Purpose Carcinoid Heart Disease (CaHD) or Hedinger syndrome is the paraneoplastic effect of Neuroendocrine Tumour (NET), formerly known as carcinoid tumour. This study aimed to analyse patient outcomes after valve surgery for CaHD during a 20-year period in our institution to investigate opportunities for improved patient care. Methodology 13 patients who had cardiac surgery in The Prince Charles Hospital for CaHD between 2003 and 2023 were included in this retrospective observational study. We collected data regarding surgery, NET management, intensive care unit stay, echocardiography and survival. Results Tricuspid valve replacement was required for all patients, 7 had pulmonary valve operated, and none required aortic or mitral valvular surgery. 7 patients (53.8%) had bioprosthetic prostheses and the rest had mechanical valve(s). PFO closure was required for 3 patients. Octreotide infusion commencement 24 hours before surgery became standard practice in 2020. 2 patients required a pacemaker for complete heart block. There was 1 perioperative death, in which the patient was severely symptomatic from carcinoid syndrome. 8 patients had passed away with median survival being 2 years and 8 months. The longest survival is 14 years 5 months and counting, which is the only case without liver metastasis and the origin of NET being the right ovary. NYHA improvement rate was 90.9% (10/11) at one-year follow-up. The right ventricular (RV) remodelling rate at one year was 87.5%, while 37.5% demonstrated improved RV systolic function. Conclusion CaHD is a rare disease. Significant symptomatic and survival benefits can be achieved with surgery. The risk of peri-operative mortality is notable but it can be minimised by pre-operative optimisation of carcinoid disease management and peri-operative care by an experienced multidisciplinary team.