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Predictors of outcome of tricuspid valve replacement in carcinoid heart disease.

Publication ,  Journal Article
Robiolio, PA; Rigolin, VH; Harrison, JK; Lowe, JE; Moore, JO; Bashore, TM; Feldman, JM
Published in: Am J Cardiol
March 1, 1995

The cardiac valvular surgical experience of patients in the Duke Carcinoid Database was reviewed to assess operative outcome. Of the 604 patients in the database, 19 patients with carcinoid heart disease were identified by cardiac catheterization or echocardiography, or both. Eight of these underwent tricuspid valve replacement surgery with bioprostheses (2 also had open pulmonic valvuloplasty). Compared with patients medically managed, surgically treated patients were similar with the exception that they had higher right atrial mean (17 +/- 6 vs 9 +/- 4 mm Hg, p = 0.03) and v-wave (27 +/- 6 vs 17 +/- 7 mm Hg, p = 0.04) pressures. Of the 8 surgical patients, 5 (63%) died within 30 days. Causes of death included tricuspid valve thrombosis, cerebral vascular accident, coagulopathy, renal failure, and intractable right heart failure. High comorbidity was present in all 8 patients. There was a weak trend (p = 0.17) toward lower Charlson comorbidity indexes in survivors (6.7 +/- 0.6) compared with nonsurvivors (7.6 +/- 0.9). Age was significantly lower (p = 0.036) in survivors (46 +/- 13 years) compared with nonsurvivors (69 +/- 4 years). Extended follow-up revealed 2 patients who survived beyond a decade. Review of 47 carcinoid valve replacement cases (Duke Carcinoid Database and 39 published cases) revealed a 30-day mortality of 56% for patients > 60 years of age, and 0% for those < or = 60 years of age (p < 0.0001). Although valve replacement surgery can afford prolonged palliation from carcinoid heart disease, it is associated with a significant mortality risk. Careful preoperative risk stratification by age and comorbidity may provide a means for optimal selection of surgical candidates.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

March 1, 1995

Volume

75

Issue

7

Start / End Page

485 / 488

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis
  • Female
  • Cardiovascular System & Hematology
 

Citation

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Robiolio, P. A., Rigolin, V. H., Harrison, J. K., Lowe, J. E., Moore, J. O., Bashore, T. M., & Feldman, J. M. (1995). Predictors of outcome of tricuspid valve replacement in carcinoid heart disease. Am J Cardiol, 75(7), 485–488. https://doi.org/10.1016/s0002-9149(99)80586-4
Robiolio, P. A., V. H. Rigolin, J. K. Harrison, J. E. Lowe, J. O. Moore, T. M. Bashore, and J. M. Feldman. “Predictors of outcome of tricuspid valve replacement in carcinoid heart disease.Am J Cardiol 75, no. 7 (March 1, 1995): 485–88. https://doi.org/10.1016/s0002-9149(99)80586-4.
Robiolio PA, Rigolin VH, Harrison JK, Lowe JE, Moore JO, Bashore TM, et al. Predictors of outcome of tricuspid valve replacement in carcinoid heart disease. Am J Cardiol. 1995 Mar 1;75(7):485–8.
Robiolio, P. A., et al. “Predictors of outcome of tricuspid valve replacement in carcinoid heart disease.Am J Cardiol, vol. 75, no. 7, Mar. 1995, pp. 485–88. Pubmed, doi:10.1016/s0002-9149(99)80586-4.
Robiolio PA, Rigolin VH, Harrison JK, Lowe JE, Moore JO, Bashore TM, Feldman JM. Predictors of outcome of tricuspid valve replacement in carcinoid heart disease. Am J Cardiol. 1995 Mar 1;75(7):485–488.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

March 1, 1995

Volume

75

Issue

7

Start / End Page

485 / 488

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Risk Factors
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Heart Valve Prosthesis
  • Female
  • Cardiovascular System & Hematology