Santangelo Gloria, Moscardelli Silvia, Barbieri Lucia, Faggiano Andrea, Carugo Stefano, Faggiano Pompilio
Department of Cardio-Thoracic-Vascular Area, Foundation IRCCS Cà Granda Ospedale Maggiore Policlinico, 20154 Milan, Italy.
Division of Cardiology, Department of Health Sciences, San Paolo Hospital, University of Milan, 20133 Milan, Italy.
J Clin Med. 2023 Sep 6;12(18):5804. doi: 10.3390/jcm12185804.
Aortic valve stenosis and malignancy frequently coexist and share the same risk factors as atherosclerotic disease. Data reporting the prognosis of patients with severe aortic stenosis and cancer are limited. Tailoring the correct and optimal care for cancer patients with severe aortic stenosis is complex. Cancer patients may be further disadvantaged by aortic stenosis if it interferes with their treatment by increasing the risk associated with oncologic surgery and compounding the risks associated with cardiotoxicity and heart failure (HF). Surgical valve replacement, transcatheter valve implantation, balloon valvuloplasty, and medical therapy are possible treatments for aortic valve stenosis, but when malignancy is present, the choice between these options must take into account the stage of cancer and associated treatment, expected outcome, and comorbidities. Physical examination and Doppler echocardiography are critical in the diagnosis and evaluation of aortic stenosis. The current review considers the available data on the association between aortic stenosis and cancer and the therapeutic options.
主动脉瓣狭窄与恶性肿瘤常并存，且与动脉粥样硬化疾病具有相同的风险因素。关于重度主动脉瓣狭窄合并癌症患者预后的数据有限。为重度主动脉瓣狭窄的癌症患者提供正确且最佳的治疗方案很复杂。如果主动脉瓣狭窄增加了肿瘤手术相关风险，并使心脏毒性和心力衰竭（HF）相关风险复杂化，进而干扰癌症患者的治疗，那么他们可能会处于更不利的境地。外科瓣膜置换术、经导管瓣膜植入术、球囊瓣膜成形术和药物治疗都是主动脉瓣狭窄的可能治疗方法，但当存在恶性肿瘤时，在这些选择之间做出抉择必须考虑癌症分期及相关治疗、预期结果和合并症。体格检查和多普勒超声心动图对主动脉瓣狭窄的诊断和评估至关重要。本综述探讨了有关主动脉瓣狭窄与癌症之间关联的现有数据以及治疗选择。
