4.4 Review

Current Practice in Carcinoid Heart Disease and Burgeoning Opportunities

Journal

CURRENT TREATMENT OPTIONS IN ONCOLOGY
Volume 23, Issue 12, Pages 1793-1803

Publisher

SPRINGER
DOI: 10.1007/s11864-022-01023-6

Keywords

Carcinoid heart disease; Carcinoid syndrome; Neuroendocrine tumor; Tricuspid valve disease; Pulmonic valve disease; Valvular heart disease; Somatostatin analogs; Cardiac surgery; Carcinoid crisis

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Cardiac surgery with tricuspid valve and potentially pulmonic valve replacement is currently the most effective treatment strategy for carcinoid heart disease. A multidisciplinary team is required for the management, and aggressive management before and after surgery is critical. Percutaneous valve repair may be a potential option in the future.
Opinion statement Cardiac surgery with tricuspid valve and potentially pulmonic valve replacement at an experienced center is currently the most effective strategy available for the treatment of carcinoid heart disease. Cardiac surgery for carcinoid heart disease requires a multidisciplinary team including cardiology, medical oncology, cardiothoracic anesthesia, and cardiac surgery. Without cardiac surgery, morbidity and mortality from carcinoid heart disease is high. Aggressive management of carcinoid before and after cardiac surgery is critical. Over time, though, circulating carcinoid hormones can lead to destruction of prosthetic valves as well, resulting in recurrent right heart failure. Percutaneous options for valve repair may be on the horizon for management of carcinoid heart disease.

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