Extracardiac fontan operation with adjustable communication

A modified technique for the Fontan operation is described in which an adjustable communication between the extracardiac conduit (systemic venous chamber) and the right atrium (pulmonary venous chamber) is constructed. Potential advantages of this technique consist of minimization of surgical manipulation of atrial tissue, reduction or elimination of myocardial ischemia, creation of a uniform and stable inferior vena cava-to-pulmonary artery conduit, and increased flexibility and safety in certain high-risk patients such as those with increased pulmonary vascular resistance, pulmonary hypertension, and impaired ventricular function.