Objectives: Various valve repair techniques have been described for prevention of Pulmonary Insufficiency (PI). The prevention of pulmonary insufficiency is a crucial part especially after repair of Tetrology of Fallot. Herein we present the early results of an alternative technique of neo pulmonary valve reconstruction using Right Atrial Appendage (RAA) tissue.

Methods: The RAA valve was constructed in 3 patients, one with critical congenital pulmonary stenosis for which balloon pulmonary valvuloplasty was done earlier in infancy and two patients was with tetralogy of Fallot. The preservation of the native valve was not possible in all patients because of a severe valve deformity. RAA valve was created in the first patient with congenital pulmonary stenosis and in the other patients after ventricular septal defect closure and infundibulectomy and was covered with cardiocel patch. The perioperative data was evaluated, and the echocardiography results were assessed immediately after the operations and in follow up.

Results: The age of the patient was 5years and 10months. The PI severity early after operation was trivial or no PI and mild pulmonary stenosis was noted in post tetralogy of Fallot. The cardiopulmonary bypass time was 240, 227 and 337 min, cross clamp time was 100, 83 and 231 min respectively. No mortality or related morbidity occurred after repair using the RAA valve. 

Conclusions: Neopulmonary valve reconstruction using RAA tissue seems to be an effective and feasible method. The most important advantage is that it is native tissue does not require anti coagulation and is costless.