Key result
Surgical mitral pannus removal plus tricuspid annuloplasty improves hemodynamics without requiring valve replacement.
Why the study?
The indication for pannus removal in patients with mitral valve replacement has not been determined.
Does mitral valve pannus removal concomitant with tricuspid annuloplasty improve hemodynamic parameters in patients with prosthetic mitral valve pannus and tricuspid regurgitation?
Case Report (n=4)
No
Does mitral valve pannus removal concomitant with tricuspid annuloplasty improve hemodynamic parameters in patients with prosthetic mitral valve pannus and tricuspid regurgitation?
Surgical removal of pannus without prosthetic valve replacement, concomitant with tricuspid annuloplasty, is a feasible approach that improves hemodynamics in patients with prosthetic mitral valve pannus.
May support pannus removal without replacement in select prosthetic mitral cases; hypothesis-generating and needs prospective validation.
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.
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Song et al. (2023) conducted a case report in Pannus in prosthetic mitral valve with severe tricuspid regurgitation (n=4). Mitral valve pannus removal concomitant with tricuspid annuloplasty vs. Pre-operative baseline was evaluated on Hemodynamic parameters (transmitral pressure gradient and pulmonary artery systolic pressure). Surgical removal of pannus in the prosthetic mitral valve concomitant with tricuspid annuloplasty successfully improved hemodynamic parameters without requiring valve replacement.
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