Post-mortem analysis of intracardiac repair for tetralogy of Fallot demonstrates excellent incorporation of Dacron patches but highlights potential long-term complications like pericardial patch dilatation.
Two adult patients with tetralogy of Fallot died in accidents 18 and 28 months, respectively, after corrective operations. Anatomical and histological studies of their hearts showed the Dacron patches used for repairing the ventricular septal defect to be securely incorporated into the ventricular septum and evenly coated by connective tissue, endothelium, and even elastic fiber formation. A similar connective tissue reaction had covered the right ventricular outflow tract in the areas of infundibular resection. One of the patients, whose defect had necessitated extensive remodeling of the pulmonary outflow tract, showed aneurysmal dilatation of the proximal pericardial bolster. The aortic homograft with its retained valve was well preserved, but distortion and incompetence of one leaflet had resulted from dilatation of the adjacent pericardial patch.
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Ceballos et al. (1973) studied this question.
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