This study examined the effects of endovascular metallic implants on the ability of magnetic resonance imaging to evaluate cardiovascular anatomy and to assess ventricular size and function in 101 consecutive patients with Fontan palliation. Compared with studies in patients without implants, in whom 100% of anatomic segments were adequately visualized and the median image quality grade for ventricular function assessment was 5 of 5, the presence of any implant (54% of studies) reduced the proportion of adequately imaged anatomy to 77% (p <0.001) and the median image quality grade for ventricular function assessment to 3 of 5 (p <0.001).