Surgical management involves ensuring adequate pulmonary blood flow via a systemic to pulmonary artery anastomosis (eg, modified Blalock-Taussig-Thomas shunt [see Tetralogy of Fallot]) for patients with decreased pulmonary blood flow, or protecting the pulmonary vascular bed and limiting pulmonary blood flow via pulmonary artery banding or some other intervention (such as a modified Norwood type reconstruction of the aortic and pulmonary roots, sometimes called a Damus-Kaye-Stansel anastomosis) if pulmonary overcirculation exists.