Tetralogy of Fallot (TF) has a worldwide prevalence of approximately 1 in 3000 live newborns, thus representing the most common cyanogenic cardiac malformation. The type of radical correction approached depends on the severity of right ventricular outflow tract (RVOT) stenosis, which is assessed depending on the Z-score of the pulmonary artery valve annulus (PAV). TF with a Z score < -3, requires PAV widening plasty with transannular application of the autologous pericardial patch. Pulmonary valve regurgitation is the most frequent and severe complication of this type of radical correction, especially in the early postoperative period. The use of a monocusp at the level of the pulmonary artery valve could reduce this phenomenon.