Carcinoid heart disease (CHD) is a rare cardiac manifestation occurring in patients with advanced neuroendocrine tumours and the carcinoid syndrome, usually involving the right-sided heart valves and eventually leading to right heart failure. The pathophysiology of CHD is still obscure and believed to be multifactorial, as a variety of vasoactive substances secreted by the tumour appear to be involved. The management of patients with CHD is complex, as both the systemic malignant disease and the heart involvement have to be addressed. Timely diagnosis and early surgical treatment in appropriately selected patients are of outmost importance, as CHD is associated with increased morbidity and mortality. Valve replacement surgery alleviates right heart failure and may also contribute to improved survival. In the present study we have comprehensively reviewed the existing literature to date, mainly focusing on the pathophysiology of CHD. Other aspects of CHD (such as the clinical presentation, diagnostic tools and therapeutic approach) are addressed in brief.

1.
Rindi G, Villanacci V, Ubiali A: Biological and molecular aspects of gastroenteropancreatic neuroendocrine tumors. Digestion 2000;62(suppl 1):19-26.
2.
Solcia E, Rindi G, Paolotti D, La Rosa S, Capella C, Fiocca R: Clinicopathological profile as a basis for classification of the endocrine tumours of the gastroenteropancreatic tract. Ann Oncol 1999;10(suppl 2):S9-S15.
3.
Raja SG, Bhattacharyya S, Davar J, Dreyfus GD: Surgery for carcinoid heart disease: current outcomes, concerns and controversies. Future Cardiol 2010;6:647-655.
4.
Oberg K: Neuroendocrine tumors of the gastrointestinal tract: recent advances in molecular genetics, diagnosis, and treatment. Curr Opin Oncol 2005;17:386-391.
5.
Modlin IM, Kidd M, Latich I, Zikusoka MN, Shapiro MD: Current status of gastrointestinal carcinoids. Gastroenterology 2005;128:1717-1751.
6.
Oates JA: The carcinoid syndrome. N Engl J Med 1986;315:702-704.
7.
Vinik AI, McLeod MK, Fig. LM, Shapiro B, Lloyd RV, Cho K: Clinical features, diagnosis, and localization of carcinoid tumors and their management. Gastroenterol Clin North Am 1989;18:865-896.
8.
Makridis C, Theodorsson E, Akerstrom G, Oberg K, Knutson L: Increased intestinal non-substance P tachykinin concentrations in malignant midgut carcinoid disease. J Gastroenterol Hepatol 1999;14:500-507.
9.
Cunningham JL, Janson ET, Agarwal S, Grimelius L, Stridsberg M: Tachykinins in endocrine tumors and the carcinoid syndrome. Eur J Endocrinol 2008;159:275-282.
10.
Feldman JM: Carcinoid tumors and syndrome. Semin Oncol 1987;14:237-246.
11.
Roberts LJ 2nd, Marney SR Jr, Oates JA: Blockade of the flush associated with metastatic gastric carcinoid by combined histamine H1 and H2 receptor antagonists. Evidence for an important role of H2 receptors in human vasculature. N Engl J Med 1979;300:236-238.
12.
Kvols LK: Metastatic carcinoid tumors and the malignant carcinoid syndrome. Ann NY Acad Sci 1994;733:464-470.
13.
Morin LJ, Zuerner RT: Retroperitoneal fibrosis and carcinoid tumor. JAMA 1971;216:1647-1648.
14.
Ansell JK, Stebbings WS: Carcinoid syndrome due to a primary ovarian carcinoid tumour. J R Soc Med 1993;86:668.
15.
Soga J: Carcinoids and their variant endocrinomas. An analysis of 11,842 reported cases. J Exp Clin Cancer Res 2003;22:517-530.
16.
Tomassetti P, Migliori M, Lalli S, Campana D, Tomassetti V, Corinaldesi R: Epidemiology, clinical features and diagnosis of gastroenteropancreatic endocrine tumours. Ann Oncol 2001;12(suppl 2):S95-S99.
17.
Fox DJ, Khattar RS: Carcinoid heart disease: presentation, diagnosis, and management. Heart 2004;90:1224-1228.
18.
Pellikka PA, Tajik AJ, Khandheria BK, Seward JB, Callahan JA, Pitot HC, Kvols LK: Carcinoid heart disease. Clinical and echocardiographic spectrum in 74 patients. Circulation 1993;87:1188-1196.
19.
Moller JE, Pellikka PA, Bernheim AM, Schaff HV, Rubin J, Connolly HM: Prognosis of carcinoid heart disease: analysis of 200 cases over two decades. Circulation 2005;112:3320-3327.
20.
Lundin L, Norheim I, Landelius J, Oberg K, Theodorsson-Norheim E: Carcinoid heart disease: relationship of circulating vasoactive substances to ultrasound-detectable cardiac abnormalities. Circulation 1988;77:264-269.
21.
Ross EM, Roberts WC: The carcinoid syndrome: comparison of 21 necropsy subjects with carcinoid heart disease to 15 necropsy subjects without carcinoid heart disease. Am J Med 1985;79:339-354.
22.
Moyssakis IE, Rallidis LS, Guida GF, Nihoyannopoulos PI: Incidence and evolution of carcinoid syndrome in the heart. J Heart Valve Dis 1997;6:625-630.
23.
Connolly HM, Schaff HV, Mullany CJ, Abel MD, Pellikka PA: Carcinoid heart disease: impact of pulmonary valve replacement in right ventricular function and remodeling. Circulation 2002;106:I51-I56.
24.
Bernheim AM, Connolly HM, Hobday TJ, Abel MD, Pellikka PA: Carcinoid heart disease. Prog Cardiovasc Dis 2007;49:439-451.
25.
Patel C, Mathur M, Escarcega RO, Bove AA: Carcinoid heart disease: current understanding and future directions. Am Heart J 2014;167:789-795.
26.
Mansencal N, Mitry E, Forissier JF, Martin F, Redheuil A, Lepere C, Farcot JC, Joseph T, Lacombe P, Rougier P, Dubourg O: Assessment of patent foramen ovale in carcinoid heart disease. Am Heart J 2006;151:1129.e1121-e1126.
27.
Mansencal N, Mitry E, Pilliere R, Lepere C, Gerardin B, Petit J, Gandjbakhch I, Rougier P, Dubourg O: Prevalence of patent foramen ovale and usefulness of percutaneous closure device in carcinoid heart disease. Am J Cardiol 2008;101:1035-1038.
28.
Gustafsson BI, Hauso O, Drozdov I, Kidd M, Modlin IM: Carcinoid heart disease. Int J Cardiol 2008;129:318-324.
29.
Oates JA, Melmon K, Sjoerdsma A, Gillespie L, Mason DT: Release of a kinin peptide in the carcinoid syndrome. Lancet 1964;1:514-517.
30.
Zuetenhorst JM, Bonfrer JM, Korse CM, Bakker R, van Tinteren H, Taal BG: Carcinoid heart disease: the role of urinary 5-hydroxyindoleacetic acid excretion and plasma levels of atrial natriuretic peptide, transforming growth factor-β and fibroblast growth factor. Cancer 2003;97:1609-1615.
31.
Gershon MD: Review article: roles played by 5-hydroxytryptamine in the physiology of the bowel. Aliment Pharmacol Ther 1999;13(suppl 2):15-30.
32.
Erspamer V, Asero B: Identification of enteramine, the specific hormone of the enterochromaffin cell system, as 5-hydroxytryptamine. Nature 1952;169:800-801.
33.
Hoyer D, Hannon JP, Martin GR: Molecular, pharmacological and functional diversity of 5-HT receptors. Pharmacol Biochem Behav 2002;71:533-554.
34.
Roth BL: Irving Page Lecture: 5-HT2A serotonin receptor biology: interacting proteins, kinases and paradoxical regulation. Neuropharmacology 2011;61:348-354.
35.
Berger M, Gray JA, Roth BL: The expanded biology of serotonin. Annu Rev Med 2009;60:355-366.
36.
Maricq AV, Peterson AS, Brake AJ, Myers RM, Julius D: Primary structure and functional expression of the 5HT3 receptor, a serotonin-gated ion channel. Science 1991;254:432-437.
37.
Roth BL, Willins DL, Kristiansen K, Kroeze WK: 5-Hydroxytryptamine2 family receptors (5-hydroxytryptamine2A, 5-hydroxytryptamine2B, 5-hydroxytryptamine2C): where structure meets function. Pharmacol Ther 1998;79:231-257.
38.
Hutcheson JD, Setola V, Roth BL, Merryman WD: Serotonin receptors and heart valve disease - it was meant 2B. Pharmacol Ther 2011;132:146-157.
39.
Ullmer C, Schmuck K, Kalkman HO, Lubbert H: Expression of serotonin receptor mRNAs in blood vessels. FEBS Lett 1995;370:215-221.
40.
Choi DS, Maroteaux L: Immunohistochemical localisation of the serotonin 5-HT2B receptor in mouse gut, cardiovascular system, and brain. FEBS Lett 1996;391:45-51.
41.
Fitzgerald LW, Burn TC, Brown BS, Patterson JP, Corjay MH, Valentine PA, Sun JH, Link JR, Abbaszade I, Hollis JM, Largent BL, Hartig PR, Hollis GF, Meunier PC, Robichaud AJ, Robertson DW: Possible role of valvular serotonin 5-HT2B receptors in the cardiopathy associated with fenfluramine. Mol Pharmacol 2000;57:75-81.
42.
Manivet P, Schneider B, Smith JC, Choi DS, Maroteaux L, Kellermann O, Launay JM: The serotonin binding site of human and murine 5-HT2B receptors: molecular modeling and site-directed mutagenesis. J Biol Chem 2002;277:17170-17178.
43.
Dahl CF, Allen MR, Urie PM, Hopkins PN: Valvular regurgitation and surgery associated with fenfluramine use: an analysis of 5,743 individuals. BMC Med 2008;6:34.
44.
Rothman RB, Baumann MH, Savage JE, Rauser L, McBride A, Hufeisen SJ, Roth BL: Evidence for possible involvement of 5-HT2B receptors in the cardiac valvulopathy associated with fenfluramine and other serotonergic medications. Circulation 2000;102:2836-2841.
45.
Antonini A, Poewe W: Fibrotic heart-valve reactions to dopamine agonist treatment in Parkinson's disease. Lancet Neurol 2007;6:826-829.
46.
Simonis G, Fuhrmann JT, Strasser RH: Meta-analysis of heart valve abnormalities in Parkinson's disease patients treated with dopamine agonists. Mov Disord 2007;22:1936-1942.
47.
Seuwen K, Magnaldo I, Pouyssegur J: Serotonin stimulates DNA synthesis in fibroblasts acting through 5-HT1B receptors coupled to a Gi-protein. Nature 1988;335:254-256.
48.
Nemecek GM, Coughlin SR, Handley DA, Moskowitz MA: Stimulation of aortic smooth muscle cell mitogenesis by serotonin. Proc Natl Acad Sci USA 1986;83:674-678.
49.
Bliziotes MM, Eshleman AJ, Zhang XW, Wiren KM: Neurotransmitter action in osteoblasts: expression of a functional system for serotonin receptor activation and reuptake. Bone 2001;29:477-486.
50.
Westbroek I, van der Plas A, de Rooij KE, Klein-Nulend J, Nijweide PJ: Expression of serotonin receptors in bone. J Biol Chem 2001;276:28961-28968.
51.
Takuwa N, Ganz M, Takuwa Y, Sterzel RB, Rasmussen H: Studies of the mitogenic effect of serotonin in rat renal mesangial cells. Am J Physiol 1989;257:F431-439.
52.
Pakala R, Willerson JT, Benedict CR: Mitogenic effect of serotonin on vascular endothelial cells. Circulation 1994;90:1919-1926.
53.
Gustafsson BI, Tommeras K, Nordrum I, Loennechen JP, Brunsvik A, Solligard E, Fossmark R, Bakke I, Syversen U, Waldum H: Long-term serotonin administration induces heart valve disease in rats. Circulation 2005;111:1517-1522.
54.
Elangbam CS, Job LE, Zadrozny LM, Barton JC, Yoon LW, Gates LD, Slocum N: 5-Hydroxytryptamine (5HT)-induced valvulopathy: compositional valvular alterations are associated with 5HT2B receptor and 5HT transporter transcript changes in Sprague-Dawley rats. Exp Toxicol Pathol 2008;60:253-262.
55.
Elangbam CS, Lightfoot RM, Yoon LW, Creech DR, Geske RS, Crumbley CW, Gates LD, Wall HG: 5-Hydroxytryptamine (5HT) receptors in the heart valves of cynomolgus monkeys and Sprague-Dawley rats. J Histochem Cytochem 2005;53:671-677.
56.
Nebigil CG, Jaffre F, Messaddeq N, Hickel P, Monassier L, Launay JM, Maroteaux L: Overexpression of the serotonin 5-HT2B receptor in heart leads to abnormal mitochondrial function and cardiac hypertrophy. Circulation 2003;107:3223-3229.
57.
Nebigil CG, Choi DS, Dierich A, Hickel P, Le Meur M, Messaddeq N, Launay JM, Maroteaux L: Serotonin 2B receptor is required for heart development. Proc Natl Acad Sci USA 2000;97:9508-9513.
58.
Kellermann O, Loric S, Maroteaux L, Launay JM: Sequential onset of three 5-HT receptors during the 5-hydroxytryptaminergic differentiation of the murine 1C11 cell line. Br J Pharmacol 1996;118:1161-1170.
59.
Tournois C, Mutel V, Manivet P, Launay JM, Kellermann O: Cross-talk between 5-hydroxytryptamine receptors in a serotonergic cell line. Involvement of arachidonic acid metabolism. J Biol Chem 1998;273:17498-17503.
60.
Manivet P, Mouillet-Richard S, Callebert J, Nebigil CG, Maroteaux L, Hosoda S, Kellermann O, Launay JM: PDZ-dependent activation of nitric-oxide synthases by the serotonin 2B receptor. J Biol Chem 2000;275:9324-9331.
61.
Nebigil CG, Launay JM, Hickel P, Tournois C, Maroteaux L: 5-Hydroxytryptamine 2B receptor regulates cell-cycle progression: cross-talk with tyrosine kinase pathways. Proc Natl Acad Sci USA 2000;97:2591-2596.
62.
Hafizi S, Taylor PM, Chester AH, Allen SP, Yacoub MH: Mitogenic and secretory responses of human valve interstitial cells to vasoactive agents. J Heart Valve Dis 2000;9:454-458.
63.
Jaffre F, Bonnin P, Callebert J, Debbabi H, Setola V, Doly S, Monassier L, Mettauer B, Blaxall BC, Launay JM, Maroteaux L: Serotonin and angiotensin receptors in cardiac fibroblasts coregulate adrenergic-dependent cardiac hypertrophy. Circ Res 2009;104:113-123.
64.
Launay JM, Birraux G, Bondoux D, Callebert J, Choi DS, Loric S, Maroteaux L: Ras involvement in signal transduction by the serotonin 5-HT2B receptor. J Biol Chem 1996;271:3141-3147.
65.
Li H, Ung CY, Ma XH, Li BW, Low BC, Cao ZW, Chen YZ: Simulation of crosstalk between small GTPase RhoA and EGFR-ERK signaling pathway via MEKK1. Bioinformatics 2009;25:358-364.
66.
Roth BL: Drugs and valvular heart disease. N Engl J Med 2007;356:6-9.
67.
Jian B, Xu J, Connolly J, Savani RC, Narula N, Liang B, Levy RJ: Serotonin mechanisms in heart valve disease I: serotonin-induced up-regulation of transforming growth factor-β1 via G-protein signal transduction in aortic valve interstitial cells. Am J Pathol 2002;161:2111-2121.
68.
Rosenkranz S: TGF-β1 and angiotensin networking in cardiac remodeling. Cardiovasc Res 2004;63:423-432.
69.
Walker GA, Masters KS, Shah DN, Anseth KS, Leinwand LA: Valvular myofibroblast activation by transforming growth factor-β: implications for pathological extracellular matrix remodeling in heart valve disease. Circ Res 2004;95:253-260.
70.
Merryman WD, Huang HY, Schoen FJ, Sacks MS: The effects of cellular contraction on aortic valve leaflet flexural stiffness. J Biomech 2006;39:88-96.
71.
Modlin IM, Shapiro MD, Kidd M: Carcinoid tumors and fibrosis: an association with no explanation. Am J Gastroenterol 2004;99:2466-2478.
72.
Bergestuen DS, Edvardsen T, Aakhus S, Ueland T, Oie E, Vatn M, Aukrust P, Thiis-Evensen E: Activin A in carcinoid heart disease: a possible role in diagnosis and pathogenesis. Neuroendocrinology 2010;92:168-177.
73.
Kidd M, Modlin I, Shapiro M, Camp R, Mane S, Usinger W, Murren J: CTGF, intestinal stellate cells and carcinoid fibrogenesis. World J Gastroenterol 2007;13:5208-5216.
74.
Kidd M, Modlin IM, Pfragner R, Eick GN, Champaneria MC, Chan AK, Camp L, Mane SM: Small bowel carcinoid (enterochromaffin cell) neoplasia exhibits transforming growth factor-β1-mediated regulatory abnormalities including up-regulation of C-Myc and MTA1. Cancer 2007;109:2420-2431.
75.
Dobson R, Burgess MI, Pritchard DM, Cuthbertson DJ: The clinical presentation and management of carcinoid heart disease. Int J Cardiol 2014;173:29-32.
76.
Bhattacharyya S, Toumpanakis C, Caplin ME, Davar J: Analysis of 150 patients with carcinoid syndrome seen in a single year at one institution in the first decade of the twenty-first century. Am J Cardiol 2008;101:378-381.
77.
Moller JE, Connolly HM, Rubin J, Seward JB, Modesto K, Pellikka PA: Factors associated with progression of carcinoid heart disease. N Engl J Med 2003;348:1005-1015.
78.
Bhattacharyya S, Toumpanakis C, Chilkunda D, Caplin ME, Davar J: Risk factors for the development and progression of carcinoid heart disease. Am J Cardiol 2011;107:1221-1226.
79.
Rorstad O: Prognostic indicators for carcinoid neuroendocrine tumors of the gastrointestinal tract. J Surg Oncol 2005;89:151-160.
80.
Korse CM, Taal BG, de Groot CA, Bakker RH, Bonfrer JM: Chromogranin-A and N-terminal pro-brain natriuretic peptide: an excellent pair of biomarkers for diagnostics in patients with neuroendocrine tumor. J Clin Oncol 2009;27:4293-4299.
81.
Nakagawa O, Ogawa Y, Itoh H, Suga S, Komatsu Y, Kishimoto I, Nishino K, Yoshimasa T, Nakao K: Rapid transcriptional activation and early mRNA turnover of brain natriuretic peptide in cardiocyte hypertrophy. Evidence for brain natriuretic peptide as an ‘emergency' cardiac hormone against ventricular overload. J Clin Invest 1995;96:1280-1287.
82.
Maeda K, Tsutamoto T, Wada A, Hisanaga T, Kinoshita M: Plasma brain natriuretic peptide as a biochemical marker of high left ventricular end-diastolic pressure in patients with symptomatic left ventricular dysfunction. Am Heart J 1998;135:825-832.
83.
Bhattacharyya S, Toumpanakis C, Caplin ME, Davar J: Usefulness of N-terminal pro-brain natriuretic peptide as a biomarker of the presence of carcinoid heart disease. Am J Cardiol 2008;102:938-942.
84.
Ramage JK, Ahmed A, Ardill J, Bax N, Breen DJ, Caplin ME, Corrie P, Davar J, Davies AH, Lewington V, Meyer T, Newell-Price J, Poston G, Reed N, Rockall A, Steward W, Thakker RV, Toubanakis C, Valle J, Verbeke C, Grossman AB: Guidelines for the management of gastroenteropancreatic neuroendocrine (including carcinoid) tumours (NETs). Gut 2012;61:6-32.
85.
Lundin L, Oberg K, Landelius J, Hansson HE, Wilander E, Theodorsson E: Plasma atrial natriuretic peptide in carcinoid heart disease. Am J Cardiol 1989;63:969-972.
86.
Bergestuen DS, Gravning J, Haugaa KH, Sahakyan LG, Aakhus S, Thiis-Evensen E, Oie E, Aukrust P, Attramadal H, Edvardsen T: Plasma CCN2/connective tissue growth factor is associated with right ventricular dysfunction in patients with neuroendocrine tumors. BMC Cancer 2010;10:6.
87.
Bhattacharyya S, Toumpanakis C, Burke M, Taylor AM, Caplin ME, Davar J: Features of carcinoid heart disease identified by 2- and 3-dimensional echocardiography and cardiac MRI. Circ Cardiovasc Imaging 2010;3:103-111.
88.
Howard RJ, Drobac M, Rider WD, Keane TJ, Finlayson J, Silver MD, Wigle ED, Rakowski H: Carcinoid heart disease: diagnosis by two-dimensional echocardiography. Circulation 1982;66:1059-1065.
89.
Dobson R, Cuthbertson DJ, Jones J, Valle JW, Keevil B, Chadwick C, Poston GP, Burgess MI: Determination of the optimal echocardiographic scoring system to quantify carcinoid heart disease. Neuroendocrinology 2014;99:85-93.
90.
Franzen D, Boldt A, Raute-Kreinsen U, Koerfer R, Erdmann E: Magnetic resonance imaging of carcinoid heart disease. Clin Cardiol 2009;32:E92-93.
91.
Klobucic M, Paar MH, Padovan RS, Vincelj J, Fila B: New images in carcinoid heart disease. Cardiovasc J Afr 2012;23:e8-10.
92.
Fiebrich HB, Brouwers AH, Links TP, de Vries EG: Images in cardiovascular medicine: myocardial metastases of carcinoid visualized by 18F-dihydroxy-phenyl-alanine positron emission tomography. Circulation 2008;118:1602-1604.
93.
Eriksson B, Kloppel G, Krenning E, Ahlman H, Plockinger U, Wiedenmann B, Arnold R, Auernhammer C, Korner M, Rindi G, Wildi S: Consensus guidelines for the management of patients with digestive neuroendocrine tumors - well-differentiated jejunal-ileal tumor/carcinoma. Neuroendocrinology 2008;87:8-19.
94.
Caplin M, Sundin A, Nillson O, Baum RP, Klose KJ, Kelestimur F, Plockinger U, Papotti M, Salazar R, Pascher A: ENETS Consensus Guidelines for the management of patients with digestive neuroendocrine neoplasms: colorectal neuroendocrine neoplasms. Neuroendocrinology 2012;95:88-97.
95.
Pape UF, Perren A, Niederle B, Gross D, Gress T, Costa F, Arnold R, Denecke T, Plockinger U, Salazar R, Grossman A: ENETS Consensus Guidelines for the management of patients with neuroendocrine neoplasms from the jejuno-ileum and the appendix including goblet cell carcinomas. Neuroendocrinology 2012;95:135-156.
96.
Plockinger U, Gustafsson B, Ivan D, Szpak W, Davar J: ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: echocardiography. Neuroendocrinology 2009;90:190-193.
97.
Grozinsky-Glasberg S, Grossman AB, Korbonits M: The role of somatostatin analogues in the treatment of neuroendocrine tumours. Mol Cell Endocrinol 2008;286:238-250.
98.
Rubin J, Ajani J, Schirmer W, Venook AP, Bukowski R, Pommier R, Saltz L, Dandona P, Anthony L: Octreotide acetate long-acting formulation versus open-label subcutaneous octreotide acetate in malignant carcinoid syndrome. J Clin Oncol 1999;17:600-606.
99.
Modlin IM, Latich I, Kidd M, Zikusoka M, Eick G: Therapeutic options for gastrointestinal carcinoids. Clin Gastroenterol Hepatol 2006;4:526-547.
100.
Anderson AS, Krauss D, Lang R: Cardiovascular complications of malignant carcinoid disease. Am Heart J 1997;134:693-702.
101.
Nishimura RA, Carabello BA, Faxon DP, Freed MD, Lytle BW, O'Gara PT, O'Rourke RA, Shah PM: ACC/AHA 2008 Guideline update on valvular heart disease: focused update on infective endocarditis: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol 2008;52:676-685.
102.
Marsh HM, Martin JK Jr, Kvols LK, Gracey DR, Warner MA, Warner ME, Moertel CG: Carcinoid crisis during anesthesia: successful treatment with a somatostatin analogue. Anesthesiology 1987;66:89-91.
103.
Claure RE, Drover DD, Haddow GR, Esquivel CO, Angst MS: Orthotopic liver transplantation for carcinoid tumour metastatic to the liver: anesthetic management. Can J Anaesth 2000;47:334-337.
104.
Castillo JG, Filsoufi F, Adams DH, Raikhelkar J, Zaku B, Fischer GW: Management of patients undergoing multivalvular surgery for carcinoid heart disease: the role of the anaesthetist. Br J Anaesth 2008;101:618-626.
105.
Ockert DB, White RD: Anesthetic management of patients with carcinoid heart disease undergoing cardiac surgery: two case reports and a review of previous experience. J Cardiothorac Anesth 1988;2:658-665.
106.
Kulke MH, O'Dorisio T, Phan A, Bergsland E, Law L, Banks P, Freiman J, Frazier K, Jackson J, Yao JC, Kvols L, Lapuerta P, Zambrowicz B, Fleming D, Sands A: Telotristat etiprate, a novel serotonin synthesis inhibitor, in patients with carcinoid syndrome and diarrhea not adequately controlled by octreotide. Endocr Relat Cancer 2014;21:705-714.
107.
Grant SC, Scarffe JH, Levy RD, Brooks NH: Failure of balloon dilatation of the pulmonary valve in carcinoid pulmonary stenosis. Br Heart J 1992;67:450-453.
108.
Hargreaves AD, Pringle SD, Boon NA: Successful balloon dilatation of the pulmonary valve in carcinoid heart disease. Int J Cardiol 1994;45:150-151.
109.
Connolly HM, Nishimura RA, Smith HC, Pellikka PA, Mullany CJ, Kvols LK: Outcome of cardiac surgery for carcinoid heart disease. J Am Coll Cardiol 1995;25:410-416.
110.
Connolly HM: Carcinoid heart disease: medical and surgical considerations. Cancer Control 2001;8:454-460.
111.
Bhattacharyya S, Davar J, Dreyfus G, Caplin ME: Carcinoid heart disease. Circulation 2007;116:2860-2865.
112.
Ridker PM, Schoen FJ: Surgical management of carcinoid heart disease. Ann Thorac Surg 1991;52:1208.
113.
Ridker PM, Chertow GM, Karlson EW, Neish AS, Schoen FJ: Bioprosthetic tricuspid valve stenosis associated with extensive plaque deposition in carcinoid heart disease. Am Heart J 1991;121:1835-1838.
114.
Ohri SK, Schofield JB, Hodgson H, Oakley CM, Keogh BE: Carcinoid heart disease: early failure of an allograft valve replacement. Ann Thorac Surg 1994;58:1161-1163.
115.
McDonald ML, Nagorney DM, Connolly HM, Nishimura RA, Schaff HV: Carcinoid heart disease and carcinoid syndrome: successful surgical treatment. Ann Thorac Surg 1999;67:537-539.
116.
Thorburn CW, Morgan JJ, Shanahan MX, Chang VP: Long-term results of tricuspid valve replacement and the problem of prosthetic valve thrombosis. Am J Cardiol 1983;51:1128-1132.
117.
Manoly I, McAnelly SL, Sriskandarajah S, McLaughlin KE: Prognosis of patients with carcinoid heart disease after valvular surgery. Interact Cardiovasc Thorac Surg 2014;19:302-305.
118.
Bhattacharyya S, Raja SG, Toumpanakis C, Caplin ME, Dreyfus GD, Davar J: Outcomes, risks and complications of cardiac surgery for carcinoid heart disease. Eur J Cardiothorac Surg 2011;40:168-172.
119.
Boglioli LR, Gardiner J, Gerstenblith G, Taff ML, Cameron DE: Carcinoid heart disease with severe hypoxia due to interatrial shunt through patent foramen ovale. Tex Heart Inst J 1997;24:125-128.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.