Author’s response to reviews Title: Surgical Strategies Protecting against Right Ventricular Dilatation following Tetralogy of Fallot Repair Authors:

Title: Surgical Strategies Protecting against Right Ventricular Dilatation following Tetralogy of Fallot Repair Authors: Amr Arafat ([email protected]) Elatafy Elatafy ([email protected]) Sahar Elshedoudy ([email protected]) Mahmoud Zalat ([email protected]) Neamat Abdallah ([email protected]) AHMED ELMAHROUK ([email protected]; [email protected]; [email protected]) Version: 1 Date: 23 Dec 2017 Author’s response to reviews: Reviewer #1: This retrospective review of patients who underwent a valve sparing TOF repair is consistent with the many publications in this area in the literature. It supports the general idea, but does not explore the limitations of the technique, specifically, how small a valve is too small and how much residual RVOTO is acceptable? Thank you very much for those valuable comments. We selected our patients according to their preoperative pulmonary annulus z score which ranged from -2 to -3. In our experience and others preservation of the valve in patients with z-score less than -3 is associated with recurrent RVOTO. We highlighted this in the discussion in the following paragraph.