Tetralogy　of　Fallot　is　the　most　common　cyanotic　congenital　heart　defect.　For　severe　cases,　inserting　a　systemic　to　pulmonary　shunt,　which　distributes　part　of　systemic　artery　blood　into　the　pulmonary　artery,　is　the　preferable　palliative　surgery.　Based　on　the　computed　tomography　images　and　three-dimensional　geometry　technologies,　two　patient-specific　anatomical　options　of　systemic　to　pulmonary　shunts　including　the　aorta　to　pulmonary　shunt　(APS)　and　innominate　artery　to　pulmonary　shunt　(IPS)　have　been　simulated　for　computational　fluid　dynamics.　The　objective　of　this　study　was　to　predict　the　hemodynamics　within　the　shunts　and　con　firm,　through　patient-specific　simulations,　the　shunt　with　the　optimal　performance.　Results　indicated　that　both　options　created　high　velocity　gradients　and　pressure　gradients　at　the　proximal　end　of　the　shunts.　Obvious　flow　recirculation　appeared　at　the　inner　region　near　the　proximal　end　of　the　shunts.　Part　of　the　reverse　flow　from　the　descending　aorta,　left　subclavian　artery,　left　carotid　artery　and　innominate　artery　was　driven　into　the　shunts　during　the　diastolic　period.　The　IPS　provided　better　balanced　and　more　adequate　blood　flow　distributions　between　the　systemic　and　pulmonary　circulations.　The　APS　provided　slightly　excessive　pulmonary　blood　flow　which　can　ultimately　result　in　cardiac　failure　and　pulmonary　hypertension.