A 2-month-old female infant with coarctation of the aorta (CoA) accompanied by ventricular septal defect (VSD) and atrial septal defect (ASD) was admitted to our hospital with pulse oxygen saturation (SpO2) of 94% and liver 1.0 cm below the ribs. She was scheduled to undergo the corrective surgery of coarctation of the aorta and the repair of VSD and ASD under general anesthesia. The left ventricular pressure was overloaded, and the perfusion of the lower body was insufficient in this case. The left-to-right shunt of VSD and ASD further reduced the effective forward blood flow of the left ventricle and caused pulmonary arterial hypertension. Therefore, before cardiopulmonary bypass, it is necessary to maintain an appropriate systemic-pulmonary circulation resistance ratio and ensure tissue perfusion in the lower body by maintaining a higher preload. After cardiopulmonary bypass, it is necessary to reduce the afterload of the right ventricle through hyperventilation and use inotropic drugs to enhance myocardial contractility to maintain circulation stability and ensure systemic tissue perfusion.