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

Total documents retrieved: 109 Results Generated From: Embase <1980 to 2026 Week 20> Embase Weekly Updates (updates since 2026-05-11) - (109 records) <1> Accession Number 2043792530 Title Surgical Risk and Revascularization-An Update. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(4) (no pagination), 2026. Article Number: 104392. Date of Publication: 01 Apr 2026. Author Marquis-Gravel G.; Tong G.; Dodd M.; Clayton T.; Ryan M.; Docherty K.F.; Williams A.; Sun J.; Fremes S.E.; Lansky A.J.; Velazquez E.J.; Perera D.; Petrie M.C.; Rouleau J.-L. Institution (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Department of Medicine, Montreal Heart Institute, Universite de Montreal, Montreal, Canada (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Yale School of Medicine, New Haven, CT, United States (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Kings College London, British Heart Foundation Centre of Research Excellence, St Thomas' Hospital, and Cardiovascular Division, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) School of Cardiovascular and Metabollic Health, University of Glasgow, Scotland, Glasgow, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Yale School of Public Health, New Haven, CT, United States (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Yale School of Public Health, New Haven, CT, United States (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Yale School of Medicine, New Haven, CT, United States (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Yale School of Medicine, New Haven, CT, United States (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Kings College London, British Heart Foundation Centre of Research Excellence, St Thomas' Hospital, and Cardiovascular Division, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) School of Cardiovascular and Metabollic Health, University of Glasgow, Scotland, Glasgow, United Kingdom (Marquis-Gravel, Tong, Dodd, Clayton, Ryan, Docherty, Williams, Sun, Fremes, Lansky, Velazquez, Perera, Petrie, Rouleau) Department of Medicine, Montreal Heart Institute, Universite de Montreal, Montreal, Canada Publisher Elsevier B.V. <2> Accession Number 2038005086 Title Prognostic value of myocardial work indices measured on echocardiography in patients with aortic stenosis undergoing transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Pakistan Journal of Medical Sciences. 42(4) (pp 1042-1050), 2026. Date of Publication: 01 Apr 2026. Author Zhou J.; Liu R.; Chen F.; Chen Y.; Xiao Q.; Yu Y. Institution (Zhou, Liu, Chen, Chen, Xiao, Yu) Department of Ultrasound, The First Hospital of Jiaxing, Zhejiang Province, Jiaxing, China Publisher Professional Medical Publications Abstract Background & Objective: Myocardial work (MW) indices offer an afterload-adjusted assessment of left ventricular (LV) function and may improve risk stratification in patients with severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR). This systematic review and meta-analysis aimed to evaluate the prognostic significance of MW indices, global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE), in patients with severe AS undergoing TAVR. Methodology: PubMed, Embase, Web of Science, and Scopus were searched from inception to 26 November 2025 for studies assessing prognostic value of MW indices in TAVR-treated AS patients. Data were synthesised qualitatively, and a random-effects meta-analysis was performed when at least three studies reported comparable effect estimates. Result(s): Five cohort studies met the inclusion criteria. Across studies, GWI consistently demonstrated strong prognostic performance. Lower post-TAVR GWI predicted mortality in multiple cohorts, with thresholds ranging from 1,095 to 1,234 mmHg% and area-under-the-curve values up to 0.71. Pooled analysis confirmed that higher GWI was associated with reduced mortality (HR: 0.94 95% CI: 0.90, 0.98 I2=68% p=0.004). GCW showed modest prognostic value, whereas GWW was not independently predictive. GWE was a significant predictor in select studies, but mostly in univariate models. Conclusion(s): Limited evidence shows that MW indices, especially GWI, may provide meaningful prognostic information in AS patients undergoing TAVR. Further studies are needed to improve the evidence. Copyright © 2026, Professional Medical Publications. All rights reserved. <3> 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. <4> Accession Number 2043417383 Title Direct oral anticoagulants versus vitamin K antagonists after heart valve bioprosthetic replacement or repair: A systematic review and meta-analysis. Source Archives of Cardiovascular Diseases. 119(4) (pp 302-308), 2026. Date of Publication: 01 Apr 2026. Author Bruno V.D.; Lester T.; Poletti E.; Celmeta B.; Viva T.; Bisogno A.; Miceli A.; Glauber M. Institution (Bruno, Celmeta, Viva, Bisogno, Miceli, Glauber) Department of Minimally Invasive Cardiac Surgery, IRCCS Galeazzi-Sant'Ambrogio Hospital, Milan, Italy (Lester) School of Medicine, University of Bristol, Bristol, United Kingdom (Poletti) Department of Cardiology, Hartcentrum Middelheim ZNA, Antwerp, Belgium Publisher Elsevier Masson s.r.l. Abstract Vitamin K antagonists are used as a temporary anticoagulation method after bioprosthetic valve replacement or repair. However, the novel direct oral anticoagulants may be a preferred method of anticoagulation because of their improved patient compliance. This meta-analysis aimed to evaluate the safety of direct oral anticoagulants versus vitamin K antagonists after biological valve replacement or repair. A systematic review and meta-analysis were performed for studies reporting the effect of direct oral anticoagulants versus vitamin K antagonists after biological valve replacement or repair. The inclusion criteria were studies of adults undergoing bioprosthetic mitral or aortic valve replacement or repair, comparing direct oral anticoagulants versus vitamin K antagonists in the early postoperative period. The main outcomes were thromboembolic and bleeding events, and short- and mid-term death rates. Six observational studies and one randomized controlled trial were included, with a total of 2994 direct oral anticoagulant recipients and 16,894 vitamin K antagonist recipients. There were no significant differences between the groups in terms of thromboembolic events (odds ratio: 0.82, 95% confidence interval: 0.45-1.49; P = 0.52) or bleeding events (odds ratio: 0.89, 95% confidence interval: 0.70-1.14, P = 0.36). Higher 30-day and mid-term death rates were observed in patients receiving direct oral anticoagulants, but this analysis was reported inconsistently, and was heavily influenced by a single study. In a mixed population of individuals undergoing bioprosthetic valve replacement or repair, there was no statistically significant difference between direct oral anticoagulants and vitamin K antagonists in terms of reducing thromboembolic or bleeding events. Further studies are needed to establish the optimal anticoagulation regimen in this context. Copyright © 2026 Elsevier Masson SAS. <5> Accession Number 2045081544 Title Outcomes and Off-Label Use of Medical Devices in Percutaneous Fetal Interventions for Congenital Heart Disease: A Systematic Review, Meta-Analysis, and Needs Identification Using the Biodesign Approach. Source Journal of Medical Devices. 20(5) (no pagination), 2026. Article Number: 051001. Date of Publication: 01 Oct 2026. Author Mehta J.; Byju A.G.; Buskmiller C.M.; Belfort M.A.; Sanz Cortes M.; Joyeux L.; Brandon Hunter R.; Koh C.; Erraguntla M.; Haridas B. Institution (Mehta, Joyeux, Brandon Hunter, Koh) Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, United States (Mehta, Buskmiller) Texas Children's Hospital, United States (Byju) Department of Biomedical Engineering, Texas A&M University, 101 Bizzell Street, 3120 TAMU, College Station, TX, United States (Byju, Erraguntla) Texas A&M University, United States (Buskmiller) Baylor College of Medicine, United States (Belfort, Sanz Cortes) Department of Industrial and Systems Engineering, Texas A&M University, 101 Bizzell Street, 3131 TAMU, College Station, TX, United States (Belfort, Sanz Cortes, Joyeux) Department of Biomedical and Mechanical Engineering, Texas A&M University, 101 Bizzell Street, 3120 TAMU, College Station, TX, United States Publisher American Society of Mechanical Engineers (ASME) Abstract There is a significant lack of medical devices designed for percutaneous fetal cardiac interventions, forcing clinicians to repurpose pediatric or adult devices for use in the fetal population, often at considerable risk to these patients. To help quantify this gap and drive innovation in this field, we conducted a systematic review (following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) performing an electronic search across PubMed, Scopus, and the Cochrane databases to (1) evaluate the outcomes of off-label use of medical devices not specifically designed for fetal use in interventions addressing severe congenital heart disease (CHD) and (2) using the Stanford Biodesign methodology to identify the unmet needs that could inspire new device solutions for percutaneous fetal interventions. The search yielded 985 results, with 53 studies reviewed after screening using the established criteria. The study revealed significant rates of technical complications and adverse events that appear attributable to limitations of current devices used for percutaneous fetal cardiac intervention. This highlights the urgent need for minimally invasive cardiac devices designed exclusively for percutaneous fetal interventions. These devices should address complications and challenges in interventions for CHD, including issues with fetal positioning and cardiac access for valvular and septal procedures. These solutions should also target problems related to visualization, enable device miniaturization, and provide precision in distal device positioning and control, within a systems engineering framework to holistically address the needs of this underserved and vulnerable patient population. Copyright © 2026 by ASME. <6> Accession Number 2045081966 Title Postoperative Complications in Patients with Frailty Syndrome Undergoing Esophagectomy-A Systematic Review with Meta-Analysis. Source Journal of Clinical Medicine. 15(8) (no pagination), 2026. Article Number: 3040. Date of Publication: 01 Apr 2026. Author Kaminska A.; Bonczar M.; Plutecki D.; Ostrowski P.; Koziej M.; Konturek A. Institution (Kaminska, Konturek) Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College Krakow, University Hospital in Krakow, Krakow, Poland (Bonczar, Plutecki, Ostrowski, Koziej) Department of Anatomy, Jagiellonian University Medical College Cracow, Krakow, Poland (Bonczar, Plutecki, Ostrowski, Koziej) Youthoria, Youth Research Organization, Krakow, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Introduction: Frailty syndrome is an increasingly recognized condition that affects a considerable proportion of elderly patients, particularly those undergoing major surgeries. In this meta-analysis, we aimed to systematically review and pool data from cohort studies to assess the effect of frailty on the clinical outcomes of patients undergoing esophagectomy for esophageal cancer. Method(s): Major online medical databases such as PubMed, Embase, Scopus, and Web of Science were searched to gather all studies on the clinical outcomes of patients with frailty syndrome who underwent esophagectomy due to esophageal cancer. The study included articles published up to March 2026. Finally, 15 articles matched the required criteria and were included in this meta-analysis. Result(s): The pooled odds ratio for surgery-related mortality in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 4.03 (Lower Limit: 2.20; Upper Limit: 7.38; p-value < 0.05). The pooled odds ratio for surgery-related postoperative pneumonia in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 1.86 (Lower Limit: 1.16; Upper Limit: 2.98; p-value < 0.05). The pooled odds ratio for surgery-related postoperative cardiac complications in patients with frailty syndrome and esophageal cancer undergoing esophagectomy has been established at 1.73 (Lower Limit: 1.54; Upper Limit: 1.94; p-value < 0.05). Conclusion(s): Frailty is a powerful predictor of mortality in patients undergoing esophagectomy, with frail individuals facing nearly four times higher odds of death. This underscores the urgent need to integrate frailty assessments into standard preoperative screening to enhance risk stratification and optimize perioperative decision-making. A multidisciplinary approach is essential to improving resilience, recovery, and long-term survival in frail esophageal cancer patients. Future large-scale prospective trials should focus on standardizing assessment tools and evaluating the lasting impact of tailored interventions to ultimately enhance patient outcomes. Copyright © 2026 by the authors. <7> Accession Number 2045157920 Title Effect of different administration times of dexmedetomidine on the ED50 of sufentanil to inhibit the cardiovascular response in elderly patients with double lumen tracheal intubation: a randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 267. Date of Publication: 01 Dec 2026. Author Lu B.; Wang Y.; Wang C.; Wang L.; Wang T.; Lin H.; Wang Z. Institution (Lu, Wang, Wang, Wang, Lin, Wang) Department of Anesthesiology, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, China (Lu, Wang, Lin) Department of Anesthesiology, Guangdong Provincial Hospital of Chinese Medicine Hainan Hospital, Haikou, China Publisher BioMed Central Ltd Abstract Objective: To investigate the effect of different administration timings of dexmedetomidine (DEX) on the median effective dose (ED50) of sufentanil required to suppress the cardiovascular response during double-lumen tracheal intubation in elderly patients. Method(s): Ninety elderly patients (aged 65-85 years, BMI 18.5-30 kg/m2, ASA physical status I-III) scheduled for elective thoracic surgery were randomized into three groups: the Control group (induction initiated following a 10-min intravenous infusion of saline), the DEX1 group (DEX 0.6 mug/kg infused over 10 min before induction), and the DEX2 group (induction initiated 20 min after completion of a 10-min intravenous infusion of DEX at a dose of 0.6 mug/kg). Anesthesia induction was initiated with intravenous sufentanil starting at 0.5 mug/kg, and subsequent doses were determined using the Dixon up-and-down sequential method with a dose ratio of 1:1.1 between adjacent dose levels. Tracheal intubation was performed 5 min after sufentanil administration according to the predefined protocol, and the infusion-to-intubation interval was predefined according to group allocation. Sequential allocation continued until at least eight crossover pairs were obtained. Patient characteristics, hemodynamic variables, Surgical Pleth Index (SPI), and adverse events were recorded from study drug administration to 5 min after intubation. Result(s): Final analysis included 87 patients (Control: n = 30, DEX1: n = 28, DEX2: n = 29). The ED50 of sufentanil was 0.675 mug/kg (95% CI: 0.634-0.732 mug/kg) in the Control group, 0.507 mug/kg (95% CI: 0.474-0.540 mug/kg) in the DEX1 group, and 0.396 mug/kg (95% CI: 0.330-0.440 mug/kg) in the DEX2 group, corresponding to relative reductions of 24.9% and 41.3%, respectively. Conclusion(s): Premedication with dexmedetomidine reduced the ED50 of sufentanil required to suppress the cardiovascular response to double-lumen tracheal intubation in elderly patients, with earlier administration producing a greater opioid-sparing effect. Administration of DEX 30 min before anesthesia induction resulted in the lowest sufentanil requirement. Trial registration: This study was registered at the China Clinical Trial Registration Center (ChiCTR2400083508, April 26, 2024). Copyright © The Author(s) 2026. <8> Accession Number 2044823230 Title Transcutaneous Auricular Vagus Nerve Stimulation and Pectoral-Intercostal Fascial Block for the Prevention of Chronic Postsurgical Pain in Elderly Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A 2x2 Factorial, Double-Blinded, Randomized Clinical Trial. Source Clinical Interventions in Aging. 21 (no pagination), 2026. Article Number: 583971. Date of Publication: 2026. Author Cui S.; Yan L.; Huang P.; Yang H.; Liang W.; Huang L. Institution (Cui, Yan, Huang, Liang, Huang) Department of Anesthesiology, The Second Hospital of Hebei Medical University, No. 215, Heping West Road, Xinhua District, Shijiazhuang, China (Yang) Division of Health Statistics, School of Public Health, Hebei Medical University, Shijiazhuang, China (Yang) Hebei Key Laboratory of Environment and Human Health, Hebei Medical University, Shijiazhuang, China (Yang) Hebei Key Laboratory of Forensic Medicine, Hebei Medical University, Shijiazhuang, China (Huang) Hebei Key Laboratory of Neurodegenerative Disease Mechanism, Hebei Medical University, Shijiazhuang, China (Huang) Key Laboratory of Clinical Neurology, Ministry of Education, Hebei Medical University, Shijiazhuang, China Publisher Dove Medical Press Ltd Abstract Background: Chronic postsurgical pain (CPSP) is common after off-pump coronary artery bypass grafting (OPCABG) in elderly patients. This trial investigated the efficacy of perioperative transcutaneous auricular vagus nerve stimulation (taVNS) and pectoral-intercostal fascial block (PIFB) for CPSP prevention. Method(s): In this 2x2 factorial trial, 260 elderly patients (>=60 years) undergoing OPCABG were randomized to taVNS + ropivacaine PIFB, taVNS + placebo PIFB, sham taVNS + ropivacaine PIFB, or sham taVNS + placebo PIFB groups. The primary outcome was CPSP incidence at 3 months postoperatively. Several secondary outcomes were evaluated. Logistic regression was employed to analyze risk factors associated with CPSP. Lastly, mediation analyses were performed to explore the mediating factors between interventions and CPSP. Result(s): The overall incidence of CPSP was 34.6%. No interaction was found between taVNS and PIFB. Compared with sham taVNS, taVNS significantly reduced CPSP incidence (28.6% vs 40.9%, P = 0.036), alleviated acute pain and improved recovery quality. PIFB did not reduce overall CPSP incidence (30.2% vs 38.8%, P = 0.143), though it alleviated acute pain on postoperative day 1 and reduced moderate-to-severe CPSP. Risk factors for CPSP included preoperative anxiety, pain catastrophizing, acute postoperative pain, and high IL-6 levels. Mediation analysis indicated taVNS's benefits were partially mediated by reducing acute pain (19.3%) and IL-6 (20.4%). Conclusion(s): Perioperative taVNS significantly reduced CPSP incidence and enhanced postoperative recovery in elderly OPCABG patients, partly mediated by alleviating acute pain and inflammation. Single-shot PIFB showed limited preventive effect on overall CPSP. Copyright © 2026 Cui et al. <9> Accession Number 2044463130 Title Prognostic value of blood pressure variability in patients with heart failure: a systematic review and meta-analysis. Source Journal of Human Hypertension. 40(5) (pp 354-362), 2026. Date of Publication: 01 May 2026. Author Nurhafizah A.; Huang W.; Frederich A.; Khairunnisa A.R.; Zahrani R.A.F.; Atmojo S.; Siswanto B.B. Institution (Nurhafizah, Huang, Frederich, Khairunnisa, Zahrani) Faculty of Medicine, University of Padjadjaran, Sumedang, Indonesia (Nurhafizah, Huang, Khairunnisa, Atmojo, Siswanto) National Cardiovascular Center Harapan Kita, Jakarta, Indonesia (Siswanto) Department of Cardiology and Vascular Medicine, Universitas Indonesia, Depok, Indonesia Publisher Springer Nature Abstract Blood pressure variability (BPV) has been associated with increased morbidity and mortality across various cardiovascular conditions, but its prognostic significance in heart failure (HF) remains insufficiently established. This review aims to assess the potential utility of BPV as a prognostic marker in the HF population. We conducted a systematic review and meta-analysis of 15 studies including 33,022 patients (mean age 66.2 +/- 10.5 years). Composite endpoints included all-cause mortality, cardiovascular mortality, HF rehospitalization, nonfatal stroke, nonfatal myocardial infarction, and heart transplantation. Pooled hazard ratios were calculated using a generic inverse variance approach under a random-effects model. Higher long-term BPV was significantly associated with increased risk of composite outcomes (HR 1.20, 95% CI 1.01-1.43; I2 = 89%, p = 0.03) and all-cause mortality (HR 1.15, 95% CI 1.05-1.25; I2 = 49%, p = 0.001). Daytime short-term BPV showed an inverse association (OR 0.96, 95% CI 0.92-0.99; I2 = 0%, p = 0.01), while a U-shaped relationship between long-term BPV and risk of composite outcomes and cardiovascular mortality was observed. These findings suggest that BPV may serve as a prognostic factor for secondary risk stratification in patients with HF. Copyright © The Author(s), under exclusive licence to Springer Nature Limited 2026. <10> Accession Number 2044560119 Title Effects of preconditioning with one-lung ventilation on perioperative oxygenation and oxidative stress in thoracoscopic surgery: a prospective single-center randomized controlled clinical trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 215. Date of Publication: 01 Dec 2026. Author Lin J.; Du X.; Zhang W.; Wu C.; Zhao D.; Fang J. Institution (Lin) Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Du, Fang) Department of Anesthesiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China (Zhang) Department of Anesthesiology, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China (Wu) Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China (Zhao) Department of Anesthesiology, Shenzhen People's Hospital, The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, China Publisher BioMed Central Ltd Abstract Background: Hypoxemia is a common and clinically significant problem during one-lung ventilation (OLV). Prophylactic ventilation strategies to prevent OLV-associated hypoxemia and lung injury remain insufficiently defined. Method(s): Patients scheduled for elective video-assisted thoracoscopic lung lobectomy or segmentectomy were enrolled and randomly assigned into a preconditioning group or a control group. After anesthesia induction, a visual double-lumen endotracheal tube was inserted. The preconditioning group underwent three cycles of OLV preconditioning protocol before surgery: 2 min OLV -> 2 min two-lung ventilation (TLV) -> 4 min OLV -> 4 min TLV -> 6 min OLV -> 6 min TLV. The control group received conventional OLV only. Ventilation parameters: the tidal volume was set at 6 mL/kg during OLV and 8 mL/kg during TLV. Respiratory rate was adjusted to maintain an end-tidal carbon dioxide partial pressure of 35-45 mmHg. The primary outcome was the oxygenation index (arterial partial pressure of oxygen/fraction of inspired oxygen, PaO<inf>2</inf>/FiO<inf>2</inf>). Secondary outcomes included perioperative oxidative stress markers and the incidence of postoperative pulmonary complications (PPCs) within 7 days after surgery. Result(s): Seventy-four patients were included in the final analysis. The oxygenation index decreased in both groups after initiation of OLV, reaching its lowest value at 30 min. At this time point, the preconditioning group showed a significantly higher oxygenation index than the control group (209 +/- 64 vs. 145 +/- 43 mmHg, P < 0.001). No significant differences were observed between the two groups in perioperative superoxide dismutase (SOD) levels [168 +/- 16 vs. 160 +/- 21 U/mL, P = 0.302] or in the incidence of PPCs (10/38 vs. 16/36, P = 0.105). Conclusion(s): OLV preconditioning improved intraoperative oxygenation during thoracic surgery, but did not significantly affect perioperative oxidative stress or the incidence of PPCs. Trial registration: The study was retrospectively registered in the Chinese Clinical Trial Registry on April 8, 2021, (http://www.chictr.org.cn, ChiCTR2100045203). Copyright © The Author(s) 2026. <11> Accession Number 2045327940 Title Oral step-down vs full-course intravenous antibiotic therapy for infective endocarditis: Protocol for a systematic review and meta-analysis. Source PLOS ONE. 21(4 April) (no pagination), 2026. Article Number: e0348084. Date of Publication: 01 Apr 2026. Author Cruz-Cuevas J.D.; Amador Bedoya J.A.; Mendez Gaitan M.P.; Ramirez M.C.; Quiroga J.G.; Rodriguez Villegas A.; Reyes A.S. Institution (Cruz-Cuevas, Amador Bedoya, Mendez Gaitan, Ramirez, Quiroga, Rodriguez Villegas, Reyes) Fundacion Cardioinfantil, Instituto de Cardiologia, Bogota, Colombia (Cruz-Cuevas, Amador Bedoya, Ramirez, Quiroga, Rodriguez Villegas) School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia (Mendez Gaitan) School of Medicine, Universidad El Bosque, Bogota, Colombia (Reyes) School of Medicine, Universidad de La Sabana, Bogota, Colombia Publisher Public Library of Science Abstract Background Infective endocarditis (IE) is a life-threatening condition traditionally managed with prolonged intravenous (IV) antibiotic therapy. However, sequential oral antibiotic therapy has emerged as a promising alternative in selected patients, potentially reducing hospital stay, adverse events, and healthcare costs. While the POET trial demonstrated non-inferiority of oral step-down therapy in a narrow subset of patients with left-sided IE, broader applicability remains uncertain. Observational studies and recent meta-analyses have yielded heterogeneous and inconclusive results, underscoring the need for a comprehensive synthesis of current evidence. Methods This protocol outlines the methodology for a systematic review and meta-analysis comparing the effectiveness and safety of sequential oral antibiotic therapy versus full-course IV therapy in adult patients with bacterial IE. We will include randomized controlled trials and observational comparative studies enrolling adults diagnosed with IE by Duke criteria, clinical judgment, or histopathological confirmation. The primary outcomes are all-cause mortality and clinical cure; secondary outcomes include relapse, unplanned cardiac surgery, embolic events, hospital length of stay, and adverse events. Searches will be conducted in MEDLINE, Embase, CENTRAL, and LILACS, with no restrictions on publication date or language. Risk of bias will be assessed using RoB 2 and ROBINS-I tools. Data synthesis will follow Cochrane guidelines, and certainty of evidence will be evaluated using the GRADE approach. Discussion This review will provide a rigorous and up-to-date synthesis of the evidence on oral step-down therapy in IE, addressing populations underrepresented in prior trials. The findings will inform clinical decision-making, guideline development, and future research on optimizing antibiotic strategies for IE. Copyright © 2026 Cruz-Cuevas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. <12> Accession Number 2044686314 Title Discrepancy Between Invasive and Echocardiographic Transvalvular Gradients After TAVI Procedure: A Review of the Literature. Source Journal of Clinical Medicine. 15(7) (no pagination), 2026. Article Number: 2740. Date of Publication: 01 Apr 2026. Author Afendoulis D.; Vlachakis P.K.; Tsiamis N.; Tsakirian F.; Tountas C.; Theofilis P.; Synetos A.; Tsalamandris S.; Toulgaridis F.; Drakopoulou M.; Aggeli K.; Tsioufis K.; Toutouzas K. Institution (Afendoulis, Vlachakis, Tsiamis, Tsakirian, Theofilis, Tsalamandris, Drakopoulou, Aggeli, Tsioufis, Toutouzas) Unit of Structural and Valvular Heart Diseases, First Department of Cardiology, National and Kapodestrian University of Athens, General Hospital of Athens "Hippokration", Athens, Greece (Tsiamis, Tountas, Toulgaridis) Catheterization Laboratory, General Hospital of Athens "Sismanogleio", Athens, Greece (Synetos) School of Medicine, European University of Cyprus, Nicosia, Cyprus Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Transcatheter aortic valve implantation (TAVI) has become an established treatment for patients with severe aortic stenosis. The accurate post-procedural assessment of transvalvular gradients is essential for evaluating procedural success and long-term prognosis. However, significant discrepancies have been reported between gradients measured invasively and those derived by Doppler echocardiography. This systematic review aims to summarize the current evidence comparing invasive and echocardiographic gradient measurements after TAVI. Method(s): A comprehensive literature search was conducted of the PubMed database from inception to 8 November 2025 using the keywords: "TAVI/TAVR," "invasive versus echocardiographic gradient," and related terms. Studies were included if they compared invasive and Doppler-derived aortic valve gradients following TAVI. Out of 44 identified articles, 12 studies met the inclusion criteria and were analyzed. Result(s): Across all the included studies, the echocardiography-derived mean gradients were consistently 4-7 mmHg higher than those obtained invasively, reflecting physiologic rather than procedural discordance. The difference was more pronounced in balloon-expandable and small-diameter valves and in patients with high-flow states. Invasive gradients were independently associated with mortality and major adverse cardiovascular events (MACEs) in multiple studies. An invasive mean gradient <= 10 mmHg immediately post-TAVI was repeatedly identified as the threshold for optimal procedural success and improved long-term outcomes. Conclusion(s): Doppler echocardiography systematically overestimates transvalvular gradients after TAVI. While both modalities remain valuable, an invasive hemodynamic assessment provides the most reliable evaluation of immediate procedural success and long-term prognosis. Echocardiographic gradients should be interpreted relative to the baseline invasive measurement to avoid overdiagnosis of prosthetic dysfunction and ensure appropriate clinical management. Copyright © 2026 by the authors. <13> Accession Number 2045463247 Title Long term outcomes of different revascularization strategies in left main coronary artery: a network meta-analysis. Source International Journal of Cardiology. 457 (no pagination), 2026. Article Number: 134539. Date of Publication: 15 Aug 2026. Author Lombardi M.; Chiabrando J.G.; Occhipinti G.; Elia E.; Laudani C.; Garibaldi S.; Audo A.; Maj G.; Vergallo R.; Porto I.; Gonzalo N.; Escaned J.; Patti G.; Secco G.G. Institution (Lombardi, Secco) Interventional Cardiology Unit, AOU SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Lombardi, Elia, Vergallo, Porto) Department of Internal Medicine and Medical Specialties (DIMI), Universita di Genova, Genova, Italy (Chiabrando, Garibaldi) Interventional Cardiology Unit, UOSD Emodinamica, Ospedale Barone Romeo, Patti, Italy (Occhipinti) Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (Occhipinti) Instituto de Investigaciones Biomedicas Agusti Pi i Sunyer (IDIBAPS), Barcelona, Spain (Laudani) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "Rodolico - San Marco", University of Catania, Catania, Italy (Laudani) Division of Cardiology, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, United States (Audo) Division of Cardiac Surgery, AOU SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Maj) Division of Cardiothoracic Intensive Care, AOU SS, Antonio e Biagio e Cesare Arrigo, Alessandria, Italy (Vergallo, Porto) Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy (Gonzalo, Escaned) Hospital Clinico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Madrid, Spain (Patti) Division of Cardiology, Maggiore della Carita Hospital, Novara, Italy (Patti, Secco) Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy Publisher Elsevier Ireland Ltd Abstract Background: The comparative effectiveness of angiography-guided versus imaging-guided PCI relative to coronary artery bypass grafting (CABG) in left main coronary artery (LMCA) disease remains uncertain. Method(s): We performed a network meta-analysis of randomized controlled trials (RCTs) including patients undergoing LMCA revascularization. Pooled incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were computed. Co-primary endpoints were major adverse cardiovascular events (MACE) by trial definition and all-cause death. Secondary endpoints included myocardial infarction (MI), stroke, target vessel revascularization (TVR), repeat revascularization, and stent thrombosis or graft occlusion. Result(s): Seventeen RCTs encompassing 7700 patients (median follow-up 2 years) were included. Angiography-guided PCI was associated with a higher risk of MACE compared with both imaging-guided PCI (IRR 1.34, 95%CI 1.05-1.72) and CABG (IRR 1.49, 95%CI 1.10-2.03). Compared with imaging-guided PCI, neither CABG (IRR 1.00 95%CI 0.81-1.24) nor angiography-guided PCI (IRR 1.04, 95%CI 0.77-1.40) differed in all-cause death. CABG was associated with a lower risk of MI, TVR and repeat revascularization, but at the expense of an increased stent thrombosis or graft occlusion. Angiography-guided PCI was associated with higher risks of TVR compared with imaging-guided PCI and a lower risk of stroke compared to both CABG and imaging-guidance. Conclusion(s): In patients with LMCA disease, no significant differences in MACE were observed between imaging-guided PCI and CABG, whereas angiography-guided PCI was associated with a higher risk of MACE compared either with imaging-guided PCI and CABG. PCI, regardless of guidance, achieved all-cause death comparable to surgery. Imaging guidance reduced stent thrombosis or graft occlusion, whereas CABG reduced MI and repeat revascularization.PROSPERO registration number: CRD420261283126. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <14> Accession Number 2045440498 Title Evaluation of the efficacy of empagliflozin in patients with preserved left ventricular ejection fraction undergoing transcatheter aortic valve implantation for aortic stenosis: protocol for a randomised, open-label, controlled study. Source BMJ Open. 16(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Okita S.; Kitahara H.; Shoji M.; Sugawara T.; Miyakoda K.; Yaginuma H.; Yamamoto H.; Kanda T.; Kinoshita M.; Sasaki H.; Suzuki-Eguchi N.; Takaoka H.; Matsuura K.; Ozawa Y.; Hanaoka H.; Matsumiya G.; Kobayashi Y. Institution (Okita, Kitahara, Miyakoda, Yaginuma, Kinoshita, Sasaki, Suzuki-Eguchi, Takaoka, Kobayashi) Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan (Shoji, Sugawara, Ozawa, Hanaoka) Clinical Research Center, Chiba University Hospital, Chiba, Japan (Yamamoto, Kanda, Matsuura, Matsumiya) Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan Publisher BMJ Publishing Group Abstract Introduction: Heart failure occasionally develops after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS), despite procedural success. Most cases present with mildly reduced or preserved left ventricular ejection fraction (LVEF), underscoring the role of diastolic dysfunction. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown benefits across the heart failure spectrum, independent of LVEF. The purpose of this randomised controlled trial is to determine whether adding a SGLT2 inhibitor to conventional medications improves LV diastolic function in patients with preserved LVEF after TAVI. Methods and analysis: This study is a prospective, single-centre, open-label, randomised, parallel-group, two-arm trial enrolling patients with mildly reduced or preserved LVEF (>=40%) undergoing TAVI for severe AS. Participants will be randomised in a 1:1 ratio to receive either conventional medications plus empagliflozin or conventional medications alone. In the empagliflozin group, participants will receive conventional medical therapy plus empagliflozin 10 mg orally once daily, initiated 4 weeks after TAVI. Empagliflozin treatment will continue throughout the study period. Participants in the control group will receive conventional medications without empagliflozin. The primary endpoint is the change in E/e', assessed by echocardiography from treatment initiation at 4 weeks post TAVI (day 1) to day 168 (week 24). Each group will include 50 patients, totalling 100 patients. Ethics and dissemination: Ethical approval for this study has been obtained from the Chiba University Hospital Certified Clinical Research Review Board (CRB0111-25). Trial registration number: jRCT1031250190. 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/. <15> Accession Number 2044195579 Title Comprehensive Options for Pediatric Donation After Circulatory Death Donors. Source Seminars in Thoracic and Cardiovascular Surgery: Pediatric Cardiac Surgery Annual. 29 (pp 102-108), 2026. Date of Publication: 01 Jan 2026. Author Kucera J.A.; Wolf S.E.M.; Skalla L.; Turek J.W.; Overbey D.M. Institution (Kucera, Wolf, Turek, Overbey) Congenital Heart Surgery Research and Training Laboratory, Duke University, Durham, North Carolina, United States (Skalla) Duke University Medical Center Library & Archives, Duke University School of Medicine, Duke University, Durham, North Carolina, United States (Turek, Overbey) Duke Children's Pediatric and Congenital Heart Center, Durham, North Carolina, United States Publisher W.B. Saunders Abstract Cardiac transplant represents the only definitive strategy for children with end-stage heart failure. Pediatric patients face significant wait-list times and resultant mortality due to a worsening shortage of hearts available for transplant. Donation after circulatory death (DCD) represents an opportunity to increase the number of hearts available to pediatric recipients by 30%. DCD donation has been historically limited in application due to logistical challenges and ethical concerns. A systematic review was carried out using the Cochrane Handbook. Eligible studies were identified using MEDLINE (via OVID), Embase (Elsevier), Cochrane Library/Cochrane Central Register of Controlled Trials (CENTRAL; Wiley), and Web of Science Core Collection (Clarivate). This search was conducted by a professional medical librarian in consultation with the author team and validated against a set of pre-selected articles. This resulted in 438 articles, which were screened based on title and abstract by 2 independent authors. Full-text review was subsequently performed, resulting in 21 articles. Agreement for inclusion included pediatric DCD, published in English, and complete manuscript availability. Four principal techniques were identified for pediatric DCD: rapid procurement and static cold storage, organ care systems, normothermic regional perfusion, and on-table reanimation. These all portend unique advantages and disadvantages and have largely evolved due to limitations of prior techniques. Providing a comprehensive approach to pediatric cardiac DCD is the most effective method to ensure organ stewardship, minimize wait list mortality, and mitigate ethical concerns associated with pediatric DCD. Copyright © 2025 <16> Accession Number 2044494698 Title Medical therapies to prevent the development and progression of calcific aortic valve stenosis: a contemporary review. Source Expert Review of Cardiovascular Therapy. 24(4) (pp 339-351), 2026. Date of Publication: 2026. Author Courtney W.A.; Walker J.; Dorai-Raj A.; Arnous S.; O'Connor C.T.; Playford D.; Ihdayhid A.; Schultz C.J.; Hillis G.S.; Kiernan T.J. Institution (Courtney, Schultz, Hillis) Medical School, University of Western Australia, Crawley, WA, Australia (Courtney, Walker, Dorai-Raj, Schultz, Hillis) Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia (Courtney, Arnous, O'Connor, Kiernan) Department of Cardiology, University Hospital Limerick, Limerick, Ireland (Playford) School of Medicine, University of Notre Dame, Fremantle, WA, Australia (Ihdayhid) Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Perth, Australia (Ihdayhid) Department of Cardiology, Fiona Stanley Hospital, Perth, Australia (Ihdayhid) Medical School, Curtin University, Bentley, WA, Australia (Kiernan) School of Medicine, University of Limerick, Castletroy, Ireland Publisher Taylor and Francis Ltd. Abstract Introduction: Aortic stenosis (AS), the leading cause of valvular heart disease related mortality, affects 12% of individuals over 75 years and is set to expand as the population ages. Once symptoms develop, severe symptomatic AS carries an average survival of approximately two years. The only management currently available is aortic valve replacement (AVR), either surgically or via transcatheter aortic valve implantation, but this addresses only the end stage of the disease process which is often associated with irreversible myocardial remodeling. There are currently no pharmacotherapies proven to treat AS. The development of this condition is an active pathophysiological process which involves complex metabolic signaling cascades providing myriad potential therapeutic targets. Areas covered: This review looks at recent and ongoing clinical trials of novel pharmacotherapies for AS, including lipid lowering therapy, nitrous oxide pathway targeting, vitamin K supplementation, renin-angiotensin-aldosterone system blockade, repurposing diabetic pharmacotherapies, colchicine, and transthyretin stabilizers. Expert opinion: AS is an active, pathological disease which should be amenable to pharmacological modulation. A wide spectrum of pharmacotherapeutic agents are currently being investigated and the authors of this review are optimistic that we might be on the cusp of a breakthrough. Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <17> Accession Number 2044848096 Title Preoperative Educational Video Viewing is Associated with a Reduced Incidence of Subconjunctival Hemorrhage Following Intravitreal Anti-VEGF Injection. Source Patient Preference and Adherence. 20 (no pagination), 2026. Article Number: 583463. Date of Publication: 2026. Author Cai H.; Xu J.; He J.; Sui A.; Zhang P.; Tang Y.; Ding J.; Hua P.; Zheng W.; Su M.; Ye P.; Fang X.; Zheng F. Institution (Cai, Xu, He, Sui, Zhang, Tang, Ding, Hua, Zheng, Su, Ye, Fang, Zheng) Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88, Jiefang Road, Hangzhou, China (Cai, Zhang, Tang, Ding, Hua) Nursing Unit, Eye Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China Publisher Dove Medical Press Ltd Abstract Objective: To assess whether preoperative viewing of an educational procedural video reduces the incidence and severity of subconjunctival hemorrhage (SCH) following intravitreal anti-VEGF injections (IVI), and improves patient experience. Method(s): In this surgeon-blind randomized controlled trial conducted at a single tertiary care center (NCT07002372), treatment-naive patients scheduled for their first IVI were prospectively enrolled and randomized to either an intervention group (video viewing) or a control group (no video viewing). All participants completed the State-Trait Anxiety Inventory-State (STAI-S) before and after the injection. SCH incidence and area were assessed via standardized post-injection photographs analyzed using ImageJ software. Additional outcomes included patient-reported pain scores, heart rate, procedure time, and surgeon-rated cooperation. Result(s): A total of 108 patients were enrolled, of whom 103 completed the study, which was fewer than the initially planned sample size. Baseline demographics were similar between groups. SCH occurred in 21/51 (41.2%) patients in the intervention group versus 36/52 (69.2%) in the control group (P = 0.004), though SCH area did not differ significantly. Logistic regression analysis revealed that the use of anticoagulant medication was positively associated with the occurrence of SCH (OR = 3.252; 95% CI, 1.166-9.071; P = 0.024), whereas watching an educational video prior to IVI was associated with a lower risk of SCH (OR = 0.275; 95% CI, 0.115-0.656; P = 0.004). Anxiety scores decreased post-procedure in both groups. In the intervention group, anxiety decreased modestly after video viewing (28.54 +/- 10.40 to 27.00 +/- 8.78, P = 0.052). Patients rated the video as helpful for understanding (8.75/10), calming nerves (8.44/10), and improving cooperation (8.55/10). No significant differences were observed in pain scores, heart rate, procedure time, or surgeon-rated cooperation. Conclusion(s): Preoperative procedural video viewing reduces the incidence of SCH and improves patients' understanding of IVI. Given its simplicity and ease of implementation, this approach may serve as a practical adjunct to enhance patient experience in clinical practice. Copyright © 2026 Cai et al. <18> [Use Link to view the full text] Accession Number 2044965550 Title What Psychiatric Drug Development Can Learn From Cardiology Drug Development: Placebo Can Detect an Increase in the Mortality Rate. Part 3. Source Advances in Anatomic Pathology. 32(1) (pp 28-30), 2026. Date of Publication: 01 Jan 2026. Author Preskorn S.H. Institution (Preskorn) Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Kansas, Wichita, KS Publisher Lippincott Williams and Wilkins Abstract This column, like the previous 2 columns in this series, shows how placebo is a control for the natural course of an illness. In the study presented in this column, the use of placebo enabled the investigators to detect that active treatment was deleterious to the patient. In the second column in the series, the use of placebo showed that adding a usually effective antibiotic for an infection did not alter the outcome because of the nature of the infection and the value of treatment as usual (TAU). The first column in the series described TAU in a double-blind randomized controlled trial (RCT). Parenthetically, that column also discussed how different TAU is in such studies versus TAU in clinical practice. Those differences likely contribute to why TAU in such trials can be quite effective and why they are frequently negative. That first paper also discussed how the Heisenberg Uncertainty Principle from physics can be applied to psychiatric clinical trials, further emphasizing the difference in care received in an RTC versus clinical practice. Thus, investigators need to take the Heisenberg Principle into account when designing their studies and readers need to consider it when assessing the results. In the studies described in the second and third columns in the series, the focus was on objective and clinically meaningful endpoints (ie, resolution of a localized infection in the second column and death in this third column) in contrast to the often subjective endpoints in many psychiatric clinical trials (eg, improvement on a rating scale of symptoms that are reported by a participant/patient). The field of psychiatry needs to aim to develop such objective and clinically meaningful endpoints for its clinical trials. Finally, all 3 columns in this series emphasize that placebo does not mean nothing but rather involves all the treatment that a patient receives during the trial, except for the investigational treatment being tested, as well as the natural history of the illness, which includes the natural fluctuation in symptoms. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <19> Accession Number 2044937197 Title Predicting Factors Affecting Postoperative Length of Stay in Patients Undergoing Coronary Artery Bypass Graft Surgery Using Machine Learning Methods: A Systematic Review. Source Health Science Reports. 9(4) (no pagination), 2026. Article Number: e72391. Date of Publication: 01 Apr 2026. Author Jafarkhani A.; Imani B.; Saeedi S.; Shams A. Institution (Jafarkhani, Imani) Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of (Saeedi) Department of Health Information Technology, School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of (Shams) Department of Cardiology, Clinical Research Development Unit of Farshchian Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background and Aim: Nowadays, coronary artery bypass graft (CABG) surgery has become a common method for treating coronary artery diseases. This surgery requires a long post-operative length of stay (PLOS) in the hospital. The purpose of this study was to systematically review the factors affecting PLOS in patients undergoing CABG surgery using machine learning methods. Method(s): A comprehensive search was conducted on PubMed, Scopus, IEEE Xplore, and Web of Science, from inception until September 25, 2023. This review was performed according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses. All studies that investigated the factors affecting PLOS using machine learning methods in patients undergoing CABG surgery were included in the study. Result(s): In total, 9715 articles were identified after the removal of the duplicates. After the systematic screening, 20 studies met the inclusion criteria. The result showed there are 56 effective factors in predicting PLOS in patients undergoing CABG surgery. Of which 15 factors: age, gender, left ventricular ejection fraction, infection, Perceived Control (PC) levels, BMI, angina class, diabetes, Logistic Euro-score, smoking, fluid balance, inotropes, low cardiac output, atrial fibrillation, and history of cerebrovascular accident are mentioned in more than one article as an affecting factors. Conclusion(s): This systematic review highlights the multifactorial nature of PLOS, showing that patients' postoperative length of stay is influenced by factors across pre-, intra-, and postoperative care. Copyright © 2026 The Author(s). Health Science Reports published by Wiley Periodicals LLC. <20> Accession Number 2044912205 Title Clinical Applications of Artificial Intelligence in Structural Heart Disease. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(4) (no pagination), 2026. Article Number: 104396. Date of Publication: 01 Apr 2026. Author Allaham H.; Chahal D.; Srivastava M.; Aalaei-Andabili S.H.; Gupta A. Institution (Allaham, Chahal, Srivastava, Aalaei-Andabili, Gupta) Division of Cardiovascular Medicine, University of Maryland Medical Center, Baltimore, MD, United States Publisher Elsevier B.V. Abstract Transcatheter cardiac interventions have advanced substantially over the past decade, providing less invasive therapeutic options for an expanding spectrum of structural heart disease. As procedural complexity increases, artificial intelligence (AI) has emerged as a complementary tool to support clinical decision making. Early studies demonstrated that AI can automate imaging analysis, quantify cardiac anatomy, and assess hemodynamics with greater accuracy, efficiency, and reproducibility than conventional methods. This comprehensive review summarizes current clinical applications of AI in structural heart disease, focusing on its role in diagnosis, assessment of disease progression, risk stratification, procedural planning, and prediction of clinical outcomes. Copyright © 2026 The Author(s). <21> Accession Number 2044898614 Title Vascular endothelial dysfunction as a mechanism of hearing loss in carotid artery stenosis: a scientific literature review. Source Egyptian Journal of Otolaryngology. 42(1) (no pagination), 2026. Article Number: 106. Date of Publication: 01 Dec 2026. Author Shodmonkulova G.; Khaydarova G.; Yulbarisov A.; Kholmuratova O.; Bobamuratova D.; Narzullayeva S. Institution (Shodmonkulova, Khaydarova) Department of Otorhinolaryngology, Tashkent State Medical University, Tashkent, Uzbekistan (Yulbarisov) Department of Angioneurology, Republican Specialized Center for Surgical Angioneurology, Tashkent, Uzbekistan (Kholmuratova) Republican Specialized Scientific and Practical Medical Center of Oncology and Radiology, Tashkent, Uzbekistan (Bobamuratova) Department of Stomatology, Tashkent State Medical University, Tashkent, Uzbekistan (Narzullayeva) Department of Clinical Sciences, Gulistan State University, Gulistan, Uzbekistan Publisher Springer Medizin Abstract Objective: This review aimed to examine the potential role of vascular endothelial dysfunction in the development of hearing loss associated with carotid artery stenosis. Method(s): A narrative literature review was conducted using PubMed, Google Scholar, Web of Science, and Scopus databases. Studies published in English up to January 2026 were identified using predefined search terms related to carotid atherosclerosis, endothelial dysfunction, and hearing loss. A total of 197 records were identified. After screening and eligibility assessment, 25 relevant epidemiological, mechanistic, clinical, and interventional studies were included in the qualitative synthesis. Result(s): The included studies suggest a consistent association between carotid atherosclerosis and sensorineural hearing loss. Increased carotid intima-media thickness and plaque burden were associated with poorer hearing thresholds and a higher risk of both sudden and progressive hearing loss. Mechanistic evidence indicates that endothelial dysfunction-characterized by reduced nitric oxide bioavailability, oxidative stress, and inflammatory activation-may contribute to impaired cochlear microcirculation and ischemic injury. Clinical manifestations range from subclinical auditory decline to sudden sensorineural hearing loss and pulsatile tinnitus. Evidence regarding hearing improvement following carotid revascularization remains limited and is primarily based on small case series. Conclusion(s): Vascular endothelial dysfunction may represent an important mechanism linking carotid artery stenosis to hearing loss. Although current evidence supports an association between vascular disease and auditory impairment, causality has not been definitively established. Recognition of this relationship may support earlier diagnosis and integrated cardiovascular-audiological management, while further prospective and interventional studies are needed to clarify underlying mechanisms and therapeutic implications. Copyright © The Author(s) 2026. <22> Accession Number 2044829360 Title Intercostal nerve cryoablation for postoperative analgesia in open thoracic surgical procedures: a GRADE-assessed systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 16. Date of Publication: 01 Dec 2026. Author Hamza M.; Shah S.Z.; Saqib H.W.; Altaf H.; Khalid A.A.; Shahid S.R.; Singh A.; Khurshid M.M.; Chaudhry I.U.H. Institution (Hamza, Chaudhry) Muzaffarabad General Hospital, AJK, Muzaffarabad, Pakistan (Shah) Frontier Medical and Dental College, Abbottabad, Pakistan (Saqib) Islamic International Medical College, Rawalpindi, Pakistan (Altaf) Combined Military Hospital CMH, AJK, Muzaffarabad, Pakistan (Khalid) Peshawar Medical College, Peshawar, Pakistan (Shahid) Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Pakistan (Singh) Southampton General Hospital, University Hospital Southampton United Kingdom, Southampton, United Kingdom (Khurshid) Anglia Ruskin University Chelmsford, Chelmsford, United Kingdom Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Major open thoracic surgery is associated with severe postoperative pain and substantial opioid requirements, contributing to pulmonary complications and delayed recovery. Thoracic epidural analgesia (TEA) remains the standard regional technique but is frequently contraindicated or associated with complications in high-risk cardiothoracic patients. Intraoperative intercostal nerve cryoablation (CRYO) has emerged as a potential opioid-sparing alternative; however, its effectiveness across diverse thoracic surgical indications remains uncertain. Method(s): A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Cochrane Library were searched from inception to January 5, 2026 for randomized and observational studies evaluating intraoperative CRYO in adult patients undergoing major open thoracic surgery. Comparators included standard multimodal analgesia and TEA. Random-effects models were applied, and certainty of evidence was assessed using GRADE. Result(s): Eight studies comprising nine independent cohorts (n = 825) were included. CRYO significantly reduced cumulative inpatient opioid consumption compared with control strategies (SMD - 0.86; 95% CI - 1.57 to - 0.15) and improved early postoperative pain scores (MD - 0.74; 95% CI - 1.45 to - 0.03). Pulmonary function recovery was significantly enhanced (SMD 0.61; 95% CI 0.20 to 1.01), with consistent effects across surgical indications. Conclusion(s): Intraoperative intercostal nerve cryoablation is associated with no significant increase in reported complications and is an effective opioid-sparing adjunct that improves early pain control and pulmonary recovery following major open thoracic surgery. Its clinical benefits are procedure-dependent, with greatest impact observed outside the lung transplantation population. CRYO represents a viable alternative to neuraxial analgesia, particularly in patients at elevated risk for epidural-related complications. Copyright © The Author(s) 2026. <23> Accession Number 2042483106 Title Aortic Valve Replacement for Severe Asymptomatic Aortic Stenosis-A Systemic Review and Bayesian Meta-analysis. Source Canadian Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Brophy J.M. Institution (Brophy) Research Institute of McGill University Health Centre, Centre for Health Outcomes Research, Montreal, QC, Canada Publisher Elsevier Inc. Abstract Background Previous meta-analyses have concluded that early aortic valve replacement (AVR) is associated with reduced cardiovascular events compared to clinical surveillance (CS) for severe asymptomatic aortic stenosis (AS). However, individual patient data (IPD) was not used and the possibility of biases not considered. Methods A systematic review of randomized clinical trials (RCTs) whose primary outcome was mortality and unplanned cardiac hospitalization. IPD data was reconstructed, permitting calculation of time varying risks. Bayesian analyses, with vague priors, were performed for each trial and combined in a meta-analysis. Results Four RCTs were identified. The pooled average long-term primary outcome was hazard ratio (HR) 0.52 (95% credible interval (CrI) 0.25 - 0.93) and the predicted HR for the next study was HR 0.52 (95% CrI 0.13 - 1.87) with increased uncertainty from between study heterogeneity. Only the EARLY_TAVR trial showed improved outcomes in year one (HR 0.33, 95% CrI 0.24 - 0.46), driven by a 142% increase in the crossover rate compared to previous trials. A one-year landmark analysis, that eliminates possible early unblinding bias, showed no long term AVR benefit for any individual study or for the pooled result (RR 0.59, 95% CI 0.20 - 1.40). Conclusions One-year landmark analysis showed no definitive longer-term benefit for early AVR compared to CS in asymptomatic AS. The EARLY_TAVR benefit is possibly the result of performance bias. Further research is required before early AVR for asymptomatic severe AS can become the new standard of care. Copyright © 2025 Canadian Cardiovascular Society. <24> Accession Number 2045364201 Title Septic arthritis due to Corynebacterium striatum in native joints: a systematic review of published cases. Source Diagnostic Microbiology and Infectious Disease. 116(1) (no pagination), 2026. Article Number: 117440. Date of Publication: 01 Sep 2026. Author Posada S.R.; Zamora P.C.; Lopez L.P.; Dominguez M.G.; Fernandez R.C.; Pardavila H.P.; Garcia P.M.A. Institution (Posada, Zamora, Lopez, Dominguez, Fernandez, Garcia) Department of Clinical Microbiology and Parasitology, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain (Pardavila) Department of Infectious Diseases, Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain Publisher Elsevier Inc. Abstract Background: Corynebacterium striatum has traditionally been regarded as a skin commensal and is frequently dismissed as a contaminant when isolated from clinical samples. However, it has increasingly been recognized as an opportunistic pathogen in selected clinical settings. Septic arthritis involving native joints remains an exceptionally rare manifestation, and its clinical significance is often difficult to interpret. Method(s): Given the absence of comprehensive analyses in this field, we performed a systematic literature review of published cases of septic arthritis caused by C. striatum involving native joints, in accordance with PRISMA 2020 guidelines. Demographic data, risk factors, clinical presentation, microbiological findings, management strategies, and outcomes were reviewed. A contemporary case was included as part of the overall analysis. Result(s): Twelve cases were identified. Most patients presented with acute monoarticular arthritis affecting large joints, particularly the knee and shoulder. Predisposing factors were present in nearly all cases, including advanced age, immunosuppression, underlying joint disease, or recent joint manipulation. Synovial fluid analysis consistently demonstrated a marked inflammatory profile. Repeated isolation of C. striatum from sterile joint samples supported its etiologic role. Management commonly included surgical irrigation and debridement combined with prolonged antimicrobial therapy, most frequently vancomycin. Overall outcomes were generally favourable, although severe complications were reported in patients with significant comorbidities. These findings identify consistent clinical and therapeutic patterns despite the rarity of the condition. Conclusion(s): Corynebacterium striatum should be considered a potential cause of septic arthritis in native joints, particularly in high-risk patients. Its clinical presentation is largely indistinguishable from that of septic arthritis caused by more common bacterial pathogens, and diagnosis relies on repeated isolation from sterile synovial samples in the context of a markedly inflammatory synovial profile. Early surgical drainage combined with targeted prolonged antimicrobial therapy, most commonly vancomycin with oral linezolid step-down when susceptible, appears to represent the most consistently supported management strategy based on available evidence. Recognition of its pathogenic potential is essential to avoid misclassification as contamination, prevent delayed diagnosis and suboptimal treatment, and ultimately improve clinical outcomes in this emerging clinical entity. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <25> [Use Link to view the full text] Accession Number 616768342 Title A comparison of extraluminal and intraluminal use of the Uniblocker in left thoracic surgery. Source Medicine (United States). 96(21) (no pagination), 2017. Article Number: e6966. Date of Publication: 01 May 2017. Author Liu Z.; He W.; Jia Q.; Yang X.; Liang S.; Wang X. Institution (Liu, Wang) Department of Anesthesiology, Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Shijiazhuang Hebei, China (He, Jia, Yang, Liang) Department of Anesthesiology, First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China Publisher Lippincott Williams and Wilkins Abstract Background: The aim of this study was to assess the feasibility and safety issues concerning extraluminal use of the Uniblocker for one-lung ventilation (OLV) in the left thoracic surgery. Method(s): Forty patients undergoing elective left thoracic surgery were included in this study, and all patients were randomly allocated to extraluminal use of Uniblocker group (E group, n = 20) or intraluminal use of Uniblocker group (I group, n = 20). Time for intubation, time for verification of the correct position of Uniblocker, incidence of Uniblocker displacement, index of pulmonary collapse, mean arterial pressure, heart rate, peak airway pressure, oxygen saturation in two-lung ventilation, and 30 minutes after OLV, bronchial damage after OLV, sore throat, and hoarseness postoperative were recorded. Result(s): The time for positioning Uniblocker was 112.6 +/- 31.2 seconds in intraluminal use group, whereas the time for positioning Uniblocker was significantly shorter in extraluminal use group (63.4 +/- 15.8 seconds). The incidence of main bronchial injury, the time of intubation, the incidence of Uniblocker malposition after initial placement, the time of OLV, the degree of pulmonary collapse, mean arterial pressure, heart rate, peak airway pressure, oxygen saturation in two-lung ventilation, and 30 minutes after OLV, the incidence of sore throat and hoarseness postoperative have no statistical significance (P > .05). Conclusion(s): Extraluminal use of the Uniblocker was proved to be a more rapid and more accurate method than conventional intraluminal use of the Uniblocker for OLV in left thoracic surgery. Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. <26> Accession Number 649779834 Title CPAP Versus Conventional Oxygenation Postextubation in Children With Congenital Heart Disease. Source Respiratory care. 71(5) (pp 460-465), 2026. Date of Publication: 01 May 2026. Author Shi A.; Li M.; Zhou J.; Peng M.; Bian L. Institution (Shi, Li) Mr. Shi and Ms. Li are affiliated with Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China (Zhou, Peng, Bian) Ms. Zhou, Peng, Bian are affiliated with Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing City, Jiangsu Province, China Abstract BACKGROUND: Congenital heart disease (CHD) is a leading contributor to pediatric morbidity and mortality worldwide. Postoperative respiratory complications, particularly reintubation, remain a critical concern following cardiac surgery in children. This study evaluates the effectiveness of early nasal CPAP in reducing reintubation rates and respiratory complications in children with CHD after extubation. METHOD(S): A single-center randomized controlled trial was conducted from July 2022 to July 2024. A total of 264 children (<=3 years) undergoing cardiac surgery for CHD were randomized to either an intervention group (n = 132), receiving nasal CPAP (4 cm H2O pressure, 5 L/min oxygen flow) immediately postextubation, or a control group (n = 132), receiving standard nasal cannula oxygen therapy. The primary outcome was reintubation within 48 h. Secondary outcomes included ventilation parameters (PaO2, PaCO2, SpO2) and respiratory complications (eg, bronchospasm, hypoxemia). RESULT(S): The reintubation rate within 48 h was significantly lower in the CPAP group compared with the control group (12% vs 28%, risk ratio 0.41, 95% CI 0.22-0.76, P < .05). The CPAP group demonstrated marked improvements in ventilation parameters (PaO2, PaCO2, SpO2) at 4, 8, and 12 h postextubation (P < .05 for all). Additionally, the incidence of respiratory complications was notably reduced in the intervention group (P < .05). CONCLUSION(S): Early application of nasal CPAP postextubation significantly reduces reintubation rates and enhances respiratory outcomes in children with CHD. This low-complexity CPAP shows promise for adoption in resource-limited settings, with potential cost advantages meriting further investigation. <27> Accession Number 2045022947 Title Perioperative Interventions Based on Fasting Protocols and Carbohydrate Loading in Non-Cardiac Surgery in Older Adults: A Scoping Review. Source Medicina (Lithuania). 62(4) (no pagination), 2026. Article Number: 756. Date of Publication: 01 Apr 2026. Author Lozano J.D.M.; Tuta-Quintero E.; Bonilla Llanos M.C.; Valencia M.C.; Solano F.; Cruz A.; Bonilla N.; Rios Barbosa F. Institution (Lozano, Bonilla Llanos, Valencia, Solano, Cruz, Bonilla, Rios Barbosa) Department of Anesthesiology, School of Medicine, Universidad de La Sabana, Campus del Puente del Comun, Km. 7, Autopista Norte de Bogota, Chia, Colombia (Tuta-Quintero) Department of Epidemiology, School of Medicine, Universidad de La Sabana, Campus del Puente del Comun, Km. 7, Autopista Norte de Bogota, Chia, Colombia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Postoperative delirium and postoperative cognitive dysfunction are common complications in older adults undergoing elective non-cardiac surgery, associated with increased morbidity and mortality, functional decline, and prolonged hospital stay. Prolonged preoperative fasting may intensify inflammatory responses and insulin resistance. Preoperative oral carbohydrate loading within ERAS protocols may modulate this response and reduce cognitive risk. Material(s) and Method(s): A scoping review was conducted following the methodological recommendations of Arksey and O'Malley, the Joanna Briggs Institute, and PRISMA-ScR. A systematic search was performed in PubMed and Scopus for studies published up to September 2025. Randomized controlled trials and observational studies including adults >= 65 years undergoing elective non-cardiac surgery were included if they evaluated fasting modifications or preoperative carbohydrate loading and reported postoperative delirium or cognitive dysfunction. Result(s): A total of eight publications were included: four randomized controlled trials, one prospective cohort study, two cross-sectional studies, and one descriptive/correlational study. Populations included older adults undergoing elective abdominal, orthopedic, colorectal, or hip surgery, as well as hospitalized elderly surgical patients. Interventions included oral carbohydrate loading, assessment of preoperative nutritional status, and enteral versus parenteral nutrition. Only four of the eight included studies directly evaluated neurocognitive outcomes. Postoperative delirium was assessed in three studies, using the Confusion Assessment Method in two studies and the Delirium Rating Scale in one study. Postoperative cognitive dysfunction was evaluated in one study using a Mini-Mental State Examination-based cognitive assessment, while the remaining four studies did not assess neurocognitive outcomes and instead focused on metabolic, inflammatory, or perioperative well-being outcomes. Conclusion(s): Available evidence suggests that perioperative fasting protocols and preoperative carbohydrate loading may influence metabolic and inflammatory responses related to postoperative neurocognitive outcomes in older adults. However, evidence remains limited and heterogeneous. Findings are exploratory and hypothesis-generating, highlighting the need for well-designed trials assessing neurocognitive outcomes in geriatric surgical populations. Copyright © 2026 by the authors. <28> Accession Number 2045087910 Title Silent Stroke in Adult Cardiac Surgery: Mechanisms, Clinical Impact, and Preventive Strategies. Source Medicina (Lithuania). 62(4) (no pagination), 2026. Article Number: 675. Date of Publication: 01 Apr 2026. Author Condello I.; Dell'Aquila M.; Condello S.; Falco G.; Totaro A.; Dsouki Y.E.; Prapas S.; Katsavrias K.; D'Onofrio A.; Newman J.; Patel N.; Kalimi R.; Gaudino M.; Calafiore A.M. Institution (Condello) School of Medicine and Surgery, University of Insubria, Varese, Italy (Dell'Aquila, Newman, Patel, Kalimi) Northwell Health, Cardiovascular Institute, New York, NY, United States (Condello) Neuromotor Rehabilitation Unit, Istituti Clinici Scientifici, Maugeri SPA, Ribera, Italy (Falco) Cardiology Unit, University Hospital Consortium Polyclinic of Bari, Bari, Italy (Totaro) Department of Medicine and Health Sciences "V. Tiberio", University of Molise, Campobasso, Italy (Dsouki) Faculty of Health, Medicine and Life Sciences, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands (Prapas, Katsavrias, Calafiore) 1st Division of Cardiac Surgery, Henry Dunant Hospital, Athens, Greece (D'Onofrio) Division of Cardiac Surgery, University of Rome "Tor Vergata", Rome, Italy (Gaudino) Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Overt perioperative stroke remains a feared complication of adult cardiac surgery. Diffusion-weighted magnetic resonance imaging (DWI-MRI) has revealed a more prevalent form of cerebral injury, termed silent stroke or silent brain injury (SBI). Covert ischemic lesions occur without focal neurological deficits but are increasingly associated with postoperative delirium, cognitive decline, and elevated long-term cerebrovascular risk. Despite growing recognition, the true burden, mechanisms, and clinical relevance of SBI remain incompletely integrated into perioperative practice. Material(s) and Method(s): We performed a narrative review of the literature published between January 2000 and December 2025, identified through PubMed/MEDLINE and Scopus. Eligible studies included prospective and retrospective cohorts, randomized trials, systematic reviews, and meta-analyses involving adult patients undergoing coronary artery bypass grafting, valve surgery, or minimally invasive cardiac procedures, with or without cardiopulmonary bypass, and reporting MRI-detected ischemic lesions or validated surrogate markers of cerebral injury. Pediatric studies, transcatheter interventions, case reports, and non-English publications were excluded. Sixty studies met the inclusion criteria. Result(s): Silent stroke occurred more frequently than clinically apparent stroke, with new DWI-MRI lesions detected in approximately 20-60% of patients following cardiac surgery. Lesions were typically small, multifocal, and embolic in distribution, predominantly affecting cortical and watershed regions. Cardiopulmonary bypass-related factors, including aortic manipulation, cerebral microembolization, hemodilution, hypoperfusion, and impaired oxygen delivery, emerged as key contributors. Several studies demonstrated associations between SBI burden and postoperative delirium, early cognitive dysfunction, and functional decline. Perfusion-based neuroprotective strategies showed mechanistic benefit, although no single intervention conclusively prevented SBI. Conclusion(s): Silent stroke represents the most frequent form of neurological injury in adult cardiac surgery. Evidence suggests that these covert lesions reflect clinically meaningful cerebral injury, with potential short- and long-term consequences. Recognition of silent stroke as a relevant neurological endpoint supports a shift toward multimodal, perfusion-driven neuroprotective strategies and the routine incorporation of MRI-based outcomes in future cardiac surgical research. Copyright © 2026 by the authors. <29> Accession Number 2040472718 Title Safety of pre-procedure fasting versus non-fasting protocols before cardiac catheterization - a Bayesian meta-analysis of randomized clinical trials. Source Cardiovascular Revascularization Medicine. 86 (pp 34-43), 2026. Date of Publication: 01 May 2026. Author Chaturvedi A.; Al Qaraghuli A.K.; Verma B.R.; Haberman D.; Cellamare M.; Zhang C.; Galo J.; Abusnina W.; Lupu L.; Hashim H.D.; Rogers T.; Ben-Dor I.; Satler L.F.; Waksman R. Institution (Chaturvedi, Verma, Haberman, Galo, Abusnina, Lupu, Hashim, Rogers, Ben-Dor, Satler, Waksman) Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States (Al Qaraghuli) Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, United States (Cellamare, Zhang) MedStar Cardiovascular Research Network, Washington, DC, United States (Rogers) Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States Publisher Elsevier Inc. Abstract Background Fasting prior to cardiac catheterization is a routine practice to minimize the risk of complications. Recent studies suggest that non-fasting protocols may be equally safe and increase patient satisfaction. We performed a meta-analysis of randomized controlled trials (RCTs) to examine the safety of fasting versus non-fasting prior to cardiac catheterization. Methods We searched for eligible RCTs comparing fasting versus non-fasting protocols prior to cardiac catheterization from inception through December 21, 2024. Studies were included if they reported at least one of the outcomes of interest- nausea/vomiting, aspiration event, new ventilation/oxygen requirements, hypotension, hypoglycemia, and acute kidney injury. The treatment effect of each outcome was measured using the logarithmic odds ratios (logOR) and estimated under the Bayesian paradigm. Under the hierarchical Bayesian random effect model, we elicited an informative prior for the logOR ~ (0, 0.1), representing the null hypothesis of no treatment effect. Between-study heterogeneity was elicited with a weakly informative half-Cauchy prior of a 0.5 scale. All analyses were conducted using R version 4.0. Results 9 studies met the inclusion criteria with a total of 3567 patients (1805 in fasting and 1762 in non-fasting). The Bayesian meta-analysis yielded a posterior mean OR of 0.99 [95 % credible interval (CrI): 0.82-1.20] for nausea and vomiting, 0.99 (95 % CrI: 0.82-1.21) for aspiration event, 1.003 (95 % CrI: 0.83-1.22) for new ventilation and oxygen requirements, 1.04 (95 % CrI: 0.87-1.25) for hypotension, 1.02 (95 % CrI: 0.85-1.24) for hypoglycemia, and 0.97 (95 % CrI: 0.81-1.18) for acute kidney injury. All CrI include 1 and the point estimates are very close to 1, indicating a lack of evidence to drive away from the prior assumption of no average effect size. Sensitivity analyses using three distinct prior scenarios (non-informative, optimistic informative, and skeptical informative) and a subset of studies conducted in 2023-2024 yielded similar findings. Conclusion Our study demonstrates that a non-fasting strategy prior to cardiac catheterization is as safe as the usual fasting strategy. Pre-procedural fasting should be individualized based on patient and procedure-related factors, and guidelines should be updated with regard to pre-cardiac procedure protocols that minimize fasting and improve patient satisfaction. Copyright © 2025. Published by Elsevier Inc. <30> Accession Number 2045326437 Title Effect of care bundle in preventing delirium after bypass surgery: a single-blind, non-randomised clinical trial. Source Heart and Lung. 79 (no pagination), 2026. Article Number: 102826. Date of Publication: 01 Sep 2026. Author Elagoz I.; Koyuncu A.; Sensoy F.; Gonel A.; Iyem H. Institution (Elagoz) Kilis 7 Aralik University, Yusuf Serefoglu Faculty of Health Sciences, Department of Nursing, Kilis, Turkey (Koyuncu) Hasan Kalyoncu University, Faculty of Health Sciences, Department of Nursing, Gaziantep, Turkey (Sensoy) Gaziantep Medical Point Hospital, Department of Neurology, Gaziantep, Turkey (Gonel) SANKO University, Faculty of Medicine, Department of Medical Biochemistry, Gaziantep, Turkey (Iyem) Gaziantep Medical Point Hospital, Department of Cardiovascular Surgery, Gaziantep, Turkey Publisher Elsevier Inc. Abstract Background: Delirium is a common complication following coronary artery bypass graft (CABG) surgery, associated with longer hospital stays, increased morbidity, and higher healthcare costs. Objective(s): To evaluate the effectiveness of a multicomponent care bundle in preventing postoperative delirium among patients undergoing CABG surgery. Method(s): This single-blind, non-randomised trial included 94 patients consecutively allocated by time period (47 per group). The primary outcome was delirium incidence at postoperative day 1 assessed by a blinded neurologist using DSM-5 criteria. Delirium subtypes were classified by RASS scores. The control group received standardised care; the study group received standardised care plus continuous family presence, patient-selected music, and earplug use. Cortisol, ACTH, glucose, sleep quality, pain, and anxiety were evaluated. Statistical significance was set at p < 0.05. Result(s): At postoperative day 1, delirium incidence assessed by DSM-5 criteria was 14.9% in the study group vs. 38.3% in controls (p = 0.013; OR = 0.28, 95% CI: 0.10-0.76; ARR = 23.4%). Hyperactive delirium was markedly lower (2.1% vs. 14.9%). At postoperative days 1 and 2, cortisol, ACTH, glucose, pain, and anxiety levels were lower, and sleep quality was higher in the study group. Adherence to all bundle components exceeded 90%. Conclusion(s): The multicomponent care bundle was associated with significant reduction in postoperative delirium (NNT = 4.3), particularly hyperactive delirium, and improvements in stress biomarkers and psychological well-being. High adherence supports feasibility of this low-cost, nurse-led intervention. Randomised trials are needed to confirm causality. Copyright © 2026 Elsevier Inc. <31> Accession Number 2043723432 Title Rapid deployment valves: current position on the market and future directions. Source Expert Review of Medical Devices. 23(5) (pp 469-473), 2026. Date of Publication: 2026. Author Szecel D.; Van den Bosch M.; Meuris B. Institution (Szecel, Van den Bosch, Meuris) Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium Publisher Taylor and Francis Ltd. Abstract Introduction: With an estimated prevalence of nine million people worldwide, calcific aortic valve stenosis is the most common valvular heart disease in North America and Western Europe. Although transcatheter procedures have expanded considerably over the past decade, surgical aortic valve replacement (SAVR) remains a reliable and trusted therapeutic option. Sutureless (SU) and rapid deployment valves (RDVs) are bioprostheses specifically designed for implantation during SAVR using few or no sutures. These bioprostheses offer well-recognized advantages, including ease of implantation and shorter operative times, although higher rates of permanent pacemaker implantation have been reported. Their use is also well documented in the context of minimally invasive surgery. Areas covered: This article presents a narrative overview of the current evidence on the benefits, limitations, and typical clinical indications of SU/RDV prostheses. Recent developments and potential future applications are also discussed. Expert opinion: In the context of a rapidly evolving treatment paradigm for aortic valve stenosis, SU and RDV bioprostheses have demonstrated their value as reliable devices for surgical valve replacement. Continued clinical research will be essential to better delineate which patients may benefit most as part of an individualized, lifetime valve-management strategy. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <32> [Use Link to view the full text] Accession Number 2044965626 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, and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, MA (Muehlschlegel) Department of Anesthesiology, The Johns Hopkins Hospital, Baltimore, MD (Pittet) Department of Anesthesiology, University of Alabama at Birmingham, Birmingham, AL (Bardia) Department of Anesthesiology, Massachusetts General Hospital, Boston, MA (Schonberger) Department of Anesthesiology, Yale School of Medicine, New Haven, CT Publisher Lippincott Williams and Wilkins 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 <33> Accession Number 2045066466 Title Assessment of the Bangla Heart Manual in patients with coronary heart disease and their caregivers in Bangladesh: a feasibility study. Source BMJ Open. 16(3) (no pagination), 2026. Date of Publication: 30 Mar 2026. Author Uddin J.; Faruque M.; Mashreky S.R.; Siddiqueea Y.; Chowdhury M.A.; Karim R.; Khaled M.F.I.; Taylor L.; Dalal H.M.; Taylor R. Institution (Uddin) MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, College of Medical Veterinary and Life Sciences, Glasgow, United Kingdom (Uddin) Department of Cardiac Surgery, Physiotherapy Unit, Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh (Faruque, Siddiqueea) Department of Noncommunicable Diseases, Bangladesh University of Health Sciences, Dhaka, Bangladesh (Mashreky) Department of Public Health, North South University, Dhaka, Bangladesh (Chowdhury, Khaled) University Cardiac Centre, Department of Cardiology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh (Karim) Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh (Taylor) The Heart Manual Department, NHS Lothian, Edinburgh, United Kingdom (Dalal) Research, Development and Innovation, Royal Cornwall Hospitals NHS Trust, Truro, United Kingdom (Dalal) Primary Care, University of Exeter Medical School, Truro, United Kingdom (Taylor) MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom Publisher BMJ Publishing Group Abstract Objectives: To assess the feasibility and acceptability of the home-based Bangla Heart Manual of Cardiac Rehabilitation (CR) programme for people with coronary heart disease (CHD) following revascularisation living in Bangladesh. Design and settings: Tertiary level cardiac hospital in Dhaka city; a single-centre feasibility pilot study, with a mixed-methods single arm pre-post design. Participant(s): The study involved 33 patients with CHD admitted for revascularisation (coronary artery bypass graft or percutaneous coronary intervention) between June and July 2024, selected from 72 screened. Two physiotherapists and one nurse conducted the research, focusing on patients deemed suitable for CR. Intervention(s): Selected patients received the Bangla Heart Manual intervention that consisted of a 6-week programme of home-based CR including exercise training, self-care, relaxation, risk factor management and psychological support facilitated by a healthcare professional. Primary and secondary outcomes: The primary outcomes focused on feasibility, assessing patient recruitment, retention and adherence to the intervention using quantitative and qualitative methods, including interviews with patients, caregivers and healthcare professionals. Secondary outcomes measured patient-reported metrics like health-related quality of life (HeartQoL, EQ-5D-5L), psychological well-being, exercise capacity (Hospital Anxiety and Depression Scale), and serious adverse events (hospitalisation and mortality) before and after the Bangla Heart Manual intervention. Result(s): The 33 patients recruited included 29 (88%) males with a mean age of 55 years. The following feasibility outcomes were achieved: 46% (33 patients from 72 screened) recruited, 91% (30/33) retention (complete outcome data at follow-up) and 75% intervention adherence (>=6 sessions attended of 8 sessions). Improvements following CR participation were seen in patient-reported outcomes and exercise capacity. Two deaths and one rehospitalisation occurred during the study. Conclusion(s): This study showed that the Bangla Heart Manual home-based CR programme was acceptable and feasible for people with CHD in Bangladesh and healthcare professional staff to deliver. Our results also support the feasibility of recruitment and data collection processes for a future multicentre randomised trial to formally test the clinical and cost effectiveness of the adapted Bangla Heart Manual. Trial registration number: ISRCTN1545620. 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/. <34> Accession Number 2045302518 Title A pilot randomized controlled trial to test the feasibility of a mobile health (mHealth) self-help intervention for adults after cardiac surgery. Source European Journal of Cardiovascular Nursing. 25(2) (pp 354-363), 2026. Date of Publication: 01 Mar 2026. Author Wynne R.; Nolte J.; Angel J.; Moore A.; Campbell T.; Ferguson C. Institution (Wynne) Centre for Quality & Patient Safety, Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, Australia (Wynne) Western Health-Deakin Partnership, Western Centre for Research & Education, Majorca Street, St Albans, VIC, Australia (Nolte) Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia (Angel) Department of Cardiothoracic Surgery, The Royal Melbourne Hospital, Grattan Street, Parkville, VIC, Australia (Moore) Healthily Pty Ltd, St Kilda Road, Melbourne, VIC, Australia (Campbell) Healthily Pty Ltd, St Kilda Road, Melbourne, VIC, Australia (Ferguson) School of Nursing, Faculty of Science, Medicine & Health, University of Wollongong, Wollongong, NSW, Australia Publisher Oxford University Press Abstract Aims: To determine feasibility, acceptability and test protocol integrity, for testing a mobile health (mHealth) intervention focused on enhancing self-management after adult cardiac surgery. Secondary aims were to assess the effect of the intervention on 30-day readmission, quality of life, and knowledge, skill and confidence for self-help. Methods and Results: A parallel-group, pilot randomized controlled trial was conducted in a major metropolitan publicly funded health service. Adult elective cardiac surgery patients discharged home within 30-days, able to understand spoken English, and use a smartphone, tablet or computer were eligible for inclusion. The mHealth intervention comprised patient narrative videos, and on-line resources focused on diagnosis, preparing for surgery, and immediate, and ongoing recovery. From August 2021 until the 23rd of December 2022, there were 341/516 elective cardiac surgery cases. Of 70 (20.5%) eligible patients, 61 (87.1%) participated. The mHealth intervention was accessed by 27 (84.4%) participants. When accessed, the intervention was feasible and acceptable for patients, there were no protocol violations. There was high viewing of content related to diagnosis, surgery and looking forward, compared with programmes related to rehabilitation. Readmission rates did not differ between groups. Participants taking action to manage their health in the intervention group incrementally increased from baseline to 90-day follow-up. Conclusion(s): The effect of patient narratives on patient activation warrants testing in an adequately powered randomized controlled trial. While the uptake of the mHealth intervention was modest, trends in actions for self-help and rate of 30-day readmission imply the intervention is potentially effective in improving self-help management. Registration: The Australian and New Zealand Clinical Trials Registry: ACTRN12621000082808. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. <35> Accession Number 2044220004 Title Conduction System vs Biventricular Pacing in Heart Failure: The PhysioSync-HF Randomized Clinical Trial. Source JAMA Cardiology. 11(4) (pp 360-368), 2026. Date of Publication: 08 Apr 2026. Author Zimerman A.; Dal Forno A.; Rohde L.E.; Ternes C.M.; Alves F.D.; Damiani L.P.; Martinelli-Filho M.; Costa R.; Fagundes A.A.; Barbosa R.M.; Gadelha E.B.; Lima C.E.; Silva M.A.; Maldonado J.A.; De Oliveira J.C.; Mallmann F.; Baggio Junior J.M.; Duarte C.E.; De Souza L.A.; Santos J.S.; Silveira A.D.; Decker S.R.R.; Zimerman L.I.; Polanczyk C.A.; D'avila A. Institution (Zimerman, Rohde, Alves, De Souza, Santos, Decker, Polanczyk) MOVE Academic Research Organization, Hospital Moinhos de Vento, Moinhos de Vento Medical School, Porto Alegre, Brazil (Zimerman, Rohde, Silveira, Zimerman, Polanczyk, D'avila) Cardiology Division, Hospital Moinhos de Vento, Porto Alegre, Brazil (Zimerman, Rohde, Alves, De Souza, Silveira, Decker, Polanczyk) Postgraduate Program in Cardiology and Cardiovascular Sciences, Federal University of Rio Grande do Sul, Porto Alegre, Brazil (Zimerman, Rohde, Ternes, Alves, De Souza, Santos, Silveira, Decker, Polanczyk) Research Projects Office, Hospital Moinhos de Vento, Porto Alegre, Brazil (Dal Forno, Ternes, D'avila) Hospital SOS Cardio, Florianopolis, Brazil (Rohde, Silveira, Zimerman, Polanczyk) Cardiology Division, Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil (Damiani) Brazilian Clinical Research Institute, Sao Paulo, Brazil (Damiani) Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil (Martinelli-Filho) Department of Cardiology, Instituto do Coracao, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil (Costa) Cardiac Pacing Division, Department of Cardiovascular Surgery, Instituto do Coracao, Hospital das Clinicas da Universidade de Sao Paulo, Sao Paulo, Brazil (Costa) Discipline of Cardiovascular Surgery, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil (Fagundes) Hospital Ana Nery, Salvador, Brazil (Barbosa) Instituto Nacional de Cardiologia, Rio de Janeiro, Brazil (Gadelha) Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil (Lima) Hospital Universitario da Universidade Federal do Piaui, Teresina, Brazil (Silva) Hospital Universitario Cassiano Antonio de Moraes, Vitoria, Brazil (Maldonado) Fundacao Hospitalar do Coracao Francisca Mendes, Manaus, Brazil (De Oliveira) Hospital Geral Universitario de Cuiaba, Cuiaba, Brazil (Mallmann) Instituto de Cardiologia de Santa Catarina, Sao Jose, Brazil (Baggio Junior) Instituto de Cardiologia do Distrito Federal, Brasilia, Brazil (Duarte) Hospital Beneficencia Portuguesa, Sao Paulo, Brazil (Decker) Internal Medicine Division, Hospital Moinhos de Vento, Porto Alegre, Brazil (Decker) Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (D'avila) Harvard-Thorndike Electrophysiology Institute, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States Publisher American Medical Association Abstract Importance: Conduction system pacing (CSP) is a promising and potentially cost-effective alternative to biventricular pacing (BiVP) in patients with heart failure with reduced ejection fraction (HFrEF) and left bundle-branch block (LBBB), but its impact on heart failure (HF) outcomes remains uncertain. Objective(s): To compare CSP vs BiVP on an HF-related outcome in patients with HFrEF and LBBB. Design, Setting, and Participant(s): PhysioSync-HF (Conduction System Pacing Versus Biventricular Resynchronization in Patients With Chronic Heart Failure) was an investigator-initiated, multicenter, noninferiority randomized clinical trial enrolling participants from November 2022 to December 2023 with 12 months of follow-up at 14 hospitals across all regions of Brazil. Adults with symptomatic HFrEF (New York Heart Association NYHA] classes II through III), left ventricular ejection fraction (LVEF) of 35% or less, and LBBB (QRS duration >=130 milliseconds) were eligible for inclusion. Data were analyzed from May to August 2025. Intervention(s): Patients were randomized 1:1 to either CSP (preferentially left bundle-branch area pacing) or BiVP. Main Outcomes and Measures: The primary outcome was a hierarchical composite of death, HF hospitalizations, urgent HF visits, and change in LVEF at 12 months. The prespecified noninferiority margin for the odds ratio (OR) was 1.2. Result(s): A total of 173 patients (median [IQR] age, 62 years [56-68]; 86 female patients [49.7%]; 115 (66.5%) with dilated cardiomyopathy; median [IQR] LVEF, 26% [22%-31%]; median [IQR] QRS, 180 milliseconds [170-200]) were included. At 12 months, CSP failed to meet noninferiority and was inferior to BiVP for the primary end point (OR, 2.36; 95% CI, 1.37-4.06; P =.99 for noninferiority; P =.002 for between-group difference). The time-to-event composite of death, HF hospitalizations, or urgent HF visits was higher in CSP (hazard ratio, 2.35; 95% CI, 0.99-5.61). Mean (SD) LVEF increased to 35% (12%) with CSP and 39% (12%) with BiVP (mean difference, 3.8%; 95% CI, 0.3%-7.3%). Relative to baseline, both groups had comparable improvements in QRS duration, Kansas City Cardiomyopathy Questionnaire Overall Summary Score, NYHA class, and natriuretic peptide levels. Total direct medical cost related to the procedure and heart failure care was the equivalent of $7090 (95% CI, $5779-$8648) lower in patients randomized to CSP at 12 months. Conclusions and Relevance: In patients with HFrEF and LBBB, CSP was inferior to BiVP for a composite of death, HF hospitalizations, urgent HF visits, and change in LVEF at 12 months. These findings do not support the routine use of CSP as the first-line resynchronization strategy in this population. Copyright © 2026 Zimerman A et al. <36> Accession Number 2045321623 Title Alcoholic cardiomyopathy presenting with severe circulatory failure requiring mechanical circulatory support: A systematic review. Source American Journal of Emergency Medicine. 106 (pp 49-54), 2026. Date of Publication: 01 Aug 2026. Author Itagaki H.; Endo T. Institution (Itagaki, Endo) Division of Emergency and Disaster Medicine, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, Sendai, Japan Publisher W.B. Saunders Abstract Background: Alcoholic cardiomyopathy (ACM) is a potentially reversible form of dilated cardiomyopathy associated with chronic excessive alcohol consumption. Although recovery of left ventricular function after alcohol abstinence has been reported, the clinical course of patients presenting with cardiogenic shock or cardiac arrest requiring mechanical circulatory support (MCS) remains poorly characterized. This study aimed to evaluate survival outcomes and myocardial recovery in patients with ACM presenting with severe circulatory failure. Method(s): A systematic literature search was conducted in PubMed, Web of Science, Google Scholar, and Ichushi-Web from database inception to February 28, 2026. Studies describing patients with ACM presenting with cardiogenic shock or severe circulatory failure requiring temporary MCS (including ECMO, Impella, intra-aortic balloon pump, or LVAD) were included. Extracted data included patient characteristics, type of circulatory support, survival outcomes, and recovery of left ventricular function. Result(s): Five studies (three case reports and two case series), including 10 patients, were identified. The median age was 43 years (IQR, 38-46), and 9 of 10 patients (90%) were male. The median baseline LVEF was 15% (IQR, 15-20%). Cardiac arrest occurred in 3 patients (30%). Veno-arterial extracorporeal support, including VA-ECMO/PCPS, was used in 9 patients (90%), Impella in 1 patient (10%), and LVAD support in 3 patients (30%). One patient ultimately underwent heart transplantation. All published cases survived. Among patients with available follow-up data, the median LVEF improved to 55% (IQR, 45-60%), representing a median absolute increase of approximately 40 percentage points. Conclusion(s): Published case-based evidence suggests that alcoholic cardiomyopathy may retain clinically meaningful reversibility even in selected patients with severe circulatory failure requiring mechanical circulatory support. Although favorable outcomes may be overrepresented in published reports, awareness of this potentially reversible phenotype may support timely recognition and appropriate management of severe circulatory failure. Copyright © 2026 Elsevier Inc. <37> Accession Number 2045067599 Title Sex differences in risk factor control and medication adherence post-ACS: insights from the TEXTMEDS randomised clinical trial. Source Open Heart. 13(1) (no pagination), 2026. Date of Publication: 2026. Author Mishra S.R.; Marschner S.; Min H.; Mahendran S.; Thiagalingam A.; Poulter R.; Redfern J.; Brieger D.B.; Thompson P.L.; Hillis G.S.; Collins N.; Shetty P.; McGrady M.; Hamilton-Craig C.; Kangaharan N.; Atherton J.; Maiorana A.; Klimis H.; Juergens C.; Chow C.K. Institution (Mishra) The University of Sydney Westmead Applied Research Centre, Westmead, NSW, Australia (Marschner, Klimis) Westmead Applied Research Centre, The University of Sydney, Westmead, NSW, Australia (Min) Westmead Applied Research Centre, The University of Sydney Faculty of Medicine and Health, Sydney, NSW, Australia (Mahendran) The University of Sydney, Sydney, NSW, Australia (Mahendran) Department of Cardiology, Westmead Hospital, Westmead, NSW, Australia (Thiagalingam) Westmead Clinical School, The University of Sydney, Sydney, NSW, Australia (Poulter) Department of Cardiology, Sunshine Coast University Hospital, Sunshine Coast, QLD, Australia (Redfern, Chow) Sydney Medical School, The University of Sydney, Sydney, NSW, Australia (Redfern, Chow) The George Institute for Global Health, Sydney, NSW, Australia (Brieger) Concord Hospital, Sydney, NSW, Australia (Thompson) Cardiovascular Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia (Hillis) Department of Cardiology, Royal Perth Hospital, Perth, Australia, Perth, WA, Australia (Collins) Cardiovascular Department, John Hunter Hospital, New Lambton Heights, NSW, Australia (Collins) The University of Newcastle, Callaghan, NSW, Australia (Shetty) Wollongong Hospital, South Coast Mail Centre, NSW, Australia (McGrady) Epidemiology and Preventive Medicine, Monash University, Melbourne, NSW, Australia (Hamilton-Craig) Department of Cardiology, Prince Charles Hospital, Merthyr Tydfil, United Kingdom (Kangaharan) Department of Cardiology, Alice Springs Hospital, Alice Springs, NT, Australia (Atherton) Royal Brisbane and Women's Hospital, Herston, QLD, Australia (Maiorana) Allied Health Department, Fiona Stanley Hospital, Murdoch, WA, Australia (Maiorana) Curtin University, Perth, WA, Australia (Juergens) The University of New South Wales, Sydney, NSW, Australia (Juergens) Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia Publisher BMJ Publishing Group Abstract Introduction: Poor adherence to risk factor control and life-saving medications is a key factor affecting long-term patient prognosis. Evidence indicates that sex plays a significant role in the uptake of both pharmacological and non-pharmacological interventions, ultimately influencing long-term outcomes. This study aimed to quantify sex differences in risk factor management and medication adherence following acute coronary syndrome (ACS). Method(s): This is a secondary analysis of the TEXTMEDS randomised clinical trial - a single-blind, multicentre randomised controlled trial of patients post-ACS. We compared sex differences in achieving clinical and lifestyle targets for secondary prevention, namely blood pressure control (<140/90 mm Hg), low-density lipoprotein cholesterol (LDL-C) (<1.8 mmol/L), healthy body mass index (BMI) (<25 kg/m2), regular physical activity (Global Physical Activity Questionnaire score >=600), smoking status and adherence to cardioprotective medications (aspirin, beta blockers, ACE/angiotensin receptor blockers, statins, antiplatelets), using adjusted logistic regression models. Medication adherence was defined as taking >=80% of prescribed doses in the month prior to follow-up, across all five drug classes, unless contraindicated. Result(s): Of 1379 patients (mean age 58.5+/-10.7 years; 1095 (79.4%) male), females were less likely than men to achieve LDL-C targets (adjusted OR (aOR): 0.61, 95% CI 0.45 to 0.82) and engage in regular physical activity (aOR: 0.61, CI 0.47 to 0.80), but more likely to achieve a healthy BMI (aOR: 1.47, CI 1.04 to 2.06). Female patients are less likely to adhere to their medication compared with male counterparts (aOR: 0.68, CI 0.50 to 0.92). However, this association weakened and lost statistical significance after further adjustment for socio-economic factors (aOR: 0.71, CI 0.50 to 1.03). There were no significant interactions between sociodemographic or clinical factors and sex in relation to overall medication adherence (P-interactions >0.05). Conclusion(s): This study reveals that female patients are less likely to achieve LDL-C targets and engage in physical activity but more likely to maintain a healthy BMI. Although females showed lower medication adherence, this association weakened after adjusting for socio-economic factors. These findings highlight the importance of sex-sensitive strategies focusing on risk factor control and medication adherence for improving cardiovascular health outcomes. Trial registration number: ACTRN12613000793718. 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/. <38> Accession Number 2045047670 Title Impacts of stent characteristics on periprocedural ischemic events in elective PCI: the ALPHEUS-stents study. Source International Journal of Cardiology. 456 (no pagination), 2026. Article Number: 134506. Date of Publication: 01 Aug 2026. Author Giovachini L.; Ferrante A.; Guedeney P.; Rahoual G.; Procopi N.; Barthelemy O.; Kerneis M.; Zeitouni M.; El Kasty M.; Cayla G.; Beygui F.; Range G.; Motovska Z.; Laredo M.; Dumaine R.; Ducrocq G.; Rouanet S.; Portal J.-J.; Vicaut E.; Montalescot G.; Silvain J. Institution (Giovachini, Ferrante, Guedeney, Rahoual, Procopi, Barthelemy, Kerneis, Zeitouni, Laredo, Montalescot, Silvain) Sorbonne Universite, ACTION Study Group, INSERM UMRS1166, Hopital Pitie-Salpetriere (AP-HP), Paris, France (El Kasty) Departement de Cardiologie, Grand Hopital de l'Est Francilien, Jossigny, France (Cayla) Cardiology Department, Nimes University Hospital, Montpellier University, ACTION Study Group, Nimes, France (Beygui) Cardiology Department, Caen University Hospital, ACTION Study Group, Caen, France (Range) Cardiology Department, Chartres Hospital, Chartres, France (Motovska) Cardiocenter, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czechia (Dumaine) Les Grands Pres Cardiac Rehabilitation Centre, Villeneuve St Denis, France (Ducrocq) Cardiology Department, Universite de Paris, Hopital Bichat, AP-HP, French Alliance for Cardiovascular Trials (FACT), INSERM U1148, Paris, France (Rouanet) Statistician Unit, StatEthic, ACTION Study Group, Levallois-Perret, France (Portal, Vicaut) ACTION Study Group, Unite de Recherche Clinique, Hopital Fernand Widal (AP-HP), EA 4543, Universite Paris 1 Pantheon-Sorbonne Paris, Paris, France Publisher Elsevier Ireland Ltd Abstract Background: Stents characteristics can have a tremendous impact on the incidence of periprocedural ischemic events following percutaneous coronary intervention (PCI) in patients with chronic coronary syndrome (CCS). The ALPHEUS-stents study aimed to describe the association between stents lengths and characteristics on the occurrence of periprocedural ischemic events. Method(s): The study included patients with CCS undergoing elective PCI with at least one high-risk feature. The primary endpoint of the study was the composite of type 4a/4b myocardial infarction (MI) and periprocedural major myocardial injury evaluated at 48 h or discharge. First, we evaluated the association between total stent length and primary outcome using a multivariate logistic regression considering stent length as a continuous variable and adjusting for relevant covariates. Then we evaluated the associations between stent diameter, strut thickness, platform composition, polymer type, coating distribution and eluted drugs with the primary endpoint using a multivariable logistic regression model, with stent length categorized within the aforementioned subgroups. Result(s): The primary endpoint occurred in 639 patients (35.8%). After adjustment, total stent length was significantly associated with the primary endpoint (adjusted Odds Ratio (aOR) 1.028 95%CI [1.028-1.029] per millimeter). No significant associations were observed across categories of stent diameter, strut thickness, platform composition or coating distribution. However, biolimus-eluting stents (aOR 1.051 [1.035-1.067], p = 0.006 vs other eluted drugs) were independently associated with an increased risk of the primary outcome. Conclusion(s): In patients undergoing elective PCI, the risk of periprocedural ischemic events is adequately captured by the total stent length. Biolimus-eluted stents might confer a higher risk of periprocedural ischemic events.ClinicalTrials.gov number: NCT02617290. Copyright © 2026 Published by Elsevier B.V. <39> Accession Number 2045067669 Title Efficacy and Safety of preoperative Controlling Heart Rate in Patients with Acute Type A Aortic Dissection (ESCORT): protocol for a randomised controlled trial. Source BMJ Open. 16(4) (no pagination), 2026. Date of Publication: 01 Apr 2026. Author Liu G.; Wang D.; Yang Y.; Zhang T.; Xie B.; Hu J.; Wei X.; Chen J.; Yuan S.; Yu C. Institution (Liu, Yuan) Anaesthesiology Centre, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China (Wang, Yu) Vascular Surgery Centre, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China (Yang) Emergency Centre, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China (Zhang) Arrhythmia Centre, Chinese Academy of Medical Sciences and Peking Union Medical College Fuwai Hospital, Beijing, China (Xie) Department of Cardiovascular Surgery, First Affiliated Hospital of Harbin Medical University, Harbin, China (Hu) Department of Cardiac and Great Vascular Surgery, West China Hospital of Sichuan University, Sichuan, Chengdu, China (Wei, Chen) Department of Cardiac Surgery, Huazhong University of Science and Technology Tongji Medical College Tongji Hospital, Hubei, Wuhan, China Publisher BMJ Publishing Group Abstract Introduction: Aortic dissection (AD) is a life-threatening cardiovascular emergency with a high mortality rate, and acute Stanford Type A AD is the most dangerous form, often requiring surgical intervention. Factors contributing to the progression of AD include increased heart rate, blood pressure and the rate of ventricular contraction (dP/dt). While heart rate control is a cornerstone of preoperative management for AD per existing guidelines, the recommended target (eg, <=60 bpm in American Heart Association 2010) is consensus-driven (Level C) and thus not grounded in high-level evidence. The ESCORT (Efficacy and Safety of preoperative Controlling heart Rate in patients with acute Type A aortic dissection) trial is designed to address this critical gap by providing high-level evidence from a randomised controlled trial to define the optimal preoperative heart rate target. Methods and analysis: The study is a multicentre, single-blind, RCT involving adult patients diagnosed with acute (Stanford Type A) AD, scheduled for aortic arch prosthetic vascular replacement and elephant trunk stent implantation surgery. 680 patients will be randomised into two groups: low heart rate target group (55-65 beats per minute) and standard heart rate target group (75-85 beats per minute). The intervention involves protocol-directed medication to achieve the target heart rates, with esmolol as the primary recommended agent. The primary outcome measure is the rate of major adverse cardiovascular event within 30 days after surgery, and secondary outcomes include various clinical, economic and biochemical measures. Discussion(s): The ESCORT study is the large-scale RCT to investigate the optimal preoperative heart rate control in patients with acute type A AD. The results of this study have the potential to fill the evidence gap in current clinical guidelines and provide evidence-based support for clinical management. The findings may influence the standard of care by either endorsing lower heart rate targets or providing alternative guidance for managing heart rate in this high-risk patient population. The study's results will be disseminated through publications and presentations at both national and international conferences, ensuring that the results are accessible to the medical community and relevant patient organisations. Ethics and dissemination: This study, including the study protocol (version 1.3, 3 December 2022), was approved by the Ethics Committee of Fuwai Hospital, CAMS and PUMC (approval number: 2022-1886). Additional approvals were obtained from the ethics committees of participating subcentres (approval numbers are listed in the main text). The findings will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences. Trial registration number: ChiCTR2300067811. 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/. <40> Accession Number 2044860349 Title First in Man Result of Clip2Edge Transcatheter Edge-to-Edge Repair System in Heart Failure Patients: One-Year Outcomes. Source Structural Heart. 10(6) (no pagination), 2026. Article Number: 100804. Date of Publication: 01 Jun 2026. Author Wang S.; Zhu W.; Han Y.; Li W.; Chen J.; Yang Z.; Liu Z.; Yang J.; Pan X.; Zhang J.; Zhu D. Institution (Wang, Zhu, Pan, Zhu) Structural Heart Center, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan, Kunming, China (Han) Department of Cardiology, Fuwai Central China Cardiovascular Hospital, Henan, Zhengzhou, China (Li) Department of Cardiac Surgery, The First Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang, Hangzhou, China (Chen) Department of Cardiology, Renmin Hospital of Wuhan University, Hubei, Wuhan, China (Yang) Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China (Liu) Department of Cardiology, Putuo District Central Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China (Yang) Department of Cardiac Surgery, Xijing Hospital, Shaanxi, Xi'an, China (Zhang) Department of Cardiology, Nanjing First Hospital, Jiangsu, Nanjing, China Publisher Cardiovascular Research Foundation <41> Accession Number 2044978874 Title N-acetyl cysteine after valve Surgery in poor ventricles: a pragmatic protocol. Source International Journal of Drug Delivery Technology. 16(1 Supplement) (pp 612-616), 2026. Date of Publication: 2026. Author Pathak S.; Yadav R.; Srivastava A.K. Institution (Pathak) Department of Cardiothoracic and Vascular Surgery, All India Institute of Medical Sciences, Uttar Pradesh, Raebareli, India (Yadav) Department of Cardiothoracic and Vascular Surgery, Institute of Medical Sciences, Banaras Hindu University, Uttar Pradesh, Varanasi, India (Srivastava) Department of Orthopaedics, Era's Medical College and Hospital, Uttar Pradesh, Lucknow, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Patients with deranged ventricular systolic function undergoing valve surgery are at high risk of low cardiac output syndrome (LCOS). N-acetylcysteine (NAC), a glutathione precursor and antioxidant, has been investigated in cardiac surgery with incongruous results. Evidence in the subset of poor ventricles after valve surgery is grossly deficient. Method(s): We performed a retrospective observational study of consecutive adults with ventricular dysfunction or global hypokinesia who underwent on-pump valve surgery at a newly established tertiary cardiac unit. Patients were managed with a post operative NAC protocol. Result(s): Total 9 patients were studied. Baseline demographics and surgical complexity were comparable after adjustment. NAC use within 48 hours of surgery was associated with a lower period of icu stay (5 days vs 12 days), reduced VIS (mean difference 14). Improvement of renal function was earlier. Hospital stay was shorter in the NAC cohort (19 days vs 24 days). 1 patient succumbed to death due to sustained non responsive ventricular fibrillation. NAC was not given in this patient. Post operative atrial fibrillation was absent in patient with preoperative tachybradyarrhythmia who received NAC before 48 hrs. No adverse reactions to NAC were documented. Conclusion(s): In this original article study of high-risk cohort of patients with poor ventricular function undergoing valve surgery, a pragmatic N-Acetyl Cysteine protocol was associated with reduced Low Cardiac Output Syndrome and improved hemodynamic stability without added safety concerns. These findings highlight the potential of NAC as an adjunct in managing vulnerable patients with impaired Ventricular function. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd.. All rights reserved. <42> Accession Number 2045094565 Title Artificial Intelligence in Cardiovascular Medicine: A Giant Step in Personalized Medicine?. Source Journal of Personalized Medicine. 16(4) (no pagination), 2026. Article Number: 192. Date of Publication: 01 Apr 2026. Author Jankauskas S.S.; Varzideh F.; Kansakar U.; Santulli G. Institution (Jankauskas, Varzideh, Kansakar, Santulli) School of Medicine, City University of New York, Manhattan, NY, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Artificial intelligence (AI) is rapidly reshaping cardiovascular (CV) medicine, driving a paradigm shift toward truly personalized and data-driven care. This comprehensive review examines the conceptual foundations, clinical applications, and future implications of AI across the CV continuum, spanning prevention, diagnosis, risk stratification, and therapy. Core AI methodologies (including machine learning, deep learning, natural language processing, and computer vision) are discussed in the context of cardiology's uniquely data-rich environment, encompassing imaging, electrocardiography, electronic health records, wearable devices, and multi-omics data. This systematic review highlights major clinical domains where AI has demonstrated a substantial impact, including CV imaging, ECG interpretation, hypertension and heart failure management, coronary artery disease, acute coronary syndromes, interventional cardiology, and cardiac surgery. AI-driven predictive analytics enable early detection of subclinical disease, improved prognostication, and individualized prevention strategies, while wearable technologies and remote monitoring platforms facilitate continuous, real-world patient surveillance. Emerging applications in pharmacotherapy, drug repurposing, and genomics further reinforce AI's role in advancing precision cardiology. Equally emphasized are the ethical, legal, and social challenges accompanying AI adoption, such as algorithmic bias, data privacy, cybersecurity, interpretability, and regulatory oversight. Our review underscores the necessity of rigorous clinical validation, transparent model design, and seamless integration into clinical workflows to ensure safety, equity, and physician trust. Ultimately, AI is best positioned as an augmentative tool that complements (but does not replace!) clinical expertise. By fostering hybrid intelligence that integrates human judgment with computational power, AI has the potential to redefine CV care delivery, improve outcomes, and support a more proactive, patient-centered healthcare model. Copyright © 2026 by the authors. <43> Accession Number 2045395107 Title Operative predictors of mortality and neurologic outcomes after modified Bentall for acute aortic dissection: A systematic review and meta-analysis. Source Asian Cardiovascular and Thoracic Annals. (no pagination), 2026. Date of Publication: 2026. Author Kurniawan K.; Wartono D.A. Institution (Kurniawan) Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia (Wartono) Department of Cardiothoracic and Vascular Surgery, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia Publisher SAGE Publications Inc. Abstract Introduction: The modified Bentall procedure is frequently required in acute type A aortic dissection (ATAAD) with root involvement, a high-risk subgroup with substantial early mortality and neurologic complications. Prior studies have examined operative predictors such as cardiopulmonary bypass (CPB) time, cross-clamp duration, circulatory arrest, and conduit type, but findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether specific operative parameters influence early mortality or neurologic outcomes following the Bentall procedure in ATAAD. Method(s): A systematic search of PubMed, Embase, CENTRAL, ProQuest, and Google Scholar was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifteen observational studies evaluating adult ATAAD patients undergoing the modified Bentall procedure were included. Pooled proportions of early mortality and neurologic complications were calculated using a random-effects model. Heterogeneity, publication bias, sensitivity testing, and meta-regression were conducted to assess associations between operative variables-including CPB time, cross-clamp time, circulatory arrest duration, operative time, conduit type, and concomitant coronary artery bypass grafting (CABG)-and postoperative outcomes. Result(s): Across 1547 patients, pooled early mortality was 13%, and the pooled rate of postoperative neurologic complications was likewise 12%. Sensitivity analyses showed stable results. Meta-regression demonstrated no significant association between any operative parameter and early mortality or neurologic events (all p > 0.05). No substantial publication bias was detected. Conclusion(s): Among ATAAD patients undergoing the modified Bentall procedure, early mortality and neurologic complication rates remain acceptable. The absence of significant operative predictors suggests that advances in perfusion, myocardial protection, and cerebral management may mitigate time-related risks. Further multicenter studies are needed to refine risk stratification. Copyright © The Author(s) 2026 <44> Accession Number 2043510213 Title A Randomized Controlled Study on the Impact of Early Urinary Catheter Removal on Postoperative Urinary Retention in Abdominal and Thoracic Surgery Patients with Thoracic Epidural Analgesia. Source Visceral Medicine. 42(2) (pp 48-54), 2026. Date of Publication: 01 Apr 2026. Author Alwali A.; Schafmayer C.; Klar E.; Philipp M.; Leuchter M.; Grambow E. Institution (Alwali, Schafmayer, Klar, Philipp, Grambow) Department of General, Visceral, Thoracic, Vascular and Transplant Surgery, University Medical Center Rostock, Rostock, Germany (Leuchter) Institute for Biostatistics and Informatics in Medicine and Ageing Research, University Medical Center Rostock, Rostock, Germany (Grambow) Department of Cardiovascular and Thoracic Surgery, University of Goettingen Medical Center, Goettingen, Germany Publisher S. Karger AG Abstract Background: Thoracic epidural analgesia (TEA) is a key component of Enhanced Recovery After Surgery protocols for major abdominal and thoracic procedures. Despite its benefits for pain management, TEA has been associated with an increased risk of postoperative urinary retention (POUR). Consequently, it is common practice to maintain a urinary catheter (UC) for the duration of TEA. This study aimed to evaluate the impact of early UC removal in patients receiving TEA through a randomized controlled trial. Method(s): In this randomized controlled trial approved by the Rostock University Medical Center Ethics Board (AZ A2018-0220), patients scheduled for elective major abdominal or thoracic surgery with anticipated TEA within 1 year were enrolled. Participants were randomized into two groups: the early removal group (ERG), where the UC was removed within 48 h post-surgery, and the standard group (SG), where the UC was retained until TEA discontinuation. POUR was defined as a residual urine volume of >=400 mL measured by ultrasound, and catheter-associated urinary tract infections (CAUTIs) were assessed. Result(s): Of the 99 patients initially enrolled, 81 patients were available for analysis. In the ERG (n = 43), the UC was removed within 48 h, whereas in the SG (n = 38), the UC was maintained until TEA cessation. The incidence of POUR was similar between the groups, with 1 patient in each group (2.3% in ERG vs. 2.6% in SG, p = 1) requiring recatheterization. CAUTI developed in 4 patients (4.9%), all of whom were in the SG (10.5%), indicating a statistically significant association between the timing of UC removal and CAUTI incidence (p = 0.044). Conclusion(s): Our results suggest that early UC removal under TEA is safe and does not significantly increase the risk of POUR while reducing the incidence of CAUTIs. These findings support the feasibility of early UC removal in this patient population and may inform future guidelines on perioperative UC management in the context of TEA. Copyright © 2026 The Author(s). Published by S. Karger AG, Basel <45> Accession Number 2045092852 Title Antibiotics and Other Drugs Removal by the CytoSorb Haemoadsorber: A Systematic Review of Available Evidence. Source Antibiotics. 15(4) (no pagination), 2026. Article Number: 409. Date of Publication: 01 Apr 2026. Author Kenda S.; Gubensek J.; Vovk T. Institution (Kenda, Vovk) Faculty of Pharmacy, University of Ljubljana, Askerceva 7, Ljubljana, Slovenia (Kenda) General Hospital Dr. Franc Derganc Nova Gorica, Padlih Borcev 13a, Sempeter Pri Gorici, Slovenia (Gubensek) Department of Nephrology, University Medical Center Ljubljana, Zaloska 7, Ljubljana, Slovenia (Gubensek) Faculty of Medicine, University of Ljubljana, Vrazov trg 2, Ljubljana, Slovenia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Haemoadsorption has recently emerged as an extracorporeal treatment option for sepsis, septic shock, intoxications, and cardiac surgery to modulate dysregulated inflammatory responses or remove a wide range of circulating molecules. To ensure appropriate clinical use of the CytoSorb haemoadsorber, it is essential to understand the extent to which specific drugs are adsorbed by the device. Method(s): We conducted a systematic literature review using the PubMed and Ovid MEDLINE database to identify studies on drug binding to the CytoSorb haemoadsorber, including both in vivo and in vitro studies. Publications in English language, available up to 31 December 2025 that reported or enabled calculation of percentage of drug removal, CytoSorb clearance or half-life during CytoSorb therapy were included. Records were screened, eligibility and quality were assessed, and data were extracted independently by two reviewers. Result(s): We found that 26 studies reported on the binding of 56 drugs to CytoSorb, with most available information relating to antibiotics used in the treatment of sepsis and septic shock. CytoSorb appears to remove vancomycin and linezolid but not meropenem, although data for other antibiotics are insufficient to assess clinical relevance. Data on the removal of anticoagulant and antithrombotic drugs with CytoSorb before and during cardiac surgery indicate that using this procedure to reduce complications associated with apixaban and ticagrelor is feasible and safe. The available evidence on the use of CytoSorb for drug poisoning is of very low quality. Conclusion(s): Although the number of studies on drug binding to the CytoSorb is increasing, the review is limited by the marked heterogeneity among the included studies. It is advised to use therapeutic drug monitoring whenever possible during CytoSorb treatment. Research of binding of drugs to CytoSorb is crucial for its safe and effective clinical use, but adequate methodology is necessary. Copyright © 2026 by the authors. <46> Accession Number 2044743061 Title Impact of LEARNS Model-Based Health Education on Swallowing Safety and Psychological Well-Being in Postoperative Esophageal Cancer Patients. Source Journal of Multidisciplinary Healthcare. 19 (no pagination), 2026. Article Number: 567792. Date of Publication: 2026. Author Hou X.; Qian Y.; Cai L.; Chen W.; Zou W. Institution (Hou, Qian, Cai, Zou) Department of Thoracic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Qiaokou District, Hubei, Wuhan, China (Qian) Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Jianghan District, Hubei, Wuhan, China (Chen) Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China Publisher Dove Medical Press Ltd Abstract Objective: This study aims to evaluate the effects of health education grounded in the LEARNS model on the swallowing safety and psychological well-being of patients following radical esophageal cancer surgery. Method(s): A randomized controlled trial was conducted. A convenience sampling method was employed to select 60 patients who underwent radical esophageal cancer surgery between July and December 2023 from a Grade III-A general hospital in Wuhan. Participants were randomly assigned to either a control group (n=30), which received standard health education, or an intervention group (n=30), which received LEARNS model-based health education. Primary outcomes included swallowing function and oral feeding ability; secondary outcomes comprised psychological status and satisfaction with health education. Outcomes were assessed one month post-discharge, and satisfaction was evaluated on the day of discharge. Result(s): Following the intervention, the intervention group demonstrated statistically significant improvements in swallowing function (SSA score: 21.86+/-4.13 vs 23.34+/-2.42, P<0.05), oral intake ability (FOIS score: 7.25+/-1.07 vs 6.92+/-1.44, P<0.05), psychological distress (DT score: 5.45+/-1.94 vs 6.38+/-1.30, P<0.05), and satisfaction with health education (total score: 21.90+/-1.86 vs 17.40+/-3.38, P<0.05) compared to the control group. Conclusion(s): The LEARNS-based health education approach may improve swallowing function, oral feeding ability, psychological status, and education satisfaction in postoperative esophageal cancer patients during short-term follow-up. These findings should be interpreted with caution due to the single-center design and limited sample size. Copyright © 2026 Hou et al. <47> Accession Number 2045227066 Title Prophylactic Use of Fibrinogen Concentrate on Postoperative Blood Fibrinogen Levels, Amount of Bleeding, and the Need for Blood Transfusion in Normofibrinogenemic Patients Undergoing Coronary Artery Bypass Graft Surgery. Source Archives of Anesthesiology and Critical Care. 12(3) (pp 288-292), 2026. Date of Publication: 01 May 2026. Author Ghavibonyeh K.; Dabbagh A.; Jahangirifard A.; Baghaei R.; Fani K.; Shahrabi M.; Fani M. Institution (Ghavibonyeh, Dabbagh, Jahangirifard, Fani, Shahrabi) Department of Anesthesiology and Critical Care, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Baghaei) Department of Cardiac Surgery, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Fani) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Tehran University of Medical Sciences Abstract Background: Different studies investigated strategies to prevent perioperative bleeding in cardiac surgeries. The use of fibrinogen concentrate is one of these efforts. In this study, we will investigate the efficacy and proper dosage of fibrinogen concentrate as a prophylactic adjuvant for reducing postoperative bleeding in patients with normal blood fibrinogen under coronary artery bypass grafting (CABG) surgery. Method(s): Patients with preoperative normal plasma fibrinogen levels were randomly divided into two groups (15 patients in each). At the final stage of cardiac surgery and after reversal of heparin, the first group received 2gr of fibrinogen IV concentrate in 15 minutes, while the other group received the same volume of placebo. In each patient, postoperative haematocrit percentage, intraoperative and postoperative administered blood products, and postoperative drainage amount were collected. Result(s): Although in the study group, the postoperative amount of plasma fibrinogen increased compared to preoperative and decreased in the control group, but this change was not statistically significant. Also there wasn't any significant difference in terms of blood drainage and blood product consumption. Conclusion(s): We did not find evidence of a significant difference in the change of fibrinogen blood level before and after the operation, the amount of drainage, and the consumption of blood products in the fibrinogen and placebo groups. Copyright © 2026 Tehran University of Medical Sciences. <48> Accession Number 2044743394 Title Comparison of Percutaneous Coronary Intervention Outcomes for in-Stent vs de Novo Chronic Total Occlusions: A Meta-Analysis. Source Therapeutics and Clinical Risk Management. 22 (no pagination), 2026. Article Number: 576328. Date of Publication: 2026. Author Mao Q.; Xie L.; Wu J. Institution (Mao, Xie) Department of Andrology, Ningbo Traditional Chinese Medicine Hospital, No. 819 Liyuan North Road, Haishu District, Zhejiang Province, Ningbo City, China (Wu) Department of Andrology, Ningbo Traditional Chinese Medicine Hospital, Zhejiang Province, Ningbo City, China Publisher Dove Medical Press Ltd Abstract Background: Chronic coronary total occlusion (CTO) represents a formidable challenge in interventional cardiology, occurring either within previously implanted stents (in-stent CTO) or in non-stented native vessels (de novo CTO). We aimed to compare the outcomes of percutaneous coronary intervention (PCI) between patients with in-stent and de novo CTO through a systematic review and meta-analysis. Method(s): PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases were searched for comparative studies published up to 20th September 20, 2025. A meta-analysis was conducted to calculate the odds ratios (OR) using a random effects model. Result(s): Nineteen studies that compared 73,945 patients with in-stent CTO and 651,961 patients with de novo CTO were included. There was no statistically significant difference in technical success between the two groups (OR, 0.97; 95% CI, 0.87, 1.08; I2=0%; p=0.67). Pooled analysis of early outcomes demonstrated no statistically significant difference in the risk of all-cause mortality, major adverse cardiovascular events (MACE), myocardial infarction (MI), stent thrombosis, or tamponade between the two groups. We also noted no statistically significant differences in long-term all-cause or cardiac mortality between the two groups. However, a meta-analysis of long-term data indicated that patients with in-stent CTO have a statistically significantly increased risk of MACE, MI, and target vessel revascularization (TVR) compared to those with de novo CTO. Conclusion(s): Our results indicate that in-stent CTO-PCI has success rates similar to those of de novo CTO-PCI. There was no difference in short-term adverse outcomes between the two groups; however, patients undergoing in-stent CTO PCI had an increased risk of MACE and MI, mainly driven by the significantly increased need for TVR. Copyright © 2026 Mao et al. <49> [Use Link to view the full text] Accession Number 2044253606 Title Cardiac Allograft Vasculopathy Inhibition With Alirocumab: The CAVIAR Trial. Source Circulation. 153(1) (pp 7-17), 2026. Date of Publication: 06 Jan 2026. Author Fearon W.F.; Terada K.; Takahashi K.; Skoda A.; Luikart H.I.; Lamendola C.A.; Zimmermann F.M.; Hashikata T.; Saito K.; Yoshida A.; Varr B.; Knowles J.W.; Woo C.; Honda Y.; Teuteberg J.; Khush K.K. Institution (Fearon, Terada, Takahashi, Skoda, Luikart, Lamendola, Hashikata, Saito, Yoshida, Knowles, Honda, Teuteberg, Khush) Division of Cardiovascular Medicine and Stanford Cardiovascular Institute, Stanford University, CA (W.F.F., K.T., K.T., A.S., H.I.L., C.A.L., T.H., K.S., A.Y., J.W.K., Y.H. (Fearon) VA Palo Alto Health Care System, CA (Zimmermann) Department of Cardiology, St. Antonius Hospital, Nieuwegein, Netherlands (Varr, Woo) Kaiser Permanente, Santa Clara, CA (Knowles) Stanford Diabetes Research Center, Stanford Prevention Research Center, Stanford, CA, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Cardiac allograft vasculopathy is an important cause of mortality after heart transplantation (HT). Dyslipidemia is a major contributor to the development of cardiac allograft vasculopathy. The safety and effectiveness of proprotein convertase subtilisin/kexin 9 inhibition to lower cholesterol and to prevent cardiac allograft vasculopathy early after HT are not well established. METHOD(S): - In this investigator-initiated, prospective, multicenter, double-blind randomized trial, participants were randomized early after HT to receive either alirocumab or placebo in addition to rosuvastatin. Before randomization and at 1 year, all participants underwent invasive coronary assessment, including angiography, fractional flow reserve, coronary flow reserve, the index of microcirculatory resistance, and intravascular ultrasound with near-infrared spectroscopy. Lipid values were assessed at baseline and at prespecified intervals. The primary end point was the change in coronary artery plaque volume from baseline to 1 year after HT based on serial intravascular ultrasound. RESULT(S): - A total of 114 HT recipients were included (57 assigned to alirocumab and 57 assigned to placebo). Baseline characteristics were well matched between the 2 groups. The low-density lipoprotein cholesterol levels decreased significantly from baseline to 1 year in the alirocumab arm (72.7+/-31.7 to 31.5+/-20.7 mg/dL; P<0.001) and did not change with placebo (69.0+/-22.4 to 69.2+/-28.1 mg/dL; P=0.92). Plaque volume increased numerically in both groups from baseline to 12 months (alirocumab, 176.3+/-95.2 to 184.5+/-105.4 mm3; P=0.23; placebo 173.7+/-96.7 to 183.1+/-109.8 mm3; P=0.15). The change in plaque volume (mean difference in differences) did not differ between groups (1.01 [0.89-1.14]; P=0.86). Fractional flow reserve, coronary flow reserve, and the index of microcirculatory resistance did not change significantly with the addition of alirocumab. There were no significant adverse events related to alirocumab. CONCLUSION(S): - Proprotein convertase subtilisin/kexin 9 inhibition with alirocumab in addition to statin therapy early after HT safely lowers low-density lipoprotein cholesterol but did not reduce coronary artery plaque progression after 1 year compared with rosuvastatin alone in patients with a low baseline low-density lipoprotein cholesterol. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT03537742. Copyright © 2025 American Heart Association, Inc. <50> 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. <51> 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/ <52> Accession Number 2040475996 Title SEPAR and SEEN Consensus Document on Nutritional Assessment and Management in Patients with COPD. Source Archivos de Bronconeumologia. 62(5) (pp 325-338), 2026. Date of Publication: 01 May 2026. Author de Miguel-Diez J.; Suarez-Llanos J.P.; Figueira-Goncalves J.M.; Breton-Lesmes I.; Torres-Castro R.; Golpe R.; Iglesias-Hernandez N.C.; Amado-Diago C.A.; Garcia-Delgado Y.; Aramburu-Ojembarrena A.; Andreu-Gosalbez M.D.; Cejudo-Ramos P.; Riestra-Fernandez M. Institution (de Miguel-Diez) Servicio de Neumologia, Hospital General Universitario Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain (Suarez-Llanos) Unidad de Nutricion Clinica y Dietetica, Servicio de Endocrinologia y Nutricion, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Figueira-Goncalves) Servicio de Neumologia, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Breton-Lesmes) Servicio de Endocrinologia y Nutricion, Hospital General Universitario Gregorio Maranon, Madrid, Spain (Torres-Castro) Departamento de Kinesiologia, Universidad de Chile, Chile (Golpe) Servicio de Neumologia, Hospital Universitario Lucus Augusti, Lugo, Spain (Iglesias-Hernandez) Servicio de Endocrinologia y Nutricion, Hospital Universitario Basurto, Bilbao, Spain (Amado-Diago) Servicio de Neumologia, Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, Instituto de investigacion sanitaria IDIVAL, Santander, Spain (Garcia-Delgado) Seccion de Endocrinologia y Nutricion, Complejo Hospitalario Universitario Insular-Materno Infantil, Gran Canaria, Spain (Aramburu-Ojembarrena) Servicio de Neumologia, Hospital Universitario Galdakao-Usansolo, Bizkaia, Spain (Andreu-Gosalbez) Servicio de Endocrinologia y Nutricion, Hospital Sierrallana, Cantabria, Spain (Cejudo-Ramos) Unidad Medico-Quirurgica de Enfermedades Respiratorias, Hospital Universitario Virgen del Rocio, Instituto de Biomedicina de Sevilla, IBiS, Sevilla, Spain (Cejudo-Ramos) Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain (Riestra-Fernandez) Seccion de Endocrinologia y Nutricion, Hospital Universitario de Cabuenes, Instituto de Investigacion Sanitaria del Principado de Asturias, Gijon, Spain Publisher Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) Abstract Malnutrition and sarcopenia are prevalent and often underdiagnosed in individuals with chronic obstructive pulmonary disease (COPD), with significant implications for morbidity, mortality, and quality of life. Despite their clinical relevance, current COPD guidelines provide limited direction regarding nutritional assessment and intervention. This consensus document, developed jointly by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Endocrinology and Nutrition (SEEN), offers evidence-based recommendations for the nutritional assessment and management of patients with COPD. A multidisciplinary panel of experts identified three key clinical issues relating to the prevalence and impact of malnutrition, appropriate assessment strategies, and the effectiveness of nutritional interventions. Systematic reviews were conducted in accordance with PRISMA guidelines, and the quality of evidence was assessed using SIGN and GRADE methodologies. These recommendations aim to support clinical decision-making and promote early, structured, and individualized nutritional strategies to improve outcomes in patients with COPD. Copyright © 2025 SEPAR <53> Accession Number 2045234983 Title The role of genetics in the prognosis of acute myocarditis: a systematic review and meta-analysis. Source Monaldi Archives for Chest Disease. 96(1) (no pagination), 2026. Article Number: 3231. Date of Publication: 2026. Author Tomas M.J.; Pinho A.I.; Pinto B.S.; Martins E. Institution (Tomas, Pinho, Martins) Faculty of Medicine, University of Porto, Portugal (Pinho, Martins) Department of Cardiology, Sao Joao University Hospital Center, Porto, Portugal (Pinto) MEDCIDS, Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Portugal (Pinto, Martins) CINTESIS@RISE - Health Research Network, Faculty of Medicine, University of Porto, Portugal (Martins) Sao Joao University Hospital Centre, European Reference Network for Rare, Low-Prevalence, or Complex Diseases of the Heart (ERN GUARD-Heart), Porto, Portugal Publisher Page Press Publications Abstract Myocarditis is a heterogeneous disease with varying clinical presentations, etiologies, and courses. Apart from environmental factors, genetic factors may also play a role in its pathophysiology. Through a systematic review and meta-analysis, we aimed to characterize the relationship between acute myocarditis (AM), underlying genetic background, and prognosis. We searched MEDLINE/PubMed and Web of Science for studies reporting clinical outcomes of patients presenting with AM and undergoing genetic testing. The prevalence of a positive genetic test result was 27.3%, with a higher proportion of males (61.3%). Patients with a positive genetic test often had a family history of cardiovascular events (53.3%) and late gadolinium enhancement on cardiac magnetic resonance (81.2%), suggesting that these clinical features may represent a population with a higher burden of genetic background and risk for worse outcomes. The risk of recurrence of AM among patients with a positive genetic test was four times greater than among non-carriers (relative risk = 4.02, p<0.001), and the most frequently observed variants among AM carriers were in the TTN, DSP, PKP2, MYH7, BAG3, RMB20, DSG2, TNNT2, and SCN5A genes. Overall, these findings underscore the need to improve the criteria used for genetic testing in the setting of AM episodes and to identify affected individuals who may benefit from increased surveillance and genetic testing. ©Copyright: the Author(s), 2025. <54> [Use Link to view the full text] Accession Number 2043575269 Title Balloon-Expandable Valves Versus Self-Expanding Valves in Patients With Small Aortic Annulus Undergoing Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-Analysis. Source Cardiology in Review. (no pagination), 2025. Article Number: 10.1097/CRD.0000000000001108. Date of Publication: 09 Dec 2025. Author Tabassum S.; Burhan M.; Shehada W.; Naeem F.; Lashin A.A.; Wagdy M.; Naeem A.; Abdelazeem B.; Minhas A.M.K.; Virk H.U.H.; Velagapudi P. Institution (Tabassum, Naeem) From the Department of Internal Medicine, The Wright Center for Graduate Medical Education, Scranton, PA, United States (Burhan) Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan (Shehada) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine (Naeem) Department of Cardiology, Massachusetts General Hospital, Boston, MA, United States (Lashin) Faculty of Medicine, Benha University, Benha, Egypt (Wagdy) Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt (Abdelazeem) Department of Cardiology, West Virginia University, Morgantown, WV, United States (Minhas) Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States (Virk) Harrington Heart & Vascular Institute, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Velagapudi) Division of Cardiology, BJC Cardiology, St Louis, MO, United States Publisher Lippincott Williams and Wilkins Abstract Patients with a small aortic annulus (SAA) undergoing transcatheter aortic valve replacement (TAVR) face a high risk of prosthesis-patient mismatch and adverse outcomes. The 2 most studied valve types, balloon-expandable valves (BEVs) and self-expanding valves (SEVs), differ in structure and deployment, potentially impacting outcomes in this subgroup. To compare the hemodynamic and clinical outcomes of BEVs versus SEVs in SAA patients undergoing TAVR. A systematic search of major databases through March 2025 identified randomized controlled trials and propensity score matching studies comparing BEVs and SEVs. Pooled analyses were conducted using a random-effects model to derive mean differences (MDs) and odds ratios (ORs) with 95% confidence intervals (CIs) in R (version 4.4.1). Thirteen studies (n = 4582; BEV: 2290; SEV: 2292) were included. BEVs were associated with smaller indexed effective orifice area (iEOA) (MD: -0.15 cm2/m2), higher mean (MD: 4.92 mm Hg) and peak (MD: 4.78 mm Hg) transvalvular gradients, and higher overall (OR: 2.64) and severe (OR: 2.72) prosthesis-patient mismatch rates. However, BEVs had a significantly lower risk of permanent pacemaker implantation (OR: 0.62). No significant differences were found in mortality, stroke, bleeding, acute kidney injury, paravalvular leak, myocardial infarction, vascular complications, or heart failure hospitalization. BEVs and SEVs demonstrate comparable mortality in SAA patients undergoing TAVR. SEVs offer superior hemodynamic outcomes, while BEVs reduce pacemaker need. Prosthetic valve selection should be individualized based on anatomy, clinical profile, and procedural factors. Future randomized trials with long-term follow-up are warranted to inform optimal device selection in this population. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <55> Accession Number 2045186340 Title Multi-center Randomized Controlled Trial of Catheter-Directed Mechanical Thrombectomy Versus Systemic Thrombolysis in Patients with Acute Intermediate-to-High-Risk Pulmonary Embolism: Study Protocol. Source CardioVascular and Interventional Radiology. (no pagination), 2026. Date of Publication: 2026. Author Wang C.; Fang P.; Zhou D.; Xu B.; Dai X.; Zhang Z.; Xie M.; Duan Z.; Zhang L.; Li Y.; Zhu Y.; Jiang Y.; Qie L.; Shi H.; Feng J.; Zhang W.; Jin X. Institution (Wang) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Fang, Xu) Department of Cardiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Zhou) Department of Pulmonary and Critical Care Medicine, Huashan Hospital Fudan University, Shanghai, China (Dai, Zhang, Xie, Duan, Shi) Department of Cardiology, Zhongshan Hospital Wusong Branch, Fudan University, Shanghai, China (Zhang, Li, Zhu) Department of Cardiology, Third Affiliated Hospital of Naval Medical University, Shanghai, China (Jiang) Emergency Department, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China (Qie) Department of Geriatric Medicine and Laboratory of Gerontology and Anti-Aging Research, Qilu Hospital of Shandong University, Shandong, China (Feng) Vascular Surgery Department, Ruijin Hospital, School of medicine, Shanghai Jiaotong University, Shanghai, China (Zhang) Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Henan, Zhengzhou, China (Jin) Department of Cardiology, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China Publisher Springer Abstract Purpose: This study aims to compare the efficacy and safety of catheter-directed mechanical thrombectomy using the Tendvia system versus systemic thrombolysis in patients with intermediate-to-high-risk acute pulmonary embolism. Material(s) and Method(s): This is a 1:1 block-randomized, controlled, open-label parallel-group, multi-center, superiority trial. Eligible patients aged 18-75 years, diagnosed with intermediate-to-high-risk acute pulmonary embolism and hemodynamic deterioration, will be included. The main exclusion criteria are unsuitable target vessel criteria; sustained systolic hypotension; severe pulmonary hypertension; hematocrit < 28%; chronic pulmonary hypertension; left bundle branch block; chronic left heart failure; renal dysfunction; coagulopathy; recent cardiothoracic surgery; intracardiac thrombus. The intervention group will undergo catheter-directed thrombectomy using the Tendvia system under fluoroscopic guidance within 4 h of computed tomography pulmonary angiography. The control group will receive standard alteplase infusion. The primary efficacy endpoint is absolute reduction in the right ventricular/left ventricular diameter ratio from baseline to 48 h post-intervention, measured by blinded core-lab computed tomography pulmonary angiography analysis. The primary safety endpoint is the rate of composite major adverse events within 48 h. Secondary endpoints include the proportion of patients achieving a >= 50% reduction from baseline in NT-proBNP level at 48 h post-intervention, dyspnea scores, change in pulmonary arterial pressure, 48-h post-procedure clinical deterioration, symptomatic recurrence within 30 days, major access site complications, device-related serious adverse events, length of post-procedure hospital and intensive care unit stay, and change in cardiac biomarkers. Expected Gain of Knowledge: This trial will provide evidence regarding the use of catheter-directed thrombectomy in intermediate-to-high-risk pulmonary embolism. Trial Registration: This study was registered in Clinicaltrials.gov on 2025-06-22 (Registration number NCT07032025) Copyright © Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2026. <56> Accession Number 2044602920 Title Effect of preoperative oral iron supplementation on postoperative outcomes in children with acyanotic congenital heart disease undergoing cardiac surgery: A pragmatic randomised clinical trial. Source Cardiology in the Young. 36(3) (pp 538-544), 2026. Date of Publication: 01 Mar 2026. Author Murugaiyan A.; Jha A.K.; Parida S.; Rajeswari Thangaswamy C.; Munuswamy H. Institution (Murugaiyan, Jha, Parida, Rajeswari Thangaswamy) Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India (Munuswamy) Cardiothoracic and Vascular Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India Publisher Cambridge University Press Abstract Background: Studies assessing the effect of preoperative iron supplementation in paediatric cardiac surgery are limited and yield conflicting data. Objective(s): The study aimed to evaluate the effect of preoperative oral iron supplementation on allogeneic blood transfusion after cardiac surgery for acyanotic CHD. Method(s): This was a prospective, open-label, outcome assessor-blinded, randomised clinical trial performed in a large tertiary care centre in India. Children (haemoglobin <13 gm/dl) with acyanotic CHD were recruited for the study. Children in the intervention arm received colloidal iron (3 mg/kg), folic acid, and cyanocobalamin according to body weight for at least 7 days before cardiac surgery. The primary outcome was the amount of allogeneic blood transfusion, while secondary outcome measures were the duration of mechanical ventilation and ICU stay. Result(s): A total of eighty-six children (43 in each arm) completed the trials. A total of 43 children received iron supplementation for a minimum of 1 month. The haemoglobin level improved by 1.3 gm/dl immediately before the cardiac surgery in the intervention arm. The allogeneic blood transfusions (ml/kg) median (IQR) were significantly lower in the intervention group (5 (0-8) vs 10 (8-12); p < 0.01). Furthermore, total cumulative allogeneic blood transfusion was also significantly lower in the intervention arm (60 ml; (0-100) vs 100 ml; (70-140); p < 0.001). The duration of mechanical ventilation, ICU stay, and hospital stay was significantly lower in the intervention arm. Conclusion(s): Preoperative oral iron supplementation significantly reduces the need for allogeneic blood transfusion in children undergoing cardiac surgery for acyanotic heart disease. Copyright © The Author(s), 2026. <57> [Use Link to view the full text] Accession Number 2042910915 Title Less Is More for Bleeding Management Algorithms in Cardiac Surgery: A Network Meta-Analysis and Meta-Regression of Randomized Studies. Source Anesthesia and Analgesia. 142(5) (pp 917-927), 2026. Date of Publication: 01 May 2026. Author Barbaria A.; Baryshnikova E.; Anguissola M.; Landi G.; Aloisio T.; Casalino S.; Ranucci M. Institution (Barbaria, Baryshnikova, Anguissola, Aloisio, Casalino, Ranucci) From the Department of Cardiovascular Anesthesia and Intensive Care, I.R.C.C.S. Policlinico San Donato, Milan, Italy (Landi) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Major bleeding after cardiac surgery is still a relatively common complication, requiring red blood cell (RBC) transfusions and use of procoagulants. The existing guidelines recommend a bleeding management based on viscoelastic tests and bleeding management algorithms (BMA). However, there are different BMAs with different trigger values prompting the use of different procoagulants; consequently, based on these trigger values, a BMA can be more or less liberal in the use of drugs and blood derivates aimed to control bleeding. At present, no studies have investigated the effectiveness of liberal versus restrictive BMAs in limiting the risk of RBC transfusion. METHOD(S): - In this study, we performed 2 network meta-analyses and a meta-regression of randomized and nonrandomized (before and after) studies where a BMA was applied. Based on the trigger values prompting the use of procoagulants (fresh frozen plasma, platelet concentrate, fibrinogen concentrate, prothrombin complex concentrate, recombinant activated factors), we have adjudicated the various BMAs to a restrictive or liberal group, and we compared the effectiveness of restrictive versus liberal BMAs in limiting RBC transfusions. Additionally, the consumption of procoagulants was compared between the 2 groups. RESULT(S): - Both restrictive and liberal BMAs were superior to conventional strategies in limiting RBC transfusions (rate and units). Restrictive BMAs were more effective than liberal BMAs in terms of RBC units transfused (mean difference -0.43 units, 95% confidence interval [CI], -0.80 to -0.07, P = .020). The RBC transfusion rate was tested after correction for potential confounders (complexity of surgery and hematocrit trigger for RBC transfusion) with a meta-regression RBC transfusion rate was significantly lower in restrictive versus liberal BMAs (odds ratio 0.728, 95% CI 0.569-0.932, P = .012). The use of any kind of procoagulants was significantly (P = .001) lower in restrictive versus liberal BMAs. CONCLUSION(S): - Overall, viscoelastic test-based BMAs are superior to conventional strategies in limiting RBC transfusions in the presence of major bleeding; however, a restrictive strategy of procoagulant administration is superior to a liberal strategy in terms of RBC transfusion containment. Liberal BMAs are associated with a significantly higher use of procoagulants without any benefit in terms of RBC transfusions; therefore, in terms of cost/benefit ratio, restrictive BMAs should be preferred. Copyright © 2025 International Anesthesia Research Society <58> [Use Link to view the full text] Accession Number 2044380187 Title Combined Anatomic and Functional Testing Identifies Patients With Obstructive Coronary Artery Disease Who Benefit From Revascularization. Source Circulation: Cardiovascular Imaging. 19(4) (pp e019267), 2026. Date of Publication: 01 Apr 2026. Author Pedersen O.B.; Rasmussen L.D.; Soby J.H.; Gormsen L.C.; Christiansen E.H.; Knuuti J.; Bottcher M.; Shaw L.; Winther S. Institution (Pedersen) Department of Cardiology, Aalborg University Hospital, Denmark (Rasmussen, Soby, Bottcher, Winther) Department of Cardiology, Godstrup Hospital, Herning, Denmark (Rasmussen) Department of Cardiology, Regional Hospital Central Jutland, Viborg, Denmark (Gormsen) Department of Nuclear Medicine and PET Centre (L.C.G.), Aarhus University Hospital, Denmark (Christiansen) Department of Cardiology (E.H.C.), Aarhus University Hospital, Denmark (Knuuti) Turku PET Centre, Turku University Hospital and University of Turku, Finland (Bottcher, Winther) Institute of Clinical Medicine, Aarhus University, Denmark (Shaw) Icahn School of Medicine at Mount Sinai, New York (L.S.) Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - In patients with obstructive coronary artery disease, early revascularization does not improve outcomes but may reduce angina symptoms. The objective of this study was to examine whether changes in health status outcomes following revascularization are explained by the extent of myocardial perfusion defects and improvement in myocardial perfusion. METHOD(S): - Two trials enrolling stable patients with new-onset chest pain suggestive of obstructive coronary artery disease, the ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) and the Dan-NICAD (Danish Study of Noninvasive Testing in Coronary Artery Disease) trials, were analyzed. Patients with single-vessel coronary artery disease who underwent nuclear myocardial perfusion imaging (nMPI) were included. In the ISCHEMIA trial, patients with moderate/severe ischemia were randomized to either optimal medical therapy alone or optimal medical therapy and invasive angiography. The Dan-NICAD trial enrolled patients with suspected stenosis on coronary computed tomographic angiography undergoing nMPI. Test-guided revascularization blinded to nMPI was performed, and patients with initially abnormal nMPI were reassessed after 12 months. The primary outcome was the change in the Seattle Angina Questionnaire angina frequency score. RESULT(S): - In total, 584 patients were eligible. In patients with a summed difference score of 5<=10 (n=149 [25%]) and >=10 (n=152 [26%]), revascularization was associated with an improved angina frequency score (mean change +/-SD: 16.4+/-20.9 and 19.0+/-24.1). No improvement was demonstrated in patients with a summed difference score <5. In multivariable logistic regression analysis (n=91), an increase in hyperemic myocardial blood flow at follow-up was associated with freedom from angina (odds ratio, 2.89 [95% CI, 1.04-8.70]). CONCLUSION(S): - In patients with single-vessel coronary artery disease, nMPI may identify patients more likely to experience improved symptoms from revascularization, potentially reflecting enhanced myocardial perfusion. Copyright © 2026 American Heart Association, Inc. <59> Accession Number 2044647336 Title Beta Blockers After Acute Myocardial Infarction Without Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Controlled Trials. Source Mayo Clinic Proceedings. 101(5) (pp 878-882), 2026. Date of Publication: 01 May 2026. Author Jain H.; Jain J.; Soni K.; Agrawal S.P.; Saad M.S.; Abbott J.D.; Vallabhajosyula S. Institution (Jain) Department of Medicine, All India Institute of Medical Sciences, Jodhpur, India (Jain) Department of Medicine, Allegheny General Hospital, Drexel University, Pittsburgh, Palestine (Soni) Department of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States (Agrawal) Department of Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI, United States (Saad, Abbott, Vallabhajosyula) Division of Cardiology, Department of Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States Publisher Elsevier Ltd <60> 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. <61> 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. <62> 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 l1 vs. 3.00 +/- 8.56 ng l1, 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. <63> Accession Number 2044266655 Title Meta-Analysis: Prevalence and Incidence of Gastroparesis Following Lung or Heart Transplantation. Source Alimentary Pharmacology and Therapeutics. 63(10) (pp 1348-1359), 2026. Date of Publication: 01 May 2026. Author Eldesouki M.H.; Marey M.M.; Ali M.A.; Genidy A.M.; Gamal M.H.; Othman A.M.; Mohamed A.N.; Al Qady A.; Amaris M.A.; Sharma A. Institution (Eldesouki) Department of Internal Medicine, New York Medical College, St Michael Medical Center, Newark, NJ, United States (Marey) Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt (Ali) Qena Faculty of Medicine, Qena University, Qena, Egypt (Genidy, Gamal) Faculty of medicine, Tanta University, Tanta, Egypt (Othman) Department of Internal Medicine, Faculty of Medicine, Kafr El-Sheik University, Kafr El-Sheik, Egypt (Mohamed) Division of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, OH, United States (Al Qady, Amaris) Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Florida, Gainesville, FL, United States (Sharma) Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of South Carolina, Charleston, SC, United States Publisher John Wiley and Sons Inc Abstract Background: Gastroparesis is a recognized complication after thoracic organ transplantation that impairs nutrition, medication absorption, and graft outcomes. Aim(s): This study aimed to quantify the risk of gastroparesis following lung (LT) and combined heart-lung transplantation (HLT). Method(s): A systematic search of PubMed, Embase, Scopus, and Web of Science from inception to January 2025 identified studies reporting gastroparesis after LT or HLT in adult cohorts with objective diagnostic testing. Random-effects meta-analysis was used to pool prevalence and incidence, with subgroup analyses by transplant type, and diagnostic modality, and meta-regression asessing the effects of age and sex. Result(s): Twenty-one studies, including 2888 patients, met the inclusion criteria. The pooled prevalence of gastroparesis was 31.87% (95% CI: 19.88-46.87). Subgroup analysis revealed a higher prevalence of gastroparesis in combined HLT recipients (44.89%, 95% CI: 17.05-76.35) compared to LT only (26.95%, 95% CI: 15.46-42.68), though this difference was not statistically significant (p = 0.31). The overall incidence was 25.67% (95% CI: 15.07-40.41), with HLT recipients showing a higher incidence (35.79%, 95% CI: 20.73-54.29) than LT only (19.38%, 95% CI: 8.3-38.9). Conclusion(s): Gastroparesis affects nearly one-third of thoracic transplant recipients, with a numerically higher burden after HLT transplantation. There was no association between age and gender and the prevalence of post-transplant gastroparesis. Copyright © 2026 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd. <64> 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. <65> Accession Number 2045412747 Title Accuracy of inflammatory biomarkers in assessing outcomes in Chagas disease: a scoping review. Source Transactions of the Royal Society of Tropical Medicine and Hygiene. 120(5) (pp 425-435), 2026. Date of Publication: 01 May 2026. Author Avila M.R.; de Oliveira L.F.F.; Silva W.T.; de Castro Faria S.C.; Mediano M.F.F.; da Costa Rocha M.O.; Costa H.S.; Menezes-Souza D. Institution (Avila) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (de Oliveira) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Silva) Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (de Castro Faria) School of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Mediano) Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (da Costa Rocha) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Costa) Universidade Federal dos Vales do Jequitinhonha e Mucuri, Minas Gerais, Diamantina, Brazil (Menezes-Souza) Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Institute of Biological Sciences, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Department of Clinical Pathology, COLTEC, Universidade Federal de Minas Gerais, Minas Gerais, Belo Horizonte, Brazil (Menezes-Souza) Vaccine Technology Center, Belo Horizonte Technology Park, Minas Gerais, Belo Horizonte, Brazil Publisher Oxford University Press Abstract Chagas disease (CD) is a global health issue with acute and chronic forms that cause severe complications, especially affecting the heart. Inflammatory biomarkers have been proposed as potential predictors of adverse outcomes in CD, however, their clinical utility remains uncertain. We conducted a scoping review of five databases, including observational studies evaluating the diagnostic and/or prognostic accuracy of inflammatory biomarkers in CD. Two reviewers independently screened and extracted data. Of 239 articles screened, 5 met the inclusion criteria. Adiponectin was associated with an increased risk of mortality and heart transplantation (hazard ratio 1.042 [95% confidence interval 1.013 to 1.072], area under the curve [AUC] 0.68, cut-off >38 mug/ml). Tumour necrosis factor alpha (TNF-alpha) and C-C motif chemokine ligand 2 (CCL2) were associated with left ventricular dysfunction (TNF-alpha: AUC 0.90; CCL2: AUC 0.69). Combined hepatocyte growth factor (HGF) and interleukin-12p40 (IL-12p40) predicted 3-y survival (accuracy 81.9%). Other biomarkers, including macrophage migration inhibitory factor, C-X-C motif chemokine ligand 12, monokine induced by interferon gamma (MIG), transforming growth factor beta1 and matrix metalloproteinases 2 and 9, showed limited utility. While TNF-alpha and HGF/IL-12p40 showed promise, most inflammatory biomarkers demonstrated limited accuracy, specifically for outcome prediction in CD; however, this does not preclude their potential usefulness for other clinical or experimental applications. Current evidence does not support the clinical use of this approach and further studies are needed. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/choru s/standard_publication_model) <66> Accession Number 651109968 Title Topical use of tranexamic acid for antifibrinolysis in cardiac surgery with cardiopulmonary bypass: a randomized clinical study. Source BMC anesthesiology. (no pagination), 2026. Date of Publication: 04 May 2026. Author Tuerhong D.; Li C.-X.; Yan L. Institution (Tuerhong, Yan) Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (Li) First Affiliated Hospital of Xinjiang Medical University, National Clinical Medical Research Institute, Urumqi, China (Li) Cancer Research Institute, Xinjiang Key Laboratory of Translational Biomedical Engineering, Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China (Li) First People's Hospital of Kashi & Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, China Abstract OBJECTIVE: To assess the non-inferiority of topical intrapericardial tranexamic acid (TXA) versus intravenous TXA for efficacy and safety in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). METHOD(S): In this single-center randomized trial, 492 patients were assigned 1:1 to topical TXA (2.5 g in 50 mL saline via pericardial drain, clamp 30 min) or standard intravenous TXA. PRIMARY ENDPOINTS: allogeneic red blood cell (RBC) transfusion rate (postoperative to discharge); 30-day composite adverse events (mortality, renal dysfunction, stroke, myocardial infarction, thromboembolism, seizures). Secondary endpoints included drainage volume, coagulation, and thromboelastography (TEG). The non-inferiority threshold was established at 10% for sensitivity. RESULT(S): RBC transfusion rate was 35.0% (topical) vs. 27.6% (intravenous; 95%CI - 1.2% to 16.0%, P = 0.080). Composite adverse events were 9.8% vs. 15.4% (95%CI - 11.2% to 0.0%, P = 0.057). Topical TXA showed delayed coagulation initiation, lower fibrinogen, and higher 24-hour drainage (all P < 0.05). At 10% margin, efficacy non-inferiority was not confirmed, but safety non-inferiority was verified for all endpoints. CONCLUSION(S): Topical intrapericardial TXA is non-inferior to intravenous TXA in safety but fails strict efficacy non-inferiority. Intravenous TXA remains first-line; topical TXA is a reasonable alternative for patients intolerant to systemic administration. Dose and timing optimization is needed to improve hemostasis. TRIAL REGISTRATION: http://www.chictr.org.cn, ChiCTR2500113718, Registration date: 2 December 2025. Retrospectively registratered. Copyright © 2026. The Author(s). <67> Accession Number 651107209 Title Effectiveness of exercise-based prehabilitation on pre and postoperative outcomes of patients undergoing cardiac surgery - an umbrella review of systematic reviews. Source European journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 05 May 2026. Author Sahu S.R.; Iyer L.; Rai G.; Padmakumar R.; Babu A.S. Institution (Sahu, Babu) Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, Karnataka, India (Iyer) Department of Physiotherapy, MGM College of Physiotherapy, Navi Mumbai, Maharashtra, India (Rai) Department of Cardiovascular & Thoracic Surgery, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India (Padmakumar) Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India Abstract AIMS: Individuals undergoing cardiac surgery are becoming older, frailer, and less mobile. Prehabilitation has shown to improve postoperative outcomes by optimizing preoperative physical function. This umbrella review aims to pool the systematic reviews assessing the effectiveness of exercise-based prehabilitation in cardiac surgery. METHODS AND RESULTS: The review followed the PRIOR checklist. PubMed, Embase, CINAHL, Cochrane library, Scopus, Web of science, ProQuest NAHD, ProQuest HMC, Open Grey and MedNar were searched using relevant keywords from inception to 16th December, 2024. Two reviewers screened and extracted data from the included reviews and assessed primary study overlap with the corrected covered area. Methodological quality of the reviews was evaluated with the A MeaSurement Tool to Assess systematic Reviews - 2 scale. Certainty of evidence was assessed using a previously developed criteria for overview of reviews. Six systematic reviews with 30 unique trials and 6705 participants were included. The interventions assessed included breathing exercises, inspiratory muscle training, and exercise training. Prehabilitation reduced length of hospital stay, postoperative pulmonary complications, and clinically improved functional capacity with a very low to moderate certainty of evidence. However, there was uncertainty regarding the effects pertaining to adverse events and quality of life. The methodological quality of all reviews was critically low. The primary trials scored poorly in the domains of selection and detection bias. CONCLUSION(S): Exercise-based prehabilitation might reduce length of hospital stay and postoperative complications, and improve functional capacity. However, the quality of evidence is poor, and individual discretion is required before implementing them into practice. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. <68> Accession Number 651107340 Title The 2026 American Association for Thoracic Surgery (AATS) Expert Consensus Document: Evaluation and Management of N2+ Non-Small Cell Lung Cancer. Source The Journal of thoracic and cardiovascular surgery. (no pagination), 2026. Date of Publication: 02 May 2026. Author Linden P.; Martin L.W.; Stiles B.; Opitz I.; Chen H.; Spicer J.; Lanuti M.; Tong B.C.; Liberman M.; Bestvina C.M.; Sands J.; Huang J.; Price M.; Samson P.; Boutros C.S.; Rabinovich E.P.; Park B.; D'Amico T.A. Institution (Linden, Boutros) Division of Thoracic and Esophageal Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Martin) Division of Thoracic Surgery, University of Virginia Health System, Charlottesville, VA, United States (Stiles) Division of Thoracic Surgery, Montefiore Einstein Medical Center, New York, NY (Opitz) Department of Thoracic Surgery, University Hospital Zurich, CH, Zurich, Switzerland (Chen) Division of Thoracic Surgery, Department of Surgery, Fudan University Shanghai Medical Center, CN, Shanghai, China (Spicer) Department of Surgery, McGill University Health Center, McGill University, Montreal, CA, United States (Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital, Boston, MA, United States (Tong, D'Amico) Division of Thoracic Surgery, Dept of Surgery, Duke University, Durham, NC, United States (Liberman) Department of Surgery, Centre Hospitalier de L'Universite de Montreal, University of Montreal, Montreal, CA, United States (Bestvina) Department of Medicine, University of Chicago Medicine, Chicago, IL, United States (Sands) Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, MA, United States (Huang, Park) Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY (Price) Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, United States (Samson) Department of Radiation oncology, Washington University, St. Louis, MO, United States (Rabinovich) Department of Surgery, University of Virginia Health System, Charlottesville, VA, United States Abstract OBJECTIVE: Multimodal therapy is recommended for the optimal treatment of N2 positive non-small cell lung cancer (NSCLC). Recent advancements in the use of immune checkpoint inhibitors and targeted therapy have dramatically changed the landscape of treatment. We reviewed recent trials and literature to develop consensus statements concerning the evaluation and treatment of potentially resectable NSCLC with N2 involvement. METHOD(S): The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international panel of medical oncologists, radiation oncologists, radiologists, and thoracic surgeons. A focused literature review was performed with the assistance of a medical librarian. The panel used a modified Delphi method to develop expert consensus statements with class of recommendation and level of evidence on issues related to the treatment of potentially resectable N2 positive NSCLC. RESULT(S): Consensus was reached on 13 statements on topics related to staging, determinants of unresectable disease, use of chemoimmunotherapy or targeted therapies, proper use of neoadjuvant and/or adjuvant therapy, restaging, and the safety of resection after chemoimmunotherapy. CONCLUSION(S): NSCLC with N2 disease remains a challenging, heterogeneous disease. These expert consensus recommendations are meant to provide guidance to identify appropriate surgical patients and to formulate the best multimodality treatment of patients with N2 positive NSCLC. Copyright © 2026. Published by Elsevier Inc. <69> [Use Link to view the full text] Accession Number 2043561792 Title Intraoperative mechanical ventilation during thoracic surgery: contemporary controversies and evolving strategies. Source Current Opinion in Anaesthesiology. Publish Ahead of Print (pp 1-8), 2025. Date of Publication: 27 Oct 2025. Author Wittenstein J.; Piccioni F.; Vanpeteghem C.M.; Gama de Abreu M. Institution (Wittenstein, Gama de Abreu) Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, Faculty of Medicine and University Hospital Carl Gustav Carus, TUD Dresden University of Technology, Dresden, Germany (Piccioni) Department of Anesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Milan, Italy (Vanpeteghem) Department of Anesthesiology and Perioperative Medicine, University Hospital Ghent, Corneel, Belgium (Gama de Abreu) Division of Intensive Care and Resuscitation, Department of Anesthesiology, Integrated Health Care Institute, Sri Lanka (Gama de Abreu) Outcomes Research Consortium, Department of Anesthesiology, Integrated Hospital-Care Institute, Cleveland Clinic, Cleveland, Ohio, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of review - To investigate and synthesize recent evidence on intraoperative mechanical ventilation strategies during thoracic surgery, with a focus on the controversies of fixed versus individualized positive end-expiratory pressure (PEEP), high versus low PEEP, mechanical and chemical power, driving pressure, and the integration of therapy bundles. Recent findings - Recent randomized controlled trials and meta-analyses have claimed that individualized PEEP titration reduces postoperative pulmonary complications (PPCs) compared with fixed PEEP. High PEEP does not universally confer benefit and may increase hemodynamic risk, while low PEEP risks atelectasis. Driving pressure has emerged as a potential modifiable risk factor for PPCs, with individualized strategies to minimize driving pressure showing improved outcomes. Mechanical power, is increasingly recognized as a predictor of PPCs, while chemical power is emerging as a new concept. Therapy bundles, including perioperative open-lung approaches and individualized postoperative care, are promising but require further validation. Summary - The current literature shows a trend toward individualized perioperative ventilation strategies in thoracic surgery, particularly individualized PEEP titration. Therapy bundles and individualized postoperative care, including high-flow nasal oxygen, are emerging as adjuncts to reduce PPCs. Large-scale, definitive trials are needed to determine the clinical value of these strategies and clarify the role of chemical power and therapy bundles. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <70> Accession Number 2045571558 Title Direct Oral Anticoagulants Compared to Warfarin Early After Cardiac Surgery: A Pilot Randomized Controlled Trial. Source CJC Open. (no pagination), 2026. Date of Publication: 2026. Author Wang E.H.Z.; Turgeon R.; Chu E.; Sun T.; Bashir J.; Peng D.; Cook R.; Atherstone J.; Gwozd T.; Ye J. Institution (Wang, Turgeon) Pharmacy Department, St. Paul's Hospital, Vancouver, BC, Canada (Wang, Turgeon) Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada (Chu) Pharmacy Department, Vancouver General Hospital, Vancouver, BC, Canada (Sun) Department of Anesthesia, St. Paul's Hospital, Vancouver, BC, Canada (Bashir, Peng, Cook, Ye) Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada (Peng) Centre for Cardiovascular Innovation, Vancouver, BC, Canada (Atherstone) Department of Anesthesiology, Vancouver General Hospital, Vancouver, BC, Canada (Gwozd) Vancouver General Hospital, Vancouver, BC, Canada Publisher Elsevier Inc. Abstract Background: The goal was to conduct a pilot randomized controlled trial (RCT) of direct oral anticoagulants (DOACs) early after cardiac surgery to determine the feasibility of a larger RCT. Method(s): We conducted an open-label, 2-site, pilot RCT of adults undergoing cardiac surgery with an indication for anticoagulation, excluding mechanical valves and bioprosthetic mitral valve replacements. We randomized patients 1:1 to receive a DOAC or warfarin started during the index hospitalization with a standardized time of postoperative initiation and bridging for high thrombosis risk. The coprimary feasibility outcome goals were recruitment of >= 70% eligible patients and adherence to the anticoagulation protocol in >= 80% patients. The primary clinical composite outcome included all-cause mortality, major bleeding, stroke, systemic embolism, or pericardial effusion requiring intervention within 3 months. Result(s): Between October 2022 and February 2024, a total of 547 patients were screened, 163 met inclusion criteria, 104 were randomized, and 100 were analyzed (50 in each group). The median age was 72 years; 22% were female; 54% had preexisting atrial fibrillation; 37% had postoperative atrial fibrillation, with a median Congestive Heart Failure, Hypertension, Age >= 75 Years, Diabetes Mellitus, Stroke, Vascular Disease, Age 65 to 74 Years, Sex Category (CHA<inf>2</inf>DS<inf>2</inf>-VASc) score of 3 and a Hypertension, Abnormal Renal/Liver Function, Stroke, Bleeding History or Predisposition, Labile INR, Elderly (> 65 Years), Drugs/Alcohol Concomitantly (HAS-BLED) score of 2. We recruited 64% of eligible patients, and anticoagulation protocol adherence was 91%. The clinical composite outcome occurred in 8% with DOAC (2 major bleeding, 1 pericardial effusion, 1 death) vs 4% with warfarin (2 strokes); log-rank P = 0.42. Conclusion(s): Although the a priori recruitment goal was not met, this trial supports the need for and provides valuable insights into key challenges to mitigate, thereby guiding the design of a large, definitive multicentre RCT comparing DOACs vs warfarin in cardiac surgery patients. Clinical Trial Registration: Clinicaltrials.gov NCT05006287. Copyright © 2026 The Authors <71> Accession Number 2045473165 Title Change in Frailty After Transcatheter and Surgical Aortic Valve Replacement for Aortic Stenosis-A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Mohiaddin H.; Hayes J.; Chotalia R.; Sze S.; Squire I.B. Institution (Mohiaddin, Sze, Squire) NIHR Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom (Mohiaddin, Hayes, Chotalia, Sze) University Hospitals of Leicester NHS Trust, Leicester, United Kingdom Publisher Elsevier Ltd Abstract Background: Frailty is common among patients awaiting intervention for aortic stenosis (AS) by transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). Although the association between pre-procedure frailty and poor outcomes is well-established, it remains unclear whether aortic valve interventions can lead to changes in frailty. Method(s): Ovid MEDLINE, SCOPUS, CINAHL and Cochrane databases were searched for studies that reported frailty assessments before and after TAVI and/or SAVR. Data from these studies were used to calculate a standardised score for change in frailty following either TAVI or SAVR, as part of a pooled random effects meta-analysis, with Hedges' adjusted g value. Result(s): Of 4,093 records screened, nine relevant studies were identified. Among 1,598 TAVI and 200 SAVR patients, no overall changes to frailty were observed, although there was considerable heterogeneity among studies. Improvements to frailty were observed in a sensitivity analysis of lower-risk TAVI cohorts (Society of Thoracic Surgeons predicted risk of mortality [STS-PROM] <=5%). Higher-risk TAVI and SAVR cohorts (STS-PROM >5%) did not show improvements in frailty post-aortic valve intervention. Conclusion(s): Overall, neither TAVI nor SAVR leads to significant changes in frailty measurements, although data are highly heterogeneous. Further research into the possible role of additional frailty interventions, particularly in higher-risk patients with AS undergoing TAVI or SAVR, should be considered. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <72> Accession Number 2045013433 Title Potential use of ivabradine in postoperative junctional ectopic tachycardia: a systematic review and single-arm meta-analysis. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 354. Date of Publication: 01 Dec 2026. Author Balweel H.; Immanuel S.S.; Budiono J.; Cusan C.; Gotama J.E.; Tafriend N.A.; Harsoyo A. Institution (Balweel, Immanuel, Tafriend, Harsoyo) Department of Cardiology, Gatot Soebroto Army Central Hospital, Jakarta, Indonesia (Immanuel, Budiono, Cusan, Gotama) School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia Publisher BioMed Central Ltd Abstract Background: Postoperative junctional ectopic tachycardia (JET) is a frequent, hemodynamically consequential arrhythmia after congenital heart surgery. Ivabradine is increasingly used off-label, but its effectiveness and safety in pediatric postoperative JET remain uncertain. Method(s): We conducted a systematic review and single-arm meta-analysis of studies enrolling children (< 18 years) with postoperative JET treated with oral or nasogastric ivabradine. Outcomes included conversion to sinus rhythm, time to conversion, recurrence, use of concomitant antiarrhythmic drugs (AADs), adverse events (AEs) (bradycardia, hypotension, QT prolongation, atrioventricular block), and all-cause mortality. Study-level event rates were pooled as proportions using random-effects models. Result(s): Five studies (1 randomized trial arm, 3 cohorts, 1 case series; N = 87) met the inclusion criteria. Ivabradine dosing ranged from 0.05 to 0.1 mg/kg every 12 h. Across ivabradine-based regimens, the pooled conversion proportion was 98.8% (95% CI 93.8-100), with reported mean times to stable sinus rhythm between 7.1 and 55.5 h. The pooled JET recurrence proportion was 3% (95% CI 0-12.1). Concomitant intravenous or oral AADs were used in 48.3% of patients (95% CI 10.4-87.2). No ivabradine-attributed bradycardia, hypotension, QT-interval prolongation, or new/worsening atrioventricular block was reported; all-cause mortality was 2.1% (95% CI 0-10.1), attributed in the primary reports to postoperative complications rather than directly to ivabradine. In a sensitivity analysis restricted to two studies with <= 25% concomitant antiarrhythmic drug use, the conversion proportion remained high (98%), but confidence intervals for recurrence and mortality were wide. Conclusion(s): In the small, predominantly observational studies available, ivabradine-based regimens were associated with high conversion to sinus rhythm and low short-term recurrence of postoperative JET, with no hemodynamic or conduction AEs reported among 87 patients. Interpretation is limited by nonrandomized designs, frequent cotreatment with other AADs, short follow-up, and regional concentration of data; the pooled proportions should be viewed as exploratory summaries rather than estimates of ivabradine's independent effect. Multicentre randomized trials are needed to define causal efficacy, optimal dosing, and longer-term safety. Trial Registration: This systematic review and single-arm meta-analysis was prospectively registered with PROSPERO (CRD420251080412). Copyright © The Author(s) 2026. <73> Accession Number 2044985429 Title Fungal multivalvular endocarditis: literature review and case report. Source Revista Medica del Hospital General de Mexico. 88(4) (pp 223-229), 2025. Date of Publication: 01 Jan 2025. Author Herrera-Salgado J.M.; Berrios-Muniz E.O.; Altamirano-Ramirez Y.E.; Gutierrez-Casco V.E.; Briones-Garduno J.C.; Gutierrez-Chavarria S.A. Institution (Herrera-Salgado) Medical Education and Research Coordination, Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE), Mexico (Herrera-Salgado) Obstetric Intensive Care Unit, Hospital Militar de Especialidades de la Mujer y Neonatologia, Mexico City, Mexico (Berrios-Muniz, Altamirano-Ramirez, Gutierrez-Casco) Critical Care Division, Hospital Militar Alejandro Davila Bolanos, Managua, Nicaragua (Briones-Garduno) Education and Research Coordination, Hospital General de Mexico, Secretaria de Salud, Mexico (Gutierrez-Chavarria) Bone Marrow Transplant Unit, ISSSTE, Mexico City, Mexico Publisher Permanyer Publications Abstract The incidence of fungal endocarditis (FEs) has decreased in most developed countries with access to harm-reduction policies and with improved infection control procedures during cardiac surgery. Use of specific blood culture bottles for diagnosis of FEs has decreased due to the optimization of media and automated culture systems. New antifungal agents available since the early 2000s may represent a dramatic improvement for FEs.The optimum antifungal therapy still remains debatable. Treating Candida endocarditis can be difficult because the Candida species can form biofilms on native and prosthetic heart valves. Combined treatment appears superior to monotherapy. Combination of antifungal therapy and surgical debridement might bring about better prognosis. In this clinical case report, we aim to make a literature review and present a challenging and rare clinical case. Copyright © (2025), (Permanyer Publications). All rights reserved. <74> Accession Number 2045419824 Title Tricuspid valve replacement outcomes by baseline tricuspid regurgitation severity: the TRISCEND II trial. Source European Heart Journal. 47(17) (pp 2059-2073), 2026. Date of Publication: 01 May 2026. Author Lurz P.; Hahn R.T.; Kodali S.; Makkar R.; Sharma R.P.; Davidson C.J.; O'Neill B.P.; Yadav P.; Zahr F.; Chadderdon S.; Eleid M.F.; Szerlip M.; Smith R.L.; Whisenant B.; Garcia S.; Kister T.; Kipperman R.M.; Lim D.S.; Saxon J.; Kapadia S.; Hermiller J.; Mishell J.M.; Rassi A.; Herrmann H.C.; Szeto W.; Hausleiter J.; Babaliaros V.; Barker C.M.; Lindman B.R.; Latib A.; Muhammad K.; von Bardeleben R.S.; Summers M.; Chetcuti S.J.; Ailawadi G.; Russo M.; Rinaldi M.; Chehab B.M.; Nickenig G.; Stinis C.; Inglessis-Azuaje I.; Dhoble A.; Chhatriwalla A.K.; Petrossian G.; Shah P.; Staniloae C.; Williams M.; Nores M.; McCabe J.M.; Singh G.; Baldus S.; Rudolph V.; Barb I.; Klodell C.; Gray W.; Strote J.; Sannino A.; Grayburn P.; Mack M.J.; Leon M.B.; Thourani V.H. Institution (Lurz) Department of Cardiology, University Medical Centre Mainz, Langenbeckstr. 1, Mainz, Germany (Hahn) Division of Cardiology, Columbia University Irving Medical Center, New York, NY, United States (Kodali) Division of Cardiology, Columbia University Irving Medical Center, New York, NY, United States (Makkar) Smidt Heart Institute for Interventional Technologies, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Sharma) Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States (Davidson) Division of Cardiology, Northwestern University, Chicago, IL, United States (O'Neill) Center for Structural Heart Disease, Henry Ford Hospital, Detroit, MI, United States (Yadav) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, United States (Zahr) Division of Cardiovascular Medicine, Oregon Health & Science University, Portland, OR, United States (Chadderdon) Division of Cardiovascular Medicine, Oregon Health & Science University, Portland, OR, United States (Eleid) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Szerlip) Department of Cardiology, Baylor Scott & White: The Heart Hospital Plano, Plano, TX, United States (Smith) Department of Cardiology, Baylor Scott & White: The Heart Hospital Plano, Plano, TX, United States (Whisenant) Division of Cardiology, Intermountain Medical Center, Murray, UT, United States (Garcia) Division of Cardiology, The Christ Hospital, Cincinnati, OH, United States (Kister) Department of Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Kipperman) Valve and Structural Heart Center, Atlantic Health System Morristown Medical Center, Morristown, NJ, United States (Lim) Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States (Saxon) Division of Cardiovascular Medicine, University of Virginia, Charlottesville, VA, United States (Kapadia) Department of Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, OH, United States (Hermiller) Division of Cardiology, Ascension St. Vincent Heart Center of Indiana, Indianapolis, IN, United States (Mishell) Department of Cardiology, Kaiser San Francisco Medical Center, San Francisco, CA, United States (Rassi) Department of Cardiology, Kaiser San Francisco Medical Center, San Francisco, CA, United States (Herrmann) Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Szeto) Department of Medicine, University of Pennsylvania, Philadelphia, PA, United States (Hausleiter) Medizinische Klinik und Poliklinik I, Klinikum der Universitat Munchen, Munich, Germany (Babaliaros) Structural Heart and Valve Center, Emory University Atlanta, Atlanta, GA, United States (Barker) Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, United States (Lindman) Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, United States (Latib) Department of Cardiology, Montefiore Medical Center, The Bronx, United States (Muhammad) Structural Heart Center, Oklahoma Heart Institute, Tulsa, OK, United States (von Bardeleben) Department of Cardiology, University Medical Centre Mainz, Langenbeckstr. 1, Mainz, Germany (Summers) Sentara Heart Valve Center, Sentara Norfolk General Hospital, Norfolk, VA, United States (Chetcuti) Department of Interventional Cardiology, University of Michigan Hospital and Health Systems, Ann Arbor, MI, United States (Ailawadi) Department of Interventional Cardiology, University of Michigan Hospital and Health Systems, Ann Arbor, MI, United States (Russo) Division of Cardiac Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States (Rinaldi) Sanger Heart & Vascular Institute, Atrium Health, Charlotte, NC, United States (Chehab) Department of Medicine, Ascension Via Christi Hospital, University of Kansas, Wichita, KS, United States (Nickenig) Department of Cardiology, University Hospital Bonn, Bonn, Germany (Stinis) Division of Cardiology, Scripps Memorial Hospital La Jolla, La Jolla, CA, United States (Inglessis-Azuaje) Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States (Dhoble) Division of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, TX, United States (Chhatriwalla) Division of Cardiovascular Disease, Saint Luke's Hospital of Kansas City, Kansas City, MO, United States (Petrossian) Heart Valve Center, St. Francis Hospital, Roslyn, NY, United States (Shah) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA, United States (Staniloae) Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, NY, United States (Williams) Department of Cardiothoracic Surgery, New York University Langone Medical Center, New York, NY, United States (Nores) Department of Cardiothoracic Surgery, Florida Heart & Vascular Care-JFK, Atlantis, FL, United States (McCabe) Department of Medicine, University of Washington, Seattle, WA, United States (Singh) Division of Cardiovascular Medicine, UC Davis Medical Center Sacramento, Sacramento, CA, United States (Baldus) Department of Cardiology, University Hospital of Cologne, Cologne, Germany (Rudolph) General and Interventional Cardiology, University of Bad Oyenhausen, Bad Oyenhausen, Germany (Barb) The Cardiac and Vascular Institute, HCA Florida, North Florida Hospital, Gainesville, FL, United States (Klodell) The Cardiac and Vascular Institute, HCA Florida, North Florida Hospital, Gainesville, FL, United States (Gray) Department of Interventional Cardiology, Lankenau Medical Center, PA, United States (Strote) UC Health Structural Heart & Valve Clinic, Medical Center of the Rockies, Loveland, CO, United States (Sannino) Cardiac Imaging Core Lab, Baylor Scott & White Research Institute Cardiac Imaging Core Laboratory, TX, United States (Grayburn) Department of Cardiology, Baylor Scott & White: The Heart Hospital Plano, Plano, TX, United States (Grayburn) Cardiac Imaging Core Lab, Baylor Scott & White Research Institute Cardiac Imaging Core Laboratory, TX, United States (Mack) Department of Cardiology, Baylor Scott & White: The Heart Hospital Plano, Plano, TX, United States (Leon) Division of Cardiology, Columbia University Irving Medical Center, New York, NY, United States (Thourani) Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, United States Publisher Oxford University Press Abstract Background and Aims: The TRISCEND II trial demonstrated superior clinical benefits for patients with >=severe tricuspid regurgitation (TR) treated with the EVOQUE transcatheter tricuspid valve replacement (TTVR) system plus medical therapy vs medical therapy alone. This work reports 1-year and 18-month outcomes in patients stratified by baseline TR severity. Method(s): The multicentre, prospective TRISCEND II trial enrolled 400 patients with symptomatic, >=severe TR, and randomized 2:1 to TTVR (n = 267) or control (n = 133). In a post hoc analysis, patients were stratified into severe TR (n = 172) and massive/torrential TR (n = 220) cohorts. Clinical and quality-of-life outcomes were reported at 1 year, with Kaplan-Meier estimates for all-cause mortality and heart failure (HF) hospitalization assessed at 18 months. Study oversight included an independent echocardiographic core laboratory, clinical events committee, and data safety monitoring board. Result(s): One year after TTVR, TR was <=mild in 95.2% of severe TR and 95.3% of massive/torrential TR patients. The primary safety and effectiveness endpoint (win ratio) favoured TTVR over control regardless of baseline TR severity: severe {1.64 [95% confidence interval (CI): 1.11, 2.43]} and massive/torrential [2.20 (1.55, 3.14)]. At 18 months, TTVR patients had similar mortality to controls [rate difference: severe 0.2% (-11.6, 11.9), massive/torrential -5.8% (-17.6, 6.0)], whereas HF hospitalization rates favoured TTVR in the massive/torrential cohort [vs control, severe 9.8% (-3.0, 22.7), massive/torrential -15.2% (-28.9, -1.5)]. Conclusion(s): Patients with >=severe TR benefit from TTVR, experiencing improvements in TR severity, functional capacity, and quality of life regardless of baseline TR severity, with a signal for greater benefit in patients with more advanced disease. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. 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. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <75> Accession Number 2045452500 Title Cyanotic Cardiomyopathy: Its Clinical Implications. Source International Journal of Drug Delivery Technology. 16(39 Supplement) (pp 333-340), 2026. Date of Publication: 2026. Author Biju A.; Chowdhury U.K.; Dubey P.; Mehak; Rachna Institution (Biju, Chowdhury, Dubey, Mehak) Nims College of Allied & Healthcare Sciences, NIMS University, Rajasthan, Jaipur, India (Rachna) Department of Medical Laboratory Technology, Nims College of Allied & Healthcare Sciences, NIMS University, Rajasthan, Jaipur, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Cardiomyopathy cyanotic is a condition characterized by progressive myocardial disease occurring as a consequence of sequelae from hypoxemia, pressure overload, and remodeling in cases of cyanotic congenital heart disease, mostly Tetralogy of Fallot (TOF). Even after corrective surgery, a considerable percentage of these patients experience ventricular dysfunction, arrhythmias, and heart failure. Therefore, it becomes imperative to understand the disease pathology associated with cardiomyopathy cyanotic. Objective(s): Objectives of the review include an assessment of the pathogenesis, clinical presentation, diagnosis, and impact of chronic hypoxemia on cyanotic cardiomyopathy, especially regarding myocardial protection during surgery, postoperative low cardiac output state, ventricular tachyarrhythmias, and sudden cardiac death. Other objectives will be a review of existing treatment measures and the identification of future research requirements. Method(s): The review was done through an extensive search of articles from various databases including PubMed, Google Scholar, Cochrane database, ScienceDirect, and JTCVS. Articles that had reports of ultrastructural changes in myocardium, histopathology, haemodynamics, and surgery outcome in patients with cyanotic CHD were considered. The studies involving only acyanotic CHD or absence of haemodynamic pathologies were disregarded. Result(s): Hypoxia-induced stress leads to the formation of cardiomyocyte hypertrophy, disturbance in mitochondria metabolism, myocardial fibrosis, and disruption of myofibrillar organization, mainly in the RVOT area. Myocardial pathohistological examination demonstrates the existence of cardiomyocyte hypertrophy or myocytolysis, combined with endocardial fibrosis and interstitial fibrosis in patients with heart surgery. Echocardiographic examination by tissue Doppler and MRI proves the presence of diastolic dysfunction, myocardial low velocities, and right ventricular dilatation even after operation. From the point of view of electrophysiological investigations, frequent ventricular arrhythmias, QRS fragmentation, and sudden death due to myocardial fibrosis are detected. Conclusion(s): Cyanotic cardiomyopathy can be viewed as a multifactorial condition characterized by various heart muscle alterations due to hypoxia, ventricular hypertrophy, and surgery. It is necessary to perform surgical interventions at the earliest possible time while taking care of heart muscle protection in the operating theatre with cold cardioplegia in addition to life-long monitoring after surgery. Copyright © 2026, Dr. Yashwant Research Labs Pvt Ltd. All rights reserved. <76> Accession Number 2045452311 Title Coagulation Disorders in Cyanotic Congenital Heart Diseases: Surgical Implications. Source International Journal of Drug Delivery Technology. 16(39 Supplement) (pp 325-332), 2026. Date of Publication: 2026. Author Mehak; Chowdhury U.K.; Dubey P.; Biju A.; Khatri R. Institution (Mehak, Chowdhury, Dubey, Biju) Nims College of Allied & Healthcare Sciences, NIMS University, Rajasthan, Jaipur, India (Khatri) Department of Medical Laboratory Technology, Cardiac Perfusion Technology, Nims College of Allied & Healthcare Sciences, NIMS University, Rajasthan, Jaipur, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Cyanotic congenital heart disease (CCHD) is an intricate congenital heart problem characterized by the passage of deoxygenated blood into the systemic circulation without passing through the lungs, resulting in chronic hypoxemia. In response, there is an increase in the number of red blood cells (secondary polycythemia), which causes the thickening of the blood and an imbalance in the normal processes of blood clotting. Thus, patients with CCHD are prone to develop both thrombosis and hemorrhage. Typical disorders include low platelets, dysfunctional platelets, low coagulation factors, enhanced fibrinolysis, and acquired von Willebrand disease. Performing surgery on such a patient, particularly when cardiopulmonary bypass is used, will further aggravate these problems due to hemodilution, inflammatory responses, and platelet activation. Objective(s): For analyzing the pathophysiology of coagulation abnormalities in patients with cyanotic congenital heart disease, studying the various diagnostic tools used in assessing these diseases, and understanding the current management techniques of such patients during surgery using cardiopulmonary bypass is essential. Method(s): This systematic review analysed published clinical studies, observational research, trials, and reviews on coagulation disorders in CCHD patients undergoing surgery. Parameters assessed included haemoglobin, haematocrit, platelet count, PT, INR, aPTT, fibrinogen, and D-dimer. Point-of-care tests such as TEG and ROTEM were also reviewed. Intraoperative factors including CPB management, anticoagulation monitoring, and blood conservation methods like modified ultrafiltration and cell saver were evaluated. Preoperative optimization strategies such as correction of iron deficiency, thrombocytopenia management, and venesection for severe polycythaemia were also examined. Result(s): Patients with CCHD showed clear coagulation abnormalities even before surgery. Common findings included raised haematocrit, thrombocytopenia, prolonged PT, INR, and aPTT, low fibrinogen levels, and deficiencies of clotting factors. Platelet dysfunction was also present in some patients despite normal platelet counts. During surgery, heparin resistance was frequently observed because polycythaemia reduced plasma volume, requiring higher heparin doses to achieve target ACT. After surgery, these patients had increased chest tube bleeding, higher blood transfusion requirements, more re-exploration procedures, and serious complications such as disseminated intravascular coagulation (DIC). The severity of abnormalities increased with higher polycythaemia, longer duration of cyanosis, and advanced pulmonary vascular disease. TEG- and ROTEM-guided transfusion strategies were more effective than empirical treatment in reducing blood product use and improving outcomes. Conclusion(s): Coagulation disorders in CCHD are multifactorial and clinically important. Effective management requires preoperative hematological assessment, careful intraoperative perfusion strategies with modified ultrafiltration and tranexamic acid, and postoperative viscoelastic monitoring. A multidisciplinary team is essential to balance the risks of thrombosis and bleeding in these patients. Copyright © 2026, Dr. Yashwant Research Labs Pvt Ltd. All rights reserved. <77> Accession Number 2045328038 Title Management algorithm for pulmonary vein stenosis: An evaluation of available surgical data. Source Heart Rhythm O2. (no pagination), 2026. Date of Publication: 2026. Author Bauer J.; Chorazy K.; Schwarz S.; Taghavi S.; Aigner C.; Vetchy V.; Gerges C.; Lang I.; Moser B. Institution (Bauer, Chorazy, Schwarz, Taghavi, Aigner, Moser) Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria (Vetchy) Department of Biomedical Imaging and Guided Therapy, Medical University of Vienna/General Hospital Vienna, Vienna, Austria (Gerges, Lang) Division of Cardiology, Department of Internal Medicine II, Vienna General Hospital, Medical University of Vienna, Vienna, Austria (Bauer, Chorazy, Schwarz, Taghavi, Aigner, Moser) Comprehensive Center for Chest Diseases, Medical University of Vienna, Vienna, Austria Publisher Elsevier B.V. Abstract Background Pulmonary vein stenosis (PVS) is a rare complication after radiofrequency ablation for patients with atrial fibrillation. However, the impact of a high-grade stenosis on a patient's hemodynamic situation and quality of life can be severe. Percutaneous balloon angioplasty or stent implantation are interventional treatment options for severe and symptomatic PVS. Owing to significant postinterventional restenosis rates, the management of PVS remains challenging, and the investigation of other options, such as surgical correction, is warranted. Objectives In this study, a structured literature review on surgical treatment strategies for PVS was performed. Based on these findings and multidisciplinary clinical experience, we developed a pragmatic management algorithm to guide individualized treatment decisions for patients with severe or recurrent PVS. Methods A literature review was conducted using PubMed, following the population, intervention, comparison, and outcome framework. A treatment algorithm was designed as a decision flowchart. Results The literature search identified 7 publications on cardiothoracic surgical techniques for the treatment of PVS, describing 11 cases. Although the most common surgical approach was pericardial patchplasty, sutureless techniques and a combination of operations, including endarterectomy, bypass, widening plasty after stent implantation, suturing the vein directly to the left auricle, or the use of pulmonary homograft tissue, were also described in the literature. Conclusion Managing PVS is challenging, especially in cases of restenosis. These patients should be discussed in a multidisciplinary setting, including cardiology, radiology, and thoracic surgery. We propose a treatment algorithm that may aid in individual decision making and serve as a starting point for future discussions. Copyright © 2026 Heart Rhythm Society. <78> Accession Number 2045310391 Title Renin-angiotensin system inhibitors use and outcomes of aortic valve replacement: A systematic review and meta-analysis. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Cheema M.R.S.; Arshad A.; Abbasi S.U.A.M.; Umar M.; Hamid M.; Kashif M.; Chattha R.R.; Babar A.; Khan M.S.; Javed S.; Fatima S.; Ismail Z.; Jain H.; Minhas A.M.K.; Goldsweig A.M. Institution (Cheema, Arshad, Abbasi, Umar, Hamid, Kashif, Chattha, Babar, Khan, Javed, Fatima, Ismail) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Jain) All India Institute of Medical Sciences, Jodhpur, India (Minhas) Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, United States (Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center, and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States Publisher Elsevier Inc. Abstract Background Aortic stenosis leads to adverse left ventricular remodeling; aortic valve replacement (AVR) remains the cornerstone of management. We evaluated clinical and echocardiographic outcomes with renin-angiotensin system inhibitor (RASi) use in patients undergoing AVR. Methods Five electronic databases were systematically queried for studies comparing outcomes with and without RASi post-AVR. Outcomes were pooled using random-effects models to calculate risk ratios (RRs), mean differences, and standardized mean differences with 95% confidence intervals. Outcomes of interest included all-cause and cardiovascular mortality, heart failure, myocardial infarction, stroke/TIA, arrhythmias, pacemaker requirement, acute kidney injury, and echocardiographic parameters. Results Seventeen studies (16 observational, 1 RCT) including 44,935 patients [RASi: 20,723; no RASi: 24,212] were included. RASi use was associated with significantly reduced all-cause mortality (RR: 0.74; 95% CI: 0.65-0.83; p ' 0.0001) and cardiovascular mortality (RR: 0.65; 95% CI: 0.49-0.85; p = 0.002), consistent across TAVR and SAVR subgroups. No significant differences were observed for heart failure, myocardial infarction, stroke, or pacemaker requirement. RASi did not increase acute kidney injury (p = 0.08) or major bleeding (p = 0.67). Echocardiographic outcomes, including peak aortic valve velocity and LV mass index, showed no significant differences between groups. Conclusions In predominantly observational studies, RASi use following AVR is associated with lower all-cause and cardiovascular mortality without increasing major adverse clinical events. Survival benefits were not accompanied by consistent echocardiographic improvements. Given substantial heterogeneity and residual confounding inherent to observational data, prospective randomized trials are needed to confirm these associations. Social media abstract Meta-analysis of 17 studies shows survival benefit with ACEI/ARB in the patients undergoing TAVR/SAVR, with no significant differences in HF, MI, stroke/TIA, AF, pacemaker, or echo outcomes. Copyright © 2026 Elsevier Inc. <79> Accession Number 2045518077 Title Impact of Cancer on Early Outcomes After Coronary Artery Bypass Grafting According to Cancer Stage-A Systematic Review and Meta-Analysis. Source American Journal of Cardiology. 270 (pp 10-16), 2026. Date of Publication: 01 Jul 2026. Author Corvisier M.F.; Ziotti S.D.V.; de Souza Rodrigues L.; Santos L.E.B.; Rios E.P.A.; de Castro Nunes Senfft I.; Rabelo A.A.; Correia M.G.; Oliveira G. Institution (Corvisier, Correia) Instituto Nacional de Cardiologia, Rio de Janeiro, Rio de Janeiro, Brazil (Ziotti) Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Sao Paulo, Sao Paulo, Brazil (de Souza Rodrigues, Rios) Universidade de Vassouras, Rio de Janeiro, Vassouras, Brazil (Santos) Hospital Vila Nova Star, Sao Paulo, Sao Paulo, Brazil (de Castro Nunes Senfft) Hospital Universitario Gaffree e Guinle, Rio de Janeiro, Rio de Janeiro, Brazil (Rabelo) Faculdade de Medicina de Bauru-USP, Sao Paulo, Bauru, Brazil (Oliveira) Tampa General Hospital, Tampa, FL, United States Publisher Elsevier Inc. Abstract Advances in cancer therapy have markedly expanded the population of survivors at risk for cardiovascular disease; however, evidence regarding the safety and outcomes of coronary artery bypass grafting (CABG) in patients with malignancy remains scarce. This study aimed to investigate the prognostic impact of cancer on early postoperative outcomes after CABG, including mortality, bleeding, infection, stroke, and acute kidney injury (AKI). We conducted a systematic review and meta-analysis according to the PRISMA and Cochrane guidelines. PubMed, Embase, and Cochrane Library were searched through August 2025 for studies comparing CABG outcomes in patients with and without cancer. Random-effects models generated pooled odds ratios (OR) and 95% confidence intervals (CI). Five studies were included, comprising 99,866 patients (30,818 with cancer). Early mortality was higher in cancer patients (OR 1.88; 95% CI [1.004 to 3.520]; p = 0.049) as well as bleeding (OR 1.47; 95% CI [1.018 to 2.138]; p = 0.044). Infection (OR 1.66; 95% CI [0.142 to 19.477]; p = 0.467), stroke (OR 0.85; 95% CI [0.463 to 1.563]; p = 0.370), and AKI (OR 1.08; 95% CI [0.755 to 1.545]; p = 0.545) did not significantly differ between groups. Sensitivity analysis excluding the only study restricted to non-metastatic solid tumors reduced heterogeneity (I2 from 87.6% to 0%) and strengthened the mortality association (OR 2.65; 95% CI [1.94 to 3.61]; p = 0.002). In conclusion, cancer was associated with increased early mortality and bleeding after CABG, whereas infection, stroke, and AKI rates were not, and CABG prognosis may depend on cancer activity and stage, underscoring the need for individualized risk assessment and prospective validation. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <80> Accession Number 2045375984 Title Comments on: "Dexmedetomidine reduces acute kidney injury in high-risk but not low-risk patients after non-cardiac surgery: secondary analysis of a randomized controlled trial". Source Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Hu J.-S.; Lv X.; Liang J.; Wan S. Institution (Hu) Department of Urology, Minda Hospital of Hubei Minzu University, Hubei, Enshi, China (Lv) Department of Urology, Central Hospital of Hefeng County, Hubei, Enshi, China (Liang) Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, China (Wan) School of Basic Medical Sciences, Hubei Minzu University, Hubei, Enshi, China Publisher Springer <81> Accession Number 651089447 Title Valve-in-Valve Transcatheter Mitral Valve Replacement Versus Redo Surgical Mitral Valve Replacement: Meta-Analysis of Early and Late Outcomes. Source Journal of the American Heart Association. (pp e050299), 2026. Date of Publication: 03 May 2026. Author Sa M.P.; Neves G.; Consoli L.; Iqbal A.; Dexheimer L.; da Hora D.A.B.; Camarotti T.; Jacquemyn X.; Napoli F.; Polanco A.; Brozzi N.A.; Navia J.L. Institution (Sa, Napoli, Polanco, Brozzi, Navia) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute Cleveland Clinic Florida Weston FL USA (Neves) Universidade do Estado do Para (UEPA) Belem Para Brazil (Consoli) Universidade Federal da Bahia (UFBA) Salvador Brazil, Brazil (Iqbal) Bacha Khan Medical College Mardan Pakistan, Pakistan (Dexheimer) Universidade de Sao Paulo (USP) Sao Paulo Brazil, Brazil (da Hora) Universidade Federal do Amazonas (UFAM) Manaus Brazil (Camarotti) Universidade de Pernambuco Recife Brazil, Brazil (Jacquemyn) UPMC Heart and Vascular Institute University of Pittsburgh Pittsburgh PA USA Abstract BACKGROUND: Bioprosthetic mitral valve degeneration is traditionally treated with redo surgical mitral valve replacement (redo-SMVR), but valve-in-valve transcatheter mitral valve replacement (ViV-TMVR) offers a less invasive alternative. METHOD(S): Systematic review and meta-analysis of studies comparing ViV-TMVR and redo-SMVR. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Meta-analyses were conducted with random-effects models to assess patient-relevant outcomes; Kaplan-Meier-derived time-to-event data were pooled to assess late outcomes. RESULT(S): Thirteen observational studies met our eligibility criteria, including 15 941 patients (ViV-TMVR: 5465; redo-SMVR: 10476). In comparison with redo-SMVR, ViV-TMVR was associated with lower risk of in-hospital mortality (risk ratio [RR], 0.72 [95% CI, 0.57-0.90]; P=0.004), stroke (RR, 0.49 [95% CI, 0.29-0.83]; P=0.008), bleeding (RR, 0.43 [95% CI, 0.20-0.94]; P=0.035), acute kidney injury (RR, 0.57 [95% CI, 0.42-0.77]; P<0.001), permanent pacemaker implantation (RR, 0.30 [95% CI, 0.19-0.49]; P<0.001), and shorter hospital length of stay (mean difference,-5.09 days [95% CI, -6.56 to -3.63]; P<0.001). There was no statistically significant difference between the groups in terms of 5-year survival (hazard ratio [HR], 0.92 [95% CI, 0.81-1.05]; P=0.256); however, the landmark analysis revealed that ViV-TMVR was associated with lower risk of death in the initial 6 months (HR, 0.69 [95% CI, 0.58-0.83]; P<0.001) but a higher risk beyond 6 months (HR, 1.47 [95% CI, 1.20-1.79]; P<0.001). CONCLUSION(S): In patients amenable to ViV-TMVR, this procedure shows a lower initial risk of death and complications, but higher mortality after 6 months in comparison with redo-SMVR. These findings highlight the importance of striking a balance between upfront surgical risk and estimated life expectancy when selecting interventions. <82> Accession Number 2045178923 Title Therapeutic impact of SGLT2 inhibitors following transcatheter aortic valve implantation: a grade-assessed systematic review and meta-analysis. Source European Journal of Clinical Pharmacology. 82(5) (no pagination), 2026. Article Number: 137. Date of Publication: 01 May 2026. Author Hamzah K.A.; Kurmasha Y.H.; Al-Shammari A.S.; shweliya M.A.; Al-Janabi A.A.H.; Shahzaib M.; akoum A.; Sattar Y. Institution (Hamzah, Al-Janabi) Department of Internal Medicine, ALkindy college of medicine, University of Baghdad, Baghdad, Iraq (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Al-Shammari, shweliya) Department of Internal Medicine, College of Medicine, University of Baghdad, 502, Filastin St, Baghdad, Iraq (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (akoum) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Al-Shammari, Sattar) Department of Cardiology, Camden Clark Medical Center, West Virginia University, Parkersburg, WV, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: We aim to evaluate the impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Method(s): We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing SGLT2 inhibitor therapy with standard care in adults undergoing TAVI. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception to November 2025. Outcomes included all-cause mortality, heart failure (HF) hospitalization, myocardial infarction (MI), cardiac death, stroke, pacemaker implantation, acute kidney injury (AKI), and bleeding events. Effect sizes were pooled using random-effects models, while time-to-event data were reconstructed for survival analyses. Result(s): Four studies comprising 12,374 patients were included. SGLT2 inhibitor therapy significantly reduced all-cause mortality (RR 0.62, 95% CI 0.49-0.78), HF hospitalization (RR 0.67, 95% CI 0.50-0.91), MI (RR 0.83, 95% CI 0.73-0.93), and bleeding events (RR 0.81, 95% CI 0.72-0.90). Effects on cardiac death, stroke, pacemaker implantation, and AKI were not statistically significant (P > 0.05). Conclusion(s): SGLT2 inhibitor therapy in patients undergoing TAVI was associated with reductions in all-cause mortality, HF hospitalization, and MI. However, these findings are based on a limited and heterogeneous evidence base, largely derived from observational studies, and should be interpreted with caution. The results should not be considered definitive or generalizable to all TAVI populations. Further adequately powered randomized trials are required. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <83> Accession Number 2045469254 Title Heart Failure and Moderate Aortic Stenosis: is Early TAVI the Better Strategy?. Source European Heart Journal, Supplement. 28(CCC 2026 - State of the Art Cardiology) (pp v1-v4), 2026. Date of Publication: 01 May 2026. Author Legati M.; Branca L.; Cersosimo A.; Adamo M. Institution (Legati) Institute of Cardiology, ASST Spedali Civili and University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Piazzale Spedali Civili 1, Brescia, Italy (Branca) Institute of Cardiology, ASST Spedali Civili and University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Piazzale Spedali Civili 1, Brescia, Italy (Cersosimo) Institute of Cardiology, ASST Spedali Civili and University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Piazzale Spedali Civili 1, Brescia, Italy (Adamo) Institute of Cardiology, ASST Spedali Civili and University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Piazzale Spedali Civili 1, Brescia, Italy Publisher Oxford University Press Abstract Aortic stenosis (AS) is the most common valvular heart disease in Western countries. Current clinical guidelines recommend intervention exclusively for severe AS, given its association with poor short-term prognosis. However, accumulating evidence over recent years suggests that even moderate AS may be associated with adverse outcomes, particularly in patients with heart failure with reduced ejection fraction (HFrEF). Consequently, an early aortic valve replacement (AVR) strategy could potentially improve survival and reduce heart-failure-related hospitalizations. Moreover, treating moderate AS in patients with HFrEF may reduce left ventricular afterload and improve haemodynamic status, thereby facilitating the initiation and/or up-titration of guideline-directed medical therapy (GDMT), especially when such therapy is poorly tolerated due to hypotension or other hypoperfusion-related factors. Nevertheless, the available evidence is derived predominantly from retrospective observational studies. The only published randomized controlled trial to date (the TAVR UNLOAD trial) failed to demonstrate a prognostic benefit of transcatheter aortic valve implantation (TAVI) in patients with moderate AS and HFrEF or heart failure with mildly reduced ejection fraction (HFmrEF). Two additional ongoing randomized trials may ultimately provide more definitive evidence. In summary, although the pathophysiological rationale is sound and the available data are encouraging, an early AVR strategy in moderate AS cannot currently be regarded as evidence-based. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. <84> Accession Number 2045502788 Title Efficacy of Combined Music and Cryotherapy for Pain Relief During Mediastinal Drain Removal After Myocardial Revascularization: A Randomized Clinical Trial Protocol. Source Global Advances in Integrative Medicine and Health. 15 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author Fernandes T.E.L.; Santos K.V.G.; Santos J.J.S.; Ferreira M.T.; Rocha D.O.; Miranda A.B.S.A.; Costa L.D.R.; Ribeiro K.R.B.; Dantas D.V.; Dantas R.A.N. Institution (Fernandes, Santos, Santos, Ferreira, Rocha, Miranda, Costa, Ribeiro, Dantas, Dantas) Federal University of Rio Grande do Norte, Natal, Brazil Publisher SAGE Publications Inc. Abstract Introduction: Coronary artery bypass grafting (CABG) is a procedure that requires the use of a mediastinal drain to prevent blood accumulation around the heart. Removal of this device is recognized as a painful experience for the patient. In this context, the adoption of cost-effective, non-pharmacological pain management strategies is essential to reduce adverse effects and minimize opioid exposure. Among these strategies, music-based intervention and cryotherapy emerge as promising interventions, supported by scientific evidence indicating their efficacy in reducing pain and anxiety. Objective(s): To evaluate the efficacy of the combined use of music and cryotherapy in alleviating pain during mediastinal drain removal in patients undergoing myocardial revascularization surgery. Methodology: This is a randomized clinical trial, developed in accordance with the SPIRIT and CONSORT guidelines. The primary outcome of the study is the reduction in pain intensity, as measured by the established Numerical Rating Scale (NRS). The study will be conducted in the Intensive Care Unit of the Heart Hospital of Natal, involving two groups: the experimental group, which will receive the music-based intervention and cryotherapy, and the control group, which will follow the institution's standard care. The sample will consist of 52 randomly allocated participants, and feasibility will be evaluated through a pilot test with the first five. Eligibility criteria include: age >=18 years, postoperative hemodynamic stability, a score of 15 on the Glasgow Coma Scale, ability to understand and respond to pain assessment instruments, and the presence of a mediastinal drain scheduled for removal. Conclusion(s): This study aims to contribute new evidence regarding integrative and complementary health practices, thereby optimizing the comprehensive care delivered to patients post-myocardial revascularization. Registration: This study is registered on the Brazilian Registry of Clinical Trials (ReBEC) platform under the number RBR-2nzh9vr and was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte (Opinion no. 83976124.0.0000.5537). Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <85> Accession Number 2045337875 Title Ultrasound-Guided Erector Spinae Plane Block versus Thoracic Epidural Analgesia for Postoperative Pain Control after Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial. Source International Journal of Current Pharmaceutical Review and Research. 18(2) (pp 1027-1032), 2026. Date of Publication: 2026. Author Chandak A.A.; Patel D.; Khatrikar M. Institution (Chandak) Department of Anaesthesia, Swaminarayan Institute of Medical Sciences & Research, Gujarat, Kalol, India (Patel, Khatrikar) Department of Anaesthesiology, The Gujarat Cancer and Research Institute, Gujarat, Ahmedabad, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Postoperative pain management following video-assisted thoracoscopic surgery (VATS) remains a significant clinical challenge. Thoracic epidural analgesia (TEA) has long been regarded as the gold standard analgesic technique for thoracic surgery; however, it is associated with invasiveness and notable complications. The ultrasound-guided erector spinae plane (ESP) block has emerged as a promising, technically simpler alternative. Method(s): This prospective, single-center, randomized controlled trial enrolled 80 adult patients (ASA I-III) undergoing elective VATS. Patients were randomly allocated to the ESP group (n = 40; ultrasound-guided continuous ESP block with 0.25% bupivacaine) or the TEA group (n = 40; continuous thoracic epidural infusion of 0.125% bupivacaine with fentanyl 2 microg/mL). The primary outcome was pain scores at rest measured using the Numerical Rating Scale (NRS) at 24 hours postoperatively. Secondary outcomes included NRS during coughing, cumulative morphine consumption at 24 and 48 hours, incidence of adverse events, patient satisfaction, and length of hospital stay. Result(s): NRS pain scores at rest at 24 hours were comparable between groups (ESP: 2.9 +/- 1.1 vs. TEA: 2.5 +/- 1.0; p = 0.098). Cumulative morphine consumption at 48 hours was significantly higher in the ESP group (18.4 +/- 5.2 mg vs. 14.1 +/- 4.7 mg; p = 0.001). TEA was associated with significantly higher rates of hypotension (25.0% vs. 7.5%; p = 0.035) and urinary retention (22.5% vs. 5.0%; p = 0.024). Patient satisfaction scores were similar. Length of hospital stay did not differ significantly between groups. Conclusion(s): Ultrasound-guided ESP block provides comparable resting pain relief to TEA after VATS, with a significantly more favorable side effect profile, despite modestly higher opioid consumption. ESP block may serve as a viable, less invasive alternative to TEA within a multimodal analgesia framework. Copyright © (2026), (Dr. Yashwant Research Labs Pvt. Ltd.). All rights reserved. <86> Accession Number 2045486486 Title Acute normovolaemic haemodilution after cardiac surgery. Comment on Br J Anaesth 2026; 136: 836a"46. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Lamba P. Institution (Lamba) Dr D.Y. Patil Vidyapeeth (Deemed to be University), Pimpri, Maharashtra, Pune, India Publisher Elsevier Ltd <87> Accession Number 2045455061 Title Cryoanalgesia in Thoracic Surgery. Source Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Drake L.; Weksler B. Institution (Drake, Weksler) Division of Thoracic and Esophageal Surgery, Cardiovascular Institute, Allegheny Health Network, PA, United States Publisher SAGE Publications Ltd Abstract Cryoanalgesia is a technique for reducing postoperative pain that involves freezing peripheral nerves while preserving their ability to regain function over time. The technique has been used for decades, and randomized trials have shown a reduction in pain and opioid use in some patients undergoing thoracotomy and pectus excavatum repair. In these trials, outcomes were highly dependent on the control groups. Randomized studies of patients undergoing minimally invasive thoracic surgery have failed to show the same results. Furthermore, several studies have reported chronic pain and neuropathic-type pain in patients treated with cryoanalgesia. In this review, we discuss the electrophysiologic and histopathologic basis of cryoanalgesia, highlight randomized trials of cryoanalgesia in thoracic surgery, and outline potential pitfalls, such as chronic pain, to offer insight into which patients may benefit most from cryoanalgesia and potential future directions of study. Copyright © The Author(s) 2026 <88> Accession Number 2045458370 Title Natural history and outcomes of early aortic valve replacement versus conservative management in asymptomatic severe aortic stenosis: A meta-analysis. Source American Journal of Medicine. (no pagination), 2026. Date of Publication: 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, United States Publisher Elsevier Inc. 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; 3960 patients: 1868 early aortic valve replacement, 2092 conservative management). Seven of these studies (1620 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 Elsevier Inc. <89> Accession Number 651083821 Title Cognitive impairment in heart transplantation: prevalence, trajectories, and prognostic impact - a systematic review. Source Aging clinical and experimental research. (no pagination), 2026. Date of Publication: 02 May 2026. Author Parrotta I.; Valente M.; Piazzalunga E.; Scarpa E.; Mantini D.; Danesin L.; Rossi C.; Borgese L.; Golfieri L.; Burgio F.; Potena L. Institution (Parrotta, Piazzalunga, Scarpa, Danesin, Burgio) IRCCS San Camillo Hospital, Venice, Italy (Parrotta, Mantini) Movement Control and Neuroplasticity Research Group, Leuven, Belgium (Valente, Rossi, Borgese, Golfieri, Potena) BolognaItaly (Piazzalunga) Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy Abstract BACKGROUND/AIM: Heart transplantation (HTx) represents the definitive treatment for patients with end-stage heart failure (HF). Neurological complications, particularly cognitive impairment (CI), may influence prognosis, thereby affecting the overall benefits of HTx. CI in HF is associated with disease severity, extracardiac dysfunction, and peri- or intra-operative factors such as prolonged ventilation, cerebral hypoperfusion, and systemic inflammation. However, existing studies on CI in HTx candidates are highly heterogeneous, limiting comparability and highlighting the need for a clearer understanding of its impact in both candidates and recipients. METHOD(S): This systematic review was registered with PROSPERO (CRD42024549051) and conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Embase were searched for studies published between 2013 and June 2025. Eligible studies assessed cognitive function in adult HF patients undergoing HTx. RESULT(S): Of 1188 records screened, eight studies met the inclusion criteria. Most cognitive studies employed the Montreal Cognitive Assessment (MoCA), while two used comprehensive neuropsychological batteries. Evidence confirmed that CI is common among HF and HTx populations. Incorporating cognitive status into frailty assessments enhanced prediction of adverse outcomes, including prolonged hospitalization and reduced survival. Cognitive decline was frequently observed in the immediate post-transplant period, often linked to high-dose immunosuppressive therapy and anemia, while long-term improvements were reported in attention, memory, and executive function. CONCLUSION(S): Cognitive assessment is essential in HTx candidates, as CI has a major impact on survival. Further studies are needed to clarify long-term cognitive trajectories and the role of immunosuppressive therapy in shaping outcomes. Copyright © 2026. The Author(s). <90> Accession Number 2045420927 Title Myocardial Fibrosis and Early Intervention in Asymptomatic Patients with Severe Aortic Stenosis: Insights from the EVOLVED Randomized Clinical Trial. Source JAMA Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Craig N.J.; Loganath K.; Everett R.J.; Bing R.; Ramtoola T.; Tsampasian V.; Molek P.; Botezatu S.; Aslam S.; Macgillivray T.; Tuck C.E.; Rayson P.; Calvert P.A.; Berry C.; Chin C.W.L.; Hillis G.S.; Fairbairn T.; Greenwood J.P.; Steeds R.; Leslie S.J.; Lang C.C.; Bucciarelli-Ducci C.; Joshi N.V.; Kunadian V.; Prendergast B.; Mills N.L.; Vassiliou V.S.; Dungu J.N.; Hothi S.S.; Boon N.; Prasad S.K.; Keenan N.G.; Dawson D.; Motwani M.; Miller C.A.; Rajani R.; Ripley D.P.; Treibel T.A.; McCann G.P.; Singh A.; Newby D.E.; Dweck M.R. Institution (Craig, Loganath, Ramtoola, Tuck, Mills, Newby, Dweck) British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, United Kingdom (Craig, Everett, Bing, Ramtoola, Mills, Newby, Dweck) Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom (Tsampasian, Vassiliou) Norwich Medical School, University of East Anglia, United Kingdom (Tsampasian, Vassiliou) Department of Cardiology, Norfolk and Norwich University Hospital, United Kingdom (Molek) Department of Coronary Disease and Heart Failure, Jagiellonian University Medical College, Krakow, Poland (Botezatu) University of Medicine and Pharmacy Carol Davila, Cardiology Department, Euroecholab, Bucharest, Romania (Aslam, McCann, Singh) Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, United Kingdom (Macgillivray) Edinburgh Imaging, The University of Edinburgh, Edinburgh, United Kingdom (Rayson) Edinburgh Clinical Trials Unit, Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom (Calvert) Royal Papworth Hospital NHS Foundation Trust, University of Cambridge, Cambridge, United Kingdom (Berry) School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Chin) Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore (Chin) Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia (Hillis) Medical School, University of Western Australia, Perth, WA, Australia (Hillis, Greenwood) Baker Heart and Diabetes Institute, Melbourne, VIC, Australia (Fairbairn) Department of Cardiology, Liverpool Centre for Cardiovascular Science, Liverpool Heart and Chest Hospital, Liverpool, United Kingdom (Greenwood) Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom (Steeds) Department of Cardiology, Queen Elizabeth Hospital Birmingham, University Hospitals of Birmingham NHS Foundation Trust, Birmingham, United Kingdom (Leslie) Cardiac Unit, Raigmore Hospital, Inverness, United Kingdom (Lang) Division of Molecular and Clinical Medicine, School of Medicine, University of Dundee, Dundee, United Kingdom (Lang) Tuanku Muhriz Chair, National University of Malaysia, Malaysia (Bucciarelli-Ducci, Joshi) Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, United Kingdom (Bucciarelli-Ducci, Prasad) Royal Brompton and Harefield Hospitals, Guys' and St Thomas NHS Foundation Trust, London, United Kingdom (Kunadian) Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle, United Kingdom (Kunadian) University and Cardiothoracic Centre, Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom (Prendergast) Cleveland Clinic London and St Thomas' Hospital, London, United Kingdom (Mills) Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom (Dungu) Essex Cardiothoracic Centre, Nethermayne, Basildon, Essex, United Kingdom (Dungu) Anglia Ruskin University, Chelmsford, Essex, United Kingdom (Hothi) Department of Cardiology, Royal Wolverhampton NHS Trust, Wolverhampton, United Kingdom (Hothi) Institute of Cardiovascular Sciences, University of Birmingham, United Kingdom (Boon) Retired, Hertfordshire, United Kingdom (Keenan) Department of Cardiology, West Hertfordshire Hospitals NHS Trust, Watford, United Kingdom (Keenan) Imperial College, London, United Kingdom (Dawson) Aberdeen Cardiovascular and Diabetes Centre, University of Aberdeen, Aberdeen, United Kingdom (Motwani) Department of Cardiology, Manchester Heart Institute, Manchester Royal Infirmary, Manchester University NHS Foundation Trust, Manchester, United Kingdom (Miller) Division of Cardiovascular Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom (Rajani) Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Ripley) Cardiology, Northumbria Healthcare NHS Foundation Trust, Newcastle Upon Tyne, United Kingdom (Treibel) Institute of Cardiovascular Sciences, University College London, St Bartholomew's Hospital, Barts Health NHS Trust, West Smithfield, London, United Kingdom Publisher American Medical Association Abstract Importance: Myocardial fibrosis burden has been associated with adverse clinical outcomes in symptomatic patients with aortic stenosis. Objective(s): To determine whether midwall myocardial fibrosis burden is associated with adverse clinical outcomes in asymptomatic patients and whether those with more fibrosis derive greater benefit from early intervention. Design, Setting, and Participant(s): This post hoc analysis of a randomized clinical trial was conducted between August 2017 and October 2022. The trial took place at 24 cardiac centers across the United Kingdom and Australia. Participants included asymptomatic patients with severe aortic stenosis and midwall fibrosis on cardiac magnetic resonance. These data were analyzed from October 2024 through June 2025. Intervention(s): Early intervention with transcatheter or surgical aortic valve replacement. Main Outcomes and Measures: Primary outcome was all-cause death or unplanned aortic stenosis-related hospitalization. Secondary outcomes included the individual components of the primary outcome. Result(s): In 224 trial participants (mean [SD] age, 73 [9] years; 63 women and 161 men, and mean [SD] aortic valve peak velocity 4.3 [0.5] m per second) with a median follow-up of 42 months, fibrosis burden (per 1% increase) was associated with an increase in the primary end point (hazard ratio [HR], 1.23; 95% CI, 1.08-1.37) and its component of unplanned aortic stenosis-related hospitalizations (HR, 1.22; 95% CI, 1.03-1.40) but not all-cause death (HR, 1.17; 95% CI, 0.98-1.35). There were no interactions between randomization arm and the midwall fibrosis burden for the primary (P for interaction =.39) or secondary end points. In patients with high fibrosis burden above the median, the primary end point occurred in 12 of 59 (20%) of those randomized to early intervention and 17 of 53 (32%) of those randomized to guideline-directed conservative management (HR, 0.62; 95% CI, 0.29-1.28). For the individual components, all-cause death occurred in 9 (15%) and 10 (19%) patients, respectively (HR, 0.84; 95% CI, 0.33-2.07), and unplanned aortic stenosis-related hospitalization in 4 (7%) and 13 (25%) patients respectively (HR, 0.27; 95% CI, 0.08-0.77). In patients with low fibrosis burden below the median, there were no differences in the primary outcome (HR, 1.05; 95% CI, 0.39-2.86) or its components between intervention groups. Conclusions and Relevance: In this study, in asymptomatic patients with severe aortic stenosis, higher midwall fibrosis burden was associated with adverse outcomes. There was no demonstrable heterogeneity by the degree of midwall fibrosis for the treatment effects of early surgical or transcatheter aortic valve replacement compared to clinical surveillance. Trial Registration: ClinicalTrials.gov Identifier: NCT03094143 Copyright © 2026 American Medical Association. <91> Accession Number 2045455419 Title Impact of Restrictive Versus Liberal Oxygenation on Pulmonary Decline After Cardiac Surgery: A Substudy of the GLORIOUS Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mikkelsen A.D.; Wiberg S.; Schultz H.H.L.; Moller-Sorensen P.H.; Hofsten D.; Kober L.; Chemtob R.A.; Jakobsen P.C.H.; Nilsson J.C.; Moller C.H.; Hassager C.; Kjaergaard J. Institution (Mikkelsen, Hofsten, Kober, Hassager, Kjaergaard) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic Anaesthesiology and Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Schultz, Chemtob, Jakobsen) Section for Heart and Lung Transplant, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Moller) Department of Cardiac Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Hassager, Kjaergaard) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher W.B. Saunders Abstract Objectives: Pulmonary dysfunction is a known complication of cardiac surgery. High fractions of inspired oxygen (FiO<inf>2</inf>) during the critical pulmonary reperfusion phase of cardiopulmonary bypass (CPB) weaning is a proposed pathophysiological contributor yet remains sparsely investigated. Design(s): Predefined, exploratory substudy of the GLORIOUS randomized, clinical trial. Setting(s): Single tertiary center with cardiothoracic surgery expertise. Participant(s): Adult patients undergoing nonemergent coronary artery bypass grafting (CABG) and/or surgical aortic valve replacement. Intervention(s): Restrictive (FiO<inf>2</inf> 50%) versus liberal (FiO<inf>2</inf> 100%) oxygenation during CPB and the first hour after weaning or until patient transfer from the operating table. Pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, and diffusion capacity of carbon monoxide) was measured preoperatively and 3 months postoperatively. Measurements and Main Results: A total of 878 patients were included in the study. Postoperatively, at the 3-month mark, pulmonary function declined across all parameters in the overall study population (median FEV1 [% predicted] by 8.3 percentage points [95% CI 6.6 to 8.3], FVC [% predicted] by 6.1 percentage points [95% CI 5.2 to 7.0], FEV1/FVC by 1.6 percentage points [95% CI 1.0 to 2.1], and diffusion capacity of carbon monoxide [% predicted corrected] by 7.7 percentage points [95% CI 6.2 to 9.1], all p< 0.001). However, no significant between-group differences in decline were observed (all p > 0.3), including in subgroup analyses. Conclusion(s): While pulmonary function exhibited a mild-to-moderate decline 3 months after cardiac surgery, a restrictive (FiO<inf>2</inf> 50%) oxygenation strategy during CPB did not attenuate this decline compared with a liberal (FiO<inf>2</inf> 100%) strategy. Findings are hypothesis-generating. Copyright © 2026 The Author(s) <92> Accession Number 2045458723 Title The link between atrial fibrosis and postoperative atrial fibrillation after cardiac surgery: A systematic review. Source Trends in Cardiovascular Medicine. (no pagination), 2026. Date of Publication: 2026. Author Nawaz A.; Sohpal A.; Mitra R.; Abu-Omar Y.; Elsebaie A.; El-Diasty M. Institution (Nawaz, Sohpal) School of Medicine, Case Western Reserve University, Cleveland, OH, United States (Mitra) Case School of Engineering, Case Western Reserve University, Cleveland, OH, United States (Abu-Omar, El-Diasty) Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Elsebaie) Department of Medicine, Queen's University, Kingston, ON, Canada (El-Diasty) Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON, Canada Publisher Elsevier Inc. Abstract Postoperative atrial fibrillation (POAF) is a common complication that can affect up to 20-44% of patients undergoing cardiac surgery. Evidence suggests that atrial fibrosis is a key factor in the development of POAF due to the disruption of the myocardial electric properties. This systematic review examines the correlation between pre-existing atrial fibrosis and the development of POAF after cardiac surgery. A systematic literature search was conducted in MEDLINE, Embase, and Google Scholar (2000 to March 2025) to identify studies that conducted comparative analysis of atrial fibrosis levels between those who did and did not develop POAF, using histological assessment methods. Extracted data, included study characteristics, histopathological staining methods and analysis findings, fibrosis quantification methods, and overall POAF incidence. Thirteen studies met the inclusion criteria, resulting in a total of 1222 patients, primarily undergoing coronary artery bypass surgery. The incidence of POAF ranged from 14%-42.4% (median 31.6%). In more than half of the studies (7/13), patients who developed POAF demonstrated statistically significant higher degrees of atrial fibrosis compared to those that remained in sinus rhythm postoperatively (four exhibited p < 0.001). Of the eight studies that conducted multivariate analyses, three identified atrial fibrosis as an independent POAF predictor. High heterogeneity precluded pooling of results into a meta-analysis. The current evidence examining the link between pre-existing atrial fibrosis and the development of POAF is restricted by methodological heterogeneity and inconsistent findings. Further efforts to standardize fibrosis quantification methods and POAF definitions are warranted before histopathological assessments can reliably inform POAF risk before cardiac surgery. Copyright © 2026 The Author(s) <93> Accession Number 2045449222 Title A minimally invasive anaesthetic approach for transcatheter aortic valve implantation: is this really supported by the evidence?. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Heringlake M.; Muras L.H.; Schemke S. Institution (Heringlake, Muras, Schemke) Department of Anaesthesiology and Intensive Care Medicine, Heart and Diabetes Center Mecklenburg - Western Pomerania, Karlsburg Hospital, Karlsburg, Germany Publisher Elsevier Ltd Abstract In association with growing operator experience and increasingly sophisticated delivery systems and valve prostheses, the anaesthetic management of patients undergoing transfemoral transcatheter aortic valve implantation (TAVI) has changed in many centres from general anaesthesia with invasive monitoring to local anaesthesia with conscious sedation or solely local anaesthesia. In a recent issue of the British Journal of Anaesthesia, a group of Italian experts in cardiac anaesthesia, cardiology, and cardiac surgery present an interdisciplinary consensus on the anaesthetic management of TAVI patients, recommending that a minimally invasive approach should be favoured in most cases. We critically evaluate the observational data supporting this consensus in comparison with the evidence from the available randomised controlled trials and highlight the need for an individual approach for anaesthetic management best suited to ensure safe and successful TAVI procedures. Copyright © 2026 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <94> Accession Number 651084627 Title Chlorhexidine Gluconate vs. Povidone-Iodine for Surgical Site Infection Prevention: A Systematic Review and Meta-Analysis Stratified by Surgery Type, Wound Classification, Antiseptic Formulation, and Country Income, with Meta-Regression. Source The Journal of hospital infection. (no pagination), 2026. Date of Publication: 30 Apr 2026. Author Benhammou M.; Elraggal D.; Saleh S.; Nobuhara C.K.; van Ramshorst G.H.; Mimoz O.; Nounou M.V.; Shawesh Q.; Tuuli M.G.; Wexner S.D.; Catena F.; Forrester J.D.; Elhadi M. Institution (Benhammou) Faculty of Medicine, University of Oran 1, Ahmed Ben Bella, Oran, Algeria (Elraggal) Alexandria faculty of medicine, Alexandria University, Alexandria, Egypt (Saleh) Hashemite University, Zarqa, Jordan (Nobuhara, Forrester) Department of Surgery, Stanford University, Stanford, CA, United States (van Ramshorst) Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium (Mimoz) CHU de Poitiers, Service des Urgences Adultes-SAS 86-Centre 15, Poitiers, France; INSERM, U1070, Pharmacologie des Agents Anti-Infectieux, Poitiers, France; Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, Queensland, Australia (Nounou) University of Nouakchott Al Aasrya, Faculty of Medicine, Mauritania (Shawesh) Department of Internal Medicine, HCA Mountain View Hospital, Las Vegas, NV, United States (Tuuli) Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brown University Warren Alpert Medical School, Providence, RI, United States (Wexner) Division of Colorectal Surgery, MedStar Georgetown University Hospital, WA, United States (Catena) Dept of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Dept of General and Emergency Surgery Bufalini Hospital AUSL Romagna Cesena ITALY (Elhadi) College of Medicine, Korea University, Seoul, South Korea Abstract BACKGROUND: The comparative effectiveness of chlorhexidine gluconate (CHG) versus povidone-iodine (PVI) for preventing surgical site infections (SSIs) remains unclear across surgical types and resource settings. This study compared CHG and PVI overall and within key clinical subgroups. METHOD(S): Five databases were searched through February 2025 for randomized controlled trials comparing CHG with PVI and reporting SSI outcomes. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals (CIs). RESULT(S): Twenty-nine RCTs involving 35,317 patients were included. CHG significantly reduced superficial incisional SSIs (OR = 0.80; 95% CI 0.67-0.95; p = 0.01; I2 = 18.4%), but not overall, deep, or organ/space infections; meta-regression indicated that patient age was a significant effect modifier. In cesarean sections, CHG lowered overall (OR = 0.64; 95% CI 0.48-0.85), superficial (OR = 0.65; 95% CI 0.48-0.87), and deep incisional SSIs (OR = 0.41; 95% CI 0.22-0.75). In abdominal surgery, CHG reduced only superficial incisional SSIs (OR = 0.68; 95% CI 0.52-0.91). No significant differences were observed in gynecologic, cardiothoracic, or orthopedic procedures. By wound classification, CHG had no effect in clean surgery but reduced superficial incisional SSIs in clean-contaminated cases (OR = 0.65; 95% CI 0.48-0.89). By income level, no differences were seen in high-income countries, while in low- and middle-income countries CHG decreased overall (OR = 0.58; 95% CI 0.46-0.74), superficial (OR = 0.54; 95% CI 0.38-0.76), and deep incisional SSIs (OR = 0.48; 95% CI 0.25-0.92). CONCLUSION(S): Alcohol-based CHG and alcohol-based PVI are comparably effective in most surgical settings. However, CHG demonstrates superior prevention of SSIs in cesarean, abdominal, and clean-contaminated surgeries, with the most substantial benefit in low- and middle-income settings. Broader use may be justified pending cost-effectiveness evaluation. Copyright © 2026 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. <95> Accession Number 2045249305 Title Beta-Blockers in Patients with Myocardial Infarction and No Heart Failure: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Canadian Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Kawtharany H.; Rayyan A.; Mestarihi A.; Hamarsha Q.; Choaib A.; Azzam M.; Arora S. Institution (Kawtharany) Department of Internal Medicine, St Louis University School of Medicine, St Louis, MO, United States (Rayyan, Mestarihi) Department of Internal Medicine, College of Medicine, University of Central Florida / HCA North Florida, Gainesville, FL, United States (Hamarsha, Choaib, Azzam) Evidence-Based Practice and Impact Center, Department of Internal Medicine, University of Kansas Medical Center, Kansas City, KS, United States (Arora) Division of Cardiology, St Louis University Hospital/SSM Health, St Louis, MO, United States Publisher Elsevier Inc. Abstract Background beta-Blockers have an established role in patients with myocardial infarction (MI) and left ventricular ejection fraction (LVEF) <40%. In those with LVEF >40%, emerging new trials have inconsistent results. We conducted a meta-analysis to evaluate the outcomes of beta-blocker therapy compared with no beta-blocker therapy in patients with MI and LVEF >40%. Methods We searched PubMed, Embase, and CENTRAL for randomized controlled trials (RCTs) published after 2000. Meta-analyses estimated hazard ratio (HR) or risk ratio (RR) with 95% confidence intervals (CIs) using RevMan web. Results Five RCTs (N = 19,826) met the inclusion criteria, with 9892 patients (49.8%) randomized to beta-blockers and 9934 (50.2%) to no beta-blockers. All trials enrolled patients with MI and LVEF >40%. Meta-analysis demonstrated that beta-blockers were not associated with significant reduction in all-cause mortality (HR 0.98, 95% CI 0.85-1.13), cardiac mortality (HR 1.16, 95% CI 0.89-1.51), unplanned coronary revascularization (HR 1.01, 95% CI 0.87-1.17), or malignant ventricular arrhythmia (RR 0.87, 95% CI 0.51-1.48). beta-Blockers were associated with a trend toward lower MI (HR 0.88, 95% CI 0.77-1.00) and new-onset heart failure (HF) (HR 0.82, 95% CI 0.63-1.07). beta-Blockers were not associated with an increase in symptomatic atrioventricular block (HR 1.06, 95% CI 0.83-1.34) or stroke (RR 1.16, 95% CI 0.9-1.48). Conclusion In patients with MI with LVEF >40%, beta-blockers were not associated with a significant effect on any outcome; beta-blockers were associated with a trend toward lower MI and HF. Registration PROSPERO CRD420251139242. Copyright © 2026 Canadian Cardiovascular Society. <96> Accession Number 651076588 Title Letter to the Editor: HTK Solution Cardioplegia in Pediatric Patients: A Meta-Analysis. Source The Thoracic and cardiovascular surgeon. (no pagination), 2026. Date of Publication: 30 Apr 2026. Author Momin S.M.; Shah S.U.; Akbar H.; Hussain S.H. Institution (Momin, Shah, Akbar, Hussain) Nowshera Medical College, Khyber Pakhtunkhwa, Pakistan <97> [Use Link to view the full text] Accession Number 2044056304 Title Evaluating the benefits of high-dose statin preloading in ST-segment elevation myocardial infarction management: insights from a systematic review and meta-analysis. Source Coronary Artery Disease. (no pagination), 2026. Article Number: 10.1097/MCA.0000000000001629. Date of Publication: 09 Mar 2026. Author Resende B.; Mata E.; Carlos T.; Portugues J.; Ribeiro S.; Gameiro J.; Lourenco A.; Goncalves L. Institution (Resende, Carlos, Gameiro, Goncalves) Cardiology Department, Unidade Local de Saude de Coimbra, Coimbra, Portugal (Mata, Portugues, Ribeiro, Lourenco) Cardiology Department, Unidade Local de Saude Alto Ave, Guimaraes, Portugal (Goncalves) Faculdade de Medicina da Universidade de Coimbra, Portugal (Goncalves) Coimbra Institute for Clinical and Biomedical Research (iCBR), Coimbra, Portugal Publisher Lippincott Williams and Wilkins Abstract Introduction: - ST-segment elevation myocardial infarction (STEMI) is a life-threatening condition needing urgent reperfusion, with better outcomes linked to optimal myocardial perfusion. Statins may reduce ischemia-reperfusion injury through pleiotropic effects. While the 2019 European Society of Cardiology (ESC) Dislipidemia Guidelines recommended high-intensity statins before percutaneous coronary intervention (PCI), this was not included in the 2023 ESC or 2025 ACC/AHA/ACEP/NAEMSP/SCAI ACS Guidelines. Objective - To evaluate the effect of high-dose statin loading before primary PCI in improving coronary reperfusion and clinical outcomes in STEMI patients through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods - On June 2025, CENTRAL, EMBASE, and PubMed were searched for RCTs comparing high-dose statin preloading with placebo or no statin in STEMI patients undergoing primary PCI. The primary outcome was post-PCI thrombolysis in myocardial infarction (TIMI) flow grade 3. Secondary outcomes included all-cause mortality and greater than or equal to 50% ST-segment resolution. Data were pooled using random-effects models, reporting odds ratios (OR) with 95% confidence intervals (CIs). Results - Nine RCTs with 1862 patients were included. High-dose statin preloading significantly increased the likelihood of achieving post-PCI TIMI flow grade 3 (OR: 1.52, 95% CI: 1.06-2.20). It was also associated with a reduction in all-cause mortality (OR: 0.59, 95% CI: 0.36-0.98). No significant difference was observed in greater than or equal to 50% ST-segment resolution (OR: 1.04, 95% CI: 0.71-1.50). Conclusion - High-dose statin loading before primary PCI in STEMI patients seems to be associated with improved coronary reperfusion and reduced all-cause mortality. These findings offer timely and clinically relevant insight, reminding the cardiovascular community of the potential value of this therapeutic. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <98> Accession Number 2045263447 Title Posterior Left Ventricular Rupture Following Mitral Valve Surgery: A Literature Review of Successful Repair Strategies. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 1964538. Date of Publication: 2026. Author Atta S.; Khalaf Y.; Marigliano A.; Bashir A.; Lloyd C. Institution (Atta, Khalaf, Marigliano, Bashir, Lloyd) Cardiothoracic Surgery Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: Posterior ventricular rupture (PVR) is an uncommon but often fatal complication of mitral valve surgery, with reported incidence between 0.6% and 1.8% and mortality rates approaching 86%. Recognized risk factors include posterior mitral annular calcification, advanced age, female sex, extensive decalcification, and infective endocarditis. Despite advances in surgical techniques, this catastrophic complication continues to pose a major challenge. We reviewed published reports of successful repair strategies to outline practical approaches and propose a management framework. Method(s): A PubMed search identified 25 reports describing 34 successful repairs of posterior LV rupture. Only cases in which patients survived were included for analysis. Result(s): Most patients (21 of 34) presented with mitral stenosis, usually associated with posterior annular calcification. The circumstances of rupture varied, occurring intraoperatively, during attempts to wean from cardiopulmonary bypass (CPB), or in the intensive care unit. Thirty cases required reinitiation of CPB to enable definitive repair. External repair methods, such as Teflon patch reinforcement and surgical sealants, were reported in 13 patients. Internal approaches most often used pericardial patch reinforcement secured with Teflon-buttressed sutures, both to restore ventricular integrity and to support the prosthetic valve. In six situations, repair was undertaken using autotransplant techniques on an explanted heart. Mechanical circulatory support was frequently required: 14 patients received intra-aortic balloon pump therapy, and one patient was supported with an Impella device, both aiming to reduce LV workload during recovery. Conclusion(s): Posterior LV rupture following mitral valve surgery demands immediate recognition and rapid reinstitution of CPB. The choice of repair-internal or external-should be guided by rupture timing, location, and patient stability. Adjunctive mechanical circulatory support can be life-saving by unloading the injured ventricle. While experience remains limited to isolated reports, systematic accumulation of cases is needed to refine treatment strategies for this highly lethal complication. Copyright © 2026 Sameh Atta et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <99> Accession Number 651077247 Title Surgical management of catamenial pneumothorax: a systematic review. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 30 Apr 2026. Author Mekhail A.; Kilby J.; Macalister S.; Manivannan P.C.; Seitz M. Institution (Mekhail, Kilby, Macalister, Manivannan, Seitz) University Hospital Geelong, Geelong, VIC, Australia Abstract BACKGROUND: Catamenial pneumothorax is a rare manifestation of thoracic endometriosis syndrome and is associated with a high risk of recurrence despite surgical intervention. Increasingly, multimodal strategies combining thoracic surgery with adjunctive hormonal therapy have been put in place as standard practice however, optimal management remains uncertain. METHOD(S): A systematic review of the literature was conducted using MEDLINE/PubMed, Scopus, CENTRAL, Google Scholar, SciSpace, and the Cochrane Library for studies published between January 2000 and December 2025. Studies reporting outcomes of surgical management for catamenial pneumothorax were included. Data was extracted on patient characteristics, surgical techniques (diaphragmatic and pleural interventions), use of postoperative hormonal therapy, and recurrence rates. RESULTS: Analysis of 37 studies encompassing over 1,800 patients suggests that treatment approach is a major determinant of outcomes. Meta-analysis demonstrates a pooled recurrence rate of 17.3% with postoperative hormonal therapy compared to 54.2% without (p < 0.01) [1], with younger age independently associated with higher recurrence risk. Diaphragmatic intervention is critical to reducing recurrence, with studies reporting 12.5% recurrence when diaphragmatic surgery is combined with pleurodesis versus 100% with pleurodesis alone [15]. Diaphragm resection has been identified as an independent protective factor against recurrence (HR 0.16; 95% CI: 0.03-0.77; p = 0.022) [5]. CONCLUSION(S): The available evidence supports a multimodal approach to the management of catamenial pneumothorax. Comprehensive thoracoscopic surgery addressing diaphragmatic pathology, combined with pleurodesis and postoperative hormonal therapy, is consistently associated with reduced recurrence. Given the observational nature of the available data, these findings should be interpreted with appropriate caution and highlight the need for prospective, collaborative studies. Copyright © 2026. The Author(s). <100> Accession Number 2038094720 Title The 2025 European Society of Cardiology/European Association for Cardio-Thoracic Surgery joint guidelines for the management of valvular heart disease: Revolution or evolution?. Source Kardiologia Polska. 84(4) (pp 459-463), 2026. Date of Publication: 2026. Author Wojakowski W.; Tendera M.; Praz F. Institution (Wojakowski, Tendera) Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (Praz) Department of Cardiology, Bern University Hospital, Bern, Switzerland Publisher Via Medica Abstract The 2025 European Society of Cardiology (ESC)/European Association for Cardio-Thoracic Surgery guidelines for the management of valvular heart disease (VHD), presented at the ESC Congress in Madrid, update the 2021 document and respond to the rapid growth of evidence from randomized trials, meta-analyses, and large registries. Developed by a multidisciplinary Heart Team including patient representatives, the guidelines emphasize patient-centered "lifetime" management, shared decision-making, and treatment at high-volume expert Heart Valve Centers, especially for complex surgical and transcatheter procedures. The scope has been broadened to address cancer and radi-ation-associated VHD, cardiogenic shock and acute heart failure (HF), multiple and mixed VHD, and sex-specific issues. Key changes in indications for imaging, treatment, and follow-up of VHD are discussed in the perspective of evidence-based medicine. Key updates include earlier intervention in severe, high-gradient, asymptomatic aortic stenosis, refined age thresholds for transfemoral transcatheter aortic valve implantation, and its use in bicuspid aortic stenosis and aortic regurgitation in high-risk or inoperable patients. Recommendations for secondary mitral regurgitation (MR) distinguish atrial from ventricular mechanisms and upgrade mitral transcatheter edge-to-edge repair (TEER) to class I in selected cases of ventricular secondary MR. At the same time, surgery remains first line for primary MR, with defined triggers for early repair and emerging roles for TEER and TEER in high-risk patients. The document also strengthens guidance on tricuspid interventions and structured assessment of right ventricular dysfunction, and simplifies antithrombotic strategies, including restricted use of dual antiplatelet therapy after transcatheter aortic valve implantation in patients without another indication for oral anticoagulation. Implementing these recommendations should streamline care pathways and reduce the burden of VHD. Copyright © by the Author(s), 2026. <101> Accession Number 2038094331 Title Transcatheter aortic valve implantation for symptomatic severe aortic stenosis and its expanding clinical indications. Source Korean Journal of Internal Medicine. 41(3) (pp 373-383), 2026. Date of Publication: 01 May 2026. Author Kook H.; Lim Y.-H. Institution (Kook, Lim) Division of Cardiology, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea Publisher Korean Association of Internal Medicine Abstract Transcatheter aortic valve implantation (TAVI) is a minimally invasive treatment for symptomatic severe aortic stenosis (AS) that was initially developed for patients with prohibitive surgical risk. Since the first-in-human procedure in 2002, TAVI has gained global acceptance owing to its favorable clinical outcomes and faster recovery than those associated with surgical aortic valve replacement. Landmark trials have demonstrated the noninferiority or superiority of TAVI across high-, intermediate-, and low-surgical risk populations, leading to guideline endorsement as a recommended option for appropriately selected patients across all surgical risk groups. Furthermore, long-term follow-up data support the durability of contemporary TAVI devices. Beyond its current established indications, TAVI is being explored for broader applications such as asymptomatic severe AS, moderate AS with heart failure, and pure aortic regurgitation; however, these uses remain investigational and are not yet part of formal guidelines. This review summarizes TAVI's historical evolution, pivotal clinical trial evidence, and procedural innovations that have enabled its widespread use. We explore Korea-specific experiences with TAVI implementation, highlighting national registry data, healthcare policy considerations, and institutional adoption. Future perspectives include long-term device performance, lifetime valve management strategies, and the integration of artificial intelligence into transcatheter valve therapy. Copyright © 2026 The Korean Association of Internal Medicine. <102> Accession Number 651076955 Title Feasibility and postoperative analgesic profile of multimodal analgesia including combined serratus anterior plane block in minimally invasive cardiac surgery: a prospective observational study. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 30 Apr 2026. Author Zengin E.N.; Aykut A.; Ozgok A.; Zengin M.; Kucuk O.; Yildiz A.I.; Ungor F.; Alagoz A.; Salman N.; Demir Z.A. Institution (Zengin) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey (Zengin) Universiteler Mahallesi, No: 9. Ankara Bilkent City Hospital, Department of Anesthesiology and Reanimation, Rifat Borekci Caddesi, Ankara, Turkey (Aykut, Ozgok, Yildiz, Ungor, Salman, Demir) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey (Zengin) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Etlik City Hospital, Ankara, Turkey (Kucuk) Department of Anesthesiology and Reanimation, University of Dokuz Eylul, School of Medicine, Izmir, Turkey (Alagoz) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Ataturk Sanatorium Training and Research Hospital, Ankara, Turkey Abstract BACKGROUND: Although minimally invasive cardiac surgery (MICS) is less invasive, patients may still experience significant postoperative pain. This observational study aimed to evaluate the feasibility and postoperative analgesic profile associated with the combined serratus anterior plane block (CSAPB), a component of multimodal analgesia in patients undergoing MICS. METHOD(S): Twenty patients, aged 18 to 80, who underwent MICS and provided written informed consent, were included in the study. Standard cardiac anesthesia monitoring was performed. Ultrasound-guided CSAPB was performed preemptively after induction of general anesthesia as part of a multimodal analgesia strategy, using a total of 40 mL of 0.25% bupivacaine, with 20 mL administered into each of the deep and superficial serratus anterior planes. All patients received intravenous acetaminophen 1 g and tramadol 1 mg.kg- 1 at the end of surgery. Within the first 24 h, patients received 1 gram of acetaminophen every 6 h. Visual Analog Scale (VAS) scores were recorded at 0, 2, 4, 8, and 12 h after extubation. If the VAS score exceeded 40 mm at any point, the initial treatment was tramadol at a dosage of 1 mg.kg- 1. If pain continued, 0.5 mg.kg- 1 morphine was planned. RESULT(S): The hemodynamic parameters remained within clinically acceptable ranges. In 2 patients (10%), VAS scores exceeded 40 mm, requiring rescue analgesia. A statistically significant difference was observed in terms of changes in rest VAS scores (p = 0.015). Significant differences were also observed in the changes in cough VAS scores over time (p = 0.003). Nausea and vomiting were observed in 2 patients (10%). No other complications were observed during the follow-up period. CONCLUSION(S): Multimodal analgesia, including CSAPB, appears to be a feasible regional analgesia technique associated with low postoperative pain scores and minimal rescue analgesic requirements in patients undergoing MICS via right mini-thoracotomy. TRIAL REGISTRATION: Clinicaltrials Registration No: NCT06326320, Registration Date: 17/03/2024. Copyright © 2026. The Author(s). <103> Accession Number 2045456044 Title Hemodynamic Response to Intubation With 4 Different Laryngoscopes in Coronary Artery Bypass Graft Surgery: A Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mermer H.A.; Yildiz M.; Tutar M.S.; Yazar M.A.; Kozanhan B. Institution (Mermer, Yildiz, Tutar, Yazar, Kozanhan) Department of Anesthesiology and Reanimation, University of Health Sciences, Konya City Hospital, Konya, Turkey Publisher W.B. Saunders Abstract Objectives: To evaluate whether different laryngoscope types influence the hemodynamic stress response to tracheal intubation in adult patients undergoing elective coronary artery bypass graft (CABG) surgery. Design(s): Prospective, randomized, controlled clinical trial. Setting(s): University-affiliated tertiary care hospital. Participant(s): A total of 112 adult patients scheduled for elective CABG surgery with no anticipated difficult airway. Intervention(s): Patients were randomly assigned to tracheal intubation using a Macintosh laryngoscope, C-MAC videolaryngoscope, EzVision videolaryngoscope, or McGrath videolaryngoscope under a standardized deep anesthesia protocol. Measurements and Main Results: Hemodynamic parameters were recorded at predefined time points. The primary outcome was the hemodynamic stress response as changes in mean arterial pressure (DELTAMAP) and heart rate (DELTAHR) between measurements obtained after anesthesia induction but before neuromuscular blockade (T2) and those obtained 1 minute after tracheal intubation (T4). Mean DELTAMAP values were 20.8 +/- 19.4 mmHg in the Macintosh group, 26.3 +/- 13.6 mmHg in the C-MAC group, 21.8 +/- 12.4 mmHg in the EzVision group, and 28.4 +/- 11.9 mmHg in the McGrath group (p = 0.168). Corresponding DELTAHR values were 7.4 +/- 8.2 bpm, 6.1 +/- 10.6 bpm, 8.6 +/- 16.4 bpm, and 7.5 +/- 7.7 bpm, respectively (p = 0.844). When hemodynamic stress response was defined as an increase of >=10 mmHg in MAP and/or >=10 beats per minute in heart rate, its incidence was 28.5%, 37.0%, 42.8%, and 42.8% in the Macintosh, C-MAC, EzVision, and McGrath groups, respectively (p = 0.653). Intubation time differed significantly among the groups (median [interquartile range]: 15 [11-18], 19 [12-22], 22 [15-28], and 16 [12-19] seconds, respectively; p < 0.001), whereas intubation success rates and complication profiles were similar across groups. Conclusion(s): Videolaryngoscopes conferred no hemodynamic advantage over direct laryngoscopy during intubation in deeply anesthetized patients undergoing CABG. Adequate anesthesia depth and pharmacologic modulation likely play a more prominent role than device type in blunting intubation stress. Copyright © 2026 Elsevier Inc. <104> Accession Number 651076802 Title Comparative Effectiveness of Balloon-Expandable and Self-Expanding Valves in Small Aortic Annulus Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis of Randomized and Propensity Score Matched Studies. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 28 Apr 2026. Author Daniyal S.M.; Riaz M.; Gul I.; Noor A.; Naveed A.; Ajaz H.; Khatoon N.M.; Khalid A.; Gondal H.T.; Batool F.; Fahim S.L.; Aftab Z.; Sarwar M.; Ashraf D.A. Institution (Daniyal, Riaz, Gul, Noor, Naveed, Ajaz, Khalid, Batool, Fahim, Aftab, Sarwar) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Khatoon) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Gondal) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Ashraf) Department of Medicine, TruGift Health LLC, Wilmington, DE, United States Abstract Patients with small aortic annuli (SAA) undergoing transcatheter aortic valve replacement (TAVR) are at increased risk of elevated transvalvular gradients and prosthesis-patient mismatch (PPM), making valve selection critical. We hypothesized that balloon-expandable valves (BEVs) and self-expandable valves (SEVs) differ in their clinical and hemodynamic outcomes in this population. We searched PubMed, Cochrane, ScienceDirect, and Google Scholar for studies published before May 2025. Randomized controlled trials (RCTs) and propensity score-matched (PSM) studies comparing BEVs and SEVs were included. Outcomes were pooled using mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CIs). Analyses were performed in R (v4.4.2), and heterogeneity was assessed using the I2 statistic. Fourteen studies, 2 RCTs, and 12 PSM studies met inclusion criteria. Compared to SEVs, BEVs were associated with a significantly lower indexed effective orifice area (MD: -0.18; 95% CI: -0.24 to -0.11; p < 0.01), higher mean transvalvular gradient (MD: 4.27; 95% CI: 3.07 to 5.47; p < 0.01), and increased risk of PPM (RR: 1.56; 95% CI: 1.14 to 2.13; p = 0.006) and severe PPM (RR: 2.66; 95% CI: 1.97 to 3.60; p < 0.001). BEVs were linked to lower rates of pacemaker implantation (RR: 0.64; 95% CI: 0.46 to 0.89; p = 0.008) and major bleeding (RR: 0.69; 95% CI: 0.50 to 0.96; p = 0.028). In SAA patients undergoing TAVR, BEVs show inferior hemodynamics but reduced need for pacemakers and bleeding risk. In conclusion, long-term prospective studies with contemporary devices are needed to clarify these tradeoffs. Copyright © 2026. Published by Elsevier Inc. <105> [Use Link to view the full text] Accession Number 2044224824 Title Safety and effectiveness of somatostatin and analogues on chest tube output after coronary artery bypass grafting: A scoping review. Source Journal of Cardiovascular Pharmacology. Publish Ahead of Print (no pagination), 2026. Article Number: 10.1097/FJC.0000000000001810. Date of Publication: 19 Feb 2026. Author Gibson C.M.; Escano A.K.; Hobe K.D.; Brody E.R.; Montealgre R.; Chery J. Institution (Gibson) Virginia Commonwealth University School of Pharmacy 410 N. 12th St Richmond, VA, United States (Escano) Virginia Commonwealth University School of Pharmacy, Inova Campus Inova Fairfax Medical Campus 3300 Gallows Road Falls Church, VA, United States (Hobe) Sentara Martha Jefferson Hospital 500 Martha Jefferson Drive Charlottesville, VA, United States (Brody) Virginia Commonwealth University Health Sciences Library 509 N. 12th St Richmond, VA, United States (Montealgre) University Medical Center 3500 Gaston Ave Dallas, TX, United States (Chery) Virginia Commonwealth University School of Medicine, Department of Surgery 1201 E Marshall St #4-100 Richmond, VA, United States Publisher Lippincott Williams and Wilkins Abstract Somatostatin and analogues may reduce chest tube (CT) output in chylothorax caused by post-coronary artery bypass grafting (CABG). However, data is limited to case reports and series. This scoping review aimed to describe the efficacy and safety of somatostatin/analogue use in post-CABG chylothorax. We retrieved from PubMed, Embase, and OVID all studies and case reports describing somatostatin/analogue use in adult patients post-CABG for resolution of chylothorax. The primary outcome was time from somatostatin/analogue initiation to daily CT output <100 mL/day. Chest tube duration, need to repeat invasive intervention, and safety events associated with somatostatin/analogues were also analyzed. Somatostatin/analogues were associated with reductions in CT output, but one-third of patients still required pleurodesis or surgical intervention. No safety events were identified. Patients with lower daily CT outputs at the time of somatostatin/analogue initiation were more likely to avoid repeat intervention than those with higher outputs. In conclusion, somatostatin/analogues appear safe and possibly effective in management of post-CABG chylothorax. Future studies should investigate which patients are most likely to benefit from this therapy. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <106> Accession Number 2045195292 Title Clinical and echocardiographic predictors of reintervention after percutaneous or surgical treatment of rheumatic mitral stenosis: A systematic review. Source Current Problems in Cardiology. 51(9) (no pagination), 2026. Article Number: 103358. Date of Publication: 01 Sep 2026. Author Gomez-Gualdron S.A.; Macias-Martinez J.S.; Pulido-Parra A.M.; Higuera-Leal S.A.; Vesga-Angarita B.E. Institution (Gomez-Gualdron) Universidad Pedagogica y Tecnologica de Colombia (UPTC), Boyaca, Colombia (Gomez-Gualdron, Higuera-Leal, Vesga-Angarita) Departamento de Medicina Interna, Universidad Industrial de Santander, Santander, Bucaramanga, Colombia (Macias-Martinez, Pulido-Parra) Universidad de Santander (UDES), Santander, Colombia (Gomez-Gualdron, Higuera-Leal, Vesga-Angarita) Grupo de Investigacion para la Renovacion Educativa de la Medicina Interna (GERMINA), Santander, UIS, Colombia (Macias-Martinez, Pulido-Parra, Higuera-Leal, Vesga-Angarita) Departamento de Cardiologia, Instituto del Corazon de Bucaramanga, Santander, Bucaramanga, Colombia Publisher Elsevier Inc. Abstract Background Rheumatic mitral stenosis remains an important cause of valvular heart disease worldwide. Although percutaneous and surgical interventions improve symptoms and hemodynamics, some patients develop restenosis, adverse events, or require repeat interventions during follow-up. Identifying clinical and echocardiographic factors associated with these outcomes is important for risk stratification. Methods A systematic review was conducted following PRISMA guidelines to identify predictors of clinical outcomes after percutaneous or surgical treatment of rheumatic mitral stenosis. A search was performed in PubMed, PMC, Ovid MEDLINE, ScienceDirect, and Scopus without language or date restrictions. Studies evaluating clinical or echocardiographic predictors and reporting OR, HR, or RR were included. Study selection, data extraction, and risk of bias assessment were performed using the Newcastle-Ottawa Scale. Due to heterogeneity among studies, a qualitative synthesis was conducted. Results Fourteen studies were included. The evaluated predictors mainly corresponded to clinical, echocardiographic, hemodynamic, and procedural variables. Some studies identified pulmonary hypertension, unfavorable valvular anatomy, and suboptimal hemodynamic results as factors associated with adverse events or reintervention. In contrast, achieving a post-procedural mitral valve area >=2 cm2 was associated with a lower risk of restenosis and cardiovascular events. Conclusions Clinical and echocardiographic characteristics influence outcomes after intervention for rheumatic mitral stenosis. Baseline valvular morphology and the immediate hemodynamic result of the procedure appear to be key determinants of prognosis and risk of reintervention. Copyright © 2026 Elsevier Inc. <107> Accession Number 2045317975 Title Left Main Revascularization in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis. Source Current Cardiology Reviews. 22(4) (no pagination), 2026. Date of Publication: 2026. Author Gialamas I.; Kalogeras K.; Pantelidis P.; Zakynthinos G.E.; Lysandrou A.; Katsianos E.; Goliopoulou A.; Gounaridi M.I.; Vythoulkas-Biotis N.; Katsarou O.; Oikonomou E.; Siasos G.; Vavuranakis M. Institution (Gialamas, Kalogeras, Pantelidis, Zakynthinos, Lysandrou, Katsianos, Goliopoulou, Gounaridi, Vythoulkas-Biotis, Katsarou, Oikonomou, Siasos, Vavuranakis) 3rd Department of Cardiology, Sotiria Chest Disease Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece (Siasos) Cardiovascular Division of Brigham and Women's Hospital, Harvard Medical School, Boston, United States Publisher Bentham Science Publishers Abstract Introduction/Objective: This systematic review and meta-analysis compares percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG) as revascularization strategies for patients with left main coronary artery disease (LMCAD) and chronic kidney disease (CKD). Method(s): A comprehensive search of PubMed, Embase, and CENTRAL was conducted, with a pre-registered study protocol registered on PROSPERO (ID: CRD42024496529). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause mortality, myocardial infarction (MI), stroke, or ischemia-driven revascularization. Secondary endpoints included each component of MACCE and 30-day all-cause mortality. Result(s): Seven studies were analyzed, including five cohort studies and two subanalyses of randomized clinical trials, encompassing 3,376 patients. PCI was associated with a higher incidence of MACCE (hazard ratio [HR]: 1.50; 95% confidence interval [CI] 1.26-1.78), driven by all-cause mortality (HR: 1.38; 95% CI 1.07-1.79), MI (HR: 1.76; 95% CI 1.15-2.71), and ischemia-driven revascularization (HR: 3.66; 95% CI 1.84-7.30). There were no differences in stroke rates (HR: 0.70; 95% CI 0.40-1.22) or 30-day all-cause mortality (odds ratio [OR]: 1.28; 95% CI 0.85-1.94). Discussion(s): While previous studies have reported conflicting evidence regarding the non-inferiority of PCI to CABG in patients with LMCAD, our pooled analysis demonstrates an increased incidence of MACCE in the PCI group, primarily driven by higher rates of all-cause mortality, MI, and ischemia-driven revascularization. The findings suggest that CKD may play a role in clinical outcomes comparable to diabetes in multivessel disease and should be a key factor in revascularization decisions. Conclusion(s): CABG is associated with superior long-term outcomes compared to PCI in patients with LMCAD and CKD. However, dedicated randomized controlled trials stratified by CKD stage are essential to guide optimal treatment strategies in this high-risk population. Copyright 2026, Bentham Science Publishers <108> Accession Number 651063515 Title Effect of Preadmission Diabetes Intervention (PREHAB) on Postoperative Patient Outcomes in Cardiac Surgery. Source Diabetes. Conference: 78th Scientific Sessions of the American Diabetes Association, ADA 2018. Orlando, FL United States. 67(Supplement 1) (no pagination), 2018. Date of Publication: 01 Jul 2018. Author Arnaout A.; Goge S. Publisher American Diabetes Association Inc. Abstract People living with diabetes are at an increased risk of developing heart disease. In patients undergoing coronary artery bypass grafting (CABG), a preexisting diagnosis of diabetes has been identified as a risk factor for postoperative sternal wound infections and prolonged hospital stay. At the University of Ottawa Heart Institute (UOHI) the wait time for elective cardiac surgery is four months. There is literature that supports the use of cardiac prehabilitation to improve postoperative outcomes such as length of stay, functional capacity and perioperative complications. However, there is no published evidence on whether pre-admission diabetes interventions lead to the same results. The aim of this study is to introduce a novel prehabilitation program for diabetes. Target Population: All elective cardiac surgery patient screened for diabetes with an HBA1C of greater than 6.5%. PrimaryOutcomes: The primary outcome is improvement in glycemic control from screening to time of elective cardiac surgery in those patients who completed prehabilitation program. SecondaryOutcomes: The secondary outcomes measured are effect of prehabilitation on length of stay and surgical site infections. Prehabilitation Methodology: In those who have an elevated HBA1C a screening phone call by cardiac rehabilitation nurse. A two hour prehabilitation session that cover topics such as nutrition, exercise and mental health. Group medical appointment led by a diabetes nurse. Result(s): 24 patients have completed the full prehabilitation program. The mean HBA1C from screening to time of surgery dropped from 7.64% to 7.3% which was not statistically significant. One surgical site infection developed in this group compared to 3 infections in the group that did not attend. Conclusion(s): Wait times for elective cardiac surgery is an opportune time to intervene and optimize patients' medical fitness for surgery and improving patient self-management of chronic medical conditions like diabetes. <109> Accession Number 2044786149 Title Summary of Best Evidence for Pain Management after Open-heart Surgery in Children with Congenital Heart Disease. Source Chinese General Practice. 29(11) (pp 1473-1480), 2026. Date of Publication: 01 Jan 2026. Author Jingran Y.; Fang M.; Yu W.; Yimei Z.; Min Z. Institution (Jingran) School of Nursing, Kunming Medical University, Kunming, China (Jingran, Fang, Yu, Yimei, Min) Department of Nursing, the First Affiliated Hospital of Kunming Medical University, Kunming, China Publisher Chinese General Practice Abstract Background The standardized management of pain after open-heart surgery in children with congenital heart disease is very important, and there is no systematic best evidence for pain management after open-heart surgery in children with congenital heart disease. Objective To summarize the best evidence for pain management after open-heart surgery in children with congenital heart disease, and provide an evidence-based basis for clinical practice. Methods We systematically searched UpToDate Clinical Advisor, BMJ Best Clinical Practice, International Guideline Collaboration Network, National Guidelines Clearinghouse, National Institute for Health and Care Excellence, Yimaitong Guideline Network, Cochrane Library, PubMed, Web of Science, Embase, CINAHL, Wanfang Data, VIP Database, CNKI, Sinomed, American Heart Association, American College of Cardiology, European Society of Cardiology, American Pain Society, and Registered Nurses' Association of Ontario for clinical decisions, guidelines, expert consensus, evidence summaries, systematic reviews, and randomized controlled trials on pain management in children with congenital heart disease after open - chest surgery. The search period was from the establishment of the database to January 1, 2025. After methodological quality evaluation, the evidence was extracted and summarized according to the themes. Results A total of 15 papers were included, including 1 guideline, 1 expert consensus, 3 systematic evaluations, and 10 randomized controlled trials, and 26 pieces of evidence in 4 areas of pain management principles, pain assessment, pharmacological pain management strategies, and nonpharmacological pain management strategies were finally summarized through reading, extraction, and summarization. Conclusion Forming the best evidence regarding pain management principles, pain assessment, drug-based pain relief strategies, and non-drug-based pain relief strategies for children with congenital heart disease after undergoing thoracotomy surgery, can provide clinical medical workers with evidence support and improve the quality of clinical care. Copyright © (2026), (Chinese General Practice). All right reserved.

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