A new technique to repair tetralogy of Fallot or double-outlet right ventricle with an anomalous right coronary artery arising from the left anterior descending coronary artery and crossing the right ventricular outflow tract is described. The right coronary artery was mobilized, transected, and re-implanted into the ascending aorta. The right ventricular outflow tract and ventricle septal defect were repaired through a ventriculotomy and pulmonary arteriotomy. The right ventricular outflow tract and pulmonary annulus were reconstructed with a pericardial patch. Five consecutive patients underwent this technique between August 2007 and October 2008. The indications of the electrocardiograms were no heart ischemia in all patients at mean follow-ups conducted at 5 to 19 months. All the patients were in New York Heart Association functional class I at the time of last follow-up. © 2010 The Society of Thoracic Surgeons.