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This special article is the 15th in an annual series for the Journal of Cardiothoracic and Vascular Anesthesia. The authors thank the editor-in-chief Dr. Kaplan and the editorial board for the opportunity to continue this series, namely the research highlights of the past year in the specialties of cardiothoracic and vascular anesthesiology. The major themes selected for 2022 are outlined in this introduction, and each highlight is reviewed in detail in the main body of the article. The literature highlights, in the specialties for 2022, begin with an update on COVID-19 therapies, with a focus on the temporal updates in a wide range of therapies, progressing from medical to the use of extracorporeal membrane oxygenation and, ultimately, with lung transplantation in this high-risk group. The second major theme is focused on medical cardiology, with the authors discussing new insights into the life cycle of coronary disease, heart failure treatments, and outcomes related to novel statin therapy. The third theme is focused on mechanical circulatory support, with discussions focusing on both right-sided and left-sided temporary support outcomes and the optimal timing of deployment. The fourth and final theme is an update on cardiac surgery, with a discussion of the diverse aspects of concomitant valvular surgery and the optimal approach to procedural treatment for coronary artery disease. The themes selected for this 15th special article are only a few of the diverse advances in the specialties during 2022. These highlights will inform the reader of key updates on a variety of topics, leading to the improvement of perioperative outcomes for patients with cardiothoracic and vascular disease.

The binding of the phototoxic non-steroidal anti-inflammatory drug naproxen (NX) to β-cyclodextrin (β-CD) in the presence of alcohols or protein (bovine serum albumin, BSA) is described. Changes in the NX fluorescence spectrum shows that it forms a moderately strong 1:1 complex with β-CD in pH 7.4 aqueous buffer at room temperature ( K app =475±35 M −1 ). The presence of 1% linear alcohols (ethanol to pentanol) systematically lowers K app for the β-CD:NX complex. The greatest reduction is observed for the longest alkyl chain. Detailed analysis of K app as a function of [pentanol] suggests that three-member complexes involving the CD, NX and pentanol form ( K 3 =141±32 M −1 ). Quenching the fluorescence of NX with NaI shows that the β-CD cavity protects NX from this aqueous phase quencher. Addition of pentanol inhibits this protective effect. Ultra-violet irradiation of NX at pH 7.4 leads to formation of photoproducts. An amount of 10 mM β-CD strongly inhibits NX photoconversion. Addition of 1% pentanol essentially eliminates the photosuppressive effect of β-CD. By contrast to the moderate CD/NX binding, NX binds very strongly to BSA ( K app =(3.2±1.6)×10 5 M −1 ). Changes in the shape and energy of the NX fluorescence spectrum in the presence of BSA and separation experiments based on molecular weight support the view that BSA essentially displaces NX entirely from the CD environment. The implications of these results for application of CDs as in vivo phototoxicity inhibitors are discussed.