Annular and leaflet augmentation in Noonan's syndrome with dysplastic pulmonary valve.

Two patients with dysplastic pulmonary valves associated with Noonan's syndrome successfully underwent leaflet augmentation with pericardial membrane and annular enlargement with preservation of valve competence. Both patients are doing well at 36 and 37 months, respectively, postoperatively. Echocardiography and clinical assessment showed gradients of 12 and 16 mmHg, respectively, and negligible pulmonary valve insufficiency. The surgical technique is simple and provides an attractive alternative in patients with dysplastic pulmonary valve and small pulmonary orifice and annulus.