The advent of surgical palliation for functional single ventricle (FSV) heart defects was an impressive feat for pediatric cardiovascular surgery and medicine just a few decades ago. Parents were given hope for what would have been uniformly fatal congenital heart disease, and today, substantial survival is expected by both families and care providers for neonates with many types of FSV defects. However, decades have since past and these very same patients who were successfully palliated are now facing despair themselves as they encounter significant cardiovascular issues. These issues can be classified as Fontan failure (as evidenced by protein losing enteropathy and plastic bronchitis) and contractile failure (systolic or diastolic) of their single ventricle.