Acute Severe Aortic Regurgitation from Catastrophic Pannus Obstruction in a Patient with Mechanical Aortic Valve Replacement

A 69-year-old woman with mechanical aortic valve presented with decompensated heart failure. Emergent echocardiogram and fluoroscopy demonstrated acute aortic regurgitation due to a dysfunctional mechanical aortic valve and non-obstructive coronary disease. An emergent valve replacement was performed confirming fixed-open valve with pathology demonstrating obstructive pannus formation without thrombosis or vegetation.