{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:30:14Z","timestamp":1789536614869,"version":"build-2803163510"},"reference-count":50,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T00:00:00Z","timestamp":1760227200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Cancer survivors can develop heart conditions such as aortic valve disease because of age and other shared risk factors. If this valve condition becomes symptomatic, the prognosis is poor if the valve is not replaced. Surgical aortic valve replacement (SAVR) is one mode of treatment. Methods: Of 2500 consecutive patients who underwent SAVR with a biological valve, 388 patients were cancer survivors. They were compared for preoperative characteristics, operative parameters, postoperative adverse events, need for resources, and long-term survival. For the latter, the six most common tumors (prostate, breast, colorectal, bladder, pulmonary, and hematologic) and the effect of the interval between cancer treatment and cardiac surgery were scrutinized. Results: Cancer increased significantly over time. Pulmonary and kidney disease differed between the groups, but cardiac comorbid conditions did not. Operative parameters, early adverse events, and need for resources did not differ. Median survival time was significantly reduced in cancer survivors: 104 (97\u2013112) versus 119 (116\u2013122) months, and this was driven by an interval of less than 5 years and prior lung cancer. Prior cancer was the least important of ten predictors for long-term mortality. Conclusions: The outcome of cancer survivors after SAVR is acceptable. For patients with pulmonary cancer, the outcome is poor.<\/jats:p>","DOI":"10.3390\/cancers17203301","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T07:51:28Z","timestamp":1760428288000},"page":"3301","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Aortic Valve Replacement in Cancer Survivors with Severe Symptomatic Aortic Valve Disease: A Retrospective Single-Center Observational Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0809-2594","authenticated-orcid":false,"given":"Ivo","family":"Deblier","sequence":"first","affiliation":[{"name":"Department Cardiovascular Surgery, ZNA Middelheim General Hospital, Lindendreef 1, 2020 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5375-2640","authenticated-orcid":false,"given":"Ruben","family":"Deblier","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8583-2524","authenticated-orcid":false,"given":"Wilhelm","family":"Mistiaen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,12]]},"reference":[{"key":"ref_1","first-page":"157","article-title":"Transcatheter aortic valve replacement in patients with a history of cancer: Periprocedural and long-term outcomes","volume":"97","author":"Murphy","year":"2021","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1536\/ihj.17-320","article-title":"Prognosis of Cancer Patients with Aortic Stenosis Under Optimal Cancer Therapies and Conservative Cardiac Treatments","volume":"59","author":"Okura","year":"2018","journal-title":"Int. Heart J."},{"key":"ref_3","first-page":"438","article-title":"An update on the management and outcomes of cancer patients with severe aortic stenosis","volume":"94","author":"Schechter","year":"2019","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"3889","DOI":"10.1093\/eurheartj\/ehz766","article-title":"A population-based study of cardiovascular disease mortality risk in US cancer patients","volume":"40","author":"Sturgeon","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/ejcts\/ezy019","article-title":"Cardiac surgery in adult patients with remitted or active malignancies: A review of preoperative screening, surgical management and short- and long-term postoperative results","volume":"54","author":"Lorusso","year":"2018","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_6","first-page":"220","article-title":"Cancer treatment and survivorship statistics","volume":"62","author":"Siegel","year":"2012","journal-title":"CA Cancer J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Santangelo, G., Moscardelli, S., Barbieri, L., Faggiano, A., Carugo, S., and Faggiano, P. (2023). Aortic Valve Stenosis and Cancer: Problems of Management. J. Clin. Med., 12.","DOI":"10.20944\/preprints202308.0404.v1"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1007\/s11764-013-0267-9","article-title":"Cardiovascular risk factors among long-term survivors of breast, prostate, colorectal, and gynecologic cancers: A gap in survivorship care?","volume":"7","author":"Weaver","year":"2013","journal-title":"J. Cancer Surviv."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1200\/JCO.2015.64.0409","article-title":"Cardiovascular Disease Among Survivors of Adult-Onset Cancer: A Community-Based Retrospective Cohort Study","volume":"34","author":"Armenian","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1161\/CIRCULATIONAHA.115.020406","article-title":"Shared Risk Factors in Cardiovascular Disease and Cancer","volume":"133","author":"Koene","year":"2016","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.atherosclerosis.2017.06.001","article-title":"Cardiovascular disease and cancer: Evidence for shared disease pathways and pharmacologic prevention","volume":"263","author":"Masoudkabir","year":"2017","journal-title":"Atherosclerosis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"557","DOI":"10.2143\/AC.61.5.2017772","article-title":"Histopathology of calcific aortic valve stenosis","volume":"61","author":"Somers","year":"2006","journal-title":"Acta Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ejcsup.2014.03.002","article-title":"Cardiovascular disease after cancer therapy","volume":"12","author":"Aleman","year":"2014","journal-title":"EJC Suppl."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1253\/circj.CJ-14-1111","article-title":"Major non-cardiac surgery is a risk factor for rapid hemodynamic progression of non-rheumatic aortic stenosis","volume":"79","author":"Mizuno","year":"2015","journal-title":"Circ. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.jcmg.2015.06.028","article-title":"Valvular dysfunction in lymphoma survivors treated with autologous stem cell transplantation: A national cross-sectional study","volume":"9","author":"Murbraech","year":"2016","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/s11886-019-1166-0","article-title":"The Onco-cardiologist Dilemma: To Implant, to Defer, or to Avoid Transcatheter Aortic Valve Replacement in Cancer Patients with Aortic Stenosis?","volume":"21","author":"Balanescu","year":"2019","journal-title":"Curr. Cardio Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e005396","DOI":"10.1161\/JAHA.116.005396","article-title":"Long-term outcomes of patients with mediastinal radiation-associated severe aortic stenosis and subsequent surgical aortic valve replacement: A matched cohort study","volume":"6","author":"Donnellan","year":"2017","journal-title":"J. Am. Heart Assoc."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.carrev.2024.05.031","article-title":"Outcomes of transcatheter aortic valve replacement in patients with history of chest wall irradiation: Propensity matched analysis of five years data from national inpatient sample (2016\u20132020)","volume":"69","author":"Gajjar","year":"2024","journal-title":"Cardiovasc. Revasc Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e014248","DOI":"10.1161\/JAHA.119.014248","article-title":"Contemporary Trends and Outcomes of Percutaneous and Surgical Aortic Valve Replacement in Patients With Cancer","volume":"9","author":"Guha","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.ijcard.2020.12.054","article-title":"Transcatheter aortic valve replacement after chest radiation: A propensity-matched analysis","volume":"329","author":"Kherallah","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_21","first-page":"7","article-title":"Mediastinal irradiation and valvular heart disease","volume":"8","author":"Patil","year":"2022","journal-title":"Cardiooncology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1016\/j.athoracsur.2003.08.049","article-title":"Effect of Prior Malignancy on Survival After Cardiac Surgery","volume":"77","author":"Mistiaen","year":"2004","journal-title":"Ann. Thorac. Surg."},{"key":"ref_23","first-page":"354","article-title":"Determinants of Survival after Aortic Valve Replacement as Treatment for Symptomatic Aortic Valve Disease in the Elderly","volume":"10","author":"Mistiaen","year":"2001","journal-title":"J. Heart Valve Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.ijcard.2011.02.026","article-title":"Prevalence of comorbidities and associated cardiac diseases in patients with valve aortic stenosis. Potential implications for the decision-making process","volume":"159","author":"Faggiano","year":"2012","journal-title":"Int. J. Cardiol."},{"key":"ref_25","first-page":"170","article-title":"Prognostic factors and valve therapy. To pause or not to pause","volume":"1","author":"Sorajja","year":"2019","journal-title":"Cardio Oncol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.ahj.2023.03.011","article-title":"Incidental detection of malignancy during preprocedural workup for transcatheter aortic valve implantation: A longitudinal cohort study","volume":"261","author":"Demirel","year":"2023","journal-title":"Am. Heart J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e002573","DOI":"10.1136\/openhrt-2023-002573","article-title":"OCEAN-TAVI investigators. Midterm outcomes of transcatheter aortic valve replacement in patients with active cancer","volume":"11","author":"Noguchi","year":"2024","journal-title":"Open Heart"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1093\/ehjci\/jev055","article-title":"Two-year survival of patients screened for transcatheter aortic valv replacement with potentially malignant incidental findings in initial body computed tomography","volume":"16","author":"Stachon","year":"2015","journal-title":"Eur. Heart J.\u2014Cardiovasc. Imaging"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.jjcc.2024.05.006","article-title":"Clinically significant incidental noncardiac findings on preprocedural computed tomography in patients with aortic stenosis undergoing aortic-valve replacement","volume":"84","author":"Yamamoto","year":"2024","journal-title":"J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Askoxylakis, V., Thieke, C., Pleger, S.T., Most, P., Tanner, J., Lindel, K., Katus, H.A., Debus, J., and Bischof, M. (2010). Long-term survival of cancer patients compared to heart failure and stroke: A systematic review. BMC Cancer, 10.","DOI":"10.1186\/1471-2407-10-105"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ijcard.2020.08.071","article-title":"Transcatheter and surgical aortic valve replacement impact on outcomes and cancer treatment schedule","volume":"326","author":"Gill","year":"2021","journal-title":"Int. J. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1016\/0003-4975(93)90034-F","article-title":"Should a Patient With a Treated Cancer Be Offered an Open Heart Operation?","volume":"55","author":"Canver","year":"1993","journal-title":"Ann. Thorac. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"708","DOI":"10.3390\/prosthesis6030050","article-title":"The Outcomes for Different Biological Heart Valve Prostheses in Surgical Aortic Valve Replacement before and after the Introduction of Transcatheter Aortic Valve Implantation","volume":"6","author":"Deblier","year":"2024","journal-title":"Prosthesis"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Deblier, I., Dossche, K., Vanermen, A., and Mistiaen, W. (2024). Predictors of the Need for Permanent Pacemaker Implantation After Surgical Aortic Valve Replacement with a Biological Prosthesis and the Effect on Long-Term Survival. J. Cardiovasc. Dev. Dis., 11.","DOI":"10.3390\/jcdd11120397"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1053\/j.jvca.2021.11.014","article-title":"One-Year Outcome After Cardiac Surgery for Patients With Cancer: An Observational Monocentric Retrospective Study","volume":"36","author":"Portefaix","year":"2022","journal-title":"J. Cardiothorac. Vasc. Anesth."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Porto, A., Stolpe, G., Badaoui, R., Boudouresques, V., Deutsch, C., Amanatiou, C., Riberi, A., Gariboldi, V., Collart, F., and Theron, A. (2023). One-year clinical outcomes following Edwards INSPIRIS RESILIA aortic valve implantation in 487 young patients with severe aortic stenosis: A single-center experience. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1196447"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1157\/13117728","article-title":"Cardiac Surgery With Extracorporeal Circulation in Cancer Patients: Influence on Surgical Morbidity and Mortality, and on Survival","volume":"61","author":"Carrascal","year":"2008","journal-title":"Rev. Esp. Cardiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"152","DOI":"10.2459\/JCM.0000000000000319","article-title":"Cardiac surgery with extracorporeal circulation and concomitant malignancy: Early and long-term results","volume":"17","author":"Nardi","year":"2016","journal-title":"J. Cardiovasc. Med."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1080\/14017431.2019.1698762","article-title":"How to manage patients in whom malignancy and infective endocarditis are associated: A review","volume":"54","author":"Mistiaen","year":"2019","journal-title":"Scand. Cardiovasc. J."},{"key":"ref_40","first-page":"e24089","article-title":"Malignancy and Endocarditis: Divulging Into the Intertwined Association","volume":"14","author":"Pugalenthi","year":"2022","journal-title":"Cureus"},{"key":"ref_41","first-page":"180","article-title":"Malignant disease as a comorbidity in patients with severe aortic stenosis: Clinical presentation, outcomes, and management","volume":"4","author":"Kato","year":"2018","journal-title":"Eur. Heart J. Qual. Care Clin. Outcomes"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1016\/j.ejcts.2003.12.006","article-title":"Cardiac operations in patients with hematologic malignancies","volume":"25","author":"Fecher","year":"2004","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1016\/j.hlc.2017.11.008","article-title":"Early and Late Survival of On-Pump Cardiac Surgery Patients Formerly Affected by Lymphoma","volume":"28","author":"Gatti","year":"2019","journal-title":"Heart Lung Circ."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.athoracsur.2021.07.059","article-title":"Impact of Chronic Lymphocytic Leukemia on Outcomes and Readmissions After Cardiac Operations","volume":"114","author":"Madrigal","year":"2022","journal-title":"Ann. Thorac. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/j.athoracsur.2020.06.033","article-title":"Impact of Hematologic Malignancies on Outcome of Cardiac Surgery","volume":"111","author":"Nguyen","year":"2021","journal-title":"Ann. Thorac. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ejcts.2010.10.031","article-title":"Cardiac surgery and hematologic malignancies: A retrospective single-center analysis of 56 consecutive patients","volume":"40","author":"Sommer","year":"2011","journal-title":"Eur. J. Cardiothorac. Surg."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e022627","DOI":"10.1161\/JAHA.121.022627","article-title":"Cause of Death After Surgical Aortic Valve Replacement: SWEDEHEART Observational Study","volume":"10","author":"Glaser","year":"2021","journal-title":"J. Am. Heart Assoc."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1016\/j.ahj.2011.03.013","article-title":"Management and outcomes of severe aortic stenosis in cancer patients","volume":"161","author":"Yusuf","year":"2011","journal-title":"Am. Heart J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.carrev.2020.08.018","article-title":"Surgical Versus Transcatheter Aortic Valve Replacement in Patients With Malignancy","volume":"23","author":"Kadri","year":"2021","journal-title":"Cardiovasc. Revasc. Med."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"100167","DOI":"10.1016\/j.jacadv.2022.100167","article-title":"Trends and Outcomes of TAVI and SAVR in Cancer and Noncancer Patients: A Nationwide Analysis","volume":"2","author":"Ullah","year":"2023","journal-title":"JACC Adv."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/20\/3301\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T08:03:03Z","timestamp":1760428983000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/20\/3301"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,12]]},"references-count":50,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["cancers17203301"],"URL":"https:\/\/doi.org\/10.3390\/cancers17203301","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,12]]}}}