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Structural Transcatheter Cardiac Interventions in the Cardio-Oncology Population

  • Cardio-Oncology (M Fradley, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

Modern cancer therapies have resulted in prolonged survival and decreased mortality for many types of cancer. Consequently, cancer patients with concomitant cardiovascular disease (CVD) present prior to diagnosis of cancer, resulting from various forms of cancer therapy, or developing after cancer remission are at higher risk for development of cardiovascular-associated morbidity and mortality. Management of CVD, particularly structural heart disease, in this patient population is challenging and associated with elevated surgical risk. Minimally invasive transcatheter procedures have emerged as lower risk treatment modalities that have been shown to be safe and efficacious. This review will evaluate the current literature on percutaneous management of aortic stenosis (AS), mitral regurgitation (MR), tricuspid regurgitation (TR), and intracardiac thrombus (ICTE) or masses in cancer patients.

Recent findings

Multiple cohort- and registry-based studies have demonstrated safe and efficacious implementation of transcatheter interventions for the management of severe AS and MR in cancer patients. The development of transcatheter interventions for severe TR is promising and may also be considered for this high-risk patient population. Interestingly, management of ICTE and cardiac masses has also been achieved with a novel transcatheter approach.

Summary

While a multidisciplinary heart team approach is necessary to properly manage cancer patients with structural heart disease and ICTE, more robust registry-based and prospective clinical trials are required to meet the needs of a rapidly growing cardio-oncology patient population.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

    Daniel J. Jimenez MD, Rushi V. Parikh MD, Megan Kamath MD, Marcella Calfon-Press MD, PhD, Olcay Aksoy MD & Eric H. Yang MD

  2. Ahmanson-UCLA Cardiomyopathy Center, University of California at Los Angeles, Los Angeles, CA, USA

    Rushi V. Parikh MD & Megan Kamath MD

  3. Interventional Radiology, Department of Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    John M. Moriarty MD

  4. Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Juan Lopez-Mattei MD, Nicolas Palaskas MD & Cezar A. Iliescu MD

  5. UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, 100 Medical Plaza, Suite 630, Los Angeles, CA, 90095, USA

    Megan Kamath MD & Eric H. Yang MD

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  1. Daniel J. Jimenez MD
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Correspondence to Eric H. Yang MD.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

Conflict of Interest

Daniel J. Jimenez declares that he has no conflict of interest. Rushi V. Parikh receives grant support from the American Heart Association and Janssen Pharmaceuticals Inc. He is an advisor to Stallion Cardio, DocVocate, and HeartCloud. He declares no relevant conflict of interest. Megan Kamath declares that she has no conflict of interest. Marcella Calfon-Press declares that she has no conflict of interest. John M. Moriarty receives grant funding from Angiodynamics Inc. He is on the advisory board of Angiodynamics Inc. and Boston Scientific Inc. He is also a consultant for BD Bard, PAVMED Inc., Thrombex Inc., and Penumbra Inc. Olcay Aksoy declares that he has no conflict of interest. Nicolas Palaskas declares that he has no conflict of interest. Juan Lopez-Mattei declares that he has no conflict of interest. Cezar A. Iliescu declares that he has no conflict of interest. Eric H. Yang receives research funding from CSL Behring. He declares no relevant conflict of interest.

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Jimenez, D.J., Parikh, R.V., Kamath, M. et al. Structural Transcatheter Cardiac Interventions in the Cardio-Oncology Population. Curr Treat Options Cardio Med 23, 20 (2021). https://doi.org/10.1007/s11936-021-00898-2

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