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Grand RoundsWeekly Evidence Brief

Cardiothoracic Surgery

Edition

30-Second Takeaway

  • Prospectively applied ML/DL decision support reduced all-cause mortality (NNT **32**) in randomized trials.
  • EXCOR Active Driver showed excellent 90-day safety with **98.1%** survival in real-world pediatric cohorts.

Week ending May 9, 2026

Selected recent advances in AI, perioperative hemodynamics, and device support relevant to cardiothoracic surgeons

Randomized trials show ML/DL decision-support shortens workflow and lowers mortality

NPJ DIGITAL MEDICINEMay 7, 2026

Systematic review of 32 randomized trials found ML/DL interventions improved workflow efficiency (SMD -0.71). Diagnostic time shortened by 30–120 s, and some trials reported 1.0–4.2 fewer hospital days. Behavioral nudges increased medication adherence (RR 1.59; NNT 12). Decision-support AI reduced all-cause mortality (RR 0.84; NNT 32), though blinding and sham-AI controls were limited.

Protocol: individualized intraoperative systolic targets for older hip fracture patients

BMC GERIATRICSMay 3, 2026

Single-center randomized trial will enroll 180 patients aged 65–85 undergoing hip fracture repair under general anesthesia. Intervention targets systolic BP within ±10% of baseline versus reactive standard care with universal MAP ≥65 mmHg. Primary outcome is postoperative organ dysfunction within 7 days; secondary outcomes include ICU stay and 30-day mortality. Results will determine whether proactive individualized BP targets reduce organ dysfunction compared with standard management.

EXCOR Active Driver shows high short-term survival and no major device malfunctions

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGYMay 6, 2026

Prospective multicenter evaluation enrolled 40 IDE patients plus 118 continued-access patients using the EXCOR Active Driver. No major device malfunctions were reported across cohorts, supporting device reliability. At 90 days among IDE patients, 65% remained on support and 17.5% were transplanted; stroke incidence was 12.5% and mortality 0%. Overall 90-day survival in continued-access patients was 98.1%, though stroke and conversions to other support occurred.

References

Numbered in order of appearance. Click any reference to view details.

Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • When adopting clinical AI, monitor for workflow gains and require sham controls where possible.
  • Individualized intraoperative BP strategies remain investigational until trial results are available.
  • For pediatric VADs, track stroke and conversion rates despite high short-term survival.