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

Total documents retrieved: 115 Results Generated From: Embase <1980 to 2026 Week 24> Embase Weekly Updates (updates since 2026-06-05) - (115 records) <1> Accession Number 2045135062 Title Outcomes of off-pump versus on-pump coronary artery bypass grafting in diabetic patients: A propensity-adjusted systematic review and meta-analysis. Source Asian Cardiovascular and Thoracic Annals. 34(5) (pp 452-460), 2026. Date of Publication: 01 Jun 2026. Author Murad Z.A.; Lahcen A.A.; Alkhawam M.; Al-awadh M.F.; Ali M.; Saeed S.A.S.; Elghazaly S.M. Institution (Murad) Faculty of Medicine and Health Science, University of Aden, Aden, Yemen (Lahcen) Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco (Alkhawam) University of Alabama at Birmingham, Birmingham, AL, United States (Al-awadh) University of Bahri, Alkadroo, Sudan (Ali, Elghazaly) Faculty of Medicine, Assiut University, Assiut, Egypt (Saeed) Ibn Sina University, Khartoum, Sudan Publisher SAGE Publications Inc. Abstract Objective: Diabetes is a major risk factor for coronary artery disease. We compared outcomes of off-pump (OPCAB) versus on-pump (ONCAB) coronary artery bypass grafting in diabetic patients using propensity-adjusted observational studies. Method(s): We searched PubMed, Scopus, Web of Science, and the Cochrane Library for studies comparing OPCAB and ONCAB in diabetic patients using propensity-score matching or covariate adjustment. Eligible studies reported short-term or long-term clinical outcomes. Primary endpoints were early (in-hospital or 30-day) mortality and long-term survival. Secondary outcomes included stroke, myocardial infarction, reoperation for bleeding, atrial fibrillation, renal replacement therapy, low cardiac output syndrome, and completeness of revascularization. Pooled odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using random-effects models. Result(s): Nine studies (observation periods 1996-2021), including >10,000 diabetic patients, met criteria. There was no significant difference in early mortality between OPCAB and ONCAB (OR 0.71, 95% CI 0.44-1.14; P = .15). Long-term mortality was significantly higher with OPCAB (HR 1.16, 95% CI 1.01-1.33; P = .04), while mid-term survival showed no difference. OPCAB was associated with lower risks of stroke (OR 0.47, 95% CI 0.24-0.94; P = .03) and reoperation for bleeding (OR 0.60, 95% CI 0.41-0.88; P = .009), but higher risks of incomplete revascularization (OR 2.07, 95% CI 1.60-2.68; P < .00001) and atrial fibrillation (OR 1.70, 95% CI 1.16-2.47; P = .006). Conclusion(s): In diabetic patients undergoing CABG, OPCAB lowers stroke and bleeding risk but increases incomplete revascularization and is associated with significantly higher long-term mortality. Choice of technique should be individualized with emphasis on complete revascularization. Copyright © The Author(s) 2026 <2> Accession Number 2044576418 Title Effect of Metabolic Bariatric Surgery on Cardiovascular Outcomes in People with Obesity and Pre-existing Cardiovascular Disease: A Systematic Review and Meta-Analysis. Source Obesity Surgery. 36(5) (pp 2634-2643), 2026. Date of Publication: 01 May 2026. Author Qazi S.U.; Shuja M.H.; Shakil F.; Ansari H.U.H.; Khan L.A.; Aziz A.A.; Dang A.K.; Hassan O.U.; Farhan M.; Ahmed R.; Hall M.E. Institution (Qazi, Shuja, Shakil, Ansari) Dow University of Health Sciences, Karachi, Pakistan (Khan, Hall) University of Mississippi Medical Center, Jackson, United States (Aziz) INTEGRIS Baptist Medical Center, Oklahoma City, United States (Dang) University of California, Riverside, Riverside, United States (Hassan) AdventHealth, FL, United States (Farhan) Imperial College London, London, United Kingdom (Ahmed) Newcastle University, Newcastle upon Tyne, United Kingdom Publisher Springer Abstract Background: Metabolic bariatric surgery (MBS) effectively lowers the risk of cardiovascular (CV) events in individuals with obesity, however, its application in those with pre-existing CV disease has been limited due to concerns about perioperative outcomes. Objective(s): This study evaluates the effectiveness and safety of bariatric surgery in reducing CV risk in people with pre-existing CV disease. Method(s): We carried out an extensive search on PubMed, Google Scholar, Science Direct, and Clinicaltrial.gov from their inception until February 2025. Key outcomes included reductions in all-cause mortality (ACM), major adverse CV events (MACE), myocardial infarction (MI), and cerebrovascular events in people with and without prior CV disease undergoing bariatric surgery. Data were combined using a random-effects model and displayed as hazard ratios (HR) along with 95% confidence intervals (CI). Result(s): Three studies (n = 3,888) were included, with 1,523 patients getting Roux-en-Y gastric bypass and 442 receiving sleeve gastrectomy. Median age ranged from 52 to 56 years. Metabolic bariatric surgery was associated with a significant reduction in ACM (HR = 0.48, 95% CI: 0.38 to 0.61, p < 0.01) and MACE (HR = 0.55, 95% CI: 0.45 to 0.67, p < 0.01). However, no significant reduction was observed for MI (HR = 0.53, 95% CI: 0.24 to 1.18, p = 0.12) or cerebrovascular events (HR = 0.99, 95% CI: 0.64 to 1.54, p = 0.96). Conclusion(s): Metabolic bariatric surgery is associated with significantly lower ACM and MACE in people with obesity and prevalent CV disease. These results highlight the necessity for additional extensive trials to validate advantages in high-risk groups, specifically older individuals and those who have experienced prior MI or heart failure. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <3> Accession Number 2044143122 Title The AtriAmp: a review of a novel device for atrial electrogram monitoring. Source Expert Review of Medical Devices. 23(6) (pp 575-581), 2026. Date of Publication: 2026. Author Cook C.; Beshish A.; Malloy-Walton L.; Al-Subu A.M. Institution (Cook) Division of Pediatric Cardiology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, American Family Children's Hospital, Madison, WI, United States (Beshish) Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, United States (Malloy-Walton) Division of Pediatric Cardiology, Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States (Al-Subu) Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, American Family Children's Hospital, Madison, WI, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Arrhythmias following cardiac surgery are a common occurrence. Continuous atrial electrograms (AEG) are a valuable diagnostic tool, though barriers often limit their use. The AtriAmp is a device designed to enable continuous AEG monitoring using existing bedside telemetry systems. Areas covered: This review summarizes postoperative arrhythmia monitoring, limitations of existing technologies, and the AtriAmp. A literature search was conducted in PubMed and Google Scholar (2000-2025) using keywords 'postoperative arrhythmia,' 'atrial electrogram,' 'AtriAmp,' and 'electrophysiology.' References from limited relevant articles were also reviewed. Expert opinion: AtriAmp displays real-time AEGs alongside surface ECG using temporary atrial pacing leads. Published evidence remains very limited with no prospective comparative studies to date demonstrating improved clinical outcomes. Available reports suggest AtriAmp may improve clinician diagnostic confidence and reduce uncertainty in selected postoperative arrhythmia scenarios. Important limitations of the AtriAmp include single-use design, reliance on surgically placed epicardial wires, amplifier saturation during pacing, the need for provider training, and a per-patient disposable cost. Nonetheless, its potential to reduce diagnostic uncertainty, guide timely interventions, and optimize postoperative outcomes is substantial. AtriAmp should therefore be viewed as an adjunct diagnostic tool, with multicenter prospective studies needed to define the target population, quantify clinical impact, and establish cost-effectiveness. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <4> Accession Number 2046228961 Title Transcatheter Tricuspid Valve Intervention Versus Optimal Medical Therapy in Symptomatic Tricuspid Regurgitation: A Systematic Review and Meta-Analysis of Randomized and Observational Studies. Source American Journal of Cardiology. 271 (pp 133-143), 2026. Date of Publication: 15 Jul 2026. Author Banga A.; Bansal V.; Rathore S.S.; Yadav A.; Jain H.; Misra S.; Agrawal A.; Ganatra S.; Yadav K.; Deedwania P.; Dhingra R.; Goldsweig A.M.; Dani S.S. Institution (Banga) Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, MA, United States (Bansal) Department of Research, WellSpan Hospital, York, PA, United States (Rathore) Department of Medicine, Ascension Columbia St. Mary's Hospital, Milwaukee, WI, United States (Yadav) Department of Cardiovascular Medicine, University of Toledo, Toledo, OH, United States (Jain) Department of Medicine, All India Institute of Medical Science, Jodhpur, India (Misra) Department of Surgery, University of Texas Southwestern Medical Center, San Antonio, TX, United States (Agrawal, Yadav) Department of Cardiovascular Medicine, University of Arizona, Little Rock, AZ, United States (Ganatra, Dani) Division of Cardiovascular Medicine, Lahey Hospital & Medical Center, Burlington, MA, United States (Deedwania) Department of Cardiovascular Medicine, University of California San Francisco, Fresno, CA, United States (Dhingra) Division of Cardiovascular Medicine, Medical College Wisconsin, Milwaukee, WI, United States (Goldsweig) Division of Cardiovascular Medicine, Baystate Medical Center, Springfield, MA, United States Publisher Elsevier Inc. Abstract Severe symptomatic tricuspid regurgitation is associated with a poor prognosis, and many patients are ineligible for surgical intervention. Transcatheter tricuspid valve intervention (TTVI) has emerged as a less invasive alternative, but its impact on clinical outcomes compared with optimal medical therapy (OMT) remains uncertain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies comparing TTVI (transcatheter edge-to-edge repair or valve replacement) with OMT. Databases were searched from inception through December 31, 2025. Outcomes included all-cause and cardiovascular mortality, heart failure hospitalization, myocardial infarction, stroke, bleeding, and new permanent pacemaker or implantable cardioverter-defibrillator implantation. Random-effects models were used to calculate pooled odds ratios. Thirteen studies encompassing 6,732 patients (3,240 TTVI; 3,492 OMT) were included. In pooled analyses of randomized and observational studies, TTVI was associated with a significant reduction in all-cause mortality compared with OMT (odds ratios 0.70; p = 0.009). However, this benefit was not observed in an RCT-only analysis. No significant differences were noted in cardiovascular mortality, heart failure hospitalization, myocardial infarction, severe bleeding, or stroke. A nonsignificant trend toward increased permanent pacemaker/implantable cardioverter-defibrillator implantation (p = 0.06) was primarily driven by valve replacement devices. In symptomatic tricuspid regurgitation, TTVI was associated with reduced all-cause mortality in pooled analyses incorporating both randomized and observational data; however, this benefit was not confirmed in RCT-only analyses, likely reflecting residual confounding in nonrandomized studies which may overestimate treatment effects. These findings support TTVI as an effective therapeutic option for appropriately selected high-risk patients. Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <5> Accession Number 2046154385 Title Cognitive dysfunction after cardiac surgery: A systematic review and meta-analysis on the mini-mental state examination findings. Source Biomedical Reports. 25(1) (no pagination), 2026. Article Number: 89. Date of Publication: 01 Jul 2026. Author Cheng H.; Yasen Y.; Cheng X.; Hu Z.; Li X.; Wu J.; Yu W.; Wang J. Institution (Cheng, Yasen, Cheng, Hu, Li, Wu, Yu, Wang) Department of Anesthesiology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumchi, China (Cheng, Yasen, Hu, Wu, Wang) Xinjiang Provincial Key Laboratory of Perioperative Organ Protection, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang, Urumchi, China Publisher Spandidos Publications Abstract Postoperative cognitive dysfunction (POCD) is a frequent complication of cardiac surgery. The present study aimed to quantify changes in Mini-Mental State Examination (MMSE) scores following on-pump cardiac surgery and explore potential study-level moderators associated with variability in cognitive outcomes. A systematic review and random-effects meta-analysis was performed following PRISMA guidelines. MEDLINE, Embase, Cumulative Index to Nursing & Allied Health Literature, Cochrane, PsycINFO, Web of Science, and Scopus were searched up to May 2025; eight prospective single-center cohorts (867 patients) met predefined criteria, providing 14 independent pre/postopera- tive comparisons of cognitive function. The mean MMSE score was extracted at baseline and final reported follow-up (7 days to 6 months). Hedges' g was pooled using a random-effects model; heterogeneity was summarized with tau2 and I2, and a 95% prediction interval (PI) was calculated. Overall, cardiac surgery was associated with a moderate decline in MMSE scores (g=-0.60, 95% confidence interval, -0.85 to -0.35; P<0.001). Heterogeneity was high (tau2=0.178; I2=88.8%), yet leave-one-out and Hartung-Knapp adjustments produced similar estimates. The 95% PI (-1.56 to 0.36) spans both nega- tive and slightly positive values, indicating that while most cohorts show cognitive decline, the inclusion of values above zero suggests that small improvements remain possible in some populations. Subgroup analysis showed a large decline among patients meeting POCD criteria (g=-0.893) compared with a small, non-significant change in non-POCD patients (g=-0.274; Q_between=9.08, P=0.003). Meta-regression identified cardiopulmonary-bypass time as the only statistically significant moderator (beta=-0.014 MMSE SD units/min; P=0.023), explaining ~50% of between-study vari- ance. Funnel-plot tests suggested possible small-study effects, but trim-and-fill imputed no missing studies and Rosenthal's fail-safe N was 431, supporting the robustness of the pooled estimate. These findings suggest that on-pump cardiac surgery is frequently associated with a moderate decline in global cognitive performance as measured by the MMSE, particularly among patients who develop clinical POCD. Awareness of this association may support perioperative cognitive monitoring and efforts to minimize modifiable intraoperative factors such as prolonged cardiopulmonary bypass duration. Copyright © 2026 Cheng et al. <6> 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. <7> Accession Number 2045395107 Title Operative predictors of mortality and neurologic outcomes after modified Bentall for acute aortic dissection: A systematic review and meta-analysis. Source Asian Cardiovascular and Thoracic Annals. 34(5) (pp 430-444), 2026. Date of Publication: 01 Jun 2026. Author Kurniawan K.; Wartono D.A. Institution (Kurniawan) Faculty of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia (Wartono) Department of Cardiothoracic and Vascular Surgery, National Cardiovascular Centre Harapan Kita, Jakarta, Indonesia Publisher SAGE Publications Inc. Abstract Introduction: The modified Bentall procedure is frequently required in acute type A aortic dissection (ATAAD) with root involvement, a high-risk subgroup with substantial early mortality and neurologic complications. Prior studies have examined operative predictors such as cardiopulmonary bypass (CPB) time, cross-clamp duration, circulatory arrest, and conduit type, but findings remain inconsistent. This systematic review and meta-analysis aimed to determine whether specific operative parameters influence early mortality or neurologic outcomes following the Bentall procedure in ATAAD. Method(s): A systematic search of PubMed, Embase, CENTRAL, ProQuest, and Google Scholar was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Fifteen observational studies evaluating adult ATAAD patients undergoing the modified Bentall procedure were included. Pooled proportions of early mortality and neurologic complications were calculated using a random-effects model. Heterogeneity, publication bias, sensitivity testing, and meta-regression were conducted to assess associations between operative variables-including CPB time, cross-clamp time, circulatory arrest duration, operative time, conduit type, and concomitant coronary artery bypass grafting (CABG)-and postoperative outcomes. Result(s): Across 1547 patients, pooled early mortality was 13%, and the pooled rate of postoperative neurologic complications was likewise 12%. Sensitivity analyses showed stable results. Meta-regression demonstrated no significant association between any operative parameter and early mortality or neurologic events (all p > 0.05). No substantial publication bias was detected. Conclusion(s): Among ATAAD patients undergoing the modified Bentall procedure, early mortality and neurologic complication rates remain acceptable. The absence of significant operative predictors suggests that advances in perfusion, myocardial protection, and cerebral management may mitigate time-related risks. Further multicenter studies are needed to refine risk stratification. Copyright © The Author(s) 2026 <8> Accession Number 649562763 Title Effectiveness of Early Mobility Interventions for the Management of Cardiac Surgery Patients: A Meta-analysis. Source Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses. 41(3) (pp 614-623), 2026. Date of Publication: 01 Jun 2026. Author Yu J.; Wei L.; Li P.; Zhang S. Institution (Yu, Wei, Li) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China (Zhang) Department of Cardiovascular and Macrovascular, Shandong Provincial Third Hospital, Jinan, Shandong, China Abstract PURPOSE: Early mobility interventions are increasingly recognized as a critical component of postoperative care for cardiac surgery patients. These interventions aim to improve functional recovery, reduce complications, and optimize resource utilization. However, the effectiveness of early mobility programs on outcomes such as the 6-minute walk distance (6-MWD), hospital and intensive care units (ICU) length of stay, and in-hospital mortality remains unclear. DESIGN: Systematic review and meta-analysis. METHOD(S): This review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines to evaluate the effectiveness of early mobility interventions in cardiac surgery patients. Relevant studies were identified from PubMed, Scopus, Web of Science, and EMBASE databases. Random-effects meta-analyses were performed to pool standardized mean differences (SMD) or odds ratios with 95% confidence intervals (CIs) for 6-MWD, length of hospital and ICU stay, and in-hospital mortality. Heterogeneity was assessed using the I2 statistic. FINDINGS: Twenty studies including 2,523 participants were analyzed. Early mobility interventions significantly improved 6-MWD (SMD: 1.22; 95% CI: 0.62 to 1.82; P < .001) and reduced hospital (SMD: -0.55; 95% CI: -0.85 to -0.24; P < .001) and ICU (SMD: -0.48; 95% CI: -0.93 to -0.03; P = .036) length of stay. Substantial heterogeneity was observed across studies (I2 > 85%). No significant reduction in in-hospital mortality was found (odds ratios: 0.56; 95% CI: 0.13 to 2.42; P = .437). CONCLUSION(S): Early mobility interventions improve functional recovery and reduce hospital and ICU stays in cardiac surgery patients. These findings support the integration of structured mobility programs into postoperative care to optimize outcomes, though further research is needed to address heterogeneity and long-term impacts. Copyright © 2026 The American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved. <9> Accession Number 2045337875 Title Ultrasound-Guided Erector Spinae Plane Block versus Thoracic Epidural Analgesia for Postoperative Pain Control after Video-Assisted Thoracoscopic Surgery: A Randomized Controlled Trial. Source International Journal of Current Pharmaceutical Review and Research. 18(2) (pp 1027-1032), 2026. Date of Publication: 2026. Author Chandak A.A.; Patel D.; Khatrikar M. Institution (Chandak) Department of Anaesthesia, Swaminarayan Institute of Medical Sciences & Research, Gujarat, Kalol, India (Patel, Khatrikar) Department of Anaesthesiology, The Gujarat Cancer and Research Institute, Gujarat, Ahmedabad, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Postoperative pain management following video-assisted thoracoscopic surgery (VATS) remains a significant clinical challenge. Thoracic epidural analgesia (TEA) has long been regarded as the gold standard analgesic technique for thoracic surgery; however, it is associated with invasiveness and notable complications. The ultrasound-guided erector spinae plane (ESP) block has emerged as a promising, technically simpler alternative. Method(s): This prospective, single-center, randomized controlled trial enrolled 80 adult patients (ASA I-III) undergoing elective VATS. Patients were randomly allocated to the ESP group (n = 40; ultrasound-guided continuous ESP block with 0.25% bupivacaine) or the TEA group (n = 40; continuous thoracic epidural infusion of 0.125% bupivacaine with fentanyl 2 microg/mL). The primary outcome was pain scores at rest measured using the Numerical Rating Scale (NRS) at 24 hours postoperatively. Secondary outcomes included NRS during coughing, cumulative morphine consumption at 24 and 48 hours, incidence of adverse events, patient satisfaction, and length of hospital stay. Result(s): NRS pain scores at rest at 24 hours were comparable between groups (ESP: 2.9 +/- 1.1 vs. TEA: 2.5 +/- 1.0; p = 0.098). Cumulative morphine consumption at 48 hours was significantly higher in the ESP group (18.4 +/- 5.2 mg vs. 14.1 +/- 4.7 mg; p = 0.001). TEA was associated with significantly higher rates of hypotension (25.0% vs. 7.5%; p = 0.035) and urinary retention (22.5% vs. 5.0%; p = 0.024). Patient satisfaction scores were similar. Length of hospital stay did not differ significantly between groups. Conclusion(s): Ultrasound-guided ESP block provides comparable resting pain relief to TEA after VATS, with a significantly more favorable side effect profile, despite modestly higher opioid consumption. ESP block may serve as a viable, less invasive alternative to TEA within a multimodal analgesia framework. Copyright © (2026), (Dr. Yashwant Research Labs Pvt. Ltd.). All rights reserved. <10> Accession Number 2045848515 Title Exploring the Potential of AI and Augmented Reality in Cardiovascular Disease Management: A Narrative Review. Source Current Cardiology Reviews. 22(4) (no pagination), 2026. Date of Publication: 2026. Author Khan A.M.; Villalobos A.; Kakadiya A.D.; Kaur H.; Tabassum S.; Faisal A.M.; Pardeshi R.; Shah D.; Ponnada S.C.; Patel K. Institution (Khan) OSF Saint Francis Medical Centre, Peoria, IL, United States (Villalobos) Ponce Health Sciences University, Ponce, United States (Kakadiya) GMERS Medical College & Hospital, Ahmedabad, India (Kaur) Government Medical College, Patiala, India (Tabassum) Dr. V.R.K Women's Medical College, Telangana, Aziz Nagar, India (Faisal) Danylo Halytsky Lviv National Medical University, Lviv, Ukraine (Pardeshi) GCS Medical College, Hospital and Research Center, Ahmedabad, India (Shah) B.J. Medical College, Ahmedabad, India (Ponnada) Great Eastern Medical School and Hospital, Srikakulam, India (Patel) Government Medical College, Surat, India Publisher Bentham Science Publishers Abstract Introduction: Cardiovascular diseases remain a leading cause of morbidity and mortality worldwide, with their rising incidence demanding a shift toward more personalized treatment approaches. Artificial intelligence (AI) and augmented reality (AR) are two newly evolving technologies that have found extensive usage in the field of cardiovascular medicine and surgery. AI-based models involve machine learning and deep learning neural networks. These primarily form the basis of prediction models, allowing the prediction of risk, survival, and risk stratification of patients. Method(s): A literature search was conducted using PubMed and Google Scholar, and it included studies published between 2003 and 2024. Articles were selected based on clinical relevance and applicability to cardiovascular disease management using artificial intelligence (AI) and AR. Keywords used included "cardiovascular disease", "artificial intelligence", "augmented reality", "diagnostic imaging", and "risk prediction". Studies were screened manually for inclusion based on the title and abstract review, followed by full-text evaluation for relevance and quality. Result(s): This narrative review highlights how artificial intelligence (AI) and augmented reality (AR) are increasingly being applied in cardiovascular disease management. Despite recent studies, there remains a lack of proper evaluation of these models' efficacy, and therefore multiple large-scale trials are needed. Discussion(s): Networks such as Convolutional Neural Networks (CNNs) and Natural Language Processing (NLP) have been used to improve image interpretation and documentation processes. Conclusion(s): Further and larger studies are needed to test the efficacy and safety of these models. This narrative review summarizes recent findings in AI and AR and offers perspectives on future research. Copyright 2026, Bentham Science Publishers <11> [Use Link to view the full text] Accession Number 2044250844 Title Influence of Pre-emptive Haptoglobin on Postoperative Acute Kidney Injury in Cardiac Surgical Patients: A Randomized Controlled Trial. Source Anesthesia and Analgesia. Publish Ahead of Print (no pagination), 2025. Article Number: 10.1213/ANE.0000000000007827. Date of Publication: 21 Nov 2025. Author Miyazaki A.; Hokka M.; Mizobuchi S. Institution (Miyazaki, Hokka, Mizobuchi) Department of Anesthesiology, Kobe University Hospital, Hyogo, Japan Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Haptoglobin may reduce hemolysis-induced kidney injury in patients undergoing cardiovascular surgery with cardiopulmonary bypass (CPB). Haptoglobin may be given empirically when hemolytic urine is observed, or pre-emptively when detected by elevated free hemoglobin concentrations. In the present study, we investigated whether pre-emptive haptoglobin therapy guided by serum-free hemoglobin concentrations could prevent postoperative renal dysfunction in patients who underwent major cardiovascular surgery using CPB. METHOD(S): - This study was a single-center, open-label, randomized controlled trial. Adult patients who underwent major cardiovascular surgery using CPB were included. Serum-free hemoglobin concentrations were measured in all patients who consented for this study. Patients with free hemoglobin concentrations that reached 0.05 g/dL were randomized to either (i) pre-emptive haptoglobin therapy group or (ii) standard of care group. Patients in the pre-emptive haptoglobin therapy group were administered 4000 U of haptoglobin when serum-free hemoglobin concentration reached 0.05 g/dL within 2 hours after the start of CPB. In the standard of care group, 4000 U of haptoglobin was administered when hemolytic urine was confirmed after the start of CPB. The primary outcome was the difference between the preoperative creatinine concentration and the maximum creatinine concentration within 48 hours after surgery (DELTACr). RESULT(S): - The study was terminated with the results of interim analysis due to patients' safety concerns. Finally, 34 patients in the pre-emptive haptoglobin therapy group and 33 in the standard of care group were included in the analysis. Median (interquartile range) DELTACr values were 0.20 (0.05-0.44) in the pre-emptive haptoglobin therapy group and 0.14 (0.04-0.19) in the standard of care group (P = .05). Multiple linear regression analysis with DELTACr as objective variable and preoperative estimated glomerular filtration rate (eGFR), age, and randomize group as explanatory variables revealed that pre-emptive administration of haptoglobin significantly increased DELTACr (P = .03). CONCLUSION(S): - The interim study results demonstrated that in patients undergoing major cardiovascular surgery using CPB, pre-emptive haptoglobin administration worsened Cr values and independently associated with increased DELTACr. Copyright © 2025 International Anesthesia Research Society <12> Accession Number 2042248337 Title Nationwide trends and in-hospital outcomes of surgical versus transcatheter aortic valve replacement in Japan: a real-world analysis using administrative data. Source Heart and Vessels. 41(6) (pp 403-413), 2026. Date of Publication: 01 Jun 2026. Author Kim Y.K.; Nagaoka E.; Oishi K.; Toba M.; Fushimi K.; Fujita T. Institution (Kim) Department of Surgery and Cancer, Imperial College London, South Kensington Campus, London, United Kingdom (Kim, Nagaoka, Oishi, Fujita) Department of Cardiovascular Surgery, Institute of Science Tokyo, M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan (Toba) Quality Management Center, Institute of Science Tokyo, M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan (Fushimi) Department of Health Policy and Informatics, Institute of Science Tokyo, M&D Tower, 1-5-45 Yushima, Bunkyo-ku, Tokyo, Japan Publisher Springer Abstract Aortic stenosis (AS) is the most prevalent valvular disease in developed nations. Transcatheter Aortic Valve Replacement (TAVR) offers a minimally invasive alternative to Surgical Aortic Valve Replacement (SAVR), particularly for high-risk patients. However, TAVR adoption and outcomes in Japan remain understudied due to limited national database analyses and differences in patient demographics compared to major international trials. We conducted a retrospective cohort study of aortic valve replacement (AVR) procedures from 2014 to 2021 using the National Healthcare Reimbursement database. In total, 103,076 cases were analyzed, with 33,881 undergoing TAVR and 31,337 undergoing SAVR for aortic stenosis. TAVR patients were older (median age 85 vs. 76 years, p < 0.0001) and more often female (66.7% vs. 51.4%, p < 0.0001). TAVR was associated with lower in-hospital mortality (0.88% vs. 2.4%, p < 0.0001), shorter hospital stays (14 vs. 24 days, p < 0.0001), but significantly higher medical costs (5,303,722 vs. 3,945,622, p < 0.0001). Among patients younger than 75 years, no significant difference in mortality was observed. In this nationwide administrative database, TAVR was associated with lower in-hospital mortality and shorter hospital stays compared to SAVR, though at a higher cost. While patient backgrounds and clinical risks could not be fully adjusted due to data limitations, the observed differences in in-hospital outcomes between TAVR and SAVR reflect real-world practice patterns. These findings should be interpreted as descriptive, not causal. The absence of a mortality difference in patients under 75 years highlights the need for further evaluation of TAVR's long-term effectiveness and cost-efficiency in younger populations. Copyright © The Author(s) 2025. <13> Accession Number 2045843389 Title Systemic Embolic Events in People Who Inject Drugs With Patent Foramen Ovale and Right-Sided Infective Endocarditis: A Systematic Review. Source Open Forum Infectious Diseases. 13(5) (no pagination), 2026. Article Number: ofag245. Date of Publication: 01 Nov 2026. Author Cuervo G.; Chesdachai S.; Gerberi D.; DeSimone C.V.; Deshmukh A.J.; Miro J.M.; El Sabbagh A.; DeSimone D.C.; Baddour L.M. Institution (Cuervo) Infectious Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Cuervo) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Cuervo) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Chesdachai) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Chesdachai) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Gerberi) Department of Library Services, Mayo Clinic, Rochester, MN, United States (DeSimone) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Deshmukh) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Miro) Infectious Diseases Department, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain (Miro) CIBERINFEC, Instituto de Salud Carlos III, Madrid, Spain (Miro) Reial Academia de Medicina de Catalunya, Barcelona, Spain (El Sabbagh) Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, United States (DeSimone) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (DeSimone) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Baddour) Department of Medicine, Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States (Baddour) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Publisher Oxford University Press Abstract Background: Knowing the prevalence of patent foramen ovale (PFO) and the increasing number of people who inject drugs (PWID) with right-sided infective endocarditis (RSIE), we aimed to better characterize the syndrome of injection drug use, RSIE, and PFO with systemic embolic events. Method(s): A systematic search across multiple databases was independently screened using predefined criteria (from inception until September 2025). Published cases of adult PWID diagnosed with RSIE and ischemic stroke or other systemic embolic event were included, provided they had PFO assessment. Individuals were excluded if they had cardiac implantable electronic device (CIED) infections or any other conditions associated with systemic or paradoxical embolism. Result(s): The review identified 13 studies with 14 young patients, mostly without comorbidities, predominantly infected with Staphylococcus aureus. In most cases, echocardiography revealed large tricuspid valve vegetations. Neuroimaging confirmed multiple ischemic infarcts, while 5 patients showed emboli outside the central nervous system (4 of them as the only systemic embolism). At least 11 (79%) patients had echocardiographic evidence of right-to-left shunting. Management included cardiac surgery in 6 cases that involved valve replacement or repair, percutaneous PFO closure in 2 cases, and percutaneous mechanical aspiration in 1 case. Three patients (21%) died during hospitalization, and only 27.3% patients had outpatient follow-up. Conclusion(s): RSIE with systemic embolism in PWID with PFO has rarely been reported, affects younger patients without sex predominance, and was usually due to S. aureus with large tricuspid vegetations. Right-to-left shunting was characteristic, and outcomes were poor despite combined medical, surgical, and interventional therapies. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the 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. <14> Accession Number 2045396734 Title Risk of stroke after bariatric surgery: a systematic review, meta-analysis and meta-regression. Source Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 62(1) (no pagination), 2026. Article Number: 107. Date of Publication: 01 Dec 2026. Author Matar H.; Al Radaideh D.; Banat S.O.; Sinjlawi S.A.; Aldeeb A.M.; Bany-yasin H.; Rasheed W.M.; Almitwali M.M.; Aldeeb O.M. Institution (Matar, Rasheed) Jordan University of Science and Technology, Irbid, Jordan (Al Radaideh, Banat, Sinjlawi, Almitwali) Yarmouk University, Irbid, Jordan (Aldeeb) Cairo University, Giza, Egypt (Bany-yasin) University Hospitals Plymouth NHS Trust, Plymouth, United Kingdom (Aldeeb) University of Jordan, Amman, Jordan Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Obesity is a major global health challenge, strongly associated with diabetes, hypertension, and cardiovascular disease, all of which increase stroke risk. Bariatric surgery is among the most effective treatments for severe obesity, leading to significant and sustained weight loss and improvements in metabolic health. However, its long-term impact on cerebrovascular outcomes remains unclear. Method(s): We searched multiple databases for cohort studies that compared stroke incidence in patients undergoing bariatric surgery. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using a random-effects model. Heterogeneity was quantified using the I2 statistic. Meta-regression was performed to explore the effects of age, BMI and follow-up duration. Result(s): Eighteen studies comprising 2,125,741 patients were included. Pooled analysis of 16 studies (975,351 patients) showed that bariatric surgery was associated with a 29% lower risk of stroke compared with non-surgical care (HR = 0.71, 95% CI 0.65-0.77, p < 0.0001). Heterogeneity was moderate (I2 = 60.6%) but resolved in sensitivity analyses. No significant publication bias was detected and meta-regression showed no effect modification by age, BMI or follow-up duration. Conclusion(s): This meta-analysis provided a robust evidence that bariatric surgery is associated with a significantly reduced risk of stroke in patients with obesity. The findings highlight bariatric surgery not only as an effective intervention for weight loss and metabolic improvement but also as a meaningful strategy for long-term cerebrovascular risk reduction. Incorporating bariatric surgery into comprehensive cardiovascular and stroke prevention strategies could have substantial public health impact. Copyright © The Author(s) 2026. <15> 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. <16> Accession Number 2045776270 Title Assessment of Quality of Life in Patients Following Coronary Artery Bypass Grafting: A Systematic Review of Physical, Psychological, and Social Outcomes. Source International Journal of Drug Delivery Technology. 16(45 supplement) (pp 414-422), 2026. Date of Publication: 2026. Author Kalita M.; Rabha P.; Dehingia M.; Lahkar P.; Medhi M.; Ao N. Institution (Kalita) Medical Surgical Nursing (CTVS) Department, Royal School of Nursing, The Assam Royal Global University, India (Rabha) Mental Health Nursing Department, NEMCARE Institute of Nursing Sciences, Mirza, Assam, India (Dehingia, Medhi) Community Health Nursing Department, Royal School of Nursing, The Assam Royal Global University, India (Lahkar) Obstetrics and Gynaecological Nursing Department, Royal School of Nursing, The Assam Royal Global University, India (Ao) Child Health Nursing Department, Royal School of Nursing, The Assam Royal Global University, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Coronary artery bypass grafting is a surgery for people with bad coronary artery disease. It helps them live longer and have a heart. It is not just about living longer. It is also about how people feel after the surgery. This is called quality of life. Quality of life after coronary artery bypass grafting is affected by things. These include how healthy people feel, how they feel inside, and how they get along with others. Different studies have different results. Aim and Objective: We want to know how coronary artery bypass grafting affects quality of life. We are looking at how people feel mentally and socially after the surgery. Method(s): We looked at studies on the internet using big databases like PubMed, Scopus, and Web of Science. We only looked at studies from 2013 to 2025. We used keywords like artery bypass grafting, quality of life, and physical recovery. We followed the rules to make sure our review was good. We picked studies that fit our rules and looked at them closely. Result(s): We found about 3,200 studies at first. Only 22 of them were good enough to use. Most of these studies showed that people felt better after the surgery. They had symptoms that could exercise more and could do more things. How people felt mentally was different. Some people still felt anxious or depressed. How people felt socially was also different. Most people went back to work. Spent time with others. This depended on who they were and how sick they were. Conclusion(s): Coronary artery bypass grafting helps people feel better physically. How people feel mentally and socially is not always the same. We need to help people in all areas of their lives to make sure they recover well in the long run. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <17> Accession Number 2043434210 Title M-TEER-interventional repair of mitral valve regurgitation. Source Herz. 51(3) (pp 163-170), 2026. Date of Publication: 01 Jun 2026. Author Iliadis C.; Baldus S. Institution (Iliadis, Baldus) Faculty of Medicine and University Hospital Cologne, Department III for Internal Medicine, University of Cologne, Cologne, Germany Publisher Springer Medizin Abstract Mitral valve transcatheter edge-to-edge repair (M-TEER) has emerged as an alternative therapy for mitral regurgitation (MR), addressing the unmet clinical need for patients with high surgical risk. Previous large randomized controlled trials (RCTs), including EVEREST II, COAPT, and MITRA-FR, have established the safety and efficacy of M-TEER for both etiologies of MR: primary (PMR) and secondary MR (SMR). The field of SMR treatment has been updated by the recent RCTs RESHAPE-HF2 and MATTERHORN, which have expanded the recommendations of M-TEER in the current European guidelines. This article summarizes key evidence from pivotal trials, discusses patient selection, and presents ongoing studies in the field of M-TEER. Copyright © The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2026. <18> [Use Link to view the full text] Accession Number 2045463896 Title 5: SUGAMMADEX VS PLACEBO IN ICU PATIENTS AFTER UNDERGOING CARDIOPULMONARY BYPASS. Source Critical Care Medicine. 54(3 Supplement 1) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Greenberg S.; Ben-Isvy N.; Locke A.; Dobrilovic N.; Shamberg R.; Bochenek A.; Patoli D.; Wang C.; Minhaj M. Institution (Greenberg) Northshore University Health System, IL, United States (Ben-Isvy) Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, United States (Locke, Dobrilovic, Shamberg, Bochenek, Patoli, Wang, Minhaj) Endeavor Health, United States Publisher Lippincott Williams and Wilkins <19> Accession Number 2044686322 Title The Impact of Coronary Artery Bypass Grafting on Respiratory Function: A Systematic Review. Source Journal of Clinical Medicine. 15(7) (no pagination), 2026. Article Number: 2793. Date of Publication: 01 Apr 2026. Author Flores G.; Duarte-Mendes P.; Fonseca H.; Monteiro D.; Silva F.M.; Couto N.; Silva A.M.; Vilas-Boas J.P. Institution (Flores, Fonseca) Faculty of Sport, University of Porto, Porto, Portugal (Flores, Fonseca) Research Center in Physical Activity Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal (Duarte-Mendes) Department of Sports and Well-Being, Polytechnic Institute of Castelo Branco, Castelo Branco, Portugal (Duarte-Mendes) Sport Physical Activity and Health Research & Innovation Center (SPRINT), Santarem, Portugal (Monteiro) School of Education and Social Sciences, Polytechnic University of Leiria, Leiria, Portugal (Monteiro, Couto) Research Centre in Sport, Health and Human Development (CIDESD), Vila Real, Portugal (Silva) School of Education and Communication, University of Algarve, Faro, Portugal (Silva) Research Unit for Sport and Physical Activity (CIDAF), University of Coimbra, Coimbra, Portugal (Couto) Sport Sciences School of Rio Maior, Santarem Polytechnic University, Santarem, Portugal (Silva) Department of Life Sciences, University of Coimbra, Coimbra, Portugal (Silva) Center for Research in Anthropology and Health (CIAS), Coimbra, Portugal (Vilas-Boas) Research Centre for Sports Research, Education, Innovation and Intervention in Sport, CIFI2D, Faculty of Sport, University of Porto, Porto, Portugal (Vilas-Boas) Porto Biomechanics Laboratory (LABIOMEP-UP), University of Porto, Porto, Portugal Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Cardiovascular diseases are the main cause of mortality and morbidity in Portugal, with coronary artery bypass grafting (CABG) being one of the most performed surgeries in cardiothoracic centers. After cardiac surgery, patients often experience a decrease in physical capacity, which results in an increased risk of mortality or hospitalization expenditures. The objective of this systematic review was to characterize changes in respiratory function in patients undergoing CABG. Method(s): This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using a predefined research strategy to identify relevant original studies published until August 2025. To be included, studies must have assessed adult patients submitted to CABG who evaluated the respiratory function before and after cardiac surgery. Studies that reported other types of cardiac surgery were excluded. The Risk of Bias in Non-randomized Studies-of-Exposure and the Cochrane risk-of-bias tool for randomized trials were used to analyze the risk of bias of the selected studies. Result(s): After screening 1184 potential articles, six studies met the inclusion criteria. The studies included participants who underwent CABG (n = 324), with a mean age ranging from 54.05 +/- 13.6 to 67 +/- 10 years. Conclusion(s): All included studies reported significant postoperative reductions in respiratory function following CABG, including forced vital capacity, forced expiratory volume in one second, maximal inspiratory pressure, and maximal expiratory pressure. Although these findings consistently indicate a decline in pulmonary function, the limited number of available studies limits the strength of the conclusions. This systematic review suggests that monitoring respiratory impairments after CABG may be clinically relevant to improve health-related quality of life. Copyright © 2026 by the authors. <20> Accession Number 2045448263 Title Cutaneous adverse drug reactions in patients with congenital heart disease: a systematic review with focus on perioperative outcomes. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 415. Date of Publication: 01 Dec 2026. Author Javier R.M.; Salsabila S.; Ditsi E.S.L.; Madrik I.R.; Moelyadi F.; Pratiwi A.Z.; Jonathan; Kosen Y.D.; Simanjuntak I.A.T.A.; Cita A.A.; Rahman A.A.; Berlian A.Z.; Nugraha M.A.; Ujianto M.A.; Gaol T.V.L.; Limanto E.J.; Putra A.P.Y.; Giantambrani C.G.; Maria A.; Bramantyo B.B.; Rahmatullah A.B.; Iman N.S.; Kurniawan K.; Aditya M.R. Institution (Javier) Department of Cardiology and Vascular Medicine, Universitas Indonesia Hospital, Jakarta, Indonesia (Javier) Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, RSUP Fatmawati, Jakarta, Indonesia (Salsabila) Subang Regional General Hospital (RSUD Subang), Subang, Indonesia (Ditsi) RSUD Pasirian, Lumajang, Indonesia (Madrik, Ujianto, Maria, Aditya) Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Moelyadi) Department of Internal Medicine, Wangaya Regional General Hospital, Denpasar, Bali, Indonesia (Pratiwi) Faculty of Medicine, Universitas Islam Indonesia, Yogyakarta, Indonesia (Jonathan) Kalideres Regional General Hospital (RSUD Kalideres), Jakarta, Indonesia (Kosen, Cita) Faculty of Medicine, Maranatha Christian University, Bandung, Indonesia (Simanjuntak) Faculty of Medicine, Universitas Kristen Duta Wacana, Yogyakarta, Indonesia (Rahman) Faculty of Medicine, Universitas Sriwijaya, Palembang, Indonesia (Berlian) Department of Internal Medicine, Division of Endocrinology, Metabolism, and Diabetes, Cipto Mangunkusumo National General Hospital (RSUPN Dr. Cipto Mangunkusumo), Jakarta, Indonesia (Nugraha) Division of Psychosomatic and Palliative Medicine, Department of Internal Medicine, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia (Gaol) Sunan Kalijaga Regional General Hospital (RSUD Sunan Kalijaga), Demak, Indonesia (Limanto) Bhayangkara Hospital Kediri (RS Bhayangkara Kediri), Kediri, Indonesia (Putra) Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia (Putra, Bramantyo) Dr. Sardjito General Hospital (RSUP Dr. Sardjito), Yogyakarta, Indonesia (Giantambrani) Faculty of Medicine, Universitas Ahmad Dahlan, Yogyakarta, Indonesia (Rahmatullah) Buton Regional General Hospital (RSUD Buton), Buton, Indonesia (Iman) Bhayangkara Hospital Yogyakarta (RS Bhayangkara Yogyakarta), Yogyakarta, Indonesia (Kurniawan) Faculty of Medicine, Universitas Katolik Indonesia Atma Jaya, Jakarta, Indonesia Publisher BioMed Central Ltd Abstract Background: Cutaneous adverse drug reactions (CADRs) are uncommon but clinically significant complications among patients with congenital heart disease (CHD), particularly those with pulmonary arterial hypertension (PAH) or perioperative hemodynamic instability. The complex pharmacologic regimens required in CHD-often involving prostaglandins, vasodilators, antibiotics, and antiepileptics-predispose patients to idiosyncratic and immune-mediated reactions. Despite increasing recognition of CADRs in cardiovascular medicine, systematic evidence focusing on CHD populations remains limited. Method(s): A systematic search of MEDLINE (PubMed), Embase, Web of Science, and CENTRAL was conducted from database inception to October 31, 2024, covering all types of congenital heart disease, both cyanotic and acyanotic, isolated and syndromic forms. Eligible studies included randomized controlled trials, observational studies, and case reports that reported CADRs in patients with structural CHD, regardless of age or surgical status. Extracted outcomes included type of CADR, implicated drug, temporal association, histopathology, management, and clinical outcome. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist for case reports and case series. Result(s): Thirteen studies encompassing 22 patients met the inclusion criteria. Most patients (68%) were neonates or infants with duct-dependent congenital heart disease receiving prostaglandin E1 (alprostadil) for lesions such as transposition of the great arteries, hypoplastic left heart syndrome, and Taussig-Bing anomaly. The most frequently reported CADRs were prostaglandin-associated vasomotor eruptions, including migratory urticaria and erythematous patches (n = 4, 18%), as well as radiographically detected brown fat necrosis and soft-tissue calcification following prolonged prostaglandin infusion (n = 9, 41%). Severe hypersensitivity reactions-including drug reaction with eosinophilia and systemic symptoms (DRESS) and Stevens-Johnson syndrome (SJS)-occurred in patients receiving antiepileptics or antibiotics (n = 3, 14%), typically in postoperative or intensive care settings. Additional reports described bosentan-associated indurated erythema in an adult with repaired tetralogy of Fallot and amoxicillin-associated morbilliform exanthem in pediatric patients after surgical repair. Overall, prostaglandin analogs accounted for the majority of implicated drugs (77%), followed by antiepileptics (9%), antibiotics (9%), and pulmonary vasodilators (5%). Methodological quality of the included studies was generally low according to the Joanna Briggs Institute appraisal tools due to descriptive study designs and limited follow-up. Conclusion(s): CADRs, though infrequently reported, occur across the therapeutic continuum of CHD management-from neonatal prostaglandin therapy to adult antimicrobial and antiepileptic use. The predominance of prostaglandin-associated reactions underscores the importance of dermatologic and metabolic surveillance during infusion therapy, while severe whereas severe hypersensitivity reactions underscore the interface between cardiology and dermatology. Larger multicenter studies are warranted to clarify incidence, risk factors, and outcomes, guiding safer pharmacologic management in congenital cardiology. Copyright © The Author(s) 2026. <21> Accession Number 2045178923 Title Therapeutic impact of SGLT2 inhibitors following transcatheter aortic valve implantation: a grade-assessed systematic review and meta-analysis. Source European Journal of Clinical Pharmacology. 82(5) (no pagination), 2026. Article Number: 137. Date of Publication: 01 May 2026. Author Hamzah K.A.; Kurmasha Y.H.; Al-Shammari A.S.; shweliya M.A.; Al-Janabi A.A.H.; Shahzaib M.; akoum A.; Sattar Y. Institution (Hamzah, Al-Janabi) Department of Internal Medicine, ALkindy college of medicine, University of Baghdad, Baghdad, Iraq (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Al-Shammari, shweliya) Department of Internal Medicine, College of Medicine, University of Baghdad, 502, Filastin St, Baghdad, Iraq (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (akoum) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Al-Shammari, Sattar) Department of Cardiology, Camden Clark Medical Center, West Virginia University, Parkersburg, WV, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: We aim to evaluate the impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). Method(s): We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing SGLT2 inhibitor therapy with standard care in adults undergoing TAVI. PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception to November 2025. Outcomes included all-cause mortality, heart failure (HF) hospitalization, myocardial infarction (MI), cardiac death, stroke, pacemaker implantation, acute kidney injury (AKI), and bleeding events. Effect sizes were pooled using random-effects models, while time-to-event data were reconstructed for survival analyses. Result(s): Four studies comprising 12,374 patients were included. SGLT2 inhibitor therapy significantly reduced all-cause mortality (RR 0.62, 95% CI 0.49-0.78), HF hospitalization (RR 0.67, 95% CI 0.50-0.91), MI (RR 0.83, 95% CI 0.73-0.93), and bleeding events (RR 0.81, 95% CI 0.72-0.90). Effects on cardiac death, stroke, pacemaker implantation, and AKI were not statistically significant (P > 0.05). Conclusion(s): SGLT2 inhibitor therapy in patients undergoing TAVI was associated with reductions in all-cause mortality, HF hospitalization, and MI. However, these findings are based on a limited and heterogeneous evidence base, largely derived from observational studies, and should be interpreted with caution. The results should not be considered definitive or generalizable to all TAVI populations. Further adequately powered randomized trials are required. Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <22> Accession Number 2045921289 Title The Impact of Pre-Transplant Ventricular Assist Device Support on Survival After Heart Transplantation in Pediatric Patients: A Systematic Review and Meta-Analysis of Reconstructed Time-To-Event Data. Source Pediatric Transplantation. 30(6) (no pagination), 2026. Article Number: e70356. Date of Publication: 01 Jun 2026. Author Fischer J.; Schwegmann S.; Plem R.; Arobo A.; Almehandi A.; Passos F.S.; Kirov H.; Doesnt T.; Kerst G.; Loukanov T.; Caldonazo T. Institution (Fischer, Schwegmann, Kirov, Doesnt, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany (Plem) Department of Neurology, Hannover Medical School, Hannover, Germany (Arobo) College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria (Almehandi) Department of Cardiovascular Science, University College London, London, United Kingdom (Passos) Department of Thoracic Surgery, MaterDei Hospital, Salvador, Brazil (Kerst) Clinic for Pediatric Cardiology and Congenital Heart Disease, Klinikum Stuttgart, Stuttgart, Germany (Loukanov) Division of Congenital Cardiac Surgery, Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany Publisher John Wiley and Sons Inc Abstract Objectives: Heart transplantation is the gold standard therapy for pediatric end-stage heart failure. Ventricular assist devices (VADs) have improved waitlist survival, but their effect on post-transplant outcomes remains uncertain. This study aimed to evaluate the impact of pre-transplant VAD support on outcomes in pediatric heart transplant recipients. Method(s): We performed a systematic review and a meta-analysis using three different databases to compare outcomes in pediatric heart transplant recipients with and without pre-transplant VAD support. The primary outcome was long-term survival. Secondary outcomes were postoperative stroke, hospital length of stay (LOS), and post-transplantation rejection. Result(s): A total of 3247 studies were identified, of which five were included in the analysis. There was no significant difference in long-term survival among patients who survived to transplantation between the groups (HR 0.963; 95% CI 0.84 to 1.10; p = 0.582). However, the postoperative stroke rate was significantly higher in the VAD group (OR 2.17; 95% CI 1.63 to 2.89; p < 0.0001), while no significant differences were observed in hospital LOS (SMD -0.09; 95% CI -0.33 to 0.14; p = 0.4375) or post-transplant rejection (OR 1.18; 95% CI 1.00 to 1.39; p = 0.0505). Conclusion(s): Pre-transplant VAD support was associated with non-inferior survival despite greater baseline severity among patients who survived to transplantation, enabling access to transplantation, but at the cost of higher VAD-related complications, particularly stroke, with no differences in hospital LOS or rejection. Copyright © 2026 Wiley Periodicals LLC. <23> Accession Number 2044846114 Title Granulocyte colony stimulating factor for acute myocardial infarction: an updated systematic review and meta-analysis of randomized controlled trials. Source Future Cardiology. 22(4) (pp 391-404), 2026. Date of Publication: 2026. Author Almeida L.G.S.; Carretta L.T.A.; Falcao L.; de Souza A.M.; Silva Y.P.; de Oliveira M.P.P.; Suruagy-Motta R.F.O.; dos Santos K.D.A.; dos Santos R.T.F.; Surgik G.; Andrade F.A. Institution (Almeida, de Oliveira) Department of Medicine, Catholic University of Brasilia, Brasilia, Brazil (Carretta) Department of Medicine, Higher School of Sciences of the Santa Casa de Misericordia de Vitoria, Vitoria, Brazil (Falcao) Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil (de Souza) Department of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil (Silva) Healthcare Center of South Iceland, Selfoss, Iceland (Suruagy-Motta) Department of Medicine, Cesmac University Center, Maceio, Brazil (dos Santos) Department of Medicine, Federal University of Roraima, Boa Vista, Brazil (dos Santos) Department of Medicine, Medical Education Institute Vista Carioca, Rio de Janeiro, Brazil (Surgik) Department of Medicine, Pontifical Catholic University of Parana, Curitiba, Brazil (Andrade) Department of Cardiology, Federal University of Sao Paulo (UNIFESP), Sao Paulo, Brazil Publisher Taylor and Francis Ltd. Abstract Introduction: Granulocyte Colony-Stimulating Factor (G-CSF) has been explored as a therapy to enhance myocardial repair after acute myocardial infarction (AMI). Earlier meta-analyses of randomized controlled trials (RCTs) reported no significant improvement but recently published studies warranted an updated synthesis. Method(s): We searched PubMed, Embase, Cochrane Library, and Web of Science for RCTs comparing G-CSF with placebo or standard care in AMI. Primary outcomes were left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF). Secondary outcomes were mortality, reinfarction, restenosis, and revascularization. Result(s): Eleven RCTs encompassing 1,073 participants were included. G-CSF significantly reduced LVEDV in echocardiography studies (MD: -4.39 mL; 95% CI -6.80, -1.98; p < 0.001), whereas no effect was observed in MRI studies (MD: -0.19 mL; 95% CI -7.22, 6.84; p = 0.958). LVEF improved in the echocardiography subgroup (MD: 6.76%; 95% CI 1.62, 11.90; p = 0.010) but not in the MRI subgroup (MD: -0.08%; 95% CI -2.38, 2.22; p = 0.947). LVESV showed no significant differences. No effects were seen for mortality, reinfarction, restenosis, or revascularization. Conclusion(s): G-CSF may confer structural benefits detectable by echocardiography, yet clinical outcomes remain unchanged. Larger, high-quality trials are needed to define its therapeutic role. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <24> Accession Number 2043840292 Title Conduction system pacing vs right ventricular pacing after TAVR: A systematic review and meta-analysis. Source Heart Rhythm O2. 7(5) (pp 887-899), 2026. Date of Publication: 01 May 2026. Author Deaconu A.; Alexandru Bistriceanu M.I.; Deaconu S.; Makdah O.; Ursu C.G.; Calin I.; Moldovan H.; Vatasescu R.G. Institution (Deaconu, Alexandru Bistriceanu, Makdah, Ursu, Moldovan, Vatasescu) Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Deaconu, Moldovan, Vatasescu) Department of Cardio-Thoracic Pathology, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania (Deaconu, Moldovan, Vatasescu) Emergency Clinical Hospital, Bucharest, Romania (Deaconu, Calin) Monza Ares Hospital, Bucharest, Romania Publisher Elsevier B.V. Abstract Background Conduction system pacing (CSP), including His bundle pacing and left bundle branch pacing, has emerged as a physiological alternative to right ventricular pacing (RVP) for patients developing conduction disturbances after transcatheter aortic valve replacement. Objective We performed a systematic review and meta-analysis to compare CSP with RVP. Methods PubMed, Embase, and Cochrane databases were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A random-effects model was used for all outcomes, and heterogeneity was assessed using I2 statistics. The protocol was registered in PROSPERO (CRD420251125169). Results 8 studies, including 784 patients, were analyzed. At 15-month follow-up, all-cause mortality did not differ significantly between CSP (left bundle branch pacing in 74%) and RVP (odds ratio 0.76; 95% confidence interval [CI] 0.51-1.14; P = .15; I2 = 0%). CSP was associated with a shorter paced QRS duration after implant (mean difference -34.6 ms; 95% CI -40.2 to -29.1; P < .001) and higher left ventricular ejection fraction (mean difference +5.4%; 95% CI 3.5-7.3; P = .003) at 15-month follow-up. Heart failure hospitalization at 15 months was associated with a reduction in CSP (odds ratio 0.44; 95% CI 0.27-0.72; P = .006), whereas cardiovascular mortality, sensing, impedance, and lead dislodgement were similar between pacing strategies. Conclusion These findings suggest that CSP provides more physiological ventricular activation and may improve functional outcomes after transcatheter aortic valve replacement without affecting overall survival. Further randomized studies are warranted to confirm these observations. Copyright © 2026 Heart Rhythm Society. <25> Accession Number 2043595163 Title Safety and Efficacy of Colchicine across the Spectrum of Coronary Artery Disease: A Systematic Review and Meta-Analysis of 20 Randomized Trials. Source Clinical Pharmacology and Therapeutics. 119(6) (pp 1431-1439), 2026. Date of Publication: 01 Jun 2026. Author Laudani C.; Bujak K.; Occhipinti G.; Rinaldi R.; Imbesi A.; Sanchez J.S.; Galli M.; Abbate A.; Ortega-Paz L.; Capodanno D.; Angiolillo D.J. Institution (Laudani, Imbesi, Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico "Rodolico - San Marco", University of Catania, Catania, Italy (Laudani, Ortega-Paz, Angiolillo) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Bujak) Department of Pharmacology, Medical University of Silesia, Katowice, Poland (Bujak) Faculty of Medical Sciences in Zabrze, 3rd Department of Cardiology, Silesian Center for Heart Diseases, Medical University of Silesia, Katowice, Poland (Occhipinti) Institut Clinic Cardiovascular, Hospital Clinic de Barcelona, University of Barcelona, Barcelona, Spain (Rinaldi) Department of Cardiovascular and Pulmonary Sciences, Catholic University of Sacred Heart, Rome, Italy (Rinaldi) Cardiology Unit, Infermi Hospital, Rimini, Italy (Sanchez) Hospital Universitario y Politecnico La Fe, Valencia, Spain (Sanchez) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid, Spain (Galli) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Galli) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Abbate) Division of Cardiology, Berne Cardiovascular Research Center, University of Virginia, Charlottesville, VA, United States Publisher John Wiley and Sons Inc Abstract Recent evidence questioned the overall safety and efficacy of colchicine in patients with coronary artery disease (CAD), as novel evidence focusing on acute coronary syndromes (ACSs) gave neutral results, while trials focusing on chronic coronary syndrome supported colchicine administration to improve long-term outcomes. However, no study has ever explored whether there is a true therapeutic difference across the populations or these discrepancies are due to additional confounders. Against this background, we performed a systematic review and meta-analysis of randomized trials of colchicine in patients with CAD. The primary endpoints were trial-defined major adverse cardiovascular events (MACE) and serious adverse events (SAEs). Secondary endpoints included all-cause death, measures of ischemia (cardiovascular death, myocardial infarction [MI], any revascularization, stroke) and measures of safety (serious infections or sepsis and gastrointestinal adverse events). All analyses included an interaction term for the clinical presentation. Sensitivity analyses were performed to explore sources of heterogeneity. After literature search, 20 trials encompassing a total of 21,486 patients (65.4% ACS) were included. Colchicine significantly reduced MACE (incidence rate ratio [IRR]: 0.70; 95% CI 0.55-0.87) without increasing risk for SAEs. Colchicine also reduced MI (IRR 0.81; 95% CI 0.70-0.94) and any revascularization (IRR 0.71; 95% CI 0.51-0.99), while increasing the risk of gastrointestinal adverse events (IRR 1.68; 95% CI 1.23-2.28). No statistically significant interaction was noted for clinical presentation for any endpoint, but a significant interaction for the drug dosage administered and the relationship with the COVID-19 pandemic was noted. In conclusion, the use of colchicine in patients with CAD reduces MACE without significantly increasing SAEs compared to control, although increasing gastrointestinal adverse events, without interaction by clinical presentation. Copyright © 2026 The Author(s). Clinical Pharmacology & Therapeutics © 2026 American Society for Clinical Pharmacology and Therapeutics. <26> [Use Link to view the full text] Accession Number 2045462967 Title 138: RENAL PROTECTION WITH AMINO ACID INFUSION AFTER CARDIAC SURGERY: REVIEW AND META-ANALYSIS OF RCTS. Source Critical Care Medicine. 54(3 Supplement 1) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Jena A.; Singh A.; Merchant K.; Antar M.; Rodriguez Ferreira E.; Navarrete Rios A.; Banker H.; Sarangi S.; Hamza Shah S.; Kumar U.; Ghosh S. Institution (Jena, Singh, Ghosh) WorcesterMAUnited States (Merchant) Mayo Clinic, Jacksonville, United States (Antar, Rodriguez Ferreira, Navarrete Rios, Hamza Shah) Ascension St. Joseph, United States (Banker) Tuscon Medical Center, United States (Sarangi) UIC- Peoria, United States (Kumar) Aga Khan University, Pakistan Publisher Lippincott Williams and Wilkins <27> Accession Number 2045767548 Title Digital and Remote Health for Older Adults in Rural or Underserved Settings: Systematic Review of Clinical, Behavioral, and Implementation Outcomes. Source JMIR Aging. 9 (no pagination), 2026. Article Number: e78913. Date of Publication: 2026. Author Beltran V.; Chaple A.; Morales-Gomez C.; Campos-Bijit V.; Contador R.; Diaz L.; Bustos J.; Fernandez E. Institution (Beltran) Clinical Investigation and Dental Innovation Center (CIDIC), Faculty of Dentistry, Center for Translational Medicine (CEMT-BIOREN), Universidad de La Frontera, Temuco, Chile (Beltran, Bustos) Centro de Excelencia de Fisica e Ingenieria en Salud (CFIS), Universidad de La Frontera, Temuco, Chile (Chaple) Facultad de Ciencias de la Salud, Universidad Autonoma de Chile, Santiago, Chile (Morales-Gomez) Department of Pathology and Oral Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile (Campos-Bijit) Laboratory of Nanobiomaterials, Research Institute of Dental Sciences, Faculty of Dentistry, University of Chile, Santiago, Chile (Campos-Bijit) Millennium Nucleus for Bioproducts, Genomics and Environmental Microbiology (BioGEM), Valparaiso, Chile (Contador, Fernandez) Department of Restorative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile (Diaz) Department of Stomatology, Faculty of Dentistry, Universidad de Sevilla, Sevilla, Spain (Diaz) Perioplastic Institute, Santiago, Chile (Diaz) Department of Prosthodontics, Faculty of Dentistry, University of Chile, Santiago, Chile (Bustos) Department of Industrial and System Engineering, Universidad de La Frontera, Temuco, Chile (Fernandez) Instituto de Ciencias Biomedicas, Universidad Autonoma de Chile, Santiago, Chile (Fernandez) Department of Restorative Dentistry Faculty of Dentistry, University of Chile Olivos, 943, Santiago, Chile Publisher JMIR Publications Inc. Abstract Background: Older adults in rural or underserved settings face persistent access barriers. Digital and remote health interventions may mitigate these gaps. Objective(s): The aim of this study is to assess technologies, effectiveness, and implementation challenges of digital or remote health interventions for adults >=60 years old in rural or underserved contexts. Method(s): A systematic search was conducted in 4 electronic databases, such as PubMed, Scopus, Web of Science, and Embase (inception: April 2025), under dual screening by 2 reviewers. The tool Cochrane Risk of Bias 2.0 was used to assess the risk of bias for randomized trials, and Risk Of Bias In Non-randomized Studies-of Interventions (ROBINS-I) was used for nonrandomized trials. For observational studies, we used the National Institutes of Health quality assessment tool, and a narrative synthesis was performed. Result(s): Fourteen studies met the inclusion criteria (randomized and nonrandomized designs; median follow-up ~12 mo). Ten of 14 (71%) reported significant improvements in at least 1 clinical end point (eg, hemoglobin A<inf>1c</inf>, blood pressure, and weight), 11 of 14 (79%) improved behavioral or psychosocial outcomes, and 5 of 9 (56%) reduced hospitalizations or acute episodes. Risk-of-bias concerns most frequently related to missing data and selective reporting. Digital literacy and broadband access were the most consistent barriers, while multicomponent, nurse-supported models achieved higher adherence. Equity-related dimensions (place, gender, and socioeconomic status) were variably reported, with limited attention to language, cultural tailoring, or social capital. No study included a formal cost-effectiveness analysis. Conclusion(s): Digital and remote health interventions can benefit older adults in rural and underserved settings by improving selected clinical and behavioral outcomes. However, heterogeneity, small sample sizes, and the absence of economic evaluations temper certainty. Importantly, gaps in equity reporting and persistent barriers to digital inclusion highlight the need for future trials to integrate PROGRESS-Plus (place of residence, race/ethnicity, occupation, gender, religion, education, socioeconomic status, social capital, plus other context-specific determinants of health equity) dimensions, embed cost-effectiveness assessments, and design interventions that are both sustainable and accessible to the most underserved populations. Copyright © Victor Beltran, Alain Chaple Gil, Constanza Morales-Gomez, Vanessa Campos-Bijit, Rafael Contador, Leonardo Diaz, Jaime Bustos, Eduardo Fernandez. <28> 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. <29> Accession Number 2045868727 Title Endobronchial Hamartoma: A Retrospective Cohort Study of 17 Cases and Systematic Review of the Contemporary Literature. Source Journal of Clinical Medicine. 15(10) (no pagination), 2026. Article Number: 3616. Date of Publication: 01 May 2026. Author Hua Q.; Chen X.; Chen W.; Guo Y. Institution (Hua, Chen, Chen, Guo) Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Hua, Chen, Chen, Guo) Institute of Respiratory Diseases, Shanghai Jiao Tong University School of Medicine, Shanghai, China Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Endobronchial hamartoma (EBH) is an exceptionally rare benign neoplasm frequently misdiagnosed as an obstructive malignancy. The therapeutic paradigm is shifting from traditional anatomical resection toward parenchyma-preserving interventional techniques. This study evaluates the efficacy and safety profiles of contemporary bronchoscopic interventions versus surgical management for EBH. Method(s): A retrospective analysis was conducted on a clinical cohort of 17 patients treated between 2013 and 2026, alongside a comprehensive systematic review of 31 contemporary studies (2013-2025). The primary endpoint was the treatment success rate at 3 months, while secondary outcomes included perioperative complications, re-intervention rates, and successful lung parenchyma preservation. Result(s): Within the analyzed cohort (median age, 58 years), lesions exhibited a significant right-sided predilection (70.6%). Preoperative imaging uniformly revealed non-specific masses, with 41.2% displaying secondary obstructive manifestations. Definitive interventions comprised bronchoscopic management (n = 11, 64.7%) and surgical resection (n = 6, 35.3%). The technical success rate was 100%, with zero major perioperative complications and only minimal-to-scant intraoperative bleeding reported. Over a median follow-up of 3 months, local recurrence was observed in three cases (17.6%)-notably spanning both surgical (n = 2) and bronchoscopic (n = 1) modalities. The systematic review corroborated these findings, underscoring the exemplary safety profile and superior lung-sparing capacity of bronchoscopic interventions. Conclusion(s): Within the limits of this retrospective cohort and literature review, interventional bronchoscopy appears to be a safe and lung-sparing approach. It may be considered as a preferable initial treatment option for anatomically suitable EBHs. Traditional surgical resection remains necessary for anatomically complex lesions or cases with irreversible distal parenchymal destruction. Vigilant longitudinal surveillance is advised across all modalities. Copyright © 2026 by the authors. <30> Accession Number 2044395055 Title Navigating Vascular Access Strategies for Transcatheter Aortic Valve Replacement in Patients With Peripheral Artery Disease: A Literature Review. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 2100-2109), 2026. Date of Publication: 01 May 2026. Author Aufazhafarin N.T.; Saputra P.B.T.; Widiarti W.; Putra R.M.; Luthfah N.; Budiarto R.M.; Putranto J.N.E.; Multazam C.E.C.Z.; Alkaff F.F. Institution (Aufazhafarin, Widiarti) Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Putra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia (Saputra, Luthfah, Budiarto, Putranto) Department of Cardiology and Vascular Medicine, Dr. Soetomo General Academic Hospital, East Java, Surabaya, Indonesia (Putra) Universitas Airlangga Hospital, East Java, Surabaya, Indonesia (Multazam) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Alkaff) Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands (Alkaff) Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, East Java, Surabaya, Indonesia Publisher John Wiley and Sons Inc Abstract Transcatheter aortic valve replacement (TAVR) is the preferred treatment for severe aortic stenosis (AS) in high-risk surgical patients. The transfemoral (TF) access is the gold standard due to its minimally invasive nature and favorable outcomes. However, peripheral artery disease (PAD), common in TAVR candidates, can complicate TF access due to calcification, tortuosity, and vessel narrowing. This literature review evaluates vascular access strategies for TAVR in patients with PAD, highlighting recent advances that support expanded use of TF access. A narrative literature review was conducted in scientific databases up to 14 April 2025. Studies reporting on access strategies for TAVR in patients with PAD were included. The SANRA scale was utilized to ensure methodological quality. TF access remains the preferred route for TAVR, associated with lower mortality and complication rates compared to alternative approaches. Tools like the Hostile Score has further strengthened pre-procedural planning by quantifying iliofemoral complexity and helping clinicians determine the safest and most feasible access route. Advances in technology have enhanced TF feasibility in patients with PAD, enabling device delivery despite complex anatomy. When TF access is not viable, alternative routes remain feasible but are linked to increased risks, including stroke and vascular complications. Expanding the eligibility for TF access through vessel preparation and imaging-guided planning can improve safety and outcomes in PAD patients undergoing TAVR. A personalized approach based on anatomy feasibility, supported with risk stratification tools and multidisciplinary collaboration is essential to selecting the optimal vascular access strategy. Copyright © 2026 Wiley Periodicals LLC. <31> 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. <32> [Use Link to view the full text] Accession Number 2044995632 Title Pulmonary Artery Denervation for the Treatment of Patients With Pulmonary Hypertension Secondary to Left-Sided Heart Failure: Rationale and Design of the Randomized Controlled PADN-HF-PH Trial. Source Cardiology Discovery. (no pagination), 2026. Date of Publication: 08 Jan 2026. Author Wang Q.; Zhang J.; Zhang H.; Liang M.; Xie D.; Cheng B.; Zhuang W.; Chen X.; Zhang C.; Huang W.; Shen J.; Wang Z.; Liu B.; He R.; Chen S.; Han Y. Institution (Wang) Department of Congenital Heart Disease, General Hospital of Northern Theater Command, Liaoning, Shenyang, China (Zhang, Zhang, Xie, Chen) Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, Nanjing, China (Liang, Han) Department of Cardiology, General Hospital of Northern Theater Command, Liaoning, Shenyang, China (Cheng) Department of Geriatric Cardiology, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology of China, Sichuan, Chengdu, China (Zhuang) Department of Cardiovascular, The First Affiliated Hospital, Fujian Medical University, Fijian, Fuzhou, China (Chen) Department of Cardiology, The Xiamen Cardiovascular Hospital of Xiamen University, Fujian, Xiamen, China (Zhang) Department of Cardiology, Guangdong Provincial Peoples Hospital, Guangdong, Guangzhou, China (Huang) Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China (Shen) Department of Cardiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China (Wang) Department of Cardiology, The First Affiliated Hospital of Harbin Medical University, Heilongjiang, Harbin, China (Liu) Department of Cardiology, The Second Hospital of Jilin University, Jilin, Changchun, China (He) Department of Cardiology, Huaihe Hospital of Henan University, Henan, Kaifeng, China Publisher Wolters Kluwer Health Abstract Abstract - It remains uncertain whether combined pulmonary artery denervation (PADN) and guideline-directed medical therapy (GDMT) can effectively reduce clinical worsening in patients with heart failure (HF) and pulmonary hypertension (PH) associated with left heart disease. The PADN-HF-PH is a prospective, multicenter, randomized, controlled trial designed to assess the superiority of PADN for the treatment of patients with PH secondary to left-sided HF despite GDMT. A total of 264 subjects with PH secondary to left-sided HF who meet the inclusion criteria and none of the exclusion criteria will be dynamically randomized (at a 1:1 ratio) to the PADN plus GDMT group or the GDMT alone group, stratified by PH secondary to left-sided HF phenotypes and participating sites. The GDMT strategy is based on the 2023 European Society of Cardiology Guidelines for HF. The primary endpoint is the composite of all-cause death, rehospitalization due to HF, requirement for intravenous medication (inotropes, diuretics, or vasodilators) due to worsening of HF, referral for heart/lung transplantation, or 6-minute walk distance decreased by >10% or >30 m compared with baseline when the last enrolled subject has at least 6 months of follow-up. The safety endpoint is the incidence of adverse events of special interest, defined as complications occurring within 30 d after the PADN procedure. The PADN-HF-PH trial is specifically designed to evaluate the effectiveness and safety of adding PADN to GDMT in patients with PH associated with left heart disease who are experiencing HF. The primary objective of this study is to generate new evidence regarding the potential benefits of combining PADN with GDMT in reducing clinical worsening events among these patients (NCT05824923). Copyright © 2026 The Chinese Medical Association, published by Wolters Kluwer Health, Inc. <33> Accession Number 2045711383 Title Methylene Blue for Prevention of Perioperative Neurocognitive Disorders: Mechanisms and Recent Clinical Evidence. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 602971. Date of Publication: 2026. Author Wu Y.; Wang J.; Wan X. Institution (Wu, Wang) Department of Anesthesiology, Bethune International Peace Hospital, Shijiazhuang, China (Wan) Department of Intensive Care Unit, Changhai Hospital, Navy Medical University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Background: Perioperative neurocognitive disorders (PND), encompassing postoperative delirium (POD) and delayed neurocognitive recovery (dNCR), affect 15-40% of elderly surgical patients and are associated with accelerated long-term cognitive decline and increased mortality. Currently, no pharmacological agent is universally accepted for PND prevention. Methylene blue (MB), a phenothiazine derivative with unique mitochondrial redox properties, has emerged as a promising multimodal neuroprotectant. Objective(s): This review synthesizes evidence supporting MB's neuroprotective mechanisms and evaluates emerging clinical data regarding its efficacy as a preventive strategy for PND in elderly surgical patients. Method(s): We conducted a comprehensive narrative review of preclinical and clinical studies investigating MB's role in perioperative neuroprotection, with particular emphasis on mechanistic pathways and randomized controlled trial evidence. Result(s): MB exerts neuroprotection through multiple convergent mechanisms: functioning as an alternative electron carrier in the mitochondrial electron transport chain, activating the Nrf2/antioxidant response element (ARE) pathway, suppressing microglia-mediated neuroinflammation, inhibiting tau protein aggregation, and preserving blood-brain barrier integrity. Recent randomized controlled trials demonstrate that single-dose intraoperative intravenous MB (2 mg/kg) significantly reduces POD incidence (from 24% to 7%, number needed to treat = 6) in elderly patients undergoing major non-cardiac surgery. Biomarker studies confirm attenuated neuronal injury (reduced serum S100beta) and decreased systemic inflammation following MB administration. Conclusion(s): MB represents a mechanism-based therapeutic strategy targeting the mitochondrial and inflammatory core of PND pathophysiology. Large-scale, multicenter randomized controlled trials with extended neurocognitive follow-up are warranted to establish MB's definitive role in perioperative neuroprotection and to optimize dosing protocols for high-risk populations. Copyright © 2026 Wu et al. <34> 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. <35> Accession Number 2041844470 Title Natural history of aortic regurgitation in the contemporary era: not so benign. Source Heart. 112(12) (pp 644-645), 2026. Date of Publication: 01 Jun 2026. Author Malahfji M. Institution (Malahfji) Houston Methodist Hospital, Houston, TX, United States Publisher BMJ Publishing Group <36> Accession Number 2045336306 Title 3D models and simulations training improves TEE performance on pediatric patients with simple valvular congenital heart disease compared to traditional apprenticeship training: a clinical randomized controlled trial. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 285. Date of Publication: 01 Dec 2026. Author Ou X.; Qiu Q.; Yang X.; Gao Y.; Zhang G.; Zhang N.; Liu J.; Zhang S.; Wei W.; Xu Y. Institution (Ou, Qiu, Gao, Zhang, Zhang, Liu, Zhang, Wei, Xu) Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China (Yang) Paediatrics School, Guangzhou Medical University, Guangzhou, China Publisher BioMed Central Ltd Abstract Background: Transesophageal echocardiography (TEE) is indispensable for intraoperative guidance and evaluation in pediatric cardiac surgery. While simulation-based medical education offers a promising alternative to the traditional apprenticeship model, evidence directly comparing its efficacy in improving live pediatric TEE performance remains limited. This study aimed to evaluate whether simulation-based training using a 3D pediatric TEE simulator is superior to traditional apprenticeship training for enhancing clinical TEE proficiency among anesthesia residents. Method(s): First- through third-year anesthesia resident physicians without prior echocardiography experience were randomized into two groups. All participants first completed a standardized 2-hour web-based foundational course. Subsequently, the intervention group (Simulation group, Group S; n = 22) received 1 h of supervised hands-on practice using the BabyWorks simulator, while the control group (Traditional group, Group T; n = 22) received 1 h of bedside apprenticeship training on live patients. One week later, all participants were assessed on their ability to independently acquire 11 standardized TEE views in pediatric patients. Performance was scored across three dimensions (imaging angle, anatomical structure, and image clarity), with a maximum total score of 110 points. The total examination duration (time) was also recorded. Result(s): Baseline knowledge scores were comparable between groups. In the clinical assessment, Group S achieved significantly higher total performance scores than Group T (Group S: 88.60 +/- 15.60 vs. Group T: 64.70 +/- 16.70; p < 0.001). Group S also demonstrated shorter examination durations (Group S: 447.60s vs. Group T: 584.50s; p = 0.007). Specifically, Group S significantly outperformed Group T in 7 of the 11 anatomical landmarks (p < 0.05), primarily in the technically demanding transgastric and advanced mid-esophageal views. Regarding dimensions, Group S scored higher in angle (p = 0.031), clarity (p < 0.001), and structures (p < 0.001). Conclusion(s): In summary, this trial provides robust evidence that 3D simulation training significantly improves live TEE performance among novice operators compared to conventional training, contributing valuable insights toward optimizing echocardiography education and enhancing perioperative safety in pediatric cardiac care. Trial registration: Chinese Clinical Trial Registry (ChiCTR.org.cn). Registration number: ChiCTR2500105325. Date of the study first posted on ChiCTR.org.cn: 2025-07-02. Date of the enrolment of the first research participant: 202507-03. Copyright © The Author(s) 2026. <37> Accession Number 2043303447 Title A Novel Technique for Percutaneous Mitral Paravalvular Leak Closure: LBBAP Lead Assisted Ventricular Septal Way. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 1682-1686), 2026. Date of Publication: 01 May 2026. Author Ari H.; Tutuncu A.; Ari S.; Balyimez A.D.; Bozat T. Institution (Ari, Tutuncu, Ari, Balyimez, Bozat) Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey Publisher John Wiley and Sons Inc Abstract Background: Percutaneous mitral paravalvular leak (PVL) closure in patients with double mechanical valves presents substantial technical challenges when conventional transseptal antegrade approaches fail. Transapical puncture, while an alternative, carries significant risks including hemothorax and coronary injury. Safe and reliable left ventricular (LV) access without high-risk transapical puncture remains a critical unmet need in complex structural heart interventions. Method(s): A 69-year-old woman with mechanical mitral and aortic valve replacements and persistent PVL despite prior percutaneous closure presented with recurrent heart failure symptoms. Transesophageal echocardiography demonstrated two moderate-to-severe PVL jets at the 7 o'clock position surrounding the previous occluder device. A Left Bundle Branch Area Pacing (LBBAP) delivery system was advanced from the left subclavian vein to create a controlled interventricular septal puncture under continuous unipolar pacing and electrocardiographic monitoring. Result(s): The LBBAP-assisted interventricular septal crossing established a stable transventricular tract from right to left ventricle, enabling advancement of an 8.5 Fr steerable sheath. A separate transseptal puncture provided left atrial access. A veno-venous loop was created using a snare technique, facilitating deployment of two Amplatzer vascular plugs (8 x 7 mm AVP-II and 12 x 5 mm AVP-III) across the mitral PVL defects under transesophageal echocardiographic and fluoroscopic guidance. At follow-up, she remained asymptomatic, with no residual ventricular septal flow on imaging. Conclusion(s): This first reported case of LBBAP-assisted interventricular septal access for mitral PVL closure demonstrates feasibility and safety as an alternative when conventional approaches are not viable. This technique avoids transapical puncture risks and may expand therapeutic options for anatomically challenging structural heart interventions, particularly in patients with double mechanical valves (NCT07129122). Copyright © 2026 Wiley Periodicals LLC. <38> 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. <39> Accession Number 2045675540 Title Impact of Prosthesis-Patient Mismatch After Surgical Mitral Valve Replacement: Systematic Review and Meta-Analysis. Source American Journal of Cardiology. 270 (pp 88-96), 2026. Date of Publication: 01 Jul 2026. Author Jacquemyn X.; Ganduboina R.; Sa M.P.; Serna-Gallegos D.; Hasan I.; Ogami T.; Bonatti J.; Sultan I. Institution (Jacquemyn, Serna-Gallegos, Hasan, Ogami, Bonatti, Sultan) UPMC Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, United States (Jacquemyn, Serna-Gallegos, Hasan, Ogami, Bonatti, Sultan) Department of Cardiothoracic Surgery, University of Pittsburgh, Pittsburgh, PA, United States (Jacquemyn) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (Ganduboina) Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Sa) Cleveland Clinic Florida, Florida, Weston Publisher Elsevier Inc. Abstract The long-term clinical impact of mitral prosthesis-patient mismatch (PPM) after mitral valve replacement (MVR) remains incompletely defined. We aimed to systematically assess the prevalence of mitral PPM and its association with long-term mortality, cardiac death, and heart failure-related hospitalizations. We conducted a systematic review and meta-analysis of observational studies reporting Kaplan-Meier time-to-event data in patients with and without mitral PPM. Sixteen studies, including 10,872 patients, were analyzed. The pooled prevalence of any mitral PPM was 43% (95% confidence interval [CI], 29% to 59%), with significant heterogeneity (I2 = 100%). All-cause mortality was higher with PPM (hazard ratio [HR], 1.32; 95% CI, 1.20 to 1.45; p < 0.001; RMST difference, -3.35 years; 95% CI, -3.98 to -2.71; p < 0.001), as was cardiac mortality (HR, 1.96; 95% CI, 1.54 to 2.51; p < 0.001) and risk of heart failure hospitalization (HR, 2.82; 95% CI, 1.86 to 4.29; p < 0.001). Risk-adjusted analyses confirmed these associations for all-cause and cardiac mortality. Severity-stratified analyses demonstrated a gradient effect: moderate PPM showed a trend toward higher mortality (HR, 1.12; 95% CI, 0.98 to 1.27; p = 0.08), whereas severe PPM significantly increased mortality risk (HR, 1.36; 95% CI, 1.15 to 1.60; p < 0.001). Sensitivity analyses according to PPM quantification method (in vivo vs Doppler) and leave-one-out testing confirmed the robustness of the results. In conclusion, mitral PPM is common and independently associated with increased long-term all-cause mortality, cardiac death, and heart failure hospitalizations after MVR, with a dose-response relationship according to PPM severity. These findings highlight the importance of preventive strategies to avoid PPM when planning MVR. Copyright © 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <40> 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. <41> Accession Number 2043231839 Title Comparison of Three TR Band Deflation Protocols Following Radial Coronary Procedures: A Prospective Randomized Trial. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 1626-1634), 2026. Date of Publication: 01 May 2026. Author Elhihi E.A.; Alromaili R.H.; Valiyapeediakkal S.; Alsharif R.H.; Ashraf L.M.; Abdul Rassak A.R.V.; Patarasa M.R.; Fouta R.S.; Elamkulavan M.R.; Alsulaimani R.W.; Alrizqi A.S.; Meleraroth M.; Albandar A.B.; Tukruni A.B. Institution (Elhihi) Nursing Research and Evidence-Based Practice Department, King Abdullah Medical City, Makkah, Saudi Arabia (Elhihi) Department of Critical Care, Faculty of Nursing, Cairo University, Giza, Egypt (Alromaili, Valiyapeediakkal, Alsharif, Ashraf, Abdul Rassak, Patarasa, Fouta, Elamkulavan, Alsulaimani, Alrizqi, Meleraroth, Albandar) Cardiac Surgery Ward, King Abdullah Medical City, Makkah, Saudi Arabia (Tukruni) Cardiac Inpatient Departments, King Abdullah Medical City, Makkah, Saudi Arabia Publisher John Wiley and Sons Inc Abstract Background: Radial artery hemostasis can be achieved through a variety of methods after the excision of the sheath. The risk of radial artery blockage presents a challenge linked to the radial approach, potentially limiting its future application. The patent hemostasis method effectively achieves hemostasis while maintaining the patency of the radial artery, thereby reducing the likelihood of radial artery occlusion. Aim(s): The aim of this study was to compare three TR band deflation protocols (early initiation with long intervals, delayed initiation with short intervals, and routine protocol) to determine the optimum approach for TR band deflation following radial coronary procedures. Method(s): A randomized controlled trial was performed at King Abdullah Medical City, including 207 cardiac patients undergoing trans-radial coronary procedures. The TR band was utilized with the patented hemostasis technique, wherein 2 mL of air was injected following the detection of the radial pulse on pulse oximetry after complete occlusion with 16 mL of air. Patients were randomized using electronic randomization in a 1:1:1 ratio into three groups. Total time for TR band removal, bleeding complications, and radial artery occlusions' occurrence were measured through one tool developed by the researcher. This study was conducted in accordance with the CONSORT guidelines. Result(s): A total of 207 patients were recruited. Protocols A, B, and C had significantly different mean percentages of total TR band removal time (194.1 +/- 38.15, 200.1 +/- 27.2, and 152.9 +/- 59.4, p = 0.000). The three groups had similar bleeding rates (11.8%, 15.9%, and 22.9%; p = 0.2). The study indicated that 10.3% of patients in protocol A, 7.2% in protocol B, and 22.9% in protocol C reported bleeding during the first hour from starting the protocol, with a significant difference (p = 0.01). In the second hour, 1.4% of protocol B patients had small hematomas (< 5 cm). No incidence of radial artery occlusion was observed in any group. Conclusion(s): The early protocol appears to be the most effective in reducing the incidence of bleeding complications, while the routine protocol offers a faster approach but is associated with earlier bleeding complications. Copyright © 2026 Wiley Periodicals LLC. <42> Accession Number 2044253736 Title Left Atrium and Mitral Valve Hemodynamics in Patients With Mitral Stenosis Pre and Post-Percutaneous Balloon Mitral Valvuloplasty: A Systematic Review and Meta-Analysis. Source Catheterization and Cardiovascular Interventions. 107(6) (pp 2078-2097), 2026. Date of Publication: 01 May 2026. Author Zaied M.A.; Shahzaib M.; Mukhlis M.; Latif J.; Fatima N.; Brohi F.; Alam U.; Singh P. Institution (Zaied) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Shahzaib) King Edward Medical University, Lahore, Pakistan (Mukhlis) Ayub Medical College, Abbottabad, Pakistan (Latif) Allama Iqbal Medical College, Lahore, Pakistan (Fatima) Gomal Medical College, Dera Ismail Khan, Pakistan (Brohi) Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan (Alam) Khyber Medical College, Peshawar, Pakistan (Singh) Kirori Mal College, Delhi University, Delhi, India Publisher John Wiley and Sons Inc Abstract Mitral stenosis (MS) is still a significant cause of cardiovascular morbidity and mortality in low- and middle-income countries, despite being nearly eradicated in the developed world. Percutaneous balloon mitral valvuloplasty (PBMV) is the treatment of choice for appropriate patients with MS, but traditional predictors such as mitral valve area and regurgitation grade fail to fully reflect long-term prognosis. This review aims to analyze pre- and post-PBMV hemodynamic changes in the left atrium and determine their prognostic significance in predicting clinical outcomes in patients with MS. This meta-analysis followed PRISMA guidelines and was registered in PROSPERO (CRD420251017356). PubMed, Scopus, and Web of Science were searched on March 23, 2025, for studies on adults >= 18 years with isolated MS undergoing PBMV. Eligible studies reported both pre- and post-procedure valve and hemodynamic parameters. Primary outcomes included mitral valve area, mean gradient, and left atrial indices. Pooled analyses were conducted in R (v 4.5.1). This meta-analysis included the outcomes of PBMV by comparing pre- and post-procedural data from 30 studies consisting of 2239 participants. Post-PBMV outcomes revealed a significant increase in mitral valve area (MD 0.8834, 95% CI: 0.80; 0.96, p < 0.0001), cardiac output (MD 0.70, 95% CI: 0.58; 0.81, p < 0.0001), and alongside significant reductions in left atrial diameter (MD -4.47; 95% CI: -6.23 to -2.71, p < 0.0001), left atrial pressure (MD -9.51, 95% CI: -11.19; -7.84, p < 0.0001), mitral valve pressure (MD -8.58, 95% CI: -9.41; -7.74, p < 0.0001), and systolic pulmonary pressure (MD -17.96, 95% CI: -21.48; -14.45, p < 0.0001). Out of 2239 patients, 71, 37, and 32 had valve replacement, PBMV repetition, and experienced death, respectively. PBMV showed promising effectiveness and safety in treating patients with MS with a significant increase in cardiac output and MV area and a significant decrease in LA diameter, LA pressure, MV pressure, and systolic pulmonary pressure post-PBMV, while observing low adverse events. Copyright © 2026 Wiley Periodicals LLC. <43> Accession Number 650536697 Title Clinical Application of Progressive Suspension in Thoracoscopic Right Upper Lobectomy. Source ANZ journal of surgery. 96(5) (pp 1164-1170), 2026. Date of Publication: 01 May 2026. Author Yang L.; Hang H.; Yang B.; Song X.; Kong F.; Bai X.; Lu H.; Guo H. Institution (Yang, Yang, Song, Kong, Lu, Guo) Department of Thoracic Surgery, Cangzhou Central Hospital, Cangzhou, Hebei, China (Hang) Graduate School, Bengbu Medical University, Bengbu, Anhui, China (Bai) Department of Gastroenterology, Cangzhou Central Hospital, Cangzhou, Hebei, China Abstract OBJECTIVE: To compare the clinical efficacy of the progressive suspension method and conventional thoracoscopic pulmonary resection in right upper lobectomy. METHOD(S): A prospective cohort study was conducted involving 60 patients admitted to the Department of Thoracic Surgery at Cangzhou Central Hospital from January 2024 to March 2025. Patients were randomly divided into the observation group (n = 30, using the progressive suspension method, including 15 cases of trans-thoracic puncture fixation and 15 cases of intra-thoracic suture fixation) and the control group (n = 30, conventional thoracoscopic pulmonary resection). Surgical field exposure, operative fluency, lymph node dissection, perioperative indicators, and hospitalization costs were compared between the two groups. RESULT(S): The observation group demonstrated significantly superior surgical field exposure (83.3% vs. 50.0%, p = 0.008) and operative fluency (73.3% vs. 33.3%, p = 0.002). The operative time [(87.5 +/- 23.2) min vs. (112.4 +/- 35.6) min, p < 0.001], intraoperative blood loss [50 (20, 50) mL vs. 80 (50, 120) mL, p < 0.001], postoperative drainage [150 (100, 200) mL vs. 250 (180, 300) mL, p = 0.003], VAS pain score [(3.2 +/- 1.1) vs. (4.8 +/- 1.5), p < 0.001], and hospitalization costs [(4.5 +/- 0.8) vs. (5.2 +/- 1.1) ten thousand yuan, p = 0.009] were all significantly better in the observation group. The number of lymph nodes dissected [(10.3 +/- 3.1) vs. (8.5 +/- 2.8), p = 0.021] showed a statistically significant difference, while the complete lymph node resection rate (93.3% vs. 80.0%, p = 0.143) and complication rate (16.7% vs. 33.3%, p = 0.132) showed no significant difference. No statistical differences were observed between the two suspension subgroups (p > 0.05). CONCLUSION(S): The progressive suspension method in thoracoscopic right upper lobectomy provides superior surgical field exposure, improved operative fluency, higher surgical efficiency, and better postoperative recovery compared to the conventional method, making it a safe and effective surgical approach. Copyright © 2026 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. <44> 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/. <45> 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. <46> 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. <47> Accession Number 2038196718 Title Application of comprehensive cardiac rehabilitation intervention based on King's goal attainment theory in middle-aged and elderly patients after percutaneous coronary intervention. Source International Journal of Clinical and Experimental Medicine. 19(5) (pp 134-143), 2026. Date of Publication: 2026. Author Zhang B.; Dai Q.; Huang F.; Lv J. Institution (Zhang, Dai, Lv) Second Clinical Medical College of China Three Gorges University, Hubei, Yichang, China (Huang) China Three Gorges University, Hubei, Yichang, China Publisher E-Century Publishing Corporation Abstract Objective: To evaluate the effects of a comprehensive cardiac rehabilitation intervention based on King's Goal Attainment Theory on exercise endurance, cardiac function, anxiety, depression, and sleep quality in middleaged and elderly patients following percutaneous coronary intervention (PCI). Method(s): A total of 72 middle-aged and elderly post-PCI patients were enrolled and equally randomized into a control group and an intervention group (34 cases in the control group and 38 cases in the intervention group). Both groups received conventional pharmacotherapy. The control group underwent standard cardiac rehabilitation, whereas the intervention group received a 6-month comprehensive cardiac rehabilitation program grounded in King's Goal Attainment Theory. Outcome measures included the 6-minute walk test (6MWT), left ventricular ejection fraction (LVEF), cardiac index (CI), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Pittsburgh Sleep Quality Index (PSQI). Assessments were performed at baseline and at 3 and 6 months post-intervention. Result(s): The intervention group showed a significantly higher overall response rate than the control group (P < 0.05). At both 3 and 6 months, all outcome measures improved significantly from baseline in both groups. Compared with the control group, the intervention group demonstrated significantly greater improvements in 6MWT, LVEF, PSQI, and PHQ-9 scores at both time points (P < 0.05). Conclusion(s): Compared with conventional cardiac rehabilitation, the comprehensive cardiac rehabilitation intervention based on King's Goal Attainment Theory is more effective in enhancing exercise endurance and cardiac function and in alleviating depressive symptoms and sleep disturbances among middle-aged and elderly patients after PCI. Copyright © 2026, E-Century Publishing Corporation. All rights reserved. <48> [Use Link to view the full text] Accession Number 2039377886 Title Multimodal Analgesia and Enhanced Recovery Outcomes in Cardiac Surgical Patients: An Observational Cohort Study. Source Anesthesia and Analgesia. 142(2) (no pagination), 2026. Date of Publication: 01 Feb 2026. Author Kleiman A.M.; Tsang S.; Walters S.M.; McNeil J.S.; Yarboro L.; Wu I.; Kertai M.D.; Glance L.; Mazzeffi M.A. Institution (Kleiman, Tsang, Walters, McNeil, Mazzeffi) Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, Virginia, United States (Yarboro) Department of Surgery, Division of Cardiothoracic Surgery, University of Virginia School of Medicine, Charlottesville, Virginia, United States (Wu, Glance) Department of Anesthesiology, University of Rochester School of Medicine, Rochester, New York, United States (Kertai) Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Multimodal analgesia, the use of more than 1 pharmacologic agent targeting different receptors, is a cornerstone of enhanced recovery after cardiac surgery (ERACS), but there are limited studies to support its efficacy. We aimed to explore associations between multimodal analgesia and enhanced recovery outcomes after cardiac surgery. METHOD(S): - We performed a retrospective cohort study using data from the Society of Thoracic Surgeons database from 2020 to 2023. Adults undergoing elective coronary artery bypass grafting (CABG), valve, or combined CABG-valve surgery were included. Our primary hypothesis was that multimodal analgesia would be associated with a lower maximum postoperative pain score on postoperative day 3 (POD3). Secondarily, we hypothesized that multimodal analgesia would be associated with reduced mechanical ventilation hours, intensive care unit stay, delirium, pneumonia, and reintubation. Linear mixed-effects regression models and generalized linear mixed-effects regression models were used to examine the extent the use of multimodal analgesia was associated with study outcomes after controlling for confounders. RESULT(S): - Over the 4-year study period, there were 17, 371 eligible cardiac surgical cases and 15, 515 patients (89.3%) received multimodal analgesia. There was no association between multimodal analgesia use and maximum postoperative pain score on POD3 (b = -0.07, 95% confidence interval [CI], -0.32 to 0.18, P = .57), after adjusting for confounders. There was an association between multimodal analgesia use and initial mechanical ventilation hours (b = 0.45 hours, 95% CI, 0.04-0.86, P = .03). Compared to patients who received multimodal analgesia, those who did not receive multimodal analgesia had approximately 30 minutes longer of initial mechanical ventilation time on average. Initial mechanical ventilation time decreased as the number of multimodal analgesic increased (b= -0.33 hours, 95% CI, -76 to -0.10, P = .14) for 1 multimodal analgesic; Est = -1.98 hours, 95% CI, -3.79 to -0.18, P = .03 for 5 multimodal analgesics). Acetaminophen use was associated with a reduced likelihood of delirium (odds ratio [OR] = 0.75, 95% CI, 0.57-0.94, P = .02), while use of a regional nerve block was associated with increased likelihood of unplanned reintubation (OR = 1.59, 95% CI, 1.12-2.27, P = .01). CONCLUSION(S): - In this retrospective study, multimodal analgesia was not associated with the primary outcome of reduction in maximum pain score but was associated with more rapid extubation. Larger prospective observational and randomized controlled trials of individual analgesic drugs are needed to optimize ERACS protocols. Copyright © 2025 International Anesthesia Research Society <49> [Use Link to view the full text] Accession Number 2043765112 Title Baduanjin sequential therapy's effects on quality of life and cardiac function in post-cardiac surgery heart disease patients: A systematic review. Source Medicine (United States). 105(1) (pp e46855), 2026. Date of Publication: 02 Jan 2026. Author Liu X.; Hao X.; Zhang W.; Zhang F.; Liu H. Institution (Liu, Hao, Zhang, Zhang, Liu) Department of Cardiovascular Surgery, Linfen Central Hospital, Linfen, Shanxi, China Publisher Lippincott Williams and Wilkins Abstract Background: - This study aimed to objectively evaluate the effects of Baduanjin exercise on the quality of life and cardiac function in patients with cardiovascular heart disease after cardiac surgery. Method(s): - Pubmed, Embase, Cochrane, Web of science, Chinese National Knowledge Infrastructure, Wanfang and Sinomed were searched from the date of their inception until March 5th, 2024 using medical subject headings terms and keywords. The primary outcomes were the quality of life and cardiac function. The quality of life was assessed using Short Form-36, the Seattle Angina Questionnaire, 6-min walk test and adverse events. The cardiac function was evaluated using the 6-min walking test. For statistical analysis, standardized mean difference or odds ratio and 95% confidence intervals were calculated using Stata 14.0. Result(s): - Baduanjin exercise demonstrated significant enhancements in quality of life across all Short Form-36 subitems. Meta-analyses revealed improvements in Seattle Angina Questionnaire scores related to physical limitation and stable angina pectoris. The incidence of adverse events decreased with Baduanjin exercise, and cardiac function, as indicated by left ventricular ejection fraction, showed significant improvement. Conclusion(s): - Baduanjin exercise is a safe, feasible, and acceptable intervention that can improve the quality of life and cardiac function in patients with cardiovascular heart disease after cardiac surgery. However, more studies with rigorous research designs are needed to assist in the rehabilitation of such patients. Copyright © 2026 Lippincott Williams & Wilkins <50> Accession Number 2045869760 Title Early Motor Interventions in Infants and Young Children: A Comprehensive Scoping Review. Source Children. 13(5) (no pagination), 2026. Article Number: 644. Date of Publication: 01 May 2026. Author Charitou S.; Skordilis E. Institution (Charitou, Skordilis) School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Early motor milestones play a critical role in shaping developmental trajectories across motor, cognitive, social, and functional domains. Increasing evidence indicates that motor competence facilitates environmental exploration, learning opportunities, and social engagement during infancy and early childhood. Method(s): The present scoping review aimed to map and synthesize the existing evidence on early motor interventions in children aged 0-6 years across diverse pediatric populations. A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science. Studies were selected based on predefined inclusion criteria, and data were extracted and synthesized using a descriptive and thematic approach. Result(s): A total of 30 studies were included, encompassing a wide range of populations, including preterm infants, children at risk of cerebral palsy, and typically developing children. Across studies, early motor interventions were associated with improvements in motor outcomes and, in many cases, broader developmental domains such as cognition and social interaction. Intervention effectiveness appeared to be influenced by factors such as timing, intensity, task specificity, and caregiver involvement. Conclusion(s): The review provides a cross-population synthesis of early motor interventions and proposes a conceptual framework that integrates shared mechanisms underlying effective intervention across diverse pediatric groups. This approach offers a more unified understanding of how early motor interventions influence developmental trajectories beyond diagnosis-specific perspectives. Copyright © 2026 by the authors. <51> Accession Number 2038195557 Title Hemodynamic stability with remimazolam versus propofol during anesthesia induction in hypertensive patients: a meta-analysis with trial sequential analysis of randomized controlled trials. Source Korean Journal of Anesthesiology. 79(3) (pp 306-317), 2026. Date of Publication: 01 Jun 2026. Author Song S.E.; Kim S.H.; Jeong S.; Kang H.; Kim H.J. Institution (Song, Kim) Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, South Korea (Kim) Department of Anesthesiology and Pain Medicine, Chosun University Hospital, Chosun University School of Medicine, Gwangju, South Korea (Jeong) Department of Anesthesiology and Pain Medicine, Chonnam National University Medical School and Hospital, Gwangju, South Korea (Kang) Department of Anesthesiology and Pain Medicine, Chung-Ang University College of Medicine, Seoul, South Korea Publisher Korean Society of Anesthesiologists Abstract Background: Hypertensive patients tend to have an increased risk of hypotension during anesthesia induction, which can result in adverse outcomes. This study aimed to compare hemodynamic stability with remimazolam versus propofol in hypertensive patients. Method(s): This meta-analysis analyzed randomized controlled trials investigating the hemodynamic outcomes of remimazolam versus propofol during anesthesia induction in hypertensive adults. A systematic search of electronic databases was conducted in Novem-ber 2024. Result(s): Six studies were included in the final analysis. The administration of remimazol-am significantly lowered the risk of hypotension (risk ratio [RR] = 0.711, 95% CI [0.545- 0.929], I2 = 67.54%) and bradycardia (RR = 0.256, 95% CI [0.101-0.649], I2 = 0.0%). It also resulted in a higher minimum mean arterial pressure (mean difference [MD] = 9.023 mmHg, 95% CI [0.243-17.802], I2 = 97.50%) and higher minimum heart rate (MD = 7.200 beats/min, 95% CI [1.960-12.441], I2 = 86.40%). Despite these findings, substantial heterogeneity was observed in continuous outcomes. The trial sequential analysis revealed that none of the outcomes reached the required information size. Conclusion(s): The administration of remimazolam showed a trend toward superior hemodynamic stability compared with propofol during anesthesia induction in hypertensive pa-tients, especially in minimizing the incidence of hypotension and bradycardia. However, the trial sequential analysis results remain inconclusive, the current evidence is limited by small sample sizes, and larger trials are needed to confirm our findings. Copyright © The Korean Society of Anesthesiologists, 2026. <52> Accession Number 2044439433 Title Patent foramen ovale closure versus medical therapy alone in elderly patients with cryptogenic stroke: a systematic review and meta-analysis. Source Neurological Sciences. 47(4) (no pagination), 2026. Article Number: 394. Date of Publication: 01 Apr 2026. Author de Deus O.; Tudella G.C.N.; Pereira M.A.O.M.; Menegucci G.; Klostermann A.U.; Pereira da Silva A.M.; Mitre L.P.; Scarcia L.; Gunkan A.; Nguyen T. Institution (de Deus) Department of Medicine, Federal University of Piaui, PI, Teresina, Brazil (Tudella, Menegucci, Klostermann) Department of Medicine, Federal University of Santa Maria, Av. Roraima, 1000, RS, Santa Maria, Brazil (Pereira) Department of Medicine, State University of Piaui, Piaui, Teresina, Brazil (Pereira da Silva) Division of Biostatistics and Clinical Epidemiology, MemoryHub, Cognitive and Neurodegenerative Disorders Research Group, SP, Sao Paulo, Brazil (Mitre) Department of Neurosurgery, Division of Surgery, Santa Casa de Sao Paulo School of Medical Sciences, SP, Sao Paulo, Brazil (Scarcia) Department of Neuroradiology (L.S.), Hopitaux Universitaires Henri-Mondor: Creteil, Creteil, France (Gunkan) Division of Vascular and Interventional Radiology, Department of Radiology and Imaging Sciences, University of Arizona, Tucson, AZ, United States (Nguyen) Department of Neurology, Boston University School of Medicine, Boston, MA, United States Publisher Springer-Verlag Italia s.r.l. Abstract Introduction: Current guideline recommendations from American Heart Association/American Stroke Association (AHA/ASA) strongly favor percutaneous patent foramen ovale closure (PFOC) over medical therapy alone only for younger patients aged 18-60 years with a prior cryptogenic stroke (CS). However, for patients aged >= 60 years, evidence remains limited and uncertain. Objective(s): To evaluate the efficacy and safety of PFOC with background medical therapy compared with medical therapy alone in elderly (>= 60 years) patients with CS. Method(s): We systematically searched PubMed, Embase, and Cochrane Library from inception to August 2025. We restricted inclusion in this study to articles that met all the following eligibility criteria: (1) RCTs and comparative retrospective or prospective observational studies; (2) that enrolled elderly (>= 60 years) participants diagnosed with CS. The primary outcome was defined as recurrent IS or TIA in the follow-up after PFOC or initiation of medical therapy alone. The safety outcomes were defined as: (1) all-cause mortality in the follow-up, (2) development of new onset atrial fibrillation (AF)/flutter and (3) major bleeding events. All statistical analyses were performed using R Studio version 4.3.2. We employed a risk ratio (RR) with 95% confidence intervals (CIs) as the measure of effect size to report binary outcomes with p-value lower than 0.05 to achieve statistical significance. Result(s): Seven observational studies were included. Publication years ranged from 2012 to 2025. A total of 6,725 patients were enrolled including 1,636 (24.3%) in the PFOC group and 5,089 (75.7%) in the medical therapy alone group. PFOC showed statistically significantly lower rates of recurrent ischemic stroke or TIA (RR 0.49; 95% CI: 0.35-0.67; p < 0.001; I2 = 3.2%) and all-cause mortality compared to medical therapy alone (RR 0.39; 95% CI: 0.18-0.87; p = 0.022; I2 = 22.0%). PFOC showed no statistically significant difference compared to medical therapy alone regarding new onset atrial fibrillation or atrial flutter (RR 1.38; 95% CI: 0.60-3.15; p = 0.448; I2 = 66.3%) and major bleeding (RR 0.99; 95% CI: 0.44-2.24; p = 0.977; I2 = 19.9%). Conclusion(s): This meta-analysis findings suggest that selected patients aged >= 60 years with CS may derive benefit from PFOC, with reductions in recurrent cerebrovascular ischemic events and mortality, without an excess risk of new onset AF/flutter or major bleeding compared to medical therapy alone. Copyright © Fondazione Societa Italiana di Neurologia 2026. <53> Accession Number 2045652554 Title Single Versus Double Perclose Devices for TF-TAVR Access Closure. Source JACC: Asia. 6(6) (pp 898-906), 2026. Date of Publication: 01 Jun 2026. Author Jiang J.; Wang L.; Hu P.; Ren K.; Lin X.; Zhu Q.; Fan J.; He Y.; Guo Y.; Liu Q.; Liang J.; Li H.; Yan H.; Wang J.; Liu X. Institution (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) Department of Cardiology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (Jiang, Wang, Hu, Ren, Lin, Zhu, Fan, He, Guo, Liu, Liang, Li, Yan, Wang, Liu) Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China (Wang, Liu) Transvascular Implantation Devices Research Institute, Hangzhou, China (Wang, Liu) Binjiang Institute of Zhejiang University, Hangzhou, China Publisher Elsevier Inc. Abstract Background The Double Perclose ProGlide (Abbott Vascular Devices) is widely adopted device for closing the main arterial access in transfemoral transcatheter aortic valve replacement (TF-TAVR). Previous observational studies have compared the single device vs double device approach, yielding controversial results and highlighting a gap in clinical randomized controlled trials. Objectives The authors sought to evaluate the effectiveness and safety of single vs double Perclose ProGlide devices in patients undergoing TF-TAVR. Methods The Single-Closure trial was been launched in 2024 ( NCT06173115 ). It is an investigator-initiated, open-label, multicenter, noninferior, randomized controlled trial designed to compare the clinical outcomes of single vs double Perclose closure devices. Eligible participants include patients over 65 years of age with severe aortic stenosis and indicated for TF-TAVR. These patients are randomly assigned in a 1:1 ratio to either the single Perclose closure group or the double Perclose closure group. Results The primary endpoint of the trial is the composite of access site or access-related major and minor vascular complications during hospitalization for the index procedure, as defined by the Valve Academic Research Consortium 3 criteria. Conclusions This trial aims to compare the clinical outcomes of single vs double Perclose closure. Results of this trial may provide valuable insights into the optimal strategy for large-bore vascular closure. Copyright © 2026 The Authors. <54> Accession Number 2044442814 Title Quality of life during electronic patient-reported outcome (ePRO) monitoring in thoracic surgery patients: a pilot randomized controlled trial. Source Quality of Life Research. 35(5) (no pagination), 2026. Article Number: 118. Date of Publication: 01 May 2026. Author Cox C.E.; Deal A.M.; Wang M.; Williams B.; Gentry A.L.; Hoch C.; Schlusser C.; Shrestha S.; Boisson-Walsh A.; Kurz C.; Happ M.; Bright A.; Hill L.; Coleman J.; Long J.; Haithcock B.; Bennett A.V.; Basch E.; Mody G.N. Institution (Cox, Gentry, Kurz, Happ, Hill, Coleman, Long, Haithcock, Mody) Department of Cardiothoracic Surgery, University of North Carolina, Burnett-Womack Building Suite 3041 Campus Box 7065, Chapel Hill, NC, United States (Deal, Wang, Bennett, Basch, Mody) Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, United States (Williams) Department of Cardiothoracic Surgery, Emory University, Atlanta, GA, United States (Hoch, Bennett) Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States (Schlusser) GlaxoSmithKline, Durham, NC, United States (Shrestha) Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States (Boisson-Walsh) Division of Infectious Diseases, Center for Emerging Pathogens, New Jersey Medical School, Rutgers University, Newark, NJ, United States (Bright) University of North Carolina School of Medicine, Chapel Hill, NC, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose: Patients undergoing thoracic surgery experience high symptom burden and negative impacts on postoperative health-related quality of life (HRQOL). Remote symptom monitoring using electronic patient-reported outcomes (ePROs) in other patient populations improves HRQOL but may increase workload for surgical providers. We evaluated the feasibility of ePRO use by thoracic surgery patients and providers as well as its impact on HRQOL. Method(s): In this single center randomized controlled trial, thoracic surgery patients were assigned to either ePROs with alerts to their providers for severe symptoms or ePROs for measurement only, for 90 days after hospital discharge. Primary outcomes were feasibility (measured by patient survey completion) and change in postoperative HRQOL, assessed using the EORTC QLQ-C30 and LC-13 instruments. We also assessed symptom burden, health care utilization during ePRO use, and provider management of alerts. Result(s): A total of 113 patients planned for thoracic surgery were randomized to ePROs with alerts (n = 56) vs. ePRO measurement (n = 57) only. Of these, 99 participants were discharged from the hospital using postoperative ePROs. More surveys were completed in the alerting arm (61.9% vs. 52.8%, p<0.001, h=0.18). HRQOL at 2 months (social and role function, summary score) was improved in the ePRO with alerts arm, and emotional function at 12 months was improved in the ePRO measurement only arm. Conclusion(s): Remote symptom monitoring using ePROs with alerts is feasible for thoracic surgery patients and providers. Short-term HRQOL may be improved with ePROs with alerts. The downstream impact of ePRO use on long-term HRQOL and other outcomes requires further study. Trial registration: https://Clinicaltrials.gov NCT04342260. Copyright © The Author(s) 2026. <55> [Use Link to view the full text] Accession Number 2044984648 Title The Predictive Power of Intraoperative EEG and Clinical Characteristics for Postoperative Delirium Following Cardiac Surgery. Source Journal of Clinical Neurophysiology. 43(1) (pp 32-38), 2026. Date of Publication: 01 Jan 2026. Author Wiredu K.; Sun H.; Boncompte G.; Westover M.B.; Pedemonte J.C.; Akeju O. Institution (Wiredu, Westover, Akeju) Department of Anesthesia, Critical Care and Pain Medicine, Mass General Hospital, Boston, Massachusetts, United States (Sun) Department of Neurology, Beth Israel Deaconess Medical Centre, Boston, Massachusetts, United States (Boncompte, Pedemonte) Division de Anestesiologia, Escuela de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile (Pedemonte) Programa de Farmacologia y Toxicologia, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile Publisher Lippincott Williams and Wilkins Abstract Introduction: - Postoperative delirium is common and associated with poor postoperative outcomes. However, the predictive power of intraoperative electroencephalogram (EEG) features for postoperative delirium has not yet been well studied. Method(s): - Intraoperative EEG data from 261 patients who underwent major cardiac surgery were analyzed. Cases were identified using the Confusion Assessment Method. Predictive analytics for delirium outcome were performed using (1) only clinical data, (2) only EEG data, and (3) a combined list of important features from the first two stages. Result(s): - Eleven percentage of participants experienced postoperative delirium. The patients were generally older and had lower physical and cognitive function. EEG models were found to be highly specific but less sensitive in identifying delirium cases. The combined EEG-clinical model performed comparably to the clinical-only model (AUC = 80%) but outperformed the EEG-only model (AUC = 56%). After adjusting for clinical covariates, only interhemispheric mutual information remained significantly associated with delirium (OR = 2.29, p = 0.03), with a positive correlation with delirium severity (rho = 0.18, P <= 0.01). Conclusion(s): - This study enhances our understanding of delirium neurophysiology by emphasizing the role of intraoperative EEG as a marker of brain vulnerability. Although EEG may not constitute a standalone biomarker of delirium, it holds promise for delirium risk stratification. Copyright © 2025 by the American Clinical Neurophysiology Society <56> Accession Number 620561350 Title Preoperative statin therapy for patients undergoing cardiac surgery. Source Cochrane Database of Systematic Reviews. 2012(4) (no pagination), 2012. Article Number: CD008493. Date of Publication: 18 Apr 2012. Author Liakopoulos O.J.; Kuhn E.W.; Slottosch I.; Wassmer G.; Wahlers T. Institution (Liakopoulos, Kuhn, Slottosch, Wahlers) Heart Center, University of Cologne, Department of Cardiothoracic Surgery, Kerpener Strasse 62, Cologne, Germany (Wassmer) University of Cologne, Department for Medical Statistics, Informatics and Epidemiology, Kerpener Strasse 62, Cologne, Germany Publisher John Wiley and Sons Ltd Abstract Background: Patients referred to cardiac surgery for cardiovascular disease are at significant risk for the development of post-operative major adverse events despite significant advances in surgical techniques and perioperative care. Statins (HMG-CoA reductase inhibitors) have gained a pivotal role in the primary and secondary prevention of coronary artery disease, and are thought to improve perioperative outcomes in patients undergoing cardiac surgery. Objective(s): To determine the effectiveness of a preoperative statin therapy in patients undergoing cardiac surgery. Search Method(s): We searched CENTRAL (Issue 2 of 4, 2010 on The Cochrane Library), MEDLINE (1950 to May, Week 1 2010), EMBASE (1980 to 2010 Week 19), and the metaRegister of Controlled Trials. Additionally, ongoing trials were searched through the National Research Register, the ClinicalTrials.gov registry and grey literature. Conference indices from relevant scientific meetings (2006-2009) were screened online for eligible trials. No language restrictions were applied. Selection Criteria: All randomized controlled trials comparing any statin treatment before cardiac surgery, for any given duration and dose, to no preoperative statin therapy (standard of care) or placebo. Data Collection and Analysis: Two authors evaluated trial quality and extracted data from titles and abstracts identified from the electronic database searches according to pre-defined criteria. Accordingly, full text articles of potentially relevant studies that met the inclusion criteria were retrieved to assess definite eligibility for inclusion. Effect measures are reported as odds ratios (OR) or weighted mean difference (WMD) with 95% confidence intervals (95%-CI). Main Result(s): Eleven randomized controlled studies including a total of 984 participants undergoing on- or off-pump cardiac surgical procedures were identified. Pooled analysis showed that statin pre-treatment before surgery reduced the incidence of post-operative atrial fibrillation (AF) (OR 0.40; 95%-CI: 0.29 to 0.55; p<0.01), but failed to influence short-term mortality (OR 0.98, 95%-CI: 0.14 to 7.10; p=0.98) or post-operative stroke (OR 0.70, 95%-CI: 0.14 to 3.63; p=0.67). In addition, statin therapy was associated with a shorter length of stay of patients on the intensive care unit (ICU) (WMD: -3.39 hours; 95%-CI: -5.77 to -1.01) and in-hospital (WMD: -0.48 days; 95%-CI: -0.85 to -0.11) where significant heterogeneity was observed. There was no reduction in myocardial infarction (OR 0.52; 95%-CI: 0.2. to 1.30) or renal failure (OR 0.41; 95%-CI: 0.15 to 1.12). These results were unaffected after subgroup analysis. No major or minor perioperative statin side-effects were reported from trials investigating this safety endpoint. Authors' conclusions: Preoperative statin therapy reduces the odds of post-operative atrial fibrillation (AF) and shortens the stay on the ICU and in the hospital. Statin pretreatment had no influence on perioperative mortality, stroke, myocardial infarction or renal failure. Since analysed studies included mainly patients undergoing myocardial revascularizations the results cannot be extrapolated to patients undergoing other cardiac procedures such as heart valve or aortic surgery. Copyright © 2013 The Cochrane Collaboration. <57> Accession Number 2043948858 Title Low-dose direct oral anticoagulation vs dual antiplatelet therapy after left atrial appendage occlusion: 1-year results from the ADALA trial. Source Revista Espanola de Cardiologia. 79(6) (pp 522-533), 2026. Date of Publication: 01 Jun 2026. Author Flores-Umanzor E.; Cruz-Gonzalez I.; Cepas-Guillen P.; Millan X.; Antunez-Muinos P.; Asmarats L.; Laffond A.; Regueiro A.; Lopez-Tejero S.; Li C.-H.P.; Sanchis L.; Rodes-Cabau J.; Arzamendi D.; Freixa X. Institution (Flores-Umanzor, Cepas-Guillen, Antunez-Muinos, Regueiro, Sanchis, Rodes-Cabau, Freixa) Departamento de Cardiologia, Instituto Cardiovascular, Instituto de Investigaciones Biomedicas August Pi i Sunyer (IDIBAPS), Hospital Clinic, Barcelona, Spain (Cruz-Gonzalez, Laffond, Lopez-Tejero) Departamento de Cardiologia, Instituto de Investigacion Biomedica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain (Cruz-Gonzalez, Laffond, Lopez-Tejero) Centro de Investigacion Biomedica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Millan, Asmarats, Li, Arzamendi) Departamento de Cardiologia, Hospital Universitario de la Santa Creu i Sant Pau, IIB Sant Pau, Barcelona, Spain (Rodes-Cabau) Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada Publisher Ediciones Doyma, S.L. Abstract Introduction and objectives: The ADALA trial showed a more favorable efficacy-safety profile with low-dose direct oral anticoagulation (LD-DOAC) vs dual antiplatelet therapy (DAPT) at 3 months after left atrial appendage occlusion (LAAO). However, outcomes after switching both regimens to single antiplatelet therapy (SAPT) remain uncertain. This study reports the 1-year results, focusing on outcomes after the switch to SAPT. Method(s): The ADALA trial was a multicenter, randomized clinical trial that enrolled 91 patients with atrial fibrillation and contraindications to oral anticoagulation. After successful LAAO, participants were randomized to receive LD-DOAC or DAPT for 3 months, after which all patients transitioned to SAPT. The primary endpoint was a composite of thromboembolic events, device-related thrombus (DRT), or major bleeding at 1-year. Result(s): At 12 months, the primary endpoint was significantly lower in the LD-DOAC group compared with the DAPT group (9.1% vs 32.6%; HR, 0.25; 95%CI, 0.08-0.74; P = .013), mainly driven by a reduction in DRT (0% vs 11.6%; P = .023). Major bleeding was numerically lower with LD-DOAC (9.1% vs 19.6%; P = .167), and total bleeding events were significantly reduced (13.6% vs 37.0%; P = .013). Landmark analysis showed significant differences during the initial 3 months (P < .001) but not from 3 to 12 months (P = .195). All DRT cases treated with LD-DOAC (n = 4) resolved completely without bleeding. Conclusion(s): LD-DOAC reduced thromboembolic and bleeding events compared with DAPT during the first year after LAAO, driven by a marked reduction in early DRT. No DRT events occurred after LD-DOAC withdrawal, supporting a strategy of LD-DOAC for 3 months followed by SAPT in this high-risk population. Copyright © 2025 <58> Accession Number 2045619585 Title Databases and registries recording the usage of cardiovascular implantable medical devices: A rapid review of the literature. Source JRSM Cardiovascular Disease. 15 (pp 1-11), 2026. Date of Publication: 01 Jan 2026. Author Marrone P.V.; Pinho Dias Scoton M.L.R.; Santos M.L.D.; Mathias F.R.; Delfino Silva Massaia I.F.; Dias E.M. Institution (Marrone) Faculty of Economics, Administration, Accounting and Actuarial Science of the University of Sao Paulo (FEA-USP), Sao Paulo, Brazil (Marrone, Pinho Dias Scoton, Santos, Mathias, Dias) Department of Energy Engineering and Electrical Automation-Polytechnic School of the University of Sao Paulo (POLI USP), Sao Paulo, Brazil (Mathias) Institute of Mathematics and Statistics of the University of Sao Paulo (IME-USP), Sao Paulo, Brazil (Delfino Silva Massaia) Pathology of Infectious Disease Unit of School of Medicine, University of Sao Paulo Hospital das Clinicas Medicine School (USP), Sao Paulo, Brazil Publisher SAGE Publications Ltd Abstract Background: Implantable Medical Devices (IMDs) are essential for ensuring the quality of life in patients. They also play a crucial role in terms of the costs associated with surgical procedures, as well as incurring potential risks requiring continuous monitoring following implantation. Objective(s): The aim of this systematic review of public health intervention was to determine which countries collect data on the utilization of implantable cardiovascular medical devices (IMD-Cs), and how countries record the captured data. We identified parameters for comparing the use of IMD-Cs among countries that could serve as an example for Latin American countries. Method(s): A Rapid Systematic Review of the literature through a survey using three search engines was carried out between July and August 2024. Eligible studies measured the annual use of IMD-Cs based on nationwide data published between January 2014 and August 2024. Data were synthesized using tables and an analytical approach. Result(s): From 1602 identified publications, 23 studies measuring the use of IMD-Cs were selected. This made it possible to map the sites where national records repositories are located and the type of data held therein. Conclusion(s): Many countries collect countrywide information on IMD-Cs and use a variety of methods to register/record the data. There are substantial advantages for a country with IMD-C registries, including monitoring access to IMD-Cs; tracking the costs of the devices; assessing the levels of incorporation of relevant new technologies; and helping improve medical and nursing protocols. Copyright © The Author(s) 2026 <59> Accession Number 2045458370 Title Natural history and outcomes of early aortic valve replacement versus conservative management in asymptomatic severe aortic stenosis: A meta-analysis. Source American Journal of Medicine. 139(8) (pp 1052-1064.e8), 2026. Date of Publication: 01 Aug 2026. Author Huang J.; Ellis J.; Wang D.; Joseph E.; Connolly J.; Hasan R.; Rahman F. Institution (Huang, Ellis, Wang, Joseph, Connolly, Hasan, Rahman) Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States Publisher Elsevier Inc. Abstract Background: For patients with asymptomatic severe aortic stenosis, optimal timing of aortic valve replacement remains unclear. We investigated the natural history of asymptomatic severe aortic stenosis and analyzed the impact of early aortic valve replacement versus conservative management using a meta-analysis. Method(s): PubMed, Embase, Cochrane, and Web Of Science were searched through June 24, 2025 for randomized controlled trials (RCTs) and observational studies comparing patients with asymptomatic severe aortic stenosis receiving early aortic valve replacement versus conservative management. A random-effects meta-analysis estimated risks of all-cause mortality, cardiovascular mortality, heart failure hospitalization, stroke, myocardial infarction, atrial fibrillation, and thromboembolic events. Result(s): Thirteen studies were included (4 RCTs, 9 observational studies; 3960 patients: 1868 early aortic valve replacement, 2092 conservative management). Seven of these studies (1620 patients) were aggregated to investigate the natural history of asymptomatic severe aortic stenosis. Over a mean follow-up of 5.6 years [5 studies]/median follow-up of 4.1 years [2 studies], 710 (44%) patients developed symptoms while 910 patients remained asymptomatic (319 undergoing aortic valve replacement, 591 managed conservatively). Of the 591 asymptomatic patients managed conservatively, 194 (33%) died. Across all 13 studies, aortic valve replacement was associated with lower all-cause mortality (RR 0.51 [95% CI 0.35-0.75], P < 0.001), cardiovascular mortality (RR 0.45 [0.37-0.67], P < 0.001), and heart failure hospitalization (RR 0.40 [0.20-0.82], P = 0.012). Conclusion(s): Approximately half of all patients with asymptomatic severe aortic stenosis developed symptoms within five years, and one-third of asymptomatic patients managed conservatively died. Aortic valve replacement was associated with lower all-cause mortality, cardiovascular mortality, and heart failure hospitalization, suggesting pre-symptom aortic valve replacement is reasonable in selected patients with asymptomatic severe aortic stenosis. Copyright © 2026 Elsevier Inc. <60> 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. <61> 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. <62> 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. <63> Accession Number 2045786278 Title CorCal Outcomes: A randomized trial using the pooled cohort equation or coronary artery calcium to select statin therapy in primary prevention patients. Study design and baseline characteristics. Source American Heart Journal. 299 (no pagination), 2026. Article Number: 107473. Date of Publication: 01 Sep 2026. Author Anderson J.L.; May H.T.; Winslow T.; Le V.T.; Iverson L.; Bair T.L.; Knowlton K.U.; Muhlestein J.B. Institution (Anderson, May, Winslow, Le, Iverson, Bair, Knowlton, Muhlestein) The Intermountain Medical Center Heart Institute, Murray, UT, United States (Anderson, Knowlton, Muhlestein) The University of Utah School of Medicine, Salt Lake City, UT, United States (Le) The Rocky Mountain University of Health Professions Master of PA Studies, Provo, UT, United States Publisher Elsevier Inc. Abstract Rationale Two methods to select statin therapy for primary prevention are the pooled cohort equation (PCE), based on traditional risk factors, and coronary artery calcium (CAC), a patient-level assessment of coronary plaque burden. How well these methods compare in reducing atherosclerotic cardiovascular disease (ASCVD) outcomes is unknown. Primary Aim The CorCal Outcomes trial is designed to evaluate the effectiveness of CAC compared to the PCE as a guide to statin initiation in preventing ASCVD events. Design CorCal Outcomes is a randomized trial comparing CAC to PCE to guide statin initiation in nondiabetic primary prevention patients. The study has a noninferiority design and will utilize a modified per-protocol approach that includes all who completed baseline testing and received a statin recommendation. Here we describe the study design and patient population. Enrollment From October 30, 2019, to March 25, 2025, 75,539 patients were screened via medical record query and randomly invited to participate; 5,772 agreed to be enrolled and were randomized (2886 per arm). Of those, 5,329 completed the necessary testing to be included in the primary analysis (PCE = 2,642 [49.6%], CAC = 2,687 [50.4%]). Characteristics Average age is 64.3 +/- 6.8 years, and 51.5% are female. Baseline demographics are well-matched between arms. The recommendations of the Data Safety Monitoring Board of December 9, 2024, and the Study Team's response are reported. Current Status Enrollment in CorCal Outcomes has resulted in well-balanced characteristics in the 2 arms used to recommend a statin. Based on study progress as of December 2024, the study is projected to end in second quarter of 2026. Trial Registration This study is registered with Clinicaltrials.gov (NCT 03439267). Copyright © 2026 Elsevier Inc. <64> Accession Number 2045656761 Title Photon-Counting CT in Cardiac Imaging: A Systematic Review of Coronary Artery Visualization, Plaque Characterization, and Dose Efficiency. Source International Journal of Drug Delivery Technology. 16(42 supplement) (pp 730-738), 2026. Date of Publication: 2026. Author Kaushik A.; Pathak R.K.; Rastogi U.; Kushwah K.; Pandey R. Institution (Kaushik) College of Applied Education & Health Sciences, Meerut, India (Pathak) I.K.Gujral Punjab Technical University, Punjab, Kapurthala, India (Rastogi) Noida International University, Greater Noida, India (Kushwah) Department of Radiological Imaging Techniques, College of Paramedical Sciences, Teerthanker Mahaveer University, Moradabad, India (Pandey) Department of Radiological Imaging Techniques, College of Paramedical Sciences, Teerthanker Mahaveer University, Moradabad, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Photon-counting computed tomography (PCCT) represents a paradigm shift in cardiac imaging, offering direct photon conversion, ultra-high spatial resolution, intrinsic spectral capability, and lower radiation exposure compared to conventional energy-integrating detector CT (EID-CT). Coronary CT angiography (CCTA) remains a first-line tool for evaluating coronary artery disease (CAD); however, traditional detectors are hindered by blooming artifacts, limited resolution, and suboptimal plaque differentiation. Objective(s): This systematic review evaluates current evidence on PCCT performance in three domains: (1) coronary artery visualization and stenosis quantification, (2) atherosclerotic plaque characterization, and (3) radiation dose efficiency in cardiac CT protocols. Method(s): A comprehensive literature search was conducted across PubMed, EMBASE, Scopus, and Google Scholar for studies published between January 2018 and March 2025, using MeSH terms including 'photon-counting CT', 'photon-counting detector CT', 'coronary CT angiography', 'plaque characterization', 'radiation dose', and 'cardiac imaging'. Eligible studies included original research, prospective clinical trials, and comparative studies involving human subjects undergoing cardiac PCCT. Studies were assessed using QUADAS-2 and GRADE frameworks. Result(s): A total of 38 studies met inclusion criteria. PCCT consistently demonstrated superior coronary artery visualization at ultra-high resolution (0.2 mm slice thickness), with significant reduction of calcium blooming artifacts and improved stenosis reclassification. Plaque characterization studies reported enhanced differentiation of calcified, non-calcified, and lipid-rich plaque components using spectral virtual monoenergetic imaging. Radiation dose was reduced by 27-67% across cardiac protocols without diagnostic quality compromise. Coronary artery calcium scoring (CACS) with PCCT yielded equivalent risk stratification at substantially lower CTDIvol. Conclusion(s): PCCT offers clinically meaningful advantages over conventional EID-CT in cardiac imaging, particularly for patients with dense coronary calcifications, stents, or high cardiovascular risk. Widespread clinical adoption requires standardization of acquisition protocols and multicenter validation. Copyright © 2026, Dr. Yashwant Research Labs Pvt Ltd. All rights reserved. <65> 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/. <66> Accession Number 2046036330 Title OPIOID-FREE ANAESTHESIA: PHARMACOLOGICAL BASIS AND CLINICAL APPLICATIONS. Source International Journal of Drug Delivery Technology. 16(49 Supplement) (pp 1317-1328), 2026. Date of Publication: 2026. Author Chawla V.; Priyanka Institution (Chawla, Priyanka) Department of Anaesthesia, MM Institute of Medical Sciences and Research, Mullana, Haryana, Ambala, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract As the use of opioids has become a growing concern, due to its side effects such as respiratory depression, postoperative nausea and vomiting, opioid induced hyperalgesia, long-term hospital stay, tolerance, dependence and contribution to long-term opioid induced use disorders, opioid free anaesthesia has been a great step forward in perioperative medicine. Many recent anaesthetic practices (such as the growing use of multimodal anaesthetic techniques, the enhanced recovery surgery pathway and patient-centred perioperative care) are of great interest when discussing opioid-free anaesthetic practices. Opioid-free anaesthesia is the complete avoidance of any opioids during the surgery itself, with the use of non-opioid drugs that act on several pathways to modulate the nociception. The pharmacological review, clinical use, efficacy, safety and perioperative outcomes of opioid-free anaesthesia are discussed. Research is done in a systematic analysis and secondary data from peer-reviewed peer published journals in Scopus, PubMed, Web of science and Cochrane databases are used for the period 2015-2026. The study looks at the pharmacodynamic and pharmacokinetic properties of non-opioid medications such as ketamine, dexmedetomidine, lidocaine, magnesium sulfate, acetaminophen, non-steroidal anti-inflammatory drugs, gabapentinoids and regional anaesthetic techniques. Numerical clinical parameters include pain scores, postoperative opioid consumption, postoperative nausea and vomiting, respiratory complications, requirement of intensive care and satisfaction scores to compare between opioid-based anaesthesia and opioid-free anaesthesia. The results indicate that opioid-free anaesthesia reduces the amount of opioids used postoperatively, the number of opioid-related side effects, and the quality of recovery after surgery, as well as stabilizes patient haemodynamics in specific patient groups during the perioperative period. Bariatric surgery, oncological surgery, laparoscopic surgery, orthopedic surgery and ambulatory surgical services are also seen to have significant savings in the study. However, using opioid free anaesthetic requires careful patient selection, a structured method for patient monitoring perioperatively, skill in using non-opioid drugs in combination and experience of the pharmacologic interactions of non-opioid drugs. The authors' findings in the study show that Opioid-Free Anaesthetic is a clinically effective and pharmacologically safe approach in the modern Perioperative Management. A multimodal strategy for pain management and implementation of evidence-based protocols may greatly improve surgical outcomes and minimize the harmful effects of opioid use. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <67> Accession Number 2046047034 Title Deferred versus Immediate Stenting in ST-segment Elevation Myocardial Infarction Patients with High Thrombus Burden: A Randomized Clinical Trial Using Three-dimensional Speckle Tracking Echocardiography. Source Journal of Cardiovascular Echography. 36(2) (pp 117-123), 2026. Date of Publication: 01 Mar 2026. Author Eldamanhory A.S.; Mosa H.H.A.; Soliman M.E.; Awadi M.I.; Roshdy H.S.; Shehata I.E. Institution (Eldamanhory, Mosa, Soliman, Awadi, Roshdy, Shehata) Department of Cardiovascular Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt Publisher Wolters Kluwer Medknow Publications Abstract Objectives: The optimal timing of stent implantation in ST-segment elevation myocardial infarction (STEMI) with high thrombus burden remains uncertain. Immediate stenting carries a risk of distal embolization and no-reflow, whereas deferred stenting may facilitate improved microvascular recovery. This study compared angiographic and echocardiographic outcomes of immediate versus deferred stenting using three-dimensional speckle tracking echocardiography (3D-STE). Material(s) and Method(s): In this randomized clinical trial, 115 STEMI patients with high thrombus burden were allocated to immediate stenting (n = 60) or deferred stenting after dual antiplatelet therapy plus enoxaparin (n = 55). Primary endpoints were final thrombolysis in myocardial infarction (TIMI) flow, myocardial blush grade (MBG), and left ventricular ejection fraction (LVEF) by 3D-STE. Secondary endpoints included global strain parameters and major adverse cardiovascular events (MACE) at 6 months. Result(s): Deferred stenting achieved higher TIMI III flow (76.4% vs. 60.0%, P < 0.001) and MBG 3 (63.6% vs. 41.7%, P = 0.0025). Both groups showed improved LVEF at 6 months, with greater gains in the deferred group (EF change: 14.05% vs. 12.89%, P = 0.043). Favorable but nonsignificant trends were noted in global longitudinal, circumferential, and radial strain. MACE rates were similar between groups (34.5% vs. 41.7%, P = 0.45). Conclusion(s): Deferred stenting in STEMI patients with high thrombus burden enhanced angiographic reperfusion and improved recovery of left ventricular function without reducing short-term MACE. These findings suggest deferred stenting as a feasible strategy to optimize myocardial reperfusion, warranting larger, long-term trials to evaluate its prognostic impact. Copyright © 2026 Journal of Cardiovascular Echography. <68> 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. <69> Accession Number 2045440498 Title Evaluation of the efficacy of empagliflozin in patients with preserved left ventricular ejection fraction undergoing transcatheter aortic valve implantation for aortic stenosis: protocol for a randomised, open-label, controlled study. Source BMJ Open. 16(5) (no pagination), 2026. Date of Publication: 01 May 2026. Author Okita S.; Kitahara H.; Shoji M.; Sugawara T.; Miyakoda K.; Yaginuma H.; Yamamoto H.; Kanda T.; Kinoshita M.; Sasaki H.; Suzuki-Eguchi N.; Takaoka H.; Matsuura K.; Ozawa Y.; Hanaoka H.; Matsumiya G.; Kobayashi Y. Institution (Okita, Kitahara, Miyakoda, Yaginuma, Kinoshita, Sasaki, Suzuki-Eguchi, Takaoka, Kobayashi) Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan (Shoji, Sugawara, Ozawa, Hanaoka) Clinical Research Center, Chiba University Hospital, Chiba, Japan (Yamamoto, Kanda, Matsuura, Matsumiya) Department of Cardiovascular Surgery, Chiba University Graduate School of Medicine, Chiba, Japan Publisher BMJ Publishing Group Abstract Introduction: Heart failure occasionally develops after transcatheter aortic valve implantation (TAVI) for severe aortic stenosis (AS), despite procedural success. Most cases present with mildly reduced or preserved left ventricular ejection fraction (LVEF), underscoring the role of diastolic dysfunction. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown benefits across the heart failure spectrum, independent of LVEF. The purpose of this randomised controlled trial is to determine whether adding a SGLT2 inhibitor to conventional medications improves LV diastolic function in patients with preserved LVEF after TAVI. Methods and analysis: This study is a prospective, single-centre, open-label, randomised, parallel-group, two-arm trial enrolling patients with mildly reduced or preserved LVEF (>=40%) undergoing TAVI for severe AS. Participants will be randomised in a 1:1 ratio to receive either conventional medications plus empagliflozin or conventional medications alone. In the empagliflozin group, participants will receive conventional medical therapy plus empagliflozin 10 mg orally once daily, initiated 4 weeks after TAVI. Empagliflozin treatment will continue throughout the study period. Participants in the control group will receive conventional medications without empagliflozin. The primary endpoint is the change in E/e', assessed by echocardiography from treatment initiation at 4 weeks post TAVI (day 1) to day 168 (week 24). Each group will include 50 patients, totalling 100 patients. Ethics and dissemination: Ethical approval for this study has been obtained from the Chiba University Hospital Certified Clinical Research Review Board (CRB0111-25). Trial registration number: jRCT1031250190. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <70> 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. <71> Accession Number 2045655104 Title Efficacy of dual antiplatelet therapy for three months versus 12 months after coronary artery bypass grafting: multicentre, double blinded, randomised controlled trial. Source BMJ. 393 (no pagination), 2026. Date of Publication: 31 Mar 2026. Author Yuan X.; Li J.; Lei L.; Chen K.; Chu Q.; Feng W.; Xu F.; Yang Y.; Wang X.; Wang H.; Dong A.; Cheng Z.; Guo H.; Zhou T.; Chen X.; Ge J.; Zhang L.; Liu S.; Shen Z.; Wang J.; Wang Y.; Li W.; Hu S. Institution (Yuan, Chen, Chu, Feng, Wang, Wang, Xu, Liu, Yang, Hu) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Li, Lei, Zhang, Li, Hu) National Clinical Research Centre for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China (Wang) Yunnan Fuwai Cardiovascular Hospital, Yunnan Province, Kunming City, China (Wang) General Hospital of Northern Theatre Command, Liaoning Province, Shenyang City, China (Dong) The Second Affiliated Hospital of Zhejiang University School of Medicine, Zhejiang Province, Hangzhou, China (Cheng) Fuwai Central China Cardiovascular Hospital, Henan Province, Zhengzhou City, China (Guo) Guangdong Provincial People's Hospital, Guangdong Province, Guangzhou City, China (Zhou) Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Hubei Province, Wuhan, China (Chen) Nanjing First Hospital, Nanjing Medical University, Jiangsu Province, Nanjing City, China (Ge) The First Affiliated Hospital of USTC (Anhui Provincial Hospital), Anhui Province, Hefei City, China (Zhang) Anhui Provincial Chest Hospital, Anhui Province, Hefei City, China (Liu) The Second Hospital of Hebei Medical University, Hebei Province, Shijiazhuang City, China (Shen) The First Affiliated Hospital of Soochow University, Jiangsu Province, Suzhou City, China (Wang) The First Affiliated Hospital of Wenzhou Medical University, Zhejiang Province, Wenzhou City, China (Wang, Li) Medical Research and Biometrics Centre, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Centre for Cardiovascular Diseases, Beijing, China Publisher BMJ Publishing Group Abstract Objectives: To evaluate the efficacy of dual antiplatelet therapy (DAPT) for three months versus 12 months in saphenous vein graft occlusion while reducing bleeding risk. Design(s): Multicentre, non-inferiority, double blind, randomised controlled trial. Setting(s): 13 cardiac surgery centres in China, with enrolment between February 2023 and July 2024. Participant(s): 2300 participants aged 18 to 80 years who underwent elective primary coronary artery bypass grafting with >=1 saphenous vein graft. Intervention(s): Participants were randomly assigned (1:1) to receive DAPT (ticagrelor 90 mg twice daily plus aspirin 100 mg once daily) for 12 months or the same dual antiplatelet regimen for the first three months, followed by placebo plus aspirin for nine months. Main Outcome Measure(s): The primary outcomes were saphenous vein graft occlusion at one year (non-inferiority) and Bleeding Academic Research Consortium (BARC) type 2, 3, or 5 bleeding (superiority). Secondary outcomes were major adverse cardiovascular events (MACCE), saphenous vein graft failure, venous or arterial graft stenosis, and venous or arterial graft occlusion. Result(s): 2290 patients (mean age 61.5 (standard deviation (SD) 8.4) years, 20.6% (n=472) women) were included in the modified intention-to-treat set. The mean number of saphenous vein graft segments was 2.5 (SD 0.8). 2070 patients (90.4%) with a total of 5125 saphenous vein graft segments were assessed at one year. Saphenous vein graft occlusion occurred in 280 of 2596 (10.8%) in the three month DAPT group and 283 of 2529 (11.2%) in the 12 month DAPT group (absolute difference -0.31%, 95% confidence interval (CI) -3.13% to 2.52%; P=0.008 for non-inferiority). During a median follow-up of 368 (interquartile range 358-382) days, BARC type 2, 3, or 5 bleeding occurred in 95 patients (8.3%) in the three month DAPT group and 149 patients (13.2%) in the 12 month DAPT group (absolute difference -4.67%, 95% CI -7.18% to -2.16%; P<0.001). The number needed to treat to prevent one bleeding event was 21 (95% CI 13 to 46). MACCE occurred in 26 (2.3%) patients in the three month DAPT group and 27 (2.7%) in the 12 month DAPT group (absolute difference -0.11%, 95% CI -1.48% to 1.26%). The findings for other secondary outcomes were also similar between the two groups. Conclusion(s): A three month DAPT strategy was non-inferior to the 12 month DAPT strategy in saphenous vein graft occlusion and was superior in reducing bleeding risk. Trial registration: ClinicalTrials.gov NCT05380063. Copyright © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 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 and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. <72> Accession Number 650825490 Title Effect of HA380 hemoadsorption on postoperative delirium in elderly cardiac surgery patients: a randomized controlled trial. Source Scientific reports. 16(1) (no pagination), 2026. Date of Publication: 05 Apr 2026. Author Wu Y.; Zou S.; Chen M.; Liu Q.; Lei L. Institution (Chen, Wu, Zou, Chen, Liu, Lei) Department of Anesthesiology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fuzhou, China Abstract To investigate the efficacy of HA380 hemoadsorption during cardiopulmonary bypass (CPB) in reducing postoperative delirium (POD) and improving clinical outcomes in elderly cardiac surgery patients. A prospective, single-center, evaluator-blinded, randomized controlled trial. Single institution, tertiary university hospital. 130 patients were randomized (HA380 n = 65; control n = 65), with 128 included in the complete-case primary analysis (64 per group). Eligible patients were aged >= 65 years and scheduled for cardiac surgery under CPB with anticipated duration > 2 h. The intervention group received HA380 hemoadsorption integrated into the CPB circuit; the control group underwent standard CPB. Outcome assessors remained blinded to group allocation. The primary endpoint was POD incidence within 7 days postoperatively, assessed using the confusion assessment method. Secondary outcomes included inflammatory biomarkers (TNF-alpha, IL-6, IL-10), liver function markers (ALT, AST, CRP), renal function (creatinine, procalcitonin), and postoperative complications. The primary unadjusted analysis showed a significantly lower incidence of delirium in the HA380 group versus controls (28.1% [18/64] vs 51.6% [33/64]; unadjusted OR 0.38, 95% CI 0.18-0.81; P = 0.012). Multivariable adjustment (primary analysis per locked SAP v1.0 Model I: age and hypertension) yielded an adjusted OR of 0.42 (95% CI 0.19-0.91; P = 0.028), with consistent results in sensitivity analysis additionally adjusting for coronary artery disease (OR 0.41, 95% CI 0.18-0.89; P = 0.025). Results were robust in random-forest multiple-imputation sensitivity analyses. HA380 significantly attenuated inflammatory markers (permutation P < 0.01 for IL-6, IL-10, and TNF-alpha at surgery-end/24 h) and significantly reduced ALT levels (permutation P = 0.015). However, no significant differences were observed for AST, CRP, creatinine, procalcitonin, mechanical ventilation duration, ICU length of stay, total hospital stay, or postoperative complications. Exploratory analyses suggested shorter delirium duration among patients who developed POD in the HA380 group (median 3 [2-3] vs 4 [3-5] days, P = 0.021). In this single-center, preliminary efficacy trial, HA380 hemoadsorption during CPB significantly reduced POD incidence in elderly cardiac surgery patients. These findings require confirmation in larger, multicenter, adequately powered trials with pre-specified secondary hierarchies and long-term cognitive follow-up. Copyright © 2026. The Author(s). <73> [Use Link to view the full text] Accession Number 2045856775 Title Bibliometric analysis of postoperative atrial fibrillation following coronary artery bypass grafting surgery. Source Medicine (United States). 105(20) (pp 1-11), 2026. Article Number: e41773. Date of Publication: 15 May 2026. Author Wang T.; Luo L.; Huang X.; Gao C.; Shu Y.; Ren Z.; Liu Y. Institution (Wang, Luo, Gao, Shu, Ren, Liu) School of Nursing, Capital Medical University, Beijing, China (Huang) Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China Publisher Lippincott Williams and Wilkins Abstract Background: - Postoperative atrial fibrillation (POAF) is a common and serious complication following cardiac surgery, particularly after coronary artery bypass grafting. Despite extensive research into its pathophysiology and management, the incidence of POAF remains high, reflecting the complexity of its underlying mechanisms. Method(s): - This study provides a comprehensive bibliometric analysis of the literature on POAF following coronary artery bypass grafting from 1999 to 2023, utilizing tools such as VOSviewer, Bibliometrix, and CiteSpace. Result(s): - We analyzed 1457 publications, identifying trends in publications, citation patterns, and collaborative networks. Key contributors, including influential authors, institutions, and countries, were mapped, and the thematic evolution of research was explored. Our findings highlight the prominent role of the United States in POAF research, the impact of key journals, and the evolving focus towards understanding inflammation, autonomic modulation, and epicardial adipose tissue in POAF development. Conclusion(s): - This analysis underscores the need for further research to develop personalized prevention and management strategies, ultimately aiming to reduce the burden of POAF and improve patient outcomes. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <74> Accession Number 2045665710 Title AI-Driven Pharmacogenomic Optimization of Drug Therapy in Patients With Type 2 Diabetes Mellitus and Cardiovascular Diseases. Source International Journal of Drug Delivery Technology. 16(44 Supplement) (pp 126-138), 2026. Date of Publication: 2026. Author Avezova D.B.; Sadikova S.A.; Rakhmanov M.A.; Sultanova M.; Qurbonov B.S. Institution (Avezova) Department of Anatomy and Clinical Anatomy (Octa), Bukhara State Medical Institute, Bukhara, Uzbekistan (Sadikova) Department of Therapeutic Dentistry, Samarkand State Medical University, Samarkand, Uzbekistan (Rakhmanov) Department of Artificial Intelligence, Tashkent University of Information Technologies, Tashkent, Uzbekistan (Sultanova) Department of Faculty and Hospital Therapy, Tashkent State Medical University, Tashkent, Uzbekistan (Qurbonov) Turon University, Karshi, Uzbekistan Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: The co-occurrence of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) represents one of the most clinically complex and pharmacologically challenging comorbidity profiles encountered in contemporary medicine. Pharmacogenomics offers a precision medicine framework for individualizing drug therapy according to patient-specific genetic variants in drug-metabolising enzymes, transporters, and pharmacodynamic targets. However, the translational implementation of pharmacogenomic data into clinical decision-making for T2DM-CVD patients remains limited by the complexity of multi-drug regimens, variant interpretation, and real-world scalability. Objective(s): To develop and prospectively validate an artificial intelligence (AI)-driven pharmacogenomic decision support system for the optimization of drug therapy in patients with concurrent T2DM and CVD, and to evaluate its impact on glycaemic control, cardiovascular outcomes, and adverse drug reaction (ADR) rates at 6-month follow-up. Method(s): A prospective, randomised, parallel-arm controlled trial was conducted at two tertiary cardio-endocrinological centres (January 2022-June 2024), enrolling 620 patients aged 40-80 years with confirmed T2DM (HbA1c >=7.0%) and established CVD (coronary artery disease, heart failure, or atrial fibrillation). Participants were randomised 1:1 to an AI-guided pharmacogenomic group (n=310) or standard care group (n=310). All enrolled patients underwent comprehensive pharmacogenomic profiling (CYP2C19, CYP2D6, CYP2C9, SLCO1B1, ABCB1, UGT1A1, VKORC1). An XGBoost-based AI decision support model integrated genomic, clinical, and laboratory data to generate individualised drug-dose recommendations in the intervention group. Primary outcomes were HbA1c change and major adverse cardiovascular events (MACE) at 6 months. Secondary outcomes included LDL-C, systolic blood pressure (SBP), fasting plasma glucose (FPG), and ADR rates. Result(s): The AI-guided group achieved significantly greater HbA1c reduction (-1.5+/-0.4% vs. -0.8+/-0.5%; p<0.001), greater LDL-C reduction (-1.2+/-0.4 vs. -0.7+/-0.4 mmol/L; p<0.001), and greater SBP reduction (-20.1+/-6.3 vs. -11.4+/-7.1 mmHg; p<0.001). MACE occurred in 4.4% of the AI-guided group versus 9.3% of the standard care group (HR 0.46, 95% CI 0.28-0.76; p=0.002). The composite ADR rate was 18.5% versus 31.6% (p<0.001). The XGBoost model demonstrated an AUC of 0.887 for MACE prediction and 0.863 for ADR prediction. Actionable pharmacogenomic variants were identified in 68.4% of patients, with CYP2C19 poor metaboliser status conferring the highest predictive weight for adverse clopidogrel outcomes. Conclusion(s): AI-driven pharmacogenomic decision support significantly improves glycaemic control, cardiovascular risk reduction, and drug safety in patients with concurrent T2DM and CVD. Integration of genomic data into AI-powered clinical decision support systems represents a scalable and clinically impactful precision medicine strategy for this high-risk population. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <75> 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. <76> Accession Number 648829516 Title Impact of metabolic and bariatric surgery on heart rate variability: a systematic review and meta-analysis. Source Updates in surgery. 78(2) (pp 881-891), 2026. Date of Publication: 01 Apr 2026. Author Jamialahmadi T.; Abdalla M.A.; Mirhadi E.; Almahmeed W.; Sukhorukov V.N.; Virani S.; Eid A.H.; Sahebkar A. Institution (Jamialahmadi) Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Abdalla) Hull York Medical School, University of Hull, Hull, United Kingdom (Mirhadi) School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Almahmeed) Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (Sukhorukov) Institute of General Pathology and Pathophysiology, 8 Baltiiskaya Street, Moscow, Russian Federation (Virani) Aga Khan University, Karachi, Pakistan (Eid) Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar (Sahebkar) Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India (Sahebkar) Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of (Sahebkar) Applied Biomedical Research Center, Basic Sciences Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran, Islamic Republic of Abstract Obesity is associated with autonomic nervous system (ANS) dysfunction, characterized by increased sympathetic activity, and reduced parasympathetic tone, which together contribute to elevated cardiovascular risk. Heart rate variability (HRV), a key marker of ANS function, is often reduced in individuals with obesity. Metabolic and bariatric surgery (MBS) is an effective intervention for severe obesity; however, its impact on HRV remains unclear. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Literature searches were performed in PubMed, Scopus, Embase, Google Scholar, and Web of Science. Studies evaluating HRV before and after MBS were included. Meta-analysis was carried out using Comprehensive Meta-Analysis (CMA) version 4 software. Eleven studies comprising 322 patients were included. MBS significantly improved HRV (weighted mean difference: 12.011; 95% CI: 6.984-17.038; p < 0.001). Meta-regression demonstrated a positive correlation between BMI reduction and HRV improvement (slope: 1.553; 95% CI: 0.203-2.903; p = 0.024). HRV improvements were observed at both short-term (< 6 months) and long-term (>= 6 months) follow-up. Roux-en-Y gastric bypass (RYGB) produced greater HRV improvements compared with sleeve gastrectomy (SG). MBS significantly enhances HRV, suggesting partial reversal of obesity-related ANS dysfunction. The observed association between weight loss and HRV improvement highlights MBS as a promising cardiometabolic intervention. Copyright © 2025. Italian Society of Surgery (SIC). <77> 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. <78> 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. <79> Accession Number 2046036285 Title USE OF MAGNESIUM SULPHATE IN ANAESTHESIA: MECHANISMS AND CLINICAL APPLICATIONS. Source International Journal of Drug Delivery Technology. 16(49 Supplement) (pp 1276-1291), 2026. Date of Publication: 2026. Author Sharma B.; Seharawat P. Institution (Sharma, Seharawat) Department of Anaesthesia, MM Institute of Medical Sciences and Research, Mullana, Haryana, Ambala, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Magnesium sulphate has made a significant contribution to modern anaesthetic practice, with its role in both its analgesic and neuroprotective actions, its cardiovascular and neuromuscular properties. The use of multimodal analgesia and opioid-sparing anaesthesia has added to the value of Magnesium Sulphate as a valuable anaesthetic agent in the perioperative period. Magnesium has a physiological calcium antagonistic effect and is a blocker of N-methyl-D-aspartate (NMDA) receptors, which play a role in pain transmission, neuronal excitability and neuromuscular transmission. In the current research paper, the mechanisms, pharmacodynamics and pharmacokinetics of magnesium sulphate in anaesthesia are discussed and its clinical use in the modulation of analgesia and neuromuscular blockade are emphasized. Based on the evidence provided for perioperative medicine, critical care medicine and surgical anaesthesia the paper reviews the effectiveness of the use of PSH in reducing the use of anaesthetic drugs, in dampening the sympathetic response, in improving postoperative pain outcomes, and in facilitating muscle relaxation. The articles were retrieved by using a narrative review method and comparative analysis of the published clinical studies retrieved from international databases. Quantitative results of selected randomized controlled trials and observational studies are synthesized in a numerical table for each of the following to evaluate the effect of magnesium sulphate on postoperative analgesia, requirement for opioids, onset and duration of neuromuscular blockade, haemodynamic stability and recovery parameters. Magnesium sulphate has been shown to be effective in decreasing peri-operative opioid consumption, prolonging analgesic effect, increasing neuromuscular blockade and stabilizing cardiovascular responses during laryngoscopy and intubation. Even more, magnesium sulfate leads to better postoperative recovery profiles, with less shivering and arrhythmias. The findings validate the use of magnesium sulphate as a helpful supplement when using balanced anaesthetic and enhanced recovery. Optimisation of dose, selection of patients, monitoring renal function and adherence to routine administration procedures are still important considerations. The paper concludes that magnesium sulphate can be used in various clinical settings in modern anaesthetic practice and should be investigated in more multi-centre clinical trials for a universal guideline to be established for its perioperative use. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <80> Accession Number 2046332118 Title TAVR in Low-Risk Patients at Long-Term Follow-Up: Promising Outcomes With Remaining Uncertainties from an Updated Meta-Analysis. Source American Journal of Cardiology. 272 (pp 66-67), 2026. Date of Publication: 01 Aug 2026. Author Di Pietro G.; Improta R.; Tocci M.; Bruno E.; Colantonio R.; Mancone M. Institution (Di Pietro, Improta, Tocci, Bruno, Colantonio, Mancone) Department of Clinical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy Publisher Elsevier Inc. <81> Accession Number 2045916671 Title Hypnosis on Perioperative Outcomes Among Patients Undergoing Non-Cardiovascular Surgeries: A Systematic Review of Randomized Trials. Source International Journal of Clinical and Experimental Hypnosis. (no pagination), 2026. Date of Publication: 2026. Author El-Allam Y.; Hafiani Y.; Khalyfa M.; Bouzid J.; Mouhajir M.; Himmouche N. Institution (El-Allam, Khalyfa, Bouzid, Himmouche) Hassan First University, Higher Institute of Health Sciences, Laboratory of Health Sciences and Technologies, Settat, Morocco (Hafiani) Pedagogic Unit of Research in Anesthesia and Intensive Care, Faculty of Medicine and Pharmacy, Mohamed V University, Rabat, Morocco (Mouhajir) Higher Institute of Nursing Professions and Health Techniques of Rabat, Ministry of Health and Social Protection, Rabat, Morocco Publisher Routledge Abstract Surgery is a disturbing factor of perioperative outcomes in surgical patients. This study aims to explore the effects of clinical hypnosis in diverse perioperative disturbances among non-cardiovascular surgical patients. This is a systematic review according to PRISMA guidelines, using following databases: Cochrane trials, Scopus, Web of Science, Medline and Google Scholar with various keywords in English and French. Studies quality was assessed using Cochrane Rob 2 tool. Thirty randomized controlled trials published between 2012 and January 2025 were included in this review. Results showed that clinical hypnosis revealed a significant effect on decreasing pre and intraoperative anxiety, medication consumption especially opioids and hypnotics intra and postoperatively, risk of postoperative nausea and vomiting was also decreased in hypnosis group. A higher level of prolactin was also observed in women on post-cesarean section. Hypnosis is an interesting perioperative strategy, particularly in decreasing preoperative anxiety and medication consumption. Its impact on pain is uncertain and it can be related to techniques, patient hypnotic profile or type of surgery. Copyright © 2026 International Journal of Clinical and Experimental Hypnosis. <82> Accession Number 651362092 Title Alpha-gal xenoantigens in bioprosthetic valve recipients: clinical implications for bioprosthesis longevity. Source Journal of cardiothoracic surgery. (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Gosden J.; Ascione G.; Wolf S.; Turek J.W.; George I. Institution (Gosden, Ascione) New York Presbyterian Hospital - Columbia University Irving Medical Center, New York, NY, USA (Wolf, Turek) Division of Cardiothoracic Surgery/Structural Heart & Valve Center, New-York Presbyterian Hospital-Columbia University Medical Center, 177 Fort Washington Ave, New York, 7GN-435, 10032, NY, USA (George) New York Presbyterian Hospital - Columbia University Irving Medical Center, New York, NY, USA. ig2006@cumc.columbia.edu (George) Duke University School of Medicine, Durham, NC, United States Abstract BACKGROUND: Structural valve degeneration (SVD) is a key limitation of bioprosthetic heart valves (BHVs). The underlying mechanisms for this degeneration and pathophysiology remains only partially defined. Emerging evidence implicates a xenogeneic carbohydrate epitope, galactose-alpha-1,3-galactose (Alpha-gal), as a potential driver of immune-mediated valve deterioration. This review explores the current knowledge on alpha-gal (AG) sensitization and evidence linking it to SVD and the potential clinical implications. METHOD(S): A literature search was conducted using Embase, PubMed and Scopus, using variants of the following keywords, such as "alpha-gal", "bioprosthetic valve", and "degeneration". Studies included reported human subject findings and focused on BHVs. Only original works were permitted, published between January 2014 and December 2025. RESULT(S): Six studies met the inclusion criteria. Case reports demonstrated heterogenous clinical outcomes with, rapid SVD observed in some alpha-gal sensitized patients, while other patients showed tolerance to bioprosthetic implantation in the perioperative and short-term period. The only study with longitudinal follow-up demonstrated that anti-AG IgG responses were associated with increased SVD and calcification. Another study found no perioperative adverse valvular outcomes, although follow-up was limited to in-hospital assessment. Overall, his manuscript identifies that AG sensitization may contribute to SVD in certain patients, however, its broader significance remains uncertain. CONCLUSION(S): Immune recognition of AG may contribute to SVD based on the limited available evidence. Larger prospective investigations are required to clarify a causal relationship and to assist in guiding potential preventative strategies. Recognition of this mechanism may ultimately inform management of valve replacement and bioprosthesis selection plans. Copyright © 2026. The Author(s). <83> Accession Number 2046311735 Title Comparison of Paravertebral Block and Erector Spinae Plane Block in Thoracotomy Using Nociception Level Index Monitoring: A Prospective Randomized Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Yorukoglu H.U.; Cesur S.; Alparslan V.; Bulut M.; Aksu C.; Kus A. Institution (Yorukoglu, Cesur, Alparslan, Bulut, Aksu, Kus) Department of Anesthesiology and Reanimation, Kocaeli University, School of Medicine, Kocaeli, Turkey Publisher W.B. Saunders Abstract Objective: Paravertebral block (PVB) is considered the gold-standard regional technique for thoracotomy analgesia, whereas the erector spinae plane block (ESPB) has gained popularity. However, evidence comparing these 2 techniques in open thoracotomy remains inconsistent. The nociception level (NOL) index provides a more objective assessment of intraoperative nociception. This study aimed to compare the analgesic efficacy of preoperative PVB and ESPB during thoracotomy using NOL-guided opioid administration. Design(s): Prospective randomized clinical trial. Setting(s): Single tertiary-care university hospital. Participant(s): Fifty-seven patients who underwent elective thoracotomy surgeries were included in this study. Intervention(s): Patients were randomized to receive preoperative ultrasound-guided PVB or ESPB at the T5 level using 20 mL of 0.25% bupivacaine. Measurements and Main Results: Intraoperative opioid infusion rate was titrated with the NOL index. Intraoperative remifentanil and postoperative morphine consumptions, pain scores at rest and during coughing, rescue analgesic need, and adverse events were recorded. Intraoperative remifentanil consumption was significantly lower in the PVB group than in the ESPB group (431.4 +/- 287.7 mcg vs 863.6 +/- 385.5 mcg, p < 0.001). Total 24-hour postoperative morphine use was also lower in the PVB group (15.2 +/- 6.6 mg vs 20.1 +/- 6.6 mg, p = 0.002). Numeric rating scale (NRS) scores at rest were significantly lower in the PVB group at 9 and 12 hours, while NRS scores during coughing were significantly lower at all postoperative time points. Conclusion(s): In patients undergoing thoracotomy, PVB provided superior intraoperative and postoperative analgesia compared with ESPB, with significantly reduced opioid requirements and lower pain scores. Objective nociception monitoring with the NOL index demonstrated that ESPB may be insufficient for major thoracic surgery. Copyright © 2026 Elsevier Inc. <84> Accession Number 2046059315 Title Artificial intelligence optimizes immune rejection prediction and management in heart transplantation: a structured narrative review. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1790244. Date of Publication: 14 May 2026. Author Chen K.; Lai J.; Luo Y.; Li C.; Wang G. Institution (Chen, Lai, Luo, Wang) Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Li) Department of Cardiovascular Surgery, Zhongnan Hospital, Wuhan University, Hubei, Wuhan, China Publisher Frontiers Media SA Abstract Background - Heart transplantation remains the definitive therapy for end-stage heart failure, yet long-term outcomes are limited by three core clinical bottlenecks in immune rejection management: imprecise preoperative donor-recipient matching, overreliance on invasive endomyocardial biopsy (EMB) for postoperative rejection surveillance, and high inter-observer variability in manual pathological diagnosis of rejection. Artificial intelligence (AI) has emerged as a promising tool to address these gaps, but the methodological quality and clinical translation readiness of supporting evidence have not been comprehensively synthesized. Methods - This structured narrative review synthesized original research published between October 1, 2020, and October 1, 2025, identified via a targeted PubMed search and manual reference screening. Two independent reviewers performed study selection and data extraction, with discrepancies resolved by consensus. Common methodological limitations across included studies were synthesized qualitatively. Results - A total of 42 studies were included in the final qualitative synthesis. Preoperatively, 3D-Convolutional Neural Networks (3D-CNNs) enabled automated, accurate total cardiac volume (TCV) measurement for anatomical matching, while machine learning models identified non-linear synergistic risk factors for postoperative adverse events, outperforming traditional regression models. Postoperatively, AI models integrating non-invasive biomarkers (gene expression profiles, extracellular vesicles, donor-derived cell-free DNA) showed high diagnostic accuracy for rejection, with one single-center retrospective study estimating a 56.8% reduction in unnecessary EMB procedures (prospective clinical validation is still required). For pathological diagnosis, AI models improved the sensitivity of high-grade acute cellular rejection (ACR) detection from 39.5% to 74.4% compared with manual assessment, generative adversarial networks (GANs) addressed rare rejection sample scarcity with a rejection region detection AUROC of 98.84%, and explainable AI tools aligned model decisions with pathologists' judgment. The overall methodological quality of included studies was suboptimal, with most studies limited by single-center retrospective design, small sample size, and lack of independent external validation. Conclusions - AI has demonstrated promising potential to optimize donor-recipient matching, enable non-invasive rejection surveillance, and standardize pathological diagnosis in heart transplantation. However, most current evidence comes from exploratory, single-center retrospective studies with important methodological limitations that restrict their immediate clinical translation. Future research should prioritize prospective, multi-center clinical validation, standardized biomarker and model reporting, and federated learning data ecosystems to translate AI innovations into routine clinical practice. Copyright © 2026 Chen, Lai, Luo, Li and Wang. <85> Accession Number 651359033 Title Intraprocedural guidance using fluoroscopy alone for left atrial appendage closure: a systematic review and meta-analysis. Source Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. (no pagination), 2026. Date of Publication: 02 Jun 2026. Author Li J.; Fan S.; Zhang F.; Yan Y.; Zhang J.; Zhang E.; Lu J.; Wu D.; Lu F.; Xu J.; Ma W. Institution (Li, Fan, Zhang, Yan, Zhang, Zhang, Wu, Lu, Xu, Ma) Chest Hospital, Tianjin University, 70 ,Xi'an Road, Tianjin, China (Li, Fan, Zhang, Yan, Zhang, Zhang, Wu, Lu, Xu, Ma) Arrhythmia Department, Tianjin Chest Hospital, 70 ,Xi'an Road, Tianjin, China (Lu) Department of Cardiology II, Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China (Ma) Clinical School of Thoracic, Tianjin Medical University, Chine, 70 ,Xi'an Road, Tianjin, China Abstract BACKGROUND: In some arrhythmia centers, intraprocedural guidance using fluoroscopy alone remains the mainstream approach for left atrial appendage closure (LAAC). This study aims to synthesize recent literature and assess the feasibility of fluoroscopy-guided LAAC performed without echocardiography. METHOD(S): A computer-based search was conducted in PubMed, Embase, and the Cochrane Library for studies comparing fluoroscopy alone versus fluoroscopy combined with echocardiography for LAAC, from the inception of each database to September 13, 2025. Summary analysis was conducted using Review Manager 5.4. RESULT(S): This meta-analysis included 7 studies with 2,472 patients, 1,358 in the Fluoroscopy group and 1,114 in the combined fluoroscopy-echocardiography group (Standard group). Both groups achieved high immediate procedural success rates, with a higher rate in the Standard group (RR 0.98, 95% CI 0.96-1.00, P = 0.030), but the difference was minimal. Fluoroscopy-guided LAAC increased fluoroscopy time (MD 1.89, 95% CI 1.61-2.17, P < 0.001) but shortened procedure time (MD -12.92, 95% CI -18.96 to -6.89, P < 0.001). Overall perioperative complications showed no significant differences between groups (RR 0.93, 95% CI 0.51-1.69, P = 0.810). In follow-up, the incidence of peri-device leak (PDL), device-related thrombosis (DRT), and stroke/TIA or death were similar between groups. CONCLUSION(S): Both intraprocedural guidance strategies for LAAC achieve high immediate procedural success rates. Although the Standard group showed a higher success rate, the advantage was minimal. The two strategies are comparable in terms of perioperative and follow-up complications. Overall, current evidence supports that fluoroscopy-guided LAAC alone is feasible by experienced operators in settings with limited resources. Copyright © 2026. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature. <86> [Use Link to view the full text] Accession Number 2045854488 Title Optimizing conduits and intraoperative graft quality in coronary artery bypass graft surgery. Source Current Opinion in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Majeed H.; Pelletier M. Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Optimization of conduits and intraoperative graft assessment remain central determinants of long-term success in coronary artery bypass grafting (CABG). This review is timely, given the recent publication of randomized data refining conduit selection, harvesting strategies, and modalities for physiologic graft verification. Recent findings - Over the past year, accumulating randomized and registry-based evidence has strengthened support for multi-arterial revascularization, while clarifying the risks and benefits of certain arterial grafting and associated techniques. Parallel investigations have emphasized atraumatic great saphenous vein (GSV) harvesting and no-touch techniques, to mitigate endothelial injury and enhance patency. Intraoperative graft assessment has increasingly shifted toward routine use of objective physiologic tools, particularly transit-time flow measurement (TTFM) with adjunctive Doppler/ultrasound or fluorescence angiography, and emerging data refining quantitative thresholds and quality benchmarks. Summary - Contemporary evidence underscores that durable surgical revascularization depends on integrated biologic, technical, and physiologic optimization. Standardizing conduit selection, minimizing conduit injury, and adopting routine intraoperative graft assessment may reduce early technical failure and improve long-term graft performance. Ongoing trials and implementation research will determine how best to translate these advances into consistent, high-quality CABG practice. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <87> Accession Number 2046079871 Title Incidence and predictors of postoperative atrial fibrillation following coronary artery bypass graft surgery: a meta-analysis of 207 studies. Source Acta Cardiologica. (no pagination), 2026. Date of Publication: 2026. Author Farzaneh A.; Zameni N.; Masoum A.; Karamian A. Institution (Farzaneh) School of Medicine, Department of Cardiology, Hamadan University of Medical Sciences, Hamadan, Iran, Islamic Republic of (Zameni) Department of Anesthesiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran, Islamic Republic of (Masoum) Faculty of Medicine, Mashhad Islamic Azad University, Mashhad, Iran, Islamic Republic of (Karamian) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Taylor and Francis Ltd. Abstract Background: Postoperative atrial fibrillation (POAF) is one of the most common tachyarrhythmias after coronary artery bypass graft (CABG) surgery. This study aimed to determine the overall incidence and predictors of POAF after CABG surgery through a systematic review of existing research findings. Method(s): The protocol of this study was registered in PROSPERO (CRD420251023423) and written under the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result(s): 207 articles with a total sample size of 180,223 participants were included in our meta-analysis. The overall incidence of POAF following CABG surgery was 24% (95% CI 23%-26%). Increased age and male gender were associated with higher odds of developing POAF (ORs of 1.06 and 1.28, respectively, p < 0.01). Comorbidities, including congestive heart failure (CHF), hypertension, COPD, renal failure, and chronic kidney disease (CKD), were shown to be predictors of POAF. Those who do not use beta-blocker or have withdrawn from it were more likely to experience POAF (OR = 2.26, 95% CI 1.35-3.78, p < 0.01). Preoperative use of statins significantly reduced the odds of POAF (OR = 0.57, 95% CI 0.42-0.78, p < 0.01). On-pump surgery, grafting >= 3 vessels, longer length of stay in hospital, use of intra-aortic balloon pump (IABP), prolonged cross-clamp time, use of inotropic medications, and higher left atrial volume index (LAVI), and LA diameter were also predictors of POAF. Higher preoperative left ventricular ejection fraction (LVEF) was another factor that was associated with lower odds of developing POAF. Conclusion(s): Recognising the risk factors for POAF helps us to identify high-risk patients to provide better preventive measures and management strategies for POAF after CABG. Copyright © 2026 Belgian Society of Cardiology. <88> [Use Link to view the full text] Accession Number 2045858073 Title Partial Oral Antibiotic Therapy in Infective Endocarditis: Evidence, Patient Selection, and Practical Implementation. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Khatami S.; Faghihi M.; Talebi-Taher M.; Yousefifard M. Institution (Yousefifard) From the Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Lippincott Williams and Wilkins Abstract Infective endocarditis (IE) is a life-threatening infection traditionally treated with 4-6 weeks of intravenous (IV) antibiotics. Emerging data, including the Partial Oral versus Intravenous Antibiotic Treatment of Endocarditis trial and recent meta-analyses, suggest that selected clinically stable patients can safely transition early to oral regimens, but practical guidance on implementation is limited. We conducted a comprehensive narrative review of randomized trials, observational studies, ongoing clinical trials, meta-analyses, and contemporary guidelines addressing partial oral antibiotic therapy in adult IE. Evidence consistently shows that after at least 10 days of effective IV treatment, patients who are afebrile, hemodynamically stable, have negative blood cultures, and no uncontrolled infection on imaging can be transitioned to dual oral regimens with high bioavailability and pathogen-directed activity. In this population, oral step-down therapy yields similar rates of death, relapse, embolic events, and unplanned cardiac surgery compared with prolonged IV therapy, while substantially reducing hospital length of stay and line-related complications. Data in people who inject drugs, those with multidrug-resistant pathogens, or severe heart failure remain limited, and robust pharmacokinetic validation of some oral beta-lactam-based combinations is still needed. Overall, partial oral antibiotic therapy represents a safe, evidence-based, and stewardship-aligned strategy for many patients with left-sided native or prosthetic valve IE when applied within structured protocols and strict selection criteria. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <89> Accession Number 651361583 Title Preoperative Stellate Ganglion Block for Postoperative Sore Throat in Patients Undergoing Double-Lumen Endotracheal Intubation: A Randomized Clinical Trial. Source Drug design, development and therapy. 20 (pp 610843), 2026. Date of Publication: 2026. Author Cong P.; Tan Y.; Li H.; Zhang H.; Zhang L.; Shan L.; Zhao Y.; Jin Y.; Wu Q.; Chen Z.; Li N. Institution (Cong, Wu, Chen) Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Translational Research Institute of Brain and Brain-Like Intelligence, Clinical Research Center for Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China (Tan, Li, Zhang, Zhang, Li) Department of Anesthesiology, Second Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China (Jin) Department of Epidemiology and Biostatistics, School of Public Health, Wannan Medical University/ Institute of Chronic Disease Prevention and Control, Wuhu, China (Shan, Zhao) Department of Thoracic Surgery, Second Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China (Jin) Department of Anesthesiology and Perioperative Medicine, Shandong Public Health Clinical Center, Shandong University, Jinan, Shandong, China Abstract Background: As a common complication of double-lumen endobronchial tube (DLT) intubation during thoracic surgery, postoperative sore throat (POST) brings adverse impacts on patient recovery. Although stellate ganglion block (SGB) can modulate sympathetic tone and inflammatory reactions, its efficacy in preventing DLT-related POST is still inconclusive. This trial aimed to determine whether SGB reduces the incidence of POST at 6 h after surgery in patients undergoing DLT intubation. Method(s): In this single-center prospective randomized controlled trial, 124 patients undergoing elective thoracic surgery with left-sided DLT intubation were randomized 1:1 to two groups: the intervention group received preoperative ultrasound-guided right-sided SGB (5 mL of 0.5% ropivacaine), and the control group received standard care (ultrasound scanning without injection plus 1% tetracaine gel lubrication). The primary endpoint was the incidence of POST at 6 h after surgery. Result(s): Of the 124 randomized patients, 111 eligible subjects were finally included in the full analysis. The incidence of POST at 6 h after surgery, was significantly decreased in the ultrasound-guided SGB intervention group compared with the standard care control group (14.3% vs 38.2%; RR = 0.37; 95% CI: 0.18-0.77; P = 0.008). This significant protective effect of SGB against POST was consistently observed at the early postoperative time point of 2 h (P = 0.017) and sustained up to 24 h after surgery (P = 0.036). SGB also significantly reduced POST severity at all time points, lowered sleep disturbance rate and improved anxiety/depression scores at 24 h after surgery (all P < 0.05). No between-group differences were observed in the incidence or severity of hoarseness or in other outcomes, and no notable complications occurred. Conclusion(s): Preoperative ropivacaine-based SGB could reduce the incidence and severity of POST in patients for DLTs in thoracic surgery, with this protective effect persisting for at least 24 h after surgery. These preliminary results require validation in larger multicenter studies. Clinical Trial Registration: Chinese Clinical Trial Registry, ChiCTR2400092313. Copyright © 2026 Cong et al. <90> Accession Number 2046322119 Title Percutaneous left atrial appendage closure following catheter ablation therapy of atrial fibrillation: outcomes stratified by bleeding risk - a sub-analysis of the OPTION study. Source Europace. 28(6) (no pagination), 2026. Article Number: euag093. Date of Publication: 01 Jun 2026. Author Phillips K.P.; Nair D.G.; Boersma L.V.A.; Doshi R.N.; Healey J.S.; Jaber W.A.; Mansour M.; Reddy V.Y.; Tondo C.; Natale A.; Sukumar A.; Leger K.; Christen T.; Sutton B.S.; Wazni O.M. Institution (Phillips) The Brisbane AF Clinic, Greenslopes Private Hospital, Suite 23, Greenslopes Specialist Centre, Newdegate Street, Brisbane, QLD, Australia (Nair) Cardiac Electrophysiology Division, St. Bernards Medical Center & Arrhythmia Research Group, Jonesboro, AR, United States (Boersma) Cardiology Department, St. Antonius Hospital, Nieuwegein and UMC, Amsterdam, Netherlands (Doshi) Cardiac Electrophysiology Division, Arizona State University John Schufeldt School of Medicine and Advanced Medical Engineering, Scottsdale, AZ, United States (Healey) Department of Cardiac Electrophysiology, McMaster University, Hamilton, ON, Canada (Jaber) Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Mansour) Department of Cardiac Electrophysiology, Massachusetts General Hospital, Boston, MA, United States (Reddy) Helmsley Electrophysiology Center, Mount Sinai Fuster Heart Hospital, New York, NY, United States (Tondo) Department of Clinical Electrophysiology & Cardiac Pacing, Centro Cardiologico Monzino, IRCCS, Milan, Italy (Tondo) Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy (Natale) Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX, United States (Natale) Department of Biomedicine and Prevention, Division of Cardiology, University of Tor Vergata, Rome, Italy (Sukumar) Boston Scientific Corporation, Marlborough, MA, United States (Leger) Boston Scientific Corporation, Marlborough, MA, United States (Christen) Boston Scientific Corporation, Marlborough, MA, United States (Sutton) Boston Scientific Corporation, Marlborough, MA, United States (Wazni) Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Foundation, Cleveland, OH, United States Publisher Oxford University Press Abstract Aims: Concerns have been raised over the safety and necessity of continuing oral anticoagulation (OAC) in patients following catheter ablation for atrial fibrillation (AF). OPTION demonstrated the safety and efficacy of left atrial appendage closure (LAAC) in a post-ablation population. We sought to analyse the impact of baseline bleeding risk, per HAS-BLED scores, on the outcomes for patients in a pre-specified sub-analysis. Methods and Results: Patients with AF and high stroke risk undergoing catheter ablation were randomly assigned to LAAC vs. OAC in OPTION and were stratified by HAS-BLED score: 0, 1, 2, >=3. OPTION enrolled 1600 patients (CHA<inf>2</inf>DS<inf>2</inf>-VASc score: 3.5 +/- 1.3; HAS-BLED score: 1.2 +/- 0.8); randomized 1:1 to ablation/LAAC or ablation/OAC. Primary effectiveness (all-cause death/stroke/systemic embolism) and safety (bleeding composite) endpoints were directionally similar in HAS-BLED subgroups; both thromboembolic and bleeding event rates were higher in patients with increasing HAS-BLED score. A significant reduction in primary safety bleeding events was noted in favour of LAAC across HAS-BLED subgroups, with more striking reductions noted for lower HAS-BLED scores of 0 (n = 265; hazard ratio: 0.25; 95% confidence interval: 0.20, 0.50) and 1 (n = 890; hazard ratio: 0.41, 95% confidence interval: 0.27-0.61). Conclusion(s): Regardless of bleeding risk, LAAC is comparable to OAC in stroke protection while demonstrating greater freedom from bleeding in a post-ablation AF population, even in patients with low HAS-BLED scores. The OPTION study highlights an opportunity to mitigate future bleeding risk with a strategy of LAAC after ablation in patients deemed at high risk of stroke according to clinical guidelines. Trial registration number: NCT03795298 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. <91> Accession Number 651356761 Title Effects of Ulinastatin and Tranexamic Acid in Cardiac Surgery: A Systematic Review and Meta-Analysis. Source Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 36(6) (pp 789-797), 2026. Date of Publication: 01 Jun 2026. Author Zhang X.; Lin H.; Xu H.; Yao Y. Institution (Zhang, Lin, Xu) Department of Anaesthesiology and Perioperative Medicine, Fuwai Central China Cardiovascular Hospital, Zhengzhou University Central China Fuwai Hospital, Zhengzhou; Laboratory of Transesophageal Echocardiography, Henan Provincial Clinical Research Centre for Cardiovascular Disease, China (Zhang, Lin, Xu) Evidence in Cardiovascular Anesthesia (EICA) Group, China, Beijing, China (Yao) Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Yao) Centre of Outcomes Research, Department of Anesthesiology, Critical Care and Pain Medicine, University of Texas, Houston, United States (Yao) Outcomes Research Consortium, Houston, United States Abstract Evidence suggests that both tranexamic acid (TXA) and ulinastatin (ULI) possess anti-inflammatory and blood-conserving properties. This study aimed to determine whether combining TXA and ULI yields additional benefits for patients undergoing cardiac surgery compared with the use of either medicine alone. This systematic review was conducted through comprehensive searches of PubMed, the Cochrane Library, EMBASE, CBM, CNKI, and WANFANG Data from their inception to December 2024 to identify all relevant clinical trials. Data from sixteen studies, encompassing 1,617 subjects, were synthesised using a random-effects meta-analysis. Primary outcomes included perioperative blood loss and blood transfusion requirements. Secondary outcomes included perioperative haemoglobin levels, coagulation function, platelet counts, and postoperative complications. This meta-analysis demonstrated that combination therapy with ULI and TXA significantly reduced total postoperative bleeding volume and RBC transfusion requirements compared to ULI monotherapy in cardiac surgery. However, no significant difference was observed compared to TXA alone. The combined regimen better preserved postoperative coagulation function, leading to significant improvements in prothrombin time, activated partial thromboplastin time, and D-dimer levels. The combination strategy may allow for reduced dosages of each drug, potentially lowering the thrombogenic risk associated with TXA. No significant adverse events were reported in the included studies. Therefore, the combination of ULI and TXA exhibits a synergistic effect on haemostasis and preservation of coagulation function, representing an optimised strategy for blood management in cardiac surgery. Key Words: Ulinastatin, Tranexamic acid, Cardiac surgery, Bleeding, Transfusion. <92> [Use Link to view the full text] Accession Number 2046033218 Title Opioid Free anesthesia in cardiac surgery: The OFACAR randomized clinical trial. Source Anesthesiology. Publish Ahead of Print (no pagination), 2026. Date of Publication: 22 May 2026. Author Guinot P.-G.; Besch G.; Jonval L.; Nguyen M.; Grelet T.; Bouhemad B. Institution (Guinot, Nguyen, Bouhemad) Department of Anesthesiology and Intensive Care, Dijon University Hospital, France (Guinot, Nguyen, Bouhemad) University of Burgundy Europe, Dijon, France (Guinot, Nguyen, Bouhemad) Center for Translational and molecular Medicine (CTM), INSERM UMR1231, Lipness Team, Dijon, France (Besch, Grelet) Universite Marie et Louis Pasteur, CHU Besancon, Inserm CIC 1431, SINERGIES (UR 4662), Departement d'Anesthesie Reanimation Chirurgicale, Besancon, France (Jonval) Delegation a la recherche clinique et a l'innovation, Dijon University Hospital, France Publisher Lippincott Williams and Wilkins Abstract Background: - Opioid-free anesthesia (OFA) may reduce postoperative complications in cardiac surgery, but evidence from large randomized trials is limited. Method(s): - We conducted a randomized, controlled, blinded, multicenter superiority trial at two tertiary university hospitals in France from August 2021 to December 2023. We enrolled 320 adult patients undergoing elective cardiac surgery with cardiopulmonary bypass. Patients were randomized to receive either OFA (n=159) consisting of intravenous ketamine, dexamethasone, lidocaine, and magnesium sulfate, or opioid anesthesia with sufentanil (n=161). The primary outcome was a composite of postoperative neurological, respiratory, cardiovascular, renal complications, and/or death within 30 days after surgery. Result(s): - Among 320 participants (mean age 66.4 +/- 10.5 years; 247 men [77.2%]), the primary outcome occurred in 120 patients (75.4%) in the OFA group compared with 136 patients (84.5%) in the control group (Risk Ratio [RR], 0.90; 95% confidence interval [CI], 0.80-0.99; P = 0.049). The fragility index for the primary outcome was 1. OFA was associated with significant reductions in cardiovascular complications (64.2% vs. 75.2%; RR, 0.86; 95% CI, 0.74-0.99; P = 0.031), particularly postoperative myocardial damage (61.6% vs. 72.1%), and digestive complications (2.5% vs. 11.2%; RR, 0.22; 95% CI, 0.08-0.65; P = 0.007). No death occurred in the OFA group compared with 6 patients in the control group (P=0.014). Conclusion(s): - In patients undergoing cardiac surgery with cardiopulmonary bypass, opioid-free anesthesia may reduce composite postoperative complications compared with opioid anesthesia. The primary endpoint composite fragility index indicate that these results should be considered hypothesis-generating and warrant confirmation in larger trials. Trial registration: - NCT04886453 Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Society of Anesthesiologists. <93> Accession Number 2046323056 Title Surgical Aortic Valve Replacement. Source Journal of the American College of Cardiology. 87(24) (pp 3483-3485), 2026. Date of Publication: 23 Jun 2026. Author Dietze Z.; Marin-Cuartas M.; Milojevic M.; Myers P.O.; Falk V.; Borger M.A. Institution (Dietze, Marin-Cuartas, Borger) University Department of Cardiac Surgery, Leipzig Heart Center, Leipzig, Germany (Milojevic) Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia (Milojevic, Myers) Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland (Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany (Falk) German Center for Cardiovascular Research (DZHK), Berlin, Germany (Falk) ETH Zurich, Department of Health Sciences and Technology, Zurich, Switzerland Publisher Elsevier Inc. <94> Accession Number 2046323059 Title Real-Time Heart Team for Revascularization in Complex Coronary Artery Disease. Source Journal of the American College of Cardiology. 87(24) (pp 3467-3479), 2026. Date of Publication: 23 Jun 2026. Author Lin S.; Su X.; Ma H.; Dou K.; Song L.; Zhao H.; Qian J.; Liu S.; Xu F.; Wang X.; Yang Y.; Su P.; Jin Z.; Wang Y.; Zheng Z. Institution (Lin, Su, Zheng) National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Lin, Liu, Xu, Wang, Yang, Zheng) Department of Cardiovascular Surgery, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Ma) Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Dou, Song, Zhao, Qian) Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Su) Department of Cardiac Surgery, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (Jin) Department of Cardiology and Macrovascular Disease, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Wang) Medical Research and Biometrics Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China Publisher Elsevier Inc. Abstract Background: The routine implementation of heart teams for patients with complex coronary artery disease (CAD) is challenging due to the insufficient multidisciplinary specialist resources for face-to-face discussion. A real-time heart team during the angiography, based on an online meeting, offers the potential to efficiently integrate resources. Objective(s): In this study, we sought to evaluate the implementation value and safety of a "real-time heart team" decision making approach. Method(s): This noninferiority randomized controlled trial enrolled patients with de novo left main or 3-vessel CAD at 3 cardiac centers. Patients were randomly assigned to the conventional heart team group (discussed by a face-to-face meeting after the angiography) or the real-time heart team group (discussed by an online meeting during the angiography). Implementation value outcomes included care efficiency (waiting time for treatment, recatheterization, specialist workload, and economic outcomes) and process evaluation metrics (discussion adequacy, surgeon participation, and shared decision making). The safety outcomes were a composite of 1-year major adverse cardiovascular and cerebrovascular events (MACCE) (including all-cause mortality, myocardial infarction, stroke, unplanned revascularization, and readmission due to reangina) and revascularization decision making. Result(s): Overall, 490 complex CAD patients were included, with 245 patients in each group. Waiting time for final therapy (median: 2 days [Q1-Q3: 0-7 days] vs 5 days [Q1-Q3: 2-10 days]; P < 0.001), recatheterization rate (12.5% vs 98.9%; P < 0.001), specialist high workload rate (5.3% vs 29.0%; P < 0.001), and percutaneous coronary intervention (PCI) hospitalization cost (percentage of decrease: 18.0%; P < 0.001) were significantly reduced in the real-time group. More discussion time spent (4.0 +/- 1.8 min vs 3.4 +/- 1.6 min), better specialist satisfaction (based on NASA Task Load Index scale), more chief surgeon participation (26.5% vs 18.8%), but less multidisciplinary synchronous shared decision making (2.0% vs 11.5%) were found in the real-time group. The real-time heart team group was noninferior to the conventional group in 1-year MACCE (8.2% vs 10.6%; risk difference: -2.45%; 95% CI: -7.61%-2.71%; P for noninferiority < 0.001). The proportions of PCI, coronary artery bypass grafting, and medical therapy were similar between the 2 groups (P = 0.892). Conclusion(s): Compared with the conventional heart team, the real-time heart team significantly improved care efficiency and process evaluation metrics, with similar clinical outcomes and decision making. However, insufficient shared decision making and intercenter generalizability should be optimized before widespread implementation of this approach. (Feasibility and Effectiveness of a Real-Time Heart Team Approach in Complex CAD [EHEART; NCT05514210]). Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <95> [Use Link to view the full text] Accession Number 651325615 Title Magnesium Sulfate to Prevent Perioperative Atrial Fibrillation in Cardiac Surgery: A Randomized Clinical Trial. Source Critical care medicine. (no pagination), 2026. Date of Publication: 28 May 2026. Author Meerman M.; Buijser M.; Neto A.S.; van den Berg L.; van den Heuvel A.-M.; Hoohenkerk G.; van Driel V.; Munsterman L.; de Vroege R.; Bailey M.; Bellomo R.; Ludikhuize J. Institution (Meerman, van den Berg, Ludikhuize) Department of Intensive Care, HagaZiekenhuis, The Hague, Netherlands (Buijser, van den Heuvel, van Driel) Department of Cardiology, HagaZiekenhuis, The Hague, Netherlands (Neto, Bellomo) Department of Intensive Care, Austin Hospital, Melbourne, VIC, Australia (Neto, Bailey, Bellomo) Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (Neto, Bellomo) Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia (Neto) Department of Critical Care Medicine, Hospital Israelita Albert Einstein, Sao Paulo, Brazil (Hoohenkerk) Department of Cardiothoracic Surgery, HagaZiekenhuis, The Hague, Netherlands (Munsterman) Department of Cardiac Anaesthesia, HagaZiekenhuis, The Hague, Netherlands (de Vroege) Department of Perfusion, HagaZiekenhuis, The Hague, Netherlands (Bellomo) Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia (Bellomo) Data Analytics Research and Evaluation Centre, Austin Hospital, Melbourne, VIC, Australia (Bellomo) Department of Intensive Care, Royal Melbourne Hospital, Melbourne, VIC, Australia Abstract OBJECTIVES: To determine whether perioperative IV magnesium sulfate infusion, targeting serum magnesium concentrations of 1.5-2.0 mmol/L, reduces the incidence of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery. DESIGN: Double-blind, randomized, placebo-controlled, single-center clinical trial with interim analysis for futility. SETTING: HagaZiekenhuis, The Hague, The Netherlands (February 2022-November 2023). PATIENTS: Adult patients undergoing coronary artery bypass grafting and/or valvular surgery without prior atrial arrhythmias or severe renal dysfunction. INTERVENTIONS: Continuous IV infusion of magnesium sulfate (3 mmol/hr, with bolus if [baseline] magnesium < 1.0 mmol/L) or placebo (Ringer's lactate), initiated after induction of anesthesia and continued until ICU discharge. MEASUREMENTS AND MAIN RESULTS: A total of 265 patients underwent randomization before the trial was stopped at interim analysis for futility. Magnesium supplementation achieved clear separation in serum magnesium concentrations between groups. POAF occurred in 50 of 132 patients (37.9%) in the magnesium group and 38 of 133 patients (28.6%) in the placebo group (relative risk, 1.29; 95% CI, 0.92-1.80). No subgroup demonstrated benefit. Time-to-event and day-by-day analyses showed no early reduction in POAF with magnesium. Vasopressor use was more frequent in the magnesium group, although differences were not statistically significant. No safety signal was identified. CONCLUSION(S): In this randomized trial, perioperative magnesium infusion targeting serum concentrations of 1.5-2.0 mmol/L did not reduce POAF after cardiac surgery. These findings do not support routine prophylactic magnesium supplementation for prevention of POAF. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. <96> Accession Number 651325807 Title Bayesian reanalysis of revascularization strategies for left main disease: coronary artery bypass grafting versus percutaneous intervention. Source The Annals of thoracic surgery. (no pagination), 2026. Date of Publication: 26 May 2026. Author Li Z.; Larson HBSc J.; Vervoort D.; Rakhshan HBSc S.; Servito M.; Tam D.Y.; Liu K.; Fremes S.E. Institution (Li) Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada (Larson HBSc) Toronto Metropolitan University, Toronto, ON, Canada (Vervoort) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario (Rakhshan HBSc) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Western University, London, Ontario, Canada (Servito) Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Cardiac Surgery, University of Manitoba, Winnipeg, Canada (Tam) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada (Liu) Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada (Fremes) Schulich Heart Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario; Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada Abstract BACKGROUND: The preferred revascularization strategy for left main disease between coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) remains controversial, given discordant conclusions from randomized and observational evidence for mortality. Accordingly, we performed a Bayesian re-analysis of the meta-analysis by Sabatine et al. to assess the probability of effectiveness using different assumptions. METHOD(S): Data were extracted from the Sabatine et al. meta-analysis of four trials. The primary outcome was all-cause mortality; Secondary outcomes included myocardial infarction, stroke, repeat revascularization, and composite outcomes. Bayesian methods estimated 5-year hazard ratios and absolute risk reductions using priors ranging from no prior preference to data-informed assumptions. RESULT(S): For all-cause mortality, Bayesian analysis indicated a higher probability of lower mortality with CABG, exceeding 80% across priors. Under the minimally informative prior, the hazard ratio was 1.1 (95% credible interval: 0.91-1.33), and the absolute risk reduction was 0.88% (95% credible interval: -0.92% to 2.76%). Under the downweighted historical prior, the hazard ratio was 1.40 (1.25-1.56) and the absolute risk reduction 4.61% (3.06%-6.11%). CABG also showed highly probable benefits for myocardial infarction, repeat revascularization and composite outcomes. Conversely, stroke favoured PCI (hazard ratio 0.83 [0.58-1.19]; absolute risk reduction -0.40% [-1.40% to 0.62%]), CONCLUSION(S): This re-analysis suggests a higher probability that CABG is associated with reduced mortality, myocardial infarction, repeat revascularization and composite outcomes, while PCI offers a lower risk of stroke. Interpretation of mortality was prior-dependent while other outcomes were largely prior-agnostic. Copyright © 2026. Published by Elsevier Inc. <97> Accession Number 2045968650 Title Methylation-centric epigenetic regulation in dilated cardiomyopathy: mechanisms, metabolic interplay, and translational potential. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1785320. Date of Publication: 11 May 2026. Author Wang Y.; Zhang Y.; Mao Z.; Xu Z. Institution (Wang, Xu) Department of Cardiothoracic Surgery, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China (Zhang) Department of Anesthesiology, The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University, Jiangsu, Huai'an, China (Mao) Anhui Key Laboratory of Infection and Immunity, Department of Pathology, Center for Innovation in Basic Medical Sciences, Bengbu Medical University, Anhui, Bengbu, China Publisher Frontiers Media SA Abstract Dilated cardiomyopathy (DCM) is one of the main causes of heart failure and heart transplantation, with complex causes involving multiple factors such as genetics, epigenetics, and environment. In recent years, methylation, as a key epigenetic regulatory approach, has increasingly garnered attention for its role in the mechanisms of DCM onset. This review comprehensively summarizes the mechanisms, functions, and metabolic regulatory characteristics of DNA methylation, histone methylation, and RNA N6-methyladenosine (m6A) modification in the occurrence and development of DCM. Literature was selected from PubMed and Web of Science, focusing on studies related to methylation and DCM published in recent years, as well as comprehensive and well-structured review articles. Studies have shown that these three methylation modifications collectively influence the phenotypic characteristics of DCM by regulating processes such as gene expression, metabolic homeostasis, inflammatory responses, fibrosis, and cell death in cardiomyocytes. Moreover, there is cross-regulation among these modifications, which is closely related to carbon metabolism and the tricarboxylic acid cycle. Further exploration of methylation regulatory mechanisms not only helps reveal the underlying basis of DCM but also opens new directions for targeted therapy and precision medicine. This article aims to summarize existing research advancements, explore the clinical translation potential of methylation-related mechanisms, and identify key questions and challenges for future studies. Copyright © 2026 Wang, Zhang, Mao and Xu. <98> [Use Link to view the full text] Accession Number 2043433088 Title Effects of Serratus Anterior Plane Block on Early Recovery from Thoracoscopic Lung Resection: A Randomized, Blinded, Placebo-controlled Trial. Source Clinical Journal of the American Society of Nephrology. (pp 1065-1074), 2026. Date of Publication: 2026. Author Jackson J.C.; Tan K.S.; Pedoto A.; Park B.J.; Rusch V.W.; Jones D.R.; Zhang H.; Desiderio D.; Fischer G.W.; Amar D. Institution (Jackson) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States (Tan) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States (Pedoto) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States (Park) Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Surgery, Weill Cornell Medical College, New York, New York, United States (Rusch) Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Surgery, Weill Cornell Medical College, New York, New York, United States (Jones) Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Surgery, Weill Cornell Medical College, New York, New York, United States (Zhang) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States (Desiderio) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States (Fischer) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States (Amar) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Anesthesiology, Weill Cornell Medical College, New York, New York, United States Publisher Lippincott Williams and Wilkins Abstract Background: - The efficacy of serratus anterior plane block for treatment of pain after minimally invasive thoracic surgery remains unclear. This trial assesses the impact of serratus anterior plane block on postoperative opioid consumption and on measures of early recovery after thoracoscopic lung resection. Method(s): - Patients undergoing minimally invasive anatomic lung resection at a single center were randomized to undergo serratus anterior plane block with 40 ml injectate containing bupivacaine 0.25%, clonidine 100 mug, and dexamethasone 4 mg (serratus anterior plane block group) or sham block with 40 ml normal saline (placebo group) at the conclusion of surgery. The primary outcome was cumulative intravenous morphine equivalents during the first 24 h postoperatively. Secondary outcomes were intravenous morphine equivalents, pain scores at rest and with cough, inspiratory volume on incentive spirometry, incidence of nausea or vomiting during the first 48 h postoperatively, Quality of Recovery-15 score on postoperative day 7, and length of stay. Result(s): - Using the protocol-specified intention-to-treat analysis, the median (interquartile range) intravenous morphine equivalents was 10.6 (5.0 to 27.1) mg in serratus anterior plane block patients (n = 46) versus 18.8 (9.9 to 29.6) mg in placebo patients (n = 46; 32% reduction; ratio, 0.68 [95% CI, 0.44 to 1.06]; P = 0.085). Of the secondary outcomes, only the composite pain with cough scores differed significantly in the serratus anterior plane block group by a coefficient of -0.41 (95% CI, -0.81 to -0.01; P = 0.044). A sensitivity as-treated analysis reported median (interquartile range) intravenous morphine equivalents of 10.0 (5.0 to 27.2) mg in serratus anterior plane block patients (n = 44) versus 19.9 (10.4 to 29.0) mg in placebo patients (n = 48; 36% reduction; ratio, 0.64 [95% CI, 0.41 to 1.00]; P = 0.048). Conclusion(s): - The protocol-specified intention-to-treat analysis demonstrated that serratus anterior plane block did not result in a significant reduction in opioid consumption when added to a multimodal analgesic regimen after thoracoscopic anatomic lung resection. The sensitivity as-treated analysis showed a significant and modest clinical reduction in the primary outcome that warrants further investigation. Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved. <99> Accession Number 2038202460 Title Influence of dual metabolic modulation with ranolazine and trimetazidine on post-operative outcomes in CABG patients: A retrospective cohort study. Source Tropical Journal of Pharmaceutical Research. 25(5) (pp 715-722), 2026. Date of Publication: 01 May 2026. Author Noueihad M.; Elhassan T.A.; Alrohily W.; Fatani S.A.; Elshafie R.M.; Gillani S.W. Institution (Noueihad) College of Pharmacy, GMU, Ajman, United Arab Emirates (Elhassan) Burjeel Hospital, United Arab Emirates (Alrohily, Fatani, Elshafie) Department of Pharmacy Practice, College of Pharmacy, Taibah University, Medina, Saudi Arabia (Elshafie) Clinical Pharmacy Department, ASUSH, Ain Shams University, Cairo, Egypt (Gillani) College of Pharmacy, GMU, Ajman, Saudi Arabia Publisher University of Benin Abstract Purpose: To investigate post-operative complications of coronary artery bypass grafting (CABG) with ranolazine and trimetazidine compared to conventional guideline-directed therapy among coronary artery disease patients in a tertiary hospital. Method(s): A total of 181 (78.69 %) patients from 230 (underwent CABG surgery) were enrolled to evaluate the outcome. These patients received ranolazine (200 mg twice daily orally) and trimetazidine (35 mg twice daily) along with conventional guideline-directed therapy during perioperative hospitalization. The outcomes and readmission rate with the interventional therapy were compared up to 3 months after surgery. Result(s): Mean age was 53.2 +/- 7.5 years, gender distribution was predominantly male (96.1 %). Hypertension was the highest comorbidity (85.7 %). Post-operative complications were recorded in 131(72.4 %) of patients. Age, body mass index (BMI), hypertension (HTN), and hyperlipidemia (HLD) showed no significant relationship with incidence of post-operative complications (p > 0.05). Furthermore, type 2 diabetes mellitus (T2DM) was significantly associated with post-operative complications (p < 0.05). During the 3-month follow-up, a total of 29(16 %) patients were readmitted of which 22(75.9 %) who experienced post-operative complications were again readmitted compared to 7(24.1 %) who did not experience complications. Conclusion(s): Adjunct therapy demonstrates no significant clinical effect on either post-operative complications or rate of readmissions in CABG patients. Further multicenter randomized clinical trials are required to evaluate the efficacy and safety of adjunct therapies. Copyright © 2026 The authors. <100> Accession Number 2046061981 Title Left atrial reservoir strain and risk of atrial fibrillation after cardiac surgery: A systematic review and meta-analysis. Source REC: CardioClinics. (no pagination), 2026. Date of Publication: 2026. Author Nin R.; Ratan P.; Clark L.; Florio L. Institution (Nin, Florio) Centro Cardiologico Americano, Sanatorio Americano, Montevideo, Uruguay (Ratan) Department of Internal Medicine, Patna Medical College and Hospital, Patna, India (Clark) Department of Internal Medicine, Memorial Hospital, Miami, FL, United States Publisher Elsevier Espana S.L.U Abstract Introduction and objectives To explore the association between left atrial reservoir strain (LASr) and postoperative atrial fibrillation (POAF) in adult patients undergoing cardiac surgery POAF is a common complication of cardiac surgery in adults. Although it is associated with adverse outcomes, reliable tools for identifying patients at an increased risk of POAF are lacking. LASr has been associated with a higher risk of atrial fibrillation in other clinical settings; however, its role in predicting POAF is less well established. We aimed to assess whether LASr is associated with POAF risk after cardiac surgery. Methods The literature was searched in PubMed, Embase, and Cochrane up to December 2024. The primary outcome was the predictive value of LASr for POAF in cardiac surgery. Secondary outcomes included the same analysis stratified by the type of surgery. Results Twenty studies were included in the review, 18 of which, encompassing 1675 patients, were eligible for the meta-analysis. The mean age was 64.4 years in the POAF group and 60.5 in the NO-POAF group, and male sex was 70.7% and 69.5% respectively. LASr was significantly lower in the POAF group across all studies (21.4% vs 29.1%). Higher LASr was significantly associated with a lower risk of POAF (OR, 0.82; 95%CI, 0.77-0.89), and also in the coronary artery bypass surgery (OR, 0.84; 95%CI, 0.76-0.91) and valvular surgery (OR, 0.64; 95%CI, 0.48-0.87; HR, 0.96; 95%CI, 0.94-0.98). Heterogeneity was high and the certainty of the results was graded as low. Conclusions A higher LASr may carry a decreased risk of POAF in adult patients undergoing cardiac surgery. (PROSPERO ID number CRD42024627341). Copyright © 2026 Sociedad Espanola de Cardiologia. <101> Accession Number 2046046453 Title Effect of catheter-based renal denervation on orthostatic blood pressure adaptation in patients with uncontrolled hypertension. Source Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Zhang Z.; Shi R.; Zhang X.; Ma J.; Ye R.; Zuo X.; Hu H.; Peng Y.; Liu K.; Chen X. Institution (Zhang, Shi, Zhang, Ma, Ye, Zuo, Hu, Peng, Liu, Chen) Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background This study aimed to evaluate the effect of catheter-based renal denervation (RDN) on orthostatic blood pressure (BP) adaptation in patients with uncontrolled hypertension. Methods This prospective observational study enrolled patients who had been previously included in the multicenter Iberis-HTN trial and NetrodTM-HTN trial. Eligible patients were randomly assigned to undergo either radiofrequency RDN or a sham procedure. BP and heart rate (HR) changes during a 3-min orthostatic challenge from supine to standing were measured at baseline and 6 months after randomization. Results At 6 months, the RDN group exhibited a significantly greater reduction in ambulatory BP, office systolic blood pressure (SBP) and BP in both supine and standing positions compared to the sham group. After adjusting for baseline values, the magnitude of changes in orthostatic SBP and diastolic blood pressure (DBP) at the 3-min timepoint, along with the maximum changes observed throughout the 3-min orthostatic test, was significantly smaller in the RDN group at 6 months (3 min: SBP/DBP, p = 0.008/0.010; Maximum: SBP/DBP, p = 0.041/0.004). The changes in orthostatic HR at 6 months were comparable between the RDN and the sham group. Conclusions Catheter-based radiofrequency RDN significantly reduced BP in both supine and standing positions during active standing at 6 months compared to the sham group. Additionally, RDN attenuated BP elevation during postural changes, and the response pattern to orthostatic stress was partially restored toward the range of normal physiological variation. This observation may be related to the reduction in excessive vascular tone in response to orthostatic stress after RDN. Copyright © 2026 Japanese College of Cardiology. <102> Accession Number 2046032670 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: 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, United States (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, United Kingdom (Iwagami) Department of Digital Health, Institute of Medicine, University of Tsukuba, Tsukuba, Japan (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) 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, Shizuoka Medical Center, Shizuoka, Japan (Kuno) Division of Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Kuno) Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) 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. Methods 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. Results 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 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. <103> Accession Number 2046262985 Title 10-Year Randomized Outcomes of Transcatheter or Surgical Aortic Valve Replacement in Intermediate-Risk Aortic Stenosis. Source Journal of the American College of Cardiology. 87(23) (pp 3309-3321), 2026. Date of Publication: 16 Jun 2026. Author Thourani V.H.; von Stein P.; Mack M.J.; Nazif T.M.; Babaliaros V.; Alkhouli M.; Fischbein M.P.; Desai N.D.; Satler L.; Zidar F.J.; Kodali S.K.; Kron I.L.; Zajarias A.; Brinkman W.; Kapadia S.; Dewey T.M.; Gossl M.; Bodenhamer R.M.; Ma Y.; Cohen D.J.; Sharma R.; Pibarot P.; Hahn R.T.; Leon M.B.; Makkar R.R. Institution (Thourani) Piedmont Heart Institute, Atlanta, GA, United States (von Stein, Cohen, Hahn, Leon) Cardiovascular Research Foundation, New York, NY, United States (Mack, Brinkman) The Heart Hospital Baylor Scott and White Plano, Plano, TX, United States (Nazif, Kodali, Hahn, Leon) Division of Cardiology, Columbia University Irving Medical Center/New York-Presbyterian Hospital, New York, NY, United States (Babaliaros) Emory University Hospital, Atlanta, GA, United States (Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Fischbein) Stanford Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA, United States (Desai) Division of Cardiovascular Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, United States (Satler) Section of Interventional Cardiology, Washington Hospital Center, Washington, DC, United States (Zidar) Austin Heart, Austin, TX, United States (Kron) Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA, United States (Zajarias) Cardiovascular Division, Washington University/Barnes Jewish Hospital, St Louis, MO, United States (Kapadia) Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Dewey) Medical City Dallas Hospital, Dallas, TX, United States (Gossl) Valve Science Center, Allina Health Minneapolis Heart Institute, Minneapolis, MN, United States (Bodenhamer) University of Oklahoma College of Medicine, Oklahoma City, OK, United States (Ma) Edwards Lifesciences, Irvine, CA, United States (Cohen) St Francis Hospital and Heart Center, Roslyn, NY, United States (Sharma) Division of Cardiovascular Medicine, Stanford Health Care, Stanford, CA, United States (Pibarot) Quebec Heart & Lung Institute, Universite Laval, Quebec, QC, Canada (Makkar) Cedars-Sinai Medical Center, Los Angeles, CA, United States Publisher Elsevier Inc. Abstract Background: Transcatheter aortic valve replacement (TAVR) is an established alternative to surgical aortic valve replacement for symptomatic severe aortic stenosis, but long-term, comparative clinical outcomes and echocardiography data are lacking. Objective(s): Our goal was to compare 10-year clinical and echocardiographic outcomes after balloon-expandable TAVR or surgery in intermediate-risk surgical patients in the PARTNER 2A randomized trial. Method(s): Between 2011 and 2013, patients with severe, symptomatic aortic stenosis at intermediate surgical risk were randomized at 57 centers to TAVR with the balloon-expandable SAPIEN XT system (Edwards Lifesciences) or to surgery. Randomization was stratified by anatomical suitability for transfemoral (TF) or transthoracic (transapical/transaortic [TA/TAo]) access. Ten-year outcomes were evaluated in the valve implant population and included all-cause mortality, aortic valve reintervention, and core laboratory-adjudicated echocardiographic outcomes. To obtain 10-year data, patient reconsent at 5 years was required, and vital status sweeps were implemented to improve data completeness for all-cause mortality. Result(s): Among 1,910 randomized patients who received a valve, 974 underwent TAVR (TF: 749/974 [76.9%]) and 936 had surgery. Mean patient age was 81.6 years, 45.4% were women, and the mean Society of Thoracic Surgeons score was 5.8%. At 10 years, vital status was available for 881 of 974 patients (90.5%) and 838 of 936 patients (89.5%). All-cause 10-year mortality with vital status sweeps was 86.1% after TAVR and 82.8% after surgery (HR: 1.13; 95% CI: 1.02-1.25; P = 0.02). When stratified by access route, rates of all-cause mortality for TAVR and surgery in the TF group were similar (83.9% vs 82.1%, respectively; P = 0.27), whereas mortality was higher for TAVR in the TA/TAo group (93.2% vs 85.1%; P < 0.01; P for interaction = 0.03). Cumulative incidence rates of aortic valve reintervention at 10 years were 6.3% for TAVR and 1.6% for surgery (P < 0.001). Of the 24 TAVR and 35 surgical patients with available echocardiographic data at 10 years, mean gradients were 12.6 mm Hg and 12.7 mm Hg, respectively. Conclusion(s): At the 10-year follow-up, TAVR in intermediate-risk patients with the SAPIEN XT prosthesis compared with surgery was associated with lower survival rates, with differences predominantly observed in the TA/TAo access cohort. TAVR with the XT valve was also associated with significantly higher rates of aortic valve reintervention. (PARTNER II Trial: Placement of AoRTic TraNscathetER Valves II - XT Intermediate and High Risk [PII A]; NCT01314313). Copyright © 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <104> Accession Number 2046264214 Title Six-Year Outcomes After Transcatheter vs Surgical Aortic Valve Replacement in Low-Risk Patients With Aortic Stenosis. Source Journal of the American College of Cardiology. 87(23) (pp 3210-3221), 2026. Date of Publication: 16 Jun 2026. Author Forrest J.K.; Yakubov S.J.; Sorajja P.; Byrne T.; Kirshner M.; Bajwa T.; Crouch J.; Coselli J.; Silva G.; Stoler R.; Islam A.; Rousou A.; Poulin M.-F.; Khabbaz K.; Bladergroen M.; Fail P.; Netherland D.; Lam K.Y.; Tonino W.A.L.; Sudre A.; Berthoumieu P.; Tchetche D.; Newman J.; Hughes G.C.; Harrison J.K.; De A.; van Mieghem N.M.; Yong G.; Agarwal S.; Park S.; Rapp J.; Kleiman N.; Reardon M.; Mohammadi S.; Rodes-Cabau J.; Sparling J.; Elkins C.C.; Gallo M.; Matthews R.V.; Starnes V.A.; Ando K.; Farge A.; Hovasse T.; DeFrain M.; Muppala M.; Vyas A.; Bagur R.; Chu M.; Fontana G.; Dev V.; Tuchek J.M.; Azuaje I.I.; Melnitchouk S.; Piazza N.; Lacappelle K.; Steinberg D.; Katz M.; Wang J.; Kozina J.; Merritt R.; Chawla A.; Jensen B.; Alvarez J.; Gooley R.; Smith J.; Ibrahim R.; Cartier R.; Rovin J.; Fukushima S.; Rutkin B.; Yakubov S.; Song H.; Zahr F.; Miyagawa S.; Rajagopal V.; Kanmanthareddy A.; Mumtaz M.; Bhindi R.; Brady P.; Batra S.; Davis T.; Iskander A.; Heimansohn D.; Hermiller J.; Takamisawa I.; Haldis T.; Yamazaki S.; Teirstein P.; Tada N.; Saito S.; Merhi W.; Leung S.; Muller D.; Timmers L.; Petrossian G.; Robinson N.; Knight P.; Ling F.; Radhakrishnan S.; Fremes S.; Lehr E.; Gafoor S.; Noel T.; Kozuma K.; Walton A.; Resar J.; Adams D.; Sharma S.; Lilly S.; Tadros P.; Zorn G.; Dauerman H.; Ittleman F.; Horlick E.; Welt F.; Sharma V.; Rushing G.; Fullerton D.; Messenger J.; Griffith B.; Gupta A.; de Marchena E.; Salerno T.; Chetcuti S.; Deeb G.M.; Sultan I.; Goel K.; Pasupati S.; Kon N.; Zhao D.; Ramlawi B.; Forrest J.; Reardon M.J. Institution (Forrest, Sorajja, Byrne, Kirshner, Bajwa, Crouch, Coselli, Silva, Stoler, Islam, Rousou, Poulin, Khabbaz, Bladergroen, Fail, Netherland, Lam, Tonino, Sudre, Berthoumieu, Tchetche, Newman, Hughes, Harrison, De, van Mieghem, Yong, Agarwal, Park, Rapp, Kleiman, Reardon, Mohammadi, Rodes-Cabau, Sparling, Elkins, Gallo, Matthews, Starnes, Ando, Farge, Hovasse, DeFrain, Muppala, Vyas, Bagur, Chu, Fontana, Dev, Tuchek, Azuaje, Melnitchouk, Piazza, Lacappelle, Steinberg, Katz, Wang, Kozina, Merritt, Chawla, Jensen, Alvarez, Gooley, Smith, Ibrahim, Cartier, Rovin, Fukushima, Rutkin, Yakubov, Song, Zahr, Miyagawa, Rajagopal, Kanmanthareddy, Mumtaz, Bhindi, Brady, Batra, Davis, Iskander, Heimansohn, Hermiller, Takamisawa, Haldis, Yamazaki, Teirstein, Tada, Saito, Merhi, Leung, Muller, Timmers, Petrossian, Robinson, Knight, Ling, Radhakrishnan, Fremes, Lehr, Gafoor, Noel, Kozuma, Walton, Resar, Adams, Sharma, Lilly, Tadros, Zorn, Dauerman, Ittleman, Horlick, Welt, Sharma, Rushing, Fullerton, Messenger, Griffith, Gupta, de Marchena, Salerno, Chetcuti, Deeb, Sultan, Goel, Pasupati, Kon, Zhao, Ramlawi, Forrest, Reardon) Yale University School of Medicine, New Haven, CT, United States (Yakubov, Sorajja, Byrne, Kirshner, Bajwa, Crouch, Coselli, Silva, Stoler, Islam, Rousou, Poulin, Khabbaz, Bladergroen, Fail, Netherland, Lam, Tonino, Sudre, Berthoumieu, Tchetche, Newman, Hughes, Harrison, De, van Mieghem, Yong, Agarwal, Park, Rapp, Kleiman, Reardon, Mohammadi, Rodes-Cabau, Sparling, Elkins, Gallo, Matthews, Starnes, Ando, Farge, Hovasse, DeFrain, Muppala, Vyas, Bagur, Chu, Fontana, Dev, Tuchek, Azuaje, Melnitchouk, Piazza, Lacappelle, Steinberg, Katz, Wang, Kozina, Merritt, Chawla, Jensen, Alvarez, Gooley, Smith, Ibrahim, Cartier, Rovin, Fukushima, Rutkin, Yakubov, Song, Zahr, Miyagawa, Rajagopal, Kanmanthareddy, Mumtaz, Bhindi, Brady, Batra, Davis, Iskander, Heimansohn, Hermiller, Takamisawa, Haldis, Yamazaki, Teirstein, Tada, Saito, Merhi, Leung, Muller, Timmers, Petrossian, Robinson, Knight, Ling, Radhakrishnan, Fremes, Lehr, Gafoor, Noel, Kozuma, Walton, Resar, Adams, Sharma, Lilly, Tadros, Zorn, Dauerman, Ittleman, Horlick, Welt, Sharma, Rushing, Fullerton, Messenger, Griffith, Gupta, de Marchena, Salerno, Chetcuti, Deeb, Sultan, Goel, Pasupati, Kon, Zhao, Ramlawi, Forrest, Reardon) OhioHealth Riverside Methodist Hospital, Columbus, OH, United States (Deeb, Sorajja, Byrne, Kirshner, Bajwa, Crouch, Coselli, Silva, Stoler, Islam, Rousou, Poulin, Khabbaz, Bladergroen, Fail, Netherland, Lam, Tonino, Sudre, Berthoumieu, Tchetche, Newman, Hughes, Harrison, De, van Mieghem, Yong, Agarwal, Park, Rapp, Kleiman, Reardon, Mohammadi, Rodes-Cabau, Sparling, Elkins, Gallo, Matthews, Starnes, Ando, Farge, Hovasse, DeFrain, Muppala, Vyas, Bagur, Chu, Fontana, Dev, Tuchek, Azuaje, Melnitchouk, Piazza, Lacappelle, Steinberg, Katz, Wang, Kozina, Merritt, Chawla, Jensen, Alvarez, Gooley, Smith, Ibrahim, Cartier, Rovin, Fukushima, Rutkin, Yakubov, Song, Zahr, Miyagawa, Rajagopal, Kanmanthareddy, Mumtaz, Bhindi, Brady, Batra, Davis, Iskander, Heimansohn, Hermiller, Takamisawa, Haldis, Yamazaki, Teirstein, Tada, Saito, Merhi, Leung, Muller, Timmers, Petrossian, Robinson, Knight, Ling, Radhakrishnan, Fremes, Lehr, Gafoor, Noel, Kozuma, Walton, Resar, Adams, Sharma, Lilly, Tadros, Zorn, Dauerman, Ittleman, Horlick, Welt, Sharma, Rushing, Fullerton, Messenger, Griffith, Gupta, de Marchena, Salerno, Chetcuti, Deeb, Sultan, Goel, Pasupati, Kon, Zhao, Ramlawi, Forrest, Reardon) University of Michigan Health Systems University Hospital, Ann Arbor, MI, United States (Reardon, Sorajja, Byrne, Kirshner, Bajwa, Crouch, Coselli, Silva, Stoler, Islam, Rousou, Poulin, Khabbaz, Bladergroen, Fail, Netherland, Lam, Tonino, Sudre, Berthoumieu, Tchetche, Newman, Hughes, Harrison, De, van Mieghem, Yong, Agarwal, Park, Rapp, Kleiman, Reardon, Mohammadi, Rodes-Cabau, Sparling, Elkins, Gallo, Matthews, Starnes, Ando, Farge, Hovasse, DeFrain, Muppala, Vyas, Bagur, Chu, Fontana, Dev, Tuchek, Azuaje, Melnitchouk, Piazza, Lacappelle, Steinberg, Katz, Wang, Kozina, Merritt, Chawla, Jensen, Alvarez, Gooley, Smith, Ibrahim, Cartier, Rovin, Fukushima, Rutkin, Yakubov, Song, Zahr, Miyagawa, Rajagopal, Kanmanthareddy, Mumtaz, Bhindi, Brady, Batra, Davis, Iskander, Heimansohn, Hermiller, Takamisawa, Haldis, Yamazaki, Teirstein, Tada, Saito, Merhi, Leung, Muller, Timmers, Petrossian, Robinson, Knight, Ling, Radhakrishnan, Fremes, Lehr, Gafoor, Noel, Kozuma, Walton, Resar, Adams, Sharma, Lilly, Tadros, Zorn, Dauerman, Ittleman, Horlick, Welt, Sharma, Rushing, Fullerton, Messenger, Griffith, Gupta, de Marchena, Salerno, Chetcuti, Deeb, Sultan, Goel, Pasupati, Kon, Zhao, Ramlawi, Forrest, Reardon) Houston Methodist-DeBakey Heart and Vascular Center, Houston, TX, United States Publisher Elsevier Inc. Abstract Background: The Evolut Low Risk trial enrolled patients with severe aortic stenosis at low surgical risk. Annual follow-up is planned for 10 years, evaluating the composite of all-cause mortality or disabling stroke and key secondary endpoints. Objective(s): Our prespecified objective was to report the 6-year clinical outcomes of transcatheter aortic valve replacement (TAVR) vs surgery from the Evolut Low Risk trial. Given an increase in reintervention rates at 6 years, we performed additional analyses in available 7-year data. Method(s): Low-risk patients with severe symptomatic aortic stenosis were randomized to TAVR or surgery from 2016-2019. Prespecified analyses at 6 years included annual follow-up of clinical outcomes reported as Kaplan-Meier estimates with log-rank test. Because the trial enrolled patients over several years, at the time of data lock, a majority of patients had completed 7-year follow-up. Given an increased reintervention rate at 6 years in the TAVR arm, we performed additional analysis of 7-year data available at the time of the database lock. Reintervention rates are reported as cumulative incidence. Result(s): A total of 1,414 patients underwent an attempted implantation (730 TAVR, 684 surgery). At 6 years, the composite endpoint of all-cause mortality or disabling stroke was 23.3% for TAVR and 20.4% for surgery (difference: 2.8% [95% CI: -1.9% to 7.6%]; P = 0.43). All-cause mortality with vital status sweep at 6 years was 23.3% (95% CI: 20.6%-26.4%) for TAVR and 20.2% (95% CI: 17.4%-23.3%) for surgery (P = 0.24). The reintervention rate at 6 years was 5.5% for TAVR and 3.3% for surgery (sHR: 1.66 [95% CI: 0.96-2.86]; P = 0.07). Using available 7-year follow-up (555 TAVR and 480 surgery), the reintervention rate for TAVR was 9.8% and for surgery was 6.0% (sHR: 1.68 [95% CI: 1.10-2.58]; P = 0.02). In the TAVR and surgery groups, the rate of reintervention for regurgitation was 5.6% vs 1.6% (sHR: 3.39 [95% CI: 1.62-7.07]; P < 0.001) and the rate of reintervention for stenosis was 3.6% vs 3.5% (sHR: 1.14 [95% CI: 0.61-2.15]; P = 0.70). Conclusion(s): The 6-year results from the Evolut Low Risk trial show no significant difference in the composite endpoint of all-cause mortality or disabling stroke. At 6 and 7 years, the TAVR arm had a higher reintervention rate compared with surgery, driven by an increased incidence of aortic regurgitation. (Medtronic Evolut Transcatheter Aortic Valve Replacement in Low Risk Patients; NCT02701283). Copyright © 2026 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <105> Accession Number 651336884 Title Negative Pressure Wound Therapy for Prevention and Treatment of Poststernotomy Complications in Adult Cardiac Surgery: A Systematic Review with Quantitative Synthesis. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 28 May 2026. Author Pollanen S.; Lee A.D.; McGuinty J.; Jeong S.; Chronis N.; Mukovozov I. Institution (Pollanen, Lee, McGuinty, Jeong, Chronis) University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada (Mukovozov) Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Toronto Dermatology Centre, Toronto, Ontario, Canada; Division of Dermatology, Women's College Hospital, Toronto, Ontario, Canada Abstract Sternal wound complications following cardiac surgery increase reoperation risk, prolong hospitalization, and complicate postoperative cardiovascular recovery, yet optimal prevention strategies remain poorly defined. We performed a systematic review with quantitative synthesis of 31 studies enrolling 6,420 adult cardiac surgery patients to evaluate the usefulness of negative pressure wound therapy (NPWT) compared with conventional dressings for preventing and managing poststernotomy wound complications. The pre-specified primary analysis focused on prophylactic NPWT applied over closed sternotomy incisions, since open and closed-incision applications represent fundamentally distinct populations with non-comparable outcomes. Within this primary analysis, prophylactic foam-based closed-incision NPWT (ciNPT) in high-risk sternotomy patients showed the most consistent reduction in surgical site infection, with relative risk estimates of 0.25 to 0.94 across 7 studies enrolling 2,178 patients. Evidence for therapeutic NPWT in established sternal wound infections was directionally favorable but derived exclusively from observational studies. Interstudy heterogeneity precluded robust aggregate pooled conclusions. In conclusion, prophylactic ciNPT may be reasonable to consider in selected high-risk patients pending randomized trial confirmation. Crown Copyright © 2026. Published by Elsevier Inc. All rights reserved. <106> Accession Number 651330594 Title Comparing Virtual Reality and Pranayama Breathing Technique on Preoperative Anxiety in Patient With Coronary Artery Bypass Graft. Source Nursing science quarterly. (pp 8943184261433810), 2026. Date of Publication: 27 May 2026. Author Mardan R.S.; Kadhim A.J.; Ahmadi Chenari H.; Baumann S.L. Institution (Mardan, Kadhim) Department of Adult Nursing, College of Nursing, University of Baghdad, Baghdad, Iraq (Ahmadi Chenari) Department of Nursing, Ferdows Faculty of Medical Sciences, Birjand University of Medical Sciences, Birjand, Iran, Islamic Republic of (Baumann) Hunter College, CUNY, NYC, Williston Park, NY, United States Abstract This study compares the effect of virtual reality (VR) and pranayama breathing technique on preoperative anxiety in patients undergoing coronary artery bypass graft (CABG) surgery. The design was a three-arm parallel randomized controlled trial conducted across three open heart centers in Baghdad, Iraq. A sample of 122 patients were randomly assigned to VR (n = 45), pranayama (n = 40), and control (n = 37) groups. Anxiety was measured in pre- and postintervention using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The results were that there were no significant differences between the two active interventions, although the largest effect size was observed in the pranayama breathing technique intervention group (eta2 = 0.381). Thus, both VR and pranayama breathing technique reduce preoperative anxiety among patients having CABG surgery and can be incorporated into routine preoperative nursing care. <107> Accession Number 651335187 Title Con: Viscoelastic Testing Should Not Be Used Routinely but Selectively in Cardiac Surgery. Source Journal of cardiothoracic and vascular anesthesia. (no pagination), 2026. Date of Publication: 27 Apr 2026. Author Cameron M.; Awad T. Institution (Cameron) Department of Anesthesia, McGill University, Montreal, Canada; Department of Anesthesia, Jewish General Hospital, Canada (Awad) Department of Anesthesiology and Critical Care Medicine, University of Chicago, Chicago, IL, United States Abstract Viscoelastic testing (VET) has become an important tool in cardiac surgery, particularly within bleeding management algorithms. However, evidence supporting its benefits largely pertains to patients with active bleeding rather than its use in all cases. VET does not reliably predict bleeding or transfusion requirements when performed preoperatively, and its indiscriminate application may lead to unnecessary blood product administration and increased costs. Randomized trials and meta-analyses consistently show that VET improves outcomes when integrated into structured blood management algorithms after bleeding is clinically evident. Established clinical predictors and standard laboratory tests remain effective for assessing bleeding risk, and recent expert guidelines explicitly discourage routine VET for all cardiac surgery patients. Selective use of VET in patients with suspected coagulopathy preserves its clinical benefits, minimizes harm, and aligns with evidence-based practice. Copyright © 2026 Elsevier Inc. All rights reserved. <108> Accession Number 2046302184 Title Comparing perioperative heparin bridging strategies in mechanical heart valve patients undergoing surgery: A systematic review and Bayesian meta-analysis. Source Thrombosis Research. 263 (no pagination), 2026. Article Number: 109735. Date of Publication: 01 Jul 2026. Author Batista P.G.; Montenegro M.V.; Gaelzer G.C.; Molinari M.E.; Malik M.; Silva R.R.A.D.S.; de Lucena L.A.; Bacca C.O.F.; Giorgi J. Institution (Batista) Federal University of Paraiba, Brazil (Montenegro) University of Pernambuco, Brazil (Gaelzer) Pontifical Catholic University of Parana, Brazil (Molinari, Bacca) University Center for the Development of Alto Vale, Brazil (Malik) Beth Israel Deaconess Medical Center, United States (Silva) Federal University of Ceara, Brazil (de Lucena) Federal University of Rio Grande do Norte, Brazil (Giorgi) Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil (Giorgi) Albert Einstein Hospital, Sao Paulo, Sao Paulo, Brazil Publisher Elsevier Ltd Abstract Introduction: Perioperative heparin bridging in surgical mechanical heart valve (MHV) patients aims to prevent thromboembolism but risks bleeding. Addressing a lack of comparative data, this study synthesizes current literature to evaluate the net clinical outcomes of bridging versus no bridging. Purpose(s): To perform a meta-analysis providing clinically actionable estimates of the benefits and risks of perioperative bridging in surgical MHV patients. Method(s): We systematically searched PubMed, Embase, and the Cochrane Library for studies comparing heparin bridging versus no bridging in surgical MHV patients. We used a Bayesian random-effects meta-analysis to estimate risk ratios (RRs) and 95% credible intervals (95% CrIs). Posterior probabilities were then calculated to assess the treatment benefit or harm. Result(s): Four studies comprising 1847 patients (64.48% bridged) met the inclusion criteria. The estimated RR for thromboembolism was 1.36 (95% CrI, 0.27 to 6.97), with only a 35.1% posterior probability of risk reduction (RR <= 1), suggesting no clear benefit. All-cause mortality estimates were uncertain (RR, 0.68; 95% CrI, 0.12 to 3.90). Conversely, safety endpoints yielded high probabilities of hemorrhagic complications. The RR for major bleeding was 2.04 (95% CrI, 0.81 to 5.14), carrying an 82.5% probability of clinically meaningful harm (RR > 1.33). Minor bleeding showed a similar pattern (RR, 1.53; 95% CrI, 0.61 to 3.93). Conclusion(s): Routine perioperative heparin bridging in surgical MHV patients increases bleeding risk without meaningful thromboembolic benefit, supporting a shift toward selective, risk-adapted management. Registration: PROSPERO identifier no. CRD420261359162. Copyright © 2026 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <109> Accession Number 2046111974 Title Tumor stage, squamous histology and male sex predict positive resection margins in non-small cell lung cancer patients undergoing anatomical resection-a retrospective study from a high-volume thoracic surgery unit. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 487. Date of Publication: 31 May 2026. Author Stoleriu M.G.; Steinestel K.; Grimmer M.; Lower-Kiem L.-M.; Witzenhausen M.; Solter J.; Brill S.; Arndt A. Institution (Stoleriu) Division for Thoracic Surgery Munich, Ludwig-Maximilians-University of Munich (LMU), Asklepios Lung Clinic Munich-Gauting, Gauting, Germany (Stoleriu) Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive, Helmholtz Center Munich, German Lung Research Center (DZL), Munich, Germany (Steinestel, Grimmer, Lower-Kiem, Arndt) Institute of Pathology and Molecular Pathology, Bundeswehrkrankenhaus Ulm, Ulm, Germany (Steinestel, Grimmer, Lower-Kiem, Witzenhausen, Solter, Brill, Arndt) Interdisciplinary Lung Cancer Center, Bundeswehrkrankenhaus Ulm, Ulm, Germany (Witzenhausen, Solter, Brill) Department of Visceral and Thoracic Surgery, Bundeswehrkrankenhaus Ulm, Ulm, Germany (Stoleriu) Marchioninistr. 15, Munich, Germany (Stoleriu) Institute for Lung Health and Immunity and Comprehensive Pneumology Center with the CPC-M bioArchive, Helmholtz Center Munich, German Lung Research Center (DZL), Munich, Germany Publisher AME Publishing Company Abstract Background: Patient-derived organoids (PDOs) are emerging as powerful ex vivo models for studying ovarian cancer biology and drug response. However, success rates for establishing ovarian cancer PDOs remain low, partly due to heterogeneous media formulations and inconsistent definitions of "success". This review aims to compare media compositions, summarize derivation efficiencies across studies, and identify cross-cancer insights that may inform optimization of ovarian cancer PDO culture conditions. Method(s): A structured PubMed search was performed using the terms "ovarian cancer PDOs" and "ovarian cancer patient-derived organoids". Studies were included if they were primary research articles, published from 2018 onward, did not use commercial PDO kits, and provided detailed descriptions of media composition and culture methods. Ten studies met all criteria and were analyzed for media components, tissue sources, derivation efficiencies, and definitions of success. Result(s): Across 10 foundational studies, success rates ranged from 13% to 65%, influenced by tissue type, histology, and variable definitions of success. Media compositions shared core components, such as advanced DMEM/F12, B27, GlutaMAX, nicotinamide, and A83-01, but differed significantly in Wnt/BMP modulators, growth factors, hormonal additives, and inhibitors. Evidence suggests that high-Wnt conditions support PDOs in colorectal and pancreatic cancers but may hinder long-term growth in HGSOC. Cross-cancer comparisons highlighted potentially transferable strategies, particularly from TP53-mutant pancreatic and colorectal PDO systems. Conclusion(s): Ovarian cancer PDO establishment remains challenging due to inconsistent culture conditions and varying success definitions. Standardizing media formulations, harmonizing reporting practices, and applying insights from other TP53-mutant cancers may improve reproducibility and clinical applicability. Tailored, subtype-specific optimization is likely necessary to enhance PDO derivation and utility in precision oncology. Copyright © AME Publishing Company. <110> Accession Number 2046212992 Title Chlorhexidine gluconate vs povidone-iodine for surgical site infection prevention: a systematic review and meta-analysis stratified by surgery type, wound classification, antiseptic formulation, and country income, with meta-regression. Source Journal of Hospital Infection. 173 (pp 140-153), 2026. Date of Publication: 01 Jul 2026. Author Benhammou M.; Elraggal D.; Saleh S.; Nobuhara C.K.; van Ramshorst G.H.; Mimoz O.; Nounou M.V.; Shawesh Q.; Tuuli M.G.; Wexner S.D.; Catena F.; Forrester J.D.; Elhadi M. Institution (Benhammou) Faculty of Medicine, University of Oran 1, Ahmed Ben Bella, Oran, Algeria (Elraggal) Alexandria Faculty of Medicine, Alexandria University, Alexandria, Egypt (Saleh) The Hashemite University, Zarqa, Jordan (Nobuhara, Forrester) Department of Surgery, Stanford University, Stanford, CA, United States (van Ramshorst) Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium (van Ramshorst) Department of Human Structure and Repair, Ghent University, Ghent, Belgium (Mimoz) CHU de Poitiers, Service des Urgences Adultes-SAS 86-Centre 15, Poitiers, France (Mimoz) INSERM, Pharmacologie des Agents Anti-Infectieux, Poitiers, France (Mimoz) Alliance for Vascular Access Teaching and Research, Griffith University, Nathan, QLD, Australia (Nounou) University of Nouakchott Al Aasrya, Faculty of Medicine, Nouakchott, Mauritania (Shawesh) Department of Internal Medicine, HCA Mountain View Hospital, Las Vegas, NV, United States (Tuuli) Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brown University Warren Alpert Medical School, Providence, RI, United States (Wexner) Division of Colorectal Surgery, MedStar Georgetown University Hospital, Washington, DC, United States (Catena) Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy (Catena) Department of General and Emergency Surgery Bufalini Hospital AUSL Romagna Cesena ITALY, Italy (Elhadi) College of Medicine, Korea University, Seoul, South Korea Publisher W.B. Saunders Ltd Abstract Background: The comparative effectiveness of chlorhexidine gluconate (CHG) vs povidone-iodine (PVI) for preventing surgical site infections (SSIs) remains unclear across surgical types and resource settings. This study compared CHG and PVI overall and within key clinical subgroups. Method(s): Five databases were searched through February 2025 for randomized controlled trials comparing CHG with PVI and reporting SSI outcomes. Random-effects models generated pooled odds ratios (ORs) with 95% confidence intervals (CIs). Result(s): Twenty-nine randomized clinical trials involving 35,317 patients were included. CHG significantly reduced superficial incisional SSIs (OR = 0.80; 95% CI: 0.67-0.95; P = 0.01; I2 = 18.4%), but not overall, deep, or organ/space infections; meta-regression indicated that patient age was a significant effect modifier. In caesarean sections, CHG lowered overall SSIs (OR = 0.64; 95% CI: 0.48-0.85), superficial incisional SSIs (OR = 0.65; 95% CI: 0.48-0.87), and deep incisional SSIs (OR = 0.41; 95% CI: 0.22-0.75). In abdominal surgery, CHG reduced only superficial incisional SSIs (OR = 0.68; 95% CI: 0.52-0.91). No significant differences were observed in gynaecologic, cardiothoracic, or orthopaedic procedures. By wound classification, CHG had no effect in clean surgery but reduced superficial incisional SSIs in clean-contaminated cases (OR = 0.65; 95% CI: 0.48-0.89). By income level, no differences were seen in high-income countries (HICs), whereas in low- and middle-income countries, CHG decreased overall SSIs (OR = 0.58; 95% CI: 0.46-0.74), superficial incisional SSIs (OR = 0.54; 95% CI: 0.38-0.76), and deep incisional SSIs (OR = 0.48; 95% CI: 0.25-0.92). Conclusion(s): Alcohol-based CHG and alcohol-based PVI are comparably effective in most surgical settings. However, CHG demonstrates superior prevention of SSIs in caesarean, abdominal, and clean-contaminated surgeries, with the most substantial benefit in low- and middle-income settings. Broader use may be justified pending cost-effectiveness evaluation. Copyright © 2026 The Healthcare Infection Society <111> Accession Number 651319547 Title A Bayesian re-analysis of hypothermic oxygenated perfusion versus static cold storage in the NIHP2019 heart transplantation trial. Source The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation. (no pagination), 2026. Date of Publication: 25 May 2026. Author Heuts S.; Lebreton G.; Dellgren G.; Wallinder A.; Rega F. Institution (Heuts) Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Cardiothoracic Surgery, Maastricht University Medical Center, Maastricht, the Netherlands (Lebreton) Cardiac Surgery Department, Pitie-Salpetriere Hospital, APHP, Sorbonne University, Paris, France (Dellgren) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden (Wallinder) Transplant Institute, Sahlgrenska University Hospital, Gothenburg, Sweden (Rega) Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium Abstract The NIHP2019-trial compared hypothermic oxygenated perfusion (HOPE) with static cold storage (SCS) during heart transplantation and investigated clinical outcomes. This post-hoc Bayesian re-analysis estimated the probability of clinically meaningful overall treatment effects. In total, 204 patients were analyzed at 12 months (HOPE n=101, SCS n=103). Bayesian models with minimally informative priors were used to derive relative risks (RR), absolute risk differences (ARD), and posterior probabilities. In these Bayesian models, HOPE was associated with lower rates of the primary composite endpoint (RR 0.71, 95%CrI 0.49-0.99; ARD -13.8%, 95%CrI -26.8;-0.4%). The probability of any benefit was 97.8%, and the probability of a clinically relevant effect exceeded 90%. For all-cause mortality, the probability of benefit was 90.5%, with a >85% probability of a clinically relevant effect. The results were robust across sensitivity analyses. These findings demonstrate clinically meaningful benefits with HOPE and provide a complementary interpretation of the NIHP2019-trial's results. Copyright © 2026. Published by Elsevier Inc. <112> Accession Number 651319165 Title The Effect of Acupressure on Procedural Pain, Anxiety, and Hemodynamic Parameters During Chest Tube Removal in Open-Heart Surgery Patients: A Randomized Sham-Controlled Study. Source Pain management nursing : official journal of the American Society of Pain Management Nurses. (no pagination), 2026. Date of Publication: 26 May 2026. Author Kandemir D.; Yuksel S.; Cam Yanik T.; Ozdemir F.E.; Altun Ugras G. Institution (Kandemir) Surgical Receiving Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom (Yuksel) Faculty of Nursing, Department of Surgical Nursing, Necmettin Erbakan University, Konya, Turkey (Cam Yanik) Faculty of Nursing, Department of Surgical Nursing, Mersin University, Mersin, Turkey (Ozdemir) Cardiovascular Surgery Intensive Care Unit, Mersin University Hospital, Mersin, Turkey (Altun Ugras) Faculty of Nursing, Department of Surgical Nursing, Mersin University, Mersin, Turkey Abstract BACKGROUND: Patients undergoing open-heart surgery often experience procedural pain and anxiety during chest tube removal (CTR), which can lead to serious complications, along with potential changes in hemodynamic parameters such as blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation. AIM: This study aimed to explore the effects of acupressure on procedural pain, anxiety, and hemodynamic parameters during CTR in open-heart surgery patients. METHOD(S): This prospective, two-arm (1:1), randomized sham-controlled trial included 68 open-heart surgery patients with chest tubes. Participants were randomly assigned to either the true acupressure group (n = 34) or the sham acupressure group (n = 34). Before CTR, patients in the true acupressure group received 12 minutes of pressure at points LI4, LI11, and HT7 on both hands, while those in the sham acupressure group received pressure applied 1.5 cm away from the same points. Data were collected at baseline (T0), immediately after CTR (T1), and 15 minutes after CTR (T2) using the Visual Analog Scale (VAS), the State Anxiety Inventory (STAI-S), and hemodynamic parameters. RESULT(S): At baseline, pain, anxiety, and hemodynamic parameters were comparable between the two groups (p > .05). Immediately after CTR (T1), pain levels were significantly lower in the true acupressure group compared with the sham acupressure group, with an effect size of 0.71 (t = 2.925, Cohen's d = 0.709, p = .005). Anxiety levels were also significantly lower in the true acupressure group both immediately after CTR (T1; effect size = 0.50, t = 2.046, Cohen's d = 0.496, p = .045) and 15 minutes post-removal (T2; effect size = 0.51, t = 2.111, Cohen's d = 0.512, p = .035). Acupressure had no significant effect on hemodynamic parameters (p > .05). CONCLUSION(S): Acupressure was effective in reducing procedural pain and anxiety associated with CTR in open-heart surgery patients, while having no measurable impact on hemodynamic parameters. CLINICAL TRIALS ID: NCT05875337 (Registered May 15, 2023). Copyright © 2026 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved. <113> Accession Number 651319086 Title The effect of the use of baby mobile accompanied by Brahms' lullaby on the physiological parameters and pain level of the baby during sternum dressing. Source Journal of pediatric nursing. 89 (pp 520-527), 2026. Date of Publication: 26 May 2026. Author Karakaya K.; Uysal G. Institution (Karakaya) Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey (Uysal) Sakarya University of Applied Sciences, Faculty of Health Sciences, Sakarya, Turkey Abstract BACKGROUND: Infants in intensive care units undergo numerous painful procedures, including medical dressings. Median sternotomy is commonly in pediatric cardiac surgery and infants experience sternum incisions in the postoperative period. To our knowledge, no studies have specifically examined pain levels during sternum dressing. PURPOSE: This randomized controlled trial was conducted to investigate the effect of a baby mobile accompanied by Brahms' Lullaby on physiological parameters and pain levels during sternum dressing in infants. METHOD(S): The study included 76 infants (aged 1-12 months) admitted to the Pediatric Cardiovascular Surgery Intensive Care Unit between July 2020 and February 2021. Data were collected using "Baby Monitoring Form" and " Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale". The clinical trial registration number was NCT04894487. RESULT(S): Heart rate, body temperature, and FLACC pain scores were significantly higher, while SpO2 levels were significantly lower in the control group compared to the intervention group (p < .05). CONCLUSION(S): This study demonstrated that using baby mobile with Brahms' Lullaby during sternum dressing effectively improved physiological parameters and reduced pain levels in infants. Its use may be recommended during painful procedures. IMPLICATIONS FOR PRACTICE: This research provides a novel, non-pharmacological approach for nurses in the clinics and demonstrated that such methods may be as effective as the pharmacological interventions. It reduced the contamination risk by keeping the babies calmer during sternum dressing, which is a painful procedure that should be done aseptically. Frequent use of this method may reduce the risk of developing tolerance to painkillers and narcotic analgesics. Copyright © 2026 Elsevier Inc. All rights reserved. <114> Accession Number 651321502 Title Enhanced Recovery After Surgery for Elderly Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review Focusing on Early Extubation and Pulmonary Outcomes. Source Ambulatory Surgery. Conference: Congress of the International Association for Ambulatory Surgery, IAAS 2026. Dubrovnik Croatia. 32 (pp 108), 2026. Date of Publication: 01 May 2026. Author Yu L.; Yang M.; Mao Y.; Gong J.; Liu Z.; Chen T. Institution (Yu, Yang, Mao, Gong, Liu, Chen) Department of General Surgery, The First Hospital of Lanzhou University, China Publisher International Association for Ambulatory Surgery Abstract Introduction Enhanced Recovery After Surgery (ERAS) and fast-track protocols are increasingly used in cardiac surgery to promote early extubation and pulmonary recovery. Elderly patients undergoing coronary artery bypass grafting (CABG) are at higher risk of postoperative pulmonary complications. However, evidence on the pulmonary benefits of ERAS-like protocols in this population remains limited. Aim This study aimed to evaluate the effects of ERAS-like or fast-track perioperative protocols on early extubation and pulmonary outcomes in elderly patients undergoing CABG. Methods This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to the most recent date. The search strategy combined terms related to ERAS and fast-track care ("enhanced recovery after surgery," "ERAS," "fast-track"), coronary artery bypass grafting ("CABG," "coronary artery bypass"), elderly populations ("elderly," "older," "geriatric"), and pulmonary outcomes ("extubation," "mechanical ventilation," "pulmonary complications"). Randomized and comparative observational studies comparing ERAS-like or fast-track perioperative care with conventional management in elderly patients undergoing isolated CABG were included. Primary outcomes were early extubation and postoperative pulmonary complications, with secondary outcomes including duration of mechanical ventilation and ICU length of stay. Random-effects meta-analysis was performed where appropriate. Results Twelve studies involving 1,635 elderly patients undergoing isolated CABG were included. ERAS-like protocols were associated with a higher rate of early extubation compared with conventional care (RR 1.45, 95% CI 1.22-1.72; I2 = 42%) and a shorter duration of mechanical ventilation (SMD -0.58, 95% CI -0.76 to -0.40; I2 = 51%). The incidence of postoperative pulmonary complications was reduced in the ERAS group (RR 0.72, 95% CI 0.55-0.94; I2 = 36%). ICU length of stay was generally shorter with ERAS-like protocols, while no significant difference in short-term mortality was observed. Conclusion ERAS-like protocols appear to enhance pulmonary recovery after CABG in elderly patients without compromising short-term survival. However, heterogeneity in protocol implementation highlights the need for standardized ERAS pathways. <115> Accession Number 651321437 Title The effect of low-dose esketamine on postoperative sleep disorders in patients undergoing day surgery for laparoscopic cholecystectomy: A randomized controlled trial. Source Ambulatory Surgery. Conference: Congress of the International Association for Ambulatory Surgery, IAAS 2026. Dubrovnik Croatia. 32 (pp 9), 2026. Date of Publication: 01 May 2026. Author Ding G.; Wang J.; Wang Y.; Song D.; Diao Y. Institution (Ding, Wang, Wang, Song, Diao) Ambulatory surgery center, General Hospital of Northern Theater Command, China Publisher International Association for Ambulatory Surgery Abstract Introduction aparoscopic cholecystectomy (LC) ambulatory surgery is widely applied due to its advantages of minimal invasiveness and rapid recovery. However, postoperative sleep disorders (PSD), characterized by insomnia, fragmented sleep and poor sleep quality, are common complications, which may delay recovery and reduce quality of life. The pathogenesis of PSD is associated with surgical trauma, inflammatory response and anesthetic drugs. Esketamine, an N-methyl-D-aspartate receptor antagonist, exerts analgesic and anti-inflammatory effects, and may regulate sleep function. Nevertheless, the effect of low-dose esketamine on PSD in LC day surgery patients remains unclear. This randomized controlled trial aims to explore whether low-dose esketamine can improve PSD in these patients, providing evidence for optimizing perioperative anesthetic management. Aim To investigate the effect of postoperative sleep disturbance by infusion of low dose esketamine during ambulatory laparoscopic cholecystectomy. Methods Patients undergoing ambulatory laparoscopic cholecystectomy under general anesthesia in General Hospital of Northern Theater Command between August and November 2024 were selected. They were randomly divided into esketamine group and control group based on a random number generator. Patients in the esketamine group received a continuous infusion of esketamine [0.3 mg/ (kg.h)] during the operation. Patients in the control group received the equivalent volume of saline. The scores of the Athens Insomnia Scale on the first day before surgery, the first day after surgery, and the third day after surgery, the incidence of sleep disturbance and the Hospital Anxiety and Depression Scale score on the first day and the third day after surgery, mean artial pressure and heart rate during surgery, operation time, anesthesia time, recovery time, total dosage of remifetanil and vasoactive drug, postoperative adverse reactions, and the Visual Analogue Scale score on the day of surgery and the first day after surgery were compared between the two groups. Results A total of 105 patients were included, including 52 in the control group and 53 in the esketamine group. The differences were statistically significant in the incidence of sleep disorders on the first day after surgery (22.64% vs. 46.15%; chi2=6.440, P=0.011), the Athens Insomnia Scale score on the first day after surgery [4 (1.5, 5) vs. 5 (4, 7); Z=-2.933, P=0.003], the cumulative amount of remifentanil used during surgery [884 (600, 1 112) vs. 572 (476, 872) mug; Z=-2.774, P=0.006], and the Visual Analogue Scale score on the day of surgery [2 (2, 3) vs. 3 (2, 3); Z=-2.488, P=0.013] between the esketamine group and the control group. There was no significant difference in mean arterial pressure, heart rate, operation time, anesthesia time, recovery time, vasoactive drug dosage, Hospital Anxiety and Depression Scale score or incidence of postoperative adverse reactions between the two groups (P>0.05). Conclusion Continuous intraoperative infusion of low dose esketamine can improve postoperative sleep disturbance, without increasing the incidence of postoperative adverse reactions in patients undergoing ambulatory laparoscopic cholecystectomy. �

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