Long-Term Incidence and Risk Factors of Subaortic Pannus Overgrowth After Bileaflet Mechanical Aortic Valve Replacement

Subaortic pannus overgrowth is a late complication after bileaflet mechanical AVR, with a gradually increasing incidence. Female sex, smaller prosthesis size, younger age, and concomitant mitral valve replacement are significant risk factors. Complete pannus removal and valve replacement should be considered during reoperation. Further research into the underlying mechanisms is warranted for prevention strategies.