Clinical Outcomes of Repeat Aortic Valve Replacement for Subaortic Pannus in Mechanical Aortic Valve.
BACKGROUND
This study aimed to evaluate the early and late clinical outcomes after repeat aortic valve replacement (AVR) for subaortic pannus in patients with mechanical valves. Methods and Results: Between 2001 and 2017, 51 patients (median age, 59 years; 42 women) with prosthetic aortic stenosis (AS) caused by pannus ingrowth underwent repeat AVR because of acute malfunction of monoleaflet valve (3 patients), severe prosthetic AS (30 patients), and moderate prosthetic AS at the time of tricuspid or mitral valve surgery (18 patients). The median follow-up duration was 100 (interquartile range, 64-138) months. Double valve replacement was performed in 45 (88%) patients. Median time interval from previous operation was 161 (interquartile range, 121-194) months. The explanted mechanical AV was monoleaflet and bileaflet in 16 (31%) and 34 (67%) patients, respectively. Concomitant procedures included 16 mitral valve replacements (14 repeat) and 36 tricuspid valve surgeries (15 replacements, 21 repairs). No hospital deaths or cases of heart block occurred. Overall survival and event-free survival rates at 10 years were 88% and 51%, respectively. Late complications included recurrent prosthetic AS (4 patients), new paravalvular leakage of the mitral valve (5 patients), and severe tricuspid regurgitation (2 patients).


CONCLUSIONS
Although repeat AVR for subaortic pannus had acceptable early and late survival, recurrent prosthetic AS was frequently observed during late follow-up.
['Park|Pyo Won|PW|', 'Park|Byungjoon|B|', 'Jeong|Dong Seop|DS|', 'Sung|Kiick|K|', 'Kim|Wook Sung|WS|', 'Lee|Young Tak|YT|', 'Park|Seung Woo|SW|']
D000368:Aged D001021:Aortic Valve D001024:Aortic Valve Stenosis D005260:Female D005500:Follow-Up Studies D019918:Heart Valve Prosthesis Implantation D006801:Humans D008297:Male D008875:Middle Aged D008943:Mitral Valve D011475:Prosthesis Failure D012086:Reoperation D013997:Time Factors D016896:Treatment Outcome D014261:Tricuspid Valve
Aortic valve Pannus Prosthesis Reoperation