Huge pannus formation on a mechanical bileaflet mitral valve prosthesis 23 years after a third operation on the mitral valve.

Supplementary material (Videos 1 and 2) is available at EJCTS online. Video 1: Transoesophageal echocardiography showing a blockade of one of the leaflets of the mitral valve prosthesis due to a giant pannus formation with a resulting stenosis and insufficiency. Video 2: Fluoroscopy of aortic valve (top) and mitral valve (bottom) prostheses. There is an almost normal motion amplitude of one leaflet of the mitral valve prosthesis, while the other leaflet is nearly completely immobilized. The aortic tilting disc prosthesis is functioning normally.