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Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
Published on: December 11, 2017
Aortic prosthesis re-replacement due to concealed stenosing subvalvular pannus ring
M Emmert1, T Kofidis, V Didilis
1Division of Thoracic and Cardiovascular Surgery, Hannover Medical School, Hannover, Germany.
The Thoracic and Cardiovascular Surgeon
|July 17, 2007
Summary
A pannus ring causing a high transvalvular gradient in a mechanical aortic valve prosthesis was identified 16 years post-procedure. Early surgical intervention is recommended for symptomatic patients with unclear prosthetic valve dysfunction.
Area of Science:
- Cardiovascular Surgery
- Cardiac Pathology
- Prosthetic Valve Dysfunction
Background:
- Mechanical aortic valve prostheses are common for treating aortic valve disease.
- Long-term complications can include prosthetic valve dysfunction.
- Pannus formation is a known, though less common, complication.
Purpose of the Study:
- To describe a case of significant pannus formation causing stenosis in a mechanical aortic valve prosthesis.
- To highlight the diagnostic challenges in cases of unclear transvalvular gradients.
- To emphasize the importance of considering pannus as a differential diagnosis.
Main Methods:
- Case report of a patient with a mechanical aortic valve prosthesis.
- Clinical presentation of a high transvalvular gradient 16 years post-implantation.
- Intraoperative findings and surgical intervention.
Main Results:
- A high transvalvular gradient was detected 16 years after mechanical aortic valve prosthesis implantation.
- Echocardiography did not reveal clear signs of the cause.
- Intraoperative findings confirmed a stenosing pannus ring, which was excised.
Conclusions:
- Pannus formation should be considered in patients with mechanical aortic valves presenting with unexplained high transvalvular gradients.
- Early surgical intervention is advised for symptomatic patients with pannus-related prosthetic valve dysfunction.
- This pathological entity requires consideration in the differential diagnosis of prosthetic valve stenosis.
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