Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation

Hossam Elbenawi; Mahmoud Eisa; Muhammad Eltony; Omar Almaadawy; Ahmed El Shaer; Khaled Elfert; Ramzi Ibrahim; Jeremiah P. Depta; Karim M. Al Azizi; Chien Jung Lin; Yiannis S. Chatzizisis; Stanislav Henkin; Martha Gulati; Andrew M. Goldsweig; Ayman Elbadawi; Islam Y. Elgendy

doi:10.1016/j.jscai.2026.104265

Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation

Hossam Elbenawi
, Mahmoud Eisa
, Muhammad Eltony
, Omar Almaadawy
, Ahmed El Shaer
, Khaled Elfert
, Ramzi Ibrahim
, Jeremiah P. Depta
, Karim M. Al Azizi
, Chien Jung Lin
, Yiannis S. Chatzizisis
, Stanislav Henkin
, Martha Gulati
, Andrew M. Goldsweig
, Ayman Elbadawi
, Islam Y. Elgendy

Producción científica: Article › revisión exhaustiva

Resumen

Background Limited data suggest that transcatheter aortic valve replacement (TAVR) is associated with similar short-term outcomes to surgical aortic valve replacement (SAVR) among patients with a history of mediastinal radiation. However, the long-term outcomes of TAVR versus SAVR in this growing patient population remain unknown. Methods We identified patients with a history of chest radiation who underwent isolated AVR using the multinational TriNetX database from 2010 through 2025. Propensity score matching was performed to account for differences in baseline characteristics. Outcomes included all-cause mortality, stroke, and all-cause hospitalization at 5 years. Results The analysis included 933 patients with prior chest radiation who underwent isolated AVR, of whom 785 (84.13%) underwent TAVR, and 148 (15.86%) underwent SAVR. After propensity score matching, 128 patients were included in each group. In the TAVR group, the mean age was 67.6 ± 10.2 years, and 72.7% were women. In the SAVR group, the mean age was 67.5 ± 8.7 years, and 69.5% were women. There was no statistically significant difference in the rates of all-cause mortality (11.7% vs 12.5%; hazard ratio [HR], 1.044; 95% CI, 0.52-2.12; P = .91), stroke (15.6% vs 13.3%; HR, 1.373; 95% CI, 0.72-2.63; P = .34), and all-cause hospitalization (56.3% vs 64.1%; HR, 0.935; 95% CI, 0.68-1.29; P = .65) between TAVR and SAVR at 5 years. Conclusions In this observational analysis from a multinational database of patients with prior mediastinal radiation, TAVR was associated with comparable long-term outcomes compared with SAVR. Further prospective studies are warranted to confirm these findings.

Idioma original	English
Número de artículo	104265
Publicación	Journal of the Society for Cardiovascular Angiography and Interventions
Volumen	5
N.º	3
DOI	https://doi.org/10.1016/j.jscai.2026.104265
Estado	Published - mar 2026

Nota bibliográfica

Publisher Copyright:
© 2026 The Author(s).

Financiación

Associate Editor Andrew M. Goldsweig had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to Deputy Editor Suzanne J. Baron. The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. This work was not supported by funding agencies in the public, commercial, or not-for-profit sectors. This study was conducted using deidentified data obtained from the TriNetX Research Network. The use of deidentified data complies with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule; therefore, the study was exempt from institutional review board approval and informed consent requirements.

Financiadores
HIPAA

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

Acceder al documento

10.1016/j.jscai.2026.104265

Otros archivos y enlaces

Citar esto

Elbenawi, H., Eisa, M., Eltony, M., Almaadawy, O., El Shaer, A., Elfert, K., Ibrahim, R., Depta, J. P., Al Azizi, K. M., Lin, C. J., Chatzizisis, Y. S., Henkin, S., Gulati, M., Goldsweig, A. M., Elbadawi, A., & Elgendy, I. Y. (2026). Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation. Journal of the Society for Cardiovascular Angiography and Interventions, 5(3), Artículo 104265. https://doi.org/10.1016/j.jscai.2026.104265

@article{63c34c1128e6436b97bf48908021015a,

title = "Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation",

abstract = "Background Limited data suggest that transcatheter aortic valve replacement (TAVR) is associated with similar short-term outcomes to surgical aortic valve replacement (SAVR) among patients with a history of mediastinal radiation. However, the long-term outcomes of TAVR versus SAVR in this growing patient population remain unknown. Methods We identified patients with a history of chest radiation who underwent isolated AVR using the multinational TriNetX database from 2010 through 2025. Propensity score matching was performed to account for differences in baseline characteristics. Outcomes included all-cause mortality, stroke, and all-cause hospitalization at 5 years. Results The analysis included 933 patients with prior chest radiation who underwent isolated AVR, of whom 785 (84.13\%) underwent TAVR, and 148 (15.86\%) underwent SAVR. After propensity score matching, 128 patients were included in each group. In the TAVR group, the mean age was 67.6 ± 10.2 years, and 72.7\% were women. In the SAVR group, the mean age was 67.5 ± 8.7 years, and 69.5\% were women. There was no statistically significant difference in the rates of all-cause mortality (11.7\% vs 12.5\%; hazard ratio [HR], 1.044; 95\% CI, 0.52-2.12; P = .91), stroke (15.6\% vs 13.3\%; HR, 1.373; 95\% CI, 0.72-2.63; P = .34), and all-cause hospitalization (56.3\% vs 64.1\%; HR, 0.935; 95\% CI, 0.68-1.29; P = .65) between TAVR and SAVR at 5 years. Conclusions In this observational analysis from a multinational database of patients with prior mediastinal radiation, TAVR was associated with comparable long-term outcomes compared with SAVR. Further prospective studies are warranted to confirm these findings.",

keywords = "aortic stenosis, long-term outcomes, mediastinal radiation, surgical aortic valve replacement, transcatheter aortic valve replacement",

author = "Hossam Elbenawi and Mahmoud Eisa and Muhammad Eltony and Omar Almaadawy and \{El Shaer\}, Ahmed and Khaled Elfert and Ramzi Ibrahim and Depta, \{Jeremiah P.\} and \{Al Azizi\}, \{Karim M.\} and Lin, \{Chien Jung\} and Chatzizisis, \{Yiannis S.\} and Stanislav Henkin and Martha Gulati and Goldsweig, \{Andrew M.\} and Ayman Elbadawi and Elgendy, \{Islam Y.\}",

note = "Publisher Copyright: {\textcopyright} 2026 The Author(s).",

year = "2026",

month = mar,

doi = "10.1016/j.jscai.2026.104265",

language = "English",

volume = "5",

journal = "Journal of the Society for Cardiovascular Angiography and Interventions",

issn = "2772-9303",

publisher = "Elsevier BV",

number = "3",

}

Elbenawi, H, Eisa, M, Eltony, M, Almaadawy, O, El Shaer, A, Elfert, K, Ibrahim, R, Depta, JP, Al Azizi, KM, Lin, CJ, Chatzizisis, YS, Henkin, S, Gulati, M, Goldsweig, AM, Elbadawi, A & Elgendy, IY 2026, 'Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation', Journal of the Society for Cardiovascular Angiography and Interventions, vol. 5, n.º 3, 104265. https://doi.org/10.1016/j.jscai.2026.104265

TY - JOUR

T1 - Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation

AU - Elbenawi, Hossam

AU - Eisa, Mahmoud

AU - Eltony, Muhammad

AU - Almaadawy, Omar

AU - El Shaer, Ahmed

AU - Elfert, Khaled

AU - Ibrahim, Ramzi

AU - Depta, Jeremiah P.

AU - Al Azizi, Karim M.

AU - Lin, Chien Jung

AU - Chatzizisis, Yiannis S.

AU - Henkin, Stanislav

AU - Gulati, Martha

AU - Goldsweig, Andrew M.

AU - Elbadawi, Ayman

AU - Elgendy, Islam Y.

PY - 2026/3

Y1 - 2026/3

N2 - Background Limited data suggest that transcatheter aortic valve replacement (TAVR) is associated with similar short-term outcomes to surgical aortic valve replacement (SAVR) among patients with a history of mediastinal radiation. However, the long-term outcomes of TAVR versus SAVR in this growing patient population remain unknown. Methods We identified patients with a history of chest radiation who underwent isolated AVR using the multinational TriNetX database from 2010 through 2025. Propensity score matching was performed to account for differences in baseline characteristics. Outcomes included all-cause mortality, stroke, and all-cause hospitalization at 5 years. Results The analysis included 933 patients with prior chest radiation who underwent isolated AVR, of whom 785 (84.13%) underwent TAVR, and 148 (15.86%) underwent SAVR. After propensity score matching, 128 patients were included in each group. In the TAVR group, the mean age was 67.6 ± 10.2 years, and 72.7% were women. In the SAVR group, the mean age was 67.5 ± 8.7 years, and 69.5% were women. There was no statistically significant difference in the rates of all-cause mortality (11.7% vs 12.5%; hazard ratio [HR], 1.044; 95% CI, 0.52-2.12; P = .91), stroke (15.6% vs 13.3%; HR, 1.373; 95% CI, 0.72-2.63; P = .34), and all-cause hospitalization (56.3% vs 64.1%; HR, 0.935; 95% CI, 0.68-1.29; P = .65) between TAVR and SAVR at 5 years. Conclusions In this observational analysis from a multinational database of patients with prior mediastinal radiation, TAVR was associated with comparable long-term outcomes compared with SAVR. Further prospective studies are warranted to confirm these findings.

AB - Background Limited data suggest that transcatheter aortic valve replacement (TAVR) is associated with similar short-term outcomes to surgical aortic valve replacement (SAVR) among patients with a history of mediastinal radiation. However, the long-term outcomes of TAVR versus SAVR in this growing patient population remain unknown. Methods We identified patients with a history of chest radiation who underwent isolated AVR using the multinational TriNetX database from 2010 through 2025. Propensity score matching was performed to account for differences in baseline characteristics. Outcomes included all-cause mortality, stroke, and all-cause hospitalization at 5 years. Results The analysis included 933 patients with prior chest radiation who underwent isolated AVR, of whom 785 (84.13%) underwent TAVR, and 148 (15.86%) underwent SAVR. After propensity score matching, 128 patients were included in each group. In the TAVR group, the mean age was 67.6 ± 10.2 years, and 72.7% were women. In the SAVR group, the mean age was 67.5 ± 8.7 years, and 69.5% were women. There was no statistically significant difference in the rates of all-cause mortality (11.7% vs 12.5%; hazard ratio [HR], 1.044; 95% CI, 0.52-2.12; P = .91), stroke (15.6% vs 13.3%; HR, 1.373; 95% CI, 0.72-2.63; P = .34), and all-cause hospitalization (56.3% vs 64.1%; HR, 0.935; 95% CI, 0.68-1.29; P = .65) between TAVR and SAVR at 5 years. Conclusions In this observational analysis from a multinational database of patients with prior mediastinal radiation, TAVR was associated with comparable long-term outcomes compared with SAVR. Further prospective studies are warranted to confirm these findings.

KW - aortic stenosis

KW - long-term outcomes

KW - mediastinal radiation

KW - surgical aortic valve replacement

KW - transcatheter aortic valve replacement

UR - https://www.scopus.com/pages/publications/105032555731

UR - https://www.scopus.com/pages/publications/105032555731#tab=citedBy

U2 - 10.1016/j.jscai.2026.104265

DO - 10.1016/j.jscai.2026.104265

M3 - Article

AN - SCOPUS:105032555731

SN - 2772-9303

VL - 5

JO - Journal of the Society for Cardiovascular Angiography and Interventions

JF - Journal of the Society for Cardiovascular Angiography and Interventions

IS - 3

M1 - 104265

ER -

Long-Term Outcomes of Transcatheter Versus Surgical Aortic Valve Replacement Among Patients With Prior Mediastinal Radiation

Resumen

Nota bibliográfica

Financiación

ASJC Scopus subject areas

Acceder al documento

Otros archivos y enlaces

Huella

Citar esto