JACC. Case reports · 2026
End-Diastolic Forward Flow Through the Pulmonic Valve in Carcinoid Heart Disease.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Hoyek Karim, Zalaquett Ziad, Collier Patrick, Burbano-Vera Nelson, Mehta Anand
Аннотация
BACKGROUND: End-diastolic forward flow (EDFF) through the pulmonic valve is classically described after repaired tetralogy of Fallot and is usually attributed to restrictive right ventricular (RV) physiology. Its significance in carcinoid pulmonic valve disease is less established.
CASE SUMMARY: We describe 6 patients with carcinoid heart disease and pulmonic valve involvement referred for operative management. Perioperative echocardiography demonstrated late-diastolic antegrade flow through the pulmonic valve after atrial activation and before ventricular systole, consistent with EDFF during atrial contraction. All patients underwent pulmonic and tricuspid valve replacement; additional left-sided valve surgery, coronary bypass, septal closure, or pulmonary artery/RV outflow tract patch augmentation was performed when indicated.
DISCUSSION: EDFF in carcinoid heart disease likely reflects organized atrial contraction, severe tricuspid and pulmonic regurgitation, altered RV diastolic properties, and incomplete pulmonic valve closure. Electrocardiography-Doppler correlation is required to avoid misclassification and underestimation of pulmonic regurgitation severity.
CASE SUMMARY: We describe 6 patients with carcinoid heart disease and pulmonic valve involvement referred for operative management. Perioperative echocardiography demonstrated late-diastolic antegrade flow through the pulmonic valve after atrial activation and before ventricular systole, consistent with EDFF during atrial contraction. All patients underwent pulmonic and tricuspid valve replacement; additional left-sided valve surgery, coronary bypass, septal closure, or pulmonary artery/RV outflow tract patch augmentation was performed when indicated.
DISCUSSION: EDFF in carcinoid heart disease likely reflects organized atrial contraction, severe tricuspid and pulmonic regurgitation, altered RV diastolic properties, and incomplete pulmonic valve closure. Electrocardiography-Doppler correlation is required to avoid misclassification and underestimation of pulmonic regurgitation severity.