Tricuspid atresia with transposition of the great arteries produces single ventricle physiology. Ultimate goals of neonatal palliative operations are to provide optimum anatomic and physiologic conditions for a Fontan procedure. A modification of the Norwood procedure is reported, with an aorto-pulmonary anatomosis, utilizing the hypoplastic right ventricle as the pulmonary out flow conduit, avoiding a left ventriculotomy and preserving its function with excellent recovery. We believe this technique has not been previously published in the English literature.