Sign in to use this feature.

Years

Between: -

Subjects

remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline
remove_circle_outline

Journals

Article Types

Countries / Regions

Search Results (213)

Search Parameters:
Keywords = pericardial effusion

Order results
Result details
Results per page
Select all
Export citation of selected articles as:
18 pages, 3880 KB  
Review
Algorithm for Cardiac Vessel Perforation: State of the Art
by Abdelrahman Elhakim, Fadhel Hamidani, Mohamed Elhakim, Mahmoud Baraka, Ibrahim Yassin, Mohamed Mosaad, Ahmad Hassaan, Mohammed Saad and Osama Bisht
Complications 2026, 3(2), 11; https://doi.org/10.3390/complications3020011 - 13 May 2026
Viewed by 73
Abstract
Background: Coronary artery perforation is a potentially life-threatening complication in 0.2–0.6% of all patients undergoing percutaneous coronary intervention. Despite the ongoing development of technical skills and coronary devices, severe recalcitrant calcified coronary lesions remain a challenge for interventional cardiologists and can carry a [...] Read more.
Background: Coronary artery perforation is a potentially life-threatening complication in 0.2–0.6% of all patients undergoing percutaneous coronary intervention. Despite the ongoing development of technical skills and coronary devices, severe recalcitrant calcified coronary lesions remain a challenge for interventional cardiologists and can carry a potential risk for life-threatening complications, including coronary perforation. Discussion and Conclusion: The algorithm for cardiac vessel perforation could be more comprehensive and cover preventive and predictive measures. It is necessary to take into consideration prompt recognition, implement actions to restabilize the hemodynamic status, understand the source and mechanism of bleeding, and classify the cause of bleeding into proximal, distal, coronary artery bypass graft and collateral vessel, pericardial, myocardial extravasation, and vessel-chamber perforation, as each causality would necessitate a different management strategy for a successful outcome. Imaging information about cardiac vessel injury is useful for a better understanding of the spatial orientation of the coronary vessels. It also helps to detect a hematoma that deteriorates the hemodynamic status without effusion “dry tamponade” and could have a particular role in cardiac interventions to predict and prevent this complication. Full article
Show Figures

Figure 1

16 pages, 1540 KB  
Article
Pericardial Effusion After Cardiac Surgery: Prevalence, Characteristics, Risk Factors and Management
by Gaia Cattadori, Anna Picozzi, Elena Tagliabue, Giovanna Elsa Ute Muti Schuenemann, Tiziana Staine, Roberta Chiodelli, Anna Scaglione, Barbara Baronio, Silvia Di Marco and Claudio Anzà
J. Clin. Med. 2026, 15(8), 3101; https://doi.org/10.3390/jcm15083101 - 18 Apr 2026
Viewed by 409
Abstract
Background/Objectives: Pericardial effusion (PEf) is a frequent finding after cardiac surgery. Progression to cardiac tamponade (CT) is a rare but life-threatening complication. Current evidence remains limited due to insufficient data on prevalence, progression predictors and management strategies. Methods: We retrospectively analyzed anamnestic, clinical, [...] Read more.
Background/Objectives: Pericardial effusion (PEf) is a frequent finding after cardiac surgery. Progression to cardiac tamponade (CT) is a rare but life-threatening complication. Current evidence remains limited due to insufficient data on prevalence, progression predictors and management strategies. Methods: We retrospectively analyzed anamnestic, clinical, laboratory, echocardiographic and therapeutic data from 2662 patients (74 ± 11 years) admitted to the Cardiac Rehabilitation ward between 2022 and 2024. Results: Among 2152 (81%) cardiac surgery patients, 382 (18%) developed PEf: 58% mild, 38% moderate, and 4% severe. Patients developing PEf tended to be younger and more frequently male. In addition, PEf development was seen more commonly after aortic and combined surgeries. All patients with severe PEf or CT had undergone surgery via sternotomy, whereas minithoracotomy was inversely associated with PEf severity. Postoperative complications occurred in 92% of PEf patients, mainly due to arrhythmia, hemodynamic deterioration, or heart failure. Overall outcome was favourable in 98% of patients. CT occurred in eight patients (2%). Anticoagulation therapy was more frequent among patients who developed PEf or CT. Preventive colchicine was prescribed in only 16% of cases. No PEf-specific therapy was administered in 56% of PEf patients, while corticosteroids and nonsteroidal anti-inflammatory drugs were used in 28% and 8% of cases, respectively, without surgical wound complications. No PEf recurrences were observed during follow up (517 ± 424 days). Conclusions: PEf is a common complication after cardiac surgery, more frequently in young males, usually of mild or moderate severity. The majority of these cases resolve using either a conservative or pharmacological approach, predominantly via corticosteroids. Patients undergoing aortic surgery, experiencing postoperative complications (especially arrhythmias), and receiving anticoagulation therapy were associated with severe PEf or CT. Despite guideline recommendations, colchicine remains markedly underutilized. Full article
Show Figures

Figure 1

22 pages, 696 KB  
Review
Acute Aortic Dissection in Women: A Comprehensive Review of Sex-Specific Differences, Clinical Management, and Outcomes
by Vasiliki Androutsopoulou, Dimitrios E. Magouliotis, Andrew Xanthopoulos, Kalliopi Keramida, Metaxia Bareka, Konstantinos Stamoulis, Kosmas Tsakiridis, Thanos Athanasiou and John Skoularigis
J. Cardiovasc. Dev. Dis. 2026, 13(4), 158; https://doi.org/10.3390/jcdd13040158 - 3 Apr 2026
Viewed by 1345
Abstract
Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency characterized by important sex-related differences in presentation, management, and outcomes. Although women account for a smaller proportion of cases, they typically present at older ages and more frequently exhibit atypical symptoms, hemodynamic instability, and [...] Read more.
Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency characterized by important sex-related differences in presentation, management, and outcomes. Although women account for a smaller proportion of cases, they typically present at older ages and more frequently exhibit atypical symptoms, hemodynamic instability, and complications such as pericardial effusion or tamponade, contributing to diagnostic delays and higher pre-hospital mortality. Beyond clinical factors, biological differences may influence disease expression in women. Menopause-associated vascular aging, hormonal modulation of extracellular matrix remodeling, and pregnancy-related hemodynamic and connective tissue changes may alter aortic wall integrity and susceptibility to dissection. Notably, women often experience dissection at smaller absolute aortic diameters, highlighting the potential importance of body-size indexing in risk stratification and surgical thresholds. In type A AAD, women are less likely to undergo extensive surgical repair in some cohorts, and although contemporary in-hospital mortality differences are narrowing, long-term survival disparities may persist. In type B AAD, women are more frequently managed conservatively, while outcomes following thoracic endovascular aortic repair appear broadly comparable between sexes. Pregnancy and the postpartum period represent particularly vulnerable windows, especially among patients with underlying heritable aortopathies. Greater awareness of sex-specific biological and clinical characteristics, incorporation of indexed aortic dimensions, and improved multidisciplinary management strategies are essential to optimize outcomes for women with acute aortic dissection. Full article
Show Figures

Figure 1

13 pages, 649 KB  
Article
Cardiovascular Safety Signals of Oral Versus Topical Minoxidil in FAERS: A Disproportionality Analysis (Analytic Cohort 2012–2025)
by Hima Bindu Makkena and Vikas Kasu
Life 2026, 16(3), 522; https://doi.org/10.3390/life16030522 - 21 Mar 2026
Viewed by 940
Abstract
Oral minoxidil, including low-dose regimens, is increasingly used off-label for alopecia, but cardiovascular safety remains a clinical concern. We compared cardiovascular adverse event reporting patterns for oral versus topical minoxidil using a disproportionality analysis of the FDA Adverse Event Reporting System (FAERS). FAERS [...] Read more.
Oral minoxidil, including low-dose regimens, is increasingly used off-label for alopecia, but cardiovascular safety remains a clinical concern. We compared cardiovascular adverse event reporting patterns for oral versus topical minoxidil using a disproportionality analysis of the FDA Adverse Event Reporting System (FAERS). FAERS data (2004Q1–2025Q3) were imported and deduplicated; minoxidil reports were restricted to primary/secondary suspect (PS/SS) drugs and eligible reports from 2012 to 2025. Exposure was classified as ORAL, TOPICAL, BOTH, or UNKNOWN using a standardized route/dose-form dictionary. Signals for Core and Expanded cardiovascular MedDRA Preferred Terms (PTs) were assessed using reporting odds ratios (RORs) with 95% confidence intervals; sensitivity analyses included alopecia-restricted cohorts excluding hypertension indications. In the primary ORAL-versus-TOPICAL cohort (559 oral; 56,947 topical), 23 Core-list PTs and 31 Expanded-list PTs met the signal definition. Strongest primary signals included pericardial effusion (ROR 307; 95% CI 158–597), hypertensive crisis (ROR 1037; 95% CI 133–8117), pulmonary hypertension (ROR 932; 95% CI 118–7368), and pulmonary edema (ROR 1965; 95% CI 114–33,813). In an alopecia-restricted sensitivity cohort excluding hypertension/blood-pressure indications (146 oral; 24,367 topical), hemodynamic and effusion-related PTs (e.g., tachycardia, palpitations, orthostatic hypotension, syncope, and pericardial effusion) remained disproportionately reported, although event counts were smaller and confidence intervals were wider. Oral minoxidil PS/SS reports in FAERS showed disproportionate reporting of several cardiovascular PTs relative to topical minoxidil reports. However, because FAERS is a spontaneous reporting system without exposed-patient denominators and with important limitations including under-reporting, stimulated reporting, incomplete clinical information, and residual confounding, these findings should be interpreted strictly as hypothesis-generating reporting signals rather than evidence of incidence, relative risk, or definitive comparative clinical safety. Full article
Show Figures

Figure 1

22 pages, 1825 KB  
Review
Diagnostic and Therapeutic Options in Myocarditis and Inflammatory Cardiomyopathy
by Heinz-Peter Schultheiss, Felicitas Escher, Ganna Aleshcheva, Gordon Wiegleb and Christian Baumeier
Biomedicines 2026, 14(3), 691; https://doi.org/10.3390/biomedicines14030691 - 17 Mar 2026
Cited by 1 | Viewed by 821
Abstract
Myocarditis and inflammatory cardiomyopathy are inflammatory diseases of the heart muscle that can have both infectious and non-infectious causes. They can be caused by an unresolved viral infection or other infection, or they can be autoimmune, toxic, or allergic in nature. The specific [...] Read more.
Myocarditis and inflammatory cardiomyopathy are inflammatory diseases of the heart muscle that can have both infectious and non-infectious causes. They can be caused by an unresolved viral infection or other infection, or they can be autoimmune, toxic, or allergic in nature. The specific identification of the pathogen and/or confirmation of inflammation can only be achieved through direct tissue analysis using endomyocardial biopsy (EMB), as neither detection of the virus nor assessment of the quality and intensity of the inflammation is possible using non-invasive methods. Accordingly, the removal and analysis of an EMB is considered the diagnostic gold standard in international guidelines and statements. The sudden onset of atypical angina pectoris and initially exertion-dependent dyspnea, as well as arrhythmias, pericardial effusion, and progressive symptoms of heart failure, indicate an acute inflammatory process of the myocardium. In addition, nonspecific symptoms such as fatigue and reduced physical performance may also occur. Diagnostic evaluation includes an electrocardiogram (ECG), cardiac imaging, and laboratory tests. The analysis of the EMB is crucial for a definitive diagnosis and thus for the initiation of an etiology-based, specific and personalized therapy. This includes histological and immunohistochemical inflammation diagnostics as well as molecular virological diagnostics. These enable both the detection of viruses and the assessment of transcriptional virus activity. New analyses using metagenomic next generation sequencing (NGS) techniques provide insights of enormous diagnostic and therapeutic relevance. This applies both to the spectrum of detectable pathogens and to the possibility of confirming transcriptional viral activity. In addition, gene expression profiling enables the differentiation of specific forms of myocardial inflammation (e.g., giant cell myocarditis, cardiac sarcoidosis, and eosinophilic myocarditis) and reduces the influence of “sampling errors” in focal inflammatory processes. The treatment of heart failure or ventricular arrhythmias is always symptomatic according to general evidence-based guidelines. In severe cases, mechanical circulatory support or even a heart transplant may be necessary. Patients with histologically confirmed myocardial inflammation or intramyocardial viral infection can be offered specific, causal, and personalized therapy. These patients can be successfully treated with immunosuppressive or antiviral therapy, which significantly improves the prognosis of the disease. Full article
(This article belongs to the Special Issue Cardiomyopathies and Heart Failure: Charting the Future—2nd Edition)
Show Figures

Figure 1

14 pages, 505 KB  
Article
Transcatheter Versus Sutureless Aortic Valve Replacement: A Propensity-Matched Single-Center Cohort Study
by Nikoleta Stanitsa, Emmanouel Tempelis, Ilias Samiotis, Dimitris Oikonomou, Konstantinos Triantafyllou, George Lazopoulos, Periklis Tomos and Panagiotis Dedeilias
Medicina 2026, 62(3), 476; https://doi.org/10.3390/medicina62030476 - 3 Mar 2026
Viewed by 552
Abstract
Background and Objectives: Over the past decade, transcatheter aortic valve replacement (TAVI) has evolved from a treatment for inoperable patients to an established option across all risk categories. In parallel, the Perceval sutureless valve has demonstrated safety and efficacy especially for minimally [...] Read more.
Background and Objectives: Over the past decade, transcatheter aortic valve replacement (TAVI) has evolved from a treatment for inoperable patients to an established option across all risk categories. In parallel, the Perceval sutureless valve has demonstrated safety and efficacy especially for minimally invasive surgical aortic valve replacement (AVR). Despite the advances of both TAVI and Perceval, robust long-term data and clear patient selection criteria are still lacking. This retrospective single-center study reports the outcomes of patients undergoing isolated AVR with the Perceval sutureless valve or with TAVI. Materials and Methods: We retrospectively reviewed consecutive patients undergoing isolated AVR at our institution between April 2013 and December 2024. Of 1006 eligible patients (424 TAVI; 582 Perceval), propensity score matching was performed for age, sex, EuroSCORE II, body surface area, and comorbidities, yielding 197 matched pairs. Primary endpoints were all-cause and cardiovascular mortality. Secondary endpoints included acute kidney injury, permanent pacemaker implantation, stroke, pericardial effusion, ICU stay, and overall hospital stay. Clinical and echocardiographic follow-up was obtained by medical-record review and routine echocardiography, with an additional prospective clinical and echocardiographic evaluation at 6–12 months. Results: Postprocedural paravalvular leak was significantly more frequent after TAVI than after Perceval AVR (23.4% vs. 2.5%; p < 0.001). At 6–12 months, TAVI was associated with greater aortic regurgitation and higher rates of para- and intra-prosthetic leak (both p < 0.001) and higher mean transvalvular gradients, particularly in small and medium valve sizes. ICU and overall hospital stay were longer after Perceval implantation (both p < 0.001). New permanent pacemaker implantation was numerically higher after TAVI (11.2% vs. 5.6%; p = 0.063). Early mortality was similar; however, 1-year mortality was higher after TAVI (16.2% vs. 9.1%; p = 0.045), and Kaplan–Meier analysis demonstrated better overall survival with Perceval (p < 0.001), while cardiovascular survival did not differ significantly (p = 0.851). Conclusions: Our study underscores the importance of meticulous patient selection when choosing between TAVI and Perceval. Perceval implantation was associated with better long-term overall survival than TAVI in the propensity-matched cohort. Paravalvular leaks were more frequent after TAVI and associated with poorer survival. Both approaches achieve excellent outcomes; however, differences in long-term survival and valve performance highlight the need for a personalized treatment strategy guided by a multidisciplinary heart team. Full article
Show Figures

Figure 1

14 pages, 3154 KB  
Article
Transvenous Lead Extraction Complicated by Lead Breakage: A Predictive Model Based on Analysis of the EXTRACT Registry
by Michal Joniec, Joanna Stachanczyk, Rafal Gardas, Sylwia Gladysz-Wanha, Eugeniusz Pilat, Anna Drzewiecka, Jolanta Biernat, Andrzej Weglarzy, Wojciech Wanha, Danuta Loboda and Krzysztof S. Golba
J. Clin. Med. 2026, 15(3), 1216; https://doi.org/10.3390/jcm15031216 - 4 Feb 2026
Cited by 1 | Viewed by 526
Abstract
Background: The lead breakage (LB) during transvenous lead extraction (TLE) increases procedural complexity, increases the risk of complications, and decreases procedural efficiency. This study aimed to identify protective and risk factors for the breakage of cardiac electronic device leads during extraction. Methods [...] Read more.
Background: The lead breakage (LB) during transvenous lead extraction (TLE) increases procedural complexity, increases the risk of complications, and decreases procedural efficiency. This study aimed to identify protective and risk factors for the breakage of cardiac electronic device leads during extraction. Methods: Data were sourced from the EXTRACT prospective registry for TLE procedures conducted between January 2016 and June 2025. A total of 702 consecutive TLE procedures involving 1375 leads were enrolled. Multivariate logistic regression was used to identify independent protective and risk factors and develop a model to predict the occurrence of LB during TLE. Results: In the analysed group, 56 (7.98%) of 702 TLE procedures were disrupted by the breakage of at least one lead. The model showed a lower lead breakage rate in procedures when an atrial lead was simultaneously extracted, a locking stylet was used, and when the procedure was conducted in older patients or those who had undergone prior cardiac surgery. Higher risk of LB was proven in the following cases: the extraction of leads implanted a long time ago; the extraction of VDD-type leads; the extraction of abandoned leads; extraction during a prolonged procedure. Occurrence of lead breakage may lead to pericardial effusion requiring intervention, acute kidney injury, or leaving remnants of the leads. Conclusions: Lead breakage is an underestimated procedural difficulty that can occur during transvenous lead extraction. In this study, several clinical and procedural variables were independently associated with lead breakage. Abandoned leads, VDD leads, and prolonged procedure time were associated with increased risk. In contrast, older age, use of a locking stylet, atrial lead extraction, prior cardiac surgery, and later year of implantation demonstrated independent protective associations. Full article
(This article belongs to the Section Cardiology)
Show Figures

Graphical abstract

10 pages, 3441 KB  
Article
The Influence of the COVID-19 Pandemic on Patients Admitted with Pericardial Effusion
by Amir Shabtay, Iftach Sagy, Elizaveta Rabaev, Hezzy Shmueli and Leonid Barski
Diagnostics 2026, 16(3), 464; https://doi.org/10.3390/diagnostics16030464 - 2 Feb 2026
Viewed by 557
Abstract
Background: SARS-CoV-2 infection, its late complications, and SARS-CoV-2 vaccines are known to cause pericardial effusion. We sought to investigate the influence of the COVID-19 outbreak on trends in pericardiocentesis. Methods: We performed a retrospective population study including all >18 years patients [...] Read more.
Background: SARS-CoV-2 infection, its late complications, and SARS-CoV-2 vaccines are known to cause pericardial effusion. We sought to investigate the influence of the COVID-19 outbreak on trends in pericardiocentesis. Methods: We performed a retrospective population study including all >18 years patients undergoing pericardiocentesis in a single tertiary hospital between January 2018 and April 2022. The effusion characteristics and patient outcomes were compared between patients admitted before and after the COVID-19 outbreak. Results: 92 patients underwent pericardiocentesis cases during the COVID-19 period compared to 65 patients during the pre-COVID-19 period (χ2 = 3.07, p = 0.0796). Only 15% of the post-COVID-19 outbreak cases were related to COVID-19 infection or vaccine. In-hospital mortality was numerically higher during the post-COVID-19 group (7.7% vs. 14.4%), but this difference did not reach statistical significance (p = 0.22). The 90-day mortality was also similar between groups. Conclusions: A numerical, yet statistically insignificant increase in pericardiocentesis was observed following the COVID-19 outbreak. We assume this observation cannot be attributed solely to the virus and vaccines per se. Neglect of other chronic diseases, social distancing, and widespread availability of point-of-care ultrasound may have contributed to this observation. Full article
(This article belongs to the Special Issue Advances in Cardiovascular Diseases: Diagnosis and Management)
Show Figures

Figure 1

10 pages, 822 KB  
Article
Echocardiographic Red Flags in Wild-Type Transthyretin Amyloidosis: Sex-Specific Gaps for Wall Thickness and Left Ventricular Mass
by Emilio Nardi, Carola Maria Gagliardo, Davide Noto, Carlo Maria Barbagallo, Antonina Giammanco, Gianluca Di Rosa, Federica Bellini, Maurizio Averna and Angelo Baldassare Cefalù
Life 2026, 16(2), 237; https://doi.org/10.3390/life16020237 - 1 Feb 2026
Viewed by 681
Abstract
Background: Wild-type transthyretin amyloidosis (ATTRwt) diagnosis remains challenging. Echocardiographic “red flags” play a significant role in raising diagnostic suspicion. Methods: Retrospective study including 33 patients diagnosed with ATTRwt. All patients underwent comprehensive echocardiographic evaluation focusing on the red flags for ATTRwt. Left ventricular [...] Read more.
Background: Wild-type transthyretin amyloidosis (ATTRwt) diagnosis remains challenging. Echocardiographic “red flags” play a significant role in raising diagnostic suspicion. Methods: Retrospective study including 33 patients diagnosed with ATTRwt. All patients underwent comprehensive echocardiographic evaluation focusing on the red flags for ATTRwt. Left ventricular hypertrophy (LVH) was defined as interventricular septal wall thickness (IVST) ≥ 12 mm and/or LV mass indexed for body surface area (LVMI) ≥ 115 g/m2 in men and ≥ 95 g/m2 in women. Results: Relative wall thickness > 0.42 and early diastolic myocardial velocity < 7 cm/s were detected in 100% of patients. Severe diastolic dysfunction (grade ≥ 3) (72.7%), apical sparing (36.4%), granular sparkling pattern (30.3%), and pericardial effusion (39.4%) were also observed. Females were younger than males (median age 68 vs. 74.5 years), and IVST ≥ 12 mm was lower in females than in males (64.4% vs. 100%, respectively, p < 0.05). The combined criterion of IVST ≥ 12 mm in men and LVMI ≥ 95 g/m2 in women was encountered in 100% of the global cohort. Conclusions: IVST is a good predictor of LVH in males but shows limited sensitivity for ATTRwt in females; a gender-differenced approach (IVST for men and LVMI for women) might better stratify for ATTRwt suspicion. Full article
(This article belongs to the Section Medical Research)
Show Figures

Figure 1

19 pages, 856 KB  
Review
Preventing Postpericardiotomy Syndrome: Current Evidence and Future Directions
by Christos E. Ballas, Thomas Theologou, Evangelia Samara, Fotios Barkas, Theodora Bampali, Kyriakos Kintzoglanakis, Christos Diamantis, Petros Tzimas, Christos S. Katsouras and Christos Alexiou
J. Cardiovasc. Dev. Dis. 2026, 13(2), 63; https://doi.org/10.3390/jcdd13020063 - 24 Jan 2026
Viewed by 1051
Abstract
Postpericardiotomy syndrome (PPS) is the most frequent inflammatory after-effect of cardiac surgery and is characterized by high morbidity, delayed hospitalization, and increased long-term mortality rates. Although PPS is common, empirical anti-inflammatory therapy has historically been employed for its prevention, and mechanism-based approaches have [...] Read more.
Postpericardiotomy syndrome (PPS) is the most frequent inflammatory after-effect of cardiac surgery and is characterized by high morbidity, delayed hospitalization, and increased long-term mortality rates. Although PPS is common, empirical anti-inflammatory therapy has historically been employed for its prevention, and mechanism-based approaches have not yet been standardized. In this literature review, which was conducted on the basis of randomized controlled trials, meta-analyses, cohort studies, and mechanistic research regarding pharmacologic interventions, surgical modalities, and biomarker-based preventive strategies, the deficiencies of a critical synthesis of existing preventive strategies and emerging risk stratification instruments for PPS are addressed. The review affirms that the most evidence-based pharmacologic intervention is colchicine, which demonstrates a consistent reduction in PPS incidence across a range of randomized trials. Nonsteroidal anti-inflammatory drugs show variable responses, whereas corticosteroids are no longer recommended for routine prophylaxis due to relapse. Specific anti–interleukin-1 therapies represent a promising novel approach for high-risk patients. Surgical interventions, such as pericardial closure using biomaterials and posterior pericardiotomy, are important and do not lead to increased hemodynamic complications, while postoperative effusions, atrial fibrillation, and tamponade are reduced. Less invasive methods may also be employed to mitigate inflammatory causes, particularly in valve-sparing procedures and congenital operations. Emerging biomarker data, including postoperative neutrophil-to-lymphocyte ratios, C-reactive protein levels, and pericardial fluid cytokines, enable the identification of high-risk patients and form the basis for a personalized prevention approach. In summary, pharmacologic prophylaxis, innovative surgical techniques, and biomarker-based risk stratification represent a pathway toward reducing the incidence and burden of PPS in modern cardiac surgery. Full article
(This article belongs to the Section Acquired Cardiovascular Disease)
Show Figures

Figure 1

10 pages, 3424 KB  
Article
Pulsed Field Ablation for the Treatment of Ventricular Arrhythmias Using a Focal, Contact-Force Sensing Catheter: A Single-Center Case Series and Review
by Cristian Martignani, Giulia Massaro, Alberto Spadotto, Maria Carelli, Lorenzo Bartoli, Alessandro Carecci, Andrea Angeletti, Matteo Ziacchi, Mauro Biffi and Matteo Bertini
J. Cardiovasc. Dev. Dis. 2026, 13(2), 59; https://doi.org/10.3390/jcdd13020059 - 23 Jan 2026
Viewed by 910
Abstract
Background: Catheter ablation is a validated treatment for ventricular arrhythmias (VA), but conventional radiofrequency (RF) energy may cause collateral injury due to non-selective thermal damage. Pulsed Field Ablation (PFA), a non-thermal modality based on irreversible electroporation, offers myocardial tissue selectivity and enhanced safety. [...] Read more.
Background: Catheter ablation is a validated treatment for ventricular arrhythmias (VA), but conventional radiofrequency (RF) energy may cause collateral injury due to non-selective thermal damage. Pulsed Field Ablation (PFA), a non-thermal modality based on irreversible electroporation, offers myocardial tissue selectivity and enhanced safety. While PFA is widely adopted for atrial arrhythmias’ ablation, its application in the ventricles remains an evolving frontier. Methods: We report a single-center experience using the Centauri PFA system integrated with a focal, contact-force sensing irrigated catheter (Tacticath™ SE, Abbott Laboratories, St. Paul, MN, USA) in four consecutive patients with drug-refractory VA. Two patients presented with frequent premature ventricular complexes (PVC) arising from the right and left ventricular outflow tract, respectively, while two had ischemic cardiomyopathy with recurrent scar-related ventricular tachycardia (VT). All procedures were guided by high-density mapping using the EnSite X system (Abbott Laboratories, St. Paul, MN, USA). Procedural safety, acute efficacy, and early follow-up outcomes were assessed. Results: All ablations achieved acute procedural success without complications. In both PVC cases, PFA led to immediate and complete suppression of ectopy, with a ≥95% reduction in arrhythmic burden at 12- and 9-months follow-up, respectively. In the VT cases, the arrhythmogenic substrate was effectively modified, rendering the clinical VT non-inducible. ICD interrogation during a 9-month follow-up showed complete absence of recurrent sustained VT. No coronary spasm, atrioventricular block, pericardial effusion, or other adverse events occurred. Conclusions: In this initial experience, focal PFA using a contact-force sensing catheter appeared feasible and effective for both focal and scar-related VA. This system provides an intuitive workflow similar to RF ablation. While our data suggest a favourable safety profile, larger studies are required to definitively confirm safety margins near critical structures. Full article
(This article belongs to the Special Issue Hybrid Ablation of the Atrial Fibrillation)
Show Figures

Figure 1

20 pages, 2443 KB  
Article
Toxic Effects of Polystyrene Microplastics and Sulfamethoxazole on Early Neurodevelopment in Embryo–Larval Zebrafish (Danio rerio)
by Fantao Meng, Shibo Ma, Yajun Wang, Chunmei Wang, Ruoming Li and Jiting Wang
Toxics 2026, 14(1), 74; https://doi.org/10.3390/toxics14010074 - 14 Jan 2026
Viewed by 866
Abstract
Microplastics (MPs) and antibiotics have emerged as contaminants of global concern, posing potential threats to ecosystem security and organismal health. To investigate the individual and combined toxicity of microplastics (PS-MPs) and sulfamethoxazole (SMX), we conducted a 120 h acute exposure experiment using embryo–larval [...] Read more.
Microplastics (MPs) and antibiotics have emerged as contaminants of global concern, posing potential threats to ecosystem security and organismal health. To investigate the individual and combined toxicity of microplastics (PS-MPs) and sulfamethoxazole (SMX), we conducted a 120 h acute exposure experiment using embryo–larval zebrafish as a toxicological model. Our findings demonstrate that both PS-MPs and SMX can induce neurodevelopmental toxicity in embryo–larval zebrafish during embryonic development. Notably, PS-MPs and SMX exerted a significant synergistic effect. PS-MPs 1 µm in diameter were restricted to the chorion surface of pre-hatching zebrafish, whereas post-hatching, PS-MPs accumulated mainly in the gut and gills, with accumulation levels increasing progressively with exposure duration. Individual exposure to PS-MPs or SMX reduced spontaneous locomotion, decreased heart rate, and shortened body length in embryo–larval zebrafish. In addition to exacerbating these effects, coexposure further increased the incidence of malformations such as pericardial effusion and spinal curvature. PS-MPs and SMX significantly decreased the levels of dopamine (DA), serotonin (5-HT), and γ-aminobutyric acid (GABA) in zebrafish while also suppressing acetylcholinesterase (AChE) activity and increasing acetylcholine (ACh) levels. Moreover, upon coexposure at high concentrations, PS-MPs and SMX acted synergistically to reduce the levels of DA and GABA. The downregulation of key neurodevelopmental genes (elavl3, gap43, and syn2a) and related neurotransmitter pathway genes indicates that PS-MPs and SMX impaired structural development and functional regulation of the nervous system. An integrated biomarker response (IBR) index confirmed that PS-MPs and SMX significantly enhanced developmental neurotoxicity during early neurodevelopment in embryo–larval zebrafish through synergistic effects. Our study provides critical toxicological evidence for the scientific assessment of the ecological risks posed by microplastic–antibiotic cocontamination. Full article
(This article belongs to the Section Ecotoxicology)
Show Figures

Figure 1

11 pages, 1084 KB  
Article
Recurrent Malignant Pericardial Effusion Management: The Pericardio-Peritoneal Window
by Antonio Mazzella, Giovanni Caffarena, Claudia Bardoni, Giuseppe Nicolosi, Patrick Maisonneuve, Giorgia Cerretani, Giulia Sedda, Luca Bertolaccini, Giorgio Lo Iacono, Monica Casiraghi and Lorenzo Spaggiari
J. Clin. Med. 2026, 15(1), 83; https://doi.org/10.3390/jcm15010083 - 22 Dec 2025
Viewed by 1219
Abstract
Introduction: Malignant pericardial effusion (MPE) represents a relatively rare complication in various types of solid tumors. Its management is often challenging. One solution can be represented by surgical approaches, including a pericardio-peritoneal window (PPW), which allows draining the fluid into the abdominal [...] Read more.
Introduction: Malignant pericardial effusion (MPE) represents a relatively rare complication in various types of solid tumors. Its management is often challenging. One solution can be represented by surgical approaches, including a pericardio-peritoneal window (PPW), which allows draining the fluid into the abdominal cavity. The aim of this study is to investigate the efficacy and long-term outcomes of the PPW procedure as a definitive therapeutic strategy for MPE. Materials and methods: We retrospectively and prospectively observed pre-, peri-, and postoperative data of patients undergoing pericardio-peritoneal window creation from 2010 to December 2023 at the European Institute of Oncology (IEO), including the surgical procedures needed, total and specific postoperative complications, 30-day mortality rate, relapse rate, and the treatment of possible relapses. Results: A total of 44 consecutive patients underwent a pericardio-peritoneal window. In 28 patients (63.8%) PPW was associated with mono or bilateral videothoracoscopy for pleural biopsies/talc poudrage. In 23 cases, pre-operative percutaneous pericardial drainage (usually 1–2 days before surgery) was performed. No intraoperative deaths were observed. The 30-day mortality was 9% (four patients). We observed pericardial effusion recurrence in three patients at two months and in five patients at six months. In only two cases we treated this condition because of a pre-tamponade condition, treated by percutaneous pericardial drainage. The success rate of the PPW regarding pericardial relapse requiring further procedures was 95.5%. Conclusions: Patients presenting with a favorable short-term prognosis benefit from the pericardio-peritoneal window as a safe and effective method for resolving malignant pericardial effusion. Conversely, pericardial drainage is recommended as the most appropriate therapy for those with a less favorable prognosis. Full article
(This article belongs to the Special Issue Latest Advances in Thoracic Surgery: 2nd Edition)
Show Figures

Figure 1

12 pages, 3027 KB  
Case Report
New Insights into Molecular Mechanisms and Radiomics in Non-Contrast CT for Aortic Dissection: A Case Report and Literature Review
by Jian-Cheng Tian, Jia-Hao Zhou, Jui-Yuan Chung, Po-Chen Lin, Giou-Teng Yiang, Ya-Chih Yang and Meng-Yu Wu
Life 2026, 16(1), 14; https://doi.org/10.3390/life16010014 - 22 Dec 2025
Viewed by 982
Abstract
Background: Computed tomography (CT) angiography is widely regarded as the gold standard for diagnosing acute aortic dissection. However, in patients with contraindications to iodinated contrast media, such as those with renal insufficiency or hemodynamic instability, non-contrast CT may offer a viable alternative for [...] Read more.
Background: Computed tomography (CT) angiography is widely regarded as the gold standard for diagnosing acute aortic dissection. However, in patients with contraindications to iodinated contrast media, such as those with renal insufficiency or hemodynamic instability, non-contrast CT may offer a viable alternative for initial evaluation. Understanding the molecular mechanisms underlying aortic dissection, including extracellular matrix degradation, smooth muscle cell apoptosis, and inflammatory pathways, is crucial for developing novel diagnostic and therapeutic approaches. This report describes a single case of acute Stanford type A aortic dissection initially detected on non-contrast CT. Case Presentation: We describe a 74-year-old man who presented to the emergency department with fever and suspected infection, but without chest pain. An incidental finding on non-contrast CT revealed ascending aortic dilatation, pericardial effusion, and a suspected intimal flap. Subsequent CT angiography confirmed a Stanford type A aortic dissection. Conclusions: This case highlights the potential value of non-contrast CT in the early detection of aortic dissection, particularly when CT angiography cannot be performed. Recent advances in artificial intelligence (AI) and radiomic analysis have shown promise in augmenting the diagnostic capabilities of non-contrast CT by identifying subtle imaging features that may correlate with underlying molecular pathology and elude human observers. Emerging evidence suggests that radiomic features may reflect molecular alterations in the aortic wall, including metalloproteinase activity, collagen degradation, and inflammatory cell infiltration. Incorporating AI-assisted interpretation alongside insights into molecular mechanisms could facilitate earlier diagnosis, improve risk stratification, and guide personalized treatment strategies in critically ill patients. Although non-contrast CT has limited sensitivity for aortic dissection, it may still reveal crucial findings in selected cases and should be considered when contrast-enhanced imaging is not feasible. Ongoing progress in AI, radiomics, and molecular biomarker research may further expand the clinical applications of non-contrast CT in emergency cardiovascular care and bridge the gap between imaging phenotypes and molecular endotypes. These findings are hypothesis-generating and require validation in larger cohorts before clinical generalization. Full article
Show Figures

Figure 1

13 pages, 2619 KB  
Article
Magnetic Resonance of Pulmonary Nodules in Oncological Patients: Are We Ready to Replace Chest CT in Detecting Extrathoracic Cancer?
by Ronak Kundalia, Jessica Gemmell, Ian Griffin, Amanda Acevedo, Joice Prodigios, Sandro Bertani, Alysson Roncally Silva Carvalho, Rosana Souza Rodrigues, Hiren J. Mehta and Bruno Hochhegger
Curr. Oncol. 2025, 32(12), 710; https://doi.org/10.3390/curroncol32120710 - 16 Dec 2025
Viewed by 1457
Abstract
Objective: This study aims to assess the accuracy of pulmonary nodule detection via MRI compared to the gold standard, CT, in patients with extrathoracic cancer. Materials and Methods: MRI of the chest was performed on oncological patients for staging extrathoracic cancer and subsequently [...] Read more.
Objective: This study aims to assess the accuracy of pulmonary nodule detection via MRI compared to the gold standard, CT, in patients with extrathoracic cancer. Materials and Methods: MRI of the chest was performed on oncological patients for staging extrathoracic cancer and subsequently compared to their CT. Only the largest nodule was considered in patients with multiple nodules. Nodule size and malignancy were recorded for each modality, as well as the presence of interstitial lung disease (ILD), adenopathy, cardiomegaly, pleural effusion, pericardial effusion, and vertebral fracture. All cases were read by two thoracic radiologists and any discrepancies were resolved by discussion. Results: A total of 154 patients with nodules were identified from 241 participants (mean age: 59 years [18–95]). Average nodule diameter was 11.5 mm (range: 3.9–29.1 mm; SD: 8.1 mm). MRI detected all nodules greater than 5 mm. Malignancy was detected in 37 nodules. The sensitivity, specificity, and accuracy values of MRI for all nodules were 93.51%, 100%, and 95.85%, respectively. For ground-glass nodules (n = 11), the values were 43.6%, 100%, and 65.0%, respectively. When compared to CT, long-axis diameter measured by MRI was underestimated by 9 ± 2.3% (p < 0.001). There was a strong correlation between measurements of CT and MRI (κ = 0.70–1.00). Furthermore, MRI accurately detected the presence of adenopathy (97.1%), cardiomegaly (99.17%), pleural effusion (98.34%), pericardial effusion (100%), and vertebral fracture (99.6%). Conclusions: These findings suggest that lung MRI accurately detects pulmonary nodules and other thoracic pathologies commonly observed in oncological patients. Lung MRI may serve as a substitute to CT for oncological patients undergoing routine extrathoracic surveillance, thereby decreasing radiation exposure. Full article
(This article belongs to the Section Thoracic Oncology)
Show Figures

Figure 1

Back to TopTop