Mediastinal irradiation and valvular heart disease

Abstract

Highlights • Mediastinal radiation therapy improves cancer survival but increases the risk of developing radiation-induced valvular heart disease, often in combination with other radiation-induced cardiovascular pathologies, ultimately leading to increased cardiovascular morbidity and mortality. • Radiation-induced valvular heart disease presents after a prolonged, albeit variable, latent period and poses unique clinical challenges, underscoring the need for timely monitoring by a cardio-oncologist. • There is an elevated risk of morbidity and mortality after valvular operations in patients with prior mediastinal radiation therapy beyond what is estimated by current preoperative risk stratification models. • Careful patient selection and management by a multidisciplinary heart team is paramount in optimizing outcomes of radiation-induced valvular heart disease. In challenging cases associated with high operative risk, transcatheter therapies may be considered.

Keywords

• Mediastinal irradiation
• Valvular heart disease
• Cancer
• Radiation-induced heart disease