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Late-onset prosthetic aortic valve stenosis caused by pannus formation
Journal article   Open access   Peer reviewed

Late-onset prosthetic aortic valve stenosis caused by pannus formation

Nicholas Roma, Kashyap Shah, Ketul Patel, Joshua Elmer, Bruce Ferraro, Prarthana Patel and Michael Durkin
Journal of cardiology cases, v 29(3), pp 140-143
01 Mar 2024
DOI: https://doi.org/10.1016/j.jccase.2023.11.011
PMID: 38481647
url
https://doi.org/10.1016/j.jccase.2023.11.011View
Published, Version of Record (VoR) Open

Abstract

Aortic valve stenosis Pannus Transcatheter aortic valve replacement
Transcatheter aortic valve replacement (TAVR) is a less invasive alternative to an open surgical aortic valve replacement (SAVR) for treating severe symptomatic aortic stenosis. Despite gaining widespread acceptance and approval for use in patients with high, moderate, and low surgical risk, the increasing use of TAVR has raised concerns about potential short- and long-term complications. We present the case of a 69-year-old female who underwent TAVR and subsequently presented to our outpatient cardiology clinic with progressively worsening dyspnea, orthopnea, and paroxysmal nocturnal dyspnea two years after the procedure. Echocardiography and stress testing revealed a recurrence of aortic stenosis, leading to a diagnosis of structural valve deterioration. The patient was subsequently scheduled for SAVR, which revealed commissural fusion, scarring, and unusual pannus formation that significantly narrowed the effective valve area, necessitating valve replacement. Despite requiring SAVR, two years after TAVR, the patient had a favorable postoperative course and outcome on follow-up. This case underscores the importance of continued surveillance and evaluation of patients who undergo TAVR, as they remain at risk for long-term complications such as structural valve deterioration. Proper management, including timely diagnosis and intervention, can lead to successful outcomes in such patients. This case underscores the importance of continued surveillance and evaluation of patients who undergo transcatheter aortic valve replacement, as they remain at risk for long-term complications such as structural valve deterioration. Proper management, including timely diagnosis and intervention, can lead to successful outcomes in such patients.

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