We describe the presentation and management of an infant with the unique constellation of a massive patent ductus arteriosus, severely insufficient pulmonary valve, hypoplastic tricuspid valve, and a resultant profoundly dilated and hypertrophic right ventricle with intact interventricular septum. Surgery consisted of ductal ligation and division, homograft patch augmentation of the aortic arch, modified Blalock-Taussig-Thomas shunt placement, right ventricle-to-pulmonary artery homograft placement, and atrial septectomy.
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