A 6-year-old boy (weight 15.5 kg) underwent pulmonary valve plasty using autologous pericardium. He received a diagnosis of aortic coarctation and ventricular septal defect. Total correction was performed at the age of 18 days ( weight 2.2 kg). Intraoperatively, to confirm the position of the ventricular septum defect, we needed to incise from the main pulmonary artery to right ventricle through a commissure part of pulmonary valve. Although he exhibited stable hemodynamics, pulmonary valve regurgitation progressed. Six years after initial operation, we performed pulmonary valve plasty. A main pulmonary arteriotomy revealed that the right and anterior cusp were damaged in the initial operation. The right cusp had 2 defects near the commissure part, and the anterior cusp had a complete defect at the commissure part. The defects were filled with sufficient size of an autologous pericardial patch to preserve adequate coaptation zone. Echocardiography 1 year later revealed satisfactory result.