el-Rassi I, Oroudji M, Tapia M, Depoix J P, Henri I, Cormier B, Vissuzaine C, Acar C
Service de chirurgie cardiaque, hôpital Bichat Claude-Bernard, Paris.
Arch Mal Coeur Vaiss. 1998 Jan;91(1):79-82.
Carcinoid cardiac disease is a common complication of metastatic carcinoid tumours. It is characterized by tricuspid regurgitation and pulmonary stenosis. A 68 years old woman with a metastatic carcinoid tumour was admitted to hospital for congestive cardiac failure secondary to severe tricuspid regurgitation. Typical carcinoid lesions of the tricuspid and pulmonary valves were observed at echocardiography. A double valve replacement was performed with a favourable outcome. Postoperative echocardiography showed a significant improvement in right ventricular function. Surgical management of carcinoid valvular heart disease of NYHA Stage III patients is associated with an improved 2 years survival (from 8 to 40%) despite a high operative mortality (about 27%). Cardiac surgery remains the only hope of long-term survival with a spectacular improvement in symptoms.
类癌性心脏病是转移性类癌肿瘤的常见并发症。其特征为三尖瓣反流和肺动脉狭窄。一名68岁患有转移性类癌肿瘤的女性因严重三尖瓣反流继发充血性心力衰竭入院。超声心动图检查发现三尖瓣和肺动脉瓣有典型的类癌病变。进行了双瓣膜置换术,效果良好。术后超声心动图显示右心室功能有显著改善。纽约心脏协会(NYHA)III级类癌瓣膜性心脏病患者的手术治疗与2年生存率提高(从8%提高到40%)相关,尽管手术死亡率较高(约27%)。心脏手术仍然是长期生存的唯一希望,症状也会有显著改善。