Q: My father, 61 years old, had an aortic valve replacement (AVR) and bypass surgery done eight years back. Now, Echocardiography shows pannus formation on the mechanical AV. The effective orifice area (EOA) of AV was 0.7 cm2 and gradients were 108 mmHg /60 mmHg (mean). One leaflet was showing restricted motion. Is a repeat surgery recommended?

A:The answer to your question is a very categorical - Yes, unless and until, it is a sudden onset clot formation, which some times may respond to clot dissolving medical treatment (thrombolytic therapy). In general terms however, pannus is mainly composed of scar tissue, which cannot be dissolved and specially if it is producing restricted motion of one leaflet, then I am afraid, you will have to go in for redo valve replacement. I hope we have answered your queries to your satisfaction, but if you have any other, please feel free to contact us and it shall be our pleasure to answer them.