Liver and cardiac function in the long term after Fontan operation

Area of Science:

• Cardiology
• Hepatology
• Pediatric Cardiac Surgery

Background:

• Patients undergoing the Fontan operation are susceptible to developing liver disease.
• Long-term assessment of liver and cardiac function is crucial for Fontan survivors.

Purpose of the Study:

• To evaluate long-term liver and cardiac function in patients after Fontan operation.
• To identify correlations between hepatic dysfunction and hemodynamic parameters in this population.

Main Methods:

• Comprehensive assessment including physical examination, biochemical tests, echocardiography, and liver ultrasonography.
• Utilized a liver disease score to correlate liver involvement with hemodynamic features.
• Included 34 patients with a median follow-up of 11.5 years.

Main Results:

• High prevalence of liver abnormalities: hepatomegaly (53%), elevated gamma GT (61%), coagulopathy (58%).
• Hepatic dysfunction was significantly correlated with low cardiac index (r²=0.34, p=0.008).
• Reduced heart rate also showed a correlation with hepatic dysfunction (r²=0.18, p=0.07).

Conclusions:

• Hepatic dysfunction in Fontan survivors is linked to impaired cardiac output and heart rate.
• Maintaining optimal cardiac index is essential for preventing or mitigating long-term liver disease.
• Further research into hemodynamic optimization could improve outcomes for Fontan patients.