Abstract
Since the introduction of a physiologically corrective procedure for patients with tricuspid atresia,' the concept of total right-heart bypass has been applied to a wide range of complex congenital heart defects. Over the years, a number of modifications of the original Fontan operation have been proposed in an effort to improve outcomes .2-6 Although an extracardiac variation of the Fontan concept was originally described by Humes et a1 and Nawa et a1 in 1988,7.8 its routine application for all forms of single ventricle hearts was first adopted by Marcelletti et al.9 For the past 5 years, we have used extracardiac conduit total cavopulmonary anastomosis as definitive palliation for almost all patients with functional single ventricle physiology.
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