A novel technique to achieve pulmonary valve competence in aortic root translocation

Many techniques have been introduced to restore pulmonary valve competence in right ventricular reconstruction surgeries, such as constructing valves from autologous or heterogenous pericardial tissue, using monocusp homograft, or using synthetic materials. Most of these approaches—except for the recently introduced transplantation of a living homograft (partial heart transplantation)—are associated with the impediment of early dysfunction and lack of growth potential.1 Due to the limited availability of donor hearts, recent studies have explored an alternative solution using the right atrial appendage (RAA) to reconstruct a bicuspid pulmonary valve intraoperatively to prevent pulmonary insufficiency.