Key result
Persistent serotonin exposure in carcinoid heart disease drives rapid native and bioprosthetic tricuspid valve degeneration.
Why the study?
Carcinoid heart disease causes serotonin-mediated fibrotic degeneration of right-sided cardiac valves, but the progression and management of native and prosthetic tricuspid valve degeneration remain challenging.
Case Report (n=3)
Highlights the progressive nature of carcinoid heart disease and the risk of rapid bioprosthetic valve degeneration, underscoring the need for close echocardiographic surveillance and multidisciplinary management.
Answers are grounded in this paper and cite their sources.
Supports intensified echocardiographic surveillance after valve intervention in carcinoid heart disease; leaves open optimal prosthetic strategies and adjunctive therapies.
BACKGROUND: Carcinoid heart disease (CaHD) is a severe complication of metastatic neuroendocrine tumors characterized by serotonin-mediated fibrotic degeneration of right-sided cardiac valves. CASE SUMMARY: We present 3 patients with metastatic neuroendocrine tumors complicated by severe carcinoid valvulopathy involving native and prosthetic tricuspid valves. Two patients underwent bioprosthetic tricuspid valve replacement for severe tricuspid regurgitation, including 1 patient who developed rapid recurrent prosthetic valve degeneration requiring transcatheter tricuspid valve-in-valve replacement. A third patient presented with advanced bivalvular carcinoid involvement requiring complex surgical reconstruction complicated by postoperative cardiogenic shock and death. DISCUSSION: These cases illustrate the progressive nature of serotonin-mediated valvular degeneration, challenges in prosthetic valve selection, and the importance of multidisciplinary management and close echocardiographic surveillance in CaHD. TAKE-HOME MESSAGES: Persistent serotonin exposure may result in rapid degeneration of native and bioprosthetic valves despite surgical intervention. Early recognition and multidisciplinary management are essential to optimize outcomes in CaHD.
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Trabucchi et al. (2026) conducted a case report in Carcinoid heart disease (n=3). Bioprosthetic tricuspid valve replacement was evaluated. Persistent serotonin exposure in carcinoid heart disease can result in rapid degeneration of native and bioprosthetic tricuspid valves despite surgical intervention.
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