Abstract: AIM:To summarize the clinical therapy experience of interventional and surgical hybrid therapy for patients with complex and cyanotic congenital heart defects with major pulmonary aorta collateral arteries and to explore its therapeutic significance, operating skills and safety. METHODS: To retrospectively analyze 41 patients with cyanotic CHD with pulmonary aorta collateral arteries. Ages of patients ranged from 1 to 28 years with a body weight of (18±8) kg. All subjects accepted CT diagnosis and 38 patients underwent interventional catheterization to close the collateral arteries. In three cases, collateral arteries were found after surgery and closed by catheterization. In all patients, one-stage repair was achieved. RESULTS: Thirty seven patients were cured, four patients died, one died from lung infection, and three patients died due to heart failure. The diameter of the collateral arteries ranged from 2.5 to 9.4 mm. Patients had 3 to 21 spring circles placed. Three patients had a second closure performed due to arterial recanalization. Fourteen patients had lung infection, three patients suffered from lung edema, and two patients had pleural fluid. CONCLUSION: Patients with complex and cyanotic congenital heart defects who have major pulmonary aorta collateral arteries can undergo interventional and surgical hybrid therapy to manage the collateral arteries. This method is effective, easy and safe, as well as being repeatable, which can reduce complications and decrease mortality.