{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T03:57:50Z","timestamp":1781841470619,"version":"3.54.5"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T00:00:00Z","timestamp":1649203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Patients with autoimmune connective tissue diseases (CTDs) have a high burden of valvular heart disease and are often thought of as high surgical risk patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>Patients undergoing aortic valve replacement (AVR) were identified in the Nationwide Readmissions Database between January 2012 and December 2018. Patients with a history of systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis, mixed C, Sj\u00f6gren syndrome, polymyositis, and dermatomyositis were included in the CTD cohort. Patients undergoing coronary artery bypass grafting concomitantly with AVR were excluded. A total of 569\u2009600 hospitalizations were included, of which16\u2009531 (2.9%) had CTD. CTD patients were more likely to be females, with higher rates of heart failure, pulmonary hypertension, and more likely to be insured by Medicare. CTD patients had lower mortality than non-CTD patients [odds ratio (OR) 0.66; 95% confidence interval (CI): 0.59\u20130.74] and stroke [OR 0.87; 95% (CI): 0.79\u20130.97]. CTD patients undergoing SAVR had lower mortality [OR 0.69; 95% (CI): 0.60\u20130.80] and stroke [OR 0.86; 95% (CI): 0.75\u20130.98). CTD patients undergoing TAVR had lower mortality outcomes [OR 0.67; 95% (CI): 0.56\u20130.80]; however, they had comparable stroke outcomes [OR 0.97; 95% (CI): 0.83\u20131.13, P\u2009=\u20090.69].<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Outcomes for patients with CTD requiring AVR are not inferior to their non-CTD counterparts. A comprehensive heart team selection of patients undergoing AVR approaches should place CTD history under consideration; however, pre-existing CTD should not be prohibitive of AVR interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeac024","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T12:32:01Z","timestamp":1649248321000},"source":"Crossref","is-referenced-by-count":8,"title":["Autoimmune connective tissue diseases and aortic valve replacement outcomes: a population-based study"],"prefix":"10.1093","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0218-3317","authenticated-orcid":false,"given":"Mohamed M.","family":"Gad","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Heart and Vascular Institute , 9500 Euclid Avenue, J2-3, Cleveland, OH 44195, USA"},{"name":"Gillings School of Global Public Health, the University of North Carolina at Chapel 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