Severe regurgitation of the atrio-ventricular valve and borderline pulmonary vascular  resistance are risk factors for failure of univentricular repair. We believe that fenestration  in the Fontan pathway plays an important role in avoiding postoperative catastrophesimmediate and late, in such high-risk substrates. Rarely, the intra-operative circumstances compel the surgeon to opt for an unconventional method of fenestration. We report an interesting case of high-risk univentricular repair, had previously
undergone pulmonary artery banding and bidirectional Glenn shunt, who now required a simultaneous repair of the regurgitant atrio-ventricular valve compelling the creation of an unconventional fenestration during Stage III palliation.