{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:29:20Z","timestamp":1793640560333,"version":"4.5.1"},"reference-count":208,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"European Association for Cardio-Thoracic Surgery","id":[{"id":"https:\/\/ror.org\/002gtx138","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Civil aviation medicine and cardiothoracic surgery intersect at a point where individual clinical outcomes and public safety are tightly coupled. Professional aircrew and other safety-critical aviation personnel must meet legally defined medical standards that are designed around an engineering approach to risk, including a low annual tolerance for sudden incapacitation, whereas passengers and cabin crew are exposed to the physiological constraints of the flight environment (hypobaric hypoxia, gas expansion, limited access to medical care, immobility, and circadian rhythm disruption). Yet, the evidence base guiding fitness-to-fly decisions after cardiothoracic procedures, treatment of aortic disease, and contemporary transcatheter interventions remains sparse and unevenly distributed across procedures, licensing classes, and operational contexts. This European Association of Cardio-Thoracic Surgery Expert Consensus Document appraises the available literature and synthesizes multidisciplinary expert knowledge to provide pragmatic, safety-oriented guidance for aeromedical examiners, treating clinicians, regulators, employers, and affected individuals. Focusing on civil aviation, it addresses return-to-duty considerations for professional aircrew and postoperative air-travel decisions for passengers. Key clinical and occupational determinants include procedure choice and durability, residual ischaemia or haemodynamic burden, arrhythmia risk, anticoagulation and device-related considerations, rehabilitation and surveillance testing, and, where appropriate, the role of operational restrictions such as multicrew limitations. Finally, it identifies key knowledge gaps and research priorities to support more consistent, evidence-based decision-making in this high-stakes setting.<\/jats:p>","DOI":"10.1093\/icvts\/ivag217","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T11:54:54Z","timestamp":1789127694000},"source":"Crossref","is-referenced-by-count":0,"title":["EACTS Expert Consensus Document on Civil Aviation Following Cardiothoracic Surgery and Transcatheter Procedures"],"prefix":"10.1093","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-2856-0204","authenticated-orcid":false,"given":"Thomas","family":"Syburra","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, H\u00f4pital de La Tour , Meyrin\/Geneva,","place":["Switzerland"]},{"name":"Aeromedical Center, Swiss Air Force , D\u00fcbendorf,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward D","family":"Nicol","sequence":"additional","affiliation":[{"name":"Departments of Cardiology and Radiology, Royal Brompton Hospital , London,","place":["United Kingdom"]},{"name":"Centre of Aviation Medicine, Royal Air Force , Henlow,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos A","family":"Mestres","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, The Robert WM Frater Cardiovascular Research Centre, The University of the Free State , Bloemfontein,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9558-0850","authenticated-orcid":false,"given":"Milos","family":"Matkovic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University Clinical Centre of Serbia , Belgrade,","place":["Serbia"]},{"name":"Faculty of Medicine, University of Belgrade , Belgrade,","place":["Serbia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"d\u2019Arcy","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust , Oxford,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Bron","sequence":"additional","affiliation":[{"name":"Aeromedical Center, Swiss Air Force , D\u00fcbendorf,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filip","family":"Casselman","sequence":"additional","affiliation":[{"name":"Heart Center AZORG, Cluster Cardiovascular Surgery , Aalst,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Czerny","sequence":"additional","affiliation":[{"name":"University Heart Center Freiburg Department for Cardiac-,Thoracic-,Vascular Surgery and Aortic Medicine, , Bad Krozingen,","place":["Germany"]},{"name":"Faculty of Medicine, Albert Ludwigs University Freiburg, University Hospital Freiburg , Freiburg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Fremes","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Toronto , Toronto, ON,","place":["Canada"]},{"name":"Schulich Heart Program, Sunnybrook Health Sciences Centre , Toronto, ON,","place":["Canada"]},{"name":"Institute of Health Policy, Management and Evaluation , Toronto, ON,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Guettler","sequence":"additional","affiliation":[{"name":"German Air Force Centre of Aerospace Medicine, Section Clinical Aviation Medicine , Cologne,","place":["Germany"]},{"name":"Medical Clinic I, Cardiology and Angiology, Justus Liebig University , Giessen,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Philipp","family":"Heinisch","sequence":"additional","affiliation":[{"name":"Department of Congenital and Pediatric Heart Surgery, TUM University Hospital German Heart Center , Munich,","place":["Germany"]},{"name":"Division of Congenital and Pediatric Heart Surgery, University Hospital of Munich, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen , Munich,","place":["Germany"]},{"name":"Europ\u00e4isches Kinderherzzentrum M\u00fcnchen , Munich,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Heathrow Medical Services , Longford, West Drayton, Middlesex,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joao Pedro","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Cirurgia Cardiotor\u00e1cica, Centro Hospitalar de Vila Nova de Gaia\/Espinho , Vila Nova de Gaia, Espinho,","place":["Portugal"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Pepper","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Brompton & Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Petrella","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, Fondazione IRCCS San Gerardo dei Tintori , Monza,","place":["Italy"]},{"name":"Department of Oncology and Hemato-Oncology, University of Milan , Milan,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Rosendahl","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Brompton & Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London,","place":["United Kingdom"]},{"name":"National Heart and Lung Institute, Imperial College , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara A","family":"Rosser","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Royal Brompton & Harefield Hospitals, Guy\u2019s and St Thomas\u2019 NHS Foundation Trust , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Spiegelstein","sequence":"additional","affiliation":[{"name":"Israel Air Force Aircrew Medical Unit, ELAL Israel Airlines, The Sackler School of Medicine, Tel Aviv University , Tel Aviv,","place":["Israel"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-9011","authenticated-orcid":false,"given":"Milan","family":"Milojevic","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery and Cardiovascular Research, National Institute for Heart and Blood Vessels \u201cDedinje\u201d , Belgrade,","place":["Serbia"]},{"name":"Department of Cardiac Surgery, University Hospital Zurich, University of Zurich , Zurich,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"EACTS Scientific Document Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Jeppsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman","family":"Sardari Nia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerry","family":"Braun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Torsten","family":"Doenst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omer","family":"Dzemali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Onorati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Siepe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Gollmann-Tepekoylu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026110212020522100_ivag217-B1"},{"key":"2026110212020522100_ivag217-B2","doi-asserted-by":"publisher","first-page":"3918","DOI":"10.3390\/s25133918","article-title":"Distance measurement and data analysis for civil aviation at 1000 frames per second using single-photon detection technology","volume":"25","author":"Shan","year":"2025","journal-title":"Sensors (Basel)"},{"key":"2026110212020522100_ivag217-B3","doi-asserted-by":"publisher","first-page":"1705","DOI":"10.3390\/s25061705","article-title":"DT-YOLO: an improved object detection algorithm for key components of aircraft and staff in airport scenes based on YOLOv5","volume":"25","author":"He","year":"2025","journal-title":"Sensors (Basel)"},{"key":"2026110212020522100_ivag217-B4","first-page":"65","article-title":"Psychiatry and fitness to fly after germanwings","volume":"48","author":"Pinsky","year":"2020","journal-title":"J Am Acad Psychiatry Law"},{"key":"2026110212020522100_ivag217-B5","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1111\/j.1440-1843.2007.01104.x","article-title":"Directly measured cabin pressure conditions during Boeing 747-400 commercial aircraft flights","volume":"12","author":"Kelly","year":"2007","journal-title":"Respirology"},{"key":"2026110212020522100_ivag217-B6","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1007\/s12024-018-9991-9","article-title":"Deep venous thrombosis, pulmonary embolism and long-distance flights","volume":"15","author":"Byard","year":"2019","journal-title":"Forensic Sci Med Pathol"},{"key":"2026110212020522100_ivag217-B7","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.ajem.2021.04.010","article-title":"The global incidence of in-flight medical emergencies: a systematic review and meta-analysis of approximately 1.5 billion airline passengers","volume":"48","author":"Borges do Nascimento","year":"2021","journal-title":"Am J Emerg Med"},{"key":"2026110212020522100_ivag217-B8","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.xjon.2021.12.003","article-title":"Early air transport after thoracic surgery might be safe: a retrospective observational study in the French Caribbean","volume":"9","author":"Lafouasse","year":"2022","journal-title":"JTCVS Open"},{"key":"2026110212020522100_ivag217-B9","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1111\/aor.13815","article-title":"Flying after left ventricular assist device implantation","volume":"45","author":"Hanke","year":"2021","journal-title":"Artif Organs"},{"key":"2026110212020522100_ivag217-B10","doi-asserted-by":"crossref","first-page":"732","DOI":"10.3357\/AMHP.5544.2020","article-title":"Selective recertification of pilots who have undergone a cardiac transplant","volume":"91","author":"Norris","year":"2020","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B11","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3357\/AMHP.6340.2024","article-title":"Centrifuge-simulated spaceflight after aortic valve replacement and atrial septal defect repair","volume":"95","author":"Fernandez","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B12","doi-asserted-by":"crossref","first-page":"s31","DOI":"10.1136\/heartjnl-2018-313055","article-title":"Management of established coronary artery disease in aircrew with previous myocardial infarction or revascularisation","volume":"105(Suppl 1)","author":"Davenport","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B13","doi-asserted-by":"crossref","first-page":"s70","DOI":"10.1136\/heartjnl-2018-313060","article-title":"Non-coronary cardiac surgery and percutaneous cardiology procedures in aircrew","volume":"105(Suppl 1)","author":"Guettler","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B14","doi-asserted-by":"crossref","first-page":"ezae345","DOI":"10.1093\/ejcts\/ezae345","article-title":"Harmonizing guidelines and other clinical practice documents: a joint comprehensive methodology manual by the American Association for Thoracic Surgery (AATS), European Association for Cardio-Thoracic Surgery (EACTS), European Society of Thoracic Surgeons (ESTS), and Society of Thoracic Surgeons (STS)","volume":"66","author":"Milojevic","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B15","doi-asserted-by":"crossref","first-page":"e100250","DOI":"10.1136\/bmjopen-2025-100250","article-title":"Prevalence and severity of coronary artery disease in asymptomatic military air crew in The Netherlands: a prospective, cross-sectional study (SUSPECT)","volume":"15","author":"Frijters","year":"2025","journal-title":"BMJ Open"},{"key":"2026110212020522100_ivag217-B16","doi-asserted-by":"crossref","first-page":"42","DOI":"10.3357\/ASEM.3134.2012","article-title":"The annual incapacitation rate of commercial pilots","volume":"83","author":"Evans","year":"2012","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B17","doi-asserted-by":"crossref","first-page":"s3","DOI":"10.1136\/heartjnl-2018-313019","article-title":"An introduction to aviation cardiology","volume":"105(Suppl 1)","author":"Nicol","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B18","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3357\/AMHP.6415.2024","article-title":"Global cardiovascular risk and associated factors in 2792 French Military and Civilian Aircrew","volume":"95","author":"Huiban","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B19"},{"key":"2026110212020522100_ivag217-B20","doi-asserted-by":"publisher","first-page":"19","DOI":"10.54560\/jracr.v13i1.353","article-title":"The sociotechnical construction of risks, and principles of the proactive approach to safety","volume":"13","author":"Barbosa","year":"2023","journal-title":"JRACR"},{"key":"2026110212020522100_ivag217-B21","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1027\/2192-0923\/a000216","article-title":"Why commercial pilots voluntarily report self-inflicted incidents: a qualitative study with aviation safety experts","volume":"11","author":"Sieberichs","year":"2021","journal-title":"Aviation Psychol Appl Hum Fact"},{"key":"2026110212020522100_ivag217-B22"},{"key":"2026110212020522100_ivag217-B23","author":"2022 Safety Reports, 1-24"},{"key":"2026110212020522100_ivag217-B24","doi-asserted-by":"crossref","first-page":"e009950","DOI":"10.1161\/CIRCINTERVENTIONS.120.009950","article-title":"Coronary artery disease evaluation and management considerations for high risk occupations: commercial vehicle drivers and pilots","volume":"14","author":"Sutton","year":"2021","journal-title":"Circ Cardiovasc Interv"},{"key":"2026110212020522100_ivag217-B25","doi-asserted-by":"crossref","first-page":"100782","DOI":"10.1016\/j.cpcardiol.2020.100782","article-title":"Commercial air travel for passengers with cardiovascular disease: recommendations for less common conditions, considerations for venous thromboembolism, and general guidance","volume":"46","author":"Koh","year":"2021","journal-title":"Curr Probl Cardiol"},{"key":"2026110212020522100_ivag217-B26","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.3357\/AMHP.5420.2019","article-title":"U.S. statement of demonstrated ability aeromedical waivers","volume":"90","author":"Mills","year":"2019","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B27","author":"Standards and Recommended Practices (SARPs)"},{"key":"2026110212020522100_ivag217-B28","author":"Matthews","year":"2026"},{"key":"2026110212020522100_ivag217-B29","author":"Akparibo","year":"2026"},{"key":"2026110212020522100_ivag217-B30"},{"key":"2026110212020522100_ivag217-B31","author":"Dhaliwal","year":"2026"},{"key":"2026110212020522100_ivag217-B32","author":"Clemente Fuentes","year":"2026"},{"key":"2026110212020522100_ivag217-B33","doi-asserted-by":"crossref","first-page":"s50","DOI":"10.1136\/heartjnl-2018-313058","article-title":"Heart muscle disease management in aircrew","volume":"105(Suppl 1)","author":"D\u2019Arcy","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B34","doi-asserted-by":"crossref","first-page":"s64","DOI":"10.1136\/heartjnl-2018-313059","article-title":"Congenital heart disease in aircrew","volume":"105(Suppl 1)","author":"Nicol","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B35","doi-asserted-by":"crossref","first-page":"s9","DOI":"10.1136\/heartjnl-2018-313052","article-title":"Assessing aeromedical risk: a three-dimensional risk matrix approach","volume":"105(Suppl 1)","author":"Gray","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B36","doi-asserted-by":"crossref","first-page":"s38","DOI":"10.1136\/heartjnl-2018-313057","article-title":"Management of cardiac conduction abnormalities and arrhythmia in aircrew","volume":"105(Suppl 1)","author":"Guettler","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B37","doi-asserted-by":"crossref","first-page":"s57","DOI":"10.1136\/heartjnl-2018-313056","article-title":"Contemporaneous management of valvular heart disease and aortopathy in aircrew","volume":"105(Suppl 1)","author":"D\u2019Arcy","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B38","doi-asserted-by":"crossref","first-page":"s31","DOI":"10.1136\/heartjnl-2018-313055","article-title":"Management of established coronary artery disease in aircrew without myocardial infarction or revascularisation","volume":"105(Suppl 1)","author":"Davenport","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B39","doi-asserted-by":"crossref","first-page":"s17","DOI":"10.1136\/heartjnl-2018-313053","article-title":"The challenge of asymptomatic coronary artery disease in aircrew; detecting plaque before the accident","volume":"105(Suppl 1)","author":"Gray","year":"2019","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B40"},{"key":"2026110212020522100_ivag217-B41","year":"2025"},{"key":"2026110212020522100_ivag217-B42"},{"key":"2026110212020522100_ivag217-B43","doi-asserted-by":"crossref","first-page":"102194","DOI":"10.1016\/j.gloenvcha.2020.102194","article-title":"The global scale, distribution and growth of aviation: implications for climate change","volume":"65","author":"G\u00f6ssling","year":"2020","journal-title":"Glob Environ Change"},{"key":"2026110212020522100_ivag217-B44","doi-asserted-by":"crossref","first-page":"2075","DOI":"10.1056\/NEJMoa1212052","article-title":"Outcomes of medical emergencies on commercial airline flights","volume":"368","author":"Peterson","year":"2013","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B45","doi-asserted-by":"publisher","first-page":"3906","DOI":"10.3390\/nu17243906","article-title":"Health implications of shift work in airline pilots and cabin crew: a narrative review and pilot study findings","volume":"17","author":"Stefa\u0144ska","year":"2025","journal-title":"Nutrients"},{"key":"2026110212020522100_ivag217-B46","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1080\/14796678.2024.2396257","article-title":"Hearts in the sky: understanding the cardiovascular implications of air travel","volume":"20","author":"Katoch","year":"2024","journal-title":"Future Cardiol"},{"key":"2026110212020522100_ivag217-B47","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1136\/hrt.2010.203091","article-title":"Fitness to fly for passengers with cardiovascular disease","volume":"96(Suppl 2)","author":"Smith","year":"2010","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B48","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1093\/qjmed\/hcv184","article-title":"The clinical, occupational and financial outcomes associated with a bespoke specialist clinic for military aircrew-a cohort study","volume":"109","author":"Pavitt","year":"2016","journal-title":"QJM"},{"key":"2026110212020522100_ivag217-B49","doi-asserted-by":"crossref","first-page":"666","DOI":"10.3357\/AMHP.6051.2022","article-title":"Exercise ECG for screening in military aircrew","volume":"93","author":"Guettler","year":"2022","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B50","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.3357\/ASEM.3690.2013","article-title":"A 5-year review of atrial fibrillation in military aircrew","volume":"84","author":"Hunter","year":"2013","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B51","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.jcct.2022.02.005","article-title":"Coronary artery calcium scoring vs. coronary CT angiography for the assessment of occupationally significant coronary artery disease","volume":"16","author":"Holland","year":"2022","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"2026110212020522100_ivag217-B52","doi-asserted-by":"publisher","first-page":"2320","DOI":"10.1016\/s0735-1097(24)04310-9","article-title":"Global prevalence of coronary artery disease: an update from the global burden of disease study","volume":"83","author":"Stark","year":"2024","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B53","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1038\/s41569-020-0428-2","article-title":"Epidemiology of the inherited cardiomyopathies","volume":"18","author":"McKenna","year":"2021","journal-title":"Nat Rev Cardiol"},{"key":"2026110212020522100_ivag217-B54","doi-asserted-by":"crossref","first-page":"2256","DOI":"10.1016\/S0140-6736(17)32250-X","article-title":"Population screening and intervention for vascular disease in Danish men (VIVA): a randomised controlled trial","volume":"390","author":"Lindholt","year":"2017","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B55","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1093\/eurheartj\/eht572","article-title":"Recommendations for organization of care for adults with congenital heart disease and for training in the subspecialty of \u2018Grown-up Congenital Heart Disease\u2019 in Europe: a position paper of the Working Group on Grown-up Congenital Heart Disease of the European Society of Cardiology","volume":"35","author":"Baumgartner","year":"2014","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B56","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/NRL.0b013e31815cffae","article-title":"Clinical epidemiology of atrial fibrillation and related cerebrovascular events in the United States","volume":"14","author":"Lakshminarayan","year":"2008","journal-title":"Neurologist"},{"key":"2026110212020522100_ivag217-B57","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1161\/CIRCRESAHA.120.316340","article-title":"Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights","volume":"127","author":"Kornej","year":"2020","journal-title":"Circ Res"},{"key":"2026110212020522100_ivag217-B58","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1038\/s41569-024-01046-6","article-title":"Global epidemiology of heart failure","volume":"21","author":"Khan","year":"2024","journal-title":"Nat Rev Cardiol"},{"key":"2026110212020522100_ivag217-B59","first-page":"1025","article-title":"Prevalence of cardiovascular abnormalities in pilots involved in fatal general aviation airplane accidents","volume":"73","author":"Taneja","year":"2002","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B60","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1177\/1741826710389417","article-title":"Prevalence of cardiovascular disease risk factors among UK commercial pilots","volume":"18","author":"Houston","year":"2011","journal-title":"Eur J Cardiovasc Prev Rehabil"},{"key":"2026110212020522100_ivag217-B61","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1186\/s12968-019-0544-5","article-title":"Cardiac MRI improves cardiovascular risk stratification in hazardous occupations","volume":"21","author":"Holdsworth","year":"2019","journal-title":"J Cardiovasc Magn Reson"},{"key":"2026110212020522100_ivag217-B62","doi-asserted-by":"crossref","first-page":"142","DOI":"10.3357\/ASEM.3352.2013","article-title":"Coronary artery disease in aircrew fatalities: morphology, risk factors, and possible predictors","volume":"84","author":"Dumser","year":"2013","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B63","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1111\/jocs.14498","article-title":"Acceleration-induced acute type A aortic dissection in the sky: 10-year follow-up","volume":"35","author":"An","year":"2020","journal-title":"J Card Surg"},{"key":"2026110212020522100_ivag217-B64","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1093\/ejcts\/ezx346","article-title":"To fly as a pilot after cardiac surgery","volume":"53","author":"Syburra","year":"2018","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B65","doi-asserted-by":"crossref","first-page":"e12241","DOI":"10.1002\/1348-9585.12241","article-title":"Return to flying after coronary artery disease: a case series among Malaysian pilots","volume":"63","author":"Mohammad","year":"2021","journal-title":"J Occup Health"},{"key":"2026110212020522100_ivag217-B66","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1002\/hbm.24587","article-title":"White matter and hypoxic hypobaria in humans","volume":"40","author":"McGuire","year":"2019","journal-title":"Hum Brain Mapp"},{"key":"2026110212020522100_ivag217-B67","doi-asserted-by":"crossref","first-page":"863","DOI":"10.3357\/ASEM.2135.2011","article-title":"Autonomic modulations during 5 hours at 4574 m (15,000 ft) breathing 40% oxygen","volume":"82","author":"Prabhakaran","year":"2011","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B68","doi-asserted-by":"crossref","DOI":"10.3390\/jcm12237492","article-title":"Selected exogenous (occupational and environmental) risk factors for cardiovascular diseases in military and aviation","volume":"12","author":"Maculewicz","year":"2023","journal-title":"J Clin Med"},{"key":"2026110212020522100_ivag217-B69","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.amj.2024.11.012","article-title":"A comparative evaluation of selection processes for helicopter emergency medical service paramedics in Australasia","volume":"44","author":"Silva","year":"2025","journal-title":"Air Med J"},{"key":"2026110212020522100_ivag217-B70","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.3390\/brainsci14121296","article-title":"Neurological biomarker profiles in royal Canadian air force (RCAF) pilots and aircrew","volume":"14","author":"Rhind","year":"2024","journal-title":"Brain Sci"},{"key":"2026110212020522100_ivag217-B71","doi-asserted-by":"crossref","first-page":"565","DOI":"10.3357\/AMHP.5401.2020","article-title":"Body composition differences in military pilots and aircrew","volume":"91","author":"Bustamante-S\u00e1nchez","year":"2020","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B72","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/978-3-642-93607-4_22","volume-title":"Die Psychologie des Menschen im Flugzeug","author":"Gerathewohl","year":"1953"},{"key":"2026110212020522100_ivag217-B73","first-page":"1","article-title":"Der kreislauf unter beschleunigung. R\u00f6ntgenaufnahmen beim affen","volume":"2","author":"Fischer","year":"1937","journal-title":"Luftfahrtmedizin"},{"key":"2026110212020522100_ivag217-B74","doi-asserted-by":"crossref","first-page":"950","DOI":"10.3357\/AMHP.5985.2021","article-title":"Grounding of pilots: medical reasons and recommendations for prevention","volume":"92","author":"Simons","year":"2021","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B75"},{"key":"2026110212020522100_ivag217-B76"},{"key":"2026110212020522100_ivag217-B77"},{"key":"2026110212020522100_ivag217-B78","doi-asserted-by":"crossref","first-page":"2125","DOI":"10.3390\/biomedicines13092125","article-title":"Work-Related stress and glucose regulation in air traffic control officers: implications for medical certification","volume":"13","author":"Verde","year":"2025","journal-title":"Biomedicines"},{"key":"2026110212020522100_ivag217-B79","author":"Air Crew, Flight Crew"},{"key":"2026110212020522100_ivag217-B80","year":"2025"},{"key":"2026110212020522100_ivag217-B81","author":"Licenses & Certificates"},{"key":"2026110212020522100_ivag217-B82","author":"Licensing for General Aviation: European Union Aviation Safety Agency (EASA)"},{"key":"2026110212020522100_ivag217-B83","author":"Guide for Aviation Medical Examiners Federal Aviation Administration (FAA)"},{"key":"2026110212020522100_ivag217-B84","author":"Medical certificates for UK licences"},{"key":"2026110212020522100_ivag217-B85","first-page":"260","article-title":"Flight safety and medical incapacitation risk of airline pilots","volume":"75","author":"Mitchell","year":"2004","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B86","doi-asserted-by":"crossref","first-page":"590","DOI":"10.3357\/AMHP.6671.2025","article-title":"Aeromedical concerns about extended minimum crew operations","volume":"96","author":"Simons","year":"2025","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B87","author":"Easy Access Rules for Medical Requirements"},{"key":"2026110212020522100_ivag217-B88","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1136\/thorax-2024-221468","article-title":"Implications of the hypobaric cabin environment during commercial air travel for passenger fitness to fly","volume":"79","author":"Hodkinson","year":"2024","journal-title":"Thorax"},{"key":"2026110212020522100_ivag217-B89","doi-asserted-by":"crossref","first-page":"2108","DOI":"10.3390\/ijerph18042108","article-title":"Relationships among affect, hardiness and Self-Efficacy in first aid provision by airline cabin crew","volume":"18","author":"Yu","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2026110212020522100_ivag217-B90","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3357\/AMHP.5715.2021","article-title":"In-flight medical events and cabin crew first aid response","volume":"92","author":"Paxinos","year":"2021","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B91","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1093\/jtm\/taw091","article-title":"Comparison of inflight first aid performed by cabin crew members and medical volunteers","volume":"24","author":"Kim","year":"2017","journal-title":"J Travel Med"},{"key":"2026110212020522100_ivag217-B92","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1016\/S0140-6736(09)60209-9","article-title":"Medical issues associated with commercial flights","volume":"373","author":"Silverman","year":"2009","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B93","author":"Medical Manual"},{"key":"2026110212020522100_ivag217-B94","doi-asserted-by":"crossref","first-page":"3415","DOI":"10.1093\/eurheartj\/ehae177","article-title":"2024 ESC guidelines for the management of chronic coronary syndromes","volume":"45","author":"Vrints","year":"2024","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B95","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.jacc.2021.05.010","article-title":"Improving terminology to describe coronary artery procedures: JACC review topic of the week","volume":"78","author":"Doenst","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B96","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S0140-6736(18)30423-9","article-title":"Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data","volume":"391","author":"Head","year":"2018","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B97","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1001\/jamainternmed.2020.4748","article-title":"Overall and cause-specific mortality in randomized clinical trials comparing percutaneous interventions with coronary bypass surgery: a meta-analysis","volume":"180","author":"Gaudino","year":"2020","journal-title":"JAMA Intern Med"},{"key":"2026110212020522100_ivag217-B98","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.jacc.2018.04.071","article-title":"Stroke rates following surgical versus percutaneous coronary revascularization","volume":"72","author":"Head","year":"2018","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B99","doi-asserted-by":"crossref","first-page":"ezad286","DOI":"10.1093\/ejcts\/ezad286","article-title":"2022 Joint ESC\/EACTS review of the 2018 guideline recommendations on the revascularization of left main coronary artery disease in patients at low surgical risk and anatomy suitable for PCI or CABG","volume":"64","author":"Byrne","year":"2023","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B100","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1016\/S0140-6736(13)60141-5","article-title":"Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial","volume":"381","author":"Mohr","year":"2013","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B101","doi-asserted-by":"crossref","first-page":"1481","DOI":"10.1016\/S0140-6736(25)00505-7","article-title":"Outcomes after fractional flow reserve-guided percutaneous coronary intervention versus coronary artery bypass grafting (FAME 3): 5-year follow-up of a multicentre, open-label, randomised trial","volume":"405","author":"Fearon","year":"2025","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B102","doi-asserted-by":"publisher","first-page":"890","DOI":"10.1161\/CIRCULATIONAHA.125.075875","article-title":"Spontaneous myocardial infarction after left main revascularization: the EXCEL trial","volume":"153","author":"Madhavan","year":"2026","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B103","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/S0140-6736(19)31997-X","article-title":"Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial","volume":"394","author":"Thuijs","year":"2019","journal-title":"Lancet"},{"key":"2026110212020522100_ivag217-B104","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1161\/CIRCULATIONAHA.125.073591","article-title":"Health status outcomes with percutaneous coronary intervention and coronary artery bypass grafting in ISCHEMIA","volume":"152","author":"Huded","year":"2025","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B105","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1093\/ehjqcco\/qcab075","article-title":"Effect of coronary artery bypass grafting on quality of life: a meta-analysis of randomized trials","volume":"8","author":"Creber","year":"2022","journal-title":"Eur Heart J Qual Care Clin Outcomes"},{"key":"2026110212020522100_ivag217-B106","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1161\/CIRCULATIONAHA.120.046289","article-title":"Ten-year all-cause death according to completeness of revascularization in patients with three-vessel disease or left main coronary artery disease: insights from the SYNTAX extended survival study","volume":"144","author":"Takahashi","year":"2021","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B107","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1056\/NEJMoa2112299","article-title":"Fractional flow reserve\u2013guided PCI as compared with coronary bypass surgery","volume":"386","author":"Fearon","year":"2022","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B108","doi-asserted-by":"crossref","first-page":"e004598","DOI":"10.1161\/JAHA.116.004598","article-title":"Impact of incomplete percutaneous revascularization in patients with multivessel coronary artery disease: a systematic review and meta-analysis","volume":"5","author":"Nagaraja","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2026110212020522100_ivag217-B109","doi-asserted-by":"crossref","first-page":"e013192","DOI":"10.1161\/CIRCINTERVENTIONS.123.013192","article-title":"Impact of incomplete revascularization after PCI in left main disease: the EXCEL trial","volume":"17","author":"Ali","year":"2024","journal-title":"Circ Cardiovasc Interv"},{"key":"2026110212020522100_ivag217-B110","doi-asserted-by":"crossref","first-page":"1318","DOI":"10.1016\/S0735-1097(86)80303-5","article-title":"Should airline pilots be eligible to resume active flight status after coronary bypass surgery?: a CASS registry study","volume":"8","author":"Chaitman","year":"1986","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B111","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1056\/NEJMoa1803538","article-title":"Five-year outcomes with PCI guided by fractional flow reserve","volume":"379","author":"Xaplanteris","year":"2018","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B112","doi-asserted-by":"crossref","first-page":"e1257","DOI":"10.4244\/EIJV11I11A247","article-title":"Long-term outcome of FFR-guided PCI for stable coronary artery disease in daily clinical practice: a propensity score-matched landmark analysis","volume":"11","author":"De Backer","year":"2016","journal-title":"EuroIntervention"},{"key":"2026110212020522100_ivag217-B113","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1016\/j.xjon.2020.11.005","article-title":"Commentary: fractional flow reserve for coronary artery bypass graft surgery-not yet ready for prime time","volume":"5","author":"Lazar","year":"2021","journal-title":"JTCVS Open"},{"key":"2026110212020522100_ivag217-B114","doi-asserted-by":"crossref","first-page":"e999","DOI":"10.4244\/EIJ-D-19-00463","article-title":"Graft patency after FFR-guided versus angiography-guided coronary artery bypass grafting: the GRAFFITI trial","volume":"15","author":"Toth","year":"2019","journal-title":"EuroIntervention"},{"key":"2026110212020522100_ivag217-B115","doi-asserted-by":"crossref","first-page":"e948","DOI":"10.4244\/EIJV15I11A177","article-title":"FFR for CABG: not ready for prime time","volume":"15","author":"Gaudino","year":"2019","journal-title":"EuroIntervention"},{"key":"2026110212020522100_ivag217-B116","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1016\/j.jacc.2018.11.053","article-title":"PCI and CABG for treating stable coronary artery disease: JACC review topic of the week","volume":"73","author":"Doenst","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B117","doi-asserted-by":"crossref","first-page":"2406","DOI":"10.1093\/eurheartj\/ehad108","article-title":"Radial artery vs. internal thoracic artery or saphenous vein grafts: 15-year results of the RAPCO trials","volume":"44","author":"Hamilton","year":"2023","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B118","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1161\/CIRCULATIONAHA.122.062343","article-title":"Long-term mortality Follow-Up of radial artery versus saphenous vein in coronary artery bypass grafting: a multicenter, randomized trial","volume":"146","author":"Goldman","year":"2022","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B119","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1056\/NEJMoa1808783","article-title":"Bilateral versus single internal-thoracic-artery grafts at 10 years","volume":"380","author":"Taggart","year":"2019","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B120","doi-asserted-by":"crossref","first-page":"e010839","DOI":"10.1161\/JAHA.118.010839","article-title":"Radial artery versus right internal thoracic artery versus saphenous vein as the second conduit for coronary artery bypass surgery: a network meta-analysis of clinical outcomes","volume":"8","author":"Gaudino","year":"2019","journal-title":"J Am Heart Assoc"},{"key":"2026110212020522100_ivag217-B121","doi-asserted-by":"crossref","first-page":"ezad163","DOI":"10.1093\/ejcts\/ezad163","article-title":"Expert systematic review on the choice of conduits for coronary artery bypass grafting: endorsed by the European Association for Cardio-Thoracic Surgery (EACTS) and the Society of Thoracic Surgeons (STS)","volume":"64","author":"Gaudino","year":"2023","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B122","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1056\/NEJMoa1716026","article-title":"Radial-artery or saphenous-vein grafts in coronary-artery bypass surgery","volume":"378","author":"Gaudino","year":"2018","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B123","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.jacc.2020.11.055","article-title":"Mortality 10 years after percutaneous or surgical revascularization in patients with total coronary artery occlusions","volume":"77","author":"Kawashima","year":"2021","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B124","doi-asserted-by":"crossref","first-page":"e042368","DOI":"10.1161\/JAHA.125.042368","article-title":"Coronary chronic total occlusions affect long-term prognosis in heart failure with mildly reduced ejection fraction","volume":"14","author":"Behnes","year":"2025","journal-title":"J Am Heart Assoc"},{"key":"2026110212020522100_ivag217-B125","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1038\/s41746-026-02410-1","article-title":"Flight rules for clinical AI: lessons from aviation for human-AI collaboration in medicine","volume":"9","author":"Ong","year":"2026","journal-title":"NPJ Digit Med"},{"key":"2026110212020522100_ivag217-B126"},{"key":"2026110212020522100_ivag217-B127","doi-asserted-by":"crossref","first-page":"ezae355","DOI":"10.1093\/ejcts\/ezae355","article-title":"2024 EACTS guidelines on perioperative medication in adult cardiac surgery","volume":"67","author":"Jeppsson","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B128","first-page":"383","article-title":"Pilot licensing after aortic valve surgery","volume":"19","author":"Syburra","year":"2010","journal-title":"J Heart Valve Dis"},{"key":"2026110212020522100_ivag217-B129","doi-asserted-by":"crossref","first-page":"ezaf276","DOI":"10.1093\/ejcts\/ezaf276","article-title":"2025 ESC\/EACTS guidelines for the management of valvular heart disease: developed by the task force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"67","author":"Praz","year":"2025","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B130","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1159\/000245936","article-title":"Screening echocardiography of military aircrew candidates: aeromedical implications","volume":"115","author":"Wand","year":"2010","journal-title":"Cardiology"},{"key":"2026110212020522100_ivag217-B131","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1017\/S1047951116002560","article-title":"Bicuspid aortic valve outcomes","volume":"27","author":"Rodrigues","year":"2017","journal-title":"Cardiol Young"},{"key":"2026110212020522100_ivag217-B132","author":"Manual of Civil Aviation Medicine"},{"key":"2026110212020522100_ivag217-B133","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/heartjnl-2014-307020","article-title":"The modern epidemiology of heart valve disease","volume":"102","author":"Coffey","year":"2016","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B134","first-page":"485","volume-title":"Rayman\u2019s Clinical Aviation Medicine","author":"Rayman","year":"2013"},{"key":"2026110212020522100_ivag217-B135","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1159\/000096024","article-title":"Effect of G-force on bicuspid aortic valve in aviators","volume":"108","author":"Carter","year":"2007","journal-title":"Cardiology"},{"key":"2026110212020522100_ivag217-B136","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1016\/j.jtcvs.2017.10.140","article-title":"Height alone, rather than body surface area, suffices for risk estimation in ascending aortic aneurysm","volume":"155","author":"Zafar","year":"2018","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026110212020522100_ivag217-B137","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.3357\/ASEM.3924.2014","article-title":"Regurgitant valvular disease prevalence and progression found on echocardiogram in military aviators","volume":"85","author":"Davis","year":"2014","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B138","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/ejcts\/ezaa263","article-title":"Essential information on surgical heart valve characteristics for optimal valve prosthesis selection: expert consensus document from the European Association for Cardio-Thoracic Surgery (EACTS)-the Society of Thoracic Surgeons (STS)-American Association for Thoracic Surgery (AATS) Valve Labelling Task Force","volume":"59","author":"Durko","year":"2021","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B139","doi-asserted-by":"crossref","first-page":"1164","DOI":"10.1016\/j.athoracsur.2024.01.023","article-title":"Patient-prosthesis mismatch after surgical aortic valve replacement: analysis of the PARTNER trials","volume":"117","author":"Thourani","year":"2024","journal-title":"Ann Thorac Surg"},{"key":"2026110212020522100_ivag217-B140","doi-asserted-by":"publisher","first-page":"ezaf295","DOI":"10.1093\/ejcts\/ezaf295","article-title":"EACTS expert consensus statement on the ross procedure in adult patients","volume":"68","author":"Vojacek","year":"2026","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B141","first-page":"845","article-title":"Military aviators with mitral valve prolapse: long-term follow-up and aeromedical endpoints","volume":"78","author":"Osswald","year":"2007","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B142","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B143","doi-asserted-by":"publisher","first-page":"ezad426","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"65","author":"Czerny","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B144","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.jtcvs.2023.06.021","article-title":"Twenty-five years of observations from the international registry of acute aortic dissection (IRAD) and its impact on the cardiovascular scientific community","volume":"168","author":"Trimarchi","year":"2024","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026110212020522100_ivag217-B145"},{"key":"2026110212020522100_ivag217-B146","doi-asserted-by":"crossref","first-page":"3952","DOI":"10.1093\/eurheartj\/ehaf192","article-title":"2025 ESC guidelines for the management of myocarditis and pericarditis","volume":"46","author":"Schulz-Menger","year":"2025","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B147","doi-asserted-by":"publisher","first-page":"ezaf330","DOI":"10.1093\/ejcts\/ezaf330","article-title":"EACTS\/STS\/AATS guidelines on temporary mechanical circulatory support in adult cardiac surgery","volume":"68","author":"Potapov","year":"2025","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B148","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1093\/ejcts\/ezz098","article-title":"2019 EACTS expert consensus on long-term mechanical circulatory support","volume":"56","author":"Potapov","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026110212020522100_ivag217-B149","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.healun.2004.01.011","article-title":"The case for selective re-issuance of medical certificates to allow pilots who have received a heart transplant to resume flying","volume":"24","author":"McGiffin","year":"2005","journal-title":"J Heart Lung Transplant"},{"key":"2026110212020522100_ivag217-B150","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1161\/CIRCULATIONAHA.113.008396","article-title":"Lifetime prevalence of congenital heart disease in the general population from 2000 to 2010","volume":"130","author":"Marelli","year":"2014","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B151","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1038\/nrcardio.2010.166","article-title":"The changing epidemiology of congenital heart disease","volume":"8","author":"van der Bom","year":"2011","journal-title":"Nat Rev Cardiol"},{"key":"2026110212020522100_ivag217-B152","doi-asserted-by":"crossref","first-page":"e1162","DOI":"10.1161\/CIR.0000000000000638","article-title":"Use of risk assessment tools to guide decision-making in the primary prevention of atherosclerotic cardiovascular disease: a special report from the American Heart Association and American College of Cardiology","volume":"139","author":"Lloyd-Jones","year":"2019","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B153","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.jacc.2010.03.085","article-title":"Changing mortality in congenital heart disease","volume":"56","author":"Khairy","year":"2010","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B154","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1093\/eurheartj\/ehaa554","article-title":"2020 ESC guidelines for the management of adult congenital heart disease","volume":"42","author":"Baumgartner","year":"2021","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B155","doi-asserted-by":"crossref","first-page":"2272","DOI":"10.1093\/hmg\/ddab189","article-title":"New insights into the evolution of human Y chromosome palindromes through mutation and gene conversion","volume":"30","author":"Bonito","year":"2021","journal-title":"Hum Mol Genet"},{"key":"2026110212020522100_ivag217-B156","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1139\/cjm-2020-0012","article-title":"Co-occurrence patterns among prokaryotes across an age gradient in pit mud of Chinese strong-flavor liquor","volume":"66","author":"Zheng","year":"2020","journal-title":"Can J Microbiol"},{"key":"2026110212020522100_ivag217-B157","doi-asserted-by":"crossref","first-page":"e179","DOI":"10.1097\/JNR.0000000000000462","article-title":"Exploring the barriers faced by nephrology nurses in initiating patients with chronic kidney disease into advance care planning using focus-group interviews","volume":"29","author":"Chen","year":"2021","journal-title":"J Nurs Res"},{"key":"2026110212020522100_ivag217-B158","doi-asserted-by":"crossref","first-page":"3182","DOI":"10.1093\/eurheartj\/ehy649","article-title":"European position paper on the management of patients with patent foramen ovale. General approach and left circulation thromboembolism","volume":"40","author":"Pristipino","year":"2019","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B159","doi-asserted-by":"crossref","first-page":"1840","DOI":"10.1111\/ene.14795","article-title":"Antiherpetic medication and incident dementia: observational cohort studies in four countries","volume":"28","author":"Schnier","year":"2021","journal-title":"Eur J Neurol"},{"key":"2026110212020522100_ivag217-B160","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1111\/j.1467-7687.2010.01008.x","article-title":"Learning to read changes children\u2019s phonological skills: evidence from a latent variable longitudinal study of reading and nonword repetition","volume":"14","author":"Nation","year":"2011","journal-title":"Dev Sci"},{"key":"2026110212020522100_ivag217-B161","first-page":"94","article-title":"An audit of persistent foramen ovale closure in 105 divers","volume":"45","author":"Pearman","year":"2015","journal-title":"Diving Hyperb Med"},{"key":"2026110212020522100_ivag217-B162","doi-asserted-by":"publisher","DOI":"10.1201\/b19572","volume-title":"Extremal Optimization: fundamentals, Algorithms, and Applications","author":"Lu","year":"2016","edition":"1st ed"},{"key":"2026110212020522100_ivag217-B163","first-page":"180","article-title":"Transcatheter PFO closure in an aircrew member with cryptogenic stroke: aeromedical disposition","volume":"75","author":"Johnson","year":"2004","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B164","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1016\/S0735-1097(01)01427-9","article-title":"Patent foramen ovale: a review of associated conditions and the impact of physiological size","volume":"38","author":"Kerut","year":"2001","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B165","first-page":"175","article-title":"Risk of decompression sickness with patent foramen ovale","volume":"25","author":"Bove","year":"1998","journal-title":"Undersea Hyperb Med"},{"key":"2026110212020522100_ivag217-B166","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/j.athoracsur.2004.06.083","article-title":"Does cross-clamping the arch increase the risk of descending thoracic and thoracoabdominal aneurysm repair?","volume":"79","author":"Girardi","year":"2005","journal-title":"Ann Thorac Surg"},{"key":"2026110212020522100_ivag217-B167","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1161\/CIRCULATIONAHA.125.076678","article-title":"Three-year follow-up of the NOTION-2 trial: TAVR versus SAVR to treat younger low-risk patients with tricuspid or bicuspid aortic stenosis","volume":"152","author":"J\u00f8rgensen","year":"2025","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B168","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1056\/NEJMoa2300213","article-title":"Five-year follow-up after transcatheter repair of secondary mitral regurgitation","volume":"388","author":"Stone","year":"2023","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B169","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1056\/NEJMoa1805374","article-title":"Percutaneous repair or medical treatment for secondary mitral regurgitation","volume":"379","author":"Obadia","year":"2018","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B170","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1056\/NEJMoa2314328","article-title":"Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation","volume":"391","author":"Anker","year":"2024","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B171","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1056\/NEJMoa2408739","article-title":"Transcatheter repair versus Mitral-Valve surgery for secondary mitral regurgitation","volume":"391","author":"Baldus","year":"2024","journal-title":"N Engl J Med"},{"key":"2026110212020522100_ivag217-B172"},{"key":"2026110212020522100_ivag217-B173"},{"key":"2026110212020522100_ivag217-B174","doi-asserted-by":"publisher","first-page":"zwac045","DOI":"10.1093\/eurjpc\/zwac045","article-title":"Possible safety hazards with cardiac implantable electronic devices in those working in the aviation industry","volume":"30","author":"Guettler","year":"2022","journal-title":"Eur J Prev Cardiol"},{"key":"2026110212020522100_ivag217-B175","doi-asserted-by":"publisher","first-page":"35","DOI":"10.3390\/jcm8010035","article-title":"Safety of permanent pacemaker implantation: a prospective study","volume":"8","author":"Carri\u00f3n-Camacho","year":"2019","journal-title":"J Clin Med"},{"key":"2026110212020522100_ivag217-B176","doi-asserted-by":"crossref","first-page":"3427","DOI":"10.1093\/eurheartj\/ehab364","article-title":"2021 ESC guidelines on cardiac pacing and cardiac resynchronization therapy","volume":"42","author":"Glikson","year":"2021","journal-title":"Eur Heart J"},{"key":"2026110212020522100_ivag217-B177","doi-asserted-by":"crossref","first-page":"e019212","DOI":"10.1161\/JAHA.120.019212","article-title":"Safety and efficacy of leadless pacemakers: a systematic review and meta-analysis","volume":"10","author":"Ngo","year":"2021","journal-title":"J Am Heart Assoc"},{"key":"2026110212020522100_ivag217-B178","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1016\/j.hrthm.2021.12.025","article-title":"Leadless atrioventricular synchronous pacing in an outpatient setting: early lessons learned on factors affecting atrioventricular synchrony","volume":"19","author":"Neugebauer","year":"2022","journal-title":"Heart Rhythm"},{"key":"2026110212020522100_ivag217-B179","doi-asserted-by":"crossref","first-page":"euae043","DOI":"10.1093\/europace\/euae043","article-title":"2024 European Heart Rhythm Association\/Heart Rhythm Society\/Asia Pacific Heart Rhythm Society\/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation","volume":"26","author":"Tzeis","year":"2024","journal-title":"Europace"},{"key":"2026110212020522100_ivag217-B180","author":"International Air Transport Association. Medical Manual","year":"2020"},{"key":"2026110212020522100_ivag217-B181","doi-asserted-by":"crossref","first-page":"e17213","DOI":"10.5812\/ircmj.17213","article-title":"Air travel considerations for the patients with heart failure","volume":"16","author":"Izadi","year":"2014","journal-title":"Iran Red Crescent Med J"},{"key":"2026110212020522100_ivag217-B182","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1136\/thoraxjnl-2021-218110","article-title":"BTS clinical statement on air travel for passengers with respiratory disease","volume":"77","author":"Coker","year":"2022","journal-title":"Thorax"},{"key":"2026110212020522100_ivag217-B183","first-page":"2586","volume-title":"Miller\u2019s Anesthesia","author":"Berg","year":"2020","edition":"9th ed"},{"key":"2026110212020522100_ivag217-B184","author":"Carriage of Special Categories of Passengers (SCPs)"},{"key":"2026110212020522100_ivag217-B185","first-page":"176","volume-title":"Taschenbuch Flugmedizin und Erste Hilfe an Bord","author":"Hufnagel","year":"2024","edition":"3rd"},{"key":"2026110212020522100_ivag217-B186","first-page":"1181","volume-title":"Cardiac Surgery in the Adult","author":"Spotnitz","year":"2017","edition":"5th ed"},{"key":"2026110212020522100_ivag217-B187","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1093\/pch\/12.1.45","article-title":"Lang M; Canadian Paediatric Society, Community Paediatrics Committee. Air travel and children\u2019s health issues","volume":"12","year":"2007","journal-title":"Paediatr Child Health"},{"key":"2026110212020522100_ivag217-B188","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1016\/j.jacc.2011.08.025","article-title":"Birth prevalence of congenital heart disease worldwide: a systematic review and meta-analysis","volume":"58","author":"van der Linde","year":"2011","journal-title":"J Am Coll Cardiol"},{"key":"2026110212020522100_ivag217-B189","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.jtcvs.2016.12.035","article-title":"Safety of air travel in the immediate postoperative period after anatomic pulmonary resection","volume":"153","author":"Cassivi","year":"2017","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026110212020522100_ivag217-B190","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1007\/s00431-018-3119-9","article-title":"Fitness to fly in the paediatric population, how to assess and advice","volume":"177","author":"Isra\u00ebls","year":"2018","journal-title":"Eur J Pediatr"},{"key":"2026110212020522100_ivag217-B191","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1136\/heartjnl-2017-312753","article-title":"Hypoxic challenge testing (fitness to fly) in children with complex congenital heart disease","volume":"104","author":"Naqvi","year":"2018","journal-title":"Heart"},{"key":"2026110212020522100_ivag217-B192","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1111\/chd.12850","article-title":"Exercise responses in children and adults with a Fontan circulation at simulated altitude","volume":"14","author":"Takken","year":"2019","journal-title":"Congenit Heart Dis"},{"key":"2026110212020522100_ivag217-B193","doi-asserted-by":"crossref","first-page":"1170275","DOI":"10.3389\/fcvm.2023.1170275","article-title":"Fitness to fly for children and adolescents after Fontan palliation","volume":"10","author":"M\u00fcller","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"2026110212020522100_ivag217-B194","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.21037\/cdt-20-494","article-title":"Altitude exposure in pediatric pulmonary hypertension\u2014are we ready for (flight) recommendations?","volume":"11","author":"Herberg","year":"2021","journal-title":"Cardiovasc Diagn Ther"},{"key":"2026110212020522100_ivag217-B195","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.3357\/AMHP.4580.2016","article-title":"Feasibility of hypoxic challenge testing in children and adolescents with congenital heart and lung disease","volume":"87","author":"Spoorenberg","year":"2016","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B196","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1089\/ham.2009.10306","article-title":"Can patients with pulmonary hypertension travel to high altitude?","volume":"10","author":"Luks","year":"2009","journal-title":"High Alt Med Biol"},{"key":"2026110212020522100_ivag217-B197","doi-asserted-by":"crossref","first-page":"e234","DOI":"10.1161\/CIR.0000000000000696","article-title":"Evaluation and management of the child and adult with Fontan circulation: a scientific statement from the American Heart Association","volume":"140","author":"Rychik","year":"2019","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B198","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1161\/01.CIR.93.2.272","article-title":"Air travel and adults with cyanotic congenital heart disease","volume":"93","author":"Harinck","year":"1996","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B199","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1161\/CIR.0000000000000329","article-title":"Pediatric pulmonary hypertension: guidelines from the American Heart Association and American Thoracic Society","volume":"132","author":"Abman","year":"2015","journal-title":"Circulation"},{"key":"2026110212020522100_ivag217-B200","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1097\/PEP.0000000000000734","article-title":"Sternal precautions and prone positioning of infants following median sternotomy: a nationwide survey","volume":"32","author":"Clifton","year":"2020","journal-title":"Pediatr Phys Ther"},{"key":"2026110212020522100_ivag217-B201","doi-asserted-by":"crossref","first-page":"1987","DOI":"10.1016\/j.athoracsur.2021.11.014","article-title":"Strategies to evaluate early sternal stability after median sternotomy in young children","volume":"114","author":"Luo","year":"2022","journal-title":"Ann Thorac Surg"},{"key":"2026110212020522100_ivag217-B202","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1378\/chest.13-2363","article-title":"Air travel and pneumothorax","volume":"145","author":"Hu","year":"2014","journal-title":"Chest"},{"key":"2026110212020522100_ivag217-B203","first-page":"287","article-title":"Helping patients travel by air","volume":"144","author":"Skjenna","year":"1991","journal-title":"CMAJ"},{"key":"2026110212020522100_ivag217-B204","doi-asserted-by":"crossref","first-page":"113","DOI":"10.3357\/AMHP.6261.2024","article-title":"Pneumothorax and timing to safe air travel","volume":"95","author":"Kashtan","year":"2024","journal-title":"Aerosp Med Hum Perform"},{"key":"2026110212020522100_ivag217-B205","doi-asserted-by":"crossref","first-page":"1961","DOI":"10.1016\/j.chest.2020.11.002","article-title":"Assessing patients for air travel","volume":"159","author":"Bellinghausen","year":"2021","journal-title":"Chest"},{"key":"2026110212020522100_ivag217-B206","first-page":"403","article-title":"Medical advice for commercial air travel","volume":"104","author":"Powell-Dunford","year":"2021","journal-title":"Am Fam Physician"},{"key":"2026110212020522100_ivag217-B207","first-page":"A1","article-title":"Medical guidelines for airline travel, 2nd ed","volume":"74","author":"Aerospace Medical Association Medical Guidelines Task Force","year":"2003","journal-title":"Aviat Space Environ Med"},{"key":"2026110212020522100_ivag217-B208","doi-asserted-by":"crossref","first-page":"423","DOI":"10.3357\/ASEM.2694.2010","article-title":"Expansion of postoperative pneumothorax and pneumomediastinum: determining when it is safe to fly","volume":"81","author":"Szymanski","year":"2010","journal-title":"Aviat Space Environ Med"}],"container-title":["Interdisciplinary CardioVascular and Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/10\/ivag217\/71626789\/ivag217.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/icvts\/article-pdf\/41\/10\/ivag217\/71626789\/ivag217.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:02:30Z","timestamp":1793638950000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/icvts\/article\/doi\/10.1093\/icvts\/ivag217\/8868926"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":208,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,7]]}},"URL":"https:\/\/doi.org\/10.1093\/icvts\/ivag217","relation":{},"ISSN":["2753-670X"],"issn-type":[{"value":"2753-670X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,10]]},"article-number":"ivag217"}}