A patient with a history of mediastinal radiation may develop aortic stenosis.
Features:
(1) history of mediastinal or chest radiation
(2) interval of many years
(3) presence of aortic stenosis
(4) symptomatic stenosis at a younger age than for senile aortic stenosis
(5) exclusion of other causes of aortic stenosis
Complicating factors:
(1) other effects of radiation to the chest or mediastinum (heart block, coronary arteriopathy)
(2) recurrent malignancy
Transcatheter aortic valve replacement (TAVR) is feasible. Open surgery may be high risk due to the effects of radiation on mediastinal structures, radiation pneumonitis and problems healing.
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