Taussig-Bing anomaly (TBA) is a complex congenital heart disease, which was treated by intracardiac correction (Rastelli method) in the early years with poor long-term results. In recent years, with the improvement of surgical operation techniques, the success rate of treatment by arterial reversal (ASO) has been significantly improved with good long-term results. Objective To present the initial experience of using arterial reversal for the treatment of right ventricular double outlet with subpulmonary ventricular defect. Methods From May 2005 to May 2006, four patients with right ventricular double outlet with subventricular pulmonary artery defect were admitted. All four cases had severe pulmonary hypertension, and the ratio of ascending aorta to main pulmonary artery diameter was 1 : 1.5 C 3.0, and the position of the two arteries ranged from positive anterior-posterior position to left-right juxtaposition. Transcutaneous oxygen saturation was 64%; – 86%;. In cases 2 and 3, due to the large difference in the caliber of the two aorta, the posterior edge of the proximal end of the new aorta was sutured with a folding suture to make the caliber of the two aorta’s. In cases 2 and 3, because of the large difference in caliber between the two aortae, the posterior edge of the proximal end of the new aorta was first folded and sutured to reduce its caliber and then connected to the distal aorta. The de novo pulmonary artery was connected using the Lecompte method. Myocardial blood flow was blocked for 129 – 149 minutes, and the extracorporeal circulation ran for 182 C 360 minutes. Results All 4 cases survived and were discharged 15 – 35 days after surgery. 1 case had intraoperative bleeding from the posterior wall of the aortic anastomosis that was difficult to stop, and closure of the chest was delayed after filling with gauze. 4 cases were followed up for 1 – 12 months, and all patients had class I cardiac function. echocardiography did not reveal incomplete closure of the de novo aortic valve or stenosis on both aortic valves. Discussion 1. In cases of right ventricular double outlet combined with inferior pulmonary valve septal defect without pulmonary stenosis, severe pulmonary hypertension can develop early after birth, which can easily lead to pneumonia and heart failure and affect the perioperative outcome. Therefore, once the diagnosis of such malformations is established, early surgical treatment should be performed. In China, it is common to see older patients with severe pulmonary hypertension in clinical practice. Such patients miss the best time for surgery, but as long as they have not yet reached the contraindication to surgery for pulmonary hypertension and make adequate perioperative preparations, they can still achieve good surgical results. 2. The treatment of TBA by endocardial tunnel correction method has poor long-term efficacy, and there is not only the problem of artificial external tube repositioning; but also the high incidence of distant left ventricular outflow tract obstruction. At present, many doctors at home and abroad are using ASO method to correct TBA, which is anatomically and physiologically corrected, and the long-term effect is more ideal, avoiding the defects of intracardiac orthodontic treatment. 3. One of the key points of ASO is the coronary artery graft. We have learned that, compared with the method of punching a hole in the wall of the adjacent pulmonary sinus or making a “U” type vascular wall resection, the coronary artery graft using an “L” type incision can not only relatively increase the length of the coronary artery, but also reduce the length of the coronary artery. The use of “L” incision for coronary artery grafting not only increases the length of the coronary artery, but also reduces the freeing and tension of the coronary artery, and prevents the twisting of the coronary artery after anastomosis. The advantages of this method are especially highlighted for those who have two large arteries in parallel positions. 4.The mismatch of the caliber of the two great arteries can make the arterial anastomosis more difficult and very easy to cause postoperative bleeding.TBA patients are often combined with severe pulmonary hypertension, especially in older patients, and the caliber of the two great arteries can differ greatly. A folded suture is used at the posterior margin of the proximal end of the de novo aorta to make its caliber smaller, which reduces the difficulty of the anastomotic connection to a certain extent.