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Operation for anorexigen-associated valvular heart disease
J A Caccitolo1, H M Connolly, D S Rubenson
1Division of Cardiovascular Surgery and Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
The Journal of Thoracic and Cardiovascular Surgery
|October 3, 2001
Summary
Anorexigen medications like fenfluramine can cause severe heart valve disease, leading to regurgitation. Early surgical intervention, including valve repair, may be successful in affected patients.
Area of Science:
- Cardiology
- Pharmacology
- Cardiac Surgery
Background:
- Valvular regurgitation has been observed in patients using fenfluramine or dexfenfluramine, often with phentermine.
- This condition is termed anorexigen-associated valvular heart disease.
Purpose of the Study:
- To describe the clinical, echocardiographic, and pathologic findings of anorexigen-associated valvular heart disease.
- To report on surgical interventions for this condition.
Main Methods:
- Review of clinical information for 14 patients with severe anorexigen-associated valvular disease who underwent cardiac operations.
- Analysis of presenting symptoms, echocardiographic data, and surgical outcomes.
Main Results:
- 13 women received fenfluramine and phentermine; 1 received dexfenfluramine and phentermine.
- All patients had severe mitral regurgitation; 7 had aortic regurgitation, and 4 had tricuspid regurgitation.
- Pathology showed glistening white valves with plaque-like encasement and fibrosis.
Conclusions:
- Anorexigen use can cause severe multivalvular regurgitation with distinct findings.
- Early surgical repair may be feasible in younger patients with this drug-induced valvulopathy.
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