Surgical Management of Carcinoid Valve Disease-Mechanical versus Tissue Valves

#1041

Introduction: The prosthetic valve of choice in patients with carcinoid valve disease (CVD) remains controversial due to the limited life expectancy of patients with advanced-stage neuroendocrine tumors (NETs) on one hand, and concerns regarding structural valve deterioration (SVD) on the other.

Aim(s): We reviewed the records of 17 patients with right heart failure due to CVD. All patients received somatostatin analogues perioperatively. Data collected included baseline characteristics, procedural profiles and clinical outcomes.

Materials and methods: The primary NET site was ileum 12, lung 2 and stomach, colon, appendix -1 each. Preoperative urine levels of 5-HIAA (61±36 mg/24h) and serum levels of chromogranin A (2926±4057 ng/ml) were 10 and 50 times greater than normal. Twenty two valves were implanted – tricuspid valve (TVR) – 5 (tissue – 4, mechanical - 1), TVR and pulmonary valve (PVR) – 3 (tissue), PVR -1(mechanical), TVR and mitral valve replacement (MVR) – 1(mechanical). 30-day mortality was 11%. Mean follow up was 22±21 months (range 1-81 months). Four patients developed SVD at 12, 14, 15 and 20 months after surgery. Actuarial 4-year survival and freedom from SVD were 23±14% and 43±15%, respectively.

Conference: 12th Annual ENETSConcerence (2015)

Presenting Author: Glasberg S

Authors: Glasberg S, Atlan J, Korach A, Dabah A, Atlan K,

Keywords: carcinoid valve disease,