The use of the right atrial free wall for reconstruction of the outflow tract in a patient with Fallot's tetralogy: a case report.

We report the use of the lateral wall of the right atrium, as a free graft, for the reconstruction of the narrow outflow tract in a patient with Fallot's tetralogy. Pericardium was used for closure of the ventricular septal defect, widening of the narrow pulmonary trunk and reconstruction of the right atrium. Postoperative echocardiographic studies showed cyclic shortening of the transplanted atrial tissue, a 40% increase in right ventricular ejection fraction and preserved (e) and (a) waves denoting normal blood flow pattern across the tricuspid value. Electrophysiological study carried out 6 months postoperatively recorded ventricular potential at the site of patch. The application of this technique may be considered, ona limited series of patients, for possible amelioration of the postoperative right ventricular dysfunction, whenever widening of its infundibulum is indicated.