A modification of the Fontan procedure incorporating anomalies of systemic and pulmonary venous return.

A modification of the Fontan procedure is described in which separation of anomalous systemic and pulmonary venous pathways is accomplished without the need for construction of a complex intraatrial baffle. The feasibility of this simplified surgical technique is predicated on the presence of a left superior vena cava draining to a coronary sinus. The design of the procedure and results in two patients with polysplenia syndrome and a constellation of systemic and pulmonary venous anomalies are presented. Early and late results have been gratifying, and continued exploration of the technique seems warranted.