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. 2021 Jan;36(1):290-294.
doi: 10.1111/jocs.15169. Epub 2020 Oct 30.

Surgical aspects of valve replacement in carcinoid heart disease

Anders Albåge  1   2 , Marco Montibello  1   2
Affiliations

Surgical aspects of valve replacement in carcinoid heart disease

Anders Albåge et al. J Card Surg. 2021 Jan.

Abstract

Tricuspid and pulmonary valve replacement in patients with advanced carcinoid heart disease (CaHD) reduces right heart failure and improves prognosis. The surgical literature is limited concerning description of technical aspects of valve replacement in CaHD. Although a dedicated multidisciplinary care is required for these frail patients, optimization of surgical technique is important and may lead to better postoperative outcomes.

Keywords: carcinoid heart disease; cardiovascular pathology; valve replacement.

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Figures

Figure 1
Figure 1
(A) Longitudinal incision from the distal PA, through the PV, into the RVOT. The exposed PV shows fibrotic cusps. (B) After excision of the PV cusps, a bioprosthesis is implanted (Carpentier–Edwards Magna Ease), conforming to the natural PV commissures. (C) The anterior portion of the bioprosthesis is left unanchored. (D and E) Enhancement of PA and RVOT dimensions is created with a bovine pericardial patch (A and D, same patient; B and C, different patients)
Figure 2
Figure 2
(A) Opened RA showing a fibrotic retracted TV. Suggested black lines for leaflet incisions to augment valve opening. (B and C) Multiple TV leaflet incisions are made from the free edge to the annulus respecting chordal attachments (different patient from A). (D and E) A pericardial bioprosthetic valve of largest possible size is implanted using everting sutures (Carpentier–Edwards Perimount Plus)
See this image and copyright information in PMC

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