Native Pulmonary Valve Restoration Late Following Transannular Patch Repair of Tetralogy of Fallot.

We present a surgical case of native pulmonary valve (PV) restoration in a 16-year-old boy with a previous history of transannular patch repair of tetralogy of Fallot in infancy. The PV was restored by approximation of split anterior commissure in the presence of developed and pliable leaflets well preserved after initial surgery. Postoperative echocardiogram showed a competent valve with peak velocity of 2.8 m/s. At six-week follow-up, the patient remained well, and echocardiogram demonstrated a competent PV with decreased velocity of 2.1 m/s across it. We encourage a mindful preservation of PV leaflets whenever it is possible at time of initial repair to implement this relatively easy operation to restore PV function later in life.