Novel approaches to direct atrial access after extracardiac fontan palliation

Catheter access to the "native" atria is limited after extra-cardiac Fontan palliation of univentricular cardiac defects Catheter access to the atria is necessary to percutaneously treat acquired abnormalities after extra-cardiac Fontan palliation Direct trans-thoracic atrial access and extra-cardiac conduit puncture is technically straightforward and allows for novel catheter interventions.