Valvular & structural heart disease
Utilization and Outcomes of Structural Heart Disease Interventions in Patients With Prior Mediastinal Radiation
Authors' conclusion
Transcatheter aortic and mitral valve interventions are performed more frequently in patients with vs without prior mediastinal radiation with similar in-hospital outcomes and readmissions. Readmissions after LAAO are higher in patients with vs without prior mediastinal radiation.
Study context
- Population
- Adults (≥18 years) undergoing structural heart disease (SHD) interventions (TAVR, mitral transcatheter edge-to-edge repair, transcatheter mitral valve replacement, LAAO)
- Participants
- 810,849 weighted hospitalizations
- Exposure
- Prior mediastinal radiation vs no prior mediastinal radiation in SHD interventions
- Outcome
- In-hospital mortality
Methodological detailsNationwide Readmissions Database (2016-2022)
- Nationwide Readmissions Database (2016-2022)
Main finding
As reported in the abstract
Adjusted in-hospital mortality
- No significant differences in adjusted in-hospital mortality after any of the 4 SHD interventions
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| Readmissions after LAAO · 90 days | 1.51 (1.21–1.89) | |
| 0.512Adjusted hazard ratio (log scale) |
| Outcome | Prior mediastinal radiation | No prior mediastinal radiation |
|---|---|---|
| Utilization rates (procedures/100,000 hospitalizations) | ||
| TAVR | 577 | 254 |
| Mitral transcatheter edge-to-edge repair | 70 | 35 |
| Transcatheter mitral valve replacement | 11 | 4 |
- Utilization rates (procedures/100,000 hospitalizations): all P < 0.001
- Utilization rates (procedures/100,000 hospitalizations): 1.3% of hospitalizations included patients with prior mediastinal radiation
Complications and resource utilization
- No significant differences after any of the 4 SHD interventions
Readmissions after transcatheter aortic and mitral valve interventions · 90 days
- Similar in patients with vs without prior mediastinal radiation
Original publication
Utilization and Outcomes of Structural Heart Disease Interventions in Patients With Prior Mediastinal Radiation. JACC Adv. Published 8 November 2025. doi:10.
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