Long-term effects of prosthetic materials.

The surgical repair of the various types of congenital cardiac defects often requires the use of prosthetic materials, both bioprosthetic and synthetic. Patches have proved highly effective in many applications and locations. All prosthetic valves have significant limitations, and particularly disappointing was the observation that bioprosthetic valves undergo accelerated degeneration in younger patients. The extracardiac conduit allowed corrective operation for several complex types of anomalies, but it suffers the double jeopardy of premature degeneration of its integral tissue valve (if any), and progressive peel formation within its lumen. A threat of infection exists in the presence of prosthetic materials, especially valves. These known limitations of prosthetic devices as well as possible potential late complications not yet fully elucidated are sufficient indication for periodic, perpetual surveillance of patients who have received cardiac prostheses.