830 Surgical Management of a Patient with Triple Carcinoid Heart Valve Disease

Abstract Background Carcinoid heart disease is an uncommon manifestation of carcinoid syndrome that can present to a cardiac surgeon as complex constellation structural problems. Patients develop progressive valve disease, more commonly the right-sided valves but sometimes involving left, which will in turn impact function. Without intervention, portends dismal prognosis. Given rarity with these cases are encountered, conjunction their complexity, it important for be equipped knowledge how operate on patients and challenges likely faced. Case A 72-year-old man, who had previously undergone small bowel resection multifocal neuroendocrine tumours, was referred our centre significant symptomatic valvulopathy affecting tricuspid, mitral aortic valves. He successfully underwent triple replacement permanent epicardial pacing system implantation along coronary artery bypass grafting. discharged after inpatient stay two weeks well at follow-up. Discussion Triple infrequently performed UK, all centres ought prepared offer this treatment select group patients. In report we describe technicalities performing such operation relevant surgical anatomy, rationale technique pre-emptive implantation, both pre- post-operative management