A 39-year-old lady presented in early 2011 with Carcinoid syndrome due to Ileal Carcinoid with liver metastases and Carcinoid valvular heart disease with Right heart failure. Liver resection combined with ethanol injection of Liver metastases was carried out after reduction of Central Venous Pressure by an initial Tricuspid valve replacement (TVR), in a staged manner, with resolution of symptoms. This case highlights the necessity of TVR prior to major Liver resection for Liver metastases in Carcinoid heart disease with Tricuspid regurgitation as well as the value of treating Carcinoid heart disease aggressively.
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