Sarioglu, C. TayyarSisli, EmrahYalcinbas, Yusuf KenanSaygili, Arda2023-02-212023-02-212015-01-0110.1016/j.athoracsur.2015.04.102https://hdl.handle.net/11443/1567http://dx.doi.org/10.1016/j.athoracsur.2015.04.102One of the options for the management of borderline/ failing extracardiac Fontan circulation is surgical creation of an atrial fenestration to decompress the systemic venous compartment and improve cardiac output. Depending on the body surface area of the patient, a 5- to 10-mm polytetrafluoroethylene (PTFE) tube graft can be used. When fenestration is required in a patient with failing Fontan circulation, particularly in redo cases, application of a side-biting clamp may be challenging because of adhesions and a thickened atrial wall. In this article, we present our off-pump technique of atrial-side anastomosis of PTFE graft interposition between an extracardiac Fontan conduit and the atrium without using a side-biting clamp. (C) 2015 by The Society of Thoracic SurgeonsArticleWOS:000362288000076