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(A) A 40-year-old woman with a bileaflet mechanical mitral prosthesis which was implanted 3 years ago, presented with progressive dyspnoea during the last 6 months. Prosthetic mitral valve mean gradient was increased and transoesophageal echocardiogram showed an echodense mass on the prosthesis consistent with pannus. (B) Surgical specimen, the pannus on the atrial surface of the mitral prosthesis
Arrow, pannus; arrowheads, the two hemidiscs. LA, left atrium; LV, left ventricle.
