Dissection in a right sided porcine-valved Dacron conduit

Seventeen years after corrective surgery for a double outlet right ventricle and pulmonary stenosis, a 30-year-old patient was admitted for reoperation for a critical stenosis of a porcine-valved Dacron conduit between the right ventricle and pulmonary artery. A residual ventricular septal defect was present. Induction of anaesthesia resulted in an inadequate pulmonary flow and uncontrollable ventricular arrhythmias. At autopsy the conduit showed a dissection between the conduit wall and the peel formation, leaving a residual lumen with a diameter of less than a third of the original. Patients with a right sided bioprosthetic valved conduit must be evaluated regularly and operated before the stenosis becomes critical.