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

Total documents retrieved: 109 Results Generated From: Embase <1980 to 2026 Week 42> Embase Weekly Updates (updates since 2026-10-08) - (109 records) <1> Accession Number 2050164181 Title Does a Simple Touch Make a Difference? The Effect of Acupressure on Pain Scores in Infants Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled Trial. Source Journal of Cardiovascular Nursing. (no pagination), 2026. Date of Publication: 2026. Author Ercan-Koyuncu I.; Gozen D. Institution (Ercan-Koyuncu, Gozen) Department of Nursing, Faculty of Health Sciences, Baskent University, Ankara, Turkey (Ercan-Koyuncu, Gozen) Department of Child Health and Diseases Nursing Doctorate Programme, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey (Gozen) Department of Pediatric Nursing, Faculty of Nursing, Koc University, Istanbul, Turkey Publisher Lippincott Williams and Wilkins Abstract Background: - Infants with congenital heart disease frequently undergo cardiac catheterization, an invasive procedure associated with pain and physiological stress. Objective(s): - Our aim was to evaluate the effects of acupressure applied before and after cardiac catheterization on pain, heart rate, and oxygen saturation. Method(s): - This randomized placebo-controlled trial was conducted in the pediatric cardiac surgery unit of Baskent University Ankara Hospital, Turkiye, between November 2024 and October 2025. Sixty infants aged 1-12 months with congenital heart disease who were undergoing cardiac catheterization were randomly assigned to the acupressure, placebo, or control group, with 20 infants in each group. Acupressure was applied to the HT7, LI4, and PC6 points before and after the procedure. Pain was assessed using the Face, Legs, Activity, Cry, Consolability scale, while heart rate and oxygen saturation were measured from the preprocedural period to discharge. Data were analyzed using analysis of variance and chi-square tests. Result(s): - Infants in the acupressure group had significantly lower pain scores than those in the placebo and control groups at all postprocedural time points. Heart rate values were also significantly lower in the acupressure group during follow-up. Analgesic use was less frequent in the acupressure group than in the placebo and control groups. Oxygen saturation improved over time, with no significant between-group differences at individual time points. Conclusion(s): - Acupressure may be an effective, noninvasive, nurse-delivered complementary intervention for reducing procedural pain, supporting physiological stability, and decreasing analgesic requirements in infants with congenital heart disease undergoing cardiac catheterization. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <2> Accession Number 2043927467 Title Endovascular treatment for basilar artery occlusion: A Bayesian network meta-analysis comparing time-to-treatment windows and medical management. Source Neuroradiology Journal. 39(5) (pp 620-635), 2026. Date of Publication: 01 Oct 2026. Author Carretta L.T.A.; Goncalves O.R.; Falcao L.; de Bastos Maximiano M.L.; Mitre L.P.; Arend R.B.; Fernandes J.V.A.; Teixeira P.R.; Di Cosmo L.; Morais T.C.; de Assis Barbosa L.; Gunkan A. Institution (Carretta, Teixeira) Department of Medicine, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria (EMESCAM), Vitoria, Brazil (Goncalves) Department of Medicine, Federal University of Piaui, Teresina, Brazil (Falcao) Department of Medicine, Bahiana School of Medicine and Public Health, Salvador, Brazil (de Bastos Maximiano) Department of Medicine, Federal Fluminense University, Niteroi, Brazil (Mitre) Department of Neurosurgery, Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, Brazil (Arend) Department of Medicine, Federal University of Fronteira Sul - UFFS, Campus, Passo Fundo, Brazil (Fernandes) Medical Sciences Center, Federal University of Paraiba, Joao Pessoa, Brazil (Di Cosmo) Department of Biomedical Sciences, Humanitas University, Milan, Italy (Morais) Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria, Vitoria, Brazil (de Assis Barbosa) Department of Neurosurgery, Hospital Estadual Central, Vitoria, Brazil (Gunkan) Department of Vascular and Interventional Radiology, University of Arizona, Tucson, United States Publisher SAGE Publications Inc. Abstract Background and objectives: Basilar artery occlusion accounts for a small fraction of ischemic strokes but carries a disproportionally poor natural history, with high rates of death and disability under best medical therapy (BMT). Endovascular treatment is used to treat these patients, though evidence of its safety and efficacy in different time windows compared to BMT remains conflicted. To address this, this Bayesian meta-analysis evaluates the outcomes of endovascular treatment for basilar artery occlusion performed in early (0-6 h) and late (>6 h) windows versus BMT. Material(s) and Method(s): Following PRISMA guidelines, databases were searched through for studies comparing endovascular versus BMT in patients with basilar artery occlusion. Randomized controlled trials, prospective, and retrospective studies reporting at least one clinical outcome were included. A Bayesian random-effects network meta-analysis was performed to compare endovascular treatment within 0-6 h and beyond 6 h with BMT. Result(s): Seven studies comprising 4,125 patients were included. EVT demonstrated superior functional outcomes compared to BMT across both time windows, with the late (>6 h) window showing a higher probability of achieving favorable modified Rankin Scale (mRS) scores (0-2). Mortality reduction was not consistent, and both early and late EVT were associated with higher risks of hemorrhagic and overall complications. Despite these safety concerns, the overall benefit-to-risk balance favored EVT as the preferred therapy for BAO. Conclusion(s): The findings underscore the importance of imaging-based selection and individualized decision-making, suggesting that EVT beyond traditional time windows remains effective when guided by appropriate clinical and radiological criteria. Copyright © The Author(s) 2026 <3> Accession Number 2047966005 Title Theoretical-Causal Validation of Risk Factors for the Nursing Diagnosis of Decreased Cardiac Output: A Systematic Review of the Literature with Meta-Analysis. Source International Journal of Nursing Knowledge. 37(4) (pp 596-609), 2026. Date of Publication: 01 Oct 2026. Author Silva Junior J.A.D.; Silva A.B.; Lopes M.V.D.O.; dos Santos I.K.; Almeida D.R.Q.D.; Andrade C.D.M.; Fernandes T.A.A.D.M.; do Nascimento E.G.C. Institution (Silva Junior, Silva, dos Santos, Almeida, Andrade, Fernandes, do Nascimento) Universidade do Estado do Rio Grande do Norte, Mossoro, Brazil (Lopes) Universidade Federal do Ceara, Fortaleza, Brazil Publisher SAGE Publications Ltd Abstract Purpose: This systematic review aimed to identify risk factors related to decreased cardiac output in adults, thereby supporting the theoretical-causal validation of the nursing diagnosis Risk for Decreased Cardiac Output. Method(s): A systematic review of etiology and risk was conducted in accordance with recognized guidelines, including meta-analysis of studies published between 1987 and 2024. Observational studies involving adult and older adult populations were selected from major electronic databases. Data extraction and quality appraisal were independently performed by multiple reviewers. Effect measures were synthesized using a random-effects model, with heterogeneity assessed across studies. Finding(s): Sixty-three studies were included, the majority with cohort designs. Key risk factors identified for decreased cardiac output were lower body surface area and lower body weight, with advanced age and female sex recognized as significant risk population characteristics. Associated conditions contributing to elevated risk included a history of stroke, shock, emergency cardiac surgery, diabetes, renal and pulmonary diseases, lower ejection fraction, and heart failure. Methodological variability in cardiac output measurement and significant heterogeneity among studies were notable challenges. Conclusion(s): Several significant risk factors for decreased cardiac output were identified and classified, providing scientific support for the theoretical-causal validation process of this nursing diagnosis. Addressing study heterogeneity and standardizing measurement methods are recommended for future research. Implications for Nursing Practice: The findings reinforce the clinical relevance of the nursing diagnosis Risk for Decreased Cardiac Output and highlight the need for tailored interventions by nursing professionals to prevent complications among at-risk cardiovascular patients. Copyright © The Author(s) 2026 <4> Accession Number 2049158206 Title Pharmacological Strategies for Postoperative Pain Control in Patients Undergoing Cardiac Surgery: A Mixed Methods Systematic Review of Clinical Efficacy, Opioid Consumption, Patient Experience, and Nursing Care. Source Journal of Indian College of Cardiology. 18(3) (pp 157-159), 2026. Date of Publication: 01 Sep 2026. Author Rajendran S.; Kuppusamy K.; Jayakumar S. Institution (Rajendran) Department of Medical Surgical Nursing, Vinayaka Mission's College of Nursing, Karaikal, Puducherry, Vinayaka Mission's Research Foundation (DU), Tamil Nadu, Salem, India (Kuppusamy) Department of Child Health Nursing, Vinayaka Mission's College of Nursing, Karaikal, Puducherry, Vinayaka Mission's Research Foundation (DU), Tamil Nadu, Salem, India (Jayakumar) Department of Mental Health (Psychiatric) Nursing, Amrita College of Nursing, Amrita Vishwa Vidyapeetham, Kerala, Kochi, India Publisher Wolters Kluwer Medknow Publications Abstract ABSTRACT - Postoperative pain following cardiac surgery remains a major challenge that can delay recovery, increase opioid use, and hinder rehabilitation. This systematic review evaluated mixed methods evidence on pharmacological pain management strategies and their integration with nursing care in adult patients undergoing cardiac surgery. A comprehensive search of PubMed, Scopus, Web of Science, CINAHL, and Google Scholar was conducted from database inception to December 2025 following PRISMA 2020 guidelines. Four mixed methods studies met the inclusion criteria. Pharmacological interventions included opioids, paracetamol, nonsteroidal anti-inflammatory drugs, gabapentinoids, ketamine, dexmedetomidine, and multimodal analgesic regimens. These approaches were associated with reduced postoperative pain, 15-38% lower opioid consumption, shorter intensive care unit stays, and improved rehabilitation. Qualitative findings emphasized patients' concerns regarding opioid dependence and sedation while highlighting the importance of nurse-led education and individualized pain assessment. Overall, multimodal opioid-sparing analgesic strategies integrated with patient-centered nursing care appear to enhance postoperative recovery after cardiac surgery, although further high-quality mixed methods research is required to strengthen the evidence. Copyright © 2026 Journal of Pharmacy and Bioallied Sciences <5> Accession Number 2045738296 Title The Effect of Acupressure on Procedural Pain, Anxiety, and Hemodynamic Parameters During Chest Tube Removal in Open-Heart Surgery Patients: A Randomized Sham-Controlled Study. Source Pain Management Nursing. 27(5) (pp e1017-e1026), 2026. Date of Publication: 01 Oct 2026. Author Kandemir D.; Yuksel S.; Cam Yanik T.; Ozdemir F.E.; Altun Ugras G. Institution (Kandemir) Surgical Receiving Unit, Queen Elizabeth University Hospital, Glasgow, United Kingdom (Yuksel) Faculty of Nursing, Department of Surgical Nursing, Necmettin Erbakan University, Konya, Turkey (Cam Yanik, Altun Ugras) Faculty of Nursing, Department of Surgical Nursing, Mersin University, Mersin, Turkey (Ozdemir) Cardiovascular Surgery Intensive Care Unit, Mersin University Hospital, Mersin, Turkey Publisher W.B. Saunders Abstract Background Patients undergoing open-heart surgery often experience procedural pain and anxiety during chest tube removal (CTR), which can lead to serious complications, along with potential changes in hemodynamic parameters such as blood pressure, heart rate, respiratory rate, and peripheral oxygen saturation. Aim This study aimed to explore the effects of acupressure on procedural pain, anxiety, and hemodynamic parameters during CTR in open-heart surgery patients. Methods This prospective, two-arm (1:1), randomized sham-controlled trial included 68 open-heart surgery patients with chest tubes. Participants were randomly assigned to either the true acupressure group (n = 34) or the sham acupressure group (n = 34). Before CTR, patients in the true acupressure group received 12 minutes of pressure at points LI4, LI11, and HT7 on both hands, while those in the sham acupressure group received pressure applied 1.5 cm away from the same points. Data were collected at baseline (T0), immediately after CTR (T1), and 15 minutes after CTR (T2) using the Visual Analog Scale (VAS), the State Anxiety Inventory (STAI-S), and hemodynamic parameters. Results At baseline, pain, anxiety, and hemodynamic parameters were comparable between the two groups ( p > .05). Immediately after CTR (T1), pain levels were significantly lower in the true acupressure group compared with the sham acupressure group, with an effect size of 0.71 (t = 2.925, Cohen's d = 0.709, p = .005). Anxiety levels were also significantly lower in the true acupressure group both immediately after CTR (T1; effect size = 0.50, t = 2.046, Cohen's d = 0.496, p = .045) and 15 minutes post-removal (T2; effect size = 0.51, t = 2.111, Cohen's d = 0.512, p = .035). Acupressure had no significant effect on hemodynamic parameters ( p > .05). Conclusion Acupressure was effective in reducing procedural pain and anxiety associated with CTR in open-heart surgery patients, while having no measurable impact on hemodynamic parameters. Clinical Trials ID NCT05875337 (Registered May 15, 2023) Copyright © 2026 American Society for Pain Management Nursing. <6> Accession Number 2048114033 Title Outcomes of Video-Assisted Thoracic Surgery Compared to Open Thoracic Surgery for Pulmonary Hydatid Disease: A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. 35(10) (pp 1395-1411), 2026. Date of Publication: 01 Oct 2026. Author Hussein A.M.; Hammadeh B.M.; Aldalati A.Y.; Albliwi M.; Odat R.M.; Shabaneh A. Institution (Hussein, Hammadeh) Faculty of Medicine, Al- Balqa' Applied University, Salt, Jordan (Aldalati, Odat) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Albliwi) Department of Internal Medicine, Cleveland Clinic, Cleveland, OH, United States (Shabaneh) Department of General Surgery, Mayo Clinic, Rochester, MN, United States Publisher Elsevier Ltd Abstract Background & Aim: Pulmonary echinococcosis, or pulmonary hydatid disease, caused by Echinococcus larvae, presents a significant health challenge, particularly in endemic areas. While surgery is the primary treatment for viable cysts, the optimal approach for this remains under debate. There is a lack of comparative evidence comparing traditional open thoracic surgery (OTS) with minimally invasive video-assisted thoracic surgery (VATS). This systematic review and meta-analysis aims to comprehensively compare the efficacy and safety of VATS versus OTS for pulmonary hydatid disease; it will expand on prior research by including patients of all ages and conducting detailed subgroup analyses, sensitivity analyses, and publication bias assessments. Method(s): Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and International Prospective Register of Systematic Reviews registration (CRD420251012764), major databases (PubMed, Scopus, Cochrane Library, Web of Science) were searched up to 5 March 2025, without language or date restrictions. Comparative studies (randomised controlled trials and observational studies) reporting perioperative, postoperative, and recovery outcomes for VATS versus OTS were included. Data were synthesised using random-effects models (calculating mean differences [MDs] or risk ratios with 95% confidence intervals). Heterogeneity (I2), risk of bias (Risk Of Bias In Non-randomised Studies of Interventions) and publication bias (Doi plots, Luis Furuya-Kanamori index) were assessed. Result(s): Nine retrospective cohort studies met the inclusion criteria. Compared with OTS, VATS was associated with significantly shorter operation times (MD -38.08 min; p<0.001; I2=92%), lower perioperative blood loss (MD -64.02 mL; p=0.006; I2=98%), reduced postoperative drainage volume (MD -124.46 mL; p=0.003; I2=85%), earlier chest drain removal (MD -2.27 days; p<0.001; I2=92%), and shorter hospital stays (MD -3.68 days; p<0.001; I2=98%). Although VATS showed a trend towards fewer postoperative complications, the difference was not statistically significant (risk ratio 0.72; p=0.13; I2=0%). Significant heterogeneity (I2>85%) was present for most continuous outcomes, and risk of bias assessment indicated high risks in confounding and reporting domains for several studies. Potential publication bias favouring VATS was detected for multiple outcomes. Conclusion(s): VATS appears to offer significant perioperative and recovery advantages over OTS for the surgical management of pulmonary hydatid disease. However, these findings must be interpreted with caution. While this review incorporates recently available randomised evidence, the majority of the data remains retrospective, and the pooled results are affected by significant heterogeneity and a high risk of bias in several domains. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <7> Accession Number 2050047504 Title The Caregiving Burden of Japan's Older Population Living With Valvular Heart Disease. Source Sage Open Aging. 11 (no pagination), 2025. Date of Publication: 01 Jan 2025. Author Chan S.; Meshulam A.; Ling B.; Ono A.; Smyth J.; Brown W.; Fung R.M.; Crawford B. Institution (Chan, Ling) Edwards Lifesciences, Singapore (Meshulam) Edwards Lifesciences, Irvine, CA, United States (Ono, Smyth) Edwards Lifesciences, Tokyo, Japan (Brown, Fung) Vista Health, Singapore (Crawford) Vista Health, Tokyo, Japan Publisher SAGE Publications Ltd Abstract Aging accelerates the degeneration and calcification of heart valves, driving valvular heart disease (VHD) development. As Japan's population ages, the prevalence of VHD continues to rise, increasing the burden on caregivers. This article draws on insights from the Japan Heart Health Survey (JHHS) and a targeted literature review to examine VHD's impact on caregivers who support older patients in Japan. The discussion also explores how promoting early diagnosis and treatment through medical innovations can help alleviate caregiver burden. Caregiving burden is multifaceted, impacting caregivers physically, emotionally, and financially. However, older patients often underestimate its impact. Underdiagnosis and undertreatment of VHD can exacerbate symptoms, contributing to greater caregiving strain. Low awareness among older adults and caregivers was identified as a key barrier to timely diagnosis and treatment of VHD. Leveraging advancements in medical innovation, including less invasive treatment options, could improve attitudes toward treatment, enhancing patient independence, and easing caregiving demands. Addressing the burden of VHD requires acknowledging its significant, often overlooked, impact on caregivers. Targeted public health initiatives can increase disease awareness and promote less invasive treatment options to encourage treatment. With more effective VHD management, both patients and caregivers can be adequately supported, ultimately improving health outcomes for all. Copyright © The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). <8> Accession Number 2049493659 Title Transcatheter vs Surgical Replacement of Degenerated Bioprosthetic Aortic Valve: A Meta-Analysis of Propensity-Score-Matched Studies. Source Heart Lung and Circulation. 35(10) (pp 1422-1437), 2026. Date of Publication: 01 Oct 2026. Author Ebrahimi P.; Taheri M.; Mahalleh M.; Soleimani H.; Taheri H.; Moradi A.; Sattartabar B.; Taebi M.; Bhia I.; Pirdehghan R.; Anafje M.; Alkhouli M.; Tajdini M.; Mohsen A.; Elgendy I.; Siegel R.J.; Mandegar M.H.; Hosseini K. Institution (Ebrahimi) Department of Cardiology, University Hospitals Birmingham, Birmingham, United Kingdom (Ebrahimi, Soleimani) Department of Cardiac Surgery, Bristol Heart Institute, University of Bristol, Bristol, United Kingdom (Taheri) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States (Mahalleh, Sattartabar, Taebi) Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Soleimani) Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Taheri, Siegel) Cedars-Sinai Medical Center, Los Angeles, CA, United States (Moradi) Internal Medicine, Blake Hospital, HCA Florida, University of South Florida, Morsani College of Medicine, Bradenton, FL, United States (Bhia) Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran, Islamic Republic of (Pirdehghan, Anafje) Rajaei Cardiovascular Medical and Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Alkhouli) Mayo Clinic Alix School of Medicine, Department of Cardiovascular Medicine, AZ, United States (Tajdini, Mohsen) Johns Hopkins University School of Medicine, Baltimore, MD, United States (Mohsen) Division of Cardiology, Loma Linda University Medical Center, Loma Linda, CA, United States (Elgendy) Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, KY, United States (Mandegar) Department of Cardiac Surgery, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of (Hosseini) Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark (Hosseini) Center for Translational Cardiology and Pragmatic Randomized Trials, Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark (Hosseini) Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran, Islamic Republic of Publisher Elsevier Ltd Abstract Introduction: Degeneration of bioprosthetic aortic valves is a common late complication. While redo surgical aortic valve replacement (redo-SAVR) has traditionally been the standard of care, transcatheter valve-in-valve implantation (ViV-TAVR) has emerged as a less invasive alternative. This meta-analysis aimed to compare outcomes between ViV-TAVR and redo-SAVR using propensity-score-matched studies. Method(s): A systematic search of Cochrane CENTRAL, Scopus, MEDLINE (via PubMed) Embase, and Scopus was conducted from inception through to 1 September 2024. Propensity-score matched cohort studies comparing ViV-TAVR and redo-SAVR were included. Risk ratios (RRs) and mean differences (MDs) or standardised mean differences (SMD), as appropriate, were pooled using a random-effects model. Result(s): Thirteen propensity score-matched studies encompassing 16,223 patients (8,463 ViV-TAVR; 7,760 redo-SAVR) with a weighted mean follow-up of 16.6 months were included. Compared to redo-SAVR, ViV-TAVR was associated with significantly lower short-term all-cause mortality (RR: 0.47; 95% confidence interval [CI]: 0.34-0.66; p<0.0001), major bleeding (RR: 0.45; 95% CI: 0.33-0.59), acute kidney injury (RR: 0.56; 95% CI: 0.38-0.84), and shorter hospital stay (SMD: -0.79; 95% CI: -1.00 to -0.57). ViV-TAVR was also associated with a significantly lower incidence of new-onset atrial fibrillation (RR: 0.22; 95% CI: 0.13-0.37) but higher post-procedural mean transvalvular gradients (SMD: 0.45; 95% CI: 0.20-0.69). No significant differences were observed in 1- or >=2-year mortality, stroke/transient ischaemic attack, myocardial infarction, permanent pacemaker implantation, or early readmission. Results remained consistent across sensitivity and subgroup analyses. Conclusion(s): ViV-TAVR offers significant short-term benefits over redo-SAVR, including lower early mortality and shorter hospitalisation. Long-term clinical outcomes remain comparable, while postprocedural mean gradients are higher after ViV-TAVR, underscoring the need for randomised trials and individualised patient selection to guide treatment decisions for degenerated bioprosthetic valves. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <9> Accession Number 2050238750 Title Effect of preoperative video-based digital educational program on incidence of delirium and length of hospital stay following coronary artery bypass grafting: A randomized controlled trial. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102963. Date of Publication: 01 Nov 2026. Author Al-Hadidi K.; Alshraideh J.A.; Rawashdeh R. Institution (Al-Hadidi, Alshraideh) School of Nursing, The University of Jordan, Amman, Jordan (Rawashdeh) School of Nursing, Philadelphia University, Jerash, Jordan Publisher Elsevier Inc. Abstract Background: Postoperative delirium is common after coronary artery bypass grafting (CABG) and is associated with prolonged hospitalization and delayed recovery. Non-pharmacological educational interventions may improve outcomes, but evidence on structured video-based education for delirium prevention remains limited. Objective(s): To evaluate the effect of a preoperative video-based educational program on postoperative delirium incidence and hospital length of stay among patients undergoing CABG surgery. Method(s): A parallel-group randomized controlled trial was conducted at Queen Alia Heart Institute, Jordan, between October 2025 and January 2026. Adult patients scheduled for elective first-time CABG surgery were randomized into intervention and control groups. Both groups received standardized multidisciplinary preoperative education through the institutional Preoperative Clinic, while the intervention group additionally received an 8-minute structured Arabic video-based educational program. Postoperative delirium was assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Result(s): Among 226 randomized participants, 213 were analyzed (105 intervention; 108 control). Delirium incidence was lower with intervention (7.6%vs 25.0%, p < .001) and remained significantly associated with study group after adjustment (OR = 3.14, 95% CI: 1.08-9.14, p = .036). Hospital stay was shorter in the intervention group unadjusted (8.38 vs 10.58 days, p < .001), but not after adjustment (B = -0.656, p = .182). Conclusion(s): Preoperative video-based education was associated with lower postoperative delirium incidence, while its association with shorter hospital stay was not maintained after adjustment. Larger multicenter trials are warranted. Copyright © 2026 Elsevier Inc. <10> Accession Number 2049794363 Title Routine versus deferred percutaneous coronary intervention in patients undergoing transcatheter aortic valve implantation: a frequentist and Bayesian meta-analysis of randomized trials with trial sequential analysis. Source IJC Heart and Vasculature. 66 (no pagination), 2026. Article Number: 102017. Date of Publication: 01 Oct 2026. Author Ibrahim A.; Shalabi L.; Giamundo D.M.; Aboueisha H.; Enani A.; Assi M.; Mojahed A.; Granata L.G.; Meyer D.M.; Sabouret P.; Ando G. Institution (Ibrahim, Enani, Mojahed) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Shalabi) Faculty of Medicine, Gharyan University, Gharyan, Libyan Arab Jamahiriya (Giamundo) Division of Cardiology, Policlinico Casilino, Rome, Italy (Aboueisha) Faculty of Medical Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands (Aboueisha) College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates (Assi) Faculty of Medicine, Al Najah National University, Nablus, Palestine (Granata) Cardiology Division, Garibaldi-Nesima Hospital, ARNAS Garibaldi, Catania, Italy (Meyer) Department of Cardiothoracic Surgery, Baylor Scott & White Health, Baylor University Medical Center, Dallas, TX, United States (Sabouret) Heart Institute and Action Group, Pitie-Salpetriere, Sorbonne University, Paris, France (Ando) Azienda Ospedaliera Papardo, Messina, Italy (Ando) Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy Publisher Elsevier Ireland Ltd Abstract Background: The optimal management of concomitant coronary artery disease (CAD) in patients undergoing transcatheter aortic valve implantation (TAVI) remains debated. Therefore, we performed this meta-analysis of randomized controlled trials (RCTs) to compare routine percutaneous coronary intervention (PCI) versus deferred PCI in patients with severe aortic stenosis and significant coronary artery disease undergoing TAVI. Method(s): We systematically searched major electronic databases for eligible RCTs. The primary efficacy outcome was spontaneous myocardial infarction (MI); the primary safety outcome was major bleeding. Bayesian random-effects meta-analysis models were fitted using weakly informative prior distributions. Effect estimates are reported as posterior median risk ratios (RR) with 95% credible intervals (CrI). The posterior probability of benefit (PPB) for efficacy outcomes or harm (PPH) for safety outcomes was calculated (RR < 1 or RR > 1, respectively). Result(s): Three RCTs comprising 1156 patients were included. Routine PCI did not demonstrate a convincing posterior probability of benefit for spontaneous MI (posterior median RR 0.84, 95% CrI 0.43-1.73; PPB: 70.2%) or all-cause mortality (posterior median RR 0.91, 95% CrI 0.60-1.43; PPB: 69.6%). However, routine PCI was associated with a reduced risk of urgent revascularization (posterior median RR 0.37, 95% CrI 0.15-0.91; PPB: 98.1%). For safety outcomes, routine PCI was associated with an increased posterior probability of harm for major bleeding (posterior median RR 1.56, 95% CrI 0.91-2.71; PPH: 95.6%) and life-threatening or disabling bleeding (posterior median RR 1.74, 95% CrI 1.00-3.07; PPH: 97.4%). Conclusion(s): Among patients undergoing TAVI with concomitant CAD, routine PCI did not reduce ischemic events or mortality but increased bleeding complications. These findings suggest that a selective revascularization strategy, rather than a routine one, may be preferable. PROSPERO registration: CRD420261386909. Copyright © 2026 <11> Accession Number 2038662228 Title Prognostic value of the New York Heart Association classification for cardiovascular events and mortality in Chagas cardiomyopathy: a systematic review and meta-analysis with GRADE recommendations. Source Revista da Sociedade Brasileira de Medicina Tropical. 59 (no pagination), 2026. Article Number: e0104-2026. Date of Publication: 2026. Author Silva W.T.; Costa H.S.; Silva H.J.; Avila M.R.; Oliveira L.F.F.; Silva J.P.; Gomes S.M.B.; Hasslocher-Moreno A.M.; Figueiredo P.H.S.; Mediano M.F.F. Institution (Silva, Silva, Hasslocher-Moreno, Mediano) Fundacao Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, RJ, Rio de Janeiro, Brazil (Silva, Costa, Avila, Oliveira, Silva, Figueiredo) Universidade Federal dos Vales do Jequitinhonha e Mucuri, Departamento de Fisioterapia, MG, Diamantina, Brazil (Avila, Oliveira) Universidade Federal de Minas Gerais, Faculdade de Medicina, MG, Belo Horizonte, Brazil (Gomes) Fundacao Oswaldo Cruz, Instituto Oswaldo Cruz, RJ, Rio de Janeiro, Brazil Publisher Sociedade Brasileira de Medicina Tropical Abstract Chagas cardiomyopathy is associated with a higher risk of severe cardiovascular events and increased mortality. Among the factors associated with Chagas cardiomyopathy, impairment in functional capacity-commonly assessed using the New York Heart Association (NYHA) functional classification-is notable and may contribute to risk stratification. In this review, we assessed the prognostic value of the NYHA classification on cardiovascular events and mortality in patients with Chagas cardiomyopathy. The search was performed across EMBASE, LILACS, MEDLINE, and Web of Science databases. Prospective and retrospective cohort studies in which the prognostic value of the NYHA classification was assessed were eligible. Risk of bias was assessed using the Quality in Prognostic Studies tool. Evidence was classified using the adapted GRADE system. Eighteen studies were included in the systematic review. The meta-analysis results indicate that the NYHA classification is an important prognostic factor for mortality. Patients with NYHA class III and IV showed a higher risk of death than those with class I and II (hazard ratio, 2.63; 95% confidence interval: 2.00-3.45; moderate GRADE evidence). Patients with NYHA class IV had a higher risk of death than those with class I, II, and III (hazard ratio, 2.80; 95% confidence interval: 1.06-7.43; low GRADE evidence). Very low evidence suggests that the NYHA classification does not predict heart transplantation or stroke, but may predict cardiac pacemaker implantation. Overall, the NYHA classification is a key prognostic indicator of mortality in Chagas cardiomyopathy, although its ability to predict stroke, heart transplantation, and pacemaker implantation is inconsistent. Copyright © 2026, Sociedade Brasileira de Medicina Tropical. All rights reserved. <12> Accession Number 2049551354 Title Erector spinae plane and superficial parasternal intercostal plane blocks vs. control for sternotomy in cardiac surgery: A prospective, randomized trial. Source Journal of Clinical Anesthesia. 115 (no pagination), 2026. Article Number: 112330. Date of Publication: 01 Nov 2026. Author Shariat A.; Egorova N.; Ouyang Y.; Fang S.; Koshchak E.; Qian D.; Armenta D.; Choi J.; Puskas J.; Bhatt H.V. Institution (Shariat, Koshchak, Armenta, Choi, Bhatt) Mount Sinai Morningside Hospital, New York, United States (Egorova, Ouyang) Department of Population Health Science and Policy at Mount Sinai, New York, NY, United States (Shariat, Egorova, Ouyang, Koshchak, Qian, Bhatt) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Fang) Maimonides Medical Center, Brooklyn, NY, United States (Puskas) Emory University Hospital, Atlanta, GA, United States Publisher Elsevier Inc. Abstract Background Cardiac surgical pain is challenging to treat because of its multifactorial nature. Fascial plane blocks present an attractive alternative analgesic technique due to their favorable safety profile and relative technical simplicity. Methods This prospective, randomized controlled trial tested the hypothesis that fascial plane blocks added to a multimodal analgesic regimen in patients undergoing cardiac surgery will decrease opioid consumption and pain scores postoperatively. Participants included adults of all genders between the ages of 18-85 who were assigned to American Society of Anesthesiologists physical status II-IV and underwent elective sternotomy procedures at Mount Sinai Morningside Hospital Center. Patients were randomized 1:1:1 to standard therapy, erector spinae plane block, or superficial parasternal intercostal plane block. Outcomes included the use of postoperative opioid medications in morphine equivalents, numerical rating scale pain scores, intensive care unit length of stay, hospital length of stay and postoperative nausea. Results A total of 271 patients were enrolled into the trial between July 2022 and July 2024. There was no significant difference in opioid consumption during the surgery and on postoperative days 0, 1, and 2, although the median morphine milligram equivalents use on postoperative day 3 was significantly different among the three groups driven by lower consumption in the ESP group, ( p = 0.047). Maximum numerical pain rating scale was significantly lower in both regional block groups compared to control for postoperative day 0, 1, 2, and 3: POD 1 ( p < 0.001), POD 2 ( p < 0.001), and POD 3 ( p = 0.002). Conclusion Patients undergoing sternotomy procedures may benefit from the addition of erector spinae plane or superficial parasternal intercostal plane blocks to a postoperative multimodal analgesic regimen. Copyright © 2026 Elsevier Inc. <13> Accession Number 2049160555 Title Remimazolam versus sevoflurane for general anaesthesia: A meta-analysis with trial sequential analysis of haemodynamic and clinical outcomes. Source European Journal of Anaesthesiology. 43(11) (pp 901-912), 2026. Date of Publication: 01 Nov 2026. Author Takayama L.T.; de Souza K.; Batista da Hora D.A.; Hakkeem B.; Dias H.S.; Bezerra F.J.L. Institution (Takayama) Pontifical Catholic University of Parana, PUCPR, Curitiba, Brazil (de Souza) Department of Medicine, Redentor University Centre, Itaperuna, Brazil (Batista da Hora) Department of Medicine, Federal University of Amazonas, UFAM, Manaus, Brazil (Hakkeem) Government Medical College Kozhikode, Kerala, India (Dias) Centro Universitario Christus, Ceara, Fortaleza, Brazil (Bezerra) Hospital Sao Luiz Itaim, Rede D'Or Sao Luiz, Sao Paulo, Brazil Publisher Lippincott Williams and Wilkins Abstract BACKGROUND - Remimazolam is a novel ultra-short-acting intravenous benzodiazepine, while sevoflurane is a widely used inhalational anaesthetic for general anaesthesia (GA). Both agents are associated with risks of haemodynamic instability and postoperative nausea and vomiting (PONV), which can affect patient safety and recovery. OBJECTIVE - To compare the efficacy and safety of remimazolam versus sevoflurane in terms of intraoperative haemodynamic stability during the maintenance phase of GA or deep sedation, and the incidence of PONV. DESIGN - Systematic review of randomised controlled trials (RCTs) and meta-analysis, with trial sequential analysis (TSA). DATA SOURCES - PubMed/MEDLINE, Embase, Cochrane CENTRAL, Web of Science and Scopus were systematically searched from inception to April 2025. ELIGIBILITY CRITERIA - RCTs comparing intraoperative use of remimazolam and sevoflurane with reported intraoperative or postoperative outcomes. Conference abstracts were excluded. RESULTS - Twelve RCTs (n = 739 patients; mean age 61.6 years; 36.8% laparoscopic procedures) were included. Remimazolam significantly reduced the risk of intraoperative hypotension (as a binary event) compared with sevoflurane [risk ratio (RR) 0.38, 95% confidence interval (CI) 0.25 to 0.57; P < 0.001]. Mean arterial pressure (MAP) was higher with remimazolam at 30 min after start of surgery (mean difference 6.05 mmHg, P < 0.03). Heart rate (HR) was consistently higher with remimazolam at 30 min (P = 0.04), at the end of surgery (P < 0.01) and in the postanaesthesia care unit (P < 0.01). Analyses suggested a reduction in PONV incidence up to 24 h with remimazolam [RR 0.65 (95% CI, 0.47 to 0.90); P = 0.01] and 72 h [RR 0.66 (95% CI, 0.50 to 0.89)]. TSA just confirmed favouring remimazolam in reducing intraoperative hypotension. CONCLUSIONS - Remimazolam was associated with a lower incidence of intraoperative hypotension compared with sevoflurane, while differences in MAP and HR were limited to specific time points. Sensitivity analyses suggested a potential reduction in PONV; however, these findings were not statistically significant in the primary analysis and should be interpreted with caution. Copyright © 2026 European Society of Anaesthesiology and Intensive Care. Unauthorized reproduction of this article is prohibited. <14> Accession Number 2049545265 Title Prevention of postoperative delirium with transcranial alternating current stimulation: study protocol for a randomised controlled trial. Source Frontiers in Psychiatry. 17 (no pagination), 2026. Article Number: 1907287. Date of Publication: 2026. Author Zeng L.; Yu X.; Yang T.; Liao J.; Ouyang Y.; Zhou J. Institution (Zeng, Yu, Yang, Liao, Ouyang) Department of Anesthesiology, Shifang People's Hospital, Sichuan, Shifang, China (Zhou) Department of Anesthesiology, The Affiliated Hospital, Southwest Medical University, Sichuan, Luzhou, China Publisher Frontiers Media SA Abstract Introduction - Postoperative delirium (POD), a common and serious neurological complication in elderly patients following non-cardiac surgery, is associated with increased risk of complications, cognitive decline, prolonged hospital stay, and higher mortality. Current prevention strategies are limited and unsatisfactory. As a non-invasive neuromodulation technique that modulates cortical oscillations and may improve age-related cognitive impairment, transcranial alternating current stimulation (tACS) emerges as a promising intervention for POD. Methods and analysis - This two-stage, randomized, double-blind, sham-controlled trial will enroll elderly patients aged >=65 years undergoing non-cardiac surgery. In Stage 1, In Stage 1, 268 patients will be randomized to physiologically matched theta-tACS, alpha-tACS, gamma-tACS (all 2 mA) or sham stimulation to identify the optimal frequency-plus-montage tACS protocol for POD prevention. In Stage 2, another 268 patients will receive optimal-frequency-plus-montage tACS at 1 mA, 1.5 mA, 2 mA or sham stimulation to determine the optimal intensity. Primary outcome is POD incidence (3D-CAM). Secondary outcomes include pain, cognition, sleep, anxiety and depression. Electroencephalography and blood biomarkers will be assessed. Data will be analyzed using SPSS 26.0. This study aims to develop an optimal tACS protocol for POD prevention in elderly surgical patients. Ethics and dissemination - This study was approved by the Ethics Committee of Shifang people's hospital (202634). The results of the trial will be presented at national and international meetings relevant to the topic area and submitted to international peer-reviewed journals. Clinical trial registration - https://www.chictr.org.cn/showproj.html?proj=317411, identifier ChiCTR2600123512. Copyright © 2026 Zeng, Yu, Yang, Liao, Ouyang and Zhou. <15> Accession Number 2050257469 Title Individualised positive end-expiratory pressure to minimise driving pressure and postoperative pulmonary complications in minimally invasive thoracic and abdominal surgery: do highly weighted open-lung trials influence the pooled estimate? Comment on Br J Anaesth 2026; 137: 231-43. Source British Journal of Anaesthesia. (no pagination), 2026. Date of Publication: 2026. Author Zhou J.; Xue W.; Zhao Z. Institution (Zhou, Zhao) Department of Gastrointestinal Surgery, the Affiliated Hospital of Southwest Medical University, Sichuan, Luzhou, China (Xue) Department of Library, Southwest Medical University, Sichuan, Luzhou, China Publisher Elsevier Ltd <16> Accession Number 2049269318 Title Antithrombotic Therapy in Coronary Artery Aneurysm, Ectasia, and Slow Flow: A Systematic Review. Source Clinical Cardiology. 49(9) (no pagination), 2026. Article Number: e70471. Date of Publication: 01 Sep 2026. Author Kheirandish N.; Kamali M.; Khodadadiyan A.; Bazroodi H.; Imani M.; Ghahramani S.; Saem A.; Imani A.; Alaei H.; Abdi-Ardekani A.; Jamshidi S.; Bazrafshan M.; Arzhangzade A.; Hooshanginezhad Z.; Bazrafshan Drissi H. Institution (Kheirandish, Khodadadiyan, Bazrafshan, Hooshanginezhad) Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Kamali, Jamshidi) Fellow of Echocardiography Cardiologist, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Bazroodi, Imani, Ghahramani, Saem, Alaei) Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Imani) Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Abdi-Ardekani, Bazrafshan Drissi) Interventional Cardiologist, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of (Arzhangzade) Department of Cardiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran, Islamic Republic of Publisher John Wiley and Sons Inc Abstract Background: Coronary artery aneurysm (CAA), coronary artery ectasia (CAE), and coronary slow flow phenomenon (CSFP) are coronary pathologies associated with altered hemodynamics and increased thrombotic risk. However, optimal antithrombotic management remains uncertain because of limited and heterogeneous evidence. Objective(s): This systematic review aimed to synthesize data on the efficacy and safety of antiplatelet and anticoagulant therapies in patients with CAA, CAE, and CSFP. Method(s): Following PRISMA 2020 guidelines, PubMed, Scopus, Web of Science, and ProQuest were searched through September 2025 for randomized and observational studies evaluating antithrombotic therapy in adults with these conditions. Outcomes included major adverse cardiovascular events and major bleeding. Narrative synthesis was conducted using the SWiM framework. Risk of bias was assessed using ROBINS-I and RoB 2.0, and certainty of evidence using GRADE. Result(s): Eleven studies comprising 3271 participants were included: six on CAE (n = 895), four on CAA (n = 2356), and one on CSFP (n = 20). In CAE, dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC) were associated with fewer ischemic events than no therapy, although direct comparisons were inconsistent. The only randomized trial in CAE showed numerically lower recurrent myocardial infarction and cardiovascular death with single antiplatelet therapy (SAPT) plus direct oral anticoagulant (DOAC) versus DAPT, but findings were nonsignificant and based on few events. Evidence for CAA and CSFP remains limited and inconclusive. Conclusion(s): Intensified antithrombotic therapy may benefit patients with CAE, but evidence remains inconclusive for CAA and CSFP. Large, multicenter randomized trials are warranted to establish condition-specific treatment recommendations. Copyright © 2026 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC. <17> [Use Link to view the full text] Accession Number 2039579064 Title Perioperative dexmedetomidine reduces the risk of postoperative complications in high-risk patients undergoing non-cardiac surgery: A randomized controlled trial. Source Chinese Medical Journal. 139(18) (pp 2770-2779), 2026. Date of Publication: 20 Sep 2026. Author Meng Z.; Ding T.; Zhao W.; Guo L.; Li M.; Zhao Z.; Zhang Y.; Li C.; Mu D.; Wang D. Institution (Meng, Ding, Li, Li, Mu, Wang) Department of Anesthesiology, Peking University First Hospital, Beijing, China (Meng) Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China (Zhao, Zhao) Department of Anesthesiology, The Fourth Hospital of Hebei Medical University, Hebei, Shijiazhuang, China (Guo, Zhang) Department of Anesthesiology, Liaocheng People's Hospital in Shandong Province, Shandong, Liaocheng, China Publisher Lippincott Williams and Wilkins Abstract Abstract - Background: - Dexmedetomidine may suppress the surgery-induced inflammatory response, which is considered the underlying mechanism of postoperative complications. This study was designed to investigate whether perioperative dexmedetomidine could decrease the risk of postoperative complications among high-risk patients. Method(s): - This multicenter randomized controlled trial is a superiority trial. Central randomization was used. Elderly patients (age >=60 years) with revised cardiac risk index (RCRI) >=3 and scheduled for major non-cardiac surgery were enrolled. Patients in dexmedetomidine group received intraoperative dexmedetomidine (a loading dose of 0.5 mug/kg followed by 0.3 mug.kg-1.h-1) as adjuvant to general anesthesia and postoperative dexmedetomidine (2 mug/h for 72 h) as supplementation to patient-controlled analgesia with sufentanil. Patients in the control group received an equivalent dose of normal saline as placebo during anesthesia and sufentanil only for postoperative analgesia. The primary outcome was the incidence of major postoperative complications including neurologic, cardiovascular, renal, pulmonary coagulation, infectious, and gastrointestinal systems within postoperative 30 days. Secondary outcomes included pain intensity, sleep quality, postoperative length of in-hospital stay, and medical expenses during hospitalization. Neutrophil-to-lymphocyte ratio (NLR) was used to monitor inflammatory response. Result(s): - This study included 272 patients, with similar median age (70 years vs. 69 years) and median RCRI (both 3) between dexmedetomidine and control groups. The incidence of major postoperative complications in the dexmedetomidine group was significantly lower than that in the control group (38.2% [52/136] vs. 52.9% [72/136], relative risk [RR] = 0.722, 95% confidence interval (CI) 0.554-0.942, P = 0.015). Postoperative in-hospital stay was shorter in the dexmedetomidine group than that in the control group (mean difference [MD] = -1 day, 95% CI: -2 to 0 days, P = 0.013). Other secondary outcomes were comparable between the two groups. The highest NLR within postoperative first 3 days in the dexmedetomidine group was lower than that in the control group (MD = -2.1, 95% CI: -4.1 to -0.3, P = 0.037). The proportion of all drug-related adverse events were comparable between the two groups. Conclusion(s): - Dexmedetomidine, infused from the beginning of anesthesia to postoperative 72 h, decreased the risk of postoperative complications in high-risk elderly patients undergoing non-cardiac surgery. Trial registration: - No. ChiCTR2000030566 at www.chictr.org.cn Copyright © 2025 The Chinese Medical Association, produced by Wolters Kluwer Health, LLC. under the CC-BY-NC-ND license. <18> Accession Number 2042577030 Title Dexmedetomidine reduces acute kidney injury in high-risk but not low-risk patients after non-cardiac surgery: secondary analysis of a randomized controlled trial. Source Journal of Anesthesia. 40(5) (pp 726-736), 2026. Date of Publication: 01 Oct 2026. Author Liang X.-Q.; Li M.-L.; Li C.-J. Institution (Liang, Li, Li) Department of Anesthesiology, Peking University First Hospital, No. 8 Xishiku St., Xicheng District, Beijing, China Publisher Springer Abstract Purpose: Acute kidney injury (AKI) is a significant postoperative complication associated with poor long-term outcomes. Dexmedetomidine, a selective alpha-adrenergic agonist with anti-inflammatory properties, may protect the kidney during non-cardiac surgery. This study examined whether intraoperative dexmedetomidine reduces AKI in both high-risk and low-risk patients. Method(s): This was a secondary analysis of a randomized double-blind placebo-controlled trial. Patients aged >= 60 years scheduled for elective non-cardiac surgery expected to last >= 2 h under general anesthesia were enrolled and classified as low-risk or high-risk using the General Surgery Acute Kidney Injury Risk Index. Participants were randomly allocated to receive intraoperative dexmedetomidine (loading dose 0.6 mug/kg over 10 min before induction, followed by 0.5 mug/kg/h until 1 h before surgery end) or normal saline. The primary endpoint was AKI incidence within 7 postoperative days. Result(s): Among high-risk patients, AKI occurred in 12.6% (13/103) of the dexmedetomidine group versus 23.4% (25/107) of controls (RR 0.54, 95% CI 0.29 to 1.00, P = 0.043); after multivariable adjustment, dexmedetomidine remained independently associated with lower AKI risk (OR 0.44, 95% CI 0.20 to 0.98, P = 0.045). In contrast, low-risk patients showed no significant difference with or without dexmedetomidine (7.9% vs 9.6%; RR 0.82, 95% CI 0.44 to 1.55, P = 0.543; adjusted OR 0.65, 95% CI 0.30 to 1.38, P = 0.260). Urological surgery was an independent predictor of AKI across the entire cohort. Conclusion(s): Intraoperative dexmedetomidine was associated with lower risk of AKI in high-risk but not in low-risk patients undergoing non-cardiac surgery. Copyright © The Author(s) 2026. <19> Accession Number 2049590243 Title PCSK9 inhibitors for lipid-lowering treatment in patients with atherosclerotic cardiovascular disease: a health technology assessment. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1853767. Date of Publication: 2026. Author Lan J.; Qiu Y.; Wang S.; Zhang Y.; Cheng S.; Chen S.; Xing Y. Institution (Lan, Qiu, Wang, Zhang, Cheng, Chen) Department of Pharmacy, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China (Xing) Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, Xi'an, China Publisher Frontiers Media SA Abstract Background - In multiple countries, clinical guidelines recommend proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors for lowering low-density lipoprotein cholesterol (LDL-C) in individuals with atherosclerotic cardiovascular disease (ASCVD). Comprehensive comparisons of the efficacy, safety, and cost-effectiveness across different PCSK9 inhibitors remain limited, and current evidence requires updating. To address this gap, this study applies a health technology assessment framework to systematically evaluate the use of PCSK9 inhibitors in patients with ASCVD. Methods - A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted from database inception to February 28, 2026 to identify randomized controlled trials (RCTs) comparing PCSK9 inhibitors with standard care (statins with or without ezetimibe) in patients with ASCVD. Both pairwise and network meta-analyses were applied to synthesize direct and indirect evidence. Trial sequential analysis (TSA) was performed to evaluate the sufficiency of the accumulated data. In addition, a Markov model was developed from the perspective of the Chinese healthcare system to assess the cost-effectiveness of PCSK9 inhibitors in ASCVD patients. Results - In total, 24 RCTs comprising 63, 328 participants were included. The results of TSA and network meta-analysis showed that, compared with SOC, all three PCSK9 inhibitors significantly reduced LDL-C levels. No statistically significant differences were found for stroke outcomes. However, both alirocumab and evolocumab significantly reduced the risk of non-fatal myocardial infarction. None of the three PCSK9 inhibitors was associated with an increased risk of serious adverse events. Using the meta-analysis findings and data from the Chinese healthcare system, the incremental cost-effectiveness ratios (ICERs) for alirocumab, evolocumab, and inclisiran versus standard care were estimated at USD 12, 791.07/QALY, USD 11, 646.38/QALY, and USD 31, 730.14/QALY, respectively. In a scenario analysis incorporating a 72.1% reduction in the price of inclisiran, its ICER decreased to USD 9, 686.31/QALY. The one-way sensitivity analysis showed that the discount rate exerted the greatest influence on model outcomes. In the price-reduction scenario, probabilistic sensitivity analysis indicated that inclisiran had a 96.6% probability of being cost-effective at a willingness-to-pay threshold of USD 13, 410/QALY. Conclusion - Currently, evolocumab demonstrates relative advantages in lipid-lowering efficacy, cardiovascular outcomes, and economic value for patients with ASCVD. Alirocumab represented a cost-effective alternative. In the scenario analysis incorporating a 72.1% reduction in the price of inclisiran, inclisiran became a potentially highly cost-effective option in the Chinese healthcare setting. Copyright © 2026 Lan, Qiu, Wang, Zhang, Cheng, Chen and Xing. <20> Accession Number 2049248005 Title Safety and Functional Outcomes of Reperfusion Therapies in Pediatric Arterial Ischemic Stroke: A Systematic Review and Meta-Analysis. Source BioChem. 6(3) (no pagination), 2026. Article Number: 24. Date of Publication: 01 Sep 2026. Author Abdullahi A.M.; Abdullahi I.M.; Abdurrahman A.Z. Institution (Abdullahi) Department of Life Sciences, University of South Wales, Pontypridd, United Kingdom (Abdullahi) GP Surgery, University of Portsmouth NHS Trust, Waterlooville, United Kingdom (Abdurrahman) Department of Family Medicine, Fylde Coast Medical Services, NHS Trust, Blackpool, United Kingdom Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Arterial ischemic stroke (AIS) is not common in pediatric patients; however, it causes significant morbidity and mortality. Reperfusion therapies, including intravenous thrombolysis (IVT) and endovascular mechanical thrombectomy (EVT) are established standards of care in selected adults with acute ischemic stroke; however, their safety and functional outcomes in the pediatric population remain poorly defined. Objective(s): To assess the safety and functional outcomes of reperfusion therapies in children with AIS. Method(s): A systematic search was conducted across major databases including PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane Library. Studies reporting on pediatric patients aged 18 years or less treated with IVT, EVT, or both for acute AIS were included. The primary safety outcome was the risk of developing symptomatic intracerebral hemorrhage (sICH). Primary functional outcomes were 90-day functional independence, measured via the Pediatric Modified Rankin Scale (Ped-mRS <= 2) or Pediatric Stroke Outcome Measure (PSOM <= 1). Secondary outcomes measured included successful recanalization (Modified Thrombolysis in Cerebral Ischemia [mTICI] grade 2b/3), and death due to any cause at 90 days. Result(s): Successful angiographic recanalization evaluated across thrombectomy and bridging arm cohorts revealed high success rate with the pooled proportion of 87.4% (95% CI: 79.1-93.9%). Reperfusion therapies are associated with significant early neurological recovery and favorable 90-day functional outcomes (Ped-mRS 0-2 achieved in a substantial majority of treated cohorts), when compared to the best medical treatment (BMT) controls. The overall rate of sICH remains low (<2%), demonstrating a much better safety profile comparable to adult benchmarks. Conclusion(s): Acute reperfusion therapies in pediatric AIS are associated with high rates of recanalization and favorable functional outcomes and had low observed rates of symptomatic intracranial hemorrhage in selected pediatric observational cohorts. However, given the absence of randomized controlled trials, these findings reflect observational associations and must be interpreted with appropriate clinical caution. Therefore, there is need for further prospective international studies capable of generating higher-quality evidence to guide future pediatric stroke management. Copyright © 2026 by the authors. <21> Accession Number 2049518233 Title Immediate Versus Staged Complete Revascularization in Multivessel Disease and STEMI. Source JACC: Cardiovascular Interventions. 19(19) (pp 2589-2600), 2026. Date of Publication: 12 Oct 2026. Author O'Callaghan D.; Rai H.; Giacoppo D.; Coughlan J.J.; Colleran R.; Durand R.; Spence M.S.; Kennedy M.; Blake G.J.; Hanratty C.G.; Kastrati A.; Byrne R.A. Institution (O'Callaghan, Rai, Giacoppo, Coughlan, Colleran, Durand, Spence, Kennedy, Blake, Hanratty, Byrne) Cardiovascular Research Institute, Mater Private Network, Dublin, Ireland (O'Callaghan, Rai, Giacoppo, Coughlan, Colleran, Spence, Kennedy, Byrne) School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland (Kastrati) TUM Klinikum Deutsches Herzzentrum, Munich, Germany Publisher Elsevier Inc. Abstract Background For patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease, complete revascularization is recommended. The timing of nonculprit lesion intervention, either immediately during the index procedure or staged at a later time, has been investigated in randomized controlled trials (RCTs). Objectives This study sought to perform a meta-analysis of RCTs comparing immediate vs staged complete revascularization in patients with multivessel disease presenting with STEMI. Methods We conducted a frequentist, pairwise meta-analysis. Studies were selected based on the following inclusion criteria: multicenter RCTs comparing immediate vs staged nonculprit revascularization in patients presenting with STEMI; exclusive use of second-generation (or newer) drug-eluting stents; a follow-up duration of >=1 year; and publication in a peer-reviewed journal. The primary outcome of interest was all-cause mortality, whereas secondary outcomes included myocardial infarction (MI), cardiac death, and unplanned revascularization. Summary estimates were computed using random-effects models with inverse-variance weighting based on trial-level HRs and 95% CIs. The study protocol was registered on PROSPERO (CRD420251124207). Results After a systematic search, 4 randomized trials comprising 2,651 patients were included in the meta-analysis. The risk of all-cause death at 1-year was higher with immediate complete revascularization (HR: 1.50; 95% CI: 1.02-2.21; P = 0.04; prediction interval [PI]: 0.80-2.81; I 2 = 0%; t 2 = 0). Immediate complete revascularization reduced the risk of recurrent MI when using the protocol specified definitions which included procedural MI (HR: 0.58; 95% CI: 0.36-0.94; P = 0.02; PI: 0.22-1.54; I 2 = 0%; t 2 = 0.034) but did not reduce risk of spontaneous MI (HR: 0.91; 95% CI: 0.55-1.48; P = 0.90; PI: 0.41-2.00; I 2 = 0%; tau2 = 0.00). The risk of cardiac death and unplanned revascularization was comparable between the treatment groups. Conclusions In STEMI and multivessel disease, immediate complete revascularization may be associated with an increased risk of all-cause death at 1-year when compared with staged complete revascularization. The treatment effect on mortality should be interpreted cautiously because of the relatively low number of deaths across the 4 trials and the statistical fragility of the findings. The findings from this analysis do not support an immediate complete revascularization strategy in these patients. Copyright © 2026 American College of Cardiology Foundation. <22> Accession Number 2038654663 Title A COMPARATIVE STUDY BETWEEN THE EFFECTS OF CISATRACURIUM AND ATRACURIUM FOR ABDOMINAL SURGERIES IN TERTIARY CARE HOSPITAL. Source International Journal of Medicine and Public Health. 16(3) (pp 5051-5058), 2026. Date of Publication: 01 Jul 2026. Author G G.V.; Kamala L.; Naik R.P. Institution (G, Naik) Department of Anesthesia, Osmania Medical College, Koti, Telangana, Hyderabad, India (Kamala) Department of Chemistry, GDC Shadnagar, Telangana, Shadnagar, India Publisher Pink Petals Publications Pvt Ltd Abstract Background: Neuromuscular blocking agents are an essential component of general anaesthesia for abdominal surgery, providing optimal conditions for tracheal intubation and surgical exposure. Atracurium and cisatracurium are intermediate-acting, non-depolarizing neuromuscular blocking agents with organ-independent elimination. However, differences in onset of action, surgical-site relaxation, haemodynamic effects, and histamine-related adverse effects may influence their clinical utility. Aim(s): To compare the clinical effects of cisatracurium 0.1 mg/kg and atracurium 0.5 mg/kg, corresponding to approximately 2 x ED95, in patients undergoing elective abdominal surgery under general anaesthesia, with particular emphasis on intubating conditions, surgical-site muscle relaxation, haemodynamic changes, and clinically apparent adverse effects. Material(s) and Method(s): This randomized comparative study included 60 adult patients aged 16-60 years, classified as American Society of Anesthesiologists (ASA) physical status I or II, undergoing elective abdominal surgery under general anaesthesia. Patients were randomly allocated into two groups of 30 each. Group I received atracurium 0.5 mg/kg intravenously, while Group II received cisatracurium 0.1 mg/kg intravenously. Standardized anaesthetic management and perioperative monitoring were used. Ease of tracheal intubation, quality of surgical-site relaxation, heart rate, systolic, diastolic and mean arterial blood pressure, end-tidal carbon dioxide, and clinically apparent features suggestive of histamine release were assessed. Result(s): Good intubating conditions were observed in 80.0% of patients receiving atracurium and 70.0% receiving cisatracurium. Excellent surgical-site relaxation was observed significantly more frequently with cisatracurium (73.3%) than with atracurium (20.0%) (chi2=17.14, p=0.000104). Heart rate increased in both groups, with the maximum increase occurring at intubation, followed by a gradual decline toward baseline. Similar peri-intubation changes were observed in blood pressure. Baseline heart rate and systolic blood pressure differed significantly between the groups, whereas baseline diastolic blood pressure and end-tidal carbon dioxide were comparable. No clinically apparent flushing, bronchospasm, or hypotension attributable to histamine release was observed in either group. Conclusion(s): Haemodynamic changes were observed predominantly around tracheal intubation and subsequently tended toward baseline values. No clinically apparent histamine-related adverse reactions were observed with either agent. The findings should be interpreted considering the small sample size and baseline differences in heart rate and systolic blood pressure between the groups. Copyright © 2026, Pink Petals Publications Pvt Ltd. All rights reserved. <23> Accession Number 2046881207 Title Comparative outcomes of balloon-expandable and self-expanding valves in transcatheter aortic valve replacement: A systematic review and meta-analysis. Source Journal of Cardiology. 88(4) (pp 297-320), 2026. Date of Publication: 01 Oct 2026. Author Hafez A.; Sobhy A.; Elshahat A.; Bruce D.; Saad O.A.; Ashour M.; Ali K.; Shebl M.A.; Bolla A.K.; Usmani R.; Aboudabash M.; Arafa A.; Shehata S.A.; Abdellatif N.; Alagab A.; Eldessouki A.; Riccelli R.; Gir D.; Elzewiei G.Y.A.; Toraih E.A.; Aiash H. Institution (Hafez) Cardiovascular Medicine Department, Mayo Clinic, Phoenix, AZ, United States (Sobhy) Faculty of Medicine, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Elshahat, Saad) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Bruce) Tulane University School of Medicine, New Orleans, LA, United States (Ashour) College of Human Medicine, Banha University, Banha, Egypt (Ali) Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, United States (Shebl) Faculty of Medicine, Cairo University, Cairo, Egypt (Bolla) Meinig School of Biomedical Engineering, Cornell University, NY, United States (Usmani) Syracuse University, College of Arts and Sciences, NY, United States (Aboudabash) School of Medicine, New Giza University, Giza, Egypt (Arafa) Faculty of Medicine, Alexandria University, Alexendria, Egypt (Shehata, Eldessouki, Aiash) Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt (Abdellatif) Gulf Medical University, Ajman, United Arab Emirates (Alagab) Faculty of Medicine, Tripoli University, Tripoli, Libyan Arab Jamahiriya (Riccelli) Christain Brothers Academy, NY, United States (Gir) St. Joseph's Medical Center, CA, United States (Elzewiei) Department of Medicine, Tobruk University, Tobruk, Libyan Arab Jamahiriya (Toraih, Aiash) Cardiovascular Perfusion Department, SUNY Upstate Medical University, Syracuse, NY, United States (Toraih) Genetics Unit, Faculty of Medicine, Suez Canal University, Ismailia, Egypt Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background Balloon-expandable valves (BEVs) and self-expanding valves (SEVs) are the two primary platforms for transcatheter aortic valve replacement (TAVR), differing in design, deployment, and hemodynamic performance. Comparative evidence on their clinical and procedural outcomes remains limited and inconsistent. Methods A systematic review and meta-analysis were conducted, searching PubMed, Scopus, Web of Science, and Cochrane Library up to July 2025 for studies comparing BEVs and SEVs in adults with severe aortic stenosis undergoing transfemoral TAVR. Outcomes included all-cause mortality, cardiovascular mortality, stroke, permanent pacemaker implantation, hemodynamic parameters, device success, and safety endpoints. Dichotomous and continuous outcomes were pooled as risk ratios (RR) and mean differences (MD) with corresponding 95% confidence intervals (CI) using a random-effects model. Results Fifty-three studies ( n = 157,921) were included (6 randomized controlled trials, 12 prospective, and 35 retrospective cohorts). BEVs showed significant early survival benefits at 1 month (RR = 0.75, 95% CI 0.57-0.97, p = 0.03) and 6 months (RR = 0.33, 95%CI0.18-0.60, p < 0.001), with reduced cardiovascular mortality at 12 months (RR = 0.88, 95% CI 0.79-0.99, p = 0.03). Permanent pacemaker implantation rates were consistently lower with BEVs (e.g. RR = 0.75, 95% CI 0.64-0.88, p < 0.001 at 1 month). SEVs exhibited superior hemodynamics, with lower mean gradients (MD = -3.16 to -7.77 mmHg) and larger aortic valve areas (MD = +0.11 to +0.13 cm2). Long-term mortality and safety outcomes, including major bleeding, vascular complications, and myocardial infarction, were comparable. Conclusion BEVs offer early survival and conduction preservation advantages, while SEVs provide superior hemodynamic performance. These findings highlight the importance of individualized valve selection based on patient-specific factors. Further randomized trials with extended follow-up are needed to evaluate long-term durability and outcomes in diverse patient populations. Copyright © 2026 Japanese College of Cardiology. <24> Accession Number 2048832068 Title Dynamic parameter-guided goal-directed fluid therapy and postoperative acute kidney injury in non-cardiac surgery: a meta-analysis of 11 randomized controlled trials. Source Journal of Anesthesia. 40(5) (pp 838-847), 2026. Date of Publication: 01 Oct 2026. Author Sun X.; Liu Y.; Ren W. Institution (Sun, Liu, Ren) Department of Anesthesiology, Tianjin Hospital, No. 406, Jiefang South Road, Hexi District, Tianjin, China Publisher Springer Abstract The efficacy of goal-directed fluid therapy (GDFT) in preventing postoperative acute kidney injury (AKI) remains controversial. This meta-analysis specifically examined dynamic parameter-guided GDFT using fluid challenges alone in non-cardiac, non-transplant surgery. We systematically searched PubMed, Embase, and the Cochrane Library from inception to December 25, 2025. Randomized controlled trials comparing dynamic index-guided GDFT (SVV, PPV, or PVI) with conventional fluid management in adults undergoing major non-cardiac surgery were included. The primary outcome was postoperative AKI. Subgroup analyses by surgical site and monitoring device invasiveness were pre-specified. The GRADE framework was used to assess evidence certainty. Eleven RCTs comprising 1698 patients were included. Overall, GDFT did not significantly reduce postoperative AKI compared with conventional management (OR 0.93; 95%CI 0.59-1.45; low certainty evidence). No significant differences were observed in 180-day mortality (OR 1.30; 95%CI 0.28-5.99; very low certainty evidence) or ICU length of stay (MD -0.20 days; 95%CI -1.72 to 1.31; very low certainty evidence). GDFT was associated with significantly higher intraoperative colloid administration (MD 167.51 mL; 95% CI 36.02-299.01; very low certainty evidence), though with substantial heterogeneity. Subgroup analysis by surgical site showed no significant differences between groups. A pre-specified subgroup analysis by monitoring device invasiveness showed a significant interaction: invasive devices showed no benefit (OR 1.10; 95%CI 0.78-1.55; very low certainty evidence), while minimally invasive/non-invasive devices were associated with reduced AKI risk (OR 0.13; 95%CI 0.02-0.79; very low certainty evidence), though based on only two small studies. In this meta-analysis, dynamic parameter-guided GDFT did not significantly reduce postoperative AKI in non-cardiac, non-transplant surgery compared with conventional management (low certainty evidence). The substantial heterogeneity in colloid administration highlights variability in GDFT protocols across studies. Trial Registration: PROSPERO Registration, CRD420251274571. Copyright © The Author(s), under exclusive licence to Japanese Society of Anesthesiologists 2026. <25> Accession Number 2042408145 Title Vacuum-assisted venous drainage versus gravitational venous drainage in patients undergoing cardiac surgery: A meta-analysis. Source Perfusion (United Kingdom). 41(7) (pp 1177-1189), 2026. Date of Publication: 01 Oct 2026. Author Motawea K.R.; Gadelmawla A.F.; Ibrahim M.M.; Soliman T.; Kheuka Y.A.; Tzagournis A.; El Diasty M.; Abu-Omar Y.; Pelletier M. Institution (Motawea, Tzagournis, El Diasty, Abu-Omar) Department of Cardiac Surgery, University Hospitals Cleveland Medical Center, Cleveland, OH, United States (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Gadelmawla) Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, United States (Ibrahim) Deapartment of Cardiology, Banner University Medical Center, Phoenix, AZ, United States (Soliman) Department of Cardiothoracic Surgery, Sheikh Zayed Specialized Hospital, Giza, Egypt (Kheuka) Department of Medicine, Azerbaijan Medical University, Baku, Azerbaijan (Pelletier) Division of Cardiac Surgery, Yale School of Medicine, New Haven, CT, United States Publisher SAGE Publications Ltd Abstract Introduction: Vacuum-assisted venous drainage (VAVD) has been proposed as a better alternative option than conventional gravitational venous drainage (GVD) in cardiac surgery. However, the literature reports conflicting results between both methods in terms of post-cardiac surgery complications. Therefore, we aimed to perform a meta-analysis to compare clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery. Method(s): PubMed, Scopus, and Web of Science databases were searched for any randomized control trials or cohort studies that compared clinical outcomes between VAVD and GVD in patients undergoing cardiac surgery. Result(s): Sixteen studies with 8426 patients were included in our study. The pooled effect estimate of the postoperative results showed a statistically significant association between VAVD and decreased blood loss/chest tube drainage (MD = -88.7, 95% CI = -154.71 to -22.69, p-value = 0.008), amount of packed red blood cells (pRBC) transfusion (MD = -0.25, 95% CI = -0.27 to -0.22, p < 0.00,001), re-exploration (RR = 0.6, 95% CI = 0.35 to 1, p = 0.05), and re-operation (RR = 0.47, 95% CI = 0.23 to 0.99, p-value = 0.05). However, our study revealed no significant difference between both groups in terms of postoperative mortality, hospital/ICU stay, other blood product transfusions, change of free hemoglobin at 24 h, and other clinical outcomes. Conclusion(s): Our study revealed that VAVD is at least equivalent and may provide some benefits compared to GVD in patients undergoing cardiac surgery. While, VAVD requires specific expertise and training in order to optimize its outcomes, its ability to reduce blood loss and blood transfusion, support its use as a valuable alternative for GVD in high-risk groups. Copyright © The Author(s) 2025 <26> Accession Number 2045634658 Title Long-Term Outcomes of Balloon Versus Surgical Aortic Valvuloplasty in Pediatric Patients with Congenital Aortic Valve Stenosis: A Meta-Analysis. Source World Journal for Pediatric and Congenital Heart Surgery. 17(6) (pp 843-854), 2026. Date of Publication: 01 Nov 2026. Author Atta K.; Abdelaziz A.; Ramadan S.; Gadelmawla A.F.; Murad M.R.; Sobhy A.; Abdelaziz M.; Elbassiouni H.; Esawy A.; Shirokova A.A.; Samoshkina E.S. Institution (Atta, Abdelaziz, Ramadan, Gadelmawla, Murad, Sobhy, Abdelaziz, Esawy) Medical Research Group of Egypt (MRGE), Negida Academy, Arlington, MA, United States (Atta, Elbassiouni) Institute of Medicine, National Research Mordovia State University (MRSU), Saransk, Russian Federation (Abdelaziz) Division of Cardiology, Montefiore Health System/Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States (Ramadan) Faculty of Medicine, Ain Shams University, Ain Shams, Egypt (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Murad, Abdelaziz) Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Sobhy) Faculty of Medicine, Kafr-Elsheikh University, Kafr-Elsheikh, Egypt (Esawy) Faculty of Medicine, Mansoura University, Mansoura, Egypt (Shirokova, Samoshkina) Department of Pediatrics of the Medical Institute, National Research Mordovia State University (MRSU), Saransk, Russian Federation Publisher SAGE Publications Inc. Abstract Background: Congenital aortic valve stenosis (AVS) is the most common cause of ventricular outflow tract obstruction. Surgical aortic valvuloplasty (SAV) and balloon aortic valvuloplasty (BAV) are the most common primary interventions, with conflicting data regarding their long-term outcomes. We aimed to study the long-term clinical outcomes of patients allocated to BAV or SAV. Method(s): We searched PubMed, Scopus, Web of Science, and Cochrane CENTRAL through August 2025 for relevant studies reporting long-term outcomes of SAV versus BAV in patients with congenital AVS. The primary outcome was the 10-year rate of aortic valve replacement (AVR). Subgroup analysis was performed for all clinical outcomes according to the age of the included children. Result(s): A total of nine trials including 1704 patients (67%, [1136/1704]) males; median follow-up of 10 years) were included. The pooled estimate showed that SAV was associated with lower long-term reintervention rates (risk ratio 0.76, 95% confidence interval (CI): 0.6 to 0.96, P = .02), and a significant reduction in peak aortic gradient pressure (PAGP) (mean difference (MD) -11.53 mm Hg, 95% CI: -18.66 to -4.41, P < .001) in patients more than 1 year of age. In addition, SAV was associated with a longer time to first reintervention in patients younger than 1 year of age (MD 2.43 years, 95% CI: 0.68 to 4.19, P = .01). There was no significant difference regarding the primary outcome or other studied outcomes. Conclusion(s): In patients with congenital aortic valve stenosis, SAV showed the greatest benefit in children older than 1 year of age with similar AVR and mortality rates; but superior durability, lower reintervention rates, and greater reductions in peak aortic pressure gradient when compared with BAV. Copyright © The Author(s) 2026 <27> [Use Link to view the full text] Accession Number 2035513246 Title Comparison of Ultrasound-guided Single-injection Erector Spinae Plane Block, Retrolaminar Block, and Paravertebral Block for Postoperative Analgesia in Single-incision Video-assisted Thoracoscopic Surgery: A 3-arm, Double-blind, Randomized Controlled Noninferiority Trial. Source Clinical Journal of Pain. 41(1) (no pagination), 2025. Article Number: e1259. Date of Publication: 01 Jan 2025. Author Zhu Y.; Yang Y.; Zhang Q.; Li X.; Xue W.; Liu Y.; Zhao Y.; Xu W.; Yan P.; Li S.; Fang Y.; Huang J. Institution (Zhu, Yang, Zhang, Li, Xue, Liu, Zhao, Xu, Yan, Li, Fang, Huang) Department of Anesthesiology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China Publisher Lippincott Williams and Wilkins Abstract Objective: - Effective postoperative analgesia is critical for thoracic surgery. This study compares the analgesic efficacy of the erector spinae plane block (ESPB), retrolaminar block (RLB), and paravertebral block (TPVB) in single-incision video-assisted thoracoscopic surgery (SITS). Method(s): - Seventy-six patients underwent general anesthesia followed by ultrasound-guided nerve blocks with 20 mL of 0.5% ropivacaine. Primary outcomes included the area under the curve (AUC) of numeric rating scale (NRS) scores during rest and coughing over 24 hours. Secondary outcomes included perioperative opioid use, plasma biomarkers, and postoperative recovery measures. Result(s): - The AUC for NRS was 107.8+/-10.53 in the ESPB group, 104.8+/-8.05 in the RLB group, and 103.6+/-10.42 in the TPVB group, demonstrating noninferiority for ESPB (difference: 4.2+/-3.0, 95% CI: -1.82 to 10.22) and RLB (difference: 1.2+/-2.6, 95% CI: -3.97 to 6.37) compared with TPVB. No statistically significant differences were observed in opioid use, plasma biomarkers, QoR-15 scores, or adverse events. Discussion(s): - ESPB and RLB provide noninferior analgesia compared with TPVB in SITS patients and are effective alternatives that enhance safety. Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved. <28> Accession Number 652211466 Title Impact of Left Internal Mammary Artery-to-Left Anterior Descending Artery Anastomotic Location on Graft Patency: A Secondary Analysis of the PATENCY Trial Data Set. Source Journal of the American Heart Association. 15(19) (pp e051333), 2026. Date of Publication: 06 Oct 2026. Author Wang C.; Tian M.; Wang Y.; Hou Z.; Feng W.; Zhang Y.; Hu Z. Institution (Wang, Tian, Feng, Zhang, Hu) Department of Cardiovascular Surgery Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China, China (Wang) Medical Research and Biometrics Center, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China, China (Hou) Department of Radiology Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing China, China Abstract BACKGROUND: The impact of the left internal mammary artery (LIMA)-to-left anterior descending artery (LAD) anastomotic location on graft patency remains uncertain. METHOD(S): This study included 1597 patients with isolated proximal LAD lesions from the PATENCY (Graft Patency Between no-touch Vein Harvesting Technique and Conventional Approach in Coronary Artery Bypass Graft Surgery) trial who underwent coronary artery bypass grafting. The relative anastomotic site (RAS) of the LIMA-LAD anastomosis was quantified using postoperative coronary computed tomography angiography and defined as the ratio of anastomotic height/heart height. The primary end point was LIMA occlusion at 3 years, and the secondary end point was major adverse cardiac events. Multivariable logistic regression was used to evaluate the association between RAS and 3-year LIMA occlusion, and Cox proportional hazards regression was used to evaluate associations with time-to-event clinical outcomes. RESULT(S): The exploratory RAS threshold was 46%. Distal anastomosis (RAS >46%) was associated with a significantly lower 3-year LIMA occlusion rate compared with proximal anastomosis (RAS <=46%) (2.3% versus 6.3%; adjusted odds ratio, 0.37 [95% CI, 0.20-0.68]; P=0.002). At 3 years, major adverse cardiac event rates were similar between groups (3.4% versus 4.4%; adjusted hazard ratio, 0.68 [95% CI, 0.40-1.15]; P=0.16). CONCLUSION(S): In patients with isolated proximal LAD disease, a more distal LIMA-LAD anastomotic location may be associated with a lower risk of graft occlusion at 3 years. Further prospective validation is warranted. <29> Accession Number 2049883756 Title Coronary Revascularization of Ischemic Territories Improves Myocardial Perfusion, Increases Submaximal Aerobic Capacity and Reduces Exercise-induced Angina in Patients With Chronic Coronary Syndrome. Source American Journal of Cardiology. 278 (pp 30-37), 2026. Date of Publication: 01 Nov 2026. Author Mosen H.; Szekely A.; Steding-Ehrenborg K.; Akil Engblom S.; Hedeer F.; Arheden H.; Erlinge D.; Engblom H. Institution (Mosen, Szekely, Steding-Ehrenborg, Akil Engblom, Hedeer, Arheden, Engblom) Department of Clinical Physiology, Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden (Erlinge) Department of Cardiology, Clinical Sciences Lund, Lund University and Skane University Hospital, Lund, Sweden Publisher Elsevier Inc. Abstract Chronic coronary syndrome (CCS) is associated with reduced stress perfusion, a predictor of adverse cardiovascular outcome. To what extent myocardial perfusion is related to cardiorespiratory fitness is not completely known. The aim was to investigate if change in myocardial perfusion correlates to change in aerobic capacity after revascularization. Sixty-two patients with suspected or established CCS underwent cardiopulmonary exercise testing (CPET) and [13N]NH<inf>3</inf> positron emission tomography (PET) before and after elective invasive coronary angiography. Thirty-six patients were revascularized and 26 were not. The angiographer was blinded to the results from CPET and PET. Myocardial perfusion was defined as decreased when below 2 ml/min/g and as myocardial perfusion reserve (MPR) <2. Change in oxygen uptake at submaximal effort (VO<inf>2</inf> at AT) correlated positively to change in MPR in revascularized patients (r = 0.36, p = 0.04), but not in conservatively treated patients (r = 0.03, p = 0.90). Change in VO<inf>2</inf> peak, however, did not correlate to change in myocardial perfusion in any of the groups. Myocardial perfusion at stress and MPR increased significantly after revascularization, when baseline perfusion was decreased (p = 0.01 stress and p = 0.001 MPR, respectively). Furthermore, the number of patients with exercise-induced angina decreased significantly for the revascularized patients (42% (14/33) at baseline versus 3% (1/33) at follow-up, p <0.001) whereas half of the conservatively treated patients still had exercise-induced angina at follow-up (42% (10/24) at baseline versus 21% (5/24) at follow-up, p = 0.12). In conclusion, change in myocardial perfusion correlates with change in submaximal aerobic capacity after revascularization and revascularization reduces exercise-induced angina. Copyright © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <30> Accession Number 2046120436 Title The European bifurcation club randomized trial of stepwise provisional stenting vs drug-coated balloon therapy for nonleft main true coronary bifurcations: The EBC DCB trial. Source American Heart Journal. 300 (no pagination), 2026. Article Number: 107463. Date of Publication: 01 Oct 2026. Author Broyd C.J.; Arunothayaraj S.; Scheller B.; Eccleshall S.; Lassen J.F.; Stankovic G.; Hildick-Smith D. Institution (Broyd, Hildick-Smith) Sussex Cardiac Centre, Royal Sussex County Hospital, Brighton, United Kingdom (Broyd, Hildick-Smith) University of Sussex, East Sussex, United Kingdom (Arunothayaraj) St Vincent's Hospital, Melbourne, Australia (Scheller) Clinical and Experimental Interventional Cardiology, Saarland University, Homburg, Germany (Eccleshall) Norfolk and Norwich University Hospitals NHS Trust, Norwich, United Kingdom (Eccleshall) Norwich Medical School, University of East Anglia, Norwich, United Kingdom (Lassen) Department of Cardiology B, Odense University Hospital, and University of Southern Denmark, Odense, Denmark (Stankovic) Department of Cardiology, University Clinical Center of Serbia, and Faculty of Medicine, University of Belgrade, Belgrade, Serbia Publisher Elsevier Inc. Abstract Background Drug-eluting stents (DES) are associated with a 2% annual failure rate and have worse outcomes at coronary bifurcations. Recent randomized control data have shown the noninferiority of drug-coated balloons (DCB) vs stents at 1 year. Possible benefits of DCBs include the lack of a metal prosthesis, absence of stent malapposition, lack of obligate antiplatelet treatment, and maintenance of vessel geometry and function. Hypothesis The use of DCBs in the treatment of nonleft main bifurcation disease is noninferior to a DES strategy for Target Bifurcation Failure at 1 year. Strategy Design The EBC DCB trial is a nonblinded, investigator-initiated, randomized control trial that will recruit 750 patients with nonleft main bifurcations requiring revascularization. Both main vessel and side branch must have significant atheroma. Subacute (NSTEMI and unstable angina) and elective presentations will be eligible for inclusion. Patients will be randomized to either a step-wise provisional DES or a DCB strategy. Major exclusion criteria include STEMI in the previous 48 hours, chronic total occlusions, and in-stent restenosis. The primary endpoint of Target Bifurcation Failure is a composite of cardiovascular death, target bifurcation myocardial infarction, or target bifurcation revascularization. Patients will be followed up at 6 months, 1, 3, 5, and 8 years. If noninferiority is met, superiority will be tested. Summary EBC DCB is an open-label, multicenter, international randomized control trial comparing the use of DCB and DES in the treatment of coronary artery bifurcation disease. The trial is registered at clinicaltrials.gov (NCT06822322). Copyright © 2026 Elsevier Inc. <31> Accession Number 2044395174 Title Skeletonized vsPedicled LIMA in Diabetic Patients Undergoing CABG: A Meta-Analysis. Source Thoracic and Cardiovascular Surgeon. 74(7) (pp 570-576), 2026. Date of Publication: 01 Oct 2026. Author Onyeji P.; Momplaisir-Onyeji S.; Consoli L.; Dani S.; Passos F.S.; Doenst T.; Kirov H.; Caldonazo T. Institution (Onyeji) All Saints University School of Medicine, Saint George Parish, Roseau, Dominica (Momplaisir-Onyeji) American University of Barbados School of Medicine, Saint Michael, Saint Michael, Barbados (Consoli) Universidade Federal da Bahia, Bahia, Salvador, Brazil (Dani) GMERS Medical College and Hospital, Ahmedabad, Gujarat, Sola, India (Passos) Mater Dei Hospital, Salvador, Brazil (Doenst) Department of Cardiothoracic Surgery, University Hospital Jena, Jena, Germany (Kirov, Caldonazo) Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, University Hospital, Jena, Germany Publisher Georg Thieme Verlag Abstract Background The left internal mammary artery (LIMA) remains the preferred conduit for coronary artery bypass grafting (CABG). However, diabetic patients face an increased risk of deep sternal wound infection (DSWI), particularly after pedicled LIMA harvesting, which may impair sternal perfusion. Skeletonized harvesting preserves sternal vascularity and may reduce infection risk, but current evidence remains limited and inconsistent. Methods Three different databases were assessed. The primary outcome was the occurrence of DSWI. Secondary outcomes were hospital length of stay (LOS), cardiopulmonary bypass (CPB) time, blood transfusion rates, and aortic cross-clamp time. A random effects model was performed. Results Three retrospective studies involving 400 diabetic patients were included, of whom 190 underwent skeletonized and 210 pedicled LIMA harvesting. Skeletonized harvesting was associated with significantly reduced risk of DSWI (odds ratio [OR]: 0.25; 95% confidence interval [CI]: 0.07-0.88; p = 0.031). CPB (mean difference [MD]: 3.03 minutes; 95% CI: 1.18-4.88; p = 0.001) and aortic cross-clamp times (MD: 3.06 minutes; 95% CI: 2.03-4.10; p < 0.001) were slightly longer in the skeletonized group. No significant differences were observed in hospital LOS (p = 0.159) or blood transfusion requirements (p = 0.959). Conclusion Skeletonized LIMA harvesting is associated with lower odds of DSWI in diabetic patients undergoing CABG, despite modestly longer operative times. Copyright © 2026. Thieme. All rights reserved. <32> Accession Number 2045614060 Title Efficacy of Dexmedetomidine in Preventing Postoperative Delirium in Patients Undergoing Brain Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Source Neurocritical Care. 45(2) (pp 737-749), 2026. Date of Publication: 01 Oct 2026. Author dos Reis M.A.O.M.; de Assis E.B.T.; Swamy H.K.; Matos B.C.M.; Ferreira M.Y.; Ben-Shalom N.; Polverini J.E.R.; Polverini A.D. Institution (dos Reis, Matos) Faculty of Medicine, Universidad Nacional de Rosario, Santa Fe, Rosario, Argentina (de Assis, Swamy) Faculty of Medicine, Baltic Federal University, Kaliningrad Oblast, Kaliningrad, Russian Federation (Ferreira, Ben-Shalom) Department of Neurosurgery, Northwell Health Hospital, New York, NY, United States (Polverini) Department of Anaesthesiology, Barretos Cancer Hospital, SP, Barretos, Brazil (Polverini) Neurosurgical Oncology Division, Barretos Cancer Hospital, SP, Barretos, Brazil Publisher Springer Abstract Background: Dexmedetomidine (DEX), a selective alpha-2 adrenergic receptor agonist, is widely used in various surgical settings, including cardiac and general surgeries, for its sedative, analgesic, and neuroprotective properties. Patients undergoing brain surgery are particularly susceptible to postoperative delirium (POD). Given the established benefits of dexmedetomidine in other surgical fields, its potential to mitigate delirium in neurosurgery warrants investigation. Method(s): A systematic search of PubMed, Embase, Scopus, and Cochrane databases was conducted from inception to January 2025 and updated in April 2025, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Risk of bias was assessed, and a meta-analysis was performed using Review Manager 5.4.1. Five randomized controlled trials were included, evaluating the efficacy of DEX in preventing POD in adult patients undergoing brain surgery. Result(s): A total of 646 patients were enrolled, with DEX administered with a loading dose ranging from 0.5 to 1 mug/kg over 10 min, followed by a maintenance infusion rate of 0.1 to 0.5 mug/kg/h during the surgical procedure. The pooled risk ratio (RR) for POD with DEX was 0.47 (95% confidence interval (CI): 0.35-0.63; p < 0.00001); reflecting a 53% reduction in the risk of postoperative delirium, with no statistical heterogeneity detected (chi2 = 2.09, degrees of freedom (df) = 4, p = 0.72; I2 = 0%). Subgroup analyses showed similar effect estimates across brain tumor and other cranial procedures. Adverse events were comparable between groups and generally mild. Conclusion(s): This meta-analysis found that perioperative dexmedetomidine was associated with a significant reduction in postoperative delirium risk in neurosurgical patients. Further multicenter trials are needed to confirm these findings and to refine optimal administration strategies. Copyright © Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2026. <33> Accession Number 652095007 Title Tricuspid-Valve Intervention in Heart Failure. Source The New England journal of medicine. 395(14) (pp 1363-1373), 2026. Date of Publication: 08 Oct 2026. Author Hausleiter J.; Stocker T.J.; Geisler T.; Lurz P.; Rottbauer W.; Lubos E.; Schofer N.; Frerker C.; Frank J.; Thiele H.; Osteresch R.; Rudolph V.; Lauten A.; Xhepa E.; Rothe J.; Rassaf T.; Baldus S.; Nickenig G.; Leistner D.M.; Tigges E.; Kehl V.; Kessler M.; Kister T.; Ruf T.; Gercek M.; Gawaz M.; Frank D.; Eitel I.; von Bardeleben R.S.; Kalbacher D.; Soliman O.; Nabauer M.; Massberg S. Institution (Hausleiter, Stocker, Nabauer, Massberg) Department of Medicine I, LMU University Hospital, Ludwig-Maximilians-Universitat Munchen, Munich, Germany (Hausleiter, Stocker, Xhepa, Massberg) German Center for Cardiovascular Research (DZHK) Partner Site Munich Heart Alliance, Munich, Germany (Geisler, Gawaz) Department of Cardiology and Angiology, Eberhard Karls University Tubingen, Tubingen, Germany (Lurz, Ruf, von Bardeleben) Department of Cardiology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany (Lurz, Leistner, Ruf, von Bardeleben) DZHK Partner Site Rhine-Main, Germany (Rottbauer, Kessler) Department of Cardiology, University Heart Center, Ulm, Germany (Lubos) Department of Cardiology, Asklepios Klinik Barmbek, Hamburg, Germany (Schofer, Kalbacher) Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany (Schofer) Department of Cardiology, Electrophysiology, Pulmonology, General Internal Medicine, Germany (Schofer, Frerker, Frank, Thiele, Frank, Eitel, Kalbacher) DZHK Partner Site North, Germany (Frerker, Eitel) University of Luebeck, Heart Center, Germany (Frerker, Eitel) Department of Cardiology, Angiology, Intensive Care Medicine, University Hospital Schleswig-Holstein, Germany (Frank, Frank) Department of Cardiology and Internal Intensive Medicine, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany (Thiele, Kister) Department of Cardiology, Heart Center Leipzig, Leipzig University, Leipzig, Germany (Osteresch) Bremen Institute for Heart and Circulation Research, Klinikum Links der Weser, Bremen, Germany (Rudolph, Gercek) Heart and Diabetes Center North Rhine-Westphalia, Department of General and Interventional Cardiology/Angiology, Ruhr University Bochum, Bad Oeynhausen, Germany (Lauten) Department of General and Interventional Cardiology and Rhythmology, Helios Klinikum Erfurt, Health and Medical University Erfurt, Erfurt, Germany (Xhepa) Department of Cardiovascular Diseases, TUM Klinikum Deutsches Herzzentrum, Technical University of Munich, Munich, Germany (Rothe) Department of Cardiology and Angiology, University Heart Center Freiburg-Bad Krozingen, Bad Krozingen, Germany (Rothe) Department of Medicine, Freiburg University, Freiburg im Breisgau, Germany (Rassaf) Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany (Baldus) Department of Cardiology, University Hospital Cologne, Cologne, Germany (Nickenig) Heart Center University Hospital Bonn, Bonn, Germany (Leistner) Department of Cardiology and Angiology, Goethe University, Frankfurt am Main, Germany (Tigges) Department of Cardiology and Intensive Care Medicine, Asklepios Clinic St. Georg, Hamburg, Germany (Kehl) Munchner Studienzentrum, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany (Kehl) Biostatistics and Clinical Epidemiology, Institute for AI and Informatics in Medicine, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany (Soliman) Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, United States (Soliman) Cardiovascular Research Institute Dublin, Mater Private Network, Dublin, United States (Soliman) Department of Cardiology, Mater Private Network, Dublin, United States Abstract BACKGROUND: The effect of transcatheter tricuspid-valve repair on clinical outcomes, including death and hospitalization for heart failure, in patients with severe tricuspid regurgitation remains uncertain. METHOD(S): We randomly assigned patients with symptomatic severe tricuspid regurgitation and an increased risk of future heart-failure events in a 2:1 ratio to tricuspid-valve repair plus medical therapy (tricuspid-repair group) or medical therapy alone (medical-therapy group). The first primary end point was a hierarchical composite of death from any cause, hospitalization for heart failure, and quality-of-life improvement at 1 year, assessed by win ratio. If the between-group difference was significant, a second primary end point would be tested: a composite of death from any cause or hospitalization for heart failure through 3 years. RESULT(S): A total of 360 patients underwent randomization (237 patients were assigned to the tricuspid-repair group and 123 to the medical-therapy group). The mean (+/-SD) age of the patients was 80.3+/-6.4 years, and 56.4% were women. The win ratio for the first primary end point was 2.42 (95% confidence interval [CI], 1.76 to 3.33; P<0.001), favoring tricuspid-valve repair. The Kaplan-Meier estimate for freedom from death from any cause or hospitalization for heart failure (second primary end point) through 3 years was 52.4% (95% CI, 43.2 to 63.6) in the tricuspid-repair group and 21.0% (95% CI, 12.7 to 34.6) in the medical-therapy group (hazard ratio for death from any cause or hospitalization for heart failure, 0.40; 95% CI, 0.29 to 0.55; P<0.001). Major adverse events within 30 days occurred in 14 patients (5.9%) in the tricuspid-repair group. CONCLUSION(S): Among patients with symptomatic severe tricuspid regurgitation, transcatheter tricuspid-valve repair plus medical therapy was superior to medical therapy alone with respect to a hierarchical composite of death from any cause, hospitalization for heart failure, and quality-of-life improvement at 1 year and was also associated with a lower risk of a composite of death from any cause or hospitalization for heart failure through 3 years. (Funded by the German Center for Cardiovascular Research and others; TRIC-I-HF ClinicalTrials.gov number, NCT04634266.). Copyright © 2026 Massachusetts Medical Society. <34> Accession Number 2047861217 Title Safety and Efficacy of Transcatheter Aortic Valve Implantation at Centres With Versus Without On-Site Cardiac Surgery: A Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. 35(10) (pp 1382-1394), 2026. Date of Publication: 01 Oct 2026. Author Elettreby A.M.; El-Sayed O.S.; Al-Hawari N.E.M.; Alqeeq B.F.; Gadelmawla A.F.; Abo Elnaga A.A.; Abushanap M.M.; Alkasasbeh J.A.; Jreisat L.; Alkhawaldeh I.M.; Bisht O. Institution (Elettreby, Abo Elnaga) Faculty of Medicine, Mansoura University, Mansoura, Egypt (El-Sayed) Faculty of Medicine, Zagazig University, Sharqia, Zagazig, Egypt (Al-Hawari) Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Alqeeq) Faculty of Medicine, Islamic University of Gaza, Gaza, Palestine (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Abushanap, Jreisat) The Hashemite University, Zarqaa, Jordan (Alkasasbeh, Alkhawaldeh) Faculty of Medicine, Mutah University, Al-Karak, Jordan (Bisht) Evanglisches Herzzentrum Coswig, Coswig, Germany Publisher Elsevier Ltd Abstract Background: Aortic stenosis (AS) is the most common heart valve disorder causing significant complications. While transcatheter aortic valve implantation (TAVI) offers a less invasive alternative to surgery, debate remains about whether it should require on-site cardiac surgery backup. This systematic review and meta-analysis evaluate existing literature comparing outcomes of TAVI performed at centres with versus without on-site cardiac surgery, aiming to guide optimal patient management and institutional decision-making. Method(s): A comprehensive literature search was conducted in multiple databases up to May 2025 to retrieve relevant studies. Random-effects meta-analyses pooled risk ratios (RR) or mean differences. Because definitions of surgical backup varied across studies, backup organisation was extracted for each study. Risk of bias was assessed with the Newcastle-Ottawa Scale and certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Result(s): Six observational cohort studies (n=6,109 patients) were included. No statistically significant differences were observed for in-hospital mortality (four studies; n=3,463; RR= 0.94), 30-day mortality (five studies; n=4,880; RR= 0.87), or emergent conversion to open-heart surgery (four studies; n=4,136; RR= 0.78). Most secondary outcomes were likewise not statistically different, but several had substantial heterogeneity or unstable leave-one-out results. In one matched registry study from the included studies, in-hospital mortality among patients requiring emergent cardiac surgery after intraprocedural complications was high in both settings (50% vs 62.5%). Conclusion(s): This observational meta-analysis did not detect statistically significant differences in short-term mortality, emergent conversion, or major complications between centres with and without on-site cardiac surgery. However, the absence of statistically significant differences does not establish safety equivalence. Certainty of evidence was low to very low, and findings should be interpreted cautiously in light of residual confounding, publication bias, and variation in backup models. Accordingly, future high-quality studies are needed to validate these findings. Copyright © 2026 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ) <35> Accession Number 2049200117 Title Impact of persistent left bundle branch block on ventricular function and clinical outcomes after transcatheter aortic valve implantation: a systematic review and meta-analysis. Source Cardiothoracic Surgeon. 34(1) (no pagination), 2026. Article Number: 41. Date of Publication: 01 Dec 2026. Author de Aquino R.G.F.; Lobo Filho H.G.; Campane R.Z.; Figueiredo Gurgel B.T.; Kilic A. Institution (de Aquino, Lobo Filho) Department of Cardiac Surgery, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Av. Frei Cirilo, 3480, CE, Fortaleza, Brazil (Lobo Filho) Department of Surgery, Universidade Federal do Ceara, Fortaleza, Brazil (Campane) Department of Medicine, Hospital Regional Hans Dieter Schimitd, Joinville, Brazil (Figueiredo Gurgel) Hospital Universitario Walter Cantidio, Universidade Federal do Ceara, Fortaleza, Brazil (Kilic) Division of Cardiac Surgery, The Johns Hopkins Hospital, Baltimore, United States Publisher Springer Science and Business Media Deutschland GmbH Abstract Background: New-onset persistent left bundle branch block (NOP-LBBB) is a frequent complication after transcatheter aortic valve implantation (TAVI), but its long-term prognostic impact remains controversial. This meta-analysis aimed to evaluate the impact of NOP-LBBB on changes in left ventricular ejection fraction (LVEF) and clinical outcomes after TAVI. Method(s): PubMed, Embase, and Cochrane Library were searched through May 2026 for studies comparing outcomes between patients with and without NOP-LBBB after TAVI. Random-effects models were used to calculate pooled mean differences (MD) for continuous outcomes and risk ratios (RR) for binary endpoints, with 95% confidence intervals (CIs). Result(s): Thirty observational studies comprising 223,419 patients were included (37,856 with NOP-LBBB). NOP-LBBB was associated with a significant reduction in LVEF (MD, - 4.65%; 95% CI, - 6.03 to - 3.27), a higher risk of all-cause mortality (RR, 1.19; 95% CI, 1.05 to 1.35), heart failure hospitalization (RR, 1.48; 95% CI, 1.10 to 1.98), and permanent pacemaker implantation (RR, 2.24; 95% CI, 1.75 to 2.86). No significant difference was observed in cardiovascular mortality (RR, 1.29; 95% CI, 0.93 to 1.81). Conclusion(s): NOP-LBBB after TAVI was associated with impaired LVEF recovery, a modest increase in all-cause mortality, and higher rates of HF hospitalization and permanent pacemaker implantation. The association with all-cause mortality remained statistically significant when restricted to studies at moderate risk of bias (RR, 1.23; 95% CI, 1.02 to 1.49) and after exclusion of the large registry cohort (RR, 1.19; 95% CI, 1.03 to 1.36); the HF hospitalization association remained statistically significant, albeit borderline, in the moderate risk-of-bias analysis (RR, 1.56; 95% CI, 1.01 to 2.42). Given the observational design of the included studies and the low-to-very-low certainty of the evidence, these findings should be regarded as hypothesis-generating and warrant confirmation in prospective studies. Copyright © The Author(s) 2026. <36> Accession Number 2044821674 Title Comparing right ventricle to pulmonary artery conduit with modified Blalock-Taussig shunt in hypoplastic left heart syndrome undergoing Norwood procedure: A meta-analysis. Source Asian Journal of Surgery. 49(10) (pp 5113-5122), 2026. Date of Publication: 01 Oct 2026. Author Yasa K.P.; Pertiwi P.F.K.; Sudarma I.W.; Harta I.K.A.P.; Bhaskara N.S.S. Institution (Yasa, Sudarma, Harta) Cardiothoracic and Vascular Surgery Division, Department of Surgery, Faculty of Medicine, Udayana University, Bali, Denpasar, Indonesia (Yasa, Sudarma, Harta) Prof. Dr. I.G.N.G. Ngoerah General Hospital, Bali, Denpasar, Indonesia (Pertiwi, Bhaskara) Faculty of Medicine, Udayana University, Prof. dr. I.G.N.G Ngoerah General Hospital, Bali, Denpasar, Indonesia Publisher Elsevier (Singapore) Pte Ltd Abstract The Norwood procedure is the first palliative surgery for Hypoplastic Left Heart Syndrome (HLHS). Traditionally, pulmonary circulation was supplied via a modified Blalock-Taussig (mBT) shunt, but the right ventricle-to-pulmonary artery (RV-PA) conduit has recently been introduced. A systematic review and meta-analysis identified 13 studies with 905 patients comparing RV-PA and mBT outcomes. RV-PA was associated with significantly lower short-term mortality (RR: 0.62 [0.45-0.85], p = 0.003) and interstage mortality (RR: 0.18 [0.05-0.63], p = 0.008). Before the hemi-Fontan procedure, RV-PA showed better late hemodynamic outcomes, including a lower pulmonary-to-systemic (Qp/Qs) ratio (MD: 0.25 [-0.43 to -0.07], p = 0.007), higher aortic diastolic pressure (MD: 5.22 [2.56-7.87], p < 0.001), and higher Nakata index (MD: 30.54 [3.34-57.75], p = 0.03). RV-PA had no significant impact on right ventricular compliance, as indicated by similar RV end-diastolic pressure (RVEDP; MD: 0.44 [-0.52 to 1.40], p = 0.37). Although RV-PA had a higher but non-significant incidence of shunt stenosis (RR: 4.68 [0.21-105.18], p = 0.33), its advantages outweighed this limitation. Kaplan-Meier analysis showed superior 3-year survival for RV-PA (72% vs. 61% for mBT, p = 0.005). These findings support RV-PA as the preferred shunt for improving survival, hemodynamic outcomes, and perioperative success in HLHS patients undergoing the Norwood procedure. Copyright © 2026 Asian Surgical Association and Taiwan Society of Coloproctology. Publishing services by Elsevier B.V. This is an open access article under the CC BY license. http://creativecommons.org/licenses/by/4.0/ <37> Accession Number 2049537791 Title Postoperative Delirium in Intensive Care Units: A Bibliometric Analysis of Nursing Studies. Source Nursing in Critical Care. 31(6) (no pagination), 2026. Article Number: e70676. Date of Publication: 01 Nov 2026. Author Unver S.; Yenigun Akbulut S.C. Institution (Unver) Faculty of Health Sciences, Department of Surgical Nursing, Trakya University, Edirne, Turkey (Yenigun Akbulut) Kumluca Faculty of Health Sciences, Department of Surgical Nursing, Akdeniz University, Antalya, Turkey Publisher John Wiley and Sons Inc Abstract Background: Delirium is a common and serious postoperative complication in intensive care units, associated with increased morbidity, mortality and long-term cognitive impairment, and despite the pivotal role of nurses in its assessment and management, variations in prevalence and gaps in intervention-focused nursing research persist, underscoring the need for a bibliometric evaluation of the literature. Aim(s): The aim of the study was to quantitatively analyse and visually map trends, citations, key terms and country contributions in nursing research on postoperative delirium in intensive care as well as to characterize the overall structure of the literature. Study Design: This study was conducted as a retrospective and descriptive research using the bibliometric analysis method on December 1, 2025. No time restrictions were imposed on the literature. Data analysis was performed using R Studio software. Result(s): The earliest study on postoperative delirium in intensive care units within the field of nursing was published in 2001, and the analysed publications covered the period from 2001 to December 2025. In addition, 55.96% of all publications have been released in the past 7 years. The journal with the highest number of publications is Nursing in Critical Care, while the United States stands out as the country with the highest research output. It can be suggested that topics such as 'cardiac surgery', 'nursing care', 'postoperative delirium', 'postoperative care' and the 'Confusion Assessment Method for the Intensive Care Unit' represent areas that warrant further investigation and development in future research. Conclusion(s): The analysis showed a marked increase in publications on postoperative delirium in intensive care nursing in recent years. The United States and the Journal Nursing in Critical Care were identified as the leading contributors to the literature. Thematic mapping indicated that the literature primarily focused on delirium assessment and intensive care nursing, with several interconnected research areas. Relevance to Clinical Practice: The findings emphasize the critical role of nurses in delirium screening and management in intensive care units. While assessment tools are well represented in the literature, further research is needed to develop and evaluate nurse-led interventions aimed at delirium prevention and care. Enhancing nursing education and institutional support may contribute to improved patient outcomes and quality of postoperative intensive care. Copyright © 2026 The Author(s). Nursing in Critical Care published by John Wiley & Sons Ltd on behalf of British Association of Critical Care Nurses. <38> Accession Number 2049543300 Title Association of Sodium-Glucose Cotransporter 2 Inhibitor Use With Outcomes in Patients Undergoing Transcatheter Aortic Valve Implantation: A Systematic Review and GRADE-Assessed Meta-Analysis. Source Cardiovascular Therapeutics. 2026(1) (no pagination), 2026. Article Number: 8933859. Date of Publication: 2026. Author Mohamed A.A.; Husain B.H.; Dali T.K.; Ahmed M.E.; Al Shawawreh G.; Galal A.S.; Moussa M.A.; Hibysh A.M.; Shehata A.S.; Ramadan Y.; Aldeeb O.M.; Saeed T.Z.; Dibas M. Institution (Mohamed, Dali, Ahmed, Moussa) Faculty of Medicine, Zagazig University, Zagazig, Egypt (Husain) Faculty of Medicine, Cairo University, Cairo, Egypt (Al Shawawreh) Faculty of Medicine, Mansoura University, Al Mansurah, Egypt (Galal, Saeed) Faculty of Medicine, Assiut University, Assiut, Egypt (Hibysh) Faculty of Medicine, New Ismaila National University, Ismaila, Egypt (Shehata) Faculty of Medicine, South Valley University, Qena, Egypt (Ramadan) Faculty of Medicine, October 6 University, Giza, Egypt (Aldeeb) School of Medicine, The University of Jordan, Amman, Jordan (Dibas) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine Publisher John Wiley and Sons Inc Abstract Background: Patients undergoing transcatheter aortic valve implantation (TAVI) remain at risk of adverse cardiovascular and renal outcomes despite procedural advancements. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated cardiovascular and renal benefits across various patient populations; however, their role in patients undergoing TAVI remains unclear. This study is aimed at evaluating the association between SGLT2 inhibitor use and clinical outcomes in this population. Method(s): We conducted a systematic review and meta-analysis comparing SGLT2 inhibitors versus non-SGLT2 inhibitors or standard care in patients undergoing TAVI. Major databases were searched through March 2026, with Embase updated through June 2026. Pooled analyses were performed using random-effects models to calculate risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs). Result(s): Five studies involving 6111 patients (SGLT2 inhibitors: n = 2933; control: n = 3178) were included. In primary random-effects models, SGLT2 inhibitors were associated with lower all-cause mortality (RR 0.68, 95% CI 0.48-0.97, p = 0.03), heart failure (HF) hospitalization (RR 0.62, 95% CI 0.42-0.90, p = 0.01), and major adverse cardiovascular events (RR 0.68, 95% CI 0.48-0.96, p = 0.03). However, in REML/Hartung-Knapp sensitivity analyses, CIs crossed the null for all-cause mortality, HF hospitalization, MACE, and pooled hazard ratios. Mortality benefits were absent at 6 and 12 months and in the randomized trial but persisted in low left ventricular ejection fraction (RR 0.56, 95% CI 0.35-0.89, p = 0.01). No significant differences occurred in acute kidney injury, urinary tract infections, or echocardiographic parameters. Conclusion(s): SGLT2 inhibitor use was associated with lower all-cause mortality and HF hospitalization after TAVI, but the evidence is limited by observational designs, heterogeneity, and low certainty for several outcomes. Further randomized trials are required. Copyright © 2026 Ahmed Adel Mohamed et al. Cardiovascular Therapeutics published by John Wiley & Sons Ltd. <39> Accession Number 2050026241 Title Liposomal bupivacaine versus ropivacaine thoracic paravertebral block for thoracoscopic atrial septal defect repair: analgesic efficacy and cardiac biomarker outcomes in a single-center, assessor-blinded, randomized trial. Source Journal of Thoracic Disease. 18(9) (no pagination), 2026. Article Number: 1049. Date of Publication: 30 Sep 2026. Author Li B.; Gao Y.; Han J.; Li Y.; Chen Y. Institution (Li, Gao, Han, Li, Chen) Department of Anesthesiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China Publisher AME Publishing Company Abstract Background: Thoracoscopic atrial septal defect (ASD) repair, although minimally invasive, can cause substantial postoperative pain. Thoracic paravertebral block (TPVB) provides effective chest wall analgesia, and liposomal bupivacaine (LB), a long-acting local anesthetic with sustained release, may prolong analgesic duration. We investigated whether ultrasound-guided TPVB using long-acting LB improves postoperative analgesia without compromising cardiovascular safety compared with ropivacaine (RP). Method(s): This randomized, assessor-blinded trial enrolled 94 patients undergoing thoracoscopic ASD repair, who were randomly assigned (1:1) to receive ultrasound-guided TPVB with either LB or RP. Eligibility criteria included age 18-55 years, American Society of Anesthesiologists (ASA) II-III, New York Heart Association (NYHA) II-III, and ejection fraction (EF) >50%. Randomization was computer-generated with sealed envelopes. Safety monitoring included continuous electrocardiography (ECG) for arrhythmias, with Clavien-Dindo grading and Naranjo causality assessment. The primary endpoint was the numerical rating scale (NRS, 0-10) pain score during coughing at 24 h postoperatively. Secondary outcomes included NRS scores at other time points, 72-h opioid consumption (morphine milligram equivalents, MME), time to first rescue analgesia, extended analgesia outcomes [postoperative days 4-7 (POD4-POD7)], perioperative hemodynamics, postoperative recovery, cardiac/inflammatory biomarker trajectories, and adverse events (with postoperative arrhythmias analyzed separately). Result(s): Baseline demographic, clinical, and intraoperative variables were well-balanced between groups (all P>0.05). Compared with RP, LB was associated with lower NRS pain scores at rest and during coughing from extubation through 72 h (all P<0.05), including the primary endpoint at 24 h. LB significantly reduced 72-h opioid consumption [median interquartile range (IQR) 7.5 (0, 42) mg vs. 45 (30, 67.5) mg; P<0.001] and increased the proportion of patients requiring no rescue analgesia within 72 h (72.4% vs. 27.6%; P=0.003). Time to first rescue analgesia was numerically longer with LB (20.5 h vs. 12.0 h; P=0.10), and opioid-sparing effects persisted on POD4-POD7 (both P<0.001). Mechanical ventilation duration was shorter in the LB group [5 (3, 6) h vs. 6 (4, 7.5) h; P=0.03]. Cardiac and inflammatory biomarker trajectories did not differ between groups. Non-arrhythmic adverse events were comparable, and postoperative arrhythmia incidence within 30 days was similar between groups (13.3% vs. 15.6%). Conclusion(s): In adults undergoing thoracoscopic ASD repair, LB-based TPVB provides superior early analgesia with sustained opioid sparing and shorter mechanical ventilation duration, without signals of increased cardiovascular risk, including postoperative arrhythmias. These findings support considering LB-TPVB as part of multimodal analgesia for thoracoscopic ASD repair, pending confirmation in larger multicenter studies. Copyright © AME Publishing Company. Open Access Statement: 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/. <40> Accession Number 2050124021 Title The effect of surgical prehabilitation on autonomic nervous system regulation: Rationale and design of the TUNE trial. Source Contemporary Clinical Trials. 170 (no pagination), 2026. Article Number: 108486. Date of Publication: 01 Nov 2026. Author D'Amico F.; Misceo F.; Benato C.; Veneziano M.; Maj G.; Notarianni L.; Guarracino F.; Oliva F.M.; Valsecchi C.; De Piccoli N.; Pontillo D.; Turi S.; Fossati L.; Ghezzi M.; Tucci M.; Belhassen L.; Bove T.; Novellis P.; Gottin L.; Paternoster G.; Landoni G.; Donadello K.; Veronesi G.; Borello M.; Bruno S.; Chiodi B.; Fumagalli A.; Giardina G.; Kozhan P.; Lembo R.; Mongardini E.; Nakhnoukh C.; Muriana P.; Tambasco A.M.; Scala C.; Viscardi S.; Barletta F.; Briganti A.; Corti G.; Tettamanti A.; Anderloni M.; Fasan M.; Rama J.; Ridolfi C.; Villano M.; Cusumano G.; Colombo S.M.; Romano B.; Dinatale G.; Meda S.; Meroi F. Institution (Borello, Bruno, Chiodi, Fumagalli, Giardina, Kozhan, Lembo, Mongardini, Nakhnoukh) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Muriana, Tambasco, Scala, Viscardi) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Barletta, Briganti) Unit of Urology, Division of Oncology, Gianfranco Soldera Prostate Cancer Lab, IRCCS San Raffaele Scientific Institute, Milan, Italy (Barletta, Briganti) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Corti, Tettamanti) Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Anderloni, Fasan, Rama) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy (Anderloni) Anesthesia and Intensive Care Unit B, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Fasan, Rama) Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Ridolfi) Mini-Invasive and Robotic Thoracic Surgery Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Villano) Department of Cardiothoracic and Vascular Anesthesia and ICU, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy (Cusumano) UOC Chirurgia Toracica, Azienda Ospedaliero Universitaria Policlinico San Marco, Catania, Italy (Cusumano) Universita di Catania, Catania, Italy (Colombo) Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy (Colombo) Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Milan, Italy (Romano) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Dinatale) Department of General and Emergency Surgery, San Carlo Hospital, Potenza, Italy (Meda) Department of Thoracic Surgery, University Hospital of Alessandria, Alessandria, Italy (Meroi) Department of Emergency, University Hospital of Udine, Azienda Sanitaria Universitaria Friuli Centrale (ASUFC), Udine, Italy (D'Amico, Veneziano, Notarianni, Oliva, De Piccoli, Pontillo, Turi, Fossati, Ghezzi, Tucci, Belhassen, Landoni) Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy (Misceo, Novellis, Veronesi) Thoracic Surgery, IRCCS San Raffaele Scientific Institute, Milan, Italy (Benato) Mini-Invasive and Robotic Thoracic Surgery Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Maj) Department of Cardiothoracic and Vascular Anesthesia, University Hospital of Alessandria, Alessandria, Italy (Valsecchi) Department of Anesthesia, Critical Care and Emergency, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy (Bove) Department of Basic Biotechnological Sciences, Intensive Care Peri-Operative Clinics, Universita Cattolica del Sacro Cuore, Rome, Italy (Bove) Department of Emergency, Anesthesiological and Reanimation Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy (Misceo, Novellis, Landoni, Veronesi) School of Medicine, Vita-Salute San Raffaele University, Milan, Italy (Gottin, Donadello) Department of Surgery, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy (Gottin) Cardio-Thoraco-Vascular Anesthesia and Intensive Care Unit, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Paternoster) Department of Health Sciences, University of Basilicata, Potenza, Italy (Paternoster) Anesthesia and ICU, San Carlo Hospital, Potenza, Italy (Donadello) Anesthesia and Intensive Care Unit B, AOUI-University Hospital Integrated Trust of Verona, Verona, Italy (Guarracino) Department of Medical, Dental and Biotechnological Sciences, University "G. D'Annunzio" Chieti - Pescara, Chieti, Italy (Guarracino) Department of Anaesthesia, Resuscitation and Intensive Care, University Hospital SS Annunziata, Chieti, Italy Publisher Elsevier Inc. Abstract Background: Prehabilitation improves physiological readiness for major surgery; however, its implementation and evaluation remain inconsistent, particularly in thoracic surgery. Current assessments largely rely on functional tests, which are difficult to standardize and provide limited knowledge of biological resilience. Heart-rate variability (HRV) is an objective marker of autonomic nervous system balance and is already widely used in sports medicine to guide training intensity and evaluate the relationship between physiological stress and recovery. Given its ability to capture the dynamicity and flexibility of autonomic regulation, HRV may become a practical tool to assess the physiological effects of prehabilitation interventions, going beyond traditional endpoints. Method(s): The TUNE trial is a multicenter, open label, randomized controlled trial involving patients scheduled for elective major thoracic surgery. Participants are randomized in a 1:1 ratio to receive either a home-based multimodal prehabilitation program in addition to standard care or standard care alone. The intervention consists of a 4 week remotely delivered program including structured physical exercise, personalized nutritional optimization and psychological support. Result(s): The trial is ongoing and currently recruiting participants. The primary endpoint is the between-group difference in the change of HRV, measured as the standard deviation of normal-to-normal intervals (SDNN), from baseline to preoperative assessment. Secondary outcomes include correlations between HRV and clinical outcomes. Conclusion(s): The TUNE trial will provide data to assess whether a prehabilitation program can improve HRV and facilitate recovery in patients undergoing major thoracic surgery. Trial registration: This trial was registered on ClinicalTrials.gov with the trial identification NCT06398301. Copyright © 2026 Published by Elsevier Inc. <41> Accession Number 2050017517 Title Patient Perspectives in Cardiovascular Research: A Qualitative Study of Barriers, Trust, and Strategies for Inclusive Clinical Trials. Source Circulation Population Health and Outcomes. 19(7) (no pagination), 2026. Article Number: e012189. Date of Publication: 01 Jul 2026. Author Nino de Rivera S.; Suero-Tejeda N.M.; Monroe R.; Tang M.; Eslami S.; Sallam A.; Gee P.O.; Redfors B.; Yancy C.W.; Gaudino M.F.L.; Stone G.W.; Spertus J.A.; Masterson Creber R.M. Institution (Nino de Rivera, Redfors, Gaudino) Weill Cornell Medicine, New York, NY, United States (Suero-Tejeda, Tang, Eslami, Masterson Creber) Columbia University School of Nursing, New York, NY, United States (Monroe) Better Outcomes Optimal Scientific Therapies (BOOST), Charlotte, NC, United States (Sallam) Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States (Gee) iAdvocate, North Chesterfield, VA, United States (Yancy) Northwestern University Feinberg School of Medicine, Chicago, IL, United States (Stone) Icahn School of Medicine at Mount Sinai, New York, NY, United States (Spertus) University of Missouri Kansas City's Healthcare Institute for Innovations in Quality, United States Publisher Lippincott Williams and Wilkins Abstract BACKGROUND: - Women, Black, and Hispanic patients bear a disproportionate burden of cardiovascular disease yet remain underrepresented in clinical trials. Understanding patient perspectives is essential to developing inclusive recruitment strategies in cardiovascular research. METHOD(S): - The RECHARGE trial (Revascularization Choices Among Underrepresented Groups Evaluation) is an ongoing comparative effectiveness study comparing percutaneous coronary intervention and coronary artery bypass grafting among women, Black, and Hispanic patients. To inform recruitment strategies, we conducted a qualitative study using in-person and virtual focus groups and semistructured interviews. Participants were US adults who identified as Black or Hispanic and had a history of percutaneous coronary intervention, coronary artery bypass grafting, or advanced cardiovascular disease. Interviews were guided by the Social-Ecological Model and analyzed using directed content analysis with a constant comparative approach. RESULT(S): - The sample included 42 participants (35 women, 7 men); 29 identified as Hispanic and 13 as Black. Barriers and facilitators to trial participation spanned multiple levels of the Social-Ecological Model. At the individual and interpersonal levels, barriers included complex study materials, excessive medical jargon, and mistrust of randomization, with concerns about being assigned a less effective treatment. At community and societal levels, participants cited limited recruitment outreach, lack of culturally and linguistically appropriate materials, and mistrust stemming from historical research injustices. Facilitators included trust in healthcare providers, reassurance regarding treatment appropriateness, and involvement of family or support systems. At the community and societal levels, accessible, visual, and multilingual materials were highlighted to support understanding. Participants emphasized the value of plain language, visual, and multilingual materials, adequate time for shared decision-making, and transparent communication about study goals. CONCLUSION(S): - Increasing representation of underrepresented populations in cardiovascular trials requires transparent, accessible communication and trust-centered recruitment strategies. Leveraging trusted healthcare providers and community-based outreach is critical to advancing equity in cardiovascular research. REGISTRATION: - URL: https://www.clinicaltrials.gov; Unique identifiers: NCT06399705 and NCT06399692. Copyright © 2026 American Heart Association, Inc. <42> Accession Number 2049766738 Title Evaluation of Neointimal Coverage After Guiding De-escalation of Antiplatelet Treatment in Patients with ST-elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention by Optical Coherence Tomography or Angiography: Rationale and Design of the DAPT-OCT Study. Source Clinical Medicine Insights: Cardiology. 20 (no pagination), 2026. Date of Publication: 01 Jan 2026. Author Ma C.; Xu K.; Qiu M.; Wang B.; Li Y.; Han Y. Institution (Li, Ma, Xu, Qiu, Wang, Li, Han) Laboratory of Frigid Zone Cardiovascular Disease, Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China Publisher SAGE Publications Ltd Abstract Background: Dual antiplatelet therapy (DAPT) de-escalation strategies including early switching from a potent P2Y<inf>12</inf> inhibitor to clopidogrel become attractive for patients with ST-elevation Myocardial Infarction (STEMI). It is unclear whether DAPT de-escalation after optical coherence tomography (OCT)- or angiography-guided percutaneous coronary intervention (PCI) improves neointimal coverage in STEMI patients who have completed 1-month DAPT with aspirin plus ticagrelor. Method(s): This report describes the design of a randomized study evaluating the neointimal coverage in STEMI patients after guiding de-escalation of DAPT from aspirin plus ticagrelor to aspirin plus clopidogrel at 1 month after PCI with drug eluting stent implantation by OCT or angiography and 1-month DAPT with aspirin plus ticagrelor. Eighty patients who meet the inclusion criteria and none of the exclusion criteria will be randomly assigned in a 1:1 fashion to the OCT- or angiography-guided group (first randomization). All patients will receive open label ticagrelor plus aspirin for 1 month after the index PCI. At 30 +/- 7 days after the index PCI, patients with no major adverse cardiovascular and cerebrovascular events (MACCE) or major bleeding (Bleeding Academic Research Consortium [BARC] 3a) will be randomized in a 1:1 fashion to either the ticagrelor plus aspirin group or clopidogrel plus aspirin group for an additional 11 months (second randomization). The primary endpoint is the stent-strut neointimal thickness by OCT assessment at 12-month follow up. Discussion(s): The data obtained from DAPT-OCT study will explore the neointimal coverage after guiding de-escalation of antiplatelet treatment in STEMI patients undergoing PCI by OCT. Trial registration: ClinicalTrials.gov identifier: NCT06339021. Copyright © The Author(s) 2026. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). <43> Accession Number 2049789230 Title Effect of remote ischemic conditioning on albuminuria in adults with diabetes mellitus (ricadime): a parallel group, double blind, sham controlled, randomized clinical trial. Source Postgraduate Medical Journal. 102(1211) (pp 840-846), 2026. Date of Publication: 01 Sep 2026. Author Dev N.; Kumar G.; Singh G.; Sankar J. Institution (Dev, Kumar, Singh) Department of Medicine, VMMC & Safdarjung Hospital, Ansari Nagar, Delhi, India (Sankar) Department of Paediatrics, AlIMS, Ansari Nagar, Delhi, India Publisher Oxford University Press Abstract Introduction: Diabetic kidney disease (DKD), a chronic microvascular complication is leading cause of End Stage Kidney disease (ESKD). Reduction of >=30% urinary albumin is recommended to slow ESKD progression. Remote Ischemic conditioning (RIC) induces brief episodes of ischemia and reperfusion and has protective effect on various organs. The current study aims to explore the effects of RIC on albuminuria reduction in adults with type-2 Diabetes Mellitus. Material(s) and Method(s): In this double blind, sham controlled, Randomized Clinical Trial, we assigned 40 normotensive Diabetic adults with moderate and severely increased albuminuria to RIC group (n = 20) or Sham group (n = 20) weekly for 8 weeks. Primary outcome was reduction in albuminuria at the end of 8 weeks. Secondary outcomes were changes in serum creatinine, e-Glomerular Filtration Rate (eGFR), and HbA1c levels. Result(s): The reduction in albuminuria at the end of 8 weeks was 37.9% [Median (IQR): -7.5, 43.9] in the RIC group while it increased by 1.10% (-5.6, 15.2) in the Sham group (P = 0.015). Significant reduction was noted in serum creatinine in RIC group from 1 to 0.83 mg/dl as compared to increase in Sham group from 0.97 to 1.1 mg/dl (P = 0.0004). The mean eGFR in the RIC group improved from 85 to 99 (ml/min/1.73m2) P = 0.0001). No significant change was detected in HbA1C levels. Mild pain was the only adverse effect noted in 10% in the RIC group and none in the Sham group. Conclusion(s): Among adults with DKD, treatment with RIC significantly reduced albuminuria and serum creatinine while improving the eGFR (CTRI/2024/09/074453). Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the Fellowship of Postgraduate Medicine. 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) <44> Accession Number 2047439434 Title Paving the Way: a Systematic Review and Meta-Analysis of Randomized Controlled Trials of Atherectomy as Vessel Preparation Prior to Balloon Angioplasty in Peripheral Arterial Disease. Source CardioVascular and Interventional Radiology. 49(9) (pp 1657-1666), 2026. Date of Publication: 01 Sep 2026. Author Ho J.Q.J.; Udayasiri S.; Stewart M.; Owen A.; Kutaiba N.; Low J.; Khabaza A.; Ranatunga D.; Maingard J.; Brooks M.; Jhamb A.; Corlette L.; Handley C.; Barras C.; Kok H.K.; Asadi H. Institution (Ho, Low) Melbourne Health, Parkville, VIC, Australia (Udayasiri, Stewart, Kutaiba, Khabaza, Ranatunga) Department of Radiology, Austin Health, Heidelberg, VIC, Australia (Owen) Department of Interventional Radiology, Austin Health, Heidelberg, VIC, Australia (Maingard, Jhamb, Asadi) Department of Neurointerventional Radiology, St. Vincent's Hospital, Fitzroy, VIC, Australia (Maingard, Brooks, Asadi) Department of Neurointerventional Radiology, Austin Health, Heidelberg, VIC, Australia (Corlette) Department of Radiology, Royal Melbourne Hospital, Melbourne, Australia (Handley) Department of Radiology, Monash Health, Clayton, VIC, Australia (Barras) Department of Radiology, Royal Adelaide Hospital, Adelaide, Australia (Barras) South Australian Health and Medical Research Institute, Adelaide, Australia (Barras) Adelaide University, Adelaide, Australia (Kok) Interventional Radiology Service, Northern Imaging Victoria, Northern Health, Melbourne, Australia (Kok) NECTAR Research Group, Northern Health, Melbourne, Australia (Kok) Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia (Kok) School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia (Asadi) Department of Neurointerventional Radiology, Monash Health, Clayton, VIC, Australia (Maingard) School of Medicine, Deakin University, Warun Ponds, Australia Publisher Springer Abstract Purpose: This systematic review and meta-analysis compares the safety and efficacy of atherectomy as a vessel preparation tool prior to balloon angioplasty (ATH + BA) versus balloon angioplasty alone (BA) for the treatment of peripheral arterial disease (PAD). Material(s) and Method(s): Medline, Embase, CENTRAL, and Clinicaltrials.gov databases were searched for randomized controlled trials (RCTs) comparing ATH + BA versus BA alone in treating PAD. The outcomes analysed included primary patency, technical success, bailout stenting, flow-limiting dissection, clinically driven target lesion revascularization (CD-TLR), distal embolization, arterial perforation, major amputation, and all-cause mortality. A subgroup analysis was done to compare femoropopliteal versus infrapopliteal and plain balloon angioplasty versus drug-coated balloon. Result(s): Seven RCTs met the inclusion criteria (489 patients). Atherectomy as vessel preparation was associated with reduced rates of bailout stenting (OR: 0.14, 95% CI 0.03-0.67, p = 0.01) and flow-limiting dissection (OR: 0.29, 95% CI 0.10-0.84, p = 0.02). Primary patency (OR: 2.13, 95% CI 1.00-4.50, p = 0.049) and CD-TLR at 6 months (OR: 0.24, 95% CI 0.06-0.96, p = 0.04) results favoured ATH + BA. No significant differences were found in technical success, 12-month primary patency, CD-TLR at 12 months, distal embolization, arterial perforation, major amputation, or all-cause mortality. Subgroup analysis demonstrated a reduction in bailout stenting in femoropopliteal studies (OR: 0.05, 95% CI 0.01-0.21) compared with infrapopliteal studies (OR: 0.86, 95% CI 0.31-2.40). Conclusion(s): This meta-analysis found that atherectomy as vessel preparation prior to BA reduced bailout stenting, flow-limiting dissections, and 6-month CD-TLR, with improved 6-month patency compared with BA alone. However, these benefits did not translate into improvements in clinical outcomes at 12 months. Larger RCTs are needed to establish the clinical benefit of atherectomy. Copyright © The Author(s) 2026. <45> Accession Number 2046551784 Title Mitral annular disjunction and high-risk profiles: a conceptual approach to risk stratification and surgical implications. Source General Thoracic and Cardiovascular Surgery. 74(10) (pp 931-938), 2026. Date of Publication: 01 Oct 2026. Author Furukawa K.; Ishii H.; Sakaguchi S.; Mori K.; Iwasaki A.; Meiri R. Institution (Furukawa, Ishii, Sakaguchi, Mori, Iwasaki, Meiri) Division of Cardiovascular Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kiyotakecho Kihara, Miyazaki, Miyazaki-City, Japan Publisher Springer Abstract Objective: Mitral annular disjunction (MAD), frequently associated with Barlow's disease, links degenerative mitral regurgitation to postoperative ventricular arrhythmias and sudden cardiac death, even after technically successful valve repair. However, despite advances in mitral repair, the arrhythmic substrate associated with MAD remains insufficiently addressed in current surgical paradigms. Method(s): A systematic search of PubMed and Google Scholar (2000-2025) was conducted using keywords including "mitral annular disjunction," "mitral regurgitation," "arrhythmic mitral valve prolapse," and "mitral valve surgery." Of 264 records screened, 41 peer-reviewed articles, prioritizing high-impact registries and surgical cohorts, were selected for synthesis. Result(s): MAD is associated with paradoxical annular curling and traction-related myocardial remodeling, which may contribute to fibrosis through pathological stretch. Observational studies suggest that higher-risk features-such as extensive MAD (>= 5 mm, particularly >= 8.5 mm), late gadolinium enhancement, or syncope-are linked to increased arrhythmic vulnerability. Although modern repair techniques can eliminate anatomical MAD, pre-existing substrate abnormalities may persist, and ventricular arrhythmias can still occur after technically successful repair. Conclusion(s): The extent of disjunction and the presence of associated substrate abnormalities appear to influence long-term rhythm stability. A conceptual, hypothesis-generating framework that integrates structural, electrical, imaging, and clinical information may help inform risk stratification. Prospective studies are needed to determine whether a risk-stratified approach or optimized intervention timing can modify arrhythmic risk or potentially affect long-term outcomes. Copyright © The Author(s) 2026. <46> Accession Number 2045600748 Title Combining external placebo-arm data in a prevention trial: effects of cocoa extract supplementation on cardiovascular disease. Source European Journal of Epidemiology. 41(8) (pp 949-958), 2026. Date of Publication: 01 Aug 2026. Author Hamaya R.; Li S.; Rist P.M.; Shadyab A.H.; Manson J.E.; Sesso H.D. Institution (Hamaya, Li, Rist, Manson, Sesso) Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States (Li) Division of Life Sciences and Medicine, Institute of Public Health Sciences, University of Science and Technology of China, Hefei, China (Rist, Manson, Sesso) Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States (Shadyab) Division of Geriatrics, Gerontology, and Palliative Care, Department of Medicine, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, United States (Manson) Mary Horrigan Connors Center for Women's Health Research, Brigham and Women's Hospital, Boston, MA, United States Publisher Springer Science and Business Media B.V. Abstract Rigorous integration of external controls in large-scale cardiovascular prevention randomized controlled trials (RCTs) is under-explored. The Cocoa Supplement and Multivitamin Outcomes Study (COSMOS), a primary prevention RCT of cocoa extract supplementation, initially showed a statistically non-significant effect on total cardiovascular disease (CVD). We aimed to obtain more robust estimates of cocoa extract effects by integrating external control data from The VITamin D and OmegA-3 TriaL (VITAL), a similarly designed large-scale RCT. We analyzed 21,442 COSMOS participants (median 3.6-year follow-up) and used the VITAL omega-3 placebo arm as an external control. Outcomes included the original COSMOS primary CVD endpoint (a composite of myocardial infarction [MI], stroke, cardiovascular death, and coronary revascularization) and major adverse cardiovascular events (MACE; MI, stroke, and cardiovascular death). Two statistical approaches were used: a propensity score-based inverse probability weighting (IPW)-weighted Cox proportional hazard model and a doubly robust method to estimate 4-year risk ratios (RRs) and 95% confidence intervals (CIs) via bootstrapping. IPW-weighted VITAL-placebo data showed similar covariate distributions and 4-year event rates to COSMOS-placebo. While COSMOS data alone showed non-significant RRs (CVD: 0.91 [95% CI 0.79, 1.04]; MACE: 0.84 [0.70, 1.00]), incorporating VITAL-placebo showed protective effects of cocoa extract for cardiovascular endpoints ; RRs were 0.87 [0.76, 0.98] for CVD and 0.80 [0.68, 0.93] for MACE in Cox models; and those were 0.84 [0.74, 0.95] for CVD and 0.77 [0.67, 0.89] for MACE in the doubly robust method. E-values and sensitivity analyses indicated robustness. The present results suggest that original non-significant results of COSMOS could be due to type 2 error. While additional assumptions are needed, external control integration offers a feasible approach to strengthen interpretations of large-scale prevention trials. Copyright © Springer Nature B.V. 2026. <47> Accession Number 2049162063 Title Robotic-assisted lung transplantation: a systematic review of early outcomes in minimally invasive transplant surgery. Source Journal of Robotic Surgery. 20(1) (no pagination), 2026. Article Number: 1004. Date of Publication: 01 Dec 2026. Author Mohammed B.K.; Muskaan A.; Syed Y.P.Q.; Prasad A.; Sheikh M.; Devarakonda T.; Kumar A. Institution (Mohammed, Devarakonda) Division of Cardiac Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, 745 N Fairbanks Ct, Chicago, IL, United States (Mohammed) Canning Thoracic Institute, Northwestern Medicine, Chicago, IL, United States (Muskaan) Department of Medicine, Ayaan Institute of Medical Sciences, Hyderabad, India (Syed) Department of Hospital Medicine, UW Health Swedish American Hospital, Rockford, IL, United States (Prasad) Department of Anesthesiology and Perioperative Medicine, UT Health Medical Center, Houston, TX, United States (Sheikh) Department of Cardiothoracic Surgery, University of California, San Francisco, CA, United States (Kumar) Department of Cardiothoracic Surgery, NYU Langone Health, New York, NY, United States Publisher Springer Nature Abstract Lung transplantation is conventionally performed through clamshell thoracosternotomy or sternotomy, approaches associated with pain, impaired wound healing, and chronic neuralgia. Robotic assistance has reached transplantation only recently. We systematically reviewed the clinical experience with robotic-assisted lung transplantation. Following PRISMA 2020 and PRISMA-S, we searched MEDLINE, Embase, Scopus, Web of Science, and Cochrane CENTRAL from inception to 15 August 2026, with trial registries, conference abstracts, and Chinese-language sources, without language restriction. Human robotic lung transplant reports with at least one clinical outcome were eligible. Because only one comparative cohort existed, synthesis was narrative; no meta-analysis was performed. Certainty was graded by outcome. PROSPERO: CRD420261479535. Out of 393 database records and 7 from other methods, six reports from five reporting centers (27 unique recipients) were included. No randomized trial or prior full-length systematic review was identified. In the only comparative cohort (robotic n = 21 vs. direct-vision minimally invasive n = 90), one-year survival was 95.0% versus 95.5% (log-rank P = 0.84) and grade-3 primary graft dysfunction at 72 h 4.8% versus 8.9% (odds ratio 0.51, 95% CI 0.06-4.34), despite longer ischemic times (486 vs. 408 min; P = 0.02). Every robotic versus direct-vision confidence interval included unity. Certainty was very low for all outcomes. Robotic lung transplantation is technically feasible across five reporting centers. Comparative evidence rests on one clinically selected, non-randomized cohort in which no difference was statistically detectable; this establishes neither equivalence nor absence of harm. Multicenter prospective evaluation with standardized outcomes is required. Registration: The protocol was registered with PROSPERO (CRD420261479535). Copyright © The Author(s) 2026. <48> Accession Number 2041282072 Title Septal Myectomy in Pediatric Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and Meta-analysis. Source Pediatric Cardiology. 47(7) (pp 2820-2827), 2026. Date of Publication: 01 Oct 2026. Author Cappellaro A.P.; de Almeida L.F.C.; Gismondi R.A.O.C.; Ayala R.; Thet M.S.; Dearani J.A. Institution (Cappellaro) Centro Universitario Mauricio de Nassau de Barreiras, Barreiras, Brazil (de Almeida) Department of Medical Sciences, Universidade Federal Fluminense, Niteroi, Brazil (Gismondi) Department of Cardiology, Universidade Federal Fluminense, Niteroi, Brazil (Ayala) Cardiovascular Surgery Department, Robert Bosch Hospital, Stuttgart, Germany (Thet) Department of Surgery & Cancer, Imperial College London, South Kensington, United Kingdom (Dearani) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States Publisher Springer Abstract Evidence regarding outcomes of septal myectomy in pediatric patients with obstructive hypertrophic cardiomyopathy (HOCM) remains limited. This meta-analysis aimed to assess surgical outcomes and long-term survival in this population. A systematic review was conducted using PubMed, Embase, Scopus, and Cochrane databases to identify studies evaluating septal myectomy in pediatric patients with obstructive HCM. Eight clinical trials comprising a total of 490 pediatric patients met the inclusion criteria. Among children undergoing septal myectomy for HOCM, the pooled early and late mortality rates were 3.3% and 8.5%, respectively. Concomitant mitral valve repair was performed in 7.3% of patients. Rates of complete atrioventricular block and permanent pacemaker implantation were 9.9% and 5.1%, respectively. The mean durations of intensive care and hospital stay were 34.6 h and 12.9 days. Postoperative wound infection and reoperation occurred in 3.4% and 6.4% of cases. Echocardiographic assessments demonstrated a marked reduction in LVOT gradient (from 86.9 to 16.2 mmHg) with preserved left ventricular ejection fraction. Mitral regurgitation decreased from 49.8 to 6.4%, and systolic anterior motion from 84.9 to 19.9%. Septal myectomy in pediatric patients with HOCM is a safe and effective procedure, associated with favorable survival and substantial symptomatic and hemodynamic improvement. However, results must be interpreted cautiously due to moderate-quality retrospective data. Copyright © The Author(s) 2025. <49> Accession Number 2047458941 Title Complete Dacron reinforcement of Ross autograft does not increase neoaortic valve regurgitation: A systematic review and meta-analysis. Source JTCVS Techniques. 39 (no pagination), 2026. Article Number: 102490. Date of Publication: 01 Oct 2026. Author Wahba A.; Elmezayen Z.W.; Elbahy O.; Elshabrawi M.N.; Ehmidat M.; Said S.M. Institution (Wahba) Department of Cardiothoracic Surgery, Port Said University, Port Said, Egypt (Wahba, Said) Division of Pediatric and Adult Congenital Cardiac Surgery, Westchester Medical Center and Maria Fareri Children's Hospital, New York Medical College, Valhalla, NY, United States (Elmezayen) Department of Surgery, Kafr Elsheikh University, Kafr Elsheikh, Egypt (Elbahy, Elshabrawi) Department of Surgery, Port Said University, Port Said, Egypt (Ehmidat) Department of Surgery, Alexandria University, Alexandria, Egypt (Said) Department of Cardiothoracic Surgery, Alexandria University, Alexandria, Egypt Publisher Elsevier Inc. Abstract Objective The Ross procedure offers superior hemodynamics and growth potential for patients with unrepairable aortic valve disease, but pulmonary autograft dilation and progressive neoaortic valve regurgitation remain key limitations. Complete autograft reinforcement with Dacron has been proposed to enhance structural stability and prevent dilation. However, concerns persist regarding potential autograft distortion, impaired leaflet coaptation, and increased valve regurgitation. This systematic review and meta-analysis compares clinical outcomes of fully Dacron-supported versus unsupported or partially supported autografts in the Ross procedure. Methods A comprehensive literature search of PubMed, Web of Science, Cochrane, and Scopus databases was conducted from inception through March 30, 2026. Five retrospective comparative cohort studies including a total of 526 patients met inclusion criteria. Outcomes evaluated were early mortality (<=30 days), overall survival, freedom from autograft reoperation, and incidence of moderate or greater neoaortic valve regurgitation. Pooled risk ratios (RRs) with 95% CIs were calculated using random-effects meta-analysis. Results No significant differences were observed between fully supported and unsupported/partially supported groups for early mortality (RR, 2.52; 95% CI, 0.28-22.51; P = .41, I 2 = 0%), overall survival (RR, 0.99; 95% CI, 0.97-1.00], P = .14, I 2 = 0%), freedom from autograft reoperation (RR, 0.90; 95% CI, 0.76-1.07], P = .25, I 2 = 79.1%), or incidence of moderate or greater neoaortic valve regurgitation (RR, 2.00; 95% CI, 0.39-10.25; P = .41, I 2 = 73.5%). Conclusions Complete Dacron reinforcement of the pulmonary autograft does not increase the risk of neoaortic valve regurgitation or adversely affect clinical outcomes compared with unsupported or partially supported autografts. This technique offers a viable strategy to improve autograft durability and may enable the Ross procedure's application in patients previously deemed suboptimal candidates. Surgical technique should be tailored to individual patient profiles and institutional expertise, rather than standardized adoption of one technique. Copyright © 2026 The Author(s). <50> Accession Number 2048819338 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. 33(5) (pp e384-e394), 2026. Date of Publication: 01 Oct 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, Al-Khobar, Saudi Arabia (Alsaif) College of Medicine, Al-Rayan Colleges, Al-Madinah, Saudi Arabia (Ashraf) Department of Medicine, Allama Iqbal Medical College, Lahore, Pakistan Publisher Lippincott Williams and Wilkins 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. 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). 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. 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. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <51> Accession Number 2049001927 Title Effect of Perioperative Oral Ascorbic Acid in Combination with Beta Blockers in Comparison to Beta Blockers Alone on Atrial Fibrillation in Elective Off Pump Coronary Artery Bypass Grafting. Source International Journal of Current Pharmaceutical Review and Research. 18(6) (pp 738-743), 2026. Date of Publication: 01 Jan 2026. Author Banerjee S.; Majumder S.; Dasghara A.; Gupta S.D. Institution (Banerjee) Department of Cardiac Anesthesia Nilratansircar Medical College and Hospital, West Bengal, Kolkata, India (Majumder, Dasghara) Department of Cardiac Anesthesia Nil Ratan Sircar Medical College and Hospital, West Bengal, Kolkata, India (Gupta) Department of Cardiac Anesthesia Nil Ratan Sircar Medical College, West Bengal, Kolkata, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Introduction: Atrial fibrillation is a common postoperative complication after CABG, mainly linked to oxidative stress and inflammation, occurring in 30-50% of patients. Risk factors include age, diabetes, hypertension, and heart disease. Vitamin C, an antioxidant, may reduce POAF by limiting oxidative injury and improving endothelial function. Despite beta-blocker use, additional prevention is needed, warranting further studies on vitamin C therapy. Aim(s): The aim of this study is to determine the effect of oral ascorbic acid in combination with beta-blockers on the incidence of postoperative atrial fibrillation in patients undergoing elective off-pump CABG. The objectives are to assess and compare the effectiveness of perioperative oral ascorbic acid with beta-blockers versus betablockers alone in preventing atrial fibrillation in these patients, and to evaluate any adverse events occurring in both treatment groups. Material(s) and Method(s): This randomized controlled single-blinded study was conducted in the Department of Cardiac Anaesthesia, NRSMCH, Kolkata, over 18 months (August 2024-February 2025). The study included 100 patients undergoing elective CABG. Participants were allocated to receive oral ascorbic acid with beta-blockers or beta-blockers alone, and outcomes were compared for POAF incidence. Result(s): The study groups were comparable in baseline, comorbidities, perioperative variables, echocardiographic parameters, and medication use. Postoperative atrial fibrillation was significantly lower in Vitamin C group (6% vs 28%, p=0.003). Other outcomes including transfusion, ventilation, ICU stay showed no significant difference. Conclusion(s): The study concluded that oral ascorbic acid with beta-blockers is more effective than beta-blockers alone in preventing postoperative atrial fibrillation after off-pump CABG. Older age, diabetes mellitus, and postoperative blood transfusion were identified as independent risk factors for developing atrial fibrillation. Copyright © 2025 This is an Open Access article that uses a funding model which does not charge readers or their institutions for access and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0) and the Budapest Open Access Initiative (http://www.budapestopenaccessinitiative.org/read), which permit unrestricted use, distribution, and reproduction in any medium, provided original work is properly credited. <52> Accession Number 2047562187 Title Safety and efficacy of magnetic-anchoring vs conventional video-assisted thoracoscopic surgery (VATS) lung resection: a randomized controlled trial. Source Surgical Endoscopy. 40(10) (pp 8544-8553), 2026. Date of Publication: 01 Oct 2026. Author Yu C.; Wang T.; Chen N.; Li X.; Lv X.; Xu H.; Liang R.; Li C.; Liu A.; Cui X.; You J.; Lv Y.; Zhang Y. Institution (Yu, Wang, Chen, Li, Xu, Liang, Li, Liu, Cui, You, Zhang) Department of Thoracic Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Otorhinolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Lv) Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China (Zhang) Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China Publisher Springer Abstract Background: Video-assisted thoracic surgery (VATS) is the preferred approach for lung resection. Magnetic anchoring technology (MAT) utilizes magnetic forces for organ retraction and improves surgical field exposure. This trial aimed to evaluate the safety and efficacy of MAT-assisted VATS for lung resection. Method(s): This single-center randomized controlled trial (registered at the Chinese Clinical Trial Registry, ChiCTR2000029676) enrolled 40 patients scheduled for lung resection and randomly assigned them to MAT-assisted VATS (Group A, n = 20) or conventional VATS (Group B, n = 20). The primary outcomes included surgical field exposure efficacy, intraoperative collateral injuries, and operator-related adverse events. Secondary outcomes included surgeon satisfaction score, number of assistants, and perioperative recovery metrics with a 1-month postoperative follow-up. Result(s): Surgical field exposure efficacy (graded as Excellent, Satisfactory, Normal, and Poor) was as follows: Group A, 15, 4, 1, and 0 cases; and Group B, 17, 2, 1, and 0 cases (p = 0.115). Intraoperative collateral injuries (graded as None, Mild, Moderate, and Severe) were as follows: Group A, 13, 6, 1, and 0 cases; Group B, 9, 6, 3, and 2 cases (p = 0.304). No significant differences were observed in the operative time (p = 0.136), intraoperative blood loss (p = 0.380), postoperative drainage tube removal time (p = 0.180), time to extubation (p = 0.529), time to ambulation (p = 0.260), total hospitalization duration (p = 0.685), or postoperative hospitalization duration (p = 0.305). Surgeon satisfaction score was significantly higher in Group A (p = 0.003). Moreover, MAT use markedly reduced dependence on surgical assistants, with fewer cases requiring two assistants in Group A (p = 0.006). The magnetic anchoring devices demonstrated seamless operability, with no adverse events reported during postoperative follow-up. Conclusion(s): MAT-assisted VATS lung resection is as effective and safe as conventional VATS. Copyright © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2026. <53> Accession Number 2047612485 Title Commentary: Genicular Artery Embolization using Imipenem/Cilastatin vs. Microsphere for Knee Osteoarthritis (GAUCHO): 12-Month Clinical Results of a Single-blind Randomized Controlled Trial. Source CardioVascular and Interventional Radiology. 49(9) (pp 1838-1839), 2026. Date of Publication: 01 Sep 2026. Author Ahmed O.; Alkhani L. Institution (Ahmed, Alkhani) Joint & Vascular Institute, 1870 W Winchester Rd, Suite 146, Libertyville, IL, United States (Ahmed) University of Utah, Salt Lake City, UT, United States (Alkhani) Northwestern University Feinberg School of Medicine, Chicago, IL, United States Publisher Springer <54> Accession Number 2050215458 Title Landiolol for the prevention of postoperative atrial fibrillation after cardiac surgery: a GRADE-assessed systematic review and meta-analysis of randomized controlled trials. Source Anaesthesia Critical Care and Pain Medicine. 45(6) (no pagination), 2026. Article Number: 101842. Date of Publication: 01 Nov 2026. Author Elbahloul M.A.; Badran A.S.; Shawky A.; Akoum A.; Awad A.K.; Medhat A.; El-Diasty M. Institution (Elbahloul) Faculty of Medicine, Kafr El-Shaikh University, Kafr El Shaikh, Egypt (Badran) Faculty of Medicine, Ain-Shams University, Cairo, Egypt (Shawky) Faculty of Medicine, Benha University, Qalyubia, Egypt (Akoum) Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United States (Awad) Faculty of Medicine, Galala University, Suez, Egypt (Medhat) Faculty of Medicine for Men in Asyut, Al-Azhar University, Egypt (El-Diasty) Division of Cardiac Surgery, Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, OH, United States Publisher Elsevier Masson s.r.l. Abstract Background: Postoperative atrial fibrillation (POAF) occurs in up to 30% of patients undergoing cardiac surgery. Landiolol is an ultrashort-acting, highly beta1-selective intravenous beta blocker. We aimed to investigate the effect of landiolol in the prevention of POAF. Method(s): Electronic databases were searched for randomized clinical trials (RCTs) evaluating landiolol for the prevention of POAF. Dichotomous outcomes were reported as odds ratios (ORs) and continuous outcomes as mean differences (MDs), each with 95% confidence intervals. The primary outcome was the incidence of POAF. Result(s): A total of 11 RCTs, including 1,264 patients, were analyzed. Landiolol was associated with a significantly lower incidence of POAF compared with the control group (OR: 0.35, 95% CI: 0.23-0.53, p < 0.01). There were no significant differences between landiolol and the control group in terms of hospital mortality, length of hospital stay, heart failure, or major complications. Conclusion(s): Landiolol appears to be an effective agent for the prevention of POAF in patients undergoing cardiac surgeries. Large-scale, multi-ethnic RCTs are needed to confirm these findings. Copyright © 2026 Societe Francaise d'Anesthesie et de Reanimation (SFAR). Published by Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies. <55> [Use Link to view the full text] Accession Number 2034641870 Title Effects of Serratus Anterior Plane Block on Early Recovery from Thoracoscopic Lung Resection: A Randomized, Blinded, Placebo-controlled Trial. Source Anesthesiology. 141(6) (pp 1065-1074), 2024. Date of Publication: 01 Dec 2024. Author Jackson J.C.; Tan K.S.; Pedoto A.; Park B.J.; Rusch V.W.; Jones D.R.; Zhang H.; Desiderio D.; Fischer G.W.; Amar D. Institution (Jackson, Tan, Pedoto, Zhang, Desiderio, Fischer, Amar) Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States (Jackson, Pedoto, Desiderio, Fischer, Amar) Department of Anesthesiology, Weill Cornell Medical College, New York, NY, United States (Park, Rusch, Jones) Thoracic Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States (Park, Rusch, Jones) Department of Surgery, Weill Cornell Medical College, New York, NY, United States Publisher Lippincott Williams and Wilkins Abstract Background: The efficacy of serratus anterior plane block for treatment of pain after minimally invasive thoracic surgery remains unclear. This trial assesses the impact of serratus anterior plane block on postoperative opioid consumption and on measures of early recovery after thoracoscopic lung resection. Method(s): Patients undergoing minimally invasive anatomic lung resection at a single center were randomized to undergo serratus anterior plane block with 40 ml injectate containing bupivacaine 0.25%, clonidine 100 mug, and dexamethasone 4 mg (serratus anterior plane block group) or sham block with 40 ml normal saline (placebo group) at the conclusion of surgery. The primary outcome was cumulative intravenous morphine equivalents during the first 24 h postoperatively. Secondary outcomes were intravenous morphine equivalents, pain scores at rest and with cough, inspiratory volume on incentive spirometry, incidence of nausea or vomiting during the first 48 h postoperatively, Quality of Recovery-15 score on postoperative day 7, and length of stay. Result(s): Using the protocol-specified intention-to-treat analysis, the median (interquartile range) intravenous morphine equivalents was 10.6 (5.0 to 27.1) mg in serratus anterior plane block patients (n = 46) versus 18.8 (9.9 to 29.6) mg in placebo patients (n = 46; 32% reduction; ratio, 0.68 [95% CI, 0.44 to 1.06]; P = 0.085). Of the secondary outcomes, only the composite pain with cough scores differed significantly in the serratus anterior plane block group by a coefficient of -0.41 (95% CI, -0.81 to -0.01; P = 0.044). A sensitivity as-treated analysis reported median (interquartile range) intravenous morphine equivalents of 10.0 (5.0 to 27.2) mg in serratus anterior plane block patients (n = 44) versus 19.9 (10.4 to 29.0) mg in placebo patients (n = 48; 36% reduction; ratio, 0.64 [95% CI, 0.41 to 1.00]; P = 0.048). Conclusion(s): The protocol-specified intention-to-treat analysis demonstrated that serratus anterior plane block did not result in a significant reduction in opioid consumption when added to a multimodal analgesic regimen after thoracoscopic anatomic lung resection. The sensitivity as-treated analysis showed a significant and modest clinical reduction in the primary outcome that warrants further investigation. Copyright © 2024 American Society of Anesthesiologists. All Rights Reserved. <56> Accession Number 2049839857 Title Perioperative Depression and Anxiety Care in Older Patients: A Randomized Clinical Trial. Source JAMA Network Open. 9(9) (no pagination), 2026. Article Number: e2632619. Date of Publication: 09 Sep 2026. Author Abraham J.; Holzer K.J.; Haroutounian S.; Pennington B.; Baumann A.; Calfee R.; Cordner T.; Freedland K.E.; Kannampallil T.; Kozower B.; Lenard E.; Miller J.P.; Politi M.; Yingling M.; Avidan M.S.; Lenze E.J. Institution (Abraham, Holzer, Haroutounian, Pennington, Cordner, Kannampallil, Avidan) Department of Anesthesiology, Washington University School of Medicine (WashU Medicine), St Louis, MO, United States (Abraham, Kannampallil, Miller) Institute for Informatics, Data Science, and Biostatistics, WashU Medicine, St Louis, MO, United States (Abraham, Freedland, Lenard, Yingling, Lenze) Department of Psychiatry, School of Medicine, WashU Medicine, St Louis, MO, United States (Baumann, Kozower) Department of Surgery, School of Medicine, WashU Medicine, St Louis, MO, United States (Calfee) Department of Orthopedics, School of Medicine, WashU Medicine, St Louis, MO, United States (Politi) Bursky School of Public Health, Washington University, St Louis, MO, United States Publisher American Medical Association Abstract Importance Depression and anxiety are common among older adults undergoing surgery and are associated with adverse postoperative outcomes. However, effective tailored perioperative mental health interventions are lacking. Objective To evaluate a perioperative intervention to optimize mental health. Design, Setting, and Participants A single-blind, hybrid, type 1, effectiveness-implementation randomized clinical trial was conducted (November 1, 2022, to March 31, 2025), with 3-month postoperative follow-up, at a US academic and community practice hospital network. Participants were 60 years or older; scheduled for cardiac, oncologic, or orthopedic surgery; and had clinically meaningful symptoms of depression and/or anxiety based on the Patient Health Questionnaire-Anxiety and Depressive Symptom (PHQ-ADS) scale. A total of 3159 patients were screened for eligibility, with 1518 ineligible, 1079 declining participation, and 236 excluded for other reasons. A total of 326 patients were enrolled and randomized (1:1), with 20 excluded after surgery cancelation. Intervention Participants were assigned to receive a perioperative intervention combining psychological management and pharmacologic optimization or enhanced usual care (materials for self-managing symptoms). Main Outcomes and Measures The primary outcome was change in PHQ-ADS score from baseline to 3 months after surgery. Other outcomes included persistent postsurgical pain, delirium, falls, quality of life, patient satisfaction, length of stay, and rehospitalizations. Implementability was evaluated through semistructured interviews and reach, acceptability, feasibility, appropriateness, and fidelity measures. Results A total of 306 older adults were included in analysis (mean [SD] age, 68.5 [6.1] years; 209 [68.3%] female; 153 randomized to intervention and 153 randomized to enhanced usual care): 102 cardiac, 100 oncologic, and 104 orthopedic patients. Participants' mean (SD) baseline PHQ-ADS score was 18.5 (7.4). At 3 months, there was a significant decrease in PHQ-ADS scores in the intervention group compared with the enhanced usual care group (mean difference, 2.20; 95% CI, 0.16-4.24; P =.03). Effects varied by surgical subgroups (oncologic patients: mean difference, 4.93; 95% CI, 1.51-8.36; P =.005; cardiac patients: mean difference, 2.68; 95% CI, -0.98 to 6.35; P =.15; and orthopedic patients: mean difference, -1.11; 95% CI, -4.62 to 2.40; P =.54). Patients and interventionists perceived the intervention as appropriate, with high-fidelity delivery and broad reach across the target population. Conclusions and Relevance In this randomized clinical trial, psychological management and pharmacologic optimization reduced anxiety and depression in older adults undergoing surgery. Future studies should assess reproducibility and determine which patients benefit most. Copyright © 2026 Abraham J et al. <57> Accession Number 2050176147 Title Interventions to Promote Utilisation of Cardiac Rehabilitation: 2026 Cochrane Systematic Review and Meta-Analysis. Source Heart Lung and Circulation. (no pagination), 2026. Date of Publication: 2026. Author Long L.; Lin C.Z.; Davies P.; Wells V.; Grace S.L.; Taylor R.S. Institution (Long, Wells, Taylor) School of Health & Wellbeing, University of Glasgow, Glasgow, United Kingdom (Lin) School of Medicine, Dentistry & Nursing, University of Glasgow, Glasgow, United Kingdom (Davies) Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom (Grace) School of Kinesiology and Health Science, York University, Toronto, ON, Canada (Grace) Toronto Rehabilitation Institute & Peter Munk Cardiac Centre, University Health Network, University of Toronto, Toronto, ON, Canada Publisher Elsevier Ltd Abstract Background: Despite strong evidence of benefit and guideline recommendation, access to cardiac rehabilitation remains low across global healthcare systems. We provide a 2026 analysis of our previous Cochrane review of randomised trial evidence for interventions designed to increase cardiac rehabilitation enrolment, adherence, and completion. Method(s): We searched CENTRAL, MEDLINE, Embase, CINAHL, CPCI-S, and trial registries up to 10 March 2025, without language restrictions. We included randomised controlled trials involving adults eligible for cardiac rehabilitation following myocardial infarction, angina, coronary revascularisation, or heart failure. Risk of bias was assessed using the Cochrane tool, and certainty of evidence assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. Data on cardiac rehabilitation enrolment, adherence, and completion were pooled using random-effects meta-analysis. Result(s): A total of 47 trials involving 10,803 participants were included. Most common intervention strategies included: education, self-management training, or motivational interviewing; alternative delivery models (home-based, digital, or hybrid); invitation letters or messaging prompts; and peer support. Compared to control, interventions showed improvements in cardiac rehabilitation program enrolment (relative risk [RR]: 1.19, 95% confidence interval [CI]: 1.11 to 1.29; participants; 27 trials, 7,216 participants; low-certainty evidence), cardiac rehabilitation program adherence (standardised mean difference: 0.32, 95% CI: 0.15 to 0.49; 18 trials, 3,024 participants; moderate-certainty evidence), and cardiac rehabilitation completion (RR:1.22, 95% CI: 1.10 to 1.35; 19 trials, participants: 5,432; moderate-certainty evidence). Conclusion(s): To overcome the persistent challenge of suboptimal cardiac rehabilitation utilisation, global healthcare systems should consider a multifaceted approach to improving cardiac rehabilitation utilisation that combines patient- and system-level intervention strategies identified in this review. Further high-quality trials targeting underserved populations are needed in order to optimise equity in future cardiac rehabilitation access. Copyright © 2026 The Authors <58> Accession Number 2049573335 Title The effect of ultrasound-guided lung recruitment maneuvers on postoperative atelectasis: a systematic review and meta-analysis of randomized controlled trials. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1890372. Date of Publication: 12 Aug 2026. Author Bao Y.; Lin H.; Tang B.; Zhang K.; Chen B. Institution (Bao, Tang, Chen) Department of Ultrasound Medicine, The First People's Hospital of Taizhou, Taizhou, China (Lin) Department of Emergency Medicine, The First People's Hospital of Taizhou, Taizhou, China (Zhang) Department of Critical Care Medicine, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China Publisher Frontiers Media SA Abstract Background - Postoperative atelectasis is common after general anesthesia. Lung ultrasound may help individualize recruitment maneuvers, but the certainty and generalizability of the evidence remain uncertain. Methods - We searched PubMed, Embase, Scopus, and the Cochrane Library through March 25, 2026 for randomized controlled trials (RCTs) of intraoperative ultrasound-guided lung recruitment maneuvers in adults undergoing elective surgery. The primary outcome was postoperative atelectasis assessed by lung ultrasound. Secondary outcomes were postoperative pulmonary complications (PPCs) and length of hospital stay. A random-effects model was used to calculate pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CIs). The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Results - Ten RCTs involving 1, 076 patients were included. Ultrasound-guided lung recruitment maneuvers were associated with a lower incidence of postoperative atelectasis (RR, 0.64, 95% CI, 0.52 to 0.77, P < 0.0001, I2 = 50.8%). The effect appeared clearer in abdominal surgery than in thoracic surgery. PPCs were not significantly reduced in the primary analysis (RR, 0.70, 95% CI, 0.48 to 1.01, P = 0.0571, I2 = 59.2%), and length of hospital stay was statistically but modestly shorter (MD -0.56 days, 95% CI -0.94 to -0.18, P = 0.0039, I2 = 67.7%). Conclusion - Ultrasound-guided lung recruitment maneuvers may reduce postoperative atelectasis, especially in abdominal surgery, but the certainty of evidence is limited by the small evidence base, residual clinical and statistical heterogeneity, operator dependency of lung ultrasound, and inconsistent outcome definitions. The modest reduction in hospital stay should be interpreted cautiously. Larger standardized trials are needed before broad clinical implementation can be recommended. Copyright © 2026 Bao, Lin, Tang, Zhang and Chen. <59> Accession Number 2013746467 Title Treatment and Prophylaxis of Post-pericardiotomy Syndrome in Cardiac Surgery Patients: a Systematic Review. Source Cardiovascular Drugs and Therapy. 37(4) (pp 771-779), 2023. Date of Publication: 21 Sep 2021. Author Giacinto O.; Minati A.; Lusini M.; Cardetta F.; Saltarocchi S.; D'Abramo M.; Miraldi F.; Chello M. Institution (Giacinto, Lusini, Cardetta, Chello) Department of Cardiovascular Surgery, University Campus Bio-Medico, Rome, Italy (Minati, Saltarocchi, D'Abramo, Miraldi) Department of Clinical, Internal Medicine, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy Publisher Springer Abstract Purpose: Post-pericardiotomy syndrome (PPS) is a common complication of cardiac surgery. This systematic review aimed to investigate the efficacy of colchicine, indomethacin, and dexamethasone in the treatment and prophylaxis of PPS. Method(s): Literature research was carried out using PubMed. Studies investigating >= 10 patients with clinically PPS treated with colchicine, dexamethasone, and indomethacin and compared with placebo were included. Animal or in vitro experiments, studies on < 10 patients, case reports, congress reports, and review articles were excluded. Cochrane risk-of-bias tool for randomized trials (RoB2) was used for the quality assessment of studies. Result(s): Seven studies were included. Among studies with postoperative colchicine treatment, two of them demonstrated a significant reduction of PPS. In the single pre-surgery colchicine administration study, a decrease of PPS cases was registered. Indomethacin pre-surgery administration was linked to a reduction of PPS. No significant result emerged with preoperative dexamethasone intake. Conclusion(s): Better outcomes have been registered when colchicine and indomethacin were administered as primary prophylactic agents in preventing PPS and PE. Further RCT studies are needed to confirm these results. Copyright © 2021, The Author(s). <60> Accession Number 2050041619 Title Intracardiac vs. transesophageal echocardiography in patients undergoing ablation for atrial fibrillation: a systematic review and meta-analysis. Source European Heart Journal Cardiovascular Imaging. 27(10) (pp 1845-1856), 2026. Date of Publication: 01 Oct 2026. Author Dandamudi M.; Hakkeem B.; Pinilla J.; Samad N.S.; de Lucena L.A.; Humayun Z.; Khairallah T.T.; Stabile F. Institution (Dandamudi) Department of Cardiology, Charleston Area Medical Center (CAMC), Charleston, WV, United States (Hakkeem) Department of Anesthesia, Government Medical College Kozhikode, Kerala, Kozhikode, India (Pinilla) Department of Medicine, CES University School of Medicine, Medellin, Colombia (Samad) College of Arts and Science, New York University, CAS XUSOM, Woodbury, NY, United States (de Lucena) Department of Medicine, Federal University of Rio Grande do Norte, RN, Natal, Brazil (Humayun) Department of Medicine, University of Missouri, Kansas City, MO, United States (Khairallah) Department of Medicine, University of Georgia, Tbilisi, Georgia (Stabile) Division of Cardiology, University Hospital Paolo Giaccone, Palermo, Italy Publisher Oxford University Press Abstract Aims: Intracardiac echocardiography (ICE) is a valuable, real-time imaging tool in structural cardiology and electrophysiology, performed without general anaesthesia. However, its safety compared to transesophageal echocardiography (TEE) remains unclear. Objective(s): To conduct a meta-analysis evaluating outcomes of catheter ablation for atrial fibrillation (AF) with or without left atrial appendage closure (LAAC) guided by TEE vs. ICE. Methods and Results: Databases were searched for studies comparing ICE with TEE guidance during AF ablation +/- LAAC. Outcomes were pooled using the inverse-variance (IV) random-effects model in R, with risk ratios (RRs) for dichotomous variables and mean or standardized mean differences (MD or SMD) for continuous variables, and 95% confidence intervals (CIs) reported. We included eight studies involving 7671 patients, of whom 3903 (50.9%) underwent procedures with ICE guidance. There were no significant differences between groups in cardiac tamponade risk (RR 0.86; 95% CI 0.44-1.66; P = 0.39), stroke, or transient ischaemic attack (RR 1.00; 95% CI 0.39-2.55; P = 0.57), and vascular complications (RR 0.80; 95% CI 0.51-1.25; P = 0.37). ICE was associated with lower pre-procedure LAA thrombus detection (RR 0.32; 95% CI 0.11-0.94; P = 0.04), radiation dose (SMD -0.47; 95% CI -0.90 to -0.04; P = 0.03), and fluoroscopy time (-4.25 min; 95% CI -6.01 to -2.49; P < 0.01) but the procedure duration was significantly lower only in combined AF ablation + LAAC (MD -19.56 min; 95% CI -24.15 to -14.97; P < 0.01). Conclusion(s): This meta-analysis indicates that ICE is a safe, effective, and non-inferior alternative to TEE for patients undergoing AF ablation +/- LAAC. However, TEE remains an effective tool for detecting LAA thrombus. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Society of Cardiology. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site-for further information please contact journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights) <61> Accession Number 2049865962 Title Triglyceride-glucose index as a metabolic risk marker for adverse outcomes after coronary artery bypass grafting: a systematic review and meta-analysis. Source Frontiers in Endocrinology. 17 (no pagination), 2026. Article Number: 1909829. Date of Publication: 11 Sep 2026. Author Zhang Y.; Zeng Y.; Ning Y.; Wang H.; Yang X.; Liao X.; Zhang Z. Institution (Zhang, Zeng, Liao, Zhang) Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Hunan, Changsha, China (Ning) Xiangya School of Medicine, Central South University, Hunan, Changsha, China (Wang) The Second Xiangya Hospital of Central South University, Hunan, Changsha, China (Yang) The First Clinical Medical College, Shanxi Medical University, Shanxi, Taiyuan, China (Liao, Zhang) Hunan Provincial Clinical Research Center for Cardiovascular Surgery, Hunan, Changsha, China Publisher Frontiers Media SA Abstract Aims - To evaluate the prognostic value of the triglyceride-glucose index (TyG), a surrogate marker of insulin resistance, for adverse cardiovascular outcomes in patients undergoing coronary artery bypass grafting (CABG). Materials and methods - This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies evaluating the association between the TyG index and postoperative outcomes after CABG were retrieved from four databases as of Jul 10, 2026. Multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were used as the primary effect estimates for major adverse cardiovascular events (MACE), with separate analyses conducted for each 1-unit increase in the TyG index and for TyG index tertiles. Crude odds ratios (ORs) comparing the higher TyG group with the lower TyG group were estimated as a supplementary event-based analysis. Results - Six retrospective cohort reports, comprising 5, 978 participants and four independent cohort families, were included, with two being multi-center studies. Each 1-unit increase in the TyG index was associated with a 62.4% higher hazard of MACE (HR: 1.624, 95% CI: 1.349-1.955). Compared with the lowest tertile group, the highest tertile group demonstrated a statistically higher hazard of MACE (HR = 2.093, 95% CI: 1.635-2.680). A higher TyG index was associated with higher odds of MACE (OR: 2.59, 95% CI: 1.97-3.40). In addition, a higher TyG index was associated with an elevated risk of all-cause mortality, nonfatal stroke, and nonfatal myocardial infarction, but was not associated with revascularization. Conclusion - The TyG index may serve as an accessible supplementary metabolic risk marker following CABG. Further prospective validation is required before it is routinely applied to individual risk prediction. Systematic Review Registration - https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251158075 Copyright © 2026 Zhang, Zeng, Ning, Wang, Yang, Liao and Zhang. <62> Accession Number 2049480394 Title Reduction of Pericardial Adhesions with Polyethylene Glycol Hydrogel Compound, BAX602 in Staged Pediatric Heart Surgery: A Randomized Controlled Trial Protocol. Source Pediatric Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Nakano T.; Kasahara S.; Murayama H.; Hirose K.; Matsushima S.; Konuma T.; Hirata Y.; Suzuki A.; Nemoto S. Institution (Nakano) Department of Cardiovascular Surgery, Fukuoka Children's Hospital, Fukuoka, Japan (Kasahara) Department of Cardiovascular Surgery, Okayama University Hospital, Okayama, Japan (Murayama) Department of Cardiovascular Surgery, Aichi Children's Health and Medical Center, Obu, Japan (Hirose) Department of Cardiovascular Surgery, Shizuoka Children's Hospital, Shizuoka, Japan (Matsushima) Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan (Konuma) Department of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan (Hirata) Department of Cardiovascular Surgery, National Center for Child Health and Development, Setagaya, Japan (Hirata) Japan Cardiovascular Surgery Database Organization, Bunkyo, Japan (Suzuki, Nemoto) Department of Thoracic and Cardiovascular Surgery, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Osaka, Takatsuki, Japan Publisher Springer Abstract BAX602, a synthetic hydrogel composed of two polyethylene glycols, is an established anti-adhesive agent in adult cardiac surgery; however, clinical data regarding its safety and efficacy in the pediatric population remain scarce. This study aims to evaluate the efficacy and safety of BAX602 in reducing pericardial adhesions in pediatric patients undergoing staged surgery for congenital heart disease (CHD). This prospective, multicenter, randomized, controlled trial will be conducted across Japan. Thirty pediatric patients (< 12 years old) undergoing their initial staged cardiac surgery via midline sternotomy and pericardiotomy will be randomized (1:1) to either the BAX602 application group or the untreated control group. Based on real-world trends from the Japan Cardiovascular Surgery Database, the interval between the first- and second-stage operations is expected to be 3-12 months. The primary endpoint is the severity of adhesions at the second surgery, quantified across six prespecified anatomical sites: the pericardiotomy edge, right ventricular anterior and diaphragmatic surfaces, right atrial body and appendage, and the ascending aorta. Adhesion severity will be evaluated using a standardized 5-grade scale ranging from 0 (no adhesions) to 4 (dense/cohesive adhesions requiring extensive sharp dissection). This protocol is designed to provide robust clinical evidence supporting the efficacy and safety of BAX602, potentially facilitating its regulatory approval and clinical integration into pediatric cardiac surgery. This trial will clarify the role of BAX602 in mitigating surgical adhesions, potentially improving safety and procedural outcomes for pediatric patients requiring multiple cardiac interventions. Clinical Trial: jRCT2032220540 (https://jrct.niph.go.jp/latestdetail/jRCT2032220540), NCT05647161 (https://clinicaltrials.gov/study/NCT05647161#study-plan). Copyright © The Author(s) 2026. <63> Accession Number 2047012736 Title Does gabapentin add value to multimodal analgesia in thoracic surgery? A procedure-specific meta-analysis. Source Pain Management. 16(10) (pp 1161-1169), 2026. Date of Publication: 2026. Author Lemos Gonzalez G.; Felippe V.A.; Wegner B.F.M.; Minetto Wegner G.R.; Lopes de Mattos I.L.; Souza do Nascimento T.; Area Leao Barreto L.; Alves Bersot C.D.; Nhuch F.; Lessa M.A. Institution (Lemos Gonzalez, Lopes de Mattos) Department of Anesthesia, Federal University of the State of Rio de Janeiro - UNIRIO, Rio de Janeiro, Brazil (Felippe) Department of Anesthesia, National Cancer Institute - INCA, Rio de Janeiro, Brazil (Wegner) College of Medicine, Federal University of Rio Grande do Sul, Rio Grande do Sul, Brazil (Minetto Wegner) College of Medicine, Federal University of Fronteira Sul, Rio Grande do Sul, Brazil (Souza do Nascimento, Lessa) Department of Anesthesia, University of Iowa Carver College of Medicine, University of Iowa, Iowa City, IA, United States (Area Leao Barreto) College of Medicine, Federal University of Ceara, Ceara, Brazil (Alves Bersot) Paulista School of Medicine, EPM-UNIFESP, Sao Paulo, Brazil (Nhuch) Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, United States Publisher Taylor and Francis Ltd. Abstract Aims: Thoracic surgery is associated with severe acute and chronic pain, high opioid use, and other adverse outcomes. Gabapentin is commonly used perioperatively, but its effectiveness remains uncertain. This systematic review and meta-analysis evaluated the efficacy and safety of perioperative gabapentin versus placebo after thoracic surgery. Patients and Methods: Cochrane, Embase, PubMed, and Web of Science were searched through 29 August 2025 for randomized controlled trials comparing gabapentin with placebo in adults undergoing thoracic surgery. The primary outcome was pain at 24 hours. Secondary outcomes included pain at other time points, opioid consumption, chronic pain, and adverse events. Data were pooled using random-effects models. Result(s) and Conclusion(s): Six trials including 748 patients were analyzed. Gabapentin had no significant effect on rest pain at 24 hours (MD -0.13; 95% CI -1.17 to 0.91). A non-significant trend toward worse cough-evoked pain at 24 hours was observed with gabapentin (MD 0.53; 95% CI 0.00 to 1.07). Gabapentin also did not significantly affect opioid consumption, pain chronification, or adverse events such as nausea, sedation, or delirium. Based on low-certainty evidence, perioperative gabapentin does not appear to provide meaningful benefit after thoracic surgery. Protocol Registration: The www.crd.york.ac.uk/prospero identifier is CRD420251136259. Copyright © 2026 Informa UK Limited, trading as Taylor & Francis Group. <64> Accession Number 2050284548 Title Minimally Invasive Versus Sternotomy in Redo Mitral Valve Surgery: Short-and Long-Term Outcomes with MetaRegression and Time-to-Event Analysis. Source Journal of the American Heart Association. 15(19) (no pagination), 2026. Article Number: e050284. Date of Publication: 2026. Author Santos K.; Kim Kim J.Y.B.; Patel N.; Sah H.; Koduru S.; Napoli F.; Brozzi N.A.; Navia J.L.; Polanco A.; Sa M.P. Institution (Santos, Patel) New Vision University School of Medicine, Tbilisi, Georgia (Kim Kim) Faculty of Medical Sciences, Universidad Nacional de Asuncion, Asuncion, Paraguay (Sah) Bahgesehir University, Istanbul, Turkey (Koduru) Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India (Napoli, Brozzi, Navia, Polanco, Sa) Department of Cardiovascular Surgery Heart, Thoracic & Vascular Institute; Cleveland Clinic Florida, Weston, FL, United States Publisher American Heart Association Inc. Abstract BACKGROUND: Redo mitral valve surgery carries substantial risk, and the relative benefits of minimally invasive (MI-MVS) versus sternotomy MVS, particularly regarding long-term survival, remain uncertain. METHOD(S): Electronic databases were searched for studies comparing MI-MVS with sternotomy MVS in adult redo MVS. Kaplan-Meier curves were digitized to reconstruct individual patient data for time-to-event analysis, with study-level hazard ratios (HR) generated using a Cox frailty model. Perioperative outcomes were pooled using random-effects models. Subgroup analyses evaluated propensity-matched cohorts, endoscopic/video-assisted minithoracotomy, and direct-vision minithoracotomy. Meta-regression explored the impact of study-level covariates on mortality. RESULT(S): Fifteen studies including 3457 patients were analyzed. MI-MVS was associated with lower perioperative mortality compared with sternotomy MVS (odds ratio [OR], 0.33 [95% CI, 0.23-0.48]; P<0.001), reduced incidence of reoperation (OR, 0.65 [95% CI, 0.44-0.98]; P=0.04), and acute kidney injury (OR, 0.58 [95% CI, 0.39-0.87]; P=0.008); rates of stroke and arrhythmia were similar. The direction and magnitude of the mortality effect consistently favored MI-MVS in the subgroup analyses. Time-to-event analysis demonstrated improved survival with MI-MVS (HR, 0.74 [95% CI, 0.62-0.89]; P=0.001), but this was attenuated in the propensity-matched analysis. Meta-regression showed that sex distribution, mean age, and baseline left ventricular ejection fraction did not significantly moderate mortality effects. CONCLUSION(S): In redo MVS, MI-MVS is associated with improved perioperative outcomes without compromising long-term survival; however, attenuation of the survival difference after propensity matching suggests that this long-term advantage may reflect baseline risk rather than procedural effect. 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. <65> Accession Number 652341167 Title Left Atrial Appendage Closure Versus Oral Anticoagulation in Atrial Fibrillation: An Updated Meta-Analysis of RCTs Using Reconstructed Individual Patient Data. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 07 Oct 2026. Author Otaal A.; Coylewright M.; Alkhouli M.; Patel N.K.; Kolte D. Institution (Otaal, Patel, Kolte) Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States (Coylewright) Heart and Vascular Center, Essentia Health, Duluth, MN, United States (Alkhouli) Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, United States Abstract Left atrial appendage closure (LAAC) is a reasonable alternative to oral anticoagulation (OAC) in selected patients with atrial fibrillation (AF). We conducted an updated meta-analysis of RCTs comparing LAAC vs. OAC in patients with AF. The primary efficacy endpoint was a composite of all stroke, systemic embolism, or cardiovascular/all-cause death. The primary safety endpoint was major bleeding. Secondary endpoints included net adverse clinical events, all-cause death, non-procedure related bleeding, and ischemic stroke. Reconstructed IPD meta-analysis using a two-stage approach and study-level meta-analysis using random-effects models were performed. Six trials enrolling 7,004 patients randomized to LAAC (n=3,681) or OAC (n=3,323) were included. There were no significant differences between LAAC vs. OAC for the primary efficacy endpoint (RMST -0.006 years; 95% CI -0.027 to 0.015 years, p=0.56) or primary safety endpoint (RMST 0.004 years; 95% CI -0.025 to 0.034 years; p=0.77) at 3 years. Non-procedure related bleeding was significantly lower with LAAC vs. OAC (RMST 0.162 years; 95% CI 0.104 to 0.220 years, p<0.001) with no difference in all-cause death (RMST 0.029 years, 95% CI -0.031 to 0.089 years, p=0.34). In a study-level meta-analysis, ischemic stroke was not significantly different with LAAC vs. OAC (RR 1.32; 95% CI 0.94 to 1.86; p=0.09). In conclusion, the trade-off between a statistically significant lower risk of non-procedure related bleeding and a numerically, but not statistically, higher risk of ischemic stroke with LAAC vs. OAC necessitates individualized risk assessment and shared decision making for patients with AF at elevated risk of stroke. Copyright © 2026 Elsevier Inc. All rights reserved. <66> Accession Number 2049588572 Title Diagnostic accuracy of doppler-derived renal ultrasound parameters for predicting acute kidney injury after cardiac surgery: a systematic review and meta-analysis. Source Clinical and Experimental Nephrology. (no pagination), 2026. Date of Publication: 2026. Author Gomez L.E.J.; Diaz-Brochero C.; Hernandez D.P.; Malagon S.V.; Caicedo-Ruiz J.D.; Martin D.; Moreno L.C.T. Institution (Gomez, Diaz-Brochero, Hernandez, Martin, Moreno) Departamento de Medicina interna, Pontificia Universidad Javeriana, Carrera 7 # 40-62. 7th floor, Bogota, Colombia (Diaz-Brochero, Caicedo-Ruiz) Departamento de Epidemiologia clinica y bioestadistica, Pontificia Universidad Javeriana, Bogota, Colombia (Malagon) Departamento de Medicina interna, Universidad Nacional de Colombia, Bogota, Colombia (Malagon, Martin) Departamento de Medicina interna, Hospital Santa Clara - ESE Centro Oriente subred, Bogota, Colombia (Caicedo-Ruiz) Departamento de Cuidados intensivos, Fundacion Universitaria Valle de Lili, Cali, Colombia Publisher Springer Abstract Background: Acute kidney injury (AKI) is a frequent and clinically significant complication following cardiac surgery. Doppler-derived renal ultrasound parameters-including the renal resistive index (RRI), semiquantitative power Doppler ultrasound (PDU) scales, and intrarenal venous flow (IRVF)-have been proposed as early, noninvasive predictors of postoperative AKI, but their diagnostic accuracy in this setting remains uncertain. Method(s): We conducted a systematic review of diagnostic test accuracy studies evaluating RRI, PDU, or IRVF for predicting AKI within 7 days after cardiac surgery in adult intensive care unit patients. MEDLINE, Embase, Cochrane CENTRAL, Scopus, Web of Science, and clinical trial registries were searched through June 2025. Sensitivity, specificity, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) were extracted or calculated. Meta-analysis was performed for RRI using hierarchical bivariate models; IRVF and PDU were summarized descriptively due to limited studies and heterogeneity. Result(s): Fourteen studies comprising 1,204 patients were included (12 RRI, 3 IRVF, 1 PDU). RRI thresholds between 0.71 and 0.74 demonstrated the highest diagnostic performance (AUC range 0.72-0.93). IRVF showed modest discrimination (AUC 0.62-0.66). Evidence for PDU was limited to one study. Substantial clinical and methodological heterogeneity was observed and overall certainty of evidence ranged from low to moderate. Conclusion(s): Among Doppler-derived renal ultrasound parameters, RRI appears to have the most consistent diagnostic accuracy for predicting AKI after cardiac surgery. However, methodological heterogeneity, the limited number of studies, and the low-to-moderate certainty of the evidence preclude definitive clinical recommendations. Prospective multicenter validation studies with standardized protocols and prespecified thresholds are warranted. Copyright © The Author(s), under exclusive licence to Japanese Society of Nephrology 2026. <67> Accession Number 2049593865 Title Ocular and Visual Complications Following Cardiac Surgery: A Scoping Review. Source SN Comprehensive Clinical Medicine. 8(1) (no pagination), 2026. Article Number: 505. Date of Publication: 01 Dec 2026. Author Georgiadou M.; Kanavos T.; Birbas E.; Marinakis M.; Tsaftaridis N. Institution (Georgiadou) Department of Ophthalmology, Papageorgiou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece (Kanavos, Birbas, Tsaftaridis) Institute of Health System Science, Feinstein Institutes for Medical Research, Manhasset, NY, United States (Marinakis) CUNY School of Public Health and Health Policy, New York, NY, United States Publisher Springer Nature Abstract Background: Cardiac surgery carries a disproportionately elevated risk of perioperative ophthalmological complications compared with other surgical procedures. Despite growing recognition of ocular and visual complications in this setting, a comprehensive synthesis of their entire spectrum has been lacking. Objective(s): To systematically identify, map, and characterize the full range of ocular and visual complications reported following cardiac surgery, including disorders affecting ophthalmic structures, ocular motility, or visual function. Method(s): This scoping review was conducted following the Joanna Briggs Institute methodology and reported according to the PRISMA-ScR recommendations. PubMed, Embase, and Web of Science were searched from inception through January 2025 for studies reporting ocular or visual complications directly associated with heart or great vessel surgery. Evidence was charted by complication type and synthesized descriptively. Result(s): Our review included 115 studies, mostly case reports. The most frequently reported complications were ischemic optic neuropathy, retinal vascular occlusive disorders, cerebral visual impairment, pituitary apoplexy, midbrain ischemia, visual pseudohallucinations, Horner syndrome, endophthalmitis, supranuclear ocular motility disorders, and orbital hemorrhage. Less recognized potential complications included ocular hypotony, amaurosis fugax, chiasmal stroke, Miller Fisher syndrome, ocular ischemic syndrome, paracentral acute middle maculopathy, and retinal detachment. Based on case report data, patients were predominantly men and most often in their 6th or 7th decades of life, ischemic optic neuropathy accounted for the most events, and coronary artery bypass grafting was the most frequently implicated operation. Recurring perioperative associations with cardiopulmonary bypass, hemodynamic instability, embolic phenomena, anemia, and preexisting vascular comorbidities were observed across studies. Visual outcomes were variable, with many ischemic complications resulting in persistent deficits. Conclusion(s): Ocular and visual complications after cardiac surgery constitute a broad, heterogeneous group of disorders that, albeit rare, may result in substantial morbidity. Clinical awareness, perioperative vigilance, and prompt multidisciplinary evaluation may facilitate early identification and timely management. Copyright © The Author(s) 2026. <68> Accession Number 2050283297 Title Clinical Outcomes of Left Atrial Appendage Occlusion During Cardiac Surgery in Patients Without Atrial Fibrillation: A Systematic Review and Meta-Analysis. Source Journal of the American Heart Association. 15(19) (no pagination), 2026. Article Number: e049033. Date of Publication: 2026. Author Song Q.; Tu X.; Zheng Z.; Song L.; Fan C. Institution (Song, Tu, Zheng, Song, Fan) Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Hunan, Changsha, China Publisher American Heart Association Inc. Abstract BACKGROUND: The left atrial appendage is the primary source of cardiac thrombi, and prophylactic exclusion during cardiac surgery may.educe thromboembolic risk. However, its benefit in patients without preoperative atrial fibrillation (AF) remains uncertain. METHOD(S): We searched PubMed, Web of Science, EMBASE, and the Cochrane Library for randomized controlled trials and observational studies comparing surgical left atrial appendage occlusion (LAAO) versus no LAAO in patients with sinus rhythm undergoing cardiac surgery. Primary outcomes were new-onset transient ischemic attack (TIA)/stroke, postoperative AF, and all-cause death. Dichotomous outcomes were pooled as odds ratios and continuous outcomes as mean differences, with 95% CIs. RESULT(S): Eleven studies involving 12 145 participants were included. Compared with no LAAO, surgical LAAO.educed newonset TIA/stroke (odds ratio, 0.75 [95% CI, 0.62-0.90]) and bleeding (odds ratio, 0.78 [95% CI, 0.60-1.00]) but increased postoperative AF (odds ratio, 1.27 [95% CI, 1.06-1.53]). No significant differences were detected between the 2 groups in all-cause death, 30-day death, and length of stay. Subgroup analyses showed some variation in effect estimates across study design, type of surgery, and LAAO technique. CONCLUSION(S): In patients with sinus rhythm undergoing cardiac surgery, surgical LAAO was associated with a lower risk of new-onset TIA/stroke and bleeding but a higher incidence of postoperative AF, with no significant differences in all-cause death, 30-day death, or length of hospital stay. Study design, type of cardiac surgery, and LAAO technique may influence these associations. These findings should be interpreted cautiously given low to moderate certainty of evidence. 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 <69> Accession Number 652340210 Title Artificial intelligence in paediatric cardiac critical care: from predictive analytics to continuous physiologic intelligence. Source Cardiology in the young. (pp 1-7), 2026. Date of Publication: 08 Oct 2026. Author Savorgnan F.; Pilla P.; Loomba R.; Flores S. Institution (Savorgnan) Pediatrics, Baylor College of Medicine, United States (Pilla) Baylor College of Medicine, United States (Loomba) Northwestern University, United States (Flores) Baylor College of Medicine, United States Abstract OBJECTIVE: Artificial intelligence is increasingly applied in paediatric cardiology and cardiac intensive care, where CHD, postoperative physiologic instability, and continuous bedside monitoring generate complex datasets. This review summarises current applications of artificial intelligence in paediatric cardiology and the cardiac ICU, focusing on cardiac imaging, electrocardiography, predictive analytics, waveform intelligence, and postoperative outcome prediction. DATA SOURCES: A narrative review of PubMed, MEDLINE, and Scopus was performed for studies published from 2018 through 2026 evaluating artificial intelligence, machine learning, or deep learning in paediatric cardiology, CHD, congenital heart surgery, and cardiac critical care. STUDY SELECTION: Studies addressing paediatric or CHD-focused applications in echocardiography, cardiac MRI, electrocardiography, cardiac ICU monitoring, waveform analytics, or postoperative complication prediction were included, together with relevant reviews. DATA EXTRACTION: Information was extracted on study population, artificial intelligence method, clinical task, model inputs, outcomes, validation strategy, and major limitations. DATA SYNTHESIS: Artificial intelligence is most developed in imaging and electrocardiography, while paediatric and complex CHD evidence remains less mature. In cardiac ICU, models using electronic health record variables, high-frequency physiologic data, and risk indices have been evaluated for cardiac arrest, low cardiac output physiology, hyperlactatemia, extubation failure, and vasoactive de-escalation. External validation, prospective deployment, calibration, and workflow-safe implementation remain major gaps. CONCLUSION(S): Artificial intelligence may improve diagnostic consistency, risk stratification, and early recognition of deterioration, but prospective validation and measurable clinical benefit are needed before autonomous use. <70> Accession Number 652339960 Title Effects of remimazolam versus propofol on cerebral oxygenation in elderly patients undergoing prone spine surgery: study protocol for a randomised controlled trial. Source BMJ open. 16(10) (pp e123988), 2026. Date of Publication: 07 Oct 2026. Author Lazaro B.; Jin Z.; Sugaya Y.; Ueda K. Institution (Lazaro, Jin, Ueda) Department of Anesthesiology, Kameda Medical Center, Kamogawa, Chiba, Japan (Jin) Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, Portland, OR, United States (Jin) Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Okayama, Japan (Sugaya) Advanced Clinical Specialist Center, Kameda Medical Center, Kamogawa, Chiba, Japan (Ueda) Department of Anesthesiology, University of Iowa Hospitals and Clinics, Iowa City, IA, United States Abstract INTRODUCTION: Prone spine surgery may increase the risk of cerebral hypoperfusion and postoperative neurological adverse events, particularly in elderly patients. Remimazolam is a novel ultra-short-acting benzodiazepine anaesthetic that may provide greater haemodynamic stability than propofol. However, its effects on cerebral oxygenation during prone spine surgery remain unclear, indicating clinical equipoise between remimazolam and propofol. This study compares the effects of remimazolam and propofol on cerebral oxygenation in elderly patients undergoing thoracic or lumbar spine surgery in the prone position under general anaesthesia. METHODS AND ANALYSIS: This prospective randomised controlled trial will be conducted at a single tertiary medical centre. Sixty patients scheduled for elective lumbar or thoracic spine surgery in prone position will be randomly assigned in a 1:1 ratio to receive either remimazolam or propofol-based total intravenous anaesthesia. Regional cerebral oxygen saturation (rScO2) will be continuously monitored using near-infrared spectroscopy. The primary outcome is the between-group difference in time-weighted average change in rScO2 (DELTArScO2) in the prone position relative to baseline values in the supine position prior to the induction of anaesthesia. Secondary outcomes include cerebral desaturation events, intraoperative haemodynamic changes, vasopressor requirements, intraoperative complications and postoperative neurocognitive disorder assessed using Mini-Cog and Ultra-Brief Confusion Assessment Method. ETHICS AND DISSEMINATION: The study was approved by the Clinical Research Review Board of Kameda Medical Center (approval number 25-130; approval date: 5 February 2026). Written informed consent will be obtained from all participants before enrolment. The findings will be disseminated through publication in peer-reviewed journals and presentation at academic conferences. TRIAL REGISTRATION NUMBER: Japan Registry of Clinical Trials, jRCT1031250782, first registered on 6 March 2026. 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. <71> Accession Number 2038725816 Title Inspiratory Muscle Strength After Threshold Inspiratory Muscle Training Versus Incentive Spirometry in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Controlled Trial. Source Natural Resources for Human Health. 6(13S) (pp 1236-1246), 2026. Date of Publication: 11 Sep 2026. Author Hadju M.F.; Warliani M.; Aritonang S.E.; Zainuddin A.A.; Waluyo Y.; Kusumanegara J. Institution (Hadju, Warliani, Aritonang, Waluyo) Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Hasanuddin University, South Sulawesi, Makassar, Indonesia (Zainuddin) Department of Public Health, Faculty of Medicine, Hasanuddin University, South Sulawesi, Makassar, Indonesia (Kusumanegara) Department of Thoracic, Cardiac, and Vascular Surgery, Faculty of Medicine, Hasanuddin University, South Sulawesi, Makassar, Indonesia Publisher Visagaa Publishing House Abstract Respiratory dysfunction after coronary artery bypass grafting (CABG) may reduce inspiratory muscle strength and affect health-related quality of life. This single-center, assessor-blinded randomized controlled trial compared threshold inspiratory muscle training (IMT) with incentive spirometry (IS) in 30 adults undergoing elective CABG. Participants were randomized 1:1 to IMT or IS. IMT was performed for five preoperative days and IS for two days; both interventions were resumed after extubation and continued until discharge. Preoperative Strength Index (S-Index) was analyzed using ANCOVA adjusted for baseline values, while SF-12 Physical and Mental Component Summary scores were assessed at baseline, discharge, and 30 days. After baseline adjustment, preoperative S-Index was significantly higher with IMT than IS (85.85 vs 75.48 cmH2O; adjusted mean difference 10.37 cmH2O, 95% CI 2.52-18.22; p=0.012; partial eta2=0.214). PCS-12 and MCS-12 changed significantly over time (both p<0.001), but time-by-group interactions were not significant (p=0.621 and p=0.174, respectively). Hospital stay (9.60 vs 11.93 days; p=0.004) and ICU stay [median 2.0 vs 4.0 days; p=0.027] were shorter with IMT, although these were exploratory outcomes. Threshold IMT produced greater short-term preoperative improvement in dynamic inspiratory muscle strength than IS, while health-related quality-of-life trajectories did not differ between groups. Copyright © 2026, Visagaa Publishing House. All rights reserved. <72> Accession Number 2049089410 Title Left atrial appendage occlusion in patients with atrial fibrillation undergoing transcatheter aortic valve replacement: A meta-analysis. Source Journal of Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Abomohsen M.; Elboliney A.; Mohamed A.E.; Mahgoub I.; Sayed R.S.; Almakadma A.H.; Gadelmawla A.F.; Awashra A.; Gunsburg M.; Chadow H.L. Institution (Abomohsen, Mohamed, Almakadma) Department of Internal Medicine, Brookdale University Hospital & Medical Center, Brooklyn, NY, United States (Elboliney) Faculty of Medicine, Alexandria University, Alexandria, Egypt (Mahgoub) St. Joseph's University Medical Center, Paterson, NJ, United States (Sayed) NYC Health & Hospitals/South Brooklyn Health, Brooklyn, NY, United States (Gadelmawla) Faculty of Medicine, Menoufia University, Menoufia, Egypt (Awashra) Department of Medicine, An Najah National University, Nablus, Palestine (Gunsburg, Chadow) Division of Cardiology, One Brooklyn Health, Brooklyn, NY, United States Publisher Japanese College of Cardiology (Nippon-Sinzobyo-Gakkai) Abstract Background Stroke prevention after transcatheter aortic valve replacement (TAVR) in patients with atrial fibrillation remains clinically challenging because thromboembolic risk must be balanced against substantial bleeding vulnerability. Left atrial appendage occlusion (LAAO) has been proposed as a nonpharmacologic alternative to long-term anticoagulation in selected patients, but its comparative role in the TAVR population remains insufficiently defined. Methods We performed a systematic review and meta-analysis of comparative studies evaluating TAVR plus LAAO versus TAVR plus medical therapy in patients with atrial fibrillation. Randomized trials and observational comparative cohorts were eligible. The primary outcome was stroke, transient ischemic attack, or systemic embolism. Secondary outcomes were major bleeding and all-cause mortality. Random-effects odds ratios (ORs) with 95% confidence intervals (CIs) were pooled. Results Four studies comprising 652 patients were included, of whom 289 underwent TAVR plus LAAO and 363 received TAVR plus medical therapy. The evidence base included two randomized trials and two observational studies, with LAAO performed either concomitantly with TAVR or in a staged manner shortly thereafter. TAVR plus LAAO was not associated with a significant reduction in stroke/transient ischemic attack/systemic embolism compared with medical therapy (OR 0.83, 95% CI 0.40-1.74). There were also no significant differences in major bleeding (OR 1.10, 95% CI 0.68-1.77) or all-cause mortality (OR 0.93, 95% CI 0.62-1.40). Conclusions In the currently available comparative evidence, adding LAAO to TAVR was associated with similar thromboembolic, bleeding, and mortality outcomes compared with medical therapy. These findings do not support routine LAAO for all patients with atrial fibrillation undergoing TAVR, but they leave room for selective use in carefully chosen patients in whom long-term anticoagulation is undesirable. Copyright © 2026. Published by Elsevier Ltd. <73> Accession Number 2049376490 Title Effects of Inspiratory Muscle Training on Pulmonary Recovery and Complications in Cardiothoracic Surgery: A Systematic Review and Meta-Analysis. Source AORN Journal. 124(4) (pp 293-297), 2026. Date of Publication: 01 Oct 2026. Author Allen G. Institution (Allen) Healthcare Epidemiology, Fresh Meadows, NY, United States Publisher John Wiley and Sons Inc <74> Accession Number 2038744201 Title Low-molecular-weight heparin vs rivaroxaban for venous thromboembolism prevention after surgery: a systematic review and meta-analysis. Source Angiologia. 78(5) (pp 232-240), 2026. Date of Publication: 01 Sep 2026. Author Gonzalez-Sagredo A.; Hospedales J.; Villoria J.; Lopez-Sobrino T.; Videla S. Institution (Gonzalez-Sagredo, Hospedales) Department of Angiology, Vascular and Endovascular Surgery, Hospital Quironsalud del Valles, Department of Angiology, Vascular and Endovascular Surgery, Hospital Universitari Sagrat Cor, Sabadell, Spain (Villoria) Department of Design and Biometrics, Medicxact, Alpedrete, Spain (Lopez-Sobrino) Cardiovascular Institute, Hospital Clinic, Universitat de Barcelona, Barcelona, Spain (Videla) Department of Pharmacology, Therapeutics and Toxicology, Universitat Autonoma de Barcelona, Neuropharmacology & Pain Group, Neuroscience Program, Bellvitge Biomedical Research Institute, Clinical Research Support Area, Hospital Universitari Germans Tries i Pujol, Barcelona, Spain Publisher ARAN Ediciones S.L Abstract Objective: to determine whether rivaroxaban is comparable to low-molecular-weight heparin (LMWH) in terms of efficacy in preventing venous thromboembolism (VTE) after surgery and safety. Method(s): this meta-analysis was registered in PROSPERO (CRD420261293821) and conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ethical approval was not required for this study. The inclusion criteria were randomized controlled trials (RCTs) comparing LMWH vs rivaroxaban for VTE prevention after surgery. The MEDLINE and Scopus electronic databases were searched. Common-effect and random-effects estimates of the overall effects were calculated using the Mantel-Haenszel method. The confidence intervals for the random-effects estimates were calculated using the Hartung-Knapp method. The efficacy outcome was VTE incidence, and the safety outcome was major bleeding. Result(s): of the 1063 records identified, 985 were excluded based on title and abstract screening. Of the remaining 78 records, 6 trials met the inclusion criteria: 4 in orthopedic surgery, 1 in thoracic surgery, and 1 in gynecology. Patients receiving rivaroxaban had a significantly lower incidence of VTE than those receiving LMWH (OR, 0.54; 95 %CI, 0.30-0.98) and a nonsignificantly higher incidence of bleeding (OR, 1.72; 95 %CI, 0.75-3.94). Conclusion(s): rivaroxaban appears to be more effective than LMWH in preventing postoperative VTE and may be considered an appropriate option in patients at low risk of bleeding. In contrast, LMWH should be considered in patients at higher bleeding risk, such as those with advanced renal disease, liver disease, a history of gastrointestinal bleeding, hematological disorders, or concomitant antiplatelet therapy. Copyright © 2026 S. <75> Accession Number 652340453 Title The Impact of Renin-Angiotensin System Inhibitors on Postoperative Outcomes Following Coronary Artery Bypass Grafting: A Systematic Review. Source Cardiology in review. (no pagination), 2026. Date of Publication: 08 Oct 2026. Author Mansour A.; Elazab A.; Elbataa A.; Shubietah A.; Elkasaby M.H.; Balbaa E.; Ali A.H.G.; Gadelmawla A.F.; Emara A.; Abdul-Hafez H.A.; Elbahloul M.A.; Hageen A.W.; Mhanna M.; Frishman W.H.; Aronow W.S. Institution (Mansour, Elbataa, Elkasaby, Emara) From the Department of Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt (Elazab) Department of Medicine, Faculty of Medicine, South Valley University, Qena, Egypt (Shubietah) Department of Medicine, Advocate Illinois Masonic Medical Center, Chicago, IL, United States (Balbaa) Department of Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt (Ali) Department of Medicine, National Research Ogarev Mordovia State University, Saransk, Russian Federation (Gadelmawla) Department of Medicine, Faculty of Medicine, Menoufia University, Egypt (Abdul-Hafez) Department of Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine (Elbahloul) Department of Medicine, Faculty of Medicine, Kafr El-Shaikh University, Egypt (Hageen) Department of Medicine, Faculty of Medicine, Tanta University, Egypt (Mhanna) Division of Cardiovascular Medicine, Department of Medicine, University of Iowa, Iowa City, IA; and (Frishman, Aronow) Departments of Medicine, New York Medical College and Westchester Medical Center, Valhalla, NY, United States Abstract Patients undergoing coronary artery bypass grafting (CABG) remain at high risk of major adverse cardiovascular events and death despite successful revascularization, and the role of renin-angiotensin system inhibitors (RASi), comprising angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in this setting is not clearly defined. We systematically reviewed the effect of RASi initiated within 30 days after CABG on postoperative outcomes. PubMed, Web of Science, Scopus, and the Cochrane Library were searched through May 2025 for randomized controlled trials and observational studies comparing patients who received RASi after CABG, alone or with other cardiovascular medications, with those who did not. Five studies (3 RCTs and 2 retrospective cohorts) comprising 47,821 patients (28,917 RASi recipients and 18,904 controls) were included. RASi use after CABG was generally associated with a lower rate of major adverse cardiovascular events, with the largest reductions observed in patients with heart failure. The effect on all-cause mortality was inconsistent: 2 studies reported a reduced risk, whereas 2 reported no significant difference. Cardiovascular mortality findings were similarly variable, with 1 study showing a marked reduction, 1 an early increase in the composite endpoint that attenuated over longer follow-up, and 1 no significant change. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <76> Accession Number 2049566118 Title Evolocumab in patients with atherosclerotic cardiovascular disease: a systematic review and meta-analysis of efficacy and safety. Source BMC Cardiovascular Disorders. 26(1) (no pagination), 2026. Article Number: 883. Date of Publication: 01 Dec 2026. Author Li S.; Zhang C.; Liu Y. Institution (Li, Zhang, Liu) Physical Examination Center, Hebei General Hospital, 348 Heping West Road, Hebei, Shijiazhuang, China Publisher BioMed Central Ltd Abstract Background: Evolocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, potently reduces low-density lipoprotein cholesterol. However, its effects on hard clinical endpoints and safety in patients with atherosclerotic cardiovascular disease (ASCVD) require updated synthesis, particularly incorporating data from recent long-term extension studies and diverse subpopulations. Objective(s): To systematically evaluate the efficacy and safety of evolocumab in patients with ASCVD. Method(s): PubMed, Embase, Cochrane Library, OVID, China National Knowledge Infrastructure (WANFANG MED ONLINE and CNKI), and ClinicalTrials.gov were systematically searched from January 2014 to March 2026. Randomized controlled trials (RCTs) comparing evolocumab with placebo in patients with ASCVD were included. The primary endpoint was major adverse cardiovascular events (MACE). A random-effects model was used for meta-analysis, with subgroup analyses, meta-regression, sensitivity analyses, and publication bias assessment. Result(s): Eight RCTs comprising 40,658 patients were included. Regarding lipid parameters, evolocumab significantly reduced levels of low-density lipoprotein cholesterol (LDL-C; standardized mean difference [SMD]: -2.546, 95% confidence interval [CI]: -3.024 to -2.067, P < 0.001), total cholesterol (TC; SMD: -1.543, 95% CI: -1.947 to -1.139, P < 0.001), apolipoprotein B (Apo B; SMD: -1.598, 95% CI: -2.169 to -1.027, P < 0.001), and lipoprotein(a) (Lp(a); SMD: -0.713, 95% CI: -0.938 to -0.489, P < 0.001) compared with placebo, but showed no significant effect on high-density lipoprotein cholesterol (HDL-C; SMD: 0.233, 95% CI: -0.058 to 0.524, P = 0.117) or triglycerides (TG; SMD: -0.315, 95% CI: -0.765 to 0.136, P = 0.171). For clinical endpoints, evolocumab significantly reduced the odds of MACE compared with placebo (OR: 0.416, 95% CI: 0.248-0.698, P < 0.001; I2 = 86.7%); however, the 95% prediction interval crossed unity (0.13-1.36), indicating uncertainty about the true effect in future studies. Myocardial infarction (OR: 0.711, 95% CI: 0.661-0.765, P < 0.001), stroke (OR: 0.774, 95% CI: 0.693-0.864, P < 0.001), and coronary revascularization (OR: 0.777, 95% CI: 0.734-0.821, P < 0.001) all showed significant odds reductions. Evolocumab significantly reduced odds of cardiovascular death (OR: 0.771, 95% CI: 0.657-0.904, P = 0.002) and all-cause mortality (OR: 0.852, 95% CI: 0.762-0.953, P = 0.004). Safety analysis indicated that injection site reactions were more common with evolocumab (OR: 1.33, 95% CI: 1.12-1.59, P < 0.01), with no significant differences in serious adverse events, neurocognitive events, muscle-related events, or liver function abnormalities. Conclusion(s): In the context of optimized background therapy, evolocumab significantly reduces the odds of MACE, myocardial infarction, and stroke, and improves multiple atherogenic lipid parameters in patients with ASCVD. Notably, significant reductions in both cardiovascular and all-cause mortality were also observed in this updated analysis. Its overall safety profile is favorable. Copyright © The Author(s) 2026. <77> Accession Number 2049562987 Title Cognitive impairment in heart transplantation: prevalence, trajectories, and prognostic impact - a systematic review. Source Aging Clinical and Experimental Research. 38(1) (no pagination), 2026. Article Number: 199. Date of Publication: 01 Dec 2026. Author Parrotta I.; Valente M.; Piazzalunga E.; Scarpa E.; Mantini D.; Danesin L.; Rossi C.; Borgese L.; Golfieri L.; Burgio F.; Potena L. Institution (Parrotta, Piazzalunga, Scarpa, Danesin, Burgio) IRCCS San Camillo Hospital, Venice, Italy (Valente, Rossi, Borgese, Golfieri, Potena) IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy (Parrotta, Mantini) Movement Control and Neuroplasticity Research Group, Leuven, Belgium (Piazzalunga) Department of Cognitive Brain Sciences, University School for Advanced Studies IUSS Pavia, Pavia, Italy Publisher Springer Science and Business Media Deutschland GmbH Abstract Background/Aim: Heart transplantation (HTx) represents the definitive treatment for patients with end-stage heart failure (HF). Neurological complications, particularly cognitive impairment (CI), may influence prognosis, thereby affecting the overall benefits of HTx. CI in HF is associated with disease severity, extracardiac dysfunction, and peri- or intra-operative factors such as prolonged ventilation, cerebral hypoperfusion, and systemic inflammation. However, existing studies on CI in HTx candidates are highly heterogeneous, limiting comparability and highlighting the need for a clearer understanding of its impact in both candidates and recipients. Method(s): This systematic review was registered with PROSPERO (CRD42024549051) and conducted in accordance with PRISMA guidelines. PubMed, Scopus, and Embase were searched for studies published between 2013 and June 2025. Eligible studies assessed cognitive function in adult HF patients undergoing HTx. Result(s): Of 1188 records screened, eight studies met the inclusion criteria. Most cognitive studies employed the Montreal Cognitive Assessment (MoCA), while two used comprehensive neuropsychological batteries. Evidence confirmed that CI is common among HF and HTx populations. Incorporating cognitive status into frailty assessments enhanced prediction of adverse outcomes, including prolonged hospitalization and reduced survival. Cognitive decline was frequently observed in the immediate post-transplant period, often linked to high-dose immunosuppressive therapy and anemia, while long-term improvements were reported in attention, memory, and executive function. Conclusion(s): Cognitive assessment is essential in HTx candidates, as CI has a major impact on survival. Further studies are needed to clarify long-term cognitive trajectories and the role of immunosuppressive therapy in shaping outcomes. Copyright © The Author(s) 2026. <78> Accession Number 2050339323 Title Percutaneous left atrial appendage occlusion versus oral anticoagulation in atrial fibrillation: A pragmatic meta-analysis of randomized trials within the DOAC era. Source American Heart Journal Plus: Cardiology Research and Practice. 71 (no pagination), 2026. Article Number: 100942. Date of Publication: 01 Nov 2026. Author Kuniyoshi G.M.; Campane R.Z.; Patil N.; de Oliveira A.C.V.; Araujo B.; Kuniyoshi R.R. Institution (Kuniyoshi) Department of Medicine, Escola Superior de Ciencias da Santa Casa de Misericordia de Vitoria (EMESCAM), 2190 Nossa Senhora da Penha Avenue, Vitoria, Brazil (Campane) Department of Medicine, Hospital Regional Hans Dieter Schimidt, 330 Xavier Arp Street, Joinville, Brazil (Patil) Hospitalist Department, Cape Fear Valley Health, 1638 Owen Drive, Fayetteville, NC, United States (de Oliveira) Department of Medicine, Universidade Federal de Lavras, Trevo Rotatorio Professor Edmir Sa Santos, Lavras, Brazil (Araujo) Department of Medicine, Universidade Nove de Julho, 90 Dom Jaime de Barros Camara Avenue, Sao Bernardo do Campo, Brazil (Kuniyoshi) Department of Cardiac Arrhythmias, Centrocor, 60 Alfeu Alves Pereira Street, Vitoria, Brazil (Kuniyoshi) Department of Cardiac Arrhythmias, Vitoria Apart Hospital, 591 Governador Mario Covas, Serra, Brazil (Kuniyoshi) Department of Electrophysiology, Hospital Universitario Cassiano Antonio Moraes (HUCAM), Universidade Federal do Espirito Santo (UFES), 1355 Marechal Campos Avenue, Vitoria, Brazil Publisher Elsevier Inc. Abstract Background: Percutaneous left atrial appendage occlusion (LAAO) is an established alternative to oral anticoagulation (OAC). However, its safety and efficacy boundaries remain incompletely defined in dedicated comparisons against direct oral anticoagulants (DOACs). Objective(s): This study applied a pragmatic framework to evaluate the comparative efficacy and safety of LAAO versus OAC in a DOAC-predominant setting. Method(s): PubMed, Embase, and Cochrane Library were searched for randomized controlled trials comparing LAAO with OAC, restricted to a DOAC-predominant comparator. Risk ratios (RR) with 95% confidence intervals (CI) were calculated via a Mantel-Haenszel random-effects model. Result(s): Four trials comprising 5890 patients were included (96.4% of controls assigned to DOACs). Overall stroke (RR 1.18, 95% CI 0.87-1.60; p = 0.28), systemic embolism (RR 1.09, 95% CI 0.29-4.08; p = 0.89), major bleeding (RR 0.98, 95% CI 0.81-1.19; p = 0.85), hemorrhagic stroke (RR 0.82, 95% CI 0.45-1.51; p = 0.53), and all-cause mortality (RR 1.00, 95% CI 0.85-1.17; p = 0.99) did not differ significantly. Ischemic stroke presented numerical asymmetry favoring OAC that approached statistical significance (RR 1.36, 95% CI 0.99-1.89; p = 0.06). Conversely, within available protocol-defined datasets, LAAO significantly reduced nonprocedural clinically relevant bleeding (RR 0.50, 95% CI 0.43-0.60; p < 0.01). Conclusion(s): In a pragmatic analysis of the DOAC era, randomized data show no statistically significant differences for hard individual endpoints, though broad confidence intervals reflect precision limits. A numerical asymmetry for ischemic stroke favored OAC, while LAAO reduced nonprocedural clinically relevant bleeding. Current evidence remains non-definitive, warranting shared clinical decision-making to balance individual thromboembolic risks against long-term bleeding susceptibility. Copyright © 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY-NC license. http://creativecommons.org/licenses/by-nc/4.0/ <79> Accession Number 2050234407 Title Very-Early Discharge After Transcatheter Aortic Valve Replacement: Updated Systematic Review and Meta-Analysis of Contemporary Readmission and Clinical Outcomes. Source Cardiology in Review. (no pagination), 2026. Date of Publication: 2026. Author Cheema A.A.A.; Alam B.; Tayyebah A.; Waqar H.; Hans K.; Nofal A.; Abdullah H.; Haseeb A.; Sharab A.; Islam M.M.; Bhatt J. Institution (Cheema) International School of Medicine, International University of Kyrgyzstan, Bishkek, Kyrgyztan (Alam) Department of Medicine, Rehman Medical College, Peshawar, Pakistan (Tayyebah, Sharab) General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia (Waqar) Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, United States (Hans) Windsor University School of Medicine, Oakbrook, IL, United States (Nofal) Services Institute of Medical Sciences, Lahore, Pakistan (Abdullah) Abdullah Memorial Hospital, Faisalabad, Pakistan (Haseeb) Shifa College of Medicine, Islamabad, Pakistan (Islam) Lady Hardinge Medical College, New Delhi, India (Bhatt) GMERS Medical Hospital, Gotri, Vadodara, India Publisher Lippincott Williams and Wilkins Abstract Very-early discharge after transcatheter aortic valve replacement (TAVR) is increasingly incorporated into contemporary care pathways, but comparative outcomes remain vulnerable to clinical selection and reverse causation. We aimed to evaluate contemporary readmission and clinical outcomes associated with very-early versus later discharge after TAVR. The Medical Literature Analysis and Retrieval System Online via PubMed and the Cochrane Central Register of Controlled Trials were searched from inception through June 2026. Comparative studies evaluating same-day discharge, next-day discharge, discharge within 24 hours, hospital length of stay of 1 day or less, or corresponding institutional strategies were eligible. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using inverse-variance random-effects models. Thirteen observational studies were included; 12 contributed crude binary data from up to 24, 984 patients. Very-early discharge was associated with lower 30-day all-cause readmission (OR, 0.74; 95% CI, 0.67-0.82), early mortality (OR, 0.40; 95% CI, 0.30-0.54), and stroke or cerebrovascular events (OR, 0.58; 95% CI, 0.45-0.76). Delayed or post-discharge permanent pacemaker implantation was inconclusive. The readmission association became nonsignificant after the exclusion of the largest study. Certainty ranged from very low to low. Very-early discharge was associated with favorable outcomes in selected cohorts, but serious bias and influential studies preclude causal or universal conclusions. Structured, criteria-based pathways require rigorous prospective validation and standardized follow-up across diverse contemporary clinical settings. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <80> Accession Number 2050092316 Title Top 20 Research Studies of 2025 for Primary Care Physicians. Source American Family Physician. 114(2) (pp 175-183), 2026. Date of Publication: 01 Aug 2026. Author Ebell M.H.; Grad R. Institution (Ebell) Department of Family Medicine, Michigan State University, East Lansing, United States (Grad) McGill University, Montreal, QC, Canada Publisher American Academy of Family Physicians Abstract This article summarizes the top 20 research studies of 2025 identified as POEMs (patient-oriented evidence that matters). Treating male sex partners of female patients with oral and topical medication reduces recurrence of bacterial vaginosis. Anti-influenza drugs do not reduce hospitalizations or mortality. COVID-19 vaccines still improve mortality and reduce hospitalizations. Influenza vaccines are safe in pregnancy. Vaginal estrogen appears to be safe in breast cancer survivors. Women with normal bone density given zoledronic acid every 5 years have fewer fractures. Early postpartum insertion of a long-acting reversible contraceptive is associated with fewer pregnancies vs delayed insertion. Early medication abortion before pregnancy confirmation is safe and effective. After stent placement in patients with atherosclerotic coronary vascular disease who are taking an anticoagulant, adding aspirin worsens outcomes. After catheter ablation for atrial fibrillation, discontinuing anticoagulants after 1 year is safe if atrial arrhythmia does not recur, whereas left atrial appendage closure is superior to oral anticoagulation. For patients with provoked venous thromboembolism and at least one ongoing risk factor, 12 months of apixaban is better than 3 months. Clopidogrel is slightly more effective than aspirin for the secondary prevention of myocardial infarction and stroke over 3 years. Intensive blood pressure lowering decreases cardiovascular events but increases rates of hypotension and syncope, and there are concerns about the applicability of the data to the United States. Duloxetine, milnacipran, and pregabalin provide meaningful pain reduction in adults with fibromyalgia. Amyloid-directed monoclonal antibodies do not provide clinically meaningful cognitive benefits and may cause harms. Bright light therapy is effective for nonseasonal depression. Water exposure 6 hours after cutaneous surgery does not increase the risk of complications. A meta-analysis of platelet-rich plasma injections for knee osteoarthritis concluded that high-quality studies found no meaningful pain improvement. Using an oral challenge to rule out sulfonamide allergy is safe when used with a risk assessment tool. Copyright © 2026 American Academy of Family Physicians. <81> Accession Number 2050354225 Title Home versus centre exercise-based cardiac rehabilitation after coronary artery bypass grafting: a systematic review and meta-analysis. Source Heart and Lung. 80 (no pagination), 2026. Article Number: 102975. Date of Publication: 01 Nov 2026. Author Zheng X.; Liu R.; Yu Z.; Lu F. Institution (Zheng, Liu, Yu, Lu) Department of Nursing, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China (Zheng) Department of Nursing, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China Publisher Elsevier Inc. Abstract Background: Exercise-based home-based cardiac rehabilitation (HBCR) is an alternative to exercise-based centre-based cardiac rehabilitation (CBCR) following coronary artery bypass grafting (CABG); however, its effects on functional capacity, psychological outcomes, and health-related quality of life remain uncertain. Objective(s): To evaluate exercise-based HBCR compared with exercise-based CBCR or usual care (UC) after CABG. Method(s): The protocol was registered in PROSPERO (CRD420251238099) on 23 November 2025, followed by the formal systematic search on 25 November 2025 in PubMed (MEDLINE), Embase, Cochrane CENTRAL, Web of Science, and CINAHL. Randomized controlled trials comparing exercise-based HBCR with CBCR or UC were included. Outcomes included peak oxygen uptake (VO2), waist-hip ratio (WHR), health-related quality of life (HRQoL), anxiety, and depression. Mean differences (MDs) with 95% confidence intervals (CIs) were pooled. Result(s): Nine trials (n = 991) were included. No significant difference in peak VO2 was observed between HBCR and CBCR (MD = -0.22, 95% CI -1.24 to 0.80; I2 = 0%). Anxiety favored HBCR over UC (MD = -2.85, 95% CI -5.05 to -0.65), but heterogeneity was extreme (I2 = 90%). No significant difference in depression was observed (MD = -1.83, 95% CI -4.15 to 0.48; I2 = 95%). HRQoL and body composition were each reported by only two studies and were not meta-analyzed. Conclusion(s): Evidence suggests no significant difference in functional capacity between exercise-based HBCR and CBCR. Evidence for patient-reported and psychosocial outcomes remains limited and inconclusive, and no firm conclusions can be drawn. Findings should be interpreted cautiously given the small number of studies and substantial heterogeneity. Copyright © 2026 <82> Accession Number 2050215693 Title Early Mitral Valve Surgery and Survival in Asymptomatic Severe Primary Mitral Regurgitation. Source JAMA Network Open. 9(10) (no pagination), 2026. Article Number: e2637061. Date of Publication: 2026. Author Ahn J.; Kwak S.; Lim J.; Kim K.; Kim J.; Sun B.J.; Kim D.-H.; Kim K.H.; Shim C.Y.; Park S.-J.; Won S.; Lee S.-P. Institution (Ahn) Division of Data Science, University of Suwon, Hwaseong, South Korea (Ahn, Won) Institute of Health and Environment, Seoul National University, Seoul, South Korea (Kwak, Lim, Lee) Division of Cardiology, Cardiovascular Center, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea (Kim, Shim) Division of Cardiology, Severance Cardiovascular Hospital, College of Medicine, Yonsei University, Seoul, South Korea (Kim, Park) Division of Cardiology, Heart Vascular Stroke Institute, Samsung Medical Centre, School of Medicine, Sungkyunkwan University, Seoul, South Korea (Sun, Kim) Division of Cardiology, College of Medicine, University of Ulsan, Asan Medical Centre, Seoul, South Korea (Kim) Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, South Korea (Won) Department of Public Health Sciences, Seoul National University, Seoul, South Korea (Won) Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul, South Korea (Won) RexSoft Inc, Seoul, South Korea (Lee) Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, South Korea (Lee) Center for Precision Medicine, Seoul National University Hospital, Seoul, South Korea Publisher American Medical Association Abstract Importance The optimal timing of mitral valve (MV) surgery in patients with asymptomatic severe primary mitral regurgitation (MR) remains uncertain because randomized clinical trials are lacking. Objective To evaluate the association of early MV surgery with long-term survival in patients with asymptomatic severe primary MR using a target trial emulation framework. Design, Setting, and Participants This cohort study used a clinical valve registry from 3 tertiary hospitals in South Korea between 2000 and 2022. Patients with asymptomatic severe primary MR were analyzed using a clone-censor-weight approach to emulate a target trial. A 6-month grace period after diagnosis was used to define treatment strategies. This analysis was conducted from September 2024 to January 2025. Exposure Early MV surgery (within 6 months of diagnosis) vs watchful waiting. Main Outcomes and Measures The primary outcome was all-cause mortality and the secondary outcome, a composite of all-cause mortality or heart failure hospitalization. Inverse probability of censoring-weighted estimates of the per-protocol effect size included restricted mean survival time (RMST) differences as the primary measure and hazard ratios (HRs) as secondary measures. Results Among 802 patients (mean [SD] age, 55 [16] years; 476 men [59%]), 344 underwent early surgery, and 458 received watchful waiting. During a median (IQR) follow-up of 7.4 (4.1-11.6) years, 27 deaths occurred in the early surgery group and 103 in the watchful waiting group. At 5 years, early surgery was associated with an RMST gain of 66 days (95% CI, 19-129 days). The survival benefit persisted up to 15 years. Early surgery was also associated with a lower risk of all-cause mortality compared with watchful waiting (HR, 0.69; 95% CI, 0.41-0.94; P =.02). Similar associations were observed in patients without left ventricular decompensation (HR, 0.61; 95% CI, 0.31-0.96; P =.04) and in those with degenerative MR (HR, 0.66; 95% CI, 0.36-0.98; P =.04). Conclusions and Relevance In this multicenter cohort study with a target trial framework, early surgery was associated with improved long-term survival among patients with asymptomatic severe primary MR. These findings support consideration of earlier surgical intervention in contemporary clinical practice. Copyright © 2026 Ahn J et al. <83> Accession Number 2050116458 Title Systematic review, meta-analysis of cusp-overlap vs. three-cusp coplanar approaches in self-expandable transcatheter aortic valve replacement. Source Frontiers in Cardiovascular Medicine. 13 (no pagination), 2026. Article Number: 1870774. Date of Publication: 2026. Author Ghannam M.; Abomohsen M.; Idries I.Y.; Shamoon F.; Vasudev R.; Moghib K.; Ghallab M.; Zghyer F.; Gonzalez A.V.; Ahmad A.; Habib H.A. Institution (Ghannam, Abomohsen, Idries) Brookdale University Hospital and Medical Center, Brooklyn, NY, United States (Shamoon, Vasudev, Ahmad, Habib) St. Joseph's University Medical Center, Paterson, NJ, United States (Moghib) Faculty of Medicine Kasralainy Cairo University, Cairo, Egypt (Ghallab) Department of Cardiovascular Medicine, Creighton University, Omaha, NE, United States (Zghyer) Heart, Vascular and Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, United States (Gonzalez) Department of Cardiology, Heart Failure Division, University of Alabama at Birmingham, Birmingham, AL, United States Publisher Frontiers Media SA Abstract Background - The cusp-overlap technique (COT) is an alternative fluoroscopic approach to the standard three-cusp technique (ST) in self-expandable transcatheter aortic valve replacement (TAVR). It may improve implantation depth and reduce conduction disturbances, but its overall clinical benefit remains unclear. Objectives - To compare the safety and efficacy of COT vs. ST in terms of mortality, conduction disturbances, permanent pacemaker implantation (PPI), and cerebrovascular accidents (CVA). Methods - This systematic review and meta-analysis followed PRISMA guidelines. PubMed, Cochrane, Scopus, Embase, and Web of Science were searched up to October 2025. Studies comparing COT and ST were included. Data extraction and risk-of-bias assessment were performed independently. Meta-analysis was conducted using R with fixed- and random-effects models. Outcomes included mortality (by follow-up), conduction disturbances, PPI, and CVA. The protocol was registered in PROSPERO (CRD420251156402). Results - Eighteen studies were analyzed, with patient numbers varying by outcome (mortality: 5, 984 patients; conduction disturbances: 7, 200 patients; PPI: 5, 712 patients; CVA: 4, 066 patients). COT significantly reduced mortality compared with ST (OR: 0.60, 95% CI: 0.40-0.88; p = 0.010; I2 = 0%), with the strongest effect observed at 30 days. Conduction disturbances were also lower with COT (OR: 0.62, 95% CI: 0.48-0.82; p = 0.0006; I2 = 77.7%), driven by reductions in both complete atrioventricular block and left bundle branch block. The risk of PPI was markedly reduced with COT (OR: 0.50, 95% CI: 0.39-0.63; p < 0.0001; I2 = 23.0%). In contrast, there was no significant difference in CVA between groups (random-effects OR: 1.05, 95% CI: 0.73-1.51; p = 0.78; I2 = 0%). Conclusion - COT in self-expandable TAVR is associated with lower rates of conduction disturbances and PPI, and reduced short-term mortality, without increasing cerebrovascular risk. While these findings are consistent and clinically plausible, the overall certainty of evidence is limited. COT appears to be a promising procedural refinement, but further randomized studies are needed to confirm long-term benefits. Systematic Review Registration - identifier CRD420251156402. Copyright © 2026 Ghannam, Abomohsen, Idries, Shamoon, Vasudev, Moghib, Ghallab, Zghyer, Gonzalez, Ahmad and Habib. <84> Accession Number 652325847 Title Twenty-Third Annual Scientific Congress. Source Journal of the Hong Kong College of Cardiology. Conference: Twenty-Third Annual Scientific Congress. Hong Kong Hong Kong. 23(1) (no pagination), 2015. Date of Publication: 01 Apr 2015. Author Anonymous Publisher Medcom Limited Abstract The proceedings contain 65 papers. The topics discussed include: novel application of transradial coronary catheter Ikari Left 5 Fr. (IL3.5/4) for both coronary and selective carotid angiography; levels of asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor, and risk of coronary artery disease: a meta-analysis based on 4,713 participants; behavioral risk factors: health - related quality of life among patient with coronary heart disease; clinical outcome of bare metal in-stent restenosis treated with drug eluting stent; outcomes in reperfusion therapy of octogenarians with ST-segment elevation myocardial infarction; 1 year outcome comparing drug coated balloon only angioplasty versus second generation DES in diabetic patients with de novo small vessel coronary artery disease; a novel mutation of TBX5 gene in Chinese patients with isolated ventricular septal defect; comparison of transcatheter aortic valve implantation (TAVI) in extreme-risk and high-risk patients in the local Asian population; changes in echocardiographic, functional and psychological improvement in adults following percutaneous transcatheter atrial septal defect closure: a pilot study; transcatheter aortic valve implantation by hydra transcatheter aortic valve system: first-in-man experience; impacts of valvulo-arterial impedance on severe aortic stenosis - a multi-imaging modalities prospective; and effect of continuous positive airway pressure therapy on right ventricular function by speckle tracking in obstructive sleep apnea subjects. <85> Accession Number 2049027135 Title Percutaneous Left Atrial Appendage Occlusion Versus Oral Anticoagulation in Atrial Fibrillation: A Systematic Review and Bayesian Meta-analysis. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(10) (no pagination), 2026. Article Number: 105625. Date of Publication: 01 Oct 2026. Author Rai A.; Kandala A.; Bola H.; Schurr J.; Singh M.; Ahmad Y.; Fanaroff A.; Hu R.; Malik N.; Frankel D.S.; Markman T.; Nazarian S.; Giri J.; Shah T.; Nathan A. Institution (Rai) Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States (Rai, Bola) Faculty of Medicine, Imperial College London, London, United Kingdom (Kandala) Faculty of Medicine, University College London, London, United Kingdom (Schurr, Fanaroff, Hu, Malik, Frankel, Markman, Nazarian, Giri, Shah, Nathan) Division of Cardiology, Hospital of the University of Pennsylvania, Philadelphia, PA, United States (Singh) Department of Medicine, University of Rochester Medical Center, Rochester, NY, United States (Ahmad) Division of Cardiology, University of California San Francisco, San Francisco, CA, United States Publisher Elsevier B.V. Abstract Background Conflicting randomized trial results have generated uncertainty regarding percutaneous left atrial appendage occlusion (LAAO) vs oral anticoagulation (OAC) for stroke prevention in atrial fibrillation (AF). Thus, the objective of this study is to estimate the posterior probability that LAAO confers clinically meaningful excess ischemic stroke risk relative to OAC. Methods A Bayesian hierarchical meta-analysis was performed of RCT comparing LAAO with OAC in nonvalvular AF. The primary outcome was ischemic stroke, analyzed using Bayesian random-effects Poisson regression under a vague (primary), skeptical, and enthusiastic prior specification. Results Six RCT (7004 patients, +18,000 patient-years) were included. Ischemic stroke incidence rate ratio (IRR) was 1.34 (95% credible interval [CrI], 0.91-1.97; P [IRR > 1.0] = 94%). The probability of exceeding 0.5 and 1.0 excess events/100 patient-years was 12% and 0.5%, respectively. The effect on any-stroke was smaller (IRR, 1.09; 95% CrI, 0.76-1.56; P [IRR > 1.0] = 70%; P [absolute rate difference >0.5%/y] = 4.7%), because of a reduction in hemorrhagic stroke (IRR, 0.55; 95% CrI, 0.23-1.18; P [IRR < 1.0] = 94.5%). The decrease in hemorrhagic stroke was attenuated among trials using direct oral anticoagulants for medical management (IRR, 0.80; 95% CrI, 0.33-1.75). Conclusions In AF, there is a high posterior probability that LAAO is associated with a higher rate of any-stroke, driven by an increase in ischemic stroke relative to OAC. However, the 95% CrI for ischemic stroke crossed unity, and the estimated absolute excess is small. This possible excess must be weighed against a substantial reduction in the risk of hemorrhagic stroke. Copyright © 2026 . <86> Accession Number 2049536885 Title Association Between Relative Plasma Hyperosmolality and Postoperative Delirium Following Cardiac Surgery: A Post Hoc Analysis. Source Journal of Perianesthesia Nursing. (no pagination), 2026. Date of Publication: 2026. Author Lingehall H.C.; Svenmarker S.; Appelblad M.; Gustafson Y.; Olofsson B. Institution (Lingehall, Olofsson) Department of Nursing, Umea University, Vasterbotten, Umea, Sweden (Lingehall) Department of Cardiothoracic Surgery, Orebro University Hospital, Narke, Orebro, Sweden (Svenmarker, Appelblad) Department of Public Health and Clinical Medicine, Heart Centre, Umea University, Vasterbotten, Umea, Sweden (Gustafson) Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umea University, Vasterbotten, Umea, Sweden (Olofsson) Department of Diagnostics and Intervention, Orthopedics, Umea University, Vasterbotten, Umea, Sweden Publisher W.B. Saunders Abstract Purpose To determine whether relative plasma hyperosmolality is independently associated with postoperative delirium (POD) and to explore the relationship between the cumulative number of concurrent perioperative variables and POD in patients aged greater than or equal to 65 years undergoing cardiac surgery. Design Post hoc analysis. Methods This post hoc analysis of a randomized controlled trial included 195 consecutive patients enrolled between March 2019 and June 2020 at a tertiary hospital in Sweden. The incidence of POD was 36% (70/195). POD was assessed preoperatively and postoperatively on days 1 and 3, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition . Plasma osmolality was measured on five occasions and coordinated with POD assessments. Potential perioperative variables associated with POD were analyzed using a multivariable logistic regression model. Findings The main findings indicate that relative hyperosmolality on the third postoperative day may represent a biochemical factor independently associated with the development of POD, and the presence of more than two concurrent perioperative factors, which may increase the likelihood of POD eightfold. Conclusions Relative plasma hyperosmolality may be associated with POD after cardiac surgery. The accumulation of concurrent perioperative variables also appears important and supports further investigation of multicomponent prevention strategies. Multicenter studies are needed to confirm these findings. Copyright © 2026 The Authors. <87> Accession Number 2049536947 Title Beyond the 100-bpm Dogma: A Physiology-Guided Approach to Early Postoperative Heart Rate Management After Heart Transplantation. Source Clinical Transplantation. 40(10) (no pagination), 2026. Article Number: e70710. Date of Publication: 01 Oct 2026. Author Franchi F.; Marianello D.; Bianchi C.; Biuzzi C.; Gottin L.; Peluso L.; Maccherini M.; Cameli M.; Vendramin I.; Scolletta S.; Sponga S. Institution (Franchi, Marianello, Bianchi) Department of Medical Science, Surgery and Neurosciences, Cardiothoracic and Vascular Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy (Biuzzi, Scolletta) Department of Medicine, Surgery and Neurosciences, Anesthesia and Intensive Care Unit, University Hospital of Siena, Siena, Italy (Gottin, Peluso) Cardiothoracic and Vascular Intensive Care Unit, University Hospital of Verona, Verona, Italy (Maccherini, Sponga) Department of Medical Science, Surgery and Neurosciences, Division of Cardiac Surgery, University of Siena, Siena, Italy (Cameli) Department of Medical Biotechnologies, Division of Cardiology, University of Siena, Siena, Italy (Vendramin) Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, University Hospital of Udine, Udine, Italy Publisher John Wiley and Sons Inc Abstract Early postoperative heart rate (HR) management after heart transplantation (HTx) remains largely guided by historical haemodynamic concepts that support maintaining elevated HR to compensate for reduced stroke volume. This structured narrative review re-examines the physiological rationale and contemporary evidence underlying this approach, with the aim of refining perioperative chronotropic strategies. A comprehensive analysis of studies addressing early HR behavior, sinus node dysfunction (SND), pacing strategies, chronotropic therapies, and their association with clinical outcomes was performed. Classic studies from the 1970s described marked stroke-volume depression and a strong dependence of cardiac output on HR, forming the basis for maintaining HR around 90-100 bpm. However, contemporary evidence indicates a more heterogeneous early graft physiology, often with less pronounced stroke-volume limitation, and highlights potential adverse effects associated with excessive adrenergic stimulation, including renal dysfunction and worse mid-term outcomes. SND is common but typically transient, and atrial or atrioventricular-synchronous pacing can restore HR without the metabolic burden of beta-adrenergic stimulation. In contrast, isoproterenol provides combined chronotropic and inotropic support but may increase myocardial oxygen consumption, shorten diastolic filling time, and impair right ventricular-pulmonary artery coupling when perfusion pressure is inadequate. Integration of perfusion markers, such as lactate and central venous oxygen saturation, with echocardiographic and invasive haemodynamic assessment is essential to determine whether HR augmentation improves oxygen delivery or instead increases metabolic stress. Early HR management after HTx should therefore be individualized and guided by integrated physiological assessment rather than fixed HR targets. Prospective studies are needed to define evidence-based chronotropic strategies. Copyright © 2026 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. <88> Accession Number 2049543299 Title Routine Versus Deferred Percutaneous Coronary Intervention in Patients Undergoing Transcatheter Aortic Valve Replacement: A Meta-analysis With Reconstructed Individual Patient Data. Source Journal of the Society for Cardiovascular Angiography and Interventions. 5(10) (no pagination), 2026. Article Number: 105566. Date of Publication: 01 Oct 2026. Author Balata M.; Badran A.S.; Gbreel M.I.; Hassan M.; Ebeid I.; Abdelrahman A.A.; Robinson D.; Bodanowitz J.; Valenta S.; Valenta C.; Kochev P.; Ince H.; Ortak J. Institution (Balata, Robinson, Bodanowitz, Valenta, Valenta, Kochev, Ince, Ortak) Department of Cardiology, University Hospital of Rostock, Rostock, Germany (Badran) Faculty of Medicine, Ain Shams University, Cairo, Egypt (Gbreel) Department of Cardiology, Ahmed Maher Teaching Hospital, Cairo, Egypt (Hassan) Theodor Bilharz Research Institute, Giza, Egypt (Ebeid) Department of Cardiology, National Institute of Diabetes and Endocrinology, Cairo, Egypt (Abdelrahman) Emergency Department, King's College Hospital, London, United Kingdom Publisher Elsevier B.V. Abstract Background The optimal management of concomitant coronary artery disease in patients undergoing transcatheter aortic valve replacement (TAVR) remains controversial. Whether routine percutaneous coronary intervention (PCI) before TAVR provides clinical benefit compared to a strategy of deferral is unclear. Methods We performed a meta-analysis of randomized controlled trials (RCT) comparing routine PCI before TAVR with a strategy of PCI deferral. The primary end points were a composite of major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause mortality. Secondary end points included myocardial infarction, stroke, revascularization, and major bleeding. We applied a random-effects model to calculate hazard ratios (HR) and 95% CI. We also performed a pooled time-to-event analysis using reconstructed individual patient data. Results We included 3 RCT (ACTIVATION, NOTION-3, and PRO-TAVI) comprising a total of 1156 patients. The pooled cohort had a median age exceeding 81 years and exhibited low anatomic coronary complexity (median SYNTAX score <=10). Routine PCI did not significantly reduce the risk of MACCE (HR, 0.84; 95% CI, 0.62-1.13; P = .25) or all-cause mortality (HR, 0.88; 95% CI, 0.67-1.17; P = .38). Pooled Kaplan-Meier analysis confirmed no difference in all-cause mortality over 48 months (HR, 0.89; 95% CI, 0.68-1.17; P = .41). Although routine PCI was associated with a significant reduction in any revascularization (HR, 0.24; 95% CI, 0.06-0.89; P = .03) and urgent revascularization (HR, 0.33; 95% CI, 0.12-0.87; P = .02), it was associated with increased bleeding events (HR, 1.96; 95% CI, 1.28-3.00; P < .01). No significant differences were observed regarding myocardial infarction or stroke. Conclusions Routine PCI before TAVR did not reduce mortality or MACCE compared to a deferral strategy. Although routine PCI lowered the risk of subsequent urgent revascularization, it significantly increased the risk of major bleeding. Copyright © 2026 The Author(s). <89> Accession Number 2049190132 Title A multicenter randomized, double-blinded placebo-controlled phase 2 trial to evaluate safety and efficacy of ilofotase alfa in patients at risk for kidney injury following open heart surgery. Source Intensive Care Medicine. (no pagination), 2026. Date of Publication: 2026. Author Mourisse L.; Ostermann M.; Thiessen S.; Dumoulin A.; Vlaar A.P.J.; Hoste E.; Mosbahi S.; Schneider A.; Zarbock A.; Boehm J.; Rosenberger P.; Thielmann M.; Dubois E.; Powell-Tuck J.; Baig K.; Renette W.; Meex I.; Klop-Rhiel M.; Opschoor K.; Vandenberghe W.; Siepe M.; Strauss C.; Wirth F.; Winkel M.; Hof L.; Kraan M.; Bernholz J.; Pickkers P.; Ristau W.; Hermann S.; Mirakaj V.; Bernard A.; Mertes M.; Booke H.; Schutzenmeister K.; Decoster L.; De Smeytere A.; Van Hecke J.; Vermeiren D.; Geelink N. Institution (Mourisse, Pickkers) Department of Intensive Care, Radboud University Medical Centre, Nijmegen, Netherlands (Ostermann, Powell-Tuck, Baig, Klop-Rhiel) Department of Critical Care, King's College London, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom (Thiessen, Meex) Department of Anaesthesiology and Intensive Care Medicine, Ziekenhuis Oost-Limburg, Genk, Belgium (Thiessen) Faculty of Medicine and Life Sciences, Department of Neurosciences, UHasselt, Hasselt, Belgium (Thiessen, Renette) Department of Cardiovascular Sciences, Anesthesiology and Algology, KULeuven, Leuven, Belgium (Dumoulin) Department of Intensive Care AZ Delta Roeselare, Roeselare, Belgium (Vlaar) Department of Intensive Care and Laboratory of Experimental Intensive Care and Anesthesiology (L.E.I.C.A.) Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands (Hoste, Vandenberghe) Department of Intensive Care Medicine, Ghent University Hospital, Ghent University, Ghent, Belgium (Mosbahi, Siepe) Department of Cardiac Surgery, Inselspital, University Hospital Bern, Bern, Switzerland (Schneider) Adult Intensive Care Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland (Zarbock, Strauss) Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Munster, Munster, Germany (Boehm, Wirth) Department of Cardiovascular Surgery, Institute Insure, TUM University Hospital - German Heart Center, TUM School of Medicine & Health, Technical University of Munich, Munich, Germany (Rosenberger) Department of Anesthesiology and Intensive Care Medicine, University Hospital Tubingen, Eberhard Karls University Tubingen, Tubingen, Germany (Thielmann) Department of Thoracic and Cardiovascular Surgery, West-German Heart & Vascular Center Essen at University Duisburg-Essen, Essen, Germany (Dubois) Department of Intensive Care Medicine, Erasmus University Medical Center, Rotterdam, Netherlands (Dubois) Department of Cardiology, Thorax Center, Erasmus University Medical Center, Rotterdam, Netherlands (Renette) Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium (Renette) Department of Anaesthesiology, University Hospitals Leuven, Leuven, Belgium (Renette, Opschoor) Department of Intensive Care, Amsterdam UMC, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands (Opschoor) Department of Anaesthesiology Amsterdam UMC, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, Netherlands (Winkel, Hof, Kraan, Bernholz) AM-Pharma BV, Utrecht, Netherlands Publisher Springer Science and Business Media Deutschland GmbH Abstract Introduction: Acute impairment of kidney function after cardiac surgery is common and associated with an increased morbidity and mortality. Ilofotase alfa has demonstrated potential to attenuate renal injury through its immunomodulatory effects. We evaluated the safety and efficacy of ilofotase alfa in preventing renal functional impairment in cardiac surgery patients. Method(s): This phase 2, multi-center, randomized, double-blinded, placebo-controlled trial employing a two-arm, parallel-group design randomized adult patients at a high risk of renal functional impairment after on-pump cardiac surgery. Patients with a pre-existent estimated glomerular filtration rate of 25-65 ml/min/1.73m2 scheduled to undergo complex cardiac surgery were eligible. Patients received two intravenous doses (128 mg) of ilofotase alfa or placebo perioperatively. The primary endpoint was the ratio between the highest serum creatinine levels within five days postoperative relative to the pre-operative level (sCrRatio). The secondary endpoint was major adverse kidney events up to day 60 (MAKE60). Result(s): In total, 244 patients were randomized of whom 204 received two doses and were included in the trial analysis: 109 patients were treated with ilofotase alfa and 95 received placebo. The mean+/-SD sCrRatio in the ilofotase alfa group was 1.21+/-0.42, compared to 1.27+/-0.50 for placebo (p=0.31). MAKE60 incidence was 15.9% in the ilofotase alfa group and 15.4% in the placebo group (p=0.87). No safety concerns were raised. Conclusion(s): Administration of ilofotase alfa did not attenuate short- and longer-term renal function loss in patients at a high risk of renal functional impairment after on-pump cardiac surgery. No safety concerns of ilofotase alfa emerged. Trial registration: EUCT Number: 2023-505859-45 US IND Number: 117 605 ClinicalTrials.gov ID: NCT06168799 Visual abstract: (Figure presented.) Copyright © The Author(s) 2026. <90> Accession Number 652320049 Title Left Atrial Appendage Occlusion Among Cancer Patients with Atrial Fibrillation: a systematic review and update meta-analysis. Source The American journal of cardiology. (no pagination), 2026. Date of Publication: 04 Oct 2026. Author Afonso L.M.; Gava G.B.; Pires H.D.S.; Fiuza E.F.; Goldwasser B.T.T.; Rolin M.; Melo E.S.A. Institution (Afonso) Universidade Federal do Cariri, Barbalha, Ceara, Brazil (Gava) Universidade Federal de Santa Maria Santa Maria, Rio Grande do Sul, Brazil (Pires) Universidade Federal de Sao Paulo, Sao Paulo, Brazil (Fiuza) Universidade Nove de Julho, Sao Paulo, Brazil (Goldwasser) Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil (Rolin) Instituto de Cardiologia de Santa Catarina, Santa Catarina, Brazil (Melo) Hospital Israelita Albert Einstein, Sao Paulo, Sao Paulo; Brazil Abstract INTRODUCTION: Left atrial appendage occlusion (LAAO) is a well-established therapy for atrial fibrillation (AF) in patients with contraindications to oral anticoagulation. However, the clinical outcomes of LAAO in patients with cancer remain poorly defined. Therefore, we performed an updated meta-analysis to evaluate the safety and efficacy of LAAO in patients with cancer. METHOD(S): PubMed, Embase and Cochrane databases were systematically searched for studies evaluating LAAO in patients with AF and cancer. Our endpoints of interest were long-term stroke, bleeding and all-cause mortality. We reported the endpoints in Hazard Ratio (HR), Odds Ratio (OR) and 95% confidence intervals (95%CI). Additionally, a prespecified subgroup analysis comparing patients with active and history of cancer was performed. Heterogeneity was assessed using the I2 statistic. RESULT(S): We included 9 studies with 209,325 patients, of whom 39,3% were female and had a mean age of 77 years. Cancer was significantly associated with higher long-term all-cause mortality (HR 1.64, 95% CI 1.20-2.23; p= 0.002). However, no significant associations were observed for long-term stroke (HR 0.59, 95% CI 0.30-1.15; p=0.12), long-term bleeding (HR 1.02, 95% CI 0.57-1.83; p=0.94). No significant difference was observed between active and history of cancer subgroups (p=0.146). CONCLUSION(S): In this meta-analysis, cancer was associated with higher long-term mortality in patients who underwent LAAO. Nevertheless, there was no difference between cancer and non-cancer groups' risk for thromboembolic or bleeding events. Copyright © 2026 Elsevier Inc. All rights reserved. <91> Accession Number 2049534733 Title Feasibility, acceptability, and preliminary estimates of a multimodal AKTIVER Heart Delirium Prevention Program in patients indicated for cardiac surgery: study protocol of a randomized controlled PREVENT POstoperative Delirium (PREVENT-POD) Pilot Study. Source Pilot and Feasibility Studies. 12(1) (no pagination), 2026. Article Number: 142. Date of Publication: 01 Dec 2026. Author Kuhnle J.; Dong M.T.; Heissenberg J.; Derad C.; Schettler E.; Neitzel C.; Itting P.T.; Botnariuc A.; Asendorf T.; Viehmeister B.; El-Essawi A.; Jebran A.-F.; Evertz R.; Badde J.C.; Steinmetz C.; Wuttke M.; David N.S.; Spank J.; Schafer D.A.; Kutschka I.; Baraki H.; Herrmann-Lingen C.; Thomas C.; von Arnim C.; Celano C.M.; Sadlonova M. Institution (Kuhnle, Dong, Heisenberg, Itting, Botnariuc, El-Essawi, Jebran, Evertz, Badde, Sadlonova) Department of Cardiothoracic and Vascular Surgery, University Medical Center Goettingen, Goettingen, Germany (Derad, Asendorf) Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany (Schettler, Neitzel, Herrmann-Lingen, Sadlonova) Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Goettingen, Goettingen, Germany (Itting, Herrmann-Lingen, von Arnim, Sadlonova) DZHK (German Center for Cardiovascular Research), Partner Site Lower Saxony, Goettingen, Germany (Viehmeister) Department of Clinical Pharmacy, University Medical Center Goettingen, Goettingen, Germany (Steinmetz, von Arnim, Sadlonova) Department of Geriatrics, University Medical Center Goettingen, Goettingen, Germany (Wuttke, David) Department of Physical Therapy, University Medical Center Goettingen, Goettingen, Germany (Spank, Thomas) Department of Psychiatry and Psychotherapy for the Elderly, Klinikum Stuttgart, Stuttgart, Germany (Schafer, Celano, Sadlonova) Department of Psychiatry, Massachusetts General Hospital, Boston, United States (Schafer, Celano) Department of Psychiatry, Harvard Medical School, Boston, United States (Kutschka, Baraki) University Heart Center Basel, University Hospital Basel, Basel, Switzerland (Thomas) Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen, Tuebingen, Germany Publisher BioMed Central Ltd Abstract Background: Postoperative delirium (POD) is a common complication in geriatric patients undergoing cardiac surgery. POD is associated with prolonged length of stay in the intensive care unit and hospital, increased mortality, institutionalization, distress, risk of cognitive impairment and dementia. The non-pharmacological, multimodal AKTIVER intervention from the multicenter PAWEL trial significantly reduced POD incidence and days with POD in older patients undergoing abdominal and orthopedic surgery. However, this positive effect on POD incidence has not yet been demonstrated in elderly patients undergoing cardiac surgery. Therefore, a specific AKTIVER Heart intervention with additional modules was developed. Method(s): In the randomized controlled PREVENT-POD pilot study, 60 patients aged 65 years or older undergoing elective cardiac surgery will be recruited and 2:1 randomized in either into the AKTIVER Heart intervention group (AKTIVER Heart) or treatment-as-usual plus (TAU+) group. In total, 40 patients will receive the non-pharmacological and modified AKTIVER Heart intervention, while the other 20 will receive TAU+ with preoperative education. The primary outcome is the feasibility and acceptability of the AKTIVER Heart intervention. Secondary outcomes include the preliminary estimates of the AKTIVER Heart on POD incidence, duration and severity, cognition, quality of life, sleep, treatment- and disease expectations, distress, depression, and anxiety symptoms. Discussion(s): This randomized controlled pilot study aims to evaluate the feasibility and acceptability of the non-pharmacological, multimodal AKTIVER Heart intervention in elderly patients undergoing elective cardiac surgery. This trial is designed to provide evidence on acceptability and feasibility of the AKTIVER Heart, and to perform a larger, well-powered multicenter POD prevention trial in cardiac surgery. Trial registration: German Clinical Trials Register (DRKS; http://www.drks.de; DRKS00035091, Registered prospectively on November 4, 2024 Copyright © The Author(s) 2026. <92> Accession Number 2049483467 Title Inspiratory muscle training as part of multimodal prehabilitation improves maximal inspiratory pressure in elderly surgical patients: an exploratory secondary analysis of a randomised controlled trial. Source BMC Geriatrics. 26(1) (no pagination), 2026. Article Number: 1237. Date of Publication: 01 Dec 2026. Author Dueblin S.W.-S.; Wuethrich P.Y.; Engel D.; Eser P.; Beilstein C.M.; Wilhelm M.; Vetsch T. Institution (Dueblin, Wuethrich, Engel, Beilstein, Vetsch) Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland (Eser, Wilhelm, Vetsch) Centre for Rehabilitation & Sports Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland Publisher BioMed Central Ltd Abstract Background: Older adults awaiting major surgery often present with reduced physical fitness and respiratory muscle weakness, which are associated with increased postoperative complications. Prehabilitation may improve functional capacity, but evidence for its effect on inspiratory muscle strength in high-risk older adults remains limited. The main objective was to assess the change in maximal inspiratory pressure (MIP) in the preoperative period in high-risk patients receiving home-based tele-supervised prehabilitation compared to standard care. Method(s): This exploratory analysis included a subset of secondary outcome data from a prospective, two-arm, parallel-group randomised controlled trial conducted at a single university hospital in Switzerland. Patients aged >= 65 years awaiting elective cardiac or major non-cardiac surgery with a proven fitness deficit measured by cardiopulmonary exercise testing (CPET) were included. Participants randomized in the intervention arm received a multimodal, home-based tele-supervised prehabilitation programme over 2-4 weeks addressing deficits in physical fitness, nutrition, and anaemia, while controls received standard preoperative care. Result(s): Eighty eight participants were analysed (intervention n = 48; control n = 40). Patients in the intervention group showed improvement in MIP after the training period, whereas the control group demonstrated a decline (median change + 10.5 [0.00; 16.2] vs. - 3.00 [-8.00; 1.50] cmH2O; p < 0.001). After adjustment for baseline MIP, the estimated between-group difference was 13.39 cmH2O (95%CI 8.12-18.75; p < 0.001). Conclusion(s): Home-based tele-supervised IMT, delivered as part of a multimodal prehabilitation programme, improved maximal inspiratory pressure over the preoperative period in elderly high-risk surgical patients. The observed MIP decline in the control group suggests that the preoperative waiting period itself may carry a risk of functional deterioration in this population. Whether MIP improvements translate into reduced postoperative morbidity will be addressed by the primary outcome of the ongoing PREHABIL trial. Trial registration: ClinicalTrials.gov Identifier NCT04461301 (First Submitted: 02.07.2020, First Posted: 08.07.2020). Copyright © The Author(s) 2026. <93> Accession Number 652319230 Title The Effect of Oncology Nurse-Led Discharge Planning on Health Outcomes in Lung Cancer Survivors: A Randomized Controlled Trial. Source International Journal of Cancer. Conference: World Cancer Congress 2026. Hong Kong Hong Kong. 159(Supplement 1) (pp 116), 2026. Date of Publication: 01 Sep 2026. Author Shi Y.; Xu H.; Yan S. Institution (Shi, Xu, Yan) Chongqing University Cancer Hospital, Chongqing, China Publisher John Wiley and Sons Inc Abstract Background: Lung cancer survivors often encounter problems such as inadequate symptom management and fragmented care coordination during the care transition period, resulting in insufficient discharge readiness, impaired social integration, and an elevated risk of unplanned hospital readmission. As a critical phase shifting from hospital-based care to home and community care, the transitional period can be effectively supported by a well-designed discharge program. Aim(s): This study aimed to investigate the effect of an oncology nurses-led integrated discharge planning program on health outcomes including discharge readiness, social integration, and hospital readmission rate among lung cancer survivors. Method(s): A randomized controlled trial with assessor-blinded, parallel-group and repeated measures design was conducted. A total of 121 lung cancer survivors discharged from the thoracic surgery department of a tertiary hospital were enrolled and randomly assigned at a 1:1 ratio to the intervention group (n = 61) and the control group (n = 60). The control group received routine discharge education. The intervention group was provided with an oncology nurse-led discharge planning program, including comprehensive baseline assessment, health education on lung cancer symptom management and respiratory rehabilitation, self-management skill training, discharge review and checklist integration, referral for post-discharge rehabilitation and social support, as well as continuous follow-up by oncology nurses at 1, 3, and 6 months after discharge. Outcome measures included discharge readiness, social integration, unplanned readmission rate, and symptom distress, assessed at 1 day before discharge, 1, 3, and 6 months after discharge. Result(s): A total of 113 participants completed the follow-up, including 57 in the intervention group and 56 in the control group. Repeated-measures analysis of variance showed that the intervention group had significantly higher scores of discharge readiness and social integration than the control group at 1, 3, and 6 months after discharge (p < 0.05), with a continuous improving trend over time. The unplanned readmission rate within 6 months was 10.5% in the intervention group, significantly lower than 26.8% in the control group (p < 0.05). Symptom distress was also significantly lower in the intervention group. The interaction effect between group and time was statistically significant, indicating a sustainable long-term intervention effect. Conclusion(s): An integrated, oncology nurse-led discharge planning program can effectively improve discharge readiness and social integration, reduce the risk of unplanned readmission, and alleviate symptom burden among lung cancer survivors. It is a feasible and effective strategy to optimize transitional care quality and improve long-term health outcomes, which can support the development of patient-centered long-term survivorship care systems. <94> Accession Number 2050184919 Title Infective endocarditis after transcatheter versus surgical pulmonary valve replacement in CHD: absolute risk translation and device-material context. Source Cardiology in the Young. (pp 1-8), 2026. Date of Publication: 2026. Author Semyashkin A.; Sandica A.; Gherta L.; Ben Mime L. Institution (Semyashkin) Department of Pediatric Cardiac Surgery and Congenital Heart Defects, Klinikum Stuttgart, Stuttgart, Germany (Sandica, Gherta, Ben Mime) Ruhr University Bochum, University Hospital Herz- und Diabeteszentrum NRW, Center for Congenital Heart Defects and Pediatric Heart Center, Pediatric Heart Surgery, Bad Oeynhausen, Germany (Sandica, Gherta, Ben Mime) Bielefeld University, Medical School OWL, Bad Oeynhausen, Germany Publisher Cambridge University Press Abstract Background: - As transcatheter pulmonary valve replacement becomes increasingly adopted in children and young adults, concerns regarding infective endocarditis remain a major limitation of this strategy. We performed a systematic review and meta-analysis comparing the risk of infective endocarditis after transcatheter and surgical pulmonary valve replacement. Material(s) and Method(s): - Comparative studies evaluating infective endocarditis after transcatheter versus surgical pulmonary valve replacement were systematically reviewed. The primary outcome was cumulative infective endocarditis during follow-up; early infective endocarditis was analysed separately. Random-effects models were used to pool odds ratios and absolute risk differences. Result(s): - Nineteen comparative cohort studies met the inclusion criteria. Fifteen studies contributed long-term data and six reported early events. In the primary long-term analysis (13 studies; 3, 917 procedures), transcatheter pulmonary valve replacement was associated with a significantly higher risk of infective endocarditis than surgical pulmonary valve replacement (odds ratio 3.18, 95% confidence interval 2.25-4.49; I 2 = 0%). The pooled absolute excess risk was 39.2 cases per 1, 000 procedures (95% confidence interval 22.7-55.6), corresponding to one additional case for every 26 procedures. Early infective endocarditis did not differ significantly between approaches (odds ratio 1.11, 95% confidence interval 0.33-3.69). Sensitivity analyses yielded consistent results. Conclusion(s): - Transcatheter pulmonary valve replacement is associated with a higher long-term risk of infective endocarditis than surgical pulmonary valve replacement, whereas evidence for early events remains inconclusive. The observed association is best interpreted in the context of prosthetic material, conduit characteristics, residual haemodynamics, and patient selection rather than as evidence of a purely procedural mechanism. Copyright © The Author(s), 2026. Published by Cambridge University Press <95> Accession Number 2050180903 Title Efficacy of Oral Clonidine On Intraoperative Hemodynamics and Postoperative Analgesia in Patients Undergoing Lumbar Spine Surgeries. Source International Journal of Drug Delivery Technology. 16(80 Supplement) (pp 1230-1234), 2026. Date of Publication: 2026. Author Chaudhari A.V.; Vazhakalayil S.T.J. Institution (Chaudhari, Vazhakalayil) Department of Anaesthesiology, Dr.D.Y.Patil Medical College, Hospital and Research Centre, Pimpri, Pune, India Publisher Dr. Yashwant Research Labs Pvt. Ltd. Abstract Background: Lumbar spine surgery is associated with significant perioperative sympathetic responses and postoperative pain. Clonidine, an alpha 2-adrenergic agonist, may attenuate hemodynamic responses while providing analgesic and anesthetic-sparing effects. This study evaluated the efficacy of oral clonidine as premedication in patients undergoing lumbar spine surgery. Method(s): This prospective, randomized, double-blinded comparative study included 64 ASA I-II patients aged 18-65 years undergoing lumbar spine surgery under general anesthesia. Patients were randomly allocated to receive oral clonidine 100 mug (Group S, n=32) or placebo (Group C, n=32) 45 minutes before surgery. Intraoperative heart rate (HR), systolic, diastolic and mean arterial pressure (MAP), fentanyl and propofol requirements were assessed. Postoperative pain, duration of analgesia, time to first rescue analgesia, rescue analgesic consumption, sedation, and adverse events were evaluated. Result(s): Baseline characteristics and hemodynamic parameters were comparable between groups. Intraoperatively, HR and MAP were significantly lower in the clonidine group at all assessed time points after baseline (p<0.001). Fentanyl consumption was significantly lower with clonidine (198.6 +/- 9.4 vs 268.3 +/- 10.6 mug; p<0.001), while additional propofol was required in 40.6 versus 100 of patients (p<0.001). Postoperative VAS scores were generally lower with clonidine, with significant differences from 60 minutes onward at most assessment points. Duration of analgesia and time to first rescue analgesia were significantly prolonged, while 24-hour rescue analgesic requirements were reduced (p<0.001). Early postoperative sedation was greater with clonidine but resolved by 2 hours. Adverse events were comparable between groups. Conclusion(s): Oral clonidine 100 mug administered 45 minutes preoperatively provided effective hemodynamic stabilization, reduced anesthetic and opioid requirements, and improved postoperative analgesia without significant additional adverse effects. Copyright © 2026, Dr. Yashwant Research Labs Pvt. Ltd. All rights reserved. <96> Accession Number 2050215668 Title No-Touch vs Conventional Vein Grafts in Coronary Surgery: Seven-Year Clinical Outcomes of the SWEDEGRAFT Randomized Clinical Trial. Source JAMA Cardiology. (no pagination), 2026. Date of Publication: 2026. Author Dalen M.; Modrau I.S.; Jeppsson A.; Dreifaldt M.; Duvernoy O.; Ericsson A.; Friberg O.; Holmgren A.; El-Akkawi A.I.; Hultkvist H.; Jensevik Eriksson K.; Liden M.; Nozohoor S.; Ragnarsson S.; Ternstrom L.; Themudo R.; Vikholm P.; Thelin S.; James S.; Sartipy U. Institution (Dalen, Sartipy) Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden (Dalen, Sartipy) Department of Cardiothoracic Surgery, Karolinska University Hospital, Stockholm, Sweden (Modrau, El-Akkawi) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Modrau) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Jeppsson, Ternstrom) Department of Cardiothoracic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden (Jeppsson) Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Dreifaldt, Friberg) Department of Cardiothoracic and Vascular Surgery, Orebro University Hospital, Orebro, Sweden (Duvernoy) Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (Ericsson) Department of Thoracic Surgery, Blekinge Hospital, Karlskrona, Sweden (Friberg) Faculty of Medicine and Health, Orebro University, Orebro, Sweden (Holmgren) Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden (Hultkvist) Department of Health, Medicine, and Caring Sciences, Linkoping University, Linkoping, Sweden (Hultkvist) Department of Cardiothoracic and Vascular Surgery, Linkoping University Hospital, Linkoping, Sweden (Jensevik Eriksson, James) Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden (Liden) Department of Radiology, Faculty of Medicine and Health, Orebro University, Orebro, Sweden (Nozohoor, Ragnarsson) Department of Cardiothoracic and Vascular Surgery, Skane University Hospital, Lund, Sweden (Nozohoor, Ragnarsson) Department of Clinical Sciences, Lund University, Lund, Sweden (Themudo) Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden (Vikholm, Thelin) Department of Thoracic Surgery, Uppsala University Hospital, Uppsala, Sweden (Vikholm, Thelin) Department of Surgical Sciences, Uppsala University, Uppsala, Sweden (James) Department of Medical Sciences, Uppsala University Hospital, Uppsala, Sweden Publisher American Medical Association Abstract Importance No-touch saphenous vein harvesting preserves perivascular tissue and may improve graft patency after coronary artery bypass grafting (CABG), but whether it reduces long-term clinical events remains uncertain. Objective To compare 7-year clinical outcomes after no-touch vs conventional saphenous vein harvesting in patients undergoing CABG. Design, Setting, and Participants This is a prespecified extended follow-up of the SWEDEGRAFT multicenter, binational, randomized clinical trial, which was conducted at 8 cardiac surgery centers in Sweden and 1 center in Denmark. Patients undergoing primary, nonemergent, isolated CABG were eligible for inclusion. The study was conducted between April 20, 2018, and June 3, 2020, and data were analyzed from February 2026 to April 2026. Intervention Patients were randomized 1:1 to no-touch or conventional saphenous vein harvesting. Main Outcomes and Measures The primary outcome was a composite of death from any cause, myocardial infarction, or repeat revascularization. Secondary outcomes were the individual components of the primary composite. Outcomes were ascertained through national population-based registries. Results A total of 902 patients undergoing primary, nonemergent, isolated CABG were randomized; 900 were included in the modified intention-to-treat population. Among 900 patients, 454 were assigned to no-touch harvesting and 446 to conventional harvesting. Mean (SD) age was 67.0 (7.6) years, 108 patients (12.0%) were women, and 419 patients (46.6%) underwent nonelective surgery. Median (IQR) follow-up was 6.46 (5.92-6.86) years. The primary outcome occurred in 90 patients in the no-touch group and 91 patients in the conventional group (19.8% vs 20.4%; hazard ratio [HR], 0.98; 95% CI, 0.73-1.31; P =.90). The adjusted 7-year risk difference was -0.8% (95% CI, -6.6% to 4.6%). The secondary outcomes did not differ significantly between groups: death (HR, 0.84; 95% CI, 0.53-1.35), myocardial infarction (HR, 0.74; 95% CI, 0.44-1.24), and repeat revascularization (HR, 1.07; 95% CI, 0.73-1.56). Prespecified subgroup analyses showed no heterogeneity in treatment effect. Conclusions and Relevance In this 7-year follow-up of the SWEDEGRAFT randomized clinical trial, no-touch saphenous vein harvesting was not shown to significantly reduce the composite of death from any cause, myocardial infarction, or repeat revascularization through 7 years of follow-up. Taken together with the previously reported excess of leg wound complications, these findings do not establish a net clinical benefit of routine no-touch harvesting. T Copyright © 2026 American Medical Association. All rights reserved, including those for text and data mining, AI training, and similar technologies. <97> Accession Number 2050252937 Title Effect of Bilateral Pectointercostal Fascial Plane Block on Chronic Postsurgical Pain After Coronary Artery Bypass Grafting: A Randomized Clinical Trial. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Mutluay Y.S.; Kozanhan B.; Yildiz M.; Sari S.; Mermer H.A.; Tutar M.S. Institution (Mutluay, Kozanhan, Yildiz, Mermer, Tutar) University of Health Sciences, Konya City Hospital, Department of Anesthesiology and Reanimation, Konya, Turkey (Sari) Aydin Adnan Menderes University Faculty of Medicine, Department of Anesthesiology and Reanimation, Aydin, Turkey (Sari) Outcomes Research Consortium, Houston, TX, United States Publisher W.B. Saunders Abstract Objectives: To evaluate whether the bilateral pectointercostal fascial plane (PIF) block reduces clinically relevant chronic postsurgical pain (CPSP) 3 months after coronary artery bypass grafting (CABG). Design(s): Single-center, prospective, randomized, controlled trial with blinded postoperative outcome assessment. Setting(s): Tertiary referral hospital. Participant(s): Fifty adults undergoing elective CABG via median sternotomy. Intervention(s): Patients were randomized 1:1 to bilateral ultrasound-guided PIF block with 0.25% bupivacaine (n = 25) or standard care without block (n = 25). Measurements and Main Results: The primary outcome was clinically relevant CPSP at 3 months, defined by International Classifications of Diseases, 11th Revision (ICD-11), criteria plus functional interference on the Brief Pain Inventory. Secondary outcomes included 72-hour morphine consumption, acute postoperative pain scores, neuropathic pain features, and quality of life. CPSP occurred in 28% of the PIF group (7/25) and 48% of controls (12/25) (odds ratio, 0.42; 95% confidence interval, 0.13-1.36; p = 0.145). In exploratory secondary analyses, acute pain scores at rest and with movement were lower in the PIF group during the first 72 postoperative hours (all p < 0.001). Cumulative 72-hour morphine consumption was lower with PIF block (34 mg [29-37 mg] vs 42 [41.0-44.5 mg]; nominal p < 0.001). No block-related complications occurred. Conclusion(s): Bilateral PIF block did not demonstrate a statistically significant decrease in clinically relevant CPSP at 3 months after CABG. Although PIF block was associated with lower acute postoperative pain scores and lower morphine consumption, these secondary findings should be interpreted as exploratory. The role of PIF block in chronic pain prevention remains uncertain. Copyright © 2026 Elsevier Inc. <98> Accession Number 652301602 Title Percutaneous left atrial appendage occlusion versus oral anticoagulation in patients with atrial fibrillation: a systematic review and meta-analysis. Source Revista espanola de cardiologia (English ed.). (no pagination), 2026. Date of Publication: 30 Sep 2026. Author Molaro M.I.; Reichardt C.; Simonetti F.; Lahu D.; Ndrepepa G.; Lenz T.; Pellegrini C.; Scheidt M.V.; Rheude T.; Voll F.; Covarrubias H.A.A.; Trenkwalder T.; Sager H.B.; Schunkert H.; Joner M.; Kastrati A.; Cassese S.; Xhepa E. Institution (Molaro, Simonetti) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany; Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy (Reichardt, Lahu, Ndrepepa, Covarrubias) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany (Lenz, Pellegrini, Scheidt, Rheude, Voll, Trenkwalder, Sager, Schunkert, Joner, Kastrati, Cassese, Xhepa) Klinik fur Herz- und Kreislauferkrankungen, TUM Klinikum Deutsches Herzzentrum, Technische Universitat Munchen, Munich, Germany; Deutsches Zentrum fur Herz- und Kreislauf-Forschung (DZHK) e.V. (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany Abstract INTRODUCTION AND OBJECTIVES: Percutaneous left atrial appendage occlusion (LAAO) has emerged as an alternative to oral anticoagulants (OACs) in patients with atrial fibrillation (AF). However, up-to-date comparisons are lacking. We performed a systematic review and meta-analysis of randomized clinical trials comparing percutaneous LAAO with OACs (either a vitamin K antagonist or a direct oral anticoagulant) in patients with AF. METHOD(S): MEDLINE and EMBASE were searched from inception through March 29, 2026. The primary outcome was all-cause death. Coprimary outcomes were stroke and any bleeding. Secondary outcomes included a composite of ischemic events, systemic embolism, cardiovascular death, ischemic stroke, hemorrhagic stroke, and nonprocedural bleeding. Random-effects meta-analyses were performed using IRRs with 95%CIs. Subgroup and meta-regression analyses were conducted. RESULT(S): Seven randomized trials including 7353 patients were analyzed. There were no significant differences between LAAO and OAC in terms of all-cause death (IRR, 0.95; 95%CI, 0.81-1.10), stroke (IRR, 1.00; 95%CI, 0.72-1.39), or any bleeding (IRR, 0.84; 95%CI, 0.64-1.08). LAAO reduced nonprocedural bleeding (IRR, 0.56; 95%CI, 0.45-0.71), but was associated with a numerically higher risk of ischemic stroke (IRR, 1.28; 95%CI, 1.00-1.66). There was a significant interaction between LAAO and the type of OAC regimen in terms of all-cause death (Pinteraction = .02). CONCLUSION(S): In patients with AF eligible for OACs, there were no significant differences in clinical efficacy between LAAO and OAC, whereas LAAO was associated with a significant reduction in nonprocedural bleeding events. The observed trend toward an increased risk of ischemic stroke requires further investigation. Copyright © 2026 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved. <99> [Use Link to view the full text] Accession Number 2050099755 Title Staged Versus Concomitant TAVI and PCI for the Treatment of Coexisting Aortic Stenosis and Coronary Artery Disease. Source Cardiology in Review. 34(6) (pp 476-482), 2026. Date of Publication: 01 Dec 2026. Author Shirke M.M.; Wang W.; Welch J.; Faisal F.; Nguyen D.; Harky A. Institution (Shirke) Department of Medicine, University Hospitals NHS Trust, Nottingham, United Kingdom (Wang) Department of Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University Of London, London, United Kingdom (Welch) Department of General Surgery, Sandwell General Hospital, Sandwell and West Birmingham NHS Trust, Birmingham, United Kingdom (Faisal) Department of Medicine, New Vision University, Tbilisi, Georgia (Nguyen) Department of Cardiology, Massachusetts General Hospital, Corrigan Minehan Heart Center, Harvard Medical School, Boston, MA, United States (Harky) Department of Cardiothoracic Surgery, Liverpool Heart and Chest, Liverpool, United Kingdom Publisher Lippincott Williams and Wilkins Abstract Aortic stenosis (AS) is one of the most common valvular pathologies. Severe coronary artery disease (CAD) often coexists with AS. Transcatheter aortic valve implantation (TAVI) and percutaneous coronary intervention (PCI) have been established as alternatives to open surgical interventions. The data on the timing for the treatment of the 2 conditions are scarce and depend on multiple factors. This review compares the clinical outcomes of the concomitant versus staged PCI and TAVI for the treatment of AS and CAD. A systematic, electronic search was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify relevant articles that compared outcomes of the staged versus concomitant approaches for the TAVI and PCI. Seven studies were included involving 3745 patients. We found no statistically significant difference in primary outcomes such as 30-day mortality [odds ratio (OR) = 0.78; 95% confidence interval (CI): 0.39-1.57] and secondary outcomes including length of hospital stay (mean difference = -4.74, 95% CI: -10.96 to 1.48), new-onset renal failure (OR = 0.83, 95% CI: 0.22-3.13), cerebrovascular accidents (OR = 1.28, 95% CI: 0.64-2.57), and intraoperative blood loss (OR = 0.83, 95% CI: 0.32-2.12). New pacemaker insertion was statistically significant in favor of the concomitant approach (OR = 0.78, 95% CI: 0.63-0.96). This analysis suggests that while the 2 approaches are largely comparable in terms of most outcomes, patients at risk of requiring a pacemaker postprocedure may benefit from a concomitant approach. In conclusion, concomitant TAVI + PCI approach is nonsuperior to the staged approach for the treatment of CAD and AS. This review calls for robust trials in the field to further strengthen the evidence. Copyright © 2024 Wolters Kluwer Health, LLC. All rights reserved. <100> Accession Number 652311323 Title Effects of dexmedetomidine on postoperative outcomes in adult non-cardiac surgical patients admitted to the intensive care unit: a systematic review and network meta-analysis of randomized controlled trials. Source Anaesthesia, critical care & pain medicine. (pp 101907), 2026. Date of Publication: 02 Oct 2026. Author Shin C.C.Y.; Karigowda L.; Zhang B.; Sadanandan D.; Shehabi Y.; Wong S.; Subramaniam A.; Deshpande K. Institution (Shin) Department of Intensive Care Medicine, Fairfield Hospital, NSW, Australia; Department of Intensive Care Medicine, Liverpool Hospital, NSW, Australia (Karigowda) Department of Intensive Care Medicine, Fairfield Hospital, NSW, Australia; Department of Intensive Care Medicine, Liverpool Hospital, NSW, Australia; Department of Intensive Care Medicine, Westmead Hospital, NSW, Australia (Zhang) Department of Intensive Care Medicine, Fairfield Hospital, NSW, Australia (Sadanandan) Research Scientist and Biostatistician, Women's & Children's Health Research Unit, Jawaharlal Nehru Medical College, KLE Academy of Higher Education and Research, Karnataka, India (Shehabi) Department of Intensive Care Medicine, Prince of Wales Hospital, NSW, Australia; Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Victoria, Australia (Wong) Department of Intensive Care Medicine, Prince of Wales Hospital, NSW, Australia (Subramaniam) Centre for Outcome and Resource Evaluation, Australian and New Zealand Intensive Care Society, Melbourne, Victoria, Australia; Department of Intensive Care Medicine, Dandenong Hospital, Monash Health, Dandenong, Vic, Australia; Department of Intensive Care Medicine, Epworth Healthcare, Richmond, Vic, Australia; Peninsula Clinical School, Monash University, Frankston, Victoria, Australia; Department of Intensive Care Medicine, Epworth Hospital, Richmond, Vic, Australia (Deshpande) Department of Intensive Care Medicine, St George Hospital, NSW, Australia; Clinical School of Medicine, University of New South Wales, New South Wales, Australia Abstract BACKGROUND: The role of dexmedetomidine in patients admitted to the intensive care unit (ICU) following non-cardiac surgery remains unclear. While dexmedetomidine is widely used for its sedative and potential delirium-sparing properties, its pooled effects on clinically relevant postoperative outcomes in this population are not well established. This systematic review and network meta-analysis evaluated the comparative effectiveness and safety of dexmedetomidine compared with other sedative strategies in postoperative non-cardiac surgical ICU patients. METHOD(S): We systematically searched PubMed, Cochrane CENTRAL, and Embase from inception to 26 May 2026 for randomised controlled trials (RCTs) comparing postoperative dexmedetomidine with normal saline or other sedatives in adults (>=18 years) admitted to the ICU after non-cardiac surgery. The primary outcome was incidence of delirium during the ICU stay. Secondary outcomes were time to extubation, ICU length of stay, duration of mechanical ventilation, and haemodynamic adverse events. Effect estimates were expressed as relative risks (RRs) or mean differences (MDs) using random-effects models. Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated using the GRADE framework. Interventions were ranked using the surface under the cumulative ranking curve (SUCRA) for each outcome. RESULT(S): Twenty-four RCTs involving 2,777 patients were included in the systematic review, of which 22 RCTs involving 2,544 patients contributed to the network meta-analysis. Compared with midazolam (RR 0.11, 95% CI 0.02 to 0.80; very low certainty) and normal saline (RR 0.46, 95% CI 0.36 to 0.59; low certainty), dexmedetomidine may reduce the risk of delirium. Evidence is insufficient to determine whether propofol differs from dexmedetomidine in its effect on delirium. There were no differences in time to extubation, duration of mechanical ventilation, or ICU length of stay across sedative strategies. Dexmedetomidine probably increases the risk of bradycardia compared with propofol (RR 3.03, 95% CI 1.39 to 6.25; low certainty), but the evidence is insufficient to determine whether the two agents differ in their effects on hypotension. In safety rankings, dexmedetomidine performed least favourably for bradycardia (SUCRA 0.03) and hypotension (SUCRA 0.13). CONCLUSION(S): Dexmedetomidine may reduce postoperative delirium in non-cardiac surgical ICU patients but does not appear to improve ventilatory recovery or ICU length of stay and is associated with higher bradycardia risk. Its principal benefit lies in delirium prevention, supporting an individualised approach to sedative selection. Copyright © 2026. Published by Elsevier Masson SAS. <101> Accession Number 2049939246 Title Impact of Colloid Cardiopulmonary Bypass Priming Strategy on Perioperative Acid-Base Balance in Coronary Artery Bypass Surgery: Physicochemical Analysis of a Double-Blinded Randomized Controlled Study. Source Journal of Cardiothoracic and Vascular Anesthesia. (no pagination), 2026. Date of Publication: 2026. Author Boer R.; Beukers A.M.; Pols J.M.; Seegers J.C.; van Haasteren N.; Ghantous D.; Nieuwenhuizen R.; Brouwers M.; Bulte C.S.E.; Duska F.; Vonk A.B.A.; Loer S.A.; Heldeweg M.L.A. Institution (Boer, Beukers, Seegers, Bulte, Loer, Heldeweg) Department of Anesthesiology, Amsterdam University Medical Center, Amsterdam, Netherlands (Seegers) Department of Intensive Care Medicine, Amsterdam University Medical Center, Amsterdam, Netherlands (Pols, Seegers, Vonk) Department of Cardiothoracic Surgery, Amsterdam University Medical Center, Amsterdam, Netherlands (van Haasteren, Ghantous, Nieuwenhuizen, Brouwers) Department of Anaesthesiology, University of Amsterdam, Amsterdam, Netherlands (Duska, Heldeweg) Department of Anesthesia and Intensive Care Medicine, The Third Faculty of Medicine, Charles University and FNKV University Hospital, Prague, Czechia Publisher W.B. Saunders Abstract Objective: To determine whether colloid choice within the cardiopulmonary bypass (CPB) priming strategy independently modifies the perioperative acid-base trajectory. Design(s): Preplanned analysis of a single-center, double-blind, 3-arm randomized controlled trial. Setting(s): A tertiary academic teaching hospital. Participant(s): Thirty-four adult patients undergoing elective coronary artery bypass grafting with CPB. Intervention(s): Patients were randomized 1:1:1 to 3 priming strategies (total 1500 mL): albumin-based, gelofusine-based, and retrograde autologous priming (reference group). Measurements and Main Results: Acid-base status was characterized using Stewart's physicochemical approach at 5 perioperative time points (postinduction to 24 hours post-intensive care unit admission). A linear mixed model was used to assess the effects of priming strategy, time, and additional crystalloids. Across 170 observations, initiation of CPB induced substantial metabolic acidosis (-0.1 pH, -4.3 mmol/L standard base excess, -6.6 mEq/L effective strong ion difference), driven by reductions in apparent strong ion difference and persisting at 24 hours. pH, standard base excess, and effective strong ion difference did not differ among the priming strategies. Albumin attenuated weak acid-anion dilution (+0.79 mEq/L; p = 0.037), while gelofusine increased the strong ion gap (+2.19 mEq/L; p < 0.001). Each additional liter of crystalloid independently lowered pH (-0.011; p = 0.035), standard base excess (-0.99 mmol/L; p = 0.022), and effective strong ion difference (-1.03 mEq/L; p = 0.025), driven by a rise in strong ion gap (+1.24 mEq/L; p = 0.001). Conclusion(s): CPB-induced metabolic acidosis is driven predominantly by reductions in apparent strong ion difference and sustained by unbalanced crystalloid load rather than by colloid choice. Acid-base optimization should prioritize balanced, strong ion difference-guided priming fluid and crystalloid strategies over colloid selection. Copyright © 2026 The Author(s) <102> Accession Number 652302606 Title Does a Simple Touch Make a Difference? The Effect of Acupressure on Pain Scores in Infants Undergoing Cardiac Catheterization: A Randomized, Placebo-Controlled Trial. Source The Journal of cardiovascular nursing. (no pagination), 2026. Date of Publication: 30 Sep 2026. Author Ercan-Koyuncu I.; Gozen D. Institution (Ercan-Koyuncu) Ilcim Ercan-Koyuncu, PhD, RN, Assistant Professor, Department of Nursing, Faculty of Health Sciences, Baskent University, Ankara, Turkey, and Department of Child Health and Diseases Nursing Doctorate Programme, Institute of Graduate Studies, Istanbul University-Cerrahpasa, Istanbul, Turkey. Duygu Gozen, PhD, RN, Professor, Department of Pediatric Nursing, Faculty of Nursing, Koc University, Istanbul, Turkey Abstract BACKGROUND: Infants with congenital heart disease frequently undergo cardiac catheterization, an invasive procedure associated with pain and physiological stress. OBJECTIVE(S): Our aim was to evaluate the effects of acupressure applied before and after cardiac catheterization on pain, heart rate, and oxygen saturation. METHOD(S): This randomized placebo-controlled trial was conducted in the pediatric cardiac surgery unit of Baskent University Ankara Hospital, Turkiye, between November 2024 and October 2025. Sixty infants aged 1-12 months with congenital heart disease who were undergoing cardiac catheterization were randomly assigned to the acupressure, placebo, or control group, with 20 infants in each group. Acupressure was applied to the HT7, LI4, and PC6 points before and after the procedure. Pain was assessed using the Face, Legs, Activity, Cry, Consolability scale, while heart rate and oxygen saturation were measured from the preprocedural period to discharge. Data were analyzed using analysis of variance and chi-square tests. RESULT(S): Infants in the acupressure group had significantly lower pain scores than those in the placebo and control groups at all postprocedural time points. Heart rate values were also significantly lower in the acupressure group during follow-up. Analgesic use was less frequent in the acupressure group than in the placebo and control groups. Oxygen saturation improved over time, with no significant between-group differences at individual time points. CONCLUSION(S): Acupressure may be an effective, noninvasive, nurse-delivered complementary intervention for reducing procedural pain, supporting physiological stability, and decreasing analgesic requirements in infants with congenital heart disease undergoing cardiac catheterization. Copyright © 2026 Wolters Kluwer Health, LLC. All rights reserved. <103> Accession Number 652311484 Title Early aortic valve replacement for asymptomatic severe aortic stenosis: an updated systematic review and meta-analysis. Source Progress in cardiovascular diseases. (no pagination), 2026. Date of Publication: 29 Sep 2026. Author Cannata F.; Del Torto A.; Stankowski K.; Fazzari F.; Mantegazza V.; Tassetti L.; Cosentino N.; Mushtaq S.; Baggiano A.; Muratori M.; Pontone G. Institution (Cannata, Del Torto, Stankowski, Fazzari, Mantegazza, Tassetti, Cosentino, Mushtaq, Baggiano, Muratori) Department of Perioperative Cardiology and Cardiovascular imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy (Pontone) Department of Perioperative Cardiology and Cardiovascular imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy Abstract BACKGROUND: The optimal timing of intervention in asymptomatic severe aortic stenosis remains debated. This updated meta-analysis evaluates the comparative effects of early surgical or transcatheter aortic valve replacement (AVR) versus conservative management by incorporating recent long-term randomized evidence. METHOD(S): We performed a systematic review and meta-analysis of randomized trials comparing early AVR with conservative management in asymptomatic severe AS. Hazard ratios and 95% confidence intervals were pooled using a random-effects model, and exploratory meta-regression analyses were conducted to identify potential treatment-effect modifiers. RESULT(S): Across the included randomized trials, an early intervention strategy was associated with significant reductions in cardiovascular hospitalizations, heart failure hospitalizations, and stroke. Reductions in all-cause and cardiovascular mortality favored early intervention but did not achieve statistical significance. Treatment benefits varied according to clinical and hemodynamic profiles: greater baseline valve severity was associated with larger therapeutic effects, whereas increasing comorbidity burden (such as diabetes) tended to result in inferior clinical outcomes. CONCLUSION(S): In asymptomatic severe AS, an early AVR strategy consistently reduces cardiovascular and heart failure hospitalizations and stroke compared with conservative surveillance, despite neutral effects on overall and cardiovascular mortality. These findings support a contemporary shift toward an individualized, phenotype-driven approach rather than universal early intervention. Integrating hemodynamic severity and comorbidity burden can help identify patients most likely to derive net clinical benefit from early valve replacement. Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved. <104> Accession Number 2049300670 Title Subvalvular Aortic Stenosis: Current Insights into an Often Overlooked Cause of Left Ventricular Outflow Tract (LVOT) Obstruction. Source Medical sciences. 14(5) (no pagination), 2026. Article Number: 515. Date of Publication: 01 Sep 2026. Author Leivaditis V.; Papatriantafyllou A.; Mulita F.; Androutsopoulou V.; Liolis E.; Tasios K.; Antzoulas A.; Litsas D.; Skoura T.; Nikolakopoulos K.; Papadoulas S.; Baikoussis N.G. Institution (Leivaditis, Papatriantafyllou) Westpfalz Klinikum, Department of Cardiothoracic and Vascular Surgery, Kaiserslautern, Germany (Mulita) Second Department of Surgery, Medical School, Democritus University of Thrace, Alexandroupolis, Greece (Androutsopoulou) Department of Cardiothoracic Surgery, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece (Liolis) General University Hospital of Patras, Department of Oncology, Patras, Greece (Tasios) John Radcliffe Hospital Emergency Department, University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford, United Kingdom (Antzoulas) General University Hospital of Patras, Department of Surgery, Patras, Greece (Litsas) General Hospital of Lamia, Department of Surgery, Lamia, Greece (Skoura) Medical School, National and Kapodistrian University of Athens (NKUA), Aretaeion Hospital, Athens, Greece (Nikolakopoulos, Papadoulas) University of Patras, Department of Vascular Surgery, Patras, Greece (Baikoussis) Ippokrateio General Hospital of Athens, Department of Cardiac Surgery, Athens, Greece Publisher Multidisciplinary Digital Publishing Institute (MDPI) Abstract Background: Subvalvular aortic stenosis (SAS) is an important cause of fixed left ventricular outflow tract obstruction and the second most common form of aortic stenosis. Although traditionally considered a congenital lesion, increasing evidence suggests that SAS often behaves as a progressive condition influenced by anatomical and hemodynamic factors. The disease may lead to significant complications, including left ventricular hypertrophy and progressive aortic regurgitation. Material(s) and Method(s): A narrative review of the current literature was performed to summarize contemporary knowledge regarding the epidemiology, pathophysiology, clinical presentation, diagnostic evaluation, and management of subvalvular aortic stenosis. Relevant studies were identified through searches of major medical databases and were critically analyzed to provide an overview of current concepts and clinical practice. Result(s): Subvalvular aortic stenosis demonstrates considerable anatomical and clinical heterogeneity, ranging from discrete subaortic membranes to fibromuscular tunnel-type obstruction. The condition often progresses over time, with increasing LVOT gradients and a high incidence of associated aortic regurgitation. Echocardiography remains the primary diagnostic modality, while advanced imaging techniques provide additional anatomical detail and assist in surgical planning. Surgical resection remains the cornerstone of treatment when significant obstruction or related complications develop. Conclusion(s): Subvalvular aortic stenosis is a complex and progressive disease requiring careful imaging assessment and timely surgical management. Although surgical outcomes are generally excellent, recurrence and progressive aortic valve involvement remain important long-term considerations. Ongoing research aimed at improving risk stratification and optimizing surgical strategies may further enhance patient outcomes. Copyright © 2026 by the authors. <105> Accession Number 652310133 Title Serum biomarkers in structural deterioration of surgical bioprosthetic aortic valves: A systematic review and meta-analysis. Source Cardiovascular revascularization medicine : including molecular interventions. (no pagination), 2026. Date of Publication: 25 Sep 2026. Author Kholeif Z.; Doma M.; Rashwan R.; Mohamed A.E.; Ali A.E.; Abouelenein M.; Awashra A.; Goldsweig A.; Eleid M.; Bagameri G.; Leiner T.; Kietselaer B. Institution (Kholeif, Rashwan, Eleid, Leiner, Kietselaer) Department of Cardiology, Mayo Clinic, Rochester, MN, United States (Doma, Abouelenein) Faculty of Medicine, Alexandria University, Egypt (Mohamed) Faculty of Medicine, Tanta University, Egypt (Ali) Crestwood, Huntsville, AL, USA (Awashra) Department of Medicine, An Najah National University, Nablus, Palestine (Goldsweig) University of Massachusetts-Baystate Medical Center, CT, United States (Bagameri) Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, United States Abstract BACKGROUND: Patients with surgically implanted bioprosthetic aortic valves remain at risk of structural valve deterioration (SVD), a progressive process that may compromise durability and clinical outcomes. In this study, we aimed to assess serum biomarkers in patients with versus without SVD following surgical aortic valve replacement (SAVR). METHOD(S): PubMed, Scopus, and Web of Science were systematically searched from inception through September 9, 2026 for studies comparing serum biomarkers in patients with versus without SVD following SAVR with a bioprosthetic aortic valve. Random-effects models were used to calculate pooled mean differences (MDs) with 95% confidence intervals (CIs). PROSPERO registration: CRD420250655746. RESULT(S): Four studies with 819 patients (193 [23.6%] with SVD) were included. Patients with SVD had higher serum levels of low-density lipoprotein (LDL) (MD 0.23 mmol/L; 95% CI 0.05-0.41; p<0.01) compared to patients without SVD. Additionally, oxidized LDL levels (MD 3.86 U/L; 95% CI 1.14-6.58; p<0.01) as well as the concentration of small dense LDL-C (MD 0.14 mmol/L; 95% CI 0.03-0.25; p<0.01) were higher among patients with SVD. Furthermore, ApoB/ApoA-1 ratio was higher among SVD patients (MD 0.07; 95% CI 0.03-0.11; p<0.01) compared to patients without SVD. However, there were no significant differences between the groups in levels of triglycerides, high-density lipoprotein (HDL), creatinine, and fasting glucose. CONCLUSION(S): In patients with surgically implanted bioprosthetic aortic valves, higher serum LDL, oxidized LDL, small dense LDL-C, and ApoB/ApoA-I ratio were associated with SVD. Given the small observational evidence base, these findings are hypothesis-generating and require validation before these biomarkers can be used for prediction or clinical decision-making. Copyright © 2026 Elsevier Inc. All rights reserved. <106> Accession Number 2049518232 Title Conduction System Versus Right Ventricular Pacing in Patients Undergoing TAVR. Source JACC: Cardiovascular Interventions. 19(19) (pp 2635-2647), 2026. Date of Publication: 12 Oct 2026. Author Diez-Delhoyo F.; Sanz-Sanchez J.; Muntane-Carol G.; Amat-Santos I.J.; Oteo Dominguez J.F.; Rivera-Lopez R.; Asmarats L.; Pan M.; Novoa Medina J.M.; Franco-Pelaez J.A.; Cuellas C.; Roa-Garrido J.; Tamargo M.; Veiga G.; Herrero-Brocal M.; Valentin Garcia P.M.; Garcia-Lara J.; Cuesta J.; Valencia-Serrano F.; Pimienta-Gonzalez R.; Linares Vicente J.A.; Palazuelos-Molinero J.; Gomez-Blazquez I.; Navarro-Manchon J.; Di Marco A.; Garnacho-Gomez L.; Vela-Martin P.; Martin-Arriscado C.; Cebada F.S. Institution (Diez-Delhoyo, Gomez-Blazquez, Cebada) Department of Cardiology, Hospital Universitario 12 de Octubre. Instituto de Investigacion Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain (Sanz-Sanchez, Navarro-Manchon) Department of Cardiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain (Sanz-Sanchez, Amat-Santos, Cuesta, Navarro-Manchon, Cebada) Centro de Investigacion Biomedica en Red (CIBERCV), Madrid, Spain (Muntane-Carol, Di Marco) Department of Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain (Muntane-Carol, Di Marco) Bio-Heart Cardiovascular, Respiratory and Systemic Diseases and Cellular Aging Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain (Amat-Santos, Garnacho-Gomez) Department of Cardiology, University Clinical Hospital of Valladolid, Valladolid, Spain (Oteo Dominguez, Vela-Martin) Department of Cardiology, Hospital Puerta de Hierro, Madrid, Spain (Rivera-Lopez) Department of Cardiology, Hospital Virgen de las Nieves, Granada, Spain (Asmarats) Department of Cardiology, Hospital Santa Creu i Sant Pau, Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain (Pan) Department of Cardiology, Hospital Reina Sofia de Cordoba, Cordoba, Spain (Novoa Medina) Department of Cardiology, Hospital Universitario de Gran Canario Dr Negrin, Las Palmas de Gran Canaria, Spain (Franco-Pelaez) Department of Cardiology, Hospital Universitario Jimenez Diaz, Instituto Investigacion sanitaria Fundacion Jimenez Diaz, Madrid, Spain (Cuellas) Department of Cardiology, Hospital Universitario de Leon, Leon, Spain (Roa-Garrido) Department of Cardiology, Hospital Universitario Juan Ramon Jimenez, Huelva, Spain (Tamargo) Department of Cardiology, Hospital Universitario Salamanca, Salamanca, Spain (Veiga) Department of Cardiology, Hospital Universitario Marques de Valdecilla, IDIVAL, Santander, Spain (Herrero-Brocal) Department of Cardiology, Hospital General Universitario Dr Balmis, Instituto de Investigacion Sanitaria y Biomedica de Alicante (ISABIAL), Alicante, Spain (Valentin Garcia) Department of Cardiology, Hospital Universitario de Albacete, Albacete, Spain (Garcia-Lara) Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, Instituto Murciano de Investigacion Biosanitaria (IMIB), Murcia, Spain (Cuesta) Department of Cardiology, Hospital Universitario de La Princesa, Universidad Autonoma de Madrid, Madrid, Spain (Valencia-Serrano) Department of Cardiology, Hospital Universaitario Torrecardenas, Almeria, Spain (Pimienta-Gonzalez) Department of Cardiology, Hospital Universitario Nuestra Senora de la Candelaria, Santa Cruz de Tenerife, Spain (Linares Vicente) Deparment of Cardiology, Hospital Universitario Lozano Blesa, Zaragoza, Spain (Palazuelos-Molinero) Department of Cardiology, Hospital Universitario La Luz, Madrid, Spain (Martin-Arriscado) Unidad de Soporte Cientifico, Instituto de Investigacion Hospital Universitario 12 de Octubre (imas12), Madrid, Spain Publisher Elsevier Inc. Abstract Background Pacemaker implantation after transcatheter aortic valve replacement (TAVR) is common and has been associated with adverse clinical outcomes. Cardiac physiological pacing (CPP) may preserve ventricular synchrony and reduce heart failure (HF) events compared with right ventricular pacing (RVP). Objectives This study sought to compare long-term clinical outcomes of CPP vs RVP in patients requiring permanent pacing after TAVR. Methods Registro de Estimulacion Fisiologica-TAVR is a retrospective, multicenter nationwide registry including patients undergoing TAVR and pacemaker implantation within 30 days. Propensity score matching (1:1) was performed using baseline clinical and echocardiographic variables, yielding 466 matched pairs. The primary endpoint was the composite of cardiovascular death or HF hospitalization. Cox proportional hazards models were used for time-to-event analyses. Median follow-up was 24 months. Results In the propensity score-matched cohort, CPP was associated with a lower incidence of the primary endpoint than RVP (9.7% vs 17.6%; HR: 0.57; 95% CI: 0.39-0.83; P = 0.003). This difference was driven by fewer HF hospitalizations (7.9% vs 13.9%; HR: 0.57; 95% CI: 0.37-0.86; P = 0.008). No significant differences were observed in cardiovascular death or all-cause mortality between groups. Conclusions In this multicenter propensity score-matched study, CPP after TAVR was associated with a lower risk of the primary endpoint, driven by fewer HF hospitalizations. These findings support the need for further randomized clinical trials to evaluate the role of CPP in post-TAVR patients requiring ventricular pacing. Copyright © 2026 American College of Cardiology Foundation. <107> Accession Number 2050164184 Title Updated Meta-Analysis of Left Atrial Appendage Closure Versus Oral Anticoagulation to Prevent Stroke in Atrial Fibrillation. Source Stroke. (no pagination), 2026. Date of Publication: 2026. Author Pekyi-Boateng P.K.; Mahadevan A.; Frimpong S.K.; Kanishka L.; Gbekor S.; Abimbilla H.; Villafuerte Trisolini B.J.; Blankson G.A.; Pekyi-Boateng P.D.; Nguyen D.Y.; Shoraka O.; Wold J.; Shoskes A.; Lyden S.; Vijayaraman P.; Dolia J.; Majersik J.J.; Tandar A.; Budohoski K.P.; Grandhi R. Institution (Pekyi-Boateng, Mahadevan, Kanishka, Wold, Shoskes, Lyden, Majersik) STROKE-2026-057089Department of Neurology, University of Utah School of Medicine, Salt Lake City, United States (Tandar) Division of Cardiovascular Medicine, Department of Internal Medicine (A.T.), University of Utah School of Medicine, Salt Lake City, United States (Frimpong) Department of Internal Medicine (S.K.F.), Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, United States (Vijayaraman) Department of Cardiac Electrophysiology (P.V.), Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA, United States (Gbekor) Department of Internal Medicine, UNC Health Blue Ridge Hospital, Morganton, NC, United States (Abimbilla) Department of Internal Medicine, St. Patrick's Hospital, Offinso, Ghana (Villafuerte Trisolini) Department of Neurology, HCA Florida Kendall Hospital, Miami, United States (Blankson) Department of Internal Medicine, Case Western Reserve University/University Hospitals Cleveland Medical Center, OH, United States (Pekyi-Boateng) School of Medical Sciences, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana (Nguyen) Department of Neurosurgery, UCHealth, Colorado Springs, CO, United States (Shoraka, Budohoski, Grandhi) Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, United States (Dolia) Department of Neurology, Emory University School of Medicine/Grady Memorial Hospital (Marcus Stroke and Neuroscience Center), Atlanta, GA, United States Publisher Wolters Kluwer Health Abstract BACKGROUND: - Ninety percent of left atrial thrombi in nonvalvular atrial fibrillation arise in the left atrial appendage, which can be occluded percutaneously (left atrial appendage closure [LAAC]). Two 2026 trials (CHAMPION-AF and CLOSURE-AF) more than doubled the available randomized evidence comparing LAAC with oral anticoagulation. We evaluated pooled effects of LAAC on stroke, bleeding, and mortality by bleeding risk, anticoagulation eligibility, and comparator. METHOD(S): - In this systematic review and meta-analysis, we searched PubMed, Scopus, and Embase from inception to April 15, 2026, for randomized controlled trials comparing percutaneous LAAC with oral anticoagulation in nonvalvular atrial fibrillation. Risk of bias was assessed with the Cochrane Risk of Bias 2 tool. Cumulative-incidence outcomes were pooled as odds ratios using random-effects models, with prediction intervals, prespecified subgroups, and trial sequential analysis. RESULT(S): - Six randomized controlled trials (2014-2026; 358 sites in North America, Europe, and Asia; 7028 patients) compared LAAC with warfarin (2 trials) or a direct oral anticoagulant (4 trials); populations were predominantly anticoagulation-eligible with low prior-stroke prevalence, plus 2 high-bleeding-risk and 1 postablation trial. Overall stroke rates were similar between arms (odds ratio, 1.10 [95% CI, 0.78-1.56]). Ischemic stroke was more frequent with LAAC (odds ratio, 1.41 [95% CI, 1.07-1.86]) but did not reach the required information size. Nonprocedural bleeding was lower with LAAC (odds ratio, 0.58 [95% CI, 0.35-0.96]), the only outcome reaching a sufficient information size, in standard-risk and postablation but not high-bleeding-risk patients. CONCLUSION(S): - LAAC is best positioned to reduce nonprocedural bleeding in anticoagulation-eligible patients at standard-to-moderate bleeding risk, rather than as a stroke-equivalent substitute for oral anticoagulation. REGISTRATION: - URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD420261370546. Copyright © 2026 American Heart Association, Inc. <108> Accession Number 652301714 Title Autologous blood pleurodesis for postoperative air leakage following video-assisted thoracoscopic surgery-a randomized controlled trial. Source European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. (no pagination), 2026. Date of Publication: 30 Sep 2026. Author Dittberner F.A.; Christensen T.D.; Licht P.B. Institution (Dittberner, Licht) Department of Cardiothoracic Surgery, Odense University Hospital, Odense, Denmark (Dittberner, Licht) Department of Clinical Research, University of Southern Denmark, Odense, Denmark (Christensen) Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark (Christensen) Department of Clinical Medicine, Aarhus University, Aarhus, Denmark Abstract OBJECTIVES: Postoperative air leakage following lung surgery prolongs chest drainage duration and length of hospitalization and the evidence regarding treatment with autologous blood pleurodesis (ABP) is scarce. We decided to investigate if ABP would influence postoperative air leakage when used on the first postoperative day following elective video-assisted thoracoscopic surgery (VATS). METHOD(S): In this multicenter randomized controlled trial, patients with an air leakage greater than 40 ml/min during cough and mobilization on their first postoperative day following elective VATS were randomized 1:1 to standard chest drain management with or without ABP (stratified by lobectomy or wedge resection). The chest drain was removed after standardized digital drainage criteria, and the primary endpoint was time to chest drain removal. Patients with persistent air leakage beyond postoperative day 7 were censored to allow for individualized management. RESULT(S): A total of 268 patients were randomized (134 in each group), after lobectomy (n = 238) or wedge (n = 30). Median chest drain duration was 3.4 days (95% CI 3.0-4.9) in the ABP group versus 5.0 days (95% CI 4.0-6.8) in the control group (p = 0.007). By postoperative day 7, chest drains had been removed in 74% versus 62% of patients, respectively. ABP significantly increased the rate of chest drain removal (HR 1.49, 95% CI 1.11-2.01; p = 0.007). The treatment effect was consistent across both participating centers. CONCLUSION(S): Early autologous blood pleurodesis significantly shortens chest drain duration in patients with postoperative air leakage following VATS. This simple and low-cost intervention should be considered in Enhanced Recovery After Surgery protocols after thoracic surgery. Copyright © The Author(s) 2026. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. 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 informat <109> Accession Number 2050176534 Title Efficacy and safety of left atrial appendage occlusion versus oral anticoagulation for stroke prevention in non-valvular atrial fibrillation: do meta-analyses sharpen blurred images?. Source Trends in Cardiovascular Medicine. (no pagination), 2026. Date of Publication: 2026. Author Slee A.; Olshansky B.; Kantharia B.K. Institution (Slee) New Arch Consulting LLC, Seattle, WA, United States (Olshansky) Francois M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, United States (Kantharia) Cardiovascular and Heart Rhythm Consultants, Icahn School of Medicine at Mount Sinai, New York, NY, United States Publisher Elsevier Inc.

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