Carcinoid heart disease.
Carcinoid heart disease.
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DOI：
10.1007/s11886-006-0019-9
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发表时间：
2006-03-01
影响因子：
3.7
通讯作者：
Pellikka, Patricia A
中科院分区：
文献类型：
--
作者：
Connolly, Heidi M;Pellikka, Patricia A
类癌疾病患者的医疗和手术治疗的进展改善了症状和生存率。类癌性心脏病仍然是恶性类癌综合征患者发病率和死亡率的主要原因。有症状的类癌性心脏病患者的药物治疗选择有限。在马约诊所（罗切斯特，明尼苏达州），我们已经采取了积极的方法来治疗类癌性心脏病引起的严重瓣膜功能障碍。严重类癌性心脏病的患者目前被转介心脏手术时，他们发展的心脏症状，心室功能不全，或（很少）在预期的肝脏手术。手术结果取决于心脏手术时患者的年龄和功能等级。尽管转移性疾病限制了寿命，但心脏手术幸存者的功能能力通常会显着改善。对于有症状的类癌性心脏病和类癌症状得到控制的患者，应尽早考虑心脏手术。一个有经验的医疗，手术和麻醉团队的方法与类癌性心脏病患者是至关重要的，以提供最先进的管理。
Progress in the medical and surgical management of patients with carcinoid disease has resulted in improved symptoms and survival. Carcinoid heart disease remains a major cause of morbidity and mortality among patients with malignant carcinoid syndrome. Limited medical treatment options are available for patients with symptomatic carcinoid heart disease. At the Mayo Clinic (Rochester, MN), we have taken an aggressive approach to severe valvular dysfunction from carcinoid heart disease. Patients with severe carcinoid heart disease currently are referred for cardiac operation when they develop cardiac symptoms, ventricular dysfunction, or (rarely) in anticipation of hepatic surgery. Surgical outcome depends on patient age and functional class at the time of cardiac surgery. Despite metastatic disease that limits longevity, cardiac surgical survivors usually demonstrate dramatic improvement in functional capacity. Cardiac surgery should be considered early for patients with symptomatic carcinoid heart disease and controlled carcinoid symptoms. An experienced medical, surgical, and anesthetic team approach to the patient with carcinoid heart disease is critical in order to provide state of the art management.