If cardiac lesions cannot be repaired, they are palliated with a variety of operations. The three most common are ductal stent, pulmonary artery band and balloon atrial septostomy (Rashkind procedure). The anaesthetic management is determined by both the underlying lesion and the palliative procedure. In a pulmonary artery band the pulmonary blood flow is limited by the tightness of the band and might limit cardiac output. A balloon atrial septostomy is done in lesions where an unrestrictive L → R shunt and mixing is needed for survival. Flow through a ductal stent can be L → R or R → L, depending on the underlying obstruction.