The reconstruction of the right ventricular outflow tract (RVOT) remains a palliative surgery consideration in selected patients. Further understanding the RVOT dysfunction and the effects following device implantation is an important area of current research. An RVOT Elan prosthesis was harvested 2 years after implantation in a 12-year-old boy and examined using both nondestructive analyses (X-ray and micro-CT scanning) and destructive methods (histology for leaflet analyses and textile analyses for the fabric). The explanted device appeared to be slightly shrunken and longitudinally guttered in its noncrimped section. The closure of the valve was therefore mildly impaired, and the coaptation of the three leaflets was disputable but they were still soft. Some fibrous proliferations with spots of mineralization together with vegetation of the connective tissue incorporating bacteremic colonizations were observed internally along the fixation annulus. Fractures were observed in collagen filaments. The textile structure did not show abrasions, fractures, or chemical degradation. The RVOT device performed adequately for the two years in vivo. The presence of vegetation with a bacteremic colonization together with the degenerative process of collagen supported the clinical indications for reoperation.