Outcomes of eight patients after surgical valve replacement for
carcinoid heart disease.
Abstract
Background and aim Carcinoid heart disease is a rare, acquired heart
valvular disease affecting mainly the right chambers. Cardiac surgery is
the only definite symptom relieving option and has significantly
transformed patient short and midterm prognosis. In this study, we aim
to retrospectively analyze the postoperative outcomes of patients with
carcinoid syndrome after heart valve surgery. Methods Data was
retrospectively collected for patients referred to our institution for
carcinoid heart disease and operated between 2013 and beginning of 2021.
Results 8 patients underwent heart valve replacement with 1 having
quadruple valve surgery, 3 patients had both tricuspid and pulmonary
valves changed while 4 had only tricuspid valve replacements ; 3
patients had mechanical prostheses. 3 deaths occurred during the
follow-up till date with 2 inside the perioperative period. No case of
valvular complications was reported. Mean ICU and hospital stay were 9,4
days (range 1-39) and 23,5 days (range 10-52) respectively. 2 patients
needed postoperative dialysis, 1 needed re-intubation and no patient
required extracorporeal life support. The mean time period from
diagnosis to valve surgery was 16,6 months (range 1-60). Follow-up (2-84
months) showed excellent postoperative clinical status with NYHA 1 in
all patients. Conclusions Timely heart valve surgery in patients with
close multidisciplinary monitoring is associated with good midterm
survival rates and low perioperative valvular complications. Patients
should be considered for surgery the soonest possible irrespective of
the number of valves concerned as functional status improves drastically
in most patients.