Cancer therapy-associated valvular heart disease is a common long-term complication of radiotherapy, with an incidence of approximately 10%. It primarily affects the left-sided heart valves, including the aortic root, aortic valve cusps, mitral annulus, basal segments, and leaflets. The main pathological changes involve thickening of the cusps and leaflets, as well as calcification and retraction of the valves, leading to stenosis or regurgitation.
Patients who undergo mediastinal radiotherapy require regular echocardiographic evaluations both before and after radiotherapy, typically every five years. This type of valvular disease is often associated with mediastinal fibrosis (which can impair wound healing), coronary artery disease, cardiomyopathy, and pericardial disease, making surgical interventions more challenging. Transcatheter valve replacement may also be considered as a treatment option in such cases.