ArticleCardio-oncology (London, England)2019
Clinical Outcomes after Transcatheter Aortic Valve Replacement in Cancer Survivors Treated with Ionizing Radiation.
Article in Cardio-oncology (London, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Clinical outcomes of transcatheter aortic valve replacement in patients with radiation-induced aortic stenosis: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2025Pooled it
- Association Between Previous or Active Cancer and Clinical Outcomes in TAVR Patients: A Systematic Review and Meta-Analysis of 255,840 Patients.Frontiers in cardiovascular medicine · 2021Pooled it
- Transcatheter Aortic Valve Implantation in Cancer Patients: A Contemporary Review of the Specific Challenges, the Outcomes, Risk Stratification, and Decision-Making.Medicina (Kaunas, Lithuania) · 2026Review
- Clinical outcomes of atrial tachyarrhythmia hospitalizations with and without prior thoracic irradiation.Frontiers in oncology · 2026Article
- Article
- Outcomes and Adverse Effects of Transcatheter Aortic Valve Replacement (TAVR) in Cancer Patients: A Meta-Analysis.Cureus · 2024Review
- Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: an updated systematic review and meta-analysis.Cardio-oncology (London, England) · 2024Review
- Accelerated Atherosclerosis and Cardiovascular Toxicity Induced by Radiotherapy in Breast Cancer.Life (Basel, Switzerland) · 2023Review
- Valvular Heart Disease Associated With Radiation Therapy: A Contemporary Review.Structural heart : the journal of the Heart Team · 2023Review
- A Rare Case of Radiation-Associated Aortic and Mitral Valve Stenosis Treated With Transcatheter Valve Replacements.JACC. Case reports · 2023Article
- Left atrial appendage volume as a prognostic Indicator of long-term mortality in Cancer survivors treated with thoracic radiation.Cardio-oncology (London, England) · 2023Article
- Cancer survivorship at heart: a multidisciplinary cardio-oncology roadmap for healthcare professionals.Frontiers in cardiovascular medicine · 2023Review
- Trends and Outcomes of TAVI and SAVR in Cancer and Noncancer Patients: A Nationwide Analysis.JACC. Advances · 2023Article
- Mediastinal irradiation and valvular heart disease.Cardio-oncology (London, England) · 2022Review
- Aortic Valve Leaflet Rupture Causing Delayed Left Main Coronary Ostial Obstruction During Valvuloplasty Preceding TAVR.JACC. Case reports · 2021Article
- Radiation-Induced Cardiovascular Disease: Review of an Underrecognized Pathology.Journal of the American Heart Association · 2021Review
- Cardiologic Long-Term Follow-Up of Patients Treated With Chest Radiotherapy: When and How?Frontiers in cardiovascular medicine · 2021Article
- Outcomes after transcatheter aortic valve replacement in cancer survivors with prior chest radiation therapy: a systematic review and meta-analysis.Cardio-oncology (London, England) · 2020Article
Corrections and comments
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Authors and funding
11 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundImproved cancer survival in patients treated with thoracic ionizing radiation (XRT) has resulted in unanticipated surge of aortic stenosis. Transcatheter aortic valve replacement (TAVR) has revolutionized the management of severe aortic stenosis. However, long-term clinical outcomes in radiation-exposed cohorts undergoing TAVR are unknown. We compared the all-cause mortality and major adverse cardiac events (MACE) in patients with prior chest XRT (C-XRT) undergoing TAVR.
methodsThis is an observational cohort study in subjects who underwent TAVR for symptomatic severe aortic stenosis from 2012 to 2017 in a tertiary care referral center. We examined the all-cause mortality and MACE using cox proportional hazard analysis to identify the clinical predictors of survival in the cohort of patients who had a history of prior C-XRT for malignancy.
resultsOf the 610 patients who underwent TAVR for symptomatic severe aortic stenosis, 75 had prior C-XRT. The majority of C-XRT patients had prior breast cancer (44%) followed by Hodgkin's lymphoma (31%), with the median time from XRT to TAVR of 19.0 years. During a mean follow up of 17.1 months after TAVR, all-cause mortality was 17%. Those with prior C-XRT had higher all-cause mortality (XRT: 29%; non-XRT:15%, p<0.01) and MACE (XRT: 57%; non-XRT: 27%, p<0.001) after TAVR. Patients with prior XRT had a higher incidence of atrial fibrillation (XRT: 48 %; non-XRT: 2.4%, p<0.01) and high-grade heart block (XRT: 20%; non-XRT: 9.1%, p=0.007) requiring pacemaker implant after TAVR. On multivariate cox proportional hazard analysis, prior XRT (HR: 2.07, p=0.003), poor renal function (HR: 1.29, p<0.001) and post-operative anemia requiring transfusion (HR: 1.16, p:0.001) were the strongest predictors of reduced survival.
conclusionsCancer survivors with prior C- XRT have higher incidence of all-cause mortality and MACE after TAVR. Careful patient selection and follow-up strategies are needed to improve outcomes.
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