{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:00Z","timestamp":1787018100050,"version":"build-2736575974"},"reference-count":39,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,5,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Patients with symptomatic severe aortic stenosis and a history of chest radiation therapy represent a complex and challenging cohort. It is unknown how transcatheter aortic valve replacement (\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      ) compares with surgical aortic valve replacement in this group of patients, which was the objective of this study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We retrospectively reviewed all patients with severe aortic stenosis who underwent either\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      or surgical aortic valve replacement at our institution with a history of mediastinal radiation (n=55 per group). End points were echocardiographic and clinical outcomes in\u2010hospital, at 30\u00a0days, and at 1\u00a0year. Inverse propensity weighting analysis was used to account for intergroup baseline differences.\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      patients had a higher\n                      <jats:styled-content style=\"fixed-case\">STS<\/jats:styled-content>\n                      score than surgical aortic valve replacement patients (5.1% [3.2, 7.7] versus 1.6% [0.8, 2.6],\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and more often (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.01 for all) a history of atrial fibrillation (45.5% versus 12.7%), chronic lung disease (47.3% versus 7.3%), peripheral arterial disease (38.2% versus 7.3%), heart failure (58.2% versus 18.2%), and pacemaker therapy (23.6% versus 1.8%). Postoperative atrial fibrillation was less frequent (1.8% versus 27.3%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and hospital stay was shorter in\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      patients (4.0 [2.0, 5.0] versus 6.0 [5.0, 8.0] days;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). The ratio of observed\u2010to\u2010expected 30\u2010day mortality was lower after\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      as was 30\u2010day mortality in inverse propensity weighting\u2013adjusted Kaplan\u2013Meier analyses.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      In patients with severe aortic stenosis and a history of chest radiation therapy,\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      performs better than predicted along with less adjusted 30\u2010day all\u2010cause mortality, postoperative atrial fibrillation, and shorter hospitalization compared with surgical aortic valve replacement. These data support further studies on the preferred role of\n                      <jats:styled-content style=\"fixed-case\">TAVR<\/jats:styled-content>\n                      in this unique patient population.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.119.012110","type":"journal-article","created":{"date-parts":[[2019,5,24]],"date-time":"2019-05-24T09:12:57Z","timestamp":1558689177000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":37,"title":["Outcomes of Patients With Severe Symptomatic Aortic Valve Stenosis After Chest Radiation: Transcatheter Versus Surgical Aortic Valve Replacement"],"prefix":"10.1161","volume":"8","author":[{"given":"Dongfeng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Peking University People's Hospital Beijing China"},{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A.","family":"Al\u2010Hijji","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdallah","family":"El Sabbagh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley R.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Section\u00a0of Biostatistics Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Greason","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurpreet S.","family":"Sandhu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackram F.","family":"Eleid","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David R.","family":"Holmes","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Herrmann","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Diseases Mayo Clinic Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.21.2831"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.99.3.538"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2015-308765"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000047200.36165.B8"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000031"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000503"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2015-000252"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.03.060"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs255"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2015.0326"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.029"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.71.6.1162"},{"key":"e_1_3_1_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000174590"},{"key":"e_1_3_1_15_2","article-title":"Guidelines for the evaluation of valvular regurgitation after percutaneous valve repair or replacement: a report from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Angiography and Interventions, Japanese Society of Echocardiography, and Society for Cardiovascular Magnetic Resonance","author":"Zoghbi WA","year":"2019","unstructured":"Zoghbi WA, Asch FM, Bruce C, Gillam LD, Grayburn PA, Hahn RT, Inglessis I, Islam AM, Lerakis S, Little SH, Siegel RJ, Skubas N, Slesnick TC, Stewart WJ, Thavendiranathan P, Weissman NJ, Yasukochi S, Zimmerman KG. 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