Bilateral patent ductus arteriosus and isolated right pulmonary artery (RPA) is a rare anomaly often interpreted as congenital absence of the RPA. Recognized early, continuity between the main pulmonary artery and distal RPA can be established and long-term sequelae avoided. We report 2 patients who underwent neonatal repair using a nonvalved pulmonary artery allograft conduit placed anterior to the aorta to establish continuity between the main pulmonary artery and RPA. Both patients continue to do well 10 and 15 years postoperatively with good growth of the distal RPA and good exercise tolerance. This approach offers good long-term palliation.
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