The McGoon ratio is calculated as the ratio of the sum of the diameters of the left and right pulmonary arteries to the diameter of the descending aorta at the diaphragm level, while the Nakata index is calculated as the sum of the cross-sectional areas of the left and right pulmonary arteries divided by the body surface area. The following criteria were used in the selection of surgical approach: 1, radical surgery: McGoon ratio 1.33 ± 0.04 (normal ≥ 2) and NaKata index 126 ± 92 mm2/m2 (normal ≥ 330 mm2/m2). 2, palliative surgery: McGoon ratio 0.84±0.13, NaKata index 81±17 (mm2/m2). The indications for corrective surgery for simple tetralogy of Fallot are mainly based on pulmonary artery and left ventricular development. Good pulmonary artery development, McGoon ratio ≥1.2, NaKata index ≥150 mm2/m2; left ventricular end-diastolic volume index ≥30 ml/m2 (normal 55 ml/m2), and right ventricular/left ventricular systolic pressure ratio ≤0.50 at the end of surgery were all safe and hemodynamically stable postoperatively. In contrast, when the McGoon ratio was <1.0; the NaKata index was <150 (mm2/m2); and the right ventricular/left ventricular systolic pressure ratio was ≥0.70 at the end of surgery, low cardiac output syndrome often occurred after radical surgery, and the long-term results were poor. When the McGoon ratio is <1.0 and the NaKata index is <120 (mm2/m2), it means that both sides of the pulmonary artery are hypoplastic and not suitable for one-stage radical surgery. Some studies have shown that the above indices are not absolute criteria for radical surgery, and Hennein et al. reported 30 neonates with tetralogy of Fallot who underwent radical surgery regardless of left ventricular development and pulmonary artery development, all of whom achieved satisfactory results. However, the extent to which the indications for surgery are relaxed depends on the technical capabilities and equipment of each cardiac center and the experience of the physicians.