A modified Fontan operation (Fontan Björk [Bjork VO, Olin CL, Bjarke BB, Thoren CA. Right atrial-right ventricular anastomosis for correction of tricuspid atresia. J Thorac Cardiovasc Surg 1979;77:452--8]) for absent right atrio-ventricular connection was done by using a homograft between the right atrium and the right ventricle in some patients. We present the case of a 31-year-old patient, 21 years after a modified Fontan operation with severe homograft dysfunction. A percutaneous "tricuspid valve" implantation was performed with a Melody valve resulting in a good functional result.
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