EPICORE Embase Updates: EMBASE Cardiac Update AutoAlert: EPICORE Cardiac Surgery Blogger2

Total documents retrieved: 127 Results Generated From: Embase <1980 to 2026 Week 17> Embase Weekly Updates (updates since 2026-04-17) - (127 records) <1> Accession Number 646115432 Title Efficacy of the intravenous formulation of fentanyl citrate administered orally as premedication in paediatric patients undergoing open cardiac surgery. Source Journal of perioperative practice. 36(5) (pp 326-335), 2026. Date of Publication: 01 May 2026. Author Elbardan I.M.; Shehab A.S.; Yacout A.G.; Mabrouk I.M. Institution (Elbardan, Shehab, Yacout, Mabrouk) Department of Anesthesia and Surgical Intensive Care, Alexandria Faculty of Medicine, Alexandria, Egypt Abstract BACKGROUND: Recently, fentanyl has become prevalent as a sedative premedication. METHOD(S): A non-inferiority parallel design quadruple-blinded randomised controlled trial of 1- to 7-year-old children scheduled for elective cardiac surgery was conducted. Participants were assigned a 1:1 allocation ratio to a control group (n = 50) given a parenteral formulation of midazolam 0.5 mg/kg and an intervention group (n = 50) given a parenteral formulation of fentanyl 10 mug/kg 30 min before admission to the operating room. RESULT(S): Fentanyl was shown to be inferior when compared to midazolam during inhalational induction but not in the 'after premedication' and 'during separation' periods. A lower percentage of children disliked the medication in the fentanyl group. CONCLUSION(S): A parenteral formulation of fentanyl can be a satisfactory alternative when given orally as a sedative pre-anaesthetic medication in paediatric cardiac surgery before admission to the operating room. <2> Accession Number 646542234 Title Transcatheter edge-to-edge mitral valve repair versus medical therapy for secondary mitral regurgitation: a meta-analysis of randomized controlled trials. Source Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace. 96(1) (no pagination), 2026. Date of Publication: 02 Mar 2026. Author Mata E.; Lage Garcia B.; Tinoco M.; Castro M.; Pinheiro L.; Portugues J.; Ferreira F.; Ribeiro S.; Melica B.; Lourenco A. Institution (Mata, Lage Garcia, Tinoco, Castro, Pinheiro, Portugues, Ferreira, Ribeiro, Lourenco) Department of Cardiology, Local Health Unit of Alto Ave, Guimaraes (Melica) Department of Cardiology, Local Health Unit of Gaia and Espinho, Vila Nova de Gaia, Portugal Abstract Secondary mitral regurgitation (SMR) is associated with increased hospitalizations and mortality. Clinical trials comparing mitral valve transcatheter edge-to-edge repair (M-TEER) with guideline-directed medical therapy (GDMT) show conflicting results, but the RESHAPE-HF2 trial offers new insights. This study aims to assess the M-TEER effect in addition to GDMT in reducing all-cause mortality, cardiovascular death, and heart failure hospitalizations (HHF) in patients with SMR when compared to GDMT alone. On September 2, 2024, PubMed, Cochrane CENTRAL, Scopus, and Web of Science were searched for randomized controlled trials comparing M-TEER in addition to GDMT with GDMT in SMR patients with heart failure. A study-level random-effects meta-analysis was conducted using trial-reported point estimates. Seven records from three trials (COAPT, MITRA-FR, RESHAPE-HF2) involving 1426 participants were included. At 24 months, M-TEER (using MitraClip) significantly reduced the first HHF [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.45-0.96] and all HHF (HR 0.63, 95% CI 0.49-0.81). However, no significant reduction was observed in all-cause mortality (HR 0.76, 95% CI 0.57-1.01) or cardiovascular death (HR 0.77, 95% CI 0.56-1.06). The intervention group had more patients in the New York Heart Association class I/II at 12 and 24 months, but no significant improvement in 6-minute walk test performance at 12 months. High trial heterogeneity requires careful interpretation of pooled estimates. Differences in medical therapy and patient characteristics likely affected outcomes across trials. While M-TEER demonstrates benefits in reducing HHF, its effectiveness in reducing mortality remains inconclusive. The degree of left ventricular enlargement may have influenced outcomes, underscoring the importance of careful patient selection. <3> Accession Number 2044710657 Title Teriparatide in Two Patients With Mucopolysaccharidosis Type IVB. Source JIMD Reports. 67(3) (no pagination), 2026. Article Number: e70088. Date of Publication: 01 May 2026. Author Wijnen M.; van Velsen E.F.S.; Milhous J.G.-J.; Oussoren E.; van der Eerden B.C.J.; Wagenmakers M.A.E.M. Institution (Wijnen, Wagenmakers) Department of Internal Medicine, Center for Lysosomal and Metabolic Diseases, Erasmus Medical Center, Rotterdam, Netherlands (Wijnen, van Velsen, van der Eerden) Department of Internal Medicine, Section Endocrinology, Erasmus MC Bone Center, Erasmus Medical Center, Rotterdam, Netherlands (Milhous) Department of Cardiology, Admiraal de Ruyter Hospital in Goes, Vlissingen, and Zierikzee, Netherlands (Oussoren) Department of Pediatrics, Center for Lysosomal and Metabolic Diseases, Erasmus Medical Center, Rotterdam, Netherlands (van der Eerden) Laboratory for Calcium and Bone Metabolism, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, Netherlands Publisher John Wiley and Sons Inc Abstract Mucopolysaccharidosis Type IV is a multisystem lysosomal storage disease characterized by severe skeletal dysplasia resulting from impaired degradation of the glycosaminoglycans keratan sulfate and chondroitin-6-sulfate. The condition is classified into Types A and B based on the underlying enzyme deficiency. Low bone mineral density (BMD) is a feature of the skeletal phenotype, contributing to increased fracture risk. Extraskeletal manifestations include, among others, cardiovascular disease due to valvular stenosis and regurgitation, myocardial remodeling, coronary artery disease, and vascular stiffness, all associated with glycosaminoglycan accumulation. We report two adult patients with mucopolysaccharidosis Type IVB treated with the osteoanabolic agent teriparatide for an apparently low BMD. The first patient presented with a non-healing femoral fracture requiring BMD improvement prior to surgical fixation. This patient was treated with teriparatide for 2 years, which resulted in significant BMD gain, enabling successful surgical fixation. The second patient received teriparatide for only 6 months and showed stable BMD. Notably, both patients developed serious cardiac problems during teriparatide treatment: the first patient experienced rapidly progressive aortic stenosis, while the second patient developed dyspnea and polyuria due to worsening dynamic left ventricular outflow tract obstruction, which had previously been asymptomatic. Both patients required invasive cardiac interventions, which carry high risk in mucopolysaccharidosis due to unique anatomical and anesthetic challenges. The temporal association between teriparatide treatment and the onset of cardiac problems in both patients is noteworthy and raises the possibility of a treatment-related effect. Therefore, we recommend cautious use of teriparatide in patients with mucopolysaccharidosis Type IV. Copyright © 2026 The Author(s). JIMD Reports published by John Wiley & Sons Ltd on behalf of SSIEM. <4> Accession Number 2044150499 Title End-diastolic forward flow (EDFF) after tetralogy of Fallot repair: Evolution of its role in management and prognosis. Source International Journal of Cardiology Congenital Heart Disease. 24 (no pagination), 2026. Article Number: 100667. Date of Publication: 01 Jun 2026. Author Baneu P.; van Dijk A.P.; Duijnhouwer A.L.; ten Cate T.; Helbing W.A.; Nijveldt R.; Zelis J.M. Institution (Baneu, van Dijk, Duijnhouwer, ten Cate, Nijveldt, Zelis) Department of Cardiology, Radboud University Medical Center, Geert Grooteplein Zuid 10, GA, Nijmegen, Netherlands (Helbing) Department of Pediatric Cardiology, Erasmus Medical Center, Dr. Molewaterplein 40, GD, Rotterdam, Netherlands Publisher Elsevier B.V. Abstract Objective In the era of personalized medicine and multimodality imaging, renewed attention is directed toward the restrictive right ventricular (RV) physiology, including its historic hallmark, the end-diastolic forward flow (EDFF), in Tetralogy of Fallot (ToF) repair. Initially perceived as a marker of favorable restriction, EDFF has been repositioned as a multifactorial hemodynamic phenomenon rather than a specific indicator of myocardial stiffness, based on recent imaging and mechanistic studies. Methods This review synthesizes the evolution of perception, the diagnostic assessment, and the prognostic relevance of EDFF in repaired ToF. A comprehensive PubMed search spanning from 1987 to 2024 identified relevant studies, including clinical trials, observational analyses, and meta-analyses on EDFF and RV restrictive physiology. Results EDFF was initially associated with smaller "protective" RVs and improved exercise tolerance in early echocardiographic studies. Later, a dual-restrictive model distinguishing beneficial (primary) from maladaptive (secondary) patterns was proposed, with the addition of cardiac magnetic resonance (CMR). EDFF has recently been demonstrated to also occur in non-restrictive RV due to altered RV-pulmonary arterial coupling, regurgitant flow dynamics, or atrioventricular dyssynchrony. Novel 4D-flow imaging has enriched the general understanding of RV restrictive physiology but has not added significant prognostic value to EDFF. Conclusions Advances in imaging and physiology have shifted EDFF from a unidimensional marker of restriction to a complex manifestation of right atrio-ventriculo-arterial interaction. While mechanistically informative, EDFF appears to lack prognostic specificity in isolation. Future research aimed at establishing standardized definitions that integrate volumetric, kinetic, and coupling parameters could enhance the diagnostic and clinical relevance. Copyright © 2026 The Authors. <5> [Use Link to view the full text] Accession Number 2043511489 Title Efficacy and Safety of Semaglutide on Cardiovascular Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Cardiology in Review. Publish Ahead of Print (no pagination), 2025. Date of Publication: 19 Sep 2025. Author Bacha Z.; Javed J.; Sheraz M.; Sikandar M.; Zakir M.; Ali M.A.; Khan M.; Iqbal A.; Rehman A.; Alam U.; Ahmed R. Institution (Bacha, Sikandar, Zakir, Ali, Khan, Rehman, Alam) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Javed) Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Sheraz) Department of Medicine, Continental Medical College, Lahore, Pakistan (Iqbal) Department of Medicine, Bacha Khan Medical College, Mardan, Pakistan (Ahmed) Department of Cardiology, National Institute of Heart and Lung, Imperial College, London, United Kingdom Publisher Lippincott Williams and Wilkins Abstract Cardiovascular complications remain the leading cause of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM), despite substantial advances in pharmacologic management. Semaglutide, a glucagon-like peptide-1 receptor agonist, has shown potential in reducing cardiovascular events through its multifaceted metabolic and anti-inflammatory effects. This systematic review and meta-analysis aimed to assess the efficacy and safety of semaglutide in improving cardiovascular outcomes among patients with T2DM. A comprehensive literature search was conducted across multiple databases up to March 30, 2025. Randomized controlled trials comparing semaglutide with placebo in adults with T2DM were included. Five randomized controlled trials with a total of 19, 717 participants were included. Semaglutide was associated with a significant reduction in major adverse cardiovascular events [risk ratios (RR), 0.82; P < 0.00001], cardiovascular death (RR, 0.81; P = 0.05), and need for coronary revascularization (RR, 0.74; P < 0.0001). A significant reduction in cardiac disorder-related adverse events was also observed (RR = 0.80; P = 0.03). No significant difference was noted in all-cause mortality (RR = 0.83; P = 0.16), hospitalization for heart failure (RR = 0.86; P = 0.10) or unstable angina (RR = 0.94; P = 0.63), nonfatal myocardial infarction (RR = 0.82; P = 0.10) or stroke (RR = 0.83; P = 0.06), and vascular disorders (RR = 1.03; P = 0.73). These findings highlight semaglutide's role as a cardioprotective agent, supporting its integration into standard care for high-risk T2DM patients. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <6> Accession Number 650546826 Title Rupture and dissection of aortic autograft following the ross procedure: a systematic review. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 09 Mar 2026. Author Ramkaran R.; Briscoe J.; Cameron D.E.; Wang H. Institution (Ramkaran) Johns Hopkins University, Baltimore, MD, United States (Briscoe, Cameron, Wang) Division of Cardiac Surgery, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, United States <7> Accession Number 2044044053 Title Transcatheter aortic valve replacement for mixed aortic valve disease: An updated meta-analysis and systematic review. Source American Journal of the Medical Sciences. 371(5) (pp 434-440), 2026. Date of Publication: 01 May 2026. Author Kidess G.G.; Hamza M.; Basit J.; Alraiyes M.; Alraies M.C. Institution (Kidess) Department of Internal Medicine, The University of Chicago Medical Center, Chicago, IL, United States (Hamza) Department of Hospital Medicine, Gurthrie Cortland Regional Medical Center, Cortland, NY, United States (Basit) Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan (Alraiyes) Department of Interventional Cardiology Research, Detroit Medical Center/Wayne State University, Detroit, MI, United States (Alraies) Cardiovascular Unit, Detroit Medical Center/Wayne State University, Detroit, MI, United States Publisher Elsevier B.V. Abstract Background: Mixed aortic valve disease (MAVD) is defined by the presence of concurrent aortic stenosis (AS) and aortic regurgitation (AR). Transcatheter aortic valve replacement (TAVR) is effective in MAVD patients with mortality rates comparable to pure aortic stenosis (PAS). While most TAVR complications also occur at similar rates between the MAVD and PAS populations, recent studies have shown conflicting results. Method(s): A systematic literature review was conducted on PubMed and Embase for studies on the outcomes of TAVR in MAVD from inception until May 2024. Primary outcomes were short- and long-term mortality. Secondary outcomes were paravalvular regurgitation (PVR), vascular and bleeding complications, pacemaker implantation, and cerebrovascular complications. A random-effects model was used to pool risk ratios (RR) and 95 % confidence intervals (CI). Result(s): Eleven observational studies, including 133,558 patients, were included in the analysis. There were no significant differences in primary endpoints (p > 0.05). MAVD was associated with a higher risk of paravalvular regurgitation (RR: 1.29, 95 % CI: 1.07-1.55) and higher risk of vascular complications (RR: 1.20, 95 % CI: 1.01-1.44). No significant differences were noted in other secondary outcomes (p > 0.05), although there was a nonsignificant trend towards a decreased risk of cerebrovascular complications associated with TAVR in MAVD patients. Conclusion(s): TAVR is an intervention with similar mortality and complication risk in MAVD and PAS patients. Future research is needed to further clarify the outcomes of TAVR in patients with MAVD, especially regarding cerebrovascular complications, long-term mortality, and the association of paravalvular regurgitation with mortality. Copyright © 2026 Southern Society for Clinical Investigation <8> Accession Number 2041591201 Title Surgical Insights into the Functional Anatomy of the Neo-aortic Root. Source World Journal for Pediatric and Congenital Heart Surgery. 17(3) (pp 295-309), 2026. Date of Publication: 01 May 2026. Author Dakik L.; Najm H.K.; Belitsis G.; Goswami D.; Anderson R.H.; Spicer D.E.; Tretter J.T. Institution (Dakik, Najm, Belitsis, Tretter) Division of Pediatric Cardiac Surgery, Department of Pediatric Cardiology, Cleveland Clinic Children's, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States (Goswami) Department of Cardiovascular Medicine, The Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States (Anderson) Newcastle University, Newcastle upon Tyne, United Kingdom (Spicer) Heart Institute, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States Publisher SAGE Publications Inc. Abstract Although the normal aortic and pulmonary roots have some features in common, they also exhibit important anatomical and functional differences. These differences increase when compared with surgically created neo-aortic roots in individuals with congenitally malformed hearts, with the substrates initially having been either a pulmonary root originating from the right or left ventricle, or a truncal root with variable ventricular origin. With the increasing application and success of these surgeries, our attention has now turned toward understanding late outcomes. Subsequent dilation, usually producing neo-aortic valvar regurgitation, is the most common cause of reoperation in any procedure involving a neo-aortic root. In this review, we describe and compare the detailed anatomy of the normal aortic, pulmonary, and common truncal roots, comparing them with the changes observed in the neo-aortic root following various common surgeries providing biventricular repair for congenital cardiac malformations. We focus on the dilated and dysfunctional neo-aortic root, assessing how the anatomical information relates to contemporary surgical techniques. Furthermore, we aim to review risk factors as they relate to the adverse anatomical features which become evident when the new root is dysfunctional, hoping to provide surgical insight toward optimizing its function and durability. Copyright © The Author(s) 2025 <9> Accession Number 2043240336 Title High-Exchange Ultrafiltration to Enhance Recovery After Pediatric Cardiac Surgery: The ULTRA Randomized Controlled Trial. Source Annals of Thoracic Surgery. 121(5) (pp 1158-1167), 2026. Date of Publication: 01 May 2026. Author Bierer J.D.; Stanzel R.; Henderson M.; Krmpotic K.; Andreou P.; Marshall J.S.; Sapp J.; Horne D. Institution (Bierer, Horne) Division of Cardiac Surgery, Dalhousie University, Halifax, NS, Canada (Stanzel, Henderson) Department of Clinical Perfusion, Nova Scotia Health Authority, Halifax, NS, Canada (Krmpotic) Department of Critical Care, Dalhousie University, Halifax, NS, Canada (Andreou) Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS, Canada (Marshall) Department of Microbiology & Immunology, Dalhousie University, Halifax, NS, Canada (Sapp) Division of Cardiology, Dalhousie University, Halifax, NS, Canada Publisher Elsevier Inc. Abstract Background Pediatric cardiac surgery with cardiopulmonary bypass (CPB) is associated with systemic inflammation. This trial aimed to determine whether continuous high-exchange ultrafiltration during CPB has a clinical immunomodulatory effect. Methods This single-center, double-blind trial enrolled pediatric patients weighing <15 kg undergoing cardiac surgery who were randomly allocated to continuous high-exchange subzero-balance ultrafiltration (H-SBUF; 60 mL/kg per hour effluent extraction) or continuous low-exchange subzero-balance ultrafiltration (L-SBUF; 6 mL/kg per hour effluent extraction) administered during CPB. The primary outcome was peak postoperative vasoactive-ventilation-renal (VVR) score. Secondary outcomes included acute kidney injury, low cardiac output syndrome, health care utilization, and inflammatory mediator fold change throughout CPB (NCT04920643). Results A total of 104 patients were randomly allocated to H-SBUF (n = 52) or L-SBUF (n = 52). The primary outcome was similar between groups as the peak VVR score was 26.9 (2.1-77.9) in the H-SBUF group and 27.8 (0.8-76.7) in the L-SBUF group ( P = .67). There were no operative deaths and no significant differences in acute kidney injury, low cardiac output syndrome, ventilation time, inotropic agent use time, intensive care unit stay, or hospital length of stay ( P > .05). The H-SBUF group had a higher fold change for interleukin-1alpha, P-selectin, and vascular cell adhesion molecule 1 ( P < .05), whereas 36 other mediators were not significantly different between groups ( P > .05). Conclusions In pediatric patients undergoing cardiac surgery with CPB, continuous high-exchange SBUF did not reduce peak VVR score compared with low-exchange SBUF. Furthermore, there were no differences in secondary clinical outcomes, and the immunologic profile was largely similar between groups. Copyright © 2026 The Authors. <10> Accession Number 2044514888 Title Percutaneous Coronary Intervention in Frail Patients Undergoing Transcatheter Aortic Valve Replacement. Source JACC: Cardiovascular Interventions. 19(7) (pp 828-839), 2026. Date of Publication: 13 Apr 2026. Author Ratcovich H.; Holmvang L.; Sadjadieh G.; Jabbari R.; Glinge C.; Sabbah M.; Veien K.T.; Niemela M.; Freeman P.; Linder R.; Sorensen R.; Ioanes D.; Terkelsen C.J.; Ellert-Gregersen J.; Christiansen E.; Eftekhari A.; Piuhola J.; Kajander O.; Koul S.; Savontaus M.; Karjalainen P.; Ruck A.; Angeras O.; Bieliauskas G.; Jorgensen T.H.; Sondergaard L.; De Backer O.; Engstrom T.; Lonborg J. Institution (Ratcovich, Holmvang, Sadjadieh, Jabbari, Glinge, Sabbah, Sorensen, Bieliauskas, Jorgensen, De Backer, Engstrom, Lonborg) Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark (Veien, Ellert-Gregersen) Department of Cardiology, Odense University Hospital, Odense, Denmark (Niemela, Piuhola) Research Unit of Biomedicine and Internal Medicine, Medical Research Center Oulu, University of Oulu and Oulu University Hospital, Oulu, Finland (Freeman, Eftekhari) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Linder, Ruck) Department of Medicine, Karolinska Institute, Stockholm, Sweden (Linder, Ruck) Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institute, Danderyd University Hospital, Stockholm, Sweden (Ioanes, Angeras) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Terkelsen, Christiansen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Terkelsen) The Danish Heart Foundation, Copenhagen, Denmark (Kajander) Heart Hospital, Tampere University Hospital, Wellbeing Services County of Pirkanmaa, Tampere, Finland (Kajander) The Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Koul) Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Lund, Sweden (Savontaus) Heart Center, Turku University Hospital, Turku, Finland (Karjalainen) Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland (Angeras) Department of Molecular and Clinical Medicine, Institute of Medicine, Gothenburg University, Gothenburg, Sweden (Sondergaard) Abbott Cardiovascular, Santa Clara, CA, United States (De Backer) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher Elsevier Inc. Abstract Background Frailty is an important predictor of outcomes in patients with coronary artery disease (CAD) and following transcatheter aortic valve replacement (TAVR). The NOTION-3 (Third Nordic Aortic Valve Intervention) trial demonstrated that performing percutaneous coronary intervention (PCI) in addition to TAVR reduced the risk for major adverse cardiac events (MACE). Whether this benefit applies to frail patients remains uncertain. Objectives The aim of this study was to evaluate efficacy and safety of PCI in frail TAVR patients with CAD. Methods NOTION-3 was an international, open-label, randomized superiority trial enrolling patients with CAD and severe aortic stenosis undergoing TAVR. Patients were randomized 1:1 to PCI or conservative treatment. Frailty was assessed post hoc using a calculated frailty score derived from baseline data on symptom-related limitations, daily function, and quality of life. Primary endpoint was a composite of all-cause mortality, myocardial infarction (MI), and urgent coronary revascularization. Safety endpoints included bleeding and acute kidney injury. Results Frailty data were available for 407 patients (90%), of whom 130 (32%) were frail. During median follow-up of 2 years (Q1-Q3: 1-4 years), PCI reduced MACE in nonfrail patients (15% vs 33%; HR: 0.42; 95% CI: 0.25-0.69; P < 0.001), as well as death of any cause (P = 0.019), MI (P = 0.004), and urgent revascularization (P = 0.005). No differences were observed in frail patients. In contrast, frail patients undergoing PCI had more bleeding events (HR: 2.51; 95% CI: 1.23-5.11; P = 0.011). Conclusions In nonfrail patients with CAD undergoing TAVR, PCI lowered the risk for MACE, all-cause mortality, and MI compared to conservative treatment. In frail patients, PCI increased bleeding without clinical benefit. These findings require confirmation in larger prospective studies. Copyright © 2026 American College of Cardiology Foundation. <11> Accession Number 2039540940 Title Network meta-analysis of cardioplegic methods, in elective isolated coronary artery bypass grafting. Source Perfusion (United Kingdom). 41(3) (pp 240-253), 2026. Date of Publication: 01 Apr 2026. Author Kalogerakos P.D.; Kokkinakis S.; Akoumianakis E.; Karagkounis T.; Gavalaki A.; Kiparakis M.; Akoumianakis I.; Lazopoulos L.; Gaitanaki T.; Andreou A.; Lasithiotakis K.; Kontopodis N.; Lazopoulos G. Institution (Kalogerakos, Karagkounis, Gavalaki, Kiparakis, Lazopoulos, Lazopoulos) Department of Cardiac Surgery, General University Hospital of Heraklion, Crete, Greece (Kokkinakis) Department of General, Visceral, Tumor, and Transplantation Surgery, University Hospital of Cologne, Cologne, Germany (Akoumianakis) Department of Otorhinolaryngology - Head and Neck Surgery, General University Hospital of Heraklion, Crete, Greece (Akoumianakis) Cardiovascular Medicine Division, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (Gaitanaki) Department of Cardiology, General University Hospital of Heraklion, Crete, Greece (Andreou, Lasithiotakis) Department of General Surgery, General University Hospital of Heraklion, Crete, Greece (Kontopodis) Department of Vascular Surgery, General University Hospital of Heraklion, Crete, Greece Publisher SAGE Publications Ltd Abstract BackgroundCardioplegic arrest can be induced by various methods, fueling a long-standing controversy about their comparative merit. We aim to compare cardioplegic methods in coronary artery disease.MethodsPubMed, Embase, and Cochrane databases were interrogated for randomized trials that compared various cardioplegic methods in adult patients undergoing elective isolated coronary artery bypass grafting. Differences in cardioplegic composition - crystalloid or blood, route of delivery - antegrade or retrograde, and temperature, were evaluated in a network meta-analysis. The endpoints were mortality, myocardial infarction, insertion of intra-aortic balloon pump, low cardiac output syndrome, increased inotropic support, as well as cardiopulmonary bypass time, aortic cross-clamp time, intensive care stay, hospital stay, new onset atrial fibrillation, reperfusion ventricular fibrillation, and neurologic event. Confidence In Network Meta-Analysis web application was employed.Results75 studies were included, with 6131 patients receiving one of 13 cardioplegic methods. Warm ante/retrograde blood cardioplegia was associated with fewer deaths (P-score 0.81), fewer intra-aortic balloon pumps (P-score 0.77), and shorter intensive care (P-score 0.69) and hospital stay (P-score 0.81). Cross clamp time was shorter with crystalloid cardioplegias, while reperfusion ventricular fibrillation was less frequent with warm blood cardioplegias. Cold cardioplegias were associated with lower rates of new onset atrial fibrillation and stroke. Confidence varied greatly across the endpoints.ConclusionThe outcomes of this network study indicate presumable advantages of warm ante/retrograde blood cardioplegia in elective isolated coronary artery bypass grafting. Under the light of certain biases and mixed confidence, the results should be cautiously interpreted. More studies are needed. Copyright © The Author(s) 2025 <12> Accession Number 2044250507 Title Comparative Outcomes of Fractional Flow Reserve and Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention in Intermediate Lesions: A Systematic Review and Meta-Analysis. Source Cardiovascular Therapeutics. 2026(1) (no pagination), 2026. Article Number: 6570642. Date of Publication: 2026. Author Jamileh E.; Akhtar Z.; Farooq K.; Babu M.; Xamza M.; Antoun I. Institution (Jamileh) Royal Blackburn Teaching Hospital, East Lancashire Hospitals Trust, England, Blackburn, United Kingdom (Akhtar) School of Medicine, University of Oxford, England, Oxfordshire, United Kingdom (Farooq) Kings College Hospital NHS Foundation Trust, England, London, United Kingdom (Babu) Royal Preston Hospital, Lancashire Hospitals NHS Trust, England, Preston, United Kingdom (Xamza) Barking, Havering and Redbridge University Hospitals NHS Trust, England, London, United Kingdom (Antoun) Department of Cardiology, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Antoun) Department of Cardiovascular Sciences, Clinical Science Wing, Glenfield Hospital, University of Leicester, Leicester, United Kingdom Publisher John Wiley and Sons Inc Abstract Objective: Advanced techniques beyond angiography increasingly guide percutaneous coronary intervention (PCI). Fractional flow reserve (FFR) and intravascular ultrasound (IVUS) are widely used for physiological and anatomical guidance, respectively. This study compares clinical outcomes of FFR versus IVUS-guided PCI. Method(s): We conducted a systematic review and meta-analysis that identified studies comparing FFR- and IVUS-guided PCI. Primary outcomes included major adverse cardiovascular events (MACE), all-cause mortality, cardiac death, nonfatal myocardial infarction (MI) and target vessel revascularisation (TVR). A secondary outcome was the number of PCI procedures performed. Random effects modelling was used for all outcomes. Result(s): Six studies comprising 5040 patients (FFR: 2517; IVUS: 2523) were included. There were no significant differences between FFR- and IVUS-guided PCI in the incidence of MACE (RR = 1.13, 95% CI 0.89-1.44), all-cause mortality (RR = 0.82, 95% CI 0.41-1.64), cardiac death (RR = 1.05, 95% CI 0.60-1.85), nonfatal MI (RR = 1.35, 95% CI 0.72-2.52) or TVR (RR = 1.21, 95% CI 0.81-1.81). Subgroup analyses by study design (observational studies and randomised control trials) showed no significant effect modification for any outcome. There was no significant difference in the number of PCI procedures performed (RR = 0.78, 95% CI 0.59-1.02), although heterogeneity was high (I2 = 95%). Conclusion(s): FFR and IVUS are both effective for guiding PCI, with similar outcomes in terms of MACE, mortality, MI, TVR and PCI procedures performed. Modality selection should be tailored to lesion complexity, institutional expertise and resource availability. Copyright © 2026 Eyad Jamileh et al. Cardiovascular Therapeutics published by John Wiley & Sons Ltd. <13> Accession Number 2040155239 Title Modified ultrafiltration warming technology in pediatric congenital heart disease surgery: A case-control study. Source Perfusion (United Kingdom). 41(3) (pp 270-279), 2026. Date of Publication: 01 Apr 2026. Author Han X.; Xu H.; Li J.; Yao Y.; Dong Y.; Cui J. Institution (Han, Xu, Li, Yao, Dong, Cui) Department of Anesthesiology, Children's Hospital of Chongqing Medical University, China (Han, Xu, Li, Yao, Dong, Cui) National Clinical Research Center for Child Health and Disorders, China (Han, Xu, Li, Yao, Dong, Cui) Ministry of Education Key Laboratory of Child Development and Disorders, China (Han, Xu, Li, Yao, Dong, Cui) Chongqing Key Laboratory of Pediatrics, China Publisher SAGE Publications Ltd Abstract BackgroundTo evaluate the effect and safety of modified ultrafiltration warming technology during pediatric congenital heart disease (CHD) surgery.MethodsA retrospective analysis included 68 children (<1 year) who underwent CHD correction surgery with cardiopulmonary bypass (CPB) and modified ultrafiltration (MUF). Patients were divided into a warmed MUF group (W-MUF, n = 38) and a conventional MUF group (n = 30). The W-MUF group used a dual-channel infusion warmer during MUF. Preoperative and postoperative parameters, including Nasopharyngeal temperature (NPT),rectal temperature (RT), hemoglobin (Hb), hematocrit (HCT),prothrombin time (PT), Prothrombin Time Ratio (PTR) ,pericardial drainage volume, the intensive care unit (ICU) stay, extubation time,and transfusion requirements were compared.ResultsNo significant differences were found between groups preoperatively. The PT and prothrombin ratio in the MUF group were significantly prolonged compared to pre-MUF values and the W-MUF group (p < .05). After MUF, the W-MUF group had higher nasopharyngeal and rectal temperatures and shorter ICU stay, faster extubation time,and lower pericardial drainage volume compared to the MUF group (p < .05). The W-MUF group also required less fresh frozen plasma, cryoprecipitate,and platelets postoperatively (p < .05),while there was no significant difference in red blood cell (RBC) transfusion requirements between the two groups.ConclusionModified ultrafiltration warming technology is safe and effective. It is beneficial for temperature regulation in CHD surgery and is worthy of promotion. Copyright © The Author(s) 2025 <14> [Use Link to view the full text] Accession Number 2043980654 Title Incidence, Risk Factors, and Outcomes in Stressor-Associated Atrial Fibrillation: Insights From the VITAL-AF Trial. Source Circulation. 153(6) (pp 367-378), 2026. Date of Publication: 10 Feb 2026. Author Haimovich J.S.; Kany S.; Chang Y.; Borowsky L.H.; McManus D.D.; Atlas S.J.; Singer D.E.; Lubitz S.A.; Ellinor P.T.; Khurshid S. Institution (Haimovich, Kany, Lubitz, Ellinor, Khurshid) Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, United States (Haimovich, Kany, Lubitz, Ellinor, Khurshid) Cardiovascular Research Center, Heart and Vascular Institute, Mass General Brigham, Boston, MA, United States (Haimovich) Cardiology Division, Heart and Vascular Institute, Mass General Brigham, Boston, United States (Kany) Department of Cardiology, University Heart and Vascular Center Hamburg-Eppendorf, Hamburg, Germany (Chang, Borowsky, Atlas, Singer) Division of General Internal Medicine, Mass General Brigham, Boston, MA, United States (Chang, McManus) Department of Medicine, University of Massachusetts Medical School, Worcester, United Kingdom (Atlas, Singer) Department of Medicine, Harvard Medical School, Boston, United States (Lubitz, Ellinor, Khurshid) Telemachus and Irene Demoulas Family Foundation Center for Cardiac Arrhythmias, Heart and Vascular Institute, Mass General Brigham, Boston, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Stressor-associated atrial fibrillation (AF), defined as newly diagnosed AF in the setting of a reversible physiological stressor, is common. However, risk factors, outcomes, and current management practices remain poorly understood. METHOD(S): - We analyzed data from VITAL-AF, a pragmatic, cluster-randomized AF screening trial conducted in 2018 and 2019 comprising adults >=65 years of age across 16 primary care practices affiliated with Massachusetts General Hospital. All participants had longitudinal follow-up for adjudicated incident AF (including whether stressor-associated versus nonstressor-associated ["primary"]) and clinical outcomes. We compared associations between clinical AF risk factors and incident AF group (stressor-associated versus primary) using Fine-Gray models handling death and each AF group as competing risks. We also quantified oral anticoagulant initiation rates after AF diagnosis. We then fit Cox proportional hazards models to quantify associations between incident AF group (as a time-varying covariate) and a composite end point of major bleeding, stroke, and all-cause mortality, with adjustment for CHADS-VASc (congestive heart failure, hypertension, age >74, diabetes, stroke or transient ischemic attack or thromboembolism, vascular disease, age 65-74, sex category; stroke) and ATRIA (Anticoagulation and Risk Factors in Atrial Fibrillation; bleeding) scores and time-varying oral anticoagulant exposure. RESULT(S): - We analyzed 30 265 patients (41% men, 83% White, and mean age 74 years). Of 988 incident AF events, 290 (29%) were stressor associated. Clinical risk factors, including age, hypertension, and heart failure, showed similar associations with both primary and stressor-associated AF. Oral anticoagulant initiation within 90 days of new AF diagnosis was lower for stressor-associated versus primary AF (56% versus 75%, P<0.001). The incidence of the composite end point was 2.30 per 100 person-years (95% CI, 2.17-2.44) for no AF, 15.09 (95% CI, 12.22-18.42) for primary AF, and 22.71 (95% CI, 16.91-29.87) for stressor-associated AF. In adjusted models and using no AF as the referent, both primary AF (hazard ratio [HR], 3.91 [95% CI, 2.89-5.28]) and stressor-associated AF (HR, 6.13 [95% CI, 4.31-8.72]) were associated with substantially higher risk of the composite end point. CONCLUSION(S): - Among >30 000 primary care patients with adjudicated AF events, nearly one-third of incident AF cases were stressor associated. Despite similar risk factor profiles and comparably high rates of adverse outcomes, oral anticoagulant initiation is lower when AF is stressor associated. Future work is needed to define optimal approaches to prevention, surveillance, and management of stressor-associated AF. Copyright © 2025 American Heart Association, Inc. <15> Accession Number 2044434702 Title Design and rationale of the prospective, randomized, controlled trial to assess the management of moderate aortic stenosis by clinical surveillance or transcatheter aortic valve replacement: The PROGRESS Trial. Source American Heart Journal. 297 (no pagination), 2026. Article Number: 107433. Date of Publication: 01 Jul 2026. Author Genereux P.; Makkar R.R.; Bax J.J.; Pibarot P.; Lindman B.R.; Prince H.; Park B.; Cohen D.J.; Mack M.J.; Leon M.B. Institution (Genereux) Morristown Medical Center, Gagnon Cardiovascular Institute, Morristown, NJ, United States (Makkar) Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States (Bax) Department of Cardiology, Leiden University Medical Center, Leiden, Netherlands (Pibarot) Quebec Heart & Lung Institute, Laval University, Quebec City, QC, Canada (Lindman) Cardiovascular Medicine Division, Structural Heart and Valve Center, Vanderbilt University Medical Center, Nashville, TN, United States (Prince, Park) Edwards Lifesciences, Irvine, CA, United States (Cohen) St. Francis Hospital and Heart Center, Roslyn, NY, United States (Cohen, Leon) Cardiovascular Research Foundation, New York, NY, United States (Mack) Department of Cardiothoracic Surgery, Baylor Research Institute, Baylor Scott and White the Heart Hospital Plano, Plano, TX, United States (Leon) Division of Cardiology, Columbia University Irving Medical Center, New York-Presbyterian Hospital, New York, NY, United States Publisher Elsevier Inc. Abstract Background For patients with moderate aortic stenosis (AS), current US guidelines recommend clinical surveillance every 1 to 2 years. However, moderate AS has been associated with increased morbidity and mortality in multiple observational studies, suggesting a possible role for earlier treatment with transcatheter aortic valve replacement (TAVR). To date, no large, randomized trial has examined whether an early intervention with TAVR will improve outcomes among these patients. Study Design and Objectives The PROGRESS trial is a prospective, open-label, randomized, controlled, multicenter trial that includes up to 750 patients with moderate AS and at-risk features randomized 1:1 to either clinical surveillance or transfemoral TAVR with the SAPIEN 3/SAPIEN 3 Ultra/SAPIEN 3 Ultra RESILIA transcatheter heart valve (Edwards Lifesciences, Irvine, CA). Patients are stratified by site, left ventricular ejection fraction, and peak jet velocity. The primary effectiveness endpoint is the composite of death or heart failure event with or without hospitalization at 2 years. The primary safety endpoint (evaluated in the TAVR arm only) is a composite of death, stroke, life threatening or fatal bleeding, acute kidney injury stage 4, hospitalization due to device- or procedure-related complications, or valve dysfunction requiring reintervention at 30 days. Patients will be followed annually through 10 years. Conclusions The PROGRESS trial is the first large, randomized trial assessing the role of early intervention among patients with moderate AS with at-risk features compared to clinical surveillance. Trial Registration Number ClinicalTrials.gov identifier: NCT04889872 Copyright © 2026 The Authors. <16> Accession Number 2044876199 Title The availability of mentorship for underrepresented minorities in surgery and surgical subspecialties: A systematic review. Source American Journal of Surgery. 257 (no pagination), 2026. Article Number: 116978. Date of Publication: 01 Jul 2026. Author Falzarano C.E.; Khalil S.K.; Mellman T.A.; Levy G. Institution (Falzarano, Khalil) Howard University College of Medicine, Washington DC, United States (Mellman) Howard University Department of Psychiatry and Behavioral Sciences, Washington DC, United States (Levy) Howard University Department of Surgery, Washington DC, United States Publisher Elsevier Inc. Abstract Surgical subspecialties have historically lacked diversity. Recently, surgical programs have begun to implement interventions for underrepresented in medicine (URiM) students to foster interest and provide mentorship for a successful residency match. A comprehensive PubMed literature search of mentorship in surgical subspecialties (general surgery, cardiothoracic surgery, neurosurgery, orthopedics, otolaryngology, plastics, urology and vascular surgery) for URiM individuals published between 2012 and 2025 was conducted. Of 255 articles identified, only 18 discussed established URiM outreach/pipeline programs and were analyzed. A majority of programs were established at the medical school level (11), followed by high school (3), undergraduate (2), and residency (1). All subspecialties were represented except vascular. Outreach programs are effective in promoting interest in surgical subspecialties and hold the potential to increase diversity in the field when targeted toward URiM students. More programs are needed at all training levels and across all subspecialties. Copyright © 2026 Elsevier Inc. <17> Accession Number 2044831315 Title Free Versus In situ Right Internal Mammary Artery as a Conduit in Coronary Artery Bypass Surgery: A Meta-Analysis. Source Interdisciplinary Cardiovascular and Thoracic Surgery. 41(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Kikuchi Y.; Sakata T.; Shimoda T.; Fukuhara S.; Shimamura J.; Hibino M.; Kaneko T.; Takayama H.; Takagi H.; Sa M.P.; Kuno T. Institution (Kikuchi) Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States (Sakata) Department of Cardiac Surgery, Thomas Jefferson University Hospital, Philadelphia, PA, United States (Shimoda) United States Naval Hospital Yokosuka, Kanagawa, Yokosuka, Japan (Fukuhara) Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI, United States (Shimamura) Division of Cardiothoracic Surgery, Westchester Medical Center, Valhalla, NY, United States (Hibino) Division of Cardiothoracic Surgery, Westchester Medical Center, Valhalla, NY, United States (Kaneko) Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, MO, United States (Takayama) Division of Cardiothoracic and Vascular Surgery, Columbia University Irving Medical Center, New York, NY, United States (Takagi) Department of Cardiovascular Surgery, Shizuoka Medical Center, Japan (Sa) Department of Cardiothoracic Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic Florida, Weston, FL, United States (Kuno) Cardiology Division, Massachusetts General Hospital Harvard Medical School, Boston, MA, United States (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Publisher Oxford University Press Abstract Abstract Objectives There is debate regarding the optimal choice for a second conduit in coronary artery bypass grafting. The right internal mammary artery (RIMA) is commonly employed as a second conduit; however, it is unclear whether the free (fRIMA) or in situ (isRIMA) configuration yields superior outcomes. We performed a systematic review and meta-analysis to compare clinical outcomes between fRIMA and isRIMA as the second conduit. Methods A comprehensive search of PubMed (MEDLINE), EMBASE, and CENTRAL was performed through May 2025 to identify studies comparing outcomes in patients undergoing coronary artery bypass grafting with either fRIMA or isRIMA as a second conduit. The outcomes of interest were overall mortality, graft occlusion, major adverse cardiac events (MACE), and repeat revascularization. Data with 95% confidence intervals (CIs) were extracted. Pooled analysis was performed using a random-effects model. Results A total of 13 studies with 9899 patients were included (fRIMA, n = 3095; isRIMA, n = 6804). The median study follow-up duration ranged from 1 to 20 years across the studies. No statistically significant differences were observed in overall mortality (hazard ratio [95% CI] = 1.16 [0.79-1.69]), graft occlusion (1.04 [0.90-1.21]), MACE (0.87 [0.62-1.21]), and repeat revascularization (1.34 [0.68-2.66]). Conclusions In this meta-analysis, no statistically significant differences were observed between fRIMA and isRIMA configurations across the evaluated clinical outcomes. These findings suggest that, within the limitations of available evidence, the choice between fRIMA and isRIMA may be guided by clinical context, surgeon preference, patient anatomy, and target vessel characteristics rather than expected differences in major clinical outcomes. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. <18> Accession Number 2044869243 Title Short-Term Outcomes of Coronary Endarterectomy as an Adjunct to Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis of Over 100000 Patients. Source Interdisciplinary Cardiovascular and Thoracic Surgery. 41(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Hon J.J.; Arjomandi Rad A.; Egrilmezer A.; Al-Zubaidi F.I.; D'Alessio A.; Sharma S.; Omar M.; Androutsopoulou V.; Ali-Hasan-Al-Saegh S.; Weymann A.; Ruhparwar A.; Sardari Nia P.; Athanasiou T.; Kourliouros A. Institution (Hon) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Arjomandi Rad) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Arjomandi Rad) Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands (Egrilmezer) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Al-Zubaidi) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (D'Alessio) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Sharma) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Omar) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Androutsopoulou) Department of Cardiothoracic Surgery, University General Hospital of Larissa, Greece (Ali-Hasan-Al-Saegh) Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany (Weymann) Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany (Ruhparwar) Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany (Sardari Nia) Department of Cardiothoracic Surgery, Maastricht University Medical Center+, Maastricht, Netherlands (Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Kourliouros) Department of Cardiothoracic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom Publisher Oxford University Press Abstract Objectives: To assess short-term outcomes of coronary artery bypass grafting (CABG) with adjunct coronary endarterectomy (CE) compared with isolated bypass grafting, and to synthesize available confounder-adjusted effect estimates. Method(s): We conducted a systematic review and meta-analysis following PRISMA guidelines. MEDLINE, Embase, and CENTRAL were searched from January 2000 to June 2025. Eligible studies compared adult patients undergoing CABG with CE versus isolated CABG. Two reviewers independently screened studies, extracted data, and assessed quality. Random-effects meta-analysis was performed. The primary outcome was 30-day or in-hospital mortality. Result(s): Sixteen studies (119 458 patients) were included. CABG with CE was associated with higher mortality (RR 1.84, 95% CI 1.65-2.04). Pooling adjusted odds ratios from 3 studies yielded OR 1.76 (95% CI 1.55-2.00), with 2 of 3 individual estimates not reaching significance. Secondary outcomes showed increased risks of perioperative myocardial infarction (RR 1.99, 95% CI 1.29-3.07), stroke (RR 1.37, 95% CI 1.08-1.75), renal failure (RR 1.62, 95% CI 1.44-1.82), and intra-aortic balloon pump use (RR 1.96, 95% CI 1.41-2.70). Sensitivity analyses confirmed consistency across all the subgroups. Conclusion(s): CABG with CE is associated with higher short-term mortality and morbidity compared with isolated bypass grafting; however, confounder-adjusted analyses suggest this excess risk is partly attributable to greater baseline disease severity rather than an independent procedural effect. The scarcity of data and absence of randomized evidence preclude definitive causal conclusions. These findings provide benchmarking data for counselling when endarterectomy is necessary to achieve complete revascularization. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. <19> Accession Number 2042694077 Title Comparison of perioperative outcomes of minimally invasive and conventional aortic root surgery in adult patients: a systematic review and meta-analysis. Source General Thoracic and Cardiovascular Surgery. 74(4) (pp 329-339), 2026. Date of Publication: 01 Apr 2026. Author Karadzha A.; Enginoev S.; Schaff H.V.; Suvorov A.; Mukharyaov M.; Babeshko S.; Chekhoeva A.; Kadyraliev B.; Bogachev-Prokophiev A. Institution (Karadzha, Schaff) Department of Cardiovascular Surgery, 200 1st St SW, Rochester, MN, United States (Enginoev) Federal State Budgetary Institution <<Federal Center for Cardiovascular Surgery>> of theMinistry of Health of the Russian Federation, Astrakhan, Russian Federation (Enginoev) Federal State Budgetary Educational Institution of Higher Education "Astrakhan State Medical University" of the Ministry of Health of the Russian Federation, Astrakhan, Russian Federation (Suvorov) Institute of Personalized Cardiology of the Center for Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation (Mukharyaov) University Clinic Jena, Thuringia, Germany (Mukharyaov) Kazan State Medical University, Kazan, Russian Federation (Babeshko) Region Hospital #1, Krasnodar Region, Russian Federation (Chekhoeva) Department of Cardiac Surgery, The University Hospital of Dusseldorf, Dusseldorf, Germany (Kadyraliev) S.G. Sukhanov Federal Center of Cardiovascular Surgery, E.A. Vagner Perm State Medical, Perm, Russian Federation (Bogachev-Prokophiev) Heart Valve Surgery Department, E. Meshalkin National Medical Research Centre, Novosibirsk, Russian Federation Publisher Springer Abstract Introduction: Minimally invasive approaches have become a gold standard for most cardiac surgery procedures, but their use in aortic root surgery remains limited. Previous analyses suggested potential benefits of minimally invasive aortic root surgery (MIARS) over conventional aortic root surgery (CARS). This study aims to provide updated insights into intraoperative and early postoperative outcomes between MIARS and CARS. Method(s):. This systematic review and meta-analysis followed PRISMA guidelines. Two-arm observational studies comparing MIARS and CARS were included. The literature search was conducted using a mix of keywords and standardized indexing terms in the eight sources up to December 16, 2024. The risk of bias was assessed using ROBINS-I. Result(s): Twenty-one studies comparing MIARS and CARS were included, resulting in 2908 MIARS and 3,456 CARS patients. Minimally invasive approaches were associated with shorter mechanical ventilation (-4.72 h; p <.001), ICU stay (-0.46 days; p <.001), hospital stay (-1.65 days; p <.001), reduced postoperative bleeding (-0.82 units; p <.001), blood transfusion (-0.50 units; p <.001) and atrial fibrillation rate (RR 0.73; p =.006). Safety outcomes, including the risk of mortality, stroke, and renal failure, as well as surgical procedure duration, reflected by aortic cross-clamp and cardiopulmonary bypass times, were comparable between MIARS and CARS. Conclusion(s): The use of minimally invasive approaches for aortic root procedures may offer benefits over median sternotomy, including shorter recovery times and reduced postoperative bleeding, without compromising safety. However, the certainty of the available evidence remains low. Copyright © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026. <20> [Use Link to view the full text] Accession Number 2043937972 Title Triple Versus Dual Lipid-Lowering Therapy in Acute Coronary Syndrome: The ES-BempedACS Randomized Clinical Trial. Source Circulation. 153(3) (pp 140-149), 2026. Date of Publication: 20 Jan 2026. Author Raposeiras-Roubin S.; Abu Assi E.; Jimenez Mendez C.; Minguez de la Guia E.; Perez Rivera J.A.; Marcos Mangas M.; Ayesta A.; Uribarri A.; Jorge Perez P.; Antunez Muinos P.J.; Bonanad Lozano C.; Carrasquer A.; Viana-Tejedor A.; Dominguez Erquicia P.; Villar Ruiz A.; Lopez Vazquez M.; Aguilar Iglesias L.; Alen Andremar A.; Vidal Burdeus M.; Martin Cabeza M.M.; Gonzalez Cambeiro M.C.; Bompart D.; Gomez Polo J.C.; Garcia Garcia M.T.; Merino Merino A.; Rozado J.; Panera de la Mano J.A.; Salmeron Martinez F.; Sanchez Corral E.; Santos Sanchez I.; Hernandez-Martos A.V.; Antelo Abejon A.; Iniguez Romo A.; Corbi-Pascual M.; Ariza-Sole A. Institution (Raposeiras-Roubin, Dominguez Erquicia, Alen Andremar, Antelo Abejon, Iniguez Romo) Cardiology Department, University Hospital Alvaro Cunqueiro and Instituto de Investigacion Sanitaria Galicia Sur, Vigo, Spain (Raposeiras-Roubin) University of Santiago de Compostela, Spain (Abu Assi) Povisa Hospital, Vigo, Spain (Jimenez Mendez, Villar Ruiz, Garcia Garcia, Panera de la Mano) Cardiology Department, University Hospital Puerta del Mar, Cadiz, Spain (Minguez de la Guia, Lopez Vazquez, Salmeron Martinez, Corbi-Pascual) Cardiology Department, University Hospital of Albacete, Spain (Perez Rivera, Aguilar Iglesias, Merino Merino, Sanchez Corral, Santos Sanchez) Cardiology Department, University Hospital of Burgos, Spain (Marcos Mangas, Hernandez-Martos, Ariza-Sole) Cardiology Department, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain (Ayesta, Alen Andremar, Rozado) Cardiology Department, University Hospital Central de Asturias, Oviedo, Spain (Uribarri, Vidal Burdeus) Cardiology Department, University Hospital Vall D'Hebron, Barcelona, Spain (Uribarri, Vidal Burdeus) CIBER-CV, Madrid, Spain (Jorge Perez, Martin Cabeza) Cardiology Department, University Hospital of Canarias, Tenerife, Spain (Antunez Muinos, Gonzalez Cambeiro) Cardiology Department, University Hospital Montecelo, Pontevedra, Spain (Bonanad Lozano, Bompart) Cardiology Department, University Clinical Hospital of Valencia and INCLIVA Health Research Institute, Spain (Bonanad Lozano) University of Valencia, Spain (Carrasquer, Viana-Tejedor) Cardiology Department, University Hospital Joan XXIII of Tarragona, Spain (Gomez Polo) Cardiology Department, University Clinical Hospital San Carlos, Madrid, Spain Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Current guidelines recommend a stepwise strategy to achieve low-density lipoprotein cholesterol (LDL-C) goals after acute coronary syndrome (ACS). Earlier intensive strategies based on a combination of lipid-lowering therapies (LLTs) could be useful from the onset of ACS. However, the role of bempedoic acid in ACS, particularly when combined with high-intensity statins and ezetimibe, remains uncertain. The aim of ES-BempedACS (Efficacy and Security of Bempedoic Acid in Acute Coronary Syndrome) was to compare the efficacy and safety of triple LLT (high-dose, high-intensity statin+ezetimibe+bempedoic acid) versus standard of care (high-dose, high-intensity statin+ezetimibe) after ACS. METHOD(S): - ES-BempedACS is a multicenter, independent, pragmatic, prospective, randomized, open, blinded end point controlled trial conducted in 12 Spanish hospitals between November 2023 and October 2024. The primary end point was the proportion of patients achieving LDL-C <55 mg/dL (<1.4 mmol/L) at 8 weeks after ACS, comparing triple LLT with standard of care. RESULT(S): - A total of 206 patients (59.5+/-10.9 years of age [mean+/-SD]; 21.4% women) were randomized within the first 72 hours of ACS to triple LLT or standard therapy of high-intensity statin+ezetimibe (ie, dual LLT). The baseline LDL-C level was 133.6+/-28.8 mg/dL. After 8 weeks, the LDL-C level was reduced to <55 mg/dL in 59.4% of patients in the triple LLT group compared with 53.1% in the control group (dual LLT; P=0.376). The percentage change in LDL-C level was 57.5+/-17.8% and 56.9+/-18.5% in the triple and dual LLT groups, respectively (P=0.823). Triple versus dual LLT showed similar results in reduction of non-high-density lipoprotein cholesterol levels (49.0+/-25.4 in triple LLT versus 49.1+/-31.2 in dual LLT; P=0.970) and triglyceride levels (14.9+/-36.9 in triple LLT versus 16.8+/-36.0 in dual LLT;) P=0.718), without differences in adverse events. CONCLUSION(S): - Both dual and triple LLT after ACS allow for high rates (>50%) of adequate LDL-C control (<55 mg/dL) at 8 weeks. Adding bempedoic acid to statin-ezetimibe therapy in the setting of ACS is safe but failed to improve the percentage of patients achieving the LDL-C goal (<55 mg/dL) at 8 weeks. Larger, randomized studies are needed to confirm our findings. REGISTRATION: - URL: https://www.clinicaltrialsregister.eu; Unique identifier: 2021-006550-31. Copyright © 2025 American Heart Association, Inc. <21> Accession Number 2039969332 Title Surgical ablation in non-mitral valve cardiac surgeries: a meta-analysis of early outcomes. Source Heart. 112(8) (pp 415-421), 2026. Date of Publication: 01 Apr 2026. Author Barbosa G.S.; Katsuyama E.S.; Fukunaga C.K.; Fernandes J.M.; Coan A.C.C.; Palatianos Y.; Fabiano R.C.; Gioli-Pereira L.; Kirov H.; Doenst T.; Caldonazo T. Institution (Barbosa, Kirov, Doenst) Department of Medicine, Faculdade Santa Marcelina, Sao Paulo, Brazil (Katsuyama, Fukunaga) Faculdade de Medicina do ABC, Santo Andre, Brazil (Fernandes) Department of Medicine, Albert Einstein Instituto Israelita de Ensino e Pesquisa, Sao Paulo, Brazil (Coan) Department of Medicine, Universidade Federal do Espirito Santo, Vitoria, Brazil (Palatianos) Department of Internal Medicine, Northwestern Medicine McHenry Hospital, McHenry, IL, United States (Fabiano) Department of Medicine, Brigham and Women's Hospital, Boston, MA, United States (Gioli-Pereira) Cardiology and Intensive Care, Albert Einstein Israelite Hospital, Sao Paulo, Brazil (Caldonazo) Jena University Hospital, Jena, Germany Publisher BMJ Publishing Group Abstract Background: Surgical ablation (SA) is a key treatment for atrial fibrillation (AF) patients undergoing heart surgery. However, direct comparisons between SA and non-mitral valve (non-MV) surgery alone are lacking. We performed a systematic review and meta-analysis comparing concomitant SA to isolated non-MV surgery in AF patients. Method(s): MEDLINE, Embase and Cochrane were searched. Outcomes of interest were: (1) postoperative AF (POAF); (2) early all-cause mortality; (3) postoperative pacemaker implantation and (4) stroke. Additionally, a subgroup analysis comparing randomised controlled trials (RCTs) and propensity score-matched studies (PSM) was conducted. Risk ratios (RRs) and their respective 95% CI were calculated using a random effects model. Result(s): After screening 6423 citations, we included 2 RCTs and 5 PSM studies encompassing 39 348 AF patients undergoing non-MV surgery, of whom 18 394 (46.7%) underwent SA. Compared with isolated non-MV surgery, SA was associated with significant POAF reduction (RR: 0.73; 95% CI: 0.67 to 0.79; I2=0%) and higher risk of postoperative pacemaker implantation (RR: 1.34; 95% CI: 1.14 to 1.57, I2=0%) compared with surgery alone. No differences were found in early all-cause mortality (RR: 0.96; 95% CI: 0.76 to 1.22; I2=65%) and postoperative stroke (RR: 1.06; 95% CI: 0.89 to 1.26; I2=0%). The subgroup analysis comparing RCTs and PSM showed significant consistency among the different designs. Conclusion(s): In this meta-analysis, SA was associated with POAF reduction in non-MV surgery. In terms of safety, it was suggested that although no difference in early mortality and postoperative stroke was observed, SA had a higher risk of pacemaker implantation than isolated non-MV surgery. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <22> Accession Number 2044647306 Title Personalized hemodynamic management targeting preoperative baseline cardiac index in high-risk patients having major abdominal surgery: rationale and design of the international multicenter randomized PELICAN trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 286. Date of Publication: 01 Dec 2026. Author Flick M.; Aasvang E.K.; Eichlseder M.; Klimovic A.; Meidert A.S.; Meyhoff C.S.; Roth S.; Steinhaus M.; Sort R.; Vives M.; Vojnar B.; Ziemann S.; Krause L.; Vettorazzi E.; Zapf A.; Kouz K.; Saugel B. Institution (Flick, Kouz, Saugel) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Aasvang) Department of Anaesthesiology, Centre for Cancer and Organ Diseases, Rigshospitalet, Copenhagen University Hospital, Copenhagen University, Copenhagen, Denmark (Eichlseder) Division of Anaesthesiology and Intensive Care 1, Department of Anaesthesiology and Intensive Care, Medical University of Graz, Graz, Austria (Klimovic) Department of Anesthesiology, Resuscitation and Intensive Care, Faculty of Medicine in Pilsen, Charles University, Prague, Czechia (Meidert) Department of Anaesthesiology, LMU University Hospital, LMU Munich, Munich, Germany (Meyhoff) Department of Anaesthesia and Intensive Care, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark (Roth) Department of Anesthesiology, University Hospital Dusseldorf, Heinrich Heine University Dusseldorf, Dusseldorf, Germany (Steinhaus) Department of Anesthesiology and Intensive Care, University of Lubeck and University Medical Center Schleswig-Holstein, Lubeck, Germany (Sort) Department of Anaesthesiology, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark (Vives) Department of Anesthesia & Critical Care, Clinica Universidad de Navarra, Pamplona, Spain (Vojnar) Department of Anesthesiology and Intensive Care Medicine, University Hospital Giessen and Marburg, Campus Marburg and Philipps-University of Marburg, Marburg, Germany (Ziemann) Department of Anaesthesiology, Medical Faculty, RWTH Aachen University Hospital, Aachen, Germany (Krause, Vettorazzi, Zapf) Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Kouz, Saugel) OUTCOMES RESEARCH Consortium, Houston, TX, United States Publisher BioMed Central Ltd Abstract Background: Intraoperative hemodynamic management is intended to ensure adequate tissue perfusion and oxygen delivery and eventually help avoid organ injury. However, the optimal strategy for intraoperative hemodynamic management in patients having non-cardiac surgery remains unclear. We here report the protocol of a trial designed to test the hypothesis that personalized intraoperative hemodynamic management targeting preoperative baseline cardiac index reduces the incidence of a composite outcome of major postoperative complications and death within 7 days after surgery compared to routine hemodynamic management in high-risk patients having elective major abdominal surgery. Method(s): The PELICAN trial is an international multicenter randomized trial in 1,128 high-risk patients having elective major abdominal surgery. The individual preoperative baseline cardiac index is determined with the patient being awake and resting in the supine position using noninvasive bioreactance. Patients are randomized to personalized hemodynamic management (intervention) or to routine hemodynamic management (control) during surgery. In patients assigned to personalized hemodynamic management, intraoperative cardiac index is maintained at least at the preoperative baseline cardiac index. In patients assigned to routine hemodynamic management, it is performed as per anesthesiologist preference (with blinded cardiac index monitoring). The primary outcome is the incidence of a composite outcome ("any event versus none") of acute kidney injury, acute myocardial injury (including myocardial infarction), non-fatal cardiac arrest, severe infectious complications, and death within 7 days after surgery. Discussion(s): Our trial will determine whether personalized intraoperative hemodynamic management targeting preoperative baseline cardiac index reduces the incidence of major postoperative complications and death within 7 days in high-risk patients having elective major abdominal surgery compared to routine hemodynamic management. Trial registration: ClinicalTrials.gov Identifier NCT05648279. Registered on 5 December 2022. Copyright © The Author(s) 2026. <23> Accession Number 2044609159 Title Comparative Outcomes of ICE Versus TEE/Fluoroscopy Guidance Transseptal Puncture in LA Procedures: A Systematic Review and Meta-Analysis. Source Annals of Noninvasive Electrocardiology. 31(3) (no pagination), 2026. Article Number: e70186. Date of Publication: 01 May 2026. Author Abdalla A.M.E.; Durga K.P.; Chukka A.; Kotte M.; Awais M.; Perveen A.; Malik J. Institution (Abdalla) Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia (Durga) Shri B M Patil Medical College and Research Center, Vijayapura, India (Chukka) Department of Internal Medicine, NRI Institute of Medical Sciences, Visakhapatnam, India (Kotte) Prime South GME, Consortium Knapp Medical Center, Weslaco, TX, United States (Awais) Department of Electrophysiology, Rawalpindi Institute of Cardiology (RIC), Rawalpindi, Pakistan (Perveen) Department of Medicine, Ibn e Seena Hospital, Kabul, Afghanistan (Malik) Department of Electrophysiology, Pakistan Air Force Hospital, Islamabad, Pakistan Publisher John Wiley and Sons Inc Abstract Objective: To evaluate the comparative efficacy, safety, and radiation exposure outcomes of intracardiac echocardiography (ICE)-guided versus TEE/fluoroscopy-guided trans-septal puncture (TSP) in left atrial procedures. Method(s): We conducted a systematic review and meta-analysis of randomized and observational studies comparing ICE-guided with TEE- or fluoroscopy-only-guided TSP. Eight studies encompassing over 9000 patients undergoing atrial fibrillation (AF) ablation or left atrial appendage occlusion (LAAO) were included. Primary endpoints were fluoroscopy time, radiation dose, first-pass success, puncture time, total procedure time, and major safety outcomes. Random-effects models were used to pool mean differences or hazard ratios with 95% confidence intervals (CIs). Risk of bias was assessed using validated tools, and funnel plots with sensitivity analyses evaluated robustness. Result(s): ICE guidance significantly reduced fluoroscopy time (MD -2.07 min, 95% CI -2.37 to -1.77; p < 0.001) and radiation dose (MD -2.30, 95% CI -3.27 to -1.27; p < 0.001). First-pass success and total procedure time were comparable between groups. Safety endpoints, including tamponade, pericardial effusion, and composite major adverse events, showed no significant increase with ICE. Funnel plots and leave-one-out analyses confirmed the stability of results. Conclusion(s): ICE-guided TSP reduces radiation exposure without compromising efficacy or safety, supporting its adoption as a valuable imaging modality in left atrial interventions. Copyright © 2026 The Author(s). Annals of Noninvasive Electrocardiology published by Wiley Periodicals LLC. <24> Accession Number 2044647307 Title Non-invasive vessel fractional flow reserve versus fractional flow reserve guidance to revascularize intermediate coronary stenosis (LIPSIA-STRATEGY) trial: study protocol for a randomized controlled trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 287. Date of Publication: 01 Dec 2026. Author Majunke N.; Desch S.; Kister T.; Buske M.; Poss J.; Feistritzer H.-J.; Erbs S.; Hosler N.; Wolff J.; Schneider S.; Ouarrak T.; Woitek F.; Lenk K.; Nef H.; Dorr O.; Sossalla S.; Achenbach S.; Marwan M.; Barlagiannis D.; Haude M.; Mahabadi A.A.; Rassaf T.; Thiele H. Institution (Majunke, Desch, Kister, Buske, Poss, Feistritzer, Erbs, Thiele) Department of Internal Medicine/Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany (Hosler, Wolff) Leipzig Heart Science, Leipzig, Germany (Schneider, Ouarrak) Institut fur Herzinfarktforschung, Ludwigshafen am Rhein, Germany (Woitek) Heart Center Dresden - Technische Universitat Dresden, Dresden, Germany (Lenk) University Clinic Leipzig, Klinik und Poliklinik fur Kardiologie, Leipzig, Germany (Nef) Cardiology Department, Heart Center, Segeberger Kliniken GmbH, Bad Segeberg, Germany (Dorr) CCB Am Markuskrankenhaus, Med. Klinik III, Agaplesion Markuskrankenhaus, Frankfurt Am Main, Germany (Sossalla) Department of Internal Medicine/Cardiology, University Clinic Giessen, Giessen, Germany (Achenbach, Marwan) Department of Cardiology, Friedrich-Alexander-Universitat Erlangen-Nurnberg (FAU), Erlangen-Nurnberg, Germany (Barlagiannis, Haude) Medical Clinic I, Rheinland Klinikum Neuss GmbH, Lukaskrankenhaus, Neuss, Germany (Mahabadi, Rassaf) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany Publisher BioMed Central Ltd Abstract Background: Current guidelines on coronary revascularization support the use of wire-based coronary physiology measurements to guide decision making in patients with coronary artery stenoses. Nevertheless, the use of these techniques in clinical practice is variable and its application worldwide remains limited by its requirement for the use of an intracoronary pressure wire and prolonged procedure time. Recently, angiography-based wire-free techniques to estimate fractional flow reserve (FFR) values have been introduced. These developments may translate towards more physiology-guided intervention bearing the potential to improve clinical outcomes in patients with stable coronary artery disease (CAD). Method(s): The LIPSIA-STRATEGY trial is a randomized controlled, investigator-initiated, multicenter, open-label study. A total of 1054 eligible patients will be randomized 1:1 to coronary revascularization based on angiography-derived vessel fractional flow reserve (vFFR) or revascularization based on FFR obtained by pressure wire measurements. The major inclusion criterion is the presence of visually assessed intermediate coronary artery stenoses in one or more native major epicardial coronary arteries in the setting of stable angina or an acute coronary syndrome (ACS). In patients with an ACS, only non-culprit vessels will be considered for inclusion. The primary endpoint is the occurrence of major adverse cardiovascular events (MACE) during the first year after randomization. Discussion(s): The LIPSIA-STRATEGY trial will be the first to compare angiography-derived vFFR with invasive FFR with respect to clinical outcomes in patients with intermediate coronary lesions. Trial registration: ClinicalTrials.gov NCT03497637. Registered 2018-04-13. Copyright © The Author(s) 2026. <25> Accession Number 2038969175 Title Association between inflammatory bowel disease, current therapies, and cardiovascular events: a review and meta-analysis of data from 2.2 million individuals. Source Journal of Crohn's and Colitis. 19(5) (no pagination), 2025. Article Number: jjaf078. Date of Publication: 01 May 2025. Author Thomas D.-R.; Huangfu G.; Yeaman F.; Sukudom S.; Lan N.S.R.; Dwivedi G.; Thin L. Institution (Thomas, Huangfu, Sukudom, Lan, Dwivedi) Department of Cardiology, Fiona Stanley Hospital, Perth, Australia (Thomas, Huangfu, Sukudom, Lan, Dwivedi, Thin) Medical School, The University of Western, Perth, Australia (Yeaman, Thin) Department of Gastroenterology, Fiona Stanley Hospital, Perth, Australia (Lan, Dwivedi, Thin) Harry Perkins Institute of Medical Research, Perth, Australia Publisher Oxford University Press Abstract Background/Aims: Inflammatory bowel disease (IBD) is associated with increased cardiovascular (CV) risk. Advanced therapies that treat IBD may modify this risk. Our systematic review and meta-analysis aim to investigate the association between IBD, its subtypes (Crohn's disease and ulcerative colitis), and its therapies, with CV disease. Method(s): Medline, Embase, Scopus, and Web of Science were searched from January 2000 to November 2023. Studies examining the relationship between IBD and the CV outcomes of incident myocardial infarction (MI), ischemic heart disease (IHD), cerebrovascular accident (CVA), and major adverse cardiovascular events (MACE) were included. Pooled hazard ratios (HRs) were calculated using inverse-variance weighted random effects meta-analysis. Incidence rate differences for MACE were derived from studies comparing IBD therapies. Result(s): Fourteen studies evaluating CV outcomes were included. Of the 2 232 375 individuals, 10.8% were IBD patients, mean age was 47.3 years, and 48.4% were male. Inflammatory bowel disease was significantly associated with MI (HR 1.29, 95% CI, 1.07-1.56, I2 = 0.87), IHD (HR 1.16, 95% CI, 1.01-1.33, I2 = 0.60), CVA (HR 1.15, 95% CI, 1.09-1.20, I2 = 0.30), and MACE (HR 1.19, 95% CI, 1.09-1.30, I2 = 0.81). Incidence rate differences (events per 1000 patient-years) for MACE, calculated for 16 comparative studies, ranged from 90.3 fewer events in tofacitinib compared with placebo to an excess of 17.9 events in a vedolizumab group compared with anti-TNFalpha biologics. Conclusion(s): There is an increased risk of MI, IHD, CVA, and MACE in IBD patients. Management of IBD needs to consider these risks and how it may be adjusted when selecting advanced therapies. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of European Crohn's and Colitis Organisation. All rights reserved. <26> [Use Link to view the full text] Accession Number 2043320613 Title Baseline use of aspirin or statins with oral estrogen and progestogens to prevent incident arterial or venous thrombotic events: a secondary analysis of the Women's Health Initiative trial. Source Menopause. 33(2) (pp 134-144), 2026. Date of Publication: 01 Feb 2026. Author Davis J.W.; Aragaki A.K.; Harrington L.B.; Rossouw J.E.; Wells G.; Shadyab A.; Schnatz P.F.; Shufelt C.L.; Warsinger-Martin L.; Wild R.A.; Manson J.E. Institution (Davis) Department of Medicine, Washington University in St. Louis, 1 Barnes Jewish Hospital, St. Louis, MO, United States (Aragaki) Division of Public Health Sciences, Fred Hutchinson Cancer Center (Harrington) Kaiser Permanente Washington Health Research Institute (Harrington) Department of Epidemiology, University of Washington School of Public Health, Seattle, WA, United States (Harrington) Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, WA, United States (Rossouw) Division of Cardiovascular Sciences, National Heart, Lung and Blood Institute, Bethesda, MD, United States (Wells) Division of Cardiovascular Diseases, Department of Internal Medicine, University of Alabama Birmingham Heersink School of Medicine, Birmingham, AL, United States (Shadyab) Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States (Shadyab) Department of Medicine, Division of Geriatrics, Gerontology and Palliative Care, University of California San Diego, La Jolla, CA, United States (Schnatz) Departments of OB-Gyn and Medicine, Drexel University, Reading, PA, United States (Shufelt) Division of General Internal Medicine, Department of Medicine, Mayo Clinic (Shufelt) Mayo Clinic Women's Health, Mayo Clinic, Jacksonville, FL, United States (Warsinger-Martin) Department of Medicine, George Washington University School of Medicine, Washington, DC, United States (Wild) Department of OB/GYN, Oklahoma University Health Sciences Center, Reproductive Endocrinology, and Department of Biostatistics and Epidemiology, College of Medicine, Oklahoma, OK, United States (Manson) Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA, United States Publisher Wolters Kluwer Health Abstract Objective: - To evaluate whether effects of oral hormone therapy (HT) on risks of venous and arterial vascular events differ by baseline statin or aspirin use. Method(s): - We performed time-to-event analysis using data from the Women's Health Initiative menopausal HT randomized trials to assess risk of thrombotic events. Women were randomized to oral conjugated equine estrogens (CEEs) alone or placebo among women with prior hysterectomy (n = 10, 739), and CEE with medroxyprogesterone acetate (MPA) or placebo among women with an intact uterus (n = 16, 608), stratified by baseline personal use of statins and aspirin. We evaluated risk of prespecified, adjudicated thrombotic events, including coronary heart disease, stroke, venous thromboembolism, and/or composite major adverse cardiovascular events, at 2 and 5 years. Result(s): - Baseline statin use (n = 827 in CEE-alone trial; n = 1, 115 in CEE+MPA trial) or aspirin use (n = 2, 212; n = 3, 431) was limited. At 5-year follow-up, coronary heart disease risk for CEE-alone versus placebo was hazard ratio (HR) = 0.81 (95% CI: 0.44-1.49) in statin users, similar to nonusers, HR = 1.07 (95% CI: 0.82-1.40). For CEE+MPA, there was also no difference by statin use, HR = 1.02 (95% CI: 0.55-1.89) and HR = 1.47 (95% CI: 1.13-1.90), respectively. Neither statin nor aspirin exposure significantly modified effects of HT on any arterial or venous thrombotic outcome at 2 or 5 years. Conclusion(s): - In this secondary randomized clinical trial analysis, neither statins nor aspirin significantly modified effects of oral HT on key arterial or venous thrombotic outcomes at 2 or 5 years. Results, however, may be underpowered given low baseline exposure prevalence for both statins and aspirin. Copyright © 2026 Wolters Kluwer Health <27> Accession Number 2044510644 Title Hybrid drug-coated balloon strategy for coronary bifurcation lesions: a systematic review and meta-analysis. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Dillen D.M.M.; van Beek K.A.J.; Vermeer A.J.E.; Vlaar P.-J.; El Farissi M.; Demandt J.P.A.; Eerdekens R.; van het Veer M.; Tonino P.A.L.; Teeuwen K. Institution (Dillen, van Beek, Vermeer, Vlaar, El Farissi, Demandt, Eerdekens, van het Veer, Tonino, Teeuwen) Catharina Hospital, Eindhoven, Netherlands (van Beek, Vermeer, van het Veer, Tonino) Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands Publisher BMJ Publishing Group Abstract ObjectivesRecently, drug-coated balloons (DCB) have emerged as a promising alternative for side branch treatment in coronary bifurcation lesions, in combination with drug-eluting stent (DES) implantation in the main vessel, the hybrid DCB approach. We aimed to evaluate clinical outcomes in patients treated with the hybrid DCB approach and to compare this strategy with other bifurcation techniques.DesignA systematic review and meta-analysis.Data sourcesMEDLINE and EMBASE were searched up until January 2025.Eligibility criteriaWe included randomised controlled trials and observational studies investigating clinical outcomes in patients treated with the hybrid DCB approach for coronary bifurcation lesions.Data extraction and synthesisTwo independent reviewers extracted data and assessed the risk of bias. The outcome of interest was the combined endpoint of cardiac death, myocardial infarction (MI) or target lesion revascularisation (TLR) at the longest available follow-up. Crude event rates, stratified by treatment strategy, were provided for the overall incidence of the primary endpoint. Furthermore, we conducted meta-analyses on the combined endpoint, comparing different bifurcation percutaneous coronary intervention (PCI) strategies. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation tool.Results13 studies, consisting of 2393 patients, were included in our systematic review. Investigated techniques were the hybrid DCB approach in all studies, and a two-stent strategy or the combination of DES in main vessel and balloon angioplasty (BA) in the side branch as potential comparators. Median follow-up duration was 12 months (IQR 7.5-12). The combined endpoint of cardiac death, MI or TLR was found in 5.6% in the hybrid DCB group, 15.4% in the two-stent group and in 10.0% in the BA group. The pooled analyses, including three and two studies, respectively, showed that the hybrid DCB approach was associated with a lower risk of the composite endpoint of cardiac death, MI or TLR when compared with a two-stent strategy (7.9% vs 15.4%; risk ratio (RR): 0.53; 95% CI 0.33 to 0.85) and compared with BA in the side branch (5.6% vs 10.0%; RR: 0.57; 95% CI 0.37 to 0.88). The certainty of the evidence was graded as very low.ConclusionThe results of this systematic review and meta-analysis suggest that the hybrid DCB approach is a feasible and promising treatment approach for bifurcation lesions, when compared with other bifurcation PCI strategies. However, the results should be interpreted cautiously as the certainty of evidence was graded as very low, underlining the importance of larger trials to confirm these findings.Trial registration numberCRD420250651469. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <28> Accession Number 2044337840 Title The journey of retained epicardial pacing wires: a systematic review of migration site and mechanisms. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 13. Date of Publication: 01 Dec 2026. Author Akele O.; Osuji E.; Parisapogu A.; Varma R.; Shahani R. Institution (Akele, Parisapogu) Department of Medicine, University of Connecticut School of Medicine, UConn Health, Farmington, CT, United States (Osuji) Department of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, United States (Varma) Department of Medicine, Cook County Hospital, Chicago, IL, United States (Shahani) Department of Cardiothoracic Surgery, Staten Island University Hospital, Staten Island, NY, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Temporary epicardial pacing wires are routinely placed during cardiac surgery and are typically removed before discharge. When resistance is encountered, wires are clipped and left in place. Although long considered benign, retained wires have increasingly been linked to delayed migration into vascular, thoracic, and abdominal structures. The patterns, timing, clinical consequences, and mechanisms of these events remain poorly defined. This systematic review followed Preferred Reporting Items for Systematic Reviews and Meta Analyses 2020 guidelines and was registered with the International Prospective Register of Systematic Reviews CRD420251103727. Main body: Twenty-two studies describing 23 patients with migration of retained temporary epicardial pacing wires were included. Ages ranged from 14 months to 89 years. Migration occurred between 12 days and 17 years after surgery, with a median interval of approximately 1 year. Cardiovascular migration was reported in 15 patients and involved the aorta, aortic arch, carotid artery, coronary artery, pulmonary artery, or cardiac chambers. Extracardiac migration was reported in 8 patients and involved the lung, bronchial tree, transverse colon, neck, jaw, and subcutaneous tissues. Migration location corresponded to the reported origin of the pacing wire. Atrial wires were described in cases involving systemic arterial structures, whereas ventricular wires were described in cases involving the right heart or pulmonary circulation. Fourteen patients were symptomatic at diagnosis, presenting with chest pain, respiratory symptoms, hemoptysis, abdominal pain, neurologic deficits, or localized inflammation. Infectious complications were reported in 8 patients, including several cases in which more than 1 wire had been retained. Computed tomography identified migration in 13 patients and was the most frequently reported diagnostic modality. Echocardiography detected intracardiac migration in 6 patients. Percutaneous extraction was reported as successful in all attempted cases. Surgical extraction was performed in 3 patients, and 2 patients were managed conservatively. Conclusion(s): Migration of retained temporary epicardial pacing wires has been reported months to years after cardiac surgery and has involved both cardiovascular and extracardiac structures. Reported cases describe migration across multiple anatomic pathways and a range of clinical presentations. Computed tomography was commonly used to identify migration, and percutaneous retrieval was reported as successful in several cases. These findings describe the reported spectrum of migration patterns, presentations, and management strategies among published cases of retained temporary epicardial pacing wire migration. Copyright © The Author(s) 2026. <29> Accession Number 2044511199 Title Multicentre, adaptive, double-blind, three-arm, placebo-controlled, non-inferiority trial examining antimicrobial prophylaxis duration in cardiac surgery (CALIPSO): trial protocol. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Stewardson A.J.; Peleg A.Y.; Myles P.S.; Peel T.; Stewardson A.; Myles P.; McGiffin D.; Smith J.; Marasco S.; Pilcher D.; Peleg A.; Forbes A.; Petrie D.; Wisniewski J.; Forster S.; Roney J.; Druce P.; Astbury S.; Berkovic D.; McCracken P. Institution (Peel) Infectious Diseases, Monash University, Melbourne, VIC, Australia (Peel, Stewardson, Roney) Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia (McGiffin) Cardiothoracic Surgery, Monash University Faculty of Medicine Nursing and Health Sciences, Melbourne, VIC, Australia (McGiffin, Wisniewski) Alfred Hospital, Melbourne, VIC, Australia (Smith) Cardiothoracic Surgery, Monash Medical Centre Clayton, Clayton, VIC, Australia (Smith) Department of Surgery, School of Clinical Sciences, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, VIC, Australia (Forbes) School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC, Australia (Marasco) Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC, Australia (Pilcher) Australian and New Zealand Intensive Care Society Centre for Outcomes and Resource Evaluation, Melbourne, VIC, Australia (Stewardson, Peleg) Centre to Impact AMR, Monash University, Melbourne, VIC, Australia (Petrie) Centre for Health Economics, Monash University, Melbourne, VIC, Australia (Peleg, Astbury) Department of Infectious Diseases, Monash University, Clayton, VIC, Australia (Peleg) Monash University Monash Biomedicine Discovery Institute, Clayton, VIC, Australia (Forster) Hudson Institute of Medical Research, Clayton, VIC, Australia (Druce, Myles) Anaesthesiology and Perioperative Medicine, Monash University, Melbourne, VIC, Australia (Druce) Anaesthesiology and Perioperative Medicine, Alfred Health, Melbourne, VIC, Australia (Berkovic) Monash University, Clayton, VIC, Australia (Mccracken) Bayside Health, Melbourne, VIC, Australia (Mccracken) Monash University, Melbourne, VIC, Australia (Myles) Anaesthesiology and Perioperative Medicine, Alfred Hospital, Melbourne, VIC, Australia Publisher BMJ Publishing Group Abstract IntroductionAdministration of antibiotics before incising the skin ('surgical antimicrobial prophylaxis') is a critical infection prevention strategy in surgery. Extending doses of prophylaxis into the postoperative period is a common practice in cardiac surgery; however, the benefit has not been clearly established and may lead to emergence of antimicrobial resistance and patient harm. We present the protocol for a large international multicentre, adaptive, pragmatic, double-blind, three-arm, placebo-controlled, randomised, non-inferiority clinical trial to compare the incidence of surgical site infection after three different durations of postoperative surgical antimicrobial prophylaxis in patients undergoing cardiac surgery.Methods and analysisThis adaptive, multi-arm multistage non-inferiority trial will compare intraoperative only (Arm A), to intraoperative and 24 hours (Arm B) and, to intraoperative and 48 hours (Arm C) of intravenous cefazolin and placebo as surgical antimicrobial prophylaxis in 9180 patients undergoing cardiac surgery. The adaptive design allows for potential dropping of any of the three arms if clear inferiority is indicated at any of the scheduled interim analyses. The trial will evaluate the clinical and cost-effectiveness of the three different antibiotic prophylaxis durations.Ethics and disseminationEthics approval will be obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences. Patients and members of the public will also be involved in the dissemination and translation of the trial results.Trial registration numberNCT05447559. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. <30> Accession Number 619230288 Title Rivaroxaban with or without aspirin in patients with stable coronary artery disease: an international, randomised, double-blind, placebo-controlled trial. Source The Lancet. 391(10117) (pp 205-218), 2018. Date of Publication: 20 Jan 2018. Author Connolly S.J.; Eikelboom J.W.; Bosch J.; Dagenais G.; Dyal L.; Lanas F.; Metsarinne K.; O'Donnell M.; Dans A.L.; Ha J.-W.; Parkhomenko A.N.; Avezum A.A.; Lonn E.; Lisheng L.; Torp-Pedersen C.; Widimsky P.; Maggioni A.P.; Felix C.; Keltai K.; Hori M.; Yusoff K.; Guzik T.J.; Bhatt D.L.; Branch K.R.H.; Cook Bruns N.; Berkowitz S.D.; Anand S.S.; Varigos J.D.; Fox K.A.A.; Yusuf S.; Sala J.; Cartasegna L.U.I.S.; Vico M.; Hominal M.A.; Hasbani E.; Caccavo A.; Zaidman C.; Vogel D.; Hrabar A.; Schygiel P.O.; Cuneo C.; Luquez H.U.G.O.; Mackinnon I.J.; Ahuad Guerrero R.A.; Costabel J.P.; Bartolacci I.P.; Montana O.; Barbieri M.; Gomez Vilamajo O.; Garcia Duran R.O.; Schiavi L.B.; Garrido M.; Ingaramo A.; Bordonava A.P.; Pelagagge M.J.; Novaretto L.; Albisu Di Gennero J.P.; Ibanez Saggia L.M.; Alvarez M.; Vita N.A.; Macin S.M.; Dran R.D.; Cardona M.; Guzman L.U.I.S.; Sarjanovich R.J.; Cuadrado J.; Nani S.; Litvak Bruno M.R.; Chacon C.; Maffei L.E.; Grinfeld D.; Vensentini N.; Majul C.R.; Luciardi H.L.; Gonzalez Colaso P.D.C.; Ferre Pacora F.A.; Van Den Heuvel P.A.U.L.; Verhamme P.; Ector B.A.V.O.; Debonnaire P.; Van De Borne P.; Leroy J.E.A.N.; Schroe H.; Vranckx P.; Elegeert I.V.A.N.; Hoffer E.; Dujardin K.A.R.L.; Indio Do Brasil C.; Precoma D.; Abrantes J.A.; Manenti E.; Reis G.; Saraiva J.O.S.E.; Maia L.; Hernandes M.; Rossi P.; Rossi Dos Santos F.; Zimmermann S.L.; Rech R.; Abib E.; Leaes P.; Botelho R.; Dutra O.; Souza W.; Braile M.; Izukawa N.I.L.O.; Nicolau J.C.; Tanajura L.F.; Serrano Junior C.V.; Minelli C.; Nasi L.A.; Oliveira L.; De Carvalho Cantarelli M.J.; Tytus R.; Pandey S.; Lonn E.V.A.; Cha J.; Vizel S.A.U.L.; Babapulle M.; Lamy A.; Saunders K.; Berlingieri J.; Kiaii B.O.B.; Bhargava R.; Mehta P.; Hill L.; Fell D.; Lam A.N.D.Y.; Al-Qoofi F.; Brown C.; Petrella R.; Ricci J.A.; Glanz A.; Noiseux N.; Bainey K.; Merali F.; Heffernan M.; Della Siega A.; Dagenais G.R.; Dagenais F.; Brulotte S.; Nguyen M.; Hartleib M.; Guzman R.; Bourgeois R.; Rupka D.; Khaykin Y.; Gosselin G.; Huynh T.H.A.O.; Pilon C.; Campeau J.E.A.N.; Pichette F.; Diaz A.; Johnston J.; Shukle P.; Hirsch G.; Rheault P.A.U.L.; Czarnecki W.; Roy A.; Nawaz S.H.A.H.; Fremes S.; Shukla D.; Jano G.; Cobos J.L.; Corbalan R.; Medina M.; Nahuelpan L.; Raffo C.; Perez L.U.I.S.; Potthoff S.; Stockins B.; Sepulveda P.; Pincetti C.; Vejar M.; Tian H.; Wu X.; Ke Y.; Jia K.; Yin P.; Wang Z.; Yu L.; Wu S.; Wu Z.; Liu S.W.; Bai X.J.; Zheng Y.A.N.G.; Yang P.I.N.G.; Yang Y.M.; Zhang J.; Ge J.; Chen X.P.; Hu T.H.; Zhang R.; Zheng Z.H.E.; Chen X.I.N.; Tao L.; Li J.; Huang W.; Fu G.; Li C.; Dong Y.; Wang C.; Zhou X.; Kong Y.E.; Sotomayor A.; Accini Mendoza J.L.; Castillo H.; Urina M.; Aroca G.; Perez M.; Molina De Salazar D.I.; Sanchez Vallejo G.; Fernando M.J.; Garcia H.; Garcia L.H.; Arcos E.; Gomez J.U.A.N.; Cuervo Millan F.; Trujillo Dada F.A.; Vesga B.; Moreno Silgado G.A.; Zidkova E.V.A.; Lubanda J.-C.; Kaletova M.; Kryza R.; Marcinek G.; Richter M.; Spinar J.; Matuska J.I.R.I.; Tesak M.; Motovska Z.; Branny M.; Maly J.I.R.I.; Maly M.; Wiendl M.; Foltynova Caisova L.; Slaby J.; Vojtisek P.E.T.R.; Pirk J.A.N.; Spinarova L.; Benesova M.; Canadyova J.; Homza M.; Florian J.; Polasek R.; Coufal Z.; Skalnikova V.; Brat R.; Brtko M.; Jansky P.E.T.R.; Lindner J.; Marcian P.; Straka Z.; Tretina M.; Duarte Y.C.; Pow Chon Long F.; Sanchez M.; Lopez J.O.S.E.; Perugachi C.; Marmol R.; Trujillo F.; Teran P.; Tuomilehto J.; Tuomilehto H.; Tuominen M.-L.; Kantola I.; Steg G.; Aboyans V.; Leclercq F.; Ferrari E.; Boccara F.; Messas E.; Mismetti P.; Sevestre M.A.; Cayla G.; Motreff P.; Stoerk S.; Duengen H.A.N.S.-D.I.R.K.; Stellbrink C.; Guerocak O.; Kadel C.; Braun-Dullaeus R.; Jeserich M.; Opitz C.; Voehringer H.-F.; Appel K.-F.; Winkelmann B.; Dorsel T.; Nikol S.; Darius H.; Ranft J.; Schellong S.; Jungmair W.; Davierwala P.; Vorpahl M.A.R.C.; Bajnok L.; Laszlo Z.; Noori E.; Veress G.; Vertes A.; Zsary A.; Kis E.R.N.O.; Koranyi L.; Bakai J.; Boda Z.; Poor F.; Jarai Z.; Kemeny V.; Barton J.O.H.N.; Mcadam B.; Murphy A.; Crean P.; Mahon N.; Curtin R.; Macneill B.; Dinneen S.E.A.N.; Halabi M.; Zimlichman R.; Zeltser D.; Turgeman Y.O.A.V.; Klainman E.; Lewis B.; Katz A.M.O.S.; Atar S.; Nikolsky E.; Bosi S.; Naldi M.; Faggiano P.; Robba D.; Mos L.; Sinagra G.; Cosmi F.; Oltrona Visconti L.; Carmine D.M.; Di Pasquale G.; Di Biase M.; Mandorla S.A.R.A.; Bernardinangeli M.; Piccinni G.C.; Gulizia M.M.; Galvani M.; Venturi F.; Morocutti G.; Baldin M.G.; Olivieri C.; Perna G.P.; Cirrincione V.; Kanno T.; Daida H.; Ozaki Y.; Miyamoto N.; Higashiue S.; Domae H.; Hosokawa S.; Kobayashi H.; Kuramochi T.; Fujii K.; Mizutomi K.; Saku K.; Kimura K.; Higuchi Y.; Abe M.; Okuda H.; Noda T.; Mita T.; Hirayama A.; Onaka H.; Inoko M.; Hirokami M.; Okubo M.; Akatsuka Y.; Imamaki M.; Kamiya H.; Manita M.; Himi T.; Ueno H.; Hisamatsu Y.U.J.I.; Ako J.; Nishino Y.; Kawakami H.; Yamada Y.; Koretsune Y.; Yamada T.; Yoshida T.; Shimomura H.; Kinoshita N.; Takahashi A.; Wan Ahmad W.A.; Abu Hassan M.R.; Kasim S.; Abdul Rahim A.A.; Mohd Zamrin D.; Machida M.; Higashino Y.; Utsu N.; Nakano A.; Nakamura S.; Hashimoto T.; Ando K.; Sakamoto T.; Prins F.J.; Lok D.I.R.K.; Milhous J.G.-J.; Viergever E.R.I.C.; Willems F.; Swart H.E.N.K.; Alings M.; Breedveld R.O.B.; De Vries K.E.E.S.-J.A.N.; Van Der Borgh R.; Oei F.; Zoet-Nugteren S.; Kragten H.A.N.S.; Herrman J.P.; Van Bergen P.A.U.L.; Gosselink M.; Hoekstra E.; Zegers E.; Ronner E.; Den Hartog F.; Bartels G.; Nierop P.; Van Der Zwaan C.O.E.N.; Van Eck J.; Van Gorselen E.; Groenemeijer B.; Hoogslag P.; De Groot M.R.; Loyola A.; Sulit D.J.; Rey N.; Abola M.T.; Morales D.; Palomares E.; Abat M.E.; Rogelio G.; Chua P.; Del Pilar J.C.; Alcaraz J.D.; Ebo G.; Tirador L.; Cruz J.; Anonuevo J.O.H.N.; Pitargue A.; Janion M.; Gajos G.; Zabowka M.; Rynkiewicz A.; Broncel M.; Szuba A.; Czarnecka D.; Maga P.; Strazhesko I.; Vasyuk Y.U.R.Y.; Sizova Z.; Pozdnyakov Y.U.R.Y.; Barbarash O.L.G.A.; Voevoda M.; Poponina T.; Repin A.; Osipova I.; Efremushkina A.N.N.A.; Novikova N.I.N.A.; Averkov O.L.E.G.; Zateyshchikov D.; Vertkin A.; Ausheva A.Z.A.; Commerford P.; Seedat S.; Van Zyl L.; Engelbrecht J.A.N.; Makotoko E.M.; Pretorius C.E.; Mohamed Z.A.I.D.; Horak A.; Mabin T.; Klug E.R.I.C.; Bae J.A.N.G.-H.O.; Kim C.; Kim C.H.O.N.G.-J.I.N.; Kim D.O.N.G.-S.O.O.; Kim Y.J.; Joo S.; Ha J.O.N.G.-W.O.N.; Park C.S.; Kim J.Y.; Kim Y.O.U.N.G.-K.W.O.N.; Jarnert C.; Mooe T.; Dellborg M.; Torstensson I.; Albertsson P.E.R.; Johansson L.A.R.S.; Al-Khalili F.; Almroth H.; Andersson T.; Pantev E.M.I.L.; Tengmark B.E.N.G.T.-O.L.O.V.; Liu B.O.; Rasmanis G.; Wahlgren C.-M.; Moccetti T.; Tseluyko V.I.R.A.; Volkov V.; Koval O.; Kononenko L.; Prokhorov O.; Vdovychenko V.; Bazylevych A.; Rudenko L.; Vizir V.; Karpenko O.; Malynovsky Y.; Koval V.; Storozhuk B.; Cotton J.; Venkataraman A.S.O.K.; Moriarty A.; Connolly D.; Davey P.; Senior R.O.X.Y.; Birdi I.; Calvert J.O.H.N.; Donnelly P.; Trevelyan J.; Carter J.; Peace A.; Austin D.; Kukreja N.; Hilton T.; Srivastava S.; Walsh R.; Fields R.; Hakas J.; Portnay E.; Gogia H.; Salacata A.; Hunter J.J.; Bacharach J.M.; Shammas N.; Suresh D.; Schneider R.; Gurbel P.A.U.L.; Banerjee S.; Grena P.A.U.L.; Bedwell N.O.E.L.; Sloan S.; Lupovitch S.; Soni A.; Gibson K.; Sangrigoli R.; Mehta R.; I-Hsuan Tsai P.; Gillespie E.V.E.; Dempsey S.; Hamroff G.; Black R.; Lader E.; Kostis J.B.; Bittner V.E.R.A.; Mcguinn W.; Branch K.; Malhotra V.; Michaelson S.; Vacante M.; Mccormick M.; Arimie R.; Camp A.L.A.N.; Dagher G.; Koshy N.M.; Thew S.; Costello F.; Heiman M.A.R.K.; Chilton R.; Moran M.; Adler F.; Comerota A.; Seiwert A.; French W.; Serota H.; Harrison R.; Bakaeen F.; Omer S.; Chandra L.; Whelan A.L.A.N.; Boyle A.; Roberts-Thomson P.; Rogers J.; Carroll P.; Colquhoun D.; Shaw J.; Blombery P.; Amerena J.O.H.N.; Hii C.; Royse A.; Singh B.; Selvanayagam J.; Jansen S.; Lo W.; Hammett C.; Poulter R.; Narasimhan S.; Wiggers H.; Nielsen H.; Gislason G.; Kober L.A.R.S.; Houlind K.I.M.; Boenelykke Soerensen V.; Dixen U.; Refsgaard J.E.N.S.; Zeuthen E.; Soegaard P.; Hranai M.; Gaspar L.; Pella D.; Hatalova K.; Drozdakova E.; Coman I.O.A.N.; Dimulescu D.; Vinereanu D.; Cinteza M.; Sinescu C.; Arsenescu C.; Benedek I.M.R.E.; Bobescu E.; Dobreanu D.A.N.; Gaita D.A.N.; Iancu A.; Iliesiu A.; Lighezan D.; Petrescu L.; Pirvu O.; Teodorescu I.; Tesloianu D.A.N.; Vintila M.M.; Chioncel O. Institution (Connolly, Eikelboom, Dyal, Lonn, Anand, Yusuf) Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (Bosch) School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada (Dagenais) Institut Universitaire de Cardiologie et Pneumologie de Quebec, Quebec, QC, Canada (Lanas) Universidad de la Frontera, Temuco, Chile (Metsarinne) Department of Medicine, Turku University Central Hospital and Turku University, Turku, Finland (O'Donnell) Department of Medicine, National University of Ireland, Galway, Ireland (Dans) Department of Medicine, University of Philippines, Manila, Philippines (Ha) Yonsei University College of Medicine, Seoul, South Korea (Parkhomenko) Institute of Cardiology, Kiev, Ukraine (Avezum) Instituto Dante Pazzanese de Cardiologia & University Santo Amaro, Sao Paulo, Brazil (Lisheng) FuWai Hospital, CAMS, Beijing, China (Torp-Pedersen) University of Aalborg, Aalborg, Denmark (Widimsky) Charles University, Prague, Czechia (Maggioni) ANMCO Research Center, Florence, Italy (Felix) Universidad Tecnologica Equinoccial, Facultad de Ciencias de la Salud Eugenio, Espejo, Quito, Ecuador (Keltai) Department of Medicine, Semmelweis University, Budapest, Hungary (Hori) Osaka International Cancer Institute, Osaka, Japan (Yusoff) Universiti Teknologi Mara, Selangor, Malaysia (Guzik) Collegium Medicum Jagiellonian University, Krakow, Poland (Guzik) University of Glasgow, Glasgow, United Kingdom (Bhatt) Brigham and Women's Hospital Heart & Vascular Center and Harvard Medical School, Boston, MA, United States (Branch) Department of Medicine, University of Washington Medical Centre, Seattle, WA, United States (Cook Bruns) Bayer AG, Wuppertal, Germany (Berkowitz) Bayer AG, Parsippany, NJ, United States (Varigos) Monash University, Melbourne, VIC, Australia (Fox) Department of Medicine, University of Edinburgh, Edinburgh, United Kingdom Publisher Lancet Publishing Group Abstract Background: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. Method(s): In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries. This paper reports on patients with coronary artery disease. Eligible patients with coronary artery disease had to have had a myocardial infarction in the past 20 years, multi-vessel coronary artery disease, history of stable or unstable angina, previous multi-vessel percutaneous coronary intervention, or previous multi-vessel coronary artery bypass graft surgery. After a 30-day run in period, patients were randomly assigned (1:1:1) to receive rivaroxaban (2.5 mg orally twice a day) plus aspirin (100 mg once a day), rivaroxaban alone (5 mg orally twice a day), or aspirin alone (100 mg orally once a day). Randomisation was computer generated. Each treatment group was double dummy, and the patients, investigators, and central study staff were masked to treatment allocation. The primary outcome of the COMPASS trial was the occurrence of myocardial infarction, stroke, or cardiovascular death. This trial is registered with ClinicalTrials.gov, number NCT01776424, and is closed to new participants. Finding(s): Between March 12, 2013, and May 10, 2016, 27 395 patients were enrolled to the COMPASS trial, of whom 24 824 patients had stable coronary artery disease from 558 centres. The combination of rivaroxaban plus aspirin reduced the primary outcome more than aspirin alone (347 [4%] of 8313 vs 460 [6%] of 8261; hazard ratio [HR] 0.74, 95% CI 0.65-0.86, p<0.0001). By comparison, treatment with rivaroxaban alone did not significantly improve the primary outcome when compared with treatment with aspirin alone (411 [5%] of 8250 vs 460 [6%] of 8261; HR 0.89, 95% CI 0.78-1.02, p=0.094). Combined rivaroxaban plus aspirin treatment resulted in more major bleeds than treatment with aspirin alone (263 [3%] of 8313 vs 158 [2%] of 8261; HR 1.66, 95% CI 1.37-2.03, p<0.0001), and similarly, more bleeds were seen in the rivaroxaban alone group than in the aspirin alone group (236 [3%] of 8250 vs 158 [2%] of 8261; HR 1.51, 95% CI 1.23-1.84, p<0.0001). The most common site of major bleeding was gastrointestinal, occurring in 130 [2%] patients who received combined rivaroxaban plus aspirin, in 84 [1%] patients who received rivaroxaban alone, and in 61 [1%] patients who received aspirin alone. Rivaroxaban plus aspirin reduced mortality when compared with aspirin alone (262 [3%] of 8313 vs 339 [4%] of 8261; HR 0.77, 95% CI 0.65-0.90, p=0.0012). Interpretation(s): In patients with stable coronary artery disease, addition of rivaroxaban to aspirin lowered major vascular events, but increased major bleeding. There was no significant increase in intracranial bleeding or other critical organ bleeding. There was also a significant net benefit in favour of rivaroxaban plus aspirin and deaths were reduced by 23%. Thus, addition of rivaroxaban to aspirin has the potential to substantially reduce morbidity and mortality from coronary artery disease worldwide. Funding(s): Bayer AG. Copyright © 2018 Elsevier Ltd <31> Accession Number 2037935254 Title Ultrasound-guided in-plane and Out-of-plane Techniques Versus Landmark Technique for Internal Jugular Vein Catheterization in Adult Cardiac Surgery Patients. Source Kathmandu University Medical Journal. 23(4) (pp 458-463), 2025. Date of Publication: 01 Oct 2025. Author Amatya A.; Pudasaini A.; Bhusal S.; Bajracharya S.M.; Shrestha B.K.; Pandey P.; Shrestha B.M. Institution (Amatya, Pudasaini, Bhusal, Bajracharya, Shrestha, Pandey, Shrestha) Department of Anesthesia, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Nepal Publisher Kathmandu University Abstract Background Internal jugular vein (IJV) catheterization is routinely performed in cardiac surgical patients. Ultrasound (US) guidance has been shown to increase success rates and reduce complications compared to landmark (LM) techniques; however, access to ultrasound machines and operator skill remain limitations in several centers. Objective To compare two different real-time 2-dimensional ultrasound-guided short axis/out-off-plane (SAX OOP) and long axis/in-plane (LAX IP) approaches and to determine whether ultrasound guidance could improve the success rate and decrease the complication rate of internal jugular vein catheterization compared with the landmark approach (LM). Method This Prospective, randomized comparative study evaluated three techniques for internal jugular vein cannulation in adult elective cardiac surgery patients (n=90): (1) real-time short-axis/out-of-plane ultrasound guidance (SAX-OOP), (2) real-time long-axis/in-plane ultrasound guidance (LAX-IP), and (3) landmark technique (LM). Primary outcomes included number of attempts and procedure duration. Secondary outcomes included mechanical complications. Chi-square for categorical variables and one-way ANOVA for continuous variables were applied to find out the associations. Result First-attempt success was highest in LAX-IP (100%), followed by SAX-OOP (96.7%) and LM (83.3%) (p=0.024). All complications (n=7) occurred in the LM group (p=0.001). Mean cannulation time was significantly longer in the LM group (90.83+/-13.23 seconds) versus SAX-OOP (60.47+/-10.96 seconds) and LAX-IP (70.47+/-23.10 seconds) (p<0.001). Conclusion Real-time ultrasound guidance, particularly the in-plane technique, significantly improves success rates, reduces complications, and shortens cannulation time compared with the landmark technique. Ultrasound guidance should be preferred for internal jugular vein cannulation in cardiac anesthesia settings. Copyright © 2025, Kathmandu University. All rights reserved. <32> 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. 74(4) (pp 340-348), 2026. Date of Publication: 01 Apr 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. <33> 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. <34> Accession Number 2044329038 Title Contemporary Management of Cardiac Implantable Electronic Devices in the LVAD Era: Evidence, Controversies, and Clinical Implications. Source Hearts. 7(1) (no pagination), 2026. Article Number: 4. Date of Publication: 01 Mar 2026. Author Sgarito G.; Campo F.; Genovese D.; Mugnai G.; Santoro F.; Francia P.; Ruggiero D.; Perrotta L.; Conti S. Institution (Sgarito, Campo) IRCCS Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione, University of Pittsburgh Medical Center, Palermo, Italy (Genovese) Cardiology Unit, Cardio-Neuro-Vascular Department, Ca' Foncello Hospital, Treviso, Italy (Mugnai) Division of Cardiology, Cardio-Thoracic Department, University Hospital of Verona, Verona, Italy (Santoro) Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy (Francia) Cardiology Unit, Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, University Sapienza, Rome, Italy (Ruggiero) Cardiology Unit, Ospedale Pio XI, Desio, Italy (Perrotta) Arrhythmia Unit, Department of Cardiology, Careggi University Hospital, Florence, Italy (Conti) Division of Cardiology, Department of Internal Medicine, The Carver College of Medicine, University of Iowa Health Care Center, University of Iowa, Iowa, IA, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract The role of cardiac implantable electronic devices (CIEDs), including implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) devices, in patients supported with left ventricular assist devices (LVADs) remains controversial. Although ICDs clearly reduce the risk of sudden cardiac death (SCD) and improve outcomes in advanced heart failure (HF), their benefit in patients with continuous-flow mechanical circulatory support is less certain. Initial small studies involving LVAD patients, particularly those with older pulsatile devices, suggested that ICDs confer a survival benefit during LVAD support. However, more recent evidence has been inconsistent. Some studies show modest protection against arrhythmic death, whereas others show no improvement in overall mortality. Similarly, CRT does not appear to offer significant additional hemodynamic benefits after LVAD implantation, and current evidence does not strongly support its routine continuation. Device-related complications-including lead failure, infection, electromagnetic interference, and inappropriate shocks-are major clinical concerns that can offset potential benefits. Accordingly, current guidelines recommend maintaining pre-existing ICD or CRT devices in LVAD patients but do not endorse the routine implantation of new devices after LVAD placement. The existing evidence highlights the need for a nuanced and individualized approach to CIED therapy in patients with LVAD. Future research should focus on randomized trials, registry-based analyses, and the exploration of novel technologies such as leadless pacing, subcutaneous ICDs, and advanced programming algorithms. Patient-centered outcomes, particularly quality of life and ethical considerations-such as ICD deactivation in end-of-life scenarios-must be considered in decision-making in this evolving field. Copyright © 2026 by the authors. <35> Accession Number 2044510602 Title Efficacy of low-dose nalmefene on recovery from general anaesthesia in adult patients: a multicentre randomised controlled study. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Ma X.; Liu J.; Zhang Y.; Li L.; Zhang G.; Xing L.; Huai X.; Tang Y.; Xie Y.; Su D. Institution (Ma, Liu) Department of Anesthesiology, Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China (Zhang, Huai) Shanghai Jiao Tong University School of Medicine Affiliated Renji Hospital, Shanghai, Shanghai, China (Li) The First Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China (Zhang) Department of Anesthesiology, Shanghai Tongren Hospital, Shanghai, Shanghai, China (Xing) The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China (Tang) Department of Anaesthesiology, Shanghai Jiaotong University, Shanghai, China (Xie) Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, University of Electronic Science and Technology of China School of Medicine, Sichuan, Chengdu, China (Su) Anesthesiology, Zhejiang University School of Medicine First Affiliated Hospital, Zhejiang, Hangzhou, China Publisher BMJ Publishing Group Abstract ObjectivesThis randomised controlled trial aims to evaluate the impact of low-dose intravenous nalmefene on anaesthesia recovery in adult patients aged 18-65 undergoing surgery under general anaesthesia.DesignThis was a multicentre, randomised, double-blind trial with two parallel arms clinical study.SettingFour hospitals from ChinaParticipantsA total of 514 patients aged 18-65 who underwent elective orthopaedic, urologic and thoracic surgeries.InterventionsOn completion of skin suturing, the intervention group received a single intravenous dose of nalmefene (0.25 microg/kg). The control group received an equivalent volume of normal saline at the same time point.Primary and secondary outcome measuresThe primary outcome was the interval time between the end of anaesthesia and the Aldrete score >=9 being achieved in the postanaesthesia care unit (PACU). The secondary endpoints included the time interval from the end of operation to extubation; Richmond Agitation Sedation Scale (RASS) score at extubation; the time at Montreal Cognitive Assessment Scale (MoCA) orientation score >=5; visual analogue scale (VAS) score in PACU and 24 hours postoperatively.Results514 patients were included in the Intention-to-Treat (ITT) analysis. The time interval between the end of anaesthesia and Aldrete score reached >=9 in PACU was significantly shorter in the intervention group than in the control group (mean (SD) 24.8 (11.8) min vs 33.8 (12.5) min; 95% CI -8.8 (-10.8 to -6.7); p<0.001). Furthermore, the time interval from the end of surgery to extubation was shorter in the intervention than in the control group (mean (SD) 20.0 (9.9)min vs 27.6 (11.6) min; 95% CI -7.6 (-9.43 to -5.7), p<0.001). The time at Montreal cognitive assessment score >=5 was also shorter in the control than in the intervention group (mean (SD) 20.0 (15.9) min vs 27.0 (20.5) min; 95% CI -7.0 (-10.2 to -3.8); p<0.001). Compared with the control group, the intervention group had better analgesic effect at the recovery endpoint (P Aldrete score >=A was achieved as well as lower 24 hours points postoperatively (p<0.05)).ConclusionsIn patients aged 18-65 who underwent elective orthopaedic, urologic and thoracic surgeries, low-dose nalmefene administered at the end of surgery can accelerate postanaesthesia recovery without compromising analgesic effects.Trial registration numberNCT04713358. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <36> Accession Number 2044326672 Title Effects of Continuous Postoperative Pericardial FLUshing with Investigational Device on Postoperative Re-Explorations for Bleeding (FLUID)-Randomized Clinical Trial. Source Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number: 2151. Date of Publication: 01 Mar 2026. Author Molenaar M.A.; Koolbergen D.R.; Vegter M.; Lam K.; Hofman F.N.; van Dinter S.R.; van 't Loo A.; de Weger A.; Janson J.A.; Bulte C.S.E.; Eberl S.; Lagrand W.K.; Vonk A.; Lucas F.R.M.; Klautz R.J.M.; Schultz M.J. Institution (Molenaar, Lagrand, Lucas, Schultz) Department of Intensive Care, Amsterdam University Medical Centers, Amsterdam, Netherlands (Molenaar, Koolbergen, Vegter, Vonk, Klautz) Department of Cardiothoracic Surgery, Amsterdam University Medical Centers, Amsterdam, Netherlands (Koolbergen, Vegter, de Weger, Klautz) Department of Cardiothoracic Surgery, Leiden University Medical Center, Leiden, Netherlands (Lam) Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands (Hofman, van Dinter, van 't Loo) Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands (Janson) Department of Intensive Care, Leiden University Medical Center, Leiden, Netherlands (Bulte, Eberl) Department of Anesthesiology, Amsterdam University Medical Centers, Amsterdam, Netherlands Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Objectives: Continuous postoperative pericardial flushing (CPPF) may prevent postoperative re-explorations for tamponade or excessive postoperative bleeding due to a non-surgical cause in cardiac surgery patients. Method(s): An investigator-initiated, national, multicenter, randomized clinical superiority trial was performed in four hospitals in the Netherlands between November 2021 and April 2023. Patients undergoing general cardiac surgery involving cardiopulmonary bypass were randomly assigned to receive CPPF or standard care. The primary endpoint was the number of surgical re-explorations for either cardiac tamponade or excessive postoperative bleeding due to a non-surgical cause in the first postoperative week. Result(s): The study was stopped after randomization of 164 patients, of which 79 were allocated to CPPF and 85 served as controls. The number of surgical re-explorations for either cardiac tamponade or excessive postoperative bleeding due to a non-surgical cause in the first postoperative week was not different between CPPF patients and control patients (3.8% vs. 2.4%; relative risk 1.61 [0.28-9.41]; p = 0.67). There were no safety issues related to use of the investigational device. Conclusion(s): In this prematurely stopped study, CPPF did not reduce the number of postoperative re-explorations for cardiac tamponade or excessive bleeding due to a non-surgical cause in cardiac surgery patients. Additional well-powered studies remain needed to determine whether CPPF has any beneficial effect on outcome. Copyright © 2026 by the authors. <37> Accession Number 2044480644 Title Perioperative outcomes and safety of Uniportal Robotic-Assisted Thoracic Surgery (U-RATS) for anatomic lung resection: a systematic review and meta-analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 399. Date of Publication: 01 Dec 2026. Author Kaaki S.; Barnawi A.B.; Robaidi H.A.; Maghrabi A.A.; Almaymuni A.D.; Alzahim A.; Almahmoud A.; Alsalem K.A.; Alshehri Y.M.; Alsharari H.S.; Hajjar W.M. Institution (Kaaki, Hajjar) Department of Surgery, Division of Thoracic Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia (Barnawi, Almahmoud, Alsalem, Alshehri) College of Medicine, Imam Mohammad Ibn Saud Islamic University (IMSIU), Riyadh, Saudi Arabia (Robaidi) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia (Maghrabi) Department of Surgery, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia (Almaymuni) Department of Surgery, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia (Alzahim) King Saud University Medical City, Riyadh, Saudi Arabia (Alsharari) College of Medicine, AlMaarefa University, Riyadh Region, SA, Riyadh, Saudi Arabia Publisher Springer Nature Abstract Uniportal robotic-assisted thoracic surgery (U-RATS) represents a recent evolution in minimally invasive lung resection, combining the single-incision philosophy with robotic technology. However, its perioperative safety and outcomes have not been clearly defined across published studies. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines and a registered protocol. PubMed, Web of Science, and the Cochrane Library were searched for studies reporting perioperative outcomes of U-RATS for anatomic lung resection in adults. Primary outcomes included conversion rate, morbidity, and mortality. Secondary outcomes were operative time, estimated blood loss, length of hospital stay, and lymph node yield. Random-effects models were applied to pool estimates. Sixteen studies encompassing 579 patients were included. The pooled conversion rate was 1.34% (95% CI: 0.42-4.15%), with no observed heterogeneity. The pooled postoperative morbidity rate was 5.99% (95% CI: 4.46-7.91%), and the pooled mortality rate was 0.21% (95% CI: 0.07-0.64%). The pooled mean operative time was 171.3 min, the estimated blood loss was 51.9 mL, and the postoperative length of stay was 4.9 days. Across 11 studies, the pooled lymph node yield was 16.6 nodes (95% CI: 14.0-19.2; I2 = 89.8%). Current evidence suggests that U-RATS is a safe and feasible approach for anatomic lung resection, with low conversion and complication rates and acceptable perioperative outcomes comparable to established minimally invasive techniques. Copyright © The Author(s) 2026. <38> Accession Number 2044340757 Title Vericiguat in patients with acute coronary syndrome and reduced ejection fraction: the EVE-ACSrEF study. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 262. Date of Publication: 01 Dec 2026. Author Shi X.; Zhao A.; Ding Y.; Gu L.; Yang T.; Wang H.; Wang Q.; Wang S.; Wang L. Institution (Shi, Zhao, Ding, Gu, Yang, Wang, Wang, Wang, Wang) Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, Jiangsu Province, Nanjing, China Publisher BioMed Central Ltd Abstract Background: Preclinical research has demonstrated that vericiguat can improve myocardial microcirculation. However, real-world evidence of using vericiguat alongside guideline-directed medical therapy (GDMT) in patients with acute coronary syndrome (ACS) complicated by heart failure with reduced ejection fraction (HFrEF) remains limited. Method(s): In this prospective cohort study, 149 ACS patients with left ventricular ejection fraction (LVEF) below 45% were grouped by their treatment preference. Multivariable analyses were used to evaluate the effect of vericiguat on the composite endpoint of hospitalization for heart failure (HHF) or cardiovascular death (CVD). A linear mixed-effects model was used to analyze changes in LVEF and N-terminal pro-brain natriuretic peptide (NT-proBNP) from baseline to 12 months. Differences in the absolute values of Kansas City Cardiomyopathy Questionnaire quality of life (KCCQ-QoL) scores during the follow-up were also evaluated. Result(s): In this study, 75 patients (50.3%) received vericiguat plus GDMT treatment, while 74 patients (49.7%) received GDMT treatment alone. The average age of enrolled patients was 65 years, with approximately 17.4% being female. 33.6% were classified as NYHA class III heart failure, and the average LVEF was 38.11%. Over the 12-month follow-up, the composite endpoint event occurred in 5 (6.67%) of 75 patients in the vericiguat group and 13 (17.57%) of 74 patients in the GDMT group (hazard ratio [HR] 0.31 [95% confidence interval (CI) 0.10-0.96]; P = 0.041). By the end of the follow-up, LVEF improved significantly more with vericiguat (least squares mean [LSM] difference 3.31% [95%CI 0.58%-6.04%]; P = 0.018). From the first month, the vericiguat group demonstrated greater reductions in NT-proBNP (P = 0.004) and improvements in KCCQ-QoL (P = 0.042) than the GDMT group, which were maintained through follow-up. Adverse events were mild with vericiguat, similar to the GDMT group. Conclusion(s): In the first prospective cohort study focusing on patients with ACS and HFrEF, vericiguat plus GDMT treatment for 12 months reduced the risk of CVD and HHF, while improving cardiac function and quality of life. Trial registration: ClinicalTrials.gov (NCT06321094). Registered on 06 March 2024, prior to the enrollment of the first participant. https://clinicaltrials.gov/search?cond=NCT06321094. Copyright © The Author(s) 2026. <39> Accession Number 2044545380 Title Safety and effectiveness of hormonal vs non-hormonal or no contraception in women with hypertension and future fertility desire: A broad-scope systematic review. Source PLOS ONE. 21(3 March) (no pagination), 2026. Article Number: e0345959. Date of Publication: 01 Mar 2026. Author Losada-Trujillo N.; Estrada-Orozco K.; Velasco-Lancheros O.J.; Ramirez-Vargas B.A.; Burgos-Cardenas A.J.; Gonzalez-Caicedo P.A.; Bedoya M.J.H.; Gaitan-Duarte H. Institution (Losada-Trujillo, Estrada-Orozco, Velasco-Lancheros, Ramirez-Vargas, Burgos-Cardenas, Gonzalez-Caicedo, Bedoya, Gaitan-Duarte) Faculty of Medicine, Universidad Nacional de Colombia, Bogota D.C, Colombia (Losada-Trujillo, Estrada-Orozco, Burgos-Cardenas, Gonzalez-Caicedo, Bedoya, Gaitan-Duarte) Clinical Research Institute, Faculty of Medicine, Universidad Nacional de Colombia, Bogota D.C, Colombia (Losada-Trujillo, Velasco-Lancheros, Ramirez-Vargas, Burgos-Cardenas, Bedoya, Gaitan-Duarte) Hospital Universitario Nacional de Colombia, Bogota D.C, Colombia (Losada-Trujillo, Estrada-Orozco, Velasco-Lancheros, Ramirez-Vargas, Gaitan-Duarte) Health Technologies and Policies Assessment Group (GETS), Bogota D.C, Colombia (Estrada-Orozco) Centro de Evidencia e Implementacion, CEI-evidence, Bogota D.C, Colombia (Burgos-Cardenas) Fundacion Cardioinfantil, Instituto de Cardiologia, Bogota D.C, Colombia Publisher Public Library of Science Abstract Objective To evaluate the safety and effectiveness of hormonal contraceptives compared to non-hormonal methods or no contraception in hypertensive women seeking future fertility. Data sources Searches were conducted in Medline, Embase, CENTRAL, and LILACS (September -October, 2022), with updates on September, 2023, and August, 2024. Clinical trial records, regulatory agencies, and gray literature were also consulted (June, 2022; August, 2023; September, 2024). Methods Eligible studies that assessed safety (major adverse cardiovascular events, pelvic inflammatory disease, vaginal infections, loss of fertility, discontinuation, worsening hypertension, peripheral arterial disease, venous thromboembolism, weight gain, liver or kidney function changes) or effectiveness (pregnancies/Pearl index) of hormonal contraceptives in hypertensive women. Eligible designs included clinical trials, cohort and case control studies, case series, case reports, and adverse event data. Two reviewers independently screened titles/abstracts, reviewed full texts, selected studies, extracted data, and assessed bias (ROBINS-I: cohorts), methodological quality (Newcastle Ottawa: case-control), and critical appraisal (Joanna Briggs Institute: case series). Certainty of evidence was evaluated using GRADE. Evidence was synthesized quantitatively and qualitatively by contraceptive and outcome. Results Of 32,225 records screened, 17 studies were included. Combined oral contraceptives may increase hemorrhagic cerebrovascular disease (OR: 1.64 (95% CI 1.08-2.50, certainty: low). Evidence is very uncertain about their effects on preventing pregnancies, and safety related to ischemic cerebrovascular disease, myocardial infarction, venous thromboembolism, weight gain, hypertension, kidney function, and lipid profile. Similarly, the effects of progestin-only pills, injectables, and vaginal rings on cardiovascular and metabolic outcomes remain highly uncertain. Certainty is also very low for combined oral contraceptives or progestogen-only pills regarding cerebrovascular disease, myocardial infarction (OR: 1.15, 95% CI 0.60-2.19), and peripheral arterial disease. Conclusions Low-certainty evidence suggests that combined oral contraceptives may increase hemorrhagic cerebrovascular disease in hypertensive women, whereas evidence for the other assessed safety and effectiveness outcomes is very low. Copyright © 2026 Losada-Trujillo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. <40> Accession Number 2044510139 Title Efficacy of perioperative intravenous lidocaine infusion on postoperative recovery and analgesia in patients undergoing video-assisted thoracoscopic surgery: study protocol for a randomised, double-blind, placebo-controlled trial. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Omindo W.W.; Xiao Z.; Wang X.; Fu L.; Wang J.; Zhang R.; Ping W.; Zhou B.; Zhang N. Institution (Omindo, Xiao, Wang, Fu, Wang, Zhang, Ping, Zhang) Department of Thoracic Surgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Hubei, Wuhan, China (Zhou) Department of Anesthesiology, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Hubei, Wuhan, China Publisher BMJ Publishing Group Abstract IntroductionDespite the minimally invasive nature of video-assisted thoracoscopic surgery (VATS), moderate-to-severe postoperative pain remains frequent and impairs recovery. Intravenous lidocaine possesses multimodal analgesic, antihyperalgesic and anti-inflammatory properties that may improve pain control and functional outcomes, but robust evidence in thoracic surgery is lacking. Moreover, its potential to attenuate neuropathic pain, a key component of chronic post-thoracic pain syndromes, has not been adequately investigated. This trial will determine whether continuous perioperative intravenous lidocaine infusion improves recovery, reduces acute pain intensity and prevents the development of neuropathic pain after VATS.Methods and analysisThis single-centre, randomised, double-blind, placebo-controlled trial will enrol 84 adult patients undergoing elective VATS. Participants will be randomised (1:1) to receive either intravenous lidocaine (bolus 1 mg/kg at induction followed by continuous infusion at 1.5 mg/kg/hour intraoperatively and postoperatively for 24 hours) or matched normal saline postoperatively, with identical intraoperative management in both groups. The primary outcome is the incidence of moderate-to-severe movement-evoked pain at 24 hours postoperatively. Secondary outcomes include pain at 48 and 72 hours, opioid consumption, pulmonary complications, sleep quality, quality of recovery, neurocognitive outcomes and chronic neuropathic pain at 3 months. Analyses will follow the intention-to-treat principle.Ethics and disseminationThe study protocol was approved by the Institutional Review Board of Tongji Hospital (Reference No. TJ-IRB202509102) and registered in the Chinese Clinical Trial Registry (ChiCTR2500111163). Written informed consent will be obtained from all participants. Results will be submitted to peer-reviewed journals and academic conferences.Trial registration numberChiCTR2500111163. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <41> Accession Number 2034534528 Title Cardiovascular Disorders in Systemic Lupus Erythematosus. Source Current Vascular Pharmacology. 24(1) (pp 20-32), 2026. Date of Publication: 2026. Author Manolis A.A.; Manolis T.A.; Manolis A.S. Institution (Manolis) Department of Internal Medicine, Elpis General Hospital of Athens, Athens, Greece (Manolis) Department of Psychiatry, Aiginiteio University Hospital, Athens, Greece (Manolis) Athens University School of Medicine, Athens, Greece Publisher Bentham Science Publishers Abstract Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease with multiorgan and system involvement, including the Cardiovascular (CV) system. Cardiac involvement in these patients is frequent and most often asymptomatic, at least in the early stages. It includes accelerated atherosclerosis, premature Coronary Artery Disease (CAD), and a high risk of CV complications. The risk of developing CV Disease (CVD) in SLE is linked not only with classical CV risk factors but also with disease-specific factors, like the degree of activity, autoantibodies, organ damage, and type of therapy. Clinical presentation comprises several clinical manifestations ranging from angina to acute Myocardial Infarction (MI) and Sudden Cardiac Death (SCD). The leading cause of death in SLE patients is from CVD due to accelerated atherosclerosis, which often has a more rapid progression compared with the general population. The CV risk in SLE is greater when antiphospholipid antibodies are present. Regarding diagnosis, apart from relevant blood tests, the simplest and readily available diagnostic test, echocardiography, with its contemporary techniques that include global longitudinal strain, is needed to provide a more thorough cardiac evaluation and allow for early management. These aspects of the disease, together with issues regarding phenotypes, biomarkers, neonatal lupus, heart block, SLE-related CV ailments such as coronary artery disease (CAD), myocarditis, valvular heart disease, and the antiphospholipid syndrome, as well as diagnostic modalities, drug and interventional therapies, and current relevant guidelines are all thoroughly reviewed and discussed in this article. Copyright 2026, Bentham Science Publishers <42> Accession Number 2037949980 Title Improved performance after neuromuscular electrical stimulation in hospitalized patients with severe heart failure. Source ESC Heart Failure. 13(1) (no pagination), 2026. Date of Publication: 01 Feb 2026. Author Betz T.M.; Kinitz H.; Kristen I.; Gunter S.; Knarr M.; Eck U.; Preusch M.; Soethoff J.P.; Karck M.; Frey N.; Katus H.A.; Friedmann-Bette B. Institution (Betz, Kinitz, Kristen, Gunter, Friedmann-Bette) Department of Sports Medicine, Medical Clinic, University Hospital Heidelberg, Im Neuenheimer Feld 410, Heidelberg, Germany (Knarr, Soethoff, Karck) Department of Cardiac Surgery, Surgical Clinic, University Hospital Heidelberg, Heidelberg, Germany (Eck) Spinal Cord Injury Center, Heidelberg University Hospital, University Hospital Heidelberg, Heidelberg, Germany (Preusch, Frey, Katus) Department of Cardiology, Angiology and Pneumonology, Medical Clinic, University Hospital Heidelberg, Heidelberg, Germany Publisher Oxford University Press Abstract Introduction Patients with severe heart failure often suffer from sarcopenia, which contributes to reduced exercise capacity and might worsen during a hospital stay. The study thus aimed to investigate the safety of neuromuscular electrical stimulation (NMES) and its effects on functional performance in hospitalized patients with severe heart failure, including patients with electronic cardiac devices, in addition to regular physiotherapeutic treatment. Methods Based on their functional performance level, 30 patients (48.0 +/- 14.3 years; 19 males, 11 females) were stratified and 1:1 randomized to either the control group (CON) with regular physiotherapeutic treatment only, or the stimulation group (STIM), who additionally received a 2-week NMES of the leg muscles. Functional performance was evaluated using a battery of 5 distinct functional tests [including the 6-minute walking test (6MWT) and the sit-to-stand test (SST)] administered at baseline (T0) and after 2 weeks (T1). The individual test outcomes were subsequently aggregated into a composite measure, the StimFIT5-Score. Furthermore, the PHQ9-Score was assessed to evaluate depressive symptoms. Results No adverse side effects occurred and specifically, no electromagnetic interferences in patients with cardiac electronic devices were detected. For the StimFIT5-Score, a significantly greater improvement (P = .002) was observed in STIM (+8.2 points, P < .001) compared to CON (+3.6 points, P = .006). The percentage improvement in the StimFIT5-Score was the greatest in STIM-patients with low StimFIT5-Scores at baseline (+53%). STIM showed significant improvements from T0 to T1 in the 6MWT (+ 68 m, P < .001) and SST (+3.8 repetitions, P < .001) but with no significantly greater improvement in both tests (6-minute walking test P = .087, SST P = .085) compared to CON (6MWT +35 m, P = .05; SST +1.7 repetitions, P = .078). There was also no significant difference (P = .078) in the improvement of the PHQ9-Score in STIM (-3.2 points, P < .001) compared to CON (-2.4 points, P = .013). In STIM, no sex-specific differences were observed for the improvement in StimFIT5-Score (P = .388), 6MWT (P = .685), and SST (P = .720), with both female and male patients showing significant improvements from T0 to T1. Conclusion In this study, NMES was safely applied in patients with severe heart failure and electronic cardiac devices. Two weeks of NMES in addition to regular physiotherapeutic treatment had significant effects on functional performance measured by StimFIT5-Score, independent of sex and with the greatest benefits observed in the least fit patients . Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. <43> Accession Number 609951326 Title A comparative study between propofol and dexmedetomidine as sedative agents during performing transcatheter aortic valve implantation. Source Journal of Clinical Anesthesia. 32 (pp 242-247), 2016. Date of Publication: 01 Aug 2016. Author Khalil M.; Al-Agaty A.; Asaad O.; Mahmoud M.; Omar A.S.; Abdelrazik A.; Mostafa M. Institution (Khalil, Al-Agaty, Asaad) Anesthesia Department, Cairo University, Giza, Egypt (Mahmoud, Abdelrazik) Critical Care Department, Cairo University, Giza, Egypt (Omar) Critical Care Department, Cairo University, Beni-Suef Division, Giza, Egypt (Mostafa) Cardiology Department, Ain-Shams University, Giza, Egypt Publisher Elsevier Inc. Abstract Objective The type of sedative drugs could play a major role in providing hemodynamic stability which is crucial during transcatheter aortic valve implantation (TAVI) procedure. The aim of this study is to compare propofol with dexmedetomidine for conscious sedation during TAVI. Design A prospective randomized pilot study. Patients Fifty patients with a mean age of 74 years, American Society of Anesthesiologists 3-4, complaining from severe aortic stenosis were enrolled in this study to undergo TAVI. Interventions The propofol group (group P; n = 25) received a bolus dose of 0.5 mg/kg propofol followed by a continuous intravenous infusion of propofol at a rate of 30 to 50 mug kg-1 min-1, and the dexmedetomidine group (group D; n = 25) received dexmedetomidine at a loading dose of 1 mug/kg and then a continuous intravenous infusion of dexmedetomidine at a rate of 0.5 mug kg-1 h-1. Measurements Heart rate, mean arterial blood pressure, number of phenylephrine boluses, oxygen saturation, sedation, and satisfaction scores were measured just after the start of infusion of the sedation drugs and at the end of the procedure. Postoperative complications were also recorded. Results There was a statistically significant reduction in the heart rate in group D in comparison to group P where it was 67.28 +/- 6.9 beats/min in the first group in comparison to 78 +/- 6.9 beats/min in the last one (P <.001). The mean arterial blood pressure was statistically significant lower in group D in comparison to group P (58.12 +/- 5.4 mm Hg in group D vs 68.24 +/- 11.4 mm Hg in group P; P <.001). Also, the number of phenylephrine boluses was higher in group D than in group P (36.5 +/- 7.17 in group D vs 20.6 +/- 2.07 in group p; P <.001). No difference between the 2 groups regarding oxygen saturation, sedation, pain, satisfaction scores, and postoperative complications. Conclusion During TAVI, dexmedetomidine may be associated with significant hypotension and bradycardia rather than propofol. Copyright © 2016 Elsevier Inc. All rights reserved. <44> [Use Link to view the full text] Accession Number 2044137602 Title Sweep Gas Nitric Oxide During Extracorporeal Membrane Oxygenation in Neonates and Children (NECTAR Trial): A Single-Center, Pilot Randomized Controlled Trial. Source Pediatric Critical Care Medicine. Publish Ahead of Print (no pagination), 2026. Date of Publication: 2026. Author Mattke A.C.; Johnson K.; Gibbons K.; Le Marsney R.; Long D.A.; O'Brien C.; Blumenthal A.; Venugopal P.S.; Alphonso N.; Schlapbach L.J. Institution (Mattke, Johnson) Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia (Mattke, Johnson) Paediatric Intensive Care Unit, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia (Gibbons, Le Marsney, Schlapbach) Children's Intensive Care Research Program, Child Health Research Centre, The University of Queensland, Brisbane, QLD, Australia (Long) School of Nursing, Centre for Healthcare Transformation, Queensland University of Technology, Brisbane, QLD, Australia (O'Brien) Department for Paediatric Radiology, Queensland Children's Hospital, Children's Health Queensland, Brisbane, QLD, Australia (Blumenthal) Frazer Institute, The University of Queensland Frazer Institute, Brisbane, QLD, Australia (Venugopal, Alphonso) Department of Cardiac Surgery, Children's Hospital Queensland, Children's Health Queensland, University of Queensland, School of Medicine, Brisbane, QLD, Australia (Schlapbach) Department of Intensive Care Medicine and Neonatology, and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland Publisher Lippincott Williams and Wilkins Abstract Objectives: - To test the feasibility and safety of a randomized controlled trial (RCT) delivering nitric oxide into the sweep gas of extracorporeal membrane oxygenation (ECMO) circuits (sNO) in critically ill children. Second, we explored whether use of sNO may influence clinical outcomes. Design(s): - Prospective pilot single-center open-label RCT (trial registration number ACTRN12619001518156). Setting(s): - Single-center, tertiary PICU with enrollment between July 2020 and July 2023. Patient(s): - Patients from birth to 16 years requiring venoarterial or venovenous ECMO support were enrolled. Intervention(s): - Randomization to sweep flow with an oxygen/nitrogen mix vs. a mix of oxygen, nitrogen and sNO (20 parts per milliion). Randomization was stratified by type of ECMO support (venoarterial vs. venovenous). Measurements and Main Results: - Of 60 eligible patients 53 underwent randomization. The median (interquartile range [IQR]) was 1 month (0.1-33.5 mo) and 6.2 months (0.5-120.2 mo) for the intervention and control arms, respectively. Venoarterial and venovenous support were used in 35 of 53 (65%) and 18 of 53 (35%) patients, respectively. In all, 17 of 53 (32%) received pulmonary, 23 of 53 (43%) cardiac and 13 of 53 (25%) extracorporeal cardiopulmonary resuscitation support. Median (IQR) survival free of ECMO and survival free of PICU censored at 30 and 90 days were similar: 18.2 days (0-25.2 d) and 69.1 days (0-85.2 d) vs. 20.8 days (0-26.3 d) and 77.7 days (0-85.9 d) with an effect estimate of -3.2 days (-16.6 to 10.1 d) and -8.8 days (-54.2 to 36.6 d) between the intervention and standard care arm. Blood product use, circuit duration to replacement, free plasma hemoglobin, degree of oxygenator thrombus, and incidence of methemoglobinemia were similar between the two groups. No major adverse events occurred related to the treatment allocation or intervention. Conclusion(s): - This single-center pilot RCT of sNO vs. standard sweep flow in the ECMO circuit demonstrated that such a trial is safe and feasible. However, given no effect of sNO on clinical outcomes was detected further exploration of dose and route of administration of NO should be undertaken before larger, definitive trials are conducted. Copyright © 2026 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies <45> Accession Number 2044438306 Title Fast and Precise: AI Medical Devices at the Intersection of Speed and Accuracy. Source Current Pharmacology Reports. 12(1) (no pagination), 2026. Article Number: 10. Date of Publication: 01 Dec 2026. Author Seth R.; Nagpal M.; Swami R.; Kaur M. Institution (Seth, Nagpal, Swami) Chitkara College of Pharmacy, Chitkara University, Punjab, India (Kaur) MM College of Pharmacy, Maharishi Markandeshwar (Deemed to Be University), Mullana, Ambala, India Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Artificial intelligence (AI) is revolutionizing healthcare by integrating into medical devices to improve diagnostic accuracy, treatment efficiency, and patient outcomes. AI technologies such as machine learning, deep learning, and edge computing play a crucial role in real-time data processing and integration into medical devices. Objective(s): This paper provides an overview of the current state of AI in medical devices, emphasizing its integration into healthcare, technological advancements, and regulatory frameworks. It explores the trade-off between speed and accuracy in AI systems, as well as ethical and practical challenges. Method(s): A comprehensive review of the AI technologies in medical devices is presented, including the categorization of AI applications, regulatory guidelines, and the role of edge computing and Internet of Things (IoT) integration. Case studies showcasing AI medical devices focusing on speed vs. accuracy trade-offs are analyzed, along with the integration of AI in diagnostic imaging, personalized medicine, and predictive analytics. Result(s): AI technologies have significantly enhanced diagnostic accuracy, clinical decision-making, and patient monitoring. The trade-off between speed and accuracy is addressed through innovative solutions like edge computing and machine learning. AI has shown potential in various fields such as radiology, cardiac monitoring, and surgical guidance, with case studies demonstrating both fast and accurate AI applications. Conclusion(s): The integration of AI into medical devices is poised to transform healthcare by improving clinical workflows, decision-making, and personalized care. However, ethical considerations and regulatory challenges related to data privacy, algorithmic fairness, and patient safety must be addressed to ensure sustainable development. Continued innovation, supported by rigorous regulatory frameworks, will be essential for the effective and ethical deployment of AI in medical devices. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <46> Accession Number 2044477515 Title Liposomal bupivacaine versus bupivacaine hydrochloride erector spinae plane blocks in cardiac surgery: protocol for a pragmatic randomized controlled trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 270. Date of Publication: 01 Dec 2026. Author Yoo J.; Pepe R.J.; Nithikasem S.; Laraia K.N.; Yang N.K.; Lee L.Y. Institution (Yoo) Department of Anesthesiology, Perioperative Care and Pain Medicine, New York University, New York, NY, United States (Pepe, Lee) Division of Cardiothoracic Surgery, Department of Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Nithikasem, Yang) Department of Surgery, Columbia University Irving Medical Center, New York, NY, United States (Laraia) Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO, United States (Lee) Robert Wood Johnson University Hospital, New Brunswick, NJ, United States Publisher BioMed Central Ltd Abstract Background: Postoperative pain management after cardiac surgery involves a multimodal approach. Recently, the erector spinae plane (ESP) block has been incorporated into multimodal pain control protocols. These measures have been taken to increase patient satisfaction while minimizing opioid usage. Prospective data is lacking to guide decisions regarding optimal regional anesthetic agents. This randomized controlled pragmatic trial protocol seeks to determine the benefit of liposomal bupivacaine relative to plain bupivacaine hydrochloride at reducing postoperative opioid consumption and other clinical outcomes following cardiac surgery. Method(s): The investigators anticipate consenting 150 subjects to obtain 96 evaluable subjects undergoing minithoracotomy (N = 24 liposomal bupivacaine, N = 24 bupivacaine hydrochloride) or open sternotomy (N = 24 liposomal bupivacaine, N = 24 bupivacaine hydrochloride). The primary outcome will be postoperative opioid consumption, reported in morphine equivalents. Secondary outcomes will include postoperative nonopioid analgesic consumption, inpatient and outpatient postoperative pain scores, 30-day mortality and major morbidity rates, postoperative quality of life, and hospitalization costs. Double blinding will be conducted with necessary measures taken to mask electronic medical records and drug preparation. Discussion(s): The trial is currently enrolling subjects at a single academic medical center in the northeastern United States. The current study aims to investigate the postoperative pain reported by patients undergoing cardiac surgery when receiving ESP blocks with liposomal bupivacaine (experimental) compared to its hydrochloride formulation (control). Trial registration: ClinicalTrials.gov NCT06077422. Registered on October 2023. https://clinicaltrials.gov/study/NCT06077422?tab=table. Copyright © This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply 2026. <47> Accession Number 2043296956 Title TAVR in Bicuspid Aortic Valve Disease: A Meta-Analysis of Surgical Comparison and Anatomic Predictors. Source Heart Lung and Circulation. 35(4) (pp 503-516), 2026. Date of Publication: 01 Apr 2026. Author Lingamsetty S.S.P.; Thyagaturu H.; Jitta S.R.; Prajapati K.; Ajibade A.; Alruwaili W.; Muntazir H.; Zeb I. Institution (Lingamsetty) Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Thyagaturu, Zeb) Department of Cardiology, West Virginia University, Heart and Vascular Institute, Morgantown, WV, United States (Jitta) Department of Internal Medicine, Mercy Hospital, St. Louis, MO, United States (Prajapati) Department of Internal Medicine, Metropolitan Hospital Center, NYC Health + Hospitals, New York, NY, United States (Ajibade, Alruwaili) Department of Internal Medicine, West Virginia University, Morgantown, WV, United States (Muntazir) Binghamton University, State University of New York, Binghamton, NY, United States Publisher Elsevier Ltd Abstract Background: Despite the proven efficacy of transcatheter aortic valve replacement (TAVR) in treating tricuspid aortic valve stenosis, the bicuspid aortic valve (BAV) population has been excluded from most of the landmark trials. Aim(s): This study aimed to assess the outcomes of TAVR compared with those of surgical aortic valve replacement (SAVR) and examine the impact of BAV type, aortopathy, excess leaflet calcification, and raphe calcification on BAV TAVR outcomes. Method(s): We searched PubMed/MEDLINE, Embase, and Cochrane Library for studies that assessed the outcomes of TAVR in the BAV population. We also included studies of patients with BAV undergoing TAVR and SAVR, and those assessing anatomical predictors of TAVR outcomes. Random-effects models were used to calculate the pooled risk ratios, mean differences, and hazard ratios. Result(s): Patients with BAV who underwent TAVR showed significantly lower risks of major bleeding and acute kidney injury, and shorter hospital stays than those who underwent SAVR. However, BAV TAVR had a higher pacemaker implantation rate. Among the BAV types, Type 0 showed a higher risk of coronary obstruction, whereas Type 1 had a lower risk of pacemaker implantation following BAV TAVR. Additionally, BAV TAVR had a higher risk of long-term mortality in patients with aortopathy (ascending aortic diameter >4.5 cm) and excessive leaflet calcification. Conclusion(s): Compared with SAVR, TAVR in BAV is associated with favourable in-hospital outcomes. Anatomical features, such as BAV type, aortopathy, excess leaflet calcification, and calcified raphe, significantly influence the outcomes of TAVR in the BAV population. Copyright © 2025 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <48> [Use Link to view the full text] Accession Number 2044138474 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. Publish Ahead of Print (no pagination), 2026. Date of Publication: 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, United States (Assayed, Gruhonjic, Minasyan, Fabian, Ledonio, Prashad) Cardiology Department, Cardiology Fellowship Program, HCA Florida Ocala Hospital, Ocala, FL, United States (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, United States Publisher Lippincott Williams and Wilkins 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. <49> Accession Number 2044647075 Title Difference of Admission Neutrophil Gelatinase-Associated Lipocalin Concentration Between Patients Developing and Not Developing Acute Kidney Injury or Need for Acute Dialysis: An Ancillary Individual-Study Data Meta-Analysis (INDICATE-AKI). Source Kidney Medicine. 8(5) (no pagination), 2026. Article Number: 101280. Date of Publication: 01 May 2026. Author Albert A.; Blume L.; Di Somma S.; Hur M.; Bellomo R.; Devarajan P.; Breidthardt T.; Camou F.; Chocron S.; Cruz D.; de Geus H.R.; Doi K.; Endre Z.H.; Garcia-Alvarez M.; Haase M.; Haase-Fielitz A.; Hjortrup P.B.; Karaolanis G.; Kavalci C.; Kim H.; Lange S.; Lauten P.; Lentini P.; Liebetrau C.; Lipcsey M.; Martensson J.; Muller C.; Nanas S.; Nickolas T.L.; Pickering J.W.; Pipili C.; Ronco C.; Rosa-Diez G.; Ralib A.M.; Soto K.; Stieger P.; Zapf A.; Braun-Dullaeus R.C.; Albert C. Institution (Albert, Lange, Albert) Department of Nephrology, Central Clinic Bad Berka, Bad Berka, Germany (Blume, Stieger, Braun-Dullaeus, Albert) University Clinic for Cardiology and Angiology, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Blume) Department of Neonatology, Charite University Medicine Berlin, Berlin, Germany (Di Somma) Postgraduate School of Emergency Medicine, Faculty of Medicine and Psychology, University La Sapienza of Rome, Rome, Italy (Hur, Kim) Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, South Korea (Bellomo) Department of Intensive Care, The Austin Hospital, Melbourne, Australia (Bellomo) Centre for Integrated Critical Care, The University of Melbourne, Melbourne, Australia (Devarajan) Division of Nephrology and Hypertension, Cincinnati Children's Hospital, University of Cincinnati, OH, United States (Breidthardt, Muller) Departments of Internal Medicine, Nephrology and Cardiology, University Hospital Basel, Basel, Switzerland (Camou) Service de reanimation medicale, Hopital Saint-Andre, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France (Chocron) Department of Thoracic and Cardio-Vascular Surgery, University Hospital Jean Minjoz, Besancon, France (Cruz) Division of Nephrology and Hypertension, University of California, San Diego, CA, United States (de Geus) Department of Intensive Care, Erasmus University Medical Center, Rotterdam, Netherlands (Doi) Department of Emergency and Critical Care Medicine, The University of Tokyo, Hongo, Tokyo, Bunkyo, Japan (Endre) Department of Nephrology, Prince of Wales Hospital and Clinical School, University of New South Wales, Randwick, Sydney, Australia (Garcia-Alvarez) Department of Anesthesiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Haase) Department of Nephrology and Hypertension, Hannover Medical School, Hannover, Germany (Haase) Medical Faculty, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Haase-Fielitz) Department of Cardiology, Immanuel Diakonie Bernau, Heart Center Brandenburg, Brandenburg Medical School Theodor Fontane (MHB), Bernau, Germany (Haase-Fielitz) Institute of Social Medicine and Health Systems Research, Otto-von-Guericke University Magdeburg, Magdeburg, Germany (Hjortrup) Department of Intensive Care, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Hjortrup) Department of Cardiothoracic Anaesthesia and Intensive Care, The Heart Center, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Karaolanis) Vascular Unit, First Department of Surgery, "Laiko" General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Kavalci) Emergency Department, Faculty of Medicine, Baskent University, Ankara, Turkey (Lauten) Department of Cardiology and Intensive Care Medicine, Central Clinic Bad Berka, Bad Berka, Germany (Lauten) Medical Faculty, Philipps University of Marburg, Marburg, Germany (Lentini) Department of Nephrology and Dialysis, San Bassiano Hospital, Bassano del Grappa, Italy (Liebetrau) Center for Cardiology and Angiology, Agaplesion Bethanien Krankenhaus, Frankfurt, Germany (Liebetrau) Department of Cardiology, Kerckhoff Clinic, Bad Nauheim, Germany (Lipcsey) CIRRUS, Hedenstierna laboratory, Anaesthesiology and Intensive care, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (Martensson) Section of Anaesthesia and Intensive Care Medicine, Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden (Nanas, Pipili) First Critical Care Department, 'Evangelismos' General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Nickolas) Department of Medicine, Division of Nephrology, Columbia University, New York, NY, United States (Pickering) Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand (Pickering) Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand (Ronco) Medical Faculty, University of Padova and Department of Nephrology, Dialysis & Transplantation, International Renal Research Institute Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy (Rosa-Diez) Department of Nephrology, Dialysis and Transplantation, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina (Ralib) Department of Anaesthesiology and Intensive Care, International Islamic University Malaysia, Pahang, Kuantan, Malaysia (Soto) Department of Nephrology, Hospital Fernando Fonseca, Lisbon, Portugal (Zapf) Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany Publisher Elsevier Inc. Abstract Rationale & ObjectivePatients admitted to the emergency department, the intensive care unit (ICU), and after cardiac surgery are at increased risk of developing adverse kidney events. Assessment of neutrophil gelatinase-associated lipocalin (NGAL) may facilitate renal risk prediction. However, the difference in NGAL-concentrations at admission in patients developing and not developing adverse events is unclear.Study DesignAn ancillary meta-analysis to a previous systematic review and meta-analysis using reanalyzed individual study-data from prospective clinical studies to compare NGAL concentrations measured using clinical laboratory platforms at patient admission. The study followed the Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data guideline.Setting & Study PopulationsStudies of adults investigating acute kidney injury (AKI) of all stages, severe AKI (stage injury or failure), and acute initiation of renal replacement therapy (RRT) in the setting of cardiac surgery, emergency department, or intensive care unit using either urinary or plasma NGAL concentrations measured on clinical laboratory platforms.Selection Criteria for StudiesData inclusion was limited to the individual study-level data from the predecessor study.Data ExtractionThis study used individual study-level data acquired using the protocol of a previous study, which was accomplished by individual authors' reassessment of their study data.Analytical ApproachClassification of AKI was harmonized among studies. Prespecified data comparison was performed for urine and plasma specimens for the outcome measures AKI, severe AKI, and acute RRT-initiation. Random effects meta-analyses were performed using the inverse variance method and the DerSimonian and Laird heterogeneity estimator.ResultsIn total, 30 data sets from 26 studies were included. The estimated mean difference of urine NGAL concentrations was 125 (95% CI, 57.33-193.54) ng/mL for AKI, 317 (95% CI, 134.95-499.82) ng/mL for severe AKI, and 331 (95% CI, 71.36-592.06) ng/mL for RRT. For plasma NGAL concentrations, the estimated mean differences were 86.04 (95% CI, 51.74-120.34) ng/mL for AKI, 150.52 (95% CI, 80.27-220.76) ng/mL for severe AKI, and 129.83 (95% CI, 79.03-180.63) ng/mL for RRT. There were subgroup differences for the clinical setting, but not for the use of the urine output criterion. Multiple studies showed elevated NGAL concentrations in patients without serum creatinine concentration-based AKI, likely identifying patients with suspected AKI stage 1S (subclinical AKI).LimitationsImperfect harmonization of data across studies because of their original protocols.ConclusionsNGAL concentration differences may facilitate identification of patients at risk of AKI or with suspected AKI stage 1S at admission. Heterogeneity and variability across studies, specimen types, and settings emphasize the importance of interpreting NGAL values within the specific clinical context and patient population.Study RegistrationThe International Database of Prospectively Registered Systematic Reviews reg. no.: CRD42016042735. Version of Record 1.2.Plain-language SummaryPatients admitted to the intensive care unit, the emergency department, or following cardiac surgery are at increased risk of acute kidney injury (AKI). Neutrophil gelatinase-associated lipocalin (NGAL) is a biomarker that may help stratify AKI risk. This meta-analysis pooled and reanalyzed data from prospective studies measuring NGAL levels at patient admission and systematically compared them in those patients who developed AKI or required renal replacement therapy with those who did not. Higher NGAL levels were found to be associated with unfavorable outcomes. However, variability across studies and settings was observed. Interestingly, some patients showed elevated NGAL levels despite not being affected by serum creatinine-based AKI, suggesting NGAL levels may reflect subclinical AKI (stage 1S). These findings highlighted the need to interpret NGAL concentrations contextually within clinical settings. Copyright © 2026 The Authors. Published by Elsevier Inc. on behalf of the National Kidney Foundation, Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <50> Accession Number 2044438833 Title Patient experiences in trials of minimally invasive thoracic surgery: A mixed-methods study. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 387. Date of Publication: 01 Dec 2026. Author Donnelly J.; Brook A.; Wright G. Institution (Donnelly, Wright) Department of Cardiothoracic Surgery, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia (Brook) MineolaTXUnited States (Wright) Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia (Wright) Research and Education Lead for Lung Cancer, Victorian Comprehensive Cancer Centre, Melbourne, Australia (Donnelly) Department of Allied Health, Swinburne University of Technology, John Street, Hawthorn, VIC, Australia Publisher Springer Nature Abstract Background: Minimally invasive thoracic surgery, including robotic-assisted and video-assisted approaches, is increasingly used to treat lung cancer. While technical outcomes are well documented, patient experiences within clinical trials remain under-explored. Objective(s): To evaluate patient experiences of clinical trial participation involving advanced surgical modalities for lung cancer. Method(s): This two-site, mixed-methods study evaluated patient perceptions of participation in the DURATION (ctDNA monitoring) and VGT-309 (fluorescent imaging) trials. Twenty-six participants completed quantitative surveys assessing pre-trial expectations, experiences, and collaboration with research teams. Sixteen participants completed semi-structured interviews, analyzed using thematic analysis. Result(s): Twenty-six participants completed surveys and sixteen completed interviews. Motivations for enrollment included advancing science (100%), altruism (80.8%), and personal benefit (61.5%). Satisfaction was universally high, with participants reporting positive surgical experiences, supportive staff interactions, and minimal procedural burden. Most participants (88.5%) expressed willingness to participate in future trials, and 96.2% would recommend trial involvement to others. Qualitative analysis identified seven domains characterizing patient experiences throughout the trial process: motivations for enrollment, communication from the trials team, influences on surgical decision-making, surgical expectations, postoperative care, challenges to participation, and overall experience. Challenges such as perioperative anxiety and logistical demands were minor and did not detract from overall satisfaction. Overall, participants described the trial experience as seamless and personally meaningful. Conclusion(s): Patients undergoing robotic-assisted or video-assisted thoracic surgery within clinical trials report overwhelmingly positive experiences. The integration of patient-centered communication and advanced technology creates a seamless perioperative journey. Clinicians should not hesitate to enroll appropriate patients in trials featuring surgical innovations. Copyright © The Author(s) 2026. <51> Accession Number 2044326325 Title Impact of Gender-Affirming Surgery on Psychiatric Outcomes and Quality of Life in Transgender Individuals: A Systematic Review of Longitudinal Cohort Studies. Source Journal of Clinical Medicine. 15(6) (no pagination), 2026. Article Number: 2213. Date of Publication: 01 Mar 2026. Author Yeo K.A.; Yeo Y.J.; Ho C.S.H. Institution (Yeo, Yeo, Ho) Department of Psychological Medicine, National University Hospital, Singapore, Singapore (Ho) Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Gender-affirming surgery (GAS) has become more accessible in recent years. It aims to align the physical characteristics of transgender individuals with their gender identity to alleviate distress associated with gender dysphoria. This may involve procedures such as genital reconstruction, breast augmentation or removal, and voice modification surgeries. However, the associations of these treatments on long-term mental health outcomes remain debated. This paper aims to review and synthesize current research on the associations of GAS on psychiatric outcomes and quality of life in transgender individuals. Method(s): In accordance with the PRISMA statement, a search on PubMed, PsychInfo, and Embase yielded 867 articles, of which 14 studies of 3023 participants met the full inclusion criteria. Result(s): There is an initial improvement in psychological well-being and quality of life within the first year post-GAS, followed by subsequent plateau or decline thereafter. Factors such as younger age, higher levels of education, noticeable improvement in secondary sexual characteristics, and a supportive social environment have been identified as predictors of positive outcomes. Conversely, non-homosexual orientation and higher levels of pre-GAS psychopathology have been associated with poorer outcomes, highlighting the importance of tailored support and pre-operative mental health care to optimize long-term success. Conclusion(s): This study underscores the need for further research into long-term outcomes and tailored support strategies to optimize the mental health and well-being of transgender individuals undergoing GAS. Copyright © 2026 by the authors. <52> Accession Number 2044461931 Title Clinical benefits of right-lumen fiberoptic bronchoscope-guided double-lumen tube placement in thoracic surgery: a randomized controlled trial. Source Journal of Thoracic Disease. 18(3) (no pagination), 2026. Article Number: 213. Date of Publication: 31 Mar 2026. Author Bao Q.; Song Z.; Zhu M.; Huang S.; Cai J.; Zhou Y.; Wang L.; Tan J. Institution (Bao, Song, Zhou, Wang, Tan) Department of Anesthesiology, Jiangsu Cancer Hospital, Nanjing, China (Bao, Zhu, Huang, Cai, Wang, Tan) Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, China Publisher AME Publishing Company Abstract Background: Single-lung ventilation is frequently required in thoracic surgery, with double-lumen tubes (DLTs) serving as the standard device for lung isolation. However, DLT placement and accurate positioning remain technically challenging, and may cause airway trauma and postoperative discomfort that affect patient satisfaction. This study aims to compare the clinical efficacy of a novel fiberoptic bronchoscope (FOB)-guided intubation technique via the right lumen of left-sided DLTs with conventional blind intubation and left-lumen FOB-guided placement. Method(s): This prospective study enrolled 120 patients [aged 18-79 years, American Society of Anesthesiologists (ASA) physical status II-III] undergoing elective thoracic surgery requiring right one-lung ventilation. Participants were randomized into Group C (n=40) undergoing conventional blind intubation, Group R (n=40) receiving FOB-guided placement through the right lumen of left-sided DLTs (L-DLTs) and Group L (n=40) receiving FOB-guided placement via the left lumen of DLTs. The primary outcome of this study was the total DLT placement time (T-total), defined as the interval from insertion of the DLT through the lips to confirmation of correct anatomical positioning by fiberoptic bronchoscopy. Secondary efficacy outcomes included the final positioning time (T3), the other procedural time components (T1 and T2), and the first-attempt success rate of DLT placement. Safety outcomes comprised peri-intubation hemodynamic changes and airway mucosal injury assessed bronchoscopically, while patient-reported outcomes included postoperative throat symptoms (hoarseness, postoperative pharyngalgia, and odynophagia) and patient satisfaction. Result(s): The primary outcome, total DLT placement time (T-total), was significantly shorter in Group R than in Groups L and C (P<0.05). Group R also showed a significantly reduced T3 compared with the other two groups (P<0.05). No significant differences were observed among the three groups for T1 and T2. The tracheal injury score and the severity of airway mucosal injury in Group R were markedly lower than those in Group C (P<0.05). On postoperative day 1, both the incidence and severity of postoperative pharyngalgia in Group R were significantly reduced compared to Group C (P<0.05). Additionally, Group R exhibited a statistically significant decrease in the incidence and severity of postoperative pharyngalgia compared with Group C, and patients in Group R also reported the highest satisfaction scores among the three groups (P<0.01). Conclusion(s): Compared to conventional blind intubation and FOB-guided placement through the left lumen of L-DLTs, the right-lumen FOB-guided DLT positioning technique not only simplified the intubation process and significantly reduced the total DLT placement time, but also decreased patient-reported postoperative discomfort (postoperative pharyngalgia and hoarseness), minimized airway mucosal injury, and enhanced overall recovery experience. These findings suggest that the right-lumen technique may be considered a feasible alternative in selected clinical settings when performed by experienced anesthesiologists. However, further multicenter studies are required to validate these results and to determine their generalizability to broader patient populations and routine clinical practice. Copyright © AME Publishing Company. <53> Accession Number 2044493251 Title Robotic-assisted versus video-assisted thoracoscopic surgery for non-small cell lung cancer after neoadjuvant immunotherapy: a systematic review and meta-analysis. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 409. Date of Publication: 01 Dec 2026. Author Barbosa S.; de Siqueira Silva A.; Rodrigues L.B. Institution (Barbosa, de Siqueira Silva) School of Medicine, Faculdade de Ciencias Medicas de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Rodrigues) Department of Thoracic Surgery, Hospital Madre Teresa, Minas Gerais, Belo Horizonte, Brazil Publisher Springer Nature Abstract Administering upfront immunomodulatory agents has completely redefined the clinical pathways for operable non-small cell lung cancer (NSCLC); however, the subsequent inflammatory response and hilar fibrosis have increased the technical complexity of surgical resections. Although robotic-assisted thoracic surgery (RATS) offers theoretical advantages in visualization and precision over video-assisted thoracoscopic surgery (VATS) to address these challenges, comparative evidence between the two platforms in the post-immunotherapy setting remains limited. This investigation sought to juxtapose the operative viability and safety metrics between robotic and video-assisted thoracic platforms following neoadjuvant immunotherapy for NSCLC. A systematic search was conducted across PubMed, Cochrane, and EMBASE databases, identifying five studies involving 984 patients. Analyzed outcomes included conversion to open thoracotomy, operative time, intraoperative bleeding, complete resection rate, blood transfusion, lymph node yield, and explored lymph node stations. RATS was associated with a significantly lower rate of conversion to thoracotomy (OR 0.28, 95% CI 0.13-0.65; P = 0.003), as well as more dissected lymph nodes (MD 4.04, 95% CI 0.93-7.16; P = 0.01) and explored lymph node stations (MD 1.22, 95% CI 0.26-2.18; P = 0.01). There were no major differences in rates of complete resection, length of surgery, blood loss, or the need for transfusions. Both robotic surgery and video-thoracoscopy demonstrated equivalent perioperative and oncological safety. However, RATS was associated with significantly lower rates of conversion to thoracotomy, particularly in cases involving dense hilar fibrosis, and achieved a more comprehensive lymph node assessment compared to VATS. Copyright © The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature 2026. <54> [Use Link to view the full text] Accession Number 2044150216 Title Extracorporeal Membrane Oxygenation Following Acute Type A Aortic Dissection Repair: A Systematic Review and Meta-Analysis. Source ASAIO Journal. 72(3) (pp 233-241), 2026. Date of Publication: 01 Mar 2026. Author Papakonstantinou N.A.; Antonopoulos C.N. Institution (Papakonstantinou) 2nd Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece (Antonopoulos) 1st Department of Vascular Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece Publisher Lippincott Williams and Wilkins Abstract Acute type A aortic dissection (ATAAD) is a life-threatening cardiovascular emergency. Despite the well-established role of veno-arterial extracorporeal membrane oxygenation (VA-ECMO) after postcardiotomy cardiogenic shock in cardiac surgery patients, its application in the context of ATAAD has been controversial. The goal of this study is to evaluate the role of postcardiotomy ECMO subsequent to ATAAD repair. A meta-analysis of nine retrospective studies approaching this topic was conducted. Finally, a total of 318 patients were analyzed. Despite a successful weaning from ECMO rate of 48.3% (95% confidence interval [CI]: 30.6-66.2), not all of them finally survived, resulting in a higher overall in-hospital mortality of 72.4% (95% CI: 61.9-81.9). Acute kidney injury requiring continuous renal replacement therapy rate was 60.5% (95% CI: 43.9-76.0), neurologic complications rate as a consequence of stroke was 24.4% (95% CI: 13.9-36.3), limb ischemia rate was 7.6% (95% CI: 1.7-16.2) and bleeding requiring reoperation rate was 29.2% (95% CI: 10.3-52.2). We estimated a pooled 6.04 days mean duration on ECMO support (95% CI: 3.88-8.20) and a pooled 24.26 days mean length of stay (95% CI: 18.81-29.71). Concerning medium-term outcomes, a pooled incidence rate of late mortality of 5.8% per 100 person-years (95% CI: 0.8-13.4) was recorded. Despite high mortality and complication rates, postcardiotomy ECMO after ATAAD repair may be reasonable, but it depends on further multicenter research to determine which patients could benefit. Copyright © ASAIO 2025 The Authors. <55> [Use Link to view the full text] Accession Number 2026676414 Title Acute pain after serratus anterior plane or thoracic paravertebral blocks for video-assisted thoracoscopic surgery: A noninferiority randomised trial. Source European Journal of Anaesthesiology. 38 (pp S97-S105), 2021. Date of Publication: 01 Aug 2021. Author Qiu Y.; Wu J.; Huang Q.; Lu Y.; Xu M.; Mascha E.J.; Yang D.; Ince I.; Sessler D.I. Institution (Qiu, Wu, Huang, Lu, Xu) Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China (Qiu, Mascha, Yang, Ince, Sessler) The Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, China (Wu) The Outcomes Research Consortium, China (Mascha, Yang) The Department of Quantitative Health Sciences, Cleveland Clinic, OH, United States (Ince) The Department of Anesthesiology and Reanimation, Ataturk University School of Medicine, Anaesthesiology Clinical Research Office, Erzurum, Turkey Publisher Lippincott Williams and Wilkins Abstract BACKGROUNDSerratus anterior plane blocks (SAPBs) and thoracic paravertebral blocks (TPVBs) can both be used for video-assisted thoracic surgery. However, it remains unknown whether the analgesic efficacy of a SAPB is comparable to that of a TPVB.OBJECTIVEWe tested the primary hypothesis that SAPBs provide noninferior analgesia compared with TPVBs for video-assisted thoracic surgery.DESIGNA noninferiority randomised trial.SETTINGShanghai Chest Hospital, between August 2018 and November 2018.PATIENTSNinety patients scheduled for video-assisted thoracic lobectomy or segmentectomy were randomised. Patients were excluded if they were unable to perform the visual analogue pain scale, or surgery was converted to thoracotomy.INTERVENTIONSBlocks were performed after induction of general anaesthesia. The three groups were paravertebral blocks (n = 30); serratus anterior plane blocks (n = 29); and general anaesthesia alone (n = 30).PRIMARY OUTCOME MEASURESVisual analogue pain scores (0 to 10 cm) at rest and while coughing, and Prince-Henry pain scores (0 to 4 points) were used to assess postoperative analgesia at 2, 24 and 48 h after surgery. We assessed the noninferiority of SAPBs with TPVBs on all three primary pain outcomes using a delta of 1 cm or one point as appropriate.RESULTSThe mean difference (95% confidence intervals) in visual analogue scores between the SAPBs and TPVBs was -0.04 (-0.10 to 0.03) cm at rest, -0.22 (-0.43 to -0.01) cm during coughing and -0.10 (-0.25 to 0.05) for Prince-Henry pain scores. As the upper limit of the confidence intervals were less than 1 (all P < 0.001), noninferiority was claimed for all three primary outcomes. Compared with general anaesthesia alone, the VAS scores at rest and while coughing, and the Prince-Henry pain scores for the two blocks were significantly lower during the initial 2 h after surgery.CONCLUSIONSSerratus anterior plane blocks are quicker and easier to perform than paravertebral blocks and provide comparable analgesia in patients having video-assisted thoracic surgery. Both blocks provided analgesia that was superior to general anaesthesia alone during the initial 2 h after surgery.TRIAL REGISTRATIONChinese Clinical Trial Registry, identifier: ChiCTR1800017671. Copyright © 2021 Lippincott Williams and Wilkins. All rights reserved. <56> Accession Number 2044843502 Title Best evidence summary for exercise adherence management in outpatient rehabilitation following coronary artery bypass graft surgery. Source Heart and Lung. 78 (no pagination), 2026. Article Number: 102787. Date of Publication: 01 Jul 2026. Author Xiu M.; Wang H.; Zhang M.; Yang F.; Wang C.; Zhang W. Institution (Xiu, Wang, Yang, Wang) Tongji University School of Medicine, Shanghai, China (Xiu, Wang, Zhang, Yang, Wang, Zhang) Department of Nursing, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China (Zhang) School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China Publisher Elsevier Inc. Abstract Background: Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease. Exercise rehabilitation is essential for secondary prevention, but patient adherence remains low. High-quality evidence is needed to guide effective adherence management strategies. Objective(s): To evaluate and summarize the existing evidence on adherence management in phase II exercise rehabilitation following CABG, providing a foundation for the development of evidence-based clinical practice. Method(s): Following the 6S pyramid model, a comprehensive top-down search was conducted to retrieve evidence related to adherence management in phase II exercise rehabilitation following CABG. The literature types included clinical decisions, guidelines, expert consensus, systematic reviews, evidence summaries, and the latest randomized controlled trials. The search period ranged from July 2015 to July 2025. Two researchers trained in evidence-based nursing graded the evidence according to the Joanna Briggs Institute evidence pre-classification and evidence recommendation level system (2014 version). Result(s): A total of 19 high-quality studies were included, from which 26 pieces of evidence were summarized. These pieces of evidence covered five aspects: overall approach, exercise plan, patient education, feedback and supervision, and management of special populations. Key strategies consistently highlighted included establishing a multidisciplinary rehabilitation team and a structured follow-up pathway, delivering individualized and progressive exercise prescriptions, providing multimodal education to enhance patients' understanding and self-efficacy, and strengthening monitoring/feedback mechanisms to support sustained self-management. Collectively, these strategies may facilitate long-term exercise adherence during phase II rehabilitation and improve the continuity and safety of post-discharge care. Conclusion(s): Evidence supports a comprehensive, integrated phase II exercise adherence-management approach for post-CABG patients, emphasizing multidisciplinary collaboration, individualized progressive exercise prescription, multimodal education, and monitoring/feedback to promote sustained self-management and adherence. Strategies should be adapted to local resources and vulnerable groups. Future research should validate these strategies in CABG-specific populations and evaluate implementation feasibility and cost-effectiveness using standardized adherence outcomes. Protocol Registration: http://ebn.nursing.fudan.edu.cn/registerResources, identifier ES20246232. Copyright © 2026 <57> Accession Number 2044414927 Title Benefits of nitric oxide administration during cardiopulmonary bypass on postoperative outcomes in adult patients: a meta-analysis and systematic review. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 206. Date of Publication: 01 Dec 2026. Author Zhang Y.; Wang M.; Chen G.; Zhou Y. Institution (Zhang, Wang, Chen, Zhou) Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Qingchun East Road No. 3, Hangzhou, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China Publisher BioMed Central Ltd Abstract Background: Nitric oxide (NO) is reported to play several protective roles in the inflammatory response and ischemia/reperfusion injury. This study evaluated the effect of nitric oxide (NO) on postoperative outcomes in adults undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): We systematically searched PubMed, Web of Science, and EMBASE (inception-April 2025) for relevant RCTs. Two reviewers independently screened studies, extracted data, and assessed risk of bias (Cochrane RoB 1) and evidence certainty (GRADE). Meta-analysis was performed using random-effects models. Result(s): Eight RCTs involving 774 patients were finally included. The use of NO did not reduce the postoperative mortality (RR 0.71, 95% CI 0.36 to 1.42), the duration of postoperative ventilation (MD -0.23 h, 95% CI -1.18 to 0.71), the length of stay in hospital (MD -0.07 days, 95% CI -0.55 to 0.42) or in intensive care unit (MD -4.17 h, 95% CI -8.74 to 0.4). This study demonstrated that NO administration significantly reduced serum levels of creatine kinase-MB at both 24 h (MD -19.36 ng/ml, 95% CI -28.72 to -10.00) and 48 h (MD -17.47 ng/ml, 95% CI -19.53 to -15.41) postoperatively, though it did not affect troponin levels. Concurrently, NO was associated with a significantly lower incidence of postoperative acute kidney injury (RR 0.78, 95% CI 0.64 to 0.93), but not with a reduced need for renal replacement therapy (RR 0.88, 95% CI 0.45 to 1.72). Conclusion(s): This meta-analysis of RCTs did not demonstrate a clear benefit of nitric oxide administered via cardiopulmonary bypass on mortality, duration of mechanical ventilation, or length of stay in adult cardiac surgery. Although suggestive renal and cardioprotective signals were observed, these findings are preliminary and require confirmation in larger, methodologically rigorous trials before definitive conclusions can be drawn. Trial registration: INPLASY2022120002. Copyright © The Author(s) 2026. <58> Accession Number 2044662847 Title The effect of adding a second multimodal analgesic component to anesthesia regimens on acute postoperative pain outcomes: a systematic review and meta-analysis. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 225. Date of Publication: 01 Dec 2026. Author van Eijk L.T.; van den Heuvel S.A.S.; van Boekel R.L.M.; van der Meer R.; Bruhn J.; Wever K.E. Institution (van Eijk, van den Heuvel, van Boekel, van der Meer, Bruhn, Wever) Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, P.O. box 9101, Geert Grooteplein Zuid 10, Nijmegen, Netherlands Publisher BioMed Central Ltd Abstract Background: Postoperative pain remains a common clinical challenge, affecting patient recovery, satisfaction, and risk of chronic pain. Conventional analgesics often inadequately address the multifactorial nature of postoperative pain, while opioids carry risks of adverse effects and dependence. Multimodal analgesia, combining agents with complementary mechanisms, aims to improve pain control and reduce opioid consumption, but the incremental benefit of adding a second component is unclear. Objective(s): To evaluate whether adding a second multimodal analgesic component to conventional regimens improves postoperative pain control and reduces opioid consumption in adult patients undergoing non-cardiac surgery. Method(s): We performed a systematic review and meta-analysis of randomized controlled trials. PubMed and EMBASE (via Ovid) were searched for eligible studies up to August 2, 2024, using search terms related to surgical patients, pain, multimodal analgesia, and ten common multimodal components. We included RCTs in adults (>= 18 years) undergoing non-cardiac surgery under general anesthesia, comparing standard care plus two multimodal components versus one component, with postoperative opioid consumption measured and pain measured by numeric rating scale (NRS) or visual analog scale (VAS). Result(s): Twenty-seven trials were included. Meta-analysis of 17 trials (24 comparisons) showed that a second multimodal component reduces 24-hour opioid consumption by 5.2 mg oral morphine equivalents (95% CI[-7.7, -2.7]; p < 0.01; I2 = 99%). Nineteen trials (29 comparisons) reported reduced pain scores at 4 h postoperatively by -0.5 points (95% CI[-0.8, -0.2]; I2 = 94%). However, heterogeneity was very high. Subgroup analyses did not reveal a superior multimodal component. Adverse events were generally comparable, with some reductions in postoperative nausea and vomiting. Data on long-term outcomes and quality of recovery were limited. Conclusion(s): Adding a second multimodal analgesic component may modestly improve acute postoperative pain control and may reduce opioid consumption. Further research is needed to determine optimal combinations for specific surgical settings, to systematically evaluate associated adverse effects and to assess long-term outcomes including chronic pain prevention. Copyright © The Author(s) 2026. <59> [Use Link to view the full text] Accession Number 2043317920 Title Class 1 Indications for Coronary Revascularization Identified in Prekidney Transplant Screening. Source Journal of the American Society of Nephrology. Publish Ahead of Print (no pagination), 2025. Date of Publication: 07 Oct 2025. Author Israni A.; Sandorffy B.L.; Liu C.S.; Fraticelli Ortiz D.I.; Gross H.M.; Nicholson J.; Cazes M.; Soomro Q.H.; Zhang X.; Wu W.; Charytan D.M. Institution (Israni, Sandorffy, Liu, Fraticelli Ortiz, Gross, Cazes, Soomro, Wu, Charytan) Nephrology Division, Department of Medicine, NYU Grossman School of Medicine, New York, New York (Nicholson) Health Sciences Library, NYU Grossman School of Medicine, New York, New York (Zhang, Wu) Biostatistics Division, Department of Population Health, NYU Grossman School of Medicine, New York, New York Publisher Wolters Kluwer Health Abstract Key Points - Coronary artery disease is a barrier to kidney transplantation. Many transplant programs mandate routine coronary artery disease screening. It remains unclear how many patients meet class 1 indication for revascularization. We conducted a meta-analysis to estimate the prevalence. Despite high frequency of screening, we found a relatively low prevalence of class 1 indication for coronary revascularization. Background - Cardiovascular disease is the most common cause of morbidity and mortality in kidney transplant recipients. Screening for coronary disease is frequently required before kidney transplantation, but coronary intervention has not been shown to be beneficial except in complex coronary artery disease. The likelihood of finding significant coronary artery disease and the benefits of routine pretransplant screening are uncertain.Methods - We performed a systematic review and meta-analysis. Medical Literature Analysis and Retrieval System Online and Excerpta Medica database were searched to identify manuscripts published between 1998 and 2024 reporting the results of pretransplant screening. The primary end points were the frequency of detecting significant coronary lesions for which there are American Heart Association class 1 indications for revascularization: (1) >50% left main stenosis or (2) multivessel disease with ejection fraction <35% during prekidney transplant screening. Secondary end points included frequency of detecting multivessel disease, proximal left anterior descending artery disease, and number of patients who underwent invasive coronary angiography. Meta-regression was used to explore outcome heterogeneity according to the presence of hypertension, diabetes, and age.Results - We identified 1273 studies, out of which 44 met eligibility criteria. The mean prevalence of class 1 indications was 2%, although the heterogeneity was high with estimates ranging from 0% to 17%. Estimated prevalence of proximal left anterior descending disease was 2% and left main stenosis was 1%, whereas 10% of patients had multivessel coronary artery disease, and 35% were referred for invasive angiography. There was no evidence of significant heterogeneity according to sex of the population or prevalence of diabetes or hypertension.Conclusions - Identification of class 1 indications for revascularization during pretransplant coronary screening was rare.Podcast - This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN /2026_01_08_ASN0000000890.mp3 Copyright © 2025 by the American Society of Nephrology <60> Accession Number 2041744500 Title The effect of perioperative erythropoietin-stimulating agents and intravenous iron on patient outcomes following solid organ transplantation: A systematic review. Source Transfusion Medicine. 36(2) (pp 95-120), 2026. Date of Publication: 01 Apr 2026. Author Lee F.; Eichbaum Q.; Cserti-Gazdewich C.; Mullane D.; Lombard F.W.; Jacobs J.W.; Pavenski K.; Englesakis M.; Dotto A.; Cho T.; Leonard-Reixa A.; Trudeau J.; Shih A.W.; Bartoszko J. Institution (Lee, Bartoszko) Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Eichbaum, Jacobs) Vanderbilt University School of Medicine, Nashville, TN, United States (Eichbaum, Jacobs) Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States (Cserti-Gazdewich, Pavenski) Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada (Mullane, Dotto, Trudeau) Department of Anesthesiology, Pharmacology, & Therapeutics, The University of British Columbia, Vancouver, BC, Canada (Lombard) Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, United States (Englesakis) Library & Information Services, University Health Network-Toronto General Hospital, Toronto, ON, Canada (Cho) Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada (Leonard-Reixa, Bartoszko) Department of Anesthesia and Pain Management, Sinai Health System, Women's College Hospital, University Health Network, Toronto, ON, Canada (Shih) Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada Publisher John Wiley and Sons Inc Abstract Solid organ transplant is associated with high rates of anaemia and transfusion, but there is little comparative data on interventions such as erythropoietin-stimulating agents (ESAs) and intravenous (IV) iron. We conducted a systematic review examining the association of ESAs and IV iron with outcomes in adults undergoing solid organ transplant. This review was registered with PROSPERO (CRD42023474722). EMBASE and MEDLINE were searched from inception to April 11, 2025. Identified studies included adults (>=18 years of age) undergoing heart, liver, lung, or kidney transplant who received any ESA and/or IV iron before, during, or up to 1 month following solid organ transplant surgery compared to patients who did not. Article screening, full text review and data extraction were performed by two independent reviewers. The primary outcome of interest was transfusion volume, with secondary outcomes including haematological parameters, graft-related outcomes and rates of major morbidity and mortality. Results were analysed descriptively and compiled into tables, and the risk of bias was assessed using the CLARITY framework. From 1693 studies identified, 22 were included (kidney transplant, n = 16; heart transplant or Left Ventricular Assist Device as a bridge to transplant, n = 4; liver transplant, n = 2). Due to heterogeneity in design, interventions and outcomes, meta-analysis was not attempted. The quality of evidence was graded as Very Low. On the whole, a comprehensive strategy implementing ESAs and IV iron may improve haematological parameters and facilitate transfusion avoidance. High-quality prospective studies assessing the impact of protocols for haemoglobin optimisation and transfusion avoidance in solid organ transplant are needed. Copyright © 2025 The Author(s). Transfusion Medicine published by John Wiley & Sons Ltd on behalf of British Blood Transfusion Society. <61> Accession Number 2037918095 Title Zero-Balance Ultrafiltration Reduces Postoperative Delirium After Cardiac Surgery with Cardiopulmonary Bypass: A Randomized Controlled Trial. Source Therapeutics and Clinical Risk Management. 21 (pp 1807-1819), 2025. Date of Publication: 2025. Author Lan X.; Tang S.; Lu J.; Tang G.; Shao Y.; Zhu Z.; Zhou K.; Xiong X.; Chen D.; Shi J. Institution (Lan, Tang, Lu, Tang, Shao, Zhu, Zhou, Xiong, Shi) Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China (Lan) Department of Anesthesiology, The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (Chen) Department of Anesthesiology, West China Second Hospital, Chengdu, China (Chen) Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Chengdu, China Publisher Dove Medical Press Ltd Abstract Purpose: To assess the effects of conventional ultrafiltration and conventional plus zero-balanced ultrafiltration on delirium and cognition in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): A total of 116 adults who were scheduled for cardiac surgery with CPB were randomly assigned to the conventional ultrafiltration group or the conventional plus zero-balanced ultrafiltration group. CPB was managed with standard protocols. In the conventional ultrafiltration group, ultrafiltration began during the rewarming phase and was performed until the CPB was terminated. In another group, perfusionists conducted zero-balance ultrafiltration after aortic cross-clamping and began conventional ultrafiltration during the rewarming phase. The primary outcome was the incidence of postoperative delirium (POD) within 7 days; the secondary outcome was postoperative cognitive dysfunction (POCD) at 1 and 3 months. In addition, the patients' vital signs and postoperative complications at different points during the operation were also recorded. Result(s): During the first 7 postoperative days, POD was observed in 12 patients in the zero-balance ultrafiltration group and 27 patients in the conventional ultrafiltration group (12/53 [22.64%] vs 27/53 [50.94%]; RR 0.45, 95% CI 0.25 to 0.78; P = 0.005). At 1 month after surgery, POCD occurred in 12 patients in the zero-balance ultrafiltration group versus 18 patients in the conventional ultrafiltration group (12/53 [22.64%] vs 18/53 [33.96%]; RR = 0.67; 95% CI 0.36-1.24; P = 0.281). By 3 months postoperatively, postoperative cognitive dysfunction occurred in 4 patients in the zero-balance ultrafiltration group and 7 patients in the conventional ultrafiltration group (4/53 [7.55%] vs 7/53 [13.21%]; RR = 0.57; 95% CI 0.18-1.84; P = 0.524). Conclusion(s): In patients who underwent cardiac surgery with CPB, zero-balance ultrafiltration significantly reduced the incidence of delirium compared with conventional ultrafiltration alone within the first 7 postoperative days. In contrast, the incidence of cognitive dysfunction did not differ significantly between the two groups at 1 or 3 months postoperatively. Copyright © 2025 Lan et al. This work is published and licensed by Dove Medical Press Limited. <62> Accession Number 2044404714 Title Transradial vs Transfemoral Access for Cerebral Angiography: A Randomized Noninferiority Clinical Trial. Source JAMA Network Open. 9(3) (no pagination), 2026. Article Number: e261929. Date of Publication: 19 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, Department of Neurosurgery, Huashan Hospital, Fudan University, Huashan Hospital, Fudan University, 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, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China (Lin, Zhou, Zeng) Department of Neurosurgery, The 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, Shanghai Jiao Tong University School of Medicine, Shanghai Ninth People's Hospital, Shanghai, China (Li, Sun) Department of Neurosurgery, Southern Central Hospital of Yunnan Province, Honghe, China (Wang, Li) Department of Neurosurgery, Zhejiang Hospital, Hangzhou, China (Wan, Wang) Department of Neurosurgery, Sir Run Run Shaw Hospital, Hangzhou, China (Ye, Xie) Nanjing University, Department of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing, China (Zhang, Zhuang) Department of Neurosurgery, Qilu Hospital of Shandong University Dezhou Hospital, Shandong University, Dezhou, China (Wang, Shi) Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China (Zhang) Caidya (formerly dMed Biopharmaceutical Co Ltd), dMed Biopharmaceutical Co Ltd, Shanghai, China (Han) Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China (Zhou, Tang, Chen) The George Institute for Global Health, University of New South Wales, Sydney, Australia (Anderson) Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia (Anderson) Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, China Publisher American Medical Association 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 To compare the efficacy and safety of TRA with TFA for diagnostic cerebral angiography. Design, Setting, and Participants 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. Interventions 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. Results 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. Copyright © 2026 Ni W et al. <63> 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. <64> Accession Number 2044429047 Title Right lateral decubitus as a strategy to improve left bronchial blocker placement in thoracic operations: a randomized clinical trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 201. Date of Publication: 01 Dec 2026. Author Chen S.; Deng Z.; He Y.; Luo J.; Li Y.; Liu Q.; Wu H.; Huang B.; Wang H.; Luo T. Institution (Chen, Deng, Luo, Li, Liu, Wu, Wang, Luo) Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Guizhou, Zunyi, China (He, Wang, Luo) Key Laboratory of Anesthesia and Organ Protection of Ministry of Education (In Cultivation), Zunyi Medical University, Guizhou, Zunyi, China (He) Department of Radiology, The Third Hospital of Zunyi Medical University, The First People's Hospital of Zunyi), Guizhou, Zunyi, China (Huang) Department of bioengineering, Imperial College London, London, United Kingdom Publisher BioMed Central Ltd Abstract Background: Left-sided bronchial blocker (BB) placement can sometimes be challenging and time-consuming, often requiring multiple fiberoptic bronchoscopic examinations. This study evaluated whether right lateral decubitus positioning improves placement compared to the supine position. Method(s): In this prospective, single-center randomized controlled trial, 90 adult patients scheduled for elective thoracic surgery with right one-lung ventilation were randomized to receive BB placement in either the right lateral decubitus or supine position. The primary outcome was ease of placement, defined as first-attempt success or successful placement under bronchoscopic guidance within 120 s. Secondary outcomes included placement time, malposition rate, intraoperative hemodynamic and blood gas changes, and postoperative recovery. Additionally, nine patients had chest CT scans in both positions to assess tracheobronchial alignment. Result(s): Right lateral positioning significantly improved placement compared to supine, with higher ease of placement (87% vs. 27%), greater first-attempt success (29% vs. 11%), shorter median time to placement (97 s vs. 201 s), and lower malposition rate (11% vs. 29%). In the supine group, all patients required bronchoscopic verification after lateral repositioning, and 11.1% needed repositioning; no additional verification was needed in the lateral group. CT analysis revealed that right lateral positioning increased the left main bronchus angle (148.3degreevs 142.9degree), aligning the BB more directly with the opening of the left main bronchus. Conclusion(s): Right lateral decubitus enhances left BB placement by increasing first-attempt success, reducing procedural time, and decreasing malposition. CT imaging confirms anatomical realignment facilitating insertion. Copyright © The Author(s) 2026. <65> Accession Number 2044458201 Title The Second Multicenter Intrapleural Sepsis Trial Dosing Regimen of Intrapleural Enzyme Therapy Remains the Benchmark in Parapneumonic Effusions and Empyema, Even Without Dwell Time. Source Chest. 169(4) (pp 878-879), 2026. Date of Publication: 01 Apr 2026. Author Mehta V. Institution (Mehta) Comprehensive Cancer Centers of Nevada and the Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, NV, United States Publisher Elsevier Inc. <66> Accession Number 2040286311 Title The Endo-Bentall Procedure in the Treatment of Ascending Aorta Pathologies: A Scoping Review. Source European Journal of Vascular and Endovascular Surgery. 71(3) (pp 415-425), 2026. Date of Publication: 01 Mar 2026. Author Shehab M.; Prendes C.F.; Wanhainen A.; Lindblom R.; James S.; Mani K. Institution (Shehab, Prendes, Wanhainen, Mani) Department of Surgical Sciences, Vascular Surgery, Uppsala University, Uppsala, Sweden (Wanhainen) Department of Surgical and Peri-operative Sciences, Surgery, Umea University, Umea, Sweden (Lindblom) Department of Surgical Sciences, Cardiothoracic Surgery, Uppsala University, Uppsala, Sweden (James) Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden Publisher W.B. Saunders Ltd Abstract Objective: The ascending aorta remains a challenging area for endovascular repair, with limited anatomical suitability of current stent grafts due to proximal landing zone constraints. This scoping review summarised, existing experiences with the Endo-Bentall procedure, evaluated its use across pathologies, identified obstacles, and proposed future advances. Data Sources: PubMed, Cochrane, and Embase were systematically searched (English language, up to 30 November 2024) for studies evaluating the Endo-Bentall procedure in treating ascending aortic pathologies. Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol extension for scoping reviews was followed, and data were reported as descriptive narratives or tables. Result(s): Twenty studies were included, comprising case reports, anatomical feasibility analyses, reviews, expert opinions, and technical notes. Proof of concept studies in ex vivo (n = 30) and in vivo (n = 20) models achieved 95 - 100% technical success rates, with sustained coronary patency. Five cases were reported; indications included aortic dissection (n = 2), aneurysm (n = 1), and post-surgical complications (n = 2). Balloon expandable transcatheter aortic valve implantation (TAVI) platforms were used in three cases (one used single stage and two used two stage procedures), while self expanding platforms were used in two cases (single stage). Technical success was achieved in all cases. Early follow up showed favourable outcomes in two of three balloon expandable cases and two of two self expanding cases. One patient died at 5 months (non-aortic cause). Anatomical feasibility studies for aortic dissection (n = 547) and aortic aneurysm (n = 80) demonstrated a median suitability rate of 68% (31 - 80%) for various device designs. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology suggested a very low certainty regarding clinical outcomes. Conclusion(s): The Endo-Bentall procedure is an emerging endovascular approach for ascending aortic pathologies, particularly for patients at high surgical risk. Early experience suggests feasibility. However, the current literature is significantly limited by publication bias and methodological heterogeneity. Further research is required, with systematic evaluation to optimise device development, surgical technique, bailout strategies, and long term outcomes. Copyright © 2025 The Author(s). Published by Elsevier B.V. on behalf of European Society for Vascular Surgery. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <67> Accession Number 2044404195 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 1-8), 2026. Article Number: e041301. Date of Publication: 13 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, United States (Ghozy) Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States (Ghozy, Verma) Radiology Department, Mayo Clinic, Rochester, MN, United States (Elgazzar) College of Medicine, Alfaisal University, Riyadh, Saudi Arabia Publisher American Heart Association Inc. 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 8.08days (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 7days 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. Copyright © 2026 The Author(s). <68> [Use Link to view the full text] Accession Number 2044258939 Title Perioperative Monitoring of Regional Oxygen Saturation in Congenital Heart Disease: Systematic Review of Literature up to 2023. Source Pediatric Critical Care Medicine. 27(3) (pp 325-335), 2026. Date of Publication: 01 Mar 2026. Author Bosch R.; Lenderink M.J.; Claessens N.H.P.; Breur J.M.P.J.; van Loon K.; van Wijk A.; Alderliesten T.; Nijman J. Institution (Bosch, Alderliesten, Nijman) Department of Pediatric Intensive Care, University Medical Center Utrecht, Utrecht, Netherlands (Lenderink, Breur) Department of Pediatric Cardiology, University Medical Center Utrecht, Utrecht, Netherlands (Claessens, Alderliesten) Department of Neonatology, University Medical Center Utrecht, Utrecht, Netherlands (Claessens) Department of Pediatrics, University Medical Center Utrecht, Utrecht, Netherlands (van Loon) Department of Anesthesiology, University Medical Center Utrecht, Utrecht, Netherlands (van Wijk) Department of Pediatric Cardiac Surgery, University Medical Center Utrecht, Utrecht, Netherlands Publisher Lippincott Williams and Wilkins Abstract Objective: - Pediatric patients with congenital heart disease (CHD) are at risk of non-cardiac complications that impact outcome. Early prognostication is necessary to tailor treatment and improve parent counseling. This systematic review assessed the prognostic value of perioperative near-infrared spectroscopy (NIRS) monitoring of regional oxygen saturation (rSO) with regard to brain injury, brain development, neurodevelopment, acute kidney injury (AKI), and necrotizing enterocolitis (NEC) in pediatric CHD patients. Data Sources: - PubMed and Embase databases. Study Selection: - We searched for original research articles published up to 2023 describing children (younger than 18 yr) with CHD using perioperative rSO monitoring, and reporting their association with at least one of the following outcomes: AKI, NEC, brain injury, brain development, or neurodevelopment. Data Extraction: - Ten studies, including a total of 562 patients, were included for brain injury, 4 studies with 229 patients for brain development, 15 studies with 1024 patients for neurodevelopment, 15 studies with 1168 patients for AKI, and 3 studies including 250 patients for NEC. The majority of the studies had a moderate to high risk of bias as assessed by the Cochrane Quality in Prognosis Studies tool. High heterogeneity in study populations and NIRS measurements was found. Data Synthesis: - Of the studies we identified, 5 of 10 in brain injury, 3 of 4 in brain development, 10 of 15 in neurodevelopment, 9 of 15 in AKI, and 1 of 3 in NEC reported associations with rSO. No meta-analysis could be performed due to heterogeneity. Conclusion(s): - Our findings highlight the need to improve methodological quality and reduce intra- and interstudy heterogeneity. Several methodological recommendations to improve future research were formulated. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies. <69> Accession Number 2044529695 Title Expert Consensus on Right Axillary Incision Approach for Open-Heart Surgery in Congenital Heart Disease. Source Congenital Heart Disease. 21(1) (no pagination), 2026. Article Number: 2. Date of Publication: 2026. Author Mo X.; Fan T.; Hua Z.; Haller C.; Oda S.; Luo S.; Liang W.; Yang Y.; Liu H.; Dong N.; Li S.; Chen X.; Chen J.; Shu Q.; Xing Q.; Zheng J.; Ming T.; An Q.; Wen P.; Wang Q.; Chen H.; Wen S.; Ye M.; Yang K.; Fang M.; Liu C.; Lin K.; Wu Z.; Fan X.; Pan Z.; Ding Y.; Pi M.; Li X.; Zou Y.; Tao S.; Chen R.; Ma L.; Zhang L.; You T.; Liao D.; Zhou C.; Li H.; Zhou G.; Gu C.; Li Z.; Li Y.; Zhang H.; He X.; Lu Y.; Hong H.; Zhang B.; Gong L.; Qi J.; Bai S.; Liu Y.; Zhao T. Institution (Mo, Yang, Qi) Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China (Fan, Liang) Department of Cardiovascular Surgery, Fuwai Central China Cardiovascular Hospital, Zhengzhou, China (Hua, Liu) Department of Cardiothoracic Surgery, Shenzhen Children's Hospital, Shenzhen, China (Haller) Department of Cardiovascular Surgery, Sick Children Hospital Toronto Canada, Toronto, ON, Canada (Oda) Division of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan (Luo) Department of Cardiovascular Surgery, West China Second Hospital of Sichuan University, Chengdu, China (Dong) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li, Yang, Zhang) Pediatric Cardiac Surgery Center, Fuwai Hospital, National Centre for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Chen, Ma) Cardiovascular Center, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Chen) Department of Cardiovascular Surgery, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China (Zhang, Zhang, Zheng, Chen, He, Lu) Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Shu, Fan) Department of Cardiac Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China (Xing) Heart Center, Qingdao Women and Children's Hospital, Qingdao, China (Li) Department of Cardiac Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China (Ming, Zou) Pediatric Heart Disease Treatment Center of Jiangxi Province, Jiangxi Provincial Children's Hospital, Nanchang, China (An, Lin) Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, China (Wen) Heart Center, Dalian Municipal Women and Children's Medical Center (Group), Dalian, China (Wang) Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wen) Department of Cardiovascular Surgery, Guangdong Provincial People's Hospital, Guangzhou, China (Chen) Department of Cardiovascular Surgery, Women and Children's Hospital of Qingdao University, Qingdao, China (Ye) Department of Cardiothoracic Surgery, Children's Hospital of Fudan University, Shanghai, China (Fang) Department of Cardiothoracic Surgery, General Hospital of Northern Theater Command, Shenyang, China (Liu) Department of Cardiology, Children's Hospital of Shanxi, Women Health Center of Shanxi, Taiyuan, China (Wu, Zhao) Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China (Pan, Li) Department of Cardiothoracic Surgery, Children's Hospital of Chongqing Medical University, Chongqing, China (Ding) Department of Pediatric Cardiology, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China (Pi, Gong) Department of Cardiothoracic Surgery, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li) Department of Cardiothoracic Surgery, Children's Hospital of Soochow University, Suzhou, China (Tao) Department of Cardiac Surgery, Children's Hospital in Hebei Province, Shijiazhuang, China (Chen) Department of Cardiothoracic Surgery, Hainan Women and Children's Medical Center, Haikou, China (Zhang) Department of Pediatric Surgery, Chengdu Women's and Children's Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China (You) Department of Cardiothoracic Surgery, Gansu Provincial Hospital, Lanzhou, China (Liao) Department of Cardiothoracic Surgery, Fujian Medical University Union Hospital, Fuzhou, China (Zhou) Department of Cardiothoracic Surgery, Union Hospital Affiliated to Tongji, Medical College of Huazhong, University of Science and Technology, Wuhan, China (Li) Department of Cardiothoracic Surgery, Shandong Provincial Hospital Affiliated, Shandong First Medical University, Jinan, China (Zhou) Department of Cardiothoracic Surgery, The 7th Medical Center of Chinese PLA General Hospital, Beijing, China (Gu) Department of Cardiothoracic Surgery, Xijing Hospital, Xi'an, China (Li, Bai) Department of Cardiothoracic Surgery, Beijing Children's Hospital, Capital Medical University, Beijing, China (Zhang) Department of Cardiothoracic Surgery, Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing, China (Hong) Department of Cardiothoracic Surgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China (Qi) Department of Cardiothoracic Surgery, Harbin Children's Hospital, Harbin Medical University, Harbin, China (Liu) Department of Cardiothoracic Surgery, Dalian municipal Women and Children's Medical Center, Dalian, China Publisher Tech Science Press Abstract Congenital heart disease (CHD) is a common birth defect in children, and surgical intervention is the primary treatment. The traditional standard median sternotomy (MS) has drawbacks such as significant trauma and obvious scarring. The right axillary incision (RAI) has gradually become a conventional approach due to its advantages of preserving thoracic cage integrity, small incision size, rapid recovery, and hidden scarring. However, there is currently a lack of relevant guidelines and consensus for its application. This consensus adopts the international Delphi process, systematically searching domestic and foreign literature on CHD from 1982 to 2024. It uses the GRADE system for evidence grading and, through multidisciplinary expert discussions, clarifies the applicable CHD types, surgical techniques, establishment of extracorporeal circulation, organ protection strategies, management of special disease types, and approaches to common complications of RAI. Results show that RAI is strongly recommended for most simple congenital heart diseases (CHDs) (e.g., simple ventricular septal defect, atrial septal defect), weakly recommended for some complex CHDs (e.g., mild tetralogy of Fallot), and not recommended for complex CHDs such as transposition of the great arteries or in children with severe right thoracic deformity. Additionally, it standardizes key operational parameters: weight (5-30 kg as optimal), age (6 months-6 years as preferred), incision location, extracorporeal circulation cannulation, and organ protection measures. This consensus provides an evidence-based basis for standardizing the clinical application of RAI in open-heart surgery for CHD, ensuring surgical safety and efficacy. Copyright © 2026 The Authors. <70> Accession Number 2044280713 Title Postnatal Steroids in Preterm Infants: A Narrative Review Series-Part 2: Cardiovascular Impacts. Source Children. 13(3) (no pagination), 2026. Article Number: 395. Date of Publication: 01 Mar 2026. Author Plessas-Azurduy P.; Lapointe A.; Wutthigate P.; Spenard S.; Villeneuve A.; Hebert A.; Shany E.; Richardson J.; Geva N.; Mawad W.; Cavalle-Garrido T.; Beltempo M.; Shalish W.; Sant'Anna G.; Altit G. Institution (Plessas-Azurduy) Division of Clinical & Translational Research, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada (Lapointe, Villeneuve) Division of Neonatology, Department of Pediatrics, Universite de Montreal, CHU Sainte-Justine, Montreal, QC, Canada (Wutthigate) Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand (Spenard, Beltempo, Shalish, Sant'Anna, Altit) Division of Neonatology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada (Hebert) Division of Neonatology, Department of Pediatrics, CHU de Quebec, Laval University, Quebec, QC, Canada (Shany, Richardson, Geva) Department of Neonatology, Saban Children's Hospital, Soroka Medical Center, Beer Sheva, Israel (Geva) Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel (Mawad, Cavalle-Garrido) Division of Cardiology, Department of Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Highlights: What are the main findings? Systemic postnatal corticosteroid use in extremely preterm infants with evolving lung disease can impact cardiovascular structure and function. Current evidence suggests it can lead to reactive myocardial hypertrophy, potentially accelerated closure of the patent ductus arteriosus and alterations in autonomic regulation and vascular resistance. Emerging diagnostic tools provide real-time monitoring capabilities: advanced techniques such as speckle tracking echocardiography, heart rate variability analysis, and biofluid markers (e.g., BNP) can detect subclinical cardiovascular changes and steroid-induced stress. What are the implications of the main findings? Routine cardiovascular surveillance is essential during steroid therapy to identify and manage potential adverse effects, such as left ventricular outflow tract obstruction or systemic hypertension, which may complicate the clinical course of infants with evolving bronchopulmonary dysplasia. Physiological data should guide a shift toward precision-based medicine, where the integration of longitudinal imaging and biomarker monitoring enables individualized steroid timing and dosing to optimize therapeutic benefits while minimizing unintended cardiovascular harm. Postnatal corticosteroids are frequently administered to extremely preterm infants to support respiratory management, yet their effects on the immature cardiovascular system are complex and underexplored. As the second installment in a series on physiology-informed steroid use, this narrative review focuses on the cardiovascular consequences of systemic corticosteroid therapy in preterm neonates. We examine how corticosteroids influence key aspects of cardiovascular physiology, including ductal closure, systemic and pulmonary vascular resistance, myocardial remodeling, and autonomic regulation. Attention is given to the hemodynamic transition of early postnatal life and how steroid exposure may interact with patency of the ductus arteriosus and vascular development. The potential for corticosteroids to contribute to reactive myocardial hypertrophy, systemic hypertension, and pulmonary hypertension is also reviewed in the context of both short- and long-term outcomes. Emerging diagnostic and monitoring tools are discussed for their potential to guide individualized therapy. These include targeted neonatal echocardiography (TnECHO) to assess cardiac function and structure, electrocardiography (ECG) for rhythm and conduction abnormalities, heart rate variability analysis for autonomic function, and circulating biomarkers to evaluate myocardial stress and inflammation. Together, these tools may inform tailored steroid timing and dosing, especially in the research context, while monitoring for signs of cardiovascular side effects in real time. By synthesizing mechanistic insights with evolving clinical evidence, this review highlights the need for a more nuanced understanding of how corticosteroids affect the developing cardiovascular system. It underscores the importance of integrating cardiovascular monitoring into routine care to optimize therapeutic benefit while minimizing unintended harm. Alongside companion reviews addressing respiratory and growth impacts, this installment contributes to a broader framework for individualized, physiology-driven steroid use in extremely preterm infants. Copyright © 2026 by the authors. <71> Accession Number 624230408 Title Comparative evaluation of analgesic sparing efficacy between dexmedetomidine and clonidine used as adjuvant to ropivacaine in thoracic paravertebral block for patients undergoing breast cancer surgery: A prospective, randomized, double-blind study. Source Saudi Journal of Anaesthesia. 12(4) (pp 548-554), 2018. Date of Publication: 01 Oct 2018. Author Mukherjee A.; Das A.; Mayur N.; Bhattacharyya C.; Biswas H.; Mitra T.; Roybasunia S.; Mandal S.K. Institution (Mukherjee, Das, Mayur, Bhattacharyya, Biswas, Mitra, Roybasunia, Mandal) Department of Anaesthesiology, NRS Medical College, 174, Gorakshabashi Road, Royal Plaza Apartment, Nagerbazar, Kolkata, West Bengal, India (Das, Mayur, Biswas, Mandal) Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India (Bhattacharyya) Department of Anaesthesiology, IPGMER, Kolkata, West Bengal, India (Mitra, Roybasunia) Department of Anaesthesiology, Murshidabad Medical College, Berhampore, West Bengal, India Publisher Wolters Kluwer Medknow Publications Abstract Introduction: Thoracic paravertebral block (TPVB) is an effective method for intra- and post-operative pain management in thoracic surgeries. For a long time, various adjuvants have been tried for prolonging the duration of TPVB. Objective(s): In this prospective study, we have compared the analgesic sparing efficacy of dexmedetomidine and clonidine, two alpha<inf>2</inf> adrenergic agonists, administered along with ropivacaine for TPVB for breast cancer surgery patients. Material(s) and Method(s): Forty-four breast cancer surgery patients undergoing general anesthesia (GA) were randomly divided into Group C and Group D (n = 44 each) receiving preoperative TPVB at T<inf>3-5</inf> level with 0.5% ropivacaine solution admixture with clonidine and dexmedetomidine, respectively. Cancer surgery was performed under GA. Intraoperative fentanyl and propofol requirement was compared. Visual analogue scale was used for pain assessment. Total dose and mean time to administration of first rescue analgesic diclofenac sodium was noted. Side effects and hemodynamic parameters were also noted. Result(s): Intraoperative fentanyl and propofol requirement was significantly less in dexmedetomidine group than clonidine. The requirement of diclofenac sodium was also significantly less and later in Group D than Group C. Hemodynamics, and side effects were comparable among two groups. Conclusion(s): Dexmedetomidine provided better intraoperative as well as postoperative analgesia than clonidine when administered with ropivacaine in TPVB before breast cancer surgery patients without producing remarkable side effects. Copyright © 2018 Saudi Journal of Anesthesia Published by Wolters Kluwer - Medknow. <72> Accession Number 2044614817 Title Guideline-directed medical therapy in Polish patients with chronic coronary syndrome and advanced chronic kidney disease: insights from the ISCHEMIA-CKD trial. Source Postepy w Kardiologii Interwencyjnej. 22(1) (pp 1-7), 2026. Date of Publication: 2026. Author Pracon R.; Anthopolos R.; Lu Y.; Demkow M.; Mazurek T.; Drozdz J.; Pruszczyk P.; Roik M.; Kryczka K.; Henzel J.; Kaczmarska-Dyrda E.; Malecki R.; Teresinska A.; Szwed H.; Ruzyllo W. Institution (Pracon, Demkow, Kryczka, Henzel, Kaczmarska-Dyrda) Coronary and Structural Heart Diseases Department, National Institute of Cardiology, Warsaw, Poland (Anthopolos, Lu) Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, United States (Mazurek) Department of Cardiology, Medical University of Warsaw, Poland (Drozdz) Department of Cardiology, Medical University of Lodz, Poland (Pruszczyk, Roik) Department of Internal Medicine and Cardiology, Medical University of Warsaw, Poland (Malecki) Nephrology Department, Miedzyleski Szpital Specjalistyczny, Warsaw, Poland (Malecki) First Department of Internal Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University, Warsaw, Poland (Teresinska, Szwed, Ruzyllo) National Institute of Cardiology, Warsaw, Poland Publisher Termedia Publishing House Ltd. Abstract Introduction: The ISCHEMIA-CKD trial showed similar outcomes with an initial conservative vs invasive approach to chronic coronary syndrome in patients with advanced chronic kidney disease. Guideline-directed medical therapy (GDMT) was recommended regardless of the randomized strategy assignment. Aim(s): To describe GDMT attainment in ISCHEMIA-CKD participants in Poland compared to other world regions. Material(s) and Method(s): Among 777 trial participants, 105 were randomized in Poland. Patients were followed for a median of 2.2 years with the following GDMT recommendations: not smoking, systolic blood pressure (SBP) < 140/ diastolic blood pressure (DBP) < 90 mm Hg, high/moderate-intensity statin, antiplatelet/anticoagulant, angiotensin-converting-enzyme inhibitors (ACE-I)/ angiotensin receptor blockers (ARB) and beta-blocker therapy, glycated hemoglobin (HbA1c) < 8% when indicated. Result(s): Participants in Poland vs other regions of the world (age 67 [60, 76] vs. 63 [55, 70] years, p < 0.001, 32% vs. 31% females, p = 0.86) had higher incidence of prior myocardial infarction (25% vs. 16%, p = 0.04), peripheral vascular disease (12% vs. 5%, p = 0.009), atrial fibrillation (23% vs. 7%, p < 0.001), and less frequently diabetes (44% vs. 59%, p = 0.004). At baseline, Polish participants were more often on antiplatelets/anticoagulants (91% vs. 83%, p = 0.04), beta-blockers (95% vs. 72%, p < 0.001), and ACE-I/ARBs (62% vs. 45%, p = 0.002), with better attainment of SBP < 140 (73% vs. 53%, p < 0.001), and HbA1c < 8% (86% vs. 56%, p = 0.003) and similar smoking and high-/moderate-intensity statin treatment frequencies. This degree of GDMT goal attainment was maintained at the last follow-up visit. Conclusion(s): In Polish patients with advanced kidney disease, high GDMT goal attainment was observed and maintained until the last follow-up visit under trial-specific, strict medical surveillance. The impact of GDMT on long-term outcomes remains to be studied in this patient population. Copyright © Termedia Sp. z o. o. <73> 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. <74> Accession Number 2042004146 Title The effect of personalized perioperative blood pressure management on intraoperative cerebral oxygen saturation, burst suppression ratio and postoperative neurological outcomes in patients having major non-cardiac surgery: an observational substudy of the IMPROVE-pilot randomized controlled trial. Source Journal of Clinical Monitoring and Computing. 40(2) (pp 363-373), 2026. Date of Publication: 01 Apr 2026. Author Khader W.; Hein M.; Kouz K.; Bergholz A.; Saugel B.; Wallqvist J.; Goldmann S.; Grafe K.; Larmann J.; Grusser L. Institution (Khader, Hein, Wallqvist, Goldmann, Grafe, Larmann, Gruser) Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany (Kouz, Bergholz, Saugel) Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Wallqvist) Alexianer Center for Mental Health, Aachen, Germany Publisher Springer Science and Business Media B.V. Abstract Abstract: It is not clear whether adopting personalized intraoperative blood pressure management could lead to better intraoperative regional cerebral saturation (rSO2), lower burst suppression ratio (BSR) or better neurological outcomes. Therefore, we performed this prespecified exploratory substudy of the IMPROVE-pilot trial to investigate the effects of personalized compared to routine intraoperative blood pressure management on the intraoperative rSO2. We also explored the effect of personalized intraoperative blood pressure management on BSR and the incidence of postoperative delirium (POD) and delayed neurocognitive recovery (dNCR). We included patients aged >= 45 years with American Society of Anesthesiologists (ASA) physical status II-IV who were scheduled for elective major surgery. Preoperative automated nighttime blood pressure measurements were performed. Patients were randomized to personalized blood pressure management maintaining intraoperative mean arterial pressure (MAP) at least at the preoperative mean nighttime MAP or to routine blood pressure management with a lower MAP intervention threshold of 65 mmHg. Intraoperative measurements of MAP, rSO2 on both hemispheres, and BSR were performed. POD was assessed daily on the first 3 postoperative days using the 3D-confusion assessment method or the confusion assessment method for the intensive care unit. We screened for dNCR using the telephone-Montreal Cognitive Assessment on postoperative days 3, 7, and 30. We enrolled 55 patients and randomized 50 patients. 49 patients were included in the final analysis. The median areas under the baseline rSO2 and BSR were similar between the two groups. One patient assigned to personalized blood pressure management and none of the patients assigned to routine blood pressure management had POD. There was no meaningful difference in the incidence of dNCR between the groups. In this substudy of the IMPROVE-pilot trial, we observed no evidence of difference in intraoperative area under baseline rSO2 between patients who received personalized compared to routine perioperative blood pressure management. Trial registration: This substudy was registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien DRKS00025762, on December 3, 2021). Copyright © The Author(s) 2025. <75> Accession Number 2035990222 Title Intraoperative renal and cerebral tissue oxygen saturation measurements to predict postoperative acute kidney injury in pediatric cardiac surgery: a prospective observational study. Source Journal of Clinical Monitoring and Computing. 40(2) (pp 405-416), 2026. Date of Publication: 01 Apr 2026. Author Massari D.; Modestini M.; Niezen C.K.; Yeh L.; Zoutman A.C.; Scheeren T.W.L.; Accord R.E.; van Amsterdam K.; Struys M.M.R.F.; Vos J.J. Institution (Massari, Modestini, Niezen, Yeh, Zoutman, Scheeren, van Amsterdam, Struys, Vos) Department of Anesthesiology, University of Groningen, University Medical Center Groningen, PO Box 30.001, Hanzeplein 1, Groningen, Netherlands (Niezen) Department of Anesthesiology, Isala Hospital, Zwolle, Netherlands (Scheeren) BD Advanced Patient Monitoring, Heidelberg, Germany (Accord) Department of Cardiothoracic Surgery, University of Groningen, University Medical Center Groningen, Groningen, Netherlands (Struys) Department of Basic and Applied Medical Sciences, Ghent University, Gent, Belgium Publisher Springer Science and Business Media B.V. Abstract Purpose: Pediatric patients undergoing cardiac surgery are at risk of developing postoperative acute kidney injury (AKI). We hypothesized that a reduction in intraoperative renal (SrO<inf>2</inf>) or cerebral (ScO<inf>2</inf>) tissue oxygen saturation is associated with postoperative AKI. Method(s): We conducted a prospective observational study including fifty pediatric patients with non-cyanotic heart disease undergoing elective surgical repair with cardiopulmonary bypass. Intraoperative SrO<inf>2</inf> and ScO<inf>2</inf> were monitored using near-infrared spectroscopy (O3 Regional Oximetry). Relative decreases of 10% and 20% from baseline SrO<inf>2</inf> and ScO<inf>2</inf> were analysed, calculating the total time below the threshold, area under the threshold, and time-weighted average. The primary outcome was the association between intraoperative SrO<inf>2</inf> and ScO<inf>2</inf> decreases, and the occurrence of postoperative AKI defined with the 'Kidney Disease: Improving Global Outcomes' criteria. Secondary outcomes included the association between other known or potential risk factors for AKI and postoperative AKI. Result(s): The incidence of postoperative AKI was 18.4%. There was no association between the duration and extent of intraoperative reductions of SrO<inf>2</inf> and ScO<inf>2</inf> below 10% and 20% from baseline, and postoperative AKI (e.g., area under the threshold for ScO<inf>2</inf> decreases below 10%: 36.8 [11.8 to 419.9] % min in patients with AKI vs. 9.6 [0.6 to 92.8] % min in patients without AKI, P = 0.117). Preoperative serum creatinine, body mass index, intraoperative hypotension, and blood lactate were associated with postoperative AKI. Conclusion(s): A decrease in intraoperative renal or cerebral tissue oxygen saturation was not associated with postoperative AKI in pediatric patients undergoing surgery for non-cyanotic congenital heart disease. Copyright © The Author(s) 2025. <76> 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. <77> Accession Number 649323960 Title Pregabalin versus dexmedetomidine for prevention of delirium after cardiac surgery: a randomized double-blind non-inferiority trial. Source Minerva anestesiologica. 92(3) (pp 176-188), 2026. Date of Publication: 01 Mar 2026. Author Morsy I.; Bakr D.M.; Abdelwahab E.H.; Abo Elkhier A.E.; Abdallah M.K.; Rehab O.M. Institution (Morsy, Abdelwahab, Abo Elkhier, Abdallah) Department of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Tanta University, Egypt (Bakr) Anesthesiology, Surgical Intensive Care and Pain Management Department, Faculty of Medicine, Helwan University, Egypt (Rehab) Department of Anesthesiology, Surgical Intensive Care and Pain Management, Faculty of Medicine, Tanta University, Egypt Abstract BACKGROUND: The incidence of postoperative delirium (POD) has been reported to be up to 53% following cardiac surgery. This trial aimed to determine the effect of perioperative administration of pregabalin versus dexmedetomidine (DEX) on the POD incidence in elderly patients planned for cardiac surgery, together with other secondary outcome measures. We hypothesized that pregabalin, with its sedative analgesic effects, would be non-inferior to DEX regarding POD prevention. METHOD(S): This randomized, double-blind, parallel-controlled, non-inferiority trial was conducted on 60 elderly cases planned for cardiac surgery. The cases were randomly assigned equally into a pregabalin group (group P) and DEX group (group D). The non-inferiority margin was set to 20%. The primary outcome was the POD incidence. Secondary endpoints included analgesic profile, sedation scale, and adverse events. RESULT(S): Pregabalin was non-inferior to DEX regarding the reduction in the incidence of POD (17.86% vs. 21.43%; risk difference, -3.6%; two-sided 95% CI, - 24.25% to 17.41%; meeting non-inferiority criteria). POD onset and duration showed an insignificant difference between the groups. The total morphine consumption in the first 48 hours after surgery was significantly lower in group P (25.64+/-7.04 mg) than in group D (34.66+/-9.25 mg; 95% CI, -13.42 to -4.61; P=0.0001). Both groups were insignificantly different regarding the visual analog scale score, sedation agitation scale measurements, recovery time, and adverse events. CONCLUSION(S): Pregabalin is non-inferior to DEX in terms of delirium prevention after cardiac surgeries with comparable sedative effects, but it has a superior analgesic profile in the form of a significantly lower 48-hour opioid dose. <78> Accession Number 2044460211 Title Association between lipoprotein levels and outcomes after coronary artery bypass grafting surgery: a systematic review and meta-analysis. Source Minerva Cardiology and Angiology. 74(1) (pp 128-134), 2026. Date of Publication: 01 Feb 2026. Author Cancelli G.; Harik L.; Ibrahim M.; Hameed I.; Rossi C.; Caldonazo T.; Dell'Aquila M.; Soletti G.J.; An K.R.; Leith J.; Demetres M.; Dimagli A.; Gaudino M.F. Institution (Cancelli, Harik, Rossi, Caldonazo, Dell'Aquila, Soletti, An, Leith, Dimagli, Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States (Ibrahim) Department of General Surgery, Maimonides Medical Center, Brooklyn, NY, United States (Hameed) Department of Cardiothoracic Surgery, Yale University School of Medicine, New Haven, CT, United States (Demetres) Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, NY, United States Publisher Edizioni Minerva Medica Abstract INTRODUCTION: Lipoprotein(a) (Lp[a]) is a variant of low-density lipoprotein (LDL) and has been associated with increased risk of vascular inflammation and thrombosis. Coronary artery bypass grafting (CABG) has been associated with local inflammation of the myocardium. It is plausible, therefore, that patients with elevated baseline Lp(a) may be prone to unfavorable clinical outcomes following CABG. We evaluate differences in outcomes between CABG patients with high and low serum Lp(a) in this meta-analysis. EVIDENCE ACQUISITION: A comprehensive literature search was performed to identify studies reporting outcomes in CABG patients stratified by preoperative Lp(a) level. When possible, the outcomes were pooled in a meta-analysis. We assessed post-operative mortality, major cardiovascular events, stroke occurrence and saphenous graft occlusion. EVIDENCE SYNTHESIS: Eight studies involving 8681 patients were included. Articles used varying cut-offs for high versus low Lp(a), and outcomes varied. In the three studies evaluating mortality, two showed no statistically significant difference between groups while one reported increased mortality associated with high Lp(a) level. Both studies investigating major adverse cardiovascular events reported higher risk in patients with high Lp(a). A study-level meta-analysis of four studies reporting saphenous vein graft occlusion incidence after CABG was performed. High (>=30 mg/dL) preoperative Lp(a) was not associated with an increased risk of graft occlusion compared with low (<30 mg/dL) preoperative Lp(a) (OR=1.88, 95% CI: 0.66-5.36; P=0.15). CONCLUSION(S): Studies evaluating the impact of Lp(a) on outcomes in CABG patients are few, with heterogenous cutoffs and outcomes In the limited ublished studies L (a) level was not associated with raft occlusion Copyright © 2024 EDIZIONI MINERVA MEDICA. <79> 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. <80> Accession Number 2043204404 Title Breathe poorly, recover worse? The impact of obstructive sleep apnea on cardiac surgery outcomes - an updated systematic review and meta-analysis. Source Sleep and Breathing. 30(1) (no pagination), 2026. Article Number: 47. Date of Publication: 01 Mar 2026. Author da Silva Ferreira M.; Oliveira de Amorim S.; Motta R.F.O.S.; Fayyat T.C.; Pereira F.H.L.; Lima N.L.; Neto J.A.; Honorato M.M. Institution (da Silva Ferreira, Oliveira de Amorim, Pereira, Neto, Honorato) Faculty of Medicine, University of the State of Para (UEPA), Para, Santarem, Brazil (Motta) Cesmac University Center, Alagoas, Maceio, Brazil (Fayyat) Positivo University, Parana, Curitiba, Brazil (Lima) Faculty of Medicine, Federal University of Santa Catarina, Santa Catarina, Florianopolis, Brazil Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: We aimed to perform a systematic review and meta-analysis of postoperative outcomes and the influence of obstructive sleep apnea (OSA) in patients undergoing cardiac surgery. Method(s): We systematically searched PubMed, Embase, Scopus, Cochrane Library and Web of Science for eligible studies from inception to May 2025. We included randomized or nonrandomized interventional studies comparing patients with versus without OSA undergoing cardiac surgery. Risk ratios (RR) with 95% confidence intervals (CI) were pooled with a random-effects model. Statistical analysis was performed using RStudio 4.5.1. Heterogeneity was assessed with I2 statistics. Result(s): A total of 2,642 studies were screened, and 33 were fully reviewed. We included seventeen studies involving 67,565 patients. Major adverse cardiac and cerebrovascular events (RR: 1.66; 95% CI: 1.358-2.035; I2 = 0.0%) was significantly increased in patients with OSA. The rates of all-cause mortality, myocardial ischemia, postoperative atrial fibrillation, acute renal failure, dialysis, pulmonary thromboembolism, tracheostomy, reintubation and bleeding were similar in both groups. Conclusion(s): The presence of OSA in patients undergoing cardiac surgery is associated with a significantly higher risk of major adverse cardiac and cerebrovascular events. However, definitive conclusions are hampered by significant heterogeneity across studies, which is likely due to the inclusion of nonrandomized studies, which underscores the need for further high-quality research. Copyright © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026. <81> [Use Link to view the full text] Accession Number 2044262704 Title Efficacy and Safety of Very Low Achieved LDL Cholesterol in Patients With Previous Ischemic Stroke. Source Circulation. 153(2) (pp 86-93), 2026. Date of Publication: 13 Jan 2026. Author Monguillon V.; Kelly P.J.; O'Donoghue M.L.; Park J.-G.; Bohula E.A.; Saver J.L.; Atar D.; Keech A.C.; Sever P.S.; Wang H.; Paiva da Silva Lima G.; Sabatine M.S.; Giugliano R.P. Institution (Monguillon, O'Donoghue, Park, Bohula, Sabatine, Giugliano) Thrombolysis in Myocardial Infarction Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Kelly) Mater Misericordiae University Hospital, Dublin, Ireland (Kelly) School of Medicine, University College Dublin, Ireland (Kelly) Health Research Board Stroke Clinical Trials Network Ireland, Dublin, Ireland (Saver) Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine, University of California-Los Angeles (Atar) Department of Cardiology, Oslo University Hospital Ulleval, Norway (Atar) Institute of Clinical Medicine, University of Oslo, Norway (Keech) Sydney Medical School, National Health and Medical Research Council Clinical Trials Centre, Australia (Sever) National Heart and Lung Institute, Imperial College London, United Kingdom (Wang, Paiva da Silva Lima) Global Development, Amgen, Thousand Oaks, CA, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Patients with previous ischemic stroke are at high risk for recurrent stroke and other major adverse cardiovascular events. The benefits of achieving very low levels of low-density lipoprotein cholesterol (LDL-C) in such patients is unclear. METHOD(S): - We analyzed patients with previous ischemic stroke enrolled in FOURIER (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk), a randomized placebo-controlled trial studying evolocumab in patients with stable atherosclerotic cardiovascular disease (median follow-up, 2.2 years), and through the open-label extension (FOURIER-OLE) period (additional median follow-up, 5 years), to examine the relationship between achieved LDL-C and the long-term incidence of the primary end point (cardiovascular death, myocardial infarction, stroke, or hospitalization for unstable angina or coronary revascularization) and stroke-related end points. RESULT(S): - The analysis included 5291 patients with previous ischemic stroke (>4 weeks). Of these, 666 (12.6%), 1410 (26.6%), 586 (11.1%), 508 (9.6%), and 2121 (40.1%) patients achieved LDL-C values of <20, 20 to <40, 40 to <55, 55 to <70, and >=70 mg/dL, respectively. The incidence of the primary end point, all stroke, and ischemic stroke each decreased in a monotonic fashion with lower achieved LDL-C levels on a continuous scale (P<inf>trend</inf><0.001, 0.002, and 0.002, respectively). Compared with patients with LDL-C >=70 mg/dL, those who achieved levels <40 mg/dL had incidence rate ratios of 0.69 (95% CI, 0.57-0.84), 0.73 (95% CI, 0.53-0.99), and 0.75 (95% CI, 0.54-1.05) for the outcomes of the primary end point, all stroke, and ischemic stroke, respectively. Hemorrhagic strokes were infrequent and unrelated to achieved LDL-C (P<inf>trend</inf>=0.85). CONCLUSION(S): - In patients with previous ischemic stroke, it appeared that the lower the LDL-C, down to levels <40 mg/dL, the lower the risk of major adverse cardiovascular events, including recurrent stroke, without a clear increase in risk of hemorrhagic stroke. These findings support the concept that more intensive LDL-C lowering in patients with previous ischemic stroke may be warranted. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT01764633/NCT01764633. Copyright © 2025 American Heart Association, Inc. <82> Accession Number 2042924723 Title Artificial intelligence-enabled clinical decision support systems in preadmission testing: a scoping review of risk prediction, triage, and perioperative workflows (2020-2025). Source Journal of Clinical Monitoring and Computing. 40(2) (pp 525-545), 2026. Date of Publication: 01 Apr 2026. Author Chinn L.W.; Nemeh I.; Chinn N.R. Institution (Chinn, Nemeh) Department of Anesthesiology and Perioperative Medicine, Rutgers New Jersey Medical School, 185 South Orange Avenue, Newark, NJ, United States (Chinn) Englewood Hospital and Medical Center, 350 Engle Street, Englewood, NJ, United States Publisher Springer Science and Business Media B.V. Abstract Preadmission testing (PAT) is a critical step in perioperative care that supports risk stratification, triage, and optimization. Tools such as the American Society of Anesthesiologists Physical Status (ASA-PS) classification have limitations. This review mapped evidence on artificial intelligence-enabled clinical decision support systems (AI-enabled CDSS) and risk prediction tools in PAT and perioperative assessment, with particular attention to their implications for perioperative efficiency and patient safety. A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. PubMed, Embase, Scopus, and CINAHL were searched for English-language studies published between January 1, 2020, and August 1, 2025. Eligible studies applied artificial intelligence (AI) or machine learning (ML) to preoperative or PAT-related evaluation, risk prediction, triage, or decision support. Two reviewers independently screened all records. The review was preregistered on the Open Science Framework (DOI: https://doi.org/10.17605/OSF.IO/JKCRH). The original registration described a broader "digital determinants of health" scope, which was refined to AI-enabled CDSS before data extraction. Fifty-six studies were included. Most were retrospective cohorts using imaging or electronic health record data. Radiomics and deep learning dominated oncologic prediction, while structured clinical and laboratory data informed models for anesthetic risk, transfusion, and postoperative complications. Natural language processing (NLP) predicted ASA-PS classification from preoperative text. Only a small number of prospective or randomized studies were identified. AI-enabled CDSS shows promise for perioperative risk prediction and PAT triage, but most applications remain at the proof-of-concept stage. When prospectively validated and embedded in perioperative workflows, these tools could streamline preoperative work-ups, reduce unnecessary testing and day-of-surgery cancellations, and support safer intra- and perioperative monitoring. Prospective, multicenter validation and real-world implementation studies are therefore needed before routine clinical use. Copyright © The Author(s) 2025. <83> Accession Number 2044833595 Title Tirzepatide therapy reduces subclinical leaflet thrombosis and paravalvular leak after transcatheter aortic valve replacement in obese patients: The TAVR-MET trial. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Thirugnanam A.M.; Chandrakanth; Pruthvi Institution (Thirugnanam, Chandrakanth, Pruthvi) Department of Interventional Cardiology, TX Hospitals, Telangana, Hyderabad, India Publisher Elsevier Inc. Abstract Background Obesity is increasingly recognized as a critical modifier of outcomes following transcatheter aortic valve replacement (TAVR), predisposing patients to subclinical leaflet thrombosis (SLT), hypo-attenuated leaflet thickening (HALT), and paravalvular leak (PVL). Metabolic inflammation, endothelial dysfunction, and pro-thrombotic states associated with obesity contribute to impaired bioprosthetic valve healing. Tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated robust metabolic, anti-inflammatory, and vascular protective effects. However, its impact on post-TAVR valve performance has not been previously evaluated. Objectives To determine whether tirzepatide therapy initiated before TAVR and continued post-procedure reduces the incidence of HALT and PVL in obese patients undergoing TAVR. Methods TAVR-MET was a prospective, randomized, open-label, multicenter trial enrolling obese patients (BMI >= 30 kg/m2) undergoing transfemoral TAVR. Patients were randomized to tirzepatide therapy or standard care. The primary endpoint was HALT incidence at 6 months assessed by 4D-CT or transesophageal echocardiography (TEE). Secondary endpoints included PVL severity, major adverse valve events (MAVE), inflammatory biomarker changes, weight reduction, and bleeding outcomes. Results Among 260 randomized patients, tirzepatide therapy significantly reduced HALT incidence (8.4% vs 21.6%, p = 0.002) and >= mild PVL (10.7% vs 25.3%, p = 0.006) at 6 months. Tirzepatide was associated with marked reductions in CRP and body weight without an increase in major bleeding. Multivariable analysis identified tirzepatide use, CRP reduction >30%, and BMI <32 kg/m2 at follow-up as independent predictors of HALT absence. Conclusions Metabolic modulation with tirzepatide significantly improves post-TAVR valve healing and hemodynamics in obese patients. These findings introduce a novel cardio-metabolic strategy to reduce structural valve complications following TAVR. Trial summary: TAVR-MET study The TAVR-MET trial was a prospective, randomized, multicenter study designed to evaluate whether metabolic modulation with tirzepatide , a dual GIP/GLP-1 receptor agonist, could improve bioprosthetic valve outcomes following transcatheter aortic valve replacement (TAVR) in obese patients. Obesity is increasingly recognized as a key determinant of post-TAVR complications, particularly subclinical leaflet thrombosis (HALT) and paravalvular leak (PVL) , driven by chronic inflammation, endothelial dysfunction, and a prothrombotic state. Tirzepatide has demonstrated potent weight-reducing, anti-inflammatory, and vascular protective effects, but its role in structural valve outcomes had not previously been explored. The trial enrolled 260 obese patients (BMI >= 30 kg/m 2 ) undergoing transfemoral TAVR across eight high-volume centers. Participants were randomized to receive tirzepatide initiated four weeks before TAVR and continued for 12 months , or standard care alone. All patients received guideline-directed antithrombotic therapy. The primary endpoint was the incidence of HALT at six months assessed by advanced imaging. Secondary endpoints included PVL severity, major adverse valve events, inflammatory biomarker changes, weight reduction, and bleeding outcomes. At six months, tirzepatide therapy was associated with a significant reduction in HALT compared with standard care, as well as a marked decrease in >= mild paravalvular leak . These structural valve improvements were accompanied by substantial weight loss and significant reductions in systemic inflammatory markers , without an increase in major bleeding or adverse safety signals. Multivariable analysis confirmed tirzepatide use and inflammation reduction as independent predictors of improved valve outcomes. In conclusion, the TAVR-MET trial provides the first clinical evidence that targeted metabolic therapy can favorably influence bioprosthetic valve healing after TAVR . These findings support a novel cardio-metabolic strategy for improving post-TAVR outcomes in obese patients and highlight the importance of addressing metabolic inflammation alongside procedural excellence in contemporary structural heart interventions. Copyright © 2026 Elsevier Inc. <84> Accession Number 2044641152 Title Efficacy and Risks of Intradiscal Electrothermal Therapy (IDET) for Treatment of Low Back Pain: A Narrative Review. Source Current Pain and Headache Reports. 30(1) (no pagination), 2026. Article Number: 38. Date of Publication: 01 Dec 2026. Author Litch A.; Thomassen A.; Sudini S.; Anwar A.I.; Broocks K.M.; Palowsky Z.R.; Ahmadzadeh S.; Chami A.A.; Shekoohi S.; Abd-Elsayed A.; Kaye A.D. Institution (Litch, Thomassen, Anwar, Broocks) School of Medicine, Louisiana State University Health Sciences Center, Shreveport, LA, United States (Sudini) School of Medicine, University of Alabama at Birmingham, Birmingham, United States (Palowsky, Ahmadzadeh, Chami, Shekoohi) Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, Shreveport, LA, United States (Abd-Elsayed) Department of Anesthesiology, University of Wisconsin, Madison, WI, United States (Kaye) Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center, Shreveport, LA, United States Publisher Springer Abstract Purpose of review: Chronic low back pain, particularly discogenic pain, remains challenging to treat effectively due to complex underlying mechanisms and variability in patient response. Intradiscal Electrothermal Therapy (IDET) has emerged as a minimally invasive intervention to alleviate discogenic back pain through targeted thermal denaturation of nociceptive nerve fibers and collagen remodeling within the intervertebral disc. The present investigation critically examines existing literature to assess efficacy, safety profile, optimal patient selection criteria, and relative effectiveness compared to alternative minimally invasive treatments such as nucleoplasty and radiofrequency annuloplasty. Recent findings: While several randomized controlled trials and meta-analyses suggest IDET provides moderate short-term relief, some studies highlight significant placebo effects and question its long-term efficacy. Notably, careful patient selection, guided by clinical presentation and diagnostic imaging, emerges as a critical factor influencing outcomes. Summary: This review addresses potential complications, including rare but serious conditions like cauda equina syndrome and discitis. Emerging techniques such as biacuplasty and radiofrequency annuloplasty are also discussed, contextualizing IDET among other minimally invasive thermal procedures. Further research with rigorous methodological standards and consistent patient criteria is necessary to clarify the clinical utility of IDET and identify the patient populations most likely to benefit from this intervention. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <85> Accession Number 2044867220 Title Design and rationale of the EMPagliflozin after Aortic Valve Replacement (EMPAVR) study: A randomized clinical trial. Source American Heart Journal. 297 (no pagination), 2026. Article Number: 107432. Date of Publication: 01 Jul 2026. Author Sorensen L.M.; Reinert M.S.; Raja A.A.; de Backer O.; Bieliauskas G.; Schou M.; Jensen J.; Moller E.L.R.; Linde J.J.; Kofoed K.F.; Kuhl J.T.; Procida K.; Petersen J.K.; Havers-Borgersen E.; Kober L.; Fosbol E. Institution (Sorensen, Reinert, Raja, de Backer, Bieliauskas, Moller, Linde, Kofoed, Kuhl, Petersen, Havers-Borgersen, Kober, Fosbol) Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (Schou, Jensen, Kober) Department of Cardiology, Copenhagen University Hospital, Herlev-Gentofte, Hellerup, Denmark (Procida) Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (Kofoed) Department of Cardiology and Radiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark (de Backer, Kofoed, Fosbol) Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark Publisher Elsevier Inc. Abstract Introduction Left ventricular (LV) hypertrophy and dysfunction secondary to aortic stenosis (AS) are key components of the disease's underlying pathophysiology. Previous trials suggest that up to 1/3 of patients do not benefit symptomatically after aortic valve replacement (AVR), which could be explained by insufficient LV remodeling. Sodium-glucose cotransporter-2 (SGLT2) inhibitors are effective in heart failure (HF) and have been shown to improve LV remodeling (change in LV mass). Methods The EMPAVR study is an investigator-initiated, randomized, placebo-controlled, and double-blinded trial comparing the effect of empagliflozin to placebo in patients with severe and symptomatic AS undergoing transcatheter aortic valve implantation (TAVI). The primary outcome for the EMPAVR trial is the difference in LV mass indexed to body surface area (measured by cardiac CT) from pre-AVR to 6 months post-AVR. Patients are randomized in a 1:1 ratio to 180 days of treatment. Discussion To the best of our knowledge, the EMPAVR study is the first placebo-controlled trial investigating the effects of SGLT2 inhibition in patients following TAVI because of AS. The EMPAVR study has the potential to pave the way for treatment of the LV in valvular heart disease and may help patients worldwide and expand our understanding of aortic stenosis. Trial registration The EMPAVR study was registered in December 2024 ( Clinical Trial Registration number: NCT06171802 ) before enrollment of the first patient. All patients will provide oral and written informed consent. The EMPAVR study is approved by the Regional Committee on Health Research Ethics and the Danish Medicines Agency. Copyright © 2026 The Author(s). <86> Accession Number 2044646322 Title Mixed-methods process evaluation of the "Karl-Heinz" cardiac prehabilitation program in older patients: protocol for the PRECOVERY trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 283. Date of Publication: 01 Dec 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, Muller) 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 Publisher BioMed Central Ltd 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 © The Author(s) 2026. <87> Accession Number 2044968983 Title Comparison of Analgesic Efficacy of Intrathecal Morphine and Ultrasound-Guided Bilateral Erector Spinae Plane Block in Patients Undergoing Open Heart Surgery with Midline Sternotomy: An Open Label Randomized Control Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 212-218), 2026. Date of Publication: 01 Apr 2026. Author Karuppiah V.; Kumar R.; Mohammed S.; Chouan A.; Kamal M.; Chhabra S.; Sharma A. Institution (Karuppiah) Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India (Kumar, Mohammed, Chouan, Kamal, Chhabra) Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India (Sharma) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Intrathecal morphine (ITM) and erector spinae plane block (ESPB) decrease postoperative pain in standard cardiac surgery. In this study, we compared the analgesic efficacy of ITM and B/L ESPB in patients undergoing open heart surgeries. Method(s): After approval from the institutional ethics committee and written informed consent from patients scheduled for open heart surgeries, they were randomized into two groups: Group ITM patients received ITM (5 mcg/kg), whereas Group ESPB patients received bilateral ESP block (0.3 mL/kg of 0.5% ropivacaine on either side). The primary outcome was to compare postoperative fentanyl consumption during the first 24 hours of ICU stay after extubation. Secondary outcomes were postoperative VAS at rest and on cough during the first 24 hours, pre- and postoperative pulmonary function, and number of rescue analgesics. Quantitative variables were presented as mean (SD) or median (IQR). Categorical variables were expressed as numbers or percentages. Spirometry variables were compared over time between the groups using Friedman test. Result(s): The ITM group had significantly less median fentanyl consumption compared to the ESPB group during the first 24 hours postoperative period [0 (0-75) mug vs. 234 (160-336) mug (95% CI, 171.65, 255.38); P < 0.001]. The VAS score at rest and during cough was significantly better in the ITM group. FEV1 and FVC reduced postoperatively in both groups with significantly better values in the ITM group. Conclusion(s): ITM administered prior to induction provides superior postoperative analgesia compared to bilateral ESPB in patients undergoing open-heart surgery. It significantly reduces opioid requirements, improves patient satisfaction, and enhances postoperative pulmonary function. Copyright © 2026 Annals of Cardiac Anaesthesia. <88> Accession Number 2044985703 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 American Journal of Cardiology. 268 (pp 64-70), 2026. Date of Publication: 01 Jun 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) Division of Cardiology, St. Michael's Hospital, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Persistent left atrial appendage thrombus despite anticoagulation is common. Current guidelines advise against percutaneous mitral balloon valvuloplasty (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 left atrial appendage (LAA) thrombus. The rate of stroke or embolic complication was 2.8% (95% CI 1.4% to 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 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <89> [Use Link to view the full text] Accession Number 650910617 Title The Association of Preoperative Cognitive Dysfunction to Common Intraoperative Electroencephalographic Parameters and Cerebral Hypoxia During Cardiac Surgery. Source Anesthesia and analgesia. 142(5) (pp 964-974), 2026. Date of Publication: 01 May 2026. Author Behera A.; Ramachandran R.V.; Hussain Z.; Ihalainen R.J.; Orui H.; Peck J.; Ananthakrishnan A.; Mathur P.; Muehlschlegel J.D.; Pittet J.F.; Bardia A.; Schonberger R.B.; Kveraga K.; Subramaniam B. Institution (Behera, Ramachandran, Hussain, Ihalainen, Orui, Peck, Ananthakrishnan, Mathur, Kveraga, Subramaniam) From the Department of Anesthesiology, Critical Care, Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States (Muehlschlegel) Department of Anesthesiology, Johns Hopkins Hospital, Baltimore, MD, Liberia (Pittet) Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL, United States (Bardia) Department of Anesthesiology, Massachusetts General Hospital, Boston, MA, United States (Schonberger) Department of Anesthesiology, Yale School of Medicine, New Haven, CT, United States Abstract BACKGROUND: Older cardiac surgery patients have a higher prevalence of cognitive dysfunction and elevated risk of perioperative neurocognitive disorders (PND), both independently related to adverse postoperative outcomes. Neuromonitoring using electroencephalogram (EEG) and cerebral oximetry (CO) may predict PND. However, preoperative factors influencing intraoperative neurophysiological characteristics are not well understood. We conducted a study in a cardiac surgery cohort to better understand the relationship of preoperative cognitive dysfunction to intraoperative burst suppression (BS), spectral edge frequency (SEF), cerebral hypoxia/desaturation, and dual cerebral events involving both BS and cerebral desaturation to potentially link preoperative cognitive dysfunction to intraoperative neuromonitoring variables associated with PND. METHOD(S): This is a secondary analysis of a triple-blinded, ongoing, multi-center randomized trial assessing the efficacy of postoperative intravenous acetaminophen to reduce postoperative delirium (POD) in older cardiac surgery patients. We studied 110 patients >=60 years who underwent CABG and/or valve surgery under general (inhalational) anesthesia at a single academic center. Preoperative cognitive status was assessed using the Montreal Cognitive Assessment (MoCA) and classified as normal (MoCA score>=26) or impaired (MoCA <26). Intraoperative frontal electroencephalogram data were recorded using the EEG monitor (SedLine, Masimo Inc). BS was detected using a recursive variance estimation algorithm, quantifying burst suppression duration (BSD). SEFs were derived through multi-taper spectral analysis. Intraoperative cerebral oxygenation was measured via cerebral oximetry (O3, Masimo), identifying cerebral desaturations (CO values <60%). Univariate analyses assessed associations between preoperative cognitive dysfunction and BSD, SEF, cerebral desaturation, and dual cerebral events of BS and cerebral desaturation. Multivariable regression analyses for these variables controlled for demographics and intraoperative confounders. RESULT(S): Baseline characteristics were comparable between the groups. There was no statistically significant correlation between preoperative cognition and BSD in cognitively impaired individuals (Cohen's d = 0.33; P = .09; remaining insignificant on adjustment, P = .8). Adjusted analyses showed those with abnormal MoCA scores had an average of 1.4 Hz lower SEF values (95% confidence interval [CI], 0.07-2.6; P = .03). Cognitively impaired patients demonstrated no significant increase in time spent in cerebral desaturations (55.4 [12.4-119] vs 46.3 [19.2-81.9] minutes; P = .6). No disparities were observed between the groups regarding concurrent and nonconcurrent abnormal EEG and CO values. CONCLUSION(S): Preoperative cognitive dysfunction was associated with significantly lower SEFs, indicating increased isoflurane sensitivity without affecting BS or correlating with CO. SEF shows potential as a marker for cognitive vulnerabilities, but further studies are needed to validate its clinical utility and establish thresholds to optimize perioperative care. Copyright © 2025 International Anesthesia Research Society. <90> Accession Number 2044968972 Title Ultrasound-Guided Superficial Versus Deep Continuous Serratus Anterior Plane Block in Patients Undergoing Thoracotomy for Lung Surgery: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 180-185), 2026. Date of Publication: 01 Apr 2026. Author Raghupathy R.; Negi S.L.; Biswas I.; Singh H.; Mandal B.; Gourav K.P.; Sharma A. Institution (Raghupathy) Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Negi, Biswas, Mandal, Gourav) Department of Cardiac Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Singh) Department of Cardiothoracic and Vascular Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India (Sharma) Department of Radiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India Publisher Wolters Kluwer Medknow Publications Abstract Background: Thoracic surgery is considered to be one of the most painful surgical procedures; therefore, providing adequate analgesia in the perioperative period is crucial. Inadequate pain control impedes deep breathing, which further leads to atelectasis and pneumonia. The optimal analgesic protocol that allows adequate postoperative pain control and facilitates fast recovery of this population has yet to be determined. The serratus anterior plane (SAP) block is a new procedure that is relatively easier to perform and safer, compared with other modalities. Material(s) and Method(s): Patients undergoing lung resection surgery via thoracotomy at a single center were randomized to undergo either superficial or deep SAP block with 0.4 mL/kg of bupivacaine 0.25%, following which 20-gauge peripheral nerve block catheter was placed above or below the serratus anterior muscle plane and continuous bupivacaine 0.125% infusion at the rate of 5-7 mL/h was initiated up to 24 hours in intensive care unit (ICU). The primary outcome was the total opioid consumption during the first 24 h in the ICU. Secondary outcomes were the severity of pain in the visual analog scale (VAS) score, patient satisfaction score, ICU stay duration, and the incidence of postoperative nausea and vomiting (PONV). Result(s): A total of 36 participants were randomized to each group, and the baseline characteristics were comparable between the groups. The total postoperative opioid consumption during the first 24 h in ICU was lower in deep SAP block (60.00 +/- 68.22) compared to superficial SAP block (85.31 +/- 68.40), but it was not statistically significant (P > 0.303). The VAS score, time to first rescue analgesia, patient satisfaction score, incidence of PONV, and the length of ICU stay were comparable between the two groups (P > 0.05). Conclusion(s): There was lower opioid consumption in the continuous deep SAP block compared to the superficial SAP block at 24 hours; however, the difference was not statistically significant. Continuous analgesia through an indwelling catheter is safe and an effective method for the management of postoperative pain in lung resection surgery. Copyright © 2026 Annals of Cardiac Anaesthesia. <91> Accession Number 2044968856 Title The Effect of Preoperative Oral Carbohydrate Loading on Insulin Resistance in Adult Patients Undergoing On-Pump Cardiac Surgery: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 228-236), 2026. Date of Publication: 01 Apr 2026. Author Nur R.F.; Synthana M.R.; Kurnia Y.; Rudiarto K.M.; Alicia R.J.; Kurniawaty J.; Pratomo B.Y.; Deviatika F.E. Institution (Nur, Synthana, Kurniawaty, Pratomo) Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (Kurnia) Department of Surgery, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia (Rudiarto) Nutrition Installation, Dr. Sardjito Hospital, Yogyakarta, Indonesia (Alicia, Deviatika) Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia Publisher Wolters Kluwer Medknow Publications Abstract Background: Preoperative oral carbohydrate loading has been shown to reduce insulin resistance in various surgical fields, but its effect in cardiac surgery remains uncertain. This study aimed to evaluate whether preoperative carbohydrate loading can reduce insulin resistance in adults undergoing on-pump cardiac surgery. Method(s): A randomized controlled trial was conducted at Dr. Sardjito Hospital, Yogyakarta, Indonesia. Fifty adults scheduled for elective cardiac surgery (January-May 2024) were randomized to receive either 400 mL of a 12.5% maltodextrin-based carbohydrate drink (CL group) or 400 mL of water 2 h before surgery (PL group). Blood glucose and insulin were measured at postinduction, 0 h, and 24 h postoperatively to calculate HOMA-IR, analyzed at a significance level of 0.05. Result(s): Blood glucose and HOMA-IR did not differ significantly between groups at any time point (all P > 0.05). Insulin was higher in the CL group than in the PL group at postinduction ((95%CI = -6.07 to - 0.42; P = 0.022)). In the PL group, insulin rose progressively (P < 0.05), while changes in the CL group were nonsignificant (P > 0.05). HOMA-IR increased from postinduction to 0 h in both groups (P < 0.05) but remained stable thereafter (P > 0.05). Conclusion(s): Preoperative oral carbohydrate loading did not significantly affect perioperative glucose or HOMA-IR in cardiac surgery. While insufficient to counteract the magnitude of CPB-induced insulin resistance, carbohydrate loading may modestly stabilize metabolic responses, as reflected by a flatter insulin trajectory. Copyright © 2026 Annals of Cardiac Anaesthesia. <92> Accession Number 2044968974 Title The Effect of Dexmedetomidine on Hemodynamic Response during Double-Lumen Tube Insertion: A Randomized Controlled Trial. Source Annals of Cardiac Anaesthesia. 29(2) (pp 191-198), 2026. Date of Publication: 01 Apr 2026. Author Govind M.R.H.; George G.; Vithayathil R.; Gowri M.; Rao V.M.; Sahajanadanan R.; Kuppuswamy B. Institution (Govind) Department of Anaesthesia, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (George) Department of Anaesthesia, Bangalore Baptist Hospital, Karnataka, Bengaluru, India (Vithayathil) Department of Anaesthesia, Bedford Hospital South Wing, Bedford, United Kingdom (Gowri) Department of Biostatistics, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (Rao) Department of Cardiothoracic Surgery, Christian Medical College and Hospital, Tamil Nadu, Vellore, India (Sahajanadanan) Department of Anaesthesia, Sultan Qaboos Cancer Centre and Research Centre and University, Seeb, Oman (Kuppuswamy) Department of Cardiac Anaesthesia, Christian Medical College and Hospital, Tamil Nadu, Vellore, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aim: Double-lumen tube (DLT) insertion, which is often necessary to isolate the lung in thoracic surgeries, causes a significant and prolonged stress response. This study aims to evaluate the effect of a single preinduction bolus of dexmedetomidine 0.5 mcg/kg on hemodynamic responses to DLT insertion and fiberoptic confirmation. Material(s) and Method(s): In this prospective randomized control trial, 60 patients coming for thoracic surgery requiring DLT insertion were recruited. Thirty were assigned to the dexmedetomidine group (A) and 30 to the placebo group (B). Group A received 0.5 mcg/kg dexmedetomidine, and Group B received normal saline over 10 min. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded at baseline, after study drug administration, just before intubation, at intubation, and thereafter at regular intervals up to 30 min. Usage of supplementary anesthetics and rescue medications was noted. Result(s): Patients in Group A had lower HR after study drug administration (P < 0.001), before intubation (P < 0.001), at intubation (P < 0.001), and at various other time points. Group A had lower SBP (P = 0.049) and DBP (P = 0.005) after study drug administration. Fewer patients in Group A required additional propofol (14 vs. 27) (P < 0.001) and lesser doses (21.3 vs. 41.0 mg) (P = 0.008). Lesser Group A patients required additional fentanyl (15 vs. 21) (P = 0.114). More patients in Group A required ephedrine (P = 0.038). Use of phenylephrine and atropine was comparable in both groups. Conclusion(s): Dexmedetomidine worked as an excellent adjuvant to anesthesia, providing good HR control and hemodynamic stability during DLT insertion and fiberoptic bronchoscopy confirmation. It decreases the overall anesthetic requirements and causes minimal side effects. Copyright © 2026 Annals of Cardiac Anaesthesia. <93> Accession Number 2044907174 Title Computed Tomography in Preoperative Planning of Minimally Invasive Valvular Heart Surgery: A Systematic Review of Mixed Evidence and Clinical Application. Source European Journal of Cardio-thoracic Surgery. 68(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Bejand E.A.; Suwita B.M.; Akowuah E.; Deshpande R.; Zacharias J.; Iyengar S.; Rajiah P.; Bahrami T.; Mirsadraee S. Institution (Bejand) National Heart and Lung Institute, School of Medicine, Imperial College London, London, United Kingdom (Suwita) Department of Radiology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Akowuah) School of Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom (Deshpande) Department of Cardiothoracic Surgery, King's College Hospital, London, United Kingdom (Zacharias) Lancashire Cardiac Centre, Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, United Kingdom (Iyengar) Department of Radiology, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, United Kingdom (Rajiah) Department of Radiology, Mayo Clinic, Rochester, MN, United States (Bahrami) Department of Cardiac Surgery, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Mirsadraee) National Heart and Lung Institute, School of Medicine, Imperial College London, London, United Kingdom (Mirsadraee) Department of Radiology, Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: Minimally invasive cardiac surgery (MICS) offers significant advantages over conventional sternotomy, including reduced trauma and faster recovery. Preoperative planning is crucial, with computed tomography (CT) emerging as an essential imaging tool. This systematic review aims to evaluate CT's role in MICS planning, focusing on imaging protocols, surgical guidance, and patient outcomes. Method(s): This study included studies published between January 2003 and January 2025 that examined the role of CT imaging in planning minimally invasive valvular heart surgery. A comprehensive search was conducted in Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica Database (EMBASE) using predefined keywords and medical subject headings (MeSH) terms related to CT imaging, angiography, minimally invasive surgery, robotic surgery, aortic valve surgery, and mitral valve surgery. Result(s): Initial search found 378 studies, and 17 studies were included in the review. The studies highlight CT's value in assessing surgical feasibility, vascular access, and risk stratification. CT aids in selecting arterial cannulation sites, guiding aortic occlusion strategies, and optimizing port placement. It also identifies contraindications, such as extensive atherosclerosis and anatomical abnormalities, that may necessitate sternotomy. Conclusion(s): Current evidence underscores CT's critical role in optimizing MICS planning and enhancing patient safety. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. <94> Accession Number 2044560618 Title Does ventilator circuit disconnection during lateral positioning reduces the rate of double-lumen endotracheal tube displacement in thoracic surgery? a study protocol for a randomized controlled trial. Source Trials. 27(1) (no pagination), 2026. Article Number: 272. Date of Publication: 01 Dec 2026. Author Lv S.; Lv M.; Du W.; Zou Z.; Zheng K.; Qu J.; Han X.; Mao J. Institution (Lv, Lv, Du, Zou, Zheng, Han, Mao) Department of Anesthesiology and Perioperative Medicine, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, Jinan, China (Qu) Shandong First Medical University, Shandong, Jinan, China Publisher BioMed Central Ltd Abstract Background: Double-lumen endobronchial tube (DLT) displacement often occurs in patients undergoing thoracic surgery after lateral positioning. There are no clinical studies investigating the effect of disconnection of the breathing circuit with DLT on the incidence of displacement after lateral positioning. Therefore, the aim of this study is to investigate the effect of disconnection of the breathing circuit with DLT on the rate of DLT displacement after lateral positioning in patients undergoing thoracic surgery. Method(s): A single-blind, parallel-group, randomized controlled study will be conducted. We will recruit 256 patients who are scheduled to undergo elective thoracic surgery. The participants will be randomly allocated to the disconnected breathing circuit group and the connected breathing circuit group. The primary outcome is the rate of DLT displacement identified via the flexible bronchoscopy before and after lateral positioning. The secondary outcomes are the effect of lung collapse, peripheral oxygen saturation at 5 and 10 min after one-lung ventilation, and the length of stay in the post-anesthesia care unit (PACU). Discussion(s): Several studies have shown promising results in reducing the incidence of DLT displacement during lateral positioning. However, no studies have investigated the effect of the disconnection of the breathing circuit from the DLT on the rate of DLT displacement after lateral positioning. We expect that disconnecting the breathing circuit when changing the patient from supine to lateral position will avoid unintended tube traction, thus reducing the incidence of DLT displacement. Trial registration: The study protocol was registered at Clinical Trials (https://register.clinicaltrials.gov/) with registration number: NCT06182371 on November 21, 2023. Copyright © The Author(s) 2026. <95> Accession Number 650896538 Title Hemofilters versus hemodialyzers: impacts on cytokine removal during cardiopulmonary bypass in pediatric cardiac surgery: a randomized controlled trial. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 13 Apr 2026. Author Abdelazim A.M.; Alaaeldin B.; Amer A.M.; Rizk A.; Mahmoud D.; Elsobky Y.; Tawfik H.; Fadaly A.S.; Elshazly M. Institution (Abdelazim) Cardiothoracic surgery Department, Alnas Hospital, Egypt (Alaaeldin, Fadaly, Elshazly) Cardiothoracic surgery Department, Alnas Hospital, Egypt (Amer) Department of Anesthesia, Intensive Care & Pain Management, Ain Shams University, Cairo, Egypt (Amer) Anesthesia Department, Alnas hospital, Egypt (Rizk) Critical Care Department, Cairo University, Cairo, Egypt (Rizk) Alnas Academy Medical Program Director, Alnas hospital, Former Laboratory and Blood Bank Director, Egypt (Mahmoud) Medical Laboratory Specialist, Alnas hospital, Laboratory and Blood Bank Department, Egypt (Elsobky) Alnas Clinical Research Center (CRC), Alnas Hospital, Egypt (Tawfik) Biostatistician, Alnas Clinical Research Center (CRC), Alnas hospital, Egypt (Fadaly) Cardiothoracic Surgery Department, Faculty of Human medicine, Zagazig University, Zagazig, Egypt (Elshazly) Cardiothoracic Surgery Department, Cairo University Hospitals, Cairo, Egypt Abstract BACKGROUND: Congenital heart disease (CHD) remains a leading cause of pediatric morbidity and mortality worldwide. Cardiopulmonary bypass (CPB) is crucial for surgical repair but is associated with systemic inflammation and/or end-organ dysfunction. Ultrafiltration (UF) techniques, particularly zero-balance ultrafiltration (Z-BUF), have been developed to mitigate these effects by removing cytokines. Conventional hemofilters are widely used, but in low- and middle-income countries, high-flux hemodialyzers are increasingly substituted, although evidence for their equivalence in pediatric CPB remains scarce. METHOD(S): In this prospective, single-blinded, randomized controlled noninferiority trial, a total of 60 pediatric patients (aged 1-15 years) who underwent elective CPB for congenital heart surgery were enrolled. Thirty patients were assigned to the Medica hemofilter group, and thirty to the Fresenius Helixone hemodialyzer group. Interleukin-6 (IL-6) was designated as the primary endpoint, whereas interleukin-1beta (IL-1beta), hematocrit, lactate levels, mechanical ventilation (MV) duration, length of stay in the intensive care unit (ICU), and overall hospital stay served as secondary endpoints. Cytokine levels were measured at baseline (T1), before Z-BUF (T2), and immediately after Z-BUF (T3). Prespecified noninferiority margins were applied, and generalized estimating equations (GEEs) were used to assess temporal trends. RESULT(S): Baseline characteristics and procedural complexity were comparable between cohorts. Following Z-BUF, changes in IL-1beta (median difference - 0.223 pg/mL) and IL-6 (0.642 pg/mL) met the predefined noninferiority criteria (p < 0.001 for both). GEE analysis revealed no significant interaction between filter type and cytokine trends. The median hematocrit, lactate levels, MV duration, length of stay in the ICU, and overall hospital stay were also similar between the study arms. Mortality was identical (3.3%) in both arms. Importantly, no cases of acute kidney injury or acute neurological events were observed in either group. CONCLUSION(S): Compared with conventional hemofilters, high-flux hemodialyzers are noninferior in controlling intraoperative cytokines during Z-BUF in pediatric CPB and demonstrate comparable clinical safety outcomes. Hemodialyzers appear to be an effective and practical alternative in resource-limited settings. Validation in larger multicenter trials with extended postoperative sampling is warranted. TRIAL REGISTRATION AND DATE: ClinicalTrials.gov (NCT06792565) on 22 March 2024. Copyright © 2026. The Author(s). <96> [Use Link to view the full text] Accession Number 2044294951 Title Stroke Risk After Bioprosthetic Aortic Valve Replacement in Aortic Stenosis: Systematic Review and Meta-Analysis. Source Stroke. (no pagination), 2026. Date of Publication: 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 (Mac Grory, Ryan, Feng, El Husseini) Department of Neurology (B.C.M.G., D.R., W.F., N.E.H.), 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 (Kaplan) Medical Center Library & Archives (S.K.), Duke University School of Medicine, Durham, NC, United States (Hassani) Department of Neurology, Feinberg School of Medicine Northwestern University, Chicago, IL (Moumneh) Inova Center of Outcomes Research, Inova Heart and Vascular, Fairfax, VA, United States Publisher Wolters Kluwer Health 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. Copyright © 2026 American Heart Association, Inc. <97> [Use Link to view the full text] Accession Number 2044225425 Title Safety and efficacy of protamine use during transcatheter aortic valve implantation: A systematic review and meta-analysis. Source Medicine (United States). 105(6) (pp e47578), 2026. Date of Publication: 06 Feb 2026. Author Khan S.A.; Parajuli S.B.; Marasini A.; Shrestha A.; Khan S.; Umirkulova F.; Anas R.; Urazbaeva D.; Bhandari B.; Kausar H.; Kauser H. Institution (Khan, Bhandari) Birat Medical College Teaching Hospital, Morang, Nepal (Parajuli) Department of Community Medicine, Birat Medical College Teaching Hospital, Morang, Nepal (Marasini) West Virginia University Health System Princeton Community Hospital, Princeton, WV, United States (Shrestha) Department of Internal Medicine, Medstar Health Georgetown University, Baltimore, MD, United States (Khan) Department of Internal Medicine, Liceo de Cagayan University, Cagayan de Oro City, Misamis Oriental, Philippines (Umirkulova) Department of Medicine, Termez University of Economics and Service, Termez, Uzbekistan (Anas) Department of Internal Medicine, Sargodha Medical College, Sargodha, Pakistan (Urazbaeva) Department of Psychology and Medicine, Mamun University, Khiva, Uzbekistan (Kausar) Department of Internal Medicine, Karnali Academy of Health Sciences, Jumla, Nepal (Kauser) Department of Pharmacology, Pokhara University, Pokhara, Nepal Publisher Lippincott Williams and Wilkins Abstract Background: - Bleeding and vascular complications are key safety concerns during transcatheter aortic valve implantation (TAVI). Protamine is routinely administered to reverse unfractionated heparin, yet its efficacy and safety profile remain debated, particularly regarding its influence on bleeding, vascular, and renal outcomes. Method(s): - A meta-analysis of published studies comparing protamine with placebo during TAVI was conducted. Primary outcomes included transfusion requirements, major and life-threatening bleeding, and major vascular complications. Secondary outcomes were acute kidney injury, cerebrovascular events, myocardial infarction, minor vascular complications, and 30-day mortality. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models, and heterogeneity was assessed with the I2 statistic. Result(s): - Protamine administration significantly reduced the need for blood transfusion (OR = 0.70; 95% CI 0.55-0.88; P = .00; I2 = 0%), major bleeding (OR = 0.54; 95% CI 0.31-0.92; P = .02; I2 = 42.6%), life-threatening bleeding (OR = 0.33; 95% CI 0.12-0.87; P = .03; I2 = 26.8%), and major vascular complications (OR = 0.44; 95% CI 0.28-0.67; P = .00; I2 = 0%). There were no significant differences in any bleeding (OR = 0.82; 95% CI 0.50-1.36; P = .45), acute kidney injury (OR = 0.81; 95% CI 0.61-1.07; P = .14), cerebrovascular events (OR = 0.82; 95% CI 0.43-1.59; P = .56), myocardial infarction (OR = 0.47; 95% CI 0.08-2.90; P = .42), minor vascular complications (OR = 0.76; 95% CI 0.51-1.15; P = .19), or 30-day mortality (OR = 1.12; 95% CI 0.68-1.85; P = .65). Heterogeneity was minimal across most analyses (I2 < 50%). Conclusion(s): - Protamine reversal of heparin during TAVI appears safe and confers significant protective effects against transfusion requirements, bleeding, and major vascular complications, supporting its routine use in the absence of contraindications. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <98> Accession Number 2044907171 Title Maternal, Valvular and Foetal Outcomes of Pregnancy Following Aortic Valve Replacement. Source European Journal of Cardio-thoracic Surgery. 68(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Khargi S.D.M.; Grashuis P.; Veen K.M.; Kluin J.; Cornette J.M.J.; Johnson M.R.; Roos-Hesselink J.W.; Takkenberg J.J.M.; Mokhles M.M. Institution (Khargi) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Grashuis) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Veen) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Kluin) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Cornette) Department of Obstetrics and Gynaecology, Erasmus Medical Centre, Netherlands (Cornette) Department of Obstetrics and Gynaecology, University of Antwerp, Antwerp, Belgium (Johnson) Department of Obstetric Medicine, Imperial College London, Kensington, London, United Kingdom (Roos-Hesselink) Department of Cardiology, Erasmus Medical Centre, Rotterdam, Netherlands (Takkenberg) Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, Netherlands (Mokhles) Department of Cardiothoracic Surgery, University Medical Centre Utrecht, Utrecht, Netherlands Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: To investigate the optimal valve substitute for young women requiring aortic valve replacement (AVR), allowing improved future valve-related outcomes for mother and foetus during pregnancy. Method(s): A systematic search was performed for publications between 1998 and 2025 reporting women experiencing pregnancy after AVR with a pulmonary autograft (Ross-procedure), homograft, bioprosthesis (xenograft), or mechanical valve. Pooled proportions were calculated to determine maternal, valvular and foetal outcomes during pregnancy using generalized linear mixed models. Result(s): Thirteen studies reporting 356 pregnancies in 251 women (pooled mean age at pregnancy 29.1 +/- 4.8 years) after AVR with a pulmonary autograft (70 women, 119 pregnancies), homograft (73 women, 99 pregnancies), bioprosthesis (37 women, 50 pregnancies), or mechanical valve (71 women, 88 pregnancies) were included. During pregnancy, valve-related reintervention in women with a bioprosthesis was 2.7% (95% CI, 0.4-16.9) at 5.1 +/- 2.5 years after AVR. This was not observed in women with pulmonary autografts (7.7 +/- 4.2 years after AVR) and homografts (4.1 +/- 3.3 years after AVR). Reintervention for valve thrombosis (4.9% [95% CI, 1.6-14.0]) and maternal death (1.1% [95% CI, 0.2-7.6]) occurred only in women with mechanical valves (8.1 +/- 4.5 years after AVR). Pooled probability of liveborn delivery was 71.7% (95% CI, 59.2-81.6) in women with a mechanical valve, compared to 90.6% (95% CI, 72.4-97.3), 92.3% (95% CI, 56.0-99.1), and 82.9% (95% CI, 53.3-95.4) in women with an autograft, homograft, and bioprosthesis respectively. Conclusion(s): Maternal mortality and valve thrombosis during pregnancy occurred only in women with mechanical valves. Although no statistical comparisons were made, pregnancies in women with pulmonary autograft, homograft or bioprosthesis showed acceptable maternal and foetal outcomes. These descriptive findings provide foundations for further investigation of tissue-valve function before, during and after pregnancy, aiming for more support of current guidelines. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. <99> Accession Number 650902685 Title What is the prevalence of impaired cognitive domains in surgical patients? A systematic review andmeta-analysis. Source Alzheimer's and Dementia. Conference: Alzheimer's Association International Conference, AAIC 2025. Toronto, ON Canada. 21(Supplement 3) (no pagination), 2025. Date of Publication: 01 Dec 2025. Author Park S.; Yan E.; Martinez-Rodriguez R.; Desai B.; Chung J.; Saripella A.; Englesakis M.; Fishman K.N.; Chung F. Institution (Park, Martinez-Rodriguez, Desai, Chung) University of Toronto, Toronto, ON, Canada (Yan, Saripella, Chung) TorontoWestern Hospital, University Health Network, Toronto, ON, Canada (Yan, Chung) Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Englesakis) University Health Network, Toronto, ON, Canada (Fishman) Baycrest Hospital, Toronto, ON, Canada (Fishman) Ontario Shores Centre forMental Health Sciences, Toronto, ON, Canada Publisher John Wiley and Sons Inc Abstract Background: Cognitive impairment is prevalent in the surgical population but remains significantly under-recognized. This systematic review and meta-analysis aims to (1) assess the prevalence of specific impaired cognitive domains in surgical patients perioperatively and (2) examine postoperative changes across the domains. Method(s): A comprehensive search was conducted in five electronic databases from inception until March 19, 2024. Studies were included if they met the following criteria: (1) surgical patients >=18 years of age; (2) sample size of >=100 surgical patients; (3) assessed cognitive domain(s) preoperatively with a neuropsychological battery or clinical evaluation; and (4) reported the prevalence of impaired cognitive domains or changes perioperatively. The exclusion criteria included neurosurgery; those with overlapping data; cross-sectional, case control, and case series studies; and non-English articles. Result(s): Of the 12,082 articles screened, 21 studies with 5,725 patients were included (11 non-cardiac surgery, 10 cardiac surgery). Preoperatively, executive function had the highest pooled prevalence of impairment (18%; 95% CI: 13%, 24%), followed by visuospatial function (16%; 95% CI: 6%, 26%) and attention/working memory/processing speed (14%, 95% CI: 9%, 18%). Rates were lower in perceptualmotor control (13%; 95% CI: 9%, 36%), language (13%; 95% CI: 8%, 17%), and learning/memory (12%; 95% CI: 8%, 16%) (Figure 1). Postoperatively, impairment was most pronounced at one week, with 35% (95% CI: 4%, 66%) in attention/working memory/processing speed, 34% (95% CI: 16%, 51%) in executive function, and 28% (95% CI: 16%, 40%) in learning/memory. Impairment reduced at three months postoperatively, with a prevalence of 16% (95% CI: 3%, 35%) in attention/working memory/processing speed,15%(95% CI: 6%, 24%) in executive function, and12%(95% CI: -2%, 25%) in learning/memory (Figure 2). Conclusion(s): Cognitive domains were impaired preoperatively in 12% to 18% of surgical patients. The most commonly impaired domains were executive function, visuospatial function, and attention/working memory/processing speed. One-week post-surgery, the prevalence of impaired cognitive domains rose to 28% to 35%, then decreased by three months to levels similar to preoperative rates (12% to 16%). Identifying commonly impaired cognitive domains can inform the selection of cognitive screening tools to assess surgical patients at greater risk for adverse outcomes. <100> Accession Number 2044823785 Title Association of S100B Serum Level With Postoperative Cognitive Dysfunction (POCD) in Non-Cardiac Surgery: A Meta-Analysis Study. Source Health Science Reports. 9(4) (no pagination), 2026. Article Number: e72400. Date of Publication: 01 Apr 2026. Author Asefi S.; Omidi P.; Jazi K.; Fateh A.; Zanjanbar D.B.; Sadeghi S.; Hajiesmaeili M. Institution (Asefi) School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Omidi) Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Jazi) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Fateh) School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran, Islamic Republic of (Zanjanbar) Pharmaceutical Science Research Center, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran, Islamic Republic of (Zanjanbar) GI Pharmacology Interest Group (GPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran, Islamic Republic of (Sadeghi) Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hajiesmaeili) Critical Care Quality Improvement Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background and Aims: Postoperative cognitive dysfunction (POCD) is defined as a persistent decline in cognitive performance after a surgical procedure, for which no cause can be identified. S100B is a calcium-binding protein present in many organs, including the brain. Serum levels have been suggested to be related to POCD. The purpose of this systematic review and meta-analysis is to assess the association between S100B serum levels and cognitive dysfunction after non-cardiac surgeries. Method(s): We conducted a systematic search using PubMed/Medline, Scopus, Web of Science, and Google Scholar databases to identify studies. Studies measuring pre- and post-operative serum S100B levels in patients undergoing non-cardiac surgeries have been included. A random effects model was applied to determine the association of the levels of S100B with POCD. Result(s): Of 280 studies screened, 11 articles were eligible for further analysis. The pooled results for pre- and post-treatment outcomes showed no significant differences. The pooled odds ratios (OR) for POCD after non-cardiac surgeries were 1.77 (95% CI = 1.17-2.67). Subgroup analysis showed that noticeable differences among age (>= 65 and < 65 years) and continent (Asia vs. Europe) groups. The higher OR observed in the >= 65 years' group (OR = 1.94; 95% CI = 0.98-3.84), and studies from Europe (OR = 1.85; 95% CI = 0.79-4.33). Conclusion(s): Overall, current evidence shows that the serum level of S100B is associated with the occurrence of POCD. The S100B monitor may help in the early diagnosis of POCD and the development of preventive strategies. Copyright © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC. <101> [Use Link to view the full text] Accession Number 2044372050 Title The effect of intravenous sodium ferric gluconate complex (Ferrlecit) on outcomes of patients undergoing transcatheter aortic valve implantation: a prospective randomized controlled trial. Source Journal of Cardiovascular Medicine. (no pagination), 2026. Article Number: 10.2459/JCM.0000000000001867. Date of Publication: 2026. Author Bar O.; Zukerman R.; Halhal B.; Marcusohn E. Institution (Bar, Zukerman, Halhal, Marcusohn) Department of Cardiology, Rambam Healthcare Campus (Zukerman, Marcusohn) Technion Israel Institute of Technology, Haifa, Israel Publisher Lippincott Williams and Wilkins Abstract Aims - The aim of this trial was to evaluate whether intravenous sodium ferric gluconate could provide benefit beyond transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis. Methods and results - Between 1 October 2020 and 1 July 2023, we conducted an investigator-initiated, single-center, randomized, single-blind, placebo-controlled trial enrolling patients electively admitted for TAVI due to severe symptomatic aortic stenosis. Patients were randomly assigned to receive intravenous sodium ferric gluconate or a placebo before the procedure and were followed for up to 3 months. After screening, 44 patients were included: 20 patients randomized to intravenous sodium ferric gluconate complex treatment and 24 patients to placebo. There was no difference in the baseline-adjusted 6-min walk distance between the two treatment arms (P = 0.215). Quality-of-life measures such as Kansas City Cardiomyopathy Questionnaire score and New York Heart Association class did not differ between the treatment arms. Conclusion - Treatment with intravenous sodium ferric gluconate did not provide clinical benefit beyond TAVI in patients with severe aortic stenosis. Clinical Trial Registration: ClinicalTrials.gov NCT04797832 Copyright © 2026 Italian Federation of Cardiology - I.F.C. All rights reserved. <102> [Use Link to view the full text] Accession Number 650898189 Title Long-term prognostic impact of atrial fibrillation subtypes in unselected patients undergoing coronary angiography. Source Coronary artery disease. (no pagination), 2026. Date of Publication: 13 Apr 2026. Author Steffen H.J.; Schupp T.; Abumayyaleh M.; Kuhn L.; Steinke P.; Dudda J.; Reinhardt M.; Weidner K.; Rusnak J.; Jannesari M.; Siegel F.; Behnes M.; Akin I. Institution (Steffen, Schupp, Abumayyaleh, Kuhn, Steinke, Dudda, Reinhardt, Weidner, Behnes, Akin) Cardiology, Haemostasis, Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University (Rusnak) Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg, Heidelberg, Germany (Jannesari, Siegel) Department of Biomedical Informatics, Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany Abstract OBJECTIVE: To evaluate the long-term prognostic impact of atrial fibrillation and its subtypes in an unselected cohort undergoing coronary angiography. BACKGROUND: Atrial fibrillation is common in patients undergoing coronary angiography and linked to adverse outcomes, but the long-term prognostic impact of atrial fibrillation subtypes, particularly regarding heart failure risk, remains unclear. METHOD(S): Patients undergoing coronary angiography from 2016 to 2022 were stratified by atrial fibrillation status and subtype (paroxysmal, persistent, permanent, new-onset). The primary endpoint was heart failure-related rehospitalization at 36 months. Secondary endpoints included coronary revascularization, acute myocardial infarction (AMI), and in-hospital all-cause mortality. RESULT(S): Among 7529 patients, 26.8% had atrial fibrillation (i.e. paroxysmal: 37.7%; persistent: 14.8%, permanent: 16.6%, and new-onset atrial fibrillation: 31.0%). Compared with patients without atrial fibrillation, atrial fibrillation patients were older (median 76 vs. 67 years; P = 0.001) and had higher rates of heart failure, chronic kidney disease, and acute heart failure. At 36 months, heart failure-related rehospitalization occurred more frequently in atrial fibrillation patients (30.2 vs. 18.4%; P = 0.001), whereas AMI rates were similar, and coronary revascularization rates were lower. Atrial fibrillation was independently associated with heart failure-related rehospitalization (hazard ratio = 1.246, 95% confidence interval: 1.108-1.400, P = 0.001), but not with coronary revascularization or AMI. H eart failure rehospitalization increased stepwise across atrial fibrillation subtypes, with the highest in permanent atrial fibrillation (42.5%; P = 0.001) and progressively lower risk in persistent (34.8%; P = 0.001), paroxysmal (26.9%; P = 0.001), and new-onset atrial fibrillation (23.6%; P = 0.002). CONCLUSION(S): Atrial fibrillation independently predicts long-term heart failure-related rehospitalization after coronary angiography, highest in permanent followed by persistent atrial fibrillation. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <103> Accession Number 2044780181 Title Intravenous lidocaine reduces systemic inflammation but not myocardial injury following thoracic surgery for lung cancer: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 238. Date of Publication: 01 Dec 2026. Author Zhang N.; Feng D.; Wu W.; Liu M.; Wu J.; Liu J.; Shi H. Institution (Zhang, Feng, Wu, Liu, Wu, Liu, Shi) Department of Anesthesiology, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China Publisher BioMed Central Ltd Abstract Background: Elevated high-sensitivity troponin T levels shortly after noncardiac surgery are closely linked to myocardial injury, a key factor in 30-day postoperative mortality. Intravenous lidocaine, known for its potent anti-inflammatory and membrane-stabilizing properties, has shown cardioprotective potential in other surgical settings, but its efficacy in noncardiac thoracic surgery remains unclear. Objective(s): This study was a double-blind, placebo-controlled randomized trial. Participants were randomly allocated to the lidocaine or placebo group with a 1:1 ratio. Design(s): Single-centre, double-blind, randomized controlled trial. Setting(s): Academic tertiary care medical centre. Patient(s): Patients scheduled for noncardiac thoracic surgery, predominantly via video-assisted thoracoscopic surgery (VATS), under general anesthesia from June 12, 2021 to June 12, 2022. Intervention(s): Patients received intravenous lidocaine (1.5 mg kg- 1 bolus pre-induction followed by 1.5 mg kg- 1 h- 1 infusion until surgery end) or volume-matched saline. Dosing was adjusted to ideal body weight for BMI >= 25 kg m-2. Study drugs were prepared by blinded staff and administered via standardized pumps. Main Outcome Measure(s): The primary outcome was high-sensitivity troponin T concentration at 24 h postoperatively. Secondary outcomes encompassed: (1) the absolute change from baseline to 24 h post-surgery for high-sensitivity troponin T (2) the occurrence of MINS, identified by high-sensitivity troponin T levels of 14 ng l- 1 or higher within 48 h after surgery; (3) levels of NT-proBNP, CK-MB, myoglobin, hs-CRP, and inflammatory markers on the first and second postoperative days; (4) overall opioid use during surgery; and (5) hemodynamic parameters during the operation. Result(s): Between June 12, 2021, and June 12, 2022, we enrolled 119 patients who underwent thoracic surgery for lung cancer (mean age 59.41 years [SD 11.085], 58 [48.7%] male). The median [IQR] 24-hour high-sensitivity troponin T level did not differ between the lidocaine and control groups (8.00 [6.00-15.00] ng l- 1 vs. 8.00 [5.00-10.00] ng l- 1, P = 0.34). Additionally, the absolute change in hs-TnT from baseline showed no significant difference (3.21 +/- 5.93 ng l-1 vs. 3.00 +/- 8.56 ng l-1, P = 0.88).The incidence of MINS was similar between the groups (23.3% vs. 23.7%, P = 0.96). Lidocaine exhibited significant anti-inflammatory properties, resulting in an 84.8% reduction in 48-hour IL-6 levels (46.5 +/- 33.6 pg ml- 1 vs. 307.0 +/- 312.2 pg ml- 1, P = 0.04). In a post-hoc analysis, age was identified as a significant independent predictor of myocardial injury (OR 0.259 for age < 65 vs. >= 65 years; 95% CI 0.107 to 0.627; P = 0.003), but no evidence of an interaction with the treatment allocation was found. Conclusion(s): Perioperative lidocaine infusion significantly suppressed systemic inflammation, but did not reduce early myocardial biomarker release in the overall cohort. The finding that younger age was associated with a lower risk of myocardial injury, irrespective of treatment group, suggests that age is a key prognostic factor. Further studies are warranted to explore age-specific cardioprotective strategies and the underlying mechanisms of inflammatory-myocardial coupling. Trial registration: ChiCTR2100047336. Registered on June 12, 2021. Copyright © The Author(s) 2026. <104> [Use Link to view the full text] Accession Number 2043505328 Title Preoperative and Intraoperative Risk Factors for Postoperative Pneumonia After Cardiac Surgery: An Ancillary Study of the STERNOCAT (Catheter Outcomes With Sternotomy Cardiac Operated) Randomized Trial and a Systematic Review With Meta-Analysis. Source Critical Care Medicine. Publish Ahead of Print (no pagination), 2026. Date of Publication: 11 Feb 2026. Author Dureau P.; Rombi L.; Ouorou R.; Hariri G.; Duceau B.; Amour J.; Bougle A.; Dechartres A. Institution (Dureau, Rombi, Hariri, Duceau, Bougle) GRC 29, Clinical Research Group in Anesthesiology, Critical Care and Perioperative Medicine, ARPE, Sorbonne University, Paris, France (Dureau, Rombi, Hariri, Duceau, Bougle) Department of Anesthesiology and Critical Care, AP-HP, Pitie Salpetriere Hospital, DMU DREAM, Paris, France (Dureau, Hariri, Dechartres) Department of Public Health, Sorbonne University, INSERM, Pierre Louis Institute of Epidemiology and Public Health, AP-HP, Pitie Salpetriere Hospital, AP-HP Center for Pharmacoepidemiology (Cephepi), Paris, France (Ouorou) Public Health Department, Pitie-Salpetriere Hospital, APHP, Paris, France (Amour) Institute of Perfusion, Critical Care and Cardiac Surgery Anesthesia, IPRA, Ramsay Sante, Jacques Cartier Private Hospital, Massy, France Publisher Lippincott Williams and Wilkins Abstract Objective: - Postoperative pneumonia (POP) is a frequent complication after cardiac surgery, which significantly worsens prognosis. This study aimed to identify preoperative and intraoperative factors independently associated with POP in a cardiac surgery cohort, perform a systematic review (SR) and meta-analysis of risk factors, outcomes, and predictive models, and validate these models in the cohort. Design(s): - This is an ancillary study of the STERNOCAT (Catheter Outcomes With Sternotomy Cardiac Operated) trial completed by an SR and meta-analysis. PubMed, Embase, and Cochrane Library were searched (January 2000 to March 31, 2025). Two reviewers independently screened references to identify studies on adult cardiac surgery patients assessing POP risk factors or predictive models, extracted data, and assessed methodological quality. Predictive models identified through the SR were externally validated using the STERNOCAT cohort. Setting(s): - Cardiac surgery units in France (STERNOCAT cohort) and international hospital settings (SR studies). Patient(s): - A total of 1, 470 patients from the STERNOCAT cohort and 172, 079 from 24 studies overall were included in the SR. Intervention(s): - None. Measurements and Main Results: - In the STERNOCAT ancillary study, 78 of 1470 patients developed POP (5.3%). Independent risk factors included ischemic cardiomyopathy (odds ratio [OR] 1.89, 95% CI [1.13-3.16]), cardiopulmonary bypass (CPB) duration (OR 1.10, 95% CI [1.02-1.18]), and catecholamine use (OR 4.07, 95% CI [2.45-6.76]). POP was associated with higher 30-day mortality (14.1% vs. 1.5%, p < 0.0001). The meta-analysis identified 14 significant risk factors for POP. Of these, 10 were non-modifiable (e.g., age, diabetes mellitus, chronic obstructive pulmonary disease, chronic renal disease, previous cardiac surgery, emergency surgery). Four were partially modifiable: active smoking, CPB duration, intraoperative transfusions (presence and amount). Only one model, limited to preoperative variables, could be externally validated and showed poor accuracy. Conclusion(s): - This study highlights the difficulty of predicting and preventing POP, as most identified risk factors are non-modifiable or require long-term preventive strategies. Perioperative optimization, particularly regarding CPB management and transfusion practices, therefore, remains essential to improving patient outcomes. Registration: - PROSPERO (CRD42024555519). Copyright © 2026 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. <105> Accession Number 2044730641 Title Systematic Review and Meta-Analysis of the Frequency of Thromboembolic Events, Bleeding, and Mortality in Patients with Atrial Fibrillation and End-Stage Renal Disease Undergoing Percutaneous Left Atrial Appendage Closure. Source Journal of Clinical Medicine. 15(7) (no pagination), 2026. Article Number: 2641. Date of Publication: 01 Apr 2026. Author Martinez-Arango J.M.; Rojas-Echavarria L.M.; Garcia-Mejia C.; Castrillon-Spitia J.D.; Higuita-Gutierrez L.F. Institution (Martinez-Arango, Garcia-Mejia, Castrillon-Spitia) Internal Medicine, School of Medicine, Universidad Cooperativa de Colombia, Medellin-Envigado Campus, Medellin, Colombia (Rojas-Echavarria) Medicine, School of Medicine, Universidad CES, Medellin Campus, Medellin, Colombia (Higuita-Gutierrez) Research Unit, School of Medicine, Universidad Cooperativa de Colombia, Medellin-Envigado Campus, Medellin, Colombia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Atrial fibrillation (AF) and end-stage renal disease (ESRD) are closely related conditions that increase the risk of disability, stroke, and mortality. Anticoagulation management in patients with ESRD and AF is challenging due to the high risk of bleeding. Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative to reduce thromboembolic events; however, evidence in this specific population remains limited. Therefore, we aimed to evaluate the frequency of thromboembolic events, bleeding complications and mortality in patients with AF and ESRD undergoing LAAC through a systematic review and meta-analysis. Method(s): A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines and registered in PROSPERO (CRD420250640241). A structured search was performed in Medline, EMBASE, Web of Science, SCOPUS, LILACs and institutional repositories through September 2024, with no language restrictions. We included original studies reporting frequencies of thromboembolic events, bleeding and mortality in patients with AF and ESRD undergoing LAAC. A random-effects model was used and heterogeneity was assessed using the I2 statistic. Result(s): Fourteen studies were included in the qualitative analysis and seven in the quantitative synthesis, comprising a total of 2433 patients with AF and ESRD undergoing LAAC. In the qualitative analysis, the mean age was 74 +/- 7.6 years; the most common comorbidities were hypertension (74%), diabetes mellitus (47%), and dyslipidemia (53%). WatchmanTM devices predominated in North America, whereas AmuletTM devices were more frequently used in Europe and Latin America. Procedural success was 98.4%, with infrequent periprocedural complications: major bleeding in 1.6% and device embolization in 0.5%. In the quantitative analysis, the pooled frequency of thromboembolic events was 3% (95% CI: 1-7%; I2 = 81.1%), pooled bleeding frequency was 6% (95% CI: 4-10%; I2 = 76.9%), and pooled mortality was 5% (95% CI: 1-22%; I2 = 97.8%). After excluding studies with extreme values, adjusted mortality was 2% (95% CI: 1-5%; I2 = 76.6%). Despite high heterogeneity, the findings suggest that LAAC may offer protection against embolic events with an acceptable bleeding risk. Conclusion(s): LAAC in patients with AF and ESRD is associated with a low frequency of thromboembolic events and bleeding when compared with standard anticoagulation therapy and no treatment. Overall mortality is moderate and appears to be primarily attributable to underlying comorbidity rather than the procedure itself. This meta-analysis provides evidence that LAAC may be a safe and effective therapeutic strategy in patients with contraindications or high risk for chronic anticoagulation. However, prospective and comparative clinical trials are needed to confirm these findings and inform future clinical practice guidelines. Copyright © 2026 by the authors. <106> Accession Number 650887946 Title Real-World Outcomes of Transcatheter Tricuspid Valve Replacement: Analysis From the STS/ACC TVT Registry. Source JAMA. (no pagination), 2026. Date of Publication: 13 Apr 2026. Author Makkar R.R.; Gupta A.; O'Neill B.P.; Lalani C.; Sharma R.P.; Yadav P.; Frisoli T.M.; Thourani V.; Makar M.; Eleid M.F.; Lee J.; Babaliaros V.C.; Haeffele C.; Bajwa T.K.; Flueckiger P.; Cubeddu R.J.; Davidson L.J.; Padang R.; Spinetto P.V.; Allaqaband S.; Narang A.; Williams M.; Gleason P.; Tang G.H.L.; Khera S.; Vavalle J.P.; Byku I.; Depta J.P.; Garcia S.; Kapadia S.; Zajarias A.; Chanin J.M.; Kodali S.K.; Herrmann H.C.; Morse M.A.; Petrossian G.; Sivak J.A.; Hahn R.T.; Song Y.; Leon M.B.; Yeh R.W.; Davidson C.J. Institution (Makkar, Gupta, Makar) Cedars-Sinai Medical Center, Los Angeles, CA, United States (O'Neill, Frisoli, Lee, Spinetto) Henry Ford Heart & Vascular Institute, Henry Ford Hospital, Detroit, MI, United States (Lalani, Song, Yeh) Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Sharma, Haeffele) Division of Cardiovascular Medicine, Stanford University/Stanford Health Care, Stanford, CA, United States (Yadav, Thourani, Flueckiger) Piedmont Heart Institute, Piedmont Atlanta Hospital, Atlanta, Georgia (Eleid, Padang) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Babaliaros, Gleason, Byku) Structural Heart and Valve Center, Emory University School of Medicine, Atlanta, Georgia (Bajwa, Allaqaband) Aurora St Luke's Medical Center, Milwaukee, WI, United States (Cubeddu) Naples Comprehensive Health Heart Institute, Naples, FL, Puerto Rico (Davidson, Narang, Davidson) Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine/Northwestern Medicine, Chicago, IL, United States (Davidson) Edwards Lifesciences, Irvine, CA, United States (Williams) New York University Langone Medical Center, NY, United States (Tang, Khera) Mount Sinai Health System, NY, United States (Vavalle, Sivak) Division of Cardiology, University of North Carolina at Chapel Hill (Depta) Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, United States (Garcia) Christ Hospital, Cincinnati, OH, United States (Kapadia) Department of Cardiovascular Medicine and Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States (Zajarias) Cardiovascular Division, Washington University School of Medicine, St Louis, MO, United States (Chanin) Intermountain Health Heart & Vascular Institute, Denver, CO, United States (Kodali, Hahn, Leon) Columbia University Irving Medical Center and Cardiovascular Research Foundation, NY, United States (Herrmann) Hospital of the University of Pennsylvania, Philadelphia, United States (Morse) Ascension Saint Thomas Hospital, Nashville, TN, United States (Petrossian) St Francis Hospital & Heart Center, Roslyn, NY, United States Abstract Importance: Transcatheter tricuspid valve replacement (TTVR) demonstrated superior outcomes over medical therapy in patients with severe tricuspid regurgitation (TR) in the Edwards EVOQUE Transcatheter Tricuspid Valve Replacement: Pivotal Clinical Investigation of Safety and Clinical Efficacy Using a Novel Device II (TRISCEND II) randomized clinical trial, and received regulatory approval in the US in 2024. Contemporary real-world data on its effectiveness and safety remain limited. Objective(s): To evaluate 30-day clinical, echocardiographic, and health status outcomes of TTVR in real-world use. Design, Setting, and Population: Retrospective cohort study of all consecutive patients who underwent TTVR in the US from February 2024 through March 2025 in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Patients had symptomatic, severe TR despite optimal medical therapy and TTVR was deemed appropriate by a heart team. Statistical analysis was conducted from September 2025 to February 2026. Exposure: Device-enabled TTVR. Main Outcomes and Measures: Thirty-day event rates (all-cause death, stroke, bleeding, new cardiac implantable electronic device [CIED] implantation, heart failure hospitalizations), TR reduction, and changes in health status (New York Heart Association [NYHA] functional class and Kansas City Cardiomyopathy Questionnaire Overall Summary [KCCQ-OS] score) are reported. Subgroup analyses examined the impact of baseline CIED status on outcomes. Result(s): Among 1034 attempted procedures at 82 centers (mean [SD] age, 77.1 [10.6] years; 69.1% female; 73.2% NYHA functional class III/IV), a valve was successfully implanted in 1017 patients (98.4%). Mild or less TR was achieved in 98.4% of patients post procedure and in 97.7% at 30 days. At 30 days, all-cause mortality was 3.1%; stroke, 0.2%; bleeding, 7.9%; new CIED, 15.9% in CIED-naive patients; and heart failure hospitalization, 3.1%. There were significant improvements in NYHA functional class (class I/II, 82.7%; P < .001) and mean KCCQ-OS score (22.4 points; P < .001) from baseline to 30 days. There were no significant differences in 30-day mortality (P = .47), heart failure hospitalization (P > .99), and functional outcomes (P = .55) when patients were stratified by baseline CIED status. Conclusions and Relevance: Early US real-world experience with TTVR confirms safety and effectiveness in patients with severe TR. Thirty-day outcomes are consistent with the TRISCEND II pivotal trial, demonstrating acceptable safety, near-complete TR elimination, and significant health status improvements in an older, comorbid population. Rates of new CIED implantation and bleeding were lower than randomized clinical trial experience. <107> Accession Number 2044830265 Title Plasmalyte versus ringer's lactate for postoperative renal function and acid-base balance in hypertensive patients on ACEI/ARB therapy: A randomized controlled trial. Source Indian Journal of Clinical Anaesthesia. 13(2) (pp 257-263), 2026. Date of Publication: 2026. Author Madigela N.; Sudhamala P.; Patki A.Y.; Yadav M.; Durga P. Institution (Madigela, Sudhamala, Patki, Yadav, Durga) Dept. of Anaesthesiology, Nizam's Institute of Medical Sciences, Telangana, Hyderabad, India Publisher IP Innovative Publication Pvt. Ltd. Abstract Background and Aims: Preoperative discontinuation of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) is advised to prevent intraoperative hypotension. However, this withdrawal may reduce renal perfusion and increase the risk of acute kidney injury (AKI). Balanced crystalloids are preferred in such patients. Although Plasmalyte demonstrates advantages over Ringer's Lactate (RL) in surgical populations, its effects in patients on chronic ACEI/ARB therapy remain unclear. This study aimed to compare the effects of Plasmalyte and Ringer's Lactate on postoperative renal function and acid-base balance in hypertensive patients on long-term ACEI/ARB therapy undergoing elective surgery under general anesthesia. Material(s) and Method(s): This prospective, observer-blinded randomized controlled trial was conducted in a tertiary care hospital. Two hundred hypertensive adults (ASA physical status I-II) on ACEI/ARB therapy for at least three months were randomized to receive Plasmalyte (n=100) or Ringer's Lactate (n=100) intraoperatively as the sole intravenous fluid. Estimated glomerular filtration rate (eGFR), pH, standard base excess, serum creatinine, potassium, chloride and lactate were measured preoperatively, one hour and 24 hours postoperatively. Result(s): At 24 hours postoperatively, eGFR was significantly better preserved in the Plasmalyte group compared to the Ringer's Lactate group (71.5+/-7.5 vs. 66.6+/-6.3 mL/min/1.73m2; p=0.024). The Ringer's Lactate group demonstrated a mild, clinically insignificant rise in lactate at one hour (1.96+/-0.50 vs. 1.59+/-0.55 mmol/L; p=0.016) and mild acidosis at one hour (pH 7.36+/-0.07 vs. 7.39+/-0.06; p=0.002) and 24 hours postoperatively (pH 7.33+/-0.08 vs. 7.37+/-0.06; p=0.0001). Serum electrolytes and creatinine values were comparable between the two groups at all time points. Conclusion(s): In ACEI/ARB-treated hypertensive patients undergoing elective non-cardiac surgery, Plasmalyte provides better preservation of eGFR and more stable acid-base status compared to Ringer's Lactate, suggesting a renal and metabolic advantage in this population. Copyright © 2026 The Author(s) <108> Accession Number 2044739351 Title Impact of prevention of postoperative pulmonary complications with penehyclidine inhalation on long-term outcomes in high-risk patients: follow-up of a randomized trial. Source Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Liang X.-Q.; Han L.; Yan T.; Shao C.-L.; Ma J.-H.; Yu K.-Y.; Wang D.-X. Institution (Liang, Han, Shao, Ma, Wang) Department of Anesthesiology, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, China (Yan) Department of Critical Care Medicine, Peking University First Hospital, Beijing, China (Yu) Department of Respiratory and Critical Medicine, Peking University First Hospital, Beijing, China (Wang) Outcomes Research Consortium, Houston, TX, United States Publisher Springer Abstract Purpose: Postoperative pulmonary complications are common and associated with worse long-term outcomes. In our previous trial, prophylactic penehyclidine inhalation reduced pulmonary complications in high-risk patients. Herein, we tested the hypothesis that penehyclidine inhalation might also improve long-term survival after surgery. Method(s): This was a long-term follow-up of a randomized trial. We enrolled 864 patients aged more than 50 years who were scheduled for major upper-abdominal or non-cardiac thoracic surgery and judged to be at high risk of pulmonary complications. Participants were randomized to receive either penehyclidine or placebo inhalation during the perioperative period. The primary endpoint was overall survival after surgery. Secondary endpoints included recurrence-free and event-free survivals. Result(s): Among patients included in the underlying trial, 826 (mean age 64 years, 63.0% male, and 87.2% had cancer surgery) completed long-term follow-up (median 56 months). At the end of the follow-up period, there were 132 deaths among 417 patients (31.7%) given penehyclidine compared with 127 deaths among 409 patients (31.1%) given placebo (hazard ratio 1.01; 95% CI 0.79-1.28; P = 0.958). Recurrence-free survival was 153/417 (36.7%) with penehyclidine versus 147/409 (35.9%) with placebo (hazard ratio 1.01; 95% CI 0.81-1.27; P = 0.934). Event-free survival was 187/417 (44.8%) with penehyclidine versus 174/409 (42.5%) with placebo (hazard ratio 1.04; 95% CI 0.85-1.28; P = 0.689). Conclusion(s): In high-risk patients undergoing major upper-abdominal or non-cardiac thoracic surgery mainly for cancer, prophylactic penehyclidine inhalation did not improve long-term survival. Current evidence does not support its routine perioperative use to enhance long-term outcomes in this population. Trial registration: ClinicalTrial.gov Identifier: NCT03868709; March 3, 2019. Copyright © The Author(s) 2026. <109> Accession Number 2044927160 Title Anticoagulation Management in Hemodialysis Patients with Atrial Fibrillation: A Clinical Dilemma. Source Current Vascular Pharmacology. (no pagination), 2026. Date of Publication: 2026. Author Triantafyllidou M.; Stamellou E.; Roumeliotis S.; Leivaditis K.; Dounousi E. Institution (Triantafyllidou, Stamellou, Dounousi) Department of Nephrology, University Hospital of Ioannina, School of Health Sciences, University of Ioannina, Ioannina, Greece (Stamellou) Department of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany (Roumeliotis, Leivaditis) 2nd Department of Nephrology, AHEPA Hospital, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece Publisher Bentham Science Publishers Abstract Atrial Fibrillation (AF) is the most common cardiac arrhythmia and is increasingly prevalent among patients on haemodialysis (HD). It presents a significant clinical challenge due to the elevated risks of both thromboembolic and bleeding events. Although the shift from Vitamin K Antagonists (VKAs) to Direct Oral Anticoagulants (DOACs) is well established in the general population and in patients with moderate Chronic Kidney Disease (CKD), uncertainty persists in HD patients due to limited evidence. This review synthesizes current evidence on anticoagulation therapy in HD patients with AF, evaluating safety, efficacy, and clinical guidelines to inform evidence-based decision-making. We reviewed current evidence, including randomized controlled trials (RCTs), observational studies, meta-analyses, and systematic reviews, on anticoagulation in HD patients with AF. Relevant articles published up to December 2024 were identified via PubMed, Cochrane Library, and EMBASE. Key clinical guidelines (KDIGO, ESH, ACC/AHA/ACCP/HPS) were also included. Overall, evidence in HD patients remains heterogeneous. Small RCTs evaluating DOACS have methodological limitations and conflicting results. However, meta-analyses and large cohort studies show that VKAs do not significantly reduce ischemic stroke or mortality in this population and may increase haemorrhagic risk; poor time-in-therapeutic range is a recurring problem. In contrast, accumulating evidence increasingly favors DOACs, with signals of lower bleeding and at least comparable stroke prevention. Left atrial appendage occlusion (LAAO) is an emerging option that may reduce stroke risk without long-term anticoagulation. While definitive randomized evidence in HD remains lacking, the current data balance suggests a cautious preference for DOACs over VKAs. Further adequately powered RCTs in HD are needed to solidify these recommendations. Copyright 2026, Bentham Science Publishers <110> [Use Link to view the full text] Accession Number 2044255800 Title Pharmacokinetic Modeling of Ticagrelor and Ticagrelor Active Metabolite Removal by the DrugSorb-ATR Device in a Randomized Controlled Study of Patients Undergoing Cardiac Surgery. Source Journal of Cardiovascular Pharmacology. 87(2) (pp 105-113), 2026. Date of Publication: 01 Feb 2026. Author Mould D.R.; Sweeney K.R.; Prats J.; Fan W.; Schneider D.J.; Storey R.F.; Deliargyris E.N. Institution (Mould, Sweeney) Projections Research, Phoenixville, PA, United States (Sweeney) Sweeney Consulting, East Lyme, CT, United States (Prats) Elysis, LLC, Carlisle, MA, United States (Fan, Schneider, Deliargyris) CytoSorbents Corporation, Princeton, NJ, United States (Schneider, Deliargyris) Department of Medicine, Cardiovascular Research Institute, University of Vermont, Burlington, VT, United States (Storey) Cardiovascular Research Unit, University of Sheffield, Sheffield, United Kingdom Publisher Lippincott Williams and Wilkins Abstract Abstract: - Excessive surgical bleeding is a potential risk in patients taking ticagrelor who must undergo urgent cardiothoracic (CT) surgery before adequate washout of the drug can occur. The DrugSorb-Antithrombotic removal (ATR) device is a polymer sorbent-filled hemoadsorption cartridge that can remove unbound (active) fractions of ticagrelor and ticagrelor active metabolite (TAM) from blood. STAR-T was a randomized double-blind sham-controlled clinical trial investigating whether the intraoperative use of the device could reduce perioperative bleeding complications in patients undergoing CT surgery within 2 days of ticagrelor discontinuation. Blood samples were collected during the study for total drug level measurements because the ability to measure unbound ticagrelor and TAM (0.2% of total levels) requires an ultra-high sensitivity assay, which is not commercially available. A published and validated pharmacokinetic (PK) model was used to explore the effect of the device on unbound ticagrelor/TAM using the total drug concentrations from the study. The model performed well for simulations of total ticagrelor and TAM, which indicated that the unbound concentrations were also appropriate. The model demonstrated that DrugSorb-ATR significantly reduced unbound ticagrelor and TAM concentrations. Linear and logistic regression analyses of summed ticagrelor and TAM concentrations showed that the DrugSorb-ATR device reduced the probability of clinically relevant bleeding in STAR-T because of the reduction in unbound ticagrelor and TAM. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <111> Accession Number 2043546710 Title Left atrial appendage closure (LAAC) in cancer patients: A systematic review and meta-analysis. Source Journal of Clinical Oncology. Conference: ASCO ANNUAL MEETING. Chicago United States. 43(16 Supplement) (no pagination), 2025. Article Number: e24010. Date of Publication: 01 Jun 2025. Author Devkota A.; Shrestha A.B.; Kc A.; Mohamed S.; Jaiswal V.; Shrestha S.; Rohita D. Institution (Devkota) Medstar Union Memorial Hospital, Baltimore, MD, United States (Shrestha) Medical Research Hub, Kathmandu, Nepal (Kc) Mayo Clinic, Jacksonville, FL, United States (Mohamed) Wayne State University/ DMC Sinai Grace, Detroit, MI, United States (Jaiswal) JCCR, Varanasi, India (Shrestha) Kist Medical College and Teaching Hospital, Lalitpur, Nepal (Rohita) Wyckoff Heights Medical Center, Brooklyn, NY, United States Publisher Lippincott Williams and Wilkins Abstract Background: Cancer increases the risk of atrial fibrillation (AF), particularly in patients over 65 or those with pre-existing cardiovascular disease. Patients with active cancer are at a higher risk of arterial and venous thrombosis. Oral anticoagulation (OAC) is recommended in most patients with comorbidities, based on the CHA2DS2-VASc score. However, because OAC raises the risk of bleeding, it might not be appropriate for patients who have significant or frequent bleeding episodes, vascular malformations, or other contraindications. Anticoagulation in cancer patients is challenging due to thrombocytopenia, bleeding risks, and interactions with chemotherapy. Left atrial appendage Closure (LAAC) offers an alternative to anticoagulation for mitigating stroke risk in nonvalvular AF patients. However, this procedure has been offered less frequently as concerns regarding its prognosis among cancer patients remain unclear. This article aims to find the prognosis of cancer patients with LAAC. Method(s): A systematic search was conducted in electronic databases from inception until June 2024 using appropriate Mesh terms. Pooled risk ratios (RR) with their corresponding 95% confidence intervals (CI) were calculated using random effects models. A p-value of <0.05 was considered statistically significant. Result(s): A total of 5 studies with a population of 1, 20, 502 (Cancer Patients: 3803 and Non- Cancer patients: 116699) were included which met all the inclusion criteria. An increased risk of in-hospital mortality among cancer patients with LAAC (RR=1.90; 95% CI=1.05-3.45, P=0.03) with statistically significant was observed. However, other parameters were comparable including, 30 days readmission (RR=1.12; 95% CI=0.95-1.032), all-cause mortality (RR=1.33; 95% CI=0.72-1.95), any bleeding complication (RR=1.04; 95% CI=0.37-1.70), Cardiovascular complication (RR=1.44; 95% CI=0.51-4.06), thromboembolism (RR= 2.28; 95% CI=0.57-9.06), and neurological complication (RR=0.81; 95% CI=0.17-1.46). Conclusion(s): There were increased chances of in-hospital mortality among cancer patients than in non-cancer patients with LAAC procedures. However, other parameters like cardiovascular complications, any bleeding complications, thromboembolism, and neurological complications were not significantly associated. Further studies are warranted to validate these findings. Copyright © 2025 American Society of Clinical Oncology <112> [Use Link to view the full text] Accession Number 2044447820 Title Efficacy and safety of invasive versus noninvasive treatments in elderly patients with non-ST-segment myocardial infarction: a systematic review and meta-analysis. Source Coronary Artery Disease. (pp 206-214), 2026. Date of Publication: 2026. Author Malik S.; Mufaddal Z.Q.; Koskina L.; Siddiqui O.M.; Mansour M.; Nusrat K.; Khan R.; Sohail M.U.; Farhan S.H.; Singh D.; Ali E.; Hameed I. Institution (Malik, Mufaddal, Siddiqui, Khan, Sohail, Farhan, Ali) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Koskina, Mansour, Singh, Hameed) Department of Medicine, Medstar Health, Baltimore, Maryland, United States (Nusrat) Department of Medicine, University at Buffalo-Catholic Health System, Buffalo, NY, United States Publisher Lippincott Williams and Wilkins Abstract Historically, the elderly population was underrepresented in clinical trials evaluating the optimal treatment for non-ST-segment elevation myocardial infarction (NSTEMI). Therefore, we aimed to compare invasive versus noninvasive strategies for the management of NSTEMI in older adults. Methods - PubMed, SCOPUS, and Cochrane Central Register of Controlled Trials were screened for studies evaluating medical therapy or invasive revascularization in elderly patients with NSTEMI. Following outcomes were extracted: all-cause mortality, cardiovascular death, fatal or nonfatal MI, repeat coronary revascularization, major adverse cardiovascular events (MACE), bleeding, stroke, noncardiovascular death, and repeat hospitalization for heart failure. Data were pooled using random-effects model to evaluate weighted mean differences and risk ratios with 95% confidence intervals (CIs). This study is registered with PROSPERO, CRD42024622236. Results - Seven studies (n = 2997 patients) were included. Patients treated with medical versus invasive therapies showed no significant difference in all-cause mortality (risk ratio: 1.05, 95% CI: 0.94-1.18, P = 0.37); however, invasive therapies significantly decreased the risk of fatal or nonfatal MI (risk ratio: 0.75, 95% CI: 0.59-0.96, P = 0.02), repeat coronary revascularizations (risk ratio: 0.29, 95% CI: 0.21-0.40, P < 0.00001), and risk of MACE (risk ratio: 0.74, 95% CI: 0.61-0.89, P = 0.002). Lastly, invasive therapies were associated with increased risk of bleeding. Conclusion - Invasive therapy, in comparison to medical management, has reduced incidence of fatal or nonfatal MI, MACE, and the need for revascularization; however, no benefit was noted for all-cause and cardiovascular mortality. Age-specific guidelines must be established for the management of NSTEMI among older adults. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <113> Accession Number 650884394 Title Individualised positive end-expiratory pressure to minimise driving pressure and postoperative pulmonary complications in minimally invasive thoracic and abdominal surgery a systematic review and meta-analysis. Source British journal of anaesthesia. (no pagination), 2026. Date of Publication: 10 Apr 2026. Author Abbott M.; Ma R.; Chakera H.; Kishibe T.; Girard M.; Turgeon A.F.; Serpa Neto A.; Sklar M.C.; Sankar A. Institution (Abbott) Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada (Ma) Michael G. Degroote School of Medicine, McMaster University, Hamilton, ON, Canada (Chakera) Schulich School of Medicine and Dentistry, Western University, London, ON, Canada (Kishibe) Library Services, St. Michael's Hospital, Toronto, ON, Canada (Girard) Department of Anesthesiology, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada; Division of Critical Care Medicine, Department of Medicine, Centre Hospitalier de l'Universite de Montreal, Montreal, QC, Canada; Imaging and engineering, CHUM Research Center, Montreal, QC, Canada (Turgeon) Department of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Faculty of Medicine, Universite Laval, Quebec City, QC, Canada; CHU de Quebec - Universite Laval Research Center, Population Health and Optimal Health Practices Research Unit (Trauma - Emergency - Critical Care Medicine), Universite Laval, Quebec City, QC, Canada (Serpa Neto) Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia; Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia; Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, VIC, Australia; Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Sklar) Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, St. Michael's Hospital, Toronto, ON, Canada; Department of Anesthesia, Unity Health Toronto - St. Michael's Hospital and Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada (Sankar) Keenan Research Center, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada; Department of Anesthesia, Unity Health Toronto - St. Michael's Hospital and Department of Anesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada Abstract BACKGROUND: Mechanical ventilation during minimally invasive surgery is associated with postoperative pulmonary complications. Limiting driving pressure appears to reduce pulmonary complications with lung-protective ventilation strategies. Whether individualising PEEP minimises driving pressure to reduce pulmonary complications is unknown. In this systematic review, we assessed whether individualised PEEP strategies during minimally invasive surgery reduce postoperative pulmonary outcomes and driving pressures or both. METHOD(S): We searched Medline, Central, LILACS, Embase, and Scopus for studies comparing individualised PEEP to lung-protective ventilation in minimally invasive thoracic and abdominal surgery (PROSPERO CRD42023495377). The primary outcome was postoperative pulmonary complication. Random-effects models generated risk ratios (RRs) with 95% confidence intervals (95% CIs) for binary outcomes. We conducted prespecified subgroup analyses by surgery type and post hoc subgroup analyses by individualised PEEP strategy and patient factors. We compared driving pressure differences between individualised PEEP and lung-protective strategies. Statistical heterogeneity was assessed using the I2 index and the risk of bias with Cochrane (RoB2) and ROBINS-I. RESULT(S): Thirty studies were included (n=3295 participants). Individualised PEEP was associated with reduced risk of postoperative pulmonary complications, compared with lung-protective ventilation (RR=0.67, 95% CI=0.56-0.79, I2=0.4%). This association was consistent in abdominal and thoracic surgery, and in subgroup analyses. Individualised PEEP was associated with lower driving pressures (mean difference= -3.17, 95% CI= -3.84 to -2.50); I2=86.6%). The certainty of evidence for PPCs was moderate, with a low risk of bias. CONCLUSION(S): Individualised PEEP was associated with fewer postoperative pulmonary complications and lower driving pressures during minimally invasive surgery; showing causality requires further research. Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved. <114> [Use Link to view the full text] Accession Number 2043635052 Title Impaired Cognitive Domains in Surgical Patients: A Systematic Review and Meta-Analysis. Source Anesthesia and Analgesia. (no pagination), 2026. Date of Publication: 16 Feb 2026. Author Park S.; Yan E.; Martinez-Rodriguez R.; Desai B.; Chung J.; Saripella A.; Englesakis M.; Fishman K.N.; Chung F. Institution (Park, Martinez-Rodriguez, Desai, Chung) Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Yan, Saripella, Chung) Department of Anesthesia and Pain Medicine, Krembil Research Institute, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada (Yan, Chung) Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Englesakis) Library & Information Services, University Health Network, Toronto, Ontario, Canada (Fishman) Neuropsychology & Cognitive Health, Baycrest Hospital, Toronto, Ontario, Canada (Fishman) Ontario Shores Centre for Mental Health Sciences, Whitby, Ontario, Canada Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Cognitive impairment is a highly prevalent but frequently overlooked issue among surgical patients preoperatively. This systematic review and meta-analysis aimed to (1) determine the perioperative prevalence of impaired cognitive domains in surgical patients, (2) explore perioperative changes in the different domains, and (3) examine postoperative outcomes associated with preoperatively impaired cognitive domains. METHOD(S): - Five electronic databases were searched from inception to March 19, 2024. Inclusion criteria were (1) surgical patients >=18 years of age; (2) preoperative cognitive assessments using a neuropsychological battery; (3) reported the prevalence of impairment in specific cognitive domains or changes perioperatively; and (4) sample size of >=100 surgical patients. The exclusion criteria included studies involving neurological surgery; cross-sectional, case-control, and case series studies; non-English articles; and studies with overlapping data. RESULT(S): - In total, of the 12, 082 articles identified from 5 databases, 21 studies (5725 patients, 11 non-cardiac surgery studies, and 10 cardiac surgery studies) were included. Among the 6 cognitive domains assessed preoperatively, the pooled prevalence of impairment was highest in executive function (18%; 95% CI, 13%-24%), visuospatial function (16%; 95% CI, 6%-26%), and attention/working memory/processing speed (14%; 95% CI, 9%-18%). Perceptual-motor control (13%; 95% CI, 9%-36%), language (13%; 95% CI, 8%-17%), and learning/memory (12%; 95% CI, 8%-16%) had lower pooled prevalence. The cognitive domains that were assessed postoperatively showed a high prevalence of impairment at 1 week, with 35% (95% CI, 4%-66%) in attention/working memory/processing speed, 34% (95% CI, 16%-51%) in executive function, and 28% (95% CI, 16%-40%) in learning/memory. The pooled prevalence subsequently decreased within 3 months to 16% (95% CI, 3%-35%) in attention/working memory/processing speed, 15% (95% CI, 6%-24%) in executive function, and 12% (95% CI, -2% to 25%) in learning/memory. CONCLUSION(S): - The prevalence of preoperatively impaired cognitive domains was the highest in executive function, followed by visuospatial function and attention/working memory/processing speed. Identifying commonly impaired cognitive domains may help optimize cognitive assessments in the perioperative setting. Further research is needed to clarify the clinical utility of assessing specific cognitive domains in surgical populations to improve postoperative outcomes and reduce cognitive deterioration. Copyright © 2026 Emerald Publishing Limited <115> Accession Number 650879879 Title Methods and criteria for evaluating the success of surgical left atrial appendage closure: A systematic review. Source European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. (no pagination), 2026. Date of Publication: 08 Apr 2026. Author Vad R.; Gosvig K.; Beetham R.; Hansson N.H.; Whitlock R.; Riber L.P.S. Institution (Vad, Gosvig, Riber) Department of Cardiothoracic and Vascular Surgery, Odense University Hospital, J. B. Winslows Vej 4, Odense, Denmark (Gosvig, Riber) Department of Clinical Research, Research unit for Cardiac Surgery, University of Southern Denmark, Campusvej 55 ,Odense M, Denmark (Beetham) Michael G. DeGroote School of Medicine, McMaster University, 90 Main St W, Hamilton, Ontario, L8P 1H6, Canada (Hansson) Department of Cardiology, Odense University Hospital, Winslows Vej 4, Odense, Denmark (Whitlock) Department of Surgery, McMaster University, 1400 Main Street West, Hamilton, Ontario, L8S 1C7, Canada Abstract OBJECTIVES: Surgical left atrial appendage closure (LAAC) is recommended as a concomitant procedure during cardiac surgery in patients with atrial fibrillation to reduce stroke risk, but the methods and criteria used to evaluate procedural success remain poorly standardized. This systematic review aims to identify and describe the imaging modalities, evaluation criteria, and validation methods used to assess the success of surgical LAAC. METHOD(S): A systematic literature search was conducted in Embase, MEDLINE, and the Cochrane Library. Clinical studies reporting intraoperative or postoperative evaluation of surgical LAAC were included. Data were extracted on imaging modality, timing of assessment, criteria for procedural success, measurement techniques, validation efforts, and reported success rates. RESULT(S): Eighty studies comprising 7,517 patients and 10,375 imaging examinations were included. Transesophageal echocardiography was the most frequently used imaging modality (83%), primarily for intraoperative assessment, while cardiac computed tomography was used in 44% of studies for postoperative evaluation. Seventeen different definitions of procedural success were identified. The most commonly applied definitions were absence of persistent flow between the left atrium and LAA and a residual stump length <10 mm. The overall procedural success rate across all modalities, timings, and criteria was 92.8%. Success rates were highest intraoperatively (96.8%) and declined with increasing postoperative time. CONCLUSION(S): There is substantial heterogeneity in the evaluation of procedural success following surgical LAAC. The lack of standardized imaging protocols and success definitions limits comparability across studies and interpretation of reported clinical outcomes. Establishing uniform evaluation criteria is essential to improve reproducibility and to clarify the relationship between technical success and clinical benefit. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. <116> Accession Number 2044884597 Title From innovation to implementation: Addressing the AI adoption gap in cardiac surgery. Source American Heart Journal Plus: Cardiology Research and Practice. 64 (no pagination), 2026. Article Number: 100746. Date of Publication: 01 Apr 2026. Author Ngwu D.; Hamadi F.; Akinyemi O.; Wokocha C.; Arora N. Institution (Ngwu, Hamadi) Division of Thoracic Surgery, Department of Surgery, King Abdullah Hospital, Bisha, Saudi Arabia (Akinyemi) Intensive Care Unit, Department of Anaesthesia, King Abdullah Hospital, Bisha, Saudi Arabia (Wokocha) Public and Occupational Health Department, King Abdullah Hospital, Bisha, Saudi Arabia (Arora) Division of Cardiac Surgery, Manipal Hospital, Kolkata, India Publisher Elsevier Inc. Abstract Background: While artificial intelligence (AI) is advancing rapidly across cardiovascular medicine, its translation into cardiac surgery remains limited. Algorithms show promise in diagnostics, perioperative risk prediction, and workflow optimization, yet most applications remain confined to research environments. A focused synthesis is needed to clarify validated clinical value and persistent implementation barriers. Method(s): We conducted a systematic review following PRISMA 2020 guidelines, searching PubMed, Scopus, and Web of Science for studies published between January 2015 and September 2024. We included 45 primary studies (2019-2024) and eight foundational studies (2015-2018) reporting original data or validated AI models relevant to any stage of cardiac surgical care. Findings were synthesized across five domains: diagnostic support, personalized treatment planning, intraoperative decision support, operational efficiency, and equitable access to care. Result(s): AI demonstrated strong performance in echocardiographic interpretation, outcome prediction, and perioperative resource planning, often surpassing conventional risk models. Computer-vision platforms supported surgical phase recognition and enhanced intraoperative imaging workflows, while operational tools improved scheduling accuracy, transfusion forecasting, and bed allocation. Evidence for AI-driven improvements in equitable care delivery was emerging but limited. Most studies were retrospective, single-center, and lacked external validation or clinical integration. Conclusion(s): AI is positioned to augment cardiac surgery, with the most mature applications in imaging and operational logistics. Adoption remains constrained by heterogeneous data, limited interpretability, regulatory uncertainty, and poor workflow integration. Progress will require multicenter data collaboratives, strong validation frameworks, and clinician-centered implementation strategies that position AI as an augmentative partner, enhancing precision, judgment, and system efficiency. Copyright © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <117> Accession Number 2044876502 Title Revolutionizing Heart Failure Treatment: The Rise of Stem Cells, Gene Therapy, and RNA-based Solutions. Source Current Drug Research Reviews. (no pagination), 2026. Date of Publication: 2026. Author Kamboj V.; Duvey B.K.; Sharma D.; Bhargava A. Institution (Kamboj) Department of Pharmacology, Ch. Devi Lal College of Pharmacy, Jagadhri, Haryana, Yamunanagar, India (Duvey, Sharma, Bhargava) Department of Pharmacy, Ch. Devi Lal College of Pharmacy, Jagadhri, Haryana, Yamunanagar, India Publisher Bentham Science Publishers Abstract This review provides a concise overview of congestive heart failure (CHF), focusing on its causes, pathophysiology, clinical manifestations, diagnosis, treatment options, and future advancements. The primary goal is to highlight key aspects of CHF management, with particular emphasis on emerging therapies aimed at improving patient outcomes. Recent studies from PubMed, Google Scholar, and Scopus were evaluated, emphasizing the relationship between etiology, pathophysiology, clinical features, diagnostic tools, and treatment strategies for CHF. Key areas include pharmacological therapies, device-based interventions, surgical approaches, lifestyle modifications, and emerging treatments, such as stem cell therapy, gene therapy, and RNA-based therapies. CHF commonly results from conditions, such as ischemic heart disease, hypertension, and cardiomyopathies, which impair cardiac function. Clinical symptoms include fatigue, shortness of breath, and fluid retention. Diagnosis relies on imaging techniques (echocardiography, MRI), biomarkers (BNP, NT-proBNP), and clinical evaluation. Standard treatment involves medications (ACE inhibitors, beta-blockers, SGLT2 inhibitors), devices (ICDs, pacemakers), and surgical interventions (CABG, valve repair). Emerging therapies, including stem cell therapy, gene therapy, and RNA-based approaches, show potential for restoring cardiac function. Prognosis depends on disease severity, comorbidities, and response to treatment. CHF is a complex condition that requires early diagnosis and targeted management. While current therapies effectively control symptoms, emerging innovations offer promise for improving long-term outcomes. Future research should focus on personalized care strategies and accessible treatments to reduce the global burden of CHF. Copyright 2026, Bentham Science Publishers <118> Accession Number 650881918 Title Impact of Resisted Inspiratory Training Using the NU SpiroBreath Device on Diaphragmatic Muscle Activity: A Randomized Crossover Trial in Healthy Adults. Source Physiotherapy research international : the journal for researchers and clinicians in physical therapy. 31(2) (pp e70210), 2026. Date of Publication: 01 Apr 2026. Author Poowaruttanawiwit P.; Nuchnueng N.; Maprom J.; Juiwong P.; Chidnok W. Institution (Poowaruttanawiwit) Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand (Nuchnueng, Maprom, Juiwong, Chidnok) Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand (Chidnok) Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand Abstract BACKGROUND AND PURPOSE: The NU SpiroBreath device was developed as a novel respiratory training tool to support post-operative recovery in cardiac and thoracic surgery patients. While previous studies have demonstrated its safety and user acceptability, its effect on diaphragmatic muscle activation during resisted inspiratory maneuvers has not been fully characterized. The aim of this study was to assess diaphragmatic muscle activity during deep inspiratory breathing with and without resistance using the NU SpiroBreath device in healthy adults. METHOD(S): Twelve healthy male participants (aged 20-30 years) participated in a single-blind, randomized, two-period crossover trial. Participants performed deep inspiratory breathing maneuvers using the NU SpiroBreath device under two conditions: 0 cm H2O (sham) and 10 cm H2O (resistance), with a 2-week washout period between sessions. Each session included a 5-min baseline control followed by three sets of 10 deep inspiratory efforts (DI1-DI3), separated by 1-min rest intervals. Diaphragm muscle activity was assessed using high-resolution surface electromyography (sEMG) recorded at 4000 Hz, filtered (20-500 Hz), and analyzed using root mean square (RMS) values. RESULT(S): Significant increases in diaphragmatic muscle activity were observed from baseline at both resistance levels (p < 0.05). At 0 cm H2O, activity increased during DI1 and DI2; at 10 cm H2O, increased activation was sustained across DI1, DI2, and DI3. However, no statistically significant differences were found between the 0 cm H2O and 10 cm H2O conditions (p > 0.05), suggesting that even minimal resistance elicits robust diaphragmatic recruitment in untrained healthy individuals. DISCUSSION(S): Inspiratory training using the NU SpiroBreath device significantly enhances diaphragmatic muscle activation regardless of resistance level. These findings support its utility as a safe, low-burden respiratory training tool. Copyright © 2026 John Wiley & Sons Ltd. <119> [Use Link to view the full text] Accession Number 2043765112 Title Baduanjin sequential therapy's effects on quality of life and cardiac function in post-cardiac surgery heart disease patients: A systematic review. Source Medicine (United States). 105(1) (pp e46855), 2026. Date of Publication: 02 Jan 2026. Author Liu X.; Hao X.; Zhang W.; Zhang F.; Liu H. Institution (Liu, Hao, Zhang, Zhang, Liu) Department of Cardiovascular Surgery, Linfen Central Hospital, Linfen, Shanxi, China Publisher Lippincott Williams and Wilkins Abstract Background: - This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life and cardiac function in patients with cardiovascular heart disease after cardiac surgery. Method(s): - Pubmed, Embase, Cochrane, Web of science, Chinese National Knowledge Infrastructure, Wanfang and Sinomed were searched from the date of their inception until March 5th, 2024 using medical subject headings terms and keywords. The primary outcomes were the quality of life and cardiac function. The quality of life was assessed using Short Form-36, the Seattle Angina Questionnaire, 6-min walk test and adverse events. The cardiac function was evaluated using the 6-min walking test. For statistical analysis, standardized mean difference or odds ratio and 95% confidence intervals were calculated using Stata 14.0. Result(s): - Baduanjin exercise demonstrated significant enhancements in quality of life across all Short Form-36 subitems. Meta-analyses revealed improvements in Seattle Angina Questionnaire scores related to physical limitation and stable angina pectoris. The incidence of adverse events decreased with Baduanjin exercise, and cardiac function, as indicated by left ventricular ejection fraction, showed significant improvement. Conclusion(s): - Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the quality of life and cardiac function in patients with cardiovascular heart disease after cardiac surgery. However, more studies with rigorous research designs are needed to assist in the rehabilitation of such patients. Copyright © 2026 Lippincott Williams & Wilkins <120> Accession Number 650866818 Title Natural History and Outcomes of Early Aortic Valve Replacement versus Conservative Management in Asymptomatic Severe Aortic Stenosis: A Meta-Analysis. Source The American journal of medicine. (no pagination), 2026. Date of Publication: 07 Apr 2026. Author Huang J.; Ellis J.; Wang D.; Joseph E.; Connolly J.; Hasan R.; Rahman F. Institution (Huang, Ellis, Wang, Joseph, Connolly, Hasan, Rahman) Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, Liberia Abstract BACKGROUND: For patients with asymptomatic severe aortic stenosis, optimal timing of aortic valve replacement remains unclear. We investigated the natural history of asymptomatic severe aortic stenosis and analyzed the impact of early aortic valve replacement versus conservative management using a meta-analysis. METHOD(S): PubMed, Embase, Cochrane, and Web Of Science were searched through June 24, 2025 for randomized controlled trials (RCTs) and observational studies comparing patients with asymptomatic severe aortic stenosis receiving early aortic valve replacement versus conservative management. A random-effects meta-analysis estimated risks of all-cause mortality, cardiovascular mortality, heart failure hospitalization, stroke, myocardial infarction, atrial fibrillation, and thromboembolic events. RESULT(S): Thirteen studies were included (4 RCTs, 9 observational studies; 3,960 patients: 1,868 early aortic valve replacement, 2,092 conservative management). Seven of these studies (1,620 patients) were aggregated to investigate the natural history of asymptomatic severe aortic stenosis. Over a mean follow-up of 5.6 years [5 studies]/median follow-up of 4.1 years [2 studies], 710 (44%) patients developed symptoms while 910 patients remained asymptomatic (319 undergoing aortic valve replacement, 591 managed conservatively). Of the 591 asymptomatic patients managed conservatively, 194 (33%) died. Across all 13 studies, aortic valve replacement was associated with lower all-cause mortality (RR 0.51 [95% CI 0.35-0.75], P<0.001), cardiovascular mortality (RR 0.45 [0.37-0.67], P<0.001), and heart failure hospitalization (RR 0.40 [0.20-0.82], P=0.012). CONCLUSION(S): Approximately half of all patients with asymptomatic severe aortic stenosis developed symptoms within five years, and one-third of asymptomatic patients managed conservatively died. Aortic valve replacement was associated with lower all-cause mortality, cardiovascular mortality, and heart failure hospitalization, suggesting pre-symptom aortic valve replacement is reasonable in selected patients with asymptomatic severe aortic stenosis. Copyright © 2026. Published by Elsevier Inc. <121> Accession Number 2044608028 Title Deferral of percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation (PRO-TAVI): an investigator-initiated, multicentre, open-label, non-inferiority, randomised controlled trial. Source The Lancet. 407(10537) (pp 1429-1438), 2026. Date of Publication: 11 Apr 2026. Author Delewi R.; Aarts H.M.; Broeze G.M.; Hemelrijk K.I.; van Ginkel D.J.; Versteeg G.A.A.; Overduin D.C.; Beijk M.A.M.; Baan J.; Vis M.M.; Lemkes J.S.; de Winter R.J.; Dickinson M.G.; Kraaijeveld A.O.; Mokhles M.M.; Dessing T.C.; van der Harst P.; Leenders G.E.H.; van der Kley F.; Grundeken M.J.; Claessen B.E.P.M.; Tonino P.A.L.; Schotborgh C.E.; Meuwissen M.; van Houwelingen G.K.; Wykrzykowska J.J.; Amoroso G.; Vossenberg T.N.; Vriesendorp P.A.; van Royen N.; ten Berg J.M.; Tijssen J.G.P.; Voskuil M. Institution (Delewi, Aarts, Broeze, Hemelrijk, Grundeken, Claessen, Tijssen, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Amsterdam University Medical Centres, Amsterdam, Netherlands (Aarts, Voskuil, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands (van Ginkel, ten Berg, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands (ten Berg, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Cardiovascular Research Institute Maastricht, Maastricht, Netherlands (Versteeg, van Royen, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Radboud University Medical Centre, Nijmegen, Netherlands (Tonino, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, Netherlands (Tonino, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Biomedical Engineering, Technical University Eindhoven, Eindhoven, Netherlands (Schotborgh, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Haga Hospital, The Hague, Netherlands (Meuwissen, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Amphia Hospital, Breda, Netherlands (van Houwelingen, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Enschede, Netherlands (Wykrzykowska, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Groningen UMC, Groningen, Netherlands (Amoroso, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, OLVG, Amsterdam, Netherlands (Vossenberg, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Medical Centre Leeuwarden, Leeuwarden, Netherlands (Vriesendorp, Delewi, Aarts, Broeze, Hemelrijk, van Ginkel, Versteeg, Overduin, Beijk, Baan, Vis, Lemkes, de Winter, Dickinson, Kraaijeveld, Mokhles, Dessing, van der Harst, Leenders, van der Kley, Grundeken, Claessen, Tonino, Schotborgh, Meuwissen, van Houwelingen, Wykrzykowska, Amoroso, Vossenberg, Vriesendorp, van Royen, ten Berg, Tijssen, Voskuil) Department of Cardiology, Maastricht University Medical Centre, Maastricht, Netherlands Publisher Elsevier B.V. Abstract Background Coronary artery disease is common in patients undergoing transcatheter aortic valve implantation (TAVI). We aimed to assess whether deferral of percutaneous coronary intervention (PCI) is non-inferior to routine PCI before TAVI in patients with coronary artery disease. Methods In this investigator-initiated, open-label, randomised controlled trial, done at 12 hospitals in the Netherlands, TAVI patients with coronary artery disease were randomly assigned in a 1:1 ratio to deferral of PCI or PCI before TAVI. Randomisation was done by use of a web-based system with random block sizes of 2 and 4, and stratification by presence of coronary artery disease involving proximal left anterior descending artery. The primary endpoint was a composite of all-cause mortality, myocardial infarction, stroke, and major bleeding at 1 year. Non-inferiority testing was done in the intention-to-treat population against the prespecified margin of 11 percentage points. The study is registered with ClinicalTrials.gov ( NCT05078619 ) and long-term follow-up is ongoing. Findings Between Oct 7, 2021, and Nov 19, 2024, 466 patients were enrolled: 233 were assigned to deferral of PCI and 233 to PCI before TAVI. Median age was 81 years (IQR 78-84), and 166 (36%) of 466 patients were female. The primary endpoint occurred in 56 (24%) of 233 patients in the deferral group as compared with 60 (26%) of 233 patients in the PCI group (rate difference -1.7% [95% CI -9.5 to 6.2]; hazard ratio 0.89 [95% CI 0.62-1.28]; p=0.0008 for non-inferiority; p=0.68 for superiority). Interpretation In patients with coronary artery disease undergoing TAVI, deferral of PCI was non-inferior to PCI before TAVI for the 1-year composite of all-cause mortality, myocardial infarction, stroke, and major bleeding. These findings suggest that an initial conservative strategy can be appropriate in selected patients, although patient-tailored treatment decisions remain essential. Funding ZonMw. Copyright © 2026 Elsevier Ltd. <122> Accession Number 2044250844 Title Influence of Pre-emptive Haptoglobin on Postoperative Acute Kidney Injury in Cardiac Surgical Patients: A Randomized Controlled Trial. Source Anesthesia and Analgesia. Publish Ahead of Print (no pagination), 2025. Article Number: 10.1213/ANE.0000000000007827. Date of Publication: 21 Nov 2025. Author Miyazaki A.; Hokka M.; Mizobuchi S. Institution (Miyazaki, Hokka, Mizobuchi) Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Haptoglobin may reduce hemolysis-induced kidney injury in patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB). Haptoglobin may be given empirically when hemolytic urine is observed, or pre-emptively when detected by elevated free hemoglobin concentrations. In the present study, we investigated whether pre-emptive haptoglobin therapy guided by serum-free hemoglobin concentrations could prevent postoperative renal dysfunction in patients who underwent major cardiovascular surgery using CPB. METHOD(S): - This study was a single-center, open-label, randomized controlled trial. Adult patients who underwent major cardiovascular surgery using CPB were included. Serum-free hemoglobin concentrations were measured in all patients who consented for this study. Patients with free hemoglobin concentrations that reached 0.05 g/dL were randomized to either (i) pre-emptive haptoglobin therapy group or (ii) standard of care group. Patients in the pre-emptive haptoglobin therapy group were administered 4000 U of haptoglobin when serum-free hemoglobin concentration reached 0.05 g/dL within 2 hours after the start of CPB. In the standard of care group, 4000 U of haptoglobin was administered when hemolytic urine was confirmed after the start of CPB. The primary outcome was the difference between the preoperative creatinine concentration and the maximum creatinine concentration within 48 hours after surgery (DELTACr). RESULT(S): - The study was terminated with the results of interim analysis due to patients' safety concerns. Finally, 34 patients in the pre-emptive haptoglobin therapy group and 33 in the standard of care group were included in the analysis. Median (interquartile range) DELTACr values were 0.20 (0.05-0.44) in the pre-emptive haptoglobin therapy group and 0.14 (0.04-0.19) in the standard of care group (P = .05). Multiple linear regression analysis with DELTACr as objective variable and preoperative estimated glomerular filtration rate (eGFR), age, and randomize group as explanatory variables revealed that pre-emptive administration of haptoglobin significantly increased DELTACr (P = .03). CONCLUSION(S): - The interim study results demonstrated that in patients undergoing major cardiovascular surgery using CPB, pre-emptive haptoglobin administration worsened Cr values and independently associated with increased DELTACr. Copyright © 2025 International Anesthesia Research Society <123> Accession Number 650863698 Title WHAT IS A MASSIVE TRANSFUSION? A SCOPING REVIEW TO INFORM AN INTERNATIONAL CONSENSUS DEFINITION. Source HemaSphere. Conference: EHA2023 Hybrid Congress. Frankfurt Germany. 7(Supplement 3) (pp 446-447), 2023. Date of Publication: 01 Aug 2023. Author Lin V.; Sun E.; Yau S.; Abeyakoon C.; Seamer G.; Bhopal S.; Tucker H.; Doree C.; Brunskill S.; Mcquilten Z.; Stanworth S.J.; Wood E.; Green L. Institution (Lin, Mcquilten, Wood) Transfusion Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia (Sun) Faculty of Medicine, Dentistry, and Health Sciences, University of Melbourne, Parkville, Australia (Yau, Seamer, Bhopal) Faculty of Medicine, Nursing, and Health Sciences, Monash University Clayton Campus, Clayton, Australia (Abeyakoon) Department of Clinical Haematology, Monash Health -Moorabbin Hospital, Bentleigh East, Australia (Tucker, Green) Blizard Institute, United Kingdom (Doree, Brunskill, Stanworth) Nhs Blood and Transplant, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: No standardized or universally accepted definition for massive transfusion (MT) currently exists, making it difficult to compare safety and efficacy data across studies on critically bleeding patients. The Bleeding Academic Research Consortium successfully standardized definitions for major bleeding in both surgical and non-surgical patients, providing proof of principle for a similar approach to be adopted for the definition of MT. Aim(s): To identify and evaluate all MT definitions used in randomized controlled trials (RCTs) to date to inform the development of an international consensus definition for MT. Method(s): We performed a scoping review of RCTs related to MT. MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Cumulative Index to Nursing and Allied Health Literature, and Transfusion Evidence Library were searched from inception until 11 August 2022 without language restriction. Ongoing trials were sought from CENTRAL, ClinicalTrials.gov, and World Health Organisation International Clinical Trials Registry Platform. To be eligible for inclusion, studies were required to: (1) be an RCT; (2) include an adult patient population with an acquired bleeding disorder who had received, or were anticipated to receive, an MT in any clinical setting; and (3) have a specified definition for MT. Conference abstracts, opinion pieces, clinical guidelines, narrative reviews, post hoc analyses, laboratory-only studies, and studies including only paediatric or non-human subjects were excluded. Result(s): of the 8,460 distinct references identified from the initial search, 30 studies were included (19 published, 11 ongoing). Several landmark trials on critically bleeding patients, including CRASH-2, were excluded as they did not report a definition for MT. Table 1 highlights the lack of uniformity in MT definitions used to date. Fifteen distinct definitions of MT have been used in RCTs across 4 different specialties (trauma, obstetrics/gynecology, cardiothoracic surgery, and orthopedic surgery) since 1986. Most were based on number of units of RBCs or whole blood administered within a certain time interval. None included other blood products (e.g., platelets, plasma), and some did not specify a time interval during which administration needed to take place. The most common definition of MT (featuring in 10/30 = 33% of studies) was the classic definition of >=10 units of RBCs in 24 hours (h), with a trend in more recent studies towards the use of shorter time frames (e.g., >=4 RBCs in 6 h in the TrauCC study registered in 2016 and T-STORHM study published in 2019; >=3 RBCs in 1 h in a Spanish trial registered in 2017 and the PROCOAG study published in 2021). The classic definition (>=10 RBCs in 24 h) was favored in trauma (featuring in 9/15 = 60% of trauma trials), whereas the most frequently used definition in obstetrics/gynecology was >5 units of whole blood (featuring in 3/6 = 50% of obstetrics/gynecology trials). Summary/Conclusion: Significant heterogeneity exists in the definitions used for MT in RCTs to date. Our findings provide a basis for the development of a consensus definition for MT (e.g., through a modified Delphi process) that can be applied consistently across future trials, which balances the strengths and weaknesses of previous definitions in a specialtyspecific manner. <124> [Use Link to view the full text] Accession Number 2044254852 Title Balloon-expandable versus self-expanding valves in severe aortic stenosis with small aortic annulus: an updated meta-analysis. Source Coronary Artery Disease. Publish Ahead of Print (no pagination), 2026. Article Number: 10.1097/MCA.0000000000001618. Date of Publication: 04 Feb 2026. Author Narciso I.A.T.; Krishna M.M.; Joseph M.; Puglla Sanchez L.R.; Ezenna C.; Ayesha A.; Pereira V.; Lajczak P.; Mendes B.S.; Schincariol M. Institution (Narciso) University Center UNIFIPMOC, Montes Claros, Brazil (Krishna, Joseph) Department of Medicine, Medical College Thiruvananthapuram, Kerala, India (Puglla Sanchez) Clinico Lozano Blesa University Hospital, Zaragoza, Spain (Ezenna) Department of Medicine, University of Massachusetts, Baystate Medical Center, Springfield, United States (Ayesha) Shifa College of Medicine, Islamabad, Pakistan (Pereira) Faculty of Biomedical Sciences Austral University, Pilar, Argentina (Lajczak) Medical University of Silesia, Katowice, Poland (Mendes) University Center UNIFIPMOC, Montes Claros, Brazil (Schincariol) Klinikum Furth, Academic Teaching Hospital of Friedrich-Alexander-Universitat Erlangen-Nurnberg, Furth, Germany Publisher Lippincott Williams and Wilkins Abstract Background - Balloon-expandable valve (BEV) and self-expanding valve (SEV) are used in transcatheter aortic valve replacement (TAVR). Patients with a small aortic annulus (SAA) make up to one-third of the cases and face higher risks of prosthesis-patient mismatch and high valvular gradients. Objectives - This meta-analysis aimed to compare balloon-expandable and self-expanding valves used in TAVR in patients with a SAA, focusing on hemodynamic and clinical outcomes. Methods - We systematically searched Cochrane Central, PubMed, and EMBASE for studies comparing balloon-expandable and self-expanding valves in patients with SAA undergoing TAVR. Random effects models were applied to generate odds ratios (ORs) and mean differences with 95% confidence interval (CI). Results - Fifteen studies (two randomized controlled trials and 13 propensity-matched studies) with 5149 patients (48.4% balloon-expandable valves) were identified. BEVs were associated with a lower indexed effective orifice area (mean difference: -0.18, 95% CI: -0.25 to -0.10; P < 0.00001) and higher transvalvular mean pressure gradient (mean difference: 4.32, 95% CI: 3.39-5.24; P < 0.00001) and peak pressure gradients (mean difference: 4.87, 95% CI: 1.23-8.51; P = 0.009). Permanent pacemaker implantation (OR: 0.57, 95% CI: 0.44-0.73; P < 0.0001) and major bleeding (OR: 0.67, 95% CI: 0.47-0.96; P = 0.03) were lower in balloon-expandable valves. BEVs increased the odds of any prosthesis-patient mismatch (OR: 2.28, 95% CI: 1.61-3.22; P < 0.00001) and severe prosthesis-patient mismatch (OR: 3.16, 95% CI: 2.19-4.58; P < 0.00001). Conclusion - In patients with SAA undergoing TAVR, SEVs offer superior hemodynamic performance, whereas BEVs are associated with fewer conduction disturbances and bleeding events. Both valve platforms yielded similar clinical outcomes, underscoring the need for individualized device selection. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <125> [Use Link to view the full text] Accession Number 650860789 Title Feasibility pilot trial for the Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia (THRIVE) Pragmatic Randomized Clinical Trial. Source Anesthesiology. (no pagination), 2026. Date of Publication: 08 Apr 2026. Author Janda A.M.; Pennington B.R.T.; Colquhoun D.A.; Kumar S.S.; Neuman M.D.; Politi M.C.; Spino C.; Kidwell K.M.; Swisher L.; Bollini M.; Vaughn M.T.; Cloyd C.; Pescatore N.A.; Thelen-Perry S.; Gregory S.H.; du Toit L.; Henrichs B.; Torres B.; Avidan M.S.; Kheterpal S. Institution (Janda, Colquhoun, Kumar, Vaughn, Cloyd, Pescatore, Kheterpal) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Pennington, Swisher, Bollini, Gregory, du Toit, Henrichs, Torres, Avidan) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, United States (Neuman) Department of Anesthesiology & Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States (Politi) School of Public Health, Washington University, St. Louis, MO, United States (Spino, Kidwell, Thelen-Perry) Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States Abstract BACKGROUND: The Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia (THRIVE) Trial is a multicenter prospective, randomized comparative effectiveness trial examining patients' experiences and outcomes after receiving either total intravenous anesthesia with propofol or inhaled volatile anesthesia for general anesthesia (NCT05991453). Prior to the 13,000-patient trial, a pilot trial (NCT05346588) was performed to establish feasibility and determine percent success of: 1) patient enrollment, 2) intervention adherence, and 3) data completion. METHOD(S): We conducted a feasibility trial including adult patients undergoing elective non-cardiac surgery requiring general anesthesia across two academic institutions in the United States. Patients were randomized to receive general anesthesia with total intravenous or inhalational anesthesia. Patients completed surveys on postoperative days 0, 1, 2, 7, 30, and 90. Percentages of consent, intervention adherence, and data completion were compared with pre-defined thresholds (10%, 80%, and 90%, respectively). RESULT(S): 300 patients were enrolled across two sites, Washington University in St. Louis and the University of Michigan, from September, 2022 through March, 2023. The percentages achieved significantly exceeded pre-defined thresholds: 351 of 663 (53%, 95% CI, 49% to 57%) patients approached were successfully consented, adherence to the randomized intervention occurred in 142 of 149 (95%, 95% CI, 92% to 99%) total intravenous anesthesia cases and 150 of 151 (99%, 95% CI, 98% to 100%) inhaled cases, and complete data collection occurred for the Quality of Recovery-15 in 279 of 299 (93%, 95% CI, 91% to 96%) patients and 299 of 299 (100% complete 95% CI, 100% to 100%) patients for the modified Brice, the intraoperative awareness screening questionnaire. CONCLUSION(S): It was feasible to enroll sufficient patients, adhere strongly to the randomized treatment allocation, and obtain adequate outcomes data at these two pilot sites for the THRIVE trial. Copyright © 2026 American Society of Anesthesiologists. All Rights Reserved. <126> Accession Number 2044913312 Title Meta-analysis of TAVI versus surgical aortic valve replacement in patients younger than 75years. Source Cirugia Cardiovascular. (no pagination), 2026. Date of Publication: 2026. Author Martin Gutierrez E.; Perez Andreu J.; Aranda Domene R.; Alfonso Colomer L.; Alcaraz Garcia M.J.; Canovas Lopez S.J. Institution (Martin Gutierrez, Perez Andreu, Aranda Domene, Alfonso Colomer, Alcaraz Garcia, Canovas Lopez) Servicio de Cirugia Cardiaca, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain (Martin Gutierrez, Perez Andreu, Aranda Domene, Alfonso Colomer, Alcaraz Garcia, Canovas Lopez) Instituto Murciano de Investigacion Biosanitaria (IMIB) Arrixaca, Murcia, Spain Publisher Sociedad Espanola de Cirugia Cardiovascular y Endovascular (SECCE) Abstract The 2025 update of the ESC-EACTS guidelines for the management of valvular heart disease has lowered the age threshold for considering transcatheter aortic valve implantation (TAVI) from 75 to 70years in patients with tricuspid aortic valves and suitable anatomy. This change raises questions about whether sufficient evidence supports its applicability in younger, low-surgical-risk patients compared with surgical aortic valve replacement (SAVR). We conducted a meta-analysis comparing TAVI versus SAVR in patients aged <=75years to assess whether current evidence justifies this modification in clinical recommendations. A systematic search was performed in PubMed including all studies comparing postprocedural mortality and morbidity between TAVI and SAVR in patients with severe aortic stenosis and a mean age <=75years. After quality assessment using the Newcastle-Ottawa scale, 11 studies were selected (4 randomized clinical trials, 6 observational studies, and 1 post-hoc analysis). Meta-analyses were conducted using fixed- or random-effects models according to heterogeneity (I2), and effect sizes were expressed as relative risk (RR) using the Mantel-Haenszel method. A total of 29,673 patients were analyzed (8,964 TAVI vs. 20,709 SAVR). The pooled quantitative analysis showed a significant survival benefit of SAVR over TAVI during follow-up (RR=1.55; 95%CI: 1.09-2.21). Subgroup analyses revealed no significant difference between treatment options in randomized trials (RR=0.90; 95%CI: 0.57-1.44), whereas propensity-matched observational studies demonstrated lower mortality with SAVR (RR=2.30; 95%CI: 1.67-3.16). Surgery was associated with a lower need for permanent pacemaker implantation (RR=1.40; P=.03) and fewer reinterventions (RR=1.34; P<.00001), with no differences in stroke, readmission, or endocarditis rates. In patients <=75years with severe aortic stenosis, SAVR remains associated with better survival and lower morbidity related to pacemaker implantation and reintervention. Current evidence does not support lowering the recommended age for TAVI to 70years in low-risk patients, underscoring the need for extended follow-up and new long-term randomized trials in younger populations. Copyright © 2026 Sociedad Espanola de Cirugia Cardiovascular y Endovascular. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <127> Accession Number 2044686322 Title The Impact of Coronary Artery Bypass Grafting on Respiratory Function: A Systematic Review. Source Journal of Clinical Medicine. 15(7) (no pagination), 2026. Article Number: 2793. Date of Publication: 01 Apr 2026. Author Flores G.; Duarte-Mendes P.; Fonseca H.; Monteiro D.; Silva F.M.; Couto N.; Silva A.M.; Vilas-Boas J.P. Institution (Flores, Fonseca) Faculty of Sport, University of Porto, Porto, Portugal (Flores, Fonseca) Research Center in Physical Activity Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal (Duarte-Mendes) Department of Sports and Well-Being, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal (Duarte-Mendes) Sport Physical Activity and Health Research & Innovation Center (SPRINT), Santarem, Portugal (Monteiro) School of Education and Social Sciences, Polytechnic University of Leiria, Leiria, Portugal (Monteiro, Couto) Research Centre in Sport, Health and Human Development (CIDESD), Vila Real, Portugal (Silva) School of Education and Communication, University of Algarve, Faro, Portugal (Silva) Research Unit for Sport and Physical Activity (CIDAF), University of Coimbra, Coimbra, Portugal (Couto) Sport Sciences School of Rio Maior, Santarem Polytechnic University, Santarem, Portugal (Silva) Department of Life Sciences, University of Coimbra, Coimbra, Portugal (Silva) Center for Research in Anthropology and Health (CIAS), Coimbra, Portugal (Vilas-Boas) Research Centre for Sports Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, Porto, Portugal (Vilas-Boas) Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Cardiovascular diseases are the main cause of mortality and morbidity in Portugal, with coronary artery bypass grafting (CABG) being one of the most performed surgeries in cardiothoracic centers. After cardiac surgery, patients often experience a decrease in physical capacity, which results in an increased risk of mortality or hospitalization expenditures. The objective of this systematic review was to characterize changes in respiratory function in patients undergoing CABG. Method(s): This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using a predefined research strategy to identify relevant original studies published until August 2025. To be included, studies must have assessed adult patients submitted to CABG who evaluated the respiratory function before and after cardiac surgery. Studies that reported other types of cardiac surgery were excluded. The Risk of Bias in Non-randomized Studies-of-Exposure and the Cochrane risk-of-bias tool for randomized trials were used to analyze the risk of bias of the selected studies. Result(s): After screening 1184 potential articles, six studies met the inclusion criteria. The studies included participants who underwent CABG (n = 324), with a mean age ranging from 54.05 +/- 13.6 to 67 +/- 10 years. Conclusion(s): All included studies reported significant postoperative reductions in respiratory function following CABG, including forced vital capacity, forced expiratory volume in one second, maximal inspiratory pressure, and maximal expiratory pressure. Although these findings consistently indicate a decline in pulmonary function, the limited number of available studies limits the strength of the conclusions. This systematic review suggests that monitoring respiratory impairments after CABG may be clinically relevant to improve health-related quality of life. Copyright © 2026 by the authors.

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