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Hepatic Fibrosis Risk Factors in Extracardiac-Fontan Patients: Observations From a Single Center.

William N Evans1,2, Ruben J Acherman1,2, Alvaro Galindo1,2

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World Journal for Pediatric & Congenital Heart Surgery
|March 8, 2023
PubMed
Summary

Risk factors like female sex and venovenous collaterals are linked to hepatic fibrosis in extracardiac Fontan patients. Identifying these factors aids in assessing liver health post-surgery.

Keywords:
extracardiac-Fontanhepatic fibrosisliver biopsyrisk factors

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Area of Science:

  • Cardiology
  • Hepatology
  • Pediatric Cardiology

Background:

  • The Fontan procedure is a palliative surgery for single-ventricle congenital heart defects.
  • Hepatic fibrosis is a known complication in Fontan patients, but risk factors require further elucidation.
  • Transvenous liver biopsy is a diagnostic tool for assessing hepatic fibrosis.

Approach:

  • Retrospective review of 127 extracardiac Fontan patients undergoing transvenous liver biopsy between 2012-2022.
  • Analysis of liver fibrosis scores in relation to sex, venovenous collaterals, and heart type (univentricular).
  • Kruskal-Wallis nonparametric testing used for statistical analysis of risk factors.

Key Points:

  • Females with two risk factors (female sex, venovenous collaterals, right-ventricular type functional univentricle) had the highest median fibrosis scores (4).
  • Males with fewer than two risk factors had the lowest median fibrosis scores (2).
  • No significant differences in fibrosis scores were observed based on other demographic or hemodynamic variables.

Conclusions:

  • Identifiable risk factors are associated with the degree of hepatic fibrosis in extracardiac Fontan patients.
  • Female sex and the presence of venovenous collaterals are significant risk factors for hepatic fibrosis.
  • These findings can help clinicians better stratify risk and monitor liver health in this population.