Abstract：
BACKGROUND: Carcinoid tumors are rare neuroendocrine tumors; about 5% of patients develop the carcinoid syndrome. We present the case of a patient with carcinoid syndrome undergoing cardiac surgery.
METHODS: A 74-year-old patient with carcinoid heart disease and hepatic metastases underwent double valve replacement and CABG. The patient was on octreotide therapy and antihypertensive medication. An octreotide infusion was commenced perioperatively. Pharmaceutical agents that could potentially precipitate histamine release or exacerbate catecholamine secretion and carcinoid crises were avoided. Postoperatively, recovery was complicated by atrial fibrillation, chest infection, pleural effusions, acute kidney injury and delirium.
CONCLUSIONS: Hepatic metastases cause systemic hormones\' secretion, which cause a carcinoid crisis. Perioperative administration of octreotide is used, while vigilance is required to differentiate between hemodynamic effects related to the operation or disease specific factors.
CONCLUSIONS: No carcinoid crisis was evident perioperatively. High vigilance with appropriate monitoring, aggressive management combined with meticulous choice of pharmaceutical agents led to this outcome.
METHODS: A 74-year-old patient with carcinoid heart disease and hepatic metastases underwent double valve replacement and CABG. The patient was on octreotide therapy and antihypertensive medication. An octreotide infusion was commenced perioperatively. Pharmaceutical agents that could potentially precipitate histamine release or exacerbate catecholamine secretion and carcinoid crises were avoided. Postoperatively, recovery was complicated by atrial fibrillation, chest infection, pleural effusions, acute kidney injury and delirium.
CONCLUSIONS: Hepatic metastases cause systemic hormones\' secretion, which cause a carcinoid crisis. Perioperative administration of octreotide is used, while vigilance is required to differentiate between hemodynamic effects related to the operation or disease specific factors.
CONCLUSIONS: No carcinoid crisis was evident perioperatively. High vigilance with appropriate monitoring, aggressive management combined with meticulous choice of pharmaceutical agents led to this outcome.
摘要：
背景：类癌是一种罕见的神经内分泌肿瘤，约5%的患者出现类癌综合征。我们介绍了一例接受心脏手术的类癌综合征患者。
方法：一名74岁的类癌心脏病和肝转移患者接受了双瓣膜置换术和CABG。患者正在接受奥曲肽治疗和降压药物治疗。围手术期开始奥曲肽输注。避免了可能导致组胺释放或加剧儿茶酚胺分泌和类癌危象的药物。术后,房颤使恢复变得复杂，胸部感染,胸腔积液,急性肾损伤和谵妄。
结论：肝转移引起全身激素分泌，导致类癌危机。围手术期使用奥曲肽，同时需要警惕，以区分与手术相关的血液动力学影响或疾病特定因素。
结论：围手术期没有明显的类癌危象。高度警惕，适当监测，积极的管理和细致的药物选择导致了这一结果.
方法：一名74岁的类癌心脏病和肝转移患者接受了双瓣膜置换术和CABG。患者正在接受奥曲肽治疗和降压药物治疗。围手术期开始奥曲肽输注。避免了可能导致组胺释放或加剧儿茶酚胺分泌和类癌危象的药物。术后,房颤使恢复变得复杂，胸部感染,胸腔积液,急性肾损伤和谵妄。
结论：肝转移引起全身激素分泌，导致类癌危机。围手术期使用奥曲肽，同时需要警惕，以区分与手术相关的血液动力学影响或疾病特定因素。
结论：围手术期没有明显的类癌危象。高度警惕，适当监测，积极的管理和细致的药物选择导致了这一结果.
