Contents
Download PDF
pdf Download XML
156328 Views
27625 Downloads
Share this article
Review Article | Volume 25 Issue 1 (, 2019) | Pages 104 - 111
Histopathological and Immunohistochemical Evaluation of Pannus Tissue in Patients with Prosthetic Valve Dysfunction
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
 ,
1
Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul.
2
Department of Pathology, Dr. Lutfi Kırdar Kartal Training and Research Hospital, Istanbul.
3
Department of Cardiovascular Surgery, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
Under a Creative Commons license
PMID : -27989094
Published
Jan. 12, 2016
Abstract

Background: Prosthetic valve dysfunction due to pannus formation is a rare but serious complication. Currently, limited data are available concerning the pathogenesis and immunohistochemical properties of pannus. The study aim was to investigate the morphological, histopathological and immunohistochemical characteristics of pannus formation in patients with prosthetic valve dysfunction.

Methods: A total of 35 patients (10 males, 25 females; mean age 44 ± 16 years) who had undergone re-do valve surgery due to prosthetic valve obstruction was enrolled in the study. Immunohistochemical studies were aimed at evaluating the expression of alphasmooth muscle actin (α-SMA) and desmin in myofibroblasts and smooth muscle cells; epithelial membrane antigen (EMA) in epithelial cells; and CD34, Factor VIII and vascular endothelial growth factor (VEGF) in endothelial cells. Matrix metalloproteinases (MMPs) -2 and -9, and transforming growth factor-beta (TGF-β) were used to demonstrate cytokine release from macrophages, leukocytes, fibroblasts and myofibroblasts.

Results: Pannus appeared as a tough and thick tissue hyperplasia which began from outside the suture ring in the periannular region and extended to the inflow and outflow surfaces of the prosthetic valves. Histopathological analysis showed the pannus tissue to consist of chronic inflammatory cells (lymphocytes, plasma cells, macrophages and foreign body giant cells), spindle cells such as myofibroblasts, capillary blood vessels and endothelial cells laying down the lumens. Calcification was present in the pannus tissue of 19 explanted prostheses. Immunohistochemical studies revealed positive α-SMA expression in all patients, whereas 60.5% of patients were positive for desmin, 50% for EMA, 42.1% for VEGF, 39.5% for TBF-β, 42.1% for MMP-2, 86.8% for CD34, and 97.4% for Factor VIII. MMP-9 was negative in all patients.

Conclusions: Pannus tissue appears to be formed as the result of a neointimal response in periannular regions of prosthetic valves that consist of periannular tissue migration, myofibroblast and extracellular matrix proliferation with vascular components. It is a chronic active process in which mediators such as TGF-β, VEGF and MMP-2 play roles in both matrix formation and degradation.

 

 

How to cite: Karakoyun, S., Ozan Gürsoy, M., Yesin, M., Kalçık, M., Astarcıoğlu, M. A., Gündüz, S., Emrah Oğuz, A., Çoban Kökten, Ş., Nimet Karadayı, A., Tuncer, A., Köksal, C., Gökdeniz, T., & Özkan, M. (2016). Histopathological and Immunohistochemical Evaluation of Pannus Tissue in Patients with Prosthetic Valve Dysfunction. The Journal of heart valve disease25(1), 104–111.

 
Keywords
Recommended Articles
Research Article
Cross Sectional Study on Nutritional Status and Prevalence of Anemia in Rural Adolescents
Published: 26/06/2013
Download PDF
Read Article
Research Article
To Study the Serum Homocysteine Profile Pattern in AMI & Ischaemic Stroke in Young Adults.
...
Published: 30/08/2025
Download PDF
Read Article
Research Article
Incidence, Clinical Profile, Complications and Outcome of Rodenticide Poisoning in Tertiary Care Hospital
...
Published: 26/08/2025
Download PDF
Read Article
Research Article
To Find Out of the Effects of Mother Nutrition Status on Birth Weight, Anthropometric Measurements of Full-Term Newborn
Published: 07/11/2022
Download PDF
Read Article
© Copyright Journal of Heart Valve Disease