{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T06:18:01Z","timestamp":1793513881905,"version":"4.5.0"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T00:00:00Z","timestamp":1649376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Carcinoid heart disease (CHD) is a consequence of neuroendocrine tumors releasing 5-hydroxytryptamine (5-HT) into the systemic circulation, affecting right heart valves, causing fibrosis, and eventually right heart failure. The aim of this study was to determine the effect of valve-replacement on kidney function, liver function, and 5-hydroxyindoleacetic acid (5-HIAA) levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A Retrospective study of 17 patients with CHD who had undergone heart-valve replacement surgery between 2010 and 2019, from the Queen Elizabeth Hospital Birmingham. 5-HIAA levels, liver, and kidney function were measured in addition to hepatic inferior vena cava (IVC) diameter and its relationship to carcinoid symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven patients were male and six were female. At time of surgery, average age was 66.6 \u00b1 8.1 years and average BMI was 25.8 \u00b1 5.5 Kg\/cm<jats:sup>2<\/jats:sup>. Three out of 17 patients had one valve replaced, 13\/17 had two replaced (tricuspid and pulmonary), and 1\/17 had three replaced (tricuspid, pulmonary and aortic). There was a 31% average decline in 5-HIAA [799.8 (343.6\u20131078.0) to 555.3 (275.8\u2013817.9), <jats:italic>p<\/jats:italic> = 0.011], a 35% decline in bilirubin [20 (16\u201329) to 13 (10\u201319), <jats:italic>p<\/jats:italic> = &amp;lt; 0.001], and a 15% reduction in the short and long axes of the IVC after valve-replacement surgery [20.0 (18.0\u201325.0) and 36.5 (29.0\u201339.8) to 17.0 (14.5\u201319.3) and 31.0 (26.5\u201334.3) respectively, <jats:italic>p<\/jats:italic> = &amp;lt; 0.001 and 0.002 respectively].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Valve replacement surgery improves 5-HIAA levels alongside improved liver function and hepatic IVC diameter. These findings are consistent with resolution of congestive hepatopathy, and therefore enhanced clearance of 5-HIAA. This suggests that valve-replacement surgery can indirectly have beneficial outcomes on hepatic function and is also associated with a drop in the circulating levels of tumor derived serotonin.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.791058","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T04:53:30Z","timestamp":1649393610000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical Correction of Carcinoid Heart Disease Improves Liver Function and 5-Hydroxyindoleacetic Acid Levels"],"prefix":"10.3389","volume":"9","author":[{"given":"Husnain 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