We reconstructed right ventricular outflow tract without prosthetic conduit for 2 year 11 month and 59 day old Tetralogy of Fallot with pulmonary atresia patients. Left appendage anastomosed between pulmonary trunk and right ventricle was utilized as the posterior wall of the tract. Pericardial patch covered the tract the beneficial methods for patients with Tetralogy of Fallot with pulmonary atresia to avoid late postoperative deleterious complications of prosthetic conduit.