Key result
TAVR after chest radiation is linked to fewer complications but more pacemakers than SAVR.
Why the study?
Patients with symptomatic severe aortic valve disease and prior chest radiation represent a high-risk group in which the optimal management approach has not yet been established.
Does transcatheter aortic valve replacement (TAVR) improve outcomes compared to surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic valve disease and prior chest radiation?
Meta-Analysis (n=11,572)
Does transcatheter aortic valve replacement (TAVR) improve outcomes compared to surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic valve disease and prior chest radiation?
p-value: p=< 0.01
In patients with severe aortic valve disease and prior chest radiation, TAVR is associated with fewer postoperative complications but a higher risk of pacemaker insertion compared to SAVR.
TAVR may be preferred over SAVR in patients with prior chest radiation; leaves open need for randomized confirmation.
BACKGROUND: Cardiac complications from prior oncologic therapies and radiation are being increasingly recognized and patients with symptomatic severe aortic valve disease and a history of prior chest radiation represent a high-risk group in which the best management approach has not yet been established. METHODS: A systematic search of PubMed, Scopus, and Cochrane identified studies comparing outcomes of transcatheter aortic valve replacement (TAVR) vs surgical aortic valve replacement (SAVR) in patients with a history of prior chest radiation. RESULTS: < 0.01) were higher among the patients undergoing TAVR. CONCLUSIONS: TAVR in patients with a history of prior radiation was associated with a lower risk for postoperative complications albeit at an increased risk for pacemaker insertion in the postoperative period compared to SAVR.
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Ntoumaziou et al. (2026) conducted a meta-analysis in symptomatic severe aortic valve disease and a history of prior chest radiation (n=11,572). Transcatheter aortic valve replacement (TAVR) vs. Surgical aortic valve replacement (SAVR) was evaluated (p=< 0.01). TAVR in patients with prior chest radiation was associated with lower postoperative complications but increased risk for pacemaker insertion compared to SAVR.
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