Ky T, Marazanof M, Dos Santos P, Guérin P, Couffinhal T, Larquey P, Roques X, Roudaut R
Service de cardiologie, Hôpital cardiologique du Haut-Lévêque, Bordeaux.
Arch Mal Coeur Vaiss. 1998 Mar;91(3):351-5.
Cardiac complications of radiotherapy for cancer, especially lymphoma and breast cancer, are well documented. The three tunics of the heart can be affected. However, valvular disease is rare and, when present, is usually regurgitant. Stenosis is very rare. The authors report the case of a 31 year old man who developed double mitro-aortic valvular stenosis 20 years after mediastinal radiotherapy associated with aortic regurgitation, right coronary stenosis and inflammatory epicardo-pericarditis with effusion. Surgery was undertaken and associated double aortic and mitral valve replacement and right coronary by pass grafting.
癌症放疗的心脏并发症,尤其是淋巴瘤和乳腺癌放疗后的心脏并发症,已有充分记录。心脏的三层结构均可受累。然而,瓣膜疾病较为罕见,一旦出现,通常为反流性。狭窄则极为罕见。作者报告了一例31岁男性病例,该患者在纵隔放疗20年后出现双二尖瓣 - 主动脉瓣狭窄,并伴有主动脉反流、右冠状动脉狭窄以及伴有积液的炎症性心外膜 - 心包炎。患者接受了手术,进行了主动脉瓣和二尖瓣联合置换以及右冠状动脉搭桥术。