Modified Fontan procedure for left atrial isomerism: alternative technique.

Anomalous systemic or pulmonary venous connections increase the risk and technical difficulty of the modified Fontan procedure. This report describes an alternative technique of total diversion of systemic venous return to the pulmonary artery in a child with left atrial isomerism, incorporating an extracardiac conduit between the hepatic veins and the right pulmonary artery.