Objective: To test the hypothesis that unidirectional valve patch (UVP) would provide benefit to early and actuarial survival for the ventricular septal defect (VSD) complicated with sever pulmonary artery hypertension (PAH). Methods: 876 cases of VSD with severe PAH were closed with or without UVP and were retrospectively classified as UVP group (n=195) and NVP group (n=681).Propensity scores of inclusion into UVP group were estimated and 138 pairs were get with the propensity score matching between the two groups. Results: For the 138 propensity matched pairs, there were 7 and 9 early deaths for the UVP and NVP group respectively, of which, 14 were due to PAH crisis and 2 were due to the reperfusion injury. The difference of the early mortality between UVP and NVP did not reached statistically differences, χ2=0.265, P=0.6064. With a mean of 9.2±4.92 years and a total of 2511 patient-years follow-up, there were 6 late deaths in UVP group and 7 late deaths in NVP group. The actuarial survival at 5, 10, 15 and 18 yrs of the two groups reached no significantly difference (Log rank test, χ2=0.565, P =0.331). The 6MWD assessed at the last follow-up of the two group were 525.9±88.0 meters for the UVP group and 536.5±95.8 meters, according to the t-test, F=1.550, P=0.214, the difference between the two groups did not reach a statistically significance. Conclusion: UVP provides no benefits to early and actuarial survival when it is used to deal with VSD complicated with severe PAH.