Valvular pannus is a rare cause of obstructive prosthesis, about which few data exist in the literature. Its diagnostic may therefore be difficult.

Analyze the characteristics of patients who underwent reoperation for obstructive aortic, reintervention delay, types of prosthesis involved, current diagnostic strategies and their evolution over the last decade.

Retrospective multicentric French study, which included all the patients reoperated for obstructive aortic pannus.

Between 2006 and 2016, 71 consecutive patients were included in 3 surgical French centers. Mean age was 62 years, and 2/3 were women. Most of pannus appeared on mechanical prosthesis (82%) with mean intervention delay of 16 years. Mean reintervention delay was significantly shorter in patients with bioprosthesis (8.1 vs. 18.2 years, P<0.0001). On the 4 tests available for the diagnostic of valvular pannus (transthoracic and trans-esophageal echocardiography, CT scan and fluoroscopy for mechanical prosthesis), CT scan was the most sensitive (50%) but also the less frequently practiced (25%). Over time, we see a clear increase in the use of CT scan for the diagnostic of pannus, this entity being more and more renown (Fig. 1).

Pannus occurs mostly on mechanical prosthesis, in a female population in majority. Reintervention delay is significantly shorter with bioprothesis. CT scan is the most sensitive exam to detect it, and should be practiced in all cases of obstructive prosthesis without evident diagnostic in stable patients.