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 (i) risk stratification of VHD in cancer patients, including the impact of chemotherapies, targeted therapies, and non-cardiac surgery, (ii) indication and timing considerations for cardiac intervention to minimize oncologic treatment delays, and (iii) comparison of surgical vs 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.
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BibTeX
@article{ternacle2026management,
title = {{Management of severe valvular heart disease in patients with active cancer: a French multidisciplinary position paper}},
author = {Julien Ternacle and Mariana Mirabel and Christelle Diakov and Sophie Ribeyrolles and Jennifer Cautela and Alexandra Meilhac and Corentin Bourg and William Uhlrich and Yohann Bohbot and Yoan Lavie-Badie and Joachim Alexandre and Julien Magne and Marco Vola and Thomas Modine and Bernard Iung and Hélène Eltchaninoff and Stephane Ederhy and Erwan Donal},
journal = {European Heart Journal - Valvular and Structural Heart Disease},
year = {2026},
month = oct,
doi = {10.1093/ehjvshd/xwag080},
url = {https://hal.science/hal-05829109v1},
note = {CC BY},
}
RIS
TY - JOUR
TI - Management of severe valvular heart disease in patients with active cancer: a French multidisciplinary position paper
AU - Julien Ternacle
AU - Mariana Mirabel
AU - Christelle Diakov
AU - Sophie Ribeyrolles
AU - Jennifer Cautela
AU - Alexandra Meilhac
AU - Corentin Bourg
AU - William Uhlrich
AU - Yohann Bohbot
AU - Yoan Lavie-Badie
AU - Joachim Alexandre
AU - Julien Magne
AU - Marco Vola
AU - Thomas Modine
AU - Bernard Iung
AU - Hélène Eltchaninoff
AU - Stephane Ederhy
AU - Erwan Donal
PY - 2026
DA - 2026/10/21
JO - European Heart Journal - Valvular and Structural Heart Disease
DO - 10.1093/ehjvshd/xwag080
UR - https://hal.science/hal-05829109v1
AB - 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 (i) risk stratification of VHD in cancer patients, including the impact of chemotherapies, targeted therapies, and non-cardiac surgery, (ii) indication and timing considerations for cardiac intervention to minimize oncologic treatment delays, and (iii) comparison of surgical vs 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.
SN - 2977-8565
ER -