SHORT REPORT INTERVENTIONS FOR VALVULAR DISEASE AND HEART FAILURE e 1771 EuroIntervention 2018;13: e 1771- e 1773 published online November 2017 published online e -edition February 2018 DOI: 10.4244/EIJ-D-17-00811 © Europa Digital & Publishing 2018. All rights reserved. *Corresponding author: Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Cardiovascular Division, 46 rue Henri Huchard, 75018 Paris, France. E-mail: david.messika-zeitoun@aphp.fr Management of radiation-induced valvular heart disease due to Hodgkin’s Lymphoma in the modern era Elise Paven 1 , MD; Claire Cimadevilla 2 , MD; Marina Urena 1 , MD, PhD; Marie-Pierre Dilly 3 , MD; Patrick Nataf 2 , MD; Richard Raffoul 2 , MD; Dominique Himbert 1 , MD; Alec Vahanian 1,4,5 , MD; David Messika-Zeitoun 1,4,5 *, MD, PhD 1. Department of Cardiology, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France; 2. Department of Cardiac Surgery, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France; 3. Department of Anaesthesiology, Assistance Publique - Hôpitaux de Paris, Bichat Hospital, Paris, France; 4. INSERM U1148, Bichat Hospital, Paris, France, 5. University Paris VII, Paris, France Introduction Irradiation doses used in the early days to cure Hodgkin’s Lymphoma are responsible for late cardiac complications includ- ing valvular heart disease (VHD). Radiation-induced VHD (RI-VHD) is a major challenge for cardiac surgeons as they may face hostile thorax and myocardial damage which are often under- estimated 1 . The last decade has seen the remarkable develop- ment of transcatheter aortic valve implantation (TAVI) and, more recently, transcatheter mitral valve implantation (TMVI) 2 . In the present study, we reviewed all consecutive patients with symp- tomatic RI-VHD due to Hodgkin’s Lymphoma who underwent either a surgery, a TAVI or a TMVI at our institution. Editorial, see page 1735 Methods Consecutive patients diagnosed with severe mitral and/or aortic RI-VHD due to Hodgkin’s Lymphoma who underwent a surgical or transcatheter intervention at Bichat Hospital were retrospectively enrolled. The decision to perform a transcatheter or a surgical intervention was left to the Heart Team. Follow-up was obtained through visits to clinics or phone calls to the patients/referring cardiologists and was complete up to July 2016. Comparisons between the groups were performed using the Student’s t-test, Mann-Whitney test, chi² test or Fisher’s exact test, as appropriate. Survival rates were assessed using the Kaplan-Meier method, and comparison according to therapy by means of log-rank test. Results Between January 2006 and January 2016, 37 patients were admit- ted and treated in Bichat Hospital for RI-VHD due to Hodgkin’s disease. Median interval between radiotherapy and transcatheter/ surgical therapy was 32 years (27-41). Twenty-one patients (57%) presented with an isolated aortic valve disease, five (13%) with an isolated mitral disease and 11 (30%) with a combined aortic and mitral valve disease. Sixteen patients (43%) were referred to surgery, 17 patients (46%) underwent a TAVI and four patients (11%) a TMVI. All interventions were successful. No combined valvular interven- tion was performed in the transcatheter groups (0%) compared to 38% in the surgical group (p<0.001). Among the 16 patients who were operated on, nine patients (56%) had an isolated aortic valve disease, one patient (6%) an isolated mitral valve disease and six SUBMITTED ON 11/09/2017 - REVISION RECEIVED ON 26/10/2017 - ACCEPTED ON 10/11/2017