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(Chest. 1973;64:291-297.)
© 1973 American College of Chest Physicians

Management of Patients with Radiation-Induced Pericarditis with Effusion: A Note on the Development of Aortic Regurgitation in Two of Them

Donald L. Morton M.D.1; D. Luke Glancy M.D., F.C.C.P.1; William L. Joseph M.D.1; and Paul C. Adkins M.D.1

1 Surgery Branch, National Cancer Institute, and the Cardiology Branch, National Heart and Lung Institute, National Institutes of Health, Bethesda, Md.: Divisions of Thoracic Surgery and Oncology, UCLA School of Medicine, Los Angeles, Calif.; Department of Surgery, George Washington University School of Medicine, Washington, D.C.; Section of Cardiology, Department of Medicine, LSU Medical Center, New Orleans, La.

Modern radiation therapy has produced considerable improvement in the results of therapy for Hodgkin's disease, but dosage of radiation sufficient to sterilize mediastinal lymph nodes often produces heart disease. Pericardial injury is the most serious cardiac consequence of radiation, and it often leads to chronic pericardial effusion and not infrequently to cardiac tamponade. Pericardiocentesis may be lifesaving, but the effusion and tamponade frequently recur. Removal of the damaged parietal pericardium by subtotal pericardiectomy effectively relieves the cardiac tamponade and probably prevents the subsequent development of constrictive pericarditis. Of 17 patients whose radiation-induced pericardial effusions were treated by subtotal pericardiectomy, 12 are living and well without evidence of significant cardiac dysfunction up to three years after operation. Pericardiectomy may be indicated even in patients with recurrent Hodgkin's disease, since further radiation or chemotherapy may provide longterm palliation.

Submitted on February 16, 1973
Accepted on March 28, 1973




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