OBJECTIVE: Rastelli procedure for right ventricular outflow tract(RVOT) obstruction has many disadvantage especially for children. Instead of using the artificial valved conduit, we applied the REV procedure for preventing the valve re-replacement after growing and observed the fate of that patch. METHOD: We performed REV procedure for RVOT reconstruction with our own hand-made monocusp patch composed of porcine pericardial cusp and bovine pericardial patch in 7 young piglets(15.3+/-1.3kg) and raised till adult pig9about 70 kg). After sacrificed the pig we explored their pulmonary arteries, monocusp patch and hearts. RESULTS: Without any stenotic residues in the pulmonary artery, we found the deformed monocusp patch with severe calcification, which deprived the adequate valve function, but kept the pig growing normally. CONCLUSION: We are sure that this REV procedure with monocusp patch could be extendedly applied to the RVOT obstruction, but we need to develope the anti-calcification method for the heterograft patch.