Role of Hepatic Resection for Patients With Carcinoid Heart Disease

Bernheim, Alain M.; Connolly, Heidi M.; Rubin, Joseph; Møller, Jacob E.; Scott, Christopher G.; Nagorney, David M.; Pellikka, Patricia A.
February 2008
Mayo Clinic Proceedings;Feb2008, Vol. 83 Issue 2, p143
Academic Journal
OBJECTIVE: To evaluate the effects of resection of hepatic carcinold metastases on progression and prognosis of carclnold heart disease. PATIENTS AND METHODS: From our database of 265 consecutive patients diagnosed as having carcinold heart disease from January 1, 1980, through December 31, 2005, we calculated survival from first diagnosis of cardiac involvement. Hepatic resection during follow-up was entered as a time-dependent covariable in a multi-variable analysis. In patients with serial echocardiograms more than 1 year apart without intervening cardiac surgery, a previously validated cardiac severity score was calculated. A score Increase that exceeded 25% was considered relevant progression. RESULTS: Hepatic resection was performed In 31 patients (12%) during follow-up. Five-year survival was significantly higher In these patients (86.5%; 95% confidence interval [CI], 73.5%-100.0%) than In patients without hepatic resection (29.0%; 95% Cl, 23.3%- 36.1%; univariable hazard ratio for hepatic resection, 0.25; 95% CI 0.12-0.53; P<.001). Hepatic resection remained strongly associated with Improved prognosis in multivariable analysis (hazard ratio, 0.31; 95% Cl, 0.14-0.66; P=.003). Among 77 patients (29%) with serial echocardiograms, 10 (13%) underwent hepatic resection during follow-up; resection was independently associated with decreased risk of cardiac progression (odds ratio, 0.29; 95% Cl, 0.06-0.75; P=.03). CONCLUSION: Despite the limitations of this retrospective nonrandomized study, our data suggest that patients with carcinold heart disease who undergo hepatic resection have decreased cardiac progression and improved prognosis. Eligible patients should be considered for hepatic surgery.


Related Articles

  • Surgical Management of Congenital Heart Disease: Contribution of the Aristotle Complexity Score to Planning and Budgeting in the German Diagnosis-Related Groups System. Sinzobahamvya, Nicodème; Photiadis, Joachim; Kopp, Thorsten; Arenz, Claudia; Haun, Christoph; Schindler, Ehrenfried; Hraska, Viktor; Asfour, Boulos // Pediatric Cardiology;Jan2012, Vol. 33 Issue 1, p36 

    Planning and budgeting for congenital heart surgery depend primarily on how closely reimbursement matches costs and on the number and complexity of the surgical procedures. Aristotle complexity scores for the year 2010 were correlated with hospital costs and with reimbursement according to the...

  • N-acetylcysteine does not prevent contrast induced nephropathy after cardiac catheterisation with an ionic low osmolality contrast medium: a multicentre clinical trial. Gomes, V. O.; de Figueredo, C. E. Poli; Caramori, P.; Lasevilch, R.; Bodanese, L. C.; Araújo, A.; P Röedel, A.; Caramori, A. P.; Brito Jr, F. S.; Bezerra, H. G.; Nery, P.; Brizolara, A. // Heart;Jun2005, Vol. 91 Issue 6, p774 

    Objective: To evaluate oral N-acelylcysteine in the prevention of contrast induced nephropathy (CIN) in patients at low to moderate risk undergoing cardiac catheterisation with ionic low osmolality contrast medium. Methods: In a multicentre double blind clinical trial 156 patients undergoing...

  • Identification of Coronary Artery Disease in the Pediatric Cardiac Transplant Patient. Maiers, Jacqueline; Hurwitz, Roger // Pediatric Cardiology;Jan2008, Vol. 29 Issue 1, p19 

    Little data exist to identify pediatric patients who have developed transplant coronary artery vasculopathy (CAV). Transplant patients do not exhibit the usual signs of coronary disease, making diagnosis more difficult. The aim of this study is to assess the use of myocardial perfusion imaging...

  • Molecular mechanisms in remote ischaemic preconditioning: from the research lab to clinical routine? Slagsvold, Katrine H.; Wahba, Alexander // European Journal of Cardio-Thoracic Surgery;Nov2015, Vol. 48 Issue 5, p738 

    The authors reflect on the cardioprotective effects of induced remote ischaemic preconditioning (RIPC). The authors states the publication of clinical trial of RIPC in cardiac surgery as well as its benefits to patients who are undergoing heart surgery. Also investigated is the levels of...

  • Surgical treatment of pleural recurrence from thymoma. Lucchi, Marco; Basolo, Fulvio; Mussi, Alfredo // European Journal of Cardio-Thoracic Surgery;Apr2008, Vol. 33 Issue 4, p707 

    Summary: A complete surgical resection represents the cornerstone of the therapy of the thymic tumours. Pleural disease may already be present at the diagnosis representing an advanced stage thymoma (Masaoka IVA) or it may appear during the follow-up, representing a pleural recurrence. The...

  • Left Atrial Myxoma in a Child with Unique Presentation: Chest Pain. Kaneko, Tsuyoshi; Walkes, Jon-Cecil; Tsai, Felix W. // Pediatric Cardiology;Feb2011, Vol. 32 Issue 2, p230 

    We present a 16-year-old girl who presented with chest pain. Given her obesity and positive family history, she was felt to have atherosclerotic heart disease. However, an echocardiogram showed an atrial myxoma, which prompted surgical excision. This case supports the routine use of...

  • Just a little pinprick…. Phillips, C. Douglas // Applied Radiology;Dec2006, Vol. 35 Issue 12, p6 

    The author describes his experiences before and after undergoing transesophageal echocardiogram and a cardiac catheterization. The plan was to have a quadrangular resection, with placement of an annuloplasty ring. As a physician, he experienced modern medicine from the other side, and it was...

  • Errors of Computer Electrocardiography. RuDusky, Basil M. // Angiology;Dec1997, Vol. 48 Issue 12, p1045 

    A review of 6938 computer-generated electrocardiogram interpretations was undertaken by a single cardiologist. The computer-assisted program correctly interpreted 51.6% of the tracings. One or more corrections were necessary in 48.4%. The greatest number of incorrect interpretations involved...

  • Changes in QT Dispersion Magnitude During Respiratory Phases: Role of Maximum Inspiration and Expiration. Yetkin, Ertan; Yanik, Ahmet; Kutlu, Makbule; İleri, Mehmet; Çehreli, Sengül // Angiology;Nov1999, Vol. 50 Issue 11, p915 

    There is still controversy about the reliability and prognostic value of QT interval dispersion because of interobserver and intraobserver variability. The authors aimed to study the effect of respiratory phases on QT dispersion. Sixty healthy volunteers (38 men, 22 women, mean age 25 ±3...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics