EPICORE Embase Updates: June 2026

Total documents retrieved: 112 Results Generated From: Embase <1980 to 2026 Week 23> Embase Weekly Updates (updates since 2026-05-29) - (112 records) <1> Accession Number 650858325 Title Effect of preoperative prehabilitation in adults undergoing cardiac surgery on physical status and perioperative complications: a systematic review and meta-analysis. Source Minerva anestesiologica. 92(5) (pp 458-468), 2026. Date of Publication: 01 May 2026. Author Gil-Casado C.; Fernandez-Vazquez U.; Luna-Rojas P.; Diaz-Vidal P.; Diz-Ferreira E.; Diz J.C. Institution (Gil-Casado, Fernandez-Vazquez, Luna-Rojas, Diaz-Vidal) School of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain (Diz-Ferreira) Well-Move Research Group, School of Medicine, University of Vigo, Vigo, Spain (Diz) Department of Anesthesia and Postoperative Critical Care, Alvaro Cunqueiro Hospital, Vigo, Spain (Diz) Department of Functional Biology and Health Sciences, Well-Move Research Group, University of Vigo, Vigo, Spain Abstract BACKGROUND: Many patients scheduled for cardiac surgery have low cardiorespiratory fitness, which is associated with increased perioperative morbidity and mortality. There is limited evidence to suggest that prehabilitation can reduce perioperative complications. The objective was to evaluate the impact of prehabilitation comprising physical exercise on the cardiorespiratory fitness of cardiac patients, and on quality of life, hospital stay, postoperative complications and mortality. METHOD(S): A systematic review and meta-analysis, following the PRISMA statement, encompassing randomized controlled trials on prehabilitation for adult patients undergoing cardiac surgery. The protocol was pre-registered on Open Science Framework. RESULT(S): We included eight studies comprising 894 patients. The prehabilitation group exhibited a greater improvement in preoperative six-minute walk test than the control group (MD 36.65 m; 95% CI 1.72, 71.58; P=0.04). The number of patients demonstrating a clinically relevant improvement was not significantly different between the groups (OR 1.86; 95% CI 0.82, 4.21). The prehabilitation group exhibited a shorter hospital stay (MD -1.01 days; 95% CI -2, -0.02; P=0.04). No differences were observed in other outcomes. Overall, the certainty of the evidence was low. CONCLUSION(S): Our findings suggest an association between prehabilitation and preoperative enhancement in cardiorespiratory fitness. However, the effect size is modest and may have marginal clinical significance. It remains unclear whether prehabilitation can improve clinical outcomes beyond the reduction of hospital length of stay. Further research is required to provide evidence of the efficacy of these programs. <2> Accession Number 2045950382 Title Effect of anti-fibrotic therapy on regression of myocardial fibrosis after TAVI: design and rationale of the Reduce-MFA DZHK25 trial. Source ESC Heart Failure. 13(3) (no pagination), 2026. Article Number: xvag083. Date of Publication: 01 Jun 2026. Author Puls M.; Zeisberg E.M.; Placzek M.; Beuthner B.E.; Jacob C.F.; Steinhaus K.E.; Lange T.; Tostmann R.; Schnelle M.; Schuster A.; Hasenfuss G.; Friede T. Institution (Puls) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Puls) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Zeisberg) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Zeisberg) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Placzek) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Placzek) Department of Medical Statistics, University Medical Centre Gottingen, Gottingen, Germany (Beuthner) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Beuthner) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Jacob) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Jacob) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Steinhaus) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Steinhaus) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Lange) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Lange) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Tostmann) Clinical Trials Unit, University Medical Centre Gottingen, Gottingen, Germany (Schnelle) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Schnelle) Department of Clinical Chemistry, University Medical Centre Gottingen, Gottingen, Germany (Schuster) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Schuster) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Schuster) FORUM Medicine, Rosdorf, Germany (Hasenfus) Department of Cardiology and Pneumology, University Medical Centre Gottingen, Robert-Koch-Strase 40, Gottingen, Germany (Hasenfus) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Friede) German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Robert-Koch-Strase 40, Gottingen, Germany (Friede) Department of Medical Statistics, University Medical Centre Gottingen, Gottingen, Germany Publisher Oxford University Press Abstract Aims: Myocardial fibrosis (MF) represents a key player in transition to heart failure in aortic stenosis (AS), and AS patients with high baseline MF are at increased risk to die within 12 months after transcatheter aortic valve implantation (TAVI). Therefore, the objective of the Reduce-MFA DZHK25 trial is to assess the impact of anti-fibrotic therapy on regression of AS-induced MF after TAVI in patients with high baseline fibrotic burden. Key secondary objectives include reverse LV remodelling, symptomatic improvement, and reduction of mortality and cardiac hospitalizations. Method(s): Reduce-MFA represents a national, prospective, randomized, parallel group, controlled, open-label interventional multi-centre trial with blinded outcome assessment (PROBE design) enrolling patients with severe AS scheduled for TAVI. The anti-fibrotic principles employed are spironolactone and low-dose dihydralazine (epigenetic reactivation of anti-fibrotic genes). Baseline burden and course of MF are assessed by cardiac MRI (CMR). Since CMR-derived extracellular volume fraction (ECV%) >= 25.9% emerged as independent mortality predictor, only patients above this cut-off are randomized into three parallel groups: (i) Standard of Care alone, (ii) + spironolactone, (iii) + spironolactone + low-dose dihydralazine, each for 12 months. To assess MF regression, CMR is repeated after 12 months. MF is assessed by quantification of the ECV-derived LV matrix volume using T1 mapping. Additionally, measures of heart failure (Kansas City Cardiomyopathies Quality of Life Questionnaire, 6MWT, NT-proBNP, NYHA class) and reverse cardiac remodelling are evaluated at 6 and 12 months. Mortality and cardiac hospitalizations are recorded. The recruitment was recently completed with 384 enrolled and 153 randomized patients. Conclusion(s): The study findings have the potential to inform the development of a novel adjuvant therapy to improve the prognosis of specific AS patients. 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. <3> Accession Number 2045345507 Title Impact of Atrial Fibrillation Pattern on Edoxaban Antithrombotic Therapy in Patients With Atrial Fibrillation and Stable Coronary Artery Disease: A Secondary Analysis of the EPIC-CAD Randomized Clinical Trial. Source Journal of the American Heart Association. 15(7) (no pagination), 2026. Article Number: e046966. Date of Publication: 01 Jan 2026. Author Yu J.-S.; Cho M.-S.; Kang D.-Y.; Ahn J.-M.; Lee J.-B.; Oh Y.-S.; Lee C.-H.; Choi E.-K.; Lee J.-H.; Kwon C.-H.; Park G.-M.; Choi H.-O.; Park K.-H.; Park K.-M.; Hwang J.-M.; Yoo K.-D.; Cho Y.-R.; Kim J.-H.; Hwang K.-W.; Jin E.-S.; Kwon O.; Kim K.-H.; Park S.-J.; Nam G.-B.; Park D.-W. Institution (Yu, Cho, Kang, Ahn, Park, Nam, Park) Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (Lee) Division of Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (Oh) Department of Cardiology, Seoul St. Mary's Hospital, Seoul, South Korea (Lee) Department of Cardiology, Veterans Health Service Medical Center, Seoul, South Korea (Choi, Lee) Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, South Korea (Kwon) Division of Cardiology, Konkuk University Medical Center, Seoul, South Korea (Park) Department of Cardiology, Ulsan University Hospital, Ulsan, South Korea (Choi) Department of Cardiology, Soonchunhyang University Hospital Bucheon, Bucheon, South Korea (Park) Department of Cardiology, Hallym University Medical Center, Anyang, South Korea (Park) Division of Cardiology, Samsung Medical Center, Seoul, South Korea (Hwang) Department of Cardiology, Keimyung University Dongsan Hospital, Daegu, South Korea (Yoo) Department of Cardiology, St. Vincent's Hospital, Suwon, South Korea (Cho) Department of Cardiology, Dong-A University Hospital, Busan, South Korea (Kim) Department of Cardiology, Dongguk University Ilsan Hospital, Goyang, South Korea (Hwang) Department of Cardiology, Pusan National University Yangsan Hospital, Yangsan, South Korea (Jin) Department of Cardiology, Kyung Hee University Hospital at Gangdong, Seoul, South Korea (Kwon) Division of Cardiology, Eunpyeong St. Mary's Hospital, Seoul, South Korea (Kim) Department of Cardiology, Haeundae Paik Hospital, Busan, South Korea Publisher American Heart Association Inc. Abstract BACKGROUND: Paroxysmal atrial fibrillation (AF) is associated with a risk of stroke or systemic embolism similar to nonparoxysmal (persistent or permanent) AF. However, whether the optimal antithrombotic strategy in patients with AF and stable coronary artery disease differs by AF pattern remains uncertain. METHOD(S): This prespecified substudy of the EPIC-CAD (Edoxaban Antithrombotic Therapy for Atrial Fibrillation and Stable Coronary Artery Disease) trial compared edoxaban monotherapy with dual antithrombotic therapy (edoxaban plus a single antiplatelet agent) in patients with AF and stable coronary artery disease. Stratified analyses were performed by AF pattern. The primary outcome was net adverse clinical events, defined as a composite of all-cause death, myocardial infarction, stroke, systemic embolism, unplanned urgent revascularization, major bleeding, or clinically relevant nonmajor bleeding within 12 months. RESULT(S): Among 1040 patients, 575 (55.3%) had paroxysmal and 465 (44.7%) had nonparoxysmal AF. The 12-month primary outcome rate was similar between paroxysmal and nonparoxysmal AF (10.3% versus 12.2%; adjusted hazard ratio [HR], 1.15 [95% CI, 0.79-1.68]). Edoxaban monotherapy was associated with a significantly lower risk of the primary outcome than dual antithrombotic therapy in both paroxysmal AF (4.6% versus 16.2%; adjusted HR, 0.23 [95% CI, 0.12-0.42]) and nonparoxysmal AF (9.3% versus 15.0%; adjusted HR, 0.56 [95% CI, 0.32-0.87]). No significant interaction was observed between antithrombotic strategy and AF pattern (P for interaction=0.10). CONCLUSION(S): In patients with AF and stable coronary artery disease, edoxaban monotherapy significantly reduced net adverse clinical events at 12 months compared with dual antithrombotic therapy, irrespective of AF pattern. REGISTRATION: URL: https://www.ClinicalTrials.gov; Unique identifier: NCT03718559. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <4> 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. 49(6) (pp 1210-1218), 2026. Date of Publication: 01 Jun 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. <5> Accession Number 2045345304 Title Incidence and Outcomes of Intraluminal Frozen Elephant Trunk Stent Graft Thrombosis After Aortic Arch Surgery: Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(7) (pp 1-11), 2026. Article Number: e047425. Date of Publication: 2026. Author Sa M.P.; Consoli L.; Neves G.; Camarotti T.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A. Institution (Sa, Napoli, Brozzi, Navia, Polanco) Department of Cardiovascular Surgery, Heart, Thoracic & Vascular Institute, Cleveland Clinic Florida, Weston, FL, United States (Consoli) School of Medicine of Universidade Federal da Bahia (UFBA), Salvador, Brazil (Neves) School of Medicine of Universidade Estadual do Para (UEPA), Belem, Brazil (Camarotti) School of Medicine of Universidade de Pernambuco (UPE), Recife, Brazil Publisher American Heart Association Inc. Abstract BACKGROUND: Intraluminal thrombosis (ILT) has been observed in endografts in the thoracic aorta after frozen elephant trunk (FET) for aortic arch pathologies. This study aimed to evaluate the incidence and clinical outcomes associated with ILT. METHOD(S): Systematic review of studies reporting incidence of ILT after FET and comparing outcomes of patients with and without ILT. PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases (inception to September 2025) were searched. Single-arm meta-analysis was conducted to determine ILT incidence and 2-arm meta-analyses between groups with ILT and without with a random-effects model to assess patient-relevant outcomes. RESULT(S): Five observational studies, including 999 patients, met our eligibility criteria. Pooled incidence of ILT after FET was 9.24% (95% CI, 6.32-13.31). Although we did not find statistically significant associations between ILT and postoperative stroke (odds ratio [OR], 0.93 [95% CI, 0.46-1.88]; P=0.845), we found statistically significant associations with embolic events (OR, 6.94 [95% CI, 1.01-47.46]; P=0.048) and early mortality (OR, 3.59 [95% CI, 1.69-7.60]; P<0.001). We found positive correlations between proportion of female patients in the populations and incidence of ILT (coefficient, 0.08 [95% CI, 0.02-0.14]; P=0.011). Meta-regression coefficients were statistically significant for embolic events and female sex (coefficient, 0.12 [95% CI, 0.06-0.18]; P<0.001), aortic aneurysm (coefficient, 0.08 [95% CI, 0.04-0.13]; P<0.001), and mean age (coefficient, 0.66 [95% CI, 0.33-0.99]; P<0.001), which means that associations differ across populations with varying mean levels of these covariates. CONCLUSION(S): Because ILT after FET seems to be associated with embolic events and early mortality, close follow-up is warranted-especially for women, older people, and patients with aortic aneurysms-and anticoagulation should be considered. Copyright © 2026 The Author(s). <6> Accession Number 2044443433 Title A systematic review of the relationship between race and health-related quality of life outcomes in patients with advanced heart failure who undergo heart transplantation or mechanical circulatory support. Source Quality of Life Research. 35(5) (no pagination), 2026. Article Number: 106. Date of Publication: 01 May 2026. Author Dixon-Evans J.; Briley A.; Way J.S.; Clay S.; Mazurek K.; Wafford Q.E.; Vela A.M.; Grady K.L. Institution (Dixon-Evans, Vela, Grady) Department of Surgery, Division of Cardiac Surgery, Northwestern University, Feinberg School of Medicine, 676 North Saint Clair Street, Arkes Pavilion, Suite 730, Chicago, IL, United States (Briley, Clay, Mazurek) College of Health and Human Sciences, Northern Illinois University, Wirtz Hall, 323, DeKalb, IL, United States (Way) Department of Physical Therapy and Health Science, Bradley University, Campustown 170, 1501 W. Bradley Ave., Peoria, IL, United States (Wafford) Feinberg School of Medicine, Northwestern University, 320 E. Superior Street, Chicago, IL, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Health inequalities may disproportionately affect health-related quality of life (HRQOL) in patients with heart failure who identify as a racial or ethnic minority and undergo advanced surgical therapies. Objectives of this systematic review were to determine the impact of race on HRQOL of adults who undergo heart transplantation (HT) or durable mechanical circulatory support (MCS), while awaiting HT or long-term, and whether race is a risk factor for worse HRQOL. Method(s): A synthesis framework was used following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Medical Subject Headings was applied to search engines. Peer reviewed articles (English) published prior to 1/5/25, examining associations between race & HRQOL of adults who underwent HT and/or MCS, were included. Excluded were systematic reviews, editorials/opinions, case series/reports, grey literature, qualitative research, and case-control studies. Risk of bias was assessed using Joanna Briggs Institute checklists and the Cochrane Risk-of-Bias tool. Result(s): Among 2,902 identified records, eight studies met inclusion criteria (HT: n = 4; MCS: n = 3; and HT and MCS: n = 1). Participants' mean age = 57 years; the majority were White (80%) and male (78%). Risk of bias varied by study. Race did not impact HRQOL in 50% of HT studies. HRQOL improved with MCS in all studies; however, compared to White patients, Black patients experienced less improvement in HRQOL. Conclusion(s): HRQOL measures were not comparable. Thus, a meta-analysis was not performed which is a study limitation. Racial differences in HRQOL may exist among adults who undergo HT and/or MCS; more research is needed. Copyright © The Author(s) 2026. <7> Accession Number 2044624085 Title Comment on"Left ventricular systolic recovery after TAVI in severe aortic stenosis: A systematic review and meta-analysis". Source International Journal of Cardiology: Cardiovascular Risk and Prevention. 29 (no pagination), 2026. Article Number: 200630. Date of Publication: 01 Jun 2026. Author Cao B.; Ouyang M. Institution (Cao) Department of Cardiology, The Central Hospital of Yongzhou, Yongzhou, China (Cao) Department of Cardiology, Yongzhou Hospital Affiliated to University of South China, Yongzhou, China (Ouyang) The First Affiliated Hospital of Jishou University, Jishou, China Publisher Elsevier B.V. <8> Accession Number 2045634068 Title What factors are associated with work after cardiothoracic transplant? A systematic review. Source Transplantation Reviews. 40(3) (no pagination), 2026. Article Number: 101025. Date of Publication: 01 Jul 2026. Author Tomic D.; Khillan A.; Hopper I.; Mobarki Y.; O'Dwyer M.; MacFarlane E.; Paraskeva M.; Patel H.; Walker-Bone K.; Keegel T. Institution (Tomic, Mobarki, O'Dwyer, MacFarlane, Walker-Bone, Keegel) Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Khillan) Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, 161 Barry Street, Carlton, VIC, Australia (Hopper, Patel) Cardiology Department and General Medical Unit, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Hopper) School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, Australia (Paraskeva) Department of Respiratory Medicine, Bayside Health, 55 Commercial Road, Melbourne, VIC, Australia (Paraskeva) Medicine Alfred Hospital, Monash University, Melbourne, VIC, Australia (Patel) Baker Heart and Diabetes Institute, 99 Commercial Road, Melbourne, VIC, Australia (Keegel) Heart and Lung Transplant Trust, PO Box 25036, Melbourne, VIC, Australia Publisher Elsevier Inc. Abstract Cardiothoracic transplantation is a lifesaving intervention for end-stage cardiopulmonary disease, however true recovery requires comprehensive social reintegration, including the opportunity for work participation. This systematic review (PROSPERO CRD42025634363) reports rates of work and characterises factors associated with working post-cardiothoracic transplant. Research questions were informed through consultation with the cardiothoracic transplant community and guided by a work and health perspective. Five databases (Ovid MEDLINE, Ovid Embase, CINAHL, Web of Science, PsycINFO) were searched for studies published 2000-2024. Quantitative and mixed-methods studies reporting post-transplant work outcomes were included. Screening, data extraction, and risk of bias assessment were conducted independently by two reviewers, with discrepancies resolved by consensus. Thirty-five manuscripts, representing 32 unique studies and 23,511 cardiothoracic transplant recipients (12,062 heart; 11,400 lung; 49 heart and lung), were included. Post-transplant employment rates at one year were 22-44% for heart and 28% for lung transplant recipients. At five years, 29.4-30% heart and 48% lung transplant recipients were employed. Return-to-work rates varied widely (heart 28-88%; lung 18-83%), with median time to return ranging from 5 to >31 months. Factors associated with higher work participation included pre-transplant employment, younger age, higher education, and male sex. Lower participation was associated with post-transplant complications, fatigue, and depression. Other work-related outcomes including work ability, absenteeism, and employer support were inconsistently reported. Methodological limitations were common, particularly reliance on self-reported, unvalidated work outcome measures and heterogeneous follow-up time points. Addressing modifiable determinants through targeted interventions is critical to improving work participation among cardiothoracic transplant recipients. Copyright © 2024 <9> Accession Number 2044581952 Title Critical insights on "Off-pump versus on-pump coronary artery bypass grafting in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis". Source General Thoracic and Cardiovascular Surgery. 74(6) (pp 631-632), 2026. Date of Publication: 01 Jun 2026. Author Hussain S.M.A.; Younas K. Institution (Hussain) Dow Medical College, Karachi, Pakistan (Younas) Bakhtawar Amin Medical and Dental College, Multan, Pakistan Publisher Springer <10> Accession Number 2045519019 Title Outcomes of Self-Expanding Versus Balloon-Expandable Transcatheter Aortic Valves in Patients With Reduced Left Ventricular Ejection Fraction: A Meta-Analysis of Observational Studies. Source Structural Heart. 10(6) (no pagination), 2026. Article Number: 100843. Date of Publication: 01 Jun 2026. Author Najah Q.; Saleh S.; Zubaidi M.; Herrmann H.C.; Pirelli L.; Hahn R.T.; Nombela-Franco L.; Pilgrim T.; Rodes-Cabau J.; Elhadi M. Institution (Najah) Faculty of Medicine, Elmergib University, Alkhums, Libyan Arab Jamahiriya (Saleh) Faculty of Medicine, Hashemite University, Zarqa, Jordan (Zubaidi) Wasit University, College of Medicine, Wasit, Iraq (Herrmann) Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States (Pirelli) Division of Cardiothoracic Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, NY, United States (Hahn) Cardiology Department, NewYork-Presbyterian/Columbia University Medical Center, New York, NY, United States (Nombela-Franco) Cardiovascular Institute, Hospital Clinico San Carlos, IdISSC, Madrid, Spain (Pilgrim) Department of Cardiology, Inselspital, University of Bern, Bern, Switzerland (Rodes-Cabau) Quebec Heart and Lung Institute, Laval University, Quebec City, QC, Canada (Elhadi) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab Jamahiriya (Elhadi) College of Medicine, Korea University, Seoul, South Korea Publisher Cardiovascular Research Foundation Abstract Patients with reduced left ventricular ejection fraction (LVEF) undergoing transcatheter aortic valve replacement remain a clinically vulnerable group. Although self-expanding valves (SEVs) and balloon-expandable valves are widely used, the optimal choice in patients with LVEF <40% remains uncertain. We aimed to synthesize the available evidence comparing these two valve types in this high-risk population. We conducted a systematic review and meta-analysis of observational studies comparing SEVs and balloon-expandable valves in patients with LVEF <40% undergoing transcatheter aortic valve replacement. Outcomes included changes in LVEF, aortic gradients, mortality, and safety endpoints. Pooled estimates were calculated using random-effects models, and multivariable meta-regression was performed to adjust for study-level confounding. Five studies comprising 5365 patients were included. SEVs were associated with a greater improvement in 1-month LVEF (mean difference, 2.33; 95% confidence interval [CI], 0.83 to 3.83; p = 0.01) and lower mean aortic gradients (mean difference, -2.72; 95% CI, -3.51 to -1.93; p < 0.01). Procedural mortality (risk ratio [RR], 0.89; 95% CI, 0.26-3.11; p = 0.86), 30-day mortality (RR, 1.52; 95% CI, 0.65-3.56; p = 0.33), and 1-year mortality (RR, 1.13; 95% CI, 0.69-1.84; p = 0.44) were similar. SEVs carried an increased risk of moderate or worse paravalvular leak (RR, 2.52; 95% CI, 1.46-4.36; p < 0.01). While SEVs may offer superior early LVEF improvement, they are associated with a higher rate of paravalvular leaks. Current data are observational and insufficient to recommend one valve type over another. Copyright © 2026 The Authors. <11> Accession Number 2041658013 Title Effects of intraoperative higher versus lower positive end-expiratory pressure during one-lung ventilation for thoracic surgery on postoperative pulmonary complications (PROTHOR): a multicentre, international, randomised, controlled, phase 3 trial. Source The Lancet Respiratory Medicine. 14(1) (pp 17-28), 2025. Date of Publication: 01 Jan 2025. Author Serpa Neto A.; Cohen E.; El Tahan M.R.; Gregoretti C.; Hachenberg T.; Nandor M.; Nisnevitch-Savarese Z.; Rossaint R.; Severgnini P.; Szegedi L.L.; Tamas V.; Vazquez de Anda G.F.; Waheedullah K.; do Nascimento Junior P.; Noto A.; Schultz M.J.; Abbenhuis J.; Abdulmomen A.; Abdyli A.; Abu Elyazed M.M.; Aguirre Puig P.; Akbudak I.H.; Aksu C.; Alagoz A.; Alhamdi M.; Almadhati S.; Altorki N.K.; Aragon Alvarez S.; Arun O.; Azizoglu M.; Baar W.; Balde D.; Balla B.; Balli Seker M.; Basheer M.; Bauer W.O.; Bence J.; Bernardi M.H.; Bigatello L.M.; Bignami E.; Bluth T.; Bonney I.; Bouhemad B.; Bradic N.; Brescianini L.; Bruthans J.; Bulte C.S.E.; Cadar G.; Cakmak G.; Cali P.; Cantatore L.P.; Chai X.; Chang Y.-T.; Chen J.; Christofaki M.; Cinnella G.; Coelho Sanches L.; Constantin A.; Contreras V.; Corsi L.; da Silva E.; Defosse J.; Deluca R.; Diaper J.; Didden L.; Dimitriou E.; Domi R.; Dorfinger L.; dos Reis Falcao L.F.; Douradinho C.; Drnovsek Globokar M.; Duran F.M.; Eldawlatly A.; El-Gendy H.M.; Elmazny M.I.; Elsherif S.-E.I.; Emara M.M.; Enriquez de los Santos S.T.; Farnell-Ward S.; Ferrufino R.; Gama de Abreu M.; Gao L.; Geyik D.; Gnezda D.; Goeden S.; Gorjup K.; Granell Gil M.; Guido Guerra R.E.; Guimaraes de Castro Pereira M.; Guinot P.-G.; Guven A.; Hager H.; Han L.; Hatipoglu Z.; Hayashi M.; Hell J.; Hofland J.; Hollmann M.W.; Hu J.; Hudacek K.; Huti G.; Ilic M.; Jankovic R.J.; Jegarl A.; Jimenez Andujar M.-J.; Jin D.; Kammerer T.; Karadza V.; Kawagoe I.; Kiran Paudel S.I.; Kiss T.; Koch T.; Kolaric N.; Koning N.J.; Kostopanagiotou K.; Kostroglou A.; Kovac P.; Kramer T.; Krassler J.; Kreft T.; Kumrular Y.; Kuut M.; Lan L.; Li P.-C.; Li X.-F.; Li L.-T.; Licker M.; Liu Y.; Longo F.; Loop T.; Lopez-Baamonde M.; Luise S.; Luo W.; Lv H.; Macias Jimenez M.D.L.A.; Magalhaes D.D.; Martuscelli M.; Mavko A.; Meco B.C.; Mermer H.A.; Miao C.; Michalek P.; Mills G.H.; Minana Aragon E.; Mirabella L.; Molyneux M.; Montrano L.; Mosqueira L.; Mourisse J.; Murrell M.T.; Navarro-Ripoll R.; Negru F.; Neskovic V.; Nikolic M.; Norberto de la Vega J.A.; Nyktari V.; Orhan Sungur M.; Ozdemir L.; Ozolina A.; Ozturk T.; Pace M.C.; Pagnussatt Neto E.; Paloczi B.; Papaioannou A.; Papamichail K.; Patroniti N.; Pektas Y.; Pereira Matalobos D.; Persec J.; Petrovic S.; Pirc D.; Plismanis G.; Prata Amendola C.; Prazetina M.; Radovic N.; Rauseo M.; Richter T.; Rivera Vallejo L.; Rodriguez Ruiz J.J.; Rondovic G.; Rosser J.; Sanchez Garcia F.J.; Sansone P.; Saracoglu A.; Saracoglu K.T.; Sazak H.; Scharffenberg M.; Schiavoni L.; Schilling T.; Sediq A.; Semmelmann A.; Senturk N.M.; Sertac Bingul E.; Sertcakacilar G.; Sfika E.; Shelley B.; Shin S.H.; Sidiropoulou T.; Silva-Jr J.M.; Socci L.; Socorro T.; Soulioti E.; Spadaro S.; Spicek-Macan J.; Spray D.; Stamenkovic D.; Stefanakis G.; Stoica R.; Stojanovic M.; Stopora P.; Sungur Z.; Svareniece-Karjaka E.; Szamos K.; Tanase N.-V.; Tanriverdi C.; Tempel F.; Terwindt L.E.; Theilen R.; Tipura D.; Tire Y.; Tomaselli E.; Tsuguie Onari N.; Tunc M.; Turhan O.; Turktan M.; Ugliola D.; Ulugol H.; Vegh T.; Vetrugno L.; Vitali C.; Volta C.A.; von Dossow V.; Voyagis G.; Vukovic R.; Vukovic A.Z.; Waeschle R.M.; Wall D.; Wang H.; Wang D.; Winroth D.; Wittenstein J.; Wu Q.; Xu P.; Yaldir O.; Yamansavci Sirzai E.; Yang X.; Yapici D.; Yildirim O.; Yildirim Guclu C.; Yu H.; Yuksel Tanriverdi S.; Zarbock A.; Zeba S.; Zhang Y.; Zhang X.; Zhang Z.; Zhang J.; Zhang G.-W.; Zhong J.; Ziemann S. Institution (Wittenstein, Kiss, Gama de Abreu) Department of Anesthesiology and Intensive Care Medicine, Pulmonary Engineering Group, Faculty of Medicine and University Hospital Carl Gustav Carus, Dresden University of Technology, Dresden, Germany (Senturk) Department of Anesthesiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey (Senturk) Department of Anesthesiology and Reanimation, School of Medicine, Acibadem University, Istanbul, Turkey (Kiss) Department of Anesthesiology, Intensive-,Pain- and Palliative Care Medicine, Radebeul Hospital, Academic hospital of the Technische Universitat Dresden, Germany (Schultz) Department of Intensive Care, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands (Serpa Neto) Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care, Melbourne Medical School, University of Melbourne, Austin Hospital, Melbourne, VIC, Australia (Serpa Neto) Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Gama de Abreu) Division of Intensive Care and Resuscitation, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States (Gama de Abreu) Outcomes Research Consortium, Department of Anesthesiology, Integrated Hospital Care Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier Ltd Abstract Background: The effect of higher positive end-expiratory pressure (PEEP) and recruitment manoeuvres aimed at lung expansion as compared with lower PEEP without recruitment manoeuvres aimed at permissive atelectasis on postoperative pulmonary complications (PPCs) in patients undergoing one-lung ventilation (OLV) during thoracic surgery is unclear. We aimed to determine the contribution of an intraoperative lung expansion strategy to preventing PPCs. Method(s): In this multicentre, randomised, controlled, international phase 3 trial (PROTHOR) conducted at 74 sites in 28 countries, we enrolled adult patients (aged >=18 years) with a BMI of less than 35 kg/m2 who were scheduled for open thoracic or video-assisted thoracoscopic surgery under general anaesthesia requiring one-lung ventilation with a double-lumen tube, with a planned operative time of more than 60 min, and an expected duration of one-lung ventilation longer than that of two-lung ventilation. Patients were randomly assigned (1:1), using permuted blocks of random size (4, 6, and 8) and stratified by study site, to receive one-lung ventilation with either a higher PEEP of 10 cm H<inf>2</inf>O and periodic lung recruitment manoeuvres (high PEEP group) or a lower PEEP of 5 cm H<inf>2</inf>O without routine recruitment manoeuvres (low PEEP group). All patients received protective tidal volumes of 5 mL/kg predicted body weight during one-lung ventilation and 7 mL/kg predicted body weight during two-lung ventilation. Postoperative assessors were masked to treatment allocation. The primary outcome was a composite of PPCs during the first 5 postoperative days, including aspiration pneumonia, moderate or severe respiratory failure, acute respiratory distress syndrome (ARDS), pulmonary infection, atelectasis, cardiopulmonary oedema, pleural effusion, non-operative pneumothorax, pulmonary infiltrates, prolonged air leak, purulent pleuritis, pulmonary embolism, and pulmonary haemorrhage. A modified intention-to-treat analysis was performed, with patients analysed according to their assigned treatment group, except in cases of withdrawal of informed consent, cancellation of surgery, and or loss to follow-up. This trial is registered with ClinicalTrials.gov (NCT02963025) and is completed. Finding(s): Between Jan 3, 2017, and Feb 12, 2024, 2200 patients were randomly allocated: 1099 to the high PEEP group and 1101 to the low PEEP group. 43 patients in the high PEEP group and 33 in the low PEEP group were excluded from the modified intention-to-treat analysis after randomisation. The primary outcome occurred in 555 (53.6%) of 1036 patients in the high PEEP group and 592 (56.4%) of 1049 patients in the low PEEP group (absolute risk difference -2.68 percentage points [95% CI -6.36 to 1.01]; p=0.155). Intraoperative complications occurred in 484 (49.8%) of 972 patients in the high PEEP group and in 305 (31.3%) of 974 patients in the low PEEP group (absolute risk difference 18.09 percentage points [95% CI 14.41-21.77]), among which hypotension (360 [37.3%] of 966 patients in the high PEEP group vs 140 [14.3%] of 978 in the low PEEP group) and new arrhythmias (89 [9.9%] of 899 vs 37 [3.9%] of 956) were more frequent in the high PEEP group, while hypoxaemia rescue manoeuvres were more frequent in the low PEEP group (29 [3.3%] of 888 vs 86 [8.8%] of 982). The proportions of patients with extrapulmonary postoperative complications (110 [10.6%] of 1036 vs 107 [10.2%] of 1049 patients), and the numbers of adverse events (209 vs 204 events), did not differ between groups. Interpretation(s): In patients with a BMI of less than 35 kg/m2 undergoing thoracic surgery, one-lung ventilation using higher PEEP with recruitment manoeuvres, compared with lower PEEP without recruitment manoeuvres, did not reduce PPCs. The choice for intraoperative lung expansion or permissive atelectasis should take the individual gas-exchange and haemodynamic conditions into account, which might vary during the intraoperative period. Funding(s): Clinical Trials Network of the European Society of Anaesthesiology and Intensive Care; Department of Anaesthesiology and Intensive Care, University Hospital Carl Gustav Carus, Technische Universitat Dresden (Dresden, Germany); Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (Brasilia, Brazil); and the Association of Anaesthetists of GB and Ireland. Copyright © 2025 Elsevier Ltd <12> Accession Number 2045927962 Title Incidence and predictors of major arrhythmic events after myocarditis: a systematic review and meta-analysis. Source Europace. 28(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Morena A.; Giacobbe F.; Candido-Todesco L.; Moretti A.; Saglietto A.; Bocchino P.P.; Garot J.; Anselmino M.; Merlo M.; Sinagra G.; El-Battrawy I.; D'Ascenzo F.; Ferraris F.; Guenancia C.; Nijveldt R.; Castagno D.; Acha M.R.; Ng C.Y.; De Lio G.; Angelini F.; Frea S.; Raineri C.; Gallone G.; Kragholm K.H.; Ravera F.; Huang F.; Kerneis M.; Pelargonio G.; Narducci M.L.; Imazio M.; De Ferrari G.M.; Dusi V. Institution (Morena) Department of Medical Sciences, University of Turin, Turin, Italy (Morena) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Giacobbe) Department of Medical Sciences, University of Turin, Turin, Italy (Giacobbe) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Candido-Todesco) Department of Medical Sciences, University of Turin, Turin, Italy (Candido-Todesco) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Moretti) Department of Medical Sciences, University of Turin, Turin, Italy (Moretti) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Saglietto) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Bocchino) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Garot) Institut Cardiovasculaire Paris Sud (ICPS), CMR Department, Hopital Prive Jacques Cartier, Ramsay Sante, Massy, France (Anselmino) Department of Medical Sciences, University of Turin, Turin, Italy (Anselmino) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Merlo) Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy (Sinagra) Center for Diagnosis and Treatment of Cardiomyopathies, Cardiovascular Department, Azienda Sanitaria Universitaria Giuliano-Isontina (ASUGI), University of Trieste, Trieste, Italy (El-Battrawy) Department of Cellular and Translational Physiology, Institute of Physiology, Ruhr University, Bochum, Germany (El-Battrawy) Department of Molecular and 2-Experimental Cardiology, Ruhr-University Bochum, Institut fur Forschung und Lehre (IFL), Bochum, Germany (El-Battrawy) Department of Cardiology and Rhythmology, St.Josef-Hospital, UK RUB, Ruhr University Bochum, Bochum, Germany (D'Ascenzo) Department of Medical Sciences, University of Turin, Turin, Italy (D'Ascenzo) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Ferraris) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Guenancia) Universite Bourgogne Europe-CHU DIJON, service de cardiologie-PEC2 UFR Sciences de Sante, Dijon, France (Nijveldt) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (Castagno) Department of Medical Sciences, University of Turin, Turin, Italy (Castagno) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Acha) Integrated Heart Center, Shaare Zedek Hospital, Hebrew University, Jerusalem, Israel (Ng) Cardiac Arrhythmia Center, Massachusetts General Hospital, Harvard University, Boston, MA, United States (De Lio) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Angelini) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Frea) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Raineri) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Gallone) Department of Medical Sciences, University of Turin, Turin, Italy (Gallone) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Kragholm) Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark (Ravera) Department of Medical Sciences, University of Turin, Turin, Italy (Huang) ACTION Study Group, Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Department of Cardiology, Paris, France (Huang) Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Medical Intensive Care Unit, Paris, France (Kerneis) ACTION Study Group, Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Department of Cardiology, Paris, France (Kerneis) Sorbonne Universite, Assistance Publique-Hopitaux de Paris, La Pitie-Salpetriere Hospital, Medical Intensive Care Unit, Paris, France (Pelargonio) Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Narducci) Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Imazio) Department of Medicine, University of Udine, Cardiothoracic Department, University Hospital Santa Maria della Misericordia, ASUFC, Udine, Italy (De Ferrari) Department of Medical Sciences, University of Turin, Turin, Italy (De Ferrari) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy (Dusi) Department of Medical Sciences, University of Turin, Turin, Italy (Dusi) Division of Cardiology, Cardiovascular and Thoracic Department, Citta della Salute e della Scienza, Turin, Italy Publisher Oxford University Press Abstract Aims: Long-term arrhythmic risk after myocarditis remains uncertain, and optimal management is debated. We aimed to assess the incidence and predictors of major arrhythmic events (MAEs) after myocarditis. Methods and Results: We conducted a systematic literature review and meta-analysis including 19 observational studies on myocarditis and MAEs during follow-up. Major arrhythmic events were defined as a composite of sudden cardiac death (SCD), ventricular fibrillation (VF), aborted cardiac arrest (ACA), sustained ventricular tachycardia (sVT), and appropriate implantable cardioverter defibrillator (ICD) or wearable-cardioverter defibrillator (WCD) intervention. The primary outcome was the incidence of MAEs after discharge; secondary outcomes included occurrence of each component of MAEs and the composite of all-cause mortality or heart transplantation (HTx). Three thousand nine hundred and fifty-four patients (71% male, 67% acute, 88% complicated myocarditis) were included. At presentation, 15% had high-grade atrioventricular block (AVB), 31% heart failure, 38% MAEs. At a median follow-up of 24 months (interquartile range 19-57), 28% suffered MAEs, with a median time of presentation of 12 months. The incidence of sVT, ACA/VF, appropriate ICD/WCD intervention, and SCD were 22%, 6%, 20%, and 1%, respectively. The combined rate of all-cause mortality/HTx was 11%. At meta-regression analysis, high-grade AVB, MAEs at presentation, and fulminant myocarditis were associated with higher risk of MAEs during follow-up, while male gender resulted as a protective factor. Conclusion(s): The incidence of MAEs after a complicated acute myocarditis can be high over time. Further prospective studies are needed to better stratify high-risk patients, identify those with an underlying arrhythmogenic cardiomyopathy, and guide antiarrhythmic strategies. 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. <13> Accession Number 2046104354 Title Effect of Breathing Exercises to Prevent Pulmonary Complications in Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery: A Pilot Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Li C.; Huo C.; Li H.; Ding R.; Zhang P. Institution (Li, Huo, Li, Ding, Zhang) Xuanwu Hospital Capital Medical University, Beijing, China Publisher W.B. Saunders Abstract Objective: To explore the impact of perioperative breathing exercises on postoperative pulmonary complications (PPCs) in patients undergoing off-pump coronary artery bypass graft (OPCABG) surgery. Design(s): A single-center, randomized controlled pilot study. Setting(s): The inpatient unit of a tertiary hospital affiliated with a university in Beijing, China. Participant(s): A total of 154 eligible elective OPCABG patients were randomized 1:1 to the intervention group (perioperative breathing exercises plus standard care, n = 77) or control group (standard care only, n = 77). Intervention(s): Breathing exercises (balloon-blowing, deep breathing, and coughing) performed for at least 5 days before surgery, in addition to standard perioperative care. Measurements and Main Results: PPC incidence was significantly lower in the intervention group (15.6% v 42.9%, p < 0.001). Postoperative PaO<inf>2</inf> was higher (p < 0.05) and 6-minute walk test distance was longer (327.01 +/- 41.07 m v 319.94 +/- 29.08 m, p = 0.03). Short Form-36 scores for physical functioning and social functioning were better in the intervention group at 1 month (p < 0.01). Conclusion(s): Perioperative breathing exercises may reduce PPC incidence, preserve arterial oxygenation, and improve functional capacity and the quality of life in OPCABG patients. Larger multicenter studies are warranted to confirm these preliminary findings. Copyright © 2026 The Authors <14> Accession Number 2045016110 Title The effect of chronic total occlusion on outcomes following transcatheter aortic valve implantation: a systematic review and meta-analysis. Source Future Cardiology. 22(5) (pp 487-496), 2026. Date of Publication: 2026. Author Dimitriadis K.; Pyrpyris N.; Beneki E.; Meier D.; Papanikolaou A.; Dris E.; Theofilis P.; Antiochos P.; Fournier S.; Tzimas G.; Aznaouridis K.; Tsioufis K. Institution (Dimitriadis, Pyrpyris, Beneki, Papanikolaou, Dris, Theofilis, Aznaouridis, Tsioufis) First Department of Cardiology, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece (Beneki, Meier, Antiochos, Fournier, Tzimas) Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland Publisher Taylor and Francis Ltd. Abstract Aim: The pre-procedural presence of chronic total occlusions (CTO) in patients undergoing transcatheter aortic valve implantation (TAVI) could be a significant predictor of outcomes. This meta-analysis aims to investigate whether CTO presence significantly alters outcomes in TAVI patients. Method(s): A systematic search was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. After study selection, a random effect meta-analysis was performed. Result(s): Seven studies with a total of 15,162 patients undergoing TAVI were included. There was no significant difference regarding in-hospital [Relative Risk (RR): 1.13; 95% Confidence Interval (95% CI): 0.82-1.55] and 1-year all-cause mortality (RR: 1.58; 95% CI: 0.71-3.50). Patients with CTO exhibited significantly increased rates of myocardial infarction (RR: 1.27, 95% CI: 1.07-1.51) and reduced rates of new pacemaker implantation (RR: 0.88, 95% CI: 0.79-0.98). No differences were found in cardiogenic shock (RR: 1.18, 95% CI: 0.97-1.44), acute kidney injury (RR: 1.06, 95% CI: 0.88-1.28), vascular complications (RR: 1.10, 95% CI: 0.91-1.33), or bleeding (RR: 1.01, 95% CI: 0.89-1.14). Conclusion(s): In TAVI patients, pre-procedural unrevascularized CTO presence is not related to short- or mid-term increased mortality. Further studies are needed to identify predictors of adverse events and phenotypes benefiting from revascularization. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <15> Accession Number 2045733673 Title Effect of Intraoperative Regional Anesthesia on Postoperative Outcomes in Pediatric Cardiac Surgery-A Systematic Review of Randomized Controlled Trials. Source Paediatric Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Hiisivuori K.; Salmi H.; Kontinen V.K.; Kuitunen I. Institution (Hiisivuori, Salmi, Kontinen) Department of Anesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland (Hiisivuori, Salmi) Pediatric Research Centre, University of Helsinki, Helsinki, Finland (Kontinen) Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland (Kuitunen) Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Publisher John Wiley and Sons Inc Abstract Objective: To conduct a meta-analysis of postoperative outcomes following the use of regional anesthesia in pediatric cardiac surgery. Data Sources: We searched PubMed (MEDLINE), Web of Science, CINAHL, CENTRAL, and Scopus in December 2024 (PROSPERO: CRD420025635423; registered January 2025). Study Selection: Two authors screened search results. We included parallel-grouped randomized controlled trials (RCT) regardless of blinding. Studies comparing adjuvant regional anesthesia (excluding neuraxial anesthesia) with general anesthesia in pediatric patients (0-17 years) having cardiac surgery via midline sternotomy were included. Data Extraction: Two authors independently extracted the data and assessed risk of bias. The main outcome measures were pain relief using any documented pain score and duration of mechanical ventilation. Other outcome measures sought were postoperative opioid consumption, time to first rescue analgesia, time in pediatric intensive care unit (PICU), length of hospital stay, complications, and patient satisfaction. Data Synthesis: We identified 15 RCTs with 1055 participants for the analysis. Pain scores were lower during the first 24 h postoperatively, with Modified Objective Pain Scale (MOPS) mean difference (MD) being 0.76 less (MD -0.76; CI -1.19 to -0.32). Duration of mechanical ventilation was 48 min shorter in the regional anesthesia group (MD -48; CI -60 to -36). Postoperative cumulative opioid consumption (morphine equivalents) was 0.21 mg/kg lower (MD -0.21; CI -0.30 to -0.11). No complications related to regional anesthesia were reported. Conclusion(s): Our meta-analysis demonstrates that regional anesthesia in pediatric cardiac surgery reduces postoperative pain, as measured by pain scores and postoperative opioid consumption, leads to shorter mechanical ventilation and PICU stays. Copyright © 2026 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd. <16> Accession Number 649649326 Title The Effects of Massage and Music Interventions on Postoperative Pain Severity Following Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Source Pain management nursing : official journal of the American Society of Pain Management Nurses. 27(3) (pp e355-e364), 2026. Date of Publication: 01 Jun 2026. Author Aktas S.; Yilmaz M. Institution (Aktas) Tokat State Hospital, Tokat, Turkey (Yilmaz) Department of Surgical Nursing, Nursing Division, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey Abstract OBJECTIVES: To investigate the impact of massage and music interventions on alleviating pain severity in the intensive care unit (ICU) within the first 48 hours after cardiac surgery. DESIGN: Systematic review and meta-analysis. METHOD(S): The study has been proactively registered in PROSPERO (CRD42022297174) to ensure transparency and compliance with scientific standards. Studies published in the English and Turkish languages until December 2024 were included in the search, utilizing various scientific databases such as MEDLINE, CINAHL, Embase, Science Direct, Web of Science, Scopus, Cumulative Index to Nursing, Cochrane Central Register of Controlled Trials, and the Turkish academic Google database. The Critical Evaluation 13 Model Checklist at the Joanna Briggs Institute was utilized to assess the quality appraisal of the studies included in the research. The data were subjected to both meta-analysis and narrative synthesis techniques. Meta-analysis was conducted using Review Manager 5.4.1 software. RESULT(S): The review included 19 randomized controlled trials. Eight were in massage intervention, and 11 were in music intervention. Massage intervention (p < .00001) and music listening (p = .0008) both demonstrated a significant reduction in pain severity within the first 48 hours of ICU admission. CONCLUSION(S): The results of this study show that both massage and music intervention resulted in a tangible and statistically significant reduction in pain severity within the first 48 hours of ICU. Copyright © 2025. Published by Elsevier Inc. <17> Accession Number 2044821607 Title Uni-leaflet mitral valve in adults: a systematic review of case reports and case series. Source Future Cardiology. 22(5) (pp 557-565), 2026. Date of Publication: 2026. Author Mookadam M.; Mookadam S.A.; Morris M.; Pradhan S.; Mookadam F. Institution (Mookadam, Pradhan) Department of Family Medicine, Mayo Clinic Arizona, Scottsdale, AZ, United States (Mookadam) Neuroscience, Arizona State University, Tempe, AZ, United States (Morris) Cardiac Radiology, Banner University Medical Center Phoenix, Phoenix, AZ, United States (Mookadam) Banner MD Anderson Cancer Center-Phoenix, University of Arizona and Cardio-Oncology Services, Phoenix, AZ, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Uni-leaflet mitral valve (ULMV) is a rare congenital anomaly historically considered incompatible with long-term survival, yet increasing reports describe diagnosis in adulthood. We conducted a systematic review to characterize clinical presentation, anatomy, imaging findings, management, and outcomes in adults with ULMV. Method(s): Following PRISMA guidelines, major databases were searched from 1960 through January 2024. Eligible studies reported adult patients with confirmed ULMV. Data were extracted on demographics, valve morphology, symptoms, associated anomalies, imaging modalities, interventions, and outcomes. Result(s): Thirty-six publications comprising 40 adult patients met inclusion criteria. Mean age at diagnosis was 50.5 years, with female predominance. Posterior leaflet hypoplasia or agenesis accounted for 97.5% of cases. Most patients were symptomatic, commonly with dyspnea or heart failure, and over half had moderate or greater mitral regurgitation. Atrial fibrillation, atrial septal defects, and aortic valve abnormalities were frequent comorbidities. Transthoracic echocardiography was used universally, with transesophageal and three-dimensional imaging providing incremental anatomical detail. Approximately one-third underwent mitral valve repair or replacement, with generally favorable outcomes. Conclusion(s): Adult ULMV demonstrates marked clinical and anatomical heterogeneity and may represent a developmental spectrum rather than a single entity. Standardized definitions and prospective registries are needed to improve risk stratification and guide management. Protocol Registration: http://www.crd.york.ac.uk/prospero identifier is CRD420251083213. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <18> Accession Number 2045729304 Title Time- and risk-dependent effects of dual antiplatelet therapy targeting the P2Y12 receptor after CABG: A network meta-analysis of graft permeability and clinical outcomes. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author Zhou Y.; Zhang X.; Gui W.; Xie J.; Chen J.; Song Y.; Ma R. Institution (Zhou, Zhang, Xie, Chen, Ma) Department of Cardiac Surgery, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan Province, Kunming, China (Gui, Song) Department of Cardiacpulmonary Bypass, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences/Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan Province, Kunming, China Publisher Springer Abstract The optimal anticoagulation strategy following Coronary artery bypass grafting remains undetermined, particularly regarding the balance between graft patency, ischemic events, and bleeding across different follow-up periods and risk profiles. A systematic search was conducted in PubMed, Embase, Web of Science, and the Cochrane Database to identify randomized controlled trials comparing regimens of aspirin, DAPT (clopidogrel or ticagrelor), and rivaroxaban. The primary angiographic endpoints were saphenous vein graft(SVG) patency and the left internal mammary artery(LIMA) occlusion; clinical endpoints included myocardial infarction, major adverse cardiovascular events(MACE), major bleeding, and all-cause mortality. A random-effects network meta-analysis was conducted, reporting odds ratios (OR) and 95% CIs, with pre-specified 1-year follow-up stratification and multiple subgroup analyses.The primary analysis included 17 RCTs with 1-year follow-up (9,831 patients). SVG occlusion: Aspirin plus ticagrelor (OR = 0.41,95% CI:0.30-0.56) and aspirin plus clopidogrel (OR = 0.59, 95% CI: 0.44-0.78) were both significantly superior to aspirin monotherapy. MACE: Compared with aspirin monotherapy, no anticoagulation strategy showed a statistically significant difference. Major bleeding: Aspirin plus ticagrelor (OR = 2.53,95% CI:1.59-4.04) and rivaroxaban monotherapy (OR = 2.33, 95% CI: 1.01-5.37) significantly increased the risk. No strategy showed statistically significant differences in myocardial infarction or all-cause mortality. No clear conclusions could be drawn regarding LIMA occlusion due to the rarity of events. Subgroup analysis: In the subgroups of off-pump CABG (OR = 0.42, 95% CI: 0.19-0.90) and early initiation <= 48 h (OR = 0.47, 95% CI: 0.29-0.75), the combination of aspirin and ticagrelor significantly reduced MACE; however, the risk of bleeding increased with this regimen when initiation was delayed (> 48 h) (OR = 2.51, 95% CI: 1.52-4.16). Sensitivity analyses showed that the conclusions regarding SVG occlusion and major bleeding were highly robust (the direction and significance of ORs remained consistent across all sensitivity scenarios), whereas estimates for MACE and all-cause mortality were sensitive to specific studies. The net benefit of post-CABG antithrombotic therapy is time- and patient-specific. DAPT (particularly aspirin plus clopidogrel) offers the optimal balance between revascularization protection and bleeding risk; the ticagrelor regimen provides stronger ischemic protection but comes at a higher cost of bleeding; the rivaroxaban regimen is not suitable for routine use. An individualized antithrombotic strategy based on risk stratification is recommended. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <19> Accession Number 2045575950 Title The psychological impact of using 3D printing and imaging technology for patient education: a scoping review. Source 3D Printing in Medicine. 12(1) (no pagination), 2026. Article Number: 14. Date of Publication: 01 Dec 2026. Author Maxwell K.; Leung S.; Ozakinci G. Institution (Maxwell, Ozakinci) Department of Urology, Western General Hospital, Edinburgh, United Kingdom (Leung) Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom Publisher BioMed Central Ltd Abstract Background: The way in which patient education is delivered during clinical consultations can have an impact on cognitive and emotional outcomes in patients. 3D printing and imaging can be used in patient education to improve understanding of the information and satisfaction with care. This scoping review sought to explore the psychological impact of using 3D models in patient education. Method(s): Searches were conducted in PsycINFO, PsycARTICLES, PubMed, Medline and CINAHL. Levac et al.'s enhanced version of Arksey & O'Malley's methodological framework for conducting scoping reviews, and the PRISMA-ScR, were used to guide the screening and identification of relevant studies. Studies were included if they investigated the effect of using 3D models in patient education and explored psychological outcomes. Both quantitative and qualitative research were included. Result(s): Eleven studies were included in the review, including 2 qualitative studies. 3D models were most often used in educational consultations preceding a surgical procedure (n = 9). Psychological outcomes assessed were anxiety, quality of life, distress relief, and decisional conflict. The results were mixed, showing that using 3D models can have a positive as well as negative effect on psychological outcomes such as fear and disempowerment. Conclusion(s): Using 3D models in patient education has the potential to improve patient anxiety and other psychological outcomes. However, more research is required to identify which patients and types of consultations 3D models are most useful for. For example, appointments involving important decision-making may benefit from the inclusion of 3D models. It is also essential to consider the communicative approach of the healthcare professional in the delivery of patient education with 3D models, as this factor is key to the outcomes of shared decision-making. Copyright © The Author(s) 2026. <20> Accession Number 2041693186 Title Natural history of asymptomatic moderate or severe aortic regurgitation: a systematic review and meta-analysis. Source Heart. 112(12) (pp 646-657), 2026. Date of Publication: 01 Jun 2026. Author Naser J.A.; Massad F.; Al-Abcha A.; Gerberi D.; Pislaru S.V.; Nkomo V.T.; Thaden J.J.; Wang Z.; Cavalcante J.L.; Pellikka P.A.; Michelena H.I.; Enriquez-Sarano M. Institution (Naser, Massad, Al-Abcha, Gerberi) Mayo Clinic, Rochester, MN, United States (Pislaru, Pellikka) Mayo Clinic, Rochester, MN, United States (Nkomo, Enriquez-Sarano) Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, United States (Thaden, Michelena) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Wang) Health Sciences Research, Mayo Clinic, Rochester, MN, United States (Cavalcante) Minneapolis Heart Institute Foundation, Minneapolis, MN, United States Publisher BMJ Publishing Group Abstract Background: The natural history of asymptomatic moderate or severe aortic regurgitation (AR) remains uncertain, with conflicting reports about its progression and surgical timing. We aimed to quantify adverse outcomes under conservative management and evaluate the association of aortic valve replacement/repair (AVR) with mortality. Method(s): Systematic searches (inception-July 2025) identified cohort studies of asymptomatic moderate/severe AR. Random-effects models estimated pooled incidence rates of adverse events; fixed-effects models were used for hazard ratios (HRs) of AVR vs conservative management. Result(s): Twenty-seven studies (4720 patients; mean age 49 years; mean follow-up 3.9 years) were included. Pooled incidence rates per 100 person-years were 1.75 (95% CI 1.27 to 2.41) for all-cause mortality, 1.29 for cardiac death, 0.29 for sudden death, 4.30 for new symptoms and 7.01 for AVR. Asymptomatic low left ventricular ejection fraction occurred in only 0.9 per 100 person-years. Mortality rates were more than double those of the general population across age groups-2.45 (1.90 to 3.18) per 100 person-years for cohorts with mean age >=50 years versus 0.59 (0.29 to 1.21) for younger cohorts. Early AVR was associated with lower mortality (pooled HR 0.33; 95% CI 0.30 to 0.37). Conclusion(s): Asymptomatic moderate/severe AR carries significant excess mortality irrespective of age, contradicting its historically benign reputation. Given the rarity of asymptomatic LV dysfunction, earlier intervention guided by more sensitive markers of LV damage may improve outcomes, although heterogeneity and study quality warrant cautious interpretation. PROSPERO registration number: CRD42024522683. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <21> Accession Number 2045257024 Title Phenotypic Diversity and Outcomes of Transcatheter Mitral Repair for Secondary Mitral Regurgitation. Source JACC: Cardiovascular Interventions. 19(9) (pp 1087-1104), 2026. Date of Publication: 11 May 2026. Author Bonnet G.; Rommel K.-P.; Redfors B.; Le Ruz R.; Lachmann M.; Alu M.C.; Iung B.; Gertz Z.M.; Modine T.; Abraham W.T.; Mewton N.; Lindenfeld J.; Messika-Zeitoun D.; Mack M.J.; Obadia J.F.; Stone G.W.; Granada J.F. Institution (Bonnet, Modine) Haut-Leveque Cardiological Hospital, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France (Bonnet, Rommel, Redfors, Alu, Granada) Cardiovascular Research Foundation, New York, NY, United States (Bonnet, Modine) RHU Envisage, ANR-23-RHUS-0007, Bordeaux, France (Rommel) Heart Center at University of Leipzig, Leipzig, Germany (Rommel) University Medical Center Mainz, Mainz, Germany (Le Ruz) Nantes Universite, CHU Nantes, Cardiology Department, l'Institut du Thorax, Nantes, France (Lachmann) First Department of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany (Lachmann) German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany (Iung) Cardiology Department, Bichat Hospital, Assistance Publique-Hopitaux de Paris, and INSERM LVTS1148, Universite Paris Cite, Paris, France (Gertz) Virginia Commonwealth University School of Medicine, Richmond, VA, United States (Abraham) The Ohio State University Wexner Medical Center, Columbus, OH, United States (Mewton, Obadia) Cardiothoracic Surgery Department, Hospices Civils de Lyon, INSERM 1407, Universite Claude Bernard, Lyon, France (Lindenfeld) Vanderbilt Heart and Vascular Institute, Nashville, TN, United States (Messika-Zeitoun) Division of Cardiology, University of Ottawa Heart Institute, Ottawa, ON, Canada (Mack) Baylor Scott and White Heart Hospital Plano, Plano, TX, United States (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Elsevier Inc. Abstract Background Mitral valve transcatheter edge-to-edge repair (M-TEER) is effective for treating patients with secondary mitral regurgitation (SMR), but therapeutic response varies because of anatomy and patient heterogeneity. Objectives The aim of this study was to identify distinct SMR phenotypes and analyze their response to M-TEER in the COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients With Functional Mitral Regurgitation) and MITRA-FR (Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation) trials. Methods Unsupervised hierarchical clustering was performed using 22 baseline parameters (clinical, echocardiographic, and laboratory features). Clusters were identified and described with clinical risk (Society of Thoracic Surgeons [STS] repair score), comorbidity burden (Charlson Comorbidity Index [CCI]), and cardiac damage (CD; a 4-stage classification). The primary outcome was heart failure hospitalization or cardiovascular death at 2 years. Results Clustering identified 3 distinct phenotypes in COAPT (n = 614): cluster 1 (21%), low clinical risk with high left ventricular CD (STS score 2.0%, CCI: 2.1 points, CD stage 2.0); cluster 2 (43%), intermediate clinical risk with biventricular CD (STS score 6.1%, CCI: 3.0 points, CD stage 2.5); and cluster 3 (36%), high clinical risk with low CD (STS score 7.6%, CCI: 3.3 points, CD stage 2.1) and the least severe SMR. Cluster 1 had the highest 2-year survival probability among the 3 groups ( P < 0.001). Following M-TEER, 2-year freedom from heart failure hospitalization and cardiovascular death was higher in clusters 1 (relative risk reduction 46%; P = 0.026) and 2 (relative risk reduction 49%; P < 0.001) compared with cluster 3 (relative risk reduction 34%; P = 0.033). A survival benefit was seen in clusters 1 ( P = 0.047) and 2 ( P = 0.018) but not in cluster 3 ( P = 0.22). Validation in MITRA-FR showed similar findings, with cluster 3 being more prevalent than in COAPT (48% vs 36%). Conclusions Clustering analysis identified 3 distinct SMR phenotypes that were validated across 2 landmark M-TEER trials. Outcomes following M-TEER are better predicted by multidimensional patient phenotypes integrating CD, surgical risk, and comorbidity burden than by any single domain alone and may help explain differences in treatment effect observed across trials. Copyright © 2026 American College of Cardiology Foundation. <22> 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) <23> Accession Number 2045921594 Title Turning Down Ileus: Does Intraoperative Warm Humidified CO<inf>2</inf> Improve Return of Bowel Function After Open Colorectal Surgery?. Source Surgical Innovation. (no pagination), 2026. Date of Publication: 2026. Author Jaffry K.; Lekamalage B.; Arachchi A. Institution (Jaffry) Department of Surgery, Monash University, Dandenong, VIC, Australia (Jaffry, Arachchi) Department of Colorectal Surgery, Monash Health, Clayton, VIC, Australia (Lekamalage) Department of General Surgery, Tauranga Hospital, Bay of Plenty, Tauranga, New Zealand Publisher SAGE Publications Inc. Abstract Background: Postoperative ileus (POI) remains one of the most common and costly complications following open colorectal surgery, prolonging hospital stay and delaying recovery despite the widespread adoption of Enhanced Recovery After Surgery (ERAS) protocols. Warm humidified carbon dioxide insufflation (WHCI), delivered intraoperatively at 37degreeC and near-100% humidity, has emerged as a promising adjunct to preserve peritoneal physiology in open surgery. By maintaining normothermia, reducing tissue desiccation, attenuating systemic inflammation, and supporting tissue oxygenation, WHCI may directly address several mechanisms implicated in the pathogenesis of POI. Purpose(s): To outline the physiological rationale for WHCI in open abdominal surgery and introduce a multicentre randomised controlled trial designed to determine whether WHCI accelerates return of bowel function following open colorectal surgery. Research Design: Perspective article incorporating a narrative review of existing evidence and the protocol overview of a forthcoming multicentre, single-blinded randomised controlled trial. Study Sample: The proposed trial will enrol 264 adults (132 per arm) undergoing elective or emergency open colorectal surgery across three Monash Health hospitals (Dandenong, Monash Medical Centre, and Casey), with randomisation stratified by urgency. Data Collection and Analysis: The primary outcome will be the proportion of patients regaining bowel function (passage of flatus or stool) within 72 hours postoperatively, assessed at 24-hour intervals. Secondary outcomes include length of stay, readmission, return to theatre, postoperative nausea and vomiting, and use of oral Gastrografin follow-through. Sample size calculations anticipate a reduction in POI from 30-35% to 15%, with alpha = 0.05 and 80% power, allowing for 10% attrition. Result(s): Existing evidence from open colorectal, cardiac, and orthopaedic surgery demonstrates reductions in peritoneal mesothelial injury, lower postoperative C-reactive protein, improved wound and core temperature, and reduced intra-wound particulate contamination. However, no adequately powered trial has yet evaluated whether these physiological benefits translate into faster return of bowel function. Conclusion(s): WHCI is a physiologically grounded, low-risk, and low-cost intraoperative adjunct that may directly address several mechanisms implicated in the pathogenesis of POI. If validated by the proposed trial, WHCI could redefine perioperative best practice and extend the thermoregulatory standards of laparoscopy into open surgery. Copyright © The Author(s) 2026 <24> Accession Number 649780531 Title Impact of early balance training on recovering following coronary artery bypass grafting. A randomized trial. Source Clinical rehabilitation. 40(6) (pp 757-768), 2026. Date of Publication: 01 Jun 2026. Author Atef H.; Marques-Sule E.; Moreno-Segura N.; Maged A.; ELSayed S.H.; Pengelly J.; Ali H.F.; Ghaffar H.A.E. Institution (Atef) School of Allied Health Professions (SAHP), Keele University, Keele, Newcastle, UK (Atef, Maged, Ghaffar) Department of Physical Therapy for Internal Medicine, Faculty of Physical Therapy, Cairo University, Al Giza, Egypt (Marques-Sule) Multispeciality Research Group (PTinMOTION), Faculty of Physiotherapy, Department of Physiotherapy, University of Valencia, Valencia, Spain (Marques-Sule, Moreno-Segura) Faculty of Physiotherapy, Department of Physiotherapy, University of Valencia, Valencia, Spain (ELSayed) Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia (Pengelly) School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia (Ali) Cardiothoracic Surgery Department, Faculty of Medicine, Cairo University, Al Giza, Egypt Abstract OBJECTIVE: To investigate the effect of early balance training combined with traditional Phase I cardiac rehabilitation (based on circulatory, respiratory and progressive aerobic exercises) compared to Phase I cardiac rehabilitation alone, on balance, functional capacity, quality of life, length of hospital stay and adverse events in patients post coronary artery bypass graft surgery. DESIGN: Randomized controlled trial. SETTING: Cardiothoracic surgery departments from the Cairo University Hospitals. PARTICIPANTS: Adults (>=55 years) undergoing coronary artery bypass graft were randomly allocated to either an early balance training plus Phase I cardiac rehabilitation group or a Phase I cardiac rehabilitation alone group. Both groups commenced within 48 hours postoperatively and performed 30 minutes of moderate-intensity Phase I cardiac rehabilitation, thrice daily for 7 days. The cardiac rehabilitation Balance group performed an additional 5 minutes of balance training each session. MAIN MEASURES: Balance (Berg Balance Scale), functional capacity (5-Repetition-Sit-to-Stand test), quality of life (Short Form-36 Health Survey Questionnaire), length of hospital stay (number of days hospitalized) and adverse events were evaluated. RESULT(S): Sixty coronary artery bypass graft patients completed the study. When compared to cardiac rehabilitation Alone group, the cardiac rehabilitation balance group significantly improved balance (39.77 +/- 4.73 vs 34.03 +/- 4.94, respectively, P < .001) functional capacity (11.93 +/- 1.70 vs 15.97 +/- 2.01, respectively, P < .001), quality of life (71.87 +/- 3.21 vs 66.17 +/- 2.94, respectively, P < .001) and hospital length stay (11.47 +/- 1.22 vs 14.93 +/- 1.36, respectively, P < .01). Additionally, both groups showed significant improvements in balance, functional capacity and quality of life. No adverse events were registered in any of the groups. CONCLUSION(S): Phase I cardiac rehabilitation plus early balance training improves balance, functional capacity, quality of life, and decreases length of hospital stay beyond that of Phase I cardiac rehabilitation alone, without an increase in adverse events.Institutional Research Committee:No: P.T.REC/012/004372Registration:clinicaltrails.gov NCT06490458). <25> 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. <26> Accession Number 2040599962 Title Revascularisation strategies for non-acute myocardial ischaemic syndromes. Source Heart. 112(10) (pp 530-538), 2026. Date of Publication: 01 May 2026. Author Kawczynski M.J.; Barili F.; Brophy J.M.; De Caterina R.; Biondi Zoccai G.; Boden W.E.; Albuquerque A.; Almeida R.; Anselmi A.; Beurtheret S.; Biondi-Zoccai G.; Boden W.; Borger M.; Brophy J.; Buttiglione G.; Dayan V.; Caterina R.D.; Cuesta M.D.L.; Firstenberg M.; Garcia-Villareal O.; Gomes W.; Heuts S.; Kaul S.; Kawczynski M.; Mandrola J.; Cuartas M.M.; Misfield M.; Musumeci F.; Parolari A.; Quintana E.; Redberg R.; Riad R.; Stuart J.R.-R.; Ronco D.; Uva M.S.; Tomasi J.; Verhoye J.-P.; Zenati M.; Dib N. Institution (Kawczynski, Heuts) Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, Netherlands (Kawczynski, Heuts) Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands (Barili, Parolari) Universita Degli Studi Di Milano, Milan, Italy (Barili) IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy (Barili) Harvard T.H. Chan School of Public Health, Boston, MA, United States (Brophy) McGill University, Montreal, QC, Canada (De Caterina) Cardiology Division, Pisa University Hospital, Pisa, Italy (Biondi Zoccai) Department of Medical Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy (Biondi Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Anselmi) Department of Thoracic and Cardiovascular Surgery, University Hospital Centre Rennes, Rennes, France (Boden) VA Boston Healthcare System, Boston University School of Medicine, Boston, MA, United States Publisher BMJ Publishing Group Abstract Background: Contemporary guidelines by the European Society for Cardiology and American College of Cardiology/American Heart Association for the treatment of non-acute myocardial ischaemic syndromes dispute the value of revascularisation and differ in their recommendation to perform revascularisation. A Bayesian network meta-analysis was performed, evaluating the strength of evidence for the comparative incremental effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) over medical therapy on long-term outcomes. Method(s): A hierarchical Bayesian network meta-analysis was designed (PROSPERO CRD42024541215, date 20 May 2024), including randomised controlled trials (RCTs) published between 2005 and 10 June 2025, which consisted of three initial treatment modalities: optimal medical therapy (OMT), PCI+OMT and CABG+OMT. The primary outcome was all-cause mortality at maximum follow-up; secondary outcomes were trates of the rates of myocardial infarction, stroke and re-revascularisation at maximum follow-up, expressed in HRs and 95% credible intervals (CrIs), accompanied by surface under the cumulative ranking curve (SUCRA) scores. Result(s): 10 RCTs, comprising 10 742 patients, were included. For all-cause mortality, the estimated median HR of CABG+OMT versus OMT was 0.84 (95% CrI 0.68-1.07); the HR of PCI+OMT versus OMT was 0.93 (0.79-1.16); and the HR of CABG+OMT versus PCI+OMT was 0.91 (0.71-1.13). The SUCRAs of a CABG+OMT strategy ranking as the optimal revascularisation treatment regarding mortality, myocardial infarction, stroke and re-revascularisation were 88.1%, 99.7%, 17.5% and 99.5%, respectively. Results were consistent across sensitivity analyses, including in the node-splitting models. Conclusion(s): This Bayesian network meta-analysis found that an initial CABG (+OMT) revascularisation strategy was associated with higher probabilities of optimal outcomes, with the exception of stroke, compared with an initial PCI (+OMT) revascularisation strategy, although CrIs overlapped, suggesting that some uncertainty remains. PROSPERO registration number: CRD42024541215. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <27> Accession Number 2045435817 Title Individual risk factors for failure after arthroscopic Bankart repair within the Instability severity Index Score (ISIS) and Glenoid Track Instability Management Score (GTIMS) frameworks: A systematic review and meta-analysis. Source Journal of ISAKOS. 18 (no pagination), 2026. Article Number: 101113. Date of Publication: 01 Jun 2026. Author Sanchez Cruz D.; Lacouture-Suarez J.D.; Rojas Lievano J.; Soto J.; Karlsson J. Institution (Sanchez Cruz, Soto) Department of Orthopaedics, Knee and Shoulder Surgery, Centro de Ortopedia y Traumatologia, Avenida 15 #124-47, Bogota D.C., Colombia (Sanchez Cruz) Department of Orthopaedics, Knee and Shoulder Surgery, Hospital Militar Central, Tv. 3C No. 49 - 02, Bogota D.C, Colombia (Lacouture-Suarez) Department of Orthopaedics, Shoulder and Elbow Surgery, Centro Hospitalario Serena del Mar, Via al Mar, Km 8, Bolivar, Cartagena, Colombia (Rojas Lievano) Department of Orthopaedics, Shoulder and Elbow Surgery, Hospital Universitario Fundacion Santa Fe de Bogota, Carrera 7 No. 117 - 15, Bogota D.C., Colombia (Karlsson) Department of Orthopaedics, Sahlgrenska University Hospital, Sahlgrenska Academy, University of Gothenburg, Bla straket 5, Gothenburg, Sweden Publisher Elsevier Inc. Abstract Importance: Recurrent anterior shoulder instability after arthroscopic Bankart repair remains a relevant clinical challenge, with reported failure rates up to 30% at long-term follow-up. Several risk stratification tools, particularly the Instability Severity Index Score (ISIS) and the Glenoid Track Instability Management Score (GTIMS), have been widely adopted in clinical practice; however, the independent contribution of their individual prognostic factors has not been comprehensively evaluated using contemporary evidence. Aim(s): To systematically assess and quantify the associations between individual prognostic factors included within the ISIS and GTIMS frameworks and recurrence after arthroscopic Bankart repair. Evidence review: A systematic search of MEDLINE, Embase, LILACS, and Epistemonikos was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and meta-analysis of observational studies in epidemiologyguidelines. Observational analytical studies evaluating prognostic factors for failure after arthroscopic Bankart repair were included, with a specific focus on variables incorporated into the ISIS and GTIMS frameworks, which are commonly used to guide clinical decision-making. Data extraction followed Checklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies - Prognostic Factors recommendations and risk of bias was assessed using the Quality in Prognostic Studies tool. Meta-analyses using Mantel-Haenszel methods were conducted, reporting pooled odds ratios (ORs) with 95% confidence intervals (CIs). Finding(s): Twenty-nine studies involving 11,038 patients were included, with a pooled recurrence rate of 13.34% (1471 failures). Among the individual components incorporated into the ISIS and GTIMS frameworks, the factors most consistently and strongly associated with recurrence were age <20 years (odds ratio [OR]: 2.14; 95% CI: 1.23-3.39, p < 0.001), participation in competitive sports (OR: 2.73; CI: 95% 1.11-6.73, p: 0.002), contact sports (OR: 1.65; 95% CI: 1.14-2.83, p: 0.007), presence of Hill-Sachs lesions on radiographs (OR: 2.63; 95% CI: 1.66-4.16, p < 0.001), and off-track lesions (OR: 4.35; 95% CI: 2.18-8.69, p < 0.001). Hyperlaxity showed a non-significant association (OR: 1.76; 95% CI: 0.98-5.21), with substantial heterogeneity across studies. Radiographic glenoid bone loss did not reach statistical significance (OR: 2.97; 95% CI: 0.96-9.25). Overall methodological quality of the included studies was moderate, with recurrent concerns related to prognostic factor measurements, outcome definition, and adjustment for confounding. Conclusion(s): Recurrence after arthroscopic Bankart repair is influenced by multiple interacting factors. Among the individual components incorporated into the ISIS and GTIMS frameworks, age <20 years, competitive and contact sports, presence of radiographic Hill-Sachs lesions, and off-track status showed the most consistent and strongest associations with failure. These findings support a nuanced interpretation of existing instability scores, in which patient age, sports exposure, and bone loss characteristics are integrated into preoperative decision-making, rather than reliance on rigid score cutoffs alone. Level of Evidence: Level III-Systematic review of prognostic cohort and case-control studies. Copyright © 2026 The Author(s). Published by Elsevier Inc. on behalf of International Society of Arthroscopy, Knee Surgery and Orthopedic Sports Medicine. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <28> Accession Number 2045419835 Title Cardiovascular benefit of continuous positive airway pressure according to high-risk obstructive sleep apnoea: a multi-trial analysis. Source European Heart Journal. 47(17) (pp 2077-2089), 2026. Date of Publication: 01 May 2026. Author Azarbarzin A.; Vena D.; Esmaeili N.; Wellman A.; Pinilla L.; Messineo L.; Zinchuk A.; Alex R.; Baumert M.; Loffler K.A.; Anderson C.S.; White D.P.; Redline S.; Gottlieb D.J.; Barbe F.; Peker Y.; Sanchez-de-la-Torre M.; McEvoy D.; Sands S.A. Institution (Azarbarzin) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Vena) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Esmaeili) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Wellman) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Pinilla) Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Level 2, Building A, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, SA, Australia (Pinilla) Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pavilion 11, Ground Floor, Madrid, Spain (Messineo) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Zinchuk) Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Yale School of Medicine, 300 Cedar Street TAC - 441 South, New Haven, CT, United States (Alex) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Baumert) Discipline of Biomedical Engineering, School of Electrical and Mechanical Engineering, The University of Adelaide, Level 3, Ingkarni Wardli Building, Adelaide, SA, Australia (Loffler) Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Level 2, Building A, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, SA, Australia (Anderson) The George Institute for Global Health, University of New South Wales, Level 18, International Towers 3, 300 Barangaroo Ave, Sydney, NSW, Australia (Anderson) Institute for Science and Technology for Brain-Inspired Intelligence, Fudan University, 220 Handan Road, Shanghai, China (Anderson) Royal Prince Alfred Hospital, 50 Missenden Rd, Camperdown, NSW, Australia (White) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Redline) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Gottlieb) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States (Barbe) Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pavilion 11, Ground Floor, Madrid, Spain (Barbe) Group of Translational Research in Respiratory Medicine, University Hospital Arnau de Vilanova and Santa Maria, University of Lleida, IRBLleida, Av. Rovira Roure, 80, Lleida, Spain (Peker) Department of Pulmonary Medicine, Koc University, Davutpasa cad, No 4, Istanbul, Turkey (Peker) Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden (Peker) Department of Clinical Sciences, Respiratory Medicine and Allergology, Faculty of Medicine, Lund University, Wigerthuset, Remissgatan 4, plan 2, SUS, Lund, Sweden (Peker) Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh School of Medicine, NW 628 UPMC Montefiore, 3459 Fifth Avenue, Pittsburgh, PA, United States (Sanchez-de-la-Torre) Centro de Investigacion Biomedica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III (ISCIII), Av. Monforte de Lemos, 3-5, Pavilion 11, Ground Floor, Madrid, Spain (Sanchez-de-la-Torre) Group of Precision Medicine in Chronic Diseases, Hospital Nacional de Paraplejicos, IDISCAM, Department of Nursing, Physiotherapy and Occupational Therapy, Faculty of Physiotherapy and Nursing, University of Castilla-La Mancha, Carretera Finca la Peraleda, sn, Toledo, Spain (McEvoy) Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Level 2, Building A, Mark Oliphant Building, 5 Laffer Drive, Bedford Park, SA, Australia (Sands) Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, 221 Longwood Ave, Boston, MA, United States Publisher Oxford University Press Abstract Background and Aims: Randomized trials of continuous positive airway pressure (CPAP) treatment for obstructive sleep apnoea (OSA) in patients with cardiovascular disease have not detected reduced risk of major adverse cardiovascular and cerebrovascular events (MACCEs). This study tested whether the cardiovascular benefit of CPAP occurs preferentially in high-risk OSA, characterized by greater OSA-related heart rate acceleration or hypoxaemia. Method(s): In a post hoc analysis of pooled Randomized Intervention with Continuous Positive Airway Pressure in Coronary Artery Disease and Obstructive Sleep Apnoea, Impact of Continuous Positive Airway Pressure on Patients with Acute Coronary Syndrome and Nonsleepy Obstructive Sleep Apnoea, and Sleep Apnoea Cardiovascular Endpoints Study randomized trials; outcomes were stratified by high-risk OSA status, defined by heart rate response following OSA respiratory events >9.4 b.p.m. (third tertile) or oxygen desaturation area under baseline (hypoxic burden) > 87.1% min/h (third tertile). Cox mixed models quantified the CPAP treatment effect on MACCE (including cardiovascular mortality, myocardial infarction, and stroke) within high-risk OSA and the difference vs low-risk status (primary test). Secondary analyses examined participants without excessive sleepiness (Epworth <11 points) or without increased blood pressure (systolic/diastolic <140/90 mmHg). Result(s): In 3549 participants, 16.6% and 16.3% reached the MACCE endpoint with CPAP (n = 1778) and usual care (n = 1771), respectively. The CPAP treatment effect was greater in participants with vs without high-risk OSA [interaction hazard ratio (iHR) .69, 95% confidence interval (CI) .50-.95, P<inf>interaction</inf> = .024; N<inf>high-risk</inf> = 1832]. The differential effect was stronger in those without excessive sleepiness (iHR .59, 95% CI .41-.84; N<inf>high-risk</inf> = 1509), or without increased blood pressure (iHR .54, 95% CI .36-.81; N<inf>high-risk</inf> = 1244). Continuous positive airway pressure benefits in high-risk OSA were observed alongside harm in low-risk OSA. Conclusion(s): Continuous positive airway pressure preferentially improves cardiovascular outcomes in high-risk OSA, while harm in low-risk OSA may counteract this effect. These findings provide a pathway to identify patients likely to benefit. 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) <29> 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. <30> Accession Number 2045337778 Title Efficacy of Vericiguat in Acute Heart Failure: A Target Trial Emulation Study. Source Journal of the American Heart Association. 15(7) (no pagination), 2026. Article Number: e046168. Date of Publication: 01 Jan 2026. Author Chen J.; Liu J.; Ruo'nan X.; Wang Y.; Gao L.; Zhao W.; Li Z.; He S.; Zhang Y.; Wen X.; Zhang D. Institution (Chen, Liu, Ruo'nan, Wang, Gao, Zhao, Li, He, Zhang, Wen) Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Chen, Liu, Ruo'nan, Zhao, Zhang) Department of Cardiology, Chongqing Emergency Medical Center, Chongqing University Central Hospital, School of Medicine, Chongqing University, Chongqing, China Publisher American Heart Association Inc. Abstract BACKGROUND: In recent trials, vericiguat reduced adverse cardiovascular outcomes in stable or recently worsening chronic heart failure (HF), although data concerning vericiguat use in the population with acute HF remain limited. METHOD(S): This target trial emulation study included 205 patients with acute HF with left ventricular ejection fraction <=45%. Vericiguat was initiated at discharge in 103 patients. Stabilized inverse probability of treatment weighting was used to adjust for baseline differences. The primary outcomes were 180-day HF rehospitalization and worsening HF events. Secondary end points included New York Heart Association class improvement, cardiac remodeling measured by echocardiography, and safety events. RESULT(S): After stabilized inverse probability of treatment weighting adjustment, vericiguat significantly reduced 180-day HF rehospitalization (16.3% versus 34.2%; hazard ratio [HR], 0.43 [95% CI, 0.23-0.80], P=0.01) and worsening HF events were numerically lower in the vericiguat group (21.2% versus 31.1%; HR, 0.64 [95% CI, 0.36-1.15], P=0.13). However, patients treated with vericiguat showed more significant improvement in New York Heart Association class (odds ratio [OR], 0.70 [95% CI, 0.50-0.96], P=0.03), though there was no significant improvement in left ventricular ejection fraction or left ventricular dimensions. The incidence of adverse events such as hypotension, hyperkalemia, and worsening renal function were comparable between the 2 groups. The beneficial effect of vericiguat was consistent across all prespecified subgroups, regardless of chronic HF history or concomitant of quadruple guideline-directed medical therapy use. CONCLUSION(S): In patients with acute HF, initiating vericiguat at discharge was observed to be associated with fewer HF rehospitalization events and improvements in New York Heart Association functional class over 180days. These results suggest that vericiguat may have potential as a treatment option during the vulnerable postacute phase. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT05799638. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <31> [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 <32> Accession Number 2045843863 Title Negative-pressure wound therapy in thoracic and abdominal surgery: meta-analysis of randomized trials. Source BJS Open. 10(3) (no pagination), 2026. Article Number: zrag027. Date of Publication: 01 Jun 2026. Author Lakha A.S.; Neves S.; Alemour Y.; McGivern H.; Gordon-Weeks A. Institution (Lakha) Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (Lakha) Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Neves) Thames Valley Foundation School, Oxford, United Kingdom (Alemour) Bodleian Healthcare Libraries, University of Oxford, Oxford, United Kingdom (McGivern) Department of Integrative Biology, Sorbonne University, Paris, France (Gordon-Weeks) Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom (Gordon-Weeks) Department of Hepatobiliary and Pancreatic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom Publisher Oxford University Press Abstract Background: Around 30 000 patients undergo emergency laparotomy in the UK each year, and a similar number of patients undergo open cardiothoracic surgery. Surgical site infection is a common complication associated with increased morbidity, prolonged hospital stay, and higher healthcare costs. Negative-pressure wound therapy has been proposed as a prophylactic strategy to reduce wound complications, but trial evidence has been inconsistent. Method(s): This systematic review and meta-analysis was carried out using PRISMA guidelines and was registered prospectively in PROSPERO (CRD420251010516). A literature search was carried out in March 2025 (updated December 2025), and titles and abstracts were screened against predefined inclusion criteria. Trials assessing patients undergoing open thoracic or abdominal surgery for any indication in adult patients assessing the risk of surgical site infection as an outcome were included. Quality assessment was performed using Cochrane's risk-of-bias 2 tool. Summary statistics for outcomes of interest underwent meta-analyses to a confidence interval of 95% and are presented as forest plots. Result(s): Some 12 427 patients across 45 randomized trials in abdominal and thoracic surgery were included for analysis. Negative-pressure wound therapy significantly reduced surgical site infection compared with standard dressings (odds ratio (OR) 0.53, 95% confidence interval 0.42 to 0.66). The effect was consistent across commercial devices (PICOTM and PrevenaTM). Negative-pressure wound therapy was associated with shorter hospital stay (mean difference -1.67 (95% confidence interval -3.19 to -0.16) days), but not with reduced risk of organ/space infection (OR 0.92, 0.67 to 1.25), wound dehiscence, or reoperation. Only three studies included thoracic surgery and no significant difference in surgical site infection was found (OR 0.44, 0.00 to 45.25). Publication bias was detected; trim-and-fill analysis attenuated but did not eliminate the benefit (adjusted OR 0.70, 0.54 to 0.90). Adverse events and patient-reported outcomes were reported infrequently, and showed no consistent differences. Conclusion(s): Negative-pressure wound therapy was associated with a nearly 50% reduction in SSI and shorter hospital stay after open abdominal surgery, with consistent benefit across device types. However, evidence of publication bias, and limited long-term and patient-reported outcome data suggest that effect size may be overestimated. Selective use in high-risk patients is supported. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of BJS Foundation Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <33> [Use Link to view the full text] Accession Number 648729517 Title Combined Pecto-intercostal Fascial Plane and Rectus Sheath Blocks Versus Local Infiltration for Pain Management Following Pediatric Cardiac Surgery: A Randomized Clinical Trial. Source Anesthesia and analgesia. 142(6) (pp 1189-1197), 2026. Date of Publication: 01 Jun 2026. Author Einhorn L.M.; Kharasch E.D.; Lim J.; Fuller M.; Turi J.L.; Jooste E.H.; Andrew B.Y.; Ames W.A. Institution (Einhorn, Jooste, Andrew, Ames) From the Division of Pediatrics, Department of Anesthesiology (Kharasch, Lim, Fuller) Department of Anesthesiology (Turi) Department of Pediatrics, Pediatric and Congenital Heart Center, Duke University School of Medicine, Durham, NC, United States Abstract BACKGROUND: Previous studies have shown that regional anesthesia (RA) use versus placebo control is associated with less postsurgical opioid requirements and improved pain scores. This trial compared a novel combination of bilateral pecto-intercostal fascial plane and unilateral rectus sheath blocks to an active comparator of surgeon-administered local anesthetic wound infiltration in children undergoing septal defect repair. The study tested the hypothesis that RA use would result in less opioid use and lower pain intensity compared to wound infiltration. METHOD(S): This double-blind, randomized, parallel group, single-center trial included children (<18 years) undergoing primary atrial septal defect (ASD) or ventricular septal defect (VSD) repair. Participants were randomized to RA consisting of ultrasound-guided pecto-intercostal fascial plane and rectus sheath blocks or no-block, consisting of local anesthetic wound infiltration. Both groups received 1.5 mL/kg of ropivacaine 0.2% for the intervention. The primary outcome was opioid use (oral morphine milligram equivalents [MME]/kg) 0-12 hours after surgery. Secondary outcomes were opioid use at additional time points, pain (0-10 scale) between 0 and 48 hours (area under the curve [AUC]), and hospital length of stay (LOS). RESULT(S): Data analysis included 42 children (24 RA, 18 infiltration), age 3.3 +/- 2.7 years (mean +/- standard deviation [SD]; median, 3; range, 4 months-10 years). Opioid use (MME/kg mean +/- SD) 0-12 hours after surgery was 0.44 +/- 0.19 in the RA group compared to 0.83 +/- 0.39 in the infiltration group (mean difference -0.39; 95% confidence interval [CI], -0.59 to -0.18; P = .001). Total postoperative opioid use from 0 to 48 hours after surgery was 0.95 +/- 0.40 in the RA group compared to 1.57 +/- 0.75 in the infiltration group (mean difference -0.64; 95% CI, -1.02 to -0.22, P = .004). Pain intensity AUC (0-48 hours) was 45.0 +/- 26.8 in the RA group compared to 94.5 +/- 55.7 in the infiltration group (mean difference -49.5 [-78.9 to -20.1]; P = .002). Opioid use between 12 and 48 hours and hospital LOS was not different between groups. CONCLUSION(S): This single-center study showed that the combined pecto-intercostal fascial plane and rectus sheath blocks were opioid-sparing and provided superior pain control compared to contemporary practice of local anesthetic infiltration in children following septal defect repair. This investigation strengthens the evidence to support RA use to improve postoperative pain in this population. Copyright © 2025 International Anesthesia Research Society. <34> Accession Number 2040429424 Title Prognostic impact of prior percutaneous coronary intervention on patients undergoing coronary artery bypass grafting - A meta-analysis of reconstructed time-to-event data. Source American Heart Journal Plus: Cardiology Research and Practice. 59 (no pagination), 2025. Article Number: 100606. Date of Publication: 01 Nov 2025. Author Kirov H.; Caldonazo T.; Woehlecke H.; Fazzini L.; Fischer J.; Costa V.; Amorim P.; Runkel A.; Rodrigues E.; Mukharyamov M.; de Sa M.P.L.; Doenst T. Institution (Kirov, Caldonazo, Woehlecke, Fischer, Runkel, Mukharyamov, Doenst) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Germany (Fazzini) Department of Medical Sciences and Public Health, Clinical Cardiology Unit, University of Cagliari, Cagliari, Italy (Fazzini) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, United States (Costa, Amorim, Rodrigues, de Sa) Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Publisher Elsevier Inc. Abstract Background: There is controversy on the effect of percutaneous coronary intervention (PCI) on outcomes of patients undergoing coronary artery bypass grafting (CABG). We meta-analytically assessed the prognostic impact of prior PCI in patients with coronary artery disease (CAD) who underwent CABG. Method(s): We performed a systematic review and meta-analysis of studies comparing patients who underwent CABG and had prior PCI in the past with patients who underwent CABG as primary treatment of CAD. Three databases were assessed. The primary endpoint was perioperative mortality. The secondary outcomes were long-term survival, perioperative myocardial infarction, neurological events, bleeding, acute renal failure, and hospital length of stay. Reconstruction of time-to-event data and pairwise meta-analysis were performed. Result(s): Nineteen studies met the criteria for inclusion in the final analysis. Risk of perioperative mortality in patients undergoing CABG after a prior PCI was higher than in those undergoing primary CABG (OR: 1.16, 95 % CI, 1.03-1.31, p = 0.02). However, the prior PCI group presented higher survival rates when compared to the primary CABG group over the entire follow-up (HR: 0.90, 95 % CI, 0.86-0.94, p < 0.01). There was no significant difference between the groups regarding the other secondary outcomes. Conclusion(s): When compared with patients who underwent CABG as primary treatment of CAD, prior PCI is associated with higher perioperative mortality for patients undergoing CABG. However, this increase in perioperative risk does not correlate with a decrease in long-term survival. Copyright © 2025 The Authors <35> Accession Number 2040069183 Title Half-Dose Anticoagulation versus Antiplatelet Therapy to Reduce Silent Cerebral Embolism after Left Atrial Appendage Occlusion (HALO-SCE Study): Rationale and Design of a Randomized Clinical Trial. Source Cerebrovascular Diseases. 55(3) (pp 394-399), 2025. Date of Publication: 15 Jul 2025. Author Wang K.; Shi L.; Ruan Z.; Jin C.; Li M.; Liu H.; Chen H.; Ju W.; Chen M. Institution (Wang, Jin, Li, Liu, Chen, Ju, Chen) Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China (Shi) Department of Cardiology, Affiliated Hospital of Nantong University, Nantong, China (Ruan) Department of Cardiology, Taizhou People's Hospital, Taizhou, China Publisher S. Karger AG Abstract Abstract - Introduction: Patients with atrial fibrillation (AF) continue to face thrombotic risks even after the left atrial appendages have been occluded, which may manifest as silent cerebral embolisms (SCEs). Half-dose anticoagulation (Hd-OAC) is a pathophysiologically more reasonable therapy in addressing this issue than antithrombotic therapy, but it still lacks strong evidence. Method(s): The trial (NCT05671276) is a multicenter, randomized controlled trial comparing the efficacy of two antithrombotic strategies (Hd-OAC therapy vs. standard antithrombotic therapy) in AF patients after left atrial appendage occlusion (LAAO). The primary endpoint is the incidence of newly detected SCEs on any magnetic resonance imaging conducted during the follow-up period. The secondary endpoints are: (1) more than two new SCEs during the follow-up, their size, and distribution; (2) cognitive function, and (3) a composite endpoint of all-cause mortality, clinical thromboembolic events, and major bleeding events. Follow-up is scheduled at 90 +/- 15 days, 180 +/- 15 days, and 365 +/- 15 days after LAAO. Conclusion(s): This trial aimed to determine whether Hd-OAC therapy can reduce the incidence of SCE and protect cognitive function in patients who have successfully undergone LAAO, compared to standard antithrombotic therapy. Copyright © 2025 S. Karger AG, Basel <36> [Use Link to view the full text] Accession Number 2039411662 Title Bioartificial Hearts, Assist Devices, and Myocardium: New Developments. Source Transplantation. 109(11) (pp 1692-1709), 2025. Date of Publication: 01 Nov 2025. Author Castellanos Vaquero P.; Rozenbaum A.; Rocchi M.; Arfaee M.; Grundeman P.F.; Kluin J. Institution (Castellanos Vaquero, Rozenbaum, Rocchi, Arfaee, Grundeman, Kluin) Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, Netherlands (Grundeman) Department of Cardiothoracic Surgery, University Medical Center Utrecht, Utrecht, Netherlands Publisher Lippincott Williams and Wilkins Abstract The rising prevalence of heart failure, global donor heart shortages, and limitations of current assist devices have driven innovation in bioartificial hearts (BAHs) and cardiac constructs. This systematic review aims to give an overview of new developments in BAHs, engineered myocardium, and biohybrid ventricular assist devices research, evaluating their clinical readiness and outcomes while addressing strengths and limitations. Significant variability in study designs and outcomes highlights both advancements and ongoing challenges in this field. Although the development of BAHs and larger cardiac tissue constructs remains in preclinical stages, progress has been achieved in the development of cardiac patches, with 2 approved for clinical use. Several critical challenges continue to hinder the successful clinical translation of bioengineered cardiac solutions. Achieving meaningful myocardial contraction remains a complex task, as well as ensuring adequate vascularization and electrical integration. Biocompatibility limits the progression of bioengineered cardiac constructs toward clinical applications. Innovations in 3-dimensional bioprinting, shape-memory materials, adhesives, microfabrication techniques, and soft and stretchable bioelectronics are driving advancements in this field. However, outcomes regarding hemodynamic performance of BAHs or constructs are marginal at best. Cardiac patches show promising results in preclinical studies, with the paracrine effect of the patches being the most plausible explanation of these results. Importantly, from very little clinical experience thus far, we cannot conclude that cardiac patches have any beneficial effects nor that they are safe. The path toward developing a fully functional BAH or even parts of a functional myocardium appears to be long, complex, and perhaps even unattainable. Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. <37> Accession Number 2034668957 Title Risk Scores for Cardiovascular Events in NSTEMI Patients with Multi-vessel Disease. Source Angiology. 77(6) (pp 785-786), 2026. Date of Publication: 01 Jul 2026. Author Aydin C.; Demirkiran A.; Orta H. Institution (Aydin, Demirkiran, Orta) Department of Cardiology, Tekirdag Namik Kemal University, Tekirdag, Turkey Publisher SAGE Publications Inc. <38> Accession Number 2045599801 Title The clinical use of cryoprecipitate and fibrinogen concentrate: A scoping review. Source Transfusion. (no pagination), 2026. Date of Publication: 2026. Author Hess A.S.; White S.K.; Crowe E.P.; Raval J.S.; Andrews J.; Cohn C.S.; Covington M.L.; Cushing M.M.; Jacquot C.; Khan J.; Panigrahi A.K.; Saifee N.H.; Tobian A.A.R.; McFarland M.M.; Stanworth S.J.; Metcalf R.A. Institution (Hess) New Zealand Blood Service, Christchurch, New Zealand (White, Metcalf) Department of Pathology, University of Utah, Salt Lake City, UT, United States (Crowe, Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MD, United States (Raval) Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States (Andrews) Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States (Andrews) Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States (Cohn) Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States (Covington) Department of Pathology, Mass General Brigham, Harvard University, Boston, MA, United States (Cushing) Department of Pathology, Weill Cornell Medicine, Cornell University, New York, NY, United States (Jacquot) Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC, United States (Khan) Department of Pathology, University of Virginia, Charlottesville, VA, United States (Panigrahi) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States (Panigrahi) Department of Pathology, Stanford University, Stanford, CA, United States (Saifee) Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States (Saifee) Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, WA, United States (McFarland) University of Utah, Spencer S. Eccles Health Sciences Library, Salt Lake City, UT, United States (Stanworth) John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Stanworth) NHS Blood and Transplant, Oxford, United Kingdom (Metcalf) ARUP Laboratories, Salt Lake City, UT, United States Publisher John Wiley and Sons Inc Abstract Background: Acquired hypofibrinogenemia poses significant bleeding risks. Concentrated sources of fibrinogen, whether cryoprecipitate or fibrinogen concentrates, are widely used. This scoping review aimed to identify and map the available evidence on fibrinogen supplementation. Study Design and Methods: We used the JBI Manual and PRISMA-ScR guidelines. We included patients of all ages treated with fibrinogen supplementation. The concept was treatment with cryoprecipitate or fibrinogen concentrate (prophylactically or therapeutically); and context was any clinical setting worldwide. Eligible studies included randomized trials and observational studies with comparator arms. Comprehensive searches of three databases were performed on February 21, 2025. Primary studies meeting inclusion criteria were selected. UpSet data visualizations displayed studies with intersecting sets of characteristics. Result(s): From 8181 references screened, 134 met inclusion criteria, of which 61 were randomized trials and 16 propensity-matched observational cohort studies. The highest proportion of trials focused on cardiovascular surgery (28/61; 46%) then trauma (12/61; 20%) populations and mainly assessed use of fibrinogen therapeutically (34/61; 56%). More trials evaluated fibrinogen concentrate (53/61; 87%) compared to cryoprecipitate (8/61; 13%). Commonly reported outcomes included bleeding, transfusion needs, or mortality. Studies inconsistently reported dosing, timing, and definitions of hypofibrinogenemia. Studies evaluating certain key populations-including obstetrics and pediatrics-were limited. All but one propensity-matched study was in either cardiovascular surgery or trauma. Discussion(s): There is a growing body of literature informing use of fibrinogen supplementation, particularly in cardiovascular surgery and trauma populations. Meta-analyses appear feasible to inform evidence-based guideline development; however, variability in dosing, timing, and definitions highlights the need for more harmonized research. Copyright © 2026 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB. <39> Accession Number 2031845553 Title Uniform or Sex-Specific Cardiac Troponin Thresholds to Rule Out Myocardial Infarction at Presentation. Source Journal of the American College of Cardiology. 83(19) (pp 1855-1866), 2024. Date of Publication: 14 May 2024. Author Li Z.; Wereski R.; Anand A.; Lowry M.T.H.; Doudesis D.; McDermott M.; Ferry A.V.; Chapman A.R.; Lee K.K.; Shah A.S.V.; Mills N.L.; Kimenai D.M.; Strachan F.E.; Tuck C.; Akinlade O.M.; Barker S.; Blades J.; Boeddinghaus J.; Bularga A.; de Bakker M.; Fujisawa T.; Georgiev K.; Lyell I.; McKinlay L.; McPherson J.; Mendusic F.; Sorbie A.; Souter G.; Schulberg S.D.; Taggart C.; Thurston A.J.; Tew Y.Y.; Perez-Vicencio D.; Wang Y.; Williams K.; Newby D.E.; Fox K.A.; Berry C.; Walker S.; Weir C.J.; Ford I.; Gray A.; Collinson P.O.; Apple F.S.; Reid A.; Cruikshank A.; Findlay I.; Amoils S.; McAllister D.A.; Maguire D.; Stevens J.; Norrie J.; Andrews J.P.; Adamson P.D.; Moss A.; Anwar M.S.; Hung J.; Malo J.; Fischbacher C.M.; Croal B.L.; Leslie S.J.; Keerie C.; Parker R.A.; Walker A.; Harkess R.; Wackett T.; Weir C.; Armstrong R.; Stirling L.; MacDonald C.; Sadat I.; Finlay F.; Harrison K.; Pamela L.; Stephen L. Institution (Li, Wereski, Anand, Lowry, Doudesis, McDermott, Ferry, Tuck, Chapman, Lee, Mills, Kimenai) BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom (Chapman) Department of Cardiology, Auckland City Hospital, Auckland, New Zealand (Shah) Department of Non-Communicable Disease, London School of Hygiene and Tropical Medicine, London, United Kingdom (Mills) Usher Institute, University of Edinburgh, Edinburgh, United Kingdom Publisher Elsevier Inc. Abstract Background: Myocardial infarction can be ruled out in patients with a single cardiac troponin measurement. Whether use of a uniform rule-out threshold has resulted in sex differences in care remains unclear. Objective(s): The purpose of this study was to evaluate implementation of a uniform rule-out threshold in females and males with possible myocardial infarction, and to derive and validate sex-specific thresholds. Method(s): The implementation of a uniform rule-out threshold (<5 ng/L) with a high-sensitivity cardiac troponin I assay was evaluated in consecutive patients presenting with possible myocardial infarction. The proportion of low-risk patients discharged from the emergency department and incidence of myocardial infarction or cardiac death at 30 days were determined. Sex-specific thresholds were derived and validated, and proportion of female and male patients were stratified as low-risk compared with uniform threshold. Result(s): In 16,792 patients (age 58 +/- 17 years; 46% female) care was guided using a uniform threshold. This identified more female than male patients as low risk (73% vs 62%), but a similar proportion of low-risk patients were discharged from the emergency department (81% for both) with fewer than 5 (<0.1%) patients having a subsequent myocardial infarction or cardiac death at 30 days. Compared with a uniform threshold of <5 ng/L, use of sex-specific thresholds would increase the proportion of female (61.8% vs 65.9%) and reduce the proportion of male (54.8% vs 47.8%) patients identified as low risk. Conclusion(s): Implementation of a uniform rule-out threshold for myocardial infarction was safe and effective in both sexes. Sex-specific rule-out thresholds should be considered, but their impact on effectiveness and safety may be limited. Copyright © 2024 <40> Accession Number 2038193511 Title Supra-Annular Self-Expanding Versus Intra-Annular Balloon-Expandable Transcatheter Aortic Valve Implantation: A Meta-Analysis of Valve-Related Outcomes. Source Reviews in Cardiovascular Medicine. 27(4) (no pagination), 2026. Article Number: 48459. Date of Publication: 01 Apr 2026. Author Ali M.; Paraskevi T.; Omari M.; Farag M.; Kuzemczak M.; Alkhalil M. Institution (Ali, Paraskevi, Omari, Farag, Alkhalil) Cardiothoracic Centre, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom (Kuzemczak) Division of Emergency Medicine, Poznan University of Medical Sciences, Poznan, Poland (Kuzemczak) Department of Internal Diseases and Cardiology, Medical University of Warsaw, Warsaw, Poland (Kuzemczak) Department of Interventional Cardiology and Internal Diseases, Military Institute of Medicine - National Research Institute, Legionowo, Poland (Alkhalil) Translational and Clinical Research Institute, Newcastle University, Newcastle-upon-Tyne, United Kingdom Publisher IMR Press Limited Abstract Background: Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis. The two most widely used platforms are either balloon-expandable intra-annular valve (BEV, Edwards) or self-expanding supra-annular valve (SEV) from Medtronic. Comparative data related to clinical and sub-clinical valve thrombosis are limited. The aim of this study-level meta-analysis is to evaluate its incidence and whether this translates into any difference in clinical outcomes. Method(s): Electronic databases were searched from inception through to October 2025 to identify randomised clinical trials of patients receiving either platform. Rates of clinical and subclinical valve thrombosis were identified and compared between the two groups. Result(s): In five randomized controlled trials including 1877 patients, the risk of clinical and sub-clinical valve thrombosis was relatively low in both groups. There was a significant 81% reduction in clinical valve thrombosis in patients undergoing SEV compared to BEV [0.4% vs. 2.1%; rate ratio (RR) 0.19, 95% confidence interval (CI) (0.04 to 0.86), p = 0.03]. Similarly, the risk of sub-clinical valve thrombosis was significantly lower in the SEV group [0.6% vs. 3.6%; RR 0.22, 95% CI (0.07 to 0.65), p = 0.006]. This difference was not translated into increased risk of stroke, valve re-intervention, or death. Conclusion(s): Patients undergoing TAVI using SEV compared to BEV have a lower risk of clinical and sub-clinical valve thrombosis in randomized trials, which is largely influenced by small annulus anatomy. Larger studies with longer term follow-up or using a dedicated imaging protocol may provide better insights into the clinical sequelae of this phenomenon. Copyright © 2026 The Author(s). Published by IMR Press. <41> Accession Number 2045910274 Title Analgesic efficacy and safety of erector spinae plane block after sternotomy and minimally invasive cardiac surgery: A systematic review and Meta-analysis of randomized trials. Source Journal of Clinical Anesthesia. 112 (no pagination), 2026. Article Number: 112240. Date of Publication: 01 Jun 2026. Author Perez-Moreno D.; Forero M.; Contreras M.F.; Mora-Arteaga J.A. Institution (Perez-Moreno) Pain and Palliative Care Unit, Instituto Nacional de Cancerologia, Bogota D.C., Colombia (Forero) Department of Anesthesia, McMaster University, Hamilton, ON, Canada (Contreras) Department of Anesthesia, Clinica Universitaria de la Sabana; Universidad de la Sabana, Chia, Colombia (Mora-Arteaga) Department of Internal Medicine, Intensive Care Unit, Hospital Universitario San Ignacio, Bogota D.C., Colombia (Mora-Arteaga) School of Medicine, Pontificia Universidad Javeriana, Bogota D.C., Colombia Publisher Elsevier Inc. Abstract Background The erector spinae plane block (ESPB) is increasingly used for analgesia in cardiac surgery, but its effectiveness across surgical approaches remains uncertain. We aimed to evaluate the analgesic efficacy, recovery effects, and safety of ESPB in adult cardiac surgery, with analyses stratified by surgical approach (median sternotomy versus minimally invasive cardiac surgery [MICS]). Methods We searched MEDLINE, Embase, CENTRAL, and Scopus (January 2016-June 2025) for randomized controlled trials (RCTs) comparing ultrasound-guided ESPB with standard systemic analgesia in adults undergoing cardiac surgery. This PRISMA-compliant review (PROSPERO: CRD42024570340) used random-effects meta-analyses with Hartung-Knapp adjustment. Risk of bias was assessed using RoB 2, and certainty of evidence using GRADE. The primary outcome was postoperative pain within 24 h. Secondary outcomes included opioid consumption, time to extubation, ICU and hospital length of stay, and complications. Results Nineteen RCTs (N = 1344; 673 received ESPB) were included. In the median sternotomy subgroup (n = 1092), ESPB was associated with modest improvements in 24-h pain (0-10 VAS/NRS; mean difference [MD] -0.65, 95% CI - 1.14 to -0.16), intraoperative and 24-h opioid consumption (MD - 80.8 and - 45.8 mg OME), time to extubation (MD -1.28 h), and ICU stay (MD -13.1 h). However, heterogeneity was substantial (I2 > 85% for most outcomes), and wide prediction intervals crossed the null, suggesting that effects may vary substantially across clinical settings. In the MICS subgroup (4 RCTs, n = 252), no clear statistically significant or clinically meaningful benefits were detected for most outcomes in pain, opioid use, or recovery outcomes. Conclusion Low- to very-low-certainty evidence suggests that ESPB is associated with modest improvements in early pain and recovery after median sternotomy; however, very high heterogeneity and wide prediction intervals indicate that effects may vary substantially between centers. In contrast, no clear benefit was demonstrated within ERAS-optimized MICS pathways, and findings in this subgroup remain preliminary. Copyright © 2024. Published by Elsevier Inc. <42> Accession Number 2046112037 Title Bibliometric and visualization analysis of non-intubated thoracic anaesthesia [2014-2025]. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 488. Date of Publication: 31 May 2026. Author Che Y.; Chen L.; Yi S.; Guo M.; Liu J.; Wang Y. Institution (Che, Yi, Guo, Liu, Wang) Department of Anaesthesiology, Shaoxing People's Hospital, Shaoxing, China (Che, Yi, Guo, Liu, Wang) School of Medicine, Shaoxing University, Shaoxing, China (Chen) Department of Anesthesiology, Affiliated Cancer Hospital, Institute of Guangzhou Medical University, Guangzhou, China Publisher AME Publishing Company Abstract Background: Non-intubated thoracic anaesthesia (NITA) is an emerging anaesthetic approach that integrates spontaneous breathing general anaesthesia with regional blockade. By avoiding tracheal intubation, NITA effectively reduces anaesthesia-related complications and significantly curtails anaesthetic consumption. Evidence indicates that this technique lowers the incidence of postoperative pulmonary complications, facilitates immediate airway clearance, permits early ambulation, improves early postoperative comfort, and shortens hospital stay, thereby accelerating patient recovery. The growing adoption of video-assisted thoracoscopic surgery (VATS) has heightened interest in NITA across various thoracic procedures. Method(s): This study applies bibliometric and visualisation methods to systematically map the NITA literature indexed in the Web of Science Core Collection (WOSCC) from January 2014 to June 2025. Relevant articles were retrieved and screened to identify research hotspots, trends, and principal findings. Data processing, network mapping, and graphical presentation were carried out with VOSviewer, CiteSpace, Scimago Graphica, and Excel 365. Result(s): The bibliometric dataset comprised 141 articles published between January 2014 and June 2025. Annual output rose steadily from 2014, peaked in 2022, and then declined in 2023-2024. Collaborative-network indicators placed China first in both publication count and total citations. The Journal of Thoracic Disease contributed the largest number of papers. Jianxing He emerged as the most prolific and highly cited author; the single most referenced article is "Nonintubated video-assisted thoracoscopic surgery under epidural anaesthesia compared with conventional anesthetic option: a randomized control study" by Liu et al. [2015]. Keyword co-occurrence analysis shows that the intersection of NITA with thoracic surgical procedures (VATS, lobectomy, anatomical resection) and anaesthetic techniques (regional blockade, preservation of spontaneous ventilation) constitutes the dominant research theme; studies integrating NITA with VATS currently represent the most active subfield. Conclusion(s): This study presents the first comprehensive bibliometric visualisation of NITA research, providing an intuitive overview of its hotspots, trends, and prospects. The findings will offer scholars a valuable reference for identifying priority topics and potential collaborators, and will clearly point the way for future NITA research. Copyright © AME Publishing Company. <43> Accession Number 2046095392 Title Expert consensus on the clinical application of oxycodone injection (2025 edition). Source National Medical Journal of China. 105 (pp 4024-4040), 2025. Date of Publication: 25 Nov 2025. Author Wang T.; Yu W.; Yang J. Institution (Wang) Department of Anesthesiology, Xuanwu Hospital Capital Medical University, Beijing, China (Yu) Department of Anesthesiology, Department of Anesthesiology, First Affiliated Hospital of Wenzhou University, Wenzhou, China (Yang) Department of Anesthesiology and Perioperative Medicine, First Affiliated Hospital of Nanjing Medical University, Nanjing, China Publisher Chinese Medical Journals Publishing House Co.Ltd Abstract Oxycodone is an agonist of mu-and kappa-opioid receptors which has been commonly used for the management of moderate to severe pain attributing to its distinct pharmacological properties. Due to the lack of unified medication guidance, significant variations exist in the clinical application of oxycodone injection among different medical institutions and healthcare providers, aggravating the standardization and homogenization of pain management. To solve this problem, the Pain Group of the Chinese Society of Anesthesiology has organized a multidisciplinary panel of experts to develop this consensus focusing on 15 key clinical questions. Based on systematic literature review and evidence evaluation, the consensus establishes 15 recommendations covering general anesthesia induction, preventive medication, postoperative analgesia, post-thoracic/abdominal surgery analgesia, epidural anesthesia, procedural sedation and analgesia, special patient use etc. This consensus aims to standardize clinical application and optimize pain management outcomes by providing evidence-based guidance on oxycodone injection. Copyright 2025, Chinese Medical Association <44> Accession Number 2046112495 Title Systemic hypothermia in non-aortic cardiac surgery: a narrative review. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 545. Date of Publication: 31 May 2026. Author Ragheb D.K.; Tabrizi N.S.; Zaki A.L.; Shapeton A.D. Institution (Ragheb, Tabrizi, Zaki) Department of Thoracic and Cardiovascular Surgery, Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Shapeton) Department of Anesthesia, Critical Care and Pain Medicine, Veterans Affairs Boston Healthcare System, Tufts University School of Medicine, Boston, MA, United States Publisher AME Publishing Company Abstract Background and Objective: Systemic hypothermia is commonly used in most cardiac operations in order to reduce metabolic demand and augment both myocardial and other end-organ protection. With modern improvements in perfusion and protection strategies, some surgeons now routinely perform non-aortic surgery under normothermic conditions. However, there is limited evidence and conflicting reports on the "optimal" temperature conditions for cardiac surgery, resulting in a paucity of guidelines and a wide variety in practice. We aim to give a thorough review of the current evidence comparing hypothermia and normothermia in cardiac surgery. Method(s): A narrative review was conducted comparing studies that involved hypothermia and/or normothermia within cardiac surgery. Search terms included: temperature cardiac surgery, temperature cardiopulmonary bypass, normothermia surgery, hypothermia surgery, normothermia cardiac, hypothermia cardiac, normothermia cardiopulmonary bypass. Applicable manuscripts and abstracts from PubMed during the timeframe of 1/1/1990 to 1/1/2025 were included, including a range of experimental, observational, prospective, and randomized studies. In addition, prior narrative reviews and meta-analyses were included. Evidence was collected and synthesized across bleeding/transfusion need, neurologic outcomes, arrhythmias, renal function, inflammation and wound healing, and anesthetic pharmacology. Key Content and Findings: Cooling effectively decreases metabolic rate and provides additional end-organ protection. Large, observational datasets have reported limited but meaningful improvements in short- and long-term survival with hypothermia. However, more modern studies across observational and randomized cohorts evaluating individual organ outcomes show limited differences between hypothermia and normothermia in cardiac surgery patients. The most meaningful difference is consistently demonstrated in greater coagulopathy in hypothermic patients. Neurologic and renal outcomes in hypothermia are conflicting between studies, with no consistent difference. There is likely a modest impact of hypothermia on worsening wound healing and higher arrhythmogenicity. Lastly, hypothermia has a known prolongation of effects and clearance of anesthetics, but in a predictable manner. Conclusion(s): No single temperature strategy is universally superior for non-aortic cardiac surgery. Hypothermia has benefits in myocardial and end-organ protection, but with a cost in coagulopathy. Temperature management should be individualized, balancing these two considerations with the modest impacts noted in renal function, neurologic outcomes, wound healing, and anesthetics. Copyright © AME Publishing Company. <45> [Use Link to view the full text] Accession Number 2045801237 Title Post-Catheter Ablation Long-Term Antithrombotic Strategies in Atrial Fibrillation: A Network Meta-Analysis of Randomized Controlled Trials. Source Circulation: Arrhythmia and Electrophysiology. (no pagination), 2026. Article Number: e014692. Date of Publication: 2026. Author Rodriguez-Riascos J.F.; Navale D.; Somappa A.; Estrada Mendizabal R.; Scott L.R.; Shen W.-K.; Srivathsan K. Institution (Rodriguez-Riascos, Navale, Somappa, Scott, Shen, Srivathsan) Department of Cardiovascular Diseases, Mayo Clinic, Phoenix, AZ, United States (Estrada Mendizabal) Department of Medicine, NYC Health and Hospitals/Elmhurst, Icahn School of Medicine at Mount Sinai, Elmhurst, NY, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Catheter ablation for atrial fibrillation is a widely used rhythm-control strategy, yet its role in reducing thromboembolic risk and enabling oral anticoagulation (OAC) discontinuation remains uncertain. This meta-analysis aims to comprehensively synthesize and evaluate randomized controlled trial evidence supporting long-term antithrombotic strategies in patients with atrial fibrillation undergoing catheter ablation. METHOD(S): - A systematic literature search was performed in MEDLINE/PubMed, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials evaluating antithrombotic strategies after catheter ablation for atrial fibrillation. The primary outcome was ischemic stroke. A frequentist network meta-analysis comparing reported treatment arms, along with a pooled incidence meta-analysis for outcomes of interest, was conducted. RESULT(S): - Four randomized controlled trials, including 3924 patients, met the inclusion criteria. Three trials compared long-term OAC continuation versus OAC discontinuation, and 1 compared OAC continuation with left atrial appendage occlusion after catheter ablation. No significant differences in stroke incidence were observed when comparing OAC or left atrial appendage occlusion with no antithrombotic therapy (incidence rate ratio, 0.90 [95% CI, 0.02-33.85]; P=0.95; incidence rate ratio, 0.79 [95% CI, 0.00-241.01]; P=0.94, respectively). Among patients who discontinued antithrombotic therapy without undergoing left atrial appendage occlusion (n=1161), with 2864 cumulative person-years of follow-up, the pooled incidence of stroke was 0.23 events per 100 person-years (95% CI, 0.02-2.43; I2=0%). CONCLUSION(S): - This analysis reinforces that, across randomized data, the incidence of thromboembolic events in patients who discontinued OAC after successful ablation remained low. However, the evaluation of net clinical benefit is limited by the low number of events across all treatment arms, underscoring the need for larger studies with prolonged follow-up to further validate the safety of this strategy, particularly in higher-risk populations. Copyright © 2026 The Authors. <46> Accession Number 2046112528 Title Advances in surgical treatment for valvular heart disease: a narrative review of 2025 studies. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 550. Date of Publication: 31 May 2026. Author Wu J.; Chen M.; Jiang C.; Qian X.; Yu K.; Zheng Y.; Fan P.; Liu Y.; Pu J.; Fan L.; Chen Z.; Zhai H.; Fan Z.; Sun J.; Zeng T.; Zhou Z.; Xu L.; Li F. Institution (Wu, Chen, Jiang, Qian, Zheng, Fan, Liu, Pu, Fan, Chen, Zhai, Fan, Sun, Zeng, Zhou, Xu, Li) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Yu) School of Foreign Languages, Guangzhou College of Commerce, Guangzhou, China Publisher AME Publishing Company Abstract Background and Objective: The field of surgical treatment for valvular heart disease (VHD) has progressed rapidly in 2025. This review aims to summarize the year's key research, focusing on comparisons of mainstream techniques for aortic, mitral, and tricuspid valve diseases, innovations in repair techniques, and advances in emerging technologies, to provide evidence-based support for individualized clinical decision-making. Method(s): A structured search of PubMed database was performed to identify randomized controlled trials (RCTs), registry studies, and meta-analyses published in 2025, and the evidence was synthesized narratively. Key Content and Findings: In the aortic valve arena, long-term follow-up from the PARTNER 3 and Evolut Low Risk trials confirmed the non-inferiority of transcatheter aortic valve replacement (TAVR) in low-risk patients. However, real-world data suggested higher long-term risks with TAVR in patients with bicuspid aortic valves (BAV) and younger patients, whereas women demonstrated greater benefit. The indication for early intervention in asymptomatic severe aortic stenosis (AS) was reinforced. Aortic valve repair and the Ross procedure accumulated more robust evidence for long-term survival and quality of life in younger patients. In the mitral valve domain, the MITRACURE study highlighted gaps between real-world practice and guidelines, including delayed referral and suboptimal repair rates for mitral regurgitation (MR). The advantages of repair for degenerative disease were further solidified, though techniques for posterior leaflet prolapse and management strategies for atrial functional regurgitation (AFMR) require optimization. Transcatheter edge-to-edge repair (TEER) was increasingly used in high-risk patients but yielded inferior long-term outcomes compared to surgery, and surgical rescue after failed TEER carried high risk. For the tricuspid valve, comparative effectiveness of transcatheter vs. surgical repair and the timing of intervention emerged as key research foci. Emerging technologies such as polymer valves, partial heart transplantation, and artificial intelligence (AI)-assisted analysis demonstrated preliminary potential. Conclusion(s): The 2025 evidence reinforces a paradigm shift from risk-score-based decision-making toward individualized valve care. Transcatheter techniques have expanded their indications, but surgery remains irreplaceable in young, low-risk, and BAV patients, as well as in degenerative MR. Real-world gaps in guideline adherence, delayed referral, and suboptimal repair rates require urgent attention. Emerging technologies show early promise, although their long term durability and clinical value await further validation. Copyright © AME Publishing Company. <47> Accession Number 2046101340 Title Systematic review of culture-confirmed septic pericarditis in systemic lupus erythematosus with an index case. Source Lupus Science and Medicine. 13(1) (no pagination), 2026. Date of Publication: 27 Apr 2026. Author Alamlih L.; Neiroukh H.; Qawasmeh N.; Rayyan M.A.; Alamlih H.; Doudin K.; Amro T.; Abumounshar J.; Henahen H. Institution (Alamlih, Alamlih) Internal Medicine, Al-Quds University, Jerusalem, Palestine (Alamlih, Qawasmeh, Rayyan, Alamlih, Doudin, Amro, Abumounshar, Henahen) Internal Medicine Department, Al-Mezan Specialty Hospital, Hebron, Palestine (Neiroukh) Al-Quds University, Jerusalem, Palestine Publisher BMJ Publishing Group Abstract Objective: Pericardial involvement is common in systemic lupus erythematosus (SLE), but distinguishing sterile immune-mediated pericarditis from septic pericarditis is difficult because clinical features overlap with sepsis, immunosuppressive effects and nonspecific serologic abnormalities. Septic pericarditis in SLE is rare yet potentially fatal and existing evidence is limited to isolated case reports. Case presentation: We describe a fatal case of a patient in the fourth decade of life with newly diagnosed SLE who developed methicillin-resistant Staphylococcus aureus (MRSA) purulent pericarditis. Despite broad-spectrum antibiotics and immunosuppressive therapy for multisystem lupus activity, the patient deteriorated rapidly due to MRSA-positive pericarditis. Method(s): In parallel with this index case, we systematically searched PubMed/MEDLINE, Google Scholar and ResearchGate for case reports and series of microbiologically confirmed septic or purulent pericarditis in SLE, from inception to March 2025 and updated through November 2025. Two reviewers independently screened studies; extracted relevant clinical, microbiologic, immunologic and outcome data; and synthesised findings descriptively. Result(s): Fifteen published culture-confirmed cases plus our index case were identified (total n=16). Most patients were female (93.8%), with a mean age of 34.1 years. Staphylococcus aureus (including MRSA) and Salmonella species predominated. Dyspnoea (68.8%) was more frequent than fever (31.3%) and nearly all patients progressed to cardiac tamponade requiring urgent drainage. Survival was 93.8% when timely pericardial drainage and pathogen-directed antimicrobial therapy were achieved, while routine serological markers failed to distinguish infection from lupus flare. Conclusion(s): Septic pericarditis in SLE is uncommon but rapidly progressive. Early echocardiography and a low threshold for diagnostic pericardiocentesis are essential to prevent fatal delay. 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/. <48> Accession Number 2045897542 Title Frailty prevalence and clinical outcomes according to assessment tools: A systematic review. Source Revista Espanola de Geriatria y Gerontologia. 61(4) (no pagination), 2026. Article Number: 101805. Date of Publication: 01 Jul 2026. Author Bermejo Boixareu C.; Martinez Velilla N.; Neira Alvarez M.; Abizanda Soler P.; Alonso Bouzon C.; Casas Herrero A.; Castro Rodriguez M.; Lisset Toapanta C.; Martin-Sanchez F.J.; Martinez Peromingo F.J.; Martinez Reig M.; Perez Bazan L.M.; Sanchez Garcia E.M.; Tarazona-Santabalbina F.J.; Vidan Astiz M.T.; Serra Rexach J.A.; Rodriguez-Manas L. Institution (Bermejo Boixareu) Geriatrics Department, Puerta de Hierro Majadahonda University Hospital, Health Research Institute Frailty and Healthy Aging Research Group Puerta Hierro-Segovia de Arana, School of Medicine, Autonoma University of Madrid, Spain (Martinez Velilla, Casas Herrero) Geriatrics Department, Navarrabiomed, Hospital Universitario de Navarra (HUN), Universidad Publica de Navarra (UPNA), IdiSNA, Pamplona, Spain (Neira Alvarez) Geriatrics Department, Infanta Leonor Hospital, Madrid, Spain (Abizanda Soler) Geriatrics Department, Complejo Hospitalario Universitario de Albacete, Spain (Abizanda Soler, Alonso Bouzon, Vidan Astiz, Serra Rexach, Rodriguez-Manas) Biomedical Research Networking Center on Frailty and Healthy Aging (CIBERFES), Madrid, Spain (Abizanda Soler) Facultad de Medicina de Albacete, Spain (Alonso Bouzon, Castro Rodriguez, Rodriguez-Manas) Geriatrics Department, Getafe University Hospital, Madrid, Spain (Lisset Toapanta) RE-FiT Barcelona Research Group, Vall d'Hebron Institute of Research (VHIR), Barcelona, Spain (Martin-Sanchez) Hospital Enfermera Isabel Zendal, Madrid, Spain (Martin-Sanchez, Vidan Astiz, Serra Rexach) Faculty of Medicine, Universidad Complutense, Madrid, Spain (Martinez Peromingo) Geriatrics Department, University Hospital Fundacion Jimenez Diaz, Madrid, Spain (Martinez Reig) Geriatrics Department, Doctor Peset University Hospital, Valencia, Spain (Perez Bazan) Geriatrics Department, Clinic de Barcelona y Parc Sanitari Pere Virgili Hospital, Barcelona, Spain (Sanchez Garcia) Geriatrics Deparment, Ramon y Cajal University Hospital, Madrid, Spain (Tarazona-Santabalbina) Geriatrics Deparment, University Hospital of La Ribera, Alzira, Valencia, Spain (Tarazona-Santabalbina) School of Medicine, Universidad Catolica de Valencia Sant Vicent Martir, Valencia, Spain (Vidan Astiz, Serra Rexach) Geriatric Department, Biopathology of Aging Group, Instituto de Investigacion Sanitaria Hospital General Universitario Gregorio Maranon, Madrid, Spain Publisher Ediciones Doyma, S.L. Abstract Frailty is a clinically recognizable state of increased vulnerability in older adults, marked by diminished physiological reserves before the onset of disability. Although multiple assessment tools exist, their inconsistent use across clinical specialties often leads to confusion and inappropriate decision-making. The objective is to describe the prevalence of frailty and its association with clinical outcomes according to different frailty assessment tools, in adults aged 65 years and older, across key clinical scenarios: acute myocardial infarction (AMI), chronic coronary artery disease (CCAD), heart failure (HF), diabetes mellitus (DM), transcatheter aortic valve implantation (TAVI), emergency departments (ED), intensive care units (ICU), and hip fracture. A systematic review with narrative synthesis was conducted in accordance with PRISMA 2020 guidelines. Searches were performed in PubMed covering the last 10 years. Included studies involved adults >=65 years, used validated frailty tools, and reported outcomes such as mortality, rehospitalization, complications, or functional decline. A total of 626 articles were reviewed, of which 158 met the inclusion criteria. Prevalence varied according to the assessment tool used (4.4-90%) across all clinical settings. In AMI, the CFS (13 studies), Fried phenotype (9) and FI (8) were the most frequently used; the CFS was associated with 6-12 month mortality (HR 3.32; HR 1.90), readmissions and bleeding. In CCAD, the Fried phenotype and the CFS were associated with post-PCI mortality (HR 2.78 vs. 5.99). In HF, the Fried scale was predominant; frailty was associated with increased mortality (adjusted RR 2.04), readmissions and functional decline. In DM, Fried was the most commonly used tool. In TAVI, the CFS and Fried were associated with mortality, acute kidney injury and bleeding. In ED settings, the CFS and PRISMA-7 were associated with mortality, prolonged length of stay and readmissions. In ICU settings, the CFS was the most frequently used and was associated with mortality and complications. In hip fracture, the CFS and FI were associated with mortality, delirium and functional impairment. As conclusion frailty is highly prevalent in older adults across diverse clinical contexts, but its outcomes and prognostic value depend on the tool and definition used. Different frailty assessment tools appear to be associated with distinct clinical outcomes depending on the context in which they are applied. Meta-analyses should avoid merging studies that apply conceptually different frailty instruments. Copyright © 2026 SEGG. <49> Accession Number 651304973 Title Superficial intercostal plane blocks for post-sternotomy pain control rationale and design for the EPOCH CardioLink-10 randomized clinical trial. Source Current opinion in cardiology. (no pagination), 2026. Date of Publication: 20 May 2026. Author Dhingra N.K.; Dennis F.; Hassan S.M.A.; Quan A.; Teoh H.; Chin K.; Ricci M.J.; Tran J.D.; Li J.; Verma R.; de Vasconcelos Papa F.; Lee Y.; Chang A.P.; Igualada J.; Morales J.F.; Ghiringhelli J.P.; Derry K.L.; George T.; Mazine A.; Rotstein O.D.; Adams C.; Cook R.C.; Hassan A.; Nagpal A.D.; Yau T.M.; Spence J.D.; Sutherland K.; Martinka P.M.; Noss C.D.; Dougherty J.L.; de Jager P.; Gregory A.J.; Arora R.C.; Verma S.; Alli A.; Mazer C.D. Institution (Dhingra, Yau) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network (Dhingra, Hassan, Rotstein, Yau, Verma) Department of Surgery, University of Toronto (Dennis, Hassan, Quan, Teoh, Verma) Division Cardiac Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto (Dennis, Hassan, Verma, Mazer) Department of Pharmacology and Toxicology, University of Toronto (Teoh) Division of Endocrinology and Metabolism (Chin, Ricci, Tran, Li, de Vasconcelos Papa, Lee, Igualada, Morales, Derry, George, Alli, Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto (Ricci, de Vasconcelos Papa, Lee, Chang, Ghiringhelli, Derry, George, Alli, Mazer) Department of Anesthesiology and Pain Medicine (Tran, Mazer) Department of Physiology, University of Toronto, Toronto, ON, Canada (Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland (Chang) Department of Anesthesia, Sunnybrook Health Sciences Center (Ghiringhelli) Department of Anesthesia and Pain Management, Mount Sinai Hospital, Toronto, ON, Canada (Mazine) Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, VIC, Australia (Rotstein) Division of General Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Toronto, ON, Canada (Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada (Cook) Division of Cardiac Surgery, Vancouver General Hospital (Cook) Division of Cardiovascular Surgery, University of British Columbia, Vancouver, BC, Canada (Hassan) MaineHealth Maine Medical Center, Portland, Maine, USA (Nagpal) Division of Cardiac Surgery (Nagpal) Division of Critical Care, London Health Science Centre, Western University, London, United Kingdom (Spence) Departments of Anesthesia, Critical Care and Health Research Methods, Evidence, and Impact, Population Health Research Institute, McMaster University, Hamilton, ON (Sutherland, Martinka) Department of Anesthesiology and Perioperative Medicine, Royal Columbian Hospital, New Westminster, BC, Canada (Martinka) Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, Canada (Noss, Gregory) Department of Anesthesiology, Perioperative and Pain Medicine & Libin Cardiovascular Institute, University of Calgary, Calgary, AB, Canada (Dougherty, de Jager) Department of Anesthesia, Pain Management & Peri-operative Medicine, Dalhousie University, Halifax, NS, Canada (Arora) Departments of Surgery and Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, United States Abstract PURPOSE OF THE TRIAL: Inadequate pain control following cardiac surgery remains a significant clinical and socioeconomic burden. Superficial parasternal intercostal plane (SPIP) blocks are not widely utilized for reducing pain and opioid consumption post-cardiac surgery because the available evidence is weak and inconsistent. METHOD(S): The double-blind, placebo-controlled, multicenter EPOCH CardioLink-10 trial was designed to evaluate how continuous bilateral SPIP blocks affect opioid consumption and recovery-related endpoints among individuals who have undergone cardiac surgery via median sternotomy. Participants from four Canadian sites are randomized to receive either 0.2% ropivacaine or placebo (0.9% sodium chloride) for 48-h following bilateral catheter insertion into the SPIP. The primary outcome is cumulative postoperative opioid use (morphine milligram equivalents) up to 72-hours post-catheter insertion. Secondary endpoints include median pain scores and the incidence of delirium over the 72-hours post-catheter insertion; cumulative postoperative opioid use up to hospital discharge; and participant-reported quality of recovery 24-96 h post-surgery. SUMMARY: EPOCH CardioLink-10 is to date the largest randomized controlled trial to evaluate an Enhanced Recovery After Surgery (ERAS) intervention among individuals who are recuperating from cardiac surgery with median sternotomy. Its overarching goal is to obtain robust data to improve clinical care and inform on post-cardiac surgery pain management guidelines. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <50> Accession Number 2045769864 Title Chagas Disease and Solid Organ Transplantation: From Diagnosis to Treatment. Source Current Infectious Disease Reports. 28(1) (no pagination), 2026. Article Number: 11. Date of Publication: 01 Dec 2026. Author Radisic M.V.; Pujato N.R. Institution (Radisic) Sanatorio Finochietto, Internal Medicine, Av. Cordoba 2674, Ciudad Autonoma de Buenos Aires, Argentina (Pujato) GRUPO MIT - Medicina Interdisciplinaria y Trasplantes, Infectious Diseases Av. Gdor. Freyre 3074, S3000 Santa Fe de La Vera Cruz, Santa Fe, Argentina Publisher Springer Abstract Purpose of Review: The aim of this review is to provide a comprehensive update on the management, screening, prevention and treatment of Chagas disease in solid organ transplantation. Recent Findings: Global migration has extended the relevance of Trypanosoma cruzi infection beyond endemic regions, making systematic risk assessment essential in transplant programs. An increasing body of evidence supports the safety and feasibility of transplanting kidneys and livers from T. cruzi-infected donors into seronegative recipients, (thereby expanding the donor pool) provided that structured post-transplant surveillance is implemented. Likewise, all types of solid organ transplantation can be performed in T. cruzi-infected recipients, although immunosuppression increases the risk of reactivation. For optimal outcomes, standardized qPCR-based surveillance provides the strongest evidence for early detection and management of donor-derived transmission or reactivation, enabling patient and graft survival rates comparable to those of non-Chagas recipients. However, validated parasitic load thresholds predicting progression to symptomatic disease are lacking, and most monitoring strategies are consensus-based rather than supported by prospective trials. When transmission or reactivation occurs, trypanocidal treatment with benznidazole or nifurtimox is generally well tolerated and highly effective. Unmet needs persist, particularly the development of validated biomarkers to assess treatment response and test-of-cure. Summary: Solid organ transplantation in patients at risk for Chagas disease can be performed safely with appropriate screening, structured monitoring, and timely treatment. Further prospective studies are needed to strengthen the evidence base guiding transplant-specific management strategies. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <51> [Use Link to view the full text] Accession Number 651304413 Title Pulsed Field Ablation Versus Sham to Treat Atrial Fibrillation: The PFA-SHAM Randomized Clinical Trial. Source Circulation. (no pagination), 2026. Date of Publication: 26 May 2026. Author Osmancik P.; Neuzil P.; Hozmanova J.; Petru J.; Herman D.; Kralovec S.; Hozman M.; Tichy M.; Waldauf P.; Karel T.; Sediva L.; Fischer J.; Stepanek L.; Mala I.; Lekesova V.; Hala P.; Funasako M.; Vesela J.; Filipcova V.; Karch J.; Whang W.; Reddy V.Y. Institution (Osmancik, Hozmanova, Herman, Hozman, Vesela, Filipcova, Karch) Cardiocenter, Third Faculty of Medicine (P.O., M.H., Charles University Prague and University Hospital Kralovske Vinohrady, Czechia (Neuzil, Petru, Kralovec, Tichy, Sediva, Lekesova, Hala, Funasako, Reddy) Department of Cardiology, 1st Faculty of Medicine, Charles University and Faculty Hospitals Motol and Homolka, Prague, Czech Republic (P.N., J.P., S.K., M.T., L. Sediva, V.L., P.H., M.F., V.Y.R.) (Waldauf) Department of Anesthesiology (P.W.), Charles University Prague and University Hospital Kralovske Vinohrady, Czechia (Karel, Fischer, Stepanek, Mala) Department of Statistical Analyses, Czech Republic (T.K., L. Stepanek, Prague University of Economics and Business (Whang, Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, NY, United States Abstract BACKGROUND: Catheter ablation for atrial fibrillation (AF) is one of the most common cardiovascular procedures being performed worldwide. Despite the large body of evidence of its effectiveness, with a single exception, prior ablation studies were largely unblinded trials. Accordingly, residual concerns remained about placebo effects, both for AF recurrence and, in particular, on subjective outcomes such as quality of life or anxiety. Here, we compared pulsed field ablation (PFA) with a sham procedure to treat patients with symptomatic AF. METHOD(S): This prospective, sham-controlled, single-blind, randomized clinical trial with blinded end-point assessment enrolled patients with AF that was highly symptomatic (Atrial Fibrillation Effect on Quality-of-Life score <50). Patients were assigned 1:1 to PFA or a sham procedure. All participants received implantable cardiac monitors for continuous rhythm monitoring during follow-up. The 6-month co-primary outcomes were (1) time to first recurrence of atrial tachyarrhythmia and (2) changes from baseline in Atrial Fibrillation Effect on Quality-of-Life scores compared between groups. Secondary outcomes were AF burden and psychological distress (assessed by the Hospital Anxiety and Depression Scale [HADS]). RESULT(S): Patients (n=60) were randomized to PFA or sham. At 6 months, the first co-primary end point of AF recurrence was met in 2 patients (6.7%) who underwent PFA and 25 patients (83.3%) who underwent sham (posterior hazard ratio, 19.6 [95% bayesian credible intervals, 6.7-76.9]; posterior probability of superiority >0.99). For the second co-primary end point, Atrial Fibrillation Effect on Quality-of-Life scores showed greater improvement from baseline with PFA than sham (improved by 43.9+18.1 points versus 11.3+27.9 points; posterior median difference, 32.6 [95% bayesian credible interval, 20.2-44.9]; posterior probability of superiority >0.99). AF burden at 6 months was significantly lower in the PFA than the sham group (0 [0-0] versus 0.43 [0.04-3.47]; between group median difference, -0.39 [95% credible interval, -2.5 to -0.1], posterior probability of superiority >0.99). The Hospital Anxiety and Depression Scale score changed by -4 points (-7.8 to -2.0) with PFA and by -0.5 (-4.5 to 1.0) with sham (group median difference, -3.5 [95% credible interval, -6.0 to -1.0]; posterior probability of superiority >0.99). CONCLUSION(S): In patients with AF, PFA was superior to sham in reducing arrhythmia recurrences and burden and improving quality of life and AF-associated psychological distress. <52> [Use Link to view the full text] Accession Number 2045881813 Title Therapeutic effectiveness of specialized core mobilization exercise on cardiopulmonary function in open-heart surgery patients: A randomized control trial with single-blind study. Source Medicine (United States). 105(19) (pp e48313), 2026. Date of Publication: 08 May 2026. Author Lee J.J.; You J.S.H. Institution (Lee) Department of Physical Therapy, Eulji University, Seongnam, South Korea (You) Department of Physical Therapy, Sports Movement Artificial-Intelligence Robotics Technology (SMART) Institute, Yonsei University, Wonju, South Korea (You) Department of Physical Therapy, Yonsei University, Wonju, South Korea Publisher Lippincott Williams and Wilkins Abstract Background: - To compare the effects of conventional cardiopulmonary physical therapy (CCPT) and specialized core mobilization exercise (SCME) on cardiopulmonary function and functional difficulties in patients after open-heart surgery. Method(s): - This randomized controlled, single-blind study used repeated-measures analysis of variance to examine time and group interaction effects across multiple postoperative assessment points. A post hoc Tukey test was performed when significant effects were identified. The study was conducted at the Myongji Hospital Cardiac Rehabilitation Center from June 2022 to July 2023 and included 37 patients (mean age = 66.1 +/- 11.4 years) who were randomly assigned to the CCPT or SCME group. Result(s): - Compared with CCPT, SCME resulted in greater improvements in peak oxygen consumption, metabolic equivalents, forced vital capacity, forced expiratory volume in 1 second, maximal voluntary ventilation (P < .05), and Functional Difficulties Questionnaire scores (P < .01). Conclusion(s): - SCME demonstrated superior effects on peak oxygen consumption, selected pulmonary function parameters, and functional thoracic mobility compared with CCPT in patients after open-heart surgery. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <53> Accession Number 2046112746 Title Risk factors, pathogenesis, and botanical drugs interventions for postoperative pulmonary complications after cardiothoracic surgery. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 539. Date of Publication: 31 May 2026. Author Wang H.; Liang Z. Institution (Wang) College of Clinical Medicine, Changchun University of Traditional Chinese Medicine, Changchun, China (Liang) Changchun University of Chinese Medicine, Changchun, China Publisher AME Publishing Company Abstract Background and Objective: Postoperative pulmonary complications (PPCs) are common and severe after cardiothoracic surgery, leading to prolonged hospital stays, increased medical burden, and elevated mortality. Driven by patient-related, surgery-related, and perioperative factors, PPCs are characterized by a pathophysiology involving inflammation, oxidative stress, alveolar injury, and airway obstruction. This review aims to systematically summarize PPCs' risk factors, pathogenesis, and the role of botanical drugs, providing a scientific basis for clinical decision-making. Method(s): Relevant literature published from 2010 to 2025 were searched in PubMed, Embase, Web of Science, and Cochrane Library using keywords such as "PPCs", "Botanical drugs", and "Cardiothoracic surgery". Eligible English studies [randomized controlled trials (RCTs), cohort studies, systematic reviews, etc.] were included, with low-quality studies and those unrelated to cardiothoracic surgery excluded. Quality assessment was performed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2), Newcastle-Ottawa Scale (NOS), and Risk of Bias Tool 2.0 (RoB 2), and 55 studies were finally included for data extraction and synthesis. Key Content and Findings: Key PPCs risk factors include patient-related [age >=65 years, chronic obstructive pulmonary disease (COPD), smoking history], surgery-related [extensive resection, prolonged one-lung ventilation (OLV)], and perioperative factors (inadequate analgesia, prolonged bed rest). Core pathophysiological mechanisms involve Toll-like receptors (TLRs) and the nuclear factor-kappaB (NFkappaB) pathway-mediated inflammation, excessive reactive oxygen species (ROS)-induced oxidative stress, alveolar type II cell dysfunction, and airway obstruction. Botanical drugs (e.g., Huanglian Jiedu Decoction, andrographolide, and Salvia miltiorrhiza extract) exert protective effects against PPCs by modulating inflammatory pathways, scavenging free radicals, and preserving the pulmonary barrier; however, relevant studies are limited by small sample sizes and single-center study designs. Conclusion(s): PPCs' pathogenesis is complex, and clarifying their risk factors and mechanisms provides clinical intervention targets. Botanical drugs, with multi-target effects, serve as valuable supplements to modern medicine for PPCs management. Future research should focus on large-sample, multicenter RCTs to validate botanical drugs' efficacy and safety, and explore integrated Chinese-Western medicine strategies to optimize postoperative recovery. Copyright © AME Publishing Company. <54> Accession Number 2046112529 Title Artificial intelligence in thoracic surgery: a narrative review of clinical advances and applications in 2025. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 549. Date of Publication: 31 May 2026. Author Zhang Y.; Yang Z.; Lin Y.; Zhao Y.; Zhou Y.; Deng C.; Dai K.; Liang H.; Su Y. Institution (Yang, Zhao, Zhou, Deng, Dai, Liang) Department of Thoracic Surgery and Oncology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China (Yang) School of Medicine, Henan University, Kaifeng, China (Su) State Key Laboratory of Respiratory Disease, Guangzhou, China Publisher AME Publishing Company Abstract Background and Objective: The integration of artificial intelligence (AI) into thoracic surgery accelerated notably over the course of 2025, transitioning from isolated diagnostic aids toward comprehensive clinical pathway integration. The objective of this narrative review is to synthesize the latest evidence on AI applications across the entire thoracic surgical workflow, organized along the patient care continuum from preoperative assessment through intraoperative execution to postoperative management. Method(s): A PubMed/MEDLINE search was performed on March 6, 2026, and retrieved 378 English-language records published between January 1, 2025 and March 6, 2026. After title and abstract screening, potentially relevant articles underwent full-text review, and studies addressing the clinical applications of AI and related digital technologies across the thoracic surgical pathway were included in this narrative review. Key Content and Findings: In the preoperative domain, large-scale foundation models and computational pathology systems have demonstrated strong performance in nodule risk stratification and noninvasive genomic prediction [area under the curve (AUC) >0.900]. Notably, dual-phase computed tomography (CT) systems such as NeoPred have achieved validation for predicting pathological response to neoadjuvant immunochemotherapy. Intraoperatively, augmented reality (AR) navigation has achieved randomized controlled trial (RCT)-level evidence outperforming conventional localization, while generative AI systems have attained expert-level anatomical recognition for surgical video analytics. Postoperatively, wearable continuous monitoring systems and digital therapeutics (DTx) entered prospective clinical validation. Furthermore, large language models (LLMs) emerged as increasingly important tools for automated surgical documentation. Despite these advances, most studies remain retrospective, and domain shift across institutions limits generalizability. Conclusion(s): While AI has substantially affected thoracic surgery, important gaps persist regarding prospective validation and regulatory governance. Future priorities must focus on prospective multicenter interventional trials linking AI predictions to standardized clinical action protocols, federated learning architectures to overcome data silos, and the development of specialty-specific guidelines building upon the Artificial Intelligence Organization for Next Generation Surgeons (AIONS) 2025 consensus. Copyright © AME Publishing Company. <55> [Use Link to view the full text] Accession Number 2045882320 Title Landscape and trends in postoperative cognitive dysfunction: A bibliometric and visualized analysis. Source Medicine (United States). 105(19) (pp e48642), 2026. Date of Publication: 08 May 2026. Author Gan W.; Li Q.; Xie J.; Liu L. Institution (Gan, Li, Xie, Liu) Department of General Surgery, General Hospital of Western Theater Command, Chengdu Sichuan, China Publisher Lippincott Williams and Wilkins Abstract Background: - Postoperative cognitive dysfunction (POCD) is a hot research topic in the field of anesthesia. Despite decades of research, its pathogenesis remains complex, and worldwide research trends are unclear. We intended to analyze the relevant researches on POCD in the past 30 years by using bibliometric methods. Method(s): - Based on Web of Science, literature published from January 1, 1993 to December 31, 2022 was retrieved. CiteSpace and VOSviewer were used for descriptive statistical analysis and visualization. Result(s): - A total of 2290 articles are included, and the number reaches peak in 2022 with 277. China is the country with the largest number of publications, but its centrality is relatively low at 0.06, much lower than that of United States (0.67), which ranks first. Capital Medical University is the institution with the highest number of publications, while Duke University is the institution with the highest centrality. The journal that ranks highest in both citations and centrality is ANESTHESIOLOGY. The most cited literature is Monk TG's research published in ANESTHESIOLOGY in 2008, while Wan YJ's research published in ANESTHESIOLOGY in 2007 has the highest centrality. Research hotspots mainly includes 6 aspects: neuroinflammation, cardiac surgery, delirium, general anesthesia, noncardiac surgery, craniopharyngioma and neuron-specific enolase. Burst keywords analysis reveals that recent studies mainly focus on perioperative neurocognitive disorder. Conclusion(s): - The global research on POCD is growing rapidly. Future studies need to pay more attention to the etiology and mechanism of POCD, and the research on perioperative neurocognitive disorder will still be the frontier hot spot. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <56> Accession Number 2045878194 Title Simulation Training in Video-Assisted and Robotic-Assisted Cardiac Surgery: A Narrative Review. Source Journal of Cardiovascular Development and Disease. 13(5) (no pagination), 2026. Article Number: 180. Date of Publication: 01 May 2026. Author Nameghi F.H.; Ali J.M. Institution (Nameghi, Ali) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Ali) School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Minimal access cardiac surgery (MACS) can mitigate the increasing risk profile of cardiac surgery patients and is associated with improved postoperative outcomes. One of the ways to manage the steep learning curve of MACS is the use of surgical simulation training. We conducted a narrative review to identify the relevant literature discussing MACS simulation training. We identified 20 studies using our search strategy. Various platforms were represented: high-fidelity (n = 8), low-fidelity (n = 6), and animal studies (n = 6). Virtual reality (VR) appeared in two wet-lab studies as an adjunct. The surgical approach was video-assisted thoracoscopic surgery (VATS) in 11 and robotic-assisted thoracoscopic surgery (RATS) in nine. The most simulated procedure was minimal access mitral valve (MV) repair (n = 16). Most studies (n = 16) evaluated the impact of simulation training on the surgical skill of participants with varying baseline MACS experience. A small proportion of included studies (n = 4) carried out only fidelity testing. While some standardised assessment tools were used, there was considerable variation in how surgical skill and fidelity were assessed. There are an increasing number of publications on MACS simulation training, with equal focus on bench and animal models. MV procedures were the most simulated, suggesting a drive towards increasing the scope of minimal access MV training. Copyright © 2026 by the authors. <57> Accession Number 2046112225 Title Video double-lumen endotracheal tube reduces hypoxemia during one-lung ventilation in thoracoscopic surgery: a prospective randomized controlled trial. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 506. Date of Publication: 31 May 2026. Author Long S.; Li Y.; Zheng X.; Ye F.; Li J.; Yu Y.; Guo J.; Huang W.; Wang Z.; Hu R. Institution (Long, Li, Zheng, Ye, Li, Yu, Guo, Huang, Wang, Hu) Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China Publisher AME Publishing Company Abstract Background: Compared to the conventional double-lumen endotracheal tube (c-DLT), the video double-lumen endotracheal tube (v-DLT) demonstrates a shorter intubation time and the capability of observing and adjusting malposition at any time. Our objective was to compare the incidence of hypoxemia during one-lung ventilation (OLV) and perioperative complications between the two tube types. Method(s): This single-center, prospective, randomized controlled trial enrolled 100 patients undergoing video-assisted thoracic surgery (VATS), who were randomized to receive either a v-DLT or a c-DLT. The primary outcome was the incidence of hypoxemia [defined as a peripheral oxygen saturation (SpO<inf>2</inf>) below 90%] during OLV. A predefined rescue protocol was initiated if SpO<inf>2</inf> fell below 95%. Secondary outcomes included the number of hypoxemia-triggered interventions during OLV, postoperative complications, and anesthesiologist satisfaction. Result(s): The incidence of hypoxemia during OLV was significantly lower in the v-DLT group compared to the c-DLT group [3/48 (6.3%) vs. 13/47 (27.7%), P=0.006]. The v-DLT group also required fewer rescue interventions for SpO<inf>2</inf> <95% (35.4% vs. 66.0%, P=0.006) and less frequent fiberoptic bronchoscopy (FOB) use (P<0.001). Anesthesiologists reported higher satisfaction, reduced workload, and shorter intubation time with v-DLT (all P<0.001). There were no significant differences in postoperative complications between the two groups. Conclusion(s): The use of v-DLT significantly reduces the incidence of hypoxemia during OLV, decreases the need for rescue interventions and FOB. Simultaneously, it improves procedural efficiency and enhances anesthesiologist satisfaction. Copyright © AME Publishing Company. <58> Accession Number 2045878267 Title Is Aspirin Still Indispensable After PCI-Rethinking Dual Antiplatelet Therapy in Contemporary Practice. Source Journal of Cardiovascular Development and Disease. 13(5) (no pagination), 2026. Article Number: 201. Date of Publication: 01 May 2026. Author Yadav K.; Ahmed S.E.S.; Abdelgader M.; Khalid R.; Veerasamy M.; Das A.; Bulluck H. Institution (Yadav, Ahmed, Abdelgader, Veerasamy, Das, Bulluck) Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom (Khalid) General Medicine, King's College Hospital NHS Foundation Trust, London, United Kingdom (Veerasamy, Das, Bulluck) Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Aspirin has been the default backbone of antiplatelet therapy after percutaneous coronary intervention (PCI) for over two decades, anchored by landmark trials that established 12-month dual antiplatelet therapy (DAPT) as the standard of care. Three developments have prompted reassessment of this paradigm: the markedly lower thrombotic risk of contemporary drug-eluting stents, the greater potency and consistency of potent P2Y<inf>12</inf> inhibitors (ticagrelor, prasugrel), and increasing recognition that major bleeding independently worsens outcomes after PCI. Recent randomised trials have systematically tested aspirin withdrawal at varying time points. Immediate aspirin-free strategies (NEO-MINDSET, STOPDAPT-3) demonstrated an early signal of excess ischaemic events in the ACS component of enrolled populations, suggesting that aspirin remains important during the earliest post-PCI period in ACS. One-month strategies (T-PASS, ULTIMATE-DAPT, TARGET-FIRST) and three-month strategies (TWILIGHT, TICO, DUAL-ACS) showed that transition to P2Y<inf>12</inf> monotherapy after an initial DAPT period significantly reduces bleeding without increasing ischaemic events in selected populations. Beyond one year, long-term randomised trials including the HOST-EXAM 10-year follow-up (Lancet 2026) and the STOPDAPT-2 5-year landmark analysis (Circ Cardiovasc Interv 2026), together with study-level meta-analyses (PANTHER) and recent individual patient data meta-analyses, provide converging evidence that clopidogrel monotherapy outperforms aspirin for chronic secondary prevention without excess bleeding. The choice of P2Y<inf>12</inf> agent is critical: clopidogrel monotherapy in ACS during the first post-procedural year carries excess thrombotic risk owing to CYP2C19 pharmacogenomic variability, whereas ticagrelor and prasugrel provide more reliable protection. This review synthesises the mechanistic rationale, trial evidence across all time points, special clinical contexts (oral anticoagulation, coronary artery bypass grafting, high bleeding risk), guideline evolution, and methodological considerations, providing a practical framework for individualising post-PCI antiplatelet therapy. Copyright © 2026 by the authors. <59> Accession Number 2045061169 Title Timing of antihypertensive medication (bedtime versus morning) and cardiovascular risk: an updated systematic review and meta-analysis. Source Frontiers in Pharmacology. 17 (pp 1-12), 2026. Article Number: 1758890. Date of Publication: 01 Jan 2026. Author Wang T.; Lai S.; Wang D.; Wang X. Institution (Wang, Wang, Wang) Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China (Lai) Geriatrics Department, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China (Wang, Wang) Institute of Cardiovascular Diseases, Beijing University of Chinese Medicine, Beijing, China Publisher Frontiers Media SA Abstract Introduction - Previous studies on the optimal timing for antihypertensive medication administration have yielded inconsistent results. While earlier meta-analyses indicated that bedtime dosing significantly reduces myocardial infarction (MI) risk, more recent research has presented conflicting evidence. Therefore, we aimed to evaluate the impact of bedtime versus morning dosing of antihypertensive drugs on cardiovascular outcomes. Methods - We conducted a systematic search across PubMed, EMBASE, and Web of Science databases, covering studies published from inception to 16 July 2025, to identify relevant randomized controlled trials. We calculated risk ratios (RRs) for dichotomous outcomes along with the corresponding 95% confidence intervals (CIs). The study protocol was registered in PROSPERO (ID: CRD420251102968). Results - In total, 8 studies involving 64, 235 patients were included in our analysis. Compared with morning dosing, bedtime dosing exhibited no significant differences in all-cause mortality (RR: 0.78; 95% CI: 0.59-1.04; P = 0.09), major adverse cardiovascular events (RR: 0.80; 95% CI: 0.61-1.05; P = 0.10) or cardiovascular death (RR: 0.59; 95% CI: 0.34-1.04; P = 0.07). However, bedtime dosing significantly decreased heart failure risk (RR: 0.67; 95% CI: 0.46-0.96; P = 0.03), lowered clinical systolic blood pressure (mean difference: -3.27 mmHg; 95% CI: -4.13 to -2.41; P < 0.00001), and improved non-dipper conversion (RR: 0.61; 95% CI: 0.47-0.77; P < 0.0001). Non-significant trends favoring bedtime dosing were noted for MI and coronary revascularization. Conclusion - For critical outcomes, including MACE, all-cause mortality and cardiovascular death, no statistically significant benefits associated with bedtime dosing were observed. The overall findings are inconsistent, and the observed advantages for endpoints such as heart failure are closely linked to a single research group, necessitating cautious interpretation. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251102968, identifier CRD420251102968. Copyright © 2026 Wang, Lai, Wang and Wang. <60> Accession Number 2045796902 Title S2133 Pancreaticopleural Fistula: An Uncommon Complication of Chronic Pancreatitis. Source The American Journal of Gastroenterology. Conference: 2025 Annual Scientific Meeting and Postgraduate Course. Phoenix United States. (no pagination), 2026. Date of Publication: 2026. Author Moon G.; Nasir A.B.; Khan M.T.; Ajayi T.; Rumman A. Institution (Moon, Nasir, Khan, Ajayi, Rumman) University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States Publisher Embase Conference Abstracts Abstract Introduction: - Pancreaticopleural fistulas (PPFs) are usually seen in middle-aged men with chronic alcoholism, occurring in 0.4% of cases of pancreatitis. It occurs when pancreatic secretions "digest" fascial planes via a pseudocyst which communicates with the pleural cavity or via a tract between the posterior pancreatic duct and the pleura. Although there is no defined cutoff value, only PPFs will demonstrate pleural fluid amylase levels >50, 000U/L. This case is unique as the patient's presentation was atypical for PPFs.Case Description/Methods: - A 43-year-old female with chronic pancreatitis, alcohol abuse, and tobacco abuse presents for SOB, recurrent abdominal pain and 30 lb weight loss in the past year. She was discharged a week prior to presentation after a month-long admission for acute on chronic pancreatitis. A CT abdomen/pelvis with contrast showed small volume ascites, bilateral pleural effusions (greatest on left), coarse calcifications throughout the pancreatic parenchyma, a lobulated fluid collection in pancreatic body which extended superiorly into the left hemithorax around the distal esophagus through the esophageal hiatus with largest component measuring 2.3 x 4.4cm, in close proximity to the pancreatic duct (Figure 1). Labs were significant for serum procalcitonin 0.04ng/mL, lipase 104U/L, hematocrit 27.7%, CRP 45.1mg/L. Based on the Atlanta Classification, the fluid collection in the pancreatic body was concerning for a pseudocyst with developing PPFs. Thoracic surgery declined surgery. GI offered ERP however patient declined the procedure. She was discharged home in a stable condition with close GI follow-up. Discussion(s): - In a systematic review, MRCP was the most sensitive diagnostic modality for detecting PPF (80%), then ERCP (78%) and then CT (47%) (1). As with chronic pancreatic sequelae, PPF patients can be managed conservatively, endoscopically, or surgically. Management should be modified based on each patient's pancreatic ductal defect. Large-scale studies examining PPF intervention success rates would be beneficial. Our patient's presentation was atypical for PPF as patients present more commonly with pulmonary rather than abdominal symptoms, the opposite of her presentation. So it is imperative to keep a high index of suspicion for the possibility of a PPF.(Figure presented.) Copyright © 2023 by The American College of Gastroenterology <61> Accession Number 2045791719 Title Valve-in-Valve TAVR in Surgical Stentless Aortic Bioprostheses, a Challenging Scenario. Source Medicina (Lithuania). 62(5) (no pagination), 2026. Article Number: 844. Date of Publication: 01 May 2026. Author Saltarocchi S.; D'Abramo M.; Chourda E.; De Orchi P.; Spunticchia F.; Totaro M.; Vinciguerra M.; Romiti S.; Giunti G.; Greco E.; Miraldi F. Institution (Saltarocchi) Department of General Surgery, Surgical Specialty and Anesthesiology "Paride Stefanini", Sapienza University of Rome, Rome, Italy (Saltarocchi, Giunti) Cardiac Surgery Unit, Department of Cardiovascular Science, San Carlo Hospital, Potenza, Italy (D'Abramo, Chourda, Spunticchia, Totaro, Miraldi) Internal, Clinical, Anesthesiological and Cardiovascular Sciences Department, Sapienza University of Rome, Rome, Italy (De Orchi) Division of Cardiac Surgery, Azienda di Rilievo Nazionale e Alta Specializzazione "G. Brotzu", Cagliari, Italy (Vinciguerra, Romiti, Greco) Department of Health and Life Sciences, European University of Rome, Rome, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and objectives: Valve-in-valve transcatheter aortic valve replacement (ViV TAVR) has become an established treatment for failed surgical bioprostheses in patients at high surgical risk. However, procedures performed in degenerated stentless aortic valves remain particularly challenging because of the absence of a radiopaque frame, variable surgical implantation techniques, and a potentially increased risk of coronary obstruction. Evidence in this specific setting is limited. We conducted a systematic review of the literature to identify studies reporting ViV TAVI in degenerated stentless surgical bioprostheses. Material(s) and Method(s): Case reports and case series were included when patient-level or clearly identifiable data were available. Baseline characteristics, anatomical features, procedural strategies, and clinical outcomes were extracted and analyzed using a descriptive approach. A total of 54 studies were included, encompassing 294 ViV TAVI procedures performed in failed stentless aortic valves. Result(s): The mean patient age was 73.9 years, and the average STS-PROM score was 13.45%, reflecting a high-risk population. The most frequently treated prosthesis was the Medtronic Freestyle valve, and the predominant mechanism of failure was regurgitation. Transfemoral access represented the most common approach, while balloon-expandable and self-expanding transcatheter valves were used with similar frequency. Coronary protection strategies were adopted in a minority of procedures, whereas adjunctive procedural techniques such as pre- or post-dilation were relatively common. Device-related complications were mainly driven by coronary obstruction, while cardiac complications included myocardial infarction and unplanned coronary intervention. Overall, VARC-3 device success was achieved in the majority of procedures, with acceptable short-term mortality despite the complexity of the treated population. Conclusion(s): ViV TAVR in degenerated stentless bioprostheses appears feasible and generally effective but remains associated with specific procedural challenges, particularly related to coronary obstruction risk. Careful anatomical assessment and tailored procedural planning are essential, and larger contemporary studies are needed to better define optimal management strategies in this complex setting. Copyright © 2026 by the authors. <62> Accession Number 2045747253 Title Safety and efficacy of single versus dual arterial access in transfemoral transcatheter aortic valve implantation: a systematic review and meta-analysis of propensity-matched cohort. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 427. Date of Publication: 01 Dec 2026. Author Adamu U.G.; Mashilo D.; Mutyaba A.; Patel A.; Farrel H.; Tsabedze N. Institution (Adamu, Mashilo, Mutyaba, Patel, Tsabedze) Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (Farrel) Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Observatory, South Africa (Farrel) Sunninghill Hospital, Sunninghill, Johannesburg, South Africa (Adamu) Division of Cardiology, Department of Internal Medicine, Faculty of Health Sciences, University of Witwatersrand, York Road, Parktown, South Africa Publisher BioMed Central Ltd Abstract Purpose of review: Transfemoral transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS). Although dual arterial access (DAA) is commonly used for catheter control and haemodynamic monitoring, single arterial access (SAA) has emerged as a minimalist strategy aimed at reducing procedural complexity and access-site complications. However, comparative outcome data remain limited. Recent findings: Four propensity score-matched observational studies comprising 540 patients (50.4% SAA) were included. Compared with DAA, SAA was associated with a significantly lower risk of total vascular complications (odds ratio [OR] 0.34, 95% confidence interval [CI] 0.17-0.67; p < 0.001), largely driven by reductions in minor access-site events (OR 0.44, 95% CI 0.20-0.95; p = 0.04), while rates of major vascular complications were similar between groups. There were no significant differences in all-cause mortality, stroke or transient ischaemic attack, paravalvular leak, or major bleeding. SAA was also associated with shorter procedural time (mean difference [MD] -17.1 min, 95% CI -32.8, -1.4; p = 0.03) and lower contrast volume use (MD -28.6 mL, 95% CI -55.3, -1.9; p = 0.04), although substantial heterogeneity was observed. Summary: In patients with symptomatic severe AS undergoing transfemoral TAVI, SAA appears to be a safe and feasible alternative to DAA and is associated with fewer vascular complications without compromising major clinical outcomes. Future prospective and randomised studies incorporating procedural complexity and device-specific outcomes are needed to confirm these results and better define optimal patient selection. Copyright © The Author(s) 2026. <63> Accession Number 2045887955 Title Routine cerebral embolic protection during TAVR: A meta-analysis and trial sequential evidence from 11,000 randomized patients. Source Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Kholeif Z.; Mohamed A.E.; Elnady M.; Abomohsen M.; Alomari A.; Rashwan R.; Tahhan I.S.; Elnashar M.; Khalafallah M.A.; Sharaf M.; Gadelmawla A.F.; Afify R.; Awashra A.; Ali A.E.; Elkasaby H.; Kietselaer B. Institution (Kholeif, Kietselaer) Cardiology Department, Mayo Clinic, Rochester, MN, United States (Kholeif) Baptist Hospital of Southeast Texas, Beaumont, TX, United States (Mohamed, Sharaf, Afify) New York University, Langone Health, Manhattan, NY, United States (Elnady) Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Abomohsen) Department of Internal Medicine, Brookdale University Hospital and Medical Center, Brooklyn, NY, United States (Alomari) Department of Clinical Medical Sciences, Yarmouk University Faculty of Medicine, Irbid, Jordan (Rashwan) Department of Internal Medicine, NYC Health and Hospitals/Lincoln, Bronx, NY, United States (Tahhan) Department of Internal Medicine, Wellington Regional Medical Center, Wellington, FL, United States (Elnashar) Department of Internal Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, United States (Khalafallah) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Awashra) Department of Medicine, An Najah National University, Nablus, Palestine (Ali) Department of Internal Medicine, Crestwood Medical Centre, Huntsville, AL, United States (Elkasaby) Newgiza University School of Medicine, Giza, Egypt Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Objectives To perform an updated meta-analysis assessing the effect of routine cerebral embolic protection (CEP) use on the incidence of stroke-disabling and non-disabling-following transcatheter aortic valve replacement (TAVR). Methods Electronic databases were systematically searched through August 2025 for eligible randomized controlled trials (RCTs) comparing CEP versus no CEP in TAVR. The primary outcomes were the incidence of overall stroke, disabling stroke, and non-disabling stroke at 2-5 days and 30 days post-procedure. Random-effects model was used to estimate risk ratios (RR) with 95% confidence intervals (CI). Evaluation of the certainty of evidence was done following the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Trial sequential analysis was performed to assess the conclusiveness and the reliability of the data. Results Eight RCTs, including 11,692 patients, were analyzed. No statistically significant difference was observed in overall stroke incidence between CEP and control groups at 2-5 days (RR = 0.95; 95% CI: 0.75-1.19; p = 0.64) or at 30 days (RR = 0.93; 95% CI: 0.57-1.53; p = 0.79). Disabling stroke rates were also similar at 2-5 days (RR = 0.70; 95% CI: 0.41-1.18; p = 0.18) and at 30 days (RR = 1.18; 95% CI: 0.36-3.87; p = 0.78). Non-disabling stroke showed no significant difference at either time point. Safety outcomes, including major bleeding, vascular complications, and acute kidney injury, were also not significantly different. Conclusion This updated meta-analysis found that a routine CEP strategy during TAVR was not associated with a statistically significant reduction in overall, disabling, or non-disabling stroke. The neutral effect on safety endpoints suggests a limited role for routine CEP use, although smaller benefits, device-specific effects, or benefits in selected higher-risk patients cannot be excluded. Copyright © 2026 Japanese College of Cardiology. <64> Accession Number 2045870704 Title Outcomes of Transcatheter Aortic Valve Implantation with Abbott's Portico Compared to Edwards' SAPIEN 3: A Systematic Review and Meta-Analysis. Source Journal of Clinical Medicine. 15(10) (no pagination), 2026. Article Number: 3573. Date of Publication: 01 May 2026. Author Gozdek M.; Kowalewski M.; Urbanowicz T.; Raffa G.M. Institution (Gozdek, Kowalewski, Urbanowicz) Thoracic Research Centre, Innovative Medical Forum, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland (Kowalewski) Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior, Warsaw, Poland (Kowalewski) Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Urbanowicz) Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland (Raffa) IRCCS-ISMETT, Palermo, Italy (Raffa) Cardiac Surgery, Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, Palermo, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Nowadays, transcatheter aortic valve implantation (TAVI) is widespread in patients with severe aortic valve stenosis. New prosthesis designs are becoming available to address the shortcomings of their predecessors and improve clinical outcomes. Method(s): Electronic databases were screened for studies comparing outcomes of TAVI with Portico and SAPIEN 3. In a random-effects meta-analysis the pooled incidence rates of procedural, clinical and functional outcomes, according to VARC-2 definitions, were assessed. Result(s): Thirteen observational studies and one multi-center randomized clinical trial enrolling 20,522 patients (Portico N = 3001 and SAPIEN 3 N = 17,521) were included in the analysis. The need for more than one prosthesis during initial implantation was significantly higher among Portico recipients compared to SAPIEN 3 recipients: (RR 2.72 [1.36, 5.45] p = 0.005). Pre- and post-dilatation were performed more frequently in the Portico group (RR 1.53 [1.12, 2.09], p = 0.008 and RR 4.21 [2.83, 6.26], p < 0.00001, respectively). Moderate-to-severe paravalvular leak (PVL) was significantly more common in the Portico arm (RR 3.27 [1.80, 5.91] p < 0.0001). In contrast, the mean gradient and rate of prosthesis-patient mismatch (PPM) was significantly lower in the Portico group (MD -31.58 [-37.02; -26.14] mmHg and RR 0.42 [0.32, 0.55], p < 0.00001). Recipients of Portico demonstrated over 60% higher risk of permanent pacemaker implantation (PPI) compared to SAPIEN 3 (RR 1.62 [1.25, 2.10], p = 0.0002). Other procedural and short-term clinical outcomes, including neurologic events, major vascular complications, life threatening or major bleeding, acute kidney injury, myocardial infarction and mortality did not differ between the devices. A difference in mortality was observed at the 1-year follow-up (RR 1.26 [1.06, 1.51], p = 0.01; I2 = 5%). Conclusion(s): The evidence shows good short-term outcomes for both valves. Compared to SAPIEN 3, Portico was associated with a significantly higher rate of moderate-to-severe PVL and PPI, but a lower mean gradient and incidence of PPM. A significantly higher 1-year mortality was observed in the Portico group. Copyright © 2026 by the authors. <65> Accession Number 2046074639 Title Effect of renin-angiotensin system inhibition on left ventricular mass regression after transcatheter aortic valve replacement: a randomised controlled trial. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Shao R.; Huang F.-Y.; Liao Y.; Li Y.-M.; Wang D.; Xiong T.; Li Y.-J.; Li C.; Zhao Z.-G.; Peng Y.; Wei J.-F.; He S.; Yang Y.; Fan Z.; Dai M.; Jin J.; Fang Z.; Xu K.; Feng Y.; Han Y.; Chen M. Institution (Shao, Huang, Liao, Li, Xiong, Li, Li, Zhao, Peng, Wei, He, Feng, Chen) Department of Cardiology, Laboratory of Cardiac Structure and Function at Institute of Cardiovascular Diseases, Cardiac Structure and Function Research Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Sichuan, Chengdu, China (Wang) Liverpool School of Tropical Medicine, Liverpool, United Kingdom (Yang) First Affiliated Hospital of Xinjiang Medical University, Urumqi, China (Fan) The Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, China (Dai) Mianyang Central Hospital, Mianyang, China (Jin) Army Medical University Xinqiao Hospital, Chongqing, China (Fang) The Second Xiangya Hospital, Central South University, Changsha, China (Xu, Han) Department of Cardiology, General Hospital of Northern Theatre Command, Liaoning, Shenyang, China Publisher BMJ Publishing Group Abstract Background: Residual left ventricular (LV) hypertrophy and incomplete reverse remodelling after transcatheter aortic valve replacement (TAVR) are associated with adverse outcomes. Whether renin-angiotensin system inhibitors (RASi) promote reverse remodelling in patients with heart failure and LV ejection fraction (LVEF) >=40% following TAVR remains uncertain. Method(s): In this multicentre, prospective, randomised, open-label, blinded-endpoint trial, patients aged >=60 years with symptomatic severe aortic stenosis, LVEF >=40% and successful TAVR were randomly assigned (1:1) to standard care alone or standard care plus RASi (ACE inhibitor, angiotensin II receptor blocker or angiotensin receptor-neprilysin inhibitor). The primary endpoint was change in LV mass index (LVMI) at 12 months. Secondary endpoints included changes in LV volumes, LVEF, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and functional status. Result(s): A total of 200 patients were randomised; 194 were included in the modified intention-to-treat analysis (RASi n=95; control n=99). At 12 months, RASi therapy was associated with a greater reduction in LVMI compared with control (adjusted mean difference -12.77 g/m2, 95% CI -24.73 to -0.81; p=0.036). Consistent improvements were observed in LV end-diastolic and end-systolic volumes. Functional status (New York Heart Association class) improved modestly in the RASi group. No significant differences were observed in LVEF or NT-proBNP. Conclusion(s): In patients with heart failure and LVEF >=40% following TAVR, RAS inhibition led to enhanced reverse LV remodelling over 12 months, reflected by greater regression of LV mass and volumes. These findings support the potential role for RASi in modifying post-TAVR myocardial remodelling, although larger trials are required to determine whether these structural benefits translate into improved clinical outcomes. Trial registration number: ChiCTR2100042266. Copyright © Author(s) (or their employer(s)) 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <66> Accession Number 2046078160 Title High-flow nasal cannula in cardiothoracic surgery: A scoping review of perioperative applications, effectiveness, and evidence gaps. Source Trends in Anaesthesia and Critical Care. 69 (no pagination), 2026. Article Number: 101664. Date of Publication: 01 Aug 2026. Author Chaves C.C.; Santos F. Institution (Chaves, Santos) Department of Anesthesiology, Unidade Local de Saude de Sao Joao, Alameda Professor Hernani Monteiro, Porto, Portugal Publisher Churchill Livingstone Abstract Background: Acute respiratory failure is a common postoperative complication following cardiothoracic surgery, associated with increased morbidity, mortality, and prolonged hospital stay. High-flow nasal cannula (HFNC) delivers heated, humidified gas at high flow rates, improving oxygenation and patient comfort compared with conventional oxygen therapy. Objective(s): To synthesize current evidence on HFNC in adult cardiothoracic surgery, focusing on physiological rationale, clinical efficacy, and implementation. Method(s): A scoping review was conducted following JBI methodology and PRISMA-ScR guidance, including randomized trials, controlled studies, and meta-analyses evaluating HFNC across perioperative phases. Data were synthesized with outcomes, including oxygenation, reintubation, and escalation of respiratory support. Result(s): Postoperative evidence suggests that HFNC is associated with reduced reintubation and need for escalation of respiratory support. Several studies show HFNC comparable to non-invasive ventilation in preventing post-extubation respiratory failure, with imporved tolerance. Evidence for preoperative and intraoperative use remains limited and heterogeneous, largely extrapolated from non-cardiothoracic populations. Conclusion(s): HFNC is a well-tolerated and relevant option for postoperative respiratory support in cardiothoracic surgery. However, optimal indications, patient selection, and titration strategies remain incompletely defined, highlighting the need for well-designed trials. Copyright © 2026 Elsevier Ltd <67> Accession Number 2045835605 Title The Prophylactic Effect of Dexmedetomidine 0.008% Versus Brimonidine 0.2% on IOP Elevation After Nd: YAG Laser Capsulotomy. Source Pharmacology Research and Perspectives. 14(3) (no pagination), 2026. Article Number: e70227. Date of Publication: 01 Jun 2026. Author Zakeri P.; Akhavanakbari G.; Ojaghi H.; Amani F. Institution (Zakeri) Ardabil University of Medical Sciences, Ardabil, Iran, Islamic Republic of (Akhavanakbari) Department of Anesthesiology, Ardabil University of Medical Sciences, Ardabil, Iran, Islamic Republic of (Ojaghi) Department of Ophthalmology, Ardabil University of Medical Sciences, Ardabil, Iran, Islamic Republic of (Amani) Department of Community Medicine and Biostatistics, Ardabil University of Medical Sciences, Ardabil, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Posterior capsule opacification (PCO) is a common post-cataract surgery complication treated with Nd:YAG laser posterior capsulotomy, which may cause intraocular pressure (IOP) spikes and threaten vision. Brimonidine and apraclonidine are widely used to prevent such elevations. This prospective, double-masked, randomized clinical trial evaluated the efficacy of topical dexmedetomidine, a novel ophthalmic drop, in preventing IOP rise after Nd:YAG laser treatment. A total of 111 eyes from 89 pseudophakic patients were randomized to receive dexmedetomidine 0.008% or brimonidine 0.2% one h before the procedure. Patients with glaucoma, baseline IOP > 24 mmHg, keratoconus, corneal edema, prior refractive/corneal surgery, or unstable cardiovascular disease were excluded. IOP was measured with air-puff tonometry at baseline, 30 min, 4 h, and 24 h post-laser. Baseline characteristics were comparable. In the dexmedetomidine group, mean IOP values were 16.3 +/- 3.6, 14.8 +/- 4.7, 17.1 +/- 6.2, and 16.7 +/- 4.5 mmHg, while in the brimonidine group, they were 16.7 +/- 2.9, 13.3 +/- 3.9, 13.2 +/- 5.5, and 14.2 +/- 3.9 mmHg, respectively. At 30 min, brimonidine significantly reduced IOP (p = 0.000), whereas dexmedetomidine did not (p = 0.116). At 4 and 24 h, IOP increased above baseline with dexmedetomidine but decreased with brimonidine (p = 0.001 and p = 0.004). Dexmedetomidine was associated with more IOP spikes > 10 mmHg (9% vs. 2%, p = 0.035) and IOP > 30 mmHg (7% vs. 2%, p = 0.09). No systemic or ocular side effects occurred. Although dexmedetomidine prevented acute IOP surges, its efficacy was inferior to brimonidine. Further studies should explore optimal dosing, formulations, and long-term safety to clarify its prophylactic potential. Copyright © 2026 The Author(s). Pharmacology Research & Perspectives published by British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics and John Wiley & Sons Ltd. <68> Accession Number 2045791425 Title Beyond the Maze: Hybrid Ablation and Left Atrial Appendage Occlusion in Cardiac Surgery: Evidence Synthesis and the MESAGE Study Protocol. Source Medicina (Lithuania). 62(5) (no pagination), 2026. Article Number: 890. Date of Publication: 01 May 2026. Author Kotoulas S.C.; Kolovos V.; Tsiamis N.; Kotoulas A.; Georgiou C.; Tsipas P.; Panagiotou I.; Antoniadis D.; Kotoulas C. Institution (Kotoulas, Kotoulas, Georgiou, Tsipas, Panagiotou, Kotoulas) Department of Cardiothoracic Surgery, 401 General Military Hospital of Athens, Panagiotis Kanellopoulos Avenue, Athens, Greece (Kolovos, Antoniadis) Department of Cardiology and Electrophysiology, 401 General Military Hospital of Athens, Athens, Greece (Tsiamis) Department of Cardiology, Sismanoglio General Hospital, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Atrial fibrillation (AF) is the most common cardiac arrhythmia, present in up to 14-20% of patients undergoing cardiac surgery, with the number of patients expected to double within the next decade. Despite a Class I recommendation for concomitant surgical ablation and a Class I-B recommendation for left atrial appendage (LAA) occlusion in patients with AF undergoing cardiac surgery (Class IIa for endoscopic or hybrid AF ablation), both procedures remain substantially underutilized in clinical practice. The design of the Mapping atrial fibrillation after Epicardial Surgical Ablation plus AtriClip to Guide Endocardial ablation (MESAGE) prospective study is presented. Material(s) and Method(s): A narrative literature review was conducted using PubMed through March 2025. Randomized controlled trials, multicenter registries, meta-analyses and current clinical guidelines were prioritized. The MESAGE study protocol is presented in accordance with the SPIRIT recommendations. Result(s): Randomized evidence demonstrates that hybrid ablation achieves 32-48% greater arrhythmia freedom than catheter ablation (CA) alone in persistent and long-standing persistent AF, with comparable safety and significantly fewer interventions at two-year follow-up. Epicardial LAA occlusion with the AtriClip device achieves complete occlusion in all patients with an 87.5% relative reduction in ischemic stroke risk in anticoagulation-free follow-up. Continuous implantable loop recorder (ILR)-based monitoring reveals AF recurrence in substantially more patients than conventional monitoring, with AF burden emerging as a more meaningful endpoint than arrhythmia freedom. The MESAGE study enrolls 40 patients undergoing cardiac surgery who have pre-existing AF, pre-randomized 1:1 to pulmonary vein isolation (PVI) alone versus PVI-BOX, with mandatory pre-operative ILR implantation, intra-operative AtriClip LAA exclusion, and systematic Day-60 endocardial mapping and supplementary ablation using the Affera dual-energy system. Conclusion(s): Hybrid epicardial-endocardial ablation combined with LAA exclusion and continuous ILR monitoring represents a comprehensive, mechanistically rational and evidence-informed approach to AF management in patients undergoing cardiac surgery, although current evidence remains heterogeneous, and the benefits depend on the AF phenotype and monitoring strategy. The MESAGE pilot study will generate hypothesis-generating prospective comparative data on epicardial PVI versus PVI-BOX in the concomitant surgical setting, assessed through systematic post-surgical endocardial mapping and continuous rhythm monitoring. Copyright © 2026 by the authors. <69> Accession Number 2045871115 Title Efficacy and Safety of Open-Source Hybrid Closed-Loop Automated Insulin Delivery in Perioperative Patients. Source Biomedicines. 14(5) (no pagination), 2026. Article Number: 1098. Date of Publication: 01 May 2026. Author Ma D.; Xu W.; Yang Y.; Bai L.; Xie J.; Tao J.; Xu S.; Dong K.; Shi X.; Song X.; Zhu Y.; Sun N.; Huang G.; Liu F.; Hu X.; Li J.; Li M.; Ao T.; Yuan J.; Yu X.; Liu Z. Institution (Ma, Xu, Yang, Bai, Xie, Tao, Xu, Dong, Shi, Song, Zhu, Sun, Huang, Yu, Liu) Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Ma, Xu, Yang, Bai, Xie, Tao, Xu, Dong, Shi, Song, Zhu, Sun, Huang, Yu, Liu) Hubei Clinical Medical Research Center for Endocrinology and Metabolic Diseases, Wuhan, China (Ma, Xu, Yang, Bai, Xie, Tao, Xu, Dong, Shi, Song, Zhu, Sun, Huang, Yu, Liu) Branch of National Clinical Research Center for Metabolic Disease, Wuhan, China (Tao, Sun, Huang) Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Liu, Hu, Li, Li, Ao, Yuan) Wuhan United Imaging Healthcare Surgical Technology Co., Ltd., Wuhan, China Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Evidence supports the effectiveness and safety of open-source automated insulin delivery (AID) in patients with type 1 diabetes. However, evidence regarding the clinical application of open-source AID in perioperative patients with type 2 diabetes remains limited. Method(s): This was an open-label, single-center, exploratory pilot randomized controlled trial (RCT) with parallel groups. Patients with diabetes (excluding type 1 diabetes mellitus) scheduled for elective surgery were randomly assigned to the closed-loop group (open-source hybrid closed-loop AID system) or the control group (conventional insulin pump). The primary outcome was the percentage of time in the target glucose range (TIR, 3.9-10.0 mmol/L). Other efficacy and safety outcomes were also compared between the groups. Result(s): A total of 49 participants were included and randomized to the closed-loop group (n = 25) or the control group (n = 24). Participants underwent abdominal, orthopedic, thoracic surgery, or neurosurgery during hospitalization. Patients in the closed-loop group had significantly higher TIR than patients in the control group (76.4 +/- 14.1% vs. 61.2 +/- 20.0%, p = 0.005). Compared with the control group, the closed-loop group also exhibited a 15.6 percentage point reduction in time above range (TAR, >10 mmol/L) without increasing time below range (TBR, <3.9 mmol/L). There were no episodes of severe hypoglycemia (<2.2 mmol/L) or diabetic ketoacidosis in either group. Conclusion(s): This study demonstrates that in patients with diabetes undergoing elective surgery, the open-source hybrid closed-loop AID system provides better glycemic control than conventional insulin pump therapy. Copyright © 2026 by the authors. <70> Accession Number 651296907 Title Lipoprotein(a) Levels, Risk of Cardiovascular Events and Benefit of Evolocumab: Findings From the VESALIUS-CV Trial. Source Circulation. (no pagination), 2026. Date of Publication: 25 May 2026. Author Monguillon V.; Marston N.A.; Bohula E.A.; Park J.-G.; Kuder J.F.; Murphy S.A.; De Ferrari G.M.; Leiter L.A.; Nicolau J.C.; Ebenbichler C.; Sinnaeve P.; Goudev A.; Budaj A.; Averkov O.; Tokgozoglu L.; Blankstein R.; Vinereanu D.; Giugliano R.P.; Sabatine M.S.; O'Donoghue M.L. Institution (Monguillon, Marston, Bohula, Park, Kuder, Murphy, Giugliano, Sabatine, O'Donoghue) Thrombolysis in Myocardial Infarction (TIMI) Study Group, Boston, MA; Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (De Ferrari) Cardiology Division, Department of Medical Sciences, University of Turin and Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza, Turin, Italy (Leiter) Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Toronto, Canada (Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil (Ebenbichler) Medical University Innsbruck Innsbruck, Austria (Sinnaeve) Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven: Leuven, Flanders, Belgium (Goudev) Medical University of Sofia, Sofia, Bulgaria (Budaj) Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland (Averkov) Pirogov Russian National Research Medical University and Hadassah Medical Ltd., Moscow, Russian Federation (Tokgozoglu) Hacettepe University, Ankara, Turkey (Blankstein) Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (Vinereanu) University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania Abstract BACKGROUND: Lipoprotein(a) [Lp(a)] is a risk factor for coronary heart disease. Whether baseline Lp(a) identifies higher risk patients who derive more benefit from evolocumab is not established in a population without prior myocardial infarction (MI) or stroke. METHOD(S): From June 2019 to November 2021, the VESALIUS-CV trial enrolled patients with qualifying atherosclerosis or high-risk diabetes, without prior MI or stroke and randomized them to evolocumab or placebo (median follow-up 4.6 years). In a prespecified analysis, Lp(a) was assessed at baseline in 7557 patients. Cox models were used to assess the adjusted risk of cardiovascular events by baseline Lp(a) in the placebo arm, and the efficacy of evolocumab by baseline Lp(a). The primary outcome of interest was the composite of major coronary events (coronary heart disease death, MI or urgent coronary revascularization). RESULT(S): Median age was 66 [interquartile range 60-71] years and 42.8% were women; median Lp(a) was 28 (interquartile range 9-132) nmol/L. Higher baseline Lp(a) was associated with an increased risk of major coronary events (HRadjusted per 100 nmol/L increase in Lp(a): 1.15; 95%CI 1.05-1.26; P=0.004), particularly for MI (HR: 1.23; 1.10-1.38; P<0.001). There was no association between Lp(a) and ischemic stroke (HR: 1.00; 0.84-1.19; P=0.99). After 48 weeks, evolocumab reduced LDL-C by 66.8 mg/dL and Lp(a) by 38.0 nmol/L in patients with baseline Lp(a) >105 nmol/L vs. 61.1 mg/dL and 6.0 nmol/L in those with baseline Lp(a) <=105 nmol/L. The relative reductions in risk of major coronary events were 41% (HR 0.59; 95%CI 0.41-0.83) in those with Lp(a) >105 nmol/L compared with 35% (HR 0.65; 95%CI 0.51-0.82) in those below (P-interaction=0.45; Lp(a) modeled as continuous variable). The corresponding absolute reductions were 3.7% vs. 2.5% (P-interaction=0.09), corresponding to a NNT of 28 versus 40 to prevent one major coronary event at 5 years. CONCLUSION(S): In patients with atherosclerosis or high-risk diabetes but without prior MI or stroke, Lp(a) was independently associated with an increased risk of major coronary events, but not ischemic stroke. Evolocumab reduced the relative risk of major coronary events to a similar degree irrespective of baseline Lp(a), with a numerically greater absolute risk reduction in patients with elevated Lp(a). <71> Accession Number 2045791549 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. 15(9) (no pagination), 2026. Article Number: e050299. Date of Publication: 01 Jan 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, United States (Neves) Universidade do Estado do Para (UEPA) Belem, Para, Brazil (Consoli) Universidade Federal da Bahia (UFBA), Salvador, Brazil (Iqbal) Bacha Khan Medical College, Mardan, Pakistan (Dexheimer) Universidade de Sao Paulo (USP) Sao Paulo, Brazil (da Hora) Universidade Federal do Amazonas (UFAM), Manaus, Brazil (Camarotti) Universidade de Pernambuco, Recife, Brazil (Jacquemyn) UPMC Heart and Vascular Institute, University of Pittsburgh, Pittsburgh, PA, United States Publisher American Heart Association Inc. 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. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. JAHA is available at: www.ahajournals.org/journal/jaha <72> Accession Number 2045791722 Title Evidence-Based Strategies for the Prevention of Cardiac Implantable Electronic Device Infections: An Up-to-Date Narrative Review. Source Medicina (Lithuania). 62(5) (no pagination), 2026. Article Number: 991. Date of Publication: 01 May 2026. Author Rimkiene M.A.; Sudaviciene D.; Rackauskas G.; Jurkuvenas P.; Gorevska V.; Stukas J.; Marinskis G. Institution (Rimkiene, Sudaviciene, Rackauskas, Jurkuvenas, Stukas, Marinskis) Clinic of Cardiac and Vascular Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania (Jurkuvenas, Gorevska) Department of Cardiac Arrhythmias, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Cardiac implantable electronic device (CIED) infections remain among the most serious complications of pacemaker, implantable cardioverter-defibrillator, and cardiac resynchronization therapy procedures. They are associated with substantial morbidity, mortality, prolonged hospitalization, system extraction, long-term antimicrobial therapy, and increased healthcare costs. As most infections arise from perioperative contamination or procedure-related complications, prevention has become a major priority in contemporary electrophysiology practice. This review aimed to summarize current evidence on the prevention of CIED infections, with particular emphasis on modifiable risk factors and perioperative preventive measures. Material(s) and Method(s): A focused narrative review was undertaken using targeted searches of PubMed/MEDLINE and Scopus, supplemented by major international guideline and consensus documents, with priority given to contemporary guidelines, randomised trials, meta-analyses, and major observational studies relevant to CIED infection prevention. Result(s): Prevention of CIED infection requires a structured, multifactorial approach spanning the entire procedural pathway. Key preventive strategies include careful reassessment of device indication, individualized device selection, correction of modifiable risk factors, postponement of elective implantation in the presence of active infection, appropriate perioperative antibiotic prophylaxis, and optimized management of anticoagulant and antiplatelet therapy to minimize pocket hematoma. Additional relevant measures include meticulous skin antisepsis, limitation of temporary invasive devices and unnecessary hardware, appropriate venous access selection, careful generator pocket creation and wound closure, and avoidance of early reintervention whenever feasible. Antibacterial envelopes may reduce major CIED infections in selected high-risk patients, whereas routine escalation of preventive measures without proven benefit is not supported. Conclusion(s): CIED infection prevention is inherently multifactorial and depends on the consistent application of evidence-based measures before, during, and after device implantation. Rigorous control of modifiable risk factors, prevention of pocket hematoma, appropriate antimicrobial prophylaxis, and meticulous procedural technique remain the cornerstones of effective infection prevention in patients undergoing CIED procedures. Copyright © 2026 by the authors. <73> Accession Number 2045791736 Title Minimally Invasive Aortic Valve Surgery: State-of-the-Art Review of Transaxillary, Thoracotomy, and Ministernotomy Approaches. Source Life. 16(5) (no pagination), 2026. Article Number: 777. Date of Publication: 01 May 2026. Author Kowalowka A.R.; Jodlowski M.; Bachowski R.; Gocol R. Institution (Kowalowka, Jodlowski, Bachowski, Gocol) Department of Cardiac Surgery, Upper-Silesian Heart Center, Katowice, Poland (Kowalowka, Jodlowski, Bachowski, Gocol) Department of Cardiac Surgery, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Minimally invasive aortic valve replacement (MIAVR) via transaxillary access, right anterior thoracotomy (RAT), and ministernotomy has matured from niche innovation to guideline-endorsed standard, yet comparative data remain heterogeneous and fragmented. Objective(s): This state-of-the-art review synthesizes contemporary evidence to define the role of each approach within modern valve care pathways. Method(s): A PRISMA 2020 systematic review with PROSPERO registration identified studies reporting outcomes of isolated AVR performed through transaxillary, RAT, or ministernotomy access. Primary endpoints were 30-day mortality, operative times, and length of stay; secondary endpoints included complications, long-term survival, learning curves, and patient-reported outcomes. Result(s): Forty-two studies encompassing 15,328 patients were included: transaxillary (n = 2156), RAT (n = 4892), and ministernotomy (n = 8280). All approaches achieved excellent perioperative safety (mortality 0.4-2.5%) and long-term survival comparable to full sternotomy, while consistently reducing blood loss, transfusion, ventilation time, and hospital stay. Ministernotomy offered the broadest anatomical applicability and the shortest learning curve (20-30 cases). RAT combined complete sternal preservation, the lowest bleeding rates, and superior cosmetic and functional recovery in anatomically suitable patients. Transaxillary access provided hidden scarring and attractive options in redo or sternum-avoidance scenarios, but higher reported stroke rates (2.0-6.3%) and greater technical demands limited its use to high-volume centers. Conclusion(s): MIAVR via ministernotomy, RAT, and transaxillary access now represents a mature, durable alternative to full sternotomy. A structured, anatomy- and center experience-driven selection strategy is essential to fully realize its benefits across diverse patient populations. Copyright © 2026 by the authors. <74> Accession Number 2046011402 Title Medical Specialty Societies: How Much Is Too Much?. Source Journal of Vascular Surgery. Conference: Journal of Vascular Surgery. Boston United States. 84(1) (pp e266), 2026. Date of Publication: 01 Jul 2026. Author Tulimieri M.; Eagleton M.J.; Yassa E.; Ascher E.; Kashyap V. Institution (Tulimieri, Eagleton) Massachusetts General Hospital, Boston, MA, United States (Yassa, Kashyap) Corewell Health, Michigan State University, Grand Rapids, MI, United States (Ascher) Department of Surgery, NYU Langone Brooklyn, Brooklyn, NY, United States (Ascher) Vascular Institute of New York, Brooklyn, NY, United States Publisher Elsevier Inc. Abstract Objectives: Medical societies play an important role in representing physicians and their interests. Our objective was to compare the number, size, and fiscal strength of vascular societies to other cardiovascular specialties. Method(s): All information was found via a systematic Internet search and with publicly available data (www.aamc.org). Medical societies representing vascular surgery, cardiology, cardiothoracic surgery (CTS), and interventional radiology (IR) in the United States were compared. Board-certified physicians (www.abms.org) and publicly available financial information were tabulated (www.ProPublica.org). Result(s): Board-certified vascular surgeons (n = 4464) can choose to join 31 vascular societies (5 national, 10 regional, 12 city/state, 4 other). In comparison, 12 societies (2 national) represent CTS (n = 5869) and 16 societies (1 national) represent IR (n = 4032) physicians. Cardiologists (n = 22843) are represented by 14 (5 national) societies and an additional 27 chapters of a parent national society. The available number of vascular surgeons per national society is markedly lower than comparative specialties (Fig). Vascular societies generated $23M in revenue (2023 data) compared to $52M for CTS, $6M for IR, and $1.03B for cardiology. Cardiology societies generated 93% of the total revenue of these four specialties. National cardiology societies have 52 times the total revenue compared to vascular societies and 55 times the total assets ($1.97B vs $36M). Conclusion(s): Compared to similar specialties, vascular surgery has few surgeons, yet a high number of medical societies. This is particularly true when looking at the number of national societies relative to the number of surgeons. This fragmentation may dilute the medical, governmental, societal, and patient advocacy impact of vascular surgery compared to its peers. [Formula presented] Copyright © 2026 <75> Accession Number 651282399 Title PLEURAL INTERVENTIONS FOR HEART FAILURE ASSOCIATED PLEURAL EFFUSIONS: A SYSTEMATIC REVIEW. Source Internal Medicine Journal. Conference: Thoracic Society of Australia and New Zealand and the Australian and New Zealand Society of Respiratory Science Annual Scientific Meeting, TSANZSRS 2026. Perth Australia. 56(Supplement 1) (pp 123), 2026. Date of Publication: 01 Mar 2026. Author Nigole W.; Huan N.-C.; Wong C.; De Silva K.; Lim W.; Jeffrey G.; McQuillan B.; Peddle McIntyre C.J.; Lee Y.C.G. Institution (Nigole, Huan, Wong, Peddle McIntyre, Lee) Centre for Innovative Pleural Research, North Metro Health Services, Australia (Nigole, Huan, Wong, Peddle McIntyre, Lee) Pleural Medicine Unit, Institute for Respiratory Health, Australia (Nigole, Lim, Jeffrey, McQuillan, Peddle McIntyre, Lee) Medical School, University of Western Australia, Australia (Huan, Lim, Peddle McIntyre) School of Medical & Health Sciences, Edith Cowan University, Perth, Australia (Huan) Dept of Respiratory Med, Queen Elizabeth Hospital, Sabah, Malaysia (Wong) Dept of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong (Nigole, Lee) Depts of Respiratory Med, Sir Charles Gairdner Hospital, Perth, Australia (Nigole, De Silva) Depts of Pulmonary Physiology, Sir Charles Gairdner Hospital, Perth, Australia (Lim) Depts of Renal Med, Sir Charles Gairdner Hospital, Perth, Australia (Jeffrey) Depts of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia (McQuillan) Depts of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia Publisher John Wiley and Sons Inc Abstract Introduction/Aim: Heart failure associated pleural effusions (HFaPEf) is the most common cause of pleural effusions but is under-researched despite its significant symptom and healthcare burdens. Diuresis is the first-line treatment of HFaPEf, however refractory cases often require pleural interventions. Robust evidence for intervention is limited, and current practice is largely extrapolated from studies of exudative effusions. This systematic review aimed to comprehensively evaluate the evidence supporting pleural interventions for HFaPEf. Method(s): We conducted a systematic review of pleural interventions for HFaPEf using the databases of Medline, CINAHL Complete, Embase, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials. Interventions include thoracentesis, pleurodesis, intercostal catheters (ICC), indwelling pleural catheters (IPC), and surgery. Paediatric, animal, non-English studies, abstracts, and case series fewer than five patients were excluded. Outcomes include clinical effectiveness, health care utilisations, impact on heart failure management, procedure feasibility and complications. Result(s): Fifteen studies [13 observational, 2 randomised control trials (RCT)] met the inclusion criteria, encompassing all pleural interventions except surgery. An RCT comparing thoracentesis with conservative therapy showed no benefit in length of hospital stay, readmission rates and mortality over 90 days. However, observational studies found thoracentesis provided sustained reduction of breathlessness for up to six months, although many still required repeat interventions. In contrast, three observational studies evaluating IPCs reported improved dyspnoea scores, fewer need for repeat interventions, and spontaneous pleurodesis in a subset of patients. A 12-week multi-centre RCT comparing IPC drainage and repeated thoracenteses found no significant difference in breathlessness outcomes. The use of sclerosing agents predictably increased pleurodesis success rate. Across all interventions, major complications were uncommon. Long-term clinical outcomes and impact on heart failure management were seldom reported highlighting a gap in current literature. Conclusion(s): Current evidence for pleural interventions in HFaPEf is limited and mostly observational. High quality RCTs are urgently needed to establish optimal practice in this population. <76> Accession Number 651281743 Title USE OF TPA-DNASE IN THE MANAGEMENT OF PLEURAL INFECTION IN A TERTIARY HOSPITAL WITH A DEDICATED PLEURAL SERVICE. Source Internal Medicine Journal. Conference: Thoracic Society of Australia and New Zealand and the Australian and New Zealand Society of Respiratory Science Annual Scientific Meeting, TSANZSRS 2026. Perth Australia. 56(Supplement 1) (pp 116), 2026. Date of Publication: 01 Mar 2026. Author Griffiths S.; Foley E.; O'Connor C.; Fitzgerald D. Institution (Griffiths, Foley, Fitzgerald) Respiratory Department, Tallaght University Hospital, Ireland Publisher John Wiley and Sons Inc Abstract Introduction: Up to 30% of patients with pleural infection fail initial therapy with antimicrobials and chest drain insertion and require surgical intervention. Intrapleural enzyme therapy treatment for complicated parapneumonic effusions or empyema, with alteplase (tPA) and dornase alfa (DNase), reduced the rate of surgical referral and duration of hospital stay in the MIST2 RCT. An observational series reported 92.3% of patients treated with tPA/DNase were managed without surgical intervention. Method(s): We conducted a retrospective, single centre review of tPA/DNase treatment for pleural infection. A secure Excel database was collated via chart review to analyse demographic data, radiology, laboratory results and follow-up between 2022 and 2025. Outcomes measured include: 1. Nature of patient presentation 2. Pleural intervention 3. Pleural fluid analysis 4. Length of stay 5. Re-intervention rate Results: 30 patients were included, 33.3% (10) female and 66.6% (20) male, with a mean age of 64.1 +/- 19.5 SD. Reported symptoms included dyspnoea (76%), chest pain (67%) and cough (63%). 93% (n = 28) of patients had a chest drain inserted, 7% (n = 2) were treated via indwelling pleural catheter (IPC). Pleural fluid analysis: mean pH 7.07 +/- 0.24; n = 17, mean LDH 999 +/- 323; n = 25, mean glucose 3.4 +/- 2.19; n = 19, mean protein 42.6 +/- 7.75; n = 27. 10% (n = 3) had positive pleural fluid culture. The standard starting dose of tPA was 5mg OD and no patient required escalation to 10mg, with tPA and DNase administered concurrently. The average length of stay was 22.8 days (median 19 days; IQR 18.75). No patients required surgical intervention. One patient required re-intervention post initial therapy, with repeat diagnostic thoracentesis and chest drain insertion. 73% (n = 22) were followed up in the pleural respiratory clinic with no residual symptoms. Conclusion(s): This analysis shows a low rate of referral to cardiothoracic surgery and re-intervention post tPA/DNase. The length of stay is(Figure presented)significantly skewed by a small number of extended hospital days, likely reflecting the significant morbidity associated with pleural infection. In appropriately selected patients, tPA/DNase is an effective treatment for pleural infection. <77> Accession Number 651280307 Title First-phase ejection fraction as a marker for timely intervention in pressure-overload rat model. Source Echo Research and Practice. Conference: British Society of Echocardiography Annual Meeting 2025. Bournemouth United Kingdom. 13(1 Supplement) (no pagination), 2026. Article Number: 9. Date of Publication: 01 Apr 2026. Author He S.; Wang J.; Gu H. Institution (He, Wang) Huazhong University of Science and Technology, Wuhan, China (Gu) King's College London, United Kingdom Publisher BioMed Central Ltd Abstract Background First-phase ejection fraction (EF1), a novel yet simple measure of early systolic function, has previously been shown to be a strong predictor of adverse outcomes in patients with aortic stenosis and is closely associated with myocardial fibrosis in pressure-overload heart failure rat models. However, it remains unclear whether early intervention-such as aortic valve replacement-can reverse early systolic dysfunction identified by EF1. Purpose To evaluate, in a randomized controlled trial using an aortic banding (AB) rat model, whether EF1-guided early intervention (aortic debanding) can reverse cardiac remodeling and improve early systolic function. Methods Abdominal AB was performed in 36 rats to induce pressure-overload, mimicking aortic stenosis. An additional 12 rats underwent a sham procedure and served as controls. The AB rats were randomly assigned to either an EF1-guided or EF-guided intervention group. Echocardiography was performed weekly to monitor EF1 and EF changes. In the EF1 group, debanding was triggered when EF1 showed a significant reduction compared to sham rats; in the EF group, debanding occurred when EF declined significantly. All animals were followed weekly with echocardiography after debanding and were then sacrificed for final analysis (Fig. 1). Results EF1 was significantly reduced in AB rats by week 3 compared to sham controls (30 +/- 1.7% vs. 34 +/- 1.3%, P<0.01), while EF showed a significant reduction at week 6 (59 +/- 2.1% vs. 62 +/- 1.0%, P<0.01). In the EF1-guided early debanding group, both EF and EF1 improved significantly six weeks after intervention. In contrast, in the EF-guided late debanding group, neither EF nor EF1 significantly improved post-intervention (Fig. 2). Conclusion EF1-guided early intervention effectively improved systolic function in a randomized controlled animal study, supporting its potential as a practical tool for timely therapeutic decision-making. <78> Accession Number 2045873901 Title Micronutrient Deficiencies in Heart Transplant Recipients-Scoping Review. Source Nutrients. 18(10) (no pagination), 2026. Article Number: 1485. Date of Publication: 01 May 2026. Author Lawniczek M.; Habryka J.; Krupa-Nurcek S. Institution (Lawniczek, Habryka) Faculty of Medicine, Collegium Medicum, University of Rzeszow, Rzeszow, Poland (Krupa-Nurcek) Department of Surgery, Faculty of Medicine, Collegium Medicum, University of Rzeszow, Rzeszow, Poland Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Heart transplant recipients are particularly at risk for micronutrient deficiencies due to chronic immunosuppression, metabolic disorders, gastrointestinal absorption disorders, and increased postoperative demand. Despite a growing body of evidence suggesting their clinical relevance, the prevalence, characteristics, and consequences of these deficiencies remain poorly defined. The aim of this review was to assess of selected micronutrient deficiencies in personnel after heart vaccination and risk factors for their control. Method(s): This scoping review was conducted in accordance with the Joanna Briggs Institute's scope review methodology and presented in accordance with the PRISMA-ScR guidelines. A systematic search of PubMed, Scopus, EBSCO, Web of Science, Google Scholar, and Cochrane Library (January-February 2026) identified studies assessing micronutrient deficiencies in adult heart transplant recipients. Original publications, meta-analyses, and reviews available in full text in English were eligible for the review. Data extraction was carried out independently by two reviewers; using the PCC (Population-Concept-Context) model. Result(s): Of the 35 pre-identified records, 12 studies met the inclusion criteria. The most commonly reported deficiencies included iron, vitamin D, and B vitamins, and their incidence varied widely due to heterogeneous diagnostic criteria. Iron deficiency-both absolute and functional-was common and often associated with inflammation and impaired hepcidin regulation. Vitamin D deficiency persisted before and after transplantation and was associated with impaired bone health, inflammation, and a potentially increased risk of infection. Elevated homocysteine levels associated with low levels of folic acid and vitamin B6 have been identified as potential contributing factors to atherosclerotic and thrombotic complications. Limited evidence also points to deficiencies in iodine, zinc, and other trace elements. Conclusion(s): Micronutrient deficiencies are common among heart transplant recipients and can adversely affect immune system function, cardiovascular risk, and overall clinical outcomes. Routine evaluation and targeted correction of deficiencies should be considered in post-transplant care. Further prospective, multicenter, and interventional studies are needed to establish standardized diagnostic criteria and evidence-based supplementation strategies. Copyright © 2026 by the authors. <79> Accession Number 2046095918 Title Randomized trial of tricuspid flexible band versus rigid ring in patients with moderate tricuspid regurgitation or greater: results of the JPH2019 trial. Source Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Xu X.; Gu J.; Liu H.; Du J.; Gu W.; Ni B.; Shao Y. Institution (Xu, Gu, Liu, Du, Gu, Ni, Shao) Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, Nanjing, China Publisher Elsevier Inc. Abstract Objective: To compare the efficacy and clinical outcomes of flexible band versus rigid ring annuloplasty for the correction of moderate tricuspid regurgitation (TR) or greater. Method(s): In this single-center randomized trial, adult patients with moderate or greater TR were assigned to receive either a flexible band or a rigid ring. The primary outcome was recurrent TR during follow-up. Secondary outcomes included death, permanent pacemaker implantation, and other adverse events. Result(s): In total, 400 patients were randomized with a 1:1 ratio, and 321 were included in the final analysis (flexible band, n = 156; rigid ring, n = 165). Baseline characteristics were balanced between arms. At discharge, recurrent TR was significantly greater in the flexible band arm than the rigid ring arm (10.1% vs 3.8%, P = .03). However, the significance was no longer significant during follow-up (6.1%/patient-years vs 4.7%/ patient-years, P = .21). Multivariable analysis identified female sex (subdistribution hazard ratio [sHR], 2.16, 95% CI, 1.1-4.22, P = .025), preoperative severe TR (sHR, 2.09; 95% CI, 1.06-4.11, P = .033) and massive TR (sHR, 4.63; 95% CI, 1.29-16.61, P = .019), and preoperative permanent pacemaker implantation (sHR, 3.69; 95% CI, 1.35-10.09, P = .011) as independent risk factors for recurrent TR. Subgroup analyses based on these factors showed no significant between-arm difference in the primary outcome. secondary outcomes were also comparable between the arms during follow-up. Conclusion(s): Both annuloplasty devices provided acceptable TR correction with similar adverse event rates over a median 3-year follow-up. Copyright © 2026 The American Association for Thoracic Surgery <80> Accession Number 2046074662 Title Evidenced based blood transfusion as an integral indicator of quality in cardiac surgery. Source Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 19(3) (pp 41-45), 2026. Date of Publication: 2026. Author Zyuzin V.S. Institution (Zyuzin) Federal Center of High Medical Technologies, Kaliningrad, Russian Federation Publisher Media Sphera Publishing Group Abstract The purpose of this review was to describe current data on evidenced based strategy for blood transfusion in adult cardiac surgery. Searching for publications was conducted in May 2025 using the PubMed database, TRANSFUSION EVIDENCE LIBRARY, and eLibrary.RU for the last five years. The following keywords were used: patient blood management in cardiac surgery, transfusion-associated immunomodulation, restrictive and liberal transfusion strategy, blood transfusion. Duplicates were excluded manually. Additional searching was performed in references. The first stage of selection after screening of abstracts took into account clinical trials, meta-analyses, randomized controlled trials, reviews and regular reviews without language restrictions. At the second stage, assessment of full-text articles was carried out with analysis of models for predicting the risk of perioperative transfusion, effectiveness and safety of restrictive or liberal transfusion strategies in cardiac surgery, modern technologies for improving the quality of donated blood components. Final analysis included 48 publications. Evidence based blood transfusion characterizes the effectiveness of blood management system as an integral indicator of quality of care in cardiac surgery. Each transfusion should be reasonable. This entails a reasonable assessment of likelihood, appropriateness of appointment, as well as use of highly effective and safe components of allogeneic blood for a particular patient. Copyright © V.S. Zyuzin <81> Accession Number 2045835881 Title Hybrid Suture- and Plug-Based Closure Versus Dual Suture Devices in Transfemoral Transcatheter Aortic Valve Replacement: A Systematic Review and Meta-analysis. Source Journal of the Society for Cardiovascular Angiography and Interventions. (no pagination), 2026. Article Number: 105339. Date of Publication: 2026. Author Moeez A.; Shah S.W.; Huma S.; Salma Shabbar Banatwala U.E.; Ali A.; Khattak L.Z.; Bacha Z.; Khan A.; Shaid F.; Azeem T.; Razzaq S.; Khan M.W.Z.; Ikram J.; Ullah F.; Shaban M. Institution (Moeez) Department of Medicine, Lady Reading Hospital, Peshawar, Pakistan (Shah, Huma, Ali, Bacha, Khan, Shaid, Azeem) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Salma Shabbar Banatwala) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Khattak, Ullah) Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan (Razzaq) Department of Medicine, Poonch Medical College, Rawalkot, Pakistan (Khan) Department of Internal Medicine, AdventHealth Orlando, Orlando, FL, United States (Ikram, Shaban) Cardiovascular Medicine, Department, Heart, Vascular & Thoracic Institute, Cleveland Clinic, Cleveland, OH, United States Publisher Elsevier B.V. Abstract Background Effective vascular closure is crucial in transfemoral transcatheter aortic valve replacement (TAVR) to minimize access-related complications. Although dual suture-based closure is widely used, a hybrid approach combining suture- and plug-based vascular closure devices (VCD) has gained increasing attention. This meta-analysis compared these 2 strategies in terms of vascular outcomes and procedural success. Methods A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, and Web of Science were searched through January 2025 for studies comparing suture-plus-plug-based vs suture-based VCD in TAVR patients. Primary outcomes were major and minor vascular complications, bleeding events, VCD failure, and unplanned interventions. Risk ratios (RRs) with 95% CIs were calculated. Results Six studies involving 2308 patients were included. The suture-plus-plug-based approach significantly reduced major vascular complications (RR, 0.50; P = .001), minor vascular complications (RR, 0.58; P < .00001), and VCD failure (RR, 0.26; P < .00001) compared with suture-based closure alone. No significant differences were observed in major (P = .30) or minor bleeding (P = .47). Unplanned interventions were less frequent with the hybrid approach, but the difference was not statistically significant (RR, 0.68; P = .19). Conclusions The combination of suture- and plug-based closure devices in transfemoral TAVR provides superior vascular outcomes and lower device failure rates without increasing bleeding risk. These findings support the hybrid approach as a safe and effective strategy, although further randomized controlled trials are warranted to confirm long-term outcomes. Copyright © 2026 The Author(s). <82> Accession Number 2046074436 Title Comparison between three single-dose cardioplegic solutions in myocardial protection: Cardioplegia Trial - a double-blind randomised clinical trial. Source Heart. (no pagination), 2026. Date of Publication: 2026. Author Lira K.B.; Delvaux R.S.; Spadini F.A.; Anschau F.; Kopittke L.; Rode J.; Ceron R.O.; Rey R.A.W.; Wittke E.I.; Rombaldi A.R.; Oliveira A.R.; Rodrigues C.L.; Pereira C.H.; Almeida A.S. Institution (Lira, Delvaux, Spadini, Rode, Ceron, Rey, Almeida) Postgraduate Program in Cardiothoracic Surgery, Nossa Senhora da Conceicao Hospital, Porto Alegre, Brazil (Lira, Spadini, Anschau, Kopittke, Wittke, Almeida) Department of Education and Research, Conceicao Hospital Group, Porto Alegre, Brazil (Anschau, Kopittke, Almeida) Health Technology Assessment Centre, Conceicao Hospital Group, Porto Alegre, Brazil (Rode, Ceron, Rey, Wittke, Rombaldi, Almeida) Department of Cardiothoracic Surgery, Nossa Senhora da Conceicao Hospital, Porto Alegre, Brazil (Oliveira, Rodrigues, Pereira) Department of Cardiothoracic Surgery, Division of Perfusion, Nossa Senhora da Conceicao Hospital, Porto Alegre, Brazil Publisher BMJ Publishing Group Abstract Objectives: To compare myocardial protection afforded by three single-dose cardioplegic solutions - Custodiol (HTK), del Nido (DN) and modified del Nido (MDN) - in adult elective cardiac surgery. Design(s): Double-blind randomised controlled trial. Setting(s): Tertiary hospital in southern Brazil. Participant(s): 99 adults undergoing elective valve or coronary artery bypass surgery with cardiopulmonary bypass. Intervention(s): Administration of HTK, DN or MDN solution during surgery. Main Outcome Measure(s): High-sensitivity cardiac troponin T (hs-cTnT) at 0, 2, 12 and 24 hours postoperatively. Additionally, indirect measures of myocardial protection were compared, both laboratory and clinical, during intraoperative and postoperative periods. Result(s): All solutions provided effective myocardial protection, with similar clinical and laboratory outcomes. DN was associated with significantly lower hs-cTnT at 2 hours (p=0.023) and fewer intraoperative transfusions (p=0.008). HTK patients had lower postoperative sodium and potassium levels (p=0.049 and p=0.002, respectively). Survival and major postoperative outcomes, including vasoactive or mechanical support, were similar across groups. Conclusion(s): The three cardioplegic strategies showed comparable biochemical profiles of myocardial injury. DN was associated with lower early troponin release and reduced transfusion requirements, while HTK produced transient electrolyte shifts. Trial registration number: ReBEC; RBR-7g5s66. 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/. <83> Accession Number 651264880 Title Acquired FVIII deficiency in the setting of prior mechanical mitral valve replacement: A delicate balance of competing hemorrhagic and thrombotic risks. Source Blood. Conference: 67th American Society of Hematology Annual Meeting, ASH 2025. Orlando, FL United States. 146(Supplement 1) (pp 6640-6641), 2025. Date of Publication: 01 Nov 2025. Author Chitkara A.; Srinivasan T.; Kuhrt N.; Anamika F.; Rhoades R. Institution (Chitkara, Srinivasan, Kuhrt, Rhoades) Thomas Jefferson University, Philadelphia, United States (Anamika) Lenox Hill Hospital, New York, United States Publisher Elsevier B.V. Abstract Introduction: Acquired Factor VIII (FVIII) deficiency, also known as acquired hemophilia A, is a rare and lethal bleeding disorder caused by the development of autoantibodies (inhibitors) against FVIII, typically resulting in spontaneous, life-threatening hemorrhages. It is associated with a high all-cause mortality rate of up to 21%. While immunosuppressive therapy (IS) is the cornerstone of therapy, its application becomes especially problematic in those who require long-term anticoagulation (AC). One such category of patients is those with MVR, for whom lifelong warfarin therapy is conventional in order to prevent valve thrombosis and systemic embolism. We were presented with the rare and complicated case of acquired FVIII deficiency in a patient with a history of MVR on long-term warfarin complicated by recent life-threatening bleeding. This resulted in a systematic review of the literature to establish current evidence in managing IS balance, anticoagulation, and control of bleeding in such complex patients. Method(s): We conducted a systematic literature review in accordance with the PRISMA 2020 guidelines. Databases searched included PubMed, Embase, Cochrane, and ClinicalTrials.gov. The search strategy utilized a combination of MeSH terms and free-text keywords. The inclusion criteria required that the studies give evidence of both a diagnosis of acquired FVIII deficiency and concurrent indications for therapeutic anticoagulation. The exclusion criteria were congenital hemophilia without inhibitor development. Result(s): Our search yielded 80 potentially relevant publications. After abstract and title screening, 29 articles underwent full-text review, of which 19 met the inclusion criteria. Notably, there is a profound paucity of evidence specifically addressing the management of anticoagulation in acquired FVIII deficiency with concurrent mechanical valve replacement. To our knowledge, only two case reports describe congenital hemophilia patients with MVR, both navigating long-term AC; however, neither discusses the acquired form or a structured approach to managing thrombotic and bleeding risk simultaneously. Most included cases involved management strategies where immunosuppression with corticosteroids (e.g., prednisone 1 mg/kg/day) combined with cyclophosphamide (1-2 mg/kg/day) or rituximab was initiated promptly to eradicate the inhibitor. FVIII activity typically begins to recover within 2 - 4 weeks of IS initiation. In our case and select others, a threshold FVIII activity level of >50% was used to resume warfarin therapy safely, with a target INR between 2.5 and 3.5 for mitral valves. Therapeutic maneuvers such as tapering IS following optimal FVIII recovery and individualized bridging with mechanical or pharmacologic prophylaxis were essential to minimize both bleeding and thrombosis. Discussion(s): Our analysis highlights the profound clinical dilemma offered by acquired hemophilia in the patient with substantial throm- botic risk from MVR. The patients require emergent removal of FVIII inhibitors and an end to bleeding, but are also at risk of valve thrombosis if anticoagulation is delayed for too long. Our findings support a stepwise approach: (1) Initiation of IS imme- diately upon diagnosis; (2) strict monitoring of FVIII levels to determine timing of anticoagulation resumption; (3) considering mechanical prophylaxis and low-dose pharmacologic bridging strategies in the interim; and (4) use of shared decision-making and interdisciplinary case conferencing for individualized risk stratification. This systemic approach combines the immediacy of hemorrhagic risk with the reality of thromboembolic complications on late long-term AC. ONLINE PUBLICATIONONLYSession 323. Disorders of Coagulation, Bleeding, or Fibrinolysis, Excluding Congenital Hemophilias: Clinical and Epidemiological Conclusion(s): Acquired FVIII deficiency in patients with prior MVR is a rare but critical clinical challenge. It is a condition that mandates prompt initiation of immunosuppression while necessitating cautious deliberation of the timing and degree of anticoagula- tion. Our literature review and experience suggest that FVIII activity >50% may serve as a reasonable threshold to cautiously resume warfarin in these patients. A multidisciplinary, patient-centered approach and stepwise escalation of anticoagulation intensity based on bleeding control and FVIII recovery offer the safest pathway. In the absence of robust guidelines, this literature review provides a provisional algorithm for managing this unique coagulopathy. <84> Accession Number 651263216 Title Efficacy of acute normovolemic hemodilution in adult cardiac surgery in reducing the need for allogenic red cell transfusion: A systematic review and updated meta-analysis of randomized controlled trials. Source Blood. Conference: 67th American Society of Hematology Annual Meeting, ASH 2025. Orlando, FL United States. 146(Supplement 1) (pp 1370-1371), 2025. Date of Publication: 01 Nov 2025. Author Mariappan T.; Hidhaya N.S.; Srinivasan G.; Saravanan H.S.; Kamaraj B.; Nagarajan H.D.P.; Ameer S.D.; Gopu S.; Vemulaghat K.T.; Puchakayala N.; Ganesan S.; Sureddi T. Institution (Mariappan, Hidhaya, Srinivasan) Stanley Medical College, Chennai, India (Saravanan) Government Medical College, Omandurar Government Estate, Chennai, India (Kamaraj, Nagarajan, Ganesan) Madurai Medical College, Madurai, India (Ameer, Gopu, Vemulaghat, Puchakayala) Osmania Medical College, Hyderabad, India (Sureddi) Virtua Health, Camden, United States Publisher Elsevier B.V. Abstract Introduction: Allogeneic red blood cell transfusions during cardiac surgery increase risks of immunologic reactions, infections, and transfusion-related complications. Acute normovolemic hemodilution (ANH) is a blood conservation technique used in cardiac surgery to reduce allogeneic transfusions and associated risks. However, its efficacy remains uncertain, partic- ularly with contemporary advanced intraoperative blood management strategies. This systematic review and meta-analysis aim to evaluate ANH's impact on transfusion requirements and perioperative outcomes in adult cardiac surgery. Method(s): We conducted a systematic review and meta-analysis following PRISMA guidelines. A literature search was per- formed across PubMed, Scopus, Embase, and Google Scholar databases up to July 2025, comparing outcomes between Acute Normovolemic Hemodilution (ANH) and standard care in adult cardiac surgery. Data were analyzed using RevMan 5.4.1. Risk ratios (RRs) and mean differences were calculated using Mantel-Haenszel and inverse variance methods. Fixed and random effects models were selected based on study characteristics. Statistical significance was determined at p< 0.05. The risk of bias was assessed using RoB 2.0. Result(s): Twelve randomized controlled trials (RCTs) encompassing 3,216 patients were included in the analysis. Of these, 1,599 patients were allocated to the ANH group, while 1,617 patients were assigned to usual care. The ANH group exhibited a significantly lower likelihood of receiving allogeneic red blood cell (RBC) transfusions (32.20%) compared to the usual care group (38.09%), corresponding to a RR reduction of 21% (RR = 0.79; 95% confidence interval [CI]: 0.64-0.98; I2= 81%). ANH was associated with a reduction in postoperative blood loss via chest drains (mean difference -14.92 mL, 95% CI: -29.87 to 0.04; p = 0.05), approaching statistical significance. The proportion of ANH patients receiving fresh frozen plasma (FFP) transfusions was 21.38% compared to 24.57% in the non-ANH group (RR: 0.70; 95% CI: 0.44-1.13; I2 = 70%), showing a trend favoring ANH without statistical significance. Platelet transfusion rates showed a non-significant preference for the ANH group (7.47% ANH vs. 7.60% usual care, 17 studies, RR 1.00; CI: 0.76 to 1.31). Mortality rates were lower in the ANH group (1.47%) compared to usual care (2.03%), though not statistically significant (p = 0.47; RR 1.75; 95% CI: 0.42-1.34; I2 = 0%). Bleeding complications occurred in 3.97% of ANH patients versus 2.89% in controls (RR 1.37; 95% CI: 0.93-2.02; I2 = 0%), showing a numerically higher rate without statistical significance. Discussion(s): Our meta-analysis of 12 RCTs, including 3,216 patients, shows a significant reduction in allogeneic red blood cell transfusions due to ANH. This intervention is associated with decreased postoperative chest tube drainage rates, suggesting enhanced blood preservation. The effect is attributed to red blood cell dilution during surgery, which reduces intraoper- ative blood loss and donor transfusion needs. However, ANH's impact on FFP or plasma transfusion rates, mortality, and bleeding rates was statistically insignificant between groups. This variation may stem from multiple factors affecting coag- ulation and hemostasis beyond the procedure. Focusing on trials conducted post year 2000, we emphasize contemporary, evidence-based medicine to establish protocols, addressing current needs with advanced cardiopulmonary bypass machines and diverse interventional options. Despite large trials, heterogeneity in outcomes persists, and long-term follow-up data remain insufficient. Future research should prioritize multicenter studies to identify populations deriving the most benefit, including those with anemia or perioperative anemia. Overall, ANH is a valuable addition to blood conservation strategies during cardiac surgeries, though it is more effective when integrated with other evidence-based practices. <85> Accession Number 651259411 Title Fibrinogen concentrate versus cryoprecipitate for bleeding in cardiac surgery patients stratified by surgery risk in the phase 3 fibres Study. Source Blood. Conference: 67th American Society of Hematology Annual Meeting, ASH 2025. Orlando, FL United States. 146(Supplement 1) (pp 4860-4861), 2025. Date of Publication: 01 Nov 2025. Author Callum J.; Karkouti K.; Solomon C.; Werner S.; Knaub S. Institution (Callum) Queen's University, Kingston, Canada (Callum) Kingston Health Sciences Centre, Kingston, Canada (Karkouti) University of Toronto, Toronto, Canada (Karkouti) University Health Network, Toronto, Canada (Solomon, Knaub) Octapharma AG, Lachen, Switzerland (Werner) Octapharma USA,Inc., Paramus, United States Publisher Elsevier B.V. Abstract Introduction The Phase 3 FIBRES study demonstrated that fibrinogen concentrate (FC) was non-inferior to cry- oprecipitate for the treatment of coagulopathic bleeding related to acquired fibrinogen deficiency (hypofibrinogenemia) in cardiac surgery patients. To further understand the role of FC, this post-hoc analysis explored the efficacy and safety of FC versus cryoprecipitate in patients from FIBRES stratified by surgical risk. Methods The FIBRES study (NCT03037424), conducted in accordance with the Declaration of Helsinki, enrolled adult patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) for whom fibrinogen replacement was ordered in response to clinically significant postbypass bleeding deemed related to acquired hypofibrinogenemia. Patients were randomized (1:1) to receive either 4 g FC or 10 units (U) of cryoprecipitate for each ordered dose within 24 h after CPB. Patients were stratified as high surgical risk if they were adjudicated by the principal investigator to be in a critical state before surgery, i.e., they underwent emergency surgery and had any of the following conditions: ventricular tachycardia, fibrillation, or cardiac arrest; preoperative cardiac massage; preoperative ventilation before anesthetic room; hemodynamic support requiring preopera- tive inotropes or ventricular assist devices; preoperative acute renal failure; or acute aortic dissection. All other patients were assigned to the category non-high surgical risk . The primary endpoint, allogeneic blood products (ABPs) administered dur- ing the first 24 h after termination of CPB, was analyzed in these subgroups. Safety was also examined in these subgroups through 28 days. Some patients experienced catastrophic bleeding necessitating transfusion of a large number of ABP units (U), likely reflect- ing multiple/severe underlying coagulopathies and potentially requiring surgical re-exploration. As it is also informative to compare the efficacy of fibrinogen replacement therapies in the most common surgical patient population, an exploratory analysis was also performed excluding the most extreme cases in the high surgical risk subgroup, i.e., patients who received >= 35 U of ABP transfusions within 24 h after CPB end. Results In total, 735 patients were included in the primary analysis (N=372 FC, N=363 cryoprecipitate). The large majority (634; 86.3%) were classified as non-high surgical risk (N=309 FC, N=325 cryoprecipitate), with 101 (13.7%) classified as high surgical risk (N=63 FC, N=38 cryoprecipitate). In the non-high-risk group (N=634), during the first 24 h after termination of CPB a mean (SD) of 13.6 (14.1) U ABPs were transfused in the FC group vs 16.2 (16.1) U in the cryoprecipitate group. FC was shown to be both non-inferior (mean ratio 0.84; 95% CI 0.00-0.87; p<0.0001) and superior (mean ratio 0.84; 95% CI 0.80-0.87; p<0.0001) to cryoprecipitate. In the high-risk group (N=101), a mean (SD) of 29.6 (21.5) U ABPs were transfused in the FC group vs 23.8 (14.4) U in the cryoprecipitate group (mean ratio 1.24; 95% CI 0.00-1.34; p=0.7928 for non-inferiority). When patients who received >= 35 U of ABPs within 24 h post-CPB were excluded, a mean (SD) of 18.3 (9.2) U ABPs were transfused in the FC group (N=42) vs 19.5 (7.4) U in the cryoprecipitate group (N=33), demonstrating non-inferiority of FC to cryoprecipitate (mean ratio 0.94; 95% CI 0.00-1.04; p<0.0001) but not superiority (mean ratio 0.94; 95% CI 0.84-1.04; p=0.2212). In the non-high-risk group, a total of 455 treatment-emergent adverse events (TEAEs) occurred in 196 (63.4%) patients in the FC group vs 577 TEAEs in 230 (70.8%) patients in the cryoprecipitate group. In the high-risk group, a total of 168 TEAEs occurred in 52 (82.5%) patients in the FC group vs 96 TEAEs in 34 (89.5%) patients in the cryoprecipitate group. Conclusion In this post-hoc analysis of the Phase 3 randomized FIBRES study, FC was superior to cryoprecipitate for the number of blood components transfused within 24 h after CPB in the patients who were not high surgical risk, representing 86% of the bleeding cardiac surgery population. Moreover, FC was non-inferior to cryoprecipitate in high-risk surgical patients when excluding the most extreme atypical clinical cases characterized by catastrophic bleeding and massive transfusion. These findings reinforce the main outcomes from the FIBRES study and support the use of FC for management of bleeding in cardiac surgical patients with acquired hypofibrinogenemia. <86> Accession Number 651265988 Title FLAG/VEN as a frontline induction therapy for AML: A multi-centre experience of Anthracycline free approach from India. Source Blood. Conference: 67th American Society of Hematology Annual Meeting, ASH 2025. Orlando, FL United States. 146(Supplement 1) (pp 3407-3408), 2025. Date of Publication: 01 Nov 2025. Author Shaikh M.R.; Soni M.S.M.; Veni K.; Chand R.; Naim F.; Halder R.; Agrawal N.; Sheth V.; Adak S.; Bhurani D.; Ahmed R. Institution (Shaikh, Adak) HCG Cancer Centre, Mumbai, India (Soni, Halder, Agrawal, Sheth, Bhurani) Rajiv Gandhi Cancer institute and Research centre, Delhi, India (Veni, Chand, Naim, Ahmed) Max Super Specialty Hospital Saket, Delhi, India Publisher Elsevier B.V. Abstract Introduction: Acute myeloid leukemia (AML) is a life-threatening hematological malignancy with reported 5-year OS of 40% to 50% with 3+7 therapy. CR/CRi rates of 76% were reported with FLAG-IDA albeit with increased toxicity. Chepsy et al. reported an induction mortality of 24.7% with 3 + 7 regimen from India. Indian registry Hematology Cancer Consor- tium reported (n = 392) induction mortality rate of 16.9% (range - 6.1-43%) with 3 + 7 protocol. Jain et al. reported that 63% of patients present with baseline infections and sepsis was the most common cause of induction mortality. FLAG-IDA-VEN approach leads to CR+CRi rates of 89% with prolonged neutropenia which restricts its adaptability to LMICs in view high prevalence of multi drug resistant organism related infections. FLAG/VEN is a novel approach adapted by us. We have pre- viously reported increased tolerability and efficacy of this approach in comparison with 3+7 as a proof of concept. We report outcomes of FLAG/VEN therapy as a frontline induction therapy at two centres in India. Method(s): Baseline variables included age, gender, ECOG PS, baseline organ function, karyotype, targeted next generation sequencing were collected from the electronic health record of the institutions. Clinical variables included data with regards to tolerance of therapy and response assessment. All patients received azole antifungals either prophylactic or therapeutic. Venetoclax dose was adjusted as per azole antifungals. This study was granted ethical approval by the Institutional Review Board No. RGCIRC/IRB-BHR/04/2023 dated 4th February 2023. Induction therapy: All patients received tumor lysis syndrome prophylaxis with intravenous hydration and Tab Febuxostat. Inj. Fludarabine 30 mg/m2 IV once daily for 4 days, Cytarabine 1500 mg/m2 IV once daily for 4 days. Inj. Filgrastim (biosimilar) 5 mcg/kg s/c once daily from day -1 to ANC > 500 cells/ muL. Tab Venetoclax was added as per treating physician discretion. Venetoclax was given as 50 mg for day 1 and 2 followed by 100 mg once daily. It was given for 7 days. Consolidation therapy: Patients underwent Allogeneic HSCT as a consolidation therapy based on feasibility. Patients [except core binding factor (CBF) AML and not a candidate of Allogeneic HSCT] in CR1 at day 28 received Cytarabine 1500 mg/m2 twice daily for 3 days every 28 days for 3 cycles as consolidation therapy. CBF AML patients in CR1 at day 28 in both arms received FLAG with Gemtuzumab Ozogamicin (GO) based consolidation therapy for 4 cycles. GO (3 mg/m2 capped at 4.5 mg) was administered in any two of the four consolidation cycles. Patients not in CR underwent re-induction with regimen of choice as per physician discretion. Result(s): A total of 44 patients received FLAG/VEN as frontline induction therapy since 2022 in two centres. 16 patients in centre A and 28 patients in centre B. Median age of patients was 40 years (18-62). 21(44%) of them were males and 23(56%) were females. 8 patients had co -morbidities. 5 patients had more than one co- morbidity and one patient had mitral valve replacement. One patient had a ECOG PS of 2, 43 patients had PS of 0-1. As per the ELN 2022 risk stratification n=10 (23%), n=18 (41%), n=13 (30%) belonged to standard, intermediate and adverse risk profile respectively. n=3 (6%) could not be risk stratified in view of culture failure on conventional karyotype and no muta- tions were captured in the NGS panel. There was no incidence of induction mortality. Twenty-eight (63%) patients developed febrile neutropenia. n=14 (31%) patients had fungal pneumonia. n=2 (4.5%) patients had tuberculosis. n=6 (14%) patients had carbapenem resistant organism related sepsis. Forty-one (93%) patients achieved CR at day 28 Bone Marrow assessment. Among 3(6.8%) patients who did not respond two had TP53 mutations and one patient had complex karyotype. Nine patients relapsed at the last recorded follow up. Fourteen patients (32%) underwent Allogeneic HSCT as a consolidation therapy. 1-year PFS is 76 % and 1-year OS is 92% for the entire cohort. Conclusion(s): Our results suggests that FLAG/VEN approach can decrease induction mortality rate which is anywhere about 20-25 % in a lower middle-income country like India. FLAG/VEN achieves high CR rates of 93% which is comparable to FLAG/IDA/VEN approach without added toxicity in the real-world scenario. This approach needs to be tested in a randomized controlled trial to establish it as a standard therapy for AML. <87> Accession Number 651268804 Title Prophylactic Closed-Incision Negative Pressure Wound Therapy After Median Sternotomy: A Scoping Review of SSI prevention Bundle Reporting and Implication for Interpretation. Source The Journal of hospital infection. (no pagination), 2026. Date of Publication: 20 May 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Abstract BACKGROUND: Closed-incision negative pressure wound therapy is increasingly used to reduce surgical site infection after median sternotomy, yet its true preventive effect remains uncertain. Published studies rarely specify which infection-prevention measures were used alongside the therapy, making interpretation difficult. AIM: In this scoping review, we examined the completeness of reporting of infection-prevention practices in studies evaluating closed-incision negative pressure wound therapy after cardiac surgery. METHOD(S): A systematic search of PubMed, Scopus, and the Cochrane Library identified studies of adult cardiac surgery in which negative pressure therapy was applied prophylactically to the closed sternal incision. Information on study design, patient characteristics, therapy protocols, clinical outcomes, and reporting of infection-prevention elements was extracted. Reporting was classified as complete, partial, or absent according to thirteen components derived from major clinical guidelines. FINDINGS: Twenty-five studies met the inclusion criteria. Most studies reported fewer surgical site infections in patients receiving negative pressure therapy, but none described a complete set of infection-prevention measures. Eighty-seven percent of recommended elements were not reported, and selective use of the therapy introduced additional bias. CONCLUSION(S): The substantial absence of infection-prevention reporting limits the interpretability and reproducibility of current evidence. Standardized and transparent documentation is required to better define the preventive value of closed-incision negative pressure wound therapy. Copyright © 2026 The Author(s). Published by Elsevier Ltd.. All rights reserved. <88> Accession Number 651275752 Title Does a Digital Prehabilitation Solution Informed by Evidence-Based Interventions Reduce the Healthcare Burden and Improve Outcomes for Patients Awaiting Cardiac Surgery?-A Systematic Review. Source Heart, lung & circulation. (no pagination), 2026. Date of Publication: 23 May 2026. Author Hines C.; Farragher J.; Vlahos R.; Denehy L.; Doull L.; El-Ansary D. Institution (Hines) School of Health and Biomedical Sciences, RMIT University, Melbourne, Vic, Australia; Shanghai University of Medicine and Health Sciences, Shanghai, China; Royal Melbourne Hospital, Melbourne, Vic, Australia (Farragher) School of Health and Biomedical Sciences, RMIT University, Melbourne, Vic, Australia; Shanghai University of Medicine and Health Sciences, Shanghai, China (Vlahos) School of Health and Biomedical Sciences, RMIT University, Melbourne, Vic, Australia (Denehy) Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Vic, Australia; Department of Health Services Research: Allied Health, Peter MacCallum Cancer Centre, Parkville, Vic, Australia; School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, Northern Ireland (Doull) Department of Surgery, The University of Melbourne, Parkville, Vic, Australia (El-Ansary) School of Health and Biomedical Sciences, RMIT University, Melbourne, Vic, Australia; Shanghai University of Medicine and Health Sciences, Shanghai, China; Department of Surgery, The University of Melbourne, Melbourne, Vic, Australia Abstract BACKGROUND AND AIMS: Prehabilitation before cardiac surgery targets modifiable risk factors to enhance surgical readiness and recovery. It can reduce complications, mortality, and hospital stay; however, remains underused in routine cardiac care. As digital health gains traction, remote delivery of prehabilitation offers a promising way to expand access and equity to cardiac patients. This review examines the delivery, outcomes, and effectiveness of digital prehabilitation for adults awaiting cardiac surgery. METHOD(S): This review followed the Preferred Reporting Items of Systematic Reviews and Meta-Analyses Analyses 2020 guidelines and was registered with PROSPERO (ID: 452250). Seven databases were searched, identifying studies which evaluated digital prehabilitation in cardiac surgery patients. Screening, selection, and data extraction were performed, and outcomes were categorised by feasibility, health outcomes, and healthcare utilisation. RESULT(S): Analysis showed significant findings in favour of digital prehabilitation over standard care in terms of feasibility, efficacy, complications, and costs/healthcare utilisation. Interrogation of the results data via meta-analysis was unsuitable due to the heterogeneity of the methodologies and evaluation time points. CONCLUSION(S): Digital prehabilitation is a safe, feasible and potentially effective strategy to improve outcomes and reduce healthcare burden in cardiac surgery. Copyright © 2026 The Author(s). Published by Elsevier B.V. All rights reserved. <89> Accession Number 2046048007 Title Current approaches to the prevention of cardioembolic complications in patients with the nonvalvular atrial fibrillation. Source Profilakticheskaya Meditsina. 29(5) (pp 106-112), 2026. Date of Publication: 2026. Author Brontveyn T.G.; Saribekian A.G.; Abdullaeva A.A.; Davtyan K.V. Institution (Brontveyn, Saribekian, Abdullaeva, Davtyan) National Medical Research Center for Therapy and Preventive Medicine, Moscow, Russian Federation Publisher Media Sphera Publishing Group Abstract Percutaneous left atrial appendage (LAA) closure has been proposed as an alternative to long-term administration of oral anticoagulants (OACs) in non-valvular atrial fibrillation, but there is insufficient comparative evidence-based data on this issue. Objective. To analyze data from studies comparing the efficacy and safety of using left atrial appendage occluding devices and direct oral anticoagulants for the prevention of cardioembolic complications in patients with atrial fibrillation. Materials and methods. A search for randomized studies for the period up to March 1, 2025, in which devices that occlude LAA were compared with the administration of OACs, was carried out in PubMed database. The selection of studies was done using the following keywords: <<atrial fibrillation>>, <<cardioembolism>>, <<oral anticoagulation>>, <<left atrial appendage closure>>. Results. The paper considers various methods for preventing cardioembolic events in non-valvular atrial fibrillation, including OACs, LAA occlusion and factor XIa inhibitors. The largest study to date, PRAGUE-17, comparing occluder implantation with OACs, showed that mechanical occlusion of the LAA is not inferior to therapy with direct OACs for the prevention of cardioembolic events, cardiovascular mortality, clinically significant bleeding or postoperative occluder-associated complications, but safety remains an open question. Similar data on efficacy and safety in smaller randomized controlled trials included in this work also indicate comparable results of using the two methods with a tendency to superiority of LAA occlusion. Conclusion. Implantation of devices occluding the left atrial appendage as a non-pharmacological alternative in atrial fibrillation is characterized by the same efficacy and safety as the use of oral anticoagulants. Further research in larger studies is needed. Copyright © T.G. Brontveyn, A.G. Saribekian, A.A. Abdullaeva, K.V. Davtyan <90> Accession Number 2038188047 Title Glucocorticoids to reduce permanent pacemaker implantation after TAVI: the GLUCO-TAVI randomised trial. Source EuroIntervention. 22(10) (pp 545-554), 2026. Date of Publication: 2026. Author Fuertes-Kenneally L.; Torres-Mezcua F.; Herrero-Brocal M.; Quesada Rico J.A.; Ajo Ferrer R.; Climent Ballester S.; Pineda Rocamora J.; Bordes Siscar P.; Valencia J.; Torres-Saura F.; Martinez Lopez D.; Yago Riquelme C.; Lopez Clemente J.C.; Lozano Palencia T.; Lopez-Menchero Ortiz De Salazar C.; Lloret Rubio A.; De La Hoz Maranon L.; Mateo Soler J.M.; Martinez J.G.; Ruiz-Nodar J.M. Institution (Fuertes-Kenneally, Torres-Mezcua, Herrero-Brocal, Pineda Rocamora, Bordes Siscar, Valencia, Torres-Saura, Martinez Lopez, Yago Riquelme, Lopez Clemente, Lozano Palencia, Lopez-Menchero Ortiz De Salazar, Lloret Rubio, De La Hoz Maranon, Mateo Soler, Martinez, Ruiz-Nodar) Cardiology Department, Dr. Balmis General University Hospital, Alicante, Spain (Fuertes-Kenneally, Torres-Mezcua, Herrero-Brocal, Ajo Ferrer, Climent Ballester, Pineda Rocamora, Bordes Siscar, Valencia, Torres-Saura, Martinez Lopez, Yago Riquelme, Lopez Clemente, Lozano Palencia, Lopez-Menchero Ortiz De Salazar, Lloret Rubio, De La Hoz Maranon, Mateo Soler, Martinez, Ruiz-Nodar) Alicante Institute for Health and Biomedical Research, ISABIAL, Alicante, Spain (Quesada Rico, Ruiz-Nodar) Department of Clinical Medicine, Miguel Hernandez University, Alicante, Spain (Climent Ballester) Department of Pharmacy, Dr. Balmis General University Hospital, Alicante, Spain Publisher Europa Group Abstract BACKGROUND: Despite the growing demand for transcatheter aortic valve implantation (TAVI), there is no strategy to prevent its most common complication: cardiac conduction disturbances (CCD). These disturbances often necessitate permanent pacemaker implantation (PPI), leading to high morbidity and costs. Post-TAVI CCD may be transient, resulting from inflammation. AIMS: We aimed to evaluate the feasibility, safety, and preliminary efficacy of glucocorticoids in preventing PPI in patients undergoing TAVI. METHOD(S): This pilot study followed a Prospective Randomised Open-label Blinded Endpoint (PROBE) design. One hundred TAVI patients were randomised 1:1 to standard care or methylprednisolone (7 mg/kg administered 1 hour preprocedure), followed by prednisone (15 mg every 12 hours for 5 days). Electrocardiograms and inflammatory biomarkers were assessed pre-and post-intervention, and at 1 month and 1 year. The primary efficacy endpoint was the 1-month incidence of PPI. Secondary outcomes included 1-year PPI, new left bundle branch block (LBBB), LBBB and PPI, other CCD, mortality, and procedural complications. RESULT(S): The primary efficacy outcome occurred in 16% of the control group and 8% of the intervention group, reflecting a 50% relative risk (RR) reduction in PPI (RR 0.50, 95% confidence interval [CI]: 0.16-1.55; p=0.23). There was no significant difference in 1-year PPI (RR 0.67, 95% CI: 0.26-1.73; p=0.41) or new LBBB (RR 1.12, 95% CI: 0.66-1.89; p=0.66). The intervention was safe, without differences in complications, mortality (4% vs 12%; p=0.27), or adverse events (n=3). CONCLUSION(S): Glucocorticoids in TAVI are feasible and safe. The observed numerical difference in PPI did not reach statistical significance. Large-scale trials are needed to confirm the results of this pilot study. Copyright © Europa Group 2026. All rights reserved. <91> Accession Number 651271337 Title Antiplatelet Therapy for Patients with Stable Coronary Artery Disease Receiving Oral Anticoagulation: A Meta-analysis of Randomized Controlled Trials. Source Journal of cardiology. (no pagination), 2026. Date of Publication: 21 May 2026. Author Hiruma Y.; Watanabe A.; Aikawa T.; Iwagami M.; Hosseini K.; Slipczuk L.; Briasoulis A.; Takagi H.; Kuno T. Institution (Hiruma) United States Naval Hospital Okinawa, Okinawa, Japan (Watanabe) Department of Medicine, Mount Sinai Morningside and West, Icahn School of Medicine at Mount Sinai, New York, NY, USA (Aikawa) Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan (Iwagami) Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London, School of Hygiene and Tropical Medicine, London, UK; Department of Digital Health, Institute of Medicine, University of Tsukuba, Tsukuba, Japan (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark; Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Slipczuk) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Bronx, NY, United States (Briasoulis) Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa, Iowa City, IA, United States (Takagi) Department of Cardiovascular Surgery, Medical Center, Shizuoka, Japan (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Abstract BACKGROUND: Evidence supporting the discontinuation of antiplatelet therapy in patients with stable coronary artery disease who require anticoagulation remains limited and continues to evolve. This study aimed to assess the efficacy and safety of antithrombotic therapy in this population. METHOD(S): We reviewed randomized controlled trials comparing the efficacy and safety of oral anticoagulant monotherapy versus oral anticoagulant plus single antiplatelet therapy in patients beyond six months after coronary revascularization requiring anticoagulation. The outcomes included major adverse cardiovascular events (MACE) and major bleeding. MACE was defined as a composite of all-cause death, myocardial infarction, stroke, systemic embolism, and revascularization. A pairwise meta-analysis using a random-effects model was conducted. RESULT(S): A total of 5924 patients from 6 randomized controlled trials were included: 2970 received oral anticoagulant alone, and 2954 received oral anticoagulant plus single antiplatelet therapy. Anticoagulant monotherapy was associated with a comparable risk of MACE [hazard ratio (HR), 0.80; 95% confidence interval (CI), 0.62-1.04] and a significantly lower major bleeding risk (HR, 0.46; 95% CI, 0.32-0.66) than the combined therapy. CONCLUSION(S): Oral anticoagulant alone may be a reasonable strategy to mitigate bleeding risk while preserving an ischemic risk comparable to combined anticoagulant and antiplatelet therapy. Copyright © 2026 Elsevier Ltd. All rights reserved. <92> Accession Number 651270686 Title Does the lung cancer screening (LCS) pathway independently improve surgical outcomes compared with the routine pathway: a matched-case analysis. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 22 May 2026. Author Mathur A.; Alzahrani M.; Abid A.; Djearaman M.; Glynn P.; Maddekar N.; Naidu B. Institution (Mathur, Naidu) Birmingham Medical School, University of Birmingham, Birmingham, United Kingdom (Alzahrani, Naidu) University of Birmingham, Birmingham, United Kingdom (Alzahrani) King Abdullah International Medical Research Center, Jeddah, Saudi Arabia (Alzahrani) College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia (Abid, Djearaman, Glynn, Maddekar, Naidu) Queen Elizabeth Hospital Birmingham, Birmingham, United Kingdom Abstract BACKGROUND: Multiple randomised controlled trials demonstrate that screening is a game changer for lung cancer outcomes. As pilot Lung Cancer Screening schemes expand across the UK, we investigate whether referral through a screening pathway independently influences early postoperative outcomes following lung cancer resection, or whether observed benefits are due to differences in patient characteristics between screened and non-screened populations. METHOD(S): A retrospective cohort analysis was conducted on 370 patients who underwent curative lung cancer resection. Of these, 35 were from the Lung Cancer Screening pathway, while 335 were diagnosed from standard of care pathways. Propensity Score Analysis was then used to create a matched cohort of 34 patients per group to minimise confounding baseline factors such as clinical characteristics and patient demographics. Postoperative outcomes including complications, length of stay, and 30-day mortality were then compared using univariate logistic and linear regression models. Imputation was used for any missing data. RESULT(S): Prior to matching, patients diagnosed via the Lung Cancer Screening pathway demonstrated more favourable baseline characteristics, subsequently requiring matching. Following matching, postoperative outcomes including length of stay (mean difference 1.81 days, p-value = 0.51), overall postoperative complication rate (OR -1.126, CI 0.701, 5.672, p-value = 0.195), complication severity objectively measured by Clavien-Dindo Classification (OR 2.039, CI 0.737, 5.638, p-value = 0.17), and Comprehensive Complication Index (OR 1.797, CI 0.644, 5.011, p-value = 0.263) were not statistically significantly different between the screened and non-screened populations. The 30-day mortality was 0% in the Lung Cancer Screening group, as opposed to 3.9% in the non-Lung Cancer Screening cohort (Absolute Risk Difference = 3.9%), however regression analysis could not be performed due to zero events in the screened group. CONCLUSION(S): The Lung Cancer Screening pathway appears to be indirectly associated with improved postoperative outcomes through patient selection rather than a direct, independent effect of the screening pathway. Larger studies are needed to validate these findings and elucidate how the downstream benefits of screening can be optimised across thoracic surgery pathways for lung cancer. Copyright © 2026. The Author(s). <93> Accession Number 2045764193 Title Intravascular Imaging-Guided Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting for Unprotected Left Main Stenosis. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Wanha W.; Kuzma L.; Swieczkowski M.; Dabrowski E.; Iwanczyk S.; Lesiak M.; Kowalewski M.; Dobrzycki S.; Kralisz P.; Kowalowka A.; Makhoul M.; Morshed K.; Wita K.; Gocol R.; Hudziak D.; Wojakowski W.; De la Torre Hernandez J.M.; Cortese B. Institution (Wanha, Wojakowski) Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland (Wanha, Cortese) DCB Academy, Milan, Italy (Wanha, Kuzma, Kowalewski) Department of Cardiac Surgery and Transplantology, National Medical Institute of the Ministry of Interior and Administration, Warsaw, Poland (Kuzma, Swieczkowski, Dabrowski, Dobrzycki, Kralisz) Department of Invasive Cardiology, Medical University of Bialystok, Bialystok, Poland (Kuzma, Kowalewski) Thoracic Research Centre, Collegium Innovative Medical Forum, Bydgoszcz, Poland (Kuzma) Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, United Kingdom (Iwanczyk, Lesiak) Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland (Kowalowka, Gocol, Hudziak) Department of Cardiac Surgery, Upper-Silesian Medical Centre, Medical University of Silesia, Katowice, Poland (Makhoul) Department of Cardiac Surgery, Harefield Hospital, London, United Kingdom (Makhoul, Morshed) Rambam Medical Centre, Haifa, Israel (Wita) First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland (De la Torre Hernandez) Servicio de Cardiologia, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain (Cortese) Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH, United States (Cortese) Fondazione Ricerca e Innovazione Cardiovascolare, Milan, Italy Publisher John Wiley and Sons Inc Abstract Background: Randomized clinical trials comparing percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) stenosis have indicated lower repeat revascularization after CABG. Aim(s): This multi-center study aimed to investigate outcomes of intravascular imaging (IVI)-guided PCI compared with CABG for treating LMCA stenosis. Method(s): Analysis included 855 patients (396 PCI) from 18 centers. The primary composite endpoint was major adverse cardiac and cerebrovascular events (MACCE: cardiovascular death, myocardial infarction, stroke, and target vessel revascularization at 2 years). Propensity score matching (PSM) analysis was used to limit differences among the groups. Cox regression event rates were calculated for matched groups. Result(s): In the overall cohort, no difference in MACCE was observed (HR 0.97, 95% CI 0.72-1.32, p = 0.84). PSM resulted in 230 pairs, with no significant differences in baseline, procedural characteristics, and SYNTAX score between the two groups. The matched cohorts had no significant differences for the primary endpoint (HR 0.85, 95% CI 0.65-1.43, p = 0.85). No differences for all-cause mortality rates between the two groups were found at 2 years (10% in the PCI and 11% in the CABG arm, p = 0.65). During follow-up, patients undergoing CABG had lower rates of myocardial infarction (8.7% vs. 14.8%, p = 0.04). More frequent stroke incidence was noticed (8.7% vs. 0%, p < 0.001). There was no significant difference in the incidence of target vessel revascularization between PCI and CABG (3.91% vs. 2.61%, p = 0.43). Conclusion(s): IVI-guided PCI for LMCA stenosis provides similar 2-year outcomes to CABG. Lower MACCE rates with PCI were observed in patients with lower anatomic complexity. Copyright © 2026 Wiley Periodicals LLC. <94> Accession Number 651257269 Title Early vs Deferred HIV Therapy and Cardiovascular Disease in People With HIV: The START Study. Source Topics in Antiviral Medicine. Conference: 2025 Conference on Retroviruses and Opportunistic Infections, CROI 2025. San Francisco, CA United States. 33(1) (pp 44), 2025. Date of Publication: 01 Apr 2025. Author Dharan N.; Mistry S.; Arenas-Pinto A.; Duprez D.; Estrada V.; Ha K.; Kundro M.; Mngqibisa R.; Mugerwa H.; Nassreddine R.; Peterson T.; Sereti I.; Trevillyan J.; Baker J.; Matthews G. Institution (Dharan) University of New South Wales Sydney, Sydney, Australia (Mistry, Duprez, Baker) University of Minnesota, Minneapolis, MN, United States (Arenas-Pinto) MRC Clinical Trials Unit at UCL, London, United Kingdom (Estrada) Hospital Universitario Clinico San Carlos, Madrid, Spain (Ha) Cooper University Hospital, Camden, NJ, United States (Kundro) Hospital Ramos Mejia, Buenos Aires, Argentina (Mngqibisa) Enhancing Care Foundation, Durban, South Africa (Mugerwa) Joint Clinical Research Centre, Kampala, Uganda (Nassreddine) Saint-Pierre University Hospital, Brussels, Belgium (Peterson) Johns Hopkins University, Baltimore, MD, United States (Sereti) National Institute of Allergy and Infectious Diseases, Baltimore, MD, United States (Trevillyan) Austin Health, Melbourne, Australia (Matthews) Kirby Institute, Sydney, Australia Publisher International Antiviral Society Abstract Background: Cardiovascular disease (CVD) risk is higher in people with HIV (PWH) than people without HIV. However, whether this elevated risk of CVD is present in antiretroviral therapy (ART)-naive PWH with high CD4+ counts, and whether delayed initiation of ART worsens CVD outcomes is unknown. Method(s): The Strategic Timing of Antiretroviral Treatment (START) study randomized ART-naive adults with HIV and CD4+ counts>500 cells/muL to immediate vs. deferred (until CD4 count <350/muL or AIDS developed) ART initiation. We report CVD event rates (composite of MI, stroke, coronary revascularization, or death from CVD) between treatment arms in three time periods: (i) pre-2016 (ART use differed by treatment arm); (ii) post-2016 (study was unblinded and continuous ART use was recommended for both groups, 2016-2021); and (iii) over the entire study. Subgroup analyses were performed according to baseline demographic, clinical characteristics and CVD risk factors. Time-to-event methods compared event rates between study arms. Result(s): Overall, 4,684 participants were randomized (median age 36 yrs, 27% female, 30% Black race); 4436 (95%) had data available after 2016. At baseline, 32% were smokers, 17% had a BMI>=30 kg/m2, and the median Framingham 10-yr risk score was 1.9%. Comorbidities included hypertension (19%), dyslipidemia (8%), and diabetes (3%); 0.8% had prior CVD. Composite CVD event rates were similar between treatment arms during the pre-and post-2016 periods: 0.18 and 0.17 per 100 person yrs (PY) pre-2016 in the immediate and deferred arms, respectively, and 0.16 and 0.17 per 100 PY post-2016 in the immediate and deferred arms, respectively (Figure 1). Over the entire study (median follow-up of 9.3 yrs), 71 participants (35 immediate, 36 deferred) had a CVD event. There was no difference in events between arms (immediate/ deferred hazard ratio [HR] 0.98; 95% confidence interval [CI] 0.61-1.56) for the composite CVD outcome or its components. Immediate vs. deferred ART was associated with a reduced risk of CVD in women (HR 0.19; CI 0.04-0.86) but not in men (HR 1.33; CI 0.79-2.24), p-value for interaction=0.014; interpretation is limited by low numbers of events. Conclusion(s): While immediate ART is known to reduce the risk of many clinical comorbidities and adverse outcomes among PWH, we did not find an effect of early ART initiation for reduction of CVD events among individuals at low CVD risk and moderate to high CD4 counts in the START study. The benefit found among women warrants further evaluation. <95> Accession Number 651262960 Title Systematic literature review and meta-analysis on the safety of fibrinogen concentrate versus cryoprecipitate in bleeding surgical patients. Source Blood. Conference: 67th American Society of Hematology Annual Meeting, ASH 2025. Orlando, FL United States. 146(Supplement 1) (pp 4858-4859), 2025. Date of Publication: 01 Nov 2025. Author Cushing M.; Fuster C.; Bader S.; Yuan Z.; Rodriguez W.; Ardiles T.; Zhou J.; Mayer B.; Gomez-Ulloa D. Institution (Cushing) Weill Cornell Medicine, Department of Pathology and Laboratory Medicine, New York, United States (Fuster, Gomez-Ulloa) Grifols SA, Global HEOR and RWE, Sant Cugat del Valles, Spain (Bader) Heritage Valley Health System-Beaver, Department of Anesthesiology, Beaver, United States (Yuan) Cytel Inc., Rotterdam, Netherlands (Rodriguez, Ardiles) Grifols SSNA, Global Medical Affairs, Durham, United States (Zhou) Grifols SSNA, Global HEOR and RWE, Durham, United States (Mayer) Cytel Inc., London, United Kingdom Publisher Elsevier B.V. Abstract Background: Fibrinogen concentrate (FC) and cryoprecipitate are plasma-derived products used to manage bleed- ing in patients with hypofibrinogenemia. While both effectively restore fibrinogen levels, randomized controlled trials (RCTs) have shown no difference in efficacy or safety between products. However, it is hypothesized that cryoprecipitate may be associated with a higher risk of thromboembolic events (TEE) due to the presence of coagulation factors (e.g. factor VIII, von Willebrand factor) and of platelet-derived microparticles generated in its manufacturing process (Cushing MM, et al. Transfusion. 2020 Jun;60 Suppl 3:S17-S23, Hensley NB and Mazzeffi MA. Anesth Analg. 2021;133(1):19-28). The aim of this study was to conduct a systematic literature review (SLR) and meta-analysis (MA) to assess the comparative safety of FC vs. cryoprecipitate in patients with surgical bleeding, focusing on the risk of TEEs. Method(s): An SLR was conducted to identify RCTs published from 2009 to February 2025 that co mpared FC with cryopre- cipitate for safety outcomes in patients experiencing bleeding during elective surgery. Outcomes assessed included the incidence of TEE, deep venous thrombosis (DVT), pulmonary embolism (PE), any adverse events (AE) and serious AEs (SAE). Identified studies were evaluated for MA feasibility. Despite substantial heterogeneity in study design and population across the studies, all eligible studies were included in the base-case MA due to the limited number of available RCTs. The base-case analysis employed a frequentist approach, with heterogeneity assessed using the I2 statistic. To explore the potential sources of heterogeneity, subgroup analyses by age (adults vs. pediatrics) and type of surgery (cardiac vs. abdominal) were conducted where data allowed. Sensitivity analyses tested the robustness of the base-case findings by excluding studies with high risk of bias, removing an outlier study with disproportionate weight, and analysis based on per-protocol population. Exploratory analyses were performed using an empirical Bayesian (EB) approach for TEE and any AEs. All analyses were conducted in R version 4.4.1 (R Studio), using the meta package (version 7.0-0) for frequentist analyses and metafor (version 4.8-0) package for EB analyses. Frequentist analyses were performed using both fixed- and random- effects (FE and RE) models. For the EB analyses, only RE model was used. Results were reported as Odds Ratio (OR) and 95% confidence intervals (CI). Result(s): The SLR yielded 7 unique studies for inclusion in the MA. The base-case MA (RE model) showed a favorable trend for FC over cryoprecipitate in reducing the risk of all TEEs (n=5, OR = 0.55; 95% CI: 0.29-1.07; I = 32%). In subgroup analyses, FC was associated with a significantly lower risk of TEEs in abdominal surgery (n=2; OR = 0.19; 95% CI: 0.05-0.70; I2 = 7%), and similar, though non-significant, trends were observed in cardiac surgery, adult, and pediatric subgroups and in sensitivity analyses. Exploratory Bayesian approach showed consistent results with the base-case analysis (n=5; OR = 0.49; 95% CI: 0.19-1.28; I = 43%). Results for specific TEEs (DVT, PE) were consistent with the overall analysis. For DVT, the OR was 0.31 (n=3; 95% CI: 0.12-0.81; I = 0%), indicating a significantly lower risk in patients treated with FC. For PE, a non-significant trend was observed (n=3; OR = 0.43; 95% CI: 0.06-2.99; I = 49%). Within the abdominal surgery subgroup, a statistically significant reduction in PE risk was observed in patients treated with FC (n=2; OR = 0.23; 95% CI: 0.06-0.88; I2 = 0%). For any AEs and SAEs, FC showed a safety benefit vs. cryoprecipitate. A statistically significant reduction was observed for any AEs (n=4; OR = 0.70; 95% CI: 0.52-0.94; I = 0%), while for SAEs, the effect also favored FC but was not statistically significant (n=3; OR = 0.50; 95% CI: 0.18-1.40; I = 73%). Subgroup and sensitivity analyses showed consistent results for both any AEs and SAEs. The exploratory Bayesian analysis for any AEs matched the results of the base-case analysis. Conclusion(s): This analysis suggests that FC has a favorable safety profile regarding TEEs, as well as AEs and SAEs, compared to cryoprecipitate in patients with surgical bleeding. Due to the limited number and heterogeneity of the identified RCTs, these results should be interpreted with caution, underscoring the need for additional clinical trials. <96> Accession Number 2046039064 Title Impact of three-dimensional heart models on surgical planning and outcomes in congenital heart disease: a systematic review and meta-analysis. Source Open Heart. 13(1) (no pagination), 2026. Article Number: e004011. Date of Publication: 01 Jan 2026. Author Arero G.; Jarsso G.; Wako A.; Fekadu D.; Mardasa K.; Godana H. Institution (Arero, Jarsso, Wako, Fekadu, Mardasa) Adama General Hospital and Medical College, Oromia, Adama, Ethiopia (Godana) Saint Paul Millennium Medical College, Adama, Ethiopia Publisher BMJ Publishing Group Abstract Background: Congenital heart disease surgery includes intricate structures that are perhaps hard to completely understand by traditional two-dimensional shapes. Individualised, centre-based three-dimensional (3D) heart models may enhance structural imaging and surgical preparation, while data on their medical effect continue to be unpredictable and uneven. This systematic review and meta-analysis assessed the impact of 3D heart simulations on surgical preparation and outcomes in congenital cardiac disease. Objective(s): To assess the successful outcomes of patient-centred 3D cardiac simulations in medical preparation, intraoperative execution and surgical results in patients experiencing operation for congenital cardiac disease. Objective(s): To evaluate the impact of patient-specific 3D heart models on surgical planning precision and preoperative outcomes in congenital heart disease surgery. Method(s): A systematic review and meta-analysis were performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards and prospectively registered in PROSPERO (CRD42024211985). PubMed, Embase, Scopus and Cochrane CENTRAL were searched through March 2025 for comparative studies evaluating 3D-printed or virtual heart models versus conventional imaging. Outcomes were harmonised and pooled as risk ratios (RRs), mean differences (MDs) or standardised MDs (SMDs) with 95% CIs using random-effects models. Result(s): 32 studies (n=1842) met inclusion criteria. The use of 3D models was associated with more frequent surgical plan modification (RR 1.42; 95% CI 1.21 to 1.67), reduced operative time (MD -18.4 min; 95% CI -27.6 to -9.2), lower postoperative complications (RR 0.74; 95% CI 0.56 to 0.98) and reduced re-operation (RR 0.52; 95% CI 0.31 to 0.86). Hospital stay was shortened (MD: 1.8 days; 95% CI -3.0 to -0.6), and surgeon confidence improved (SMD 0.88; 95% CI 0.60 to 1.15). The confidence of indication extended from modest to small because of non-experimental research and variability. Conclusion(s): Individualised-centred 3D heart stimulation improves structural imaging and medical preparation in congenital cardiac disease, chiefly for intricate lacerations and can increase preoperative competence, while statistics for conclusive diagnosis results continue to be restricted and mainly experiential. Upcoming potential, large-scale investigator-led research with consistent result events are required to ratify their medical success. 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/. <97> Accession Number 2045782145 Title Prehabilitation Before Cardiac Surgery and Structural Heart Interventions: An Umbrella Review of Pooled Evidence. Source Journal of Clinical Medicine. 15(10) (no pagination), 2026. Article Number: 3821. Date of Publication: 01 May 2026. Author Hughes E.H.; Lotto R.; Dawson E.A.; Saber M.; Richards E.; Morris A.; Mayhew D.; Faraz F.; Ashrafi R.; Jones J.D. Institution (Hughes, Saber, Morris, Mayhew, Faraz, Ashrafi, Jones) Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom (Hughes, Dawson) Research Institute for Sport and Exercise Science, Faculty of Health, Innovation, Technology & Science, Liverpool John Moores University, Liverpool, United Kingdom (Hughes, Lotto, Dawson, Mayhew, Faraz, Ashrafi, Jones) Liverpool Centre for Cardiovascular Science, Liverpool, United Kingdom (Lotto) School of Nursing, Public and Allied Health, Faculty of Health, Innovation, Technology & Science, Liverpool John Moores University, Liverpool, United Kingdom (Richards) School of Medicine, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Prehabilitation aims to optimise patients before cardiac procedures through interventions including exercise training, respiratory conditioning, nutritional support, psychological preparation and multimodal lifestyle programmes. Evidence from systematic reviews and meta-analyses is increasing but remains heterogeneous due to variation in intervention design, patient populations and overlap of primary studies. Method(s): We conducted an umbrella review of 17 systematic reviews and meta-analyses evaluating prehabilitation prior to cardiac surgery and structural heart interventions in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Methodological quality of included reviews was assessed using A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR 2). Outcomes of interest were postoperative pneumonia, hospital length of stay (LOS), and mortality. Result(s): Across pooled analyses, the most consistent finding was a reduction in postoperative pneumonia, particularly in studies incorporating inspiratory muscle training (IMT), with relative risk reductions of approximately 55-62%, corresponding to a modest absolute risk reduction. Reductions in hospital LOS were also reported, although effect sizes were smaller and more variable. In contrast, no consistent reduction in short-term mortality was demonstrated, likely reflecting low event rates. The evidence base was limited by substantial overlap between reviews and predominantly low or critically low methodological quality. Conclusion(s): Prehabilitation, particularly when incorporating IMT, is consistently associated with a reduction in postoperative pneumonia and may contribute to modest reductions in hospital LOS. However, the evidence base is constrained by heterogeneity, study overlap and low methodological quality. Further high-quality, adequately powered randomised trials are required to define the role of prehabilitation in contemporary cardiac surgical and structural intervention practice. Copyright © 2026 by the authors. <98> Accession Number 651270412 Title Comparing short- and long-term outcomes of transcatheter valve-in-valve versus redo surgical aortic valve replacement: a literature review. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 22 May 2026. Author Ebrahimi P.; Eshraghi R.; Moradi A.; Javid R.N.; Khalique O.; Darouei B.; Rafiei N.; Kampaktsis P.; Spilias N.; Siegel R.; Fogli M.; Taheri H.; Mandegar M.H.; Kumar H.; Taheri M.; Hosseini K. Institution (Ebrahimi) Department of Cardiology, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, United Kingdom (Eshraghi) Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Moradi) HCA Healthcare, Blake Hospital, University of South Florida, Morsani College of Medicine, FL, United States (Javid, Mandegar, Hosseini) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Khalique) Division of Cardiovascular Imaging, St Francis Hospital and Catholic Health, Roslyn, NY, United States (Darouei) Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Rafiei) School of medicine, Isfahan University of Medical Sciences, Isfahan, Iran, Islamic Republic of (Kampaktsis) Division of Cardiology, Columbia University Irving Medical Center, NY, United States (Spilias) University of Miami Miller School of Medicine, Miami, FL, United States (Siegel, Taheri) Los AngelesCAUnited States (Fogli) Department of Cardiology, Ascension St. John Medical Center, Tulsa, OK, United States (Kumar) Liaquat National Hospital and Medical College, Karachi, Pakistan (Taheri) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Abstract Valve-in-valve transcatheter aortic valve replacement (ViV-TAVR) and redo-surgical aortic valve replacement (redo-SAVR) are two primary strategies for managing degenerated bioprosthetic aortic valves. ViV-TAVR has gained prominence due to its minimally invasive nature, shorter recovery time, and reduced perioperative risk, making it preferable for high-risk patients with multiple comorbidities. In contrast, redo-SAVR remains the gold standard for younger, lower-risk patients because of its superior long-term durability, lower residual gradients, and decreased risk of patient-prosthesis mismatch (PPM). ViV-TAVR and redo-SAVR are key strategies for managing degenerated bioprosthetic aortic valves. ViV-TAVR is favored for high-risk patients due to its minimally invasive nature, shorter recovery, and reduced perioperative risks, while redo-SAVR remains the gold standard for younger, lower-risk patients owing to its long-term durability and reduced risk of patient-prosthesis mismatch. Ongoing concerns regarding long-term durability, higher transvalvular gradients, and potential coronary obstruction exist. Although redo-SAVR offers better longevity, it has higher perioperative risks and longer recovery times. Across the included propensity-score matched studies and meta-analyses, long-term all-cause mortality was generally comparable between ViV-TAVR and redo-SAVR, although results were heterogeneous and some studies suggested a possible advantage for redo-SAVR in selected populations and/or with longer follow-up. However, ViV-TAVR may be associated with increased heart failure hospitalizations (HHF) after two years and redo-SAVR has superior short-term outcomes with regard to decreased myocardial infarction and PPM. Comparative studies also highlight a lower risk of atrial fibrillation (AF) and major adverse cardiovascular events (MACE) with ViV-TAVR, while redo-SAVR patients may experience better mid- to long-term survival. Copyright © 2026. The Author(s). <99> Accession Number 2045912849 Title Impact of Obesity on Outcomes after Minimally Invasive Mitral Valve Surgery: A Systematic Review and Meta-Analysis. Source IJC Heart and Vasculature. 64 (no pagination), 2026. Article Number: 101944. Date of Publication: 01 Jun 2026. Author Onyeji P.C.; Momplaisir-Onyeji S.; Majumdar A.; Nowakowski P.; Passos F.S.; Kirov H.; Treml R.E.; Doenst T.; Tkebuchava S.; Caldonazo T. Institution (Onyeji) All Saints University School of Medicine, Roseau, Dominica (Momplaisir-Onyeji) American University of Barbados, School of Medicine, Bridgetown, Barbados (Majumdar) GMERS Medical College and Hospital, Ahmedabad, Sola, India (Nowakowski) Medical University of Silesia, Zabrze, Poland (Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador, Brazil (Kirov, Doenst, Tkebuchava, Caldonazo) Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany (Treml) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, United States Publisher Elsevier Ireland Ltd Abstract Background: Minimally invasive mitral valve surgery (MIMVS) is increasingly used as an alternative to conventional sternotomy for patients with mitral valve pathologies. This systematic review and meta-analysis aimed to evaluate whether obesity (BMI >=30 kg/m2) is associated with different perioperative and postoperative outcomes in patients undergoing MIMVS. Method(s): MEDLINE, EMBASE, and Cochrane Library were systematically searched to identify studies comparing outcomes between BMI groups in patients undergoing MIMVS. The primary outcome was in-hospital mortality. The secondary outcomes were stroke, re-exploration for bleeding, intensive care unit (ICU) length of stay (LOS), hospital LOS, postoperative atrial fibrillation (POAF), requirement of permanent pacemaker implantation (PPI), duration of mechanical ventilation, and wound complications. A random-effects model was performed. Results Six studies comprising 5,925 patients met the inclusion criteria. Compared with BMI <30 kg/m2, obesity was not associated with higher in-hospital mortality (RR 1.29; 95%CI 0.67 to 2.48; p=0.446; I2=31.6%). However, obese patients had significantly higher rates of postoperative atrial fibrillation (RR 1.28; 95%CI 1.12 to 1.46; p<0.001; I2=0%), longer intubation duration (MD 0.88; 95%CI 0.11 to 1.65; p=0.02; I2=35.7%), longer hospital LOS (MD 0.51; 95%CI 0.04 to 0.99; p=0.03; I2=82.3%), and higher requirement for permanent pacemaker implantation (RR 1.43; 95%CI 1.01 to 2.01; p=0.043; I2=0%). No significant differences were observed in stroke, ICU LOS, re-exploration for bleeding, or wound complications. Sensitivity analyses confirmed the robustness of the pooled estimates. Conclusions In patients undergoing MIMVS, obesity was associated with higher rates of POAF and modestly prolonged postoperative recovery, without increased in-hospital mortality. Copyright © 2026 The Authors <100> Accession Number 651270360 Title Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 23 May 2026. Author Almehandi A.; Altarkait A.; Ali Y.; Alhajri M.; Alenezi M.; Diniz L.; Al-Naseem A.O.; Al Kindi H.; Thani S.A. Institution (Almehandi) Department of Cardiovascular Science, University College London, 118 E Ferry Rd, London, United Kingdom (Altarkait) General Surgery, Sheikh Jaber Al-Ahmad Al-Sabah Hospital, Kuwait City, Kuwait (Ali) Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom (Alhajri) School of Medicine, University of Leeds, Leeds, United Kingdom (Alenezi) Department of Surgery, Al-Adan Hospital, Kuwait City, Kuwait (Diniz) Department of Medical Sciences, Federal Fluminense University, Niteroi, Brazil (Al-Naseem) Department of Surgery, McGill University, Montreal, Canada (Al Kindi) Department of Cardiothoracic Surgery, Sultan Qaboos University Hospital, Sib, Oman (Thani) Pediatric Intensive Care Unit, Royal Hospital, Muscat, Oman Abstract BACKGROUND: Survival following the Norwood procedure has improved substantially, but outcomes for the high-risk subgroup requiring postoperative extracorporeal membrane oxygenation (ECMO) remain unclear. We explored short- and intermediate-term outcomes in these neonates. MAIN BODY: We systematically searched PubMed, EMBASE, Cochrane Central and Web of Science (final search: 25 February 2025). Comparative studies reporting outcomes for patients with versus without postoperative ECMO were included. Primary outcomes were short-term mortality, secondary outcomes included stages-2-and-3 palliation completion, operative times, recovery parameters, and complications. Statistical analysis used RevMan 5.4 to calculate pooled risk ratio (RR), odds ratios (OR) or mean differences (MD) with 95% confidence intervals employing random-effects models; heterogeneity was assessed using I2 statistics and Cochran's Q test. Eight studies (2,612 patients: 15% with ECMO) were included. In-hospital mortality was five times greater in the ECMO group (RR = 5.53, CI = 4.41-6.93, p = 0.0003), though survival to Glenn and Fontan completion were comparable. Cardiopulmonary bypass duration was significantly longer in the ECMO group (MD = 28.07 min, CI = 18.19-37.95, p = 0.0004). Postoperative ICU recovery was significantly prolonged for ECMO patients (MD = 10.56 days, CI = 1.28-19.83, p = 0.03), though hospital recovery was similar. Postoperative atrioventricular valve regurgitation, Norwood reoperation, delayed chest closure, unplanned reoperation or death/transplantation were comparable. Risk of bias (ROBINS-I) was formally assessed. CONCLUSION(S): Our analysis supports that ECMO use post-Norwood procedure identifies a high-risk subgroup with significantly higher early-mortality and resource utilisation. However, this association must be interpreted cautiously due to heterogenous ECMO indications. Future efforts should focus on identifying modifiable risk factors to improve outcomes. Copyright © 2026. The Author(s). <101> Accession Number 651271095 Title Baroreflex activation therapy in heart failure - the Barostim-Enabled Neurohormonal Intervention for Improving Treatment of Heart Failure (BENEFIT-HF) trial rationale and design. Source Journal of cardiac failure. (no pagination), 2026. Date of Publication: 21 May 2026. Author Sheikh F.H.; Abraham W.T.; Adamson P.B.; Anker S.D.; Brown S.; Butler J.; Friede T.; Lindenfeld J.; Perez-Izquierdo M.; Sears S.F.; Wilks S.J.; Zannad F.; Zile M.R. Institution (Sheikh) MedStar Heart and Vascular Institute/Georgetown University School of Medicine, WA, United States (Abraham) Division of Cardiovascular Medicine, Davis Heart and Lung Research Institute, Ohio State University Wexner Medical Center, Columbus, OH, United States (Adamson, Wilks) CVRx, Inc., Minneapolis, MN, United States (Anker) Department of Cardiology (CVK) of German Heart Center Charite; German Centre for Cardiovascular Research (DZHK) partner site Berlin, Charite Universitatsmedizin, Berlin, Germany (Brown) Bright Research, Minneapolis, MN, United States (Butler) Baylor Scott and White Research Institute, Dallas, Texas, USA; University of Mississippi, Jackson, Mississippi, USA (Friede) Department of Medical Statistics, University Medical Centre Gottingen, Gottingen, Germany (Lindenfeld) Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States (Perez-Izquierdo) Department of Vascular Surgery, Health First, Melbourne, FL, United States (Sears) East Carolina University, East Carolina Heart Institute, Greenville, NC, United States (Zannad) Inserm, Centre d'Investigations Cliniques, Inserm U1116, CHRU Nancy, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists), Universite de Lorraine- Plurithematique 14-33, Nancy, France (Zile) Division of Cardiology, Department of Medicine, Medical University of South Carolina and RHJ Department of Veterans Affairs, Charleston, SC, United States Abstract BACKGROUND: Baroreflex activation therapy (BAT) using an implanted neurostimulator enhances functional status and quality of life in patients with symptomatic heart failure with reduced ejection fraction (HFrEF). Nonetheless, its influence on mortality, heart failure morbidity, and optimal patient subgroups requires further study. METHOD(S): BENEFIT-HF is a prospective, randomized, open-label trial recruiting patients with left ventricular ejection fraction (LVEF) <50% who remain symptomatic despite guideline-directed medical and device therapies. A total of 2500 eligible ambulatory patients with stable heart failure will be randomized 2:1 to BAT implantation (Barostim System, CVRx, Inc., Minneapolis, MN, USA) plus standard care (Treatment Group) or standard care alone (Control Group). The primary efficacy endpoint is a 24-month composite of all-cause mortality, left ventricular assist device implantation or heart transplantation, and recurrent heart failure events. Secondary endpoints encompass changes in health status via the Minnesota Living with Heart Failure Questionnaire, 6-minute hall walk distance, days lost due to death or hospitalization, N-terminal pro-B-type natriuretic peptide levels, and all-cause mortality. CONCLUSION(S): BENEFIT-HF represents the largest device-based trial evaluating BAT as a neurohormonal modulator in a diverse cohort of HFrEF and heart failure with mildly reduced ejection fraction (HFmrEF) patients, aimed at determining its effects on morbidity, mortality, health status, and functional capacity. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <102> Accession Number 2038188046 Title Timing of transcatheter aortic valve implantation in patients with aortic stenosis. Source EuroIntervention. 22(10) (pp 530-544), 2026. Date of Publication: 2026. Author Craig N.J.; Prendergast B.; Newby D.E.; Dweck M.R. Institution (Craig, Newby, Dweck) British Heart Foundation Centre of Research Excellence, University of Edinburgh, Edinburgh, United Kingdom (Prendergast) Cleveland Clinic London, London, United Kingdom (Prendergast) St Thomas' Hospital, London, United Kingdom Publisher Europa Group Abstract Aortic stenosis is the most prevalent valvular heart disease in the Western world, affecting over 12% of individuals aged 75 years and older. The optimal timing of transcatheter aortic valve implantation or surgical aortic valve replacement remains one of the most debated topics in contemporary cardiology, particularly for asymptomatic patients with severe disease or symptomatic patients with moderate aortic stenosis. Whilst symptomatic severe aortic stenosis has established indications for intervention, the management of these other groups of patients requires careful consideration of disease progression, myocardial damage, procedural risks, and long-term outcomes. Recent randomised controlled trials have provided preliminary evidence regarding early intervention strategies. This review examines the current evidence base for the timing of aortic valve replacement, with a particular focus on transcatheter aortic valve implantation, and discusses the implications of recent trial data for clinical practice and guideline recommendations. Copyright © Europa Group 2026. All rights reserved. <103> Accession Number 2045957306 Title Islam and Pain Management. Source Anaesthesia, Pain and Intensive Care. 30(4) (pp 408-410), 2026. Date of Publication: 22 May 2026. Author Ali M. Institution (Ali) Main Operation Theatre, CMH Lahore, Lahore, Pakistan Publisher Faculty of Anaesthesia, Pain and Intensive Care, AFMS Abstract In the contemporary clinical setting, pain is often viewed strictly from the perspective of pathophysiology, a signal to be suppressed or a symptom to be managed. However, for the nearly two billion Muslims worldwide, pain is rarely a purely physical phenomenon. It is an experience deeply embedded in a theological framework that balances sabr(steadfast patience) with the ethical mandate for shifa (healing). Empirical evidence highlights the efficacy of Islamic spiritual interventions as adjuncts to standard care. Multiple randomized controlled trials demonstrate that listening to Qur'anic recitation (Murottal Quran) significantly reduces pain intensity, anxiety, and hospital/ICU length of stay in postoperative (e.g., CABG), critically ill, burn, and oncology patients, outperforming or complementing controls such as classical music. Clinicians should adopt culturally competent strategies: conduct spiritual assessments, prioritize halal medications, accommodate Ramadan fasting, address opioid hesitancy openly, and facilitate access to recitation or chaplain support. Integrating these faith-informed approaches enhances trust, adherence, and holistic outcomes in an increasingly diverse global patient population. For the clinician, understanding these distinctions is not merely an exercise in cultural competency; it is a clinical necessity for effective pain management and patient adherence. Pain is a universal human experience but its interpretation and expression are deeply influenced by cultural and religious factors. The Islamic world view, encompassing spiritual, ethical, and legal dimensions (Sharia), offers a comprehensive perspective on health, illness, and suffering.1 Islamic teachings profoundly shape the experience and management of pain. Pain is not viewed merely as a physiological symptom to be suppressed but as a multifaceted phenomenon encompassing physical suffering, spiritual testing, growth and the potential purification of the soul. The Quran states that believers will be tested with "fear and hunger and a loss of wealth and lives" (Surah Al-Baqarah 2:155). This editorial integrates Islamic sources (Qur'an and Sunnah), scholarship, modern fatwas, and empirical studies on pain management in Islam. Key themes include the redemptive value of patient endurance (sabr), the religious mandate to seek healing, the permissibility of pharmacological and non-pharmacological interventions, and the integration of spiritual care. Copyright © 2026, Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved. <104> Accession Number 2045795503 Title S722 Transesophageal Echo Associated Gastrointestinal Injuries: A Pooled Rate of Injuries. Source Embase Conference Abstracts. Conference: 2025 Annual Scientific Meeting and Postgraduate Course. Phoenix United States. (no pagination), 2026. Date of Publication: 2026. Author Gangwani M.K.; Hayat U.; Awan R.U.; Aziz A.; Dahiya D.S.; Aziz M.; Lee-Smith W.M.; Amantul-Raheem H.; Nawras Y.; Kamal F.; Inamdar S. Institution (Gangwani, Aziz, Lee-Smith, Nawras) University of Toledo, Toledo, OH, United States (Hayat) Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, United States (Awan) Ochsner Rush Medical Center, Meridian, MS, United States (Aziz) University of Augusta, Augusta, GA, United States (Dahiya) University of Kansas School of Medicine, Kansas City, KS, United States (Amantul-Raheem) Deccan College of Medical Sciences, Toledo, OH, United States (Kamal) Thomas Jefferson Health, Philadephia, PA, United States (Inamdar) University of Arkansas, Toledo, OH, United States Publisher Embase Conference Abstracts Abstract Introduction: - Transesophageal echocardiography (TEE) is a growing modality that plays a significant role in guiding clinical decision-making. However, upper gastrointestinal (GI) injuries are frequently observed as complications of TEE. The objective of this study is to systematically review the incidence rates and different types of GI injuries associated with TEE. Method(s): - A comprehensive literature search was performed across multiple databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science Core Collection, and the Global Index Medicus. The search utilized specific keywords related to "TEE" and "GI injuries". Pooled rates were calculated for overall injuries, GI complications, lacerations, and perforations, with corresponding 95% confidence intervals (CI). Additionally, a subgroup analysis was conducted using odds ratios (OR) to compare bleeding rates between the variceal and non-variceal groups. Result(s): - A total of 1, 151 articles were evaluated, and 26 studies with 55, 319 patients were included in the analysis. The overall rate of adverse events was found to be 0.51% with a 95% confidence interval (CI) of 0.3% to 0.7%. Among all adverse events, bleeding was the most commonly reported, followed by dysphagia and lacerations (refer to Table 1 for details). The highest rates of adverse events were observed in liver transplant patients at 1.35%, followed by critically ill patients in the intensive care unit (ICU) and in-hospital settings at 1.1%. Adverse events during intraoperative TEE were noted at a rate of 0.7%, while patients undergoing cardiac procedures experienced adverse events at a rate of 0.67%. The pooled complication rate for bleeding was calculated to be 0.17% with a 95% CI of 0.1% to 0.3%. The rate of odynophagia/dysphagia was estimated to be 0.27% with a 95% CI of -0.1% to 0.5%, and lacerations had a rate of 0.12% with a 95% CI of -0.1% to 0.5%. A subgroup analysis comparing variceal and non-variceal cohorts across three studies revealed no significant difference in bleeding rates (Figure 1). Conclusion(s): - Our review documented the complications associated with TEE and their correlation with different patient subgroups. Our study demonstrates benefits of TEE outweigh the minimal risks involved in at-risk patients including those with varices. Further studies are needed to validate our findings and provide valuable insights for future clinical decision-making.(Figure presented.) Copyright © 2023 by The American College of Gastroenterology <105> Accession Number 2046020030 Title A randomized controlled trial of electrical cardiometry-guided perioperative hemodynamic management in children undergoing cardiac surgery. Source Annals of Pediatric Cardiology. 19(2) (pp 139-146), 2026. Date of Publication: 01 Mar 2026. Author Thottan R.S.; Das S.; Makhija N.; Hasija S.; Chauhan S. Institution (Thottan, Das, Makhija, Hasija, Chauhan) Department of Cardiac Anaesthesia and Critical Care, Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi, India Publisher Wolters Kluwer Medknow Publications Abstract Background and Aims: Children undergoing corrective surgery for congenital heart disease (CHD) are at risk of perioperative hemodynamic instability and low cardiac output syndrome (LCOS). Conventional monitoring relies on static parameters that may inadequately reflect real-time cardiac performance. Electrical cardiometry (EC) provides continuous, noninvasive assessment of cardiac output and related indices. This study evaluated whether EC-guided perioperative management improves early postoperative outcomes compared with conventional monitoring in pediatric CHD surgery. Method(s): In this prospective randomized controlled trial, 60 children (0-15 years) undergoing elective corrective CHD surgery were randomized to EC-guided management (Group 1, n = 30) or conventional monitoring (Group 2, n = 30). In Group 1, perioperative fluid and vasoactive therapy were guided by EC-derived parameters, including cardiac index (CI), stroke volume, thoracic fluid content, and stroke volume variation. Group 2 was managed using standard clinical and invasive parameters. The primary outcome was the incidence of LCOS within 48 h postoperatively. The secondary outcomes included vasoactive inotropic score (VIS), major adverse cardiac events, and in-hospital mortality. Result(s): Baseline characteristics were comparable. Group 1 demonstrated significantly higher mean arterial pressure (MAP) at 8, 16, and 24 h postoperatively, faster lactate clearance, and lower VIS during the early postoperative period. CI correlated positively with MAP and urine output and inversely with lactate levels. No mortality occurred. Conclusion(s): EC-guided perioperative management aids in achieving early postoperative hemodynamic stability and metabolic recovery in children undergoing corrective CHD surgery and represents a valuable noninvasive adjunct to conventional monitoring. Copyright © 2026 Annals of Pediatric Cardiology. <106> Accession Number 2045869827 Title Incidence, Predictors, Management, and Clinical Impact of Major Bleeding Following Left Atrial Appendage Occlusion: The Amulet IDE Randomized Clinical Trial. Source JAMA Cardiology. 11(5) (pp 469-474), 2026. Date of Publication: 13 May 2026. Author Schmidt B.; Windecker S.; Thaler D.; Ellis C.R.; Nielsen-Kudsk J.E.; Freixa X.; Aminian A.; Anderson J.A.; Gage R.; Alkhouli M.; Lakkireddy D. Institution (Schmidt) Cardioangiologisches Centrum Bethanien, Frankfurt, Germany (Windecker) Inselspital, University of Bern, Bern, Switzerland (Thaler) Tufts Medical Center, Boston, MA, United States (Ellis) Vanderbilt Heart Institute, Nashville, TN, United States (Nielsen-Kudsk) Aarhus University Hospital, Aarhus N, Denmark (Freixa) Hospital Clinic of Barcelona, Barcelona, Spain (Aminian) Department of Cardiology, Centre Hospitalier Universitaire de Charleroi, Charleroi, Belgium (Anderson, Gage) Abbott Structural Heart, Plymouth, MN, United States (Alkhouli) Mayo Clinic, Rochester, MN, United States (Lakkireddy) Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, KS, United States Publisher American Medical Association Abstract Importance Left atrial appendage occlusion (LAAO) is used in patients with contraindications to oral anticoagulation, who are at increased risk for major bleeding (MB). Objective To evaluate the incidence, predictors, management, and clinical outcomes of MB after LAAO in the Amulet IDE trial. Design, Setting, and Participants The randomized clinical Amulet IDE trial enrolled patients from 2016 through 2019 with 5-year follow-up. Procedures were performed at specialized LAAO centers. Of 1878 randomized patients (1:1 Amulet vs Watchman), 1833 underwent attempted LAAO implantation. These data were analyzed from May 2025 through November 2025. Main Outcomes and Measures Pooled (Amulet and Watchman) patients with vs without MB (Bleeding Academic Research Consortium [BARC] score >=3: overt bleeding with transfusion and >=3 g/dL hemoglobin drop) were compared. Results This study included a total of 1833 patients (57.7% male and 42.3% female; mean [SD] age, 75.8 [7.5] years). MB occurred in 331 patients (18.1%) over 5 years (annualized rate 5.9% per year). Patients with MB were older (76.8 vs 74.7 years) and had higher CHA<inf>2</inf>DS<inf>2</inf>-VASc (4.8 vs 4.6) and HAS-BLED (3.4 vs 3.2) scores, as well as greater prevalence of diabetes (38.7% vs 34.1%), prior MB (45.3% vs 28.0%), and kidney disease (9.4% vs 4.5%). MB risk was highest in the first 6 months after LAAO (20.5% per year), then decreased to 3.9% per year through 5 years. Most MB events were nonprocedural (88.8%) with gastrointestinal bleeding accounting for 252 of 438 events. Independent predictors of MB included increasing age (hazard ratio [HR], 1.04; 95% CI, 1.02-1.06), female sex (HR, 1.25; 95% CI, 1.01-1.56), diabetes (HR, 1.26; 95% CI, 1.01-1.58), prior MB (HR, 1.93; 95% CI, 1.55-2.40), and kidney disease (HR, 2.15; 95% CI, 1.48, 3.12). At first MB event, 47.1% of patients were not receiving antithrombotic therapy and 92 patients had recurrent events. Patients with MB had significantly higher rates of the composite of stroke, systemic embolism, or cardiovascular death (32.5% vs 18.0%; P <.001), driven by higher stroke (14.7% vs 6.6%) and cardiovascular death (24.4% vs 12.9%) rates. All-cause mortality was also higher (49.2% vs 25.4%; P <.001). MB was fatal (BARC score of 5) in 25 patients (1.4%). Conclusions and Relevance In this study, MB was common in this high-risk population and largely related to underlying patient factors. Early MB risk was highest 6 months post-LAAO, then dropped considerably. Most events were gastrointestinal and occurred even in patients on minimal or no antithrombotic therapy. MB after LAAO was strongly associated with increased stroke and mortality. Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <107> Accession Number 2038183103 Title Taiwan Association of Thoracic and Cardiovascular Surgery (TATCS) Position Statement: Surgeon's Role in the Present Era of Isolated Severe Aortic Stenosis Patient Management. Source Acta Cardiologica Sinica. 42(3) (pp 479-485), 2026. Date of Publication: 01 May 2026. Author Chang C.-Y.; Lee Y.-T.; Lin C.-Y.; Chang J.-C.; Chen I.-C.; Chen S.-W.; Chen Y.-C.; Cheng B.-C.; Chi N.-H.; Hsieh C.-C.; Hsu C.-P.; Kang P.-L.; Ke H.-Y.; Li P.-C.; Lin C.-H.; Roan J.-N.; Shen T.-C.; Tsai Y.-T.; Wang C.-H.; Wu N.-C.; Shih C.-C. Institution (Chang, Lee, Chen) Department of Cardiovascular Surgery, Cheng Hsin General Hospital, Taiwan (Republic of China) (Lee) Department of Exercise and Health Science, National University of Nursing and Health Sciences, Taiwan (Republic of China) (Lin, Ke, Tsai) Division of Cardiovascular Surgery, Department of Surgery, Tri-Service General Hospital, Taiwan (Republic of China) (Lin) College of Biomedical Science, Institute of Biochemistry, National Defense Medical University, Taipei, Taiwan (Republic of China) (Chang) Division of Cardiovascular Surgery, Department of Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan (Republic of China) (Chang) School of Medicine, Tzu Chi University, Hualien, Taiwan (Republic of China) (Chen) Department of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital at Linkou, Taiwan (Republic of China) (Chen) College of Medicine, Chang Gung University, Taoyuan, Taiwan (Republic of China) (Chen) Division of Cardiovascular Surgery, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan (Republic of China) (Cheng, Wu) Department of Cardiovascular Surgery, Chi Mei Medical Center, Tainan, Taiwan (Republic of China) (Chi, Wang) Cardiovascular Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan (Republic of China) (Hsieh) Department of Cardiovascular Surgery, Kaohsiung Medical University Hospital, Taiwan (Republic of China) (Hsieh) Graduate Institute of Clinical Medicine, Taiwan (Republic of China) (Hsieh) Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (Republic of China) (Hsu) Cardiovascular Center, Taipei Veterans General Hospital, Taipei, Taiwan (Republic of China) (Kang) Department of Cardiovascular Surgery, Pingtung Veterans General Hospital, Pingtung City, Taiwan (Republic of China) (Li) Department of Cardiovascular Surgery, China Medical University Hospital, Taichung, Taiwan (Republic of China) (Lin) Department of Cardiovascular Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan (Republic of China) (Roan) Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, Taiwan (Republic of China) (Roan) College of Medicine, National Cheng Kung University, Tainan, Taiwan (Republic of China) (Shen) Division of Cardiovascular Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Taipei Branch, New Taipei City, Taiwan (Republic of China) (Tsai) School of Medicine, National Defense Medical Center, Taiwan (Republic of China) (Wang) College of Medicine, National Taiwan University, Taipei, Taiwan (Republic of China) (Wang) Cardiovascular Center, National Taiwan University Hospital-Yunlin Branch, Yunlin County, Taiwan (Republic of China) (Shih) Division of Cardiovascular Surgery, Department of Surgery, Taipei Municipal Wanfang Hospital, Taipei Medical University, Taiwan (Republic of China) (Shih) Taipei Heart Institute, Taipei Medical University, Taiwan (Republic of China) (Shih) Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan (Republic of China) Publisher Republic of China Society of Cardiology Abstract Background: Aortic stenosis (AS) is the most common primary valvular disease, with a high prevalence (12.4%) among older patients aged 75 years. Early intervention for AS is critical, as untreated moderate and severe AS are associated with high mortality rates. Evolving patient demographics and procedural trends in surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) call for a structured framework of favorable treatment options for AS comorbidities and cardiac anatomic variants. Method(s): The Taiwan Association of Thoracic and Cardiovascular Surgery held multiple meetings in 2024-2025 for local experts to examine the latest evidence and current trends and to facilitate discussion on the management of isolated severe AS in Taiwan. Result(s): Patient age, comorbidities, and unique cardiac structure frequently involve complex situations requiring treatment beyond SAVR or TAVI in AS management, emphasizing the need for thorough patient evaluation, accurate valvular imaging, and comprehensive patient-centered care with a multi-disciplinary heart team. Conclusion(s): Treatment options for individual patients must be carefully considered regarding their risk factors, anticipated life expectancy, and baseline health status. The cardiac surgeon provides valuable insights into surgical and alternative treatment methods tailored to individual patient conditions, and plays a critical role in the shared decision-making process in AS management. Copyright © 2026, Republic of China Society of Cardiology. All rights reserved. <108> Accession Number 2045791872 Title Long-Term Outcomes of Transcatheter Aortic Valve Replacement in Low-Flow Low-Gradient Aortic Stenosis: A Reconstructed Time-to-Event and Multivariate Meta-Analysis. Source Journal of the American Heart Association. 15(9) (no pagination), 2026. Article Number: e044431. Date of Publication: 2026. Author Moghadam A.S.; Kazemian S.; Moghadam S.S.; Nasiri P.; Mojahedi A.; Geraiely B.; Larti F.; Latib A.; Scotti A.; Kuno T.; Kolte D. Institution (Moghadam, Kazemian, Moghadam) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Nasiri) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mojahedi) Department of Internal Medicine, Stony Brook University Hospital, Stony Brook, NY, United States (Geraiely, Larti) Cardiology Department, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Latib, Scotti) Division of Cardiology, Montefiore Medical Center, The Bronx, NY, United States (Kuno, Kolte) Cardiology Division, Massachusetts General Hospital, Beth Israel Deaconess Medical CenterHarvard Medical School, Boston, MA, United States (Kuno) Division of Cardiology, Beth Israel Deaconess Medical CenterHarvard Medical School, Boston, MA, United States Publisher American Heart Association Inc. Abstract BACKGROUND: There are uncertainties regarding long-term outcomes of low-flow, low-gradient (LFLG) severe aortic stenosis (AS) following transcatheter aortic valve replacement (TAVR). This study investigates long-term outcomes of TAVR for highgradient (HG), classical LFLG, and paradoxical LFLG AS. METHOD(S): We systematically searched PubMed, Embase, Scopus, and Cochrane Library databases until January 2025 for studies comparing HG, classical LFLG, and paradoxical LFLG AS outcomes following TAVR. The primary outcome was allcause mortality, analyzed using reconstructed individual patient data meta-analysis. Secondary outcomes included cardiovascular mortality, heart failure hospitalization, acute kidney injury, bleeding events, stroke, myocardial infarction, permanent pacemaker implantation, and echocardiographic outcomes, analyzed using multivariate meta-analysis. RESULT(S): We included 19 observational studies comprising 20 493 patients who underwent TAVR for severe AS. Time-to- event meta-analysis indicated a higher risk of 5-year all-cause mortality in patients with classical and paradoxical LFLG AS compared with HG AS (hazard ratio [HR], 1.92 [95% CI, 1.62-2.27] and HR, 1.20 [95% CI, 1.07-1.34], respectively). Multivariate meta-analysis indicated an increased risk of cardiovascular mortality in patients with LFLG versus HG AS (classical LFLG HR, 1.94 [95% CI, 1.74-2.16]; paradoxical LFLG HR, 1.40 [95% CI, 1.25-1.57]). Classical and paradoxical LFLG AS were also associated with a higher risk of heart failure hospitalization (HR, 4.12 [95% CI, 2.16-7.83]; HR, 1.80 [95% CI, 1.14-2.85], respectively) compared with HG AS. CONCLUSION(S): Classical and paradoxical LFLG AS were associated with higher all-cause and cardiovascular mortality following TAVR compared with HG AS. Future studies are needed to determine strategies to improve outcomes following TAVR in patients with LFLG AS. Copyright © 2026 The Author(s). <109> Accession Number 2046026152 Title Comparing mitral transcatheter edge-to-edge repair and surgical intervention in mitral regurgitation: A meta-analysis. Source Journal of Cardiovascular and Thoracic Research. 18(1) (pp 4-14), 2026. Date of Publication: 2026. Author Mata E.; Garcia B.L.; Castro M.; Tinoco M.; Pinheiro L.; Portugues J.; Ferreira F.; Calvo L.; Ribeiro S.; Lourenco A. Institution (Mata, Garcia, Castro, Tinoco, Pinheiro, Portugues, Ferreira, Calvo, Ribeiro, Lourenco) Cardiology Department, Unidade Local de Saude de Alto Ave, Guimaraes, Portugal Publisher Tabriz University of Medical Sciences Abstract Surgery remains the standard treatment for severe mitral valve regurgitation (MR), but growing evidence highlights the potential role of mitral valve percutaneous edge-to-edge repair (M-TEER). This meta-analysis aims to compare 12-month all-cause mortality between M-TEER and surgical intervention (SMVI). A systematic search (October 2024) of PubMed, Cochrane, Scopus, and Web of Science identified randomized control trials (RCTs) and propensity-matched observational studies comparing 12-month all-cause mortality in MR patients treated with M-TEER or SMVI. An inverse variance random-effects meta-analysis assessed outcomes using risk ratios (RR) and 95% confidence intervals (CI). Two RCTs (MATTERHORN and EVEREST II) and three observational studies totaling 1,782 patients, were included in the final analysis. A non-significant trend of higher mortality at 30 days was observed in the SMVI group (RR: 0.72; CI: 0.26-2.00), along with higher complication rates mainly due to bleeding. At 12 months follow-up, SMVI was associated with a significantly lower risk of all-cause mortality (RR: 1.41; CI: 1.11-1.81), while the M-TEER group had more patients with MR grade 3 or higher (RR: 4.05; CI: 1.54-10.67), with a non-significant trend of higher rate of MR reintervention (RR 2.51; CI 0.83-7.66) at 12 months. Based on current evidence, M-TEER should continue to be reserved for patients with prohibitive high surgical risk. While propensity-matched cohorts were pooled for the study estimates, the limited available data from randomized trials, combined with heterogeneity in patient populations, particularly regarding MR etiology, underscores the need for further studies. Copyright © 2026 The Author(s). <110> Accession Number 651242638 Title Cost-Effectiveness of Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation: Insights from CASTLE-HTx. Source Heart rhythm. (no pagination), 2026. Date of Publication: 19 May 2026. Author Boettger P.; Moersdorf M.; Sommer P.; Marrouche N.F.; Costard-Jaeckle A.; Crijns H.J.G.M.; Bergau L.; Fox H.; Hindricks G.; Dagres N.; Schramm R.; Fink T.; Khalaph M.; Sciacca V.; Didenko M.; Konietschke F.; Rudolph V.; Gummert J.; Tijssen J.G.P.; Sossalla S.; Sohns C. Institution (Boettger) Department of Cardiology, Angiology and Critical Care Medicine, Justus Liebig University of Giessen, Giessen, Germany; Department of Health Policy, London School of Economics and Political Sciences, London, UK (Moersdorf) Department of Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany; Cardiology Department, Tulane University School of Medicine, New Orleans, Louisiana, USA (Sommer, Bergau, Fink, Khalaph, Sciacca, Didenko, Sohns) Department of Electrophysiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany (Marrouche, Gummert) Cardiology Department, Tulane University School of Medicine, New Orleans, LA, United States (Costard-Jaeckle, Fox, Schramm) Clinic for Thoracic and Cardiovascular Surgery, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Med. Fakultat OWL (Universitat Bielefeld), Bad Oeynhausen, Germany; Heart Failure Department, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Med. Fakultat OWL (Universitat Bielefeld), Bad Oeynhausen, Germany (Crijns) Department of Cardiology and CARIM, Maastricht University, Cardiovascular Research Institute Maastricht, Maastricht, Netherlands (Hindricks, Dagres) Department of Cardiology, Angiology and Intensive Care Medicine, German Heart Center of the Charite-University Medicine Berlin, Charite Campus Mitte, Germany (Konietschke) Institute of Biometry and Clinical Epidemiology, Corporate Member of Freie Universitat Berlin and Humboldt-Universitat zu Berlin, Charite-Universitatsmedizin Berlin, Berlin, Germany (Rudolph) Clinic for General and Interventional Cardiology/Angiology, Herz- und Diabeteszentrum NRW, Ruhr-Universitat Bochum, Bad Oeynhausen, Germany (Tijssen) Department of Cardiology, University of Amsterdam, Amsterdam, Netherlands (Sossalla) Department of Cardiology, Angiology and Critical Care Medicine, University of Giessen & Kerckhoff Heart Center, Germany Abstract BACKGROUND: The CASTLE-HTx trial (NCT04649801) showed that the combination of catheter ablation and guideline-directed medical therapy (GDMT) was associated with a lower likelihood of a composite of death from any cause, implantation of a left ventricular assist device (LVAD), or heart transplantation (HTx) in patients with end-stage heart failure (HF) and atrial fibrillation (AF). OBJECTIVE(S): This analysis evaluates the cost-effectiveness of catheter ablation plus GDMT versus medical therapy alone in patients with end-stage HF and AF referred for HTx evaluation. METHOD(S): In CASTLE-HTX, we randomized 194 patients in end-stage HF and AF to receive catheter ablation and GDMT (n=97) or medical therapy alone (n=97). Details of study design, outcome definitions, and results have been published. A cohort-based Markov model projected lifetime costs, life-years (LYs), and quality-adjusted life-years (QALYs) from the perspective of the German statutory health insurance (GKV) system using three-year outcomes from CASTLE-HTx. RESULT(S): In lifetime projections, the combination of AF ablation and GDMT was associated with a mean survival gain of ~1.7 LYs/patient at an incremental cost of ~12,000, yielding an incremental cost-effectiveness ratio (ICER) of ~7,300/LY gained. The ICERs/QALY in lifetime projections (8,600) and at 36 months (30,400) were below 50,000/QALY, indicating cost-effectiveness at contemporary thresholds. Within 36 months, this survival benefit resulted in a gain of 0.34 LYs, reflecting prevention of death and worsening HF. The long-term benefit emerged early and remained consistent across sensitivity analyses. CONCLUSION(S): The combination of catheter ablation and GDMT is cost-effective and economically favorable in patients with end-stage HF and AF who are referred for HTx evaluation. Copyright © 2026. Published by Elsevier Inc. <111> Accession Number 2045791868 Title Cardiovascular Outcomes in Patients With Deferred and Performed Coronary Revascularization Based on Intracoronary Physiology: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(9) (no pagination), 2026. Article Number: e042044. Date of Publication: 01 Jan 2026. Author Lombardi M.; Travieso A.; Cerrato E.; Mohammad M.A.; Gotberg M.; Davies J.; Escaned J. Institution (Lombardi, Travieso, Escaned) Hospital Clinico San Carlos, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC) and Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Complutense University of Madrid, Madrid, Spain (Lombardi) Department of Internal Medicine, University of Genova, Genoa, Italy (Cerrato) Interventional Cardiology Unit, San Luigi Gonzaga University Hospital, Orbassano, Rivoli Infermi Hospital, Turin, Rivoli, Italy (Mohammad, Gotberg) Cardiology Unit, Department of Clinical Sciences Lund, Lund University, Lund, Sweden (Mohammad, Gotberg) Department of Cardiology, Skane University Hospital, Lund, Sweden (Davies) National Heart and Lung InstituteImperial College London, London, United Kingdom Publisher American Heart Association Inc. Abstract BACKGROUND: Although large studies and pooled analyses of individual patient data have demonstrated the safety of deferring coronary revascularization based on a nonischemic intracoronary pressure index result, conflicting findings have emerged in specific patient subsets and with varying follow-up. Thus, we conducted an updated comprehensive systematic review and meta-analysis to investigate the cardiovascular outcomes associated with deferred or performed coronary revascularization based on intracoronary physiology. METHOD(S): Available studies were identified through a systematic search of PubMed, EMBASE, and CENTRAL. Efficacy outcomes investigated were major adverse cardiovascular events, all-cause death, cardiovascular death, noncardiovascular death, myocardial infarction, and unplanned revascularization. RESULT(S): A total of 24 studies enrolling 24 285 patients were included in the meta-analysis. After a mean+/-SD follow-up of 2.6+/-1.6 years, patients undergoing physiology-guided deferred revascularization show consistently better outcomes than patients who underwent revascularization, including all-cause death (incidence rate ratio [IRR], 1.14 [95% CI, 1.00-1.30]; P=0.05), cardiovascular death (IRR, 1.53 [95% CI, 1.17-2.00]; P=0.002), and unplanned revascularization (IRR, 1.38 [95% CI, 1.06-1.79]; P=0.01). For major adverse cardiovascular events (IRR, 1.15 [95% CI, 0.99-1.34]; P=0.07) and myocardial infarction (IRR, 1.24 [95% CI, 0.95-1.61]; P=0.11), the associations did not reach statistical significance. CONCLUSION(S): Patients in whom revascularization was deferred based on intracoronary physiology show lower risk of adverse cardiovascular events compared with those who underwent revascularization. These findings suggest that pressure wire assessment has prognostic implications besides the indication for revascularization. Copyright © 2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. <112> Accession Number 2045962656 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 American Journal of Cardiology. 271 (pp 65-75), 2026. Date of Publication: 15 Jul 2026. Author Daniyal S.M.; Riaz M.; Gul I.; Noor A.; Naveed M.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, Khatoon, Khalid, Gondal, Batool, Fahim, Aftab, Sarwar) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Ashraf) Department of Medicine, TruGift Health LLC, Wilmington, DE, United States Publisher Elsevier Inc. 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 the 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 3.07-5.47; p <0.01), and increased risk of PPM (RR 1.56; 95% CI 1.14-2.13; p = 0.006) and severe PPM (RR 2.66; 95% CI 1.97-3.60; p <0.001). BEVs were linked to lower rates of pacemaker implantation (RR 0.64; 95% CI 0.46-0.89; p = 0.008) and major bleeding (RR 0.69; 95% CI 0.50-0.96; 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 trade-offs. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

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