Simultaneous Transcatheter Pulmonary and Tricuspid Valve Replacement in Carcinoid Heart Disease

Abstract

Background: Neuroendocrine tumors can cause carcinoid heart disease, often presenting with pulmonary and tricuspid regurgitation. Valvular pathology and right heart failure can influence prognosis more than the tumor itself. Given high surgical risk, prolonged recovery, and limited life expectancy, interventional valve replacement is a strong alternative.

Case summary: We present a patient with severe pulmonary and torrential tricuspid regurgitation caused by carcinoid heart disease. Despite stable neuroendocrine tumor control, the patient developed progressive right heart failure, requiring urgent valve therapy. Simultaneous transcatheter pulmonary and tricuspid valve replacements were performed, almost eliminating tricuspid and pulmonary regurgitation.

Discussion: Right heart valve failure is frequent in carcinoid heart disease and significantly impacts outcomes. Although surgical valve replacement remains the standard, transcatheter approaches provide an effective, less invasive alternative for high-risk patients, offering symptom relief and excellent results.

Take-home message: Simultaneous interventional valve replacement in carcinoid heart disease is feasible and effective.

Keywords: carcinoid heart disease; echocardiography; neuroendocrine tumor; pulmonary valve; tricuspid valve; valve replacement.