{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:02Z","timestamp":1787018042346,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Surgical aortic valve replacement (SAVR) is associated with adverse outcomes in patients with radiation-associated aortic stenosis. Transcatheter aortic valve replacement (TAVR) may improve outcomes in this population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We evaluated 1668 TAVR and 2611 patients with SAVR enrolled in the Society of Thoracic Surgeons\u2019 database between 2011 and 2018. Multiple logistic regression was used to compare 30- day outcomes between TAVR and SAVR. Propensity-matched analysis was performed to confirm results of the overall cohort. Additionally, the cohort was stratified into early (2011\u20132014) versus contemporary (2015\u20132018) TAVR eras, and 30-day outcomes for TAVR and SAVR were compared. Finally, outcomes with transfemoral TAVR versus SAVR were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, TAVR was associated with significantly reduced 30-day mortality (odds ratio [OR]\n                      <jats:sub>TAVR\/SAVR<\/jats:sub>\n                      =0.60 [0.40\u20130.91]). Postoperative atrial fibrillation, pneumonia, pleural effusion, renal failure, and bleeding also occurred less frequently with TAVR. Stroke\/transient ischemic attack (TIA; OR\n                      <jats:sub>TAVR\/SAVR<\/jats:sub>\n                      , 2.03 [1.09\u20133.77]) and pacemaker implantation (OR\n                      <jats:sub>TAVR\/SAVR<\/jats:sub>\n                      , 1.62 [1.21\u20132.17]) were higher with TAVR. Propensity-matched analysis yielded similar results as the overall cohort. Following stratification by era, TAVR versus SAVR was associated with reduced 30-day mortality in the contemporary but not early era (OR\n                      <jats:sub>Early<\/jats:sub>\n                      , 0.78 [0.48\u20131.28]; OR\n                      <jats:sub>Contemporary<\/jats:sub>\n                      , 0.31 [0.14\u20130.65]). Pacemaker implantation was higher with TAVR versus SAVR in both eras (OR\n                      <jats:sub>Early<\/jats:sub>\n                      , 1.60 [1.03\u20132.46]; OR\n                      <jats:sub>Contemporary<\/jats:sub>\n                      , 1.64 [1.10\u20132.45]). There was also a nonsignificant trend towards increased stroke\/TIA with TAVR during both eras (OR\n                      <jats:sub>Early<\/jats:sub>\n                      , 1.39 [0.58\u20133.36]; OR\n                      <jats:sub>Contemporary<\/jats:sub>\n                      , 2.46 [0.99\u20136.10]). Finally, transfemoral TAVR (N=1369) versus SAVR revealed similar findings as the overall cohort; however, the association of TAVR with stroke\/TIA was not statistically significant (OR\n                      <jats:sub>Stroke\/TIA<\/jats:sub>\n                      , 1.57 [0.79\u20133.09]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>TAVR provides an effective and evolving alternative to SAVR for radiation-associated severe aortic stenosis and was associated with lower 30-day mortality and postoperative complications. TAVR was associated with increased pacemaker implantation and a trend towards increased stroke\/TIA. In this unique population with extensive valvular and vascular calcifications, the risk of stroke\/TIA with TAVR requires careful consideration and further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.120.010009","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T06:00:01Z","timestamp":1612504801000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Short-Term Outcomes of Transcatheter Versus Isolated Surgical Aortic Valve Replacement for Mediastinal Radiation-Associated Severe Aortic Stenosis"],"prefix":"10.1161","volume":"14","author":[{"given":"Victor","family":"Nauffal","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine (V.N., P.B.S., P.S.S., P.O., A.N.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camden","family":"Bay","sequence":"additional","affiliation":[{"name":"Center for Clinical Investigation (C.B.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinak B.","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (V.N., P.B.S., P.S.S., P.O., A.N.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piotr S.","family":"Sobieszczyk","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (V.N., P.B.S., P.S.S., P.O., A.N.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery (T.K.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0601-1088","authenticated-orcid":true,"given":"Patrick","family":"O\u2019Gara","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (V.N., P.B.S., P.S.S., P.O., A.N.), Brigham and Women\u2019s Hospital, Boston, MA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7113-1118","authenticated-orcid":true,"given":"Anju","family":"Nohria","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine (V.N., P.B.S., P.S.S., P.O., A.N.), Brigham and Women\u2019s Hospital, Boston, MA."},{"name":"Cardio-Oncology Program, Dana-Farber Cancer Institute and Brigham and Women\u2019s Hospital, Boston, MA (A.N.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.04.028"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005396"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2018.03.002"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816885"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1700456"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1103510"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.118.035514"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012110"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40959-019-0044-7"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.08.2172"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.carpath.2019.107176"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2017.06.037"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.04.053"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00381"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.11.033"}],"container-title":["Circulation: Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCINTERVENTIONS.120.010009","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:56:30Z","timestamp":1715554590000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCINTERVENTIONS.120.010009"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2]]},"references-count":15,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,2]]}},"alternative-id":["10.1161\/CIRCINTERVENTIONS.120.010009"],"URL":"https:\/\/doi.org\/10.1161\/circinterventions.120.010009","relation":{},"ISSN":["1941-7640","1941-7632"],"issn-type":[{"value":"1941-7640","type":"print"},{"value":"1941-7632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2]]},"assertion":[{"value":"2020-08-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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