Quadruple valve replacement for carcinoid heart disease
Rev. bras. cir. cardiovasc
; 33(4): 398-403, July-Aug. 2018. tab, graf
Artigo
em Inglês
| LILACS
| ID: biblio-958424
Biblioteca responsável:
BR1.1
ABSTRACT
Abstract Introduction:
Carcinoid heart disease most frequently involves the tricuspid or, more rarely, the pulmonary valve and presents with right heart failure as 5-HT is metabolized by the lung. Left-sided valve involvement is quite rare. We describe our experience of 3 patients presenting with heart failure secondary to carcinoid heart disease affecting all four cardiac valves. There are only four previous isolated case reports in the literature.Methods:
All three patients underwent quadruple valve replacement during a single operation. Right ventricular outflow tract reconstruction with a pericardial patch was performed in all patients. For 24 hours prior to surgery, all patients received intravenous octreotide, which continued in intensive care for at least 24 hours.Results:
Mean cross-clamp and bypass times were 175 (range 164-197 minutes) and 210 (range 195-229 minutes) minutes, respectively. Mean intensive treatment unit (ITU) and inpatient stays were 2.3 (range 2-3 days) and 12 (range 9-16 days) days, respectively. One patient was reopened for bleeding 4 hours postoperatively from a ventricular pacing wire site. None required a permanent pacemaker postoperatively. There were no other complications in any patient. The quality of life was excellent at 6-16 months clinic follow-up as they were in NYHA 1. Postoperative echocardiography showed no paravalvular leaks and well-functioning prostheses in all cases.Conclusion:
Surgery to replace all four valves is feasible with excellent medium-term survival and a very low rate of complications. Patients with carcinoid heart disease should always be considered for surgery irrespective of the extent of valvular involvement.
Texto completo:
Disponível
Coleções:
Bases de dados internacionais
Base de dados:
LILACS
Assunto principal:
Doença Cardíaca Carcinoide
/
Implante de Prótese de Valva Cardíaca
/
Doenças das Valvas Cardíacas
Aspecto:
Preferência do paciente
Limite:
Humanos
Idioma:
Inglês
Revista:
Rev. bras. cir. cardiovasc
Assunto da revista:
Cardiologia
/
CIRURGIA GERAL
Ano de publicação:
2018
Tipo de documento:
Artigo
País de afiliação:
Reino Unido
Instituição/País de afiliação:
Freeman Hospital Newcastle/GB