Management of Severe Valvular Heart Disease in Patients with Active Cancer: A French Multidisciplinary Position Paper
Abstract The co-existence of valvular heart disease (VHD) and active cancer presents a unique clinical challenge, necessitating an individualized multidisciplinary strategy to balance oncologic treatment urgency with cardiovascular risk. The indication, optimal timing and modality of VHD intervention in patients with active cancer remain unclear, particularly given the risks of cancer treatment-related cardiac dysfunction, perioperative complications, delays in oncologic therapy and the cancer prognosis. This multidisciplinary position paper aims to provide evidence-based suggestions on the management of severe VHD in active cancer patients, focusing on 1) Risk stratification of VHD in cancer patients, including the impact of chemotherapies, targeted therapies and non-cardiac surgery, 2) Indication and timing considerations for cardiac intervention to minimize oncologic treatment delays, and 3) Comparison of surgical versus percutaneous interventions, highlighting patient selection criteria. A conservative approach should be discussed insofar as it does not limit access to optimal oncology care. Percutaneous interventions should be favoured when feasible to minimize oncologic delays (<4 weeks), while surgical approaches remain essential in select cases with anatomical contraindications. Future research should focus on prospective studies.
Authors
- Bernard Iung (ORCID: https://orcid.org/0000-0002-9127-348X)
- Yohann Bohbot (ORCID: https://orcid.org/0000-0002-2695-9848)
- Erwan Donal (ORCID: https://orcid.org/0000-0003-2677-3389)
- Sophie Ribeyrolles (ORCID: https://orcid.org/0000-0001-7462-7533)
- Julien Magné (ORCID: https://orcid.org/0000-0001-7598-8234)
- Mariana Mirabel (ORCID: https://orcid.org/0000-0002-9969-8896)
- Julien Ternacle (ORCID: https://orcid.org/0000-0002-9629-5864)
- Stéphane Éderhy (ORCID: https://orcid.org/0000-0002-0792-2521)
- Jennifer Cautela (ORCID: https://orcid.org/0000-0003-1284-8191)
- Yoan Lavie‐Badie (ORCID: https://orcid.org/0000-0002-8310-4512)
- Alexandra Meilhac (ORCID: https://orcid.org/0000-0003-1892-2014)
- Marco Vola
- William Uhlrich
- Christelle Diakov (ORCID: https://orcid.org/0000-0002-6291-7960)
- Joachim Alexandre (ORCID: https://orcid.org/0000-0002-9197-8404)
- Thomas Modine (ORCID: https://orcid.org/0000-0002-7822-3736)
- Hélène Eltchaninoff (ORCID: https://orcid.org/0000-0002-2652-7973)
- Corentin Bourg
Institutions
- Université de Bordeaux (FR)
- Inserm (FR)
- Aix-Marseille Université (FR)
- Sorbonne Université (FR)
- Institute Mutualiste Montsouris (FR)
- Centre Hospitalier Universitaire Amiens-Picardie (FR)
- Hôpital Saint-Antoine (FR)
- Normandie Université (FR)
- Hôpital Cardiologique du Haut-Lévêque (FR)
- Hôpital Rangueil (FR)
- Hôpital Louis Pradel (FR)
- Hôpital Bichat-Claude-Bernard (FR)
- Centre de Recherche Cardio-Thoracique de Bordeaux (FR)
- Centre Hospitalier Universitaire de Rennes (FR)
- Institut de Recherche pour le Développement (FR)
- Université de Rouen Normandie (FR)
- Université de Limoges (FR)
- Université de Caen Normandie (FR)
Publication Details
- Journal
- European Heart Journal - Valvular and Structural Heart Disease
- Published
- 2026-09-10
- DOI
- https://doi.org/10.1093/ehjvshd/xwag080
- Primary Topic
- Chemotherapy-induced cardiotoxicity and mitigation
- Type
- article
- Field-Weighted Citation Impact
- 0.00