A murmur is often produced in the child’s heart after surgery for law IV, which is produced by blood flow through a relatively narrow area. A murmur will be milder after surgery for a non-severe tetralogy of Fallot if a transannular patch is applied, but there will be a considerable amount of pulmonary regurgitation, which can be a major problem in the future. The problem of pulmonary regurgitation is being taken more and more seriously, especially in developed countries. The presence of a murmur does not mean that there is a problem. Patients with mild pulmonary stenosis have the same life expectancy and quality of life as normal people, but they all have a murmur. The transannular patch is a special material that is cut into the pulmonary annulus and covered with a deliberate widening of the annulus size, such as an autologous pericardial piece or a bovine jugular vein, but it will calcify and harden in the future, causing regurgitation of the pulmonary valve. After a certain degree of pulmonary regurgitation, the right ventricle will enlarge, the patient’s activity tolerance will decrease, and the incidence of sudden death will increase. after 25 years, about 6% die suddenly. Most children with tetralogy of Fallot have a postoperative quality of life comparable to that of a normal person. However, it depends on the presence of complications and the original pathological changes and also the degree of pulmonary regurgitation. Patients should be followed up after surgery even if there are no problems, because it takes 20 years for pulmonary regurgitation to become symptomatic. There is no problem with advancement to employment.