Surgical repair of tricuspid atresia was performed in three patients, with two operations successful. The procedure involves redirecting all vena caval blood to the lungs, with only oxygenated blood returning to the left heart. The right atrium is 'ventriclized' to direct inferior vena caval blood to the left lung, while the right pulmonary artery receives superior vena caval blood via a cava-pulmonary anastomosis. This technique requires large, low-pressure pulmonary arteries and is suitable for well-developed children. Palliative procedures, such as systemic vein to pulmonary artery anastomosis, are used in younger children or those with small pulmonary arteries but result in only partial improvement due to blood mixing. A new corrective procedure was introduced, which completely suppresses blood mixing by arterializing the entire vena caval return in the lungs. This procedure is not anatomical but physiological, restoring pulmonary blood flow. It was successful in two of three patients, with the first case followed for 30 months. The procedure is not suitable for children with pulmonary arterial hypertension. The surgical technique involves anastomosing the superior vena cava to the distal end of the right pulmonary artery and the proximal end of the right pulmonary artery to the right atrium. Aortic valve homografts are used to prevent blood reflux. The operation is performed through a median sternotomy, with careful examination of the pulmonary arteries and pressures to ensure no hypertension. The procedure is performed under cardiopulmonary bypass, with the superior vena cava cannulated and the inferior vena cava cannulated via the right external iliac vein. The operation includes closing the atrial septal defect, inserting a pulmonary valve homograft into the inferior vena cava, and ligating the main pulmonary artery. Postoperative care includes monitoring for complications such as anuria, pleural effusion, and hepatomegaly. The procedure was successful in two patients, with the third patient dying due to mitral insufficiency. The technique is technically feasible and has promising results, though long-term outcomes of homografts are unknown. The procedure is suitable for well-developed children with normal-sized pulmonary arteries and low pressure. It is not suitable for younger children or those with small pulmonary arteries. The procedure is not technically difficult and has a good immediate outcome, though long-term hemodynamic consequences of atrial rhythm disturbances remain unpredictable. The indications for the procedure apply to many patients, particularly those with normal-sized pulmonary arteries and low pressure. The procedure is a double cava-pulmonary anastomosis and is suitable for well-developed children.Surgical repair of tricuspid atresia was performed in three patients, with two operations successful. The procedure involves redirecting all vena caval blood to the lungs, with only oxygenated blood returning to the left heart. The right atrium is 'ventriclized' to direct inferior vena caval blood to the left lung, while the right pulmonary artery receives superior vena caval blood via a cava-pulmonary anastomosis. This technique requires large, low-pressure pulmonary arteries and is suitable for well-developed children. Palliative procedures, such as systemic vein to pulmonary artery anastomosis, are used in younger children or those with small pulmonary arteries but result in only partial improvement due to blood mixing. A new corrective procedure was introduced, which completely suppresses blood mixing by arterializing the entire vena caval return in the lungs. This procedure is not anatomical but physiological, restoring pulmonary blood flow. It was successful in two of three patients, with the first case followed for 30 months. The procedure is not suitable for children with pulmonary arterial hypertension. The surgical technique involves anastomosing the superior vena cava to the distal end of the right pulmonary artery and the proximal end of the right pulmonary artery to the right atrium. Aortic valve homografts are used to prevent blood reflux. The operation is performed through a median sternotomy, with careful examination of the pulmonary arteries and pressures to ensure no hypertension. The procedure is performed under cardiopulmonary bypass, with the superior vena cava cannulated and the inferior vena cava cannulated via the right external iliac vein. The operation includes closing the atrial septal defect, inserting a pulmonary valve homograft into the inferior vena cava, and ligating the main pulmonary artery. Postoperative care includes monitoring for complications such as anuria, pleural effusion, and hepatomegaly. The procedure was successful in two patients, with the third patient dying due to mitral insufficiency. The technique is technically feasible and has promising results, though long-term outcomes of homografts are unknown. The procedure is suitable for well-developed children with normal-sized pulmonary arteries and low pressure. It is not suitable for younger children or those with small pulmonary arteries. The procedure is not technically difficult and has a good immediate outcome, though long-term hemodynamic consequences of atrial rhythm disturbances remain unpredictable. The indications for the procedure apply to many patients, particularly those with normal-sized pulmonary arteries and low pressure. The procedure is a double cava-pulmonary anastomosis and is suitable for well-developed children.