Bidirectional cavopulmonary anastomosis and modified Fontan procedure are the main surgical procedures for the treatment of single ventricle. Bidirectional cavopulmonary anastomosis, also known as bidirectional Glenn shunt, is an end-to-side anastomosis of the superior vena cava with the ipsilateral pulmonary artery, allowing superior vena cava flow to the biphasic pulmonary artery, and is a better palliative procedure for functional single ventricle. The modified Fontan procedure is a second-stage procedure. The modified Fontan procedure consists of a bidirectional cavopulmonary anastomosis in addition to the anastomosis of the inferior vena cava blood to the pulmonary artery by means of an intra-atrial plate barrier or an external conduit to achieve a connection of all vena cava to the pulmonary artery. The modified Fontan procedure is the definitive procedure for the treatment of single ventricle and is a physiologic radical treatment. A bidirectional cavopulmonary anastomosis is currently advocated prior to the modified Fontan procedure, allowing for a gradual hemodynamic transition. There are strict contraindications to the modified Fontan procedure, including significant cardiac insufficiency, pulmonary artery dysplasia, presence of pulmonary hypertension or increased pulmonary resistance, presence of mild to moderate atrioventricular regurgitation, cardiac rhythm disturbances, and age less than 2 years. If these conditions are present, the operative mortality rate is significantly increased.