Transcatheter prosthetics in post-radiation aortic stenosis: a review of literature

Abstract

Aortic stenosis belongs to the most common acquired cardiac defects in adults, affecting about 2 % of those over 65 years old and 4 % of those over 85 years old. One of the common causes of aortic stenosis is radiation therapy of the mediastinum for malignant neoplasms localised in the thorax. According to the American Society of Clinical Oncology, 10–30 % of patients receiving radiation therapy tend to develop cardiovascular complications, usually after an average follow-up period of 5 to 10 years. About 80 % of cardiovascular complications of radiation therapy are valve diseases, aortic stenosis accounting for a significant part of them. Radiation causes late cicatrisation, fibrous thickening, retraction and calcification of aortic valve cusps, contributing to the restriction of their movement and therefore to the narrowing of the aortic valve orifice. Patients with aortic valve stenosis have an average lifespan of about 3 years after coronary symptoms or syncopal conditions appear, and about 1.5 years after congestive heart failure begins to manifest. Aortic valve prosthetics is the sole effective and radical treatment method for patients with aortic valve stenosis that allows to improve their condition and prolong their life. Transcatheter aortic valve prosthetics are the treatment of choice in this category of patients.