Hemodynamic Improvement after Surgical Intervention for Pannus in Prosthetic Mitral Valve

Abstract

The indication of pannus removal in patients with mitral valve (MV) replacement has not been determined. In the present study, four patients underwent secondary open cardiac surgery for MV pannus removal concomitant with tricuspid annuloplasty. After the first open cardiac surgery, these patients presented with gradual elevation in the transmitral pressure gradient (TMPG) and pulmonary artery systolic pressure (PASP) with aggravation of tricuspid regurgitation related to pannus formation in the prosthetic MV. Notably, the function of the prosthetic valve was normal in all patients. We performed tricuspid annuloplasty concomitant with pannus removal in the prosthetic MV alone. Pannus in the prosthetic MV was successfully removed without valve replacement, and improvement was noted in hemodynamic parameters, including TMPG and PASP after the operation. Herein, we share our experience and opinions about pannus removal in the prosthetic MV concomitant with tricuspid valve surgery.