A 15-year-old male child was found to have exacerbation of end extremity bruising and decreased mobility recently. Echocardiography showed corrected transposition of the great arteries (C-TGA) with ventricular septal defect (VSD) and ventricular outflow tract (LVOT) obstruction. He was scheduled to undergo the Senning + Rastelli procedure under general anesthesia. The preoperative examination indicated a relative decrease in pulmonary blood flow. Before cardiopulmonary bypass (CPB), it is better to adjust the systemic-pulmonary vascular resistance ratio (SVR/PVR) to balance the systemic-pulmonary circulation blood flow (Qp/Qs ratio). The increase of Qp and mixing blood mix between the systemic-pulmonary circulation can be achieved by moderate reduction of PVR while maintaining the SVR. After CPB, it is better to maintain the smooth transition of myocardial systolic function, actively manage the cardiac arrhythmia, maintain a slightly lower-than-normal range of preload, and increase the myocardial contractility while decreasing the ventricular afterload.