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Total cavopulmonary connection using an extracardiac conduit technique has become one of the most commonly used modifications of Fontan-type operations.However,the insertion of a tube conduit is sometimes technically demanding due to the crumpled stump of the inferior vena cava (IVC) caused by a tourniquet of the IVC near the division line.We present a new technique using an open anastomosis of the IVC and a tube conduit with the application of vacuum-assisted venous drainage.