title: Carcinoid heart disease without the carcinoid syndrome but with quadrivalvular regurgitation and unsuccessful operative intervention.
abstract: A 53-year-old woman is described who underwent mitral and aortic valve replacement and tricuspid valve annuloplasty for pure regurgitation at all 3 valve sites for unrecognized carcinoid heart disease without the carcinoid syndrome 22 days before death. Metastatic carcinoid was not recognized until necropsy, which disclosed a probable ovarian primary but with large hepatic metastases and left-sided cardiac involvement either greater than or equal to the right-sided involvement. Pulmonary hypertension, very unusual in carcinoid heart disease, persisted postoperatively and probably played a role in the patient's early death. Hepatic metastasis with ovarian primary is most unusual in this circumstance.
authors.affiliation: Department of Pathology, Baylor University Medical Center, Dallas, TX, USA. wc.roberts@baylorhealth.edu
authors.forename: William Clifford
authors.initials: WC
authors.lastname: Roberts
authors.forename: Cyril Abie
authors.initials: CA
authors.lastname: Varughese
authors.forename: Jong Mi
authors.initials: JM
authors.lastname: Ko
authors.forename: Paul A
authors.initials: PA
authors.lastname: Grayburn
authors.forename: Robert Frederick
authors.initials: RF
authors.lastname: Hebeler
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Burton
mesh_terms: D002275:Carcinoid Heart Disease / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D004452:Echocardiography; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D006350:Heart Valve Prosthesis; D006801:Humans; D008303:Malignant Carcinoid Syndrome; D008875:Middle Aged; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D014262:Tricuspid Valve Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000601:surgery