{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:11:16Z","timestamp":1782259876686,"version":"3.54.5"},"reference-count":56,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Transcatheter aortic valve replacement (TAVR) has rapidly become a viable alternative to the conventional isolated surgical aortic valve replacement (iSAVR) for treating severe symptomatic aortic stenosis. However, data on younger patients is scarce and a gap exists between data-based recommendations and the clinical use of TAVR. In our study, we utilized a machine learning (ML) driven approach to model the complex decision-making process of Heart Teams when treating young patients with severe symptomatic aortic stenosis with either TAVR or iSAVR and to identify the relevant considerations. Out of the considered factors, the variables most prominently featured in our ML model were congestive heart failure, established risk assessment scores, previous cardiac surgeries, a reduced left ventricular ejection fraction and peripheral vascular disease. Our study demonstrates a viable application of ML-based approaches for studying and understanding complex clinical decision-making processes.<\/jats:p>","DOI":"10.3390\/jpm11111062","type":"journal-article","created":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T09:18:09Z","timestamp":1634894289000},"page":"1062","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A Sneak-Peek into the Physician\u2019s Brain: A Retrospective Machine Learning-Driven Investigation of Decision-Making in TAVR versus SAVR for Young High-Risk Patients with Severe Symptomatic Aortic Stenosis"],"prefix":"10.3390","volume":"11","author":[{"given":"Ena","family":"Hasimbegovic","sequence":"first","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9049-9989","authenticated-orcid":false,"given":"Laszlo","family":"Papp","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Grahovac","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1786-4297","authenticated-orcid":false,"given":"Denis","family":"Krajnc","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0374-8375","authenticated-orcid":false,"given":"Thomas","family":"Poschner","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waseem","family":"Hasan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Imperial College London, London SW7 2AZ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Andreas","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1583-5783","authenticated-orcid":false,"given":"Christoph","family":"Gross","sequence":"additional","affiliation":[{"name":"Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Vienna North Hospital\u2014Floridsdorf Clinic and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Strouhal","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hospital Hietzing and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Delle-Karth","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hospital Hietzing and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Grabenw\u00f6ger","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sigmund Freud University, 1090 Vienna, Austria"},{"name":"Imed19\u2014Internal Medicine Doebling, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Adlbrecht","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Hospital Hietzing and the Karl Landsteiner Institute for Cardiovascular and Critical Care Research, 1090 Vienna, Austria"},{"name":"Imed19\u2014Internal Medicine Doebling, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-4914","authenticated-orcid":false,"given":"Markus","family":"Mach","sequence":"additional","affiliation":[{"name":"Division of Cardiac 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