Percutaneous Pulmonary Valve Implantation With Self-Expanding Valves for Carcinoid Heart Diseases

Abstract

Carcinoid heart disease is an important complication of neuroendocrine tumors that may lead to significant morbidity and mortality. Right-sided heart valve involvement with consequent valve dysfunction is one of the common manifestations. Patients often have multiple, significant comorbidities with advanced metastatic disease and, as such, may not be suitable for surgical valve replacement due to excessive risk. Transcatheter valve replacement using balloon-expandable valves has been the mainstay of management for these patients, particularly with stenotic lesions but there is limited experience in patients with pulmonary regurgitation and dilated pulmonary arteries outside the dimensions that would be suitable for these valves. We report three successful cases of percutaneous pulmonary valve implantation with the VenusP-valve, a large self-expanding valve platform, and highlight the technical aspects and challenges specific to treatment of pulmonary regurgitation in patients with carcinoid heart disease. Percutaneous pulmonary valve implantation, using the VenusP-valve, may be considered an effective treatment in this patient group.