Quadruple Valve Replacement for Carcinoid Heart Disease
| Autor: | Syed Saleem Mujtaba, Stephen Clark |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
lcsh:Diseases of the circulatory (Cardiovascular) system medicine.medical_treatment Heart Valve Diseases lcsh:Surgery Octreotide Carcinoid Heart Disease Review Article Heart Valves/surgery 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Valve replacement Intensive care medicine Ventricular outflow tract Humans Malignant Carcinoid Syndrome Bioprosthesis Heart Valve Prosthesis Implantation business.industry General Medicine lcsh:RD1-811 A300 medicine.disease Heart Valves Surgery medicine.anatomical_structure Echocardiography lcsh:RC666-701 Pulmonary valve Heart failure Heart Valve Prosthesis Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | Brazilian Journal of Cardiovascular Surgery, Volume: 33, Issue: 4, Pages: 398-403, Published: AUG 2018 Brazilian Journal of Cardiovascular Surgery, Vol 33, Iss 4, Pp 398-403 Brazilian Journal of Cardiovascular Surgery Brazilian Journal of Cardiovascular Surgery v.33 n.4 2018 Sociedade Brasileira de Cirurgia Cardiovascular (SBCCV) instacron:SBCCV |
| ISSN: | 1678-9741 |
| Popis: | 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.\ud \ud 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.\ud \ud 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.\ud \ud 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|