Do you take any special precautions when radiating the mediastinum of a patient with moderate or severe aortic valve stenosis?

Yes, but this is challenging to quantify. For patients with lung cancer, I generally try to minimize dose to the heart (particularly the left ventricle and coronary arteries) when possible. With aortic stenosis, the left ventricle is particularly “strained”, so one might be particularly-diligent abo...