Techniques for performing the Fontan completion procedure after Kawashima procedure have developed in recent years. This paper presents a case in which we performed an off-pump hepatic-to-azygos connection by autologous pericardial roll via thoracotomy as a modified Fontan completion. The operation wound was limited, and the short-term follow-up was satisfactory. Notably, it was found that the autologous pericardium might require a shorter period of anticoagulation treatment than what is needed for artificial prosthetic materials.