الفهرس 
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Abstract
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease beyond 1 week of age. Neonates are often asymptomatic. Right ventricular outflow tract (RVOT) stenosis tends to increase with time, and infants typically become symptomatic after a few months of age.
Initial TOF repairs were mostly done with large transannular RVOT patches. chronic right ventricular (RV) volume loading caused by pulmonary regurgitation (PR) is now recognized as injurious to the RV. Thus, virtually every surgeon would agree that pulmonary valve preservation is beneficial in this setting.
Tetralogy of Fallot (TOF) is a spectrum of disease that ranges from mild to severe form. So different techniques were developed to preserve the annulus which is challenging especially in severe forms.
We perform an aggressive valvotomy and sometimes detach the cusps at the commissures. In those cases in which an infundibular patch is required, we believe that two patches above and below the annulus are preferable to a single patch crossing the annulus. A Hegar dilator can be used to measure the orifice before and after and also to gently dilate the pulmonary valve under direct vision.
Our objective was to analyze patients operated with a pulmonary annulus sparing procedure, the general outcome post operative RVOTO, pulmonary regurge, RV Function, morbidities and mortality and follow up after 6 months.
There was significant negative correlation between preoperative pulmonary Z score and post repair PVA gradient with optimal results in patients with Z score more than -2.
Keywords: Valve Sparing Strategy; Fallot Repair