Carcinoid Heart Disease

Abstract

A patient with carcinoid syndrome with both tricuspid and pulmonic valvular lesions has been described. Successful repair of the valvular lesions was performed under cardiopulmonary bypass. The operation consisted of pulmonic valvotomy with the excision of a single pulmonic valve cusp, and replacement of the tricuspid valve by a Starr-Edwards prosthesis. Postoperatively, the patient noted marked improvement in symptomatology, and there was a concomitant improvement in serial hemodynamic studies. The development of the signs of tricuspid regurgitation and pulmonic stenosis in patients with metastatic carcinoid tumor should alert the physician to the possible presence of carcinoid heart disease. If hemodynamic and angiocardiographic studies confirm the presence of significant valvular lesions, corrective cardiac surgery should be performed in selected patients.