Management of radiation-induced valvular heart disease due to Hodgkin's Lymphoma in the modern era.

Series purely related to radiation-induced valvular heart diseases (RI-VHD) due to Hodgkin's lymphoma are scarce. We sought to report their contemporary management at the area of transcatheter therapies.We retrospectively enrolled all consecutive patients who underwent a surgical/transcatheter procedure between 2006 and 2016 at our institution for symptomatic RI-VHD due to Hodgkin's lymphoma. Management was left at the discretion of the heart team. Thirty-seven patients were included (17 surgery, 16 transcatheter aortic valve implantations (TAVI) and 4 transcatheter mitral valve implantations (TMVI)). Surgery was mostly used in patients with multiple VHD and/or associated disease (p<0.001). Overall in-hospital mortality was 14 % and tended to be lower in the transcatheter groups (25% in the surgical group, 6% in the TAVI group and 0% in the TMVI group, p=0.19) with shorter length of stay duration (14days in the surgical group, 7 days in the TAVI group and 6 days in the TMVI group, p=0.07). One-year mortality was 24% overall, 25% in surgical group, 18% in TAVI group and 50% in TMVI group (p=0.18) mainly related to the severe condition of the patients.In this homogeneous and contemporary series of patients with RI-VHD due to Hodgkin's disease, overall prognosis remained poor despite a successful management of the valvular disease. Transcatheter interventions appeared a reasonable alternative to surgery although further validation at the mitral level is required.