Impact of Liver Disease After the Fontan Operation

Lindsay, Iain; Johnson, Janice H.; Everitt, Melanie D.; Hoffman, James P.; Yetman, Anji T.

doi:10.1016/j.amjcard.2014.10.032

Cited by 65 publications

(51 citation statements)

References 10 publications

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“…76 Exercise intolerance and reduced oxygen consumption is prevalent, especially in patients with complex forms of CHD, [77][78][79] and progressive hepatic fibrosis occurs in patients with elevated systemic venous pressures. 80,81 Not surprisingly, among adult women with CHD who become pregnant, adverse cardiovascular events occurring in pregnancy and childbirth are considerably more likely during admission for delivery than the general population, particularly among those with complex CHD or pulmonary hypertension. [82][83][84][85] As a result of these pathophysiologies, significant, lesion-specific effects on life expectancy can be forecast (Figure 7).…”

Section: Adults With Chdmentioning

confidence: 99%

Trends in Congenital Heart Disease

2016

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Section: Adults With Chdmentioning

confidence: 99%

Trends in Congenital Heart Disease

2016

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“…[96][97][98][99] Epidemiologic data are limited in other CHD populations in which routine surveillance is uncommon and recognition therefore is less likely.…”

Section: -95mentioning

confidence: 99%

Diagnosis and Management of Noncardiac Complications in Adults With Congenital Heart Disease: A Scientific Statement From the American Heart Association

Lui¹,

Saïdi²,

Bhatt³

et al. 2017

Circulation

175

136

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ABSTRACT:Life expectancy and quality of life for those born with congenital heart disease (CHD) have greatly improved over the past 3 decades. While representing a great advance for these patients, who have been able to move from childhood to successful adult lives in increasing numbers, this development has resulted in an epidemiological shift and a generation of patients who are at risk of developing chronic multisystem disease in adulthood. Noncardiac complications significantly contribute to the morbidity and mortality of adults with CHD. Reduced survival has been documented in patients with CHD with renal dysfunction, restrictive lung disease, anemia, and cirrhosis. Furthermore, as this population ages, atherosclerotic cardiovascular disease and its risk factors are becoming increasingly prevalent. Disorders of psychosocial and cognitive development are key factors affecting the quality of life of these individuals. It is incumbent on physicians who care for patients with CHD to be mindful of the effects that disease of organs other than the heart may have on the well-being of adults with CHD. Further research is needed to understand how these noncardiac complications may affect the long-term outcome in these patients and what modifiable factors can be targeted for preventive intervention.

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“…Progressive hepatic cirrhosis is a risk factor for the development of hepatocellular carcinoma, gastrointestinal bleeding, hepatic failure, and hepatic encephalopathy, and may be a contraindication to heart transplantation [22][23][24][25]. In a small series of asymptomatic patients a mean of 16 years post-Fontan, a liver biopsy was performed during cardiac catheterization and hepatic fibrosis was present in 18/21 (85%) patients.…”

Section: Hepatic Fibrosis and Cirrhosismentioning

confidence: 99%