Pulmonary cusp and annular extension technique for reconstruction of right ventricular outflow in tetralogy of Fallot.

An alternative pulmonary valve-sparing technique for primary repair of tetralogy of Fallot is presented. Reconstruction of the right ventricular outflow tract was accomplished by augmentation of the anterior facing pulmonary cusp, the pulmonary annulus, and the main pulmonary artery using a single autologous pericardial patch. This valve-sparing technique preserves the coaptation and suspension mechanisms of the native pulmonary cusp and therefore may minimize pulmonary insufficiency in the long term.