Abstract
We report the morphological changes in a patient with combined pulmonary autograft and homograft dysfunction after 9 years of implantation. The case highlights long-term adaptive changes in the autograft to withstand systemic blood pressure with formation of exuberant pannus rich in elastic tissue. In the homograft, maturation of pannus had produced shortening of the 3 cusps with resultant incompetence.
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