Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies
Carcinoid heart disease (CHD) affects right-sided valves and causes significant mortality and morbidity. Even though the pathophysiology of the disease is not entirely understood, it is known that chronic exposure to high levels of circulating serotonin is the main factor responsible for developing...
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MDPI AG
2024-11-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/11/359 |
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| author | Mariagrazia Piscione Valeria Cammalleri Giorgio Antonelli Valeria Maria De Luca Myriam Carpenito Dario Gaudio Nino Cocco Antonio Nenna Carmelo Dominici Antonio Bianchi Francesco Grigioni Gian Paolo Ussia |
| author_facet | Mariagrazia Piscione Valeria Cammalleri Giorgio Antonelli Valeria Maria De Luca Myriam Carpenito Dario Gaudio Nino Cocco Antonio Nenna Carmelo Dominici Antonio Bianchi Francesco Grigioni Gian Paolo Ussia |
| author_sort | Mariagrazia Piscione |
| collection | DOAJ |
| description | Carcinoid heart disease (CHD) affects right-sided valves and causes significant mortality and morbidity. Even though the pathophysiology of the disease is not entirely understood, it is known that chronic exposure to high levels of circulating serotonin is the main factor responsible for developing valvular heart disease. Cardiac imaging plays a critical role in the management of CHD, so the final diagnosis can be performed through multimodal imaging techniques and the measurement of biomarkers. Moreover, in observational studies, surgical treatment of carcinoid-induced valve disease has been found to improve outcomes. Despite advancements in pre-operative preparation in recent years, mortality rates remain high in elderly patients and those with multiple comorbidities due to the risk of intra-operative carcinoid crisis and high post-operative bleeding. In this comprehensive review, we will analyze the causes of carcinoid syndrome and how it can result in severe right heart failure. The role of different imaging modalities in detecting heart valve disease will be discussed together with the therapeutic options at our disposal, such as medical treatment, surgery, and the novel role of transcatheter intervention. |
| format | Article |
| id | doaj-art-900193c8b55a4ad1bd1c19c66b9f2433 |
| institution | Kabale University |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-900193c8b55a4ad1bd1c19c66b9f24332024-11-26T18:07:24ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-11-01111135910.3390/jcdd11110359Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic StrategiesMariagrazia Piscione0Valeria Cammalleri1Giorgio Antonelli2Valeria Maria De Luca3Myriam Carpenito4Dario Gaudio5Nino Cocco6Antonio Nenna7Carmelo Dominici8Antonio Bianchi9Francesco Grigioni10Gian Paolo Ussia11Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyUnit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyUnit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyUnit of Cardiovascular Science, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, ItalyDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyDepartment of Cardiovascular Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyInternal Medicine, Endocrinology and Diabetes Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Department of Medical and Surgical Sciences, Catholic University of the Sacred Heart, 00168 Rome, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyDepartment of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, ItalyCarcinoid heart disease (CHD) affects right-sided valves and causes significant mortality and morbidity. Even though the pathophysiology of the disease is not entirely understood, it is known that chronic exposure to high levels of circulating serotonin is the main factor responsible for developing valvular heart disease. Cardiac imaging plays a critical role in the management of CHD, so the final diagnosis can be performed through multimodal imaging techniques and the measurement of biomarkers. Moreover, in observational studies, surgical treatment of carcinoid-induced valve disease has been found to improve outcomes. Despite advancements in pre-operative preparation in recent years, mortality rates remain high in elderly patients and those with multiple comorbidities due to the risk of intra-operative carcinoid crisis and high post-operative bleeding. In this comprehensive review, we will analyze the causes of carcinoid syndrome and how it can result in severe right heart failure. The role of different imaging modalities in detecting heart valve disease will be discussed together with the therapeutic options at our disposal, such as medical treatment, surgery, and the novel role of transcatheter intervention.https://www.mdpi.com/2308-3425/11/11/359carcinoid heart diseasesurgical valve replacementtranscatheter edge-to-edge repair |
| spellingShingle | Mariagrazia Piscione Valeria Cammalleri Giorgio Antonelli Valeria Maria De Luca Myriam Carpenito Dario Gaudio Nino Cocco Antonio Nenna Carmelo Dominici Antonio Bianchi Francesco Grigioni Gian Paolo Ussia Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies Journal of Cardiovascular Development and Disease carcinoid heart disease surgical valve replacement transcatheter edge-to-edge repair |
| title | Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies |
| title_full | Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies |
| title_fullStr | Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies |
| title_full_unstemmed | Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies |
| title_short | Cardiac Surgery and Transcatheter Intervention for Valvular Heart Disease in Carcinoid Syndrome: Risk Factors, Outcomes, and Evolving Therapeutic Strategies |
| title_sort | cardiac surgery and transcatheter intervention for valvular heart disease in carcinoid syndrome risk factors outcomes and evolving therapeutic strategies |
| topic | carcinoid heart disease surgical valve replacement transcatheter edge-to-edge repair |
| url | https://www.mdpi.com/2308-3425/11/11/359 |
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