PamPatty, that's crazy rough to have heart issues requiring surgery on top of a bc diagnosis. I think it's smart to look up the long term results that have been seen with radiation to an artificial heart valve.

Here's some studies you may have seen. I know that rads are known to cause heart damage, so I understand your fear. They ignore the topic of radiation beam scatter which is known to occur. I know that my heart was damaged to some degree, even doing that "breath hold technique". The below study is doing valve replacement surgery after rads, which would be opposite of your situation. Would rads affect your valve replacement? I have no idea, and wonder if doctors can be counted on to be honest about the real long term risks.

So far I have only seen complete and full disclosure of side effects rarely. This thread is full of other women, besides me, who also haven't been given the complete truth. If even one woman is told a line of BS, it's one woman too many.

Good luck with making the best decision for yourself.

-------------------------------------------------------------------------------------------------------------------------------

Long-Term Outcomes of Patients With Mediastinal Radiation-Associated Severe Aortic Stenosis and Subsequent Surgical Aortic Valve Replacement: A Matched Cohort Study.

Donnellan E1, Masri A1, Johnston DR1, Pettersson GB1, Rodriguez LL1, Popovic ZB1, Roselli EE1, Smedira NG1, Svensson LG1, Griffin BP1, Desai MY2.

Author information

1

Centers for Radiation Heart Disease and Heart Valve Disease, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH.replacement

2

Centers for Radiation Heart Disease and Heart Valve Disease, Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH desaim2@ccf.org.

Abstract

BACKGROUND:

Cardiac disease after mediastinal radiotherapy for thoracic malignancy (chest radiotherapy [XRT]) often manifests as progressive aortic stenosis. In patients with XRT-induced severe aortic stenosis undergoing surgical aortic valve replacement (SAVR), we sought to: (1) study long-term survival and compare these patients with a matched cohort undergoing SAVR during the same time frame; and (2) identify potential predictors of long-term mortality.

METHODS AND RESULTS:

We studied patients with symptomatic severe aortic stenosis undergoing SAVR at our institution, of which there were 172 mediastinal XRT patients (63±13 years, 62% women) matched in a 1:1 fashion (based on age, sex, time of surgery, and aortic valve area) with 172 non-XRT patients (comparison group). Baseline clinical and postoperative data were obtained. Society of Thoracic Surgeons score was calculated and mortality was recorded. In the XRT group, the median Society of Thoracic Surgeons score was 4% (interquartile range 2-13), while mean left ventricular ejection fraction, left ventricular stroke volume index, and mean aortic valve gradient were 54±11%, 38±14 mL/m2, and 39±11 mm Hg, respectively. In the entire cohort, 27% and 34% of patients underwent concomitant coronary artery bypass grafting and aortic surgery at the time of SAVR, respectively. Thirty-day/in-hospital deaths occurred in 4 (2%) patients in the XRT group and 0 patients in the comparison group. At 6±3 years of follow-up, on matched group analysis, there were 95 (28%) deaths (83 [48%] in the XRT group versus 12 [7%] in the comparison group (log-rank 89, P<0.001). On multivariable Cox survival analysis, in the whole cohort, higher Society of Thoracic Surgeons score (hazard ratio, 1.14; 95% CI, 1.03-1.26) and mediastinal XRT (hazard ratio, 8.12; 95% CI, 4.26-15.64) were associated with increased longer-term mortality (both P<0.01).

CONCLUSIONS:

In patients with severe aortic stenosis undergoing SAVR, patients with prior mediastinal XRT have significantly worse longer-term survival versus a matched cohort.

------------------------------------------------------------------------------------------------------------------------------------

Rate of Progression of Aortic Stenosis and its Impact on Outcomes in Patients With Radiation-Associated Cardiac Disease: A Matched Cohort Study.

Donnellan E1, Griffin BP1, Johnston DR2, Popovic ZB1, Alashi A1, Kapadia SR1, Tuzcu EM1, Krishnaswamy A1, Mick S2, Svensson LG2, Desai MY3.

Author information

1

Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.

2

Department of Cardiac Surgery, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio.

3

Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio. Electronic address: desaim2@ccf.org.

Abstract

OBJECTIVES:

The aim of this study was to study differences in progression of aortic stenosis (AS) in patients with mediastinal radiotherapy (XRT)-associated moderate AS versus a matched cohort during the same time frame, and to ascertain need for aortic valve replacement (AVR) and longer-term survival.

BACKGROUND:

Rate of progression of XRT-associated moderate AS and its impact on outcomes is not well-described.

METHODS:

We included 81 patients (age 61 ± 13 years; 57% female) with at least XRT-associated moderate AS (aortic valve area [AVA] 1.05 ± 0.3 cm2; mean gradient 24 ± 10 mm Hg) who had ≥2 transthoracic echocardiograms (TTEs) 1 year apart and matched them in a 1:2 fashion on the basis of age, sex, and AVA with those without prior XRT. Serial aortic valve gradients and AVA were recorded. AVR and longer-term all-cause mortality during follow-up were recorded.

RESULTS:

A total of 100% of patients had 1, a total of 71% had 2, and 39% had 3 follow-up TTEs. Before AVR, mean AVG and AVA were not significantly different between XRT and comparison groups. At 3.6 ± 2.0 years from baseline TTE, 146 (60%) underwent AVR (16% transcatheter), with significantly more patients in the XRT group undergoing AVR (80% vs. 50%; p < 0.01), at a much shorter time (2.9 ± 1.6 years vs. 4.1 ± 2.4 years; p < 0.01). At 6.6 ± 4.0 years from the initial TTE, 49 (20%) patients died, with a significantly higher mortality in the XRT group (40% vs. 11%; p < 0.01), with prior XRT associated with increased longer-term mortality, whereas AVR was associated with improved longer-term survival.

CONCLUSIONS:

In patients with moderate AS, those with prior XRT have a similar rate of progression of AS versus a comparison group. A higher proportion of patients in the XRT group were referred for AVR at a shorter time from baseline TTE. Despite that, the XRT patients had significantly higher longer-term mortality, and prior exposure to XRT was associated with significantly increased longer-term mortality.

Copyright © 2018 American College of Cardiology Foundation. Published by Elsevier

Mysticalcity. Thanks for the understanding. Sometimes people have come on to this thread to make it seem as if this horrible rad "treatment " only rarely causes adverse consequences. It drives me crazy when someone does that.

Flashlight, no diagnosis would ever justify frying me straight through to my back, making me nearly choke on my own saliva for an entire weekend due to swelling of my throat, and then saying to me, " we didn't think it would happen yet"

YET??? So, in other words they full expected to fry my neck so severely that I was supposed to have trouble breathing and swallowing, AND THEY FORGOT TO MENTION THAT LITTLE DETAIL????? Should they have said OOPS when they managed to get their head out of their butts and see the light of day, there in chrisine fang' s rad central at scca?

Also christine fang, idiot that she was, told me about Miaderm a week after the open and bleeding sores had already started. Miaderm says not to be used on open wounds.

I am sure you get the irony of recommending a cream to prevent burns AFTER I was burnt to a frigging crisp.

Good luck to you flashlight and hope you recover from the damages associated with this awful, barbaric excuse for "treatment " as I still have not one thing good to say about it and am unable to pretend otherwise.

bump