Ascites after cardiac surgery

Quintana, Efrén Martínez; Monescillo, Alberto; González, Fayna Rodríguez

doi:10.1111/j.1478-3231.2008.01735.x

Liver International

2008

DOI: 10.1111/j.1478-3231.2008.01735.x

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Ascites after cardiac surgery

Efrén Martínez Quintana

Alberto Monescillo

Fayna Rodríguez González

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2010

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“…We previously reported the case of a patient with cyanotic congenital heart disease who had a single ventricle congenital heart defect and a palliative Fontan procedure performed late in life and who developed refractory ascites without limb edema associated with liver histological findings of periportal fibrosis. 5 This prompted us to review our patients with cyanotic congenital heart disease to determine clinical status, existence of ascites, laboratory data, abdominal ultrasound imaging, and liver histological findings in those who had undergone liver biopsy.…”

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Ascites in Adult Patients With Cyanotic Congenital Heart Disease

Martínez‐Quintana

Rodríguez‐González

Cabrera-Pérez

et al. 2010

World J Pediatr Congenit Heart Surg

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Hematologic, neurologic, renal, and rheumatic complications in patients with cyanotic congenital heart disease are well known. However, the effects of this condition on the liver are poorly described. Between April 2005 and April 2010, 25 adults with cyanotic congenital heart disease were studied to determine clinical history, liver ultrasonographic data, and liver histological presentation. Twenty-five patients, with a median age of 28.7 ± 8.3 years and a basal tissue hemoglobin oxygen saturation of 83.3% ± 6.8%, were studied. Liver ultrasonographic examination showed abnormalities in 10 of 20 patients (50%): 6 patients (30%) had hepatomegaly, 2 patients (10%) heterogeneous parenchyma echo pattern, and 2 patients (10%) increased portal echogenicity. Ascites was found in 7 patients (28%): 4 patients had refractory ascites and 3 patients anasarca. Patients with anasarca responded well to oral and intravenous furosemide, but those with isolated ascites did not. No data to indicate severe ventricular dysfunction or severe valve regurgitation were seen. In patients with refractory ascites who had therapeutic paracentesis, serum-ascites albumin gradient in ascites was greater than 1.1 g/dL. No significant association was found between patients with or without ascites when laboratory data and New York Heart Association functional class were compared. Liver biopsy was performed in 6 patients (24%). The most remarkable liver histological finding, in those with refractory ascites, was the existence of periportal fibrosis associated with sinusoidal dilatation. Periportal liver fibrosis associated with congestive heart failure, sepsis, or a long-term Fontan procedure can trigger refractory ascites formation.

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confidence: 99%

Ascites in Adult Patients With Cyanotic Congenital Heart Disease

Martínez‐Quintana

Rodríguez‐González

Cabrera-Pérez

et al. 2010

World J Pediatr Congenit Heart Surg

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Ascites after cardiac surgery

Cited by 1 publication

References 3 publications

Ascites in Adult Patients With Cyanotic Congenital Heart Disease

Ascites in Adult Patients With Cyanotic Congenital Heart Disease

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