This report describes a child with tetralogy of Fallot and acquired pu
lmonary valve atresia in whom the pulmonary blood flow was provided so
lely by retrograde now from an anomalous right coronary artery origina
ting from the main pulmonary artery. Complete repair with preservation
of the native pulmonary valve and implantation of the right coronary
artery into the ascending aorta is described.