Thirteen patients with tetralogy of Fallot underwent reconstruction for hypoplastic right ventricular outflow tract using a preserved homograft or xenograft patch with single or double cusps. Homografts and xenografts preserved in 70% ethanol were implanted in 10 patients, and xenografts treated with glutaraldehyde were used in 3 patients. All the patients are doing well in their profession without one who died 18 years after operation. Valve-retaining homograft and xenograft patches provided excellent early hemodynamic function, but did not prevent pulmonary insufficiency late after the operation. Both homograft and xenograft cusps tended to degenerate several years after implantation, but cusp failure was not accompanied by outflow stenosis.