A cohort research on the long-term survival of individuals diagnosed with radiation heart disease who had cardiac surgery

Abstract

Author(s): Sudhanshu Dev, Prashant S. Pawar, Shashikant Deepak, Sulabh Mahajan, Suhas Ballal

Background: Radiation Heart Disease (RHD) results from thoracic radiotherapy and often necessitates Cardiothoracic Surgery (CTS). This study investigates the Long-Term Survival (LTS) of cardiac surgery patients with RHD. Objective: To evaluate the LTS outcomes for patients with RHD who have undergone cardiac surgery.

\Materials and Methods: This cohort study involved 268 RHD patients and 400 control patients, matched by age, gender, and type/time of CTS. Most RHD patients had a history of Hodgkin lymphoma or breast cancer, with an average of 20 years to 22 years since radiation therapy. Mortality was analyzed using Multivariate Cox Proportional Hazard Analysis (MCPHA).

Results: Clinical and surgical parameters, including all-cause mortality and preoperative STS score, were assessed. The mean STS score was comparable between RHD and control groups. RHD patients had a higher incidence of proximal coronary artery disease but lower rates of redo CTS compared to controls. Approximately two-thirds of patients in both groups underwent combined surgical procedures. Over an average follow-up period of 8 years, the RHD group had a significantly higher mortality rate compared to the control group. Higher mortality was linked to the absence of β-blockers, a higher STS score, and RHD status in the MCPHA.

Conclusions: RHD patients undergoing CTS have reduced LTS compared to non-RHD patients. Improved therapeutic strategies can be needed to enhance survival outcomes for RHD patients.

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