Objective To explore the value of standardized pulmonary indexes based on echocardiography in the prediction of the prognosis of repaired tetralogy of Fallot（TOF）.Methods The data of 465 patients with TOF in our hospital were retrospectively analyzed.The pulmonary valve annulus Z-score（PVAZ）

main pulmonary artery Z-score（MPAZ） and Nakata index were calculated by preoperative echocardiography.Receiver operating characteristic（ROC） curve was drawn to predict the practice of trans-annular patch（TAP）

sensitivity

specificity

area under curve（AUC） and 95% confidence interval（CI） were calculated.Spearman correlation analysis was used to analyze the correlation between PVAZ

MPAZ

Nakata index and perioperative clinical indicators.ROC curve was used to determine the cut-off value of parameters.Log-Rank was used to compare the survival differences between groups and Kaplan-Meier survival curve were drawn.Results Among the 465 TOF cases

a total of 413 cases（88.82%） underwent TAP during complete repair.PVAZ of the TAP patients was significantly smaller than that of non-TAP patients[-2.81（-3.31

-2.04） vs.-1.51（-2.52

-0.75）]

there was significant difference（P<0.05）.ROC curve analysis showed the cut-off value of PVAZ for the practice of TAP was-2.73

AUC was 0.740（95%CI:0.641～0.839）

sensitivity was 52.8%

specificity was 86.0%.PVAZ

MPAZ and Nakata index were negatively related to the perioperative results.There were 23 cases（4.95%） of death during a median follow-up time of 2.03 years.The cut-off values of PVAZ and MPAZ for postoperative survival were-2.98 and-3.47

respectively.The survival rate between PVAZ<-2.98 patients and PVAZ≥-2.98 patients

MPAZ<-3.47 patients and MPAZ≥-3.47 patients were both statistically significant（P=0.044

0.002）.Conclusion Standardized pulmonary indexes based on echocardiographic evaluation is a good indicator to predict the prognosis of repaired TOF

which may be of great guiding significance in the clinical hazard stratification.