One-year and two-month-old boy with pulmonary artery sling underwent pulmonary artery reconstruction with autologous pulmonary arterial tissue. Surgical repair consisted of the transection of the left pulmonary artery at its origin with trimming a button hole and the creation of an oval hole with the same size to the left pulmonary button. An autologous pulmonary patch and the left pulmonary button were exchanged and sutured to the former partner's place. He recovered uneventfully in post-operative course. Postoperative CT revealed a well developed left pulmonary artery from 5 mm to 10 mm in diameter without any distortion or stenosis. This exchange method could allow the natural growth of the anastomotic places without narrowing or distortion.