Clinical Outcomes in Fenestrated Extra-Cardiac Fontan in Low Preoperative Risk Profiles

Inclusion Criteria: * This study will includeall patients referred for an elective TCPC procedure at the period of the study, who demonstrated a standard risk profile * Preoperative evaluation consisted of ECG, transthoracic echocardiogram, and complete cardiac catheterization. Patients with the following parameters will be eligible for enrollment in the study: * Sinus Rhythm * Atriovnetricular valve regurgitation not more than mild * Aortic (neoaortic) valve regurgitation not more than mild * Normal systolic dominant ventricle function * Mean pulmonary artery pressure not more than 15 mmHg (measured directly or estimated by pulmonary vein wedge pressure) * Pulmonary vascular resistance not more than 2 woods unit * End diastolic ventricular filling pressure not more than 8 mm Hg Patient with the following will not be eligible for inclusion: * Patients with pulmonary artery distortion, stenosis or thrombus requiring surgical or interventional additional procedures before or during the Fontan operation. * Pacemaker insertion before or during Fontan operation. * Significant pulmonary arteriovenous malformations (AVMs) rendering fenestration potentially a cause of excessive cyanosis. * Patients for whom the cardiology/cardiac surgery case conference decision is strongly in favor of fenestration for any other cause.