Hepatic Abnormalities Are Present Before and Early After the Fontan Operation

Area of Science:

• Pediatric Cardiology
• Hepatology
• Cardiac Surgery

Background:

• Progressive hepatic fibrosis is a known complication following the Fontan operation.
• The precise timing and onset of hepatic abnormalities in relation to this procedure remain unclear.

Purpose of the Study:

• To investigate the presence of hepatic abnormalities before the Fontan operation.
• To identify any new hepatic abnormalities that develop shortly after the Fontan operation.

Main Methods:

• Prospective enrollment of patients undergoing the Fontan operation.
• Hepatic ultrasound with Doppler and serum liver function tests were performed immediately before and 3-6 months after surgery.

Main Results:

• 10% of patients had abnormal hepatic echotexture pre-operatively.
• Post-operatively, liver length increased, hepatic artery flow velocity decreased, and liver enzymes (AST, ALT, GGT) significantly elevated.
• New hepatic echotexture abnormalities were noted in one patient post-surgery.

Conclusions:

• Hepatic abnormalities are present in some patients prior to the Fontan operation.
• New hepatic abnormalities can emerge in the early post-operative period.
• These findings indicate that liver insult may occur before or shortly after the Fontan operation.