Pulmonary insufficiency secondary to outflow tract reconstruction remains an unsolved problem. Although a number of surgical techniques have been designed to avoid or palliate this condition, none so far has been satisfactory. This report describes a new composite stented porcine monocusp patch, which, because of its desirable hemodynamic characteristics, promises to yield stable and reproducible results. The clinical effectiveness of the patch is documented by its successful application in a patient with tetralogy of Fallot.