“…After the initial technique described for tricuspid atresia (1), the Fontan circulation has evolved in technique, beginning from the right atrial to pulmonary connection (6,(138)(139)(140), to right atrial to right ventricular connection for patients with tricuspid atresia (141)(142)(143)(144), to tricuspid valve exclusion for patients with single ventricle (6,145), to now the two surgical techniques most frequently used: the lateral tunnel (146,147), and the extra-cardiac conduit (148)(149)(150). Improvements in intra-operative techniques, as well of the available materials, has allowed accomplishment of Fontan completion while the heart continues to beat, therefore avoiding myocardial ischemia (151), or even without requiring cardiopulmonary bypass (152).…”