Damus-Kaye-Stansel (DKS) is an operation used for relief of systemic outflow tract obstruction, usually in a single ventricle circulation. The unobstructed pulmonary outflow is connected to the aorta and pulmonary blood flow is provided by a modified BT shunt or an right ventricle to pulmonary artery conduit. Anaesthetically the pulmonary vascular resistance should be kept high with air and mild hypoventilation, but in case of an obstructed/ stenosed or kinked conduit, oxygen and mild hyperventilation can be used to improve pulmonary blood flow. Inotropes might be needed for impaired function.