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Aortic valve stenosis and cancer: a common and complex association
Silvia Frattini1, Giovanni Troise2, Carlo Fucci3
1Cardiology Division, Cremona Hospital, Cremona, Italy.
Expert Review of Cardiovascular Therapy
|March 10, 2021
Summary
Aortic valve stenosis (AS) and cancer often coexist in older adults. Treatment decisions for severe AS in cancer patients require careful consideration of valve disease, cancer prognosis, and patient factors.
Area of Science:
- Cardiology
- Oncology
- Geriatrics
Background:
- Aortic valve stenosis (AS) and malignancy are prevalent, particularly in elderly populations and developed nations.
- These conditions frequently coexist and share risk factors with atherosclerotic disease.
- Cardiovascular risk factors and cancer treatments like radiotherapy may accelerate calcified AS progression.
Purpose of the Study:
- To review the challenges and considerations in managing patients with coexisting severe aortic valve stenosis and cancer.
- To highlight the limited information on malignancy's impact on AS outcomes and the lack of established treatment policies.
Main Methods:
- Literature review focusing on the intersection of aortic valve stenosis and malignancy.
- Analysis of treatment options for severe AS in cancer patients, including surgical aortic valve replacement and transcatheter aortic valve implantation.
- Discussion of factors influencing treatment decisions.
Main Results:
- Cancer patients with severe AS often present high surgical risk, favoring transcatheter approaches.
- Treatment decisions require integrating valve disease severity, cardiac outcomes, cancer prognosis, and patient-specific factors.
- Limited data exists on how malignancy affects outcomes in severe AS patients.
Conclusions:
- Clinicians must balance valve disease management with cancer treatment needs and patient comorbidities.
- Age and frailty are critical factors in deciding the timing and method of aortic valve replacement.
- Further research is needed to establish evidence-based treatment guidelines for this complex patient group.
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