Figure 38: Types of Fontan operations likely to be seen in adult congenital centers today. A - The atriopulmonary connection was abandoned in the mid - 1980s because of dilatation of the right atrium predisposing to thrombosis and atrial arrhythmias. B - lateral tunnel is used widely in part because of the ease of fenestration of this type. C - extracardiac conduit is also widely used because it can be performed without bypass and does not create extensive atrial suture lines. This type is more difficult to fenestrate. (Modified from Valente et al. [11] with permission).