Our Summary

This research paper discusses two cases of patients suffering from carcinoid heart disease, a condition where a type of cancerous tumor affects the heart, in this case, all four heart valves. This is a relatively rare disease and it’s even more uncommon for it to affect the left side of the heart, which happened in these cases without the presence of an intracardiac shunt (a passage or hole that allows blood to move from one part of the heart to another).

The patients were showing signs of ‘regurgitation’, meaning the blood was flowing backwards into their heart due to the damaged valves. To treat this, all four valves were replaced with biological ones. The paper concludes that this quadruple valve replacement can significantly improve the condition of patients with this disease, and the risks involved in this procedure are considered acceptable.

FAQs

  1. What is carcinoid heart disease?
  2. What is the significance of a quadruple valve replacement in patients with carcinoid heart disease?
  3. Are biological valves used in all cases of valve replacement in patients with carcinoid heart disease?

Doctor’s Tip

One helpful tip a doctor might tell a patient about valve replacement is to diligently follow post-operative care instructions, including taking prescribed medications, attending follow-up appointments, and participating in cardiac rehabilitation if recommended. It is important for patients to listen to their bodies, report any new or worsening symptoms to their healthcare provider, and maintain a healthy lifestyle to optimize the longevity and function of their new valves.

Suitable For

Patients with carcinoid heart disease affecting all four valves are typically recommended valve replacement. This condition can cause regurgitation in all four valves, leading to significant symptoms and functional impairment. Left-sided involvement is less common but can still occur. Quadruple valve replacement, using biological valves, can result in functional improvement and is considered in symptomatic patients with acceptable risks.

Timeline

Pre-operation:

  • Patient presents with symptoms such as shortness of breath, fatigue, chest pain, and palpitations
  • Diagnosis of carcinoid heart disease is confirmed through imaging tests such as echocardiograms and cardiac catheterization
  • Patient is evaluated by a multidisciplinary team including cardiologists, cardiac surgeons, and oncologists
  • Decision is made to proceed with quadruple valve replacement surgery using biological valves

Post-operation:

  • Patient undergoes quadruple valve replacement surgery, which involves replacing all four affected valves with biological valves
  • Patient is closely monitored in the intensive care unit post-operatively for complications such as bleeding, infection, and arrhythmias
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Patient experiences gradual improvement in symptoms such as shortness of breath and fatigue
  • Long-term follow-up is necessary to monitor for valve function and potential recurrence of carcinoid heart disease

Overall, quadruple valve replacement in patients with carcinoid heart disease can lead to significant functional improvement and symptom relief, with acceptable risks when performed by experienced cardiac surgeons.

What to Ask Your Doctor

  1. What are the risks and benefits of valve replacement surgery for my specific condition?
  2. What type of valve (biological or mechanical) is recommended for me and why?
  3. What is the expected recovery time and rehabilitation process after valve replacement surgery?
  4. How often will I need follow-up appointments and monitoring after the surgery?
  5. Are there any specific lifestyle changes or medications I will need to take after the valve replacement surgery?
  6. What are the potential complications or long-term effects of having all four valves replaced?
  7. How will valve replacement surgery improve my symptoms and quality of life in the long term?
  8. Are there any alternative treatments or procedures that I should consider before deciding on valve replacement surgery?
  9. Will I need to make any changes to my diet or exercise routine after valve replacement surgery?
  10. What is the success rate of quadruple valve replacement surgery for patients with carcinoid heart disease, like my case?

Reference

Authors: Walsh E, Steeds R, Rooney S, Santo K. Journal: Indian J Thorac Cardiovasc Surg. 2021 Jul;37(4):431-433. doi: 10.1007/s12055-020-00949-6. Epub 2021 Jan 4. PMID: 34220026