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A simple solution to a difficult problem: mitral pannus removal using a minimal access approach
  1. David Rose,
  2. Palanikumar Saravanan,
  3. Joseph Zacharias
  1. Lancashire Cardiac Centre, Blackpool, Lancashire, UK
  1. Correspondence to Dr David Rose, Lancashire Cardiac Centre, Whinney Heys Road, Blackpool, Lancashire FY3 8NR, UK; davidrose{at}libero.it

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A 64-year-old woman had a mitral valve repair 10 years previously and subsequently had her mitral valve replaced for recurrence of severe mitral regurgitation with a 29-mm St Jude's bileaflet mechanical prosthesis at another institution 5 years ago. She presented to our department following a recent transient ischaemic attack and an echogenic lesion was picked up on the sewing ring of her mitral prosthesis (figure 1A, see online supplementary video 1).

Figure 1

(A) Transoesophageal echocardiography. White arrow shows the …

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