Objective Modified B-T shunt (MBTS) and central shunt (CS) are two common surgical procedures for the treatment of tetralogy of fallot (TOF). The purpose is to analyze and compare the hemodynamic features of MBTS and CS. Methods 3D anatomy was reconstructed by medical images obtained from a patient with TOF, and two computational models were generated through virtual operations. A lumped parameter model was constructed to predict the post-operational boundary conditions. Computational fluid dynamics (CFD) was performed for the two models. Results A persistent pulmonary blood perfusion was observed in each model both during the systolic phase and diastolic phase, but the maximum velocities in the shunt were different for the two models. The pressure drop of the shunt in CS model was higher than that in MBTS model. The wall shear stress of the shunt in the MBTS model ranged unevenly from 0.025 to 340 Pa, while the wall shear stress in CS model ranged relatively evenly from 32.2 to 72.6 Pa. Conclusions Pulmonary artery blood was increased effectively for both options. The blood perfusion of right upper extremity was decreased in the MBTS model. More blood was directed into the pulmonary artery in CS model. Attention should be paid to the fact that the pressure gradient was large at the proximal anastomosis in both models in clinic. This study provides important theoretical references for surgeons to make choice from the surgery options in the treatment with TOF.