OBJECTIVE

To analyze the early postoperative results of cardiac surgery in patients with previous radiotherapy for Hodgkin’s lymphoma.

MATERIAL AND METHODS

A retrospective analysis included 29 patients who underwent cardiac surgery between 2003 and 2019. Previous radiotherapy for Hodgkin’s lymphoma was performed in 1972—2008. Mean age of patients was 49.8±9.5 years (range 35—69, median 49). There were 19 (68%) women. Age of patients at the time of radiotherapy ranged from 3 to 39 years (mean 22.1±9.7, median 21). Mean period between radiotherapy and cardiac surgery was 27.9±9 years (range 11—42).

RESULTS

Prolonged mechanical ventilation (>72 hours) was required in 10 patients. Mean ICU stay was 26 hours (IQR 22.5—91.5). In-hospital mortality was 17% (5 patients). Progressive heart failure was predominant cause of in-hospital mortality. In early postoperative period, effusion pleuritis occurred in 9 patients, right-sided hydrothorax in 3 cases, bilateral hydrothorax in 4 cases, left-sided hydrothorax in 2 cases. Thoracocentesis was performed in 6 cases. Pericardial effusion was diagnosed in 7 patients.

CONCLUSION

Despite high risk of postoperative complications, severity of calcification of heart structures, lung fibrosis and extended cardiac surgery were not significant factors affecting survival rate. These patients can successfully undergo on-pump cardiac surgery. To reduce in-hospital mortality, a more thorough assessment of baseline cardiac and non-cardiac complications of radiotherapy is required.