Ghosh RM, Griffis HM, Glatz AC, et al. - Given recent studies indicating the role of lymphatic congestion in development of late Fontan complications, such as protein‐losing enteropathy, researchers sought to define the role of the lymphatic circulation in early post Fontan outcomes. In this retrospective, single‐center study, they assessed 238 patients who were undergoing first‐time Fontan completion from 2012 to 2017. They assigned complication causes to 1 of 4 groups: (1) Fontan circuit obstruction, (2) ventricular dysfunction or atrioventricular valve regurgitation, (3) persistent pleural effusions in the absence of Fontan obstruction or ventricular dysfunction, and (4) chylothorax or plastic bronchitis. Early complications developed in 58 (24%). Early complications developed in 58 (24%). They observed a substantial morbidity in the early post Fontan period. Lymphatic failure or persistent effusions unrelated to structural or functional abnormalities were observed among half of those who developed early complications. Preoperative T2 imaging demonstrated significantly more likelihood to develop early complications among patients with higher‐grade lymphatic perfusion abnormalities. These findings may allow risk stratification and optimization of patients before Fontan palliation.