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

Total documents retrieved: 117 Results Generated From: Embase <1980 to 2026 Week 29> Embase Weekly Updates (updates since 2026-07-10) - (117 records) <1> Accession Number 2046664578 Title Prehabilitation in Patients Undergoing Cardiac Surgery: An Umbrella Review of Systematic Reviews and Meta-Analysis. Source Surgeries (Switzerland). 7(2) (no pagination), 2026. Article Number: 49. Date of Publication: 01 Jun 2026. Author Sidik A.I.; Khavandeev M.L.; Al-Ariki M.K.; Dontsov V.V.; Karpenko I.G.; Djumanov A.K.; Ogurchikova A.V.; Kurnosov S.A.; Shirin D. Institution (Sidik, Al-Ariki, Ogurchikova) Medical Insitute, Peoples' Friendship University of Russia, Moscow, Russian Federation (Khavandeev) Department of Cardiac Surgery, Gusak Institute of Emergency and Reconstructive Surgery, Donetsk, Russian Federation (Dontsov, Kurnosov) Moscow Regional Research and Clinical Institute Named After M.F. Vladimirsky, Moscow, Russian Federation (Karpenko) Department of Cardiac Surgery, A.A. Vishnevskiy Hospital, Kranogorsk, Russian Federation (Djumanov, Shirin) Department of Surgical Diseases No. 2, Tashkent State Medical University, Tashkent, Uzbekistan Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objective: Prehabilitation aims to improve physiological reserve before surgery to enhance postoperative outcomes. Multiple systematic reviews have evaluated preoperative interventions in adult cardiac surgery; however, variability in scope, methodological quality, and overlap of primary trials complicates interpretation. The aim of this study is to synthesise and critically appraise evidence from systematic reviews and meta-analyses evaluating prehabilitation interventions in adults undergoing cardiac surgery. No funding was received for this study. Method(s): We conducted an umbrella systematic review following a prospectively registered protocol (PROSPERO: CRD420261292354) and PRISMA 2020 guidance. PubMed, Web of Science, and Scopus were searched from inception to 31 December 2025. Eligible reviews included adults (>=18 years) undergoing cardiac surgery, evaluated and compared preoperative inspiratory muscle training (IMT), respiratory muscle training, and exercise-based, educational, or multimodal prehabilitation with usual care or sham intervention. Reviews focused solely on postoperative interventions or non-cardiac surgery were excluded. Methodological quality was assessed using AMSTAR-2. Certainty of evidence was evaluated using GRADE. Overlap of primary studies was quantified using the Corrected Covered Area (CCA). A structured narrative synthesis with a direction-of-effect framework was applied. Result(s): Eighteen systematic reviews (published 2012-2025) were included, comprising 46 unique primary studies and more than 6674 participants (exact totals unavailable due to incomplete reporting in at least one review). Overall overlap was high (CCA 12.5%). Respiratory-focused prehabilitation, particularly IMT, demonstrated consistent reductions in postoperative pulmonary complications (PPCs) (risk ratios approximately 0.42-0.53), pneumonia (RR ~0.44-0.45), and atelectasis (RR ~0.49-0.59), favouring prehabilitation over usual care. Hospital length of stay was reduced by approximately 1.5-3 days across multiple reviews. Inspiratory muscle strength improved consistently (mean difference ~+12 to +17 cmH<inf>2</inf>O). Effects on ICU length of stay and mechanical ventilation duration were inconsistent or non-significant. Exercise-based programmes improved functional capacity (6 min walk distance increase ~50-75 m) and showed modest reductions in hospital stay, but heterogeneity was substantial. No intervention demonstrated a consistent reduction in postoperative mortality. Evidence was limited by clinical heterogeneity, performance bias in primary trials, inconsistent outcome definitions, and high overlap of key IMT trials across reviews. Mortality outcomes were underpowered. Conclusion(s): Preoperative IMT provides evidence for reducing pulmonary complications and shortening hospital stays in adult cardiac surgery. Exercise-based prehabilitation improves functional capacity but requires further high-quality, standardised trials. Integration of respiratory prehabilitation into cardiac surgical pathways appears supported by the current evidence. Copyright © 2026 by the authors. <2> Accession Number 648263205 Title Predictive factors and pharmacological preventive interventions for atrial fibrillation after aortic valve replacement. Source Journal of cardiothoracic surgery. 20(1) (pp 328), 2025. Date of Publication: 09 Aug 2025. Author Chen L.; Liu Y.; Ge J. Institution (Chen, Liu, Ge) Department of Cardiovascular Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu, China Abstract OBJECTIVE: This study aims to investigate the predictive factors for postoperative atrial fibrillation (POAF) following aortic valve replacement (AVR) and evaluate the preventive effect of combined atorvastatin and metoprolol therapy on POAF. METHOD(S): This study employed a mixed design of retrospective cohort analysis and prospective randomized controlled trial, including 268 patients who underwent isolated AVR from January 1, 2022, to March 31, 2024. The 168 patients from January 1, 2022, to May 31, 2023, were analyzed for POAF predictive factors, while 100 patients from June 1, 2023, were included in the prospective trial. The intervention group (n = 50) received combined atorvastatin and metoprolol treatment starting 7 days before surgery. RESULT(S): Multivariate logistic regression analysis identified age (OR = 1.12, 95% CI: 1.04-1.20, p = 0.003), history of stroke (OR = 10.94, 95% CI: 1.32-90.66, p = 0.027), EuroSCORE II (OR = 2.90, 95% CI: 1.61-5.20, p < 0.001), NT-proBNP level (OR = 1.002, 95% CI: 1.001-1.004, p = 0.009), hs-CRP level (OR = 1.55, 95% CI: 1.16-2.07, p = 0.003), and operation time (OR = 1.02, 95% CI: 1.01-1.04, p = 0.008) as independent predictors of POAF. Pharmacological intervention significantly reduced POAF incidence (p = 0.005) and shortened hospital stay (p < 0.001), ICU stay (p = 0.002), and mechanical ventilation time (p < 0.001). The AUC of the predictive model was 0.952, with a calibrated C-statistic of 0.904. Decision curve analysis demonstrated significant clinical utility across multiple risk thresholds. CONCLUSION(S): Age, history of stroke, EuroSCORE II, NT-proBNP and hs-CRP levels, and operation time are independent predictors of POAF. Combined preventive treatment with atorvastatin and metoprolol reduced POAF incidence and postoperative hospital stay, showing promising clinical application prospects. <3> Accession Number 649820956 Title Effect of intraoperative ventilation strategy on postoperative pulmonary complications in thoracic surgery under general anesthesia: a meta-analysis. Source Journal of cardiothoracic surgery. 21(1) (pp 66), 2026. Date of Publication: 04 Jan 2026. Author Wang Y.; Ouyang F.; Ding Z.; Xu L.; Wang J.; Chen Z.; Zhang L. Institution (Wang, Xu, Wang, Zhang) Department of Anesthesiology, Wuhan No.1 Hospital, No. 215, Qiaokou District, Wuhan, China (Ouyang) Department of Anesthesiology, Thrid People's Hospital of Hubei Province, Wuhan, China (Ding) Department of Painology, Wuhan No.1 Hospital, Wuhan, China (Chen) Department of Anesthesiology, Wuhan No.1 Hospital, No. 215, Qiaokou District, Wuhan, China Abstract BACKGROUND: Thoracic surgery is essential for treating various chest diseases. The ventilation strategies used during surgery can affect the risk of postoperative pulmonary complications (PPCs). OBJECTIVE(S): This meta-analysis assesses how lung-protective ventilation strategies (LPVS) affect PPCs compared with conventional strategies in adult patients undergoing thoracic surgery under general anesthesia through a meta-analysis. METHOD(S): A systematic literature search was conducted across PubMed, Embase, Cochrane, and Web of Science databases. Heterogeneity among studies was analyzed using the Q test and I2 statistic Pooled results were presented as relative risk (RR) with 95% confidence intervals (CIs). RESULT(S): A total of 11 randomized controlled trials, encompassing 1915 participants, were analyzed. LPVS significantly reduced the incidence of PPCs (RR = 0.82, 95%CI = 0.71-0.95). Subgroup analyses revealed significant effects in Asian countries (RR = 0.59, 95%CI = 0.39-0.87) and patients >= 60 years old both in control (RR = 0.84, 95% CI = 0.72-0.98) and research group (RR = 0.82, 95% CI = 0.70-0.9). Significant effects were also found in control group with tidal volume >= 8 ml/kg (RR = 0.67, 95% CI = 0.51-0.89) and research group with tidal volume <= 5 ml/kg (RR = 0.84, 95% CI = 0.73-0.98). CONCLUSION(S): LPVS effectively reduce PPCs in thoracic surgery, particularly among older patients. Future research should standardize protocols and explore long-term outcomes. <4> Accession Number 2046120436 Title The European bifurcation club randomized trial of stepwise provisional stenting vs drug-coated balloon therapy for nonleft main true coronary bifurcations: The EBC DCB trial. Source American Heart Journal. 300 (no pagination), 2026. Article Number: 107463. Date of Publication: 01 Oct 2026. Author Broyd C.J.; Arunothayaraj S.; Scheller B.; Eccleshall S.; Lassen J.F.; Stankovic G.; Hildick-Smith D. Institution (Broyd, Hildick-Smith) Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom (Broyd, Hildick-Smith) University of Sussex, East Sussex, United Kingdom (Arunothayaraj) St Vincent's Hospital, Melbourne, Australia (Scheller) Clinical and Experimental Interventional Cardiology, Saarland University, Homburg, Germany (Eccleshall) Norfolk and Norwich University Hospitals NHS Trust, Norwich, United Kingdom (Eccleshall) Norwich Medical School, University of East Anglia, Norwich, United Kingdom (Lassen) Department of Cardiology B, Odense University Hospital, and University of Southern Denmark, Odense, Denmark (Stankovic) Department of Cardiology, University Clinical Center of Serbia, and Faculty of Medicine, University of Belgrade, Belgrade, Serbia Publisher Elsevier Inc. Abstract Background Drug-eluting stents (DES) are associated with a 2% annual failure rate and have worse outcomes at coronary bifurcations. Recent randomized control data have shown the noninferiority of drug-coated balloons (DCB) vs stents at 1 year. Possible benefits of DCBs include the lack of a metal prosthesis, absence of stent malapposition, lack of obligate antiplatelet treatment, and maintenance of vessel geometry and function. Hypothesis The use of DCBs in the treatment of nonleft main bifurcation disease is noninferior to a DES strategy for Target Bifurcation Failure at 1 year. Strategy Design The EBC DCB trial is a nonblinded, investigator-initiated, randomized control trial that will recruit 750 patients with nonleft main bifurcations requiring revascularization. Both main vessel and side branch must have significant atheroma. Subacute (NSTEMI and unstable angina) and elective presentations will be eligible for inclusion. Patients will be randomized to either a step-wise provisional DES or a DCB strategy. Major exclusion criteria include STEMI in the previous 48 hours, chronic total occlusions, and in-stent restenosis. The primary endpoint of Target Bifurcation Failure is a composite of cardiovascular death, target bifurcation myocardial infarction, or target bifurcation revascularization. Patients will be followed up at 6 months, 1, 3, 5, and 8 years. If noninferiority is met, superiority will be tested. Summary EBC DCB is an open-label, multicenter, international randomized control trial comparing the use of DCB and DES in the treatment of coronary artery bifurcation disease. The trial is registered at clinicaltrials.gov (NCT06822322). Copyright © 2026 Elsevier Inc. <5> [Use Link to view the full text] Accession Number 2045940011 Title Pre-operative single-level ultrasound-guided superficial parasternal intercostal plane block and pulmonary recovery after cardiac surgery with sternotomy: a randomised controlled trial. Source European Journal of Anaesthesiology. 43(8) (pp 712-713), 2026. Date of Publication: 01 Aug 2026. Author Huette P.; Daumin C.; Fontaine R.; Lefebvre T.; Tarpin P.; Beyls C.; Gubler B.; Mahjoub Y.; Ollier A.; Abou-Arab O. Institution (Huette, Daumin, Fontaine, Lefebvre, Tarpin, Beyls, Mahjoub, Abou-Arab) The Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, France (Huette, Tarpin, Beyls, Mahjoub) UR UPJV 7518 SSPC Research Unit, Jules Verne University of Picardie, France (Gubler) Immunology Department & EA4666-HEMATIM, Amiens University Hospital, Amiens, France (Ollier) Department of Biostatistics, Amiens Picardy University Hospital, France (Abou-Arab) Laboratoire MP3CV, CURS, Universite Picardie Jules Verne, France Publisher Lippincott Williams and Wilkins <6> Accession Number 2046626352 Title The Role of the Cardiothoracic Surgeon in the Age of AI-Are the Robots Going to Take Our Jobs?. Source Medical sciences. 14(2) (no pagination), 2026. Article Number: 164. Date of Publication: 01 Jun 2026. Author Streian C.-G.; Meche V.-A.; Feier H.B.; Cozma D.; Dima C.N.; Luca C.T.; Matei S.-C. Institution (Streian, Feier, Dima) Clinic of Cardiovascular Surgery, Institute of Cardiovascular Diseases of Timisoara, Gheorghe Adam Street, No. 13A, Timisoara, Romania (Streian, Feier, Dima) Department VI Cardiology-Cardiovascular Surgery Clinic, "Victor Babes" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, Timisoara, Romania (Meche) Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania (Feier, Cozma, Luca) Advanced Research Center of the Institute for Cardiovascular Diseases, Timisoara, Romania (Cozma, Luca) Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania (Cozma, Luca) Institute of Cardiovascular Diseases Timisoara, Timisoara, Romania (Matei) Abdominal Surgery and Phlebology Research Center, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania (Matei) 1st Surgical Department, Pius Brinzeu Emergency County Hospital, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Introduction: Artificial intelligence (AI) and robot-assisted platforms are increasingly influencing cardiothoracic surgery. AI enhances risk prediction, imaging interpretation, and early complication detection, while robotics improves visualization, dexterity, and minimally invasive access. This systematic review evaluates the current evidence supporting these technologies and their implications for clinical practice. Method(s): A systematic literature search was conducted across PubMed, Embase, Scopus, Web of Science, and Google Scholar (January 2000-May 2025) following PRISMA 2020 guidelines. After screening and eligibility assessment, 67 studies met predefined inclusion criteria and were incorporated into the qualitative synthesis. Additional high-impact reviews and consensus documents were consulted for contextual interpretation. Result(s): Machine learning models demonstrated modest but consistent improvements in predictive performance compared with EuroSCORE II and STS scores, particularly in high-risk cohorts. Robot-assisted mitral and coronary procedures showed reduced postoperative pain, blood loss, ICU stay, and recovery time in experienced centers, though early learning phases were associated with longer operative, cross-clamp, and bypass times. AI-enabled intraoperative tools, such as video analysis, workflow recognition, and real-time anatomical segmentation, emerged as promising adjuncts for surgical precision. Structured robotic training programs, especially simulation-based and dual-console pathways, accelerated proficiency acquisition. Conclusion(s): AI and robotic systems act as augmentative technologies that enhance rather than replace the surgeon's role. Their safe and effective adoption requires standardized training, transparent AI decision pathways, and clear ethical and medico-legal governance. Copyright © 2026 by the authors. <7> Accession Number 649951457 Title Robotic-assisted thoracic surgery for resectable lung cancer: efficacy, safety and surgical approaches - an umbrella review of meta-analyses. Source BMC surgery. 26(1) (pp 123), 2026. Date of Publication: 16 Jan 2026. Author Xu Y.; Han Q.; Wang C.; Xu J.; Li X.; Zhang Q. Institution (Xu, Wang) Thoracic Surgery Department of Second Affiliated Hospital of Shandong First, Medical University & Shandong Academy of Medical Sciences, No.706 Taishan Street, Shandong, China (Han) Respiratory Medicine Department of Second Affiliated Hospital of Shandong, First Medical University & Shandong Academy of Medical Sciences, China (Xu) Thoracic Surgery Department of Fourth Affiliated Hospital of Harbin Medical University, Harbin, China (Li) Thoracic Surgery Department of The First Affiliated Hospital of Soochow University, No.899 Pinghai Street, Suzhou, Jiangsu, China (Zhang) Thoracic Surgery Department of Second Affiliated Hospital of Shandong First, Medical University & Shandong Academy of Medical Sciences, No.706 Taishan Street, Shandong, China Abstract Lung cancer is still a tumor type with high incidence in the world. Although there are many treatment options for lung cancer, surgical resection is widely used for I-IIIA lung cancer. Video assisted thoracic surgery (VATS) has been proved to have significant intraoperative and postoperative and efficacy and safety advantages compared with traditional thoracotomy. Furthermore, current robotic assisted thoracic surgery (RATS) has created a new development chapter for minimally invasive lung surgery. RATS provides a series of advantages due to its advanced technology, such as three-dimensional vision, tenx magnification video imaging, and robotic arms that can simulate the degree of freedom of the human hand. Surgical participants allowed to dissect thoracic structures and lymph node resection during procedure more comfortably and accurately, thereby reducing blood loss and the possibility of intraoperative cardiac and respiratory accidents. This article combines the robotic surgery we have performed with the published researches about robotic lung cancer surgery, to further review the application, advantages and a series of challenges of RATS in lobectomy, segmentectomy, bronchial sleeve lobectomy (BSL), which surgeries required elaborate dissection of blood vessels, trachea and lymph nodes. It is expected to further explore the direction of RATS in the development of lung surgery. <8> Accession Number 2046662225 Title A Review of Risk Assessment in the Evolving Heart Transplant Landscape. Source Transplantology. 7(2) (no pagination), 2026. Article Number: 14. Date of Publication: 01 Jun 2026. Author Labrada L.; Shah M.; Saiganesh P.; Inam M.; Hamad E. Institution (Labrada, Shah, Saiganesh, Hamad) Department of Medicine, Lewis Katz School of Medicine at Temple University, Temple University Hospital, Philadelphia, PA, United States (Inam) Department of Medicine, Yale School of Medicine, New Haven, CT, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Heart transplantation remains a vital therapy for patients with end-stage heart failure, yet organ scarcity and evolving allocation policies necessitate robust risk prediction models to optimize outcomes and equity. This narrative review explores the current landscape of risk assessment in heart transplantation, contextualized within the broader framework of solid organ allocation and the emerging continuous distribution (CD) model. While kidney, liver, and lung transplantation have integrated validated risk scores into allocation systems, heart transplantation continues to rely on therapy-based criteria without a unified, benefit-based approach. We examine existing pre- and post-transplant predictive models and highlight their strengths and limitations. Additionally, we discuss the multidimensional factors influencing transplant success, ranging from donor and recipient characteristics to psychosocial and system-level variables. As CD expands across organ types, the development and integration of validated heart-specific risk scores will be essential to ensure equitable and effective organ allocation. Copyright © 2026 by the authors. <9> Accession Number 2046393607 Title The 2026 American Association for Thoracic Surgery Expert Consensus Document: Evaluation and management of N2+ non-small cell lung cancer. Source Journal of Thoracic and Cardiovascular Surgery. 172(2) (pp 450-466.e2), 2026. Date of Publication: 01 Aug 2026. Author Linden P.A.; Martin L.W.; Stiles B.; Opitz I.; Chen H.; Spicer J.; Lanuti M.; Tong B.C.; Liberman M.; Bestvina C.M.; Sands J.; Huang J.; Price M.; Samson P.; Boutros C.S.; Rabinovich E.P.; Park B.; D'Amico T.A. Institution (Linden, Boutros) Division of Thoracic and Esophageal Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States (Martin) Division of Thoracic Surgery, University of Virginia Health System, Charlottesville, VA, United States (Stiles) Division of Thoracic Surgery, Montefiore Einstein Medical Center, New York, NY, United States (Opitz) Department of Thoracic Surgery, University Hospital Zurich, Zurich, Switzerland (Chen) Division of Thoracic Surgery, Department of Surgery, Fudan University Shanghai Medical Center, Shanghai, China (Spicer) Department of Surgery, McGill University Health Center, McGill University, Montreal, QC, Canada (Lanuti) Division of Thoracic Surgery, Massachusetts General Hospital, Boston, Mass, United States (Tong, D'Amico) Division of Thoracic Surgery, Department of Surgery, Duke University, Durham, NC, United States (Liberman) Department of Surgery, Centre Hospitalier de L'Universite de Montreal, University of Montreal, Montreal, QC, Canada (Bestvina) Department of Medicine, University of Chicago Medicine, Chicago, Ill, United States (Sands) Department of Medicine, Lowe Center for Thoracic Oncology, Dana-Farber Cancer Institute, Boston, Mass, United States (Huang, Park) Department of Surgery, Thoracic Service, Memorial Sloan Kettering Cancer Center, New York, NY, United States (Price) Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex, United States (Samson) Department of Radiation Oncology, Washington University, St Louis, Mo, United States (Rabinovich) Department of Surgery, University of Virginia Health System, Charlottesville, VA, United States Publisher Elsevier Inc. Abstract Objective: Multimodal therapy is recommended for the optimal treatment of N2 positive non-small cell lung cancer (NSCLC). Recent advancements in the use of immune checkpoint inhibitors and targeted therapy have dramatically changed the landscape of treatment. We reviewed recent trials and literature to develop consensus statements concerning the evaluation and treatment of potentially resectable NSCLC with N2 involvement. Method(s): The American Association for Thoracic Surgery Clinical Practice Standards Committee assembled an international panel of medical oncologists, radiation oncologists, radiologists, and thoracic surgeons. A focused literature review was performed with the assistance of a medical librarian. The panel used a modified Delphi method to develop expert consensus statements with class of recommendation and level of evidence on issues related to the treatment of potentially resectable N2 positive NSCLC. Result(s): Consensus was reached on 13 statements on topics related to staging, determinants of unresectable disease, use of chemoimmunotherapy or targeted therapies, proper use of neoadjuvant and/or adjuvant therapy, restaging, and the safety of resection after chemoimmunotherapy. Conclusion(s): NSCLC with N2 disease remains a challenging, heterogeneous disease. These expert consensus recommendations are meant to provide guidance to identify appropriate surgical patients and to formulate the best multimodality treatment of patients with N2-positive NSCLC. Copyright © 2026 The American Association for Thoracic Surgery <10> [Use Link to view the full text] Accession Number 2044993696 Title Feasibility Pilot Trial for the Trajectories of Recovery after Intravenous Propofol versus Inhaled Volatile Anesthesia (THRIVE) Pragmatic Randomized Clinical Trial. Source Anesthesiology. 145(1) (pp 59-71), 2026. Date of Publication: 01 Jul 2026. Author Janda A.M.; Tellor Pennington B.R.; Colquhoun D.A.; Kumar S.S.; Neuman M.D.; Politi M.C.; Spino C.; Kidwell K.M.; Swisher L.; Bollini M.; Vaughn M.T.; Cloyd C.; Pescatore N.A.; Thelen-Perry S.; Gregory S.H.; du Toit L.; Henrichs B.; Torres B.; Avidan M.S.; Kheterpal S.; Rosen S.; Percich J.; Valdez M.; Karanikolas E.; Budelier T.; Shoemake R.; Huynh D.; Patel A.; Sieg A.; Bahamonde A.; Santos D.; Jung Y.A.; Zittleman A.; Coleman R.; Dehring M.; Sinha A.; Romanowski M.; Liu X.; Balaji M.; Shah N.; Burns M.; Krambrink A.; Ignacio R.V.; Huang S.; Swanson B.; Hoover D.; Moskal D.; Menio D.; Ziegler G.; Klosterman H.; Robison L.; Campos H.; Oberst K.; Fodor K.; Zukowski L.; Grant M.; Wurst M.; Geml T.; Sychtysz M.; Hicks M.; Dacey R.; Kronzer A.; McKinnon S.; Abdallah A.B.; Lane-Fall M.; Hall B.L.; Price A.; Chu L.; Saffary R.; Carron J.; Vlisides P.E.; Mashour G.A.; Kent C.D.; Hassett A. Institution (Janda) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Tellor Pennington) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Colquhoun) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Kumar) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Neuman) Department of Anesthesiology and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States (Politi) School of Public Health, Washington University, St. Louis, MI, United States (Spino) Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States (Kidwell) Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States (Swisher) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Bollini) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Vaughn) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Cloyd) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Pescatore) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Thelen-Perry) Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States (Gregory) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (du Toit) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Henrichs) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Torres) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Avidan) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Kheterpal) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Rosen) Clinical Research Coordinator, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Percich) Clinical Research Coordinator, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Valdez) Clinical Research Coordinator, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Karanikolas) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Budelier) Clinical Research Coordinator, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Shoemake, Patel, Huynh, Patel, Sieg, Santos) Clinical Research Coordinator, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Bahamonde) Clinical Research Coordinator and Medical Student, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Jung) Research Assistant, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Zittleman) Clinical Informatics Specialist, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Coleman, Romanowski, Liu, Balaji) Developer, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Dehring) Technical Lead, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Sinha) Technical Lead, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Shah) Clinical Professor of Anesthesiology and Associate Chair for Technology, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Burns) Clinical Associate Professor of Anesthesiology, Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Krambrink, Ignacio, Huang) Statistician, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States (Swanson, Hoover, Moskal, Menio, Ziegler) Patient Partner, St. Louis, MO, United States (Klosterman, Robison) Patient Partner, Portland, OR, United States (Campos) Patient Partner, Oakland, CA, United States (Oberst) Patient Partner, Department of Anesthesiology, Stanford Anesthesia and Informatics Media Lab, Stanford School of Medicine, Stanford, CA, United States (Fodor) Patient Partner, Philadelphia, PA, United States (Zukowski) Patient Partner, Livonia, MI, United States (Grant) Patient Partner, St. Louis, MO, United States (Wurst) Patient Partner, St. Louis, MO, United States (Geml) Patient Partner, Goodrich, MI, United States (Sychtysz) Patient Partner, Manassas, VA, United States (Hicks) Patient Partner, Department of Anesthesiology, Stanford Anesthesia and Informatics Media Lab, Stanford School of Medicine, Stanford, CA, United States (Dacey) Patient Partner, Department of Neurosurgery, Washington University School of Medicine, St. Louis, MI, United States (Kronzer) Medical Informaticist, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (McKinnon) Manager of Clinical Research - Regulatory and Compliance, Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Abdallah) Department of Anesthesiology, Washington University School of Medicine, St. Louis, MI, United States (Lane-Fall) Epidemiology and Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States (Hall) Department of Surgery, Washington University School of Medicine and BJC Healthcare, St. Louis, MI, United States (Price) Department of Anesthesiology, Stanford Anesthesia and Informatics Media Lab, Stanford School of Medicine, Stanford, CA, United States (Chu) Perioperative and Pain Medicine, Department of Anesthesiology, Stanford Anesthesia and Informatics Media Lab, Stanford School of Medicine, Stanford, CA, United States (Saffary) Clinical Assistant Professor, Department of Anesthesiology, Stanford Anesthesia and Informatics Media Lab, Stanford School of Medicine, Stanford, CA, United States (Carron) BJC HealthCare, St. Louis, MO, United States (Vlisides) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Mashour) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States (Kent) Department of Anesthesiology, University of Washington, Seattle, WA, United States (Hassett) Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States Publisher Lippincott Williams and Wilkins Abstract Background: - The Trajectories of Recovery after Intravenous propofol versus inhaled VolatilE anesthesia (THRIVE) trial is a multicenter prospective, randomized comparative effectiveness trial examining patients' experiences and outcomes after receiving either total intravenous anesthesia with propofol or inhaled volatile anesthesia for general anesthesia (NCT05991453). Before the 13, 000-patient trial, a pilot trial (NCT05346588) was performed to establish feasibility and determine the percentage of success of (1) patient enrollment, (2) intervention adherence, and (3) data completion. Method(s): - This feasibility trial included adult patients undergoing elective noncardiac surgery requiring general anesthesia across two academic institutions in the United States. Patients were randomized to receive general anesthesia with total intravenous or inhalational anesthesia. Patients completed surveys on postoperative days 0, 1, 2, 7, 30, and 90. The percentages of consent, intervention adherence, and data completion were compared with predefined thresholds (10%, 80%, and 90%, respectively). Result(s): - A total of 300 patients were enrolled across two sites: Washington University in St. Louis (St. Louis, Missouri) and the University of Michigan (Ann Arbor, Michigan), from September 2022 through March 2023. The percentages achieved significantly exceeded predefined thresholds: 351 of 663 (53%; 95% CI, 49 to 57%) patients approached were successfully consented, adherence to the randomized intervention occurred in 142 of 149 (95%; 95% CI, 92 to 99%) total intravenous anesthesia cases and 150 of 151 (99%; 95% CI, 98 to 100%) inhaled cases, and complete data collection occurred in 279 of 299 (93%; 95% CI, 91 to 96%) patients for the Quality of Recovery-15 and 299 of 299 (100% complete 95% CI, 100 to 100%) patients for the modified Brice, the intraoperative awareness screening questionnaire. Conclusion(s): - It was feasible to enroll sufficient patients, adhere strongly to the randomized treatment allocation, and obtain adequate outcomes data at these two pilot sites for the THRIVE trial. Copyright © 2026 American Society of Anesthesiologists. All Rights Reserved. <11> Accession Number 2044526271 Title The Efficacy of Gabapentin in Reducing Perioperative Opioid Requirements in Pediatric Cardiac Surgery: A Randomized, Double-Blinded Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(7) (pp 2061-2068), 2026. Date of Publication: 01 Jul 2026. Author Sayedalahl M.A.; Hassan A.A.; Elmaddawy A.E.A.; Abdelbaser I.; Abdelfattah M.; Badr-Eldin M.N.; Elmorsi Hewidi G.Z.; Gabr M.A.; Elemam E.M.; Eltanany E.; Eissa A.A.; Hassanin Taraby A.I.; Bakrey S.; El Morsy M.M. Institution (Sayedalahl, Elmaddawy, Abdelbaser, Abdelfattah, Badr-Eldin, Elmorsi Hewidi, Elemam, Eltanany, Eissa, Hassanin Taraby, Bakrey) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt (Hassan) Department of Anesthesiology and Intensive Care, Faculty of Medicine, Port Said University, Port Said, Egypt (Gabr) Department of Cardiothoracic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt (El Morsy) Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Damietta University, New Damietta, Egypt Publisher W.B. Saunders Abstract Objectives: To assess the efficacy of gabapentin administration in reducing perioperative opioid consumption among pediatric patients undergoing cardiac surgery with cardiopulmonary bypass. Design(s): A prospective, randomized, double-blinded, placebo-controlled trial. Setting(s): University children's hospital. Participant(s): Eighty patients aged 3 to 12 years undergoing elective corrective cardiac surgery. Intervention(s): Participants were randomly allocated to receive either gabapentin (10 mg/kg/d in 3 divided doses) (group G) or placebo (group P), starting preoperatively and continuing for 48 hours postoperatively. Measurements and Main Results: The primary outcome measured was the total rescue fentanyl consumption (in micrograms per kilogram) during the first 48 postoperative hours. Secondary outcomes included intraoperative fentanyl consumption, Modified Objective Pain Score (MOPS), time to extubation, duration of intensive care unit (ICU) stay, and adverse effects. Group G demonstrated a significantly lower requirement for fentanyl (4.04 +/- 1.59 microg/kg) compared with group P (7.01 +/- 1.53 microg/kg, p < 0.001). Gabapentin also resulted in reduced intraoperative opioid use, lower postoperative pain score, shorter time to extubation, and decreased ICU length of stay, without an increase in adverse events. Conclusion(s): Perioperative gabapentin administration effectively reduces opioid requirements, provides effective postoperative analgesia as assessed by the MOPS, and accelerates recovery in pediatric cardiac surgery. Copyright © 2026 Elsevier Inc. <12> Accession Number 2046395954 Title Effects of digoxin in modern heart failure treatment: Rationale and design of the DIG-Mod HF trial. Source Revista Portuguesa de Cardiologia. 45(7) (pp 393-400), 2026. Date of Publication: 01 Jul 2026. Author Valentim Goncalves A.; Cardim N.; Fiarresga A.; Pereira-da-Silva T.; Ilhao-Moreira R.; Galrinho A.; Rio P.; Carvalheiro R.; Ferreira F.; Lopes J.; Marques Antunes M.; Selas M.; Viana B.; Domingues L.; Cruz Ferreira R. Institution (Valentim Goncalves, Fiarresga, Pereira-da-Silva, Ilhao-Moreira, Galrinho, Rio, Carvalheiro, Ferreira, Lopes, Marques Antunes, Selas, Viana, Cruz Ferreira) Departamento de Cardiologia, Hospital de Santa Marta, Centro Hospitalar Universitario de Lisboa Central. Centro Clinico Academico de Lisboa, Lisboa, Portugal (Valentim Goncalves, Cardim, Fiarresga, Pereira-da-Silva) NOVA Medical School, Centro Clinico Academico de Lisboa, Lisboa, Portugal (Valentim Goncalves, Cardim, Rio) Hospital CUF Descobertas, Lisboa, Portugal (Domingues) NOVA Clinical Research Unit - NOVA CRU, NOVA Medical School, Lisboa, Portugal Publisher Sociedade Portuguesa de Cardiologia Abstract Aims: Even though it is the oldest heart failure (HF) medication still in use, digoxin has not been evaluated alongside the updated algorithm for treating HF with reduced ejection fraction patients. This could help explain the low use of digoxin in recent HF studies. The main objective is to assess the effectiveness of digoxin in functional capacity and cardiac function when combined with modern HF therapy. Method(s): An interventional, open-label, randomised, crossover trial among adults with chronic Heart Failure and reduced ejection fraction (<=45%) was designed to allocate 50 patients for 24 weeks in each arm (48 weeks of study). The arms are daily intake of digoxin 0.125 mg plus standard of care versus standard of care alone. Both patients with sinus rhythm and atrial fibrillation were enrolled. At the end of each 24-week arm, patients will undergo the co-primary outcome measurement of the peak oxygen consumption, evaluated through cardiopulmonary exercise test, and the global work index, measured by transthoracic echocardiography. Key secondary outcome includes a safety composite of death, need for urgent heart transplantation or mechanical assist device, total hospitalizations and sustained ventricular arrhythmias. The study completed recruitment in April 2025 and will complete follow up in March 2026. Conclusion(s): The use of digoxin could be significantly affected by evidence that it still has a considerable effect on functional capacity and cardiac function in HF patients. EU CT Number: 2024-513448-26-00. Copyright © 2026 Sociedade Portuguesa de Cardiologia <13> [Use Link to view the full text] Accession Number 2046072831 Title Magnesium Sulfate to Prevent Perioperative Atrial Fibrillation in Cardiac Surgery: A Randomized Clinical Trial. Source Critical Care Medicine. 54(7) (pp 1635-1646), 2026. Date of Publication: 01 Jul 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, SP, 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 Publisher Lippincott Williams and Wilkins 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(s): - Double-blind, randomized, placebo-controlled, single-center clinical trial with interim analysis for futility. Setting(s): - HagaZiekenhuis, The Hague, The Netherlands (February 2022-November 2023). Patient(s): - Adult patients undergoing coronary artery bypass grafting and/or valvular surgery without prior atrial arrhythmias or severe renal dysfunction. Intervention(s): - 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. <14> Accession Number 2046655540 Title Transcatheter Aortic Valve Implantation in Cancer Patients: A Contemporary Review of the Specific Challenges, the Outcomes, Risk Stratification, and Decision-Making. Source Medicina (Lithuania). 62(6) (no pagination), 2026. Article Number: 1139. Date of Publication: 01 Jun 2026. Author Keramida K.; Mavraganis G.; Masoura C.; Aznaouridis K.; Androutsopoulou V.; Tsioufis K. Institution (Keramida) Cardiology Department, General Anticancer Oncological Hospital, Agios Savvas, Athens, Greece (Mavraganis) Department of Clinical Therapeutics, Alexandra Hospital, School of Medical, National and Kapodistrian University of Athens, 80 Vas. Sofias Str., Athens, Greece (Masoura) Department of Cardiology, General Hospital of Athens "Laiko", Athens, Greece (Aznaouridis, Tsioufis) Department of Cardiology, "Hippokration" General Hospital of Athens, Athens, Greece (Androutsopoulou) Department of Cardiothoracic Surgery, University Hospital of Larissa, Larissa, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract The coexistence of cancer and severe aortic stenosis (AS) is increasing as a result of population aging and substantial improvements in cancer survival. Transcatheter aortic valve implantation (TAVI) has transformed the management of AS; however, patients with active malignancy or a history of cancer remain markedly under-represented in pivotal randomized trials. This under-representation has resulted in persistent uncertainty regarding patient selection, risk stratification, and the expected benefit of TAVI in this growing and clinically heterogeneous population. This review provides a comprehensive and contemporary synthesis of the evidence on TAVI in patients with cancer, integrating cardiovascular (CV), oncologic, and geriatric perspectives. Available data on epidemiological overlap, cancer-specific procedural challenges, and short- and long-term outcomes following TAVI are critically examined, with particular emphasis on distinctions between active cancer and cancer survivorship. Key modifiers of risk and benefit-including prior thoracic radiotherapy, competing thrombotic and bleeding risk, immunosuppression, frailty, sarcopenia, and nutritional status-are discussed in detail. Limitations of conventional surgical risk scores in oncology populations are highlighted, underscoring the need for individualized assessment beyond traditional CV metrics. Across registries and meta-analyses, TAVI is associated with high procedural success and comparable short-term outcomes in patients with and without cancer. Excess mortality observed during mid- and long-term follow-up is driven predominantly by non-CV causes related to malignancy rather than valve-related complications. Importantly, patients with cancer in remission demonstrate outcomes similar to those of non-cancer populations, whereas prognosis in active cancer is strongly influenced by disease stage, biology, and competing risks. Overall, cancer diagnosis alone should not preclude consideration of TAVI. Optimal management requires multidisciplinary, goal-oriented decision-making that integrates oncologic prognosis, functional status, and patients' priorities. As cancer survivorship continues to expand, prospective studies, integrated risk stratification tools, and closer alignment between cardio-oncology and structural heart programs are essential to guide evidence-based and equitable care. Copyright © 2026 by the authors. <15> Accession Number 650151426 Title Randomized trial of smartphone application and bed sensor for atrial fibrillation detection in high-risk patients. Source Scientific reports. 16(1) (pp 7088), 2026. Date of Publication: 03 Feb 2026. Author Lehto J.; Nuotio J.; Relander A.; Jaakkola J.; Lahdenoja O.; Vasankari T.; Anzanpour A.; Elnaggar I.; Rekola R.; Sandelin J.; Hurnanen T.; Airaksinen J.K.; Koivisto T.; Kiviniemi T.O. Institution (Lehto, Nuotio, Relander, Jaakkola, Vasankari, Airaksinen) Heart Center, Turku University Hospital and University of Turku, Turku, Finland (Lahdenoja, Anzanpour, Elnaggar, Rekola, Sandelin, Hurnanen, Koivisto) Department of Computing, University of Turku, Turku, Finland (Kiviniemi) Heart Center, Turku University Hospital and University of Turku, Turku, Finland (Kiviniemi) Heart Center, Turku University Hospital and University of Turku T-hospital, Hameentie 11, Turku, Finland Abstract This two-arm single-center exploratory randomized controlled trial evaluated the efficacy of prolonged rhythm monitoring in atrial fibrillation (AF) detection after an invasive cardiac procedure. Altogether 150 patients were enrolled. In the intervention group (IG), a bed sensor (EMFIT QS) and twice-daily smartphone recordings (CardioSignal app) were used, followed by a 12-lead ECG and a continuous three-to-seven-day ECG monitoring if alerts occurred. The control group (CG) received usual care. Overall, 78 patients were assigned to the IG and 72 to CG. During the three-month follow-up, AF was detected in 6/78 (7.7%) patients in the IG and in 0/72 (0.0%) in the CG (absolute risk difference 7.7%, 95% CI 1.8-13.6%, p = 0.029). After exclusion of patients who withdrew before the 3-month follow-up, 33/68 (48.5%) patients had alarms not leading to ECG-verified AF diagnosis, indicating that the current approach, in its present form, is not suitable for routine clinical implementation. Future studies should concentrate on minimizing alarms not leading to AF diagnosis when developing these novel non-ECG-based technologies. ClinicalTrials.gov Identifier: NCT05351775, 2022/04/28. <16> Accession Number 2046530817 Title Rectus sheath catheters versus thoracic epidural analgesia for pain management after open surgery: systematic review and meta-analysis. Source British Journal of Surgery. 113(6) (no pagination), 2026. Article Number: znag058. Date of Publication: 01 Jun 2026. Author Fankhauser C.D.; Breitenstein S.; Gelpke H.; Madjdpour C.; Meili G.; Sultan-Beyer L.; Wyss T.R.; Kaufmann E. Institution (Fankhauser) Division of Urology, Department of Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Fankhauser, Kaufmann) Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland (Fankhauser, Kaufmann) Clinic for Urology, University Teaching and Research Hospital of the University of Lucerne, Lucerne, Switzerland (Fankhauser, Breitenstein, Madjdpour) Faculty of Medicine, University of Zurich, Zurich, Switzerland (Breitenstein, Gelpke) Department of Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Madjdpour) Department of Anaesthesiology, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Meili, Sultan-Beyer) Department of Gynaecology and Obstetrics, Cantonal Hospital of Winterthur, Winterthur, Switzerland (Wyss) Department of Vascular Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Wyss) Department of Interventional Radiology and Vascular Surgery, Cantonal Hospital of Winterthur, Winterthur, Switzerland Publisher Oxford University Press Abstract Background: Thoracic epidural analgesia (TEA) remains the 'gold standard' for postoperative pain management after major open surgery, but is potentially associated with hypotension, urinary retention, and delayed recovery. Rectus sheath catheters (RSCs) offer a simple regional alternative that avoids sympathetic blockade while maintaining somatic analgesia. The aim of this review was to compare analgesic efficacy, complications, recovery, patient satisfaction, and costs between RSCs and TEA in open surgical procedures. Method(s): This systematic review was registered with PROSPERO, the international prospective register of systematic reviews (registration number: CRD420251234467). A systematic PubMed search was conducted to identify studies comparing continuous wound infusion via RSCs with TEA in adult patients undergoing open abdominal, pelvic, thoracic, or vascular surgery. RCTs, as well as prospective and retrospective comparative studies, were included. A meta-analysis was performed for randomized trials. Result(s): In total, 31 studies (21 prospective and 10 retrospective) involving 2162 patients were included. RSCs and TEA did not differ significantly with respect to postoperative pain (standardized mean difference -0.35 (95% c.i. -2.01 to 1.32)) or opioid consumption (standardized mean difference -0.32 (95% c.i. -1.71 to 1.07)). No differences were observed in recovery of bowel function, urinary retention, time to mobilization, or length of hospital stay. RSCs significantly reduced the risk of hypotension compared with TEA (risk ratio 0.40 (95% c.i. 0.26 to 0.60)) and were associated with lower costs with savings ranging from $500 to $6632 per case. Subgroup analyses suggested less urinary retention and earlier mobilization with RSCs in non-visceral surgery and non-laparotomy incisions. Conclusion(s): RSCs provide analgesia comparable to TEA with fewer complications, facilitating earlier recovery and potential cost savings. Considering the growing shift toward fast-track surgery, RSCs represent a pragmatic and resource-efficient alternative for postoperative pain management in open surgical procedures. 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. <17> Accession Number 649719945 Title Low-dose nicardipine during cardiopulmonary bypass improves carotid hemodynamics in CABG patients: a randomized controlled trial. Source Journal of cardiothoracic surgery. 20(1) (pp 468), 2025. Date of Publication: 24 Dec 2025. Author Zhu D.; Han Y.; Zhou X.; Wang Z.; Sun B.; Shi H.; Zhao Y. Institution (Zhu, Zhou, Wang, Sun) Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (Han) Department of Anesthesiology, Children's Hospital of Jiangnan University (Wuxi Children's Hospital), Wuxi, Jiangsu, China (Shi) Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China (Zhao) Department of Anesthesiology, Perioperative and Pain Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China Abstract BACKGROUND: Postoperative cognitive dysfunction (POCD) is a common complication of coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB), largely associated with cerebral hemodynamic disturbances. Carotid duplex ultrasonography-derived parameters, including peak systolic velocity (PSV-ICA) and end-diastolic velocity (EDV-ICA), provide reliable, noninvasive indicators of cerebral blood flow. This study evaluated whether intraoperative nicardipine infusion improves carotid blood flow and mitigates postoperative cognitive decline. METHOD(S): In this randomized, double-blind trial, 64 elderly patients undergoing CABG were assigned to receive either continuous low-dose nicardipine (0.2-0.5 microg/kg.min) during CPB (nicardipine group, n = 32) or saline (control group, n = 32). The co-primary endpoints were intraoperative PSV-ICA and EDV-ICA at four predefined time points (T1: pre-anesthesia; T2: surgery initiation; T3: during CPB; T4: post-CPB). Secondary endpoints included regional cerebral oxygen saturation (rScO2), plasma neuron-specific enolase (NSE), Mini-Mental State Examination (MMSE) scores, vasopressor use, ventilation time, ICU stay, and hospitalization length. RESULT(S): Baseline and intraoperative characteristics were comparable. Both groups showed reduced carotid flow velocities during CPB, but recovery of PSV-ICA at the end of CPB was significantly greater with nicardipine (63.7 +/- 15.2 vs. 54.3 +/- 13.9 cm/s; P = 0.025). EDV-ICA exhibited a similar trend without significant between-group differences. Secondary outcomes (MMSE, NSE) did not differ, and no adverse events occurred. CONCLUSION(S): Continuous low-dose nicardipine during CPB significantly improved the recovery of PSV-ICA without affecting systemic hemodynamics or increasing adverse events. These findings suggest a potential intraoperative neuroprotective role of nicardipine, warranting confirmation in larger trials with long-term cognitive outcomes. <18> [Use Link to view the full text] Accession Number 2046331203 Title Improved Early Outcomes With Off-Pump Coronary Artery Bypass Grafting in Patients With Left Ventricular Dysfunction: A Systematic Review and Meta-Analysis. Source Cardiology in Review. 34(4) (pp 341-346), 2026. Date of Publication: 01 Aug 2026. Author Abdul Qadeer M.; Khalid M.; Abdul Muqeet Farid A.; Fatima T.; Mariam Khalid F.; Ali S.I.; Mujtaba G.; Elahi N.; Kamal Siddiqi A.; Said S.M. Institution (Abdul Qadeer, Ali) From the Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan (Khalid) Department of Medicine, Karachi Medical and Dental College, Karachi, Pakistan (Abdul Muqeet Farid, Kamal Siddiqi) Department of Medicine, Ziauddin Medical University, Karachi, Pakistan (Fatima, Mujtaba, Elahi) Department of Internal Medicine, Dow University of Health Sciences, Karachi, Pakistan (Mariam Khalid) Department of Emergency Medicine, Jinnah Medical and Dental College, Karachi, Pakistan (Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Maria Fareri Children's Hospital, Valhalla, NY, United States (Said) Department of Surgery, Westchester Medical Center, Valhalla, NY, United States (Said) Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt Publisher Lippincott Williams and Wilkins Abstract The ongoing debate surrounding coronary artery bypass grafting (CABG) with or without cardiopulmonary bypass persists, particularly in individuals with left ventricular dysfunction. The objective of this study was to evaluate the safety and efficacy of these 2 strategies through a comprehensive meta-analysis of existing studies. A systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Central Registry was conducted from inception to July 2023. The primary focus was on studies comparing on-pump versus off-pump CABG as the primary treatment for multivessel coronary artery disease in patients with left ventricular dysfunction (ejection fraction <=40%), with mortality as the primary outcome. The meta-analysis included 26 studies with a total of 35, 863 patients. The results revealed a significant reduction in mortality risk [risk ratio (RR), 0.75; 95% confidence interval (CI), 0.60-0.93; P = 0.009] and other perioperative morbidities associated with off-pump CABG. These included stroke (RR, 0.67; 95% CI, 0.54-0.82; P = 0.0002), myocardial infarction (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), pulmonary complications (RR, 0.71; 95% CI, 0.55-0.92; P = 0.010), postoperative transfusion (RR, 0.70; 95% CI, 0.55-0.88; P = 0.002), neurological dysfunction (RR, 0.80; 95% CI, 0.64-1.00; P = 0.05), infection (RR, 0.74; 95% CI, 0.56-0.97; P = 0.03), renal failure (RR, 0.79; 95% CI, 0.67-0.95; P = 0.010), and reoperation for bleeding (RR, 0.66; 95% CI, 0.52-0.84; P = 0.0006). However, no significant difference was observed between the 2 groups regarding postoperative atrial fibrillation (RR, 0.97; 95% CI, 0.84-1.12; P = 0.69). In conclusion, off-pump CABG demonstrates a lower perioperative mortality risk and improved overall early outcomes compared with on-pump techniques in individuals with reduced left ventricular function. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. <19> Accession Number 2045599801 Title The clinical use of cryoprecipitate and fibrinogen concentrate: A scoping review. Source Transfusion. 66(7) (pp 1424-1437), 2026. Date of Publication: 01 Jul 2026. Author Hess A.S.; White S.K.; Crowe E.P.; Raval J.S.; Andrews J.; Cohn C.S.; Covington M.L.; Cushing M.M.; Jacquot C.; Khan J.; Panigrahi A.K.; Saifee N.H.; Tobian A.A.R.; McFarland M.M.; Stanworth S.J.; Metcalf R.A. Institution (Hess) New Zealand Blood Service, Christchurch, New Zealand (White, Metcalf) Department of Pathology, University of Utah, Salt Lake City, UT, United States (Crowe, Tobian) Department of Pathology, Johns Hopkins University, Baltimore, MD, United States (Raval) Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, United States (Andrews) Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, United States (Andrews) Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States (Cohn) Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States (Covington) Department of Pathology, Mass General Brigham, Harvard University, Boston, MA, United States (Cushing) Department of Pathology, Weill Cornell Medicine, Cornell University, New York, NY, United States (Jacquot) Department of Pathology and Laboratory Medicine, Children's National Hospital, Washington, DC, United States (Khan) Department of Pathology, University of Virginia, Charlottesville, VA, United States (Panigrahi) Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, CA, United States (Panigrahi) Department of Pathology, Stanford University, Stanford, CA, United States (Saifee) Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, United States (Saifee) Department of Laboratory Medicine and Pathology, Seattle Children's Hospital, Seattle, WA, United States (McFarland) University of Utah, Spencer S. Eccles Health Sciences Library, Salt Lake City, UT, United States (Stanworth) John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Stanworth) NHS Blood and Transplant, Oxford, United Kingdom (Metcalf) ARUP Laboratories, Salt Lake City, UT, United States Publisher John Wiley and Sons Inc Abstract Background: Acquired hypofibrinogenemia poses significant bleeding risks. Concentrated sources of fibrinogen, whether cryoprecipitate or fibrinogen concentrates, are widely used. This scoping review aimed to identify and map the available evidence on fibrinogen supplementation. Study Design and Methods: We used the JBI Manual and PRISMA-ScR guidelines. We included patients of all ages treated with fibrinogen supplementation. The concept was treatment with cryoprecipitate or fibrinogen concentrate (prophylactically or therapeutically); and context was any clinical setting worldwide. Eligible studies included randomized trials and observational studies with comparator arms. Comprehensive searches of three databases were performed on February 21, 2025. Primary studies meeting inclusion criteria were selected. UpSet data visualizations displayed studies with intersecting sets of characteristics. Result(s): From 8181 references screened, 134 met inclusion criteria, of which 61 were randomized trials and 16 propensity-matched observational cohort studies. The highest proportion of trials focused on cardiovascular surgery (28/61; 46%) then trauma (12/61; 20%) populations and mainly assessed use of fibrinogen therapeutically (34/61; 56%). More trials evaluated fibrinogen concentrate (53/61; 87%) compared to cryoprecipitate (8/61; 13%). Commonly reported outcomes included bleeding, transfusion needs, or mortality. Studies inconsistently reported dosing, timing, and definitions of hypofibrinogenemia. Studies evaluating certain key populations-including obstetrics and pediatrics-were limited. All but one propensity-matched study was in either cardiovascular surgery or trauma. Discussion(s): There is a growing body of literature informing use of fibrinogen supplementation, particularly in cardiovascular surgery and trauma populations. Meta-analyses appear feasible to inform evidence-based guideline development; however, variability in dosing, timing, and definitions highlights the need for more harmonized research. Copyright © 2026 The Author(s). Transfusion published by Wiley Periodicals LLC on behalf of AABB. <20> Accession Number 2046531787 Title Left Atrial Appendage Closure vs. Oral Anticoagulation in Patients With Atrial Fibrillation: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Journal of Arrhythmia. 42(3) (no pagination), 2026. Article Number: e70382. Date of Publication: 01 Jun 2026. Author Chilaka C.; Khan H.D.; Sarfraz M.U.; Farooq Z.; Hassan E.; Sabir R.; Siddique S.; Zahid N.; Rehman M.U.; Salih M.; Umer M.; Alsubari A.M.A.; Ehsan M. Institution (Chilaka) Lagos State University, Nigeria (Khan) Rashid Latif Medical College, Lahore, Pakistan (Sarfraz, Umer, Ehsan) King Edward Medical University, Lahore, Pakistan (Farooq) Punjab Rangers Teaching Hospital, Lahore, Pakistan (Hassan, Sabir) Allama Iqbal Medical College, Lahore, Pakistan (Siddique) Jinnah Postgraduate Medical Center, Karachi, Pakistan (Zahid) National Hospital and Medical Center, Lahore, Pakistan (Rehman) Khyber Teaching Hospital, Peshawar, Pakistan (Salih) Dow University Hospital, Karachi, Pakistan (Alsubari) Faculty of Medicine, Sana'a University, Sana'a, Yemen Publisher John Wiley and Sons Inc Abstract Background: While oral anticoagulants (OACs) remain the cornerstone of stroke prevention, left atrial appendage closure (LAAC) is a potential alternative, particularly for patients with high bleeding risk or contraindications to long-term anticoagulation. Method(s): Multiple databases were searched to identify relevant randomized controlled trials (RCTs), and four trials were shortlisted. Study selection, data extraction, and quality assessment were performed independently by two reviewers. Outcomes assessed included stroke (all, ischemic, hemorrhagic), systemic embolism, major bleeding, non-procedure-related bleeding, and mortality. Risk of bias was evaluated using Rob 2.0, and meta-analyses were conducted using RevMan software. Dichotomous outcomes were reported as risk ratios (RR) while continuous outcomes were reported as mean differences (MD), with 95% confidence intervals (CIs). Result(s): A total of 3116 participants were analyzed across outcomes. LAAC significantly reduced non-procedure-related bleeding (RR: 0.48, 95% CI: 0.37-0.61; p < 0.00001) and all-cause mortality (RR: 0.74, 95% CI: 0.55-0.99; p = 0.04). A marginal reduction was observed in the composite outcome of stroke, systemic embolism, or death (RR: 0.77, 95% CI: 0.59-1.00; p = 0.05). No significant differences were found for major bleeding (RR: 0.82, 95% CI: 0.56-1.22), all strokes (RR: 0.84, 95% CI: 0.56-1.25), ischemic stroke (RR: 1.15, 95% CI: 0.72-1.85), hemorrhagic stroke (RR: 0.46, 95% CI: 0.11-2.02), systemic embolism (RR: 1.52, 95% CI: 0.36-6.41), or cardiovascular/unexplained death (RR: 0.60, 95% CI: 0.29-1.23). Conclusion(s): LAAC offers a viable alternative to standard anticoagulation in selected AF patients with comparable efficacy and a particular benefit in reducing non-procedure-related bleeding and mortality advantages. Copyright © 2026 The Author(s). Journal of Arrhythmia published by John Wiley & Sons Australia, Ltd on behalf of Japanese Heart Rhythm Society. <21> Accession Number 2046112225 Title Video double-lumen endotracheal tube reduces hypoxemia during one-lung ventilation in thoracoscopic surgery: a prospective randomized controlled trial. Source Journal of Thoracic Disease. 18(5) (no pagination), 2026. Article Number: 506. Date of Publication: 31 May 2026. Author Long S.; Li Y.; Zheng X.; Ye F.; Li J.; Yu Y.; Guo J.; Huang W.; Wang Z.; Hu R. Institution (Long, Li, Zheng, Ye, Li, Yu, Guo, Huang, Wang, Hu) Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China Publisher AME Publishing Company Abstract Background: Compared to the conventional double-lumen endotracheal tube (c-DLT), the video double-lumen endotracheal tube (v-DLT) demonstrates a shorter intubation time and the capability of observing and adjusting malposition at any time. Our objective was to compare the incidence of hypoxemia during one-lung ventilation (OLV) and perioperative complications between the two tube types. Method(s): This single-center, prospective, randomized controlled trial enrolled 100 patients undergoing video-assisted thoracic surgery (VATS), who were randomized to receive either a v-DLT or a c-DLT. The primary outcome was the incidence of hypoxemia [defined as a peripheral oxygen saturation (SpO<inf>2</inf>) below 90%] during OLV. A predefined rescue protocol was initiated if SpO<inf>2</inf> fell below 95%. Secondary outcomes included the number of hypoxemia-triggered interventions during OLV, postoperative complications, and anesthesiologist satisfaction. Result(s): The incidence of hypoxemia during OLV was significantly lower in the v-DLT group compared to the c-DLT group [3/48 (6.3%) vs. 13/47 (27.7%), P=0.006]. The v-DLT group also required fewer rescue interventions for SpO<inf>2</inf> <95% (35.4% vs. 66.0%, P=0.006) and less frequent fiberoptic bronchoscopy (FOB) use (P<0.001). Anesthesiologists reported higher satisfaction, reduced workload, and shorter intubation time with v-DLT (all P<0.001). There were no significant differences in postoperative complications between the two groups. Conclusion(s): The use of v-DLT significantly reduces the incidence of hypoxemia during OLV, decreases the need for rescue interventions and FOB. Simultaneously, it improves procedural efficiency and enhances anesthesiologist satisfaction. Copyright © AME Publishing Company. <22> Accession Number 2047020515 Title Varenicline and Ventricular Ectopy After Myocardial Infarction. Source Journal of the American College of Cardiology. 88(2) (pp 170-184), 2026. Date of Publication: 14 Jul 2026. Author Shen Y.; Zeng C.; Wang D.W.; Han W.; Cheng X.; Hu X.; Xie D.; Liu Y.; Liang D.; Duan R.; Yang B.; Zhang Q.; Li H.; Zhang B.; Sun G.; Ouyang N.; Guo X.; Zhang S.; Zhou B.; Zheng L.; Liu S.; Xiong K.; Wang G.; Zou Q.; Shao B.; Chen Z.; Wang K.; Wang X.; Han F.; Wu Y.; Li Z.; Sun Y.; Chen Y.-H. Institution (Shen, Han, Xie, Liu, Liang, Duan, Yang, Zhang, Li, Zhang, Zheng, Liu, Xiong, Wang, Zou, Shao, Chen, Wu, Chen) State Key Laboratory of Cardiovascular Diseases, Department of Cardiology, Shanghai Arrhythmia Research Center, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China (Guo, Wang, Wang, Han) Department of Cardiology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China (Zeng, Zhou) Key Laboratory of Geriatric Cardiovascular and Cerebrovascular Disease Research, Ministry of Education of China, Department of Cardiology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing, China (Wang, Li) Division of Cardiology, Department of Internal Medicine, Tongji Hospital and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Huazhong University of Science and Technology, Wuhan, China (Cheng) Department of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Hu) Department of Cardiology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China (Sun, Ouyang, Guo, Zhang, Sun) Department of Cardiology, The First Hospital of China Medical University, Shenyang, China Publisher Elsevier Inc. Abstract Background: Conventional antiarrhythmic drugs that target cardiac ion channels carry proarrhythmic risks, highlighting the need for alternative therapeutic approaches. Cardiac nicotinic acetylcholine receptors (nAChRs) represent a novel electrophysiological target. Objective(s): The aim of this exploratory, proof-of-concept phase 2 trial was to evaluate the effect of varenicline, a partial nAChR agonist, on frequent premature ventricular complexes (PVCs) after myocardial infarction (MI) and to assess its short-term safety and biological target engagement. Method(s): In this multicenter, randomized, double-blind, placebo-controlled trial, adults with frequent PVCs (>=1,000/24 h) assessed using 72-hour ambulatory electrocardiographic monitoring at >=4 weeks post-MI were randomly assigned (1:1) to varenicline 0.5 mg twice daily or matching placebo for 45 days, in addition to guideline-directed medical therapy. The primary endpoint was the percentage change in 24-hour PVC count from baseline to week 6. Key secondary endpoints included responder rate (>=50% reduction in PVC count) and the incidence of nonsustained ventricular tachycardia (VT). Result(s): Among 118 randomized patients, varenicline produced a 60.1 percentage point greater reduction in PVC burden compared with placebo (95% CI: 21.3-98.8 percentage points; P = 0.001). The responder rate was higher with varenicline (67.8% vs 30.5%; RR: 2.22; 95% CI: 1.46-3.39; P < 0.0001), and nonsustained VT incidence was lower (20.3% vs 37.3%; RR: 0.49; 95% CI: 0.29-0.85; P = 0.007). No deaths or malignant ventricular arrhythmias occurred in the varenicline group, with comparable adverse event rates between groups. Conclusion(s): In this phase 2 trial, varenicline significantly reduced PVC burden and nonsustained VT incidence in post-MI patients without evidence of a proarrhythmic effects. These findings support cardiac nAChRs as a potential antiarrhythmic target and justify further evaluation in larger outcome-driven trials. (Efficacy of Varenicline Tartrate in Treating Frequent Premature Ventricular Contractions: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial [Var-PVC]; NCT06780215) 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/ <23> Accession Number 2047422392 Title Virtual reality for opioid reduction in postoperative cardiac and thoracic surgery: A randomized controlled trial protocol. Source MethodsX. 17 (no pagination), 2026. Article Number: 104029. Date of Publication: 01 Dec 2026. Author de Araujo D.D.; Zeferino S.P.; Galas F.R.B.G. Institution (de Araujo, Zeferino, Galas) Department of Surgery, Anesthesiology, Surgical Sciences and Perioperative Medicine Program (ACCEPT), Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, Brazil (de Araujo, Zeferino, Galas) Heart Institute (InCor), Hospital das Clinicas HCFMUSP, Sao Paulo, Brazil Publisher Elsevier B.V. Abstract This protocol describes a randomized controlled trial designed to evaluate the efficacy of Virtual Reality (VR) as a non-pharmacological intervention for pain management in the immediate postoperative period of cardiac and thoracic surgeries. Postoperative pain in these major procedures is often intense and historically managed with high doses of opioids, which are associated with significant side effects and potential dependence. By leveraging the "limited capacity theory of attention," this study uses immersive and passive VR environments to compete with painful stimuli for cognitive resources, thereby aiming to reduce total opioid consumption.* This protocol establishes a standardized three-arm methodology to compare active VR immersion, passive VR contemplation, and conventional multimodal analgesia in a high-complexity surgical setting.* It provides a detailed framework for integrating digital distraction technology into intensive care unit (ICU) routines, including a rigorous equipment hygiene protocol to ensure patient safety.* The study focuses on a specific younger demographic (16-40 years) to evaluate the impact of VR on recovery outcomes, opioid sparing, and patient satisfaction. Copyright © 2026 Published by Elsevier B.V. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <24> Accession Number 2046626562 Title Inequalities in Access to and Outcomes of Cardiac Surgery Among Patients with Mental Health Disorders. Source Medical sciences. 14(2) (no pagination), 2026. Article Number: 277. Date of Publication: 01 Jun 2026. Author Leivaditis V.; Mitsos S.; Mulita F.; Maniatopoulos A.; Baikoussis N.G.; Shaska E.; Andrikopoulou C.; Liolis E.; Skoura T.; Antzoulas A.; Boucharas I.; Sepetis A.; Tomos P.; Dahm M. Institution (Leivaditis, Dahm) Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany (Mitsos, Tomos) Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Mulita, Andrikopoulou, Boucharas) Department of General Surgery, General Hospital of Eastern Achaia-Unit of Aigio, Aigio, Greece (Maniatopoulos) Department of Electrical and Computer Engineering, Democritus University of Thrace, Xanthi, Greece (Baikoussis) Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Athens, Greece (Shaska) Department of Psychiatry, "Ali Mihali" Psychiatric Hospital, Vlora, Albania (Liolis) Department of Oncology, General University Hospital of Patras, Patras, Greece (Skoura) Medical School, National and Kapodistrian University of Athens, NKUA, Aretaeion Hospital, Athens, Greece (Antzoulas) Department of Surgery, General University Hospital of Patras, Patras, Greece (Sepetis) Postgraduate Health and Social Care Management Program, Department of Business Administration, University of West Attica, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Cardiovascular disease remains the leading global cause of morbidity and mortality. Mental health disorders are common comorbidities that significantly influence how patients access and navigate specialist care. Increasingly, mental illness is recognized not merely as a comorbidity but as a potential driver of inequities in cardiovascular care, affecting diagnosis, referral, procedural management, and long-term secondary prevention. These concerns are particularly relevant in cardiac surgery, where care pathways are complex and resource-intensive. Aims and Objectives: This narrative review examines recent evidence on inequalities in access to cardiac surgery and postoperative outcomes among patients with mental health disorders. Particular emphasis is placed on severe mental illness, mood disorders, anxiety-related conditions, and mixed psychiatric cohorts. Material(s) and Method(s): A structured narrative review approach was employed. PubMed and ScienceDirect were systematically searched for peer-reviewed studies published between 2020 and 2025, including cohort studies, registry analyses, systematic reviews, and meta-analyses. The evidence was synthesized thematically, focusing on access to care, perioperative management, clinical outcomes, underlying mechanisms, ethical considerations, policy implications, and future research directions. Result(s): Evidence suggests that patients with mental health disorders are more likely to undergo cardiac surgery via emergency pathways, experience longer hospital stays, and have higher rates of readmission. Individuals with severe mental illness are less likely to receive invasive coronary procedures compared to the general population and exhibit higher short- and long-term mortality following acute coronary syndromes. Among psychiatric subgroups, psychosis-spectrum disorders appear to be associated with the greatest excess risk of morbidity, mortality, and adverse long-term surgical outcomes. Conclusion(s): Patients with mental health disorders face inequities across the entire surgical pathway, including preoperative, perioperative, and postoperative phases. Key contributing factors include stigma, diagnostic overshadowing, fragmented healthcare systems, socioeconomic disadvantage, and insufficiently developed models of integrated care. Addressing these disparities requires redesigned referral pathways, strengthened multidisciplinary collaboration (including cardiology, cardiac surgery, psychiatry, and primary care), and a shift toward interventional research aimed at reducing inequities rather than solely documenting them. Copyright © 2026 by the authors. <25> Accession Number 2043717355 Title Consensus Document on the Multidisciplinary Management of Advanced-Stage Respiratory Diseases. Source Archivos de Bronconeumologia. 62(7) (pp 481-498), 2026. Date of Publication: 01 Jul 2026. Author de Miguel-Diez J.; Castillo-Padros M.; Figueira-Goncalves J.M.; Torres-Castro R.; Gainza-Miranda D.; Golpe R.; Cuervo-Pinna M.A.; Perez-Rojo R.; Gonzalez-Barboteo J.; Callejas-Gonzalez F.J.; Calvo-Espinos C.; Rio-Ramirez M.T.; Olalla-Gallo M.A.; Salinas-Lasa M.B.; Salcedo-Peris T. Institution (de Miguel-Diez) Servicio de Neumologia, Hospital General Universitario Gregorio Maranon, Instituto de Investigacion Sanitaria Gregorio Maranon (IiSGM), Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain (Castillo-Padros) Unidad de Cuidados Paliativos, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Figueira-Goncalves) Servicio de Neumologia, Complejo Hospitalario Universitario Nuestra Senora de Candelaria, Tenerife, Spain (Torres-Castro) Departamento de Kinesiologia, Facultad de Medicina, Universidad de Chile, Santiago, Chile (Gainza-Miranda) Unidad de Cuidados Paliativos, Hospital Universitario Principe de Asturias, Madrid, Spain (Golpe) Servicio de Neumologia, Hospital Universitario Lucus Augusti, Lugo, Spain (Cuervo-Pinna) Equipo de Cuidados Paliativos, Hospital Universitario de Badajoz, Badajoz, Spain (Perez-Rojo) Servicio de Neumologia, Hospital Universitario 12 de Octubre, Madrid, Spain (Gonzalez-Barboteo) Servicio de Cuidados Paliativos, Grupo de Investigacion y Conocimiento en Cuidados Paliativos (GRICOPAL), Instituto Catalan de Oncologia-L'Hospitalet, Barcelona, Spain (Callejas-Gonzalez) Servicio de Neumologia, Complejo Hospitalario Universitario de Albacete, Albacete, Spain (Calvo-Espinos) Unidad de Cuidados Paliativos, Fundacion Rioja Salud, La Rioja, Spain (Rio-Ramirez) Servicio de Neumologia, Hospital Universitario de Getafe, Universidad Europea de Madrid, Madrid, Spain (Olalla-Gallo) Equipo de Soporte de Atencion Domiciliaria, Gerencia de Atencion Primaria de Burgos, SACYL, Burgos, Spain (Salinas-Lasa) Servicio de Neumologia, Hospital Universitario Galdakao-Usansolo, Galdakao, Spain (Salcedo-Peris) Unidad de Cuidados Paliativos, Hospital General Universitario Ciudad Real, Ciudad Real, Spain Publisher Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) Abstract Advanced respiratory diseases, particularly chronic obstructive pulmonary disease (COPD) and interstitial lung diseases (ILD), constitute an increasing challenge for healthcare systems due to their high prevalence, substantial symptom burden, and significant resource use. This consensus document, developed jointly by the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Palliative Care (SECPAL), provides recommendations for a multidisciplinary, integrated model of care. Using the SIGN methodology and a systematic literature review, a multidisciplinary panel developed 70 evidence-based recommendations addressing key domains: identification of patients with palliative care needs; management of respiratory symptoms; strategies to improve quality of life; communication and shared decision-making; caregiver support; and coordination across care settings. A needs-based approach, rather than reliance on prognosis alone, is recommended to facilitate earlier recognition of patients with advanced COPD and ILD and to enable the timely integration of palliative care alongside disease-directed therapies. Adoption of these recommendations is expected to improve quality of life, reduce symptom burden and suffering, and optimize care for patients with advanced respiratory diseases. Copyright © 2026 SEPAR <26> Accession Number 2043371464 Title Ticagrelor-Based antiplatelet therapy versus aspirin alone after coronary artery bypass grafting: A systematic review and Meta-Analysis with trial sequential analysis. Source Journal of Thrombosis and Thrombolysis. 59(4) (pp 876-887), 2026. Date of Publication: 01 Apr 2026. Author Bacha Z.; Khalid A.A.; Sikandar M.; Siddique K.; Rashid A.Z.; Shah Z.A.; Qazi K.; Javed J.; Khan N.A. Institution (Bacha, Sikandar, Shah, Khan) Department of Medicine, Khyber Medical College, Peshawar, Pakistan (Khalid) Department of Medicine, Peshawar Medical College, Peshawar, Pakistan (Siddique) Department of Medicine, Nishtar Medical University, Multan, Pakistan (Rashid) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan (Qazi, Javed) Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan Publisher Springer Abstract Introduction: Coronary artery bypass grafting (CABG) is a common surgical treatment for coronary artery disease; however, long-term success is limited by saphenous vein graft (SVG) occlusion. Aspirin remains the standard lifelong antiplatelet therapy; however, graft failure and adverse events persist after its use. More potent agents, such as ticagrelor, have been proposed, although the evidence is inconsistent, and concerns about bleeding risk remain. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing ticagrelor-based therapy with aspirin monotherapy in patients who underwent CABG. A comprehensive literature search of major databases was performed until August 2025. The primary endpoints were major bleeding, MACE, and all-cause mortality. The secondary outcomes included saphenous vein graft failure, stroke, myocardial infarction, and repeat revascularization. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random-effects model. Five randomized controlled trials comprising 4,208 patients (ticagrelor-based therapy = 2,108; aspirin monotherapy = 2,100) were included. Across the primary clinical endpoints, ticagrelor-based therapy showed no significant advantage over aspirin, with comparable rates of MACE (RR 1.05, 95% CI 0.78-1.41; p = 0.75; I2 = 20%), all-cause mortality (RR 1.02, 95% CI 0.74-1.40; p = 0.93; I2 = 0%), and major bleeding (RR 1.09, 95% CI 0.68-1.74; p = 0.73; I2 = 51%). Similarly, no significant differences were observed for stroke (RR 1.10, 95% CI 0.70-1.75; p = 0.67; I2 = 0%), myocardial infarction (RR 1.52, 95% CI 0.94-2.46; p = 0.09; I2 = 27%), or repeat revascularization (RR 1.02, 95% CI 0.71-1.45; p = 0.93; I2 = 7%). In contrast to the neutral clinical outcomes, ticagrelor-based therapy was associated with a significant reduction in saphenous vein graft (SVG) failure compared with aspirin monotherapy (RR 0.62, 95% CI 0.50-0.78; p < 0.0001; I2 = 0%). Subgroup analysis revealed no meaningful differences between ticagrelor monotherapy and ticagrelor plus aspirin for major clinical events. Ticagrelor-based therapy did not reduce major clinical outcomes (MACE, mortality, MI, stroke, revascularization, or major bleeding) compared with aspirin after CABG, although it was associated with improved SVG patency. Routine use cannot be recommended; ticagrelor may be considered in selected high-risk patients. Further large, long-term trials are needed to determine whether patency benefits translate into improved clinical outcomes. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <27> Accession Number 2042873561 Title Sex-based differences in outcomes between male and female patients with bicuspid aortic stenosis following transcatheter aortic valve replacement: A meta-analysis. Source Precision Medical Sciences. 15(2) (pp 70-79), 2026. Date of Publication: 01 Jun 2026. Author Khan M.H.A.; Khawar M.; Farooq A.U.; Khalid A.; Ahsan S.M.; Awan M.H.N.; Nisar M.S.; Elahi A.; Faizan M.A.; Shahid I.; Ahmed A.M.; Haider F.; Chhetri R. Institution (Khan, Ahsan, Elahi) Department of Medicine, Harlingen Medical Center, Harlingen, TX, United States (Khawar, Farooq, Awan, Nisar, Shahid, Ahmed) Department of Medicine, King Edward Medical University, Punjab, Lahore, Pakistan (Khalid) Department of Medicine, Rawalpindi Medical University, Punjab, Rawalpindi, Pakistan (Faizan) Gomal Medical College, Khyber Medical University, Khyber Pakhtunkhwa, Peshawar, Pakistan (Haider) Department of Medicine, Allama Iqbal Medical College, Punjab, Lahore, Pakistan (Chhetri) Department of Medicine, Nepalgunj Medical College, Kohalpur, Nepal Publisher John Wiley and Sons Inc Abstract Bicuspid aortic valve (BAV) is a common congenital anomaly leading to early aortic stenosis. Although transcatheter aortic valve replacement (TAVR) offers a less invasive treatment for BAV stenosis, sex-specific outcome data are scarce. This study evaluates clinical outcomes after TAVR by sex in BAV patients. A systematic literature search was performed across PubMed, ClinicalTrials.gov, and Cochrane CENTRAL to identify relevant English-language randomized controlled trials and observational studies. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed- or random-effects models based on heterogeneity. Statistical significance was set at p <.05, and heterogeneity was assessed using the I2 statistic. Analyses were performed with Review Manager Version 5.3. Four observational studies comprising 7585 patients met inclusion criteria. Males had a higher incidence of acute kidney injury (AKI) (RR = 1.33; 95% CI: 1.13-1.57; p =.0008) and acute myocardial infarction (MI) (RR = 2.18; 95% CI: 1.54-3.07; p =.00001), but a lower risk of in-hospital mortality (RR = 0.71; 95% CI: 0.51-0.99; p =.04), stroke (RR = 0.70; 95% CI: 0.50-0.95; p =.02), and bleeding (RR = 0.79; 95% CI: 0.63-0.98; p =.03) compared to females. No statistically significant differences were observed in one-year mortality (RR = 1.08; 95% CI: 0.58-2.03; p =.81), 30-day mortality (RR = 1.18; 95% CI: 0.51-2.75; p =.69), or arrhythmia (RR = 0.83; 95% CI: 0.52-1.33; p =.45). Males had increased risks of AKI and MI, while females experienced higher in-hospital mortality, stroke, and bleeding. These findings, derived from a limited number of retrospective observational studies, are hypothesis-generating and highlight the need for sex-specific risk stratification and further prospective research to confirm these patterns and guide clinical practice. Copyright © 2026 The Author(s). Precision Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Nanjing Medical University Affiliated Cancer Hospital & Jiangsu Cancer Hospital. <28> Accession Number 2043351710 Title Intravenous Bolus Fluid Therapy Versus No Fluid Therapy Prior to Pericardiocentesis in Dogs: A Randomized Controlled Trial in 30 Dogs. Source Journal of Veterinary Emergency and Critical Care. 36(3) (pp 298-307), 2026. Date of Publication: 01 May 2026. Author Jones N.; Humm K.; Tinson E.W. Institution (Jones, Humm, Tinson) Veterinary Clinical Science and Services, The Royal Veterinary College, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Objective: To determine the cardiovascular and respiratory effects of bolus IV isotonic crystalloid fluid therapy before pericardiocentesis in dogs with pericardial effusion. Design(s): Prospective, randomized, nonblinded clinical trial (January 2021 to November 2022). Setting(s): University teaching hospital. Animals: Thirty dogs diagnosed with pericardial effusion. Intervention(s): Dogs were randomized to receive a 10-mL/kg IV bolus of compound sodium lactate (IV fluid bolus [IVFB] group) or no fluid bolus (no-IVFB group) over 10 min before pericardiocentesis. Measurements and Main Results: Cardiovascular parameters, respiratory rate, peripheral blood lactate concentration, and point-of-care ultrasound (POCUS) findings were assessed. Shock index (SI) was calculated as heart rate divided by systolic blood pressure. Measurements were recorded at four time points (T): baseline (T0), 15 min later (T1, after fluid bolus for the IVFB group), immediately after pericardiocentesis (T2), and 4 h after pericardiocentesis (T3). Significant decreases in SI were observed in the no-IVFB group between T1 and T2 and between T1 and T3, and in the IVFB group between T1 and T3 (p = 0.034, p = 0.003, and p = 0.027, respectively). No differences in SI were found between the groups when compared at the same time point. Administration of an IVFB did not result in adverse respiratory effects, as no dogs required supplemental oxygen by T3, and there were no differences in respiratory rate. The no-IVFB group had a higher incidence of new B-lines compared with the IVFB group (60% vs. 20%), but the median B-line score was <=1 at all POCUS sites at T0 and T3. Twenty-four dogs survived to hospital discharge with no difference in survival between groups. Conclusion(s): Administering an IVFB of 10 mL/kg isotonic crystalloid before pericardiocentesis in dogs with pericardial effusion did not alter SI. This dose appears to be safe, with no adverse respiratory effects seen. However, the current study was underpowered to detect a significant difference, and further studies are needed. Copyright © 2026 Veterinary Emergency and Critical Care Society. <29> Accession Number 2041192686 Title Modern anticoagulation strategies in cardiovascular surgery: nonvitamin K antagonist oral anticoagulants versus warfarin after aortic bioprosthetic valve replacement. Source Journal of Thrombosis and Thrombolysis. 59(4) (pp 902-916), 2026. Date of Publication: 01 Apr 2026. Author Chaudhri M.; Mahrizi A.D.A.; Nadeem S.A.; Canal A.; Rajendran P.; Rapelli V.R.; Gill H.; Haroon B.; Shahzad A.; Acquah F.; Kaunzinger C.; Albert C.; Raza M.R. Institution (Chaudhri, Acquah, Kaunzinger, Raza) Hackensack Meridian Ocean University Medical Center, Brick Township, NJ, United States (Mahrizi, Haroon) Faculty of Medicine and Surgery, University of Malta, Msida, Malta (Nadeem) Drexel University, Philadelphia, PA, United States (Canal, Rapelli, Gill) Rowan-Virtua School of Osteopathic Medicine, Stratford, NJ, United States (Rajendran) Hackensack Meridian School of Medicine, Hackensack, NJ, United States (Shahzad) Saint Barnabas Hospital, Bronx, NY, United States (Albert) Robert Wood Johnson University Hospital, New Brunswick, NJ, United States (Chaudhri) Department of Medicine, Hackensack Meridian Ocean University Medical Center, Brick, NJ, United States Publisher Springer Abstract The optimal postaortic valve replacement (AVR) anticoagulation strategy remains poorly defined, particularly when comparing nonvitamin K antagonist oral anticoagulants (NOACs) versus warfarin. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of NOACs compared with warfarin in these patients. Our study was registered on PROSPERO (ID CRD420251028998). A search of the PubMed, EMBASE, and Cochrane databases was conducted on April 9, 2025, for studies published between 2015 and 2025 that compared NOACs to warfarin after aortic bioprosthetic valve replacement. Inclusion criteria included randomized controlled trials (RCTs) and observational studies reporting thromboembolic events, major bleeding, and mortality with at least 6 months of follow-up. Studies on mechanical valves, case reports, and publications that could not be translated into English were excluded. Data extraction was conducted based on study design, patient demographics, clinical outcomes, and effect sizes, expressed as hazard ratios (HRs) with 95% confidence intervals (CIs) using a random effects model. Risk of bias was assessed using the ROBINS-I tool. Seventeen studies (n = 93,510 participants) were included. NOACs were associated with an HR of 0.91 for thromboembolic events (95% CI: 0.76-1.09) and a pooled HR of 1.22 for major bleeding (95% CI: 0.88-1.68). Several studies have suggested a trend toward lower all-cause mortality and major bleeding with NOACs, particularly in patients with lower bleeding risk. In patients undergoing aortic bioprosthetic valve replacement, NOACs show similar efficacy and safety to warfarin for preventing thromboembolic events and major bleeding. However, anticoagulation decisions should be individualized, and larger RCTs are needed to determine the optimal approach. Copyright © The Author(s) 2025. <30> Accession Number 2046895961 Title Robotic versus traditional coronary artery bypass grafting (CABG): A dual-phase meta-analysis comparing human and AI-derived evidence. Source American Journal of Surgery. 260 (no pagination), 2026. Article Number: 117072. Date of Publication: 01 Oct 2026. Author Georginian N.; Wijeewera C.; Tran H.T.; Wilson H.; Carney T.; Wilson M.K.; Preda V.A. Institution (Georginian, Wilson, Preda) Macquarie University Hospital, 2 Technology Place Macquarie Park, Sydney, Australia (Wilson, Carney, Wilson) SurgicalXR, Suite 203, 2 Technology Place Macquarie Park, Sydney, NSW, Australia (Wijeewera) Bairnsdale Regional Health Service, East Gippsland, Victoria, NSW, Australia (Tran) Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia (Preda) Faculty of Medicine Health and Human Sciences, Macquarie University, Suite 407, 2 Technology Place, Sydney, NSW, Australia Publisher Elsevier Inc. Abstract Background: Robotic-assisted coronary artery bypass grafting (CABG) is gaining attention as a viable alternative to traditional CABG with reported benefits secondary to reduced invasiveness of procedure. Despite this, advantages, the impact of robotic-assisted CABG on critical outcomes such as graft patency, mortality, and need for reintervention remains incompletely defined. The emergence of artificial intelligence (AI) based large language models (LLMs) promise the ability to rapidly deliver robust secondarily derived data, like that obtained from gold standard human meta-analyses. However, there is a lack of direct comparison between these modalities, preventing adoption of these tools in clinical practice. Method(s): We conduct a dual-phase study, by first performing a rigorous, traditional human-led systematic review and meta-analysis comparing robotic-assisted CABG with traditional CABG with respect to graft patency, mortality, reintervention rates, and operative time. In the second phase, we compare outputs of flagship multimodal LLMs from five major vendors-OpenAI (GPT-4o), Anthropic (Claude Sonnet 4), xAI (Grok 3), Google (Gemini 2.5 Pro), and High-Flyer (DeepSeek-R1)-to the same clinical question, called via public, and domain specific API. Sensitivity analyses were performed excluding studies comparing robotic-assisted CABG with conventional minimally invasive direct CABG (MIDCAB) to address procedural heterogeneity. Result(s): Meta-analysis of 27 studies found no significant differences between robotic and conventional CABG in reintervention (OR 0.92, 95% CI 0.61-1.38), mortality (OR 0.65, 95% CI 0.38-1.13), or graft patency (P = 0.29). Sensitivity analysis excluding MIDCAB comparator studies did not materially alter these findings. Operative time analyses showed heterogeneous results: pooled estimates suggested shorter times with robotic CABG, but subgroup analyses revealed longer durations for multi-vessel procedures and shorter harvest times for single ITA grafts. Overall, robotic CABG demonstrated comparable outcomes to conventional surgery. Conclusion(s): Operative time findings were heterogeneous, with shorter durations observed in single-vessel procedures and longer operative times in multivessel robotic CABG. Domain-specific orchestration-such as that employed by CardioCanon-can substantially improve the clinical fidelity and interpretive quality of AI-generated evidence synthesis in cardiovascular surgery. Human oversight remains essential for robust use of AI and LLM in clinical research. Copyright © 2026 The Author(s) <31> Accession Number 2046549644 Title Practical applications of gamification in patient-centered outcomes research and digital health, and its acceptance in clinical trials. Source Frontiers in Digital Health. 8 (no pagination), 2026. Article Number: 1652217. Date of Publication: 2026. Author Hartford C.; Barge R.; McDowell T.; Gentsch B.; Symonds T.; Rofail D. Institution (Hartford, Barge, Rofail) Regeneron Pharmaceuticals, Inc., Sleepy Hollow, NY, United States (McDowell, Symonds) Clinical Outcomes Solutions, Folkestone, Kent, United Kingdom (Gentsch) Washington University in St. Louis, St. Louis, MO, United States Publisher Frontiers Media SA Abstract Background - The application of game elements to engage participants and improve data collection for clinical trials is relatively novel, with limited research around the impact of gamification in clinical research. This article explores published literature and surveys from patients and clinical sites. Methods - A targeted literature review was completed in November 2025 to identify published articles (<=10 years) on the application of gamification in clinical trials. Synthesized findings informed the design of two surveys of US adults (n = 1, 044 from UserTesting.com) and clinical trial sites (n = 311) on their perceptions of gamification and acceptance in clinical trials. Both were ~5-minute online surveys utilizing five open- and closed-ended questions. Results - Twenty-four articles were focused on the application of gaming design and mechanics to non-gaming activities. Three primary areas identified were education (n = 3), health outcomes measures (n = 7), and patient engagement (n = 14). Eighteen studies reported an advantage of gamification, including positive impacts on health outcomes measures (n = 5) and patient engagement (n = 11). Survey respondents (adults) were most familiar with computer games (62%), stating a preference for participating in trials that included gamified cell phone applications, with the ability to customize application elements as the most important. From a thematic analysis of respondents' comments, potential impacts on human behavior and performance (33%) were the most prevalent concerns. Data (26%; including concerns about privacy, integrity, and security), and software (22%; including adaptability to account for ability and skill variation, satisfaction, user experience, controls, customization, and personalization) were also key areas of concern for patients. Key perceived benefits included improvements in experience (31%) and engagement (24%). Site respondents were most familiar with managing gamified clinical trials with gamified cell phone applications (30%) and would prefer to manage trials that included these elements vs. traditional trials. Notifications, education, and training were the most important gamification elements for site respondents. Conclusions - Potential advantages of gamification include increased engagement, trial education, adherence to protocols, and enjoyment of the clinical trial experience, which may increase retention and data completeness. Further research is required to better understand the potential impact of gamification on scores of how patients feel or function. Copyright © 2026 Hartford, Barge, McDowell, Gentsch, Symonds and Rofail. <32> Accession Number 2044435760 Title Safety and efficacy of ticagrelor plus aspirin vs. aspirin monotherapy in patients undergoing coronary artery bypass grafting: A meta-analysis with trial sequential analysis. Source Journal of Thrombosis and Thrombolysis. 59(4) (pp 832-849), 2026. Date of Publication: 01 Apr 2026. Author Hammadeh B.M.; Hussein A.M.; Alhamwi N.; Odat R.M.; Naseem M.; Asawaeer M. Institution (Hammadeh, Hussein) Al-Balqa' Applied University, As-Salt, Jordan (Alhamwi) The University of Jordan, Amman, Jordan (Odat) Jordan University of Science and Technology, Irbid, Jordan (Naseem) Department of Internal Medicine, LSU HEALTH Shreveport, Shreveport, LA, United States (Asawaeer) Burnett School of Medicine, Texas Christian University, Fort Worth, TX, United States (Asawaeer) Division Chief of Cardiology, Texas Health Harris Methodist Hospital Fort Worth, Fort Worth, TX, United States Publisher Springer Abstract Optimal antiplatelet therapy after coronary artery bypass grafting (CABG) remains debated. While aspirin is standard, the benefit of adding ticagrelor, a P2Y1 inhibitor with distinct pharmacological properties, is unclear. We compared the efficacy and safety of ticagrelor plus aspirin versus aspirin alone in patients undergoing CABG. We systematically searched major databases for randomized controlled trials and observational studies comparing ticagrelor plus aspirin with aspirin alone in post-CABG patients. The primary efficacy endpoint was trial-defined MACE. Secondary efficacy endpoints included all-cause mortality, cardiovascular death, stroke, MI, revascularization, and saphenous vein graft failure. The primary safety endpoint was major bleeding. A total of seven studies (five randomized controlled trials (RCTs) and one observational study) were included, enrolling 11,893 patients post-CABG, primarily for acute coronary syndrome or stable angina. The majority of studies had a follow-up duration of one year. Ticagrelor plus aspirin significantly reduced the risk of trial-defined MACE (RR 0.61, 95% CI 0.45-0.84; I2 = 0%) and stroke (RR 0.49, 95% CI 0.29-0.82; I2 = 11.5%), but did not reduce all-cause mortality, myocardial infarction, or cardiovascular death. However, it significantly increased the risk of major bleeding (RR 1.70, 95% CI 1.06-2.71; I2 = 42%), while minor bleeding showed no difference (RR 2.38, 95% CI 0.88, 6.43; I2 = 39%). In a sensitivity analysis restricted to RCTs alone (n = 4,905), the reduction in trial-defined MACE remained significant (RR 0.61, 95% CI 0.45-0.84), while the reduction in stroke (RR 0.74, 95% CI 0.35-1.56) and the increase in major bleeding (RR 1.82, 95% CI 0.77-4.34) were no longer statistically significant. In patients undergoing CABG, the addition of ticagrelor to aspirin reduces trial-defined MACE and stroke compared with aspirin alone, but increases the risk of major bleeding without a mortality benefit. These findings support a personalized, risk-stratified approach to antiplatelet therapy, though they are limited by the number and heterogeneity of available studies. Further trials are warranted to define the optimal antiplatelet regimen in this population. Clinical Trial Registration Number: Not applicable. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <33> Accession Number 2045099769 Title Management patterns of acute coronary syndrome among patients with malignancy: a systematic review and meta-analysis. Source Expert Review of Cardiovascular Therapy. 24(5) (pp 463-474), 2026. Date of Publication: 2026. Author Nadeem M.A.; Ahmad A.; Awan A.R.; Singh R.P.; Silva N.C.; Ali S.H.; Ayyazuddin M.; Haseeb B.; Daniyal M.; Khan B.; Sohail A.H.; Sheikh A.B. Institution (Nadeem) Department of Liver Transplant Surgery, Digestive Diseases and Surgery Institute, Cleveland Clinic, Cleveland, OH, United States (Ahmad) Department of Medicine, CMH Lahore Medical College, Lahore, Pakistan (Awan) Nishtar Medical University, Multan, Pakistan (Singh, Silva, Sheikh) Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States (Ali) Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan (Ayyazuddin) Department of Internal Medicine, Carepoint Bayonne Medical Center, Bayonne, NJ, United States (Haseeb) Department of Medical Oncology, Jinnah Hospital Lahore, Lahore, Pakistan (Daniyal) Montefiore Medical Center, Wakefield, NY, United States (Khan) Department of Internal Medicine, Vanderbilt University, Nashville, TN, United States (Sohail) Department of Surgical Oncology, University of New Mexico, Albuquerque, NM, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Patients presenting with acute coronary syndrome (ACS) and a history of cancer are high-risk. Prior studies suggest differences in acute treatment and discharge prescribing compared with non-cancer patients. Method(s): PubMed, Scopus, Embase, andClinicalTrials.gov were searched on 24 January 2025, for studies published between 2000 and 2025. Studies comparing ACS management and medication use in patients with versus without a history of malignancy were included. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Result(s): Seventeen studies were included. During hospitalization, cancer patients with ACS were significantly less likely to undergo percutaneous coronary intervention (PCI), receive drugeluting stents, or receive glycoprotein IIb/IIIa inhibitors (all p < 0.001), compared to non-cancer patients. No significant differences were observed in the administration of beta-blockers (p = 0.26) or P2Y12 inhibitors (p = 0.39). At discharge, cancer patients were less likely to be prescribed dual antiplatelettherapy (p = 0.02), aspirin (p < 0.001), beta-blockers (p = 0.03), and statins (p = 0.02). No significant differences were found in prescriptions for P2Y12 inhibitors, oral anticoagulants, nitrates, calcium channel blockers, or ACE inhibitors/ARBs. Conclusion(s): Differences in treatment persist in both in-hospital management and discharge prescribing for cancer patients with ACS, underscoring the need for standardized, evidence-based protocols to ensure equitable care. Registration: This meta-analysis was prospectively registered with PROSPERO (CRD420251275640.). Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <34> Accession Number 2043990022 Title Cocoa flavanol supplementation and prevention of cardiovascular disease: a novel analysis of the COSMOS randomized trial using "win ratio". Source European Journal of Epidemiology. 41(5) (pp 599-609), 2026. Date of Publication: 01 May 2026. Author Ogata S.; Manson J.E.; Rist P.M.; Hamaya R.; Aragaki A.K.; Allison M.; Haring B.; Martin L.W.; Nishimura K.; Clar A.; Sesso H.D. Institution (Ogata, Nishimura) Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Osaka, Suita, Japan (Manson, Rist, Hamaya, Clar, Sesso) Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States (Manson, Rist, Hamaya, Sesso) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Aragaki) Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, United States (Allison) Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA, United States (Haring) Department of Medicine III, Saarland University, Saarland, Homburg, Germany (Martin) Division of Cardiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, United States Publisher Springer Science and Business Media B.V. Abstract Cocoa flavanols may reduce cardiovascular disease (CVD) risk, yet large randomized trials remain inconclusive. The COcoa Supplement and Multivitamin Outcomes Study (COSMOS) suggested a modest, nonsignificant benefit using Cox models, which do not account for event severity in composite outcomes. To address this, we applied generalized pairwise comparison (GPC), or "win ratio" (WR), to assess cocoa flavanols versus placebo on hierarchical CVD outcomes among healthy older US adults. This secondary analysis of COSMOS, a randomized, placebo-controlled, 2 x 2 factorial trial of cocoa extract and multivitamins for preventing CVD and cancer, included 21,442 adults (women >= 65, men >= 60 years) followed for a median of 3.6 years. The primary outcome was a hierarchical composite of total CVD, prioritizing: fatal CVD, non-fatal myocardial infarction (MI), non-fatal stroke, coronary revascularization, carotid surgery, peripheral artery surgery, and hospitalized unstable angina. Analyses followed the intention-to-treat principle. GPC estimated WRs and net treatment benefits (NTBs) for cocoa flavanols versus placebo. GPC analyses showed cocoa flavanol wins of 3.41% and placebo wins of 2.87%, yielding a reciprocal WR of 0.84 (95% CI 0.72-0.99) and negative NTBs of - 0.54% (- 1.04 to - 0.03), p = 0.037. Sensitivity analyses prioritizing stroke over MI produced similar findings. By contrast, Cox regression of the same composite yielded a nonsignificant hazard ratio of 0.90 (95% CI 0.79-1.03), suggesting standard time-to-first-event models underestimated benefit. GPC "WR" analyses showed cocoa flavanols significantly reduced CVD events by accounting for event severity in the composite CVD outcome, whereas Cox regression marginally missed these effects. Copyright © Springer Nature B.V. 2026. <35> Accession Number 2045362425 Title Growth rate of the ascending aorta and risk of aortic dissection or reintervention in patients with bicuspid or tricuspid aortic valves undergoing valve interventions: A systematic review and meta-analysis. Source Revista Portuguesa de Cardiologia. 45(7) (pp 363-374), 2026. Date of Publication: 01 Jul 2026. Author Fernandes Pedro J.; Figueiredo A.R.M.; Almeida R.; de Sousa C.; Pinto F.J.; Caldeira D. Institution (Fernandes Pedro, Figueiredo, de Sousa, Pinto, Caldeira) Servico de Cardiologia, Departamento de Coracao e Vasos, ULS Santa Maria, CAML, Lisboa, Portugal (Fernandes Pedro, Figueiredo, de Sousa, Pinto, Caldeira) Centro Cardiovascular da Universidade de Lisboa (CCUL@RISE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal (Almeida) USF Moscavide, ULS Lisboa Central, Portugal (Caldeira) Centro de Estudos de Medicina Baseada na Evidencia (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal (Caldeira) Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal Publisher Sociedade Portuguesa de Cardiologia Abstract Background: Bicuspid aortic valve (BAV) is associated with premature valve dysfunction and progressive aortic dilation, potentially leading to dissection. The evolution of aortic dimensions after valve replacement remains uncertain, particularly compared with tricuspid aortic valve (TAV) disease. This systematic review and meta-analysis aimed to compare postoperative aortic growth and the risk of major aortic events between BAV and TAV patients. Method(s): A systematic search of MEDLINE, CENTRAL, and Web of Science (from inception to April 2025) identified prospective and retrospective cohort studies including adult patients with BAV or TAV undergoing surgical (SAVR) or transcatheter (TAVI) aortic valve replacement. Studies were required to report longitudinal data on aortic growth rate (mm/year) or the incidence of aortic dissection or reintervention; those with concomitant aortic surgery were excluded. Random-effects meta-analyses estimated mean differences (MD) and risk ratios (RR) with 95% confidence intervals (CI). Result(s): Fifteen studies were included (n=1772 for aortic growth; n=2307 for aortic dissection; n=2598 for aortic reintervention). There was no significant difference in annual aortic growth between BAV and TAV (MD 0.15 mm/year; 95% CI -0.03 to 0.33; p=0.09; I2=82.6%). Meta-regression confirmed that age differences between BAV and TAV cohorts did not modify the overall neutral effect on aortic growth rate. Subgroup analyses showed similar findings across study designs, but small differences in procedure types (SAVR MD 0.21 mm/year, p=0.07; TAVI MD -0.04 mm/year, p=0.53; p=0.02 for SAVR vs. TAVI differences). No significant differences were found in the risk of aortic dissection (RR 1.34; 95% CI 0.63-2.83; p=0.44) or aortic reintervention (RR 0.95; 95% CI 0.56-1.61; p=0.84). Conclusion(s): Postoperative aortic growth and event rates were comparable between BAV and TAV patients after valve replacement. These results challenge the long-standing assumption that bicuspid morphology intrinsically accelerates postoperative aortopathy in all patients. Copyright © 2026 Sociedade Portuguesa de Cardiologia <36> Accession Number 2046626695 Title Depression and Suicidality in Patients with Left Ventricular Assist Devices and Advanced Cardiac Therapies: Mechanisms, Risk Factors, and Clinical Management. Source Medical sciences. 14(2) (no pagination), 2026. Article Number: 244. Date of Publication: 01 Jun 2026. Author Leivaditis V.; Mulita F.; Andrikopoulou C.; Shaska E.; Liolis E.; Mitsos S.; Grapatsas K.; Tomos P.; Baikoussis N.G. Institution (Leivaditis) Department of Cardiothoracic and Vascular Surgery, Westpfalz Klinikum, Kaiserslautern, Germany (Mulita, Andrikopoulou) Department of General Surgery, General Hospital of Eastern Achaia-Unit of Aigio, Aigio, Greece (Shaska) Department of Psychiatry, "Ali Mihali" Psychiatric Hospital, Vlora, Albania (Liolis) Department of Oncology, General University Hospital of Patras, Patras, Greece (Mitsos, Tomos) Department of Thoracic Surgery, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece (Grapatsas) Department of Thoracic Surgery and Thoracic Endoscopy, Ruhrlandklinik, West German Lung Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany (Baikoussis) Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: The increasing use of advanced cardiac surgical therapies, particularly left ventricular assist devices (LVADs), has improved survival in patients with end-stage heart failure. However, the psychological burden associated with these therapies-especially depression and suicidality-remains underrecognized. Objective(s): This narrative review synthesizes current evidence on the prevalence, underlying mechanisms, risk factors, screening strategies, and management of depression and suicidality in patients undergoing LVAD implantation and other advanced cardiac surgical interventions. Method(s): A structured literature search of PubMed, Embase, and Scopus was conducted for studies published between 2020 and 2025 addressing depression, suicidal ideation, suicide attempts, and psychological distress in LVAD and advanced cardiac therapy populations. Result(s): Depression affects approximately 20-42% of patients with advanced heart failure, including those supported with LVADs, while suicidal ideation is reported in up to 12% of LVAD recipients, with higher rates of suicide attempts compared to other chronic disease populations. Risk factors are multifactorial and can be categorized into patient-related, disease-related, device-related, and psychosocial domains. Proposed mechanisms include neurohormonal dysregulation, systemic inflammation, and psychological processes such as loss of autonomy and existential distress. Although validated screening tools and multidisciplinary management strategies are available, their implementation in routine clinical practice remains inconsistent. Conclusion(s): Depression and suicidality represent significant and complex challenges in patients undergoing advanced cardiac therapies, particularly LVAD support. Systematic mental health screening and integrated, multidisciplinary care models are essential to improve patient outcomes. Future research should focus on longitudinal assessment, standardized suicide risk monitoring, and the development of targeted, evidence-based interventions for this vulnerable population. Copyright © 2026 by the authors. <37> Accession Number 2045733673 Title Effect of Intraoperative Regional Anesthesia on Postoperative Outcomes in Pediatric Cardiac Surgery-A Systematic Review of Randomized Controlled Trials. Source Paediatric Anaesthesia. 36(8) (pp 899-907), 2026. Date of Publication: 01 Aug 2026. Author Hiisivuori K.; Salmi H.; Kontinen V.K.; Kuitunen I. Institution (Hiisivuori, Salmi, Kontinen) Department of Anesthesia and Intensive Care, Helsinki University Hospital, Helsinki, Finland (Hiisivuori, Salmi) Pediatric Research Centre, University of Helsinki, Helsinki, Finland (Kontinen) Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland (Kuitunen) Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland (Kuitunen) Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Publisher John Wiley and Sons Inc Abstract Objective: To conduct a meta-analysis of postoperative outcomes following the use of regional anesthesia in pediatric cardiac surgery. Data Sources: We searched PubMed (MEDLINE), Web of Science, CINAHL, CENTRAL, and Scopus in December 2024 (PROSPERO: CRD420025635423; registered January 2025). Study Selection: Two authors screened search results. We included parallel-grouped randomized controlled trials (RCT) regardless of blinding. Studies comparing adjuvant regional anesthesia (excluding neuraxial anesthesia) with general anesthesia in pediatric patients (0-17 years) having cardiac surgery via midline sternotomy were included. Data Extraction: Two authors independently extracted the data and assessed risk of bias. The main outcome measures were pain relief using any documented pain score and duration of mechanical ventilation. Other outcome measures sought were postoperative opioid consumption, time to first rescue analgesia, time in pediatric intensive care unit (PICU), length of hospital stay, complications, and patient satisfaction. Data Synthesis: We identified 15 RCTs with 1055 participants for the analysis. Pain scores were lower during the first 24 h postoperatively, with Modified Objective Pain Scale (MOPS) mean difference (MD) being 0.76 less (MD -0.76; CI -1.19 to -0.32). Duration of mechanical ventilation was 48 min shorter in the regional anesthesia group (MD -48; CI -60 to -36). Postoperative cumulative opioid consumption (morphine equivalents) was 0.21 mg/kg lower (MD -0.21; CI -0.30 to -0.11). No complications related to regional anesthesia were reported. Conclusion(s): Our meta-analysis demonstrates that regional anesthesia in pediatric cardiac surgery reduces postoperative pain, as measured by pain scores and postoperative opioid consumption, leads to shorter mechanical ventilation and PICU stays. Copyright © 2026 The Author(s). Pediatric Anesthesia published by John Wiley & Sons Ltd. <38> Accession Number 650355039 Title Frailty and functional recovery after cardiac surgery: a randomized pilot trial of extended exercise-based rehabilitation. Source BMC geriatrics. 26(1) (no pagination), 2026. Date of Publication: 24 Feb 2026. Author Tamuleviciute-Prasciene E.; Balne K.; Kuznecova I.; Beigiene A.; Stonkuviene V.; Kubilius R. Institution (Tamuleviciute-Prasciene, Beigiene, Stonkuviene, Kubilius) Department of Rehabilitation, Lithuanian University of Health Sciences, Eiveniu Str. 2, Kaunas, Lithuania (Balne, Kuznecova) Department of Cardiology, Lithuanian University of Health Sciences, Eiveniu Str.. 2, Kaunas, Lithuania Abstract OBJECTIVES: Pilot branch study of the FrailHeart clinical trial aimed to assess the feasibility and preliminary performance of the Edmonton Frail Scale (EFS) for detecting changes in frailty status over a 3-month follow-up period after cardiac surgery in older adults, and to explore frailty within the context of exercise-training-based (ET) cardiac rehabilitation (CR) in order to inform the design and implementation of future definitive studies targeting frailty in this population. METHOD(S): Patients who arrived at an inpatient CR hospital after open-heart surgery between November 19, 2020, and January 3, 2022, were invited to participate. Out of 336 assessed for eligibility, 100 patients (38 females, 62 males) met the inclusion criteria and were randomized into intervention (IG, N = 50) and control groups (CG, N = 50). All participants underwent comprehensive inpatient CR based on ET. After discharge, IG continued a 12-week home ET program while CG maintained usual physical activity. Assessment times: before randomization (admittance to CR) (V1); CR completion (V2), and three months post-CR (V3). Assessment included clinical examination: six-minute walk test (6MWT), veloergometry (peak workload (W), maximal heart rate (max.HR, beats/minute), metabolic equivalent (MET), timed up and go (TUG), frailty (EFS score/status). RESULT(S): As a result of inpatient-CR all measured parameters except max. HR enhanced significantly for all study participants (6MWT, TUG, EFS, W, MET (p < 0.001)). Analysis of differences between groups at V2 showed significantly better physical capacity for IG (MET, p = 0.037), without statistical significant differences in other outcomes. 58 patients attended V3 and completed the entire study (IG n = 33, CG n = 25). Only W, MET and EFS enhanced for all patients significantly (p < 0,01) without statistical differences between groups. Changes in frailty status over time (V1-V3) were statistically significant (V1-V2: IG p < 0.01; V1-V3: CG p < 0.05; V1-V3: IG p < 0.05) whereas no statistically significant between-group differences were observed (chi2 p = 0.32). All IG patients were able to successfully participate in the home ET program, no AE were registered. CONCLUSION(S): Within-group analyses indicated that EFS scores changed over time, suggesting that the instrument is capable of capturing short-term variation in frailty status in this clinical context. The structured CR ET program was found to be feasible and safe in this high-risk population. Although reductions in frailty scores were observed over time within groups, between-group differences were not consistently demonstrated, and the study was not powered to establish intervention effectiveness. Future adequately powered, multi-center studies incorporating comparator instruments are needed to confirm the responsiveness of the EFS and to clarify the effects of CR and ET on frailty trajectories in this population.ClinicalTrials.gov (No. NCT04636970). TRIAL REGISTRATION: This study was registered at ClinicalTrials.gov (ID NCT04636970). First Posted 19/11/2020. <39> Accession Number 650617091 Title Simulation training for invasive cardiovascular procedures: the Heart-SIMS-1 randomized trial. Source BMC medical education. 26(1) (no pagination), 2026. Date of Publication: 14 Mar 2026. Author Oliveira-Santos M.; Guerreiro C.; Lobo B.; Marinho A.V.; Borges-Rosa J.; Guardado J.; Santos E.O.; Costa M.; Goncalves L.; Bogle R.; Dudek D.; Pires-Morais G.; Marques J.S.; Khokhar A.A. Institution (Oliveira-Santos, Marinho, Borges-Rosa, Costa, Goncalves) Servico de Cardiologia, Unidade Local de Saude de Coimbra, Coimbra, Portugal (Oliveira-Santos, Lobo, Borges-Rosa, Goncalves) Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal (Oliveira-Santos, Santos, Marques) 3D CardioSolutions, Coimbra, Portugal (Guerreiro, Pires-Morais) Servico de Cardiologia, Unidade Local de Saude de Gaia/Espinho, Vila Nova de Gaia, Portugal (Guardado, Marques) Unidade Cardiovascular, Riachos, Portugal (Bogle) Department of Cardiology, Epsom & St Helier University Hospitals NHS Trust, St George's, Surrey, United Kingdom (Dudek) Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland (Marques) Servico de Cardiologia, Unidade Local de Saude de Santa Maria, Lisboa, Portugal (Khokhar) Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark Abstract BACKGROUNDS: Interventional cardiology training has a long learning curve, with potential procedural risks to patients and clinicians. We aimed to assess whether mentored simulation-based training with 3D-printed models can improve the skills of beginners in coronary diagnostic procedures in a pilot randomized trial. METHOD(S): Twenty-nine final-year medical students recruited from a single University were lectured on the fundamentals of invasive coronary angiography (ICA) for one-hour, and then randomized to conventional or simulation training. Conventional training (n = 15) consisted of watching a 20-minute video demonstrating ICA steps performed in a 3D-printed coronary simulator. The simulation training group (n = 14) were offered, in pairs, the same content in a 20-minute hands-on session using a 3D-printed simulator. The co-primary endpoint was efficacy and safety of performing a simulated ICA in the angiography suite. Efficacy and safety were graded using a 13-point procedural checklist (0-100%) and the identification of five procedural "red flags" items, respectively. The secondary endpoint was theoretical knowledge (multiple-choice test). RESULT(S): All participants completed the protocol. In both components of the co-primary endpoint, the simulation group scored higher: efficacy score of 91.5 +/- 3.8% vs. 64.6 +/- 8.3% (mean difference 95% CI [20.8, 30.8]) and safety score 100.0% (100.0-100.0%) vs. 62.5 (20.8-79.2%) (median difference 95% CI [20.8, 79.2]), p < 0.001. The median number of "red flags" were 2 (1-4) in conventional and 0 (0-0) in simulation training (p < 0.001). Also, simulation group obtained a higher score in the theoretical knowledge test: 85.7 +/- 9.0% vs. 76.8 +/- 12.7%, p = 0.039. CONCLUSION(S): Mentored simulation-based training using 3D-printed simulators significantly improved theoretical knowledge and basic procedural skills of ICA. These results suggest that simulation-based training should be pursued for improving patient safety and technical proficiency. TRIAL REGISTRATION: NCT06224101. <40> Accession Number 2046873198 Title Safety and Efficacy of a Novel Rotational Atherectomy System in Coronary Calcifications. Source JACC: Asia. 6(7) (pp 1135-1145), 2026. Date of Publication: 01 Jul 2026. Author Li C.; Wang M.; Jiang J.; Ma X.; Yu H.; Dong P.; Chen X.; Wang L.; Hong L.; Xie P.; Yang Q.; Ma G.; Zhong Y.; Lin B.; Cao R.; Wu T.; Shen J.; Yue B.; Wang J. Institution (Li, Jiang, Wang) Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Li, Jiang, Wang) State Key Laboratory of Transvascular Implantation Devices, Hangzhou, China (Li, Jiang, Wang) Heart Regeneration and Repair Key Laboratory of Zhejiang Province, Hangzhou, China (Li, Jiang, Wang) Transvascular Implant Instrument Research Institute, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Wang) Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China (Ma) Department of Cardiology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China (Yu) Department of Cardiology, Huzhou Central Hospital, Huzhou, China (Dong) Department of Cardiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China (Chen) Department of Cardiology, The First Affiliated Hospital of Ningbo University, Ningbo, China (Wang) Department of Cardiology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China (Hong) Department of Cardiology, Jiangxi Provincial People's Hospital, Nanchang, China (Xie) Department of Cardiology, Gansu Provincial Hospital, Lanzhou, China (Yang) Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China (Ma) Department of Cardiology, Zhongda Hospital Southeast University, Nanjing, China (Zhong) Department of Cardiology, First Affiliated Hospital of Gannan Medical University, Ganzhou, China (Lin) Department of Cardiology, Wenzhou Central Hospital, Wenzhou, China (Cao, Yue) Shanghai MicroPort Medical (Group) Co., Ltd., Shanghai, China (Wu) Shanghai MicroPort RotaPace MedTech Co., Ltd., Shanghai, China (Shen) De'Aurora Pty Ltd., Dean, Australia Publisher Elsevier Inc. Abstract Background Calcified coronary lesions present challenges during percutaneous coronary intervention, often impeding successful stent delivery and expansion. Rotational atherectomy (RA) facilitates plaque modification in such cases. However, clinical performance of a novel RA system remains unclear. Objectives This noninferiority study evaluated the safety and efficacy of the novel system. Methods This trial included 2 prospective phases, a first-in-human (FIH) study and a pivotal randomized controlled trial. In the FIH study, 15 patients underwent percutaneous coronary intervention with the novel RA system, and clinical success was assessed. In pivotal trial, 224 patients with calcified lesions were randomized to receive RA using either the novel (n = 111) or established (n = 113) system, followed by stenting. The primary endpoint was freedom from major adverse cardiovascular events (MACEs), a composite of cardiac death, myocardial infarction, and target vessel revascularization, at 30 days. Secondary endpoints included MACEs at 12 months and quantitative imaging analyses. Results All FIH patients achieved clinical success. In pivotal study, the median follow-up time was 349.5 (IQR: 343, 359) days. Freedom from MACEs at 30 days was 97.3% (108 of 111 vs 110 of 113; 95% CI: 92.3%-99.4% vs 92.4%-99.5%) in both groups ( P for noninferiority <0.0001). At 12 months, MACEs remained low in both groups (2.7%; 95% CI: 0.9%-8.1% vs 2.7%; 95% CI: 0.9%-8.0%; P = 1.0000). Postprocedural minimal stent area was similar on intravascular ultrasound between the 2 groups (5.29 +/- 1.20 vs 5.29 +/- 1.47 mm2, P = 0.9921). Conclusions The novel RA system demonstrated noninferior safety and efficacy to established system, offering an effective alternative for the treatment of complex calcified coronary lesions. (CorOnary atheRectomy system in patiEnts with Coronary arTery calcification (CORECT); NCT05447585 ) Copyright © 2026 The Authors. <41> [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 <42> [Use Link to view the full text] Accession Number 2045808047 Title The efficacy and safety of serratus anterior plane block in patients undergoing cardiac surgery: A systematic review and meta-analysis. Source Medicine (United States). 105(11) (no pagination), 2026. Article Number: e48013. Date of Publication: 13 Mar 2026. Author Cui X.-B.; Cui M.-Z.; Yang Q.-J.; Liu Y.; Yi M.-Q.; Zhang X.-Y.; Yao Y.-T. Institution (Cui, Cui, Yi) Department of Anesthesiology and Perioperative Medicine, People's Hospital of Henan University, Henan Provincial People's Hospital, Zhengzhou, China (Yang, Liu, Zhang) Department of Anesthesiology and Perioperative Medicine, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital, Henan, Zhengzhou, China (Yao) Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China (Yao) Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China (Yao) Department of Anesthesiology, Center of Outcomes Research, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Yao) Outcomes research Consortium, Houston, TX, United States Publisher Lippincott Williams and Wilkins Abstract Background: - Serratus anterior plane block (SAPB) is a widely used fascial block that reduces postoperative pain and perioperative opioid consumption. This meta-analysis assessed the efficacy and safety of SAPB in cardiac surgery patients. Method(s): - We systematically searched PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, and Wanfang databases on May 10, 2024. Pooled relative risks and mean differences (MD) with 95% confidence intervals (CI) were calculated for dichotomous and continuous outcomes, respectively. Heterogeneity was assessed using the I2 statistic, and publication bias was evaluated using Egger test. Subgroup analyses were stratified by study design (randomized controlled trials vs cohort studies) and patient age to explore methodological heterogeneity. Result(s): - Fifteen studies, encompassing 1169 adult and pediatric participants, were included. Overall, compared to general anesthesia (GA) alone, the SAPB + GA group significantly reduced intensive care unit length of stay (MD = -6.61 hours, 95% CI: -10.91 to -2.32), decreased postoperative analgesic consumption (MD = -4.20 mg morphine equivalents, 95% CI: -6.52 to -1.88), and lowered the risk of complications (relative risk = 0.63, 95% CI: 0.40-0.99). SAPB + GA also lowered postoperative Visual Analogue Scale pain scores (MD = -1.25, 95% CI: -1.74 to -0.75) and serum cortisol levels (MD = -35.43 nmol/L, 95% CI: -58.58 to -12.27). No local anesthetic toxicity or mortality was reported. Conclusion(s): - Perioperative SAPB combined with GA provides significant benefits in cardiac surgery, including accelerated intensive care unit discharge, reduced opioid use and pain scores, attenuated stress response (reduced cortisol), and favorable safety, which supports enhanced patient recovery. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, Inc. <43> Accession Number 2046543150 Title Topical use of tranexamic acid for antifibrinolysis in cardiac surgery with cardiopulmonary bypass: a randomized clinical study. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 376. Date of Publication: 01 Dec 2026. Author Tuerhong D.; Li C.; Yan L. Institution (Tuerhong, Yan) Department of Anesthesiology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China (Li) The First Affiliated Hospital of Xinjiang Medical University, National Clinical Medical Research Institute, Urumqi, China (Li) Cancer Research Institute, Xinjiang Key Laboratory of Translational Biomedical Engineering, The Affiliated Cancer Hospital of Xinjiang Medical University, Urumqi, China (Li) The First People's Hospital of Kashi & Xinjiang Key Laboratory of Artificial Intelligence Assisted Imaging Diagnosis, Kashi, China Publisher BioMed Central Ltd Abstract Objective: To assess the non-inferiority of topical intrapericardial tranexamic acid (TXA) versus intravenous TXA for efficacy and safety in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Method(s): In this single-center randomized trial, 492 patients were assigned 1:1 to topical TXA (2.5 g in 50 mL saline via pericardial drain, clamp 30 min) or standard intravenous TXA. Primary endpoints: allogeneic red blood cell (RBC) transfusion rate (postoperative to discharge); 30-day composite adverse events (mortality, renal dysfunction, stroke, myocardial infarction, thromboembolism, seizures). Secondary endpoints included drainage volume, coagulation, and thromboelastography (TEG). The non-inferiority threshold was established at 10% for sensitivity. Result(s): RBC transfusion rate was 35.0% (topical) vs. 27.6% (intravenous; 95%CI - 1.2% to 16.0%, P = 0.080). Composite adverse events were 9.8% vs. 15.4% (95%CI - 11.2% to 0.0%, P = 0.057). Topical TXA showed delayed coagulation initiation, lower fibrinogen, and higher 24-hour drainage (all P < 0.05). At 10% margin, efficacy non-inferiority was not confirmed, but safety non-inferiority was verified for all endpoints. Conclusion(s): Topical intrapericardial TXA is non-inferior to intravenous TXA in safety but fails strict efficacy non-inferiority. Intravenous TXA remains first-line; topical TXA is a reasonable alternative for patients intolerant to systemic administration. Dose and timing optimization is needed to improve hemostasis. Trial registration: http://www.chictr.org.cn, ChiCTR2500113718, Registration date: 2 December 2025. Retrospectively registratered. Copyright © The Author(s) 2026. <44> Accession Number 2046809202 Title Haemodynamic Stability During Anaesthesia Induction and Sternotomy in Patients with Ischaemic Heart Disease: A Comparison of Various Anaesthetic Techniques. Source International Journal of Drug Delivery Technology. 16(61 Supplement) (pp 58-64), 2026. Date of Publication: 2026. Author Ranjith Veeramani T.; Saravanan M.; Imran J.M.; Vellingiri M.; Senthilkumar V.; Veeravijayan A. Institution (Ranjith Veeramani) Department of Anaesthesiology, Institute of Child Health - Madras Medical College (Saravanan) Department of Anaesthesiology, Chengalpattu Medical College (Imran, Vellingiri, Senthilkumar) Institute of Anaesthesiology and Critical Care, Madras Medical College (Veeravijayan) Department of Forensic Medicine, Chettinad Hospital and Research Institute Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background and Aims Haemodynamic stability during anaesthesia induction is critical in patients with ischaemic heart disease undergoing coronary artery bypass grafting. This study aimed to compare haemodynamic stability between thiopentone 3 mg/kg and 6 mg/kg and etomidate 0.4 mg/kg during anaesthesia induction and sternotomy. Methods A prospective randomised controlled trial was conducted on 60 patients with good left ventricular function undergoing elective coronary artery bypass grafting. Patients were randomly allocated into three equal groups (n=20 each): thiopentone 3 mg/kg (THIO3), thiopentone 6 mg/kg (THIO6), and etomidate 0.4 mg/kg (ETO). Haemodynamic parameters including heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, rate pressure product, and pressure rate quotient were recorded at eight standardised time points. Results Significant haemodynamic variations were observed among the three groups (p<0.001). The THIO3 group demonstrated the highest haemodynamic fluctuations with peak heart rate elevation at T4 (103.2+/-22.5 beats per minute, p<0.001) compared to THIO6 (68.9+/-11.2 beats per minute) and etomidate (73.7+/-6.1 beats per minute). Systolic blood pressure changes were significantly higher in thiopentone groups, with a mean difference of 16.18 mmHg between THIO3 and etomidate (p<0.001). Etomidate maintained superior haemodynamic stability across all parameters with minimal fluctuations in heart rate, blood pressure, and arterial pressure indices. Conclusion Etomidate provides superior haemodynamic stability during anaesthesia induction and sternotomy in patients with ischaemic heart disease. In resource-limited settings, thiopentone 6 mg/kg can be used with strict haemodynamic monitoring as a comparable alternative to etomidate. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <45> Accession Number 2047250584 Title Long-Term Mobile-Based Glycemic Intervention for Secondary Prevention in Patients With Diabetes Undergoing Surgical Revascularization: Multicenter Randomized Controlled Trial. Source Journal of Medical Internet Research. 28 (no pagination), 2026. Article Number: e72226. Date of Publication: 2026. Author Song Y.; Nan Y.; Tiemuerniyazi X.; Yang Z.; Zhang S.; Li X.; Feng W. Institution (Song, Nan, Tiemuerniyazi, Yang, Zhang, Feng) Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Fuwai Hospital, Beijing, China (Li) National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China Publisher JMIR Publications Inc. Abstract Background: Despite the growing amount of patients who underwent coronary artery bypass grafting (CABG) in low- and middle-income countries like China, their glucose control was suboptimal, likely due to poor adherence to healthy lifestyles and preventive medications. Mobile health tools facilitating secondary prevention seem promising, but evidence focusing on this high-risk population is scarce. Objective(s): This study aimed to evaluate the significance of mobile health tools in long-term glycemic management for post-CABG patients with comorbid diabetes mellitus. Method(s): GUIDEME (glycemic control using mini program-based intervention in patients with diabetes undergoing coronary artery bypass to promote self-management) is a multicenter, open-label, closed-user group, randomized controlled trial, in which 1066 patients with diabetes who had recently undergone CABG were enrolled and allocated into 2 groups. Patients in the control group received conventional health education before discharge, whereas those in the intervention group additionally received automatic delivery of bite-sized health education and medication reminders through a smartphone app during the 6 months after discharge. The primary end point was a change in glycosylated hemoglobin (HbA<inf>1c</inf>) from baseline to 6 months. Result(s): Among the 1066 eligible participants enrolled, a total of 1038 (97.4%) had completed the follow-up, while 1000 (93.8%) had 6-month HbA<inf>1c</inf> results available. Although only 79 (14.9%) patients in the intervention group were defined as active users, a greater reduction of HbA<inf>1c</inf> in the intervention group was observed (adjusted between-group mean difference -0.13, 95% CI -0.25 to -0.01; P=.04). The intervention group also had a high proportion of good medication adherence (96.1% vs 93.2%, P=.04). There was no difference between the 2 groups regarding the secondary end points. Conclusion(s): Health education and medication reminders based on smartphone app achieved a statistically significant but modest between-group difference in HbA<inf>1c</inf>, the clinical relevance of which remains uncertain. Copyright © Yangwu Song, Yifeng Nan, Xieraili Tiemuerniyazi, Ziang Yang, Shicheng Zhang, Xi Li, Wei Feng. <46> Accession Number 2044868890 Title Quality of Life After Percutaneous Coronary Intervention or Medical Therapy for Chronic Total Coronary Occlusions. Source Journal of the American College of Cardiology. 88(1) (pp 24-37), 2026. Date of Publication: 07 Jul 2026. Author Kim J.-H.; Kang D.-Y.; Yuste V.M.; Ahn J.-M.; Park D.-W.; Park S.-J.; Boudou N.; Louvard Y.; Tchetche D.; Leymarie J.-L.; Martin-Yuste V.; Rumoroso J.R.; Escaned J.; Teruel L.; Goicolea J.; Serra A.; Hildick-Smith D.; di Mario C.; Spratt J.C.; Gershlick A.H.; Cotton J.; Werner G.S.; Bufe A.; Lauer B.; Reifart N.; Buttner H.-J.; Gelev V.; Erglis A.; Christiansen E.H.; Giudice P.; Galassi A.R.; Gagnor A. Institution (Werner, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) University Heart Center, Goethe University, Frankfurt/Main, Germany (Kim, Kang, Ahn, Park, Park, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (Hildick-Smith, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) University Hospitals Sussex, Brighton, United Kingdom (Yuste, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Interventional Cardiology, Centre hospitalier d'Angouleme, Angouleme, France (Boudou, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Interventional Cardiology, Clinique Saint Augustin, Bordeaux, France (Louvard, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Institut Jacques Cartier, Massy, France (Christiansen, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Erglis, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Pauls Stradins Clinical University Hospital, Riga, Latvia (Rumoroso, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Hospital Galdakao-Usansolo, Galdakao, Spain (di Mario, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Department of Cardiology, University of Florence, Florence, Italy (Escaned, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain (Teruel, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Bellvitge University Hospital, Barcelona, Spain (Bufe, Boudou, Louvard, Tchetche, Leymarie, Martin-Yuste, Rumoroso, Escaned, Teruel, Goicolea, Serra, Hildick-Smith, di Mario, Spratt, Gershlick, Cotton, Werner, Bufe, Lauer, Reifart, Buttner, Gelev, Erglis, Christiansen, Giudice, Galassi, Gagnor) Helios Klinikum Krefeld, Krefeld, Germany Publisher Elsevier Inc. Abstract Background: The benefit of percutaneous coronary intervention (PCI) for chronic total coronary occlusions (CTOs) to improve clinical symptoms and quality of life (QoL) as compared with optimal medical therapy (OMT) is still under debate because of the scarcity of available randomized trials (RCTs). Objective(s): We evaluated the effect of PCI vs OMT in patients with a CTO and no concomitant coronary lesions in a post-hoc pooled analysis of 2 RCTs. Method(s): A total of 518 patients with a single CTO and no other significant coronary lesion were extracted from 2 RCTs, EUROCTO and DECISION-CTO, which had compared PCI vs OMT. Randomization to PCI or OMT was 1:1 in DECISION and 2:1 in EUROCTO. The clinical status was assessed by the Seattle Angina Questionnaire (SAQ) at baseline and after 12 months, and clinical events were monitored for 3 years. Result(s): PCI was successful in 92.2%. On an intention-to-treat analysis, PCI appeared to be superior to OMT for the change of angina frequency scores between baseline and follow-up (12.2 vs 8.6; P = 0.009), QoL (19.5 vs 11.3; P < 0.001), and the SAQ summary score (13.8 vs 8.5; P < 0.001). For physical limitation, the difference was just at the level of the Bonferroni correction for multiple tests (P = 0.01). There was a wide variability of changes in SAQ scores. For QoL, the major determinant for a significant improvement was a low baseline score and the assignment to PCI, whereas gender, diabetes, or lesion complexity had no influence. During a mean follow-up of 3.1 years, the clinical endpoints of cardiac death or nonfatal myocardial infarction were similar in both groups (OMT vs PCI: 2.7% vs 5.1%; P = 0.17). The rates of stroke or hospitalization for bleeding were similar, and only target lesion revascularizations were more frequent with OMT (18.8% vs 10.6%; P = 0.005). Conclusion(s): In this post-hoc analysis from 2 RCTs of patients with a single CTO and no significant concomitant lesion, PCI achieved better improvement in QoL, angina frequency, and the SAQ summary score than OMT with no signal of excess harm regarding clinical endpoints. (EUROCTO [Evaluate the Utilization of Revascularization or Optimal Medical Therapy for the Treatment of Chronic Total Coronary Occlusions; NCT01760083] and DECISION-CTO [Drug-Eluting Stent Implantation Versus Optimal Medical Treatment in Patients With Chronic Total Occlusion; NCT01078051]) Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <47> Accession Number 2046905452 Title Efficacy of Adding Ultrasound-guided Bilateral Erector Spinae Block to Standard Anaesthesia Care Versus General Anaesthesia in Patients Undergoing Single-level Transforaminal Lumbar Interbody Fusion Surgery: A Double-blinded Randomised Controlled Study. Source Apollo Medicine. 23(4) (pp 318-325), 2026. Date of Publication: 01 Jul 2026. Author Vineetha S.; Roopan V. Institution (Vineetha, Roopan) Department of Anaesthesiology, Apollo Hospitals, Tamil Nadu, Chennai, India Publisher SAGE Publications Ltd Abstract Introduction: The erector spinae plane (ESP) block, introduced in 2016, is a fascial plane block gaining popularity for its analgesic efficacy in multiple cardiac, thoracic and abdominal surgeries. It involves injecting local anaesthetic deep into the erector spinae muscles. Multiple large retrospective and prospective studies have shown the efficacy of ESP blocks in various surgeries, and we determined to evaluate them in Spinal surgeries. Method(s): This study evaluated the efficacy of erector spinae block in single-level lumbar fusion surgery. Pain scores, surgical field, opioid use and adverse effects were compared in a double-blind randomised controlled trial (RCT). The block group received 20 mL of 0.375% ropivacaine on each side and the control group received 20 mL of 0.9% normal saline. Result(s): The ESP block group showed lower pain scores in the post anaesthesia care unit (PACU) and up to eight hours postoperatively, with 82.4% requiring no additional analgesia, unlike the control group, where all patients needed supplements like tramadol or buprenorphine. Surgical field conditions, assessed using Boezaart's grading scale, were significantly better up to 30 minutes after incision. Although blood loss differences were statistically significant (P = .048), correlation was weak. Adverse effects, including constipation, nausea and drowsiness, were higher in the control group due to greater opioid use. Conclusion(s): The ultrasound-guided ESP block is a practical, feasible analgesic modality for lumbar spine surgeries, suitable for multimodal and opioid-sparing analgesia. Copyright © 2025 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <48> Accession Number 2047173446 Title Association between preoperative atherogenic index of plasma and postoperative pneumonia in patients undergoing off-pump coronary artery bypass grafting. Source Chinese Journal of Anesthesiology. 46(5) (pp 538-543), 2026. Date of Publication: 20 May 2026. Author Zhang Z.; Zhai W.; Er J.; Yuan B.; Ren M.; Chen Q.; Guo Z.; Han J. Institution (Zhang, Zhai, Er, Yuan, Han) Department of Anesthesiology, Chest Hospital, Tianjin University, Tianjin, China (Zhang, Zhai, Er, Yuan, Chen, Guo, Han) Tianjin Key Laboratory of Cardiovascular Emergency and Critical Care, Tianjin, China (Ren) Tianjin Cardiovascular Institute, Tianjin, China (Chen, Guo) Department of Cardiovascular Surgery, Chest Hospital, Tianjin University, Tianjin, China Publisher Chinese Medical Journals Publishing House Co.Ltd Abstract Objective To evaluate the association between preoperative atherogenic index of plasma (AIP) and postoperative pneumonia in patients undergoing off-pump coronary artery bypass grafting (OPCABG). Methods This study was a secondary analysis of data from a randomized controlled trial "perioperative management guided by multisite tissue oxygenation and hemodynamic monitoring in OPCABG". Medical records of patients, aged 60-80 yr, of American Society of Anesthesiologists Physical Status classification III or , with a body mass index of 18-30 kg/m2, who underwent elective OPCABG from June 2021 to December 2023 at Tianjin Chest Hospital, were collected. AIP before surgery was calculated as log10(preoperative triglyceride concentration/preoperative high-density lipoprotein cholesterol concentration in serum). Patients were divided into low AIP, intermediate AIP and high AIP groups based on the tertiles of AIP. The primary outcome was postoperative pneumonia within 30 days after surgery. The association between AIP and postoperative pneumonia was evaluated using multivariable logistic regression, restricted cubic spline analysis, and subgroup analyses. Results A total of 1 920 patients were included, with 638 cases in low AIP group (AIP < -0.11), 641 cases in intermediate AIP group (AIP -0.11 to 0.24), and 641 cases in high AIP group (AIP > 0.24). There was significant difference in the incidence of postoperative pneumonia within 30 days after surgery among the three groups (P=0.001), with the highest incidence in high AIP group (14.2%). Multivariable logistic regression analysis showed that, in the fully adjusted model, higher AIP was associated with an increased risk of postoperative pneumonia when AIP was included as a continuous variable (OR=1.73, 95% confidence interval 1.03-2.90, P=0.038). When AIP was included as a categorical variable, compared with low-AIP group, the risk of postoperative pneumonia was increased in high AIP group (OR=1.58, 95% confidence interval 1.05-2.38, P=0.027), and no statistically significant change was observed in the risk of postoperative pneumonia in intermediate AIP group (P>0.05). Restricted cubic spline analysis showed a linear positive association between AIP and the risk of postoperative pneumonia (P for overall association=0.004, P for nonlinearity=0.337). Subgroup analyses showed that age, sex, body mass index, smoking history, and comorbid hypertension and diabetes did not interact with the association between AIP and the risk of postoperative pneumonia (P for interaction>0.05). Conclusions Preoperative AIP is associated with the risk of postoperative pneumonia in patients undergoing OPCABG. Copyright 2026, Chinese Medical Association <49> Accession Number 2044266658 Title Radiofrequency Needle and Conventional Mechanical Needle for Transseptal Access: A Systematic Review and Meta-Analysis. Source PACE - Pacing and Clinical Electrophysiology. 49(6) (pp 742-752), 2026. Date of Publication: 01 Jun 2026. Author de Amorim S.O.; Ferreira M.D.S.; Soares C.; Bastos V.C.L.; Aires M.F.M.; Pereira F.H.L.; da Silva N.F.C.; Neto J.A.; Honorato M.M. Institution (de Amorim, Ferreira, Pereira, da Silva, Neto, Honorato) Faculty of Medicine, University of the State of Para (UEPA), Para, Santarem, Brazil (Soares) Faculty of Medicine, UniAtenas, Minas Gerais, Passos, Brazil (Bastos, Aires, Honorato) Faculty of Medicine, Amazon University Center (UNAMA), Para, Santarem, Brazil Publisher John Wiley and Sons Inc Abstract Background: Transseptal puncture (TSP) is essential for various structural and electrophysiological cardiac procedures. However, the conventional mechanical needle can be challenging in complex anatomies. Radiofrequency (RF)-assisted puncture systems offer an alternative to facilitate septal crossing and potentially reduce complications. This study aimed to evaluate the efficacy and safety of RF needle TSP compared with the conventional mechanical approach. Material(s) and Method(s): A systematic review and meta-analysis was conducted following PRISMA guidelines (PROSPERO: CRD420251272470). Primary efficacy outcomes included unassisted success, crossover, and TSP and fluoroscopy time, failure to obtain left atrial access, while safety outcomes included pericardial effusion or cardiac tamponade. Statistical analyses were conducted in R software (version 4.5.1) risk ratios (RR) and differences (MD), and heterogeneity was assessed by I2 statistics. Result(s): This review included nine studies, amongst them randomized and nonrandomized. The RF needle demonstrated statistically significant superiority in several efficacy outcomes: increased unassisted success (RR: 1.05; 95% CI: 1.01-1.10), marked reduction risk in crossover rate (RR: 0.11; 95% CI: 0.03-0.38), and failure to obtain transseptal access (RR: 0.11; 95% CI: 0.04-0.33). Furthermore, the RF technique significantly reduced TSP time (MD: -154.7 s) and fluoroscopy time (MD: -84.5 s). Successful TSP rates (RR: 1.03; 95% CI: 0.99-1.06) and pericardial effusion or cardiac tamponade (RR: 0.55; 95% CI: 0.12-2.57) were comparable between groups. Conclusion(s): RF-assisted TSP demonstrated superior performance compared with the conventional mechanical technique, offering higher unassisted primary efficacy, reducing access failures, and improving procedural efficiency. Although major complication rates are similar, RF may be considered a preferred strategy, especially in complex anatomies, due to its predictability and potential benefit in neurological safety. Copyright © 2026 Wiley Periodicals LLC. <50> Accession Number 2047083403 Title From evidence to practice: Identifying candidates for semaglutide in chronic atherosclerotic disease. Source International Journal of Cardiology. 461 (no pagination), 2026. Article Number: 134646. Date of Publication: 15 Oct 2026. Author Maggioni A.P.; Orso F.; Lucci D.; De Luca L.; Colivicchi F. Institution (Maggioni, Orso, Lucci) ANMCO Research Center, HCF Fondazione ANMCO per il Tuo cuore ETS, Firenze, Italy (De Luca) Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (Colivicchi) Clinical and Rehabilitation Cardiology Department, San Filippo Neri Hospital, ASL Roma 1, Roma, Italy Publisher Elsevier Ireland Ltd Abstract Background and aim: Randomised clinical trials (SELECT and SOUL) demonstrated that semaglutide, a GLP-1 receptor agonist, reduces the combined outcome measure of atherothrombotic events or cardiovascular mortality in patients with coronary artery disease, both with and without diabetes. Because real-world populations may differ from trial cohorts, we assessed the proportion of patients potentially eligible for semaglutide using the criteria set out by the regulatory authorities based on the SELECT and SOUL results. Methods and Results: Patients whose clinical characteristics were comparable to those of patients enrolled in the SELECT and SOUL trials were identified within the START and BRING-UP prevention registries. Among 12,430 patients, 623 were excluded because of severe renal impairment or ongoing GLP-1 receptor agonist therapy. The final population included 11,807 patients: 8682 without diabetes and 3125 with diabetes. Among non-diabetic patients, 3689 (42.5%) were SELECT-like, defined as overweight or obese individuals with established coronary disease. Among diabetic patients, 3059 (97.9%) were SOUL-like, defined as individuals aged >=50 years with cardiovascular disease. Overall, 6748 of 12,430 patients (54.3%) theoretically fulfilled eligibility criteria for semaglutide treatment in real-world cardiology practice. Conclusion(s): According to the criteria set out by the regulatory authorities based on the SELECT and SOUL trial results, a large proportion of patients with coronary artery disease managed by cardiologists may be potentially eligible for semaglutide therapy. Identifying the target population for this therapeutic strategy may help clinicians and healthcare authorities estimate unmet clinical needs and evaluate the sustainability of innovative approaches for secondary cardiovascular prevention. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <51> Accession Number 2047113398 Title Long-Term Clinical and Angiographic Outcomes With Transcatheter Versus Surgical Aortic Valve Replacement in the Low- and Intermediate-Risk Population: An Updated Meta-Analysis of Randomized Controlled Trials. Source Journal of Interventional Cardiology. 2026(1) (no pagination), 2026. Article Number: 3341689. Date of Publication: 2026. Author Saleem M.M.; Tariq M.H.; Brar A.; Usman A.; Upadhyay M.; Mudassar M.; Ibrahim S.; Bajwa M.S. Institution (Saleem, Upadhyay) Internal Medicine, Michigan State University, Flint, MI, United States (Tariq) Internal Medicine, Northwest Medical Center, Tucson, AZ, United States (Brar, Usman) Internal Medicine, Hurley Medical Center, Flint, MI, United States (Mudassar) Internal Medicine, King Edward Medical College, Lahore, Pakistan (Ibrahim) Internal Medicine, King Edward Medical University, Lahore, Pakistan (Bajwa) Neurology, JFK University Medical Center, Edison, NJ, United States Publisher John Wiley and Sons Inc Abstract Background: Transcatheter aortic valve replacement (TAVR) is preferred over surgical aortic valve replacement (SAVR) in patients at high risk of morbidity or mortality from surgery. However, surgery is still preferred in younger and healthier patients with symptomatic severe aortic stenosis, although recent trials support comparable efficacy and safety of TAVR even in low-risk patients. Method(s): An intention-to-treat analysis was conducted to construct a forest plot. The primary clinical outcome was the relative risk (RR) of stroke, and the secondary outcomes included the RR of all-cause mortality, cardiovascular mortality, myocardial infarction, new-onset atrial fibrillation, aortic reinterventions, and new permanent pacemaker implantation at the longest available follow-up. Angiographic outcomes were measured in terms of the standardized mean difference (SMD) in effective orifice area (EOA) and the RR of paravalvular leakage (PVL). Subgroup analysis was performed for the clinical outcomes at a 5-year follow-up as well. Result(s): No difference was seen between the two groups in terms of the RR of mortality (RR: 0.92, 95% CI: 0.75, 1.12) as well as stroke (RR: 1.05, 95% CI: 0.81, 1.35) in both the low- and intermediate-risk patients and patients < 80 years old. The RR of cardiovascular mortality, disabling stroke, and myocardial infarction was also similar. Five-year follow-up did not show any significant difference in risk of mortality (RR: 0.97, 95% CI: 0.86, 1.11) or stroke (RR: 1.05, 95% CI: 0.89, 1.25). TAVR was associated with a lower risk of new-onset atrial fibrillation (RR: 0.35, 95% CI: 0.25, 0.49, p < 0.00001). TAVR was associated with an increased risk of PVL (RR: 5.21; 95% CI: 2.70-10.07; p < 0.00001), aortic reintervention (RR: 1.95, 95% CI: 1.38, 2.77, p = 0002), and permanent pacemaker implantation (RR: 2.04, 95% CI: 1.55, 2.69, p < 0.00001). No statistically significant difference was found in the EOA; however, sensitivity analysis showed improved EOA with TAVR (SMD: 0.24, 95% CI: 0.12, 0.35). Conclusion(s): TAVR is angiographically comparable and clinically as safe and effective as SAVR in low-risk patients, even at longer follow-up durations. Copyright © 2026 Muhammad M. Saleem et al. Journal of Interventional Cardiology published by John Wiley & Sons Ltd. <52> Accession Number 2047031966 Title Dynamic coronary roadmap-guided versus traditional percutaneous coronary intervention techniques in contrast medium volume reduction: a systematic review and meta-analysis. Source Egyptian Heart Journal. 78(1) (no pagination), 2026. Article Number: 51. Date of Publication: 01 Dec 2026. Author Almansi A.; Alqato S.; Taher L.H.; Elettreby A.M.; Batarseh S.F.; Al-dardery N.M.; Otmani Z.; Elshenawy S.; Abouzid M. Institution (Almansi) Prince Hamza Hospital, Amman, Jordan (Alqato) Arab Medical Center, Amman, Jordan (Taher) Ain Shams University, Cairo, Egypt (Elettreby) Mansoura University, Al Mansurah, Egypt (Batarseh) Jordan University of Science and Technology, Irbid, Jordan (Al-dardery) Fayoum University, Al Fayyum, Egypt (Otmani) Mouloud Mammeri University of Tizi-Ouzou, Tizi Ouzou, Algeria (Elshenawy) Alexandria University, Alexandria, Egypt (Abouzid) Poznan University of Medical Sciences, Poznan, Poland Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Dynamic Coronary Roadmap (DCR) is a novel software providing a motion-compensated, real-time overlay of coronary arteries to assist PCI device navigation with a single contrast injection. This meta-analysis evaluated the effectiveness and safety of DCR. Method(s): We searched PubMed, Scopus, Web of Science, Cochrane Library, and Embase from inception to May 5, 2024. Outcomes were pooled as risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI) using random-effects models. PROSPERO registration: CRD42024553689. Result(s): Eight studies (two RCTs, six observational; 1,512 patients) were included. DCR-guided PCI significantly reduced contrast media volume (MD = - 45.82 mL, 95% CI - 68.33 to - 23.30; P < 0.001; I2 = 97%), air kerma (MD = - 283.09 mGy, 95% CI - 474.47 to - 91.70; P = 0.004; I2 = 99%), dose area product (MD = - 6.85 Gy/cm2, 95% CI - 10.48 to - 3.22; P = 0.0002; I2 = 82%), radiation duration (MD = - 2.79 min, 95% CI - 4.59 to - 0.98; P = 0.002; I2 = 94%), and procedural duration (MD = - 3.51 min, 95% CI - 6.69 to - 0.32; P = 0.03; I2 = 0%). No significant differences were found in procedural success (RR = 1.00; 95% CI 0.99-1.01; I2 = 0%) or acute kidney injury incidence (RR = 0.40; 95% CI 0.15-1.08; I2 = 0%). Risk of bias was mixed for RCTs (low to high risk across domains) and moderate to high for observational studies, with most scoring >= 7 on the Newcastle-Ottawa Scale. Conclusion(s): DCR-guided PCI was associated with reductions in contrast use and radiation metrics without compromising procedural success; however, the overall certainty of evidence is low due to study design limitations, risk of bias, and substantial heterogeneity, warranting cautious interpretation. Copyright © The Author(s) 2026. <53> Accession Number 2046474634 Title Intravenous methadone versus regional and neuraxial analgesic techniques in the peri-operative period: a scoping review. Source Anaesthesia Reports. 14(1) (no pagination), 2026. Article Number: e70070. Date of Publication: 01 Jan 2026. Author Lim Z.J.; Rough K.; Dubey H.; Lee S. Institution (Lim, Dubey, Lee) Department of Anaesthesia, Eastern Health, Box Hill Hospital, Box Hill, VIC, Australia (Lim) Department of Anaesthesia, Austin Health, Austin Hospital, Heidelberg, VIC, Australia (Lim) Department of Critical Care, Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia (Rough) Research Library, Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia Publisher John Wiley and Sons Inc Abstract There is a renewed interest in intravenous methadone as a long-acting peri-operative opioid. However, evidence comparing intravenous methadone with contemporary regional and neuraxial analgesic techniques remains unclear. This scoping review aimed to map the current evidence evaluating intravenous methadone against regional and neuraxial analgesic techniques in the peri-operative period. This review conformed to Preferred Reporting Items for Systematic Reviews and Meta-analyses (extension for Scoping Reviews) guidelines. Relevant articles were searched in Medline, Scopus, Web of Science, EMBASE and CENTRAL from January 2000 to May 2026. All studies were reviewed with no language restrictions. Four retrospective studies involving 1341 patients were included. Intravenous methadone was compared with intrathecal morphine, epidural analgesia and transversus abdominis plane blocks across cardiac, abdominal, thoracic, pancreatic and caesarean surgeries. Three studies reported higher postoperative pain scores among patients receiving intravenous methadone compared with neuraxial analgesia, although this did not translate to clinically significant differences in opioid consumption. Shorter vasopressor requirements and earlier mobilisation were reported in patients receiving intravenous methadone. Complications were inconsistently reported across studies. In conclusion, current evidence comparing intravenous methadone with regional and neuraxial analgesic techniques remains limited and highly heterogeneous. Although neuraxial techniques were associated with lower pain scores, this did not consistently translate into higher opioid consumption among patients receiving intravenous methadone. Prospective multicentre randomised controlled trials are required to better define the role of intravenous methadone within contemporary peri-operative analgesic pathways. Copyright © 2026 The Author(s). Anaesthesia Reports published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <54> Accession Number 2046953528 Title Effects of Inspired Oxygen Concentrations During Cardiopulmonary Bypass on the Pulmonary Function of Patients Undergoing a Modified Morrow Procedure via a Small Right Axillary Incision. Source Anesthesiology Research and Practice. 2026(1) (no pagination), 2026. Article Number: 9078621. Date of Publication: 2026. Author Xu L.; Wang L.; Yan M.; Wei H.; Jiang T.; Wang H.; Guo J.; Cui Y. Institution (Xu, Yan, Wei, Jiang, Wang, Guo) Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Zhejiang, Hangzhou, China (Wang) Department of Anesthesiology, The First Affiliated Hospital of Shantou University Medical College, Guangdong, Shantou, China (Cui) Heart Center, Department of Cardiovascular Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Zhejiang, Hangzhou, China Publisher John Wiley and Sons Ltd Abstract Background: Patients with hypertrophic obstructive cardiomyopathy (HOCM) undergoing minimally invasive modified Morrow procedure may be vulnerable to postoperative pulmonary dysfunction. During cardiopulmonary bypass (CPB), lung-protective ventilation has been proposed, but the optimal inspired oxygen concentration under this strategy remains unclear. This study aimed to compare different inspired oxygen concentrations under a fixed lung-protective ventilation strategy during CPB. Method(s): This was a prospective clinical observation study involving 97 patients scheduled for modified Morrow procedures via a small right axillary incision between January 2023 and November 2023 at a single center. Patients were randomized to receive CPB ventilation with FiO<inf>2</inf> of 30%, 50%, or 100% under a standardized ultra-low-tidal-volumelung-protective strategy. The primary outcomes included the Horowitz Index (HI = PaO<inf>2</inf>/FiO<inf>2</inf>), respiratory index (RI = P(A-a)O<inf>2</inf>/PaO<inf>2</inf>), and alveolar-arterial oxygen pressure difference [P(A-a)O<inf>2</inf>] at six different time points within the first 24 h postoperatively, as well as postoperative pulmonary complications. Secondary outcomes included plasma levels of inflammatory cytokines, endothelial glycocalyx (eGC) components, and measures of postoperative rehabilitation and other complications. Result(s): There were no significant differences in terms of postoperative complications and rehabilitation among the three groups with different inspired oxygen concentrations under a fixed lung-protective ventilation strategy during CPB. Compared with the 100% FiO<inf>2</inf> group, the 30% FiO<inf>2</inf> group exhibited higher HI at 6 h and 24 h postoperatively with lower P(A-a)O<inf>2</inf> at 18 h and 24 h postoperatively and a lower RI at 24 h postoperatively. In addition, the 30% FiO<inf>2</inf> group showed lower plasma levels of inflammatory cytokines and eGC. Conclusion(s): These findings indicate that the use of 30% 100% FiO<inf>2</inf> group with ultra-low tidal volume ventilation during CPB in patients undergoing a modified Morrow procedure via a small right axillary incision was safe and associated with improved early postoperative oxygenation and attenuated inflammatory response. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2400084443. Copyright © 2026 Linting Xu et al. Anesthesiology Research and Practice published by John Wiley & Sons Ltd. <55> Accession Number 2047105843 Title Contemporary approach and key considerations to asymptomatic aortic stenosis treatment. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Banovic M.; Iung B. Institution (Banovic) Belgrade Medical School, University of Belgrade, Belgrade, Serbia (Banovic) Cardiology Department, University Clinical Center of Serbia, Belgrade, Serbia (Iung) Cardiology Department, Bichat Hospital, APHP, INSERM LVTS1148, Universite Paris-Cite, Paris, France Publisher Taylor and Francis Ltd. Abstract Introduction: Aortic stenosis (AS) is the most common and the deadliest valvular disease. The treatment of asymptomatic patients with severe AS remains a subject of investigation. Recently, ESC/EACTS guidelines for valvular diseases introduced a new indication for the treatment of asymptomatic low-risk patients with isolated high-gradient severe AS, as an alternative to clinical surveillance Area covered: This paper attempts to provide a rational, clinically oriented and evidence-based approach to the treatment of asymptomatic patients with high-gradient severe AS without additional adverse factors such as decrease in left ventricular systolic function or increase in natriuretic peptides. We searched for original and review papers through the PubMed database using the keywords: aortic stenosis, asymptomatic, risk stratification and intervention, without limiting the time period of the analyzed papers Expert opinion: The latest ESC/EACTS recommendations for the treatment of asymptomatic AS should be considered adequate. Considering differences in patient characteristics and heterogeneous treatment modalities, as well as differences in institutional-level outcomes, the optimal intervention strategy still needs clarification. Ongoing trials in asymptomatic patients with severe AS should provide significant new evidence. The diverse array of therapeutic options emphasizes the need for TAVI vs. SAVR randomized trial in middle-aged asymptomatic patients. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <56> [Use Link to view the full text] Accession Number 2045411388 Title 164: MITOCHONDRIAL-DIRECTED THERAPY IN PREVENTION OF CABG-ASSOCIATED AKI: MTDNA AS EARLY BIOMARKER. Source Critical Care Medicine. 54(3 Supplement 1) (no pagination), 2026. Date of Publication: 01 Mar 2026. Author Kumar V.; Hayase N.; Shaykhinurov E.; Saleem H.; Akben S.; Dawson G.; Song S.; Teehan E.; Abubaker T.; Perkins J.; Fox E.; Hawkins K.; Al-Mashat M.; Yamane D.; Ma P.; Yuen P.; Davison D.; Abdalla Y. Institution (Kumar) VAUnited States (Hayase) National Institutes of Health, Rockville, MD, United States (Shaykhinurov) Washington DCUnited States (Saleem, Dawson, Al-Mashat) Department of Anesthesiology and Critical Care Medicine, The George Washington Medical Faculty Associates, United States (Akben) AnkaraTurkey (Song, Teehan) George Washington University School of Medicine and Health Sciences, United States (Abubaker, Yamane, Ma, Abdalla) George Washington University, United States (Perkins) George Washington University, Division of Genomic Medicine, United States (Fox) The George Washington University Hospital, United States (Hawkins) George Washington University Hospital, United States (Yuen) Renal Diagnostics and Therapeutics Unit, National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, United States (Davison) George Washington University Hospital, Washington, DC, United States Publisher Lippincott Williams and Wilkins <57> [Use Link to view the full text] Accession Number 2045940319 Title Colchicine for Major Adverse Cardiovascular Events: An Updated ChatGPT-Assisted Systematic Review and Meta-Analysis. Source Journal of Cardiovascular Pharmacology. (no pagination), 2025. Date of Publication: 25 Nov 2025. Author Teperikidis L.; Boulmpou A.; Chownk M.; Jagdale R.; Booz G.W.; Biondi-Zoccai G.; Bhatt D.L. Institution (Teperikidis, Chownk, Jagdale) Synthesa, Inc., 19 West 24th St., New York, NY, United States (Teperikidis) Clinical Research Unit, Special Unit for Biomedical Research and Education (SUBRE), School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece (Teperikidis, Boulmpou) Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Booz) Department of Pharmacology & Toxicology, School of Medicine, University of Mississippi Medical Center, Jackson, MS (Biondi-Zoccai) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Biondi-Zoccai) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract Colchicine has been studied as an anti-inflammatory treatment for cardiovascular prevention, but findings from randomized trials have been inconsistent. This meta-analysis evaluated the efficacy and safety of colchicine in reducing major adverse cardiovascular events (MACE) and its individual components, using ChatGPT as an assistant throughout the process. Randomized trials of colchicine for cardiovascular prevention were systematically identified, and data extraction, risk of bias assessment, and meta-analyses were performed with ChatGPT under human supervision. The primary outcome was MACE, while secondary outcomes included myocardial infarction (MI), stroke, revascularization, cardiovascular mortality, and all-cause mortality. Eleven trials involving 30, 888 patients were included. Colchicine significantly reduced MACE (risk ratio 0.75, 95% CI 0.63-0.88), though no significant effects were observed for MI, stroke, cardiovascular mortality, or all-cause mortality. In addition to its clinical findings, this study illustrates the potential of ChatGPT to assist in systematic reviews and meta-analyses by automating screening, data extraction, bias assessment, and statistical code generation. This integration reduced researcher time by over 70% while maintaining accuracy through human validation. Overall, colchicine appears to lower the risk of MACE but the results of the CLEAR trial have lowered certainty, while the findings highlight the feasibility and efficiency gains of using large language models in evidence synthesis workflows. Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved. <58> Accession Number 2046591502 Title A virtual reality-based multicomponent intervention program for preventing postoperative delirium in the intensive care unit for cardiac surgery patients: from evidence-based design to a pilot trial. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1815659. Date of Publication: 2026. Author Dong J.; Ni Q.; Gong X.; Sui W.; Wang L.; Huang Z.; Yi J.; Yan R.; Jiang W.; Zhou H.; Zhang J.; Zhuang Y. Institution (Dong, Ni, Gong, Sui, Wang, Huang, Yi, Yan, Jiang, Zhou, Zhang, Zhuang) Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China (Dong, Ni, Huang, Yi, Yan, Jiang, Zhou, Zhuang) Zhejiang University School of Medicine, Hangzhou, China Publisher Frontiers Media SA Abstract Background - Postoperative delirium (POD) after cardiac surgery in the intensive care unit (ICU) has a high incidence and poor outcomes. Virtual reality (VR) is a non-pharmacological intervention of growing interest, but its effects in cardiac surgery patients remain underexplored. Aim - To evaluate the feasibility of a perioperative VR-based intervention program and to explore its preliminary clinical effects on POD, anxiety, depression, cognition, sleep, and mobility in cardiac surgery patients. Study design - A randomized controlled trial was conducted from February to March 2025 in a tertiary hospital in China. Forty participants undergoing elective cardiac surgery were assigned to usual care (control group) or usual care plus daily VR sessions from preoperative preparation until ICU discharge (intervention group) (n=20 each). Outcomes included delirium incidence, severity, duration, onset time, and changes in stress, cognition, sleep, and mobility with time perioperatively. Results - In this pilot trial, the intervention group had a lower incidence of delirium than the control group (5% vs. 35%, p=0.048). However, the study was not powered to detect differences in delirium incidence, and the limited number of events (n=8) makes this estimate unstable. Therefore, this finding should be interpreted as a hypothesis-generating signal only, not as evidence of clinical efficacy. The intervention group also had lower delirium severity, higher Barthel Index scores, and shorter ICU length of stay (all p<0.05). In addition, patients in the intervention group had lower stress levels at multiple perioperative time points, better sleep on the first and last ICU nights, and higher cognitive scores at ICU discharge than those in the control group. Repeated-measures analyses suggested favorable changes over time in anxiety, depression, and sleep in the intervention group. Conclusion - Perioperative VR-based multicomponent intervention was feasible and well accepted in this pilot study, and may indicate potential benefit in reducing POD and improving selected psychological and functional outcomes in cardiac surgery patients. These findings are preliminary and require confirmation in larger, adequately powered multicenter trials. Copyright © 2026 Dong, Ni, Gong, Sui, Wang, Huang, Yi, Yan, Jiang, Zhou, Zhang and Zhuang. <59> Accession Number 2044456198 Title Year in Review 2025: Noteworthy Literature in Cardiac Anesthesiology. Source Seminars in Cardiothoracic and Vascular Anesthesia. 30(2) (pp 103-114), 2026. Date of Publication: 01 Jun 2026. Author Yao A.; Asseff D.; Badakhsh O.; Jamal A.; Li D.; Liu H.; Peterfreund G.; Weitzel N. Institution (Yao, Asseff, Badakhsh, Jamal, Li, Liu, Peterfreund, Weitzel) Department of Anesthesiology and Pain Medicine, University of California, Davis Health, Sacramento, CA, United States Publisher SAGE Publications Inc. Abstract Cardiac anesthesiology continues to evolve as new evidence reshapes practice across multiple domains of patient care. The pace and volume of publication make it increasingly difficult for clinicians to identify studies that are most likely to change day-to-day practice. We performed a structured search of major bibliographic databases and targeted high-impact journals to identify significant cardiac anesthesia research published in 2025. Of 639 records identified, 24 publications were selected by three reviewers based on methodological rigor, clinical relevance, and anticipated impact on perioperative management. The included literature clustered into six themes: prevention of acute kidney injury, blood conservation and coagulation management, multimodal analgesia and opioid-sparing strategies, Enhanced Recovery After Surgery (ERAS) protocols with emphasis on ventilation strategies and delirium prevention, point-of-care ultrasound applications, and workforce sustainability. Together, these studies highlight a continued shift from reactive rescue to proactive optimization-before, during, and after cardiac surgery. This review summarizes the most practice-informing cardiac anesthesiology publications from 2025 to support evidence-based decision-making at the bedside. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <60> Accession Number 2038316985 Title Conduit Choice for Coronary Artery Bypass Grafting in Women. Source Journal of Updates in Cardiovascular Medicine. 14(2) (pp 33-35), 2026. Date of Publication: 01 Jun 2026. Author Bradshaw A.; Lawton J.S. Institution (Bradshaw, Lawton) Johns Hopkins University Faculty of Medicine, Department of Surgery, Division of Cardiac Surgery, MD, United States Publisher Heart and Health Foundation of Turkey (HHFT) <61> Accession Number 2047143991 Title Comment on "Sex-related differences in long-term mortality after coronary artery bypass graft surgery: a systematic review and meta-analysis". Source International Journal of Cardiology: Cardiovascular Risk and Prevention. 30 (no pagination), 2026. Article Number: 200673. Date of Publication: 01 Sep 2026. Author Yashinova D.Z.; Yuldashev S.; Khodjaniyazov A.; Murodovna A.G. Institution (Yashinova) Department of Obstetrics and Gynecology in Family Medicine, Bukhara State Medical Institute Named After Abu Ali ibn Sino, Bukhara, Uzbekistan (Yuldashev) Republican Specialized Scientific and Practical Medical Centre for Maternal and Child Health, Department of Surgical Gynecology, Uzbekistan (Khodjaniyazov) Department of Surgical Diseases and Transplantology, Urgench State Medical Institute, Uzbekistan (Murodovna) Department of Obstetrics and Gynecology No. 2, Andijan State Medical Institute, Andijan, Uzbekistan Publisher Elsevier B.V. <62> Accession Number 2046947709 Title Focal and Diffuse Coronary Artery Disease Patterns and Placebo-Controlled Angina Relief With Percutaneous Coronary Intervention. Source Journal of the American College of Cardiology. 88(1) (pp 42-58), 2026. Date of Publication: 07 Jul 2026. Author Chiew K.; Foley M.J.; Chotai S.; Naderi Z.; Rajkumar C.A.; Ahmed-Jushuf F.; Simader F.A.; Ganesananthan S.; Nagaraj V.; Khandelwal P.; Hartley A.; Keeble T.R.; Ruparelia N.; Seligman H.; Francis D.P.; Shun-Shin M.J.; Al-Lamee R.K. Institution (Chiew, Foley, Chotai, Naderi, Rajkumar, Ahmed-Jushuf, Simader, Ganesananthan, Nagaraj, Khandelwal, Hartley, Ruparelia, Seligman, Francis, Shun-Shin, Al-Lamee) National Heart and Lung Institute, Imperial College London, London, United Kingdom (Keeble) Essex Cardiothoracic Centre, Essex, United Kingdom (Keeble) Anglia Ruskin School of Medicine and Medical Technology Research Centre, Chelmsford, United Kingdom Publisher Elsevier Inc. Abstract Background: Unblinded studies have demonstrated superior procedural and clinical outcomes of percutaneous coronary intervention (PCI) in focal compared with diffuse coronary artery disease. However, data from the first placebo-controlled study did not demonstrate a differential impact of disease pattern on symptom endpoints. Objective(s): The study sought to test the ability of pattern of coronary artery disease to predict the placebo-controlled efficacy of PCI. Method(s): In the ORBITA-2 (Objective Randomised Blinded Investigation with Optimal Medical Therapy of Angioplasty in Stable Angina-2) randomized placebo-controlled trial of angioplasty for stable angina, patients underwent prerandomization nonhyperemic pressure wire pullback assessments. Seven blinded interventional cardiologists independently reviewed each pullback trace to categorize disease patterns as focal, diffuse, or mixed. These were assigned numerical values of 1, 0, and 0.5, respectively. Overall disease pattern score was determined by the mean. A score >0.5 was considered focal and <=0.5 was considered diffuse. Bayesian proportional odds modeling was used. Result(s): A total of 245 patients with 300 target vessel pullbacks were analyzed. With adjustment for prerandomization nonhyperemic pressure ratio, PCI in focal compared with diffuse disease resulted in greater improvement in angina symptom score (OR: 1.80; 95% credible interval [CrI]: 1.48-2.18; Pr[Benefit] > 99.9%) and daily episodes of angina (OR: 1.55; 95% CrI: 1.26-1.89; Pr[Benefit] > 99.9%). Focal disease also predicted greater placebo-controlled benefit in exercise treadmill time (Pr[Interaction] > 99.9%), Canadian Cardiovascular Society class (Pr[Interaction] = 99.0%), EuroQol Group 5-Dimensions 5-Level questionnaire (Pr[Interaction] = 95.1%), and Seattle Angina Questionnaire angina frequency (Pr[Interaction] = 99.5%). There was weaker evidence of interaction between disease pattern and the placebo-controlled impact of PCI on improvement in dobutamine stress echocardiography score (Pr[Interaction] = 83%). Conclusion(s): In focal disease, PCI resulted in greater placebo-controlled improvement of symptoms compared with diffuse disease. Physiological patterns of disease may be useful to guide treatment decision making with PCI for symptom relief. Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <63> Accession Number 2044281715 Title Estimated End-Tidal Sevoflurane Concentration to Maintain Optimal Anesthetic Depth During Cardiopulmonary Bypass: A Meta-Analysis. Source Biomedicines. 14(3) (no pagination), 2026. Article Number: 535. Date of Publication: 01 Mar 2026. Author Lee S.-H.; Kang T.H.; Yoo S.; Kim K. Institution (Lee, Kang) Department of Anesthesiology and Pain Medicine, Kyungpook National Medical Center, Kyungpook National University School of Medicine, Daegu, South Korea (Yoo, Kim) Department of Anesthesiology and Pain Medicine, Anam Hospital, Korea University College of Medicine, Seoul, South Korea Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Volatile anesthetic dosing during cardiopulmonary bypass (CPB) is poorly standardized. We estimated the end-tidal sevoflurane (ETsevo) concentration required to maintain adequate anesthesia during CPB and investigated the effects of age and body temperature. Method(s): This study is a PRISMA-compliant, PROSPERO-registered meta-analysis. PubMed, Embase, and the Cochrane Library were searched. Prospective studies of adults who underwent cardiac surgery with CPB and receiving sevoflurane were included. Primary outcome was mean ETsevo concentration when bispectral index (BIS) was 40-60. Three-level random-effects meta-analytic models with robust variance estimation were used to pool repeated measurements within studies. Age and body temperature were then examined as study-level moderators. Risk of bias was determined using ROBINS-I. Result(s): Five studies (n = 129) fulfilled the criteria. Pooled ETsevo during CPB was 0.88 vol% (95% confidence interval [CI] 0.29 to 1.46; p = 0.02) with substantial heterogeneity (I2 = 87.6%). Body temperature was not a significant moderator (difference 0.26 vol%; 95% CI -1.12 to 1.64; p = 0.27). Higher mean age was associated with lower ETsevo, evidenced by the finding that patients with a mean age of >62.0 years required 0.45 vol% less ETsevo (95% CI -0.78 to -0.13; p = 0.01), and sensitivity analysis revealed a 0.05 vol% decrease per additional year. Conclusion(s): To maintain BIS at 40-60 during CPB, the estimated ETsevo requirement is 0.88 vol% (minimum alveolar concentration 0.53-0.58 in patients in their 60s). Requirements decreased with age, and body temperature exerted no detectable effect. Copyright © 2026 by the authors. <64> Accession Number 2047234600 Title SGLT2 inhibitors after transcatheter aortic valve implantation: a systematic review and exploratory meta-analysis. Source IJC Heart and Vasculature. 65 (no pagination), 2026. Article Number: 101963. Date of Publication: 01 Aug 2026. Author Spadafora L.; Bernardi M.; Sarto G.; Frati G.; Valenti V.; Peruzzi M.; Galli M.; Tocci G.; Simeone B.; Nardoianni G.; Lodoli C.; Di Muro F.M.; Stefanini G.; Versaci F.; Biondi-Zoccai G.; Sciarretta S. Institution (Spadafora, Frati, Valenti, Galli, Simeone, Biondi-Zoccai, Sciarretta) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Spadafora, Bernardi, Versaci) UOC UTIC Emodinamica e Cardiologia, Santa Maria Goretti Hospital, Latina, Italy (Sarto) Cardiology Division, ICOT Istituto 'Marco Pasquali' University Hospital, Latina, Italy (Frati, Sciarretta) IRCCS NeuroMed, Pozzilli, Italy (Valenti, Peruzzi, Galli, Biondi-Zoccai) Maria Cecilia Hospital, GVM Care and Research, Cotignola, Italy (Peruzzi) Department of Medical and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy (Tocci, Nardoianni) Division of Cardiology, Department of Clinical and Molecular Medicine, University of Rome Sapienza, Sant'Andrea Hospital, Rome, Italy (Lodoli) Department of Maternal and Child Health and Urological Sciences - Policlinico Umberto I, Rome, Italy (Di Muro) Cardiology Unit, Cardiovascular and Thoracic Department, University Hospital "San Giovanni Di Dio E Ruggi d'Aragona" Largo Citta Di Ippocrate, Salerno, Italy (Di Muro) Department of Medicine, Surgery, and Dentistry, University of Salerno, Salerno, Italy (Stefanini) Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy Publisher Elsevier Ireland Ltd <65> Accession Number 2046665722 Title Lipoprotein(a) Levels, Risk of Cardiovascular Events, and Benefit of Evolocumab: Findings From the VESALIUS-CV Trial. Source Circulation. 153(25) (no pagination), 2026. Date of Publication: 23 Jun 2026. Author Monguillon V.; Marston N.A.; Bohula E.A.; Park J.-G.; Kuder J.F.; Murphy S.A.; De Ferrari G.M.; Leiter L.A.; Nicolau J.C.; Ebenbichler C.; Sinnaeve P.; Goudev A.; Budaj A.; Averkov O.; Tokgozoglu L.; Blankstein R.; Vinereanu D.; Giugliano R.P.; Sabatine M.S.; O'Donoghue M.L. Institution (Monguillon, Marston, Bohula, Park, Kuder, Murphy, Giugliano, Sabatine, O'Donoghue) TIMI (Thrombolysis in Myocardial Infarction Study) Group, Boston, MA, United States (Monguillon, Marston, Bohula, Park, Kuder, Murphy, Blankstein, Giugliano, Sabatine, O'Donoghue) Heart Vascular Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Blankstein) Department of Radiology (R.B.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (De Ferrari) Cardiology Division, Department of Medical Sciences, University of Turin and Azienda Ospedaliero-Universitaria Citta della Salute e della Scienza, Italy (Leiter) Division of Endocrinology and Metabolism, St. Michael's Hospital, University of Toronto, Canada (Nicolau) Instituto do Coracao (InCor), Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo, Brazil (Ebenbichler) Department of Internal Medicine I, Medical University Innsbruck, Australia (Sinnaeve) Department of Cardiology, Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven, Belgium (Goudev) Division of Cardiology, Medical University of Sofia, Bulgaria (Budaj) Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland (Averkov) Pirogov Russian National Research Medical University and Hadassah Medical Ltd, Moscow, Russian Federation (Tokgozoglu) Department of Cardiology, Hacettepe University, Ankara, Turkey (Vinereanu) Cardiology and Cardiovascular Surgery Department, University of Medicine and Pharmacy Carol Davila, University and Emergency Hospital, Bucharest, Romania Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Lp(a) (lipoprotein[a]) is a risk factor for coronary heart disease. Whether baseline Lp(a) identifies higher-risk patients who derive more benefit from evolocumab is not established in a population without previous myocardial infarction (MI) or stroke. METHOD(S): - From June 2019 to November 2021, the VESALIUS-CV trial (Effect of Evolocumab in Patients at High Cardiovascular Risk Without Prior Myocardial Infarctions or Stroke) enrolled patients with qualifying atherosclerosis or high-risk diabetes without previous MI or stroke and randomized them to evolocumab or placebo (median follow-up 4.6 years). In a prespecified analysis, Lp(a) was assessed at baseline in 7557 patients. Cox models were used to assess the adjusted risk of cardiovascular events by baseline Lp(a) in the placebo arm, and the efficacy of evolocumab by baseline Lp(a). The primary outcome of interest was the composite of major coronary events (coronary heart disease death, MI, or urgent coronary revascularization). RESULT(S): - Median age was 66 [interquartile range, 60-71] years, and 42.8% were women; median Lp(a) was 28 [interquartile range, 9-132] nmol/L. Higher baseline Lp(a) was associated with an increased risk of major coronary events (adjusted hazard ratio [HR<inf>adjusted</inf>] per 100 nmol/L increase in Lp(a), 1.15 [95% CI, 1.05-1.26]; P=0.004), particularly for MI (HR<inf>adjusted</inf>, 1.23 [95% CI, 1.10-1.38]; P<0.001). There was no association between Lp(a) and ischemic stroke (HR<inf>adjusted</inf>, 1.00 [95% CI, 0.84-1.19]; P=0.99). After 48 weeks, evolocumab reduced LDL-C (low-density lipoprotein cholesterol) by 66.8 mg/dL and Lp(a) by 38.0 nmol/L in patients with baseline Lp(a) >105 nmol/L versus 61.1 mg/dL and 6.0 nmol/L in those with baseline Lp(a) <=105 nmol/L. The relative reductions in the rate of major coronary events were 41% (HR, 0.59 [95% CI, 0.41-0.83]) in those with Lp(a) >105 nmol/L compared with 35% (HR, 0.65 [95% CI, 0.51-0.82]) in those below (P-interaction=0.45 for Lp[a] modeled as continuous variable). The corresponding absolute reductions were 3.7% versus 2.5% (P-interaction=0.09), corresponding to a number needed to treat of 28 versus 40 to prevent 1 major coronary event at 5 years. CONCLUSION(S): - In patients with atherosclerosis or high-risk diabetes but without previous MI or stroke, Lp(a) was independently associated with an increased risk of major coronary events but not ischemic stroke. Evolocumab reduced the relative risk of major coronary events to a similar degree irrespective of baseline Lp(a), with a numerically greater absolute risk reduction in patients with elevated Lp(a). REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifier: NCT03872401. Copyright © 2026 American Heart Association, Inc. <66> Accession Number 2046785117 Title A Trends Analysis and Scoping Review: Minimal Invasive Extracorporeal Circulation. Source Cardiovascular Engineering and Technology. (no pagination), 2026. Date of Publication: 2026. Author Hemsinli D.; Karakisi S.O.; Kilic H. Institution (Hemsinli, Karakisi) Faculty of Medicine, Department of Cardiovascular Surgery, Recep Tayyip Erdogan University, Rize, Turkey (Kilic) Faculty of Medicine, Department of Medical Biochemistry, Recep Tayyip Erdogan University, Rize, Turkey Publisher Springer Abstract Purpose: The minimal invasive extracorporeal circulation (MiECC) was developed as abiocompatible alternative to conventional cardiopulmonary bypass (cCPB), intending to mitigate haemodilution, lessen the systemic inflammatory response, and enhance organ protection. AQ2 Although the evidence base has grown over the past 30 years, there has been no systematic mappingof the evolution of research activity and its results. Method(s): The objectives are to perform a detailed analysis of the temporal, geographical, methodological, and clinical trends within MiECC research published between 1990 and 2025. Studies involving original human clinical data (randomized controlled trials, cohort studies, observational reports, methodological or protocol papers) that reported perioperative or clinical outcomes of MiECC were included. Exclusion criteria comprised reviews, meta-analyses, editorials, letters, guidelines, animal studies, and conference abstracts lacking full text. A comprehensive search of PubMed/MEDLINE, Web of Science, Scopus, and Cochrane databases was conducted up to September 2025 to gather evidence. Reference lists of included articles and relevant reviews were also screened. Data were extracted on publication year, country, sample size, study design, surgical procedure, and reported outcomes. Two reviewers independently charted the data, and discrepancies were resolved by a third reviewer. Result(s): A total of 151 studies were identified, of which 128 met eligibility criteria. Publication activity increased substantially after 2002 and peaked in 2021, with major contributions from European centres (Germany, Italy, Switzerland, Greece, and the Netherlands). Methodological/protocol papers and Randomize Controlled Trials (RCT) predominated (respectively, n = 37, n = 36). Most studies focused on coronary artery bypass grafting (CABG), while valve surgery and paediatric populations were underrepresented. Reported outcomes shifted over time: early studies emphasised transfusion and inflammatory markers, whereas more recent investigations increasingly examined renal function, neurological complications, and survival. Subgroup analyses suggested notable benefits in elderly patients, those with renal dysfunction, and individuals with low ejection fraction (EF). Conclusion(s): MiECC research has progressed from feasibility series to large multicentre trials, generating evidence for reduced transfusion requirements, attenuated inflammatory response, and better organ protection, though no clear mortality benefit has been demonstrated. Copyright © The Author(s) 2026. <67> Accession Number 2046487703 Title Percutaneous left atrial appendage closure in non-valvular atrial fibrillation with concomitant heart failure: a systematic review and meta-analysis of periprocedural and long-term outcomes. Source Current Medical Research and Opinion. 42(4) (pp 677-697), 2026. Date of Publication: 2026. Author Yusuf M.; Milla C.; Chandra L.A.; Ievan Hakim D.; Subali A.D.; Aditya M.R.; Mulia R.H.; Kizzandy K.; Susilo H.; Kencono Wungu C.D.; Papageorgiou P. Institution (Yusuf, Chandra, Ievan Hakim, Subali, Aditya, Mulia, Kizzandy) Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia (Milla) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Susilo) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Kencono Wungu) Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Kencono Wungu) Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia (Papageorgiou) Department of Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece Publisher Taylor and Francis Ltd. Abstract Objective: Heart failure (HF) frequently coexists with non-valvular atrial fibrillation (NVAF) and may adversely affect outcomes after percutaneous left atrial appendage closure (LAAC). However, data on the safety and efficacy of LAAC in this high-risk subgroup remain inconsistent. Method(s): A comprehensive search of PubMed, Cochrane Library, ScienceDirect, Epistemonikos, and MedRxiv was conducted from inception to August 2025 for studies comparing outcomes of LAAC in NVAF patients with versus without HF. Random-effects meta-analyses were performed to estimate pooled odds ratios (ORs) for periprocedural outcomes, and hazard ratios (HRs) or ORs for long-term outcomes, with 95% confidence intervals (CIs). Result(s): Forty studies comprising 351,266 patients were included, with thirty-three contributing to quantitative synthesis. Compared with patients without HF, those with HF had higher odds of periprocedural major adverse events (OR 1.17, 95% CI 1.03-1.32), periprocedural mortality (OR 2.41, 95% CI 1.84-3.16), and major bleeding (OR 1.26, 95% CI 1.08-1.45). No significant differences were observed for periprocedural stroke or pericardial effusion. During long-term follow-up, HF was associated with increased all-cause mortality (HR 1.83, 95% CI 1.50-2.22), major adverse events (HR 1.21, 95% CI 1.00-1.46), and device-related thrombus (OR 1.45, 95% CI 1.17-1.79). Rates of long-term stroke, major bleeding, and peri-device leak were similar between groups. Conclusion(s): In NVAF patients undergoing LAAC, HF confers higher procedural risk and worse long-term survival, while protection against thromboembolism and major bleeding appears comparable. These findings underscore the need for careful patient selection, optimized procedural care, and individualized post-implant antithrombotic strategies. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <68> Accession Number 2046705485 Title Psychological Experiences of Pregnancy Following Transplantation: A Systematic Qualitative Review. Source Medicina (Lithuania). 62(6) (no pagination), 2026. Article Number: 1072. Date of Publication: 01 Jun 2026. Author Papalois K.-B.; Tsarna E.; Vakas P.; Stavros S.; Matsas A.; Christopoulos P. Institution (Papalois) Oxford University Hospitals NHS Foundation Trust, Churchill Hospital, Old Rd, Headington, Oxford, United Kingdom (Tsarna, Vakas, Matsas, Christopoulos) Second Department of Obstetrics and Gynecology, Aretaieion Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece (Stavros) Third Department of Obstetrics and Gynecology, General University Hospital Attikon, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: To examine the psychological parameters among pregnant organ transplant recipients that are understudied compared to the physical health of women during post-transplantation pregnancy. Material(s) and Method(s): Systematic review based on PubMed, EMBASE, CINAHL, and PsycInfo that were searched until 15 January 2025. Quality Assessment and meta-aggregation were applied to qualitative studies. Result(s): Out of 4361 screened unique studies, six are included. Most studies were retrospective and focused on liver, kidney, and heart transplants. Meta-aggregation identified four synthesized findings: "Perception of Pregnancy after Transplantation", "Concerns about Maternal Physical Health", "Concerns about Fetal Health", and "Emotional Burden by Expectant Mothers and Coping Strategies". The review was constrained by the potential exclusion of relevant studies due to language restrictions and uncontrolled bias in the included studies. Conclusion(s): Several psychological themes were identified, not all exclusive to transplant recipients. Developing a targeted questionnaire to gather primary data could enhance clinical practice and improve counseling services for this patient population. Copyright © 2026 by the authors. <69> Accession Number 2047511840 Title Angiography-derived physiology versus pressure wire-based fractional flow reserve for coronary revascularization guidance: A systematic review and meta-analysis. Source JRSM Cardiovascular Disease. 15 (no pagination), 2026. Article Number: 20480040261469414. Date of Publication: 01 Jan 2026. Author Shah M.M.; Fatima S.; Khachatryan M.; Angela I.C.; Arshad U.; St. Jacques J.; Agha N.; Hashmi H.; Malombe B.A.; Ayaz Z.; Khawar M.M.H.; Khawar M. Institution (Shah) Department of Medicine, GMERS Medical College and Hospital, Gujarat, Patan, India (Fatima) Department of Medicine, Dow Medical College, Karachi, Pakistan (Khachatryan) Department of Medicine, Fanarjyan Clinic, Yerevan, Armenia (Angela) Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria (Arshad, Khawar) Department of Medicine, Services Institute of Medical Sciences, Lahore, Pakistan (St. Jacques) Faculty of Medical Sciences, University of the West Indies, Kingston, Jamaica (Agha) Department of Medicine, Foundation University Medical College, Islamabad, Pakistan (Hashmi) Department of Medicine, Aga Khan University, Karachi, Pakistan (Malombe) Department of Pathology, Catholic University of Health and Allied Science (CUHAS)-Bugando, Mwanza, Tanzania (Ayaz) Department of Medicine, Khyber Medical University, Peshawar, Pakistan (Khawar) Department of Medicine, King Edward Medical University, Lahore, Pakistan Publisher SAGE Publications Ltd Abstract Background: Pressure-wire-based fractional flow reserve (FFR) is the gold standard for physiological assessment of intermediate coronary stenoses but remains underutilized owing to procedural complexity, cost, and the need for hyperemic agents. Angiography-derived physiology (ADP) platforms offer a wire-free, adenosine-free alternative. This systematic review and meta-analysis compared the clinical outcomes of ADP-guided versus FFR-guided revascularization in patients with coronary artery disease. Method(s): Comprehensive searches were performed in PubMed, Embase, ScienceDirect, and Cochrane CENTRAL from inception to April 2026. Dichotomous outcomes were pooled as risk ratios (RRs) with 95% confidence intervals using random-effects models and robustness was checked with trial sequential analysis (TSA). Result(s): Three multicenter randomized controlled trials involving 6165 patients were included. There was no significant difference in the primary composite endpoint (RR: 1.14, 95% CI: 0.85-1.54; p = 0.37; I2 = 57%), all-cause mortality (RR: 1.08, 95% CI: 0.75-1.56; p = .68), cardiac death (RR: 0.89, 95% CI: 0.53-1.49; p = .66), and any myocardial infarction (RR: 1.14, 95% CI: 0.66-1.98; p = .64) between ADP-guided and pressure-wire-based FFR-guided strategies. Clinically indicated revascularization was significantly higher with ADP (RR: 1.12, 95% CI: 1.05-1.20; p = .005; I2 = 0%). Trial sequential analysis confirmed that the accumulated evidence was sufficient to conclude no clinically meaningful difference in composite outcome. Conclusion(s): ADP-guided revascularization achieves broadly comparable clinical outcomes to pressure-wire-based FFR. Although ADP offers procedural advantages, certain platforms were associated with modestly higher revascularization rates. These findings support ADP as a practical alternative to conventional FFR in selected patients. Copyright © The Author(s) 2026 <70> Accession Number 2047444662 Title Artificial intelligence in the prediction of intraoperative red blood cell transfusion in cardiac surgery: a systematic review and diagnostic test accuracy meta-analysis. Source Brazilian Journal of Anesthesiology (English Edition). 76(4) (no pagination), 2026. Article Number: 844782. Date of Publication: 01 Jul 2026. Author Valerio F.G.; Rodrigues A.C.; de Amorim D.R.S.G.; Cantarino R.E.; de Araujo G.M.; Yusuf J.; Bessa L.V.L.S.; Leme M.M.A.P.; Euzebio M.F.D.C.; Seixas F.L.; Assad A.R.; Diego L.A.D.S. Institution (Valerio, Cantarino, de Araujo, Yusuf, Bessa, Leme, Euzebio) Universidade Federal Fluminense (UFF), RJ, Niteroi, Brazil (Rodrigues) Faculdade de Ciencias Medicas da Santa Casa de Sao Paulo, (FCMSCSP), SP, Sao Paulo, Brazil (de Amorim) Universidade de Pernambuco (UPE), PE, Recife, Brazil (Seixas) Universidade Federal Fluminense, Institute of Computing, RJ, Niteroi, Brazil (Assad) Universidade Federal do Rio de Janeiro, Department of General and Specialized Surgery, Postgraduate Program in Surgical Sciences, RJ, Rio de Janeiro, Brazil (Diego) Universidade Federal Fluminense (UFF), Faculdade de Medicina, Department of Surgery, RJ, Niteroi, Brazil Publisher Elsevier Editora Ltda Abstract Background: Red Blood Cell (RBC) transfusion in cardiac surgery is associated with risks. Conventional prediction scores lack accuracy, conflicting with Patient Blood Management (PBM) principles. Artificial Intelligence (AI) offers a potential avenue for developing precise, data-driven predictive models to enhance clinical decision-making and optimize patient outcomes. Method(s): A systematic review and meta-analysis of diagnostic test accuracy studies was conducted following PRISMA guidelines, searching PubMed, Embase, and Cochrane Library databases until April 2025. Studies developing AI models to predict intraoperative Red Blood Cell (RBC) transfusions in adult cardiac surgery were included. Pooled sensitivity, specificity, and Area Under the receiver operating Characteristic Curve (AUC) were calculated using a bivariate random-effects model. To summarize overall diagnostic performance, Summary Receiver Operating Characteristic curves were generated. Result(s): Five studies encompassing 3,063 patients were analyzed in the meta-analysis. AI models demonstrated high pooled specificity, ranging from 86.3% (95% CI 82.8%-89.1%) to 93.6% (95% CI 84.3%-97.6%), whereas pooled sensitivity ranged from 50.3% (95% CI 20.9%-79.6%) to 55.7% (95% CI 33.8%-75.6%). AUC values ranged between 0.793 (95% CI 0.634-0.899) and 0.892 (95% CI 0.740-0.943). Preoperative hemoglobin levels and patient age were consistently identified as clinical predictors for intraoperative RBC transfusion. Conclusion(s): This systematic review and meta-analysis suggests that AI models may have potential for predicting intraoperative RBC transfusion in cardiac surgery, with consistently high specificity but only moderate sensitivity. However, given the low certainty of evidence, substantial heterogeneity, and reliance on non-standardized transfusion practices, these findings should be interpreted cautiously. Copyright © 2026 Sociedade Brasileira de Anestesiologia <71> Accession Number 2047119340 Title Ivabradine in Heart Transplant Recipients With Sinus Tachycardia: A Systematic Review and Meta-Analysis. Source Journal of Cardiovascular Pharmacology. (no pagination), 2026. Date of Publication: 2026. Author Hamzah K.A.; Kurmasha Y.H.; Rasheed W.M.; Al-Shammari A.S.; Shahzaib M.; Akoum A.; Shweliya M.A.; Ramadan A.; Al-Taii H.; Refaat M.M. Institution (Hamzah) 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 (Rasheed) Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Al-Shammari, Shweliya) Department of Internal Medicine, University of Baghdad College of Medicine, Baghdad, Iraq (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Akoum) Department of Internal Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Ramadan) Department of Internal Medicine, Faculty of Medicine, South Valley University, Qena, Egypt (Al-Taii) Department of Cardiology, Aultman Hospital, Canton, OH, United States (Refaat) Department of Cardiology, American University of Beirut Medical Center, Beirut, Lebanon Publisher Lippincott Williams and Wilkins Abstract Sinus tachycardia is common after heart transplantation (HTx) and may worsen graft function via increased oxygen demand and remodeling. Ivabradine, a selective If channel inhibitor, lowers heart rate independently of sympathetic activity. This meta-analysis evaluates its efficacy and safety versus standard care in HTx recipients. A comprehensive search of PubMed, Embase, WoS, Scopus, and Cochrane was conducted through September 2025. Eligible studies included randomized and non-randomized comparative trials. Data were pooled with a random-effects model to estimate mean differences (MD) for continuous outcomes and risk ratios (RR) for dichotomous outcomes. Six studies, including 852 adult HTx recipients, were included. Ivabradine consistently reduced HR across all time points. Statistical significance was reached at 24 months (MD -16.82 bpm; P=0.04) and 36 months (MD -12.94 bpm; P=0.04). A significant reduction was observed in LVMI (MD -11.10 g/m2; 95% CI -17.15 to -5.06; P<0.05; I^2=0%). While LVM and LVEF showed trends toward improvement at final follow-up (MD = -11.23 for LVM and +2.94% for LVEF), neither reached statistical significance (P = 0.06 and P = 0.48, respectively). No significant differences were found between the ivabradine and control groups regarding all-cause mortality (RR 1.16 at final follow-up; P=0.90), graft rejection (RR 1.14; P=0.87), or systolic blood pressure (MD 0.50 mmHg; P=0.83). Ivabradine lowers heart rate after heart transplantation but shows no clear benefit on mortality, rejection, or ejection fraction. It does not significantly affect blood pressure, supporting its tolerability, particularly when beta-blockers are not tolerated. Copyright © 2026 Wolters Kluwer Health, Inc. All rights reserved. <72> Accession Number 2047355468 Title Long-Term Outcomes and Predictors After Percutaneous Balloon Pulmonary Valvuloplasty for Pediatric Isolated Valvular Pulmonary Stenosis: A Systematic Review. Source Pediatric Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Pereira M.M.; Miranda J.O. Institution (Pereira, Miranda) Faculty of Medicine, University of Porto, Porto, Portugal (Miranda) Department of Pediatric Cardiology, Centro Materno-Infantil do Norte, ULS Santo Antonio, Porto, Portugal Publisher Springer Abstract Percutaneous Balloon Pulmonary Valvuloplasty (BPV) is the gold standard treatment for isolated pulmonary valve stenosis in the pediatric population. However, its long-term outcomes and associated risk factors remain incompletely characterized. This systematic review aimed to assess BPV long-term outcomes and predictors for restenosis/reintervention and pulmonary insufficiency (PI) following BPV in this population. PubMed, Scopus, Web of Science and Cochrane databases were searched to identify studies including pediatric populations with a minimum follow up of five years after BPV (ranging up to 20 years). Fifteen studies were included, comprising 1505 patients. BPV was associated with sustained relief of pulmonary valve stenosis and low procedure-related and late mortality (ranges 0-4.2% and 0-6%, respectively). Restenosis occurred in a minority of patients, (range 0-38%), and reintervention was uncommon (median rates: repeat BPV 5.0%, surgery 4.5%). Both were consistently associated with unfavorable hemodynamic characteristics including a higher initial transvalvular pulmonary gradient or a higher right ventricular overload and residual obstruction after the procedure, as well as unfavorable anatomical characteristics including a smaller pulmonary valve annulus size. PI was the most frequently late outcome identified (range 5.6%-60%), and was predominantly associated with younger age at intervention, lower body weight and greater severity of stenosis at baseline. Pulmonary valve replacement remained uncommon during follow-up (range 0-12.3%, median 1.4%). These results highlight the differential impact of anatomical, hemodynamic and procedural factors on long-term outcomes after BPV in pediatric patients. Due to substantial heterogeneity in outcome definitions and gradient assessment methods, results were synthesized narratively. Copyright © The Author(s) 2026. <73> Accession Number 2047474679 Title CPAP Versus Conventional Oxygenation Postextubation in Children With Congenital Heart Disease. Source Respiratory Care. 71(5) (pp 460-465), 2026. Date of Publication: 01 May 2026. Author Shi A.; Li M.; Zhou J.; Peng M.; Bian L. Institution (Shi, Li) Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Jiangsu Province, Nanjing City, China (Zhou, Peng, Bian) Department of Nursing, Children's Hospital of Nanjing Medical University, Jiangsu Province, Nanjing, China Publisher SAGE Publications Ltd Abstract Background: Congenital heart disease (CHD) is a leading contributor to pediatric morbidity and mortality worldwide. Postoperative respiratory complications, particularly reintubation, remain a critical concern following cardiac surgery in children. This study evaluates the effectiveness of early nasal CPAP in reducing reintubation rates and respiratory complications in children with CHD after extubation. Method(s): A single-center randomized controlled trial was conducted from July 2022 to July 2024. A total of 264 children (<=3 years) undergoing cardiac surgery for CHD were randomized to either an intervention group (n = 132), receiving nasal CPAP (4 cm H<inf>2</inf>O pressure, 5 L/min oxygen flow) immediately postextubation, or a control group (n = 132), receiving standard nasal cannula oxygen therapy. The primary outcome was reintubation within 48 h. Secondary outcomes included ventilation parameters (PaO<inf>2</inf>, P<inf>aCO</inf>, S<inf>pO</inf>) and respiratory complications (eg, bronchospasm, hypoxemia). Result(s): The reintubation rate within 48 h was significantly lower in the CPAP group compared with the control group (12% vs 28%, risk ratio 0.41, 95% CI 0.22-0.76, P < .05). The CPAP group demonstrated marked improvements in ventilation parameters (PaO<inf>2</inf>, P<inf>aCO</inf>, S<inf>pO</inf>) at 4, 8, and 12 h postextubation (P < .05 for all). Additionally, the incidence of respiratory complications was notably reduced in the intervention group (P < .05). Conclusion(s): Early application of nasal CPAP postextubation significantly reduces reintubation rates and enhances respiratory outcomes in children with CHD. This low-complexity CPAP shows promise for adoption in resource-limited settings, with potential cost advantages meriting further investigation. Copyright © Daedalus Enterprises <74> Accession Number 2047478917 Title Impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery. Source Journal of Investigative Medicine. 74(6) (pp 547-553), 2026. Date of Publication: 01 Aug 2026. Author Zhang L.; Zhai H.; Zeng H.; Qiu L.; Huang R. Institution (Zhang, Zhai, Zeng, Qiu, Huang) Anesthesia Surgery Center, The First People's Hospital, Sichuan, Guangyuan, China Publisher SAGE Publications Inc. Abstract This study aims to unravel the impact of anesthesia precision intervention on perioperative serum myocardial injury markers and major adverse cardiac events in high-risk cardiovascular patients undergoing non-cardiac surgery. One hundred and sixty high-risk cardiovascular disease patients were randomly allocated into two groups. The control group received conventional empirical management, while the observation group underwent precise anesthesia interventions. We compared the general data, the levels of myocardial injury markers, including cardiac troponin (cTn), creatine kinase isoenzyme (CK-MB), and myoglobin (Mb). Furthermore, the levels of cardiac function markers, such as brain natriuretic peptide (BNP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), as well as the levels of inflammatory factors and the incidence of adverse cardiac events were compared between the two groups. Postoperatively, the observation group exhibited significantly lower levels of cTn, CK-MB, Mb, BNP, NT-proBNP, C-reactive protein. Additionally, the total incidence of adverse cardiac events in the observation group was noticeably lower than that in the control group. The application of precise anesthetic intervention in the perioperative period of non-cardiac surgery for high-risk cardiovascular patients can further mitigate cardiac injury and reduce the incidence of adverse cardiac events, making it worthy of clinical application. Copyright © 2025 American Federation for Medical Research <75> Accession Number 651632775 Title Integrating transfusion laboratory workflows into trial randomisation: A discrete event simulation of operational and economic impact in the PROPHESY cardiac surgery programme. Source Vox Sanguinis. Conference: 39th International Congress of the ISBT. Kuala Lumpur Malaysia. 121(Supplement1) (pp 123), 2026. Date of Publication: 01 Jun 2026. Author de Chaumont L.; Baglow-Micic L.; Green L.; Tomini F. Institution (de Chaumont, Tomini) Wolfson Institute of Population Health, Queen Mary University of London, London, United Kingdom (Baglow-Micic) NHS Blood and Transplant, Barnsley, United Kingdom (Green) Blizard Institute, Queen Mary University of London, United Kingdom (Green) Barts Health NHS Trust, NHS Blood and Transplant, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: Clinical trials are a complex and resource-intensive process and recruitment performance strongly influences study timelines, statistical validity, and overall cost. Delays in enrolment can extend trial duration, increase expenditure, and slow evidence generation. In transfusion medicine, recruitment may be particularly sensitive to operational factors as bleeding events are unpredictable and time critical, with short eligibility windows that may occur outside routine working hours. As a result, recruitment rates may reflect not only clinical incidence but also organisational design and workflow structures. These considerations are especially relevant for perioperative bleeding trials, where enrolment processes, timelines, and economic consequences are closely connected. Aim(s): This study evaluates, using a discrete event simulation (DES) model, the operational and economic impact of alternative randomisation delivery models, comparing integration of transfusion laboratory staff with a conventional research-staff-led approach, using the PROPHESY cardiac surgery bleeding trial as an empirical case study. Method(s): A DES model was developed to represent patient identification and randomisation processes within the PROPHESY trial, a pilot RCT comparing prothrombin complex concentrate with fresh frozen plasma for the management of bleeding within 24 h of surgery. Two randomisation strategies were specified: (1) an integrated pathway in which transfusion laboratory staff performed randomisation as part of routine workflows, and (2) a conventional pathway in which randomisation was conducted by research staff. Inputs were informed by trial data and hospital workflow characteristics, such as staff structure and availability. Bleeding events were modelled stochastically to reflect real-world variability. Primary outcomes included time to target recruitment, missed enrolment opportunities, resource utilisation, and total operational costs. Results were synthesised using a cost-consequence framework. Result(s): The model demonstrated that integrating transfusion laboratory staff into the randomisation process substantially reduced the projected time required to achieve the target sample size from 529 days (SD: 81.86) to 243 days (SD: 39.16) under the integrated pathway, representing a reduction of 54%. This effect was driven primarily by improved coverage during out-of-hours periods and reduced missed recruitment opportunities during time sensitive bleeding events. Analysis indicated that the cost to randomise a single patient via the integrated pathway was marginally higher (12.69) due to increased labour and training costs. However, this does not capture the savings associated with the significantly shorter trial duration. When considering this factor, it is likely that total costs for the integrated pathway are significantly lower. Summary/Conclusions: This study demonstrates that organisational design in trial delivery can influence recruitment timelines and operational costs in time-critical research. By explicitly modelling workflow configuration and staffing structures, the analysis provides evidence that delivery models shape trial performance. These findings are directly relevant to PROPHESY-II and inform policy discussions on improving efficiency and value in clinical trials. Ongoing multicentre model extension and scenario analyses will support evidence-based optimisation of trial delivery. <76> Accession Number 2047415629 Title Predictors of Procedural and Clinical Outcomes Following Transcatheter Tricuspid Edge-to-Edge Repair. Source JACC: Cardiovascular Interventions. 19(10) (pp 1195-1209), 2026. Date of Publication: 25 May 2026. Author Gibson W.; Wunderlich N.C.; Alranini I.; Karaduman B.D.; Al Asmar M.; Buithieu J.; Chetrit M.; de Varennes B.; Drullinsky D.; Fam N.P.; Kedhi E.; Lachapelle K.; Modine T.; Mousavi N.; Mylotte D.; Prendergast B.; Spaziano M.; Theriault-Lauzier P.; Stephan von Bardeleben R.; Zgheib A.; Martucci G.; Piazza N. Institution (Gibson, Alranini, Al Asmar, Buithieu, Chetrit, de Varennes, Drullinsky, Kedhi, Lachapelle, Mousavi, Spaziano, Zgheib, Martucci, Piazza) Division of Cardiology, Department of Medicine, Glen Hospital, McGill University Health Center, Montreal, QC, Canada (Wunderlich) Asklepios Klinik Langen, Langen, Germany (Karaduman) Health Sciences University, Ankara Bilkent City Hospital, Ankara, Turkey (Fam) St. Michael's Hospital/University of Toronto, Toronto, ON, Canada (Modine) CHU Bordeaux, Hopital Cardiologique Haut-Leveque, Pessac, France (Mylotte) Department of Cardiology, University Hospital Galway, Galway, Ireland (Prendergast) Cleveland Clinic London and St. Thomas' Hospital, London, United Kingdom (Theriault-Lauzier) Ottawa Heart Institute, Ottawa, ON, Canada (Stephan von Bardeleben) University Medical Center Mainz, Mainz, Germany Publisher Elsevier Inc. Abstract Tricuspid transcatheter edge-to-edge repair alleviates symptoms, but survival benefit remains inconsistent. The authors conducted a Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020-compliant systematic review and meta-analysis ( CRD42024600438 ) to identify multivariable predictors of procedural success and adverse outcomes. PubMed, Scopus, the Cochrane Library, and Google Scholar were searched (from January 2008 to March 2025) for adjusted predictors of mortality, heart failure hospitalization, major adverse cardiovascular events, and procedural success. Random-effects meta-analysis was performed when >=2 independent cohorts reported comparable estimates. Fifty-nine studies met the inclusion criteria. Baseline tricuspid regurgitation severity (OR: 2.50; 95% CI: 1.33-4.71), nonanteroseptal jet location (OR: 2.46; 95% CI: 1.08-5.60), and increasing coaptation gap (HR: 1.19 per mm; 95% CI: 1.07-1.33) predicted residual tricuspid regurgitation. Residual tricuspid regurgitation >=3+ was the only predictor suitable for pooled synthesis across endpoints and was associated with all-cause mortality (HR: 2.19; 95% CI: 1.60-3.00) and major adverse cardiovascular events (HR: 1.84; 95% CI: 1.37-2.48) ( I 2 = 0%-2%.) Renal dysfunction, impaired right ventricular function and remodeling, pulmonary hypertension, and right ventricular-pulmonary arterial uncoupling reflect advanced disease substrate and demonstrated consistent associations with adverse outcomes. Among surgical risk models, the European System for Cardiac Operative Risk Evaluation II score showed limited discrimination, whereas the TRI-SCORE performed better; tricuspid transcatheter edge-to-edge repair-specific clinical models remain limited, and validated procedural prediction models are emerging. Limited data suggest that an intermediate disease profile may derive the greatest benefit, but this finding is confined to single-registry analyses. Further work is required to define optimal disease-stage thresholds and develop integrated risk models incorporating procedural outcome predictors. Copyright © 2026 . <77> Accession Number 2047327657 Title Dual antiplatelet therapy with aspirin and ticagrelor vs aspirin alone in patients with acute coronary syndrome undergoing coronary artery bypass graft surgery: a systematic review and meta-analysis. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author AlSejari N.Y.; Gadelmawla A.F.; Alsubaiei A.A.; Alsultan A.M.; Alawadhi A.N.; Alwazzan A.; Alwazzan M.A.; Alkubaisi M.I.; AlSafy D.; Alattar R.N.; Alzeaby A.S.; Alwazzan H.A.; Alaskari E.; AlMadsari E.A.; Alharran A.M. Institution (AlSejari, Alsubaiei, Alsultan) Kuwait Institute for Medical Specializations, Kuwait City, Kuwait (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Alawadhi, Alwazzan, Alwazzan, AlSafy, Alattar, Alwazzan, Alaskari) University of Jordan, Amman, Jordan (Alkubaisi, Alzeaby, AlMadsari, Alharran) College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain Publisher Springer Abstract The role of dual antiplatelet therapy (DAPT) with ticagrelor plus aspirin after coronary artery bypass grafting (CABG) in patients with acute coronary syndrome (ACS) remains uncertain. We performed a systematic review and meta-analysis to compare ticagrelor plus aspirin versus aspirin alone in ACS patients undergoing CABG. We performed a comprehensive search of MEDLINE, Cochrane Library, Scopus, and Web of Science for studies that compared ticagrelor plus aspirin to aspirin alone in patients with ACS undergoing CABG. The main meta-analysis was restricted to randomized controlled trials, while observational evidence was incorporated only in exploratory analyses. Outcomes including myocardial infarction (MI), ischemic stroke, all-cause mortality, bleeding, repeat revascularization, graft occlusion, and major adverse cardiovascular events (MACE) were analyzed. Risk of bias was assessed using Rob-2 for RCTs and the Newcastle-Ottawa Scale (NOS) for cohort studies. GRADE was used to assess the certainty of the evidence. Seven articles representing five studies were included. There were no significant differences in myocardial infarction (MI) (OR: 0.95, 95% CI 0.53-1.72), ischemic stroke, all-cause mortality, while a significant increase in major bleeding was observed. No difference was also found in repeat revascularization, graft occlusion, or minor bleeding. Sensitivity analyses identified single studies as key sources of heterogeneity for several outcomes. In the combined analysis including randomized and observational evidence, ticagrelor plus aspirin showed a lower risk of study-defined MACE compared with aspirin alone (OR 0.6, 95% CI 0.43-0.83) although this estimate was based on only two studies and was largely driven by one observational cohort. Ticagrelor plus aspirin after CABG for ACS significantly increased major bleeding, while other ischemic, graft-related, and minor bleeding outcomes showed no consistent significant differences. Further high-quality randomized evidence is needed to clarify the net clinical benefit of this strategy. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <78> Accession Number 651632277 Title Effect of acute normovolemic hemodilution on allogeneic blood transfusion in adult cardiac surgery: A systematic review and meta-analysis. Source Vox Sanguinis. Conference: 39th International Congress of the ISBT. Kuala Lumpur Malaysia. 121(Supplement1) (pp 581), 2026. Date of Publication: 01 Jun 2026. Author Hu Y.; Zhang L.; Li L.; Liu Z. Institution (Hu, Liu) Clinical Transfusion Research Center, Chinese Academy of Medical Sciences, Peking Union Medical College, Chengdu, China (Zhang, Li) Department of Blood Transfusion, The Third People's Hospital of Chengdu, Chengdu, China Publisher John Wiley and Sons Inc Abstract Background: Cardiac surgery consumes significant amounts of allogeneic blood, and transfusion is associated with increased morbidity and resource use. Acute normovolemic hemodilution (ANH) is used as an autologous blood-conservation strategy, but evidence has been inconsistent. Aim(s): To conduct a systematic review and meta-analysis of the effect of ANH in adult cardiac surgery on allogeneic transfusion requirement and clinical outcomes. Method(s): We conducted this systematic review and meta-analysis following PRISMA guidelines. PubMed, EMBASE, Cochrane Library, Web of Science, and the Chinese Biomedical Literature Database (CBM) were searched up to August 10, 2025, without language restrictions. Eligible studies were randomized clinical trials (RCTs) in adults undergoing cardiac surgery comparing ANH with no ANH (or usual care). Data were analyzed using R (version 4.5.2) and relevant packages. Random-effects meta-analyses were performed using odds ratios (ORs) and mean differences (MDs), with heterogeneity quantified by the I2 statistic. Three authors independently screened studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias 2 tool. The primary outcome was the allogeneic RBC transfusion rate. Secondary outcomes included other transfusion requirements, postoperative drainage, ICU and hospital stay, acute kidney injury, myocardial infarction, and stroke/transient ischemic attack (TIA) occurrence. Subgroup analyses were conducted according to ANH volume, transfusion threshold, and on-pump versus off-pump procedures. Result(s): Thirty-two RCTs encompassing 4360 patients were included. We found no significant reduction in RBC transfusion rate with ANH (OR, 0.66; 95% CI, 0.44-1.08; I2 = 73.6%). In subgroups, ANH reduced the RBC transfusion rate in trials using liberal transfusion strategies (OR, 0.53; 95% CI, 0.30-0.93) and high-volume ANH (OR, 0.32; 95% CI, 0.11-0.93), but interaction tests were not significant. Platelet transfusion rates showed a non-significant preference for the ANH group (OR, 1.02; 95% CI, 0.76-1.35; p = 0.915), with no heterogeneity (I2 = 0%; p = 0.68). However, ANH significantly decreased the transfusion rate of any blood component (OR, 0.52; 95% CI, 0.36-0.75; p = 0.0004). Among patients who underwent Cardiopulmonary Bypass (CPB), ANH significantly reduced postoperative blood loss via chest drainage (MD, -66.8 mL; 95% CI, -96.3 to -37.3; p < 0.001), and a significant interaction was observed between ANH and CPB use (p = 0.018). No significant differences were observed in acute kidney injury, myocardial infarction, stroke/TIA occurrence, or length of stay in the ICU/hospital. Summary/Conclusions: ANH did not significantly reduce the allogeneic RBC transfusion rate in adult cardiac surgery. Nowadays, with the restrictive transfusion strategy being one standard practice, these findings may not support the routine use of ANH, but when blood availability is limited and substantial blood loss with cardiopulmonary bypass is anticipated, high-volume ANH may be reasonable. <79> Accession Number 2046197146 Title Clinical value of the water injection, dilution, and drainage method for blind nasoenteric tube placement in patients receiving sequential enteral nutrition support after major thoracic surgery. Source Frontiers in Oncology. 16 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author Cheng K.; Zhang L. Institution (Cheng, Zhang) Outpatient Nursing Group, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China Publisher Frontiers Media SA Abstract Aim - This study aimed to evaluate the clinical effectiveness of a blind nasoenteric tube placement technique based on water injection, dilution, and drainage in patients receiving sequential enteral nutrition support after major thoracic surgery. Methods - Eighty patients who underwent major thoracic surgery were enrolled and equally assigned to an observation group and a control group. The control group received conventional blind nasoenteric tube placement using gas injection, whereas the observation group received the water injection, dilution, and drainage method. The evaluated outcomes included catheterization success rate, catheterization time, length of hospital stay, nutritional indicators, serum nutritional markers, inflammatory response markers, immune function markers, quality of life, and incidence of adverse events. Results - Compared with the control group, the observation group showed significantly shorter catheterization time and hospital stay, as well as a significantly higher catheterization success rate (P < 0.05). After the intervention, both groups demonstrated improvements in body mass index (BMI), triceps skinfold thickness (TSF), mid-arm muscle circumference (MAMC), hemoglobin, serum albumin, transferrin levels, and quality of life scores. These improvements were more pronounced in the observation group than in the control group (P < 0.05). In addition, after the intervention, the observation group had significantly lower levels of inflammatory markers, including C-reactive protein (CRP), procalcitonin (PCT), and interleukin-6 (IL-6), and significantly higher levels of immune function markers, including CD3+, CD4+, and the CD4+/CD8+ ratio, compared with the control group (P < 0.05). Moreover, the incidence of adverse reactions was significantly lower in the observation group (P < 0.05). Conclusion - The blind nasoenteric tube placement protocol based on water injection, dilution, and drainage is associated with improved catheterization success and procedural efficiency in patients receiving sequential enteral nutrition support after major thoracic surgery. The observed improvements in nutritional status, inflammatory markers, immune function, and quality of life are likely indirect and should not be attributed to the catheterization technique itself. Given the presence of multiple co-interventions and the lack of intervention isolation, these findings should be interpreted as associative and hypothesis-generating rather than causal. Copyright © 2026 Cheng and Zhang. <80> Accession Number 2046199116 Title Outcomes after using cerebral embolic protection devices during transcatheter aortic valve replacement: an updated meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1782285. Date of Publication: 01 May 2026. Author Sayed M.S.; AlQurm A.K.; Rasheed W.M.; Abedal- Kareem K.Y.; Albsoul S.M.; AlQurm S.K.; Ramadneh S.M.; Haddad J.N.; Aqtash O.; Caldonazo T. Institution (Sayed) Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt (AlQurm, Abedal- Kareem, AlQurm, Ramadneh, Haddad) School of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Rasheed) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Albsoul) Faculty of Medicine, Yarmouk University, Irbid, Jordan (Aqtash) Department of Cardiology, Baylor Scott & White, the Heart Hospital, Plano, TX, United States (Caldonazo) Department of Cardiothoracic Surgery, Jena University Hospital, Jena, Germany Publisher Frontiers Media SA Abstract Background - Cerebral embolic protection (CEP) devices have been developed to reduce periprocedural embolization through transcatheter aortic valve replacement (TAVR), yet their clinical benefit remains uncertain. This study aimed to systematically evaluate the efficacy and safety of CEP devices during TAVR using evidence restricted to randomized controlled trials (RCTs). Methods - We conducted a systematic review and meta-analysis following PRISMA guidelines. MEDLINE, Embase, Web of Science, Scopus, and Cochrane CENTRAL were searched through July 2025 for RCTs comparing CEP devices vs. no protection in patients undergoing TAVR. The primary outcome was the all-cause stroke. Random-effects model was applied for the primary analysis. Results - Nine RCTs comprising 11, 696 patients (6, 000 patients in CEP, 5, 696 patients in control) were analyzed. CEP use did not significantly reduce the overall risk of all-cause stroke (RR 0.92; 95% CI 0.73-1.14; p = 0.43). The results were consistent across different subgroups, either Sentinel (filter device) (RR 0.88; 95% CI 0.70-1.11; I2 = 0.00%) or TriGuard (deflection device) (RR 1.40; 95% CI 0.67-2.94; I2 = 0.00%) (Pinteraction = 0.50). Similarly, no significant differences between the two groups were observed for the risk of all-cause mortality, disabling stroke, non-disabling stroke, cardiovascular mortality, transient ischemic attack, major adverse cardiovascular and cerebrovascular events, major bleeding, major vascular complications, or acute kidney injury. Conclusions - Among patients undergoing TAVR, CEP devices could not reduce the risk of stroke compared with the control group. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251114450, CRD420251114450. Copyright © 2026 Sayed, AlQurm, Rasheed, Abedal- Kareem, Albsoul, AlQurm, Ramadneh, Haddad, Aqtash and Caldonazo. <81> Accession Number 651632629 Title Transfusion-Associated Circulatory Overload (TACO) in cardiac surgery: An underrecognized clinical challenge. Source Vox Sanguinis. Conference: 39th International Congress of the ISBT. Kuala Lumpur Malaysia. 121(Supplement1) (pp 545), 2026. Date of Publication: 01 Jun 2026. Author Spiljak A. Institution (Spiljak) Department of General Medicine, Institute for Healthcare of Transportation Employees Sarajevo, Sarajevo, Bosnia and Herzegovina Publisher John Wiley and Sons Inc Abstract Background: Transfusion-associated circulatory overload (TACO) is one of the leading causes of transfusion-related morbidity and mortality. Patients undergoing cardiac surgery are particularly vulnerable due to advanced age, pre-existing cardiac dysfunction, perioperative fluid shifts, and frequent exposure to blood products. Despite its clinical relevance, TACO remains underrecognized and is often misdiagnosed as other causes of postoperative respiratory deterioration. Aim(s): To highlight the clinical relevance of TACO in cardiac surgery and to increase awareness of its risk factors, diagnostic challenges, and implications for patient safety in transfusion practice. Method(s): A narrative review of the literature was conducted, focusing on transfusion-associated circulatory overload in the context of cardiac surgery. Data from observational studies, haemovigilance reports, and clinical guidelines were reviewed to summarize current evidence regarding incidence, risk factors, diagnostic criteria, and preventive strategies. Result(s): Available data indicate that cardiac surgery patients represent a high-risk population for TACO, particularly in the presence of impaired ventricular function, renal dysfunction, and perioperative massive or rapid transfusion. TACO is frequently underreported and may be confused with transfusion-related acute lung injury (TRALI) or postoperative heart failure. Delayed recognition is associated with prolonged intensive care stay and increased morbidity. Preventive measures, including individualized transfusion thresholds, careful volume assessment, and slower transfusion rates, have been shown to reduce risk. Summary/Conclusions: TACO is a common yet underrecognized complication of transfusion in cardiac surgery. Improved awareness, early recognition, and targeted preventive strategies are essential to enhance patient safety. Greater emphasis on haemovigilance and education may significantly reduce transfusion-related complications in this vulnerable population. <82> Accession Number 2047347461 Title Preoperative Ultrasound-Guided Stellate Ganglion Block for Prevention of Postoperative Sore Throat After Thoracic Surgery: Study Protocol for a Randomized Controlled Trial. Source Journal of Pain Research. 19 (no pagination), 2026. Article Number: 612817. Date of Publication: 2026. Author Wang L.; Yan X.; Jiang J.; Wu A. Institution (Wang, Yan, Jiang, Wu) Anesthesia & Operation Center, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China Publisher Dove Medical Press Ltd Abstract Purpose: Postoperative sore throat (POST) is one of the most common complaints after thoracic surgery with double-lumen endobronchial tubes (DLTs), significantly impacting postoperative recovery and patient satisfaction, yet it is often overlooked. Stellate ganglion block (SGB), a minimally invasive technique, may alleviate airway inflammation and modulate sympathetic tone. It has significant potential in reducing the incidence of POST, but evidence in DLTs patients is lacking. This trial aims to test whether preoperative ultrasound-guided SGB can ameliorate the incidence and severity of POST after thoracic surgery. Study Design and Methods: In this prospective double-blind, randomized controlled trial, 132 patients undergoing thoracoscopic resection of pulmonary lobes/segments with DLTs will be randomized to receive either US-guided SGB with 0.25% ropivacaine 4mL (Group S) or 0.9% saline 4mL (Group C) at the C6 level, on the same side as the thoracic surgery before anesthesia induction. The primary outcome is POST incidence at 6 hours postoperatively. The secondary outcomes include the incidence and severity of POST at 1, 24 and 48 hours, postoperative pain score (NRS) at different time points, postoperative nausea and vomiting, hoarseness, Quality of Recovery-15 scores, RCSQ sleep score, PCIA dosage at 24 and 48 hours. Intraoperative hemodynamic fluctuations, regional cerebral oxygen saturation (rSO<inf>2</inf>), anesthetic and vasoactive drugs will be recorded. All statistical analyses will be performed using SPSS version 26.0. Two-sided P values <0.05 will be considered statistically significant. Discussion(s): This is the first prospective trial evaluating ultrasound-guided SGB for POST after thoracic surgery with DLTs, also assessing the effect of SGB on postoperative recovery quality. The findings will provide more clinical evidence for perioperative SGB application to enhance early postoperative recovery and patient satisfaction. Copyright © 2026 Wang et al. <83> Accession Number 651632857 Title A treatment in search of evidence: A systematic review and meta-analysis of randomised trials of plasma transfusion. Source Vox Sanguinis. Conference: 39th International Congress of the ISBT. Kuala Lumpur Malaysia. 121(Supplement1) (pp 97), 2026. Date of Publication: 01 Jun 2026. Author Raza S.; Bathla A.; Maynard S.; La Rocca U.; Jacobs J.; Callum J.; Stanworth S. Institution (Raza, Bathla) Canadian Blood Services, Toronto, Canada (Maynard, Stanworth) Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (La Rocca) Italian National Blood Center, National Institute of Health, Rome, Italy (Jacobs) Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States (Callum) Kingston Health Sciences Centre, Department of Pathology and Molecular Medicine, Kingston, Canada Publisher John Wiley and Sons Inc Abstract Background: Despite widespread use, there is a lack of consensus on indications for plasma transfusion leading to substantial variability in practice. Aim(s): We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to study the efficacy of plasma for the prevention or treatment of bleeding. Method(s): We searched multiple bibliographic databases (MEDLINE (Ovid), Embase (Ovid) and Transfusion Evidence Library for published literature and ClinicalTrials.gov, WHO International Clinical Trials Registry Platform (ICTRP) and CENTRAL (The Cochrane Library 2024) for trials from January 2011 to October 2024. The search was supplemented with trials identified in prior systematic reviews. We included RCTs that compared plasma with a non-plasma comparator or no intervention. We excluded studies comparing different plasma formulations and those evaluating plasma for apheresis procedures. Abstract screening, data extraction, and risk-of-bias assessments were performed in Microsoft excel with double adjudication. Primary outcomes of interest were all-cause mortality and blood loss. Meta-analyses were conducted using inverse-variance random-effects models in RevMan. Continuous outcomes reported using heterogeneous scales were pooled as standardized mean differences (SMDs), and mortality was pooled using risk differences (RDs). We pre-defined the following populations: cardiac surgery, pre-hospital trauma, trauma treated in hospital, disseminated intravascular coagulation (DIC)/sepsis, and intraventricular hemorrhage (IVH). Result(s): Of 5745 screened citations, 48 RCTs met eligibility criteria. Populations in the included studies were cardiac surgery (13 trials, 1117 patients for mortality; 17 trials, 1403 patients blood loss), pre-hospital trauma (4 trials; 545 patients), in-hospital trauma (4 trials; 269 patients), DIC and sepsis (4 trials; 206 patients), neonates at risk of IVH (4 trials, 995 patients), renal impairment (1 trial; 63 patients) and liver disease (1 trial, 50 patients). Plasma transfusion showed no benefit compared to alternative treatments for mortality and bleeding in any patient populations (Table 1). For adult patients undergoing cardiac surgery, therapeutic plasma transfusion was associated with increased 24-h blood loss, compared with any alternative strategies (SMD 0.38, 95%CI 0.18-0.58), including prothrombin complex concentrate (SMD 0.37, 95%CI 0.11, 0.64).(Table Presented) Summary/Conclusions: There is a growing body of evidence from randomized controlled trials evaluating plasma transfusion to prevent or treat bleeding. However, our meta-analyses did not demonstrate a reduction in mortality or bleeding outcomes among patients undergoing cardiac surgery, those with pre-hospital trauma or trauma treated in hospital, DIC/sepsis, or IVH. Our findings suggest that both prophylactic and therapeutic plasma transfusion practices warrant reevaluation to better align clinical care with the current evidence base. This study was conducted on behalf of the International Collaboration for Transfusion Medicine Guidelines (ICTMG). <84> Accession Number 651632229 Title A framework and randomized blinded evaluation of a retrieval-augmented large language model for viscoelastic testing to guide transfusion. Source Vox Sanguinis. Conference: 39th International Congress of the ISBT. Kuala Lumpur Malaysia. 121(Supplement1) (pp 638), 2026. Date of Publication: 01 Jun 2026. Author Raza S.; Helmann M.; Maynard S.; Raslan I.; Dilly L.; Hu Y.; Jacobs J.; Relke N.; Tabatabaey A.; Booth G.; Thaya A.; Anand A. Institution (Raza) Medical Affairs and Innovation, Canadian Blood Services, Canada (Helmann) Department of Biostatistics, University of Toronto, Toronto, Canada (Maynard) Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom (Raslan) Division of Hematology-Oncology, St Michael's Hospital, Toronto, Canada (Dilly) Department of Pathology, University of California San Diego, La Jolla, United States (Hu) Department of Anesthesiology, University of British Columbia, Vancouver, Canada (Jacobs, Booth) Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States (Relke, Tabatabaey) Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada (Thaya) Department of Management Sciences and Engineering, University of Waterloo, Waterloo, Belgium (Anand) School of Computing, Queen's University, Kingston, Canada Publisher John Wiley and Sons Inc Abstract Background: Clinical practice guidelines remain a cornerstone of standardized clinical practice, yet knowledge translation can be labored. Large language models (LLMs) with access to clinical guidelines may improve point-of-care interpretation and decision support. Aim(s): To propose a validation pathway for retrieval-augmented generation (RAG) LLMs grounded in clinical guidelines, and to apply it to a recently published viscoelastic testing guideline. Method(s): We conducted a randomized, blinded physician-expert evaluation comparing an open-weight 120B-parameter base LLM versus a RAG-enhanced variant with access to the British Society for Haematology viscoelastic testing guideline. Eight physician participants individually authored six clinically relevant, guideline-focussed question prompts, totalling 48 prompts. Each question was independently assessed by two physicians who did not author the prompt (blinded pairwise tasks), with a third tie-breaker evaluation if necessary. Raters selected the better response and scored standardized domains (accuracy, concision, trustworthiness, hallucination) on a 5-point Likert scale. Data were collected using a custom developed remote evaluation platform. A binomial exact test assessed model preference; logistic regression tested which Likert-domain differences predicted the preferred response. Analyses were performed using R version 4.4.1. Result(s): Eight physicians performed a total of 96 blinded AI evaluations. Physician specialties were hematology (n = 3), pathology (n = 3), anesthesiology (n = 1), and emergency medicine (n = 1). Across the 48 queries, prompts related to factual retrieval were most frequent (n = 14), followed by population-specific clinical scenarios: cardiac surgery (n = 7), obstetrics (n = 7), trauma (n = 6), liver disease (n = 6), liver transplantation (n = 3), massive hemorrhage (n = 3), and non-cardiac pediatrics (n = 2). In primary analysis, the RAG model was preferred to the base model in 76% (73/96) of tasks (binomial exact test p < 0.001; 95% CI 65.7%-82.5%). Mean Likert ratings favored the RAG model across all domains (mean [95% CI]): accuracy 3.76 (3.56-3.96) vs 3.05 (2.83-3.28); concision 3.92 (3.73-4.11) vs 2.78 (2.59-2.97); trustworthiness 3.59 (3.41-3.78) vs 2.91 (2.71-3.10); hallucination 3.77 (3.57-3.97) vs 2.82 (2.59-3.06); and overall quality 3.70 (3.50-3.90) vs 2.81 (2.64-2.99). In logistic regression, higher perceived accuracy (OR 42.7; 95% CI 1.27-1437.0; p = 0.036) and trustworthiness (OR 73.0; 95% CI 2.34-2277.2; p = 0.014) were significant predictors of preference for the RAG model.(Table presented) Summary/Conclusions: We developed and applied a novel framework for a randomized, blinded clinician evaluation. We found that guideline-grounded RAG substantially improved clinician preference and average quality ratings for LLM responses to viscoelastic testing questions. Accuracy and trustworthiness were the main drivers of preference, supporting structured validation of RAG as a practical approach to accelerate guideline translation in transfusion and hemostasis decision support. Our study provides a feasible paradigm for validation of AI models to support evidence-based practice in transfusion medicine. <85> Accession Number 2047361941 Title Balloon-Expandable Versus Self-Expanding Transcatheter Heart Valves: Considerations for Device Selection for the Treatment of Aortic Stenosis. Source Current Treatment Options in Cardiovascular Medicine. 28(1) (no pagination), 2026. Article Number: 15. Date of Publication: 01 Dec 2026. Author Misra S.; Berry N.C.; Tannous H.J.; Albaghdadi M.; Szerlip M.; Baron S.; DeVries J.T.; Young M.N. Institution (Misra, Berry, DeVries, Young) Division of Cardiology, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Dartmouth, Lebanon, NH, United States (Tannous) Department of Cardiothoracic Surgery, Heart and Vascular Center, Dartmouth-Hitchcock Medical Center, Geisel School of Medicine, Lebanon, NH, United States (Albaghdadi) Department of Cardiology, NCH Rooney Heart Institute, Naples, FL, United States (Szerlip) Department of Cardiovascular Medicine, Baylor Scott & White the Heart Hospital - Plano, Plano, TX, United States (Baron) Department of Cardiovascular Medicine, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, United States Publisher Springer Abstract Purpose of Review: This review provides a practical, evidence-based summary of optimal device selection for patients with aortic stenosis undergoing transcatheter aortic valve replacement in order to guide clinicians in providing the most current treatment options for their patients. Recent Findings: The use of transcatheter heart valves has expanded to include younger patients and those with low or moderate surgical risk. There have been significant technological advances in both balloon-expandable and self-expanding valves to provide a minimally invasive approach toward valve replacement; however, device selection is based on numerous patient factors that have been better characterized in recent literature. Summary: Heart centers involving multi-disciplinary care teams are equipped to provide patients with advanced diagnostic imaging and novel transcatheter options for aortic valve replacement. Both balloon-expandable and self-expanding valves play an integral role and optimal device selection is achieved through a nuanced, bespoke approach that prioritizes the lifetime management of each patient. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <86> Accession Number 2047348542 Title Crystalloid fluids choices during cardiopulmonary bypass, outcomes of acid-base and lactate levels in cardio surgery. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 418. Date of Publication: 01 Dec 2026. Author Pabarjay M.; Azarfarin R.; Alizadeh-Ghavidel A.; Hamidi S.H.; Bakhshandeh H.; Tarkhan F.; Alijanpour S. Institution (Pabarjay) Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Azarfarin) Echocardiography Research Center, Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Alizadeh-Ghavidel) Heart Valve Disease Research Center, Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Hamidi) Department of Anesthesiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Bakhshandeh) Shahid Rajaie Cardiovascular Medical and Research Institute, Tehran, Iran, Islamic Republic of (Tarkhan) Department of Anesthesiology, Ayatollah Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of (Alijanpour) Department of Nursing, School of Nursing and Midwifery, Babol University of Medical Sciences, Babol, Iran, Islamic Republic of Publisher BioMed Central Ltd Abstract Background: Ultrafiltration is integral to cardiopulmonary bypass, yet the optimal replacement fluid for zero-balance ultrafiltration requires further investigation to guide clinical practice. This study aimed to compare the efficacy of Normal saline, Ringer's solution, and Ringer's lactate on lactate management, acid-base balance, and clinical outcomes. Method(s): This semi-experimental study enrolled 90 patients undergoing cardiopulmonary bypass (CPB) into three groups of 30. In Group-R, Ringer's solution was used as replacement fluid in Z-BUF. In Group-RL, Ringer's lactate and in Group-NS, Normal saline was used. Lactate and pH levels were measured at five points: before CPB and after anesthesia induction, after cardioplegia, before starting Z-BUF, after Z-BUF and after CPB. Result(s): While there was no significant difference in baseline lactate (T1), an increasing trend was observed up to T3. At T4, immediately after Z-BUF, lactate levels were significantly higher in Group-RL (3.5 +/- 1.0 mEq/L) compared to Group-R (2.3 +/- 1.0 mEq/L) and Group-NS (1.9 +/- 0.6 mEq/L) (p < 0.05). By T5, lactate in Group-RL decreased, showing no significant difference between groups. There were no statistically significant differences in pH between groups at any time point. However, the magnitude of pH decrease from T3 to T4 was smaller in Group-RL (7.38 +/- 0.05 to 7.37 +/- 0.03) compared to Group-R (7.39 +/- 0.05 to 7.35 +/- 0.04) and Group-NS (7.41 +/- 0.07 to 7.35 +/- 0.05). Conclusion(s): While Ringer's lactate demonstrated favorable pH stability, its clinical superiority in preventing significant acidosis or reducing bicarbonate requirements, and the implications for postoperative nursing monitoring and fluid management protocols, require validation in larger trials. Copyright © The Author(s) 2026. <87> Accession Number 2047377628 Title Artificial intelligence in congenital heart surgery: a scoping review and primer for surgeons. Source Translational Pediatrics. 15(6) (no pagination), 2026. Article Number: 244. Date of Publication: 2026. Author Francis J.; Singhania A.; Dawson S.; Caputo M.; Savovic J.; Stoica S. Institution (Francis) Department of Cardiac Surgery, St Thomas' Hospital, London, United Kingdom (Francis) Faculty of Medicine, King's College London, London, United Kingdom (Singhania, Caputo) Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom (Dawson, Savovic) Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (Dawson, Savovic) NIHR Applied Research Collaboration West (ARC West), University Hospitals Bristol, Weston NHS Foundation Trust, Bristol, United Kingdom (Stoica) Department of Paediatric Cardiac Surgery, Bristol Royal Children's Hospital, Bristol, United Kingdom Publisher AME Publishing Company Abstract Background: Congenital heart surgery (CHS) encompasses a wide spectrum of complex cardiac defects, many of which demand specialised perioperative management and tailored surgical planning. Artificial intelligence (AI), including machine learning (ML), is gaining prominence as a tool to optimise clinical decision-making and achieve better outcomes. This scoping review aims to map and summarise the existing applications of AI modalities in CHS. Method(s): A comprehensive search of MEDLINE, Embase, and Web of Science was performed, combining terms for AI with terms for congenital heart disease and surgery. Result(s): A total of 2,871 articles were retrieved from the search, of which 93 studies were included. The majority of studies focused on outcome prediction and imaging-based applications. Smaller proportions addressed decision-making and data augmentation, omics integration, benchmarking and quality improvement. The majority of studies examined heterogeneous congenital heart disease (CHD) populations, with tetralogy of Fallot (TOF) and single ventricle physiology most frequently represented. Conclusion(s): AI applications in CHS are rapidly expanding across diverse domains, with early studies showing encouraging potential to support diagnostics, guide surgical decision-making, and improve perioperative outcomes. However, most models remain in the preliminary stage with limited external validation. Emerging advances in AI may further accelerate progress, but careful evaluation and integration are essential to translate this promise into tangible clinical benefits. Copyright © AME Publishing Company. <88> Accession Number 2047477584 Title Surgical management of pulmonary tuberculosis sequelae in the era of multidrug-resistant TB: A critical review from a high-burden country perspective. Source Indian Journal of Tuberculosis. (no pagination), 2026. Date of Publication: 2026. Author Fadhil M. Institution (Fadhil) Department of Anatomy, Faculty of Medicine, Universitas Pembangunan Nasional Veteran Jakarta, Jl. RS Fatmawati Raya, Pondok Labu, Cilandak, Jakarta Selatan, Indonesia Publisher Tuberculosis Association of India Abstract Background: Indonesia carries the world's second-largest TB burden (~1.06 million cases) with significant multidrug-resistant TB (MDR-TB). Many patients develop pulmonary sequelae requiring surgery: tuberculous empyema, destroyed lung syndrome, pulmonary aspergilloma, and massive hemoptysis. Following 2022 WHO endorsement of adjunctive surgery for MDR-TB, thoracic surgery has regained importance, yet practice in high-burden resource-limited settings remains heterogeneous and uncoordinated. Method(s): A narrative critical review using systematic search (PubMed, Scopus, Cochrane, Web of Science, Indonesian repository, 2000-2026) yielded 89 eligible articles, from which 40 were retained as the cited evidence base. Thematic synthesis covered four sequelae domains and adjunctive MDR/XDR-TB surgery; evidence quality was appraised using GRADE methodology. Key Findings: A meta-analysis of 24 studies (4020 patients) shows adjunctive surgery achieves 84% sputum conversion with 2.6% perioperative mortality, though evidence remains low-to-moderate quality with selection bias. An individual patient data meta-analysis supports partial pulmonary resection (odds ratio ~3.0 for treatment success). Early VATS decortication provides better outcomes for fibrinopurulent empyema. Pneumonectomy for destroyed lung carries 3-12% mortality in experienced centers. Aspergilloma surgery with perioperative antifungal therapy reduces recurrence; bronchial artery embolization is first-line for massive hemoptysis. Translation to high-burden settings faces capacity gaps, missing referral pathways, and incomplete surgical registries. Conclusion(s): Surgery has resurfaced in the MDR-TB era as essential for TB sequelae management. Realizing this potential in high-burden countries requires coordinated referral networks, structured outcome registries, integrated CPA case-finding, and explicit incorporation of surgical pathways into national TB guidelines. Copyright © 2026 Tuberculosis Association of India. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <89> Accession Number 2047369319 Title Quantitative PET coronary flow capacity and comprehensive management of chronic CAD: Lessons from the randomized CENTURY trial. Source Atherosclerosis. 419 (no pagination), 2026. Article Number: 120831. Date of Publication: 01 Aug 2026. Author Gould K.L.; Johson N.P. Institution (Gould, Johson) From the Weatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, McGovern Medical School, University of Texas, and Memorial Hermann Hospital, Houston, TX, United States Publisher Elsevier Ireland Ltd Abstract Background and aims Randomized trials in chronic coronary artery disease (CAD) tested single interventions of lifestyle, medical treatment, or revascularization. The randomized CENTURY trial tested a comprehensive strategy integrating intense lifestyle modification, medical treatment and revascularization reserved for severely reduced coronary flow capacity (CFC) by positron emission tomography (PET), for reducing death, myocardial infarction and revascularization compared with referring-cardiologist-directed standard community care. Methods Participants with high risk factors, suspected or known CAD were randomly assigned to comprehensive or standard care. Rest-stress PET quantified CFC for physiological CAD severity at baseline, 2 and 5 years. Comprehensive care group reviewed PET results with frequent clinic visits and open 24/7 phone/email support. Standard care lacked supportive contact with blinded PET results, unblinded for severely reduced CFC with high mortality risk for potential revascularization. Results Of 1028 randomized participants, 515 were assigned to comprehensive care and 513 to standard care for the 5-year protocol with additional follow-up over next 5 to 11 years. Comprehensive vs standard care significantly decreased summed risk factor score at 5-years (P < 0.0001), all-cause death (4.7% vs. 8.2%; P = 0.023), death or MI (7.0% vs. 11.1%; P = 0.024), late revascularization (9.6% vs 14.8%; P = 0.011) and major adverse cardiac events (20.5% vs 29.9%; P = 0.0006). Only 56 of 1028 (5.4%) CENTURY patients had revascularization within 90 days guided by CFC severity, thereby reassuring and motivating patients and physicians for safely pursuing preventive risk factor goals while reserving angiogram-revascularization for high-risk, severe CFC. Intensity of adherence to comprehensive risk factor control during 5-years associated with additional significantly reduced death, MI and revascularizations over next 5 to 11 years. Conclusions The randomised CENTURY trial demonstrates that comprehensive integrated lifestyle modification and optimal medical treatment with revascularization reserved for severely reduced CFC significantly reduced death, death or MI, and revascularization at 5 years and potentially over extended 5 to 11 years of non-predefined follow-up. ( ClinicalTrials.gov NCT00756379). Copyright © 2026 The Authors. <90> Accession Number 2047473844 Title Long-term survival after percutaneous coronary intervention or coronary artery bypass grafting in patients with diabetes and multivessel disease. Source Journal of Thoracic and Cardiovascular Surgery. (no pagination), 2026. Date of Publication: 2026. Author Ameen C.; Hansson E.C.; Milojevic M.; Omerovic E.; Jeppsson A.; Nielsen S.J. Institution (Ameen, Hansson, Omerovic, Jeppsson, Nielsen) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden (Hansson, Jeppsson, Nielsen) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Milojevic) Department of Cardiac Surgery and Cardiovascular Research, Dedinje Cardiovascular Institute, Belgrade, Serbia (Milojevic) Department of Cardiac Surgery, University Hospital Zurich, University of Zurich, Zurich, Switzerland (Omerovic) Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden Publisher Elsevier Inc. Abstract Objective: The study objective was to compare mortality risks, survival times, and regional differences after coronary artery bypass grafting or percutaneous coronary intervention in patients with diabetes and multivessel disease in a large nationwide cohort of patients. Method(s): The SWEDEHEART registry was used to identify 26,166 patients with diabetes and multivessel disease who underwent percutaneous coronary intervention (n = 16,739, 64.0%) or coronary artery bypass grafting (n = 9427, 36.0%) in Sweden from 2006 to 2020. Individual patient data from 5 mandatory national registries were merged. Inverse probability of treatment weighting was used to compare groups. Sensitivity analyses included multivariable Cox regression and instrumental variable analysis. The median follow-up time was 5.5 years (range, 0-15 years). Result(s): Weighted all-cause mortality (hazard ratio, 0.80; 95% CI, 0.76-0.84) and cardiovascular mortality (hazard ratio, 0.73; 95% CI, 0.68-0.78) risks were lower after coronary artery bypass grafting compared with percutaneous coronary intervention. The weighted median survival time was 0.9 years longer (95% CI, 0.5-1.4) after coronary artery bypass grafting compared with percutaneous coronary intervention, with markedly longer survival found in patients with left main stem stenosis or 3-vessel disease (+4.1; 95% CI, 3.3-4.9 and +3.4; 95% CI, 2.8-4.0 years, respectively). The results of the sensitivity analyses supported the primary analysis. The percutaneous coronary intervention-to-coronary artery bypass grafting ratio varied markedly across Sweden's 19 health care regions, ranging from 0.9 to 7.6. Conclusion(s): Coronary artery bypass grafting was associated with significantly lower risk of all-cause and cardiovascular mortality as well as longer weighted median survival time compared with percutaneous coronary intervention in patients with diabetes and multivessel disease, particularly among patients with left main stem stenosis or 3-vessel disease. Copyright © 2026 The Authors <91> Accession Number 2047467958 Title Colchicine for Prevention of Perioperative Atrial Fibrillation and Myocardial Injury After Major Thoracic Surgery: Surgical Subgroup Analyses From the COP-AF Trial. Source European Journal of Cardio-thoracic Surgery. 68(7) (no pagination), 2026. Article Number: ezag190. Date of Publication: 01 Jul 2026. Author Wang M.K.; Devereaux P.J.; Popova E.; Razeghi G.; Finley C.; Alvarez-Garcia J.; Borges F.K.; Cata J.P.; Chan M.T.V.; Fleischmann E.; Ghasemi F.; Guerra J.M.; Landoni G.; McIntyre W.F.; McLean S.R.; Ofori S.N.; Reimer C.; Sessler D.I.; Shargall Y.; Srinathan S.K.; Tandon V.; Conen D. Institution (Wang, Devereaux, Borges, Ofori, Conen) Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada (Wang, Devereaux, Borges, McIntyre, Ofori, Sessler, Conen) Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada (Wang, Devereaux, Borges, Ghasemi, McIntyre, Ofori, Tandon, Conen) Department of Medicine, McMaster University, Hamilton, ON, Canada (Popova, Alvarez-Garcia, Guerra) Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares, Madrid, Spain (Razeghi) Department of Medicine, University of Ottawa, Ottawa, ON, Canada (Finley, Shargall) Department of Surgery, McMaster University, Hamilton, ON, Canada (Alvarez-Garcia) Department of Cardiology, Ramon y Cajal University Hospital, Madrid, Spain (Cata) Department of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States (Chan) Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong (Fleischmann) Department of Anesthesia, Intensive Care and Pain Medicine, Medical University of Vienna, Vienna, Austria (Guerra) Department of Cardiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (Guerra) Institut de Recerca Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain (Guerra) Department of Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain (Landoni) Anesthesia and Intensive Care Department, IRCCS San Raffaele Scientific Institute, Milan, Italy (Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (McIntyre) St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada (McIntyre) Hamilton Health Sciences, Hamilton, ON, Canada (McLean) Vancouver Acute Department of Anesthesiology, Vancouver General Hospital, Vancouver, BC, Canada (McLean) Department of Anesthesiology, Pharmacology & Therapeutics, The University of British Columbia, Vancouver, BC, Canada (Reimer) Department of Anesthesiology, Queen's University, Kingston, ON, Canada (Sessler) Center for Outcomes Research and Department of Anesthesiology, University of Texas Health Science Center, Houston, TX, United States (Srinathan) Department of Surgery, University of Manitoba, Winnipeg, MB, Canada Publisher European Association for Cardio-Thoracic Surgery <92> Accession Number 2047447057 Title Comparing outcomes of TAVI and SAVR in low or intermediate risk symptomatic severe aortic stenosis: A systematic review and meta-analysis. Source Open Medicine (Poland). 21(1) (no pagination), 2026. Article Number: 20261466. Date of Publication: 01 Jan 2026. Author Rashid K.; Hasan A.; Javaid M.; Ansar F.; Khan Y.; Kazmi M.H.; Farid T.; Waheed F.; Ali L.; Ali Saleh S.; Akbar R.A.; Waheed M.A. Institution (Rashid) North Cumbria Integrated Care Nhs Foundation Trust, Carlisle, United Kingdom (Hasan) University of Minnesota, Minneapolis, MN, United States (Javaid) Oxford University Hospitals, Oxford, United Kingdom (Ansar) Alkhidmat Raazi Hospital, Rawalpindi, Pakistan (Khan) Institute of Kidney Disease, Peshawar, Pakistan (Kazmi) Sunderland Royal Hospital, Sunderland, United Kingdom (Farid) Ninewell Hospital, Dundee, United Kingdom (Waheed) Hayatabad Medical Complex, Peshawar, Pakistan (Ali) Nowshera Medical College, Peshawar, Pakistan (Ali Saleh, Akbar) Hamad General Hospital, Doha, Qatar (Waheed) Hamad General Hospital, Qatar University, Doha, Qatar Publisher Walter de Gruyter GmbH Abstract Objectives: To compare the mortality and clinical outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in patients with low- or intermediate-risk symptomatic severe aortic stenosis through an updated systematic review and meta-analysis of randomized controlled trials. Method(s): This systematic review was performed using PubMed, Medline, Embase, and Cochrane databases for RCTS between 2017 and 2024 which evaluated mortality outcomes in patients with low to intermediate risk AS who received TAVI vs. SAVR. Relative risks (RRs) with 95% confidence intervals (CIs) were pooled using random effects models. Result(s): TAVI showed a numerically lower but statistically insignificant mortality risk compared to SAVR (RR: 0.88, 95% CI: 0.62-1.25, p=0.49). TAVI was associated with a higher risk of PPM insertion (RR: 2.19, 95% CI: 1.55-3.16, p<0.001, i2: 80%), aortic valve re-intervention (RR: 2.51, 95% CI: 1.40-4.51, p<0.001; I2=0%), new-onset bundle branch block (RR: 2.10, 95% CI: 1.21-3.67, p<0.01; I2=84%), and vascular site complications (RR: 4.77, 95% CI: 2.11-10.81, p<0.001; I2=62%). Atrial fibrillation incidence was lower with TAVI (RR: 0.29, 95% CI: 0.23-0.38, p<0.001; I2=73). There was no significant difference in the rates of post-procedural myocardial infarction, stroke and endocarditis between TAVI and SAVR. Conclusion(s): TAVI has mortality outcomes comparable to SAVR in low to intermediate risk patients. TAVI offers advantages in atrial fibrillation reduction, but is associated with increased risk of PPM insertion, vascular complications, new-onset bundle branch block, aortic valve re-intervention. Individualized treatment decisions remain important for optimizing outcomes in low to intermediate risk patients. Prospero registration number: CRD42024547882. Copyright © 2026 the author(s), published by De Gruyter, Berlin/Boston. <93> Accession Number 2038356516 Title Enhanced Recovery After Surgery (ERAS) in Gynecological Procedures. Source International Journal of Clinical Obstetrics and Gynaecology. 10(3) (pp 909-913), 2026. Date of Publication: 01 May 2026. Author Sharma A.D.; Shaboo S.; Solanki S.; Rohini; Maini S. Institution (Sharma, Shaboo, Solanki, Rohini, Maini) Department of Anaesthesia, Noida International Institute of Medical Sciences (NIIMS), Yamuna Expressway, Gautam Budh Nagar, Uttar Pradesh, India Publisher Integrated Publishers Abstract Enhanced Recovery After Surgery (ERAS) protocols represent a multimodal, evidence-based perioperative care pathway designed to minimise surgical stress, accelerate physiological recovery, and reduce postoperative morbidity. Despite proven efficacy in colorectal and cardiac surgery, their systematic adoption in gynaecological procedures remains limited and inconsistently studied. This prospective, randomised controlled study evaluated the clinical effectiveness of a structured ERAS protocol versus conventional perioperative care in 120 women undergoing elective gynaecological surgeries-including total abdominal hysterectomy, laparoscopic myomectomy, and staging laparotomy-at a tertiary care academic centre over a 12-month period. Patients were randomly assigned to either the ERAS group (n = 60) or the standard care group (n = 60). Primary outcomes included length of hospital stay, postoperative pain scores (Numerical Rating Scale), time to first oral intake, and time to ambulation. Secondary outcomes encompassed intraoperative haemodynamic stability, anaesthetic drug consumption, postoperative nausea and vomiting (PONV) incidence, and overall patient satisfaction. The ERAS cohort demonstrated a statistically significant reduction in mean length of hospital stay (2.8 +/- 0.6 days vs. 4.9 +/- 0.9 days; p < 0.001), lower NRS pain scores at 24 hours (3.1 +/- 0.7 vs. 5.4 +/- 1.1; p < 0.001), earlier return to oral feeding (6.2 +/- 1.4 hours vs. 18.7 +/- 3.2 hours; p < 0.001), and reduced PONV incidence (18.3% vs. 41.7%; p = 0.006). Patient satisfaction was significantly higher in the ERAS group (92% vs. 63%; p < 0.001). These findings affirm that ERAS protocols are safe, effective, and feasible in the gynaecological surgical setting, yielding measurable improvements in clinical and patient-reported outcomes. Routine implementation of ERAS in gynaecological care is strongly recommended. Copyright © Gynaecology Journal. <94> Accession Number 2047377607 Title Risk factors and predictive models for perioperative acute kidney injury in children: a narrative review. Source Translational Pediatrics. 15(6) (no pagination), 2026. Article Number: 252. Date of Publication: 2026. Author He L.; Zhuang M. Institution (He, Zhuang) Department of Operation Room, Guangdong Provincial Key Laboratory of Major Obstetric Diseases, Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China Publisher AME Publishing Company Abstract Background and Objective: Perioperative acute kidney injury (AKI) is a serious complication in children, with an incidence of 5-30% and up to 40% in neonates after cardiac surgery. It increases mortality and the risk of chronic kidney disease. This narrative review synthesizes current evidence on risk factors and predictive models for perioperative AKI in children, aiming to inform early risk stratification and preventive care. Method(s): A literature search was conducted up to March 2024 using PubMed/MEDLINE, Embase, Web of Science, and Cochrane Library. The search combined terms related to AKI, pediatrics, the perioperative period, risk factors, and prediction models. Studies focusing on pediatric patients (<=18 years) were included. Key Content and Findings: Key risk factors include young age, congenital heart disease, exposure to nephrotoxic medications, and major surgeries like those using cardiopulmonary bypass. The review evaluates predictive models, from traditional statistical methods to machine learning models that incorporate novel biomarkers such as neutrophil gelatinase-associated lipocalin and kidney injury molecule-1 for earlier detection. Promising biomarkers like urinary L-FABP and TIMP-2xIGFBP7 are also highlighted. Integrating these tools into clinical workflows can guide proactive management. Conclusion(s): Early identification of high-risk children is crucial. While predictive modeling is advancing, a gap remains in models specifically validated for pediatric populations. Future research should focus on multicenter studies to refine pediatric-specific models, validate novel biomarkers, and develop personalized approaches. Implementing evidence-based, risk-stratified care has the potential to significantly improve outcomes and long-term renal health for children undergoing surgery. Copyright © AME Publishing Company. <95> Accession Number 2047324221 Title Neosinus and Valve Thrombosis After Transcatheter Aortic Valve Replacement. Source Journal of the American Heart Association. 15(9) (pp 1-15), 2026. Article Number: e048121. Date of Publication: 2026. Author Chen N.; Mao Y.; Zhang H.-P. Institution (Chen, Zhang) Department of Cardiology, Institute of Geriatric Medicine, Beijing Hospital, National Center of Gerontology, Chinese Academy of Medical Sciences, Beijing, China (Mao) Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China (Mao) Department of Cardiovascular Surgery, Xijing Hospital, Xi'an, Shaanxi, China Publisher American Heart Association Inc. Abstract Transcatheter aortic valve replacement is regarded as an effective intervention for patients with aortic stenosis and has now been extended to low--risk populations. Leaflet thrombosis is a distinct and concerning form of transcatheter aortic valve dysfunction following transcatheter aortic valve replacement. Emerging studies have consistently shown that the formation of the neosinus after transcatheter aortic valve replacement and the resulting local hemodynamic changes are closely related to the occurrence of leaflet thrombosis. However, there is currently a lack of systematic integration of this evidence. This review aims to systematically summarize 4 key aspects of neosinus thrombosis after transcatheter aortic valve replacement: the incidence of thrombosis, the anatomical and pathological remodeling of the neosinus, the mechanisms of neosinus thrombosis, and the hemodynamic determinants within the neosinus. Local hemodynamics is the dominant and modifiable factor affecting thrombosis. Future research may integrate patient--specific modeling with long--term clinical outcomes to optimize the design and surgical strategies of transcatheter heart valves. Copyright ©2026 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. <96> Accession Number 2038344267 Title Current trends in transcatheter aortic valve implantation modelling and simulation. Source Series on Biomechanics. 39(2) (pp 3-23), 2025. Date of Publication: 2025. Author Pil N.; Selivanov G.; Seleznev M.; Pandelani T.; Krestyaninov O.; Nemavhola F.; Kuchumov A.G. Institution (Pil, Selivanov, Seleznev, Kuchumov) Biofluids Laboratory, Perm National Research Polytechnic University, Perm, Russian Federation (Pandelani) Department of Mechanical, Bioresources and Biomedical Engineering, University of South Africa, Pretoria, South Africa (Krestyaninov) Research Department of Endovascular Surgery, Academician E.N. Meshalkin National Medical Research Center, Novosibirsk, Russian Federation (Nemavhola) Department of Mechanical Engineering, Faculty of Engineering and the Built Environment, Durban University of Technology, Durban, South Africa (Kuchumov) Department of Computational Mathematics, Mechanics and Biomechanics, Perm National Research Polytechnic University, Perm, Russian Federation Publisher Bulgarska Akademiya na Naukite Abstract Transcatheter aortic implantation (TAVI) is an important minimally invasive procedure used to treat aortic stenosis, especially in high-risk patients. In recent years, there has been a significant increase in the number of TAVI procedures due to improved clinical outcomes and expanded indications for this technology in low-and intermediate-risk groups. Objective(s): This article provides an overview of current technologies and methods used to model and optimize transcatheter aortic valves. Material(s) and Method(s): The most prominent and authoritative scientific databases were utilized, including PubMed, Scopus, Web of Science, and Google Scholar papers published between 2010 and 2025.Search queries included combinations of keywords such as <<TAVI>>, <<transcatheter aortic valve implantation>>, <<aortic stenosis>>, <<computational modeling of TAVI>>, <<fluid-structure interaction>> and <<hemodynamics of TAVI>>. Result(s): We performed a systematic literature survey of peer-reviewed studies on numerical simulation of TAVI devices, focusing on Bernoulli-Euler beam approximations and Auricchio-Taylor model for shape memory stent, isotropic and anisotropic hyperelastic models of leaflet and skirt tissues-including Mooney-Rivlin, Ogden, and modified Holzapfel-Gasser-Ogden formulations and coupling strategies in fluid- structure interaction (FSI) frameworks. Key material parameters, modeling assumptions, and solver methodologies were extracted and compared. Discussion(s): This review provides a comprehensive analysis of the status and trends in TAVI, with an emphasis on the use of computer models and experimental studies to improve clinical outcomes. In addition, the future direction in personalized modeling using digital patient twins is discussed, allowing for accurate prediction of procedure outcomes and improved patient-specific valve selection. Copyright © 2025, Bulgarska Akademiya na Naukite. All rights reserved. <97> Accession Number 2047384537 Title Noninvasive Cardiac Output Monitoring Combined With Critical Care Ultrasound for Postoperative Volume Management in Cardiac Surgery Patients: A Randomized Controlled Trial. Source Journal of Surgical Research. 326 (pp 53-63), 2026. Date of Publication: 01 Oct 2026. Author Xu Y.; Zhang L.; Pan X.; Jiang Y.; Lv J. Institution (Xu, Zhang, Pan, Jiang, Lv) Department of Critical Care Medicine, Tongji University East Hospital, Shanghai, China, China Publisher Academic Press Inc. Abstract Introduction: Postoperative hemodynamic instability and low cardiac output syndrome are common complications following cardiac surgery. Conventional volume management guided by central venous pressure and mean arterial pressure has well-documented limitations. Noninvasive cardiac output monitoring (NICOM) and critical care ultrasound (CCUS) provide complementary, real-time hemodynamic and volumetric assessments. This randomized controlled trial evaluated whether NICOM+CCUS-guided fluid management improves clinical outcomes in cardiac surgery patients with postoperative hemodynamic instability. Material(s) and Method(s): In this single-center, parallel-group randomized controlled trial conducted at Tongji University East Hospital (January-December 2024), 86 adults (>=18 y) with postoperative hemodynamic instability cardiac index (CI) < 2.5 L/min/m2 plus >=1 of: lactate >2 mmol/L or norepinephrine >0.05 mug/kg/min after cardiac surgery were randomized 1:1 (control n = 43, observation n = 43) to conventional monitoring (central venous pressure/mean arterial pressure-guided) or NICOM+CCUS-guided management. Eighty-one patients (control n = 40, observation n = 41) completed analysis. Primary outcomes: extubation time category (<24 h, 24-48 h, >48 h), left ventricular ejection fraction (LVEF), and brain natriuretic peptide at intensive care unit (ICU) discharge. Secondary Outcomes: lactate normalization time (<2 mmol/L), 24-h urine output, net fluid balance, acute heart failure incidence, intra-aortic balloon pump use, mechanical ventilation duration, and ICU length of stay. Categorical variables were analyzed using chi2/Fisher's exact tests; continuous variables were analyzed using t-test/Mann-Whitney U-test after Shapiro-Wilk normality testing. Within-group changes were assessed using paired t-test/Wilcoxon test. Significance: P < 0.05 (two-sided). Result(s): Baseline characteristics were balanced (P > 0.05). The observation group had higher 24-h extubation rates 92.7% versus 60.0%; odds ratio 7.96 (95% CI 2.14-29.63), P < 0.001 and greater LVEF improvement median DELTA6.7% (95% CI 3.2-10.2), P < 0.001 versus control at discharge. The greater LVEF improvement in the observation group was accompanied by lower net fluid balance, earlier lactate normalization, and reduced diuretic use, suggesting that optimized volume status and improved oxygen delivery contributed to enhanced myocardial recovery. Brain natriuretic peptide reduction was more pronounced DELTA-104.0 +/- 68.2 versus -58.8 +/- 62.1 pg/mL; P = 0.031. Secondary outcomes favored the observation group: lactate normalization 16.2 +/- 8.5 versus 28.3 +/- 11.4 h; mean difference (MD) -12.1 h (95% CI -16.7 to -7.5), P < 0.001, urine output 4846.7 +/- 1653.4 versus 4086.5 +/- 1113.8 mL; MD 760.2 mL (95% CI 148.6-1371.8), P = 0.015, net fluid balance 101.4 +/- 32.3 versus 347.6 +/- 64.2 mL; MD -246.2 mL (95% CI -278.5 to -214.0), P < 0.001, acute heart failure 4.8% versus 17.5%; odds ratio 0.24 (95% CI 0.05-1.17), P = 0.045, mechanical ventilation 15.1 +/- 9.3 versus 27.3 +/- 11.5 h; MD -12.2 h (95% CI -16.9 to -7.5), P < 0.001, and ICU stay 31.1 +/- 13.3 versus 42.5 +/- 13.1 h; MD -11.4 h (95% CI -17.4 to -5.4), P < 0.001. Conclusion(s): NICOM+CCUS-guided fluid management significantly improved hemodynamic stability, cardiac recovery, and resource utilization compared to conventional monitoring. This noninvasive strategy reduced fluid overload and complications in high-risk cardiac surgery patients. Multicenter trials enrolling a broader range of cardiac surgical procedures with long-term follow-up are warranted. Copyright © 2026 Elsevier Inc. <98> Accession Number 2047346341 Title Comparison of the Efficacy of Ciprofol and Propofol for Rapid Sequence Induction and Intubation in Elective Non-Cardiac Surgery: A Prospective, Randomized, Non-Inferiority Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 614980. Date of Publication: 2026. Author Lin Y.; Wang C.; Wu J.; Liu J.; Liu M.; Miao C.; Liang C. Institution (Lin, Wu, Wang, Wu, Liu, Liu, Miao, Liang) Department of Anesthesiology, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Dove Medical Press Ltd Abstract Background: Rapid sequence induction and intubation (RSII) requires an agent that provides excellent intubating conditions with minimal hemodynamic disturbance. Propofol is standard but often causes hypotension. We compared the novel agent ciprofol with propofol for RSII in adult patients scheduled for elective non-cardiac surgery. Method(s): In this prospective, randomized, double-blind, non-inferiority trial, 170 adult patients scheduled for elective non-cardiac surgery were allocated to receive intravenous ciprofol (0.4 mg/kg, n = 85) or propofol (2.0 mg/kg, n = 85) for induction, with remifentanil and rocuronium. The non-inferiority margin was set at -10% for the primary outcome. The primary outcome was the proportion of patients with excellent intubation conditions (Viby-Mogensen scale). Secondary outcomes included incidence of hypotension, induction success rate, time to loss of consciousness (LOC), bispectral index (BIS) values, and pain on injection. Result(s): Excellent intubation conditions were achieved in 96.5% (82/85) of the ciprofol group and 95.3% (81/85) of the propofol group (difference 1.2%, 95% CI: -4.4% to 6.7%). The lower limit of the 95% CI exceeded the prespecified non-inferiority margin of -10%. The per-protocol analysis confirmed non-inferiority (difference 1.2%, 95% CI -4.2% to 6.7%). The incidence of post-induction hypotension was significantly lower in the ciprofol group (15.3% vs 43.5%; RR 0.35, 95% CI 0.20 to 0.61; P < 0.001). No patient reported injection pain with ciprofol, compared to 68.2% with propofol (P < 0.001). Time to LOC and induction success rates were similar between groups. Conclusion(s): In adult patients undergoing elective non-cardiac surgery under a standardized RSI protocol, ciprofol 0.4 mg/kg provided intubating conditions non-inferior to propofol 2.0 mg/kg and was associated with less post-induction hypotension and injection pain. Further studies are needed in emergency, critically ill, and high-risk RSI populations. Trial Registration: Chinese Clinical Trial Registry (ChiCTR2500095742). Copyright © 2026 Lin et al. <99> Accession Number 2047437946 Title Efficacy of intraoperative hemoadsorption in patients undergoing cardiac surgery, a meta-analysis. Source Perfusion (United Kingdom). (no pagination), 2026. Date of Publication: 2026. Author Motawea K.R.; Abouainain L.; Amer A.E.; Mohamed M.S.; Kandil O.; Kheuka Y.A.; Almaraihah R.A.; Pelletier M.; El-Diasty M.; Elgudin Y.; Sabik J.; Abu-Omar Y. Institution (Motawea, El-Diasty, Elgudin, Sabik, Abu-Omar) Division of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Abouainain) Faculty of Medicine, University of Jordan, Amman, Jordan (Amer) Pulmonary and Critical Care Department, Tufts Medical Center, Boston, MA, United States (Mohamed) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Kandil) Department of Cardiothoracic Surgery, Mayo Clinic, Phoenix, AZ, United States (Kheuka) Department of Medicine, Azerbaijan Medical University, Baku, Azerbaijan (Almaraihah) Department of Cardiac Surgery, University College London Hospitals, London, United Kingdom (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher SAGE Publications Ltd Abstract Objectives: Comparing clinical outcomes after cardiopulmonary bypass with hemodsorption (HA) versus cardiopulmonary bypass without HA in patients undergoing cardiac surgery in terms of mortality and major complications. Method(s): PubMed, Scopus, and Web of Science databases were searched for relevant randomized control trials (RCTs) that compared postoperative clinical outcomes between patients receiving intraoperative HA with cardiopulmonary bypass versus patients receiving cardiopulmonary bypass without intraoperative HA in cardiac surgery. Result(s): Sixteen RCTs with 851 patients (433 in the HA group and 418 in the control group), were included in our meta-analysis. Our meta-analysis found no significant differences between the intraoperative HA group and the control group in patients undergoing cardiac surgery in terms of 30-days/in-hospital mortality, new-onset atrial fibrillation, stroke or cerebrovascular events, postoperative delirium, renal failure/acute kidney injury, need for renal replacement, postoperative liver dysfunction, thrombocytopenia, bleeding, volume of blood loss, pneumonia, sepsis, respiratory insufficiency, duration of postoperative ventilation, distributive/septic shock, pericardial tamponade, need for extracorporeal membrane oxygenation (ECMO) support, sequential organ failure assessment (SOFA) score at ICU admission, plasma-free hemoglobin levels, and fibrinogen levels. However, the pooled analysis showed a significant association between HA and decreased albumin at ICU admission (MD = - 0.28, 95% CI [0.55 to 0.01], p-value = 0.04), decreased length of ICU stay (MD = -0.66, 95% CI [-1.24 to 0.08], p-value = 0.03), and decreased length of hospital stay (MD = -0.99, 95% CI [-1.88 to -0.10], p-value = 0.03). Conclusion(s): Our findings suggest that there is not enough evidence to endorse the role of routine intraoperative HA during cardiopulmonary bypass in improving clinical outcomes after cardiac surgery. Factors such as patient risk profile, procedure complexity, and cost implications should be taken into account when considering this adjunct therapy. Copyright © The Author(s) 2026 <100> Accession Number 2047402647 Title Dexmedetomidine for the prevention of postoperative atrial fibrillation: A systematic review and meta-analysis. Source Journal of International Medical Research. 54(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Chen Y.-J.; Xu S.-S.; Shen Q.-H.; Yu D.-H. Institution (Chen) Department of Anesthesiology, Sir Run Run Shaw Hospital Affiliated with the Zhejiang University, China (Xu, Shen, Yu) Department of Anesthesiology, Affiliated Hospital of Jiaxing University, China Publisher SAGE Publications Ltd Abstract Objective: Postoperative atrial fibrillation, a prevalent complication following cardiac surgery, significantly increases patient morbidity and healthcare expenditures. Although dexmedetomidine has been proposed as a potential strategy to mitigate the risk of postoperative atrial fibrillation risk, existing evidence from randomized controlled trials has shown conflicting results. Method(s): To evaluate the efficacy of perioperative dexmedetomidine in adult cardiac surgery patients, we conducted a systematic search across four major electronic databases: (a) PubMed; (b) Embase; (c) the Cochrane Library; and (d) Web of Science. Our search sought all relevant randomized controlled trials on this specific intervention and patient population. We utilized random-effects models to synthesize treatment effects, expressed as risk ratios with 95% confidence intervals. Furthermore, trial sequential analysis and the Grading of Recommendations Assessment, Development, and Evaluation framework were applied to determine the robustness and certainty of the evidence, respectively. Result(s): Our analysis included 22 randomized controlled trials, involving a total of 4063 patients. Dexmedetomidine administration significantly lowered the risk of postoperative atrial fibrillation risk compared with control groups (risk ratio 0.80, 95% confidence interval: 0.70-0.93; I2 = 28%). Subgroup analysis specifically indicated a significant reduction in postoperative atrial fibrillation risk in placebo-controlled trials, while no notable difference was observed when dexmedetomidine was compared with other active sedative agents. In addition, dexmedetomidine was associated with a reduced risk of postoperative delirium (risk ratio 0.62, 95% confidence interval: 0.44-0.87; I2 = 56%). Conclusion(s): Perioperative dexmedetomidine appears to reduce the risk of both postoperative atrial fibrillation risk and delirium in adult cardiac surgery patients, particularly compared with placebo. However, its efficacy relative to alternative active prophylactic agents remains unclear, necessitating rigorous comparative effectiveness trials. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <101> Accession Number 2047296501 Title Robotic coronary revascularization: a scoping review of the published evidence. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 31. Date of Publication: 01 Dec 2026. Author Arafat A.A.; Alshehri S.; Alhijab F.; Elkhouly A.; Alsaadi R.; Rafiq R.; Rafiq F.; Selan J.; Elmahrouk Y.; Alnasrallah S.; Alotaibi K.A.; AlAklabi M.M. Institution (Arafat, Alshehri, Alhijab, Alotaibi, AlAklabi) Cardiac Surgery Department, Prince Sultan Cardiac Center, Makkah Almukaramah Branch Road, Riyadh, Saudi Arabia (Arafat, Selan, Alnasrallah) Research and Innovation Institute, Ministry of Defense Health Services, Riyadh, Saudi Arabia (Elkhouly) Cardiothoracic Surgery Department, Tanta University, Tanta, Egypt (Alsaadi) Research Center, King Faisal Specialized Hospital and Research Center, Jeddah, Saudi Arabia (Rafiq) Army Medical College, Rawalpindi, Pakistan (Rafiq) Shifa College of Medicine, Islamabad, Pakistan (Elmahrouk) Faculty of Medicine, Tanta University, Tanta, Egypt Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: Robotic coronary artery bypass grafting (CABG) has been performed for more than 25 years, but the published evidence base is dispersed across single-center experience, registry analyses, and a small number of trials. A consolidated map of what has been studied, where, and which outcomes have been reported is needed to support clinical decision-making and guide future research. This study aimed to systematically map the published original literature on robotic CABG, characterizing study designs, geography, sample sizes, procedures, and the outcomes reported. A scoping review was conducted and reported in accordance with PRISMA-ScR. PubMed/MEDLINE, Scopus, Embase, and Google Scholar were searched from 1998 to October 2025; 69 additional records were identified from secondary sources. Records were de-duplicated in Covidence; two reviewers independently screened titles, abstracts, and full texts. Editorials, commentaries, reviews, meta-analyses, abstracts, operative-technique articles, laser-revascularization studies, and full texts that could not be retrieved were excluded. Result(s): Of 3065 records identified, 2277 unique studies were screened, 595 underwent full-text review, and 369 met inclusion criteria. The evidence base was predominantly observational (cohort 64.8%; case report 17.1%; case series 15.7%); randomized trials accounted for only 1.9% (n = 7). Most studies were single-center (87.8%) and conducted in the United States (39.8%), Germany (8.7%), Canada, and Austria (each 7.9%). Sample sizes were highly skewed (median: 72, IQR: 12-234). TECAB was the most common procedure (43.4%), followed by robotic-assisted MIDCAB (39.0%) and hybrid coronary revascularization (13.0%). Some version of the da Vinci platform was used in 73.0% of studies; ZEUS accounted for 5.4%. Conduit use was dominated by the LIMA (84.8%); the RIMA was reported in 30.4%. In-hospital mortality was the most consistently reported outcome (69.6%); long-term graft patency (24.7%), economic outcomes (6.8%), and patient-reported outcomes (22.0%) were under-reported. Conclusion(s): The published evidence on robotic coronary revascularization is abundant but methodologically uneven: the field is dominated by single-center cohort experience, with very few randomized trials and limited reporting of long-term, economic, and patient-reported outcomes. Future research should prioritize multicenter prospective studies, standardized core-outcome reporting, and direct comparison with conventional and minimally invasive alternatives. Copyright © The Author(s) 2026. <102> Accession Number 2047402673 Title Rehabilitation strategies for abdominal wall reinnervation after intercostal nerve injury: A narrative review. Source Journal of International Medical Research. 54(7) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Bagheri K.; Reid A.; Daley D.N.; Eriksson E.; Kolski M.C.; Sherrier M.C. Institution (Bagheri) Department of Physical Medicine & Rehabilitation, HonorHealth, United States (Reid, Daley, Sherrier) Department of Orthopaedics and Physical Medicine & Rehabilitation, Medical University of South Carolina, United States (Eriksson) Department of Surgery, Medical University of South Carolina, United States (Kolski) Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, United States (Kolski) Department of Physical Therapy and Human Movement Sciences, Shirley Ryan AbilityLab, United States Publisher SAGE Publications Ltd Abstract The abdominal wall musculature, including the rectus abdominis, transversus abdominis, and internal and external obliques, is a complex, multifunctional unit essential for trunk stability, postural control, and respiratory function. Injury to the intercostal nerves innervating these muscles, which may occur following rib fractures, thoracic surgery, trauma, or iatrogenic interventions, can lead to significant motor and respiratory deficits, including abdominal wall bulging, reduced trunk stability, impaired cough, and diminished forced expiration. Surgical interventions such as intercostal nerve exploration and neurolysis with possible direct neurorrhaphy versus allograft nerve reconstruction offer the potential for reinnervation; however, successful functional recovery depends on structured, targeted rehabilitation. This narrative review synthesizes current knowledge on abdominal wall anatomy, intercostal nerve injury consequences, surgical repair strategies, and rehabilitation principles, focusing on abdominal wall-specific recovery. It proposes a phased rehabilitation framework that integrates motor retraining, respiratory optimization, cortical plasticity-guided techniques, and functional retraining. Objective outcome measures, including ultrasound, electrodiagnostic testing, and timed leg-lowering tests and respiratory metrics such as peak cough flow, can guide and track recovery. By combining neuroplasticity-driven interventions, respiratory integration, and progressive, task-specific retraining, clinicians may optimize functional outcomes for patients following intercostal nerve injury. Future research should prioritize the standardization of assessment methods and validation of structured rehabilitation protocols. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <103> Accession Number 651605536 Title Analgesic efficacy of locoregional anesthesia techniques in cardiac surgery: a systematic review and network meta-analysis of randomized trials. Source Regional anesthesia and pain medicine. (no pagination), 2026. Date of Publication: 25 Jun 2026. Author Dejaegere M.; Vandepitte J.; Van den Eynde J.; Coppens S.; Oosterlinck W.; Rex S.; Hoogma D.F. Institution (Dejaegere, Vandepitte, Coppens, Rex, Hoogma) Department of Anesthesiology, University Hospitals Leuven, Leuven, Belgium (Van den Eynde, Coppens, Oosterlinck, Rex, Hoogma) Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium (Oosterlinck) Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium Abstract BACKGROUND: Postoperative pain following cardiac surgery remains a clinical challenge. Despite opioids remaining central to perioperative analgesia, their adverse-effect burden drives the search for effective locoregional analgesic (LRA) alternatives; yet guideline recommendations remain constrained by the lack of high-quality comparative data among LRA techniques. METHOD(S): This systematic review and network meta-analysis evaluated the analgesic efficacy of relevant LRA techniques in adult patients undergoing cardiac surgery. Primary outcomes were opioid consumption, pain scores, and time to first rescue analgesia within 24 hours postoperatively. Secondary outcomes included intensive care unit (ICU) and hospital length of stay (LOS), block-related complications, and side effects. PubMed, Embase, and CENTRAL were searched up to June 30, 2025. A Bayesian random-effects network meta-analysis was performed. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation. RESULT(S): 133 randomized trials (9816 patients) were included. Compared with control, three LRA techniques reduced 24-hour opioid consumption (MME, mean difference (95% credible interval)): intrathecal opioids (IT) -14.8 (-20.7; -9.2), erector spinae plane block (ESPB) -9.7 (-14.8; -4.9), and parasternal intercostal plane block (PIPB) -6.3 (10.5; -2.3). IT produced the largest and consistent pain score reductions (-1.2 cm (-3.3; -0.7) on the visual analog scale at 24 hours). No technique prolonged time to first rescue analgesia. ESPB -8.3 hours (-13.7; -2.8), PIPB -7.2 hours (-12.2; -2.3), and TEA -11.8 hours (-20.2; -3.0) reduced ICU LOS, while only TEA reduced hospital LOS by 1.2 days (-1.7; -0.6). No major block-related complications were reported. CONCLUSION(S): IT demonstrated the largest reductions in opioid consumption and pain scores in the first 24 hours. ESPB and PIPB represent promising alternatives when neuraxial techniques are contraindicated, though effect sizes were smaller, often below thresholds of clinical relevance. Substantial interstudy heterogeneity emphasizes the need for rigorous, high-quality trials to standardize LRA strategies in cardiac surgery and to better define their impact on recovery and safety endpoints. PROSPERO REGISTRATION NUMBER: CRD42021261282. Copyright © American Society of Regional Anesthesia & Pain Medicine 2026. No commercial re-use. See rights and permissions. Published by BMJ Group. <104> Accession Number 2047312795 Title Intracardiac Echocardiography for Procedural Guidance of Left Atrial Appendage Occlusion From Right Atrium: A Subgroup From a Multicenter Randomized Controlled Trial With Two Intracardiac Echocardiography Imaging Systems. Source Journal of Cardiovascular Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Huang B.; Hao Z.; Kuang Y.; Wang J.; Chu H.; Ning Z.; Li H.; Ma W.; Zhang X.; He B.; Xu J.; Jiang L. Institution (Huang, Kuang, Wang, He, Xu, Jiang) Department of Cardiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China (Hao) Department of Cardiology, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Chu) Department of Cardiology, The First Affiliated Hospital of Ningbo University, Zhejiang, Ningbo, China (Ning) Department of Cardiology, Shanghai Pudong New District Zhoupu Hospital, Shanghai, China (Li) Department of Cardiology, Shenzhen Hospital, The University of Hong Kong, Shenzhen, China (Ma) Department of Cardiology, Peking University First Hospital, Beijing, China (Zhang) Department of Cardiology, Huai'an First People's Hospital, Jiangsu, Huai'an, China Publisher John Wiley and Sons Inc Abstract Background: Intracardiac echocardiography (ICE)-guided left atrial appendage occlusion (LAAO) from left atrium under local anesthesia showed potential advantages over transesophageal echocardiography (TOE). This study sought to demonstrate the intraprocedural efficiency and safety of LAAO with ICE guidance in right atrium. Method(s): In a multicenter randomized controlled trial to assess whether the imaging quality of a novel DynaSight ICE system (SONOSEMI, Shenzhen, China) is noninferior to the SoundStar (Biosense Webster, USA), a sub-group analysis was performed in patients who underwent LAAO under local anesthesia with ICE guidance in right atrium. Result(s): Thirty-three of 66 in the DynaSight group and 30 of 67 in the SoundStar group were performed LAAO with ICE guidance in right atrium. There were no statistical differences between two groups in baseline characteristics including demographics, cardiovascular comorbidities, CHA2DS2-VASc score, and HAS-BLED score. Both ICE systems had similar clear image qualities according to multi-plane assessments for home view, atrial septum and left atrium, and judgments for occluders including displaying location and resolution. There was comparable procedural successful rate for device implantation (100% in the DynaSight group vs. 96.67% in the SoundStar group, p = 0.4762) and occurrence of major peri-procedural complications including tamponade, device embolism, death, major bleeding, and ischemic stroke/transient ischemic attack/systemic embolism (0 of 33 in the DynaSight group vs. 3 of 30 in the SoundStar group, p = 0.1022). Conclusion(s): The DynaSight ICE system has the same clear image quality as the SoundStar, which-guided LAAO with the catheter in right atrium is intraprocedural effective and safe for device implantation. Copyright © 2026 Wiley Periodicals LLC. <105> Accession Number 651614729 Title Annual Meeting 2026 Swiss Society of Cardiology (SSC), Swiss Society for Heart and Thoracic Vascular Surgery (SSCS), Swiss Society of Pneumology (SSP) and Swiss Society for Thoracic Surgery (SSTS). Source Swiss Medical Weekly. Conference: Annual Meeting Swiss Society of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery, SSCS, Swiss Society of Pneumology, SSP and Swiss Society for Thoracic Surgery, SSTS 2026. Basel Switzerland. 156(6 Supplement 298) (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Anonymous Publisher SMW supporting association Abstract The proceedings contain 189 papers. The topics discussed include: decoding lung fibroblast-endothelial dialogue driving pulmonary hypertension in cardiometabolic HFpEF; CSF2-driven myeloid reprogramming connects metabolic stress to pulmonary vascular remodeling in HFpEF and PH; real world safety and efficacy of mavacamten for hypertrophic obstructive cardiomyopathy: the SWISS-MAVA cohort; renin-angiotensin-aldosterone system blockade in patients with chronic heart failure and end-stage kidney disease: a systematic review and meta-analysis; incremental prognostic value of four chamber strain for death in arrhythmogenic right ventricular cardiomyopathy: a practical stepwise approach; CMR-derived parameters increase H2FPEF score diagnostic performance; prognostic factors and impact of immunosuppression regimens in giant cell myocarditis: a systematic review and individual patient data meta-analysis; atrial function by long-axis shortening enhances risk stratification beyond traditional CMR makers in possible myocarditis; a metabolome-wide mendelian randomization study reveals causal links of urinary 2-hydroxybutyrate/2-hy-droxyisobutyrate with heart failure in patients with hypertension; prognostic value of artificial intelligence-derived echocardiographic measurements in cardiac amyloidosis; identification of vascular phenotypes in heart failure by unsupervised hierarchical clustering using retinal vessel analysis; geographic and community responder determinants of return of spontaneous circulation in out-of-hospital cardiac arrest with shockable rhythm: a nationwide Swiss study; and long-term outcomes after atrial appendage closure in frail and non-frail patients: a nationwide cohort study. <106> Accession Number 651614512 Title Prognostic Factors and Impact of Immunosuppression Regimens in Giant Cell Myocarditis: A Systematic Review and Individual Patient Data Meta-Analysis. Source Swiss Medical Weekly. Conference: Annual Meeting Swiss Society of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery, SSCS, Swiss Society of Pneumology, SSP and Swiss Society for Thoracic Surgery, SSTS 2026. Basel Switzerland. 156(6 Supplement 298) (pp 9S), 2026. Date of Publication: 01 Jun 2026. Author Donlagic A.; Geiser A.; Ly T.-D.; Tzimas G.; Monney P.; Pascale P.; Muller O.; Lu H.; Antiochos P. Institution (Donlagic, Geiser, Ly, Tzimas, Monney, Pascale, Muller, Lu, Antiochos) Lausanne University Hospital, Lausanne, Switzerland Publisher SMW supporting association Abstract Introduction: Giant cell myocarditis (GCM) is a rare inflammatory cardiomyopathy. While historical data suggest a poor prognosis, contemporary predictors of death/heart transplantation (HTx) and the optimal immunosuppressive regimen remain unclear. We performed the largest individual patient data (IPD) meta-analysis to date to investigate both. Material(s) and Method(s): We conducted a systematic review of all available published GCM cases to build a unified IPD database. The primary endpoint was a composite of death or HTx. Multivariable Cox regression with forward stepwise selection was utilized to identify independent predictors. Result(s): We included 909 patients (49+/-16 years; 51% female). Over a mean follow-up of 20 months, 574 (63%) met the primary endpoint. Multivariable analysis identified a specific high-risk phenotype driven by autoimmune comorbidities (HR 1.46, p = 0.017), cardiogenic shock (HR 1.67, p = 0.010), and high-risk ECG features including LBBB (HR 1.91, p = 0.021), ST-elevation (HR 1.52, p = 0.013), or ST- depression (HR 3.36, p = 0.012). Notably, admission biomarkers (Troponin T, NTproBNP) were not associated with outcomes, while higher baseline LVEF was protective (HR 0.98 per%, p = 0.003). Regarding management, the absence of immunosuppression was the strongest predictor of death or HTx (HR 2.12, p <0.001). We observed a distinct interaction with regimen composition: while triple-therapy (corticosteroids + calcineurin-inhibitors + anti-metabolites - such as azathioprine, mycophenolate) was associated with higher risk (HR 1.68, p = 0.008) compared to standard therapy (corticosteroids + calcineurin-inhibitors alone), quadruple regimens incorporating targeted biologic immunomodulators - such as muromonab - reversed this risk, conferring the highest transplant-free survival (HR 0.36, 95% CI 0.15-0.85, p = 0.020).(Figure presented)Conclusion: GCM remains a fulminant disease with high mortality and transplantation rates predicted by hemodynamic and electrical instability rather than biomarker elevation. Our data suggest that the integration of adjunctive biologic immunomodulators to standard treatment regimens is essential to improve transplant-free survival in GCM, a finding that warrants further study in prospective trials. <107> Accession Number 2047375228 Title An Insight Into a Potential Antithrombin-Independent Mechanism of Inadequate Heparin Response in Neonates and Infants Undergoing Pediatric Cardiac Surgery: An Exploratory Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Swangwong S.; Sullivan K.; Malm E.; Kim S.; Faraoni D.; Odegard K.; Yuki K. Institution (Swangwong, Sullivan, Malm, Kim, Faraoni, Odegard, Yuki) Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA, United States (Swangwong, Faraoni, Odegard, Yuki) Department of Anaesthesia, Harvard Medical School, Boston, MA, United States (Swangwong) Department of Anesthesiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand (Yuki) Department of Immunology, Harvard Medical School, Broad Institute of MIT and Harvard, Cambridge, MA, United States Publisher W.B. Saunders Abstract Objectives: Inadequate heparin response is frequently observed in neonates and young infants. While low antithrombin level is considered to be the primary cause, the existing literature suggests that it is not necessarily responsible. However, granular coagulation factor profiling data are rather limited. Design(s): Prospective, single-center study. Setting(s): Tertiary academic hospital in the United States. Participant(s): Total of 30 neonates and infants who underwent cardiac surgery with cardiopulmonary bypass between May 31, 2022, and February 22, 2023. Intervention(s): None. Measurements and Main Results: Comparison between the heparin response group and the inadequate heparin response group demonstrated that antithrombin levels were comparable. However, levels of another thrombin inhibitor, alpha<inf>2</inf>-macroglobulin, and coagulation factor adjunct protein S were significantly lower in the inadequate heparin response group. Conclusion(s): Lower alpha<inf>2</inf>-macroglobulin and protein S levels may be at least partly responsible for inadequate heparin response in the study cohort. Copyright © 2026 Elsevier Inc. <108> Accession Number 651614566 Title Annual Meeting 2026 Swiss Society of Cardiology (SSC), Swiss Society for Heart and Thoracic Vascular Surgery (SSCS), Swiss Society of Pneumology (SSP) and Swiss Society for Thoracic Surgery (SSTS). Source Swiss Medical Weekly. Conference: Annual Meeting Swiss Society of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery, SSCS , Swiss Society of Pneumology, SSP and Swiss Society for Thoracic Surgery, SSTS 2026. Basel Switzerland. 156(6 Supplement299) (no pagination), 2026. Date of Publication: 01 Jun 2026. Author Anonymous Publisher SMW supporting association Abstract The proceedings contain 189 papers. The topics discussed include: decoding lung fibroblast-endothelial dialogue driving pulmonary hypertension in cardiometabolic HFpEF; CSF2-driven myeloid reprogramming connects metabolic stress to pulmonary vascular remodeling in HFpEF and PH; real world safety and efficacy of mavacamten for hypertrophic obstructive cardiomyopathy: the SWISS-MAVA cohort; renin-angiotensin-aldosterone system blockade in patients with chronic heart failure and end-stage kidney disease: a systematic review and meta-analysis; incremental prognostic value of four chamber strain for death in arrhythmogenic right ventricular cardiomyopathy: a practical stepwise approach; CMR-derived parameters increase H2FPEF score diagnostic performance; prognostic factors and impact of immunosuppression regimens in giant cell myocarditis: a systematic review and individual patient data meta-analysis; atrial function by long-axis shortening enhances risk stratification beyond traditional CMR makers in possible myocarditis; a metabolome-wide mendelian randomization study reveals causal links of urinary 2-hydroxybutyrate/2-hy-droxyisobutyrate with heart failure in patients with hypertension; prognostic value of artificial intelligence-derived echocardiographic measurements in cardiac amyloidosis; identification of vascular phenotypes in heart failure by unsupervised hierarchical clustering using retinal vessel analysis; geographic and community responder determinants of return of spontaneous circulation in out-of-hospital cardiac arrest with shockable rhythm: a nationwide Swiss study; and long-term outcomes after atrial appendage closure in frail and non-frail patients: a nationwide cohort study. <109> Accession Number 2047374399 Title Spanish Clinical Practice Guidelines for the Diagnosis and Management of Alpha-1 Antitrypsin Deficiency: 2026 Update. Source Archivos de Bronconeumologia. (no pagination), 2026. Date of Publication: 2026. Author Calle Rubio M.; Lopez-Campos J.L.; Casas Maldonado F.; Torres Duran M.; Rigau Comas D.; Barrecheguren M.; Bustamante A.; Cabero Perez M.J.; Cadenas Menendez S.; Callejas Gonzalez F.J.; Castillo Corullon S.; Curi Chercoles S.; Dasi Fernandez F.J.; Diab L.; Gonzalez Villaescusa M.C.; Goyanes E.; Hernandez Perez J.M.; Lazaro Asegurado L.; Martinez Delgado B.; Martinez Gonzalez C.; Michel de la Rosa F.J.; Moya Alvarez V.; Pastor M.; Parra Garcia I.; Penalver C.; Pons Delgado M.; Priegue Carrera A.; Rodriguez Frias F.; Rodriguez Garcia C.; Ruiz-Serrano de la Espada M.R.; Miravitlles M. Institution (Calle Rubio) Servicio de Neumologia, Hospital Clinico San Carlos, Departamento de Medicina, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigacion Sanitaria del Hospital Clinico San Carlos (IdISSC), Spain (Calle Rubio, Lopez-Campos, Torres Duran) CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain (Lopez-Campos) Respiratory Disease Medical-Surgical Unit, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain (Casas Maldonado) Unidad de Gestion Clinica de Neumologia, Hospital Universitario San Cecilio, Granada, Spain (Torres Duran, Priegue Carrera) Servicio de Neumologia, Hospital Alvaro Cunqueiro, Vigo, Spain (Torres Duran, Priegue Carrera) Instituto de Investigacion Sanitaria Galicia Sur, Spain (Rigau Comas) Asociacion Colaboracion Cochrane Iberoamerica (ACCIb), Institut de Recerca Sant Pau (IR Sant Pau), Barcelona, Spain (Barrecheguren, Miravitlles) Servicio de Neumologia, Hospital Universitari Vall d'Hebron/Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain (Bustamante) Servicio de Neumologia, Hospital de Sierrallana, Torrelavega, Cantabria, Spain (Cabero Perez) Neumologia Infantil, Hospital Universitario Marques de Valdecilla, Universidad de Cantabria, Spain (Cadenas Menendez) Servicio de Neumologia, Hospital Clinico Universitario de Salamanca, Spain (Callejas Gonzalez) Servicio de Neumologia, Hospital Universitario de Albacete, Spain (Castillo Corullon) Unidad de Neumologia Infantil y Fibrosis Quistica, Hospital Clinico Universitario de Valencia, Spain (Curi Chercoles) Servicio de Neumologia, Complejo Hospitalario de Navarra, Spain (Dasi Fernandez) Fundacion de Investigacion Hospital Clinico Valencia, Instituto de Investigacion Sanitaria INCLIVA, Spain (Diab) Servicio de Neumologia, Hospital Universitario Doce de Octubre, Madrid, Spain (Gonzalez Villaescusa) Servicio de Neumologia, Hospital Clinico Valencia, Spain (Goyanes, Pastor) Asociacion Alfa 1 Espana, Spain (Hernandez Perez) Servicio de Neumologia, Hospital Universitario Nuestra Senora de Candelaria, Canary Islands, Santa Cruz de Tenerife, Spain (Lazaro Asegurado) Servicio de Neumologia, Complejo Hospitalario de Burgos, Spain (Martinez Delgado) Departamento de Genetica Molecular, Seccion de Genetica Humana, Instituto de Investigacion en Enfermedades Raras (IIER), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (Martinez Gonzalez) Hospital Universitario Central de Asturias-Instituto Nacional de Silicosis, Spain (Michel de la Rosa) Servicio de Neumologia, Hospital Universitario Donostia, Basque Country, Spain (Moya Alvarez) Servicio de Neumologia, Hospital Clinico Lozano Blesa, Zaragoza, Spain (Parra Garcia, Penalver) Servicio de Neumologia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain (Pons Delgado) Unidad de Higado, Departamento de Enfermedades Digestivas, Hospital Vall d'Hebron, Barcelona, Spain (Rodriguez Frias) Servicio de Bioquimica, Hospital Vall d'Hebron, Barcelona, Spain (Rodriguez Garcia) Servicio de Neumologia, Complejo Hospitalario Universitario de Ferrol, Spain (Ruiz-Serrano de la Espada) Servicio de Neumologia, Hospital Universitario Virgen del Rocio, Seville, Spain Publisher Sociedad Espanola de Neumologia y Cirugia Toracica (SEPAR) Abstract Alpha-1 antitrypsin deficiency (AATD) is a genetic condition characterized by reduced blood levels of alpha-1 antitrypsin (AAT), which confers an increased risk of developing several disorders throughout life, mainly pulmonary emphysema and liver involvement. AATD remains substantially underdiagnosed and is often diagnosed late; consequently, many individuals with severe deficiency do not benefit from disease-specific counseling or tailored care modifications. Since 2015, when the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) published an updated document on the detection and treatment of patients with chronic obstructive pulmonary disease (COPD) associated with AATD, new diagnostic procedures and studies on augmentation therapy have been developed. A systematic review was conducted using the GRADE and ADOLOPMENT frameworks, with an updated literature review that, together with expert opinion, served as the basis for formulating recommendations. Testing for AATD is recommended in all individuals with COPD at the time of diagnosis, in individuals with adult-onset asthma and persistent airflow obstruction, and in individuals with bronchiectasis of unknown etiology. We recommend a 2-step diagnostic approach combining serum AAT levels and characterization of the genetic defect (genotype) or protein abnormality (phenotype) in individuals with AAT concentrations below 116 mg/dL, as measured by immunonephelometry, and with a normal C-reactive protein (CRP) level. The panel recommends augmentation therapy for patients with documented severe AATD, with a genotype associated with severe deficiency and AAT levels <57.2 mg/dL (<11 mumol/L), and with emphysema documented on computed tomography and impaired pulmonary function test results, who are receiving optimal pharmacologic and nonpharmacologic treatment and are not active smokers. Copyright © 2026 SEPAR <110> Accession Number 651611836 Title Family Health Conversations-A Short-Term Supportive Intervention to Improve Family Well-Being, Functioning, and Involvement in Care After Open-Heart Surgery: A Multicenter, Randomized, Parallel-Group Superiority Trial. Source Journal of family nursing. 32(3) (pp 159-176), 2026. Date of Publication: 01 Aug 2026. Author Drakenberg A.; Smith D.R.; Sundqvist A.-S.; Swenne C.L.; Ericsson E. Institution (Drakenberg, Sundqvist, Ericsson) School of Health Sciences, Faculty of Medicine and Health, Orebro University, Sweden (Drakenberg) Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Sweden (Smith) School of Medical Sciences, Faculty of Medicine and Health, Orebro University, Sweden (Swenne) Department of Public Health and Caring Sciences, Uppsala University, Sweden Abstract In this study, a nurse-led supportive family health conversation intervention delivered through one to three video-conferencing sessions was evaluated for patients undergoing open-heart surgery and their self-selected family members. Based on the Family Systems Nursing framework, the intervention aimed to improve family well-being, functioning, and involvement by fostering shared understanding and challenging limiting beliefs. Patients and family members were randomized into two groups. Both received usual surgical care, while the intervention group also participated in digital family health conversations before and after surgery. Participants completed questionnaires at baseline and at 30 and 90 days after discharge. The analysis included 101 patients (control = 54, intervention = 47) and 99 family members (control = 52, intervention = 47). The intervention was not superior to usual care for the primary outcome, family well-being. Most secondary outcomes showed no effect, although some aspects of quality of life improved. Further research should examine long-term effects, feasibility, and appropriate outcome measures.Clinical trials register number and URL: NCT05045196, https://clinicaltrials.gov/study/NCT05045196?cond=NCT05045196&rank=1. <111> Accession Number 651614722 Title Impact of Aspirin Use on Mortality and Cardiac Allograft Vasculopathy After Heart Transplantation: A Systematic Review and Meta-analysis. Source Swiss Medical Weekly. Conference: Annual Meeting Swiss Society of Cardiology, SSC, Swiss Society for Heart and Thoracic Vascular Surgery, SSCS, Swiss Society of Pneumology, SSP and Swiss Society for Thoracic Surgery, SSTS 2026. Basel Switzerland. 156(6 Supplement 298) (pp 41S-42S), 2026. Date of Publication: 01 Jun 2026. Author Fournier N.; Antiochos P.; Nowacka A.; Abdurashidova T.; Yerly P.; Meyer P.; Rancatti V.; Verdy F.; Ltaief Z.; Kirsch M.; Hullin R.; Lu H. Institution (Fournier, Antiochos, Nowacka, Abdurashidova, Yerly, Rancatti, Verdy, Ltaief, Kirsch, Hullin, Lu) CHUV-Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (Meyer) Hopitaux Universitaires de Geneve, Geneve, Switzerland Publisher SMW supporting association Abstract Introduction: Heart transplant (HTx) remains the treatment of choice for eligible patients with end-stage heart failure, with 5-year survival reaching =75% in contemporary cohorts. Cardiac allograft vasculopathy (CAV) is a major cause of long-term graft failure and post-transplant morbidity. Management of CAV is primarily preventive, focusing on cardiovascular risk factor control, rejection prevention, and mitigation of cytomegalovirus-related risk. Although aspirin is commonly recommended for the prevention of CAV, the evidence supporting a clinical benefit remains limited. We conducted a systematic review and meta-analysis to assess the association between aspirin use and clinical outcomes in HTx recipients Material(s) and Method(s): The primary outcome was all-cause mortality. The secondary outcome was a composite endpoint of CAV related graft dysfunction and CAV related death. A systematic literature search of PubMed and EMBASE was performed, covering the period from inception to December 2025. Studies comparing the outcomes of interest in HTx patients treated with aspirin versus no aspirin were included. Hazard ratios (HRs) and their corresponding 95% confidence intervals (CIs) were meta-analyzed across studies. Result(s): A total of five observational studies were included, comprising 1,983 HTx recipients (mean age =51 years, 793 men [40.0%]), of whom 730 received aspirin and 1,253 did not. Aspirin use was associated with a significant reduction in all-cause mortality (HR 0.30 [95% CI: 0.15-0.58]; Panel A). No significant association was observed between aspirin use and the secondary outcome (HR 0.71 [95% CI: 0.26-1.91]; Panel B). Conclusion(s): In HTx recipients, aspirin use was associated with a significant reduction in all-cause mortality, with no clear effect on graft dysfunction or CAV progression, possibly reflecting limited power due to the small number of studies reporting this outcome. These findings underscore the need for well-designed prospective trials to better define the role of aspirin in CAV and post-transplant outcomes.(Figure presented) <112> Accession Number 2047246410 Title Early mortality after mitral surgery for failed MitraClip/TEER: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 30. Date of Publication: 01 Dec 2026. Author Campailla A.; Lorusso R.; Agostinelli A.; Benassi F.; Oliva R.; Grassa G.; Nicolini F.; Carino D. Institution (Campailla, Agostinelli, Benassi, Oliva, Grassa, Nicolini, Carino) Cardiac Surgery Unit, Department of Medicine and Surgery, University of Parma, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, Parma, Italy (Lorusso) Cardio-Thoracic Surgery Department, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Lorusso) Cardiovascular Research Institute Maastricht, Maastricht, Netherlands Publisher Springer Science and Business Media Deutschland GmbH Abstract Objectives: To estimate pooled early all-cause mortality after mitral surgery for failed transcatheter edge-to-edge repair (M-TEER) and, as an exploratory objective, to describe the feasibility of surgical repair while explicitly accounting for the limitations of the retrospective evidence base. Method(s): This systematic review and meta-analysis followed PRISMA 2020. MEDLINE, Embase, Scopus, and Web of Science were searched from inception to 8 January 2026, with reference-list screening. Eligible studies included adults undergoing mitral surgery after failed MitraClip/TEER and reporting extractable operative, in-hospital, or 30-day mortality. Reports with likely overlapping cohorts were adjudicated, and the most informative dataset was retained for the main analytic set. Pooled proportions were estimated using random-effects single-arm meta-analysis with logit transformation, with endpoint-homogeneous and small-study sensitivity analyses. Certainty of evidence was assessed using GRADE. The pooled estimates are derived entirely from retrospective case series/registries with high risk of bias and no adjustment for confounders; they should not be used for individual risk prediction without center-specific validation. Result(s): Fifteen full-text reports were identified; one was excluded for insufficient sample size. Fourteen studies entered the qualitative synthesis, and 8 unique surgical cohorts (N = 951) formed the main analytic set after overlap adjudication. The pooled mixed-definition early mortality was 11.7% (95% CI: 8.4-16.0%; I2 = 39.2%; 95% prediction interval: 5.5-23.1%). Endpoint-homogeneous analyses were directionally consistent but underpowered: operative-only mortality 9.5%, in-hospital-only mortality 11.9%, and 30-day-only mortality 15.3%. The pooled repair rate was 12.5% (95% CI: 6.1-24.1%), with considerable heterogeneity (I2 = 85.1%) and a prediction interval of 1.1-64.4%. Certainty of evidence was very low for both outcomes. Conclusion(s): Mitral surgery after failed M-TEER is associated with substantial early mortality in the published retrospective literature, but the pooled estimate is crude, unadjusted, and based on heterogeneous endpoint definitions. Valve replacement remains the predominant surgical strategy. Surgical repair is reported in a minority of patients and should be interpreted as an exploratory, center- and anatomy-dependent outcome rather than as a generalizable probability. These estimates should not be used for individual risk prediction without center-specific validation. Copyright © The Author(s) 2026. <113> Accession Number 2047104668 Title Approaches to transcatheter aortic valve replacement failure: is more focus on prevention required?. Source Expert Review of Cardiovascular Therapy. (no pagination), 2026. Date of Publication: 2026. Author Androutsopoulou V.; Xanthopoulos A.; Zotos P.-A.; Athanasiou T.; Brecher V.; Magouliotis D.E. Institution (Androutsopoulou, Zotos) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Xanthopoulos) Department of Cardiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Brecher, Magouliotis) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States Publisher Taylor and Francis Ltd. Abstract Introduction: Transcatheter aortic valve replacement (TAVR) has transformed the management of severe aortic stenosis across all surgical risk strata. As its use expands to younger, lower-risk patients, the durability of transcatheter heart valves and the clinical consequences of prosthetic failure have become critically important. Despite a growing literature on reintervention strategies, systematic prevention of TAVR failure remains comparatively underemphasized. Areas covered: We searched PubMed and the Cochrane Library (2000-2026, English language) for studies on TAVR failure and its prevention. This review examines the mechanisms of TAVR failure, including structural valve deterioration, paravalvular leak, prosthesis-patient mismatch, subclinical leaflet thrombosis, valve endocarditis, and device migration; appraises current management, including valve-in-valve TAVR, redo surgical aortic valve replacement, and medical therapy; and reviews prevention strategies spanning patient selection, procedural optimization, antithrombotic management, structural surveillance, coronary access preservation, and lifetime planning. Expert opinion: The evidence base has focused disproportionately on reintervention rather than prevention. Greater emphasis on structured lifetime management planning at index TAVR, individualized antithrombotic strategies, and evidence-based surveillance is needed. Several proposed measures, however, including routine anticoagulation for subclinical leaflet thrombosis and routine CT or artificial-intelligence-based surveillance, are not yet supported by outcome data and require prospective validation. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <114> Accession Number 2047087674 Title Machine learning model predicts acute kidney injury in pediatric patients after cardiac surgery: a systematic review and meta-analysis. Source BMC Nephrology. 27(1) (no pagination), 2026. Article Number: 400. Date of Publication: 01 Dec 2026. Author Fan X.; Zhuang J.; Xiong Z.; Chen Z.; Yang N.; Li T. Institution (Li) Shenzhen Baoan Women's and Children's Hospital, Shenzhen, China (Fan, Zhuang, Xiong, Chen, Yang) Department of Nursing, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China (Fan, Zhuang) School of Nursing, Guangdong Pharmaceutical University, Guangzhou, China Publisher BioMed Central Ltd Abstract Background: Acute kidney injury (AKI) is a common complication following pediatric cardiac surgery, frequently leading to poor outcomes and even death in severe cases. Early prevention remains the primary intervention strategy. Studies have developed prediction models to identify at-risk children at an early stage. This study systematically evaluate existing AKI prediction models to support their clinical utility and future refinement. Method(s): PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang and SinoMed were searched from inception to 31 December, 2024. The search of references from included studies, as well as the manual search, extended until November 30, 2025. Literature searching, screening, and data extraction were done by two authors. Quality evaluation according to prediction model risk of bias assessment tool (PROBAST). Area under the receiver operating characteristic curve (AUROC) was pooled using a random-effects model to summarize the overall performance of existing models, exploring sources of heterogeneity of performance through subgroup analysis and meta-regression. Sensitivity analysis and Egger's method were used to analyze the stability of the included studies and to identify publication bias. This study was registered with PROSPERO (CRD42024593112) and reported following the Transparent Reporting of Multivariable Prediction Models for Individual Prognosis or Diagnosis: Checklist for Systematic Reviews and Meta-Analysis (TRIPOD-SRMA). Result(s): A total of 2189 studies were screened which represented the total number of studies retrieved from the database search, the search of references from included studies, and the manual search. Nineteen studies were included in this review. Included studies differed in study design, AKI definition, predictor screening, model development and validation and model performance. The overall pooled AUROC was 0.850 (95% CI, 0.810-0.890), but all studies were evaluated as high risk of bias using the PROBAST. Heterogeneity in model performance was high, and study design and development methods were identified as possible sources of heterogeneity in pooled AUROC. Included studies were stable and free of publication bias. Conclusion(s): This systematic review suggested that machine learning models for predicting postoperative AKI in pediatric cardiac surgery indicated good discriminative ability. However, the high risk of bias across all included studies and the significant heterogeneity in model performance indicated that the reported performance may be overestimated. The high heterogeneity observed highlights the substantial variability in model performance, which is likely driven by differences in study design and development methods. The clinical utility of these models was currently limited due to the lack of external validation in most studies and the methodological limitations identified. Future research must incorporate rigorous study design, transparent reporting based on the TRIPOD guidelines, and external validation to develop prediction models with clinical utility. Copyright © The Author(s) 2026. <115> Accession Number 2047198918 Title Current Advances and Navigating the Complexities of SVG-PCI. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Attachaipanich T.; Virk H.U.H.; Khawaja M.; Alam M.; Krittanawong C. Institution (Attachaipanich) Department of Internal Medicine, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States (Virk) Division of Cardiovascular Disease, Case Western Reserve University, Cleveland, OH, United States (Khawaja) Department of Cardiology, Emory University, Atlanta, GA, United States (Alam) Texas Heart Institute and Baylor College of Medicine, Houston, TX, United States (Krittanawong) HumanX, DE, United States Publisher John Wiley and Sons Inc Abstract Saphenous vein graft (SVG) percutaneous coronary intervention (PCI) remains technically challenging and clinically high risk due to the friable, thrombus-rich nature of SVG lesions, which predispose to distal embolization, no-reflow, and periprocedural myocardial infarction (MI). The role of embolic protection devices in contemporary practice remains unclear. Although early randomized trials demonstrated significant reductions in periprocedural MI and no-reflow, contemporary observational studies and meta-analyses have not shown consistent clinical benefit. Similarly, while intracoronary imaging modalities provide detailed plaque characterization, their clinical application in guiding SVG-PCI remains unclear. Revascularization after prior coronary artery bypass grafting (CABG) requires individualized, multidisciplinary decision-making. Factors favoring PCI include a patent left internal mammary artery (IMA)-left anterior descending artery graft and suitable coronary anatomy, whereas redo-CABG may be preferred in patients with multiple failing grafts or complex anatomy in which an IMA conduit can be used. Although guidelines have historically favored native-vessel PCI when feasible, the only randomized trial comparing SVG-PCI with native-vessel PCI in a contemporary setting demonstrated that SVG-PCI may offer superior outcomes in certain patient populations, particularly when native coronary disease is complex, and the chronic total occlusion burden is high. Predictors of adverse outcomes have been identified across patient-, lesion-, and procedure-related characteristics; however, their integration into clinical decision-making is limited by the lack of validated risk-stratification tools. Future randomized studies in the contemporary PCI era are needed. Additionally, the integration of imaging technologies, together with artificial intelligence and machine-learning-enhanced risk prediction models, may help individualize patient selection and optimize procedural strategy. Copyright © 2026 Wiley Periodicals LLC. <116> Accession Number 2047406489 Title Protective effects of penehyclidine hydrochloride on the myocardium in patients undergoing cardiac surgery with cardiopulmonary bypass: A meta-analysis. Source Asian Journal of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Zhu Y.; Fan J.; Chen H.; Yao J. Institution (Zhu, Fan, Chen, Yao) The First Affiliated Hospital of Hebei North University, Changqing Road No.12, Zhangjiakou, China Publisher Elsevier (Singapore) Pte Ltd <117> Accession Number 2047189892 Title A Randomized Controlled Trial Comparing the TruSteer and FXD Double Curve Delivery Systems for Left Atrial Appendage Occlusion With the Watchman FLX Pro Device-The GUIDE-LAAO Study. Source Catheterization and Cardiovascular Interventions. (no pagination), 2026. Date of Publication: 2026. Author Taieb P.; Frazzetto M.; Teixeira P.S.; Filby S.J. Institution (Taieb, Frazzetto, Teixeira, Filby) Harrington Heart & Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Taieb) Jesselson Integrated Heart Center, Shaare Zedek Medical Center and Hebrew University Faculty of Medicine, Jerusalem, Israel Publisher John Wiley and Sons Inc Abstract Background: Deflectable delivery systems have been introduced to enhance coaxial alignment and procedural efficacy during left atrial appendage occlusion (LAAO), yet randomized comparisons with conventional fixed-curve systems are lacking. Aim(s): The GUIDE-LAAO trial evaluated whether the TruSteer deflectable delivery system is non-inferior to the FXD Double Curve (FXD DC) delivery system for procedural success in patients undergoing LAAO with the Watchman FLX Pro device. Method(s): In this prospective, randomized, all-comers trial, 50 patients with non-valvular atrial fibrillation undergoing LAAO were assigned 1:1 to TruSteer (n = 25) or FXD DC (n = 25). The primary endpoint was procedural success, defined as successful device implantation without major procedural or periprocedural complications. Secondary endpoints included technical success, device success, procedural efficiency, and safety outcomes. Result(s): Procedural success occurred in 100% of TruSteer-treated patients and 84% of FXD DC-treated patients (risk difference 16%; 95% confidence interval -6.9% to 34.7%), meeting criteria for non-inferiority; superiority was not demonstrated (p = 0.11). Technical and device success were 100% with TruSteer and 92% with FXD DC. Procedural time (34.6 +/- 7.1 vs. 36.5 +/- 13.0 min), fluoroscopy time (22.3 +/- 4.4 vs. 22.1 +/- 7.2 min), and contrast volume (34.5 +/- 12.1 vs. 36.8 +/- 13.5 mL) were similar. Periprocedural complications occurred in 4% and 16%, respectively, with no deaths or strokes. Conclusion(s): In this first randomized comparison of LAAO delivery systems, TruSteer was non-inferior to a standard fixed-curve system, with comparable efficiency and safety in an unselected population. These findings provide randomized evidence supporting deflectable delivery technology in contemporary LAAO practice and inform future studies in anatomically complex subsets. Copyright © 2026 The Author(s). Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC. �

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