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

Total documents retrieved: 93 Results Generated From: Embase <1980 to 2026 Week 34> Embase Weekly Updates (updates since 2026-08-13) - (93 records) <1> Accession Number 2043730146 Title Effect of Stellate Ganglion Block on Internal Mammary Artery Dynamics: A Randomized Controlled Clinical Trial. Source Seminars in Cardiothoracic and Vascular Anesthesia. 30(3) (pp 172-182), 2026. Date of Publication: 01 Sep 2026. Author Aboelnile D.B.; Ghallab M.A.; Attia E.H.A.; Hawas A.Y.; Kamal Eldin F. Institution (Aboelnile, Ghallab, Attia, Hawas, Kamal Eldin) Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt Publisher SAGE Publications Inc. Abstract The left internal mammary artery (LIMA) is commonly selected as the graft of choice for coronary artery bypass procedures. Various pharmacological agents have been used to enhance LIMA blood flow. Left stellate ganglion block (LSGB) has been utilized to achieve sympathetic blockade, promote vasodilation in the upper extremities, and manage refractory angina. This randomized controlled clinical trial aimed to evaluate the effect of preoperative LSGB on LIMA blood flow in patients undergoing elective coronary artery bypass grafting (CABG). Seventy patients (aged 18-80 years, of both genders) scheduled for elective CABG were equally divided into two groups: the LSGB group and the control group. Patients in the intervention group received an ultrasound-guided LSGB using 8 mL of 0.25% bupivacaine. Both groups received topical nitroglycerin during LIMA harvesting. LIMA diameter was measured at baseline and again after an equal time interval before the induction of anaesthesia. Additionally, LIMA free flow after harvesting and mean graft flow were measured using a transit time flow metre (TTFM). LIMA free blood flow was significantly increased in the LSGB group (50.57 +/- 5.79 mL/min) compared to the control group (46.86 +/- 8.32 mL/min), with a P-value = 0.034. Similarly, the LIMA diameter was significantly greater in the LSGB group (2.38 +/- 0.17 mm) than in the control group (2.31 +/- 0.14 mm), with a P-value = 0.04, suggesting that preoperative LSGB significantly enhances LIMA blood flow and diameter in patients undergoing CABG. Copyright © The Author(s) 2026 <2> Accession Number 2047692044 Title Is Faster Always Better? Ultra-Fast-Track Versus Fast-Track Extubation in Adult Cardiac Surgery: A Comprehensive Meta-analysis With Meta-regression. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2845-2855), 2026. Date of Publication: 01 Sep 2026. Author Santos K.; Patel N.; Umibe T.; Abo T.; Sakai W.; Oya K.; Kim Kim J.Y.B.; Plonek T. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Umibe, Abo, Sakai, Oya) National Center for Global Health and Medicine, Tokyo, Japan (Kim Kim) Faculty of Medical Sciences, Universidad Nacional de Asuncion, Asuncion, Paraguay (Plonek) Department of Cardiothoracic Surgery, Thorax Centrum Twente, Medisch Spectrum Twente, Enschede, Netherlands Publisher W.B. Saunders Abstract Objectives: To compare the clinical outcomes of ultra-fast-track extubation (UFTE), defined as extubation in the operating room or within 1 hour postoperatively, versus fast-track extubation (FTE), defined as extubation within 6 hours in the intensive care unit [ICU]), in adult patients undergoing cardiac surgery. Design(s): Systematic review and meta-analysis. Setting(s): Studies identified from MEDLINE, Scopus, and the Cochrane Library. Participant(s): Adult patients undergoing cardiac surgery. Intervention(s): Comparison of UFTE versus FTE. Measurements and Main Results: Twenty studies including nearly 800,000 patients were analyzed. UFTE was associated with lower 30-day mortality (odds ratio [OR], 0.54), shorter ICU length of stay (LOS) (mean difference [MD], -12.27 hours), shorter hospital LOS (MD, -1.19 days), reduced stroke rate (OR, 0.85) and reduced readmission rate (OR, 0.64). Rates of reintubation, reoperation for bleeding, acute kidney injury, pneumonia, and atrial fibrillation were similar. In the minimally invasive cardiac surgery subgroup, UFTE was associated with lower reintubation risk (OR, 0.26), whereas in the coronary artery bypass grafting subgroup, only hospital LOS was reduced. In propensity-matched cohorts, mortality and reintubation were comparable, although ICU and hospital stays remained shorter with UFTE. Meta-regression identified male sex and baseline left ventricular ejection fraction as significant moderators of the mortality effect. Conclusion(s): UFTE appears safe in selected patients and is associated with improved efficiency and recovery, particularly reduced ICU and hospital LOS. However, the observed mortality benefit is not sustained after adjustment, suggesting an important role of patient selection and perioperative optimization. Prospective randomized trials are required to confirm these findings. Copyright © 2026 Elsevier Inc. <3> Accession Number 2047545947 Title Intermittent Bolus versus Continuous Infusion Erector Spinae Catheters for Median Sternotomy Incisions:A Randomized Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2792-2799), 2026. Date of Publication: 01 Sep 2026. Author Forrest P.B.; Guerra-Londono C.E.; Nowak K.; Meadows A.; Dexter F. Institution (Forrest, Guerra-Londono, Nowak, Meadows) Department of Anesthesiology, Pain Management, and Perioperative Medicine, Henry Ford Health, Detroit, MI, United States (Dexter) Department of Anesthesia, University of Iowa, Iowa City, IA, United States Publisher W.B. Saunders Abstract Objective: To compare the analgesic efficacy of programmed intermittent boluses (PIB) and continuous infusion via indwelling erector spinae plane (ESP) catheters following open heart surgery. It was hypothesized that the use of PIB would result in superior analgesia compared to continuous infusion of local anesthetics through ESP catheters after cardiac surgery. Design(s): An Institutional Review Board-approved parallel-group, prospective, randomized, double-blind trial. Setting(s): A large academic hospital in the midwestern United States. Participant(s): Adults undergoing open heart surgery via midline sternotomy and scheduled ESP analgesia with bilateral indwelling catheters. Intervention(s): Continuous infusion versus PIB of ropivacaine 0.2% via an electronic infusion pump. Measurements and Main Results: The primary outcome was postoperative opioid consumption in oral morphine milligram equivalents (OMME) through 72 hours. The secondary outcomes included postoperative pain intensity on a numerical rating scale, length of stay, quality of recovery (QoR-15), time to first bowel movement, and antiemetic use. A total of 240 participants were randomized at a 1:1 ratio to PIB or continuous infusion. The PIB group had an estimated 1.08-fold greater OMME than the continuous infusion group (95% confidence interval [CI], 0.90-1.31; p = 0.40). The mean difference was 4.1 OMME greater per day for the PIB group (95% CI, -5.6 to +13.8 mg; p = 0.41). There were no statistically significant differences in secondary outcomes between the 2 groups. Conclusion(s): In adults undergoing open heart surgery, ESP catheter-based analgesia via PIB did not significantly reduce early postoperative opioid consumption compared to a continuous infusion method. Copyright © 2026 The Authors <4> Accession Number 2047131423 Title Descending Necrotizing Mediastinitis Across Age and Host-Status Groups: Diagnosis, Treatment Phases, and Outcomes in the Literature, with an Illustrative Case. Source Infectious Diseases and Therapy. 15(9) (pp 2279-2306), 2026. Date of Publication: 01 Sep 2026. Author Ionescu C.; Cambrea C.S.; Bulbuc I.; Neagu E.; Caraban B.M. Institution (Ionescu, Cambrea, Bulbuc, Neagu, Caraban) Faculty of Medicine, Ovidius University, Constanta, Romania (Ionescu, Neagu, Caraban) Sf. Apostol Andrei Clinical Emergency County Hospital, Constanta, Romania Publisher Adis Abstract Introduction: Descending necrotizing mediastinitis (DNM) is a rare but life-threatening infection originating from odontogenic, tonsillopharyngeal, or deep cervical sources, and propagating through the cervical fascial planes into the mediastinum. Despite advances in cross-sectional imaging, thoracic surgery, intensive care medicine, and antimicrobial therapy, DNM remains associated with mortality ranging from 11 to 40% across contemporary series. The evidence base is fragmented and lacks a unified framework integrating anatomical, physiological, microbiological, and critical care dimensions. The aims of this study are to map the DNM literature across five predefined age and host-status subgroups, to synthesize differences in source infection, diagnostic pathway, mediastinal extent, treatment phases, ICU burden, microbiological evolution, and outcomes, to appraise methodological quality, and to identify future research priorities. Method(s): A scoping review was conducted in accordance with PRISMA-ScR, with incorporation of a prespecified illustrative institutional case for contextual comparison and pregnancy subgroup representation. Structured searches of PubMed/MEDLINE, Scopus, and Web of Science were supplemented by systematic citation chaining and revised eligibility criteria, allowing the inclusion of mixed infectious mediastinitis studies when the DNM subgroup could be clearly distinguished, yielding 18 studies (881 patients) in the final synthesis. A prospectively documented institutional case of DNM in pregnancy was analyzed separately from the PRISMA-tracked literature and used only to contextualize the pregnancy subgroup and to compare the proposed phase-based framework with a high-complexity observed clinical course. Result(s): The methodological quality of the PRISMA-tracked studies was predominantly Fair to Good; the illustrative institutional case was appraised separately as Fair. The reviewed literature suggested a hypothesis-generating, generally recurrent, phase-based clinical trajectory across subgroups. The institutional case was broadly consistent with the literature-derived pattern in seven of eight phases and differed mostly in the degree of multidrug-resistant microbiological complexity during Phase 7, an exploratory finding that may extend, rather than contradict, the proposed framework. Six recurrent adverse inflection points were identified, while evidence density varied across phases. Conclusion(s): DNM may be more usefully interpreted as a staged infectious syndrome rather than as an exclusively anatomical or surgical entity. The proposed phase-based framework, derived from structured synthesis of heterogeneous literature and contextualized by a prospectively documented severe case, should be interpreted as a conceptual, hypothesis-generating complement to existing anatomical staging systems rather than as a validated clinical model. Prospective multicenter registries, standardized reporting frameworks, and reproducibility testing should be regarded as the highest-priority research needs. Copyright © The Author(s) 2026. <5> Accession Number 2043624729 Title Efficacy of Hemoadsorption in Cardiac Surgery with Cardiopulmonary Bypass: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2966-2978), 2026. Date of Publication: 01 Sep 2026. Author Samaniego-Laguna M.A.; Queiroz I.; Pinilla J.; Ruelas M.G.; Piedra-Calle C.A.; Giorgi J.; Katz J.N. Institution (Samaniego-Laguna) Universidad Autonoma Metropolitana, Mexico City, Mexico (Queiroz) Department of Medicine, Catholic University of Pernambuco, Brazil (Pinilla) School of Medicine, CES University, Medellin, Colombia (Ruelas) Instituto de Investigacion Nutricional, Lima, Peru (Piedra-Calle) Hospital Universitario Son Espases, Palma de Mallorca, Spain (Giorgi) Hospital Sirio Libanes, Sao Paulo, Brazil (Giorgi) Hospital Albert Einstein, Sao Paulo, Brazil (Katz) Department of Medicine, NYU Grossman School of Medicine, New York, NY, United States (Katz) Cardiolog, y Department, Bellevue Hospital, New York, NY, United States Publisher W.B. Saunders Abstract Objectives: To evaluate the efficacy of intraoperative hemoadsorption (HA) during cardiopulmonary bypass (CPB) in reducing acute kidney injury (AKI) and other major postoperative complications in patients undergoing cardiac surgery. Design(s): Systematic review and meta-analysis of randomized controlled trials (RCTs) conducted in accordance with PRISMA guidelines, with a protocol registered in PROSPERO (CRD42025638656). Setting(s): Multicountry, multi-institutional hospital-based studies of patients undergoing cardiac surgery with CPB. Participant(s): A total of 1133 patients from 16 RCTs comparing CPB with versus without intraoperative HA. Intervention(s): Intraoperative HA using sorbent-based devices (e.g., CytoSorb, oXiris, Jafron HA 380). Measurements and Main Result: Primary outcomes included AKI incidence, renal replacement therapy requirement, and mortality. Secondary outcomes included intensive care unit/hospital length of stay, postoperative delirium, stroke, sepsis, and reoperation. HA significantly reduced the incidence (RR 0.75; 95% CI 0.59-0.96; p = 0.020). No significant differences were observed for renal replacement therapy (RR 0.64; p = 0.58) or mortality (RR 0.96; p = 0.861). No significant effects were found for secondary outcomes. Conclusion(s): Intraoperative HA during CPB reduces the risk of AKI but does not significantly affect other major postoperative outcomes. Further studies are needed to determine its clinical relevance and optimal patient selection. Copyright © 2026 Elsevier Inc. <6> Accession Number 2046502373 Title Anticholinergic Burden as a Modifiable Risk Factor in Cardiac Surgery: A Randomized Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2761-2772), 2026. Date of Publication: 01 Sep 2026. Author Cobas M.; Demir Z.A.; Aykut A.; Ozsan N.; Yigit C.A.; Kurtbeyoglu S.; Katipoglu B.; Akca O. Institution (Cobas, Demir, Aykut, Ozsan, Yigit, Kurtbeyoglu) Department of Anesthesiology and Reanimation, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey (Katipoglu) Department of Geriatrics, University of Health Sciences, Balikesir Ataturk City Hospital, Balikesir, Turkey (Akca) Department of Anesthesiology & Critical Care Medicine, School of Medicine, Johns Hopkins University, Johns Hopkins Hospital, Baltimore, MD, United States Publisher W.B. Saunders Abstract Objectives: This study assessed whether reducing immediate perioperative anticholinergic burden improves functional recovery in older patients undergoing coronary artery bypass grafting (CABG). Design(s): Prospective randomized controlled study. Setting(s): Single-institution tertiary care hospital. Participant(s): One hundred twenty-two patients aged >=60 years with preoperative Anticholinergic Cognitive Burden scores >=3. Intervention(s): Patients were assigned to either standard anesthetic and/or analgesic care including anticholinergic drugs (standard group) or a deprescribing strategy avoiding perioperative anticholinergic anesthetic and analgesic drugs (deprescribing group). Measurements and Main Results: Primary outcomes were functional recovery on postoperative day 90 assessed using the Katz Index and the Clinical Frailty Scale. On postoperative day 90, full independence (Katz Index score of 6) was significantly more frequent in the deprescribing group than in the standard group (75.0% v 41.1%, p < 0.001). Frailty scores were significantly lower in the deprescribing group at 90 days (median, 3 [interquartile range (IQR), 3-3] v 4 [IQR, 3-4]; p < 0.001). Multivariate logistic regression identified perioperative use of anticholinergic anesthetic and analgesic drugs as an independent predictor of 90-day total complications (odds ratio, 2.430; 95% confidence interval, 1.031-5.726; p = 0.042). Within-group analyses showed decreased frailty scores and increased Katz Index scores from baseline to day 90 in the deprescribing group (p < 0.001 for both), whereas the standard group showed increased frailty (p < 0.001) with no significant change in Katz Index scores (p = 0.317). Conclusion(s): In older CABG patients, immediate perioperative deprescribing of anticholinergic medications improved 90-day functional recovery trajectories and was associated with fewer cardiac and pulmonary complications. Anticholinergic burden may represent a modifiable perioperative risk factor that should be routinely addressed in surgical care pathways to optimize outcomes in older adults. Copyright © 2026 Elsevier Inc. <7> 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. 40(9) (pp 2675-2680), 2026. Date of Publication: 01 Sep 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. <8> Accession Number 2048311665 Title Long-Term Outcomes of LAAO Versus DOACs in Nonvalvular Atrial Fibrillation: A Meta-Analysis of Randomized Trials. Source PACE - Pacing and Clinical Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Ezenna C.; Sawalha K.; Ibrahim S.; Krishna M.M.; Joseph M.; Janga L.S.N.; Nadeem S.; Mohammed-Murtala A.-D.; Rossi R.; Goldsweig A.M. Institution (Ezenna, Nadeem) Department of Medicine, University of Massachusetts - Baystate Medical Center, Springfield, MA, United States (Sawalha, Goldsweig) Department of Cardiovascular Medicine, Baystate Medical Center and Division of Cardiovascular Medicine, University of Massachusetts-Baystate, Springfield, MA, United States (Ibrahim) Department of Cardiovascular Medicine, Mayo Clinic, Phoenix, AZ, United States (Krishna, Joseph) Department of Medicine, Medical College Thiruvananthapuram, Kerala, Thiruvananthapuram, India (Janga) Department of Medicine, Mount Auburn Hospital-Havard Medical School, Cambridge, MA, United States (Mohammed-Murtala) Department of Radiology, 37 Military Hospital, Accra, Ghana (Rossi) Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT, United States Publisher John Wiley and Sons Inc Abstract Background: Percutaneous left atrial appendage occlusion (LAAO) is an alternative strategy for stroke prevention in patients with nonvalvular atrial fibrillation (AF) with contraindications to long-term oral anticoagulation therapy. However, evidence comparing the long-term outcomes of LAAO with those of direct oral anticoagulants (DOAC) remains limited. Method(s): A systematic search was conducted across PubMed, Scopus, and the Cochrane databases through April 2026. Co-primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCE; composite of cardiac death, stroke, or systemic embolism) and net adverse clinical events (NACE; composite of MACCE and non-procedure-related bleeding). Secondary endpoints included individual components of co-primary endpoints, ischemic and hemorrhagic stroke, all-cause death, major or clinically significant bleeding (procedure + non-procedure related), and stroke or systemic embolism. The random-effects model was used to generate risk ratios (RRs) and 95% CIs. Result(s): Four randomized controlled trials comprising 5890 AF patients and a median follow-up of 3 years were included. There was no significant difference between LAAO and DOAC therapy in the risk of MACCE (RR 1.17; 95%CI 0.96-1.41; I2 = 0%) or NACE (RR 0.89; 95%CI 0.65-1.24; I2 = 85%). Both LAAO and DOAC therapy were similar in risk of cardiac death, stroke, systemic embolism, hemorrhagic stroke, ischemic stroke, all-cause mortality, stroke or systemic embolism, and pericardial effusion. LAAO was associated with a lower risk of non-procedure-related bleeding (RR 0.60; 95%CI 0.47-0.76; I2 = 59%). Conclusion(s): LAAO demonstrated efficacy comparable to DOAC therapy in reducing the risk of MACCE, NACE, and ischemic events, while significantly reducing the risk of non-procedure-related bleeding. Our findings support a tailored approach to stroke prevention in AF, wherein LAAO serves as an effective alternative for patients with contraindications to DOAC therapy. Copyright © 2026 Wiley Periodicals LLC. <9> Accession Number 2045455419 Title Impact of Restrictive Versus Liberal Oxygenation on Pulmonary Decline After Cardiac Surgery: A Substudy of the GLORIOUS Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2837-2844), 2026. Date of Publication: 01 Sep 2026. Author Mikkelsen A.D.; Wiberg S.; Schultz H.H.L.; Moller-Sorensen P.H.; Hofsten D.; Kober L.; Chemtob R.A.; Jakobsen P.C.H.; Nilsson J.C.; Moller C.H.; Hassager C.; Kjaergaard J. Institution (Mikkelsen, Hofsten, Kober, Hassager, Kjaergaard) Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Moller-Sorensen, Nilsson) Department of Cardiothoracic Anaesthesiology and Intensive Care, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Schultz, Chemtob, Jakobsen) Section for Heart and Lung Transplant, Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Moller) Department of Cardiac Surgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark (Wiberg, Hassager, Kjaergaard) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher W.B. Saunders Abstract Objectives: Pulmonary dysfunction is a known complication of cardiac surgery. High fractions of inspired oxygen (FiO<inf>2</inf>) during the critical pulmonary reperfusion phase of cardiopulmonary bypass (CPB) weaning is a proposed pathophysiological contributor yet remains sparsely investigated. Design(s): Predefined, exploratory substudy of the GLORIOUS randomized, clinical trial. Setting(s): Single tertiary center with cardiothoracic surgery expertise. Participant(s): Adult patients undergoing nonemergent coronary artery bypass grafting (CABG) and/or surgical aortic valve replacement. Intervention(s): Restrictive (FiO<inf>2</inf> 50%) versus liberal (FiO<inf>2</inf> 100%) oxygenation during CPB and the first hour after weaning or until patient transfer from the operating table. Pulmonary function (forced expired volume in 1 second [FEV1], forced vital capacity [FVC], FEV1/FVC, and diffusion capacity of carbon monoxide) was measured preoperatively and 3 months postoperatively. Measurements and Main Results: A total of 878 patients were included in the study. Postoperatively, at the 3-month mark, pulmonary function declined across all parameters in the overall study population (median FEV1 [% predicted] by 8.3 percentage points [95% CI 6.6 to 8.3], FVC [% predicted] by 6.1 percentage points [95% CI 5.2 to 7.0], FEV1/FVC by 1.6 percentage points [95% CI 1.0 to 2.1], and diffusion capacity of carbon monoxide [% predicted corrected] by 7.7 percentage points [95% CI 6.2 to 9.1], all p< 0.001). However, no significant between-group differences in decline were observed (all p > 0.3), including in subgroup analyses. Conclusion(s): While pulmonary function exhibited a mild-to-moderate decline 3 months after cardiac surgery, a restrictive (FiO<inf>2</inf> 50%) oxygenation strategy during CPB did not attenuate this decline compared with a liberal (FiO<inf>2</inf> 100%) strategy. Findings are hypothesis-generating. Copyright © 2026 The Author(s) <10> Accession Number 629599809 Title Protocol for the electroencephalography guidance of anesthesia to alleviate geriatric syndromes (ENGAGES-Canada) study: A pragmatic, randomized clinical trial. Source F1000Research. 8 (no pagination), 2023. Article Number: 1165. Date of Publication: 2023. Author Deschamps A.; Saha T.; El-Gabalawy R.; Jacobsohn E.; Overbeek C.; Palermo J.; Robichaud S.; Dumont A.A.; Djaiani G.; Carroll J.; Kavosh M.S.; Tanzola R.; Schmitt E.M.; Inouye S.K.; Oberhaus J.; Mickle A.; Ben Abdallah A.; Avidan M.S. Institution (Deschamps) Department of Anesthesiology and Pain Medicine, Montreal Heart Institute and Universite de Montreal, Montreal, QC, Canada (Saha, Tanzola) Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Kingston, ON, Canada (El-Gabalawy) Department of Clinical Health Psychology, Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, MB, Canada (Jacobsohn) Departments of Anesthesia and Internal Medicine, University of Manitoba, Winnipeg, MB, Canada (Overbeek, Palermo) Department of Anesthesiology and Pain Medicine, University of Montreal, Montreal, QC, Canada (Robichaud) Montreal Heart Institute, Montreal, QC, Canada (Dumont) Montreal Health Innovation Coordinating Center, Montreal Heart Institute, Montreal, QC, Canada (Djaiani, Carroll) Department of Anesthesia, University of Toronto, Toronto, ON, Canada (Kavosh) Department of Anesthesiology, Perioperative and Pain Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada (Schmitt, Inouye) Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States (Oberhaus, Mickle, Ben Abdallah, Avidan) Department of Anesthesiology, Washington University School of Medicine, St-Louis, MO, United States Publisher F1000 Research Ltd Abstract Background: There is some evidence that electroencephalography guidance of general anesthesia can decrease postoperative delirium after non-cardiac surgery. There is limited evidence in this regard for cardiac surgery. A suppressed electroencephalogram pattern, occurring with deep anesthesia, is associated with increased incidence of postoperative delirium (POD) and death. However, it is not yet clear whether this electroencephalographic pattern reflects an underlying vulnerability associated with increased incidence of delirium and mortality, or whether it is a modifiable risk factor for these adverse outcomes. Method(s): The Electroe ncephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES-Canada) is an ongoing pragmatic 1200 patient trial at four Canadian sites. The study compares the effect of two anesthetic management approaches on the incidence of POD after cardiac surgery. One approach is based on current standard anesthetic practice and the other on electroencephalography guidance to reduce POD. In the guided arm, clinicians are encouraged to decrease anesthetic administration, primarily if there is electroencephalogram suppression and secondarily if the EEG index is lower than the manufacturers recommended value (bispectral index (BIS) or WAVcns below 40 or Patient State Index below 25). The aim in the guided group is to administer the minimum concentration of anesthetic considered safe for individual patients. The primary outcome of the study is the incidence of POD, detected using the confusion assessment method or the confusion assessment method for the intensive care unit; coupled with structured delirium chart review. Secondary outcomes include unexpected intraoperative movement, awareness, length of intensive care unit and hospital stay, delirium severity and duration, quality of life, falls, and predictors and outcomes of perioperative distress and dissociation. Discussion(s): The ENGAGES-Canada trial will help to clarify whether or not using the electroencephalogram to guide anesthetic administration during cardiac surgery decreases the incidence, severity, and duration of POD. Registration: ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02692300 NCT02692300) 26/02/2016 Copyright: © 2023 Deschamps A et al. <11> Accession Number 2040907302 Title Intravenous Ferric Carboxymaltose in Ischemic vs Nonischemic Heart Failure and Iron Deficiency: Insights From FAIR-HF2. Source Journal of Cardiac Failure. 32(8) (pp 1308-1319), 2026. Date of Publication: 01 Aug 2026. Author Khan M.S.; Butler J.; Karakas M.; Placzek M.; HASENFUss G.; Talha K.M.; Bayes-Genis A.; Coats A.J.; Bohm M.; Rosano G.; Savarese G.; Anker M.S.; Ponikowski P.; Friede T.; Anker S.D. Institution (Khan, Butler) Baylor Scott and White Research Institute, Baylor Scott and White Health, Dallas, TX, United States (Khan) Baylor Scott and White Health-The Heart Hospital, Plano, TX, United States (Khan) Department of Medicine, Baylor College of Medicine, Temple, TX, United States (Butler, Talha) Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States (Karakas) Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Karakas) German Centre for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lubeck, Hamburg, Germany (Placzek, Friede) Department of Medical Statistics, University Medical Center Gottingen, German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Gottingen, Germany (Hasenfus) Clinic for Cardiology and Pneumology, University Medical Center Gottingen, German Centre for Cardiovascular Research (DZHK), partner site Lower Saxony, Gottingen, Germany (Bayes-Genis) Heart Failure Clinic and Cardiology Department, Hospital Germans Trias i Pujol, CIBERCV, Badalona, Spain (Bayes-Genis) Department of Medicine, Universitat Autonoma de Barcelona (UAB), Carretera del Canyet s/n, Barcelona, Spain (Coats) Heart Research Institute, University of Sydney, NSW, Australia (BOHm) HOMICAREM (HOMburg Institute for CArdioREnalMetabolic Medicine), Saarland University and Universitatsklinikum des Saarlandes, Klinik fur Kardiologie, Angiologie und Internistische Intensivmedizin, Homburg/Saar, Germany (Rosano) Department of Human Sciences and Promotion of Quality of Life, San Raffaele Open University of Rome, Rome, Italy (Rosano) 14 IRCCS San Raffaele Roma, Italy (Savarese) Department of Clinical Science and Education, Sodersjukhuset; Karolinska Institutet, Stockholm, Sweden (Anker) Charite -University Medicine Berlin corporate member of Free University Berlin and Humboldt-University Berlin, Berlin, Germany (Anker, Anker) German Centre for Cardiovascular Research partner site Berlin and Berlin Institute of Health Center for Regenerative Therapies, Berlin, Germany (Anker, Anker) Department of Cardiology, Angiology and Intensive Care Medicine CBF, German Heart Center Charite, Berlin, Germany (Anker) School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, United Kingdom (Ponikowski) Institute of Heart Diseases, Wroclaw Medical University, Ul. Borowska 213, Wroclaw, Poland (Ponikowski) Clinical Department of Cardiology, Jan Mikulicz Radecki University Hospital in Wroclaw, Wroclaw, Poland (Anker) Department of Cardiology, Campus Virchow Clinic of German Heart Center Charite, Charite-University Medicine Berlin, Berlin, Germany Publisher Elsevier B.V. Abstract Background Previous studies have suggested that patients with ischemic etiology of heart failure (HF) and iron deficiency may derive greater benefits from intravenous ferric carboxymaltose (FCM). We aim to assess the effects of FCM vs placebo in patients with ischemic vs nonischemic etiology of HF. Methods and Results The FAIR-HF2 trial included 1105 patients with HF, with a left-ventricular ejection fraction <= 45% and concomitant iron deficiency. Patients were randomized 1:1 to either intravenous FCM or placebo. Ischemic etiology was defined as investigator-reported or prior coronary revascularization or myocardial infarction. The primary endpoints were time-to-first-event of cardiovascular death or hospitalization due to HF, total HF hospitalizations, and time-to-first event of cardiovascular death or HF hospitalization in patients with transferrin saturation < 20% at baseline. Of 1105 patients, 858 (78%) had ischemic etiologies of HF. They were more commonly older and male and had more comorbidities. For the first primary endpoint, FCM was associated with a hazard ratio (HR) of 0.85 (95%CI: 0.66-1.10; P = 0.23) for ischemic HF and 0.61 (95% CI: 0.39-0.98; P = 0.038) for nonischemic HF ( P -interaction = 0.26). The HR for the second primary endpoint was 0.87 (95% CI: 0.63-1.21, P = 0.41) for ischemic HF and 0.57 (95% CI: 0.35-0.94; P = 0.028) for nonischemic HF ( P -interaction = 0.17), while HR for the third primary endpoint was 0.84 (95% CI: 0.62-1.14; P = 0.27) for ischemic HF and 0.63 (95% CI: 0.37-1.07; P = 0.087) for nonischemic HF ( P -interaction = 0.35). Conclusions The effect of intravenous iron supplementation is likely to be similar in patients with ischemic or nonischemic etiology of HF, just like other HF guideline-directed medical therapies. Copyright © 2025 Elsevier Inc. <12> Accession Number 645687837 Title Foot Reflexology for Pain and Anxiety Associated with Chest Tube Removal in Patients After Coronary Artery Bypass Graft: A Randomized Controlled Trial. Source Alternative therapies in health and medicine. 31(1) (pp 15-21), 2025. Date of Publication: 01 Jan 2025. Author Budak Erturk E.; Karadag M. Abstract Background: Reflexology is a method used to control the pain and anxiety associated with chest tube removal in patients undergoing cardiovascular surgery. Primary Study Objective: This study aimed to identify the effect of foot reflexology applied before chest tube removal on pain and anxiety levels in patients with coronary artery bypass graft surgery. Methods/Design: This study was a randomized controlled clinical trial. Setting(s): This study was conducted in the cardiovascular surgery intensive care unit of the Baskent University Ankara Hospital. Participant(s): Patients, who underwent coronary artery bypass graft surgery, were randomly assigned either to the reflexology group or the control group (n = 28 individuals/group). Intervention(s): The reflexology group received foot reflexology for 30 minutes in two sessions (first postoperative day and before chest tube removal). Primary Outcome Measures: The primary outcomes of the surgery were pain, evaluated using a Numeric Pain-Rating Scale; and anxiety, evaluated using the Profile of Mood States Scale Tension-Anxiety Subscale. Pain and anxiety were determined on the first (before and after the reflexology) and second postoperative days (before and after the reflexology and immediately, 15 min, 1 hour (only pain level) after chest tube removal). Result(s): The mean pain scores of the control and intervention groups were similar during chest tube removal, 15 minutes after, and 1 hour after (P > .05). Although mean anxiety scores were comparable after chest tube removal in both groups (P > .05), a significant difference was found 15 minutes later (P < .05). The increase in pain (P = .0001) and anxiety (P = .032) levels before and after the removal was significantly less in the intervention group compared to the control group, based on pain and anxiety scores. Conclusion(s): Foot reflexology significantly reduced the increase in pain and anxiety during chest tube removal in patients with coronary artery bypass graft surgery. <13> Accession Number 2047595294 Title From fast track to ultrafast track extubation in cardiac surgery: a systematic review. Source Minerva Anestesiologica. 92(6) (pp 588-600), 2026. Date of Publication: 01 Jun 2026. Author Silvetti S.; Fresilli S.; Abelardo D.; Ajello V.; Aloisio T.; Capuano P.; Guarracino F.; Labanca R.; Landoni G.; Lobdell K.W.; Meani P.; Pieri M.; Ranucci M.; Sepolvere G.; Toscano A.; Scolletta S.; Stoppe C.; Weltert L.; Zarbock A.; Paternoster G. Institution (Silvetti) Department of Cardioanesthesia and Intensive Care, Cardiovascular Network, IRCCS Ospedale Policlinico San Martino, Genoa, Italy (Fresilli, Labanca, Landoni, Pieri) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Abelardo) Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy (Ajello) Department of Cardiac Anesthesia, Tor Vergata University Hospital, Rome, Italy (Aloisio, Ranucci) Department of Cardio-Thoraco-Vascular Anesthesia and Intensive Therapy, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy (Capuano) IRCCS ISMETT, Palermo, Italy (Capuano) UPMC Italy, Palermo, Italy (Guarracino) Department of Medical,, Oral and Biotechnological Sciences "Gabriele d'Annunzio" University, Chieti, Italy (Landoni, Pieri) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Lobdell) Sanger Heart and Vascular Institute, Advocate Health, Charlotte, NC, United States (Meani) Department of Cardiothoracic Surgery, Heart and Vascular Centre, Maastricht University Medical Centre, Maastricht, Netherlands (Sepolvere) Intensive Care Unit, Department of Anesthesia and Cardiac Surgery, San Michele Hospital, Caserta, Italy (Toscano) Department of Anesthesia and Intensive Care, ASL TO4, Ivrea Hospital, Ivrea, Turin, Italy (Scolletta) Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy (Stoppe) Department of Anesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Stoppe, Zarbock) UTHealth, Center for Outcomes Research, Department of Anesthesiology, Houston, TX, United States (Weltert) Saint Camillus International University for Health Science, Rome, Italy (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Paternoster) Department of Health Science, Anesthesia and Intensive Care Unit, San Carlo Hospital, University of Basilicata, Potenza, Italy Publisher Edizioni Minerva Medica Abstract BACKGROUND: This study aimed to evaluate interventions that facilitate rapid extubation in adult cardiac surgery patients, defined as extubation within six hours, three hours, or one hour post-surgery. Early extubation is a critical component of enhanced recovery pathways in cardiac surgery and plays an essential role in improving patient outcomes. Several strategies have been investigated, including the use of locoregional anesthesia techniques, dexmedetomidine, and adaptive support ventilation. METHOD(S): A systematic review of randomized controlled trials (RCTs) was conducted, searching the Medline, Central, and Embase databases from January 2015 to May 2025. Studies were included if they compared interventions for rapid extubation and achieved extubation within at least one study group for more than 75% of patients. Fifty-seven trials were included in the review. RESULT(S): Out of the 57 trials, 42 studies reported extubation within six to three hours post-surgery. These results were predominantly associated with locoregional anesthesia techniques, particularly fascial blocks, as well as dexmedetomidine use and adaptive support ventilation. Eleven studies reported extubation within three hours and one hour, with the majority of these trials also involving fascial blocks. Among the 57 studies, four focused specifically on ultrafast track strategies. Notably, only one study assessing the erector spinae plane block achieved extubation within one hour in over 75% of patients, with a median extubation time of 10 minutes (range 10-120 minutes), compared to 60 minutes (range 10-225 minutes) in the control group (P=0.06). CONCLUSION(S): While ultrafast extubation is currently limited to select patients, it appears to be safe and effective when carefully applied. The study supports the use of various interventions for facilitating rapid extubation and highlights the importance of individualized patient selection. Further high-quality trials are needed to identify the most effective combinations of these interventions and to standardize protocols for broader clinical practice. Copyright © 2025 EDIZIONI MINERVA MEDICA. <14> Accession Number 2046095918 Title Randomized trial of tricuspid flexible band versus rigid ring in patients with moderate tricuspid regurgitation or greater: results of the JPH2019 trial. Source Journal of Thoracic and Cardiovascular Surgery. 172(3) (pp 547-555.e10), 2026. Date of Publication: 01 Sep 2026. Author Xu X.; Gu J.; Liu H.; Du J.; Gu W.; Ni B.; Shao Y. Institution (Xu, Gu, Liu, Du, Gu, Ni, Shao) Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Jiangsu, Nanjing, China Publisher Elsevier Inc. Abstract Objective: To compare the efficacy and clinical outcomes of flexible band versus rigid ring annuloplasty for the correction of moderate tricuspid regurgitation (TR) or greater. Method(s): In this single-center randomized trial, adult patients with moderate or greater TR were assigned to receive either a flexible band or a rigid ring. The primary outcome was recurrent TR during follow-up. Secondary outcomes included death, permanent pacemaker implantation, and other adverse events. Result(s): In total, 400 patients were randomized with a 1:1 ratio, and 321 were included in the final analysis (flexible band, n = 156; rigid ring, n = 165). Baseline characteristics were balanced between arms. At discharge, recurrent TR was significantly greater in the flexible band arm than the rigid ring arm (10.1% vs 3.8%, P =. 03). However, the significance was no longer significant during follow-up (6.1%/patient-years vs 4.7%/ patient-years, P =. 21). Multivariable analysis identified female sex (subdistribution hazard ratio [sHR], 2.16, 95% CI, 1.1-4.22, P =. 025), preoperative severe TR (sHR, 2.09; 95% CI, 1.06-4.11, P =. 033) and massive TR (sHR, 4.63; 95% CI, 1.29-16.61, P =. 019), and preoperative permanent pacemaker implantation (sHR, 3.69; 95% CI, 1.35-10.09, P =. 011) as independent risk factors for recurrent TR. Subgroup analyses based on these factors showed no significant between-arm difference in the primary outcome. secondary outcomes were also comparable between the arms during follow-up. Conclusion(s): Both annuloplasty devices provided acceptable TR correction with similar adverse event rates over a median 3-year follow-up. Copyright © 2026 The American Association for Thoracic Surgery <15> Accession Number 643996451 Title Significance Analysis of the Improvement in Postoperative Recovery of Cardiac Surgery Patients Based on the Graded Management Established Using the Delirium Prediction Model. Source Alternative therapies in health and medicine. 31(1) (pp 338-342), 2025. Date of Publication: 01 Jan 2025. Author Zhang H.; Wang Q.; Feng P. Abstract Objective: To investigate the impact of graded management based on delirium prediction modeling on the improvement of recovery of cardiac surgery patients. Method(s): Three hundred and twenty patients admitted to the Department of Critical Care Medicine of Nanjing Hospital affiliated with Nanjing Medical University from June 2021 to December 2023 after Type A aortic coarctation were selected as study subjects. They were grouped according to the randomized scale method and divided into 160 cases in each the control group and the observation group. In the control group, conventional nursing measures were adopted, and in the observation group, graded nursing interventions were carried out according to the established delirium risk prediction model. Comparison between the two groups in terms of the intensive care unit (ICU) monitoring time, hospitalization time, duration of delirium, and delirium incidence, and investigated nursing satisfaction, and quality of care scores. Result(s): Compared with the control group, the observation group's ICU custody time, hospitalization time, and delirium duration, decreased, and the quality of care, and satisfaction increased (P < .05). At the same time, the incidence of delirium in the observation group was also lower than that in the control group (P < .05). Conclusion(s): The graded management based on the delirium prediction model can effectively reduce the incidence of postoperative delirium in critically ill patients with Type A aortic coarctation, and at the same time improve patient satisfaction and quality of care. <16> Accession Number 2048090967 Title Comparing the Efficacy of Mechanochemical Ablation Versus Radiofrequency Ablation for Treating Great Saphenous Vein Incompetence: A Meta-Analysis. Source Annals of Vascular Surgery. 132 (pp 622-635), 2026. Date of Publication: 01 Nov 2026. Author Cheng Q.; Zhao Q.; Cao J.; Wang J.; Jiang L.; Zhou X. Institution (Cheng, Cao, Wang, Jiang, Zhou) Department of Vascular Surgery, Hexi University Affiliated to Zhangye People's Hospital, Gansu, Zhangye, China (Zhao) Department of Vascular Surgery, the Affiliated People's Hospital of Ningbo University, Zhejiang, Ningbo, China Publisher Elsevier Inc. Abstract Background The objective of this meta-analysis was to compare the efficacy of mechanochemical ablation (MOCA) and radiofrequency ablation (RFA) in the treatment of great saphenous vein (GSV) incompetence. Methods Online databases including PubMed, Cochrane Library, Embase, and Web of Science were searched to collect randomized controlled trials (RCTs) and cohort studies comparing MOCA and RFA in the treatment of varicose veins in lower extremities from database inception to October 2025. Primary outcome was anatomic success. Secondary outcomes were visual analog scale (VAS), Aberdeen Varicose Vein Questionnaire score (AVVQ), and complications. Two reviewers independently screened the retrieved literature, extracted data, and assessed the risk of bias in the included studies. Subsequent analysis was performed using RevMan 5.3. Results A total of four RCTs, one cohort study and retrospective cross-sectional study involving 737 patients (380 MOCA patients and 357 RFA patients) were included. The meta-analysis results showed that the RFA group was significantly better than the MOCA group in short term and long term of anatomical success rate [(odds ratio [OR] = 0.38; 95% confidence interval [CI] (0.20, 0.71), P = 0.003), (OR = 0.17, 95% CI (0.06, 0.45), P = 0.0003)], but patients in the MOCA group had significantly lower perioperative period pain (mean difference [MD] = -4.48, 95% CI (-7.58, -1.37), P = 0.005] and required fewer days to return to normal activities (MD = -0.76, 95% CI, (-0.95, -0.57), P < 0.001). No significant differences were observed between the two groups in minor and major complications [(OR = 0.93, 95% CI (0.66, 1.33), P = 0.70), (OR = 1.30, 95% CI (0.32, 5.28), P = 0.72)] or quality of life scores (MD = -0.45, 95% CI (-2.53 to 1.63), P = 0.67). Conclusion MOCA of GSV incompetence is an effective and safe method. Compared with RFA, it has lower postoperative pain score and faster recovery time. However, the anatomical success rates were significantly lower with MOCA than with RFA. Therefore, long-term follow-up to evaluate the impact on clinical results is required. Copyright © 2026 Elsevier Inc. <17> Accession Number 2047787442 Title Transseptal Access to the Left Atrium: A Narrative Review of Techniques, Indications, and Device Innovations. Source Life. 16(7) (no pagination), 2026. Article Number: 1179. Date of Publication: 01 Jul 2026. Author Rosu A.M.; Badea T.G.; Tomescu F.L.; Radu E.S.; Tanasescu M.-D.; Cismas E.G.; Popa O.A. Institution (Rosu, Radu, Popa) Prof. Dr. Agripa Ionescu Emergency Hospital, Department of Cardiology, Balotesti, Romania (Badea, Tomescu) Prof. Dr. Agripa Ionescu Emergency Hospital, Department of Radiology, Balotesti, Romania (Tomescu) Carol Davila University of Medicine and Pharmacy, Department of Radiology, Bucharest, Romania (Tanasescu) Emergency University Hospital, Carol Davila University of Medicine and Pharmacy, Department of Semiology, Bucharest, Romania (Cismas) "Sf. Ioan" Emergency Clinical Hospital, Department of Cardiology, Bucharest, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Transseptal puncture (TSP) is a critical technique for accessing the left atrium in various structural and electrophysiological cardiac procedures. Originally introduced for diagnostic catheterization in the mid-20th century, it has evolved into a cornerstone of modern interventional cardiology. This article was designed as a targeted narrative review, rather than a systematic or comprehensive review, and synthesizes selected peer-reviewed evidence spanning 1955 to 2025, retrieved through a targeted literature search. We explore the anatomical foundations of TSP, its historical development, and modern refinements such as radiofrequency-assisted puncture, balloon septoplasty, and fluoroless or image-fusion-guided access. Clinical applications-including mitral valve interventions, left atrial appendage closure, and decompression during extracorporeal membrane oxygenation (ECMO)-are reviewed alongside safety considerations and complication management strategies. Advances in imaging modalities, including three-dimensional echocardiography and computed tomography, have enhanced precision and safety. Because of the narrative design, the review emphasizes clinical relevance, procedural applicability, and evidence synthesis without formal risk-of-bias scoring or quantitative evidence grading. Overall, TSP demonstrates a high success rate and low complication profile when performed with appropriate imaging and operator expertise. Ongoing innovation in technique and technology continues to expand its utility across cardiac disciplines. Copyright © 2026 by the authors. <18> Accession Number 2048076983 Title Diuretic therapy for critically ill patients: a systematic review and network meta-analysis. Source Annals of Intensive Care. 16 (no pagination), 2026. Article Number: 100120. Date of Publication: 01 Jan 2026. Author Kuriyama A.; Polok K.; Malhotra N.; Kuse N.; Pitre T.; Lakhanpal D.; Sun R.; Soni K.D.; Campbell K.; Burry L.D.; Clark E.G.; Lewis K.; Moller M.H.; Gershengorn H.B.; Rochwerg B. Institution (Kuriyama, Lewis, Rochwerg) Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada (Polok) Centre for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Krakow, Poland (Malhotra) Department of Medicine, Division of Cardiology, McMaster University, Hamilton, ON, Canada (Malhotra) Department of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada (Kuse) Firestone Institute for Respiratory Health at St. Joseph's Healthcare, Hamilton, ON, Canada (Pitre) University Health Network, University of Toronto, Toronto, ON, Canada (Lakhanpal) Department of Chemical and Physical Sciences, University of Toronto, Toronto, ON, Canada (Sun) Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Soni) Critical and Intensive Care, JPN Apex Trauma Centre, All India Institute of Medical Sciences, New Delhi, India (Campbell) Campbell Information Consulting, Inc., Petawawa, ON, Canada (Burry) Departments of Pharmacy, Medicine, Sinai Health Research, Sinai Health, Toronto, ON, Canada (Burry) Leslie Dan Faculty of Pharmacy and Interdepartmental Division of Critical Care, University of Toronto, Toronto, ON, Canada (Clark) Division of Nephrology, Department of Medicine, University of Ottawa, Ottawa, ON, Canada (Clark) Kidney Research Centre, Ottawa Hospital Research Institute, Ottawa, ON, Canada (Lewis, Rochwerg) Department of Medicine, McMaster University, Hamilton, ON, Canada (Moller) Department Of Intensive Care, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark (Moller) Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark (Gershengorn) Division of Pulmonary, Critical Care, and Sleep Medicine, University of Miami Miller School of Medicine, Miami, FL, United States (Gershengorn) Division of Critical Care Medicine, Albert Einstein College of Medicine, Bronx, NY, United States Publisher Societe de Reanimation de Langue Francaise Abstract Background Fluid overload is common in critically ill patients and is associated with worse outcomes. Diuretics are the mainstay of active fluid removal in patients with preserved renal function. The optimal diuretic strategy for fluid removal remains uncertain. Methods We conducted a systematic review and Bayesian random-effects network meta-analysis of randomized controlled trials comparing two or more diuretic strategies for fluid removal in critically ill adults. We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials via Ovid, as well as trial registries, from inception to November 20, 2025. Two reviewers independently extracted data and assessed risk of bias using ROBUST-RCT. Certainty of evidence was evaluated using the GRADE approach for network meta-analysis. Treatment effects were summarized as odds ratios (ORs) or mean differences (MDs) with 95% credible intervals (CrIs). Results Twenty-six randomized controlled trials involving 1,652 participants were included. Evaluated interventions included bolus loop diuretics (19 studies), continuous loop infusion (15 studies), oral loop diuretics (5 studies), and loop diuretics combined with tolvaptan (8 studies), spironolactone (3 studies), thiazides (2 studies), acetazolamide (1 study), or triamterene (1 study). Compared with bolus loop diuretics, continuous loop infusion had an uncertain effect on mortality (OR 1.26; 95% CrI 0.62 to 2.55; very low certainty) and may increase ICU length of stay (MD 1.56 days; 95% CrI -0.02 to 3.16; low certainty). Tolvaptan monotherapy may reduce acute kidney injury compared with bolus or continuous loop diuretics (OR 0.12; 95% CrI 0.01 to 0.87; low certainty), although no studies evaluated its effect on the need for renal replacement therapy. For most other comparisons and outcomes, the certainty of evidence was low or very low. Conclusions Available evidence comparing diuretic strategies for fluid removal during ICU-level care is limited, clinically heterogeneous, and derived largely from heart failure and post-cardiovascular surgery populations. Bolus loop diuretics were at least comparable to alternate diuretic strategies for patient important outcomes in critically ill adults, but this was based mostly on low or very low certainty evidence. Tolvaptan monotherapy may decrease acute kidney injury, but its effect on subsequent need for RRT and mortality remains uncertain. Copyright © 2026 The Authors. <19> Accession Number 651457904 Title Applying the fear-avoidance model to exercise rehabilitation after coronary artery bypass grafting a nurse-led intervention study. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 09 Jun 2026. Author Xia L.; Hua J.; Xuan L. Institution (Xia) Department of cardiac surgery, Anhui Chest Hospital, Hefei, Anhui, China (Hua, Xuan) Department of cardiac surgery, Anhui Chest Hospital, Hefei, Anhui, China Abstract OBJECTIVE: To examine whether a nurse-led intervention grounded in the Fear-Avoidance Model (FAM) reduces postoperative kinesiophobia indirectly by improving patients' perceived physical capability. METHOD(S): We conducted a single-center, parallel-group randomized controlled trial. A total of 122 patients who underwent coronary artery bypass grafting (CABG) were randomized 1:1 to an intervention group or a usual-care control group (n = 61 each). The intervention included graded activity, functional feedback, goal setting, structured education, and post-discharge follow-up. Perceived physical capability and kinesiophobia were assessed 30 days after discharge. Mediation analysis was used to test whether perceived physical capability mediated the effect of the intervention on kinesiophobia. RESULT(S): The intervention was associated with higher perceived physical capability (a = 2.43, p = 0.031). Perceived physical capability was inversely associated with kinesiophobia (b = - 0.775, p < 0.001). The indirect effect of the intervention on kinesiophobia through perceived physical capability was significant (ab = - 1.879; bootstrapped 95% CI [- 3.702, - 0.288]). In contrast, the total effect (c = - 1.557, p = 0.433) and the direct effect (c'=0.322, p = 0.860) were not statistically significant. CONCLUSION(S): These findings suggest a rehabilitation-relevant pathway in which strengthening perceived capability may help reduce avoidance-oriented responses after CABG. A nurse-led approach that combines graded mobilization, performance feedback, and goal-based progression may support engagement in early recovery activities and may offer a practical framework for transitional rehabilitation support. Copyright © 2026. The Author(s). <20> Accession Number 651420575 Title Preoperative IV iron and postoperative blood transfusion reduction in non-anaemic patients undergoing cardiac surgery: a systematic review and meta-analysis of RCTs. Source Journal of cardiothoracic surgery. 21(1) (no pagination), 2026. Date of Publication: 06 Jun 2026. Author Murad Z.A.; Lahcen A.A.; Alkhawam M.; Elbasosy M.Y.; Abdelhamid M.O.; El Hilali A.; Abdallatif L.A.; Abdelrahman H.; Agnaou Y. Institution (Murad) Faculty of Medicine and Health Sciences, University of Aden, P.O. Box 878, Aden, Yemen (Lahcen) Faculty of Medicine and Pharmacy of Marrakech, Cadi Ayyad University, Marrakesh, Morocco (Alkhawam) Division of Cardiovascular, University of Alabama at Birmingham, Birmingham, AL, United States (Elbasosy, Abdelhamid) Menoufia University Hospitals, Egypt (El Hilali) Faculty of Medicine and Pharmacy of Agadir, Ibn Zohr University, Agadir, Morocco (Abdallatif) Capital University, Cairo, Egypt (Abdelrahman) Cairo University Hospitals, Cairo, Egypt (Agnaou) Faculte de Sante de Creteil - UPEC (Paris 12) Paris-Est Creteil Val-de-Marne university Paris, Creteil, France Abstract BACKGROUND: Preoperative intravenous iron has become increasingly popular as a strategy to optimize hemoglobin before major surgery. However, its potential benefit in non-anaemic patients undergoing cardiac surgery remains unclear. To address this uncertainty, we conducted a systematic review and meta-analysis to investigate whether preoperative IV iron reduces red blood cell transfusion requirements and improves hematologic and clinical outcomes in adults with normal baseline hemoglobin undergoing cardiac surgery. METHOD(S): We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library until October 2025 for randomized controlled trials. Eligible studies compared preoperative IV iron to a control (placebo, saline, or standard care) in non-anaemic (per WHO definition) adult patients (>= 18 years) undergoing cardiac surgery. The primary outcomes were the incidence of postoperative RBC transfusion and the number of units transfused. Secondary outcomes included postoperative hemoglobin level, Postoperative iron indices, length of ICU stay, length of hospital stay (LOS), overall postoperative infection, All-cause mortality, and adverse events possibly related to IV iron (hypersensitivity, anaphylaxis). We used the Cochrane ROB 2 tool for bias assessment and for evidence certainty. Pooled Risk ratios, odds ratios, mean difference, and standardized mean difference with 95% confidence intervals were calculated using random-effects models, with the fixed-effects model applied when heterogeneity was absent or low (I2 < 10%). RESULT(S): From 529 initial records, 3 RCTs met the inclusion criteria, encompassing 338 patients. The overall risk of bias was low to moderate. Preoperative IV iron significantly reduced the incidence of postoperative RBC transfusion compared to the control group (Risk Ratio [RR] = 0.62; 95% CI 0.43-0.88; p = 0.008; I2 = 0%), representing a 38% relative risk reduction. Furthermore, IV iron significantly decreased the mean number of RBC units transfused (Mean Difference [MD] = - 1.08 units; 95% CI - 1.61 to - 0.54; I2 = 0%). While no significant difference was observed in hemoglobin levels at 48 h or one week postoperatively, the IV iron group showed significantly higher hemoglobin at 4-6 weeks (MD = 0.84 g/dL; 95% CI 0.41-1.26; p = 0.0001). IV iron also significantly increased postoperative serum ferritin and transferrin saturation. There were no statistically significant differences in overall postoperative infection rates (RR = 1.16; 95% CI 0.64-2.08) or all-cause mortality (Risk Difference = - 0.00; 95% CI - 0.03 to 0.03). The GRADE certainty of evidence for the primary outcome was moderate. CONCLUSION(S): In non-anaemic adult patients undergoing cardiac surgery, preoperative IV iron administration significantly reduces the incidence of postoperative RBC transfusion and the total volume of blood transfused. This intervention also improves hemoglobin levels during the 4-6 week recovery period without an increased risk of infection or mortality. The moderate-certainty evidence suggests this is a beneficial strategy, though further adequately powered RCTs are warranted to strengthen these findings. PROSPERO REGISTRY REFERENCE: CRD420251161421. Copyright © 2026. The Author(s). <21> Accession Number 2045345892 Title Efficacy of Surgeon-Administered Regional Anesthesia in Cardiac Surgery: A Double-Blinded, 2-Center, Randomized, Placebo-Controlled Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2800-2807), 2026. Date of Publication: 01 Sep 2026. Author Rasmussen J.J.; Bisgaard J.; Honge J.L.; Sperling P.K.; Simonsen C.; Juhl-Olsen P.; Modrau I.S. Institution (Rasmussen, Honge, Juhl-Olsen, Modrau) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Bisgaard, Sperling) Department of Anesthesiology, Aalborg University Hospital, Aalborg, Denmark (Bisgaard) Department of Clinical Medicine, Aalborg University, Aalborg, Denmark (Simonsen) Department of Cardiothoracic Surgery, Aalborg University Hospital, Aalborg, Denmark (Juhl-Olsen, Modrau) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Publisher W.B. Saunders Abstract Objectives: Managing pain after median sternotomy is a clinical challenge of balancing adequate pain relief with avoidance of excessive opioid consumption. While regional anesthesia techniques are increasingly recommended and applied in cardiac surgery, evidence of sustained postoperative benefit remains limited and heterogeneous. The authors aimed to evaluate the efficacy and safety of long-acting regional infiltration anesthesia in patients undergoing coronary artery bypass grafting. Design(s): The trial was conducted as a double-blinded, placebo-controlled trial in which participants were randomized 1:1 to intervention or placebo. Setting(s): Cardiothoracic departments at 2 Danish university hospitals. Participant(s): Patients undergoing non-emergent coronary artery bypass grafting. Intervention(s): Participants were allocated to receive surgeon-administered intraoperative infiltration of the sternum and chest wall with either 62.5 mL of bupivacaine with epinephrine, clonidine, and dexamethasone or an equivalent volume of isotonic saline solution as placebo. Measurements and Main Results: The primary endpoint was total opioid consumption within the first 24 postoperative hours. Secondary endpoints included patient-reported postoperative pain, as well as measures of recovery, respiratory impact, and chronic opioid use. A total of 113 patients were randomized, with 100 patients completing the trial and being included in the final analysis. No difference in opioid consumption was observed between the two groups. The median oral morphine equivalents were 62.3 mg (interquartile range, 70.8 mg) in the active intervention group and 64.0 mg (interquartile range, 46.8 mg) in the placebo group (p = 0.649). None of the secondary or safety endpoints showed significant differences. Conclusion(s): In this double-blind, randomized trial, surgeon-administered regional anesthesia did not reduce opioid consumption or provide additional clinical benefits following median sternotomy. Copyright © 2026 The Authors <22> Accession Number 650899637 Title Sex differences in coronary disease health Status outcomes: the ISCHEMIA trial. Source European heart journal. Quality of care & clinical outcomes. 12(5) (pp 765-769), 2026. Date of Publication: 11 Aug 2026. Author Grodzinsky A.; Cho Y.J.; Jones P.G.; Shaw L.J.; Merz C.N.B.; Boden W.E.; Stone G.W.; Mark D.B.; Spertus J.A.; Maron D.J.; Hochman J.S.; Reynolds H.R. Institution (Grodzinsky, Cho, Jones) Saint Luke's Mid America Heart Institute, Saint Luke's Muriel I. Kauffman Institute for Women's Cardiovascular Research, University of Missouri-Kansas City, Kansas City, United States (Shaw) Zena and Michael A. Wiener Cardiovascular Institute, Blavatnik Family Women's Health Research Institute, Icahn School of Medicine at Mount Sinai, United States (Merz) Barbra Streisand Women's Heart Center, Los Angeles, CA, United States (Boden) VA New England Healthcare System, Boston, United States (Stone) Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, United States (Mark) Duke Clinical Research Institute, Durham, United States (Spertus) Saint Luke's Mid America Heart Institute, Kansas City, United States (Maron) Department of Medicine, Stanford University School of Medicine, Stanford, United States (Hochman, Reynolds) Cardiovascular Clinical Research Center, Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, 530 First Avenue, United States Abstract AIMS: In the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial, women had worse angina than men despite less severe coronary artery disease (CAD) and ischaemia. We examined which patient and treatment factors might explain sex-based differences in angina. METHODS AND RESULTS: ISCHEMIA randomized patients with moderate or severe ischaemia to an initial invasive strategy of cardiac catheterization with complete revascularization plus guideline-directed medical therapy (GDMT), or an initial conservative strategy of GDMT alone with invasive management reserved for GDMT failure. Coronary CT angiography was performed in most participants. Angina-related health status was collected at baseline and 1-year using the Seattle Angina Questionnaire (SAQ). Of 4617 ISCHEMIA participants with complete SAQ data, women averaged 6.5 points (95% CI 5.2 to 7.8) lower (worse) baseline SAQ-summary scores (SS) than men. This difference was not reduced by adjustment for demographics and clinical characteristics. Women had lower unadjusted 1-year SAQ-SS than men (Invasive -3.8 points, Conservative -5.7 points). These sex-based differences were attenuated but not eliminated by adjustment for baseline SAQ-SS. Adjustment for post-randomization treatment (GDMT intensity, risk factor goal achievement and, in the invasive strategy, complete revascularization) did not narrow the sex difference. CONCLUSION(S): Women with chronic CAD in ISCHEMIA had worse angina-related health status than men at baseline and 1-year. Differences were not explained by demographic or clinical characteristics, intensity of GDMT, or completeness of revascularization. It is thus important to consider other factors that may mediate these results, including differences in nociception, coronary microvascular dysfunction, and/or vasospasm. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01471522; https://clinicaltrials.gov/ct2/show/NCT01471522. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact <23> [Use Link to view the full text] Accession Number 650827805 Title Effect of Family Intervention on Postoperative Delirium in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-Analysis. Source The Journal of cardiovascular nursing. 41(5) (pp E510-E523), 2026. Date of Publication: 01 Sep 2026. Author Yue Y.; Liu S.; Martin-Payo R.; Zhang F.; Xie X. Institution (Yue) BSN, West China Hospital/West China School of Nursing, Sichuan University, MSN Candidate, Chengdu, China (Liu) MSN, Vice General Head Nurse, Department of Urology, Institute of Urology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China (Martin-Payo) Ruben Martin-Payo, PhD, Associate Professor, Department of Medicine, University of Oviedo, Spain; and Precam Research Group, Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain (Zhang) West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China (Xie) Xiaofeng Xie, West China Hospital/West China School of Nursing, Sichuan University, Chengdu, China Abstract BACKGROUND: Postoperative delirium (POD) is a common and serious complication after cardiac surgery. Although family involvement is considered a promising nonpharmacological strategy, its efficacy specifically in patients undergoing cardiac surgery remains inadequately supported by systematic evidence. OBJECTIVE(S): Our aim was to evaluate the effectiveness of family interventions in preventing POD among patients undergoing cardiac surgery. METHOD(S): We systematically searched multiple databases from inception to July 2025 for randomized controlled trials (RCTs) assessing family intervention for POD in patients undergoing cardiac surgery. Study selection, quality assessment, and data extraction were performed independently by 2 reviewers. We conducted a meta-analysis using RevMan 5.4 and Stata 18.0, with effects expressed as risk ratios or standard mean differences and 95% confidence intervals (CIs). We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework to evaluate evidence quality. The protocol was registered on PROSPERO (CRD42024627097). RESULT(S): A total of 6 RCTs with 508 patients were included in the analysis. Family intervention significantly reduced the incidence of POD (risk ratio = 0.38, 95% CI: 0.25-0.58, P < .001) and shortened hospital length of stay (standard mean difference = -1.07, 95% CI: -1.91 to -0.24, P < .05). Our subgroup analysis revealed no significant differences in outcomes based on family involvement level, age, or sample size. Additionally, interventions improved psychological well-being and increased caregiver satisfaction ( P < .05). CONCLUSION(S): Family intervention reduces POD incidence and hospital stay and enhances psychological outcomes for patients and caregivers. However, due to small sample sizes, further large-scale high-quality RCTs are warranted. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <24> Accession Number 2048012474 Title The internal mammary artery in autologous breast reconstruction and coronary artery bypass grafting. Source European Journal of Plastic Surgery. 49(1) (no pagination), 2026. Article Number: 148. Date of Publication: 01 Dec 2026. Author Ozturk M.; Niederegger T.; Schaschinger T.; Brandt J.; Didzun O.; Panayi A.C.; Haug V.; Gazyakan E.; Bigdeli A.; Kneser U.; Hundeshagen G. Institution (Haug, Gazyakan, Kneser, Hundeshagen) Department of Hand, Plastic, and Reconstructive Surgery, Burn Center at Heidelberg University, BG Klinik Ludwigshafen, Ludwigshafen, Germany (Niederegger, Schaschinger, Brandt) Medical Faculty, Heidelberg University, Heidelberg, Germany (Didzun, Bigdeli) Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, Klinikum Kassel, Kassel, Germany (Panayi) Department of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, Ramistrasse 100, Zurich, Switzerland (Ozturk) Institute for Molecular and Cellular Anatomy, University of Regensburg, Universitatsstrase 31, Regensburg, Germany (Ozturk) Institute for Medical Science & Engineering (IMSE), Deggendorf Institute of Technology, Deggendorf, Germany (Ozturk) Department of Plastic Surgery, Kliniken am Goldenen Steig, Freyung, Germany Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: The internal mammary artery (IMA) is a critical vessel for both autologous breast reconstruction (ABR) and coronary artery bypass grafting (CABG), creating potential conflict when both procedures are needed. This review evaluates evidence on the feasibility, safety, and vascular consequences of using the IMA in ABR while preserving future CABG options. Method(s): A PRISMA-2020 aligned systematic review assessed IMA use in ABR and implications for future CABG. PubMed, EMBASE, and Web of Science were searched through March 10, 2025, using terms related to ABR and CABG. Result(s): Ten studies (2004-2025) met inclusion criteria, involving female patients aged 24-77 years. Most studies used the deep inferior epigastric perforator flap for ABR, with the IMA as the predominant recipient vessel. Notably, end-to-side arterial anastomosis and dissection at or below the fourth intercostal space were frequently applied to preserve IMA length and integrity for future CABG. Myocardial complication rates after ABR were comparable to flap loss rates, and one patient subsequently underwent CABG using an alternative graft due to prior IMA harvest. Importantly, one cohort study introduced the Breast Reconstruction and Internal Mammary Artery Assessment (BRIMA) score, a cardiovascular risk-stratification tool designed to guide IMA selection in reconstructive planning. Conclusion(s): The IMA may be used in selected ABR cases without significantly limiting future CABG if end-to-side anastomoses or internal mammary artery perforators preserve conduit integrity. Because the IMA is the primary CABG graft, careful surgical planning and cardiovascular risk assessment are crucial. Further prospective data are needed to guide long-term management as the population ages. Level of Evidence: no gradable. Copyright © The Author(s) 2026. <25> Accession Number 2047784535 Title Statin Therapy and Cardiovascular Prevention: Contemporary Evidence, Challenges, and Future Directions-A Narrative Review. Source International Journal of Environmental Research and Public Health. 23(7) (no pagination), 2026. Article Number: 921. Date of Publication: 01 Jul 2026. Author Zachariah D.; Kakooza D.; Pothas S.; Thomas A.; Kruger L. Institution (Zachariah, Kakooza, Pothas, Thomas, Kruger) North West University, Faculty of Health Sciences, Potchefstroom, South Africa Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, and lowering low-density lipoprotein cholesterol (LDL-C) remains a cornerstone of cardiovascular prevention. Statins are among the most extensively studied and widely prescribed medications and have demonstrated substantial benefits in reducing major adverse cardiovascular events in both primary and secondary prevention settings. Nevertheless, the effectiveness of statin therapy in routine clinical practice is frequently compromised by poor adherence, treatment discontinuation, concerns regarding adverse effects, and persistent residual cardiovascular risk. This narrative review synthesises contemporary evidence relating to the mechanisms of action of statins, their role in primary and secondary prevention, determinants of medication adherence, statin-associated muscle symptoms (SAMSs), and emerging developments in precision cardiovascular medicine. Current evidence indicates that although statins remain highly effective in reducing cardiovascular risk, long-term treatment success is strongly influenced by behavioural, psychological, social, and healthcare system factors. Increasing attention has also been directed towards the multifactorial nature of SAMSs and the contribution of nocebo effects to perceived statin intolerance. Emerging approaches involving pharmacogenomics, artificial intelligence, digital health technologies, and multidimensional risk assessment offer opportunities for more individualised prevention strategies, although important limitations relating to cost, accessibility, and external validity remain. Overall, contemporary cardiovascular prevention requires a patient-centred approach that integrates biological, behavioural, and social determinants of health to optimise treatment adherence and improve long-term cardiovascular outcomes. Copyright © 2026 by the authors. <26> Accession Number 2046683276 Title Regional Anesthesia Approaches for Transcatheter Aortic Valve Implantation: When and Where Does It Add Value? A Narrative Review of Techniques by Access Route. Source Journal of Cardiothoracic and Vascular Anesthesia. 40(9) (pp 2951-2957), 2026. Date of Publication: 01 Sep 2026. Author Nguyen B.T.; Truong D.B.; Nguyen T.T.; Tran H.A.T.; Nguyen N.H.T.; Nguyen H.N.T. Institution (Nguyen, Truong, Nguyen, Tran, Nguyen) Department of Anesthesiology and Pain Management, Vinmec Central Park International Hospital, Ho Chi Minh City, Vietnam (Nguyen, Nguyen, Nguyen) Department of Anesthesiology, College of Health Sciences, VinUniversity, Hanoi, Vietnam (Nguyen) Cardiology Center, Vinmec Central Park International Hospital, Ho Chi Minh City, Vietnam Publisher W.B. Saunders Abstract Transcatheter aortic valve implantation (TAVI) is increasingly performed using local infiltration (LI) with monitored anesthesia care (MAC) as outcomes are equivalent to those of general anesthesia. The key clinical question is when regional anesthesia (RA) offers meaningful benefits beyond LI-MAC across different access routes. The objectives were to identify access-specific situations in which RA may provide clinical advantages over LI-MAC and to summarize implications for patient comfort, hemodynamics, and procedural safety. A narrative review of studies retrieved from PubMed (MEDLINE), Embase, and the Cochrane Library through September 2025 was performed. Eligible studies included case reports, randomized trials, observational cohort studies, and reviews describing RA techniques used for TAVI. Data were extracted on access route, RA technique, outcomes, and complications. For transfemoral (TF) TAVI, evidence supports LI-MAC as the default strategy, and RA has not been shown to improve major clinical outcomes. Selective RA adjuncts may enhance intraprocedural comfort: Ilioinguinal-iliohypogastric block reduces sedative and analgesic requirements, and fascia iliaca block may reduce opioid requirements in selected settings. For non-TF access, particularly subclavian or axillary and carotid routes, RA may preserve spontaneous ventilation, stabilize hemodynamics, and enable continuous neurologic monitoring. In transapical and transaortic procedures, thoracic epidural analgesia shows strong observational support for improved pulmonary and clinical outcomes, with paravertebral and plane blocks serving as neuraxial-sparing alternatives. RA should be used selectively when it enhances analgesia, reduces sedative requirements, or confers physiological advantages, particularly for non-TF access. Further studies directly comparing RA with LI-MAC are needed to clarify its access-specific role. Copyright © 2026 Elsevier Inc. <27> Accession Number 2048094968 Title Efficacy and safety of different antithrombotic treatment regimens in patients undergoing transcatheter mitral valve repair and atrial fibrillation; A meta-analysis and systematic review. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1743097. Date of Publication: 2026. Author Zhu F.; Yu Z.; He Z. Institution (Zhu, He) Department of Cardiology, Beijing Luhe Hospital, Capital Medical University, Beijing, China (Yu) Department of Clinical Medicine, Chengde Medical University, Chengde City, Hebei, China Publisher Frontiers Media SA Abstract Background - Optimal antithrombotic therapy following transcatheter mitral valve repair (TMVR/TEER) in patients with atrial fibrillation remains uncertain, with substantial practice variation and reliance on nonrandomized data. Methods - We performed a systematic review and network meta-analysis of observational studies evaluating antithrombotic strategies after TMVR/TEER with atrial fibrillation. Antithrombotic regimens were harmonized into two main categories: oral anticoagulation [OAC; including vitamin K antagonists [VKAs] and direct oral anticoagulants [DOACs]] and antiplatelet therapy (APT; including aspirin or clopidogrel, alone or in combination). Outcomes of interest were ischemic stroke, major bleeding, and all-cause mortality. Pairwise and network random-effects models were applied to derive odds ratios (ORs) with 95% confidence intervals (CIs). Results - Four multicenter observational cohorts (n = 2, 098) were included. Across comparisons, OAC strategies demonstrated a favorable profile compared with APT for bleeding risk reduction, while DOACs showed heterogeneous results depending on comparator drug and study region (phenprocoumon in Europe vs. warfarin in the U.S.). Mortality findings consistently favored OAC (particularly DOACs) potential benefits over APT. For stroke, OAC (phenprocoumon) showed better ischemic prevention, indicating more effectiveness in minimizing stroke risk compared with APT. Network geometry was limited, with most contrasts informed by only one or two studies. Conclusions - In patients undergoing TMVR/TEER with atrial fibrillation, OAC strategies appeared to be associated with lower bleeding risk and potentially favorable mortality outcomes compared with antiplatelet therapy. However, conclusions regarding comparative efficacy, particularly for stroke prevention, should be interpreted cautiously due to the limited number of studies and the observational nature of the available evidence. Thus, the evidence base remains limited by observational design, heterogeneous comparators, and inconsistent outcome definitions. Randomized trials are urgently needed to guide antithrombotic management in this high-risk population. Copyright © 2026 Zhu, Yu and He. <28> Accession Number 2048210468 Title Cardiovascular Disease (CVD) Risk in Women With Endometriosis: A Comprehensive Meta-Analysis. Source Clinical Cardiology. 49(8) (no pagination), 2026. Article Number: e70443. Date of Publication: 01 Aug 2026. Author Mylavarapu M.; Samuel J.; Thandi R.; Mubashir R.; Veeranagari V.R.; Barakat A.; Neto J.F.B.; Osman A.; Thiyagarajan S.; Mohamed R.; Hassan M.J. Institution (Mylavarapu) Department of Cardiology, Endeavor Health Northshore Cardiovascular Institute, Endeavor Health Glenbrook Hospital, Glenview, IL, United States (Mylavarapu) Department of Medicine, Division of Cardiology, University of Chicago Pritzker School of Medicine, Chicago, IL, United States (Samuel) Department of Medicine, Sugam Hospital, Tamil Nadu, Chennai, India (Thandi) Department of Medicine, Wenzhou Medical University, Zhejiang, Wenzhou, China (Mubashir) Department of Medicine, North Cumbria Integrated Care NHS Foundation Trust, Carlisle, United Kingdom (Veeranagari) Department of Medicine, Sri Ramachandra Institute of Higher Education and Research, Tamil Nadu, Chennai, India (Barakat) Department of Internal Medicine, Medway NHS Foundation Trust, Kent, United Kingdom (Neto) Department of Medicine, Rio de Janeiro State University (UERJ; Portuguese: Universidade do Estado do Rio de Janeiro), Rio de Janeiro, Brazil (Osman) Department of Medicine, Lebanese University Faculty of Medical Sciences, Hadath, Lebanon (Thiyagarajan) Department of Medicine, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, United Kingdom (Mohamed) Department of Medicine, Hamad Medical Corporation, Doha, Qatar (Hassan) Department of Medicine, Faisalabad Medical University, Faisalabad, Pakistan Publisher John Wiley and Sons Inc Abstract Background: Cardiovascular disease (CVD) remains the leading cause of mortality globally. Emerging evidence indicates that cardiovascular risk in women is frequently underestimated, underscoring the importance of recognizing sex-specific contributors. Endometriosis is a chronic inflammatory disorder affecting 5%-10% of reproductive-aged women. However, previous syntheses evaluating its cardiovascular implications have yielded inconsistent results or were narrow in scope. Method(s): A systematic literature search was conducted across databases, adhering to PRISMA guidelines. Studies comparing cardiovascular outcomes in women with versus without endometriosis were included. Primary outcomes were overall CVD and major adverse cardiovascular events (MACE). Secondary outcomes included ischemic heart disease (IHD), coronary artery disease (CAD), heart failure (HF), arrhythmias, coronary revascularization, and a composite of angina/acute myocardial infarction (Angina-AMI). Random-effects models with inverse variance weighting were used to calculate risk ratios (RRs) and 95% confidence intervals (CIs). Result(s): Women with endometriosis exhibited a significantly higher risk of primary outcomes, including overall CVD (RR 1.21; 95% CI 1.09-1.35; p = 0.004) and MACE (RR 1.23; 95% CI 1.10-1.38; p = 0.01). Regarding secondary outcomes, endometriosis was significantly associated with elevated risks of IHD (RR 1.57; 95% CI 1.14-2.17; p = 0.01), CAD (RR 1.36; 95% CI 1.32-1.41; p < 0.0001), and Angina-AMI (RR 1.62; 95% CI 1.18-2.21; p = 0.002). Moderate-to-high statistical heterogeneity was observed across most secondary endpoints, except for CAD. Conclusion(s): Endometriosis is significantly associated with an increased risk of overall CVD, MACE, and ischemic coronary complications. These findings suggest that endometriosis should be recognized as an important sex-specific modifier of cardiovascular risk. Copyright © 2026 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC. <29> Accession Number 2048064474 Title Management of inflammatory cardiopulmonary manifestations in systemic lupus erythematosus: a systematic review. Source Advances in Rheumatology. 66(1) (no pagination), 2026. Article Number: 47. Date of Publication: 01 Dec 2026. Author Hao Y.; Montes R.; Oon S.; Nikpour M. Institution (Hao, Oon, Nikpour) The University of Melbourne at St Vincent's Hospital, 29 Regent Street, Fitzroy, VIC, Australia (Hao, Oon, Nikpour) Department of Rheumatology, St. Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, Australia (Montes) Rheumatology Department, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (Nikpour) University of Sydney Musculoskeletal Research Centre and School of Public Health, Charles Perkins Centre, Johns Hopkins Drive, Camperdown, NSW, Australia (Nikpour) Department of Rheumatology, Royal Prince Alfred Hospital, 57 Missenden Road, Camperdown, NSW, Australia (Nikpour) The University of Sydney School of Public Health, University of Sydney, Room 132, Edward Ford Building, Fisher Road, Sydney, NSW, Australia Publisher BioMed Central Ltd Abstract Background: Cardiopulmonary involvement in systemic lupus erythematosus (SLE) refers to a group of serious manifestations, with a high prevalence for some, such as pericarditis and pleuritis, and high mortality in others, such as lupus myocarditis (LM) and diffuse alveolar haemorrhage (DAH). There is a paucity of systematic literature reviews on the management of inflammatory cardiopulmonary manifestations in SLE. We aimed to assess the available evidence in this area. Method(s): A systematic literature search was conducted from January 1990 to June 2025 using keywords related to the cardiac and pulmonary systems, SLE, and treatments. Manifestations related to atherosclerosis or anti-phospholipid syndrome were excluded. Result(s): A total of 67 studies, covering pericarditis, LM, pulmonary arterial hypertension (PAH), pleuritis, acute lupus pneumonitis (ALP), DAH, interstitial lung disease, and shrinking lung syndrome (SLS) were included. Glucocorticoids (GCs) were utilized as first-line treatment for all these conditions, and GC pulse was commonly administered in serious manifestations such as pericardial tamponade, LM, ALP, and DAH. Cyclophosphamide was the most used immunosuppressant, with low-to-moderate evidence indicating its effectiveness. Low-to-moderate evidence supported rituximab as a second-line therapy for LM, DAH, and SLS, and plasma exchange was commonly used in DAH. For PAH, high-quality evidence from RCTs supported the use of PAH-targeted therapies, and initial PAH-targeted combination therapy showed more benefits than monotherapy. In addition, immunosuppressive therapy may be beneficial for SLE-PAH patients, especially those with early, mild PAH. Anti-fibrotic therapy, such as nintedanib and pirfenidone, had no evidence of effectiveness in SLE-ILD. Evidence for the benefit of belimumab and anifrolumab for cardiopulmonary manifestations was also minimal. Patients with some conditions, such as LM, ALP, and DAH, had poor prognoses under current therapies, with reported short-term mortalities of up to 40%-60%. Conclusion(s): GC and conventional IS currently remain the most evidence-based approaches for managing most cardiopulmonary manifestations in SLE. Despite aggressive immunosuppressive therapies, patients with some conditions, such as LM, ALP, and DAH, still experience high mortality. The quality of the existing evidence and the insights into novel therapies in these patients were limited, highlighting the urgent need for RCTs and optimized management in this area. Copyright © The Author(s) 2026. <30> Accession Number 2038462303 Title Systematic Review Transcatheter Aortic Valve Replacement for Bicuspid Versus Tricuspid Aortic Stenosis: A Systematic Review and Meta-Analysis. Source Reviews in Cardiovascular Medicine. 27(7) (no pagination), 2026. Article Number: 49401. Date of Publication: 01 Jul 2026. Author Zhu F.-H.; Peng X.; Zhang Y.-Q.; Chen N.; Zhao X.-H.; Zhang H.-P. Institution (Zhu, Zhang, Chen, Zhao, Zhang) Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China (Peng) Arrhythmia Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China Publisher IMR Press Limited Abstract Background: Although the bicuspid aortic valve (BAV) is a major cause of aortic stenosis (AS), limited evidence exists regarding the safety and efficacy of transcatheter aortic valve replacement (TAVR) in BAV patients. This study aimed to compare TAVR outcomes between BAV and tricuspid aortic valve (TAV) cohorts. Method(s): We conducted a systematic search of PubMed, Web of Science, Em-base, and the Cochrane Library to identify studies reporting 1-year follow-up outcomes. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were derived from a random-effects model. Result(s): The analysis included 31 studies involving 192,691 patients. Patients with BAV were younger than those with TAV (71.2 vs. 73.2 years, p < 0.01) and exhibited lower society of thoracic surgeons (STS) scores (3.5% vs. 4.3%, p < 0.05). Compared with TAV, BAV was associated with a lower likelihood of device success (OR = 0.80 95% CI 0.65-0.98 p = 0.03) and an increased risk of moderate/severe paravalvular leak (PVL) (OR = 1.39 95% CI 1.22-1.58 p < 0.01). No significant differences were observed in in-hospital mortality (OR = 1.10, 95% CI 0.86-1.42 p = 0.44), or major peri-procedural complications between the two cohorts. At 30 days, all-cause mortality (OR = 1.19, 95% CI 0.96-1.47, p = 0.11) and cardiovascular mortality (OR = 1.59, 95% CI 0.87-2.90 p = 0.13) were similar between BAV and TAV groups. While 1-year cardiovascular mortality showed no significant difference (OR = 0.70, 95% CI 0.42-1.16 p = 0.17), BAV patients exhibited a significant reduction in 1-year all-cause mortality (OR = 0.84, 95% CI 0.73-0.97 p = 0.01). This survival benefit was consistent in propensity-score matched cohorts (OR = 0.78, 95% CI 0.64-0.95 p = 0.01). Subgroup analysis further identified distinct survival advantages for BAV patients who were younger (OR = 0.82, 95% CI 0.71-0.95, p = 0.01), had lower STS scores (OR = 0.68, 95% CI 0.50-0.92, p = 0.01), or received balloon-expandable valves (OR = 0.76, 95% CI 0.61-0.94, p = 0.01). Notably, 1-year all-cause mortality rates were similar when stratified by aortic diameter or paravalvular leak (PVL) incidence. Conclusion(s): This meta-analysis demonstrated that TAVR had similar safety and efficacy profiles for BAV and TAV patients. Additionally, BAV patients undergoing TAVR exhibited a reduced 1-year all-cause mortality compared to TAV patients. The PROSPERO Registration: CRD42025618185, https://www.crd.york.ac.uk/PROSPERO/view/CRD42025618185. Copyright © 2026 The Author(s). <31> Accession Number 2048100802 Title Antegrade dissection and re-entry vs retrograde strategy in chronic total occlusion percutaneous coronary intervention: Rationale and design of the ADRENALINE randomized study. Source American Heart Journal. 301 (no pagination), 2026. Article Number: 107538. Date of Publication: 01 Nov 2026. Author Opolski M.P.; Spiewak M.; Machaj F.; Borzuta H.; Sobieszek G.; Drozd J.; Kiljanski F.; Matsko P.; Klopotowski M.; Zieba B.; Kula W.; Marczak M.; Debski A.; Witkowski A.; Knaapen P.; Leibundgut G.; Ungureanu C.; Rinfret S.; Brilakis E.S. Institution (Opolski, Borzuta, Kiljanski, Matsko, Klopotowski, Debski, Witkowski) Department of Interventional Cardiology and Angiology, National Institute of Cardiology, Warsaw, Poland (Spiewak, Marczak) Magnetic Resonance Unit, National Institute of Cardiology, Warsaw, Poland (Machaj) First Department of Arrhythmia, National Institute of Cardiology, Warsaw, Poland (Borzuta) Chair and Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland (Sobieszek, Zieba) Department of Cardiology, First Military Hospital in Lublin, Lublin, Poland (Drozd, Kula) Department of Cardiology, SP ZOZ Ministry of Internal Affairs and Administration, Lublin, Poland (Knaapen) Departments of Cardiology, Amsterdam University Medical Centers, Amsterdam, Netherlands (Leibundgut) Department of Cardiology, Basel University Hospital, Basel, Switzerland (Ungureanu) Department of Cardiology, Jolimont Hospital, La Louviere, Belgium (Rinfret) Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, United States (Brilakis) Minneapolis Heart Institute and Minneapolis Heart Institute Foundation, Minneapolis, MN, United States Publisher Elsevier Inc. Abstract Rationale While antegrade wiring (AW) is the most common initial strategy for chronic total occlusion (CTO) percutaneous coronary intervention (PCI), difficult CTO lesions frequently require either antegrade dissection and re-entry (ADR) or a retrograde strategy. Comparative data between ADR and the retrograde approach remain limited. Design The Antegrade Dissection vs Retrograde re-ENtry And Load of Interventionalist Effort (ADRENALINE) is a prospective, multicenter randomized study with a superiority design. It is planned to enroll 121 patients with difficult coronary CTO (J-CTO score >=2) referred for CTO-PCI in accordance with the hybrid algorithm. Subjects undergoing successful AW will be included in the observational arm. Patients with failed or unattempted AW will be randomized 1:1 to ADR or retrograde CTO crossing strategy ( n = 74). All patients will undergo pre- and postprocedural laboratory testing (including cardiac troponin T and creatine kinase-MB), cardiac magnetic resonance (CMR) for late gadolinium enhancement, and health status assessment by the Seattle Angina Questionnaire and the Rose Dyspnea Scale. The co-primary endpoints are total procedure time and successful guidewire crossing. Additionally, the relationship between different recanalization strategies and stress among interventional cardiologists will be explored. Conclusion ADRENALINE is the first randomized study of ADR vs retrograde strategy for difficult CTO PCI, assessing procedural outcomes, CMR-detected myocardial infarction, and 3-month quality of life. Enrolment status The first patient was enrolled on July 29, 2025. As of June 14, 2026, 45 patients (26 randomized, 19 observational) of the planned 121 patients have been enrolled. Trials registration Clinicaltrials.gov : Identifier, NCT06878729. Copyright © 2026 The Authors. <32> Accession Number 2041920422 Title Watchman FLX versus Amplatzer amulet for percutaneous left atrial appendage occlusion: A systematic review and meta-analysis. Source Journal of Cardiology. 88(2) (pp 109-115), 2026. Date of Publication: 01 Aug 2026. Author de Pontes V.B.; Carvalho P.E.P.; Felix N.; Nogueira A.; Clemente M.R.C.; Gastaldelo V.; Preda A.; Garot P. Institution (de Pontes, Gastaldelo) Division of Medicine, Centro Universitario das Faculdades Associadas de Ensino, Sao Joao da Boa Vista, Brazil (Carvalho) Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, MN, United States (Felix) Division of Medicine, Federal University of Campina Grande, Campina Grande, Brazil (Nogueira) Division of Medicine, Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil (Clemente) Division of Medicine, Petropolis Medical School, Rio de Janeiro, Brazil (Preda) De Gasperis Cardio Center, Electrophysiology Unit, Niguarda Hospital, Milan, Italy (Garot) Institut Cardiovasculaire Paris Sud (ICPS), Hopital Jacques Cartier, Ramsay-Sante, Massy, France Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background The comparative safety and efficacy of Watchman FLX (Boston Scientific, Marlborough, MA, USA) and Amplatzer Amulet (Abbott, Abbott Park, IL, USA) devices for left atrial appendage occlusion (LAAO) remain unclear. Objective To compare Watchman FLX and Amplatzer Amulet devices for LAAO. Methods We systematically searched PubMed, Embase, and Cochrane Library for studies comparing Watchman FLX versus Amulet in patients with atrial fibrillation (AF) undergoing percutaneous LAAO. We applied a random-effects model to pool risk ratios (RR) with corresponding 95 % confidence intervals (CI) for binary endpoints. Results We included five studies comprising 1316 patients with AF undergoing LAAO for high bleeding risk. A total of 629 (47.8 %) patients underwent LAAO with Watchman FLX. Amulet was associated with lower rates of stroke or transient ischemic attack (TIA) (RR 2.31; 95 % CI 1.02-5.25; p = 0.04; I2 = 0 %), but no differences were observed in terms of peridevice leak (RR 1.57; 95 % CI 0.86-2.89; p = 0.14; I2 = 0 %) between Watchman and Amulet devices. Additionally, no differences were found in terms of device-related thrombus (RR 2.01; 95 % CI 0.87-4.68; p = 0.10; I2 = 0 %), or pericardial effusion (RR 1.00; 95 % CI 0.17-5.96; p = 1.00; I2 = 59.7 %) between both groups. Conclusion This meta-analysis indicates a lower risk of stroke or TIA with Amulet compared to Watchman FLX. Copyright © 2025 Elsevier Ltd. <33> Accession Number 2047980112 Title Impact for Treatment Decision-Making and Clinical Outcome of Angiography-Derived Fractional Flow Reserve. Source JACC: Cardiovascular Interventions. 19(15) (pp 2116-2126), 2026. Date of Publication: 10 Aug 2026. Author Tanigaki T.; Mizukami T.; Arai T.; Hagiya K.; Kikuta Y.; Yoshida T.; Yamamoto H.; Takahara M.; Isodono K.; Kawase Y.; Okubo M.; Zen K.; Hikichi Y.; Kinoshita N.; Kitamura R.; Ogawa T.; Kozuma K.; Nanasato M.; Ako J.; Otake H.; Yokoi H.; Matsuo H. Institution (Tanigaki, Kawase, Okubo, Matsuo) Department of Cardiovascular Medicine, Gifu Heart Center, Japan (Mizukami) Division of Clinical Pharmacology, Department of Pharmacology, Showa University School of Medicine, Japan (Arai) Department of Medicine, Division of Cardiology, Showa University School of Medicine, Japan (Hagiya, Nanasato) Department of Cardiology, Sakakibara Heart Institute, Japan (Kikuta) Department of Cardiology, Fukuyama Cardiovascular Hospital, Japan (Yoshida) Department of Cardiology, Saga-Ken Medical Centre Koseikan, Japan (Yamamoto, Kozuma) Division of Cardiology, Department of Internal Medicine, Teikyo University, Japan (Takahara, Zen) Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, Japan (Isodono, Kitamura) Department of Cardiology, Ijinkai Takeda General Hospital, Japan (Hikichi) Department of Cardiology, Fukuoka Kieikai Hospital, Japan (Kinoshita) Department of Cardiology, Koseikai Takeda Hospital, Japan (Ogawa) Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Japan (Ako) Department of Cardiovascular Medicine, Kitasato University, Japan (Otake) Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan (Yokoi) Department of Cardiology, Fukuoka Sanno Hospital, Japan Publisher Elsevier Inc. Abstract Background Pressure wire-based fractional flow reserve (FFR) is the reference standard for physiologic lesion assessment but remains underutilized owing to the need for hyperemia, procedural complexity, and wire-related risks. Angiography-derived FFR provides a wire- and hyperemia-free assessment derived from routine angiography; however, its clinical impact in guiding treatment remains uncertain. Objectives This study aimed to determine whether angiography-derived FFR is noninferior to pressure wire-based FFR in guiding revascularization decisions among patients with stable coronary artery disease. Methods PROVISION (Prospective randomized trial of clinical outcomes of angiography-based fractional flow reserve guidance versus wire-based fractional flow reserve guidance) was a prospective, multicenter, randomized study. Participants were randomized 1:1 to angiography-derived FFR-guided or pressure wire-based FFR-guided revascularization. The primary endpoint was the noninferiority of angiography-derived FFR in terms of revascularization rate, defined as the proportion of patients undergoing percutaneous coronary intervention or coronary artery bypass grafting based on physiologic assessment. Secondary endpoints included the 1-year incidence of major adverse cardiac events (cardiac death, any myocardial infarction, or ischemia-driven target vessel revascularization). Results Overall, 401 patients (483 vessels) were enrolled at 13 Japanese centers. Revascularization was performed in 41.4% of patients in the angiography-derived FFR group and 37.9% in the pressure wire-based FFR group (absolute difference: 3.5%; 95% CI: -6.0 to 13.1; P for noninferiority = 0.049). At 1 year, major adverse cardiovascular events occurred in 8.4% and 10.1% of patients, respectively (HR: 0.84; 95% CI: 0.44-1.60; P = 0.591). Conclusions Angiography-derived FFR-guided revascularization was noninferior to pressure wire-based FFR-guided strategy for determining revascularization in patients with stable coronary artery disease. This finding suggests that angiography-derived FFR may serve as a practical, wire-free alternative for physiologic guidance of coronary revascularization, warranting confirmation in larger outcome-driven trials. (PROVISION; UMIN000049230) Copyright © 2026 American College of Cardiology Foundation. <34> Accession Number 2047796768 Title Perioperative changes in right ventricular function following coronary artery bypass grafting: A prospective observational study using transoesophageal echocardiography. Source Indian Journal of Clinical Anaesthesia. 13(3) (pp 426-431), 2026. Date of Publication: 2026. Author Kharbudnah C.J.B.; Nagalingam S.; Kodali R.K.V.; Karthekeyan R.B.; Kamalakkannan G.S.; Vakamudi M. Institution (Kharbudnah, Nagalingam, Karthekeyan, Kamalakkannan) Dept. of Cardiac Anaesthesiology, Sri Ramachandra Medical College and Research Institute, Tamil Nadu, Chennai, India (Kodali, Vakamudi) Dept. of Anaesthesiology, Sri Ramachandra Medical College and Research Institute, Tamil Nadu, Chennai, India Publisher IP Innovative Publication Pvt. Ltd. Abstract Background: Right ventricular (RV) dysfunction is a significant predictor of adverse outcomes following coronary artery bypass grafting (CABG). While the impact of on-pump surgery is well-documented, data regarding RV performance during off-pump CABG (OPCABG) remain sparse. This study aimed to prospectively evaluate alterations in RV systolic function using intraoperative transoesophageal echocardiography (TEE) in patients undergoing OPCABG. Material(s) and Method(s): Following institutional ethics committee approval, 50 adult patients with preserved left ventricular function scheduled for elective OPCABG were enrolled in this prospective observational study. Key RV systolic function parameters, including tricuspid annular plane systolic excursion (TAPSE) and fractional area change (FAC), were measured using intraoperative TEE at two time points: pre-grafting (baseline) and following the completion of all proximal anastomoses (post-grafting). Hemodynamic variables were recorded concurrently. Statistical analysis was performed using a paired Student's t-test. Result(s): A statistically significant decline in RV systolic function was observed post-grafting. Mean TAPSE decreased from a baseline of 16.72 +/- 2.1 mm to 15.32 +/- 1.9 mm (p = 0.001). Similarly, mean FAC reduced from 47.61 +/- 5.4% to 42.34 +/- 4.9% (p < 0.0001). This decline occurred despite relative hemodynamic stability, although there were significant reductions in systolic blood pressure (123.46 vs. 116.96 mmHg; p = 0.009), diastolic blood pressure (72.46 vs. 68.56 mmHg; p = 0.026), and central venous pressure (7.94 vs. 6.9 mmHg; p = 0.004). Conclusion(s): Off-pump CABG (OPCABG) is associated with a subtle but statistically significant impairment of RV systolic function, which is detectable by intraoperative transoesophageal echocardiography (TEE) even in hemodynamically stable patients. These findings highlight the utility of routine intraoperative TEE for the early identification of subclinical RV dysfunction, facilitating timely intervention and potentially improving perioperative outcomes. Copyright © 2026 The Author(s), Published by IP Innovative Publication Pvt. Ltd. <35> Accession Number 2047823329 Title Risk Recognition and Phenotyping in Cardiac and Vascular Diseases. Source Biomedicines. 14(7) (no pagination), 2026. Article Number: 1583. Date of Publication: 01 Jul 2026. Author Barnaba I.; Massari F.; Scicchitano P. Institution (Barnaba) Cardiology Section, University of Bari, BA, Bari, Italy (Massari, Scicchitano) Cardiology Section, Hospital "F. Perinei" ASL BA, BA, Altamura, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) <36> Accession Number 2047867327 Title Effects of Levosimendan on Hemodynamic Parameters in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting: A Randomized, Double-Blind, Placebo- Controlled Trial. Source Acta Medica International. 13(1) (pp 216-219), 2026. Date of Publication: 01 Jan 2026. Author Khatoon S.; Ali N.; Mazumderpinaki Institution (Khatoon) Department of Anaesthesiology, Pt JNM Medical College, Chhattisgarh, Raipur, India (Ali) Department of Anaesthesiology, DKS superspeciality Hospital, Chhattisgarh, Raipur, India (Mazumderpinaki) Department of Anaesthesiology, Medical College Hospital, West Bengal, Kolkata, India Publisher Parsvnath Publishing House Abstract Background: Levosimendan, a calcium-sensitizing agent, possesses positive inotropic and peripheral vasodilatory effects mediated through ATP-sensitive potassium channels. In off-pump coronary artery bypass grafting (OPCABG), hemodynamic instability during cardiac manipulation remains a challenge. The effects of levosimendan on afterload and perfusion pressure in this surgical situation are not definitively established. Material(s) and Method(s): This is a prospective, randomized and masked study in which 30 patients undergoing elective OPCABG were randomized to either group L(n=15) or group P(n=15). Group L patients received Levosimendan (0.07 microg/kg/min), whereas group P patients received placebo. Predefined amounts of time (before and after surgery) were taken in which the aim was to record hemodynamic variables (Mean arterial pressure (MAP), central venous pressure (CVP), cardiac output (CO), cardiac index (CI), stroke volume index (SVI), stroke volume variation (SVV), systemic vascular resistance (SVRI) and central venous oxygen saturation (ScvO<inf>2).</inf> Results: There was better MAP among patients who used levosimendan (as compared to placebo) during the fourth hour after surgery up to 24 hours (p<0.05). At the same time, the levels of SVR and SVRI were significantly lower in the levosimendan arm than at the third-hour mark and beyond (p < 0.05). The CVP level was temporarily elevated in the levosimendan arm during the first 3 hours. Intergroup differences in CO, CI, SVI and ScvO2 at any time point were not significant statistically(p value >0.05). Conclusion(s): OPCABG, supported by levosimendan administration, results in sustained decreases in systemic vascular resistance, preservation of elevated mean arterial pressure and cardiac output and unimpaired global tissue perfusion. Copyright © 2026 Acta Medica International. <37> Accession Number 2048100786 Title Early aortic valve intervention versus clinical surveillance in patients with asymptomatic severe aortic stenosis: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1830856. Date of Publication: 2026. Author Adamu U.G.; Makgoro C.; Adamu E.-a.U.; Mashilo D.; Patel A.; Tsabedze N. Institution (Adamu, Makgoro, Mashilo, Patel, Tsabedze) Division of Cardiology, Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa (Adamu) Department of Internal Medicine, Federal Teaching Hospital, Birnin Kebbi, Nigeria Publisher Frontiers Media SA Abstract Background - The optimal timing of aortic valve replacement (AVR) in patients with asymptomatic severe aortic stenosis (AS) remains uncertain. The aim of this study was to evaluate the efficacy and safety of early AVR compared to clinical surveillance (CSV) in patients with asymptomatic severe AS. Methods - We systematically searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus through August 2025 for studies that compared early AVR with conservative management in asymptomatic patients with severe AS. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using random-effects models. Results - Eight studies including four randomized controlled trials and four propensity-matched observational studies, enrolling 3, 086 patients, of whom 1, 539 (49.9%) underwent early AVR were included. Compared with CSV, AVR was associated with significant reduction in MACE (OR: 0.41, 95% CI: 0.29-0.59; P < 0.001), all-cause mortality (OR: 0.59, 95% CI: 0.39-0.88; P = 0.011), cardiovascular mortality (OR: 0.49, 95% CI: 0.35-0.69; P < 0.001), hospitalization for heart failure (OR 0.36, 95% CI 0.20-0.65; P < 0.001), and sudden death (OR: 0.51, 95% CI: 0.29-0.88; P = 0.015). Major vascular bleeding was more frequent in the early AVR group than in the conservative surveillance group (OR: 1.75, 95% CI: 1.05-2.92; P = 0.032). The risk of myocardial infarction, stroke, pacemaker implantation, or infective endocarditis were similar between groups. Conclusion - In patients with asymptomatic severe aortic stenosis, an early AVR strategy was associated with reduced heart failure hospitalization, favorable composite and procedural safety outcomes compared with CSV. Although a survival benefit was observed in pooled analyses, this was not consistently demonstrated in randomized trials. These findings support a more individualized approach to the timing of intervention. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/viewCRD420251135500. Copyright © 2026 Adamu, Makgoro, Adamu, Mashilo, Patel and Tsabedze. <38> Accession Number 2047903009 Title ICE-guided left atrial appendage closure: Reassuring real-world outcomes in an era of conflicting randomized evidence. Source International Journal of Cardiology. 462 (no pagination), 2026. Article Number: 134690. Date of Publication: 01 Nov 2026. Author Ebrahimi S. Institution (Ebrahimi) Department of Cardiology, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States Publisher Elsevier Ireland Ltd <39> Accession Number 2047902421 Title Unimodal to multimodal: a systematic review of predictive machine learning models for valvular heart diseases. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1855775. Date of Publication: 01 Jul 2026. Author Idakwo V.O.; Strote C.; Goelz C.; Shafei Q.; Stocker T.J.; Hausleiter J.; Vieluf S. Institution (Idakwo, Strote, Goelz, Shafei, Stocker, Hausleiter, Vieluf) Department of Medicine I, LMU University Hospital, LMU Munich, Munich, Germany (Idakwo, Goelz, Stocker, Hausleiter, Vieluf) DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany (Idakwo, Vieluf) relAI - Konrad Zuse School of Excellence in Reliable AI, Munich, Germany (Shafei) Faculty of European Campus Rottal-Inn, Deggendorf Institute of Technology (DIT), Pfarrkirchen, Germany Publisher Frontiers Media SA Abstract Objectives - We aimed to synthesize existing evidence on predictive machine learning (ML) models for valvular heart disease (VHD) and examine how these models have been applied across clinical tasks, data modalities and validation settings. Background - ML is gaining traction for improving cardiovascular care, particularly in the management of VHDs. However, empirical evidence on how ML models handle the multimodal complexity of valvular pathologies remain sparse. Methods - We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines searching PubMed, Web of Science, and Embase from 2014 to 2025. We included articles that developed ML for clinical prediction in VHD patients. (PROSPERO: CRD42025644167). Results - We identified 195 studies that met the inclusion criteria. Seventy-five studies (38.5%) developed single-lesion models for aortic stenosis. Retrospective datasets were used in 86% of the included studies and 79% relied on internal validation. Sixteen studies (8.2%) developed multimodal models, integrating different types of ML input data. The multimodal models demonstrated a 6.3 percentage point increase in average performance across tasks compared to their unimodal counterparts within the same cohort. Conclusion - Across the literature, unimodal ML models for VHDs demonstrate promising performance for disease detection, patient stratification, and risk prediction, but multimodal approaches are emerging with potential advantages for procedural planning and outcome forecasting. Translation to clinical practice will require large, multicenter datasets to validate and standardize data-driven VHD management. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD42025644167. Copyright © 2026 Idakwo, Strote, Goelz, Shafei, Stocker, Hausleiter and Vieluf. <40> Accession Number 2048340719 Title Percutaneous and surgical left atrial appendage occlusion in non-valvular atrial fibrillation: Contemporary narrative review. Source Current Problems in Cardiology. 51(11) (no pagination), 2026. Article Number: 103426. Date of Publication: 01 Nov 2026. Author Chestaro J.A.; Price H.; Matthews J.; Adrejiya P.; Stepanyan T.; Check L.; Nagabandi S.; Khouzam R.N. Institution (Chestaro, Price, Nagabandi, Khouzam) Grand Strand Medical Center, Myrtle Beach, SC, United States (Matthews) Bon Secous Saint Francis Health System, Greenville, SC, United States (Adrejiya) Wellstar Spalding Medical Center, Griffin, GA, United States (Stepanyan) VCOM-Carolinas Campus, SC, United States (Check) Medical University of South Carolina, Charleston, SC, United States Publisher Elsevier Inc. Abstract Background Left atrial appendage occlusion (LAAO) reduces thromboembolic risk in patients with atrial fibrillation (AF) who have contraindications to oral anticoagulation (OAC). LAAO can be performed surgically (S-LAAO) or percutaneously (pLAAO), but direct comparative evidence remains limited. Methods We conducted a contemporary narrative review of evidence for S-LAAO and pLAAO, emphasizing randomized controlled trials (RCTs) and systematic reviews (SRs), with and without meta-analyses. A focused PubMed/MEDLINE search evaluated procedural safety, thromboembolic outcomes, and completeness of LAA exclusion. Preprocedural, intraprocedural, and postprocedural imaging evidence was additionally assessed using guidelines, expert consensus statements, observational studies, and emerging clinical trials. Results RCTs and SRs support both S-LAAO and pLAAO for reducing thromboembolic events. S-LAAO reduces stroke and systemic embolism when performed during concomitant cardiac surgery, with the strongest evidence from LAAOS III. Evidence for isolated S-LAAO, including epicardial AtriClip closure, remains limited. pLAAO has been evaluated in multiple RCTs and SRs and has demonstrated noninferiority to OAC in selected populations. Incomplete LAA exclusion remains a concern with both approaches, manifesting as residual stumps after surgical closure and peri-device leaks after percutaneous implantation. TEE and cardiac CT remain key imaging modalities, while ICE, CMR, and DSA/fluoroscopy-guided techniques are increasingly investigated. Conclusion Both S-LAAO and pLAAO effectively reduce thromboembolic risk; however, evidence does not establish superiority of one approach. Evidence is substantially greater for pLAAO, whereas S-LAAO is primarily studied during concomitant cardiac surgery. Direct comparative studies are needed. Future research should address residual LAA patency, postprocedural antithrombotic therapy, and emerging imaging strategies. Copyright © 2026 Elsevier Inc. <41> Accession Number 2048096530 Title Association Between Acute Gastrointestinal Injury and Mortality Risk in Critically Ill Patients: A Systematic Review and Meta-Analysis. Source Clinical and Translational Gastroenterology. 17(6) (no pagination), 2026. Article Number: e01028. Date of Publication: 01 Jun 2026. Author Gao T.; Liu J.; Du Y.; Yang J.; Sheng G.; Zhou L.; Qiu Y.; Zhang Q.; Duan M. Institution (Gao, Duan) Department of Anesthesiology, Jinling Hospital, Nanjing University of Chinese Medicine, Nanjing, China (Liu) Endocrinology Department, Liuzhou Traditional Chinese Medical Hospital, Liuzhou City, China (Liu, Du, Yang, Sheng, Zhou) Department of Intensive Care Medicine, Liuzhou Traditional Chinese Medical Hospital, Liuzhou City, China (Du, Yang) Department of Critical Care Medicine, Liuzhou Traditional Chinese Medical Hospital, Liuzhou City, China (Sheng) Trauma Orthopedics, Liuzhou Traditional Chinese Medical Hospital, Liuzhou City, China (Zhou) Rehabilitation Department, Liuzhou Traditional Chinese Medical Hospital, Liuzhou City, China (Qiu) Guangxi University of Chinese Medicine, Nanning City, China (Zhang) Endocrinology Department, People's Hospital of Chongqing, Chongqing, China Publisher Lippincott Williams and Wilkins Abstract INTRODUCTION: - To systematically evaluate the association between severe acute gastrointestinal injury (AGI)/gastrointestinal dysfunction score (GIDS) and mortality risk in adult intensive care unit (ICU) patients. METHOD(S): - We conducted a systematic review and meta-analysis. We searched the MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials databases for articles published between January 2016 and January 2025. Observational cohort studies reporting mortality outcomes in ICU patients with AGI (grades III-IV vs 0-II) or GIDS (scores 2-4 vs 0-1) were included. Studies focusing on specific subpopulations such as patients after cardiac surgery or with COVID-19 were excluded to maintain population homogeneity. The primary outcome was short-term all-cause mortality. Random-effects meta-analysis using inverse-variance weighting was performed using odds ratios (ORs) with 95% confidence intervals (CIs). RESULT(S): - Eight studies involving 2, 786 critically ill patients were included. The pooled analysis demonstrated that severe GI dysfunction (AGI III-IV or GIDS 2-4) was significantly associated with increased mortality risk (OR 2.78, 95% CI 2.19-3.52, I2 = 42.5%). Subgroup analyses by outcome type (28-day/ICU mortality: OR 2.70, 95% CI 2.04-3.58; in-hospital mortality: OR 4.27, 95% CI 1.63-11.18) and scoring system (AGI: OR 2.75, 95% CI 2.07-3.67; GIDS: OR 3.18, 95% CI 1.43-7.07) showed consistent results. The addition of a large-scale prospective Chinese study (n = 1, 102) and a multicenter European cohort (n = 540) strengthened the findings and broadened generalizability. DISCUSSION(S): - Severe AGI is strongly associated with increased mortality in critically ill patients. Early recognition and assessment of GI dysfunction using standardized grading systems may facilitate risk stratification and guide clinical management. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology <42> Accession Number 2048331223 Title Transcatheter mitral edge-to-edge repair vs optimal medical therapy in secondary mitral regurgitation: a meta-analysis. Source REC: Interventional Cardiology. 8(3) (no pagination), 2026. Date of Publication: 01 Jul 2026. Author Paulino-Gonzalez D.; Pardino-Vega M.A.; Garcia-Loera A.L.; Zuniga-Montano K.P.; Navarro-Martinez D.A. Institution (Paulino-Gonzalez) Facultad de Medicina, Universidad Autonoma Metropolitana, Mexico City, Mexico (Paulino-Gonzalez) Departamento de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico (Pardino-Vega, Garcia-Loera) Escuela Superior de Medicina, Instituto Politecnico Nacional, Mexico City, Mexico (Zuniga-Montano) Facultad de Medicina, Universidad Catolica Boliviana, Santa Cruz, Bolivia (Navarro-Martinez) Department of Medicine, Indiana University School of Medicine, IN, United States Publisher Sociedad Espanola de Cardiologia Abstract Introduction and objectives: Mitral regurgitation is one of the most common heart valve diseases. Valve replacement surgery is a guideline-recommended option; however, in a significant proportion of patients, this option is not feasible. In such cases, mitral transcatheter edge-to-edge repair (M-TEER) is a potential therapeutic alternative. Nevertheless, the results of a randomized clinical trial have shown divergent results. Recently, the results of the RESHAPE-HF2 trial were published, providing additional insights. The objective of this work is to evaluate whether there are any differences between performing M-TEER and keeping patients under guideline-directed medical therapy (GDMT). Method(s): We conducted a meta-analysis following the PRISMA guidelines. We searched for studies across the PubMed, Embase, and Cochrane databases until February 2025. We establish the following inclusion criteria: patients with secondary mitral regurgitation, studies comparing M-TEER plus GDMT vs GDMT alone, and who reported hospitalization due to heart failure (HF) or mortality. Result(s): A total of 3 randomized clinical trials meet the inclusion criteria, including a total of 1423 patients: 704 received M-TEER and 719, GDMT alone. M-TEER was associated with a reduced risk of HF-related hospitalization with a risk ratio (RR) of 0.71 (95%CI, 0.56-0.90; P = .004). We did not find any differences in all-cause mortality with a RR of 0.80 (95%CI, 0.63-1.02; P = .07). Conclusion(s): In this meta-analysis, M-TEER plus GDMT shows a lower risk of HF-related hospitalization vs GDMT alone. We did not find any differences in the risk of all-cause mortality or cardiac death. Copyright © 2025 Sociedad Espanola de Cardiologia. Published by Permanyer Publications. This is an open access journal under the CC BY-NC-ND 4.0 license. <43> Accession Number 2048255441 Title Comparison of Ciprofol and Propofol on Postoperative Quality of Recovery and Intraoperative Cerebral Oxygen Saturation in Patients Undergoing Thoracoscopic Thoracic Surgery: A Randomized, Double-Blind, Non-Inferiority Trial. Source Drug Design, Development and Therapy. 20 (no pagination), 2026. Article Number: 625833. Date of Publication: 2026. Author Guo L.; Cai L.; Ni B.; Shi S.; Huang C.; Lai H.; Li Q.; Mo P. Institution (Guo, Cai, Ni, Shi, Huang, Lai, Li, Mo) Department of Anesthesiology, School of Medicine, The Sixth Affiliated Hospital of South China University of Technology (Nanhai District People's Hospital of Foshan), Guangdong, Foshan, China (Guo, Mo) South China University of Technology, Guangdong, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Purpose: Ciprofol provides more stable induction, though its impact on patients' quality of recovery (QoR) and brain oxygenation requires clarification. This trial assessed whether propofol anesthesia is non-inferior to ciprofol regarding postoperative recovery quality, while additionally comparing their effects on intraoperative cerebral oxygenation. Patients and Methods: This single-center, randomized, double-blind, non-inferiority study involved 94 patients scheduled for elective surgery, randomized equally to receive ciprofol (Group C) or propofol (Group P). The primary outcome was the global QoR-15 score measured 24 hours after surgery, with a non-inferiority threshold set at -6.0. Secondary outcomes included 48-hour QoR-15 scores, injection pain frequency, vasopressor requirements, and regional cerebral oxygen saturation (rScO<inf>2</inf>). Result(s): Eighty- eight patients completed the study (Group C: 44; Group P: 44). In ITT analysis, the mean QoR-15 score at 24 hours for Group C was non-inferior to Group P (P<inf>non-inferiority</inf> < 0.001), with consistent findings in the PP analysis. Similar non-inferiority was observed at 48 hours. However, Group C experienced a notably lower rate of injection pain (4.5% vs 59.0%, P < 0.001) and required less phenylephrine (P = 0.009). Although Group P had higher heart rates after induction of anesthesia (P < 0.05), its average arterial pressure was notably reduced (P < 0.05). Notably, rScO<inf>2</inf> in group C was higher than that in group P after induction of anesthesia (P = 0.046) and during the anesthesia maintenance phase (P < 0.05). Conclusion(s): Ciprofol is non-inferior to propofol regarding early postoperative recovery quality. Furthermore, ciprofol mitigates injection pain, reduces vasoconstrictor requirements, and better maintains cerebral oxygenation. Copyright © 2026 Guo et al. <44> Accession Number 2048461684 Title Rationale and design of a pilot randomized control trial of permissive hypotension after cardiac surgery: The PHACS trial. Source American Heart Journal Plus: Cardiology Research and Practice. 70 (no pagination), 2026. Article Number: 100852. Date of Publication: 01 Oct 2026. Author Miranda D.W.; Makarem A.; Liquori C.; Galvis A.; Bagchi A.; Nikolic I.; Aguirre A.D.; Bloom J.P.; Rabi S.A.; D'Alessandro D.A.; Melnitchouk S.; Jassar A.S.; Langer N.B.; Hosseini M.; Kreso A.; Sundt T.M.; Osho A.A.; Silverman M.G. Institution (Miranda, Makarem, Bloom, D'Alessandro, Melnitchouk, Jassar, Langer, Hosseini, Kreso, Sundt, Osho) Division of Cardiac Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Liquori) University of Massachusetts Chan Medical School, Worcester, MA, United States (Galvis) Division of Cardiology, Massachusetts General Hospital, Boston, MA, United States (Bagchi) Department of Anesthesia, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Nikolic) Division of Cardiology, Los Angeles General and USC Medical Center, Los Angeles, CA, United States (Aguirre, Silverman) Division of Cardiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Rabi) Division of Cardiovascular Surgery of the Peter Munk Cardiac Centre, Toronto General Hospital, University of Toronto, Toronto, ON, Canada Publisher Elsevier Inc. Abstract Background: Vasopressors are frequently used in the early postoperative period after cardiac surgery to treat hypotension and support organ perfusion. However, increasing evidence suggests that excessive vasopressor exposure may lead to adverse outcomes. In critically ill populations, permissive hypotension has been shown to reduce vasopressor use without increasing harm. This strategy has not been studied in postoperative cardiac surgery patients. Study design: The Permissive Hypotension After Cardiac Surgery (PHACS) Trial is a pilot single-center, open-label, pragmatic randomized controlled trial of adult patients undergoing non-emergent cardiac surgery. Patients who develop hypotension requiring vasopressor support within the first 24 h of intensive care unit (ICU) admission are randomized 1:1 to a permissive hypotension arm (target mean arterial pressure [MAP] 60-65 mmHg) or usual care. The primary outcome is hourly MAP during vasopressor therapy. Secondary outcomes include vasopressor and inotrope exposure, ICU and hospital length of stay, end-organ injury and support requirements, and in-hospital mortality. Conclusion(s): The PHACS Trial is designed to address a critical gap in postoperative cardiac surgical care by evaluating whether a permissive hypotension strategy can safely reduce vasopressor exposure. The study results will help define optimal vasopressor use and blood pressure targets in cardiac surgery patients where evidence-based targets remain undefined. Results from this pilot trial will inform the development of a larger multicenter trial. Trial registration: NCT 06476613. Copyright © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. http://creativecommons.org/licenses/by-nc-nd/4.0/ <45> Accession Number 2048190719 Title Extracorporeal Membrane Oxygenation in the Interstage Period After Norwood and Related Stage I Palliations in Infants With Single Ventricle: A Systematic Review of Incidence, Risk Factors, and Outcomes. Source Journal of the American Heart Association. 15(12) (no pagination), 2026. Article Number: e047642. Date of Publication: 2026. Author Li D.; Bottrell S.J.; Horton S.B.; Brizard C.P.; Pepe S. Institution (Li, Bottrell, Horton, Brizard, Pepe) Department of Paediatrics, Royal Children's Hospital Melbourne, University of Melbourne, Australia (Bottrell, Horton, Brizard, Pepe) Heart Research Group, Murdoch Children's Research Institute, Royal Children's Hospital Melbourne, Australia (Bottrell, Horton, Brizard) Department of Cardiac Surgery, Royal Children's Hospital Melbourne, Australia Publisher American Heart Association Inc. Abstract BACKGROUND: Neonates with congenital univentricular conditions require staged palliation culminating in a Fontan circulation to support survival. The first-stage Norwood procedure carries substantial risk of myocardial dysfunction, frequently necessitating extracorporeal membrane oxygenation (ECMO) support. The aim of this systematic review was to examine the incidence, risk factors, and outcomes of post-Norwood ECMO use during the interstage period. METHOD(S): We systematically searched MEDLINE, Embase, Cochrane Library, and Clini calTr ials. gov for studies published between January 1990 and March 2026 reporting ECMO use following Norwood procedures. Studies evaluating ECMO as part of postoperative management strategies were included. RESULT(S): From 1509 identified studies, 15 met inclusion criteria, encompassing 4030 patients. The pooled incidence of post-Norwood ECMO was 18.1% (685/3775 patients), ranging from 15.5% to 29.4% across studies. In-hospital survival among ECMO-supported patients ranged from 28.6% to 50%, with no clear temporal improvement. Risk factors for ECMO initiation included low birth weight (<2.5 kg), prolonged cardiopulmonary bypass time, moderate-to-severe preoperative atrioventricular valve regurgitation, and complex cardiac anatomy (aortic atresia, diminutive ascending aorta). Factors associated with poor outcomes included prolonged ECMO duration and ECMO-related complications, particularly neurological events, renal failure, and bleeding. CONCLUSION(S): Despite increasing post-Norwood ECMO use, survival outcomes remain poor. Identified risk factors may inform prospective risk stratification strategies, early identification of high-risk patients, and evidence-based decision-making regarding ECMO initiation, continuation, or withdrawal in this vulnerable population. Significant heterogeneity across studies precluded meta-analysis, highlighting the need for standardized reporting in future research. 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. <46> Accession Number 2048098842 Title Viability testing for guiding revascularization in ischemic cardiomyopathy. Source Current Opinion in Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Li K.Y.; Dhingra N.K.; Patel R.; Kalra S.; Rabi A. Institution (Li, Dhingra, Rabi) Division of Cardiovascular Surgery (Patel, Kalra) Division of Cardiology, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Myocardial viability testing has traditionally been used to guide revascularization decisions in ischemic cardiomyopathy on the assumption that identifying dysfunctional but viable myocardium predicts functional recovery and improved survival following revascularization. Recent trials have challenged this assumption, highlighting the need to re-evaluate the clinical role of viability testing in the context of contemporary revascularization strategies and modern guideline-directed medical therapy. Recent findings - The STICH trial and its extended follow-up demonstrated that CABG improves long-term survival independently of viability status and independently of whether ejection fraction improves, challenging the mechanistic assumption of viability-guided revascularization. REVIVED-BCIS2 showed that PCI may not improve survival benefit, even in patients selected with demonstrated viability. A prespecified imaging substudy of REVIVED identified scar burden, rather than the presence of viable myocardium, as the strongest independent predictor of adverse outcomes, reframing the prognostic question from the detection of viable tissue toward the quantification of irreversible myocardial loss. Summary - Viability should be reconceptualized as a continuous spectrum rather than a binary construct. Scar quantification, particularly through late gadolinium enhancement cardiac magnetic resonance (CMR), may offer greater prognostic utility than viability detection alone. A prospective randomized trial integrating contemporary imaging with modern guideline-directed medical therapy is needed to resolve the clinical role of viability-guided revascularization. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <47> Accession Number 2048361777 Title Efficacy and safety of drinking ice-carbonated water and ice-purified water immediately after extubation in paediatric patients with congenital heart disease: A randomised, controlled three-arm trial. Source Australian Critical Care. 39(5) (no pagination), 2026. Article Number: 101663. Date of Publication: 01 Oct 2026. Author Zhang X.; Chen Y.; Peng Y.; Li S.; Chen L.; Lin Y. Institution (Zhang, Chen) School of Nursing, Fujian Medical University, Fujian, Fuzhou, China (Zhang) Department of Nursing, The Second Affiliated Hospital of Xiamen Medical College, China (Peng, Lin) Department of Nursing, Fujian Medical University Union Hospital, Fujian, Fuzhou, China (Li, Chen, Lin) Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fujian, Fuzhou, China (Chen) Fujian Provincial Special Reserve Talents Laboratory, Fujian, Fuzhou, China Publisher Elsevier Ireland Ltd Abstract Background: Children who undergo congenital heart disease (CHD) surgery face increased postoperative thirst, which can cause discomfort and lead to serious consequences. There is a lack of effective thirst management strategies for this vulnerable group. Objective(s): The aim of this study was to evaluate the efficacy and safety of ice-carbonated water and ice-purified water in alleviating thirst in children following CHD surgery. Result(s): A generalised estimating equation analysis demonstrated group-by-time interactions for both primary outcomes. At T5, the between-group difference in thirst NRS was -4.71 points (95% confidence interval [CI]: -5.12 to -4.30) for H<inf>2</inf>O-ice-carb group vs. control group and -3.86 points (95% CI: -4.36 to -3.35) for H<inf>2</inf>O-ice group vs. control group (both P < 0.001). The H<inf>2</inf>O-ice-carb group demonstrated greater improvement than the H<inf>2</inf>O-ice group (difference = -0.85; 95% CI: -1.26 to -0.44; P < 0.001), with the difference apparent from T1 (P = 0.009). For oral moisture, the H<inf>2</inf>O-ice-carb group showed the strongest effect (2.51% per hour), followed by the H<inf>2</inf>O-ice group (1.66% per hour; both P < 0.001). No differences in adverse events were found among the three groups (P = 0.364). Conclusion(s): Immediate consumption of ice-carbonated and ice-purified water following extubation effectively and safely alleviates postoperative thirst in children after CHD surgery, with ice-carbonated water showing better results. These findings may inform the development of postoperative fasting and fluid management protocols for paediatric patients. Copyright © 2026 The Author(s) <48> Accession Number 2048329392 Title Rationale and design of the TAILOR-HCM multicenter randomized controlled trial: Transapical beating-heart septal myectomy for obstructive hypertrophic cardiomyopathy. Source American Heart Journal. 301 (no pagination), 2026. Article Number: 107543. Date of Publication: 01 Nov 2026. Author Fang J.; Ma Y.; Chen Y.; Lai Y.; Wang C.; Guo H.; Ma L.; Yan X.; Wang D.; Wan S.; Wei X. Institution (Fang, Ma, Chen, Wan, Wei) Division of Cardiovascular Surgery, Department of Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Fang, Ma, Chen, Wan, Wei) Hubei Engineering Research Center for Diagnostic and Therapeutic Equipment in Precision Cardiovascular Surgery, Wuhan, China (Fang, Ma, Chen, Wan, Wei) Key Laboratory of Organ Transplantation, Ministry of Education; NHC Key Laboratory of Organ Transplantation; Key Laboratory of Organ Transplantation, Chinese Academy of Medical Sciences, Organ Transplantation Clinical Medical Research Center of Hubei Province, Wuhan, China (Lai) Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wang) Department of Cardiovascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China (Guo) Guangdong Provincial People's Hospital, Guangdong Cardiovascular Institute, Guangdong Academy of Medical Sciences, Guangzhou, China (Ma) Department of Cardiovascular Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Yan) Peking University First Hospital, Peking University Clinical Research Institute, Beijing, China (Wang) Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom Publisher Elsevier Inc. Abstract Background Septal myectomy is the gold standard treatment for drug-refractory obstructive hypertrophic cardiomyopathy (oHCM). However, conventional septal myectomy (CSM) has been largely confined to specialized centers owing to its technical complexity. Transapical beating-heart septal myectomy (TA-BSM) can simplify CSM, enabling minimally invasive tailored septal resections in the beating heart under real-time echocardiographic guidance. Despite single-institution experience showed favorable efficacy and safety, whether TA-BSM can achieve similar clinical outcomes as CSM remains unknown since randomized controlled trial comparing the 2 approaches was unavailable. Methods The TAILOR-HCM trial (Transapical Beating-Heart Septal Myectomy vs Conventional Surgical Myectomy in Patients with Obstructive Hypertrophic Cardiomyopathy) is a multicenter, randomized, controlled, assessor-blinded, noninferiority trial evaluating the safety and efficacy of a novel device-based TA-BSM procedure conducted at 11 experienced CSM centers in China. In total, 216 symptomatic patients with oHCM who meet guideline-directed indications for septal myectomy will be randomly assigned in a 1:1 ratio to TA-BSM or CSM. The primary endpoint is relief of left ventricular outflow tract (LVOT) obstruction at 12 months, defined as a resting LVOT gradient <30 mm Hg and a standardized Valsalva maneuver-provoked LVOT gradient <50 mm Hg. Secondary endpoints include cardiac hemodynamic and structural parameters, procedure-related outcomes, quality of life, and laboratory examinations. The key safety outcome is all-cause mortality within 12 months after surgery. Conclusions TAILOR-HCM is the first multicenter randomized controlled trial evaluating both TA-BSM and CSM in oHCM. Through comparative evidence against CSM, this study will inform future clinical decision-making. If noninferior hemodynamic efficacy with favorable safety is confirmed, TA-BSM may represent an alternative surgical approach that expands therapeutic options and improves access to definitive septal reduction therapy for patients with oHCM. Clinical Trial Registration https://www.chictr.org.cn . Unique Identifier: ChiCTR2400087414. Copyright © 2026 Elsevier Inc. <49> Accession Number 2048167699 Title Superficial intercostal plane blocks for post-sternotomy pain control rationale and design for the EPOCH CardioLink-10 randomized clinical trial. Source Current Opinion in Cardiology. 41(5) (no pagination), 2026. Date of Publication: 01 Sep 2026. Author Dhingra N.K.; Dennis F.; Hassan S.M.A.; Quan A.; Teoh H.; Chin K.; Ricci M.J.; Tran J.D.; Li J.; Verma R.; de Vasconcelos Papa F.; Lee Y.; Chang A.P.; Igualada J.; Morales J.F.; Ghiringhelli J.P.; Derry K.L.; George T.; Mazine A.; Rotstein O.D.; Adams C.; Cook R.C.; Hassan A.; Nagpal A.D.; Yau T.M.; Spence J.D.; Sutherland K.; Martinka P.M.; Noss C.D.; Dougherty J.L.; de Jager P.; Gregory A.J.; Arora R.C.; Verma S.; Alli A.; Mazer C.D. Institution (Dhingra, Yau) Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, University Health Network (Dhingra, Hassan, Rotstein, Yau, Verma) Department of Surgery, University of Toronto (Dennis, Hassan, Quan, Teoh, Verma) Division Cardiac Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto (Dennis, Hassan, Verma, Mazer) Department of Pharmacology and Toxicology, University of Toronto (Teoh) Division of Endocrinology and Metabolism (Chin, Ricci, Tran, Li, de Vasconcelos Papa, Lee, Igualada, Morales, Derry, George, Alli, Mazer) Department of Anesthesia, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto (Ricci, de Vasconcelos Papa, Lee, Chang, Ghiringhelli, Derry, George, Alli, Mazer) Department of Anesthesiology and Pain Medicine (Tran, Mazer) Department of Physiology, University of Toronto, Toronto, ON, Canada (Verma) School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland (Chang) Department of Anesthesia, Sunnybrook Health Sciences Center (Ghiringhelli) Department of Anesthesia and Pain Management, Mount Sinai Hospital, Toronto, ON, Canada (Mazine) Department of Cardiothoracic Surgery, Royal Children's Hospital, Melbourne, VIC, Australia (Rotstein) Division of General Surgery, Li Ka Shing Knowledge Institute, St. Michael's Hospital of Unity Health Toronto, Toronto, ON, United States (Adams) Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, AB, United States (Cook) Division of Cardiac Surgery, Vancouver General Hospital (Cook) Division of Cardiovascular Surgery, University of British Columbia, Vancouver, BC, Canada (Hassan) MaineHealth Maine Medical Center, Portland, Maine, United States (Nagpal) Division of Cardiac Surgery (Nagpal) Division of Critical Care, London Health Science Centre, Western University, London, United Kingdom (Spence) Departments of Anesthesia, Critical Care and Health Research Methods, Evidence, and Impact, Population Health Research Institute, McMaster University, Hamilton, ON, United States (Sutherland, Martinka) Department of Anesthesiology and Perioperative Medicine, Royal Columbian Hospital, New Westminster, BC, United States (Martinka) Department of Anesthesiology, Pharmacology & Therapeutics, University of British Columbia, Vancouver, BC, United States (Noss, Gregory) Department of Anesthesiology, Perioperative and Pain Medicine & Libin Cardiovascular Institute, University of Calgary, Calgary, AB, United States (Dougherty, de Jager) Department of Anesthesia, Pain Management & Peri-operative Medicine, Dalhousie University, Halifax, NS, Canada (Arora) Departments of Surgery and Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illnois, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of the trial - Inadequate pain control following cardiac surgery remains a significant clinical and socioeconomic burden. Superficial parasternal intercostal plane (SPIP) blocks are not widely utilized for reducing pain and opioid consumption post-cardiac surgery because the available evidence is weak and inconsistent. Methods - The double-blind, placebo-controlled, multicenter EPOCH CardioLink-10 trial was designed to evaluate how continuous bilateral SPIP blocks affect opioid consumption and recovery-related endpoints among individuals who have undergone cardiac surgery via median sternotomy. Participants from four Canadian sites are randomized to receive either 0.2% ropivacaine or placebo (0.9% sodium chloride) for 48-h following bilateral catheter insertion into the SPIP. The primary outcome is cumulative postoperative opioid use (morphine milligram equivalents) up to 72-hours post-catheter insertion. Secondary endpoints include median pain scores and the incidence of delirium over the 72-hours post-catheter insertion; cumulative postoperative opioid use up to hospital discharge; and participant-reported quality of recovery 24-96 h post-surgery. Summary - EPOCH CardioLink-10 is to date the largest randomized controlled trial to evaluate an Enhanced Recovery After Surgery (ERAS) intervention among individuals who are recuperating from cardiac surgery with median sternotomy. Its overarching goal is to obtain robust data to improve clinical care and inform on post-cardiac surgery pain management guidelines. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <50> Accession Number 2048433363 Title Transseptal versus left atrial approach for mitral valve surgery: A systematic review and meta-analysis. Source Asian Cardiovascular and Thoracic Annals. (no pagination), 2026. Article Number: 02184923261476111. Date of Publication: 2026. Author Paramkusam S.M.C.; Paramkusam A.V.; Abuzayed B.; Omaruddin L.; Pavuluri K.S.; Ghosh A.; Basri A.; Malik A.B.; Ramkhalawon S.V.; Mukunde A.-C.; Imam B.; Ezhil S.R. Institution (Paramkusam) Katuri Medical College and Hospital, Andhra Pradesh, Guntur, India (Paramkusam) Jonelta Foundation School of Medicine - UPHSD, Las Pinas, Philippines (Abuzayed) Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom (Omaruddin) (Pavuluri) ESH, Surrey and Sussex Healthcare NHS Trust, Redhill, United Kingdom (Ghosh) Nazareth Hospital, Philadelphia, PA, United States (Basri) Internal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan (Malik) Washington University in St Louis, St Louis, United States (Ramkhalawon) SAJ Flacq Hospital, Flacq, Mauritius (Mukunde) Universidad de Montemorelos, Montemorelos, Mexico (Imam) University of Pittsburgh Medical Center, Pittsburgh, United States (Ezhil) M.S. Ramaiah Medical College, Bangalore, India (Paramkusam, Paramkusam, Abuzayed) Publisher SAGE Publications Inc. Abstract Objective: Surgical access to the mitral valve can be achieved through various techniques, with the transseptal (TS) and left atrial (LA) approaches being the most commonly used in mitral valve surgery (MVS). However, the optimal approach remains a subject of debate, as studies report differing perioperative and postoperative outcomes associated with each technique. This meta-analysis aims to systematically compare the clinical outcomes of TS versus LA approaches in MVS. Method(s): This meta-analysis followed the PRISMA guidelines. A comprehensive literature search of PubMed, Embase and Scopus databases was performed until June 2025. The primary outcome was permanent pacemaker (PPM) implantation. Result(s): Twenty-five studies were included. The TS approach was associated with higher risk of PPM implantation (risk ratio: 1.44, 95% confidence interval [1.07-1.95]; P = 0.01), postoperative atrial fibrillation, postoperative junctional rhythm, atrioventricular block, need for temporary pacing and longer cardiopulmonary bypass time, aortic cross-clamp time (CCT), hospital-stay and bleeding. No significant differences were found in intensive care unit stay, mortality, infections, stroke and renal failure. Subgroup analysis of isolated MVS showed no differences in most outcomes except for a higher risk of PPM implantation and postoperative atrial fibrillation in the TS group. Conclusion(s): Our meta-analysis demonstrates that the TS approach is associated with longer operative times and a higher risk of postoperative conduction disturbances and PPM implantation. However, no significant differences were observed in other major clinical outcomes. These findings do not support the overall superiority of either approach, and surgical access should be individualized according to patient anatomy, procedural requirements, and surgeon experience. Further high-quality studies are needed to strengthen the available evidence. Copyright © The Author(s) 2026 <51> Accession Number 2038506939 Title Efficacy and safety of three different doses of intravenous dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation: A prospective, double-blind, randomized controlled trial. Source International Journal of Medical Anesthesiology. 9(8) (no pagination), 2026. Date of Publication: 01 Aug 2026. Author Ansari S.B.M.Y.; Bedade S.M.; Jumnake P.S. Institution (Ansari, Bedade, Jumnake) Department of Anesthesiology, Government Medical College and Hospital, Maharashtra, Nagpur, India Publisher AkiNik Publications Abstract Background: Direct laryngoscopy and endotracheal intubation provoke a transient but intense sympathetic response, leading to tachycardia and hypertension. While dexmedetomidine is known to attenuate this response, the optimal dosing regimen remains debated. This study aimed to compare the clinical efficacy and safety of three different intravenous (IV) doses of dexmedetomidine for this purpose. Method(s): In this prospective, double-blind, randomized controlled trial, 63 ASA I and II patients (aged 18-60 years) scheduled for elective non-cardiac surgery were allocated into three equal groups. Patients received IV dexmedetomidine at doses of 0.5 microg/kg (Group D1), 0.75 microg/kg (Group D2) or 1 microg/kg (Group D3) infused over 10 minutes prior to induction. Hemodynamic parameters (Heart Rate [HR], Systolic Blood Pressure [SBP], Diastolic Blood Pressure [DBP] and Mean Arterial Pressure [MAP]) were recorded at baseline, pre-induction, induction, intubation and at 1, 3, 5 and 10 minutes post-intubation. Result(s): Demographic profiles were comparable across all groups. Group D3 (1 microg/kg) demonstrated a significantly superior attenuation of HR, SBP and DBP at all post-intubation intervals compared to Groups D1 and D2 (p < 0.05). While all groups showed a post-intubation decrease in parameters compared to baseline, the maximum reduction in HR (up to 12%) and SBP (18%) occurred in Group D3. Bradycardia was noted in 4 patients but was easily managed with IV atropine, with no major adverse events reported. Conclusion(s): Intravenous dexmedetomidine at a dose of 1 microg/kg provides exceptionally effective and safe attenuation of the hemodynamic stress response to laryngoscopy and intubation compared to lower doses. Copyright © 2026, AkiNik Publications. All rights reserved. <52> Accession Number 2048400469 Title Minimally invasive extracorporeal circulation protects against postoperative pulmonary endothelial injury in elderly cardiac surgery via suppressing the C5a-mtDNA-cGAS-STING axis: a mechanistic randomized controlled trial. Source International Immunopharmacology. 188 (no pagination), 2026. Article Number: 117281. Date of Publication: 01 Jan 2026. Author Zhao Y.; Wang J.; Yang Z.; Ma W.; Wang C.; Wei L.; Zhao D.; Zhang S. Institution (Zhao, Wang) Department of Cardiac Surgery, Shanghai Geriatric Medical Center, Shanghai, China (Yang, Ma, Wang, Wei, Zhao, Zhang) Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai, China Publisher Elsevier B.V. Abstract Background: Elderly patients undergoing cardiac surgery are highly susceptible to postoperative pulmonary complications triggered by conventional extracorporeal circulation (CECC)-driven systemic inflammation and subsequent pulmonary endothelial injury. Minimally invasive extracorporeal circulation (MiECC) lowers perioperative hemodilution and systemic inflammatory load, yet the underlying intracellular protective mechanisms in aged populations remain incompletely understood. This study therefore aimed to delineate the C5a-mtDNA-cGAS-STING signaling cascade as the central pathway mediating MiECC's pulmonary protective effect. Method(s): This prospective randomized controlled trial enrolled 94 patients >=70 years undergoing elective valve or coronary bypass surgery, randomly allocated to MiECC (n = 46) or CECC (n = 48). Perioperative hemoglobin trajectories and 7-day postoperative adverse events were compared using appropriate statistical tests. For mechanistic validation, serum from 5 propensity-matched patient pairs (matched by age, surgery type, and CPB duration) was used to stimulate human pulmonary microvascular endothelial cells (HPMECs). Quantitative phenotypic assays, including fluorometric quantification coupled with high-content screening, were employed to evaluate endothelial barrier integrity, apoptosis, mitochondrial dysfunction, and activation of the cGAS-STING signaling axis. Two targeted pharmacological rescue experiments were conducted using C5a receptor antagonist PMX53 and STING selective inhibitor C-176, to establish the hierarchical causality of this proposed signaling axis. Result(s): No perioperative mortality was recorded in either cohort. The MiECC group exhibited markedly higher intraoperative hemoglobin levels and a 52.6% relative risk reduction in postoperative pulmonary exudative complications, with no extension of postoperative recovery timelines. Postoperative serum levels of complement C5a, pro-inflammatory cytokines, and endothelial injury biomarkers were significantly lower in the MiECC cohort. Quantitative analyses demonstrated that MiECC serum significantly attenuated endothelial hyperpermeability and reduced apoptosis rates. At the mechanistic level, MiECC serum suppressed mitochondrial superoxide accumulation (38.2% reduction) and preserved mitochondrial membrane potential, resulting in a 46.5% reduction in cytosolic mtDNA leakage. Consequently, MiECC serum downregulated cGAS and STING protein expression and suppressed nuclear translocation of phosphorylated IRF3 (p-IRF3). The dual inhibitor rescue demonstrated that pretreatment with PMX53 fully reversed all CECC serum-induced pathological phenotypes, whereas the STING inhibitor C-176 selectively ameliorated downstream endothelial injury without rescuing upstream mitochondrial dysfunction or cytosolic mtDNA leakage. Dual inhibitor rescue demonstrated that PMX53 completely reversed all pathological phenotypes, whereas C-176 only rescued downstream endothelial injury without correcting upstream mitochondrial damage or mtDNA release. Conclusion(s): MiECC is a safe, effective perfusion strategy that mitigates postoperative pulmonary exudation in elderly cardiac surgical recipients. At the mechanistic level, MiECC restricts CPB-induced C5a overproduction, thereby preventing C5a-driven mitochondrial impairment and mtDNA release, which initiates the cGAS-STING inflammatory cascade. Selective C5aR blockade fully interrupts this pathological axis, providing robust translational evidence to support broader adoption of MiECC in high-risk elderly patients and identifying C5aR as a tractable therapeutic target for CPB-associated lung injury. Copyright © 2026 Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <53> Accession Number 2048193475 Title Interventions to reduce the impact of post-tuberculosis lung disease: a scoping review of the literature. Source BMC Pulmonary Medicine. 26(1) (no pagination), 2026. Article Number: 345. Date of Publication: 01 Dec 2026. Author Byrne A.L.; Gunther G.; Tadyanemhandu C.; de Almeida C.P.B.; Dewi I.M.W.; Mitnick C.D.; Koenig S.P.; Romanowski K.; Wallis R.S. Institution (Byrne) Department of Thoracic Medicine, Heart Lung Stream, St Vincent's Hospital, Sydney, Australia (Byrne) Faculty of Medicine, St Vincent's Clinical School, University of New South Wales, Sydney, Australia (Gunther) Department of Pulmonology, Allergology and Clinical Immunology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland (Gunther) Department of Clinical Sciences, School of Medicine, University of Namibia, Windhoek, Namibia (Tadyanemhandu) Department of Physiotherapy, Fatima College of Health Sciences, Abu Dhabi, United Arab Emirates (de Almeida) Faculty of Public Health, Federal University of Sul e Sudeste do Para, Maraba, Brazil (Dewi) Department of Biomedical Sciences, Faculty of Medicine Universitas Padjadjaran, Bandung, Indonesia (Dewi) Research Center for Care and Control of Infectious Diseases (RC3ID), Universitas Padjadjaran, Bandung, Indonesia (Mitnick) Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, United States (Koenig) Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States (Romanowski) Department of Global and Public Health, McGill University, Montreal, Canada (Wallis) The Aurum Institute, Johannesburg, South Africa Publisher BioMed Central Ltd Abstract Background: Post tuberculosis lung disease (PTLD) is an increasingly recognized contributor of long-term morbidity among the estimated 155 million survivors of Mycobacterium tuberculosis disease. While a range of interventions may influence PTLD risk, the full spectrum has not been systematically reviewed. Method(s): We conducted a scoping review following Joanna Briggs Institute methodology to identify interventions delivered during or after TB treatment with potential to affect PTLD outcomes. Embase was searched from inception to March 31, 2025, for seven intervention categories: host-directed therapy (HDT), therapeutic drug monitoring (TDM), inhaled pharmacotherapy, antimicrobials beyond TB treatment, treatment shortening, thoracic surgery, and microbiome-altering interventions. Outcomes were grouped into disability, lung function, radiology, biomarkers, and histopathology, and categorized as showing improvement, worsening, or no effect on PTLD. Result(s): Of 7,965 records screened, 87 studies were included. Most were small, uncontrolled, and designed to assess microbiological cure rather than post-TB sequelae. Radiology and unstructured symptom reports were the most common outcomes, while validated disability tools and advanced lung function measures were rarely used. Corticosteroids and several HDTs showed signals of radiological or spirometric benefit, but the findings were inconsistent. Doxycycline and metformin improved cavity resolution in small trials. Inhaled bronchodilators demonstrated short-term spirometric gains in two studies and a survival benefit in one retrospective cohort. Antifungals for chronic pulmonary aspergillosis improved symptoms, radiology, and inflammatory biomarkers, whereas evidence for antibacterial or NTM-directed therapy was lacking. TDM was associated with faster culture conversion in some studies but was not linked to PTLD-specific outcomes. Microbiome studies consistently reported reduced diversity and altered composition during TB treatment, but no direct associations with PTLD. Conclusion(s): Evidence for interventions to prevent or mitigate PTLD remains sparse, heterogeneous, and largely incidental. High-quality studies using standardized, person-centered outcomes are urgently needed to guide care for TB survivors worldwide. Copyright © The Author(s) 2026. <54> Accession Number 2048338216 Title Perception and satisfaction with a Tai Chi-based community cardiac rehabilitation program: a qualitative sub-study of a pilot randomised controlled trial. Source European Journal of Integrative Medicine. 87 (no pagination), 2026. Article Number: 102717. Date of Publication: 01 Oct 2026. Author Jung J.; Chow C.; Ee C.; Liao A.; Chang D.; Kiat H.; Yang G. Institution (Jung) School of Medicine, Western Sydney University, Penrith, NSW, Australia (Chow) Faculty of Medicine and Health, Westmead Applied Research Centre, The University of Sydney, NSW, Australia (Ee, Liao, Chang, Kiat, Yang) NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia (Ee) Caring Futures Institute, College of Health and Enablement, Flinders University, Bedford Park, SA, Australia (Kiat, Yang) Faculty of Medicine and Health, The University of Sydney, NSW, Australia (Kiat) Faculty of Medicine, Human and Health Sciences, Macquarie University, NSW, Australia (Kiat) College of Health and Medicine, Australian National University, ACT, Australia (Kiat) Cardiac Health Institute, Sydney, Australia Publisher Elsevier GmbH Abstract Introduction: Cardiac rehabilitation (CR) programs are increasingly incorporating innovative delivery models and interventions to improve implementation and enhance recovery following acute coronary events. This qualitative study aims to explore the perceptions and satisfaction of a novel CR program for Chinese migrants in Australia. Method(s): This is a qualitative sub-study embedded in a 24-week pilot randomised controlled trial evaluating a community-based CR program among participants who were of Chinese migrant background and had undergone a recent stent placement or coronary bypass graft surgery. This program consists of a virtual shared medical appointment, virtual Tai Chi classes, and semi-personalised health education messages delivered via text messages. Upon completion of the program, participants were invited to participate in a semi-structured interview conducted in Chinese. Interviews were conducted online via Zoom meetings, transcribed verbatim, translated in English, and analysed using NVivo software (version 20). Result(s): Interviews with eleven participants (mean age 69 years, 82% male) found that the CR program integrating Tai Chi was well-received, with physical improvements cited as the most common benefit. Half of the participants reported notable psychological benefits from Tai Chi including reduced depressive symptoms, heightened body awareness, and improved mood. The program also fostered strong social connectedness between Chinese participants, with participants valuing the shared experience and mutual encouragement among peers with similar health conditions. Remote delivery of Tai Chi was widely accepted, noting its convenience and cultural relevance. However, the health education text messaging component received mixed feedback due to the generic messages and/or accessibility issues. Overall satisfaction with the program was high, driven by supportive interactions with the rehabilitation and research team, perceived benefits, and the sustainability of Tai Chi as a long-term exercise modality. Suggested areas for improvement included expansion of services and more frequent engagement with healthcare professionals to support their recovery. Conclusion(s): Participants described generally high satisfaction and positive experiences with the telehealth-delivered, Tai Chi-based CR program. Culturally tailored exercise components appeared to support social connection, and flexible delivery models were viewed as helpful for program participation and engagement. Findings of this study may inform future CR program designs for diverse populations in Australia. Copyright © 2026 The Authors <55> Accession Number 2048312872 Title Meta-Analysis of Cardiorespiratory Fitness Impairment in Pediatric Heart Transplant Recipients. Source Clinical Transplantation. 40(8) (no pagination), 2026. Article Number: e70646. Date of Publication: 01 Aug 2026. Author Wu N.; Foulkes S.J.; Weeldreyer N.R.; Kruger C.; Tomczak C.R.; Khoury M.; Conway J.L.; Haykowsky M.J. Institution (Wu, Foulkes, Weeldreyer, Kruger, Haykowsky) Integrated Cardiovascular Exercise Physiology and Rehabilitation Laboratory, Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada (Foulkes) Heart, Exercise and Research Trials Lab, St Vincent's Institute of Medical Research, Fitzroy, VIC, Australia (Foulkes) Baker Department of Cardiometabolic Health, University of Melbourne, Parkville, VIC, Australia (Tomczak) College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada (Khoury, Conway) Department of Pediatrics, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada (Haykowsky) Hochgebirgsklinik Davos, Medicine Campus Davos, Davos, Switzerland Publisher John Wiley and Sons Inc Abstract Pediatric heart transplant (PHTR) recipients have reduced cardiorespiratory fitness (VO<inf>2</inf>peak); however, the magnitude of this impairment and its underlying central hemodynamic mechanisms remain poorly characterized. This systematic review and meta-analysis quantified differences in VO<inf>2</inf>peak and peak exercise central hemodynamics between PHTR recipients and age-matched healthy controls (CON). MEDLINE (PubMed) was searched for studies comparing VO<inf>2</inf>peak in PHTR recipients and CON. Pooled effect sizes were expressed as weighted mean differences (WMD) using a DerSimonian-Laird random-effects model, and weighted least-squares meta-regression assessed the moderating effects of age and time post-transplant. Seven unique studies (PHTR n = 90; CON n = 118) reported VO<inf>2</inf>peak and peak HR. PHTR had significantly lower VO<inf>2</inf>peak (WMD = -9.5 mL/kg/min), peak HR (WMD: -30 bpm), and CO (n = 3 studies, WMD: -2.5 L/min), with no difference in peak SBP (n = 3 studies). Meta-regression revealed no significant moderating effect of age or time post-transplant on the VO<inf>2</inf>peak deficit. The markedly reduced VO<inf>2</inf>peak in PHTR recipients is driven primarily by impaired peak CO and persistent chronotropic incompetence, consistent with cardiac allograft sympathetic denervation. Copyright © 2026 The Author(s). Clinical Transplantation published by John Wiley & Sons Ltd. <56> Accession Number 2038497921 Title INCIDENCE OF DELIRIUM WITH DEXMEDETOMIDINE COMPARED WITH FENTANYL BASED THERAPY IN POSTOPERATIVE CARDIAC SURGICAL PATIENTS: A RANDOMIZED CONTROLLED SINGLE BLINDED STUDY. Source Genetics and Molecular Research. 25(13s) (no pagination), 2026. Date of Publication: 05 Aug 2026. Author Mishra R.D.; Paidi P.; Acharya R.; Apurva G.; Bhoi S.K. Institution (Mishra, Paidi, Apurva) Department of Anesthesia and Critical Care Medicine, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India (Acharya) Department of Anesthesiology and Critical Care and Pain Medicine, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India (Bhoi) Department of Cardiac Anaesthesia, IMS and SUM Hospital, Siksha 'O' Anusandhan, Deemed to be University, Bhubaneswar, India Publisher Fundacao de Pesquisas Cientificas de Ribeirao Preto Abstract Background: Postoperative Delirium represents complication in cardiac surgery, associated with increased morbidity and mortality. This study compared the efficacy of dexmedetomidine versus fentanyl-based therapy on clinical outcomes in postoperative cardiac surgical patients. Method(s): This study design was a single blinded Randomized Control Trial was conducted in tertiary hospitals in IMS and SUM between January 2023 to January 2025. Patients were randomized into two groups i.e., Dexmedetomidine (DEX) and fentanyl-based therapy in cardiac surgery patient. The primary endpoint was delirium incidence and severity, assessed 12-hourly for 7 days via CAM-ICU. Secondary outcomes included pain (CPOT/Wong-Baker), sedation (RASS), extubation time, and hemodynamic stability. Analysis was performed using SPSS v27, with significance set at p < 0.05. Result(s): One hundred fifty patients were randomized (n=75 per group) with no significant differences in age, weight, or gender. While delirium incidence was similar initially, Dexmedetomidine showed significantly lower mean delirium scores from day 5 to day 7 (p < 0.05) compared to Fentanyl. Additionally, Dexmedetomidine demonstrated significantly better sedation (RASS) and analgesia (CPOT) scores from 12 to 48 hours (p < 0.001). Furthermore, Dexmedetomidine group achieved significantly earlier extubation (17.54 +/- 2.59 vs. 18.4 +/- 3.16 hours; p = 0.03), lower incidences of tachyarrhythmias, and reduced rescue analgesia requirements. Hemodynamic parameters remained stable across both cohorts. Conclusion(s): Postoperative dexmedetomidine significantly reduced delirium severity, improves sedation quality, and provided superior analgesia compared to fentanyl. Dexmedetomidine is a more effective postoperative sedative-analgesic than fentanyl, supports modern cardiac surgical protocols to improve clinical outcomes in high-risk populations. Copyright © 2026, Fundacao de Pesquisas Cientificas de Ribeirao Preto. All rights reserved. <57> Accession Number 2048319737 Title Impact of a multimodal prehabilitation program on postoperative cognitive dysfunction: a single-center randomized controlled trial. Source Journal of Clinical Anesthesia. 114 (no pagination), 2026. Article Number: 112300. Date of Publication: 01 Sep 2026. Author Perdomo-Linares J.; Lopez-Baamonde M.; Mellado-Artigas R.; Tort-Merino A.; Garavito-Henao L.; Arguis M.J.; Navarro-Ripoll R.; Lopez-Hernandez A.; Balasa M.; Rivas E.; Martinez-Palli G. Institution (Perdomo-Linares, Lopez-Baamonde, Mellado-Artigas, Garavito-Henao, Arguis, Navarro-Ripoll, Lopez-Hernandez, Rivas, Martinez-Palli) Department of Anesthesiology, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain (Perdomo-Linares, Navarro-Ripoll, Rivas, Martinez-Palli) Departament de Cirurgia i Especialitats Medicoquirurgiques, Facultat de Medicina i Ciencies de la Salut, Universitat de Barcelona (UB), Barcelona, Spain (Tort-Merino, Balasa) Department of Neurology, Hospital Clinic de Barcelona, Universitat de Barcelona (UB), Barcelona, Spain (Mellado-Artigas, Tort-Merino, Arguis, Navarro-Ripoll, Balasa, Rivas, Martinez-Palli) Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Rivas, Martinez-Palli) CIBER Enfermedades Respiratorias (CIBERES), Madrid, Spain (Rivas) Outcomes Research Consortium, Houston, United States Publisher Elsevier Inc. Abstract Background Postoperative cognitive dysfunction (POCD) is a frequent complication after cardiac surgery. Exercise-based prehabilitation may enhance functional reserve and reduce vulnerability to perioperative cerebral insults. We hypothesized that multimodal prehabilitation reduces POCD 3 months after cardiac surgery. Methods This prespecified substudy of a single-center randomized controlled trial ( NCT03466606 ) included patients aged >=50 years undergoing elective coronary artery bypass grafting and/or valve surgery. Participants were randomized 1:1 to 4-6 weeks of multimodal prehabilitation (exercise training, nutritional support, and psychological support) or standard preoperative care. Cognitive function was assessed at baseline and 3 months postoperatively using an age- and education-adjusted neuropsychological battery. POCD was defined as performance >=1.5 standard deviations below normative values in at least 2 cognitive tests, excluding the Mini-Mental State Examination. Logistic regression analyses were performed to evaluate factors associated with POCD. Results Of 160 participants screened from the parent trial, 134 met eligibility criteria for the substudy and were randomized; 116 completed 3-month follow-up (prehabilitation n = 53; control n = 63). POCD occurred in 29 patients (25%), including 15/53 (28%) in the prehabilitation group and 14/63 (22%) in controls (odds ratio [OR] 1.37, 95% confidence interval [CI] 0.54-3.50, P = 0.52). In multivariable analysis, preoperative cognitive impairment was independently associated with POCD (OR 13.28, 95% CI 4.06-43.41, P < 0.001), whereas prehabilitation was not (OR 1.09, 95% CI 0.35-3.45, P = 0.877). Higher physical activity levels at 3 months were associated with lower odds of POCD (OR 0.97, 95% CI 0.95-1.00, P = 0.047). Conclusions In this randomized controlled trial, a 4-6-week multimodal prehabilitation program did not reduce postoperative cognitive dysfunction 3 months after cardiac surgery. Although the intervention did not achieve measurable cognitive protection, the observed association between postoperative physical activity levels and postoperative cognitive dysfunction warrants further investigation. Copyright © 2026 Elsevier Inc. <58> Accession Number 2048135737 Title A meta-analysis of randomized controlled trials on atenolol's impact on postoperative atrial fibrillation in adults undergoing cardiac surgery. Source Medicine (United States). 105(31) (no pagination), 2026. Article Number: e50029. Date of Publication: 31 Jul 2026. Author Deng J.-H.; He F.-R.; Yao Y.-T. Institution (Deng) Department of Anesthesiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China (He) Department of Obstetrics and Gynecology, The Air Force Hospital of Southern Theater Command, Guangzhou, 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) Center of Outcomes Research, Department of Anesthesiology, 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 Prior research has conducted a limited number of studies on the efficacy of atenolol in preventing atrial fibrillation following cardiac surgery (CS). Consequently, a comprehensive evaluation and meta-analysis were undertaken to assess the effectiveness and safety of atenolol in patients undergoing CS for the prevention of postoperative atrial fibrillation (POAF). A meta-analysis of randomized controlled trials was performed. Searches were conducted across multiple databases up to December 1, 2024. The primary focus was the incidence of POAF. Risk ratios (RRs) for treatment effects on dichotomous variables were calculated. The data analysis encompassed 6 randomized controlled trials involving a total of 870 patients. The meta-analysis revealed that atenolol significantly reduces the incidence of POAF in adult patients undergoing CS (RR, 0.55; 95% confidence interval [CI]: 0.32-0.93; P = .03) with moderate heterogeneity (I2 = 57%; P = .10). Atenolol did not demonstrate superiority over sotalol in reducing POAF (RR, 2.39; 95% CI: 1.41-4.04; P = .001) with moderate heterogeneity (I2 = 40%; P = .19). Furthermore, no significant difference was observed between atenolol and the control group (comprising propafenone, metoprolol, nebivolol, and digoxin) in the prevention of POAF (RR, 1.28; 95% CI: 0.76-2.16; P = .35) with moderate heterogeneity (I2 = 43%; P = .15). Recent studies suggest that atenolol could be a safe and effective intervention for the prevention of POAF in adult patients undergoing CS. Copyright © 2026 the Author(s). Published by Wolters Kluwer Health, LLC. <59> Accession Number 651949570 Title Determining when patients with thyroid illnesses should be cleared for surgery. Source Current opinion in endocrinology, diabetes, and obesity. (no pagination), 2026. Date of Publication: 13 Aug 2026. Author Paul A.; Abraham A.A.; George T. Institution (Paul) Department of General Medicine, Christian Medical College and Hospital, Vellore, Tamil Nadu, India Abstract PURPOSE OF REVIEW: Thyroid dysfunction often delays surgery during preoperative evaluation, though evidence on perioperative risk and biochemical optimization is limited. This review explores recent literature on perioperative outcomes in hypothyroidism and hyperthyroidism, focusing on surgery delays, rapid optimization strategies, and areas of uncertainty. RECENT FINDINGS: Observational studies and meta-analyses link subclinical hypothyroidism with adverse cardiovascular outcomes in cardiac surgeries, but evidence for non-cardiac surgeries is limited. Overt hypothyroidism is associated with complications like impaired wound healing, prolonged ventilation, and cardiovascular issues, making euthyroid state preferable before surgery, despite retrospective, heterogeneous data. For hyperthyroid patients undergoing total thyroidectomy, recent literature questions the need for biochemical euthyroid state; evidence for non-thyroid surgeries is sparse and extrapolated from thyroid surgeries. Selective use of liothyronine and therapeutic plasma exchange in severe or urgent cases shows promise, but evidence is limited and low quality. SUMMARY: Current management of thyroid dysfunction is largely consensus-driven and based on limited evidence. Routine elective surgery optimization is advised for overt thyroid disease; however, in urgent cases, surgery after starting appropriate therapy and multidisciplinary planning is often reasonable. Future research should focus on prospective outcome data, rapid correction strategies, and the role of modern care pathways in reducing endocrine-related surgical risks. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <60> Accession Number 651947835 Title Nurse-Led Algorithm-Based Early Mobilization Protocol for Reducing Post-Intensive Care Syndrome in Intensive Care Unit Patients: A Randomized Controlled Trial. Source The Journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 12 Aug 2026. Author Jeong Y.; Lee H. Institution (Jeong) MSN, Staff Nurse, Graduate Student, Cardiovascular Intensive Care Unit, Gil Medical Center, College of Nursing, Research Institute of AI and Nursing Science, Gachon University, South Korea. Hyeongsuk Lee, RN, Incheon, South Korea Abstract BACKGROUND: Post-intensive care syndrome (PICS) is a significant challenge for cardiac surgery survivors. While early mobilization (EM) is recommended, there is a lack of evidence regarding the effectiveness and safety of nurse-led, algorithm-based protocols in cardiovascular intensive care units (ICUs). OBJECTIVE(S): To evaluate the effects of a nurse-led algorithm-based EM protocol on PICS scores, psychological distress (anxiety and depression), sleep quality, and nursing satisfaction in patients following cardiac surgery. METHOD(S): A randomized controlled pretest-posttest study was conducted with 38 adult patients at a Korean tertiary hospital. Participants were randomly assigned to a control (n = 19) or experimental (n = 19) group. The experimental group received the protocol from 12 hours post-intensive care admission until transfer. Outcomes were measured using the PICS Questionnaire, Hospital Anxiety and Depression Scale, Korean Modified Leeds Sleep Evaluation Questionnaire, and Nursing Service Satisfaction Tool. Data were analyzed using nonparametric tests. RESULT(S): Significant improvements were observed in the experimental group compared with the control group in PICS scores (Z = -3.83, P < .001), anxiety and depression (Z = -3.52, P < .001), sleep quality (Z = -3.83, P < .001), and all subdomains of nursing satisfaction (Z = -3.58 to -3.83, P < .001). No mobilization-related adverse events occurred, indicating the safety of the protocol. CONCLUSION(S): The application of a nurse-led algorithm-based EM protocol is a safe and effective strategy to reduce PICS, alleviate psychological distress, and enhance sleep and nursing satisfaction after cardiac surgery. This standardized nurse-driven approach should be integrated into routine cardiovascular ICU clinical practice. TRIAL REGISTRATION: This study was registered with the Korean Clinical Research Information Service (CRIS) (identifier: KCT0010880, https://cris.nih.go.kr). Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <61> Accession Number 2048300621 Title The efficacy and safety of low dose colchicine in atherosclerotic cardiovascular disease: a systematic review and meta-analysis. Source European Journal of Preventive Cardiology. 33(5) (pp 694-704), 2026. Date of Publication: 01 Mar 2026. Author Tucker B.; Tucker W.J.; Chung J.S.; Figtree G.A.; Keech A.; Patel S. Institution (Tucker, Chung, Keech, Patel) Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia (Tucker, Keech, Patel) Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia (Tucker) Department of Medicine, Tweed Valley Hospital, Cudgen, NSW, Australia (Figtree) Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia (Figtree) Cardiovascular Discovery Group, Kolling Institute of Medical Research, St Leonards, NSW, Australia (Figtree) Department of Cardiology, Royal North Shore Hospital, St Leonards, NSW, Australia (Patel) Coronary Diseases Group, Heart Research Institute, Newtown, NSW, Australia Publisher Oxford University Press Abstract Aims: Colchicine has recently been approved for the treatment of atherosclerotic cardiovascular disease (ASCVD). Since then, three large trials of colchicine in ASCVD have failed to reach their primary endpoints. Methods and Results: A systematic search of PubMed, Embase and Cochrane Central Register of Controlled Trials was performed (PROSPERO registration: CRD42024616378). The primary endpoint of major adverse cardiovascular events (MACE) was defined as a composite of myocardial infarction (MI), stroke and cardiovascular death. The key secondary endpoint of extended MACE (eMACE) was defined as MACE plus coronary revascularisation. Pooled estimates were calculated using a random-effects model and are presented as risk ratio [95% confidence interval (CI)]. 1624 articles were screened. 12 met inclusion criteria, yet one trial reported zero endpoint events in both arms. As such, 11 trials were included in the meta-analysis, with a total of 1983 primary endpoint events across 30 808 participants. Colchicine was associated with a 17% reduction in the incidence of MACE [0.83 (0.73, 0.95); P = 0.006] and 23% reduction in the incidence of eMACE [0.77 (0.63, 0.94); P = 0.01]. This reduction was driven by a lower rate of MI [0.78 (0.63, 0.95); P = 0.02] and coronary revascularisation [0.73 (0.55, 0.97); P = 0.03]. There were also numerically fewer strokes in the colchicine-treated population [0.81 (0.63, 1.04); P = 0.11]. Colchicine had no effect on cardiovascular [0.96 (0.79, 1.15); P = 0.64] or non-cardiovascular mortality [1.04 (0.76, 1.41); P = 0.81]. Conclusion(s): Colchicine reduces the risk of non-fatal ischaemic events in patients with ASCVD. Further studies are required to identify a population(s) who stands to benefit most from this promising therapy. Copyright © The Author(s) 2025. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <62> Accession Number 2048254713 Title The Evolution of Esophagectomy to Robotic-Assisted Minimally Invasive Esophagectomy (RAMIE) in the Treatment of Esophageal Cancer: Historical Insights and Comparative Outcomes. Source Cancers. 18(15) (no pagination), 2026. Article Number: 2444. Date of Publication: 01 Aug 2026. Author Hoover E.; Salami A.; Porembka M.; Sarkaria I. Institution (Hoover, Salami, Sarkaria) Division of Thoracic Surgery, Department of Cardiovascular and Thoracic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States (Porembka) Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Robotic-assisted minimally invasive esophagectomy (RAMIE) has emerged as an increasingly utilized approach for the surgical management of esophageal malignancies, offering potential advantages over conventional minimally invasive esophagectomy (MIE) and open esophagectomy (OE). Advances in robotic technology, enhanced visualization, instrument articulation, and surgeon ergonomics have facilitated wider adoption of RAMIE in thoracic surgical oncology. This review summarizes contemporary evidence regarding intraoperative, postoperative, oncologic, and patient-centered outcomes associated with RAMIE while highlighting emerging technologies and future directions in the field. Current literature, including randomized controlled trials, meta-analyses, propensity-matched studies, and international registry data, suggests that RAMIE is associated with reduced blood loss, improved lymph node harvest, and lower pulmonary morbidity compared with OE, while demonstrating outcomes comparable or favorable to conventional MIE. Oncologic outcomes, including R0 resection rates and overall survival, appear equivalent across approaches in most contemporary studies. In addition, robotic platforms may facilitate recurrent laryngeal nerve lymphadenectomy and complex mediastinal dissection. Despite these advantages, RAMIE is frequently associated with longer operative times and remains dependent on institutional expertise, surgeon experience, and resource availability. Current evidence is promising but remains limited by heterogeneity of surgical techniques, institutional expertise, and a relative scarcity of long-term randomized data. Emerging innovations including fluorescence-guided imaging, perfusion assessment technologies, artificial intelligence integration, augmented reality, and advanced robotic platforms may further enhance precision, safety, and personalization of esophageal cancer surgery. As robotic technology and perioperative systems continue to evolve, ongoing prospective investigation and long-term oncologic evaluation will remain essential to define the optimal role of RAMIE within multidisciplinary esophageal cancer care. Copyright © 2026 by the authors. <63> Accession Number 2048333104 Title Effects of Short-Term Mindfulness Combined with Acupressure on Preoperative Emotional Status in Patients Undergoing Heart Valve Replacement: A Randomized Controlled Study. Source Acupuncture and Electro-Therapeutics Research. (no pagination), 2026. Date of Publication: 2026. Author Xiang S.; Yang Z.; Deng M.; Chen L.; Chen Q.; Wang R. Institution (Xiang) School of Nursing, Guizhou Medical University, Guiyang, China (Yang) Department of Acupuncture, Songtao County People's Hospital, Songtao, China (Deng, Chen, Chen) Department of Cardiac Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China (Wang) Department of Nursing, Affiliated Hospital of Guizhou Medical University, Guiyang, China Publisher SAGE Publications Ltd Abstract Objective: This study aimed to investigate the effects of a combined regimen of short-term mindfulness (STM) and acupressure on preoperative mood and physiological responses in patients undergoing heart valve replacement (HVR). Method(s): A randomized controlled study was conducted in 62 patients admitted to the Department of Cardiac Surgery of a tertiary hospital in Guizhou from May to October 2024. Patients were randomly assigned to an intervention group or a control group, with 31 patients in each group. The intervention group received routine psychological care plus STM combined with acupressure, while the control group received routine psychological care plus a placebo intervention. Preoperative anxiety, depressive symptoms, and mindfulness level were assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS), Self-Rating Depression Scale (SDS), and Five Facet Mindfulness Questionnaire (FFMQ), respectively. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were also recorded. Result(s): Sixty patients completed the study. After the intervention, the intervention group had lower APAIS anxiety scores and SDS scores than the control group, and higher total FFMQ scores. Scores for observing, acting with awareness, non-judging, and non-reactivity were also higher in the intervention group. In addition, SBP, DBP, and HR were lower in the intervention group than in the control group (all p < 0.05). Conclusion(s): STM combined with acupressure may improve mindfulness level, relieve preoperative anxiety and depressive symptoms, and help stabilize BP and HR in patients undergoing HVR. These preliminary findings suggest that this combined intervention may be a feasible adjunctive preoperative supportive strategy, but further studies with larger samples and longer follow-up are needed to verify its clinical applicability. Copyright © The Author(s) 2026 <64> Accession Number 2048186020 Title Systematic Review Certainty of Evidence and Procedural Durability of Septal Reduction Therapies in Obstructive Hypertrophic Cardiomyopathy: An Umbrella Review of Meta-Analyses. Source Acta Cytologica. (pp 1-10), 2026. Date of Publication: 2026. Author Simao A.C.; de Oliveira M.B.G.; Menezes Junior A.D.S. Institution (Simao, de Oliveira, Menezes Junior) Faculty of Medicine, Federal University of Goias, Goiania, Brazil (Menezes Junior) Department of Medicine, School of Medical and Life Sciences, Pontifical Catholic University of Goias, Goiania, Brazil Publisher S. Karger AG Abstract Abstract - Introduction: This umbrella review aimed to evaluate the certainty and consistency of the available evidence rather than to provide a new procedural comparison. We synthesized systematic reviews comparing surgical septal myectomy (SM) versus alcohol septal ablation (ASA) for symptomatic obstructive hypertrophic cardiomyopathy (oHCM) to critically assess the certainty of findings. Method(s): An umbrella review of meta-analyses was conducted following Cochrane and PRISMA guidelines. A systematic search of four databases was performed. Methodological quality, risk of bias, and study overlap were assessed. Quantitative synthesis was performed using a random-effects model, and the certainty of evidence was classified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Result(s): Six meta-analyses comprising 31 unique primary studies and 12, 860 patients were included, demonstrating very high study overlap. ASA was associated with a significantly higher risk of reoperation compared to SM, supported by high-certainty evidence. Conversely, for all other outcomes, including mortality and permanent pacemaker implantation, the certainty of evidence was consistently classified as very low due to inconsistency and imprecision. Conclusion(s): High-certainty evidence supports SM as the more durable intervention for oHCM, demonstrated by a reduced need for reoperations. Notably, the evidence for mortality outcomes is of very low certainty, precluding definitive conclusions regarding clinical equivalence or technique superiority. This review identifies current knowledge gaps regarding survival benefits to inform clinical practice and future research. Plain Language Summary Hypertrophic cardiomyopathy is a genetic condition in which the heart muscle becomes abnormally thick. In many patients, this thickening blocks blood flow out of the heart, causing severe symptoms like shortness of breath and chest pain. When medication fails to relieve these symptoms, doctors recommend "septal reduction therapies" to reduce the muscle thickness. There are two main options: septal myectomy (an open-heart surgery to cut away excess muscle) and alcohol septal ablation (a minimally invasive procedure that injects alcohol into a specific artery to shrink the muscle). Patients and doctors often face a difficult choice between these two methods because previous research has shown conflicting results about which is safer or more effective. To address this uncertainty, our study conducted an "umbrella review, " which analyzes all existing systematic reviews to evaluate the quality and certainty of the available medical evidence. We found with high certainty that surgery (myectomy) provides a more durable solution than alcohol ablation. This means that patients who undergo surgery are significantly less likely to need a second procedure in the future. However, regarding safety risks, such as the risk of death or the need for a permanent pacemaker, we found that the current evidence is of low quality and does not definitively prove that one technique is superior to the other. Therefore, while surgery is the most reliable option for long-term relief, the choice of treatment should be individualized based on the patient's specific health needs and preferences. Copyright © 2026 S. Karger AG, Basel <65> Accession Number 651929848 Title Elevated Cardiopulmonary Bypass Flow for Renal Protection in Cardiac Surgery: A Randomized Trial. Source Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 10 Aug 2026. Author Wijk J.; Corderfeldt-Keiller A.; Redfors B.; Lannemyr L. Institution (Wijk, Redfors, Lannemyr) From the Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg and Section of Cardiothoracic Anaesthesia and Intensive Care (Corderfeldt-Keiller) Department of Perfusion, Sahlgrenska University Hospital, Gothenburg, Sweden (Corderfeldt-Keiller) Department of Anaesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Abstract BACKGROUND: Acute kidney injury (AKI) is a common and severe complication after cardiac surgery with cardiopulmonary bypass (CPB). Experimental data suggest that increasing CPB flow beyond standard targets may improve renal oxygenation, but clinical evidence is limited. We hypothesized that increasing CPB flow would attenuate renal injury and improve organ perfusion. METHOD(S): In this single-center, randomized controlled trial, 89 adults undergoing elective cardiac surgery were allocated to either high-flow (2.9 L.min.m-2) or standard-flow (2.4 L.min.m-2) during CPB. Mean arterial pressure (MAP) was maintained at 60 to 80 mm Hg by use of norepinephrine. Primary outcomes were urine biomarkers of renal injury; N-acetyl-beta-d-glucoseaminidase (NAG) and tissue inhibitor of metalloproteinase-2 x insulin-like growth factor binding protein-7 [TIMP-2 x IGFBP-7] levels at 60 minutes post-CPB. Additional outcomes included serum creatinine changes, AKI incidence, perioperative norepinephrine dose, and fluid balance. RESULT(S): High-flow significantly reduced renal injury biomarkers compared to standard-flow, geometric mean ratio for NAG: 0.43; 95% confidence interval (CI), 0.26 to 0.70, P < .001, and [TIMP-2 x IGFBP-7]: 0.46; 95% CI, 0.30 to 0.73; P < .001. Median S-creatinine remained below baseline for the first three postoperative days in the high-flow group, and above baseline in the standard-flow group. AKI incidence was 16% (7/45) in the high-flow group vs 25% (11/44) in the standard-flow group, odds ratio 1.90; 95% CI, 0.64 to 5.60, P = .248. Norepinephrine doses were significantly reduced in the high-flow-group, both intraoperatively and up until 4 hours after CPB. There were no significant differences in fluid balance, bleeding, or adverse events. CONCLUSION(S): Increasing CPB flow by 20% reduced renal injury biomarkers and postoperative creatinine and improved early hemodynamic stability. Further large-scale, multicenter trials are required to validate these findings and determine patient subgroups most likely to benefit. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the International Anesthesia Research Society. <66> Accession Number 2048280261 Title Machine-Learning Versus Traditional Scores for Predicting Outcomes After Coronary Artery Bypass Graft Surgery: A Systematic Review and Meta-Analysis. Source Surgical Innovation. (no pagination), 2026. Date of Publication: 2026. Author Gupta A.K.; Zaka A.; Tyagi D.; Mutahar D.; Parvez R.; Muston B.; Farag M.; Lombardo A.; Eranki A.; Wilson-Smith A.; Song G.; Stretton B.; Kovoor J.G.; Bacchi S.; Ramponi F.; Chan J.C.Y.; Zaman S.; Chow C.; Kovoor P.; Bennetts J.S.; Maddern G.J. Institution (Gupta, Stretton, Kovoor, Bacchi, Maddern) Discipline of Surgery, University of Adelaide, Adelaide, SA, Australia (Zaka, Mutahar) Department of Medicine, Gold Coast University Hospital, Southport, QLD, Australia (Tyagi) School of Medicine, University of Newcastle, Callaghan, NSW, Australia (Parvez) School of Medicine, Bond University, Varsity Lakes, QLD, Australia (Muston, Wilson-Smith) Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, NSW, Australia (Farag, Lombardo) Department of Surgery, Princess Alexandra Hospital, Brisbane, QLD, Australia (Eranki) Department of Cardiothoracic Surgery, Royal Hobart Hospital, TAS, Australia (Song) School of Medicine, Deakin University, Burwood, VIC, Australia (Ramponi) Yale University, New Haven, CT, Australia (Chan) New York University, New York, NY, United States (Zaman, Chow) Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia (Zaman, Chow, Kovoor) Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia (Bennetts) School of Medicine, Monash University, Melbourne, VIC, Australia (Bennetts) Department of Cardiothoracic Surgery, Victorian Heart Hospital, Melbourne, VIC, Australia (Maddern) Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Adelaide, SA, Australia (Maddern) Research, Audit and Academic Surgery, Royal Australasian College of Surgeons, Adelaide, SA, Australia Publisher SAGE Publications Inc. Abstract Background: Coronary artery bypass grafting (CABG) is associated with significant morbidity and mortality. Traditional risk scores, such as the Society of Thoracic Surgery (STS) and EuroSCORE II, have limitations in predicting outcomes, particularly in high-risk patients. Machine learning (ML) models may address these issues by detecting nuanced data patterns not captured by conventional methods. This systematic review and meta-analysis compared the efficacy of ML models with traditional risk scores in predicting outcomes after CABG. Method(s): A comprehensive literature search of records up to August 14th 2025, was conducted using PubMed, Embase, Web of Science, and the Cochrane Library. Studies included used ML algorithms and traditional risk scores to predict all-cause mortality (in-hospital, 30-day, or longer term as reported by each study) following CABG. Data extraction and quality assessment were independently performed by two reviewers. Meta-analyses were conducted using a linear mixed-effects model, with C-statistics as the primary measure of discrimination. Result(s): Twenty-six studies, comprising 565 063 participants, met the inclusion criteria. The pooled C-statistic for ML models was 0.82 (95% CI 0.79-0.85), significantly higher than the 0.73 (95% CI 0.71-0.76) for traditional risk scores (P < 0.0001). The top-performing ML model achieved a C-statistic of 0.98 (CI 0.95-1.00). Calibration was reported inconsistently across studies and was synthesised narratively rather than quantitatively. Where reported, ML calibration was generally adequate but a robust head-to-head comparison with traditional risk scores was not possible. Subgroup analyses revealed consistent superior performance of ML models across various algorithms and covariate sets. Conclusion(s): In this meta-analysis of predominantly internally-validated models, ML approaches showed higher pooled discrimination than traditional risk scores for mortality after CABG. However, given the small number of pooled studies, very high between-study heterogeneity (I2 = 98%), the predominance of high risk-of-bias studies, and the scarcity of external validation, these findings should be interpreted as supporting the promise of ML rather than establishing proof of clinical superiority. Confirmatory prospective, externally validated studies are required before ML can be recommended for routine pre-operative risk stratification. 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). <67> Accession Number 651927872 Title Meta-Analysis of TAVR Versus SAVR in Bicuspid Valve: Mortality, Complications, and Long-Term Outcomes. Source Current cardiology reviews. (no pagination), 2026. Date of Publication: 30 Jul 2026. Author Borra V.; Senapati S.G.; Mahadevan A.; Vempati R.; Tamirisa K.; Borra N.; Ogbu I. Institution (Borra) Department of Internal Medicine, University of Texas Rio Grande Valley, Edinburg, TX, United States (Senapati) Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, United States (Mahadevan) Department of Neurology, University of Utah, Salt Lake City, UT, United States (Vempati) Department of Internal Medicine, Trinity Health, Livonia, MI, United States (Tamirisa) Department of Public Health, Washington University in St. Louis, MO, United States (Borra) Department of Internal Medicine, Sri Venkateswara Institute of Medical Sciences, India (Ogbu) Department of Internal Medicine, Mountainview Hospital, Las Vegas, NV, United States Abstract INTRODUCTION: Bicuspid Aortic Valve (BAV) is the most common congenital heart disease and often causes aortic stenosis in younger adults. There are few prospective randomized trials comparing Transcatheter Aortic Valve Replacement (TAVR) and Surgical Aortic Valve Replacement (SAVR) in BAV patients, since these patients are usually excluded from major studies because of their complex anatomy. A meta-analysis to compare clinical outcomes between TAVR and SAVR in people with BAV was conducted. METHOD(S): PubMed, Google Scholar, and SCOPUS were searched for studies published up to December 2023 that compared TAVR and SAVR in patients with BAV. The main outcomes that were examined were mortality, atrial fibrillation, permanent pacemaker implantation, stroke, respiratory complications, and acute kidney injury. Forward and backward citation searches were also used. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals, and heterogeneity was assessed using the I2 statistic. Sensitivity analyses were performed by removing one study at a time. RESULT(S): The analysis included seven studies with a total of 96,430 BAV patients. Of these, 41,110 had TAVR and 55,320 had SAVR. Patients who had TAVR were less likely to experience in-hospital respiratory complications, bleeding or need for transfusion, and new-onset atrial fibrillation. However, they were more likely to need a permanent pacemaker. There were no significant differences between the groups in short-term mortality, stroke, or acute kidney injury. DISCUSSION(S): Lower peri-procedural morbidity with TAVR likely reflects its minimally invasive nature, whereas higher pacemaker rates may relate to bicuspid valve anatomy and conduction system vulnerability. CONCLUSION(S): TAVR appears to be a reasonable alternative to SAVR in carefully selected BAV patients, but randomized trials and long-term follow-up remain necessary. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net. <68> Accession Number 651931465 Title Utility of polygenic risk score for prediction of dilated cardiomyopathy and modulation of severity of LV dysfunction among cases. Source Orphanet Journal of Rare Diseases. Conference: ERICA ERN Research Conference. Udine Italy. 21(Supplement 1) (no pagination), 2026. Article Number: 248. Date of Publication: 01 Jul 2026. Author Kramarenko D.R.; Jurgens S.J.; Ramo J.T.; Van Orsouw C.A.; Hottenga J.J.; Charron P.; Meder B.; Palotie A.; Daly M.; Ellinor P.T.; Pinto Y.M.; Aragam K.G.; Van Der Crabben S.N.; Amin A.S.; Bezzina C.R. Institution (Kramarenko, Jurgens, Van Orsouw, Pinto, Van Der Crabben, Amin, Bezzina) Amsterdam UMC - Location Academic Medical Center, Amsterdam, Netherlands (Ramo, Palotie, Daly) Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland (Hottenga) Vrije Universiteit Medical Centre (VUMC), Department of Biological Psychology, Amsterdam, Netherlands (Charron) Institute of Cardiometabolism and Nutrition - ICAN, Paris, France (Meder) University Hospital Heidelberg, Department of Medicine III, Heidelberg, Germany (Ellinor, Aragam) Broad Institute, Cardiovascular Disease Initiative, Cambridge, United States (Kramarenko, Amin) ERN-GUARD Heart, Amsterdam, Netherlands Publisher BioMed Central Ltd Abstract Background Dilated cardiomyopathy (DCM) is a predominant cause of heart failure and a leading indication for cardiac transplantation, yet its aetiology remains incompletely elucidated. While rare genetic variants are established as causative factors in familial forms of the disease, recent genome-wide association studies (GWAS) have also underscored the significant contribution of common genetic variation to DCM. Polygenic scores (PGS) constructed from GWAS have demonstrated promise in risk stratification for a range of common diseases and may similarly have value for risk prediction in DCM. However, data regarding the clinical utility of PGS in DCM remains sparse. Purpose We aimed to evaluate the utility of PGS for prediction of DCM and its association with left ventricular ejection fraction (LVEF) and family history. We further aimed to assess the contribution of PGS in DCM patients with established causative rare variants (genotype-positive) and those without (genotype-negative). Methods We used a previously-constructed PGS, which was developed from a GWAS meta-analysis (8387 DCM cases and 939161 controls) and multitrait analysis (MTAG) with cardiac MRI traits. In the present analysis, we calculated PGS for a newly assembled cohort of 978 DCM cases sourced from a major university medical centre and 7207 controls from a national register. To evaluate the clinical utility of PGS, we built logistic(Figure presented) regression models and assessed the association between PGS and DCM status. Subsequently, we performed subgroup analyses, including: (i) individuals of European ancestry, (ii) non-European ancestry, (iii) males, (iv) females, (v) genotype-positive participants(n=193), and (vi) genotype-negative participants (n=294). We then used linear and logistic regression models, respectively, to assess the associations of PGS with LVEF and documented family history of DCM. Results PGS demonstrated a significant enrichment among DCM cases compared to controls (OR per SD 1.93, P = 9.47E-68). This association persisted with consistent edect estimates - ranging from OR 1.5 to 2.2 - across all examined subgroups and demonstrated sudicient statistical significance (all P<1.58E-06) (Figure 1). Genotype-negative cases had a significantly higher PGS compared to genotype-positive individuals (P = 0.0015), although PGS was significantly enriched in both groups as compared to controls. Furthermore, among DCM cases, higher PGS was significantly associated with lower LVEF at rst presentation (P=0.03, beta=-0.5% per SD) (Figure 2). There was no significant association found between PGS and family history. Conclusions PGS is strongly associated with risk of DCM, and may modulate the severity of LV dysfunction among DCM cases. Polygenic burden contributes to DCM risk in both genotype-positive and negative cases, although the contribution is stronger in patients without known causative rare variants. Overall, our results suggest a potential clinical applicability for PGS in DCM risk stratification. <69> Accession Number 651937456 Title Cost-effectiveness analysis of total intravenous vs. inhalation anaesthesia among adults aged >=50 y undergoing major non-cardiac surgery. Source Anaesthesia. (no pagination), 2026. Date of Publication: 12 Aug 2026. Author Frempong S.; Kandiyali R.; Mason J.; Hiller L.; Dunn J.; Booth K.; Moonesinghe R.; Pearse R.; Shelley B.; Jhanji S.; Yeung J. Institution (Frempong, Kandiyali, Mason) Centre of Health Economics, University of Warwick, Coventry, United Kingdom (Hiller, Dunn, Booth, Yeung) Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Moonesinghe) Department of Targeted Intervention, University College London, London, United Kingdom (Pearse) Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom (Shelley) School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom (Jhanji) Department of Anaesthesia, Perioperative Medicine and Critical Care, Royal Marsden NHS Foundation Trust, London, United Kingdom (Jhanji) Division of Radiotherapy and Imaging, Institute of Cancer Research, London, United Kingdom Abstract INTRODUCTION: Total intravenous and inhalational anaesthesia are used widely to maintain general anaesthesia for major non-cardiac surgery, yet their comparative cost-effectiveness remains uncertain. The VITAL trial evaluated clinical outcomes, showing no difference in days alive and at home at 30 days. We conducted an economic evaluation alongside VITAL to determine whether total intravenous anaesthesia offers an economic advantage within the UK NHS. METHOD(S): A within-trial economic evaluation was conducted from the NHS and personal social services perspective over a 6-month time horizon. Resource use was collected from trial records and questionnaires, and health-related quality of life was measured using EuroQol five-dimension five-level instrument at baseline, discharge, 30 days and 6 months. Costs were evaluated using national sources and quality-adjusted life years were calculated using the area under the curve approach. Incremental cost-effectiveness ratios were estimated using imputed datasets, with uncertainty explored through bootstrapping and the probability of cost-effectiveness illustrated using a cost-effectiveness acceptability curve across a range of willingness-to-pay thresholds. RESULT(S): A total of 2507 patients were allocated randomly: 1253 (50%) received total intravenous anaesthesia; and 1254 (50%) inhalational anaesthesia. Mean costs and quality-adjusted life years were similar across groups. Incremental cost was -145 (95%CI -1510-1220) and incremental quality-adjusted life years -0.001 (95%CI -0.008-0.005). Total intravenous anaesthesia showed a 56-57% probability of cost-effectiveness at standard willingness-to-pay thresholds. Sensitivity analyses, including complete-case and societal-perspective models, yielded consistent findings of equivalence. DISCUSSION(S): Total intravenous and inhalational anaesthesia show comparable cost-effectiveness for adults aged >= 50 y undergoing major non-cardiac surgery. Given clinical equipoise and equivalent economic outcomes, anaesthetic choice should continue to be guided by patient factors, clinician expertise and organisational context. Further research may be justified given the large population undergoing major surgery. Copyright © 2026 The Author(s). Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists. <70> Accession Number 651937619 Title The Effect of Repeated Bilateral Deep Parasternal Intercostal Plane Catheter Boluses on Analgesia After Cardiac Surgery: A Randomized Controlled Trial. Source Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 11 Aug 2026. Author Kuuskoski R.A.; Saari T.I.; Karvonen S.I.; Singh B.; Tiainen S.-M.; Rantanen M.J.M.; Kallioinen-Sainio M.J.; Hynninen V.-V.; Uusalo P.I.J.; Loyttyniemi E.; Peltoniemi M.A. Institution (Kuuskoski, Saari, Tiainen, Rantanen, Kallioinen-Sainio, Hynninen, Uusalo, Peltoniemi) From the Department of Anesthesiology and Intensive Care, University of Turku, Turku, Finland (Kuuskoski, Saari, Rantanen, Kallioinen-Sainio, Hynninen, Uusalo, Peltoniemi) Division of Perioperative Services, Intensive Care and Pain Medicine, Turku University Hospital, Turku, Finland (Karvonen) Medical Faculty, University of Turku, Turku, Finland (Singh, Loyttyniemi) Department of Biostatistics, University of Turku, Turku, Finland (Tiainen) Division of Perioperative Services and Intensive Care, Satasairaala Central Hospital, Pori, Finland Abstract BACKGROUND: Median sternotomy for cardiac surgery is associated with significant postoperative pain. We evaluated whether repeated ropivacaine boluses via bilateral deep parasternal intercostal plane (DPIP) catheters improve analgesia after cardiac surgery. METHOD(S): In this randomized, placebo-controlled trial, 120 adult patients undergoing elective coronary artery bypass grafting or heart valve replacement were allocated to receive repeated boluses of either ropivacaine (R) or saline (P) via bilateral DPIP catheters for 72 hours postoperatively. Patients, researchers, and clinical staff were blinded to group allocation. The primary endpoint was postoperative pain intensity, assessed by the visual analog scale or, in sedated patients, the behavioral pain scale. Secondary endpoints included cumulative oxycodone consumption, adverse events, postoperative sedation, and mechanical ventilation. RESULT(S): Pain trajectories over the 72-hour postoperative period did not differ between groups (group x time interaction P = .77 at rest; P = 1.00 with movement). No statistically significant differences were observed between groups in cumulative opioid consumption. For the first 12 hours, the median (95% confidence interval [CI] for median) oxycodone dose was 24 mg (18-27) (P = .55) and from 12 to 24 hours, 24 mg (21-30) in the placebo group and 30 mg (24-39) in the ropivacaine group (P = .32). Corresponding values from 24 to 48 hours were 39 mg (33-45) and 48 mg (39-66) (P = .23), and from 48 to 72 hours 18 mg (12-24) and 24 mg (12-33), respectively (P = .21). Postoperative nausea and vomiting was the most common adverse event, occurring in 38% overall: 18 of 60 (30%) in the placebo group and 28 of 60 (46.7%) in the ropivacaine group, with a higher incidence among ropivacaine-treated valve surgery patients (placebo 9/34 [26.5%] vs ropivacaine 20/33 [60.6%], P = .012). Five patients had symptoms suggestive of local anesthetic systemic toxicity; all cases were self-limiting. Four pneumothoraces occurred, one of which was clearly surgically related. The catheter became dislodged in nine patients. Also, among the dropouts, three patients reported pain during injection of the study drug indicating suboptimal catheter positioning. Postoperative sedation and mechanical ventilation times did not differ between groups. Median (interquartile range and 95% CI for median) time until extubation was 348 minutes (278-412 minutes; CI 337-446 minutes) in the placebo group and 340 minutes (289-539 minutes; CI 400-650 minutes) in the ropivacaine group. CONCLUSION(S): Repeated ropivacaine boluses via DPIP catheters did not improve postoperative pain control or reduce opioid consumption compared with placebo after median sternotomy. Routine use of DPIP catheters after cardiac surgery should therefore be avoided. Further research is warranted to determine whether continuous infusion techniques or selective use in high-risk patients may yield greater benefit. Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the International Anesthesia Research Society. <71> Accession Number 2048312527 Title One-year mortality in patients with pulmonary hypertension undergoing TAVI: a systematic review and descriptive meta-analysis. Source Romanian Journal of Cardiology / Revista Romana de Cardiologie. (no pagination), 2026. Date of Publication: 2026. Author Emara H.; Emara N.; Sadykova A.; Hammoud A.; Emara S. Institution (Emara) Oxford University Hospitals NHS Trust, Oxford University Hospitals NHS Foundation Trust, United Kingdom (Emara) Nadia Emara, Ain Shams University, Egypt (Sadykova) Aigerim Sadykova, Kazan State Medical Academy, Kazanskij gosudarstvennyj medicinskij universitet Ministerstva zdravoohranenia Rossijskoj Federacii, Russian Federation (Hammoud) Ali Hammoud, American University of Beirut, Lebanon (Emara) Shady Emara, Mid Cheshire Hospitals NHS Foundation Trust, United Kingdom Publisher Paradigm Publishing Services Abstract Background: Pulmonary hypertension (PH) is a frequent comorbidity in severe aortic stenosis (AS) and is associated with poorer outcomes following transcatheter aortic valve implantation (TAVI). This study aims to provide a descriptive synthesis of 1-year all-cause mortality rates among TAVI recipients with pre-existing PH. Objective(s): To characterise 1-year all-cause mortality rates in patients with PH undergoing TAVI, to assess the impact of study quality on reported mortality and to explore sources of heterogeneity in reported outcomes. Design(s): Systematic review and descriptive meta-analysis. Data Sources: MEDLINE, Embase, Scopus, Web of Science and Cochrane CENTRAL were searched from inception to 18 September 2024, without language restrictions. Eligibility Criteria: Observational cohorts reporting >=1-year mortality after TAVI in patients with PH defined by echocardiography or right-heart catheterisation. Systematic reviews were included for qualitative synthesis only. Data Extraction and Synthesis: Two reviewers independently extracted the data and assessed the quality (Newcastle-Ottawa Scale [NOS]). A random-effects meta-analysis with logit transformation was used to pool 1-year mortality estimates from observational cohorts. Heterogeneity was quantified by I2; subgroup and sensitivity analyses were performed, stratified by study quality and PH definition. Result(s): Eleven observational cohorts (N = 10,665 patients) were included in the quantitative synthesis. Pooled 1-year mortality was 24.5% (95% CI 20.0%-29.6%; I2 = 96.7%). High-quality studies (NOS >= 8) showed 23.7%, while moderate-quality (NOS 6-7) showed 26.2%. Substantial heterogeneity was observed, influenced by variations in PH definition and measurement modality. Systematic reviews (n = 6) provided additional qualitative context on the association between PH and TAVI outcomes. Conclusion(s): Patients with PH undergoing TAVI exhibit high 1-year mortality rates, with approximately one in four dying within a year. Marked heterogeneity underscores differences in PH definitions and measurement. Standardised PH assessment and right-heart phenotyping are essential for improved risk stratification and patient selection, and to enable more robust prognostic studies in the future. Copyright © 2026 Haytham Emara et al. <72> Accession Number 2048229916 Title Interventions for Silent Brain Infarction and Perioperative Neurocognitive Disorders in Cardiovascular Surgery (INSPIRE): study protocol for a multicentre randomised controlled trial. Source BMJ Open. 16(6) (no pagination), 2026. Article Number: e116246. Date of Publication: 01 Jun 2026. Author Wang L.; Li S.; Devereaux P.J.; Lv H.; Li T.; Zhang L.; An Y.; Chen J.; Wei C.; Zhao L.; Peng Y.; Shi J. Institution (Wang, Lv, Li, Zhang, Shi) Department of Anaesthesiology, Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China (Li, Peng) Department of Anaesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (Li, Peng) Outcomes Research Consortium, Houston, Texas, United States (Devereaux) World Health Research, Population Health Research Institute, Departments of Health Research Methods, Evidence and Impact, and Medicine, McMaster University, Hamilton, ON, Canada (An, Zhao) Department of Anaesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, China (Chen) Department of Anaesthesiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Wei) Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China Publisher BMJ Publishing Group Abstract Introduction: The incidence of silent brain infarction (SBI) and perioperative neurocognitive disorders (PND) is higher in cardiac surgery. However, standard preventive strategies remain unknown due to limited evidence. Methods and analysis: This multicentre, prospective, randomised controlled clinical trial with a 1-year follow-up includes patients undergoing elective cardiac surgery with cardiopulmonary bypass (CPB). 912 participants are randomly assigned 1:1 into either the intervention group with neuroprotective anaesthesia targets (mean arterial pressure 65-90 mm Hg, bispectral index 40-60, bilateral regional cerebral oxygen saturation >=60%, arterial inflow temperature <37 and rewarming rate <0.5/min after exceeding 30 during CPB) or the control group maintained by anaesthetists according to routine care. The primary outcome is the 7-day incidence of new-onset SBI. The key secondary outcome is the 30-day incidence of PND. The secondary outcomes include the 5-day incidence of postoperative delirium, the 30-day incidence of new-onset overt stroke, the 1-year incidence of new-onset overt stroke, the 30-day incidence of transient ischaemic attack (TIA), the 1-year incidence of TIA, the 1-year incidence of PND, the 30-day and 1-year composite incidence of major adverse events (renal insufficiency, myocardial infarction, pulmonary embolism, seizure, all-cause mortality), length of stay (LOS) in intensive care unit, LOS in hospital and hospitalisation cost. Ethics and dissemination: The trial was approved by the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital (Approval No. 2024-2445) and all participating centres. We will disseminate the trial findings in peer-reviewed journals and present the results at national or international conferences. Trial registration number: NCT07048002. Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/. <73> Accession Number 2048248025 Title Surgical outcomes, medical management, accessibility to pediatric cardiac care, and survival in Indian tertiary centers: A Systematic review. Source International Journal of Life Sciences Biotechnology and Pharma Research. 15(8) (pp 186-201), 2026. Date of Publication: 01 Aug 2026. Author Arora V.; Kumar S.; Duggal M. Institution (Arora, Kumar, Duggal) Department of Pediatrics, Kalpana Chawla Government Medical College, Karnal, India Publisher International Journal of Life Sciences Biotechnology and Pharma Research Abstract Background: Congenital heart disease (CHD) remains the most common congenital anomaly worldwide and is a leading contributor to childhood morbidity and mortality. India accounts for one of the largest global burdens of pediatric CHD due to its high birth rate, delayed diagnosis, unequal healthcare distribution, and limited accessibility to specialized cardiac centers. Although remarkable advances in pediatric cardiac surgery have significantly improved survival, disparities in healthcare infrastructure, socioeconomic factors, and delayed referrals continue to adversely affect outcomes. Medical management remains an important component of patient stabilization and long-term care; however, evidence comparing its effectiveness with definitive surgical intervention within the Indian healthcare system remains fragmented. Objective(s): To systematically evaluate the available evidence on surgical and medical management outcomes, accessibility to pediatric cardiac care, and survival among children with congenital heart disease treated in Indian tertiary healthcare centers. Method(s): A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Published studies evaluating pediatric congenital heart disease managed in Indian tertiary-care hospitals were reviewed. Data relating to surgical outcomes, perioperative and medical management, mortality, survival, healthcare accessibility, referral pathways, socioeconomic determinants, and healthcare infrastructure were extracted and synthesized qualitatively. Evidence from multicenter studies, systematic reviews, observational cohorts, and institutional experiences was critically appraised to identify common determinants influencing clinical outcomes. Result(s): The available literature consistently demonstrated that surgical correction remains the definitive treatment for the majority of congenital heart defects, producing substantial improvements in survival and long-term quality of life. Contemporary Indian data report an overall pooled in-hospital surgical mortality of approximately 5.6%, with lesion-specific mortality varying according to disease complexity. Mortality was consistently influenced by delayed diagnosis, advanced disease at presentation, malnutrition, pulmonary vascular disease, postoperative complications, and limited access to specialized pediatric cardiac services. Medical management primarily served as a supportive strategy for hemodynamic stabilization, heart failure control, infection management, and perioperative optimization rather than definitive therapy. Significant disparities in healthcare accessibility persisted between urban and rural populations owing to financial constraints, inadequate referral systems, shortage of trained pediatric cardiac specialists, and unequal geographic distribution of tertiary cardiac centers. Government-funded health insurance schemes and structured referral programs have improved access to surgery in selected regions but remain insufficient to meet the national demand. Conclusion(s): Despite substantial progress in pediatric cardiac surgery across India, survival outcomes continue to be influenced by delayed diagnosis, inequitable healthcare accessibility, and socioeconomic disparities rather than surgical expertise alone. Strengthening early screening programs, expanding pediatric cardiac centers, improving referral networks, enhancing multidisciplinary perioperative care, and establishing comprehensive national outcome registries are essential to further reduce mortality and improve long-term survival among Indian children with congenital heart disease. Copyright ©2026 Int. J. Life Sci. Biotechnol. Pharma. Res. <74> Accession Number 2048219408 Title Great debate: surgical aortic valve replacement is first choice for aortic stenosis in patients with a life expectancy beyond 5 years. Source European Heart Journal. 47(30) (pp 4086-4099), 2026. Date of Publication: 07 Aug 2026. Author Doenst T.; Prendergast B.; Allen C.J.; Barili F.; Falk V.; Kirov H.; Patterson T.; Redwood S.; Baumgartner H. Institution (Doenst, Kirov) Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University of Jena, Jena, Germany (Prendergast, Redwood) Cardiology Department, Cleveland Clinic London, London, United Kingdom (Prendergast, Allen, Patterson, Redwood) Cardiology Department, St Thomas' Hospital, London, United Kingdom (Allen) Cedars-Sinai Medical Center, Smidt Heart Institute, Los Angeles, CA, United States (Barili) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Barili) University Cardiac Surgery Unit, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy (Falk) Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany (Baumgartner) Department of Cardiology III-Adult Congenital and Valvular Heart Disease, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, Muenster, Germany Publisher Oxford University Press Abstract Transcatheter aortic valve implantation (TAVI) is increasingly used for the treatment of aortic stenosis. Recently published guidelines favour now TAVI in all patients 70 years or older who have tricuspid valves and suitable anatomy. However, while a number of randomized controlled trials confirm that TAVI and surgical aortic valve replacement (SAVR) provide equivalent outcomes up to 5 years, data beyond 5 years are still scarce and real-world registry data report indeed conflicting results. Higher rates of complications after TAVI such as pacemaker requirement and paravalvular regurgitation, which have been shown to be associated with worse outcome may become more relevant after 5 years and still favour surgery on long-term. In addition, long-term durability data for TAVI are still insufficient. Thus, the question whether SAVR should still be the first choice for patients with a life expectance beyond 5 years is therefore justified. This debate summarizes the pros and cons for this claim. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <75> Accession Number 2048219441 Title Conduction disturbances after transcatheter aortic valve implantation. Source European Heart Journal. 47(30) (pp 4032-4054), 2026. Date of Publication: 07 Aug 2026. Author Maznyczka A.; Pilgrim T.; Philippon F.; Rodes-Cabau J.; De Backer O. Institution (Maznyczka) The Heart Centre, Rigshospitalet, Inge Lehmanns Vej 7, Copenhagen, Denmark (Pilgrim) Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Philippon, Rodes-Cabau) Institut Universitaire de Cardiologie et de Pneumologie de Quebec, Laval University, Quebec City, QC, Canada (Rodes-Cabau) Cardiology Department, Institut Clinic Cardiovascular, Clinic Barcelona, Barcelona, Spain (De Backer) The Heart Centre, Rigshospitalet, Copenhagen, Denmark (De Backer) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark Publisher Oxford University Press Abstract Conduction disturbances and permanent pacemaker implantation remain the most common complications after transcatheter aortic valve implantation. The strongest predictors of conduction abnormalities and subsequent permanent pacemaker implantation after transcatheter aortic valve implantation include pre-existing right bundle branch block, a short membranous interventricular septum, deep transcatheter heart valve implantation, and valve type. Importantly, both new permanent pacemaker implantation and new left bundle branch block after transcatheter aortic valve implantation are associated with increased mortality and heart failure hospitalizations. As transcatheter aortic valve indications expand to lower risk and younger populations, with longer life expectancy, strategies to minimize the risk of conduction disturbances and optimize their detection and management become increasingly crucial. Refined transcatheter heart valve implantation techniques may be associated with a reduction in rhythm disturbances after transcatheter aortic valve implantation and anti-inflammatory treatments are under investigation. Ongoing trials are investigating the impact of beta-blocker withdrawal to prevent conduction abnormalities, electrophysiology studies for risk stratification, and conduction system pacing to prevent adverse cardiac remodelling. This review aims to provide an overview of the incidence, pathophysiology, and consequences of conduction disturbances after transcatheter aortic valve implantation, discuss preventive strategies, highlight the relevant ongoing studies, and provide an evidence-based framework for the management of this important clinical issue. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <76> Accession Number 2048181503 Title High-flow nasal cannula oxygen versus facemask ventilation during anesthesia induction in patients undergoing off-pump coronary artery bypass grafting: an exploratory randomized controlled trial. Source European Journal of Medical Research. 31(1) (no pagination), 2026. Article Number: 1108. Date of Publication: 01 Dec 2026. Author Cai Y.; Zheng X.; Jin M.; Lin P.; Li S.; Liu D.; Xie F.; Wang S. Institution (Cai, Zheng, Jin, Lin, Li, Liu, Xie, Wang) Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China Publisher BioMed Central Ltd Abstract Background and objective: Patients undergoing off-pump coronary artery bypass grafting (OPCABG) often have limited cardiopulmonary reserve and may be vulnerable to hypoxemia during anesthesia induction and tracheal intubation. High-flow nasal cannula oxygen therapy (HFNC) allows continuous oxygen delivery during laryngoscopy, whereas facemask ventilation (FMV) provides conventional positive-pressure ventilation before intubation but requires mask removal during airway instrumentation. This exploratory randomized controlled trial compared two standardized oxygenation workflows during anesthesia induction in OPCABG patients, focusing on oxygen reserve and short-term peri-intubation physiological and procedure-related outcomes. Method(s): This single-center, parallel-group, exploratory randomized controlled trial was conducted at a tertiary cardiac center from December 2025 to January 2026. One hundred ASA physical status III-IV adults scheduled for elective OPCABG were randomized 1:1 to the HFNC group or the FMV group. In the HFNC group, 100% oxygen was delivered at 40 L/min for 10 min during preoxygenation and then increased to 60 L/min during apneic oxygenation and laryngoscopy. In the FMV group, patients received 10 min of facemask preoxygenation followed by 3 min of volume-controlled ventilation before intubation; oxygen delivery was interrupted after mask removal. The primary outcome was arterial oxygen partial pressure (PaO<inf>2</inf>) after 10 min of preoxygenation. Secondary outcomes included arterial blood gas parameters, end-tidal gas concentrations, hemodynamic variables, comfort, and procedure-related safety events. Result(s): All 100 randomized patients were included in the analysis. PaO<inf>2</inf> after preoxygenation was higher in the HFNC group than in the FMV group [374.0 (64.8) vs. 280.7 (58.1) mmHg; mean difference, 93.3 mmHg; 95% CI, 68.9-117.7; P < 0.001]. The lowest EtO<inf>2</inf> within 2 min after intubation was also higher in the HFNC group [84.4 (3.0)% vs. 77.8 (4.3)%; mean difference, 6.6%; 95% CI, 5.1-8.1; P < 0.001]. At completion of intubation, PaCO<inf>2</inf> was modestly higher and pH was slightly lower in the HFNC group. Peri-intubation hemodynamic variables were broadly similar between groups. Two patients in the HFNC group required rescue facemask ventilation for oxygen desaturation; both recovered promptly and were successfully intubated. No severe hemodynamic instability, refractory new-onset arrhythmia, or failed intubation was observed. Conclusion(s): During anesthesia induction in high-risk patients undergoing OPCABG, HFNC preoxygenation achieved an oxygen reserve at least comparable to that provided by conventional facemask preoxygenation, with higher PaO<inf>2</inf> after preoxygenation and better preservation of early post-intubation EtO<inf>2</inf>. However, HFNC does not replace effective alveolar ventilation and may be associated with mild CO<inf>2</inf> retention and a decrease in pH; rescue facemask ventilation may still be required in selected patients. HFNC may be considered a feasible adjunctive oxygenation strategy, but its clinical value and safety require further validation in larger multicenter studies. Trial registry This trial was registered at the Chinese Clinical Trial Registry (ChiCTR) on 27 November 2025 with the registration number ChiCTR2500113370. The full trial protocol and statistical analysis plan can be accessed through the Chinese Clinical Trial Registry (ChiCTR) (https://www.chictr.org.cn/). Copyright © The Author(s) 2026. <77> Accession Number 2048007165 Title Sodium-Glucose Cotransporter-2 Inhibitors in Valvular Heart Disease: From Mechanistic Insights to Clinical Application. Source Journal of the Society for Cardiovascular Angiography and Interventions. (no pagination), 2026. Article Number: 105568. Date of Publication: 2026. Author Allaham H.; Gibson C.M.; Finn A.; Alhaddad I.; Gupta A. Institution (Allaham, Finn, Gupta) Division of Cardiovascular Medicine, Department of Medicine, University of Maryland Medical Center, Baltimore, MD, United States (Gibson) Division of Cardiovascular Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States (Finn) CVPath Institute, Gaithersburg, MD, United States (Alhaddad) Division of Cardiovascular Medicine, Jordan Hospital, Amman, Jordan Publisher Elsevier B.V. Abstract Valvular heart disease encompasses a diverse group of hemodynamic disorders that are frequently associated with heart failure, recurrent hospitalizations, and substantial morbidity despite advances in transcatheter and surgical therapies. Sodium-glucose cotransporter-2 (SGLT2) inhibitors have emerged as a cornerstone of cardiovascular and renal disease management, demonstrating consistent benefits across a broad range of patient populations. Beyond their established effects in heart failure, diabetes mellitus, and chronic kidney disease, accumulating evidence suggests that SGLT2 inhibitors may favorably influence key biological pathways involved in valvular heart disease, including inflammation, oxidative stress, fibrosis, endothelial dysfunction, and adverse cardiac remodeling. Preclinical and translational studies have provided mechanistic support for a potential role of SGLT2 inhibition in modifying valvular and myocardial disease processes. Emerging clinical evidence suggests possible benefits across several forms of valvular heart disease, including degenerative aortic stenosis, functional mitral regurgitation, tricuspid regurgitation, rheumatic mitral stenosis, and bioprosthetic valve degeneration. In addition, growing interest has focused on the integration of SGLT2 inhibitors into contemporary structural heart practice, particularly among patients undergoing transcatheter aortic valve replacement, transcatheter edge-to-edge repair, and other structural interventions. This narrative review summarizes the mechanistic rationale, current clinical evidence, and practical considerations surrounding the use of SGLT2 inhibitors in valvular heart disease and structural heart interventions. We discuss the strengths and limitations of the existing literature, identify important gaps in knowledge, and highlight future directions for research aimed at defining the role of SGLT2 inhibitors as an adjunctive therapy in structural heart disease. Copyright © 2026 The Author(s). <78> Accession Number 2048323516 Title Interpreting Contemporary PCI for Diabetes and Multivessel Coronary Disease After FREEDOM. Source Journal of the American College of Cardiology. 88(8) (pp 828-830), 2026. Date of Publication: 25 Aug 2026. Author Fuster V.; Vazirani R. Institution (Fuster, Vazirani) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fuster, Vazirani) Centro Nacional de Investigaciones Cardiovasculares Carlos III (Carlos III National Center of Cardiovascular Research), Madrid, Spain Publisher Elsevier Inc. <79> Accession Number 2048182122 Title Coronary Artery Bypass Grafting Based on Computed Tomography-Derived Fractional Flow Reserve vs Angiography (CABG-COREA trial): Early Results. Source Annals of Thoracic Surgery. (no pagination), 2026. Date of Publication: 2026. Author Kim M.-S.; Ryu A.-J.; Kim J.W.; Lee C.H.; Hwang S.W.; Kim K.-B. Institution (Kim, Kim, Lee, Hwang, Kim) Cardiovascular Center, Myongji Hospital, Gyeonggido, South Korea (Kim) Hanyang University College of Medicine, Seoul, South Korea (Ryu) AiMEDiC, Seoul, South Korea Publisher Elsevier Inc. Abstract Background This randomized trial was designed to compare 1-year outcomes in patients who received revascularization on the basis of computed tomography-derived fractional flow reserve (CT-FFR) vs quantitative coronary angiography (QCA). In this early analysis, early angiographic and clinical outcomes were compared. Methods A total of 106 patients were randomized to undergo coronary artery bypass grafting on the basis of CT-FFR (n = 53) or QCA (n = 53). Complete revascularization was achieved for coronary arteries with CT-FFR <=0.78 (CT-FFR group) or those with QCA stenosis (>70% stenosis for left and >=90% stenosis for right coronary artery territories; QCA group). Angiography was performed at median 1 (1-1) postoperative day in all patients. Angiographic findings of graft flow were categorized as perfectly patent, competitive (bidirectionally or unidirectionally competitive), or occluded. Results There were no differences in patient characteristics between the groups. The average number of revascularized coronary arteries per patient was 3.7 +/- 0.8 in the CT-FFR group and 3.5 +/- 0.7 in the QCA group ( P = .089). The median difference in expected anastomosis sites was 2 (1-3). There was no operative mortality and no difference in morbidities between the groups. The number of perfectly patent, bidirectionally competitive, and unidirectionally competitive grafts was 167 (85.2%), 10 (5.1%), and 19 (9.7%), respectively, in the CT-FFR group (n = 196) and 133 (72.7%), 23 (12.6%), and 27 (14.8%), respectively, in the QCA group (n = 183). There was a significant difference in the number of perfectly patent grafts between the groups ( P = .007). Conclusions The average number of distal anastomoses was similar between the groups. However, the number of competitive grafts was significantly reduced in the CT-FFR group compared with the QCA group. Copyright © 2026 The Society of Thoracic Surgeons. <80> [Use Link to view the full text] Accession Number 2048199629 Title Effect of Pre-operative Intravenous Crystalloid Bolus on Post-Induction Blood Pressure - a randomized blinded intervention trial. Source Anesthesiology. (no pagination), 2026. Date of Publication: 2026. Author Eichinger M.; Reiterer C.; Eichlseder M.; Pichler A.; Taschner A.; Horvath K.; Essber H.; Freidorfer D.; Adamowitsch N.; Hantakova N.; Heri A.; Heuschneider L.; Graf A.; Fraunschiel M.; Bornemann-Cimenti H.; Kabon B.; Fleischmann E.; Bayer A.; Hodl M.; Wild G.; Eckhardt A.; Reisinger A.C.; Kurz A. Institution (Eichinger, Eichlseder, Pichler, Essber, Freidorfer, Heri, Heuschneider, Bornemann-Cimenti, Bayer, Hodl, Wild, Eckhardt, Kurz) Division of Anesthesiology and Intensive Care Medicine 1, Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Graz, Austria (Eichinger, Reiterer, Eichlseder, Pichler, Essber, Freidorfer, Kabon, Fleischmann, Kurz) Outcomes Research, Texas, United States (Reiterer, Taschner, Horvath, Adamowitsch, Hantakova, Kabon, Fleischmann) Medical University of Vienna, Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Division of General Anaesthesia and Intensive Care Medicine, Vienna, Austria (Graf) Medical University of Vienna, Institute of Medical Statistics, Centre for Medical Data Science, Vienna, Austria (Fraunschiel) Medical University of Vienna, IT Services and Strategic Information Management, Vienna, Austria (Reisinger) Division of Intensive Care Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria Publisher Lippincott Williams and Wilkins Abstract Background: - Post-induction hypotension in major non-cardiac surgery is common and a modifiable risk factor for adverse outcomes. There is an ongoing debate whether pre-operative crystalloid fluid administration can reduce the incidence or severity of post-induction hypotension. This study aims to assess whether a pre-operative intravenous crystalloid bolus reduces post-induction hypotension in high-risk patients under general anesthesia. Method(s): - This was a prospective, randomized, single-blind clinical trial conducted at two centers in Austria (Medical University of Graz, Medical University of Vienna). Adult patients aged 45 years and older with cardiovascular risk factors undergoing major surgery were enrolled and randomly assigned to receive a pre-operative crystalloid bolus within 60 +/- 15 minutes before anesthetic induction, or to receive standard care. The primary outcome was the time-weighted average mean arterial pressure of <65 mmHg within the first 20 minutes after induction or until surgical incision. Result(s): - Of the 504 patients analyzed (247 in the intervention group and 257 in the control group), no statistically significant difference in median time-weighted average of the mean arterial pressure <65 mmHg was observed (Intervention group: 0.0 mmHg (IQR 0.0-0.56); Standard of Care group: 0.0 mmHg (IQR 0.0-0.84, p=0.368). Conclusion(s): - In this blinded randomized clinical trial, administering a crystalloid fluid bolus within 60 minutes before surgery did not significantly reduce the time-weighted average of a mean arterial pressure less than 65 mmHg compared to standard care in patients with cardiovascular risk factors undergoing major non-cardiac surgery. Our study suggests that administering crystalloids before surgery does not prevent post-induction hypotension. Copyright 2026 <81> Accession Number 2048168169 Title Multimodal opioid-free anesthesia containing esketamine versus opioid-based anesthesia: a systematic review and meta-analysis. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 471. Date of Publication: 01 Dec 2026. Author Fang Y.; Gao M.; Wang X.; Zheng B.; He M.; Zeng X.; Shi Y.; Li L.; Zhang B.; Xu Y.; Gong X. Institution (Fang, Zheng, He, Zeng, Shi, Li, Zhang, Xu) Department of Pain, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, 5 Lu men Avenue, Xiang Zhou District, Hubei Province, Xiangyang City, China (Gao) Department of Anesthesiology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, China (Wang, Gong) Department of Anesthesiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, 5 Lu men Avenue, Xiang Zhou District, Hubei Province, Xiangyang City, China Publisher BioMed Central Ltd Abstract Introduction: The paradigm shift toward opioid-free anesthesia (OFA) is gaining traction, yet evidence regarding specific viable alternatives remains fragmented. This meta-analysis comprehensively evaluates the efficacy and safety of multimodal OFA regimens containing esketamine compared to traditional opioid-based anesthesia (OBA). Method(s): This study conducted a systematic review and meta-analysis by searching the electronic databases PubMed, The Cochrane Library, Web of Science, and Embase, including randomized controlled trials published from inception to September 20, 2024. The included studies had to feature at least one OFA group (defined as a multimodal regimen containing esketamine), where opioids were not used during the preoperative phase, anesthetic induction, intraoperative maintenance, or before anesthesia recovery. Result(s): A total of 14 RCTs (1,703 patients) were analyzed. Regarding the primary outcomes, postoperative pain scores at 24 h (MD = -0.07; 95% CI: -0.27, 0.13; moderate certainty) and 48 h (MD = 0.00; 95% CI: -0.29, 0.30; moderate certainty) showed no statistically significant differences between the groups. However, multimodal OFA regimens containing esketamine demonstrated a reduced risk of chronic postoperative pain based exclusively on data from only two thoracic surgery trials (RR = 0.64; 95% CI: 0.44, 0.92; low certainty). Regarding secondary outcomes, the OFA group showed a significantly lower incidence of intraoperative hypotension (RR = 0.29; 95% CI: 0.17, 0.49; high certainty) and postoperative nausea and vomiting (PONV) (RR = 0.47; 95% CI: 0.27, 0.79; high certainty). No statistically significant differences were detected in extubation time, PACU length of stay, rescue analgesia requirements, or the incidence of nightmares or hallucinations. Notably, substantial statistical heterogeneity was observed across several outcomes, including pain scores, PONV, extubation time, and PACU length of stay. Conclusion(s): Multimodal OFA regimens containing esketamine provide comparable postoperative analgesia to opioid-based anesthesia while reducing PONV and intraoperative hypotension. However, these findings represent combined multimodal effects across heterogeneous settings, and potential benefits for chronic pain prevention should be viewed strictly as hypothesis-generating. Trial registration: PROSPERO ID: CRD42024588900 Copyright © The Author(s) 2026. <82> Accession Number 2048191351 Title The Battle of the Shunts: A Systematic Review and Meta-Analysis of Cryopreserved and Antibiotic-Preserved Saphenous Vein Homografts Versus Polytetrafluoroethylene Grafts for Systemic-to-Pulmonary Artery Shunts in Pediatric Patients. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Wahba A.; El-Helbawy A.; Hanna F.; Kandil A.H.; Said S.M. Institution (Wahba) From the Department of Cardiothoracic Surgery, Faculty of Medicine, Port Said University, Port Said, Egypt (El-Helbawy) Faculty of Medicine, Helwan University, Cairo, Egypt (Hanna) Faculty of Medicine, Kasr-Alainy, Cairo University, Cairo, Egypt (Kandil) Faculty of Medicine, Benha University, Benha, Egypt (Wahba, Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Westchester Medical Center and Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, United States (Said) Department of Cardiothoracic Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt Publisher Lippincott Williams and Wilkins Abstract Abstract: Polytetrafluoroethylene (PTFE) grafts are the most widely used conduits for systemic-to-pulmonary artery shunts in pediatric patients with congenital heart disease requiring supplemental pulmonary blood flow, yet they carry well-documented risks of thrombosis, neointimal hyperplasia, and seroma formation. Saphenous vein homografts (SVH), available as cryopreserved or antibiotic-preserved preparations, have emerged as a biological alternative, but no prior meta-analysis has compared these conduit types. We systematically searched PubMed, Scopus, Web of Science, and Google Scholar from inception through 2026, identifying 16 studies (3 comparative, 13 single-arm, and 684 patients). Double-arm meta-analysis employed fixed-effect risk ratios (RR) with generalized linear mixed model sensitivity analysis; single-arm proportional meta-analysis used Freeman-Tukey double arcsine transformation. In the double-arm analysis (235 patients), SVH was associated with significantly lower early shunt thrombosis compared to PTFE [RR 0.29; 95% confidence interval (CI): 0.08-0.96; P = 0.04; I2 = 0.0%), confirmed by sensitivity analysis (odds ratio 0.25; P = 0.03). No significant differences were observed in overall mortality (RR 1.00; 95% CI: 0.44-2.24), infection (RR 0.68; 95% CI: 0.05-9.13), or catheter-based reintervention (RR 0.86; 95% CI: 0.52-1.42). Single-arm analyses showed similar early mortality (SVH 9% vs PTFE 11%) and stenosis rates (both 8%). GRADE certainty was very low to low for all outcomes. SVH is associated with significantly reduced early shunt thrombosis without increased mortality or reintervention; however, the low certainty of evidence underscores the need for adequately powered multicenter randomized trials with standardized perioperative protocols. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <83> Accession Number 2048090976 Title Early versus delayed percutaneous coronary revascularization in patients with concomitant sepsis and non-ST elevation myocardial infarction. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Golzarian H.; Tabares D.; Kalidas A.; Hamideh M.; Shah A.; Janjua A.; Tatapudi S.; Elbey M.; Khan Z.; Niknam N.; Patel D.; Almahmoud M.; Mgbemena O.N. Institution (Golzarian, Elbey, Khan, Niknam, Almahmoud, Mgbemena) Department of Cardiovascular Disease, HCA Houston Healthcare - Kingwood/University of Houston College of Medicine, Houston, TX, United States (Tabares, Kalidas, Hamideh, Janjua, Tatapudi, Patel) Department of Internal Medicine, HCA Houston Healthcare - Kingwood/University of Houston College of Medicine, Houston, TX, United States (Shah) Department of Internal Medicine, Baptist Hospitals of Southeast Texas, Beaumont, TX, United States Publisher Elsevier Inc. Abstract Background The prognosis of patients with concomitant sepsis and severe coronary artery disease (CAD) who develop acute myocardial infarction (AMI) is poor. While percutaneous coronary intervention (PCI) can improve survival in AMI during and post sepsis, the decision is complex due to high mortality rates and increased risk of complications. The optimal timing of intervention for these patients, once clinically indicated, remains controversial, with specific recommendations for revascularization lacking in current guidelines. This retrospective analysis investigates and compares clinical outcomes of early PCI strategy (<72 h from diagnosis of MI) versus delayed PCI strategy (>=72 h) in patients who were hospitalized with sepsis and concomitantly developed AMI. Methods This multicenter retrospective study included 217 hospitalized patients with sepsis and AMI who underwent PCI after sepsis treatment, from January 2016 to May 2024. Patients with ST-elevation myocardial infarctions and non-obstructive CAD were excluded. Of these, 75 patients received early PCI, and 142 underwent delayed PCI. We analyzed in-hospital all-cause mortality, major cardiovascular events, progression to shock, length of stay, and readmission rates at 45 days and 1 year. Results The mean peak serum troponin I level in the early revascularization cohort was higher (13.1 ng/mL vs. 7.8 ng/mL; P < 0.01). Baseline characteristics were otherwise similar. There was significantly higher all-cause mortality (16% vs. 3.5%; P < 0.01) associated with early PCI in patients with concomitant sepsis. However, a delayed invasive strategy was associated with a 28% longer length of stay (14.6 days vs. 11.4 days) and a greater likelihood of progression to shock (RR 1.41). There were no major differences in 45-day and 1-year readmission rates between the cohorts. Conclusions In patients with non-ST elevation myocardial infarction in the context of sepsis, early PCI was associated with higher all-cause mortality compared to delayed PCI. The delayed PCI cohort had longer lengths of stay; however, these findings may be attributable to the lower mortality in this group. This study suggests that in select patients with concomitant MI and sepsis, it may not be unreasonable to prioritize treating the sepsis prior to attempting revascularization. However, major limitations exist in the study and a randomized controlled trial is warranted to further investigate these findings. Copyright © 2026 Elsevier Inc. <84> Accession Number 2048160335 Title Dapagliflozin and Acute Kidney Injury Following Cardiac Surgery: A Randomized Clinical Trial. Source JAMA. (no pagination), 2026. Date of Publication: 2026. Author Oosterom-Eijmael M.J.P.; Hulst A.H.; Monteiro de Oliveira N.P.; Niesten E.D.; Wietsma N.E.; Gerritse B.M.; Scohy T.V.; Rettig T.C.D.; Snellen F.T.F.; Voogd M.F.; Godfried M.B.; de Boer R.N.; Wink J.; van der Werff L.M.M.; Cobbaert C.M.; Ruhaak L.R.; Eberl S.; Preckel B.; Hollmann M.W.; Schenk J.; Hermanides J.; van Raalte D.H. Institution (Oosterom-Eijmael, Hulst, Eberl, Preckel, Hollmann, Hermanides) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands (Oosterom-Eijmael, van Raalte) Department of Endocrinology, Amsterdam University Medical Center, Amsterdam, Netherlands (Oosterom-Eijmael, Hulst, Preckel, Hollmann, van Raalte) Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, Netherlands (Hulst) Amsterdam Gastroenterology Endocrinology Metabolism Research Institute, Amsterdam, Netherlands (Monteiro de Oliveira, Niesten, Wietsma) Department of Anesthesiology, Medisch Spectrum Twente, Enschede, Netherlands (Gerritse, Scohy, Rettig) Department of Anesthesiology and Intensive Care, Amphia Hospital, Breda, Netherlands (Snellen) Department of Anesthesiology and Intensive Care, Isala Clinics, Zwolle, Netherlands (Voogd) Department of Anesthesiology, Medisch Centrum Leeuwarden, Leeuwarden, Netherlands (Godfried, de Boer) Department of Anesthesiology, OLVG, Amsterdam, Netherlands (Wink, van der Werff) Department of Anesthesiology, Leiden University Medical Center, Leiden, Netherlands (Cobbaert, Ruhaak) Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, Netherlands (Preckel, Hollmann, Hermanides) Amsterdam Public Health Research Institute, Quality of care, Amsterdam, Netherlands (Schenk) Department of Intensive Care, Amsterdam University Medical Center, Amsterdam, Netherlands (Schenk) Department of Epidemiology and Data Science, Amsterdam University Medical Center, Amsterdam, Netherlands Publisher American Medical Association Abstract IMPORTANCE Two percent to 50% of patients undergoing elective cardiac surgery experience acute kidney injury (AKI) postoperatively. Medications to prevent AKI after elective cardiac surgery have not been identified. OBJECTIVE In patients undergoing elective cardiac surgery, to evaluate whether initiating dapagliflozin 1 day prior to surgery reduces the incidence of AKI at 7 days after cardiac surgery, compared with placebo. DESIGN, SETTING, AND PARTICIPANTS Multicenter, double-blind, placebo-controlled randomized clinical trial conducted at 2 academic medical centers and 5 nonacademic hospitals in the Netherlands. Eligible participants were adults undergoing elective cardiac surgery. Enrollment occurred between June 8, 2023, and January 27, 2025. Final follow-up occurred May 16, 2025. INTERVENTION Patients were randomized 1:1 to receive either dapagliflozin (10 mg orally; n = 392) or placebo once daily (n = 392), beginning on the day before surgery and continuing through the second postoperative day (total of 4 doses). MAIN OUTCOME AND MEASURE The primary outcome was the between-group difference in AKI (defined as an increase in serum creatinine level by at least 0.3 mg/dL [26.5 mumol/L] within 48 hours after surgery, a 1.5-fold creatinine increase within 7 days of surgery, or urine output less than 0.5 mL/kg/h for 6 to 12 hours according to Kidney Disease: Improving Global Outcomes criteria) during the first 7 postoperative days. RESULTS Of 784 participants enrolled, 778 (99%) completed follow-up testing (median age, 68 [61-74] years; 76% male; 97% White; median body mass index, 27 [IQR, 25-30]; and median estimated glomerular filtration rate, 80 [IQR, 67-89] mL/min/1.73 m2). Compared with placebo, dapagliflozin reduced the incidence of AKI (28% vs 52%; relative risk, 0.54 [95% CI, 0.45-0.65]; P <.001) over 7-day follow-up after surgery. Atrial fibrillation and reoperation were the most frequent adverse events. The incidence of atrial fibrillation was 45% (176/392) in the dapagliflozin group vs 45% (176/392) in the placebo group, and the incidence of reoperation was 11% (43/392) vs 10% (39/392), respectively. CONCLUSIONS AND RELEVANCE In patients undergoing elective cardiac surgery, 4 doses of dapagliflozin, beginning the day before surgery, reduced the incidence of AKI during the 7-day postoperative period. Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <85> Accession Number 2048090966 Title De-escalation of antiplatelet therapy to evaluate platelet reactivity and clinical outcomes after coronary stenting in patients at high bleeding risk and recent acute coronary syndrome: Rationale and design of the DESC-HBR trial. Source Cardiovascular Revascularization Medicine. (no pagination), 2026. Date of Publication: 2026. Author Costa F.; Vizzari G.; Zecchino S.; Galli M.; Montalto C.; Carciotto G.; Quadri G.; Vergallo R.; Castriota F.; Soraci E.; Magliarditi A.; Giudice S.L.; Iuvara G.; Munafo A.; Giannino F.; Pallante F.; Franzino M.; Teresi L.; Piccolo R.; Varbella F.; Musumeci G.; Di Bella G.; Ortega-Paz L.; Angiolillo D.J.; Micari A. Institution (Costa) Cardiology Department, University Hospital Virgen de la Victoria, Instituto de Investigacion Biomedica de Malaga (IBIMA), Malaga, Spain (Costa) Centro de Investigacion Biomedica en Red en Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Costa, Vizzari, Carciotto, Giudice, Iuvara, Giannino, Pallante, Di Bella, Micari) Department of Biomedical and Dental Sciences and of Morphological and Functional Images, University of Messina, Messina, Italy (Zecchino, Varbella) Division of Cardiology, Interventional Unit-Infermi Rivoli Hospital, Turin, Italy (Galli) Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy (Galli, Castriota) Maria Cecilia Hospital, GVM Care & Research, Cotignola, Italy (Montalto, Munafo) De Gasperis Cardio Center, Interventional Cardiology Unit, Niguarda Hospital, Milan, Italy (Quadri, Musumeci) Interventional Cardiology Unit, A.O. Ordine Mauriziano, Turin, Italy (Vergallo) Interventional Cardiology Unit, Cardiothoracic and Vascular Department (DICATOV), IRCCS Azienda Ospedaliera Metropolitana, Largo R. Benzi, 10, Genoa, Italy (Soraci, Magliarditi) U.O.S. Emodinamica, Department of Medicine, Ospedale Barone Romeo di Patti, Messina, Italy (Franzino) Cardiology Department, Sant'Andrea Hospital, Vercelli, Italy (Teresi) Cardiovascular Department, Clinical and Interventional Arrhythmology, ARNAS Ospedale Civico Di Cristina Benfratelli, Palermo, Italy (Piccolo) Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy (Ortega-Paz, Angiolillo) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Zecchino, Varbella) San Luigi Gonzaga University Hospital, Turin, Italy (Montalto, Munafo) School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (Vergallo) Department of Internal Medicine and Medical Specialties (DIMI), University of Genoa, Genoa, Italy Publisher Elsevier Inc. Abstract Background Patients at high bleeding risk (HBR) presenting with acute coronary syndrome (ACS) and treated with percutaneous coronary intervention (PCI) have competing hazards of ischemic and bleeding events. In unselected ACS populations, trials of unguided de-escalation of P2Y<inf>12</inf> inhibition reduce bleeding without excess ischemia; however, HBR patients were largely underrepresented in these studies. Comparative evidence across multiple de-escalation regimens in this vulnerable cohort is currently lacking. Study design DESC-HBR is a prospective, multicenter, randomized, open-label trial with blinded endpoint adjudication enrolling 200 HBR patients (PRECISE-DAPT >=25 or ARC-HBR criteria) at 30 +/- 7 days after ACS-PCI. Following one month of dual antiplatelet therapy (DAPT) with prasugrel 10 mg once daily or ticagrelor 90 mg twice daily, on a background of aspirin 100 mg, patients are randomized (1: 1:1:1) to clopidogrel 75 mg once daily, prasugrel 5 mg once daily, ticagrelor 60 mg twice daily, or continuation of full-dose potent therapy. The primary endpoint is the proportion of patients achieving optimal platelet reactivity (VerifyNow PRU 85-208) at 14 +/- 2 days post-randomization, 2-h after maintenance dose. Key secondary outcomes include BARC bleeding, net adverse clinical events, quality of life and adherence. Pharmacodynamic profiling incorporates VerifyNow and Total Thrombus Formation Analysis (T-TAS). A total sample of 200 patients allows >80% power to detect superiority of each de-escalation arm versus control (alpha = 0.017). Conclusions DESC-HBR is the first randomized trial directly comparing multiple P2Y<inf>12</inf> inhibitor de-escalation strategies in HBR patients post-ACS. By integrating pharmacodynamic, clinical, and patient-reported outcomes, it will provide information to guide individualized antiplatelet strategies balancing ischemic protection and bleeding mitigation in HBR patients. Clinical trial registration unique identifier NCT05903976 , EudraCT 2023-000029-10. Copyright © 2026. Published by Elsevier Inc. <86> Accession Number 2048132297 Title Efficacy and safety of thoracoscopic surgery in pediatrics: a systematic review and meta-analysis. Source Journal of Pediatric Endoscopic Surgery. (no pagination), 2026. Date of Publication: 2026. Author Brohi A.R.; Fatima N.; Momna F.N.U.; Saddique M.N.; Momin S.M.; Sawaira F.N.U.; Jalal A.A.; Hussain S.H.; Rehman M.A.; Yousaf S.; Ahmed S.; Ahmed A. Institution (Brohi) Institute of Mother and Child Health, IMCH, Nawabshah, Pakistan (Fatima, Momna) People's University of Medical and Health Sciences for Women, Nawabshah, Pakistan (Saddique, Yousaf) King Edward Medical University, Lahore, Pakistan (Momin, Hussain) Nowshera Medical College, Nowhera, Pakistan (Sawaira) Khyber Girls Medical College, Peshawar, Pakistan (Jalal) Jinnah Sindh Medical University, Karachi, Pakistan (Rehman) Bacha Khan Medical College, Mardan, Pakistan (Ahmed) Sir Salimullah Medical College, Dhaka, Bangladesh (Ahmed) Liaquat University of Medical Health Sciences, Jamshoro, Jamshoro, Pakistan Publisher Springer Abstract Background: Respiratory diseases are a major cause of pediatric morbidity and mortality, with congenital thoracic malformations such as congenital pulmonary airway malformations (CCAM), bronchopulmonary sequestration, and congenital lobar emphysema (CLE) contributing significantly. Thoracoscopic surgery has emerged as a minimally invasive alternative, offering shorter hospital stays, faster recovery, and comparable long-term outcomes. Method(s): A comprehensive search was conducted through PubMed, Embase, Scopus, and Cochrane databases for relevant literature from inception up to May 2025. Eleven studies focusing on the efficacy and safety of thoracoscopic surgery were included. Risk of Bias assessment using the Newcastle-Ottawa Scale (NOS). The outcomes were pooled as untransformed proportions with 95% confidence interval (CI) using a random effect model. A p value of less than 0.05 was considered significant. All the calculations were performed using OpenMetaAnalyst 3.1. Result(s): This meta-analysis included 11 studies with 715 patients of mean age 2 weeks to 18 years, associated with CCAM, ClE, emphysema, and empyema undergoing lobectomy, segmentectomy, and atypical resection. Thoracoscopy was associated with mean operative time (min) 168.90 (95% CI [120.43-217.36]), hospital stay (days) 5.48 (95% CI [4.40-6.56]), blood loss (ml) 44.40 (95% CI [9.71-79.08]), persistent respiratory symptoms 0.16 (95% CI [- 0.06 to 0.38]), chest tube duration (days) 3.15 (95% CI [2.463-3.84]) and conversion to thoracotomy 4.9% (95% CI [0.7-9.1]). Conclusion(s): Our findings suggest that thoracoscopic surgery promises as a reliable minimally invasive approach in pediatric thoracic surgery. Higher quality, multicentre trials and longitudinal studies with larger sample sizes are required to establish conclusive evidence. Copyright © The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd. 2026. <87> Accession Number 2048144521 Title Percutaneous Coronary Intervention Prior to Transcatheter Aortic Valve Implantation: A Bayesian Meta-analysis of Randomized Controlled Trials. Source Canadian Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Batista P.G.; Albino dos Santos Silva R.R.; Malik M.; Gaelzer G.C.; Montenegro M.V.; Fischer Bacca C.O.; Giorgi J. Institution (Batista) Federal University of Paraiba, Paraiba, Joao Pessoa, Brazil (Albino dos Santos Silva) Federal University of Ceara, Ceara, Fortaleza, Brazil (Malik) Beth Israel Deaconess Medical Center, Boston, MA, United States (Gaelzer) Pontifical Catholic University of Parana, Parana, Curitiba, Brazil (Montenegro) University of Pernambuco, Pernambuco, Recife, Brazil (Fischer Bacca) University Center for the Development of Alto Vale, Santa Catarina, Rio do Sul, Brazil (Giorgi) Hospital Sirio Libanes, Sao Paulo, Sao Paulo, Brazil (Giorgi) Albert Einstein Hospital, Sao Paulo, Sao Paulo, Brazil Publisher Elsevier Inc. Abstract Background The optimal management of concomitant coronary artery disease (CAD) during transcatheter aortic valve implantation (TAVI) remains controversial because of conflicting data from randomized controlled trials (RCTs). Methods A systematic review and Bayesian meta-analysis of RCTs (through April 2026) compared pre-TAVI percutaneous coronary intervention (PCI) vs conservative management in TAVI patients with CAD. Effect measures were risk ratios (RRs) with 95% credible intervals (CrIs) using a Bayesian random effects model. Results Three RCTs involving 1156 patients were included, with 579 (50%) randomized to pre-TAVI PCI. No evidence of benefit was observed for myocardial infarction (RR, 0.83; 95% CrI, 0.44-1.60), all-cause mortality (RR, 0.92; 95% CrI, 0.62-1.35), acute kidney injury (RR, 1.01; 95% CrI, 0.41-2.73), rehospitalization (RR, 1.08; 95% CrI, 0.67-1.75), cardiovascular death (RR, 0.74; 95% CrI, 0.44-1.24), or stroke (RR, 0.71; 95% CrI, 0.42-1.20). Although pre-TAVI PCI was associated with fewer subsequent revascularizations (RR, 0.27; 95% CrI, 0.11-0.66), this outcome is vulnerable to ascertainment and treatment bias. Conversely, point estimates favored conservative management for major bleeding (RR, 1.57; 95% CrI, 0.96-2.57). Conclusions Pre-TAVI PCI yielded no hard clinical benefits and likely increased major bleeding risk. Although it reduced subsequent revascularizations, a soft, clinician-driven endpoint, this did not improve hospital-free survival. These findings strongly support a selective, lesion-guided approach over routine intervention. Registration PROSPERO CRD420261364736. Copyright © 2026 Canadian Cardiovascular Society. <88> Accession Number 2048100780 Title Esketamine improves postoperative sleep quality in thoracic surgery patients with preoperative sleep disturbance: a randomized controlled trial. Source Frontiers in Pharmacology. 17 (no pagination), 2026. Article Number: 1843977. Date of Publication: 01 Jun 2026. Author Wang X.; Wang H.; Luo H. Institution (Wang, Wang, Luo) Xiangyang NO.1 People's Hospital, Hubei University of Medicine, Xiangyang, China Publisher Frontiers Media SA Abstract Objective - To investigate the effect of multiple intraoperative subanesthetic doses of esketamine on postoperative sleep quality in non-cardiac thoracic surgery patients with preoperative sleep disturbance. Methods - This was a prospective single-center, double-blind placebo-randomized controlled trial of 100 patients undergoing elective non-cardiac thoracic surgery under general anesthesia with preoperative sleep disturbance who were given 0.25 mg/kg esketamine at induction of anesthesia and cutaneous suture compared with placebo to prevent the occurrence of postoperative sleep disturbance. Primary outcomes were the incidence of postoperative sleep disturbance on postoperative day 1, as assessed by Numeric Rating Scale, Athens Insomnia Scale and RCSQ. Secondary outcomes included the incidence of postoperative sleep disturbance on postoperative day 3 and 5, sleep duration, proportion of deep sleep, proportion of rapid eye movement sleep, postoperative pain score, postoperative anxiety score and depression score, intraoperative hemodynamic parameters and blood biomarkers (IL-6, IL-10, and brain-derived neurotrophic factor). Result - A total of 100 patients were randomized to the control group and the esketamine group. The incidence of postoperative sleep disturbance in the esketamine group was significantly lower than in the control group on POD 1 (50%vs 82%; odds ratio [OR], 0.2 [95% CI, 0.1-0.5]; P = 0.001) and POD 3 (22%vs 42%; OR, 0.4 [95% CI, 0.2-0.9]; P = 0.032). And there were significant differences in sleep duration, proportion of deep sleep and proportion of REM sleep (Based on exploratory Fitbit-derived estimates) on postoperative day 1 and 3. By POD 5, the difference was no longer statistically significant. Postoperative pain scores at rest and during movement were significantly lower in the esketamine group immediately after surgery and on postoperative day 1 compared with the control group, with no significant differences on postoperative days 3 and 5. Anxiety and depression scores (HADS) were significantly lower in the esketamine group on postoperative days 1, 3, and 5. Intraoperative hemodynamic parameters demonstrated higher systolic and mean arterial pressures in the esketamine group during anesthesia induction (T2) and lower pressures and heart rate during extubation (T6), indicating attenuated hypotension at induction and blunted stress response at extubation. Intraoperative sufentanil consumption was significantly lower in the esketamine group. Compared with preoperative levels, serum IL-6 concentrations increased in both groups on POD 1, 3, and 5; however, the esketamine group exhibited lower IL-6 levels than the control group on POD one and POD 3, with the difference attenuating by POD 5. Serum IL-10 levels were elevated on POD 1, 3, and five in the esketamine group and were significantly higher than those in the control group at all three time points. Serum BDNF concentrations were increased relative to baseline on POD 1, 3, and five in both groups, and were consistently higher in the esketamine group than in the control group across all postoperative assessments. Subgroup analyses demonstrated that intraoperative esketamine consistently reduced the incidence of postoperative sleep disturbance across predefined subgroups stratified by age, sex, PSQI score, and ASA classification, with no significant interaction effects observed. Conclusion - Multiple intraoperative infusion of 0.25 mg/kg esketamine can effectively improve the postoperative sleep quality of non-cardiac thoracic surgery patients with preoperative sleep disturbance, reduce the incidence of postoperative sleep disturbance, reduce the use of opioids, reduce the occurrence of intraoperative hypotension events, reduce the stress response during extubation, maintain the stability of intraoperative hemodynamics, reduce postoperative pain, and relieve adverse emotions. Moreover, esketamine decreased the level of the pro-inflammatory cytokine IL-6, increased the level of the anti-inflammatory cytokine IL-10, attenuated the postoperative inflammatory response, and promoted the release of BDNF. Clinical Trial Registration - https://www.chictr.org.cn/bin/project/edit?pid=248681, identifier ChiCTR2500096036. Copyright © 2026 Wang, Wang and Luo. <89> Accession Number 2048295231 Title Efficacy and safety of concomitant left atrial appendage closure and pulmonary vein isolation compared to left atrial appendage closure only - A meta-analysis. Source IJC Heart and Vasculature. 66 (no pagination), 2026. Article Number: 101988. Date of Publication: 01 Oct 2026. Author Rattka I.; Poch C.; Mews T.; Friesacher C.; Jurik N.; Martens E.; Laugwitz K.-L.; Steger A.; Rattka M. Institution (Rattka, Poch, Mews, Friesacher, Jurik, Martens, Laugwitz, Steger, Rattka) School of Medicine and Health, Department of Clinical Medicine-Clinical Department for Cardiology, University Medical Centre, Technical University of Munich, Munich, Germany Publisher Elsevier Ireland Ltd Abstract Background: Atrial fibrillation (AF) is associated with an increased risk of ischemic stroke, primarily originating from the left atrial appendage (LAA). Percutaneous LAA closure (LAAC) reduces appendage-borne thromboembolism, while pulmonary vein isolation (PVI) restores sinus rhythm. Observational data on the combined one-stop procedure are heterogeneous, and data on its risk-benefit profile remain scarce. Thus, a meta-analysis was performed to compare the efficacy and safety of combined LAAC+PVI versus LAAC-only. Method(s): A structured systematic search of PubMed, MEDLINE, Scopus and Web of Science was performed for studies comparing outcomes of AF patients undergoing combined LAAC+PVI or LAAC-only. Result(s): Fifteen studies reporting data from 335,013 patients (11,839 LAAC+PVI; 323,174 LAAC-only) were included. Combined LAAC+PVI was associated with significantly fewer systemic thromboembolisms at follow-up (OR = 0.76, 95% CI = 0.60-0.96, I2 = 1%) compared to LAAC-only. However, periprocedural pericardial effusion requiring drainage was significantly more frequent in the combined group (OR = 1.72, 95% CI = 1.26-2.34, I2 = 0%). Peri-device leaks were significantly less common immediately post-procedure (OR = 0.57, 95% CI = 0.35-0.92, I2 = 19%), but significantly more frequent on follow-up echocardiography (OR = 1.56, 95% CI = 1.14-2.12, I2 = 71%). Mortality, major bleeding, device-related thrombus, and pericardial effusion without drainage did not differ significantly between groups. Conclusion(s): Combined LAAC+PVI was associated with fewer systemic thromboembolisms than LAAC-only, but a higher periprocedural risk of pericardial effusion requiring drainage and divergent temporal behaviour of peri-device leaks. Randomized controlled trials are warranted to confirm these findings. Copyright © 2026 The Author(s) <90> Accession Number 2048285030 Title Machine Learning for Predicting Mortality Following Transcatheter Aortic Valve Replacement: A Scoping Review of Current Literature. Source CJC Open. (no pagination), 2026. Date of Publication: 2026. Author Elsherbini A.H.; Cherif I.A.; Ahmed A.; Haider A.; Alaraki A.; Gemae M.R.; Ansari F.; Harby A.A.; Chaudhary V.; Abu-Omar Y.; El-Diasty M. Institution (Elsherbini, Cherif, Ahmed, Haider) Faculty of Medicine, University of Toronto, Toronto, ON, Canada (Alaraki) Faculty of Health Sciences, Queen's University, Kingston, ON, Canada (Gemae) Department of Opthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada (Ansari) Department of Emergency Medicine, McMaster University, Hamilton, ON, Canada (Harby) The School of Computing, Queen's University, Kingston, ON, Canada (Chaudhary) Computer and Data Sciences, Case Western Reserve University, Cleveland, OH, United States (Abu-Omar, El-Diasty) Harrington Heart and Vascular Institute, Cardiac Surgery Department, University Hospitals, Cleveland, OH, United States Publisher Elsevier Inc. Abstract This scoping review aims to consolidate the current evidence on the use of machine learning (ML) algorithms to predict mortality following transcatheter aortic valve replacement (TAVR) procedures. This review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases, including Medline, Embase, Cochrane, and ClinicalTrials.gov, were searched for studies assessing the use of ML models for the prediction of mortality in patients undergoing TAVR. A total of 1076 citations were screened, of which 21 studies underwent full-text review. Ultimately, 11 studies comprising 101,030 patients were included for data extraction. Study sample sizes ranged from 178 to 54,739 patients, with reported mortality intervals ranging from 30 days to 5 years after surgery. The parameters that were included in these ML models included demographic and clinical variables, electrocardiographic findings, laboratory results, computed tomography scans, and the type and size of the selected TAVR device. A total of 13 ML models were assessed across the included studies. Random Forest appeared to be the highest performing ML model in predicting 30-day and 1-year survival following TAVR, with reported area under the receiver operating characteristic (AUROC) scores ranging from 0.66 to 0.97. In addition, the gradient-boosted machine seemed to outperform the CoreValve and TAVI2-SCORE in predicting 1-year survival. ML models may allow for accurate prediction of mortality following TAVR and may offer advantages over traditional clinical risk scores. However, limited datasets and variability in algorithm metric scores remain the main limitations to the implementation of these models in clinical practice. Copyright © 2026 The Authors <91> Accession Number 2048263937 Title Sepsis and atrial fibrillation: the role of amiodarone, alternative strategies and metabolic therapy. A systematic review. Source Kardiologiya i Serdechno-Sosudistaya Khirurgiya. 19(4) (pp 44-50), 2026. Date of Publication: 2026. Author Simutis I.S.; Semigolovskii N.Y.; Zelenaya E.A.; Danilov M.S. Institution (Simutis, Semigolovskii, Zelenaya, Danilov) Sokolov North West Regional Scientific and Clinical Center of the Federal Medical and Biological Agency, Saint Petersburg, Russian Federation (Semigolovskii) Saint Petersburg State University, Saint Petersburg, Russian Federation (Simutis, Danilov) North Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russian Federation Publisher Media Sphera Publishing Group Abstract Objective. To analyze the role of amiodarone, alternative rhythm and rate control strategies, and metabolic therapy in sepsis-associated atrial fibrillation (AF). Methods. A systematic search was conducted in PubMed/MEDLINE, Embase, Cochrane Library, and RSCI up to January 2026. Randomized controlled trials (RCTs), prospective and retrospective cohort studies (n>=30), and controlled experimental studies in adults with sepsis/septic shock and supraventricular tachyarrhythmias were included. Additionally, RCTs of succinate-containing and metabolic therapies in other critical conditions (acute myocardial infarction, cardiac surgery, stroke, severe traumatic brain injury) evaluating arrhythmic or mechanistically relevant endpoints were considered. Results. New-onset AF in sepsis is associated with a 2- to 3-fold increase in mortality. Amiodarone effectively controls rhythm and rate but does not improve survival in septic shock and carries risks of negative inotropy, hypotension, torsade de pointes, and organ toxicity. In an RCT, propafenone provided faster cardioversion and fewer AF recurrences compared to amiodarone with similar mortality; a survival benefit was observed in patients without significant left atrial dilatation. Short-acting beta1-blockers (esmolol, landiolol) safely control heart rate in hyperdynamic shock. Simultaneous correction of hypokalemia and hypomagnesemia increases the likelihood of spontaneous cardioversion. Succinate-containing infusions (Reamberin) and Cytoflavin in RCTs for critical illness reduce reperfusion arrhythmias and improve left ventricular systolic function. Discussion. Evidence supporting propafenone and beta-blockers is derived from a limited number of RCTs with heterogeneous inclusion criteria. Data on metabolic therapy in sepsis-associated AF are extrapolated from studies in other critical conditions (AMI, COVID-19). Direct multicenter RCTs of succinate-based therapies with arrhythmic endpoints in sepsis are lacking. Conclusion. In sepsis-associated AF, amiodarone should be reserved for patients with significant structural heart disease and left atrial dilatation. Propafenone and short-acting beta1-blockers are preferable alternatives in patients without substantial myocardial remodeling. Succinate-containing and metabolic therapy is pathogenetically justified as an organ-protective adjuvant but requires dedicated RCTs in the sepsis population. Copyright © I.S. Simutis, N.Yu. Semigolovskii, E.A. Zelenaya, M.S. Danilov <92> Accession Number 2038484636 Title Effectiveness of Cardiac Telerehabilitation in Improving Functional Capacity, Quality of Life, and Cardiovascular Outcomes in Patients After Acute Coronary Syndrome and/or Coronary Revascularization (PCI/CABG): A Systematic Review Comparing Telerehabilitation With Traditional Cardiac Rehabilitation. Source Medical Science Monitor. 32 (no pagination), 2026. Article Number: e953366. Date of Publication: 2026. Author Nowaczyk A. Institution (Nowaczyk) Department of Cardiac Rehabilitation and Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun, Bydgoszcz, Poland Publisher International Scientific Information, Inc. Abstract Background: This systematic review evaluates the effectiveness of telerehabilitation via mobile applications compared with conventional cardiac rehabilitation in patients after acute coronary syndrome (ACS) and/or coronary revascularization, including percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). The analysis focuses on physical capacity, quality of life, psychological well-being, health behaviors, cardiovascular and anthropometric parameters, and biochemical outcomes. Material/Methods: This systematic review was conducted in accordance with PRISMA and PICO guidelines. A total of 3674 records were identified through searches of PubMed, Scopus, and Web of Science, of which 12 randomized controlled trials involving 1911 participants were included. The studies evaluated telerehabilitation delivered via mobile or web-based platforms in patients after ACS and/or coronary revascularization (PCI/CABG), compared with structured center-based cardiac rehabilitation or usual care. Result(s): Telerehabilitation was associated with greater improvements in exercise capacity, as measured by the 6-minute walk test and maximal oxygen uptake, adherence to physical activity and dietary recommendations, and selected quality of life and psychological outcomes compared with control conditions (P<0.05). In contrast, cardiovascular risk factors, including blood pressure, body mass index, waist-hip ratio, lipid profile, blood glucose level, and smoking cessation, improved in both groups, with no significant between-group differences (P>0.05). The magnitude of observed effects varied depending on the type of comparator. Conclusion(s): Telerehabilitation appears to be a comparable alternative to traditional cardiac rehabilitation in patients after ACS and/or coronary revascularization (PCI/CABG), with potential benefits in adherence and selected patient-reported outcomes. However, the findings should be interpreted with caution due to heterogeneity in comparator interventions. Copyright © 2026, International Scientific Information, Inc.. All rights reserved. <93> Accession Number 2048129449 Title Direct oral anticoagulant dose vs dual antiplatelet therapy after left atrial appendage closure in patients with nonvalvular atrial fibrillation: a systematic review and meta-analysis. Source Journal of Thrombosis and Thrombolysis. (no pagination), 2026. Date of Publication: 2026. Author Alam U.; Ahmed A.U.; Javed J.; Khan A.; Ansab M.; khan I.; Rafi S.; Mushahid Z.; Nawaz B.; Asif M.A.; Lohana R.; Khan S.N.; Moiz A.; Bibi F.; Aslam B. Institution (Alam) Khyber Medical College, Peshawar, Pakistan (Ahmed, Rafi) Punjab Medical College, Faisalabad Medical University, Faisalabad, Pakistan (Javed) Jinnah Sindh Medical University, Karachi, Pakistan (Khan) Lady Reading Hospital, Peshawar/Nowshera Medical College, Peshawar/Nowshera, Pakistan (Ansab) Services Institute of Medical Sciences, Lahore, Pakistan (khan) FMH College of Medicine and Dentistry, Lahore, Pakistan (Mushahid, Lohana) Dow University of Health Sciences, Karachi, Sindh, Pakistan (Nawaz) Islamic International Medical College, Rawalpindi, Pakistan (Asif) University of Western Ontario, London, Canada (Khan) Azad Jammu and Kashmir Medical College, Muzaffarabad, Pakistan (Moiz) Bacha Khan Medical College, Mardan, Pakistan (Bibi) Jinnah Medical and Dental College, Karachi, Pakistan (Aslam) University of Lahore, Lahore, Pakistan Publisher Springer Abstract Left atrial appendage closure (LAAC) is increasingly used in patients with non-valvular atrial fibrillation (NVAF) who are at high risk of bleeding. However, the optimal post-procedural antithrombotic strategy remains uncertain. This meta-analysis compares the efficacy and safety of direct oral anticoagulants (DOACs) versus dual antiplatelet therapy (DAPT) following LAAC. A systematic review and meta-analysis were conducted according to PRISMA and Cochrane guidelines. PubMed, Embase, and Cochrane were searched from inception to November 2025 for randomized controlled trials and cohort studies comparing DOACs with DAPT after LAAC in NVAF patients. Outcomes included all-cause mortality, cardiac mortality, stroke, major bleeding, device-related thrombosis (DRT), and thromboembolic events. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random- or fixed-effects models as appropriate. Seven studies (3 RCTs and 4 observational studies) comprising 2,103 patients (1,003 DOAC; 1,096 DAPT) were included. DOAC therapy significantly reduced all-cause mortality (RR = 0.55, 95% CI 0.34-0.89), major bleeding (RR = 0.55, 95% CI 0.37-0.81), and device-related thrombosis (RR = 0.46, 95% CI 0.24-0.91) compared with DAPT. No statistically significant differences were observed for stroke, cardiac mortality, or overall thromboembolic events, although effect estimates consistently favored DOACs. Thromboembolic events associated with major bleeding were markedly lower with DOACs (RR = 0.14, 95% CI 0.05-0.36). However, sensitivity analyses restricted to randomized controlled trials did not demonstrate statistically significant benefits for all-cause mortality, major bleeding, or device-related thrombosis. Therefore, the observed overall benefit appeared to be mainly driven by observational studies, and these findings should be interpreted cautiously. DOAC therapy after LAAC may be associated with a favorable clinical profile compared with DAPT, with significant reductions in all-cause mortality, major bleeding, and device-related thrombosis in the overall pooled analysis. However, these benefits were not confirmed in sensitivity analyses restricted to randomized controlled trials and appeared to be primarily driven by observational studies. Therefore, these findings should be interpreted cautiously and should not be used to support a definitive preference for DOACs over DAPT without further adequately powered randomized evidence. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026.

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