title: Bioprosthetic tricuspid valve replacement in carcinoid heart disease from primary ovarian carcinoid tumor.
abstract: Carcinoid heart disease (CHD) commonly occurs in association with primary gastrointestinal tract carcinoid tumors with hepatic metastases. Unlike primary gastrointestinal tract carcinoid tumors, primary ovarian carcinoid tumors may cause CHD without hepatic metastases, accounting for only 0.3 % of all carcinoid tumors. Only 37 cases of CHD from primary ovarian carcinoid tumors have been reported. We present a case of CHD in which tricuspid valve thickening and shortening led to reduced valve mobility with the resulting severe tricuspid regurgitation. Considering these characteristics of an abnormal tricuspid valve, we suspected CHD, but prosthetic valve replacement was performed without sufficient systemic examination before surgery. Two years after valve replacement, the patient underwent excision of a mass in the lower abdomen, which was diagnosed as an ovarian carcinoid tumor by histopathological examination. The patient has been observed for more than 3 years after tricuspid valve replacement. She has not experienced bioprosthetic valve leaflet degeneration or dysfunction, although it has been reported that bioprosthetic valves may degenerate in patients with carcinoid tumors. Sufficient systemic examinations should be performed to explore the cause of disease.
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan. tsugu917@gmail.com.|Department of Cardiology, Hino Municipal Hospital, 4-3-1 Tamadaira, Hino, Tokyo, 191-0062, Japan. tsugu917@gmail.com.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Tsugu
authors.affiliation: Department of Cardiology, Saitama International Medical Center, Saitama, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Iwanaga
authors.affiliation: Department of Laboratory Medicine, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Mitsushige
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Cardiology, School of Medicine, Keio University, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
mesh_terms: D001705:Bioprosthesis; D002275:Carcinoid Heart Disease / Q000150:complications*; D002276:Carcinoid Tumor / Q000150:complications* / Q000556:secondary*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000473:pathology*; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000209:etiology* / Q000601:surgery*
keywords: Bioprosthetic valve replacement; Carcinoid heart disease; Cartinoid tumor; Echocardiography