Open heart surgery after mediastinal radiation therapy

ABSTRACT

The use of radiation therapy has led to a significant improvement in the survival rate of patients treated for Hodgkin's disease, breast cancer and other malignances, however as patients live longer the potentially serious adverse effects of radiation on the heart raised increasing concern. A retrospective chart review was performed to compare two groups of patients, post mediastinal radiation therapy group [MRT] and patients who did not receive radiation [a control group] who underwent open heart surgery for postoperative complications and mortality. Radiation can affect all structures in the heart, coronaries, conductive system, valves and pericardium, we demonstrated an increase incidence of postoperative inotropic support and the need for pacemaker implantation as well as infection rate in MRT group compared to the control group, the mortality rate was higher as well. Patients who receive mediastinal radiation therapy before cardiac surgery suffer from more post-operative cardiac complications than patients who have not been exposed to radiation therapy