30-Second Takeaway
- A larger RCT comparing pulmonary artery versus central venous catheters is feasible but safety signals (AKI) require confirmation.
- Persistent opioid use after surgery is common in the U.S. surgical population, occurring in about **7%** of opioid-naïve patients.
- Percutaneous removal of right-sided heart masses in older adults associates with lower in-hospital mortality than surgery, with similar 2‑year survival.
Latest - Week ending July 4, 2026
Five recent studies informing perioperative monitoring, cardioprotection, opioid stewardship, and intervention selection in structural heart disease
PUMA Pilot: PA catheter feasible but linked to more AKI in low-risk cardiac surgery
This multicentre pilot randomized trial enrolled 149 adults having low-risk cardiac surgery and randomized 76 to pulmonary artery catheter and 73 to central venous catheter. Protocol adherence and data completeness were high, supporting feasibility for a larger definitive RCT. Acute kidney injury occurred more often with pulmonary artery catheters (34% vs 19%). The trial was not powered for clinical efficacy; the AKI signal requires confirmation in a larger trial.
Cardio‑oncology trials show modest prevention effects and heterogeneous safety reporting
This review found randomized cardio-oncology trials yield modest, inconsistent benefits, mainly on subclinical endpoints like imaging or biomarkers. Clinically meaningful outcome reductions, such as less heart failure or cardiovascular mortality, remain limited across studied interventions. Trials commonly use heterogeneous event definitions and often exclude patients with pre-existing cardiac disease, limiting external validity. The authors recommend risk-enriched trial designs, standardized safety frameworks, and structured surveillance to improve applicability.
New persistent opioid use after surgery averages about 7% in opioid‑naïve U.S. adults
This meta-analysis of 43 observational studies (n=6,507,173) estimated pooled new persistent opioid use (NPOU) at 7.15% (95% CI 6.02–8.38). Incidence varied by NPOU definition, higher with 90–180 day windows (8.29%) and lower with stringent 180-day criteria (2.89%). Heterogeneity was substantial (I2=100%) and most included studies were moderate quality, limiting precision. Findings support prioritizing opioid-sparing strategies and targeted follow-up to reduce transition to chronic opioid use.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.