[HSF] Pannus Formation

[Nasser F. Abou'Seada]

Oh Dear God ... I should celebrate ... 

NFA

> From: hgrmd at aol.com
> Nasser,
>   I would agree with your observations as well as your surgical policies
for this entity.
> Frankly, I recall only having to operate only a couple of aortic cases for
pannus
> formation.
> Hal
> 
> 
> -----Original Message-----
> From: nfaabouseada at gmail.com
> To: OpenHeart-L at lists.hsforum.com
> Sent: Mon, 16 Oct 2006 4:53 AM
> Subject: RE: [HSF] Pannus Formation
> 
> 
> Dear Hal
> I would be very reluctant to ascribe pannus formation for poor
> anticoagulation as a prime variable ..... frank clotting would have been
the
> result then .... also ... Pannus is formed on the UNDER SURFACE of the
valve
> .... ventricular surface of a mitral prosthesis ... and Aortic Prosthesis
> .... whereas clots are usually starting on the other valve surface -atrial
> surface of a mitral prosthesis .... and aortic surface of an aortic
> prosthesis  !!! - ...
> In the combined cases that I've seen, pannus has always been there on the
> Ventricular surface of the Aortic prosthesis ..... with / without clot
> formation on the atrial surface of the mitral prosthesis .... pannus
> formation on the ventricular surface of the mitral prosthesis has been
> observed as well .......
> 
> NFA
> 
> > From: hgrmd at aol.com
> > Bob,
> >   I've never heard a good explanation for the cause of pannus.  Is the
> majority of it
> > due to poor anticoagulation?  I recall having had to explant a few
porcine
> mitrals that
> > had subvalvular pannus around the struts causing stenosis.  Obviously,
> none of these
> > were on coumadin.  Should they have been?  I would agree with your
general
> > recommendation to "start over".  However, I also understand Prasanna's
> approach
> > given the different financial conditions under which he operates.
> > Hal
> >
> >
> > -----Original Message-----
> > From: Rwmfglycar at aol.com
> > To: OpenHeart-L at lists.hsforum.com
> > Sent: Mon, 16 Oct 2006 1:33 AM
> > Subject: Re: [HSF] redo double valve
> >
> >
> > For whatever reason I saw very few absolutely pure pannus cases. If the
> > pannus is the consequence of poorly controlled AC with thrombus, fibrous
> > organisation of thrombus, further thrombus etc. then it is obviously
> better to
> > start
> > all over again with an absolutely bare valve or even switch to  a
> > bioprosthesis in some cases. Another problem is that patients who are
> > unreliable about AC
> > are also those who are unreliable about follow up so one  never is quite
> sure
> > whether the choice one made had a good outcome or not.
> > Bobhn
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