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Acute Obstruction by Pannus in Patients With Aortic Medtronic-Hall Valves: 30 years of Experience  Vegard Skalstad Ellensen, MD, Knut Sverre Andersen,

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Presentation on theme: "Acute Obstruction by Pannus in Patients With Aortic Medtronic-Hall Valves: 30 years of Experience  Vegard Skalstad Ellensen, MD, Knut Sverre Andersen,"— Presentation transcript:

1 Acute Obstruction by Pannus in Patients With Aortic Medtronic-Hall Valves: 30 years of Experience 
Vegard Skalstad Ellensen, MD, Knut Sverre Andersen, MD, PhD, Nicola Vitale, MD, PhD, Einar Skulstad Davidsen, MD, PhD, Leidulf Segadal, MD, PhD, Rune Haaverstad, MD, PhD  The Annals of Thoracic Surgery  Volume 96, Issue 6, Pages (December 2013) DOI: /j.athoracsur Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Incidence of pannus obstruction from time of primary operation. Kaplan-Meier plot of freedom from valve obstruction caused by pannus after implantation of a Medtronic-Hall aortic valve. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 Distribution of valve sizes. Bars show the distribution of Medtronic-Hall aortic valve prostheses with pannus obstruction, stratified by size and sex. Diamonds represent the total number of implanted Medtronic-Hall aortic valves by size. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Typical ultrasound findings in obstructed Medtronic-Hall aortic valve prostheses. (A) Continuous wave Doppler registration through the mechanical aortic valve prosthesis shows an initial regurgitation between the two closing lines, and the disc is temporarily obstructed by pannus. The first closing line (1’) represents the initial, incomplete closure of the disc. The second closing line (2’) represents the complete closure. (B) Parasternal M-mode through mechanical aortic valve prosthesis, showing two-step closing movement. The horizontal transient between the two steps (arrow) depicts the position of the semiclosed disc. Both images are from the same patient. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Cinefluoroscopic view of obstructed Medtronic-Hall aortic valve prosthesis; the tilting disc of the Medtronic-Hall aortic valve blocked in an open (dashed, red line) or closed position. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Localization of pannus in obstructed Medtronic-Hall aortic valve prostheses. (A) The valve disc is blocked in an open position as a result of pannus (arrow) in the minor valve orifice. (B) Pannus obstructed the minor valve orifice in 100% of the cases, and in 63% the major orifice was affected as well. (LCA = left coronary artery; RCA = right coronary artery.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2013 The Society of Thoracic Surgeons Terms and Conditions

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