Percutaneous Transcatheter Valve-in-Valve Pulmonary and Tricuspid Replacement in Carcinoid Heart Disease

Luthra, Suvitesh; Olevano, Carlo; Richens, Trevor; Tsang, Geoff

doi:10.1016/j.jaccas.2019.11.089

Cited by 8 publications

(6 citation statements)

References 8 publications

(7 reference statements)

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“…Q9: “Nonsurgical” interventional options for CHD 8 The experience with minimally invasive options (percutaneous catheter‐based interventions, valve‐in‐valve replacements) is limited; however, this approach will play a growing role in the future, as: Valve‐in‐valve replacement is feasible in degenerated surgical bioprosthesis, and should be the first choice in CHD patients 79 The mechanism of degeneration should be evaluated and if there are features of bioprosthetic valve thrombosis, VKA should be tried initially if the patient is clinically stable Endocarditis should be excluded as a cause for bioprosthetic valve degeneration prior to considering valve‐in‐valve treatment. For first‐time procedures, percutaneous valve implantation has been reported for the pulmonary valve in CHD in selected patients. Conversely to the left side, the risk of outflow tract obstruction, para‐valvular leaks, and haemolysis is low. The expected valve durability in this low‐pressure environment is probably better but valve thrombosis remains a concern in transcatheter valves. A study (TRICAR), evaluating whether valved stent graft implant reduces TR and improves the symptoms and QoL in CHD patients who are unable to have a new valve via a surgical procedure, is ongoing (ClinicalTrials.gov Identifier: NCT05064514).…”

Section: Therapymentioning

confidence: 99%

“…Valve‐in‐valve replacement is feasible in degenerated surgical bioprosthesis, and should be the first choice in CHD patients 79 The mechanism of degeneration should be evaluated and if there are features of bioprosthetic valve thrombosis, VKA should be tried initially if the patient is clinically stable Endocarditis should be excluded as a cause for bioprosthetic valve degeneration prior to considering valve‐in‐valve treatment. …”

Section: Therapymentioning

confidence: 99%

See 1 more Smart Citation

European Neuroendocrine Tumor Society (ENETS) 2022 Guidance Paper for Carcinoid Syndrome and Carcinoid Heart Disease

Glasberg

Davar

Hofland

et al. 2022

J Neuroendocrinology

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Data regarding the diagnosis, management, and follow-up of carcinoid syndrome (CS) and carcinoid heart disease (CHD) were identified by searches of the MEDLINE database using specific terms in human studies: CS; CHD; screening; epidemiology; diagnosis; treatment; prognosis. The search results were supplemented by manual searching of relevant journals, reference lists in key articles and other appropriate documents, and expert opinion. All recommendations are offered on the basis of the best available evidence, supplemented by the authors' experiences in managing CS and CHD. Each recommendation for treatment will have a level of evidence and grade of recommendation as per the GRADE system (adapted in Infectious Disease society This first ENETS guidance paper on CS aims to provide practical guidance for NEN specialists in the diagnosis and management of CS, with special emphasis on CHD.

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Section: Therapymentioning

confidence: 99%

Section: Therapymentioning

confidence: 99%

European Neuroendocrine Tumor Society (ENETS) 2022 Guidance Paper for Carcinoid Syndrome and Carcinoid Heart Disease

Glasberg

Davar

Hofland

et al. 2022

J Neuroendocrinology

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“…In addition, the recent introduction of percutaneous valve-in-valve technology in subjects with a failing bioprosthetic valve has broadened treatment selections for less invasive procedures, and a transcatheter heart valve placed in the inferior vena cava may decrease carcinoid hormone levels and relieve symptoms in patients with severe carcinoid syndrome symptoms [86,87].…”

Section: Cardiac Surgerymentioning

confidence: 99%

What do we know about carcinoid heart disease in the present era?

et al. 2022

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Carcinoid heart disease (CHD) is a severe complication of carcinoid syndrome (CS) found primarily in patients with small intestine neuroendocrine neoplasms (SI-NENs). Patients who develop CHD have significantly worse morbidity and mortality outcomes, highlighting the importance of clinical practice recommendations for CHD screening, diagnosis, and treatment that are both consistent and practical. CHD is characterized by white plaque-like deposits on the endocardial surface of heart structures, generally affecting the right heart valves, causing tricuspid and pulmonary regurgitation and, less commonly, valve stenosis. Cardiac imaging is essential for both the diagnosis and management of CHD. Previously, imaging for CHD was mostly achieved by echocardiography, but more recently, imaging has become multimodal. N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 5-hydroxyindoleacetic acid in the urine (u5-HIAA) are currently the most effective markers used in screening CS patients and evaluating CHD severity. Managing patients with CHD is challenging since both systemic malignant disease and cardiac involvement must be treated concurrently. Early diagnosis and surgical intervention when required are critical to patient prognosis, especially in those without primary tumor resection. Valve replacement surgery is the most effective treatment for patients with advanced carcinoid heart disease for alleviating cardiac symptoms and contributing to survival outcomes. To deliver effective patient treatment, multidisciplinary team collaboration is needed. This review summarizes current research findings on CHD pathogenesis, clinical and epidemiological features, useful biomarkers and imaging modalities, and treatment strategies.

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“…In this issue of JACC: Case Reports , Luthra et al ( 1 ) provide an important contribution, illustrating the application of evolving percutaneous cardiac valve replacement techniques to the troubling phenomenon of recurrent serotonin-induced valvulopathy in carcinoid heart disease. First, a few comments about the problem of recurrent carcinoid valvulopathy on newly implanted bioprosthetic valves.…”

mentioning

confidence: 99%