A Simple Technique to Create a Stent-Expandable Polytetrafluoroethylene Extracardiac Fontan Conduit

The extracardiac Fontan conduit is widely used but remains limited by its fixed diameter, which does not accommodate somatic growth and may contribute to late venous hypertension and Fontan-associated liver disease. We describe a simple, reproducible technique to create a handcrafted stent-expandable conduit using a standard expanded polytetrafluoroethylene graft. A longitudinal slit is created and closed with a continuous locking suture, forming a controlled expansion seam suitable for future balloon dilation and covered stent implantation. The technique was applied successfully in two patients without perioperative complications. This approach preserves the advantages of the extracardiac Fontan while enabling potential future catheter-based enlargement.