Hepatic pathology in patients after Fontan operation: A computed tomography imaging study

Area of Science:

• Cardiology
• Radiology
• Hepatology

Background:

• Hepatic dysfunction is a significant long-term complication following Fontan surgery.
• Understanding post-operative liver changes is crucial for patient management.

Purpose of the Study:

• To evaluate computed tomography (CT) findings of the liver after Fontan surgery.
• To identify associations between hepatic CT findings and clinical parameters in Fontan patients.

Main Methods:

• Retrospective review of 43 patients (aged 15.3 ± 6.8 years) who underwent Fontan surgery.
• Analysis of clinical data including age, sex, heart defect type, laboratory results, and hepatic CT findings.
• Statistical analysis to determine relationships between hepatic findings and clinical parameters.

Main Results:

• Abnormal hepatic parenchymal enhancement was present in 77% of patients.
• Significant risk factors for abnormal enhancement included hypoplastic left heart syndrome (HLHS), mean pulmonary artery pressure, and pulmonary vascular resistance index.
• Follow-up duration and brain natriuretic peptide levels were also associated in univariate analysis.

Conclusions:

• Abnormal hepatic parenchymal enhancement on CT is a frequent finding in Fontan patients.
• Regular liver function tests and imaging studies are recommended for monitoring Fontan survivors.