Tricuspid and pulmonary valve replacement in carcinoid heart disease: two case reports and a review of the literature.

Valve replacement is the only definitive treatment for patients with carcinoid heart disease. Without valve surgery most of these patients die of progressive right heart failure within one year after the onset of symptoms. The choice of a mechanical versus a biological prosthesis is not clearly defined. We report two cases in whom St. Jude Medical prostheses were used to replace both the tricuspid and pulmonary valves. In one of these patients a concomitant coronary artery bypass operation was performed. This patient is alive 6.5 years after surgery. This is the longest follow up after double valve replacement in carcinoid heart disease.