Absence of the tricuspid valve due to severe carcinoid heart disease.

from the right atrium (Figure 1B: MV, mitral valve; TV, tricuspid valve), from the right ventricle (Figure 1C), and lastly, a lateral view after offline subtraction of the anterolateral wall of the right ventricle (Figure 1D). The surgical analysis confirmed the 3D echocardiographic findings and additionally disclosed severe involvement of the subvalvular apparatus and endocardial deposit of pearly fibrous plaques, a characteristic of carcinoid heart disease (figure 2A and 2B: AL, anterior leaflet; PL: posterior leaflet; SL: septal leaflet). The patient underwent multivalvular surgery, with mitral repair, tricuspid valve and pulmonary valve replacement, and reconstruction of the right ventricular outflow tract. Funding: project funded by the Department of Cardiothoracic Surgery.