169 results on '"Carcinoid Heart Disease complications"'
Search Results
52. Successful Hepatectomy Using Venovenous Bypass in a Patient With Carcinoid Heart Disease and Severe Tricuspid Regurgitation.
- Author
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Suphathamwit A, Dhir A, Dobkowski W, and Quan D
- Subjects
- Female, Humans, Middle Aged, Carcinoid Heart Disease complications, Gastrointestinal Neoplasms pathology, Hepatectomy methods, Liver Neoplasms secondary, Liver Neoplasms surgery, Tricuspid Valve Insufficiency complications
- Published
- 2016
- Full Text
- View/download PDF
53. Maximizing Information From Routine Staging Computed Tomography in Functional Neuroendocrine Neoplasms: Are There Findings Indicating the Presence of Carcinoid Heart Disease?
- Author
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Baur AD, Kunz F, Schwenke C, Pschowski R, Röpke TK, Pavel M, and Denecke T
- Subjects
- Adult, Aged, Aged, 80 and over, Carcinoid Heart Disease complications, Contrast Media, Female, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Humans, Male, Middle Aged, Neoplasm Staging, Neuroendocrine Tumors complications, Observer Variation, Radiographic Image Enhancement, Retrospective Studies, Sensitivity and Specificity, Ventricular Dysfunction, Right complications, Ventricular Dysfunction, Right diagnostic imaging, Ventricular Dysfunction, Right pathology, Carcinoid Heart Disease diagnostic imaging, Carcinoid Heart Disease pathology, Neuroendocrine Tumors diagnostic imaging, Neuroendocrine Tumors pathology, Tomography, X-Ray Computed
- Abstract
Purpose: The aim of this study was to evaluate signs of right-sided heart dysfunction on staging computed tomography (CT) as indirect indicators of carcinoid heart disease., Patients and Methods: Patients with functionally active neuroendocrine neoplasm and different grades of tricuspid valve regurgitation (TR) were identified. Two readers independently reviewed contrast-enhanced staging CT performed within 90 days before or after echocardiography. Logistic regression and receiver operating analyses were used to asses the predictive value of right ventricle-left ventricle ratio (RV-LV ratio), ventricular septal bowing, retrograde contrast filling of the hepatic veins during contrast injection, and time to aortal enhancement greater than 100 Hounsfield units during bolus tracking for TR., Results: Forty-four examinations were evaluated (11 with TR = 0, 16 with TR = 1, 9 with TR = 2, and 8 with TR = 3). Right ventricle-LV ratio was found to predict TR less than or equal to 1 versus TR greater than 1 (P = 0.0188) and TR less than or equal to 1 versus TR equals 2 (P = 0.0082). A prolonged time to aortal enhancement greater than 100 Hounsfield units during bolus tracking predicted TR less than or equal to 1 versus TR greater than 1 (P = 0.0077). Area under the curve for RV-LV ratio was 0.86 when differentiating TR less than or equal to 1 versus TR equals 2. With a cutoff of 1.07, sensitivity was 0.89, and specificity was 0.72., Conclusions: In patients with functionally active neuroendocrine neoplasm, an RV-LV ratio of more than 1.07 predicted TR with a relatively high sensitivity and moderate specificity and thus could serve as an indicator of subclinical carcinoid heart disease on routine staging CT.
- Published
- 2016
- Full Text
- View/download PDF
54. Transcatheter pulmonary and tricuspid valve-in-valve replacement for bioprosthesis degeneration in carcinoid heart disease.
- Author
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Khan JN, Doshi SN, Rooney SJ, Bhabra MS, and Steeds RP
- Subjects
- Aged, Bioprosthesis adverse effects, Female, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases etiology, Heart Valve Prosthesis Implantation methods, Humans, Prosthesis Failure, Recurrence, Reoperation, Time Factors, Treatment Outcome, Ultrasonography, Carcinoid Heart Disease complications, Heart Valve Diseases therapy, Heart Valve Prosthesis Implantation instrumentation, Pulmonary Valve, Tricuspid Valve
- Published
- 2016
- Full Text
- View/download PDF
55. Staged Catheter-Based Valve Treatment of Severe Carcinoid Heart Disease.
- Author
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Laule M, Pschowski R, Pape UF, Pavel M, Stangl V, Baumann G, Wiedenmann B, and Stangl K
- Subjects
- Aged, Carcinoid Heart Disease complications, Echocardiography, Transesophageal, Female, Humans, Neuroendocrine Tumors complications, Neuroendocrine Tumors surgery, Carcinoid Heart Disease surgery, Cardiac Catheterization methods, Heart Valve Prosthesis, Tricuspid Valve surgery
- Abstract
Purpose: Carcinoid heart disease (CHD) with severe valve destruction represents the major cause of high morbidity and mortality in patients with carcinoid syndrome. In this paper, we present a novel interventional treatment approach and report the first clinical result achieved in a patient with extensive CHD., Methods and Results: A woman with an ileal neuroendocrine tumour (G2, Ki67: 5%) presented with severe CHD (NYHA IV) affecting both the pulmonary and the tricuspid valve. First, a balloon-expandable 23-mm Edwards SAPIEN™ was successfully implanted percutaneously into the pulmonary valve. Since no catheter-based techniques were available for the replacement of the native tricuspid valve, we implanted an Edwards SAPIEN 26-mm valve into the vena cava inferior between the right atrium and the ostium of the hepatic veins to reduce abdominal congestion. The implantation was technically successful and completely prevented regurgitation into the vena cava inferior and abdominal veins. After this procedure, the patient's clinical condition improved significantly, and she achieved near-normal exercise tolerance (VO2 max: 24.4 ml O2/kg/min, NYHA II)., Conclusion: We demonstrated that percutaneous valve implantation may offer a novel, minimally invasive option in high-risk patients with severe CHD., (© 2015 S. Karger AG, Basel.)
- Published
- 2016
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- View/download PDF
56. Transcatheter pulmonic valve replacement in carcinoid heart disease.
- Author
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Heidecker B, Moore P, Bergsland EK, Merrick SH, and Rao RK
- Subjects
- Carcinoid Heart Disease diagnostic imaging, Female, Follow-Up Studies, Humans, Middle Aged, Minimally Invasive Surgical Procedures methods, Pulmonary Valve Stenosis etiology, Risk Assessment, Treatment Outcome, Carcinoid Heart Disease complications, Cardiac Catheterization methods, Echocardiography, Doppler, Color methods, Heart Valve Prosthesis Implantation methods, Pulmonary Valve Stenosis diagnostic imaging, Pulmonary Valve Stenosis surgery
- Published
- 2015
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57. Bioprosthetic tricuspid valve replacement in carcinoid heart disease from primary ovarian carcinoid tumor.
- Author
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Tsugu T, Iwanaga S, Murata M, and Fukuda K
- Subjects
- Female, Humans, Middle Aged, Bioprosthesis, Carcinoid Heart Disease complications, Carcinoid Tumor complications, Carcinoid Tumor secondary, Heart Valve Prosthesis, Ovarian Neoplasms pathology, Tricuspid Valve surgery, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency surgery
- Abstract
Carcinoid heart disease (CHD) commonly occurs in association with primary gastrointestinal tract carcinoid tumors with hepatic metastases. Unlike primary gastrointestinal tract carcinoid tumors, primary ovarian carcinoid tumors may cause CHD without hepatic metastases, accounting for only 0.3 % of all carcinoid tumors. Only 37 cases of CHD from primary ovarian carcinoid tumors have been reported. We present a case of CHD in which tricuspid valve thickening and shortening led to reduced valve mobility with the resulting severe tricuspid regurgitation. Considering these characteristics of an abnormal tricuspid valve, we suspected CHD, but prosthetic valve replacement was performed without sufficient systemic examination before surgery. Two years after valve replacement, the patient underwent excision of a mass in the lower abdomen, which was diagnosed as an ovarian carcinoid tumor by histopathological examination. The patient has been observed for more than 3 years after tricuspid valve replacement. She has not experienced bioprosthetic valve leaflet degeneration or dysfunction, although it has been reported that bioprosthetic valves may degenerate in patients with carcinoid tumors. Sufficient systemic examinations should be performed to explore the cause of disease.
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- 2015
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58. Failing stentless Bioprostheses in patients with carcinoid heart valve disease.
- Author
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Schaefer A, Sill B, Schoenebeck J, Schneeberger Y, Reichenspurner H, and Gulbins H
- Subjects
- Adult, Female, Humans, Male, Middle Aged, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Stenosis etiology, Recurrence, Reoperation, Bioprosthesis, Carcinoid Heart Disease complications, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Pulmonary Valve Insufficiency surgery, Pulmonary Valve Stenosis surgery
- Abstract
Background: Carcinoid tumor with consecutive endocardial fibroelastosis of the right heart, known as carcinoid heart valve disease (CHVD) or Hedinger's syndrome, is accompanied by combined right-sided valvular dysfunction with regurgitation and stenosis of the affected valves. Cardiac surgery with replacement of the tricuspid and/or pulmonary valve is an established therapeutic option for patients with Hedinger's syndrome. Little is known about the long term outcome and the choice of prosthesis for the pulmonal position is still a matter of debate., Methods: The authors report three cases of pulmonary valve replacement with stentless bioprostheses (Medtronic Freestyle, Medtronic PLC, Minneapolis, MN, USA) due to severe pulmonary valve degeneration in consequence of Hedinger's syndrome., Results: All patients presented with re-stenosis of the pulmonal valve conduit at the height of the anastomoses in a premature fashion. Due to the increased risk for repeat surgical valve replacement, two patients were treated by transcatheter heart valves., Conclusion: We do not recommend the replacement of the pulmonary valve with stentless bioprostheses in patients with CHVD. These valves presented with an extreme premature degeneration and consecutive re-stenosis and heart failure.
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- 2015
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59. A heart gripping case: carcinoid heart disease.
- Author
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Magulick JP, Flynt FL, Steel KE, and Shumway NM
- Subjects
- Abdominal Pain etiology, Carcinoid Heart Disease complications, Chest Pain etiology, Duodenal Neoplasms complications, Female, Hot Flashes etiology, Humans, Middle Aged, Appendiceal Neoplasms secondary, Carcinoid Heart Disease diagnosis, Duodenal Neoplasms pathology, Heart Neoplasms secondary, Ileal Neoplasms secondary, Liver Neoplasms secondary
- Published
- 2015
60. Clues to diagnosing carcinoid heart disease as the cause of isolated right-sided heart failure.
- Author
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Roberts CC, Parmar RJ, Grayburn PA, Patankar GR, Ko JM, Hamman BL, and Roberts WC
- Subjects
- Aged, Carcinoid Heart Disease complications, Dextrocardia diagnosis, Diagnosis, Differential, Female, Follow-Up Studies, Heart Failure diagnosis, Humans, Carcinoid Heart Disease diagnosis, Cardiac Catheterization methods, Dextrocardia complications, Echocardiography, Transesophageal methods, Electrocardiography, Heart Failure etiology, Tomography, X-Ray Computed methods
- Abstract
Described herein is a 67-year-old woman who underwent replacement of both tricuspid and pulmonic valves because of severe isolated right-sided systolic heart failure. The cause of the heart failure preoperatively was believed to be the result of left breast radiation a year earlier. At operation, however, the pulmonic valve was excised and a biopsy of the stiff-walled right atrium was performed, and histologic examination of each was classic of carcinoid heart disease. She never awoke postoperatively. Postoperatively, computed tomography disclosed numerous masses in the liver. Retrospectively, clues to the presence of carcinoid heart disease include thickening of both the tricuspid and pulmonic valve leaflets by echocardiogram, a pressure gradient, albeit small, across the pulmonic valve, the plastering of the septal tricuspid-valve leaflet to the ventricular septum, the total absence of left-sided heart disease, and the presence of extremely low 12-lead QRS electrocardiographic voltage., (Copyright © 2014 Elsevier Inc. All rights reserved.)
- Published
- 2014
- Full Text
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61. Myocardial metastases on 6-[18F] fluoro-L-DOPA PET/CT: a retrospective analysis of 116 serotonin producing neuroendocrine tumour patients.
- Author
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Noordzij W, van Beek AP, Tio RA, van der Horst-Schrivers AN, de Vries EG, van Ginkel B, Walenkamp AM, Glaudemans AW, Slart RH, and Dierckx RA
- Subjects
- Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Female, Heart Neoplasms diagnostic imaging, Humans, Male, Middle Aged, Multimodal Imaging, Neuroendocrine Tumors diagnostic imaging, Neuroendocrine Tumors pathology, Retrospective Studies, Ultrasonography, Dihydroxyphenylalanine analogs & derivatives, Heart Neoplasms secondary, Myocardium pathology, Positron-Emission Tomography, Serotonin biosynthesis, Tomography, X-Ray Computed
- Abstract
Purpose: This study evaluates the prevalence of cardiac metastases in patients with serotonin producing neuroendocrine tumours (NET), examined with 18F-FDOPA PET/CT, and the relationship of these metastases to the presence of carcinoid heart disease (CHD) based on echocardiography., Background: CHD occurs in patients with serotonin producing NET. The diagnostic method of choice remains echocardiography. The precise prevalence of cardiac metastases is unknown given the limitations of standard technologies. Nuclear medicine modalities have the potential to visualize metastases of NET., Methods: All patients who underwent 18F-FDOPA PET/CT because of serotonin producing NET between November 2009 and May 2012 were retrospectively analyzed. The presence of cardiac metastasis was defined as myocardial tracer accumulation higher than the surrounding physiological myocardial uptake. Laboratory tests and transthoracic echocardiography (TTE) results were digitally collected., Results: 116 patients (62 male) underwent 18F-FDOPA PET/CT, mean age was 61±13 years. TTE was performed in 79 patients. Cardiac metastases were present in 15 patients, of which 10 patients also underwent TTE. One patient had both cardiac metastasis (only on 18F-FDOPA PET/CT) and echocardiographic signs of CHD. There were no differences in echocardiographic parameters for CHD between patients with and without cardiac metastases. TTE in none of the 79 patients showed cardiac metastases., Conclusion: The prevalence of cardiac metastases detected with 18F-FDOPA PET/CT in this study is 13%. 18F-FDOPA PET/CT can visualize cardiac metastases in serotonin producing NET patients. There appears to be no relationship between the presence of cardiac metastases and TTE parameters of CHD.
- Published
- 2014
- Full Text
- View/download PDF
62. Carcinoid heart disease.
- Author
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Flaherty AM
- Subjects
- Female, Humans, Middle Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease therapy
- Abstract
The patient, C.P., is a 59-year-old woman who was diagnosed with metastatic carcinoid of the terminal ileum in May 2003. In June 2003, she underwent an extensive resection including hemicolectomy, cholecystectomy, distal pancreatectomy, and splenectomy with metastatic disease in her pancreas, mesentery, and liver. She had been treated with octreotide, everolimus, oxaliplatin, and multiple hepatic artery embolizations in the past eight years and, most recently, capecitabine and bevacizumab with monthly octreotide. She has had intermittent pleural effusions not requiring intervention and a trace pericardial effusion. Her tumor is functional, meaning it demonstrates hormonal hypersecretion which causes flushing, diarrhea, bronchospasm, and abdominal pain.
- Published
- 2014
- Full Text
- View/download PDF
63. A hot flush signals the way to a woman's heart.
- Author
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Melo P, Cahill TJ, and Kardos A
- Subjects
- Carcinoid Heart Disease complications, Carcinoid Heart Disease surgery, Carcinoid Tumor complications, Carcinoid Tumor surgery, Female, Hot Flashes etiology, Humans, Middle Aged, Carcinoid Heart Disease diagnosis, Carcinoid Tumor diagnosis, Hot Flashes diagnosis
- Published
- 2014
- Full Text
- View/download PDF
64. Early diffuse coronary artery spasm after heart valve surgery in the carcinoid syndrome.
- Author
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Anselmi A, Corbineau H, Boulmier D, and Ruggieri VG
- Subjects
- Aged, Carcinoid Heart Disease complications, Coronary Angiography, Heart Failure etiology, Humans, Injections, Intra-Arterial, Male, Nitroglycerin administration & dosage, Severity of Illness Index, Time Factors, Vasodilator Agents administration & dosage, Carcinoid Heart Disease surgery, Coronary Artery Disease diagnostic imaging, Coronary Artery Disease drug therapy, Postoperative Complications diagnostic imaging, Spasm diagnostic imaging, Spasm drug therapy, Tricuspid Valve surgery
- Abstract
Background: Coronary spasm has been described in the context of carcinoid heart disease, but few information are available over perioperative coronary spasm., Methods: We describe the case of a patient developing severe spasm of the entire coronary tree immediately after tricuspid valve surgery for carcinoid heart disease, leading to severe myocardial failure., Results: The spasm was diagnosed by coronary angiography and resolved by intracoronary injection of trinitrine. We present the angiographic features of simultaneous spasm of all coronary arteries and of its evolution., Conclusion: The present case illustrates the likelihood of perioperative spasm of the entire coronary tree in carcinoid heart disease, and the usefulness of coronary angiography for both diagnosis and treatment., (© 2013 Wiley Periodicals, Inc.)
- Published
- 2013
- Full Text
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65. Carcinoid heart disease: outcome after balloon pulmonary valvuloplasty.
- Author
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Carrilho-Ferreira P, Silva D, Almeida AG, Infante de Oliveira E, Ferreira C, Miranda L, Rosa R, Canas da Silva P, Bicha Castelo H, and Nunes Diogo A
- Subjects
- Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease therapy, Cardiac Catheterization, Echocardiography, Echocardiography, Doppler, Color, Female, Follow-Up Studies, Humans, Middle Aged, Pulmonary Valve Stenosis diagnosis, Pulmonary Valve Stenosis etiology, Balloon Valvuloplasty methods, Carcinoid Heart Disease complications, Pulmonary Valve Stenosis therapy
- Abstract
Carcinoid heart disease typically presents with pulmonary stenosis and tricuspid regurgitation. Management is intended for symptomatic relief, and valvular intervention is indicated in refractory heart failure. Balloon valvuloplasty is an option for patients not suitable for surgery. We report the case of a patient with a carcinoid tumour, who developed postoperative refractory hypoxemia. Transthoracic echocardiogram revealed carcinoid pulmonary and tricuspid valve disease, with severe pulmonary stenosis. Balloon valvuloplasty was performed with major clinical improvement., (Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)
- Published
- 2013
- Full Text
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66. [Carcinoid heart disease].
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Bencze A, Szücs N, Igaz P, Leiszter K, Nagy Z, Patócs A, and Rácz K
- Subjects
- Carcinoid Heart Disease complications, Carcinoid Heart Disease metabolism, Diagnosis, Differential, Echocardiography, Doppler, Color, Flushing etiology, Humans, Ileal Neoplasms pathology, Ileal Neoplasms surgery, Lymphatic Metastasis, Male, Malignant Carcinoid Syndrome diagnosis, Malignant Carcinoid Syndrome therapy, Middle Aged, Octreotide therapeutic use, Prognosis, Radiotherapy, Adjuvant, Severity of Illness Index, Tomography, X-Ray Computed, Yttrium Radioisotopes therapeutic use, Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease therapy, Ileal Neoplasms diagnosis, Ileal Neoplasms therapy, Octreotide analogs & derivatives
- Abstract
Carcinoids are rare tumors originating from neuroendocrine cells. A large proportion of these tumors produce serotonin and other biologically active hormones which may produce carcinoid syndrome characterized by flushing, diarrhoea and bronchospasm. Carcinoid heart disease, a rare complication of carcinoid syndrome, may itself have a great impact on life expectancy of patients with carcinoid syndrome. The authors present a case history of a patients with carcinoid heart disease and they review the symptoms, diagnosis and therapeutic options of this rare complication of carcinoid syndrome.
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- 2013
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67. Double valve replacement due to dysfunction secondary to carcinoid tumor.
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Pêgo-Fernandes PM, Laurino AM, Ferronato Dde S, Costa FP, Anbar R, and Jatene FB
- Subjects
- Humans, Male, Middle Aged, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Insufficiency surgery, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency surgery, Bioprosthesis, Carcinoid Heart Disease complications, Pulmonary Valve surgery, Tricuspid Valve surgery
- Published
- 2013
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68. Echo rounds: Undiagnosed severe pulmonic regurgitation in a carcinoid patient for tricuspid valve replacement and patent foramen ovale closure.
- Author
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Hastie MJ, Souh J, Ju A, and Shanewise JS
- Subjects
- Aged, Carcinoid Heart Disease surgery, Heart Ventricles diagnostic imaging, Humans, Hypertrophy, Right Ventricular diagnostic imaging, Male, Pulmonary Valve diagnostic imaging, Serotonin metabolism, Ultrasonography, Carcinoid Heart Disease complications, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent surgery, Heart Valve Prosthesis Implantation, Pulmonary Valve Insufficiency diagnostic imaging, Tricuspid Valve diagnostic imaging, Tricuspid Valve surgery
- Published
- 2013
- Full Text
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69. Adjuvant therapy with methylene blue in the treatment of postoperative vasoplegic syndrome caused by carcinoid crisis after tricuspid valve replacement.
- Author
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Raikhelkar JK, Weiss AJ, Maysick L, and Scurlock C
- Subjects
- Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Chemotherapy, Adjuvant methods, Humans, Male, Treatment Outcome, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Insufficiency etiology, Vasoplegia diagnosis, Vasoplegia etiology, Carcinoid Heart Disease drug therapy, Heart Valve Prosthesis Implantation adverse effects, Methylene Blue administration & dosage, Tricuspid Valve Insufficiency drug therapy, Vasoplegia drug therapy
- Published
- 2012
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70. Live/Real time three-dimensional transthoracic echocardiographic assessment of the involvement of cardiac valves and chambers in carcinoid disease.
- Author
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Dumaswala B, Bicer EI, Dumaswala K, Donmez C, Bhagatwala KD, Karia N, McKay J, Joshi D, Sadat K, and Nanda NC
- Subjects
- Computer Systems, Female, Humans, Middle Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Three-Dimensional methods, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases etiology, Heart Valves diagnostic imaging
- Abstract
We present an adult with metastatic carcinoid disease affecting the heart, in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over two-dimensional transthoracic echocardiography (2DTTE). Initial 2DTTE was able to demonstrate severe pulmonic and tricuspid regurgitation, but was unable to visualize the posterior leaflet of the tricuspid valve or the right (right anterior) leaflet of the pulmonic valve. Further analysis with 3DTTE demonstrated thickening, restricted mobility, and noncoaptation of all three leaflets of both the tricuspid and the pulmonary valves. En face viewing of tricuspid and pulmonary regurgitation vena contractas permitted more reliable quantification of regurgitation severity. In addition, localized, linear, echogenic areas consistent with carcinoid deposits were noted along the inner walls of the right atrium, atrial septum, and inferior vena cava. To the best of our knowledge, endocardial carcinoid deposits have never been reported by 2D or 3D echocardiography. En face viewing of these deposits by 3DTTE enabled measurement of their dimensions and areas. Subcostal examination also identified large circumscribed hepatic lesions consistent with metastatic disease. Neither the carcinoid deposits nor the metastatic lesions were detected by 2DTTE. This case demonstrates the usefulness of 3DTTE as a supplement to 2DTTE in more comprehensively assessing carcinoid involvement of the heart.
- Published
- 2012
71. Live/real time three-dimensional transthoracic echocardiographic assessment of the involvement of cardiac valves and chambers in carcinoid disease.
- Author
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Dumaswala B, Bicer EI, Dumaswala K, Donmez C, Bhagatwala KD, Karia N, McKay J, Joshi D, Sadat K, and Nanda NC
- Subjects
- Computer Systems, Female, Humans, Middle Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Three-Dimensional methods, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Insufficiency etiology, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency etiology
- Abstract
We present an adult with metastatic carcinoid disease affecting the heart, in whom live/real time three-dimensional transthoracic echocardiography (3DTTE) provided incremental value over two-dimensional transthoracic echocardiography (2DTTE). Initial 2DTTE was able to demonstrate severe pulmonic and tricuspid regurgitation, but was unable to visualize the posterior leaflet of the tricuspid valve or the right (right anterior) leaflet of the pulmonic valve. Further analysis with 3DTTE demonstrated thickening, restricted mobility, and noncoaptation of all three leaflets of both the tricuspid and the pulmonary valves. En face viewing of tricuspid and pulmonary regurgitation vena contractas permitted more reliable quantification of regurgitation severity. In addition, localized, linear, echogenic areas consistent with carcinoid deposits were noted along the inner walls of the right atrium, atrial septum, and inferior vena cava. To the best of our knowledge, endocardial carcinoid deposits have never been reported by 2D or 3D echocardiography. En face viewing of these deposits by 3DTTE enabled measurement of their dimensions and areas. Subcostal examination also identified large circumscribed hepatic lesions consistent with metastatic disease. Neither the carcinoid deposits nor the metastatic lesions were detected by 2DTTE. This case demonstrates the usefulness of 3DTTE as a supplement to 2DTTE in more comprehensively assessing carcinoid involvement of the heart., (© 2012, Wiley Periodicals, Inc.)
- Published
- 2012
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72. Management of ovarian carcinoid syndrome.
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Pappa I, Peros G, Lappas C, Vassiliu P, Arkadopoulos N, and Smyrniotis V
- Subjects
- Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease pathology, Carcinoid Heart Disease surgery, Diagnosis, Differential, Edema, Fallopian Tubes surgery, Female, Humans, Hysterectomy, Laparoscopy, Malignant Carcinoid Syndrome complications, Malignant Carcinoid Syndrome pathology, Malignant Carcinoid Syndrome surgery, Middle Aged, Ovarian Neoplasms complications, Ovarian Neoplasms pathology, Ovariectomy, Malignant Carcinoid Syndrome diagnosis, Ovarian Neoplasms diagnosis
- Published
- 2011
- Full Text
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73. What is your diagnosis?
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Wysocka K, Okoń K, and Matyja A
- Subjects
- Adult, Anorexia diagnosis, Anorexia etiology, Biopsy, Carcinoid Heart Disease complications, Female, Gastrectomy, Humans, Melena complications, Melena diagnosis, Stomach pathology, Stomach surgery, Weight Loss, Carcinoid Heart Disease diagnosis
- Published
- 2011
74. Quadruple valve replacement for valve destruction in carcinoid heart disease.
- Author
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McAlindon E, Peterson M, Bryan A, and Townsend M
- Subjects
- Aged, Female, Heart Valve Diseases etiology, Humans, Ileal Neoplasms complications, Intestinal Obstruction etiology, Carcinoid Heart Disease complications, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation methods
- Published
- 2011
- Full Text
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75. Early bioprosthetic valve failure due to carcinoid heart disease.
- Author
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Najib MQ, Vittala SS, Lanza LA, Lee HR, and Chaliki HP
- Subjects
- Aged, Carcinoid Heart Disease diagnostic imaging, Fatal Outcome, Female, Humans, Pulmonary Valve pathology, Treatment Failure, Tricuspid Valve pathology, Tricuspid Valve Stenosis, Ultrasonography, Carcinoid Heart Disease complications, Foramen Ovale, Patent therapy, Heart Valve Prosthesis
- Published
- 2011
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76. [Three-dimensional echocardiography in carcinoid heart disease].
- Author
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Silva Marques J, Ribeiro S, Martins SR, and Diogo AN
- Subjects
- Aged, Carcinoid Heart Disease complications, Echocardiography, Humans, Male, Tricuspid Valve Insufficiency etiology, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Three-Dimensional methods, Tricuspid Valve Insufficiency diagnostic imaging
- Published
- 2011
- Full Text
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77. Carcinoid heart disease without the carcinoid syndrome but with quadrivalvular regurgitation and unsuccessful operative intervention.
- Author
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Roberts WC, Varughese CA, Ko JM, Grayburn PA, Hebeler RF Jr, and Burton EC
- Subjects
- Carcinoid Heart Disease complications, Carcinoid Heart Disease surgery, Echocardiography, Fatal Outcome, Female, Follow-Up Studies, Humans, Malignant Carcinoid Syndrome, Middle Aged, Tricuspid Valve diagnostic imaging, Tricuspid Valve pathology, Tricuspid Valve surgery, Tricuspid Valve Insufficiency complications, Tricuspid Valve Insufficiency surgery, Carcinoid Heart Disease diagnosis, Heart Valve Prosthesis, Tricuspid Valve Insufficiency diagnosis
- Abstract
A 53-year-old woman is described who underwent mitral and aortic valve replacement and tricuspid valve annuloplasty for pure regurgitation at all 3 valve sites for unrecognized carcinoid heart disease without the carcinoid syndrome 22 days before death. Metastatic carcinoid was not recognized until necropsy, which disclosed a probable ovarian primary but with large hepatic metastases and left-sided cardiac involvement either greater than or equal to the right-sided involvement. Pulmonary hypertension, very unusual in carcinoid heart disease, persisted postoperatively and probably played a role in the patient's early death. Hepatic metastasis with ovarian primary is most unusual in this circumstance., (Copyright © 2011 Elsevier Inc. All rights reserved.)
- Published
- 2011
- Full Text
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78. Patent foramen ovale in carcinoid heart disease.
- Author
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Mansencal N, Touhami I, Mitry E, Rougier P, and Dubourg O
- Subjects
- Aged, Angioplasty, Balloon, Coronary, Carcinoid Heart Disease therapy, Female, Foramen Ovale, Patent therapy, Humans, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnosis
- Abstract
Carcinoid heart disease (CHD) is an uncommon valvular heart disease that may occur in the case of carcinoid syndrome, due to the release of serotonin. Right-sided CHD is more frequent than left-sided CHD because of inactivation of serotonin by the lung. We report the case of a 74-year-old woman who had a previous history of digestive endocrine tumor and carcinoid syndrome, presented with a significant progression of its valvular heart disease during a follow-up of 1 year. A severe shunt through a patent foramen ovale (PFO) was observed and was associated with the development of left-sided CHD. We performed percutaneous closure of PFO, with a reduction of symptoms. Our report highlights that assessment of PFO in patient with carcinoid syndrome is of importance because it allows to detect patient at high risk of CHD progression and percutaneous PFO closure may thus be proposed., (Copyright (c) 2008 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2010
- Full Text
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79. Carcinoid heart disease: case and literature review.
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Dumoulein M, Verslype C, van Cutsem E, Meuris B, Herijgers P, Flameng W, and Herregods MC
- Subjects
- Aged, Diagnosis, Differential, Disease Progression, Female, Humans, Prognosis, Severity of Illness Index, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Tricuspid Valve pathology, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Insufficiency etiology
- Abstract
We present the case of a 69-year-old woman with a metastatic neuroendocrine tumour of the ileum and severe tricuspid valve regurgitation due to carcinoid valvulopathy. Carcinoid heart disease arises in the context of metastatic serotonin-producing neuroendocrine tumours and typically presents as structural and functional abnormalities of tricuspid (TV) or pulmonary valve (PV). Carcinoid heart disease arises from a low-grade neuroendocrine tumour derived from serotonin-producing enterochromaffin cells that reduces the mobility of the leaflets. Following the development of this type of heart failure, the prognosis is unfavourable and patients usually die as a result of heart failure and not because of the metastatic disease. Our patient was not considered a candidate for valvular surgery because of the progressive nature of the malignancy. However, surgical valve replacement is a therapeutic option that, although it has a significant mortality, needs to be considered in selected patients and leads to improvement in functional capacity and survival.
- Published
- 2010
- Full Text
- View/download PDF
80. Features of carcinoid heart disease identified by 2- and 3-dimensional echocardiography and cardiac MRI.
- Author
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Bhattacharyya S, Toumpanakis C, Burke M, Taylor AM, Caplin ME, and Davar J
- Subjects
- Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Carcinoid Heart Disease pathology, Disease Progression, Female, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent pathology, Heart Atria diagnostic imaging, Heart Atria pathology, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases etiology, Heart Valve Diseases pathology, Heart Valves diagnostic imaging, Heart Valves pathology, Heart Ventricles diagnostic imaging, Heart Ventricles pathology, Humans, Male, Middle Aged, Myocardium pathology, Positron-Emission Tomography, Predictive Value of Tests, Prospective Studies, Severity of Illness Index, Carcinoid Heart Disease diagnosis, Echocardiography, Three-Dimensional, Echocardiography, Transesophageal, Magnetic Resonance Imaging
- Abstract
Background: Carcinoid heart disease is a rare form of valvular heart disease. We sought describe the spectrum of carcinoid heart disease identified by echocardiography and cardiac MRI., Method and Results: Two hundred fifty-two patients with carcinoid syndrome underwent a range of investigations including 2D transthoracic echocardiography, 3D transthoracic echocardiography and transesophageal echocardiography, and cardiac MRI. Fifty-two patients had evidence of carcinoid heart disease. Involvement of the tricuspid, pulmonary, mitral, and aortic valves were found in 47 (90%), 36 (69%), 15 (29%), and 14 (27%), respectively. Myocardial metastases were found in 2 (3.8%) patients. Several patterns of disease were identified depending on the extent and severity to which each leaflet and its associated subvalvular apparatus was affected. Thirteen of 15 (87%) patients with left-sided carcinoid involvement had a patent foramen ovale. Three patients with severe degree of shunting had severe valvular regurgitation. Patients with mild/moderate degree of shunting had mild or moderate valvular regurgitation. Three-dimensional transthoracic echocardiography/transesophageal echocardiography provided detailed anatomic information particularly for the tricuspid and pulmonary valves. Cardiac MRI allowed complementary assessment of valvular heart disease and delineation of myocardial metastases. Gallium-68 octreotide positron emission tomography identified neuroendocrine metastases., Conclusions: Carcinoid heart disease is a heterogeneous disease with a wide spectrum of echocardiographic findings. A multimodality approach is needed in patients with this complex pathology.
- Published
- 2010
- Full Text
- View/download PDF
81. Tricuspid valve replacement for carcinoid heart disease to allow liver transplantation.
- Author
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Jaussaud N, Gariboldi V, Thuny F, Camerlo A, Grisoli D, Collart F, Le Treut YP, and Riberi A
- Subjects
- Carcinoid Heart Disease surgery, Female, Humans, Liver Transplantation, Middle Aged, Tricuspid Valve Insufficiency etiology, Carcinoid Heart Disease complications, Heart Valve Prosthesis Implantation, Tricuspid Valve Insufficiency surgery
- Published
- 2009
82. Transannular pulmonary enlargement and bioprostheses for carcinoid disease.
- Author
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Choong CK, Arrowsmith JE, Klein AA, and Wells FC
- Subjects
- Animals, Carcinoid Heart Disease surgery, Cattle, Female, Heart Valve Diseases etiology, Humans, Middle Aged, Prosthesis Design, Treatment Outcome, Bioprosthesis, Carcinoid Heart Disease complications, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Pulmonary Valve surgery, Tricuspid Valve surgery
- Abstract
A diminutive pulmonary artery and right ventricular outflow tract in a 46-year-old woman with a 10-year history of carcinoid syndrome required transannular pulmonary patch enlargement to allow replacement of the pulmonary and tricuspid valves with bioprostheses. The avoidance of anticoagulation permitted further hepatic arterial embolization without an increased risk of bleeding.
- Published
- 2009
- Full Text
- View/download PDF
83. Cardiovascular magnetic resonance imaging in the assessment of carcinoid heart disease.
- Author
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Sandmann H, Pakkal M, and Steeds R
- Subjects
- Carcinoid Heart Disease complications, Heart Valve Diseases diagnosis, Humans, Magnetic Resonance Imaging methods, Pulmonary Valve Insufficiency complications, Pulmonary Valve Insufficiency diagnosis, Pulmonary Valve Stenosis complications, Pulmonary Valve Stenosis diagnosis, Tricuspid Valve Insufficiency complications, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Stenosis complications, Tricuspid Valve Stenosis diagnosis, Ventricular Dysfunction, Right etiology, Carcinoid Heart Disease diagnosis, Heart Valve Diseases complications, Ventricular Dysfunction, Right diagnosis
- Abstract
Carcinoid disease arises from a low-grade neuroendocrine tumour derived from serotonin-producing enterochromaffin cells. It is the most common tumour affecting the small bowel. The majority of patients who progress to carcinoid syndrome develop cardiac disease selectively involving the right side of the heart, whereas left heart disease is unusual. The most common cause of death is dilatation and dysfunction of the right ventricle. Right ventricular dysfunction is largely secondary to pathological endocardial fibrosis of the tricuspid and pulmonary valves, presenting with regurgitation and stenosis. Average survival falls to only 11 months with the onset of symptoms, but recent evidence suggests that survival can be improved by early surgery in selected individuals. This article reviews the particular role that cardiovascular magnetic resonance imaging has in the management of carcinoid heart disease.
- Published
- 2009
- Full Text
- View/download PDF
84. Magnetic resonance imaging of carcinoid heart disease.
- Author
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Franzen D, Boldt A, Raute-Kreinsen U, Koerfer R, and Erdmann E
- Subjects
- Bioprosthesis, Carcinoid Heart Disease complications, Carcinoid Heart Disease surgery, Cardiovascular Agents therapeutic use, Disease Progression, Female, Fibrosis, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Humans, Middle Aged, Predictive Value of Tests, Treatment Outcome, Tricuspid Valve surgery, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency surgery, Carcinoid Heart Disease diagnosis, Magnetic Resonance Imaging, Cine, Tricuspid Valve pathology, Tricuspid Valve Insufficiency diagnosis
- Abstract
In a 56-year-old lady, a carcinoid tumor of the terminal ileum metastasized to regional lymph nodes, and the liver was removed by hemicolectomy in 2002. Following a history of cutaneous flushing, diarrhea, and bronchoconstriction 3 years later, a somatostatin therapy was instituted. As flushing and diarrhea resolved and levels of urinary excretion of 5-hydoxyindoleacetic acid decreased, shortness of breath was progressive and prompted a cardiac exam. Despite poor resolution, echocardiography revealed a thickening of the tricuspid valves (TK) with reduced mobility along with right atrial (RA) and right ventricular (RV) dilatation. The pulmonary valve was unobtrusive. Magnetic resonance (MR) imaging revealed extensive fibrous tissue extending from the valvular base to the tip of the tricuspid leaflets. Retraction and immobilization of the TK caused a mild stenosis and a large regurgitant flow. Because medical treatment of tricuspid regurgitation was ineffective, the TK was excised and a Hancock 25-mm bioprosthetic valve was implanted. The postoperative course was uncomplicated, and the patient recuperated and resumed normal daily activities., (2009 Wiley Periodicals, Inc.)
- Published
- 2009
- Full Text
- View/download PDF
85. Image. Tricuspid and pulmonary valve involvement in carcinoid heart disease.
- Author
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Ederhy S, Engel F, and Cohen A
- Subjects
- Bioprosthesis, Carcinoid Heart Disease complications, Carcinoid Heart Disease surgery, Female, Heart Valve Prosthesis, Heart Valve Prosthesis Implantation instrumentation, Humans, Middle Aged, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Insufficiency surgery, Pulmonary Valve Stenosis etiology, Pulmonary Valve Stenosis surgery, Treatment Outcome, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency surgery, Tricuspid Valve Stenosis etiology, Tricuspid Valve Stenosis surgery, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Doppler, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Stenosis diagnostic imaging, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Stenosis diagnostic imaging
- Published
- 2009
- Full Text
- View/download PDF
86. Severe intra-operative carcinoid crisis in a patient having carcinoid heart disease.
- Author
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Yazbek-Karam VG, Haswani RW, Mousallem NM, Abou Jaoude E, Nassar NE, Hirbli KE, El Khoury JM, Tarcha WS, Baraka AS, and Aouad MT
- Subjects
- Blood Pressure, Carcinoid Heart Disease complications, Carcinoid Heart Disease physiopathology, Humans, Jejunal Neoplasms complications, Jejunal Neoplasms diagnostic imaging, Male, Middle Aged, Monitoring, Intraoperative, Tomography, X-Ray Computed, Carcinoid Heart Disease pathology, Carcinoid Heart Disease surgery
- Published
- 2009
- Full Text
- View/download PDF
87. Quadruple valve replacement for carcinoid heart disease.
- Author
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Raja SG, Bhattacharyya S, Davar J, Caplin ME, Burke M, and Dreyfus GD
- Subjects
- Carcinoid Heart Disease complications, Female, Heart Failure etiology, Heart Failure surgery, Heart Valve Diseases etiology, Heart Valve Diseases surgery, Heart Valve Prosthesis, Heart Valves diagnostic imaging, Humans, Middle Aged, Ultrasonography, Carcinoid Heart Disease surgery, Heart Valves surgery
- Abstract
Cardiac surgery for symptomatic carcinoid heart disease in conjunction with adjunctive therapy is being increasingly shown to improve the long-term outlook of patients with carcinoid heart disease. Herein is reported the case of a female patient with heart failure, secondary to carcinoid heart disease affecting all four cardiac valves, who successfully underwent quadruple valve replacement in the same sitting. The patient made an uneventful postoperative recovery, and had an excellent quality of life at the one-year follow up examination.
- Published
- 2009
88. Tricuspid and mitral valve carcinoid disease in the setting of a patent foramen ovale.
- Author
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Mizuguchi KA, Fox AA, Burch TM, Cohn LH, and Fox JA
- Subjects
- Carcinoid Heart Disease pathology, Echocardiography, Transesophageal, Female, Heart Valve Diseases pathology, Humans, Middle Aged, Mitral Valve Insufficiency complications, Mitral Valve Stenosis complications, Tricuspid Valve Insufficiency complications, Tricuspid Valve Stenosis complications, Carcinoid Heart Disease complications, Foramen Ovale, Patent complications, Heart Valve Diseases complications, Mitral Valve pathology, Tricuspid Valve pathology
- Published
- 2008
- Full Text
- View/download PDF
89. Management of patients undergoing multivalvular surgery for carcinoid heart disease: the role of the anaesthetist.
- Author
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Castillo JG, Filsoufi F, Adams DH, Raikhelkar J, Zaku B, and Fischer GW
- Subjects
- Adult, Aged, Antineoplastic Agents, Hormonal therapeutic use, Aprotinin therapeutic use, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Carcinoid Heart Disease drug therapy, Cardiopulmonary Bypass, Echocardiography, Doppler methods, Female, Follow-Up Studies, Heart Valve Diseases diagnostic imaging, Hemostatics therapeutic use, Humans, Intraoperative Care methods, Intraoperative Complications prevention & control, Male, Middle Aged, Octreotide therapeutic use, Retrospective Studies, Treatment Outcome, Vasoconstrictor Agents therapeutic use, Ventricular Dysfunction, Right prevention & control, Anesthesia, General methods, Carcinoid Heart Disease surgery, Heart Valve Diseases surgery
- Abstract
Background: The management of patients with carcinoid heart disease poses two major challenges for the anaesthetist: carcinoid crisis and low cardiac output secondary to right ventricular (RV) failure. Carcinoid crises may be precipitated by the administration of catecholamines and histamine-releasing drugs., Methods: We analysed a series of 11 patients [six males, median (range) age 60 (42-73) yr] with severe symptomatic carcinoid heart disease who underwent multivalve surgery (right-sided valves, n=8; right- and left-sided valves, n=3) between 2001 and 2007., Results: All patients received octreotide intraoperatively [650 (300-1050) microg] to prevent carcinoid symptoms and vasoplegia. Those patients on a greater preoperative octreotide regime required additional intraoperative octreotide [median (range) dose 320 (300-850) vs 750 (650-1050) mug]. Similarly, the use of greater doses of aprotinin (> 5 KIU) was associated with greater requirements for octreotide [475 (300-700) vs 750 (320-1050) microg] and higher glucose levels (> or =8.5 mmol litre(-1)). Catecholamines were generally required in those patients who presented with a worse New York Heart Association functional class. Overall mortality was 18% (n=2) and only one episode of mild intraoperative carcinoid crisis was observed., Conclusions: Carcinoid crisis and RV failure still remain the primary challenges for the anaesthesiologist while managing patients with carcinoid heart disease. Our study supports the administration of catecholamines to wean patients off cardiopulmonary bypass, particularly in the presence of myocardial dysfunction. Those patients on higher octreotide dosages may require close intraoperative glucose monitoring. Despite high operative mortality, surgical outcome has been improved potentially due to earlier patient referral and better perioperative management.
- Published
- 2008
- Full Text
- View/download PDF
90. Isolated severe tricuspid regurgitation: the importance of identifying underlying mechanism.
- Author
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Poh KK, Solis J, and Hung J
- Subjects
- Aged, 80 and over, Anti-Bacterial Agents therapeutic use, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease drug therapy, Female, Humans, Tricuspid Valve Insufficiency drug therapy, Tricuspid Valve Insufficiency diagnosis, Tricuspid Valve Insufficiency etiology
- Abstract
An 88-year-old woman presented with right heart failure, history of diarrhoea, abdominal pain, weight lost, dyspnoea over several weeks and a new pan-systolic murmur. Echocardiography showed retracted tricuspid leaflets with incomplete coaptation resulting in severe regurgitation. Subcostal view showed an adjacent hepatic cyst leading to biopsy, which revealed neoplastic neuroendocrine cells. Her 24-hour urinary 5-hydroxyindoleacetic acid level was elevated. The unifying diagnosis was carcinoid syndrome for which she was treated. Echocardiography is an important tool for diagnosis, management and prognosis of carcinoid heart disease.
- Published
- 2008
- Full Text
- View/download PDF
91. Urgent transcatheter closure of patent foramen ovale followed by elective right-sided valve surgery for decompensated carcinoid heart disease.
- Author
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Hayashi Y, McGaw DJ, and Goldstein J
- Subjects
- Aged, Foramen Ovale, Patent complications, Heart Valve Prosthesis Implantation, Humans, Male, Prosthesis Implantation, Pulmonary Valve Insufficiency complications, Tricuspid Valve Insufficiency complications, Carcinoid Heart Disease complications, Foramen Ovale, Patent surgery, Pulmonary Valve Insufficiency surgery, Tricuspid Valve Insufficiency surgery
- Abstract
The presence of a patent foramen ovale (PFO) is associated with morbidity and mortality in patients with carcinoid heart disease (CHD). We report a 66-year-old male patient with tricuspid and pulmonary valve regurgitation secondary to CHD, who developed severe hypoxia due to a right-to-left shunt through a PFO. A 35 mm Amplatzer septal occluder was deployed to reduce the right-to-left shunt as an urgent procedure. Tricuspid and pulmonary valve replacements were electively performed using ON-X mechanical prostheses (31/33 mm and 19 mm, respectively) 70 days after the percutaneous procedure. Transcatheter closure of a PFO prior to definitive right-sided valve surgery can be a useful treatment for CHD patients with acute haemodynamic derangement.
- Published
- 2008
- Full Text
- View/download PDF
92. Prevalence of patent foramen ovale and usefulness of percutaneous closure device in carcinoid heart disease.
- Author
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Mansencal N, Mitry E, Pillière R, Lepère C, Gérardin B, Petit J, Gandjbakhch I, Rougier P, and Dubourg O
- Subjects
- Aged, Carcinoid Heart Disease complications, Cardiac Catheterization, Case-Control Studies, Feasibility Studies, Female, Foramen Ovale, Patent complications, Humans, Incidence, Male, Middle Aged, Prevalence, Prospective Studies, Treatment Outcome, Carcinoid Heart Disease epidemiology, Foramen Ovale, Patent epidemiology, Foramen Ovale, Patent therapy, Prosthesis Implantation
- Abstract
The aim of this study was to assess (1) the incidence of patent foramen ovale (PFO) in carcinoid syndrome (CS) and (2) the feasibility of percutaneous closure procedure in selected patients with CS. One hundred eight patients were prospectively studied: 54 with CS and an age- and gender-matched control group. All patients underwent conventional and contrast echocardiography. Patients with clinical signs of dyspnea (New York Heart Association class > or =III), cyanosis, carcinoid heart disease (CHD), and severe PFO were referred for the percutaneous closure of PFO. The prevalence of PFO was 41% in patients with CS and 22% in the control group (p = 0.03) and was significantly higher in patients with CHD (59%, p = 0.009). Four patients (14% of those with CHD) were referred for the percutaneous closure of PFO, and 3 patients ultimately underwent PFO closure (using Amplatzer septal occluders). At 6-month follow-up, New York Heart Association class was improved in all patients, as well as arterial blood gas results (p = 0.04) and 6-minute walking distance (p = 0.03), but all patients presented residual right-to-left shunts. In conclusion, this prospective study demonstrates that in patients with CHD, the prevalence of PFO is high and that percutaneous closure of PFO is feasible, with a reduction in symptoms but with residual shunting.
- Published
- 2008
- Full Text
- View/download PDF
93. Carcinoid pulmonary valvulopathy evaluated by real-time 3-dimensional transthoracic echocardiography.
- Author
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Lee KJ, Connolly HM, and Pellikka PA
- Subjects
- Female, Humans, Middle Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Three-Dimensional methods, Heart Valve Diseases diagnostic imaging, Heart Valve Diseases etiology, Tricuspid Valve diagnostic imaging
- Abstract
A 55-year-old woman with carcinoid valvular heart disease was referred for consideration of right-sided valve replacement. By transthoracic 2-dimensional and Doppler echocardiography, there was severe tricuspid regurgitation and mild right ventricular dysfunction. The pulmonary valve was thickened with annular constriction and severe regurgitation. Real-time 3-dimensional transthoracic echocardiography provided an en face view of pulmonary valve from the right ventricular outflow perspective, not obtainable by routine 2-dimensional echocardiography. Three-dimensional echocardiography may play an incremental role for the preoperative assessment of the pulmonary valve in patients with carcinoid heart disease.
- Published
- 2008
- Full Text
- View/download PDF
94. Profound hypoxaemia corrected by PFO closure device in carcinoid heart disease.
- Author
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Mottram PM, McGaw DJ, Meredith IT, Peverill RE, and Harper RW
- Subjects
- Aged, Catheterization, Echocardiography, Transesophageal, Foramen Ovale, Patent complications, Foramen Ovale, Patent diagnostic imaging, Foramen Ovale, Patent physiopathology, Heart Septal Defects, Atrial complications, Heart Septal Defects, Atrial diagnostic imaging, Heart Septal Defects, Atrial physiopathology, Humans, Male, Carcinoid Heart Disease complications, Foramen Ovale, Patent surgery, Heart Septal Defects, Atrial surgery, Hypoxia etiology
- Abstract
A 66-year-old man with known metastatic carcinoid tumor presented with increasing dyspnoea, right heart failure and marked hypoxaemia which did not correct with oxygen. Echocardiography demonstrated severe tricuspid regurgitation, moderate pulmonary regurgitation and marked right heart dilatation. The inter-atrial septum was aneurysmal, with a large patent foramen ovale (PFO) with continuous right to left shunting. Cardiac catheterization demonstrated oxygen saturations of 96% in the pulmonary veins and 74% in the left atrium with a significant right to left shunt. During percutaneous closure of the PFO, anaesthetic induction resulted in marked systemic hypotension and worsening hypoxia related to systemic vasodilatation and increased shunting. PFO flow was temporarily obstructed with a sizing balloon resulting in a rapid increase in arterial oxygen saturation from 60% to >90%, but marked systemic hypotension due to acute left ventricular preload reduction, requiring volume replacement and adrenaline. Following deployment of a PFO occluder device, prominent pulsatile splaying of the right and left discs was noted due to the severe tricuspid regurgitation, resulting in some residual inter-atrial shunting. Arterial oxygen saturation was 83%, increasing to 92% at day 4 post-procedure as tissue organization occurred within the device, and the patient reported improvement in dyspnoea.
- Published
- 2008
- Full Text
- View/download PDF
95. Valvular heart disease caused by carcinoid syndrome: emphasis on the use of intraoperative transesophageal echocardiography.
- Author
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Banzali FM Jr, Tiwari AK, Frantz R, and D'Attellis N
- Subjects
- Adult, Carcinoid Heart Disease complications, Carcinoid Heart Disease surgery, Female, Humans, Intraoperative Care, Pulmonary Valve Insufficiency etiology, Pulmonary Valve Insufficiency surgery, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency surgery, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Transesophageal, Pulmonary Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency diagnostic imaging
- Published
- 2007
- Full Text
- View/download PDF
96. Fungal endocarditis of the eustachian valve in carcinoid heart disease: a case report.
- Author
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Jagernauth S, Patel A, Baig K, and De Souza A
- Subjects
- Carcinoid Heart Disease microbiology, Endocarditis complications, Endocarditis diagnostic imaging, Humans, Male, Middle Aged, Ultrasonography, Vena Cava, Inferior diagnostic imaging, Vena Cava, Inferior microbiology, Candidiasis complications, Carcinoid Heart Disease complications, Endocarditis microbiology, Heart Valves microbiology
- Abstract
The case is presented of a fungal-origin endocarditis affecting the eustachian valve. During surgery for pulmonary and tricuspid valve replacement, a 54-year-old male with carcinoid disease was found to have a 3-cm vegetation attached to the eustachian valve. Histopathological assessment of the vegetation revealed the presence of Candida species. The patient made a good postoperative recovery and was continued on a three-month course of antifungal therapy.
- Published
- 2007
97. Primary ovarian carcinoid heart disease curatively treated with a two-stage procedure.
- Author
-
Bonaros N, Müller S, Bonatti J, Kafka R, Tzankov A, Bale R, and Bartel T
- Subjects
- Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease etiology, Carcinoid Heart Disease pathology, Carcinoid Tumor complications, Carcinoid Tumor pathology, Echocardiography, Doppler, Female, Humans, Ovarian Neoplasms complications, Ovarian Neoplasms pathology, Patient Selection, Severity of Illness Index, Time Factors, Tomography, X-Ray Computed, Treatment Outcome, Tricuspid Valve Insufficiency etiology, Tricuspid Valve Insufficiency pathology, Carcinoid Heart Disease surgery, Carcinoid Tumor surgery, Heart Valve Prosthesis Implantation, Ovarian Neoplasms surgery, Ovariectomy, Tricuspid Valve Insufficiency surgery
- Abstract
Primary ovarian carcinoid disease with cardiac involvement is a very rare syndrome, which requires interdisciplinary management. We report on a patient with primary ovarian carcinoid tumor with severe tricuspid valve insufficiency who was curatively treated after successful tumor resection and tricuspid valve replacement.
- Published
- 2007
- Full Text
- View/download PDF
98. Tricuspid valve involvement in carcinoid disease.
- Author
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Abi-Saleh B, Schoondyke JW, Abboud L, Downs CJ, Haddadin TZ, and Iskandar SB
- Subjects
- Aged, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Humans, Male, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency etiology, Pulmonary Valve Insufficiency diagnostic imaging, Pulmonary Valve Insufficiency etiology, Tricuspid Valve Insufficiency diagnostic imaging, Carcinoid Heart Disease complications, Tricuspid Valve Insufficiency etiology
- Published
- 2007
- Full Text
- View/download PDF
99. Three-dimensional echocardiogram of severe tricuspid regurgitation from carcinoid syndrome.
- Author
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Shakur R and Becher H
- Subjects
- Diagnosis, Differential, Humans, Male, Middle Aged, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnostic imaging, Echocardiography, Doppler, Tricuspid Valve Insufficiency diagnostic imaging, Tricuspid Valve Insufficiency etiology
- Published
- 2007
- Full Text
- View/download PDF
100. Atrial fibrillation in carcinoid heart disease: The role of serotonin. A review of the literature.
- Author
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Langer C, Piper C, Vogt J, Heintze J, Butz T, Lindner O, Burchert W, Kersting C, and Horstkotte D
- Subjects
- Aged, Atrial Fibrillation etiology, Atrial Fibrillation surgery, Biomarkers, Tumor blood, Carcinoid Heart Disease complications, Carcinoid Heart Disease diagnosis, Carcinoid Heart Disease surgery, Carcinoid Tumor blood, Carcinoid Tumor complications, Carcinoid Tumor diagnosis, Carcinoid Tumor surgery, Electrocardiography, Humans, Intestinal Neoplasms blood, Intestinal Neoplasms complications, Intestinal Neoplasms diagnosis, Intestinal Neoplasms surgery, Intestine, Small, Male, Malignant Carcinoid Syndrome complications, Malignant Carcinoid Syndrome diagnosis, Malignant Carcinoid Syndrome surgery, Treatment Outcome, Atrial Fibrillation blood, Carcinoid Heart Disease blood, Malignant Carcinoid Syndrome blood, Serotonin blood, Serotonin Agents blood
- Published
- 2007
- Full Text
- View/download PDF
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