RADIATION-ASSOCIATED VALVULAR DISEASE
RADIATION-ASSOCIATED VALVULAR DISEASE
复制标题
DOI：
10.1378/chest.99.3.538
复制
发表时间：
1991-03-01
期刊：
影响因子：
9.6
通讯作者：
ALEXANDER, JA
中科院分区：
文献类型：
--
作者：
CARLSON, RG;MAYFIELD, WR;ALEXANDER, JA
由于纵隔照射后的生存时间延长，辐射相关心脏病的患病率正在增加。放射的副作用包括心包炎、冠状动脉加速病变、心肌纤维化和瓣膜损伤。我们评估了三例年轻患者在纵隔照射后有明显的瓣膜疾病的证据。一名患者接受了首次报道的成功的主动脉瓣和二尖瓣置换术，以治疗放射相关瓣膜疾病（RAVD），同时进行冠状动脉血管重建术。文献回顾显示35例RAVD报告，只有一例瓣膜置换术成功，仅限于主动脉瓣。无症状的RAVD在纵隔照射后11.5年被诊断，而有症状的患者则为16.5年，这强调了对接受纵隔照射的患者进行长期随访的重要性。本研究定义了放射后连续的瓣膜疾病，从轻度无症状的瓣膜增厚开始，发展为严重的瓣膜纤维化，血流动力学受损，需要手术干预。
The prevalence of radiation-associated cardiac disease is increasing due to prolonged survival following mediastinal irradiation. Side effects of radiation include pericarditis, accelerated coronary artery disease, myocardial fibrosis and valvular injury. We evaluated the cases of three young patients with evidence of significant valvular disease following mediastinal irradiation. One patient underwent the first reported successful aortic and mitral valve replacement for radiation-associated valvular disease (RAVD) as well as concurrent coronary artery revascularization. A review of the literature revealed 35 reported cases of RAVD, with only one successful case of valve replacement that was limited to the aortic valve. Asymptomatic RAVD is diagnosed 11.5 years after mediastinal irradiation compared with 16.5 years for symptomatic patients, emphasizing that long-term follow-up is important for patients receiving mediastinal irradiation. This study defines a continuum of valvular disease following radiation that begins with mild asymptomatic valvular thickening and progresses to severe valvular fibrosis with hemodynamic compromise requiring surgical intervention.