{"id":3112,"date":"2023-03-01T00:29:09","date_gmt":"2023-03-01T00:29:09","guid":{"rendered":"https:\/\/www.heart-valve-surgery.com\/learning\/?page_id=3112"},"modified":"2024-11-07T19:43:38","modified_gmt":"2024-11-07T19:43:38","slug":"radiation-associated-heart-valve-disease","status":"publish","type":"page","link":"https:\/\/www.heart-valve-surgery.com\/learning\/radiation-associated-heart-valve-disease\/","title":{"rendered":"Radiation Associated Heart Valve Disease: What Should Patients Know?"},"content":{"rendered":"<p>Cancer treatments for conditions including Hodgkin&#8217;s disease are often regarded as &#8220;medical miracles&#8221;. However, patients are often unaware that radiation therapy can negatively impact the functioning of organs including the heart, the lungs and the esophagus. Specific to cardiac function, there is a strong association among radiation therapy and heart valve disease, coronary artery disorders, ascending aorta defects and pericardium issues.<\/p>\n<p>To help you learn more about the association between radiation therapy and heart valve disease, I interviewed <a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Douglas-Johnston-Chicago-Illinois.php\">Dr. Doug Johnston<\/a>, Chief of Cardiac Surgery at Northwestern Medicine in Chicago, Illinois. During his extraordinary career, Dr. Johnston has performed over 3,000 heart valve repair and replacement procedures.<\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" title=\"YouTube video player\" src=\"https:\/\/www.youtube.com\/embed\/kPVq5ty08dQ?rel=0\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<h2>Key Learnings About Radiation Therapy &amp; Heart Valve Disease<\/h2>\n<p>Here are the key learnings shared by Dr. Johnston about radiation therapy and heart valve disease:<\/p>\n<ul>\n<li>Cancer treatments using radiation therapy have been very successful for the treatment of various types of conditions including Hodgkin&#8217;s disease. &#8220;It\u2019s a medical miracle,&#8221; states Dr. Johnston.\u00a0 &#8220;So many people are living, surviving after these cancers.&#8221;<\/li>\n<li>How, radiation therapy may have &#8220;late effects&#8221; on organs within the chest cavity including the heart, the lungs and the esophagus.<\/li>\n<li>Specific to heart valves, radiation therapy may cause the heart valve leaflet to experience tissue fibrosis, a thickening of the valve leaflets that impacts the opening and closing of the heart valves. &#8220;Radiation causes fibrosis in tissue.\u00a0 How that manifests over time is often a slow thickening of these tissues,&#8221; states Dr. Johnston. &#8220;Typically, what we see initially is thickening and reduced mobility of the leaflets. This can be, in particular, the aortic and mitral valves.&#8221;<\/li>\n<li>The impact of radiation therapy on heart valves is not predictable.<\/li>\n<li>Over time, calcium can form on multiple valves and in the ascending aorta. Furthermore, calcium can build-up between the aortic and mitral valve which may require a complex surgery. &#8220;In the most typical fashion, it [calcium] forms between the two valves, what we call the aorta-mitral curtain, and this is what makes it such a surgical challenge and why we need to approach this disease differently than we would other kinds of heart valve disease.&#8221;<\/li>\n<li>Surgical treatments for radiation associated heart valve disease can be very successful. In addition, transcatheter techniques may be used to treat radiation associated heart valve disease (e.g. TAVR).<\/li>\n<li>Dr. Johnston may use the &#8220;Commando Operation&#8221; to treat the aortic and mitral valves which are defective due to radiation. &#8220;That\u2019s the Commando operation, which involves replacing the calcium between the two valves,&#8221; states Dr. Johnston. &#8220;[It] sounds like a big operation and it is. But the outcomes are actually quite good. Most of these patients can live for a very long time and have a good quality of life after even a very extensive operation.&#8221;<\/li>\n<li>According to Dr. Johnston, it is important for patients with heart valve disease from radiation to realize that they are unique. &#8220;You and similar patients are unique from other valve disease patients, and you as an individual are going to have a unique presentation within the heart,&#8221; states Dr. Johnston.\u00a0 &#8220;The key consideration for patients is that this really requires a team of experts to figure out exactly what\u2019s going on with your heart.&#8221;<\/li>\n<li>To help Dr. Johnston and his team determine therapeutic approaches for their patients, Dr. Johnston requires patients to get an echocardiogram, an MRI, a CT scan and, at times, a left and right heart catheterization. &#8220;The key consideration is timing,&#8221; states Dr. Johnston. &#8220;When does something need to be done? When will we be improving the long-term outcome by doing something now? That\u2019s a joint conversation between us and the patient. It\u2019s a hard to make a decision, and that decision\u2019s never made on just an echo alone.&#8221;<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h2>Patient Question Regarding Radiation Location<\/h2>\n<p>After watching the video above, we received an interesting patient question from Doug, who asked, \u201cWas the video referring to radiation strictly of the chest area or is there evidence of targeted radiation on other parts of the body causing valve disease? I had radiation treatment for Non-Hodgkin&#8217;s lymphoma in my jaw in 2019. About two years later, my echocardiograms started to show worsening mitral valve regurgitation. It went from zero to mild regurgitation for 20 years before radiation to moderate and then severe regurgitation afterwards. I ended up having a successful minimally-invasive robotic mitral valve repair last January. Very curious if the valve disease may have worsened due to radiation or was it simply age related deterioration.\u201d<\/p>\n<p>In his response to Doug&#8217;s question, Dr. Johnston stated, &#8220;Radiation heart disease is directly related to the amount of radiation received by the heart. \u00a0In some cases, radiation for neck tumors extends into the chest and can affect the heart, but rarely. \u00a0The way mitral valve disease progresses is very different from patient-to-patient. So, it is hard to know what caused the progression in your case. \u00a0Very happy to hear about your successful repair!&#8221;<\/p>\n<p>&nbsp;<\/p>\n<h2>Many Thanks Dr. Johnston &amp; Northwestern Medicine<\/h2>\n<p>Many thanks to Dr. Johnston for taking the time to educate our patient community about radiation associated heart valve disease. We also want to thank the entire Northwestern Medicine team for taking such great care of patients from the HeartValveSurgery.com community!<\/p>\n<p>Related Links:<\/p>\n<ul>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/heart-surgery-blog\/2023\/03\/05\/hodgkins-lymphoma\/\">Surgeon Q&amp;A Follow-Up: 3 Patient Questions About Radiation Associated Heart Valve Disease<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/surgeons\/dr-Douglas-Johnston-Chicago-Illinois.php\">See Dr. Johnston\u2019s Interactive Surgeon Profile<\/a><\/li>\n<li><a href=\"https:\/\/www.heart-valve-surgery.com\/hospital\/northwestern-memorial-valve-program\">Explore the Northwestern Medicine Heart Valve Microsite<\/a><\/li>\n<\/ul>\n<p>Keep on tickin!<br \/>\nAdam<\/p>\n<p>P.S. For the deaf and hard of hearing members of our community, I have provided a written transcript of my interview with Dr. Johnston below.<\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":2,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"cms.php","meta":{"_acf_changed":false,"footnotes":""},"categories":[2],"class_list":["post-3112","page","type-page","status-publish","hentry","category-adams-updates"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/comments?post=3112"}],"version-history":[{"count":18,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3112\/revisions"}],"predecessor-version":[{"id":5045,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/pages\/3112\/revisions\/5045"}],"wp:attachment":[{"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/media?parent=3112"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.heart-valve-surgery.com\/learning\/wp-json\/wp\/v2\/categories?post=3112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}