Carcinoid disease of the heart

Surgical management of ten patients

C. J. Knott-Craig, Hartzell V Schaff, C. J. Mullany, L. K. Kvols, C. G. Moertel, W. D. Edwards, G. K. Danielson

Research output: Contribution to journalArticle

41 Citations (Scopus)

Abstract

Between 1982 and 1989, 10 patients with carcinoid heart disease underwent tricuspid valve replacement with a mechanical prosthesis at our institution. Pulmonary valvectomy was performed in nine patients and pulmonary valve replacement with a pulmonary homograft was performed in one. Two patients had carcinoid tumor metastatic to the heart, involving the right atrium in one case and both ventricles in the other. One patient had concomitant coronary artery bypass with the saphenous vein, and one patient had a quadruple valve replacement for histologically proved carcinoid disease of all four valves. The 30-day mortality was 10% and the late mortality was 30%. The remaining six patients were alive 4, 4, 4, 7, 24, and 46 months postoperatively. A review of the English literature identified 28 additional patients who underwent tricuspid valve replacement for carcinoid heart disease. There was no significant difference in the survival of patients with a bioprosthesis versus a mechanical valve in the tricuspid position. The 4-year survival for the 38 patients undergoing tricuspid valve replacement for carcinoid heart disease was 48% ± 13%. Symptomatic patients who have carcinoid heart disease and whose metastatic malignant disease is not an imminent threat to life should be offered valve replacement. Operating soon after the onset of increasing cardiac symptoms, before the often rapid deterioration in right ventricular failure, optimizes the benefits.

Original languageEnglish (US)
Pages (from-to)475-481
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume104
Issue number2
StatePublished - 1992

Fingerprint

Carcinoid Heart Disease
Tricuspid Valve
Carcinoid Tumor
Bioprosthesis
Pulmonary Valve
Lung
Survival
Mortality
Saphenous Vein
Heart Atria
Coronary Artery Bypass
Prostheses and Implants
Allografts

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Knott-Craig, C. J., Schaff, H. V., Mullany, C. J., Kvols, L. K., Moertel, C. G., Edwards, W. D., & Danielson, G. K. (1992). Carcinoid disease of the heart: Surgical management of ten patients. Journal of Thoracic and Cardiovascular Surgery, 104(2), 475-481.

Carcinoid disease of the heart : Surgical management of ten patients. / Knott-Craig, C. J.; Schaff, Hartzell V; Mullany, C. J.; Kvols, L. K.; Moertel, C. G.; Edwards, W. D.; Danielson, G. K.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 104, No. 2, 1992, p. 475-481.

Research output: Contribution to journalArticle

Knott-Craig, CJ, Schaff, HV, Mullany, CJ, Kvols, LK, Moertel, CG, Edwards, WD & Danielson, GK 1992, 'Carcinoid disease of the heart: Surgical management of ten patients', Journal of Thoracic and Cardiovascular Surgery, vol. 104, no. 2, pp. 475-481.
Knott-Craig CJ, Schaff HV, Mullany CJ, Kvols LK, Moertel CG, Edwards WD et al. Carcinoid disease of the heart: Surgical management of ten patients. Journal of Thoracic and Cardiovascular Surgery. 1992;104(2):475-481.
Knott-Craig, C. J. ; Schaff, Hartzell V ; Mullany, C. J. ; Kvols, L. K. ; Moertel, C. G. ; Edwards, W. D. ; Danielson, G. K. / Carcinoid disease of the heart : Surgical management of ten patients. In: Journal of Thoracic and Cardiovascular Surgery. 1992 ; Vol. 104, No. 2. pp. 475-481.
@article{5fe169b2609b4b7d99480e299fd910e1,
title = "Carcinoid disease of the heart: Surgical management of ten patients",
abstract = "Between 1982 and 1989, 10 patients with carcinoid heart disease underwent tricuspid valve replacement with a mechanical prosthesis at our institution. Pulmonary valvectomy was performed in nine patients and pulmonary valve replacement with a pulmonary homograft was performed in one. Two patients had carcinoid tumor metastatic to the heart, involving the right atrium in one case and both ventricles in the other. One patient had concomitant coronary artery bypass with the saphenous vein, and one patient had a quadruple valve replacement for histologically proved carcinoid disease of all four valves. The 30-day mortality was 10{\%} and the late mortality was 30{\%}. The remaining six patients were alive 4, 4, 4, 7, 24, and 46 months postoperatively. A review of the English literature identified 28 additional patients who underwent tricuspid valve replacement for carcinoid heart disease. There was no significant difference in the survival of patients with a bioprosthesis versus a mechanical valve in the tricuspid position. The 4-year survival for the 38 patients undergoing tricuspid valve replacement for carcinoid heart disease was 48{\%} ± 13{\%}. Symptomatic patients who have carcinoid heart disease and whose metastatic malignant disease is not an imminent threat to life should be offered valve replacement. Operating soon after the onset of increasing cardiac symptoms, before the often rapid deterioration in right ventricular failure, optimizes the benefits.",
author = "Knott-Craig, {C. J.} and Schaff, {Hartzell V} and Mullany, {C. J.} and Kvols, {L. K.} and Moertel, {C. G.} and Edwards, {W. D.} and Danielson, {G. K.}",
year = "1992",
language = "English (US)",
volume = "104",
pages = "475--481",
journal = "Journal of Thoracic and Cardiovascular Surgery",
issn = "0022-5223",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - Carcinoid disease of the heart

T2 - Surgical management of ten patients

AU - Knott-Craig, C. J.

AU - Schaff, Hartzell V

AU - Mullany, C. J.

AU - Kvols, L. K.

AU - Moertel, C. G.

AU - Edwards, W. D.

AU - Danielson, G. K.

PY - 1992

Y1 - 1992

N2 - Between 1982 and 1989, 10 patients with carcinoid heart disease underwent tricuspid valve replacement with a mechanical prosthesis at our institution. Pulmonary valvectomy was performed in nine patients and pulmonary valve replacement with a pulmonary homograft was performed in one. Two patients had carcinoid tumor metastatic to the heart, involving the right atrium in one case and both ventricles in the other. One patient had concomitant coronary artery bypass with the saphenous vein, and one patient had a quadruple valve replacement for histologically proved carcinoid disease of all four valves. The 30-day mortality was 10% and the late mortality was 30%. The remaining six patients were alive 4, 4, 4, 7, 24, and 46 months postoperatively. A review of the English literature identified 28 additional patients who underwent tricuspid valve replacement for carcinoid heart disease. There was no significant difference in the survival of patients with a bioprosthesis versus a mechanical valve in the tricuspid position. The 4-year survival for the 38 patients undergoing tricuspid valve replacement for carcinoid heart disease was 48% ± 13%. Symptomatic patients who have carcinoid heart disease and whose metastatic malignant disease is not an imminent threat to life should be offered valve replacement. Operating soon after the onset of increasing cardiac symptoms, before the often rapid deterioration in right ventricular failure, optimizes the benefits.

AB - Between 1982 and 1989, 10 patients with carcinoid heart disease underwent tricuspid valve replacement with a mechanical prosthesis at our institution. Pulmonary valvectomy was performed in nine patients and pulmonary valve replacement with a pulmonary homograft was performed in one. Two patients had carcinoid tumor metastatic to the heart, involving the right atrium in one case and both ventricles in the other. One patient had concomitant coronary artery bypass with the saphenous vein, and one patient had a quadruple valve replacement for histologically proved carcinoid disease of all four valves. The 30-day mortality was 10% and the late mortality was 30%. The remaining six patients were alive 4, 4, 4, 7, 24, and 46 months postoperatively. A review of the English literature identified 28 additional patients who underwent tricuspid valve replacement for carcinoid heart disease. There was no significant difference in the survival of patients with a bioprosthesis versus a mechanical valve in the tricuspid position. The 4-year survival for the 38 patients undergoing tricuspid valve replacement for carcinoid heart disease was 48% ± 13%. Symptomatic patients who have carcinoid heart disease and whose metastatic malignant disease is not an imminent threat to life should be offered valve replacement. Operating soon after the onset of increasing cardiac symptoms, before the often rapid deterioration in right ventricular failure, optimizes the benefits.

UR - http://www.scopus.com/inward/record.url?scp=0026806168&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0026806168&partnerID=8YFLogxK

M3 - Article

VL - 104

SP - 475

EP - 481

JO - Journal of Thoracic and Cardiovascular Surgery

JF - Journal of Thoracic and Cardiovascular Surgery

SN - 0022-5223

IS - 2

ER -