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Objectives: Nonvalve transannular patch repair of right ventricular outflow tract obstructive defects results in pulmonary insufficiency, which can contribute to early postoperative right ventricular dysfunction. Pulmonary valve cusp augmentation with the pericardium would decrease pulmonary insufficiency and improve the early outcome for transatrial-transpulmonary tetralogy of Fallot repair requiring a transannular patch. Methods: From 1/2011 to 6/2012, 56 patients with tetralogy of Fallot had relief of right ventricular outflow tract obstruction with a transannular patch, plus pulmonary valve cusp augmentation. Results: The median age of patients was 4.82 ± 3.68 years. The diameter of the pulmonary valve annulus with Z-value <-2. The mean aortic clamp time was 57.12 ± 14.31 minutes and the median cardiopulmonary bypass time was 104.93 ± 25.21 minutes. One hundred percent of patients were under intubation for less than 24 hours. Discharge echocardiograms demonstrated mild or moderate pulmonary insufficiency in 100% patients, with a pulmonary valve cusp augmentation. Conclusions: Augmentation of a pulmonary valve cusp reduces the incidence of clinically significant postoperative pulmonary insufficiency. This technique may improve the early outcomes for patients with tetralogy of Fallot requiring a transannular patch.

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