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Echocardiographic Assessment of Mantle Radiation Mitral Stenosis
Author(s) -
Bastiaenen Rachel,
Sneddon James,
Sharma Rajan
Publication year - 2016
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13092
Subject(s) - medicine , stenosis , radiation therapy , cardiology , radiology , mitral valve , surgery
The long‐term sequelae of mantle radiotherapy include lung disease and cardiac disorders. Dyspnea on exertion is a common complaint and can be due to one or more pathologies. We describe a case of mantle radiotherapy‐induced mitral stenosis, characterized by aorto‐mitral continuity calcification and absent commissural fusion which precludes balloon valvotomy. The latency period is long, and this patient presented 42 years after radiotherapy. Importantly, as previously described with radiation‐induced valve disease, significant mitral stenosis developed 10 years after surgery for significant aortic stenosis. Two‐dimensional and three‐dimensional transthoracic and transesophageal echocardiography should be considered during assessment of symptomatic survivors of Hodgkin's disease where the index of suspicion for valvular stenosis increases over time. Given the natural history of mantle radiation valvular disease, a lower threshold for surgical intervention in radiation‐induced mitral stenosis may need to be considered if cardiac surgery is planned for other reasons in order to avoid repeated sternotomy in patients with prior irradiation.

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