Noninvasive Assessment of Liver Fibrosis in Adult Patients Following the Fontan Procedure

Ginde, Salil; Hohenwalter, Mark D.; Foley, W. Dennis; Sowiński, J; Bartz, Peter J.; Venkatapuram, Suneetha; Weinberg, Catherine R.; Tweddell, James S.; Earing, Michael G.

doi:10.1111/j.1747-0803.2012.00632.x

Cited by 56 publications

(50 citation statements)

References 30 publications

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“…182 Other potential mechanisms of liver injury include thrombosis of intrahepatic vessels, hepatotoxic medications, and infections. [183][184][185][186] These insults can result in increased inflammatory activity in the liver and subsequent fibrosis. 186 These structural changes may then lead to functional changes in the liver, with subsequent liver dysfunction and failure.…”

Section: Pathogenesismentioning

confidence: 99%

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

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203

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Section: Pathogenesismentioning

confidence: 99%

Congenital Heart Disease in the Older Adult

Bhatt¹,

Foster²,

Kuehl³

et al. 2015

Circulation

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203

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“…However, most of these have been developed and validated to predict cirrhosis or advanced fibrosis for patients with hepatitis C and may or may not be useful for screening for liver disease in patients with CHD. [121][122][123][124] Baseline laboratory studies to evaluate liver health are performed in patients with clinical evidence of liver disease or considered to be at risk for liver disease; that is, individuals with central venous hypertension or impaired cardiac output. This would include all patients with signs or symptoms of congestive heart failure and all patients with Fontan physiology starting 5 years after Fontan completion.…”

Section: Managementmentioning

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

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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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“…Imaging has been shown to accurately identify structural liver disease, but not necessarily the degree or severity, and laboratory evaluation of serum biomarkers has been shown to correlate with the degree of fibrosis in various types of liver disease. 51 However, no studies to date have accurately correlated imaging and laboratory findings with histopathology from liver biopsy specimens. This will be an important area of future research in developing screening guidelines for liver disease in adult patients with Fontan palliation.…”

Section: Fontan Physiology: An Interplay Of Pulmonary Vascular Resistmentioning

confidence: 99%

The Adult With a Fontan: A Panacea Without a Cure?

Lastinger

Zaidi

2013

Circ J

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The univentricular heart includes a spectrum of complex cardiac defects that are managed by staged palliative surgical procedures, ultimately resulting in a Fontan procedure. Since 1971, when it was first developed, the procedure has undergone several variations. These patients require lifelong management, including a thorough knowledge of their anatomic substrate, hemodynamic status, management of rhythm and ventricular function, together with multi-organ evaluation. As these patients enter middle age, there is increasing awareness of long-term complications and mortality. This review highlights the concept behind the staged surgical palliations, the unique single ventricle physiology and the long-term complications in this complex cohort of patients. (Circ J 2013; 77: 2672 -2681

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Noninvasive Assessment of Liver Fibrosis in Adult Patients Following the Fontan Procedure

Abstract: Liver fibrosis detected by serum biomarkers and dual phase CT scan is common in adult patients following the Fontan procedure. Further studies are needed to determine the long-term clinical significance of these findings.

Cited by 56 publications

References 30 publications

Congenital Heart Disease in the Older Adult

Congenital Heart Disease in the Older Adult

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

The Adult With a Fontan: A Panacea Without a Cure?

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