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<1>
Accession Number
2043911445
Title
Angiography-derived fractional flow reserve versus coronary angiography to
guide coronary artery bypass grafting in patients undergoing surgical
valve procedures with concomitant coronary artery disease in China (FAVOR
IV-QVAS): a multicentre, triple-blind, randomised trial.
Source
The Lancet. 407(10534) (pp 1161-1170), 2026. Date of Publication: 21 Mar
2026.
Author
Zhu Y.; Cheng Z.; Zhao Y.; Han L.; Zhang W.; Zhang C.; Yang S.; Ma L.;
Qiao C.; Guo Z.; Zhu D.; Zhang X.; Chen L.; Wang Z.; Ye X.; Zhou M.; Li
H.; Qiu J.; Xu H.; Sun Y.; Zhu J.; Xu Z.; Qin G.; Wijns W.; Redfors B.;
Sandner S.; Gaudino M.; Tu S.; Zhao Q.
Institution
(Zhu, Wang, Ye, Zhou, Li, Qiu, Xu, Sun, Zhu, Zhao) Department of
Cardiovascular Surgery, Ruijin Hospital Shanghai Jiao Tong University
School of Medicine, Shanghai, China
(Cheng) Department of Cardiac Surgery, Fuwai Central China Cardiovascular
Hospital, Zhengzhou, China
(Zhao) Department of Cardiovascular Surgery, The Second XiangYa Hospital
of Central South University, Changsha, China
(Han, Xu) Department of Cardiovascular Surgery, Changhai Hospital of
Shanghai, Shanghai, China
(Zhang, Qin) Department of Biostatistics, School of Public Health, Fudan
University, Shanghai, China
(Zhang) Department of Cardiovascular Surgery, The First Affiliated
Hospital of Anhui Medical University, Hefei, China
(Yang) Department of Cardiovascular Surgery, The Affiliated Hospital of
Qingdao University, Qingdao, China
(Ma) Department of Cardiovascular Surgery, The First Affiliated Hospital
Zhejiang University School of Medicine, Hangzhou, China
(Qiao) Department of Cardiovascular Surgery, The First Affiliated Hospital
of Zhengzhou University, Zhengzhou, China
(Guo) Department of Cardiovascular Surgery, Tianjin Chest Hospital,
Tianjin, China
(Zhu) Department of Cardiovascular Surgery, Shanghai Chest Hospital,
Shanghai, China
(Zhang) Department of Cardiovascular Surgery, Qilu Hospital of Shandong
University, Jinan, China
(Chen) Department of Cardiovascular Surgery, Fujian Medical University
Union Hospital, Fuzhou, China
(Wijns) Lambe Institute for Translational Research, Smart Sensors
Laboratory and CURAM, University of Galway, Galway, Ireland
(Redfors) Department of Population Health Sciences, Weill Cornell
Medicine, New York, NY, United States
(Redfors) Department of Cardiology, Sahlgrenska University Hospital,
Gothenburg, Sweden
(Sandner) Department of Cardiac and Thoracic Aortic Surgery, Medical
University of Vienna, Vienna, Austria
(Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, NY, United States
(Tu) Biomedical Instrument Institute, School of Biomedical Engineering,
Shanghai Jiao Tong University, Shanghai, China
Publisher
Elsevier B.V.
Abstract
Background For patients undergoing surgical valve procedures with
concomitant coronary artery disease, current guidelines recommend that
coronary artery bypass grafting (CABG) should be anatomically guided on
the basis of stenosis severity, as assessed by coronary angiography. We
aimed to test whether a physiologically guided strategy using
angiography-derived fractional flow reserve (FFR) could improve clinical
outcomes in this population. Methods FAVOR IV-QVAS is an
investigator-initiated, multicentre, randomised, triple-blind trial done
at 12 tertiary hospitals in China. Eligible patients were aged 18 years or
older and were scheduled for valve surgery, with at least one clinically
significant stenosis in a major coronary artery. Patients were randomly
assigned (1:1) to undergo physiologically guided CABG (for lesions with an
angiography-derived FFR value <=0.80) or anatomically guided CABG (for
lesions with a stenosis diameter >=50% on coronary angiography).
Randomisation was done using a web-based program and stratified by site
with fixed blocks of four. Patients, surgeons, follow-up physicians, and
outcome assessors were masked to treatment allocation. The primary outcome
was a composite of death, myocardial infarction, stroke, unplanned
coronary revascularisation, and new renal failure requiring dialysis
within 30 days after surgery. The key secondary outcome was a composite of
death, myocardial infarction, stroke, unplanned coronary
revascularisation, and hospitalisation for unstable angina or heart
failure at a minimum follow-up of 1 year. The primary analysis of the
primary and key secondary outcomes was done in a modified
intention-to-treat population that included all randomly assigned patients
who underwent surgery and had available data for the primary outcome.
Missing data for the primary outcome were planned to be analysed using
complete-case analysis or multiple imputation, with a proportion of
missing data of 2% as the threshold. This trial is registered at
ClinicalTrials.gov (NCT03977129); extended follow-up is ongoing. Findings
Between Aug 4, 2019, and Aug 13, 2024, 793 patients were enrolled. 396
were randomly assigned to the angiography-derived FFR group and 397 to the
coronary angiography group; one patient in the coronary angiography group
declined surgery and was excluded from the modified intention-to-treat
population. The median age was 65 years (IQR 59-70), 221 (28%) patients
were female, and 571 (72%) were male. Concomitant CABG was done in 223
(56%) patients in the angiography-derived FFR group and in 388 (98%)
patients in the coronary angiography group. The primary outcome occurred
in 31 (7.8%) patients in the angiography-derived FFR group and 53 (13.4%)
in the coronary angiography group (absolute difference -5.6 percentage
points [95% CI -9.9 to -1.3]; risk ratio 0.58 [95% CI 0.38 to 0.89];
p=0.011). Death within 30 days occurred in 11 (2.8%) patients in the
angiography-derived FFR group and 17 (4.3%) patients in the coronary
angiography group. At a median follow-up of 27 months (28 months [IQR
18-44] in the angiography-derived FFR group and 27 months [18-42] in the
coronary angiography group), the key secondary outcome occurred in 82
(20.7%) patients in the angiography-derived FFR group and in 106 (26.8%)
patients in the coronary angiography group (hazard ratio 0.74 [95% CI
0.55-0.98]; p=0.036). Interpretation Among patients undergoing valve
surgery with concomitant coronary artery disease, physiologically guided
CABG using angiography-derived FFR reduced the incidence of the composite
perioperative outcome compared with anatomically guided CABG. These
findings support a selective approach to surgical coronary
revascularisation guided by physiological assessment in patients
undergoing valve procedures. Funding Shanghai Hospital Development Center,
Shanghai Municipal Science and Technology Commission, and Ministry of
Science and Technology of the People's Republic of
China. Copyright © 2026 Elsevier Ltd.

<2>
Accession Number
2037792676
Title
The use of jet ventilation in today's anesthesia: a narrative review.
Source
Acta Anaesthesiologica Belgica. 76(suppl 1) (pp 63-75), 2025. Date of
Publication: 01 Dec 2025.
Author
Henrard G.; Beck F.; Kirsch M.
Institution
(Henrard, Beck, Kirsch) Departement of Anesthesia and Intensive Care
Medicine, Liege University Hospital Center, Liege, Belgium
Publisher
BeSARPP
Abstract
Objective: This narrative review seeks to examine the fundamental
mechanisms, optimal settings, current applications, and emerging
indications of jet ventilation. This review is focused on jet ventilation
in interventional procedures both within and outside the operating
theatre, through a critical analysis of existing literature.
 Background(s): Jet ventilation is primarily utilized in
otolaryngology (ENT) surgical procedures, particularly those involving the
larynx or trachea. It allows for an unobstructed operating field by
eliminating the need of a conventional endotracheal tube. Because of the
minimal thoracic expansion it generates, jet ventilation is now used in
other fields such as interventional radiology and electrophysiology.
Despite its benefits, this technique carries risks such as barotrauma,
hypoventilation, hypercapnia, and catheter misplacement. Expertise and a
thorough understanding of its principles are therefore essential for its
use. Method(s): A literature search was conducted in October 2024
using the PubMed Database. Additional search es were carried out in Google
Scholar. Main keywords were combine using the Boolean equations. This
narrative study does not aim to be as methodologically comprehensive as a
systematic review. The selection of articles is influenced by clinical
relevance. However, it offers a critical overview of current practices and
future prospects for jet ventilation. This article respect the Scale for
the quality Assessment of Narrative Review Articles (SANRA).
 Result(s): Fifty-five publications from 1956 to 2024 were selected
for the review. Only three of these articles were published before the
year 2000. A thematic analysis was used to structure the results. The use
of high-frequency jet ventilation is validated in ear, nose and throat
(ENT) surgery, interventional pulmonology, and has its place in emergency
situations. It can be used in both adults and children. More recently, its
use in interventional radiology, electrophysiology, and lithotripsy has
been studied and appears to show certain advantages. The complications
related to the use of jet ventilation are generally associated with a lack
of experience from the teams. Conclusion(s): Jet ventilation is a
critical modality in certain clinical settings, particularly within
anesthesia for upper airway procedures, laryngeal surgery, bronchoscopy,
or when surgical access necessitates an unobstructed operating field. The
principal benefits of jet ventilation include preserving excellent
operative visibility, minimizing thoracic movement, and frequently
ensuring adequate oxygenation despite low tidal volumes. This technique
necessitates specialized expertise and diligent monitoring due to its
limitations, such as the risk of barotrauma or CO2 accumulation. Further
research, including comprehensive comparative studies, is necessary to
more precisely delineate its indications, contraindications, and long-term
effects, particularly in emerging fields such as interventional radiology,
electrophysiology, and lithotripsy. Copyright © 2025, BeSARPP.
All rights reserved.

<3>
Accession Number
2044149799
Title
Impact of resection vs respect techniques on left ventricular function
after mitral valve repair: a systematic review and meta-analysis.
Source
Heart, Vessels and Transplantation. 9(4) (no pagination), 2025. Date of
Publication: 01 Dec 2025.
Author
Christiany C.; Nababan V.J.; Satria D.
Institution
(Christiany, Nababan) Department of Thoracic, Cardiac, and Vascular
Surgery, BP Batam Hospital, Riau Island, Batam, Indonesia
(Satria) Department of Thoracic, Cardiac, and Vascular Surgery, Syiah
Kuala University, Aceh, Banda Aceh, Indonesia
Publisher
Bishkek: Center for Scientific Research and Development of Education
Abstract
Objective: Mitral valve disease, ranging from degenerative to infective
origin, is one of the most prevalent left heart diseases globally and
affects a large number of individuals. Conventionally, surgical repair has
grown to become the treatment of choice, with two main techniques being
resection and respect. Current literature has yet to address which
technique is superior to the other, particularly in regard to left
ventricular (LV) function. Method(s): We performed a systematic
review and meta-analysis on three databases with a primary outcome of LV
function alongside its' parameters, and a secondary outcome of repair
durability, mitral valve gradient, and mortality rates. Meta-analysis was
performed using random effects, and results were displayed in forest
plots. Risk of bias was conducted using the Newcastle-Ottawa Scale.
 Result(s): Six retrospective studies were included, evaluating a
total of 3376 patients. Pooled results showed that LV function were
preserved equally in both groups, showing no statistically significant
differences. The respect group had slightly lower mortality rates in
comparison to the resect group, and the repair success rate showed a
slight superiority in the respect group. Significant heterogeneity was
observed on left atrial diameter (LAD) measurement, indicating
variability. The overall differences in LV function coming from both
techniques appear intangible. Plenty of consideration must be made beyond
LV function in determining which repair technique should be performed on a
patient. Conclusion(s): This study demonstrated that both the resect
and respect techniques were found to be equally excellent in preserving
left ventricular function after mitral valve repair. Copyright
©2025 Heart, Vessels and Transplantation. This is an open access
article CC-BY-NC-ND 4.0 license (http://hvt-journal.com/pages/aims-scope)

<4>
Accession Number
2037800457
Title
Vitamin C in cardiac surgery: a narrative review.
Source
Acta Anaesthesiologica Belgica. 76(Supplement 1) (pp 103-115), 2025. Date
of Publication: 01 Dec 2025.
Author
Lelong Q.; Maseri A.; Coulie R.; Dincq A.S.
Institution
(Lelong, Maseri, Coulie, Dincq) Universite catholique de Louvain, CHU UCL
Namur, Anesthesiology Department, Yvoir, Belgium
Publisher
BeSARPP
Abstract
Cardiothoracic surgery, particularly when involving extracorporeal
circulation, is associated with a systemic inflammatory response and
oxidative stress resulting from the ischemia-reperfusion phenomenon. This
phenomenon leads to the release of free radicals, causing cellular damage,
activation of pro-inflammatory signaling pathways, and depletion of
endogenous antioxidants. These processes contribute to various
perioperative complications, including postoperative atrial fibrillation,
pulmonary complications and endothelial dysfunction. Due to its
antioxidant properties, vitamin C has been proposed to exert a protective
effect against these adverse responses and to potentially enhance
postoperative recovery. This narrative review aims to evaluate the role of
vitamin C in cardiothoracic surgery and to examine its potential benefits
with regard postoperative atrial fibrillation, fatigue, etomidate-induced
adrenergic inhibition, cardiac allograft vasculopathy, postoperative
pulmonary complications, endothelial function, vasoplegia, acute renal
failure, biochemical markers and erythrocytes integrity. The only outcomes
with consistent evidence of benefit from vitamin C supplementation were a
reduction in the incidence of postoperative atrial fibrillation, an
improvement in endothelial function and a reduction in oxidative stress.
Further large-scale, multicenter randomized controlled trials are
warranted to establish the optimal dosage, timing of administration and
specific patient populations that may derive the greatest benefit from
vitamin C administration. Copyright © 2025, BeSARPP. All rights
reserved.

<5>
Accession Number
2042858793
Title
Management of anaesthesia for transfemoral transcatheter aortic valve
implantation: an Italian interdisciplinary consensus statement.
Source
British Journal of Anaesthesia. 136(3) (pp 824-835), 2026. Date of
Publication: 01 Mar 2026.
Author
Ajello V.; Fresilli S.; D'Amico F.; Franceschini G.; Aloisio T.; Gottin
L.; Baiocchi M.; Guarracino F.; Bertini P.; Napodano M.; D'Amora M.;
Panascia E.; Meani P.; Weltert L.; Monaco F.; Pieri M.; Sangalli F.;
Santonocito C.; Silvetti S.; Landoni G.; Ranucci M.; Scolletta S.;
Paternoster G.
Institution
(Ajello, Franceschini) Department of Cardiothoracic Anaesthesia,
University Hospital Tor Vergata, Rome, Italy
(Fresilli, D'Amico, Pieri, Landoni) Department of Anaesthesia and
Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy
(Aloisio, Ranucci) Department of Cardiac Anesthesia and Intensive Care,
IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy
(Gottin) Unit of Cardiothoracic and Vascular Intensive Care Verona
Hospital and University Trust, Department of Surgery, Dentistry and
Paediatrics and Gynaecology, University of Verona, Verona, Italy
(Baiocchi) Cardiothoracic and Vascular Anaesthesia and Intensive Care,
IRCCS Azienda Ospedaliero Universitaria di Bologna, Bologna, Italy
(Guarracino) Department of Cardiothoracic and Vascular Anaesthesia and
Intensive Care, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
(Bertini) Department of Anaesthesia and Intensive Care Medicine, Casa di
Cura Privata San Rossore, Pisa, Italy
(Napodano) Cardiologia Interventistica. Dipartimento
Cardio-Toraco-Vascolare, Azienda Ospedale Universita di Padova, Padua,
Italy
(D'Amora) Department of Cardiac, Thoracic, and Vascular Anaesthesia,
University Hospital "San Giovanni Di Dio e Ruggi D'Aragona", Salerno,
Italy
(Panascia, Santonocito) Anaesthesia and Critical Care Medicine III - CAST,
Policlinico University Hospital, Catania, Italy
(Meani) Cardio-Thoracic and Vascular Anaesthesia and Intensive Care, ASST
Grande Ospedale Metropolitano Niguarda, Milan, Italy
(Weltert) Heart Surgery Department, Saint Camillus International
University for Health Sciences, Rome, Italy
(Sangalli) Department of Anaesthesia and Intensive Care, ASST Brianza,
University of Milano-Bicocca, Vimercate, Italy
(Silvetti) Department of Cardiac Anesthesia and Intensive Care, Ospedale
Policlinico San Martino IRCCS- IRCCS Cardiovascular Network, Italy
(Pieri, Landoni) School of Medicine, Vita-Salute San Raffaele University,
Milan, Italy
(Scolletta) Department of Medical Science, Surgery, and Neurosciences,
Urgency-Emergency Anesthesia and Intensive Care Unit, University Hospital
of Siena, Siena, Italy
(Paternoster) Department of Health Sciences, Anaesthesia and ICU, School
of Medicine, University of Basilicata San Carlo Hospital, Potenza, Italy
(Monaco) Departement of Medical and Surgical Sciences (DIMEC)Alma Mater
Studiorum - University of Bologna, Italy
(Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care IRCCS
Azienda Ospedaliero-Universitaria Sant'Orsola, BolognaVia Massarenti,
Bologna, Italy
Publisher
Elsevier Ltd
Abstract
BackgroundTransfemoral transcatheter aortic valve implantation (TAVI) is a
minimally invasive treatment for patients with severe aortic stenosis who
are at elevated surgical risk. Despite widespread use, optimal
periprocedural anaesthetic management remains highly variable, and
evidence-based guidance is lacking.MethodsAn interdisciplinary panel of
Italian experts in anaesthesiology, cardiology, and cardiac surgery
conducted a systematic review of the literature and used the RAND/UCLA
Appropriateness Method to evaluate 1032 clinical scenarios across a range
of risk profiles and comorbid conditions. Ratings were conducted over
three rounds, including a moderated in-person meeting to refine and
discuss appropriateness scores.ResultsA minimally invasive approach, local
anaesthesia alone, and conscious sedation were judged appropriate across
most clinical scenarios. Invasive monitoring, such as placement of an
additional arterial catheter or a central venous catheter, was recommended
only in selected high-risk patients. Several approaches or interventions
were consistently rated inappropriate across all evaluated scenarios,
including nurse-administered anaesthesia, pulmonary artery
catheterisation, and cardiac output monitoring using pulse wave analysis.
Other approaches, such as general anaesthesia and deep sedation, were
considered inappropriate in most cases but retained uncertainty in select
clinical contexts. Several recommendations were rated as necessary to
define a minimum standard of care.ConclusionsThis Italian consensus
statement provides practical, expert-driven recommendations to standardise
anaesthetic care for transfemoral TAVI. While many recommendations reached
strong consensus, areas of uncertainty remain, underscoring the need for
further clinical research. Patient-centred, individualised decision-making
remains essential, guided by institutional experience and procedural
complexity. Copyright © 2025 British Journal of Anaesthesia.
Published by Elsevier Ltd. All rights are reserved, including those for
text and data mining, AI training, and similar technologies.

<6>
Accession Number
2043015732
Title
Acute normovolaemic haemodilution after cardiac surgery: a meta-analysis
of randomised controlled trials.
Source
British Journal of Anaesthesia. 136(3) (pp 836-846), 2026. Date of
Publication: 01 Mar 2026.
Author
Pruna A.; Oriani A.; Monaco F.; Landoni G.; Bonizzoni M.A.; Losiggio R.;
Ajello V.; Beretta L.; Zangrillo A.; Pontillo D.; Teresa Agosta V.;
Carravetta M.; Chiodi B.; Oliva F.M.; Ronca E.; Likhvantsev V.; Farag
A.G.; Bukamal N.A.
Institution
(Pruna, Oriani, Landoni, Bonizzoni, Losiggio, Beretta, Zangrillo,
Pontillo, Teresa Agosta, Carravetta, Chiodi, Oliva, Ronca) Department of
Anaesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute,
Milan, Italy
(Monaco) Department of Medical and Surgical Sciences (DIMEC), Alma Mater
Studiorum - University of Bologna, Bologna, Italy
(Monaco) Cardiothoracic and Vascular Anaesthesia and Intensive Care, IRCCS
Azienda Ospedaliero-Universitaria Sant'Orsola, Bologna, Italy
(Landoni, Beretta, Zangrillo) School of Medicine, Vita-Salute San Raffaele
University, Milan, Italy
(Ajello) Department of Cardiothoracic Anaesthesia, University Hospital Tor
Vergata, Rome, Italy
(Likhvantsev) Federal Clinical and Research Centre of Intensive Care and
Rehabilitation, Moscow, Russian Federation
(Likhvantsev) Loginov Moscow Clinical Scientific Centre, Moscow, Russian
Federation
(Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City,
Makkah, Saudi Arabia
(Bukamal) Mohamed Bin Khalifa Specialist Cardiac Centre - Royal Medical
Services, Awali, Bahrain
Publisher
Elsevier Ltd
Abstract
BackgroundAcute normovolaemic haemodilution (ANH) is a widely adopted
packed red blood cells (pRBC) transfusion sparing strategy after cardiac
surgery. While the intraoperative effect is plausible and likely enhanced
by the lack of blinding, the effect on the overall in-hospital transfusion
rate is unknown. We conducted a meta-analysis of randomised controlled
trials to assess whether ANH reduced the proportion of cardiac surgery
patients who received allogeneic pRBC transfusions during the
postoperative hospital stay.MethodsWe searched for trials on ANH in adults
undergoing elective cardiac surgery. The primary outcome was the number of
patients receiving allogenic pRBC transfusions during the in-hospital
postoperative period (excluding trials which solely reported observation
period <=48 h). Secondary outcomes included the number of patients
transfused within 48 h after surgery, surgical revision, and all-cause
mortality.ResultsThe proportion of patients who received allogeneic pRBC
transfusions was similar in the ANH and standard groups (755/1899 [40%] vs
831/1914 [43%]; risk ratio [RR] 0.94, 95% confidence interval, CI
0.85-1.02]; P=0.15; I2=80%), while they received fewer transfusions in the
first 48 postoperative hours (RR 0.64, 95% CI [0.48-0.84]; P=0.001;
I2=73%). There was no difference in surgical revision rate (RR 1.22, 95%
CI [0.91-1.65]; P=0.18; I2=0%;), all-cause mortality (RR 0.73, 95% CI
[0.43-1.24]; P=0.25; I2=0%), or other secondary outcomes. Most included
trials had intermediate risk of bias because of lack of outcomes reporting
and blinding.ConclusionsAcute normovolaemic haemodilution did not reduce
the proportion of cardiac surgery patients who received allogeneic packed
red blood cell transfusions during the postoperative hospital stay. This
result should be interpreted considering the risk of bias of the included
trials.Systematic review protocol. PROSPERO
(CRD420251054530). Copyright © 2025 British Journal of
Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including
those for text and data mining, AI training, and similar technologies.

<7>
Accession Number
2043006376
Title
Invasive versus conservative strategy in older adults >=70 years of age
with non-ST-segment-elevation myocardial infarction: a GRADE-assessed
systematic review and meta-analysis of randomized controlled trials with
trial sequential analysis.
Source
Future Cardiology. 22(3) (pp 285-299), 2026. Date of Publication: 2026.
Author
Khan U.; Ali J.; Khan M.H.; Abdelgalil M.S.; Majeed Z.; Naveed M.A.; Amin
A.M.; Nawaz A.; Abuelazm M.; Turkmani M.; Aamir M.; Vyas A.V.; Dani S.
Institution
(Khan) Division of Cardiology, University of Maryland School of Medicine,
Baltimore, MD, United States
(Ali) Department of Medicine, Saint Peter's University Hospital, New
Brunswick, NJ, United States
(Khan) Department of Medicine, Saidu Medical College, Swat, Pakistan
(Abdelgalil) Faculty of Medicine, Ain Shams University, Cairo, Egypt
(Majeed) Department of Medicine, King Edward Medical University, Lahore,
Pakistan
(Naveed) Department of Medicine, Dow Medical University, Karachi, Pakistan
(Amin) Faculty of Medicine, Mansoura University, Mansoura, Egypt
(Nawaz) Department of Radiology, Pakistan Atomic Energy Commission
Hospital, Islamabad, Pakistan
(Abuelazm) Faculty of Medicine, Tanta University, Tanta, Egypt
(Turkmani) Division of Pulmonary and Critical Care, University of Toledo,
Toledo, OH, United States
(Aamir, Vyas) Department of Cardiology, Lehigh Valley Heart and Vascular
Institute, Allentown, PA, United States
(Dani) Department of Cardiology, Lahey Hospital & Medical Center,
Burlington, MA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Older adults with Non-ST-Segment Elevation Myocardial
Infarction (NSTEMI) are often undertreated invasively due to concerns
about risks and comorbidities, despite potential benefits. Their limited
inclusion in clinical trials leaves a gap in evidence-based management.
This meta-analysis compared invasive versus conservative strategies in
elderly NSTEMI patients. Method(s): A systematic search was conducted
across PubMed, CENTRAL, Web of Science, Scopus, and Embase through
December 2024. Pooled results were reported using risk ratios (RR) for
dichotomous outcomes and mean differences (MD) for continuous outcomes
with 95% confidence intervals (CI). Result(s): A total of 11
randomized controlled trials involving 4114 patients were included.
Invasive treatment significantly reduced the composite of all-cause
mortality and non-fatal MI (RR: 0.82; 95% CI: 0.68-0.99; p = 0.04) and MI
alone (RR: 0.68; 95% CI: 0.56-0.84; p = 0.0003). There was no significant
difference in all-cause mortality (RR: 1.04; 95% CI: 0.92-1.16; p = 0.55)
or cardiovascular death (RR: 0.96; 95% CI: 0.78-1.18; P = 0.67). Invasive
strategy significantly lowered the need for revascularization (RR: 0.29;
95% CI: 0.21-0.40; p < 0.0001). Conclusion(s): In NSTEMI patients
aged >=70, invasive management reduces the risk of MI and
revascularization without increasing mortality risk. More elderly-focused
trials are warranted. Protocol Registration:
https://www.crd.york.ac.uk/prospero identifier is
CRD42025633157. Copyright © 2026 Informa UK Limited, trading as
Taylor & Francis Group.

<8>
Accession Number
2044136116
Title
Narrative review on driving pressure guided ventilation in surgical
patients.
Source
Acta Anaesthesiologica Belgica. 76(Supplement 1) (pp 133-141), 2025. Date
of Publication: 01 Dec 2025.
Author
Saharkhiz N.; Sottiaux T.
Institution
(Saharkhiz) Department of Anesthesiology, Cliniques Universitaires
Saint-Luc, Universite Catholique de Louvain (UCLouvain), Belgium
(Sottiaux) Department of Anesthesiology, Clinique Notre-Dame de Grace
ASBL, Gosselies, Belgium
Publisher
BeSARPP
Abstract
Background: BackgroundPostoperative pulmonary complications (PPC) are
common in surgical patients although a lung-protective ventilation
strategy approach is used. Driving pressure (deltaP) is an important
component of mechanical ventilation and the research in acute respiratory
distress syndrome (ARDS) patients shows that an increase of deltaP is
associated with increased mortality. Objective(s): This review
analyzes the impact of deltaP guided Positive End-expiratory Pressure
(PEEP) in ventilated patient during general surgery. Method(s):
PubMed was searched using the keywords: "driving pressure", "mechanically
ventilated patients", "surgery" and "anesthesia". Additional research was
added using the references of appropriate studies. Result(s): Most
studies suggest that deltaP guided PEEP lowers PPC, however there is no
clear consensus depending on the type of surgery. More studies should use
objective measurement of deltaP guided PEEP titration to have a better
understanding of its impact on ventilation. Conclusion(s): In recent
years, personalized medicine has become more prominent. deltaP guided PEEP
may guide personalized ventilator strategy and thus improve the outcome of
the anesthetized patient by minimising PPC. More research should be done
to understand the impact of deltaP on postoperative
outcomes. Copyright © 2025, BeSARPP. All rights reserved.

<9>
Accession Number
2043934339
Title
The influence of lipoprotein(a) on coronary revascularization after
percutaneous coronary intervention.
Source
Acta Cardiologica. (no pagination), 2026. Date of Publication: 2026.
Author
Srikulmontri T.; Pantarote S.; Kulthamrongsri N.; Wattanachayakul P.;
Vutthikraivit W.; Amanullah A.
Institution
(Srikulmontri, Wattanachayakul) Department of Internal Medicine, Jefferson
Einstein Hospital, Philadelphia, PA, United States
(Srikulmontri, Wattanachayakul, Amanullah) Department of Medicine, Sidney
Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA,
United States
(Pantarote) Department of Medicine, College of Medicine, Rangsit
University, Bangkok, Thailand
(Kulthamrongsri) Department of Internal Medicine, University of Hawai'i,
Honolulu, HI, United States
(Vutthikraivit) Department of Cardiology, Intermountain Health Saint
George Regional Hospital, Saint George, UT, United States
(Amanullah) Department of Cardiology, Jefferson Einstein Hospital,
Philadelphia, PA, United States
Publisher
Taylor and Francis Ltd.
Abstract
Background: Lipoprotein(a) (Lp(a)) is a proatherogenic lipoprotein
associated with increased cardiovascular risk and is minimally responsive
to statins or lifestyle changes. While Lp(a) is linked to adverse
cardiovascular events, its role in predicting repeat revascularization
after percutaneous coronary intervention (PCI) remains unclear. This
review evaluates the relationship between Lp(a) levels and coronary
revascularization outcomes. Method(s): A systematic review and
meta-analysis of studies from MEDLINE and EMBASE through June 18, 2025,
evaluated the association between elevated Lp(a) and revascularization
outcomes post-PCI. Random-effects models using the DerSimonian-Laird
method were used to pool odds (ORs) and hazard ratios (HRs). Heterogeneity
was assessed using the I2 statistic and Cochran's Q test, and
publication bias was evaluated with Egger's regression test.
 Result(s): Twenty studies were included in the systematic review, of
which eighteen were included in the meta-analysis. Elevated Lp(a) levels
were associated with a higher risk of any repeat revascularization, with
pooled OR 1.33 (95% CI: 1.17-1.52) and HR 1.15 (95% CI: 1.05-1.25). High
Lp(a) was also linked to increased risk of target vessel revascularization
(TVR) (OR 1.42; 95% CI: 1.12-1.81). A non-significant trend towards
increased target lesion revascularization (TLR) was observed (OR 1.25; 95%
CI: 0.96-1.64). Conclusion(s): Elevated Lp(a) levels were associated
with a higher risk of repeat revascularization and TVR, with a
non-significant trend towards increased TLR. Further studies are warranted
to confirm these findings and explore the potential benefit of
Lp(a)-lowering strategies. Copyright © 2026 Belgian Society of
Cardiology.

<10>
Accession Number
2043841774
Title
Noninferiority of Ultrasound-Guided Modified Intercostal Block to
Traditional Approach for Analgesia After Minimally Invasive Repair of
Pectus Excavatum in Children: A Randomized Trial.
Source
Pain Research and Management. 2026(1) (no pagination), 2026. Article
Number: 2183328. Date of Publication: 2026.
Author
Yang M.-W.; Duan X.-L.; Cai Y.-Z.; Xia Y.; Sun Y.-Y.; Cheng X.-Q.
Institution
(Yang, Cheng) Department of Anesthesiology, First Affiliated Hospital of
Anhui Medical University, 218 Jixi Road, Anhui, Hefei, China
(Yang, Cai, Xia, Sun) Department of Anesthesiology, Anhui Provincial
Children's Hospital, 39 Wangjiang East Road, Anhui, Hefei, China
(Duan) Department of Pediatric Thoracic Surgery, Anhui Provincial
Children's Hospital, 39 Wangjiang East Road, Anhui, Hefei, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: For pediatric pectus excavatum, the standard treatment is
minimally invasive repair of pectus excavatum (MIRPE). A major challenge,
however, is the severe postoperative pain. Although ultrasound-guided
intercostal nerve block (UINB) offers effective analgesia, the technique's
complexity and associated safety concerns are significant barriers,
deterring its routine use. Modified intercostal nerve block (MINB) is
effective in adult thoracic surgery but unvalidated in pediatric MIRPE.
 Objective(s): To evaluate MINB's noninferiority to UINB for
postoperative analgesia and safety in children undergoing MIRPE.
 Design(s): Single-center randomized noninferiority trial.
 Method(s): Seventy-six ASA I-II pediatric patients (8-18 years)
scheduled for single-bar MIRPE were 1:1 randomized to the MINB or UINB
group. Primary outcome includes 24-h postoperative coughing visual analog
scale (VAS) score (noninferiority margin DELTA = 1.0). Secondary outcomes
include resting/coughing VAS scores at 3, 6, 9, 12, 24, and 48 h
postoperatively; procedure duration; local anesthetic dose; needle
complications; opioid consumption; rescue analgesia; and adverse events.
 Result(s): The mean difference in 24-h coughing VAS (MINB-UINB) score
was -0.02 (95% CI: -0.85 to 0.80), confirming noninferiority of MINB
(upper 95% CI limit 0.80 < noninferiority margin DELTA = 1.0). MINB
reduced procedure time by 65% (4.6 +/- 1.3 vs. 13.2 +/- 1.6 min; p <
0.001), decreased ropivacaine dose by 19% (50.0 +/- 0.0 vs. 61.9 +/- 4.6
mg; p < 0.001), shortened anesthesia duration (119.6 +/- 18.3 vs. 131.8
+/- 14.6 min; p = 0.002), and eliminated vascular injuries (0% vs. 16.2%;
p = 0.025). All other outcomes demonstrated no statistically significant
differences in the comparisons between the groups (p > 0.05).
 Conclusion(s): For children undergoing single-bar MIRPE, MINB
provides noninferior analgesia to UINB with critical advantages: 65%
faster placement, 19% lower ropivacaine dose, reduced anesthesia duration,
and elimination of vascular injuries. These findings suggest that MINB
offers a valuable alternative to UINB for post-MIRPE analgesia, as it
appears to provide a more favorable balance between safety and efficiency.
Trail Registration: Chinese Clinical Trial Registry:
ChiCTR2200057961. Copyright © 2026 ming-Wen Yang et al. Pain
Research and Management published by John Wiley & Sons Ltd.

<11>
Accession Number
2042216836
Title
Prophylactic norepinephrine infusion to reduce severe hypotension during
induction of anaesthesia in patients undergoing cardiac surgery: a
randomised controlled single-centre clinical trial.
Source
British Journal of Anaesthesia. 136(3) (pp 856-864), 2026. Date of
Publication: 01 Mar 2026.
Author
Gaillard C.; Breul L.; Foucher A.; Rigal J.-C.; David C.-H.; Souab F.;
Canevet M.; Ryan M.; Bailly A.; Morin H.; Cadiet J.; Geay C.; Rozec B.;
Vourc'h M.
Institution
(Gaillard, Breul, Rigal, Souab, Canevet, Ryan, Bailly, Morin, Cadiet,
Rozec, Vourc'h) Anesthesie et reanimation chirurgie cardiaque, Hopital
Laennec, Centre Hospitalier Universitaire de Nantes, Nantes Universite,
Nantes, France
(Foucher) Anesthesie et reanimation Polyvalente, Hopital Laennec, Centre
Hospitalier Universitaire de Nantes, Nantes Universite, Nantes, France
(David) Department of Thoracic and Cardiovascular Surgery, l'Institut du
Thorax, Hopital Laennec, Centre Hospitalier Universitaire de Nantes,
Nantes Universite, Nantes, France
(Geay) Plateforme de Methodologie et Biostatistique, Direction de la
Recherche et de l'Innovation, Centre Hospitalier Universitaire, Nantes,
France
(Rozec) Nantes Universite, CNRS, INSERM, l'institut du thorax, Nantes,
France
(Vourc'h) INSERM CIC 0004 Immunologie et infectiologie, Nantes Universite,
Nantes, France
Publisher
Elsevier Ltd
Abstract
BackgroundThe EPITUBE trial aimed to determine whether a prophylactic
infusion of norepinephrine reduced severe hypotension after induction of
general anaesthesia and tracheal intubation in patients undergoing cardiac
surgery.MethodsWe performed a randomised controlled single-centre clinical
trial including patients undergoing cardiac surgery. In the experimental
group, infusion of norepinephrine started from the start of preoxygenation
at an infusion rate of 0.06 mug kg-1 min-1, secondarily titrated to
maintain mean arterial pressure (MAP) between 65 and 80 mm Hg. In the
control group, ephedrine was administered if MAP decreased <65 mm Hg.
Primary outcome was the occurrence of MAP <55 mm Hg. Secondary measures
included tracheal intubation-related complications, postoperative
complications, duration of ICU stay, and mortality.ResultsOf 210 patients
randomised and analysed in the intention-to-treat analysis, the incidence
of severe hypotension was not different between the groups: 43.8% in the
norepinephrine group vs 44.8% in the control group (odds ratio 0.96, 95%
confidence interval [CI] 0.56-1.66, P=0.99). The incidence of MAP <65 mm
Hg was lower in the norepinephrine group than in the control group: 63.8%
vs 78.1% (odds ratio 0.49, 95% CI 0.26-0.90, P=0.02). The rate of
intubation-related complications was not different between the
norepinephrine and control groups, 22.9% vs 32.4%, respectively (odds
ratio 0.62, 95% CI 0.33-1.14, P=0.13). There was no difference in
postoperative outcomes including acute kidney injury, time on ventilator,
or length of stay in the ICU.ConclusionsIn patients undergoing cardiac
surgery, infusion of norepinephrine before general anaesthesia at a
starting dose of 0.06 mug kg-1 min-1 did not reduce severe hypotension
compared with on-demand ephedrine.Clinical trial
registrationClinicalTrials.gov Identifier: NCT05335954. Copyright
© 2025 British Journal of Anaesthesia. Published by Elsevier Ltd. All
rights are reserved, including those for text and data mining, AI
training, and similar technologies.

<12>
Accession Number
2044018066
Title
Direct oral anticoagulants versus vitamin K antagonists for postoperative
atrial fibrillation after cardiac surgery: a systematic review and
meta-analysis of randomized controlled trials.
Source
BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number:
207. Date of Publication: 01 Dec 2026.
Author
Ahmed O.A.O.; Abbas M.; Ahmed A.A.O.; Ibrahim M.A.A.; Abakar M.E.M.; Yasir
E.; Edris M.E.E.; Ahmed R.A.O.; Babkir M.; Abdulaziz M.A.M.; Sota H.A.;
Gilbert C.; Eissa A.A.
Institution
(Ahmed, Abdulaziz) Faculty of Medicine, University of Khartoum, Khartoum,
Sudan
(Abbas, Ahmed, Yasir, Edris, Ahmed, Ahmed) Faculty of Medicine, National
Ribat University, Khartoum, Sudan
(Ibrahim, Abakar, Babkir) Faculty of Medicine, Sudan International
University, Khartoum, Sudan
(Sota, Gilbert) St. Georges University, St. Georges, Grenada
(Eissa) Cardiac Academy, Ain Shams University, Cairo, Egypt
Publisher
BioMed Central Ltd
Abstract
Background: Postoperative atrial fibrillation (POAF) is a common
complication after cardiac surgery. Although direct oral anticoagulants
(DOACs) have revolutionized stroke prevention in non-surgical atrial
fibrillation, their role relative to vitamin K antagonists (VKAs)
specifically in POAF is unclear. Method(s): A systematic review and
meta-analysis were performed from randomized controlled trials comparing
DOACs (apixaban, rivaroxaban, or dabigatran) vs. VKAs in adult patients
with POAF following cardiac surgery. The primary outcomes included
stroke/systemic embolism as an efficacy endpoint and major bleeding as a
safety endpoint. Secondary outcomes comprised any bleeding and
cost-effectiveness. We searched the following databases: PubMed, Scopus,
Cochrane Central, and Google Scholar from inception through November 2025.
The study protocol was registered with PROSPERO (Registration number:
CRD420251249764). Result(s): Four randomized controlled trials (RCTs)
were included (n = 202 patients). Stroke/systemic embolism occurred in
1.0% (1/103) of DOAC patients versus 1.0% (1/99) of VKA patients (RR 0.80,
95% CI 0.06-11.5; P = 0.87). Major bleeding occurred in 1.9% (2/103)
versus 4.0% (4/99) (RR 0.55, 95% CI 0.11-2.64; P = 0.46). Any bleeding
occurred in 10.7% (11/103) versus 11.1% (11/99) (RR 1.01, 95% CI
0.31-3.30; P = 0.99). Two trials reported lower costs with DOACs in their
local settings, though these findings are exploratory and not
generalizable. Conclusion(s): Among patients with POAF following
cardiac surgery, DOACs appear to have efficacy and safety profiles similar
to those of VKAs, with non-significant trends toward lower major bleeding
rates. Reported cost advantages are preliminary and context-specific.
These findings are based on a small number of trials with limited sample
sizes and very low event rates, and do not demonstrate equivalence; they
warrant confirmation in larger, adequately powered studies. Copyright
© The Author(s) 2026.

<13>
Accession Number
2041303293
Title
Right ventricular function assessment following transcatheter aortic valve
implantation/replacement (TAVI/TAVR): a systematic review and
meta-analysis comparing speckle tracking and conventional
echocardiographic approaches.
Source
Journal of Echocardiography. 24(1) (pp 1-13), 2026. Date of Publication:
01 Mar 2026.
Author
Goudarzi E.; Aghajani S.; Ebrahimi N.; Akarzadeh D.; Javadi M.; Layegh
Mirhosseyni S.S.; Zarinfar Y.; Khaheshi I.
Institution
(Goudarzi, Aghajani, Ebrahimi, Zarinfar) School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Akarzadeh) Student Research Committee, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Javadi) Department of Medicine, Faculty of Medicine, Tehran University of
Medical Sciences, Tehran, Iran, Islamic Republic of
(Layegh Mirhosseyni) Department of Medicine, School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Goudarzi, Khaheshi) Cardiovascular Research Center, Shahid Beheshti
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Khaheshi) Echocardiography Fellowship Program, Division of Cardiology,
Vancouver General Hospital, University of British Columbia, Vancouver,
Canada
Publisher
Springer
Abstract
This study evaluates alterations in right ventricular strains using
speckle-tracking echocardiography (STE) following transcatheter aortic
valve implantation/replacement (TAVI/TAVR) and compares these alterations
with conventional echocardiographic measurements. A systematic search
identified studies assessing RVFWLS and RVGLS via STE pre- and
post-TAVI/TAVR. Secondary outcomes included LVEF, TAPSE, FAC, and LVGLS
changes. Echocardiographic parameters of TAVI/TAVR patients were compared
to those of SAVR patients. Subgroup analyses were based on follow-up
duration (<= 1 month vs. >1 month). Meta-regression examined associations
between baseline LVEF, RV strain parameters, and AVA with RV strain
changes. Risk of bias assessments, sensitivity analyses, and publication
bias evaluations ensured result robustness. Thirteen studies comprising
1,399 patients were analyzed. RVFWLS significantly improved post-TAVI/TAVR
(MD = 1.57, SMD = 0.23, p < 0.001). RVGLS showed minor improvement (SMD =
0.09, p = 0.028). LVGLS exhibited considerable improvement (MD = 1.14, SMD
= 0.27, p < 0.001). RVFWLS demonstrated the most improvement among all
parameters at follow-up > 1 month, whereas within the first month, LVGLS
showed greater improvement than RVFWLS. (SMD = 0.30, MD = 1.98, p <
0.001). Lower AVA was associated with greater RVFWLS improvement
(coefficient= -0.11, p = 0.08). Among the echocardiographic parameters,
only RVFWLS and LVGLS showed consistent improvement after TAVI/TAVR.
RVFWLS demonstrated the greatest improvement beyond 1 month of follow-up,
whereas LVGLS showed the largest early improvement within the first month.
In contrast, changes in RVGLS, LVEF, TAPSE, and FAC were generally
small.Keywords: speckle-tracking echocardiography, echocardiography,
transcatheter aortic valve implantation, transcatheter aortic valve
replacement, right ventricle. Copyright © Japanese Society of
Echocardiography 2025.

<14>
Accession Number
2044050577
Title
Effect of oliceridine versus morphine on the quality of early recovery
after thoracoscopic surgery: a randomized, controlled clinical trial.
Source
BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 178. Date
of Publication: 01 Dec 2026.
Author
Na X.; Chen Y.; Liu X.; Yang J.; Tan M.; Zhou Y.; Shi M.; Ouyang J.; Si Y.
Institution
(Na, Chen, Liu, Yang, Tan, Zhou, Shi, Ouyang, Si) Department of
Anesthesiology, The Second Affiliated Hospital of Kunming Medical
University, Yunnan Province, Kunming, China
Publisher
BioMed Central Ltd
Abstract
Background: Thoracic surgery is frequently accompanied by severe pain.
Although opioids remain the primary choice for effective analgesia in
acute moderate-to-severe pain, their use is limited by adverse effects.
Oliceridine, a novel G protein-biased mu-receptor agonist, has
demonstrated a potentially improved safety compared to traditional opioid
medications. Therefore, we investigated a short-course regimen of
oliceridine for postoperative analgesia to evaluate its effects on early
recovery quality in patients undergoing video-assisted thoracoscopic
surgery (VATS). Method(s): A total of 100 patients (ages 18-75 years)
scheduled for elective thoracoscopic surgery were enrolled and randomly
assigned to either the oliceridine group or the morphine group (n = 50 per
group). Standardized anesthesia protocols were implemented. At the
conclusion of surgery, patients received an intravenous loading dose of
either oliceridine (1.5 mg) or morphine (4 mg). Supplemental analgesia
(oliceridine 0.5 mg or morphine 1 mg) was administered as needed in the
post-anesthesia care unit (PACU). The primary outcome measure was time to
extubation. Secondary outcome measures included time to alertness
recovery, Numerical Rating Scale (NRS) pain scores, requirement for
analgesic rescue, adverse events during PACU stay, Quality of Recovery-15
(QoR-15) scores at 24 h postoperatively, time to first oral intake, time
to first ambulation, and incidence of 24-h gastrointestinal adverse
events. Result(s): A total of 95 patients completed the study
(Oliceridine group: n = 46, Morphine group: n = 49). Compared with the
Morphine group, the Oliceridine group demonstrated a shorter time to
extubation (12 +/- 4 min vs. 20 +/- 8 min, mean difference -7.6 min,95% CI
-10.4 - -4.9, P < 0.001); faster alertness recovery (18 +/- 5 min vs. 29
+/- 10 min, P < 0.001); and lower NRS pain scores at 5 min post-extubation
(3 points vs. 5 points, P < 0.001); a lower proportion of patients
requiring analgesic rescue (45.7% vs. 77.6%, P = 0.001); fewer overall
adverse events occurred during PACU stay (19.6% vs. 38.8%, P = 0.04).
However, no statistically significant differences were observed between
the two groups in postoperative recovery metrics assessed at 24 h,
including QoR-15 scores, time to first oral intake, time to first
ambulation, and gastrointestinal adverse events (P > 0.05).
 Conclusion(s): Oliceridine demonstrated significant early recovery
benefits compared to morphine in VATS patients, including faster
extubation, quicker return of alertness, superior immediate analgesia, and
fewer PACU adverse events. These advantages, however, were restricted to
the immediate postoperative period and did not extend to 24-h recovery
metrics. Therefore, while oliceridine is a potential option for optimizing
early recovery pathways, its longer-term efficacy and role require further
investigation. Trial registration: Randomized controlled trial; Chinese
Clinical Trial Registration, ChiCTR2500096716 (Date 05/02/2025). This
study was reported in accordance with the CONSORT guidelines (Consolidated
Standards of Reporting Trials). Copyright © The Author(s) 2026.

<15>
Accession Number
2025286467
Title
High Efficacy and Low Early Mortality in High-Volume Center Tricuspid
Valve Surgery.
Source
Thoracic and Cardiovascular Surgeon. 74(3) (pp 232-238), 2026. Date of
Publication: 01 Apr 2026.
Author
Gotte J.; Zittermann A.; Schramm R.; Bleiziffer S.; Deutsch M.A.; Renner
A.; Gummert J.F.
Institution
(Gotte, Zittermann, Schramm, Bleiziffer, Deutsch, Renner, Gummert) Clinic
for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum Nrw,
Ruhr-University Bochum, Bad Oeynhausen, Germany
Publisher
Georg Thieme Verlag
Abstract
Background Isolated tricuspid valve surgery has been associated with early
mortality rates of up to 10%. With rapidly emerging interventional
catheter-based options, the question arises whether current technical and
perioperative protocols in cardiac surgery translate into lower than
previously expected mortality rates, especially when looking at data from
high-volume centers. Methods We performed a retrospective single-center
analysis in 369 patients undergoing isolated tricuspid valve repair (n =
256) or replacement (n = 113) between 2009 and 2021. Surgical approaches
included full sternotomy, as well as right-sided minithoracotomy.
According to a recently introduced clinical risk score, patients were
divided into scoring groups, and observed (O) versus expected (E) early
mortality were compared. Pre- and postoperative tricuspid valve function
was also analyzed. Results Overall, 30-day mortality was 4.1%, ranging
from 0% (scoring group 0-1 points) to 8.7% (scoring group >= 10 points),
which was substantially lower than the expected early mortality (2% in the
lowest to 34% in the highest scoring group). Preoperative tricuspid
regurgitation was severe in 71.3% (n = 263), moderate to severe in 14.9%
(n = 55), and mild or less in 6.5% (n = 24). The corresponding
postoperative values were 0% (n = 0), 1.4% (n = 5), and 81.6% (n = 301).
Conclusion Our high-volume center data indicate substantially lower than
predicted 30-day mortality in different cardiac surgical risk scoring
groups. The majority of patients had zero to minimal residual tricuspid
valve insufficiency postoperatively. Randomized controlled trials are
needed to compare tricuspid valve functional results and long-term
outcomes of surgical versus interventional procedures in patients
undergoing isolated tricuspid valve procedures. Copyright © 2026
Georg Thieme Verlag. All rights reserved.

<16>
Accession Number
2042622543
Title
Longitudinal exposure to non-HDL-C and cardiovascular events, all-cause
mortality in type 2 diabetes: A post hoc analysis of the ACCORD trial.
Source
Diabetes, Obesity and Metabolism. 28(4) (pp 3095-3104), 2026. Date of
Publication: 01 Apr 2026.
Author
Wang Y.; Meng X.; Zhang X.; Li M.; Wang T.; Zhao Z.; Lu J.; Xu M.; Zheng
J.; Wang W.; Ning G.; Bi Y.; Xu Y.
Institution
(Wang, Meng, Zhang, Li, Wang, Zhao, Lu, Xu, Zheng, Wang, Ning, Bi, Xu)
Department of Endocrine and Metabolic Diseases, Shanghai Institute of
Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong
University School of Medicine, Shanghai, China
(Wang, Meng, Zhang, Li, Wang, Zhao, Lu, Xu, Zheng, Wang, Ning, Bi, Xu)
National Clinical Research Center for Metabolic Diseases (Shanghai), Key
Laboratory for Endocrine and Metabolic Diseases of the National Health
Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor,
State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao
Tong University School of Medicine, Shanghai, China
Publisher
John Wiley and Sons Inc
Abstract
Aims: To evaluate the association between longitudinal non-HDL-C exposure
and the risks of major adverse cardiovascular events (MACEs) and all-cause
mortality in type 2 diabetes patients on lipid-lowering therapy.
 Material(s) and Method(s): This post hoc analysis of the Action to
Control Cardiovascular Risk in Diabetes (ACCORD) Lipid trial included
patients with type 2 diabetes who had non-HDL-C measured at baseline and
four subsequent visits over 24 months. Longitudinal exposure was assessed
using cumulative load, variability (standard deviation) and trajectory
(slope). Outcomes were MACEs and all-cause mortality. Cox proportional
hazard models were used to obtain hazard ratios (HRs) and 95% confidence
intervals (CIs). Result(s): Among 4673 participants with a median
follow-up of 7.5 years, 695 MACEs and 842 deaths occurred. After adjusting
for baseline and mean non-HDL-C levels, the highest quartile of cumulative
load (HR, 1.81; 95% CI, 1.41-2.32), variability (HR, 1.27; 95% CI,
1.00-1.60) and the most rapidly increasing slope (HR, 1.26; 95% CI,
1.02-1.56) were each associated with increased risks of MACEs, compared to
the lowest quartile. The association with all-cause mortality followed a
similar pattern, except for the non-HDL-C slope. Stratified analyses
showed that cumulative load and variability were associated with MACEs
among participants with baseline non-HDL-C < 130 mg/dL, and with all-cause
mortality among those with baseline >=130 mg/dL. No significant
associations with slope were observed within strata of baseline non-HDL-C.
 Conclusion(s): Longitudinal non-HDL-C exposure showed associations
with both MACEs and mortality, independent of baseline non-HDL-C,
underscoring the need for sustained and stable non-HDL-C control over
time. Copyright © 2026 John Wiley & Sons Ltd.

<17>
Accession Number
2042023939
Title
Effects of continuation versus interruption of oral anticoagulation during
transcatheter aortic valve implantation on hemostasis function.
Source
Journal of Thrombosis and Haemostasis. 24(4) (pp 1263-1278), 2026. Date of
Publication: 01 Apr 2026.
Author
van Ginkel D.J.; Stragier H.; Bor W.L.; Rosseel L.; Konings J.; Ninivaggi
M.; de Simone I.; Huskens D.; Roest M.; van Lenthe I.; Overduin D.C.;
Aarnink E.W.; Rooijakkers M.J.P.; Peper J.; Brouwer J.; Nijenhuis V.J.;
Rensing B.J.W.M.; Timmers L.; Swaans M.J.; Hackeng C.M.; ten Cate H.; de
Laat B.; ten Berg J.M.
Institution
(van Ginkel, Bor, van Lenthe, Overduin, Aarnink, Peper, Brouwer,
Nijenhuis, Rensing, Timmers, Swaans, ten Berg) Department of Cardiology,
St. Antonius Hospital, Nieuwegein, Netherlands
(Stragier, ten Cate, ten Berg) Cardiovascular Research Institute
Maastricht, Maastricht, Netherlands
(Stragier, de Laat) Department of Anesthesiology, Intensive Care Medicine,
Emergency Medicine and Pain Therapy, Hospital Oost-Limburg, Genk, Belgium
(Rosseel) Department of Cardiology, Hartcentrum Aalst, Aalst, Belgium
(Konings, Ninivaggi, de Simone, Huskens, Roest) Department of Functional
Coagulation, Synapse Research Institute, Maastricht, Netherlands
(Rooijakkers, Nijenhuis) Department of Cardiology, Radboud University
Medical Center, Nijmegen, Netherlands
(Hackeng) Department of Clinical Chemistry, St. Antonius Hospital,
Nieuwegein, Netherlands
(ten Cate) Department of Internal Medicine, Maastricht University Medical
Centre, Maastricht, Netherlands
(ten Cate) Laboratory for Clinical Thrombosis and Hemostasis, Department
of Biochemistry, Maastricht University, Maastricht, Netherlands
(ten Cate) Thrombosis Expertise Center, Maastricht University Medical
Centre, Maastricht, Netherlands
(ten Berg) Department of Cardiology, Maastricht University Medical Center,
Maastricht, Netherlands
Publisher
Elsevier B.V.
Abstract
Background One-third of patients undergoing transcatheter aortic valve
implantation (TAVI) have a concomitant indication for oral anticoagulation
(OAC). Previous studies suggested that periprocedural continuation of OAC
could reduce transient hypercoagulation after TAVI. Objective To evaluate
the effects of continuation versus interruption of OAC on periprocedural
hemostasis function. Methods Patients were randomized 1:1 to OAC
continuation vs interruption. Plasma samples were taken at 6 time points,
and hemostasis function was assessed by measuring thrombin and plasmin
generation, as well as biomarkers of coagulation, fibrinolysis, platelet
activation, and endothelial function. Results A total of 167 patients were
included: 82 were assigned to OAC continuation and 85 to OAC interruption.
Pre-TAVI, a significantly lower endogenous thrombin potential (ETP) was
observed in the continuation group compared with the interruption group.
In both groups, ETP was reduced immediately post-TAVI, and its restoration
was significantly lower in the continuation group. In contrast, levels of
prothrombin fragment 1 + 2 were similar between the groups. A
significantly lower endogenous plasmin potential was observed in the
continuation group from pre-TAVI to 8 hours post-TAVI. In both groups,
fibrin degradation products increased immediately post-TAVI, while this
increase was significantly lower in the continuation group. Markers of
endothelial and platelet activation were unaffected by the randomized
strategy. Conclusion Continuation of OAC during TAVI modestly reduced the
acute activation of coagulation and fibrinolysis compared with the
interruption of OAC. This did not translate into any apparent differences
in thromboembolic risk in the main trial. However, continuation of OAC
resulted in a marked suppression of ETP and an increased risk of
bleeding. Copyright © 2025 International Society on Thrombosis
and Haemostasis.

<18>
Accession Number
2040212305
Title
Safety of cardioversion without anticoagulation in patients' status post
left atrial appendage occlusion: A systematic review and meta-analysis.
Source
Cardiovascular Revascularization Medicine. 84 (pp 105-109), 2026. Date of
Publication: 01 Mar 2026.
Author
Sawalha K.; Alakchar M.; Mamas M.A.; Johnson D.; Bhan A.; Goldsweig A.M.
Institution
(Sawalha, Goldsweig) Department of Cardiovascular Medicine, Baystate
Medical Center and Division of Cardiovascular Medicine, University of
Massachusetts Baystate, Springfield, MA, United States
(Alakchar) Department of Cardiovascular Medicine, Southern Illinois
University, Springfield, IL, United States
(Mamas) Keele Cardiovascular Research Group, Keele University, Stoke on
Trent, United Kingdom
(Johnson) Department of Cardiology, University of Illinois at Chicago,
Chicago, IL, United States
(Bhan) Department of Cardiology, Heart Vascular Institute, Advocate Christ
Medical Center, Oak Lawn, IL, United States
Publisher
Elsevier Inc.
Abstract
Background Direct current cardioversion (DCCV) is commonly used for rhythm
control in atrial fibrillation (AF). Left atrial appendage occlusion
(LAAO) provides stroke prevention in patients with contraindications to
oral anticoagulation (OAC), but the safety of DCCV without periprocedural
anticoagulation in this group remains uncertain. Objective To evaluate the
safety of performing DCCV without systemic anticoagulation in patients
with prior LAAO. Methods We conducted a systematic review and
meta-analysis following PRISMA guidelines. PubMed, ScienceDirect, and the
Cochrane Library were searched (January 2010-April 2025). Studies
comparing outcomes of patients undergoing DCCV after LAAO, with versus
without subsequent anticoagulation, were included. Primary outcomes were
thromboembolic events and clinically significant bleeding. Odds ratios
(ORs) were calculated using random-effects modeling, with heterogeneity
assessed via I2 statistic. Results Five observational studies
(1697 DCCV procedures; 965 patients receiving post-DCCV anticoagulation)
met inclusion criteria. Thromboembolic events occurred in 3.8 % of
patients without OAC versus 1.6 % with OAC, with no statistically
significant difference (OR 0.48; 95 % CI 0.16-1.43; p = 0.19;
I2 = 17 %). Clinically significant bleeding occurred in 4.1 %
without OAC and 4.0 % with OAC, also without significant difference (OR
1.22; 95 % CI 0.75-2.00; p = 0.42; I2 = 0 %). Pre-DCCV imaging
protocols varied widely among studies. Conclusions In selected patients
post-LAAO with no device-related thrombus or significant peri-device leak,
DCCV without subsequent anticoagulation demonstrated low thromboembolic
and bleeding risks. These findings, derived from limited observational
data, require confirmation by randomized controlled trials. Copyright
© 2025 Elsevier Inc.

<19>
Accession Number
2043768409
Title
Treatment of rheumatoid arthritis-associated interstitial lung disease:
what is new since the 2022 SER-SEPAR recommendations?.
Source
Reumatologia Clinica. 22(4) (no pagination), 2026. Article Number: 502104.
Date of Publication: 01 Apr 2026.
Author
Narvaez J.; Diaz del Campo Fontecha P.; Nieto M.A.; Villaverde Garcia V.;
Candelas Rodriguez G.; Balsa A.
Institution
(Narvaez) Servicio de Reumatologia, Hospital Universitario de Bellvitge,
Barcelona, Hospitalet de Llobregat, Spain
(Diaz del Campo Fontecha) Unidad de Investigacion, Sociedad Espanola de
Reumatologia, Madrid, Spain
(Nieto) Servicio de Neumologia, Hospital Clinico San Carlos, Madrid, Spain
(Villaverde Garcia) Servicio de Reumatologia, Hospital Universitario de
Mostoles, Madrid, Mostoles, Spain
(Candelas Rodriguez) Servicio de Reumatologia, Hospital Universitario
Clinico San Carlos, Madrid, Spain
(Balsa) Servicio de Reumatologia, Hospital Universitario La Paz, Madrid,
Spain
Publisher
Ediciones Doyma, S.L.
Abstract
Objective: In 2020, the Spanish Society of Rheumatology (SER) and the
Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) published
joint recommendations on the management of rheumatoid arthritis-associated
interstitial lung disease (RA-ILD). Since then, new evidence has emerged
supporting an update focused on treatment. Method(s): A systematic
literature review was conducted covering the period from October 2020 to
October 2025. Result(s): IL-6 and JAK inhibitors (JAKi) show efficacy
comparable to rituximab (RTX) and abatacept (ABA) in controlling joint
disease, preserving pulmonary function, limiting radiological progression,
and reducing RA-ILD-related mortality, without a significant increase in
serious respiratory events. ABA has not demonstrated a lower risk of
severe or opportunistic infections; therefore, these four options (ABA,
RTX, anti-IL6, and JAKi) may be used interchangeably in RA-ILD patients
requiring treatment intensification. In those with a progressive fibrosing
phenotype and intolerance to nintedanib, pirfenidone may be considered.
 Conclusion(s): Recent evidence has expanded the therapeutic options
available for RA-ILD. Copyright © 2026 Sociedad Espanola de
Reumatologia (SER), Colegio Mexicano de Reumatologia (CMR) y Elsevier
Espana, S.L.U.

<20>
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. 40(5) (pp 1397-1407),
2026. Date of Publication: 01 May 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. 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. Intervention(s): Topical
versus intravenous TXA administration in cardiac surgery.
 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. 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. Copyright © 2026 Elsevier Inc.

<21>
Accession Number
2042225509
Title
Acute Kidney Injury in Cardiac Surgery: A Comprehensive Review of
Perioperative Strategies and Emerging Biomarkers.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(5) (pp 1541-1554),
2026. Date of Publication: 01 May 2026.
Author
Cuttone G.; La Via L.; SenussiTesta T.; Sinatra N.; Deana C.; Roberti E.;
Montisci A.; Pappalardo F.
Institution
(Cuttone) Anesthesia and Intensive Care, 'Abele Ajello' Hospital, ASP
Trapani, Mazara del Vallo, Italy
(La Via) Department of Anesthesia and Intensive Care, University Hospital
Policlinico G. Rodolico-San Marco, Catania, Italy
(SenussiTesta) Department of Cardiac Anesthesia and Intensive Care,
Cardiovascular Network, IRCCS Policlinico San Martino Hospital, Genova,
Italy
(Sinatra) Nephrology and Dialysis Unit, "Paolo Borsellino" Hospital, ASP
Trapani, Marsala, Italy
(Deana) Anesthesia and Intensive Care 1, Department of Emergency, Academic
Hospital "S.M. della Misericordia", Health Integrated Agency of Friuli
Centrale, Udine, Italy
(Roberti) Department of Anesthesia, Intensive Care and Emergency Medicine,
ASST Spedali Civili, Brescia, Italy
(Montisci) Division of Cardiothoracic Intensive Care, ASST Spedali Civili,
Brescia, Italy
(Pappalardo) Faculty of Medicine and Surgery, Kore University of Enna,
Enna, Italy
(Pappalardo) Centro Cuore GB Morgagni, Catania, Italy
Publisher
W.B. Saunders
Abstract
Acute kidney injury (AKI) is a significant complication following cardiac
surgery, affecting 20% to 30% of patients and contributing to increased
morbidity and mortality. Cardiac surgery-associated AKI (CSA-AKI) is
linked to higher short-term mortality rates, extended intensive care unit
stays, and substantial health care costs. This review examines the
multifactorial pathophysiology of CSA-AKI, which includes renal
hypoperfusion, systemic inflammatory response, and nephrotoxic exposures.
Current definitions of AKI, primarily based on KDIGO criteria, highlight
the limitations of serum creatinine as a diagnostic marker. Preoperative
optimization is essential for risk stratification, using validated
prediction models like the Cleveland Clinic score and EuroSCORE II. The
article discusses the importance of volume status assessment and careful
management of nephrotoxic medications. Intraoperative strategies, such as
surgical technique selection and hemodynamic optimization, are crucial for
preventing AKI during surgery. Postoperatively, maintaining fluid balance
and avoiding nephrotoxin exposure are vital. Implementing KDIGO care
bundles has demonstrated effectiveness in reducing AKI incidence. Emerging
biomarkers, such as NGAL and KIM-1, offer promising avenues for early
detection of renal injury, potentially enabling timely interventions. In
conclusion, comprehensive prevention of AKI in cardiac surgery demands a
multimodal approach, integrating preoperative risk assessment,
intraoperative management, and postoperative care. Advances in biomarker
research and monitoring technologies may facilitate earlier and more
effective interventions, ultimately reducing the incidence of AKI in
high-risk patients. Copyright © 2025 Elsevier Inc.

<22>
Accession Number
2043851585
Title
Impact of Transcatheter Mitral and Tricuspid Valve Repair on Hepatic
Function and Outcomes in Patients with Cirrhosis or Advanced Liver
Disease-A Personalized Approach.
Source
Journal of Clinical Medicine. 15(5) (no pagination), 2026. Article Number:
1883. Date of Publication: 01 Mar 2026.
Author
Becic T.; Jukic I.; Prizmic P.S.; Matulic I.; Dogas H.; Radic M.; Radic
J.; Vukovic J.; Fabijanic D.
Institution
(Becic, Fabijanic) Department of Cardiovascular Diseases, University
Hospital of Split, Split, Croatia
(Jukic, Vukovic) Department of Internal Medicine, Division of
Gastroenterology, University Hospital of Split, Split, Croatia
(Jukic) Faculty of Health Sciences, University of Split, Split, Croatia
(Prizmic, Radic) Department of Internal Medicine, Division of
Rheumatology, Allergology and Clinical Immunology, University Hospital of
Split, Split, Croatia
(Matulic) Private Clinic Matulic, Osjecka Ulica 24a, Split, Croatia
(Dogas) Department of Neurology, University Hospital of Split, Split,
Croatia
(Radic, Radic, Vukovic) Department of Internal Medicine, School of
Medicine, University of Split, Split, Croatia
(Radic) Department of Internal Medicine, Division of Nephrology, Dialysis
and Arterial Hypertension, University Hospital of Split, Split, Croatia
(Fabijanic) Department of Clinical Propedeutics, School of Medicine,
University of Split, Split, Croatia
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Transcatheter edge-to-edge repair (TEER) has emerged as an
established treatment option for patients with severe mitral (MR) and
tricuspid regurgitation (TR) who are at high surgical risk. Patients
referred for TEER frequently present with advanced comorbidities,
including cirrhosis or chronic liver disease (CLD). Hepatic dysfunction,
driven by chronic venous congestion and impaired cardiac output,
represents a key yet underrecognized determinant of prognosis in this
population. The impact of TEER on hepatic function and outcomes in
patients with advanced liver disease remains incompletely defined.
 Method(s): This systematic review was conducted in accordance with
PRISMA 2020 guidelines and registered in PROSPERO. A comprehensive
literature search of PubMed, Scopus, Web of Science, and the Cochrane
Library was performed up to 16 January 2026, without language
restrictions. Studies evaluating mitral or tricuspid TEER in adult
patients with cirrhosis, chronic or advanced liver disease, congestive
hepatopathy, or cardiohepatic syndrome were included. Hepatic function was
assessed using biochemical markers, clinical diagnoses, or composite
scores such as Model for End-Stage Liver Disease (MELD) score and Model
for End-Stage Liver Disease Excluding INR (MELD-XI). A qualitative
synthesis was performed due to heterogeneity in study design and outcome
reporting. Result(s): Twelve studies were included, comprising
prospective and retrospective cohorts, registry-based analyses,
mechanistic studies, and one illustrative case report. Six studies
evaluated mitral TEER (M-TEER) and six tricuspid (T-TEER). Across both
valve interventions, impaired baseline hepatic function was consistently
associated with increased mortality and adverse clinical outcomes. MELD
and MELD-XI scores emerged as robust prognostic markers following both
M-TEER and T-TEER. Successful reduction in valvular regurgitation was
associated with stabilization or improvement of hepatic parameters in
selected patients, particularly after T-TEER. However, advanced
cardiohepatic syndrome and limited hepatic reserve were linked to poor
outcomes despite procedural success. Conclusion(s): Hepatic
dysfunction is a powerful determinant of prognosis in patients undergoing
M-TEER and T-TEER. While TEER may improve hepatic congestion and
liver-related parameters in selected patients, outcomes are highly
dependent on baseline hepatic reserve and global hemodynamic status. A
personalized approach integrating hepatic assessment into patient
selection and risk stratification is essential to optimize outcomes in
this complex and growing population. Copyright © 2026 by the
authors.

<23>
Accession Number
2044095552
Title
Increased cardiovascular mortality with single antiplatelet therapy in
anticoagulation-treated chronic coronary syndrome patients: meta-analysis
of randomized trials.
Source
Polish Archives of Internal Medicine. 136(2) (no pagination), 2026.
Article Number: 17201. Date of Publication: 26 Feb 2026.
Author
Navarese E.P.; Kereiakes D.J.; Henry T.D.; Isgender M.; Talanas G.; Kubica
J.; Farkouh M.E.; Andreotti F.
Institution
(Navarese) Department of Life and Health Sciences, Link Campus University,
Rome, Italy
(Navarese) SIRIO MEDICINE Research Network, Nicolaus Copernicus
University, Bydgoszcz, Poland
(Kereiakes, Henry) The Christ Hospital and Lindner Research Center,
Cincinnati, OH, United States
(Isgender) Republican Clinical Hospital, Department of Cardiology,
Azerbaijan Medical University, Baku, Azerbaijan
(Talanas) Department of Cardiology, University of Sassari, Sassari, Italy
(Kubica) Department of Cardiology and Internal Medicine, Ludwik. Rydygier
Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
(Farkouh) Departments of Academic Affairs and Cardiology, Cedars Sinai
Health System, Los Angeles, CA, United States
(Andreotti) Cardiothoracic Department, Catholic University Medical School,
Rome, Italy
(Andreotti) Cardiovascular Science Department, Fondazione Policlinico
Universitario Agostino Gemelli IRCCS, Rome, Italy
Publisher
Medycyna Praktyczna Cholerzyn
Abstract
INTRODUCTION The optimal antithrombotic regimen for chronic coronary
artery disease (CAD) requiring long-term anticoagulation remains
uncertain. OBJECTIVES We aimed to determine the effects of oral
anticoagulation (OAC) monotherapy in comparison with OAC plus single
antiplatelet therapy (OAC+SAPT) on cardiovascular mortality in chronic
CAD. The secondary objective was to assess the effects of both
antithrombotic approaches on major bleeding, nonfatal ischemic events, and
all-cause death. PATIENTS AND METHODS We searched PubMed, Embase, and
Cochrane CENTRAL (up to August 2025) for randomized trials comparing OAC
alone vs OAC+SAPT in chronic CAD. Fixed-effects models were used when
heterogeneity was low (I2 <50%); otherwise, random-effects models were
applied. Prespecified sensitivity analyses included a Bayesian
meta-analysis and trial sequential analysis (TSA). The primary outcome was
cardiovascular death; secondary outcomes were all-cause death, major
bleeding, nonfatal myocardial infarction, and ischemic stroke. RESULTS
Five trials (AFIRE, AQUATIC, EPIC-CAD, OAC-ALONE, and PRAEDO AF; n = 4964;
follow-up range, 12-30 mo) met the eligibility criteria. Cardiovascular
death occurred in 2.7% of the patients on OAC alone vs 3.8% on OAC+SAPT
(hazard ratio [HR], 0.69; 95% CI, 0.5-0.96; P = 0.02). The Bayesian
analysis confirmed the result (HR, 0.75; 95% credible interval,
0.61-0.93). TSA crossed the efficacy boundary, supporting firm evidence
for cardiovascular mortality reduction with OAC alone. All-cause mortality
was numerically, but not significantly, lower on OAC alone (4.9% vs 6.7%;
HR, 0.79; 95% CI, 0.5-1.24; P = 0.3). Major bleeding was reduced on OAC
alone (3.3% vs 6.4%; HR, 0.51; 95% CI, 0.39-0.66; P <0.001). Myocardial
infarction and ischemic stroke incidence did not differ significantly in
the treatment arms. CONCLUSIONS In chronic CAD requiring anticoagulation,
OAC monotherapy vs OAC+SAPT reduced cardiovascular mortality and major
bleeding without an excess in nonfatal thrombotic events, generally
supporting OAC alone as the preferred long-term strategy in this patient
population. Copyright © by the Authors, 2026.

<24>
Accession Number
2044242365
Title
Efficacy of Combined Pecto-Intercostal and Recto-Intercostal Fascial Plane
Blocks for Cardiac Surgery: A Prospective, Randomized, Controlled Trial.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 32(1) (pp
13-19), 2026. Date of Publication: 2026.
Author
Omur B.; Yildiz Y.; Celik E.C.; Alver S.; Tor I.H.; Ciftci B.
Institution
(Omur, Yildiz, Ciftci) Department of Anesthesiology and Reanimation,
Istanbul Medipol University, Istanbul, Turkey
(Celik) Department of Anesthesiology and Reanimation, Ataturk University
Faculty of Medicine, Erzurum, Turkey
(Alver) Department of Anesthesiology and Reanimation, Biruni University,
Istanbul, Turkey
(Tor) Department of Anesthesiology and Reanimation, University of Health
Sciences, Erzurum Regional Training and Research Hospital, Erzurum, Turkey
Publisher
Kare Publishing
Abstract
Objectives: The aim of this study was to evaluate the effects of combined
bilateral pecto-intercostal fascial plane block (PIFB) and
rectointercostal fascial plane block (RIFPB) on the quality of
postoperative analgesia and recovery in cardiac surgery patients
undergoing median sternotomy. Method(s): This prospective, randomized
controlled study was conducted in 40 patients who underwent cardiac
surgery via median sternoto-my. Patients were randomized into two groups:
the block group (PIFB+RIFPB, n=20) and the control group (no regional
block, n=20). The pri-mary outcome measure was postoperative pain scores
(NRS) during the first 24 hours. Secondary outcomes were the Quality of
Recovery-15 (QoR-15) score at 24 hours postoperatively, opioid
consumption, and opioid-related side effects. Blocks were performed
bilaterally using PIFB (20 mL of 0.25% bupivacaine on each side) and RIFPB
(10 mL of 0.25% bupivacaine on each side) under ultrasound guidance.
 Result(s): Pain scores (NRS) were significantly lower in the block
group during the first 24 postoperative hours, both at rest and during
move-ment. Consequently, QoR-15 scores at 24 hours were significantly
higher in the block group than in the control group. Tramadol consumption
was significantly lower in the block group. Additionally, opioid-related
side effects, such as nausea and vomiting, were significantly less common
in the block group. No complications related to the blocks were observed.
 Conclusion(s): The combination of bilateral PIFB and RIFPB after
median sternotomy significantly improved postoperative analgesia, reduced
opioid use, and increased the quality of recovery by minimizing side
effects. These results, evaluated for the first time in a prospective
randomized controlled trial, indicate that the combination of PIFB and
RIFPB can be included in multimodal analgesia protocols in cardiac
surgery. Copyright © 2026, Kare Publishing. All rights reserved.

<25>
Accession Number
2037814027
Title
The Effect of Magnesium Infusion in Postoperative Analgesia in Coronary
Artery Bypass Graft Surgery.
Source
Gogus-Kalp-Damar Anestezi ve Yogun Bakim Dernegi Dergisi. 32(1) (pp
32-36), 2026. Date of Publication: 2026.
Author
Yilmaz S.; Kudsioglu S.T.
Institution
(Yilmaz, Kudsioglu) Department of Anesthesiology and Reanimation, Ministry
of Health, Dr. Siyami Ersek Cardiovascular and Thoracic Surgery Center
Training and Research Hospital, Istanbul, Turkey
Publisher
Kare Publishing
Abstract
Objectives: It has been shown that patients who have undergone noncardiac
surgery experience decreased postoperative pain when given magnesium
sulfate (MgSO). In this study, we aimed to investigate the effects of MgSO
infusion on postoperative pain in coronary artery bypass graft (CABG)
surgery. Method(s): After approval from the Ethics Committee and
obtaining informed consent, 100 patients undergoing elective CABG,
classified as ASA-III and having a preoperative EF above 40%, were
selected. The patients were prospectively randomized to group I (n=50),
which received MgSO (15 mg-1kg-1h-1), and
group II (control) (n=50). Both groups received morphine infusion (0.07
mg-1kg-1h-1) postoperatively via PCA. To
evaluate analgesia, pain scores were assessed using VAS immediately after
extubation and at 2, 6, and 12 hours. Simultaneously, the number of
requests made to the PCA device, the number of requests met, and the total
morphine dose were determined and recorded. In the statistical analysis
(SPSS), differences between groups were evaluated using Student's t test
and two-way analysis of variance (p<0.05). The results were expressed as
mean value+/-standard deviation. Result(s): VAS scores at the
6th and 12th hours after extubation were lower in
the magnesium group compared with the control group (p<0.05). The total
morphine amount and frequency of PCA use were lower in the magnesium group
than in the control group. However, these differences were not
statistically significant. Conclusion(s): We suggest that magnesium
therapy for postoperative analgesia could be a useful option in CABG
surgery. Copyright © 2026, Kare Publishing. All rights reserved.

<26>
Accession Number
2043751613
Title
Risk factors for acute kidney injury after coronary artery bypass graft
surgery: a systematic review and meta-analysis.
Source
Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1722801.
Date of Publication: 2026.
Author
Chu H.; Li S.; Cao L.; Xu G.; Yang L.; Ma C.
Institution
(Chu, Xu) College of Traditional Chinese Medicine, Changchun University of
Chinese Medicine, Jilin, Changchun, China
(Li, Yang, Ma) Department of Geriatrics, Affiliated Hospital of Changchun
University of Traditional Chinese Medicine, Jilin, Changchun, China
(Cao) College of Integrated Traditional Chinese and Western Medicine,
Changchun University of Chinese Medicine, Jilin, Changchun, China
Publisher
Frontiers Media SA
Abstract
Background: Acute kidney injury (AKI) is one of the common and severe
complications following coronary artery bypass graft (CABG) surgery,
significantly increasing patient mortality, complication rates, and length
of hospital stay. Although numerous studies have explored risk factors for
postoperative AKI after CABG, results remain inconsistent. This systematic
review and meta-analysis aim to synthesize existing evidence to identify
the primary risk factors for AKI following CABG. Method(s):
Systematically searched PubMed, Embase, Web of Science, and Cochrane
Library databases from their inception to 20 September 2025. Observational
studies reporting risk factors for postoperative AKI following CABG were
included. Two researchers independently performed literature screening,
data extraction, and quality assessment. Random-effects models were used
to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs).
The I2 statistic was employed for heterogeneity analysis, and
funnel plots and Egger's test were used to assess publication bias.
 Result(s): A total of 17 research papers involving 33,809 patients
were included. The results of the meta-analysis suggest that older age [OR
= 1.05, 95% CI (1.03, 1.08)], prolonged cardiopulmonary bypass [OR = 1.14,
95% CI (1.06, 1.22)], diabetes [OR = 1.29, 95% CI (1.15, 1.45)],
intra-aortic balloon pump [OR = 3.19, 95% CI (1.74, 5.85)], transfusion of
red blood cells [OR = 1.73, 95% CI (1.25, 2.38)] may be associated with
the occurrence of AKI after CABG. Conclusion(s): Meta-analysis
results indicate that older age, prolonged cardiopulmonary bypass
duration, diabetes, intra-aortic balloon pump use, and red blood cell
transfusion are all significant risk factors for AKI following CABG. Among
these, prolonged cardiopulmonary bypass duration and intra-aortic balloon
pump use exert a particularly pronounced effect on AKI occurrence.
Systematic review registration: [https://www.crd.york.ac.uk/prospero/],
identifier [CRD420251144655]. Copyright © 2026 Chu, Li, Cao, Xu,
Yang and Ma.

<27>
Accession Number
2043105385
Title
Staged interventional strategies for acute ST-segment elevation myocardial
infarction patient with multivessel disease: Rationale and design of a
multicenter, randomized STAGED trial.
Source
American Heart Journal. 295 (no pagination), 2026. Article Number: 107352.
Date of Publication: 01 May 2026.
Author
Chen X.; Li S.; Wang B.; Chen G.; Yao Y.; He Y.; Wu X.; Yang Y.; Kang H.;
Ding L.; Cheng Y.; Shen Q.; Guo H.; Wang J.; Wen S.; Zhu L.; Xing Y.; Tong
Q.; Li P.; Liu Y.; Peng X.; Chen S.-L.; Wang Y.
Institution
(Chen, Li, Wang, Yao, Kang, Ding, Cheng, Wang) Department of Cardiology,
Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, China
(Chen) Department of Cardiology, Nanjing First Hospital, Nanjing Medical
University, Nanjing, China
(Chen, Guo) Department of Cardiology, Fuding Hospital, Fujian University
of Traditional Chinese Medicine, Fuding, China
(He) Department of Cardiology, China-Japan Union Hospital, Jilin
University, Changchun, China
(Wu) Department of Cardiology, The First Affiliated Hospital of Dali
University, Dali, China
(Yang) Vasculocardiology Department, The Third People's Hospital of
Datong, Datong, China
(Shen) Department of Cardiology, Changshu Hospital affiliated to Nanjing
University of Chinese Medicine, Suzhou, China
(Wang) Department of Cardiology, Shanxi Cardiovascular Hospital, Taiyuan,
China
(Wen) Department of Cardiology, Tianjin Fourth Central Hospital, Tianjin,
China
(Zhu) The Center for Translational Medicine, Taizhou People's Hospital,
Nanjing Medical University, Taizhou, China
(Xing) Department of Cardiology, Gaochun People's Hospital, Nanjing, China
(Tong) Department of Cardiology, The First Hospital of Jilin University,
Changchun, China
(Li) Department of Cardiology, The First Hospital of Yulin, Yunlin, China
(Liu) Department of Cardiology, Tianjin Chest Hospital, Tianjin, China
(Peng) Department of Cardiology, The First Affiliated Hospital of Nanchang
University, Nanchang, China
Publisher
Elsevier Inc.
Abstract
Background Complete revascularization (CR) has been shown to reduce the
risk of adverse cardiovascular events compared with culprit-only
revascularization (COR) in acute ST-segment elevation myocardial
infarction (STEMI) patients with multivessel disease (MVD). However, the
optimal timing of staged complete revascularization (SCR) after primary
percutaneous coronary intervention (PCI) remains unclear. Trial design The
STAGED trial is an investigator-initiated, multicenter, randomized study
involving 37 sites, aiming to include 1,586 acute STEMI patients with MVD
undergoing successful primary PCI of the culprit lesion followed by SCR.
Eligible patients will be assigned to two groups based on the timing of
SCR: early-staged PCI and delayed-staged PCI. The primary endpoint is
major adverse cardiac event (MACE), including cardiovascular death,
myocardial infarction, or ischemia-driven revascularization for both
culprit and nonculprit vessels at 12 months since the randomization. The
secondary endpoint is individual components of primary endpoint, all-cause
death, heart failure-related rehospitalization, stroke, contrast-induced
nephropathy, and radiation exposure dose. Follow-up will be conducted
through clinic visits or telephone interviews at 1, 3, and 12 months after
the index procedure. Conclusion The STAGED trial is the first randomized
controlled study specifically designed to evaluate the clinical efficacy
and safety of different timing strategies for SCR in acute STEMI patients
with MVD. Trial registration clinicaltrials.gov,
NCT04918030. Copyright © 2026 Elsevier Inc.

<28>
Accession Number
2044005376
Title
Safety and efficacy of short-term ventricular assist devices in paediatric
heart transplant candidates: a systematic review and single arm
meta-analysis.
Source
BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number:
225. Date of Publication: 01 Dec 2026.
Author
Yap N.Q.E.; Nasr J.; Miangul S.; Bitton L.; Seneviratne S.Z.; Farzad A.;
Emil-Inyang J.F.; Nasser M.L.; Sivanathan S.; Than C.A.; Burns J.W.F.
Institution
(Yap, Than) Cambridge University Hospitals NHS Foundation Trust,
Addenbrookes Hospital, Cambridge, United Kingdom
(Nasr) Baim Institute for Clinical Research, 930W Commonwealth Ave,
Boston, MA, United States
(Miangul) Blackpool Victoria Teaching Hospital, Whinney Heys Rd,
Blackpool, United Kingdom
(Bitton, Emil-Inyang) University of Nicosia Medical School, Nicholas St
93, Nicosia, Egkomi, Cyprus
(Seneviratne) Faculty of Medicine, University of Queensland, Herston,
Australia
(Seneviratne) Queensland Health Department, Mackay Base Hospital, Mackay,
Australia
(Farzad) Division of Experimental Medicine, McGill University Montreal,
Quebec, Canada
(Nasser) Department of Internal Medicine, University of Connecticut,
Farmington, CT, United States
(Sivanathan) Oxford University Hospitals NHS Foundation Trust, John
Radcliffe Hospital, Headley Way, Headington, Oxford, United Kingdom
(Than) School of Biomedical Sciences, University of Queensland, St Lucia,
Brisbane, Australia
(Burns) Bolton NHS Foundation Trust, Minerva Road, Farnworth, Bolton,
United Kingdom
Publisher
BioMed Central Ltd
Abstract
Background: Safety and efficacy of short-term ventricular assist devices
(VAD) remains incompletely understood, particularly in younger children.
This systematic review and meta-analysis aims to evaluate outcomes,
including bridging success, complications, and mortality, associated with
short-term VAD support in paediatric heart transplant candidates.
 Method(s): A systematic search of PubMed, EMBASE, CINAHL, Cochrane
Central Register of Controlled Trials, Cochrane Database of Systematic
Reviews, Scopus, and Web of Science was conducted from inception to 2
December 2024. Eligible studies reported patients <= 18 years supported by
short-term VADs. This review was registered in PROSPERO (ID:
CRD42023468125). Result(s): Twelve retrospective studies met the
inclusion criteria, encompassing 532 paediatric patients (mean age 10.0
years, < 0.1-18.3, mean weight 39.5 +/- 30.3 kg). Pooled proportions show
that with a mean support duration of 15.2 days, 50.7% were successfully
bridged to transplant (95% CI 36.4%, 65.0%; I2 = 91.1%) with a
24.8% waitlist mortality (95% CI 17.6%, 31.9%; I2 = 63.8%),
14.0% (95% CI 7.2%, 20.9%; I2 = 97.5%) weaned off support and
5.4% (95% CI 2.6%, 8.3%; I2 = 39.1%) remaining on support.
Complication rates were high with haemorrhage (38.9%), renal impairment
(35.2%), cerebrovascular events (29.5%), infection (17.8%), and
thromboembolism (9.9%) being the most reported. Conclusion(s):
Short-term VADs offer a feasible bridge to transplant in paediatric
patients, with success rates comparable to registry data. However, high
rates of serious complications and waitlist mortality persist,
particularly in these younger children. These findings demonstrate the
need for improved patient selection, standardized outcome reporting, and
development of safer, size-appropriate devices for paediatric
use. Copyright © The Author(s) 2026.

<29>
Accession Number
2044105439
Title
Mild induced hypothermia in patients with infarct-related cardiogenic
shock and cardiac arrest: insights from the CULPRIT-SHOCK trial.
Source
European Heart Journal: Acute Cardiovascular Care. 15(1) (pp 15-23), 2026.
Date of Publication: 01 Jan 2026.
Author
Zeymer-Von Metnitz D.; Ouarrak T.; Huber K.; Noc M.; Desch S.; Freund A.;
Zeymer U.; Thiele H.; Poss J.
Institution
(Zeymer-Von Metnitz) Department of Ophthalmology, University Hospital
Tubingen, Tubingen, Germany
(Ouarrak, Zeymer) Institut fur Herzinfarktforschung, Ludwigshafen, Germany
(Huber) Austrian Heart Foundation and Luwig Boltzmann Institute for
Cardiovascular Research, Vienna, Austria
(Noc) Center for Intensive Internal Medicine, University Medical Center
Ljubljana, Ljubljana, Slovenia
(Desch, Freund, Thiele, Poss) Department of Internal Medicine/Cardiology,
Heart Center Leipzig, Leipzig University, Strumpellstrase 39, Leipzig,
Germany
(Zeymer) Department of Cardiology, University Heart Center Freiburg, Bad
Krozingen, Germany
Publisher
Oxford University Press
Abstract
Aims Mild induced hypothermia (MIH) is often applied in patients with
cardiac arrest (CA), but its impact on patients with infarct-related
cardiogenic shock (CS) and CA remains unclear. Objectives To evaluate the
characteristics and outcomes of patients with infarct-related CS and CA
who received MIH vs. those who did not in the randomized CULPRIT-SHOCK
trial and the accompanying registry. Methods and results We included
patients with CS and CA from the CULPRIT-SHOCK trial and registry. The
primary endpoint was 1-year mortality. Secondary endpoints included death
or renal replacement therapy within 30 days. A multivariate regression
analysis was performed for 1-year mortality, adjusted for relevant
baseline parameters. Among 550 patients with CA, 288 (52.4%) received MIH.
Patients treated with MIH were younger (64 vs. 67 years, P = 0.03), had
higher rates of mechanical ventilation (94.5% vs. 78.8%, P < 0.01), and
higher mean arterial pressure (82 vs. 76 mmHg, P = 0.002). The unadjusted
hazard ratio (HR) for 1-year mortality favoured MIH [HR: 0.77, 95%
confidence interval (CI): 0.61-0.97, P = 0.024]; however, after
multivariate adjustment, this effect was not statistically significant
(HR: 0.83, 95% CI: 0.64-1.09, P = 0.18). MIH was associated with a higher
need for renal replacement therapy (15.2% vs. 7.5%, P = 0.005) and less
use of mechanical circulatory support (21.2% vs. 34.2%, P < 0.001).
Conclusion In this retrospective analysis MIH was not significantly
associated with lower 1-year mortality in patients with infarct-related CS
and CA. Because of the numerically lower mortality rate, further research
is necessary to clarify the role of MIH in this patient population. Trial
registration ClinicalTrials.gov Identifier: NCT01927549 Copyright
© The Author(s) 2025. Published by Oxford University Press on behalf
of the European Society of Cardiology. All rights reserved.

<30>
Accession Number
2043864036
Title
PERSISTENT ORAL INFECTIONS MAY INCREASE THE RISK OF INFECTIOUS
COMPLICATIONS IN ORGAN TRANSPLANT RECIPIENTS.
Source
Journal of Evidence-Based Dental Practice. 26(2) (no pagination), 2026.
Article Number: 102232. Date of Publication: 01 Jun 2026.
Author
Zanjir M.; Azarpazhooh A.
Publisher
Elsevier Inc.
Abstract
Article Title and Bibliographic Information Olsson J, Hunfjord S, Braun O,
Haggman-Henrikson B, Ljunggren A. Impact of Oral Infection on Organ
Transplantation: A Systematic Review. J Evid Based Dent Pract. 2024
Dec;24(4):102035. doi: 10.1016/j.jebdp.2024.102035 . Epub 2024 Sep 5.
PMID: 39631966. Source of Funding No grants were received from funding
agencies in the public, commercial, or not-for-profit sectors. Type of
Study/Design Systematic review Copyright © 2026. Published by
Elsevier Inc.

<31>
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. 40(5) (pp 1390-1396),
2026. Date of Publication: 01 May 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.
 Design(s): A prospective observational cohort study with systematic
protocol implementation and data collection. Setting(s): A single
academic medical center. Participant(s): Six hundred twenty-eight
patients undergoing elective cardiac surgery with cardiopulmonary bypass
between November 2024 and June 2025. 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. 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).
 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. Copyright © 2026 Elsevier Inc.

<32>
Accession Number
2043005525
Title
Peripheral Regional Anesthesia Techniques in Pediatric Cardiac Surgery: A
Scoping Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(5) (pp 1496-1510),
2026. Date of Publication: 01 May 2026.
Author
Kataoka K.; Park S.; Shingala D.; Cheng S.; Sumie M.; Niimi N.; Cunningham
J.; Chin V.; Pankiv E.; Hayes J.; Maynes J.T.; Kirsch R.; Aoyama K.
Institution
(Kataoka, Shingala, Sumie, Niimi, Chin, Pankiv, Hayes, Maynes, Kirsch,
Aoyama) Department of Anesthesia and Pain Medicine, The Hospital for Sick
Children, Toronto, ON, Canada
(Kataoka, Park, Cheng, Sumie, Niimi, Cunningham, Chin, Pankiv, Hayes,
Maynes, Kirsch, Aoyama) Temerty Faculty of Medicine, University of
Toronto, Toronto, ON, Canada
(Sumie, Aoyama) Program in Child Health Evaluative Sciences, SickKids
Research Institute, Toronto, ON, Canada
(Sumie) Department of Anesthesiology, St. Mary's Hospital, Fukuoka, Japan
(Sumie) Department of Anesthesiology and Critical Care Medicine, of
Medical Sciences, Kyushu University, Fukuoka, Japan
(Cunningham) Health Sciences Library, The Hospital for Sick Children,
Toronto, ON, Canada
(Maynes) Program in Molecular Medicine, SickKids Research Institute,
Toronto, ON, Canada
Publisher
W.B. Saunders
Abstract
Peripheral regional anesthesia (PRA) techniques have gained increasing
attention as adjuncts to multimodal analgesia and enhanced recovery
pathways. This scoping review aims to summarize the current evidence on
the use of PRA in pediatric patients undergoing cardiac surgery and seeks
to inform clinical practice by answering 10 predetermined research
questions. This scoping review adhered to the Preferred Reporting Items
for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews
guidelines. We searched 6 databases and trial registries up to August
2025. Eligible studies were randomized controlled trials of patients aged
<18 years undergoing cardiac surgery under general anesthesia, with
interventions involving PRA, published in English. We also performed a
post hoc screening to identify evidence synthesis studies relevant to the
current scoping review. We extracted and qualitatively synthesized data on
block techniques, perioperative outcomes, and PRA-related complications.
Twenty-nine randomized controlled trials were eligible, in which 11 PRA
techniques were reported. The post hoc screening identified 5 systematic
reviews with meta-analysis. Compared with placebo, PRA was associated with
reduced intraoperative and postoperative opioid consumption, shorter time
to extubation, decreased intensive care unit length of stay, and lower
pain scores at 8 to 24 hours postoperatively in most studies. PRA-related
complications, such as pneumothorax or block failure, were rare, and the
incidence was not different from placebo. Trials comparing the PRA
techniques were limited, and the findings were inconclusive. In
conclusion, PRA techniques improve perioperative outcomes in pediatric
cardiac surgery, including opioid sparing, earlier extubation, and shorter
intensive care unit stay, with a favorable safety profile. The results are
descriptive, and further trials are needed to standardize dosing and
optimize block selection. Copyright © 2025 Elsevier Inc.

<33>
Accession Number
2043911553
Title
Natural products targeting the gut-brain axis for the treatment of
post-cardiac procedures anxiety or depression.
Source
Phytomedicine. 155 (no pagination), 2026. Article Number: 158061. Date of
Publication: 01 Jun 2026.
Author
Ning B.; Wei Y.; Luo C.; Yang L.; Zheng Z.; Fang P.; Ge T.; Wang C.; Hu
J.; Zhao Q.; Bo J.; Dong Y.; Lei Y.; He L.; Zhang Z.; Zhao M.; Peng J.;
Zou R.; Fan X.
Institution
(Ning, Yang, Zheng, Ge, Wang, Hu, Zhao, Bo, Zou, Fan) The Second Clinical
College of Guangzhou University of Chinese Medicine, Guangzhou, China
(Wei) The Fourth Clinical Medical College of Guangzhou University of
Chinese Medicine, Shenzhen, China
(Luo) The Clinical Medical College of Chengdu University of Traditional
Chinese Medicine, Chengdu, China
(Fang) The First Clinical College of Guangzhou University of Chinese
Medicine, Guangzhou, China
(Wang, Peng, Zou, Fan) Guangdong Provincial Hospital of Chinese Medicine,
the Second Affiliated Hospital of Guangzhou University of Chinese
Medicine, Guangzhou, China
(Dong) The First Clinical Medical College of Yunnan University of Chinese
Medicine, Kunming, China
(Lei, He, Zhang) The First Clinical Medical College of Shaanxi University
of Chinese Medicine, Xianyang, China
(Zhao) Affiliated Hospital of Shaanxi University of Chinese Medicine,
Xianyang, China
(Zou, Fan) State Key Laboratory of Traditional Chinese Medicine Syndrome,
State Key Laboratory of Dampness Syndrome of Chinese Medicine, Guangdong
Provincial Key Laboratory of TCM Emergency Research, Guangzhou, China
Publisher
Elsevier GmbH
Abstract
Background Post-cardiac surgery anxiety or depression (PCPAD) is a common
neuropsychiatric complication following cardiovascular interventional
procedures, which significantly increases the risk of adverse
cardiovascular events and long-term mortality. Existing treatment
strategies have limitations, and clinical needs remain unmet. The
gut-brain axis (GBA) serves as a core network regulating neuroimmune and
endocrine responses, and its imbalance involves key links such as
intestinal flora dysbiosis and neuroimmune crosstalk disorders. It is
closely related to the pathogenesis of this complication, providing a
novel perspective for targeted interventions. Objective This review aims
to systematically clarify the mechanism of GBA in PCPAD, comprehensively
explore therapeutic strategies targeting this axis, and focus on the
intervention value and application potential of natural products. Methods
The study was designed and conducted in strict accordance with the PRISMA
2020 guidelines. Relevant literatures were searched from PubMed, Web of
Science Core Collection, ScienceDirect, Embase, Cochrane Library, and CNKI
databases from their inception to December 2025. Literatures focusing on
GBA-related mechanisms of PCPAD or investigating the mechanisms and
clinical applications of natural products targeting GBA for PCPAD
treatment were included. Conference abstracts, case reports, duplicate
publications, and other ineligible literatures were excluded. Through
quality control strategies including double independent screening and
verification, priority inclusion of high-credibility evidence, and data
cross-validation, 168 eligible literatures were finally included. The
composition and functions of GBA, its imbalance mechanisms, and the basic
and clinical evidence of natural product-based interventions were
systematically analyzed. Results Studies have shown that GBA imbalance is
the core pathogenesis of PCPAD, among which the inflammatory cascade
initiated by intestinal flora dysbiosis, abnormal activation of the
neuroendocrine axis, disorder of immune-nerve crosstalk, and abnormal gene
and epigenetic regulation are key pathological links. In summary, GBA
imbalance, especially gut microbiota dysbiosis and neuroimmune
interactions, plays a critical role in the pathogenesis of PCPAD. Natural
products (including traditional Chinese medicine (TCM) monomers, TCM
compound prescriptions, patented TCM drugs, and natural products from
other plant sources worldwide) can exert therapeutic effects by
synergistically regulating GBA homeostasis through multiple targets.
Specifically, they include increasing the abundance of beneficial bacteria
such as Bifidobacterium and Lactobacillus, promoting the production of
anti-inflammatory metabolites such as short-chain fatty acids, repairing
intestinal barrier function, inhibiting pro-inflammatory pathways such as
NF-kappaB and NLRP3 inflammasome, and regulating the levels of
neurotransmitters and neurotrophic factors such as 5-HT and BDNF. Basic
and clinical studies have confirmed that these natural products have high
biocompatibility and low toxic side effects, and are compatible with the
safe medication needs of patients during the organ function recovery
period after cardiac surgery. Several natural products have been proven to
modulate GBA dysfunction, with potential for clinical therapeutic
application. Conclusions This review systematically elucidates a new
paradigm of precise intervention for PCPAD via natural products that
regulate GBA through multiple targets, addressing the limitation of
traditional single-target therapies and providing a low-cost, easily
promotable solution for clinical translation. Additionally, natural
product-based interventions offer a novel approach for treating
post-cardiac surgery complications. In the future, it is necessary to
further conduct large-sample, multicenter clinical trials to clarify their
mechanisms of action and standardized dosage regimens, strengthen
toxicological research, facilitate the translation from basic research to
clinical practice, and provide more precise therapeutic strategies for
patients. Copyright © 2026 Elsevier GmbH.

<34>
Accession Number
2044082163
Title
Efficacy and Safety of Sodium-Glucose Cotransporter 2 Inhibitors in Heart
Transplant Recipients: A Systematic Review and Meta-analyses.
Source
American Journal of Cardiovascular Drugs. (no pagination), 2026. Date of
Publication: 2026.
Author
Cahuapaza-Gutierrez N.L.; Calderon-Hernandez C.C.; Umeres-Bravo M.M.;
Villavicencio-Escudero T.V.
Institution
(Cahuapaza-Gutierrez, Calderon-Hernandez, Villavicencio-Escudero)
Universidad Cientifica del Sur, Lima, Peru
(Cahuapaza-Gutierrez, Calderon-Hernandez, Umeres-Bravo) Cardiology
Research Department, N y C-Center of Research and Medical Excellence
(CRME), Lima, Peru
(Umeres-Bravo) Facultad de Ciencias de la Salud, Carrera de Medicina,
Universidad de Aquino Bolivia, Cochabamba, Bolivia
Publisher
Adis
Abstract
Background: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have
demonstrated efficacy and safety in patients with type 2 diabetes
mellitus, chronic kidney disease, and heart failure. However, their
effects in heart transplant recipients, a population with high
cardiovascular risk, remain poorly understood. Method(s): Clinical
trials and observational studies were included. A systematic search was
conducted in PubMed, Scopus, EMBASE, and Web of Science. Mean differences
(MD) were calculated for continuous outcomes and risk ratios (RR) for
binary outcomes, both with 95% confidence intervals (CI). Analyses were
performed using RevMan version 5.4.1. Result(s): Five retrospective
cohort studies including 1512 heart transplant recipients (312 SGLT2i
users and 1200 controls) were analyzed. SGLT2i use was not associated with
significant changes in renal function (MD in eGFR: 3.96 mL/min/1.73
m2; 95% CI: - 2.33 to 10.26; p = 0.22) or glycemic control (MD
in HbA1c: - 0.20%; 95% CI: - 0.73 to 0.34; p = 0.47). Mortality was
comparable between groups (RR: 0.64; 95% CI: 0.29-1.40; p = 0.26), with no
significant increase in urinary tract infections (RR: 1.40; 95% CI:
0.25-7.72; p = 0.70). However, SGLT2i use was associated with significant
reductions in body mass index (MD: - 0.90 kg/m2; 95% CI: - 1.67
to - 0.14; p = 0.02) and systolic blood pressure (MD: - 4.69 mmHg; 95% CI:
- 7.27 to - 2.12; p < 0.001). Conclusion(s): In heart transplant
recipients, the use of SGLT2 inhibitors was not associated with
significant improvements in renal function or glycemic control and did not
increase mortality or the incidence of urinary tract infections. However,
SGLT2 inhibitor therapy was associated with significant reductions in body
mass index and systolic blood pressure, suggesting a potential
cardiometabolic benefit in this high-risk population. Given that
hypertension and obesity are well-established cardiovascular risk factors
and that hypertension, in particular, is a common complication among heart
transplant recipients, these blood pressure and weight-lowering effects
may be clinically meaningful. Systematic Review Registration: PROSPERO
CRD420251057335. Copyright © The Author(s), under exclusive
licence to Springer Nature Switzerland AG 2026.

<35>
Accession Number
2044351608
Title
Hemolysis and Acute Kidney Injury Following Cardiac Surgery With
Cardiopulmonary Bypass in Patients With Preexisting Renal Dysfunction.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Volleman C.; Phelp P.G.; Dubelaar D.P.C.; Tuip-de Boer A.M.; Hollander
R.V.G.; Nieuwland R.; Vlaar A.P.J.; van den Brom C.E.
Institution
(Volleman, Phelp, Dubelaar, Tuip-de Boer, Vlaar, van den Brom) Department
of Intensive Care Medicine, Amsterdam UMC, University of Amsterdam,
Amsterdam, Netherlands
(Volleman, Phelp, Dubelaar, Tuip-de Boer, Hollander, Vlaar, van den Brom)
Laboratory for Experimental Intensive Care and Anesthesiology (LEICA),
Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
(Volleman, van den Brom) Department of Anesthesiology, Amsterdam UMC, VU
University, Amsterdam, Netherlands
(Nieuwland) Amsterdam Vesicle Center, Amsterdam UMC, University of
Amsterdam, Amsterdam, Netherlands
(Nieuwland) Laboratory of Experimental Clinical Chemistry, Department of
Laboratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam,
Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: Acute kidney injury (AKI) is a common complication following
cardiac surgery with cardiopulmonary bypass (CPB). This study investigated
whether cell-free hemoglobin (CFHb) levels after CPB are associated with
endothelial damage and postoperative AKI in patients with preexisting
renal dysfunction. Design(s): A substudy of a randomized controlled
trial. Setting(s): Secondary referral and tertiary hospital.
 Participant(s): Adult patients undergoing cardiac surgery with CPB
and an estimated glomerular filtration rate (eGFR) <50 mL/min/1.73
m2 or diabetes mellitus with an eGFR of <60 mL/min/1.73
m2. Intervention(s): Clinical data and plasma samples were
collected after induction of anesthesia, within 1 hour at the intensive
care unit, and 24 and 48 hours postoperatively. Measurements and Main
Results: Of the 89 patients included, 21% developed AKI. CFHb peaked at 1
hour postoperatively (22.5 v 5.4 mg/dL, p < 0.001), and lactate
dehydrogenase rose until 48 hours postoperatively (119 v 339 U/L, p <
0.001). Tumor necrosis factor alpha and intercellular adhesion molecule 1
increased following surgery (7.06 v 9.21 ng/mL, p = 0.020; 247 v 388
ng/mL, p < 0.001). Angiopoietin-2 rose until 48 hours postoperatively and
was higher in patients with AKI at 24 hours (4,162 v 3,374 pg/mL, p =
0.027). Similarly, neutrophil gelatinase-associated lipocalin increased in
patients with AKI (43.1 v 88.0 ng/mL, p < 0.001). CFHb at 1 hour
postoperatively was not associated with angiopoietin-2 at 24 or 48 hours.
Adding CFHb to a prediction model of AKI did not improve model fit (p =
0.28) or discrimination (p = 0.32). Conclusion(s): This study
demonstrates that CPB induces hemolysis and endothelial activation and
damage in patients with preexisting renal dysfunction. Although CFHb
concentrations were higher in those developing AKI, CFHb did not predict
AKI or correlate with markers of endothelial damage. Copyright ©
2026 The Author(s)

<36>
Accession Number
2040496160
Title
Efficacy of clopidogrel monotherapy versus aspirin monotherapy after
percutaneous coronary intervention.
Source
Journal of Thrombosis and Thrombolysis. 59(2) (pp 286-296), 2026. Date of
Publication: 01 Feb 2026.
Author
Waqas S.A.; Imran Z.; Bilal A.R.; Ahmed S.; Gaba H.; Chew N.W.S.; Greene
S.J.; Khan M.S.
Institution
(Waqas, Imran) Department of Medicine, Dow University of Health Sciences,
Karachi, Pakistan
(Bilal, Gaba) Department of Medicine, Ziauddin Medical College, Karachi,
Pakistan
(Ahmed) Department of Medicine, Fatima Memorial Hospital College of
Medicine and Dentistry, Lahore, Pakistan
(Chew) Department of Cardiology, National University Heart Centre,
National University Health System, Singapore, Singapore
(Chew) Yong Loo Lin School of Medicine, National University of Singapore,
Singapore, Singapore
(Greene) Duke Clinical Research Institute, Durham, NC, United States
(Greene) Division of Cardiology, Duke University School of Medicine,
Durham, NC, United States
(Khan) Baylor College of Medicine, Temple, TX, United States
(Khan) Baylor Scott and White Heart Hospital, Plano, TX, United States
(Khan) Baylor Scott and White Research Institute, Baylor Scott and White
Health, Dallas, TX, United States
Publisher
Springer
Abstract
Following percutaneous coronary intervention (PCI), dual antiplatelet
therapy (DAPT) is standard to reduce thrombotic complications. However,
the optimal monotherapy after DAPT remains debated. Clopidogrel may offer
better protection than aspirin. We conducted a systematic review and
meta-analysis of randomized controlled trials (RCTs) comparing clopidogrel
versus aspirin monotherapy after DAPT in PCI patients. Searches were
performed in MEDLINE, Embase, Scopus, CENTRAL, and ClinicalTrials.gov up
to April 12, 2025. Outcomes included stroke, myocardial infarction (MI),
all-cause mortality, and cardiovascular (CV) death. Hazard ratios (HRs)
were pooled using random-effects models. Four RCTs comprising 19,554
patients (clopidogrel: 9,846; aspirin: 9,708) were included. Clopidogrel
was associated with a significantly lower risk of stroke (HR: 0.69; 95%
CI: 0.51-0.94; p = 0.02; I2 = 28%) and MI (HR: 0.71; 95% CI: 0.51-0.99; p
= 0.05; I2 = 48%) compared with aspirin. There was no significant
difference between clopidogrel and aspirin in terms of all-cause mortality
(HR: 0.99; 95% CI: 0.78-1.25; p = 0.92; I2 = 55%), CV death (HR: 0.87; 95%
CI: 0.70-1.08; p = 0.22; I2 = 0%), coronary revascularization (HR: 0.95;
95% CI: 0.83-1.09; p = 0.44; I2 = 0%), major bleeding (HR: 0.97; 95% CI:
0.70-1.35; p = 0.87; I2 = 57%), or stent thrombosis (HR: 0.66; 95% CI:
0.38-1.15; p = 0.15; I2 = 0%). Clopidogrel monotherapy post-DAPT after PCI
reduces stroke and MI risk compared to aspirin, without increasing
mortality or bleeding. These findings support clopidogrel as a favorable
alternative for monotherapy. Copyright © The Author(s), under
exclusive licence to Springer Science+Business Media, LLC, part of
Springer Nature 2025.

<37>
Accession Number
2042851037
Title
Combined Inhaled Pulmonary Vasodilators in Cardiac Surgery: A Scoping
Review.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(5) (pp 1484-1495),
2026. Date of Publication: 01 May 2026.
Author
Soto L.; Lareau A.; Ducharme M.-P.; Elmi-Sarabi M.; Jarry S.; Couture E.;
Beaubien-Souligny W.; Huard K.; Lepage M.-A.; Denault A.
Institution
(Soto, Lareau, Ducharme, Elmi-Sarabi, Jarry, Denault) Department of
Anesthesiology, Montreal Heart Institute, Universite de Montreal,
Montreal, Canada
(Couture) Department of Anesthesiology and Department of Medicine,
Division of Intensive Care Medicine, Institut Universitaire de Cardiologie
et de Pneumologie de Quebec, Universite Laval, Quebec City, Canada
(Beaubien-Souligny) Department of Nephrology, Centre Hospitalier de
l'Universite de Montreal, Montreal, Canada
(Huard) Universite de Montreal, Montreal, Canada
(Lepage) Department of Anesthesiology and Critical Care Medicine, Division
of Critical Care Medicine, CHU de Quebec-Universite Laval, Quebec City,
Canada
Publisher
W.B. Saunders
Abstract
Pulmonary hypertension is a risk factor for increased morbidity and
mortality in cardiac surgery. The use of a combination of inhaled
vasodilator agents could have an improved effect on pulmonary vascular
resistance in the perioperative cardiac surgery setting without causing
the systemic side effect of hypotension observed with intravenous agents.
There is currently limited evidence regarding the use of combination
therapy for pulmonary hypertension in the context of cardiac surgery. A
scoping review was conducted to retrieve relevant literature on the use of
a combination of inhaled vasodilator agents in the treatment of pulmonary
hypertension and/or right ventricular dysfunction in adults and children
undergoing cardiac surgery. The authors searched MEDLINE, Embase, and the
Cochrane Central Register of Controlled Trials from inception to April
2025 for relevant articles. They identified 23 studies including 432
patients. The combined inhaled therapies reported in the literature are
nitric oxide or milrinone combined with prostacyclin analogues. Of the 23
studies, 18 reported a hemodynamic benefit of the drugs in decreasing
pulmonary hypertension and improving right ventricular function. Decreased
intraoperative and postoperative vasopressor and/or inotropic use also was
observed. Moreover, the impact on clinical outcomes, such as difficulty in
weaning from cardiopulmonary bypass and length of intensive care unit
stay, showed conflicting results. No study has reported an impact on
mortality, length of hospital stay, or other intraoperative or
postoperative complications. Combined therapies are promising therapeutic
alternatives for the management of pulmonary hypertension and/or right
ventricular dysfunction in cardiac surgery, but more studies are required
to determine their systemic effects and impact on clinical
outcomes. Copyright © 2025 Elsevier Inc.

<38>
Accession Number
2042910521
Title
Pressure Monitoring-Augmented Long-Axis In-Plane Versus Long-Axis In-Plane
Alone for Ultrasound-Guided Radial Artery Catheterization in Elderly
Patients Undergoing Coronary Artery Bypass Grafting: A Randomized
Prospective Trial.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(4) (pp 1074-1080),
2026. Date of Publication: 01 Apr 2026.
Author
Lu Y.; Yuan Z.; He W.; Song X.; Teng S.
Institution
(Lu, Yuan, He, Song, Teng) Department of Anesthesiology, First Hospital of
Jilin University, Changchun, China
Publisher
W.B. Saunders
Abstract
Objectives: Radial artery catheterization is challenging in patients with
poor vascular conditions, particularly those with severe atherosclerotic
changes. The long-axis in-plane ultrasound technique provides full
visualization and reduces the risk of posterior vessel wall injury;
however, its precision is compromised by slice-thickness artifacts
inherent to ultrasound beam physics. The authors hypothesized that
combining pressure monitoring with ultrasound-guided long-axis in-plane
catheterization would improve first-attempt success by mitigating
ultrasound beam-thickness artifacts. Design(s): Single-center
prospective randomized controlled study. Setting(s): Tertiary
academic cardiac hospital. Participant(s): One hundred eight elderly
patients scheduled for coronary artery bypass grafting were enrolled, with
54 patients allocated to each study group. Nine junior anesthesiologists
performed the procedures after standardized training.
 Intervention(s): Patients were randomly assigned to 2 groups:
pressure monitoring combined with ultrasound-guided long-axis in-plane
catheterization (intervention group) and long-axis in-plane
ultrasound-guided catheterization alone (control group). Measurements
and Main Results: The primary outcome was the first-attempt success rate;
secondary outcomes included procedural time, overall success rate, number
of attempts, and complication rate. The intervention group showed a higher
first-attempt success rate (74.07% [40 of 54] v 53.70% [29 of 54];
difference, 20.37% [95% confidence interval, 4.2%-36.5%], p = 0.028) and a
shorter median procedural time (48.15 seconds [interquartile range,
40.95-116.73 seconds] v 62.05 seconds [interquartile range, 46.08-165.68
seconds]; p = 0.024). Fewer attempts were needed in the intervention group
(p = 0.039). No significant differences were observed in overall success
rate (90.74% [49 of 54] v 81.48% [44 of 54], p = 0.164) or hematoma rate
(5.56% [3 of 54] v 9.26% [5 of 54], p = 0.462), and arterial thrombosis
did not occur in either group. Conclusion(s): Pressure monitoring
combined with ultrasound-guided long-axis in-plane catheterization is an
improved technique. In this study, it helped junior operators achieve
higher success rates of radial artery catheterization in elderly patients
undergoing coronary artery bypass grafting compared with the conventional
long-axis in-plane technique. Copyright © 2025 Elsevier Inc.

<39>
Accession Number
2044072162
Title
Comparative evaluation of clonidine and metoprolol for perioperative
hemodynamic stability, blood loss control, and postoperative recovery in
patients undergoing elective surgery: a prospective randomized controlled
study.
Source
Anaesthesia, Pain and Intensive Care. 30(2) (pp 189-199), 2026. Date of
Publication: 01 Feb 2026.
Author
Sereen B.V.A.; Natarajan S.; Arunkumar B.; Shanmugasundaram S.; Choudhary
A.K.; Periasamy P.
Institution
(Sereen, Shanmugasundaram) Dept. of Anesthesiology, VMMC & H, VMRF-DU,
Salem, India
(Natarajan) Dept. of Anesthesiology, PSG IMS & R, Coimbatore, India
(Arunkumar) VMMC & H, VMRF-DU, Salem, India
(Choudhary, Periasamy) Govt. Erode Medical College, Tamil Nadu, Erode,
India
Publisher
Faculty of Anaesthesia, Pain and Intensive Care, AFMS
Abstract
Background & objective: Maintaining hemodynamic stability and minimizing
blood loss are critical goals in perioperative care. Clonidine, an
alpha2-adrenergic agonist, and metoprolol, a selective beta1-blocker, are
frequently used to modulate cardiovascular responses during surgery.
However, their comparative efficacy in reducing intraoperative blood loss
and supporting postoperative recovery remains a subject of clinical
interest. This study compared the efficacy of the both to facilitate the
choice. Methodology: This prospective, randomized controlled trial
included 60 ASA I-II patients aged 18-60 years undergoing elective surgery
under general anesthesia. Participants were randomized to receive either
oral clonidine (0.15 mg, Group-C, n = 30) or metoprolol (50 mg, Group-M, n
= 30) two hours before surgery. Intraoperative hemodynamic parameters,
estimated blood loss, surgical field quality, and postoperative outcomes
including pain score, nausea incidence, recovery time, and hospital stay
were recorded and statistically analyzed. Result(s): Both groups
maintained stable intraoperative heart rate, blood pressure, and oxygen
saturation (P > 0.05). Clonidine significantly reduced intraoperative
blood loss compared to metoprolol (137 +/- 14.71 mL vs. 151 +/- 9.94 mL, P
= 0.0002) and achieved better surgical field visibility (Good field: 70%
vs. 56.7%, P = 0.041). Postoperative outcomes, including pain scores,
recovery time, and hospital stay, were comparable across groups (P >
0.05). Conclusion(s): Clonidine and metoprolol are both effective for
intraoperative hemodynamic control and safe postoperative recovery.
However, clonidine demonstrates a distinct advantage in minimizing blood
loss and improving surgical field quality. These findings support its
preferential use in procedures where blood conservation is crucial. Larger
multicentric studies are recommended to guide patient-specific drug
selection in perioperative management. Copyright © 2026, Faculty
of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

<40>
Accession Number
2037827764
Title
Transcatheter valve-in-valve versus redo-surgical valve replacement for
mitral bioprosthetic valve dysfunction: rationale and design of the SURVIV
randomised trial.
Source
EuroIntervention. 22(6) (pp 358-366), 2026. Date of Publication: 16 Mar
2026.
Author
Siqueira D.A.; Abizaid A.A.C.; Ramos A.A.; Issa M.; Cervone A.C.; Bezerra
C.G.; Falcao B.A.A.; Cortes L.A.; Guimaraes L.F.C.; Sao Thiago L.E.K.;
Rezende M.; Delamain T.R.; Togna D.D.; Assef J.E.; Vilela A.A.; Paladino
A.T.; Pinto I.M.; Franchini K.; Bhatt D.L.; Feres F.
Institution
(Siqueira, Ramos, Issa, Cervone, Rezende, Delamain, Togna, Assef, Vilela,
Paladino, Pinto, Franchini, Feres) Instituto Dante Pazzanese de
Cardiologia, Sao Paulo, Brazil
(Abizaid) Instituto do Coracao (INCOR), Sao Paulo, Brazil
(Bezerra) Hospital Ana Nery, Salvador, Brazil
(Falcao) Hospital de Messejana, Fortaleza, Brazil
(Cortes) Instituto Nacional de Cardiologia (INC), Rio de Janeiro, Brazil
(Guimaraes) Universidade Federal de Sao Paulo (UNIFESP), Sao Paulo, Brazil
(Sao Thiago) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil
(Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at
Mount Sinai, New York, NY, United States
Publisher
Europa Group
Abstract
Bioprosthetic mitral valves are prone to structural valve deterioration
(SVD) over time, which can lead to bioprosthetic valve dysfunction (BVD)
requiring reintervention. Surgical redo-mitral valve replacement (rMVR) is
currently the standard treatment, although it is associated with
significant mortality in high-risk patients. Transcatheter mitral
valve-in-valve (mViV) has emerged as an alternative to surgical rMVR in
patients with failed bioprostheses, but randomised studies comparing the
two treatments are lacking. The SURVIV trial is an investigator-initiated,
prospective, multicentre, open-label, randomised controlled trial that
will enrol 150 patients with mitral BVD suitable for surgical rMVR or
transcatheter mViV. Participants will be randomised 1:1 to transseptal
mViV with a balloon-expandable transcatheter heart valve or to
conventional surgical rMVR. Procedures will be performed according to
local best practices with contemporary medical devices. The primary
endpoint is the composite of all-cause mortality or disabling stroke at 12
months. Key secondary endpoints are major complications (cardiovascular
death, disabling stroke, life-threatening or major bleeding, acute kidney
injury stage 2 or 3, and major vascular complications) at 30 days,
according to Mitral Valve Academic Research Consortium criteria;
rehospitalisation for cardiovascular causes at 12 months;
echocardiographic and/or tomographic signs of prosthetic valve thrombosis
and early SVD at 3 and 12 months; and health-related quality of life
(EQ-5D-5L) at 3 and 12 months. Clinical follow-up will continue up to 10
years. SURVIV is the first randomised trial to compare a transcatheter
mViV procedure with surgical rMVR for mitral BVD and may provide further
clinical evidence to guide the management of patients with failed mitral
bioprostheses. ClinicalTrials.gov: NCT04402931. Copyright ©
Europa Group 2026. All rights reserved.

<41>
[Use Link to view the full text]
Accession Number
2043316424
Title
Radial artery occlusion after cardiac catheterization and impact of
anticoagulation as medical treatment: a meta-analysis.
Source
Coronary Artery Disease. 37(2) (pp 133-141), 2026. Date of Publication: 01
Mar 2026.
Author
Didagelos M.; Papazoglou A.S.; Moysidis D.V.; Pagiantza A.; Afendoulis D.;
Kakderis C.; Daios S.; Anastasiou V.; Theodoropoulos K.C.; Kouparanis A.;
Kartalis A.; Kamperidis V.; Kassimis G.; Ziakas A.
Institution
(Didagelos, Pagiantza, Kakderis, Daios, Anastasiou, Theodoropoulos,
Kouparanis, Kamperidis, Ziakas) First Cardiology Department, AHEPA
University General Hospital
(Papazoglou) Cardiology Department, Athens Naval Hospital, Athens, Greece
(Moysidis, Pagiantza) Cardiology Department, 424 General Military
Hospital, Thessaloniki, Greece
(Afendoulis, Kartalis) Cardiology Department, General Hospital of Chios
'Skylitseio'
(Kassimis) Second Department of Cardiology, Hippokration Hospital,
Thessaloniki, Greece
Publisher
Lippincott Williams and Wilkins
Abstract
Background - Radial artery occlusion (RAO) is one of the most common
complications associated with transradial access in cardiac
catheterization procedures. To date there are no standardized protocols,
and only a few studies have evaluated the use of anticoagulation for RAO
treatment. The current meta-analysis aimed to assess the impact of various
anticoagulation strategies on RAO treatment after cardiac catheterization
via the transradial route. Methods - Literature search was performed in
PubMed, Web of Science, and CENTRAL databases, from inception until
September 2024. The primary outcome of this study was the incidence of
radial artery recanalization. The secondary outcomes were the incidence of
any bleeding events and symptom resolution during patient follow-up.
Results - A total of six studies with 398 patients were included in the
analysis. Patients with RAO under anticoagulation had a sevenfold
increased chance of radial artery recanalization [pooled odds ratio (pOR)
= 7.36 (3.82-14.17), P < 0.001]. Regarding the symptom persistence, there
was no statistically significant difference between patients receiving and
not receiving anticoagulation [pOR = 2.61 (0.26-25.86), P = 0.41].
Regarding bleeding events, no pooled data could be extracted; however, no
major bleeding events were reported in any study. Conclusion - This
meta-analysis provides compelling evidence that anticoagulation therapy
significantly improves radial artery recanalization rates in patients with
RAO without increasing the risk of major bleeding events; however, its
effect on symptom resolution remains limited, suggesting the need for a
comprehensive approach to RAO management. Copyright © 2025
Wolters Kluwer Health, Inc. All rights reserved.

<42>
Accession Number
2044008901
Title
The role of early ezetimibe combination with atorvastatin in patients with
atherosclerotic cardiovascular disease.
Source
BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number:
233. Date of Publication: 01 Dec 2026.
Author
Kang S.-H.; Kwon S.U.; Lee J.-Y.; Seo S.M.; Nam C.-W.; Park G.-M.; Hong
Y.J.; Lee W.Y.; Jang J.E.; Chae I.-H.
Institution
(Kang, Chae) Seoul National University Bundang Hospital, Seongnam-si,
South Korea
(Kwon) Inje University College of Medicine, Ilsan Paik Hospital, Goyang,
South Korea
(Lee) Kangbuk Samsung Hospital, Sungkyunkwan University School of
Medicine, Seoul, South Korea
(Lee) Hallym University College of Medicine, Hallym University Sacred
Heart Hospital, Anyang, South Korea
(Seo) Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic
University of Korea, Seoul, South Korea
(Nam) Dongsan Hospital, Keimyung University, Daegu, South Korea
(Park) Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, South Korea
(Hong) Chonnam National University Medical School, Chonnam National
University Hospital, Gwangju, South Korea
(Lee, Jang) Organon, Seoul, South Korea
Publisher
BioMed Central Ltd
Abstract
Background: Despite statin therapy, achieving target low-density
lipoprotein cholesterol (LDL-C) levels remain suboptimal in high-risk
patients with atherosclerotic cardiovascular disease (ASCVD). This study
evaluated efficacy and safety of early addition of ezetimibe (EZ) with
atorvastatin (AS), prior to reaching the maximally tolerated dose of
statin, in very high-risk patients. Method(s): This phase 4
(NCT05761444), multicenter, randomized, open-label, active-controlled
study enrolled patients (>= 30 years) with very high-risk of ASCVD.
Eligible patients had LDL-C >= 70 mg/dL with low/moderate intensity statin
monotherapy or statin-naive or not been on stable statin regimen prior to
enrollment. Patients were randomized 1:1 to EZ10/AS40 mg combination
therapy or AS40 mg statin alone for 12 weeks. Primary endpoint was
percentage change in LDL-C from baseline to week 6. Result(s):
Patients (N = 137) received EZ/AS (n = 67) or AS (n = 70) once a day. The
EZ/AS lipid-lowering effect was statistically greater than AS monotherapy
at week 6 (LSMD: 21.2; P < 0.0001) and week 12 (LSMD: 16.0; P < 0.0001).
At week 12, higher proportions of patients who received EZ/AS achieved
target LDL-C < 55 mg/dL (55.0% vs. 15.4%; P < 0.0001) and LDL-C < 70 mg/dL
(85.0% vs. 58.5%; P = 0.0009) than in AS group. Higher reduction from
baseline was observed for lipid parameters in EZ/AS group than AS
monotherapy. Incidence of adverse events were comparable between EZ/AS and
AS groups. Conclusion(s): Early combination of EZ with AS, rather
than a stepwise approach, significantly reduced LDL-C levels and improved
LDL-C reduction target achievement compared to AS monotherapy in very
high-risk patients with dyslipidemia with no new safety issues. Trial
registration: NCT05761444; Registration date: March 9, 2023. Copyright
© The Author(s) 2026.

<43>
Accession Number
2043768350
Title
Effect of age on restrictive and liberal transfusion outcomes in patients
with anemia and myocardial infarction.
Source
American Heart Journal. 297 (no pagination), 2026. Article Number: 107381.
Date of Publication: 01 Jul 2026.
Author
Goldsweig A.M.; Ballantyne C.M.; White H.D.; Abbott J.D.; Fergusson D.A.;
Herbert B.M.; Goodman S.G.; Carson J.L.; Brooks M.M.
Institution
(Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center
and Division of Cardiovascular Medicine, University of
Massachusetts-Baystate, Springfield, MA, United States
(Goldsweig) Division of Cardiovascular Medicine, University of Nebraska
Medical Center, Omaha, NE, United States
(Ballantyne, Herbert, Brooks) Department of Epidemiology, University of
Pittsburgh, Pittsburgh, PA, United States
(White) Green Lane Clinical Coordinating Centre, Auckland, New Zealand
(Abbott) Division of Cardiology, Warren Alpert Medical School, Brown
University, Providence, RI, United States
(Fergusson) Ottawa Hospital Research Institute, Ottawa, ON, Canada
(Goodman) St. Michael's Hospital, University Health Toronto, Toronto, ON,
Canada
(Goodman) Peter Munk Cardiac Centre, University Health Network, Toronto,
ON, Canada
(Goodman) University of Toronto, Toronto, ON, Canada
(Goodman) Canadian VIGOUR Centre, University of Alberta, Edmonton, AB,
Canada
(Carson) Division of General Internal Medicine, Rutgers Robert Wood
Johnson Medical School, New Brunswick, NJ, United States
Publisher
Elsevier Inc.
Abstract
For patients with anemia and myocardial infarction (MI), the randomized,
3,504-patient MINT trial found that a liberal transfusion threshold (10
g/dL) may be preferable to a restrictive threshold (8 g/dL) in terms of
death or MI. The relative effects of liberal versus restrictive
transfusion in younger and older patients are unknown. The present
prespecified MINT substudy found no significant interaction between age
and transfusion strategy for death or MI, heart failure, revascularization
procedures, cardiac death, pulmonary embolism or deep vein thrombosis,
bacteremia or pneumonia, and death at 30 and 180 days. A liberal
transfusion approach appears to be safe and may be the preferred
transfusion strategy in anemic patients with MI, regardless of age. MINT
Trial, ClinicalTrials.gov Number NCT02981407, https://www.minttrial.org/
. Copyright © 2026 Elsevier Inc.

<44>
Accession Number
2043929079
Title
The Effect of White and Pink Noise on Dental Anxiety in Children Aged 6-9
Years During Pulpotomy Procedures: A Randomized Controlled Clinical Study.
Source
International Journal of Dentistry. 2026(1) (no pagination), 2026. Article
Number: 3330992. Date of Publication: 2026.
Author
Araman D.; Laflouf M.; Al-Shiekh M.N.
Institution
(Araman, Laflouf, Al-Shiekh) Department of Pediatric Dentistry, Faculty of
Dentistry, Damascus University, Damascus, Syrian Arab Republic
Publisher
John Wiley and Sons Ltd
Abstract
Background: In recent years, white and pink noise have emerged as
nonpharmacological methods that may make dental visits less stressful and
more comfortable for children. This study aimed to evaluate the effect of
white and pink noise on anxiety levels in children undergoing pulpotomy.
 Material(s) and Method(s): A randomized controlled clinical trial was
conducted involving 75 children aged 6-9 years. Participants were randomly
assigned to three equal groups: Group A (Tell-Show-Do [TSD] combined with
white noise during the pulpotomy), Group B (TSD combined with pink noise
during the pulpotomy), and Group C (control group without audio
distraction during the pulpotomy). Anxiety levels were evaluated using the
Facial Image Scale (FIS) at three time points: at baseline, following the
administration of local anesthesia, and after completion of the pulpotomy
procedure. Heart rate was also recorded at these same intervals, as well
as after 10 min of noise exposure, following rubber dam placement, and
during access preparation of the pulp chamber. Statistical analysis was
performed using SPSS version 25, with a significance level set at p-value
< 0.05. Result(s): This study showed that at baseline and subsequent
time points, no significant differences were observed in FIS anxiety
scores among the three groups (p-value = 0.825, 0.178, 0.792,
respectively). In terms of heart rate, there was a significant difference
just during pulp chamber access (p-value = 0.014), where Group A (white
noise) showed lower heart rates (93.80 +/- 14.64) than Groups B (pink
noise) (100.36 +/- 10.98 and C (control) (103.80 +/- 12.20).
 Conclusion(s): Although no significant differences were found between
groups, music intervention may help reduce anxiety and enhance comfort.
Notably, white noise significantly lowered heart rate during pulp chamber
access, suggesting a mild physiological calming effect. Trial
Registration: ISRCTN Registry: ISRCTN11867479. Copyright © 2026
Dana Araman et al. International Journal of Dentistry published by John
Wiley & Sons Ltd.

<45>
Accession Number
2044297893
Title
Clinical outcomes and haemodynamic response after blinded stress
assessment of moderate aortic stenosis.
Source
EuroIntervention. 22(6) (pp 347-357), 2026. Date of Publication: 16 Mar
2026.
Author
Eerdekens R.; Johnson N.P.; Adrichem R.; Van Mieghem N.M.; Eftekhari A.;
Kakouros N.; Demandt J.P.A.; El Farissi M.; Vervaat F.E.; Houthuizen P.;
Felix S.E.A.; Bouwmeester S.; van't Veer M.; Johnson D.T.; Gould K.L.;
Tonino P.A.L.
Institution
(Eerdekens, Demandt, El Farissi, Vervaat, Houthuizen, Felix, Bouwmeester,
van't Veer, Tonino) Department of Cardiology, Catharina Hospital,
Eindhoven, Netherlands
(Johnson, Johnson, Gould) Division of Cardiology, Department of Medicine,
Weatherhead PET Center, McGovern Medical School at UTHealth, Memorial
Hermann Hospital, Houston, TX, United States
(Adrichem, Van Mieghem) Department of Cardiology, Erasmus University
Medical Center, Thoraxcenter, Rotterdam, Netherlands
(Eftekhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Kakouros) Division of Cardiovascular Medicine, University of
Massachusetts Medical School, Worcester, MA, United States
(van't Veer, Tonino) Department of Biomedical Engineering, Technical
University Eindhoven, Eindhoven, Netherlands
Publisher
Europa Group
Abstract
BACKGROUND: Assessing aortic stenosis (AS) haemodynamics under stress may
distinguish physiological responses beyond traditional severity metrics.
AIMS: We aimed to evaluate symptomatic patients with moderate AS and
preserved left ventricular ejection fraction (LVEF) using invasive and
non-invasive assessments at rest and during stress, hypothesising that the
stress aortic valve index (SAVI) would show only modest agreement with
echocardiographic parameters of AS severity but would be associated with
clinical outcomes. METHOD(S): We prospectively enrolled 52 patients
with moderate AS and preserved LVEF but who were symptomatic without an
alternative explanation. The SAVI, quantifying the relative reduction in
maximal flow, was measured but remained blinded. Comprehensive assessment
included echocardiography (at rest, bicycle and dobutamine stress),
calcium scoring, and clinical outcomes. Patients were managed according to
current standards without knowledge of the SAVI and followed for >=1 year.
 RESULT(S): Invasive transvalvular gradient increased from 25+/-9 mmHg
at rest to 42+/-14 mmHg during dobutamine. The aortic-to-left ventricular
pressure ratio declined from 0.82 (interquartile range [IQR] 0.78-0.88) at
rest to a SAVI of 0.70 (IQR 0.63-0.79) under stress. Resting aortic valve
area (AVA) did not predict stress haemodynamics, underscoring
physiological heterogeneity. Notably, 25/52 (48%) of patients demonstrated
a SAVI <=0.70, comparable with a severe AS cohort studied separately.
Blinded SAVI scores independently predicted the need for clinical aortic
valve (AV) intervention (hazard ratio 5.7; p=0.007), whereas AVA and
sex-specific calcium thresholds did not. CONCLUSION(S): Stress
haemodynamic assessment in moderate AS unmasks a subgroup, not identified
by conventional metrics, who are at significantly higher risk for AV
intervention. Patients with abnormal stress physiology despite only
moderate AS at rest may benefit from AV intervention, supporting this
pilot study as the basis for a future randomised trial. Copyright
© Europa Group 2026. All rights reserved.

<46>
Accession Number
2043962951
Title
Hybrid Machine Learning Method and Standard Data Analysis Approaches for
Predicting Treatment Outcomes of Cardiovascular Diseases: A Randomized
Controlled Trial.
Source
Clinica Terapeutica. 177(2) (pp 209-217), 2026. Date of Publication: 02
Mar 2026.
Author
Berestova A.; Klyueva Y.; Gorozhanina E.; Timoshina M.
Institution
(Berestova) Institute of Clinical Morphology and Digital Pathology,
Sechenov First Moscow State Medical University, Moscow, Russian Federation
(Klyueva) Department of Pharmacy Organizing and Economics, Sechenov First
Moscow State Medical University, Moscow, Russian Federation
(Gorozhanina) Department of Biology and General Genetics, Sechenov First
Moscow State Medical University, Moscow, Russian Federation
(Timoshina) Department of Propaedeutics of Dental Diseases of the E.V.
Borovsky Institute of Dentistry, Sechenov First Moscow State Medical
University, Moscow, Russian Federation
Publisher
Societa Editrice Universo
Abstract
Background. This study aimed to assess the effectiveness of data analysis
using a hybrid method in predicting and diagnosing cardiovascular diseases
compared to standard methods. Methods. The study involved 200 patients
diagnosed with cardiovascular diseases (arterial hypertension, ischemic
heart disease, heart failure) in Moscow, Russia. Patients were randomly
assigned to two equal groups. Group A underwent analysis of clinical data
using random forest, support vector machines, and linear regression
methods. Group B was subjected to hybrid method analysis. For Group B,
patient survival was higher by 5%, and complication frequency was lower by
3%. The hybrid method demonstrated superior forecasting and treatment
efficacy (p < 0.001) compared to similar indicators in Group A. Results.
PCA analysis revealed that principal components explained over 70% of the
variability among clinical parameters. Kaplan-Meier survival curves showed
a statistically significant influence of cholesterol levels on survival
and complication frequency (p < 0.05). Correlation analysis identified an
inverse relationship between cholesterol levels and survival (p < 0.05). A
hybrid data analysis method proves more effective than standard methods in
predicting cardiovascular treatment outcomes and improving patient
survival. The use of a hybrid method demonstrates the success of new data
processing techniques in clinical practice, enabling the optimization of
therapies and improving the quality of care for patients with
cardiovascular disease. Conclusion. The use of a hybrid method
demonstrates the success of new data processing techniques in clinical
practice, enabling the optimization of therapies and improving the quality
of care for patients with cardiovascular disease. Conclusion. The use of a
hybrid method demonstrates the success of new data processing techniques
in clinical practice, enabling the optimization of therapies and improving
the quality of care for patients with cardiovascular
disease. Copyright © 2026 Societa Editrice Universo (SEU), Roma,
Italy. This work is licensed under a Creative Commons
Attribution-NonCommercial 4.0 International License. This is an Open
Access article distributed under the terms of the Creative Commons
Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which
permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly cited.

<47>
Accession Number
2042013334
Title
Dissecting the "Triple Hit" of Perioperative Neurocognitive Disorders
after CABG: A Narrative Review of Microemboli, Hypoperfusion, and
Inflammation.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(5) (pp 1528-1540),
2026. Date of Publication: 01 May 2026.
Author
Zhou Z.; Wan W.; Wei S.
Institution
(Zhou) Cardiovascular Center, Beijing Tongren Hospital, Capital Medical
University, Beijing, China
(Wan) Department of Neurosurgery, Beijing Tiantan Hospital, Capital
Medical University; National Clinical Research Center for Neurological
Diseases; Center for Stroke, Beijing Institute for Brain Disorders,
Beijing Key Laboratory of Translational Medicine for Cerebrovascular
Disease, Beijing, China
(Wei) Department of Neurosurgery, Yangpu District Shidong Hospital of
Shanghai, Shanghai, China
Publisher
W.B. Saunders
Abstract
Perioperative neurocognitive disorders, encompassing a spectrum from
delirium to long-term cognitive decline, remain one of the most
significant and prevalent complications following coronary artery bypass
grafting, profoundly impacting patient recovery and quality of life.
However, perioperative neurocognitive disorders represent only one facet
of a broader spectrum of perioperative neurologic injury (PNI) that also
includes overt stroke and prognostically crucial silent brain infarcts.
The etiology of this injury spectrum is unequivocally multifactorial. This
comprehensive review conceptualizes the intricate pathogenesis of
post-coronary artery bypass grafting neurologic injury through an expanded
"triple-hit" framework. Building on the foundational "double-hit"
hypothesis of embolism and hypoperfusion, this model integrates the
massive systemic inflammatory response as a third, synergistic pillar. We
posit that it is the convergence of these three intraoperative
insults-microembolic events, cerebral hypoperfusion, and
inflammation-acting in a vicious cycle on a patient's preexisting cerebral
vulnerabilities (the "vulnerable brain") that overwhelms cerebral reserve
and precipitates the full spectrum of PNI. This review systematically
deconstructs the pathophysiological mechanisms of each component,
critically appraises clinical evidence for the entire PNI spectrum,
evaluates the influence of evolving surgical and anesthetic techniques,
and explores the pivotal causal link between postoperative delirium and
the trajectory toward long-term dementia. Finally, drawing on
authoritative guidelines, we synthesize the evidence into a holistic,
team-based, and actionable perioperative brain health pathway, providing
practical guidance for the entire perioperative team to preserve the
cognitive function that defines patients' quality of life. Copyright
© 2025 Elsevier Inc.

<48>
Accession Number
2035606163
Title
Continuous vital sign monitoring on surgical wards: The COSMOS pilot.
Source
Journal of Clinical Anesthesia. 99 (no pagination), 2024. Article Number:
111661. Date of Publication: 01 Dec 2024.
Author
Anusic N.; Gulluoglu A.; Ekrami E.; Mascha E.J.; Li S.; Coffeng R.; Turan
A.; Clemens A.; Perez C.; Beard J.W.; Sessler D.I.; Rodriguez F.;
Mueller-Wirtz L.; Mueller C.M.; Slife M.; Mosqueda M.; Gatt R.; Nikoo
M.Z.; Cekmecelioglu B.T.; Kopac O.; Singh S.; Corrales Martinez M.J.;
Karki D.; Medellin S.; Erazo V.L.; Brooker J.; Rossler J.; Mukhia R.; Pu
X.
Institution
(Anusic, Gulluoglu, Ekrami) Research Fellow, OUTCOMES RESEARCH Consortium,
Department of Anesthesiology, Cleveland Clinic, Cleveland, OH, United
States
(Mascha) Staff Biostatistician, Department of Quantitative Health
Sciences, OUTCOMES RESEARCH Consortium, Department of Anesthesiology,
Cleveland Clinic, Cleveland, OH, United States
(Li) Statistical Programmer, Department of Quantitative Health Sciences,
OUTCOMES RESEARCH Consortium, Department of Anesthesiology, Cleveland
Clinic, Cleveland, OH, United States
(Coffeng) GE HealthCare - Patient Care Solutions, Helsinki, Finland
(Turan) Director, Outcomes Research Consortium, Professor of
Anesthesiology, Department of Anesthesiology and Center for OUTCOMES
RESEARCH, University of Texas Health Science Center, Houston, TX, United
States
(Clemens, Perez) Nurse Manager, Office of Nursing Research and Innovation,
Zielony Nursing Institute, Cleveland Clinic, Cleveland, OH, United States
(Beard) Chief Medical Officer, GE HealthCare - Patient Care Solutions,
Chicago, IL, United States
(Sessler) Vice-President for Clinical and Outcomes Research, Professor of
Anesthesiology, Department of Anesthesiology and Center for OUTCOMES
RESEARCH, University of Texas Health Science Center, Houston, TX, United
States
(Rodriguez, Mueller-Wirtz, Mueller, Slife, Mosqueda, Gatt, Nikoo,
Cekmecelioglu, Kopac, Singh, Corrales Martinez, Karki, Medellin, Erazo,
Brooker, Rossler, Mukhia, Pu) Outcomes Research Consortium, Department of
Anesthesiology, Cleveland Clinic, Cleveland, OH, United States
Publisher
Elsevier Inc.
Abstract
Study objectives: Alerts for vital sign abnormalities seek to identify
meaningful patient instability while limiting alarm fatigue. Optimal vital
sign alarm settings for postoperative patients remain unknown, as is
whether alerts lead to effective clinical responses reducing vital sign
disturbances. We conducted a 2-phase pilot study to identify thresholds
and delays and test the hypothesis that alerts from continuous monitoring
reduce the duration of vital sign abnormalities. Design(s): Two-phase
pilot. Patient(s): 250 adults having major non-cardiac surgery.
 Setting(s): Surgical wards. Intervention(s): All patients had
routine vital sign monitoring by nurses at 4-h intervals. We initially
continuously recorded clinician-blinded saturation, heart rate, and
respiratory rate in 100 patients. In the second phase, we randomized 150
patients to blinded versus unblinded continuous vital sign monitoring. In
unblinded patients, nurses were verbally alerted to abnormal vital signs.
Measurements: In the first phase, we modeled expected alarm counts using
6082 h of continuous oxygen saturation, heart rate, and respiratory rate
data. Thresholds and delays targeting ~3 alarms per patient per day were
selected for phase two. Primary analysis assessed the effect of unblinded
monitoring across a 5-component primary composite of cumulative durations
of vital sign abnormalities. Secondary outcomes included fraction of
alerts deemed meaningful by nurses and number of clinical interventions.
 Result(s): In phase one, we identified alarm settings that yielded an
average of 2.3 alerts per patient per day. In phase two, the average
relative effect ratio of geometric duration means for vital signs
exceeding thresholds was 0.75 [95 % CI: 0.51, 1.1], P = 0.17. Sixty alarms
(82 %) were deemed useful in unblinded patients, leading to 60 % more
interventions in unblinded patients. Conclusion(s): We were able to
select continuous saturation, heart rate, and respiratory rate thresholds
that generated about 2 alerts per patient per day, nearly all of which
were considered useful by nurses. Unblinded monitoring and nursing alerts
led to interventions (mostly increasing oxygen delivery) that
non-significantly reduced vital sign abnormalities by 25 %.
ClinicalTrials.gov registration: NCT05280574. Copyright © 2024

<49>
Accession Number
2044257642
Title
Periodontal inflammation indices in association to systemic diseases.
Source
Journal of Dentistry. 168 (no pagination), 2026. Article Number: 106630.
Date of Publication: 01 May 2026.
Author
Walther K.-A.; Vogler J.A.H.; Wostmann B.; Groger S.
Institution
(Walther, Wostmann, Groger) Department of Periodontology, Dental Clinic,
Justus Liebig University of Giessen, Schlangenzahl 14, Giessen, Germany
(Walther, Vogler, Wostmann) Department of Prosthodontics, Dental Clinic,
Justus Liebig University of Giessen, Schlangenzahl 14, Giessen, Germany
(Groger) Department of Orthodontics, Dental Clinic, Justus Liebig
University of Giessen, Schlangenzahl 14, Giessen, Germany
Publisher
Elsevier Ltd
Abstract
Objectives: Periodontitis is a multifactorial inflammatory disease that
has been associated with several systemic inflammatory conditions.
Periodontal inflammation indices are quantitative tools used to estimate
the inflammatory burden of periodontitis and its potential systemic
relevance. The aim of this review was to summarise and critically evaluate
the current evidence on periodontal inflammation indices as connecting
factors between periodontitis and systemic inflammatory diseases, and to
assess their responsiveness to periodontal and systemic therapy. Data and
sources: This narrative review included intervention studies investigating
patients with both periodontitis and systemic inflammatory diseases by
monitoring the inflammatory status using a periodontal inflammation index.
Relevant studies were identified through systematic searches across major
electronic databases. Result(s): The available evidence is limited
and methodologically heterogeneous. Most studies focused on
periodontal-inflamed-surface-area (PISA). Intervention studies using PISA
have been reported in relation to diabetes mellitus, cardiovascular
disease, rheumatoid arthritis, and chronic kidney disease. Several studies
indicate that reductions in periodontal inflammatory burden following
periodontal or systemic therapy may be accompanied by improvements in
selected systemic inflammatory or disease-related parameters. However,
these findings are inconsistent and often limited by small sample sizes,
short follow-up periods, and inadequate control of confounding factors.
 Conclusion(s): While periodontal inflammation indices provide a
biologically plausible framework for quantifying inflammatory burden, the
bidirectional relationship between periodontal and systemic inflammation,
as well as the long-term impact of therapeutic interventions, remains
incompletely understood. Clinical significance: Periodontal inflammation
indices may support the assessment of periodontitis as a contributor to
systemic inflammatory burden. Although high-quality evidence is limited,
periodontal therapy may represent a non-pharmacological adjunct in the
management of certain systemic inflammatory diseases. Consequently, it may
be worthwhile for various medical disciplines, researchers, and
professional organisations to engage in comprehensive discourse and issue
official statements concerning periodontal therapy as a primary and
secondary prevention for systemic diseases. Copyright © 2026 The
Author(s)

<50>
Accession Number
2043751361
Title
Comparison of a TrachoSpray Device and Manual Lidocaine Spray on
Hemodynamic Stability and Postoperative Sore Throat in Patients Undergoing
Double-Lumen Tube Intubation: A Randomized Controlled Trial.
Source
Journal of Investigative Surgery. 39(1) (no pagination), 2026. Article
Number: 2586017. Date of Publication: 2026.
Author
Tumer M.; Geyik F.D.; Buz M.; Taskin K.; Sogut M.S.; Cevik B.; Demirhan R.
Institution
(Tumer) Department of Anesthesiology and Reanimation, VKV Amerikan
Hospital, Istanbul, Turkey
(Geyik, Taskin, Cevik) Department of Anesthesiology and Reanimation,
Health Sciences University Kartal Dr. Lutfi Kirdar High Specialization
Training and Research Hospital, Istanbul, Turkey
(Buz, Demirhan) Department of Thoracic Surgery, Health Sciences University
Kartal Dr. Lutfi Kirdar High Specialization Training and Research
Hospital, Istanbul, Turkey
(Sogut) Department of Anesthesiology and Reanimation, Koc University,
Faculty of Medicine, Istanbul, Turkey
Publisher
Taylor and Francis Ltd.
Abstract
Background: Postoperative sore throat (POST) is an distressing
complication following endotracheal intubation, particularly with
double-lumen tube (DLT) intubation. Study evaluated the effects of two
local anesthetic techniques on hemodynamic responses and POST in
DLT-intubated patients. Method(s): A randomized controlled study was
conducted with 60 patients scheduled for elective thoracic surgery.
Participants were randomized into three groups: TrachoSpray group (2 mL of
10% lidocaine), Manual spray group (10% lidocaine) and, Control group
(0.9% saline). Hemodynamic parameters, including systolic blood pressure
(SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP),
were monitored preoperatively, intraoperatively, and postoperatively. POST
was assessed using a visual analog scale at 2, 6, 12, and 24 h
post-extubation. Result(s): Both lidocaine groups demonstrated
significant reductions in SBP, DBP, and MAP at key time points compared to
control group. Post-extubation, MAP was significantly higher in
TrachoSpray group than lidocaine group (p = 0.04). No statistically
significant differences in POST scores were observed between groups.
 Conclusion(s): TrachoSpray device and manual lidocaine spray improved
hemodynamic stability in DLT-intubated patients; however, neither method
resulted in a significant reduction in POST scores. Further research is
needed to confirm these hemodynamic benefits and to explore potential
effects on long-term outcomes. Copyright © 2026 The Author(s).
Published with license by Taylor & Francis Group, LLC.

<51>
Accession Number
2041910473
Title
Continuing versus Withholding Renin-Angiotensin-Aldosterone System
Antagonists Before Noncardiac Surgery: A Systematic Review and
Meta-Analysis.
Source
Tunisie Medicale. 103(9) (pp 1146-1156), 2025. Date of Publication: 01 Sep
2025.
Author
Daghmouri M.A.; Haddad F.; Kammoun E.; Jebali F.; Jeddou H.; Chaouch M.A.
Institution
(Daghmouri) Department of Anesthesiology, Montreuil Intercommunal Hospital
Center, France
(Haddad, Kammoun) Department of Anesthesiology and Critical Care Medicine,
Faculty of Medicine of Tunis, Mongi Slim Teaching Hospital, University of
Tunis El Manar, Tunis, Tunisia
(Jebali) Department of Anesthesiology B, Monastir Teaching Hospital,
University of Monastir, Monastir, Tunisia
(Jeddou) Department of Hepatobiliary and Digestive Surgery, University
Hospital, Rennes 1 University, Rennes, France
(Jeddou) Inserm, EHESP, Irset (Institut de recherche en sante,
environnement et travail)-UMR_S 1085, Rennes 1 University, Rennes, France
(Chaouch) Department of Visceral and Digestive Surgery, Monastir
University Hospital, Monastir, Tunisia
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Background: It remains unclear whether to continue or withdraw angiotensin
receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors
(ACEI) before noncardiac surgery to reduce perioperative morbidity. This
systematic review and meta-analysis aimed to analyze the consequences of
continuing ARB or ACEi in the incidence of intraoperative hypotension and
postoperative complications. Method(s): This systematic review and
meta-analysis followed the PRISMA 2020 guidelines and was registered in
the PROSPERO database. We conducted a comprehensive search in several
bibliographic databases for studies comparing continuing versus
withholding renin angiotensin aldosterone system antagonists before
noncardiac surgery. Primary outcomes included the incidence of
intraoperative hypotension, while secondary outcomes covered the
intraoperative use of the vasoactive agent, the incidence of severe
hypotension, intraoperative and postoperative hypertension, the incidence
of acute kidney injury (AKI), 30-day postoperative all-cause mortality,
and the incidence of major cardiocerebral events (MACCE). Result(s):
Five randomized controlled trials, three nonrandomized controlled trials,
and four retrospective case-control studies were included that involved
50184 patients. Meta-analysis revealed that continuing ACEI or ARBs before
surgery increased the incidence of intraoperative hypotension (OR = 1.96,
95%CI [1.30, 2.96] p=0.001). Heterogeneity was substantial across studies
but was significantly reduced in subgroup analyses. Furthermore, the use
of vasoactive agents and the incidence of severe hypotension were
significantly higher in the continuing group. No significant differences
in intraoperative hypertension and the incidence of AKI and MACCE at 30
days after the operation. Conclusion(s): Continued ACEI or ARBs
before non-cardiac surgery increases the incidence of intraoperative
hypotension, without reducing the incidence of both AKI and MACCE
postoperatively. More research is necessary to explore the appropriate
perioperative management of ACE-I and ARB. Copyright © 2025,
Societe Tunisienne des Sciences Medicales. All rights reserved.

<52>
Accession Number
2040999773
Title
Neoaortic outcomes after the arterial switch operation: A systematic
review and meta-analysis.
Source
Archives of Cardiovascular Diseases. 119(3) (pp 233-243), 2026. Date of
Publication: 01 Mar 2026.
Author
Negm S.; Mahmoud A.B.; Desnous B.; Elatafy E.E.; Fouilloux V.; Gran C.;
Mace L.; Lenoir M.
Institution
(Negm, Desnous, Fouilloux, Gran, Mace, Lenoir) Department of
Cardio-Thoracic Surgery, Hopital de la Timone Enfants et Adultes, AP-HM,
Aix-Marseille University, Marseille, France
(Negm, Mahmoud, Elatafy) Department of Cardio-Thoracic Surgery, Faculty of
Medicine, Tanta University, Tanta, Egypt
Publisher
Elsevier Masson s.r.l.
Abstract
Background The arterial switch operation has become the treatment of
choice for neonates with transposition of great arteries. Aim This
systematic review and meta-analysis aimed to summarize the current
evidence regarding neoaortic root dilatation and aortic valve
insufficiency as long-term outcomes after the arterial switch operation,
and to identify associated risk factors. Methods A systematic search of
PubMed, EMBASE and Cochrane databases was conducted for human studies
published in English or French until May 2024. Results Out of 1480
identified records, 80 studies were included in the final analysis. The
total incidence of moderate-to-severe aortic insufficiency was 588 out of
20,338 patients (2.89%). The total number of neoaortic reinterventions was
306 in 11,291 patients (2.71%). The total number of neoaortic
reinterventions for aortic insufficiency was 78 in 4757 patients (1.63%).
Distensibility of both the aortic root and the ascending aorta in patients
after the arterial switch operation was significantly lower than in the
normal population. Several factors were significantly associated with an
increased risk of moderate-to-severe aortic insufficiency: ventricular
septal defect (P < 0.001); pulmonary artery banding (P = 0.007);
aortopulmonary mismatch (P < 0.001); and neoaortic root dilatation (P <
0.001). Coronary anomalies showed a borderline association (P = 0.055),
and the trapdoor technique was significant in one study (P = 0.0005).
Distensibility of both the aortic root and the ascending aorta was found
to be significantly reduced in patients after the arterial switch
operation compared with healthy controls, reflecting increased vascular
stiffness. Conclusions Significant neoaortic valve insufficiency and
reintervention remain relatively rare after the arterial switch operation.
However, measurable risk factors-including ventricular septal defect,
pulmonary artery banding, aortopulmonary mismatch and coronary
anomalies-are associated with an increased long-term risk of valve
dysfunction or surgical reintervention. Copyright © 2025 The
Authors.

<53>
Accession Number
2041244082
Title
Interventions to prevent postoperative neurocognitive complications: an
umbrella review of meta-analyses of randomised controlled trials.
Source
Anaesthesia. 81(4) (pp 532-540), 2026. Date of Publication: 01 Apr 2026.
Author
D'Amico F.; Turi S.; Manazza M.; Lo Bianco G.; Monti G.; Zangrillo A.;
Landoni G.; Beretta L.
Institution
(D'Amico, Turi, Manazza, Lo Bianco, Monti, Zangrillo, Landoni, Beretta)
Department of Anaesthesia and Intensive Care, IRCCS San Raffaele
Scientific Institute, Milan, Italy
(Monti, Zangrillo, Landoni, Beretta) Vita-Salute San Raffaele University,
Milan, Italy
Publisher
John Wiley and Sons Inc
Abstract
Introduction: The certainty of the effectiveness of interventions to
manage postoperative neurocognitive complications remains unclear. The
objective of this umbrella review was to synthesise and evaluate the
evidence for interventions aimed at reducing the incidence of
peri-operative neurocognitive complications. Method(s): We searched
relevant databases from inception to 23 August 2025. We included
systematic reviews and meta-analyses of randomised trials evaluating
pharmacological and non-pharmacological interventions for the prevention
of postoperative neurocognitive complications in adult surgical
populations. Certainty of evidence for each intervention was assessed
using the GRADE framework. Methodological quality was appraised using
AMSTAR and the Ioannidis classification. Result(s): A total of 114
systematic reviews and meta-analyses, with data from 250,777 patients,
were included. Dexmedetomidine, cerebral monitoring, acupuncture, sleep
interventions, steroids, antipsychotics, peripheral nerve blocks,
esketamine and remimazolam were associated with reductions in
postoperative neurocognitive complications. Subgroup analyses indicated
that these interventions also showed potential benefits across
non-cardiac, orthopaedic and cardiac surgery. However, the overall
certainty of evidence for all these interventions was predominantly very
low. Discussion(s): A number of peri-operative interventions are
associated with a reduction in postoperative neurocognitive complications
but the certainty of evidence supporting these interventions to prevent is
very low. High-quality research is needed to advance the evidence base and
inform future clinical practice. Copyright © 2025 The Author(s).
Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists.

<54>
Accession Number
2043386475
Title
Technological advancements for improving preoperative assessment and
precision in cardiovascular surgery.
Source
Expert Review of Cardiovascular Therapy. 24(3) (pp 149-157), 2026. Date of
Publication: 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
Publisher
Taylor and Francis Ltd.
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 three-dimentional (3D)
printing, is also presented. Expert opinion: In the next 5 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. Copyright
© 2026 Informa UK Limited, trading as Taylor & Francis Group.

<55>
Accession Number
2043137056
Title
Agreement Between Ventricular-Arterial Coupling Measured by Carotid
Ultrasound and Transesophageal Echocardiography in Cardiac Surgery
Patients:A Proof-of-Concept Study.
Source
Journal of Cardiothoracic and Vascular Anesthesia. 40(4) (pp 1122-1129),
2026. Date of Publication: 01 Apr 2026.
Author
de Raat F.M.; de Boer E.C.; Paulussen I.W.F.; van Houte J.; Bouwman R.A.;
Montenij L.J.
Institution
(de Raat, de Boer, Paulussen, Bouwman, Montenij) Department of Electrical
Engineering, Technical University of Eindhoven, Eindhoven, Netherlands
(de Raat, de Boer, Paulussen, van Houte, Bouwman, Montenij) Department of
Anesthesiology, Pain Therapy and Intensive Care, Catharina Hospital,
Eindhoven, Netherlands
Publisher
W.B. Saunders
Abstract
Objectives: Ventricular-arterial coupling (VAC), defined as the ratio of
arterial elastance (E<inf>a</inf>) to left ventricular end-systolic
elastance (E<inf>es</inf>), provides valuable insights for optimizing
perioperative hemodynamic management. While transthoracic echocardiography
and transesophageal echocardiography (TEE) are used to estimate
E<inf>es</inf>, both modalities require substantial operator expertise and
transthoracic echocardiography may be limited by suboptimal imaging
conditions, especially in the perioperative setting. Therefore, the
authors propose using carotid ultrasound as a noninvasive and more
accessible alternative to estimate VAC. Given its close anatomic and
physiological relationship with the proximal aorta, the carotid artery
reflects central arterial hemodynamics and may serve as a promising
surrogate for VAC. This study aimed to evaluate the agreement between
carotid ultrasound and TEE in measuring VAC in patients undergoing cardiac
surgery. Design(s): Prospective observational pilot study.
 Setting(s): Operating room. Participant(s): Twelve adult
patients undergoing elective coronary artery bypass grafting surgery.
 Intervention(s): Ultrasound measurements were obtained both
preoperatively and postoperatively using carotid ultrasound and TEE, and
the interchangeability between E<inf>a</inf>, E<inf>es</inf>, and VAC was
evaluated with correlation and Bland-Altman analyses. E<inf>a</inf> was
calculated using the systolic blood pressure and stroke volume, while
E<inf>es</inf> was estimated using the single-beat method proposed by Chen
et al. Measurements and Main Results: Strong correlations were
observed between carotid ultrasound and TEE measurements for E<inf>a</inf>
(r = 0.87; 95% confidence interval [CI], 0.73-0.95), E<inf>es</inf> (r =
0.82; 95% CI, 0.63-0.92), and VAC (r = 0.79; 95% CI, 0.56-0.90). The
estimation of VAC using carotid ultrasound demonstrated clinically
acceptable accuracy and precision, with a bias of -0.01 (95% CI, -0.07 to
0.05) and limits of agreement of +/-0.30 (range, -0.18 to 0.39).
 Conclusion(s): Carotid ultrasound-derived VAC demonstrated good
correlation with VAC measured using TEE in this pilot study. These
preliminary results suggest that carotid ultrasound may be useful for
investigating VAC at the bedside, but further studies with larger sample
sizes are needed to validate these findings. Copyright © 2025 The
Authors

<56>
[Use Link to view the full text]
Accession Number
650121557
Title
Balloon- Versus Self-Expanding Transcatheter Valves for Failed Small
Surgical Aortic Bioprostheses: 3-Year Results of the LYTEN Trial.
Source
Circulation. Cardiovascular interventions. 19(3) (pp e016255), 2026. Date
of Publication: 01 Mar 2026.
Author
Cepas-Guillen P.; Abbas A.E.; Serra V.; Vilalta V.; Nombela-Franco L.;
Regueiro A.; Al-Azizi K.M.; Iskander A.; Conradi L.; Forcillo J.; Lilly
S.; Calabuig A.; Fernandez-Nofrerias E.; Mohammadi S.; Giuliani C.;
Pelletier-Beaumont E.; Pibarot P.; Rodes-Cabau J.
Institution
(Cepas-Guillen, Mohammadi, Giuliani, Pelletier-Beaumont, Pibarot,
Rodes-Cabau) Quebec Heart and Lung Institute, Cardiology Department, Laval
University, C.G., E.P.-B., Canada
(Cepas-Guillen, Regueiro, Rodes-Cabau) Clinic Cardiovascular Institute,
Hospital Clinic de Barcelona, Cardiology Department, Institut
d'Investigacions Biomediques August Pi i Sunyer, University of Barcelona,
A.R
(Abbas) Cardiology Department, William Beaumont University Hospital, Royal
Oak, Corewell Health East
(Serra, Calabuig) Hospital Universitari Vall d'Hebron, Cardiology
Department, Barcelona, Philippines
(Vilalta, Fernandez-Nofrerias) Hospital Universitari Germans Trias i
Pujol, Badalona, Spain
(Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos,
Cardiology Department, Instituto de Investigacion Sanitaria del Hospital
Clinico San Carlos (IdISSC), Madrid, Spain
(Al-Azizi) Baylor Scott and White the Heart Hospital Plano, Cardiology
Department
(Iskander) St. Joseph's Health (SJH) Cardiology Associates, Cardiology
Department, Syracuse, United States
(Conradi) University Heart and Vascular Center, Cardiology Department,
Germany (L.C.), Hamburg, Germany
(Forcillo) Centre Hospitalier Universitaire de Montreal, Cardiology
Department, QC, Canada
(Lilly) Ohio State University (OSU) Heart and Vascular Research
Organization, Cardiology Department, Richard M. Ross Hospital, Columbus,
United States
Abstract
BACKGROUND: Data comparing valve systems in the valve-in-valve
transcatheter aortic valve replacement (TAVR) field have been obtained
from retrospective studies. This prespecified secondary analysis of the
LYTEN randomized trial (Comparison of the Balloon-Expandable Edwards Valve
and Self-Expandable CoreValve Evolut R or Evolut PRO System for the
Treatment of Small, Severely Dysfunctional Surgical Aortic Bioprostheses)
aims to compare the 3-year hemodynamic performance and clinical outcomes
between balloon-expandable valves (BEV) SAPIEN 3/ULTRA (Edwards
Lifesciences) and self-expanding valves (SEV) Evolut R/PRO/PRO+
(Medtronic) in valve-in-valve TAVR. METHOD(S): Patients with a failed
small (<=23 mm) surgical valve undergoing valve-in-valve TAVR were
randomized to receive a SEV or a BEV. Patients had a clinical and valve
hemodynamic (Doppler echocardiography) evaluation at 3-year follow-up.
Study outcomes were defined according to VARC (Valve Academic Research
Consortium)-2/VARC-3 criteria. Intended performance of the valve was
defined as mean gradient <20 mm Hg, peak velocity <3 m/s, Doppler velocity
index >=0.25, and less than moderate aortic regurgitation. RESULT(S):
Ninety-eight patients underwent TAVR (46 BEV [SAPIEN 3/ULTRA], 52 SEV
[Evolut R-PRO-PRO+]). At 3 years, patients receiving a SEV had a higher
rate of intended valve performance (BEV: 27.6% versus SEV: 82.4%;
P<0.001), with lower mean gradients (BEV: 20+/-9 versus SEV: 13+/-9 mm Hg;
P=0.002), and larger indexed effective orifice area (BEV: 0.69+/-0.27
versus SEV: 0.93+/-0.32 cm2/m2; P=0.002). The rate of moderate aortic
regurgitation was 0% in the BEV group versus 2.9% in the SEV group
(P=0.582). Functional status and quality of life improved similarly in
both groups. No differences were observed in the composite end point of
death, stroke, or heart failure-related hospitalization (BEV: 32.6% versus
SEV: 25.5%; P=0.489). Mortality was also not statistically different
between groups (BEV: 23.3% versus SEV: 15.7%; P=0.375). No significant
differences were observed in other adverse events. CONCLUSION(S): In
patients undergoing valve-in-valve TAVR for failed small aortic
bioprostheses, SEV demonstrated a superior valve hemodynamic performance
at 3-year follow-up, with similar clinical outcomes and functional
improvement compared with BEV. REGISTRATION: URL:
https://www.clinicaltrials.gov; Unique identifier: NCT03520101.

<57>
Accession Number
2041803736
Title
Peri-operative risk of non-cardiac surgery in patients with aortic
stenosis: a systematic review and meta-analysis.
Source
Anaesthesia. 81(4) (pp 570-579), 2026. Date of Publication: 01 Apr 2026.
Author
Place A.; Rodrigues T.S.; Naimo P.S.; Lee M.G.Y.; Batchelor R.J.; Weinberg
L.; Miles L.F.; Lefkovits J.; Koshy A.N.
Institution
(Place, Naimo, Lee, Batchelor, Lefkovits, Koshy) Department of Cardiology,
The Royal Melbourne Hospital, Melbourne, VIC, Australia
(Rodrigues, Naimo, Lee, Koshy) Department of Medicine, Melbourne Medical
School, The University of Melbourne, Melbourne, VIC, Australia
(Rodrigues, Weinberg, Miles, Koshy) Department of Cardiology, Austin
Health, Melbourne, VIC, Australia
(Weinberg, Miles) Department of Anaesthesia, Austin Health, Melbourne,
VIC, Australia
Publisher
John Wiley and Sons Inc
Abstract
Introduction: Aortic stenosis is a risk factor for adverse outcomes
following non-cardiac surgery; however, existing data regarding
peri-operative morbidity and mortality in this patient cohort remain
conflicted. This systematic review and meta-analysis aimed to quantify the
peri-operative risks in patients with aortic stenosis undergoing
non-cardiac surgery. Method(s): Following the development of our
search strategy, we searched databases for relevant studies. The primary
endpoint was all-cause in-hospital or 30-day mortality associated with
aortic stenosis in patients undergoing non-cardiac surgery. Secondary
endpoints included: myocardial infarction; heart failure; stroke;
delirium; venous thromboembolism; and acute kidney injury. Result(s):
Nineteen studies involving 100,486 patients were included. The estimated
all-cause mortality was 3.8% (95%CI 3.7-3.9%) for patients with any degree
of aortic stenosis and 9.6% (95%CI 7.7-12.1%) for those with severe aortic
stenosis. A meta-analysis of 14 comparative studies involving 2,885,254
patients revealed significantly increased mortality in patients with
aortic stenosis compared with those without aortic stenosis (relative risk
1.58, 95%CI 1.18-2.12, p < 0.001). Aortic stenosis was also associated
with an elevated risk of postoperative myocardial infarction (relative
risk 1.79, 95%CI 1.2-2.67, p < 0.001) and heart failure (relative risk
2.06, 95%CI 1.19-3.59, p < 0.001). Discussion(s): Aortic stenosis in
patients undergoing non-cardiac surgery is associated with a three-fold
relative increase in the risk of mortality. These results highlight the
need for further delineation of which surgical procedures are associated
with the greatest risk of poor peri-operative outcomes to guide heightened
surveillance protocols, optimised peri-operative management and thresholds
for pre-operative intervention. Copyright © 2025 Association of
Anaesthetists.

<58>
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. 15(1) (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.
 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. 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.
 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. Copyright © 2026. The Author(s).

<59>
Accession Number
650614516
Title
Resumption of Warfarin After Intracranial Hemorrhage in Patients With
Mechanical Heart Valves: A Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. 15(6) (pp e041301), 2026. Date
of Publication: 17 Mar 2026.
Author
Sakusic A.; Ghozy S.; Verma Y.; Elgazzar T.; Rabinstein A.A.; Braksick
S.A.; Wijdicks E.F.M.; Fugate J.E.; Hawkes M.A.
Institution
(Sakusic, Rabinstein, Braksick, Wijdicks, Fugate, Hawkes) Neurology
Department Mayo Clinic Rochester MN USA
(Ghozy) Department of Neurologic Surgery Mayo Clinic Rochester MN USA
(Ghozy, Verma) Radiology Department Mayo Clinic Rochester MN USA
(Elgazzar) College of Medicine Alfaisal University Riyadh Saudi Arabia,
Saudi Arabia
Abstract
BACKGROUND: Resuming anticoagulation in patients with mechanical heart
valves after intracranial hemorrhage presents a clinical dilemma. The
optimal timing must balance the risk of thromboembolism against
hemorrhagic expansion. Prior studies have addressed this issue, but most
were limited by small sample sizes. This systematic review and
meta-analysis aimed to determine the optimal timing for anticoagulation
resumption in this population. METHOD(S): We conducted a systematic
review and meta-analysis using PubMed, Embase, Web of Science, and Scopus
from database inception to August 23, 2024. The target population included
adults with intracranial hemorrhage who required anticoagulation for
mechanical heart valves. RESULT(S): Thirteen studies involving 788
patients were included: 12 retrospective and 1 prospective observational
study. While off anticoagulation, 32 patients developed ischemic stroke,
with a pooled event rate of 5.23% (95% CI, 3.80-7.20%) and negligible
heterogeneity (I2 = 0%). The pooled average time to stroke was 8.08 days
(95% CI, 1.99-14.18). After anticoagulation resumption, 73 patients
experienced hemorrhagic recurrence, corresponding to a pooled event rate
of 10.95%, with nonsignificant heterogeneity (I2 = 40.4%).
 CONCLUSION(S): Withholding anticoagulation for up to 7 days after
intracranial hemorrhage in patients with mechanical heart valves appears
relatively safe. Hemorrhagic recurrence after resumption was more common
than ischemic stroke during interruption. However, the included studies
were observational and carried serious or critical risk of bias.
Prospective multicenter studies, and ideally randomized trials, are needed
to provide more definitive evidence.

<60>
[Use Link to view the full text]
Accession Number
2043320738
Title
Prevalence and clinical implications of angiodysplasia in patients with
aortic stenosis: a systematic review and meta-analysis.
Source
European Journal of Gastroenterology and Hepatology. Publish Ahead of
Print (no pagination), 2025. Date of Publication: 2025.
Author
Abdel-Gawad M.; Almansoury Y.; Nagdy H.; El-Raey F.; El-Kassas M.
Institution
(Abdel-Gawad) Hepatology, Gastroenterology, and Infectious Diseases
Department, Assiut Faculty of Medicine, Al-Azhar University, Assiut
(Almansoury) Gastroenterology and Hepatology Division, Internal Medicine
Department, South Valley University, Qena
(Nagdy) Internal Medicine Department, College of Medicine, Arab Academy
for Science and Technology and Maritime Transport, Alexandria
(El-Raey) Hepatogastroenterology and Infectious Diseases Department,
Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt
(El-Raey) Clinical Science Department, College of Medicine, Suliman
Alrajhi University, Al Bukayriyah, Al Qassim, Saudi Arabia
(El-Kassas) Endemic Medicine Department, Faculty of Medicine, Helwan
University, Cairo, Egypt
(El-Kassas) Applied Science Research Center. Applied Science Private
University, Amman, Jordan
Publisher
Lippincott Williams and Wilkins
Abstract
Gastrointestinal angiodysplasia is frequently observed in patients with
aortic stenosis and may present with bleeding and anemia. We conducted a
systematic review and meta-analysis to estimate its prevalence in this
population and to summarize outcomes after valve intervention. Following
PRISMA 2020, we searched PubMed, Scopus, and Web of Science and registered
the protocol in PROSPERO (CRD42024550839). Eligible observational studies
reporting angiodysplasia, von Willebrand factor abnormalities, or both in
aortic stenosis were appraised for quality and pooled using a random
effects model; heterogeneity and publication bias were assessed with I2
and Egger's test. Eleven studies were included. The pooled prevalence of
gastrointestinal angiodysplasia among patients with aortic stenosis was
6.3% (95% confidence interval: 4.51-8.38, I2 = 98.68, P < 0.0001), with no
evidence of publication bias. Across studies that reported longitudinal
outcomes, aortic valve replacement or transcatheter aortic valve
implantation was associated with a reduction in lesion burden and lower
rates of gastrointestinal bleeding, anemia, transfusion, and readmission,
although early postprocedural bleeding could occur and typically declined
over follow-up. These findings indicate that angiodysplasia is a
clinically relevant comorbidity in aortic stenosis and support proactive
gastrointestinal evaluation in patients with anemia or unexplained
bleeding. Standardized diagnostic criteria and prospective studies are
needed to clarify long-term outcomes after valve therapy and to define
screening and management pathways. Copyright © 2026

<61>
Accession Number
2044238110
Title
Efficacy of thromboprophylaxis following stage II surgical palliation for
single-ventricle physiology: A systematic review and meta-analysis.
Source
Annals of Pediatric Cardiology. 18(6) (pp 598-608), 2025. Date of
Publication: 01 Nov 2025.
Author
Fakhri D.; Setiabudi M.A.; Yogananda K.S.S.
Institution
(Fakhri, Setiabudi) Department of Surgery, Pediatric and Congenital Heart
Surgery Unit, National Cardiovascular Center Harapan Kita, Java West,
Jakarta, Indonesia
(Yogananda) Faculty of Medicine, Public Health and Nursing, Universitas
Gadjah Mada, Yogyakarta, Indonesia
Publisher
Wolters Kluwer Medknow Publications
Abstract
Background: Postoperative thrombosis remains a significant cause of
mortality and morbidity, especially in patients with single-ventricle
physiology (SVP). The standard management plan for SVP consists of a
three-stage surgical palliation, with widely varying thromboprophylaxis
strategies. While routine thromboprophylaxis is standard after stages I
and III, its role for stage II palliation remains controversial. This
study aims to evaluate the impact of routine thromboprophylaxis in
patients undergoing stage II palliation, with particular attention to
cases involving pulmonary artery (PA) reconstruction, where the
risk-to-benefit ratio of therapy may differ from routine stage II
procedures. Methods and Results: Analyses were conducted across 15
studies published between 1981 and 2021 (n = 1682), assessing the impact
of routine thromboprophylaxis on thromboembolic events, mortality, and
major adverse events (MAEs). A significant potential benefit of
thromboprophylaxis use was observed only in the subgroup of patients
undergoing PA reconstruction (14% in the thromboprophylaxis group versus
6% in the no-thromboprophylaxis group; P = 0.01). The prevalence of
thromboembolic events in the overall population was 5% (95% confidence
interval [CI]: 3%-8%) without a significant difference between the two
groups (P = 0.88). The pooled odds ratio (OR) showed a nonsignificant
effect of thromboprophylaxis in reducing thrombotic events (OR = 0.35, 95%
CI: 0.02-7.81). No significant differences were observed in thromboembolic
events, MAEs, and mortality rates between the groups receiving
thromboprophylaxis or no thromboprophylaxis (P = 0.88, 0.29, 0.45,
respectively). Conclusion(s): This study supports the use of routine
thromboprophylaxis following second-stage palliation of SVP, particularly
in patients undergoing PA reconstruction. However, the evidence is limited
by observational study designs, heterogeneity among studies, and the lack
of recent high-quality data. Further well-designed studies are warranted
to confirm these findings and to identify the optimal antithrombotic
agent. Copyright © 2026 Annals of Pediatric Cardiology.

<62>
Accession Number
2043754705
Title
Analgesic efficacy and safety of lidocaine administered by intravenous
route vs erector spinae plane blocks following open heart surgery: An
open-label, randomized clinical trial.
Source
Journal of Clinical Anesthesia. 111 (no pagination), 2026. Article Number:
112166. Date of Publication: 01 Apr 2026.
Author
Selvamani B.J.; Sharma A.; Farhat B.; Sahin L.; Seering M.S.; Parra M.;
Swaran Singh T.S.; Sibenaller Z.A.; Singhal A.K.; Bashir M.A.; Sondekoppam
R.V.
Institution
(Selvamani, Parra) Department of Anesthesia, Mayo Clinic, Rochester, MN,
United States
(Sharma, Seering, Swaran Singh, Sibenaller) Department of Anesthesia,
University of Iowa, Iowa City, IA, United States
(Singhal, Bashir) Department of Cardiothoracic Surgery, University of
Iowa, Iowa City, IA, United States
(Farhat) Department of Anesthesia, University of Mississippi Medical
Center, Jackson, MS, United States
(Sahin) Department of Anesthesia, Washington University School of
Medicine, St. Louis, MO, United States
(Sondekoppam) Department of Anesthesia, Perioperative and Pain Medicine,
Stanford University, Palo Alto, United States
Publisher
Elsevier Inc.
Abstract
Introduction The erector spinae plane (ESP) block is a widely used
regional analgesic technique for truncal analgesia. This randomized,
open-label trial compared intravenous (IV) lidocaine to lidocaine
administered via bilateral continuous ESP blocks for analgesic efficacy in
the context of open heart surgery. Methods Seventy patients (18-80 years)
undergoing primary single procedure elective cardiac surgery via midline
sternotomy were randomized to receive lidocaine infusion via IV or
continuous bilateral ESP block routes. The primary outcomes were
cumulative opioid consumption in the first 48 h postoperatively (Oral
Morphine milligram equivalents- OME) and pain scores at 48 h (Numeric
Rating Scale NRS). Secondary outcomes included additional timepoints for
pain and opioid consumption measures within the first 48 postoperative
hours and plasma lidocaine levels at various timepoints within 24 h of
initiating therapy. Results Sixty patients were analyzed after various
exclusions. Both groups achieved acceptable analgesia, but the ESP group
was not found to be superior to IV lidocaine in reducing opioid
consumption in the first 48 hours (MD = -12.43 [95% CI, -43.7 to 18.8], p
= 0.375) or pain scores at 48 h (MD 0.05 [95% CI, -1.7 to 1.8], p =
0.878). No significant differences were found in secondary outcomes.
Plasma arterial lidocaine levels exceeded 5 mug/mL in 4 patients in the IV
group and 2 in the ESP group at 24 h. Conclusions ESP blocks utilizing
lidocaine did not demonstrate superior postoperative analgesia compared to
intravenous lidocaine in patients undergoing elective primary cardiac
surgery via midline sternotomy. Safety concerns regarding systemic
lidocaine accumulation from both administration routes warrant further
evaluation. Copyright © 2026 Elsevier Inc.

<63>
Accession Number
2042216845
Title
Sex-Based Differences in Outcomes of Surgical Aortic Valve Replacement: A
Meta-Analysis with Reconstructed Time-to-Event Data.
Source
CJC Open. 8(3) (pp 344-355), 2026. Date of Publication: 01 Mar 2026.
Author
Consoli L.N.; Majeed M.W.; Cetinel E.; Lajczak P.; Koziakas I.G.;
Caldonazo T.
Institution
(Consoli) Federal University of Bahia, Salvador, Brazil
(Majeed) Government Medical College Srinagar, Srinagar, India
(Cetinel) San Raffaele University, Milan, Italy
(Lajczak) Medical University of Silesia, Katowice, Poland
(Koziakas) Cardiac Surgery Department, Onassis Hospital, Athens, Greece
(Caldonazo) Department of Cardiothoracic Surgery, Jena University
Hospital, Friedrich Schiller University of Jena, Jena, Germany
(Caldonazo) Department of Cardiothoracic Surgery, Weill Cornell Medicine,
New York, New York, United States
Publisher
Elsevier Inc.
Abstract
Background: Results in the literature are mixed on how patient sex impacts
the outcomes of surgical aortic valve replacement (SAVR), with a high risk
of confounding bias due to different risk profiles at presentation. We
aimed to assess short- and long-term outcomes of SAVR in male and female
patients. Method(s): We searched PubMed, Embase, and the Cochrane
Library for eligible confounder-adjusted studies, including those that
used propensity-score-matching, multivariable regressions, and inverse
probability of treatment weighting. Meta-analysis was performed for
short-term (early mortality and procedural complications) and long-term
(late mortality, reoperation, and adverse events) endpoints. We compared
endpoints, using risk ratio (RR) for short-term endpoints and hazards
ratio (HR) for long-term endpoints. We calculated 95% confidence intervals
(CIs) for all outcomes. A meta-analysis of Kaplan-Meier-derived individual
patient data was done for long-term mortality. Result(s): We included
13 studies (n = 159,415). In the short-term, female patients had a higher
mortality rate (RR 1.25 [95% CI 1.19, 1.32], P < 0.001), more operative
deaths (RR 1.33 [95% CI 1.01, 1.75], P = 0.04), and required more blood
product use (RR 1.36 [95% CI 1.14, 1.63], P < 0.001). Male patients had
more transient ischemic attacks (RR 0.74 [95% CI 0.56, 0.99], P = 0.04)
and acute kidney injury (RR 0.73 [95% CI 0.7, 0.77], P < 0.001). At
long-term follow-up, male patients had a higher mortality rate (HR 0.93
[95% CI 0.88, 0.98], P = 0.001), and more reoperations; no significant
differences were seen in the rates of late stroke or bleeding.
 Conclusion(s): This meta-analysis found that, compared to male
patients, female patients had higher early mortality but lower late
mortality following SAVR. Copyright © 2025 The Authors

<64>
Accession Number
2043753648
Title
Fosaprepitant versus Ondansetron for Preventing Postoperative Nausea and
Vomiting After Video-Assisted Thoracoscopic Lung Resection: A Randomized
Controlled Clinical Trial.
Source
Drug Design, Development and Therapy. 20 (no pagination), 2026. Article
Number: 584402. Date of Publication: 2026.
Author
Qi X.; Zhang J.; Sun J.; Wang X.; Chang T.; Yi W.; Zhang Y.; Zhang P.
Institution
(Qi, Zhang, Sun, Yi, Zhang, Zhang) Department of Anesthesiology, Qilu
Hospital of Shandong University, Shandong University, Shandong, Jinan,
China
(Wang) Department of Anesthesiology, The First Affiliated Hospital of
Shandong First Medical University, Shandong, Jinan, China
(Wang) Shandong Institute of Anesthesia and Respiratory Critical Care
Medicine, The First Affiliated Hospital of Shandong First Medical
University, Shandong, Jinan, China
(Wang) Shandong Provincial Clinical Research Center for Anesthesiology,
the First Affiliated Hospital of Shandong First Medical University,
Shandong, Jinan, China
(Chang) Department of Clinical Epidemiology, Qilu Hospital of Shandong
University, Shandong University, Shandong, Jinan, China
Publisher
Dove Medical Press Ltd
Abstract
Purpose: Postoperative nausea and vomiting (PONV) is a frequent
complication after video-assisted thoracoscopic lung resection,
particularly in patients at moderate to high risk, and substantially
hinders recovery. Fosaprepitant, a neurokinin-1 (NK-1) receptor
antagonist, is approved for PONV prevention; however, its efficacy in
video-assisted thoracoscopic lung resection remains uncertain. This
randomized trial evaluated the efficacy of fosaprepitant versus
ondansetron in preventing PONV in high-risk patients undergoing
video-assisted thoracoscopic lung resection. Patients and Methods: In
this prospective, double-blind, randomized controlled clinical trial, 233
adults aged 18-70 years undergoing elective video-assisted thoracoscopic
lung resection with an Apfel score >= 2 were randomized 1:1 to receive
intravenous fosaprepitant 150 mg or ondansetron 8 mg, each combined with
dexamethasone 5 mg. The primary outcome was the incidence of PONV at 24
hours postoperatively. Secondary outcomes included the incidence and
severity of PONV at 6, 12, and 48 hours postoperatively, the use of rescue
antiemetics, adverse events, and recovery outcomes. Result(s): The
24-hour incidence of PONV was 31.0% [36] in the fosaprepitant group and
41.0% [48] in the ondansetron group (OR, 0.76; 95% CI, 0.53 to 1.07;
P=0.112). Fosaprepitant significantly reduced PONV at 48 hours (10.3% [12]
vs 20.5% [24]; OR, 0.51; 95% CI, 0.27 to 0.96; P=0.032), as well as
vomiting at 24 hours (8.6% [10] vs 21.4% [25]; OR, 0.40; 95% CI, 0.20 to
0.80; P=0.006) and 48 hours (0% [0] vs 5.1% [6]; OR, 0.07; 95% CI, 0.00 to
1.32; P=0.040). Conclusion(s): Fosaprepitant was superior to
ondansetron in preventing early postoperative vomiting and delayed-phase
PONV, and it represents an effective antiemetic strategy for high-risk
thoracic surgical patients. Trial Number and Registry Url: Registration
number, NCT05881486; https://clinicaltrials.gov. Copyright © 2026
Qi et al.

<65>
Accession Number
2043922084
Title
Is Baduanjin beneficial and safe for the rehabilitation of patients with
acute myocardial infarction undergoing percutaneous coronary intervention?
A systematic review and meta-analysis of randomised controlled trials.
Source
Complementary Therapies in Medicine. 98 (no pagination), 2026. Article
Number: 103345. Date of Publication: 01 Jun 2026.
Author
Liang S.-B.; Li Y.-F.; Zhang Y.-Y.; Wei K.-K.; Zhu Y.-S.; Robinson N.; Liu
J.-P.; Wang Y.-F.; Li Y.-L.
Institution
(Liang, Wang) Clinical Study Center, Affiliated Hospital of Shandong
University of Traditional Chinese Medicine, Jinan, China
(Liang, Wang) Centre for Evidence-Based Chinese Medicine, Shandong
University of Traditional Chinese Medicine, Jinan, China
(Liang, Wei) Postdoctoral Research Station, Shandong University of
Traditional Chinese Medicine, Jinan, China
(Li, Robinson, Liu) Centre for Evidence-Based Chinese Medicine, Beijing
University of Chinese Medicine, Beijing, China
(Zhang) College of Acupuncture-Moxibustion and Tuina, Shaanxi University
of Chinese Medicine, Xianyang, China
(Zhang) Institute for Chinese Medicine Frontier Interdisciplinary Science
and Technology, Shaanxi University of Chinese Medicine, Xianyang, China
(Wei, Wang, Li) Cardiovascular Disease Center, Affiliated Hospital of
Shandong University of Traditional Chinese Medicine, Jinan, China
(Zhu) Department of Emergency Center, Affiliated Hospital of Shandong
University of Traditional Chinese Medicine, Jinan, China
(Robinson) Institute of Health and Social Care, London South Bank
University, London, United Kingdom
(Li) The First School of Clinical Medicine, Shandong University of
Traditional Chinese Medicine, Jinan, China
(Li) Shandong Engineering Laboratory of Traditional Chinese Medicine
Precision Therapy for Cardiovascular Diseases, Shandong University of
Traditional Chinese Medicine, Jinan, China
Publisher
Elsevier Ltd
Abstract
Background Baduanjin, a traditional Chinese exercise, is commonly used in
China as a rehabilitation intervention for patients who have undergone
percutaneous coronary intervention (PCI) following an acute myocardial
infarction (AMI) (AMI-PCI). However, current evidence supporting its
application remains limited. Objectives To assess the clinical benefits
and safety of Baduanjin in the rehabilitation of patients with AMI-PCI.
Methods PubMed, the Cochrane Library, CNKI, VIP, and Wanfang were
systematically searched for randomised controlled trials (RCTs) assessing
the therapeutic effects and safety of Baduanjin in patients with AMI-PCI.
The search was conducted up to 18 January 2025. Data were analysed using
RevMan 5.4. For dichotomous outcomes, effect sizes were expressed as risk
ratios (RRs) with 95% confidence intervals (CIs); the number needed to
treat (NNT) was calculated where appropriate. For continuous outcomes
measured on the same scale, the mean difference (MD) with 95% confidence
interval (CI) was used. When outcomes were assessed using different
instruments or scales, results were synthesised descriptively. Results
Thirteen studies involving 1293 participants (870 males and 423 females)
were identified. Baduanjin significantly improved left ventricular
ejection fraction (LVEF [MD = 6.20%, 95% CI (3.14, 9.25), Z = 3.98, P <
0.0001, 1003 participants] and 6-minute walk distance (6-MWD) [MD = 60.21
m, 95% CI (17.96, 102.46), Z = 2.79, P = 0.005, 589 participants]. It also
led to clinically meaningful improvements in quality of life (QOL), as
measured by the Seattle Angina Questionnaire [MD = 11.36, 95% CI (7.66,
15.06), Z = 6.02, P < 0.00001, 150 participants], the Angina Pectoris
Quality of Life Questionnaire [MD = 3.71, 95% CI (0.92, 6.50), Z = 2.61, P
= 0.009, 92 participants], and the WHOQOL-BREF [MD = 91.40, 95% CI (90.59,
92.21), Z = 220.28, P < 0.00001, 60 participants]. Significant
reductions in anxiety and depression symptoms were observed across
multiple instruments: on the Hamilton Anxiety Rating Scale, the mean
reduction from baseline was greater in the Baduanjin group by 1.40 points
[95% CI (0.47, 2.33), Z = 2.95, P = 0.003]; on the Generalized Anxiety
Disorder-7 scale, post-intervention scores were lower in the Baduanjin
group by 2.67 points [95% CI (2.20, 3.14), Z = 11.14, P < 0.00001].
Similarly, for depression, the mean reduction from baseline on the
Hamilton Depression Rating Scale was greater by 2.80 points [95% CI (1.63,
3.97), Z = 4.71, P < 0.00001], and post-intervention scores on the
Patient Health Questionnaire-9 were lower by 2.73 points [95% CI (2.25,
3.21), Z = 11.11, P < 0.00001]. Baduanjin did not appear to increase
the risk of adverse events and may even reduce the incidence of certain
cardiovascular adverse events [15/133 vs. 40/133, RR = 0.40, 95% CI (0.25,
0.65), Z = 3.75, P = 0.0002, NNT = 5]. Conclusions The evidence suggests
that Baduanjin may provide therapeutic benefits for patients with AMI-PCI,
including improvements in cardiac function (LVEF), exercise capacity
(6-MWD), QOL, and mental health. Moreover, the practice appears to be safe
and may reduce the incidence of certain cardiovascular adverse events.
These findings highlight the potential role of Baduanjin in the management
and rehabilitation of patients with AMI-PCI, although further
well-designed studies are warranted to confirm its efficacy. PROSPERO
registration number CRD 42025634145
(https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42025634145)
. Copyright © 2026. Published by Elsevier Ltd.

<66>
Accession Number
614828959
Title
Efficacy of the "head-up position" in returning cardiopulmonary bypass
blood to the patient and reducing the required blood transfusion: A
randomized trial.
Source
Iranian Heart Journal. 18(1) (pp 6-15), 2017. Date of Publication: 2017.
Author
Azarfarin R.; Dashti M.; Totonchi Z.; Ziyaeifard M.; Mehrabanian M.;
Alizadehasl A.; Gorjipour F.
Institution
(Azarfarin, Alizadehasl) Echocardiography Research Center, Rajaie
Cardiovascular, Medical, and Research Center, Iran University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Dashti) Department of Anesthesiology, Sadoughi University of Medical
Sciences, Yazd, Iran, Islamic Republic of
(Totonchi, Ziyaeifard, Mehrabanian, Gorjipour) Rajaie Cardiovascular,
Medical, and Research Center, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
Publisher
Iranian Heart Association
Abstract
Background: All intraoperative strategies that may assist an
anesthesiologist with lowering the blood transfusion rate must be
considered. We assessed the efficacy of the 30degree head-up position at
the end of cardiopulmonary bypass (CPB) in returning CPB reservoir blood
to patients, reducing the transfusion rate, and conferring hemodynamic
stability after the transfer of patients to the intensive care unit (ICU).
 Method(s): In a single-center clinical trial, 88 adult patients
undergoing elective isolated coronary artery bypass graft surgery were
randomly allocated to the head-up group (n=44), in which the 30degree
head-up position was applied during separation from CPB, and the supine
group (n=44), in which weaning from CPB was performed in the supine
position. All the patients had left ventricular ejection fractions > 35%.
The primary end point was the returned volume of filtered CPB blood to the
patients. The secondary outcome measures were intraoperative and early
postoperative hemodynamic parameters. Additionally, blood products
transfused during surgery and in the 1st 6 hours following ICU admission
were recorded. Result(s): There were no statistically significant
differences in intraoperative and early postoperative hemodynamics between
the 2 groups except in the returned blood volume to the patients after
separation from CPB (714 +/- 99 mL in the head-up position group vs 285
+/- 78 mL in the supine group; P = 0.0001). There were no significant
differences between the 2 groups regarding the transfused blood products
during surgery and the 1st 6 hours following ICU admission.
 Conclusion(s): Using the 30degree head-up position at the end of CPB
conferred a higher return of blood to the patients but did not
significantly reduce postoperative transfusion. Copyright © 2017,
Iranian Heart Association. All rights reserved.

<67>
Accession Number
2042370593
Title
Auricular Vagus Nerve Stimulation Reduces Postoperative Delirium After
Major Non-Cardiac Surgery in Elderly Patients.
Source
Clinical Interventions in Aging. 21 (pp 1-12), 2025. Date of Publication:
2025.
Author
Shi J.; Gao D.; Hu X.; Zhang Y.; Guo T.; Mao Q.; Liu Q.; Ji M.
Institution
(Shi, Hu, Zhang, Guo, Mao, Ji) Department of Anesthesiology, The Second
Affiliated Hospital of Nanjing Medical University, Nanjing, China
(Shi, Zhang, Mao) Department of Anesthesiology, Jiangsu Province Academy
of Traditional Chinese Medicine, Nanjing, China
(Gao) Department of Anesthesiology, Jinling Hospital, Nanjing University
School of Medicine, Nanjing, China
(Liu) Department of Anesthesiology, Xishan People's Hospital of Wuxi City,
Wuxi, China
Publisher
Dove Medical Press Ltd
Abstract
Background: Postoperative delirium (POD) is a prevalent and devastating
complication in elderly patients undergoing major surgery, marked by
substantial increases in morbidity, mortality, and long-term cognitive
decline. However, treatment and prevention methods are limited.
Accumulating evidence suggests that vagus nerve stimulation effectively
enhances cognitive function. Objective(s): To evaluate the efficacy
of transcutaneous auricular vagus nerve stimulation (taVNS) on POD in
elderly patients undergoing major non-cardiac surgery. Method(s):
Patients aged >=65 years scheduled for major non-cardiac surgery were
randomly assigned to either the active taVNS group or the sham taVNS
group, with stimulation targeting the cymba conchae or earlobe,
respectively. In both groups, stimulation was initiated 5 minutes prior to
anesthesia induction and continued until the end of surgery. The only
difference between the two groups was the stimulation site. The primary
outcome was the incidence of POD during the first 3 postoperative days.
 Result(s): A total of 150 patients (median age, 73 years; 96 women
[64%]) completed this trial. The incident POD risk was 12% (n = 9) vs
25.3% (n = 19) in active-taVNS and sham-taVNS groups, respectively
(relative risk, 0.47; 95% CI, 0.23-0.98; P = 0.036). The mediation
analysis revealed that postoperative sleep quality played a significant
mediating role in the effect of taVNS on POD (z = -2.30, P = 0.02).
 Conclusion(s): In this study, taVNS reduces the incidence of POD in
elderly patients undergoing major non-cardiac surgery, possibly by
improving postoperative sleep quality. We suggest that this non-invasive
neuromodulation technique could be considered as a potential preventive
strategy for POD. Further validation in future large-scale randomized
controlled trials is warranted. Copyright © 2026 Shi et al.

<68>
Accession Number
2044212703
Title
Risk Factor Analysis of Post-TEVAR Distal Aortic Expansion: A Systematic
Review and Meta-Analysis.
Source
Journal of Endovascular Therapy. (no pagination), 2026. Date of
Publication: 2026.
Author
Cui D.; Li X.; Chen Y.; Zhang X.; Huang J.; Bi J.; Dai X.
Institution
(Cui, Li, Zhang, Bi, Dai) Department of Vascular Surgery, Tianjin Medical
University General Hospital, Tianjin, China
(Cui, Li, Chen, Zhang, Bi, Dai) Tianjin Key Laboratory of Precise Vascular
Reconstruction and Organ Function Repair, Tianjin, China
(Chen) Department of Vascular Surgery, The First Affiliated Hospital of
Zhengzhou University, Zhengzhou, China
(Huang) Dazhangzhuang Town Community Health Service Center, Tianjin, China
Publisher
SAGE Publications Inc.
Abstract
Background: Distal aortic expansion (DAE) after thoracic endovascular
aortic repair (TEVAR) remains a critical long-term outcome-related
determinant. The aim of this study was to identify risk factors for
postoperative DAE through a meta-analysis and meta-regression.
 Method(s): In this systematic review and meta-analysis, the PubMed,
Embase, and the Cochrane Library databases were searched from database
inception to April 1, 2025. The primary outcome was the incidence of
distal aortic expansion (DAE) after TEVAR. Pooled effect estimates were
calculated using random-effects models, and heterogeneity was assessed
with Cochran's Q test and the I2 statistic. Meta-regression was
performed to explore potential predictors of DAE. Publication bias was
evaluated using Egger's test and funnel plots. Result(s): Twenty-four
studies were included, with a pooled DAE incidence of 27% (95% CI:
21%-35%). Meta-regression indicated that male sex (RR = 3.00, p=0.020),
myocardial infarction (RR = 5.98, p<0.001), peripheral vascular disease
(RR = 3.39, p=0.007), malperfusion (RR = 1.52, p=0.050), and postoperative
false lumen expansion (RR = 1.18, p=0.046) were associated with increased
DAE risk. Older age, prior cardiac surgery, congestive heart failure,
residual dissection, and post-false lumen (FL) complete thrombosis
(distal) were protective factors. Conclusion(s): DAE after TEVAR is
determined by a combination of patient comorbidities and aortic remodeling
features. Identifying high-risk profiles-such as male sex, cardiovascular
comorbidities, and persistent false lumen-may help optimize surveillance
and reduce late aortic complications. Clinical Impact: Distal aortic
expansion (DAE) remains a major determinant of late failure after TEVAR
for type B aortic dissection. This study provides a comprehensive
quantitative synthesis of clinical and remodeling-related predictors of
DAE, highlighting high-risk profiles such as male sex, hypertension, prior
myocardial infarction, peripheral vascular disease, and persistent false
lumen patency. By integrating demographic, comorbidity, and morphological
factors, the findings support a risk-adapted surveillance strategy rather
than uniform follow-up protocols. Importantly, the study underscores the
prognostic significance of false lumen dynamics, reinforcing the role of
adjunctive techniques aimed at promoting distal thrombosis. These insights
may facilitate individualized monitoring, earlier intervention, and
improved long-term durability after TEVAR. Copyright © The
Author(s) 2026

<69>
Accession Number
2042340649
Title
Impact of Intravenous Hydrocortisone on Postoperative Atrial Fibrillation
and Outcomes in Patients Receiving Vasopressor Support Following On-Pump
Coronary Artery Bypass Grafting.
Source
Hospital Pharmacy. 61(2) (pp 184-189), 2026. Date of Publication: 01 Apr
2026.
Author
Paytes E.; Mefford B.; Love B.; Amick A.; Cox J.
Institution
(Paytes) Cone Health, Greensboro, NC, United States
(Mefford, Amick, Cox) Prisma Health Richland Hospital, Columbia, SC,
United States
(Love, Amick, Cox) University of South Carolina, Columbia, SC, United
States
(Love) Center for Outcomes Research and Evaluation, Columbia, SC, United
States
Publisher
SAGE Publications Ltd
Abstract
Background: Although 2019 EACTS Guidelines on Cardiopulmonary Bypass in
Adult Cardiac Surgery recommend against routine use of prophylactic
corticosteroids, perioperative glucocorticoids are still often used to
mitigate hypotension, cardiac arrhythmias and respiratory failure
following surgery with cardiopulmonary bypass (CPB). Limited data exists
on safety and efficacy of intravenous (IV) hydrocortisone in this setting.
 Objective(s): To assess the impact of intravenous hydrocortisone on
postoperative complications after on-pump coronary artery bypass grafting
(CABG). Method(s): This was a single-center, retrospective chart
review between 2021 and 2023. Adult patients with on-pump CABG requiring
vasopressor therapy postoperatively were included. Result(s): Of 153
patients included, 39 received IV hydrocortisone and 114 did not. The
hydrocortisone group had significantly lower cortisol levels (15.8 mcg/dL
vs 23.9 mcg/dL, P < 0.001) and higher incidence of a past medical history
of atrial fibrillation (23.1% vs 2.6%, P < 0.001) compared to the control
group. Rates of postoperative atrial fibrillation (POAF) were similar
between groups with 23.1% in the hydrocortisone group and 21.9% in the
control group (P = 0.88), which maintained after controlling for age,
history of atrial fibrillation, sex, and propensity score (P = 0.86). Mean
cumulative norepinephrine equivalents (NEE) were similar between
hydrocortisone group and control (10.4 mcg/min vs 8.9 mcg/min, P = 0.12).
Hydrocortisone administration was associated with longer durations of
vasopressor therapy (45.8 vs 28.9 hours, P = 0.001), insulin therapy
(149.4 vs 82.2 hours, P = 0.003), and total mechanical ventilation time
(59.3 vs 19.4 hours, P = 0.049). There were no differences in surgical
site infections between the hydrocortisone group versus control group
(5.2% vs 5.2%, P = 1.00), including both non-infectious (2.6% vs 2.6%, P =
1.00) and infectious surgical site complications (2.6% vs 2.6%, P = 1.00).
 Conclusion(s): After controlling for sex, age, history of atrial
fibrillation/flutter, and propensity score, there was no significant
association between the administration of IV hydrocortisone and POAF in
patients receiving vasopressor support following on-pump CABG. Further
prospective studies are needed to confirm these findings. Copyright
© The Author(s) 2025

<70>
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. 62(1) (pp
99-105), 2026. Date of Publication: 01 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. SETTING: Tertiary teaching hospital. POPULATION:
Adult post-cardiac surgery patients were randomized to early mobilization
group or usual care group. 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. 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. 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.

<71>
Accession Number
2042916134
Title
Hemodynamic monitoring strategies in cardiac surgery: an update systematic
review.
Source
Journal of Clinical Monitoring and Computing. 40(1) (pp 7-20), 2026. Date
of Publication: 01 Feb 2026.
Author
Melo R.; Galindo V.; Gioli-Pereira L.; Joelsons D.; Assuncao M.; Alves B.;
Souza G.; Bravim B.; Passos R.
Institution
(Melo, Gioli-Pereira) Hospital Municipal Gilson de Cassia Marques de
Carvalho, Hospital Israelita Albert Einstein, Av. Albert Einstein,
627/701, SP, Sao Paulo, Brazil
(Galindo, Joelsons, Assuncao, Alves, Bravim, Passos) Department of
Critical Care, Hospital Israelita Albert Einstein, SP, Sao Paulo, Brazil
(Souza) Hospital Ortopedico Do Estado da Bahia, Hospital Israelita Albert
Einstein, BA, Salvador, Brazil
Publisher
Springer Science and Business Media B.V.
Abstract
Hemodynamic monitoring is a cornerstone of perioperative care in cardiac
surgery, where patients are at high risk of cardiovascular instability and
organ hypoperfusion. In recent years, goal-directed therapy (GDT)
protocols have increasingly incorporated advanced monitoring technologies
to optimize perfusion and improve outcomes. This systematic review aims to
critically appraise contemporary hemodynamic monitoring strategies and
their integration into GDT protocols in adult patients undergoing cardiac
surgery. A systematic review of studies published between January 2015 and
May 2025 was conducted using PubMed, Embase, Scopus, and the Cochrane
Library. The last search was conducted on 17 May 2025 in all databases.
Eligible studies included adult cardiac surgical patients managed with
perioperative hemodynamic monitoring strategies that incorporated cardiac
output assessment and structured GDT protocols. A qualitative synthesis of
monitoring modalities, targeted hemodynamic endpoints, and reported
clinical outcomes was performed. Our analysis included 15 studies
comprising 4,224 patients. Monitoring strategies ranged from pulmonary
artery catheters to minimally invasive and noninvasive tools such as
FloTrac/EV1000 and esophageal Doppler. Cardiac index and stroke volume
variation were the most frequently targeted parameters, often in
combination with perfusion markers such as mean arterial pressure or
central venous oxygen saturation. GDT protocols were associated with
reductions in AKI, duration of mechanical ventilation, and ICU/hospital
stay. Mortality benefits were inconsistently reported and not predefined
in most studies. Current evidence supports the physiological rationale for
GDT guided by advanced hemodynamic monitoring in cardiac surgery.
Nonetheless, substantial heterogeneity in strategies and outcomes
highlights the need for standardized protocols and high-quality
multicenter trials to determine the most effective, patient-centered
approaches. Trial registration: PROSPERO registration number:
CRD420251102582, retrospectively registered on 11 July 2025. Copyright
© The Author(s) 2026.

<72>
Accession Number
2043996470
Title
The prognostic value of systemic inflammatory response index (SIRI) in
acute coronary syndrome patients treated with primary percutaneous
coronary intervention: a meta-analysis and systematic review.
Source
Clinical Research in Cardiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Hu C.; Ye Q.; You S.; Li S.; Dostal C.; Ernst M.; Paneni F.; Pokreisz P.;
Szabo G.T.; Kiss A.; Podesser B.K.
Institution
(Hu, Ye, Dostal, Ernst, Pokreisz, Szabo, Kiss, Podesser) Center for
Biomedical Research and Translational Surgery, Medical University of
Vienna, Wahringer Gurtel 18-20, Leitstelle 1Q, Vienna, Austria
(You) Department of Plastic and Burn Surgery, National Key Clinical
Construction Specialty, The Affiliated Hospital of Southwest Medical
University, Luzhou, China
(Li) Department of Dermatology, Meishan People's Hospital, Meishan, China
(Paneni) Center for Translational and Experimental Cardiology (CTEC),
Department of Cardiology, University Hospital Zurich and University of
Zurich, Wagistrasse 12, Schlieren, Switzerland
(Paneni) Department of Cardiology, University Heart Center, University
Hospital Zurich, Zurich, Switzerland
(Szabo) Faculty of Medicine, Department of Cardiology, University of
Debrecen, Debrecen, Hungary
(Hu, Ye, Ernst, Kiss, Podesser) Ludwig Boltzmann Institute for
Cardiovascular Research, 1090, Waehringer Guertel 18-20, Vienna, Austria
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: The systemic inflammatory response index (SIRI)-an
inflammatory index derived from neutrophil, monocyte, and lymphocyte
counts-has shown potential in predicting cardiovascular risk. However, its
prognostic value in patients with acute coronary syndrome (ACS) treated
with primary percutaneous coronary intervention (pPCI) remains unclear.
This study was aimed at evaluating the prognostic significance of SIRI in
this specific high-risk population. Method(s): We conducted a
systematic search of PubMed, Embase, and The Cochrane Library up to June
2025 to identify all relevant studies about SIRI applied to patients with
ACS after pPCI. The primary outcome was all-cause mortality. Among major
adverse cardiovascular events (MACE), new-onset acute myocardial
infarction (AMI), revascularization, and stroke were included as secondary
outcomes. Risk estimates were pooled as odds ratios (OR) with 95%
confidence intervals (CI). Result(s): A total of nine studies
involving 7679 patients were included. The pooled analysis demonstrated
that an elevated SIRI was a significant predictor for both all-cause
mortality (OR 3.32; 95% CI 1.29 to 8.54; p = 0.01), MACE (OR 2.45; 95% CI
1.74 to 3.45; p = 0.001), new-onset AMI (OR 1.86; 95% CI 1.25 to 2.77; p =
0.001), and myocardial revascularization (OR 1.64; 95% CI 1.35 to 1.98; p
= 0.001). Conclusion(s): Our meta-analysis demonstrates that an
elevated SIRI is a useful predictor of all-cause mortality, MACE,
new-onset AMI, and revascularization in patients with ACS undergoing PCI.
As a simple and cost-effective index, SIRI shows significant potential for
early risk stratification and may help guide clinical management in this
patient population. Copyright © The Author(s) 2026.

<73>
Accession Number
2019171065
Title
Isolated Coarctation of the Aorta: Current Concepts and Perspectives.
Source
Frontiers in Cardiovascular Medicine. 9 (no pagination), 2022. Article
Number: 817866. Date of Publication: 25 May 2022.
Author
Bhatt A.B.; Lantin-Hermoso M.R.; Daniels C.J.; Jaquiss R.; Landis B.J.;
Marino B.S.; Rathod R.H.; Vincent R.N.; Keller B.B.; Villafane J.
Institution
(Bhatt) Departments of Internal Medicine and Pediatrics and Division of
Cardiology, Harvard Medical School, Boston, MA, United States
(Lantin-Hermoso) Section of Cardiology, Department of Pediatrics, Baylor
College of Medicine, Houston, TX, United States
(Daniels) Departments of Pediatrics and Internal Medicine, The Ohio State
University Medical Center, Columbus, OH, United States
(Jaquiss) Department of Cardiovascular and Thoracic Surgery and Department
of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States
(Landis) Department of Pediatrics and Department of Medical and Molecular
Genetics, Indiana University School of Medicine, Indianapolis, IN, United
States
(Marino) Department of Pediatric Cardiology, Cleveland Clinic Children's,
Cleveland, OH, United States
(Rathod) Department of Pediatrics, Harvard Medical School, Boston, MA,
United States
(Vincent) Department of Pediatrics, New York Medical College, Valhalla,
NY, United States
(Keller, Villafane) Cincinnati Children's Heart Institute, Department of
Pediatrics, University of Cincinnati, Cincinnati, OH, United States
Publisher
Frontiers Media SA
Abstract
Current management of isolated CoA, localized narrowing of the aortic arch
in the absence of other congenital heart disease, is a success story with
improved prenatal diagnosis, high survival and improved understanding of
long-term complication. Isolated CoA has heterogenous presentations,
complex etiologic mechanisms, and progressive pathophysiologic changes
that influence outcome. End-to-end or extended end-to-end anastomosis are
the favored surgical approaches for isolated CoA in infants and
transcatheter intervention is favored for children and adults. Primary
stent placement is the procedure of choice in larger children and adults.
Most adults with treated isolated CoA thrive, have normal daily
activities, and undergo successful childbirth. Fetal echocardiography is
the cornerstone of prenatal counseling and genetic testing is recommended.
Advanced 3D imaging identifies aortic complications and myocardial
dysfunction and guides individualized therapies including re-intervention.
Adult CHD program enrollment is recommended. Longer follow-up data are
needed to determine the frequency and severity of aneurysm formation,
myocardial dysfunction, and whether childhood lifestyle modifications
reduce late-onset complications. Copyright © 2022 Bhatt,
Lantin-Hermoso, Daniels, Jaquiss, Landis, Marino, Rathod, Vincent, Keller
and Villafane.

<74>
Accession Number
2035204568
Title
Resuscitative Mean Arterial Pressure Targets in Cardiovascular Disease: A
Narrative Review of Clinical Outcomes.
Source
Cardiovascular Drugs and Therapy. 40(2) (pp 757-777), 2026. Date of
Publication: 01 Apr 2026.
Author
Kotta P.A.; Uppalapati L.; Elango M.; Triska J.; Senussi M.H.
Institution
(Kotta, Uppalapati, Triska) Department of Internal Medicine, Baylor
College of Medicine, Houston, TX, United States
(Elango) Department of General Surgery, Houston Methodist Hospital,
Houston, TX, United States
(Senussi) Section of Cardiology, Baylor College of Medicine, Texas Heart
Institute, Houston, TX, United States
Publisher
Springer
Abstract
Mean arterial pressure (MAP) is a commonly used hemodynamic proxy for
tissue perfusion. Continuous MAP monitoring and maintenance of MAP targets
remains a cornerstone for managing shock states. However, co-morbidities
and individual variations can complicate the relationship between MAP and
organ perfusion. Factors such as fluid balance, microvascular circulation,
and endothelial function all influence tissue perfusion. This review
examines the nuances of MAP management across various patient populations
with cardiovascular disease, including acute myocardial infarction
cardiogenic shock, non-acute myocardial infarction cardiogenic shock,
cardiac arrest, and cardiac surgery. We discuss the importance of
individualized MAP targets, considering underlying health conditions,
clinical scenarios, and individual shock physiology. Additionally, the
importance of monitoring end-organ autoregulation and perfusion is
emphasized to optimize shock management. We discuss a limited body of
literature which indicates that higher MAPs are associated with improved
outcomes in patients with cardiogenic shock, post-cardiac arrest, and
after cardiac surgery. However, owing to the post-hoc and retrospective
nature of most of these studies, whether higher MAPs truly lead to
improved clinical outcomes or whether patients with higher MAPs are
inherently less sick and therefore more likely to have better outcomes
cannot be discerned from the available data. Further research,
particularly prospective RCTs, is essential to define MAP targets that may
improve outcomes across different patient populations and clinical
settings. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<75>
Accession Number
2043024225
Title
Optimizing preoperative CTA protocols for TAVR: enhanced image quality and
reduced radiation and contrast doses with dual-source Turbo Flash mode.
Source
Chinese Journal of Academic Radiology. 9(1) (pp 77-85), 2026. Date of
Publication: 01 Mar 2026.
Author
Liu W.; Zheng Y.; Chen J.; Li J.; Du M.; Zeng J.; Chen X.; Chen W.; Li L.
Institution
(Liu, Zheng, Chen, Li, Du, Zeng, Chen, Li) First Affiliated Hospital of
Army Medical University, Chongqing, China
(Chen) University of Birmingham, Birmingham, United Kingdom
Publisher
Springer
Abstract
Purpose: This study aimed to investigate the feasibility of using the
Turbo Flash mode for transcatheter aortic valve replacement (TAVR)
computed tomography (CT) with a single contrast agent injection, aiming to
reduce contrast agent volume and radiation dose while maintaining image
quality. Method(s): Ninety patients were randomly assigned to either
the Turbo Flash group, which received a single contrast agent injection
and underwent the Turbo Flash scan without electrocardiogram
synchronization, or the conventional group, which received two contrast
agent bolus injections and underwent a standard scan. Result(s):
Compared with the conventional group (110 mL contrast agent), the Turbo
Flash group showed a 30% reduction in iodine usage (80 mL contrast agent).
All examination image qualities met diagnostic requirements. No
significant differences were noted between the two groups in terms of
subjective and objective aortic root computed tomography angiography (CTA)
scores. However, the Turbo Flash group had a significantly higher
subjective score for aorta-femoral artery CTA compared with the
conventional group (P < 0.001). The Turbo Flash group demonstrated lower
radiation doses for aorto-femoral artery scanning (474.73 +/- 127.48 mGy
cm) compared to the conventional group (661.97 +/- 172.91 mGy cm), a 28.3%
reduction (P < 0.05). No significant difference in the radiation dose for
aortic root scanning was observed between the two groups.
 Conclusion(s): Performing pre-TAVR CT with a single segmented
contrast agent injection is feasible and effective. These images can meet
clinical diagnostic needs while reducing contrast agent volume and
radiation dose. Copyright © The Author(s) 2026.

<76>
Accession Number
2034823998
Title
Coronary Artery Bypass Grafting With or Without Concomitant Surgical
Ventricular Reconstruction in Ischemic Cardiomyopathy Patients.
Source
Cardiovascular Drugs and Therapy. 40(2) (pp 681-695), 2026. Date of
Publication: 01 Apr 2026.
Author
Liao J.; Zhou Z.; Zhang Y.; Miao Z.; Li G.; Xiao H.; Ren Q.; Jian B.; Wu
Z.; Liang M.
Institution
(Liao, Zhou, Zhang, Miao, Li, Xiao, Ren, Jian, Wu, Liang) Department of
Cardiac Surgery, First Affiliated Hospital of Sun Yat-Sen University, 58
Zhongshan II Road, Guangzhou, China
(Zhou) Department of Anesthesiology, Brigham and Women's Hospital, Harvard
Medical School, Boston, MA, United States
Publisher
Springer
Abstract
Purpose: The present study aims to compare the long-term outcomes of
surgical ventricular reconstruction (SVR) combined with coronary artery
bypass grafting (CABG) versus CABG alone in patients with ischemic
cardiomyopathy (ICM). Method(s): A systematic literature search was
conducted in PubMed, Embase, Scopus, Cochrane Library, and Web of Science
until November 2024. Studies comparing SVR + CABG and CABG in patients
with ischemic cardiomyopathy (left ventricular ejection fraction less than
40%) were included. The primary outcome included long-term mortality, and
the secondary outcomes included hospital mortality, rehospitalization for
cardiac causes, and other cardiac function indicators. Result(s):
Twelve studies with a total of 3188 patients were included, with 1629
undergoing SVR + CABG and 1559 undergoing CABG. Patients who underwent SVR
+ CABG had a higher survival rate (HR 0.82; 95% CI, 0.69-0.96;
I2 = 4%; P = 0.01) and a more significant postoperative left
ventricular end-systolic volume index (ESVI) reduction (MD 15.53; 95% CI,
6.41-24.65; I2 = 93%; P = 0.01). In the subgroup analysis, the
Dor (endoventricular circular patch plasty) surgery provided additional
survival benefits compared with CABG (HR 0.83; 95% CI, 0.70-0.97;
I2 = 9%; P = 0.02). The reconstructed Kaplan-Meier curves show
that the survival rates in the SVR + CABG, Dor, Non-Dor, Mannequin-free,
Mannequin, and CABG groups were 81.13%, 82.02%, 76.38%, 83.23%, 69.40%,
and 71.42% at 60 months, respectively. Conclusion(s): Compared with
CABG, SVR + CABG is associated with higher survival, a more significant
reduction in ESVI, fewer rehospitalizations for cardiac causes, and more
patients gaining postoperative New York Heart Association class
improvement. Copyright © The Author(s), under exclusive licence
to Springer Science+Business Media, LLC, part of Springer Nature 2025.

<77>
Accession Number
2043687089
Title
Effects of Acute Exercise and 12-Week High-Intensity Interval Training on
Inflammatory Biomarkers in Stable Coronary Artery Disease: A Randomized
Controlled Trial.
Source
Journal of the American Heart Association. 15(4) (pp 1-15), 2026. Article
Number: e042256. Date of Publication: 03 Feb 2026.
Author
Kristiansen J.; Kristensen S.D.; Hvas A.-M.; Ellingsgaard H.; Mohr M.;
Grove E.L.; Sjurdarson T.
Institution
(Kristiansen) Department of Medicine, National Hospital of the Faroe
Islands, Torshavn, Faroe Islands
(Kristiansen, Hvas) Department of Clinical Biochemistry, Aarhus University
Hospital, Aarhus, Denmark
(Kristiansen, Kristensen, Grove) Department of Cardiology, Aarhus
University Hospital, Aarhus, Denmark
(Kristiansen, Kristensen, Hvas, Grove) Faculty of Health, Aarhus
University, Aarhus, Denmark
(Kristiansen, Mohr, Sjurarson) Centre of Health Sciences, Faculty of
Health, University of the Faroe Islands, Torshavn, Faroe Islands
(Ellingsgaard) Centre for Physical Activity Research, Rigshospitalet,
University of Copenhagen, Copenhagen, Denmark
(Mohr) Department of Sports Science and Clinical Biomechanics, SDU Sport
and Health Sciences Cluster, University of Southern Denmark, Odense,
Denmark
Publisher
American Heart Association Inc.
Abstract
BACKGROUND: Persistent low-grade inflammation contributes to coronary
artery disease (CAD), but how acute vigorous exercise and structured
training affect systemic inflammatory biomarkers in stable CAD remains
unclear. We evaluated the acute response to a single vigorous bout and the
effects of a 12-week high-intensity interval training program on systemic
inflammation in patients with stable CAD. METHOD(S): In 168 patients
with stable CAD, blood samples were collected before, immediately after,
and 2 hours after a maximal incremental cycling test. Participants were
then randomized to 12 weeks of high-intensity interval training or
standard care; 142 completed follow-ups. High-sensitivity CRP (C-reactive
protein), leukocytes, interleukin-2, interleukin-6, interleukin-10,
interferon-gamma, and tumor necrosis factor-alpha were measured at
baseline, week 6, and week 12. RESULT(S): Acute exercise elevated CRP
by 7.7% [95% CI, 5.5-10.0] and leukocytes by 50.5% [95% CI, 48.2-52.8];
CRP returned to baseline by 2 hours, whereas leukocytes remained elevated.
Interferon-gamma increased by 13.1% [95% CI, 9.2-17.3] following exercise
but fell below baseline after 2 hours. Tumor necrosis factor-alpha (12.9%
[95% CI, 8.4-17.4]), interleukin-2 (22.8% [95% CI, 17.5-28.5]), and
interleukin-6 (42.4% [95% CI, 36.5-48.5]) also increased following acute
exercise and stayed elevated after 2 hours, while interleukin-10 decreased
by 9.2% [95% CI, -14.1 to -4.0] and returned to baseline after 2 hours.
Over 12 weeks, high-intensity interval training did not significantly
alter these inflammatory markers compared with standard care.
 CONCLUSION(S): Acute strenuous exercise induces transient increases
in inflammatory markers in stable CAD, which begin to resolve within 2
hours. In this optimally treated cohort, regular high-intensity interval
training did not produce a sustained anti-inflammatory
effect. Copyright © 2026 The Author(s).

<78>
Accession Number
2040260187
Title
The effectiveness and side effects of anti-coagulant drugs in pregnant
women with mechanical or bio-prosthetic heart valves: A systematic review
and meta-analysis study.
Source
Journal of Cardiology. 87(4) (pp 354-365), 2026. Date of Publication: 01
Apr 2026.
Author
Shishesaz M.I.; Eshraghi R.; Bahrami A.; Farzan M.; Hajibeygi R.; Fathi
M.; Yaghoobpoor S.; Tavasol A.; Gorjizad M.; Dehghani M.; Akbari A.;
Rafiei N.; Roostaie M.; Eslami S.; Taherkhani M.; Movahed M.R.
Institution
(Shishesaz) School of Medicine, Iran University of Medical Sciences,
Tehran, Iran, Islamic Republic of
(Eshraghi) Social Determinants of Heath 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
(Farzan, Farzan) Medical Plants Research Center, Basic Health Sciences
Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran,
Islamic Republic of
(Farzan) Student Research Committee, Shahrekord University of Medical
Sciences, Shahrekord, Iran, Islamic Republic of
(Hajibeygi) School of Medicine, Tehran University of Medical Science,
Tehran, Iran, Islamic Republic of
(Fathi, Yaghoobpoor, Tavasol, Gorjizad, Akbari) School of Medicine, Shahid
Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Dehghani, Rafiei) School of Medicine, Isfahan University of Medical
Sciences, Isfahan, Iran, Islamic Republic of
(Roostaie) School of Medicine, Islamic Azad University Tehran Medical
Branch, Tehran, Iran, Islamic Republic of
(Eslami) Firoozgar Hospital, Iran University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Taherkhani) Clinical Research Development Unit (CRDU) of Loghman Hakim
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Movahed) University of Arizona Sarver Heart Center, Tucson, AZ, United
States
(Movahed) University of Arizona College of Medicine, Phoenix, AZ, United
States
(Hajibeygi) Department of Radiology and Biomedical Imaging, Yale School of
Medicine, CT, United States
Publisher
Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai)
Abstract
Background and objectives Patients with pregnancy and mechanical or
bio-prosthetic heart valves (BHVs) need tailored antithrombotic therapy to
prevent thromboembolism. The goal of this study was to evaluate the
effects and complications of various anticoagulation strategies used
during pregnancy in these patients using a meta-analysis. Method We
searched PubMed, Google Scholar, Scopus, EMBASE, and Web of Science
databases and discovered 24 articles. We also discarded some articles when
evaluating them in detail due to inadequate information. Finally, 24
studies were included in the systematic review. We compared pregnancy
outcomes in three groups of pregnant women: 1) Those taking warfarin; 2)
Those taking LMWH (Low Molecular Weight Heparin) or UFH (Unfractionated
Heparin); 3) Those on no anticoagulant therapy. The authors would like to
thank the Clinical Research Development Unit (CRDU) of Loghman Hakim
Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran for
their support, cooperation and assistance throughout the period of study.
The ethic code is: IR.SBMU.RETECH.REC.1403.831. Results The incidence of
maternal thromboembolic events was higher in the UFH or LMWH group, but
fetal complications (FC) were lower in this group. Using warfarin during
the first trimester was associated with a higher abortion rate,
embryopathies, and FCs overall. Using '5 mg of warfarin daily to maintain
their targeted INR had a lower risk of developing. Preterm labor and
spontaneous abortion were observed in 0.09 (95 % CI = 0.04-0.14) and 0.08
(95 % CI = 0.01-0.14) of cases in the LMWH/UFH subgroup. In terms of
maternal complications (MCs) in Warfarin subgroup, maternal hemorrhagic
complications, maternal thromboembolic events, and valve thrombosis were
respectively observed in 2.0 (95 % CI = 0-3), 0.01 (95 % CI = 0.00-0.03),
0.01 (95 % CI = 0.00-0.03); in LMWH subgroup the rates were 0.18 (95 % CI
= 0.09-0.27), 0.03 (95 % CI = 0.00-0.06), and 0.28 (95 % CI = 0.15-0.71);
and finally in those taking no anticoagulant therapy, the rates were 0.02
(95 % CI = 0.03-0.06), 0.07 (95 % CI = 0.06-0.19). Conclusions According
to the results, preterm labor is a significant fatal complication in
pregnant women on warfarin. Maternal hemorrhagic complications and
thromboembolic events occur in the LMWH subgroup. There are no significant
differences in other complications between the three
subgroups. Copyright © 2025 Elsevier Ltd.

<79>
Accession Number
2041232787
Title
Machine learning models for predicting postoperative delirium in
non-cardiac surgery patients - systematic review and meta-analysis.
Source
GeroScience. 48(1) (pp 135-156), 2026. Date of Publication: 01 Feb 2026.
Author
Das O.; Tang L.Y.; Oh E.S.; Suarez J.; Theodore N.; Azad T.D.
Institution
(Das, Tang, Theodore, Azad) Department of Neurosurgery, Johns Hopkins
University School of Medicine, 1800 Orleans St, Baltimore, MD, United
States
(Oh) Division of Geriatric Medicine and Gerontology, Department of
Medicine, Johns Hopkins University School of Medicine, Baltimore, MD,
United States
(Suarez) Division of Neurosciences Critical Care, Departments of
Anesthesiology and Critical Care Medicine, Neurology, and Neurosurgery,
Johns Hopkins University School of Medicine, Baltimore, MD, United States
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Early diagnosis of post-operative delirium (POD) in the older surgical
population allows for timely interventions and reduces morbidities. Risk
prediction models (RPMs) utilizing machine learning have emerged as
promising tools to predict POD, but their performance and applicability in
clinical settings remain uncertain. This systematic review evaluates the
predictive accuracy and quality of RPMs for POD developed from 2014 to
2024 focusing on patients after non-cardiac surgery. PubMed and EMBASE
were systematically searched for studies that developed RPMs predicting
POD. Two authors independently screened 298 potential studies for
eligibility, and quality assessment was performed using the Prediction
model Risk of Bias Assessment Tool (PROBAST). Pooled performance metrics,
including AUROC, sensitivity, specificity, and precision, were calculated.
Twenty-two articles matched review criteria, with the majority employing
machine learning techniques such as gradient boosting and random forests.
The pooled AUROC was 0.82 (95% CI: 0.79-0.85), indicating moderate-to-high
predictive accuracy. Sensitivity, specificity, and precision were 0.78,
0.83, and 0.55, respectively. Studies utilizing more predictors and
complex model architectures did not show substantial increases in
performance compared to simpler models developed pre-2014. We demonstrated
that while newer RPMs for POD are more likely to be validated and utilize
advanced machine learning algorithms, their interpretability and clinical
applicability remain limited. ML models hold promise in reducing the
incidence of POD, but significant effort is needed to facilitate the
integration of these models into clinical practice. Future efforts should
focus on validating models externally, reducing false positive
predictions, and translating model predictions into clinical
actions. Copyright © The Author(s), under exclusive licence to
American Aging Association 2025.

<80>
Accession Number
2044196532
Title
Effects of Transradial Catheterisation on Radial Artery Bypass Graft
Patency: A Systematic Review and Meta-Analysis.
Source
Heart Lung and Circulation. (no pagination), 2026. Date of Publication:
2026.
Author
Wang Y.; Sharma V.; Vu T.; Marasco S.F.
Institution
(Wang) School of Translational Medicine, Monash University, Melbourne,
VIC, Australia
(Wang, Marasco) Department of Surgery, Monash University, Melbourne, VIC,
Australia
(Sharma) Department of Cardiac Surgery, Austin Health, Heidelberg, VIC,
Australia
(Vu, Marasco) Department of Cardiothoracic Surgery and Transplantation,
The Alfred, Melbourne, VIC, Australia
Publisher
Elsevier Ltd
Abstract
Background: Transradial catheterisation is the default approach of
coronary angiography, and the radial artery (RA) is a popular conduit
choice for coronary artery bypass grafting (CABG). Whether a previously
catheterised RA (CRA) remains an optimal bypass conduit for CABG is
uncertain. This systematic review and meta-analysis sought to evaluate the
previous CRA bypass graft patency. Method(s): A systematic search is
conducted in MEDLINE, Embase, and Scopus for comparative studies of CRA
versus non-CRA (NCRA) grafts. The primary outcome of this study was RA
graft patency. Random-effects models generated pooled effect sizes with
heterogeneity assessed by I2; small-study effects were examined
with funnel plot/Egger's test, and influence analyses were performed in
the meta-analysis. Result(s): Of the 1,661 studies screened, four
observational studies of 400 patients (175 CRA and 379 NCRA grafts) were
included in the analysis. Across the included studies, the mean time from
catheterisation to CABG was 27.4+/-16.0 days; the mean follow-up imaging
was conducted at 2.06+/-1.88 years. CRA graft patency was lower than NCRA
(73.2% vs 83.9%), and the pooled odds of graft failure were higher with
CRA (odds ratio 1.82; 95% confidence interval 1.26-2.61; p=0.001;
I2=33%). There were no significant small-study biases detected
on planned assessments. Conclusion(s): Prior transradial
catheterisation is associated with reduced patency of RA bypass grafts.
Surgeons should exercise caution when selecting CRA for critical targets,
and prospective controlled data are needed to define patient and
procedural modifiers of risk. Copyright © 2025

<81>
Accession Number
2043864764
Title
EACTS Expert Consensus Statement on the Ross Procedure in Adult Patients.
Source
European Journal of Cardio-thoracic Surgery. 68(2) (no pagination), 2026.
Article Number: ezaf295. Date of Publication: 01 Feb 2026.
Author
Vojacek J.; Gofus J.; Andreas M.; Bavaria J.E.; Berdajs D.; Casselman
F.P.A.; El-Hamamsy I.; Holubec T.; de Kerchove L.; Milojevic M.; Mulinari
L.; Ouzounian M.; Skillington P.; Takkenberg J.J.M.; Verbrugghe P.
Institution
(Vojacek, Gofus) Department of Cardiac Surgery, Charles University,
Faculty of Medicine, University Hospital in Hradec Kralove, Hradec
Kralove, Czechia
(Andreas) Division of Cardiac Surgery, Department of Surgery, Medical
University Graz, Graz, Austria
(Bavaria) Department of Surgery, Thomas Jefferson University,
Philadelphia, PA, United States
(Berdajs) Department of Cardiac Surgery, University Hospital of Basel,
Basel, Switzerland
(Casselman) Department of Cardiac Surgery, Heart Center Azorg, Aalst,
Belgium
(El-Hamamsy) Department of Cardiovascular Surgery, Mount Sinai Hospital,
Icahn School of Medicine at Mount Sinai, New York, NY, United States
(Holubec) Department of Cardiovascular Surgery, University Heart and
Vascular Centre, University Hospital Frankfurt, Goethe University
Frankfurt, Main, Frankfurt, Germany
(de Kerchove) Division of Cardiothoracic and Vascular Surgery, Cliniques
Universitaires Saint-Luc, Pole de Recherche Cardiovasculaire, Institut de
Recherche Experimentale et Clinique, Universite Catholique de Louvain,
Brussels, Belgium
(Milojevic) Department of Cardiac Surgery and Cardiovascular Research,
Dedinje Cardiovascular Institute, Belgrade, Serbia
(Milojevic) Department of Cardiac Surgery, University Hospital Zurich,
University of Zurich, Zurich, Switzerland
(Mulinari) Pediatric and Congenital Cardiac Surgery, Department of
Surgery, Miller School of Medicine, University of Miami, Miami, FL, United
States
(Ouzounian) Peter Munk Cardiac Centre, University Health Network,
Department of Surgery, University of Toronto, ON, Canada
(Skillington) Department of Cardiothoracic Surgery, Royal Melbourne
Hospital, Epworth Hospital, Melbourne, VIC, Australia
(Takkenberg) Department of Cardio-Thoracic Surgery, Erasmus University
Medical Center, Rotterdam, Netherlands
(Verbrugghe) Department of Cardiac Surgery, UZ Leuven, Leuven, Belgium
Publisher
European Association for Cardio-Thoracic Surgery
Abstract
The Ross procedure, which involves replacing a diseased aortic valve with
the patient's own pulmonary valve (pulmonary autograft), has gained
renewed attention in adult patients due to mounting evidence of excellent
long-term outcomes. With increasing data demonstrating restoration of life
expectancy and improved valve-related outcomes, it is now considered a
viable first-line option for selected young and middle-aged adults with
non-repairable aortic valve disease. Nonetheless, its adoption remains
inconsistent across institutions, partly due to concerns about surgical
complexity, long-term durability, and the need for structured follow-up.
This expert consensus document, commissioned by the European Association
for Cardio-Thoracic Surgery, synthesizes the current evidence and offers
clinical statements for using the Ross procedure in adults. Developed
through a systematic review and informed by the collective experience of a
multidisciplinary panel of internationally recognized experts, the
document addresses key topics including patient selection, technical
refinements, and perioperative management. Emphasis is also placed on the
need for procedural standardization, high-volume surgical expertise, and
longitudinal imaging-based follow-up. Moreover, comparative outcome data
and subgroup considerations are critically appraised, and areas for future
investigation are outlined. This clinical practice document is intended to
assist clinicians and Heart Teams in making informed treatment decisions,
support harmonized implementation across centres, provide technical
considerations to optimize procedural success, and substantially improve
outcomes for patients considered for this complex but promising
procedure. Copyright © European Association for Cardio-Thoracic
Surgery 2025.

<82>
Accession Number
2042447186
Title
Long-term outcome of patients undergoing pacemaker implantation after
transcatheter aortic valve implantation: a systematic review and
meta-analysis.
Source
Cardiovascular Intervention and Therapeutics. 41(2) (pp 425-433), 2026.
Date of Publication: 01 Apr 2026.
Author
Veraar C.; Lamm G.; Merl L.; Fischer-Hammerschmied A.; Granner M.; Will
M.; Schwarz K.; Kammerlander A.; Mascherbauer J.
Institution
(Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Karl
Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Strase 30,
Krems, Austria
(Veraar, Lamm, Merl, Granner, Will, Schwarz, Mascherbauer) Division of
Internal Medicine 3, University Hospital St. Polten, Dunant- Platz 1, St.
Polten, Austria
(Fischer-Hammerschmied) Department of Anesthesiology, Intensive Care
Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular
Anesthesia and Intensive Care Medicine, Medical University of Vienna,
Vienna, Austria
(Kammerlander) Department of Cardiology, Medical University of Vienna,
Vienna, Austria
Publisher
Springer
Abstract
The long-term prognostic relevance of permanent pacemaker (PM)
implantation after transcatheter aortic valve implantation (TAVI) remains
uncertain. We performed a meta-analysis to evaluate its association with
all-cause mortality beyond five years. Following MOOSE recommendations,
PubMed and Embase were searched through September 2025 for studies
reporting long-term outcomes after TAVI, including hazard ratios (HRs)
comparing patients with and without new PM implantation. Pooled HRs were
calculated using random-effects models with restricted maximum likelihood
estimation and Hartung-Knapp adjustment. Heterogeneity was quantified
using I2, and robustness was tested by leave-one-out procedures and
alternative model estimators. Random-effects meta-regression examined
whether study-level covariates modified the association. Seven
observational studies comprising 59 635 patients were included, of whom 11
325 (19%) received a new PM within 30 days after TAVI. Follow-up ranged
from 60 to 120 months. PM implantation was associated with higher
long-term all-cause mortality {pooled HR 1.13 (95% CI 1.07-1.19); I2 =
0%}. Leave-one-out analyses confirmed stability (HR 1.11-1.13), and
funnel-plot inspection revealed no asymmetry. None of the examined
covariates-female sex, diabetes, atrial fibrillation, conduction
disturbances, coronary artery disease, or left-ventricular ejection
fraction-significantly affected the association (beta range - 0.018 to +
0.024; exp(beta) 0.98-1.02; all p > 0.10). Across seven contemporary
registries, PM implantation after TAVI was consistently linked to a modest
increase in long-term mortality, independent of baseline comorbidities,
emphasizing the need for conduction-preserving implantation and
physiologic pacing strategies. Copyright © The Author(s) 2026.

<83>
Accession Number
2043679828
Title
The Global Burden and Diagnostic Challenges of Undiagnosed Congenital
Heart Disease in Resource-Limited Settings: A Comprehensive Review from
2019 to 2025.
Source
Research Reports in Clinical Cardiology. 17 (no pagination), 2026. Article
Number: 558007. Date of Publication: 2026.
Author
Al-Shawki Y.M.A.A.
Institution
(Al-Shawki) Department of Medicine, Faculty of Medicine and Health
Sciences, Amran University, Amran, Yemen
Publisher
Dove Medical Press Ltd
Abstract
Background: Congenital Heart Disease (CHD) remains the most prevalent
congenital anomaly globally, with approximately 90% of affected neonates
born in low- and middle-income countries (LMICs). Despite significant
advances in paediatric cardiac care over the preceding decade, a
substantial proportion of CHD cases in resource-limited settings evade
timely detection, resulting in avoidable morbidity and premature
mortality. This systematic review synthesizes contemporary evidence
published between 2019 and 2025 to delineate the prevalence, determinants,
and consequences of undiagnosed CHD in LMICs, whilst critically evaluating
emerging strategies for diagnostic optimization. Method(s): A
systematic literature search was conducted across PubMed/MEDLINE, Emblaze,
Scopus, and the Cochrane Library for peer-reviewed studies published
between January 2019 and January 2025. The review adhered to PRISMA
guidelines. Forty-five primary studies met predefined eligibility
criteria, comprising observational cohorts, cross-sectional analyses, and
health systems research investigations focusing on pediatric populations
(neonates to 18 years) in World Bank-classified LMICs. Data regarding
diagnostic timing, barrier categorization, screening implementation, and
clinical outcomes were extracted and subjected to qualitative synthesis.
 Result(s): Analysis of 45 studies encompassing diverse geographical
regions-including sub-Saharan Africa, Southeast Asia, the Middle East, and
Latin America-revealed consistently protracted diagnostic delays, with
median age at CHD confirmation ranging from 4 days for critically cyanotic
lesions to 98 months for acyanotic defects. Pooled prevalence estimates
indicated that 47-63% of CHD cases in LMICs are diagnosed following the
onset of irreversible complications. Congestive heart failure was present
in 49.4% of patients at initial presentation, whilst Eisenmenger syndrome
complicated 15.8% of delayed left-to-right shunt diagnoses. Three
principal barrier domains were consistently identified: (i)
infrastructural deficiencies, including absent or non-functional
echocardiography services in peripheral facilities; (ii) workforce
shortages, with pediatric cardiologist-to-population ratios reaching 1:8
million in several regions; and (iii) socioeconomic constraints, including
prohibitive out-of-pocket expenditure and geographical maldistribution of
specialized centres. Contemporary studies evaluating pulse oximetry
screening demonstrated high diagnostic accuracy (sensitivity 76-93%,
specificity 99.4%) for critical CHD; however, implementation fidelity was
compromised by absent referral infrastructure and inadequate postnatal
follow-up. Conclusion(s): This systematic review confirms that
undiagnosed CHD in resource-limited settings constitutes a persisting
public health emergency, characterized by predictable diagnostic delays
and preventable clinical deterioration. The evidence synthesis identifies
actionable targets for health system strengthening, including mandatory
pulse oximetry integration, task-shifting to non-specialist providers, and
decentralized tele-echocardiography networks. Without urgent,
context-appropriate intervention, the diagnostic gap will continue to
exact an unacceptable toll on pediatric populations in
LMICs. Copyright © 2026 Al-Shawki.

<84>
Accession Number
2037023679
Title
Cardiovascular risk and JAK inhibitor for the treatment of
spondyloarthritis: A systematic review protocol.
Source
Tunisie Medicale. 103(8) (pp 975-977), 2025. Date of Publication: 01 Aug
2025.
Author
Dhahri R.; Bellakhal S.; Boussaid S.; Ammar L.B.; Bettaieb H.; Gharsallah
I.; Sahli H.; Douggui M.H.
Institution
(Dhahri, Bellakhal, Boussaid, Ammar, Bettaieb, Gharsallah, Sahli, Douggui)
University of Tunis El Manar, Faculty of Medicine of Tunis, Tunis, Tunisia
(Dhahri, Ammar, Gharsallah) Department of Rheumatology, Military Hospital,
Tunis, Tunisia
(Bellakhal, Bettaieb, Douggui) Internal Medicine department, Internal
Forces Security Hospital, Rue Taher Ben Achour, La Marsa, Tunisia
(Boussaid, Sahli) Department of Rheumatology, La Rabta Universitary
Hospital, Tunisia
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Introduction: JAK inhibitors, a newer class of medications, work by
blocking specific enzymes (Janus kinases) that play a key role in
inflammation. By inhibiting these enzymes, JAK inhibitors help alleviate
inflammation and symptoms, providing an alternative treatment option to
conventional therapies like NSAIDs and biologics. Considering the lack of
updated findings on cardiovascular effects in SpA patients treated with
JAK inhibitors, we will perform a systematic review of the literature to
investigate the safety of JAK inhibitors in SpA patients. The aim of this
review is to evaluate cardiovascular safety of JAK inhibitors.
 Method(s): We will search multiple databases, including PubMed,
Embase, and the Cochrane Library, using specific keywords such as "Janus
kinase inhibitors," "JAK inhibitors," "spondyloarthritis," and "cardiac
risk." Our inclusion criteria will focus on randomized controlled trials,
that reports Major Adverse Cardiovascular Events (MACE), in patients
treated with JAK inhibitors for spondyloarthritis. We will exclude cohort
studies, and those without relevant cardiac data, as well as animal
studies or those outside the scope of JAK inhibitor treatment. After
screening titles and abstracts, we performed a full-text review of the
selected articles to ensure the inclusion of studies with high
methodological quality and relevant data on cardiac risk factors. The
various stages of this literature search will be summarized using the
Preferred Reporting of Systematic Reviews and Meta-Analysis (PRISMA) flow
chart format to visualize the processes and findings of the review.
 Result(s): The preliminary results demonstrated that the existing
data indicated no significant change in cardiovascular risk for JAK
inhibitors-treated patients with SpA. Data analyze find no notable
difference in the occurrence of MACE between the interventions and the
placebo groups. These finding are to interpret with caution, given the
limitations of the study numbers and duration. However, these findings
provide a foundation for further investigation in this area.
 Conclusion(s): This systemic review highlights the safety of JAK
inhibitors according to MACE occurrence in patients with SpA when compared
to placebo. These results needs to be interpreted with caution regarding
the limited long-term data and small sample sizes in clinical trials.
Long-term studies are needed to clarify these risks. Copyright ©
2025, Societe Tunisienne des Sciences Medicales. All rights reserved.

<85>
Accession Number
2042004264
Title
Effects of Bariatric Surgery on the Pharmacokinetics of Cardiovascular
Drugs: A Systematic Review and Meta-Analysis.
Source
Obesity Surgery. 36(2) (pp 804-817), 2026. Date of Publication: 01 Feb
2026.
Author
Zarinfar Y.; Babaei S.; Majidzadeh M.J.; Masoumipoya Z.; Gheymati A.;
Eslami V.
Institution
(Zarinfar) School of Medicine, Shahid Beheshti University of Medical
Science, Tehran, Iran, Islamic Republic of
(Babaei, Majidzadeh, Masoumipoya) Department of Medicine, Arak University
of Medical Science, Arak, Iran, Islamic Republic of
(Gheymati) Tehran University of Medical Sciences, School of Pharmacy,
Tehran, Iran, Islamic Republic of
(Eslami) Shahid Beheshti University of Medical Sciences, Cardiovascular
Research Center, Shahid Modarres Hospital, Tehran, Iran, Islamic Republic
of
Publisher
Springer
Abstract
Background: Obesity is a global health issue associated with increased
cardiovascular risk. Bariatric surgery is the most effective long-term
treatment for severe obesity, but it may alter drug pharmacokinetics,
impacting the management of cardiovascular medications. Method(s): A
systematic review and meta-analysis were conducted according to PRISMA
2020 guidelines. Four databases (PubMed, Embase, Web of Science, Scopus)
were searched for studies examining the pharmacokinetics of cardiovascular
drugs before and after bariatric surgery. After duplicate removal, titles
and abstracts were screened, followed by a full-text review with inclusion
criteria of adult patients undergoing bariatric surgery who reported
pharmacokinetic or pharmacodynamic outcomes for cardiovascular drugs.
Meta-analysis was performed using a random-effects model in R (meta and
metafor packages), with effect sizes and heterogeneity (I2) reported.
 Result(s): From 817 identified records, 24 studies met the inclusion
criteria, revealing that bariatric surgery has varied and drug-specific
effects on the pharmacokinetics of cardiovascular medications. Among
anticoagulants, systemic exposure of all of them did not significantly
change. Rivaroxaban and apixaban pharmacokinetics remained largely
unchanged, and warfarin dosing requirements slightly decreased. The impact
of beta-blockers was highly dependent on the specific drug and
formulation; peak concentrations (Cmax) of atenolol increased slightly,
whereas those of immediate-release metoprolol tended to increase, but both
types of carvedilols (S- and R-carvedilol) and controlled-release
metoprolol and propranolol showed a decrease. Regarding statins,
atorvastatin absorption was significantly delayed, as shown by a prolonged
time to peak concentration Tmax (pooled SMD = 0.99, p < 0.05), without a
significant change in Cmax (slightly decreased). Both rosuvastatin and
simvastatin showed transient changes in exposure, which normalized over
time. Conclusion(s): Bariatric surgery can significantly impact the
pharmacokinetics of cardiovascular drugs, especially atorvastatin and
beta-blockers, highlighting the need for individualized dose adjustments
and therapeutic monitoring. These findings provide essential evidence for
optimizing cardiovascular pharmacotherapy in post-bariatric surgery
patients, supporting the development of tailored dosing
guidelines. Copyright © The Author(s), under exclusive licence to
Springer Science+Business Media, LLC, part of Springer Nature 2025.

<86>
Accession Number
2043903004
Title
Design and rationale of the COMPARE-TAVI 2 trial: An all-comers
head-to-head comparison of Evolut FX+ and Sapien 3 Ultra Resilia
transcatheter heart valves.
Source
American Heart Journal. 297 (no pagination), 2026. Article Number: 107387.
Date of Publication: 01 Jul 2026.
Author
Thim T.; Nissen H.; Niemela M.; Eftekhari A.; Jalanko M.; Savontaus M.;
Jaaskelainen P.; Hensey M.; Jensen R.V.; Norgaard B.L.; Frederiksen C.A.;
Vase H.O.; Pedersen L.; Sorensen H.T.; Christiansen E.H.; Terkelsen C.J.
Institution
(Thim, Jensen, Norgaard, Frederiksen, Vase, Christiansen, Terkelsen)
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
(Thim, Norgaard, Frederiksen, Christiansen, Terkelsen) Department of
Clinical Medicine, Aarhus University, Aarhus, Denmark
(Nissen) Department of Cardiology, Odense University Hospital, Odense,
Denmark
(Niemela) Department of Cardiology, Oulu University Hospital, Oulu,
Finland
(Niemela) Research Unit of Biomedicine and Internal Medicine, Medical
Research Center Oulu, University of Oulu, Oulu, Finland
(Eftekhari) Department of Cardiology, Aalborg University Hospital,
Aalborg, Denmark
(Jalanko) Department of Cardiology, Helsinki University Hospital,
Helsinki, Finland
(Savontaus) Heart Center, Turku University Hospital, Turku, Finland
(Jaaskelainen) Heart Center, Kuopio University Hospital, Kuopio, Finland
(Hensey) Department of Cardiology, St James's Hospital, Dublin, Ireland
(Pedersen) Department of Clinical Epidemiology, Aarhus University Hospital
and Aarhus University, Aarhus, Denmark
(Sorensen) Department of Clinical Epidemiology, Center for Population
Medicine, Aarhus University Hospital and Aarhus University, Aarhus,
Denmark
Publisher
Elsevier Inc.
Abstract
Introduction The COMPARE-TAVI trial framework was launched for direct
comparison of transcatheter aortic valve implantation (TAVI) valves. The
COMPARE-TAVI 1 trial, comparing Myval/Myval Octacor versus Sapien 3/Sapien
3 Ultra transcatheter heart valves (THVs), was recently published. Here,
we present the design and rationale for the COMPARE-TAVI 2 trial comparing
the Evolut FX+ self-expandable THV with the Sapien 3 Ultra Resilia
balloon-expandable THV. Methods and analysis In the COMPARE-TAVI 2 trial
(ClinicalTrials.gov NCT06470022), patients will be randomized 1:1 between
the THVs. The trial will test whether the Evolut FX+ self-expandable THV
is noninferior to the Sapien 3 Ultra Resilia balloon-expandable THV in
terms of the combined 1-year primary composite endpoint of all-cause
mortality, stroke, moderate/severe total aortic regurgitation, or
moderate/severe hemodynamic THV deterioration, according to VARC-3
criteria. If noninferiority is proven, superiority analyses may apply.
Based on a power of 80%, alpha level of 0.05, 1-sided test, noninferiority
margin of 4.5%, and expected event rate of 12%, the necessary sample size
has been estimated to be 1,364 patients. Prespecified secondary endpoints,
including long-term follow-up for 10 years, will also be investigated.
Summary The COMPARE-TAVI 2 will provide important information on the
short- and long-term outcomes among patients treated with the Evolut FX+
self-expandable and the Sapien 3 Ultra Resilia balloon-expandable
THVs. Copyright © 2026 The Author(s).

<87>
Accession Number
2043701402
Title
Association between prognostic nutritional index and prognosis of patients
receiving coronary artery bypass grafting surgery: a systematic review and
meta-analysis.
Source
Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article
Number: 1673038. Date of Publication: 2026.
Author
Lei Y.; Wang W.; Hua C.; Chen Y.
Institution
(Lei, Wang, Hua, Chen) Department of Rehabilitation Medicine, The First
Affiliated Hospital of Chongqing Medical and Pharmaceutical College,
Chongqing, China
Publisher
Frontiers Media SA
Abstract
Objectives: To conduct the first systematic review and meta-analysis to
assess the association between prognostic nutritional index (PNI) and
prognosis of patients receiving coronary artery bypass grafting surgery
(CABG). Method(s): We conducted a systematic literature search via
PubMed, Embase, Web of Science, and Cochrane until March 2025, for studies
that evaluated the association between PNI and prognosis of patients
receiving CABG. All-cause mortality and acute kidney injury (AKI) were the
primary outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were
used for data pooling. In addition, sensitivity analysis and subgroup
analysis were performed to evaluate the stability of the results and
potential sources of heterogeneity. All data analyses were conducted using
Review Manager 5.4 and STATA 15.1 software. Result(s): A total of 11
studies including 11,444 patients were included in the meta-analysis. The
results showed that, compared with the low PNI group, the high PNI group
had a significantly lower all-cause mortality rate (OR: 0.81; 95% CI:
0.72, 0.90) and a significantly lower risk of acute kidney injury (OR:
0.82; 95% CI: 0.77, 0.86). Sensitivity analyses confirmed that the
associations between PNI and all-cause mortality and AKI were stable.
 Conclusion(s): PNI can effectively predict postoperative all-cause
mortality and AKI in patients undergoing CABG. Considering the inevitable
heterogeneity and potential publication bias in this article, more
large-scale, multicenter, prospective cohort studies are needed in the
future to assess the predictive value of PNI for prognosis after CABG and
to identify its influencing factors. Systematic Review Registration:
https://www.crd.york.ac.uk/PROSPERO/view/CRD420251077959, PROSPERO
CRD420251077959. Copyright 2026 Lei, Wang, Hua and Chen.

<88>
Accession Number
2037022290
Title
Continuing versus Withholding renin angiotensin aldosterone system
antagonists before non-cardiac surgery: A protocol of a systematic review
and meta-analysis.
Source
Tunisie Medicale. 103(8) (pp 978-981), 2025. Date of Publication: 01 Aug
2025.
Author
Chaouch M.A.; Haddad F.; Kammoun E.; Clautiaux H.; Daghmouri M.A.
Institution
(Chaouch) Department of Visceral and Digestive Surgery, Monastir
University Hospital, Monastir, Tunisia
(Haddad, Kammoun) University Tunis El Manar, Faculty of medicine of Tunis,
Mongi Slim Hospital, Department of anesthesia and intensive care, Tunis,
Tunisia
(Clautiaux, Daghmouri) Department of Anesthesiology, Montreuil
Intercommunal Hospital Center, France
Publisher
Societe Tunisienne des Sciences Medicales
Abstract
Introduction: Perioperative use of ACE inhibitors (ACEIs) and angiotensin
II receptor blockers (ARBs) has been linked to early postinduction
hypotension requiring vasopressor use under general anesthesia,
potentially leading to complications like acute renal injury, myocardial
injury, or stroke. However, the relationship between perioperative
ACEI/ARB use and major morbidity remains uncertain. Aim(s): This
meta-analysis assessed the differences between the continuation or
discontinuation of ACE inhibitor (ACE-I) or angiotensin II receptor
blocker (ARB) therapy during the perioperative period and hemodynamical
instability, mortality, and major morbidity outcomes. Method(s): The
protocol was registered in the PROSPERO database (ID: CRD42024519162).
Literature searches of electronic databases and manual searches on the
Medline, Embase, Scopus, and Web of Science databases up to August 30,
2024, will be performed. Case-control studies, cohort studies,
non-randomized controlled trials, and randomized controlled trials (RCTs)
involving adult patients aged over 18 years, who were chronically using
ACEIs or ARBs due to chronic hypertension, undergoing non-cardiac surgery,
where ACEIs or ARB therapy was either withheld or continued less than 10
hours before surgery will be included. The primary outcome will be the
incidence of intraoperative hypotension. Secondary outcomes will be the
intraoperative use of vasoactive agent (incidence, dose of ephedrine (mg)
and dose of phenylephrine (ng)), the incidence of severe hypotension,
hospital length of stay, intraoperative and postoperative hypertension,
the incidence of acute kidney injury, 30-day postoperative all-cause
mortality and incidence of major cardio-cerebral events.
 Conclusion(s): The results of this systematic review and
meta-analysis should provide evidence for withholding or continuing
perioperative ACE-I or ARB in noncardiac surgery. Copyright ©
2025, Societe Tunisienne des Sciences Medicales. All rights reserved.

<89>
Accession Number
2044198298
Title
Early Versus Late Extubation After Pediatric Cardiac Surgery: A Systematic
Review and Meta-analysis.
Source
Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026.
Date of Publication: 2026.
Author
Alkhatip A.A.A.M.M.; Mills K.E.; Akram A.; Farag E.; Hamza M.K.;
Abdelkader M.; Bahr M.; ELEmady M.F.M.; Hosny H.; Sallam A.; Farag A.M.G.;
Wagih M.
Institution
(Alkhatip) Department of Anaesthesia, Birmingham Children's Hospital,
Birmingham, United Kingdom
(Alkhatip, Farag, Abdelkader, Bahr) Department of Anesthesia, Pain
Management and Surgical Intensive Care, Beni-Suef University Hospital and
Faculty of Medicine, Beni Suef University, Beni Suef, Egypt
(Mills) Department of Science and Technology, University of Canberra,
Canberra, ACT, Australia
(Akram) Dow Medical College, Dow University of Health Sciences, Karachi,
Pakistan
(Hamza, ELEmady, Hosny, Wagih) Department of Anesthesia, Kasr Al Ainy
Faculty of Medicine and Cairo University Hospitals, Cairo University,
Cairo, Egypt
(Hosny) Department of Cardiothoracic Anaesthesia and Intensive Care
Medicine, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust,
Newcastle upon Tyne, United Kingdom
(Sallam) Department of Anaesthesia, St. Vincent's University Hospital,
Dublin, Ireland
(Farag) Department of Cardiac Anaesthesia, King Abdullah Medical City,
Makkah Mukarramah, Saudi Arabia
Publisher
W.B. Saunders
Abstract
Early extubation after pediatric cardiac surgery has been increasingly
adopted as part of fast-track and enhanced recovery pathways, but its
association with postoperative outcomes remains uncertain. The authors
conducted a systematic review and meta-analysis of studies comparing early
extubation (defined as extubation in the operating room or within 24 hours
postoperatively) versus delayed extubation after pediatric cardiac
surgery. Electronic databases were searched from inception through April
2024. Random-effects models were used to pool effect estimates for
mortality, reintubation, and length-of-stay outcomes. Prespecified
subgroup and sensitivity analyses were performed. Twenty-eight studies,
including 37,995 children, were analyzed. Early extubation was associated
with lower in-hospital mortality (odds ratio, 0.19; 95% confidence
interval, 0.14-0.25); however, absolute mortality rates were low, and this
association was vulnerable to confounding by indication and preferential
selection of clinically stable patients for early extubation. Early
extubation was also associated with lower reintubation rates and shorter
intensive care unit and hospital lengths of stay. Associations were more
consistent among older children than among neonates. In this predominantly
observational evidence base, early extubation should be interpreted
primarily as a marker of patient stability and institutional practice
rather than a proven intervention that reduces mortality. Given the low to
very low certainty of evidence, these findings are hypothesis-generating
and may inform quality-improvement initiatives and future prospective
studies, rather than definitive clinical guidance. Copyright ©
2026 Elsevier Inc.

<90>
Accession Number
2043808882
Title
Research Trends in Pain Management After Thoracoscopic Surgery
(2015-2024): A Bibliometric Analysis.
Source
Pain Research and Management. 2026(1) (no pagination), 2026. Article
Number: 2700117. Date of Publication: 2026.
Author
Jiang D.; Liu F.; Liu Z.; Peng J.; Liu Y.; Weng Y.; Wang R.; Zhong Q.
Institution
(Jiang, Peng, Liu, Wang) Department of Anesthesiology, Chengdu Jinniu
District People's Hospital, Sichuan, Chengdu, China
(Jiang, Liu) Graduate School, Chengdu Medical College, Sichuan, Chengdu,
China
(Liu, Liu, Weng, Zhong) Department of Anesthesiology, The People's
Hospital of Jianyang/The Affiliated Jianyang Hospital of Chengdu Medical
College, Sichuan, Jianyang, China
(Liu, Zhong) Department of Anesthesiology, The Affiliated Hospital of
Southwest Medical University, Sichuan, Luzhou, China
Publisher
John Wiley and Sons Ltd
Abstract
Background: Thoracoscopic surgery, a representative minimally invasive
approach in thoracic surgery, is increasingly employed. However,
postoperative pain remains a significant barrier to recovery and quality
of life. We aimed to quantitatively analyze research on postoperative pain
following thoracoscopic surgery over the past decade; to identify the
current research landscape, research hotspots, and future trends; and to
provide a reference for future studies. Method(s): Publications on
postoperative pain following thoracoscopic surgery from 2015 to 2024 were
retrieved from the Web of Science database. CiteSpace, VOSviewer, and
Bibliometrix were used to analyze publication trends, journals, authors,
institutions, countries, regions, and keywords. Result(s): The number
of publications increased steadily between 2015 and 2024. China and the
United States were the leading contributors, forming a global
collaboration network with Europe. Major contributing institutions
included Tongji Medical College, Guangzhou Medical University, and the
Cleveland Clinic. Leading authors included Jianxing He, Hengrui Liang, and
Ali Alagoz. Research areas spanned thoracic surgery, pain medicine, and
anesthesiology. Frequently cited keywords were "pain," "rapid recovery,"
"analgesia," "pain management," "paravertebral nerve block," and "erector
spinae plane block." Key research themes included multimodal analgesia,
chronic pain, and quality of life. Conclusion(s): Research on
postoperative pain after thoracoscopic surgery has evolved from clinical
observation to multimodal analgesia, making advancements toward precision
medicine and long-term outcomes. Current research hotspots include
optimizing analgesic strategies, understanding pain mechanisms, refining
surgical techniques, and promoting rapid recovery. Promising areas include
regional analgesia techniques, liposomal bupivacaine, chronic pain
prevention, opioid-sparing strategies, and spontaneous ventilation
anesthesia. Copyright © 2026 Dezhou Jiang et al. Pain Research
and Management published by John Wiley & Sons Ltd.

<91>
Accession Number
2044193233
Title
A comparative study of the effect of slow and rapid initiation of
cardiopulmonary pump on tissue oxygenation index and ischemic
complications.
Source
Journal of Extra-Corporeal Technology. 58(1) (pp 73-78), 2026. Date of
Publication: 01 Mar 2026.
Author
Bagherinasab M.; Rezaei S.; Moradi A.R.; Jabbari A.; Noori A.; Archer Z.;
Darban N.H.
Institution
(Bagherinasab) Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Rezaei) Student Research Committee, Faculty of Nursing, Tehran University
of Medical Sciences, Tehran, Iran, Islamic Republic of
(Moradi, Noori) Student Research Committee, Faculty of Nursing,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Jabbari) Golestan University of Medical Science, Gorgan, Iran, Islamic
Republic of
(Archer, Darban) College of Health Sciences, Cardiovascular Science
Program, Glendale, AZ, United States
Publisher
EDP Sciences
Abstract
Introduction: Although the use of the heart-lung machine (HLM) is routine
in cardiac operating theaters, there is still a lack of evidence-based
guidelines concerning the optimal speed to reach full flow during
initiation to reduce critical episodes of cerebral ischemia. Therefore, we
have designed a study to compare two distinct initiation times for the
commencement of cardiopulmonary bypass (CPB). Method(s): We conducted
a randomized, monocentric, double-blind, prospective study to assess the
impact of two different CPB initiation speeds - rapid initiation at 30 s
and slow initiation at 180 s - on cerebral tissue oxygenation (TOI via
NIRS), arterial oxygen pressure, hematocrit (HCT) variation, and the
incidence of postoperative delirium. The target flow rate was set at 2.4
L/min/m2, with adjustments made according to the patient's body
surface area. Result(s): The absolute values of the tissue
oxygenation index (TOI) and HCT showed no differences between the study
during the first 180 s following commencement of CPB. Patients in the fast
group exhibited significantly lower arterial oxygen pressure at the
initiation of the (P < 0.05). Additionally, patients in the fast group
experienced a higher incidence of delirium in the second and third days
following surgery. While clinically relevant, the elevated incidence of
delirium fell short of being statistically significant, with
post-operative days 2 and 3 having P-values of 0.06 and 0.08,
respectively. Conclusion(s): The results of this study indicate that,
despite the absence of a significant difference in TOI between the study
groups, patients in the slow group exhibited a not statistically
significant trend for a lower incidence of delirium, as defined by
CAMICU-7, in comparison to those in the fast group. Copyright ©
The Author(s), published by EDP Sciences, 2026.

<92>
Accession Number
650711782
Title
Efficacy of PEP in the prevention and treatment of postoperative pulmonary
complications following thoracic and abdominal surgery.
Source
European Respiratory Journal. Conference: European Respiratory Society
Congress, ERS 2025. Amsterdam Netherlands. 66(Supplement 69) (no
pagination), 2025. Date of Publication: 01 Sep 2025.
Author
Dolic D.; Salvitti S.
Institution
(Dolic) Universita degli Studi di Udine, Udine, Italy
(Salvitti) Azienda Sanitaria Universitaria Friuli Centrale, Universita
degli Studi di Udine, Udine, Italy
Publisher
European Respiratory Society
Abstract
Introduction: Postoperative pulmonary complications (PPCs), including
atelectasis, pneumonia, and respiratory failure, are common after thoracic
and abdominal surgeries, leading to increased morbidity, prolonged
hospital stays, and higher healthcare costs. Positive Expiratory Pressure
(PEP) is a respiratory physiotherapy technique widely used for PPC
prevention, but its efficacy remains debated. Objective(s): This
systematic review aims to evaluate the effectiveness of PEP devices in
preventing and managing PPCs. Method(s): In according with PRISMA
guidelines, a systematic review with meta-analysis was conducted by
searching Medline, Embase, Cochrane Library, OvID, Scopus, ProQuest,
PEDro, and Cinahl. Randomized controlled trials (RCTs) meeting predefined
PICO criteria were included. Two blinded reviewers independently selected
studies and extracted data. The Risk of Bias 2 (RoB2) tool was used for
quality assessment. Result(s): Twelve studies were included in the
systematic review, with seven incorporated into the meta-analysis. Results
varied regarding PEP efficacy in preventing PPCs. The metaanalysis showed
a non-significant trend favoring control groups over PEP-treated patients.
The overall quality of included studies was generally low.
 Conclusion(s): Current evidence does not support PEP devices as a
primary tool for PPC prevention following thoracic and abdominal
surgeries. Further research is needed to clarify their role and prevent
indiscriminate use in clinical practice.

<93>
Accession Number
650708666
Title
Comparison of Open surgery versus Video Assisted Thoracic Surgery in
Non-Small Cell Lung Cancer (NSCLC) recurrence; A Local DGH retrospective
study.
Source
European Respiratory Journal. Conference: European Respiratory Society
Congress, ERS 2025. Amsterdam Netherlands. 66(Supplement 69) (no
pagination), 2025. Date of Publication: 01 Sep 2025.
Author
Mujeeb M.; Duta J.; Radia P.; Mcmillan A.; Win T.
Institution
(Mujeeb, Duta) StevenageUnited Kingdom
(Radia, Mcmillan, Win) LondonUnited Kingdom
Publisher
European Respiratory Society
Abstract
Introduction: Surgical management of NSCLC offers the best chances of
survival amidst with the chance of recurrence which is around 20%. Aims
and objectives: Surgical resection of NSCLC was limited to open
thoracotomy until 1992 when VATS lobectomy was introduced and hence
yielded numerous advantages. However there seems to be notable deficiency
in Randomized control trials to compare these two techniques and their
recurrence rate. We conducted this retrospective study to ascertain the
recurrence of these two techniques. Method(s): Retrospective analysis
had been conducted for 252 patients who had undergone curative intent
surgery between 2010-2019 after a diagnosis of NSCLC at a local District
general hospital and then systemic follow up was done to analyse
recurrence after surgery. We had conducted Chi-squared tests and ttests to
investigate the various association between surgeries and recurrence.
 Result(s): 74 patients who underwent open thoracotomy eventually had
a recurrence rate of 32.43% whereas 169 patients who had been subjected to
VATS had a recurrence rate of 21.3%. In this cohort lobectomy, wedge
resection and pneumonectomy were done aswell. Chemotherapy and
radiotherapy modalities were also utilized but not emphasised on this
study. Conclusion(s): Our study showed that the minimally invasive
approach constitutes a modern intervention for the treatment of lung
cancer and yielded a difference of 11.13% against open thoracotomy
procedure. With the advent of early cancer detection with ung health check
programmes this would yeild as a prime tool in order to establish early
curative intent with minimal post-operative complications.

<94>
Accession Number
2044288799
Title
WCN26-5467 ASPIrin to Reduce Events in Dialysis (ASPIRED) trial: a
pragmatic, registry-based, double-blind randomized clinical trial.
Source
Kidney International Reports. Conference: Kidney International Reports.
Yokohama Japan. 11(4 Supplement) (no pagination), 2026. Article Number:
104237. Date of Publication: 01 Apr 2026.
Author
Fan L.; Wong M.G.; Chen W.; Ye Z.; Jardine M.; Badve S.; Billot L.; Tan
N.; Monaghan H.; Chen M.; Coggan S.; Kotwal S.; Ma G.; Perkovic V.; Yu X.
Institution
(Fan, Ye, Yu) Department of Nephrology, Guangdong Provincial People's
Hospital (Guangdong Academy of Medical Sciences), Southern Medical
University, Guangzhou, China
(Wong) Department of Nephrology, Concord Repatriation General Hospital;
University of Sydney, Sydney, Australia
(Chen) Department of Nephrology, The First Affiliated Hospital of Sun-yet
Sun University, Guangzhou, China
(Jardine) NHMRC Clinical Trials Centre, University of Sydney, Sydney,
Australia
(Badve) Renal and Metabolic ProgramResearch Innovation & Director of
Biostatistics and Data Science, University of New South Wales; The George
Institute for Global Health, Sydney, Australia
(Billot) Biostatistics and Data ScienceMedicine and Health, University of
New South Wales; The George Institute for Global Health, Sydney, Australia
(Tan) Department of Cardiology, Guangdong Provincial People's Hospital
(Guangdong Academy of Medical Sciences), Southern Medical University,
Guangzhou, China
(Monaghan, Coggan) Renal and Metabolic Program, University of New South
Wales; The George Institute for Global Health, Sydney, Australia
(Chen) Department of Nephrology, Ningxia General Hospital, Ningxia, China
(Kotwal) Department of Nephrology, Prince of Wales Hospital, University of
New South Wales; The George Institute for Global Health, Sydney, Australia
(Ma) Department of Neurology, Guangdong Provincial People's Hospital
(Guangdong Academy of Medical Sciences), Southern Medical University,
Guangzhou, China
(Perkovic) None, University of New South Wales, Sydney, Australia
Publisher
Elsevier Inc.
Abstract
Introduction: Individuals with kidney failure receiving dialysis have a
substantially greater risk of suffering cardiovascular (CV) events than
the age- and gender-matched general population. Although aspirin is an
effective antiplatelet agent commonly used for primary and secondary CV
prevention, data regarding its role in the dialysis population is limited
to a few post hoc analyses of larger trials, partly due to the paradoxical
relationship between thromboembolic and bleeding risk in patients on
dialysis. Here, we report the trial design and recruitment status of an
adequately powered, pragmatic, registry-based, double blind, randomised
controlled trial aiming to determine the efficacy and safety of low dose
aspirin versus placebo in reducing CV events and mortality in patients on
maintenance hemodialysis (HD) or peritoneal dialysis (PD) (NCT04381143).
 Method(s): ASPIRED is a multicentre, investigator-initiated,
collaborative study jointly designed by the Guangdong People Provincial
Hospital (GDPH) and the George Institute for Global Health (TGI). Eligible
participants are pre-identified from the Chinese Dialysis Registry
(n~29,000) with broad inclusion criteria i.e. prevalent or incident adults
(>=18 years old) on maintenance HD or PD who are able to provide informed
consent. Individuals with aspirin intolerance or an indication for
antiplatelet/ anticoagulation therapy, recent intracranial bleed, or
deemed not suitable by treating clinicians, are excluded. Consenting
participants are randomised to either oral aspirin 100mg daily or matched
placebo in a 1:1 ratio stratified by centre, dialysis modality, a history
of CV disease and presence of diabetes mellitus. The primary endpoint is
the composite of major adverse cardiovascular events (MACE), defined as
the first occurrence of myocardial infarction, ischemic stroke or death
from CV causes. Secondary endpoints include a composite of MACE and
all-cause death, hospitalised unstable angina and transient ischaemic
attack, the individual components of the primary composite, all-cause
mortality, coronary revascularisation, fistula or graft thrombosis,
intracranial haemorrhage, and ischaemic events. The main safety endpoint
is major bleeding. A sample size of 9000 participants is estimated to give
90% power to detect an 18.5% relative risk reduction with low dose aspirin
versus placebo, based on an estimated 1011 primary events. This
event-based trial utilises an intention to treat analysis with three
protocol-specified interim analyses planned using Haybittle-Peto efficacy
boundaries. The trial Steering Committee is responsible for the overall
trial conducts, and a Data Safety Monitoring Committee provides ongoing
independent review of trial safety parameters. Result(s): The study
is ongoing with 8118 participants randomized in Oct 2025 from 107 centers
in China. Approximately 2/3 are male with a similar proportion receiving
HD. Two protocol specified interim analyses were completed to date and the
DMSC has advised continuation of the trial. Conclusion(s): To date,
ASPIRED trial is the largest definitive trial of aspirin vs placebo in
patients receiving dialysis, and will provide much-needed evidence
regarding benefits in preventing CV events and mortality, as well as any
risks. Irrespective of the outcome, the results of the ASPIRED trial will
be impactful and likely to change clinical practice. I have no potential
conflict of interest to disclose. I did not use generative AI and
AI-assisted technologies in the writing process. Copyright © 2026

<95>
Accession Number
650698401
Title
The Economic Burden of Metabolic Syndrome in Elective Surgery: An
Australian Cost-of-Illness Study.
Source
ANZ journal of surgery. (no pagination), 2026. Date of Publication: 20
Mar 2026.
Author
Norris P.; Gow J.; Arthur T.; Rodda D.; Coory J.; Oprescu F.; Neville S.;
Ralph N.
Institution
(Norris) School of Nursing and Midwifery, University of Southern
Queensland, Toowoomba, Australia
(Gow, Oprescu, Neville, Ralph) School of Health, University of the
Sunshine Coast, Sippy Downs, Australia
(Gow) School of Accounting, Economics and Finance, University of
KwaZulu-Natal, Durban, South Africa
(Arthur) St Andrew's Toowoomba Hospital, Toowoomba, Australia
(Rodda, Coory) Sunshine Coast Orthopaedic Group, Sunshine Coast University
Private Hospital, Australia
Abstract
BACKGROUND: Metabolic syndrome (MetS) is common in elective surgical
populations and is associated with increased postoperative complications.
The national economic burden of MetS-attributable surgical morbidity in
Australia has not been quantified. METHOD(S): A prevalence-based
cost-of-illness model was constructed using Australian elective surgery
volume data from the Australian Institute of Health and Welfare (2.3
million admissions, 2021-2022). MetS prevalence was modelled at 35%
(sensitivity range 25%-46%). Complication risks were derived from a
systematic review and meta-analysis of over 13 million surgical patients.
Excess direct hospital costs were estimated from an Australian public
hospital system perspective for surgical site infections, cardiovascular
events, 30-day readmissions, and extended length of stay. Unit costs were
obtained from the National Hospital Cost Data Collection and the
Independent Hospital Pricing Authority, reported in 2023 Australian
dollars. Deterministic sensitivity analysis tested model robustness.
 RESULT(S): The annual cost burden attributable to MetS was AUD 1.98
billion (95% CI: AUD 1.32-2.64 billion). Costs were driven primarily by
extended length of stay (AUD 1.15 billion), followed by readmissions (AUD
345 million), cardiovascular events (AUD 243 million), and surgical site
infections (AUD 242 million). Costs ranged from AUD 1.32 billion at 25%
prevalence to AUD 2.64 billion at 46% prevalence. The mean additional cost
per MetS surgical patient was AUD 2460. CONCLUSION(S): MetS imposes a
substantial direct hospital cost burden on the Australian public hospital
system. These findings support evaluation of routine preoperative MetS
screening and optimisation strategies. Copyright © 2026 The
Author(s). ANZ Journal of Surgery published by John Wiley & Sons
Australia, Ltd on behalf of Royal Australasian College of Surgeons.

<96>
Accession Number
650717365
Title
Impact of Genetic Testing Among Patients With Familial
Hypercholesterolemia on Adverse Cardiovascular Events- The Hokuriku-Plus
Familial Hypercholesterolemia Registry Study.
Source
Circulation journal : official journal of the Japanese Circulation
Society. (no pagination), 2026. Date of Publication: 20 Mar 2026.
Author
Tada H.; Takeji Y.; Goten C.; Okada H.; Yoshida S.; Shimojima M.; Nomura
A.; Mori M.; Takashima S.-I.; Kato T.; Usui S.; Sakata K.; Hayashi K.;
Fujino N.; Nagase K.; Kawashiri M.-A.; Takamura M.
Institution
(Tada, Takeji, Goten, Okada, Yoshida, Shimojima, Nomura, Mori, Takashima,
Kato, Usui, Sakata, Hayashi, Fujino, Takamura) Department of
Cardiovascular Medicine, Kanazawa University Graduate School of Medical
Sciences
(Nagase) Innovative Clinical Research Center, Kanazawa University
(Kawashiri) Department of Internal Medicine, Kaga Medical Center
Abstract
BACKGROUND: We aimed to clarify the impact of genetic testing on major
adverse cardiovascular events (MACE) among patients with heterozygous
familial hypercholesterolemia (HeFH) using data from the Hokuriku-plus FH
Registry (UMIN000038210). METHODS AND RESULTS: In all, 431 patients were
enrolled in the study, with a median follow-up of 3.9 years. The primary
outcome was time to first MACE, defined as cardiovascular death, non-fatal
myocardial infarction, coronary revascularization, or non-fatal stroke.
Using Cox proportional hazards regression models, we examined whether
undergoing genetic testing was associated with a reduced risk of MACE.
Among the 431 patients, sufficient data were available for 386 with HeFH,
of whom 202 (52.3%) underwent genetic testing. Low-density lipoprotein
cholesterol (LDL-C) levels at follow-up were significantly lower in group
that underwent genetic testing than in the group that did not (median 102
vs. 130 mg/dL, respectively; P<0.001). During follow-up, 23 MACE occurred
(18 in the non-testing group and 5 in the genetic testing group). Notably,
undergoing genetic testing was significantly associated with a reduced
risk of MACE, even after adjusting for LDL-C levels (hazard ratio 0.66;
95% confidence interval 0.20-0.92; P=0.033). CONCLUSION(S): Genetic
testing in patients with HeFH was associated with a reduced risk of MACE
independent of LDL-C. Randomized controlled trials will be needed to
clarify whether providing genetic testing can reduce MACE among patients
with HeFH.

<97>
Accession Number
2044519346
Title
Preclinical and clinical developments in Treg therapy for heart
transplantation: Critical assessment and translational challenges.
Source
Human Immunology. 87(4) (no pagination), 2026. Article Number: 111681.
Date of Publication: 01 Apr 2026.
Author
Mengrelis K.; Wolner L.; Lakatos R.L.; Zuckermann A.; Pilat N.
Institution
(Mengrelis, Wolner, Zuckermann, Pilat) Medical University of Vienna,
Department of Cardiac and Thoracic Aortic Surgery, Vienna, Austria
(Wolner, Lakatos, Pilat) Medical University of Vienna, Center for
Biomedical Research and Translational Surgery, Vienna, Austria
Publisher
Elsevier Inc.
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. Copyright © 2026 The Author(s). Published by Elsevier
Inc. on behalf of American Society for Histocompatibility and
Immunogenetics. This is an open access article under the CC BY license.
http://creativecommons.org/licenses/by/4.0/

<98>
Accession Number
2044281250
Title
Oxidative Stress and the KEAP1/NRF2 Axis in Saphenous Vein: Implications
for Graft Patency.
Source
Cells. 15(6) (no pagination), 2026. Article Number: 563. Date of
Publication: 01 Mar 2026.
Author
Layton G.R.; Marston E.; Musa H.L.; Ladak S.; Copperwheat A.; Oluwanifemi
A.; Antoun I.; Zakkar M.
Institution
(Layton, Marston, Musa, Ladak, Antoun, Zakkar) Department of
Cardiovascular Sciences, University of Leicester, Leicester, United
Kingdom
(Layton, Copperwheat, Oluwanifemi, Zakkar) Department of Cardiac Surgery,
University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
(Layton, Marston, Ladak, Zakkar) Leicester British Heart Foundation Centre
of Research Excellence, Leicester, United Kingdom
(Antoun) Department of Cardiology, University Hospitals of Leicester NHS
Trust, Leicester, United Kingdom
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Vein graft disease remains a significant limitation to the long-term
patency of venous conduits following coronary artery bypass grafting.
Early oxidative stress, triggered by ischaemia-reperfusion injury and
haemodynamic changes following the implantation of veins into the arterial
circulation, disrupts endothelial integrity and initiates inflammation,
apoptosis, and maladaptive remodelling. The KEAP1-NRF2 axis is a central
regulator of cellular antioxidant responses; however, its role in the
development of vein graft disease remains poorly defined. This narrative
review aimed to summarise what is known about NRF2/KEAP1 signalling in
modulating vein graft pathology. Method(s): A systematic search of
PubMed was conducted to identify original research studies examining the
NRF2/KEAP1 pathway in human saphenous vein tissue in vivo or ex vivo.
Narrative synthesis was performed due to limited evidential availability
and study heterogeneity. Result(s): Only one study has directly
evaluated NRF2 pathway activation directly in human saphenous vein tissue,
and it demonstrated that Protandim (a herbal dietary supplement) treatment
increased antioxidant enzyme activity and reduced oxidative stress
markers, including superoxide and 4-hydroxynonenal, both known activators
of MAPK-dependent smooth muscle proliferation. Adjacent studies in other
cells and tissues reveal that NRF2 intersects with multiple pathways
central to vein graft pathology: it suppresses NFkappaB-mediated
inflammation, modulates eNOS-NO signalling, inhibits NADPH oxidase
expression, regulates MAPK activation, and influences angiogenic
responses. However, context-dependent activation of NRF2 under arterial
cyclic stretch can paradoxically drive proliferation through p62-mediated
KEAP1 sequestration and enhanced glutathione synthesis.
 Conclusion(s): The NRF2/KEAP1 pathway serves as a central integrator
of oxidative stress responses that directly intersect with established
mechanisms of intimal hyperplasia and pathological angiogenesis.
Post-translational KEAP1 inhibition may offer a targeted intervention
point to limit these processes. Critical gaps remain regarding our
understanding of the role of NRF2 in human saphenous vein under
physiological arterial conditions and sex-specific pathway regulation.
Mechanistic studies in vein-specific models are essential for advancing
our understanding and any potential therapeutic translation. Copyright
© 2026 by the authors.

<99>
Accession Number
2044079947
Title
Perioperative and Long-Term Cardiorenal Outcomes of SGLT2 Inhibitors in
Cardiac Surgery Patients: A Systematic Review and Meta-Analysis.
Source
Cardiovascular Drugs and Therapy. (no pagination), 2026. Date of
Publication: 2026.
Author
Rajpar N.A.; Meghwar S.; Nabi R.; Khaskheli S.A.; Khan S.; Rehman A.;
Fatima M.; Abbasi S.U.A.M.; Shaikh N.; Nabi Z.; Ahmed S.; Ahmed R.
Institution
(Rajpar) Bilawal Medical College, Liaquat University of Medical and Health
Sciences, Jamshoro, Pakistan
(Meghwar, Khaskheli, Shaikh) Liaquat University of Medical and Health
Sciences, Jamshoro, Pakistan
(Nabi) Islamic International Medical College, Rawalpindi, Pakistan
(Khan) Nishtar Medical University and Hospital, Multan, Pakistan
(Rehman, Abbasi) Allama Iqbal Medical College, Lahore, Pakistan
(Fatima) People's University of Medical and Health Sciences for
Women-Nawabshah, Nawabshah, Pakistan
(Nabi) KRL Hospital, Islamabad, Pakistan
(Ahmed) Sunderland Royal Hospital, Sunderland, United Kingdom
(Ahmed) Newcastle University Medical School, Newcastle, United Kingdom
(Ahmed) The Medical School, Newcastle University, Framlington Place,
Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom
Publisher
Springer
Abstract
Background: Cardiac-surgery-associated acute kidney injury (CSA-AKI)
occurs in 20-30% of patients undergoing valve surgery or CABG and is
linked to prolonged ICU stay, increased costs, and higher mortality.
Sodium-glucose cotransporter 2 inhibitors (SGLT2i), initially for
diabetes, confer cardiovascular and renal protection. We conducted the
first meta-analysis to evaluate perioperative SGLT2i use in cardiac
surgery patients. Method(s): Randomized controlled trials and
observational studies evaluating SGLT2i in cardiac surgery patients were
identified through comprehensive database searches to July 2025. Risk of
bias was assessed with RoB 2.0 and the Newcastle-Ottawa Scale. Pooled
effect estimates were calculated as risk ratios (RR) with 95% confidence
intervals using Mantel-Haenszel random-effects models. Heterogeneity was
quantified with I2, with prespecified subgroup and sensitivity analyses
performed. Result(s): Perioperative SGLT2i use significantly reduced
acute kidney injury (RR 0.39, 95% CI 0.29-0.53; I2=1%). Secondary outcomes
showed reduced heart failure hospitalization (RR 0.49, 95% CI 0.36-0.67;
I2=0%) and major adverse cardiovascular events (RR 0.64, 95% CI 0.48-0.85;
I2=50%). A reduction in mortality was observed (RR 0.51, 95% CI 0.30-0.86;
I2=47%), although this effect was primarily driven by observational
studies and not confirmed in randomized trials. No significant differences
were observed for stroke, myocardial infarction, hypoglycaemia, or urinary
tract infection. Conclusion(s): Perioperative SGLT2 inhibitor use was
associated with improved renal and cardiovascular outcomes after cardiac
surgery. While a mortality benefit was suggested, it was not confirmed in
randomized trials. Larger, high-quality RCTs are required to establish
definitive efficacy and guide perioperative use. Copyright © The
Author(s), under exclusive licence to Springer Science+Business Media,
LLC, part of Springer Nature 2026.

<100>
Accession Number
2044271340
Title
Twin Transformation in Cardiothoracic Surgery: The Convergence of Digital
Innovation and Sustainability.
Source
Journal of Cardiovascular Development and Disease. 13(3) (no pagination),
2026. Article Number: 122. Date of Publication: 01 Mar 2026.
Author
Leivaditis V.; Gottardi R.; Maniatopoulos A.A.; Mulita F.; Pylarinou C.;
Papadoulas S.; Nikolakopoulos K.; Panagiotopoulos I.; Koletsis E.; Dahm
M.; Sepetis A.
Institution
(Leivaditis, Gottardi, Dahm) Department of Cardiothoracic and Vascular
Surgery, Westpfalz Klinikum, Kaiserslautern, Germany
(Maniatopoulos) Department of Electrical and Computer Engineering,
Democritus University of Thrace, Xanthi, Greece
(Mulita) Department of General Surgery, General Hospital of Eastern
Achaia-Unit of Aigio, Aigio, Greece
(Pylarinou) Department of Mechanical and Aeronautical Engineering,
University of Patras, Patras, Greece
(Papadoulas, Nikolakopoulos) Department of Vascular Surgery, General
University Hospital of Patras, Patras, Greece
(Panagiotopoulos) Department of Cardiac Surgery, Hippokration General
Hospital of Athens, Athens, Greece
(Koletsis) Department of Cardiothoracic Surgery, General University
Hospital of Patras, Patras, Greece
(Sepetis) Postgraduate Health and Social Care Management Program,
Department of Business Administration, University of West Attica, Athens,
Greece
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: Cardiothoracic surgery is among the most technologically
advanced and resource-intensive medical specialties, placing it at the
intersection of rapid digital innovation and growing demands for
environmental sustainability. Addressing these parallel pressures requires
integrated strategies that reconcile clinical excellence with ecological
responsibility. Method(s): This narrative review synthesizes
PubMed-indexed literature published over the past two decades,
supplemented by relevant policy documents and guidelines. The review
examines digital transformation and sustainability initiatives in
cardiothoracic surgery through the lens of the twin transformation
framework, which conceptualizes digitalization and sustainability as
interdependent and mutually reinforcing processes. Result(s): Key
domains of digital transformation include artificial intelligence and big
data-driven decision-making, robotic and minimally invasive surgical
techniques, digital twins and simulation-based training, telemedicine and
remote monitoring, and interoperable electronic health records.
Sustainability-related themes encompass the substantial environmental
burden of operating rooms, green surgical practices, sustainable
procurement, and hospital-level decarbonization strategies. Emerging
evidence suggests that aligning digital technologies with sustainability
objectives can improve clinical outcomes, enhance operational efficiency,
and reduce environmental impact. However, current evidence is largely
derived from pilot studies and single-center experiences.
 Conclusion(s): Twin transformation offers a coherent and
forward-looking framework for the future evolution of cardiothoracic
surgery, demonstrating that digital innovation and sustainability can be
synergistic rather than competing goals. While significant challenges
remain-including high implementation costs, limited long-term data, and
fragmented regulatory frameworks-integrating digital health technologies
with sustainable practices represents a promising pathway toward
high-quality, efficient, and environmentally responsible cardiothoracic
care. Copyright © 2026 by the authors.

<101>
Accession Number
2044395174
Title
Skeletonized vsPedicled LIMA in Diabetic Patients Undergoing CABG: A
Meta-Analysis.
Source
Thoracic and Cardiovascular Surgeon. (no pagination), 2026. Date of
Publication: 2026.
Author
Onyeji P.; Momplaisir-Onyeji S.; Consoli L.; Dani S.; Passos F.S.; Doenst
T.; Kirov H.; Caldonazo T.
Institution
(Onyeji) All Saints University School of Medicine, Saint George Parish,
Roseau, Dominica
(Momplaisir-Onyeji) American University of Barbados School of Medicine,
Saint Michael, Saint Michael, Barbados
(Consoli) Universidade Federal da Bahia, Salvador, Bahia, Brazil
(Dani) GMERS Medical College and Hospital, Sola, Gujarat, Ahmedabad, India
(Passos) Mater Dei Hospital, Salvador, Brazil
(Doenst) Department of Cardiothoracic Surgery, University Hospital Jena,
Jena, Germany
(Kirov, Caldonazo) Department of Cardiothoracic Surgery,
Friedrich-Schiller-University Jena, University Hospital, Jena, Germany
Publisher
Georg Thieme Verlag
Abstract
Background The left internal mammary artery (LIMA) remains the preferred
conduit for coronary artery bypass grafting (CABG). However, diabetic
patients face an increased risk of deep sternal wound infection (DSWI),
particularly after pedicled LIMA harvesting, which may impair sternal
perfusion. Skeletonized harvesting preserves sternal vascularity and may
reduce infection risk, but current evidence remains limited and
inconsistent. Methods Three different databases were assessed. The primary
outcome was the occurrence of DSWI. Secondary outcomes were hospital
length of stay (LOS), cardiopulmonary bypass (CPB) time, blood transfusion
rates, and aortic cross-clamp time. A random effects model was performed.
Results Three retrospective studies involving 400 diabetic patients were
included, of whom 190 underwent skeletonized and 210 pedicled LIMA
harvesting. Skeletonized harvesting was associated with significantly
reduced risk of DSWI (odds ratio [OR]: 0.25; 95% confidence interval [CI]:
0.07-0.88; p = 0.031). CPB (mean difference [MD]: 3.03 minutes; 95% CI:
1.18-4.88; p = 0.001) and aortic cross-clamp times (MD: 3.06 minutes; 95%
CI: 2.03-4.10; p < 0.001) were slightly longer in the skeletonized group.
No significant differences were observed in hospital LOS (p = 0.159) or
blood transfusion requirements (p = 0.959). Conclusion Skeletonized LIMA
harvesting is associated with lower odds of DSWI in diabetic patients
undergoing CABG, despite modestly longer operative times. Copyright
© 2026. Thieme. All rights reserved.

<102>
Accession Number
650695722
Title
The Outcomes of Percutaneous Mitral Balloon Valvuloplasty In Patients With
Severe Rheumatic Mitral Stenosis and Left Atrial Appendage Thrombus:
Systematic Review and Meta-Analysis.
Source
The American journal of cardiology. (no pagination), 2026. Date of
Publication: 18 Mar 2026.
Author
Dave P.; Moey M.Y.Y.; Alfaifi A.; Attumalil T.V.; Pandya D.; Fam N.P.;
Alnasser S.M.
Institution
(Dave, Moey, Alfaifi, Attumalil, Pandya, Fam, Alnasser) Structural Heart
Team, Division of Cardiology, St. Michael's Hospital, Toronto, ON, Canada
Abstract
Persistent left atrial appendage thrombus despite anticoagulation is
common. Current guidelines advise against PMBV because of perceived
thromboembolic risk, leaving surgical mitral valve replacement-an option
associated with substantial morbidity-as the primary alternative. However,
the procedural risk of PMBV in the setting of left atrial appendage
thrombus remains poorly established. We conducted a systematic review and
meta-analysis to assess this. Of the 2,136 studies identified in the
initial search, 17 were included in the analysis, comprising 386 patients
undergoing PMBV with LAA thrombus. The rate of stroke or embolic
complication was 2.8% (95% CI 1.4% - 5.5%). No stroke or embolic
complications occurred in Type Ia thrombus. In conclusion, LAA-confined
thrombus (Type 1a) was not associated with embolic events, supporting a
morphology-based approach to patient selection and emphasizing the need
for prospective data to refine the current guidelines. Copyright
© 2026. Published by Elsevier Inc.

<103>
Accession Number
2044290860
Title
WCN26-9053 The Efficacy of Nicorandil in Preventing Contrast-Induced
Nephropathy: A Systematic Review and Meta-Analysis.
Source
Kidney International Reports. Conference: Kidney International Reports.
Yokohama Japan. 11(4 Supplement) (no pagination), 2026. Article Number:
105051. Date of Publication: 01 Apr 2026.
Author
Cervantes P.A.; Villacete C.B.
Institution
(Cervantes, Villacete) Medicine, St. Luke's Medical Center Quezon City,
Quezon City, Philippines
Publisher
Elsevier Inc.
Abstract
Introduction: Contrast-induced nephropathy (CIN) is a common and serious
complication following procedures that use iodinated contrast media,
leading to increased morbidity and mortality. Nicorandil, a potassium
channel opener with vasodilatory effects, has been proposed as a potential
nephroprotective agent. This systematic review and meta-analysis was
conducted to determine the efficacy of nicorandil in preventing CIN in
patients undergoing cardiovascular procedures involving contrast agents.
 Method(s): A systematic review and meta-analysis of randomized
controlled trials (RCTs) was performed. We conducted a comprehensive
search of PubMed, Embase, Cochrane Library, and Google Scholar for RCTs
comparing nicorandil to placebo or standard hydration for CIN prevention.
The primary outcome was the incidence of CIN. A fixed-effects model was
used to calculate the pooled risk ratio (RR) and 95% confidence interval
(CI), as statistical heterogeneity was low. Publication bias was assessed
using a funnel plot. Result(s): Nine RCTs met the inclusion criteria,
comprising a total of 2,276 patients (1,137 randomized to nicorandil and
1,139 to the control group). The pooled analysis showed that nicorandil
administration was associated with a significant 65% reduction in the
incidence of CIN compared to the control group (RR: 0.35, 95% CI:
0.28-0.44, p < 0.00001). No significant heterogeneity was observed across
the included studies (I2 = 0%). The funnel plot analysis was
symmetrical, indicating a low likelihood of publication bias. Sensitivity
analyses suggested that intravenous administration provided the most
reliable estimates of efficacy. Conclusion(s): This meta-analysis
provides strong evidence that nicorandil is an effective intervention for
reducing the risk of contrast-induced nephropathy. Given its significant
protective effect and low heterogeneity across studies, nicorandil should
be considered a valuable adjunct to standard prevention protocols,
particularly for high-risk patients undergoing contrast-based procedures.
I have no potential conflict of interest to disclose. I did not use
generative AI and AI-assisted technologies in the writing
process. Copyright © 2026

<104>
Accession Number
650702859
Title
BSC 45th Annual Congress 2026.
Source
BSC 45th Annual Congress 2026. Conference: 45th Annual Congress of the
Belgian Society of Cardiology, BSC 2026. Brussel Belgium. 81(Supplement 1)
(no pagination), 2026. Date of Publication: 2026.
Author
Anonymous
Publisher
Taylor and Francis Ltd.
Abstract
The proceedings contain 73 papers. The topics discussed include:
validation of new methods assessing aortic valve opening and pulse wave
velocity based on seismocardiography; prolonged rhythm monitoring in
sports cardiology: a comparison of different rhythm monitoring modalities
in endurance athletes; ventricular arrhythmia characteristics and
concomitant atrial behavior: a comparison between ischemic and
non-ischemic cardiomyopathy; impact of age and ablation timing on outcome
after atrial fibrillation radiofrequency ablation; ventricular
fibrillation after amiodarone administration in patients with
Wolff-Parkinson-White Syndrome; a systematic review; percutaneous left
atrial appendage closure with and without simultaneous pulmonary vein
isolation: a single center experience; atrial fibrillation detection
following embolic stroke of undetermined source: a predictive approach; 4D
analysis of left atrial dynamics after pulsed-field ablation; left bundle
branch area pacing (LBBAP) in a real-world monocentric cohort: electrical,
functional and safety outcomes; incidence and risk factors of atrial
fibrillation after percutaneous PFO occlusion: a single-center
retrospective cohort study; determinants of mental and physical health in
patients with an implantable cardioverter-defibrillator - preliminary
results of the QoL-ICD I study; accelerometer-based detection of atrial
fibrillation in a leadless pacemaker cohort; and pulmonary vein isolation
with optimized linear ablation for long-standing persistent atrial
fibrillation in older patients.

<105>
Accession Number
650696264
Title
"Real-world prognostic performance of different severe and advanced heart
failure definitions: data from the Swedish Heart Failure Registry".
Source
The Journal of heart and lung transplantation : the official publication
of the International Society for Heart Transplantation. (no pagination),
2026. Date of Publication: 18 Mar 2026.
Author
Guidetti F.; Lund L.H.; Benson L.; Hage C.; Lindberg F.; Basile C.;
Villaschi A.; Musella F.; Stolfo D.; Scorza R.; Baudry G.; Ljungman C.;
Braun O.; Valente V.; Bozkurt B.; Metra M.; Savarese G.
Institution
(Guidetti) Department of Clinical Science and Education, Sodersjukhuset;
Karolinska Institute; Stockholm, Sweden; Department of Cardiology,
University Cardiovascular Center, Bern University Hospital, Inselspital,
Bern, Switzerland
(Lund, Hage) Division of Cardiology, Department of Medicine, Karolinska
Institutet, Stockholm, Sweden
(Benson) Department of Clinical Science and Education, Sodersjukhuset;
Karolinska Institute; Stockholm, Sweden; Division of Cardiology,
Department of Medicine, Karolinska Institutet, Stockholm, Sweden
(Lindberg, Basile, Scorza, Valente, Savarese) Department of Clinical
Science and Education, Sodersjukhuset; Karolinska Institute; Stockholm,
Sweden
(Villaschi) Department of Clinical Science and Education, Sodersjukhuset;
Karolinska Institute; Stockholm, Sweden; Department of Biomedical
Sciences, Humanitas University, Pieve Emanuele-Milan, Italy
(Musella) Department of Clinical Science and Education, Sodersjukhuset;
Karolinska Institute; Stockholm, Sweden; Cardiology Department, Santa
Maria delle Grazie Hospital, Naples, Italy
(Stolfo) Department of Clinical Science and Education, Sodersjukhuset;
Karolinska Institute; Stockholm, Sweden; Division of Cardiology,
Cardiovascular Department, Azienda Sanitaria Universitaria Integrata di
Trieste (ASUITS), Trieste, Italy
(Baudry) Universite de Lorraine, INSERM, Centre d'Investigations Cliniques
Plurithematique, INSERM 1433, CHRU de Nancy, Institut Lorrain du Coeur et
des Vaisseaux, Nancy, France; REICATRA, Universite de Lorraine,
Vandoeuvre-les-Nancy, France
(Ljungman) Department of Molecular and Clinical Medicine, Institute of
Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg,
Sweden
(Braun) Department of Clinical Sciences, Lund University and Skane
University Hospital, Lund, Sweden
(Bozkurt) Winters Center for Heart Failure Research, Cardiovascular
Research Institute, Baylor College of Medicine, Houston, TX, United States
(Metra) Department of Medical and Surgical Specialties, Radiological
Sciences and Public Health, University of Brescia, Brescia, Italy
Abstract
BACKGROUND: A valid definition of severe heart failure (HF) is essential
for earlier identification, timely referral for advanced therapies, and to
optimize clinical trial design. OBJECTIVE(S): To assess the
prevalence, prognostic performance, and 1-year outcomes associated with
different definitions of severe and advanced HF (AdvHF) in patients with
heart failure with reduced ejection fraction (HFrEF). METHOD(S): We
included 15,153 patients with EF <40%, HF duration >6 months, and no prior
left ventricular assist device or heart transplant, from the Swedish Heart
Failure Registry. Several definitions of severe/AdvHF were evaluated: a
simplified Heart Failure Association (HFA) definition (NYHA III-IV, EF
<30%, >=2 HF hospitalizations in 12 months), the
GALACTIC-Severe-definition (NYHA III-IV, EF <30%, >=1 hospitalization in 6
months), and variations adding/removing criteria such as NT-proBNP levels
and diuretic dose to the HFA-AdvHF definition. Predictive performance and
1-year outcomes were analyzed. RESULT(S): The HFA-definition
identified 6.4% of patients, with a 1-year cardiovascular death/HF
hospitalization risk of 70% and all-cause mortality of 45% (AUC = 0.72).
The GALACTIC-Severe definition identified 12.6% of patients with slightly
lower but still substantial event rates (59% and 38%, respectively; AUC =
0.73). Definitions incorporating NT-proBNP >=2000 pg/ml had the highest
prognostic accuracy (AUC = 0.75). CONCLUSION(S): The HFA-AdvHF
definition selected a smaller, high-risk group, while the GALACTIC-Severe
criteria identified a broader population, with a lower, but still high
risk. NT-proBNP, HF hospitalization history, and diuretic dose might
represent valuable enrichment tools for future trials. Copyright
© 2026 International Society for the Heart and Lung Transplantation.
Published by Elsevier Inc. All rights reserved.

<106>
Accession Number
2044427047
Title
Brain protection during transcatheter aortic valve implantation: clinical
case study.
Source
Clinical and Experimental Surgery. 13(1) (pp 120-126), 2025. Date of
Publication: 2025.
Author
Tarasova I.V.; Tarasov R.S.; Kupriyanova D.S.; Sosnina A.C.; Syrova I.D.;
Trubnikova O.A.; Ganyukov V.I.
Institution
(Tarasova, Tarasov, Kupriyanova, Sosnina, Syrova, Trubnikova, Ganyukov)
Research Institute of Complex Issues of Cardiovascular Diseases, Kemerovo,
Russian Federation
Publisher
Geotar Media Publishing Group
Abstract
This article describes transcatheter aortic valve implantation (TAVI) with
and without the brain embolism protection system (BPS). A clinical case
study shows that the use of the Sentinel TM CPS BPS prevented
deterioration of the neurophysiological status in the early postoperative
period of TAVI. A randomized prospective study is needed to evaluate the
effect of BPS on a relevant sample of patients. Copyright All articles
in our journal are distributed under the Creative Commons Attribution 4.0
International License (CC BY 4.0 license)
https://creativecommons.org/licenses/by/4.0/deed.en

<107>
Accession Number
2044473447
Title
Radial Versus Femoral Secondary Access in Patients Undergoing TAVI:
Rationale and Design of the RADIAL-TAVI Trial.
Source
American Journal of Cardiology. 265 (pp 27-31), 2026. Date of Publication:
15 Apr 2026.
Author
von Ehr A.; Zeymer U.; Schneider S.; Besler C.; Valina C.; Seiffert M.;
Mahfoud F.; Sossalla S.; Hilgendorf I.; Wolf D.; Moser M.; Ziegler L.;
Niehoff M.; Olivier C.B.; Westermann D.; von zur Muhlen C.
Institution
(von Ehr, Zeymer, Besler, Valina, Hilgendorf, Wolf, Moser, Ziegler,
Niehoff, Olivier, Westermann, von zur Muhlen) Department of Cardiology and
Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of
Medicine, University of Freiburg, Freiburg, Germany
(Schneider) Institut fur Herzinfarktforschung, Ludwigshafen am Rhein,
Germany
(Seiffert) Department of Cardiology and Angiology, BG University Hospital
Bergmannsheil, Ruhr-University Bochum, Bochum, Germany
(Mahfoud) Department of Cardiology, Biomedical Engineering and
Biomedicine, University Heart Center, University Hospital Basel, Basel,
Switzerland
(Sossalla) Department of Cardiology, Campus Kerckhoff of the
Justus-Liebig-University Giessen, Kerckhoff-Klinik, Bad Nauheim, Germany
(Sossalla) German Center for Cardiovascular Research (DZHK), Partner Site
Rhine-Main, Bad Nauheim, Germany
(Sossalla) Department of Cardiology and Angiology, Medical Clinic I,
University Hospital Giessen, Justus-Liebig-University Giessen, Giessen,
Germany
(Hilgendorf) DZHK (German Centre for Cardiovascular Research), Berlin,
Germany
(Hilgendorf) Department of Cardiology, Angiology and Intensive Care
Medicine, Deutsches Herzzentrum der Charite (DHZC), Campus Virchow
Klinikum, Berlin, Germany
Publisher
Elsevier Inc.
Abstract
Transcatheter aortic valve implantation (TAVI) has become the standard
treatment for patients with severe symptomatic aortic stenosis (AS) across
most surgical risk categories. Despite its minimally invasive nature,
transfemoral TAVI requires both a primary and a secondary arterial access
site. While the femoral artery is most commonly used for secondary access,
vascular and bleeding complications remain frequent and are associated
with adverse outcomes. Observational evidence from TAVI cohorts suggests
that radial secondary access may reduce such complications compared to
femoral access. The RADIAL-TAVI trial is a prospective, randomized,
controlled, multicenter, open-label study designed to compare radial
versus femoral secondary access in patients undergoing transfemoral TAVI.
A total of 434 patients will be randomized in a 1:1 ratio. The primary
endpoint is the incidence of vascular and bleeding complications at the
secondary access site within 30 days, adjudicated according to VARC-3
criteria. Secondary endpoints include early safety, cardiovascular
mortality, major adverse cardiovascular and cerebrovascular events
(MACCE), quality of life, and health economic aspects up to 30 days, as
well as long-term mortality up to 12 months. The study is powered to
detect a reduction in the primary endpoint from 8% with femoral to 2% with
radial access. The RADIAL-TAVI trial will provide the first randomized
evidence on the optimal secondary access strategy in transfemoral TAVI. If
radial access proves superior, it has the potential to redefine standard
practice, reduce complication rates, and improve patient safety and
outcomes. Copyright © 2026 The Author(s). Published by Elsevier
Inc. This is an open access article under the CC BY license.
http://creativecommons.org/licenses/by/4.0/

<108>
Accession Number
2044266655
Title
Meta-Analysis: Prevalence and Incidence of Gastroparesis Following Lung or
Heart Transplantation.
Source
Alimentary Pharmacology and Therapeutics. (no pagination), 2026. Date of
Publication: 2026.
Author
Eldesouki M.H.; Marey M.M.; Ali M.A.; Genidy A.M.; Gamal M.H.; Othman
A.M.; Mohamed A.N.; Al Qady A.; Amaris M.A.; Sharma A.
Institution
(Eldesouki) Department of Internal Medicine, New York Medical College, St
Michael Medical Center, Newark, NJ, United States
(Marey) Department of Internal Medicine, Faculty of Medicine, Alexandria
University, Alexandria, Egypt
(Ali) Qena Faculty of Medicine, Qena University, Qena, Egypt
(Genidy, Gamal) Faculty of medicine, Tanta University, Tanta, Egypt
(Othman) Department of Internal Medicine, Faculty of Medicine, Kafr
El-Sheik University, Kafr El-Sheik, Egypt
(Mohamed) Division of Gastroenterology and Hepatology, Cleveland Clinic
Foundation, Cleveland, OH, United States
(Al Qady, Amaris) Division of Gastroenterology and Hepatology, Department
of Internal Medicine, University of Florida, Gainesville, FL, United
States
(Sharma) Division of Gastroenterology and Hepatology, Department of
Internal Medicine, Medical University of South Carolina, Charleston, SC,
United States
Publisher
John Wiley and Sons Inc
Abstract
Background: Gastroparesis is a recognized complication after thoracic
organ transplantation that impairs nutrition, medication absorption, and
graft outcomes. Aim(s): This study aimed to quantify the risk of
gastroparesis following lung (LT) and combined heart-lung transplantation
(HLT). Method(s): A systematic search of PubMed, Embase, Scopus, and
Web of Science from inception to January 2025 identified studies reporting
gastroparesis after LT or HLT in adult cohorts with objective diagnostic
testing. Random-effects meta-analysis was used to pool prevalence and
incidence, with subgroup analyses by transplant type, and diagnostic
modality, and meta-regression asessing the effects of age and sex.
 Result(s): Twenty-one studies, including 2888 patients, met the
inclusion criteria. The pooled prevalence of gastroparesis was 31.87% (95%
CI: 19.88-46.87). Subgroup analysis revealed a higher prevalence of
gastroparesis in combined HLT recipients (44.89%, 95% CI: 17.05-76.35)
compared to LT only (26.95%, 95% CI: 15.46-42.68), though this difference
was not statistically significant (p = 0.31). The overall incidence was
25.67% (95% CI: 15.07-40.41), with HLT recipients showing a higher
incidence (35.79%, 95% CI: 20.73-54.29) than LT only (19.38%, 95% CI:
8.3-38.9). Conclusion(s): Gastroparesis affects nearly one-third of
thoracic transplant recipients, with a numerically higher burden after HLT
transplantation. There was no association between age and gender and the
prevalence of post-transplant gastroparesis. Copyright © 2026 The
Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley
& Sons Ltd.

<109>
Accession Number
2044260268
Title
Lifetime Management of Aortic Stenosis: Evolving Strategies and
Personalized Decision-Making.
Source
Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number:
2269. Date of Publication: 01 Mar 2026.
Author
Mansour C.M.; Nguyen L.-C.L.; Sagebin F.; Frangieh A.H.
Institution
(Mansour, Nguyen, Frangieh) Mary & Steve Wen Cardiovascular Division,
University of California Irvine, Irvine, CA, United States
(Sagebin) Division of Cardiac Surgery, University of California Irvine,
Irvine, CA, United States
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background: The landscape surrounding aortic stenosis continues to evolve
as transcatheter aortic valve replacement (TAVR) is increasingly performed
in younger and lower-risk patients who are likely to outlive their index
prosthesis. With the rapid evolution in management of aortic stenosis,
treatment has shifted from a single-procedure paradigm toward a lifetime
strategy that anticipates future reinterventions. Therefore, having a
foundational understanding and a thoughtful strategy when selecting the
index procedure is paramount. Objective(s): The objectives of this
review article are to review contemporary evidence and provide a
structured framework for lifetime management of severe AS. We focus on
optimizing index valve selection and planning durable, safe pathways for
subsequent reinterventions. Conclusion(s): Lifetime management of
aortic stenosis requires a forward-looking, patient-centered Heart Team
approach that extends beyond immediate procedural success. Strategic
selection of the index valve intervention is crucial, and this is guided
by anatomy, life expectancy, comorbidities, patient preference, and future
reintervention feasibility. Together, these factors are essential to
optimize long-term outcomes. As treatment paradigms continue to evolve,
anticipatory planning and advanced simulation technologies will play an
increasingly central role in delivering durable personalized care for
patients with severe AS. Copyright © 2026 by the authors.

<110>
Accession Number
2044326699
Title
Myocardial Injury After Non-Cardiac Surgery in Otolaryngology: Evidence
Gaps and a Systematic Review.
Source
Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number:
2186. Date of Publication: 01 Mar 2026.
Author
Domka J.; Kasza R.; Zietek L.; Smyla-Gruca W.; Antkowiak M.; Koniewska A.;
Gamrot-Wrzol M.; Kowalski D.; Misiolek H.; Misiolek M.; Bialka S.
Institution
(Domka) Clinical Department of Anaesthesiology and Intensive Care,
University Clinical Hospital Fryderyk Chopin in Rzeszow, Rzeszow, Poland
(Kasza, Zietek, Smyla-Gruca) Student Scientific Society of Anesthesiology
and Intensive Care, Department of Anesthesiology and Intensive Care,
Medical University of Silesia, Zabrze, Poland
(Antkowiak, Koniewska, Gamrot-Wrzol, Misiolek) Department of
Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical
University of Silesia, Zabrze, Poland
(Kowalski, Misiolek, Bialka) Department of Anesthesiology and Intensive
Care, Medical University of Silesia, Zabrze, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Background/Objectives: Myocardial injury after non-cardiac surgery (MINS)
is a common and serious postoperative complication. Its largely
asymptomatic course hampers early recognition, highlighting the importance
of systematic biomarker monitoring. The aim of this review is to summarize
current evidence on the diagnosis, risk factors, and management of MINS,
with a focus on otolaryngology, where intraoperative hypotensive
techniques may increase risk. Method(s): A basic science review was
conducted using PubMed, Embase, and the Cochrane Library (2005-2025). From
2712 records, 30 studies met the inclusion criteria after removing
duplicates, screening titles/abstracts, and full-text assessment. These
studies formed the basis for the final analysis. Result(s):
Observational studies and reviews identify perioperative troponin
monitoring as the diagnostic gold standard. However, no evidence-based
management guidelines exist, and otorhinolaryngology-specific data remain
rare but not entirely absent. Troponin elevation in the early
postoperative period reliably predicts adverse outcomes. While MINS is
well documented in vascular and orthopedic surgery, evidence in
otolaryngology is limited. Controlled hypotension in procedures such as
functional endoscopic sinus surgery or head and neck tumor resection may
further elevate risk. Conclusion(s): MINS is an underrecognized
complication with major prognostic significance. The lack of standardized
management and the absence of large otolaryngology cohorts underscore an
urgent need for targeted research and specialty-specific guidelines and
support the justification for integrating existing evidence into
otolaryngologic practice. Copyright © 2026 by the authors.

<111>
Accession Number
2044447014
Title
Randomized, sham-controlled trial of intraoperative ticagrelor removal to
reduce perioperative bleeding.
Source
Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2026.
Date of Publication: 2026.
Author
Mack M.J.; Whitlock R.; Chu M.W.A.; Taylor B.; Zias E.A.; Liu D.; Protos
A.N.; Rokkas C.; Pelletier M.; Choi C.W.; Saha T.; Sellke F.W.; Schneider
D.J.; Thourani V.H.; Douketis J.; Mazer C.D.; Fan W.; Deliargyris E.N.;
Gibson C.M.
Institution
(Mack) Cardiovascular Surgery, Baylor Scott & White Health, Dallas, Tex,
United States
(Whitlock) Cardiovascular Surgery, Population Health Research Institute,
Hamilton, Canada
(Chu) Division of Cardiac Surgery, Western University, London Health
Sciences Centre, London, Canada
(Taylor) Division of Cardiac Surgery, University of Maryland Medical
Center, Baltimore, Md, United States
(Zias) Department of Cardiothoracic Surgery, NYU Langone School of
Medicine, New York, NY, United States
(Liu) Department of Cardiac Surgery, Beth Israel Deaconess Medical Center,
Boston, Mass, United States
(Protos) Division of Cardiac Surgery, University of Mississippi Medical
Center, Jackson, Miss, United States
(Rokkas) Division of Cardiac Surgery, University of Wisconsin, Madison,
Wis, United States
(Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New
Haven, Conn, United States
(Choi) Division of Cardiothoracic Surgery, Virtua Health, Cherry Hill, NJ,
United States
(Saha) Division of Cardiac Anesthesia, Kingston General Hospital,
Kingston, Canada
(Sellke) Division of Cardiothoracic Surgery, Rhode Island Hospital,
Providence, RI, United States
(Schneider) Department of Medicine, Cardiovascular Research Institute,
University of Vermont, Burlington, VT, United States
(Thourani) Department of Cardiovascular Surgery, Piedmont Heart Institute,
Atlanta, GA, United States
(Douketis) Department of Medicine, Thrombosis and Atherosclerosis Research
Institute, McMaster University, Hamilton, Canada
(Mazer) Department of Anesthesia, St. Michael's Hospital, University of
Toronto, Toronto, Canada
(Fan, Deliargyris) CytoSorbents Corporation, Princeton, NJ, United States
(Gibson) Department of Medicine, Beth Israel Deaconess Medical Center,
Boston, Mass, United States
(Gibson) Baim Institute for Clinical Research, Boston, Mass, United States
Publisher
Elsevier Inc.
Abstract
Objective: Patients on ticagrelor who are undergoing cardiac surgery
before completing guideline-recommended washout are at high risk for
severe bleeding. This study evaluated whether a novel drug removal device
reduces bleeding in patients operated within 2 days from ticagrelor
discontinuation. Method(s): Eligible patients were randomized 1:1 to
intraoperative DrugSorb-ATR or sham control. Primary safety end point was
adverse events at 30 days. Efficacy was assessed by composite end points
comprising bleeding events using Universal Definition of Perioperative
Bleeding (UDPB) and 24-hour chest tube drainage (CTD) in the overall and
isolated coronary artery bypass grafting (CABG) populations with a
hierarchical win ratio (WR) method. Result(s): In total, 140 patients
were randomized; 132 had surgery and received a study device; and 92% were
isolated CABG. Mean age was 65 +/- 5 years, and 15% were female. The
primary safety end point was met, with similar adverse events reported
between groups. The primary efficacy end point was not met in the overall
or CABG populations (Win ratio [WR], 1.07; 95% CI, 0.72-1.58; P = .748 and
WR, 1.33; 95% CI, 0.86-2.04; P = .202 respectively). The supplementary
efficacy end point was met in the CABG population (WR, 1.59; 95% CI,
1.02-2.46, P = .041) with significant reductions also shown in large CTD
bleeding events (P = .016) and major bleeding, a composite of severe
bleeding events or 24-hour CTD >=1 L (P = .041). The number needed to
treat to prevent a major bleed was 6. Conclusion(s): Intraoperative
use of DrugSorb-ATR is safe in patients operated within 2 days of
ticagrelor discontinuation. Although the primary end point was not met in
the overall population, there were significant reductions in severe
bleeding events in the prespecified CABG population. Copyright ©
2026 The American Association for Thoracic Surgery

<112>
Accession Number
650689140
Title
Association between different biomarkers and mortality in moderate or
asymptomatic severe aortic stenosis: A systematic review.
Source
Medicina clinica. 166(6) (pp 107408), 2026. Date of Publication: 18 Mar
2026.
Author
Carneiro J.A.; Costa A.R.; Araujo C.
Institution
(Carneiro) Faculdade de Medicina, Universidade do Porto, Porto, Portugal
(Costa) EPIUnit ITR, Instituto de Saude Publica da Universidade do Porto,
Universidade do Porto, Porto, Portugal; Departamento de Ciencias da Saude
Publica e Forenses e Educacao Medica, Faculdade de Medicina, Universidade
do Porto, Porto, Portugal
(Araujo) EPIUnit ITR, Instituto de Saude Publica da Universidade do Porto,
Universidade do Porto, Porto, Portugal; Departamento de Ciencias da Saude
Publica e Forenses e Educacao Medica, Faculdade de Medicina, Universidade
do Porto, Porto, Portugal; Unidade Local de Saude do Medio Ave, Santo
Tirso, Portugal
Abstract
Circulating biomarkers may enhance risk stratification and guide treatment
in diseases with heterogeneous prognosis, namely in moderate and
asymptomatic severe aortic stenosis (AS). Therefore, this study aims to
assess the association between biomarkers and mortality in patients with
these diseases. MEDLINE, Web of Science, and Scopus were searched from
inception up to January 2025. Cohort studies evaluating BNP, NT-proBNP,
troponin, galectin-3 or ST2, before aortic valve replacement, and
reporting mortality outcomes, were eligible. Two independent reviewers
performed screening, data extraction and quality assessment. A total of
ten studies were included: five focused on BNP and the other five on
NT-proBNP. Despite methodological heterogeneity and a high risk of bias in
most studies, a positive association was observed between high levels of
these biomarkers and mortality. Further research should ascertain
biomarkers' standardized thresholds, as well as the prognostic role of
other biomarkers in this population. Copyright © 2026 Elsevier
Espana, S.L.U. All rights reserved.

<113>
Accession Number
650687028
Title
Transradial vs Transfemoral Access for Cerebral Angiography: A Randomized
Noninferiority Clinical Trial.
Source
JAMA network open. 9(3) (pp e261929), 2026. Date of Publication: 02 Mar
2026.
Author
Ni W.; Yang H.; Su J.; Peng Y.; Lin Z.; Sun J.; Li Y.; Wang J.; Wan S.; Ye
X.; Zhang Q.; Wang D.; Gao C.; Jiang H.; Gao X.; Zhang Y.; Han B.; Cao J.;
Zhu X.; Zhou S.; Zeng Y.; Chen F.; Lin Y.; Ba H.; Chen X.; Liu X.; Hao J.;
Sun Z.; Li M.; Wang M.; Xie D.; Zhuang Z.; Shi L.; Zhou L.; Tang H.; Chen
D.; Anderson C.S.; Kang D.; Gu Y.
Institution
(Ni, Yang, Su, Gao, Jiang, Gao, Gu) Department of Neurosurgery, Huashan
Hospital, Fudan University, Shanghai, China
(Peng, Cao, Zhu) Department of Neurosurgery, First People's Hospital of
Changzhou, Changzhou, China
(Wang, Chen, Lin, Kang) Department of Neurosurgery, First Affiliated
Hospital of Fujian Medical University, Fuzhou, China
(Lin, Zhou, Zeng) Department of Neurosurgery, First Affiliated Hospital of
Ningbo University, Ningbo, China
(Sun, Ba, Chen) Department of Neurosurgery, Panvascular Disease Management
Center, Wenzhou Central Hospital, Wenzhou, China
(Chen, Liu) Department of Neurosurgery, Affiliated Zhongshan Hospital of
Fudan University, Qingpu Branch, Shanghai, China
(Wang, Hao) Department of Neurosurgery, Liaocheng People's Hospital,
Liaocheng, China
(Li, Sun) Department of Neurosurgery, Shanghai Ninth People's Hospital,
Shanghai Jiao Tong University School of Medicine, Shanghai, China
(Wang, Li) Department of Neurosurgery, Southern Central Hospital of Yunnan
Province, China
(Wan, Wang) Department of Neurosurgery, Zhejiang Hospital, Hangzhou, China
(Ye, Xie) Department of Neurosurgery, Sir Run Run Shaw Hospital, Hangzhou,
China
(Zhang, Zhuang) Department of Neurosurgery, Nanjing Drum Tower Hospital,
Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
(Wang, Shi) Department of Neurosurgery, Qilu Hospital of Shandong
University Dezhou Hospital, Dezhou, China
(Zhang) Department of Neurology, Zhongshan Hospital, Fudan University,
Shanghai, China
(Han) Department of Neurosurgery, Second People's Hospital of Dongying,
Dongying, China
(Zhou, Tang, Chen) ShanghaiChina
(Anderson) Institute for Science and Technology for Brain-inspired
Intelligence, Fudan University, Shanghai, China
(Anderson) George Institute for Global Health, University of New South
Wales, Sydney, Australia
(Anderson) Neurology Department, Royal Prince Alfred Hospital, Sydney,
Australia
(Gu) Department of Neurosurgery, National Regional Medical Center, Fujian
Medical University, Binhai Campus of the First Affiliated Hospital,
Fuzhou, China
Abstract
Importance: Transradial access (TRA) has emerged as a promising
alternative to standard transfemoral access (TFA) for interventional
cardiac procedures, but its application for examination of the cerebral
circulation has not been tested in a clinical trial. Objective(s): To
compare the efficacy and safety of TRA with TFA for diagnostic cerebral
angiography. Design, Setting, and Participant(s): This
investigator-initiated, multicenter, open-label, noninferiority randomized
clinical trial with a blinded outcome assessment was conducted at 13 sites
in China. Patients eligible for cerebral angiography were randomized
between September 15, 2023, and November 4, 2024, with final follow-up
performed on November 27, 2024. The primary analysis was performed in the
intention-to-treat population; secondary analyses were performed in the
per-protocol population. Intervention(s): Patients were randomly
allocated to TRA (n = 431) or TFA (n = 430) for diagnostic cerebral
angiography. Main Outcomes and Measures: The primary outcome was the
success of diagnostic cerebral angiography. Secondary outcomes were
success in achieving an accurate diagnosis, duration of angiography and
fluoroscopy, time in bed, and patient-reported satisfaction on an 11-point
visual analog scale for pain (ranging from 0 [none] to 10 [worst
possible]) within 24 hours after the procedure. The noninferiority margin
was an absolute difference of 5% in success of angiographic diagnosis and
success of accurate diagnosis. Result(s): A total of 858 patients
(median age, 58.4 [IQR, 52.0-67.0] years; 479 [55.8%] male) completed the
trial. Success of diagnostic cerebral angiography in the TRA group was
lower than that in the TFA group (392 of 431 [91.0%] vs 409 of 427
[95.8%]; difference, -4.8 percentage points [pp] [95% CI, -8.1 to -1.5
pp]; relative risk [RR], 0.95 [95% CI, 0.92-0.98]; P = .46 for
noninferiority test). The success rate of accurate diagnosis was 78.9% in
the TRA group vs 91.1% in the TFA group (difference, -12.2 pp [95% CI,
-16.9 to -7.5 pp]; RR, 0.87 [95% CI, 0.82-0.92]; P = .99 for
noninferiority test). Compared with the TFA group, the TRA group had
longer median times for angiography (33.7 [IQR, 23.0-40.0] vs 38.7 [IQR,
26.0-47.0] minutes; P < .001) and fluoroscopy (10.6 [IQR, 5.6-12.9] vs
11.8 [IQR, 6.2-15.0] minutes; P = .02); the TRA group had significantly
shorter median time in bed (188.4 [IQR, 3.0-180.0] vs 1079.0 [IQR,
842.0-1366.0] minutes; P < .001) and lower median pain scores (0.5 [IQR,
0.0-1.0] vs 0.7 [IQR, 0.0-1.0]; P < .001). Overall angiography
complications were comparable between the groups (19 of 445 [4.3%] vs 25
of 413 [6.1%]; P = .28), but TRA had more radial artery puncture failures
than TFA. Conclusions and Relevance: In this randomized clinical
trial of patients undergoing diagnostic cerebral angiography, TRA was not
shown to be noninferior to TFA with regard to the success rate of
diagnostic cerebral angiography. Additional research, including
superiority trials, is needed to clearly define the comparative benefits
of TRA and TFA. Trial Registration: ClinicalTrials.gov Identifier:
NCT05401669.

<114>
Accession Number
650688366
Title
Antithrombin Concentrate in Congenital and Acquired Antithrombin
Deficiency: Two Phase 3 Studies.
Source
Hamostaseologie. Conference: GTH Congress 2026 - 70th Annual Meeting of
the Society of Thrombosis and Haemostasis Research - Connected Science -
Advanced Solutions. Bonn Germany. 46(Supplement 1) (pp S11-S12), 2026.
Date of Publication: 01 Feb 2026.
Author
Kessler C.M.; Solomon C.; Weisz T.-E.; Werner S.; Knaub S.; Levy J.H.
Institution
(Kessler) Georgetown University Medical Center, Georgetown, United States
(Solomon, Knaub) Octapharma AG, Lachen, Switzerland
(Weisz) Octapharma Pharmazeutika Produktionsgesellschaft, mbH, Vienna,
Austria
(Werner) Octapharma, USA, Inc, Paramus, United States
(Levy) Duke University School of Medicine, Durham, United States
Publisher
Georg Thieme Verlag
Abstract
Introduction Antithrombin concentrates are used to treat patients with
inherited (congenital) or acquired antithrombin deficiency. Acquired
deficiency can result from conditions such as disseminated intravascular
coagulopathy, prior heparin therapy, or major surgeries such as cardiac
surgery with cardiopulmonary bypass (CPB). Several commercial antithrombin
concentrates with different compositions and purities are available for
use. Octapharma's plasma-derived, highly purified, double
virus-inactivated, lyophilized antithrombin concentrate is established as
safe and effective for use in many European countries; however, it is not
yet approved for the treatment of congenital or acquired antithrombin
deficiency in the United States (US). Production of this antithrombin
concentrate involves two independent pathogen inactivation steps and a
specific cleansing step to remove denatured antithrombin. Due to its high
purity, the final product does not require heparin as a stabiliser. Two
prospective Phase 3 studies, ATN-106 and ATN-108, aim to provide
additional evidence on the efficacy and safety of this antithrombin
concentrate. Method ATN-106 (NCT04918173) is a multicentre, open-label,
uncontrolled study to assess the efficacy, safety, and pharmacokinetics of
Octapharma's antithrombin concentrate in patients with congenital
antithrombin deficiency undergoing surgery or childbirth. ATN-108
(NCT06096116) is a multicentre, double-blind, placebo-controlled study in
heparin-resistant patients with acquired antithrombin deficiency scheduled
for cardiac surgery necessitating CPB. The protocol for ATN-108 was
recently amended to include a revised dosing regimen and additional study
sites/regions. ATN-106 and ATN-108 are funded by Octapharma and conducted
according to the ethical principles outlined in the Declaration of
Helsinki. Patient consent is required for both studies. Further details of
ATN-106 and ATN-108 are shown in Figure 1,2, respectively. Results ATN-106
is ongoing across 30 sites in 14 countries worldwide. The study started in
Q3 2022, has enrolled 22 patients to date, and is anticipated to conclude
in Q2 2026. ATN-108 started in Q3 2024 and 22 patients were enrolled.
Recruitment will target 120 patients with the protocol amendment. ATN-108
will be conducted across 40 sites worldwide and is now expected to end in
Q1 2028. Conclusion The results of both ATN-106 and ATN-108 aim to provide
further evidence on the efficacy and safety of this antithrombin
concentrate in patients with congenital antithrombin deficiency undergoing
surgery or childbirth, and in those with acquired deficiency scheduled for
cardiac surgery necessitating CPB, respectively.

<115>
Accession Number
650689267
Title
Unidirectional valve apparatus improved nondependent lung collapsing
during one-lung ventilation in daytime thoracic surgery: A prospective
randomized controlled trial.
Source
IAAS 15th International Congress on Ambulatory Surgery. Conference: 15th
Congress of the International Association of Ambulatory Surgery, IAAS
2024. Oslo Norway. 30(2) (pp 24), 2024. Date of Publication: 01 Jun 2024.
Author
Liang P.; Tang M.-Y.; Wu H.
Institution
(Liang, Tang, Wu) West China Hospital, Sichuan University, China
Publisher
International Association for Ambulatory Surgery
Abstract
Aims Good collapse of the nondependent lung is very important for thoracic
surgery, especially in day surgery patient.While passive ventilation
because of mediastinum movement from dependent lung ventilation results in
tidal movement and affects nondependent lung collapsing during one lung
ventilation (OLV). We assumed that unidirectional valve apparatus,
blocking room air entry into independent lung would improve lung
collapsing. Methods Design: A prospective randomized controlled trial.
 Patient(s): 60 patients with double lumen tubes (DLTs) for
thoracoscopic day time surgeries in day surgery ward or thoracic surgery
ward were randomly divided into two groups (conventional OLV, COLV;
unidirectional valve OLV, UOLV). Intervention(s): In the UOLV group,
the distal port of the nondependent lumen of DLTs was connected with a
unidirectional valve apparatus which gas only goes out but not in.
Measurements: The primary outcome included lung collapse score at
different setting points by a verbal rating scale scored from 0 to 10, and
the duration from pleural opening to satisfactory lung collapse. Secondary
outcome included intraoperative and postoperative complications. Results
Duration from pleural opening to satisfactory lung collapse was
significantly shorter in the UOLV group, with the median lung collapse
time 3 (1-5) minutes in UOLV groupv.s.5 (5-9) minutes in COLV group,
P=0.003.At 0, 5 and 10 minutes after pleural opening, lung collapse score
in the UOLV group was higher than COLV group. None of patients showed
related complications include intraoperative hypoxemia and PPCs.
Conclusions The unidirectional valve apparatus can improve nondependent
lung collapsing during OLV, and do not affect intraoperative and
postoperative complications.

<116>
[Use Link to view the full text]
Accession Number
650686328
Title
Stroke Risk After Bioprosthetic Aortic Valve Replacement in Aortic
Stenosis: Systematic Review and Meta-Analysis.
Source
Stroke. (no pagination), 2026. Date of Publication: 20 Mar 2026.
Author
Bou Dargham T.; Hassani S.; Mac Grory B.C.; Daubert M.A.; Ryan D.; Truong
T.; Moumneh M.B.; Kaplan S.; Feng W.; El Husseini N.
Institution
(Bou Dargham) Department of Neurosurgery (T.B.D.), Duke University School
of Medicine, Durham, NC, United States
(Hassani) Department of Neurology, Feinberg School of Medicine
Northwestern University
(Mac Grory, Ryan, Feng, El Husseini) Department of Neurology (B.C.M.G.,
D.R., Duke University School of Medicine, Durham, NC, United States
(Daubert) Division of Cardiology, Department of Medicine (M.A.D.), Duke
University School of Medicine, Durham, NC, United States
(Truong) Department of Biostatistics & Bioinformatics (T.T.), Duke
University School of Medicine, Durham, NC, United States
(Moumneh) Inova Center of Outcomes Research, Inova Heart and Vascular,
Fairfax, United States
(Kaplan) Medical Center Library & Archives (S.K.), Duke University School
of Medicine, Durham, NC, United States
Abstract
BACKGROUND: Stroke is a possible complication after bioprosthetic aortic
valve replacement (AVR) for severe aortic stenosis (AS), impacting
morbidity and mortality. Accurate estimates of the proportion of
individuals who experience stroke within and beyond the periprocedural
period after transcatheter AVR (TAVR), surgical AVR, and valve-in-valve
(ViV) replacement are essential for management and prognostication. The
objective was to determine the proportion of adults aged >18 who
experienced an ischemic stroke after bioprosthetic AVR for AS.
 METHOD(S): A systematic search of MEDLINE, Embase, and Web of Science
was conducted from database inception through March 2024. Studies
reporting on stroke rates at least 90 days after bioprosthetic AVR for
severe AS, including ViV procedures, and meeting predefined eligibility
criteria were included. The pooled proportion of individuals experiencing
a stroke was estimated for TAVR and ViV procedures, whereas comparative
analyses between TAVR and surgical AVR were performed using mixed-effects
models in studies directly comparing both procedures. RESULT(S):
Twenty-seven studies were included in the native AS treatment cohort, and
5 in the ViV subanalysis. In native AS, the pooled 30-day proportion of
individuals who had a stroke after TAVR was 3.0% (95% CI, 2.5-3.9), with
different studies reporting major and minor stroke proportions of 1.7%
each. At 1 year, all stroke proportion was 5.0% (95% CI, 4.0-6.0), major
stroke was 3.0%, and minor stroke was 2.0%. Comparative analysis
demonstrated that TAVR was associated with significantly lower odds of all
stroke at 30 days compared with surgical AVR (odds ratio, 0.73 [95% CI,
0.57-0.93]). No significant difference in the proportions of individuals
who had a stroke was observed in TAVR versus surgical AVR at 1, 2, or 5
years. In the ViV cohort, the pooled 30-day and 1-year all stroke
proportion after ViV was 2.0% (95% CI, 1.0-3.0) and 3.0% (95% CI,
2.0-6.0), respectively. CONCLUSION(S): This meta-analysis provides
updated estimates of stroke after bioprosthetic AVR for AS, capturing risk
beyond the early periprocedural period. Future studies should investigate
the causes of long-term stroke post-AVR, the effects of different
antithrombotic therapies on the risk of stroke, as well as the potential
impact of these procedures on short and long-term cognitive function.

<117>
Accession Number
650684516
Title
The Effect of Exercise Training on Body Composition after Metabolic
Bariatric Surgery.
Source
Obesity. Conference: 41st Annual Meeting of the Obesity Society at Obesity
Week. Dallas, TX United States. 31(Supplement 2) (pp 144), 2023. Date of
Publication: 01 Feb 2023.
Author
Goldenshluger A.; Sakran N.; Dicker D.; Raziel A.; Friedman L.; Goitein
D.; Duvnov-Raz G.; Mahler I.; Gepner Y.
Institution
(Goldenshluger, Raziel) Tel AvivIsrael
(Sakran) NazarethIsrael
(Dicker) Petah TikvaIsrael
(Gepner) Ramat AvivIsrael
Publisher
John Wiley and Sons Inc
Abstract
Background: Metabolic bariatric surgery (MBS) is the most effective
treatment for morbid obesity, however, little is known on the effect of
exercise training on body composition and resting metabolic rate (RMR)
following MBS. Method(s): In this sub-sample 6 months randomized
controlled trial participants were randomly assigned into exercise
training intervention group (n = 23) and a control group (n = 7) with
routine care (the entire study aim for total of 60 participants). The
supervised exercise intervention increased gradually after the MBS and
included aerobic and resistance training 3 times/week. Before the surgery
and after 6-month of intervention we measured body composition using
Dual-x-ray absorptiometry (DEXA), RMR by indirect calorimetry, and body
function and strength by handgrip, six-minute walk, sit to stand and one
repetition maximum test (1RM). Result(s): In our preliminary results
among 31 participants (aged 39.9 +/- 10.3 y, 80% females, BMI 42.5 +/- 4.4
kg/m2) mean weight loss was 32.8 +/- 11.3 kg with an excess
weight loss (EWL) of 62.9 +/- 10.5%. Fat mass decreased by -9.9 +/- 3.7%
(p > 0.001) and fat-free mass FFM by 6.6 +/- 3.0 Kg (p < 0.001). RMR
decreased after the surgery by 374 +/- 274 Kcal/day but increased for
RMR/KG by 2.4 +/- 3.7 Kcal/kg/day. Six-minute walk significantly improved
(p = 0.033). The exercise group showed a significant improvement in
resting heart rate from 79 to 68 bpm (p = 0.031). EWL% was negatively
associated with baseline handgrip (r = -0.66, p < 0.05) and FFM change (r
= -0.71, p < 0.05). Conclusion(s): Body composition improved
six-month following MBS; despite a significant loss of FFM. Exercise
contributes to improving body function and heart rate after surgery
suggesting the importance of a qualitative approach of surgery results.

<118>
[Use Link to view the full text]
Accession Number
650695695
Title
GRACE score for risk stratification and completeness of revascularization
in older patients with myocardial infarction.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 27(3) (pp 182-191),
2026. Date of Publication: 01 Mar 2026.
Author
Spadafora L.; Bernardi M.; Biondi-Zoccai G.; Colaiori I.; Guiducci V.;
Escaned J.; Moreno R.; Casella G.; Cavazza C.; Vadala G.; Tebaldi M.;
Sarti A.; Clo S.; Marchini F.; Caglioni S.; Cocco M.; Campo G.; Biscaglia
S.; Versaci F.
Institution
(Spadafora, Bernardi, Biondi-Zoccai) Department of Medical-Surgical
Sciences and Biotechnologies, Sapienza University of Rome
(Spadafora, Bernardi, Colaiori, Versaci) Division of Cardiology and
Interventional Cardiology, Santa Maria Goretti Hospital, Latina, Italy
(Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola,
Italy
(Guiducci) Cardiology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy
(Escaned) Hospital Clinico San Carlos IDISCC, Complutense University of
Madrid, Calle del Prof Martin Lagos s/n, Madrid, Spain
(Moreno) Centro de Investigacion Biomedica en Red en Enfermedades
Cardiovasculares (CIBERCV)
(Moreno) Instituto de Investigacion Hospital La Paz (IDIPAZ), University
Hospital La Paz, Madrid, Spain
(Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy
(Cavazza) Cardiovascular Department, Infermi Hospital, Rimini, Italy
(Vadala) Azienda Ospedaliero Universitaria Policlinico Paolo Giaccone,
Palermo, Italy
(Tebaldi) Cardiology Unit, AUSL Romagna, Faenza, Italy
(Sarti, Clo, Marchini, Caglioni, Cocco, Campo, Biscaglia) Cardiology Unit,
Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy
Abstract
BACKGROUND: The GRACE score is a well established tool for predicting
mortality outcomes in patients with myocardial infarction (MI). However,
its prognostic role and interaction with revascularization strategies in
older patients with MI remain unclear. This study aimed to assess whether
the GRACE score was predictive of adverse events in the FIRE trial cohort
and whether the benefits of complete revascularization were consistent
across the spectrum of the GRACE score. METHOD(S): The FIRE trial
randomized 1445 patients aged 75 years or older with MI and multivessel
coronary artery disease to receive either culprit-only or complete
revascularization. In this subanalysis, patients were stratified according
to GRACE score tertiles: the first tertile (GRACE 92.6-128.0), the second
tertile (GRACE 128.1-146.5), and the third tertile (GRACE 146.6-236.0).
The primary endpoint was all-cause mortality at 1 year. Other key
endpoints included cardiovascular death and a composite of cardiovascular
death or MI at 1 year. RESULT(S): According to GRACE score tertiles,
487 patients were in the first tertile (33.7%), 477 in the second tertile
(33.0%), and 481 in the third tertile (33.3%). Patients in the third
tertile were more compromised in terms of cardiovascular risk factors and
comorbidities. At 1 year, all-cause mortality was significantly higher in
the third tertile (P < 0.0001), as well as cardiovascular death (P <
0.0001) and the composite of cardiovascular death or MI (P < 0.0001).
However, the effect of physiology-guided revascularization did not differ
across GRACE score tertiles (P for interaction > 0.05 for all the outcomes
of interest). Survival analysis confirmed that the GRACE score was
significantly associated with increased all-cause mortality [hazard ratio
1.027, 95% confidence interval (95% CI) 1.021-1.033, P < 0.001],
cardiovascular death (hazard ratio 1.031, 95% CI 1.023-1.039, P < 0.001),
and the composite of cardiovascular death or MI (hazard ratio 1.020, 95%
CI 1.013-1.026, P < 0.001). Again, no interaction was found between
revascularization strategy and GRACE score (all P for interaction > 0.05).
The best discriminative value of the GRACE score for all-cause mortality
at 1 year was 137. CONCLUSION(S): The GRACE score was confirmed to be
predictive of adverse outcomes even in older MI patients.
Physiology-guided complete revascularization was associated with benefit
across the GRACE spectrum, suggesting that the GRACE score alone should
not preclude this strategy in older patients with MI. Copyright ©
2026 Italian Federation of Cardiology - I.F.C. All rights reserved.

<119>
Accession Number
2044258706
Title
MicroRNAs as Biomarkers of Short-Term Complications After Cardiac Surgery.
Source
Genes. 17(3) (no pagination), 2026. Article Number: 326. Date of
Publication: 01 Mar 2026.
Author
Kozik A.; Kowalewska K.K.; Piotrowski M.; Kowalewski M.; Burysz M.; Batko
J.
Institution
(Kozik, Kowalewska, Piotrowski, Kowalewski, Burysz, Batko)
CAROL-Cardiothoracic Anatomy Research Operative Lab, Department of
Cardiovascular Surgery and Transplantology, Institute of Cardiology,
Jagiellonian University Medical College, Krakow, Poland
(Kowalewski, Batko) Department of Cardiac Surgery and Transplantology,
National Medical Institute of the Ministry of the Interior and
Administration, 137 Woloska Street, Warsaw, Poland
(Kowalewski, Burysz) Thoracic Research Centre, Collegium Medicum, Nicolaus
Copernicus University, Innovative Medical Forum, Bydgoszcz, Poland
(Kowalewski) Cardio-Thoracic Surgery Department, Heart and Vascular
Centre, Maastricht University Medical Centre, Maastricht, Netherlands
(Burysz) Department of Cardiac Surgery, Regional Specialist Hospital,
Grudziadz, Poland
(Burysz) Faculty of Medicine, Bydgoszcz University of Science and
Technology, Bydgoszcz, Poland
Publisher
Multidisciplinary Digital Publishing Institute (MDPI)
Abstract
Cardiac surgery carries substantial risk of early postoperative
complications including postoperative atrial fibrillation (POAF, 30-50%),
periprocedural myocardial infarction (PMI), acute kidney injury (AKI,
3.8-54.4%), bleeding (3-5%), stroke, and cognitive dysfunction. This
narrative review synthesizes 30+ studies on circulating microRNAs (miRNAs)
as perioperative biomarkers, identifying strongest evidence for
cardiac-enriched miR-499 (AUC 0.93, sensitivity 85.7%, specificity 93.3%)
and miR-133a (peaks 1-3 h post-declamping) in PMI diagnosis -outperforming
troponins' 6h kinetics. POAF prediction favors preoperative miR-483-5p
(AUC 0.78), while AKI, bleeding (miR-223), and neurological injury show
emerging but less validated candidates (miR-21, miR-210-3p). We critically
analyze limitations across studies and outline clinical translation
barriers (3-6 h assay times, heparin inhibition, lacking standardization)
with solutions for point-of-care implementation. Copyright © 2026
by the authors.

<120>
Accession Number
2044190565
Title
Avoidance of Hyperoxemia Versus Routine Hyperoxia During Cardiopulmonary
Bypass in Children With Cyanotic Congenital Heart Disease-A Systematic
Review and Meta-Analysis.
Source
Paediatric Anaesthesia. (no pagination), 2026. Date of Publication: 2026.
Author
Fischer J.; Arobo A.; Almehandi A.; Leidens E.C.; Apostu E.B.; Passos
F.S.; Kirov H.; Doenst T.; Kerst G.; Loukanov T.; Caldonazo T.
Institution
(Fischer, Leidens, Apostu, Kirov, Doenst, Caldonazo) Department of
Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany
(Arobo) College of Health Sciences, Obafemi Awolowo University, Ile-Ife,
Nigeria
(Almehandi) Department of Cardiovascular Science, University College
London, London, United Kingdom
(Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador,
Brazil
(Kerst) Clinic for Pediatric Cardiology and Congenital Heart Disease,
Klinikum Stuttgart, Stuttgart, Germany
(Loukanov) Division of Congenital Cardiac Surgery, Department of Cardiac
Surgery, University Hospital Heidelberg, Heidelberg, Germany
Publisher
John Wiley and Sons Inc
Abstract
Background: Children with cyanotic congenital heart disease undergoing
cardiac surgery with cardiopulmonary bypass (CPB) are exposed to varying
oxygenation strategies, and the optimal oxygenation strategy and the
impact of limiting hyperoxic exposure remain uncertain. This study aimed
to compare oxygenation strategies designed to avoid hyperoxemia versus
routine hyperoxic management in this population. Method(s): A
systematic search was conducted in four databases. The primary outcome was
postoperative intubation time. Secondary outcomes included intensive care
unit (ICU) length of stay (LOS), hospital LOS, total operative duration,
and epinephrine requirement. Standardized mean difference (SMD) and odds
ratios (OR) with 95% confidence intervals (CI) were calculated for
continuous and categorical outcomes, respectively. A random-effects model
was applied to all outcomes. Result(s): Seven studies (six randomized
controlled trials; one observational) met all the inclusion criteria.
Strategies avoiding hyperoxemia did not significantly reduce postoperative
intubation time compared with routine hyperoxia (SMD: -0.25; 95% CI:
-0.52-0.03; p = 0.077; I2 = 15%). Also, no significant
differences were observed for ICU LOS (SMD: -0.04; 95% CI: -0.46-0.38; p =
0.859; I2 = 64%), hospital LOS (SMD: 0.24; 95% CI: -0.01-0.50;
p = 0.064; I2 = 0%), operative duration (SMD: -0.66; 95% CI:
-1.90-0.58; p = 0.294; I2 = 84%), and epinephrine use (OR:
0.66; 95% CI: 0.28-1.57; p = 0.350; I2 = 0%).
 Conclusion(s): No significant differences in postoperative outcomes
were observed between oxygenation strategies aimed at avoiding hyperoxemia
and routine hyperoxic management during CPB. Copyright © 2026
John Wiley & Sons Ltd.

<121>
Accession Number
2043990022
Title
Cocoa flavanol supplementation and prevention of cardiovascular disease: a
novel analysis of the COSMOS randomized trial using "win ratio".
Source
European Journal of Epidemiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Ogata S.; Manson J.E.; Rist P.M.; Hamaya R.; Aragaki A.K.; Allison M.;
Haring B.; Martin L.W.; Nishimura K.; Clar A.; Sesso H.D.
Institution
(Ogata, Nishimura) Department of Preventive Medicine and Epidemiology,
National Cerebral and Cardiovascular Center, Osaka, Suita, Japan
(Manson, Rist, Hamaya, Clar, Sesso) Division of Preventive Medicine,
Brigham and Women's Hospital and Harvard Medical School, Boston, MA,
United States
(Manson, Rist, Hamaya, Sesso) Department of Epidemiology, Harvard T.H.
Chan School of Public Health, Boston, MA, United States
(Aragaki) Division of Public Health Sciences, Fred Hutchinson Cancer
Center, Seattle, WA, United States
(Allison) Department of Family Medicine and Public Health, University of
California San Diego, San Diego, CA, United States
(Haring) Department of Medicine III, Saarland University, Saarland,
Homburg, Germany
(Martin) Division of Cardiology, School of Medicine and Health Sciences,
George Washington University, Washington, DC, United States
Publisher
Springer Science and Business Media B.V.
Abstract
Cocoa flavanols may reduce cardiovascular disease (CVD) risk, yet large
randomized trials remain inconclusive. The COcoa Supplement and
Multivitamin Outcomes Study (COSMOS) suggested a modest, nonsignificant
benefit using Cox models, which do not account for event severity in
composite outcomes. To address this, we applied generalized pairwise
comparison (GPC), or "win ratio" (WR), to assess cocoa flavanols versus
placebo on hierarchical CVD outcomes among healthy older US adults. This
secondary analysis of COSMOS, a randomized, placebo-controlled, 2 x 2
factorial trial of cocoa extract and multivitamins for preventing CVD and
cancer, included 21,442 adults (women >= 65, men >= 60 years) followed for
a median of 3.6 years. The primary outcome was a hierarchical composite of
total CVD, prioritizing: fatal CVD, non-fatal myocardial infarction (MI),
non-fatal stroke, coronary revascularization, carotid surgery, peripheral
artery surgery, and hospitalized unstable angina. Analyses followed the
intention-to-treat principle. GPC estimated WRs and net treatment benefits
(NTBs) for cocoa flavanols versus placebo. GPC analyses showed cocoa
flavanol wins of 3.41% and placebo wins of 2.87%, yielding a reciprocal WR
of 0.84 (95% CI 0.72-0.99) and negative NTBs of - 0.54% (- 1.04 to -
0.03), p = 0.037. Sensitivity analyses prioritizing stroke over MI
produced similar findings. By contrast, Cox regression of the same
composite yielded a nonsignificant hazard ratio of 0.90 (95% CI
0.79-1.03), suggesting standard time-to-first-event models underestimated
benefit. GPC "WR" analyses showed cocoa flavanols significantly reduced
CVD events by accounting for event severity in the composite CVD outcome,
whereas Cox regression marginally missed these effects. Copyright
© Springer Nature B.V. 2026.

<122>
Accession Number
650690717
Title
OMEGA LAA OCCLUDER FOR TINY LEFT ATRIAL APPENDAGES: A EUROPEAN MULTICENTER
CASE SERIES.
Source
Giornale Italiano di Cardiologia. Conference: 46. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 26(10 Supplement 1) (pp e31), 2025. Date of Publication: 2025.
Author
Tumminello G.; Barbieri L.; Mallardi G.P.F.; Pellegrini D.; Sacchetta D.;
Guarracini S.; Piccaluga E.; Fassini G.; Cereda A.; Colombo F.; Gobbi C.;
Mircoli L.; Ruscica M.; Carugo S.
Institution
(Tumminello, Barbieri, Mallardi, Colombo, Gobbi, Mircoli, Carugo)
Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca'
Granda Ospedale Maggiore Policlinico, Milano, Italy
(Pellegrini) Cardiology Division, IRCCS Ospedale Galeazzi Sant'Ambrogio,
milano, Italy
(Sacchetta) Department of Cardiology, ASL 03 Abruzzo, Pescara, Italy
(Guarracini) Department of Cardiology, "Pierangeli" Hospital, Pescara,
Italy
(Piccaluga) Cardiology I, 'A.De Gasperis' Department, Niguarda Ca' Granda
Hospital, milano, Italy
(Fassini) Department of Clinical Electrophysiology, Cardiac Pacing Heart
Rhythm Center, Monzino Cardiac Center, IRCCS, milano, Italy
(Cereda) ASST Santi Paolo e Carlo, Milano, Italy
(Ruscica) Department of Pharmacological and Biomolecular Sciences "Rodolfo
Paoletti", Universita degli Studi di Milano, Milano, Italy
(Carugo) Department of Clinical Sciences and Community Health, Universita
degli Studi di Milano, Milano, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction: Left atrial appendage (LAA) occlusion is an interventional
technique used to prevent ischemic strokes in patients with atrial
fibrillation and a contraindication for oral anticoagulation. Current left
atrial appendage occlusion devices do not fit all anatomical variations of
the left atrial appendage. The Omega left atrial appendage occluder is a
highly conformable device, which can occlude LAAs with a minimum landing
zone diameter as small as 10.5 mm. Our registry aimed to determine if very
small LAAs, with a landing zone <10.5 mm, which is below the recommended
size for most LAA occluders, including Omega, can be safely closed.
 Method(s): This multicentre retrospective registry involved 10
patients from seven European centres between May 2023 and July 2024. All
patients had atrial fibrillation with an indication for left atrial
appendage occlusion and a minimum LAA diameter less than 10.5 mm. The
primary endpoint was to assess the safety and efficacy of the procedure,
while secondary endpoints included complete left atrial appendage closure,
absence of embolization, and incidence of stroke during follow-up.
 Result(s): The Omega device was successfully implanted, without
complications, and achieved complete left atrial appendage closure without
significant peri-device leak in all patients. No events occurred within 7
days post implant. Similarly, at an average follow-up of 130 +/- 69 days,
there were no device embolization, thrombosis, thromboembolic events,
major bleedings or deaths. Conclusion(s): The registry suggest that
Omega left atrial appendage occluder may be safely and effectively
utilized in patients with very small left atrial appendages, offering a
viable alternative for stroke prevention in atrial fibrillation; further
prospective, randomized, controlled studies are needed to confirm and
support these data

<123>
Accession Number
650690585
Title
PHYSIOLOGY-GUIDED COMPLETE REVASCULARIZATION IN OLDER PATIENTS WITH
MYOCARDIAL INFARCTION AND COMPLEX NON-CULPRIT LESION: A FIRE TRIAL
SUBANALYSIS.
Source
Giornale Italiano di Cardiologia. Conference: 46. Congresso Nazionale
della Societa Italiana di Cardiologia Interventistica - GISE. Milano
Italy. 26(10 Supplement 1) (pp e1), 2025. Date of Publication: 2025.
Author
Sarti A.; Erriquez A.; Dal Passo B.; Casella G.; Guiducci V.; Moreno R.;
Escaned J.; Marchini F.; Cocco M.; Verardi F.M.; Clo S.; Caglioni S.;
Farina J.; Barbato E.; Campo G.; Biscaglia S.
Institution
(Sarti, Erriquez, Dal Passo, Campo, Biscaglia) Cardiology Unit, Azienda
Ospedaliero Universitaria di Ferrara, Ferrara, Italy
(Casella) Cardiology Unit, Ospedale Maggiore, Bologna, Italy
(Guiducci) Cardiology Unit, Azienda USL-IRCCS Reggio Emilia, Reggio
Emilia, Italy
(Moreno) Hospital Universitario La Paz, Madrid, Spain
(Escaned) Hospital Clinico San Carlos, Madrid, Spain
(Marchini, Cocco, Verardi, Clo, Caglioni, Farina) Azienda Ospedaliero
Universitaria di Ferrara, Ferrara, Italy
(Barbato) Sapienza University of Rome, Roma, Italy
Publisher
Il Pensiero Scientifico Editore s.r.l.
Abstract
Introduction The Functional Assessment in Elderly MI Patients With
Multivessel Disease (FIRE) randomized clinical trial showed that
physiology-guided complete revascularization was superior as compared to
culprit-only strategy in older (>=75 years) with multivessel disease
patients admitted to hospital for myocardial infarction (MI). Older MI
patients tend to have more complex coronary artery disease (CAD) as
compared to younger ones. Accordingly, it would be interesting to
understand if the benefit of physiology-guided complete revascularization
was consistent across simple and complex CAD. The aim of the present
analysis is to investigate if the benefit of physiology-guided complete
revascularization vs a culprit only strategy was consistent in patients
with complex non-culprit lesion (NCL). Methods This was a sub-analysis of
the Functional Assessment in Elderly MI Patients With Multivessel Disease
(FIRE) randomized clinical trial data. FIRE was an investigator-initiated,
open-label, multicenter trial. Patients 75 years or older with MI and
multivessel disease were enrolled at 34 European centers from July 2019
through October 2021. Patients were randomized to receive either
physiology-guided complete or culprit-only revascularization. For the
scope of the present analysis, patients were divided into patients having
at least one NCL meeting CHIP criteria vs others. CHIP criteria of
interest were: angiographic heavy calcification, true bifurcation lesions
involving side-branches >2.5mm, in-stent restenosis, long-lesions
(estimated stent length > 28mm), being left main disease and chronic total
occlusion exclusion criteria. The primary endpoint was the 3-year
occurrence of all-cause mortality, stroke, reinfarction or ischemia-driven
revascularization. Secondary endpoints were the singular components of the
primary endpoint. Results Among 1445 patients, 641 (44%) patients had at
least one NCL meeting CHIP criteria. At univariate analysis patients with
complex NCL were at higher risk for the primary end point (hazard ratio
[HR], 1.29; 95% Cl, 1.05-1.58; p = 0.013), cardiovascular death or MI (HR,
1.41; 95% CI, 1.07-1.85; p = 0.013), MI or ischemia-driven coronary
revascularization at 3 years [(HR, 2.37; 95% CI, 1.47-3.82; p < 0.001),
(HR, 2.26; 95% CI, 1.45-3.51; p < 0.001) respectively]. After adjustment
for potential confounding factors, patients with at least one complex NCL
remained at higher risk of MI and ischemia-driven coronary
revascularization at 3 years. No signal of interaction was noted between
revascularization strategy and presence of at least one complex NCL for
the primary endpoint. On the contrary, we observed significant interaction
between randomization arm and complex NCL in terms of secondary endpoint
MI and ischemia-driven revascularization. Physiology-guided complete
revascularization as compared with culprit-only strategy reduced the risk
of MI at 3 years significantly only in patient with complex NCL (p for
interaction 0.021). Physiology-guided complete revascularization as
compared with culprit-only strategy reduced the risk of ischemia-driven
coronary revascularization at 3 years significantly in patient with
complex NCL (p for interaction 0.0002). Conclusions Complex coronary
anatomy status is frequent among older patients with Ml, significantly
increasing the likelihood of adverse events. Physiology guided complete
revascularization emerges as an effective strategy, in comparison with
culprit-only revascularization, for mitigating adverse events in patients
having NCL meeting CHIP criteria, in particular reducing MI and
ischemia-driven coronary revascularization.

<124>
Accession Number
650685830
Title
Prehabilitation for patients with mild to moderate frailty undergoing
coronary artery and valve surgery: A pilot randomized controlled trial.
Source
European journal of cardiovascular nursing. (no pagination), 2026. Date
of Publication: 20 Mar 2026.
Author
Li P.W.C.; Yu D.S.F.; Chan D.T.L.; Ho C.K.L.; Lam S.C.C.; Chiu P.K.C.; Wan
S.H.Y.; Lam L.; Hung N.
Institution
(Li, Yu) School of Nursing, LKS Faculty of Medicine, University of Hong
Kong, Hong Kong
(Chan, Ho, Wan) Department of Cardiothoracic Surgery, Queen Mary Hospital,
Hong Kong
(Lam, Chiu) Department of Medicine, Queen Mary Hospital, Hong Kong
(Lam, Hung) Physiotherapy Department, Queen Mary Hospital, Hong Kong
Abstract
AIMS: Although prehabilitation is increasingly studied to address
preoperative frailty in cardiac surgery candidates, most interventions
overlook recommended exercise principles for frailty. This study evaluated
the feasibility and effects of a frailty-specific prehabilitation program
on health outcomes in frail patients undergoing cardiac surgery. METHODS
AND RESULTS: Adult patients with mild to moderate frailty scheduled for
elective coronary or valve surgery were randomized to prehabilitation
(n=26) or usual care (n=25). The program combined education, nutritional
optimization, stress management, and individualized resistance-focused
exercise training via center-based, home-based, and online sessions over
at least four weeks. Primary outcome was functional capacity. The
prehabilitation group showed significant improvements in functional
capacity measured by the Short Physical Performance Battery at one day
before surgery (beta=0.99, 95% CI=0.08-1.90, p=0.032) and 3-month
post-intervention (beta=1.04, 95% CI=0.05-2.03, p=0.040). Frailty level
measured by Fried criteria showed significant reductions at one day before
surgery (p=0.005) and at 3-month follow-up (p=0.043), with large effect
sizes (Hedges' g=0.92-1.18). Health-related quality of life measured by
the MacNew Questionnaire improved significantly at 1-month (p=0.006) and
3-month post-intervention (p=0.007), with large effect sizes (Hedges'
g=-0.89 - -0.96). The program demonstrated high feasibility (89%
adherence) and safety (minimal adverse events). No significant differences
were found in biomarkers or clinical events, unplanned readmission or
length of stay. CONCLUSION(S): This frailty-specific prehabilitation
program is feasible and safe for cardiac surgical patients, demonstrating
improvements in functional capacity, frailty, and quality of life. A
full-scale trial is warranted to confirm its efficacy and guide clinical
implementation. REGISTRATION: ClinicalTrials.gov Identifier:
NCT06323317. Copyright © The Author(s) 2026. Published by Oxford
University Press on behalf of the European Society of Cardiology.

<125>
[Use Link to view the full text]
Accession Number
650695621
Title
Balloon-expandable valve vs. self-expandable valve for small aortic
annuli: a GRADE-assessed systematic review and updated meta-analysis.
Source
Journal of cardiovascular medicine (Hagerstown, Md.). 27(3) (pp 207-220),
2026. Date of Publication: 01 Mar 2026.
Author
Alam U.; Shahid A.R.; Qadri M.; Khan H.; Rath S.; Sriram K.; Yaseen A.M.;
Shahid M.; Malik A.A.; Ali M.; Faisal U.; Javed J.; Naz S.; Kabir M.M.;
Husain K.; Bibi F.; Ahmed R.
Institution
(Alam) Khyber Medical College, Peshawar, Pakistan
(Shahid, Kabir) Wah Medical College
(Qadri) Jinnah Sindh Medical University, Karachi, Pakistan
(Khan) Saidu Medical College, Swat, Pakistan
(Rath) All India Institute of Medical Sciences Bhubaneswar, India
(Sriram) Flinders University, Australia
(Yaseen) Faisalabad Medical University
(Shahid) Faisalabad Medical University, Faisalabad, Pakistan
(Malik) United Medical and Dental College
(Ali) Women Medical College, Abbottabad, Pakistan
(Faisal) Jinnah Medical and Dental College
(Javed) Jinnah Sindh Medical University, Karachi, Pakistan
(Naz) HCA Westside Regional Medical Center, FL, United States
(Ahmed) Jinnah Medical and Dental College, Karachi, Pakistan
(Husain) Jawaharlal Nehru Medical College, Aligarh, India
(Bibi) Jinnah Medical and Dental College, Pakistan
(Ahmed) Academic Clinical Lecturer
(Ahmed) Freeman Hospital, Newcastle upon Tyne, United Kingdom
(Ahmed) Royal Brompton Hospital, London, United Kingdom
Abstract
INTRODUCTION: Aortic stenosis is a prevalent and serious heart valve
disorder, particularly affecting older adults. A significant subset of
these patients presents with small aortic annuli (SAA), complicating the
selection of optimal transcatheter aortic valve replacement (TAVR)
devices. The comparative efficacy and safety of balloon-expandable valves
(BEV) vs. self-expandable valves (SEV) for this subgroup remain uncertain.
PURPOSE: This systematic review and meta-analysis aimed to evaluate and
compare the clinical and hemodynamic outcomes of BEV and SEV in patients
with SAA undergoing TAVR, using the GRADE approach to assess the certainty
of evidence. METHOD(S): A comprehensive electronic search was
conducted in PubMed, Embase, Scopus, and other databases up to July 2025.
Studies were included if they compared BEV and SEV in patients with SAA.
Data extraction and quality assessment followed the Cochrane and PRISMA
guidelines. The primary outcomes were new permanent pacemaker implantation
and paravalvular leak greater than mild. Secondary outcomes included
indexed effective orifice area, mean transvalvular gradient, and
prosthesis-patient mismatch (PPM). Random-effects meta-analyses were
performed to pool odds ratios (ORs) or mean differences (MDs) with 95%
confidence intervals (CIs). RESULT(S): Fourteen studies comprising
8451 patients (4797 BEV, 3654 SEV) met the inclusion criteria. There was
no significant difference in the risk of severe PPM (OR = 0.61, 95% CI:
0.27-1.37, P = 0.23) or moderate/severe PPM (OR = 0.78, 95% CI: 0.45-1.38,
P = 0.40) between BEV and SEV. The mean indexed orifice area did not
differ significantly (MD = -0.01, 95% CI: -0.12-0.11, P = 0.93). The risk
of new permanent pacemaker implantation was similar between groups (OR =
1.03, 95% CI: 0.67-1.59, P = 0.89). BEV were associated with a
near-significant increase in moderate or greater paravalvular leak (OR =
1.39, 95% CI: 1.00-1.93, P = 0.05). Mean transvalvular gradients showed no
significant difference (MD = -0.91 mmHg, 95% CI: -3.38-1.57, P = 0.47),
though SEV showed a trend toward lower gradients. The certainty of
evidence was rated as moderate across most outcomes. CONCLUSION(S):
In patients with SAA undergoing TAVR, BEV and SEV yield comparable rates
of PPM and permanent pacemaker implantation. However, BEV may be
associated with a higher risk of moderate or greater paravalvular leak.
Valve selection should be individualized, considering patient anatomy and
device-specific characteristics to optimize outcomes. Copyright ©
2026 Italian Federation of Cardiology - I.F.C. All rights reserved.

<126>
Accession Number
650689379
Title
IAAS 15th International Congress on Ambulatory Surgery.
Source
IAAS 15th International Congress on Ambulatory Surgery. Conference: 15th
Congress of the International Association of Ambulatory Surgery, IAAS
2024. Oslo Norway. 30(2) (no pagination), 2024. Date of Publication: 01
Jun 2024.
Author
Anonymous
Publisher
International Association for Ambulatory Surgery
Abstract
The proceedings contain 121 papers. The topics discussed include: limiting
factors for daycare laparoscopic cholecystectomy in a rural setup in
India; analysis of humanistic care ability of day surgery nurses in
Sichuan Province - a mediation effect model; unidirectional valve
apparatus improved nondependent lung collapsing during one-lung
ventilation in daytime thoracic surgery: a prospective randomized
controlled trial; case series: combined mastectomies and hysterectomy for
gender-affirmation at an ambulatory surgery center; clinical application
analysis of spinal endoscopy in the treatment of lumbar disc herniation in
centralized management of ambulatory surgery mode; the laryngeal gel mask
airway - a new airway device; the preoperative anxiety status and its
influencing factors in gynecological patients undergoing consecutive day
surgery; ambulatory surgery for unilateral inguinal and umbilical hernias
with bilayer meshes (PHS & UHS): learnings from 1293 surgeries; first-year
outcomes of Thailand's new ambulatory protocol for laparoscopic
cholecystectomy: a cohort study using propensity score analysis with
inverse probability treatment weighting; the feasibility of day case
cochlear implant surgery; first world use of the laryngeal mask airway
gastro (LMAG) in bariatric surgery; safety and efficacy of ambulatory
hysteroscopic suture fixation of the levonorgestrel-releasing intrauterine
system in women with an expulsion history: a prospective cohort study;
outcome indicators in ambulatory surgery - where do we stand?; and total
mastectomy in outpatient surgery with a nursing system for post-ambulatory
support and follow-up at home.

<127>
Accession Number
2044447813
Title
Figure-of-8 Suture With a 3-Way Tap Versus Manual Compression After Atrial
Fibrillation Ablation: The HARNESS Randomized Controlled Trial.
Source
JACC: Clinical Electrophysiology. (no pagination), 2026. Date of
Publication: 2026.
Author
Mills M.T.; Calvert P.; Tidbury L.; Wilson K.; Evans T.; de Francesco L.;
Najm A.; Tripathi R.; Farinha J.M.; Xydis P.; Thu K.; Snowdon R.; Borbas
Z.; Waktare J.; Mahida S.N.; Denham N.; Ashrafi R.; Todd D.; Modi S.;
Luther V.; Gupta D.
Institution
(Mills, Calvert, Evans, de Francesco, Najm, Tripathi, Farinha, Xydis, Thu,
Snowdon, Borbas, Waktare, Mahida, Denham, Ashrafi, Todd, Modi, Luther,
Gupta) Department of Cardiology, Liverpool Heart & Chest Hospital,
Liverpool, United Kingdom
(Mills, Calvert, Tidbury, Luther, Gupta) Liverpool Centre for
Cardiovascular Science at University of Liverpool, Liverpool John Moores
University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
(Tidbury, Wilson) Research Department, Liverpool Heart & Chest Hospital,
Liverpool, United Kingdom
Publisher
Elsevier Inc.
Abstract
Background: Reliable hemostasis is essential to minimize femoral venous
access site complications after transcatheter cardiovascular procedures,
particularly atrial fibrillation (AF) ablation, which require large-bore
sheath insertion and systemic heparinization. A figure-of-8 suture secured
with a 3-way tap (Fo8<inf>TAP</inf>) offers a simple and low-cost
alternative to manual compression (MC). Objective(s): The HARNESS
(Haemostasis After Venous Access in Atrial Fibrillation Catheter Ablation)
randomized controlled trial evaluated the efficacy of Fo8TAP and its
impact on post-procedural bed rest duration. Method(s): Patients
undergoing AF ablation via unilateral femoral venous access were
randomized 1:1:1 to: 1) MC with 4-hour bed rest (MC-4), 2)
Fo8<inf>TAP</inf> with 4-hour bed rest (TAP-4), and 3) Fo8<inf>TAP</inf>
with 2-hour bed rest (TAP-2). The primary endpoint of any access site
complication before hospital discharge was assessed for superiority (TAP-4
vs MC-4) and noninferiority (TAP-2 vs TAP-4). Bleeding was graded from 1
(minor) to 4 (life-threatening). Secondary endpoints included times to
hemostasis, catheter laboratory exit, and mobilization. Result(s):
Three hundred thirty-six patients (median age 64 years, 34.2% female,
median body mass index 28.9 kg/m2) were enrolled and randomized
to MC-4 (n = 110), TAP-4 (n = 110), and TAP-2 (n = 116). The primary
endpoint occurred in 16 patients (14.5%) in the TAP-4 group and 36
patients (32.7%) in the MC-4 group (P = 0.002 for superiority). In the
TAP-2 group, the primary endpoint occurred in 36 (31.0%) patients (P =
0.156; which did not meet the prespecified noninferiority margin vs
TAP-4). No major vascular complications occurred. Most events were grade 1
bleeding (85/92, 92.4%), with the remainder minor hematomas (7/92, 7.6%).
Median time to hemostasis was significantly shorter with Fo8<inf>TAP</inf>
(MC-4: 12 min; TAP-4 and TAP-2: 1 min; P < 0.001). Median time to catheter
laboratory exit was shortest with Fo8<inf>TAP</inf> (MC-4: 16 min; TAP-4:
9 min; TAP-2: 8 min; P < 0.001). Median time to mobilization was shortest
with TAP-2 (MC-4: 242 min; TAP-4: 241 min; TAP-2: 122 min; P < 0.001).
 Conclusion(s): After AF catheter ablation, Fo8<inf>TAP</inf> was
superior to MC in lowering the incidence of access site complications and
was associated with health care efficiencies. However, a 2-hour bed rest
strategy failed to meet noninferiority criteria versus 4 hours.
(Haemostasis After Venous Access in Atrial Fibrillation Catheter Ablation
[HARNESS]; NCT06470555) Copyright © 2026 The Authors

<128>
Accession Number
650649717
Title
Effect of Preadmission Diabetes Intervention (PREHAB) on Postoperative
Patient Outcomes in Cardiac Surgery.
Source
Diabetes. Conference: 78th Scientific Sessions of the American Diabetes
Association, ADA 2018. Orlando, FL United States. 67(Supplement 1) (no
pagination), 2018. Date of Publication: 01 Jul 2018.
Author
Arnaout A.; Goge S.
Publisher
American Diabetes Association Inc.
Abstract
People living with diabetes are at an increased risk of developing heart
disease. In patients undergoing coronary artery bypass grafting (CABG), a
preexisting diagnosis of diabetes has been identified as a risk factor for
postoperative sternal wound infections and prolonged hospital stay. At the
University of Ottawa Heart Institute (UOHI) the wait time for elective
cardiac surgery is four months. There is literature that supports the use
of cardiac prehabilitation to improve postoperative outcomes such as
length of stay, functional capacity and perioperative complications.
However, there is no published evidence on whether pre-admission diabetes
interventions lead to the same results. The aim of this study is to
introduce a novel prehabilitation program for diabetes. Target Population:
All elective cardiac surgery patient screened for diabetes with an HBA1C
of greater than 6.5%. Primary Outcomes: The primary outcome is improvement
in glycemic control from screening to time of elective cardiac surgery in
those patients who completed prehabilitation program. Secondary
Outcomes: The secondary outcomes measured are effect of prehabilitation on
length of stay and surgical site infections. Prehabilitation Methodology:
In those who have an elevated HBA1C a screening phone call by cardiac
rehabilitation nurse. A two hour prehabilitation session that cover topics
such as nutrition, exercise and mental health. Group medical appointment
led by a diabetes nurse. Result(s): 24 patients have completed the
full prehabilitation program. The mean HBA1C from screening to time of
surgery dropped from 7.64% to 7.3% which was not statistically
significant. One surgical site infection developed in this group compared
to 3 infections in the group that did not attend. Conclusion(s): Wait
times for elective cardiac surgery is an opportune time to intervene and
optimize patients' medical fitness for surgery and improving patient
self-management of chronic medical conditions like diabetes.

<129>
Accession Number
2044143122
Title
The AtriAmp: a review of a novel device for atrial electrogram monitoring.
Source
Expert Review of Medical Devices. (no pagination), 2026. Date of
Publication: 2026.
Author
Cook C.; Beshish A.; Malloy-Walton L.; Al-Subu A.M.
Institution
(Cook) Division of Pediatric Cardiology, Department of Pediatrics,
University of Wisconsin, School of Medicine and Public Health, American
Family Children's Hospital, Madison, WI, United States
(Beshish) Division of Pediatric Cardiology, Department of Pediatrics,
Emory University School of Medicine, Children's Healthcare of Atlanta,
Atlanta, GA, United States
(Malloy-Walton) Division of Pediatric Cardiology, Department of
Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas
City, MO, United States
(Al-Subu) Division of Pediatric Critical Care Medicine, Department of
Pediatrics, University of Wisconsin School of Medicine and Public Health,
American Family Children's Hospital, Madison, WI, United States
Publisher
Taylor and Francis Ltd.
Abstract
Introduction: Arrhythmias following cardiac surgery are a common
occurrence. Continuous atrial electrograms (AEG) are a valuable diagnostic
tool, though barriers often limit their use. The AtriAmp is a device
designed to enable continuous AEG monitoring using existing bedside
telemetry systems. Areas covered: This review summarizes postoperative
arrhythmia monitoring, limitations of existing technologies, and the
AtriAmp. A literature search was conducted in PubMed and Google Scholar
(2000-2025) using keywords 'postoperative arrhythmia,' 'atrial
electrogram,' 'AtriAmp,' and 'electrophysiology.' References from limited
relevant articles were also reviewed. Expert opinion: AtriAmp displays
real-time AEGs alongside surface ECG using temporary atrial pacing leads.
Published evidence remains very limited with no prospective comparative
studies to date demonstrating improved clinical outcomes. Available
reports suggest AtriAmp may improve clinician diagnostic confidence and
reduce uncertainty in selected postoperative arrhythmia scenarios.
Important limitations of the AtriAmp include single-use design, reliance
on surgically placed epicardial wires, amplifier saturation during pacing,
the need for provider training, and a per-patient disposable cost.
Nonetheless, its potential to reduce diagnostic uncertainty, guide timely
interventions, and optimize postoperative outcomes is substantial. AtriAmp
should therefore be viewed as an adjunct diagnostic tool, with multicenter
prospective studies needed to define the target population, quantify
clinical impact, and establish cost-effectiveness. Copyright ©
2026 Informa UK Limited, trading as Taylor & Francis Group.

<130>
Accession Number
650654396
Title
Incidence and Outcomes of Intraluminal Frozen Elephant Trunk Stent Graft
Thrombosis After Aortic Arch Surgery: Systematic Review and Meta-Analysis.
Source
Journal of the American Heart Association. (pp e047425), 2026. Date of
Publication: 18 Mar 2026.
Author
Sa M.P.; Consoli L.; Neves G.; Camarotti T.; Napoli F.; Brozzi N.A.; Navia
J.L.; Polanco A.
Institution
(Sa, Napoli, Brozzi, Navia, Polanco) Department of Cardiovascular Surgery,
Heart, Thoracic & Vascular Institute Cleveland Clinic Florida Weston FL
USA
(Consoli) School of Medicine of Universidade Federal da Bahia (UFBA)
Salvador Brazil, Brazil
(Neves) School of Medicine of Universidade Estadual do Para (UEPA) Belem
Brazil
(Camarotti) School of Medicine of Universidade de Pernambuco (UPE) Recife
Brazil, Brazil
Abstract
BACKGROUND: Intraluminal thrombosis (ILT) has been observed in endografts
in the thoracic aorta after frozen elephant trunk (FET) for aortic arch
pathologies. This study aimed to evaluate the incidence and clinical
outcomes associated with ILT. METHOD(S): Systematic review of studies
reporting incidence of ILT after FET and comparing outcomes of patients
with and without ILT. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane
databases (inception to September 2025) were searched. Single-arm
meta-analysis was conducted to determine ILT incidence and 2-arm
meta-analyses between groups with ILT and without with a random-effects
model to assess patient-relevant outcomes. RESULT(S): Five
observational studies, including 999 patients, met our eligibility
criteria. Pooled incidence of ILT after FET was 9.24% (95% CI,
6.32-13.31). Although we did not find statistically significant
associations between ILT and postoperative stroke (odds ratio [OR], 0.93
[95% CI, 0.46-1.88]; P=0.845), we found statistically significant
associations with embolic events (OR, 6.94 [95% CI, 1.01-47.46]; P=0.048)
and early mortality (OR, 3.59 [95% CI, 1.69-7.60]; P<0.001). We found
positive correlations between proportion of female patients in the
populations and incidence of ILT (coefficient, 0.08 [95% CI, 0.02-0.14];
P=0.011). Meta-regression coefficients were statistically significant for
embolic events and female sex (coefficient, 0.12 [95% CI, 0.06-0.18];
P<0.001), aortic aneurysm (coefficient, 0.08 [95% CI, 0.04-0.13];
P<0.001), and mean age (coefficient, 0.66 [95% CI, 0.33-0.99]; P<0.001),
which means that associations differ across populations with varying mean
levels of these covariates. CONCLUSION(S): Because ILT after FET
seems to be associated with embolic events and early mortality, close
follow-up is warranted-especially for women, older people, and patients
with aortic aneurysms-and anticoagulation should be considered.

<131>
Accession Number
650659810
Title
Mechanical versus biological aortic valve replacement in patients aged
50-70 years: a systematic review and meta-analysis.
Source
Heart (British Cardiac Society). (no pagination), 2026. Date of
Publication: 18 Mar 2026.
Author
Trevis J.; Cheong J.; Wilkinson C.; Ogundimu E.; Maier R.; Austin D.;
Akowuah E.
Institution
(Trevis, Cheong, Wilkinson, Maier, Austin, Akowuah) Academic
Cardiovascular Unit, South Tees Hospitals NHS Foundation Trust,
Middlesbrough, United Kingdom
(Wilkinson) Hull York Medical School, University of York, York, United
Kingdom
(Ogundimu) Department of Mathematical Sciences, Durham University, Durham,
United Kingdom
(Maier, Austin) Population Health Science Institute, Newcastle University,
Newcastle upon Tyne, United Kingdom
(Akowuah) Translational and Clinical Research Institute, Newcastle
University, Newcastle upon Tyne, United Kingdom
Abstract
OBJECTIVES: The optimal prosthetic aortic valve replacement (AVR) for
long-term outcomes in patients aged 50-70 years remains uncertain.
International guidelines differ; contemporary randomised trials are
lacking, and use of bioprosthetic valves has increased. This review
synthesised evidence comparing efficacy and safety outcomes between valve
types in this age group. METHOD(S): A systematic review and
meta-analysis of randomised and observational studies comparing mechanical
and bioprosthetic AVR in patients aged 50-70 years was conducted. Medline,
Embase and the Cochrane Library were searched. The primary outcome was
overall survival; secondary outcomes were major bleeding, reoperation and
stroke. Data were pooled using inverse variance random-effects
meta-analysis and presented as HRs with 95% CIs. RESULT(S): 30
studies involving 120 844 patients were included, 29 of which were
observational. Mechanical valves were associated with better overall
survival (HR 0.88; 95% CI 0.81 to 0.94; p=0.001). Stroke rates did not
differ significantly (HR 1.07; 95% CI 0.91 to 1.27; p=0.37). Mechanical
valves carried a higher risk of major bleeding (HR 1.60; 95% CI 1.43 to
1.78; p<0.001), while bioprosthetic valves had higher reoperation rates
(HR 0.44; 95% CI 0.33 to 0.57; p<0.001). CONCLUSION(S): Drawing
largely from observational data, mechanical valves were associated with
superior overall survival but increased bleeding due to lifelong
anticoagulation. Bioprosthetic valves offer lower bleeding risk but higher
reoperation rates from structural degeneration. The growing use of
bioprosthetic valves in this age group may lead to more reinterventions in
older, more comorbid patients. Contemporary randomised trials are needed
to evaluate outcomes with modern valve designs. PROSPERO REGISTRATION
NUMBER: CRD42024540272. Copyright © Author(s) (or their
employer(s)) 2026. No commercial re-use. See rights and permissions.
Published by BMJ Group.

<132>
Accession Number
2044126352
Title
Prevalence of persistent left superior vena cava in the general
population: a systematic review with meta-analysis.
Source
Anatomical Science International. (no pagination), 2026. Date of
Publication: 2026.
Author
Gondorf D.; Triantafyllou G.; Paschopoulos I.; Arkoudis N.-A.; Prountzos
S.; Samolis A.; Tsakotos G.; Piagkou M.
Institution
(Gondorf, Triantafyllou, Paschopoulos, Samolis, Tsakotos, Piagkou)
Department of Anatomy, School of Medicine, Faculty of Health Sciences,
National and Kapodistrian University of Athens, 75 Mikras Asias str.,
Goudi, Athens, Greece
(Triantafyllou, Piagkou) "VARIANTIS" Research Laboratory, Department of
Clinical Anatomy, Masovian Academy in Plock, Plock, Poland
(Arkoudis) Research Unit of Radiology and Medical Imaging, National and
Kapodistrian University of Athens, Athens, Greece
(Arkoudis, Prountzos) Second Department of Radiology, General University
Hospital "Attikon", National and Kapodistrian University of Athens,
Athens, Greece
Publisher
Springer
Abstract
Persistent left superior vena cava is a congenital variation of the
thoracic venous system. Although it is often asymptomatic, its presence
can complicate procedures such as central venous access, cardiac device
implantation, and cardiothoracic surgery. Reported prevalence data are
inconsistent and predominantly derived from populations with underlying
cardiac pathology. This study seeks to provide a robust, evidence-based
estimate of the prevalence of persistent left superior vena cava in
populations not preselected for congenital heart disease. Additionally, it
aims to quantify its principal anatomical configurations, including the
laterality of the superior vena cava and the presence or absence of a
bridging brachiocephalic vein. A systematic search was conducted using
PubMed, Google Scholar, Scopus, and Web of Science. Studies documenting
the prevalence of persistent left superior vena cava in populations not
selected on the basis of congenital heart disease criteria were included.
Statistical analysis was carried out using random-effects meta-analytic
models. Eighteen studies (n = 169,835 individuals) were included. The
pooled prevalence of persistent left superior vena cava was 0.61% (95% CI:
0.38-0.89), with substantial heterogeneity across studies. Subgroup
analysis demonstrated higher detection rates in cadaveric investigations
(2.08%) compared with interventional studies (0.38%), likely reflecting
differences in detection sensitivity. Bilateral superior vena cava was
observed in 0.32% of the population, whereas isolated persistent left
superior vena cava occurred in 0.10%. A bridging brachiocephalic vein was
present in approximately 0.11% of the total population. Although uncommon,
persistent left superior vena cava is a reproducible component of thoracic
venous morphology with embryological significance. Awareness of its
anatomical configurations is important in diagnostic and procedural
contexts, especially when a dilated coronary sinus is observed during
imaging. Copyright © The Author(s) 2026.

<133>
Accession Number
2044298651
Title
Effect of Lemon Inhalation Aromatherapy on Postoperative Pain, Nausea and
Vomiting, Delirium, and Inflammatory Markers After Coronary Artery Bypass
Grafting: A Triple-Blind Randomized Trial.
Source
Iranian Journal of Pharmaceutical Research. 25(1) (no pagination), 2026.
Article Number: e168770. Date of Publication: 01 Dec 2026.
Author
Sangi S.; Amouzegar Zavareh S.M.; Sahraei H.; Sepandi M.; Moradi A.
Institution
(Sangi) Student Research Center, School of Medicine, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
(Sangi) Department of Anesthesiology and Operation Room, School of Nursing
and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran,
Iran, Islamic Republic of
(Amouzegar Zavareh) Atherosclerosis Research Center, Clinical Sciences
Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran,
Islamic Republic of
(Sahraei) Neuroscience Research Center, Baqiyatallah University of Medical
Sciences, Tehran, Iran, Islamic Republic of
(Sepandi) Department of Epidemiology and Biostatistics, Faculty of Health,
Baqiyatallah University of Medical Sciences, Tehran, Iran, Islamic
Republic of
(Moradi) Student Research Committee, Faculty of Nursing, Baqiyatallah
University of Medical Sciences, Tehran, Iran, Islamic Republic of
Publisher
Brieflands
Abstract
Background: Complementary and integrative medicine has gained increasing
attention as a safe adjunct for improving postoperative outcomes,
particularly in cardiac surgery where pain, postoperative nausea and
vomiting (PONV), and delirium remain common and debilitating
complications. Objective(s): This randomized clinical trial aimed to
investigate the effect of lemon inhalation aromatherapy on postoperative
pain, PONV, delirium, and inflammatory markers in patients undergoing
coronary artery bypass grafting (CABG) surgery. Method(s): In this
triple-blind, parallel-group randomized controlled trial, 104 adult
patients scheduled for elective CABG surgery were randomly allocated to
either lemon aromatherapy or an odorless placebo. Aromatherapy began the
evening before surgery, was administered every two hours until anesthesia
induction, and resumed continuously during mechanical ventilation and for
72 hours after extubation. Pain and PONV were assessed every 6 hours
across eight postoperative shifts using a 0 - 10 Numeric Rating Scale.
Delirium was evaluated at 24, 48, and 72 hours using the intensive care
delirium screening checklist (ICDSC). Inflammatory markers [C-reactive
protein (CRP), neutrophil-to-lymphocyte ratio (NLR)] were measured at
baseline and 72 hours. Data were entered after double-checking into SPSS
version 26. Continuous variables were tested for normality using the
Shapiro-Wilk test; normally distributed variables were compared using
independent t-tests, and non-normal variables with the Mann-Whitney U
test. Categorical variables were analyzed using chi-square or Fisher's
exact test. All analyses were two-tailed with a significance level of P <
0.05. Result(s): Of the 104 randomized patients, 103 completed the
study (one patient in the intervention group was withdrawn due to
postoperative cerebrovascular insult). The two groups were well-balanced
at baseline with respect to demographic and clinical characteristics. Pain
scores were significantly lower in the intervention group at all eight
postoperative shifts (P < 0.001). Postoperative nausea and vomiting
severity was significantly reduced across all shifts (P < 0.001), with
fewer vomiting episodes and lower need for rescue antiemetic medications.
The incidence of delirium was significantly lower in the intervention
group at 24 hours (11.8% vs. 28.8%), 48 hours (15.7% vs. 34.6%), and 72
hours (7.8% vs. 23.1%) (all P < 0.05). Significant improvements were also
observed in multiple ICDSC subscales, particularly inattention,
disorientation, sleep-wake disturbances, and inappropriate speech/mood. At
72 hours, both CRP and NLR levels were significantly lower in the
aromatherapy group, suggesting attenuation of the postoperative
inflammatory response. No aromatherapy-related adverse events were
observed. Conclusion(s): Lemon inhalation aromatherapy was effective
in significantly reducing postoperative pain, PONV, delirium incidence,
and inflammatory markers following CABG surgery. As a safe, low-cost, and
non-invasive complementary intervention, lemon aromatherapy may enhance
postoperative recovery and represents a promising adjunct to standard care
in cardiac surgery. Copyright © 2026, Sangi et al.

<134>
Accession Number
2044282733
Title
Development of a machine learning algorithm model to predict
intraoperative hypotension in elderly patients undergoing thoracic and
abdominal surgeries.
Source
Open Medicine (Poland). 21(1) (no pagination), 2026. Article Number:
20261381. Date of Publication: 01 Jan 2026.
Author
An Y.; Liu P.; Liu L.; Hu X.; Qiao H.; Sheng W.
Institution
(An, Liu, Hu, Qiao, Sheng) Department of Anesthesiology, Beijing Shijitan
Hospital, Capital Medical University, Beijing, China
(Liu) Department of Science and Technology, Beijing Shijitan Hospital,
Capital Medical University, Beijing, China
Publisher
Walter de Gruyter GmbH
Abstract
Objectives: To develop and validate machine learning (ML) models for
identifying key predictors and estimating the risk of intraoperative
hypotension (IOH) in elderly patients undergoing general anesthesia.
 Method(s): This secondary analysis included 1,720 elderly surgical
patients from a randomized controlled trial. Data were split
chronologically into training sets. Feature selection was performed using
univariate analysis and the Boruta algorithm. Eight ML models - logistic
regression, Bayesian model, K-nearest neighbor, support vector machine,
neural network, classification and regression tree, extreme gradient
boosting, and random forest - were developed with cross-validation,
hyperparameter tuning, and random oversampling. Model performance was
evaluated using ROC, PRC, calibration, and decision curve analyses, and
interpretability was enhanced using SHapley Additive exPlanations (SHAP).
 Result(s): Key predictors included anesthesia protocol, Charlson
comorbidity index, preoperative sodium, creatinine, BUN/creatinine ratio,
intraoperative drug use (e.g., sevoflurane, lidocaine, morphine),
preoperative MAP and MHR, surgical and anesthesia duration, and surgical
site. The random forest model achieved the best performance
(accuracy=0.9917; MCC=0.9832; AUC-ROC=0.9998; AUC-PRC=0.9998).
 Conclusion(s): A robust ML-based model was established to accurately
predict IOH in elderly patients. These findings may support individualized
anesthesia management and targeted preventive strategies to reduce IOH
incidence. Copyright © 2026 the author(s)

<135>
Accession Number
2043995629
Title
Valve-sparing root replacement versus Bentall procedure with bioprosthetic
valves in patients with aortic insufficiency: a meta-analysis.
Source
General Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date
of Publication: 2026.
Author
Yokoyama Y.; Shimoda T.M.; Kuno T.; Sa M.P.; Miyamoto Y.; Takagi H.;
Fukuhara S.; Kaneko T.
Institution
(Yokoyama) Division of Cardiothoracic Surgery, Emory University School of
Medicine, 100 Woodruff Circle, Atlanta, GA, United States
(Shimoda) Department of Cardiovascular Surgery, University of Tsukuba,
Tsukuba, Japan
(Kuno) Cardiology Division, Massachusetts General Hospital, Harvard
Medical School, Boston, MA, United States
(Sa) Department of Cardiac Surgery, Massachusets General Hospital, Harvard
Medical School, Boston, MA, United States
(Miyamoto) Department of Real-world Evidence, Graduate School of Medicine,
The University of Tokyo, Tokyo, Japan
(Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center,
Shizuoka, Japan
(Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann
Arbor, MI, United States
(Kaneko) Division of Cardiothoracic Surgery, Washington University in St.
Louis, St. Louis, MO, United States
Publisher
Springer
Abstract
Objective: The use of bioprosthetic valves in the Bentall procedure
(bio-Bentall) has increased for its anticoagulant-free lifestyle benefits.
Valve-sparing root replacement (VSRR) offers an alternative to the
bio-Bentall with the preservation of native valves. However, comparative
evidence between VSRR and bio-Bentall is scarce. This meta-analysis aims
to address this knowledge gap. Method(s): A systematic review was
conducted on databases from inception through December 2025. Studies
reporting adjusted outcomes were included. The primary outcome was
mid-term all-cause mortality and aortic valve reoperation. Secondary
outcomes included perioperative mortality, stroke, reoperation for
bleeding, new dialysis initiation, and permanent pacemaker implantation.
Pooled analyses were performed using a random-effects model.
 Result(s): Four observational studies with 1,468 patients (VSRR =
771, bio-Bentall = 697) were included. Mean follow-up durations ranged
from 2.3 to 9.8 years. Except for lower stroke rates in the VSRR group, no
significant differences were found in perioperative outcomes between the
two groups. VSRR was associated with favorable mid-term mortality compared
with bio-Bentall (adjusted hazard ratio [aHR] [95% confidence interval
[CI]] = 0.59 [0.42-0.85]), and reduced aortic valve reoperation rates (aHR
[95% CI] = 0.41 [0.24-0.71]). Conclusion(s): VSRR was associated with
comparable perioperative outcomes to bio-Bentall, with favorable mid-term
mortality and aortic valve reoperation rates. Larger studies with longer
follow-up are necessary to elucidate the potential benefits of VSRR in
aortic root surgery. Copyright © The Author(s), under exclusive
licence to The Japanese Association for Thoracic Surgery 2026.

<136>
Accession Number
2044299330
Title
A Systematic Review of Inflatable Transcervical Mediastinoscopic
Oesophagectomy and McKeown Oesophagectomy in Oesophageal Cancer.
Source
Journal of the College of Physicians and Surgeons Pakistan. 36(3) (pp
374-381), 2026. Date of Publication: 01 Mar 2026.
Author
Onyebuchi I.C.; Zhu S.; Qi Y.; Hou G.
Institution
(Onyebuchi, Zhu, Qi) Department of Thoracic Surgery, First Affiliated
Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China
(Hou) Department of Thoracic Surgery, Henan Provincial People's Hospital,
Henan, China
Publisher
College of Physicians and Surgeons Pakistan
Abstract
This study compared the clinical efficacy and practicality of inflatable
transcervical mediastinoscopic oesophagectomy (TIME) versus minimally
invasive 3-stage McKeown oesophagectomy (MIME) for oesophageal cancer. A
comprehensive literature search from 2018 onwards was conducted in
databases such as PubMed and Wiley Online Library, focusing on studies
that detail these surgical methods. Primary outcomes assessed the
feasibility and practicality of TIME and MIME, with secondary outcomes
including post-surgical complications, using data from published sources.
Results indicate that TIME is generally less invasive, associated with
fewer pulmonary complications (6.43 vs. 15.42; p = 0.06, 95% CI: 3.71-
21.71) and shorter operative time (270.75 vs. 337.01 minutes; p = 0.60,
95% CI: 5,47-8.61) compared to MIME, making it preferable for patients
with previous thoracic surgeries or elderly patients. TIME also shows
advantages in terms of shorter hospital stays (15.37 vs. 24.28 days; p =
0.21, 95% CI: 5.90- 23.74), less operative bleeding (138.94 vs. 187.53 ml;
p = 0.28, 95% CI: 4.65-12.2), and fewer postoperative complications.
However, concerns remain regarding the capability of TIME for lymph node
dissection (15.47 vs. 29.42; p = 0.05, 95% CI: 4.74-32.65) and the
resection of large tumours, such as T3 and T4 tumours, where MIME is
perceived to perform better. The mortality rate was insignificant for both
surgical methods (0.50 vs. 0.20; p = 0.22, 95% CI: 1.11-5.61),
demonstrating their safety for patients with oesophageal cancer.
Nonetheless, both techniques are deemed safe and effective for treating
oesophageal cancer, with TIME demonstrating capability in resecting T3
tumours with good post-surgical outcomes. Copyright © 2026
College of Physicians and Surgeons Pakistan. All rights reserved.

<137>
Accession Number
650657527
Title
Treatment Stability of Warfarin and Acenocoumarol in Patients With
Mechanical Heart Valves and Atrial Fibrillation: A One-Year Cohort Study.
Source
Acta medica academica. (no pagination), 2026. Date of Publication: 02 Mar
2026.
Author
Hajdari Toskic S.; Mevic A.; Kulo Cesic A.
Institution
(Hajdari Toskic) Department for Detection of Coagulation Disorders, Blood
Transfusion Institute of the Federation of Bosnia and Herzegovina,
Sarajevo, Bosnia and Herzegovina
(Mevic) Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and
Herzegovina
(Kulo Cesic) Institute of Pharmacology, Clinical Pharmacology and
Toxicology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia
and Herzegovina
Abstract
OBJECTIVE: This study aimed to investigate which of the two vitamin K
antagonists, warfarin or acenocoumarol, provides more stable
anticoagulation control in patients with mechanical heart valves and
atrial fibrillation. PATIENTS AND METHODS: This was a prospective,
one-year clinical cohort study. In total, 73 outpatients with mechanical
heart valves and atrial fibrillation who were already treated with
warfarin or acenocoumarol were recruited from the Blood Transfusion
Institute of the Federation of Bosnia and Herzegovina. The prothrombin
time target values, expressed as the international normalized ratio (INR),
were 2.0-3.0/4.0. Numerical data between the treatment groups were
summarized descriptively. RESULT(S): Patients in the warfarin (N=35)
and acenocoumarol (N=38) treatment groups were similar in terms of sex,
age, body mass index, body surface area, and number of concomitant drugs
known to interact with vitamin K antagonists. The number of INR
measurements per patient, number of INR measurements within the
therapeutic range per patient, mean time interval between successive INR
measurements, and mean INR values across consecutive measurements were
similar in both groups. However, compared to acenocoumarol, warfarin
treatment seemed to be associated with more stable anticoagulation, i.e.,
with a higher mean time in the therapeutic range (TTR) (76.1+/-24.2 vs.
69.1+/-21.5%) and a smaller proportion of patients below all predefined
TTR thresholds (<60%, <65%, and <70%). CONCLUSION(S): Our unadjusted
descriptive results suggested that warfarin, compared to acenocoumarol,
may provide more stable and therefore safer anticoagulation control in
patients with mechanical heart valves and atrial fibrillation. To confirm
this, larger prospective clinical studies are needed in patients with
mechanical heart valves with or without atrial fibrillation.

<138>
Accession Number
650664144
Title
Unmasking platypnoea-orthodeoxia syndrome: a systematic review of the
pathophysiology, clinical spectrum and outcomes of percutaneous
intracardiac shunt closure.
Source
Heart (British Cardiac Society). (no pagination), 2026. Date of
Publication: 18 Mar 2026.
Author
Ermongkonchai T.; Ha F.J.; Yudi M.B.; Yeoh J.; Anandaraj A.; Theuerle J.;
Lim H.S.; Wilson W.; English K.; Teo E.; Koshy A.N.
Institution
(Ermongkonchai, Yudi, Yeoh, Anandaraj, Theuerle, Lim, Koshy) Department of
Cardiology, Austin Health, Heidelberg, VIC, Australia
(Ha) Department of Cardiology, Victorian Heart Hospital, Clayton, VIC,
Australia
(Yudi, Yeoh, Anandaraj, Theuerle, Lim) Department of Medicine, University
of Melbourne, Parkville, VIC, Australia
(Wilson, English, Teo, Koshy) Department of Cardiology, Royal Melbourne
Hospital, Parkville, VIC, Australia
Abstract
BACKGROUND: Platypnoea-orthodeoxia syndrome (POS) is a rare but
underdiagnosed cause of positional dyspnoea and hypoxaemia. It results
from right-to-left interatrial shunting through a patent foramen ovale
(PFO) or atrial septal defect (ASD), often precipitated by anatomical or
functional distortions. OBJECTIVE(S): We systematically characterised
the clinical spectrum, anatomical correlates and procedural outcomes
associated with percutaneous closure in patients diagnosed with
intracardiac POS. METHOD(S): A systematic search of PubMed, Embase
and MEDLINE databases was conducted. Case reports, case series and
observational studies were included if they involved patients with POS
with percutaneous closure of PFO/ASD. RESULT(S): A total of 469
patients from 196 studies (183 case reports/series, 13 observational
studies) were identified (mean age 68.3+/-14.1 years; 51% female). Common
symptoms included orthodeoxia (95%), exertional dyspnoea (42%) and
platypnoea (35%) with a median time from symptoms to diagnosis of 13 (IQR
4-26) weeks. Anatomical contributors included aortic dilation (33%),
thoracic structural abnormalities/surgery (33%) and right heart disorders
(15%). A mean PFO/ASD diameter of 11.5+/-5.2 mm and a pulmonary blood
flow/systemic blood flow ratio of 0.89+/-0.34 was noted. Amplatzer
occluders were the most used device (60% of closures). Postclosure oxygen
saturation improved significantly (pre: 79.5+/-8.7% vs post: 94.5+/-5.0%).
Symptomatic improvement was reported in 82% of cases, with a low
procedural complication rate of 5%. CONCLUSION(S): POS remains an
underdiagnosed clinical entity, where systematic evaluation for POS should
be considered in patients with positional desaturation and unexplained
hypoxaemia. Percutaneous closure of the interatrial shunt offers
significant symptomatic and physiological benefit with a favourable safety
profile. PROSPERO REGISTRATION NUMBER: CRD420250652717. Copyright
© Author(s) (or their employer(s)) 2026. No commercial re-use. See
rights and permissions. Published by BMJ Group.

<139>
Accession Number
650663989
Title
Mixed-methods process evaluation of the "Karl-Heinz" cardiac
prehabilitation program in older patients: protocol for the PRECOVERY
trial.
Source
Trials. (no pagination), 2026. Date of Publication: 18 Mar 2026.
Author
Munderloh A.; Steinmetz C.; Heinemann S.; von Arnim C.A.F.; Asendorf T.;
Mathes T.; Sadlonova M.; Sekanina U.; Hummers E.; Muller C.A.
Institution
(Munderloh, Sekanina, Hummers) Department of General Practice, University
Medical Center Gottingen, Gottingen, Germany
(Steinmetz, Heinemann, von Arnim, Sadlonova) Department of Geriatrics,
University Medical Center Gottingen, Gottingen, Germany
(von Arnim, Sadlonova) German Center for Cardiovascular Research (DZHK),
Partner Site Lower Saxony, Gottingen, Germany
(Asendorf, Mathes) Department of Medical Statistics, University Medical
Center Gottingen, Gottingen, Germany
(Sadlonova) Department of Cardiothoracic and Vascular Surgery, University
Medical Center Gottingen, Gottingen, Germany
(Sadlonova) Department of Psychosomatic Medicine and Psychotherapy,
University Medical Center Gottingen, Gottingen, Germany
(Muller) Department of General Practice, University Medical Center
Gottingen, Gottingen, Germany
Abstract
BACKGROUND: Structured cardiac prehabilitation programs for older patients
prior to cardiac procedures address an unmet medical need, yet
implementation evidence remains scarce. "Karl-Heinz" (Kognitiv & kardiale
Prehabilitation vor Herzinterventionen; cognitive and cardiac
prehabilitation prior to cardiac procedures) is a tailored prehabilitation
program designed to improve quality of life and reduce mortality 12 months
after elective cardiac procedures. PRECOVERY is a randomized, controlled,
two-arm parallel group, assessor-blinded, multicenter trial evaluating its
clinical efficacy. This study protocol outlines the embedded mixed-methods
process evaluation examining both the delivery and implementation of
"Karl-Heinz." The objectives are (1) to examine the implementation process
across prehabilitation centers, including contextual barriers and
facilitators; (2) to assess the intervention's fidelity, dose,
adaptations, reach, and the quality of health professional training; and
(3) to analyze key stakeholders' perspectives on implementation and
perceived impact. METHOD(S): The quantitative strand will collect
standardized questionnaires from trial participants (n = 422, aged >= 65
years), their relatives, and health professionals from participating
prehabilitation centers. Additional data sources include therapy plans and
patient diaries. Furthermore, we will systematically analyze evaluation
data from health professionals delivering the intervention to assess
training delivery. The data will be analyzed using the "joint frailty
model for longitudinal data and terminal event", supplemented by
exploratory analyses of main trial data. The qualitative strand will
include semi-structured interviews with a subsample of patients (n = 24)
and relatives (n = 24) before and after the cardiac procedure. We will
interview physicians performing the cardiac procedure (n = 9) and conduct
focus groups (three with health professionals involved in prehabilitation
delivery, two with general practitioners of prehabilitated patients).
Qualitative data will be analyzed using structured qualitative content
analysis. The results from both strands will be triangulated and related
to the results from the main trial. DISCUSSION(S): This process
evaluation will provide detailed insights into the implementation and
perceived impact of "Karl-Heinz." Capturing perspectives from multiple
stakeholder groups along with a detailed analysis of training processes
will help to identify contextual factors, facilitators, barriers, and
deviations. The mixed-methods approach will enable a thorough
understanding, support the intervention's refinement, optimize allocation
of resources, overall reproducibility, and the assessment of possible
integration into routine care. TRIAL REGISTRATION: German Clinical Trials
Register (DRKS; http://www.drks.de; DRKS00030526). Registered on 30
January 2023. Copyright © 2026. The Author(s).

<140>
[Use Link to view the full text]
Accession Number
650664079
Title
Left Atrial Appendage Closure or Medical Therapy in Atrial Fibrillation.
Source
The New England journal of medicine. (no pagination), 2026. Date of
Publication: 18 Mar 2026.
Author
Landmesser U.; Skurk C.; Kirchhof P.; Lewalter T.; Hartung J.; Rroku A.;
Pieske B.; Brachmann J.; Akin I.; Jacobshagen C.; Meder B.; Zeiher A.;
Anker S.D.; Thiele H.; Blankenberg S.; Massberg S.; Schunkert H.; Frey N.;
Joost A.; Bergmann M.; von Bardeleben R.S.; Friede T.; Placzek M.; Suling
A.; Haeusler K.G.; Endres M.; Wegscheider K.; Boldt L.-H.; Eitel I.
Institution
(Landmesser, Skurk, Hartung, Rroku) Department of Cardiology, Angiology,
Intensive Care Medicine, Campus Benjamin Franklin, Charite University
Medicine Berlin, Berlin, Germany
(Landmesser, Skurk, Hartung, Anker, Endres, Boldt) German Center for
Cardiovascular Research (DZHK) Partner Site Berlin, Berlin, Germany
(Landmesser) Friede Springer Cardiovascular Prevention Center, Berlin,
Germany
(Kirchhof, Blankenberg) Department of Cardiology, University Heart and
Vascular Center Hamburg, Hamburg, Germany
(Kirchhof, Blankenberg, Joost, Wegscheider, Eitel) DZHK Partner Site
Hamburg-Kiel-Lubeck, Hamburg, Germany
(Kirchhof) Institute of Cardiovascular Sciences, University of Birmingham,
Birmingham, United Kingdom
(Lewalter) Department of Cardiology and Intensive Care Unit, Peter Osypka
Heart Center, Hospital Munich South, Munich, Germany
(Pieske) Division of Cardiology, Department of Internal Medicine,
University Medicine Rostock, Rostock, Germany
(Brachmann) Department of Cardiology, Klinikum Coburg, Coburg, Germany
(Akin) Department of Cardiology, Hemostaseology, Medical Intensive Care,
University Medical Center Mannheim, Heidelberg University, Mannheim,
Germany
(Jacobshagen) Department of Cardiology, Intensive Care Medicine,
Angiology, Vincentius-Diakonissen Hospital, Karlsruhe, Germany
(Meder, Frey) Precision Digital Health, Department of Internal Medicine
III, Cardiology, University Heidelberg, Heidelberg, Germany
(Meder, Frey) DZHK Partner Site Heidelberg, Heidelberg, Germany
(Zeiher) Department of Medicine III, Goethe University, Frankfurt am Main,
Germany
(Zeiher) DZHK Partner Site Rhein-Main, Frankfurt, Germany
(Anker) Institute of Health Center for Regenerative Therapies, Charite
University Medicine, Berlin, Germany
(Thiele) Department of Internal Medicine-Cardiology, Heart Center at
Leipzig University, Leipzig, Germany
(Massberg) Department of Medicine I, LMU University Hospital, Ludwig
Maximillian University of Munich, Munich, Germany
(Massberg, Schunkert) DZHK Partner Site Munich, Munich Heart Alliance,
Munich, Germany
(Schunkert) Department of Cardiovascular Diseases, German Heart Center,
School of Medicine and Health, TUM University Hospital, Technical
University of Munich, Munich, Germany
(Joost, Eitel) University Heart Center Lubeck, Lubeck, Germany
(Bergmann) Department of Cardiology, Asklepios Klinik Altona, Hamburg,
Germany
(von Bardeleben) Department of Cardiology, University Medical Center,
Mainz, Germany
(Friede, Placzek) Department of Medical Statistics, University Medical
Center Gottingen, Gottingen, Germany
(Friede, Placzek) DZHK Partner Site Lower Saxony, Gottingen, Germany
(Suling, Wegscheider) Department of Medical Biometry and Epidemiology,
University Medical Center Hamburg-Eppendorf, Hamburg, Germany
(Haeusler) Department of Neurology, University Hospital Ulm, Ulm, Germany
(Endres) Department of Neurology, Charite University Medicine Berlin,
Berlin, Germany
(Boldt) Department of Cardiology, Angiology, and Intensive Care Medicine,
Deutsches Herzzentrum der Charite; Campus Virchow, Berlin
Abstract
BACKGROUND: Catheter-based closure of the left atrial appendage is an
alternative to oral anticoagulation for stroke prevention in patients with
atrial fibrillation. The effectiveness of this strategy, as compared with
physician-directed best medical care, in patients at high risk for stroke
and bleeding is unknown. METHOD(S): In this multicenter randomized
trial conducted in Germany, we assigned patients with atrial fibrillation
and a high risk of stroke and bleeding to undergo left atrial appendage
closure or to receive physician-directed best medical care (including
direct oral anticoagulants, if eligible). The primary end point, tested
for noninferiority, was a composite of stroke (ischemic or hemorrhagic),
systemic embolism, major bleeding, or cardiovascular or unexplained death,
assessed in a time-to-event analysis. The noninferiority margin was a
hazard ratio of 1.3. RESULT(S): A total of 912 adult patients
underwent randomization. The primary end-point analysis included 446
patients who were assigned to undergo left atrial appendage closure
(device group) and 442 who were assigned to physician-directed best
medical care (medical-therapy group). The mean (+/-SD) age was 77.9+/-7.1
years; 38.6% of the patients were women, the mean CHA2DS2-VASc score was
5.2+/-1.5 (range, 0 to 9, with higher scores indicating a greater risk of
stroke), and the mean HAS-BLED score was 3.0+/-0.9 (range, 0 to 9, with
higher scores indicating higher risk of bleeding). After a median
follow-up of 3 years (interquartile range, 1.7 to 4.7), a first primary
end-point event had occurred in 155 patients (incidence per 100
patient-years, 16.8) in the device group and in 127 patients (incidence
per 100 patient-years, 13.3) in the medical-therapy group (difference in
restricted mean survival time, -0.36 years; 95% confidence interval, -0.70
to -0.01; P = 0.44 for noninferiority). Serious adverse events occurred in
368 patients (82.5%) in the device group and 342 (77.4%) in the
medical-therapy group. CONCLUSION(S): Among patients with atrial
fibrillation at high risk for stroke and bleeding, left atrial appendage
closure was not noninferior to physician-directed best medical care with
regard to a composite end point of stroke, systemic embolism, major
bleeding, or cardiovascular or unexplained death. (Funded by the German
Center for Cardiovascular Research; CLOSURE-AF ClinicalTrials.gov number,
NCT03463317.). Copyright © 2026 Massachusetts Medical Society.

<141>
Accession Number
650633283
Title
Chemotherapy-Induced Cardiotoxicity: A Comprehensive Review of Current
Understanding and Future Directions.
Source
Current cardiology reviews. (no pagination), 2026. Date of Publication:
09 Mar 2026.
Author
Rama Rao L.; Mylavarapu M.; Prakash K.; Manoukian G.; Abraham A.T.;
Kabassakalian E.; Sreekumar A.; Sara Dileep H.; Arshad A.; Bilgi A.T.;
Usman R.; Azhar M.; Majumder K.
Institution
(Rama Rao, Prakash) Department of Internal Medicine, MVJ Medical College
and Research Hospital, Bangalore, India
(Mylavarapu) Department of Public Health, Adelphi University, NY, United
States
(Manoukian) Department of Anatomy, West Indies, St. George's University
School of Medicine, Grenada
(Abraham) Department of Internal Medicine, Pondicherry Institute of
Medical Sciences, Pondicherry University, Pondicherry, India
(Kabassakalian) Department of Internal Medicine, Faculty of General
Medicine, Yerevan State Medical University after Mikhtar Heratsi, Yerevan,
Armenia
(Sreekumar) Department of Internal Medicine, Rohini Hospital, Thrissur,
Kerala, India
(Sara Dileep) Department of Internal Medicine, MES Medical College,
Perinthalmanna, Kerala, India
(Arshad) Department of Internal Medicine, Shalamar Hospital, Shalamar
Institute of Health Sciences, Lahore, Pakistan
(Bilgi) Department of Internal Medicine, Ayaan Institute of Medical
Sciences, Telangana, India
(Usman) Department of Internal Medicine, Dow International Medical
College, Karachi, Pakistan
(Azhar) Department of Internal Medicine, Allama Iqbal Medical College,
Lahore, Pakistan
(Majumder) Department of Internal Medicine, R.G. Kar Medical College and
Hospital, Kolkata, West Bengal, India
Abstract
INTRODUCTION: Chemotherapy-Induced Cardiotoxicity (CIC) has become a
growing concern in modern oncology. While chemotherapy remains one of the
most effective treatments against cancer, its potential to harm the heart
often limits its use. The underlying mechanisms involve oxidative stress,
mitochondrial dysfunction, and inflammation, all contributing to the
gradual weakening of cardiac muscle. As cancer survival improves, the
burden of cardiovascular complications is more visible than ever,
emphasizing the need for early recognition, prevention, and long-term
management. METHOD(S): This review draws upon published literature,
recent clinical trials, and translational research to explore current
understanding and future directions in CIC. Studies on anthracyclines and
HER2 inhibitors were reviewed in depth, along with new data on diagnostic
biomarkers, imaging techniques, and evolving therapeutic strategies.
Particular attention was given to the role of pharmacogenomics, preventive
interventions, and emerging therapies aimed at protecting or restoring
cardiac function in patients undergoing chemotherapy. RESULT(S): CIC
can present as heart failure, arrhythmia, hypertension, myocardial
ischemia, or thromboembolism. Factors such as age, obesity, cumulative
drug exposure, and genetic predisposition significantly raise the risk.
Recent advances have improved early detection-troponins, natriuretic
peptides, and echocardiography with Global Longitudinal Strain (GLS) allow
for identification before overt symptoms appear. Preventive strategies,
including dose adjustments, liposomal formulations, and the
cardioprotective agent dexrazoxane, have shown measurable benefits.
Established cardiotoxicity can be managed with conventional heart failure
medications, antihypertensives, and anticoagulants. Experimental
approaches-ranging from mitochondrial stabilizers and histone deacetylase
inhibitors to mesenchymal stem cell therapy-show promise in reversing
cardiac injury. DISCUSSION(S): CIC reflects a complex interaction
between cancer biology, treatment intensity, and patientspecific
vulnerability. A proactive, multidisciplinary approach involving both
oncologists and cardiologists is key to balancing cancer control with
heart health. Lifestyle measures such as regular exercise and dietary
optimization can further strengthen cardiovascular resilience. Advances in
genetic testing, molecular imaging, and regenerative therapy are gradually
shifting the field toward more personalized cardio-oncology care.
 CONCLUSION(S): Chemotherapy-induced cardiotoxicity continues to
challenge clinicians striving for a cure without compromise. The future of
cancer care lies in integrating precision medicine with preventive
cardiology to minimize cardiac injury while maintaining therapeutic
efficacy. Continued research into molecular targets, biomarkers, and
cell-based therapies offers genuine hope for improving both survival and
quality of life in cancer patients. Copyright© Bentham Science
Publishers; For any queries, please email at epub@benthamscience.net.

<142>
Accession Number
2044021994
Title
Trial of Edaravone for severe hypoxic ischemic encephalopathy in adults: a
double-blind placebo-controlled study.
Source
Journal of Neurology. 273(3) (no pagination), 2026. Article Number: 207.
Date of Publication: 01 Mar 2026.
Author
Razmeh S.; Karimi A.A.; Dashti A.M.; Vafapour F.; Mousavizadeh A.
Institution
(Razmeh) Neurology Department, Yasuj University of Medical Science, Yasuj,
Iran, Islamic Republic of
(Karimi, Dashti) Yasuj University of Medical Sciences, Shahid Motahari
Blvd, Kohgiluyeh and Boyer-Ahmad Province, Yasuj, Iran, Islamic Republic
of
(Vafapour) Department of Internal Medicine, Yasuj University of Medical
Science, Yasuj, Iran, Islamic Republic of
(Mousavizadeh) Department of Biostatistics and Epidemiology, School of
Health, Yasuj University of Medical Sciences, Yasuj, Iran, Islamic
Republic of
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: Hypoxic ischemic encephalopathy (HIE) is a severe brain injury
that can lead to death and long-term disability. HIE can be treated with
therapeutic hypothermia, and various adjuvant treatments (such as
melatonin) are also utilized. Adjuvant therapies are not recommended
outside clinical trials, and therapeutic hypothermia is not universally
available. This study aimed to investigate the effects of Edaravone on
improving levels of consciousness, hemodynamic stability, and short-term
clinical outcomes of adult patients with severe HIE. To the best of our
knowledge, this study is the first randomized clinical trial investigating
the effects of Edaravone in adult patients with severe HIE.
 Method(s): A double-blind clinical trial enrolled 72 severe HIE
patients (aged > 18) within 24 h of onset who were diagnosed clinically
and radiologically. Patients were randomized to Edaravone group (n = 20)
and non-Edaravone group (n = 52). Measured parameters included level of
consciousness, vital signs, Barthel index, and patient outcome (death or
discharge). Statistical analysis was performed using SPSS version 27, with
a significance level of P < 0.05. Result(s): In short-term assessment
of the patient's level of consciousness, the Edaravone group showed
significant improvement in the Glasgow Coma Scale (GCS) post-intervention
(p = 0.001). While the Edaravone group and non-Edaravone group showed no
significant difference in outcome (p = 0.863) and Barthel score for
discharged patients (P = 0.557). Vital signs showed significant
differences between groups in temperature (P = 0.002). In the comparison
of comorbidities between the Edaravone and non-Edaravone groups, only
coronary artery bypass grafting was significantly different (P = 0.021).
 Conclusion(s): Edaravone improved the short-term level of
consciousness in severe HIE adult patients, but there was no significant
effect on outcome and level of independence in performing activities of
daily living. Further investigation into Edaravone's effectiveness is
warranted, particularly in patients with milder forms of HIE, as well as
longer follow-up periods. Copyright © Springer-Verlag GmbH
Germany, part of Springer Nature 2026.

<143>
Accession Number
650633574
Title
Mental Health and Substance Use Disorders in Advanced Heart Failure
Patients Undergoing VAD Implantation and Cardiac Transplantation: How Much
do We Know?.
Source
Current cardiology reviews. (no pagination), 2026. Date of Publication:
13 Mar 2026.
Author
Nair N.; Grzyb C.; Du D.; Mahesh B.
Institution
(Nair) Division of Cardiology, Department of Medicine, Penn State Health
Milton S. Hershey Medical Center, Hershey, United States
(Grzyb) Heart and Vascular Institute, Pennsylvania State University
College of Medicine, Hershey, United States
(Du) Department of Industrial, Manufacturing, Systems Engineering, Texas
Tech University, Lubbock, United States
(Mahesh) Division of Cardiothoracic Surgery, Department of Surgery, Penn
State Health Milton S. Hershey Medical Center, Hershey, United States
Abstract
BACKGROUND: Patients who undergo cardiac transplantation or implantation
of LVADs are significantly affected by mental health disorders and
substance use problems, which can negatively impact their compliance and
quality of life. There is a paucity of research regarding mental health
and substance abuse disorders in the post-LVAD implant/ cardiac transplant
population. This narrative review will focus on the knowledge gaps 
Methods: A qualitative review was performed by conducting a literature
search using PubMed and Google Scholar. Adults 18 years and older with
LVAD or cardiac transplant were included. The keywords used were anxiety,
depression, mood disorder, panic disorder, PTSD, adjustment disorder, and
eating disorders in LVAD patients, and anxiety, depression, mood disorder,
panic disorder, PTSD, and adjustment disorder in heart transplant
patients. No geographical parameters were used in the search. All papers
retrieved were reviewed qualitatively, and relevant information obtained
was synthesized to arrive at the results and conclusions presented in this
review. Results: This narrative review showed that anxiety,
depression, mood disorder, panic disorder, PTSD, adjustment disorder, and
eating disorder exist in patients undergoing advanced surgical therapies
(durable LVADs and cardiac transplantation). Most of the relevant studies
are retrospective chart analyses done in single centers. Incidence and
prevalence vary widely. Discussion: This review highlights the
importance of mental health surveillance in patients undergoing LVAD and
cardiac transplantation to enhance outcomes by improving behavioral health
and compliance. Conclusion(s): There are no granular guidelines
to address psychosocial evaluation in this population. The current
literature does not help to distinguish any differences mechanical support
would have on the psychology of these patients as compared to cardiac
transplantation. Knowledge gaps exist in risk assessment and risk
stratification of patients, which need further
investigation. Copyright© Bentham Science Publishers; For any
queries, please email at epub@benthamscience.net.

<144>
Accession Number
650633432
Title
Comparing the Long-term Outcomes of Coronary Artery Bypass Grafting (CABG)
vs. Percutaneous Coronary Intervention (PCI) in Patients with Multivessel
Disease- A Systematic Review and Meta-Analysis.
Source
Current cardiology reviews. (no pagination), 2026. Date of Publication:
10 Mar 2026.
Author
Ray R.; Singla S.; Virk G.S.; Hack S.; Abbas Z.; Murugesan H.A.; Mahmood
A.; Shah M.; Khalid S.; Afzal S.; Izzat I.
Institution
(Ray) Bankura Sammilani Medical College, Bankura, India
(Singla) Tidal Health, Salisbury, MD, United States
(Virk) Avalon University School of Medicine, Willemstad, Netherlands
(Hack) St. George's University, St. George's, Grenada
(Abbas) Quaid e Azam Medical College, Bahawalpur, Pakistan
(Murugesan) Government Vellore Medical College, Vellore, India
(Mahmood) Henry Ford Health System, Detroit, United States
(Shah) King Edward Medical University, Lahore, Pakistan
(Khalid) Jinnah Medical & Dental College, Karachi, Pakistan
(Afzal) Lahore Medical and Dental College, Lahore, Pakistan
(Izzat) Caribbean Medical University, Willemstad, Netherlands
Abstract
INTRODUCTION: Coronary Artery Bypass Grafting (CABG) and Percutaneous
Coronary Intervention (PCI) are standard treatments for Multivessel
Coronary Artery Disease (MVD). Their long-term comparative effectiveness
remains debated. METHOD(S): A systematic review and meta-analysis of
randomized and observational studies was conducted, including patients
with MVD followed for >=5 years. Data were pooled using randomor
fixed-effects models, depending on the level of heterogeneity.
 RESULT(S): Thirteen studies met the inclusion criteria. CABG was
associated with reduced all-cause mortality (RR 0.82, 95% CI 0.72-0.91)
and fewer repeat revascularizations (RR 1.98, 95% CI 1.74-2.26) compared
with PCI. Stroke risk was slightly higher after CABG. DISCUSSION(S):
Findings suggest CABG provides superior survival and event reduction in
long-term follow-up, particularly in higher-risk subgroups. However, the
modestly increased stroke risk highlights the need for individualized
decision-making, taking into account patient comorbidities, anatomy, and
surgical suitability. CONCLUSION(S): CABG offers long-term survival
and durability advantages over PCI in MVD, while PCI remains suitable for
patients with lower-risk anatomy or when surgery is
contraindicated. Copyright© Bentham Science Publishers; For any
queries, please email at epub@benthamscience.net.

<145>
Accession Number
2044038182
Title
Salvage surgery in non-small cell lung cancer: a three-decade bibliometric
and clinical appraisal of the most influential studies.
Source
Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 8.
Date of Publication: 01 Dec 2026.
Author
Ozturk O.; Akcay O.; Acar T.; Gursoy S.
Institution
(Ozturk, Akcay, Acar, Gursoy) Department of Thoracic Surgery, Bakircay
University Cigli Training and Research Hospital, Yeni Mahalle, Murat
Karayalcin Bulvari No. 18, Cigli/Izmir, Turkey
Publisher
Springer Science and Business Media Deutschland GmbH
Abstract
Background: This study aims to provide a comprehensive bibliometric
evaluation of the most influential publications on salvage surgery for
non-small cell lung cancer from 1991 to 2023, highlighting scientific
trends, geographic contributions, journal impact, and major clinical
themes. A systematic search was conducted in the Web of Science Core
Collection using the terms "salvage surgery" and "non-small cell lung
cancer." Only English, SCI-Expanded research articles reporting surgical
intervention were included. Among 302 records, the 20 most cited studies
were selected. Publication year, country, journal, citation count,
clinical characteristics, surgical details, and oncologic outcomes were
extracted and analyzed. Despite increasing clinical interest, no prior
study has systematically synthesized both bibliometric trends and clinical
outcomes in salvage surgery for NSCLC. Result(s): The included
studies received a total of 508 citations, with Japan contributing the
highest number (45%). Seventy-five percent of publications were produced
in the last decade, reflecting rising academic interest. The most
prominent journals were The Annals of Thoracic Surgery and The Journal of
Thoracic and Cardiovascular Surgery. Clinical cohorts were small and
typically composed of advanced-stage non-small cell lung cancer patients.
Lobectomy was the predominant procedure, while morbidity ranged from 19 to
70% and mortality remained low. Achieving R0 resection, pathological N0
status, and lower disease stage were consistently associated with improved
survival. Conclusion(s): This bibliometric assessment demonstrates
that salvage surgery is a feasible and oncologically valuable option for
selected non-small cell lung cancer patients following definitive
chemoradiotherapy or other non-operative treatments. Despite high
morbidity, perioperative mortality is acceptable, and complete resection
remains the strongest predictor of long-term survival. Future prospective,
multicenter, and standardized studies are required to strengthen the
evidence base and refine patient selection. Copyright © The
Author(s) 2026.

<146>
[Use Link to view the full text]
Accession Number
650618402
Title
The efficacy and safety of serratus anterior plane block in patients
undergoing cardiac surgery: A systematic review and meta-analysis.
Source
Medicine. 105(11) (pp e48013), 2026. Date of Publication: 13 Mar 2026.
Author
Cui X.-B.; Cui M.-Z.; Yang Q.-J.; Liu Y.; Yi M.-Q.; Zhang X.-Y.; Yao Y.-T.
Institution
(Cui, Cui, Yi) Department of Anesthesiology and Perioperative Medicine,
People's Hospital of Henan University, Henan Provincial People's Hospital,
Zhengzhou, China
(Yang, Liu, Zhang) Department of Anesthesiology and Perioperative
Medicine, People's Hospital of Zhengzhou University, Henan Provincial
People's Hospital, Zhengzhou, Henan, 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) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China
(Yao) Department of Anesthesiology, Center of Outcomes Research, Critical
Care and Pain Medicine, University of Texas, Houston, TX, United States
(Yao) Outcomes research Consortium, Houston, TX, United States
Abstract
BACKGROUND: Serratus anterior plane block (SAPB) is a widely used fascial
block that reduces postoperative pain and perioperative opioid
consumption. This meta-analysis assessed the efficacy and safety of SAPB
in cardiac surgery patients. METHOD(S): We systematically searched
PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge
Infrastructure, and Wanfang databases on May 10, 2024. Pooled relative
risks and mean differences (MD) with 95% confidence intervals (CI) were
calculated for dichotomous and continuous outcomes, respectively.
Heterogeneity was assessed using the I2 statistic, and publication bias
was evaluated using Egger test. Subgroup analyses were stratified by study
design (randomized controlled trials vs cohort studies) and patient age to
explore methodological heterogeneity. RESULT(S): Fifteen studies,
encompassing 1169 adult and pediatric participants, were included.
Overall, compared to general anesthesia (GA) alone, the SAPB + GA group
significantly reduced intensive care unit length of stay (MD = -6.61
hours, 95% CI: -10.91 to -2.32), decreased postoperative analgesic
consumption (MD = -4.20 mg morphine equivalents, 95% CI: -6.52 to -1.88),
and lowered the risk of complications (relative risk = 0.63, 95% CI:
0.40-0.99). SAPB + GA also lowered postoperative Visual Analogue Scale
pain scores (MD = -1.25, 95% CI: -1.74 to -0.75) and serum cortisol levels
(MD = -35.43 nmol/L, 95% CI: -58.58 to -12.27). No local anesthetic
toxicity or mortality was reported. CONCLUSION(S): Perioperative SAPB
combined with GA provides significant benefits in cardiac surgery,
including accelerated intensive care unit discharge, reduced opioid use
and pain scores, attenuated stress response (reduced cortisol), and
favorable safety, which supports enhanced patient recovery. Copyright
© 2026 the Author(s). Published by Wolters Kluwer Health, Inc.

<147>
Accession Number
2044128026
Title
1708 Improving Patient Education with Visual Aids During Transplant Organ
Viewing.
Source
Laboratory Investigation. Conference: Laboratory Investigation The Science
That Advances Pathology. San Antonio United States. 106(3 Supplement) (no
pagination), 2026. Article Number: 106011. Date of Publication: 01 Mar
2026.
Author
Hurst P.; Amundson A.; Bois M.; Maleszewski J.; Froemming J.B.; Layman A.;
Yi E.; Lo Y.-C.; Scott J.; Kennedy C.; Roden A.
Institution
(Hurst, Bois, Maleszewski, Froemming, Layman, Yi, Lo, Scott, Kennedy,
Roden) Mayo Clinic, Rochester, MN, United States
(Amundson) Mayo Clinic College of Medicine and Science, Rochester, MN,
United States
Publisher
Elsevier B.V.
Abstract
Disclosures: Philip Hurst: None; Aaron Amundson: None; Melanie Bois: None;
Joseph Maleszewski: None; Jennifer Boland Froemming: None; Andrew Layman:
None; Eunhee Yi: None; Ying-Chun Lo: None; John Scott: None; Cassie
Kennedy: None; Anja Roden: None Background: Patients undergoing heart/lung
transplantation may face challenges in understanding the pathology that
led to the need for transplantation. We offer a unique opportunity where
patients view their explanted organ(s) with a pathologist. A systematic
review of our processes was undertaken by faculty and trainees,
identifying a need for visual aids to illustrate diagnostic processes and
pathophysiology. To enhance patient education and engagement, this quality
improvement project aimed to (i) identify needs that would facilitate
patient education, (ii) develop supplementary tools, including QR codes
linking to interactive digital representations of both healthy and
patient-specific diseased anatomy that would enhance the comprehension of
organ viewing and (iii) to evaluate the effectiveness of these tools.
 Design(s): Faculty involved in our transplant organ viewing program
were surveyed to assess needs for improved visual aids (Figure 1). A
6-question survey was designed to assess the effectiveness of these new
visual aids and their effects on patient comprehension, understanding of
the pathologist's role, and the ability to communicate their condition to
others (Table 1). Result(s): Results from the faculty survey showed
that 5/6 respondents (83.3%) felt the visual aids would help to discuss
disease processes with patients and all respondents indicated they would
incorporate the aids into their patient visits. Free text response
indicated an interest in having physical models available in these
sessions. A brochure was developed to prepare patients for what to expect
during their organ viewing. QR code-linked 3D models were generated for
both hearts and lungs to be used during the patient encounter and for
side-by-side comparison between normal and diseased anatomy (Figure 2).
The post-viewing patient questionnaire was created and administered to
patients before introduction of the QR code-provided 3D models and to
patients who viewed their organs using these models to compare their
experiences. [Formula presented] [Formula presented] [Formula presented]
 Conclusion(s): The ongoing project will address needs and provide
insights into the effectiveness of the new visual aids in enhancing
patients' understanding and experience during their explant viewing. The
impact of this educational approach on improving patient care and
self-management post-transplant will also be assessed. The information
gathered may have further use in patient education and can be extrapolated
for further improvement of other organ system explant viewing
services. Copyright © 2025

<148>
Accession Number
2037842721
Title
Influence on Depression, Anxiety, and Satisfaction of the Relatives' Visit
to Intensive Care Units prior to Hospital Admission for Elective Cardiac
Surgery: A Randomized Clinical Trial.
Source
International Journal of Clinical Practice. 2022 (no pagination), 2022.
Article Number: 1746782. Date of Publication: 2022.
Author
Gonzalez-Martin S.; Becerro-de-Bengoa-Vallejo R.; Rodriguez-Garcia M.;
Losa-Iglesias M.E.; Mazoteras-Pardo V.; Palomo-Lopez P.; Rodriguez-Sanz
D.; Calvo-Lobo C.; Lopez-Lopez D.
Institution
(Gonzalez-Martin, Becerro-de-Bengoa-Vallejo, Rodriguez-Garcia,
Rodriguez-Sanz, Calvo-Lobo) Faculty of Nursing, Physiotherapy and
Podiatry, Universidad Complutense de Madrid, Madrid, Spain
(Losa-Iglesias) Faculty of Health Sciences, Universidad Rey Juan Carlos,
Mostoles, Spain
(Mazoteras-Pardo) Department of Nursing, Physiotherapy and Occupational
Therapy, School of Physiotherapy and Nursing, University of Castilla-La
Mancha, Toledo, Spain
(Palomo-Lopez) University Center of Plasencia, Universidad de Extremadura,
Plasencia, Spain
(Lopez-Lopez) Research, Health and Podiatry Group, Department of Health
Sciences, Faculty of Nursing and Podiatry, Industrial Campus of Ferrol,
Universidade da Coruna, A Coruna, Spain
Publisher
John Wiley and Sons Ltd
Abstract
Background. Intensive care units (ICUs) may produce stress on the
relatives of patients that have long-term physiological and psychological
implications. Objectives. this study aimed to evaluate the e5ects of the
relatives' visit prior to hospital admission(s) on the patient's scheduled
cardiac surgery regarding depression, anxiety, and satisfaction of the
patient's family in an ICU. Methods. A randomized clinical trial
[NCT03605420] was carried out according to the CONSORTcriteria.
thirty-eight relatives of ICU patients were recruited at an ICU and
randomized into study groups. Experimental group participants (n = 19)
consisted of relatives who received 1 ICU visit prior to the patient's
admission. Control group participants (n = 19) consisted of patients'
relatives who received standard care alone. A self-report test battery,
including the Impact of Event Scale-Revised (IES-R) and the Hospital
Anxiety and Depression Scale (HADS), was completed by the patient's
relative prior to the patient's ICU admission and again three and 90 days
after ICU discharge. Furthermore, the Family Satisfaction with Care in the
Intensive Care Unit (FS-ICU) and Critical Care Family Needs Inventory
(CCFNI) were administered to help determine the respondents' satisfaction
three days after the patient's ICU discharge. Results. Statistically
signiBcant di5erences in FS-ICU results were found between control and
experimental groups; no statistically signiBcant di5erences were found in
IES-R, HADS, and CCFNI results. thus, members in the control group were
more satisBed with the time elapsed to raise their concerns (p = 0.005),
emotional support provided (p = 0.020), quality of care (p = 0.035),
opportunities to express concerns and ask questions (p = 0.005), and
general satisfaction with the ICU's decisionmaking (p = 0.003).
Conclusions. Relatives' satisfaction during patients' ICU admission may be
impaired after their prior visit to the hospital admission. Relative's
anxiety and depression scores did not seem to be signiBcantly a5ected.
Relatives' visit prior to elective cardiac surgery hospital admission
impaired their satisfaction in an ICU and may not be advisable for
healthcare practice. Copyright © 2022, Sara Gonzalez-Martin et
al.

<149>
Accession Number
2043984914
Title
Intraoperative text messaging to reduce parental stress during outpatient
pediatric surgery: a randomized trial.
Source
Pediatric Research. (no pagination), 2026. Date of Publication: 2026.
Author
Linke R.; Mayer S.; Suttkus A.; Thiery J.; Hoehne C.; Laufs U.; Wachter
R.; Treml J.; Mende M.; Pfaeffle R.; Lacher M.; Gosemann J.-H.
Institution
(Linke, Mayer, Suttkus, Lacher, Gosemann) Department of Pediatric Surgery,
University of Leipzig Medical Center, Leipzig, Germany
(Thiery) Institute of Laboratory Medicine, Clinical Chemistry and
Molecular Diagnostics, University of Leipzig Medical Center, Leipzig,
Germany; Faculty of Medicine, Deanship, University of Kiel, Kiel, Germany
(Hoehne) Department of Anesthesiology, University of Leipzig Medical
Center, Leipzig, Germany; Department of Anesthesiology, Intensive Care
Medicine and Pain Therapy, DRK Hospital Berlin-Koepenick, Berlin, Germany
(Laufs, Wachter) Department of Cardiology, University of Leipzig Medical
Center, Leipzig, Germany
(Treml) Department of Psychosomatic Medicine and Psychotherapy, University
of Leipzig Medical Center, Leipzig, Germany
(Mende) Clinical Trial Centre (ZKS Leipzig) and Institute of Medical
Informatics, Statistics and Epidemiology, Leipzig University, Faculty of
Medicine, Leipzig, Germany
(Pfaeffle) Department of Pediatrics, Pediatric Endocrinology, University
of Leipzig Medical Center, Leipzig, Germany
Publisher
Springer Nature
Abstract
Background: This study examined parental stress indicators during
outpatient pediatric surgery and whether intraoperative text messaging
could alleviate stress. Method(s): This randomized trial assigned
parents of children aged 6 months to 6 years undergoing minor outpatient
surgery to an intervention group, receiving standardized intraoperative
text messages, or a control group without messages. Both groups received a
postoperative phone call. Stress was assessed using salivary cortisol,
heart rate, heart rate variability, and subjective ratings at multiple
perioperative time points. Result(s): Fifty-one families
participated, predominantly mothers (71%). Cortisol and heart rate
variability peaked preoperatively, while heart rate and subjective stress
were elevated pre- and intraoperatively regardless of messaging. Fathers
had lower cortisol at the end of surgery, heart rate pre- and
postoperative and subjective stress at pre-treatment consultation compared
to mothers, who exhibited lower heart rate variability the evening before
surgery. Messaging reduced postoperative cortisol and intraoperative
subjective stress among fathers but increased subjective stress at surgery
onset within mothers and had no significant effect on stress indicators
across the full cohort. Conclusion(s): Intraoperative text messaging
reduced stress in fathers but not in mothers or the full cohort. The
preoperative period remained the most stressful. Future research should
explore gender-specific strategies to improve perioperative parental
support. Impact: This study assessed parental stress during outpatient
pediatric surgery and the impact of intraoperative text messaging as a
supportive intervention. Text messages reduced stress in fathers but
showed minimal benefit and potential adverse effects in mothers, with
increased subjective stress at surgery onset; no overall stress reduction
was observed in the full cohort. The preoperative phase was identified as
the most stressful for parents. These findings inform pediatric surgical
teams that text-based interventions may support fathers' perioperative
coping and postoperative compliance but may be ineffective or
counterproductive for mothers, highlighting the need in future research
for gender-sensitive stress-reduction strategies. Copyright © The
Author(s) 2026.

<150>
Accession Number
650617091
Title
Simulation training for invasive cardiovascular procedures: the
Heart-SIMS-1 randomized trial.
Source
BMC medical education. (no pagination), 2026. Date of Publication: 14 Mar
2026.
Author
Oliveira-Santos M.; Guerreiro C.; Lobo B.; Marinho A.V.; Borges-Rosa J.;
Guardado J.; Santos E.O.; Costa M.; Goncalves L.; Bogle R.; Dudek D.;
Pires-Morais G.; Marques J.S.; Khokhar A.A.
Institution
(Oliveira-Santos, Marinho, Borges-Rosa, Costa, Goncalves) Servico de
Cardiologia, Unidade Local de Saude de Coimbra, Coimbra, Portugal
(Oliveira-Santos, Lobo, Borges-Rosa, Goncalves) Faculdade de Medicina da
Universidade de Coimbra, Coimbra, Portugal
(Oliveira-Santos, Santos, Marques) 3D CardioSolutions, Coimbra, Portugal
(Guerreiro, Pires-Morais) Servico de Cardiologia, Unidade Local de Saude
de Gaia/Espinho, Vila Nova de Gaia, Portugal
(Guardado, Marques) Unidade Cardiovascular, Riachos, Portugal
(Bogle) Department of Cardiology, Epsom & St Helier University Hospitals
NHS Trust, St George's, Surrey, United Kingdom
(Dudek) Institute of Cardiology, Jagiellonian University Medical College,
Krakow, Poland
(Marques) Servico de Cardiologia, Unidade Local de Saude de Santa Maria,
Lisboa, Portugal
(Khokhar) Rigshospitalet, Copenhagen University Hospital, Copenhagen,
Denmark

<151>
Accession Number
650614956
Title
Effects of individualized PEEP titration on intraoperative cardiac output
in thoracoscopic lung surgery: a prospective randomized trial.
Source
Scientific reports. (no pagination), 2026. Date of Publication: 12 Mar
2026.
Author
Zhu M.; Song T.; Bao Q.; Wang J.; Wang W.; Song Z.; Tan J.
Institution
(Zhu, Song, Bao, Wang, Wang, Song, Tan) Jiangsu Province Key Laboratory of
Anesthesiology, Xuzhou Medical University, Xuzhou, China
(Wang, Song, Tan) Department of Anesthesiology, Jiangsu Cancer Hospital,
Nanjing, China
Abstract
Personalized positive end-expiratory pressure (PEEP) based on pulmonary
compliance may improve intraoperative hemodynamics and postoperative
outcomes in thoracic surgery. This study aimed to evaluate the effect of
individualized, compliance-guided PEEP titration on cardiac output (CO)
and postoperative pulmonary complications (PPCs) in patients undergoing
video-assisted thoracoscopic pulmonary resection. In this prospective
randomized controlled trial, 80 patients scheduled for thoracoscopic
pulmonary resection were allocated to either an individualized PEEP group
(Group N) or a fixed PEEP group (Group C). Group N received dynamic PEEP
titration starting at 15 cmH2O, adjusted to optimize compliance; Group C
received a fixed PEEP of 5 cmH2O. Hemodynamic parameters including CO,
heart rate (HR), and systemic vascular resistance (SVR) were recorded at
five time points: baseline after admission (T1), 20 min after initiating
two-lung ventilation (T2), 30 min following PEEP implementation (T10), 60
min post-PEEP adjustment (T11), and upon completion of one-lung
ventilation (T12). PPCs and postoperative pneumonia incidence were also
recorded. Seventy-six patients completed the study (n = 38 per group). At
T11, T12, Group N showed significantly higher CO than Group C. The optimal
PEEP range for compliance was 7-13 cmH2O. Compared to 5 cmH2O PEEP of
individualized PEEP during OLV resulted in better lung compliance, lower
driving pressure, and higher mean airway pressure, without differences in
peak airway pressure or PETCO2. Postoperative pulmonary complications
(PPCs) occurred more frequently in Group C (42.1% vs. 13.2%, p = 0.004).
No significant differences were observed in overall SVR trends between
groups, except at T11, T12. Compliance-guided individualized PEEP improves
cardiac output and may reduce postoperative pulmonary complications in
patients undergoing thoracoscopic lung resection. This approach holds
promise for enhancing perioperative respiratory and hemodynamic
stability.Trial registration: ChiCTR2100048201, intervention study,
registered on 04/07/2021. Copyright © 2026. The Author(s).

<152>
[Use Link to view the full text]
Accession Number
650606350
Title
Do Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio Reflect
Coronary Artery Disease Severity Assessed by SYNTAX Score?: A
Meta-Analysis.
Source
Cardiology in review. (no pagination), 2026. Date of Publication: 12 Mar
2026.
Author
Assayed A.; Aburumman S.; Abunemr I.; Salih A.R.F.; Gruhonjic H.; Minasyan
A.; Fabian D.; Ledonio C.; Prashad R.
Institution
(Assayed, Gruhonjic, Minasyan, Fabian) From the Department of Cardiology,
University of Central Florida, Orlando, FL, Puerto Rico
(Assayed, Gruhonjic, Minasyan, Fabian, Ledonio, Prashad) Cardiology
Department, Cardiology Fellowship Program, HCA Florida Ocala Hospital,
Ocala, FL, Puerto Rico
(Aburumman, Abunemr, Salih) Department of Internal Medicine, University of
Jordan Queen Rania Street, Amman, Jordan
(Prashad) Professor UCF College of Medicine, University of Central
Florida, Orlando, FL, Puerto Rico
Abstract
Coronary artery disease is a major global cause of morbidity and
mortality, with systemic inflammation playing a central role in its
pathophysiology. The SYNTAX (Synergy Between percutaneous coronary
intervention With Taxus and Cardiac Surgery) score is widely used to
quantify the anatomical complexity of coronary lesions, but its
invasiveness and cost limit routine application. Hematologic inflammatory
indices such as the neutrophil-to-lymphocyte ratio (NLR) and
platelet-to-lymphocyte ratio (PLR) have been proposed as simple,
inexpensive biomarkers that may reflect the presence and severity of
coronary disease. This meta-analysis evaluated the association between NLR
and PLR and angiographic complexity measured by the SYNTAX score. A
systematic search of PubMed, MEDLINE, Cochrane, and CINAHL through May
2024 identified studies reporting correlations between NLR and/or PLR and
SYNTAX scores in adults with coronary artery disease. Random-effects
models using Fisher's z-transformation were applied to pool correlation
coefficients. Heterogeneity was assessed using Cochran's Q, I2, and tau2.
Subgroup analyses examined the effects of country, study design, and
publication year, and meta-regression explored the influence of mean age
and sex distribution. Publication bias was evaluated with funnel plots and
Egger's regression. Fifteen studies involving 17,348 participants were
included. NLR showed a significant positive correlation with SYNTAX score
(r = 0.37; 95% CI, 0.28-0.45). PLR demonstrated a similar association (r =
0.38; 95% CI, 0.23-0.51). Heterogeneity was substantial for both indices.
Stronger correlations were observed in Turkish cohorts, and increasing
mean age was associated with larger effect sizes. No significant
publication bias was detected. Both NLR and PLR correlate moderately with
coronary lesion complexity and may provide accessible adjunctive markers
for preprocedural risk stratification. Copyright © 2026 Wolters
Kluwer Health, Inc. All rights reserved.

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