The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform
Shigeaki Aoyagi - One of the best experts on this subject based on the ideXlab platform.
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Mitral Stenosis due to Pannus Overgrowth after Rigid Ring Annuloplasty
The Journal of heart valve disease, 2010Co-Authors: Takeshi Oda, Seiya Kato, Eiki Tayama, Shuji Fukunaga, Hidetoshi Akashi, Shigeaki AoyagiAbstract:Although mitral stenosis (MS) due to Pannus overgrowth after mitral valve repair for rheumatic mitral regurgitation (MR) is not uncommon, it is extremely rare in relation to non-rheumatic mitral regurgitation. Whilst it has been suggested that the rigid annuloplasty ring induces Pannus overgrowth in the same manner as the flexible ring, to date only in cases using the flexible ring has Pannus formation been confirmed by a pathological examination after redo surgery. The case is described of a woman who had undergone mitral valve repair using a 28 mm rigid ring three years previously because of non-rheumatic MR, and subsequently suffered from MS due to Pannus formation over the annuloplasty ring. To the present authors' knowledge, this is the first report of MS due to Pannus formation after mitral valve repair using a rigid annuloplasty ring to treat non-rheumatic MR documented at reoperation.
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Pannus overgrowth after mitral valve replacement with a Carpentier-Edwards pericardial bioprosthesis
Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs, 2009Co-Authors: Takeshi Oda, Seiya Kato, Eiki Tayama, Shuji Fukunaga, Hidetoshi Akashi, Shigeaki AoyagiAbstract:A Carpentier-Edwards pericardial (CEP) bioprosthesis was explanted from an 81-year-old woman due to nonstructural dysfunction 9 years after mitral valve replacement. The nonstructural dysfunction produced severe regurgitation in the mitral position. During the surgery, excessive Pannus overgrowth was seen on the left ventricular side of the CEP bioprosthesis. Pannus overgrowth was prominent on one leaflet. That leaflet was stiff and shortened due to the excessive overgrowth of Pannus. In this patient, the distortion of one leaflet was the main reason for transvalvular leakage of the CEP bioprosthesis in the mitral position. A new CEP bioprosthesis was implanted in the mitral position. Pathological analysis revealed fibrotic Pannus with a small amount of cellular material over the leaflets of the resected CEP valve. This change was marked on the distorted leaflet.
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Obstruction of St Jude Medical valves in the aortic position: histology and immunohistochemistry of Pannus.
The Journal of thoracic and cardiovascular surgery, 2003Co-Authors: Hideki Teshima, Eiki Tayama, Shuji Fukunaga, Hidetoshi Akashi, Nobuhiko Hayashida, Hirohisa Yano, Masaru Nishimi, Takemi Kawara, Shigeaki AoyagiAbstract:Abstract Objective This study aims to reveal the morphological, histological, and immunohistochemical mechanism of Pannus formation using resected Pannus tissue from patients with prosthetic valve dysfunction. Method Eleven patients with prosthetic valve (St Jude Medical valve) dysfunction in the aortic position who underwent reoperation were studied. We used specimens of resected Pannus for histological staining (hematoxylin and eosin, Grocott's, azan, elastica van Gieson) and immunohistochemical staining (transforming growth factor-beta, transforming growth factor-beta receptor 1, α-smooth muscle actin, desmin, epithelial membrane antigen, CD34, factor VIII, CD68KP1, matrix metalloproteinase-1, matrix metalloproteinase-3, and matrix metalloproteinase-9). Results Pannus without thrombus was observed at the periannulus of the left ventricular septal side; it extended into the pivot guard, interfering with the movement of the straight edge of the leaflet. The histological staining demonstrated that the specimens were mainly constituted with collagen and elastic fibrous tissue accompanied by endothelial cells, chronic inflammatory cells infiltration, and myofibroblasts. The immunohistochemical findings showed significant expression of transforming growth factor-beta, transforming growth factor-beta receptor 1, CD34, and factor VIII in the endothelial cells of the lumen layer; strong transforming growth factor-beta receptor 1, α-smooth muscle actin, desmin, and epithelial membrane antigen in the myofibroblasts of the media layer; and transforming growth factor-beta, transforming growth factor-beta receptor 1, and CD68KP1 in macrophages of the stump lesion. Conclusions Pannus appeared to originate in the neointima in the periannulus of the left ventricular septum. The structure of the Pannus consisted of myofibroblasts and an extracellular matrix such as collagen fiber. The Pannus formation after prosthetic valve replacement may be associated with a process of periannular tissue healing via the expression of transforming growth factor-beta.
Daewon Sohn - One of the best experts on this subject based on the ideXlab platform.
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real time 3d tee for diagnosis of subvalvular Pannus formation in mechanical aortic valves comparison with multidetector ct and surgical findings
Jacc-cardiovascular Imaging, 2015Co-Authors: Sahmin Lee, Seungpyo Lee, Eunah Park, Jihyun Kim, Hyungkwan Kim, Whal Lee, Yong Jin Kim, Mi Kyeong Hong, Daewon SohnAbstract:Subvalvular Pannus formation is a rare but clinically important complication that can be missed in patients with prosthetic valves [(1)][1]. The only definite treatment for patients with prosthetic valve obstruction as a result of Pannus ingrowth is reoperation. However, currently available
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abstract 13031 real time three dimensional transesophageal echocardiography for diagnosis of Pannus formation in mechanical aortic valves comparison with multi detector computed tomography and surgical findings
Circulation, 2014Co-Authors: Sahmin Lee, Seungpyo Lee, Eunah Park, Mikyung Hong, Jihyun Kim, Hanmo Yang, Hyungkwan Kim, Whal Lee, Yong Jin Kim, Daewon SohnAbstract:Introduction: Pannus formation is a rare but important complication that can be missed in patients with prosthetic valves. However, currently available methodologies are not sufficient to diagnose subvalvular Pannus formation especially in mechanical aortic valves. Hypothesis: In this study, we explored a series of experiences with three-dimensional transesophageal echocardiography (3D-TEE) for the visualization and accurate assessment of subvalvular Pannus in patients with mechanical aortic valve. Methods: We enrolled 11 patients (mean age 64±8.6 years, 10 patients with either double or triple valve replacement) who had previously implanted mechanical aortic valve, with transaortic mean pressure gradient >40mmHg or transaortic maximal velocity >4m/sec despite normal occluder motion. All patients underwent 3D-TEE examination to rule out Pannus formation and these findings were compared with multi-detector computed tomography (MDCT) images and/or surgical findings. Results: In 10 patients, 3D-TEE allowed good visualization of subaortic Pannus formation whereas there was no significant Pannus ingrowth in one patient. Through cropping full-volume 3D-TEE images, subaortic Pannus formation could be visualized well in en face view, which was confirmed by MDCT images. The 3D-TEE images of the Pannus were also matched with intraoperative findings in 7 patients undergoing reoperation of the mechanical aortic valve (Figure). Quantitative measurement of geometric subvalvular area using 3D planimetry was feasible and correlated well with the area measured by MDCT and with transaortic mean pressure gradient on transthoracic echocardiography (Spearman’s ρ=0.761 and -0.726, all p-value<0.05). Conclusions: Real-time 3D-TEE is a useful diagnostic tool for the anatomical assessment of subvalvular Pannus formation in mechanical aortic valves. ![][1] [1]: /embed/graphic-1.gif
A R Cabral - One of the best experts on this subject based on the ideXlab platform.
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osteoarthritis and rheumatoid arthritis Pannus have similar qualitative metabolic characteristics and pro inflammatory cytokine response
Clinical and Experimental Rheumatology, 2008Co-Authors: J Furuzawacarballeda, P M Maciprodriguez, A R CabralAbstract:ObjectivePannus in osteoarthritis (OA) has only recently been characterized. Little is known, however, regarding the behavior of OA Pannus in vitro compared to rheumatoid arthritis (RA) Pannus. The purpose of our study was to compare OA with RA Pannus.MethodsPannus and synovial tissue co-cultures from 5 patients with OA and 5 patients with RA obtained during arthroplasty were studied. Pannus was defi ned as the microscopic invasive granulation tissue covering the articular surface. Tissues were cultured for 7 days and stained with Alcian Blue technique. Interleukin-1β (IL-1(IL-1β), IL-8, IL-10, IL-12, tumor necrosis ), IL-8, IL-10, IL-12, tumor necrosis factor-α (TNF-(TNF-α), and interferon gamma (IFN-), and interferon gamma (IFN-γ) were also determined in supernatants by ELISA. Cartilage oligomeric ) were also determined in supernatants by ELISA. Cartilage oligomeric matrix protein (COMP), type II collagen, TNF-α, IL-10 and Ki-67 expression were also detected by immunohistochemistry., IL-10 and Ki-67 expression were also detected by immunohistochemistry.ResultsAll patients had vascular or fi brous Pannus. Synovial proliferation, infl ammatory infi ltrates and a decrease of extracellularmatrix proteins were observed in all tissue samples. Chondrocyte proliferation was lower in OA than RA cartilage. OA synovial tissue expressed lower levels of proteoglycans than RA synoyium. Type II collagen levels were lower in OA than in RA cartilage. Signifi cantly higher levels of IL-1β were found in the supernatants of RA Pannus compared to OA Pannus were found in the supernatants of RA Pannus compared to OA Pannus (p<0.05). High but similar levels of TNF-α, IL-8 and TIMP-1 were detected in OA and RA Pannus supernatants. , IL-8 and TIMP-1 were detected in OA and RA Pannus supernatants. IL-10, IL-12 and IFN-γ were undetectable.were undetectable.ConclusionRA and OA Pannus had similar pro-infl ammatory and anti-infl ammatory cytokine profi le expression. OA cartilage, synovial tissue and Pannus had lower production of proteoglycans, type II collagen and IL-1β. It remains to be elucidated why OA . It remains to be elucidated why OA Pannus invades the cartilage surface but does not cause the marginal erosions typically seen in RA.Key wordsOsteoarthritis, rheumatoid arthritis, Pannus, synovial tissue, cartilage, cytokines.
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Osteoarthritis and rheumatoid arthritis Pannus have similar qualitative metabolic characteristics and pro-inflammatory cytokine response.
Clinical and experimental rheumatology, 2008Co-Authors: J Furuzawa-carballeda, P M Macip-rodríguez, A R CabralAbstract:ObjectivePannus in osteoarthritis (OA) has only recently been characterized. Little is known, however, regarding the behavior of OA Pannus in vitro compared to rheumatoid arthritis (RA) Pannus. The purpose of our study was to compare OA with RA Pannus.MethodsPannus and synovial tissue co-cultures from 5 patients with OA and 5 patients with RA obtained during arthroplasty were studied. Pannus was defi ned as the microscopic invasive granulation tissue covering the articular surface. Tissues were cultured for 7 days and stained with Alcian Blue technique. Interleukin-1β (IL-1(IL-1β), IL-8, IL-10, IL-12, tumor necrosis ), IL-8, IL-10, IL-12, tumor necrosis factor-α (TNF-(TNF-α), and interferon gamma (IFN-), and interferon gamma (IFN-γ) were also determined in supernatants by ELISA. Cartilage oligomeric ) were also determined in supernatants by ELISA. Cartilage oligomeric matrix protein (COMP), type II collagen, TNF-α, IL-10 and Ki-67 expression were also detected by immunohistochemistry., IL-10 and Ki-67 expression were also detected by immunohistochemistry.ResultsAll patients had vascular or fi brous Pannus. Synovial proliferation, infl ammatory infi ltrates and a decrease of extracellularmatrix proteins were observed in all tissue samples. Chondrocyte proliferation was lower in OA than RA cartilage. OA synovial tissue expressed lower levels of proteoglycans than RA synoyium. Type II collagen levels were lower in OA than in RA cartilage. Signifi cantly higher levels of IL-1β were found in the supernatants of RA Pannus compared to OA Pannus were found in the supernatants of RA Pannus compared to OA Pannus (p
Pyo Won Park - One of the best experts on this subject based on the ideXlab platform.
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Repair for mitral stenosis due to Pannus formation after Duran ring annuloplasty.
The Annals of thoracic surgery, 2010Co-Authors: Seunghwan Song, Seong Ho Cho, Ji-hyuk Yang, Pyo Won ParkAbstract:Mitral stenosis after mitral repair with using an annuloplasty ring is not common and it is almost always due to Pannus formation. Mitral valve replacement was required in most of the previous cases of Pannus covering the mitral valve leaflet, which could not be stripped off without damaging the valve leaflets. In two cases, we removed the previous annuloplasty ring and Pannus without leaflet injury, and we successfully repaired the mitral valve. During the follow-up of 4 months and 39 months respectively, we observed improvement of the patients' symptoms and good valvular function. Redo mitral repair may be a possible method for treating mitral stenosis due to Pannus formation after ring annuloplasty.
Sahmin Lee - One of the best experts on this subject based on the ideXlab platform.
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real time 3d tee for diagnosis of subvalvular Pannus formation in mechanical aortic valves comparison with multidetector ct and surgical findings
Jacc-cardiovascular Imaging, 2015Co-Authors: Sahmin Lee, Seungpyo Lee, Eunah Park, Jihyun Kim, Hyungkwan Kim, Whal Lee, Yong Jin Kim, Mi Kyeong Hong, Daewon SohnAbstract:Subvalvular Pannus formation is a rare but clinically important complication that can be missed in patients with prosthetic valves [(1)][1]. The only definite treatment for patients with prosthetic valve obstruction as a result of Pannus ingrowth is reoperation. However, currently available
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abstract 13031 real time three dimensional transesophageal echocardiography for diagnosis of Pannus formation in mechanical aortic valves comparison with multi detector computed tomography and surgical findings
Circulation, 2014Co-Authors: Sahmin Lee, Seungpyo Lee, Eunah Park, Mikyung Hong, Jihyun Kim, Hanmo Yang, Hyungkwan Kim, Whal Lee, Yong Jin Kim, Daewon SohnAbstract:Introduction: Pannus formation is a rare but important complication that can be missed in patients with prosthetic valves. However, currently available methodologies are not sufficient to diagnose subvalvular Pannus formation especially in mechanical aortic valves. Hypothesis: In this study, we explored a series of experiences with three-dimensional transesophageal echocardiography (3D-TEE) for the visualization and accurate assessment of subvalvular Pannus in patients with mechanical aortic valve. Methods: We enrolled 11 patients (mean age 64±8.6 years, 10 patients with either double or triple valve replacement) who had previously implanted mechanical aortic valve, with transaortic mean pressure gradient >40mmHg or transaortic maximal velocity >4m/sec despite normal occluder motion. All patients underwent 3D-TEE examination to rule out Pannus formation and these findings were compared with multi-detector computed tomography (MDCT) images and/or surgical findings. Results: In 10 patients, 3D-TEE allowed good visualization of subaortic Pannus formation whereas there was no significant Pannus ingrowth in one patient. Through cropping full-volume 3D-TEE images, subaortic Pannus formation could be visualized well in en face view, which was confirmed by MDCT images. The 3D-TEE images of the Pannus were also matched with intraoperative findings in 7 patients undergoing reoperation of the mechanical aortic valve (Figure). Quantitative measurement of geometric subvalvular area using 3D planimetry was feasible and correlated well with the area measured by MDCT and with transaortic mean pressure gradient on transthoracic echocardiography (Spearman’s ρ=0.761 and -0.726, all p-value<0.05). Conclusions: Real-time 3D-TEE is a useful diagnostic tool for the anatomical assessment of subvalvular Pannus formation in mechanical aortic valves. ![][1] [1]: /embed/graphic-1.gif
