), Hamilton, ON, Canada
(Bergeron, Laforge, Paradis, Gagne, Soleil, Dumont, Charest) Institut
Universitaire de Cardiologie et de Pneumologie de Quebec, Universite
Laval, Quebec City, QC, Canada
Publisher
American Medical Association
Abstract
Importance: Excessive bleeding is a common and prognostically important
complication of cardiac surgery. For bleeding related to coagulation
factor deficiency, frozen plasma is the most used therapy. Preliminary
trials indicate that 4-factor prothrombin complex concentrate (PCC) may be
a suitable alternative. <br/>Objective(s): To compare the efficacy and
safety of PCC with frozen plasma in patients undergoing cardiac surgery
with coagulopathic bleeding. <br/>Design, Setting, and Participant(s):
Unblinded randomized noninferiority controlled clinical trial at 12
hospitals in Canada and the US involving adults (>=18 years) who had
developed bleeding related to coagulation factor deficiency after
termination of cardiopulmonary bypass during surgery (November 30, 2022,
to May 28, 2024). Final 30-day follow-up visit was completed on June 28,
2024. <br/>Intervention(s): A total of 265 patients were randomized to
receive PCC (1500 IU <=60 kg; 2000 IU >60 kg) and 263, frozen plasma (3 U
<=60 kg; 4 U >60 kg) in the operating room. A second dose was allowed over
the next 24 hours if indicated; thereafter, only frozen plasma could be
used. <br/>Main Outcomes and Measures: The primary outcome was hemostatic
response (effective if no hemostatic interventions occurred from 60
minutes to 24 hours after treatment initiation). The noninferiority of PCC
vs frozen plasma was assessed using a 10% margin and a 1-sided alpha of
.025, with subsequent testing for superiority if noninferiority was
demonstrated. Secondary outcomes included allogeneic blood transfusions
and adverse events. Patients were followed up until postoperative day 30.
<br/>Result(s): Of 538 enrolled patients, 420 patients (median age, 66
years [IQR, 57-73 years]; 74%, male; 10%, Asian; 1%, Black; and 65%,
White) were included in the primary analysis; of those, 296 (70%)
underwent complex surgeries. Compared with the 207 patients in the frozen
plasma group, the 213 patients in the PCC group had higher hemostatic
effectiveness (166 [77.9%] vs 125 [60.4%]; difference, 17.6%; 95% CI,
8.7%-26.4%; P <.001 for noninferiority and superiority) and had received
fewer transfusions including red blood cells, platelets, and
noninvestigational frozen plasma units (mean, 6.6 units; 95% CI, 5.7-7.7
vs 9.3 units; 95% CI, 8.0-10.8; difference, 2.7; 95% CI, 1.0-4.4; P
=.002). Seventy-seven patients (36.2%) in the PCC group vs 98 (47.3%) in
the frozen plasma group experienced serious adverse events (relative risk
[RR], 0.76; 95% CI, 0.61-0.96; P =.02). Twenty-two patients (10.3%) in the
PCC group and 39 (18.8%) in the frozen plasma group had acute kidney
injury (RR, 0.55; 95% CI, 0.34-0.89; P =.02). <br/>Conclusions and
Relevance: In this unblinded randomized clinical trial, PCC had superior
hemostatic efficacy and safety advantages to frozen plasma among patients
requiring coagulation factor replacement for bleeding during cardiac
surgery.<br/>Copyright &#xa9; 2025 American Medical Association.

<110>
Accession Number
649951457
Title
Robotic-assisted thoracic surgery for resectable lung cancer: efficacy,
safety and surgical approaches - an umbrella review of meta-analyses.
Source
BMC surgery. 26(1) (pp 123), 2026. Date of Publication: 16 Jan 2026.
Author
Xu Y.; Han Q.; Wang C.; Xu J.; Li X.; Zhang Q.
Institution
(Xu, Wang) Thoracic Surgery Department of Second Affiliated Hospital of
Shandong First, Medical University & Shandong Academy of Medical Sciences,
No.706 Taishan Street, Shandong, China
(Han) Respiratory Medicine Department of Second Affiliated Hospital of
Shandong, First Medical University & Shandong Academy of Medical Sciences,
China
(Xu) Thoracic Surgery Department of Fourth Affiliated Hospital of Harbin
Medical University, Harbin, China
(Li) Thoracic Surgery Department of The First Affiliated Hospital of
Soochow University, No.899 Pinghai Street, Suzhou, Jiangsu, China
(Zhang) Thoracic Surgery Department of Second Affiliated Hospital of
Shandong First, Medical University & Shandong Academy of Medical Sciences,
No.706 Taishan Street, Shandong, China

<111>
Accession Number
650297896
Title
Comparative risk of adverse cardiovascular outcomes in heart transplant
recipients by statin intensity.
Source
Postgraduate Medicine. Conference: Cardiometabolic Health Congress Annual
Conference, CMHC 2025. Boston, MA United States. 138(Supplement 1) (pp
25-26), 2026. Date of Publication: 2026.
Author
Price B.; Foley S.J.; Hegde S.
Institution
(Price, Foley, Hegde) University of Massachusetts, Chan Medical School,
Worcester, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Heart transplant recipients face a high risk of adverse
cardiovascular outcomes, including cardiac allograft vasculopathy (CAV),
graft failure, and major adverse cardiovascular events (MACE).
Dyslipidemia is prevalent in this population, driven by immunosuppressive
therapy and metabolic changes, and is strongly linked to accelerated
atherosclerosis and poor long- term outcomes. Statins are routinely
prescribed post- transplant to lower lipid levels and improve survival in
post-transplant patients with current guidelines recommending targeting
LDL < 100 mg/dL. Evidence from meta-analyses suggests that statins may
also reduce rejection episodes and mortality beyond lipid lowering alone.
However, the impact of statin intensity on outcomes remains less clear.
While some studies report no significant differences in CAV progression
between low and high-intensity statin therapy, both groups often maintain
relatively low LDL cholesterol levels, potentially obscuring differential
effects. Given the progressive nature of CAV-with incidence rising from 8%
at 1 year to nearly 50% at 10 years-understanding the role of statin
intensity in mitigating CAV risk and progression is critical. Clarifying
this relationship could optimize lipid management strategies and improve
long-term graft and patient survival in heart transplant recipients.
<br/>Purpose(s): Here, this study utilizes the large global federated
electronic medical record database (TriNetX) to compare the relative
mortality benefit of lipid lowering therapy in heart transplant recipients
based on statin intensity. This study accesses the most current electronic
health record (EHR) data from dozens of healthcare organizations (HCOs) to
provide a distinctively broad representation of the long-term
cardiovascular outcomes after heart transplant across the United States.
The results of this study are intended to add to the current literature
regarding perioperative management of cardiovascular disease in heart
transplant recipients. <br/>Method(s): A TriNetX query was conducted using
EHR data within the US Collaborative Network including 45 HCOs. Patients
aged 18 to 75 years with ICD or CPT codes for diagnosis, procedure, or
evaluation related to heart transplant (index event) between January 1,
2015 and December 31, 2024 were included. All study patients were
prescribed an immunosuppressant (excluding cyclosporine) within the first
year after the index event (IE). Patients prescribed GLP-1 agonists during
the study period were excluded. Cohorts were distinguished based on
treatment with high-intensity (HI) vs low- and moderate-intensity (LMI)
statins, and patients must have been prescribed for at least three
instances within the first year after IE. Propensity score matching by
baseline demographics (age at IE, race, sex), comorbidities (hypertension,
dyslipidemia, T2DM, PVD, nicotine dependence), and characteristics (BMI,
HbA1c, creatinine) yielded 797 subjects within each group. Outcomes were
analyzed from 30 days to 10 years following IE. The primary outcome was
combined 5-Point MACE (angina/myocardial infarction, stroke, cardiac
arrest, heart failure, invasive cardiac procedure). Secondary outcomes
included all-cause mortality, cardiovascular disease, ischemic heart
disease, cerebrovascular disease, heart failure, invasive cardiac
procedures, and myalgia. Patients with outcomes prior to the time window
were excluded from risk calculations. <br/>Result(s): Patients in the HI
statin cohort were predominantly White (62.5% vs 62.4%, p=0.959) and male
(73.7% vs 73.3%, p = 0.865), and the average age at IE was 56.1 +/- 11.4
years (vs 57.0 +/- 11.7, p=0.110). Prior to heart transplant, the baseline
metabolic profile was similar between the HI vs LMI cohorts: BMI 28.1 +/-
5.6 vs 27.7 +/- 5.0 (p=0.221), LDL-C 83.4 +/- 39.3 vs 80.7 +/- 34.4
(p=0.172), and systolic BP 122.2 +/- 22.9 vs 120.8 +/- 24.0 (p=0.322). For
immunosuppression, most patients were prescribed tacrolimus (66.4% in HI
cohort vs 68.6% in LMI cohort, p = 0.336). At the 10-year timepoint
following heart transplant, there was no significant difference in risk of
any 5-Point MACE occurring in the HI vs LMI cohorts, RR = 0.918 (95% CI:
0.609-1.383). Similarly, there was no significant difference in risk of
secondary outcomes including: all-cause mortality RR = 0.913 (95% CI:
0.732-1.138), cardiovascular disease RR=0.722 (95% CI: 0.491-1.062),
ischemic heart disease RR=1.027 (95% CI: 0.696-1.515), cerebrovascular
disease RR=1.539 (95% CI: 0.860, 2.756), heart failure RR=1.050 (95% CI:
0.709-1.556). However, the risk of invasive cardiac procedures was
significantly lower in the HI cohort, RR=0.736 (95% CI: 0.590-0.918).
Also, the hazard ratio for cardiovascular disease was significantly lower,
HR=0.717 (95% CI: 0.556-0.924). By excluding patients with prior outcomes
from analysis, these data highlight higher rates of new onset
cardiovascular disease (CVD) or first incidence of MACE but do not account
for benefits of continuing statins in the context of pre-existing CVD.
Interestingly, the HI cohort was less likely to report the adverse effect
of myalgia, RR = 0.478 (95% CI: 0.313-0.732). This may be attributed to
the observed lower rates of statin intolerance in patients prescribed
rosuvastatin due to its water solubility leading to reduced penetration
and accumulation in muscle tissue. <br/>Conclusion(s): In heart transplant
patients, higher intensity statin therapy was not associated with a
statistically significant reduction in any 5-Point MACE, all-cause
mortality, cardiovascular disease, ischemic heart disease, new onset heart
failure or cerebrovascular disease. These findings were examined despite
the perceived lower rates of myalgia as a surrogate marker for statin
intolerance, suggesting that the HI cohort may have recorded lower rates
of statin discontinuation.

<112>
Accession Number
650293307
Title
The effect of early mobilization of post-cardiac surgery patients on
delirium: a pilot study.
Source
European journal of physical and rehabilitation medicine. (no
pagination), 2026. Date of Publication: 18 Feb 2026.
Author
Xu J.; Yu W.; Yu Y.; Zhou J.; Deng M.; Wang W.; Jiang J.; Chang W.; Yang
Y.; Cao H.; Guo F.
Institution
(Xu, Chang, Yang) Jiangsu Provincial Key Laboratory of Critical Care
Medicine, Department of Critical Care Medicine, Zhongda Hospital, School
of Medicine, Southeast University, Nanjing, China
(Yu, Yu, Deng, Wang) Department of Critical Care Medicine, Zhongda
Hospital, School of Medicine, Southeast University, Nanjing, China
(Zhou, Jiang, Cao) Department of Cardiac Surgery, Zhongda Hospital, School
of Medicine, Southeast University, Nanjing, China
(Guo) Jiangsu Provincial Key Laboratory of Critical Care Medicine,
Department of Critical Care Medicine, Zhongda Hospital, School of
Medicine, Southeast University, Nanjing, China
Abstract
BACKGROUND: The best time to perform mobilization in patients after
cardiac surgery is still unknown. Specifically, the efficacy and safety of
initiating mobilization within the first 24 hours remain unclear. AIM: We
evaluated the effect of early mobilization within 24 hours post cardiac
surgery on the incidence of delirium. DESIGN: This was a single-centered
randomized pilot study. SETTINGS: Tertiary teaching hospital. POPULATION:
Adult post-cardiac surgery patients were randomized to early mobilization
group or usual care group. <br/>METHOD(S): In the early mobilization
group, sitting down with no support on a wheelchair for more than 30
minutes were implemented within 24 hours of intensive care unit (ICU)
admission, then performed every day until day 7. In the usual care group,
mobilization was performed after transferred to the cardiac surgery
department, then performed every day until day 7. Screening for delirium
by Confusion Assessment Method for the ICU (CAM-ICU) was performed on
anesthesia recovery period, 8 hours after awakening, on the second day
postsurgery, and every morning until 7 days. The primary outcome was the
incidence of delirium during the first 7 days after randomization. The
secondary outcomes included duration of delirium, mechanical ventilation
time, length of ICU stay and in-hospital mortality. <br/>RESULT(S): Sixty
patients were enrolled, 30 assigned to each group. No baseline difference
was identified between the early mobilization group and usual care group.
The incidence of delirium was 26.7%. In the early mobilization group, a
trend toward a lower incidence of delirium on the second day was found,
and the duration of delirium was significantly shorter. No severe adverse
events were identified during the first mobilization time, which lasted
for almost 40 minutes. <br/>CONCLUSION(S): Early mobilization might be
effective in reducing delirium incidence and duration for post-cardiac
surgery patients, despite not significantly reducing its incidence. These
preliminary findings should be tested in larger multicenter trials.
CLINICAL REHABILITATION IMPACT: Early mobilization within 24 hours
post-cardiac surgery might be effective in reducing delirium and is safe
for post-cardiac surgery patients, which should be tested in larger
multicenter trials.

<113>
Accession Number
650293456
Title
Levosimendan vs. Intra-Aortic Balloon Pump in Coronary Artery Bypass
Grafting: A Meta-Analysis.
Source
Brazilian journal of cardiovascular surgery. 41(3) (no pagination), 2026.
Date of Publication: 01 May 2026.
Author
Wang Y.; Qu J.; Sheng D.; Sun X.; Zhong L.; Wu Y.; Liang H.
Institution
(Wang, Sheng, Zhong, Wu, Liang) Hunan University of Chinese Medicine
Institute of Traditional Chinese Medicine Diagnostics Changsha Hunan
People's Republic of China Institute of Traditional Chinese Medicine
Diagnostics, Hunan University of Chinese Medicine, Changsha, Hunan, China
(Qu) Hunan University of Chinese Medicine, Hunan University of Chinese
Medicine School of Integrated Chinese and Western Medicine Changsha Hunan
People's Republic of China School of Integrated Chinese and Western
Medicine, Changsha, Hunan, China
(Sun) Changsha Hospital of Traditional Chinese Medicine Cardiology
Department Changsha Hunan People's Republic of China Cardiology
Department, Changsha Hospital of Traditional Chinese Medicine, Changsha,
Hunan, China
Abstract
OBJECTIVE: To compare the clinical efficacy and safety of intra-aortic
balloon pump (IABP) and levosimendan in coronary artery bypass grafting
(CABG). <br/>METHOD(S): A systematic search of PubMed, Embase, Cochrane
Library, and Google Scholar was conducted through July 2024. Outcomes
analyzed included atrial fibrillation, postoperative mediastinitis, the
requirement for inotropic support, in-hospital mortality, postoperative
intensive care unit (ICU) stay, postoperative length of stay, ventilation
time, and mean arterial pressure (MAP) levels. <br/>RESULT(S): The
analysis included nine studies with 681 patients. Levosimendan presented
advantage over IABP in CABG patients in terms of postoperative ICU stay,
postoperative length of stay, and reduction in MAP levels, with effect
sizes: mean difference (MD) = -0.83, 95% confidence interval (CI) -0.97 to
-0.68, P < 0.00001, MD = -1.14, 95% CI: -1.33 to -0.95, P < 0.00001, and
MD = -4.55, 95% CI: -6.14 to -2.96, P < 0.00001, respectively.
Levosimendan had an advantage on subgroup analyses in terms of
postoperative ICU stay and postoperative length of stay, with effect
sizes: MD = -0.83, 95% CI: -0.93 to -0.72, P < 0.00001 and MD = -1.14, 95%
CI: -1.28 to -1.01, P < 0.00001, respectively. However, the incidence of
postoperative mediastinitis was higher in the levosimendan group (relative
risk = 1.45, 95% CI: 0.88 to 2.38), though not statistically significant.
<br/>CONCLUSION(S): Levosimendan may improve recovery and hemodynamic
outcomes in high-risk CABG patients compared to IABP but may be associated
with a higher, though non-significant, risk of mediastinitis. Further
high-quality studies are warranted.

<114>
Accession Number
650289319
Title
Technological advancements for improving preoperative assessment and
precision in cardiovascular surgery.
Source
Expert review of cardiovascular therapy. (no pagination), 2026. Date of
Publication: 17 Feb 2026.
Author
Galyfos G.; Chamzin A.; Theodorou A.; Sigala F.; Filis K.; Theodorou D.
Institution
(Galyfos, Chamzin, Theodorou, Sigala, Filis, Theodorou) Vascular Surgery
Unit, First Department of Propedeutic Surgery, National and Kapodistrian
University of Athens, Hippocration Hospital, Athens, Greece
Abstract
INTRODUCTION: Cardiovascular surgery including cardiac surgery and complex
endovascular procedure needs careful preoperative planning as well as
intraoperative precision to improve outcomes and ameliorate complications.
During the last decades, several technological advancements have been made
that could improve preoperative assessment, design of the surgical
procedure, risk prediction as well as surgical precision. AREAS COVERED:
Several areas of technological advancements referring to cardiovascular
surgery are discussed in this review. Data have been collected using the
Pubmed, Scopus and Google scholar databases. We report advancements
regarding the utilization of artificial intelligence in preoperative
assessment and risk prediction. We also report on advancements made in
intraoperative imaging including holographic and fusion imaging
techniques. Furthermore, operating techniques such as the use of novel
endovascular tools or robotic surgery are also discussed. Finally, other
novel technologies such as 3-Dimentional (3-D) printing is also presented.
EXPERT OPINION: In the next five years, technological advancements in
cardiovascular surgery will be definitely improved and more broadly used.
Although these advancements are associated with a very high cost and a
longer learning curve, the associated healthcare cost benefit is evident.
Due to bioethical reasons, this progress will need to be contained and
controlled by humans.

<115>
Accession Number
650300962
Title
Optymalna terapia medyczna u pacjentow ze stabilna choroba wiencowa w
Polsce w porownaniu do innych krajow. Doswiadczenie badania ISCHEMIA.
Source
Kardiologia Polska. Conference: 25th International Congress of the Polish
Cardiac Society. Online. 79(Supplement 1) (pp 15-16), 2021. Date of
Publication: 2021.
Author
Pracon R.; Demkow M.; Anthopolos R.; Mazurek T.; Drozdz J.; Witkowski A.;
Gajos G.; Pruszczyk P.; Roik M.; Loboz-Grudzien K.; Lesiak M.; Reczuch K.;
Kalarus Z.; Kryczka K.; Henzel J.; Kaczmarska-Dyrda E.; Maksym J.; Jonik
S.; Krekora J.; Celinska-Spodar M.; Jaroch J.; Lanocha M.; Szulik M.;
Szwed H.; Ruzyllo W.
Institution
(Pracon, Demkow) Klinika Choroby Wiencowej i Strukturalnych Chorob Serca,
Narodowy Instytut Kardiologii, Warszawa, Poland
(Anthopolos) NYU Grossman School of Medicine, New York, United States
(Mazurek, Krekora) I Katedra i Klinika Kardiologii, Warszawskiego Uniw
Medycznego, Warszawa, Poland
(Drozdz) II Klinika Kardiologii, Katedra Kardiologii, Kardiochirurgii i
Chorob Naczyn, UM W Lodzi, Lodz, Poland
(Witkowski) Klinika Kardiologii i Angiologii Interwencyjnej, Narodowy
Instytut Kardiologii, Warszawa, Poland
(Gajos) Department of Coronary Disease and Heart Failure, Faculty of
Medicine, Jagiellonian University Medical College, Krakow, Poland
(Pruszczyk, Roik) Klinika Chorob Wewnetrznych i Kardiologii Z Ctr.,
Diagnostyki i Leczenia Zylnej Choroby Zakrzepowo-Zatorowej, Warszawski
Uniwersytet Medyczny, Warszawa, Poland
(Loboz-Grudzien, Lesiak) Dolnoslaski Szpital Specjalistyczny Im. T.
Marciniaka, Oddzial Kardiologi, Wroclaw, Poland
(Reczuch) I Klinika Kardiologii, Uniwersytet Medyczny Im. Karola
Marcinkowskiego, Poznan, Poland
(Kalarus) Katedra Chorob Serca, Uniwersytet Medyczny We Wroclawiu,
Wroclaw, Poland
(Kryczka) Katedra Kardiologii, Wrodzonych Wad Serca i Elektroterapii,
Slaskie Centrum Chorob Serca, Zabrze, Poland
(Henzel, Kaczmarska-Dyrda) Klin Choroby Wiencowej i Strukturalnych Chorob
Serca, Narodowy Inst Kardiologii, Warszawa, Poland
(Maksym) Klinika Choroby Wiencowej i Strukturalnych Chorob Serca, Instytut
Kardiologii, Warszawa, Poland
(Jonik) I Katedra i Klinika Kardiologii, Warszawskiego Uniwersytetu
Medycznego, Warszawa, Poland
(Celinska-Spodar) II Klinika Kardiologii Katedry Kardiologii,
Kardiochirurgii i Chorob Naczyn, Centralny Szpital Kliniczny Uniwersytetu
Medycznego, Lodz, Poland
(Jaroch, Ruzyllo) Narodowy Instytut Kardiologii, Warszawa, Poland
(Lanocha) Dolnoslaski Szpital Specjalistyczny Im. T. Marciniaka, Oddzial
Kardiologii, Wroclaw, Poland
(Szulik) I Katedra i Klinika Kardiologii, Uniwersytet Medyczny Im. Karola
Marcinkowskiego, Poznan, Poland
(Szwed) Wrodzonych Wad Serca i Elektroterapii, Oddzial Kliniczny
Kardiologii Slaskiego Uniwersytetu Medycznego, Slaskie Centrum Chorob
Serca, Zabrze, Poland
Publisher
Via Medica
Abstract
INTRODUCTION The ISCHEMIA Trial showed similar outcomes of initial
conservative vs invasive approach to stable coronary artery disease, with
optimal medical therapy (OMT) remaining the cornerstone of treatment. To
describe OMT goal attainment among ISCHEMIA participants in Poland
compared to other countries. MATERIAL AND METHODS Among 5179 trial
participants 333 were randomized in Poland. The median follow-up duration
was 3.2 years with the following OMT targets: not-smoking, high-intensity
statin therapy, low-density lipoprotein cholesterol (LDL-C) <70 mg/dl,
systolic blood pressure (SBP) <140 mm Hg, antiplatelet agent therapy, and
angiotensin converting enzyme inhibitory/ /angiotensin II receptor
blockers (ACE-I/ARB), beta-blocker therapy if indicated. RESULTS Compared
to other countries worldwide, at randomization participants in Poland were
older (67 [62, 75] yrs vs 65 [58, 71] yrs; P <0.005), more often female
(30% vs 22%; P <0.005), with longer angina duration (3 [1, 9] yrs vs 1 [0,
3] yrs; P <0.001), more prior myocardial infarctions (32% vs 18%; P
<0.005) and coronary revascularization procedures (percutaneous coronary
intervention: 40% vs 19%; coronary artery bypass grafting: 11% vs 3%; P
<0.001). Number of OMT goal attainment increased from baseline to last
follow-up (5 [4, 6] vs 6 [5, 6]; P <0.0001) in Poland and other countries
alike (P = 0.89, and P = 0.14, respectively). In Poland, significant
improvements were achieved regarding high-intensity statin therapy (27% vs
50%), LDL-C <70mg/dl (29% vs 65%), and SBP <140 mm Hg (63% vs 81%); P
<0.001; whereas not-smoking (89% vs 89%), antiplatelet (91% vs 88%),
ACE-I/ARB (91% vs 93%), and beta-blocker therapy (89% vs 91%) remained
similarly high. CONCLUSIONS With regular surveillance and concurrent
medical therapy, high OMT goal attainment was achievable among ISCHEMIA
participants in Poland relative to other countries. There is still room
for improvement in lipids and blood pressure management.

<116>
Accession Number
2043340493
Title
The impact of acute normovolemic hemodilution on blood transfusions in
cardiac surgery: a GRADE-assessed systematic review and meta-analysis of
30 randomized controlled trials with trial sequential analysis.
Source
Naunyn-Schmiedeberg's Archives of Pharmacology. (no pagination), 2026.
Date of Publication: 2026.
Author
Alam U.; Rath S.; Ansab M.; Khattak F.; Siddiqui H.T.; Burhan M.; Moiz A.;
Sabir V.; Afridi Z.A.K.
Institution
(Alam, Khattak, Sabir, Afridi) Khyber Medical College, Peshawar, Pakistan
(Rath) All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar,
India
(Ansab) Services Institute of Medical Sciences, Lahore, Pakistan
(Siddiqui) Jinnah Sindh Medical University, Karachi, Pakistan
(Burhan) Dow University of Health Sciences, Sindh, Karachi, Pakistan
(Moiz) Bacha Khan Medical College, Mardan, Pakistan
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Acute normovolemic hemodilution (ANH) is an intraoperative blood
conservation technique that involves removing a portion of the patient's
blood after anesthesia induction and replacing it with fluids to maintain
normovolemia. The purpose of this systematic review and meta-analysis was
to assess the efficacy and safety of ANH in reducing transfusion
requirements and improving hemorrhagic outcomes in adult cardiac surgery
patients. Studies were identified through systematic searches of PubMed,
Embase, and Cochrane Central databases. Effect estimates were calculated
using random-effects models, with heterogeneity assessed using the
I² statistic. Trial sequential analysis (TSA) was employed to
evaluate the robustness of cumulative evidence. randomized controlled
trials (RCTs) involving 4473 patients were included for further analysis.
ANH was associated with a 27% relative reduction in the incidence of
allogeneic blood transfusions (RR = 0.73, 95% CI = 0.60 to 0.88; p =
0.0008) and a decrease in the volume of allogeneic red blood cell units
transfused (MD = - 0.75 units, 95% CI = - 1.41 to - 0.08; p = 0.020).
Fresh frozen plasma transfusion requirements were also significantly
reduced (MD = - 0.21 units, 95% CI = - 0.39 to - 0.03; p = 0.0248), along
with total blood loss (MD = - 64.35 mL, 95% CI = - 114.57 to - 14.13; p =
0.012). However, chest tube drainage, surgical revision, and stroke
incidence showed no significant differences between ANH and usual care.
This meta-analysis demonstrates that ANH significantly reduces the need
for allogeneic blood transfusions and improves outcomes such as red blood
cell and fresh frozen plasma usage during cardiac surgery. The findings
highlight ANH's potential as an effective blood conservation strategy,
though variability in outcomes and heterogeneity warrant further
high-quality research to optimize its application in contemporary cardiac
surgical practices.<br/>Copyright &#xa9; The Author(s), under exclusive
licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026.

<117>
Accession Number
2043717355
Title
Consensus Document on the Multidisciplinary Management of Advanced-Stage
Respiratory Diseases.
Source
Archivos de Bronconeumologia. (no pagination), 2026. Date of Publication:
2026.
Author
de Miguel-Diez J.; Castillo-Padros M.; Figueira-Goncalves J.M.;
Torres-Castro R.; Gainza-Miranda D.; Golpe R.; Cuervo-Pinna M.A.;
Perez-Rojo R.; Gonzalez-Barboteo J.; Callejas-Gonzalez F.J.; Calvo-Espinos
C.; Rio-Ramirez M.T.; Olalla-Gallo M.A.; Salinas-Lasa M.B.; Salcedo-Peris
T.
Institution
(de Miguel-Diez) Servicio de Neumologia, Hospital General Universitario
Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon
(IiSGM), Facultad de Medicina, Universidad Complutense de Madrid, Madrid,
Spain
(Castillo-Padros) Unidad de Cuidados Paliativos, Complejo Hospitalario
Universitario Nuestra Senora de Candelaria, Tenerife, Spain
(Figueira-Goncalves) Servicio de Neumologia, Complejo Hospitalario
Universitario Nuestra Senora de Candelaria, Tenerife, Spain
(Torres-Castro) Departamento de Kinesiologia, Facultad de Medicina,
Universidad de Chile, Santiago, Chile
(Gainza-Miranda) Unidad de Cuidados Paliativos, Hospital Universitario
Principe de Asturias, Madrid, Spain
(Golpe) Servicio de Neumologia, Hospital Universitario Lucus Augusti,
Lugo, Spain
(Cuervo-Pinna) Equipo de Cuidados Paliativos, Hospital Universitario de
Badajoz, Badajoz, Spain
(Perez-Rojo) Servicio de Neumologia, Hospital Universitario 12 de Octubre,
Madrid, Spain
(Gonzalez-Barboteo) Servicio de Cuidados Paliativos, Grupo de
Investigacion y Conocimiento en Cuidados Paliativos (GRICOPAL), Instituto
Catalan de Oncologia-L'Hospitalet, Barcelona, Spain
(Callejas-Gonzalez) Servicio de Neumologia, Complejo Hospitalario
Universitario de Albacete, Albacete, Spain
(Calvo-Espinos) Unidad de Cuidados Paliativos, Fundacion Rioja Salud, La
Rioja, Spain
(Rio-Ramirez) Servicio de Neumologia, Hospital Universitario de Getafe,
Universidad Europea de Madrid, Madrid, Spain
(Olalla-Gallo) Equipo de Soporte de Atencion Domiciliaria, Gerencia de
Atencion Primaria de Burgos, SACYL, Burgos, Spain
(Salinas-Lasa) Servicio de Neumologia, Hospital Universitario
Galdakao-Usansolo, Galdakao, Spain
(Salcedo-Peris) Unidad de Cuidados Paliativos, Hospital General
Universitario Ciudad Real, Ciudad Real, Spain
Publisher
Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR)
Abstract
Advanced respiratory diseases, particularly chronic obstructive pulmonary
disease (COPD) and interstitial lung diseases (ILD), constitute an
increasing challenge for healthcare systems due to their high prevalence,
substantial symptom burden, and significant resource use. This consensus
document, developed jointly by the Spanish Society of Pulmonology and
Thoracic Surgery (SEPAR) and the Spanish Society of Palliative Care
(SECPAL), provides recommendations for a multidisciplinary, integrated
model of care. Using the SIGN methodology and a systematic literature
review, a multidisciplinary panel developed 70 evidence-based
recommendations addressing key domains: identification of patients with
palliative care needs; management of respiratory symptoms; strategies to
improve quality of life; communication and shared decision-making;
caregiver support; and coordination across care settings. A needs-based
approach, rather than reliance on prognosis alone, is recommended to
facilitate earlier recognition of patients with advanced COPD and ILD and
to enable the timely integration of palliative care alongside
disease-directed therapies. Adoption of these recommendations is expected
to improve quality of life, reduce symptom burden and suffering, and
optimize care for patients with advanced respiratory
diseases.<br/>Copyright &#xa9; 2026 SEPAR

<118>
Accession Number
2043351864
Title
Renal Protection at a Metabolic Cost: A Systematic Review and
Meta-Analysis of Perioperative Use of Sodium-Glucose Cotransporter 2
Inhibitors.
Source
Endocrinology, Diabetes and Metabolism. 9(2) (no pagination), 2026.
Article Number: e70180. Date of Publication: 01 Mar 2026.
Author
Balbaa E.; Gadelmawla A.F.; Ibrahim A.; Manasrah A.; Elbataa A.; Shubietah
A.; Elgendy M.S.; Sobhy A.; Mansour A.; Awashra A.; Elguindy N.N.;
Bazzazeh M.; Ben-Selma A.
Institution
(Balbaa, Ibrahim, Bazzazeh) Faculty of Medicine, Alexandria University,
Alexandria, Egypt
(Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt
(Gadelmawla) Medical Research Group of Egypt, Negida Academy, Arlington,
MA, United States
(Manasrah, Ben-Selma) Department of Internal Medicine, United Health
Services-Wilson Medical Center, Johnson city, NY, United States
(Elbataa, Mansour) Faculty of Medicine, Al-Azhar University, Cairo, Egypt
(Shubietah) Department of Medicine, Advocate Illinois Masonic Medical
Center, Chicago, IL, United States
(Elgendy) Faculty of Medicine, Tanta University, Tanta, Egypt
(Sobhy) Faculty of Medicine, Kafr Elshiekh University, Kafr el-Sheikh,
Egypt
(Awashra) Department of Medicine, An Najah National University, Nablus,
Palestine
(Elguindy) Faculty of Medicine, Ainshams University, Cairo, Egypt
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Concerns about diabetic ketoacidosis (DKA) and euglycemic
ketoacidosis (eKA) are balanced against possible organ-protective benefits
in the debated perioperative management of sodium-glucose cotransporter-2
(SGLT2) inhibitors. This meta-analysis compared the perioperative clinical
and laboratory outcomes associated with perioperative exposure to SGLT2i.
<br/>Method(s): Through July 31, 2025, we searched PubMed, Web of Science,
Scopus, and CENTRAL for observational studies and randomised controlled
trials comparing the outcomes of preoperative use of SGLT2 inhibitors with
non-use in patients undergoing cardiac or non-cardiac surgery. We pooled
data using a random-effects model and investigated heterogeneity using
leave-one-out sensitivity analyses. PROSPERO-ID: CRD420251155809.
<br/>Result(s): There were 10 studies comprising 246,242 patients. Due to
considerable heterogeneity, the primary pooled analysis revealed no
significant association between SGLT2 inhibitor use and either eKA (OR
4.86; p = 0.11) or DKA (OR 2.21; p = 0.11). However, a significant
increase in the risk of eKA (OR 1.11; p < 0.001) and DKA (OR 5.33; p <
0.001) was observed using leave-one-out sensitivity analysis to identify
outliers. On the other hand, the usage of SGLT2 inhibitors was associated
with a statistically significant decrease in both mortality (OR 0.73; p =
0.006) and acute renal injury (OR 0.68; p < 0.0001). The SGLT2 inhibitor
group had significantly lower perioperative pH, base excess, and blood
glucose levels. <br/>Conclusion(s): The use of perioperative SGLT2
inhibitors poses a clinical paradox between significant renoprotection and
survival advantages and a latent risk of ketoacidosis concealed by
considerable heterogeneity. While metabolic monitoring is essential,
current surgeries requiring more prolonged withholding may need to weigh
metabolic risk against the drug's significant benefit in reducing acute
kidney injury and mortality.<br/>Copyright &#xa9; 2026 The Author(s).
Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.

<119>
Accession Number
2043346969
Title
Invasive and medical management approaches to non-acute myocardial
ischaemic syndromes.
Source
Nature Reviews Cardiology. (no pagination), 2026. Date of Publication:
2026.
Author
Chiu N.; Bhatt D.L.; De Caterina R.; Doenst T.; Kirov H.; Dayan V.; Faxon
D.P.; Kaul S.; Perera D.; Puskas J.D.; Steg P.G.; Boden W.E.
Institution
(Chiu, Faxon) Brigham and Women's Hospital Heart and Vascular Center,
Harvard Medical School, Boston, MA, United States
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
(De Caterina) Cardiovascular Division, Pisa University Hospital -
University of Pisa, Pisa, Italy
(Doenst, Kirov) Department of Cardiothoracic Surgery, Jena University
Hospital, Friedrich Schiller University, Jena, Germany
(Dayan) Centro Cardiovascular Universitario, Hospital de Clinicas,
Universidad de la Republica, Montevideo, Uruguay
(Kaul) Division of Cardiology, Cedars-Sinai Heart Institute, Cedars-Sinai
Medical Center, David Geffen School of Medicine, University of California,
Los Angeles, CA, United States
(Perera) British Heart Foundation Centre for Research Excellence, School
of Cardiovascular and Metabolic Medicine and Sciences, King's College,
London, United Kingdom
(Puskas) Emory Heart and Vascular Center, Emory University School of
Medicine, Atlanta, GA, United States
(Steg) Universite Paris-Cite, Assistance Publique - Hopitaux de Paris,
INSERM U1148 and FACT (French Alliance of Cardiovascular Trials), Paris,
France
(Boden) VA Boston Healthcare System, Boston University School of Medicine,
Boston, MA, United States
Publisher
Nature Research
Abstract
Over the past two decades, approaches to managing patients with coronary
artery disease have improved substantially with advances in percutaneous
coronary intervention (PCI), coronary artery bypass graft (CABG) surgery,
pharmacological secondary prevention, anti-anginal agents and lifestyle
interventions. Accordingly, clinical management choices in non-acute
myocardial ischaemic syndromes (NAMIS) remain a timely and important
topic. The risks and benefits of an invasive strategy combined with
optimal medical therapy (OMT) versus a conservative strategy of OMT alone
should be discussed with patients to facilitate shared clinical decision
making. The findings from high-quality, randomized, controlled trials in
the era of modern OMT form an essential platform for these informed
conversations. In totality, the evidence from randomized, controlled
trials supports OMT as the first-line therapeutic approach in patients
with NAMIS, whereas selected patients at high anatomical risk or those
with persistent anginal symptoms despite initial OMT often derive further
symptom relief from invasive therapy with PCI. In patients with high-risk
NAMIS, including those with multivessel disease and diabetes mellitus,
CABG surgery improves survival, whereas the benefit is less clear for PCI.
In this Review, we discuss the findings from contemporary trials
evaluating outcomes in patients with NAMIS treated invasively or
conservatively with OMT alone, and we conclude with proposed management
pathways.<br/>Copyright &#xa9; This is a U.S. Government work and not
under copyright protection in the US; foreign copyright protection may
apply 2026.

<120>
Accession Number
2043717116
Title
Renin-angiotensin-aldosterone system (RAAS) antagonists in the
perioperative setting: An updated review.
Source
American Journal of Medicine. (no pagination), 2026. Date of Publication:
2026.
Author
Nahlawi R.; Majeed Z.; Motairek I.; Martyn T.; Alvarez P.; Jaber W.A.;
Auron M.
Institution
(Majeed, Motairek) Department of Internal Medicine, Cleveland Clinic,
Cleveland, OH, United States
(Nahlawi, Auron) Case Western Reserve University School of Medicine,
Cleveland, OH, United States
(Martyn, Alvarez, Jaber) Department of Cardiovascular Medicine, Cleveland
Clinic, Cleveland, OH, United States
(Auron) Department of Hospital Medicine, Cleveland Clinic, Cleveland, OH,
United States
(Auron) Outcomes Research Consortium, Houston, TX, United States
Publisher
Elsevier Inc.
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)

<121>
Accession Number
2043662716
Title
Left atrial appendage closure versus direct oral anticoagulants after
pulmonary vein isolation for atrial fibrillation: protocol for a
multicentre, prospective, randomised, non-inferiority trial (PROMOTE
study).
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e103632. Date of
Publication: 16 Feb 2026.
Author
Jiang L.; Hao Z.; Chu H.; Wang X.; Ning Z.; Zhang J.; Yang B.; Xu Y.; Fang
R.; Kong L.; Zhang X.; He Q.; Zhang Z.; Zhang T.; Du C.; Wu Y.; Zhao D.;
Huang H.; Ma W.; Liang Z.; Pan X.; Wang C.; Miao Y.; Shen L.; He B.
Institution
(Shen) University of Pittsburgh Medical Center Health System, Pittsburgh,
PA, United States
(Jiang, Yang, Wu, He) Department of Cardiology, Shanghai East Hospital,
Tongji University School of Medicine, Shanghai, China
(Hao, Liang, Pan, Wang, Miao, Shen) Department of Cardiology, Shanghai
Chest Hospital, Shanghai Jiao Tong University School of Medicine,
Shanghai, China
(Chu, Fang) Department of Cardiovascular Medicine, The First Affiliated
Hospital of Ningbo University, Ningbo University, Zhejiang, Ningbo, China
(Wang, Kong) Department of Cardiology, Renji Hospital, Shanghai Jiaotong
University, School of Medicine, Shanghai, China
(Ning, Zhang) Department of Cardiology, Shanghai Pudong New District
Zhoupu Hospital, Pudong, Shanghai, China
(Zhang, He, Zhang, Zhang) Department of Cardiology, Shanghai Jiao Tong
University School of Medicine, Affiliated Ninth People's Hospital,
Shanghai, China
(Xu, Zhao) Department of Cardiology, Shanghai Tenth People's Hospital,
Shanghai Jiaotong University School of Medicine, Shanghai, China
(Du) Department of Geriatrics, The Ninth People's Hospital, Affiliated of
Shanghai Jiaotong University, Shanghai, China
(Huang) School of Public Health, Shanghai Jiao Tong University School of
Medicine, Shanghai Jiao Tong University, Shanghai, China
(Ma) Clinical Research Unit, Shanghai Chest Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
Publisher
BMJ Publishing Group
Abstract
Introduction Atrial fibrillation (AF), with a prevalence of 1-2%, is the
most common cardiac arrhythmia. AF is associated with a fivefold increased
risk of cardioembolic events; approximately 20% of all strokes are caused
by AF. Pulmonary vein isolation (PVI) has become the first-line treatment
for AF. However, PVI cannot eliminate the residual stroke risk. Current
guidelines recommend that anticoagulation be continued in this specific
group of patients, regardless of the presence or absence of AF. In this
large AF population post-PVI, who are considered to be in an earlier stage
of AF, it is unknown whether left atrial appendage closure (LAAC) offers
an alternative to direct oral anticoagulant (DOAC) therapy. Methods and
analysis The trial will be a prospective, randomised, multicentre
non-inferiority study comparing two treatment strategies in AF patients
after atrial ablation. Patients will be randomly assigned to either
percutaneous LAAC (group A) or DOAC treatment (group B) in a 1:1 ratio;
both sequential and concomitant planned ablation with or without LAAC are
accepted. Randomisation will be conducted using web-based randomisation
software. A total of 1012 participants (506 patients per group) will be
enrolled. The primary effectiveness measure will be the occurrence of any
of the specified events within 24 months after randomisation:
stroke/transient ischaemic attack/systemic thromboembolism, cerebral
haemorrhage, other major haemorrhages (Bleeding Academic Research
Consortium >=2), cardiovascular mortality and all-cause mortality. Ethics
and dissemination The study was approved by the Ethical Review Board of
Shanghai Chest Hospital, China (KS(Y)20287). Written informed consent will
be obtained from all participants. The trial will follow the Declaration
of Helsinki and Good Clinical Practice. Confidentiality will be maintained
with anonymised, securely stored data. Findings will be disseminated
through peer-reviewed publications and conferences.<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.

<122>
Accession Number
2043667237
Title
Antithrombotic strategies and DOAC dosing following left atrial appendage
occlusion: a network meta-analysis.
Source
European Heart Journal - Cardiovascular Pharmacotherapy. 12(1) (pp 38-51),
2026. Date of Publication: 01 Jan 2026.
Author
Samaras A.; Karakasis P.; Feidakis A.; Giannakoulas G.; Fragakis N.;
Nielsen-Kudsk J.-E.; Freixa X.; Nair D.G.; Freeman J.V.; Bergmann M.;
Landmesser U.; Tzikas A.
Institution
(Samaras, Tzikas) School of Medicine, Faculty of Health Sciences,
Aristotle University of Thessaloniki, Thessaloniki, Greece
(Samaras, Karakasis, Fragakis, Tzikas) Second Department of Cardiology,
Thessaloniki, Greece
(Feidakis) Department of Cardiology, Heart Center, University of Cologne,
Germany
(Giannakoulas) First Department of Cardiology, AHEPA University Hospital
of Thessaloniki, Thessaloniki, Greece
(Nielsen-Kudsk) Department of Cardiology, Aarhus University Hospital,
Aarhus, Denmark
(Freixa) Department of Cardiology, Institut Cardiovascular, IDIBAPS,
Barcelona, Spain
(Nair) Department of Cardiac Electrophysiology, St Bernard's Heart and
Vascular Center, Jonesboro, AR, United States
(Freeman) Section of Cardiovascular Medicine, Yale University School of
Medicine, New Haven, CT, United States
(Freeman) Center for Outcomes Research and Evaluation, Yale-New Haven
Hospital, New Haven, CT, United States
(Bergmann) Department of Cardiology and Intensive Care Medicine, Asklepios
Klinik Altona, Hamburg, Germany
(Landmesser) BerlinGermany
(Landmesser) German Centre for Cardiovascular Research (DZHK), Partner
Site Berlin, Berlin, Germany
(Landmesser) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum Charite, Campus Benjamin Franklin, Germany
(Landmesser) Berlin Institute of Health, Berlin, Germany
(Tzikas) European Interbalkan Medical Center, Thessaloniki, Greece
Publisher
Oxford University Press
Abstract
Aims The optimal short-term antithrombotic strategy following left atrial
appendage occlusion (LAAO) remains uncertain, with the need to balance
thromboembolic prevention and bleeding risk presenting a critical
challenge. Recent evidence suggests that direct oral anticoagulants
(DOACs) may provide a favourable safety-efficacy profile, with low-dose
regimens showing potential benefits during the device endothelialization
period. This network meta-analysis (NMA) aimed to compare the efficacy and
safety of various antithrombotic strategies, including DOAC dosing,
following LAAO. Methods and results A systematic review and NMA were
conducted following Cochrane and PRISMA guidelines. Eligible studies
included randomized controlled trials (RCT) and observational studies
comparing at least two antithrombotic regimens in patients with
non-valvular atrial fibrillation undergoing percutaneous LAAO. Primary
outcomes were major bleeding and thromboembolism. Secondary outcomes
included device-related thrombosis (DRT) and all-cause mortality. Pairwise
and network meta-analyses were performed using a random-effects model. A
total of 52 studies (49 observational and 3 RCTs) involving 69 751
patients were included. DOACs were consistently associated with
significantly lower rates of major bleeding and all-cause mortality than
other antithrombotic regimens. Low-dose DOACs showed a potential advantage
over standard-dose DOACs in reducing major bleeding risk (odds ratio 0.45,
95% confidence interval: 0.22-0.92). For thromboembolism and DRT,
standard-dose DOAC significantly reduced risk compared with single
antiplatelet therapy (SAPT) but not with dual antiplatelet therapy (DAPT),
whereas low-dose DOAC significantly reduced both outcomes compared with
SAPT, DAPT, and vitamin K antagonists plus SAPT. In ranking analysis,
DOACs emerged as the most effective and safest antithrombotic strategy,
with low-dose DOACs demonstrating further safety benefits in bleeding
outcomes. Conclusion DOACs provide a superior safety-efficacy profile
compared with other antithrombotic strategies following LAAO,
significantly reducing the risks of major bleeding, thromboembolic events,
and mortality. While low-dose DOACs may offer additional bleeding risk
reduction without compromising efficacy, further research is warranted to
confirm their role in clinical practice.<br/>Copyright &#xa9; The
Author(s) 2025. Published by Oxford University Press on behalf of European
Society of Cardiology.

<123>
Accession Number
2043311149
Title
Effect of transcutaneous electrical nerve stimulation on patients after
coronary artery bypass grafting: a systematic review and meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article
Number: 1690565. Date of Publication: 2026.
Author
Zhang E.; Kang J.; Liu Y.; Wang L.; Wan B.; Li X.
Institution
(Zhang, Kang, Liu, Wang, Wan, Li) Department of Rehabilitation Medicine,
The Second Hospital of Lanzhou University, Gansu, Lanzhou, China
Publisher
Frontiers Media SA
Abstract
Objective: This study aims to systematically evaluate the potential
effects of transcutaneous electrical nerve stimulation (TENS) on analgesic
consumption, pain relief, and pulmonary function outcomes in patients
following coronary artery bypass grafting (CABG). <br/>Method(s): A
systematic literature search was conducted across four core
databases-PubMed, Embase, Web of Science, and the Cochrane Library.
Methodological quality was evaluated using the Cochrane Risk of Bias (RoB
2.0) tool, and the certainty of evidence was evaluated using the GRADE
system. For statistical analysis, standardized mean differences (SMDs)
with 95% confidence intervals (CIs) were calculated for continuous
variables. Heterogeneity was assessed via the I² statistic
(threshold: 50%), with fixed-effects models applied when I² <=
50% or random-effects models applied when I² > 50%. Subgroup
analyses stratified by intervention duration were performed for outcomes
demonstrating significant heterogeneity (I2 >= 50%). <br/>Result(s):
First, regarding pain management, TENS demonstrated greater efficacy in
postoperative acute pain at rest (within 12 h) than control interventions
(SMD = -1.02, 95% CI: -0.23-2.28; P = 0.11), albeit with high
heterogeneity (I² = 88.50%). Postoperative chronic pain at rest
(5 days) was more pronounced (SMD = -2.00, 95% CI: -4.15-0.15; P = 0.07).
Second, in terms of pulmonary recovery, TENS significantly improved forced
expiratory volume within 1 s (FEV<inf>1</inf>: SMD = 0.85, 95% CI:
0.43-1.26; P = 0.00) but not forced vital capacity (FVC: SMD = -1.02, 95%
CI: -0.23-2.28; P = 0.11), with heterogeneity levels of 54.00% and 88.50%,
respectively. Third, regarding analgesic use, TENS reduced postoperative
opioid consumption (SMD = -4.23, 95% CI: -7.31 to -1.15; P = 0.007),
although heterogeneity remained high (I² = 96.20%).
<br/>Conclusion(s): The current evidence preliminarily suggests that TENS
may reduce postoperative analgesic dependence and modestly improve
pulmonary function in patients following CABG; however, it has not
demonstrated a statistically significant advantage in pain relief. Given
the substantial heterogeneity across studies, these findings should be
interpreted with caution. Future large-scale RCTs with standardized
protocols are needed to validate these findings. Systematic Review
Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024594786,
PROSPERO CRD42024594786.<br/>Copyright 2026 Zhang, Kang, Liu, Wang, Wan
and Li.

<124>
Accession Number
650300465
Title
Clinical Profile of Perioperative Stroke in Patients Undergoing CABG
Procedure in A Tertiary Cardiac Care Centre.
Source
Annals of Indian Academy of Neurology. Conference: 32nd Annual Conference
of the Indian Academy of Neurology. Varanasi India. 29(Supplement 1) (pp
S183), 2026. Date of Publication: 01 Jan 2026.
Author
Ramachandraiah K.; Huded V.; Rangarajan A.
Institution
(Ramachandraiah) Apollo Hospitals Bengaluru, Karnataka, India
(Huded, Rangarajan) Narayana Health City, Karnataka, Bengaluru, India
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background and aim: Perioperative stroke, a devastating and potentially
life-threatening complication, remains a significant concern in the field
of heart surgery. Approximately 40% of strokes occur intraoperatively and
most of the remaining strokes occur during the first 48 hours
postoperatively. In 2016, systematic review and meta-analysis published in
the Journal of Cardiothoracic Surgery, the authors reported a pooled
incidence of perioperative stroke of 2.2%, with a range of 0.2% to 7.2%.
Defining the characteristics of the modifiable risk factors will provide
more knowledge about the clinical and radiological profile in
perioperative stroke subjects. The findings from this study will serve as
a valuable resource for further investigations and interventions targeting
the prevention and management of perioperative stroke. The aim and
objectives of the study is to study the clinical profile of perioperative
stroke in patients undergoing coronary artery bypass grafting (CABG)
procedure. Methodology: This is a descriptive study which includes
retrospective and prospective analysis between January 2021 and December
2022. <br/>Result(s): The incidence of perioperative stroke in CABG
procedure was 0.68%. About 60% of the triple vessel disease (TVD) patient
had carotid artery stenosis including common carotid artery (CCA) and
internal carotid artery (ICA). Maximum number of the perioperative stroke
cases was noted during the first 48 hrs. About 1/3rd of the perioperative
stroke was due to large artery atherosclerosis representing watershed
infarcts in imaging. <br/>Discussion(s): The present study describes the
clinical characteristics of perioperative stroke in CABG patients. Stroke
is one of the dreadful complications during or post-surgery leading to
prolonged hospital stay, morbidity and mortality. During the study period
between January2021 to December 2022, which was conducted in Narayana
health city, a total of 42 confirmed cases of perioperative stroke
patients were included. <br/>Conclusion(s): Perioperative stroke in this
study could be due to intraoperative handling of aorta, prior aortic arch
disease, and co-existing untreated carotid. A careful assessment reduces
the risk of perioperative stroke.

<125>
Accession Number
650287099
Title
Impaired Cognitive Domains in Surgical Patients: A Systematic Review and
Meta-Analysis.
Source
Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 16
Feb 2026.
Author
Park S.; Yan E.; Martinez-Rodriguez R.; Desai B.; Chung J.; Saripella A.;
Englesakis M.; Fishman K.N.; Chung F.
Institution
(Park, Martinez-Rodriguez, Desai, Chung) From the Temerty Faculty of
Medicine, University of Toronto, Toronto, ON, Canada
(Yan, Saripella, Chung) Department of Anesthesia and Pain Medicine,
Krembil Research Institute, University of Toronto, Toronto Western
Hospital ,University Health Network, Toronto, ON, Canada
(Yan, Chung) Institute of Medical Science, Temerty Faculty of Medicine,
University of Toronto, Toronto, ON, Canada
(Englesakis) Library & Information Services, University Health Network,
Toronto, ON, Canada
(Fishman) Neuropsychology & Cognitive Health, Baycrest Hospital, Toronto,
ON, Canada
(Fishman) Ontario Shores Centre for Mental Health Sciences, Whitby, ON,
Canada
Abstract
BACKGROUND: Cognitive impairment is a highly prevalent but frequently
overlooked issue among surgical patients preoperatively. This systematic
review and meta-analysis aimed to (1) determine the perioperative
prevalence of impaired cognitive domains in surgical patients, (2) explore
perioperative changes in the different domains, and (3) examine
postoperative outcomes associated with preoperatively impaired cognitive
domains. <br/>METHOD(S): Five electronic databases were searched from
inception to March 19, 2024. Inclusion criteria were (1) surgical patients
>=18 years of age; (2) preoperative cognitive assessments using a
neuropsychological battery; (3) reported the prevalence of impairment in
specific cognitive domains or changes perioperatively; and (4) sample size
of >=100 surgical patients. The exclusion criteria included studies
involving neurological surgery; cross-sectional, case-control, and case
series studies; non-English articles; and studies with overlapping data.
<br/>RESULT(S): In total, of the 12,082 articles identified from 5
databases, 21 studies (5725 patients, 11 non-cardiac surgery studies, and
10 cardiac surgery studies) were included. Among the 6 cognitive domains
assessed preoperatively, the pooled prevalence of impairment was highest
in executive function (18%; 95% CI, 13%-24%), visuospatial function (16%;
95% CI, 6%-26%), and attention/working memory/processing speed (14%; 95%
CI, 9%-18%). Perceptual-motor control (13%; 95% CI, 9%-36%), language
(13%; 95% CI, 8%-17%), and learning/memory (12%; 95% CI, 8%-16%) had lower
pooled prevalence. The cognitive domains that were assessed
postoperatively showed a high prevalence of impairment at 1 week, with 35%
(95% CI, 4%-66%) in attention/working memory/processing speed, 34% (95%
CI, 16%-51%) in executive function, and 28% (95% CI, 16%-40%) in
learning/memory. The pooled prevalence subsequently decreased within 3
months to 16% (95% CI, 3%-35%) in attention/working memory/processing
speed, 15% (95% CI, 6%-24%) in executive function, and 12% (95% CI, -2% to
25%) in learning/memory. <br/>CONCLUSION(S): The prevalence of
preoperatively impaired cognitive domains was the highest in executive
function, followed by visuospatial function and attention/working
memory/processing speed. Identifying commonly impaired cognitive domains
may help optimize cognitive assessments in the perioperative setting.
Further research is needed to clarify the clinical utility of assessing
specific cognitive domains in surgical populations to improve
postoperative outcomes and reduce cognitive deterioration.<br/>Copyright
&#xa9; 2026 International Anesthesia Research Society.

<126>
Accession Number
650297800
Title
Impact of obicetrapib on major adverse cardiovascular events: a pooled
analysis of phase 3 clinical trials.
Source
Postgraduate Medicine. Conference: Cardiometabolic Health Congress Annual
Conference, CMHC 2025. Boston, MA United States. 138(Supplement 1) (pp
14-15), 2026. Date of Publication: 2026.
Author
Nicholls S.J.; Nelson A.J.; Ray K.K.; Ditmarsch M.; Kling D.; Hsieh A.;
Szarek M.; Kastelein J.J.P.; Davidson M.H.
Institution
(Nicholls, Nelson) Victorian Heart Institute, Monash University, Clayton,
Australia
(Ray) Imperial College London, London, United Kingdom
(Ditmarsch, Kling, Hsieh, Kastelein) NewAmsterdam Pharma, Amsterdam,
Netherlands
(Szarek, Davidson) State University of New York Downstate, School of
Public Health, Brooklyn, NY, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: The highly selective cholesteryl ester transfer protein
inhibitor, obicetrapib, decreases levels of low-density lipoprotein
cholesterol (LDL-C) and lipoprotein(a) [Lp(a)] and raises high-density
lipoprotein cholesterol (HDL-C) in patients treated with maximally
tolerated statin therapy as evident within the Phase III BROOKLYN
(NCT05425745) trial assessing the effects of daily administration of
obicetrapib 10 mg compared with matching placebo (2:1) for 365 days on
changes in lipid and lipoprotein parameters in 364 patients with
heterozygous familial hypercholesterolemia (HeFH)) and in the Phase III
BROADWAY (NCT05142722) trial involving 2530 patients with atherosclerotic
cardiovascular disease (ASCVD) with or without HeFH. <br/>Purpose(s):
Since the effect of obicetrapib on cardiovascular events is unknown, a
pooled analysis of both BROOKLYN and BROADWAY trials was conducted.
<br/>Method(s): The time to first occurrence of major adverse
cardiovascular events was compared between the treatment groups in a
pooled analysis of both trials in an analysis that included stratification
by the presence of HeFH, statin intensity at baseline and study.
<br/>Result(s): The pooled cohort had a median age of 66 years, 36% were
female with a history of ASCVD in 82%, HeFH in 27% and diabetes in 35%.
Baseline medication use included statins in 91%, high-intensity statins in
69%, ezetimibe in 30% and PCSK9 inhibitors in 5%. Median baseline lipid
levels included LDL-C of 92 mg/dL, HDL-C of 48 mg/dL, apoB of 87 mg/dL and
Lp(a) of 40.5 nmol/L. Treatment with obicetrapib produced greater
reductions in LDL-C (-37.8% vs -4.6%), apoB (-21.7% vs -3.6%) and Lp(a)
(-32.5% vs 0%) and greater increases in HDL-C (+140.0% vs +1.5%) compared
with placebo. The incidence of the composite of coronary heart disease
death, myocardial infarction, ischemic stroke or coronary
revascularization was lower in the obicetrapib group (3.9% vs 5.0%, HR
(95% CI) 0.77 (0.54, 1.11), P=0.16). A time-based analysis revealed no
effect of obicetrapib in the first 6 months (HR (95% CI) 1.03 (0.59,
1.78), P=0.92) and a reduction in risk in the second 6 months (HR (95% CI)
0.60 (0.37, 0.99), P=0.04). The incidence of the composite of coronary
heart disease death, myocardial infarction or coronary revascularization
was lower in the obicetrapib group (3.2% vs 4.7%, HR (95% CI) 0.68 (0.46,
1.00), P=0.048). A time-based analysis revealed no effect of obicetrapib
in the first 6 months (HR (95% CI) 1.06 (0.60, 1.90), P=0.83) and a
reduction in risk in the second 6 months (HR (95% CI) 0.45 (0.26, 0.77),
P=0.003). Mediation analysis will investigate whether changes in LDL-C,
apoB, Lp(a) and HDL-C contribute to the reduction in cardiovascular
events. <br/>Conclusion(s): Treatment of high cardiovascular risk patients
with obicetrapib resulted in a decrease in LDLC, apoB and Lp(a), increase
in HDL-C and a reduction in coronary events, which became evident beyond 6
months of treatment. This highlights the potential for obicetrapib to be a
useful adjunctive therapy to lower cardiovascular risk.

<127>
Accession Number
2043568929
Title
Five-Year Quality of Life Outcome From a Randomized Controlled Trial
Comparing Aortic Valve Replacement Through Upper Hemisternotomy and Full
Median Sternotomy.
Source
European Journal of Cardio-thoracic Surgery. 68(2) (no pagination), 2026.
Article Number: ezag077. Date of Publication: 01 Feb 2026.
Author
Van Putten S.E.; Klop I.D.G.; Nieuwkerk P.T.; Friguech B.; Kloppenburg
G.T.L.; Klautz R.J.M.; Van Putte B.P.; Klein P.
Institution
(Van Putten, Klop, Friguech, Kloppenburg, Van Putte, Klein) Department of
Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
(Van Putten, Klautz, Van Putte, Klein) Department of Cardiothoracic
Surgery, Amsterdam University Medical Centre, Amsterdam, Netherlands
(Nieuwkerk) Department of Medical Psychology, Amsterdam University Medical
Centre, Amsterdam, Netherlands
(Nieuwkerk) Amsterdam Public Health, Amsterdam University Medical Centre,
Amsterdam, Netherlands
(Nieuwkerk) Amsterdam Institute for Immunology and Infectious Diseases,
Amsterdam, Netherlands
(Klautz) Department of Cardiothoracic Surgery, Leiden University Medical
Centre, Leiden, Netherlands
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
Objectives: The impact of minimally invasive surgical aortic valve
replacement (SAVR) on long-term quality of life (QoL) is uncertain. This
randomized controlled trial compared QoL 5 years after SAVR through upper
hemisternotomy (UHS) or full median sternotomy. <br/>Method(s): Patients
undergoing SAVR were randomized to UHS or full median sternotomy. The
primary outcome was postoperative cardiac-specific QoL during 5 years,
assessed by the Kansas City Cardiomyopathy Questionnaire physical
limitations domain. Secondary outcomes include survival, other QoL
domains, and factors associated with declined QoL between 1 and 5 years.
<br/>Result(s): Surgical aortic valve replacement via UHS resulted in
better QoL as indicated by more favourable physical limitation and total
symptoms scores (estimated mean difference [95% confidence interval] -1.89
[-2.93 to -0.85; P-value <=.001] and 2.96 [-4.71 to -1.22; P-value=.016],
respectively). Quality of life improvement persisted for 5 years, despite
a decline after 1 year postoperative. Age and valve size smaller than or
equal to 21 were independent predictors of decline in physical
functioning, while full median sternotomy independently predicted declined
total symptoms score. Five-year survival was 91.9% and similar between
approaches (P-value=.417). <br/>Conclusion(s): Minimally invasive SAVR was
associated with a modest but statistically significant improvement in
cardiac-specific QoL over 5 years compared to median sternotomy, driven by
earlier recovery, with comparable outcomes at 5 years. Full median
sternotomy independently predicted decline in QoL demonstrated by
decreased total symptom scores.<br/>Copyright &#xa9; The Author(s) 2026.
Published by Oxford University Press on behalf of the European Association
for Cardio-Thoracic Surgery.

<128>
Accession Number
2043717395
Title
Evaluation of the Effect of Intravenous Lidocaine on the Systemic
Inflammatory Response Associated With Cardiopulmonary Bypass in Valvular
and/or Coronary Cardiac Surgery: Protocol for a Double-Blind Randomized
Clinical Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Fernandez-Martinez A.; Lopez Picado A.; Gonzalez-Garcia J.; Aguado Sevilla
M.; Lobato Solores F.; Castroviejo Ibanez B.; de Miguel Fernandez P.;
Benito Martinez P.; Valero Gonzalez S.; Galve Marques A.I.; Mainar Gil I.;
Boukichou Abdelkader N.; Iniguez Martinez M.; Bermejo Bravo A.; Apinaniz
Apinaniz R.; Corral Cardenas E.; Ferreira Laso L.
Institution
(Fernandez-Martinez) Faculty of Medicine, University of the Basque
Country, Bizkaia, Leioa, Spain
(Fernandez-Martinez, Aguado Sevilla, Lobato Solores, Castroviejo Ibanez,
de Miguel Fernandez, Benito Martinez, Valero Gonzalez, Galve Marques,
Ferreira Laso) Anaesthesiology, Resuscitation and Pain Management,
Hospital Universitario San Pedro, Logrono, Spain
(Lopez Picado) Department of Public Health and Preventive Medicine,
University of the Basque Country, Bilbao, Spain
(Gonzalez-Garcia) Department of Surgery, Radiology and Physical Medicine,
University of the Basque Country, Bilbao, Spain
(Gonzalez-Garcia) Anaesthesiology, Resuscitation and Pain Management,
Hospital Universitario de Basurto, Bilbao, Spain
(Mainar Gil) Intensive Care Medicine, Hospital Universitario San Pedro,
Logrono, Spain
(Boukichou Abdelkader) Department of Statistics, Data Science Unit, La
Rioja Biomedical Research Center (CIBIR), Logrono, Spain
(Iniguez Martinez) Department of Infectious Diseases, La Rioja Biomedical
Research Center (CIBIR), Logrono, Spain
(Bermejo Bravo, Apinaniz Apinaniz) Hospital Pharmacy, Hospital
Universitario San Pedro, Logrono, Spain
(Corral Cardenas) Hospital Universitario San Pedro, Logrono, Spain
Publisher
W.B. Saunders
Abstract
Objectives: To assess whether intravenous lidocaine reduces the systemic
inflammatory response associated with cardiopulmonary bypass (CPB) and
improves clinical outcomes in adult patients undergoing elective valvular
and/or coronary cardiac surgery. <br/>Design(s): Single-center,
parallel-group, double-blind, randomized clinical trial. <br/>Setting(s):
San Pedro University Hospital, Logrono, Spain. <br/>Participant(s): Ninety
adult patients (>=18 years) scheduled for elective valvular and/or
coronary surgery with CPB who provide informed consent.
<br/>Intervention(s): Patients will be randomly assigned to receive either
intravenous lidocaine (1.5-mg/kg bolus followed by 1.5-mg/kg/h infusion
until sternal closure) or an equivalent volume of saline solution as
placebo. For patients with a body mass index greater than 30 kg/m2, the
infusion dose will be adjusted according to ideal body weight, calculated
as height (in centimeters) - 100 for men and height (in centimeters) - 110
for women. <br/>Measurements and Main Results: The primary outcome is the
interleukin 6 level at 6 hours postoperatively. Secondary outcomes include
trajectories of inflammatory and myocardial injury biomarkers (C-reactive
protein, high-sensitivity troponin T, and tumor necrosis factor alpha),
postoperative complications related to the systemic inflammatory response
(acute kidney injury, transfusion requirements, vasoplegia, respiratory
dysfunction, delirium, infection, and multiorgan dysfunction),
postoperative pain, intensive care unit length of stay, 30-day mortality,
and incidence of post-CPB atrial fibrillation. The analysis will be
conducted on an intention-to-treat basis. <br/>Conclusion(s): This trial
will determine whether intravenous lidocaine attenuates the systemic
inflammatory response induced by CPB and improves clinical outcomes in
adult patients undergoing elective cardiac surgery.<br/>Copyright &#xa9;
2026 The Author(s)

<129>
Accession Number
2043575202
Title
Postcardiac Injury Syndrome After Cardiac Surgery: An Evidence-Based
Review.
Source
Cardiology in Review. 34(1) (pp 19-23), 2026. Date of Publication: 01 Feb
2026.
Author
Tahir M.H.; Sohail S.; Shahid D.; Hussain I.; Malik J.; Iqra S.; Faraz M.
Institution
(Tahir, Sohail, Shahid, Hussain, Malik, Iqra, Faraz) From the Department
of Cardiovascular Medicine, Cardiovascular Analytics Group, Islamabad,
Pakistan
Publisher
Lippincott Williams and Wilkins
Abstract
Postcardiac injury syndrome (PCIS) serves as a comprehensive term
encompassing a spectrum of conditions, namely postpericardiotomy syndrome,
postmyocardial infarction (MI) related pericarditis (Dressler syndrome),
and post-traumatic pericarditis stemming from procedures like percutaneous
coronary intervention or cardiac implantable electronic device placement.
These conditions collectively give rise to PCIS, triggered by cardiac
injury affecting pericardial or pleural mesothelial cells, leading to
subsequent inflammation syndromes spanning from uncomplicated pericarditis
to substantial pleural effusion. A thorough literature search conducted on
MEDLINE/PubMed utilizing search terms including "postacute cardiac injury
syndrome, " "postcardiac injury syndrome, " "postcardiotomy syndrome, "
"postpericardiotomy syndrome, " and "post-MI pericarditis" was
instrumental in collating pertinent studies. To encapsulate the amassed
evidence, relevant full-text materials were meticulously selected and
amalgamated narratively. The pathophysiology of PCIS is proposed to
manifest through an autoimmune-mediated process, particularly in
predisposed individuals. This process involves the development of
anti-actin and antimyosin antibodies after a cascade of cardiac injuries
in diverse forms. Treatment strategies aimed at preventing recurrent PCIS
episodes have shown efficacy, with colchicine and nonsteroidal
anti-inflammatory drugs, including ibuprofen, demonstrating positive
outcomes. Conversely, corticosteroids have exhibited no discernible
benefit concerning prognosis or recurrence rates for this ailment. In
summary, PCIS serves as a unifying term encompassing a spectrum of cardiac
injury-related syndromes. A comprehensive review of relevant literature
underscores the autoimmune-mediated pathophysiology in susceptible
individuals. The therapeutic landscape involves the proficient use of
colchicine and Nonsteroidal anti-inflammatory drugs to deter recurrent
PCIS episodes, while corticosteroids do not appear to contribute to
improved prognosis or reduced recurrence rates. This nuanced understanding
contributes to an enhanced comprehension of PCIS and its multifaceted
clinical manifestations, potentially refining its diagnosis and
management.<br/>Copyright &#xa9; 2024

<130>
Accession Number
2043319148
Title
The Society of Thoracic Surgeons (2025) Expert Consensus Document on
Interventions for Screen-Detected Lung Nodules.
Source
Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Servais E.L.; Hayanga J.W.A.; Linden P.; Sood P.; Raymond D.P.; Antonoff
M.B.; Chudgar N.P.; Keshava H.B.; Velotta J.B.; Crabtree T.; Jeffrey Yang
C.-F.; Raz D.; Tong B.; Cooke D.T.; Erkmen C.P.; Shaller B.; Kent M.S.;
McKee A.; Phan C.T.; Daly M.E.; Onaitis M.W.; Edwards J.P.; Yang S.C.;
Merritt R.E.; Shrager J.
Institution
(Servais) Department of Thoracic Surgery, Lahey Hospital and Medical
Center, Burlington, MA, United States
(Servais) Department of Surgery, UMass Chan Medical School, Worcester, MA,
United States
(Hayanga) Department of Cardiovascular and Thoracic Surgery, Heart and
Vascular Institute, West Virginia University Medicine, Morgantown, WV,
United States
(Linden) Division of Thoracic and Esophageal Surgery, University Hospitals
Cleveland Medical Center, Cleveland, OH, United States
(Sood) The Society of Thoracic Surgeons, Chicago, IL, United States
(Raymond) Department of Thoracic and Cardiovascular Surgery, Cleveland
Clinic, Cleveland, OH, United States
(Antonoff) Division of Surgery, Department of Thoracic and Cardiovascular
Surgery, University of Texas MD Anderson Cancer Center, Houston, TX,
United States
(Chudgar) Department of Cardiothoracic and Vascular Surgery, Montefiore
Medical Center/Albert Einstein College of Medicine, New York, NY, United
States
(Keshava) Division of Thoracic Surgery, Department of Surgery, University
of California, Irvine, Irvine, CA, United States
(Velotta) Divison of Thoracic Surgery, Kaiser Permanente, Oakland, CA,
United States
(Velotta) Department of Surgery, University of California, San Francisco
School of Medicine, San Francisco, CA, United States
(Velotta) Department of Clinical Science, Kaiser Permanente Bernard J.
Tyson School of Medicine, Pasadena, CA, United States
(Crabtree) Division of Cardiothoracic Surgery, Southern Illinois
University Medical Center, Springfield, IL, United States
(Jeffrey Yang) Division of Thoracic Surgery, Department of Surgery,
Massachusetts General Hospital, Boston, MA, United States
(Raz) Division of Thoracic Surgery, City of Hope, Duarte, CA, United
States
(Tong) Division of Thoracic Surgery, Department of Surgery, Duke
University Medical Center, Durham, NC, United States
(Cooke) Division of General Thoracic Surgery, University of California,
Davis Health, Sacramento, CA, United States
(Erkmen) Division of Surgery, Lewis Katz School of Medicine at Temple
University, Philadelphia, PA, United States
(Shaller) Division of Pulmonary, Allergy and Critical Care Medicine,
Stanford University School of Medicine, Stanford, CA, United States
(Kent) Division of Thoracic Surgery and Interventional Pulmonology, Beth
Israel Deaconess Medical Center, Harvard Medical School, Boston, MA,
United States
(McKee) Department of Radiation Oncology, Lahey Hospital and Medical
Center, Burlington, MA, United States
(Phan) Division of Pulmonary, Critical Care and Sleep Medicine, University
of California, Davis Health, Sacramento, CA, United States
(Daly) Department of Radiation Oncology, University of California, Davis
Comprehensive Cancer Center, Sacramento, CA, United States
(Onaitis) Department of Surgery, University of California, La Jolla, San
Diego, CA, United States
(Edwards) Section of Thoracic Surgery, Department of Surgery, University
of Calgary, Calgary, AB, Canada
(Yang) Division of Thoracic Surgery, Department of Surgery, The Johns
Hopkins Medical Institutions, Baltimore, MD, United States
(Merritt) Division of Thoracic Surgery, The Ohio State Wexner Medical
Center, Columbus, OH, United States
(Shrager) Division of Thoracic Surgery, Department of Cardiothoracic
Surgery, Stanford University School of Medicine, Stanford, CA, United
States
(Shrager) Veterans Affairs Palo Alto Health Care Center, Palo Alto, CA,
United States
Publisher
Elsevier Inc.
Abstract
Background Computed tomographic (CT) lung cancer screening (LCS) reduces
lung cancer-specific mortality and improves survival. We reviewed
contemporary literature to develop consensus recommendations on
perioperative quality standards for LCS programs to optimize outcomes.
Methods The Society of Thoracic Surgeons (STS) Task Force on Lung Cancer
Screening and STS Workforce on Evidence Based Surgery convened a
multidisciplinary panel of thoracic surgeons, radiation oncologists, and
interventional pulmonologists. A comprehensive literature review was
conducted using the PICO (Population, Intervention, Comparisons, Outcome)
framework. Consensus statements were developed through a modified Delphi
process addressing: (1) preoperative biopsy and diagnostic surgical
procedures, (2) acceptable rates of complications from diagnostic and
therapeutic procedures, and (3) timing of intervention after a suspicious
LCS finding, and the role of the multidisciplinary team in patient
management. Consensus required >=75% agreement. Results The panel
developed 23 consensus statements after 3 Delphi rounds; 20 achieved
consensus in the first round. Surgery without tissue diagnosis was
acceptable for carefully selected patients, favoring minimally invasive,
parenchymal-sparing approaches. Pneumonectomy without diagnosis was
unanimously rejected. Programs should track benign resection rates.
Acceptable complication benchmarks included pneumothorax <5%, hemoptysis
<2%, and mortality <1% for bronchoscopic biopsy; and surgical morbidity
<10% and 30-day mortality <1%, per STS database standards. Definitive
resection should occur within 12 weeks of the inciting imaging study.
Multidisciplinary teams should include thoracic surgery, oncology,
pulmonology, and radiology. Preoperative pulmonary rehabilitation and
smoking cessation were emphasized. Conclusions This STS consensus defines
perioperative quality standards for CT LCS programs, supporting shared
decision-making, multidisciplinary care, and quality
improvement.<br/>Copyright &#xa9; 2026 The Society of Thoracic Surgeons.

<131>
Accession Number
2043375593
Title
Incidence and risk factors of hypoxemia after general anesthesia in
children undergoing non-cardiac surgery: a systematic review and
meta-analysis.
Source
Pediatric Surgery International. 42(1) (no pagination), 2026. Article
Number: 105. Date of Publication: 01 Dec 2026.
Author
Zhang D.; Yu X.; Cui Y.
Institution
(Zhang, Cui) Department of Anesthesiology, School of Medicine, Chengdu
Women's and Children's Central Hospital, University of Electronic Science
and Technology of China, Sichuan, Chengdu, China
(Yu) Department of Clinical Laboratory, School of Medicine, Chengdu
Women's and Children's Central Hospital, University of Electronic Science
and Technology of China, Sichuan, Chengdu, China
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Postoperative hypoxemia is a critical complication in
pediatric (<= 18 years) patients undergoing non-cardiac surgeries with
endotracheal intubation, which will potentially lead to poorer outcomes.
Despite its clinical significance, systematic approaches to ascertain
prevalence and risk factors are lacking. Thus, our study aims to conduct a
systematic review and meta-analysis to assess the prevalence of
postoperative hypoxemia in pediatric patients following endotracheal
intubation for non-cardiac procedures and to identify associated risk
factors. <br/>Method(s): A comprehensive search of PubMed, Ovid, Embase,
Web of Science, and Cochrane Library was conducted from inception to
November 30, 2024, using terms related to children, postoperative, and
hypoxemia. Observational and interventional studies reporting
postoperative hypoxemia in pediatric patients undergoing non-cardiac
surgeries with endotracheal intubation were included. Two reviewers
independently extracted data. Random-effects meta-analysis estimated
pooled prevalence. Subgroup analyses examined age, publication year, and
geographic region. Meta-regression examined surgical types. The primary
outcome was the overall incidence of postoperative hypoxemia. The
secondary outcomes were the risk factors related to postoperative
hypoxemia. <br/>Result(s): A total of 37 studies involving 14,597 patients
were identified. The pooled prevalence of postoperative hypoxemia was
10.1% (95% CI: 0.066-0.142). Infants (< 1 year) had a higher prevalence
than older children (17.5% vs. 7.4%; p = 0.025). Studies published before
2010 reported higher rates (15.4-20.6%) than post-2010 studies (5.5-6.7%).
No significant variations were observed across World Health Organization
regions, World Bank income classifications or surgical types.
<br/>Conclusion(s): This study provides a global estimation of
postoperative hypoxemia prevalence in pediatric patients undergoing
non-cardiac surgeries with endotracheal intubation. Standardizing the
definition of hypoxemia in future research is crucial to enhance
comparability and clinical relevance. Trial registration: The review
protocol was registered in advance with PROSPERO (ID CRD42025631572), date
of registration: Dec 26 2024.<br/>Copyright &#xa9; The Author(s), under
exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature
2026.

<132>
Accession Number
2043683917
Title
Preventive effect of liraglutide on postoperative delirium in elderly
patients undergoing cardiac surgery: protocol for a single-centre,
randomised, double-blind, placebo-controlled trial.
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e110759. Date of
Publication: 15 Feb 2026.
Author
Bai S.; Wei M.; Wu Y.; Zhu X.; Wang Z.; Wang Y.; Zhu C.; Guan Y.; Wang D.;
Liu W.
Institution
(Bai, Wang, Wang, Zhu, Guan, Wang, Liu) Department of Cardio-Thoracic
Surgery, Nanjing Drum Tower Hospital, Nanjing University Medical School,
Nanjing, China
(Wei, Wu) Department of Cardio-Thoracic Surgery, Drum Tower Clinical
College, Nanjing University of Chinese Medicine, Nanjing, China
(Zhu) Department of Anesthesiology, Nanjing University Medical School,
Nanjing Drum Tower Hospital, Nanjing, China
Publisher
BMJ Publishing Group
Abstract
Introduction Postoperative delirium (POD) is a common and serious
complication after cardiac surgery, particularly in elderly patients, and
is associated with adverse short- and long-term outcomes. Effective
preventive strategies remain limited. Liraglutide, a glucagon-like
peptide-1 receptor agonist, has demonstrated potential neuroprotective,
anti-inflammatory and metabolic benefits, which may reduce the incidence
of POD. Methods and analysis This is a single-centre, randomised,
double-blind, placebo-controlled trial in elderly patients undergoing
elective cardiac surgery. Participants will be randomised in a 1:1 ratio
to receive liraglutide or placebo from the day before surgery until
postoperative day 3. A total of 260 patients are planned to be enrolled in
this study. The primary endpoint is the incidence of POD within 7days,
assessed using the Confusion Assessment Method (CAM) or CAM-intensive care
unit. Secondary outcomes include delirium severity, neurocognitive and
psychological function, cardiac function, clinical outcomes, major adverse
cardiovascular events within 1 year and perioperative biomarker changes.
Exploratory outcomes include functional MRI in selected subgroups and
additional biomarker analyses. Ethics and dissemination The protocol has
been approved by the Medical Ethics Committee of Nanjing Drum Tower
Hospital. Written informed consent will be obtained from all participants.
Findings will be disseminated in peer-reviewed journals and academic
conferences.<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.

<133>
Accession Number
2043751781
Title
Dexmedetomidine vs. Magnesium Sulfate as Anesthetic Adjuvants in Spine
Surgery: Effects on Inflammatory Response, Hemodynamics, Recovery, and
Opioid Use in a Randomized Controlled Trial.
Source
Archives of Anesthesiology and Critical Care. 12(2) (pp 137-142), 2026.
Date of Publication: 2026.
Author
Pulubuhu S.J.; Husain A.A.A.; Hisbullah; Salahuddin A.; Adil A.; Wirawan
N.S.
Institution
(Pulubuhu, Husain, Hisbullah, Salahuddin, Adil, Wirawan) Department of
Anesthesiology and Intensive Care, Faculty of Medicine, Hasanuddin
University, Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia
Publisher
Tehran University of Medical Sciences
Abstract
Background: Non-cardiac surgery in patients with cardiovascular risk can
lead to Spine surgery often leads to significant postoperative pain,
inflammation, and hemodynamic instability, necessitating opioid use, which
increases the risk of side effects. Dexmedetomidine (DEX) and magnesium
sulfate (MgSO<inf>4)</inf> are anesthetic adjuvants that may enhance
recovery and reduce opioid consumption. This study aimed to compare the
effects of DEX and MgSO<inf>4</inf> as an anesthetic adjuvant on
interleukin-6 (IL-6) levels, hemodynamic stability, postoperative
recovery, and opioid consumption in spine surgery. <br/>Method(s): A
randomized controlled trial was performed on 24 patients undergoing spine
surgery under general anesthesia. Participants were randomly divided into
two groups: Group 1 received DEX (a 1 microg/kg bolus followed by a
continuous infusion of 0.3-0.5 microg/kg/h), while Group 2 was given
MgSO<inf>4</inf> (a 30-50 mg/kg bolus followed by an infusion of 10-20
mg/kg/h). Hemodynamic parameters, IL-6 levels (pre- and postoperatively),
opioid use, and recovery outcomes were analyzed. <br/>Result(s): IL-6
levels decreased significantly in both groups (p=0.001), with a greater
reduction in the DEX group (-60.5 pg/dL vs. -24.9 pg/dL), though not
statistically significant. Hemodynamic stability was comparable, but DEX
provided better pulse rate control. Opioid consumption was lower in the
DEX group at 24 and 48 hours postoperatively (p < 0.05). The DEX group
also showed higher Aldrete scores (p<0.05) and shorter hospital stays
(3.75 vs. 4.83 days, p<0.05). <br/>Conclusion(s): DEX provides superior
anti-inflammatory effects, hemodynamic stability, reduced opioid use, and
improved recovery compared to MgSO<inf>4</inf> as an anesthetic adjuvant
in spine surgery patients.<br/>Copyright &#xa9; 2026 Tehran University of
Medical Sciences.

<134>
Accession Number
2043561642
Title
Airway management in thoracic anesthesia in the light of the guidelines of
EACTAIC-thoracic group: what is next?.
Source
Current Opinion in Anaesthesiology. Publish Ahead of Print (no
pagination), 2026. Date of Publication: 2026.
Author
Granell Gil M.; Martinez Plumed R.
Institution
(Granell Gil, Martinez Plumed) Surgery Department, University of Valencia,
Consorcio Hospital General Universitario of Valencia, Valencia, Spain
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review - This article reviews the latest literature and
discusses future guidance on airway management in thoracic surgery. Recent
findings - It has been recommended for the preoperative assessment to use
validated scales such as the Airway Risk Index combined with tools for
predicting difficult lung isolation, especially in patients with chronic
obstructive pulmonary disease, endobronchial tumors, or tracheal
pathology. Preoperative imaging plays a crucial role in predicting and
planning lung isolation in thoracic anesthesia, with computed tomography
(e.g. three-dimensional reconstructions and virtual bronchoscopy) being
very useful for identifying airway abnormalities and guiding the selection
of appropriate lung isolation devices. One of the most reliable methods to
achieve lung collapse with a bronchial blocker is the apnea-disconnection
for improvate nonventilated lung collapse. Recent studies suggest that the
adoption of videolaryngoscopes in thoracic surgery procedures involving
double-lumen endotracheal intubation may enhance patient safety and
outcomes by reducing the incidence of malpositioned tubes. In addition,
the development of double-lumen tubes with integrated cameras enables
real-time visualization of tube positioning, a growing trend that may
partially replace conventional bronchoscopy. Summary - The field of airway
management is constantly evolving, with new technologies and techniques
emerging regularly, improving patient safety, reducing the risk of
complications, and enhancing surgical conditions.<br/>Copyright &#xa9;
2025

<135>
Accession Number
650260134
Title
Unintended Retained Surgical Items: A Systematic Review of 743 Cases.
Source
International journal for quality in health care : journal of the
International Society for Quality in Health Care. (no pagination), 2026.
Date of Publication: 16 Feb 2026.
Author
Park S.-H.; Cho Y.S.
Institution
(Park) School of Nusing, Soonchunhyang University, 22 Soonchunhyang-ro,
Shinchang-myeon, Asan, Chungnam, 31538, Republic of Korea Seong-Hi Park,
PhD.,, Tel: 82-41-530-4854; Fax: 82-41-570-2498
(Cho) Department of Nursing, Seoil University, 28 Yongmasan-ro 90-gil,
Jungnang-gu, Seoul, 02192, Republic of Korea Yoon Soo Cho, PhD., Tel:
82-2-490-7514; Fax: 82-2-490-7225
Abstract
BACKGROUND: Despite efforts to count and verify surgical items before skin
closure, retained surgical items (RSIs) continue to be reported in
hospital settings. This study systematically analyzed both the impact and
characteristics of RSI on patients by reviewing relevant studies published
since 2000. <br/>METHOD(S): MEDLINE, EMBASE, and CINAHL databases were
searched. Case reports or case studies reporting items unintentionally
left inside the patient's body during invasive procedures were included.
Two reviewers independently extracted data and assessed study quality
using the Joanna Briggs Institute's Critical Appraisal Checklist for Case
Reports. <br/>RESULT(S): Data from 634 studies included 743 RSI cases
across 78 countries. Incidence was higher in women aged 20-49 than in men.
RSI occurred across all age groups and surgical sites, with cesarean
section, cholecystectomy, hysterectomy, coronary bypass, and appendectomy
accounting for 34.6% of cases. The time to discovery of RSI was 24.3
months (median), with 22.6% of cases taking over 10 years. Most patients
(60.0% except not reported) initially presented to another hospital, with
pain (54.9%) as the primary complaint; symptom duration was 4.1 months
(median). Computed tomography was the most frequently used diagnostic
method (40.3%), and RSI was confirmed prior to re-surgery in only 24.9% of
patients. Surgical intervention was performed in 90.8% of cases, although
some patients either declined surgery or did not receive treatment. Most
types of RSI (92.0%) involved surgical items subjected to counting. While
56.3% of patients recovered well, 2.6% died. The hospital stay after
surgery was 5 days (median). <br/>CONCLUSION(S): RSI is a socially
unacceptable never event, but it continues to occur worldwide. The
symptoms are often common and nonspecific, making diagnosis difficult
without clear information about prior surgeries. This review highlights
the ongoing problem of RSIs and emphasizes that preventing them requires
multiple technical measures and a strong culture of surgical
safety.<br/>Copyright &#xa9; The Author(s) 2026. Published by Oxford
University Press on behalf of International Society for Quality in Health
Care. All rights reserved. For commercial re-use, please contact
reprints@oup.com for reprints and translation rights for reprints. All
other permissions can be obtained through our RightsLink service via the
Permissions link on the article page on our site-for further information

<136>
Accession Number
650259130
Title
Fibrinolysis versus Urgent Surgery in Obstructive Prosthetic Valve
Thrombosis: Updated Evidence from a Systematic Review and Meta-Analysis.
Source
Journal of thrombosis and haemostasis : JTH. (no pagination), 2026. Date
of Publication: 13 Feb 2026.
Author
Resende B.; Mata E.; Castro M.; Pinto A.M.; Ribeiro S.; Gameiro J.;
Lourenco A.; Ferraz-Costa G.; Goncalves L.
Institution
(Resende) Servico de Cardiologia, Unidade Local de Saude de Coimbra,
Coimbra, Portugal
(Mata, Castro, Pinto, Ribeiro) Servico de Cardiologia, Unidade Local de
Saude do Alto Ave, Guimaraes, Portugal
(Gameiro) Servico de Cardiologia, Unidade Local de Saude de Coimbra,
Coimbra, Portugal
(Lourenco) Servico de Cardiologia, Unidade Local de Saude do Alto Ave,
Guimaraes, Portugal
(Ferraz-Costa) Servico de Cardiologia, Unidade Local de Saude de Coimbra,
Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra,
Coimbra, Portugal. Electronic address: gnfcosta.93@gmail.com
(Goncalves) Servico de Cardiologia, Unidade Local de Saude de Coimbra,
Coimbra, Portugal; Faculdade de Medicina da Universidade de Coimbra,
Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research
(iCBR), Coimbra, Portugal. Electronic address: lgoncalv@ci.uc.pt
Abstract
BACKGROUND: Obstructive prosthetic valve thrombosis (PVT) is a
life-threatening complication. The first-line therapy remains uncertain.
While surgery has historically been preferred, advances in low-dose,
slow-infusion fibrinolysis protocols have improved outcomes.
<br/>METHOD(S): Following a systematic search of five databases, a
meta-analysis compared fibrinolysis with urgent valve surgery for
obstructive PVT. The primary outcomes were in-hospital all-cause mortality
and complete restoration of valve function. Secondary outcomes included
stroke, systemic embolism, major bleeding, recurrent PVT, and all-cause
mortality during follow-up. Data were pooled as risk ratio (RR) using
random-effects models, with sensitivity and meta-regression analyses.
<br/>RESULT(S): Across 12 observational studies and one randomized
controlled trial, 1300 patients (fibrinolysis/surgery: 714/586) were
included. No significant difference was observed in in-hospital mortality
(RR: 0.59 [0.27-1.30]; I2=57.1%). However, fibrinolysis was associated
with lower complete restoration of valve function (RR: 0.82 [0.70-0.96];
I2=71.6%) and higher risks of stroke (RR: 3.19 [1.30-7.85]; I2=0%),
systemic embolism (RR: 3.88 [1.44-10.4]; I2=0%), and recurrent PVT (RR:
2.44 [1.18-5.05]; I2=58.3%). No differences were found in major bleeding
or all-cause mortality during follow-up. Sensitivity analyses restricted
to alteplase-based regimens favored fibrinolysis, showing lower
in-hospital mortality (RR: 0.12 [0.05-0.29]; I2=0%), consistent with
meta-regression findings, and efficacy comparable to surgery.
<br/>CONCLUSION(S): Our study suggests that surgery offers higher
immediate success with fewer embolic or recurrent events. However,
contemporary alteplase protocols may be associated with improved safety
outcomes relative to surgery, with no apparent loss of efficacy. Given the
low certainty of available evidence, treatment should be individualized
according to patient risk profile, and institutional
resources.<br/>Copyright &#xa9; 2026 International Society on Thrombosis
and Haemostasis. Published by Elsevier Inc. All rights reserved.

<137>
Accession Number
2043240336
Title
High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac
Surgery: The ULTRA Randomized Controlled Trial.
Source
Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication:
2026.
Author
Bierer J.D.; Stanzel R.; Henderson M.; Krmpotic K.; Andreou P.; Marshall
J.S.; Sapp J.; Horne D.
Institution
(Bierer, Horne) Division of Cardiac Surgery, Dalhousie University,
Halifax, NS, Canada
(Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health
Authority, Halifax, NS, Canada
(Krmpotic) Department of Critical Care, Dalhousie University, Halifax, NS,
Canada
(Andreou) Department of Community Health & Epidemiology, Dalhousie
University, Halifax, NS, Canada
(Marshall) Department of Microbiology & Immunology, Dalhousie University,
Halifax, NS, Canada
(Sapp) Division of Cardiology, Dalhousie University, Halifax, NS, Canada
Publisher
Elsevier Inc.
Abstract
Background Pediatric cardiac surgery with cardiopulmonary bypass (CPB) is
associated with systemic inflammation. This trial aimed to determine
whether continuous high-exchange ultrafiltration during CPB has a clinical
immunomodulatory effect. Methods This single-center, double-blind trial
enrolled pediatric patients weighing <15 kg undergoing cardiac surgery who
were randomly allocated to continuous high-exchange subzero-balance
ultrafiltration (H-SBUF; 60 mL/kg per hour effluent extraction) or
continuous low-exchange subzero-balance ultrafiltration (L-SBUF; 6 mL/kg
per hour effluent extraction) administered during CPB. The primary outcome
was peak postoperative vasoactive-ventilation-renal (VVR) score. Secondary
outcomes included acute kidney injury, low cardiac output syndrome, health
care utilization, and inflammatory mediator fold change throughout CPB
(NCT04920643). Results A total of 104 patients were randomly allocated to
H-SBUF (n = 52) or L-SBUF (n = 52). The primary outcome was similar
between groups as the peak VVR score was 26.9 (2.1-77.9) in the H-SBUF
group and 27.8 (0.8-76.7) in the L-SBUF group ( P = .67). There were no
operative deaths and no significant differences in acute kidney injury,
low cardiac output syndrome, ventilation time, inotropic agent use time,
intensive care unit stay, or hospital length of stay ( P > .05). The
H-SBUF group had a higher fold change for interleukin-1alpha, P-selectin,
and vascular cell adhesion molecule 1 ( P < .05), whereas 36 other
mediators were not significantly different between groups ( P > .05).
Conclusions In pediatric patients undergoing cardiac surgery with CPB,
continuous high-exchange SBUF did not reduce peak VVR score compared with
low-exchange SBUF. Furthermore, there were no differences in secondary
clinical outcomes, and the immunologic profile was largely similar between
groups.<br/>Copyright &#xa9; 2026 The Authors.

<138>
Accession Number
650256625
Title
Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement
in Low-Risk Patients With Aortic Stenosis.
Source
Journal of the American College of Cardiology. (no pagination), 2026.
Date of Publication: 16 Feb 2026.
Author
Forrest J.K.; Yakubov S.J.; Deeb G.M.; Reardon M.J.
Institution
(Forrest) Yale University School of Medicine, New Haven, CT, United States
(Yakubov) OhioHealth Riverside Methodist Hospital, Columbus, OH, United
States
(Deeb) University of Michigan Health Systems University Hospital, Ann
Arbor, MI, United States
(Reardon) Houston Methodist-DeBakey Heart and Vascular Center, Houston,
TX, United States
Abstract
BACKGROUND: The Evolut Low Risk trial enrolled patients with severe aortic
stenosis at low surgical risk. Annual follow-up is planned for 10 years,
evaluating the composite of all-cause mortality or disabling stroke and
key secondary endpoints. <br/>OBJECTIVE(S): Our prespecified objective was
to report the 6-year clinical outcomes of transcatheter aortic valve
replacement (TAVR) vs surgery from the Evolut Low Risk trial. Given an
increase in reintervention rates at 6 years, we performed additional
analyses in available 7-year data. <br/>METHOD(S): Low-risk patients with
severe symptomatic aortic stenosis were randomized to TAVR or surgery from
2016-2019. Prespecified analyses at 6 years included annual follow-up of
clinical outcomes reported as Kaplan-Meier estimates with log-rank test.
Because the trial enrolled patients over several years, at the time of
data lock, a majority of patients had completed 7-year follow-up. Given an
increased reintervention rate at 6 years in the TAVR arm, we performed
additional analysis of 7-year data available at the time of the database
lock. Reintervention rates are reported as cumulative incidence.
<br/>RESULT(S): A total of 1,414 patients underwent an attempted
implantation (730 TAVR, 684 surgery). At 6 years, the composite endpoint
of all-cause mortality or disabling stroke was 23.3% for TAVR and 20.4%
for surgery (difference: 2.8% [95% CI: -1.9% to 7.6%]; P = 0.43).
All-cause mortality with vital status sweep at 6 years was 23.3% (95% CI:
20.6%-26.4%) for TAVR and 20.2% (95% CI: 17.4%-23.3%) for surgery (P =
0.24). The reintervention rate at 6 years was 5.5% for TAVR and 3.3% for
surgery (sHR: 1.66 [95% CI: 0.96-2.86]; P = 0.07). Using available 7-year
follow-up (555 TAVR and 480 surgery), the reintervention rate for TAVR was
9.8% and for surgery was 6.0% (sHR: 1.68 [95% CI: 1.10-2.58]; P = 0.02).
In the TAVR and surgery groups, the rate of reintervention for
regurgitation was 5.6% vs 1.6% (sHR: 3.39 [95% CI: 1.62-7.07]; P < 0.001)
and the rate of reintervention for stenosis was 3.6% vs 3.5% (sHR: 1.14
[95% CI: 0.61-2.15]; P = 0.70). <br/>CONCLUSION(S): The 6-year results
from the Evolut Low Risk trial show no significant difference in the
composite endpoint of all-cause mortality or disabling stroke. At 6 and 7
years, the TAVR arm had a higher reintervention rate compared with
surgery, driven by an increased incidence of aortic regurgitation.
(Medtronic Evolut Transcatheter Aortic Valve Replacement in Low Risk
Patients; NCT02701283).<br/>Copyright &#xa9; 2026 The Authors. Published
by Elsevier Inc. All rights reserved.

<139>
Accession Number
2043519327
Title
A Comparison of Two Vascular Closure Strategies in Transcatheter Aortic
Valve Replacement: Suture and Plug versus Suture Alone - A Systematic
Review and Meta-Analysis.
Source
Cardiology (Switzerland). (pp 1-12), 2026. Date of Publication: 2026.
Author
Megantara H.P.; Dakota I.; Taofan T.; Indriani S.; Aurora R.G.; Adiarto S.
Institution
(Megantara, Dakota, Taofan, Indriani, Aurora, Adiarto) Department of
Cardiology and Vascular Medicine, Faculty of Medicine Universitas
Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
(Megantara) Department of Medical Education Unit, Faculty of Medicine
Universitas Indonesia, Jakarta, Indonesia
Publisher
S. Karger AG
Abstract
Introduction: Vascular complications following transcatheter aortic valve
replacement (TAVR) significantly contribute to morbidity and mortality.
Conventional suture-based closure technique has been widely utilized for
large-bore arterial access closure. Recent findings on hybrid strategy
combining plug and suture-based devices has been on spotlight as it may
improve the hemostatic efficacy and lower the access-site related
complications and clinical outcomes. <br/>Method(s): We performed a
systematic review and meta-analysis of studies comparing a suture-based
approach with a hybrid closure strategy (suture+plug) in aortic stenosis
patients undergoing TAVR. Included studies were appraised following the
Cochrane Risk of Bias and Newcastle-Ottawa Scale tools. Forest plots were
extracted in Review Manager with a main outcome of pooled-risk ratio (RR).
The primary endpoint was the composite of access-site related vascular
complications as defined by Valve Academic Research Consortium criteria
whilst secondary end-points were in-hospital bleeding, closure device
failure, mortality, and unplanned endovascular or surgical intervention.
<br/>Result(s): Six eligible studies encompassing 2, 064 patients were
analyzed. Compared with suture-based closure, hybrid closure exhibited a
lower rate of vascular complications (pooled-RR 0.46; 95% confidence
interval [CI], 0.38-0.57; p < 0.001), closure device failure (pooled-RR
0.35; 95% CI, 0.13-0.96; p = 0.04), in-hospital bleeding events (pooled-RR
0.38; 95% CI, 0.26-0.55; p < 0.001), and mortality (pooled-RR 0.51; 95%
CI, 0.26-0.99; p = 0.049). Unplanned endovascular or surgical intervention
was no different among two groups (pooled-RR 0.42; 95% CI, 0.17-1.06; p =
0.07). <br/>Conclusion(s): Hybrid vascular closure strategy offers better
efficacy with fewer complications amongst patients undergoing TAVR,
directing the clinical adoption of hybrid techniques, although further
large-scale multicenter studies are warranted to confirm the benefit and
optimize patient selection.<br/>Copyright &#xa9; 2025 S. Karger AG, Basel

<140>
Accession Number
2043600661
Title
Calcific aortic valve disease: can targeting endothelial-mesenchymal
transition be a new alternative to surgery? -a narrative review.
Source
Cardiovascular Diagnosis and Therapy. 16(1) (no pagination), 2026. Article
Number: 7. Date of Publication: 28 Feb 2026.
Author
Song C.; Sha T.; Liu C.; Li J.
Institution
(Song, Sha) The Second School of Clinical Medicine of Binzhou Medical
University, Yantai, China
(Song, Sha, Liu, Li) Department of Cardiac Surgery, Yantai Yuhuangding
Hospital, Yantai, China
Publisher
AME Publishing Company
Abstract
Background and Objective: Calcific aortic valve disease (CAVD) is a
prevalent and progressive cardiovascular condition, particularly found in
the elderly population, characterized by the thickening, calcification,
and increased stiffness of the aortic valve leaflets. These structural
changes lead to impaired valve function and ultimately contribute to heart
failure and increased cardiovascular mortality. Surgical aortic valve
replacement (SAVR) and transcatheter aortic valve replacement (TAVR)
remain the only effective treatments but are associated with significant
risks, high costs, and limited suitability for early-stage or asymptomatic
patients. Therefore, the development of non-invasive, disease-modifying
therapies is of critical importance. This review aims to summarize current
evidence on the role of endothelial-mesenchymal transition (EndMT) in the
pathogenesis of CAVD and to explore its potential as a therapeutic target
for future non-surgical interventions. <br/>Method(s): A comprehensive
literature search was performed in PubMed, Web of Science, and Embase.
Studies related to aortic valve stenosis published between January 1, 2019
and December 20, 2024, as well as all available reports on EndMT published
prior to the search date, were included. Only English-language
publications were considered, and relevant findings were synthesized to
support this review. Key Content and Findings: Recent studies have
highlighted the pivotal role of EndMT in the pathogenesis of CAVD. EndMT
contributes to valvular fibrosis, inflammation, and osteogenic
differentiation, all of which drive disease progression. Targeting key
EndMT-related pathways-such as transforming growth factor-beta (TGF-beta),
Notch, and Wnt-offers promising therapeutic potential. Moreover, combining
EndMT-targeted strategies with anti-inflammatory and anti-calcification
interventions may enable early-stage intervention, thereby slowing disease
progression and reducing reliance on surgical treatments. This review
summarizes current understanding of EndMT mechanisms in CAVD and explores
emerging therapeutic strategies beyond current surgical options.
<br/>Conclusion(s): CAVD progresses through complex mechanisms involving
inflammation, lipid deposition, and osteoblastic differentiation. EndMT
has emerged as a key driver of fibrosis and osteogenesis in valve
mesenchymal cells, thereby accelerating calcification. However, its
regulatory networks and pathway interactions remain incompletely
understood. Further research is needed to clarify these mechanisms and
develop EndMT-targeted interventions, which may offer new avenues for
early diagnosis and treatment of CAVD.<br/>Copyright &#xa9; AME Publishing
Company.

<141>
Accession Number
2043510213
Title
A Randomized Controlled Study on the Impact of Early Urinary Catheter
Removal on Postoperative Urinary Retention in Abdominal and Thoracic
Surgery Patients with Thoracic Epidural Analgesia.
Source
Visceral Medicine. (pp 1-7), 2026. Date of Publication: 2026.
Author
Alwali A.; Schafmayer C.; Klar E.; Philipp M.; Leuchter M.; Grambow E.
Institution
(Alwali, Schafmayer, Klar, Philipp, Grambow) Department of General,
Visceral, Thoracic, Vascular and Transplant Surgery, University Medical
Center Rostock, Rostock, Germany
(Leuchter) Institute for Biostatistics and Informatics in Medicine and
Ageing Research, University Medical Center Rostock, Rostock, Germany
(Grambow) Department of Cardiovascular and Thoracic Surgery, University of
Goettingen Medical Center, Goettingen, Germany
Publisher
S. Karger AG
Abstract
Background: Thoracic epidural analgesia (TEA) is a key component of
Enhanced Recovery After Surgery protocols for major abdominal and thoracic
procedures. Despite its benefits for pain management, TEA has been
associated with an increased risk of postoperative urinary retention
(POUR). Consequently, it is common practice to maintain a urinary catheter
(UC) for the duration of TEA. This study aimed to evaluate the impact of
early UC removal in patients receiving TEA through a randomized controlled
trial. <br/>Method(s): In this randomized controlled trial approved by the
Rostock University Medical Center Ethics Board (AZ A2018-0220), patients
scheduled for elective major abdominal or thoracic surgery with
anticipated TEA within 1 year were enrolled. Participants were randomized
into two groups: the early removal group (ERG), where the UC was removed
within 48 h post-surgery, and the standard group (SG), where the UC was
retained until TEA discontinuation. POUR was defined as a residual urine
volume of >=400 mL measured by ultrasound, and catheter-associated urinary
tract infections (CAUTIs) were assessed. <br/>Result(s): Of the 99
patients initially enrolled, 81 patients were available for analysis. In
the ERG (n = 43), the UC was removed within 48 h, whereas in the SG (n =
38), the UC was maintained until TEA cessation. The incidence of POUR was
similar between the groups, with 1 patient in each group (2.3% in ERG vs.
2.6% in SG, p = 1) requiring recatheterization. CAUTI developed in 4
patients (4.9%), all of whom were in the SG (10.5%), indicating a
statistically significant association between the timing of UC removal and
CAUTI incidence (p = 0.044). <br/>Conclusion(s): Our results suggest that
early UC removal under TEA is safe and does not significantly increase the
risk of POUR while reducing the incidence of CAUTIs. These findings
support the feasibility of early UC removal in this patient population and
may inform future guidelines on perioperative UC management in the context
of TEA.<br/>Copyright &#xa9; 2025 S. Karger AG, Basel

<142>
Accession Number
2043269975
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. 27(1) (no pagination), 2026. Article Number: 143. Date of
Publication: 01 Dec 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, No. 87 Dingjiaqiao, Jiangsu Province,
Nanjing City, China
Publisher
BioMed Central Ltd
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; The Author(s) 2026.

<143>
Accession Number
650264619
Title
TRIGs trial: Does Tranexamic acid modulate the immune response in
gastrointestinal surgery?.
Source
Journal of Thrombosis and Haemostasis. Conference: 27th Congress of the
International Society for Fibrinolysis and Proteolysis, ISFP/PA and 28th
Workshop of the International Fibrinogen Research Society, IFRS 2025.
Corfu Greece. 23(Supplement) (pp S6-S7), 2025. Date of Publication: 01 Nov
2025.
Author
Lam T.; Chia J.; Liu Z.; Myles P.S.; Medcalf R.L.
Institution
(Lam, Chia, Liu, Medcalf) Australian Centre for Blood Diseases, Monash
University, Australia
(Myles) Department of Anaesthesiology and Perioperative Medicine, Alfred
Hospital, Monash University, Australia
Publisher
Elsevier B.V.
Abstract
Background: Tranexamic acid (TXA) is a lysine analogue used to inhibit
plasmin generation and reduce bleeding. Besides fibrinolysis, plasmin
plays important rolesin regulating immunity.Asub-studyof the ATACAS trial
where patients undergoing cardiac surgery randomised to TXA displayed an
altered cell surface immune profile and reduced post-operative surgical
site infection rates only in non-diabetic patients. This prompted the
TRIGs study where patients undergoing gastrointestinal surgery are
randomised to TXA/placebo and where the primary outcome is infection rate.
<br/>Aim(s): To investigate the effects of TXA on temporal changes in
fibrinolysis, inflammation and immune modulation in diabetic and
non-diabetic patients recruited to the TRIGS trial. <br/>Method(s):
Peripheral blood mononuclear cells (PBMC) will be prepared from blood
drawn pre- and post-operatively and on days 1 and 3 (approximately n =
300). Cells will be stained against a novel 40-colour antibody panel for
flow cytometry that includes activation, suppressor markers and the
plasminogen receptor, plg-RKT. In vitro treatment of normal PBMCs will be
used to evaluate immune responses to TXA. Plasma fibrinolytic activity
will also be evaluated with various assays. Results and
<br/>Conclusion(s): Our preliminary findings using 23 patients, reveal
changes to fibrinolysis in ~50% of patients randomised to TXA or placebo
after surgery, consistent with a TXA treatment effect (Figure 1). We also
provide evidence that mitogenicstimulationof normal PBMCs increased
plg-RKT receptor expression in natural killer T-like cells. Whether TXA
causes any alteration in cell surface immune profile and/or reduction in
infection rates will be revealed later in 2025.

<144>
Accession Number
650254346
Title
Antithrombotic therapy in patients after transcatheter aortic valve
implantation: A network meta-Analysis.
Source
JACCP Journal of the American College of Clinical Pharmacy. Conference:
2023 ACCP Annual Meeting. Dallas, TX United States. 6(12) (pp 1512), 2023.
Date of Publication: 01 Dec 2023.
Author
Turgeon R.; Ellis U.; Barry A.
Institution
(Turgeon) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC, Canada
(Ellis) Woodward Library, University of British Columbia, Vancouver, BC,
Canada
(Barry) Faculty of Pharmaceutical Sciences, University of British
Columbia, Vancouver, BC, Canada
Publisher
John Wiley and Sons Inc
Abstract
Background: The optimal regimen of antithrombotic therapy in adult
patients who undergo transcatheter aortic valve implantation (TAVI) is
unknown. We performed a systematic review/network meta-Analysis to compare
different anticoagulant/antiplatelet regimens. The primary outcome was
all-cause death. Secondary outcomes were major adverse cardiovascular
events (MACE) and major bleeding. <br/>Method(s): We searched MEDLINE,
Embase, and CENTRAL from inception to April 2023. Included were randomized
controlled trials that compared single antiplatelet therapy (SAPT), dual
antiplatelet therapy (DAPT), or oral anticoagulant (OAC) therapy
with/without SAPT, and reported one or more outcomes of interest. No
language restrictions were applied. Quality assessments were performed
using the Cochrane risk-of-bias tool 2. Bayesian network meta-Analyses
were performed to compare all interventions simultaneously using the
Markov-chain Monte Carlo method with median ranking. Odds ratios (OR) with
95% credible intervals (CrI) were generated using a hierarchical Bayesian
framework and random-effects model with informative priors.
<br/>Result(s): From 262 citations, 11 RCTs (N=6415) were included. Median
age was 81 years. Median follow-up was 6 months. Compared to DAPT,
DOAC+SAPT had a higher risk of all-cause death (OR 1.77, 95% CrI
1.15-2.75) with no difference between DAPT and SAPT (OR 0.99, 95% CrI
0.58-1.66). DOAC+SAPT increased the risk of major bleeding compared to
DAPT (OR 2.18, 95% CrI 1.09-4.54), while SAPT lowered the risk (OR 0.41,
95% CrI 0.19-0.84). There was no difference in MACE between DAPT and other
regimens. SAPT ranked best for all-cause death, MACE, and major bleeding.
<br/>Discussion(s): In post-TAVI patients, SAPT may provide the optimal
balance of reducing thrombotic events while minimizing risk of bleeding.
Overall risk of bias was low or with some concerns. This network
meta-Analysis used widely-Accepted methodology and standardized outcome
definitions. There remains a need for an adequatelypowered trial to
compare SAPT and DAPT.

<145>
Accession Number
2043534386
Title
Per-Protocol Analysis of Chlorthalidone Versus Hydrochlorothiazide for
Cardiovascular Event Prevention-Diuretic Comparison Project.
Source
Journal of the American Heart Association. 15(3) (pp 1-9), 2026. Article
Number: e046142. Date of Publication: 30 Jan 2026.
Author
Anand S.T.; Hau C.; Davenport M.J.; Ishani A.; Cushman W.C.; Glassman
P.A.; Taylor A.A.; Lew R.A.; Ferguson R.E.; Leatherman S.M.
Institution
(Anand, Hau, Davenport, Lew, Ferguson, Leatherman) Cooperative Studies
Program Coordinating Center, VA Boston Healthcare System, Boston, MA,
United States
(Ishani) Minneapolis VA Healthcare System, Minneapolis, MN, United States
(Ishani) Department of Medicine, University of Minnesota, MN, United
States
(Cushman) Medical Service, Memphis VA Medical Center, Memphis, TN, United
States
(Cushman) Department of Preventive Medicine, University of Tennessee
Health Science Center, Memphis, TN, United States
(Glassman) Pharmacy Benefits Management Services, Department of Veterans
Affairs, Washington, DC, United States
(Glassman) VA Greater Los Angeles Healthcare System, Los Angeles, CA,
United States
(Glassman) David Geffen School of Medicine at UCLA, Los Angeles, CA,
United States
(Taylor) Michael E. DeBakey VA Medical Center, Houston, TX, United States
(Taylor) Department of Medicine, Baylor College of Medicine, Houston, TX,
United States
(Lew, Leatherman) Department of Biostatistics, Boston University School of
Public Health, Boston, MA, United States
(Ferguson, Leatherman) Department of MedicineBoston University Chobanian
and Avedisian School of Medicine, Boston, MA, United States
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: The DCP (Diuretic Comparison Project), a pragmatic trial,
evaluated whether chlorthalidone compared with hydrochlorothiazide would
reduce the risk of nonfatal cardiovascular disease or noncancer-related
death. The intent-to-treat analysis found no difference in such comparison
(hazard ratio, 1.04 [95% CI, 0.94-1.16]). The objective of the current
study is to estimate the per-protocol effect of chlorthalidone (12.5/25 mg
daily) compared with hydrochlorothiazide (25/50 mg daily) in preventing
major adverse cardiovascular events among older patients with
hypertension. <br/>METHOD(S): The effect of adhering to treatment
strategies was assessed by censoring at first instance of nonadherence,
defined as a gap (>90-day gap in drug coverage), switch (switching between
study medications), and discontinuation (stop taking
chlorthalidone/hydrochlorothiazide altogether for >90 days before the end
of the study). The primary outcome was a composite of nonfatal myocardial
infarction, stroke, heart failure resulting in hospitalization, urgent
coronary revascularization for unstable angina, and noncancer-related
death. Using inverse probability weighting, we evaluated the per-protocol
effect of chlorthalidone and hydrochlorothiazide using DCP trial data.
<br/>RESULT(S): Nonadherence was found in 5476 (40%) participants; among
8047 (60%) adherents, 3905 (49%) were randomized to chlorthalidone and
4142 (51%) to hydrochlorothiazide. After censoring time when participants
deviated from the assigned treatments, the estimated 5-year risk ratio of
the composite primary outcome of nonfatal cardiovascular disease and
noncancer-related death was 1.36 (95% CI, 0.96-2.12) in chlorthalidone
compared with hydrochlorothiazide. <br/>CONCLUSION(S): The per-protocol
analysis indicated a lower risk with hydrochlorothiazide compared with
chlorthalidone in preventing nonfatal cardiovascular disease and
noncancer-related death; however, this difference was not statistically
significant using dispensation data to identify adherence.<br/>Copyright
&#xa9; 2026 The Author(s).

<146>
Accession Number
2043608796
Title
Sleep Disordered-Breathing and Aortic Valve Stenosis: A Systematic Review
and Meta-Analysis.
Source
Sleep Medicine Research. 16(4) (pp 202-208), 2025. Date of Publication: 01
Dec 2025.
Author
Ramadan H.
Institution
(Ramadan) Pharmacy Department, Agamy Medical District, Ministry of Health
and Population, Agamy, Egypt
Publisher
Korean Society of Sleep Medicine
Abstract
Background and Objective Sleep-disordered breathing (SDB), including
obstructive sleep apnea (OSA) and central sleep apnea (CSA), is common in
older adults and linked to cardiovascular disease. Aortic stenosis (AS),
is another prevalent condition in this population. The interaction between
SDB and AS remains unclear, particularly regarding outcomes after surgical
aortic valve replacement or transcatheter aortic valve implantation. This
review systematically examines the prevalence, clinical impact, and
potential bidirectional relationship between SDB and AS. Methods Following
PRISMA guidelines, multiple databases were searched. Eligible
observational studies included adults with both AS and SDB, reporting
prevalence or comparative outcomes. Data extraction included study
characteristics, diagnostic methods, interventions, and prevalence
estimates. Quality assessment employed JBI and Newcastle-Ottawa tools.
Meta-analyses were performed using odds ratios (OR), standardized mean
differences, and prevalence estimates with random or fixed effects models
based on heterogeneity. Results A total of 11 studies met inclusion
criteria (9 prevalence-focused, 2 comparative). Pooled prevalence of SDB
in AS patients was 76% (95% confidence interval [CI]: 63%-89%). Both OSA
(49%) and CSA (51%) were observed. Male sex was more common among patients
with SDB (OR=1.68, 95% CI: 1.07-2.62). Body mass index (BMI) tended to be
higher in OSA than CSA, though not consistently significant. In
comparative analyses, patients with SDB showed higher odds of AS (OR=1.16,
95% CI: 1.14-1.17). Conclusions SDB is highly prevalent in AS and may
contribute to disease progression. Findings suggest a possible
bidirectional association influenced by sex and BMI. Larger well-matched
cohorts with long-term follow-up before and after valve interventions are
needed to clarify causality and treatment effects.<br/>Copyright &#xa9;
2025 The Korean Society of Sleep Medicine. This is an Open Access article
distributed under the terms of the Creative Commons Attribution
Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0)
which permits unrestricted non-commercial use, distribution, and
reproduction in any medium, provided the original work is properly cited.

<147>
[Use Link to view the full text]
Accession Number
2043472985
Title
Normothermic machine perfusion applications in kidney transplantation.
Source
Current Opinion in Organ Transplantation. Publish Ahead of Print (no
pagination), 2026. Date of Publication: 10 Feb 2026.
Author
Holzner M.L.; Jaynes C.; Garonzik-Wang J.
Institution
(Holzner) Recanti/Miller Transplantation Institute, Icahn School of
Medicine at Mount Sinai, New York, New York, United States
(Jaynes) 34Lives, Public Benefit Company, West Lafayette, Indiana, United
States
(Jaynes) Department of Surgery-Organ Donation and Transplantation,
University Medical Center Groningen, Netherlands
(Garonzik-Wang) Comprehensive Transplant Institute, Department of Surgery,
University of Alabama at Birmingham, Birmingham, Alabama, United States
Publisher
Lippincott Williams and Wilkins
Abstract
Purpose of review - Normothermic machine perfusion (NMP) has emerged as
technology for organ preservation and assessment. While NMP has been
widely adopted for liver, lung, and heart transplantation, kidney NMP has
faced slower clinical integration. Normothermic perfusion may potentially
improve kidney transplant through improved preservation, graft viability
assessment, mitigation of ischemia reperfusion injury, and treatment prior
to transplant. The purpose of this review is to highlight the applications
of NMP in kidney transplantation. Recent findings - Kidney NMP has been
proven well tolerated and feasible in multiple studies. Two recent
randomized controlled trials did not demonstrate a benefit of NMP compared
to cold storage. The use of NMP may increase utilization through improved
logistics. Graft assessment during perfusion may allow for well tolerated
transplantation of marginal kidneys. Successful long-term perfusion up to
4 days of discarded kidneys has been performed. Gene therapies and
treatments, including immune modification, have been carried out during
kidney NMP. Summary - Normothermic perfusion has several applications to
kidney transplantation including preservation, assessment, and treatment.
Perfusion protocols viability criteria need to be defined. A portable,
commercially available device is needed to increase clinical use. Further
studies are needed to compare NMP to current preservation
methods.<br/>Copyright &#xa9; 2026

<148>
[Use Link to view the full text]
Accession Number
2043318841
Title
Anticoagulation monitoring using point-of-care testing combined with
mobile remote management in postoperative cardiac valve replacement
patients receiving warfarin therapy: A single-center cross-sectional
study.
Source
Medicine (United States). 105(5) (pp e47395), 2026. Date of Publication:
30 Jan 2026.
Author
Huang L.; Ouyang C.; Ye X.; Ren M.; Da Q.; Han Z.
Institution
(Huang, Ouyang, Ye, Ren, Da, Han) Department of Cardiovascular Surgery,
Peking University Shenzhen Hospital, Shenzhen, China
Publisher
Lippincott Williams and Wilkins
Abstract
Lifelong anticoagulation monitoring is essential for mechanical heart
valve recipients. While conventional hospital-based monitoring creates
significant patient and system burdens, combining mobile remote monitoring
(MRM) with point-of-care testing (POCT) may provide a more efficient
solution. This study evaluated whether MRM + POCT enhances warfarin
therapy quality and patient outcomes. This study compared conventional
anticoagulation management versus MRM + POCT in 148 post-valve replacement
patients (74 per group). The conventional cohort underwent standard
in-hospital testing and received anticoagulation management guidance from
outpatient clinic physicians. In contrast, the MRM + POCT group utilized
POCT for self-monitoring, with anticoagulation therapy guided remotely by
physicians via the MRM system. We assessed prothrombin time/international
normalized ratio values, time to therapeutic anticoagulation, time in the
therapeutic range, costs, complications, and satisfaction over 12 months.
Compared with conventional anticoagulation management, MRM + POCT resulted
in superior outcomes: Faster therapeutic anticoagulation (P < .01), a
greater time in the therapeutic range (P < .05), fewer complications (P <
.05), lower costs (P < .01), and better satisfaction (P < .01),
demonstrating improved clinical and patient-centered outcomes.
Additionally, both clinicians and patients found the integrated system
user-friendly, easy to master, and expressed a strong intention to
continue its use. MRM + POCT optimizes warfarin therapy by improving
efficacy, safety, and cost-effectiveness while enhancing patient outcomes,
supporting its implementation as standard care for remote anticoagulation
management.<br/>Copyright &#xa9; 2026 the Author(s). Published by Wolters
Kluwer Health, Inc.

<149>
[Use Link to view the full text]
Accession Number
2043528781
Title
Potential Double Counting in Meta-Analysis of Combined Heart-liver
Transplantation.
Source
Transplantation. Publish Ahead of Print (no pagination), 2026. Date of
Publication: 2026.
Author
Nakayama T.; Attia A.; Ahn D.J.; Sasaki K.
Institution
(Nakayama, Attia, Ahn, Sasaki) Division of Abdominal Transplantation,
Stanford Transplant Outcomes Research Center (STORC), Stanford University
Medical Center, Stanford, CA, United States
Publisher
Lippincott Williams and Wilkins

<150>
Accession Number
650230409
Title
Preclinical and Clinical Developments in Treg Therapy for Heart
Transplantation: Critical Assessment and Translational Challenges.
Source
Human immunology. 87(4) (pp 111681), 2026. Date of Publication: 10 Feb
2026.
Author
Mengrelis K.; Wolner L.; Lakatos R.L.; Zuckermann A.; Pilat N.
Institution
(Mengrelis, Zuckermann) Medical University of Vienna, Department of
Cardiac and Thoracic Aortic Surgery, Vienna, Austria
(Wolner, Pilat) Medical University of Vienna, Department of Cardiac and
Thoracic Aortic Surgery, Vienna, Austria; Medical University of Vienna,
Center for Biomedical Research and Translational Surgery, Vienna, Austria
(Lakatos) Medical University of Vienna, Center for Biomedical Research and
Translational Surgery, Vienna, Austria
Abstract
Regulatory T cells (Tregs) represent a promising approach to induce
donor-specific tolerance in cardiac transplantation, potentially reducing
reliance on chronic immunosuppression. This review critically evaluates
preclinical and clinical evidence. Preclinical studies demonstrate that
adoptively transferred Tregs prolong cardiac allograft survival and
prevent chronic allograft vasculopathy (CAV) in murine models through
multiple suppressive mechanisms. Phase I/II trials in kidney and liver
transplantation have already confirmed safety and feasibility of
polyclonal Treg cell therapy, with evidence of immunosuppression reduction
in selected patients. However, no cardiac-specific trials have been
completed in adults, and critical translational barriers persist including
limited in vivo persistence, phenotypic instability under inflammatory
conditions, manufacturing complexity and incompatibility with deceased
donor timelines. Emerging approaches show promise: CAR-engineered Tregs
targeting HLA-A2 demonstrate enhanced specificity and establish infectious
tolerance in preclinical cardiac transplant models, with preliminary data
from the first-in-human kidney transplant data suggesting safety and
efficacy. Thymus-derived Tregs offer advantages for pediatric recipients,
with the first treated cardiac transplant patient showing preserved Treg
homeostasis. This review identifies key research priorities necessary to
translate Treg therapy into clinical cardiac transplantation
practice.<br/>Copyright &#xa9; 2026 The Author(s). Published by Elsevier
Inc. All rights reserved.

<151>
Accession Number
650231070
Title
Accuracy of inflammatory biomarkers in assessing outcomes in Chagas
disease: a scoping review.
Source
Transactions of the Royal Society of Tropical Medicine and Hygiene. (no
pagination), 2026. Date of Publication: 12 Feb 2026.
Author
Avila M.R.; de Oliveira L.F.F.; Silva W.T.; Faria S.C.C.; Mediano M.F.F.;
Rocha M.O.D.C.; Costa H.S.; Menezes-Souza D.
Institution
(Avila, de Oliveira, Rocha, Menezes-Souza) Postgraduate Program in Health
Sciences: Infectious Diseases and Tropical Medicine, Faculty of Medicine,
Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
(Silva, Mediano) Postgraduate Program in Clinical Research in Infectious
Diseases, Evandro Chagas National Institute of Infectious Disease, Oswaldo
Cruz Foundation, Rio de Janeiro, Brazil
(Faria) School of Medicine, Universidade Federal de Minas Gerais, Belo
Horizonte, Minas Gerais, Brazil
(Costa) Postgraduate Program in Rehabilitation and Functional Performance,
Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina,
Minas Gerais, Brazil
(Menezes-Souza) Postgraduate Program in Parasitology, Institute of
Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte,
Minas Gerais, Brazil
(Menezes-Souza) Department of Clinical Pathology, COLTEC, Universidade
Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
(Menezes-Souza) Vaccine Technology Center, Belo Horizonte Technology Park,
Belo Horizonte, Minas Gerais, Brazil
Abstract
Chagas disease (CD) is a global health issue with acute and chronic forms
that cause severe complications, especially affecting the heart.
Inflammatory biomarkers have been proposed as potential predictors of
adverse outcomes in CD, however, their clinical utility remains uncertain.
We conducted a scoping review of five databases, including observational
studies evaluating the diagnostic and/or prognostic accuracy of
inflammatory biomarkers in CD. Two reviewers independently screened and
extracted data. Of 239 articles screened, 5 met the inclusion criteria.
Adiponectin was associated with an increased risk of mortality and heart
transplantation (hazard ratio 1.042 [95% confidence interval 1.013 to
1.072], area under the curve [AUC] 0.68, cut-off >38 mug/ml). Tumour
necrosis factor alpha (TNF-alpha) and C-C motif chemokine ligand 2 (CCL2)
were associated with left ventricular dysfunction (TNF-alpha: AUC 0.90;
CCL2: AUC 0.69). Combined hepatocyte growth factor (HGF) and
interleukin-12p40 (IL-12p40) predicted 3-y survival (accuracy 81.9%).
Other biomarkers, including macrophage migration inhibitory factor, C-X-C
motif chemokine ligand 12, monokine induced by interferon gamma (MIG),
transforming growth factor beta1 and matrix metalloproteinases 2 and 9,
showed limited utility. While TNF-alpha and HGF/IL-12p40 showed promise,
most inflammatory biomarkers demonstrated limited accuracy, specifically
for outcome prediction in CD; however, this does not preclude their
potential usefulness for other clinical or experimental applications.
Current evidence does not support the clinical use of this approach and
further studies are needed.<br/>Copyright &#xa9; The Author(s) 2026.
Published by Oxford University Press on behalf of Royal Society of
Tropical Medicine and Hygiene. All rights reserved. For commercial re-use,
please contact reprints@oup.com for reprints and translation rights for
reprints. All other permissions can be obtained through our RightsLink
service via the Permissions link on the article page on our site-for
further information pl

<152>
Accession Number
2043536758
Title
Prevalence and Incidence of Dilated Cardiomyopathy in the United States
and Western Europe: A Systematic Review.
Source
Cardiology Research. 16(4) (pp 295-305), 2025. Date of Publication: 01 Aug
2025.
Author
Myers M.C.; Berge A.; Zhong Y.; Maruyama S.; Bueno C.; Bastien A.; Hofer
K.; Kaur R.; Fazeli M.S.; Golchin N.
Institution
(Myers, Berge, Zhong, Maruyama, Bueno, Bastien, Golchin) Bristol Myers
Squibb, Princeton, NJ, United States
(Hofer, Kaur, Fazeli) Evidinno Outcomes Research Inc., Vancouver, BC,
Canada
Publisher
Elmer Press
Abstract
Background: Dilated cardiomyopathy (DCM) is a major contributing factor
for heart failure and cardiac transplantation worldwide. Estimating the
prevalence and incidence of DCM is critical for understanding the burden
of illness in these patients and improving the landscape of preventative
treatments. Previous reviews have shown substantial prevalence and
incidence estimates for DCM within key regions such as the United States
and several European countries. This review aimed to describe the
published evidence on the prevalence and incidence of DCM within the
United States, France, Germany, Italy, Spain, and the United Kingdom.
<br/>Method(s): MEDLINE and Embase were searched from database inception
to May 9, 2023 for English-language studies reporting the prevalence or
incidence of DCM within general populations of adults or children in
countries of interest. Manual searches of relevant conferences and
bibliographies of previous literature reviews were also conducted.
<br/>Result(s): Of 6,145 identified articles, 10 unique studies were
included in the review. Six studies reported prevalence, and five studies
reported incidence of DCM in various populations. Prevalence estimates of
DCM, including idiopathic and non-idiopathic causes, within adults (>= 18
years) and/or heterogeneous (all ages) populations ranged from 42.8 to
118.3 per 100,000 persons; idiopathic DCM estimates ranged from 8.3 to
59.2 per 100,000 persons. Prevalence of adolescent (about 11 - 18 years)
DCM, including idiopathic and non-idiopathic causes, ranged from 2.6 to
212.8 per 100,000 persons. Annual incidence rates of idiopathic DCM in
adult/heterogeneous populations ranged from 6.0 to 7.0 per 100,000
persons. Annual incidence of DCM due to idiopathic/non-idiopathic causes
among pediatric populations was reported as 0.6 per 100,000 persons.
Reported prevalence and incidence rates by sex showed male preponderance,
and estimates were higher in Black persons compared with White and
Hispanic persons; higher DCM prevalence estimates were observed in studies
utilizing newer DCM definitions using ICD coding compared with older
definitions. <br/>Conclusion(s): This study highlights the varied
prevalence and incidence rates of DCM reported across different geographic
locations, time periods, sexes, races, and disease definitions. When
comparing these rates, it is crucial to consider factors such as data
sources, case definitions, case-finding methodologies, and study
populations.<br/>Copyright (c) 2025 The authors. This work is licensed
under a Creative Commons Attribution-NonCommercial 4.0 International
License https://creativecommons.org/licenses/by-nc/4.0/.

<153>
Accession Number
2043600633
Title
Postoperative complications of coronary artery bypass grafting: a
narrative review on pathophysiology, management strategies, and the
emerging role of artificial intelligence.
Source
Cardiovascular Diagnosis and Therapy. 16(1) (no pagination), 2026. Article
Number: 10. Date of Publication: 28 Feb 2026.
Author
Kumar R.; Jamaleddin Ahmad F.A.; Fattouh M.A.S.; Issimdar I.A.; Ghosh A.;
Ahmed A.O.A.; Soussi Y.E.; Erandi G.A.C.; Leena J.; Hejleh K.A.;
Mylavarapu M.
Institution
(Kumar) Royal College of Surgeons in Ireland, Dublin, Ireland
(Jamaleddin Ahmad) American University of the Caribbean Medical School,
Cupecoy, Saint Martin (French Part)
(Fattouh) Altinbas University, Istanbul, Turkey
(Issimdar) University College Dublin, Dublin, Ireland
(Ghosh) Nazareth Hospital, Philadelphia, PA, United States
(Ahmed) Sudan International University, Khartoum, Sudan
(Soussi) University of Sharjah, Sharjah, United Arab Emirates
(Erandi) Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
(Leena) Dr. Somervell Memorial CSI Medical College, Karakonam, India
(Hejleh) Washington University of Health and Science, Chicago, IL, United
States
(Mylavarapu) Endeavor Health Cardiovascular Institute, Glenview, IL,
United States
Publisher
AME Publishing Company
Abstract
Background and Objective: Coronary artery bypass grafting (CABG) remains a
vital treatment option for high-risk patients with advanced coronary
artery disease, especially those with multivessel disease, extensive left
main disease, or refractory angina. While CABG effectively lowers
long-term mortality and morbidity, it is still associated with many
postoperative complications that can hinder recovery and affect quality of
life. This review aims to thoroughly explore risk factors, prevention, and
management strategies of major postoperative complications after CABG,
categorized by physiological systems. <br/>Method(s): A comprehensive
literature review was conducted on PubMed and Google Scholar from January
1, 2005, to August 6, 2025, without applying filters, but only including
English-language publications, to gather a wide range of studies. Full
texts were chosen based on set criteria, followed by a qualitative
analysis to identify common themes, results, and gaps. Key Content and
Findings: Post-CABG complications span neurological, cardiac, pulmonary,
renal, gastrointestinal/hepatobiliary, infectious, endocrine, and
psychosocial domains. Across systems, consistently identified significant
risk factors include advanced age, diabetes, renal dysfunction, prolonged
cardiopulmonary bypass time, prior stroke, chronic obstructive pulmonary
disease (COPD), and impaired left ventricular (LV) function. Effective
preventive strategies included optimized glycemic control, early
mobilization and rehabilitation, targeted use of anti-inflammatory and
antioxidant therapies, prophylactic amiodarone or magnesium for atrial
fibrillation (AF), strict infection-control measures, renal-protective
protocols, and multimodal pain management. Recently, artificial
intelligence (AI)-based tools, including machine learning models for
predicting acute kidney injury, delirium, stroke, arrhythmias, and
surgical-site infections, are emerging as promising adjuncts for earlier
risk identification and personalized postoperative care.
<br/>Conclusion(s): Post-CABG complications remain across organ systems,
emphasizing the need for early risk identification and targeted
prevention. Major risk factors include age, diabetes, renal dysfunction,
and prolonged bypass time. Multidisciplinary care and emerging AI-based
prediction tools may improve individualized risk assessment and
postoperative outcomes.<br/>Copyright &#xa9; AME Publishing Company.

<154>
Accession Number
650231802
Title
Predictive and prognostic performance of urinary albumin-to-creatinine
ratio for acute kidney injury: a systematic review and meta-analysis.
Source
Scientific reports. (no pagination), 2026. Date of Publication: 12 Feb
2026.
Author
Kitisin N.; Ismail J.; Raykateeraroj N.; Hikasa Y.; Caroli A.; Nubel J.;
Eastwood G.; Bellomo R.; Neto A.S.
Institution
(Kitisin, Ismail, Hikasa, Caroli, Nubel, Eastwood, Bellomo, Neto)
Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia
(Kitisin, Raykateeraroj) Department of Anesthesiology, Faculty of
Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
(Raykateeraroj) Department of Anesthesiology, Austin Hospital, Heidelberg,
VIC, Australia
(Caroli) Dipartimento Di Scienze Dell'Emergenza, Anestesiologiche E Della
Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome,
Italy
(Nubel) Department of Cardiology, Brandenburg Medical School (MHB) Theodor
Fontane, University Hospital Heart Centre Brandenburg, Bernau, Germany
(Bellomo, Neto) Australian and New Zealand Intensive Care Research Centre
(ANZIC-RC), School of Public Health and Preventive Medicine, Monash
University, Melbourne, Australia
(Bellomo, Neto) Department of Critical Care, School of Medicine,
University of Melbourne, Parkville, VIC, Australia
(Bellomo, Neto) Data Analytics Research and Evaluation (DARE) Centre,
Austin Hospital, Melbourne, Australia
(Neto) Department of Critical Care Medicine, Hospital Israelita Albert
Einstein, Sao Paulo, Brazil
Abstract
The urine albumin-to-creatinine ratio (UACR) is a well-established marker
for chronic kidney disease, but its utility in predicting acute kidney
injury remains uncertain. This systematic review and meta-analysis aimed
to evaluate predictive performance for AKI development and prognostic
performance for AKI progression in hospitalized adults. A comprehensive
search of Ovid MEDLINE, Embase, and CENTRAL databases identified 13
studies (n = 10,438) on AKI incidence and three studies (n = 1596) on AKI
progression. Elevated UACR was associated with an increased risk of AKI
(pooled OR 1.39; 95% CI 1.08-1.79) and AKI progression (pooled OR 3.76;
95% CI 2.59-5.45). The pooled sensitivity and specificity for AKI
prediction were 0.71 (95% CI 0.59-0.80) and 0.67 (95% CI 0.56-0.76),
respectively, with an area under the curve (AUC) of 0.74. However, there
was high heterogeneity across studies, and UACR thresholds for AKI
prediction varied widely. Despite these limitations, UACR appears to be a
promising, low-cost biomarker for predicting AKI, particularly in
high-risk settings such as cardiac surgery. Standardization of thresholds
and further validation are needed to support its clinical
implementation.<br/>Copyright &#xa9; 2026. The Author(s).

<155>
Accession Number
650225909
Title
Does tranexamic acid fix all bleeding in surgery?.
Source
Journal of the National Medical Association. (no pagination), 2026. Date
of Publication: 10 Feb 2026.
Author
Lonjin T.; Prasanna P.; Zhang D.
Institution
(Lonjin, Prasanna) Department of Anesthesiology, Virginia Commonwealth
University, Richmond, VA, United States
(Zhang) Virginia Commonwealth University School of Medicine, Richmond, VA,
United States
Abstract
Excessive hemorrhage is a major contributor to morbidity and mortality in
perioperative settings. Tranexamic acid (TXA), a synthetic
antifibrinolytic agent, effectively reduces blood loss by preventing
fibrin degradation. This review summarizes the clinical applications,
efficacy, and safety considerations of TXA across various surgical
specialties. A comprehensive review of studies across various surgical
specialties confirms TXA's efficacy in minimizing the risk of hemorrhage
and transfusion needs. While TXA is a valuable tool in hemostasis, proper
patient selection and dosing are crucial to avoid risks, especially in
those with thromboembolic conditions or renal impairment. Further research
is needed to refine dosing protocols and expand its safe use across
patient populations.<br/>Copyright Published by Elsevier Inc.

<156>
Accession Number
650244545
Title
Wedge Resection for Early-Stage NSCLC: Are We There Yet?.
Source
The Annals of thoracic surgery. (no pagination), 2026. Date of
Publication: 10 Feb 2026.
Author
Baiu I.; Alkorki N.K.; Kneuertz P.J.
Institution
(Baiu, Kneuertz) Department of Surgery, Division of Thoracic Surgery, Ohio
State University Wexner Medical Center, Columbus, OH, United States
(Alkorki) Department of Cardiothoracic Surgery, Weill Cornell Medicine/New
York-Presbyterian Hospital, New York, NY, USA
Abstract
The optimal extent of resection for early-stage non-small cell lung cancer
(NSCLC) remains one of the most debated questions in thoracic surgery.
While lobectomy has traditionally represented the standard of care,
contemporary randomized trials have redefined the role of sublobar
resection. For appropriately selected patients with small, peripherally
located tumors, segmentectomy has shown oncologic equivalence to
lobectomy1, whereas the evidence supporting wedge resection remains less
definitive2. This review synthesizes the available evidence comparing
wedge resection and segmentectomy, contextualized against lobectomy as the
historical benchmark. A comprehensive literature review was performed,
focusing on studies published over the last 30 years reporting outcomes of
anatomic and non-anatomic, lobar and sublobar lung resections in patients
with stage I NSCLC. Wedge resection offers a less invasive option for
early-stage NSCLC, with potential benefits in pulmonary preservation and
perioperative safety. However, current evidence remains mixed, and while
wedge resection may be appropriate in carefully selected standard-risk
patients, its routine use awaits further high-level validation. Careful
patient selection, attention to margins, appropriate lymph node
evaluation, genetic and consideration of tumor biology are critical in
determining patients for whom a wedge resection can be oncologically
adequate.<br/>Copyright &#xa9; 2026. Published by Elsevier Inc.

<157>
Accession Number
2043559674
Title
Shall We Step Outside the Cage? Non-Intercostal Approaches to Pulmonary
Lobectomy.
Source
Seminars in Thoracic and Cardiovascular Surgery. (no pagination), 2026.
Date of Publication: 2026.
Author
Maqueda L.B.; Tetu M.; Alkathiri O.A.M.; Alreshidi O.F.; Lima P.G.R.;
Seitlinger J.; Renaud S.; Ferraro P.; Liberman M.
Institution
(Maqueda, Tetu, Alkathiri, Alreshidi, Lima, Ferraro, Liberman) Division of
Thoracic Surgery, CHUM Endoscopic Tracheobronchial and Oesophageal Center
(CETOC), Centre Hospitalier de l'Universite de Montreal (CHUM), University
of Montreal, Montreal, QC, Canada
(Seitlinger, Renaud) Department of Thoracic Surgery, Nancy Regional
University Hospital, Vandoeuvre-les-Nancy, France
Publisher
W.B. Saunders
Abstract
Pulmonary lobectomy via a minimally invasive surgery (MIS) approach
represents the current standard of care in early-stage non-small cell lung
cancer. However, MIS has mostly relied on intercostal incisions, with the
inherent risk of intercostal nerve injury. As a result, several
non-intercostal approaches were developed. However, published data on the
subject remain scarce. We aim to review existing non-intercostal MIS
lobectomy techniques to specifically assess their feasibility and safety.
Systematic review from 2010-2025. The outcomes for feasibility and safety
were conversion rate and 30-day mortality, respectively. A total of 17
studies were included in the qualitative synthesis. From a combined total
of 2376 patients included in the study, 66% (n = 1570) underwent a
non-intercostal lobectomy. Among these, 83.5% (n = 1312) were performed
via a subxiphoid approach, 15% (n = 236) via subcostal incisions. Among
the studies that reported on outcomes, conversion rate and mortality were
reported, respectively, as 4.3% (n = 53/1228) and 0.4% (n = 1/259) for
subxiphoid approach, 1.4% (n = 2/140) and 0.7% (n = 1/140) for subcostal
incisions. There has been growing interest in various non-intercostal
approaches to pulmonary lobectomy over the past decade. Notably, recent
studies suggest a shift toward higher-quality research and a transition
from subxiphoid video-assisted to subcostal robotic-assisted thoracic
surgery techniques. Among these, Outside the Cage (OTC) RATS
robotic-assisted thoracic surgery emerges as the only fully
non-intercostal reproducible robotic approach. Despite encouraging early
data, further efforts are required to rigorously evaluate potential
benefits. Nonetheless, the evidence to date suggests that it could be both
feasible and safe to step "outside the cage."<br/>Copyright &#xa9; 2026
Elsevier Inc. All rights are reserved, including those for text and data
mining, AI training, and similar technologies.

<158>
Accession Number
2043660882
Title
Left ventricular perforation following impella CP placement in a
resuscitated STEMI patient with cardiogenic shock: a rare complication and
case report.
Source
European Heart Journal - Case Reports. 10(2) (no pagination), 2026.
Article Number: ytag050. Date of Publication: 01 Feb 2026.
Author
Hajji O.; Abumayyaleh M.; Schupp T.; Behnes M.; Akin I.
Institution
(Hajji, Abumayyaleh, Schupp, Behnes, Akin) Department of Cardiology,
Haemostaseology and Medical Intensive Care, University Medical Center
Mannheim, Medical Faculty Mannheim, Heidelberg University,
Theodor-Kutzer-Ufer 1-3, Mannheim, Germany
Publisher
Oxford University Press
Abstract
Background The use of mechanical circulatory support (MCS) for acute
haemodynamic stabilization in cardiogenic shock has increased over the
past decade. Impella heart pumps (Abiomed) are intravascular microaxial
blood pumps designed to provide temporary MCS during high-risk
percutaneous coronary intervention (HRPCI) and the management of
cardiogenic shock. However, despite their increasing use, there are
limited randomized clinical trials to support the benefits of the therapy
and growing concern regarding complication rates. The objective of this
report is to present a rare case of a left ventricular perforation after
Impella CP placement in a resuscitated patient after ST-elevation
myocardial infarction (STEMI). Case summary We present the case of a
54-year-old patient who suffered an out-of-hospital cardiac arrest (OHCA)
due to STEMI and was successfully resuscitated. Due to persistent
cardiogenic shock, Impella CP support was initiated. The clinical course
was complicated by recurrent and refractory ventricular fibrillation (VF),
requiring multiple resuscitations in the intensive care unit (ICU). These
resuscitative efforts, combined with friable necrotic myocardial tissue
from the infarction, contributed to a left ventricular perforation and
dislocation of the Impella device in the pericardium. To stabilize the
patient, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) was
initiated, followed by transfer to the cardiac surgery department. Despite
the severity of the complications, the Impella was successfully explanted
and replaced with a transaxillary Impella 5.5 pump without the need for
open-heart surgery. Extubation was achieved few days later, and the
patient demonstrated progressive clinical recovery with successful weaning
from the ECMO as well as the Impella 5.5. Conclusion This case
demonstrates that profound myocardial fragility following resuscitated
STEMI may be a critical co-factor for Impella-related perforation,
underscoring the necessity for extreme procedural vigilance and timely,
multidisciplinary management in patients requiring mechanical circulatory
support.<br/>Copyright &#xa9; The Author(s) 2026. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<159>
Accession Number
2043522533
Title
Comparison of 6% hydroxyethyl starch 130/0.4 vs 5% albumin in
cardiopulmonary bypass for cardiac surgery.
Source
World Journal of Cardiology. 18(1) (no pagination), 2026. Article Number:
114123. Date of Publication: 26 Jan 2026.
Author
Alqarni A.; Algarni A.; Chhetri R.
Institution
(Alqarni, Algarni) Department of Cardiology, King Abdullah Medical
Complex, Ministry of Health, Jeddah, Makkah al Mukarramah, Saudi Arabia
(Chhetri) Department of Cardiology, Nepalgunj Medical College, Kohal,
Nepal
Publisher
Baishideng Publishing Group Inc
Abstract
BACKGROUND The choice of priming and volume replacement fluids during
cardiopulmonary bypass (CPB) in cardiac surgery impacts hemodynamic
stability, coagulation, renal function, and patient outcomes. Hydroxyethyl
starch (HES) 130/0.4 and human albumin are commonly used colloids, but
their relative safety and efficacy remain debated. AIM To compare the
outcomes of 6% HES 130/0.4 vs 5% albumin in patients undergoing cardiac
surgery with CPB. METHODS A comprehensive literature search was performed
in PubMed, EMBASE, ScienceDirect, and grey literature sources up to August
2025. Randomized controlled trials and controlled observational studies
comparing 6% HES 130/0.4 with 5% albumin in patients who underwent cardiac
surgery were included. Data extraction and risk of bias assessment
followed PRISMA and Cochrane guidelines. Meta-analyses were conducted
using RevMan 5.4, applying random-effects models. Heterogeneity was
assessed with I² statistics, and meta-regression explored
baseline covariables. Publication bias was evaluated with funnel plots and
the Egger's test. RESULTS Twelve studies involving 908 patients (455 in
the HES group, 453 in the albumin group) were included. No significant
differences were observed between the HES and albumin groups for
postoperative blood loss [mean difference = 42.4 mL, 95% confidence
interval (CI): -90.0 to 174.9; P = 0.53], packed red blood cell
transfusion [odds ratio (OR) = 0.78, 95%CI: 0.65-1.10; P = 0.16)],
mortality (OR = 1.11, 95%CI: 0.63-1.96; P = 0.80), intensive care unit
stay, hospital stay, or postoperative platelet count and creatinine
levels. However, HES was associated with a significantly higher risk of
acute kidney injury (AKI) (OR = 1.79, 95%CI: 1.08-2.97; P = 0.02),
indicating that while many clinical outcomes showed no significant
difference, there is a specific safety concern related to renal function
with HES use. Meta-regression did not identify baseline factors explaining
heterogeneity in bleeding or AKI outcomes (all P > 0.10). No significant
publication bias was detected. CONCLUSION The 6% HES 130/0.4 and 5%
albumin exhibit similar efficacy for volume management in cardiac surgery
with CPB; however, HES is associated with a higher risk of
AKI.<br/>Copyright &#xa9; The Author(s) 2026. Published by Baishideng
Publishing Group Inc. All rights reserved.

<160>
Accession Number
650224980
Title
Melatonin administration improves delirium and associated outcomes in
intensive care unit patients: A meta-Analysis.
Source
Canadian Journal of Anesthesia. Conference: Critical Care Canada Forum
2024. Toronton, ON Canada. 72(Supplement 1) (pp 123-124), 2025. Date of
Publication: 01 Jun 2025.
Author
Tang B.H.Y.; Lewis K.
Institution
(Tang, Lewis) Department of Medicine, McMaster University, Hamilton, ON,
Canada
(Lewis) Department of Health Research Methods, Evidence and Impact,
McMaster University, Hamilton, ON, Canada
(Lewis) Division of Critical Care, St. Joseph's Healthcare Hamilton,
Hamilton, ON, Canada
Publisher
Springer
Abstract
INTRODUCTION Melatonin has wide-ranging effects in the body, including the
regulation of circadian rhythm regulation and potentiation of cellular
immune and antioxidant activities.1 In critically ill patients, melatonin
has been shown to be markedly altered, with increasing derangement
associated with worsening morbidity.2,3 Trials have suggested that
melatonin supplementation can improve melatonin levels and improve
outcomes in animal models of critical illness.4 It has been thus
hypothesized that supplementation would improve intensive care unit (ICU)
outcomes. OBJECTIVES The purpose of this review was to identify and
summarize the findings from randomized controlled trials of the impact of
melatonin administration on outcomes in critically ill patients. METHODS
We searched eight electronic databases for randomized controlled trials
comparing melatonin administration to another intervention for adult
patients admitted to ICU. Included studies were graded for risk of bias.
We abstracted data on pre-defined outcomes. We aggregated data as relative
risks (RR), mean differences (MD) and standard mean differences (SMD)
using a random-effects model and calculated variance using the DerSimonian
and Laird model. Supporting evidence for each effect was evaluated for
certainty using the GRADE approach. Large between-study heterogeneity, as
identified by the Higgins and Thompson's I2 statistic, was explored with
pre-defined subgroups. Risk of bias sensitivity analysis and funnel plot
assessment for publication bias were also performed. RESULTS We included
30 studies reporting 3,530 total cases in neurological, cardiovascular and
medical-surgical ICUs, comparing melatonin or ramelteon to standard care,
placebo or benzodiazepines. Publications employed melatonin dosages
ranging from 3 mg to 500 mg per day. Timing of administration also varied
from single nightly to multiple daily doses. We found that melatonin
reduced delirium incidence by 30% (95% confidence interval [CI], 13 to
44%), reduced ICU length of stay by 0.49 days (95% CI, 0.10 to 0.89 days),
improved reported sleep quality by a SMD of 0.54 (95% CI, 0.01 to 1.07),
and improved ICU anxiety by 4.00 on the Hamilton Anxiety Rating Scale (95%
CI, 2.40 to 5.60). Melatonin reduced costs by a SMD of 0.31 (95% CI, 0.17
to 0.44). The incidence of adverse effects was not increased with
melatonin use. However, melatonin did not improve short or long-Term
mortality, delirium duration, agitation prevalence, sleep quantity,
mechanical ventilation duration, hospital length of stay, or post-ICU
function or cognition. CONCLUSION Our findings suggest that melatonin
administration in the critically ill may improve morbidity and reduce
costs, without increasing adverse effects. These results, drawn from a
large and varied body of evidence, support the implementation of melatonin
supplementation in the ICU. However, certainty of evidence was affected by
risk of bias and heterogeneity. Lack of standardization in available
melatonin supplements also impacts the reliability of findings and poses a
barrier to implementation of the intervention.5 In addition to rigorous
standards, future research should focus on identifying possible adverse
effects, optimal dosing, administration timing, and target populations.

<161>
Accession Number
650227151
Title
Comparison of the effects of dexmedetomidine and lidocaine on
postoperative analgesia and recovery characteristics: a meta-analysis of
randomized controlled trials.
Source
Systematic reviews. (no pagination), 2026. Date of Publication: 11 Feb
2026.
Author
Hung K.-C.; Chang L.-C.; Wang W.-T.; Liao S.-W.; Hsu C.-W.; Wu J.-Y.; Chen
I.-W.
Institution
(Hung, Liao) Department of Anesthesiology, Chi Mei Medical Center, Tainan
City, Taiwan (Republic of China)
(Hung) School of Medicine, College of Medicine, National Sun Yat-Sen
University, Kaohsiung, Taiwan (Republic of China)
(Chang, Wang) Department of Anesthesiology, E-Da Hospital, I-Shou
University, Kaohsiung City, Taiwan (Republic of China)
(Liao) Center of General Education, Chia Nan University of Pharmacy and
Science, Tainan City, Taiwan (Republic of China)
(Hsu) Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and
Chang Gung University College of Medicine, Kaohsiung City, Taiwan
(Republic of China)
(Wu) Department of Nutrition, Chi Mei Medical Center, Tainan City, Taiwan
(Republic of China)
(Wu) Department of Public Health, College of Medicine, National Cheng Kung
University, Tainan City, Taiwan (Republic of China)
(Chen) Department of Anesthesiology, Chi Mei Medical Center, Tainan City,
Liouying, Taiwan (Republic of China)
Abstract
BACKGROUND: Dexmedetomidine and lidocaine are commonly used adjuvants in
postoperative pain management; however, their comparative efficacy is
unclear. This meta-analysis compared the effects of intravenous
dexmedetomidine and lidocaine on postoperative analgesia and recovery.
<br/>METHOD(S): Cochrane Library, Medline, Embase, and Google Scholar were
searched from their inception to July 1, 2024, to identify relevant
randomized controlled trials (RCTs) comparing intravenous dexmedetomidine
and lidocaine in adult patients undergoing non-cardiac surgery under
general anesthesia. The primary outcomes were the postoperative pain score
at 24 h and postoperative opioid consumption. The secondary outcomes
included early postoperative pain scores, intraoperative opioid/anesthetic
requirements, hemodynamic parameters, recovery characteristics, and
inflammatory markers. <br/>RESULT(S): Twenty-four studies (1,697 patients)
were included. There was no significant difference between dexmedetomidine
and lidocaine in terms of pain scores at 24 h (mean difference [MD]: 0.01,
p = 0.88) or overall postoperative opioid consumption (standardized
MD[SMD]: -0.51, p = 0.06). However, dexmedetomidine was associated with
lower pain scores at 2-4 h postoperatively (MD:-0.41, p = 0.02), reduced
intraoperative anesthetic agent requirements (SMD:-1.1, p = 0.004), a
longer time to rescue analgesic (MD: -29.93 min, p < 0.00001), and
improved quality of recovery scores (SMD: 1.72, p = 0.01). Dexmedetomidine
resulted in lower heart rate and blood pressure compared to lidocaine,
without differences in other recovery characteristics and inflammation.
<br/>CONCLUSION(S): Both dexmedetomidine and lidocaine are effective
adjuvants for improving postoperative outcomes. Nevertheless,
dexmedetomidine has shown advantages in terms of early pain control,
reduced anesthetic requirements, and improved quality of recovery. The
choice of these agents should be based on individual patient factors and
specific surgical procedures.<br/>Copyright &#xa9; 2026. The Author(s).

<162>
Accession Number
2043176524
Title
Pulmonary Valve Replacement: Update on Timing and Ventricular Remodelling.
Source
Journal of Clinical Medicine. 15(3) (no pagination), 2026. Article Number:
1295. Date of Publication: 01 Feb 2026.
Author
Ortiz-Garrido A.; Rozewicz Juraszek M.; Gabbert D.D.; Jussli-Melchers J.;
Voges I.
Institution
(Ortiz-Garrido) Section of Paediatric Cardiology, Hospital Materno
Infantil, Regional Universitario de Malaga, Malaga, Spain
(Ortiz-Garrido) Faculty of Medicine, University of Malaga, Malaga, Spain
(Rozewicz Juraszek, Gabbert, Voges) Department of Congenital Heart Disease
and Paediatric Cardiology, University Hospital Schleswig-Holstein, Campus
Kiel, Kiel, Germany
(Gabbert, Voges) German Centre for Cardiovascular Research (DZHK), Partner
Site Hamburg/Kiel/Lubeck, Kiel, Germany
(Jussli-Melchers) Department of Cardiac Surgery, Universitatsklinikum
Schleswig-Holstein, Kiel, Germany
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Chronic pulmonary regurgitation (PR) after the repair of tetralogy of
Fallot (TOF) and other right ventricular outflow tract (RVOT)
interventions leads to progressive right ventricular (RV) dilatation,
altered ventricular-ventricular interaction, and an increased risk of
arrhythmia and heart failure. Pulmonary valve replacement (PVR), whether
surgical or transcatheter, effectively eliminates or reduces PR and is
associated with short- and mid-term improvement in RV size, symptoms, and
electrocardiographic markers. However, the optimal timing of intervention
remains unresolved: operating late can result in irreversible myocardial
damage and arrhythmogenic substrates, whereas operating early can lead to
repeated reinterventions, the impact of which on hard outcomes is
uncertain. This review summarizes contemporary evidence on ventricular
remodelling after PVR, focusing on cardiovascular magnetic resonance (CMR)
and echocardiographic markers, and critically appraises proposed criteria
for timing PVR. Classic CMR-derived thresholds (RV end-diastolic volume
index [RVEDVi] 150-170 mL/m², RV end-systolic volume index
[RVESVi] 80-90 mL/m²) and QRS duration cut-offs are discussed
alongside emerging markers of risk, including the RV mass-to-volume ratio,
diffuse myocardial fibrosis (extracellular volume fraction), strain
imaging, and diastolic dysfunction. Meta-analyses show consistent reverse
remodelling and symptomatic benefit after PVR, but no conclusive survival
benefit has been demonstrated, and data on arrhythmic outcomes remain
conflicting. Key gaps include (i) the lack of prospective randomized or
carefully matched comparative studies of "early" versus "deferred" PVR;
(ii) limited understanding of how myocardial fibrosis, RV hypertrophy, and
diastolic dysfunction interact with volume load and timing to influence
long-term outcomes; (iii) under-representation of adult and older adult
TOF cohorts; and (iv) insufficient integration of multiparametric risk
scores and machine-learning approaches into clinical decision-making.
Future research should prioritize multicentre longitudinal cohorts with
standardized imaging, electrophysiological and clinical endpoints,
incorporate advanced imaging techniques (e.g., strain, 3D late gadolinium
enhancement, and T1 mapping), and explore precision-medicine strategies to
individualize PVR timing.<br/>Copyright &#xa9; 2026 by the authors.

<163>
Accession Number
2037666505
Title
Colchicine in Cardiology Practice. Mechanisms of Influence on the
Cardiovascular System, Use in the Treatment of Pericarditis and Ischemic
Heart Disease.
Source
Kardiologiya. 65(11) (pp 101-111), 2025. Date of Publication: 2025.
Author
Sukmarova Z.N.; Simonenko V.B.
Publisher
Limited Liability Company KlinMed Consulting
Abstract
Despite significant advances in pharmacological, interventional, and
surgical treatments for cardiovascular diseases (CVDs) in recent decades,
it appeared that the effectiveness of standard treatments has reached a
ceiling, and growing attention has been paid to the regulation of
inflammation. Immune inflammation is a key component in the pathogenesis
of atherosclerosis and its complications, cardiac arrhythmias, and heart
failure, but it is also an integral part of tissue regeneration.
Consistently, the indiscriminate use of various anti-inflammatory agents
with pronounced immunosuppressive properties has failed to demonstrate
benefits in heart disease. Numerous studies, including long-term ones,
have demonstrated that colchicine remains an anti-inflammatory drug that
is not associated with the development of iatrogenic immunodeficiency or
increased cardiovascular mortality. Considering this, as well as the
effects of colchicine on the immune system components involved in the
pathophysiology of CVD, its short half-life, its century-long history of
use in rheumatology, and the fact that colchicine is "familiar" to
cardiologists from the experience of treatment of pericarditis, colchicine
appears the most promising and safe for use in common cardiology practice.
However, the use of immunomodulators requires a better understanding of
the pathophysiology of inflammation, differentiating physiological and
excessive inflammation, and the risks associated with impaired endogenous
defense. Therefore, colchicine and other immunosuppressants, as distinct
from acetylsalicylic acid, cannot be prescribed for formal indications. To
define more clearly the patient groups most likely to benefit from
colchicine, further research, new diagnostic methods, and the opinion of a
cardiologist are needed. This review includes clinical studies, abstracts,
and meta-analyses published online with no publication date restrictions
up to July 2025. The PubMed, ScienceDirect, Google Scholar, and CENTRAL
databases were used, in which 520 literature sources were reviewed
describing the clinical efficacy of colchicine drugs and the heterogeneity
of its effects in different treatment regimens for various
CVDs.<br/>Copyright &#xa9; 2025, Limited Liability Company KlinMed
Consulting. All rights reserved.

<164>
Accession Number
2043176035
Title
Noninvasive Biomarkers for Cardiac Allograft Rejection Monitoring:
Advances, Challenges, and Future Directions.
Source
Journal of Clinical Medicine. 15(3) (no pagination), 2026. Article Number:
986. Date of Publication: 01 Feb 2026.
Author
Luo Y.; Lai J.; Li C.; Wang G.
Institution
(Luo, Lai, Wang) Department of Cardiovascular Surgery, Union Hospital,
Tongji Medical College, Huazhong University of Science and Technology,
Wuhan, China
(Li) Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan
University, Wuhan, China
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac transplantation remains an important therapy for end-stage heart
failure, although allograft rejection continues to pose significant
clinical challenges. This review evaluates both established and emerging
blood-based biomarkers for noninvasive monitoring of rejection in heart
transplant recipients. Donor-derived cell-free DNA (ddcfDNA) and gene
expression profiling (GEP) represent well-validated, commercially
available molecular tools that demonstrate strong discriminative capacity
for acute rejection episodes. Additionally, microRNAs (miRs) and
extracellular vesicles (EVs) show considerable potential as novel
biomarkers, although further validation is required. In contrast,
conventional biomarkers such as B-type natriuretic peptide (BNP), cardiac
troponins, and creatine kinase-MB (CK-MB) offer limited specificity in the
context of rejection. This review synthesizes current evidence on the
clinical utility, methodological challenges, and integration strategies of
these biomarkers, highlighting a shift toward molecular-based approaches
for improving post-transplant surveillance and patient
outcomes.<br/>Copyright &#xa9; 2026 by the authors.

<165>
[Use Link to view the full text]
Accession Number
2043317920
Title
Class 1 Indications for Coronary Revascularization Identified in Prekidney
Transplant Screening.
Source
Journal of the American Society of Nephrology. Publish Ahead of Print (no
pagination), 2025. Date of Publication: 07 Oct 2025.
Author
Israni A.; Sandorffy B.L.; Liu C.S.; Fraticelli Ortiz D.I.; Gross H.M.;
Nicholson J.; Cazes M.; Soomro Q.H.; Zhang X.; Wu W.; Charytan D.M.
Institution
(Israni, Sandorffy, Liu, Fraticelli Ortiz, Gross, Cazes, Soomro, Wu,
Charytan) Nephrology Division, Department of Medicine, NYU Grossman School
of Medicine, New York, New York
(Nicholson) Health Sciences Library, NYU Grossman School of Medicine, New
York, New York
(Zhang, Wu) Biostatistics Division, Department of Population Health, NYU
Grossman School of Medicine, New York, New York
Publisher
Wolters Kluwer Health
Abstract
Key Points - Coronary artery disease is a barrier to kidney
transplantation. Many transplant programs mandate routine coronary artery
disease screening. It remains unclear how many patients meet class 1
indication for revascularization. We conducted a meta-analysis to estimate
the prevalence. Despite high frequency of screening, we found a relatively
low prevalence of class 1 indication for coronary revascularization.
Background - Cardiovascular disease is the most common cause of morbidity
and mortality in kidney transplant recipients. Screening for coronary
disease is frequently required before kidney transplantation, but coronary
intervention has not been shown to be beneficial except in complex
coronary artery disease. The likelihood of finding significant coronary
artery disease and the benefits of routine pretransplant screening are
uncertain.Methods - We performed a systematic review and meta-analysis.
Medical Literature Analysis and Retrieval System Online and Excerpta
Medica database were searched to identify manuscripts published between
1998 and 2024 reporting the results of pretransplant screening. The
primary end points were the frequency of detecting significant coronary
lesions for which there are American Heart Association class 1 indications
for revascularization: (1) >50% left main stenosis or (2) multivessel
disease with ejection fraction <35% during prekidney transplant screening.
Secondary end points included frequency of detecting multivessel disease,
proximal left anterior descending artery disease, and number of patients
who underwent invasive coronary angiography. Meta-regression was used to
explore outcome heterogeneity according to the presence of hypertension,
diabetes, and age.Results - We identified 1273 studies, out of which 44
met eligibility criteria. The mean prevalence of class 1 indications was
2%, although the heterogeneity was high with estimates ranging from 0% to
17%. Estimated prevalence of proximal left anterior descending disease was
2% and left main stenosis was 1%, whereas 10% of patients had multivessel
coronary artery disease, and 35% were referred for invasive angiography.
There was no evidence of significant heterogeneity according to sex of the
population or prevalence of diabetes or hypertension.Conclusions -
Identification of class 1 indications for revascularization during
pretransplant coronary screening was rare.Podcast - This article contains
a podcast at
https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN
/2026_01_08_ASN0000000890.mp3<br/>Copyright &#xa9; 2025 by the American
Society of Nephrology

<166>
Accession Number
2043176507
Title
Cardiac Rehabilitation in Patients After Coronary Artery Bypass Grafting:
Core Components and Long-Term Follow-Up.
Source
Journal of Clinical Medicine. 15(3) (no pagination), 2026. Article Number:
1103. Date of Publication: 01 Feb 2026.
Author
Prisacariu I.; Iorescu L.-V.; Aboueddahab C.; Taheri M.; Beneki E.; Akinci
B.; Batalik L.; Dumitrescu S.I.; Marketou M.; Perone F.
Institution
(Prisacariu, Iorescu, Dumitrescu) Central Military Emergency University
Hospital "Dr. Carol Davila", Bucharest, Romania
(Aboueddahab) Department of Cardiology, Ibn Sina University Hospital,
Mohammed V University of Rabat, Rabat, Morocco
(Taheri) Department of Cardiovascular Medicine, Mayo Clinic, Rochester,
MN, United States
(Beneki) Department of Cardiology, CHUV Lausanne University Hospital,
Lausanne, Switzerland
(Akinci) Department of Physiotherapy and Rehabilitation, Faculty of Health
Sciences, Biruni University, Istanbul, Turkey
(Akinci) Biruni University Research Center (B@MER), Biruni University,
Istanbul, Turkey
(Batalik) Department of Rehabilitation, University Hospital Brno, Brno,
Czechia
(Batalik) Department of Physiotherapy and Rehabilitation, Faculty of
Medicine, Masaryk University, Brno, Czechia
(Batalik) Rehabilitation Clinic, Faculty of Medicine, Masaryk University,
Brno, Czechia
(Batalik) Department of Public Health, Faculty of Medicine, Masaryk
University, Brno, Czechia
(Marketou) School of Medicine, University of Crete, Crete, Greece
(Perone) Cardiac Rehabilitation Unit, Rehabilitation Clinic "Villa delle
Magnolie", 81020 Castel Morrone, Caserta, Italy
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac rehabilitation is strongly recommended in secondary cardiovascular
prevention. In patients after coronary artery bypass grafting, this
intervention is suggested to reduce mortality, morbidity, and disability.
In addition, rehabilitation programs improve quality of life and
cardiorespiratory fitness. Modern cardiac rehabilitation programs include
structured exercise training, education, nutritional counseling,
psychosocial support, and management of cardiovascular risk factors, each
tailored to the specific needs of post-coronary artery bypass grafting
patients who often face a high burden of comorbidities and surgical
recovery challenges. For these reasons, cardiac rehabilitation should be
regarded as standard of care. Evidence supports early cardiac
rehabilitation initiation and individualized multidisciplinary plans,
which have shown to improve exercise capacity, health-related quality of
life, and medication adherence. Long-term follow-up is essential, as
studies have demonstrated a clear association between sustained cardiac
rehabilitation engagement and decreased rates of rehospitalization and
all-cause mortality. Therefore, this comprehensive review presents recent
advances and updates on the management of patients after coronary artery
bypass grafting during cardiac rehabilitation, with a focus on the core
components and long-term follow-up.<br/>Copyright &#xa9; 2026 by the
authors.

<167>
Accession Number
650221744
Title
Effects of combined Triflow, deep breathing and coughing exercises on
postoperative pulmonary function after mitral valve replacement: a
randomized controlled trial.
Source
BMC surgery. (no pagination), 2026. Date of Publication: 10 Feb 2026.
Author
Akinci N.; Eren E.
Institution
(Akinci) Department of Nursing, Faculty of Health Sciences, Fenerbahce
University, Istanbul, Turkey
(Eren) Department of Nursing, Faculty of Health Sciences, Istanbul Medipol
University, Istanbul, Turkey
Abstract
BACKGROUND: Postoperative pulmonary complications remain a major cause of
morbidity after cardiac valve surgery. Although incentive spirometry
(Triflow) is routinely used in postoperative care, evidence regarding the
additional benefits of combining Triflow with deep breathing and coughing
exercises remains limited. This study aimed to evaluate the effects of
combined Triflow, deep breathing, and coughing exercises on postoperative
pulmonary function in adult patients undergoing mitral valve replacement.
<br/>METHOD(S): This randomized controlled, single-blind trial was
conducted between May and August 2025 in a private hospital in Istanbul. A
total of 60 adult patients undergoing mitral valve replacement were
randomly allocated to an experimental group (n = 30) or a control group (n
= 30) using simple randomization. The experimental group performed Triflow
combined with deep breathing and coughing exercises, while the control
group performed Triflow alone. <br/>RESULT(S): Postoperative SpO2 levels
were significantly higher in the experimental group at T1 (p = 0.009; 95%
CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95%
CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the
experimental group compared with the control group at discharge (p <
0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in
the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p <
0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37).
Hematocrit levels were significantly lower in the experimental group at T1
(p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to -
1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were
significantly lower in the experimental group at T1 (p < 0.001; 95% CI:
-2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to
first mobilization was significantly shorter in the experimental group (p
< 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary
complications were observed in either group. <br/>CONCLUSION(S): The
combined application of Triflow, deep breathing, and coughing exercises
was associated with significant improvements in postoperative pulmonary
function, oxygen saturation, pain reduction, and earlier mobilization
compared with Triflow alone in patients undergoing mitral valve
replacement. These findings suggest that a structured, combined
respiratory exercise protocol may provide additional clinical benefits in
the early postoperative period. TRIAL REGISTRATION: ClinicalTrials.gov
Identifier NCT06997224 (First registered on 15 May 2025).<br/>Copyright
&#xa9; 2026. The Author(s).

<168>
[Use Link to view the full text]
Accession Number
650216163
Title
Preoperative and Intraoperative Risk Factors for Postoperative Pneumonia
After Cardiac Surgery: An Ancillary Study of the STERNOCAT (Catheter
Outcomes With Sternotomy Cardiac Operated) Randomized Trial and a
Systematic Review With Meta-Analysis.
Source
Critical care medicine. (no pagination), 2026. Date of Publication: 11
Feb 2026.
Author
Dureau P.; Rombi L.; Ouorou R.; Hariri G.; Duceau B.; Amour J.; Bougle A.;
Dechartres A.
Institution
(Dureau, Rombi, Hariri, Duceau, Bougle) Clinical Research Group in
Anesthesiology, Critical Care and Perioperative Medicine, Sorbonne
University, Paris, France
(Dureau, Rombi, Hariri, Duceau, Bougle) Department of Anesthesiology and
Critical Care, AP-HP, Pitie Salpetriere Hospital, Paris, France
(Dureau, Hariri, Dechartres) Department of Public Health, Sorbonne
University, INSERM, Pierre Louis Institute of Epidemiology and Public
Health, AP-HP, Pitie Salpetriere Hospital, AP-HP Center for
Pharmacoepidemiology (Cephepi), Paris, France
(Ouorou) Public Health Department, Pitie-Salpetriere Hospital, APHP,
Paris, France
(Amour) Critical Care and Cardiac Surgery Anesthesia, IPRA, Jacques
Cartier Private Hospital, Massy, France
Abstract
OBJECTIVE: Postoperative pneumonia (POP) is a frequent complication after
cardiac surgery, which significantly worsens prognosis. This study aimed
to identify preoperative and intraoperative factors independently
associated with POP in a cardiac surgery cohort, perform a systematic
review (SR) and meta-analysis of risk factors, outcomes, and predictive
models, and validate these models in the cohort. DESIGN: This is an
ancillary study of the STERNOCAT (Catheter Outcomes With Sternotomy
Cardiac Operated) trial completed by an SR and meta-analysis. PubMed,
Embase, and Cochrane Library were searched (January 2000 to March 31,
2025). Two reviewers independently screened references to identify studies
on adult cardiac surgery patients assessing POP risk factors or predictive
models, extracted data, and assessed methodological quality. Predictive
models identified through the SR were externally validated using the
STERNOCAT cohort. SETTING: Cardiac surgery units in France (STERNOCAT
cohort) and international hospital settings (SR studies). PATIENTS: A
total of 1,470 patients from the STERNOCAT cohort and 172,079 from 24
studies overall were included in the SR.None. MEASUREMENTS AND MAIN
RESULTS: In the STERNOCAT ancillary study, 78 of 1470 patients developed
POP (5.3%). Independent risk factors included ischemic cardiomyopathy
(odds ratio [OR] 1.89, 95% CI [1.13-3.16]), cardiopulmonary bypass (CPB)
duration (OR 1.10, 95% CI [1.02-1.18]), and catecholamine use (OR 4.07,
95% CI [2.45-6.76]). POP was associated with higher 30-day mortality
(14.1% vs. 1.5%, p < 0.0001). The meta-analysis identified 14 significant
risk factors for POP. Of these, 10 were non-modifiable (e.g., age,
diabetes mellitus, chronic obstructive pulmonary disease, chronic renal
disease, previous cardiac surgery, emergency surgery). Four were partially
modifiable: active smoking, CPB duration, intraoperative transfusions
(presence and amount). Only one model, limited to preoperative variables,
could be externally validated and showed poor accuracy.
<br/>CONCLUSION(S): This study highlights the difficulty of predicting and
preventing POP, as most identified risk factors are non-modifiable or
require long-term preventive strategies. Perioperative optimization,
particularly regarding CPB management and transfusion practices,
therefore, remains essential to improving patient outcomes. REGISTRATION:
PROSPERO (CRD42024555519).<br/>Copyright &#xa9; 2026 by the Society of
Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights
Reserved.

<169>
Accession Number
2043482460
Title
Randomized controlled trials in valvular heart disease: the evolving role
of multimodality imaging.
Source
European Heart Journal Cardiovascular Imaging. 27(2) (pp 187-205), 2026.
Date of Publication: 01 Feb 2026.
Author
Tastet L.; Naser J.A.; Dahl J.S.; Beaudoin J.; Hung J.W.
Institution
(Tastet, Beaudoin) Department of Medicine, Institut Universitaire de
Cardiologie et de Pneumologie de Quebec, Universite Laval, 2725 chemin
Sainte-Foy, Quebec, Canada
(Naser, Dahl) Department of Cardiovascular Medicine, Mayo Clinic, 200
First Street SW, Rochester, MN, United States
(Dahl) Department of Cardiology, Odense University Hospital, J.B. Winslows
Vej 4, Odense, Denmark
(Hung) Division of Cardiology, Cardiac Ultrasound Laboratory,
Massachusetts General Hospital, 55 Fruit St, Boston, MA, United States
Publisher
Oxford University Press
Abstract
Valvular heart disease represents a significant global health burden, with
an estimated prevalence of 2.5% in high-income countries and projected
increases due to population ageing. Randomized controlled trials in
valvular heart disease have undergone substantial evolution, shifting from
mortality-focused endpoints toward comprehensive assessments integrating
imaging parameters and patient-centered outcomes. Cardiovascular imaging
modalities, including echocardiography, cardiac computed tomography, and
cardiac magnetic resonance, have become pivotal in trial design, patient
selection, and endpoint definition. Recent landmark trials in aortic
stenosis, including EARLY-TAVR and EVOLVED, have challenged traditional
symptom-based intervention thresholds by incorporating imaging biomarkers
of subclinical myocardial dysfunction and cardiac damage staging. In
aortic regurgitation, the paucity of randomized controlled trials evidence
contrasts with emerging transcatheter technologies, highlighting critical
knowledge gaps. Mitral regurgitation trials have demonstrated the
importance of patient phenotyping, with divergent outcomes between COAPT
and MITRA-FR emphasizing the role of imaging in optimal patient selection.
The recent TRILUMINATE and TRISCEND trials have transformed tricuspid
regurgitation management through transcatheter interventions, prioritizing
quality-of-life improvements alongside traditional clinical endpoints.
Future directions include standardization of imaging protocols across
modalities, development of artificial intelligence-enhanced analysis, and
integration of multiparametric biomarkers for personalized risk
stratification. The paradigm shift toward imaging-guided, patient-centered
trial design represents a fundamental reimagining of therapeutic success
in valvular heart disease, moving beyond procedural outcomes toward
comprehensive assessment of clinical benefit and improved patient
care.<br/>Copyright &#xa9; The Author(s) 2025. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<170>
Accession Number
2043504946
Title
Effect of preoperative prehabilitation on the 6-minute walk distance and
postoperative outcomes in adult patients: meta-analysis.
Source
BJS Open. 10(1) (no pagination), 2026. Article Number: zraf162. Date of
Publication: 01 Feb 2026.
Author
Diaz-Vidal P.; Gil-Casado C.; Fernandez-Vazquez U.; Diz-Ferreira E.;
Luna-Rojas P.; Diz J.C.
Institution
(Diaz-Vidal, Gil-Casado, Fernandez-Vazquez, Diz-Ferreira, Luna-Rojas)
School of Medicine, University of Santiago de Compostela, Santiago de
Compostela, Spain
(Diz-Ferreira, Diz) Well-Move Research Group, Galicia Sur Health Research
Institute (IIS Galicia Sur), Vigo, Spain
(Diz) Department of Anaesthesia and Postoperative Critical Care, Hospital
Alvaro Cunqueiro, Vigo, Spain
(Diz) Department of Functional Biology and Health Sciences, University of
Vigo, Vigo, Spain
Publisher
Oxford University Press
Abstract
Background: Low cardiorespiratory fitness (CRF) has been demonstrated to
be associated with increased perioperative morbidity and mortality.
However, evidence regarding the effect of prehabilitation on CRF and
postoperative outcomes remains inconclusive. <br/>Method(s): A systematic
review and meta-analysis were conducted in accordance with the PRISMA
statement encompassing randomized clinical trials (RCTs) published in
PubMed and Web of Science up to June 2025 on the effects of
prehabilitation with exercise, measured using the 6-minute walk test, for
adult patients undergoing surgery. The primary objective was to examine
the effect of prehabilitation based on physical exercise on the
preoperative physical condition of adults scheduled to undergo elective
surgery, measured as the change in the 6-minute walk distance (6MWD).
Factors associated with changes in the 6MWD and the effect of
prehabilitation on postoperative CRF were analysed, as were the length of
hospital stay and mortality. Effect sizes and their 95% confidence
interval (c.i.) were estimated with a random-effects model.
<br/>Result(s): Of 107 RCTs screened, 21 were included in the analysis,
comprising 1649 patients (828 undergoing prehabilitation) across several
specialities, the most prevalent being cardiac (501 patients), colorectal
(423 patients), and thoracic surgery (364 patients). The prehabilitation
group exhibited a greater improvement in the 6MWD before surgery (mean
difference (MD) 29 m; 95% c.i. 14 to 42 m; P < 0.001; I ² =
84%) and in the first month after surgery (MD 22 m; 95% c.i. 0 to 43 m; P
= 0.05; I ² = 92%). A greater proportion of patients in the
prehabilitation group had a clinically significant improvement in the 6MWD
both before (odds ratio (OR) 2.66; 95% c.i. 1.76 to 4.0; P < 0.001; I
² = 53%) and after (OR 2.59; 95% c.i. 1.05 to 6.35; P = 0.04; I
² = 69%) surgery. There were no differences between the groups
in length of hospital stay (MD -0.24; 95% c.i. -0.65 to 0.17; P = 0.25; I
² = 25%) or mortality (OR 0.71; 95% c.i. 0.26 to 1.92; P = 0.5;
I ² = 0%). <br/>Conclusion(s): Prehabilitation involving
physical exercise before surgery was associated with an improvement in
preoperative CRF. However, no differences were observed between the groups
in length of hospital stay or postoperative mortality. The improvement in
CRF persists in the postoperative period, suggesting a potential benefit
for patient recovery.<br/>Copyright &#xa9; The Author(s) 2026. Published
by Oxford University Press on behalf of BJS Foundation Ltd.

<171>
Accession Number
2043510944
Title
Cost analyses in randomized trials on robot-assisted surgery: systematic
review.
Source
BJS Open. 10(1) (no pagination), 2026. Article Number: zraf161. Date of
Publication: 01 Feb 2026.
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,
Amsterdam UMC, 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
Publisher
Oxford University Press
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. Methods 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.
Results 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%). Conclusion
Randomized trials comparing RAS with other surgical approaches rarely
perform adequate cost assessments and costeffectiveness analyses. The
substantial risk of bias, methodological heterogeneity, and partial cost
reporting observed underline the need for uniform economic evaluation in
RCTs on RAS.<br/>Copyright &#xa9; The Author(s) 2026. Published by Oxford
University Press on behalf of BJS Foundation Ltd.

<172>
Accession Number
2043154196
Title
Cardiothoracic Transplant Surgery and Enhanced Recovery: Recent Advances
and Perspectives.
Source
Journal of Clinical Medicine. 15(3) (no pagination), 2026. Article Number:
1179. Date of Publication: 01 Feb 2026.
Author
Aggarwal R.; Hutson J.; Zapata D.; Massey H.; Taylor B.; Griffith B.;
Robinson J.
Institution
(Aggarwal, Hutson, Robinson) College of Human Medicine, Michigan State
University, Grand Rapids, MI, United States
(Zapata, Massey, Taylor, Griffith, Robinson) Department of Surgery,
University of Maryland School of Medicine, Baltimore, MD, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Introduction: Cardiothoracic transplant surgery represents a critical
intervention for patients with end-stage heart and/or lung failure. While
advancements in surgical techniques and perioperative management have
enhanced survival rates, these procedures remain associated with
significant morbidity, extended hospitalizations, and complex recovery
trajectories. Background/Objectives: Enhanced Recovery After Surgery
(ERAS) protocols, originally developed for colorectal surgery, have shown
promise in optimizing perioperative care across various surgical
disciplines. However, their application in cardiac and thoracic
transplantation is still emerging. This article evaluates recent
advancements in ERAS protocols tailored to cardiac and thoracic transplant
patients, focusing on preoperative, intraoperative, and postoperative
interventions. <br/>Result(s): Evidence highlights the potential of ERAS
to reduce complications, shorten hospital stays, and improve long-term
outcomes. Key strategies include preoperative optimization through
nutritional and psychosocial prehabilitation, intraoperative adoption of
minimally invasive techniques and refined anesthesia practices, and
postoperative protocols emphasizing opioid-sparing pain management, early
mobilization, and nutritional recovery. <br/>Conclusion(s): This review
identifies gaps in current research and offers recommendations for the
broader implementation and standardization of ERAS protocols in
cardiothoracic surgery, with emphasis on cardiothoracic transplantation,
aiming to improve outcomes for this high-risk population.<br/>Copyright
&#xa9; 2026 by the authors.

<173>
[Use Link to view the full text]
Accession Number
650215796
Title
Discharge Readiness and Self-Efficacy After Coronary Artery Bypass
Surgery: The Power of Different Discharge Education Materials.
Source
Computers, informatics, nursing : CIN. (no pagination), 2026. Date of
Publication: 09 Feb 2026.
Author
Sahan D.; Gezer N.
Institution
(Sahan) Faculty of Nursing, Department of Surgical Nursing, Aydin Adnan
Menderes University, Turkey
Abstract
The aim of this study is to examine the effect of different discharge
education methods on readiness for discharge and self-efficacy in
individuals undergoing coronary artery bypass graft surgery. This
quasi-experimental study included 72 CABG patients in a university
hospital in the Aegean Region, Turkey, from October 2019 to March 2022.
The Standard Care Group (n=24) received no intervention, while the
Education Booklet Group (n=24) received discharge education via a booklet,
and the Mobile Application Group (n=24) via a mobile app. There was no
statistically significant difference between the Education Booklet Group
and the Mobile Application Group in terms of readiness for discharge and
self-efficacy scores, but the scores of the Education Booklet Group and
the Mobile Application Group were statistically higher than those of the
Standard Care Group. While readiness for discharge and self-efficacy
showed no significant difference between the 2 intervention groups, the
mobile app was found to be at least as effective, usable, and highly
recommended as the education traditionally given with the education
booklet.<br/>Copyright &#xa9; 2026 Wolters Kluwer Health, Inc. All rights
reserved.

<174>
Accession Number
2043482685
Title
Evaluation of a pharmacist-led patient-self-testing model for warfarin
management in patients undergoing mechanical heart valve replacement in
China: a multicentre, open-label, randomised, controlled trial.
Source
BMJ Open. 16(2) (no pagination), 2026. Article Number: e105575. Date of
Publication: 09 Feb 2026.
Author
Wang C.; Luo J.; Zhou X.; Guo Y.; Cao W.; Zhang D.; Song L.; Tan S.
Institution
(Wang, Luo, Tan) Department of Pharmacy, The Second Xiangya Hospital of
Central South University, Central South University, Hunan, Changsha, China
(Zhou) Department of Cardiovascular Surgery, The Second Xiangya Hospital
of Central South University, Hunan, Changsha, China
(Guo) Department of Pharmacy, Taoyuan People's Hospital, Hunan, Changde,
China
(Cao) Department of Pharmacy, Xiangtan Central Hospital, Hunan, Xiangtan,
China
Publisher
BMJ Publishing Group
Abstract
Objectives Patient self-testing (PST) for warfarin management is
well-established in developed countries but remains underused in
developing regions. This study compared the safety and effectiveness of
PST with usual care (UC) in China. Design A multicentre, open-label,
randomised, controlled trial. Setting A total of five centres participated
in this study, including one provincial tertiary hospital, two municipal
tertiary hospitals and two primary hospitals. Participants Patients
undergoing mechanical heart valve (MHV) replacement at five centres were
prospectively enrolled. Patients were trained and stratified according to
time on warfarin at enrolment and were randomly assigned to the PST or UC
group. Interventions The PST group used a point-of-care testing device for
at-home international normalised ratio (INR) monitoring with
pharmacist-guided warfarin dosing, while the UC group attended outpatient
clinics for INR monitoring and dosing. Primary and secondary outcome
measures The primary outcome was the difference in time in therapeutic
range (TTR). The secondary outcomes were incidences of major bleeding,
thromboembolism and all-cause deaths in 12 months. Results From March 2021
to March 2023, a total of 556 patients were enrolled, with a mean age of
47.5 years, 45.1% being male. 342 were newly initiating warfarin therapy,
while 214 had been on warfarin for over 6months. Baseline characteristics
were similar between the PST and UC groups. The PST group showed
significantly higher TTR (67.2% vs 55.1%, p<0.001) and lower incidences of
major bleeding (0.7% vs 7.9%, p<0.001) and thromboembolism (0.4% vs 6.8%,
p<0.001), with no difference in all-cause mortality (0.4% vs 1.8%,
p=0.22). Logistic regression identified that using PST and younger age
were independent factors associated with fewer warfarin-related adverse
events. Conclusions A pharmacist-led PST intervention with ongoing
education and counselling led to improved TTR and clinical outcomes in
patients with MHV in China.<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.

<175>
Accession Number
650215836
Title
Choosing Between CABG and PCI for 3-Vessel Coronary Disease: What's Cost
Got to Do With It?.
Source
Journal of the American College of Cardiology. (no pagination), 2026.
Date of Publication: 02 Feb 2026.
Author
Mark D.B.; Rao S.V.
Institution
(Mark) Duke Clinical Research Institute, Duke University, Durham, North
Carolina, USA; Division of Cardiology, Duke University Medical Center,
Durham, North Carolina, USA
(Rao) New York University Grossman School of Medicine, NY, United States

<176>
Accession Number
2043556024
Title
Comparison of Classical Blood Cardioplegia and Modified Del Nido
Cardioplegia on Postoperative Serum Lactate Levels and Extubation Times.
Source
Journal of the College of Physicians and Surgeons Pakistan. 36(2) (pp
243-247), 2026. Date of Publication: 01 Feb 2026.
Author
Tamtekin B.; Ersoy G.G.
Institution
(Tamtekin, Ersoy) Department of Cardiovascular Surgery, Faculty of
Medicine, Kastamonu University, Kastamonu, Turkey
Publisher
College of Physicians and Surgeons Pakistan
Abstract
Objective: To compare the effects of intermittent classical blood
cardioplegia and single-dose modified Del Nido cardioplegia on
postoperative serum lactate levels and extubation time in patients
undergoing coronary artery bypass grafts (CABG). <br/>Study Design: An
observational study. Place and Duration of the Study: Department of
Cardiovascular Surgery, Faculty of Medicine, Kastamonu University,
Kastamonu, Turkiye, from 2020 to September 2023. Methodology: Forty
patients who underwent CABG between 2020 and 2023 were randomly divided
into two groups. Group 1 formed 20 patients who received intermittent
classical blood cardioplegia, and Group 2 formed 20 patients who received
single-dose modified Del Nido cardioplegia. Demographic data, bypassed
vessels, cardiopulmonary bypass (CPB) time, aortic cross clamp (ACC) time,
postoperative drainage, inotrope required and extubation time, glomerular
filtration rate (GFR), and serum lactate levels were recorded 2 hours
after surgery. The Shapiro-Wilk test was utilised to evaluate the
normality of data distribution. The Mann-Whitney U test was employed for
variables that did not follow a normal distribution, whereas normally
distributed variables were analysed using the independent samples t-test.
Additionally, the chi-square test was applied to compare categorical
variables across groups. <br/>Result(s): No statistically significant
differences were detected between the groups with respect to demographic
data, ACC time, CPB time, bypassed vessels, postoperative drainage,
inotrope requirement, or GFR. Postoperatively, lactate levels were
statistically lower in Group 2 than in Group 1, and extubation time was
statistically shorter in Group 2 than in Group 1 (p <0.001).
<br/>Conclusion(s): Modified Del Nido cardioplegia reduces postoperative
lactate levels and extubation time. Therefore, modified Del Nido
cardioplegia provides better patient stability and myocardial protection
than the classical blood cardioplegia after CABG.<br/>Copyright &#xa9;
2026 College of Physicians and Surgeons Pakistan. All rights reserved.