Currently,patients with a functionally single ventricle physiology or selected patients with very complex malformations (which can/should not be offered a 2—ventricle repair) undergo a staged palliative surgical treatment.Step 1:shunt procedure.Step 2:Partial cavopulmonary connection (PCPC).Step 3:Total cavopulmonary connection (TCPC).During the PCPC,any shunt take—down can be combined with patch enlargement of the pulmonary artery bed.The transition from the former lateral tunnel or other types of a "Fontan circulation" to the extracardiac TCPC has been widely accepted.The extracardiac connection not only facilitates surgery,but may i.e.also help to reduce arrhythmias at long—term.Continued surveillance of this cohort is needed.Future problems may include i.e.protein loosing enteropathy,plastic bronchitis and deterioration of the functionally single ventricle.We have performed "Fontan—type" operations at the German Heart Center Munich since 1974 and have also moved towards an extracardiac TCPC in recent years,even offering conversion to a TCPC in selected patients.