TAVR, other interventional procedures may provide value for patients with carcinoid heart disease
Transcatheter valve replacements may be a safe, effective treatment strategy for patients with carcinoid heart disease (CHD), according to new data published in Interdisciplinary CardioVascular and Thoracic Surgery.[1]
CHD is a known complication among patients with neuroendocrine tumors. This study’s authors shared their initial experience with treating high-risk CHD patients with transcatheter valve replacement procedures.
“CHD is characterized by fibrotic degeneration and retraction of the right-sided heart valves, leading to progressive tricuspid and/or pulmonary regurgitation and right heart failure,” wrote first author Marie-Anne Barbier, a researcher with Hospices Civils de Lyon in France, and colleagues. “Surgical valve replacement has traditionally been the only definitive treatment … however, surgery carries a substantial perioperative risk, prompting the exploration of less invasive strategies such as transcatheter valve replacement.”
Barbier et al. shared data from nine consecutive patients treated at a single hospital between 2021 and 2025. Patients were selected by a team that included cardiologists, cardiac surgeons, anesthesiologists and oncologists. CHD was diagnosed using echocardiography results, and the preoperative workup included transthoracic echocardiography, CT and cardiac MRI.
Each patient received octreotide 24 hours before and 48 hours after treatment to reduce the risk of carcinoid crisis. Each valve procedure was performed under both fluoroscopic and transesophageal echocardiographic guidance. Valve types were chosen for each individual patient based on their anatomy and other key factors.
Overall, the nine patients underwent a total of 15 transcatheter valve procedures, including nine transcatheter pulmonary valve replacements, five transcatheter tricuspid valve replacements and a single transcatheter aortic valve replacement. While some patients underwent two of these procedures simultaneously, others underwent multiple procedures within a period of three to six weeks.
After a median follow-up period of nearly 10 months, all patients showed signs of “clinical improvement.” Echocardiography results confirmed these individuals experienced reductions in right ventricular diameter.
“This case series supports the feasibility, safety, and potential benefit of complete transcatheter valve replacement—whether tricuspid, pulmonary, or combined in one or two stages—in patients with CHD,” the authors concluded. “These preliminary findings suggest that a fully percutaneous, less invasive approach may represent a new treatment paradigm for selected high-risk patients. Further validation in larger, multicenter cohorts with longer follow-up is warranted.”
Click here to read the full study in Interdisciplinary CardioVascular and Thoracic Surgery, a journal from the European Association for Cardio-Thoracic Surgery.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.