Hundertmark Fabian, Tomsic Anton, Owais Tamer, Girdauskas Evaldas
Department of Cardiothoracic Surgery, University Hospital Augsburg, Stenglinstraße 2, 86152 Augsburg, Germany.
Department of Cardiothoracic Surgery, Helios-University-Wuppertal, Arrenberger Straße 20, 42117 Wuppertal, Germany.
Eur Heart J Case Rep. 2025 Sep 23;9(9):ytaf440. doi: 10.1093/ehjcr/ytaf440. eCollection 2025 Sep.
Subaortic pannus formation (SAP) is a recognized complication following surgical aortic valve replacement (SAVR), typically manifesting around 5 years post-implantation. However, SAP occurrence after transcatheter aortic valve implantation (TAVI) remains poorly documented and investigated.
This case report presents a 79-year-old male who presented to our clinic with fatigue on exertion after having undergone TAVI with a 26-mm Edwards SAPIEN 3 valve 3 years prior to presentation. Echocardiography revealed elevated transprosthetic gradients, with no improvement after initiation of anticoagulation therapy. On cardiac tomography imaging, SAP was suspected. The patient underwent successful reoperative SAVR with concomitant mitral and tricuspid valve repair. Intraoperatively, severe pannus formation with subvalvular obstruction of the valve opening area was observed.
This case highlights the risk of early SAP formation following TAVI, underscoring the need for long-term follow-up and a more thorough understanding of the underlying pathophysiology.
主动脉瓣下赘生物形成（SAP）是外科主动脉瓣置换术（SAVR）后一种公认的并发症，通常在植入后约5年出现。然而，经导管主动脉瓣植入术（TAVI）后SAP的发生情况仍缺乏充分的文献记载和研究。
本病例报告介绍了一名79岁男性，在就诊前3年接受了26毫米爱德华 Sapien 3瓣膜的TAVI手术，因劳力性疲劳前来我院就诊。超声心动图显示人工瓣膜跨瓣压差升高，抗凝治疗开始后无改善。心脏断层扫描成像怀疑有SAP。患者接受了成功的再次手术SAVR，并同时进行了二尖瓣和三尖瓣修复。术中观察到严重的赘生物形成，瓣膜开口区域有瓣下梗阻。
本病例突出了TAVI后早期SAP形成的风险，强调了长期随访的必要性以及对潜在病理生理学进行更深入了解的重要性。
