Takemoto S, Kumano H, Shimamura J, Shiose A. Pannus formation: a rare culprit of early bioprosthetic valve dysfunction-a case report.
Eur Heart J Case Rep 2024;
8:ytae518. [PMID:
39364357 PMCID:
PMC11448332 DOI:
10.1093/ehjcr/ytae518]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/12/2024] [Accepted: 09/13/2024] [Indexed: 10/05/2024]
Abstract
Background
Early bioprosthetic valve dysfunction (BVD) due to pannus formation is uncommon in elderly patients, and only a limited number of cases have been reported.
Case summary
An 84-year-old man presented with exertional dyspnoea 3 years after surgical aortic valve replacement (SAVR) with a 19 mm Epic™ valve (Abbott, Santa Clara, CA, USA). Transthoracic echocardiography demonstrated progressive BVD, and cardiac computed tomography (CT) revealed sub-aortic pannus formation. Re-operative SAVR was performed using a 19 mm INSPIRIS RESILIA® valve (Edwards Lifesciences, Irvine, CA, USA), and pathological examination confirmed valve leaflet deformation caused by pannus overgrowth. At the 18-month follow-up, the patient exhibited favourable progress, with no indications of BVD or pannus recurrence.
Discussion
This case highlights the importance of recognizing early pannus formation as a cause of BVD, even in elderly patients. Early detection of BVD based on clinical symptoms and echocardiography is vital to allow timely surgical intervention before the deterioration of cardiac function. Cardiac CT helps to differentiate pannus from thrombus formation and guide treatment decisions.
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