Dissection in a right sided porcine-valved Dacron conduit

Seventeen years after corrective surgery for a double outlet right ventricl e and pulmonary stenosis, a 30-year-old patient was admitted for reoperatio n for a critical stenosis of a porcine-valved Dacron(R) conduit between the tight 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 sho wed 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. Patie nts with a right sided bioprosthetic valved conduit must be evaluated regul arly and operated before the stenosis becomes critical.