Background: Appropriate pulmonary blood flow is important for addressing systemic circulatory instability in infants with hypoplastic left heart syndrome (HLHS). To address such problems, we have developed a novel strategy to control shunt flow, which is partial clipping on the PTFE graft. Methods: Since 2005, we conducted this strategy in infants with HLHS who had right ventricle to pulmonary (RV-PA) shunt at the time of Norwood operation for HLHS if the patients fulfilled at least one of the following conditions; 1) high pulmonary blood flow (SpO2>85% in 0.2-0.4 of FiO2), 2) low cardiac output, 3) more than moderate tricuspid valve regurgitation, 4) low body weight. A 5 or 6mm PTFE tube were used for the establishing RV-PA shunt, and partially clipped (approximately 1/4 to 1/3 of diameter) using hemoclip under the careful monitoring of systemic oxygen saturation. Results: In 71 patients with HLHS who underwent Norwood operation, 7 infants (age, 3 days to 3 months) received this technique. Four of 7 infants developed cyanosis and required of balloon dilatation of RV-PA shunt and removal of clip at 5.5±0.4 (range, 4-6) months after the initial surgery. Systemic oxygen saturation increased from 78±1 to 86±3% after the intervention. Remaining 3 infants have reached to the bidirectional Glenn procedure without requiring any additional interventions. Conclusions: This novel strategy contributes to appropriate RV-PA shunt flow in infants with Norwood operation of HLHS. Development of cyanosis related with patient’s somatic growth can be avoided by subsequent balloon dilatation of the clipping site.