Background The Lecompte(REV)procedure is used to correct abnormal ventriculoarterial connedions in patients with congenial heart diseases;it avoids the need for an extracardiac conduit for pulmonary outflow tract reconstruction.The present study aimed to investigate effectiveness and criteria of the REV procedure in children with abnormal ventriculoarteriaI connections. Methods Thirty-eight children(mean age,(2.2+1.7)years;mean weight,(11.5±3.8)kg)with abnormal ventrieuloarterial connections who had an REV procedure in our hospital from January 1998 to May 2006 were studied.Only 10 patients had the usual anteroposterior relationship of the two great arteries.The infundibular septum between the two semilunar valves was aggressively resected to enlarge it and construct a straighter left ventricular outflow tract and a wide tunnel between the ventricular septal defect(VSD)and the aorta.Eighteen cases had the original REV procedure;20 had a modified REV procedure.Results All patients are alive;none developed severe complications.The postoperative right ventricular(RV)to left ventricular(LV)pressure ratio was 0.20-0.45.Five patients had RV dysfunction;2 patients had a pressure gradient in the RV ventricular outlet of 30.0-34.5 mmHg;3 cases had a 37.5-47.3 mmHg pressure difference in the RPA.All patients had an RV pressure less than half the systemic pressure.These gradients'magnitudes in all patients were consistent with the post-operative RV to LV pressure ratio(P