The child was 7 months old, male, 10 kg; diagnosis: “pulmonary atresia, somatic pulmonary collateral supplying the right and left pulmonary arteries, ventricular septal defect” Surgery: free the tortuous somatic pulmonary collateral and ligate it; the right pulmonary artery can be passed through a 10 mm probe, the left pulmonary artery has a narrow opening, free and widen it to the pulmonary hilum, which can be passed through a 6 mm probe, and apply autologous pericardium to the outflow tract Reconstruction; repair of ventricular septal defect. The procedure went well, with 3 micrograms of dobutamine maintaining circulation; the patient was taken off ventilator-assisted ventilation the day after surgery and released from the care unit today. The patient may face the impact of pulmonary regurgitation on right ventricular function in the long term, but it can be tolerated early after surgery, and the widening of the outflow tract during surgery should be conservative. In next week’s case of 15-year-old pulmonary atresia, we need to prepare a valved tube. The application of a valved tube in an older child is still beneficial for postoperative recovery, but the problem of distant tube degeneration is never resolved.