We report three cases of children who underwent definitive conversion to the Fontan circulation using a new surgical technique, Extracardiac Epicardial Lateral Tunnel. This new procedure allows the operation to be performed as a totally extracardiac operation [especially in ventricular dysfunction] and allows it to be performed in a very small atrium and in cases with unsuitable pulmonary venous drainage.Our data suggest that this procedure may achieve satisfactory hemodynamics of the total cavopulmonary connection.