Optimal Use of Z -Scores to Preserve the Pulmonary Valve Annulus During Repair of Tetralogy of Fallot

Objective: The size of the pulmonary annulus measured as a z-score is often used to determine when to insert a transannular patch (TAP). Multiple “cutoffs” are quoted in the literature; this could lead to inappropriate insertion. We aimed to determine whether the use of z-scores derived from diff…