JACC. Case reports · 2026
Rapid Native and Bioprosthetic Tricuspid Valve Degeneration in Carcinoid Heart Disease.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Trabucchi Lucia, Forgiarini Richiele, Ardid Maria I, Abdemur Abraham, Herrera Raul E, Arce Rodolfo, Nguyen Tom C, Quesada Ramon, Elias Elliott J, Patel Nish
Аннотация
BACKGROUND: Carcinoid heart disease (CaHD) is a severe complication of metastatic neuroendocrine tumors characterized by serotonin-mediated fibrotic degeneration of right-sided cardiac valves.
CASE SUMMARY: We present 3 patients with metastatic neuroendocrine tumors complicated by severe carcinoid valvulopathy involving native and prosthetic tricuspid valves. Two patients underwent bioprosthetic tricuspid valve replacement for severe tricuspid regurgitation, including 1 patient who developed rapid recurrent prosthetic valve degeneration requiring transcatheter tricuspid valve-in-valve replacement. A third patient presented with advanced bivalvular carcinoid involvement requiring complex surgical reconstruction complicated by postoperative cardiogenic shock and death.
DISCUSSION: These cases illustrate the progressive nature of serotonin-mediated valvular degeneration, challenges in prosthetic valve selection, and the importance of multidisciplinary management and close echocardiographic surveillance in CaHD.
TAKE-HOME MESSAGES: Persistent serotonin exposure may result in rapid degeneration of native and bioprosthetic valves despite surgical intervention. Early recognition and multidisciplinary management are essential to optimize outcomes in CaHD.
CASE SUMMARY: We present 3 patients with metastatic neuroendocrine tumors complicated by severe carcinoid valvulopathy involving native and prosthetic tricuspid valves. Two patients underwent bioprosthetic tricuspid valve replacement for severe tricuspid regurgitation, including 1 patient who developed rapid recurrent prosthetic valve degeneration requiring transcatheter tricuspid valve-in-valve replacement. A third patient presented with advanced bivalvular carcinoid involvement requiring complex surgical reconstruction complicated by postoperative cardiogenic shock and death.
DISCUSSION: These cases illustrate the progressive nature of serotonin-mediated valvular degeneration, challenges in prosthetic valve selection, and the importance of multidisciplinary management and close echocardiographic surveillance in CaHD.
TAKE-HOME MESSAGES: Persistent serotonin exposure may result in rapid degeneration of native and bioprosthetic valves despite surgical intervention. Early recognition and multidisciplinary management are essential to optimize outcomes in CaHD.