{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T17:01:37Z","timestamp":1779987697020,"version":"3.53.1"},"reference-count":3,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["annalsthoracicsurgery.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["The Annals of Thoracic Surgery"],"published-print":{"date-parts":[[2026,3]]},"DOI":"10.1016\/j.athoracsur.2025.06.041","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T07:51:59Z","timestamp":1752565919000},"page":"761","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":1,"title":["Mechanical Valves in Young Women in Low-Income Countries: How Does Rwanda Succeed?"],"prefix":"10.1016","volume":"121","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5740-7707","authenticated-orcid":false,"given":"Valdano","family":"Manuel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.athoracsur.2025.06.041_bib1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1016\/j.athoracsur.2025.06.008","article-title":"A 17-year experience of valvular heart surgery in Rwanda","volume":"121","author":"Musoni","year":"2026","journal-title":"Ann Thorac Surg"},{"key":"10.1016\/j.athoracsur.2025.06.041_bib2","doi-asserted-by":"crossref","DOI":"10.1177\/21501351251345805","article-title":"Historical, cultural, and structural barriers for cardiac surgery in sub-Saharan Africa: lessons learned from Angola","author":"Manuel","year":"2025","journal-title":"World J Pediatr Congenit Heart Surg"},{"key":"10.1016\/j.athoracsur.2025.06.041_bib3","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2024.1347838","article-title":"Mechanical valve replacement for patients with rheumatic heart disease: the reality of INR control in Africa and beyond","volume":"11","author":"Zilla","year":"2024","journal-title":"Front Cardiovasc Med"}],"container-title":["The Annals of Thoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0003497525006460?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0003497525006460?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T16:01:45Z","timestamp":1779984105000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0003497525006460"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":3,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["S0003497525006460"],"URL":"https:\/\/doi.org\/10.1016\/j.athoracsur.2025.06.041","relation":{},"ISSN":["0003-4975"],"issn-type":[{"value":"0003-4975","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Mechanical Valves in Young Women in Low-Income Countries: How Does Rwanda Succeed?","name":"articletitle","label":"Article Title"},{"value":"The Annals of Thoracic Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.athoracsur.2025.06.041","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.athoracsur.2025.06.008","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 by The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}