{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:47:58Z","timestamp":1787892478518,"version":"build-2784847793"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Hedinger syndrome (HS) or carcinoid heart disease (CD) is a rare and challenging manifestation of malignant neuroendocrine tumours (NETs) involving the heart. We aimed to report our experience with surgical strategies and midterm results in HS patients. Methods: Eleven patients (58 \u00b1 11 (range 41 to 79 years); 5 females) with HS who underwent cardiac surgery in our department between 07\/2005 and 05\/2023 were analysed. Results: All patients showed a New York Heart Association (NYHA) class III\u2013IV and in all the tricuspid valve (TV) was involved. Four patients received a TV replacement, and three TV reconstruction. Recently, to preserve the geometry and function of the compromised right ventricle (RV), we have applied the TV \u201cbio-prosthesis in native-valve\u201d implantation technique with the preservation of the valve apparatus (tricuspid valve implantation: TVI) in four cases. Concomitant procedures included pulmonary valve replacement in four, pulmonary implantation in one, and aortic valve replacement in three cases. To treat RV failure, we adapted a combined TandemHeart\u00ae-CytoSorb\u00ae haemoperfusion strategy in Patient #10 and venoarterial extracorporeal membrane oxygenation (V-A ECMO) support avoidance, after experiencing an ECMO-induced carcinoid-storm-related death in Patient #8. Mortality at 30 days was 18% (2\/11). The median follow up was 2 \u00b1 2.1 years (range 1 month to 6 years) with an overall mortality during the follow-up period of 72.7% (8\/11). Conclusions: HS surgery, despite being a high-risk procedure, can efficiently prolong survival, and represents a safe and feasible procedure. However, patient selection seems to be crucial. Further follow up and larger cohorts are needed.<\/jats:p>","DOI":"10.3390\/jcdd10100413","type":"journal-article","created":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T04:28:08Z","timestamp":1696220888000},"page":"413","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Hedinger Syndrome\u2014Lessons Learnt: A Single-Center Experience"],"prefix":"10.3390","volume":"10","author":[{"given":"Mohamed","family":"El Gabry","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Centre, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1300-7327","authenticated-orcid":false,"given":"Sven","family":"Arends","sequence":"additional","affiliation":[{"name":"Department for Anesthesiology and Intensive Care Medicine, University of Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1638-0493","authenticated-orcid":false,"given":"Sharaf-Eldin","family":"Shehada","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Centre, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harald","family":"Lahner","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, University Hospitals Duisburg-Essen, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6608-8496","authenticated-orcid":false,"given":"Markus","family":"Kamler","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Centre, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Wendt","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Centre, 45147 Essen, Germany"},{"name":"CytoSorbents Europe GmbH, 12587 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8965-4702","authenticated-orcid":false,"given":"Konstantina","family":"Spetsotaki","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Cardiovascular Surgery, West-German Heart and Vascular Centre, 45147 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,1]]},"reference":[{"key":"ref_1","first-page":"e26528","article-title":"Hedinger Syndrome: A Rare Cardiac Manifestation of Carcinoid Syndrome","volume":"14","author":"Ghukasyan","year":"2022","journal-title":"Cureus"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1159\/000051851","article-title":"Biological and molecular aspects of gastroenteropancreatic neuroendocrine tumors","volume":"62","author":"Rindi","year":"2000","journal-title":"Digestion"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1530\/ERC-11-0013","article-title":"Classification and pathology of gastroenteropancreatic neuroendocrine neoplasms","volume":"18","year":"2011","journal-title":"Endocr. 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