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A Journal on Surgery

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Chirurgia 2011 February;24(1):29-31

language: English

Double valve reconstruction due to severe regurgitation caused by cabergoline treatment for Parkinson’s disease

Rubio Á., Harig F., Weyand M.

Department of Cardiac Surgery, Erlangen University Hospital, Erlangen, Germany


Commonly used drugs for the treatment of Parkinson’s disease such as ergot alkaloids can cause progressive cardiac and non-cardiac fibrotic reactions like valve fibrosis, constrictive pericarditis, and pleuropulmonary fibrosis. Examples of such drugs are cabergoline, bromocriptine, pergolide, lisuride, and the antimigraine drug methysergide. Agonists of 5-HT2B serotonin receptors produce structural changes in heart valves that result in regurgitation. Cabergoline has high affinity for the 5-HT2B serotonin receptors, which are expressed in heart valves and might mediate mitogenesis and, therefore, the proliferation of fibroblasts. We report the case of a 56-year-old man presented with a 2 week history of increasing dyspnoea and moderate oedema of both legs. Parkinson’s disease had been diagnosed seven years previously and treated with cabergoline 4 mg daily for seven years. Aortic and mitral valve regurgitation were confirmed at intraoperative echocardiogram. The valves showed fibrotic reactions consisting of moderate retraction and light stiffening, resulting in incomplete leaflet coaptation and consecutive regurgitation. Therefore double valve reconstruction based on improving the leaflet coaptation was performed. An annuloplasty ring in mitral position was implated additionally.

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