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"42874761", "title": "Prevalence of Guideline-Recommended Genetic Testing in Patients at Risk for Heritable Thoracic Aortic Disease.", "doi": "10.1016/j.amjcard.2026.10.012", "pmid": "42874761", "firstPublicationDate": "2026-10-14", "pubTypeList": { "pubType": [ "Journal Article" ] }, "isOpenAccess": "N", "inPMC": "N", "inEPMC": "N", "fullTextUrlList": { "fullTextUrl": [ { "availability": "Subscription required", "availabilityCode": "S", "documentStyle": "doi", "site": "DOI", "url": "https://doi.org/10.1016/j.amjcard.2026.10.012" } ] } } ] } }, "pubmed_records": { "41730622": { "pmid": "41730622", "title": "Double Mutations in the FLNA and MYH11 Genes Causing Familial Thoracic Aortic Aneurysm and Dissection: A Report of Two Cases.", "abstract": "In some cases, familial thoracic aortic aneurysm and dissection is caused by multiple gene mutations. A 36-year-old woman (Patient 1) experienced acute aortic dissection requiring emergency surgery. Eight years later, her child (Patient 2) was diagnosed with an aortic aneurysm, and head magnetic resonance imaging revealed periventricular nodular heterotopia, thus prompting genetic testing to identify possible mutations in the FLNA and MYH11 genes. Subsequently, Patient 1 underwent genetic testing, which revealed the same mutations. Double mutations in FLNA and MYH11 can lead to aortic aneurysms and aortic dissection, while often manifesting at a young age.", "authors": [ "OgasawaraNobuhiroNDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan.", "SatoWakanaWDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan.", "MorisakiHirokoHDepartment of Medical Genetics, Sakakibara Heart Institute, Japan.", "WatanabeHiroyukiHDepartment of Cardiovascular Medicine, Akita University Graduate School of Medicine, Japan." ], "journal": "Internal medicine (Tokyo, Japan)", "journal_abbrev": "Intern Med", "publication_types": [ "Journal Article", "Case Reports" ], "ids": { "pubmed": "41730622", "doi": "10.2169/internalmedicine.6761-25" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-02-24" } ], "journal_date": "2026Oct15" }, "42223160": { "pmid": "42223160", "title": "Blunt Thoracic Aortic Injury in the Geriatric Population: Results from the Aortic Trauma Foundation.", "abstract": "BACKGROUND: The management of blunt thoracic aortic injury (BTAI) is evolving as the trauma population ages, yet the impact of age on treatment patterns and outcomes remains incompletely defined.\nSTUDY DESIGN: A retrospective analysis of the Aortic Trauma Foundation registry (November 2016 to November 2023) identified 823 patients with BTAI, including 118 geriatric patients (65 years and older). Demographics, injury characteristics, management strategies, and outcomes were compared between the geriatric and younger (younger than 65 years) cohorts.\nRESULTS: Geriatric patients more frequently presented after falls (17.8% vs 6.7%, p < 0.0001) and had a higher proportion of grade IV injuries (18.5% vs 9.2%, p = 0.0021), with no difference in admission systolic blood pressure (116 vs 116, p = 0.960) or Injury Severity Score (31 vs 33, p = 0.150). Management strategies were similar between groups, including nonoperative (37.3% vs 36.9%, p = 0.932), open (4.2% vs 1.9%, p = 0.132), and endovascular repair (58.5% vs 61.1%, p = 0.584). Despite comparable treatment approaches, geriatric patients had higher in-hospital mortality (27.1% vs 10.9%, p < 0.0001) and aortic-related mortality (8.5% vs 3.4%, p = 0.010).\nCONCLUSIONS: Geriatric patients with BTAI sustain more severe injuries and experience significantly higher mortality despite similar management strategies. These findings suggest that current treatment paradigms may not adequately address age-associated risk and highlight the need for age-specific management considerations.", "authors": [ "GaitherMorganMFrom the Department of Surgery and Perioperative Care, The University of Texas at Austin, Dell Medical School, Austin, TX.", "PetrikasMadelineM", "MacHughAlexandraA", "CrappsJoshuaJ", "Yep MendizabalFiorellaF", "MiserlisDimitriosD", "CardenasTatianaT", "BrownCarlosC", "TeixeiraPedroP", "DuBoseJosephJ", "Aortic Trauma Foundation" ], "journal": "Journal of the American College of Surgeons", "journal_abbrev": "J Am Coll Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42223160", "doi": "10.1097/XCS.0000000000002051", "pii": "00019464-202611000-00030" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Nov01" }, "42460806": { "pmid": "42460806", "title": "Approach to the patient with elevated lipoprotein(a).", "abstract": "Lipoprotein(a) [Lp(a)] is a common, genetically determined lipoprotein that is independently associated with myocardial infarction, stroke, peripheral artery disease, and calcific aortic stenosis. Because Lp(a) levels are stable over time and minimally influenced by lifestyle, the 2026 ACC/AHA/Multisociety Dyslipidemia Guideline now recommends one-time measurement in all adults and cascade screening in high-risk families; as a result, endocrinologists can expect to encounter and manage elevated Lp(a) frequently in routine clinical practice. Despite its clinical importance, no approved drug therapies specifically targeting Lp(a) yet exist; therefore, management should currently focus on aggressive optimization of traditional risk factors, particularly LDL-C lowering with statins and selective use of adjunctive therapies such as PCSK9 inhibitors and lipid apheresis. Emerging evidence suggests a potential benefit of selective aspirin use, while novel therapeutics-antisense oligonucleotides and small interfering RNAs-which robustly lower Lp(a) are currently being tested in phase 3 clinical trials. We present case-based examples to highlight practical approaches to risk assessment and management of elevated Lp(a).", "authors": [ "McGinnisTimothyTDepartment of Internal Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.", "SaxonDavid RDR0000-0002-4309-855XDivision of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.Division of Endocrinology, Rocky Mountain Regional VA Medical Center, Aurora, CO 80045, USA." ], "journal": "The Journal of clinical endocrinology and metabolism", "journal_abbrev": "J Clin Endocrinol Metab", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42460806", "doi": "10.1210/clinem/dgag286", "pii": "8735767" }, "article_dates": [], "journal_date": "2026Oct16" }, "42569985": { "pmid": "42569985", "title": "Giant Ascending Aortic Aneurysm With Atypical Presentation as Abdominal Pain.", "abstract": "BACKGROUND: Ascending aortic aneurysms typically present with chest or back pain; however, atypical presentations may delay diagnosis.\nCASE SUMMARY: A 58-year-old woman presented with acute lower abdominal pain and diaphoresis. Hypertension and a new diastolic murmur prompted cardiology evaluation, revealing clinical signs of chronic severe aortic regurgitation. Imaging confirmed a giant ascending aortic aneurysm (89 × 83 mm) with severe aortic regurgitation.\nDISCUSSION: This case emphasizes atypical presentations of thoracic aortic disease, compensated high-risk anatomy, and timely referral to specialized aortic centers to facilitate definitive surgical care despite temporary institutional capacity constraints.\nTAKE-HOME MESSAGES: Giant ascending aortic aneurysms may remain clinically compensated despite high-risk anatomy and present atypically, requiring high clinical suspicion and early multimodality imaging. When definitive repair is delayed by system-level constraints, structured interim stabilization, surveillance, and referral coordination are critical.", "authors": [ "Moreno DirzoJuan PJPHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico. Electronic address: drjpablomoreno@gmail.com.", "Castillo EsquivelFernanda MFMHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.", "Guatemala MorenoLiliana ALAHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.", "MendozaAdolfo ChávezACHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.", "Ivey MirandaJuan BJBHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.", "Mendoza ZavalaGenaro HGHHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico.", "SerranoAntonio MagañaAMHeart Failure Department, Unidad Médica de Alta Especialidad Hospital de Cardiología Centro Médico Nacional Siglo XXI, IMSS, Mexico City, Mexico." ], "journal": "JACC. Case reports", "journal_abbrev": "JACC Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42569985", "doi": "10.1016/j.jaccas.2026.109767", "pii": "S2666-0849(26)02928-1" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-08-08" } ], "journal_date": "2026Oct14" }, "42578908": { "pmid": "42578908", "title": "Bilateral Central Retinal Artery Occlusion Immediately After Thoracic Endovascular Aortic Repair.", "abstract": "BACKGROUND: Although complications of thoracic endovascular aortic repair (TEVAR), such as spinal cord ischemia and peripheral embolism, are well known, there have been no previous reports of central retinal artery occlusion (CRAO).\nCASE SUMMARY: A 69-year-old man was transferred to our hospital with abdominal pain and diagnosed with combined type B aortic dissection and abdominal aortic aneurysm. Endovascular repair for abdominal aortic aneurysm was initially performed. After TEVAR for primary entry closure, he reported bilateral vision loss. Ophthalmological examination diagnosed bilateral CRAO. After prompt treatment, the patient's vision recovered to its preoperative level.\nDISCUSSION: In this case, it is conceivable that a microembolism was dispersed into the head and neck vasculature, leading to occlusion at the level of the central retinal artery. Furthermore, the left subclavian artery was partially covered, suggesting that reduced perfusion reserve in the posterior circulation may have lowered the ischemic tolerance of retinal tissue, thereby amplifying the clinical impact of microemboli reaching the ocular circulation.\nTAKE-HOME MESSAGE: Complete visual recovery in bilateral CRAO is extremely rare, and this case is considered an important example demonstrating the value of early diagnosis and treatment after TEVAR.", "authors": [ "YamazakiHajimeHDepartment of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Kita-ku, Okayama, Japan.", "HiraokaArudoADepartment of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Kita-ku, Okayama, Japan. Electronic address: bassbord1028@yahoo.co.jp.", "ChikazawaGentaGDepartment of Cardiovascular Surgery, The Sakakibara Heart Institute of Okayama, Kita-ku, Okayama, Japan." ], "journal": "JACC. Case reports", "journal_abbrev": "JACC Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42578908", "doi": "10.1016/j.jaccas.2026.109771", "pii": "S2666-0849(26)02932-3" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-08-11" } ], "journal_date": "2026Oct14" }, "42683679": { "pmid": "42683679", "title": "Self-Amplifying AIE Probe for HClO-Activatable Imaging and Antioxidative/Anti-Inflammatory Therapy of Thoracic Aortic Dissection.", "abstract": "Thoracic aortic dissection (TAD) is a highly lethal cardiovascular disease, yet its accurate diagnosis and effective treatment remain challenging due to poor imaging contrast and insufficient specificity. Leveraging the overexpressed reactive oxygen species (ROS) in TAD, we reported a hypochlorous acid (HClO)-activatable molecular probe DT-PZ. It enables two-stage self-amplifying fluorescence imaging (chemical activation and then physical aggregation) and light-independent therapy on a single chemical entity. The probe initially exhibits quenched fluorescence via photoinduced electron transfer (PET). Two pathways can turn on the fluorescence via chemical activation: (1) oxidation by HClO blocks PET and turns on the emission; (2) photo-triggered radicals generation of HClO (via chloride ions or myeloperoxidase) to activate neighboring probes, creating self-amplifying fluorescence. Upon accumulation at the lesion site, the physical aggregation caused by the aggregation-induced emission effect further amplifies the fluorescence signals. This two-stage fluorescence amplification mechanism enables TAD visualization within 2 min in vivo. For therapy, the phenothiazine scavenges excess ROS during non-illuminated periods, down-regulates the NF-κB/P65 signal pathway, and up-regulates eNOS and P-Akt expressions, protecting endothelial homeostasis and then improving murine survival from 50% to 90%. Collectively, DT-PZ synergizes self-amplifying fluorescence imaging with light-independent antioxidation/anti-inflammatory therapy, holding great promise for managing deep-seated cardiovascular diseases.", "authors": [ "XuYanziY0009-0001-0484-2884School of Chemistry, Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, Xi'an Jiaotong University, Xi'an, P. R. China.", "LuoYunpengYDepartment of Cardiovascular Surgery, Xijing Hospital of Air Force Military, Xi'an, P. R. China.", "ShenJialeJSchool of Chemistry, Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, Xi'an Jiaotong University, Xi'an, P. R. China.", "DengZihaoZDepartment of Chemistry and Department of Chemical and Biological Engineering, The Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong, P. R. China.", "GaoAnranASchool of Chemistry, Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, Xi'an Jiaotong University, Xi'an, P. R. China.", "YangShengyiSDepartment of Chemistry and Department of Chemical and Biological Engineering, The Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong, P. R. China.", "LamJacky W YJWYDepartment of Chemistry and Department of Chemical and Biological Engineering, The Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong, P. R. China.", "KwokRyan T KRTK0000-0002-6866-3877Department of Chemistry and Department of Chemical and Biological Engineering, The Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong, P. R. China.", "XuChanghuoC0000-0002-0831-3357MOE Frontiers Science Center for Precision Oncology, Faculty of Health Sciences, University of Macau, Macao, P. R. China.", "MengLingjieL0000-0003-0428-9780School of Chemistry, Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, Xi'an Jiaotong University, Xi'an, P. R. China.Instrumental Analysis Center of Xi'an Jiaotong University, Xi'an, P. R. China.", "DuanWeixunW0000-0003-4475-7067Department of Cardiovascular Surgery, Xijing Hospital of Air Force Military, Xi'an, P. R. China.", "DangDongfengD0000-0003-4697-5447School of Chemistry, Engineering Research Center of Energy Storage Materials and Devices, Ministry of Education, Xi'an Jiaotong University, Xi'an, P. R. China.", "TangBen ZhongBZ0000-0002-0293-964XDepartment of Chemistry and Department of Chemical and Biological Engineering, The Hong Kong Branch of Chinese National Engineering Research Center for Tissue Restoration and Reconstruction, Division of Life Science and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Hong Kong, P. R. China.Guangdong Basic Research Center of Excellence for Aggregate Science, School of Science and Engineering, The Chinese University of Hong Kong (Shenzhen), Shenzhen, Guangdong, P. R. China." ], "journal": "Angewandte Chemie (International ed. in English)", "journal_abbrev": "Angew Chem Int Ed Engl", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42683679", "doi": "10.1002/anie.3622603" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-02" } ], "journal_date": "2026Oct19" }, "42757002": { "pmid": "42757002", "title": "An LLM-enhanced AI agent for rapid diagnosis of acute aortic dissection in multi-center settings.", "abstract": "Acute aortic dissection (AAD) is a high-mortality cardiovascular emergency, yet early diagnosis before computed tomography angiography (CTA) remains challenging. We developed AAD-Agent as a pre-imaging triage aid-not as a replacement for CTA-and evaluated it in a retrospective, multi-center study. Using 869 suspected patients from 3 Chinese hospitals for internal validation and 200 from 2 additional hospitals for external validation, we compared AAD-Agent against a machine learning (ML) ensemble model. The ML-ensemble model performed well internally (accuracy 0.948, F1-score 0.964) but deteriorated externally (0.540, 0.600). In contrast, AAD-Agent maintained external stability across LLMs: DeepSeek-R1 (accuracy 0.715, F1-score 0.820), GPT-3.5 (0.715, 0.825), and GPT-4o (0.710, 0.803). Although the case-enriched design inflates these metrics, prevalence-adjusted negative predictive value (≈99.6% at 1% prevalence) supports AAD-Agent as a safe, low-cost rule-out aid to defer CTA in low-risk patients. Its low external specificity precludes confirmatory diagnosis, limiting use to rule out pending prospective validation.", "authors": [ "LiHunianHDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.", "PeiYuchenYSchool of Computer Science, Central China Normal University, Wuhan, China.", "HuTaoTDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.", "HuXiaoyuXSchool of Computer Science, Central China Normal University, Wuhan, China.", "LuoJiazhenJDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.", "ZhuManliMDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.", "LiJieJDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.", "MaYutaoYSchool of Computer Science, Central China Normal University, Wuhan, China.", "YanLiLDepartment of Emergency, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.Department of Intensive Care Unit, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China." ], "journal": "iScience", "journal_abbrev": "iScience", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42757002", "pmc": "PMC13583947", "doi": "10.1016/j.isci.2026.117503", "pii": "S2589-0042(26)02882-8" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-10" } ], "journal_date": "2026Oct16" }, "42863075": { "pmid": "42863075", "title": "Heterochronicity shapes brain network formation.", "abstract": "Brain network formation unfolds on a nonuniform developmental timetable, with different cortical regions generating connections at different developmental phases. Generative network models (GNMs) aim to uncover the principles underpinning the organization of connectomes by creating synthetic networks according to simple computational rules. These models capture the connectome's topology, operationalized here as the cumulative distributions of network metrics (e.g., modularity, small-worldness, rich-club structure). However, GNMs typically ignore the differential timing of connectivity formation, and by omitting this temporal programme they often misplace topological features in physical space. Here, we add a heterochronous growth term to GNMs and use a model fitness function that weighs topology and topography equally. Topography refers to the spatial embedding of the network-the actual anatomical positions of the axonal tracts. With these advances, we can generate synthetic networks that more faithfully reproduce the spatial layout of diffusion-MRI connectomes from two independent adult cohorts. Compared with classical, temporally agnostic models, heterochronous simulations improve model fit, accurately locate cortical hubs and modules across individuals, and converge on a single caudal-to-rostral gradient of brain maturation. Overall, integrating heterochronicity makes GNMs more faithful to brain development, and allows for better identification of individual differences in network formation.", "authors": [ "PoliFrancescoF0000-0001-9841-0056Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, United Kingdom.https://ror.org/013meh722Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom.https://ror.org/013meh722", "OldhamStuartS0000-0002-9619-6102Developmental Imaging, Murdoch Children's Research Institute, The Royal Children's Hospital Melbourne, Melbourne VIC 3052, Australia.https://ror.org/02rktxt32Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash Biomedical Imaging, Monash University, Clayton, Melbourne, VIC 3800, Australia.https://ror.org/02bfwt286", "MousleyAlexaAMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, United Kingdom.https://ror.org/013meh722Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom.https://ror.org/013meh722", "BullmoreEdward TET0000-0002-8955-8283Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom.https://ror.org/013meh722School of Academic Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, United Kingdom.https://ror.org/0220mzb33", "VértesPetra EPE0000-0002-0992-3210Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom.https://ror.org/013meh722", "AstleDuncan EDEMedical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge CB2 7EF, United Kingdom.https://ror.org/013meh722Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, United Kingdom.https://ror.org/013meh722" ], "journal": "Proceedings of the National Academy of Sciences of the United States of America", "journal_abbrev": "Proc Natl Acad Sci U S A", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42863075", "doi": "10.1073/pnas.2610400123" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-12" } ], "journal_date": "2026Oct20" }, "42870283": { "pmid": "42870283", "title": "Radiographic phenotyping of healthy and diseased aortas.", "abstract": "BACKGROUND: Ascending aortic diameter guides intervention for thoracic aneurysms. Many patients with acute type A aortic dissection (ATAAD) present with ascending aortic diameters below 5.5 cm, rendering diameter an insufficient risk discriminator. This study evaluated computed tomography angiography (CTA) morphology to identify predissection radiographic features associated with ATAAD.\nMETHODS: Control (n = 50, CTA for non-aortic indications), aneurysm (n = 61, thoracic ascending aorta [TAA] ≥ 4.5 cm), and predissection (n = 13, CTA within 3 years before dissection) groups were studied. Scans were interpreted by thoracic radiologists using predefined measurements.\nRESULTS: Age and sex distribution differed overall among groups (P < 0.001 and P = 0.010, respectively). The aneurysm group was older than controls, but the age difference from the predissection group was not significant (P = 0.084). Maximum TAA diameter (MaxD) was 3.11 ± 0.30, 4.96 ± 0.52, and 3.89 ± 0.60 cm in control, aneurysm, and predissection groups respectively; all predissection MaxD values were below 5.5 cm (maximum, 4.9 cm). Ascending aortic length (AAL) was elevated in both disease groups (aneurysm group, 9.03 ± 1.08 cm; predissection group, 10.73 ± 1.41 cm; P < 0.001 vs. control group, 6.38 ± 0.75 cm). The AAL/MaxD ratio differed significantly between every pair of groups (control group, 2.06 ± 0.22; aneurysm group, 1.83 ± 0.21; predissection group, 2.80 ± 0.50; all pairwise P < 0.001), reflecting disproportionate elongation in predissection aortas. Aneurysm patients demonstrated diffuse thoracic dilation, whereas predissection group patients showed predominantly ascending aortic involvement.\nCONCLUSIONS: In a small exploratory study, predissection aortas displayed a distinct morphological phenotype characterized by disproportionate elongation, moderate dilation, and a relatively nondilated descending aorta-distinct from the diffuse dilation of aneurysm. Ascending aortic length and the AAL/MaxD ratio may provide complementary morphological information beyond maximal diameter alone.", "authors": [ "BoudreauxJoel CJCDepartment of Cardiothoracic Surgery, University of Iowa, Iowa City, IA, USA.", "ChaudhrySulemanSDepartment of Cardiothoracic Surgery, University of Iowa, Iowa City, IA, USA.", "YasmineNikahatNDepartment of Radiology, University of Iowa, Iowa City, IA, USA.", "DhakalSaubhagyaSDepartment of Radiology, University of Iowa, Iowa City, IA, USA.", "ZhangHonghaiHDepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA.The Iowa Institute of Biomedical Imaging, University of Iowa, Iowa City, IA, USA.", "SonkaMilanMDepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA.The Iowa Institute of Biomedical Imaging, University of Iowa, Iowa City, IA, USA.", "WahleAndreasADepartment of Electrical and Computer Engineering, University of Iowa, Iowa City, IA, USA.The Iowa Institute of Biomedical Imaging, University of Iowa, Iowa City, IA, USA.", "VigmostadSarahSRoy J. Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA.", "RamachandraAbhay BABDepartment of Mechanical Engineering, Iowa State University, Ames, IA, USA.", "ThielWilliam HWHDepartment of Internal Medicine and The François M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA.", "SmithLoren ELEDepartment of Anesthesia, University of Iowa, Iowa City, IA, USA.", "StreeterJenniferJDepartment of Internal Medicine and The François M. Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA, USA.", "BelloRodrigo MRMDepartment of Radiology, University of Iowa, Iowa City, IA, USA. rodrigo-moreirabello@uiowa.edu.", "SinghalArun KAK0000-0003-3298-4131Department of Cardiothoracic Surgery, University of Iowa, Iowa City, IA, USA. arun-singhal@uiowa.edu." ], "journal": "Journal of cardiovascular imaging", "journal_abbrev": "J Cardiovasc Imaging", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42870283", "pmc": "PMC13660285", "doi": "10.1186/s44348-026-00086-5", "pii": "10.1186/s44348-026-00086-5" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-13" } ], "journal_date": "2026Oct13" }, "42870456": { "pmid": "42870456", "title": "A Real-World Clinical Study on Computed Tomography Pulmonary Angiography-Based Artificial Intelligence-Driven Risk Stratification in Pulmonary Embolism.", "abstract": "PURPOSE: To evaluate the efficacy of a computed tomography pulmonary angiography (CTPA)-based artificial intelligence system for use in the clinical setting to stratify the risk of pulmonary embolism (PE).\nMATERIALS AND METHODS: This study enrolled 115 patients diagnosed with PE based on positive CTPA reports at our institution between January 1 and October 10, 2023. Cases were classified as relatively high-risk or low-risk according to the 2019 ESC Guidelines. Two radiologists independently and blindly measured risk-related imaging parameters, including main pulmonary artery diameter (MPAD), ascending aortic diameter (AAD), right and left ventricular diameters (RVD, LVD), the right-to-left ventricular diameter ratio (RVD/LVD ratio), pulmonary artery obstruction index (PAOI), and pulmonary embolism volume (PEV). These results were compared with those from the automated artificial intelligence (AI) system to assess consistency.\nRESULTS: The agreement (intraclass correlation coefficients, ICCs) of MPAD, AAD, RVD, PAOI, LVD, and RVD/LVD ratio between AI system and manual measurements were 0.94, 0.79, 0.78, 0.80, 0.54, and 0.48, respectively. Among the AI-extracted covariates, an RVD/LVD ratio >1.2 showed good performance in identifying relatively high-risk PE cases, with an area under the curve (AUC) of 0.771. The AI model incorporating all covariates achieved an AUC of 0.848 for classifying high-risk PE.\nCONCLUSIONS: The CTPA-based AI system can rapidly extract the key imaging parameters relevant to PE risk stratification in real-world clinical settings, significantly reducing the CTPA interpretation time and improving evaluation efficiency.", "authors": [ "LiZhujunZDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "ZhengJieJDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "YangShutongSDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "ZhangBaopingBDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "HouWeiWDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "TianQianQDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "ZhuShumengSDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "XiaoYaoYDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "ZhaoWenzheWDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "HuangXinXDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "JinChaoCDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "JianZhijieZDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "WeiYingYDepartment of Research and Development, United Imaging Intelligence, Shanghai, China.", "ShiFengFDepartment of Research and Development, United Imaging Intelligence, Shanghai, China.", "YangJianJDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an.", "LiuZheZDepartment of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an." ], "journal": "Journal of thoracic imaging", "journal_abbrev": "J Thorac Imaging", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42870456", "doi": "10.1097/RTI.0000000000000913", "pii": "00005382-990000000-00251" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42870459": { "pmid": "42870459", "title": "Post-treatment risks of transcatheter aortic valve implantation: should we be increasing preventative measures?", "abstract": "INTRODUCTION: Transcatheter aortic valve implantation (TAVI) has become an established treatment for severe aortic stenosis across an expanding risk spectrum. As indications extend to younger and lower-risk patients, post-treatment complications with implications for survival, quality of life, and valve durability require attention.\nAREAS COVERED: This narrative review discusses major post-TAVI complications with direct implications for procedural planning and lifetime management, including cerebrovascular events, conduction abnormalities, coronary obstruction and aortic root injury, bioprosthetic valve dysfunction, valve thrombosis, residual regurgitation, and TAVI-associated infective endocarditis. Evidence was reviewed from pivotal randomized trials, contemporary registries, consensus documents, systematic reviews, and mechanistic studies addressing incidence, pathophysiology, predictors, prognosis, prevention, diagnosis, and management of these complications.\nEXPERT OPINION: Post-TAVI risk reduction should move beyond reactive complication management toward individualized prevention. Meticulous computed tomography-based planning, optimized valve selection and implantation technique, rational antithrombotic therapy, structured rhythm and valve surveillance, selective use of cerebral embolic protection, timely correction of clinically or hemodynamically significant residual regurgitation, and infection-prevention pathways are central components of contemporary care. Future progress will depend on better risk stratification, longer-term durability data, and targeted preventive strategies adapted to lower-risk patients with longer life expectancy.", "authors": [ "TheofilisPanagiotisPFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "VlachakisPanayotis KPKFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "KoutsopoulosGeorgeGFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "KachrimanidisIoannisIFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "IliakisPanagiotisPFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.Department of Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Ruhr University Bochum, Knappschaft Kliniken University Hospital Bochum, Bochum, Germany.", "KtenopoulosNikolaosNFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "PatsalisPolykarpos ChristosPCDepartment of Medicine, Division of Cardiology, Angiology and Internal Emergency Medicine, Ruhr University Bochum, Knappschaft Kliniken University Hospital Bochum, Bochum, Germany.", "ToutouzasKonstantinosKFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece.", "TsioufisKonstantinosKFirst Department of Cardiology, \"Hippokration\" General Hospital, University of Athens Medical School, Athens, Greece." ], "journal": "Expert review of cardiovascular therapy", "journal_abbrev": "Expert Rev Cardiovasc Ther", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42870459", "doi": "10.1080/14779072.2026.2749914" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42870968": { "pmid": "42870968", "title": "Transaxillary access for ascending aortic and root surgery: a single-center comparison with full and partial sternotomy.", "abstract": "BACKGROUND: Minimally invasive approaches for ascending aortic and root surgery remain controversial regarding operative complexity and safety. The transaxillary (TAX) approach avoids sternotomy entirely but has not been compared with both full sternotomy (FS) and partial upper sternotomy [minimally invasive cardiac surgery (MIC)]. This study evaluates perioperative outcomes across these three access strategies.\nMETHODS: Between January 2022 and December 2025, 194 consecutive patients undergoing elective isolated ascending aortic or root surgery were retrospectively analyzed. Surgical access was FS (n=52), MIC (n=106), or TAX (n=36). TAX suitability was assessed by team consensus on electrocardiogram (ECG)-gated computed tomography (CT). Primary endpoints were in-hospital mortality, major complications [Society of Thoracic Surgeons (STS) composite], and hospital length of stay. TAX was compared with MIC after 1:2 propensity score matching. FS served as descriptive reference.\nRESULTS: FS patients had higher EuroSCORE II (median 2.7 vs. MIC 2.2 vs. TAX 2.3%, P=0.006). Cardiopulmonary bypass time was longer in TAX {196 [interquartile range (IQR): 175-239] vs. MIC 160 [138-192] vs. FS 172 [140-198] min, P<0.001}, while cross-clamp time did not differ (P=0.34). In-hospital mortality was 3.8% (FS), 0% (MIC), and 0% (TAX). Major complications occurred in 26.9%, 12.3%, and 8.3% (P=0.02), and acute kidney injury (AKI) in 28.8%, 8.5%, and 2.8% (P<0.001). One stroke occurred in the FS group. In the matched cohort (34 TAX vs. 68 MIC), bypass time remained longer in TAX {196 [175-240] vs. 160 [139-190] min, P<0.001}, whereas cross-clamp time, intensive care unit (ICU) and hospital stay, major complications (5.9% vs. 11.8%), AKI (2.9% vs. 10.3%), atrial fibrillation, and wound complications did not differ significantly.\nCONCLUSIONS: TAX ascending aortic and root surgery was feasible in carefully selected patients, with no in-hospital mortality, no stroke, and no wound complications. In a propensity-matched comparison with partial upper sternotomy, early outcomes did not differ significantly despite longer bypass time. TAX extends the sternal-sparing concept to the aortic root and ascending aorta and warrants prospective evaluation.", "authors": [ "DohleDaniel-SebastianDSDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "PfeifferPhilippPDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "KellerChristianCDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "ZancanaroEdoardoEDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "GhazyAhmedADepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "MasseliFranzFDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "ProbstChrisCDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany.", "TreedeHendrikHDepartment of Cardiac and Vascular Surgery, University Medical Center Mainz, Mainz, Germany." ], "journal": "Annals of cardiothoracic surgery", "journal_abbrev": "Ann Cardiothorac Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42870968", "pmc": "PMC13657871", "doi": "10.21037/acs-2026-0307-tdv", "pii": "acs-15-5-65" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-29" } ], "journal_date": "2026Sep30" }, "42871221": { "pmid": "42871221", "title": "A Difference-in-Differences Analysis of Low-Value Opioid Utilization for Acute Low Back Pain, 2019-2021.", "abstract": "INTRODUCTION: The use of opioids for acute low-back pain (LBP) is considered low-value in most clinical scenarios. Understanding trends in low-value opioid utilization can inform interventions to support guideline-concordant care. This study evaluated the utilization of low-value opioids for acute LBP, and variation by rurality, payer, and sex, before and during the COVID-19 pandemic.\nMETHODS: In this retrospective cohort study, we examined opioid claims from Virginia's All-Payer Claims Database among adults with commercial, Medicare Advantage (MA), or Medicaid insurance during 2019-2021. We identified low-value opioid claims for acute LBP and quantified utilization rates per 1,000 patients. Heterogeneous difference-in-differences models generated incidence rate ratios (IRRs) stratified by rurality, payer, and sex to estimate differences between the observed (during-pandemic) and expected (prepandemic) rates.\nRESULTS: Among our cohort (n = 853,775), 73.9% of opioids utilized for acute LBP were low-value. Utilization rates declined from 155.0 prescriptions/1,000 patients in 2019 to 107.5 prescriptions/1000 patients in 2021 and were 20.0% lower during the pandemic than expected rates (marginal IRR: 0.80, P = 0.002). Utilization was higher in rural than nonrural areas (marginal IRR: 1.74, P<0.001) without pandemic effect interaction (IRR: 1.02, P = 0.604). The rural effect was smaller for MA beneficiaries (IRR: 0.75, P = 0.046), and larger among males (IRR: 1.25, P<0.001).\nCONCLUSIONS: The decline in low-value opioid utilization for acute LBP was accelerated during 2020-2021. Utilization was consistently higher in rural than nonrural areas. Findings highlight the need for targeted interventions and policy to reduce low-value opioid utilization, especially in rural areas to ensure equitable, high-value care for acute pain.", "authors": [ "TurnerJamie KJKTranslational Biology, Medicine, and Health Graduate Program, Virginia Tech, Roanoke, VA.Department of Family and Community Medicine, Carilion Clinic, Roanoke, VA.", "GrubbChristopher TCTCenter for Biostatistics and Health Data Science, Virginia Tech, Roanoke, VA.", "BritzJacqueline BJBDepartment of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA.", "HardenSamantha MSMDepartment of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA.Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA.", "HanlonAlexandra LALCenter for Biostatistics and Health Data Science, Virginia Tech, Roanoke, VA.", "EplingJohn WJWDepartment of Family and Community Medicine, Carilion Clinic, Roanoke, VA.Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA.", "RockwellMichelle SMSDepartment of Family and Community Medicine, Carilion Clinic, Roanoke, VA.Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, VA." ], "journal": "PRiMER (Leawood, Kan.)", "journal_abbrev": "PRiMER", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42871221", "pmc": "PMC13658999", "doi": "10.22454/PRiMER.2026.0061", "pii": "PRiMER-2026-0061" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-10" } ], "journal_date": "2026" }, "42871352": { "pmid": "42871352", "title": "Cytomegalovirus Enteritis after Surgery for Acute Type A Aortic Dissection Complicated by Malperfusion and Thymoma: A Case Report.", "abstract": "INTRODUCTION: Cytomegalovirus (CMV) enteritis is a potentially life-threatening gastrointestinal infection typically observed in immunocompromised individuals, such as transplant recipients or patients receiving chemotherapy or long-term corticosteroids. However, CMV enteritis can also develop in the absence of overt immunosuppression, particularly in elderly or critically ill patients under physiological stress, nutritional decline, or prolonged hospitalization. Diagnosis in these settings is challenging because clinical symptoms and imaging findings are nonspecific and may overlap with ischemic or other infectious enteritis.\nCASE PRESENTATION: We report a rare case of CMV enteritis in a 65-year-old man who underwent emergent surgical repair for acute type A aortic dissection complicated by superior mesenteric artery (SMA) malperfusion. He underwent total arch replacement, aortic valve replacement with a bioprosthetic valve, and concomitant thymectomy for an anterior mediastinal mass. On POD 4, additional endovascular interventions were performed, including thoracic endovascular aortic repair and SMA stenting. His postoperative course was notable for persistent ileus, poor oral intake, progressive nutritional deterioration, and sustained postoperative fever with elevated inflammatory markers. Because these symptoms and inflammatory findings persisted without an identified infectious source, CMV testing was performed on POD 20. The results, which became available on POD 23, showed positive CMV antigenemia (C7-HRP: 42/50000 WBC) and CMV DNA (1.2 × 104 IU/mL). Abdominal CT demonstrated diffuse small-bowel wall thickening and submucosal edema. Because of his clinical status, endoscopic biopsy was deferred, and CMV enteritis was diagnosed presumptively based on clinical, radiologic, and virologic findings. Intravenous ganciclovir (300 mg every 12 hours) was initiated and continued for 22 days, resulting in gradual improvement in abdominal symptoms, a marked decrease in CMV DNA levels, and conversion of CMV antigenemia to negative. He was transferred to another facility on POD 90.\nCONCLUSIONS: CMV enteritis should be considered as a cause of unexplained postoperative fever after open-heart surgery, particularly following repair of acute aortic dissection complicated by malperfusion-related intestinal ischemia, even without classic immunosuppressive conditions. Surgical stress, ischemic bowel injury, and delayed nutritional recovery may predispose critically ill postoperative patients to CMV reactivation. Early CMV testing and timely antiviral therapy may facilitate diagnosis and help prevent clinical deterioration.", "authors": [ "FukutaHanaHDepartment of Cardiovascular Surgery, Seitetsu Memorial Muroran Hospital, Muroran, Hokkaido, Japan.", "NaritaMasahikoMDepartment of Cardiovascular Surgery, Seitetsu Memorial Muroran Hospital, Muroran, Hokkaido, Japan.", "UshiodaRyoheiRDepartment of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.", "NakatsuTomokiTDepartment of Cardiovascular Surgery, Seitetsu Memorial Muroran Hospital, Muroran, Hokkaido, Japan.", "KadohamaTakayukiTDepartment of Cardiovascular Surgery, Seitetsu Memorial Muroran Hospital, Muroran, Hokkaido, Japan.", "KamiyaHiroyukiHDepartment of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan." ], "journal": "Surgical case reports", "journal_abbrev": "Surg Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42871352", "pmc": "PMC13659060", "doi": "10.70352/scrj.cr.26-0318", "pii": "scrj.cr.26-0318" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-08" } ], "journal_date": "2026" }, "42871388": { "pmid": "42871388", "title": "Staged total arch repair for acute aortic dissection using physician-modified fenestrated thoracic endovascular aortic repair: a case report.", "abstract": "BACKGROUND: Acute type A aortic dissection is a life-threatening condition requiring prompt surgical intervention. Although extensive repair, such as total arch replacement (TAR) with frozen elephant trunk (FET), may reduce late aortic events, this approach can be technically demanding and may increase procedural invasiveness and patient burden. A staged approach combining initial surgery with subsequent endovascular treatment may represent a practical alternative.\nCASE DESCRIPTION: We report a case of acute type A aortic dissection managed using a staged treatment strategy. Initial surgery was performed using transatrial left-ventricular (TALV) cannulation and partial aortic arch replacement with distal anastomosis in Ishimaru zone 2. This approach was selected to achieve rapid establishment of cardiopulmonary bypass and to avoid more extensive arch reconstruction during the emergency phase. After postoperative stabilisation and follow-up assessment of the residual dissection, physician-modified endograft (PMEG) fenestrated thoracic endovascular aortic repair (TEVAR) was performed as a second-stage procedure. The fenestration was tailored according to postoperative computed tomography (CT) findings, allowing the extension of treatment to the residual dissected arch and descending aorta while using the prosthetic graft as the proximal landing zone. This staged strategy may reduce the invasiveness of the initial lifesaving surgery while preserving the option for more complete aortic treatment after recovery.\nCONCLUSIONS: This case suggests that, in selected patients with acute type A aortic dissection, zone 2 aortic arch replacement followed by staged PMEG fenestrated TEVAR may be a feasible strategy. Careful postoperative assessment of residual dissection is essential to identify patients who may benefit from additional endovascular intervention.", "authors": [ "AratameAtsutakaA0000-0002-4321-2762Department of Cardiovascular Surgery, Bell-land General Hospital, Sakai City, Osaka, Japan.", "KakuDaisukeDDepartment of Cardiovascular Surgery, Bell-land General Hospital, Sakai City, Osaka, Japan.", "BabaToshioTDepartment of Cardiovascular Surgery, Bell-land General Hospital, Sakai City, Osaka, Japan." ], "journal": "AME case reports", "journal_abbrev": "AME Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42871388", "pmc": "PMC13659147", "doi": "10.21037/acr-2026-0216", "pii": "acr-10-2026-0216" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-08-30" } ], "journal_date": "2026" }, "42871548": { "pmid": "42871548", "title": "Hybrid approach with thoracic endovascular treatment and abdominal aortic replacement for acute type B aortic dissection complicated by ruptured abdominal aortic aneurysm.", "abstract": "The coexistence of a ruptured abdominal aortic aneurysm and acute aortic dissection is an unusual and life-threatening condition. We present the case of a patient who underwent simultaneous thoracic endovascular aortic repair and graft replacement for synchronous acute type B aortic dissection and ruptured abdominal aortic aneurysm. After deployment of the stent graft at the distal arch, graft replacement was accomplished without hemodynamic deterioration. The true lumen of the infrarenal abdominal aorta expanded, and a secure proximal anastomosis was achieved. A hybrid approach can be considered when different aortic diseases involve the same aortic lesion in an emergent setting.", "authors": [ "OmineKaitoKDepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.", "TodaYukiYDepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.", "OtakeSatoshiSDepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.", "YamashitaAtsushiADepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.", "KawaharaYuYDepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.", "AbeKazuoKDepartment of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42871548", "pmc": "PMC13659668", "doi": "10.1016/j.jvscit.2026.102504", "pii": "S2468-4287(26)00388-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-07" } ], "journal_date": "2026Dec" }, "42872173": { "pmid": "42872173", "title": "Early-term and midterm outcomes of endovascular completion of high-risk subacute and early chronic residual dissection after type A repair.", "abstract": "OBJECTIVES: Late mortality, progressive aneurysmal degeneration, and major reinterventions remain frequent after repair of type A aortic dissection. This study aimed to evaluate early- and midterm outcomes of endovascular completion in patients with high-risk residual dissection treated during the subacute or early chronic phase.\nMETHODS: This study was a single-center retrospective analysis of a prospectively maintained institutional database. All consecutive patients undergoing endovascular completion for high-risk residual aortic dissection after type A dissection repair between January 2017 and September 2025 were included. Completion was performed using thoracic endovascular aortic repair alone or combined with the stented-assisted balloon-induced intimal disruption and relamination technique when distal extension exceeded Ishimaru zone 5. Primary outcomes were 30-day mortality and morbidity, as well as 3- and 5-year survival and reintervention rates.\nRESULTS: Among 127 patients surviving initial type A repair, 48 (37.8%) underwent endovascular completion (subacute n = 33; early chronic n = 15). No 30-day deaths occurred, and technical success was achieved in all cases. Major adverse events occurred in 6.2%, with no spinal cord ischemia. Five patients (10.4%) required early reintervention. Median clinical follow-up was 54 months. Estimated survival was 97.9% at 3 years and 90.3% at 5 years. Freedom from major reintervention was 93.5% at 3 years and 89.1% at 5 years. False lumen thrombosis was achieved in 89.6% of thoracic and 81.4% of visceral segments.\nCONCLUSIONS: Endovascular completion of high-risk residual dissection after type A repair is safe and effective, providing excellent midterm survival, low major reintervention rates, and high rates of aortic remodeling.", "authors": [ "FerraresiMarcoMDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "KatsarouMariaMDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "Luigi MolinariAlessandro CarloACDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "JovanovicJankoJDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "SegretiSaraSDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "ClericiAlbertoADivision of Cardiac Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "GalantiAndreaADivision of Cardiac Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy.", "RossiGiovanniGDivision of Vascular Surgery, Cardio-Thoraco-Vascular Department, A. Manzoni Hospital, Lecco, Italy." ], "journal": "JTCVS structural and endovascular", "journal_abbrev": "JTCVS Struct Endovasc", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42872173", "pmc": "PMC13660646", "doi": "10.1016/j.xjse.2026.100148", "pii": "S2950-6050(26)00053-7" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-09" } ], "journal_date": "2026Dec" }, "42873216": { "pmid": "42873216", "title": "Protocol-based medical management for inflammatory abdominal aortic aneurysms: a five-year single-center experience.", "abstract": "BACKGROUND: Inflammatory abdominal aortic aneurysm (IAAA), a distinct clinical entity characterized by dense periaortic fibrosis and elevated inflammatory markers, lacks a consensus-driven optimal management strategy. While medical therapy is often utilized, comparative data against surgical or endovascular interventions remain limited. We report our experience with a standardized medical protocol for the management of IAAAs.\nMETHODS: We conducted a retrospective cohort study of 27 consecutive patients diagnosed with IAAA between 2012 and 2019. Predefined diagnostic criteria for IAAA included an ESR>100 mm/h, aortic wall thickness >10 mm, and inflammatory symptoms. Risk of rupture was assessed using a PET-CT scan for patients with a maximal aortic diameter exceeding 5.5 cm. A standardized medical protocol was used for low rupture risk patients including IV methylprednisolone followed by oral prednisone taper. Methotrexate was introduced for steroid-refractory cases. Endovascular or open aortic repair was used for patients with high risk of rupture.\nRESULTS: Patients had a mean age of 62.3 years, and 70.4% were male. The mean baseline aortic diameter was 48±5 mm (95% CI 46.0-50.0). Twenty-three patients (85.2%) were treated initially with corticosteroids. At the 3-month mark, 69.6% of medically treated patients achieved an acceptable response with steroids alone. Five steroid-refractory patients received methotrexate and demonstrated clinical improvement. ESR normalized in 95.7% of medically treated patients. During five-year follow-up, no medically managed patient required emergency surgical intervention. Eleven patients required temporary steroid reintroduction at 3 years, with sustained stability at 5 years. Three patients underwent EVAR with favorable outcomes. One patient underwent open repair, which was associated with significant perioperative morbidity and late mortality.\nCONCLUSIONS: In selected patients with low risk of aortic rupture, protocol-based medical therapy for IAAA is safe and effective with minimal risk upon mid-term follow-up. PET-CT scan assessment for risk of immediate rupture is appropriate for patients with aortic diameter between 5.5 to 6.5 cm. Methotrexate introduction may be effective for steroid-refractory cases. Endovascular repair remains a suitable option when intervention is required. Larger prospective studies are needed to establish definitive management guidelines for IAAAs.", "authors": [ "HamzahMohammadMGilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon.", "HayekFadiFLebanese American University Medical Center-Rizk Hospital (LAUMCRH), Department of Surgery, Beirut, Lebanon.", "SfeirJulienJLebanese American University Medical Center-Rizk Hospital (LAUMCRH), Department of Surgery, Beirut, Lebanon - julien.md77@gmail.com." ], "journal": "The Journal of cardiovascular surgery", "journal_abbrev": "J Cardiovasc Surg (Torino)", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42873216", "doi": "10.23736/S0021-9509.26.13657-X", "pii": "S0021-9509.26.13657-X" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42874424": { "pmid": "42874424", "title": "Epidemiology and treatment strategies of intracranial aneurysms associated with Loeys-Dietz syndrome: A systematic review, meta-analysis, and a case presentation.", "abstract": "BACKGROUND: Recent studies have suggested that intracranial aneurysms (IAs) may be a common arterial manifestation of Loeys-Dietz syndrome (LDS). However, the prevalence, characteristics, and treatment strategies remain unclear because of limited and fragmented evidence.\nMETHODS: We searched PubMed and Scopus through April 2026. Inclusion criteria were studies reporting epidemiological characteristics or surgical interventions of LDS-associated IAs. Studies with high risk of bias according to an adapted Newcastle-Ottawa Scale were excluded from the meta-analysis. Prevalence and risk factors of harboring IAs in patients with LDS were meta-analyzed using a random-effects model. Between-study heterogeneity was assessed by the I2 statistic. The review protocol was registered with PROSPERO (Registration ID: CRD420261374963).\nRESULTS: Nine observational studies were eligible for the meta-analysis. The pooled IA prevalence was 23 % (64/282; 95 % confidence interval, 18-28 %) with low across-study heterogeneity (I2 = 6.4 %). Mean aneurysm size was 3.23 mm, and 78.1 % (50/64) of the aneurysms were saccular. Eighty-five percent (63/74) of IAs were located in the anterior circulation or the posterior communicating artery. The prevalence was significantly higher in women than in men (odds ratio, 2.49; 95 % confidence interval, 1.51-4.10, I2 = 0 %). Current smoking and prior arterial dissection were consistently associated with increased odds of harboring IAs (odds ratio > 4) across two studies. No statistically significant differences in IA prevalence were detected across pathogenic variant groups, although statistical power was limited. No rupture events were reported among 62 IAs during mean or median follow-up periods ranging from 2.0 to 8.9 years. Data about the safety and efficacy of surgical interventions were only available through case reports. A systematic review of 11 case reports, including the case presented herein, identified 16 surgically treated LDS-associated IAs. Angiographic occlusion was achieved in all 16 aneurysms, with no major complications clearly attributable to the underlying connective tissue disorder.\nCONCLUSIONS: This study highlights the high prevalence and risk factors of IAs among patients with LDS. The available data do not suggest a high rupture rate in small LDS-associated IAs; however, evidence remains insufficient to define their natural history. Current management strategies are largely extrapolated from sporadic IAs and may not fully reflect LDS-specific vascular pathology.", "authors": [ "ShimizuKampeiKDepartment of Biomedical Engineering, Yale University, New Haven, CT, USA; Department of Neurosurgery and Stroke Center, Tenri Hospital, Tenri, Nara, Japan. Electronic address: kampei.shimizu@gmail.com.", "TaniShoichiSDepartment of Neurosurgery and Stroke Center, Tenri Hospital, Tenri, Nara, Japan; Department of Neurosurgery, Hyogo Prefectural Amagasaki General Medical Center, Amagasaki, Hyogo, Japan." ], "journal": "Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia", "journal_abbrev": "J Clin Neurosci", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42874424", "doi": "10.1016/j.jocn.2026.112330", "pii": "S0967-5868(26)00481-9" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42874761": { "pmid": "42874761", "title": "Prevalence of Guideline-Recommended Genetic Testing in Patients at Risk for Heritable Thoracic Aortic Disease.", "abstract": "Heritable thoracic aortic diseases (HTAD) include genetic conditions that increase risk of thoracic aortic aneurysm and dissection. The 2022 American College of Cardiology/American Heart Association (ACC/AHA) guidelines recommend genetic testing for at-risk individuals, but real-world uptake remains unclear. We evaluated adherence to testing recommendations and demographic differences across major HTAD risk cohorts. We conducted a retrospective study using the TriNetX Research Network (2005-2025). Three guideline-based cohorts were identified using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes: (1) thoracic aortic aneurysm/dissection before age 60, (2) family history of thoracic aortic disease, and (3) non-thoracic arterial aneurysms. Genetic testing was defined by ICD-10-CM codes for genetic screening or susceptibility. Testing prevalence was stratified by age, sex, race, and ethnicity, and annual testing incidence (2005-2024) was evaluated. Among 57,935 patients with thoracic aortic aneurysm/dissection before age 60, 1,205 (2.09%) underwent genetic testing. Among 2,811,862 patients with a family history of thoracic aortic disease, 66,699 (2.38%) received testing. Among 347,000 patients with non-thoracic arterial aneurysms, 4,913 (1.42%) underwent testing. Testing was consistently higher in females than males and varied across age groups. Annual testing incidence increased over time but remained <0.6% by 2024. In conclusion, genetic testing for HTAD remains markedly underutilized, with < 2.5% of at-risk patients tested despite guideline recommendations, highlighting persistent implementation gaps and the need to improve equitable access to genetic evaluation.", "authors": [ "RobledoAriadnaADepartment of Medicine, University of Miami, Miami, FL, USA. Electronic address: ari.rbandala@gmail.com.", "O'LearySeanSDepartment of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA.", "PedrosaDaniel Del ToroDDTDepartment of Medicine, University of Miami, Miami, FL, USA.", "PenalverJorgeJDepartment of Medicine, University of Miami, Miami, FL, USA.", "SancassaniRheaRDepartment of Medicine, University of Miami, Miami, FL, USA." ], "journal": "The American journal of cardiology", "journal_abbrev": "Am J Cardiol", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42874761", "doi": "10.1016/j.amjcard.2026.10.012", "pii": "S0002-9149(26)00632-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42874838": { "pmid": "42874838", "title": "Clinical Outcomes and Exploratory Haemodynamic Numerical Simulation of Patients with Multichannelled Aortic Dissection: A Multicentre, Retrospective Cohort Study.", "abstract": "OBJECTIVE: Multichannelled aortic dissection (MCAD) is a rare type of aortic dissection with limited data on its clinical features and outcomes. This multicentre, retrospective cohort study compared clinical outcomes between MCAD and double channelled aortic dissection (DCAD) and explored haemodynamic differences.\nMETHODS: Patients with aortic dissection were enrolled from three tertiary hospitals. Patients with one true lumen and one false lumen were classified as having DCAD, whereas those with one true lumen and multiple false lumina were classified as having MCAD. Propensity score matching balanced baseline characteristics. Primary outcomes were 30 day and five year all cause mortality after diagnosis. Secondary outcomes included preprocedural mortality, aortic dissection related mortality, post-operative complications, and re-intervention. Overall survival was assessed using Kaplan-Meier analysis. Haemodynamic differences were evaluated by exploratory computational fluid dynamics (CFD) analysis.\nRESULTS: After matching, 50 patients were included in each group (n = 100). The difference in 30 day mortality was significant (p = .046) and largely reflected preprocedural deaths, which occurred in six patients with MCAD (12%) and none with DCAD (p = .027). Overall survival differed between groups (log rank p = .037; hazard ratio 2.72, 95% confidence interval 1.03 - 7.18; p = .044). Kaplan-Meier estimated mortality at 30 days, one year, and five years was 16%, 23%, and 29% in MCAD compared with 4%, 8%, and 12% in DCAD, respectively. Among treated patients, re-intervention was more frequent in MCAD than in DCAD (21% vs. 6%; p = .036), whereas post-operative complication rates did not differ. Exploratory CFD analysis suggested greater false lumen haemodynamic burden in MCAD.\nCONCLUSION: MCAD was associated with greater preprocedural mortality and more frequent re-intervention than DCAD. These findings may identify MCAD as a higher risk phenotype warranting closer surveillance and timely evaluation. Haemodynamic observations remain exploratory and require validation in larger prospective cohorts.", "authors": [ "YangJizhouJDepartment of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.", "LuanJingyangJDepartment of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, China.", "ShaoShujingSDepartment of Technology, Boea Wisdom (Hangzhou) Network Technology Co. Ltd, Hangzhou, China.", "YangYiminYDepartment of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.", "MaoLeLDepartment of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Shanghai Geriatric Medical Center, Shanghai, China.", "HeFurongFDepartment of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.", "LuoYuanmingYDepartment of Mechanical Engineering, The University of Iowa, Iowa City, IA, USA.", "ZhuTingTDepartment of Vascular Surgery, Huadong Hospital, Fudan University, Shanghai, China; Department of Vascular Surgery, Zhongshan Hospital, Fudan University, Shanghai, China. Electronic address: zhu.ting@zs-hospital.sh.cn." ], "journal": "European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery", "journal_abbrev": "Eur J Vasc Endovasc Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42874838", "doi": "10.1016/j.ejvs.2026.10.004", "pii": "S1078-5884(26)00970-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42874978": { "pmid": "42874978", "title": "Impact of Anticoagulant and Antiplatelet Agents on the Management of Acute Type A Aortic Dissection.", "abstract": "", "authors": [ "SnyderMatthew MMMDepartment of Cardiovascular and Thoracic Surgery, West Virginia University, 1 Medical Center Way, Morgantown, WV 26501.", "MehaffeyJ HunterJHDepartment of Cardiovascular and Thoracic Surgery, West Virginia University, 1 Medical Center Way, Morgantown, WV 26501. Electronic address: james.mehaffey@wvumedicine.org." ], "journal": "The Annals of thoracic surgery", "journal_abbrev": "Ann Thorac Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42874978", "doi": "10.1016/j.athoracsur.2026.10.003", "pii": "S0003-4975(26)01022-2" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42875881": { "pmid": "42875881", "title": "Von Willebrand Factor Biomarkers in Prosthetic Valve Dysfunction: An Adjunct to Imaging and Hemodynamic Assessment.", "abstract": "Imaging remains the foundation of prosthetic valve surveillance because it identifies valve morphology, lesion mechanism, and hemodynamic severity. However, acoustic shadowing, eccentric or multiple regurgitant jets, loading conditions, and reader variability can complicate assessment, particularly for paravalvular regurgitation after transcatheter aortic valve replacement. High shear stress unfolds von Willebrand factor (VWF), promotes proteolysis of its high-molecular-weight multimers, and produces a measurable defect in primary hemostasis. Multimer analysis, closure time with adenosine diphosphate (CT-ADP), and the VWF activity-to-antigen ratio therefore provide a biologic signal of abnormal flow rather than an anatomic image. Prospective studies show that VWF abnormalities track residual paravalvular regurgitation during transcatheter aortic valve replacement, occur with dysfunctional prostheses, change after mitral paravalvular-leak repair, and are associated with bleeding. The evidence nevertheless remains observational; most diagnostic cohorts are small and single-center, thresholds lack independent validation, assays are vulnerable to hematologic and preanalytic confounding, and no completed randomized trial has shown that VWF-guided management improves outcomes. VWF testing is best viewed as an investigational adjunct when imaging and the clinical picture are discordant or when prosthetic dysfunction coexists with otherwise unexplained bleeding. It should not replace guideline-directed echocardiography or be used for routine surveillance outside research protocols.", "authors": [ "ArshadSameedSFrom the Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA.", "KhanSabirSDepartment of Internal Medicine, Pennsylvania Hospital, University of Pennsylvania, Philadelphia, PA.", "ZahidMuhammadMFrom the Department of Internal Medicine, Saint Agnes Medical Center, Fresno, CA." ], "journal": "Cardiology in review", "journal_abbrev": "Cardiol Rev", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42875881", "doi": "10.1097/CRD.0000000000001496", "pii": "00045415-990000000-01040" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42876259": { "pmid": "42876259", "title": "Identification of perioperative risk factors for retrograde type A dissection after thoracic endovascular aortic repair for type B dissection.", "abstract": "OBJECTIVE: To identify risk factors and develop a predictive model for retrograde type A dissection (RTAD) following thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD).\nMETHODS: We analyzed TBAD patients who underwent TEVAR from 2014 to 2024 (IRB:No. TJ-IRB20230805). Patients developing RTAD within 1 year were matched with controls by age, sex, operation date, and location. Logistic regression identified risk factors, and a nomogram was constructed. Model performance was assessed using ROC curves.\nRESULTS: Of 2383 patients, 76 (3.19%) developed RTAD within one year. 65 RTAD cases and 195 matched controls were analyzed. RTAD patients had a greater horizontal distance of the ascending aorta (HDAA) than controls (53.34 mm vs. 43.05 mm, p < .001). Multivariate analysis identified younger age (OR = 0.95, p = .008), larger HDAA (OR = 1.14, p < .001), aortic root dilatation (OR = 2.85, p = .006), shorter stent length (OR = 0.99, p = .029), and absence of postoperative bradycardic drug use (OR = 0.31, p = .005) as independent RTAD risk factors. The model showed good discrimination (AUC = 0.85).\nCONCLUSION: Younger age, larger HDAA, aortic root dilatation, shorter stent length, and no bradycardic drugs postoperatively are independent predictors of RTAD after TEVAR. For TBAD patients with a high risk of RTAD, clinicians should consider the possibility of having connective tissue diseases, select stents appropriately, and optimize postoperative treatment with strict follow-up.", "authors": [ "LiJiajunJ0000-0002-5367-5752Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.Department of Cardiovascular Surgery, School of Medicine, The First Affiliated Hospital of Zhejiang University, Hangzhou, China.", "ZhangYucongY0000-0002-2991-5066Institute of Gerontology, Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "ChenXueguiX0009-0003-7732-4054Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "TanXinyuX0009-0000-4018-8931The First Clinical School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "XieAiniA0000-0003-2965-5628Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "MaMingjiaM0000-0002-9512-8159Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "WangJingJ0009-0002-4313-9849Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "WeiXiangX0000-0001-8812-6377Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.", "HuMinM0000-0002-1803-0975Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China." ], "journal": "Postgraduate medicine", "journal_abbrev": "Postgrad Med", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42876259", "doi": "10.1080/00325481.2026.2748100" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42876341": { "pmid": "42876341", "title": "Endovascular aortic arch repair: a review of current technologies, clinical outcomes, and future directions.", "abstract": "Endovascular treatment of the aortic arch (EndoArch) has emerged as an increasingly important therapeutic option for the management of complex aortic arch disease, driven by continuous advances in device technology, imaging, procedural planning, and operator experience. Although conventional open arch replacement remains the reference treatment for many patients, endovascular approaches have considerably expanded therapeutic options for individuals considered at high surgical risk. However, the anatomical complexity of the aortic arch, the need to preserve supra-aortic trunk perfusion, and the risk of neurological complications continue to make these procedures technically demanding. This review provides an updated overview of contemporary EndoArch, with a particular focus on currently available endovascular and hybrid strategies, clinical outcomes, procedure-related complications, and future perspectives. Available evidence demonstrates encouraging technical success and acceptable early and mid-term results in carefully selected patients treated at experienced aortic centers, although most data derive from retrospective observational studies and long-term durability has yet to be established. Careful patient selection, meticulous procedural planning, and a multidisciplinary approach remain fundamental to achieving optimal outcomes. Ongoing technological developments, including improvements in endograft design, procedural standardization, advanced imaging, and the progressive extension of endovascular treatment to more proximal aortic segments, are expected to further broaden the applicability of EndoArch. Continued clinical experience and longer-term follow-up will be essential to better define the role of these techniques in contemporary management of aortic arch disease.", "authors": [ "GrassoEmanuele CECDepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France - gr.emanuele@gmail.com.Department of Vascular and Endovascular Surgery, ASST Fatebenefratelli-Sacco, Milan, Italy - gr.emanuele@gmail.com.", "PennettaFederico FFFDepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France.", "DeryckeLucieLDepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France.", "CostanzoAlessandroADepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France.", "FabreDominiqueDDepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France.", "HaulonStéphanSDepartment of Cardiac and Vascular Surgery, Aortic Center, Hôpital Marie Lannelongue, Paris Saint Joseph Hospital, INSERM UMR_S 999, Paris-Saclay University, Paris, France." ], "journal": "Minerva surgery", "journal_abbrev": "Minerva Surg", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42876341", "doi": "10.23736/S2724-5691.26.11214-3", "pii": "S2724-5691.26.11214-3" }, "article_dates": [], "journal_date": "2026Aug" }, "42876780": { "pmid": "42876780", "title": "Unexplained intraoperative cardiac tamponade during thoracoscopic lobectomy: a case report.", "abstract": "BACKGROUND: Cardiac tamponade is a life-threatening emergency characterized by reduced cardiac output and circulatory failure. It most commonly occurs during cardiac surgery, interventional cardiology procedures, pericardiocentesis, or central venous catheterization, as well as in the setting of acute myocardial infarction or aortic dissection. To the best of our knowledge, cardiac tamponade during video-assisted thoracoscopic surgery (VATS) lobectomy has not been reported and may has an insidious presentation, making diagnosis challenging in the absence of obvious pericardial injury.\nCASE PRESENTATION: We report a case of unexplained intraoperative cardiac tamponade in a 74-year-old man undergoing VATS left upper lobectomy. During hilar vessel dissection, the blood pressure decreased to 82/65mmHg. The heart rate increased to 95 beats/min, requiring norepinephrine infusion (0.2-0.3 μg·kg⁻¹·min⁻¹) to maintain blood pressure. However, no bleeding was evident in the surgical field, hemoglobin and lactate levels remained stable, and oxygenation and airway pressures were unchanged. After considering and excluding major differential diagnoses, including tension pneumothorax, hypovolemic shock, and pulmonary embolism, intraoperative point-of-care transthoracic echocardiography (TTE) was performed and revealed pericardial effusion with echocardiographic features of cardiac tamponade. Creation of a pericardial window with drainage of approximately 200 mL of bloody fluid. Immediately, blood pressure rose to 170/90 mmHg and heart rate decreased to 82 beats per minute. No definitive source of bleeding was identified during the operation. On postoperative day1, the patient developed paroxysmal atrial fibrillation, which resolved after treatment with amiodarone. Serial TTE on postoperative days 1, 2, and 6 showed no significant abnormalities. The chest tube was removed on postoperative day 6, and the patient was discharged the following day.\nCONCLUSION: During VATS lobectomy, intraoperative hypotension that cannot be explained by blood loss or changes in ventilation parameters, particularly when accompanied by a narrowed pulse pressure, should prompt consideration of occult cardiac tamponade. Early point-of-care ultrasonography and timely pericardial drainage are essential for rapid diagnosis and hemodynamic stabilization.", "authors": [ "ZhangWenyuWDepartment of Anesthesiology and Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China.", "YanRuixuRDepartment of Anesthesiology and Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China.", "LuXiujieXDepartment of Anesthesiology and Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China.", "LiuJunchaoJDepartment of Anesthesiology and Surgery, Qingdao Municipal Hospital, Qingdao, Shandong, China." ], "journal": "Frontiers in surgery", "journal_abbrev": "Front Surg", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42876780", "pmc": "PMC13662177", "doi": "10.3389/fsurg.2026.1936557" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-30" } ], "journal_date": "2026" }, "42877836": { "pmid": "42877836", "title": "Cat Bite Leading to Thoracic Aortic Endograft Infection and Fatal Haemoptysis.", "abstract": "UNLABELLED: Thoracic aortic graft infection is a rare but life-threatening complication of aortic repair, associated with high mortality due to sepsis, aortic rupture and fistulisation. Typical causative bacteria include Staphylococcus spp., Enterobacteriaceae and Pseudomonas spp. However, atypical microorganisms may be implicated. A 53-year-old patient with a history of thoracic aortic endovascular repair following dissection presented with fever, cough and dyspnoea, initially attributed to non-specific viral illness that led to discharge. Blood cultures later grew Capnocytophaga canimorsus. Subsequent history revealed a recent cat bite, and a fluorine-18 -fluorodeoxyglucose positron emission tomography scan suggested thoracic aortic graft infection. Despite antibiotic therapy and endovascular intervention following a single episode of haemoptysis, fatal haemoptysis occurred. This case highlights the potential for a minor cat bite to cause bacteraemia and catastrophic vascular graft infection. Thorough evaluation, including animal exposure history, and a high index of clinical suspicion are essential in patients with aortic grafts presenting with an infection of unclear origin.\nLEARNING POINTS: Aortic graft infections carry a high risk of a fatal outcome, making early identification and multidisciplinary management critical.Early fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography scan should be considered when aortic graft infection is suspected despite inconclusive initial imaging.Capnocytophaga canimorsus bacteraemia following a cat bite can cause life-threatening infections, even in immunocompetent patients.", "authors": [ "LujanAlejandroADepartment of Internal Medicine, Geneva University Hospitals, Geneva, Switzerland.", "RomaoDiogoDDepartment of Anaesthesiology, Geneva University Hospitals, Geneva, Switzerland.", "MathouxGregoryGDepartment of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland." ], "journal": "European journal of case reports in internal medicine", "journal_abbrev": "Eur J Case Rep Intern Med", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42877836", "pmc": "PMC13666563", "doi": "10.12890/2026_007484", "pii": "7484" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-28" } ], "journal_date": "2026" }, "42877920": { "pmid": "42877920", "title": "Mechanical Thrombectomy of the Left Brachial Artery for Graft Occlusion after Debranching Thoracic Endovascular Aortic Repair: A Case Report.", "abstract": "In patients who have undergone debranching thoracic endovascular aortic repair, the access route and system for mechanical thrombectomy must be carefully selected on a case-by-case basis. We report an 82-year-old man in whom mechanical thrombectomy was successfully performed via the left brachial artery for occlusion of a bypass graft. He was admitted with impaired consciousness and was diagnosed with left common carotid artery occlusion on magnetic resonance angiography. The patient had previously undergone debranching thoracic endovascular aortic repair with a right subclavian artery-left common carotid artery-left subclavian artery bypass for a thoracic aortic aneurysm 4 years earlier. Because a femoral artery approach was considered unfeasible, mechanical thrombectomy was performed via the left brachial artery. A 6 Fr guiding sheath was advanced into the left brachial artery, and angiography demonstrated that both the bypass graft to the left common carotid artery and the left common carotid artery itself were occluded by a large thrombus. Multiple mechanical thrombectomy attempts using various techniques were performed, and a thrombus measuring approximately 3 cm was retrieved, resulting in successful grade 2c Thrombolysis in Cerebral Infarction reperfusion. For patients who have undergone debranching thoracic endovascular aortic repair, the brachial approach may be considered as a potential alternative when femoral access is not feasible. The choice of access route might be influenced by the specific type of cervical vascular reconstruction and the location of the lesion.", "authors": [ "NakashimaKoichiKDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "MurakamiTomoakiTDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "ToyotaShingoSDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "OkochiKoseiKDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "OkuharaShukiSDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "YamadaShuheiSDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "AchihaTakamuneTDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "KobayashiMakiMDepartment of Neurosurgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.", "KishimaHaruhikoHDepartment of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan." ], "journal": "NMC case report journal", "journal_abbrev": "NMC Case Rep J", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42877920", "pmc": "PMC13668436", "doi": "10.2176/jns-nmc.2026-0091" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-17" } ], "journal_date": "2026" }, "42878372": { "pmid": "42878372", "title": "When the Aorta Speaks, The Eye Answers: Retinal Ischemia After TEVAR.", "abstract": "", "authors": [ "BenckeEduardo LeiriaELOphthalmology Department, Hospital Banco de Olhos, Porto Alegre, Rio Grande do Sul, Brazil.", "SaadiRodrigo PetersenRPCardiovascular Surgery, Hospital Mãe de Deus, Porto Alegre, Rio Grande do Sul, Brazil. Electronic address: rodrigopsaadi@gmail.com." ], "journal": "JACC. Case reports", "journal_abbrev": "JACC Case Rep", "publication_types": [ "Editorial" ], "ids": { "pubmed": "42878372", "doi": "10.1016/j.jaccas.2026.110014", "pii": "S2666-0849(26)03175-X" }, "article_dates": [], "journal_date": "2026Oct14" }, "42878521": { "pmid": "42878521", "title": "Paracentral Acute Middle Maculopathy Prompting Diagnosis of Severe Aortic Regurgitation and Ascending Aortic Aneurysm.", "abstract": "PURPOSE: To report a case of paracentral acute middle maculopathy (PAMM) in which persistent paracentral dysfunction prompted cardiovascular investigation and diagnosis of severe aortic regurgitation, reduced ejection fraction, and ascending aortic aneurysm.\nMETHODS: Longitudinal ophthalmic assessment, multimodal retinal imaging, Humphrey SITA Central 10-2 testing, cardiovascular evaluation, surgical findings, histopathology, and targeted aortopathy genetic testing were reviewed.\nRESULTS: A 44-year-old man presented with intermittent right-eye visual disturbance and persistent paracentral scotoma after non-explanatory neuroimaging. Unaided visual acuity remained 20/25 (6/7.5; approximately 0.10 logMAR) in each eye, intraocular pressure was 16-19 mmHg, and anterior-segment examination was unremarkable. Multimodal imaging supported PAMM, with structural OCT inner retinal/inner nuclear layer involvement and qualitative OCT-A/fluorescein angiographic parafoveal perfusion compromise. The affected inner retinal/inner nuclear layer region decreased from 45 micrometres to 32 micrometres. Right-eye Humphrey SITA Central 10-2 mean deviation worsened from -3.67 dB on 03 March 2020 to -5.19 dB in February 2026 despite unchanged central acuity. Cardiovascular assessment revealed a 5.5-cm ascending aortic aneurysm, severe aortic regurgitation, and left-ventricular ejection fraction of 49%. The patient underwent elective Bentall procedure, with postoperative ejection-fraction improvement to 55%. No postoperative quantitative OCT-A reperfusion claim is made.\nCONCLUSION: PAMM may warrant systemic cardiovascular assessment when ocular findings do not fully explain persistent paracentral dysfunction. This case supports cautious multidisciplinary evaluation while avoiding unsupported claims of causality, quantitative OCT-A perfusion deficit, or postoperative retinal reperfusion.", "authors": [ "PalexasGeorge NGN0009-0004-8095-7925Department of Ophthalmology, North Middlesex University Hospital NHS Trust, Sterling Way, Edmonton, London, United Kingdom." ], "journal": "Retinal cases & brief reports", "journal_abbrev": "Retin Cases Brief Rep", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42878521", "doi": "10.1097/ICB.0000000000002002", "pii": "01271216-990000000-00731" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-14" } ], "journal_date": "2026Oct14" }, "42878823": { "pmid": "42878823", "title": "Anesthesia Clinical Practice Guidelines for Ehlers-Danlos Syndrome: A Modified Delphi Survey.", "abstract": "Ehlers-Danlos syndrome (EDS) is a family of inherited connective tissue disorders distinguished by joint hyperextensibility, skin hyperelasticity, and increased tissue friability. No standardized anesthesia guidelines currently exist for this population, despite facing increased perioperative risks. To address this gap in literature, a three-round modified Delphi survey was conducted with 15 experts in anesthesia and EDS. Seven preliminary guidelines, developed from a comprehensive literature review, were evaluated and refined across three rounds. Consensus was achieved for all seven guidelines by the third round. Key recommendations include comprehensive airway assessment for all EDS subtypes; bleeding risk evaluation and consideration of desmopressin in classical, classical-like, kyphoscoliotic, and vascular EDS; multimodal analgesia and regional anesthesia strategies for hypermobile EDS; perioperative planning that incorporates common comorbidities; and cautious use of regional or neuraxial anesthesia in vascular EDS, requiring individual risk-benefit analysis due to hematoma risk. This study establishes the first consensus-based clinical practice guidelines for the anesthetic care of patients with EDS. While limited by sample size and gaps in existing evidence, these recommendations provide a framework to enhance patient safety by guiding clinical decision-making and encouraging future research in the perioperative management of EDS.", "authors": [ "AmaralDanielleDCRNA in northern Virginia. Email: amaraldanielle@outlook.com.", "PatrickKathrynKPlans to practice as a CRNA in northeast Ohio. Email: kgp21@georgetown.edu.", "RedekerGriffinGCRNA in New Hampshire. Email: gr603@georgetown.edu.", "HorvathCatherineCAssociate Professor at the Medical University of South Carolina, Charleston, South Carolina. Email: horvatca@musc.edu.", "MorganBrettBDistinguished Scholar and Associate Professor at Western Carolina University, Asheville, North Carolina. Email: morganb@wcu.edu.", "DalleyCarrie BowmanCBAssociate Professor and the DNAP Program Director at the Berkley School of Nursing, Georgetown University, Washington, DC. Email: ccb23@georgetown.edu." ], "journal": "AANA journal", "journal_abbrev": "AANA J", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42878823", "doi": "10.70278/AANAJ/.0000001099" }, "article_dates": [], "journal_date": "2026Oct01" }, "42878989": { "pmid": "42878989", "title": "2025 European Society of Cardiology guidelines for the management of cardiovascular disease and pregnancy : Statement of endorsement by the NVVC.", "abstract": "This article contextualises the 2025 European Society of Cardiology (ESC) guidelines for managing cardiovascular disease (CVD) and pregnancy in the Netherlands. The guideline addendum provides additional recommendations for situations where the ESC guidelines may not fully align with Dutch clinical practice. By endorsing the ESC guidelines through this addendum, the Netherlands Society of Cardiology (Nederlandse Vereniging Voor Cardiologie) supports its members in adhering to evidence-based management strategies for CVD and pregnancy.", "authors": [ "van der ZwaanHeleen BHBDepartment of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands. h.b.vanderzwaan-3@umcutrecht.nl.", "KalkmanDeborah NDNDepartment of Cardiology, Amsterdam University Medical Center, Amsterdam, The Netherlands.", "BroekmanMarjolijn JMJDepartment of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands.", "EversAnnemiek C CACCDepartment of Obstetrics and Gynaecology, University Medical Center Utrecht, Utrecht, The Netherlands.", "StegemanBernardine HBHKnowledge Institute of the Federation of Medical Specialists, Utrecht, The Netherlands.", "KièsPhilippinePDepartment of Cardiology, Heart Lung Center, Leiden University Medical Center Leiden, Leiden, The Netherlands.", "van der MarelCaroline MCMDepartment of Anesthesia, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.", "van der VloedJudithJDutch Heart Foundation, Den Haag, The Netherlands.", "WestendorpIris C DICDDepartment of Cardiology, Red Cross Hospital, Beverwijk, The Netherlands.", "CornetteJérôme M JJMJDepartment of Obstetrics and Fetal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands." ], "journal": "Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation", "journal_abbrev": "Neth Heart J", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42878989", "doi": "10.1007/s12471-026-02085-z", "pii": "10.1007/s12471-026-02085-z" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42879453": { "pmid": "42879453", "title": "Lived experiences of post-traumatic growth in patients with acute type A aortic dissection: A qualitative study.", "abstract": "INTRODUCTION: Acute type A aortic dissection is a life-threatening cardiovascular emergency characterized by sudden onset, severe pain, and high mortality, exerting profound physical and psychological burdens on affected individuals. While negative psychological sequelae predominate in most cases, a subset of patients demonstrates remarkable resilience, manifesting post-traumatic growth-a positive psychological transformation emerging in the aftermath of trauma. This qualitative study aimed to investigate the lived experiences of post-traumatic growth among Acute type A aortic dissection survivors, shedding light on this understudied dimension of their recovery trajectory.\nMETHODS: A qualitative study was conducted using a phenomenological approach. Twenty patients diagnosed with Acute type A aortic dissection were recruited through purposive sampling from a tertiary hospital in China. Data were collected via in-depth, face-to-face semi-structured interviews and analyzed using Colaizzi's seven-step method to extract key themes and sub-themes.\nRESULTS: Three overarching themes and eight sub-themes were identified, reflecting the multidimensional nature of post-traumatic growth in Acute type A aortic dissection patients: Reevaluating Life Priorities (reordering life priorities, valuing life), Behavioral Transformation (improving unhealthy habits, enhancing treatment adherence), and Enhanced Social Connections (strengthened family ties, gratitude for social support, reintegration into family and society, altruistic behavior).\nCONCLUSIONS: This study elucidates three core dimensions of post-traumatic growth in survivors of acute type A aortic dissection: life priority reassessment, adoption of positive health behaviors, and enhanced social connectedness. The findings underscore the critical role of guided self-reflection, supported behavior change, and robust family-social support systems in facilitating psychological recovery. We recommend integrating interventions focused on post-traumatic growth, such as psychological counseling and structured family support, into standard cardiac rehabilitation protocols to promote holistic recovery. Together, these insights provide a theoretical and practical foundation for developing tailored psychosocial interventions for this patient population.", "authors": [ "ZhangPingP0009-0001-1962-0432Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.", "LiuChunCDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.", "HuAnniADepartment of Emergency, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.", "WangDiDDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.", "WangXueruiXDepartment of General Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.", "ZhouQingQDepartment of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.", "SuYunyanY0000-0001-7208-6163Department of Cardiac Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China." ], "journal": "PloS one", "journal_abbrev": "PLoS One", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42879453", "pmc": "PMC13671528", "doi": "10.1371/journal.pone.0358013", "pii": "PONE-D-25-38836" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026" }, "42880311": { "pmid": "42880311", "title": "Photon-counting computed tomography depicts seven multifocal ulcer-like projections with jet-like blood flow in aortic dissection.", "abstract": "", "authors": [ "DuQinglinQDepartment of Radiology, West China Hospital, Sichuan University, Guoxue Xiang No. 37, Chengdu 610000, China.", "ShenYifanY0009-0003-4542-7905Institute of Research and Clinical Innovations, Neusoft Medical Systems Co., Ltd., Shanghai, China.", "SunJiayuJDepartment of Radiology, West China Hospital, Sichuan University, Guoxue Xiang No. 37, Chengdu 610000, China." ], "journal": "European heart journal", "journal_abbrev": "Eur Heart J", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42880311", "doi": "10.1093/eurheartj/ehag844", "pii": "8923698" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42880520": { "pmid": "42880520", "title": "Emergency vascular surgery in space, on the moon, and mars: fundamental principles, technical protocols, and hemostatic methods under different gravitational regimes (0 g, 0.16 g, 0.38 g).", "abstract": "Human exploration of the Moon and Mars presents unprecedented challenges for emergency vascular surgery, as gravitational environments ranging from microgravity (0 g) to partial gravity on the lunar (0.16 g) and Martian (0.38 g) surfaces render conventional Earth-based techniques inadequate. This review synthesizes data from experimental physiology, ground-based analog models, parabolic flight testing, and theoretical hemodynamic modeling to establish a framework for vascular interventions across three gravitational regimes. In microgravity, electrosurgery is entirely inapplicable, necessitating the use of hermetically sealed fluid-filled surgical systems (AISS) for all vascular procedures. On the lunar surface, bipolar electrosurgery may be employed with strict limitations, including mandatory smoke aspiration, reduced power output, and limited activation time. Mars, with 0.38 g, most closely approximates Earth conditions, allowing standard surgical techniques with minor modifications. Differentiated technical protocols are proposed for five critical vascular emergencies: peripheral arterial thromboembolism, ascending thrombophlebitis, aortic dissection, cerebral thrombosis, and coronary thrombosis. Endovascular approaches are prioritized due to their minimally invasive nature and reduced resource requirements. Gravity-independent hemostatic modalities (laser, ultrasonic, mechanical) represent strategic priorities for future mission planning. AISS is mandatory for microgravity and lunar operations, while artificial gravity through centrifugation substantially expands endovascular therapeutic options.", "authors": [ "KazantsevAnton NANMinistry of defense of the Russian Federation, Moscow, Russia. Electronic address: dr.antonio.kazantsev@mail.ru.", "BlinovOleg VOVFederal State Budgetary Institution \"Research Institute of the Yuri Gagarin Cosmonaut Training Center\", Moscow, Russia." ], "journal": "Current problems in cardiology", "journal_abbrev": "Curr Probl Cardiol", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42880520", "doi": "10.1016/j.cpcardiol.2026.103486", "pii": "S0146-2806(26)00227-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42880614": { "pmid": "42880614", "title": "In-hospital vascular surgery consultation is associated with improved follow-up and earlier identification of aneurysmal degeneration after acute Type A aortic dissection.", "abstract": "OBJECTIVE: Acute Type A aortic dissections (TAAD) are historically managed by cardiac surgery. However, subsequent treatment of residual dissection within the thoracoabdominal aorta often requires vascular surgical intervention and lifelong surveillance. This study assesses long-term outcomes by completeness of follow-up after operative intervention for acute TAAD.\nMETHODS: Patients who underwent surgical intervention for acute TAAD from 2014 to 2025 were identified. Patients who experienced death within 30-days or those with dissection limited to Zone 0/Zone 1 were excluded. Vascular surgery evaluation and time to consultation (index-hospitalization, outpatient, none) was documented. Follow-up was classified as complete, incomplete, or lost (LTF) according to the frequency of contrasted thoracoabdominal imaging, consistent with clinical practice guidelines. Trends in completeness of follow-up were described. Demographics, anatomic/operative characteristics, and perioperative outcomes were compared between complete follow-up and incomplete follow-up/LTF groups. Long-term outcomes (aortic degeneration, planned secondary intervention, survival) were assessed with Kaplan-Meier and multivariable Cox regression analysis.\nRESULTS: 241 patients were included; 80% had vascular surgery consultation (70% inpatient, 30% outpatient) and 86% of consultations occurred within 1-year of index procedure. In total, 46% of patients had complete follow-up, 41% had incomplete follow-up, and 13% were LTF. In-hospital consultation increased by 58% over the study period. Demographics, comorbidities, and anatomic characteristics were similar between groups. Patients with complete follow-up had higher rates of complex arch repair (Zone 1-3) (complete 56% vs. incomplete/LTF 27%, p<0.001), were more likely to undergo genetic testing (complete 52% vs. incomplete/LTF 18%, p<0.001), in-hospital TEVAR extension (7% vs. 2%, p=0.028), and TEVAR extension within 3 months (complete 17% vs. incomplete/LTF 5%, p=0.002). In time-to-event analysis, complete follow-up was associated with more planned secondary interventions (complete: 12% vs. incomplete: 5%, p=0.007) and identified aneurysmal degeneration (32% vs. 15%, p=0.002) within 1-year of acute dissection. Long-term survival differed by completeness of follow-up; 1-year (complete: 97% vs. incomplete: 97% vs. LTF: 91%), 3-years (complete: 92% vs. incomplete: 95% vs. LTF: 81%, p=0.021). There were no aortic-related deaths for patients with complete follow-up and five aortic-related deaths (5%) in patients with incomplete follow-up (p=0.13). In-hospital vascular surgery consultation was associated with complete follow-up (HR 2.87, 95% CI 1.6-5.1) and planned secondary interventions (HR 2.07, 95% CI 1.1-3.9).\nCONCLUSION: Vascular surgery consultation is associated with increased identification of aneurysmal degeneration, planned secondary interventions, and mid-term survival. These data suggest that longitudinal vascular surgical care, starting with in-hospital consultation, is a critical component of care following acute TAAD and should be strongly considered to ensure appropriate postoperative surveillance and improve long-term patient outcomes.", "authors": [ "MurphyBlake EBEDivision of Vascular Surgery, University of Washington, Seattle, WA, USA. Electronic address: bmurphy8@uw.edu.", "LeeAmanda EAEDivision of Vascular Surgery, University of Washington, Seattle, WA, USA.", "StoneKyle WKWDivision of Vascular Surgery, University of Washington, Seattle, WA, USA.", "DeRooScott CSCDivision of Cardiothoracic Surgery, University of Washington, Seattle WA, USA.", "BurkeChristopher RCRDivision of Cardiothoracic Surgery, University of Washington, Seattle WA, USA.", "SmithMatthew CMCDivision of Vascular Surgery, University of Washington, Seattle, WA, USA.", "SweetMatthew PMPDivision of Vascular Surgery, University of Washington, Seattle, WA, USA.", "ZettervallSara LSLDivision of Vascular Surgery, University of Washington, Seattle, WA, USA. Electronic address: szetterv@uw.edu." ], "journal": "Journal of vascular surgery", "journal_abbrev": "J Vasc Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42880614", "doi": "10.1016/j.jvs.2026.09.047", "pii": "S0741-5214(26)01755-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42880660": { "pmid": "42880660", "title": "Contemporary Management of Subclavian and Axillary Artery Aneurysms in Connective Tissue Disease: Navigating Therapeutic Uncertainty in a Rare Vascular Disease Without Dedicated Guidelines.", "abstract": "BACKGROUND: Subclavian artery aneurysms (SAAs) represent one of the rarest forms of peripheral arterial aneurysmal disease. Despite their low incidence, management in patients with underlying connective tissue disorders poses specific challenges related to intrinsic vessel fragility. Because of their rarity, the available literature is largely confined to case reports and small, heterogeneous retrospective series, and management remains largely experience-based rather than evidence-based. Explicit guidance from the Society for Vascular Surgery and the European Society for Vascular Surgery is lacking.\nMETHODS: We performed a systematic review of the English-language literature to identify all reported cases of subclavian and axillary artery aneurysms in patients with heritable connective-tissue disorders. Searches were conducted in PubMed, Scopus, and Web of Science from inception to June 30, 2025. Data were extracted on treatment modality (open surgical, endovascular, or hybrid) and clinical outcomes (limb loss, revascularization patency, complications, and need for reintervention). The review protocol was registered on PROSPERO (CRD420261332695) RESULTS: Of 142 records identified, 24 studies met the inclusion criteria after duplicate removal and screening. These studies described 43 subclavian and axillary artery aneurysms in 25 patients (15 men [60%] and 10 women [40%]; median age, 46 years; range, 11-68). Aneurysm diameter was reported for 36 of 43 aneurysms (84%; median, 40 mm; range, 22-100 mm) and was not reported for the remaining 7 (16%). Marfan syndrome was the most frequent underlying disorder (20/25, 80%), followed by vascular Ehlers-Danlos syndrome type IV (3/25, 12%) and Loeys-Dietz syndrome/TGFBR2-related arteriopathy (2/25, 8%). Eight aneurysms (8/43, 19%) required urgent or emergent treatment. Treatment modalities comprised open surgical repair in 22 of 43 aneurysms (51%) - including interposition grafting in 12/22 (55%), bypass in 5/22 (23%), arterial ligation in 3/22 (14%), and aneurysmectomy with end-to-end anastomosis in 2/22 (9%) - hybrid procedures in 15 (35%), and endovascular therapy in 6 (14%) - including covered stent-grafting in 5/6 (83%) and coil/liquid embolization in 1/6 (17%). Immediate technical success - complete aneurysm exclusion without endoleak at the index procedure- was 95% (41 of 43 aneurysms). Two aneurysms (4.7%), both in the hybrid group, represented an index-procedure failure due to endoleak (one type I, one type III); freedom from reintervention was therefore 95% (41/43). Both were subsequently excluded after a secondary reintervention, yielding a delayed technical success rate of 100% (43/43). No 30-day mortality or limb loss was reported. Primary patency of the treated segment was 100% (43/43), as no graft/segment thrombosis, occlusion, or flow-limiting stenosis occurred; secondary patency was 100% (43/43). Where a numeric follow-up duration could be extracted, mean follow-up was 8 months (range, 6-11 months) in the endovascular group (4/5 patients), 15 months (range, 2 weeks-4 years) in the open group (5/13 patients), and 15 months (range, 1-60 months) in the hybrid group (6/7 patients); a precise duration was not reported for the remaining patients.\nCONCLUSION: The available evidence demonstrates that both open and endovascular repair can achieve satisfactory short- and mid-term outcomes. However, patient selection, procedural planning, and surveillance protocols remain poorly standardized. The observed recurrences and the limited duration of follow-up reported in the literature underscore the need for rigorous, lifelong surveillance. Prospective multicenter registries are warranted to refine best practice and to guide the development of devices and techniques tailored to fragile connective-tissue vessels.", "authors": [ "BorgheseOttaviaOUnit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: ottaviaborghese@gmail.it.", "LodicoTeresaTUnit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.", "IbrahimiArisaAUniversità Cattolica del Sacro Cuore, Rome, Italy.", "FeliceGiuliaGUnit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy.", "SposatoFrancescoFUnit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.", "PisaniAngeloADepartment of Cardiac Surgery, Sapienza University of Rome, Rome, Italy.", "TshombaYamumeYUnit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy; Università Cattolica del Sacro Cuore, Rome, Italy." ], "journal": "Annals of vascular surgery", "journal_abbrev": "Ann Vasc Surg", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42880660", "doi": "10.1016/j.avsg.2026.09.057", "pii": "S0890-5096(26)00715-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42880760": { "pmid": "42880760", "title": "Clinical and cardiovascular impact of pregnancy in women with Marfan syndrome.", "abstract": "BACKGROUND: Marfan syndrome (MS) is associated with mutations in the FBN1 gene, which encodes fibrillin-1, an essential protein in elastic fibers. Cardiovascular damage in MS has serious complications such as aneurysms and aortic dissection (AD), which increase during pregnancy.\nOBJECTIVE: To evaluate the cardiovascular and clinical status of women with Marfan syndrome and pregnancy.\nMATERIALS AND METHODS: Retrospective study in women with MS or other connective tissue diseases (CTD) classified according to the 2010 Ghent criteria.\nRESULTS: One hundred women were included, 35 were admitted as pediatric patients, and 65 as adults. Ten women without medical records were excluded. Forty-eight non-pregnant women and 46 pregnant women were analyzed. 20 births, 26 cesarean sections, 9 preeclampsia, and 14 miscarriages. Of the total group, 14 had con-genital heart disease, 36 had AD, 47 had aortic regurgitation, 22 had mitral valve regurgitation, 15 had tricuspid valve regurgitation, 39 had valve prolapse, 67 had surgeries, and 15 had stents. 19 died, 5 due to aneurysm rupture, 4 had AD, 3 had cardiogenic shock, 5 had septic shock, and 2 had hypovolemic shock.\nCONCLUSIONS: Cardiovascular damage in pregnancies of women with MS or CTD is complex. The diagnosis of MS is late in some cases; it is at the time of delivery, and genetic counseling is not timely. These are areas of opportunity to impact on prevention, timely gynecological and obstetric status, and surgery.", "authors": [ "SotoM ElenaMEResearch Directorate, Instituto Nacional de Cardiología Ignacio Chávez.Cardiovascular Line, Hospital Observatorio ABC México.", "Santos-AragónMiguelMDepartment of Cardiology, Instituto Nacional de Cardiología Ignacio Chávez.", "Mora-CervantesRegina de laRDepartment of Computed Tomography, Instituto Nacional de Cardiología Ignacio Chávez. Mexico City, Mexico." ], "journal": "Gaceta medica de Mexico", "journal_abbrev": "Gac Med Mex", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42880760", "doi": "10.24875/GMM.M26001111", "pii": "j162/1/97" }, "article_dates": [], "journal_date": "2026" }, "42881039": { "pmid": "42881039", "title": "Lipoprotein(a): Particle vs mass and prevalent cardiovascular disease in the cardiovascular risk in Young Finns study population.", "abstract": "BACKGROUND: Lipoprotein(a) [Lp(a)] can be reported as mass (mg/dL) or particle concentration (nmol/L). Because Lp(a) acts at the particle level, molar concentration may better reflect biologically relevant exposure.\nOBJECTIVE: To compare molar- and mass-based Lp(a) in relation to cardiovascular outcomes, risk classification, LPA genetic variation, and apo(a) isoform phenotype in the Young Finns Study.\nMETHODS: Molar Lp(a) was measured using a traceable Roche Tina-quant Gen.2 assay and mass using a nontraceable Thermo Fisher assay. Associations with cardiovascular outcomes and aortic valve stenosis were assessed by logistic regression in adults aged ≥40 years (N = 3898). Agreement was assessed using Bland-Altman analysis and guideline-based risk reclassification. Associations with LPA genetic risk score and apo(a) isoform phenotype were assessed using Spearman correlation.\nRESULTS: Both metrics showed similar associations across cardiovascular outcomes, with significant associations for coronary artery disease (CAD) and aortic valve stenosis. In fully adjusted CAD models, the odds ratio for the highest vs lowest quintile was 1.55 for molar and 1.67 for mass. Agreement between guideline-based risk categories was 95.6%. Molar assigned 2.9% of individuals to a higher risk category than mass, vs 1.5% in the opposite direction. The molar-to-mass ratio was associated with LPA score and apo(a) isoform size, with greater attenuation after adjustment for molar than mass.\nCONCLUSION: Molar and mass showed comparable associations with cardiovascular outcomes. However, molar reporting aligned more closely with the genetic and structural determinants of Lp(a) and more often assigned individuals to higher guideline-based risk categories, supporting continued standardization toward particle-based reporting.", "authors": [ "RaitakariOlliOCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland (Raitakari); InFLAMES Research Flagship, University of Turku, Turku, Finland (Raitakari). Electronic address: olli.raitakari@utu.fi.", "KnuutiMatiasMCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen).", "Linko-ParvinenAnnaAClinical Chemistry, Tyks Laboratories, Turku University Hospital and University of Turku, Turku, Finland (Linko-Parvinen).", "PahkalaKatjaKCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Paavo Nurmi Centre & Sports and Exercise Medicine, University of Turku, Turku, Finland (Pahkala).", "RovioSuviSCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland (Rovio).", "KartiosuoNooraNCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Department of Mathematics and Statistics, University of Turku, Turku, Finland (Kartiosuo).", "StenbackaSiniSCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen).", "LisinenIrinaICentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen).", "LooBritt-MarieBMJoint Clinical Biochemistry Laboratory, Turku University Hospital, and University of Turku, Turku, Finland (Loo).", "LehtimäkiTerhoTDepartment of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Lehtimäki).", "KähönenMikaMDepartment of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland (Kähönen).", "LaminaClaudiaCInstitute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria (Lamina and Kronenberg).", "KronenbergFlorianFInstitute of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria (Lamina and Kronenberg).", "JuonalaMarkusMDepartment of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (Juonala and Viikari).", "ViikariJorma S AJSADepartment of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Turku, Finland (Juonala and Viikari).", "MykkänenJuhaJCentre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen); Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland (Raitakari, Knuuti, Pahkala, Rovio, Kartiosuo, Stenbacka, Lisinen, and Mykkänen)." ], "journal": "Journal of clinical lipidology", "journal_abbrev": "J Clin Lipidol", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42881039", "doi": "10.1016/j.jacl.2026.09.019", "pii": "S1933-2874(26)00528-3" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-25" } ], "journal_date": "2026Sep25" }, "42881547": { "pmid": "42881547", "title": "Targeting Nupr1-Mediated p53 Mitochondrial Sequestration Alleviates Aortic Dissection by Restoring the Gadd45b-Dependent Survival Program.", "abstract": "Aortic dissection (AD) is a catastrophic cardiovascular emergency triggered by severe pathological stress. While continuous stress drives vascular smooth muscle cell (VSMC) apoptosis via mitochondrial dysfunction, the precise upstream orchestrators linking these stress signals to the mitochondrial apoptotic cascade remain elusive. By integrating clinical observations and single-cell RNA sequencing, we found that Nuclear Protein 1 (Nupr1), a critical stress-responsive factor, is significantly upregulated in aortas from AD patients and murine models, with enrichment in VSMCs. Remarkably, VSMC-specific Nupr1 deficiency significantly ameliorated AD progression in vivo. Mechanistically, Nupr1 undergoes massive mitochondrial accumulation in Ang II-induced apoptotic VSMCs. Rather than operating as a conventional transcriptional regulator, mitochondrially enriched Nupr1 functions as a pathological spatial switch. It sequesters p53 within mitochondria, driving transcription-independent apoptosis while simultaneously blunting the protective Gadd45b-mediated survival program. Furthermore, in vivo Gadd45b overexpression was sufficient to rescue mitochondrial dysfunction and ameliorate vascular collapse. Taken together, our findings conceptualize the Nupr1-p53-Gadd45b axis as an important determinant of VSMC fate and provide a novel and promising therapeutic strategy for preventing AD progression.", "authors": [ "YangXiX0000-0002-5814-8708Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "ChenKe-YuanKYDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "TianYueY0000-0002-9139-6658Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "JiangZong-ShengZSDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "LeiJianJ0000-0002-5214-4730Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "ZhuangXing-HuiXH0000-0003-4342-5597Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "WuJiang-BinJB0009-0003-3177-2265Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "TangLe-LeLLDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "LiHao-YuHYDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "ChenXiao-HuiXHDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "WangYueYDepartment of Anesthesiology, Union Hospital, Fujian Medical University, Fuzhou, China.", "LiYu-MeiYM0000-0002-6158-7488The School of Pharmacy, Fujian Medical University, Fuzhou, China.Fujian Center for Safety Evaluation of New Drug, Fujian Medical University, Fuzhou, China.", "QiuZhi-HuangZH0000-0002-5917-8968Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "CaiZi-WenZWDepartment of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China.", "ChenLiang-WanLW0000-0002-4211-3842Department of Cardiovascular Surgery, Fujian Medical University Union Hospital, Fuzhou, China.Key Laboratory of Cardio-Thoracic Surgery (Fujian Medical University), Fujian Province University, Fuzhou, China.Engineering Research Center of Tissue and Organ Regeneration, Fujian Province University, Fuzhou, China." ], "journal": "Advanced science (Weinheim, Baden-Wurttemberg, Germany)", "journal_abbrev": "Adv Sci (Weinh)", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42881547", "pmc": "PMC13672869", "doi": "10.1002/advs.78143" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42881914": { "pmid": "42881914", "title": "Transcatheter Aortic Valve Implantation in Complex Anatomy: An Anatomy-Driven Framework for Bicuspid Stenosis, Pure Aortic Regurgitation, and the Small Annulus in the Era of Lifetime Management.", "abstract": "Background: Transcatheter aortic valve implantation is established for severe calcific tricuspid aortic stenosis, but its application in bicuspid aortic valve (BAV) stenosis, pure native aortic regurgitation (AR), and small aortic annulus anatomy remains limited by heterogeneous morphology, device-specific constraints, and uncertain long-term outcomes. These settings require decisions that extend beyond immediate procedural success to encompass coronary access, reintervention, valve durability, and associated aortopathy. This review synthesizes current evidence and proposes an anatomy-driven framework integrating imaging, device selection, procedural planning, and lifetime management. Methods: A structured narrative review was conducted in accordance with the Scale for the Assessment of Narrative Review Articles (SANRA) criteria. PubMed/MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched from 1 January 2010 to 31 March 2026 for studies addressing TAVI in BAV stenosis, pure native AR, and small aortic annulus anatomy. Randomized trials, meta-analyses, multicenter registries, pivotal device studies, and guideline or consensus documents were prioritized. After screening 2663 records and assessing 330 full-text reports, 101 records were retained for qualitative synthesis. Evidence was appraised by anatomical substrate, imaging phenotype, device strategy, procedural hazards, and implications for lifetime management. Results: In BAV stenosis, contemporary registry and prospective cohort data support high device success and acceptable early and mid-term outcomes in carefully selected patients; however, calcified raphe, bulky asymmetric leaflet or left ventricular outflow tract calcification, annular eccentricity, and concomitant aortopathy identify higher-risk phenotypes that often favor surgery. Randomized evidence in younger low-risk BAV patients remains limited and exploratory, with the NOTION-2 trial showing a numerically higher 3-year composite event rate after TAVI than surgical aortic valve replacement (20.4% vs. 7.8%; hazard ratio 2.9, 95% confidence interval 0.9-9.0) in the small bicuspid subgroup. In pure native AR, lack of annular calcification and frequent root dilatation impair anchoring of conventional transcatheter heart valves, increasing risks of migration, embolization, residual AR, and second-valve implantation. Dedicated leaflet-anchoring devices have improved outcomes: in ALIGN-AR, the JenaValve Trilogy system achieved procedural success above 95% in high-surgical-risk patients, although evidence remains single-arm and nonrandomized. In small annuli, the strongest comparative evidence comes from the SMART trial, in which supra-annular self-expanding valves were non-inferior to balloon-expandable valves for the 12-month clinical composite and reduced moderate/severe prosthesis-patient mismatch at 30 days (11.2% vs. 35.3%). Across all three phenotypes, electrocardiography-gated computed tomography is fundamental for defining anchoring, sizing, calcium distribution, root and coronary anatomy, anticipated coronary re-access, and the feasibility of redo-TAVI. Surgery remains particularly relevant when aortic repair, annular/root enlargement, or a more durable lifetime strategy is required. Conclusions: TAVI is feasible in selected patients with BAV stenosis, pure native AR, and small aortic annuli, but the evidentiary strength and optimal procedural strategy differ substantially across these anatomies. Treatment should be guided by an anatomy-driven, computed-tomography-based Heart Team assessment that integrates immediate procedural feasibility with age, surgical candidacy, aortopathy, prosthesis-patient mismatch risk, coronary access, durability, and future reintervention options. Surgery remains the more established strategy for many younger, operable patients with unfavorable BAV morphology or aortopathy, AR with root dilatation, or very small annuli amenable to enlargement. Dedicated randomized trials, standardized imaging criteria, and long-term durability data are needed to refine lifetime management in complex aortic valve anatomy.", "authors": [ "BrieDaniel MironDM0000-0001-9003-456XCardiovascular Disease Institute Timisoara, Gheorghe Adam Street, No. 13A, 300310 Timisoara, Romania.Research Center, Institute of Cardiovascular Diseases, Gheorghe Adam Street, No. 13A, 300310 Timisoara, Romania.", "MornoșCristianC0000-0002-6096-9601Cardiovascular Disease Institute Timisoara, Gheorghe Adam Street, No. 13A, 300310 Timisoara, Romania.Research Center, Institute of Cardiovascular Diseases, Gheorghe Adam Street, No. 13A, 300310 Timisoara, Romania.Department of Cardiology, \"Victor Babeș\" University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania.", "PopescuRoxanaR0000-0002-9387-1141Department of Cell and Molecular Biology, \"Victor Babeș\" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, 300174 Timisoara, Romania.ANAPATMOL Research Center, \"Victor Babeș\" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, 300174 Timisoara, Romania.", "BrieAlina DiduțaAD0009-0002-4078-1537Department of Cell and Molecular Biology, \"Victor Babeș\" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, 300174 Timisoara, Romania.ANAPATMOL Research Center, \"Victor Babeș\" University of Medicine and Pharmacy, Tudor Vladimirescu Street, No. 14, 300174 Timisoara, Romania.\"Louis Țurcanu\" Emergency Children Hospital, Doctor Iosif Nemoianu Street, No. 2, 300011 Timisoara, Romania." ], "journal": "Journal of clinical medicine", "journal_abbrev": "J Clin Med", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42881914", "pmc": "PMC13665837", "doi": "10.3390/jcm15197452", "pii": "jcm15197452" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-24" } ], "journal_date": "2026Sep24" }, "42882018": { "pmid": "42882018", "title": "Clinical Outcomes of Combined TAVR-PCI Versus SAVR-CABG in Patients with Aortic Stenosis and Coronary Artery Disease: A Systematic Review and Meta-Analysis.", "abstract": "Background/Objectives: Coronary artery disease coexists with severe aortic stenosis in about half of patients. Surgical aortic valve replacement with coronary artery bypass grafting (SAVR+CABG) is guideline-recommended, but transcatheter aortic valve replacement with percutaneous coronary intervention (TAVR+PCI) is increasingly used. Prior meta-analyses double-counted overlapping populations and did not report randomized evidence separately; we re-examined the comparison after correcting both. Methods: PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and ClinicalTrials.gov were searched up to July 2026 for randomized and comparative observational studies, excluding reports with overlapping populations. Outcomes were pooled with random-effects models, stratified by study design, and re-analysed without administrative databases. Certainty was rated with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Results: Fourteen studies were included (two randomized trials, nine cohorts, three administrative databases), comprising 154,892 patients (28,569 TAVR+PCI; 126,323 SAVR+CABG). TAVR+PCI was associated with lower early mortality (odds ratio (OR) 0.60, 95% confidence interval (CI) 0.44-0.84) and less acute kidney injury (OR 0.34, 0.20-0.57), but greater pacemaker implantation (OR 2.18, 1.93-2.46) and major vascular complications (OR 3.38, 1.65-6.89). Stroke, myocardial infarction and one-year mortality (OR 0.80, 0.58-1.10) did not differ; bleeding results were inconsistent (I2 = 95%). Over 12-72 months, mortality was higher with TAVR+PCI (hazard ratio (HR) 1.38, 1.28-1.49; nine observational studies), unchanged without the largest cohort. Administrative databases drove heterogeneity but not the direction of any early outcome. Certainty was moderate for pacemaker implantation and low or very low otherwise; randomized data were too limited to confirm these findings. Conclusions: In predominantly observational evidence, TAVR+PCI was associated with lower early risk but higher mortality over longer follow-up. This trade-off supports individualized Heart Team decisions rather than the superiority of either strategy. Adequately powered randomized trials with long-term follow-up are needed.", "authors": [ "Rodriguez MejiaRicardo AntonioRAhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "AldaoudMathharMDepartment of Cardiology, Faculty of Medicine, https://ror.org/05k89ew48University of Jordan, Amman 11942, Jordan.", "MomoduIfeanyiIhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "DongolMerinaMhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "FeyissaGirumGhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "AruoguKelechiKhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "BhattiZamaraq MZMhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "RiazAbdul HaseebAHhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA.", "SaleemNafisaNhttps://ror.org/045czjy48Cape Fear Valley Medical Center, Methodist University Cape Fear Valley Health School of Medicine, Fayetteville, NC 28304, USA." ], "journal": "Journal of clinical medicine", "journal_abbrev": "J Clin Med", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42882018", "pmc": "PMC13665907", "doi": "10.3390/jcm15197556", "pii": "jcm15197556" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-29" } ], "journal_date": "2026Sep29" }, "42882065": { "pmid": "42882065", "title": "Perspectives on Thoracic Endovascular Aortic Repair for Uncomplicated Type B Aortic Dissection: An International Survey Within the SUNDAY Network.", "abstract": "Background: Thoracic endovascular aortic repair (TEVAR) is increasingly considered in selected patients with uncomplicated type B aortic dissection (uTBAD), but uncertainty remains regarding indications for intervention and treatment strategies. This study aimed to explore potential variation in TEVAR indications and treatment strategies for uTBAD among principal investigators (PIs) of the Scandinavian trial of Uncomplicated Aortic Dissection Therapy (SUNDAY). Methods: A prospective, cross-sectional, questionnaire-based study was conducted among PIs of the SUNDAY trial network. A structured survey was developed by the first and last author using contemporary guidelines and relevant literature and was subsequently reviewed by all co-authors. The questionnaire addressed three topics: definitions, TEVAR indications, and treatment strategies. Data were collected via Castor and analyzed using SPSS version 29.0. A center-weighted sensitivity analysis and within-center concordance analysis were performed to account for multiple respondents from the same center. Results: The response rate was 78.2% (43/55 PIs), representing 31 centers. The presence or development of complications was the main driver for TEVAR (37/43, 86.0%). Rupture (43/43, 100%), clinical signs of malperfusion (43/43, 100%), and rapid aortic expansion (38/43, 88.4%) were consistently considered indications for TEVAR, whereas more variation was observed for refractory pain (28/43, 65.1%) and refractory hypertension (26/43, 60.5%). Interpretation of high-risk imaging features varied, with 37.2% (16/43) considering multiple features an indication for TEVAR. Procedural strategies varied, with spot stenting selected by 58.1% (25/43) of respondents, although more extensive aortic coverage was also reported. Landing zone characteristics and oversizing preferences were more consistent, with 79.1% (34/43) defining a healthy landing zone by the absence of intramural hematoma or dissection, 58.1% (25/43) preferring a landing zone length of 2 cm, and 51.2% (22/43) preferring 10% stent graft oversizing. Center-weighted sensitivity analyses showed generally similar estimates, whereas within-center concordance varied across items (range 20-100%), with complete agreement for 8 of 50 items. Conclusions: Among SUNDAY PIs, there was broad agreement regarding the distinction between uncomplicated and complicated type B aortic dissection (TBAD) and the role of TEVAR in the presence of complications, whereas variation remained in the interpretation of high-risk imaging features and procedural strategies. These findings highlight variation in decision-making regarding the management of uTBAD within the SUNDAY network and support the need for prospective evidence to guide TEVAR decision-making.", "authors": [ "BierstekerBiancaB0009-0008-5480-4027Department of Vascular Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.", "HersFelixFDepartment of Vascular Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.", "LangenhuijzenMeikeMDepartment of Vascular Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.", "de BruinJorg LucasJLDepartment of Vascular Surgery, Erasmus Medical Center, Molenwaterplein 40, 3015 GB Rotterdam, The Netherlands.", "de VriesJean-Paul Petrus MariaJPM0000-0002-2669-320XDepartment of Surgery, Division of Vascular Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.", "DirvenMarkM0009-0002-5941-557XDepartment of Vascular Surgery, Radboudumc, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, The Netherlands.", "TeraaMartinM0000-0002-6751-6752Department of Vascular Surgery, University Medical Center Utrecht, Hiedelberglaan 100, 3584 CX Utrecht, The Netherlands.", "ManiKevinKDepartment of Surgical Sciences, Uppsala University, Sjukhusvägen 70, 751 85 Uppsala, Sweden.", "ReschTimothy AndrewTADepartment of Vascular Surgery, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark.Faculty of Health Sciences, Copenhagen University, Blegdamsvej 3B, 2200 Copenhagen, Denmark.", "MeesBarend Mathijs EduardBMEDepartment of Vascular Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.", "YeungKak KheeKKDepartment of Vascular Surgery, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.Department of Atherosclerosis & Aortic Diseases, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Location AMC, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.", "Budtz-LillyJacobJ3 Department of Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, DK-8200 Aarhus, Denmark.", "VorstJoost Renier van derJRV0000-0002-0669-4272Department of Vascular Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands." ], "journal": "Journal of clinical medicine", "journal_abbrev": "J Clin Med", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42882065", "pmc": "PMC13666122", "doi": "10.3390/jcm15197604", "pii": "jcm15197604" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-30" } ], "journal_date": "2026Sep30" }, "42882075": { "pmid": "42882075", "title": "Preoperative Inflammatory Risk Markers and Postoperative Creatinine and Lactate as Mortality Markers After Surgery for Stanford Type A Acute Aortic Dissection.", "abstract": "Objective: The primary objective was to evaluate the association between preoperative platelet-to-lymphocyte ratio (PLR), measured at admission, and 30-day mortality after emergency surgical repair for Stanford type A acute aortic dissection (TAAD). Secondary analyses evaluated other preoperative inflammatory and biochemical markers, postoperative biomarker measurements as indicators of evolving postoperative physiology, and their associations with 2-year mortality. Methods: This retrospective study included 506 patients who underwent emergency surgery for TAAD. Preoperative and postoperative laboratory parameters-including creatinine, sodium, potassium, lactate, NLR, PLR, SII, and MLR-were collected along with perioperative clinical variables. Group comparisons were performed according to 30-day and 2-year mortality outcomes. Spearman correlation analysis was used to assess associations between biomarkers and clinical parameters. Receiver operating characteristic (ROC) analyses were conducted to determine the discriminative performance of inflammatory indices and biochemical markers. Statistical significance was defined as p < 0.05. Results: Non-survivors had significantly higher preoperative and postoperative creatinine levels (p = 0.008 and p = 0.003), longer aortic cross-clamp and circulatory arrest times (both p < 0.001), and elevated postoperative lactate levels (p = 0.029). All inflammatory indices-including NLR, PLR, and SII-were markedly higher in patients who died within 30 days (all p < 0.001). MLR was also significantly elevated in non-survivors, although the magnitude of increase was more modest compared with the other inflammatory indices (preoperative p = 0.011; postoperative p = 0.007-0.010). In the primary analysis, preoperative PLR showed good discrimination for 30-day mortality (AUC 0.819, 95% CI 0.750-0.889) and remained independently associated with 30-day mortality after adjustment for age, preoperative creatinine, aortic cross-clamp time, and total circulatory arrest time (adjusted OR 1.004, 95% CI 1.002-1.007; p < 0.001). Postoperative inflammatory indices, creatinine, and lactate were also associated with mortality and were interpreted as markers of evolving postoperative physiological deterioration, whereas sodium showed no meaningful prognostic contribution. For 2-year mortality, elevated preoperative and postoperative creatinine and lactate levels, together with persistently higher inflammatory indices at all measured time points, were significantly associated with long-term death (all p < 0.001). No inflammatory index showed a meaningful correlation with postoperative complications. Conclusions: Preoperative PLR was associated with 30-day mortality after TAAD surgery. Postoperative inflammatory indices; creatinine; and lactate were also associated with mortality but may primarily have reflected evolving postoperative physiological deterioration. Prospective multicenter validation is required before these biomarkers are incorporated into clinical risk models or used to guide management decisions.", "authors": [ "ÖnderRaufR0000-0003-4433-7855Department of Cardiovascular Surgery, Gaziantep Islam Science and Technology University, Gaziantep 27010, Turkey.Department of Cardiovascular Surgery, Gaziantep City Hospital, Gaziantep 27010, Turkey.", "ÖzçobanoğluSalihSDepartment of Cardiovascular Surgery, Antalya University, Antalya 07190, Turkey." ], "journal": "Journal of clinical medicine", "journal_abbrev": "J Clin Med", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42882075", "pmc": "PMC13666380", "doi": "10.3390/jcm15197614", "pii": "jcm15197614" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-01" } ], "journal_date": "2026Oct01" }, "42882489": { "pmid": "42882489", "title": "Brown Adipocyte BMAL1 Deficiency Is Associated with PVAT Remodeling and Increased Atherosclerosis.", "abstract": "Perivascular adipose tissue (PVAT) is increasingly recognized as an active vascular regulator that influences inflammation, metabolism, and atherosclerotic progression. In healthy vessels, PVAT displays brown adipose-like features and contributes to vascular protection, whereas PVAT dysfunction is associated with adipose whitening, inflammatory activation, and enhanced plaque formation. Circadian clock genes are major regulators of tissue metabolism, yet their role in PVAT biology and atherosclerosis remains incompletely understood. Here, we investigated the function of the core circadian factor BMAL1 in brown adipocytes and PVAT using a brown adipocyte-specific BMAL1 knockout model (Bmal1BAKO) and ApoE-deficient atherosclerosis-prone mice. Transcriptomic profiling of thoracic aortic PVAT and abdominal aortic PVAT revealed that BMAL1 deficiency induces a shift in metabolic gene expression profiles characterized by upregulation of glycolytic and lipogenic gene programs, together with suppression of genes linked to thermogenic and vascular homeostasis. Mechanistically, BMAL1 loss increased Mlxipl (encoding ChREBP) expression, and ChREBP knockdown attenuated the glycolytic-lipogenic transcriptional response to BMAL1 depletion in cultured brown adipocytes. In parallel, BMAL1-deficient PVAT exhibited enlarged lipid droplets, increased oxidative stress-related transcriptional profile, and inflammatory remodeling accompanied by macrophage accumulation. In ApoE-/- mice, brown adipocyte-specific BMAL1 deletion aggravated atherosclerotic lesion formation in both chow-fed aging mice and Western diet-fed young mice, without major changes in systemic energy balance. In conclusion, brown adipocyte BMAL1 deficiency was associated with ChREBP-linked metabolic reprogramming, loss of brown-like PVAT features, oxidative and macrophage-associated remodeling, and increased atherosclerosis.", "authors": [ "XuRuiyanR0000-0002-4992-8112Key Laboratory for Arteriosclerology of Hunan Province, Institute of Cardiovascular Disease, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Department of Pathophysiology, Hengyang Medical School, University of South China, Hengyang 421001, China.Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "WangZhenguoZDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "MuWenjuanWDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "ZhongJuanJDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "LiuYaoY0000-0003-3063-2167Key Laboratory for Arteriosclerology of Hunan Province, Institute of Cardiovascular Disease, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Department of Pathophysiology, Hengyang Medical School, University of South China, Hengyang 421001, China.Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "GuoYanhongY0000-0002-3334-9159Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "ZhangJifengJDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "ChenY EugeneYEDepartment of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA.", "LiGuohuaGKey Laboratory for Arteriosclerology of Hunan Province, Institute of Cardiovascular Disease, Hunan International Scientific and Technological Cooperation Base of Arteriosclerotic Disease, Department of Pathophysiology, Hengyang Medical School, University of South China, Hengyang 421001, China.", "ChangLinL0000-0002-5621-8426Department of Internal Medicine, Frankel Cardiovascular Center, University of Michigan, Ann Arbor, MI 48105, USA." ], "journal": "Cells", "journal_abbrev": "Cells", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42882489", "pmc": "PMC13664416", "doi": "10.3390/cells15191791", "pii": "cells15191791" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-30" } ], "journal_date": "2026Sep30" }, "42883840": { "pmid": "42883840", "title": "Myf5 Progenitors Define the Lineage Identity of Somitic Vascular Smooth Muscle Cells.", "abstract": "Vascular smooth muscle cell (VSMC) heterogeneity drives region-specific aortic pathologies, yet the roles of somite-derived lineages remain unclear. Utilizing Myf5 and MyoD lineage tracing alongside a smooth muscle-specific Myf5 conditional knockout model, we show that Myf5-derived cells selectively populate the thoracic aortic media, whereas the MyoD lineage completely spares large arteries. Early embryonic Myf5 deletion suppressed embryonic VSMC proliferation and downregulated α-SMA, reduced the synthesis of elastic, establishing its necessity in aortic morphogenesis. Upon in vitro ox-LDL challenge and calcification induction, the non-Myf5 lineage primarily drives excessive proliferation and osteogenic transdifferentiation, whereas Myf5 lineage VSMCs exhibit remarkable phenotypic stability and resistance to PDGF-BB-induced dedifferentiation compared to their non-Myf5 counterparts. Collectively, our findings demonstrate a strict lineage divergence between Myf5 and MyoD, suggesting that Myf5 lineage cells play an important role in maintaining aortic integrity, and uncover a lineage-imprinted plasticity that explains regional vascular heterogeneity.", "authors": [ "HuDonghuaDShanghai Key Laboratory of Bioactive Small Molecules, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.", "ChenKunKDepartment of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "ChangXifengXDepartment of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "HuXiX0009-0007-0930-5299Department of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.Shanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "ChenHongjinH0009-0002-1820-2244Department of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "ZhaiXingrongXDepartment of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "QuXinkaiXDepartment of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "FuLeiLShanghai Key Laboratory of Clinical Geriatric Medicine, Shanghai Institute of Geriatrics and Gerontology, Huadong Hospital, Fudan University, Shanghai 200040, China.", "RuanCheng-ChaoCCShanghai Key Laboratory of Bioactive Small Molecules, Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.", "ShiKaileiKDepartment of Cardiology, Huadong Hospital, Fudan University, Shanghai 200040, China." ], "journal": "International journal of molecular sciences", "journal_abbrev": "Int J Mol Sci", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42883840", "pmc": "PMC13664892", "doi": "10.3390/ijms27198594", "pii": "ijms27198594" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-25" } ], "journal_date": "2026Sep25" }, "42885774": { "pmid": "42885774", "title": "Exercise and Thoracic Aortic Aneurysms: A Paradigm Shift Toward Informed, Personalized Activity Guidelines.", "abstract": "Exercise is widely recognized for its cardiovascular benefits; however, its safety and role in patients with thoracic aortic aneurysms (TAAs) remains complex due to its distinctive biomechanical vulnerabilities. Fundamentally different from abdominal aortic aneurysms, TAAs develop from distinct pathophysiological processes that affect their hemodynamic responses to stressors and influence their risk of adverse aortic events. Exercise induces acute hemodynamic changes, including increased stroke volume, systolic and pulse pressures, and transient aortic stiffening. These changes impose mechanical stress on the aortic wall, potentially accelerating aneurysm progression or triggering adverse aortic events. Although moderate aerobic exercise generally appears safe with potential cardiovascular benefits, evidence supporting safe practices in TAAs is limited. Current guidelines frequently extrapolate from abdominal aortic aneurysm data, which overlook the specificities of the thoracic aorta. This review underscores the urgent need for comprehensive research, using advanced imaging, biomarker profiling, and real-time hemodynamic monitoring to understand how different exercise modalities and intensities affect TAAs. Well-designed prospective studies are crucial to improve risk stratification, optimize antihypertensive strategies, develop personalized exercise prescriptions, and provide evidence-informed guidance to patients. Perioperative strategies like prehabilitation and structured postoperative rehabilitation show promise but lack rigorous evaluation. Ultimately, this work advocates a paradigm shift from conservative inactivity toward informed, individualized physical activity regimens tailored to each patient's risk profile. This approach aims to maximize cardiovascular benefits while minimizing adverse aortic events, thereby improving overall health and quality of life in patients with TAAs.", "authors": [ "JabagiHabibH0000-0003-2326-8336Division of Cardiothoracic Surgery The Valley Hospital Ridgewood NJ USA.Department of Cardiovascular Surgery Mt. Sinai Hospital, Icahn School of Medicine New York NY USA.", "ImperatoreGiuseppeG0009-0003-9242-4897Health Science Interdisciplinary Center Scuola Superiore Sant'Anna Pisa Italy.", "NantsiosAlexADivision of Cardiothoracic Surgery Washington University St. Louis MO USA.", "SunLouise YLY0000-0003-3381-3115Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine Stanford University School of Medicine Stanford CA USA.Stanford Cardiovascular Institute Stanford University School of Medicine Stanford CA USA.", "LewisAlexandraADivision of Cardiothoracic Surgery The Valley Hospital Ridgewood NJ USA.", "BoodhwaniMunirMDivision of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada.", "MirHassanHDivision of Cardiac Prevention and Rehabilitation University of Ottawa Heart Institute Ottawa Ontario Canada.Division of Cardiology University of Ottawa Heart Institute Ottawa Ontario Canada.", "TakayamaHirooH0000-0002-7840-801XDepartment of Surgery Columbia University New York NY USA.", "PatelHimanshuH0000-0001-7639-2416Department of Cardiac Surgery University of Michigan Ann Arbor MI USA.", "BurnsPaulPDivision of Cardiothoracic Surgery The Valley Hospital Ridgewood NJ USA.", "GrauJuan BJBDivision of Cardiothoracic Surgery The Valley Hospital Ridgewood NJ USA.Division of Cardiac Surgery University of Ottawa Heart Institute Ottawa Ontario Canada." ], "journal": "Journal of the American Heart Association", "journal_abbrev": "J Am Heart Assoc", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42885774", "doi": "10.1161/JAHA.125.046671" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42886117": { "pmid": "42886117", "title": "Valve-in-Root TAVI vs Redo Surgery in a Young Adult With Failed Bioprosthesis.", "abstract": "TOPIC OF CONTROVERSY: Whether valve-in-valve (ViV) transcatheter aortic valve implantation (TAVI) or redo surgical aortic valve replacement (SAVR) is preferred for structural valve degeneration of a Freestyle stentless aortic root in a young adult, and whether a Ross procedure at index surgery would have better served lifetime management.\nCASE SUMMARY: A 30-year-old man with a failed stentless aortic root (implanted at age 20 for bicuspid aortic valve regurgitation) presented with severe bioprosthetic regurgitation and ventricular dilatation. Transfemoral ViV TAVI with a 29-mm Edwards SAPIEN 3 Ultra Resilia was performed successfully.\nPRO VIEWPOINT: ViV TAVI avoids redo sternotomy, preserves future options, and aligns with patient preference to avoid anticoagulation.\nCON VIEWPOINT: Redo SAVR with a mechanical valve-and a Ross procedure at the index operation-may offer superior lifetime sequencing, avoiding constraints of successive transcatheter implants.\nTAKE-HOME MESSAGE: Lifetime planning must begin at the index operation; both ViV TAVI and redo SAVR require heart team deliberation with explicit consideration of all future interventions.", "authors": [ "PurmessurRushmiRDepartment of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom.", "D'ErricoLuigiaLDepartment of Radiology, Royal Papworth Hospital, Cambridge, United Kingdom.", "CostopoulosCharisCDepartment of Cardiology, Royal Papworth Hospital, Cambridge, United Kingdom.", "AliJasonJDepartment of Cardiothoracic Surgery, Royal Papworth Hospital, Cambridge, United Kingdom. Electronic address: jason.ali@nhs.net." ], "journal": "JACC. Case reports", "journal_abbrev": "JACC Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42886117", "doi": "10.1016/j.jaccas.2026.110733", "pii": "S2666-0849(26)03893-3" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42886123": { "pmid": "42886123", "title": "Transcatheter Edge-to-Edge Repair in Advanced Heart Failure and Ventricular Dysfunction: An Evolving Heart Team Strategy.", "abstract": "BACKGROUND: Patients with severe left ventricular (LV) dysfunction and mitral regurgitation are underrepresented in pivotal transcatheter edge-to-edge repair trials and are often ineligible for transplantation or LV assist devices, leaving limited options when guideline-directed medical therapy fails.\nCASE SUMMARY: We describe 6 patients aged 38 to 82 years with LV ejection fraction 10% to 20% and severe (4+) to torrential (5+) mitral regurgitation, 4 patients presenting in or near cardiogenic shock requiring inotropic, vasopressor, or intra-aortic balloon pump support. All underwent transcatheter edge-to-edge repair as our multidisciplinary heart team strategy evolved.\nDISCUSSION: With increasing experience, the heart team incorporated individualized pharmacologic or temporary mechanical support, preprocedural hemodynamic optimization, and anatomy-driven device selection. One patient initially referred for palliative care was subsequently reassessed and treated. This series illustrates how iterative multidisciplinary learning may expand transcatheter edge-to-edge repair candidacy in carefully selected, high-risk patients with advanced heart failure and profound ventricular dysfunction and limited therapeutic alternatives.", "authors": [ "AlBadriAhmedAWellStar Center for Cardiovascular Care, Marietta, Georgia, USA. Electronic address: ahmedalbadrimd@gmail.com.", "MakarMoodyMSmidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.", "BurkeJamesJWellStar Center for Cardiovascular Care, Marietta, Georgia, USA.", "ManninoSalvotoreSWellStar Center for Cardiovascular Care, Marietta, Georgia, USA.", "GiuseffiJenniferJWellStar Center for Cardiovascular Care, Marietta, Georgia, USA.", "PrasadRajnishRWellStar Center for Cardiovascular Care, Marietta, Georgia, USA.", "JoshiGagandeepGWellStar Center for Cardiovascular Care, Marietta, Georgia, USA.", "BikakAbdul LatifALWellStar Center for Cardiovascular Care, Marietta, Georgia, USA." ], "journal": "JACC. Case reports", "journal_abbrev": "JACC Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42886123", "doi": "10.1016/j.jaccas.2026.110759", "pii": "S2666-0849(26)03919-7" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42886153": { "pmid": "42886153", "title": "Optimizing Echocardiographic Evaluation of Chronic Mitral Regurgitation: Comparison With Cardiac Magnetic Resonance Imaging and Implications for Guideline Recommendations.", "abstract": "BACKGROUND: The ASE (American Society of Echocardiography) guidelines recommend the presence of at least 4 specific criteria to confirm a diagnosis of definite severe mitral regurgitation (MR). However, the performance of these criteria, particularly when <4 are present, remains unclear.\nOBJECTIVES: This study aims to evaluate and optimize the ASE native MR guidelines by comparing them with quantitative cardiac magnetic resonance (CMR), considered the reference standard for MR assessment.\nMETHODS: In this prospective study, 177 patients underwent near-simultaneous CMR and transthoracic echocardiography for the assessment of MR. MR severity was classified using a 4-grade scale based on CMR-derived regurgitant volume, which was calculated as the difference between total left ventricular (LV) stroke volume and aortic forward flow. MR severity was similarly graded using the ASE algorithm, with quantification performed when necessary, by averaging the regurgitant volume from 3 methods: 1) the proximal isovelocity surface area method; 2) the biplane LV volumetric method; and 3) the mitral valve volumetric method.\nRESULTS: The study cohort had a median age of 61.7 years, with 55% being men. Primary MR was the predominant pathology (73% of patients), with 42% having mitral valve prolapse and 25% presenting with flail leaflets. There was exact agreement between transthoracic echocardiography and CMR MR grading in 51% of cases, whereas agreement within 1 grade was observed in 89%. Patients who met any of the ASE severe MR criteria were predominantly classified as having grades 3 to 4 MR by CMR. The following ASE parameters demonstrated high specificity for identifying grade 4 MR by CMR: pulmonary vein systolic flow reversal (specificity 88%), enlarged LV with normal systolic function (specificity 85%), proximal isovelocity surface area radius ≥1.0 cm (specificity 83%), and vena contracta width ≥0.7 cm (specificity 80%). Combining color Doppler with either pulmonary vein systolic reversal or enlarged LV with normal function resulted in 91%-95% specificity for severe MR. Importantly, reliance on fewer ASE criteria reduced the need for quantification from 86% (4 criteria) to 73% (3 criteria) and 59% (2 criteria), thereby enhancing diagnostic efficiency.\nCONCLUSIONS: Certain ASE criteria, especially when used in combination, are highly specific for diagnosing severe MR, even when <4 criteria are present. This study suggests that in many cases, the reliance on extensive quantification may be reduced, streamlining the diagnostic process and improving clinical workflow.", "authors": [ "El-TallawiK CarlosKCHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "AnguloClaraCHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "Chamsi-PashaMohammedMHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "QamarFatimaFHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "GravissEdward AEAHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "ShahDipan JDJHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA.", "ZoghbiWilliam AWAHouston Methodist DeBakey Heart & Vascular Center, Houston, Texas, USA. Electronic address: wzoghbi@houstonmethodist.org." ], "journal": "JACC. Cardiovascular imaging", "journal_abbrev": "JACC Cardiovasc Imaging", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42886153", "doi": "10.1016/j.jcmg.2026.07.025", "pii": "S1936-878X(26)00450-X" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-15" } ], "journal_date": "2026Oct15" }, "42886845": { "pmid": "42886845", "title": "Beta-blocker therapy and aortic growth in nonsyndromic ascending thoracic aortic aneurysms: a serial CT analysis.", "abstract": "BACKGROUND: The role of beta blockers in slowing aneurysm progression in patients with nonsyndromic ascending thoracic aortic aneurysms (aTAA) remains uncertain. We investigated the association between beta blocker therapy and longitudinal ascending aortic growth measured by serial computed tomography (CT).\nMETHODS: This retrospective single-center cohort study included 390 adults with nonsyndromic aTAA who underwent at least two contrast-enhanced CT examinations separated by a minimum of 2 years. Patients were classified according to beta blocker therapy (311 users and 79 nonusers). The primary outcome was the annual ascending aortic growth rate. Secondary outcomes included changes in the ascending aortic size index (ASI) and ascending aortic height index (AHI). Univariate and multivariable linear regression analyses were performed to identify independent predictors of annual aortic growth.\nRESULTS: Baseline ascending aortic diameter was comparable between beta blocker users and nonusers (45.1 ± 3.5 vs. 45.2 ± 3.6 mm, P = 0.73). During a mean CT follow-up of 73.2 ± 39.1 months, annual ascending aortic growth rates were similar between groups (0.40 ± 0.54 vs. 0.45 ± 0.65 mm/year, P = 0.49). Likewise, changes in ASI and AHI did not differ according to beta blocker therapy. In multivariable linear regression analysis, beta blocker use was not independently associated with annual ascending aortic growth (standardized β = -0.031, P = 0.548). Exploratory subgroup analyses demonstrated numerically lower annual growth rates among beta blocker users with baseline ascending aortic diameters ≥48 mm and bicuspid aortic valves; however, neither comparison reached statistical significance.\nCONCLUSIONS: In this long-term CT-based cohort of patients with nonsyndromic aTAA, beta blocker therapy was not independently associated with slower ascending aortic growth or changes in indexed aortic dimensions. Larger prospective studies are needed to further clarify the role of beta blockers in limiting aneurysm progression.", "authors": [ "İşletmeAydinAHealth Sciences University, Derince Training and Research Hospital, Department of Cardiology, Kocaeli.", "DeveciSercanSMinistry of Health Kirikhan State Hospital, Department of Cardiology, Hatay.", "ErenSemihSHealth Sciences University, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye.", "HatipoğluElifEHealth Sciences University, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye.", "GümüşdağAyçaAHealth Sciences University, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye.", "KarataşMehmet BaranMBHealth Sciences University, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye.", "DurmuşGündüzGHealth Sciences University, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, İstanbul, Türkiye." ], "journal": "Journal of cardiovascular medicine (Hagerstown, Md.)", "journal_abbrev": "J Cardiovasc Med (Hagerstown)", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42886845", "doi": "10.2459/JCM.0000000000001947", "pii": "01244665-202610000-00004" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-02" } ], "journal_date": "2026Oct01" }, "42887389": { "pmid": "42887389", "title": "Integrated network pharmacology, transcriptomics, and molecular simulations reveal polydatin protects against aortic dissection associated with PPARγ/Nrf2-related antioxidant signaling.", "abstract": "Aortic dissection (AD) is a life-threatening vascular disease characterized by medial degeneration, extracellular matrix (ECM) destruction, inflammation, and oxidative stress. Polydatin (PD), a natural stilbene glucoside, has cardiovascular protective potential, but its mechanism against AD remains unclear. This study investigated the therapeutic mechanism of PD in AD by integrating network pharmacology, transcriptomic analysis, weighted gene co-expression network analysis (WGCNA), molecular modeling, and in vivo validation. IGF1, PPARG, and KDR were identified as core targets in the PD-AD network, with PPARG prioritized for its association with vascular redox homeostasis, inflammation, and antioxidant defense. Molecular docking and molecular dynamics simulations indicated stable interactions between PD and PPARγ and Keap1, a key regulator of Nrf2 stability. In a β-aminopropionitrile (BAPN)-induced AD mouse model, PD significantly reduced aortic dilation and medial injury, preserved elastic fiber architecture, and attenuated ECM degradation. PD also decreased ROS and MDA levels, restored SOD, GSH-Px, and CAT activities, and upregulated PPARγ, Nrf2, HO-1, and NQO1 expression. These findings suggest that PD alleviates AD by restoring vascular redox homeostasis, potentially involving PPARγ-associated signaling and Nrf2-related antioxidant responses, supporting PD as a potential therapeutic candidate for AD-related vascular degeneration.", "authors": [ "YangWeiweiWDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "PangShulanSDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "LiYiYDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "ChenJiahongJDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "JiaoQiuhongQDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "LiuAilinADepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "LiuTiansenTDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "HuangTaoTDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.", "WangHongjieHDepartment of Cardiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China; Hubei Provincial Engineering Research Center of Vascular Interventional Therapy, Wuhan, Hubei, 430030, China.", "XuXiufengXDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China. Electronic address: wyxxf2986@126.com.", "ZhangYuqingYDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China. Electronic address: zhangyuqing5641907@163.com.", "DongPeikangPDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China. Electronic address: dongpeikang@163.com.", "WangTaoTDepartment of Cardiology, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China. Electronic address: wangtao575.happy@163.com." ], "journal": "Biochemical and biophysical research communications", "journal_abbrev": "Biochem Biophys Res Commun", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42887389", "doi": "10.1016/j.bbrc.2026.154738", "pii": "S0006-291X(26)01504-4" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-13" } ], "journal_date": "2026Oct13" }, "42887570": { "pmid": "42887570", "title": "EARLY STROKE AFTER AORTIC ARCH REPAIR: COMPARATIVE AND PROPORTIONAL META-ANALYSES OF OPEN, HYBRID, AND TOTAL ENDOVASCULAR STRATEGIES.", "abstract": "OBJECTIVE: Early stroke remains one of the most devastating complications after aortic arch repair. This systematic review and meta-analysis evaluated early stroke after open, hybrid, and total endovascular aortic arch repair using separate comparative and proportional frameworks.\nMETHODS: PubMed, Scopus, and Web of Science were searched from inception through July 27, 2026. Observational studies reporting neurological outcomes after adult open, hybrid, or total endovascular aortic arch repair were included. The primary comparative meta-analysis pooled propensity score-matched or weighted studies comparing hybrid with open repair using random-effects restricted maximum likelihood models with Hartung-Knapp adjustment. Separate proportional random-effects meta-analyses estimated pooled stroke incidences for each strategy. Risk of bias was assessed using ROBINS-I and the Joanna. Briggs Institute Critical Appraisal Checklist. The protocol was prospectively registered in PROSPERO (CRD420261461659).\nRESULTS: Thirty-four studies were included. Seven propensity score-matched or weighted cohorts comprising 948 patients (474 open and 474 hybrid repairs) contributed to the primary comparative meta-analysis. No significant difference in early stroke was identified between hybrid and open repair (OR 1.99, 95% CI 0.46-8.58; P=.292; I2=52.9%). Post hoc comparative analyses restricted to dissection cohorts (3 cohorts; 572 patients) and Zone 0 hybrid repair (3 cohorts; 448 patients) were also inconclusive and highly imprecise. In descriptive proportional analyses, pooled early-stroke incidences were 5.3% after open, 7.5% after hybrid, and 6.4% after total endovascular repair. Technique-stratified incidences were 6.1% for conventional open repair, 4.4% for open repair with frozen elephant trunk, and 5.3% for branched total endovascular repair.\nCONCLUSION: Adjusted comparative evidence showed no significant difference in early stroke between hybrid and open aortic arch repair. Evidence for total endovascular repair remains predominantly non-comparative. Treatment should be individualised according to aortic pathology, urgency, anatomy, operative risk, and institutional expertise.", "authors": [ "Lourdes Del Río SoláMMDepartment of Surgery, School of Medicine, Universidad de Valladolid, Valladolid, Spain; Department of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. Electronic address: marialourdes.rio@uva.es.", "CajaMarina JiménezMJDepartment of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.", "de la Torre CasasecaClaraCDepartment of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.", "GarcíaEva ÁlvarezEÁDepartment of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.", "PadrónCarlos GarcíaCGDepartment of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.", "FernándezSandra PérezSPDepartment of Angiology and Vascular Surgery, Hospital Clínico Universitario de Valladolid, Valladolid, Spain." ], "journal": "Journal of vascular surgery", "journal_abbrev": "J Vasc Surg", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42887570", "doi": "10.1016/j.jvs.2026.09.048", "pii": "S0741-5214(26)01757-X" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42887698": { "pmid": "42887698", "title": "Functional outcome after recurrent laryngeal nerve injury following thoracic aortic surgery.", "abstract": "OBJECTIVES: Recurrent laryngeal nerve injury is a recognized complication of aortic surgery, yet data on long-term functional outcomes remain limited. This study aimed to evaluate the incidence of recurrent laryngeal nerve injury and to assess voice recovery after thoracic aortic surgery.\nMETHODS: Single-centre retrospective analysis included adult patients undergoing aortic arch or thoracoabdominal aortic surgery between 2001 and 2024. Recurrent laryngeal nerve injury was diagnosed by postoperative vocal cord paralysis. Aortic arch surgery included partial and total arch replacement, while thoracoabdominal surgery involved the proximal descending aorta. The primary endpoint was full voice recovery. Secondary endpoints included recovery of normal vocal cord mobility, residual dysphonia, the need for voice therapy, and vocal cord interventions.\nRESULTS: Among 2,983 patients undergoing aortic surgery, 70 (2.3%) were diagnosed with postoperative recurrent laryngeal nerve injury. Median follow-up was 17 [IQR: 7-25] months. The incidence of recurrent laryngeal nerve injury was 1.7% after arch surgery and 5.3% after thoracoabdominal procedures. At final follow-up, 34 patients (50%) achieved full voice recovery, while 20 (30%) had mild dysphonia, 9 (13%) moderate dysphonia, and 5 (7%) severe dysphonia. Voice therapy was performed in 49 (70%) patients, and 10 (14%) required additional vocal cord interventions.\nCONCLUSIONS: In this large cohort, the incidence of recurrent laryngeal nerve injury after aortic surgery was lower than previously reported. Functional outcomes were favourable, with most patients achieving full or near-complete voice recovery through conservative or interventional management. Structured follow-up and multidisciplinary care remain essential to optimize outcomes after recurrent laryngeal nerve injury.", "authors": [ "PregaldiniFabioFDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. Electronic address: fabiomatteo.pregaldini@extern.insel.ch.", "PotratzPaulPDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "SeifertEberhardEDepartment of Otolaryngology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "NuceraMariaMDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "MosbahiSelimSDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "BartkevicsMarisMDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "SchmidliJürgJDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "SiepeMatthiasMDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "YildizMuratMDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.", "SchoenhoffFlorian SFSDepartment of Cardiac Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland." ], "journal": "The Journal of thoracic and cardiovascular surgery", "journal_abbrev": "J Thorac Cardiovasc Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42887698", "doi": "10.1016/j.jtcvs.2026.09.030", "pii": "S0022-5223(26)01383-8" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42887709": { "pmid": "42887709", "title": "Bicuspid Aortic Valve with Giant Non-Coronary Sinus Aneurysm Compressing the Sinoatrial Node Causing Arrhythmia and Coarctation of the Aorta: A Case on Clinical Decision-Making and Surgical Challenges.", "abstract": "BACKGROUND: Bicuspid aortic valve, the most common congenital valvular disease, frequently coexists with aortic pathologies. Symptomatic arrhythmias from unruptured giant aortic sinus aneurysm compressing the sinoatrial node are exceedingly rare. The coexistence of bicuspid aortic valve, arrhythmogenic sinus aneurysm, coarctation of the aorta, and right coronary artery occlusion represents an extraordinarily complex malformation with scarce documentation and controversial management strategies.\nCASE PRESENTATION: A 67-year-old male patient presented with chest tightness and palpitations. Echocardiography and computed tomography angiography revealed Type 0 bicuspid aortic valve (two-sinus type) with giant unruptured non-coronary sinus aneurysm (52 mm × 48 mm), descending coarctation of the aorta (14 mm), post-stenotic aneurysm (42 mm), and right coronary artery occlusion. Imaging confirmed direct sinoatrial node compression. First-stage surgery comprised biological aortic valve replacement, sinus repair, and coronary artery bypass grafting. The coarctation of the aorta was managed conservatively based on borderline transcoarctation gradient and favorable clinical status.\nCONCLUSION: Direct mechanical sinoatrial node compression combined with compromised nodal arterial supply constituted the pathophysiological basis for arrhythmia. For bicuspid aortic valve with multisegmental aortic disease, individualized strategy based on anatomical characteristics, hemodynamic parameters (such as transcoarctation gradient, aortic isthmus ratio, and extremity blood pressure difference), and systemic condition is essential. Staged repair prioritizing hemodynamically threatening lesions reduces surgical trauma and spinal ischemia risk, providing clinical guidance for managing such rare complex aortic pathologies.", "authors": [ "LiuSidaSDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "ZhangZhaoyuZDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "YangKaiKDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "ChenWeiqiangWDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "CaoWenfengWDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "WangLixingLDepartment of Cardiology, the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "DongShuqiangSDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.", "ZhangYuYDepartment of Cardiovascular Surgery (Department of High-Altitude Medicine), the 940th Hospital of the Joint Logistics Support Force of the Chinese People's Liberation Army, Lanzhou 730050, Gansu Province, China.. Electronic address: Dr_zhangy940@163.com." ], "journal": "Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology", "journal_abbrev": "Cardiovasc Pathol", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42887709", "doi": "10.1016/j.carpath.2026.107866", "pii": "S1054-8807(26)00057-8" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026Oct16" }, "42888271": { "pmid": "42888271", "title": "Matrix metalloproteinase imaging and survival prospects with aging in murine aortic aneurysm.", "abstract": "BACKGROUND: Matrix metalloproteinases (MMPs) are elevated in aortic aneurysm (AA), where older age is a risk factor. The relationship among aging, aortic MMP activity, and AA development has not been systematically evaluated. This study leveraged MMP-targeted molecular imaging to investigate how aging affects aortic MMP activity, aneurysm development, and survival.\nRESULTS: AA development and animal survival were monitored for 28 days after Angiotensin (Ang)-II infusion in 8-10-week-old (young) and > 51-week-old (old) apolipoprotein E (Apoe)-/- mice. Old animals' survival at 28 days was significantly lower than that of young Ang-II-infused Apoe-/- mice (P < 0.05). 64Cu-RYM2 PET/CT showed significantly higher aortic MMP activation before and 1 week after Ang-II infusion in old compared to young Apoe-/- mice. The 64Cu-RYM2 signal was significantly higher in animals that did not survive 28 days than in those that did (P < 0.01). MMP activity significantly increased after Ang-II infusion and correlated with aortic macrophage infiltration. The increase in MMP activity preceded aortic dissection. Finally, MMP activity was heterogeneous along the aorta of control and Ang-II-infused young and old Apoe-/- mice, and of old wild-type mice.\nCONCLUSIONS: Aging is associated with increased MMP activity along the aorta and worse AA survival. MMP-targeted molecular imaging provides insights regarding aneurysm survival prospects in this exploratory cohort. Combining MMP inhibitors and tracers may help prevent and track aneurysm growth, dissection, and rupture.", "authors": [ "GhimMeanMYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "VarliOnurOYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "AhmadAzmi AAAYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.", "NeishabouriAfarinAYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.", "KukrejaGunjanGYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.", "ZhangZhengxingZYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "ZarnegarSaalarSYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "GangemiNicholasNYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "HedayatyanfardKeshvadKYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "ToczekJakubJYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.", "WangLingyunLYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA.", "ZhangJiashengJYale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA.", "LiuChiCDepartment of Radiology and Biomedical Imaging, Yale University, New Haven, CT, USA.", "LiuYongjianYDepartment of Radiology, Washington University, St. Louis, MO, USA.", "GroplerRobert JRJDepartment of Radiology, Washington University, St. Louis, MO, USA.", "SadeghiMehran MMM0000-0002-5074-3510Yale Cardiovascular Research Center, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 300 George Street, Room 770G, New Haven, 06511, CT, USA. mehran.sadeghi@yale.edu.Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA. mehran.sadeghi@yale.edu." ], "journal": "EJNMMI research", "journal_abbrev": "EJNMMI Res", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42888271", "pmc": "PMC13675461", "doi": "10.1186/s13550-026-01521-w", "pii": "10.1186/s13550-026-01521-w" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-22" } ], "journal_date": "2026Sep22" }, "42890356": { "pmid": "42890356", "title": "Hybrid pin penetration open stent technique: Retrospective study of a new approach to frozen elephant trunk procedure.", "abstract": "Total arch replacement using the frozen elephant trunk technique for acute type A aortic dissection involving the aortic arch remains technically demanding because of complex supra-aortic branch reconstruction and prolonged circulatory arrest. We developed a modified fenestrated open stent technique, termed the hybrid pin-penetration open stent (HIPPOS) technique, to simplify branch reconstruction while minimizing supra-aortic vessel manipulation. We retrospectively reviewed 15 consecutive patients who underwent total arch replacement using HIPPOS between May 2024 and May 2026 at a single institution by a single surgeon. Following deployment of a Frozenix open stent graft (Japan Lifeline), antegrade fenestrations were created under direct vision using needle penetration and sequential dilation, followed by reconstruction with balloon-expandable covered stent grafts. All procedures were successfully completed. Operative durations decreased with increasing numbers of fenestrations, reflecting procedural refinement and the surgical learning curve. Two perioperative deaths occurred in patients with profound preoperative shock, and one patient experienced a nondisabling stroke. No postoperative hoarseness, paraplegia, fenestration-related endoleak, or distal stent-induced new entry was observed. Follow-up computed tomography angiography confirmed satisfactory graft conformability and durable branch patency. HIPPOS is a reproducible modification of the frozen elephant trunk procedure with encouraging early clinical outcomes.", "authors": [ "KaoChih-ChenCCDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "HuangYao-KuangYKDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "TsengIminIDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "LinChien-ChaoCCDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "KuoHo-ChengHCDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "WangTsung-ShunTSDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.", "LuChu-HsuehCHDepartment of Cardiovascular Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan.Department of Medicine, Chang Gung University, Taoyuan, Taiwan.Department of Nursing, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi, Taiwan." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42890356", "pmc": "PMC13672969", "doi": "10.1016/j.jvscit.2026.102505", "pii": "S2468-4287(26)00389-8" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-07" } ], "journal_date": "2026Dec" }, "42890379": { "pmid": "42890379", "title": "Renal artery covered stent placement eliminated false lumen perfusion after provisional extension to induce complete attachment.", "abstract": "Thoracic endovascular aortic repair with the provisional extension to induce complete attachment (PETTICOAT) technique can cause persistent false-lumen perfusion through distal re-entry tears, leading to late aneurysmal degeneration and challenging reinterventions. We report the use of renal artery covered stent placement to treat persistent false-lumen perfusion after PETTICOAT caused by a re-entry tear in a 57-year-old man with chronic type B aortic dissection. Preoperative assessment of the relationship between the re-entry tear and bare-stent struts enabled device delivery and false-lumen exclusion, while preserving renal perfusion. This approach represents a feasible branch-preserving reintervention strategy after PETTICOAT.", "authors": [ "IshidaKeiichiKDepartment of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan.", "KatadaYoshiakiYDepartment of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan.Department of Radiology, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan.", "NakanowatariHitoshiHDepartment of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan.", "ShibasakiIkukoIDepartment of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan.", "IrieYoshihitoYDepartment of Cardiovascular Surgery, Iwaki City Medical Center, Iwaki, Japan." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42890379", "pmc": "PMC13672974", "doi": "10.1016/j.jvscit.2026.102503", "pii": "S2468-4287(26)00387-4" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-06" } ], "journal_date": "2026Dec" }, "42890397": { "pmid": "42890397", "title": "A snare-assisted pull-up technique for side-branch component delivery during thoracic endovascular aortic repair for distal aortic arch aneurysm using Gore Thoracic Branch Endoprosthesis.", "abstract": "We report a case of thoracic endovascular aortic repair using a thoracic branch endoprosthesis for aneurysm enlargement caused by an endoleak after prior fenestrated repair. A 75-year-old man with previous left subclavian artery stenting presented with aneurysm growth. Advancement of the side-branch component through the pre-existing stent was difficult because of severe angulation, and standard push-up techniques failed. A snare-assisted pull-up technique via a pre-existing 6F brachial sheath enabled direct capture and controlled pull-and-push advancement of the device. This method may serve as a simple bailout strategy for difficult branch component delivery.", "authors": [ "SuzukiTakehiroTDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "OhkiTakaoTDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "ShukuzawaKotaKDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "FukushimaSoichiroSDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "OmoriMakikoMDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "OzawaHirotsuguHDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "NishideRyoRDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.", "YamagishiDaisukeDDivision of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42890397", "pmc": "PMC13672979", "doi": "10.1016/j.jvscit.2026.102481", "pii": "S2468-4287(26)00365-5" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-08-25" } ], "journal_date": "2026Dec" }, "42890460": { "pmid": "42890460", "title": "Open surgical repair of complex non-Type A and non-Type B aortic dissection in a right aortic arch-case report.", "abstract": "OBJECTIVE: To report the diagnostic and treatment process of a patient with complex non-Type A and non-Type B aortic dissection, and to discuss its clinical characteristics and surgical strategy.\nMETHODS: A retrospective analysis was conducted on the clinical data of a patient with complex non-Type A and non-Type B aortic dissection.\nRESULTS: After admission, the patient was diagnosed with complex non-Type A and non-Type B aortic dissection through computed tomography angiography (CTA). The aorta exhibited a right-sided arch, with the left common carotid artery originating from the ascending aorta and the aberrant left subclavian artery arising from the distal aortic arch. The right vertebral artery originated from the right-sided aortic arch. The dissection tear was located at the distal part of the aortic isthmus, approximately 2 cm in width. The dissection flap extended proximally to the distal aspect of the right subclavian artery origin and distally to the proximal aspect of the left renal artery origin. Due to the high difficulty of endovascular repair and the increased risk of long-term complications, an open surgical approach was chosen. This involved deep hypothermic circulatory arrest with elephant trunk stenting, left common carotid to left subclavian artery bypass. The patient was discharged one week after surgery in good health.\nCONCLUSION: This case illustrates that open surgical repair can be a feasible and effective option for selected patients with non-A non-B aortic dissection and complex arch anatomy that limits endovascular repair. Treatment should be individualized according to entry-tear location, arch-branch anatomy, landing-zone feasibility, malperfusion risk, and institutional expertise. Due to the special anatomical structure and high surgical difficulty, a personalized treatment plan must be developed. Open surgery still offers irreplaceable advantages in certain cases.", "authors": [ "PengTailuanTDepartment of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.", "XuMingkunMDepartment of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.", "XiangChaohuCDepartment of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.", "XiangJunJDepartment of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China.", "LiuYongYDepartment of Cardiovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China." ], "journal": "Frontiers in cardiovascular medicine", "journal_abbrev": "Front Cardiovasc Med", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42890460", "pmc": "PMC13673147", "doi": "10.3389/fcvm.2026.1784447" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-02" } ], "journal_date": "2026" }, "42890613": { "pmid": "42890613", "title": "Staged Omental Wrapping for Perigraft Fluid Collection after Total Aortic Arch Replacement: A Case Report.", "abstract": "INTRODUCTION: Perigraft fluid collection after aortic graft replacement is often self-limiting; however, progressive enlargement or the development of symptoms warrants careful evaluation. The differential diagnosis includes hematoma, abscess, seroma, and lymphatic leakage. However, differentiating among these conditions can be challenging based solely on clinical symptoms and imaging findings.\nCASE PRESENTATION: A 51-year-old man underwent total aortic arch replacement (TAR) for chronic Stanford type A aortic dissection. Nine months later, he developed rapidly progressive swelling and erythema over the upper portion of the median sternotomy incision. Contrast-enhanced CT revealed a low-attenuation fluid collection surrounding the prosthetic graft and extending into the subcutaneous mass. Although there was no evidence of active extravasation, anastomotic disruption, or gas formation suggestive of graft infection, exploratory resternotomy was performed under cardiopulmonary bypass (CPB) standby because a redo TAR might have become necessary if either anastomotic disruption or gross graft infection had been identified intraoperatively. Intraoperative inspection revealed no evidence of active bleeding. However, graft infection could not be definitively excluded because yellowish-brown turbid fluid was drained from the subcutaneous mass and around the prosthetic graft. Fluid samples were obtained for microbiological culture, and the perigraft space was thoroughly irrigated. Based on the intraoperative findings, fluid characteristics, and negative microbiological culture results, a sterile inflammatory perigraft fluid collection was considered the most likely diagnosis. Omental wrapping was subsequently performed as a second-stage procedure to manage the large residual space and prevent graft infection. No recurrence was observed during 12 months of follow-up.\nCONCLUSIONS: Perigraft fluid collection after aortic graft replacement has a broad differential diagnosis. When active bleeding or graft infection cannot be confidently excluded, an exploratory resternotomy under CPB standby may be a practical option for direct evaluation and management. Omental wrapping may be a simple and effective option for preventing recurrence and graft infection.", "authors": [ "TomitaGakuGDepartment of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan.", "AbeShinjiSDepartment of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan.", "TsuchidaHikaruHDepartment of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan.", "AndoNorihiroNDepartment of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan.", "MakinoYutakaYDepartment of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Hokkaido, Japan." ], "journal": "Surgical case reports", "journal_abbrev": "Surg Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42890613", "pmc": "PMC13673656", "doi": "10.70352/scrj.cr.26-0473", "pii": "scrj.cr.26-0473" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-16" } ], "journal_date": "2026" }, "42890866": { "pmid": "42890866", "title": "Divergent aortic root cusp-to-cusp measurement techniques on CMR: geometric implications and threshold reclassification.", "abstract": "OBJECTIVE: To evaluate discrepancies between current European guidelines (ESC vs. EACTS) regarding aortic root cusp-to-cusp measurements and assess their impact on risk stratification for prophylactic root replacement.\nMETHODS AND RESULTS: A retrospective analysis was performed on a relative young cohort of 50 patients (mean age 42 years) who underwent non-contrast 3D cardiovascular magnetic resonance (CMR) imaging. We compared the widest-to-widest cusp measurements and the middle cusp-to-cusp measurements with each other and against a traced aortic root perimeter. The widest cusp-to-cusp measurement yielded systematically higher values compared to the middle measurement, showing a significant mean difference of 3.60 mm (P < 0.001). The middle measurement demonstrated better statistical agreement with the traced aortic root perimeter, achieving a Lin's Concordance Correlation Coefficient (CCC) of 0.98 and a Mean Absolute Error (MAE) of 3.96 mm. Conversely, widest cusp-to-cusp measurements exhibited substantially lower agreement (CCC 0.80) and significantly higher error rates (MAE 16.88 mm), consistently overestimating the perimeter. This led to the upward reclassification of 10.0% (5/50) and 16.0% (8/50) of patients across the 40 and 45 mm guideline thresholds, respectively.\nCONCLUSION: Cusp-to-cusp measurement techniques recommended by ESC and EACTS produce systematically divergent aortic root dimensions, resulting in significant patient reclassification across clinical thresholds. Although the middle measurement aligns more closely with the traced anatomical perimeter, the principal finding of this study is that guideline choice fundamentally alters patient categorization. Standardization of aortic root measurement conventions is essential to ensure consistent international care, improve research comparability, and reconcile historical risk thresholds with modern 3D imaging.", "authors": [ "ZelisJo MJM0000-0003-2110-4901Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands.", "van DijkArieA0000-0002-7843-8251Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands.", "DuijnhouwerToon DTD0000-0001-5064-0143Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands.", "SalahKhibarKRadiology Department, Radboud University Medical Center, Nijmegen, The Netherlands.", "HeijmenRobin HRH0000-0003-1503-2374Cardiothoracic Surgery Department, Radboud University Medical Center, Nijmegen, The Netherlands.", "NijveldtRobinR0000-0003-1530-6363Cardiology Department, Radboud University Medical Center, Nijmegen, The Netherlands." ], "journal": "European heart journal. Imaging methods and practice", "journal_abbrev": "Eur Heart J Imaging Methods Pract", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42890866", "pmc": "PMC13674802", "doi": "10.1093/ehjimp/qyag173", "pii": "qyag173" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-12" } ], "journal_date": "2026Oct" }, "42891021": { "pmid": "42891021", "title": "Hot wire technique for septal fenestration in chronic type B aortic dissection: A case report.", "abstract": "Persistent false lumen in chronic type B aortic dissection complicates endovascular repair. The hot wire technique offers a precise method for septal fenestration, enabling endovascular treatment when standard approaches are not feasible. We present a case of a 65-year-old man with prior ascending aorta replacement and elephant trunk, who developed a large descending aortic aneurysm with residual dissection and a false lumen in which the elephant trunk resided, prohibiting conventional thoracic endovascular aortic repair. Septal fenestration allowing continuous flow was created using the hot wire technique, demonstrating the safety and effectiveness of this technique in complex chronic dissections with challenging anatomy.", "authors": [ "ShuliElonEDepartment of Vascular Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.", "RosenthalEyalEDepartment of Vascular Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.", "DvirDannyDDepartment of Cardiology, Shaare Zedek Medical Centre, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.", "Sheick-YousifBasheerBDepartment of Vascular Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42891021", "pmc": "PMC13672972", "doi": "10.1016/j.jvscit.2026.102479", "pii": "S2468-4287(26)00363-1" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-07" } ], "journal_date": "2026Dec" }, "42891228": { "pmid": "42891228", "title": "Functional pseudocoarctation after branched arch endograft implantation in a patient with previous type A aortic dissection repair.", "abstract": "", "authors": [ "LorenzVeronicaVDepartment of Medicine, Surgery and Neuroscience, Cardiac Surgery Unit, University of Study of Siena, Siena, Italy.", "MuzziLuigiLDepartment of Medicine, Surgery and Neuroscience, Cardiac Surgery Unit, University of Study of Siena, Siena, Italy.", "NeriEugenioEDepartment of Medicine, Surgery and Neuroscience, Cardiac Surgery Unit, University of Study of Siena, Siena, Italy." ], "journal": "JTCVS techniques", "journal_abbrev": "JTCVS Tech", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42891228", "pmc": "PMC13674021", "doi": "10.1016/j.xjtc.2026.102574", "pii": "S2666-2507(26)00381-0" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-08-17" } ], "journal_date": "2026Oct" }, "42892020": { "pmid": "42892020", "title": "Global oncological surgery at a crossroads: Overcoming inequities and disparities through collective action and strategic vision.", "abstract": "Surgical oncology is essential for the management of most solid tumours, yet access to safe, timely, and appropriate cancer surgery remains severely limited in low- and middle-income countries (LMICs), as well as among vulnerable populations globally. This position paper presents a shared assessment of inequity in surgical oncology and a framework for addressing it across epidemiological, socioeconomic, and structural factors. Major barriers identified include critical workforce shortages, inadequate pathology and radiotherapy infrastructure, financial toxicity, geographic disparities in service concentration, fragmented national cancer control policies, and the persistent absence of multidisciplinary tumour board structures in most LMICs. Proposed solutions include the expansion of patient navigation programmes, telemedicine and virtual tumour boards, structured workforce development through international fellowships and bidirectional educational exchange, population-based cancer registries for rational capacity planning, and North-South research partnerships. Failure to act is projected to result in cumulative global GDP losses of US$6.2 trillion by 2030. New international initiatives like the World Society of Surgical Oncology (founded 6 November 2025) may advance collaboration through capacity building, advocacy, and evidence generation.", "authors": [ "PinheiroRodrigo NascimentoRNPostgraduate Programme in Interdisciplinary Surgical Science, Escola Paulista de Medicina - UNIFESP, São Paulo, Brazil. Electronic address: rodrigo@cancerdf.com.br.", "D'UgoDomenicoDSurgery, Catholic University of Rome, \"A.Gemelli\" Medical School, Italy.", "CoimbraFelipe José FernándezFJFUpper GI & HPB Oncology, AC Camargo Cancer Center, Brazil.", "PawlikTimothy MTMOhio State University Wexner Medical Center, USA.", "SantosLucio LaraLLExperimental Pathology & Therapeutics Group, Department of Surgical Oncology, Portuguese Institute of Oncology, Porto, Portugal.", "SousaJoaquim AbreuJASurgical Oncology Service, Portuguese Institute of Oncology, Porto, Portugal.", "KleeffJörgJDepartment of Surgery, Martin-Luther-Universität Halle-Wittenberg, Germany.", "RosaNilton Caetano daNCDTeaching and Research, Instituto Angolano de Controlo do Câncer (IACC), Angola.", "JacintoDelfina Irina BernardoDIBHospital Materno Infantil - Irene Neto, AORTIC Southern Region, Huíla, Angola.", "van RamshorstGabrielle HGHDepartment of Gastrointestinal Surgery, Ghent University Hospital, Department of Human Structure and Repair, Ghent University, Belgium.", "GuiloviçaMauro AcrisioMASurgery Department, Maputo Military Hospital - Ministry of Defence of Mozambique, Mozambique.", "NairChandramohan KrishnanCKInstitutional Relations, Clinical Services, Department of Surgical Oncology, Sreemookambika Cancer Centre, Sreemookambika Institute of Medical Sciences, India.", "OliveiraAlexandre FerreiraAFFederal University of Juiz de Fora (UFJF), Brazil." ], "journal": "European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology", "journal_abbrev": "Eur J Surg Oncol", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42892020", "doi": "10.1016/j.ejso.2026.112203", "pii": "S0748-7983(26)00822-X" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-13" } ], "journal_date": "2026Oct13" }, "42892169": { "pmid": "42892169", "title": "Geometry-Guided Graph Encoding Network (G3e-Net) for Patient-Specific Prediction of Vascular Haemodynamics.", "abstract": "Patient-specific haemodynamic assessment is essential for clarifying vascular pathophysiology and guiding clinical decision-making. While computational fluid dynamics offers high-fidelity flow quantification, its routine clinical use remains limited by the time-consuming iterative solution process required for patient-specific simulations. To tackle these issues, we developed a geometry-guided graph encoding network (G3e-Net), a CFD-supervised image-derived prediction framework that learns anatomically informed representations from CTA-derived vascular geometries. G3e-Net coupled centerline-guided spectral encoding to resolve global topology with multi-scale curvature descriptors capturing local boundary nuances. An attention mechanism then combined these different spatial representations, allowing the network to dynamically balance global connectivity with local geometry in complicated vascular structures. By learning a direct mapping from CTA-derived point clouds to three-dimensional haemodynamic fields, G3e-Net enables rapid functional estimation without requiring volumetric meshing or iterative numerical optimization during inference. Extensive validation on thoracic aortas and carotid arteries from multiple hospitals confirmed that G3e-Net outperformed state-of-the-art baselines, reducing prediction errors for velocity, pressure, and WSS by 10-20%. Notably, inference on high-resolution aortic geometries comprising approximately 200,000 nodes was completed in less than 4 seconds, providing substantial acceleration compared with conventional CFD. These results support the potential of anatomically informed graph representation learning for rapid image-derived haemodynamic analysis and patient-specific functional vascular assessment in thoracic aortic and carotid artery applications.", "authors": [ "QinLinyuLSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: linyu.qin@foxmail.com.", "ZhangShuaitongSSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: zhangshuaitong@bit.edu.cn.", "ZhangXuyangXSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: 3120215706@bit.edu.cn.", "ZhangXuehuanXSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: xuehuan_zhang@163.com.", "YangYutingYSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: yyt_yuting@163.com.", "LiXiaofanXSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: lbqdlxf@163.com.", "LiangShichaoSSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: liangshichao@bit.edu.cn.", "XuYaoYSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: 13910770526@163.com.", "XiongJiangJDepartment of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, 100000, China. Electronic address: xiongjiangdoc@126.com.", "LiHaiyangHDepartment of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100013, China. Electronic address: ocean0203@163.com.", "VentikosYiannisYFaculty of Engineering, Monash University, Clayton, Victoria, 3800, Australia. Electronic address: Yiannis.Ventikos@monash.edu.", "ChenDuanduanDSchool of Medical Science and Engineering, Beijing Institute of Technology, Beijing, 100081, China. Electronic address: duanduan@bit.edu.cn." ], "journal": "Medical image analysis", "journal_abbrev": "Med Image Anal", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42892169", "doi": "10.1016/j.media.2026.104358", "pii": "S1361-8415(26)00427-5" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-12" } ], "journal_date": "2026Oct12" }, "42892740": { "pmid": "42892740", "title": "MYLK c.4079G>A, p.(Gly1360Asp) Variant Associated With Hereditary Thoracic Aortic Diseases and Early Onset Aortic Dissection.", "abstract": "AIMS: Thoracic aortic aneurysms and dissections are major causes of sudden cardiovascular death. We aimed to evaluate the clinical significance of the MYLK c.4079G>A, p.(Gly1360Asp) variant in Finnish families with heritable thoracic aortic disease (HTAD) and to assess evidence for a potential founder effect.\nMETHODS: We evaluated the clinical significance and potential founder effect of the missense variant MYLK c.4079G>A, p.(Gly1360Asp) in Finnish families. Eight individuals from four unrelated Finnish families carrying the MYLK c.4079G>A heterozygous variant were recruited. Clinical histories, imaging data, and pedigrees were reviewed. Genetic testing included exome‑based gene panel sequencing or targeted familial variant testing. Variant classification followed the American College of Medical Genetics and Genomics 2015 guidelines.\nRESULTS: Thoracic aortic dilatation or aneurysm occurred in 6/8 carriers (75%), with a mean age at diagnosis of 45 years (range 34-67). Ascending aortic diameters ranged from 26-59 mm, most often measured at the aortic root. Aortic dissection occurred in 4/8 (50%) at a mean age of 46 years (range 34-68), including three early‑adult events. Extrathoracic arterial involvement (carotid) was observed in one variant‑positive individual.\nCONCLUSION: The MYLK c.4079G>A, p.(Gly1360Asp) variant was present in six affected individuals from four unrelated families and is enriched in the Finnish population, supporting a founder effect. The MYLK c.4079G>A, p.(Gly1360Asp) variant is associated with early‑adult‑onset, high‑penetrance thoracic aortic disease and substantial dissection risk, underscoring the need for vigilant surveillance and early intervention in affected individuals and at‑risk relatives.", "authors": [ "VirtanenMinjaMDepartment of Genomics, Turku University Hospital, Turku, Finland.Faculty of Science, University of Turku, Turku, Finland.", "KeskinenSiniSDepartment of Genomics, Turku University Hospital, Turku, Finland.", "BjörnRikhardRHeart Center, Turku University Hospital, University of Turku, Turku, Finland.", "PaavolaMinnaMDepartment of Genomics, Turku University Hospital, Turku, Finland.", "PohjolaPiaPDepartment of Genomics, Turku University Hospital, Turku, Finland.", "HietalaMarjaMDepartment of Clinical Genetics, Turku University Hospital, Turku, Finland.", "HaanpääMaria KMKDepartment of Genomics, Turku University Hospital, Turku, Finland.", "MalmbergMarkusMHeart Center, Turku University Hospital, University of Turku, Turku, Finland.", "RahikkalaElisaEDepartment of Genomics, Turku University Hospital, Turku, Finland.Research Unit of Clinical Medicine and Medical Research Center Oulu, University of Oulu and University Hospital, Oulu, Finland." ], "journal": "Annals of human genetics", "journal_abbrev": "Ann Hum Genet", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42892740", "doi": "10.1111/ahg.70064" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-18" } ], "journal_date": "2026Oct18" }, "42892871": { "pmid": "42892871", "title": "Arterial tortuosity syndrome with coronary artery involvement in a middle-aged female: A case report.", "abstract": "Arterial tortuosity syndrome (ATS) is a rare autosomal recessive connective-tissue arteriopathy characterized by diffuse elongation and tortuosity of large and medium-sized arteries. Although it is typically diagnosed during childhood, adult presentation may occur and can be overlooked when overt connective-tissue manifestations are absent; coronary involvement is uncommon but clinically important. A 41-year-old woman presented with a two-week history of exertional substernal chest pain and dyspnea. CT coronary angiography demonstrated marked tortuosity of the left main coronary artery with focal kinking approximately 6.8 mm from its origin and 40-45% luminal stenosis (CAD-RADS 2). Contrast-enhanced CT angiography of the chest, abdomen, and pelvis demonstrated generalized arterial elongation and marked tortuosity involving the thoracic aorta, supra-aortic branches, and abdominal aortic branches, together with early branching of the main pulmonary artery, without aneurysm, dissection, or intramural hematoma. Conventional coronary angiography was technically unsuccessful because of severe arterial tortuosity, with unsuccessful catheter advancement and coronary engagement despite radial and subsequent femoral access. The overall clinical and imaging findings were highly suggestive of ATS with coronary involvement, although molecular genetic confirmation was not available. The patient was managed conservatively with vascular risk-factor optimization and structured follow-up, with symptomatic improvement at one month. This case highlights that ATS may present in adulthood with coronary artery tortuosity and focal kinking and emphasizes the importance of recognizing diffuse multi-territory arterial tortuosity on CT. Comprehensive vascular imaging can establish a strong radiological suspicion of ATS, identify coronary involvement and procedural challenges, and guide surveillance even when genetic confirmation is unavailable.", "authors": [ "ShresthaPrinsaPDepartment of Internal Medicine, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.", "ShahAminADepartment of Internal Medicine, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.", "GcSarojSDepartment of Internal Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal.", "SharmaNiraj KumarNKDepartment of Radiodiagnosis and Imaging, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.", "MahasethAdityaADepartment of Cardiology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.", "ShresthaSanjaya KumarSKDepartment of Cardiology, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal." ], "journal": "Radiology case reports", "journal_abbrev": "Radiol Case Rep", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42892871", "pmc": "PMC13675733", "doi": "10.1016/j.radcr.2026.09.029", "pii": "S1930-0433(26)00865-4" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-10" } ], "journal_date": "2026Dec" }, "42893145": { "pmid": "42893145", "title": "Bacteroides fragilis Empyema Secondary to Ruptured Pyogenic Liver Abscess: A Rare Cause of Septic Shock.", "abstract": "Pyogenic liver abscess is an uncommon but potentially life-threatening intra-abdominal infection associated with significant morbidity and mortality. Although hepatic abscesses most commonly present with systemic infection or intra-abdominal complications, transdiaphragmatic spread into the pleural cavity resulting in empyema is rare. Bacteroides fragilis, an anaerobic gram-negative bacillus that forms part of the normal gastrointestinal flora, is a well-recognized pathogen in polymicrobial intra-abdominal infections but is infrequently reported as a primary pathogen in empyema originating from hepatic sources. We present the case of a 59-year-old man with uncontrolled hypertension, type 2 diabetes mellitus, and alcohol use disorder who presented with acute right-sided chest pain radiating to the back accompanied by dyspnea, fever, nausea, and malaise. On presentation, he was febrile, hypotensive, and tachypneic. Computed tomography (CT) imaging obtained to evaluate possible aortic pathology revealed a mild ascending thoracic aortic aneurysm measuring 4.1 cm without evidence of dissection, as well as a large fluid collection measuring 9.05 × 4.37 cm posterior to the right hepatic lobe concerning for a ruptured hepatic abscess and a moderate right-sided pleural effusion. Abdominal ultrasound confirmed a 9.6 cm hepatic abscess. The patient underwent interventional radiology-guided percutaneous drainage of the hepatic abscess and thoracentesis. Pleural fluid cultures grew Bacteroides fragilis and Staphylococcus warneri, while culture of the hepatic abscess also yielded Bacteroides fragilis, supporting transdiaphragmatic spread of infection from the ruptured hepatic abscess. Despite initial management with broad-spectrum intravenous antibiotics, persistent loculated pleural infection required video-assisted thoracoscopic surgery (VATS) with decortication. The patient subsequently improved clinically and was discharged on oral antibiotics to complete therapy. This case highlights the importance of early recognition of intra-abdominal sources in patients presenting with empyema and underscores the critical role of prompt diagnostic imaging, targeted antimicrobial therapy, and multidisciplinary source control, including percutaneous drainage and surgical intervention, in achieving favorable clinical outcomes and preventing disease progression.", "authors": [ "AlaliMohammadMInternal Medicine, Henry Ford Macomb Hospital, Macomb, USA.", "Al-MwajehTesneemTInternal Medicine, Henry Ford Macomb Hospital, Macomb, USA.", "TalaatMichaelMInternal Medicine, Henry Ford Macomb Hospital, Macomb, USA.", "NaveedAhmed KunwerAKInternal Medicine, Henry Ford Macomb Hospital, Macomb, USA." ], "journal": "Cureus", "journal_abbrev": "Cureus", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42893145", "pmc": "PMC13676434", "doi": "10.7759/cureus.116438" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-17" } ], "journal_date": "2026Sep" }, "42893206": { "pmid": "42893206", "title": "Carotid atherosclerosis and aortic stiffness in masters athletes: Multimodality vascular phenotyping from the Master@Heart study.", "abstract": "BACKGROUND: Middle-aged male Masters athletes exhibit a higher burden of coronary atherosclerosis on coronary computed tomography angiography (CCTA) compared with healthy controls. Whether this is accompanied by differences in carotid atherosclerosis or aortic stiffness remains uncertain. We assessed carotid atherosclerosis and aortic stiffness across groups, association between carotid atherosclerosis and coronary disease, and the incremental value of carotid plaque beyond traditional risk factors.\nMETHODS: In this cross-sectional analysis of the Master@Heart study, 549 low cardiovascular risk men (median age 55 [50-60] years), including lifelong athletes, late-onset athletes, and healthy controls, underwent vascular phenotyping. Carotid plaque was assessed by ultrasound, aortic stiffness by carotid-femoral pulse wave velocity (PWV), and coronary atherosclerosis by CCTA. Group differences were assessed using chi-square and Kruskal-Wallis tests. Association between carotid and coronary atherosclerosis was evaluated using regression models. Incremental discriminatory value was assessed using ROC curve analysis.\nRESULTS: Prevalence of ≥1 carotid plaque did not differ between lifelong athletes, late-onset athletes, and controls (29.5%vs. 33.2% vs. 27.9%; p = 0.54). Carotid stenosis ≥50% was rare (1.2%-2.7%) and similar across groups (p = 0.54). Median PWV did not differ between groups (p = 0.29). Carotid plaque was associated with coronary atherosclerosis on CCTA. However, adding carotid plaque to traditional risk factors did not improve discrimination of coronary atherosclerosis.\nCONCLUSION: In middle-aged male Masters athletes, excess subclinical coronary atherosclerosis is observed without corresponding differences in carotid plaque or aortic stiffness. Although carotid plaque is associated with coronary atherosclerosis, it does not meaningfully improve risk discrimination beyond traditional risk factors.", "authors": [ "PauwelsRikRDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "DausinChristopheCDepartment of Movement Sciences, KU Leuven, Leuven, Belgium.", "De BosscherRubenRDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "De PaepeJarneJDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "BekhuisYouriYDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "DelpireBorisBDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "FavereKasperKDepartment of Cardiology, Ghent University, Ghent, Belgium.", "DuchenneJürgenJDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.", "EijsvogelsThijs M HTMHDepartment of Medical BioSciences, Exercise Physiology Research Group, Radboud University Medical Center, Nijmegen, The Netherlands.", "SinnaevePeterPDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "DymarkowskiStevenSDepartment of Radiology, University Hospitals Leuven, Leuven, Belgium.", "GhekiereOlivierOFaculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Radiology, Jessa Ziekenhuis, Hasselt, Belgium.", "KuznetsovaTatianaTDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.", "HeyningCaroline M Van DeCMVDepartment of Cardiology, Antwerp University Hospital, Antwerp, Belgium.Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.", "Van HerckPaul LPLDepartment of Cardiology, Antwerp University Hospital, Antwerp, Belgium.Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.", "RobynsTomasTDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "HerbotsLievenLDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.", "La GercheAndréAHeart, Exercise and Research Trials (HEART) Lab, St. Vincent's Institute of Medical Research, Melbourne, Australia.Department of Cardiology, St. Vincent's Hospital Melbourne, Fitzroy, Australia.HEART Lab, Victor Chang Cardiovascular Research Institute, Darlinghurst, NSW, 2010, Australia.", "HeidbuchelHeinHDepartment of Cardiology, Antwerp University Hospital, Antwerp, Belgium.Department of Cardiovascular Sciences, University of Antwerp, Antwerp, Belgium.", "WillemsRikRDepartment of Cardiovascular Sciences, KU Leuven, Leuven, Belgium.Department of Cardiology, University Hospitals Leuven, Leuven, Belgium.", "ClaessenGuidoGDepartment of Cardiology, Hartcentrum, Jessa Ziekenhuis, Hasselt, Belgium.Faculty of Medicine and Life Sciences, Biomedical Research Institute, LCRC, UHasselt, Diepenbeek, Belgium.Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium." ], "journal": "American journal of preventive cardiology", "journal_abbrev": "Am J Prev Cardiol", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42893206", "pmc": "PMC13676064", "doi": "10.1016/j.ajpc.2026.101771", "pii": "S2666-6677(26)00345-4" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-07-25" } ], "journal_date": "2027Jan" }, "42893525": { "pmid": "42893525", "title": "Environmental Exposures, Chronic Sinusitis, and Olfaction in People With Cystic Fibrosis.", "abstract": "BACKGROUND: Environmental air pollutants may contribute to chronic rhinosinusitis (CRS), but their relationship with upper airway disease in people with cystic fibrosis (CF) remains poorly understood. This study evaluated associations between long-term ambient air pollutant exposure and CRS severity and olfactory dysfunction in adults with CF and CRS.\nMETHODS: 80 adults with CF and comorbid CRS were prospectively enrolled from 2019 to 2023 at multiple U.S. academic rhinology centers. Long-term exposure to PM2.5, PM10, CO, SO2, NO2, and ozone was estimated using the nearest U.S. Environmental Protection Agency monitor linked to each participant's residential ZIP code, with 3-year mean exposure calculated before enrollment. CRS severity and olfaction were assessed using Lund-Kennedy endoscopy scores, Lund-Mackay CT scores, SNOT-22, Questionnaire of Olfactory Disorders-Negative Statements, and 40-item Smell Identification Test. Analyses used Spearman correlations and nonparametric group comparisons.\nRESULTS: Higher ozone exposure was associated with worse total SNOT-22 scores (Rs = 0.34 p = 0.002), including ear/facial, psychological, and sleep dysfunction domains, as well as worse olfactory-specific outcomes, including higher QOD-NS scores (Rs = 0.30, p = 0.007) and lower Smell Identification Test scores (Rs = -0.30, p = 0.018). Other pollutants did not show significant associations with CRS or olfactory outcomes.\nCONCLUSIONS: In adults with CF and CRS, higher long-term ambient ozone exposure was associated with greater sinonasal symptom burden and worse olfactory function. These findings suggest that ozone may be an environmental contributor to upper airway disease severity in this population and support further study in larger, adjusted analyses.\nKEY POINTS: Increased ozone pollution correlates with more severe CRS in people with CF. Among people with CF and CRS, higher ozone exposure is associated with worse olfactory function.", "authors": [ "TullisBentonBDepartment of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.", "NicolasLarissaL0009-0009-0886-6849Department of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.", "AltJeremiah AJA0000-0003-0560-5028Department of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.", "BodnerTodd ETEDepartment of Psychology, Portland State University, Portland, Oregon, USA.", "ChangMichaelM0000-0001-9519-5880Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California, USA.", "ChowdhuryNaweed INIDepartment of Otolaryngology - Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.", "ChungSeiSDepartment of Otolaryngology, University of Texas Southwestern, Dallas, Texas, USA.", "EshaghianPatriciaPDepartment of Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.", "GaoYuqing AYADepartment of Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.", "GetzAnneADepartment of Otolaryngology - Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.", "GillAmarbir SASDepartment of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA.", "HwangPeter HPH0000-0002-0786-4675Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California, USA.", "KhanwalkarAshokeA0000-0001-9960-7758Department of Otolaryngology - Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.", "KimpleAdam JAJDepartment of Otolaryngology - Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.", "KingdomToddT0000-0002-4379-0490Department of Otolaryngology - Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.", "LeeJivianne TJTDepartment of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.", "LiDouglas ADADepartment of Pediatric Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.", "MaceJess CJC0000-0001-5009-3426Department of Otolaryngology - Head and Neck Surgery, Oregon Health & Science University, Portland Oregon, USA.", "NayakJayakar VJV0000-0003-4454-0861Department of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California, USA.", "NorrisMeghanMDepartment of Otolaryngology - Head and Neck Surgery, University of North Carolina, Chapel Hill, North Carolina, USA.", "OverdevestJonathan BJB0000-0002-1152-2512Department of Otolaryngology, Columbia University Medical Center, New York, New York, USA.", "PatelZara MZM0000-0003-2072-982XDepartment of Otolaryngology - Head and Neck Surgery, Stanford University, Stanford, California, USA.", "PochKatieKDepartment of Medicine, National Jewish Health, Denver, Colorado, USA.", "SchlosserRodney JRJ0000-0001-6480-0275Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.", "SmithKristine AKADepartment of Otolaryngology - Head and Neck Surgery, University of Utah, Salt Lake City, Utah, USA.", "SolerZachary MZMDepartment of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.", "SuhJeffrey DJDDepartment of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.", "TurnerGrant AGADepartment of Pulmonary Medicine, University of California Los Angeles, Los Angeles, California, USA.", "WangMarilene BMBDepartment of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA.", "SaavedraMilene TMTDepartment of Medicine, National Jewish Health, Denver, Colorado, USA.", "TaylorJennifer LJLDepartment of Otolaryngology - Head and Neck Surgery, University of Colorado, Aurora, Colorado, USA.Department of Medicine, National Jewish Health, Denver, Colorado, USA.", "BeswickDaniel MDM0000-0001-8612-5442Department of Otolaryngology - Head and Neck Surgery, University of California Los Angeles, Los Angeles, California, USA." ], "journal": "International forum of allergy & rhinology", "journal_abbrev": "Int Forum Allergy Rhinol", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42893525", "doi": "10.1002/alr.70204" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-18" } ], "journal_date": "2026Oct18" }, "42893682": { "pmid": "42893682", "title": "8th International consensus guidelines for the management of advanced breast cancer (ABC8 guidelines).", "abstract": "The Advanced Breast Cancer (ABC) 8th international consensus conference took place on 6-8 November 2025, in Lisbon, and updated the previous ABC international consensus guidelines that are described in this manuscript. These guidelines reflect the work of a large and global consensus panel, comprising healthcare professionals and patients, and provide recommendations on how to best manage patients with advanced breast cancer (inoperable locally advanced or metastatic), of all breast cancer subtypes. The guidelines are based on the best available evidence or on expert opinion when a higher level of evidence is lacking and aim to cover the needs of the person living with ABC, including but also beyond the main therapeutic recommendations. Each guideline is accompanied by the level of evidence (LoE), the grade of recommendation (GoR), and the percentage of consensus reached at the consensus session. Updated diagnostic and treatment algorithms are also provided. These guidelines are endorsed by several international oncology organizations (AGO, AORTIC, ECO, EONS, ESO, ESTRO, EUSOMA, GECO Perú, SUMA, MASCC, French Breast Cancer Guidelines and AMAAC) and have official representation from ASCO, NCCN and ABC-NZ. Inequalities in access to high-quality care have increased in the last decade, both between and within countries, and are a major concern. The ABC guidelines provide guidance on the best available management options for patients living with ABC globally, assuming availability of the recommended therapies. Their adaptation is often needed in resource-constrained settings, and the grading of each recommendation may help in prioritizing access to available options.", "authors": [ "CardosoFatimaFABC Global Alliance, Lisbon, Portugal; Centre Antoine Lacassagne, Nice, France. Electronic address: fcardoso@abcglobalalliance.org.", "RibeiroJoana MouratoJMGustave Roussy, Villejuif, France.", "Schumacher-WulfEvaEMamma Mia, Kronberg, Germany.", "SwainSandra MSMGeorgetown University Lombardi Comprehensive Cancer Center and MedStar Health, Washington, USA.", "Paluch-ShimonShaniSHadassah University Hospital - Sharett Institute of Oncology and Faculty of Medicine, Hebrew University, Jerusalem, Israel.", "Penault-LlorcaFrederiqueFCentre Jean Perrin, Université Clermont Auvergne, INSERM, U1240 Imagerie Moléculaire et Stratégies Théranostiques, Clermont Ferrand, France.", "LinNancy UNUDana-Farber Cancer Institute, Boston, USA.", "FrancisPrudence APAPeter MacCallum Cancer Centre Melbourne, Australia.", "Kuper-HommelMarionMTe Whatu Ora-Health New Zealand, Te Manawa Taki, Waikato District, Hamilton, New Zealand.", "MayAnneAUniversity Medical Center Utrecht, Netherlands.", "HilbersFlorentineFNetherlands Cancer Institute, The Netherlands and AURORA Steering Committee, Amsterdam, Netherlands.", "GuerreroAngelAInstituto Valenciano de Oncologia, Valencia, Spain; AURORA Steering Committee, Valencia, Spain.", "AaproMatti SMSIMO Clinique de Genolier, Institut Multidisciplinare d'Oncologie, Genolier, Switzerland.", "AzmiRaniaRFadia Survive & Thrive, Salmiya, Kuwait.", "BajpaiJyotiJTata Memorial Hospital, Mumbai, India.", "BarriosCarlosCCentro de Pesquisa em Oncologia, Hospital São Lucas, PUCRS and Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil.", "BiganzoliLauraLDepartment of Oncology, Hospital of Prato, Azienda USL Toscana Centro, Prato, Italy.", "BoyleFranFThe Pam McLean Centre, Royal North Shore Hospital, St. Leonards, Australia.", "CaceresValeriaVInstituto de Oncología \"Ángel H. Roffo\", Buenos Aires, Argentina.", "CareyLisa ALAUNC Lineberger Comprehensive Cancer Center, Chapel Hill, USA.", "Chavez-MacGregorMarianaMThe University of Texas MD Anderson Cancer Center, Houston, USA.", "CortésJavierJInternational Breast Cancer Center (IBCC), Madrid and Barcelona, Spain.", "DentRebeccaRNational Cancer Center Singapore, Singapore.", "DruryAmandaATrinity Centre for Healthcare Practice and Innovation, School of Nursing and Midwifery, Trinity College Dublin, Ireland.", "El SaghirNagi SNSNK Basile Cancer Institute American University of Beirut Medical Center, Beirut, Lebanon.", "ElghazalyHeshamHBreast and Gynaecological International Cancer Society, Cairo, Egypt.", "EniuAlexandruABreast Center, Genolier Cancer Center, Genolier, Switzerland.", "FallowfieldLesleyLSussex Health Outcomes Research & Education in Cancer, Brighton & Sussex Medical School, University of Sussex, Brighton, UK.", "Franco MillanSandra XimenaSXCTIC Cancer Treatment and Research Center, Bogotá, Colombia.", "GelmonKarenKBritish Columbia Cancer Agency, Vancouver, Canada.", "GilchristJennyJMacquarie University, Sydney, Australia.", "GligorovJosephJCancer Est APHP Tenon, University Paris VI, Paris, France.", "GradisharWilliam JWJRobert H. Lurie Comprehensive Cancer Center and Northwestern University Feinberg School of Medicine, Chicago, USA.", "HarbeckNadiaNBreast Centre, University of Munich, Munich, Germany.", "HuXichunXFudan University Shanghai Cancer Center, Shanghai, China.", "Kaidar-PersonOritOSheba Medical Center, Ramat Gan and Gray Faculty of Medical & Health Sciences, Tel Aviv University, Israel.", "KaurRanjitRNational Cancer Society Malaysia (NCSM), Kuala Lumpur, Malaysia.", "KielyBelindaBNHMRC Clinical Trials Centre, Sydney Medical School, Sydney, Australia.", "KimSung-BaeSBAsan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea.", "NyagabonaSarah KutikaSKMuhimbili National Hospital, Dar es Salaam, Tanzania.", "LustbergMaryamMYale Cancer Center, New Haven, USA.", "MuellerVolkmarVUniversity Medical Center Hamburg-Eppendorf, Hamburg, Germany.", "MutebiMiriamMAga Khan University, Department of Surgery, Nairobi, Kenya.", "NeciosupSilviaSNational Institute of Neoplastic Diseases, Lima, Peru.", "OhnoShinjiSSagara Hospital, Kagoshima, Japan.", "PistilliBarbaraBGustave Roussy, Villejuif, France.", "RugoHope SHSCity of Hope Comprehensive Cancer Center, San Francisco, USA.", "SpanicTanjaTEuropa Donna Slovenia, Ljubljana, Slovenia.", "TsangJaniceJThe University of Hong Kong, Hong Kong Special Administrative Region of China.", "VuylstekePeterPCHU Brugmann Hospital, Brussels, Belgium.", "XuBingheBNational Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China.", "NortonLarryLMemorial Sloan-Kettering Cancer Centre, New York, USA.", "WinerEric PEPYale Cancer Center, Yale University School of Medicine, New Haven, CT, USA." ], "journal": "Breast (Edinburgh, Scotland)", "journal_abbrev": "Breast", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42893682", "doi": "10.1016/j.breast.2026.104921", "pii": "S0960-9776(26)00231-6" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-17" } ], "journal_date": "2026Sep17" }, "42894227": { "pmid": "42894227", "title": "Emergency ascending aortic replacement for acute type a aortic dissection in a 31-week pregnant patient with Marfan syndrome.", "abstract": "BACKGROUND: Acute type A aortic dissection during pregnancy is a rare but life-threatening condition, with an estimated incidence of approximately 4 cases per 1 million women aged 15-45 years. Hormonal and hemodynamic changes during pregnancy are factors that may predispose to aortic dissection. These changes begin in the first and second trimesters but are most pronounced in the third trimester and the early postpartum period. Genetic syndromes, such as Marfan syndrome, significantly increase the risk of aortic dissection.\nCASE PRESENTATION: A 41-year-old pregnant woman at 31 weeks of gestation with genetically confirmed Marfan syndrome presented with acute, severe, sharp retrosternal chest pain lasting four hours, radiating to the neck, accompanied by weakness and dizziness. Transthoracic echocardiography revealed dilation of the ascending aorta without significant aortic valve regurgitation. Computed tomography angiography confirmed the diagnosis of Stanford type A aortic dissection. Following a multidisciplinary team decision, an initial cesarean section with subsequent uterine artery embolization was performed, followed by emergency ascending aortic replacement. The patient and the newborn were successfully discharged on postoperative day 20.\nCONCLUSIONS: Although aortic dissection during pregnancy is rare, clinicians must maintain a high suspicion index for pregnant women presenting with severe chest pain. Careful monitoring of patients with suspected or confirmed connective tissue disorders is essential. This case demonstrates that acute type A aortic dissection may occur in pregnant patients with Marfan syndrome despite only moderate aortic root enlargement and highlights the value of rapid multidisciplinary management, including coordinated obstetric, endovascular, and cardiac surgical intervention.", "authors": [ "UpenieksKrišjānisKRīga Stradiņš University, Riga, Latvia. krisjanisupenieks@gmail.com.", "MeidropsKristiānsKDepartment of Surgery, Riga Stradiņš University, Riga, Latvia.Centre of Cardiac Surgery, Pauls Stradiņš Clinical University Hospital, Riga, Latvia.", "BrečsIvarsIDepartment of Surgery, Riga Stradiņš University, Riga, Latvia.Centre of Cardiac Surgery, Pauls Stradiņš Clinical University Hospital, Riga, Latvia.", "VeissAndrisAInstitute of Diagnostic Radiology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia." ], "journal": "Journal of cardiothoracic surgery", "journal_abbrev": "J Cardiothorac Surg", "publication_types": [ "Journal Article", "Case Reports" ], "ids": { "pubmed": "42894227", "doi": "10.1186/s13019-026-04575-y", "pii": "10.1186/s13019-026-04575-y", "pmc": "PMC13679015" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-07-22" } ], "journal_date": "2026Jul22" }, "42894393": { "pmid": "42894393", "title": "Predictors of Surveillance Imaging Non-compliance Among Patients with TEVAR for Blunt Thoracic Aortic Injury.", "abstract": "ObjectivesBlunt Thoracic Aortic Injury (BTAI) is the second leading cause of death for patients with blunt trauma. Thoracic endovascular aortic repair (TEVAR) has become the standard of care for high-grade BTAI, reducing morbidity and mortality while requiring long-term surveillance imaging to ensure graft integrity and prevent future complications. However, adherence to this protocol is poor. Previous studies evaluating the factors associated with post-operative imaging non-compliance have yielded conflicting results. This study aimed to evaluate predictors of post-TEVAR non-compliance inpatients presenting with BTAI.MethodsA retrospective study on 23 patients was conducted using a single institution Aortic Center Database (2015-2025). Inclusion criteria included patients who were age >18 years and underwent TEVAR for BTAI. Demographic, comorbidity, hospital course, and follow-up data were collected. The Distressed Communities Index (DCI) score was derived from patient's home address ZIP code. Time-to-event analysis defined loss to follow up (LTFU) for vascular imaging as the failure event. Patients were censored at death or if compliant through 1 year following the index TEVAR. Statistical analysis included chi-square, t-tests, and Kaplan-Meier survival.ResultsBased on this single-center review on TEVAR follow-up for BTAI, sex, race, and hospital length of stay did not impact compliance. Medical comorbidities were also non-significant. Patients who presented with a lower injury severity score (P = 0.02) and lived more than 20 miles from their follow-up appointment (P = 0.02) were more likely to be LTFU. While the type of facility was not impactful, all patients who were discharged to a non-home location were LTFU. Interestingly, DCI and insurance status had no impact on follow-up non-compliance.ConclusionsThis study supports the development of targeted, patient-centered surveillance strategies, especially amongst rural populations and those discharged to a non-home location. To fully understand this complex problem, further investigation using a larger database may be indicated.", "authors": [ "PekarBorisBDivision of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.2345", "AndersonMatthew PatrickMPDivision of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.2345", "GadsdenLizaLDivision of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.2345", "TaniousAdamADivision of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.2345", "MukherjeeRupakRDivision of Cardiothoracic Surgery, Medical University of South Carolina, Charleston, SC, USA.2345", "RuddyJean MarieJM0000-0002-4148-9549Division of Vascular Surgery, Medical University of South Carolina, Charleston, SC, USA.2345Ralph H Johnson VA Medical Healthcare System, Charleston, SC, USA." ], "journal": "Vascular and endovascular surgery", "journal_abbrev": "Vasc Endovascular Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42894393", "doi": "10.1177/15385744261501084" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-18" } ], "journal_date": "2026Oct18" }, "42894505": { "pmid": "42894505", "title": "Unexpected major venous injury in the setting of percutaneous arterial access for GORE TAG Thoracic Branch Endoprosthesis.", "abstract": "Inferior vena cava (IVC) injury during thoracic endovascular aortic repair is exceedingly rare. We present the case of an 80-year-old woman who developed a fatal IVC perforation at the iliac confluence during large-bore (24F) sheath insertion for thoracic endovascular aortic repair. Despite successful thoracic endograft deployment, the patient developed acute hypotension and hemorrhagic shock. Emergent exploratory laparotomy revealed hemoperitoneum from an IVC tear, likely caused by shearing forces transmitted through heavily calcified iliac arteries. This case highlights the importance of preoperative access planning in patients with small, calcified iliac vessels and maintaining a low threshold for suspecting retroperitoneal venous injury when clinical findings differ from angiography results.", "authors": [ "DoehringSamantha GSGBoonshoft School of Medicine, Wright State University, Dayton, OH.", "MoberlyAuroraADepartment of Surgery, Wright State University, Dayton, OH.", "PanJamesJDepartment of Surgery, Wright State University, Dayton, OH.Premier Vascular Surgeons, Premier Health, Dayton, OH.", "SchwartzbergGlenGDepartment of Surgery, Wright State University, Dayton, OH.Premier Vascular Surgeons, Premier Health, Dayton, OH.", "FoorJohnJDepartment of Surgery, Wright State University, Dayton, OH.Premier Vascular Surgeons, Premier Health, Dayton, OH.", "SassonJordanJDepartment of Surgery, Wright State University, Dayton, OH.Premier Vascular Surgeons, Premier Health, Dayton, OH.", "AuyangPhilipPDepartment of Surgery, Wright State University, Dayton, OH.Premier Vascular Surgeons, Premier Health, Dayton, OH." ], "journal": "Journal of vascular surgery cases and innovative techniques", "journal_abbrev": "J Vasc Surg Cases Innov Tech", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42894505", "pmc": "PMC13676473", "doi": "10.1016/j.jvscit.2026.102502", "pii": "S2468-4287(26)00386-2" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-04" } ], "journal_date": "2026Dec" }, "42894960": { "pmid": "42894960", "title": "Comprehensive cardiac, vascular, and pulmonary characterization of a cardiometabolic HFpEF model.", "abstract": "BACKGROUND: Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous syndrome in which translational progress is limited by experimental models that insufficiently reflect the cardiometabolic phenotype while affecting endogenous endothelial function. We aimed to characterize a cardiometabolic \"two-hit\" HFpEF model combining metabolic stress (db/db) with chronic mineralocorticoid excess (d-aldosterone), focusing on integrated cardiac, vascular, and pulmonary phenotyping.\nMETHODS: Female db/db mice received 4-week d-aldosterone (0.3 µg/h) or vehicle via osmotic minipumps. Metabolic profiling, high-resolution echocardiography including strain and left atrial mechanics, invasive right-heart catheterization, and thoracic aortic wire myography were performed.\nRESULTS: Aldosterone-treated db/db mice developed cardiac hypertrophy and pulmonary congestion with preserved LVEF but marked diastolic dysfunction, left atrial remodeling with increased stiffness, and impaired global longitudinal LV strain. Pulmonary hypertension with right ventricular dysfunction was evidenced by elevated RVSP/estimated mPAP, reduced PAT/PET, and reduced TAPSE. Thoracic aortae from untreated db/db mice already showed impaired endothelium-dependent relaxation, which was further aggravated by aldosterone, whereas maximal endothelium-independent relaxation remained largely preserved.\nCONCLUSIONS: The db/db+d-aldosterone model recapitulates key features of cardiometabolic HFpEF across the cardiac-vascular-pulmonary axis and provides a translational platform for mechanistic and therapeutic studies targeting endothelial and ventricular-vascular dysfunction in HFpEF. New & Noteworthy: Current HFpEF animal models often limit the investigation of vascular dysfunction, a central component of cardiometabolic HFpEF. We provide a comprehensive functional characterization of a db/db+d-aldosterone two-hit model demonstrating obesity, diabetes, diastolic dysfunction, atrial remodeling, endothelial dysfunction, pulmonary hypertension, and right ventricular impairment. By preserving endogenous endothelial nitric oxide signaling, this model offers a translational platform for studying vascular and cardiopulmonary mechanisms in cardiometabolic HFpEF.", "authors": [ "AykacIbrahimI0000-0002-1346-6227Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria.Institue for Experimental Cardiology, University Hospital Heidelberg, Heidelberg, Germany.", "BaumgartnerChristoph ACA0009-0008-8859-4355Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria.", "HamzaOuafaO0000-0002-3025-7064Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria.", "KissAttilaA0000-0003-4652-1998Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria.", "PodesserBruno KBK0000-0002-4641-7202Center for Biomedical Research and Translational Surgery, Medical University of Vienna, Vienna, Austria." ], "journal": "Disease models & mechanisms", "journal_abbrev": "Dis Model Mech", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42894960", "doi": "10.1242/dmm.053163", "pii": "373209" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct19" }, "42895002": { "pmid": "42895002", "title": "Cardiovascular Genetic Counseling Is Associated With Improved Patient-Reported Outcomes Across Clinical Indications and Settings.", "abstract": "BACKGROUND: Contemporary guidelines recommend genetic counseling for potentially inherited cardiomyopathies, channelopathies, aortopathies, and dyslipidemias, but few small studies characterize cardiovascular genetic counseling (CVGC) outcomes, impeding efforts to improve CVGC service delivery. We aimed to (1) quantify psychosocial CVGC outcomes, (2) identify clinical, demographic, and service delivery characteristics associated with the extent of benefit from CVGC, and (3) determine how outcomes are associated with patient-reported quality of the genetic counselor:patient alliance.\nMETHODS: The MCVGC-GO (Multicenter Cardiovascular Genetic Counseling Outcomes Study) is a longitudinal survey-based study with pre- and post- genetic counseling data collection. Eight hundred ninety adults attending a first outpatient CVGC appointment at 8 United States and Canadian medical centers completed questionnaires assessing empowerment (Genetic Counseling Outcome Scale-24), worry (modified Cancer Worry Scale), cardiac anxiety (Cardiac Anxiety Questionnaire [CAQ]), and genetic counselor:patient alliance (Working Alliance Inventory-patient) before and up to 4 weeks post-CVGC, but before results of genetic tests ordered were returned to decouple CVGC and genetic test result impact.\nRESULTS: Following CVGC, empowerment increased (Genetic Counseling Outcome Scale score change, +5.94±11.6; P<0.001), worry decreased (Cancer Worry Scale score change, -0.40±3.55; P=0.002), and cardiac fear decreased (CAQ fear subscale change, -0.034±0.46; P=0.033) with no change in whole-scale CAQ (0.013±0.34; P=0.29). In linear regression, worry decreased most in patients with less formal education (P=0.0021), with an arrhythmia indication (P=0.013), and who were at-risk family members (P=0.016) and the strength of the genetic counselor:patient alliance had no impact. In contrast, the genetic counselor:patient alliance was strongly positively associated with change in empowerment (P<0.001).\nCONCLUSIONS: This observational, multicenter, multiprovider study provides foundational evidence that CVGC is associated with increased empowerment and decreased worry in adults attending outpatient CVGC and suggests opportunities for optimizing CVGC services.", "authors": [ "MurrayBrittneyB0000-0001-7870-8584Division of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "GordonCatherineCDivision of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "ChristianSusanS0000-0001-5248-3049Department of Medical Genetics, University of Alberta, Edmonton, Canada (S.C., T.D.).3158", "DzwinielTaraT0009-0008-8051-8825Department of Medical Genetics, University of Alberta, Edmonton, Canada (S.C., T.D.).3158", "TichnellCrystalCDivision of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "BrownEmilyE0000-0001-7642-9784Division of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "MacCarrickGretchenG0000-0003-4286-0693Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD (G.M., C.A.J.).1466", "McClellanRebeccaR0000-0002-7020-7758Division of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "ReuterChloeC0000-0002-0429-9922Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "IsonHannahH0000-0002-7352-4281Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "CarterJenneferJ0000-0003-0830-3535Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "MoscarelloTiaT0000-0001-7606-9459Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "MurthaRyanR0000-0002-1209-6914Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "ParianiMitchelM0000-0002-6925-2869Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "PlattJuliaJ0000-0002-2486-9902Division of Cardiovascular Medicine, Department of Medicine, Stanford Center for Inherited Cardiovascular Disease, Stanford University School of Medicine, Palo Alto, CA (C. Reuter, H.I., J.C., T.M., R. Murtha, M.P., J.P.).", "RigelskyChristinaCDepartment of Medical Genetics and Genomics, Cleveland Clinic, OH (C. Rigelsky, D.C., P.C., J.L.).2569", "ClementsDianeD0009-0004-5000-7937Department of Medical Genetics and Genomics, Cleveland Clinic, OH (C. Rigelsky, D.C., P.C., J.L.).2569", "CrawfordPaulP0009-0001-9988-439XDepartment of Medical Genetics and Genomics, Cleveland Clinic, OH (C. Rigelsky, D.C., P.C., J.L.).2569", "LiuJosephJ0000-0001-6358-1533Department of Medical Genetics and Genomics, Cleveland Clinic, OH (C. Rigelsky, D.C., P.C., J.L.).2569", "JordanElizabethE0000-0002-2073-3258Division of Human Genetics, Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, OH (E.J.).", "HylindRobyn JRJ0000-0002-8280-4541Center for Cardiovascular Genetics, Boston Children's Hospital and Harvard Medical School, MA (R.J.H., A.C.S.).", "WongEugene KEK0000-0001-7866-733XCardiology Division, Cardiovascular Genetics Program, Massachusetts General Hospital, Boston (E.K.W., S.W.).Center for Genomic Medicine, Massachusetts General Hospital, Boston (E.K.W., S.W.).", "WangSarahSCardiology Division, Cardiovascular Genetics Program, Massachusetts General Hospital, Boston (E.K.W., S.W.).Center for Genomic Medicine, Massachusetts General Hospital, Boston (E.K.W., S.W.).", "Lindsay-MillsZoeZ0009-0005-2473-322XDepartment of Genomic Health, College of Health Sciences, Geisinger, Danville, PA (Z.L.-M., M.B., E.T., A.C.S., A.H.B.).", "BettsMeganM0009-0004-7308-103XDepartment of Genomic Health, College of Health Sciences, Geisinger, Danville, PA (Z.L.-M., M.B., E.T., A.C.S., A.H.B.).Department of Precision Medicine and Genomics, WellSpan Health, York, PA (M.B.).", "TricouEricE0000-0002-8098-1990Department of Genomic Health, College of Health Sciences, Geisinger, Danville, PA (Z.L.-M., M.B., E.T., A.C.S., A.H.B.).", "SturmAmy CAC0000-0001-6839-7786Center for Cardiovascular Genetics, Boston Children's Hospital and Harvard Medical School, MA (R.J.H., A.C.S.).Department of Genomic Health, College of Health Sciences, Geisinger, Danville, PA (Z.L.-M., M.B., E.T., A.C.S., A.H.B.).", "BuchananAdam HAH0000-0002-6518-2453Department of Genomic Health, College of Health Sciences, Geisinger, Danville, PA (Z.L.-M., M.B., E.T., A.C.S., A.H.B.).", "Fitzgerald-ButtSaraS0000-0003-2316-2486Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis (S.F.-B., B.M.H.).12250", "HelmBenjamin MBM0000-0002-5597-0202Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis (S.F.-B., B.M.H.).12250", "YeatesLauraL0000-0001-8348-815XGenomics and Inherited Disease Program, Garvan Institute of Medical Research, and UNSW Sydney, New South Wales, Australia (L. Yeates, J.I.).School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia (L. Yeates, J.I.).", "CaleshuColleenC0000-0002-5339-8150Genome Medical, Inc, South San Francisco, CA (C.C.).", "InglesJodieJ0000-0002-4846-7676Genomics and Inherited Disease Program, Garvan Institute of Medical Research, and UNSW Sydney, New South Wales, Australia (L. Yeates, J.I.).School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia (L. Yeates, J.I.).", "YanekLisa RLR0000-0001-7117-1075Division of General Internal Medicine, Department of Medicine (L. R. Yanek), Johns Hopkins University School of Medicine, Baltimore, MD.1500", "JamesCynthia ACA0000-0001-8040-4600Division of Cardiology, Department of Medicine (B.M., C.G., C.T., E.B., R. McClellan, C.A.J.), Johns Hopkins University School of Medicine, Baltimore, MD.1500Department of Genetic Medicine, Johns Hopkins University, Baltimore, MD (G.M., C.A.J.).1466" ], "journal": "Circulation. Genomic and precision medicine", "journal_abbrev": "Circ Genom Precis Med", "publication_types": [ "Journal Article", "Multicenter Study" ], "ids": { "pubmed": "42895002", "doi": "10.1161/CIRCGEN.125.005514" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct" }, "42895320": { "pmid": "42895320", "title": "Successful systemic fibrinolysis in pulmonary embolism with a thrombus-in-transit.", "abstract": "Right heart thrombus-in-transit with acute pulmonary embolism (PE) is a rare but potentially lethal clinical finding. Optimal management remains controversial, particularly when major contraindications or risk factors coexist. We present a 72-year-old male admitted to the emergency room with leading diagnosis acute coronary syndrome who was later diagnosed with acute PE and a massive, mobile right heart thrombus along with a concomitant ascending aortic aneurysm. Due to high surgical risk, systemic fibrinolysis was performed under close monitoring. Follow-up echocardiography demonstrated complete resolution of the intracardiac thrombus, rapid right ventricular recovery, and an intact thoracic aorta. This case highlights the importance of echocardiography in initial evaluation of patients with acute cardiovascular symptoms and also systemic thrombolysis as a viable, life-saving strategy for right heart thrombosis even in complex clinical scenarios.", "authors": [ "IvanovaSilviaSDepartment of Cardiology, Aleksandrovska University Hospital, Medical University of Sofia.", "IrfanIrfanIDepartment of Anesthesiology and Intensive care, Alexandrovska University Hospital, Sofia, Bulgaria.", "RadkovaMariaMDepartment of Cardiology, Aleksandrovska University Hospital, Medical University of Sofia.", "StoyanovaKristinaKDepartment of Cardiology, Aleksandrovska University Hospital, Medical University of Sofia.", "KaramfiloffKirilKDepartment of Cardiology, Aleksandrovska University Hospital, Medical University of Sofia." ], "journal": "Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis", "journal_abbrev": "Blood Coagul Fibrinolysis", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42895320", "doi": "10.1097/MBC.0000000000001468", "pii": "00001721-990000000-00281" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-20" } ], "journal_date": "2026Oct20" }, "42895672": { "pmid": "42895672", "title": "ASO Author Reflections: Para-aortic Lymph Node Metastasis in Colorectal Cancer.", "abstract": "", "authors": [ "DenysAndreasADepartment of Human Structure and Repair, Ghent University, Ghent, Belgium.Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.", "VerstraeteAmandaADepartment of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.", "GeboesKarenKDepartment of Human Structure and Repair, Ghent University, Ghent, Belgium.Department of Gastroenterology, Ghent University Hospital, Ghent, Belgium.", "van RamshorstGabrielle HGHDepartment of Human Structure and Repair, Ghent University, Ghent, Belgium. gabrielle.vanramshorst@uzgent.be.Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium. gabrielle.vanramshorst@uzgent.be." ], "journal": "Annals of surgical oncology", "journal_abbrev": "Ann Surg Oncol", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42895672", "doi": "10.1245/s10434-026-20803-0", "pii": "10.1245/s10434-026-20803-0" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct19" }, "42896564": { "pmid": "42896564", "title": "Updated treatment targets in inflammatory bowel disease (STRIDE-III): an initiative of the International Organization for the Study of IBD.", "abstract": "Since Selecting Therapeutic Targets in Inflammatory Bowel Disease-II (STRIDE-II), new evidence has become available across inflammatory and patient-centred outcomes. We aimed to update the STRIDE recommendations for Crohn's disease and ulcerative colitis. We searched MEDLINE, Embase, and Cochrane CENTRAL for studies published after the STRIDE-II search period. Findings were integrated with surveys of International Organization for the Study of IBD (IOIBD) members and paediatric gastroenterologists from the Porto group of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition. Statements were subsequently voted on using a modified Delphi approach; consensus was defined as ≥75% of participants rating a statement 7-10 on a 10-point scale. Of 13 071 records identified in the systematic review, 1018 were included. Surveys were completed by 60 of 79 IOIBD gastroenterologists and 23 of 30 paediatric gastroenterologists in the Porto group. STRIDE-III defines three conceptually distinct categories of treatment targets. Actionable targets include clinical response and remission, which reflect patient priorities, and objective inflammatory targets (C-reactive protein normalisation, faecal calprotectin within target range, and endoscopic remission), supported by interventional evidence demonstrating benefits of target-guided treatment modification. Adjunctive targets (ie, urgency, histological remission in ulcerative colitis, transmural remission in Crohn's disease, and growth) are supported by studies showing association with favourable outcomes and guide treatment optimisation and tighter monitoring but do not necessarily require a change in therapeutic class. Patient-centred targets (ie, disability, fatigue, and quality of life) directly reflect patients' well-being and are impaired in a substantial proportion of patients with inflammatory bowel disease; impairment should prompt assessment of inflammation and alternative causes and management through shared decision-making. Targets are further classified as immediate, short-term, intermediate, and long-term. STRIDE-III also defines treatment-specific times to target achievement, new faecal calprotectin thresholds, and adaptations for resource-limited settings. STRIDE-III distinguishes targets that should prompt treatment change from those that primarily guide optimisation and monitoring, while establishing a separate patient-centred pathway based on shared decision-making. This framework supports consistent, evidence-based treat-to-target care.", "authors": [ "TurnerDanDThe Juliet Keidan Institute of Pediatric Gastroenterology, Hepatology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.", "RicciutoAmandaADivision of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Department of Paediatrics, University of Toronto, Toronto, ON, Canada.", "Yuval Bar-AsherShiraSThe Juliet Keidan Institute of Pediatric Gastroenterology, Hepatology and Nutrition, The Eisenberg R&D Authority, Shaare Zedek Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.", "VuyyuruSudheer KSKDivision of Gastroenterology, Department of Medicine, Western University, London, ON, Canada.", "SolitanoVirginiaVDivision of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.", "BockNadineNDepartment of Medicine I, Agaplesion Markus Hospital, Goethe University Frankfurt, Frankfurt, Germany.", "EstevinhoMaria ManuelaMMDepartment of Gastroenterology, Unidade Local de Saúde Gaia Espinho, Vila Nova de Gaia, Portugal; Department of Biomedicine, Unit of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Porto, Portugal.", "YuanYuhongYDivision of Gastroenterology, Department of Medicine, Western University, London, ON, Canada.", "IacucciMariettaMDepartment of Medicine, College of Medicine and Health, University College Cork, Cork, Ireland.", "RiederFlorianFDepartment of Gastroenterology, Hepatology and Nutrition, Digestive Diseases Institute, Cleveland Clinic, Cleveland, OH, USA.", "LeongRupert WRWDepartment of Gastroenterology, Concord Repatriation General Hospital, and Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.", "ReinischWalterWDivision of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.", "LoftusEdward VEVJrDivision of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.", "Peyrin-BirouletLaurentLNorthwestern Medicine, Digestive Health Institute, Chicago, IL, USA.", "DaneseSilvioSDivision of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.", "PanaccioneRemoRDivision of Gastroenterology and Hepatology, Department of Medicine, University of Calgary, Calgary, AB, Canada.", "YamamotoTakayukiTIBD Center, Yokkaichi Hazu Medical Center, Yokkaichi, Japan.", "SchreiberStefanSDepartment of Internal Medicine I and Institute of Clinical Molecular Biology, University Hospital Schleswig-Holstein and Kiel University, Kiel, Germany.", "DubinskyMarlaMSusan and Leonard Feinstein IBD Clinical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.", "AhujaVineetVDepartment of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.", "BernsteinCharles NCNUniversity of Manitoba IBD Clinical and Research Centre, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada.", "RubinDavid TDTInflammatory Bowel Disease Center, University of Chicago Medicine, Chicago, IL, USA.", "MantzarisGerassimos JGJDepartment of Gastroenterology, Medical Center of Athens, Athens, Greece.", "MagroFernandoFDepartment of Gastroenterology, University Hospital of São João, Porto, Portugal.", "DotanIrisIDivision of Gastroenterology, Rabin Medical Center, Petah Tikva, and Gray Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.", "JairathVipulVDivision of Gastroenterology, Department of Medicine, Western University, London, ON, Canada.", "DignassAxelADepartment of Medicine I, Agaplesion Markus Hospital, Goethe University Frankfurt, Frankfurt, Germany. Electronic address: axel.dignass@agaplesion.de." ], "journal": "The lancet. Gastroenterology & hepatology", "journal_abbrev": "Lancet Gastroenterol Hepatol", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42896564", "doi": "10.1016/S2468-1253(26)00292-X", "pii": "S2468-1253(26)00292-X" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct19" }, "42896747": { "pmid": "42896747", "title": "Percutaneous approach to aortic disease: EVAR, TEVAR and newer techniques for more proximal disease.", "abstract": "Advances in device design, imaging and vascular-closure technology have driven a progressive shift from surgical femoral exposure to totally percutaneous strategies for endovascular aortic repair. This narrative review summarises contemporary evidence and practical considerations for percutaneous access across the spectrum of aortic disease, from infrarenal endovascular aneurysm repair (EVAR) to thoracic endovascular aortic repair (TEVAR), fenestrated/branched repair and endovascular treatment of the aortic arch. Percutaneous femoral access is now supported by randomized evidence, large registries and administrative cohorts showing high technical success, fewer wound complications, shorter operative times and shorter hospital stay compared with routine surgical cutdown, and real-time ultrasound-guided puncture has become a guideline-endorsed standard of care. Major contemporary developments include computed tomography-based access planning centred on calcification burden and sheath-to-artery ratio; an individualised, anatomy-driven choice between suture- and plug-based closure devices; endovascular preparation of hostile iliofemoral anatomy with pave-and-crack, endoconduits and intravascular lithotripsy; low-profile endografts that have widened transfemoral eligibility; and percutaneous axillary and carotid routes that enable complex TEVAR, fenestrated/branched and selected arch repairs in experienced centres, although evidence for these latter applications remains largely observational. Looking ahead, further reductions in delivery-system profile, dedicated large-bore closure technologies, image-fusion guidance and off-the-shelf branched devices are expected to extend fully percutaneous repair to increasingly complex anatomy, while prospective, aortic-specific and device-level comparisons with standardized anatomical metrics and long-term follow-up are needed to refine patient selection and confirm durable limb and target-vessel patency.", "authors": [ "BorgheseOttaviaOUnit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy; Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy. Electronic address: ottaviaborghese@gmail.com.", "LodicoTeresaTUnit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy; Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy.", "FeliceGiuliaGUnit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy; Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy.", "TshombaYamumeYUnit of Vascular Surgery, Fondazione Policlinico Universitario Gemelli IRCCS, Rome, Italy; Unit of Vascular Surgery, Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Gemelli IRCCS-Università Cattolica del Sacro Cuore, Largo Agostino Gemelli, 8, 00168 Rome, Italy." ], "journal": "Progress in cardiovascular diseases", "journal_abbrev": "Prog Cardiovasc Dis", "publication_types": [ "Journal Article", "Review" ], "ids": { "pubmed": "42896747", "doi": "10.1016/j.pcad.2026.10.005", "pii": "S0033-0620(26)00114-3" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct19" }, "42897936": { "pmid": "42897936", "title": "Early and Late Outcomes Following Cardiac Surgery in Patients With Immune-Mediated Inflammatory Diseases.", "abstract": "BACKGROUND: Immune-mediated inflammatory diseases (IMIDs) are associated with increased cardiovascular risk, but surgical outcomes in the modern era of immunosuppressive therapy remain unclear. We evaluated early and late outcomes after cardiac and thoracic aortic surgery in patients with IMIDs, focusing on the impact of glucocorticoids and disease-modifying antirheumatic drugs (DMARDs).\nMETHODS: A total of 140 patients with IMIDs who underwent cardiac or thoracic aortic surgery between 2008 and 2025 were retrospectively analyzed. The primary endpoints were in-hospital mortality and long-term overall survival.\nRESULTS: Median age was 70 [61-76] years, and 62% were women. Rheumatoid arthritis was the most common IMID (36%). Prednisolone and DMARDs were used in 68% and 33% of patients, respectively. Procedures included valve (43%), ischemic (26%), and thoracic aortic surgery (23%). In-hospital mortality was 4.3%. During a median follow-up of 5.9 years (93% completeness), overall survival was 91% at 1 year, 87% at 3 years, 78% at 5 years, and 62% at 10 years, respectively. Outcomes did not differ by a surgical category or IMID subtype. Glucocorticoid use was independently associated with worse late survival (HR, 2.91; 95% CI, 1.01-8.41; p = 0.048), whereas DMARD use showed a trend toward improved survival (HR 0.46; 95% CI, 0.19-1.09; p = 0.08). Notably, a dose-dependent relationship was observed, with high-dose prednisolone (≥ 5 mg/day) showing significantly worse survival compared with low-dose (< 5 mg/day) or no glucocorticoid use (p = 0.004). Diabetes mellitus and preoperative anemia were also independent predictors of late mortality.\nCONCLUSIONS: Cardiac surgery in patients with IMIDs provides acceptable early outcomes but suboptimal long-term survival. Glucocorticoid use was associated with worse late survival, with a dose-dependent relationship, whereas DMARD use showed a nonsignificant trend toward better survival, underscoring the importance of optimized immunosuppressive management.", "authors": [ "AmanoKentaroKDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "TakamiYoshiyukiY0000-0002-4623-6233Department of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "AkitaKiyotoshiKDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "MatsuhashiKazukiKDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "NiwaWakanaWDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "OkamotoKazumaKDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "KawamotoNaonoriNDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan.", "AbeTomonobuTDepartment of Cardiac Surgery, Fujita Health University School of Medicine, Toyoake, Japan." ], "journal": "World journal of surgery", "journal_abbrev": "World J Surg", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42897936", "doi": "10.1002/wjs.70619" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-19" } ], "journal_date": "2026Oct19" }, "42898212": { "pmid": "42898212", "title": "Circulating musclin as a potential prognostic biomarker for major adverse cardiovascular events in surgically treated acute aortic dissection: a retrospective cohort study.", "abstract": "BACKGROUND: Musclin is a skeletal muscle-derived myokine with reported cardioprotective effects; however, its prognostic relevance in acute aortic dissection (AAD) remains uncertain. This study examined whether admission Musclin levels were associated with postoperative major adverse cardiovascular events (MACE) and whether they added prognostic information beyond conventional clinical indicators.\nMETHODS: We retrospectively enrolled 108 surgically treated AAD patients from 2022 to 2023. Musclin levels were measured by ELISA in residual serum samples collected at admission. The primary endpoint was composite MACE. Kaplan-Meier survival analysis, multivariate Cox regression, time-dependent ROC, IDI and NRI were used to evaluate the predictive and incremental value of Musclin.\nRESULTS: During 400-day follow-up, 36 patients (33.3%) developed MACE. The CART-derived optimal Musclin cutoff was 4.815 ng/mL. Kaplan-Meier analysis showed that low Musclin group had significantly higher MACE cumulative incidence than high Musclin group (48.2% vs. 17.3%, log-rank P < 0.001). Multivariate Cox regression confirmed circulating Musclin associated with a lower risk of MACE (HR = 0.314, 95%CI: 0.104-0.943, P = 0.039). Time-dependent AUC analysis demonstrated that the combined model incorporating Musclin (model 2) achieved superior AUC compared with the clinical model (model 1). Even at the 250-day time point, where the incremental gain (ΔAUC) was minimal, the combined model still exhibited significantly better discriminative performance (0.876 vs. 0.837, DeLong P = 0.013). At the 250-day landmark, IDI was 0.153 (95%CI: 0.018-0.286, P = 0.012) and overall NRI was 0.167 (95%CI: 0.003-0.336, P = 0.044), with event-specific NRI reaching 0.361 (P = 0.012). Sensitivity analyses yielded directionally consistent associations when Musclin was analyzed using the cohort median or as a continuous variable.\nCONCLUSIONS: In this single-center retrospective cohort, lower admission Musclin was associated with a higher risk of postoperative MACE. Musclin may be a severity-related biomarker that could complement conventional risk indicators, but its independent clinical utility, optimal threshold, and role in risk stratification require prospective multicenter validation with comprehensive perioperative adjustment before clinical use.", "authors": [ "LiuJiaJDepartment of Cardiac Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "LiuZhihuiZSchool of Nursing, Hebei Medical University, Shijiazhuang, Hebei, China.", "GuoLiangLDepartment of Cardiac Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "WangZhiyuanZDepartment of Cardiac Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "WuJinfangJEndoscopy Center, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "LiXiaobingXDepartment of Cardiac Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "ZhangHuijunHDepartment of Cardiac Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.", "LiuHuiningHDepartment of Thoracic Surgery, The First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China." ], "journal": "Frontiers in cardiovascular medicine", "journal_abbrev": "Front Cardiovasc Med", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42898212", "pmc": "PMC13677462", "doi": "10.3389/fcvm.2026.1953235" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-05" } ], "journal_date": "2026" }, "42898220": { "pmid": "42898220", "title": "Catching Two Birds with One Stone: A Primary Open Revascularisation First Approach in a Case Report of Chronic Mesenteric Ischaemia.", "abstract": "INTRODUCTION: Symptomatic chronic mesenteric artery occlusive disease requires timely revascularisation. Although endovascular management is guideline endorsed as first line treatment, inferior mesenteric artery (IMA) revascularisation lacks evidence based guidance. This report presents a case in which an open repair first approach was selected with the IMA as the primary revascularisation target, aiming to provide long term benefit while enabling concomitant superior mesenteric artery (SMA) revascularisation.\nREPORT: A 60 year old woman, who was a smoker (40 pack/year), had a past medical history of hypertension and hypercholesterolemia, and a current body mass index of 17 kg/m2, was diagnosed with chronic mesenteric ischaemia (CMI). Anatomically, while both the coeliac and SMA were occluded, severe stenosis of the IMA ostium was also present. An open revascularisation addressing the IMA disease with venous patch and concomitant aorta to SMA bypass was performed through a limited midline transperitoneal approach without adverse events. The patient was discharged two days post-operatively. At one year follow up, an asymptomatic bypass stenosis just after the IMA take off (approximately 2 cm from the proximal anastomosis) was identified on duplex ultrasound (peak systolic velocity 396 cm/second, end diastolic velocity 35 cm/second) and subsequently treated with a paclitaxel eluting balloon (5 x 60 mm) with angiographic resolution. No signs of IMA re-stenosis were detected. At the six month post-angioplasty follow up, no signs of clinical or haemodynamic recurrence were noted in the SMA bypass or IMA ostium.\nCONCLUSION: In selected CMI patients, an open first revascularisation strategy may be performed with a low risk of adverse events.", "authors": [ "OliveiraNelsonNAngiology and Vascular Surgery Department, Hospital do Divino Espírito Santo - Ponta Delgada, São Miguel, Azores, Portugal.Faculdade de Ciências e Tecnologia, Universidade dos Açores, São Miguel, Açores, Portugal.", "SilvaManuel JoãoMJAngiology and Vascular Surgery Department, Hospital do Divino Espírito Santo - Ponta Delgada, São Miguel, Azores, Portugal.Faculdade de Ciências e Tecnologia, Universidade dos Açores, São Miguel, Açores, Portugal.", "PereirinhaBrunoBAngiology and Vascular Surgery Department, Hospital do Divino Espírito Santo - Ponta Delgada, São Miguel, Azores, Portugal.Faculdade de Ciências e Tecnologia, Universidade dos Açores, São Miguel, Açores, Portugal." ], "journal": "EJVES vascular forum", "journal_abbrev": "EJVES Vasc Forum", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42898220", "pmc": "PMC13677564", "doi": "10.1016/j.ejvsvf.2026.09.001", "pii": "S2666-688X(26)00056-0" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-12" } ], "journal_date": "2026" }, "42898885": { "pmid": "42898885", "title": "A Conservatively Managed Giant Ascending Aortic Aneurysm Presenting With New Atrial Fibrillation and Heart Failure.", "abstract": "Ascending aortic aneurysms bigger than 9 cm are not common these days. Most are found and fixed while they are still much smaller. We report an 88-year-old woman who came into hospital with palpitations, worsening breathlessness on exertion, and swollen ankles. She had a history of high blood pressure, stage 3 kidney disease, and high cholesterol. On examination, her pulse was irregular, she had crackles at the bottom of both lungs, and swelling up to her knees. Her ECG showed atrial fibrillation with a fast heart rate, and her B-type natriuretic peptide (BNP) blood test was very high at 4544 ng/L. She was treated for heart failure caused by the new atrial fibrillation and started on medicine to slow her heart rate and thin her blood. An echo scan, done just to check how well her heart was pumping, picked up something unexpected: the main part of her aorta near the heart was very dilated, there was leaking through the aortic valve, and there was fluid around the heart. A CT scan confirmed a 9.3 cm aneurysm of the ascending aorta, starting at the root, with no tear or bleeding. The heart surgeons felt she was too old and frail, with too many other health problems, to have surgery to fix it. She was treated for decompensated heart failure occurring in the setting of new-onset atrial fibrillation with a rapid ventricular response and was started on rate-control therapy and anticoagulation. We talked to her about whether to keep her on blood thinners even though the aneurysm could not be repaired. She chose to stay on her blood thinner after the risks were explained to her. She went home after five days and was doing better when seen again two months later, and the aneurysm had not grown. This case shows how much a routine echo can find, and how hard the decision about blood thinners can be when there is an aneurysm that cannot be operated on.", "authors": [ "HusseinAlyaaACardiology, University Hospitals of Leicester NHS Trust, Leicester, GBR.", "AliMohamedMCardiology, University Hospitals of Leicester NHS Trust, Leicester, GBR.", "JamesDianeDRespiratory Medicine, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, GBR.", "HamzaHamzaHRespiratory Medicine, University Hospitals of Leicester NHS Trust, Leicester, GBR.", "BehounekMartinMCardiology, University Hospitals of Leicester NHS Trust, Leicester, GBR." ], "journal": "Cureus", "journal_abbrev": "Cureus", "publication_types": [ "Case Reports", "Journal Article" ], "ids": { "pubmed": "42898885", "pmc": "PMC13678326", "doi": "10.7759/cureus.116519" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-09-18" } ], "journal_date": "2026Sep" }, "42900419": { "pmid": "42900419", "title": "Computer tomography imaging for suspected acute aortic syndrome.", "abstract": "BACKGROUND: Acute Aortic Syndrome (AAS) is a life-threatening condition that presents diagnostic challenges due to variable clinical presentations. Limited data exists regarding Computed Tomography Angiography (CTA) utilisation patterns and outcomes for patients with suspected AAS in Irish emergency departments (ED). This study evaluates trends in CTA utilisation and positivity rate for patients with suspected AAS presenting to a level 4 hospital ED.\nMETHODS: A retrospective single-centre chart review was conducted of all adult patients (≥ 16 years) who underwent CTA aorta imaging requested by emergency medicine physicians in Tallaght University Hospital between January 2018 and December 2025. Patient demographics, imaging findings, time metrics, disposition and mortality were analysed.\nRESULTS: Among 457,735 ED attendances, 797 eligible CTA aorta studies were performed. There was a 2.86 fold increase in CTA scans done across the study period from 37 studies in 2018 to 106 in 2025. Overall positivity rate for AAS was 2.76% (n = 22). Acute aortic dissection accounted for 77% of positive cases (n = 17), followed by penetrating atherosclerotic ulcers (n = 3) and intramural hematomas (n = 2). Overall mortality among patients with confirmed AAS was 27.27%.\nCONCLUSION: This study highlights the low positivity rate of CTA aorta scans in an Irish ED but high mortality of patients diagnosed with acute aortic syndrome. Increasing CTA utilisation, alongside the overall low incidence of AAS, suggests opportunities to improve diagnostic efficiency.", "authors": [ "LeslieJoshua AllanJA0009-0009-9713-1608Department of Emergency Medicine, Tallaght University Hospital, Dublin, Dublin 24, Ireland. Joshua.allanleslie@tuh.ie.", "PisanieLouiso duLD0000-0003-3021-0423Department of Emergency Medicine, Tallaght University Hospital, Dublin, Dublin 24, Ireland.", "BaileyKateKDepartment of Radiology, Tallaght University Hospital, Dublin, Ireland.", "GaineVictoria WilliamsVWDepartment of Emergency Medicine, Tallaght University Hospital, Dublin, Dublin 24, Ireland.", "TurnerHannahHDepartment of Radiology, Tallaght University Hospital, Dublin, Ireland.", "MeighanVictoriaVDepartment of Emergency Medicine, Tallaght University Hospital, Dublin, Dublin 24, Ireland.Discipline of Emergency Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland.", "HalpennyDarraghDDepartment of Radiology, Tallaght University Hospital, Dublin, Ireland.", "McCabeAileenA0000-0002-9462-5874Department of Emergency Medicine, Tallaght University Hospital, Dublin, Dublin 24, Ireland.Discipline of Emergency Medicine, School of Medicine, Trinity College Dublin, Dublin, Ireland." ], "journal": "Irish journal of medical science", "journal_abbrev": "Ir J Med Sci", "publication_types": [ "Journal Article" ], "ids": { "pubmed": "42900419", "doi": "10.1007/s11845-026-04689-1", "pii": "10.1007/s11845-026-04689-1" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-20" } ], "journal_date": "2026Oct20" }, "42901411": { "pmid": "42901411", "title": "The Society of Thoracic Surgeons (2026) Expert Consensus Document on Management of Borderline Left Heart Excluding Unbalanced Atrioventricular Septal Defect and Strategies for Biventricular Conversion.", "abstract": "BACKGROUND: Strategies to recruit the left ventricle in borderline left heart (BLH), whether utilizing primary or staged recruitment strategy, are challenged by lack of consensus regarding optimal substrate, timing, and technique.\nMETHODS: A panel of experienced congenital cardiac surgeons, cardiologists and imaging experts were convened to develop key questions related to BLH management, excluding unbalanced atrioventricular septal defect, from neonatal period through 1 year, using the PICO (Patients/Population, Intervention, Comparison/Control, Outcome) framework. Literature searches were performed for each question. Using a modified Delphi method, consensus statements were developed.\nRESULTS: For neonates with BLH, primary biventricular repair should be adopted cautiously, and only with favorable anatomic and physiologic criteria determined by echocardiography and/or magnetic resonance imaging. Neonates in the 'grey-zone', with smaller mitral and aortic valve sizes, endocardial fibroelastosis, indexed left ventricular diastolic volume < 25 ml/m2 and ascending aortic flow < 2.0 L/min/m2, should undergo staged recruitment to potentially facilitate growth of left-sided structures and more durable surgical rehabilitation of left ventricular inflow and outflow. Timing and type of subsequent procedures should be guided by interval cardiac catheterization and magnetic resonance imaging data. Initial palliation of grey-zone neonates can be accomplished with either surgical Norwood or hybrid stage 1 with possible atrial level restriction, and subsequent endocardial fibroelastosis resection along with aortic and mitral valve repair as components of successful complete biventricular conversion.\nCONCLUSIONS: Biventricular approaches in BLH should be guided by integration of anatomic and physiologic criteria, with most neonates recommended for staged recruitment rather than primary repair.", "authors": [ "KaramlouTaraTDivision of Pediatric Cardiac Surgery, Akron Children's, Akron, OH; Division of Pediatric Cardiothoracic Surgery, Cincinnati Children's Hospital, Akron, OH. Electronic address: tkaramlou@akronchildrens.org.", "WooJoyce LJLDepartment of Pediatrics (Cardiology) and Medical Social Sciences, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL.", "LamChristopher ZCZDepartment of Diagnostic & Interventional Radiology, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.", "EmaniSitaramSDepartment of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA.", "BarronDavid JDJDivision of Cardiac Surgery, Evelina Children's and Royal Brompton Hospitals, London, UK.", "HonjoOsamiODepartment of Pediatric Cardiac Surgery, The Hospital for Sick Children, Toronto, ON, Canada.", "JacobsJeffrey PJPCongenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL.", "OhNicholasNDepartment of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA.", "MoralesDavid LDLDivision of Pediatric Cardiothoracic Surgery, Cincinnati Children's Hospital, Akron, OH.", "PatelC RCRDivision of Pediatric Cardiac Surgery, Akron Children's, Akron, OH.", "AndersonBrett RBR(a) Center for Child Health Services Research, Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY; (b)Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY (c) Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY.", "NajmHani KHKDivision of Pediatric Cardiac Surgery, Cleveland Clinic Children's, Cleveland, OH.", "PizarroChristianCDivision of Pediatric Cardiac Surgery, Nemours Children's Hospital, Wilmington, DE.", "BleiweissMarkMCongenital Heart Center, Division of Cardiovascular Surgery, Departments of Surgery and Pediatrics, University of Florida, Gainesville, FL.", "FeinsEricEDepartment of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA." ], "journal": "The Annals of thoracic surgery", "journal_abbrev": "Ann Thorac Surg", "publication_types": [ "Journal Article", "Practice Guideline" ], "ids": { "pubmed": "42901411", "doi": "10.1016/j.athoracsur.2026.09.059", "pii": "S0003-4975(26)01047-7" }, "article_dates": [ { "DateType": "Electronic", "date": "2026-10-20" } ], "journal_date": "2026Oct20" } }, "trials": [ { "id": "NCT00126204", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00126204", "status": "COMPLETED", "last_update": { "date": "2010-03-04", "type": "ESTIMATED" }, "primary_completion": null, "completion": { "date": "2006-07" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 75 }, "title": "Adjunctive Treatment With Doxycycline to Enhance the Durability of Endovascular Aortic Aneurysm Repair" }, { "id": "NCT00429364", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00429364", "status": "COMPLETED", "last_update": { "date": "2025-03-07", "type": "ACTUAL" }, "primary_completion": { "date": "2014-02", "type": "ACTUAL" }, "completion": { "date": "2014-02", "type": "ACTUAL" }, "results": true, "results_posted": { "date": "2015-04-01", "type": "ESTIMATED" }, "results_last_update": null, "enrollment": { "count": 608, "type": "ACTUAL" }, "title": "Comparison of Two Medications Aimed at Slowing Aortic Root Enlargement in Individuals With Marfan Syndrome" }, { "id": "NCT00485368", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00485368", "status": "COMPLETED", "last_update": { "date": "2007-06-13", "type": "ESTIMATED" }, "primary_completion": null, "completion": { "date": "2006-09", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 17, "type": "ACTUAL" }, "title": "Angiotensin Converting Enzyme Inhibitors in Marfan Syndrome" }, { "id": "NCT00538967", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00538967", "status": "COMPLETED", "last_update": { "date": "2007-10-03", "type": "ESTIMATED" }, "primary_completion": null, "completion": { "date": "2005-08", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 60, "type": "ACTUAL" }, "title": "The Effect of Doxycycline on Matrix Metalloproteinase Expression and Activity in the Abdominal Aneurysm" }, { "id": "NCT00593710", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00593710", "status": "COMPLETED", "last_update": { "date": "2012-07-12", "type": "ESTIMATED" }, "primary_completion": { "date": "2010-10", "type": "ACTUAL" }, "completion": { "date": "2011-12", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 17, "type": "ACTUAL" }, "title": "Losartan Versus Atenolol for the Treatment of Marfan Syndrome" }, { "id": "NCT00683124", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00683124", "status": "UNKNOWN", "last_update": { "date": "2011-07-22", "type": "ESTIMATED" }, "primary_completion": { "date": "2013-07", "type": "ESTIMATED" }, "completion": { "date": "2013-07", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 291, "type": "ESTIMATED" }, "title": "Nebivolol Versus Losartan Versus Nebivolol+Losartan Against Aortic Root Dilation in Genotyped Marfan Patients" }, { "id": "NCT00723801", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00723801", "status": "COMPLETED", "last_update": { "date": "2014-09-09", "type": "ESTIMATED" }, "primary_completion": { "date": "2012-12", "type": "ACTUAL" }, "completion": { "date": "2012-12", "type": "ACTUAL" }, "results": true, "results_posted": { "date": "2014-09-01", "type": "ESTIMATED" }, "results_last_update": null, "enrollment": { "count": 40, "type": "ACTUAL" }, "title": "Effects of Losartan Versus Atenolol on Aortic and Cardiac Muscle Stiffness in Adults With Marfan Syndrome" }, { "id": "NCT00763893", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00763893", "status": "TERMINATED", "last_update": { "date": "2015-11-04", "type": "ESTIMATED" }, "primary_completion": { "date": "2014-01", "type": "ACTUAL" }, "completion": { "date": "2014-12", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 303, "type": "ACTUAL" }, "title": "Study of the Efficacy of Losartan on Aortic Dilatation in Patients With Marfan Syndrome" }, { "id": "NCT00782327", "url": "https://clinicaltrials.gov/api/v2/studies/NCT00782327", "status": "COMPLETED", "last_update": { "date": "2022-12-22", "type": "ACTUAL" }, "primary_completion": { "date": "2014-11-26", "type": "ACTUAL" }, "completion": { "date": "2014-11-26", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 22, "type": "ACTUAL" }, "title": "Randomized, Double-blind Study for the Evaluation of the Effect of Losartan Versus Placebo on Aortic Root Dilatation in Patients With Marfan Syndrome Under Treatment With Beta-blockers" }, { "id": "NCT01145612", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01145612", "status": "UNKNOWN", "last_update": { "date": "2010-08-12", "type": "ESTIMATED" }, "primary_completion": { "date": "2013-02", "type": "ESTIMATED" }, "completion": { "date": "2013-02", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 140, "type": "ACTUAL" }, "title": "Atenolol Versus Losartan in the Prevention of Progressive Dilation of the Aorta in Marfan Syndrome" }, { "id": "NCT01295047", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01295047", "status": "COMPLETED", "last_update": { "date": "2011-02-14", "type": "ESTIMATED" }, "primary_completion": { "date": "2007-12", "type": "ACTUAL" }, "completion": { "date": "2008-12", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 18, "type": "ACTUAL" }, "title": "Comparison of Medical Therapies in Marfan Syndrome." }, { "id": "NCT01361087", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01361087", "status": "WITHDRAWN", "last_update": { "date": "2016-02-05", "type": "ESTIMATED" }, "primary_completion": { "date": "2014-12", "type": "ACTUAL" }, "completion": null, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 0, "type": "ACTUAL" }, "title": "Circulating Transforming Growth Factor Beta (TGF-β) in Individuals With Marfan Syndrome" }, { "id": "NCT01415804", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01415804", "status": "COMPLETED", "last_update": { "date": "2011-08-12", "type": "ESTIMATED" }, "primary_completion": { "date": "2010-10", "type": "ACTUAL" }, "completion": { "date": "2011-03", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 140, "type": "ACTUAL" }, "title": "Investigation of Stent-grafts in Aortic Dissection (INSTEAD)" }, { "id": "NCT01715207", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01715207", "status": "COMPLETED", "last_update": { "date": "2017-06-05", "type": "ACTUAL" }, "primary_completion": { "date": "2014-10", "type": "ACTUAL" }, "completion": { "date": "2014-12", "type": "ACTUAL" }, "results": true, "results_posted": { "date": "2017-05-04", "type": "ACTUAL" }, "results_last_update": null, "enrollment": { "count": 30, "type": "ACTUAL" }, "title": "Comparison of Aliskiren vs Negative Controls on Aortic Stiffness in Patients With MFS" }, { "id": "NCT01756833", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01756833", "status": "COMPLETED", "last_update": { "date": "2021-11-26", "type": "ACTUAL" }, "primary_completion": { "date": "2019-07-23", "type": "ACTUAL" }, "completion": { "date": "2019-07-23", "type": "ACTUAL" }, "results": true, "results_posted": { "date": "2021-11-26", "type": "ACTUAL" }, "results_last_update": null, "enrollment": { "count": 261, "type": "ACTUAL" }, "title": "Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial" }, { "id": "NCT01949233", "url": "https://clinicaltrials.gov/api/v2/studies/NCT01949233", "status": "UNKNOWN", "last_update": { "date": "2015-06-09", "type": "ESTIMATED" }, "primary_completion": { "date": "2015-10", "type": "ESTIMATED" }, "completion": { "date": "2017-12", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 56, "type": "ESTIMATED" }, "title": "The Oxford Marfan Trial" }, { "id": "NCT02086136", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02086136", "status": "COMPLETED", "last_update": { "date": "2019-01-03", "type": "ACTUAL" }, "primary_completion": { "date": "2016-12", "type": "ACTUAL" }, "completion": { "date": "2016-12", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 1900, "type": "ACTUAL" }, "title": "Aortic Dissection Detection Risk Score Plus D-dimer in Suspected Acute Aortic Dissection" }, { "id": "NCT02201589", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02201589", "status": "RECRUITING", "last_update": { "date": "2025-05-06", "type": "ACTUAL" }, "primary_completion": { "date": "2028-12", "type": "ESTIMATED" }, "completion": { "date": "2033-12", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 20, "type": "ESTIMATED" }, "title": "Feasibility of Endovascular Repair Of Ascending Aortic Pathologies" }, { "id": "NCT02256163", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02256163", "status": "COMPLETED", "last_update": { "date": "2017-11-20", "type": "ACTUAL" }, "primary_completion": { "date": "2016-12", "type": "ACTUAL" }, "completion": { "date": "2017-03", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 258, "type": "ACTUAL" }, "title": "Identification of Genes and Pathogenesis Involved in Familial Thoracic Aortic Aneurysm" }, { "id": "NCT02299947", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02299947", "status": "TERMINATED", "last_update": { "date": "2019-05-10", "type": "ACTUAL" }, "primary_completion": { "date": "2018-04-26", "type": "ACTUAL" }, "completion": { "date": "2018-04-26", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 27, "type": "ACTUAL" }, "title": "Bloodtranfusions After Aortic Surgery" }, { "id": "NCT02538822", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02538822", "status": "TERMINATED", "last_update": { "date": "2023-05-24", "type": "ACTUAL" }, "primary_completion": { "date": "2018-09-16", "type": "ACTUAL" }, "completion": { "date": "2018-09-16", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 31, "type": "ACTUAL" }, "title": "Risk of Rupture of Aneurysms of the Thoracic Ascending Aorta (ATA) From the Dynamic Imaging" }, { "id": "NCT02724072", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02724072", "status": "COMPLETED", "last_update": { "date": "2022-05-16", "type": "ACTUAL" }, "primary_completion": { "date": "2019-06-24", "type": "ACTUAL" }, "completion": { "date": "2021-07-30", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 84, "type": "ACTUAL" }, "title": "Thoraflex™ Hybrid IDE Study" }, { "id": "NCT02777528", "url": "https://clinicaltrials.gov/api/v2/studies/NCT02777528", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2026-09-10", "type": "ACTUAL" }, "primary_completion": { "date": "2024-03", "type": "ACTUAL" }, "completion": { "date": "2028-03", "type": "ESTIMATED" }, "results": true, "results_posted": { "date": "2025-06-25", "type": "ACTUAL" }, "results_last_update": null, "enrollment": { "count": 79, "type": "ACTUAL" }, "title": "Evaluation of the GORE® TBE Device in the Treatment of Lesions of the Aortic Arch and Descending Thoracic Aorta, Zone 0/1", "baseline_note": "Not in prior manifest tracked snapshot; newly cited in prior sweep. Compare against prior prose only." }, { "id": "NCT03090763", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03090763", "status": "UNKNOWN", "last_update": { "date": "2017-03-27", "type": "ACTUAL" }, "primary_completion": { "date": "2018-05-01", "type": "ESTIMATED" }, "completion": { "date": "2019-06-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 200, "type": "ESTIMATED" }, "title": "Role of Circulating MicroRNAs in Pathogenesis of Aneurysms of the Abdominal and Thoracic Aorta - Study \"Micro AAA\"" }, { "id": "NCT03142074", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03142074", "status": "UNKNOWN", "last_update": { "date": "2024-07-01", "type": "ACTUAL" }, "primary_completion": { "date": "2025-12", "type": "ESTIMATED" }, "completion": { "date": "2025-12", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 180, "type": "ESTIMATED" }, "title": "Biomechanical and Microstructural Properties of Ascending Aortic Aneurysms" }, { "id": "NCT03214601", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03214601", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2025-05-31", "type": "ACTUAL" }, "primary_completion": { "date": "2023-09-18", "type": "ACTUAL" }, "completion": { "date": "2028-08-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 30, "type": "ACTUAL" }, "title": "Early Feasibility Study of the RelayBranch Thoracic Stent-Graft System" }, { "id": "NCT03322033", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03322033", "status": "TERMINATED", "last_update": { "date": "2026-03-02", "type": "ACTUAL" }, "primary_completion": { "date": "2021-10-22", "type": "ACTUAL" }, "completion": { "date": "2021-10-22", "type": "ACTUAL" }, "results": true, "results_posted": { "date": "2026-03-02", "type": "ACTUAL" }, "results_last_update": null, "enrollment": { "count": 1, "type": "ACTUAL" }, "title": "Feasibility of Endovascular Repair of Ascending Aortic Pathologies" }, { "id": "NCT03410420", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03410420", "status": "COMPLETED", "last_update": { "date": "2026-01-23", "type": "ACTUAL" }, "primary_completion": { "date": "2025-09-01", "type": "ACTUAL" }, "completion": { "date": "2025-09-01", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 9, "type": "ACTUAL" }, "title": "Detection of Hypoxia in Human Thoracic Aorta Using Pimonidazole Hydrochloride" }, { "id": "NCT03440697", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03440697", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2026-02-13", "type": "ACTUAL" }, "primary_completion": { "date": "2030-12-31", "type": "ESTIMATED" }, "completion": { "date": "2030-12-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 3000, "type": "ESTIMATED" }, "title": "Pathogenetic Basis of Aortopathy and Aortic Valve Disease" }, { "id": "NCT03507413", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03507413", "status": "UNKNOWN", "last_update": { "date": "2024-03-28", "type": "ACTUAL" }, "primary_completion": { "date": "2024-05-01", "type": "ESTIMATED" }, "completion": { "date": "2024-05-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 170, "type": "ESTIMATED" }, "title": "Metformin Therapy in Non-diabetic AAA Patients" }, { "id": "NCT03536312", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03536312", "status": "RECRUITING", "last_update": { "date": "2026-09-28", "type": "ACTUAL" }, "primary_completion": { "date": "2035-05-31", "type": "ESTIMATED" }, "completion": { "date": "2035-05-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 610, "type": "ESTIMATED" }, "title": "Treatment in Thoracic Aortic Aneurysm: Surgery vs Surveillance" }, { "id": "NCT03861741", "url": "https://clinicaltrials.gov/api/v2/studies/NCT03861741", "status": "UNKNOWN", "last_update": { "date": "2021-05-03", "type": "ACTUAL" }, "primary_completion": { "date": "2022-05-20", "type": "ESTIMATED" }, "completion": { "date": "2022-05-20", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 70, "type": "ACTUAL" }, "title": "A Study to Evaluate the Feasibility of Screening Relatives of Patients Affected by Non-Syndromic Thoracic Aortic Diseases" }, { "id": "NCT04197648", "url": "https://clinicaltrials.gov/api/v2/studies/NCT04197648", "status": "RECRUITING", "last_update": { "date": "2025-06-29", "type": "ACTUAL" }, "primary_completion": { "date": "2026-10", "type": "ESTIMATED" }, "completion": { "date": "2027-04", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 30, "type": "ESTIMATED" }, "title": "Effects of Exercise on Thoracic Aneurysms" }, { "id": "NCT04224051", "url": "https://clinicaltrials.gov/api/v2/studies/NCT04224051", "status": "UNKNOWN", "last_update": { "date": "2023-09-06", "type": "ACTUAL" }, "primary_completion": { "date": "2026-01", "type": "ESTIMATED" }, "completion": { "date": "2026-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 500, "type": "ESTIMATED" }, "title": "Metformin for Abdominal Aortic Aneurysm Growth Inhibition" }, { "id": "NCT04381507", "url": "https://clinicaltrials.gov/api/v2/studies/NCT04381507", "status": "TERMINATED", "last_update": { "date": "2024-10-18", "type": "ACTUAL" }, "primary_completion": { "date": "2024-07-24", "type": "ACTUAL" }, "completion": { "date": "2024-07-24", "type": "ACTUAL" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 1, "type": "ACTUAL" }, "title": "A Study in Patients with a Descending TAA or PAU Treated with the E-nya Thoracic Stent Graft System" }, { "id": "NCT04500756", "url": "https://clinicaltrials.gov/api/v2/studies/NCT04500756", "status": "RECRUITING", "last_update": { "date": "2025-04-18", "type": "ACTUAL" }, "primary_completion": { "date": "2028-06-30", "type": "ESTIMATED" }, "completion": { "date": "2028-06-30", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 314, "type": "ESTIMATED" }, "title": "Limiting AAA With Metformin (LIMIT) Trial" }, { "id": "NCT04545502", "url": "https://clinicaltrials.gov/api/v2/studies/NCT04545502", "status": "RECRUITING", "last_update": { "date": "2026-08-20", "type": "ACTUAL" }, "primary_completion": { "date": "2028-08", "type": "ESTIMATED" }, "completion": { "date": "2037-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 2000, "type": "ESTIMATED" }, "title": "PANTHER Study of Terumo Aortic Knitted and Woven Grafts, and Cardiovascular Patches" }, { "id": "NCT05174767", "url": "https://clinicaltrials.gov/api/v2/studies/NCT05174767", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2025-01-15", "type": "ACTUAL" }, "primary_completion": { "date": "2023-12-11", "type": "ACTUAL" }, "completion": { "date": "2029-12-06", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 115, "type": "ACTUAL" }, "title": "PERSEVERE- A Trial to Evaluate AMDS in Acute DeBakey Type I Dissection" }, { "id": "NCT05215587", "url": "https://clinicaltrials.gov/api/v2/studies/NCT05215587", "status": "RECRUITING", "last_update": { "date": "2025-08-11", "type": "ACTUAL" }, "primary_completion": { "date": "2026-12-31", "type": "ESTIMATED" }, "completion": { "date": "2030-12-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 554, "type": "ESTIMATED" }, "title": "Scandinavian Trial of Uncomplicated Aortic Dissection Therapy" }, { "id": "NCT05361772", "url": "https://clinicaltrials.gov/api/v2/studies/NCT05361772", "status": "UNKNOWN", "last_update": { "date": "2022-05-05", "type": "ACTUAL" }, "primary_completion": { "date": "2024-06-01", "type": "ESTIMATED" }, "completion": { "date": "2025-12-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 230, "type": "ESTIMATED" }, "title": "Low-dose Colchicine Inhibit Abdominal Aortic Aneurysm Growth Trial" }, { "id": "NCT05715203", "url": "https://clinicaltrials.gov/api/v2/studies/NCT05715203", "status": "RECRUITING", "last_update": { "date": "2025-09-10", "type": "ACTUAL" }, "primary_completion": { "date": "2025-11-30", "type": "ESTIMATED" }, "completion": { "date": "2025-12-31", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 250, "type": "ESTIMATED" }, "title": "Aortic Stiffness in Patients With Genetic Aortopathies" }, { "id": "NCT05800743", "url": "https://clinicaltrials.gov/api/v2/studies/NCT05800743", "status": "ENROLLING_BY_INVITATION", "last_update": { "date": "2026-05-29", "type": "ACTUAL" }, "primary_completion": { "date": "2029-10", "type": "ESTIMATED" }, "completion": { "date": "2034-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 370, "type": "ESTIMATED" }, "title": "Evaluation of the GORE® Ascending Stent Graft" }, { "id": "NCT06044259", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06044259", "status": "RECRUITING", "last_update": { "date": "2026-09-30", "type": "ACTUAL" }, "primary_completion": { "date": "2027-09-30", "type": "ESTIMATED" }, "completion": { "date": "2028-09-30", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 72, "type": "ESTIMATED" }, "title": "Study Comparing Hemiarch Replacement and Hemiarch Plus Stent Implantation in Acute Aortic Dissection" }, { "id": "NCT06280482", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06280482", "status": "RECRUITING", "last_update": { "date": "2025-09-12", "type": "ACTUAL" }, "primary_completion": { "date": "2027-07-25", "type": "ESTIMATED" }, "completion": { "date": "2027-07-25", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 15, "type": "ESTIMATED" }, "title": "Nicotinamide Riboside (NR) to Treat Moyamoya-like Cerebrovascular Disease in Smooth Muscle Dysfunction Syndrome (SMDS)" }, { "id": "NCT06377033", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06377033", "status": "RECRUITING", "last_update": { "date": "2026-08-14", "type": "ACTUAL" }, "primary_completion": { "date": "2027-06-30", "type": "ESTIMATED" }, "completion": { "date": "2027-06-30", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 1000, "type": "ESTIMATED" }, "title": "Using the EHR to Advance Genomic Medicine Across a Diverse Health System" }, { "id": "NCT06550986", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06550986", "status": "RECRUITING", "last_update": { "date": "2026-03-23", "type": "ACTUAL" }, "primary_completion": { "date": "2027-02-15", "type": "ESTIMATED" }, "completion": { "date": "2029-02-15", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 30, "type": "ESTIMATED" }, "title": "False Lumen Treatment for Prevention of Aortic Growth Using Shape Memory Polymer - First-in-Human Study" }, { "id": "NCT06740721", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06740721", "status": "NOT_YET_RECRUITING", "last_update": { "date": "2026-01-29", "type": "ACTUAL" }, "primary_completion": { "date": "2027-01-04", "type": "ESTIMATED" }, "completion": { "date": "2029-01-03", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 15, "type": "ESTIMATED" }, "title": "False Lumen Treatment for Prevention of Aortic Growth Using Shape Memory Polymer - First-in-Human Study (FLAGSHIP_FRA)" }, { "id": "NCT06783803", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06783803", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2025-01-20", "type": "ACTUAL" }, "primary_completion": { "date": "2029-05", "type": "ESTIMATED" }, "completion": { "date": "2029-06", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 20, "type": "ESTIMATED" }, "title": "Application of Linkage Analysis in the Identification of Novel Hereditary Factors in Familial Aneurysms" }, { "id": "NCT06827990", "url": "https://clinicaltrials.gov/api/v2/studies/NCT06827990", "status": "RECRUITING", "last_update": { "date": "2026-08-11", "type": "ACTUAL" }, "primary_completion": { "date": "2030-09-01", "type": "ESTIMATED" }, "completion": { "date": "2031-09-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 112, "type": "ESTIMATED" }, "title": "GORE® Ascending Stent Graft in the Treatment of De Novo Type A Aortic Dissections" }, { "id": "NCT07034430", "url": "https://clinicaltrials.gov/api/v2/studies/NCT07034430", "status": "ACTIVE_NOT_RECRUITING", "last_update": { "date": "2025-06-27", "type": "ACTUAL" }, "primary_completion": { "date": "2026-01-01", "type": "ESTIMATED" }, "completion": { "date": "2026-01-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 102, "type": "ESTIMATED" }, "title": "Aortic Dilatation Under 5 cm: Genetic Risk Mapping" }, { "id": "NCT07166133", "url": "https://clinicaltrials.gov/api/v2/studies/NCT07166133", "status": "RECRUITING", "last_update": { "date": "2026-10-05", "type": "ACTUAL" }, "primary_completion": { "date": "2028-07", "type": "ESTIMATED" }, "completion": { "date": "2036-03", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 125, "type": "ESTIMATED" }, "title": "GORE® TAG® Thoracic Branch Endoprosthesis Zone 0/1 Post-Approval Study", "baseline_note": "Not in prior manifest tracked snapshot; newly cited in prior sweep. 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"count": 50, "type": "ESTIMATED" }, "title": "HEART: Pilot Randomized Controlled Trial" }, { "id": "NCT07495267", "url": "https://clinicaltrials.gov/api/v2/studies/NCT07495267", "status": "NOT_YET_RECRUITING", "last_update": { "date": "2026-03-27", "type": "ACTUAL" }, "primary_completion": { "date": "2028-03-01", "type": "ESTIMATED" }, "completion": { "date": "2028-03-01", "type": "ESTIMATED" }, "results": false, "results_posted": null, "results_last_update": null, "enrollment": { "count": 15, "type": "ESTIMATED" }, "title": "Nutritional Ketosis Marfan" } ], "web_sources": { "https://www.eacts.org/our-community/news-hub/new-eacts-expert-consensus-documents-published/": { "retrieval": "web open", "finding": "15 October announcement links the three aorta-related documents already catalogued." }, "https://www.acc.org/Guidelines": { "retrieval": "web open", "finding": "Guideline hub retrieved; no new aortic document retained." }, "https://www.escardio.org/Guidelines": { "retrieval": "web 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Brief report has no numerical table. BAV, prior surgery and root dissection excluded. Clinical superiority not tested." }, "42879453": { "url": "https://www.ebi.ac.uk/europepmc/webservices/rest/PMC13671528/fullTextXML", "alternative_url": "https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0358013", "sections": [ "Participants and setting", "Tables 1–3", "Limitations" ], "quote": "all participants were interviewed prior to discharge", "numeric_provenance": "Methods explicitly report total n=20, corroborated by Table 1 participant rows. Table 2 contains a positive-change prompt; Table 3 gives themes. 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