Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery
Late complications affecting the cardiovascular system depend on the extent of the capture of cardiac structures in the radiation field and the cumulative dose of exposure. They are characterized by polymorphism in clinical manifestations. Objective: to identify the predictors influencing in-hospita...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
2025-03-01
|
| Series: | Вестник трансплантологии и искусственных органов |
| Subjects: | |
| Online Access: | https://journal.transpl.ru/vtio/article/view/1848 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849691849282813952 |
|---|---|
| author | M. N. Sorkomov S. I. Babenko D. A. Titov A. S. Sachkov M. I. Terekhov R. A. Serov R. M. Muratov |
| author_facet | M. N. Sorkomov S. I. Babenko D. A. Titov A. S. Sachkov M. I. Terekhov R. A. Serov R. M. Muratov |
| author_sort | M. N. Sorkomov |
| collection | DOAJ |
| description | Late complications affecting the cardiovascular system depend on the extent of the capture of cardiac structures in the radiation field and the cumulative dose of exposure. They are characterized by polymorphism in clinical manifestations. Objective: to identify the predictors influencing in-hospital mortality (IHM) in order to optimize the treatment of patients with radiation-induced heart disease. Materials and methods. This is a single-patient cohort study that was retrospective from 2004 to 2018 and prospective from 2018. Death after 30 days following heart valve surgery (HVS) under artificial circulation was taken as the end point of the study. The study included 86 patients (mean age 59 ± 13 years, 81.4% female) who underwent HVS. They were split into 2 groups (extensive, tangential) depending on the cause of cancer. Results. In the postoperative period, the group with extensive irradiation had statistically significant differences in the need for prolonged ventilation, OR 5.17 (CI 95% 1.7–15.7), more frequent exudative pleurisy OR 3.4 (CI 95% 1.1–10.8), and acute renal failure OR 1.2 (CI 95% 1.05–1.37). Regardless of postoperative complications, the length of hospital stay did not differ statistically across the groups, with a median of 10.5 (CI 7.25:16.75) vs. 11 (CI 9:15.25) days, respectively. Overall IHM was 14 (16.27%) patients. Multiple organ failure (MOF) was the cause of death in 9 cases. Multivariate analysis revealed that extensive irradiation for lymphogranulomatosis increased IHM risk by 5.099 times, and an increase in the EuroSCORE II score by every «1» increased IHM risk by 1.19 times. Conclusion. Patients with post-radiation damage to heart valves and coronary arteries with a history of tangential irradiation can be successfully operated on. Extensive irradiation in anamnesis is associated with a high risk of heart failure and MOF in the early postoperative period. |
| format | Article |
| id | doaj-art-d64f97e81efa460c8006bae161cdcfb0 |
| institution | DOAJ |
| issn | 1995-1191 |
| language | Russian |
| publishDate | 2025-03-01 |
| publisher | Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov |
| record_format | Article |
| series | Вестник трансплантологии и искусственных органов |
| spelling | doaj-art-d64f97e81efa460c8006bae161cdcfb02025-08-20T03:20:54ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912025-03-0127119820810.15825/1995-1191-2025-1-198-2081330Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgeryM. N. Sorkomov0S. I. Babenko1D. A. Titov2A. S. Sachkov3M. I. Terekhov4R. A. Serov5R. M. Muratov6Bakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryBakulev National Medical Research Center for Cardiovascular SurgeryLate complications affecting the cardiovascular system depend on the extent of the capture of cardiac structures in the radiation field and the cumulative dose of exposure. They are characterized by polymorphism in clinical manifestations. Objective: to identify the predictors influencing in-hospital mortality (IHM) in order to optimize the treatment of patients with radiation-induced heart disease. Materials and methods. This is a single-patient cohort study that was retrospective from 2004 to 2018 and prospective from 2018. Death after 30 days following heart valve surgery (HVS) under artificial circulation was taken as the end point of the study. The study included 86 patients (mean age 59 ± 13 years, 81.4% female) who underwent HVS. They were split into 2 groups (extensive, tangential) depending on the cause of cancer. Results. In the postoperative period, the group with extensive irradiation had statistically significant differences in the need for prolonged ventilation, OR 5.17 (CI 95% 1.7–15.7), more frequent exudative pleurisy OR 3.4 (CI 95% 1.1–10.8), and acute renal failure OR 1.2 (CI 95% 1.05–1.37). Regardless of postoperative complications, the length of hospital stay did not differ statistically across the groups, with a median of 10.5 (CI 7.25:16.75) vs. 11 (CI 9:15.25) days, respectively. Overall IHM was 14 (16.27%) patients. Multiple organ failure (MOF) was the cause of death in 9 cases. Multivariate analysis revealed that extensive irradiation for lymphogranulomatosis increased IHM risk by 5.099 times, and an increase in the EuroSCORE II score by every «1» increased IHM risk by 1.19 times. Conclusion. Patients with post-radiation damage to heart valves and coronary arteries with a history of tangential irradiation can be successfully operated on. Extensive irradiation in anamnesis is associated with a high risk of heart failure and MOF in the early postoperative period.https://journal.transpl.ru/vtio/article/view/1848radiation therapycardiac surgeryin-hospital mortality |
| spellingShingle | M. N. Sorkomov S. I. Babenko D. A. Titov A. S. Sachkov M. I. Terekhov R. A. Serov R. M. Muratov Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery Вестник трансплантологии и искусственных органов radiation therapy cardiac surgery in-hospital mortality |
| title | Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| title_full | Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| title_fullStr | Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| title_full_unstemmed | Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| title_short | Effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| title_sort | effect of mediastinal radiotherapy on 30 day mortality after cardiac surgery |
| topic | radiation therapy cardiac surgery in-hospital mortality |
| url | https://journal.transpl.ru/vtio/article/view/1848 |
| work_keys_str_mv | AT mnsorkomov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT sibabenko effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT datitov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT assachkov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT miterekhov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT raserov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery AT rmmuratov effectofmediastinalradiotherapyon30daymortalityaftercardiacsurgery |