In this study, we defined a ratio of aortic KE and LV KE to represent LV-Ao efficiency. We aimed to evaluate LV-Ao energy efficiency in rTOF patients and evaluate the relationship between LV-Ao efficiency and RV hypertrophy. The aortic root KE, LV KE, and LV-Ao efficiency in rTOF group were comparable with normal group. The indexed LV-Ao efficiency was negatively correlated with age and RV volumetric parameters. The association between LV-Ao efficiency and age and RV hypertrophy suggested that the adverse interaction between RV and LV was expanded to the aorta in rTOF patients with preserved LV function.