HEART-VALVE OPERATION IN ACROMEGALY

Background. Intractable congestive heart failure is known as a serious complication of acromegaly, but valvular heart disease rarely occurs in acromegalic patients. We experienced 5 surgical cases of valvular h eart disease associated with acromegaly. We describe the features of t hose cases in this report. Methods. The patient characteristics and op erative and pathologic findings were retrospectively studied. Results. There were 4 men and 1 woman. Age at operation was 59 +/- 5.5 years. Cardiac lesions consisted of 1 case of aortic regurgitation associated with mitral regurgitation, 1 of aortic regurgitation, and 3 of mitral regurgitation. Operative procedures consisted of 1 double valve repla cement (aortic and mitral valve replacement), 1 aortic valve replaceme nt, and 3 mitral valve replacements. The causes of aortic valvular reg urgitation were aortic valvular degeneration and aortic annular dilata tion. The causes of mitral regurgitation were chordal rupture and mitr al valvular degeneration. Histopathologic examination of the excised v alves showed mucopolysaccharide deposits and myxomatous degeneration o f the leaflets. The myocardium showed fibrosis of interstitial spaces and endocardium, and disarrangement of muscle fibers. Conclusions. We report 5 successful surgical cases of valvular heart disease associate d with acromegaly. Earlier operation is recommended for such cases bec ause of acromegalic cardiomyopathy. (C) 1997 by The Society of Thoraci c Surgeons.