Heart diseases following mediastinal irradiation: surgical management
| Autor: | Birnbaum De, Reber D, Tollenaere P |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Pulmonary and Respiratory Medicine
Aortic valve Adult Male medicine.medical_specialty Heart disease Heart Diseases Coronary Disease Internal thoracic artery Coronary artery disease Aortic valve replacement Risk Factors medicine.artery medicine Myocardial Revascularization Humans cardiovascular diseases Myocardial infarction Radiation Injuries Aged Retrospective Studies Radiotherapy business.industry Mediastinum General Medicine Aortic Valve Stenosis Middle Aged medicine.disease Ventricular aneurysm Surgery medicine.anatomical_structure Aortic Valve Heart Valve Prosthesis cardiovascular system Female Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 9(4) |
| ISSN: | 1010-7940 |
| Popis: | Twelve patients underwent cardiac surgical procedures after having previously received irradiation of the mediastinum for various types of malignancies (Hodgkin's disease, carcinoma of the breast and seminoma). The patients' ages ranged from 39 to 69 years (mean 57 years); nine patients were female and three male. The average length of time from radiation to surgery was 15 years (3-24 years interval). The patients were divided into two groups according to the type of heart disease: Group I included seven patients who developed coronary artery disease (CAD) despite minimal risk factors. Three asymptomatic patients developed sudden myocardial infarction. In two patients the myocardial infarction was complicated (with ventricular septal defect in one and ventricular septal defect plus ventricular aneurysm in the other). All seven patients were surgically managed. Internal thoracic artery (ITA) was used in three patients as a conduit of myocardial revascularization. There were two hospital deaths in this group. The five patients in Group II underwent aortic valve replacement for aortic stenoses. Prior to the irradiation, none of the patients had a documented history of rheumatic fever, bacterial endocartitis, significant murmur, etc. There were no deaths in this group. Intraoperative findings for both groups included thickening and/or fibrosis of the ascending aortic wall, coronary arteries and aortic valve tissue. Epicardium was whitish colored and thickened. |
| Databáze: | OpenAIRE |
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