Late Repair of Native Pulmonary Valve for Severe Pulmonary Regurgitation After Transannular Patch Repair in Tetralogy of Fallot.

Despite advances in surgical repair of tetralogy of Fallot, long-term complications such as pulmonary regurgitation occur frequently. We present a case of a 10-year-old boy who underwent transannular repair of tetralogy of Fallot at 6 months of age. Chronic severe pulmonary regurgitation necessitated late primary repair of his pulmonary valve with resection of the transannular patch, improving his right ventricular function. Postoperative recovery was uneventful. This case underscores the importance of high-resolution preoperative imaging in guiding surgical management and timely intervention for complications after repair and highlights an alternative strategy to minimize the need for repeated valve replacements.