PMID- 21156347
OWN - NLM
STAT- MEDLINE
DCOM- 20120113
LR  - 20220410
IS  - 1873-734X (Electronic)
IS  - 1010-7940 (Linking)
VI  - 40
IP  - 1
DP  - 2011 Jul
TI  - Outcomes, risks and complications of cardiac surgery for carcinoid heart disease.
PG  - 168-72
LID - 10.1016/j.ejcts.2010.10.035 [doi]
AB  - OBJECTIVE: The development of carcinoid heart disease causes significant valvular 
      dysfunction, eventually leading to symptomatic right heart failure and impaired 
      survival. Data regarding cardiovascular surgery are limited. We sought to 
      identify outcomes, risks and complications of valve surgery for carcinoid heart 
      disease. METHODS: Twenty-two patients with carcinoid heart disease underwent 
      cardiac valve surgery between 2006 and 2010. Patients were considered for surgery 
      if (1) they had stable carcinoid tumour, (2) they had severe valvular dysfunction 
      and (3) were symptomatic and (4) they had no other significant co-morbidities. 
      Three patients underwent tricuspid valve replacement alone, 15 patients underwent 
      tricuspid and pulmonary valve replacement, two patients underwent tricuspid, 
      pulmonary and mitral valve replacement and two patients underwent quadruple valve 
      replacement. RESULTS: Overall 30-day mortality was 18%. Causes of death were 
      right ventricular dysfunction (two patients), carcinoid crises (one patient) and 
      pneumonia (one patient). Four patients required permanent pacemaker for complete 
      heart block. Of those that survived initial surgery, median follow-up was 26 
      months (interquartile range 8-42); 1- and 2-year survival rates were 56% and 44%, 
      respectively. There was no significant difference in survival between those 
      patients in the New York Heart Association (NYHA) class I/II, mild/moderate right 
      ventricular dilatation or N-terminal brain natriuretic peptide (NT-proBNP) <1245 
      pg ml(-1) compared with those in NYHA class III/IV, severe right ventricular 
      enlargement or NT-proBNP > 1245 pg ml(-1), respectively. Long-term causes of 
      death were related to advanced metastatic carcinoid tumour. No patient required 
      re-operation for bioprosthetic degeneration. CONCLUSION: Valve surgery for 
      carcinoid heart disease is of higher risk compared with most other forms of 
      valvular surgery. However, in those that survive the operation significant 
      improvement in functional class occurs. Most long-term complications were related 
      to the tumour itself rather than cardiac complications.
CI  - Copyright (c) 2010 European Association for Cardio-Thoracic Surgery. Published by 
      Elsevier B.V. All rights reserved.
FAU - Bhattacharyya, Sanjeev
AU  - Bhattacharyya S
AD  - Department of Cardiology, Royal Free Hospital, Pond Street, London NW3 2QG, UK.
FAU - Raja, Shahzad G
AU  - Raja SG
FAU - Toumpanakis, Christos
AU  - Toumpanakis C
FAU - Caplin, Martyn E
AU  - Caplin ME
FAU - Dreyfus, Gilles D
AU  - Dreyfus GD
FAU - Davar, Joseph
AU  - Davar J
LA  - eng
PT  - Journal Article
DEP - 20101214
PL  - Germany
TA  - Eur J Cardiothorac Surg
JT  - European journal of cardio-thoracic surgery : official journal of the European 
      Association for Cardio-thoracic Surgery
JID - 8804069
SB  - IM
MH  - Aged
MH  - Carcinoid Heart Disease/diagnostic imaging/*surgery
MH  - Epidemiologic Methods
MH  - Female
MH  - Heart Valve Diseases/diagnostic imaging/*surgery
MH  - Heart Valve Prosthesis Implantation/*adverse effects/methods
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/diagnostic imaging/surgery
MH  - Prognosis
MH  - Pulmonary Valve/diagnostic imaging/surgery
MH  - Treatment Outcome
MH  - Tricuspid Valve/diagnostic imaging/surgery
MH  - Ultrasonography
EDAT- 2010/12/16 06:00
MHDA- 2012/01/14 06:00
CRDT- 2010/12/16 06:00
PHST- 2010/07/19 00:00 [received]
PHST- 2010/10/04 00:00 [revised]
PHST- 2010/10/07 00:00 [accepted]
PHST- 2010/12/16 06:00 [entrez]
PHST- 2010/12/16 06:00 [pubmed]
PHST- 2012/01/14 06:00 [medline]
AID - S1010-7940(10)00927-9 [pii]
AID - 10.1016/j.ejcts.2010.10.035 [doi]
PST - ppublish
SO  - Eur J Cardiothorac Surg. 2011 Jul;40(1):168-72. doi: 10.1016/j.ejcts.2010.10.035. 
      Epub 2010 Dec 14.