Anesthetic management of carcinoid heart disease after cardiac surgery. A possible use of veno-arterial extracorporeal membrane oxygenation support

In particular the former is related to the clinical vasomotor manifestations due to the release of serotonin, 5-hydroxytryptophan, histamine, bradykinin, tachykinins, kallikrein and prostaglandins [1] secreted by neuroendocrine tumours. Since the serotonin, delivered from the liver to the right hear...

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Bibliographic Details
Published in:Journal of clinical anesthesia 2018-11, Vol.50, p.91-92
Main Authors: Di Tomasso, Nora, Carcò, Francesco, Arangino, Cristina, De Luca, Monica, Bove, Tiziana, Zangrillo, Alberto, Monaco, Fabrizio
Format: Article
Language:English
Subjects:
Anemia
Cardiovascular disease
Electrocardiography
Extracorporeal membrane oxygenation
Heart surgery
Histamine
Weaning
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Summary:In particular the former is related to the clinical vasomotor manifestations due to the release of serotonin, 5-hydroxytryptophan, histamine, bradykinin, tachykinins, kallikrein and prostaglandins [1] secreted by neuroendocrine tumours. Since the serotonin, delivered from the liver to the right heart, is associated with the accumulation of fibrous material on both tricuspid and pulmonary valve leaflets and subvalvular apparatus [2], stenosis with or without regurgitation is a common finding [3]. [...]the carcinoid-crisis and post-cardiotomic myocardial stunning usually resolve themselves within 48 h and have a favourable outcome if organs support is guarantee in the meantime. The release of histamine from mast cells and the respiratory depression with hypercapnia can worsen vasodilation.
ISSN:0952-8180
1873-4529
DOI:10.1016/j.jclinane.2018.06.036