Total documents retrieved: 138 Results Generated From: Embase <1980 to 2026 Week 36> Embase Weekly Updates (updates since 2026-08-28) - (138 records) <1> Accession Number 651539341 Title Impact of liposomal bupivacaine parasternal block combined with rectus sheath block on postoperative pain in patients undergoing sternotomy for cardiac surgery: a randomized controlled trial. Source BMC anesthesiology. 26(1) (no pagination), 2026. Date of Publication: 17 Jun 2026. Author Huang Y.; Hong M.; Mao Q.; Liang D.; Liu G.; Huang M.; Zhong H.; Lu Y.; Zhong Y.; Chen Y. Institution (Huang, Hong, Mao, Liang, Liu, Huang, Zhong) Department of Anesthesiology and Operating Center, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China (Lu) Department of Anesthesiology and Operating Center, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China (Zhong) Department of Anesthesiology and Operating Center, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China (Chen) Department of Anesthesiology and Operating Center, First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, China Abstract OBJECTIVE: To compare the effects of liposomal bupivacaine and ropivacaine for ultrasound-guided parasternal block combined with rectus sheath block (PSB + RSB) on acute and chronic postoperative pain in patients undergoing cardiac sternotomy, so as to provide an evidence-based basis for optimizing the multimodal analgesia regimen for such surgeries. <br/>METHOD(S): A total of 90 patients scheduled for elective median sternotomy cardiac and great vessel surgery at the Institute of Cardiovascular Diseases, The First Affiliated Hospital of Guangxi Medical University from April 2024 to February 2025 were enrolled. They were divided into the liposomal bupivacaine group (group LB, n=45) and the ropivacaine group (group ROP, n=45) using the random number table method. After endotracheal intubation under general anesthesia, group LB was given 40 mL of 266 mg liposomal bupivacaine injection for bilateral PSB+RSB, while group ROP was administered 40 mL of 0.375% ropivacaine injection for the same block regimen.The following outcomes were recorded at different postoperative time points: cumulative consumption of analgesic drugs (calculated as morphine milligram equivalents, MMEs), scores of Numeric Rating Scale (NRS, 0-10 points) for pain assessment, scores of Quality of Recovery-15 (QoR-15) scale, and the incidence of adverse events. <br/>RESULT(S): A total of 88 patients completed the study (2 patients in group LB were excluded due to surgical duration exceeding 8 hours). At 24 h and 48 h after the first postoperative awakening, the cumulative MMEs consumption in group LB was significantly lower than that in group ROP [55.30(47.80,62.10) vs 68.00(48.40,80.00) mg, 76.30(68.80, 83.10) mg vs 86.00(63.40,119.60), all P < 0.05]. At 4 h and 12 h post-extubation, the activity-related NRS scores in group LB were significantly lower than those in group ROP [ 2.00(2.00, 2.00) points vs 2.00(2.00,3.00) points, 2.00(2.00,3.00) points vs 3.00(2.00,4.00) points, all P < 0.05]. At 24 h, 48 h and 72 h post-extubation, the QoR-15 scores in group LB were significantly higher than those in group ROP [(85.4+/-11.78) points vs (74.7+/-9.89) points, (91.6+/-10.4) points vs (86.8+/-8.6) points, (107.1+/-9.87) points vs (100.0+/-9.15) points, all P < 0.05]. The incidence of postoperative nausea and vomiting in group LB (16.3%, 7/43) was significantly higher than that in group ROP (2.2%, 1/45) (P < 0.05). There were no significant differences between the two groups in postoperative endotracheal extubation time, ICU stay time, hospital stay, and the incidence of chronic postsurgical pain (CPSP) at 3 months after surgery . <br/>CONCLUSION(S): The use of liposomal bupivacaine for PSB+RSB block in patients undergoing cardiac sternotomy can significantly reduce postoperative analgesic consumption, optimize early analgesic effect, and improve postoperative recovery quality. However, attention should be paid to the risk of nausea and vomiting, and individualized selection should be made after balancing the benefits and risks in clinical application. TRIAL REGISTRATION: Trial registration:This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2400084078) on May 10, 2024 ( https://www.chictr.org.cn/ ).<br/>Copyright © 2026. The Author(s). <2> Accession Number 2048787221 Title Perioperative mechanical ventilation strategies in adult cardiac surgery with cardiopulmonary bypass: a meta-analysis of randomised controlled trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mariotti C.; Guarnieri M.; Lazzari S.; Losiggio R.; Suriano P.; Pedrazzini G.; Stoppe C.; Ke L.; Wang Z.; Zangrillo A.; Landoni G.; Belletti A.; Pontillo D.; D'Amico F.; Labanca R.; Fresilli S.; Bonizzoni M.A.; D'Andria Ursoleo J.; Bugo S.; Redaelli M.B.; Borello M.; Zaraca L.; Mongardini E.; Bruno S. Institution (Mariotti, Lazzari, Losiggio, Zangrillo, Landoni, Belletti) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Guarnieri, Suriano, Pedrazzini) Department of Anesthesia and Intensive Care, IRCCS Centro Cardiologico Monzino, Milan, Italy (Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Stoppe) Department of Cardiac Anaesthesiology and Intensive Care Medicine, Charite, Berlin, Germany (Ke) Department of Critical Care Medicine, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China (Ke) National Institute of Healthcare Data Science, Nanjing University, Jiangsu, Nanjing, China (Wang) Jiangsu Provincial Key Laboratory of Critical Care Medicine, Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China (Zangrillo, Landoni) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Pontillo, D'Amico, Labanca, Fresilli, Bonizzoni, D'Andria Ursoleo, Bugo, Borello, Zaraca, Mongardini, Bruno) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Redaelli) General and Neurosurgical Intensive Care Units, ASST Sette Laghi, Ospedale Di Circolo, Varese, Italy Publisher Elsevier Ltd Abstract Background: Pulmonary complications occur frequently after cardiac surgery. Various intraoperative and perioperative mechanical ventilation strategies were investigated to reduce postoperative lung injury. Evidence of their benefits remains inconclusive. <br/>Method(s): We performed a systematic review and meta-analysis of RCTs investigating ventilation strategies applied during the preoperative, intraoperative, or postoperative period of cardiac surgery requiring cardiopulmonary bypass. The primary outcome was all-cause mortality. Secondary outcomes included the rate of infections, postoperative pulmonary complications, and the duration of mechanical ventilation. <br/>Result(s): We identified 105 RCTs. We conducted a meta-analysis of the 39 studies suitable for quantitative synthesis. Postoperative pulmonary complications were reduced when using ventilation during cardiopulmonary bypass (risk ratio [RR]=0.87; 95% confidence interval [CI]=0.79 to 0.96; P=0.005; I<sup>2</sup>=0%, with 15 studies included). Mortality was 17/414 (4.1%) in patients receiving postoperative noninvasive respiratory support vs 24/377 (6.4%) in control group patients (RR=0.60; 95% CI=0.34 to 1.08; P=0.09; I<sup>2</sup>=0%, with five studies included). Pressure-controlled vs volume-controlled ventilation during surgery and adaptive support ventilation vs conventional ventilation in the postoperative period were not associated with improvements in primary or secondary outcomes. <br/>Conclusion(s): Ventilation strategies in cardiac surgery remain highly heterogeneous regarding protocols and timing. Ventilation during cardiopulmonary bypass significantly reduced postoperative pulmonary complications. Postoperative noninvasive respiratory support showed a non-significant trend toward improved survival and remains hypothesis-generating. Additional evidence is required to validate these results. Registration: PROSPERO registration number CRD420251057156.<br/>Copyright © 2026 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <3> Accession Number 2011486117 Title European Resuscitation Council Guidelines 2021: Executive summary. Source Resuscitation. 161 (pp 1-60), 2021. Date of Publication: 01 Apr 2021. Author Perkins G.D.; Graesner J.-T.; Semeraro F.; Olasveengen T.; Soar J.; Lott C.; Van de Voorde P.; Madar J.; Zideman D.; Mentzelopoulos S.; Bossaert L.; Greif R.; Monsieurs K.; Svavarsdottir H.; Nolan J.P. Institution (Perkins, Nolan) Warwick Clinical Trials Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom (Perkins) University Hospitals Birmingham, Birmingham, United Kingdom (Graesner) University Hospital Schleswig-Holstein, Institute for Emergency Medicine, Kiel, Germany (Semeraro) Department of Anaesthesia, Intensive Care and Emergency Medical Services, Maggiore Hospital, Bologna, Italy (Olasveengen) Department of Anesthesiology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Norway (Soar) Southmead Hospital, North Bristol NHS Trust, Bristol, United Kingdom (Lott) Department of Anesthesiology, University Medical Center, Johannes Gutenberg-University Mainz, Germany (Van de Voorde) Department of Emergency Medicine, Faculty of Medicine Ghent University, Ghent, Belgium (Van de Voorde) EMS Dispatch Center, East-West Flanders, Federal Department of Health, Belgium (Madar) Department of Neonatology, University Hospitals Plymouth, Plymouth, United Kingdom (Zideman) Thames Valley Air Ambulance, Stokenchurch, United Kingdom (Mentzelopoulos) National and Kapodistrian University of Athens Medical School, Athens, Greece (Bossaert) University of Antwerp, Antwerp, Belgium (Greif) Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland (Greif) School of Medicine, Sigmund Freud University Vienna, Vienna, Austria (Monsieurs) Department of Emergency Medicine, Antwerp University Hospital and University of Antwerp, Belgium (Svavarsdottir) Akureyri Hospital, Akureyri, Iceland (Svavarsdottir) University of Akureyri, Akureyri, Iceland (Nolan) Royal United Hospital, Bath, United Kingdom Publisher Elsevier Ireland Ltd Abstract Informed by a series of systematic reviews, scoping reviews and evidence updates from the International Liaison Committee on Resuscitation, the 2021 European Resuscitation Council Guidelines present the most up to date evidence-based guidelines for the practice of resuscitation across Europe. The guidelines cover the epidemiology of cardiac arrest; the role that systems play in saving lives, adult basic life support, adult advanced life support, resuscitation in special circumstances, post resuscitation care, first aid, neonatal life support, paediatric life support, ethics and education.<br/>Copyright © 2021 <4> Accession Number 2048582130 Title Post-Intubation Hypotension After Titrated Induction with Ciprofol versus Propofol in Older Adults Undergoing Non-Cardiac Surgery: A Randomized Controlled Trial. Source Clinical Interventions in Aging. 21 (no pagination), 2026. Article Number: 609412. Date of Publication: 2026. Author Bai H.; Guo J.; Li Y.; Zhang S.; Chen S.; Wang Z.; Lu K.; Zhang L.; Zhong F.; Gong R.; Li J.; Han J.; Song X.; Jin S. Institution (Bai, Guo, Li, Zhang, Chen, Wang, Lu, Zhang, Zhong, Gong, Li, Han, Song, Jin) Department of Anesthesia, The Sixth Affiliated Hospital, Sun Yat-sen University, No. 2, Guangzhou, China (Bai, Guo, Li, Zhang, Jin) Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China Publisher Dove Medical Press Ltd Abstract Purpose: To compare ciprofol with propofol for titrated induction of anesthesia in older adults undergoing non-cardiac surgery, with a focus on post-intubation hypotension and related hemodynamic burden. <br/>Method(s): In this prospective, randomized, double-blind trial, adults aged 65-89 years undergoing elective non-cardiac surgery were randomly assigned in a 1:1 ratio to receive either ciprofol or propofol, following an identical titration-to-effect induction protocol. The primary outcome was post-intubation hypotension, defined as any mean arterial pressure (MAP) <= 65 mmHg during the 15-minute period after successful tracheal intubation and before surgical incision. Secondary outcomes included hypotension burden expressed as area under the curve (AUC), norepinephrine requirement, cardiac output trajectories, time to loss of consciousness, and early postoperative recovery outcomes. <br/>Result(s): 160 patients were randomized. Post-intubation hypotension occurred less frequently in the ciprofol group than in the propofol group (28/77 [36.3%] vs 53/79 [67.0%]; adjusted odds ratio 0.28, 95% confidence interval [CI] 0.15-0.54; P < 0.001), consistent across BIS-adjusted sensitivity analyses. Ciprofol was also associated with a lower AUC for MAP <= 65 mmHg (0.0 [0.0-3.2] vs 2.5 [0.0-14.8] mmHg min; P = 0.047), reduced norepinephrine requirement (0.0 [0.0-10.0] microg vs 10.0 [0.0-20.0] microg; P < 0.001), and milder early cardiac output decline (group-by-time interaction beta = -0.008, 95% CI -0.010 to -0.005; P < 0.001). No significant between-group differences were observed in early postoperative adverse outcomes. <br/>Conclusion(s): In this single-center trial of older adults undergoing non-cardiac surgery, ciprofol-based titrated induction was associated with less post-intubation hypotension, lower rescue vasopressor requirement, and less cumulative hypotensive exposure than propofol, without an apparent increase in early adverse recovery outcomes. These findings suggest a favorable hemodynamic profile of ciprofol, which requires confirmation in larger multicenter studies.<br/>Copyright © 2026 Bai et al. <5> Accession Number 2048819950 Title The Effect of Slow Deep Breathing Relaxation Exercise on Pain and Anxiety Levels During and Post-Chest Tube Removal After CABG. Source Critical Care Nursing Quarterly. 49(4) (pp 392-409), 2026. Date of Publication: 01 Dec 2026. Author Abu Sabiha A.L.; Salameh B.; Alkubati S.A.; Salameh Y. Institution (Abu Sabiha) Men's Surgical Ward, Rafidia Hospital, Palestinian Ministry of Health, Nablus, Palestine (Salameh) Faculty of Nursing, Arab American University, Jenin, Palestine (Alkubati) Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail, Saudi Arabia (Salameh) Faculty of Medicine, Medical Intern, Ain Shams University Hospitals, Ain Shams University, Cairo, Egypt Publisher Wolters Kluwer Health Abstract Chest tube removal after coronary artery bypass graft is frequently reported by patients as stressful and painful, highlighting the need for effective nonpharmacological interventions. Slow deep breathing relaxation exercises (SDBREs) may serve as a simple nursing strategy to reduce discomfort. In this study, we aimed to evaluate the effect of SDBRE on pain and anxiety during and after chest tube removal following coronary artery bypass grafting in Nablus hospitals. An experimental design was used with 80 patients recruited from 2 hospitals. Participants were randomly assigned to either an intervention group (n = 40) that practiced SDBRE or a control group (n = 40) that received standard care. Data were collected through a self-administered questionnaire, the Numeric Pain Scale, and the Visual Anxiety Scale. Data collection occurred from March to October 2024. The intervention group reported significantly lower pain scores during removal (M: 5.325 vs 7.125, P <.001) and after removal (P <.001). Anxiety scores were significantly lower both during and after removal (P <.001). Pain correlated with duration, with more complex operations and prolonged chest tube insertion linked to higher scores. SDBRE significantly reduced pain and anxiety during and after chest tube removal, supporting its integration into routine postoperative nursing care.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <6> Accession Number 2048766799 Title Intraoperative corticosteroid administration and postoperative pulmonary complications: a secondary analysis of the iPROVE clinical trials. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Zorrilla-Vaca A.; Zapata-Pena D.A.; Allen M.B.; Linares M.; Sanahuja P.; Librero J.; Ferrando C. Institution (Zorrilla-Vaca, Zapata-Pena, Allen) Department of Anesthesiology, Mass General Brigham, Brigham and Women's Hospital, Boston, MA, United States (Linares, Sanahuja, Ferrando) Red de Investigacion en Servicios de Salud, Navarrabiomed, Complejo Hospitalario de Navarra, Pamplona, Spain (Librero) Department of Anesthesiology and Critical Care, Hospital Clinic de Barcelona, Barcelona, Spain (Ferrando) Institut D'investigacio August Pi I Sunyer, Barcelona, Spain (Ferrando) CIBER de Enfermedades Respiratorias CIBERES, Instituto de Salud Carlos III, Madrid, Spain Publisher Elsevier Ltd Abstract Background: This study aimed to explore the effect of intraoperative corticosteroid administration at antiemetic doses on postoperative pulmonary complications in adult patients undergoing major surgery. <br/>Method(s): We designed a post hoc analysis of two clinical trials conducted across 30 hospitals that included adult patients undergoing major abdominal or thoracic surgeries. Patients who received intraoperative corticosteroids were identified and balanced with those who did not receive corticosteroids using inverse probability of treatment weighting based on preoperative confounders. The primary outcome was a composite of postoperative pulmonary complications within 30 days after surgery. Generalised mixed-effects models with random intercepts at each hospital were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). <br/>Result(s): A total of 1963 patients were included. Before weighting for potential confounders, the incidence of severe postoperative pulmonary complications was lower in those who received corticosteroids than those who did not (9.3% [107/1142] vs 14.0% [113/821], P=0.002). After weighting, intraoperative corticosteroids were not associated with a significant reduction in the incidence of postoperative pulmonary complications (OR 0.86, 95% CI 0.62-1.18, P=0.347), but there was a modest improvement in partial pressure of oxygen in arterial blood-to-fraction of inspired oxygen ratios in the PACU in those who received intraoperative corticosteroids compared with those who did not (adjusted mean difference 19.9 mm Hg, 95% CI 0.64-39.1, corrected P=0.043). <br/>Conclusion(s): Corticosteroid administration at antiemetic doses in adult patients having major abdominal or thoracic surgery was not associated with a lower incidence of postoperative pulmonary complications. Postoperative pulmonary gas exchange marginally improved in patients receiving intraoperative corticosteroids. Clinical trial registration: NCT03182062 and NCT02798133.<br/>Copyright © 2026 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <7> Accession Number 643013511 Title Impact of carotid artery stenosis on outcomes of transcatheter aortic valve replacement: a systematic review and meta-analysis. Source European Heart Journal. Conference: European Society of Cardiology Congress, ESC 2023. Amsterdam Netherlands. 44(Supplement 2) (no pagination), 2023. Date of Publication: 01 Nov 2023. Author Gibicoski T.B.; Caetano L.; Silva E.P.; Rodriguez F.A.; Scabello I.; Iplinski B. Institution (Gibicoski, Rodriguez) Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil (Caetano) Federal University of Paraiba, Joao Pessoa, Brazil (Silva) Santo Amaro Hospital, Recife, Brazil (Scabello) Joao Pessoa University Center, Joao Pessoa, Brazil (Iplinski) Santa Casa de Misericordia Hospital, Porto Alegre, Brazil Publisher Oxford University Press Abstract Background/Introduction: Carotid Artery Stenosis (CAS) is common in elderly patients undergoing Transcatheter Aortic Valve Replacement (TAVR). However, the impact of CAS on the outcomes of TAVR is unclear. <br/>Purpose(s): This systematic review and meta-analysis aimed to compare the clinical and periprocedural outcomes in patients with and without CAS undergoing TAVR. <br/>Method(s): PubMed, Embase, and Cochrane databases were searched up to February 2023. We included studies that performed a direct comparison of outcomes of TAVR in CAS versus non-CAS patients. Data were extracted from published reports and the ROBINS-I tool was utilised for quality assessment. Review Manager 5.1 was adopted for statistical analysis. A random-effects model was used to calculate a pooled effect size and 95% confidence interval. <br/>Result(s): Five observational studies and 111,915 patients were included. Follow-up ranged from 30 days to 1 year. The mean age was 80.7 +/- 8.2 years and 46.3% were female. The risk of stroke or transient ischaemic attack was elevated in the group of patients with CAS (OR 1.44; 95% CI 1.05-1.99; p=0.02; Figure 1A). Similarly, there was an increased risk of myocardial infarction in the CAS group (OR 1.25; 95% CI 1.06-1.47; p= 0.008; Figure 1B). In contrast, all-cause mortality (OR 0.99; 95% CI 0.71-1.37; p=0.94; Figure 2A) and major bleeding (OR 1.14; 95% CI 0.98-1.32; p=0.08; Figure 2B) were not significantly different between CAS and non-CAS groups. There was also no significant difference in acute kidney injury (OR 0.99; 95% CI 0.79-1.23; p=0.99) and new pacemaker implantation (OR 0.95; 95% CI 0.70-1.30; p=0.76) between patients with and without CAS. <br/>Conclusion(s): Our findings suggest that CAS is significantly associated with cerebrovascular events and myocardial infarction in patients who undergo TAVR, without a significant impact on all-cause mortality. Further prospective studies are needed for a more granular assessment of additional determinants of this association, such as unilateral vs. bilateral involvement and whether there is a threshold of CAS severity for increased risk. <8> Accession Number 645623659 Title Hybrid strategy as an alternative to norwood surgery for hypoplastic left heart syndrome: an updated systematic review and meta-analysis. Source Cardiology in the Young. Conference: 8th World Congress of Pediatric Cardiology and Cardiac Surgery, WCPCCS 2023. Washington, DC United States. 34(Supplement 1) (pp S541-S542), 2024. Date of Publication: 01 May 2024. Author Montana-Jimenez L.P.; Mejia-Quinones V.; Pizarro A.B.; Gempeler A. Institution (Montana-Jimenez, Mejia-Quinones, Pizarro, Gempeler) Fundacion Valle del Lili/ Universidad Icesi, Cali, Valle del Cauca, Colombia Publisher Cambridge University Press Abstract Background: The hybrid procedure (HP) emerged as an alternative for palliation in patients with hypoplastic left heart syndrome (HLHS) with high risk for the Norwood procedure (NP). Existing metanalyses showed better outcomes for NP but did not consider differences in baseline risk in study populations. Studies comparing the two should be synthesized considering baseline confounding and other aspects that determine the certainty of the evidence. <br/>Method(s): We performed a systematic review that followed Cochrane guidelines and PRISMA recommendations (PROSPERO registration CRD42021281510). We searched MEDLINE, EMBASE, LILACS, and Central in October 2021 for randomized controlled trials and observational studies comparing NS and HP for HLHS palliation. Outcomes of interest were mortality (in-hospital, stage 1, late), 1-,3-, and 5-year survival. ROBINS-1 tool was used to assess the risk of bias. We followed the GRADE approach for rating the quality of evidence. <br/>Result(s): We identified 444 articles; 55 were reviewed in full-text. 30 fulfilled selection criteria and were included for quantitative (25 studies included in metanalyses) or narrative synthesis (five studies). All were observational studies. They had overall low risk of bias and metanalyses had no inconsistency or imprecision, but their observational nature determined moderate certainty on the results. Comparison of HP and NP for hospital mortality (RR=1.19 [0.83-1.71], 8 studies, n=486), stage I mortality (RR=0.97[0.78 - 1.22], 9 studies, n=1014 patients), late death (RR=0.37 [0.11 - 1.28], 4 studies, n=205), 1-year survival (RR=0.99, [0.92- 1.06], 17 studies, n=1828), 3-year survival (RR=1.00 [0.93- 1.09], 12 studies, n=1495) and 5-year survival (RR=0.96 [0.85- 1.08], 6 studies, n=630) yielded estimates suggesting no clinically-important differences between the two procedures. <br/>Conclusion(s): HP and NP may be comparable for initial palliation in patients with HLHS regarding intermediate and long-term survival. Certainty is limited by the observational nature although low risk of bias and sufficient precision suggests that clinically important differences in survival are unlikely. Differences in secondary outcomes and additional advantages are to be studied further as they are currently not reported by most of the studies. <9> [Use Link to view the full text] Accession Number 646742084 Title Immediate versus staged percutaneous coronary intervention of nonculprit lesions in patients with st-elevation myocardial infarction and multivessel disease: a meta-analysis of 4,120 patients. Source Circulation. Conference: American Heart Association's 2024 Scientific Sessions and the American Heart Association's 2024 Resuscitation Science Symposium. Chicago, IL United States. 150(Supplement 1) (no pagination), 2024. Date of Publication: 01 Nov 2024. Author Paulino D.; Arbaiza E.A.; Martinez D.N.; Xiloj S.; Hernandez B.; Garcia-Mena L. Institution (Paulino) Universidad Autonoma Metropolitana, Mexico City, Mexico (Arbaiza) Universidad de El Salvador, San Miguel, El Salvador (Martinez) Indiana University, Indianapolis, IN, United States (Xiloj) Universidad de San Carlos de Guatemala, Guatemala, Guatemala (Hernandez, Garcia-Mena) Universidad Nacional Autonoma de Mexico, Mexico City, Mexico Publisher Lippincott Williams and Wilkins Abstract Introduction: Multivessel coronary artery disease is common in patients with ST-segment elevation myocardial infarction (STEMI). Previous trials have shown that comprehensive revascularization of nonculprit arteries with significant stenosis reduces the risks of cardiovascular death, myocardial infarction, and ischemia-driven revascularization compared to culprit-only revascularization. However, the optimal timing for revascularizing non-culprit lesions-immediate versus staged percutaneous coronary intervention (PCI)-remains unclear. This meta-analysis aims to determine if staged or immediate PCI is associated with fewer major adverse cardiovascular events. <br/>Method(s): A meta-analysis was conducted following PRISMA guidelines, with a protocol registered in PROSPERO (CRD42023485163). We included studies from PubMed, Embase, and Cochrane databases until October 10, 2023. Inclusion criteria were: 1) patients over 18 with STEMI and hemodynamically stable multivessel disease; 2) intervention: immediate PCI; 3) comparator: staged PCI; 4) study types: randomized clinical trials (RCTs) and cohort studies. Study quality was assessed using ROBINS-I for observational studies and ROB 2 for RCTs. <br/>Result(s): Nine studies met inclusion criteria: 3 RCTs and 6 cohort studies, with a total of 4,120 patients. Staged PCI was significantly associated with reduced cardiovascular death (RR<sup>2</sup>= 1.77; 95% CI = 1.11- 2.81; p = 0.02, I<sup>2</sup>= 24%) and all-cause mortality (RR<sup>2</sup>= 1.83; 95% CI = 1.19-2.79; p = 0.005, I<sup>2</sup>= 42%). Hazard ratio analysis also favored staged PCI for cardiovascular death (HR<sup>2</sup>= 4.11; 95% CI = 1.07-5.87; p = 0.04, I<sup>2</sup>= 12%) and all-cause mortality (HR<sup>2</sup>= 8.13; 95% CI = 1.01-8.17; p = 0.05, I<sup>2</sup>= 37%). No significant differences were found for major adverse cardiovascular events (RR<sup>2</sup>= 0.98; 95% CI = 0.74- 1.28; p = 0.86, I<sup>2</sup>= 53%) or in major bleeding, stroke, or target vessel revascularization. <br/>Conclusion(s): In patients with STEMI and multivessel disease, staged coronary revascularization is associated with a lower risk of major adverse cardiovascular events, cardiovascular death, and all-cause mortality compared to immediate revascularization, without increasing adverse outcomes. Further research is needed to confirm these findings. <10> Accession Number 643014126 Title A systematic review of the evidence supporting the use of surgical aortic and mitral valves: an update from the CORE MD consortium. Source European Heart Journal. Conference: European Society of Cardiology Congress, ESC 2023. Amsterdam Netherlands. 44(Supplement 2) (no pagination), 2023. Date of Publication: 01 Nov 2023. Author Mcgovern L.; Coughlan J.J.; Siontis G.; Frenk A.; Melvin T.; Mcgauran G.; Geertsma R.; Schnell-Inderst P.; Fraser A.G.; Windecker S.; Byrne R.A. Institution (Mcgovern) Cardiovascular Research Institute (CVRI), Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland (Coughlan) Cardiovascular Research Institute (CVRI)/Mater Private, Dublin, Ireland (Siontis, Frenk, Windecker) Bern University Hospital, Bern, Switzerland (Melvin) Trinity College Dublin, Dublin, Ireland (Mcgauran) Health Products Regulatory Authority (HPRA), Dublin, Ireland (Geertsma) RIVM: National Institute for Public Health and the Environment, Utrecht, Netherlands (Schnell-Inderst) UMIT TIROL, Tirol, Austria (Fraser) University Hospital for Wales, Cardiff, United Kingdom (Byrne) Cardiovascular Research Institute (CVRI), Royal College of Surgeons in Ireland (RCSI)/Mater Private, Dublin, Ireland Publisher Oxford University Press Abstract Introduction: The European Union (EU) Medical Device Regulation (MDR) 2017/745 challenges the medical community to engage with regulators, notified bodies and industry to develop transparent, rigorous and proportionate methods to evaluate the clinical safety and efficacy of medical devices and to monitor their performance. As part of the EU Horizon 2020 funded CORE-MD project, we performed a systematic review of the published scientific evidence available for surgical heart valve replacements for native aortic and mitral valve pathologies. <br/>Purpose(s): The aim of this analysis is to review the scientific evidence available which supports the use of currently available surgical aortic and mitral valves. <br/>Method(s): A systematic literature review was conducted using Ovid, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL). We included only surgical aortic and mitral valves that received CE Mark approval from the year 2000 onwards. We included any study of prospective design (randomised or non-randomised clinical trials of any design) in humans, published between 2000 and 2021. We excluded retrospective studies, case reports, reviews, systematic reviews, meta-analyses, and expert opinion documents. Title and abstract screening, full-text review, risk of bias evaluation and data collection were performed by two authors independently, with disagreements resolved by discussion with a third author. <br/>Result(s): A total of 17 surgical aortic valves and 4 surgical mitral valves were identified based on the CE mark criterion (Figure 1). The initial literature search identified 4901 and 3696 potentially eligible papers in the aortic and mitral valve categories, respectively. Finally, 39 aortic and 3 mitral valve studies were included (Figure 2). The majority of included studies (90%) had a non-randomised, prospective, observational design, with 68% receiving industry funding. The median number of patients included was 295 [interquartile range (IQR): 153, 689] with a median maximum follow up of 24 months [IQR: 12, 60]. Only 50% of the identified studies had a pre-specified registered study protocol and only 5% included a power calculation to estimate the required study size. No study reported patient involvement in the study design and only 15% of studies had a comparator group. Using the ROBINS I AND II assessment tools, 90% of the included studies were classified as having a high or serious risk of bias. <br/>Conclusion(s): The evidence available for currently used surgical aortic and mitral replacement heart valves is largely from small, industry funded, non-randomised controlled trials. The median duration of maximum follow up was only 24 months, the majority of studies were classed as having a high/serious risk of bias and only half had a pre-registered study protocol. These results highlight the limitations of the available scientific evidence supporting the surgical aortic and mitral valves used in current clinical practice. (Table Presented). <11> Accession Number 2038756056 Title Outcomes of Endovascular Repair Confined to the Ascending Thoracic Aorta: A Systematic Review and Meta-Analysis. Source Journal of Vascular Surgery. Conference: ESVS Annual Meeting 2025. Istanbul Turkey. 81(6) (pp 1529), 2025. Date of Publication: 01 Jun 2025. Author de Kort J.F.; Mandigers T.J.; Bissacco D.; Domanin M.; Piffaretti G.; Twine C.P.; Wanhainen A.; van Herwaarden J.A.; Trimarchi S.; de Vincentiis C. Publisher Elsevier Inc. Abstract Objective: High risk, inoperable patients with ascending aortic disease are increasingly managed with thoracic endovascular aortic repair (TEVAR). The aim of this study was to assess the available literature on TEVAR confined to the ascending aorta (a-TEVAR), describing study and patient characteristics, procedural and stent graft details, and outcomes. Data sources: This was a systematic review and meta-analysis. MEDLINE, Web of Science, and Scopus were systematically searched for eligible studies reporting on outcomes after a-TEVAR (PROSPERO ID: CRD42023440826). Eligible studies reported outcomes after a-TEVAR without adjunctive supra-aortic vessel treatment. Review Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was followed. The ROBINS-I and Joanna Briggs Institute Critical Appraisal Checklist were used as quality assessment tools. A Grading of Recommendations Assessment, Development, and Evaluation (GRADE) evidence certainty analysis was performed for the main outcomes. The main outcome was death. A proportional meta-analysis was performed with a mean and 95% confidence interval (CI) for the main outcomes. All articles were included up to 1 January 2024. <br/>Result(s): Ninety four studies were included (19 cohort studies, 75 case reports or series), reporting on 259 patients (57.8% male). The mean age was 69.1 (95% CI 65.0 - 73.1) years and mean follow up 19.6 (95% CI 14.5 - 24.6) months. The most common comorbidity was prior cardiac or thoracic surgery (n = 191). The most frequent indications for a-TEVAR (52.1% urgent a-TEVAR) were type A aortic dissection (43.6%) and pseudoaneurysm (38.6%). The most commonly deployed stent grafts were Gore (44.5%), Cook (23.5%), and Medtronic (17.0%). The in hospital mortality rate was 7.3% (95% CI 4.7 - 11.2%), 30 day mortality rate 7.7% (95% CI 5.1 - 11.6%), and overall mortality rate 17.0% (95% CI 12.9 - 22.0%) during follow up. GRADE showed very low evidence certainty for all outcomes. Eighty eight complications were reported and there was a re-operation rate of 13.1% (95% CI 9.5 - 17.8%). In hospital and 30 day mortality rates for type A dissection were 12.4% (95% CI 7.5 - 19.7%) (n = 14) and 13.3% (95% CI 8.2 - 20.8%) (n = 15), respectively, and for pseudoaneurysm 4.0% (95% CI 1.6 - 9.8%) (n = 4) and 4.0% (95% CI 1.6 - 9.8) (n = 4), respectively. <br/>Conclusion(s): Despite heterogeneous literature and very low GRADE evidence certainty, a-TEVAR seems technically feasible in high risk patients. In addition, there is need for a consensus on when and how to use a-TEVAR and a need for a specific endograft for use in the ascending aorta. <12> Accession Number 646878300 Title Does Heparin Rebound lead to Postoperative Blood Loss in Patients undergoing Cardiac Surgery with Cardiopulmonary Bypass. Source Anesthesia and Analgesia. Conference: 18th World Congress of Anaesthesiologists. Singapore Singapore. 139(6 Supplement 2) (pp 383-385), 2024. Date of Publication: 01 Dec 2024. Author Rijpkema M.; Vlot E.A.; Stehouwer M.C.; Bruins P. Institution (Rijpkema) Medical Centre Leeuwarden, Leeuwarden, Netherlands (Rijpkema, Vlot, Bruins) St. Antonius Hospital, Nieuwegein, Netherlands (Stehouwer) Perfusion Department, St. Antonius Hospital, Nieuwegein, Netherlands Publisher Lippincott Williams and Wilkins Abstract Background and Objectives: Heparin rebound is a common observed phenomenon after cardiac surgery with CPB and is associated with increased postoperative blood loss. However, the administration of extra protamine may lead to increased blood loss as well. Therefore, we want to investigate the relation between heparin rebound and postoperative blood loss and the necessity to provide extra protamine to reverse heparin rebound. <br/>Method(s): We searched PubMed, Cochrane, EMBASE, Google Scholar and Web of Science to review the question: ?Does heparin rebound lead to postoperative blood loss in patients undergoing cardiac surgery with cardiopulmonary bypass.? Combination of search words were framed within four major categories: heparin rebound, blood loss, cardiac surgery and cardiopulmonary bypass. All studies that met our question were included. Quality assessment was performed using the Cochrane risk of bias (RoB2) tool for randomized controlled trials and the risk of bias in non-randomized studies of intervention (ROBINS-I) for non-randomised trials. <br/>Result(s): 4 randomized (Kaul TK et al., 1979; Martin et al., 1992; Pardanani et al., 1970; Purandare et al., 1979) and 17 non-randomized (Abuelkasem et al., 2019; Ellison et al., 1974; Esposito et al., 1983; Galeone et al., 2013; Gollub S, 1967; Gravlee et al., 1992; Ichikawa et al., 2014; Kesteven et al., 1986; Kuitunen et al., 1991; Pifarre et al., 1989; Radulovic V et al., 2015; Shore- Lesserson et al., 1998; Subramaniam et al., 1995; Taneja et al., 2009; Teoh et al., 1993, 2004; Umlas et al., 1983) studies were included. The mean incidence of heparin rebound was 40%. The postoperative heparin levels, due to heparin rebound, were often below or equal to 0.2 IU/mL. We could not demonstrate an association between heparin rebound and postoperative blood loss or transfusion requirements. However the quality of evidence was poor due to a broad variety of definitions of heparin rebound, measured by various coagulation tests and studies with small sample sizes. Discussion and <br/>Conclusion(s): The influence of heparin rebound on postoperative bleeding seems to be negligible, but might get significant in conjunction with incomplete heparin reversal or other coagulopathies. For that reason, it might be useful to get a picture of the entire coagulation spectrum after cardiac surgery, as can be done by the use of a viscoelastic test in conjunction with an aggregometry test. <13> 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. <br/>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. <br/>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. <br/>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.<br/>Copyright © The Author(s) 2026. <14> Accession Number 2048680140 Title Simultaneous Pancreas-Kidney Transplantation Versus Kidney Transplantation Alone in Type 1 Diabetes: Does Pancreas Transplantation Improve Clinical Outcomes? A Systematic Review and Exploratory Meta-Analysis. Source Medical sciences. 14(4) (no pagination), 2026. Article Number: 454. Date of Publication: 01 Aug 2026. Author Bellini M.I.; De Intinis C.; D'Andrea G.; D'Andrea V.; Vichi M. Institution (Bellini, De Intinis, D'Andrea) Sapienza University, Department of Surgery, Rome, Italy (D'Andrea, Vichi) Sapienza University, Department of Statistical Sciences, Rome, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Simultaneous pancreas-kidney transplantation (SPKT) restores both renal function and endogenous insulin secretion in selected patients with type 1 diabetes mellitus (T1DM) and end-stage renal disease (ESRD). Whether SPKT provides superior patient survival, kidney graft outcomes and cardiovascular benefit compared with kidney transplantation alone (KTA) remains debated, particularly when KTA is performed from a living donor. <br/>Method(s): A systematic review was conducted according to PRISMA 2020 guidelines. PubMed/MEDLINE was searched using a predefined strategy including terms related to pancreas transplantation, kidney transplantation alone, T1DM, and ESRD/chronic kidney disease. Eligible studies included adult T1DM/ESRD populations comparing SPKT with KTA, including living-donor kidney transplantation (LDKT) and deceased-donor kidney transplantation (DDKT) and reporting clinically relevant outcomes. Full texts were reviewed and categorized as core comparative evidence, secondary/supportive evidence or excluded records. A quantitative synthesis was additionally performed for studies reporting directly comparable adjusted hazard ratios for patient mortality and kidney graft failure in the SPKT versus LDKT comparison. <br/>Result(s): Nineteen observational studies met the inclusion criteria and were included in the qualitative synthesis. SPKT consistently provided superior metabolic control and insulin independence when pancreas graft function was maintained. Compared with deceased-donor or mixed KTA cohorts, SPKT was frequently associated with more favorable long-term patient survival and cardiovascular outcomes in selected recipients. However, comparisons with LDKT yielded less consistent results, with several registry-based analyses reporting equivalent or superior kidney graft and survival outcomes after living-donor transplantation. Quantitative synthesis of the two studies providing directly comparable adjusted hazard ratios demonstrated a higher risk of patient mortality (HR 1.30, 95% CI 1.10-1.54) and kidney graft failure (HR 1.43, 95% CI 1.24-1.66) following SPKT compared with LDKT. Formal meta-analysis of SPKT versus DDKT was not feasible because of substantial heterogeneity in outcome definitions, statistical reporting methods and follow-up duration across studies. <br/>Conclusion(s): In adults with T1DM and ESRD, successful SPKT provides a durable metabolic advantage and may improve long-term outcomes compared with deceased-donor KTA in selected patients. Across analyses that included all transplanted recipients from the time of surgery (intent-to-treat), early perioperative risk is higher after SPKT but may be offset over time when pancreas graft function is maintained. Evidence does not support a universal survival superiority of SPKT over living-donor kidney transplantation. Our quantitative synthesis of intent-to-treat, transplant-date analyses indicates that LDKT is associated with lower risks of patient mortality and kidney graft failure compared with SPKT when a suitable living donor is available. Treatment decisions should be individualized, considering living-donor availability, anticipated waiting time and dialysis exposure, cardiovascular and surgical risk, and the likelihood of durable pancreas graft function, with greater weight given to contemporary cohorts.<br/>Copyright © 2026 by the authors. <15> Accession Number 2046228246 Title Randomized Clinical Trial Comparing Effects of Pulsatile vs Nonpulsatile Cardiopulmonary Bypass on Neurologic Outcomes. Source Annals of Thoracic Surgery. 122(3) (pp 669-678), 2026. Date of Publication: 01 Sep 2026. Author Rajesh S.; Dayi K.; Lussier M.J.; McKeone D.J.; Halstead E.S.; Kunselman A.R.; Myers J.L.; Undar A. Institution (Rajesh, Dayi, Lussier, McKeone, Halstead, Kunselman, Myers, Undar) Penn State Hershey Pediatric Cardiovascular Research Center, Penn State College of Medicine, Penn State Health Children's Hospital, Hershey, PA, United States (McKeone) Division of Pediatric Critical Care Medicine, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States (Halstead) Division of Pediatric Hematology/Oncology, Division of Pediatric Critical Care Medicine, Penn State College of Medicine, Hershey, PA, United States (Halstead) Department of Molecular and Precision Medicine, Penn State College of Medicine, Hershey, PA, United States (Kunselman) Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, United States (Myers, Undar) Division of Pediatric Cardiology, Department of Pediatrics, Penn State College of Medicine, Hershey, PA, United States (Myers, Undar) Department of Surgery, Penn State College of Medicine, Hershey, PA, United States (Undar) Department of Biomedical Engineering, College of Engineering, The Pennsylvania State University, University Park, PA, United States Publisher Elsevier Inc. Abstract Background The objective of this secondary analysis was to examine the impact of 2 perfusion modalities on S100 calcium-binding protein B (S100B) levels and neural injury outcomes in patients undergoing congenital heart surgery with cardiopulmonary bypass (CPB). Methods Pediatric patients (aged <18 years) were randomly assigned to nonpulsatile or pulsatile perfusion. S100B levels were measured in patients at 5 time points (baseline before incision, 3 to 5 minutes on pump, right before weaning from CPB, 1 hour after CPB, and 24 hours after CPB). All patients were assessed for short-term clinical outcomes and with chart review for postsurgical neural injury: stroke, seizure, white matter injury, developmental delays, behavioral issues, memory loss, unexplained loss of consciousness, hearing impairment, and attention-deficit/hyperactivity disorder. Results A total of 144 consecutive patients were enrolled (70 nonpulsatile, 74 pulsatile). Pulsatile perfusion produced CPB characteristics similar to those of nonpulsatile perfusion and created a greater pulsatility index in the middle cerebral artery and arterial line. S100B levels at all measured time points were similar between both perfusion modalities. A total of 36 patients had neural injuries (15 nonpulsatile, 21 pulsatile). Additionally, S100B levels at all measured time points were similar in patients with and without neural injury. In all groups, S100B levels rose during CPB and were greatest before weaning from CPB and 1 hour after CPB. The 24-hour S100B levels had a weak association with clinical outcomes (0.25 < r <inf> S </inf> <0.5). Conclusions The choice of perfusion modality did not appear to affect S100B levels. Additionally, the measurements of S100B may not be sufficiently sensitive to predict neural injury reliably in patients with congenital heart defects who are undergoing CPB.<br/>Copyright © 2026 The Society of Thoracic Surgeons. <16> Accession Number 2048643739 Title Digital Rhythm Surveillance After Postoperative Atrial Fibrillation in Cancer Survivors: A Cardio-Oncology Survivorship Pathway. Source Medicina (Lithuania). 62(8) (no pagination), 2026. Article Number: 1597. Date of Publication: 01 Aug 2026. Author Kyriakou S.; Georghiou G.P.; Georghiou P.; Kyriakou A.; Georgiou A.; Neokleous M.; Xanthopoulos A.; Triposkiadis F. Institution (Kyriakou, Georghiou) Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom (Georghiou) Department of Surgery, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel (Georghiou, Xanthopoulos, Triposkiadis) School of Medicine, European University Cyprus, Nicosia, Cyprus (Kyriakou) Barking, Havering and Redbridge University Hospitals NHS Trust, London, United Kingdom (Georgiou) Krankenhaus Maria Hilf Krefeld, Duseldorf, Germany (Neokleous) School of Medicine, University of Cyprus, Nicosia, Cyprus Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Postoperative atrial fibrillation (POAF) after cardiac surgery is often managed as a transient inpatient arrhythmia, yet recurrent or silent atrial fibrillation (AF) after discharge may identify persistent atrial vulnerability. This issue is particularly relevant in cancer survivors, whose thrombotic and bleeding risks vary according to cancer activity, treatment exposure, thrombocytopenia, frailty and planned procedures. For this narrative review, PubMed/MEDLINE and Scopus were searched from inception to 16 June 2026, with Google Scholar used for supplementary citation tracking. A total of 50 publications were included in the final narrative synthesis. Direct evidence at the intersection of cancer, cardiac surgery, POAF and digital monitoring remains limited. Accordingly, the proposed "Digital Cancer-POAF Survivorship Pathway" is presented as a conceptual, hypothesis-generating framework, rather than a validated clinical algorithm. Its distinctive contribution is to connect cancer-state phenotyping and treatment-specific arrhythmic risk with post-discharge rhythm surveillance, electrocardiogram (ECG) confirmation, multidisciplinary interpretation, data governance and outcomes for prospective validation. Digital monitoring may increase AF detection; however, whether it reduces stroke, bleeding, readmission, or healthcare utilisation in this population is unknown. Neither a low detected AF burden nor the absence of AF during finite monitoring has been validated as an independent basis for anticoagulation decisions.<br/>Copyright © 2026 by the authors. <17> Accession Number 650948425 Title Direct oral anticoagulants vs dual antiplatelet therapy following left atrial appendage closure in atrial fibrillation. Source Heart rhythm. 23(9) (pp e1947-e1957), 2026. Date of Publication: 01 Sep 2026. Author Kaisaier W.; Xu Z.; Ye M.; Wu Z.; Dong Y.; He J.; Liu C.; Chen Y.; Lip G.Y.H.; Zhu W. Institution (Kaisaier, Ye, Wu, Dong, He, Liu, Zhu) Department of Cardiology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China (Xu) Department of Emergency, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (Chen) Department of Cardiology, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China (Lip) Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiology, Lipidology and Internal Medicine with Intensive Coronary Care Unit, Medical University of Bialystok, Bialystok, Poland Abstract BACKGROUND: Percutaneous left atrial appendage closure (LAAC) is an established alternative to oral anticoagulants for preventing thromboembolic events for selected patients with atrial fibrillation (AF). However, optimal post-procedural antithrombotic therapy remains uncertain, particularly regarding the use of direct oral anticoagulants (DOACs) vs dual antiplatelet therapy (DAPT). <br/>OBJECTIVE(S): This meta-analysis aimed to compare the efficacy and safety outcomes of DOACs vs DAPT in the early post-implant period following LAAC in patients with AF. <br/>METHOD(S): We systematically searched PubMed and Embase until November 2025 to identify randomized controlled trials (RCTs) that compared DOACs with DAPT after LAAC. Efficacy outcomes included device-related thrombosis (DRT), stroke, and all-cause mortality, whereas safety outcomes encompassed major and minor bleeding. Pooled effect estimates were calculated as odds ratios (ORs) with 95% confidence intervals (CIs). Where appropriate, fixed- or random-effects models were applied according to between-study heterogeneity. <br/>RESULT(S): 3 RCTs (ADRIFT, ADALA, ANDES) involving 704 patients (mean age 75.8-78.4 years; 65% males) were included, with 368 assigned to DOAC and 336 to DAPT. Baseline thromboembolic and bleeding risk were high (mean CHA2DS2-VASc 4.0-4.7; mean HAS-BLED 3.5-3.8). Clinical outcomes were evaluated at 2-3 months. Compared with DAPT, DOACs were associated with significantly lower risks of DRT (OR = 0.16; 95% CI: 0.05-0.57), major bleeding (OR = 0.46; 95% CI: 0.26-0.81) and minor bleeding (OR = 0.59; 95% CI: 0.38-0.92). No significant differences were observed in stroke (OR = 0.46; 95% CI: 0.07-3.13) and all-cause mortality (OR = 0.60; 95% CI: 0.23-1.54). <br/>CONCLUSION(S): In randomized trials of patients with AF undergoing LAAC, short-term DOAC-based regimens were associated with lower rates of DRT and fewer bleeding events than DAPT, without differences in stroke or mortality. These findings support DOACs as a favorable short-term antithrombotic option after LAAC in selected patients.<br/>Copyright © 2026. Published by Elsevier Inc. <18> Accession Number 2040499637 Title Long-Term Outcomes and Complications of Pulmonary Valve Replacement: A Meta-Analysis of Mechanical Versus Biological Prostheses. Source Pediatric Cardiology. 47(6) (pp 2534-2543), 2026. Date of Publication: 01 Aug 2026. Author Vahidshahi K.; Mofidi S.A.; Oraee S.; Ghafourian K.; Firouzabadi S.R.; Mohammadi I.; Soltani S.M.; Shayesteh H.; Dastjerdi P.; Ghotbi N.; Abdollahi M.; Meysami A.; Mesdaghi M.; Fatahi S. Institution (Vahidshahi) Modarres Teaching Hospital, Pediatric cardiology ward, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Vahidshahi, Mesdaghi, Fatahi) Research and Intervention Academic leadership (HATAM), Clinical Research Development Center, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Mofidi, Oraee, Ghafourian, Firouzabadi, Mohammadi, Soltani) School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Shayesteh) Student Research Committee, Islamic Azad University, Mashhad Branch, Mashhad, Iran, Islamic Republic of (Dastjerdi) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Ghotbi) Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran, Islamic Republic of (Abdollahi) Medical Student, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Meysami) Medical Student, Tehran University of Medical Science, Tehran, Iran, Islamic Republic of (Mesdaghi) Department of Immunology and Allergy, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Fatahi) Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Springer Abstract This meta-analysis exclusively examines pulmonary valve replacement (PVR) outcomes in congenital heart disease (CHD) patients. CHD affects nearly 1% of live births globally, with a significant subset eventually requiring PVR due to valve dysfunction following primary repair procedures. Choosing between mechanical and biological valves is challenging, as both have significant limitations, including thrombosis, bleeding, degradation, and the need for reoperations. This study systematically evaluates the long-term outcomes and complications of PVR options to provide evidence-based guidance. Its goal is to optimize care and improve outcomes for pediatric CHD patients. This systematic review and meta-analysis followed PRISMA guidelines to compare outcomes and complications of mechanical versus biological PVR in congenital heart disease patients. A comprehensive search was conducted in PubMed, World of Science, and Scopus, screening studies based on defined inclusion and exclusion criteria. Data extraction and analysis were performed independently by two reviewers, with pooled prevalence rates calculated using a random-effects model. Ethical approval was not required as only published data were analyzed. This meta-analysis included 158 studies with a marked imbalance between valve types: 145 biological PVR studies (20,499 patients) versus only 13 mechanical PVR studies (1060 patients) from 7178 screened articles. This 19:1 patient ratio reflects the clinical rarity of mechanical PVR in CHD patients. For biological PVR, valve dysfunction rates increased over time: 4% at 1 year, 8% at 2-3 years, 12% at 4-6 years, 31% at 7-10 years, and 27% at 15-20 years. Reintervention rates also rose: 3% at 1 year, 7% at 2-3 years, 12% at 4-6 years, 29% at 7-10 years, and 43% at 15-20 years. Redo-PVR rates followed a similar trend: 2% at 1 year, 4% at 2-3 years, 8% at 4-6 years, 22% at 7-10 years, and 26% at 15-20 years. Mortality rates remained stable: 4% at 1-3 years, 6% at 4-6 years, and 6% at 15-20 years. Complications included arrhythmias (5%), infective endocarditis (3%), and overall complications (11%). For mechanical PVR, valve dysfunction was 4%, reoperation 6%, and redo-PVR 5%. Thrombosis occurred in 9%, bleeding in 4%, and mortality was 1%. Mechanical valves showed lower reintervention rates but higher thrombosis risks compared to biological valves. PVR shows low long-term mortality and complication rates for both mechanical and biological valves, though mechanical valves reduce redo-PVR but increase thrombosis and bleeding risks. The limited mechanical PVR data necessitates cautious interpretation due to small sample sizes and potential selection bias. Future research should explore outcomes across diverse patients, CHD types, and implantation methods.<br/>Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2025. <19> Accession Number 651550024 Title Effect of the active cycle breathing technique on pain, anxiety and arterial blood oxygen saturation in patients undergoing coronary artery bypass grafting. Source BMC anesthesiology. 26(1) (no pagination), 2026. Date of Publication: 17 Jun 2026. Author Solati Kooshkqazi M.; Rakhshan M.; Roosta H.; Shirazi F. Institution (Solati Kooshkqazi) School of Nursing and Midwifery, Shiraz University of Medical Sciences, Namazi Square, Shiraz, Iran, Islamic Republic of (Rakhshan) Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Roosta) Al-Zahra Heart and Martyr Hejazi Hospital, Shiraz, Iran, Islamic Republic of (Shirazi) Community Based Psychiatric Care Research Center, Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of Abstract PURPOSE: Addressing pain and anxiety after coronary artery bypass grafting (CABG) is essential. This research evaluates the associations between the Active Cycle of Breathing Technique (ACBT) and pain levels, anxiety, and blood oxygen saturation in patients recovering from CABG surgery. <br/>METHOD(S): Seventy-six patients undergoing CABG surgery were randomly assigned using permuted block randomization (19 blocks of 4 participants) to either the intervention group (n = 38) or the control group (n = 38). After exclusions (2 reoperations in control, 1 withdrawal in intervention), 73 patients completed the study (intervention: n = 37; control: n = 36). The intervention group received ACBT alongside standard respiratory care, consisting of four sessions (two sessions daily at 10:00 AM and 5:00 PM on postoperative days 2 and 3), with each session lasting 10 min and including three phases: breathing control, thoracic expansion exercises, and coughing technique. The control group received standard respiratory care with incentive spirometry (10-20 deep breaths per session) over the same schedule. Outcome measures pain (Visual Analog Scale), anxiety (State-Trait Anxiety Inventory), and arterial oxygen saturation (pulse oximetry) were assessed before intervention and after each of the four sessions by a blinded research assistant. Data were analyzed using repeated measures ANOVA. <br/>RESULT(S): Baseline pain levels differed significantly between groups (p = 0.005), with the intervention group reporting higher pain. After adjusting for baseline differences, the ACBT group demonstrated significantly lower pain scores after the second (p < 0.001), third (p = 0.007), and fourth (p < 0.001) sessions compared to the control group. Anxiety levels were significantly lower in the ACBT group after all four sessions (p = 0.005, p = 0.019, p = 0.010, p = 0.004, respectively). Arterial oxygen saturation was significantly higher in the ACBT group after all four sessions (p < 0.001). Repeated measures ANOVA revealed significant group effects for pain (p < 0.001), anxiety (p = 0.006), and oxygen saturation (p < 0.001). Time effects were significant for anxiety (p < 0.001) and oxygen saturation (p < 0.001), but not for pain (p = 0.491). The group x time interaction was significant only for oxygen saturation (p < 0.001). <br/>CONCLUSION(S): ACBT was associated with lower pain and anxiety and higher arterial oxygen saturation in patients after CABG surgery. These findings suggest that ACBT may warrant consideration for integration into postoperative respiratory care protocols, pending further research with stronger methodological controls. However, the absence of participant blinding and potential attention bias limit causal inference, and future studies with sham controls are needed.<br/>Copyright © 2026. The Author(s). <20> Accession Number 2048643470 Title Modifiable Perioperative Practices for the Prevention of Postoperative Complications After Cardiac Surgery: A Narrative Review. Source Medicina (Lithuania). 62(8) (no pagination), 2026. Article Number: 1469. Date of Publication: 01 Aug 2026. Author Gheta L.; Patru O.; Virtosu M.; Grigorescu A.; Braescu L.; Alsarhan G.; Buriman D.; Feier H. Institution (Gheta, Patru, Virtosu, Buriman) Doctoral School, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania (Gheta, Patru, Virtosu, Grigorescu, Braescu, Alsarhan, Buriman, Feier) Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, Timisoara, Romania (Gheta, Patru, Virtosu, Grigorescu, Braescu, Feier) Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, Timisoara, Romania (Patru, Grigorescu, Braescu, Feier) Department of Cardiology, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., Timisoara, Romania (Buriman) Centre for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., Timisoara, Romania (Buriman) Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Despite substantial advances in surgical techniques, anesthesia, and perioperative care, postoperative complications remain a major source of morbidity, mortality, prolonged hospitalization, and healthcare utilization following adult cardiac surgery (CS). Increasing evidence suggests that many of these complications are influenced by modifiable perioperative factors that can be addressed through multidisciplinary care. <br/>Material(s) and Method(s): A narrative review was conducted to synthesize current evidence regarding perioperative practices associated with the prevention of postoperative complications in adult CS. A comprehensive literature search of PubMed/MEDLINE, Scopus, and Web of Science identified studies published between January 2015 and April 2026, supplemented by landmark studies and relevant clinical guidelines. <br/>Result(s): The identified evidence was organized into four major domains: infection prevention practices, physiological optimization strategies, protocol adherence and patient safety measures, and organizational and human factors. The strongest evidence supports timely antimicrobial prophylaxis, standardized infection prevention bundles, perioperative glycemic control, maintenance of normothermia, and patient blood management as key interventions associated with improved postoperative outcomes. Surgical safety checklists, standardized perioperative pathways, and adherence to evidence-based protocols further contributed to improved patient safety and consistency of care. Emerging evidence also highlighted the importance of communication, teamwork, safety culture, workload management, and healthcare professionals' knowledge in facilitating successful implementation of perioperative interventions. <br/>Conclusion(s): Prevention of postoperative complications following CS requires a multidisciplinary, systems-based approach integrating evidence-based clinical interventions with standardized perioperative protocols and effective organizational practices that facilitate consistent implementation of evidence-based perioperative care. Future research should focus on prospective evaluation of integrated perioperative strategies, development of practical risk-stratification models, and further investigation of organizational determinants influencing implementation and postoperative outcomes.<br/>Copyright © 2026 by the authors. <21> [Use Link to view the full text] 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. <br/>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). <br/>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, I<sup>2</sup> = 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. <br/>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.<br/>Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology <22> Accession Number 2048645831 Title Effect of Transcutaneous Electrical Nerve Stimulation on Multidimensional Pain Outcomes After Thoracic Surgery: A Secondary Analysis of a Randomized Controlled Trial. Source Medicina (Lithuania). 62(8) (no pagination), 2026. Article Number: 1543. Date of Publication: 01 Aug 2026. Author Alamo-Arce D.D.; Lopez-Fernandez D.; Medina-Ramirez R.; Etopa-Bitata M.D.P.; Quintana-Montesdeoca M.D.P.; Garcia-Rodriguez I.; Dominguez-Trujillo P.D.; Garcia-Quintana M.; Freixinet-Gilart J.L. Institution (Alamo-Arce, Medina-Ramirez, Garcia-Rodriguez, Garcia-Quintana) Soc-Dig Research Group, University of Las Palmas de Gran Canaria, 35016, Las Palmas, Spain (Lopez-Fernandez, Dominguez-Trujillo, Freixinet-Gilart) Health Science Faculty, University of Las Palmas de Gran Canaria, Las Palmas, Spain (Etopa-Bitata) Education Sciences Faculty, University of Las Palmas de Gran Canaria, Las Palmas, Spain (Quintana-Montesdeoca) Mathematic Department, University of Las Palmas de Gran Canaria, Las Palmas, Spain Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background and Objectives: Postoperative pain after thoracic surgery is a multidimensional experience that includes both sensory, evaluative, and affective components. While transcutaneous electrical nerve stimulation (TENS) has demonstrated benefits for postoperative pain management, its association with affective pain outcomes remains less explored. This study aimed to explore the affective dimension of postoperative pain through a secondary analysis of data from a previously conducted randomized controlled trial. <br/>Material(s) and Method(s): Data were derived from a randomized controlled trial investigating the effects of TENS on postoperative recovery after thoracic surgery. A total of 109 patients were included and allocated into three groups: experimental (TENS + physiotherapy, n = 37), placebo (sham TENS + physiotherapy, n = 37), and control (physiotherapy alone, n = 35). The main outcome of interest in this exploratory secondary analysis was the affective dimension of pain, assessed using the Pain Rating Index-Affective (PRI-A) subscale of the McGill Pain Questionnaire before and after the 3-week rehabilitation program. <br/>Result(s): Improvements were observed across several pain-related variables during the intervention period. For the affective dimension of pain, the experimental group demonstrated greater reduction in PRI-A scores than the placebo and control groups. The mean reduction in PRI-A was 0.97 in the experimental group, compared to 0.27 in the placebo group and 0.57 in the control group (p < 0.0001). Between-group comparisons showed moderate to large standardized effect sizes favoring the experimental group, although the absolute magnitude of PRI-A changes was modest. <br/>Conclusion(s): This secondary exploratory analysis suggests that TENS combined with physiotherapy may contribute to improvements in the affective dimension of postoperative pain following thoracic surgery. These findings support further investigation of multidimensional pain outcomes within postoperative rehabilitation settings.<br/>Copyright © 2026 by the authors. <23> 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. <br/>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]. <br/>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.<br/>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) <24> Accession Number 2048300608 Title Colchicine for secondary prevention in established ASCVD: a systematic review and meta-analysis. Source European Journal of Preventive Cardiology. 33(5) (pp 788-790), 2026. Date of Publication: 01 Mar 2026. Author Abdelaziz A.; Sobhy A.; Nazmy A.; Atta K.; Elshahat A.; Abdelaziz M.; Lorenzatti D.; Radparvar A.; Kuno T.; Filtz A.; Lavie C.J.; Gulati M.; Bhatt D.L.; Virani S.S.; Shapiro M.D.; Slipczuk L. Institution (Abdelaziz, Sobhy, Nazmy, Atta, Elshahat, Abdelaziz) Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, United States (Abdelaziz, Lorenzatti, Radparvar, Filtz, Slipczuk) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Montefiore Medical Center, 111 E 210th St., Bronx, NY, United States (Sobhy, Nazmy) Faculty of Medicine, Kafr-Elsheikh University, Kafr-Elsheikh, Egypt (Atta) Institute of Medicine, National Research Mordovia State University, Saransk, Russian Federation (Elshahat, Abdelaziz) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Kuno) Division of Cardiology, Massachusetts General Hospital/Harvard Medical School, Boston, MA, United States (Lavie) Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-the UQ School of Medicine, New Orleans, LA, United States (Gulati) The Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Gulati) Baim Institute for Clinical Research, Boston, MA, United States (Bhatt) Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Virani) Department of Medicine, The Agha Khan University, Karachi, Pakistan (Shapiro) Center for Prevention of Cardiovascular Disease, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States Publisher Oxford University Press <25> Accession Number 2046631039 Title Rheumatic mitral valve disease: Comparative outcomes of repair versus replacement. Source Global Cardiology Science and Practice. 2025(6) (no pagination), 2025. Article Number: 60. Date of Publication: 2025. Author Araujo S.; Silva H.; Filho R.; Alves N.; de Lima A.; Aires J.; Chaves F. Institution (Araujo, Silva, Filho, Alves, de Lima, Aires, Chaves) Universidade de Pernambuco, Faculdade de Ciencias Medicas de Pernambuco, Rua Arnobio Marques, 310, Bairro de Santo Amaro, PE, Recife, Brazil Publisher HBKU Press Abstract Rheumatic mitral valve disease remains a major cause of cardiovascular morbidity and mortality in developing countries where rheumatic fever is still prevalent. In advanced stages, surgical treatment becomes necessary, with mitral valve repair/valvuloplasty (MVP) and mitral valve replacement (MVR) representing the main strategies. However, evidence comparing their long-term outcomes is heterogeneous and often conflicting. The objective of this study was to map and synthesize the scientific evidence comparing the long-term results of repair versus replacement in rheumatic mitral disease. A systematic review was conducted in accordance with established methodological guidelines. Searches were performed in PubMed, Virtual Health Library, and Cochrane databases. Eligible studies, published between 2016 and April 2025, included adult patients undergoing surgical treatment with follow-up of at least five years. Nine studies met the inclusion criteria, comprising 36,136 patients, with 12,042 undergoing repair and 24,094 undergoing replacements. Repair was associated with lower early mortality (0.96% versus 2.2%), fewer thromboembolic events (114 versus 323), fewer hemorrhagic events (39 versus 252), and better preservation of left ventricular function. However, reoperation rates were higher after repair (7-19%) compared to replacement (<2%). Quality-of-life measures also favored repair, while replacement remained the preferred strategy in cases of extensive calcification, fibrosis, or severe stenosis. In conclusion, repair, when anatomically feasible, provides superior early outcomes and fewer long-term complications. Surgical decisions should be individualized, considering valve anatomy, patient profile, and surgical expertise.<br/>Copyright © 2025 The Author(s), licensee Magdi Yacoub Institute. This is an open access article distributed under the terms of the Creative Commons Attribution license CC BY-4.0, which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. <26> 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.<br/>Copyright © 2026 Elsevier Inc. <27> Accession Number 2046046453 Title Effect of catheter-based renal denervation on orthostatic blood pressure adaptation in patients with uncontrolled hypertension. Source Journal of Cardiology. 88(3) (pp 213-219), 2026. Date of Publication: 01 Sep 2026. Author Zhang Z.; Shi R.; Zhang X.; Ma J.; Ye R.; Zuo X.; Hu H.; Peng Y.; Liu K.; Chen X. Institution (Zhang, Shi, Zhang, Ma, Ye, Zuo, Hu, Peng, Liu, Chen) Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background This study aimed to evaluate the effect of catheter-based renal denervation (RDN) on orthostatic blood pressure (BP) adaptation in patients with uncontrolled hypertension. Methods This prospective observational study enrolled patients who had been previously included in the multicenter Iberis-HTN trial and NetrodTM-HTN trial. Eligible patients were randomly assigned to undergo either radiofrequency RDN or a sham procedure. BP and heart rate (HR) changes during a 3-min orthostatic challenge from supine to standing were measured at baseline and 6 months after randomization. Results At 6 months, the RDN group exhibited a significantly greater reduction in ambulatory BP, office systolic blood pressure (SBP) and BP in both supine and standing positions compared to the sham group. After adjusting for baseline values, the magnitude of changes in orthostatic SBP and diastolic blood pressure (DBP) at the 3-min timepoint, along with the maximum changes observed throughout the 3-min orthostatic test, was significantly smaller in the RDN group at 6 months (3 min: SBP/DBP, p = 0.008/0.010; Maximum: SBP/DBP, p = 0.041/0.004). The changes in orthostatic HR at 6 months were comparable between the RDN and the sham group. Conclusions Catheter-based radiofrequency RDN significantly reduced BP in both supine and standing positions during active standing at 6 months compared to the sham group. Additionally, RDN attenuated BP elevation during postural changes, and the response pattern to orthostatic stress was partially restored toward the range of normal physiological variation. This observation may be related to the reduction in excessive vascular tone in response to orthostatic stress after RDN.<br/>Copyright © 2026 Elsevier Ltd. <28> Accession Number 2047748383 Title Treatment of Bicuspid Aortic Valve Stenosis Using Transcatheter Heart Valves. Source Interventional Cardiology Clinics. 15(4) (pp 549-563), 2026. Date of Publication: 01 Oct 2026. Author Kolkailah A.A.; Engel Gonzalez P. Institution (Kolkailah) Division of Cardiology, Department of Medicine, The Warren Alpert Medical School of Brown University, Providence, RI, United States (Engel Gonzalez) Division of Cardiology, Department of Medicine, Henry Ford Health System, Detroit, MI, United States Publisher Elsevier Inc. Abstract The paucity of data from randomized clinical trials regarding the use of transcatheter aortic valve replacement (TAVR) in bicuspid aortic valve anatomy due to exclusion from pivotal studies continues to present a challenge as we expand TAVR to patients with BAV. This article discusses the important anatomic and clinical considerations in the selection and management of BAV patients with TAVR and reviews the emerging evidence, which increasingly suggests this procedure is safe, device success is excellent, and procedural outcomes are much improved.<br/>Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <29> 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. <br/>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>). <br/>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). <br/>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.<br/>Copyright © 2026 Guo et al. <30> 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. <br/>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. <br/>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. <br/>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.<br/>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. <31> Accession Number 2048556583 Title Innovations in transcatheter interventions for hypoplastic left heart syndrome and borderline left heart structures from fetal to neonatal life: current evidence and systematic review of recent advances (2016-2025). Source European Journal of Pediatrics. 185(9) (no pagination), 2026. Article Number: 686. Date of Publication: 01 Sep 2026. Author Sperotto F.; Recco D.P.; Kizilski S.B.; Porras D.; Quinn B.P.; Esch J.J.; Tworetzky W.; Maschietto N. Institution (Sperotto, Porras, Quinn, Esch, Tworetzky, Maschietto) Department of Cardiology, Boston Children's Hospital, and Department of Pediatrics, Harvard Medical School, 300 Longwood Avenue, Boston, MA, United States (Recco, Kizilski) Department of Cardiac Surgery, Boston Children's Hospital, and Department of Surgery, Harvard Medical School, Boston, MA, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Alongside advances in surgical and medical care, catheter-based interventions have reshaped the care of fetuses and neonates with hypoplastic left heart syndrome (HLHS) or borderline left heart structures over the last decades. These interventions include fetal aortic valvuloplasty (FAV), fetal and neonatal atrial septal interventions, the hybrid Stage-1 procedure (HS1P), and the emerging total transcatheter Stage-1 procedure (TTS1P). We summarize the current evidence on catheter-based interventions for HLHS and borderline left heart structures from fetal to neonatal life and systematically review recent advances (2016-2025). Among 361 studies identified (+ 12 manually), 68 were included (17: FAV, 4: fetal/neonatal atrial septal interventions, 39: HS1P, 8: TTS1P). FAV outcomes have continued to improve over time, confirming its potential to alter the progression to HLHS in selected patients. In patients with HLHS and an intact or severely restrictive atrial septum, fetal and neonatal atrial septal interventions can mitigate severe perinatal respiratory failure; however, outcomes in this population remain significantly burdened by underlying lung disease. In the neonatal period, both HS1P and TTS1P offer less invasive alternatives to the surgical Stage-1 procedure, spanning both univentricular and biventricular recruitment pathways. HS1P offers a cardiopulmonary bypass-sparing strategy with favorable outcomes in experienced centers. TTS1P further reduces invasiveness by eliminating both sternotomy and cardiopulmonary bypass and has demonstrated promising early results. As techniques, devices, and patient selection continue to evolve, further research will be critical to establish the most appropriate application of each approach and to align prenatal and postnatal management pathways to optimize outcomes.<br/>Copyright © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2026. <32> [Use Link to view the full text] Accession Number 2040278628 Title Completed and ongoing trials in minimally invasive cardiac surgery coronary surgery. Source Current Opinion in Cardiology. 40(6) (pp 406-409), 2025. Date of Publication: 01 Nov 2025. Author Boskovski M.T.; Tseng E.E. Institution (Boskovski, Tseng) Division of Cardiac Surgery & Lung Transplantation, University of California San Francisco, San Francisco VA Healthcare System, San Francisco, CA, United States Publisher Lippincott Williams and Wilkins Abstract Purpose of review - Minimally invasive cardiac surgery (MICS) coronary artery bypass grafting (CABG), first established two decades ago, offers multivessel revascularization via a small left anterior thoracotomy and without the need for cardiopulmonary bypass, potentially leading to lower complication rates and faster recovery. However, adoption of MICS CABG has been slow, in part due to lack of randomized trial data. Here, we review important retrospective studies, as well as ongoing and completed MICS CABG trials. Recent findings - The majority of studies remain single-center observational studies demonstrating that MICS CABG yields comparable perioperative morbidity and mortality to conventional CABG, with excellent angiographic graft patency, comparable long-term outcomes and faster recovery times. There are two ongoing randomized controlled trials, the MIST and MICS-CABG PRPP trials, both comparing quality of life and recovery in the early postoperative period between patients undergoing MICS CABG versus sternotomy CABG. Summary - The MIST and MICS-CABG PRPP trials will for the first time provide prospective, randomized data on the benefits of MICS CABG. However, both trials involve highly experienced MICS CABG surgeons. As such, the findings will likely not be generalizable to the general cardiac surgery community and MICS CABG will remain a boutique operation offered in highly specialized centers.<br/>© 2025, Written work prepared by employees of the Federal Government as part of their official duties is, under the U.S. Copyright Act, a "work of the United States Government" for which copyright protection under Title 17 of the United States Code is not available. As such, copyright does not extend to the contributions of employees of the Federal Government. <33> Accession Number 2048666692 Title Effect of salbutamol during one-lung ventilation in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Source Canadian Journal of Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Oh Y.J.; Kim N.; Choo H.; Lee K. Institution (Oh, Kim, Choo, Lee) Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, Seoul, South Korea (Oh, Kim, Choo, Lee) Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, South Korea Publisher Springer Abstract Purpose: Ventilation-perfusion mismatch during one-lung ventilation (OLV) for thoracic surgery increases the risk of hypoxemia. Salbutamol may selectively dilate pulmonary vessels and enhance perfusion of the ventilated lung. We sought to investigate whether selective salbutamol nebulization to the ventilated lung during OLV improves gas exchange and respiratory mechanics in patients with chronic obstructive pulmonary disease (COPD). <br/>Method(s): In this prospective randomized controlled trial, we randomly allocated 90 patients scheduled for lung resection to receive salbutamol or placebo nebulization 30 min after OLV initiation and analyzed 82 patients (41 per group). The primary endpoint was the change in the partial pressure of arterial oxygen/fraction of inspired oxygen (PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf>) after nebulization. Secondary outcomes included other gas exchange and respiratory mechanics indices, hemodynamic variables, and perioperative complications. <br/>Result(s): Compared with placebo, salbutamol increased PaO<inf>2</inf>/F<inf>I</inf>O<inf>2</inf> (mean difference, 26; 95% confidence interval [CI], 0 to 53; P = 0.03) and decreased alveolar dead space (mean difference, -1.7; 95% CI, -4.3 to -0.1; P = 0.04) as well as serum potassium (mean difference, -0.2; 95% CI, -0.4 to 0.0; P = 0.01). Heart rate rose transiently without arrhythmia. In a subgroup of patients who had received preoperative inhaler therapy, no between-group differences were observed. <br/>Conclusion(s): Selective salbutamol nebulization during OLV improved oxygenation and respiratory mechanics without serious adverse events, and it may be considered as an adjunctive option for the management of intraoperative hypoxemia in patients with COPD. The lack of benefit among patients who received preoperative inhaler therapy suggests that intraoperative selective one-lung nebulization may be more advantageous than preoperative two-lung nebulization. Study registration: ClinicalTrials.gov (NCT05914285); first submitted 13 June 2023.<br/>Copyright © Canadian Anesthesiologists' Society 2026. <34> Accession Number 2048660414 Title Public Reporting in Cardiothoracic Surgery: Does Transparency Improve Care?. Source Medical sciences. 14(4) (no pagination), 2026. Article Number: 461. Date of Publication: 01 Aug 2026. Author Leivaditis V.; Mulita F.; Mitsos S.; Tomos P.; Kontodimopoulos N.; Liolis E.; Nikolakopoulos K.; Pano I.; Skoura T.; Koletsis E.; Baikoussis N.G.; Sepetis A. Institution (Leivaditis) Westpfalz Klinikum, Department of Cardiothoracic and Vascular Surgery, Kaiserslautern, Germany (Mulita) Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Mitsos, Tomos) Attikon General Hospital, National and Kapodistrian University of Athens, Department of Thoracic Surgery, Athens, Greece (Kontodimopoulos) Harokopio University, Department of Economics and Sustainable Development, Athens, Greece (Liolis) General University Hospital of Patras, Department of Oncology, Patras, Greece (Nikolakopoulos) Department of Vascular Surgery, General University Hospital of Patras, Patras, Greece (Pano) University of Medicine Tirana, Department of Clinical Subject, Tirana, Albania (Skoura) Medical School, National and Kapodistrian University of Athens (NKUA), Aretaeion Hospital, Athens, Greece (Koletsis) Department of Cardiothoracic Surgery, General University Hospital of Patras, Patras, Greece (Baikoussis) Department of Cardiac Surgery, Ippokrateio General Hospital of Athens, Athens, Greece (Sepetis) Postgraduate Health and Social Care Management Program, Department of Business Administration, University of West Attica, 12243, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Introduction: Transparency and public reporting have become central components of quality governance in cardiothoracic surgery, promoting professional accountability, supporting informed patient decision-making, and strengthening public trust. Their importance is particularly evident in a specialty characterized by technically demanding procedures and high clinical risk. Aims and Objectives: This narrative review examines the impact of public reporting of cardiothoracic surgical outcomes on clinical practice, ethical decision-making, surgeon well-being, and patient choice. It explores both the intended benefits of transparency and its potential unintended consequences. Unlike previous reviews focusing primarily on quality metrics or reporting systems, this review integrates clinical evidence with ethical analysis to propose a balanced framework for responsible transparency in cardiothoracic surgery. <br/>Material(s) and Method(s): A narrative literature review was conducted using the PubMed and ScienceDirect databases. Relevant articles published between 2000 and 2026 were identified using the search terms "cardiothoracic surgery," "public reporting," "transparency," and "risk adjustment." Results: Public reporting has been associated with improved benchmarking, enhanced quality improvement initiatives, greater institutional accountability, and more informed patient choice. Evidence also suggests modest improvements in selected clinical outcomes. However, these benefits may be accompanied by unintended effects, including risk-averse decision-making, avoidance of high-risk cases, distortion of clinical judgment, reduced willingness to adopt innovative techniques, and potential inequities for institutions caring for more complex patient populations. <br/>Conclusion(s): Public reporting should evolve beyond the simple disclosure of performance metrics toward an ethically grounded model of transparency that is context-sensitive, appropriately risk-adjusted, and patient-centered. Such an approach should promote shared accountability, emphasize continuous quality improvement rather than punitive performance assessment, and incorporate expert clinical interpretation to ensure fairness, preserve innovation, and support equitable patient care.<br/>Copyright © 2026 by the authors. <35> Accession Number 2048371155 Title Triglyceride-glucose index and atrial fibrillation: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1818372. Date of Publication: 2026. Author Song Y.; Pan X.; Gao L.; Fan Q.; Xiao Q. Institution (Song, Pan, Gao, Fan, Xiao) Department of Cardiology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an, Shandong, China Publisher Frontiers Media SA Abstract Background and objectives - Insulin resistance (IR) plays a pivotal role in the onset and progression of atrial fibrillation (AF). As a simple, reliable surrogate marker of IR, the triglyceride-glucose (TyG) index has drawn growing attention for its association with AF. This study aimed to comprehensively evaluate the strength of the association between the TyG index and AF, as well as its specific subtypes including new-onset AF, AF recurrence after catheter ablation, and postoperative AF, via a systematic review and meta-analysis. Methods - Relevant literature was systematically retrieved from PubMed, Web of Science, CNKI, Wanfang Data Knowledge Service Platform, and VIP Chinese Journal Database from their inception to September 30, 2025. Literature screening, data extraction and quality assessment (using the Newcastle-Ottawa Scale) were independently performed by two researchers. A random-effects model was adopted to calculate the pooled standardized mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CIs), so as to compare TyG index levels between AF and non-AF populations, and to assess the association of the TyG index (treated as both a continuous and categorical variable) with AF risk. Subgroup analysis, meta-regression and sensitivity analysis were conducted to explore sources of heterogeneity and verify the robustness of the results. Results - A total of 19 observational studies were included, involving an overall sample of 25, 376 participants. The meta-analysis yielded the following findings: 1 Based on 15 studies, TyG index levels were significantly higher in AF patients than in non-AF individuals (SMD: 0.65; 95% CI: 0.34-0.95; I<sup>2</sup> = 98%; P < 0.001), and this association remained statistically significant in the new-onset AF (SMD = 0.55) and postoperative AF (SMD = 0.94) subgroups. 2 Based on 11 studies, each 1-unit increment in the TyG index was associated with a 114% increase in overall AF risk (OR: 2.14; 95% CI: 1.73-2.65; I<sup>2</sup> = 81%; P < 0.001). Subgroup analysis demonstrated that this risk elevation was consistent across new-onset AF (OR = 2.04), post-ablation AF recurrence (OR = 1.85) and postoperative AF (OR = 3.78). 3 Based on 6 studies, the pooled adjusted hazard ratio of AF for the highest TyG index group was 211% higher than that for the lowest group (aHR = 3.11, 95% CI: 1.75-5.52; P < 0.001). High heterogeneity was detected across the included studies, but sensitivity analysis confirmed the robustness of the pooled results. Conclusions - Current evidence, predominantly derived from Asian populations, indicates a significant positive association between the TyG index and AF risk. The TyG index may serve as a promising potential biomarker for predicting new-onset AF, post-ablation AF recurrence and postoperative AF in this population. Its generalizability to non-Asian populations requires further validation. Nevertheless, with the advantages of convenient measurement and low cost, the TyG index holds broad application prospects in clinical risk stratification and early prevention of AF.<br/>Copyright © 2026 Song, Pan, Gao, Fan and Xiao. <36> Accession Number 2046228365 Title Cardiovascular safety of proton pump inhibitors in post-percutaneous coronary intervention patients receiving dual antiplatelet therapy: A meta-analysis. Source World Journal of Cardiology. 18(5) (pp 1-12), 2026. Article Number: 119100. Date of Publication: 26 May 2026. Author Sohail R.; Khattak R.; Khan A.; Chaudhry S.; Namal F.; Orciuolo J.; Khan Z.; Shah H.H.; Khan U.; Mansoor H.; Desai S.; Singh M. Institution (Sohail, Khattak, Khan, Chaudhry, Namal, Orciuolo) Internal Medicine, Bayhealth Medical Center, Dover, DE, United States (Khan) Internal Medicine, Indiana University School of Medicine, Southwest Internal Medicine Residency Program, Evansville, IN, United States (Shah) Department of Medicine, Bayhealth Hospital, Kent Campus, Dover, DE, United States (Khan) Department of Medicine, Dow University of Health Sciences, Sindh, Karachi, Pakistan (Mansoor) Department of Medicine, Quaid-e-Azam Medical College, Punjab, Bahawalpur, Pakistan (Desai) Department of Medicine, Temple University, Philadelphia, PA, United States (Singh) Cardiology and Cardiovascular Diseases, Bayhealth Medical Center, Dover, DE, United States Publisher Baishideng Publishing Group Inc Abstract BACKGROUND: Proton pump inhibitors (PPI) are often prescribed alongside dual antiplatelet therapy (DAPT) to mitigate risk of gastrointestinal (GI) bleeding. Despite GI protection, there is emerging concerns about potential interference with antiplatelet efficacy and increased cardiovascular risk. AIM: To determine the cardiovascular impact of PPI on DAPT efficacy. <br/>METHOD(S): Online databases were searched from inception until April 2025, and a total of three randomized controlled trials (RCTs) and five observational studies were identified. Data were pooled using a random-effects model, and results were generated using Review Manager in form of risk ratios (RRs) with 95% confidence intervals (CIs). <br/>RESULT(S): The RCTs showed no association between PPI use and risk of ACS (RR = 0.84; 95%CI: 0.70-1.00; P = 0.005), cardiac death (RR = 1.25; 95%CI: 0.35-4.38; P = 0.73) and all-cause mortality (RR = 0.77; 95%CI: 0.370-1.60; P = 0.49). Similarly, observational studies confirmed no significant effect of PPI on risk of ACS (RR = 1.22; 95%CI: 0.89-1.66; P = 0.21), cardiac death (RR = 1.30; 95%CI: 0.66-2.58; P = 0.45), all-cause mortality (RR = 1.21; 95%CI: 0.96-1.53; P = 0.10), stent thrombosis (RR = 1.63; 95%CI: 0.83-3.21; P = 0.16), revascularization (RR = 1.08; 95%CI: 0.59-1.97; P = 0.81) and ischemic stroke (RR = 0.82; 95%CI: 0.34-2.02; P = 0.67), yet and increased risk of major adverse cardiovascular event (RR = 1.29; 95%CI: 1.11-1.50; P = 0.001). <br/>CONCLUSION(S): Even though RCTs confirmed that PPI use is generally safe in post-percutaneous coronary intervention patients receiving DAPT, observational studies raised suspicion of increased risk warranting a need for further studies.<br/>Copyright © Author(s) 2026. <37> 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. <br/>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. <br/>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. <br/>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.<br/>Copyright © The Author(s) 2026. <38> Accession Number 2048660625 Title From Automated ECG Interpretation to Multimodal Cardiovascular Intelligence: The Evolution of Artificial Intelligence in Cardiovascular Medicine. Source Medical sciences. 14(4) (no pagination), 2026. Article Number: 434. Date of Publication: 01 Aug 2026. Author Rech L. Institution (Rech) MunichGermany Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Artificial intelligence (AI) is rapidly transforming cardiovascular medicine, driven by the increasing availability of large-scale clinical data and advances in machine learning. Early computational applications in cardiology were primarily limited to rule-based electrocardiogram interpretation systems. Over time, these approaches have evolved into sophisticated deep learning models capable of analysing complex cardiovascular signals and imaging data. In parallel with the broader development of digital health technologies, including wearable devices, electronic health records, and remote monitoring systems, AI applications have expanded across multiple domains of cardiovascular care. These now include electrocardiographic (ECG) and electrophysiological analysis, cardiovascular imaging, surgical planning, and multimodal risk prediction. More recently, multimodal AI models have emerged that integrate heterogeneous data sources such as imaging, physiological signals, clinical records, and genomic information, enabling more comprehensive characterisation of cardiovascular disease. Beyond diagnostic applications, AI is increasingly influencing system-level aspects of cardiovascular medicine, including clinical decision support, workflow optimisation, medical education, and clinical trial design. This narrative review traces the historical and clinical evolution of artificial intelligence in cardiovascular medicine from early automated ECG interpretation systems to contemporary multimodal and system-level applications. It highlights key technological developments, current clinical applications, translational challenges, and the emerging role of AI within digital cardiovascular health ecosystems, with particular emphasis on early disease detection, risk stratification, prognostic modelling, and personalised cardiovascular care.<br/>Copyright © 2026 by the author. <39> 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. <br/>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. <br/>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. <br/>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.<br/>Copyright © 2026, AkiNik Publications. All rights reserved. <40> Accession Number 2046747344 Title Safety of Invasive Procedures During Adult Extracorporeal Membrane Oxygenation: A Systematic Review. Source Journal of Clinical Medicine. 15(12) (no pagination), 2026. Article Number: 4792. Date of Publication: 01 Jun 2026. Author Neri G.; Mazza G.; Mastrangelo H.; Ielapi J.; Longhini F.; Bosco V.; Russo A.; Serapide F.; Aquila I.; Sacco M.A.; Caroleo Z.; Bruni A.; Garofalo E. Institution (Neri, Mazza, Ielapi, Longhini, Bosco, Russo, Serapide, Aquila, Sacco, Garofalo) Department of Medical and Surgical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy (Mastrangelo) ASP Catanzaro, Catanzaro, Italy (Caroleo, Bruni) Department of Pharmacy and Health and Nutrition Sciences, University of Calabria, Cosenza, Italy Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Adult patients supported with extracorporeal membrane oxygenation (ECMO) frequently require invasive diagnostic, therapeutic, surgical, or bedside procedures during ongoing extracorporeal support. These procedures are clinically challenging because ECMO-related anticoagulation, platelet dysfunction, acquired coagulopathy, and circuit-related coagulation activation may increase both bleeding and thrombotic risks. This systematic review evaluated the safety of invasive procedures performed during adult ECMO support, excluding tracheostomy/tracheotomy because this procedure has recently been addressed in a dedicated systematic review. <br/>Method(s): A systematic search of PubMed/MEDLINE and Scopus was performed. The final bibliographic data collection was completed in April 2026. Studies were eligible if they included adult ECMO or extracorporeal life support patients undergoing invasive procedures during ongoing ECMO support, or with ECMO used as procedural support, and reported at least one procedure-specific safety outcome. Primary outcomes were procedure-related complications, bleeding, major bleeding, and transfusion requirements. Secondary outcomes included thrombotic and circuit-related complications, oxygenator exchange, reintervention, reoperation, procedural failure, ECMO duration, intensive care unit and hospital length of stay, and mortality. <br/>Result(s): The final qualitative synthesis included 46 studies, comprising 26 studies from PubMed/MEDLINE and 20 additional unique studies from Scopus. Included procedures were grouped into six domains: airway, bronchoscopic, and tracheobronchial procedures; thoracic surgery and lung resections; abdominal surgery, gastrointestinal endoscopy, and decompressive laparotomy; lung transplantation and perioperative extracorporeal life support; cardiovascular, vascular, pulmonary embolism-related, and mechanical circulatory support-related procedures; and mixed non-cardiac surgery. Airway and bronchoscopic procedures generally showed high procedural success in selected cohorts, although registry-level tracheal procedure data reported hemorrhagic complications in 26.0% and surgical-site bleeding in 13.0%. Emergency thoracic and abdominal procedures carried the highest bleeding, transfusion, reintervention, and mortality burden. Lung transplantation studies showed that ECMO can be integrated into perioperative pathways, but hemothorax, transfusion, thromboembolism, and anticoagulation strategy remained central safety issues. <br/>Conclusion(s): Invasive procedures during adult ECMO are feasible in selected patients and experienced centers, but procedural safety varies markedly by procedure type, urgency, baseline disease severity, and anticoagulation strategy. A procedure-centered, multidisciplinary approach with individualized anticoagulation management and careful planning is essential.<br/>Copyright © 2026 by the authors. <41> Accession Number 2048490375 Title Effects of FiO2 adjustment on hyperoxia biomarkers and postoperative complications using oxygen reserve index during one-lung ventilation. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 514. Date of Publication: 01 Dec 2026. Author Aykenar B.; Ayhan A.; Issi S.; Kilic M.D.; Zeyneloglu P. Institution (Aykenar) Department of Intensive Care, Faculty of Medicine, Gazi University, Mevlana street, Ankara, Turkey (Ayhan, Zeyneloglu) Department of Anesthesia and Reanimation, Faculty of Medicine, Baskent University, Ankara, Turkey (Issi, Kilic) Department of Thoracic Surgery, Faculty of Medicine, Baskent University, Ankara, Turkey Publisher BioMed Central Ltd Abstract Background: One-lung ventilation (OLV) is commonly used in thoracic surgery but increases the risk of intraoperative hypoxemia. To prevent hypoxia, high fractions of inspired oxygen (FiO) are frequently administered; however, excessive oxygen exposure may lead to hyperoxia and oxidative tissue injury. The Oxygen Reserve Index (ORi) is a non-invasive monitoring parameter that provides real-time information on moderate hyperoxia. This study aimed to evaluate whether ORi-guided oxygen titration reduces intraoperative FiO exposure and influences oxidative stress biomarkers and postoperative outcomes in patients undergoing OLV. <br/>Method(s): In this prospective, randomized controlled trial, 60 patients undergoing elective thoracic surgery requiring OLV were allocated to either an ORi-guided group or a conventional oxygen management group. In the ORi group, FiO was adjusted according to predefined ORi thresholds, whereas in the control group oxygen management was guided solely by pulse oximetry. The primary outcome was the mean intraoperative FiO administered during OLV and throughout the entire surgery. Secondary outcomes included serum and tracheal aspirate levels of interleukin-6 (IL-6), superoxide dismutase (SOD), and malondialdehyde (MDA), postoperative pulmonary complications, and surgical site infections. <br/>Result(s): Mean intraoperative FiO was significantly lower in the ORi group compared with the control group during OLV and across total surgery duration (p < 0.001). Oxygen saturation and ventilatory parameters were comparable between groups. Biomarker levels showed significant time-dependent changes; however, no significant differences were observed between groups, and no significant group x time interaction was detected. The incidence of postoperative pulmonary complications and surgical site infections did not differ between groups. <br/>Conclusion(s): ORi-guided oxygen titration during OLV enables safe reduction of intraoperative FiO while maintaining adequate oxygenation. Although this strategy did not translate into measurable differences in oxidative stress biomarkers or postoperative complications, these findings provide important clinical evidence regarding the physiological impact of moderate hyperoxia in thoracic surgery. Trial registration: ClinicalTrials.gov identifier NCT07359833. First submission date: 17.01.2026 Retrospectively registered on 21.1.2026.<br/>Copyright © The Author(s) 2026. <42> Accession Number 2046061794 Title Early Intervention Versus Watchful Waiting in Asymptomatic Severe Aortic Stenosis. Source JACC: Asia. 6(8) (pp 1577-1580), 2026. Date of Publication: 01 Aug 2026. Author Ma J.R.; Haji K.; Zheng W.; Wilson W.; Taylor A.; Chan W. Institution (Ma, Zheng) Alfred Health, Melbourne, VIC, Australia (Haji, Chan) Western Health, Melbourne, VIC, Australia (Wilson, Taylor, Chan) Royal Melbourne Hospital, Melbourne, VIC, Australia Publisher Elsevier Inc. <43> Accession Number 2046746938 Title The Effectiveness of Methylene Blue in Adult Shock: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials. Source Journal of Clinical Medicine. 15(12) (no pagination), 2026. Article Number: 4481. Date of Publication: 01 Jun 2026. Author Rodriguez-Lima D.R.; Rodriguez-Villegas A.; Toro Egas J.D.; Bautista E.M.C. Institution (Rodriguez-Lima) Critical and Intensive Care Medicine, Hospital Universitario Mayor-Mederi, Bogota, Colombia (Rodriguez-Lima) Clinical Research Group, School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia (Rodriguez-Villegas, Toro Egas) School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia (Bautista) Cardiology Department, La Cardio, Bogota, Colombia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Methylene blue (MB) has re-emerged as an adjunctive vasopressor-sparing therapy in vasoplegic shock states, with emerging evidence supporting its hemodynamic benefits; however, its effect on mortality remains uncertain. We systematically evaluated the effectiveness of MB versus standard therapy in adults with circulatory shock. <br/>Method(s): We performed a systematic review and meta-analysis of randomized controlled trials registered in PROSPERO (CRD420261326534) and reported according to PRISMA. MEDLINE, Embase, and the Cochrane Library were searched through February 2026. An additional AI-assisted supplementary search was conducted to minimize the risk of missing eligible studies. Eligible studies enrolled adults with shock and compared MB with standard therapy or placebo. The primary outcome was 28-30-day all-cause mortality. Secondary outcomes were renal replacement therapy (RRT), hospital length of stay, and intensive care unit (ICU) length of stay. Risk of bias was assessed with RoB 2. <br/>Result(s): Nine randomized trials involving 535 participants met the eligibility criteria; most evaluated septic shock, while one trial included post-cardiac surgery vasoplegic shock. Eight trials contributed to the quantitative synthesis of mortality. MB was not associated with a statistically significant reduction in short-term mortality. Secondary analyses also did not demonstrate significant pooled effects for RRT, hospital length of stay, or ICU length of stay, although several individual trials reported faster hemodynamic improvement and reduced vasopressor exposure with MB. Overall confidence in the pooled estimates was limited by small sample sizes, clinical heterogeneity, imprecision, and risk-of-bias concerns in some studies. <br/>Conclusion(s): Current randomized evidence does not demonstrate a clear mortality or resource use benefit of MB in adult shock, despite signals of hemodynamic improvement. MB appears promising as an adjunctive therapy, but adequately powered, methodologically rigorous trials are required before its routine early use can be recommended.<br/>Copyright © 2026 by the authors. <44> Accession Number 2048555615 Title Are Homografts Superior to Prosthetic Valves in Destructive Aortic Endocarditis? A Systematic Review and Pairwise Meta-Analysis of Early-Midterm Outcomes. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 8734329. Date of Publication: 2026. Author Cubas W.S.; Gundelach J.; Arimura S.; Alfabeto A.; Kawaguchi Y.; Hong J.; Guo L.-R.; Chu M.W.A. Institution (Cubas, Arimura, Alfabeto, Kawaguchi, Hong, Guo, Chu) Department of Surgery, Division of Cardiac Surgery, Western University, London, ON, Canada (Gundelach) Department of Cardiac Surgery, Las Higueras Hospital, Talcahuano, Chile Publisher John Wiley and Sons Inc Abstract Background: Destructive aortic endocarditis (DAE) requires complex surgery. Homografts are traditional gold standards, but emerging evidence questions their superiority over prosthetic valves. This systematic review and pairwise meta-analysis compare early-midterm outcomes. <br/>Method(s): A comprehensive search of PubMed, Embase, Scopus, and Cochrane (1990-2025) identified studies comparing homografts, mechanical, and bioprosthetic valves for DAE. Outcomes included mortality, reoperation, stroke, reinfection, and midterm survival. Pairwise meta-analysis and Pearson's correlation were applied. <br/>Result(s): Sixteen studies (9948 patients) were included (homograft n = 1359; mechanical n = 2717; biological n = 5872). The mean age was 53.5 years, and 74.9% were male. No significant differences were observed in 30-day mortality (homograft vs mechanical: OR 1.31, 95% CI 0.99-1.72; vs biological: OR 1.15, 95% CI 0.73-1.81), midterm survival (RR 1.00, 95% CI 0.92-1.09; RR 1.06, 95% CI 0.88-1.28), or reinfection (homograft vs mechanical: RR 0.99, 95% CI 0.82-1.19; vs biological: RR 0.77, 95% CI 0.44-1.36). Reoperation was significantly higher with homografts versus mechanical (OR 1.58, 95% CI 1.17-2.14) and biological valves (OR 1.45, 95% CI 1.22-1.72), with no heterogeneity (I<sup>2</sup> = 0%). Stroke risk was comparable across all comparisons, with nonsignificant numerical trends favoring homografts: homograft vs mechanical (OR 0.86, 95% CI 0.37-1.20), homograft vs biological (OR 0.65, 95% CI 0.30-1.41), and mechanical vs biological (OR 0.99, 95% CI 0.80-1.23). Unadjusted pooled proportions suggested higher early mortality with homografts (19.1%) compared to mechanical (16.8%) and biological (15.1%) valves, though these differences were not statistically significant in adjusted pairwise meta-analyses. <br/>Conclusion(s): Homografts do not demonstrate definitive superiority for DAE. While nonsignificant numerical trends toward lower stroke rates were observed with homografts, no statistically significant benefits were confirmed for mortality, reinfection, or midterm survival. Homografts were associated with significantly higher reoperation rates without a survival advantage. Valve selection requires patient-tailored balancing of infection control, durability, and procedural risk.<br/>Copyright © 2026 W. Samir Cubas et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <45> Accession Number 2034837216 Title Mortality and Survival after Norwood Procedure Comparison between Shunt Type in Patients with Hypoplastic Left Heart Syndrome or Its Variants: A Systematic Review and Meta-Analysis Study. Source Journal of Cardiac Surgery. 2023 (no pagination), 2023. Article Number: 8534205. Date of Publication: 2023. Author Arnaout A.Y.; Nerabani Y.; Alhaj Ali H.; Shahrour M.Z.; Fallaha M.Y.; Arnaout I.; Sajjee A.; Morjan M.; Al-Kanj H. Institution (Arnaout, Nerabani, Alhaj Ali, Shahrour, Fallaha, Arnaout, Sajjee) Faculty of Medicine, University of Aleppo, Aleppo, Syrian Arab Republic (Morjan) Department of Pediatric Surgery, Aleppo University Hospital, Aleppo, Syrian Arab Republic (Al-Kanj) Cardiovascular Surgery Department, Aleppo University Hospital, Aleppo, Syrian Arab Republic Publisher Wiley-Hindawi Abstract Background. In the Norwood procedure, a conduit is performed either from the subclavian artery to the pulmonary artery, Blalock-Taussig shunt (mBTs), or from the right ventricle to the pulmonary artery (RV-PA shunt). There are some concerns regarding the two shunts and which one is better according to morbidity and mortality in patients with hypoplastic left heart syndrome or its variants. Methods. We systematically searched PubMed, Web of Science, Scopus, Embase, and Cochrane Library databases from inception to 04/June/2021 to collect articles reporting a comparison of RV-PA shunt and mBTs. Results. Our meta-analysis showed that the mortality rate after 6 months, 1, 2, 3, 4, 5, and 6 years for the mBTS group was 16.3%, 28.6%, 34.8%, 42.4%, 44.6%, 45.1%, and 39.6%, respectively, and for the RV-PAS, 14.8%, 26.6%, 31%, 40.1%, 36.1%, 37.5%, and 34.0%, respectively. The mortality rate was significantly higher in the mBTs group at 1 and 2 years; otherwise, there is no significance differences. Overall complications rate was higher in the mBTs group than in the RV-PAs group (17.8% vs. 8.5%). In contrast, the rate of cardiac complications was higher in the RV-PAS group. Conclusions. The RV-PA shunt had lower mortality and overall complications rate than mBT shunt at the short-term outcome within the first two years, but at the long term, there was no difference between the two shunts. On the other hand, the mBT shunt had a lower incidence of cardiac complications at the early stage after the operations. However, some studies are poor due to the difficulties in conducting original research in this field. Therefore, we recommend conducting systematic reviews and original studies to compare these and other therapeutic procedures for these patients.<br/>Copyright © 2023 Ahmad Yamen Arnaout et al. <46> Accession Number 2048624771 Title Polygenic Risk Based Detection and Treatment of Subclinical Coronary Atherosclerosis in the PROACT Clinical Trials. Source Journal of the American College of Cardiology. 88(10) (pp 1050-1067), 2026. Date of Publication: 08 Sep 2026. Author Abou-Karam R.; Kim M.S.; Jemma Cho S.M.; Bitar F.; Gady S.; Cheng F.; Thompson A.G.; Karlson E.W.; Natarajan P.; Ellinor P.T.; Foldyna B.; Ghebremichael M.S.; Atlas S.J.; Ridker P.M.; Lu M.T.; Fahed A.C. Institution (Abou-Karam, Kim, Jemma Cho, Bitar, Gady, Cheng, Thompson, Natarajan, Ellinor, Fahed) Cardiovascular Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Abou-Karam, Kim, Jemma Cho, Bitar, Gady, Cheng, Thompson, Natarajan, Ellinor, Fahed) Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, United States (Karlson) Mass General Brigham Personalized Medicine, Boston, MA, United States (Foldyna, Lu) Cardiovascular Imaging Research Center, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States (Ghebremichael) Ragon Institute of MGH, MIT, and Harvard, Cambridge, MA, United States (Ghebremichael) MGH Biostatistics Center, Boston, MA, United States (Atlas) Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, United States (Ridker) Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, MA, United States Publisher Elsevier Inc. Abstract Background: Coronary artery disease (CAD) polygenic risk scores (PRS) may identify individuals at elevated genetic risk "flying under the radar" in contemporary practice. The aims of the PROACT (Polygenic Risk Based Detection and Treatment of Subclinical Coronary Atherosclerosis) trials are to prospectively identify these individuals, quantify subclinical coronary plaque, and slow its progression with pharmacologic interventions. <br/>Objective(s): The aim of this study is to report interim feasibility and implementation findings from PROACT, a genotype-first, biobank-enabled trial, characterizing eligibility yield, callback engagement, and subclinical coronary atherosclerosis on coronary computed tomographic angiography among individuals with high CAD PRS. <br/>Method(s): Within a hospital-based biobank, adults 40 to 75 years of age with high CAD PRS, without cardiovascular disease, and not on lipid-lowering therapy were invited. The authors characterize 2,495 eligible individuals with high CAD PRS, report on the feasibility and early operational outcomes of a genotype-first callback strategy for a clinical trial in the first 1,314 invited, and describe plaque prevalence by age and sex in the first 204 participants using coronary computed tomographic angiography. <br/>Result(s): Among 64,092 genotyped participants, 2,495 (3.9%) were eligible and had high CAD PRS despite low clinical risk (median 10-year pooled cohort equations risk for atherosclerotic cardiovascular disease 3%; Q1-Q3: 1%-8%). Recruitment showed high engagement: among 1,314 invited individuals, 283 (21.5%) opted in, and 204 (15.5%) completed baseline imaging. Compared with participants who did not opt in, those who opted in had higher specialty care engagement and lived closer to the study site. Analysis of the first 204 participants enrolled by January 31, 2025 (mean age 56.3 +/- 8.5 years, 69% women), showed that despite the low clinical risk and favorable cardiovascular health (mean Life's Essential 8 score 73.3 +/- 11.5 vs the U.S. average of ~65), one-half the participants (102 of 204) had subclinical plaque. Subclinical plaque prevalence was 76.2% in men and 38.3% in women and was high across age groups. <br/>Conclusion(s): These exploratory findings highlight the feasibility of implementing genotype-first recruitment for prevention trials and reveal a large proportion of "silent" high-genetic risk individuals with subclinical plaque for whom pharmacotherapy could be beneficial but who remain undetected by standard clinical assessments. (Polygenic Risk Based Detection of Subclinical Coronary Atherosclerosis and Change in Cardiovascular Health [PROACT 1], NCT05819814; Polygenic Risk Based Detection of Subclinical Coronary Atherosclerosis and Intervention With Statin and Colchicine [PROACT 2], NCT05850091)<br/>Copyright © 2026 by the American College of Cardiology Foundation. Published by Elsevier. <47> Accession Number 2038546462 Title Frailty and intraoperative hypotension as interrelated predictors of postoperative outcomes. Source International Journal of Medical Anesthesiology. 9(8) (pp 9-14), 2026. Date of Publication: 01 Aug 2026. Author Anshul Institution (Anshul) Postgraduate Institute of Medical Sciences, PGIMS, Haryana, Rohtak, India Publisher AkiNik Publications Abstract This article examines the relationship between frailty and intraoperative hypotension in the context of postoperative outcomes among non-cardiac surgical patients. The study was conducted as a systematic review of scientific publications followed by an analytical synthesis of evidence regarding patient physiological vulnerability, intraoperative hemodynamic instability, and the most significant postoperative complications. Particular attention is paid not to individual risk factors but to their interaction. A comparative analysis of contemporary approaches to frailty assessment, the characteristics of intraoperative hypotension, and their associations with delirium, acute kidney injury, myocardial injury, prolonged hospitalization, hospital readmissions, and mortality was performed. It was found that reduced physiological reserves are associated with increased sensitivity to intraoperative hemodynamic disturbances. At the same time, clinical significance is determined not only by the absolute level of arterial blood pressure. Equally important is the patient's ability to tolerate periods of relative tissue hypoperfusion. An original conceptual model is proposed that integrates frailty, intraoperative hypotension, and postoperative complications within a unified pathophysiological framework. The model considers intraoperative hypotension as an intermediate mechanism through which the risk associated with diminished physiological reserves is realized. The findings expand current understanding of the mechanisms underlying postoperative outcomes and may be of interest to specialists in anesthesiology, perioperative medicine, and gerontology.<br/>Copyright © 2026, AkiNik Publications. All rights reserved. <48> Accession Number 2048574854 Title The effects of animation-based education provided to older patients scheduled for coronary artery bypass graft surgery on patients' pain, fear, anxiety, and self-care management: A randomized controlled trial. Source Geriatric Nursing. 73 (no pagination), 2026. Article Number: 104257. Date of Publication: 01 Oct 2026. Author Yavuz A.S.P.I.R.G.A.I.P.; Karaman Ozlu Z. Institution (Yavuz) Ataturk University Research Hospital, Department of Cardiovascular Surgery, Erzurum, Turkey (Karaman Ozlu) Ataturk University, Nursing Faculty, Department of Surgical Nursing, Erzurum, Turkey Publisher Elsevier Inc. Abstract The present research was performed to evaluate the effects of animation-based education provided to older patients scheduled for coronary artery bypass graft surgery on patients' pain, fear, anxiety, and self-care management. The research was carried out using a randomized controlled experimental design, with the intervention group receiving animation-based education and the control group participating in the preoperative clinical routine practice. The research data were collected from patients aged 65 and older who were scheduled for coronary artery bypass graft surgery between April 2023 and January 2025. The study was completed with 72 patients undergoing coronary artery bypass graft surgery, including 35 in the intervention group and 37 in the control group. The intervention group had significantly lower mean scores on the Visual Analog Scale, Surgical Fear Questionnaire, and Hospital Anxiety and Depression Scale compared with the control group (p ' 0.05). In contrast, the intervention group demonstrated significantly higher scores on the Self-Care Management in Chronic Diseases Scale and its subscales than the control group (p ' 0.05). The findings indicate that animation-based education provided before coronary artery bypass graft surgery effectively reduced postoperative pain, fear, anxiety, and depression levels while improving self-care management among older adults. Therefore, animation-based education may be considered an effective nursing intervention to support perioperative care and postoperative recovery in older patients undergoing CABG surgery.<br/>Copyright © 2026 Elsevier Inc. <49> Accession Number 2042694077 Title Comparison of perioperative outcomes of minimally invasive and conventional aortic root surgery in adult patients: a systematic review and meta-analysis. Source General Thoracic and Cardiovascular Surgery. 74(4) (pp 329-339), 2026. Date of Publication: 01 Apr 2026. Author Karadzha A.; Enginoev S.; Schaff H.V.; Suvorov A.; Mukharyaov M.; Babeshko S.; Chekhoeva A.; Kadyraliev B.; Bogachev-Prokophiev A. Institution (Karadzha, Schaff) Department of Cardiovascular Surgery, 200 1st St SW, Rochester, MN, United States (Enginoev) Federal State Budgetary Institution <<Federal Center for Cardiovascular Surgery>> of theMinistry of Health of the Russian Federation, Astrakhan, Russian Federation (Enginoev) Federal State Budgetary Educational Institution of Higher Education "Astrakhan State Medical University" of the Ministry of Health of the Russian Federation, Astrakhan, Russian Federation (Suvorov) Institute of Personalized Cardiology of the Center for Digital Biodesign and Personalized Healthcare, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation (Mukharyaov) University Clinic Jena, Thuringia, Germany (Mukharyaov) Kazan State Medical University, Kazan, Russian Federation (Babeshko) Region Hospital #1, Krasnodar Region, Russian Federation (Chekhoeva) Department of Cardiac Surgery, The University Hospital of Dusseldorf, Dusseldorf, Germany (Kadyraliev) S.G. Sukhanov Federal Center of Cardiovascular Surgery, E.A. Vagner Perm State Medical, Perm, Russian Federation (Bogachev-Prokophiev) Heart Valve Surgery Department, E. Meshalkin National Medical Research Centre, Novosibirsk, Russian Federation Publisher Springer Abstract Introduction: Minimally invasive approaches have become a gold standard for most cardiac surgery procedures, but their use in aortic root surgery remains limited. Previous analyses suggested potential benefits of minimally invasive aortic root surgery (MIARS) over conventional aortic root surgery (CARS). This study aims to provide updated insights into intraoperative and early postoperative outcomes between MIARS and CARS. <br/>Method(s):. This systematic review and meta-analysis followed PRISMA guidelines. Two-arm observational studies comparing MIARS and CARS were included. The literature search was conducted using a mix of keywords and standardized indexing terms in the eight sources up to December 16, 2024. The risk of bias was assessed using ROBINS-I. <br/>Result(s): Twenty-one studies comparing MIARS and CARS were included, resulting in 2908 MIARS and 3,456 CARS patients. Minimally invasive approaches were associated with shorter mechanical ventilation (-4.72 h; p <.001), ICU stay (-0.46 days; p <.001), hospital stay (-1.65 days; p <.001), reduced postoperative bleeding (-0.82 units; p <.001), blood transfusion (-0.50 units; p <.001) and atrial fibrillation rate (RR 0.73; p =.006). Safety outcomes, including the risk of mortality, stroke, and renal failure, as well as surgical procedure duration, reflected by aortic cross-clamp and cardiopulmonary bypass times, were comparable between MIARS and CARS. <br/>Conclusion(s): The use of minimally invasive approaches for aortic root procedures may offer benefits over median sternotomy, including shorter recovery times and reduced postoperative bleeding, without compromising safety. However, the certainty of the available evidence remains low.<br/>Copyright © The Author(s), under exclusive licence to The Japanese Association for Thoracic Surgery 2026. <50> Accession Number 2048588076 Title Managing Cardiogenic Shock in the Era of Multimodal Mechanical Support: Bridging to Transplant or Recovery. Source Current Heart Failure Reports. 23(1) (no pagination), 2026. Article Number: 42. Date of Publication: 01 Dec 2026. Author Ortega-Hernandez J.A.; Baldetti L.; Gallone G.; Cacioli G.; Bocchino P.P.; Rojas-Cruz G.; Neri-Bale R.R.; Loforte A.; Hernandez-Montfort J. Institution (Ortega-Hernandez) Coronary Care Unit, Instituto Nacional de Cardiologia Ignacio Chavez, Juan Badiano 1, Seccion XVI, Tlalpan, Ciudad de Mexico, Mexico (Ortega-Hernandez, Rojas-Cruz) Cardiac & Intensive Care Unit, Hospital Angeles del Pedregal, Camino Sta. Teresa 1055-S, Heroes de Padierna, Heroes de Padierna, La Magdalena Contreras, Ciudad de Mexico, Mexico (Baldetti) Cardiac Intensive Care Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (Gallone, Bocchino, Loforte) Division of Cardiology, "Citta della Salute e della Scienza" Hospital, Turin, Italy (Gallone, Loforte) Department of Medical Sciences, University of Turin, Turin, Italy (Cacioli) Cardiac Surgery and Heart Transplant Unit, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy (Neri-Bale, Hernandez-Montfort) Advanced Heart Failure and Recovery Program for Central Texas, Baylor Scott & White Health, 302 University Blvd, Round Rock, TX, United States Publisher Springer Abstract Purpose of Review: To review the contemporary management of cardiogenic shock in the era of multimodal temporary mechanical circulatory support, with emphasis on phenotype-guided device selection, serial trajectory assessment, and bridging toward recovery, durable left ventricular assist device implantation, or heart transplantation. Recent Findings: Temporary mechanical circulatory support is now used to influence clinical outcomes, not just as rescue therapy. Devices like intra-aortic balloon pumps, microaxial flow pumps, and venoarterial extracorporeal membrane oxygenation affect heart function and recovery differently; their use should be tailored to the type of ventricular failure and monitored with hemodynamics and imaging. Expanded focus on upper-limb access and prolonged support has broadened temporary support's role in bridging patients to decision, recovery, or transplant. <br/>Summary: Cardiogenic shock remains a leading cause of mortality in acute myocardial infarction and advanced heart failure despite major advances in temporary mechanical circulatory support. Contemporary outcomes depend not only on device availability, but on matching support intensity to shock phenotype, recognizing trajectory early, minimizing complications, and preserving end-organ function. This review summarizes current evidence on device-specific physiology, escalation and weaning, pulmonary vascular considerations, and post-transplant outcomes, and proposes an integrated framework for individualized, trajectory-based decision-making.<br/>Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <51> 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. <br/>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). <br/>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. <br/>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.<br/>Copyright © 2026 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC. <52> Accession Number 2046641802 Title Pericoronary fat attenuation index and major adverse cardiovascular events: a systematic review and meta-analysis. Source Quantitative Imaging in Medicine and Surgery. 16(6) (pp 1-13), 2026. Date of Publication: 01 Jun 2026. Author Wang Z.; Lyu C.; Yang D.; Zhu Y.; Zhang Y.; Tian J.; Gao B. Institution (Wang, Zhu, Zhang, Gao) Department of Radiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China (Lyu) Department of Psychiatry, The Affiliated Hospital of Guizhou Medical University, Guiyang, China (Yang) Qinghai University Affiliated Hospital, Xining, China (Tian) Center for Evidence-Based Medicine, Lanzhou University, Lanzhou, China Publisher AME Publishing Company Abstract Background: Perivascular adipose tissue (PVAT) plays a significant role in the pathophysiology of atherosclerosis. Changes in its computed tomography (CT) attenuation reflect the inflammatory status of the vascular wall. The pericoronary fat attenuation index (FAI), derived from coronary computed tomography angiography (CCTA), is a non-invasive imaging biomarker that quantifies the CT attenuation of pericoronary fat to indirectly assess local inflammatory activity. This study aimed to evaluate the predictive value of CCTA-derived FAI for major adverse cardiovascular events (MACEs) through a meta-analysis. <br/>Method(s): Two investigators systematically searched the PubMed and Web of Science databases from inception until 21 October 2025 for cohort studies assessing the association between FAI and MACE. Study quality was assessed using the Newcastle-Ottawa Scale (NOS), and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Adjusted hazard ratios (aHRs) and their 95% confidence intervals (CIs) were pooled using a random-effects model. Meta-analysis and sensitivity analyses were performed to explore sources of heterogeneity and the robustness of the results. <br/>Result(s): A total of 11 studies involving 10,288 patients were included. The meta-analysis showed the following: (I) categorical variable (high vs. low FAI): high FAI was significantly associated with an increased risk of MACE (pooled aHR =5.00; 95% CI: 3.30-7.58; P<0.001), with moderate GRADE evidence quality. (II) Continuous variable [per 1 Hounsfield unit (HU) increase]: each 1 HU increase in FAI was associated with a 24% increase in MACE risk (pooled aHR =1.24; 95% CI: 1.08-1.43; P=0.002), with low GRADE evidence quality. Sensitivity analyses and funnel plots indicated robust pooled results and a low likelihood of publication bias. <br/>Conclusion(s): CCTA-derived FAI is a strong independent predictor of MACE. Incorporating FAI into routine CCTA assessment may improve cardiovascular risk stratification, demonstrating significant potential for clinical translation.<br/>Copyright © 2026, AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <53> Accession Number 2048497322 Title Semaglutide for primary prevention of major adverse cardiac and cerebrovascular events in patients with type 2 diabetes and comorbid rheumatoid arthritis: a target-trial emulation. Source European Heart Journal - Cardiovascular Pharmacotherapy. 12(5) (pp 368-378), 2026. Date of Publication: 01 Aug 2026. Author Malik F.; Shah M.; Chang Y.; Chowdhury I.; Mangalesh S.; Morgan A.A.; Pascal E.; Modak V.; Lebovics N.; Adhikari S.; Lee P.-L.; Chen W.-C.; Chi K.-Y. Institution (Malik, Shah, Chowdhury, Mangalesh, Morgan, Modak, Lebovics, Adhikari, Lee, Chi) Department of Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY, United States (Chang) Section of Neurosurgery, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan (Republic of China) (Pascal) Department of Internal Medicine, Jacobi Medical Center/North Central Bronx, Albert Einstein College of Medicine, Bronx, NY, United States (Chen) Department of Orthopedics, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan (Republic of China) Publisher Oxford University Press Abstract Aims: Rheumatoid arthritis (RA)-related physical limitations often hinder sustained physical activity and weight management, thereby amplifying cardiovascular risk through adverse metabolic profiles and chronic inflammation. We aimed to assess the effectiveness of semaglutide on the risk of incident major adverse cardiovascular and cerebrovascular events (MACCE) in obese adults with type 2 diabetes mellitus (T2DM) and RA in a primary-prevention setting. <br/>Methods and Results: We emulated a target trial using data from the TriNetX US database, including obese adults [aged >=18 years; body mass index (BMI) >=30 kg/m<sup>2</sup>] with T2DM and comorbid RA and no prior history of stroke, heart failure (HF), acute coronary syndrome, or coronary revascularization. Using a new-user design, we compared patients initiating semaglutide with those initiating non-GLP-1 receptor agonist (GLP-1RA) second-line glucose-lowering therapies. Patients with contraindications to GLP-1RAs were excluded. Propensity-score matching (PS) (1:1) was used to balance baseline covariates. The primary outcome was incident MACCE, defined as a composite of all-cause mortality, myocardial infarction (MI), HF, or stroke. Secondary outcomes included individual MACCE components, HF hospitalization, and disease-modifying anti-rheumatic drug (DMARD) escalation, with Bonferroni correction applied for multiple comparisons. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazards models over a follow-up of up to 2 years. Between 1 January 2014 and 1 January 2025, we identified 1200 and 2972 patients who initiated semaglutide and non-GLP-1RA therapies, respectively, within 3 months of meeting eligibility. After PS matching, 1017 semaglutide users were compared with 1017 non-GLP-1RA users (mean age 59.5 vs. 59.3 years; women 81.3% vs. 81.0%; mean BMI 38.2 vs. 38.0 kg/m<sup>2</sup>; HbA1c, 6.8% vs. 7.0%). Semaglutide initiation was associated with a significantly lower risk of incident MACCE compared with non-GLP-1RA therapies (12.7% vs. 16.5%; HR, 0.75; 95% CI, 0.60-0.94; P = 0.01). This benefit was driven primarily by a lower risk of incident HF (8.9% vs. 12.5%; HR, 0.69, 95% CI, 0.53-0.91; P = 0.007). Semaglutide use was also associated with significantly lower DMARD escalation (16.6% vs. 21.6%; HR, 0.75; 95% CI, 0.60-0.90; P = 0.003). No significant differences were observed in all-cause mortality, MI, or stroke. <br/>Conclusion(s): Among obese adults with T2DM and comorbid RA, initiation of semaglutide was associated with a reduced risk of incident MACCE, driven predominantly by a reduction in incident HF, in a primary-prevention setting. Prospective studies are needed to confirm these observations and establish causality.<br/>Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <54> Accession Number 2046446486 Title Orforglipron Added to Titrated Insulin Glargine in Type 2 Diabetes The ACHIEVE-5 Randomized Clinical Trial. Source JAMA. 336(5) (pp 389-399), 2026. Date of Publication: 04 Aug 2026. Author Giorgino F.; D'Souza S.; Ludwig L.; Kiyosue A.; Ibriga H.; Rha H.; Denning M.; Wu W.-S.; Lando L.F.; Tobian J. Institution (Giorgino) Department of Regenerative and Precision Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy (D'Souza) St Luke's Endocrinology, Boise, ID, United States (Ludwig, Ibriga, Rha, Denning, Wu, Lando, Tobian) Eli Lilly and Company, Indianapolis, IN, United States (Kiyosue) Tokyo-Eki Centre-Building Clinic, Tokyo, Japan (Giorgino) Department of Regenerative and Precision Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Piazza Giulio Cesare 11, Bari, Italy Publisher American Medical Association Abstract IMPORTANCE The effects of orforglipron, an oral, nonpeptide glucagon-like peptide 1 receptor agonist, added to insulin glargine for treatment of type 2 diabetes have not been described. OBJECTIVE To assess efficacy and safety of orforglipron added to titrated insulin glargine in adults with type 2 diabetes and inadequate glycemic control. DESIGN, SETTING, AND PARTICIPANTS Randomized, double-blind, phase 3 study conducted at 72 sites across the US, Brazil, China, Japan, and Romania between November 10, 2023, and September 15, 2025, in adults with type 2 diabetes taking insulin glargine with or without metformin and/or sodium-glucose cotransporter 2 inhibitors over 40 weeks. INTERVENTIONS Participants were randomized (1:1:1:1) to receive once-daily 3-mg (n = 137), 12-mg (n = 132), or 36-mg (n = 136) dosages of orforglipron or placebo (n = 141), in addition to titrated insulin glargine. MAIN OUTCOMES AND MEASURES The primary outcome was mean hemoglobin A<inf>1c</inf> (HbA<inf>1c</inf>) change from baseline to week 40 (for the 12-mg once daily and 36-mg once daily dosages of orforglipron). Key secondary outcomes were mean HbA<inf>1c</inf> change from baseline (for the 3-mg once daily dosage of orforglipron), proportion of participants achieving HbA<inf>1c</inf> targets of lower than 7.0% and 6.5% or lower, and mean body weight change and percentage change from baseline to week 40. RESULTS Among 546 randomized participants (median age, 61.0 [IQR, 26-95] years; 52.9% male; median duration of type 2 diabetes, 14.6 [IQR, 0.1-40.7] years; mean HbA<inf>1c</inf>, 8.50% [SD, 0.95%]; mean body mass index, 30.8 [SD, 6.1]), 507 (92.9%) completed the trial. At week 40, the mean changes from baseline in HbA<inf>1c</inf> were -1.58%, -1.88%, and -1.82% with orforglipron, 3 mg, 12 mg, and 36 mg once daily, respectively, vs -0.79% with placebo. Each dosage of orforglipron was superior to placebo (estimated treatment differences: 3 mg once daily, -0.78% [95% CI, -1.02% to -0.55%]; 12 mg once daily, -1.08% [95% CI, -1.33% to -0.83%]; 36 mg once daily, -1.03% [95% CI, -1.28% to -0.77%]; P < .001 for all). All key secondary outcomes demonstrated statistically significant differences in favor of orforglipron compared with placebo. Mean percentage body weight change from baseline was -2.6%, -4.8%, and -5.4% with orforglipron, 3 mg once daily, 12 mg once daily, and 36 mg once daily, respectively, vs 0.2% with placebo. The most frequent adverse events with orforglipron were gastrointestinal (mild to moderate). Orforglipron did not increase the risk of clinically significant hypoglycemia vs placebo. CONCLUSIONS AND RELEVANCE In participants with type 2 diabetes inadequately controlled by insulin glargine, addition of oral orforglipron significantly improved glycemic control and body weight, without increasing hypoglycemia risk, compared with placebo.<br/>Copyright © 2026 American Medical Association. All rights reserved, <55> Accession Number 2048345291 Title Rapid Inflation-Deflation vs Pressure-Optimized Stenting During Primary PCI. Source JACC: Cardiovascular Interventions. 19(16) (pp 2234-2246), 2026. Date of Publication: 24 Aug 2026. Author Hakeem A.; Ishaq H.; Memon F.F.; Shah J.A.; Ahmed I.; Mengal M.N.; Lakho A.A.; Solangi B.; Haq E.U.; Kumar R.; Shar G.S.; Bhatti K.I.; Ali A.; Mandokhail Z.I.; Zada S.; Mir A.; Kumari S.; Rai L.; Lehri W.A.; Kumar M.; Muhammad A.S.; Akhtar B.; Bai P.; Shabbir A.; Hussain A.; Naqvi K.Z.; Jabran I.; Modi N.; Brohi A.; Kumar D.; Khan A.; Rabia H.; Rehman I.; Humza A.; Karim M.; Saghir T. Institution (Hakeem, Ishaq, Ali, Shah, Mengal, Lakho, Solangi, Haq, Kumar, Shar, Bhatti, Ali, Mandokhail, Zada, Mir, Kumari, Kumar, Lehri, Kumar, Muhammad, Bai, Shabbir, Naqvi, Jabran, Modi, Rabia, Rehman, Humza, Karim, Saghir) National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan (Memon, Rai, Hussain, Brohi, Kumar, Khan) Sindh Institute of Cardiovascular Diseases (SICVD), Hyderabad, Pakistan (Ahmed, Akhtar) Sindh Institute of Cardiovascular Diseases (SICVD), Lyari, Pakistan Publisher Elsevier Inc. Abstract Background Incomplete microvascular reperfusion during primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains a major challenge. Objectives This study sought to determine whether the pressure optimization protocol (POP) improves reperfusion outcomes compared with conventional rapid inflation-deflation stenting in patients undergoing primary PCI for STEMI. Methods In this multicenter randomized trial with blinded endpoint assessment, patients undergoing primary PCI were assigned 1:1 to POP (stent inflation to >=14 atm maintained until pressure stability, defined as no pressure drop >=0.3 atm over 30 seconds) or conventional rapid inflation-deflation stenting. The primary endpoint was hierarchical reperfusion success, analyzed using the Finkelstein-Schoenfeld unmatched WIN ratio: ST-segment resolution >=70% at 90 minutes, final TIMI grade 3, and absence of slow-flow/no-reflow. Results Between September 30, 2024, and November 11, 2025, 607 patients underwent randomization (POP arm, n = 307; conventional arm, n = 300). POP improved the primary hierarchical reperfusion endpoint (WIN ratio: 1.42; 95% CI: 1.11-1.79; P = 0.004). The net WIN difference was +12.64% (95% CI: 3.69-20.98), driven mainly by the first 2 hierarchical components, ST-segment resolution >=70% (+5.70%; 95% CI: -1.89 to 12.56) and final TIMI grade 3 flow (+5.95%; 95% CI: 1.80-10.00). Postdilation was less frequent with POP (213 of 326 stents [65.3%] vs 294 of 323 [91.0%]; P < 0.001). At median follow-up of 30 days (IQR: 29-32), major adverse cardiovascular events (death, myocardial infarction, stent thrombosis, or stroke) occurred in 6 of 307 vs 12 of 300 patients; Kaplan-Meier estimated event rates were 2.0% (95% CI: 0.4-3.5) and 4.1% (95% CI: 1.8-6.3), respectively (HR: 0.49; 95% CI: 0.18-1.31; P = 0.15). Conclusions Among patients with STEMI undergoing primary PCI, pressure-optimized stent inflation resulted in significantly higher rates of successful reperfusion than conventional stenting and reduced need for post dilation. A trend toward fewer 30-day major adverse cardiovascular events was observed. Larger trials are warranted to assess effects on longer-term clinical outcomes. (RAPID-POP: A Randomized Controlled Trial; NCT06430892 )<br/>Copyright © 2026 American College of Cardiology Foundation. <56> Accession Number 2032563909 Title Efficacy and safety of anticoagulant and antiplatelet therapies in the medical management of carotid free-floating thrombus: A systematic review. Source Interventional Neuroradiology. 32(4) (pp 1796-1805), 2026. Date of Publication: 01 Aug 2026. Author Camerotte R.; Vilardo M.; Ribeiro F.V.; Bocanegra-Becerra J.E.; Goncalves O.R.; Paleare L.; Dominici S.; Corvelo A.P.C.; Fukunaga C.K.; Mitre L.P.; Sobral T.; Ferreira M.Y.; Ferreira C.; Gordon D.; Langer D.; Serulle Y. Institution (Camerotte) Faculty of Medicine, Federal University of Rio de Janeiro, RJ, Rio de Janeiro, Brazil (Vilardo) School of Medicine, Catholic University of Brasilia, DF, Brasilia, Brazil (Ribeiro) Faculty of Medicine, Barao de Maua University Center, SP, Ribeirao Preto, Brazil (Bocanegra-Becerra) Academic Department of Surgery, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru (Goncalves) School of Medicine, Federal University of Piaui, PI, Teresina, Brazil (Paleare) School of Medicine, Pontifical Catholic University of Parana, PR, Curitiba, Brazil (Dominici) School of Medicine, Federal University of Maranhao, MA, Sao Luis, Brazil (Corvelo) Faculty of Medicine, University of Grande Rio, RJ, Duque de Caxias, Brazil (Fukunaga) Faculty of Medicine, FMABC University Center, SP, Sao Paulo, Brazil (Mitre) Faculty of Medicine, Santa Casa de Sao Paulo School of Medical Sciences, SP, Sao Paulo, Brazil (Sobral) Faculty of Medicine, Cesmac University Center, AL, Maceio, Brazil (Ferreira, Langer, Serulle) Department of Neurosurgery, Lenox Hill Hospital, Northwell Health, New York, NY, United States (Ferreira, Gordon) Department of Neurosurgery, Phelps Hospital, Northwell Health, New York, NY, United States Publisher SAGE Publications Inc. Abstract Background: The optimal treatment for carotid free-floating thrombus (CFFT) remains uncertain due to limited evidence, with no randomized clinical trials and scarce guidelines, such as ESVS 2023, favoring conservative management. Anticoagulation (ACT) and antiplatelet (APT) therapies are emerging as promising alternatives to high-risk surgical interventions. This systematic review aimed to evaluate the safety and efficacy of ACT and APT therapies for CFFT. <br/>Method(s): A systematic search was performed across PubMed, Embase, Web of Science, and Cochrane databases. Safety and efficacy endpoints were assessed. A two-sample t-test compared baseline characteristics between groups, and a Chi-square test evaluated differences in categorical variables. Statistical significance was set at p < 0.05. Data were analyzed using R 4.3.0 with the meta package v.7.0-0. <br/>Result(s): Four studies met the inclusion criteria, involving 170 patients diagnosed with CFFT. The APT group included 96 patients (mean age 55.35 +/- 13.52 years; 56.25% male), and the ACT group included 74 patients (mean age 58.57 +/- 14.28 years; 51.35% male). Thrombus regression was slightly lower in APT (42%) compared to ACT (48%). Both groups showed similar rates of residual stenosis. Antiplatelet had fewer ischemic events within 30 days (none vs. 4% in ACT) and lower intracranial hemorrhage rates (3.3% vs. 5.4% in ACT) but higher mortality (6.3% vs. none in ACT). <br/>Conclusion(s): Both ACT and APT are effective for managing CFFT, each with distinct efficacy and safety profiles. However, randomized trials are necessary to better assess these therapies in CFFT management.<br/>Copyright © The Author(s) 2024 <57> Accession Number 2047435870 Title Suitability of sedative usage in patients undergoing cardiovascular surgery. Source Expert Review of Cardiovascular Therapy. 24(8) (pp 715-727), 2026. Date of Publication: 2026. Author Martin N.J.; Brinkman H.M.; Ellis S.; Nabzdyk C.G.S.; Ortoleva J.P.; Wittwer E.D.; D'Andria Ursoleo J.; Wieruszewski P.M.; Monaco F. Institution (Martin, Brinkman, Wieruszewski) Department of Pharmacy, Mayo Clinic, Rochester, MN, United States (Ellis) Department of Anesthesiology, University of California San Diego, San Diego, CA, United States (Nabzdyk, Wittwer, Wieruszewski) Department of Anesthesiology, Mayo Clinic, Rochester, MN, United States (Ortoleva) Department of Anesthesiology, Boston Medical Center, Boston, MA, United States (D'Andria Ursoleo) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Monaco) Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy (Monaco) Cardiothoracic and Vascular Anesthesia and Intensive Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy Publisher Taylor and Francis Ltd. Abstract Introduction: The provision of optimal anesthesia care is essential to the safe conduct of cardiac surgery. Nevertheless, evidence regarding ideal choices for anesthetic induction and maintenance remain conflicting. Individualized regimens balancing the patient's cardiac pathology and the expected hemodynamic perturbations from the anesthetics are likely optimal, underscoring the rationale for this review of contemporary anesthetic strategies in cardiac surgery. Areas covered: Descriptions of cardiac surgery trends and advancements that necessitate concomitant anesthesia, including the challenges with the provision of anesthesia in these patients were introduced. Induction and maintenance anesthesia considerations are discussed next, along with individual medication-specific commentary on volatile anesthetics, propofol, benzodiazepines, barbiturates, ketamine, etomidate, opioids, dexmedetomidine, and remimazolam. PubMed/MEDLINE, EMBASE, and Google Scholar were searched without date restriction through April 2026. Expert opinion: An optimal blanket anesthetic strategy for patients undergoing cardiac surgery remains elusive. Thoughtful combinations of multiple agents considering the patient's physiology, anticipated hemodynamic perturbations, and type and length of surgery are likely to continue to dominate practice. Novel agents, like remimazolam, may prove especially fruitful for patients given their unique properties, but more evidence is needed to prove impact on patient outcomes for this, and other agents in combination.<br/>Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <58> Accession Number 2048368739 Title Risk factors for diaphragmatic dysfunction in mechanically ventilated patients: a systematic review and meta-analysis. Source Frontiers in Medicine. 13 (no pagination), 2026. Article Number: 1828707. Date of Publication: 2026. Author Che R.; Pan S.; Han J.; Ma Q.; Xue A. Institution (Che, Xue) Qinghai University, Xining, China (Pan, Han, Ma) Department of Critical Care Medicine, Qinghai Provincial People's Hospital, Xining, China Publisher Frontiers Media SA Abstract Objective - To systematically identify and evaluate the risk factors for diaphragmatic dysfunction (DD) in mechanically ventilated patients. Methods - A comprehensive search of PubMed, Embase, Web of Science, CNKI, Wanfang, VIP, and CBM was conducted from database inception through July 2025. Case-control, cohort, and cross-sectional studies reporting risk factors for DD in mechanically ventilated patients were eligible. Two reviewers independently screened records, extracted data, and assessed risk of bias. Meta-analyses were performed using Review Manager 5.4. Results - Eleven studies comprising 5, 272 mechanically ventilated patients were included (7 cohort, 1 case-control, 3 cross-sectional). Meta-analysed risk factors: infection/sepsis (OR=2.65, 95% CI: 1.32-5.34, p=0.006), higher APACHE II score (OR=1.19, 95% CI: 1.09-1.30, p<0.0001), older age (OR=1.02, 95% CI: 1.00-1.04, p=0.02), and higher BMI (OR=1.03, 95% CI: 1.01-1.06, p=0.02) were each independently associated with increased DD risk. Meta-analysed protective factors: higher serum albumin (OR=0.88, 95% CI: 0.79-0.98, p=0.018) and greater grip strength (OR=0.70, 95% CI: 0.62-0.78, p<0.0001) were protective. Narrative-only findings: MV-related exposures could not be pooled owing to incompatible operationalisations across five studies; surgery-related factors (CABG, valve replacement, CPB duration) yielded inconclusive results due to extreme inter-study heterogeneity (I <sup>2</sup>=88-95%). Conclusion - Sepsis/infection, disease severity, advanced age, and elevated BMI are independent risk factors for DD in mechanically ventilated patients, whereas adequate nutritional status and preserved muscle strength are protective. Early identification of high-risk patients, nutritional optimisation, and infection control may reduce DD incidence. Systematic review registration - The publicly accessible registration URL is: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261302793, this systematic review was registered with PROSPERO under the unique identifier CRD420261302793.<br/>Copyright © 2026 Che, Pan, Han, Ma and Xue. <59> 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. <br/>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. <br/>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, I<sup>2</sup> = 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, I<sup>2</sup> = 0%). Peri-device leaks were significantly less common immediately post-procedure (OR = 0.57, 95% CI = 0.35-0.92, I<sup>2</sup> = 19%), but significantly more frequent on follow-up echocardiography (OR = 1.56, 95% CI = 1.14-2.12, I<sup>2</sup> = 71%). Mortality, major bleeding, device-related thrombus, and pericardial effusion without drainage did not differ significantly between groups. <br/>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.<br/>Copyright © 2026 The Author(s) <60> Accession Number 2048508093 Title Real-time AR navigation with dynamic tracking for millimeter-level pulmonary nodule localization: A randomized clinical trial. Source Cell Reports Medicine. 7(8) (no pagination), 2026. Article Number: 102942. Date of Publication: 18 Aug 2026. Author Huang S.; Wang L.; Wang X.; Sun W.; Sun F.; Guo Z.; Zhao M.; Chen T.; Wen J.; Shen X.; Shi X.; Zhang L.; Wan Z.; Chen Q.; Deng J.; She Y.; Xie D.; Zhao D.; Chen C. Institution (Huang, Wang, Wang, Sun, Sun, Guo, Zhao, Chen, Wen, Shen, Shi, Zhang, Wan, Chen, Deng, She, Xie, Zhao, Chen) Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China Publisher Cell Press Abstract Precise localization of small pulmonary nodules is crucial for surgery. Augmented reality (AR) navigation provides real-time guidance, potentially improving localization efficiency. This open-label randomized controlled trial compares AR-guided localization with conventional computed tomography (CT)-guided localization in 168 participants with peripheral pulmonary nodules <=2 cm. The primary outcome is localization accuracy; secondary outcomes are success rate, procedural time, radiation dose, insertion attempts, and complications. In the intention-to-treat population, the AR group shows significantly lower localization error than the CT group (4.50 +/- 3.07 vs. 6.50 +/- 3.54 mm), with shorter procedural time, lower radiation exposure, and fewer needle adjustments. Both groups show high success rates and similar complication rates, with no severe adverse events. AR-guided localization provides noninferior accuracy while reducing radiation exposure and procedural time, supporting an efficient alternative to CT guidance. The trial is registered at www.clinicaltrials.gov (NCT06335563).<br/>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/ <61> Accession Number 2046812787 Title Comparison of oxycodone hydrochloride injection versus sufentanil for postoperative analgesia in patients undergoing minimally invasive cardiac valve replacement: study protocol for a single-centre, randomised, double-blind non-inferiority trial. Source BMJ Open. 16(6) (no pagination), 2026. Article Number: e113082. Date of Publication: 01 Jun 2026. Author Chen X.; Shi Y.; Jin J.; Bao X.; Li Y.; Du H.; Pei L.; Song P.; Zhu Y. Institution (Chen, Shi, Jin, Bao, Li, Du, Song, Zhu) Department of Anesthesiology and Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China (Pei) Department of Epidemiology and Health Statistics, Xi'an Jiaotong University Health Science Center, Shaanxi, Xi'an, China Publisher BMJ Publishing Group Abstract Introduction: With the advancement of the ERAS (Enhanced Recovery After Surgery) concept, minimally invasive heart valve replacement surgery has become widely performed due to its advantages of smaller trauma and fewer adverse reactions. However, postoperative pain management remains complex and traditional opioid analgesia is often associated with adverse side effects. Oxycodone, an opioid agonist, has strong analgesic effects with relatively few side effects. This study aims to explore the efficacy and safety of oxycodone hydrochloride injection in multimodal pain management following minimally invasive heart valve replacement surgery. Methods and analysis: This is a prospective, double-blind, randomised controlled clinical trial designed as a non-inferiority study. The schedule of enrolment, interventions and outcome assessments is summarised in figure 2. The study period is from October 2024 to September 2027, and between 30 April 2026 and 31 October 2026, a total of 130 patients undergoing minimally invasive heart valve replacement surgery will be planned to recruit and randomly assign in a 1:1 ratio to receive either oxycodone hydrochloride injection or sufentanil for postoperative patient-controlled analgesia. The primary outcome is the Numerical Rating Scale pain score during coughing at 24 hours postoperatively. Secondary outcomes include measures of postoperative pain control, analgesic consumption, adverse events and recovery-related indicators. To address the risk of type I error due to multiple secondary outcomes, secondary endpoints are prespecified and categorised into key secondary outcomes and exploratory outcomes with corresponding statistical analysis strategies planned. This protocol is V.2.0, dated 29 December 2025. Ethics and dissemination: Ethical approval has been obtained from the Ethics Committee of the First Affiliated Hospital of Xi'an Jiaotong University (XJTU1AF2024LSYY-389-04). The study will be conducted in accordance with the Declaration of Helsinki, and informed consent will be obtained from all participants. Study results will be disseminated through peer-reviewed journals, scientific conferences and appropriate public channels. Trial registration: ChiCTR2400094930.<br/>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/. <62> Accession Number 2048536144 Title Intrawound Vancomycin Powder in Surgical Site Infection Prophylaxis: A Comprehensive Review of Mechanisms, Efficacy, Safety, and Clinical Controversies. Source Advances in Therapy. (no pagination), 2026. Date of Publication: 2026. Author Abd-Elsayed A.; Troka M.P.; Ortega J.L.; Riad A.I.; Bianco G.L.; Kaye A.D.; Reilly M.J. Institution (Abd-Elsayed, Troka, Ortega, Reilly) Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin, 600 Highland Avenue, B6/319 CSC, Madison, WI, United States (Riad) Department of Biology, The Ohio State University, Columbus, OH, United States (Bianco) Responsabile U.O. Analgesia E Chirurgia Percutanea, Fondazione Istituto G. Giglio, Sicily, Cefalu, Italy (Kaye) Department of Anesthesiology, Louisiana State University School of Medicine, Shreveport, LA, United States Publisher Adis Abstract Surgical site infections (SSIs) remain a critical postoperative complication that causes significant morbidity, mortality, and healthcare costs. To mitigate these risks, intrawound vancomycin powder has been increasingly adopted as a prophylactic option, particularly for high-risk procedures such as spine, orthopedic trauma, and cardiothoracic surgeries. However, the decision ultimately remains at the surgeon's discretion. This comprehensive review evaluates the mechanisms, clinical efficacy, and controversies surrounding the application of topical vancomycin. The current literature shows that intrawound vancomycin powder effectively reduces Gram-positive SSIs, overcomes ischemic barriers to early biofilm formation, and maintains a safe systemic profile while remaining highly cost-effective. However, serious clinical concerns remain about its widespread use, including higher rates of sterile wound dehiscence, possible localized cellular toxicity that may impair bone fusion, changes in pathogen profiles, and the growing threat of antimicrobial resistance. The absence of a US Food and Drug Administration (FDA) approval, lack of standardized dosing regimens, and warnings from major health organizations complicate its true clinical utility. Ultimately, the available literature suggests a shift away from universal application and toward tightly controlled, targeted interventions guided by strict antimicrobial stewardship. However, it remains for surgeons to evaluate risks versus benefits when administering vancomycin powder into incisions. Ongoing large-scale randomized controlled trials and emerging translational approaches, such as extended-release carrier systems and personalized bacteriological profiling, are essential for establishing definitive, evidence-based clinical guidelines.<br/>Copyright © The Author(s) 2026. <63> 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. <br/>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. <br/>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.<br/>Copyright © 2026, International Scientific Information, Inc.. All rights reserved. <64> Accession Number 2048488556 Title Comment on "Thrombolytic therapy versus cardiac surgery for left-sided prosthetic heart valve thrombosis: A systematic review and meta-analysis". Source American Heart Journal Plus: Cardiology Research and Practice. 70 (no pagination), 2026. Article Number: 100855. Date of Publication: 01 Oct 2026. Author Rohtagi R.; Ratnakar P.J.; Sati D.M.; Srinivasan H. Institution (Rohtagi) Sharda University School of Medical Sciences and Research, India (Ratnakar) Dr D Y Patil Vidyapeeth (Deemed to be University), India (Sati) Graphic Era Deemed to be University, India (Srinivasan) SIMATS Deemed University Saveetha Medical College and Hospital, India Publisher Elsevier Inc. <65> Accession Number 2048077717 Title Lesion length-dependent effects of quantitative flow ratio-guided percutaneous coronary intervention. Source Journal of Geriatric Cardiology. 23(7) (pp 385-395), 2026. Date of Publication: 2026. Author Jia D.; Guo Q.-Y.; Wang Z.-J.; Shi D.-M.; Wang J.; Chen Y.-D.; Pu J.; Chen L.-L.; Qu X.-K.; Yang J.-Q.; Liu X.-B.; Guo L.-J.; Guan C.-D.; Wang Y.; Huang Y.-F.; Qiao S.-B.; Zhou Y.-J.; Song L.; Stone G.W. Institution (Jia, Guo, Wang, Shi, Zhou) Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Beijing Institute of Heart Lung and Blood Vessel Disease, Clinical Center for Coronary Heart Disease, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China (Wang) Department of Cardiology, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China (Chen) Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Pu) The Sixth Medical Centre, Chinese PLA General Hospital, Beijing, China (Chen) Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China (Qu) Fujian Medical University Union Hospital, Fuzhou, China (Yang) Huadong Hospital Affiliated to Fudan University, Shanghai, China (Liu) Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (Guo) Tongji Hospital, Tongji University School of Medicine, Shanghai, China (Guan, Wang, Huang, Qiao, Song) Peking University Third Hospital, Beijing, China (Stone) Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States (Stone) Cardiovascular Research Foundation, New York, NY, United States Publisher Tsinghua University Press Abstract Background The FAVOR III China trial previously revealed that quantitative flow ratio (QFR)-guided percutaneous coronary intervention (PCI) achieved superior outcomes compared with angiography guidance. This predefined subgroup analysis was conducted to examine whether coronary lesion length modifying the clinical effect of QFR based revascularization strategy. Methods Overall, 3,825 patients were randomly assigned to either QFR-guided PCI (PCI performed only when QFR <= 0.80) or angiography-guided PCI. Lesions were categorized as long (>= 20 mm) or short (< 20 mm), based on measurements from an independent imaging core laboratory. The primary study endpoint consisted of the composite of major adverse cardiac events (MACE), including myocardial infarction, ischemia-associated revascularization, and all-cause mortality over three years of follow-up. Results A total of 1,877 patients were classified into the long-lesion group (931 QFR-guided and 946 angiography-guided), and 1,925 into the short-lesion group (974 QFR-guided, 951 angiography-guided). After three years, patients with longer lesions had a greater incidence of MACE relative to those with shorter lesions (15.5% vs. 9.8%; P < 0.0001). Relative to angiography, QFR guidance led to a reduction in PCI procedures in both strata 14.8% in the short-lesion group and 2.4% in the long-lesion group. Relative risk reduction in MACE with QFR guidance was consistent regardless of lesion length: 7.1% versus 12.6% (HR = 0.55; 95% CI: 0.41-0.74) in the short-lesion group and 13.9% versus 17.0% (HR = 0.79; 95% CI: 0.63-1.00) in the long-lesion group (P<inf>interaction</inf> = 0.06). Conclusions QFR-guided PCI was linked to fewer MACE relative to PCI guided by angiography after three years. The relative benefit was most pronounced in patients with shorter lesions.<br/>Copyright © 2026 JGC All rights reserved. <66> Accession Number 2048560265 Title Effects of Adding Incentive Spirometry to Hospital-Based Cardiovascular Rehabilitation on Pulmonary Complications, Hospital Length of Stay, and Clinical-Functional Recovery After Cardiac Surgery: A Randomized Controlled Trial. Source Physiotherapy Research International. 31(4) (no pagination), 2026. Article Number: e70325. Date of Publication: 01 Oct 2026. Author Messias B.E.S.; Silva T.A.S.; Schreiner R.A.; Torres L.; Bischoff J.; Oliveira T.F.; Peringer V.; Bortagarai F.M.; Marques M.D.; Eibel B.; Callegaro C.C. Institution (Messias, Silva, Callegaro) Graduate Program in Human Communication Disorders, Federal University of Santa Maria-UFSM, Rio Grande do Sul, Santa Maria, Brazil (Messias, Silva, Schreiner, Bortagarai, Marques, Callegaro) Physiology and Rehabilitation Laboratory, Federal University of Santa Maria-UFSM, Rio Grande do Sul, Santa Maria, Brazil (Torres, Bischoff, Oliveira, Peringer, Eibel) Institute of Cardiology of Porto Alegre-University Foundation of Cardiology (IC/FUC), Rio Grande do Sul, Porto Alegre, Brazil (Callegaro) Physiotherapy and Rehabilitation Department, Federal University of Santa Maria-UFSM, Rio Grande do Sul, Santa Maria, Brazil Publisher John Wiley and Sons Ltd Abstract Background and Purpose: This study investigated the effects of combining incentive spirometry with cardiac rehabilitation compared with cardiac rehabilitation alone on postoperative pulmonary complications, clinical-functional recovery, and hospital length of stay in patients undergoing cardiac surgery. <br/>Method(s): Randomized controlled trial was conducted from May 2019 to October 2023 in two hospitals, including 46 inpatients undergoing cardiac surgery. Participants were assigned to incentive spirometry plus cardiac rehabilitation or cardiac rehabilitation alone. Both interventions were performed twice daily; spirometry used a volume-oriented device, and rehabilitation followed a seven-step protocol (2-4 METs). Outcomes included postoperative pulmonary complications, functional capacity (6-min walk test), handgrip strength, respiratory muscle function, and length of hospital stay. <br/>Result(s): The incentive spirometry associated with cardiac rehabilitation group had a longer extracorporeal circulation time (98 +/- 26 min) than the cardiac rehabilitation group (76 +/- 1; p = 0.008). Both groups showed a postoperative decline in respiratory muscle strength, and walking distance (MD: -64.37 m; 95% CI: [-24.1; -104.6]; d = 0.71), with no difference in postoperative pulmonary complications and handgrip strength. The incentive spirometry associated with cardiac rehabilitation group did not significantly differ on postoperative hospital stay compared with the cardiac rehabilitation group (MD: -1 day; 95% CI: [-4.71; 2.71]; d = -0.19). <br/>Conclusion(s): In this study, no additional benefit was observed with the addition of incentive spirometry to cardiac rehabilitation compared with cardiac rehabilitation alone. No significant differences were detected between groups in postoperative pulmonary complications, hospital length of stay, or clinical-functional recovery among individuals undergoing cardiac surgery. Trial Registration: Brazilian Registry of Clinical Trials (REBEC) under the number RBR-8tsjf97.<br/>Copyright © 2026 The Author(s). Physiotherapy Research International published by John Wiley & Sons Ltd. <67> Accession Number 2048488583 Title Systematic Review of Acute Coronary Artery Revascularization During Pregnancy. Source American Journal of Cardiology. 275 (pp 51-57), 2026. Date of Publication: 15 Sep 2026. Author Basala T.R.; Mutlu D.; Romano E.; Wanar A.; Carvalho P.E.P.; Rangan B.V.; Sandoval Y.; Sharkey S.W.; Saxena R.; Brilakis E.S. Institution (Basala, Mutlu, Carvalho, Rangan, Sandoval, Brilakis) The Center for Coronary Artery Disease, Minneapolis Heart Institution Foundation and Minneapolis Heart Institute, Minneapolis, MN, United States (Basala, Romano, Wanar) The University of Michigan Medical School, Ann Arbor, MI, United States (Sharkey, Saxena) The Penny Anderson Women's Cardiovascular Center, Minneapolis Heart Institution Foundation and Minneapolis Heart Institute, Minneapolis, MN, United States Publisher Elsevier Inc. Abstract Acute coronary syndrome during pregnancy is rare but its incidence may rise in the future due to increasing rates of cardiovascular risk factors in young adults. Little is known about revascularization strategies and outcomes among pregnant patients. Therefore, we performed a systematic search of published cases of coronary revascularization during pregnancy with percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery. A total of 60 cases of PCI (n = 42) and CABG (n = 19) were included (1 case with both). The median age at presentation was 33 [31,38] years. The median gestational age was 22 [12,32] weeks. Most patients presented in the third trimester (38%). The most common cardiovascular and obstetric risk factors included hypertension (23%), previous (44%) and current tobacco use (34%), and advanced maternal age (37%). Patients most commonly presented with ST-elevated myocardial infarction (63%) and lesions in the left anterior descending artery (72%). The overall procedural complication rate was 11.7% (95% CI 4.8% to 22.6%) for all cases, 16.7% (7.0% to 31.4%) for PCI, and 5.3% (0.1% to 26.0%) for CABG. The overall rate of successful delivery was 83.3% (95% CI 68.6% to 93.0%), with most pregnancies resulting in cesarean deliveries (69%). In conclusion, this systematic review of published cases of coronary artery revascularization during pregnancy found low rates of procedural complications and high rates of successful deliveries. Hypertension, tobacco use, and advanced maternal age were common risk factors preceding presentation.<br/>Copyright © 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <68> Accession Number 652072868 Title BARTONELLA QUINTANA ENDOCARDITIS CAUSING CATASTROPHIC AORTIC VALVE DESTRUCTION REQUIRING MECHANICAL VALVE REPLACEMENT AND CABG IN A PREVIOUSLY HEALTHY YOUNG MALE AFTER MISLEADING VECTOR EXPOSURE. Source Journal of General Internal Medicine. Conference: 2026 Annual Meeting of the Society of General Internal Medicine. Washington United States. 41(1 Supplement 1) (pp S140-S141), 2026. Date of Publication: 01 Jul 2026. Author Makonyonga R.D.; Amedetowou S.F.; Brothers V. Institution (Makonyonga, Amedetowou, Brothers) Medical Center Internal Medicine Residency, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States Publisher Springer Abstract CASE: Bartonella quintana is a rare cause of culture-negative infective endocarditis (IE), typically associated with homelessness, body lice exposure, poor hygiene, or alcoholism. Diagnosis is often delayed because blood cultures are frequently negative, and early serologies may be falsely low. Although infection usually presents subacutely, B. quintana can cause rapidly destructive valvular disease requiring urgent surgery. We present a case of B. quintana endocarditis in a patient without classic risk factors, initially misdirected by an acute coronary syndrome like presentation. A 41-year-old man with a history of smoking presented with acute chest pain several days after a bug bite. He had no fever, chills, or stigmata of IE. ECG showed lateral T-wave inversions and subtle ST depressions, but serial troponins remained flat at approximately 150 ng/L. A new holosystolic murmur was noted on exam. CTA showed a calcified-appearing aortic valve. Echocardiography revealed a mobile aortic-valve mass, leaflet perforation, and severe aortic regurgitation. Coronary angiography showed left-dominant anatomy with 90% mid-RCA stenosis. He underwent mechanical AVR and CABG x1. Postoperatively, broad infectious and autoimmune testing was negative, including blood cultures and serologies for Coxiella burnetii, Brucella, fungal pathogens, and ANA. Preoperative Bartonella titers were mildly positive (1:64) but rose to 1:512 and 1:1024, confirming B. quintana IE. He was treated with doxycycline and rifampin. IMPACT/DISCUSSION: Bartonella quintana endocarditis is rare and difficult to recognize, especially without classic risk factors. It can mimic ACS, as in this case where ischemic ECG changes and chest pain misled early evaluation, though flat troponins suggested a non-ischemic cause. A systematic review shows its severity: 98% require valve surgery and mortality approaches 10%. Culture-negative status and low early titers often delay diagnosis, reinforcing the need for repeat Bartonella testing. This patient's rapid valve destruction and need for AVR/CABG highlight the organism's aggressive nature. Clinicians should consider B. quintana in severe culture-negative IE, even in atypical hosts. <br/>CONCLUSION(S): This case demonstrates that Bartonella quintana endocarditis can occur in patients without traditional risk factors and may closely mimic acute coronary syndrome, particularly when ischemic ECG changes dominate the presentation. Persistently flat troponins, culture-negative testing, and early echocardiography were essential in redirecting the diagnostic pathway. Delayed serologic conversion ultimately confirmed the diagnosis, underscoring the importance of repeat Bartonella testing when suspicion persists. Given its potential for rapid and destructive valvular injury requiring urgent surgical intervention, clinicians should maintain B. quintana on the differential for severe culture-negative endocarditis-even in atypical hosts. <69> Accession Number 652066598 Title "Heart in a Box," a Novel Organ Care System for Heart Transplantation. Source Cardiology in review. (no pagination), 2026. Date of Publication: 26 Aug 2026. Author Kallash M.; Frishman W.H. Institution (Kallash) From the Department of Medicine, Montefiore Medical Center, Bronx, NY, United States (Frishman) Department of Medicine, School of Medicine, New York Medical College, Valhalla, NY, United States (Frishman) Department of Medicine, Westchester Medical Center, Valhalla, NY, United States Abstract As the global burden of heart failure continues to rise, heart transplantation-the only definitive therapy for heart failure-has become a major focus of clinical research aimed at increasing the availability of suitable donor allografts. Historically, heart transplantation has been limited to the availability of hearts obtained from donors after brain death within relatively short distances. The TransMedics Organ Care System (OCS) Heart is a novel technology that allows for portable extracorporeal nonischemic perfusion of the heart after the circulatory death of the donor. Often referred to as "Heart in a Box," the OCS Heart is a potential major advancement in heart transplantation because of its ability to preserve the heart in a metabolically active state after the circulatory death of the donor, allowing for longer-distance transport compared to traditional cold storage methods. Numerous randomized controlled trials studying the efficacy of the OCS Heart technology from donors after circulatory death compared to traditional cold storage methods from donors after brain death demonstrated noninferiority. By allowing for preservation after circulatory death and for longer transport times, the OCS Heart can potentially significantly expand the donor pool and increase the number of heart transplants. The major limitations of its use include the expensive costs of operation, the increased level of training required for personnel, and the risk of technological malfunctions compared to traditional cold storage methods. Nevertheless, the OCS Heart is poised as a critical development in the field of heart transplantation, with an expectation that adoption rates for its use will increase in the coming years.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <70> Accession Number 652067607 Title Left atrial appendage closure versus medical therapy in atrial fibrillation: An updated meta-analysis of randomized trials on the trade-off between stroke prevention and bleeding. Source Kardiologia polska. (no pagination), 2026. Date of Publication: 27 Aug 2026. Author Di Pietro G.; Improta R.; Bruno E.; Musto C.; Gaspardone A.; Mancone M. Institution (Di Pietro, Improta, Bruno, Mancone) Department of Clinical and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy (Musto) Cardiology Unit, Ospedale S. Giovanni Evangelista, Tivoli, Italy (Gaspardone) Division of Cardiology, Sant' Eugenio Hospital, Rome, Italy Abstract BACKGROUND: Long-term oral anticoagulation remains the standard of care for patients with atrial fibrillation, despite the non-negligible risk of bleeding. Percutaneous left atrial appendage closure (LAAC) has emerged as an alternative strategy for preventing stroke with inconclusive modern data. AIMS: Our aim was to evaluate the comparative efficacy and safety of LAAC vs. medical therapy in patients with atrial fibrillation. <br/>METHOD(S): A systematic search of PubMED, Scopus and EMBASE was conducted up to April 2026 to identify randomized controlled trials comparing LAAC with medical therapy. The primary endpoint was overall stroke. The secondary endpoints were ischemic stroke, hemorrhagic stroke, systemic embolism, mortality, major bleeding and non-procedural bleeding. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using a random-effects model with restricted maximum likelihood estimation and Hartung-Knapp adjustment. <br/>RESULT(S): Six randomized controlled trials, encompassing 7004 patients globally (device group: 3681 patients; medical therapy group: 3323 patients), were included in the analysis. LAAC was associated with a similar risk of stroke to medical therapy (OR, 0.92; 95% CI, 0.65-1.3; P = 0.55) at a median 39 (interquartile range 36-47) months of follow-up. No significant differences were observed in ischemic stroke, hemorrhagic stroke, systemic embolism, all-cause mortality or cardiovascular mortality. Rates of major bleeding were comparable (OR, 1.13; 95% CI, 0.90-1.43; P = 0.23). However, medical therapy was associated with a significantly higher risk of non-procedural bleeding compared with LAAC (OR, 1.95; 95% CI, 1.67-2.27; P <0.001). These findings were consistent across subgroup analyses. <br/>CONCLUSION(S): LAAC provides thromboembolic protection comparable to medical therapy while reducing non-procedural bleeding. These findings support its role as an alternative strategy in selected patients at increased bleeding risk. <71> [Use Link to view the full text] Accession Number 2047709150 Title The Use of Methadone in Adult Cardiac Surgery: A Systematic Review With Narrative Synthesis. Source Anesthesia and Analgesia. (no pagination), 2026. Date of Publication: 2026. Author Kumar N.; Bardia A.; Hussain N.; Gerner P. Institution (Kumar, Bardia, Gerner) Department of Anesthesia, Critical Care Medicine, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States (Hussain) Department of Anesthesiology, The Ohio State University Wexner Medical Center, Columbus, OH, United States Publisher Lippincott Williams and Wilkins Abstract Methadone is a long-acting opioid with multifaceted analgesic properties that is under increasing investigation as an intraoperative analgesic in cardiac surgery. A systematic search of United States National Library of Medicine Database (MEDLINE) and Excerpta Medica Database (EMBASE) databases identified publications investigating the use of intraoperative methadone in adult cardiac surgical patients. The risk of bias and quality of evidence of these studies were assessed, and data from these reports were extracted and presented in a narrative format. Sixteen eligible publications were included. Although the quality of the studies was moderate to high, the certainty of the evidence is low due to the limited available data regarding optimal dosing strategies, timing of administration in relation to cardiopulmonary bypass, and long-term safety outcomes. The composite data suggest that a single dose of intraoperative methadone results in less postoperative pain and opioid consumption postoperatively without any increased risk for QTc prolongation or respiratory depression. Doses of 0.1 to 0.3 mg/kg are reported in the cardiac surgery literature; however, there is evidence of a dose-response relationship with methadone's analgesic benefits and increased deliriogenic side effects. Studies using 0.1 mg/kg reveal equivocal analgesia, whereas the studies administering >=0.2 mg/kg consistently report lower postoperative pain scores and opioid consumption compared to short-acting intravenous (IV) opioids. Crucially, the use of cardiopulmonary bypass significantly impacts methadone's plasma concentrations and must be considered when determining the optimal dose and timing of administration. Further, recent observational studies offer valuable insight into methadone's role in multimodal enhanced recovery after cardiac surgery protocols. Additional trials are needed to refine methadone usage in this population.<br/>Copyright © 2026 International Anesthesia Research Society <72> Accession Number 652073042 Title HOW LOW CAN YOU GO? LDL MANAGEMENT IN HIGH-RISK ATHEROSCLEROTIC CARDIOVASCULAR DISEASE PATIENTS. Source Journal of General Internal Medicine. Conference: 2026 Annual Meeting of the Society of General Internal Medicine. Washington United States. 41(1 Supplement 1) (pp S31), 2026. Date of Publication: 01 Jul 2026. Author Battle L.; Rahman I.; Koransky A. Institution (Battle, Rahman, Koransky) Mount Sinai Health System, New York, NY, United States Publisher Springer Abstract CASE: A 71-year-old male with history of coronary artery disease post stenting, hypertension (HTN), and hemorrhagic stroke presented with vertigo and headache, and was found to have a cerebral aneurysm. Neurosurgery recommended noninvasive monitoring and strict blood pressure and lipid control. Patient had been on a high intensity statin for years. At presentation, lipid panel showed cholesterol 71 mg/dL, HDL 29 mg/dL, and LDL 33 mg/dL. Routine follow up one year later showed LDL 13 mg/dL. IMPACT/DISCUSSION: Observational data suggests association between low LDL and increased risk of hemorrhagic stroke and cerebral aneurysms. Cohort studies found an association with low LDL and increased risk of hemorrhagic stroke; however randomized trial data has not shown significant increased risk at LDL <70 mg/dL. It is thought that low LDL does not increase risk of hemorrhagic stroke in patients with no prior cerebrovascular disease, however in patients with history of hemorrhage, the American Heart Association (AHA) states there is not yet a consensus on optimal LDL management. Additionally, metaanalyses have shown hypercholesterolemia is associated with lower risk of cerebral aneurysm rupture, and statins have not been shown to significantly reduce aneurysm growth. These studies are limited, and further exploration is needed to determine the role of LDL lowering therapy in aneurysm growth and rupture risk. Multiple cardiovascular societies recommend aggressive LDL reduction in patients with atherosclerotic cardiovascular disease (ASCVD) to LDL <70 mg/dL, and <55 mg/dL in very high-risk patients. Very high-risk patients have history of multiple major ASCVD events, or one major ASCVD event and >=2 high risk conditions (>=65 years, familial hypercholesterolemia, coronary revascularization, diabetes mellitus (DM), congestive heart failure, HTN, chronic kidney disease, tobacco use, LDL >=100 mg/dL despite maximal therapy). This is associated with a reduced risk of major ASCVD events, shown to be inversely proportional to the LDL to as low as <20 mg/dL. Notably, society guidelines have not specified a minimum threshold of LDL in ASCVD patients, with an AHA review article endorsing, "lowest is best". Statin therapy has been associated with a modest increase incidence of DM, as mechanistically statins may impair insulin sensitivity and secretion. Yet, multi society guidelines agree that ASCVD benefits outweigh the risk of new DM. Importantly, there remains a gap in knowledge regarding low LDL, especially in patients with history of cerebrovascular disease, which warrants further exploration as lipid lowering recommendations intensify. This case exemplifies why further investigation is needed in this area. <br/>CONCLUSION(S): 1. Guidelines recommend aggressive LDL reduction in patients with ASCVD, however goals must be individualized in patients with cerebrovascular disease namely hemorrhagic stroke 2. Further exploration is required on patients with low LDL and cerebrovascular disease <73> Accession Number 652078200 Title Transcatheter Aortic Valve Replacement or Medical Treatment for Paradoxical Low-Flow, Low-Gradient Aortic Valve Stenosis: REBOOT-PARADOX. Source Journal of the American College of Cardiology. (no pagination), 2026. Date of Publication: 28 Aug 2026. Author Mehilli J.; Steffen J.; Rudolph T.; Haum M.; Giannini C.; Stark K.; Ince H.; Conradi L.; Joner M.; Schafer A.; Karcher A.-K.; Landt M.; Adam M.; Thiele H.; Geisler T.; Jochheim D.; Hagl C.; Zeymer U.; Windecker S.; Massberg S. Institution (Mehilli) LA-Regio Kliniken, Klinik Landshut-Achdorf, Landshut, Germany; Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Steffen, Haum, Stark, Massberg) Medizinische Klinik und Poliklinik I, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany; DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany (Rudolph) Klinik fur Kardiologie, Bad Oeynhausen, Germany (Giannini) Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Ince) Klinik und Poliklinik fur Kardiologie, Department fur Innere Medizin, Universitatsmedizin Rostock, Rostock, Germany (Conradi) Universitares Herz- und Gefaszentrum Hamburg, Klinik und Poliklinik fur Herz- und Gefaschirurgie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany; Herzzentrum der Universitat Koln, Klinik und Poliklinik fur Herzchirurgie, Uniklinik Koln, Cologne, Germany (Joner) DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany; TUM Universitatsklinikum Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany (Schafer) Klinik und Poliklinik fur Herz- und Gefaschirurgie, Universitatsklinikum Hamburg-Eppendorf, Hamburg, Germany (Karcher) Medizinische Klinik B, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany (Landt) Kardiologie und Angiologie, HerzzentrumSegeberger Kliniken, Bad Segeberg, Germany (Adam) Department of Cardiology, Heart Center Cologne, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany (Thiele) Department of Cardiology and Leipzig Heart Science, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Geisler) Innere Medizin III, Universitatsklinikum Tubingen, Tubingen, Germany (Jochheim) Medizinische Klinik und Poliklinik I, LMU University Hospital, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Hagl) DZHK (German Centre for Cardiovascular Research), Munich Heart Association (MHA), Munich, Germany; Herzchirurgische Klinik und Poliklinik, LMU University Hospital, LMU Medizin, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Zeymer) Medizinische Klinik B, Klinikum der Stadt Ludwigshafen am Rhein gGmbH, Ludwigshafen, Germany; Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Faculty of Medicine, University of Freiburg, Freiburg, Germany (Windecker) Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Abstract BACKGROUND: Paradoxical low-flow, low-gradient (pLFLG) aortic stenosis (AS) has an adverse prognosis in comparison to other AS subtypes. Transcatheter aortic valve replacement (TAVR) has never been compared with optimal medical therapy (OMT) alone in a dedicated randomized trial in this population. <br/>OBJECTIVE(S): The trial sought to determine whether TAVR added to OMT reduces all-cause mortality in symptomatic patients with pLFLG AS. <br/>METHOD(S): In this multicenter, open-label trial, patients with symptomatic pLFLG AS (aortic valve area <=1.0 cm2, mean gradient <40 mm Hg, stroke volume index <35 mL/m2, ejection fraction >=50%) were randomly assigned 2:1 to TAVR plus OMT or OMT alone. The primary endpoint was all-cause death, assessed 2 years after enrollment of the last patient. Enrollment was stopped prematurely for slow recruitment. <br/>RESULT(S): Of 783 planned patients, 120 (median age 82 years; 53.3% women) were randomized (80 TAVR, 40 OMT). A total of 19 OMT patients eventually crossed over to TAVR, most for symptom progression. The primary endpoint occurred in 29.0% vs 37.1% (HR: 0.83; 95% CI: 0.41-1.66; P = 0.60), and 5-year mortality was 44.9% vs 56.6% (HR: 0.76; 95% CI: 0.43-1.35; P = 0.35). TAVR was associated with improved symptoms (NYHA functional class I/II at 1 year, 83.0% vs 59.0%) and lower cumulative incidence of first endpoint-related rehospitalizations, and there were no differences in functional capacity or quality of life. <br/>CONCLUSION(S): Although the effect of TAVR on mortality remains unresolved, these findings support an individualized strategy with close surveillance and timely TAVR upon clinical deterioration in selected patients with pLFLG AS. Adequately powered randomized trials are needed to define the effect of early TAVR on prognosis. (accuRate Evaluation of Benefit with Optimal medical treatment with or withOut Transcatheter valve repair of PARADOXical low flow low gradient aortic stenosis [REBOOT-PARADOX Trial]; NCT03863132).<br/>Copyright © 2026 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. <74> Accession Number 652079563 Title Response-Tailored or Standard-Duration Antibiotic Treatment for Infective Endocarditis. Source The New England journal of medicine. (no pagination), 2026. Date of Publication: 28 Aug 2026. Author Bundgaard H.; Pries-Heje M.; Hjulmand J.; Hasselbalch R.; Jorgensen P.G.; Fano S.; Kober N.; Tuxen C.; Kader N.; Seven E.; Rasmussen L.E.; Wienberg M.; Bruun N.E.; Tofterup M.; Rasmussen M.; Baden L.R.; Woolley A.; Lange T.; Helweg-Larsen J.; Povlsen J.A.; Fosbol E.; Moser C.; Iversen K. Institution (Bundgaard, Pries-Heje, Hjulmand, Hasselbalch, Kader, Fosbol) Department of Cardiology, Copenhagen University Hospital-Hjertecentret and Rigshospitalet, Copenhagen, Denmark (Bundgaard, Seven, Bruun, Fosbol, Iversen) Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark (Hasselbalch, Jorgensen, Fano, Iversen) Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte Hospital, Copenhagen, Denmark (Hasselbalch, Iversen) Department of Emergency Medicine, Copenhagen University Hospital-Herlev and Gentofte Hospital, Herlev, Denmark (Hasselbalch) Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark (Kober, Tuxen) Department of Cardiology, Copenhagen University Hospital-Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark (Seven) Department of Cardiology, Copenhagen University Hospital-Amager and Hvidovre, Copenhagen, Denmark (Rasmussen) Department of Cardiology, Godstrup Regional Hospital, Denmark (Wienberg) Department of Cardiology, Copenhagen University Hospital-North Zealand, Denmark (Bruun) Department of Cardiology, Zealand University Hospital, Roskilde, Denmark (Bruun) Department of Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark (Tofterup) Department of Cardiology, Odense University Hospital, Odense, Denmark (Rasmussen) Department of Infectious Diseases, Skane University Hospital, Lund, Sweden (Rasmussen) Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden (Baden, Woolley) Harvard Medical School, Boston, United States (Baden) Dana-Farber Cancer Institute, Boston, United States (Baden, Woolley) Division of Infectious Diseases, Brigham and Women's Hospital, Boston, United States (Lange) Department of Public Health, University of Copenhagen, Copenhagen, Denmark (Helweg-Larsen) Department of Infectious Diseases, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Povlsen) Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (Moser) Department of Clinical Microbiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark (Moser) Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark Abstract BACKGROUND: In patients with infective endocarditis on the left side of the heart, the current recommendation of up to 6 weeks of antibiotic therapy is based largely on expert consensus opinion. Whether a clinical response-tailored antibiotic management strategy can shorten treatment duration without compromising safety is unclear. <br/>METHOD(S): In this international, open-label, randomized trial, we assigned adults in stable condition with infective endocarditis caused by Staphylococcus aureus, Enterococcus faecalis, or streptococcus species to receive either response-tailored or standard-duration antibiotic therapy. Before randomization, all the patients received at least the prespecified 2 to 4 weeks of therapy and met criteria for clinical stabilization. After randomization, patients in the tailored-therapy group discontinued antibiotics and those in the standard-therapy group continued standard treatment (total duration, 4 to 6 weeks). The primary efficacy end point was days alive without antibiotic treatment for infective endocarditis or bacteremia within 6 months after randomization (tested for superiority). The primary safety end point was a composite of death from any cause, unplanned cardiac surgery, or symptomatic embolic events within 6 months after randomization (tested for noninferiority; margin, 7.5 percentage points). Relapse of bacteremia or infective endocarditis was a key secondary end point. <br/>RESULT(S): A total of 508 patients underwent randomization, with 255 assigned to response-tailored therapy and 253 to standard-duration therapy. The median time alive without antibiotic treatment was 183 days (interquartile range, 181 to 183) with tailored therapy and 169 days (interquartile range, 166 to 171) with standard therapy (Hodges-Lehmann estimated difference, 13 days; 95% confidence interval [CI], 12 to 13; P<0.001 for superiority). A primary safety end-point event occurred in 21 patients (8.2%) with tailored therapy and in 27 patients (10.7%) with standard therapy (absolute between-group difference, -2.4 percentage points; 95% CI, -7.7 to 2.7; P<0.001 for noninferiority), indicating noninferiority. Relapse occurred in 13 patients (5.1%) with tailored therapy and in 4 patients (1.6%) with standard therapy (P = 0.04). <br/>CONCLUSION(S): Among patients with infective endocarditis on the left side of the heart, the use of a response-tailored antibiotic strategy resulted in a longer time alive without antibiotic therapy than standard-duration therapy and met the criterion for noninferiority with respect to safety but was associated with a higher incidence of relapse of bacteremia or infective endocarditis. (Funded by Sygeforsikringen "danmark" and others; POET II ClinicalTrials.gov number, NCT03851575.).<br/>Copyright © 2026 Massachusetts Medical Society. <75> Accession Number 652067773 Title Treatment effects of dapagliflozin in patients with aortic stenosis undergoing transcatheter aortic valve implantation across left ventricular ejection fraction. Source European journal of heart failure. (no pagination), 2026. Date of Publication: 27 Aug 2026. Author Raposeiras Roubin S.; Gonzalez-Manzanares R.; Amat-Santos I.; Melendo Viu M.; Dobarro D.; Lopez Otero D.; Nombela Franco L.; Gheorge L.; Sanz-Sanchez J.; Carlos B.Z.; Ojeda S.; Iniguez Romo A.; Munoz Garcia A.J.; Vilalta V.; Veiga Fernandez G.; Cordoba Soriano J.G.; Regueiro A.; Sandin Rollan M.; Flores Rios X.; Uribarri A.; Martin Reyes R.; Romaguera R.; Avanzas P.; Garcia Blas S.; Franco-Pelaez J.A.; Martin Moreiras J.; Gonzalez Juanatey J.R.; Tirado G.; Calle G.; Diez J.L.; Santos-Martinez S.; Gonzalez Ferreiro R.; Munoz Garcia E.; Carrillo Suarez X.; Sanmartin X.; Gonzalo N.; Gutierrez Barri A.; Asmarats L.; Diaz Del Hoyo F.; Camacho Freire S.; Yanes G.; Astorga Burgo J.C.; Molina Navarro E.; Caballero Borrego J.; Gonzalez Bermudez I.; Fuster V.; Ibanez B. Institution (Raposeiras Roubin, Melendo Viu, Dobarro, Iniguez Romo, Gonzalez Ferreiro, Gonzalez Bermudez) Cardiology Department, University Hospital Alvaro Cunqueiro, Vigo, Spain (Raposeiras Roubin, Melendo Viu, Dobarro, Lopez Otero, Iniguez Romo, Gonzalez Ferreiro, Sanmartin, Gonzalez Bermudez) Cardiology Department, Instituto de Investigacion Sanitaria Galicia Sur, Vigo, Spain (Raposeiras Roubin) Medicine Department, University of Santiago de Compostela, Spain (Raposeiras Roubin, Fuster, Ibanez) Cardiology Department, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain (Gonzalez-Manzanares, Ojeda) Department of Cardiology, Reina Sofia University Hospital, Cordoba, Spain (Gonzalez-Manzanares, Ojeda) Cardiology Department, Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain (Gonzalez-Manzanares, Ojeda) Department of Medicine, University of Cordoba, Cordoba, Spain (Gonzalez-Manzanares, Amat-Santos, Carlos, Ojeda, Santos-Martinez) Cardiology Department, Centro de Investigacion Biomedica en Red Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain (Amat-Santos, Carlos, Santos-Martinez) Cardiology Department, University Clinical Hospital of Valladolid, Valladolid, Spain (Lopez Otero, Sanmartin) Cardiology Department, University Hospital Montecelo, Pontevedra, Spain (Nombela Franco, Tirado, Gonzalo) Cardiology Department, Clinical Hospital San Carlos, Madrid, Spain (Gheorge, Calle, Gutierrez Barri) Cardiology Department, University Hospital Puerta del Mar, Cadiz, Spain (Sanz-Sanchez, Vilalta, Diez) Cardiology Department, University Hospital La Fe, Valencia, Spain (Munoz Garcia, Munoz Garcia) Cardiology Department, University Hospital Virgen de la Victoria, Malaga, Spain (Veiga Fernandez) Cardiology Department, University Hospital Marques de Valdecilla, Santander, Spain (Veiga Fernandez) Cardiology Department, Instituto de Investigacion Valdecilla, Santander, Spain (Cordoba Soriano) Cardiology Department, University Hospital of Albacete, Albacete, Spain (Regueiro) Cardiology Department, University Clinical Hospital, Barcelona, Spain (Sandin Rollan) Cardiology Department, University General Hospital of Alicante, Alicante, Spain (Flores Rios) Cardiology Department, University Hospital Juan Canalejo, A Coruna, Spain (Uribarri) Cardiology Department, University Hospital Vall D'Hebron, Barcelona, Spain (Martin Reyes) Cardiology Department, University Hospital Quiron Salud La Luz, Madrid, Spain (Romaguera) Cardiology Department, University Hospital Bellvitge, Barcelona, Spain (Avanzas) Cardiology Department, University Hospital Central de Asturias, Oviedo, Spain (Garcia Blas) Cardiology Department, Clinic University Hospital of Valencia, Valencia, Spain (Garcia Blas) Cardiology Department, INCLIVA Biomedical Research Institute, Valencia, Spain (Franco-Pelaez, Ibanez) Cardiology Department, University Hospital Fundacion Jimenez Diaz, Madrid, Spain (Martin Moreiras) Cardiology Department, University Clinical Hospital of Salamanca, Salamanca, Spain (Gonzalez Juanatey) Cardiology Department, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain (Carrillo Suarez) Cardiology Department, University Hospital German Trias I Pujol, Badalona, Spain (Asmarats) Cardiology Department, University Hospital Santa Creu I Sant Pau, Barcelona, Spain (Diaz Del Hoyo) Cardiology Department, University Hospital 12 de Octubre, Madrid, Spain (Camacho Freire) Cardiology Department, University Hospital Juan Ramon Jimenez, Huelva, Spain (Yanes) Cardiology Department, University Hospital of Canarias, Tenerife, Spain (Astorga Burgo) Cardiology Department, University Hospital of Cruces, Spain (Molina Navarro) Cardiology Department, University Hospital Virgen de las Nieves, Granada, Spain (Caballero Borrego) Cardiology Department, University Hospital San Cecilio, Granada, Spain (Fuster) Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, NY, United States Abstract AIMS: Sodium-glucose cotransporter 2 (SGLT2) inhibitors improve outcomes in heart failure (HF) across the left ventricular ejection fraction (LVEF) spectrum, but patients with severe valvular heart disease have been excluded from pivotal trials. We investigated the efficacy and safety of dapagliflozin across the full range of baseline LVEF in elderly patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: DapaTAVI was a pragmatic, multicentre, randomized, open-label trial with blinded endpoint adjudication conducted at 39 Spanish centres. Patients with severe aortic stenosis undergoing TAVI were randomized after the procedure to dapagliflozin 10 mg once daily or standard of care. The primary endpoint was a composite of all-cause death or worsening HF. Among 1223 patients with available baseline LVEF, 213 (17.4%) had LVEF <=40% and 1010 (82.6%) had LVEF >40%. During 1-year follow-up, the primary endpoint occurred in 20.2% of patients with LVEF <=40% and 17.0% of those with LVEF >40% (adjusted HR 1.28, 95% CI 0.91-1.80; P = .15). Dapagliflozin reduced the risk of the primary endpoint consistently across LVEF subgroups, with no significant interaction between treatment effect and baseline LVEF (P for interaction = .41). Analyses modelling LVEF as a continuous variable confirmed a homogeneous treatment effect across the entire LVEF spectrum. Dapagliflozin was well tolerated, with a safety profile comparable to control across all LVEF categories, although genitourinary infections were more frequent with dapagliflozin. <br/>CONCLUSION(S): In elderly patients undergoing TAVI, dapagliflozin reduced the risk of all-cause death or worsening HF irrespective of baseline LVEF and was safe across the full LVEF spectrum. These findings extend the benefits of SGLT2 inhibition to patients with severe aortic stenosis treated with TAVI, independent of systolic function.<br/>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 <76> Accession Number 652077592 Title Comparing the Safety and Efficacy of Outpatient Parenteral Antibiotic Therapy Versus Hospital-Based Antibiotic Therapy in Patients with Infective Endocarditis: A Systematic Review and Meta-Analysis. Source American journal of therapeutics. (no pagination), 2026. Date of Publication: 28 Aug 2026. Author Alkuwaiti M.A.; Al-Harbi F.A.; Alkuwaiti F.A.; Alsaif A.K.; Ashraf H. Institution (Alkuwaiti) College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia (Al-Harbi) Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Alkuwaiti) Division of Cardiology, Department of Internal Medicine, King Fahad Hospital of the University, Academic Medical City, Imam Abdulrahman Bin Faisal University, Saudi Arabia (Alsaif) College of Medicine, Al-Rayan Colleges, Al-Madinah, Saudi Arabia; and (Ashraf) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan Abstract INTRODUCTION: Infective endocarditis (IE) requires 4 to 6 weeks of intravenous antibiotics. Outpatient parenteral antibiotic therapy (OPAT) is increasingly used and guideline endorsed, but IE-specific comparative evidence is limited, as prior meta-analyses pooled single-arm data without an inpatient comparator. We compared the safety and efficacy of OPAT versus continued hospital-based antibiotic therapy. <br/>METHOD(S): This systematic review and meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020. PubMed/MEDLINE, Embase, Cochrane CENTRAL, and Web of Science were searched to 18 April 2026 for comparative studies of adults with IE. Two reviewers screened using Rayyan and extracted data, and risk of bias was assessed with Risk Of Bias In Non-randomized Studies of Interventions. Random-effects meta-analyses (DerSimonian-Laird) produced risk ratios with 95% confidence intervals (CIs) (RevMan 5.4). <br/>RESULT(S): Five comparative studies (3497 adults) were included. OPAT was associated with lower all-cause mortality (risk ratio [RR]: 0.40, 95% CI: 0.18-0.90; I2 = 87%, P = 0.03) and with lower acute kidney failure (RR: 0.71, 95% CI: 0.59-0.86, P = 0.0004). No significant differences were seen for readmission (RR: 1.09), relapse (0.73), valve replacement (1.15), arrhythmia, sepsis, stroke, embolic complications, or heart failure. <br/>CONCLUSION(S): In appropriately selected, stabilized patients, OPAT was associated with lower all-cause mortality and acute kidney failure, with no significant differences in major other adverse events. Protocol: CRD420261410723.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <77> Accession Number 2048849379 Title SURGELLA: A Scoping Review of Impella-Assisted Hemodynamic Support in High-Risk Non-Cardiac Surgery. Source Artificial Organs. (no pagination), 2026. Date of Publication: 2026. Author Elghazaly H.; Allaf M.; Mian A.; Ahmed H.; Gordon-Weeks A.; Tindale A.; Panoulas V. Institution (Elghazaly) Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom (Elghazaly) William Harvey Research Institute, Queen Mary University of London, London, United Kingdom (Allaf, Tindale, Panoulas) Royal Brompton and Harefield Hospitals, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Mian, Gordon-Weeks) Nuffield Department of Surgical Sciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom (Mian, Gordon-Weeks) Department of Hepato-Pancreato-Biliary Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom (Ahmed) Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom (Ahmed) Department of Medicine, University of Cambridge, Cambridge, United Kingdom (Panoulas) National Heart and Lung Institute, Imperial College London, London, United Kingdom Publisher John Wiley and Sons Inc Abstract Background: Patients with advanced heart failure or severe ventricular dysfunction are often considered prohibitively high risk for non-cardiac surgery. Impella may provide temporary perioperative hemodynamic support by augmenting cardiac output and unloading the left ventricle, but evidence for this strategy remains limited and largely case based. <br/>Method(s): We conducted a scoping review of Impella use for adult high-risk non-cardiac surgery. MEDLINE and Embase were searched from inception to April 2026, with supplementary hand-searching and citation tracking. Eligible reports were synthesized descriptively, with particular attention to implantation timing, operative context, device strategy, outcomes, and complications. <br/>Result(s): Twenty-three publications comprising 36 unique patients were identified. Evidence consisted mainly of case reports and small series. Impella was used across bariatric, abdominal, oncological, endocrine, transplant-related, vascular, orthopedic, and neurosurgical procedures. Clinical strategies included planned pre-emptive support, surgery during established Impella or ECMELLA support, rescue implantation after perioperative deterioration, and combined support strategies. Operative completion was usually reported and 34 of 36 unique published patients survived to hospital discharge; however, this reflects selected published experience rather than a reliable estimate of effectiveness or safety. <br/>Conclusion(s): Impella-supported non-cardiac surgery appears technically feasible in highly selected patients treated in specialist centers. Current evidence supports feasibility, not comparative benefit or generalizable safety. Prospective multicenter data with standardized reporting are required before wider adoption can be justified.<br/>Copyright © 2026 The Author(s). Artificial Organs published by International Center for Artificial Organ and Transplantation (ICAOT) and Wiley Periodicals LLC. <78> Accession Number 2048778107 Title Effect of protective ventilation throughout the intubation period on perioperative oxygenation in patients undergoing MIDCABG: a randomised controlled trial. Source Annals of Medicine. 58(1) (no pagination), 2026. Article Number: 2720367. Date of Publication: 2026. Author Qian M.; Cong Z.; Yang N.; Li B.; Liu W.; Wu C.; Xu M. Institution (Qian, Cong, Yang, Li, Liu, Wu, Xu) Department of Anaesthesiology, Peking University Third Hospital, Beijing, China (Qian, Cong, Yang, Li, Liu, Wu, Xu) Beijing Center of Quality Control and Improvement on Clinical Anesthesia, Peking University Third Hospital, Beijing, China Publisher Taylor and Francis Ltd. Abstract Introduction: Minimally invasive direct coronary artery bypass grafting (MIDCABG) requires prolonged one-lung ventilation (OLV), increasing postoperative pulmonary complications (PPCs) risk. We investigated whether protective lung ventilation (PLV) throughout intubation benefits MIDCABG patients. <br/>Method(s): In this single-center randomized study, MIDCABG patients received PLV (low tidal volume of 6-8 mL.kg<sup>-1</sup>, PEEP of 6 cm H<inf>2</inf>O, alveolar recruitment maneuvers) or conventional mechanical ventilation (CMV, tidal volume of 8-10 mL.kg<sup>-1</sup>, without PEEP or maneuvers) from tracheal intubation to extubation. The primary outcome was perioperative oxygenation, assessed by the PaO<inf>2</inf>/FiO<inf>2</inf> ratio. <br/>Result(s): Sixty patients (n = 30 per group) were enrolled. Compared with CMV, PLV improved PaO<inf>2</inf>/FiO<inf>2</inf> ratios (mean difference at OLV<inf>60</inf>: 34.56 mmHg; 95% CI: 11.78-57.33; p < 0.01), shortened median durations of postoperative mechanical ventilation (median difference: -4.5 h, 95% CI: -8.5 to -0.5; p = 0.013) and hospital stay (median difference: -3.0 days, 95% CI: -5.0 to -1.0; p = 0.019). PLV also reduced driving pressure, airway pressure and intrapulmonary shunt during OLV (all p < 0.05). Desaturation occurred in 23.3% of CMV patients and 13.3% of PLV patients (p = 0.506). Hemodynamic parameters were generally comparable between groups, except for lower MPAP and PVRI in the PLV group during OLV and after ICU admission (p < 0.05). The incidence of PPCs did not differ between groups. <br/>Conclusion(s): In patients undergoing MIDCABG, PLV applied throughout intubation improved perioperative oxygenation and shortened the duration of postoperative mechanical ventilation and hospital stay, but did not reduce PPCs. Clinical trial registration: ChiCTR1900022005.<br/>Copyright © 2026 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. <79> Accession Number 2048759588 Title PCSK9 Inhibition Lowers LDL Cholesterol After Heart Transplantation: An Updated Systematic Review and Meta-Analysis. Source Lipids. (no pagination), 2026. Date of Publication: 2026. Author Megantara H.P.; Anjanie N.; Soelistyaningroem J. Institution (Megantara) Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia (Anjanie) Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia (Soelistyaningroem) Department of Cardiovascular Medicine, Mitra Keluarga Cibubur General Hospital, Bekasi, Indonesia Publisher John Wiley and Sons Inc Abstract Lipid management after heart transplantation (HT) is complicated by post-transplant dyslipidemia, immunosuppression, statin intolerance, and cardiac allograft vasculopathy (CAV). Proprotein convertase subtilisin/kexin Type 9 (PCSK9) inhibitors lower LDL-C in non-transplant populations, but HT recipients were under-represented in pivotal lipid trials. This updated systematic review and exploratory meta-analysis synthesized full-text evidence of PCSK9 inhibition after adult HT, predominantly with alirocumab or evolocumab. LDL-C lowering was the primary lipid outcome. CAV imaging/physiology, rejection, donor-specific antibodies, immunosuppression stability, and safety were secondary outcomes. PubMed/MEDLINE, Scopus, Cochrane Library, and Google Scholar were searched through June 20, 2026. Sixteen primary studies were included. Two independent randomized trials, EVOLVD and CAVIAR, both conducted during the first post-transplant year, provide the highest-quality evidence. The remaining evidence consists of an EVOLVD physiology/OCT substudy and observational or case-based reports. Ten studies contributed LDL-C effect and variance data. The exploratory random-effects summary estimated an LDL-C reduction of 73.6 mg/dL (95% CI, 58.8-88.4, I<sup>2</sup> = 89.8%). The randomized-trial subgroup showed a smaller but consistent reduction of 41.8 mg/dL (95% CI, 35.9-47.7). Observational estimates were larger but derived from selected, lower-certainty cohorts. Randomized first-year evidence did not show clear improvement in CAV imaging or coronary physiology. PCSK9 inhibition lowers LDL-C after HT and appears tolerable, but CAV modification and graft-outcome benefit remain unproven.<br/>Copyright © 2026 AOCS. <80> Accession Number 2048854498 Title Off-Pump CABG With and Without Sternotomy: A Meta-Analysis of Comparative Studies. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 3088217. Date of Publication: 2026. Author Yoshida S.; Ishida O.; Tsutsumi K. Institution (Yoshida, Ishida, Tsutsumi) Department of Cardiovascular Surgery, National Defense Medical College, Tokorozawa, Japan Publisher John Wiley and Sons Inc Abstract Objectives: Minimally invasive coronary artery bypass grafting (MICS-CABG) has emerged as a less invasive alternative to conventional off-pump CABG (OPCAB), but direct comparative evidence remains limited. This meta-analysis synthesizes outcomes from randomized controlled trials (RCTs) and propensity-adjusted observational studies comparing these two off-pump strategies. <br/>Method(s): A comprehensive literature search was conducted according to PRISMA 2020. Eligible studies compared MICS-CABG and sternotomy OPCAB under strictly off-pump conditions. Quantitative synthesis was limited to RCTs and cohort studies using propensity score matching (PSM) or inverse probability of treatment weighting (IPTW) to reduce confounding. Random-effects meta-analyses accounted for clinical and methodological heterogeneity. <br/>Result(s): Twelve of 40 eligible studies were included in the meta-analysis, comprising 3 RCTs, 1 IPTW cohort study, and 8 PSM cohort studies. Although the primary analysis suggested lower postoperative mortality (OR 0.54, 95% CI 0.38-0.77), this finding was not consistently supported across complementary analyses. Exclusion of the largest IPTW study reversed the direction of the pooled estimate (OR 1.34), and no significant mortality difference was observed in the multivessel subgroup (OR 1.55). In the subgroup analysis restricted to patients with multivessel disease, no statistically significant difference in mortality was observed (OR 1.55). MICS-CABG was consistently associated with longer operative time but shorter length of hospital stay, although substantial heterogeneity was observed. <br/>Conclusion(s): In comparisons restricted to off-pump strategies, MICS-CABG was associated with shorter hospital stay but longer operative time, without consistent differences in major adverse cardiovascular and cerebrovascular events. The apparent mortality benefit observed in the primary analysis was not consistently supported across complementary analyses. Sternotomy OPCAB remains a robust standard strategy, whereas MICS-CABG may represent a less invasive alternative for selected patients.<br/>Copyright © 2026 Shotaro Yoshida et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <81> Accession Number 2048846781 Title Ischaemic Optic Neuropathy After Cardiac Surgery: A Systematic Review and Meta-Analysis of Incidence and Risk Factors. Source ANZ Journal of Surgery. (no pagination), 2026. Date of Publication: 2026. Author Mutahar D.; Zaka A.; Sidhu A.S.; Goswami S.; Singh A.; Ng J.; Stretton B.; Kovoor J.G.; Gupta A.K.; Bacchi S.; Chan W.O.; Chen C. Institution (Mutahar, Zaka) Department of Cardiology, Gold Coast University Hospital, Southport, QLD, Australia (Mutahar, Goswami, Singh, Ng) Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia (Sidhu) Department of Ophthalmology, Sydney and Sydney Eye Hospital, Sydney, NSW, Australia (Stretton, Chan) Royal Adelaide Hospital, Adelaide, SA, Australia (Kovoor, Gupta) Adelaide University, Adelaide, SA, Australia (Bacchi) Massachusetts General Hospital, Boston, MA, United States (Chen) Department of Ophthalmology, Flinders University, Adelaide, SA, Australia Publisher John Wiley and Sons Inc Abstract Background: Ischaemic optic neuropathy (ION) is the most common cause of perioperative visual loss, with the highest incidence reported after cardiac surgery involving cardiopulmonary bypass (CPB). Despite devastating complications, the overall incidence and risk factors for patients with ION in the setting of cardiac surgery remain contentious. We performed a systematic review and meta-analysis to evaluate the pooled incidence and risk factors for ION after cardiac surgery. <br/>Method(s): This review conformed to PRISMA guidelines. PubMed, MEDLINE, Web of Science and Cochrane were searched up to 24 March 2024 for multivariable-adjusted and propensity-matched observational studies assessing the incidence of ION exclusively in patients undergoing cardiac surgery. Odds ratios (ORs) with 95% confidence intervals (CIs) for each risk factor were pooled from the selected studies using a random-effects model. <br/>Result(s): Eleven studies totalling 6 471 577 patients were included. The pooled incidence of ION was approximately 1.50 per 10 000 cardiac surgeries. Significant risk factors for developing ION included coronary artery disease (OR 1.81, 95% CI 1.17-2.79), peripheral vascular disease (OR 1.67, 95% CI 1.10-2.54) and anaemia (OR 1.06, 95% CI 1.00-1.13). Notably, the incidence varied widely between studies, reflecting differences in diagnostic criteria and reporting standards. Newcastle-Ottawa risk of bias assessment found the studies to be of overall moderate methodological quality, with a high risk of bias. <br/>Conclusion(s): This study demonstrates a relatively low overall pooled incidence of ION following cardiac surgery, with identifiable risk factors such as pre-existing coronary artery disease, peripheral vascular disease and perioperative anaemia.<br/>Copyright © 2026 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons. <82> Accession Number 2048847085 Title "Left Atrial Appendage Closure Versus Medical Therapy in Atrial Fibrillation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials". Source Journal of Cardiovascular Electrophysiology. (no pagination), 2026. Date of Publication: 2026. Author Al-Janabi A.A.H.; Al-Shammari A.S.; Hageen A.W.; Al-Tuaama A.Z.H.; Al-Ibraheem A.M.T.; Shahzaib M.; Rathi D.; Hamzah K.A.; shweliya M.A.; Kurmasha Y.H.; Wagdy M.; Refaat M.M. Institution (Al-Janabi, Al-Ibraheem, Hamzah) Department of Internal Medicine, ALkindy college of medicine/University of Baghdad, Baghdad, Iraq (Al-Shammari, shweliya) Department of Internal Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq (Hageen) Faculty of Medicine, Tanta University, Tanta, Egypt (Al-Tuaama) Department of Internal Medicine, Privolzhsky Research Medical University, Novgorod, Nizhny, Russian Federation (Shahzaib) Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan (Rathi) Dow University of Health Sciences, Karachi, Pakistan (Kurmasha) Department of Internal Medicine, College of Medicine, University of Kufa, Najaf, Iraq (Wagdy) Faculty of Medicine, Modern University for Technology and Information, Cairo, Egypt (Refaat) Division of Cardiology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Publisher John Wiley and Sons Inc Abstract We aim to compare the impact of left atrial appendage closure vs. medical therapy on clinical outcomes in patients with atrial fibrillation, focusing on key clinical outcomes relevant to thromboembolic prevention. We conducted a PRISMA-guided systematic review and meta-analysis of studies comparing LAAC with medical therapy in AF adults. PubMed, Embase, Scopus, ClinicalTrial. gov, and Cochrane Library were searched from inception to March 2026. Outcomes included all-cause mortality, any stroke, ischemic stroke, hemorrhagic stroke, major bleeding, systemic embolism and cardiac death. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Reconstructed individual patient-level survival data from published Kaplan-Meier curves were used for time-to-event analyses. Trial sequential analysis (TSA) assessed the conclusiveness of cumulative evidence. Six randomized controlled trials involving 7004 patients were included. LAAC demonstrated comparable outcomes to medical therapy for all-cause mortality, any stroke, major bleeding, systemic embolism, and cardiac death. There was a non-significant trend toward increased ischemic stroke and reduced hemorrhagic stroke with LAAC. Reconstructed time-to-event analyses showed similar cumulative incidence of stroke and bleeding outcomes over follow-up. TSA demonstrated that the required information size was not reached for any major endpoint, indicating that current evidence remains underpowered and additional randomized trials are needed. LAAC provides similar overall efficacy and safety compared with medical therapy for stroke prevention in AF but should currently remain reserved for selected patients rather than replacing oral anticoagulation broadly. Further adequately powered trials with longer follow-up are required.<br/>Copyright © 2026 Wiley Periodicals LLC. <83> Accession Number 2048836089 Title Thyroid Cancer Management in Contemporary Practice: A Systematic Review and Meta-Analysis of Diagnostic Pathways, Surgical Strategies, Airway Challenges, and Mediastinal Extension. Source Clinica Terapeutica. 177(5) (pp 1281-1298), 2026. Date of Publication: 28 Aug 2026. Author Koraitim A.F.I.; Mohamed M.M.; Alwaseef M.A.E.; Mawkili A.; Abdesalam H.A.; Abu Halimah J.H.; Allam K.A.; Ibrahim A.A.A.M.; Ibrahim H.S.E.-S.; Abdelaziz S.M.M.E.; Abdalgaleel M.A.; Barakat M.; Bukas S.G.; Omar A.; Mobasher M.A. Institution (Koraitim) Department of Anesthesia, ICU and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt (Mohamed) Department of anaesthesia and ICU, Faculty of medicine, Assiut University, Egypt (Alwaseef, Omar) Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Mawkili, Abu Halimah) Department of Surgery, college of Medicine, Jazan University, Jazan, Saudi Arabia (Abdesalam) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Allam) Department of general surgery, Ahmad Maher Teaching Hosp., GOTHI, Cairo, Egypt (Ibrahim) Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Al-Azhar University, New Damietta, Egypt (Ibrahim, Abdelaziz) Department of Anesthesiology, Armed Forces Hospital Southern Region (AFHSR), Khamis Mushait, Saudi Arabia (Abdelaziz) Department of Anesthesiology, The Memorial Institute for Ophthalmic Research, Giza, Egypt (Abdalgaleel) Department of Surgical Oncology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Barakat) Department of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Bukas) Cheeloo College of Medicine, Shandong University, Shandong, Jinan, China (Mobasher) Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt Publisher Societa Editrice Universo Abstract Background. Thyroid cancer is the most common endocrine malignancy worldwide, with a clinically significant subset of patients presenting with locally advanced disease involving the trachea, recurrent laryngeal nerve, esophagus, and superior mediastinum. However, evidence describing the integrated burden of diagnostic limitations, airway complications, surgical outcomes, and mediastinal involvement remains fragmented across small and heterogeneous studies. Objectives. This study aimed to systematically evaluate and quantitatively synthesize evidence on diagnostic performance, perioperative airway management, surgical outcomes, and mediastinal extension in thyroid cancer, with emphasis on locally advanced and complex disease reported between January 2021 and January 2026. Methods. A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and the MOOSE framework. PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase were searched. Studies reporting surgical outcomes, airway complications, mediastinal extension, recurrent laryngeal nerve injury, and imaging diagnostic accuracy in thyroid cancer were included. Secondary systematic reviews and meta-analyses were excluded from quantitative pooling to avoid data duplication. Risk of bias was assessed using the Newcastle-Ottawa Scale and Cochrane RoB 2 tool where applicable. Random-effects meta-analyses were performed using the DerSimonian-Laird method. Results. Eleven primary studies published between 2021 and 2026, comprising 6,142 patients, were included. The pooled incidence of difficult airway was 9.4% (95% CI: 6.1-14.2%; I2 = 61.3%), while overall surgical morbidity was 21.3% (95% CI: 16.8-26.5%; I2 = 72.6%). Tracheal invasion was present in 28.7% (95% CI: 21.4-37.3%) of locally advanced cases. Mediastinal extension requiring thoracic surgical access occurred in 18.3% (95% CI: 12.7-25.7%) of retrosternal cases. Recurrent laryngeal nerve injury ranged from 2.8% to 5.9% (transient) and 0.5% to 1.4% (permanent) across studies. Computed tomography demonstrated a pooled sensitivity of 61.4% and specificity of 90.8% for tracheal invasion detection. Conclusion. This meta-analysis provides the most comprehensive and up-to-date quantitative synthesis of surgical complexity in thyroid cancer across diagnostic, airway, surgical, and mediastinal domains. Locally advanced disease is consistently associated with increased rates of difficult airway management, tracheal invasion, and requirement for thoracic surgical access, highlighting its substantially elevated perioperative risk profile. These findings underscore the importance of structured multidisciplinary preoperative assessment, advanced airway planning, and the routine use of intraoperative neuromonitoring in high-risk cases to optimise surgical safety and outcomes.<br/>Copyright © 2026 Societa Editrice Universo (SEU), Roma, Italy. This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0). <84> Accession Number 2048696004 Title Systemic Use of Oral Rapamycin, Prednisone and Colchicine After Coronary Bare-Metal Stent Implantation: Narrative Review of Randomized Clinical Trials. Source Biomedicines. 14(8) (no pagination), 2026. Article Number: 1685. Date of Publication: 01 Aug 2026. Author Fernandez-Pereira C.; Rodriguez A.E. Institution (Fernandez-Pereira, Rodriguez) Cardiac Unit, Cardiovascular Research Center (CECI), Otamendi Hospital, Buenos Aires, Argentina Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Coronary stenting remains the cornerstone of interventional cardiology. Drug-eluting stents (DES) have reduced restenosis compared to bare-metal stents (BMS), but their high cost and need for prolonged dual antiplatelet therapy (DAPT) limit accessibility in many regions. Recent evidence has revisited the potential role of systemic pharmacologic adjuncts-oral sirolimus (rapamycin), prednisone and colchicine-as cost-effective therapies to mitigate restenosis and adverse events following BMS implantation. <br/>Objective(s): This review critically evaluates the clinical and mechanistic evidence supporting the use of oral immunosuppressive or anti-inflammatory drugs following BMS implantation, with emphasis on their applicability in both resource-limited and general cardiology settings. Three randomized clinical trials comparing this strategy against DES are analyzed and discussed in this review. <br/>Conclusion(s): Oral sirolimus, prednisone, and colchicine demonstrate promising anti-inflammatory and antiproliferative effects that translate into clinical outcomes comparable to DES in a highly select population. Their systemic administration following BMS implantation may provide a feasible, cost-effective alternative where DES use is restricted by cost or clinical contraindications. Larger-scale, long-term trials are warranted to confirm safety, optimize dosing, and identify ideal patient populations for this "pharmacologic stent hybrid" strategy.<br/>Copyright © 2026 by the authors. <85> Accession Number 2048800561 Title Vagus nerve management in lung cancer surgery: anatomical preservation, functional modulation and postoperative outcomes-a narrative review. Source Chinese Clinical Oncology. 15(4) (no pagination), 2026. Article Number: 60. Date of Publication: 31 Aug 2026. Author Suriano I.; Frasca L.; Sarubbi A.; Longo F.; Crucitti P. Institution (Suriano, Frasca, Sarubbi, Longo, Crucitti) Department of Thoracic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy (Suriano) Department of Thoracic Surgery, Hopital Avicenne, Bobigny, France (Frasca) Microbiology, Immunology, Infectious Diseases, and Transplants (MIMIT), University Tor Vergata, Rome, Italy (Sarubbi) Campus Bio-Medico University, Rome, Italy Publisher AME Publishing Company Abstract Background and Objective: The vagus nerve plays a fundamental role in regulating bronchomotor tone, cardiac rhythm, cough reflex pathways, and neuroimmune inflammatory responses. During lung cancer surgery, particularly during mediastinal lymphadenectomy, cardiopulmonary vagal branches may be exposed to traction, thermal injury, or intentional transection. With the progressive development of minimally invasive and robotic-assisted thoracic surgery, increasing attention has been directed toward functional preservation and postoperative quality of life in addition to oncological radicality. This narrative review aimed to summarize the current anatomical, physiological, and clinical evidence regarding vagus nerve management during lung cancer surgery. <br/>Method(s): A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Web of Science, and manual bibliography screening to identify relevant anatomical, physiological, clinical, and translational studies addressing vagus nerve management during lung cancer surgery. No strict temporal restriction was applied. Clinical studies evaluating preservation or transection of vagal branches during thoracoscopic lung resection were qualitatively analyzed. Key Content and Findings: Current evidence suggests that preservation of pulmonary vagal branches may reduce postoperative cough, inflammatory response, autonomic dysfunction, and impairment of postoperative recovery. Conversely, selective transection of specific pulmonary vagal afferents has also shown potential benefit in selected patients with refractory postoperative cough. Recent advances in robotic magnification, intraoperative neuromonitoring, and neuromodulatory strategies such as transcutaneous auricular vagus nerve stimulation (taVNS) may further improve perioperative functional outcomes. <br/>Conclusion(s): The vagus nerve represents both a critical anatomical structure and a major functional regulator during thoracic oncologic surgery. Integration of autonomic preservation strategies into modern minimally invasive lung cancer surgery may contribute to improved postoperative recovery and quality of life. Further prospective multicenter studies are required to standardize vagus nerve preservation and neuromodulatory approaches.<br/>Copyright © AME Publishing Company. This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/. <86> Accession Number 2048566227 Title Cardioprotective effects of remimazolam in elderly hypertensive patients undergoing gastrointestinal tumor surgery: A randomized controlled trial. Source World Journal of Gastrointestinal Oncology. 18(8) (no pagination), 2026. Article Number: 121785. Date of Publication: 15 Aug 2026. Author Ma T.-T.; Tong J.; Liu M.-Y. Institution (Ma) Department of Anesthesiology, Yizheng Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Yangzhou, China (Tong) Department of General Surgery, Yizheng Hospital of Nanjing Drum Tower Hospital Group, Jiangsu Province, Yangzhou, China (Liu) Department of Anesthesiology, Jiangdu People's Hospital Affiliated to Yangzhou University, Jiangsu Province, Yangzhou, China Publisher Baishideng Publishing Group Inc Abstract BACKGROUND Elderly patients with hypertension undergoing gastrointestinal tumor surgery are at increased risk of perioperative cardiovascular complications, particularly myocardial injury after non-cardiac surgery (MINS). Anesthetic management plays a crucial role in maintaining hemodynamic stability and reducing cardiac stress in this vulnerable population. Remimazolam, a novel ultra-short-acting benzodiazepine, has shown potential advantages in cardiovascular stability compared with conventional anesthetic agents, however, its cardioprotective effects in high-risk surgical patients remain insufficiently explored. AIM To evaluate the cardioprotective effects and safety of remimazolam-based general anesthesia compared with conventional anesthesia in elderly hypertensive patients undergoing gastrointestinal tumor surgery, with a particular focus on myocardial injury markers, hemodynamic stability, postoperative recovery, and the incidence of MINS. METHODS A total of 80 elderly hypertensive patients who underwent gastrointestinal tumor surgery at Yizheng Hospital of Nanjing Drum Tower Hospital Group between bApril 2024 and August 2025 were selected. Patients were randomly divided into a control group (P group) and an experimental group (R group) using the envelope method. P group received conventional general anesthesia, while R group received remimazolam-based general anesthesia. Perioperative serum biomarkers, arterial blood gas indices, postoperative pain, incidence of postoperative complications, surgical indicators, and adverse events within 30 days of follow-up were compared between the two groups. Patients were further divided into non-MINS and MINS groups based on the occurrence of MINS. Differences in clinical indicators between the two groups were analyzed. Binary logistic regression was used to identify risk factors for MINS, and a predictive model was constructed and validated based on these factors. RESULTS At T0, creatine kinase (CK) levels were significantly lower and lactate levels significantly higher in P group compared with R group (P < 0.05). At T1, systolic and diastolic blood pressures were significantly lower in P group than in R group (P < 0.05). At T6, CK-MB levels were significantly higher in P group (P < 0.05). At T7, High-Sensitivity Troponin (hs-cTn), CK-MB, and aspartate aminotransferase were significantly higher in P group (P < 0.05). At T8, CK-MB and N-terminal pro-brain natriuretic peptide (NT-proBNP) were significantly higher in P group (P < 0.05). Visual Analog Scale scores at T7 and T8 were significantly higher in P group (P < 0.05). Postoperative agitation scores and incidence were significantly higher in P group (P < 0.05), as was the incidence of MINS (P < 0.05). Intraoperatively, colloid use was significantly lower, while crystalloid and norepinephrine use were significantly higher in P group (P < 0.05). There was no significant difference in the incidence of adverse events within 30 days postoperatively between the two groups (P?> 0.05). Compared with the MINS group, the non-MINS group had significantly lower proportions of colon cancer and conventional general anesthesia, as well as lower levels of hs-cTn, CK-MB, NT-proBNP at T6-T8, and shorter operative time (P < 0.05). Multivariate analysis showed that tumor type, anesthesia method, NT-proBNP at T7, and NT-proBNP at T8 were independent risk factors for MINS. The area under the curve for NT-proBNP at T8 and the predictive model was?> 0.7. CONCLUSION The use of remimazolam for general anesthesia in elderly hypertensive patients undergoing gastrointestinal tumor surgery can reduce myocardial injury and the incidence of MINS. It helps stabilize perioperative blood pressure, alleviates postoperative pain, reduces the risk of postoperative agitation, and decreases intraoperative norepinephrine requirements. It is safe and does not increase postoperative complications or adverse events within 30 days. Tumor type, anesthesia method, and postoperative NT-proBNP levels can help predict the risk of MINS, providing a reference for prevention and treatment strategies.<br/>Copyright © Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc. <87> Accession Number 652063518 Title Catheter-Based Left Atrial Appendage Closure vs Oral Anticoagulation in Patients With Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source JAMA cardiology. (no pagination), 2026. Date of Publication: 26 Aug 2026. Author Laudani C.; Bujak K.; Giacoppo D.; Finocchiaro S.; Cutore L.; Mauro M.S.; Redigolo P.; Mazzone P.M.; Di Leo G.; Nasisi F.; Spagnolo M.; Greco A.; Capodanno D. Institution (Laudani, Bujak, Giacoppo, Finocchiaro, Cutore, Mauro, Redigolo, Mazzone, Di Leo, Nasisi, Spagnolo, Greco, Capodanno) Division of Cardiology, Azienda Ospedaliero-Universitaria Policlinico Rodolico - San Marco, University of Catania, Catania, Italy (Bujak) Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland (Bujak) 3rd Department of Cardiology, Silesian Center for Heart Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland Abstract Importance: In patients with atrial fibrillation (AF), oral anticoagulation (OAC) is the gold standard for preventing ischemic stroke, at the expense of a higher risk of bleeding. Catheter-based left atrial appendage closure (LAAC) has been proposed as an alternative strategy to prevent stroke, but the efficacy and safety compared to OAC are uncertain. <br/>Objective(s): To evaluate the efficacy and safety of catheter-based LAAC compared to OAC in patients with AF at high risk of stroke. <br/>Data Sources: PubMed, Cochrane Central, and Web of Science were screened up to March 2026. The websites of leading cardiology societies, news outlets, and reference lists of each eligible study were also inspected. Study Selection: Studies enrolling patients with AF randomly assigned to catheter-based LAAC or OAC and reporting at least 1 outcome of interest were included. Data Extraction and Synthesis: Two investigators independently extracted data of interest and assessed data quality. Catheter-based LAAC vs OAC comparisons were pooled as incidence rate ratios (IRRs) using a frequentist random-effect model. <br/>Main Outcomes and Measures: Primary and coprimary outcomes were long-term stroke and major bleeding. Secondary outcomes included the composite of cardiovascular death, stroke, or systemic embolism, all-cause death, the single components of the composite end point, ischemic stroke, hemorrhagic stroke, and nonprocedural major bleeding. Periprocedural events (ie, stroke, major bleeding, death, device embolization, and pericardial effusion) were also combined. <br/>Result(s): Eight trials (7434 patients) were included in the meta-analysis. After a weighted mean follow-up of 37.9 months, no significant differences were detected for stroke (IRR, 1.08; 95% CI, 0.82-1.41) and major bleeding (IRR, 0.96; 95% CI, 0.81-1.14). However, catheter-based LAAC was associated with a higher risk of ischemic stroke (IRR, 1.34; 95% CI, 1.01-1.77) and a lower risk of nonprocedural major bleeding (IRR, 0.73; 95% CI, 0.58-0.92) compared with OAC. Periprocedural events per 1000 patients were 5 strokes, 9 episodes of bleeding, 1 death, 5 episodes of device embolization, and 9 pericardial effusions. <br/>Conclusions and Relevance: In patients with AF, at long-term follow-up, transcatheter LAAC was associated with similar rates of any type of stroke and major bleeding compared with OAC, while increasing the risk of ischemic stroke and lowering the risk of nonprocedure-related major bleeding. These findings do not support the routine use of LAAC as a first-line strategy for stroke prevention in patients with AF at moderate to high risk of stroke. <88> Accession Number 2038561655 Title Sternal Closure Techniques Using Steel Wires and Predictors of Sternal Wound Complications: A Randomized Controlled Trial. Source Brazilian Journal of Cardiovascular Surgery. 41(3) (no pagination), 2026. Article Number: e20260056. Date of Publication: 2026. Author Mogahed M.A.; Abdelaal M.M.; Elfeky W.M.; Elghanam A.R.; Elesawy M.M.; Abdelalim M.M. Institution (Mogahed, Abdelaal, Elfeky, Elghanam, Elesawy, Abdelalim) Department of Cardiothoracic Surgery, Faculty of Medicine, Kafr Elsheikh University, Kafr El Sheikh, Egypt Publisher Sociedade Brasileira de Cirurgia Cardiovascular Abstract Introduction: Median sternotomy is the gold standard for cardiac surgery but carries a significant risk of wound complications, including sternal dehiscence and wound infections. <br/>Objective(s): This study aimed to compare the early efficacy and complication rates of three distinct steel-wire sternal closure techniques and identify potential risk factors of complications. <br/>Method(s): We conducted a randomized controlled study on patients undergoing cardiac surgery. Patients were randomly allocated into three groups of sternal closure techniques: simple interrupted (Group A), figure-of-eight (Group B), or a modified combined technique (Group C). Baseline characteristics, intraoperative parameters, postoperative recovery outcomes, and sternal wound complications including sternal dehiscence and superficial and deep wound infections were evaluated. Binomial logistic regression was performed to determine independent risk factors for complications. <br/>Result(s): One hundred sixty-five adult cardiac patients were finally included in the study. All three intervention groups (n = 55) were well-matched regarding baseline characteristics and intraoperative parameters. The incidence of sternal dehiscence (6.1%) and superficial (7.9%) and deep wound infections (3.6%) did not differ significantly among the three wire closure techniques (P > 0.05). However, logistic regression identified numerous factors associated with superficial sternal wound infections including old age, obesity (body mass index > 30), comorbidities, elevated C-reactive protein and HbA1C, prolonged cardiopulmonary bypass time, extended operative time, and longer intensive care unit stay (P < 0.05 for all). <br/>Conclusion(s): The three steel-wire closure techniques demonstrated comparable early postoperative stability and similar rates of sternal wound complications. Technique choice may be based on surgeon preference.<br/>Copyright © 2026, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved. <89> Accession Number 2038561740 Title The Effect of Preoperative Hydration on Cardiac Surgery-Associated Acute Kidney Injury. Source Brazilian Journal of Cardiovascular Surgery. 41(2) (no pagination), 2026. Article Number: e20240354. Date of Publication: 2026. Author Karakoc A.Z.; Ozcan E.; Akardere O.F.; Cevirme D.; Zengin A.; Sunar H. Institution (Karakoc) Department of Cardiovascular Surgery, Sehit Prof. Dr. Ilhan Varank Sancaktepe Research and Training Hospital, Istanbul, Turkey (Ozcan, Akardere, Sunar) Department of Cardiovascular Surgery, Kartal Kosuyolu Heart Research and Training Hospital, Istanbul, Turkey (Cevirme) Department of Cardiovascular Surgery, Istinye University Faculty of Medicine, Istanbul, Turkey (Zengin) Department of Cardiovascular Surgery, Fatih Gebze State Hospital, Kocaeli, Turkey Publisher Sociedade Brasileira de Cirurgia Cardiovascular Abstract Objective: The aim of this study was to determine the effect of preoperative intravenous saline hydration on postoperative renal functions and the prevention of acute kidney injury subsequent to open-heart surgery. <br/>Method(s): Our investigation was designed as a prospective, randomized, and controlled single-center trial. We included 110 patients with basal renal functions that were not disrupted and who were undergoing cardiac surgery from October to December 2020. The first group (control) had fluid restriction for 12 hours prior to surgery (n = 55), and the second group (case) was hydrated with 0.9% normal saline for 12 hours before surgery (n = 55). <br/>Result(s): In the hydration group, creatinine values dropped below the preoperative values (P = 0.008) and the glomerular filtration rate values rose above the preoperative levels (P = 0.003). The early-term mortality rates were 0% for the hydration group and 5.45% for the control group (n = 3). Besides, in the hydration group, the glomerular filtration rate values on the 30<sup>th</sup> day and 360<sup>th</sup> day after surgery increased to levels even higher than those recorded preoperatively. <br/>Conclusion(s): As a result of much effort, we showed that preoperative hydration can prevent severe cardiac surgery-associated acute kidney injury and related in-hospital mortality.<br/>Copyright © 2026, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved. <90> Accession Number 2048661431 Title Fibrinogen Concentrate in Acute Hemorrhage: Mechanistic Insight, Thresholds, and Targeted Replacement. Source Journal of Clinical Medicine. 15(16) (no pagination), 2026. Article Number: 6156. Date of Publication: 01 Aug 2026. Author Rahe-Meyer N.; Bartoszko J.; Levy J.H. Institution (Rahe-Meyer) Clinic for Anesthesiology and Intensive Care Medicine, Franziskus Hospital, 33615 Bielefeld, Germany (Bartoszko) University of Toronto, Department of Anesthesiology and Pain Medicine, Toronto, ON, Canada (Bartoszko) Department of Anesthesia and Pain Management, Toronto General Hospital-University Health Network, Toronto, ON, Canada (Levy) Department of Anesthesiology, Critical Care Medicine, and Surgery (Cardiothoracic), Duke University School of Medicine, Durham, NC, United States (Levy) The Centre for Blood Research, University of British Columbia, Vancouver, BC, Canada Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Fibrinogen is an essential component of hemostasis and clot formation that stabilizes the platelet-dependent primary hemostatic process. Low fibrinogen levels can be primary (congenital) or secondary (acquired). Acquired hypofibrinogenemia may result from chronic diseases (e.g., liver, autoimmune diseases, and malignancies) or major hemorrhage (e.g., trauma, surgery). Low fibrinogen levels are both a symptom and a precipitating factor for coagulopathy and ongoing bleeding. Fibrinogen repletion with fibrinogen-containing products is important for managing coagulopathic bleeding with suspected or documented hypofibrinogenemia. Different available fibrinogen sources include fibrinogen concentrate, cryoprecipitate, and frozen plasma and vary based on multiple factors including fibrinogen content, purity, other clotting or non-clotting proteins (e.g., immunomodulating proteins or proteins of unknown function), preparation time, safety, volumes, and availability. Fibrinogen replacement strategies have been studied in trauma but also in patients undergoing spine, cytoreductive, and cardiac surgery. In this review, we discuss the physiological actions of fibrinogen, strategies for control of coagulopathic bleeding related to hypofibrinogenemia, and the therapeutic, logistical, and economic factors that influence treatment decisions. In addition, current guidelines and clinical studies were considered regarding the formation of evidence-based treatment strategies that can be individualized at the patient's bedside.<br/>Copyright © 2026 by the authors. <91> Accession Number 2048767869 Title Postoperative Care, Perioperative Risks, and the Continuum of Care in Thoracic Surgery: A Comprehensive AI-Augmented Review of Evidence. Source Zentralblatt fur Chirurgie - Zeitschrift fur Allgemeine, Viszeral- und Gefasschirurgie. 151 (pp S28-S45), 2026. Date of Publication: 01 Aug 2026. Author Jahn N.; Volker M.T.; Hau H.-M.; Starke H.; Laudi S. Institution (Jahn) Department of Anesthesiology and Intensive Care Medicine, Medical University of Graz, Styria, Austria (Volker, Laudi) Department of Anesthesiology and Intensive Care Medicine, University of Leipzig, Faculty of Medicine, Leipzig, Saxony, Germany (Hau) Department of Surgery, Division of General Visceral and Transplantation Surgery, Medical University of Graz, Styria, Austria (Starke) Department of Anesthesiology and Surgical Intensive Care, Dgd Lung Hospital Hemer, North Rhine-Westphalia, Germany Publisher Georg Thieme Verlag Abstract Background Thoracic surgery remains essential for lung cancer treatment, yet postoperative pulmonary complications (PPCs) affect up to 50% of patients, driving up mortality and prolonging hospital stays. As the surgical population ages and frailty increases, optimising perioperative care is critical to improving outcomes. Methods This narrative review utilised an AI-augmented drafting and verification workflow. Initial drafts were generated using large language models (Antigravity/Google Gemini 3 Pro, Anthropic Claude), with systematic evidence verification carried out with the Consensus.app. The search focused on high-quality trials, meta-analyses, and guidelines published between 2016 and 2026. All clinical interpretations remained under human control. Results and discussion Preoperative frailty and nutritional screening identify high-risk patients for targeted optimisation. Prehabilitation significantly reduces PPCs and length of hospital stay. Intraoperative strategies, including individualised PEEP titration and erector spinae plane blocks, offer safer alternatives to traditional methods. Recent evidence supports high-flow nasal oxygen over non-invasive ventilation for most patients and highlights the efficacy of digital drainage systems and restrictive fluid management. Furthermore, procalcitonin-guided antibiotic stewardship reduces exposure, while the Failure to Rescue framework, bolstered by continuous wearable monitoring, is essential for preventing ICU readmissions. Conclusion Improving thoracic surgery outcomes requires shifting from reactive management to proactive, individualised care. Integrating risk stratification, prehabilitation, modern ventilation, and AI-assisted monitoring are fundamental to advancing precision medicine in thoracic surgery.<br/>Copyright © 2026 Georg Thieme Verlag. All rights reserved. <92> Accession Number 2048661648 Title Sodium-Glucose Cotransporter 2 Inhibitors in Valvular Heart Disease: Cardiovascular Benefit, Valve-Specific Effects, and Evidence Gaps-A Structured Narrative Review. Source Journal of Clinical Medicine. 15(16) (no pagination), 2026. Article Number: 6355. Date of Publication: 01 Aug 2026. Author Rada M.; Craciun M.-L.; Pah A.-M.; Hogea G.S.; Gurgus D.; Velimirovici M.D.; Surducan D.A.; Mahmoud A.; Utu D.; Avram C.-A. Institution (Rada, Craciun, Pah, Hogea) Department VI-Cardiology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Gurgus) Department XVI-Balneology, Medical Rehabilitation and Rheumatology, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Velimirovici) Department I-Nursing, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Surducan) Department III-Functional Sciences, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Mahmoud) Department of Family Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Utu) Department II-Physiology and Pathophysiology, Faculty of Pharmacy, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania (Avram) Department of Internal Medicine I, Faculty of Medicine, "Victor Babes" University of Medicine and Pharmacy of Timisoara, Eftimie Murgu Square 2, Timisoara, Romania Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background/Objectives: Native valvular heart disease (VHD) lacks established lesion-modifying pharmacotherapy. Sodium-glucose cotransporter 2 inhibitors (SGLT2is) improve heart-failure and cardiorenal outcomes, but their relevance to VHD differs by phenotype and treatment setting. <br/>Method(s): MEDLINE/PubMed, Scopus, Web of Science Core Collection and Cochrane CENTRAL were searched from inception to 27 July 2026, together with trial registries, conference proceedings and reference lists. Evidence was synthesized by clinical setting, study design and mechanistic proximity to valve tissue. <br/>Result(s): Functional/secondary mitral regurgitation (MR) currently provides the most convincing valve-related signal: EFFORT and DEFORM showed concordant reductions in MR severity with favorable remodeling surrogates, consistent with HF-directed unloading rather than a primary leaflet effect. DapaTAVI provides the strongest hard-outcome evidence after the mechanical correction of aortic stenosis, reducing the 1-year death/worsening-HF composite in selected high-risk patients. In 28,940 HF patients from the SHEBAHEART registry, SGLT2i use was associated with reduced death/HF hospitalization and a 28% lower adjusted risk of tricuspid-regurgitation progression, but these data remain observational. Native aortic-stenosis progression is supported only by target-trial emulation, and no dedicated clinical evidence exists for native aortic regurgitation. <br/>Conclusion(s): SGLT2is should be integrated into guideline-directed HF therapy when indicated. In secondary MR, reassessment after optimized therapy should precede mitral intervention when clinically appropriate. A post-TAVI benefit should be interpreted as cardiorenal/HF protection, not valve modification. The current evidence does not justify SGLT2is solely to modify an untreated native valve lesion.<br/>Copyright © 2026 by the authors. <93> Accession Number 2048693681 Title Local Recurrence After Lung Segmentectomy-Risk Factors and Future Directions: A Contemporary Review. Source Cancers. 18(16) (no pagination), 2026. Article Number: 2649. Date of Publication: 01 Aug 2026. Author Buzas A.; Egyed K.; Furak J. Institution (Buzas) National Koranyi Institute of Pulmonology, Department of Thoracic Surgery, Budapest, Hungary (Egyed) Department of Anaesthesiology and Intensive Therapy, Pest County Flor Ferenc Hospital, Kistarcsa, Hungary (Furak) Department of Surgery, Thoracic Surgery, University of Szeged, Szeged, Hungary Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Anatomical segmentectomy has increasingly emerged as an accepted surgical strategy for selected patients with early-stage non-small cell lung cancer (NSCLC), particularly following the JCOG0802/WJOG4607L and CALGB/Alliance 140503 randomized trials. Although these studies demonstrated oncologic equivalence-or even superiority in overall survival-compared with lobectomy in carefully selected tumors, concerns persist regarding increased locoregional recurrence after segmentectomy. Recent evidence suggests that recurrence is influenced not only by surgical technique but also by tumor biology, radiological characteristics, nodal assessment, and patient-specific factors. <br/>Method(s): This narrative review critically summarizes contemporary evidence regarding local recurrence after anatomical segmentectomy for early-stage NSCLC. A literature review was performed using PubMed/MEDLINE database and recent thoracic surgical literature published primarily from 2015 onwards. Randomized trials, prospective and retrospective studies, meta-analyses, and expert consensus statements were included, with particular focus on recurrence patterns, tumor biology, radiological features, surgical factors, lymph node assessment, and emerging technologies. <br/>Result(s): Segmentectomy provides comparable overall survival to lobectomy in selected patients with small peripheral NSCLC; however, locoregional recurrence remains more frequent after segmentectomy. Major predictors of recurrence include pure-solid radiological appearance, high consolidation-to-tumor ratios, larger tumor size, STAS positivity, lymphovascular invasion, aggressive adenocarcinoma subtypes, inadequate lymph node assessment, and insufficient surgical margins. Hypermetabolic tumors on PET imaging and occult nodal disease further increase recurrence risk. Several studies identified delayed recurrence patterns occurring beyond 5 years after surgery. <br/>Conclusion(s): Local recurrence remains the principal oncologic limitation of segmentectomy. Contemporary evidence supports a shift from size-based toward biology-driven surgical decision-making integrating tumor morphology, metabolic activity, histopathological aggressiveness, STAS status, and nodal involvement into surgical planning.<br/>Copyright © 2026 by the authors. <94> Accession Number 2048771213 Title Closing the Gap: Examining Representation of Women in Ischemic Heart Disease Guideline Studies. Source Journal of the American Heart Association. 15(10) (no pagination), 2026. Article Number: e038120. Date of Publication: 2026. Author Abdelnour J.; Alameh A.; Anaya F.; Driscoll K.; Abdelnour N.; Sukhon F.; Jabri A.; Alhuneafat L.; Yaghmour R.; Alqarqaz M.; Aggarwal V.; Abbas A.E.; Nandar P.P.; Siraj A.; Gulati M. Institution (Abdelnour, Anaya, Driscoll, Yaghmour) Department of Medicine, Cleveland, OH, United States (Alameh, Sukhon, Nandar, Siraj) Heart and Vascular Department, Case Western MetroHealth Medical Center, Cleveland, OH, United States (Abdelnour) Northeast Ohio Medical University, Rootstown, OH, United States (Jabri, Abbas) Division of Cardiovascular Medicine, William Beaumont University Hospital, Royal Oak, OH, United States (Alhuneafat) Division of Cardiovascular Medicine, Henry Ford Hospital, Detroit, MI, United States (Alhuneafat) Michigan State University College of Human Medicine, Grand Rapids, MI, United States (Alqarqaz, Aggarwal) Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, United States (Gulati) Department of Cardiology, Cedars-Sinai Medical Center, Barbra Streisand Women's Heart Center, Smidt Heart Institute, Los Angeles, CA, United States (Gulati) Baim Institute for Clinical Research, Boston, MA, United States Publisher American Heart Association Inc. Abstract BACKGROUND: This study aimed to evaluate the representation of women in cardiovascular clinical trials referenced in the American College of Cardiology and American Heart Association guidelines, given the historical underrepresentation of women in such trials, which limits generalizability and perpetuates health care disparities. <br/>METHOD(S): We conducted a systematic review of studies referenced in American College of Cardiology and American Heart Association guidelines for chronic coronary artery disease, chest pain, and coronary artery revascularization. Data extraction focused on study type, publication year, total study population, and proportion of women enrolled. Participation-to-prevalence ratios were calculated to assess gender representation relative to disease prevalence among women in the United States. <br/>RESULT(S): Our systematic review encompassed 1690 studies revealing persistent underrepresentation of women across all guideline areas: revascularization (29.5%), chronic coronary artery disease (33.3%), and chest pain (40%). Participation-toprevalence ratios ranged from 68.2% to 83.2%, indicating substantial gaps in representation compared with disease burden. Trends over 4 decades showed variability in women's inclusion, with some improvement but minimal overall progress. <br/>CONCLUSION(S): Despite increased awareness and advocacy, our findings highlight ongoing gender disparities in cardiovascular research. Proactive strategies are needed to enhance women's participation in clinical trials, ensuring equitable and effective health care interventions. Addressing these disparities is critical for developing tailored treatments and improving cardiovascular outcomes globally. Future research should prioritize identifying and overcoming barriers to women's enrollment in cardiovascular trials to promote inclusive clinical practice and mitigate health care disparities.<br/>Copyright © (2026), (American Heart Association Inc.). All rights reserved. <95> Accession Number 2048662880 Title A Sufficiently Effective and Low-Risk Plane Block: A Randomized Controlled Trial Evaluating the Modified Parasternal Block in Off-Pump Coronary Artery Bypass Grafting with Sternotomy. Source Journal of Clinical Medicine. 15(16) (no pagination), 2026. Article Number: 6472. Date of Publication: 01 Aug 2026. Author Feng X.; Kang R.; Huang L.; Yan F.; Yao D.; Li X. Institution (Feng, Kang, Huang, Li) The Second Hospital of Hebei Medical University, Department of Anesthesiology, Shijiazhuang, China (Yan) Department of Cardiac Surgery Intensive Care Unit, The Second Hospital of Hebei Medical University, Shijiazhuang, China (Yao) Department of Emergency, The Second Hospital of Hebei Medical University, Shijiazhuang, China Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: This study aims to assess the effectiveness and safety of modified parasternal nerve block (MPSB) in providing perioperative analgesia and improving postoperative recovery in patients undergoing off-pump coronary artery bypass grafting (OPCABG). <br/>Method(s): Sixty-five patients scheduled for OPCABG were randomly assigned to either the intervention group (MPSB group), which received a preoperative modified parasternal block, or the control group. The primary outcome measured was intraoperative opioid consumption. Secondary outcomes included levels of inflammatory markers, postoperative pain scores (assessed using the Visual Analog Scale, VAS), incidence of postoperative nausea and vomiting (PONV), total plasma ropivacaine concentration, gastrointestinal recovery parameters, mobilization metrics, intensive care unit (ICU) parameters (mechanical ventilation duration, ICU length of stay, requirement for rescue analgesics), length of hospital stay, incidence of postoperative pulmonary complications (PPCs), and chronic pain. <br/>Result(s): Intraoperative sufentanil consumption was significantly reduced in the MPSB group (130.0 [IQR, 110.0-167.5] mug vs. 280.0 [IQR, 192.5-327.5] mug; p < 0.01). Inflammatory markers were consistently lower in the MPSB group. Pharmacokinetic analysis revealed a mean peak plasma ropivacaine concentration of 0.88 mug/mL, with the maximum individual concentration reaching 1.76 mug/mL at 5 min post-administration. The MPSB group demonstrated superior postoperative outcomes, including lower VAS pain scores, earlier return of gastrointestinal function, reduced duration of mechanical ventilation, decreased rescue analgesic requirements in the ICU, shorter hospital stays, and lower incidence of PPCs. <br/>Conclusion(s): Preoperative modified parasternal block significantly reduced perioperative opioid consumption in cardiac surgery patients. This intervention demonstrated benefits in facilitating rapid postoperative recovery. The conventional ropivacaine dosing regimen was a safe and effective analgesic approach, associated with a low risk of local anesthetic systemic toxicity.<br/>Copyright © 2026 by the authors. <96> Accession Number 2048701953 Title Feasibility and Safety of Operating Room Extubation After Minimally Invasive Cardiac Valve Surgery: A Systematic Review and Meta-Analysis. Source Journal of Cardiovascular Development and Disease. 13(8) (no pagination), 2026. Article Number: 368. Date of Publication: 01 Aug 2026. Author Magouliotis D.E.; Sicouri S.; Androutsopoulou V.; Baudo M.; Brecher V.; Avgerinos D.V.; Athanasiou T.; Ramlawi B. Institution (Magouliotis, Sicouri, Baudo, Brecher, Ramlawi) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States (Androutsopoulou) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Larissa, Greece (Avgerinos) Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece (Athanasiou) Department of Surgery and Cancer, Imperial College London, London, United Kingdom (Ramlawi) Department of Cardiac Surgery, Lankenau Heart Institute, Main Line Health, Wynnewood, PA, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Minimally invasive cardiac valve surgery has emerged as a preferred approach in selected patients, yet optimal postoperative extubation timing remains debated. This systematic review and meta-analysis examined clinical outcomes associated with extubation in the operating room (OR) versus the intensive care unit (ICU) among adult patients undergoing minimally invasive cardiac valve surgery. <br/>Method(s): The study was conducted according to PRISMA guidelines. A single unit of analysis was applied throughout. Pooled odds ratios were computed with the Mantel-Haenszel random-effects method; where a study reported only a matched or covariate-adjusted estimate, that estimate was reserved for a prespecified sensitivity analysis using the generic inverse-variance method. <br/>Result(s): Five observational studies (2023-2025) including 1101 OR-extubated and 899 ICU-extubated patients from high-volume centers with fast-track or enhanced recovery pathways were included. OR extubation was associated with lower odds of reintubation (OR 0.40; 95% CI 0.24-0.69; I<sup>2</sup> = 0%), postoperative delirium (OR 0.47; 95% CI 0.31-0.72; I<sup>2</sup> = 0%), and pneumonia (OR 0.30; 95% CI 0.16-0.53; I<sup>2</sup> = 0%). No significant differences were observed for new-onset atrial fibrillation, stroke, or reoperation for bleeding. Thirty-day mortality was reported by four of the five studies and comprised few events (5 of 1043 ORE versus 17 of 645 ICE across the four studies reporting this outcome); given the small number of events, the concentration of deaths in the higher-risk ICU-extubated patients, and the reliance of the pooled estimate on two confounded cohorts, this difference is not interpretable as a treatment effect, and no pooled odds ratio is reported here. Length of stay was consistently shorter after OR extubation but was not pooled because of extreme heterogeneity (I<sup>2</sup> = 96-100%). Sensitivity analyses using adjusted estimates attenuated the associations for reintubation and pneumonia, consistent with substantial confounding by indication. <br/>Conclusion(s): In appropriately selected patients undergoing minimally invasive valve surgery, OR extubation is feasible and is associated with a recovery profile at least comparable to that of ICU extubation. Because extubation location was determined largely by intraoperative and early postoperative stability, these associations should be read as reflecting patient selection rather than a causal benefit of the strategy. The findings support the feasibility of OR extubation in appropriately selected patients at experienced centers and motivate prospective, ideally randomized, evaluation.<br/>Copyright © 2026 by the authors. <97> Accession Number 2048765456 Title The Long-Term Impact of a Teleprehabilitation Programme on Modifiable Risk Factors and Quality of Life After Cardiac Surgery. Source European Journal of Cardio-thoracic Surgery. 68(8) (no pagination), 2026. Article Number: ezag207. Date of Publication: 01 Aug 2026. Author van Susante L.; Janssen L.; Bidar E.; Slooter G.; Sardari Nia P. Institution (van Susante, Bidar, Sardari Nia) Department of Cardiothoracic Surgery, Heart and Vascular Center, Maastricht University Medical Center, Maastricht, Netherlands (van Susante, Janssen, Slooter) Department of Surgery, Maxima Medical Center, Veldhoven, Netherlands (van Susante, Bidar, Sardari Nia) Department of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, Netherlands Publisher European Association for Cardio-Thoracic Surgery Abstract Objectives: To assess the long-term effects of teleprehabilitation on modifiable risk factors and quality of life up to 1 year following elective cardiac surgery. <br/>Method(s): This secondary analysis of the Digital Cardiac Counselling trial, a randomized controlled trial, compared multimodal teleprehabilitation with standard care in patients undergoing elective cardiac surgery. The teleprehabilitation programme targeted physical fitness, inspiratory muscle training, psychological support, nutritional optimization, and smoking cessation. Outcomes included trajectories of modifiable risk factors and quality of life measured preoperatively and at 3, 6, and 12 months postoperatively. Generalized linear mixed models assessed differences over time between groups, with exploratory post hoc analyses for individual timepoints. <br/>Result(s): Both groups showed postoperative reductions in all assessed modifiable risk factors and improvements in quality of life over time (P < .001), except for nutritional optimization (P = .173). Teleprehabilitation was associated with more favourable trajectories for smoking behaviour (P = .045) and nutritional risk (P = .011), with consistently lower incidences throughout follow-up. Smoking prevalence remained significantly lower in the teleprehabilitation group at all timepoints (P < .05), while malnutrition prevalence was lower at 3 months postoperatively (P = .012). Quality-of-life scores were consistently higher in the teleprehabilitation group throughout follow-up (P = .002). <br/>Conclusion(s): Teleprehabilitation in cardiac surgery patients not only reduces postoperative complications, but may also provide additional long-term benefits, particularly in smoking cessation, nutritional optimization, and quality of life. These findings support teleprehabilitation as a valuable addition to standard preoperative care, with possible sustained benefits for long-term lifestyle and quality of life.<br/>Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. <98> Accession Number 2048696000 Title Clinical Outcomes and Postprocedural Antithrombotic Management After Left Atrial Appendage Occlusion in Patients with Gastrointestinal Bleeding: A Systematic Review and Expert-Informed Clinical Framework. Source Biomedicines. 14(8) (no pagination), 2026. Article Number: 1801. Date of Publication: 01 Aug 2026. Author Vukovic J.; Becic T.; Radic J.; Radic M.; Marcic L.; Fabijanic D.; Jukic I. Institution (Vukovic, Jukic) Department of Internal Medicine, Division of Gastroenterology, University Hospital of Split, Split, Croatia (Vukovic, Radic, Radic) Department of Internal Medicine, School of Medicine, University of Split, Split, Croatia (Becic, Fabijanic) Department of Cardiovascular Diseases, University Hospital of Split, Split, Croatia (Radic) Department of Internal Medicine, Division of Nephrology, Dialysis and Arterial Hypertension, University Hospital of Split, Split, Croatia (Radic) Department of Internal Medicine, Division of Rheumatology, Allergology and Clinical Immunology, University Hospital of Split, Split, Croatia (Marcic) Department of Diagnostic and Interventional Radiology, University Hospital of Split, Split, Croatia (Fabijanic) Department of Clinical Propedeutics, School of Medicine, University of Split, Split, Croatia (Jukic) Faculty of Health Sciences, University of Split, Split, Croatia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Patients with atrial fibrillation (AF) and a history of gastrointestinal (GI) bleeding represent a particularly challenging clinical population due to the coexistence of elevated thromboembolic and hemorrhagic risks. Percutaneous left atrial appendage occlusion (LAAO) has emerged as an alternative strategy for stroke prevention in patients in whom long-term oral anticoagulation is contraindicated or poorly tolerated. However, evidence specifically addressing clinical outcomes and optimal postprocedural antithrombotic management in this subgroup remains limited. <br/>Method(s): A comprehensive systematic literature search was conducted across PubMed, Scopus, Web of Science, and Cochrane CENTRAL from database inception to April 2026. Studies were eligible if they included patients with prior gastrointestinal bleeding as the primary study population or reported separately extractable outcomes for a predefined gastrointestinal bleeding subgroup. The primary outcomes were recurrent GI bleeding, thromboembolic events, and all-cause mortality, while secondary outcomes included procedural success, device-related thrombosis, and postprocedural antithrombotic strategies. Owing to substantial clinical and methodological heterogeneity, findings were synthesized qualitatively in accordance with PRISMA 2020 recommendations. <br/>Result(s): Five observational studies reporting GI bleeding-specific outcomes were included in the systematic evidence synthesis. Procedural success rates were consistently high, and LAAO was associated with acceptable thromboembolic outcomes during follow-up. Nevertheless, recurrent GI bleeding remained a clinically relevant complication, particularly in patients with a prior bleeding history. Postprocedural antithrombotic regimens varied widely, ranging from short-term oral anticoagulation to dual or single antiplatelet therapy and reduced-intensity strategies. Less intensive regimens appeared feasible in carefully selected patients at very high bleeding risk; however, no universally optimal approach could be identified. <br/>Conclusion(s): Available observational evidence suggests that LAAO may represent a stroke prevention option in selected patients with AF and prior GI bleeding, although firm conclusions regarding net clinical benefit and the optimal postprocedural antithrombotic strategy cannot currently be drawn. Its net clinical benefit is closely linked to individualized postprocedural management, particularly the choice and intensity of antithrombotic therapy. These findings highlight the importance of a multidisciplinary, patient-centered approach and underscore the need for prospective studies to establish evidence-based treatment strategies in this high-risk population.<br/>Copyright © 2026 by the authors. <99> Accession Number 2048764881 Title Cytokine trajectories after cardiopulmonary bypass in children: a systematic review and quantitative synthesis. Source International Journal of Cardiology Congenital Heart Disease. 25 (no pagination), 2026. Article Number: 100698. Date of Publication: 01 Sep 2026. Author Pisesky A.E.; Breatnach C.; Foroutan F.; Parshuram C.; Floh A. Institution (Pisesky) Department of Pediatrics, Stollery Children's Hospital, University of Alberta, 8440 112 St NW, Edmonton, Canada (Breatnach) Intensive Care Medicine, Children's Health Ireland at Crumlin, Cooley St, Dublin, Ireland (Foroutan) Ted Rogers Centre for Heart Research, University Health Network, Toronto, Canada (Parshuram, Floh) Department of Critical Care Medicine, The Hospital for Sick Children, 170 Elizabeth Street, Toronto, Canada (Parshuram) Centre for Safety Research, Child Health Evaluative Sciences, The Research Institute, The Hospital for Sick Children, 170 Elizabeth Street, Toronto, Canada (Parshuram) Department of Paediatrics and Interdepartmental Division of Critical Care Medicine, University of Toronto, 27 King's College Circle, Toronto, Canada (Floh) Labatt Family Heart Centre, Division of Cardiac Critical Care, The Hospital for Sick Children, Toronto, Canada Publisher Elsevier B.V. <100> Accession Number 2048842762 Title Crystalloids Versus Colloids: Fluid Strategies for Better Recovery Outcomes in Cardiac Surgery. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 4873161. Date of Publication: 2026. Author Rajah T.; Volpi S.; Ali J. Institution (Rajah) University of Warwick, Warwickshire, United Kingdom (Rajah) University Hospitals Coventry and Warwick NHS Trust, Coventry, United Kingdom (Volpi) Department of Cardiothoracic Surgery, St Thomas' Hospital, London, United Kingdom (Ali) Department of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom (Ali) Department of Surgery, University of Cambridge, Cambridge, United Kingdom Publisher John Wiley and Sons Inc Abstract Objectives: Perioperative fluid resuscitation in cardiac surgery is vital, yet the optimal strategy remains debated. This review evaluates the current evidence on colloid versus crystalloid fluid resuscitation and considers whether alternative outcome measures may help us better identify optimal methods of fluid resuscitation for patients. <br/>Method(s): A search of electronic databases PubMed, Medline and Google Scholar was performed from inception to June 2025 to synthesise findings on the perioperative fluid management of patients undergoing cardiac surgery. <br/>Result(s): Thirteen studies, involving a total of 34,935 patients, were included in this narrative review. Evidence comparing colloids and crystalloids perioperatively in cardiac surgery is mixed. Colloids, particularly albumin, show advantages in fluid balance, reduce vasopressor use and shorten ICU stays, but carry a higher risk of acute kidney injury, especially with synthetic colloids like hydroxyethyl starch. Crystalloids are less associated with renal complications yet contribute to increased fluid retention and longer hospital stays. Few studies, however, report on fluid balance, renal function and preservation of microcirculation, limiting the understanding of fluid strategies on these relevant postoperative outcomes. <br/>Conclusion(s): Mortality alone may be an insufficient measure for evaluating fluid resuscitation strategies in cardiac surgery. Expanding outcome measures to include fluid balance, preservation of microcirculation and a standardised assessment of renal function could yield more clinically relevant actionable insights and support safer, more individualised fluid management. Further research is warranted to assess these outcomes and establish more holistic, patient-centred standards in postoperative care.<br/>Copyright © 2026 Tanisha Rajah et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <101> Accession Number 2048762069 Title Hemodynamic and Perioperative Effects of Remimazolam Versus Propofol in Adult Cardiac Surgery: A Grade-Assessed Systematic Review and Meta-Analysis. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Salameh H.; Khalili H.; Hashem W.; Assi S.; Nazzal Z. Institution (Salameh, Khalili, Hashem, Assi, Nazzal) Department of Medicine, Faculty of Medicine and Allied Sciences, An-Najah National University, Nablus, Palestine Publisher W.B. Saunders Abstract Hemodynamic instability during adult cardiac surgery increases perioperative risk. Propofol is widely used but may cause dose-dependent hypotension and myocardial depression. Remimazolam, an ultra-short-acting benzodiazepine, has emerged as a potentially more hemodynamically stable alternative, although evidence in cardiac surgery remains limited. A PRISMA-compliant systematic review and meta-analysis were conducted to compare remimazolam with propofol in adult cardiac surgery. PubMed, Embase, Web of Science, and Scopus were searched from inception to January 2026. Randomized controlled trials (RCTs) and comparative cohort studies were included. Primary outcomes included study-defined hypotensive events, mean arterial pressure, heart rate, bispectral index, and operative time. Random-effects models were used for pooled analyses, and evidence certainty was assessed using the GRADE approach. Nine studies involving 903 patients were included. Compared with propofol, remimazolam significantly reduced the incidence of intraoperative hypotensive events (risk ratio 0.50, 95% confidence interval 0.31-0.80) with minimal heterogeneity. Mean arterial pressure and heart rate were comparable between groups. Remimazolam was associated with faster emergence, including shorter times to eye opening and extubation, while operative time, anesthetic depth, postoperative nausea and vomiting, delirium, and hospital stay showed no significant differences. Postoperative adverse events were reduced with remimazolam. Evidence certainty ranged from high to low, mainly due to heterogeneity and imprecision. Remimazolam may provide superior hemodynamic stability and faster postoperative recovery compared with propofol in adult cardiac surgery without compromising anesthetic efficacy or safety. Larger multicenter trials are needed to confirm these findings and define their long-term clinical benefits.<br/>Copyright © 2026 Elsevier Inc. <102> Accession Number 2048795270 Title Sex-Specific Differences in Clinical Outcomes After Transcatheter Aortic Valve Replacement: A Meta-Analysis of Reconstructed Individual Patient Survival Data. Source Structural Heart. 10(9) (no pagination), 2026. Article Number: 101100. Date of Publication: 01 Sep 2026. Author Abdelaziz A.M.; Nounou M.V.; Al Othman A.; Alasnag M.; Chieffo A.; Abbott J.D.; Al-Allawee A.; Zreigh S.; Benhammou M.; Dervis M.; Guerguer W.; Haidarah A.; Elmezayen R.; Alzu'bi M.; Almzainy S.; Khalid S.; Shawesh Q.; Abuajamieh M.; Elhadi M.; Bagur R.; Mamas M.A. Institution (Abdelaziz) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Nounou) Faculty of Medicine, University of Nouakchott Al Aasrya, Nouakchott, Mauritania (Al Othman) Department of Medicine, Faculty of Medicine, Near East University, Nicosia, Cyprus (Alasnag) Cardiac Center, King Fahd Armed Forces Center, Jeddah, Saudi Arabia (Chieffo) Cardiology Department, Vita Salute San Raffaele University, Milan, Italy (Chieffo) San Raffaele Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (Abbott) Department of Medicine, Division of Cardiology, Warren Alpert Medical School of Brown University, Providence, RI, United States (Al-Allawee) College of Medicine, University of Fallujah, Fallujah, Iraq (Zreigh, Dervis) Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, Turkey (Benhammou) Faculty of Medicine, University of Oran 1, Oran, Algeria (Guerguer) Faculty of Medicine, University of Health Sciences, Algiers, Algeria (Haidarah) West China Hospital, Sichuan University, Sichuan, Chengdu, China (Elmezayen) Faculty of Medicine, Kafr El-Sheikh University, Kafr El-Sheikh, Egypt (Alzu'bi) Faculty of Medicine, The Hashemite University, Zarqa, Jordan (Almzainy, Elhadi) Faculty of Medicine, University of Tripoli, Tripoli, Libyan Arab Jamahiriya (Khalid) Faculty of Medicine, University of Benghazi, Benghazi, Libyan Arab Jamahiriya (Shawesh) Department of Internal Medicine, HCA Mountain View Hospital, Las Vegas, NV, United States (Abuajamieh) Faculty of Medicine, Cairo University, Cairo, Egypt (Elhadi) College of Medicine, Korea University, Seoul, South Korea (Bagur) Department of Medicine, London Health Sciences Centre, Western University, London, ON, Canada (Mamas) Keele Cardiovascular Research Group, Centre for Prognosis Research, Keele University, Keele, United Kingdom (Mamas) National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, Birmingham, United Kingdom Publisher Cardiovascular Research Foundation Abstract Background Females with severe aortic stenosis present with distinct anatomical and clinical characteristics compared to males, which may influence outcomes following transcatheter aortic valve replacement (TAVR). We sought to investigate the prognostic impact of sex-specific differences on short- and long-term outcomes following TAVR. Methods PubMed, Embase, Scopus, and Web of Science were searched through August 2025 for randomized and observational studies reporting sex-specific outcomes after TAVR. Reconstructed individual patient data from published Kaplan-Meier (KM) curves were used to estimate long-term survival outcomes. Results Overall, 71 studies involving 481,353 patients were included. Compared with males, females demonstrated a higher short-term risk of adverse outcomes, including 30-day all-cause mortality (hazard ratio [HR]: 1.064, 95% CI: 1.005-1.127; p = 0.033) and stroke/transient ischemic attack (HR: 1.511, 95% CI: 1.317-1.734; p < 0.001). Females were also more likely to experience life-threatening bleeding (risk ratio [RR]: 1.29, 95% CI: 1.03-1.62; p = 0.028), major bleeding (RR: 1.26, 95% CI: 1.13-1.41; p < 0.001), and major vascular complications (RR: 1.66, 95% CI: 1.53-1.81; p < 0.001). Despite these higher periprocedural risks, females demonstrated superior long-term outcomes, with lower all-cause mortality (HR: 0.812, 95% CI: 0.794-0.831; p < 0.001) and cardiovascular mortality (HR: 0.837, 95% CI: 0.784-0.893; p < 0.001) during follow-up extending to 10 years, whereas risks of stroke/transient ischemic attack and myocardial infarction were comparable between sexes. Conclusions Females undergoing TAVR experience higher early risks of mortality, stroke, bleeding, and vascular complications, but exhibit a sustained long-term survival advantage compared with males, highlighting the need for sex-centered periprocedural management strategies.<br/>Copyright © 2026 The Author(s). <103> Accession Number 2048755306 Title Effects of discharge education program on recovery and quality of life after cardiac surgery: a 12 week follow-up single-blind randomized controlled trial. Source BMC Surgery. 26(1) (no pagination), 2026. Article Number: 572. Date of Publication: 01 Dec 2026. Author Kajti E.; Selcuk I.; Selcuk U.N.; Tokoz H.; Ozbas A. Institution (Kajti) Istanbul Atlas University, Istanbul, Turkey (Selcuk) Istanbul Dr. Siyami Ersek Chest and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey (Selcuk, Tokoz) Atasehir Acibadem Private Hospital, Istanbul, Turkey (Ozbas) Demiroglu Bilim University Florence Nightingale School of Nursing, Istanbul, Turkey Publisher BioMed Central Ltd Abstract Aims: In the contemporary era of rapid societal and technological advancement, factors such as sedentary lifestyles, environmental pollution, unhealthy dietary habits, consumption of sugar-sweetened beverages, tobacco and alcohol use, and the growing prevalence of comorbid conditions associated with these risk factors have contributed to cardiovascular diseases becoming one of the leading causes of mortality worldwide. Among the therapeutic interventions for cardiovascular diseases, open-heart surgery remains one of the principal treatment modalities, as it is associated with superior symptom control, enhanced quality of life, and improved long-term survival outcomes compared with medical management alone. Beside the surgical intervention one of the main components determining the outcomes of the surgery is the patient education therefore this study was conducted to determine the effect of discharge education provided after cardiac surgery on recovery and quality of life. <br/>Methods and Results: This research was conducted as a randomized pretest-posttest controlled study to determine the effects of discharge education after cardiac surgery on recovery and quality of life. The study was conducted between March 2022 and July 2023, in two Training and Research Hospitals with 70 inpatients. The data of the study were collected face to face and via telephone calls using the 'Patient's Personal Information Form', 'Multidimensional Index of Life Quality-MILQ-TR', 'Quality of Recovery - 40 Questionnaire-QOR-40' and 'Telephone Follow-Up Form'. According to this study's results, the recovery quality level and the quality of life of the patients in the intervention group was significantly higher than the patients in the control group. <br/>Conclusion(s): According to the results of the study, which was evaluated at a 95% confidence interval and a significance level below p < 0.05; the quality of recovery and quality of life of the intervention group patients were statistically higher, the complications were fewer, and the level of knowledge was higher. Trial registration: Trial Registry The Effects of Discharge Education Program on Recovery and Quality of Life After Cardiac Surgery. Unique Identifying Number NCT05631340. Date of Registration 21/11/2022. (https://clinicaltrials.gov/study/NCT05631340)<br/>Copyright © The Author(s) 2026. <104> Accession Number 2048667591 Title Better Discrimination, Unchanged Practice: Are Machine Learning Models Ready to Replace Established Risk Scores in Cardiac Surgery? A Narrative Review. Source Life. 16(8) (no pagination), 2026. Article Number: 1371. Date of Publication: 01 Aug 2026. Author Magouliotis D.E.; Sicouri S.; Androutsopoulou V.; Zotos P.-A.; Baudo M.; Ramlawi B. Institution (Magouliotis, Sicouri, Baudo, Ramlawi) Department of Cardiac Surgery Research, Lankenau Institute for Medical Research, Wynnewood, PA, United States (Androutsopoulou, Zotos) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Ramlawi) Department of Cardiac Surgery, Lankenau Medical Center, Wynnewood, PA, United States Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Preoperative risk stratification underpins consent, treatment selection, and quality benchmarking in cardiac surgery, a task served for two decades by regression-derived scores such as the European System for Cardiac Operative Risk Evaluation II (EuroSCORE II) and the Society of Thoracic Surgeons Predicted Risk of Mortality (STS PROM), together with procedure-specific tools. A rapidly expanding literature reports that machine learning (ML) models achieve higher discrimination than these scores, yet established scores remain the instruments actually used at the bedside. This narrative review examines that paradox. Drawing on studies emphasized between 2023 and 2026, we argue that the reported advantage of ML is real but modest. This advantage is driven primarily by improved discrimination, while key measures of clinical value, including calibration, net benefit, and external or temporal validation, are infrequently reported. We organize the evidence around a four-lens appraisal (discrimination, calibration, clinical utility, and generalizability) and show that most cardiac surgery ML studies focus only on discrimination. We then consider why superior discrimination has not changed practice and outline the evidence needed for an ML-based risk model to justify replacing an established scoring system. The current literature supports a measured conclusion: ML is a discrimination upgrade in search of clinical proof.<br/>Copyright © 2026 by the authors. <105> Accession Number 2048743852 Title Risk Prediction Models for Unplanned 30-Day Readmission After Discharge of Patients After Undergoing Coronary Revascularization: A Systematic Review and Meta-Analysis. Source Journal of Endovascular Therapy. (no pagination), 2026. Article Number: 15266028261477984. Date of Publication: 2026. Author Wang S.; Li J.; Zhang H.; Zhang Q.; Wang T.; Xie Z.; Yang J. Institution (Wang, Li, Zhang, Zhang, Wang) School of Nursing, Hubei University of Chinese Medicine, Wuhan, China (Xie) Department of Operating Room, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (Yang) Nursing Department, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China Publisher SAGE Publications Inc. Abstract Background: Unplanned 30-day readmission is a critical quality indicator in clinical health care. Although the number of risk prediction models related to this research is increasing, uncertainties remain regarding their methodological rigor and clinical practical value. <br/>Objective(s): This study aims to systematically evaluate risk prediction models for unplanned 30-day readmission following coronary revascularization, providing evidence to inform clinical practice and guide future model development. <br/>Method(s): We identified studies that developed or validated risk prediction models for unplanned 30-day readmission following coronary revascularization. Literature searches were conducted from database inception to June 7, 2025. Study screening and data extraction were performed independently by 2 reviewers. Methodological quality of the included studies was assessed using the Prediction model Risk Of Bias Assessment Tool (PROBAST) tool, covering both risk of bias and applicability. Meta-analyses of model discrimination, measured by the area under the receiver operating characteristic curve (AUC), and frequently reported predictors were conducted using R software (version 4.5.1). <br/>Result(s): A total of 4961 records were initially identified, of which 14 studies meeting the eligibility criteria were included, encompassing 19 prediction models. The reported 30-day unplanned readmission rates ranged from 0.7% to 18.08%. Meta-analysis showed that older age, female sex, diabetes, chronic pulmonary disease, and heart failure were significantly associated with an increased risk of unplanned readmission (P < .05), with AUC values ranging from 0.604 to 0.999. Assessment using the PROBAST tool revealed that the included studies generally had a high risk of bias, primarily attributable to poor reporting quality of the analysis methods. <br/>Conclusion(s): Existing forecasting models for unintended readmission within 30 days after coronary revascularization show considerable variability in effectiveness and are typically vulnerable to a considerable risk of bias. Although some models show potential predictive value, most are in the early stages of development and lack reliable external validation. Future studies should strictly adhere to Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) reporting guidelines, improve transparency in study design and reporting, and prioritize independent external validation to enhance model stability and generalizability. Clinical Impact: This research offers a thorough and current assessment of risk prediction models for unintended readmissions within 30 days after coronary revascularization, identifying the overall quality and limitations of current models. The results provide evidence-based support for clinical risk assessment, promote early screening of high-risk cases, and offer methodological recommendations for the development of future prediction models.<br/>Copyright © The Author(s) 2026 <106> Accession Number 2048643936 Title Effects of Permissive Hypercapnia During Lung Surgery on Inflammatory Biomarkers in Serum and Bronchoalveolar Lavage Fluid: A Randomized Controlled Trial. Source Metabolites. 16(8) (no pagination), 2026. Article Number: 550. Date of Publication: 01 Aug 2026. Author Stojanovic M.; Vasilijic M.; Zivadinovic J.; Randjelovic M.; Nikolic A.; Jevtovic Stoimenov T.; Jankovic R. Institution (Stojanovic, Vasilijic, Zivadinovic, Randjelovic, Nikolic, Jankovic) Clinic for Anaesthesia and Intensive Therapy, University Clinical Center Nis, Nis, Serbia (Zivadinovic, Nikolic, Jevtovic Stoimenov, Jankovic) School of Medicine, University of Nis, Nis, Serbia (Jevtovic Stoimenov) Department for Biochemistry, School of Medicine, University of Nis, Nis, Serbia Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Introduction: Permissive hypercapnia has become an integral component of lung-protective ventilation strategies during one-lung ventilation (OLV), particularly in thoracic surgery. Its potential immunomodulatory effects have attracted increasing interest; however, clinical evidence remains limited and inconsistent. The Aim: The primary objective was to evaluate the effects of permissive hypercapnia on inflammatory biomarkers in bronchoalveolar lavage fluid and serum during one-lung ventilation. The secondary objective was to assess the influence of different ventilation modes on these inflammatory responses. <br/>Method(s): Forty patients undergoing elective lung surgery requiring OLV were prospectively enrolled and allocated to either a normocapnic (n = 20) or hypercapnic group (n = 20). BAL concentrations of TNF-alpha, IL-1beta, IL-6, and IL-8 were measured before and after intervention. Serum IL-6, C-reactive protein (CRP), and leukocyte counts were also assessed. Outcome Measures: Primary outcome: Change in bronchoalveolar lavage (BAL) levels of preselected biomarkers for inflammation (TNF-alpha, IL-1beta, IL-6, and IL-8) and in serum (IL-6, CRP, and WBC) between the normocapnic and hypercapnic groups during one-lung ventilation. Secondary outcome: Whether the inflammatory response differed according to the ventilation mode (pressure-controlled versus volume-controlled ventilation). <br/>Result(s): Baseline and post-intervention BAL concentrations of TNF-alpha, IL-1beta, IL-6, and IL-8 were generally comparable between the hypercapnic and normocapnic groups. No significant differences were observed in post-intervention BAL concentrations of TNF-alpha, IL-1beta, or IL-6 among the ventilated subgroups. However, post hoc analysis demonstrated significantly lower IL-8 concentrations in the hypercapnic-PC subgroup compared with the normocapnic-PC subgroup (p = 0.034). Within the normocapnic cohort, BAL IL-8 concentrations were significantly higher in the PC subgroup than in the VC subgroup (p = 0.012). In serum, postoperative IL-6 concentrations were significantly higher in the hypercapnic than in the normocapnic group (p = 0.003). <br/>Conclusion(s): Permissive hypercapnia was not associated with a reduction in BAL concentration of the pro-inflammatory cytokines TNF-alpha, IL-1beta, IL-6, and IL-8. However, postoperative serum IL-6 concentrations were significantly higher in patients exposed to hypercapnia. As the duration of surgery, one-lung ventilation, and mechanical ventilation was longer in the hypercapnic group, the observed increase in serum IL-6 cannot be attributed solely to hypercapnia. Further large-scale randomized studies are required to clarify the immunological effects of permissive hypercapnia during thoracic surgery.<br/>Copyright © 2026 by the authors. <107> Accession Number 652037123 Title Evaluating the use of proactive surveillance and remote patient monitoring to guide the timing of valve intervention in patients with severe asymptomatic aortic stenosis (APRAISE-AS): results of a pilot randomised controlled trial. Source Heart (British Cardiac Society). (no pagination), 2026. Date of Publication: 25 Aug 2026. Author Khan N.; Steeds R.P.; Mehta S.; Sun Y.; Kyte D.; Fabritz L.; Collis P.; Stubbs C.; Nulty M.; Cotton J.M. Institution (Khan) Department of Cardiology (QEHB), University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (Khan, Steeds, Fabritz) Department of Cardiovascular Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom (Steeds) Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom (Mehta, Sun, Stubbs, Nulty) University of Birmingham Clinical Trials Unit, Birmingham, United Kingdom (Kyte) Institute for Applied Health Research, University of Birmingham, Birmingham, United Kingdom (Kyte) School of Health and Wellbeing, University of Worcester, Worcester, United Kingdom (Fabritz) University Heart and Vascular Centre, University Hospital Hamburg-Eppendorf Department of Diagnostic and Interventional Neuroradiology, Hamburg, Germany (Collis) Department of Cardiovascular Sciences, University of Birmingham, Birmingham, United Kingdom (Cotton) Department of Cardiology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, United Kingdom (Cotton) Faculty of Science and Engineering, University of Wolverhampton, Wolverhampton, United Kingdom Abstract BACKGROUND: The insidious nature of aortic stenosis (AS) combined with the advanced age of the affected population results in underreporting of symptoms and underestimation of impact on functional capacity and quality of life. Although guidelines recommend early valve replacement in severe asymptomatic AS when coupled with adverse prognostic features, capacity within healthcare systems may limit translation into clinical practice. The use of remote monitoring and proactive surveillance to inform clinical management of heart valve disease is an underexplored area. APRAISE-AS evaluated the utility of remote monitoring to pre-empt/detect a change in clinical status (incorporating a symptom tracker, frailty assessment and quality of life score) to inform patient management. <br/>METHOD(S): 12-month open-label, two-arm, parallel group randomised controlled pilot trial conducted in two tertiary cardiac centres. 38/66 participants (>=18 years) with asymptomatic severe AS were randomly assigned (1:1) to standard care or the APRAISE-AS intervention in addition to standard care. The primary aim of the study was to (1) test the trial protocol, (2) determine acceptability of the APRAISE-AS intervention and (3) inform the most appropriate outcome measure(s) and sample size for a full-scale randomised controlled trial. <br/>RESULT(S): 38 participants were assigned to standard care (n=19) or to standard care plus the APRAISE-AS intervention (n=19). Adherence rates were high: 81% for the weekly symptom assessments, 91% for the fortnightly timed up and go tests and 93% for the monthly health-related quality of life assessments using the Kansas City Cardiomyopathy Questionnaire (KCCQ). Clinical review and onward referral for valve replacement were triggered by a change from baseline in symptoms and KCCQ scores. <br/>CONCLUSION(S): Remote monitoring of severe asymptomatic AS can be safely delivered in practice. Although the pilot did not recruit to target, a digitally enabled clinical pathway to optimise the management of asymptomatic severe AS is acceptable to clinicians and patients. TRIAL REGISTRATION NUMBER: ISRCTN19413194.<br/>Copyright © Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group. <108> Accession Number 2048611102 Title Health-Related Quality of Life in Patients Undergoing Cardiac Surgeries in Low- and Lower-Middle-Income Countries: A Systematic Review and Meta-Analysis. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 4261303. Date of Publication: 2026. Author Wang S.; Tabrizi N.S.; Wang E.Y.; Min J.; Musoni M.; Lin Y. Institution (Wang) Stanford University School of Medicine, Stanford University, Palo Alto, CA, United States (Tabrizi) Department of Cardiothoracic Surgery, Cleveland Clinic, Cleveland, OH, United States (Wang) Department of Cardiothoracic Surgery, Stanford University, Palo Alto, CA, United States (Min) Department of Surgery, Stanford University, Palo Alto, CA, United States (Musoni) Department of Cardiothoracic Surgery, King Faisal Hospital, Kigali, Rwanda (Lin) Department of Cardiothoracic Surgery, Univeristy of Washington, Seattle, WA, United States Publisher John Wiley and Sons Inc Abstract Objective: Health-related quality of life (HRQoL) assessment is pivotal for advancing sustainable global cardiac surgery. However, the use and applicability of HRQoL instruments in low- and lower-middle-income countries (LI-LMICs) remain poorly characterized. <br/>Method(s): A systematic review of studies assessing HRQoL among patients undergoing cardiac surgery in LI-LMICs was performed using PubMed/MEDLINE, Embase, Scopus, Global Index Medicus, and CABI Global Health. Primary outcomes included the prevalence and types of HRQoL instruments adopted. A meta-analysis of pooled HRQoL scores was performed to examine the impact of cardiac surgery. <br/>Result(s): Thirty-eight studies comprising 12,397 patients from seven countries were identified. Most studies were conducted in Iran (21, 55%) or India (7, 18%); only one study (2.6%) originated from a LIC (Rwanda). Generic HRQoL instruments predominated (28/41, 68%), most commonly the Short Form-12/36 (SF-12/36; 20, 49%) and the World Health Organization Quality of Life (WHOQOL) or WHOQOL Brief (WHOQOL-BREF) (4, 9.8%). Cardiac surgery was associated with significant postoperative improvements in HRQoL, including physical (standardized mean difference [SMD]:1.17; 95% CI 0.83-1.51; p < 0.0001) and mental (0.78; 95% CI 0.47-1.09; p < 0.0001) component scores measured by SF-12/36. Significant improvements were also observed across WHOQOL domains: physical (0.84; 95% CI 0.51-1.08; p < 0.0001), psychological (0.54; 95% CI 0.32-0.75; p < 0.0001), social (0.33; 95% CI 0.12-0.53; p = 0.002), and environmental (0.34; 95% CI 0.14-0.55; p = 0.001). <br/>Conclusion(s): The use of validated and culturally appropriate HRQoL instruments is crucial for assessing patient-centered outcomes in global cardiac surgery. Although significant improvements in HRQoL following cardiac surgery were observed in LI-LMICs, fewer than 9% of LI-LMICs were represented in the existing literature, highlighting a substantial gap in outcome assessment of global cardiac surgery.<br/>Copyright © 2026 Songnan Wang et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <109> Accession Number 652038278 Title Machine Learning Models for Predicting Permanent Pacemaker Implantation After Transcatheter Aortic Valve Replacement: A Scoping Review. Source Cardiology in review. (no pagination), 2026. Date of Publication: 25 Aug 2026. Author Saleh Y.; Afridi M.; Blackledge M.; Phaneuf A.; El Sherbini A.; El-Wakeel A.; El Diasty M. Institution (Saleh, Afridi, Phaneuf, El Sherbini) From the Faculty of Health Sciences, Queen's University, Kingston, ON, Canada (Blackledge) Case Western Reserve University School of Medicine, Cleveland, OH, United States (El-Wakeel) Lane Department of Computer Science and Electrical Engineering, West Virginia University, Morgantown, WV, United States (El Diasty) Department of Cardiac Surgery, Harrington Heart and Vascular Institute, University Hospitals Cleveland Medical Center, Cleveland, OH, United States Abstract Permanent pacemaker (PPM) implantation has been reported in up to 26% of patients undergoing transcatheter aortic valve replacement (TAVR). Machine learning (ML) models have increasingly been developed to predict the need for PPM after TAVR, offering the potential to improve preprocedural risk stratification and optimize perioperative management. We conducted a systematic literature search of MEDLINE, Embase, Cochrane Central, ClinicalTrials.gov, and Google Scholar to identify primary studies evaluating ML models for predicting PPM implantation following TAVR. Data extracted included study characteristics, ML methodologies, predictor variables, and model performance metrics. Seven studies comprising 4528 patients who underwent TAVR met the inclusion criteria. The evaluated TAVR devices included balloon-expandable, self-expandable, and mechanically expandable Lotus valves. The incidence of PPM implantation ranged from 14% to 41.7%. ML approaches included random forest, gradient boosting, neural networks, support vector machines, and logistic regression. Predictive performance varied across studies, with area under the receiver operating characteristic curve values ranging from 0.61 to 0.92. Frequently identified predictors of PPM implantation included prosthetic valve size, preprocedural right bundle branch block, atrioventricular block, leaflet calcification, larger left ventricular outflow tract diameter, prior aortic valve interventions, and use of self-expanding valves. Overall, ML models demonstrate promising predictive capability for identifying patients at risk of requiring PPM after TAVR, although model performance remains inconsistent across studies. Further external validation, standardization of model development, and prospective evaluation are needed before these tools can be confidently incorporated into routine clinical decision-making and risk stratification following TAVR.<br/>Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <110> Accession Number 2048643070 Title Premedication of Pediatric Cardiac Population with Midazolam: Comparison of Oral and Sublingual Administration Regarding Plasma Midazolam Concentration, Clinical Effectiveness, Hemodynamic and Behavioral Outcomes. Source Children. 13(8) (no pagination), 2026. Article Number: 1067. Date of Publication: 01 Aug 2026. Author Kousi T.; Karafotia A.; Karageorgos V.; Gkantinas G.; Sofianidou I.; Kanakis M.; Smina A.; Zergioti I.; Tamvakopoulos C.; Antoniou T. Institution (Kousi, Karafotia, Karageorgos, Gkantinas, Sofianidou, Antoniou) Department of Anesthesiology, Onassis Hospital Athens, Athens, Greece (Kanakis) Department of Congenital Cardiac Surgery, Onassis Hospital Athens, Athens, Greece (Smina, Tamvakopoulos) Center for Clinical, Experimental Surgery and Translational Research, Pharmacology-Pharmacotechnology, Biomedical Research Foundation, Academy of Athens, Athens, Greece (Zergioti) School of Applied Mathematical and Physical Sciences, National Technical University of Athens, Heroon Polytehneiou 9, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Midazolam is widely used as a pediatric premedication, but evidence from direct comparisons of oral and sublingual administration in children with congenital heart disease remains limited, particularly that from pharmacokinetic and physiologic data analyzed together. <br/>Method(s): We conducted a single-center prospective randomized study comparing oral midazolam 0.5 mg/kg with sublingual midazolam 0.3 mg/kg in children undergoing cardiac surgery or catheterization procedures under general anesthesia. Plasma midazolam and 1-hydroxymidazolam concentrations were measured approximately 30 min after administration. Log-transformed concentrations were compared using regression/ANCOVA models adjusted for dose and age. Changes in mean arterial pressure (MAP), heart rate (HR), and oxygen saturation (SpO<inf>2</inf>) were analyzed from baseline to 15 and 30 min. Behavioral outcomes included the sedation score, separation from parents, and mask acceptance. <br/>Result(s): Sixty-eight children were randomized; 65 had evaluable pharmacokinetic samples and formed the complete-case pharmacokinetic cohort. Adjusted plasma midazolam concentrations did not differ significantly between the groups, with an adjusted geometric mean ratio for sublingual versus oral administration of 0.98 (95% CI 0.53-1.79; unadjusted p = 0.940; Holm-adjusted p = 1.000). The corresponding ratio for 1-hydroxymidazolam was 1.37 (95% CI 0.55-3.41; unadjusted p = 0.494; Holm-adjusted p = 1.000). HR and SpO<inf>2</inf> changes were non-significant between the groups. At 30 min, sublingual administration was associated with a lower adjusted change in MAP compared with oral administration (adjusted difference -12.08 mmHg, 95% CI -19.74 to -4.42; unadjusted p = 0.002, Holm-adjusted p = 0.012). Behavioral outcomes did not differ significantly between the groups. <br/>Conclusion(s): In this prospective randomized pediatric cardiac cohort, oral midazolam 0.5 mg/kg and sublingual midazolam 0.3 mg/kg produced comparable plasma concentrations and similar behavioral outcomes. Sublingual administration was not associated with worse HR or SpO<inf>2</inf> responses, although an isolated lower MAP change at 30 min warrants confirmation in larger studies. Sublingual midazolam may represent a feasible lower-dose alternative for premedication in this population.<br/>Copyright © 2026 by the authors. <111> Accession Number 2048581112 Title Global Utilization of Intra-Aortic Balloon Pump: Current Status and Future Trends: A Bibliometric Analysis. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 4539132. Date of Publication: 2026. Author Deng J.-H.; Lu A.-Y.; He F.-R.; Yao Y.-T. Institution (Deng, Lu) Department of Anesthesiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangdong Province, Guangzhou, China (He) Department of Gynecology and Obstetrics, The Air Force Hospital of Southern Theater Command, Guangdong Province, 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) Department of Anesthesiology, Center of Outcomes Research, Critical Care and Pain Medicine, University of Texas, Houston, TX, United States (Yao) Outcomes Research Consortium, Houston, TX, United States (Yao) The Evidence in Cardiovascular Anesthesia (EICA) Group, Beijing, China Publisher John Wiley and Sons Inc Abstract Background: Despite extensive research on perioperative intra-aortic balloon pump (IABP) use, a comprehensive bibliometric analysis of this literature is absent. The aim is to offer clinicians, scientists, and stakeholders an updated overview of the research status and development trends of the IABP through bibliometric analysis. <br/>Method(s): This study performed an extensive search in the Web of Science Core Collection (WoSCC) for publications on IABP from January 1, 1994, to December 31, 2023. A total of 3056 publications were analyzed using Microsoft Excel and visualization tools like CiteSpace, VOSviewer, and Pajek to identify specific characteristics. <br/>Result(s): The study analyzed 3056 articles on IABP, revealing a steady annual growth over the last 30 years. The USA, Germany, and Japan emerged as dominant contributors in the field of IABP research. Among institutions, Harvard University had the highest publication output in IABP-related research. Professor Thiele emerged as the leading author, having published 35 articles. Citation bursts and co-citation analysis reveal ongoing uncertainty about the safety and efficacy of the IABP, highlighting the need for further research into its potential benefits for patients with cardiogenic shock (CS). <br/>Conclusion(s): This study offers a holistic overview of IABP research hotspots and evolving trends. Contemporary mechanical circulatory support guidelines discourage universal IABP implantation among unselected patients with acute myocardial infarction (AMI)-associated CS. Even so, IABP maintains distinct clinical value as an affordable, straightforward temporary circulatory support device for targeted cardiac and surgical populations, with particular relevance across resource-constrained regions worldwide.<br/>Copyright © 2026 Jin-He Deng et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <112> Accession Number 652037769 Title Thromboembolic prophylaxis in kidney failure patients with atrial fibrillation undergoing hemodialysis: from risk stratification to decision making on anticoagulants or left atrial appendage closure. A position paper endorsed by the Italian Society of Nephrology. Source Journal of nephrology. (no pagination), 2026. Date of Publication: 26 Aug 2026. Author Genovesi S.; Regolisti G.; Ferraro P.M.; Bianchi S.; De Nicola L.; Boriani G. Institution (Genovesi) Istituto Auxologico Italiano, IRCCS, Milan, Italy (Genovesi) School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (Regolisti) Clinica e Patologia Medica, Dipartimento di Medicina e Chirurgia, Universita di Parma; Azienda Ospedaliero Universitaria di Parma, Italy (Ferraro) Section of Nephrology, Department of Medicine, Universita degli Studi di Verona; Nephrology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Italy (Bianchi) Department of Internal Medicine, Nephrology and Dialysis Complex Operative Unit, Livorno, Italy (De Nicola) NaplesItaly (Boriani) Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy Abstract Atrial fibrillation (AF) is highly prevalent in patients with kidney failure (KF) who are undergoing hemodialysis (HD). All patients with AF and a thromboembolic risk score (CHA2DS2-VA) of two or more should be prescribed oral anticoagulant therapy (OAC), according to cardiology guidelines. However, there are no randomized controlled trials (RCTs) demonstrating that OAC protects against thromboembolic events in HD patients. Furthermore, evidence from observational studies is insufficient to demonstrate the benefits of OAC for preventing thromboembolism in HD patients with AF. Instead, it suggests that OAC is associated with an increased risk of bleeding in these patients. Left atrial appendage closure (LAAC) has been proposed as a means of preventing thromboembolic events in patients with AF. RCTs conducted in populations with preserved kidney function have demonstrated that the procedure is not inferior to OAC in terms of efficacy, and is associated with greater safety. Although no RCTs have tested the safety and efficacy of LAAC in KF patients undergoing HD, some observational studies suggest that LAAC has a similar efficacy profile in patients with and without KF. However, a higher incidence of peri-procedural complications has been reported. Observational studies comparing the efficacy and safety of LAAC with OAC in KF patients have shown a similar or reduced incidence of thromboembolism and bleeding in patients undergoing the procedure. The purpose of this Position Paper is to provide comprehensive, evidence-based information on the advantages and limitations of LAAC in KF patients with AF undergoing HD.<br/>Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of Societa Italiana Nefrologia/Italian Society of Nephrology; Society ownership. 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 s <113> Accession Number 2048708671 Title Effect of Continuous Bilateral Erector Spinae Plane Block on Neutrophil-Lymphocyte Ratio in On-Pump CABG: A Prospective Randomized Study. Source Seminars in Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Kumar A.; Dheeraj P.S.; Ameta N. Institution (Kumar, Dheeraj, Ameta) Department of Anaesthesia & Critical Care, Armed Forces Medical College, Pune, India Publisher SAGE Publications Inc. Abstract Background: Cardiac surgery using cardiopulmonary bypass causes a pronounced systemic inflammatory response. The neutrophil-lymphocyte ratio (NLR) is a readily accessible inflammatory biomarker associated with adverse outcomes after cardiac surgery. Regional anesthesia has been shown to modulate the inflammatory process by various mechanisms. Erector spinae plane (ESP) block reduces nociception and opioid use, but its effect on perioperative inflammatory markers is not well described. This study evaluated whether bilateral ESP block attenuates the perioperative rise in NLR in patients undergoing on-pump coronary artery bypass graft (CABG) surgery. <br/>Method(s): This prospective randomized study included 120 adults undergoing elective on-pump CABG randomized to bilateral ultrasound-guided ESP block (ESP, n = 60) or conventional opioid-based analgesia (Opioid, n = 60). ESP was performed pre-induction. NLR and platelet-lymphocyte ratio (PLR) were measured until the second postoperative day (POD). Secondary endpoints included ICU length of stay, mechanical ventilation duration, and total opioid consumption. <br/>Result(s): Baseline characteristics were comparable between groups. NLR increased in both groups after surgery and peaked at POD1. However, POD1 NLR was significantly lower in the ESP group compared with the opioid group (13.99 vs 18.58, P = 0.007). The ESP group showed shorter ICU stay (P = 0.02) and lower total perioperative opioid consumption (P = 0.01). <br/>Conclusion(s): Bilateral ESP block attenuated the early postoperative rise in NLR and reduced opioid requirements in on-pump CABG patients, suggesting modulation of the inflammatory response in addition to analgesic benefits.<br/>Copyright © The Author(s) 2026 <114> Accession Number 2048678651 Title Impact of Early Nonfatal Complications After Transcatheter Aortic Valve Implantation on 1-Year Mortality and Quality of Life: Insights From the LANDMARK Trial. Source Structural Heart. 10(9) (no pagination), 2026. Article Number: 101101. Date of Publication: 01 Sep 2026. Author Tobe A.; Onuma Y.; van Royen N.; Amat-Santos I.J.; Hudec M.; Bunc M.; van den Branden B.J.L.; Laanmets P.; Unic D.; Merkely B.; Hermanides R.S.; Ninios V.; Protasiewicz M.; Rensing B.J.W.M.; Martin P.L.; Feres F.; de Sousa Almeida M.; Van Belle E.; Linke A.; Ielasi A.; Montorfano M.; Webster M.; Toutouzas K.; Teiger E.; Bedogni F.; Voskuil M.; Pan M.; Angeras O.; Kim W.-K.; Rothe J.; Abdel-Wahab M.; Kristic I.; Peral V.; Garg S.; Thakkar A.; Chandra U.; Smits P.C.; Morice M.-C.; Baumbach A.; Serruys P.W. Institution (Tobe, Onuma, Serruys) CORRIB Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Galway, Ireland (van Royen) Department of Cardiology, Radboud University Medical Center, Nijmegen, Netherlands (Amat-Santos) Centro de Investigacion Biomedica en Red - Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain (Amat-Santos) Department of Cardiology, Hospital Clinico Universitario de Valladolid, Valladolid, Spain (Hudec) Department of Acute Cardiology, Middle-Slovak Institute of Cardiovascular Diseases, Banska Bystrica, Slovakia (Bunc) Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia (van den Branden) Department of Cardiology, Amphia Hospital, Breda, Netherlands (Laanmets) Department of Invasive Cardiology, North Estonia Medical Centre, Tallinn, Estonia (Unic) Department of Cardiac and Transplant Surgery, University Hospital Dubrava, Zagreb, Croatia (Merkely) Heart and Vascular Center, Semmelweis University, Budapest, Hungary (Hermanides) Department of Cardiology, Isala Hospital, Zwolle, Netherlands (Ninios) Department of Cardiology, European Interbalkan Medical Center, Thessaloniki, Greece (Protasiewicz) Department of Cardiology, Institute of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland (Protasiewicz) Department of Non-Procedural Clinical Sciences, Wroclaw University of Science and Technology, Faculty of Medicine, Wroclaw, Poland (Rensing) Department of Cardiology, St Antonius Hospital, Nieuwegein, Netherlands (Martin) Department of Interventional Cardiology, University Hospital of Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Spain (Feres) Department of Invasive Cardiology, Instituto Dante Pazzanese, Sao Paulo, Brazil (de Sousa Almeida) CHRC, NOVA Medical School, NOVA University Lisbon, Lisbon, Portugal (Van Belle) Department of Interventional Cardiology, Lille University Hospital, Lille, France (Linke) Department of Internal Medicine and Cardiology, Heart Center Dresden, University of Technology Dresden, Dresden, Germany (Ielasi) Cardiologia Ospedaliera, IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy (Montorfano) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Montorfano) Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy (Webster) Department of Cardiology, Auckland City Hospital, Auckland, New Zealand (Toutouzas) Department of Cardiology, Hippokration Hospital, Athens, Greece (Teiger) Department of Cardiology, Henri Mondor University Hospital, Assistance Publique-Hopitaux de Paris (AP-HP), Creteil, France (Bedogni) Department of Clinical Cardiology, IRCCS Policlinico San Donato, San Donato Milanese, Italy (Voskuil) Department of Cardiology, University Medical Center Utrecht, Utrecht, Netherlands (Pan) Department of Cardiology, University Hospital Reina Sofia, University of Cordoba, IMIBIC, CIBERCV, Cordoba, Spain (Angeras) Department of Thoracic Surgery and Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (Angeras) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Kim) Department of Cardiology & Angiology, University of Giessen and Marburg, Giesen, Germany (Kim) Department of Cardiology, Kerckhoff Heart Center, Bad Nauheim, Germany (Rothe) Department of Cardiology and Angiology, Campus Bad Krozingen, University Heart Center-University of Freiburg, Bad Krozingen, Germany (Rothe) Faculty of Medicine, University of Freiburg, Freiburg, Germany (Abdel-Wahab) Department of Structural Heart Disease/Cardiology, Heart Center Leipzig at Leipzig University, Leipzig, Germany (Kristic) Department of Cardiology, University Hospital of Split, Split, Croatia (Peral) Department of Cardiology University Hospital Son Espases, Health Research Institute of the Balearic Islands, Palma de Mallorca, Spain (Garg) Department of Cardiology, Royal Blackburn Hospital, Blackburn, United Kingdom (Garg) School of Medicine, University of Central Lancashire, Preston, United Kingdom (Thakkar, Chandra) Department of Clinical Research, Meril Life Sciences Pvt. Ltd., Vapi, India (Smits, Morice) Cardiovascular European Research Center (CERC), Massy, France (Morice) ICPS, Hopital Prive Jacques Cartier, Massy, France (Baumbach) Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London and Barts Heart Centre, London, United Kingdom (Baumbach) Cleveland Clinic, London, United Kingdom Publisher Cardiovascular Research Foundation Abstract Background The impact of early nonfatal complications on subsequent mortality and quality of life (QOL) after contemporary transcatheter aortic valve implantation (TAVI) remains unclear. Methods This post-hoc substudy of the LANDMARK trial included patients with severe aortic stenosis randomized to the Myval transcatheter heart valve (THV) series or to contemporary THV (Sapien or Evolut) series. Early nonfatal complications were defined as events occurring within 30 days after TAVI in patients surviving the first 30 days and included stroke, type 3 bleeding, major vascular complications, acute kidney injury stages 2-4, moderate or severe aortic regurgitation, new permanent pacemaker implantation, or reintervention according to the VARC-3 early safety endpoint. The primary endpoint was all-cause mortality from 30 to 365 days. QOL was assessed using the Short Form-12 at baseline, 30 days, and 1 year. Results Of the 768 randomized patients, 742 were alive at 30 days. Of these, 177 (23.9%) experienced at least 1 early nonfatal complication, whereas 565 (76.1%) did not. Age (80 +/- 5 years vs. 80 +/- 6 years, p = 0.67) and Society of Thoracic Surgeons score (median 2.6 [interquartile range: 1.6-3.9] vs. 2.6 [1.7-3.9], p = 0.76) were similar between groups. Patients with early nonfatal complications had higher mortality between 30 and 365 days (8.0% vs. 3.9%, p = 0.03). Early nonfatal complications were independently associated with increased 1-year mortality (hazard ratio = 2.14; 95% CI, 1.07-4.27; p = 0.03). One-year QOL did not differ between groups. Conclusions In this post-hoc, hypothesis-generating analysis, early nonfatal complications after TAVI were associated with increased 1-year mortality, whereas 1-year QOL was comparable among survivors; findings should be interpreted with caution due to potential survivor bias. Trial registration number ClinicalTrials.gov , NCT04275726.<br/>Copyright © 2026 The Authors. <115> Accession Number 2048573112 Title Optimizing Saphenous Vein Graft Quality in CABG: Overdistension as a Central, Modifiable Target for Surgical Standardization. Source Journal of Cardiac Surgery. 2026(1) (no pagination), 2026. Article Number: 2521690. Date of Publication: 2026. Author Rajakumar C.; Sebastian W.; Abramova M.; Gerlock S.S.; Petrides M.; Asgarian K. Institution (Rajakumar, Sebastian, Abramova, Petrides, Asgarian) Department of Cardiac Surgery, Jersey Shore University Medical Center, Neptune, NJ, United States (Gerlock) Department of Education, St. George's University School of Medicine, St. George's, Grenada Publisher John Wiley and Sons Inc Abstract Saphenous vein graft (SVG) failure remains a major limitation of coronary artery bypass grafting (CABG), with endothelial injury serving as a critical early determinant of long-term patency. Among modifiable intraoperative factors, overdistension during graft preparation has emerged as a key mechanism driving endothelial dysfunction, thrombosis, and intimal hyperplasia. Experimental and translational data consistently demonstrate that supraphysiologic intraluminal pressures result in endothelial denudation and impaired nitric oxide bioavailability, initiating a cascade that contributes to graft failure. Despite this, intraoperative handling of SVGs remains highly variable, and pressure-controlled strategies are not universally adopted. This narrative review synthesizes current evidence on the pathophysiology of overdistension-induced injury, its impact on graft durability, and evolving strategies to mitigate damage, including pressure-controlled flushing, no-touch harvesting, external stenting, and optimized preservation techniques. We additionally address whether a definitive "safe" distension pressure can be defined and conclude that the evidence supports an operational ceiling of <= 140 mmHg-a validated upper limit rather than an identified injury threshold-the reliability of which depends on device-imposed pressure limitation rather than tactile estimation. We propose that standardization of SVG handling-particularly the routine use of pressure-limiting strategies-represents a practical and underutilized opportunity with the potential to improve CABG outcomes. Integration of these approaches into surgical protocols and quality metrics may enhance long-term graft patency.<br/>Copyright © 2026 Clement Rajakumar et al. Journal of Cardiac Surgery published by John Wiley & Sons Ltd. <116> Accession Number 2048664095 Title A Review of Sex Differences in Patients with Aortic Stenosis: A Focus on Diagnostic and Treatment Differences, a Narrative Review. Source Journal of Clinical Medicine. 15(16) (no pagination), 2026. Article Number: 6362. Date of Publication: 01 Aug 2026. Author Khan H.; Das S.; Das R. Institution (Khan, Das) Freeman Hospital, Cardiothoracic Department, Newcastle upon Tyne, United Kingdom (Das) School of Medicine, University of Leeds, Leeds, United Kingdom (Das) Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Severe aortic stenosis represents a growing burden of disease globally with a high risk of death if untreated. There are sex differences in the pathophysiological disease process affecting the aortic valve, patients' clinical presentation, progression of valve disease, ventricular adaptation, timing of symptom onset, delays in diagnosis, and treatment strategies. Female patients are more likely than male patients to have preserved left ventricular function with concentric left ventricular hypertrophy and smaller left ventricular cavity sizes, which consequently produce low stroke volumes and more paradoxical low flow low gradient severe aortic stenosis. These differences can lead to diagnostic uncertainty resulting in delays to treatment and associated morbidity and mortality. The higher mortality rate reported in women in observational cohorts is multifactorial. It is influenced by delayed diagnosis, lower referral rates, older age at intervention and frailty; rather than female sex alone. There exist variations in the treatment and management of aortic stenosis with women being underdiagnosed and conservatively managed compared to men. A better understanding of the differences in pathophysiology, ventricular adaptation and haemodynamic effects between the sexes are key to improving diagnostic accuracy and referral for timely intervention. Women may require a more tailored approach to their lifetime management of aortic stenosis due to their smaller anatomy and greater comorbidity burden at presentation. This narrative review explores the epidemiology, pathophysiology, presentation, diagnosis and management of aortic stenosis in female patients.<br/>Copyright © 2026 by the authors. <117> Accession Number 652039822 Title Association Between Intraoperative Anesthesia Handover and Patient Morbidity and Mortality: a Systematic Review and Meta-Analysis. Source Anesthesia and analgesia. (no pagination), 2026. Date of Publication: 24 Aug 2026. Author Yao Y.-T.; Samost-Williams A.; Allafy L.; More A.; Lin W.W.; Li Y.-F.; Chao M.; Baranov A.; Anderson V.L.; Chamoun R.; Tore M.; Tharavath V.; Nacif L.O.; Dhakal B.R.; Khudirat M.; Akinwunmi S.; Luo Y.-T.; Tolan J.; Uzair S.; Turan A. Institution (Yao) From the 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, Samost-Williams, Allafy, More, Lin, Li, Chao, Baranov, Anderson, Chamoun, Tore, Tharavath, Nacif, Dhakal, Khudirat, Akinwunmi, Luo, Tolan, Uzair, Turan) Department of Anesthesiology, Critical Care and Pain Medicine, Center of Outcomes Research, University of Texas, Houston, TX, United States (Yao, Samost-Williams, Allafy, More, Lin, Li, Chao, Baranov, Anderson, Chamoun, Tore, Tharavath, Nacif, Dhakal, Khudirat, Akinwunmi, Luo, Tolan, Uzair, Turan) Outcomes Research Consortium, Houston, TX, United States Abstract BACKGROUND: Intraoperative anesthesia handovers (IAHs) are common during prolonged procedures and shift-based staffing, but their association with postoperative outcomes remains uncertain. We performed an updated systematic review and meta-analysis to evaluate whether IAH, compared with no IAH, is associated with postoperative morbidity and mortality in surgical patients. <br/>METHOD(S): We searched PubMed, Embase, and Cochrane databases from inception to July 10, 2025, without language restriction. Eligible studies were observational studies or randomized controlled trials (RCTs) comparing patients with versus without IAH and reporting postoperative mortality or morbidity. Because of substantial clinical and methodological heterogeneity, narrative synthesis was the primary approach. As an exploratory analysis, adjusted odds ratios (aORs) were pooled using the generic inverse variance method with a random-effects model only for studies reporting adjusted effect estimates for clinically comparable composite short-term postoperative morbidity and mortality outcomes. Studies reporting mortality alone, morbidity alone, unadjusted estimates only, or noncomparable outcome definitions were summarized narratively. Sensitivity analyses excluded studies with distinct populations or designs, including the RCT, pediatric cohort, and thoracic surgery cohort. <br/>RESULT(S): Thirteen studies were included, comprising 12 retrospective cohort studies and 1 multicenter RCT, representing 5 additional studies compared with the largest previous meta-analysis and including 1 RCT not available in previous quantitative syntheses. Overall, 1030,883 patients were included, 170,746 patients (16.6%) of whom experienced IAH and 860,137 did not. Seven studies, comprising 6 retrospective cohort studies and 1 RCT and involving 485,623 patients, contributed to the exploratory meta-analysis of composite short-term postoperative morbidity and mortality. The included studies varied substantially in surgical populations, definitions of IAH, outcome definitions, data sources, and adjustment strategies. The multicenter RCT found no significant effect of IAH on 30-day mortality, readmission, or postoperative complications. In the exploratory pooled analysis, IAH was not significantly associated with composite postoperative morbidity and mortality (aOR = 1.04; 95% confidence interval [CI], 0.98-1.11; P = 0.18; I2 = 72%). Sensitivity analyses excluding the RCT, pediatric cohort, or thoracic surgery cohort yielded similar nonsignificant findings. <br/>CONCLUSION(S): Current evidence does not support a consistent independent association between IAH and increased postoperative morbidity and mortality. However, substantial heterogeneity and residual confounding limit causal interpretation. Future prospective studies should clarify context-specific risks and evaluate standardized IAH interventions.<br/>Copyright © 2026 International Anesthesia Research Society. <118> Accession Number 652038854 Title The role of anti-Factor-Xa monitoring in the dosing and administration of low molecular weight heparins in pregnancy: a systematic review and meta-analysis. Source Journal of thrombosis and haemostasis : JTH. (no pagination), 2026. Date of Publication: 25 Aug 2026. Author Ashraf R.; Mohamed D.; Sayfi S.; Bowen J.M.; Steinberg I.; Shehata N.; Hwang M.; D'Souza R. Institution (Ashraf, Sayfi) Department of Obstetrics & Gynaecology, McMaster University, Hamilton, United Kingdom (Mohamed) McGill University, Montreal, France (Bowen) Program for Health System and Technology Evaluation, Ted Rogers Centre for Heart Research at Peter Munk Cardiac Centre, Toronto General Hospital Research Institute (TGHRI), University Health Network (UHN); Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University; Institute of Health Policy, Management & Evaluation, Dalla Lana School of Public Health, University of Toronto (Steinberg) USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, Keck School of Medicine of USC, University of Southern California, CA, United States (Shehata) Departments of Medicine and Laboratory Medicine and Pathobiology, Division of Haematology, University of Toronto, Mount Sinai Hospital ,University Health Network, Toronto, United States (Hwang) Library & Knowledge Services, Trillium Health Partners (D'Souza) Department of Obstetrics & Gynaecology, McMaster University, Hamilton; Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University Abstract BACKGROUND: Our aim was to determine the risk of thromboembolic complications (TECs) and major bleeding with weight-based, fixed- and anti-Xa-monitored dosing of low molecular weight heparins (LMWH) during pregnancy. <br/>METHOD(S): We conducted a systematic review wherein we searched seven databases for articles published before August 2024 that reported on dosing and monitoring of LMWH during pregnancy. We calculated event rates and 95% confidence intervals (95%CI) for maternal death, TECs and major bleeding using random effects meta-analysis. We assessed Risk-of-bias using Quality In Prognosis Studies tool and certainty of evidence (CoE) using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. FINDINGS: We identified 5007 studies, of which 94 studies (53 case series, 30 cohort and 11 randomized trials) were eligible. For thromboprophylaxis and treatment of venous thromboembolism (VTE), fixed-, weight-based, and anti-Xa-guided LMWH doses had broadly overlapping pooled event rates for TECs and major bleeding. For mechanical heart valves (MHVs), the risk of death, TECs and major bleeding was 2.7% (95%CI 0.3-6.5%), 7.9% (2.8- 14.6%) and 8.4% (2.0 -17.2%) respectively. The CoE for all estimates were low-to-very-low, mainly due to imprecision, risk-of-bias and publication bias. INTERPRETATION: The pooled single-arm event rates and confidence limits appeared broadly overlapping for the main outcomes across various LMWH dosing regimens currently used in pregnancy for thromboprophylaxis, treatment of VTE and anticoagulation in individuals with MHVs. These findings should be interpreted in the light of small sample sizes, wide 95%CIs and low CoE and not as evidence of comparable effectiveness or safety.<br/>Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <119> Accession Number 2048329526 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: 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.; Aittokallio J.; Anttila V.; Gronlund J.; Kentala E.; Laitio T.; Leino K.; Malmberg M.; Peltonen V.; Saarikoski T.; Scheinin A.; Soderholm O.; Valtonen M. 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 Publisher Lippincott Williams and Wilkins 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. <br/>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. <br/>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. <br/>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.<br/>Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. on behalf of the International Anesthesia Research Society. <120> Accession Number 2048580813 Title Impact of Epstein-Barr Virus Donor Serostatus on Post-Transplant Mortality and Post-Transplant Lymphoproliferative Disorder in Epstein-Barr Virus Seropositive Thoracic Organ Transplant Recipients: Data from the Organ Procurement and Transplantation Network. Source Journal of Medical Virology. 98(8) (no pagination), 2026. Article Number: e71117. Date of Publication: 01 Aug 2026. Author Aldhaheri K.; Wright R.C.; Lee S.; Ali M.; Clarke B.; Bergeron C.; Mah A.; Wright A.; Belga S. Institution (Aldhaheri) Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates (Aldhaheri, Mah, Wright, Belga) Department of Medicine, Division of Infectious Disease, University of British Columbia, Vancouver, BC, Canada (Wright) Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada (Wright) BC Children's Hospital Research Institute, Vancouver, BC, Canada (Lee) Department of Medicine, Division of Infectious Diseases, University of Saskatchewan, Saskatoon, SK, Canada (Ali) Department of Pediatrics, Division of Infectious Diseases, Hospital for Sick Children, Toronto, ON, Canada (Ali) Department of Pediatrics, London Health Sciences Centre, Division of Infectious Diseases, London, ON, Canada (Clarke) Department of Medicine, Division of Cardiology, University of British Columbia, Vancouver, BC, Canada (Bergeron) Department of Medicine, Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada (Belga) Immunity and Infection Research Centre, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada Publisher John Wiley and Sons Inc Abstract Donor Epstein-Barr virus (EBV)-seropositive (D +) serostatus is a risk factor for post-transplant lymphoproliferative disorder (PTLD) in EBV-seronegative recipients. The impact of donor EBV serostatus on mortality and PTLD in EBV-seropositive (R +) thoracic organ transplant recipients is unknown. We analyzed 49 458 EBV R+ thoracic transplant recipients from the Organ Procurement and Transplantation Network (2004-2021). The primary exposure was EBV D+ serostatus; outcomes were death and PTLD. Associations were assessed using multivariable Cox and logistic regression models. EBV D+ serostatus was not associated with mortality but significantly reduced the hazard of PTLD in lung and heart-lung (L/HLT) recipients (adjusted hazard ratio, 0.59; 95% CI: 0.42-0.83). No association was observed in heart transplants. Notably, 48.7% of PTLD cases in EBV R + L/HLT occurred early after transplant when the donor was EBV-seronegative (D-). In an exploratory subgroup analysis of PTLD cases, EBV D+ serostatus was associated with lower odds of early vs late PTLD (adjusted odds ratio [aOR]: 0.40; 95% CI: 0.22-0.73). Conversely, L/HLT had twice the odds of early PTLD (aOR: 2.62; 95% CI: 1.68 - 4.08). EBV D-/R + L/HLT recipients carry a substantially higher risk of PTLD than EBV D + /R+ recipients, driven predominantly by early-onset disease.<br/>Copyright © 2026 The Author(s). Journal of Medical Virology published by Wiley Periodicals LLC. <121> Accession Number 2048473610 Title Pre- and Immediate Postoperative Prediction Model for Organ Dysfunction or Death Early After Cardiac Surgery: A Post Hoc Analysis of a Multicenter Randomized Trial. Source Journal of the American Heart Association. 15(14) (no pagination), 2026. Article Number: e044394. Date of Publication: 2026. Author Dresen E.; Heyland D.K.; Lee Z.Y.; O'Brien B.; Elke G.; Radke D.I.; Meybohm P.; Schoenrath F.; Sundermann S.H.; von Dossow V.; McDonald B.; Christopher K.B.; Fremes S.E.; Mohammadi S.; Niemann B.; Boning A.; Mazer C.D.; Ke L.; Zarbock A.; Day A.G.; Stoppe C. Institution (Dresen, Lee, Meybohm, Stoppe) Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, University Hospital Wurzburg, Wurzburg, Germany (Heyland, Day) Clinical Evaluation Research Unit, Department of Critical Care Medicine, Queen's University, Kingston, ON, Canada (Lee) Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia (Lee, O'Brien, Stoppe) Department of Cardiac Anesthesiology and Intensive Care Medicine, Deutsches Herzzentrum der Charite, Berlin, Germany (Lee, O'Brien, Schoenrath, Sundermann, Stoppe) Charite - Universitatsmedizin Berlin, Corporate Member, Freie Universitat Berlin, Humboldt-Universitat zu Berlin, Berlin, Germany (O'Brien, Schoenrath, Sundermann, Stoppe) German Centre for Cardiovascular Research (DZHK), partner site Berlin, Berlin, Germany (Elke) Department of Anaesthesiology, Intensive Care, Pain and Emergency Medicine, St. Bernward Hospital, Hildesheim, Germany (Radke) Department of Anesthesiology and Intensive Care Medicine, University Medical Center Schleswig-Holstein, Campus Kiel, Kiel, Germany (Schoenrath, Sundermann) Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum der Charite, Berlin, Germany (von Dossow) Heart and Diabetes Centre North Rhine Westphalia, Institute of Anesthesiology and Pain Therapy, Ruhr-University Bochum, Bad Oeynhausen, Germany (McDonald) Division of Cardiac Anesthesiology, University of Ottawa Heart Institute, Ottawa, ON, Canada (Christopher) Division of Renal Medicine, Brigham and Women's Hospital, Boston, MA, United States (Fremes) Division of Cardiac Surgery, Sunnybrook Health Sciences Centre, Schulich Heart Centre, University of Toronto, Toronto, ON, Canada (Mohammadi) Quebec Heart and Lung University Institute, Laval University, Quebec City, QC, Canada (Niemann) Department of Thoracic and Cardiovascular Surgery, University Medical Center Gottingen, Gottingen, Germany (Boning) Department of Adult and Pediatric Cardiovascular Surgery, Giessen University Hospital, Giessen, Germany (Mazer) Li Ka Shing Knowledge Institute of St. Michael's Hospital, Departments of Anesthesiology and Pain Medicine, Physiology, and Pharmacology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada (Ke) Department of Critical Care Medicine, Jinling Hospital, Medical School of Nanjing University, Jiangsu, Nanjing, China (Ke) National Institute of Healthcare Data Science, Nanjing University, Nanjing, China (Zarbock) Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Zarbock) Department of Anesthesiology, Critical Care and Pain Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United States (Zarbock, Stoppe) Center for Outcomes Research, Department of Anesthesiology, UTHealth, Houston, TX, United States (Day) Kingston Health Sciences Centre - Research Institute, Kingston, ON, Canada Publisher American Heart Association Inc. Abstract BACKGROUND: Development of organ dysfunction or death is still common in patients undergoing cardiac surgery. Yet, current risk stratification tools fail to adequately incorporate both preoperative vulnerability and immediate postoperative physiological derangements. This study aims to develop a predictive model integrating these critical timepoints to identify high-risk patients for presence of organ dysfunction or death 48hours after surgery. <br/>METHOD(S): This is a post hoc analysis of an international, multicenter, randomized, controlled trial in patients undergoing cardiac surgery (n=1394). Prespecified patient characteristics (age, Clinical Frailty Scale, at nutrition risk, combined procedures, urgent surgery, moderate-severe chronic kidney disease, left ventricular ejection fraction, European System for Cardiac Operative Risk Evaluation II, cardiopulmonary bypass duration, sex, Charlson Comorbidity Index, and Sequential Organ Failure Assessment score) were included in logistic regression models employing bootstrap validation. <br/>RESULT(S): A total of 434 (31.1%) patients had organ dysfunction or died 48hours after surgery. The preoperative model identified Clinical Frailty Scale, nutrition risk, urgent surgery and European System for Cardiac Operative Risk Evaluation II as significant predictors of organ dysfunction or death 48 hours after surgery (optimism-corrected area under the receiver operating characteristic curve, 0.644 [95% CI, 0.610-0.678]). Incorporation of postoperative variables (Sequential Organ Failure Assessment score at intensive care unit admission, and cardiopulmonary bypass duration) improved predictive performance (area under the receiver operating characteristic curve, 0.773 [95% CI, 0.745-0.801]). <br/>CONCLUSION(S): Incorporation of variables collected the day of surgery substantially improved the ability to predict organ dysfunction or death 48hours after surgery compared with using presurgical variables only. This pragmatic, clinically actionable model may enable targeted resource allocation and personalized interventions and may provide a stratification tool for future research.<br/>Copyright © 2026 The Author(s). <122> Accession Number 2048684643 Title COMPARATIVE STUDY OF USG GUIDED SERRATUS ANTERIOR PLANE BLOCK AND ERECTOR SPINAE PLANE BLOCK IN PATIENTS POSTED FOR OFF PUMP CORONARY ARTERY BYPASS GRAFTING SURGERIES. Source International Journal of Drug Delivery Technology. 16(77 Supplement) (pp 386), 2026. Date of Publication: 2026. Author Ponkiya D.A.; Kanase N.; Madanaik S.; Dimble K. Institution (Ponkiya, Kanase, Madanaik, Dimble) Dept of Anaesthesia, Krishna Institute of Medical Sciences Karad Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Effective perioperative analgesia is essential in patients undergoing off-pump coronary artery bypass grafting (OPCABG) to reduce opioid consumption and enhance postoperative recovery. Ultrasound-guided fascial plane blocks such as the erector spinae plane (ESP) block and serratus anterior plane (SAP) block have emerged as useful regional anesthesia techniques for thoracic and cardiac surgeries. This study aimed to compare the analgesic efficacy of ESP block and SAP block in patients undergoing OPCABG. <br/>Method(s): This prospective, randomized, double-blinded study was conducted in the Department of Anaesthesiology at Krishna Hospital and Medical Research Centre, Karad, Maharashtra. A total of 84 adult patients scheduled for elective OPCABG were randomly allocated into two groups (n=42 each). Group A received ultrasound-guided bilateral ESP block and Group B received ultrasound-guided bilateral SAP block with 30 mL of 0.25% ropivacaine. The primary outcome was total intraoperative fentanyl consumption. Secondary outcomes included postoperative pain scores assessed using the Visual Analogue Scale (VAS), time to first rescue analgesia, total opioid consumption within 24 hours, postoperative recovery parameters, complications, and patient satisfaction. <br/>Result(s): In the present study, the ESP group demonstrated significantly lower VAS scores at 6 and 12 hours postoperatively, a longer time to first rescue analgesia (362.4 +/- 85.7 vs 241.6 +/- 72.3 minutes), fewer rescue analgesic doses, and lower total opioid consumption within the first 24 hours (p < 0.001). Additionally, patients in the ESP group showed earlier extubation, shorter duration of mechanical ventilation, earlier ambulation, a lower incidence of postoperative nausea and vomiting, and higher patient satisfaction compared to the SAP group. <br/>Conclusion(s): Ultrasound-guided ESP block provides superior perioperative analgesia, reduces opioid requirement, and improves postoperative recovery compared to SAP block in patients undergoing OPCABG surgery.<br/>Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <123> Accession Number 2048337821 Title ALCAPA: navigating the complexities of a rare congenital heart defect-a narrative review. Source Emergency and Critical Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Wang Z.; Wang Y.; Cao H.; Liang Y.; Li W.; Zhang Y. Institution (Wang, Li, Zhang) Department of Cardiovascular Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Wang) Zhejiang Provincial Key Laboratory of Pancreatic Disease, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China (Cao) Department of Cardiology, Shibei Hospital, Shanghai, China (Liang) Clinical Medicine, Shanghai Jiao Tong University School of Medicine, Shanghai, China Publisher Lippincott Williams and Wilkins Abstract This narrative review aimed to synthesize the current evidence on anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA), with particular emphasis on age-dependent presentation, multimodality diagnosis, age-tailored surgical decision-making, long-term postoperative issues, and realistic future directions for developmental and genomic research. PubMed, Embase, and the Web of Science Core Collection were searched for English-language publications from January 1933 to August 2025 using combinations of "ALCAPA, " "anomalous left coronary artery from the pulmonary artery, " "Bland-White-Garland, " "diagnosis, " "surgery, " "mitral regurgitation, " "outcome, " "embryology, " and "genetics." Original studies, reviews, guideline documents, and illustrative case series relevant to epidemiology, imaging, operative management, and follow-up were included; duplicate publications, non-human mechanistic reports without translational relevance, and reports lacking sufficient clinical detail were excluded. Evidence was synthesized narratively because of marked heterogeneity in patient age, anatomy, operative strategy, and outcome reporting. ALCAPA remains a rare but potentially lethal coronary anomaly. Echocardiography is the preferred first-line screening tool, whereas computed tomography angiography and cardiac magnetic resonance provide higher anatomic and functional resolution for confirmation, operative planning, and postoperative surveillance. Surgical restoration of a 2-coronary-artery system is recommended irrespective of age once the diagnosis is established, but the preferred technique differs according to coronary anatomy, patient age, and tissue mobility. Direct coronary reimplantation is generally favored when feasible; Takeuchi repair and coronary artery bypass grafting remain selective alternatives with distinct late complications. In contrast, the genomic literature is still sparse and currently provides hypotheses rather than clinically actionable biomarkers.<br/>Copyright © 2026 The Author(s). Published by Wolters Kluwer Health, LLC. <124> Accession Number 652029113 Title Pretreatment with P2Y12 inhibitors in Acute and Chronic Coronary Syndromes: for whom, when and how. Source The American journal of medicine. (no pagination), 2026. Date of Publication: 24 Aug 2026. Author Cirillo P.; Berteotti M.; Galli M.; Gargiulo G.; Gragnano F.; Terracciano F.; Cavallari I.; Ricottini E.; Greco A.; Capranzano P.; Renda G.; Prisco D.; Calabro P.; Patti G.; Marcucci R.; Capodanno D.; Filardi P.P.; Angiolillo D.J.; Gibson C.M.; De Caterina R. Institution (Cirillo, Gargiulo, Filardi) Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy (Berteotti, Prisco, Marcucci) Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy (Galli) Istituto di Ricovero e Cura a Carattere Scientifico Maria Cecilia Hospital, Gruppo Villa Maria Care & Research, Cotignola, Italy (Gragnano, Terracciano, Calabro) Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Caserta, Italy; Division of Clinical Cardiology, Azienda Ospedaliera di Rilievo Nazionale "Sant'Anna e San Sebastiano", Caserta, Italy (Cavallari, Ricottini) Unit of Cardiac Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy (Greco, Capranzano, Capodanno) Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico-San Marco", University of Catania, Catania, Italy (Renda) Department of Neuroscience, Imaging and Clinical Sciences, Center for Advanced Studies and Technology (CAST), G. d'Annunzio University Chieti-Pescara (Patti) University of Piemonte Orientale, Department of Cardiology, Ospedale Maggiore della Carita di Novara, Italy (Angiolillo) Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States (Gibson) Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States (De Caterina) Department of Surgical, Medical and Molecular Pathology and of Critical Sciences, University of Pisa, Pisa, Italy Abstract In patients with acute or chronic coronary syndromes undergoing percutaneous coronary intervention, dual antiplatelet therapy - with aspirin and a P2Y12 inhibitor - is the cornerstone of pharmacological treatment to prevent stent thrombosis and atherothrombotic complications. However, the timing of P2Y12 inhibitor initiation has been a matter of considerable debate. Administering a P2Y12 inhibitor added to aspirin before percutaneous coronary intervention without knowing coronary anatomy has the potential to ensure antithrombotic protection at percutaneous coronary intervention and to reduce procedural thrombotic complications, but also exposes patients to an increased bleeding risk, may prevent or retard surgical myocardial revascularization when needed, and may be futile or even dangerous in patients not requiring percutaneous coronary intervention. The latest 2023 European Society of Cardiology guidelines have downgraded previous recommendations to pretreatment also in ST-elevation myocardial infarction. The present Systematic Review and Consensus Document aims at reviewing clinical evidence on pretreatment across various clinical scenarios, proposing a nuanced approach that considers clinical presentation, time to treatment, the clinical setting and the probability of non-thrombotic primary causes.<br/>Copyright © 2026 Elsevier Inc. All rights reserved. <125> Accession Number 2048701181 Title Comparative Evaluation of Erector Spinae Plane Block Versus Serratus Anterior Plane Block for Postoperative Analgesia in Patients Undergoing Thoracic Surgery: A Randomised Controlled Trial. Source International Journal of Life Sciences Biotechnology and Pharma Research. 15(5) (pp 1739-1746), 2026. Date of Publication: 01 May 2026. Author Patil V.S.; Vadigeri P.; Sulepetkar S. Institution (Patil) Department of Anesthesiology, Pain Medicine and Critical Care, Mahadevappa Rampure Medical College, Karnataka, Kalaburagi, India (Vadigeri) Department of Anaesthesiology and Critical Care, Navodaya Medical College Hospital and Research Centre, Karnataka, Raichur, India (Sulepetkar) Department of Orthopedics, Gulbarga Institute of Medical Science, Karnataka, Kalaburagi, India Publisher International Journal of Life Sciences Biotechnology and Pharma Research Abstract Background: Erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) are increasingly used for postoperative analgesia following thoracic surgery. This study compared their analgesic efficacy and safety. <br/>Method(s): This randomized controlled trial included 120 patients undergoing thoracic surgery, allocated equally to ESPB and SAPB groups (n=60 each). Postoperative Numerical Rating Scale (NRS) scores, time to first rescue analgesia, analgesic requirements, opioid consumption, and adverse events were assessed during the first 24 hours. <br/>Result(s): ESPB was associated with significantly lower resting and dynamic NRS scores during the first 12 postoperative hours. Time to first rescue analgesia was longer with ESPB (9.84+/-3.16 vs. 7.12+/-2.74 hours; p<0.001), and fewer patients required rescue analgesia (41.7% vs. 65.0%; p=0.010). Twenty-four-hour opioid consumption was significantly lower with ESPB (7.82+/-4.26 vs. 11.64+/-5.18 mg morphine equivalent; p<0.001). Both techniques had favourable safety profiles without major block-related complications. <br/>Conclusion(s): ESPB provided better early postoperative analgesia, prolonged analgesic duration, and reduced opioid requirements compared with SAPB, suggesting that ESPB may be an effective opioid-sparing technique for thoracic surgery.<br/>Copyright ©2026 Int. J. Life Sci. Biotechnol. Pharma. Res. <126> Accession Number 2048456366 Title Early predictive value of prediction models for mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Date of Publication: 15 Jul 2026. Author Wang R.; He M.; Yuan Z.; Zhou J.; Han L.; Cheng X.; Chen Y.; Wang F. Institution (Wang, Yuan) School of Nursing, Bengbu Medical University, Anhui, Bengbu, China (He, Wang) Department of Cardiology, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Zhou) Nursing Department, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Han) Department of Hematology, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China (Cheng, Chen) Department of Internal Medicine, The First Affiliated Hospital of Bengbu Medical University, Anhui, Bengbu, China Publisher Frontiers Media SA Abstract Background - Transcatheter aortic valve replacement (TAVR) is increasingly used due to the rising incidence of aortic stenosis (AS). Early identification of mortality risk after TAVR is challenging. Although various prediction models have been developed, no systematic review has evaluated their effectiveness in predicting mortality risk. Therefore, this study aimed to systematically evaluate the performance of models for early prediction of mortality risk after TAVR, so as to provide evidence-based support for the future development or updating of risk assessment tools. Methods - Databases (PubMed, Web of Science, Embase, and Cochrane Library) were systematically searched for studies on tools for predicting the risk of mortality after TAVR, up to June 2024. PROBAST was used to assess the risk of bias in the included studies. A subgroup analysis was conducted based on different time points. Results - This systematic review included 36 studies with 272, 390 patients receiving TAVR and 6 major scoring tools encompassing 23 new machine learning models. The meta-analysis showed that the concordance index (C-index) was 0.610 (95% CI: 0.588-0.632) for European System for Cardiac Operative Risk Evaluation I (EuroSCORE I), 0.615 (95% CI: 0.588-0.643) for EuroSCORE II, 0.578 (95% CI: 0.531-0.625) for French Aortic National CoreValve and Edwards II (France II), 0.594 (95% CI: 0.554-0.633) for the OBSERVANT score, 0.648 (95% CI: 0.622-0.674) for the Society of Thoracic Surgeons (STS) risk model, 0.632 (95% CI: 0.616-0.648) for the American College of Cardiology Transcatheter Valve Therapy (ACC TVT) risk model, and 0.705 (95% CI: 0.677-0.733) for summarized machine learning models. Conclusion - Determining the predictive performance of current established risk assessment tools for predicting the risk of modality after TAVR is challenging. Machine learning models seem to be more effective. Therefore, future research should include more subjects to develop more accurate models. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023485237.<br/>Copyright © 2026 Wang, He, Yuan, Zhou, Han, Cheng, Chen and Wang. <127> Accession Number 2048472805 Title Determinants and Implementation of Hybrid Cardiac Rehabilitation in Adolescents and Young Adults With Congenital Heart Disease: Insight From the QUALIREHAB Study. Source Journal of the American Heart Association. 15(14) (no pagination), 2026. Article Number: e049698. Date of Publication: 10 Jul 2026. Author Andrianoely M.; Desir A.; Huguet H.; Picot M.-C.; Audie M.; Lagorce S.; Venna A.; Rheault M.; Batterton M.-K.; Weissland T.; Marguin G.; Auer A.; Guillaumont S.; Amedro P. Institution (Andrianoely, Amedro) IHU Liryc, INSERM 1045, University of Bordeaux, Bordeaux, France (Andrianoely) Just Coaching, Paris, France (Desir, Venna, Rheault, Batterton, Amedro) Heart & Lung Center, Heart Research Institute, Children's National Hospital, Washington, DC, United States (Huguet, Picot) Epidemiology and Clinical Research Department, Clinical Investigation Center, INSERM 1411, France (Guillaumont) Pediatric and Congenital Cardiology Department, M3C Regional Reference CHD Center, Montpellier University Hospital, Montpellier, France (Audie, Lagorce, Amedro) Pediatric and Congenital Cardiology Department, M3C National Reference Center, Bordeaux University Hospital, Bordeaux, France (Audie) Rehabilitation Center Le Hillot, Pessac, France (Venna, Amedro) The George Washington University School of Medicine & Health Sciences, Washington, DC, United States (Weissland) PMH_DySCo, IMS Bordeaux, University of Bordeaux, Talence, France (Marguin) Patient advocacy "Petit Coeur de Beurre", Paris, France (Auer, Guillaumont) Pediatric Cardiac Rehabilitation Center, Saint-Pierre Institute, Palavas-Les-Flots, France Publisher American Heart Association Inc. Abstract BACKGROUND: The QUALIREHAB (Cardiac Rehabilitation in Youth With Congenital Heart Disease) trial demonstrated the efficacy of a hybrid cardiac rehabilitation model in adolescents and young adults with congenital heart disease. This post hoc mixed-methods study aimed to identify baseline predictors of clinical improvement and to characterize key components supporting implementation and scalability. <br/>METHOD(S): Seventy participants aged 13 to 25 years from the intervention arm were analyzed. Clinical improvement was defined as a clinically meaningful increase in cardiopulmonary fitness (increase in peak oxygen uptake >=3.5 mL/kg per min) or health-related quality of life (Pediatric Quality of Life Inventory increase >=4.3 points). Multivariable logistic regression models identified predictors of clinical improvement. Semistructured interviews with patients and health care professionals explored experiences, barriers, and implementation mechanisms. <br/>RESULT(S): The absence of prior cardiac surgery or interventional catheterization was independently associated with short-term improvement in peak oxygen uptake. At 1 year, male sex and lower baseline ventilatory anaerobic threshold were associated with greater peak oxygen uptake improvement. Lower baseline ventilatory anaerobic threshold was also the only predictor of clinically meaningful health-related quality of life improvement. Qualitative findings highlighted the accessibility and acceptability of the hybrid model but underscored the need for higher-intensity and more varied exercise modalities, integrated digital tools, continuous psychological support, family involvement, and structured postrehabilitation follow-up to sustain long-term benefits. <br/>CONCLUSION(S): Among treated participants, male sex, absence of prior cardiac surgery, and marked baseline deconditioning were associated with greater clinical improvement, supporting a shift from standardized toward tailored cardiac rehabilitation in congenital heart disease. By addressing key logistical and psychosocial barriers, this scalable framework offers a pragmatic model for routine care implementation and may be transferable to other pediatric chronic conditions. Sources of Funding The original QUALIREHAB trial was supported by public grants from the Direction Generale de l'Offre de Soins (National Health Department, GIRCI SOHO, PHRCI2017-SOHO-39). This post hoc study is part of the QUALIREHAB implementation research project, funded in Europe by the "Innovate to Prevent" European Joint Transnational Call (JTC-THCS 2024) and supported in the United States by institutional funding from the Children's National Hospital Foundation (Dunn Family Endowed Professorship of Cardiac Research, Heart Research Institute).<br/>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. <128> Accession Number 2048764013 Title Etomidate and Ciprofol for Induction in CABG Under Cardiopulmonary Bypass: Mechanistic Rationale, Evidence Gaps, and Future Trial Design. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Li Y.-N.; Yang Q.; He L.-X.; Li L.; Huang X.-J.; Yang B.-C.; Yang K. Institution (Li) Department of Anesthesiology, Dali University, Yunnan, Dali, China (Li, Yang, He, Li, Huang, Yang, Yang) Department of Anesthesiology, Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences, Affiliated Cardiovascular Hospital of Kunming Medical University, Yunnan, Kunming, China Publisher W.B. Saunders Abstract Patients undergoing coronary artery bypass grafting (CABG) with cardiopulmonary bypass (CPB) are exposed to substantial perioperative stress, inflammation, and perfusion vulnerability, which may increase the risk of postoperative acute kidney injury (AKI) and postoperative delirium (POD). Although anesthesia induction is brief, it can influence blood pressure, vascular responsiveness, vasopressor exposure, cerebral oxygenation, and tissue perfusion. Etomidate is widely used in high-risk patients because of its hemodynamic stability, but it inhibits adrenal 11beta-hydroxylase and attenuates the cortisol stress response. Ciprofol, a newer intravenous anesthetic, has shown favorable induction hemodynamics and less injection pain in some studies; however, current evidence largely comes from propofol comparisons, non-CABG populations, or process outcomes. No randomized evidence directly compares ciprofol with etomidate in adults undergoing CABG with CPB using AKI or POD as core outcomes. Thus, the superiority of either agent for organ outcomes is unproven. This narrative review summarizes the mechanistic rationale and evidence gaps and proposes standardized design considerations for future high-quality clinical trials. Future studies should use standardized Kidney Disease: Improving Global Outcomes AKI criteria and Confusion Assessment Method (CAM) or CAM-intensive care unit delirium assessment while controlling CPB management, transfusion, vasopressor use, sedation, analgesia, and perioperative steroid exposure. This review aims to construct testable clinical hypotheses and provide a rationale for future trials, rather than to determine the absolute clinical superiority of either agent.<br/>Copyright © 2026 Elsevier Inc. <129> Accession Number 652025536 Title COMPARISON OF POSTOPERATIVE ATRIAL FIBRILLATION, STROKE, MORTALITY, AND ECONOMIC OUTCOMES IN LOW-RISK TRANSCATHETER AORTIC VALVE REPLACEMENT (TAVR) PATIENTS: A SYSTEMATIC REVIEW USING THE PARTNER 3 TRIAL AS A COMPARATOR TO REAL-WORLD EVIDENCE. Source Value in Health. Conference: ISPOR 2026. Philadelphia United States. 29(6 Supplement 1) (pp S409-S410), 2026. Date of Publication: 01 Jun 2026. Author Rajagopalan A. Institution (Rajagopalan) Getinge, East Brunswick, NJ, United States Publisher Elsevier Ltd Abstract Objectives: To systematically evaluate real-world evidence (RWE) on postoperative atrial fibrillation (POAF), stroke, mortality, and economic outcomes in low-risk TAVR patients, and compare findings with the PARTNER 3 randomized trial. <br/>Method(s): A systematic literature review was conducted for studies published January 1, 2019 - June 30, 2025, following PRISMA 2020 guidelines. Databases searched included PubMed, Embase, Scopus, Cochrane Library and registries. Eligible studies reported POAF, stroke, mortality, or economic outcomes in low-risk TAVR patients (STS-PROM <=4% or study-defined). Data on patient characteristics, interventions, and outcomes were extracted. Risk of bias was assessed using ROBINS-I. Outcomes were synthesized narratively and compared with PARTNER 3. <br/>Result(s): Real-world low-risk populations were older (68-85 vs 73 years), with higher comorbidity (diabetes 14-48%, prior AF/AFL 0.3-35%) and more complex anatomy. Clinical outcomes showed higher AF/POAF (1-35% vs 5%), PPM implantation (1.8-19% vs 6.5%), stroke (0.6-3.3% vs 0.6%), 30-day mortality (0.7-4% vs 0.4%), and 1-year mortality (1-10.3% vs 1%). PVL, LOS (4-8.8 vs 3 days), and readmissions (1-24% vs 6.6%) were also increased. Trial-based economic outcomes (USD 2020) indicated that TAVR had lower cumulative costs than SAVR ($66,834 vs $68,864), shorter ICU LOS (0.8 vs 2.7 days), and slightly higher QALYs (+0.05). Real-world data (AUD 2017-2018) showed the TAVR index plus 30-day costs were lower than SAVR at a device cost of AUD 25,000 (-10%), but savings diminished at higher device prices. Risk of bias was moderate-to-serious due to confounding, inconsistent outcome definitions, and incomplete adjustment for confounders. <br/>Conclusion(s): Real-world studies indicate that clinical outcomes of TAVR in low-risk patients, particularly POAF and 30-day stroke rates, are generally consistent with PARTNER 3. However, real-world economic evidence remains limited, emphasizing the need for further research to assess costs and resource utilization in this population to guide clinical and policy decisions. <130> Accession Number 2048620579 Title Strategies to Improve Neurologic Outcomes in Neonatal Cardiac Surgery. Source Current Treatment Options in Pediatrics. 12(1) (no pagination), 2026. Article Number: 27. Date of Publication: 01 Dec 2026. Author Hsia J.; Herrup E.A.; Burnham A.A.; Hampton L.; Lynch J.M.; Massey S.L.; Naim M.Y. Institution (Hsia, Herrup, Naim) Division of Cardiac Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA, United States (Burnham) Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Hampton) Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Lynch) Division of Cardiothoracic Anesthesia, Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, United States (Massey) Division of Neurology, Departments of Neurology and Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Purpose of Review: Neonates with congenital heart disease (CHD) necessitating repair during infancy are at risk for adverse neurodevelopmental outcomes throughout their lifespan. The etiology of brain injury in this population is multifactorial and includes both modifiable and non-modifiable risk factors. We aim to review modifiable risk factors and evidence-based interventions aimed at improving short- and long- term neurodevelopmental outcomes. Recent Findings: Despite increasing focus in recent years on improving neurodevelopmental outcomes in individuals with CHD, there remains a paucity of literature on interventions that improve neurodevelopmental outcomes. This is likely due to the complex interactions between the many risk factors, some of which are non-modifiable, for brain injury in this population. The heterogeneity of each specific cardiac lesion and the differential risk they may confer to brain injury make studying this population challenging. Potential interventions to improve outcomes span a wide variety of clinical care settings and require collaboration among a large multidisciplinary team, including the prenatal care team, cardiac intensive care team, operative team (cardiac surgery, anesthesia, perfusion), neurology, outpatient cardiology, outpatient primary care pediatricians, and developmental specialists. <br/>Summary: Improving neurodevelopmental outcomes in neonates with CHD is multifaceted, and there likely is no one intervention that will unequivocally improve outcomes. Improving outcomes will require a multidisciplinary team spanning prenatal, inpatient, and outpatient care. More data are needed to identify modifiable risk factors and targeted interventions that will improve both short- and long- term neurodevelopmental outcomes.<br/>Copyright © The Author(s) 2026. <131> Accession Number 2038546966 Title Progress in Understanding Brain Injury After Cardiopulmonary Bypass in Cardiac Surgery: A Narrative Review. Source Reviews in Cardiovascular Medicine. 27(8) (no pagination), 2026. Article Number: 50277. Date of Publication: 01 Aug 2026. Author Zhang S.; Hao J.; Fan W.; Liu B.; Li W.; Wen L.; Zhang D. Institution (Zhang, Hao, Fan, Liu, Wen, Zhang) Department of Radiology, Xinqiao Hospital, Army Medical University, Chongqing, China (Li) Department of Radiology, 987th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army, Shaanxi, Baoji, China Publisher IMR Press Limited Abstract The application of cardiopulmonary bypass (CPB) has significantly advanced cardiovascular surgery. However, CPB-associated brain injury remains a critical complication that affects patient prognosis and quality of life. Overt stroke occurs in approximately 1-5% of cases, while postoperative delirium affects 20-50% of patients, and perioperative neurocognitive disorders are reported in 10-40%, depending on the diagnostic criteria used. This narrative review provides a comprehensive summary of recent research progress on CPB-associated brain injury in cardiac surgery, along with a critical appraisal of the supporting evidence. While the main focus is on adult patients, various pediatric conditions are also discussed. We review the evolution of CPB technology; the classification and clinical burden of brain injury; detailed pathophysiological mechanisms, including hemodynamic injury, microembolism, systemic inflammatory response, and blood-brain barrier disruption; current cerebral protection strategies advances in personalized cerebral perfusion. Furthermore, special consideration is given to genetic susceptibility (such as apolipoprotein E (APOE) polymorphisms), and pediatric cardiac surgery. A systematic screening of high-quality literature from the past five years highlights the challenges that continue to impede clinical translation, despite progress in neuromonitoring and minimally invasive CPB technologies. Future research directions include the application of artificial intelligence and real-time cerebral autoregulation monitoring to support the transition from empirical medicine to precision, individualized cerebral protection.<br/>Copyright © 2026 The Author(s). <132> Accession Number 652026314 Title ECONOMIC IMPACT OF CARDIOVASCULAR BENEFIT OF SEMAGLUTIDE VERSUS TIRZEPATIDE IN PATIENTS WITH OVERWEIGHT OR OBESITY IN CHINA. Source Value in Health. Conference: ISPOR 2026. Philadelphia United States. 29(6 Supplement 1) (pp S84), 2026. Date of Publication: 01 Jun 2026. Author Meng N.; Wan Z.; Dou L. Institution (Meng, Wan, Dou) Department of Social Medicine and Health Management, School of Public Health, Shandong University, jinan, China Publisher Elsevier Ltd Abstract Objectives: The cardiovascular (CV) benefit of semaglutide has been proved in the CV outcome trial, which STEER real-word study showed that semaglutide significantly reduced the primary composite endpoint (myocardial infarction, heart failure, stroke, coronary revascularization, and all-cause mortality) compared to Tirzepatide. This study aimed to evaluate the economic impact of preventing adverse CV outcomes by semaglutide compared to tirzepatide in patient with overweight or obesity in China. <br/>Method(s): A 10-year cost-consequence model was built to compare the economic impact of semaglutide and tirzepatide. Incidence rates of four major CV complications (myocardial infarction, stroke, heart failure, and coronary revascularization) were extracted from STEER. Only direct medical costs were included in the cost components, with data sourced from the most recent literature. Annual cost differences (years 1-10) were calculated and the contribution of each complication to overall savings was quantified. <br/>Result(s): Compared with tirzepatide, semaglutide saves a total of CNY 17,050 in direct medical costs per patient over 10 years-equivalent to CNY 4.7 per day. CNY 5,575 of the total saving was already realized within the first five years, primarily driven by fewer cardiovascular complications. Decade-long savings by complication are CNY 7,124 (myocardial infarction, 41.8%), CNY 2,056 (stroke, 12.1%), CNY 3,623 (heart failure, 21.2%), and CNY 4,247 (coronary revascularization, 24.9%). <br/>Conclusion(s): In Chinese patients with overweight or obesity, semaglutide produces significant and steadily increasing direct medical-cost savings compared with tirzepatide by reducing the incidence of cardiovascular events and their downstream complications, with myocardial infarction contributing the largest share of the long-term cumulative reduction. <133> Accession Number 2048601887 Title Impact of opioid free anesthesia on postoperative nausea and vomiting, chronic pain, and quality of recovery in patients undergoing video-assisted thoracoscopic surgery: a systematic review and meta-analysis of randomized controlled trials. Source BMC Anesthesiology. 26(1) (no pagination), 2026. Article Number: 520. Date of Publication: 01 Dec 2026. Author Yang J.; Liao T.; Luo J.; Ma A.; He J.; Li H.; Liu R.; Yu Y.; Peng J. Institution (Yang, Liao, Ma, He, Li) The College of Medicine, Kunming University of Science and Technology, Yunnan, Kunming, China (Yang, Liao, Ma, He, Li, Liu, Yu, Peng) Department of Thoracic Surgery, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Yunnan, Kunming, China (Luo) Department of Anaesthesiology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Yunnan, Kunming, China Publisher BioMed Central Ltd Abstract Background: Opioids are frequently used in general anesthesia but may delay recovery owing to adverse effects, which include respiratory depression, postoperative nausea and vomiting (PONV), and opioid-induced hyperalgesia. Opioid-free anesthesia (OFA), based on multimodal analgesia, offers an alternative to mitigate these issues and enhance recovery in thoracic surgery. However, high-quality evidence confirming its effectiveness and safety is needed. <br/>Method(s): The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in this study. PubMed, Web of Science, Embase, and Cochrane Library were systematically searched from inception to March 01, 2025, for randomized controlled trials (RCTs) that compared OFA and opioid-based anesthesia (OBA) in patients undergoing video-assisted thoracoscopic surgery (VATS). Study titles, abstracts, and full texts were separately evaluated for eligibility by two researchers; disagreements were resolved by discussion or a third researcher. The Cochrane Risk of Bias tool was used to evaluate the risk of bias in included studies. Primary outcomes included PONV incidence and 24-h postoperative pain scores. Secondary outcomes included chronic pain, intraoperative hemodynamic events, length of stay in the recovery room, length of hospitalization, and quality of recovery (as measured by QoR-40/QoR-15). <br/>Result(s): This systematic review and meta-analysis consisted of 10 RCTs involving 1,106 patients. OFA reduced the risk of PONV (risk ratio (RR) = 0.41, 95% confidence interval (CI): 0.380-0.665) and the incidence of postoperative chronic pain at 3 months (RR = 0.566, 95% CI: 0.347-0.925), compared with OBA. However, the 24-h postoperative pain scores did not differ (MD = 0.082, p = 0.305). Bradycardia incidence was lower in the OFA group, but hypotension rates did not differ. The length of stay in recovery rooms and the length of hospitalization did not differ significantly. Although 24-h QoR-40 scores favored OFA (mean difference = 2.914, 95% CI: 1.017-4.811), this improvement did not reach the clinically established threshold of 6.3 points. <br/>Conclusion(s): Without worsening intraoperative hemodynamic instability or extending postoperative recovery, OFA significantly reduced the incidence of PONV and chronic pain in patients undergoing VATS. These results validate OFA as a potentially safe and effective anesthetic strategy for improving postoperative recovery after thoracic surgery. Further large-scale RCTs are warranted to standardize OFA protocols and validate its long-term advantages. Trial registration: Registration of systematic reviews: CRD42025636410.<br/>Copyright © The Author(s) 2026. <134> Accession Number 2048722625 Title Post-transplant Epstein-Barr virus-associated lymphoproliferative disorder after cardiac transplantation: a scoping review. Source Transplant Immunology. 98 (no pagination), 2026. Article Number: 102447. Date of Publication: 01 Oct 2026. Author Calpey J.; Beaton R.; Osorio S.V.; Machado C.J.; Knudsen R.; Kalathoor J.; Knecht M.; Sacca L. Institution (Calpey, Beaton, Osorio, Machado, Knudsen, Kalathoor, Knecht, Sacca) Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, United States Publisher Elsevier B.V. Abstract Background: Post-transplant lymphoproliferative disorder (PTLD) is a serious complication following cardiac transplantation, frequently driven by Epstein-Barr virus (EBV) in the setting of chronic immunosuppression. Despite its clinical significance, data specific to adult cardiac transplant recipients remain fragmented, with variability in reported incidence, risk factors, and outcomes. <br/>Method(s): A scoping review was conducted using the Arksey and O'Malley framework and Joanna Briggs Institute guidelines. Five databases were searched for studies published between 2000 and 2025 focusing on EBV-associated PTLD in adult heart transplant recipients. Inclusion criteria encompassed observational and experimental studies conducted in the United States and Canada. Data extraction and screening were performed using Covidence, with study characteristics, incidence, risk factors, prevention strategies, and outcomes synthesized qualitatively. <br/>Result(s): Six studies met inclusion criteria. PTLD incidence ranged from 0.83% to 5.1%, with 43% to 98% of cases associated with EBV. Donor-positive/recipient-negative EBV serologic mismatch and intensity of immunosuppression were the most consistent risk factors. Median time to PTLD diagnosis ranged from 3.6 to 4.4 years, though late-onset cases were reported. Preventive strategies included EBV PCR surveillance and modification of immunosuppressive regimens, particularly conversion to sirolimus-based therapy. Treatment approaches primarily involved reduction of immunosuppression, rituximab-based therapy, and chemotherapy, with variable outcomes and persistent high morbidity and mortality. <br/>Conclusion(s): EBV-associated PTLD remains a significant complication after cardiac transplantation. Risk stratification based on EBV serostatus and immunosuppression, along with standardized surveillance and tailored therapeutic strategies, is critical to improving outcomes in this high-risk population.<br/>Copyright © 2026 Published by Elsevier B.V. <135> Accession Number 2038546967 Title Reconstruction of the Aorto-Mitral Curtain in Complex Infective Endocarditis: A Contemporary Narrative Review of the Commando Procedure. Source Reviews in Cardiovascular Medicine. 27(8) (no pagination), 2026. Article Number: 49123. Date of Publication: 01 Aug 2026. Author Lai Y.; Zheng J.; Han Y.; Ma L.; Ni Y.; Zhao H. Institution (Lai) School of Medicine, Zhejiang University, Hangzhou, China (Zheng, Han, Ma, Ni, Zhao) Department of Cardiovascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China Publisher IMR Press Limited Abstract Infective endocarditis (IE) remains a life-threatening condition, particularly in complex cases with destruction of the aorto-mitral curtain (AMC), also known as the intervalvular fibrous body (IVFB). Multiple factors have contributed to an increased incidence of IE and more extensive destruction of the valvular apparatus, necessitating more aggressive surgical intervention. Thus, this study aimed to evaluate the role and outcomes of the Commando procedure in managing IE involving the AMC. A narrative literature review was conducted to provide a comprehensive overview of the Commando procedure in IE involving the AMC, focusing on recent trends, indications, operative strategies, and outcomes. The keywords "infective endocarditis", "Commando procedure", "aorto-mitral curtain", "intervalvular fibrous body", and "double-valve replacement" were searched in PubMed, Web of Science, and Google Scholar. Only English language studies were included. Inclusion criteria comprised studies involving IE patients who underwent the Commando procedure or any associated modified version; studies reporting conventional double-valve replacement (DVR) performed for IE without AMC involvement were also included for comparison. Exclusion criteria included patients who underwent the Commando procedure for non-infection indications, such as small annuli or calcification. Commando surgery was associated with a 30-day mortality of 9- 32%, with 1-, 5-, and 10-year survival rates of 55.4-92.9%, 37.7-68%, and 37-48%, respectively. High-risk factors included infection by specific microorganisms and the need for emergency surgery. The Hemi-Commando procedure demonstrated lower early mortality (8-13.6%), higher 1-year survival (77.5-91%), and 92.3% freedom from reoperation at 1-3 years. Compared with DVR, the Commando procedure had higher operative mortality but similar long-term survival after risk adjustment. Despite the associated high perioperative risks, the Commando surgical procedure remains critical for managing complex IE with AMC destruction. Modified techniques may balance infection control and functional preservation, potentially improving survival in selected patients. Future research should focus on standardized surgical protocols, long-term durability, and multidisciplinary collaboration to optimize outcomes.<br/>Copyright © 2026 The Author(s). <136> Accession Number 652023122 Title Clinical Presentation, Diagnosis, Treatment, and Outcome of Heart Disease in Becker Muscular Dystrophy. Source Anatolian journal of cardiology. (no pagination), 2026. Date of Publication: 24 Aug 2026. Author Finsterer J. Institution (Finsterer) Department of Neurology, Neurology & Neurophysiology Center, Vienna, Austria Abstract Becker muscular dystrophy (BMD) is a primary myopathy caused by mutations in the dystrophin gene on chromosome Xq21.2, which often affects the myocardium and cardiac conduction system. However, there is limited experience with cardiac disease in BMD. This review aims to summarize and discuss recent advances and future perspectives regarding the clinical presentation, diagnosis, treatment, and outcome of cardiac involvement in BMD. Data were retrieved by searching for relevant articles in the PubMed and Google Scholar databases. Cardiac disease in BMD is characterized by myocardial fibrosis, can be subclinical or clinical, and manifests as left or right ventricular systolic dysfunction with/without heart failure due to dilated or hypertrophic cardiomyopathy, diastolic dysfunction with preserved/decreased systolic function, conduction disturbances and supraventricular/ventricular arrhythmias, thrombus formation, arterial hypertension, pulmonary hypertension, left ventricular hypertrabeculation, coronary artery disease, and valve defects. Cardiac involvement in BMD must be detected and treated at an early stage, because it progresses over time and has a significant impact on the course of the disease. Established treatment methods include non-invasive therapies with small molecules and catheter-based invasive therapies (stent implantation, endocardial and epicardial ablation), device-related treatments (pacemaker, implantable cardioverter-defibrillator, cardiac resynchronization therapy, left ventricular assist device), and heart surgery. Cardiac involvement in BMD occurs in about two-thirds of patients, is subclinical in the early stages but becomes symptomatic as the heart disease progresses, requires early diagnosis, and can be treated with non-invasive and invasive therapies, with prognosis improving with early detection and adequate treatment. <137> Accession Number 2048248805 Title Machine learning models for predicting postoperative acute kidney injury in pediatric cardiac surgery: a systematic review and meta-analysis. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Date of Publication: 18 Jun 2026. Author Sihombing N.M.I.; Raz H.F.; Siahaan S.R.U.; Sihombing S.Y.R.; Rifa'i A.D.; Duha M.H. Institution (Sihombing, Siahaan, Sihombing, Rifa'i, Duha) Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia (Raz) Division of Thoracic, Cardiac, and Vascular Surgery, Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Haji Adam Malik General Hospital, Medan, Indonesia Publisher Frontiers Media SA Abstract Background - Acute kidney injury (AKI) occurs in up to 42% of pediatric cardiac surgeries and is associated with prolonged intensive care, increased morbidity and in-hospital mortality. Machine learning (ML) has emerged as a promising approach for early AKI risk stratification by modeling complex, high-dimensional clinical data. Objectives - To systematically review and meta-analyze the diagnostic accuracy of ML models for predicting pediatric cardiac surgery associated AKI (CSA-AKI). Methods - We performed a systematic search of PubMed, ScienceDirect, Springer, and DOAJ. The review protocol was prospectively registered in PROSPERO (CRD420251145645). Study quality was assessed using QUADAS-2 tool and PROBAST + AI. A bivariate random-effects diagnostic meta-analysis was performed using Stata 17.0 to estimate the pooled area under the summary receiver operating characteristic curve (SROC AUC), sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR). Results - A meta-analysis of seven studies yielded a pooled SROC AUC of 0.91 (95% CI 0.88-0.93), driven predominantly by internally validated models (AUC 0.93, Sensitivity of 0.84, Specificity of 0.95). Externally validated models showed substantially lower performance (Sensitivity 0.70, Specificity 0.80), representing the more clinically relevant benchmark. A sensitivity analysis using median-performing models confirmed directional consistency (AUC 0.85, Sensitivity 0.75, Specificity 0.91). Substantial heterogeneity was observed (I<sup>2</sup> = 81.48%). Conclusion - ML models show promising accuracy for predicting pediatric CSA-AKI. Substantial heterogeneity and limited external validation warrant cautious interpretation and further multicenter validation before clinical use. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/view/CRD420251145645.<br/>Copyright © 2026 Sihombing, Raz, Siahaan, Sihombing, Rifa'i and Duha. <138> Accession Number 652019915 Title Does Tranexamic acid fix all bleeding in surgery?. Source Journal of the National Medical Association. (no pagination), 2026. Date of Publication: 15 Jul 2026. Author Lonjin T.; Zhang D.; Prasanna P. Institution (Lonjin, Prasanna) Department of Anesthesiology, Virginia Commonwealth University, Richmond, VA, United States (Zhang) Virginia Commonwealth University School of Medicine, Richmond, VA, United States Abstract Excessive hemorrhage is a major contributor to morbidity and mortality in perioperative settings. Tranexamic acid (TXA), a synthetic antifibrinolytic agent, effectively reduces blood loss by preventing fibrin degradation. This review summarizes the clinical applications, efficacy, and safety considerations of TXA across various surgical specialties. A comprehensive review of studies across various surgical specialties confirms TXA's efficacy in minimizing the risk of hemorrhage and transfusion needs. While TXA is a valuable tool in hemostasis, proper patient selection and dosing are crucial to avoid risks, especially in those with thromboembolic conditions or renal impairment. Further research is needed to refine dosing protocols and expand its safe use across patient populations.<br/>Copyright © 2026. Published by Elsevier Inc. �
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