Tricuspid and pulmonary valve involvement in carcinoid disease

We report the case of a 62-year-old woman in whom carcinoid disease had bee n diagnosed 6 years earlier. She subsequently developed tricuspid and pulmo nary valve dis ease. Both valves were incompetent and mildly stenotic. The tricuspid valve required surgery; the pulmonary valve was explored but not treated. Valve surgery in patients with carcinoid disease is discussed in light of t he prognosis of these patients, the timing of valvular lesion presentation, and he choice of prosthesis. The justification for multiple-valve procedur es in such cases is also considered.