Obstruction of St. Jude medical valves in the aortic position: plasma transforming growth factor type beta 1 in patients with pannus overgrowth.

The study investigated the hypothesis that plasma transforming growth factor type beta 1 (TGF-beta1) initiated pannus overgrowth in cases with aortic prosthetic valve dysfunction (PVD). Patients with obstruction of an aortic St. Jude Medical valve in 26 cases (PVD group) and without obstruction in 48 cases (control group) were studied. Plasma TGF-beta1, the intensity of the prothrombin time-international normalized ratio (PT-INR), and the interruption of an oral anticoagulant medicine were conducted. Plasma TGF-beta1 levels in the PVD group (87.7 +/- 29.2 ng/mL) were significantly higher (P < 0.05) than in the control group (73.7 +/- 25.2 ng/mL). The interruption of an oral anticoagulant medicine in 54% of the PVD group versus 12% of the control group was identified (P < 0.001). The mean value of the PT-INR in the PVD group (1.75 +/- 0.30) and control group (1.75 +/- 0.30) was not significantly different (P = 0.82). In conclusion, elevated levels of plasma TGF-beta1 may play a role in pannus overgrowth.