A closed technique was applied successfully in a patient with Fallot's tetralogy in whom total correction had been previously performed, for creation of continuity between the right ventricle and left pulmonary artery without the use of cardiopulmonary bypass. A surgical approach was achieved by an anterolateral thoracotomy incision in the left third intercostal space. A Dacron non-valved tubular graft, 10 mm. in diameter, was anastomosed to the proximal end of the left pulmonary artery. The proximal end of the graft was anastomosed to the pericardial outflow tract patch with a running technique using a monofilament suture. The peripheral arterial oxygen saturation increased postoperatively, and the patient's condition improved dramatically.