Impact of liver disease after the fontan operation

Ian Lindsay, Joy Johnson, Melanie D. Everitt, James Hoffman, Angela T Yetman

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Liver disease is being reported with increased frequency in survivors of the Fontan operation. The clinical impact of structural hepatic abnormalities in these patients remains largely unknown. We sought to assess if, and how, cardiologists are screening for hepatic disease in these patients to evaluate for clinical or laboratory correlates of structural hepatic disease and determine the prevalence and clinical impact of such disease. Retrospective data analysis from tertiary institutions was performed. Hepatic imaging studies and serology performed over the last decade were reviewed and clinical and laboratory correlates of structural hepatic alterations on liver imaging or biopsy were sought. Outcomes were determined. In this cohort study, 53 of 60 adult survivors (88%) underwent hepatic imaging with computed tomography, magnetic resonance imaging, or ultrasound with a median number of 2 (0 to 10) studies over the past decade. The frequency of hepatic imaging varied widely with 70% of patients undergoing serial studies. Cirrhosis with or without abnormal hepatic nodules was seen in 29 of 53 patients (55%) at 18.4 ± 5.6 years after the Fontan procedure. Adverse hepatic-related outcome occurred in 22% of the entire patient cohort and was unrelated to time from Fontan operation. In conclusion, there exists significant variability in the type and timing of testing for hepatic complications after the Fontan procedure. Structural hepatic alterations are common and can be associated with significant morbidity and mortality. Routine imaging, and serologic evaluation, is recommended in all Fontan survivors.

Original languageEnglish (US)
Pages (from-to)249-252
Number of pages4
JournalAmerican Journal of Cardiology
Volume115
Issue number2
DOIs
StatePublished - Jan 15 2015

Fingerprint

Fontan Procedure
Liver Diseases
Liver
Survivors
Serology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of liver disease after the fontan operation. / Lindsay, Ian; Johnson, Joy; Everitt, Melanie D.; Hoffman, James; Yetman, Angela T.

In: American Journal of Cardiology, Vol. 115, No. 2, 15.01.2015, p. 249-252.

Research output: Contribution to journalArticle

Lindsay, Ian ; Johnson, Joy ; Everitt, Melanie D. ; Hoffman, James ; Yetman, Angela T. / Impact of liver disease after the fontan operation. In: American Journal of Cardiology. 2015 ; Vol. 115, No. 2. pp. 249-252.
@article{c1bcb18620bd4d45a38b3a3daf1701db,
title = "Impact of liver disease after the fontan operation",
abstract = "Liver disease is being reported with increased frequency in survivors of the Fontan operation. The clinical impact of structural hepatic abnormalities in these patients remains largely unknown. We sought to assess if, and how, cardiologists are screening for hepatic disease in these patients to evaluate for clinical or laboratory correlates of structural hepatic disease and determine the prevalence and clinical impact of such disease. Retrospective data analysis from tertiary institutions was performed. Hepatic imaging studies and serology performed over the last decade were reviewed and clinical and laboratory correlates of structural hepatic alterations on liver imaging or biopsy were sought. Outcomes were determined. In this cohort study, 53 of 60 adult survivors (88{\%}) underwent hepatic imaging with computed tomography, magnetic resonance imaging, or ultrasound with a median number of 2 (0 to 10) studies over the past decade. The frequency of hepatic imaging varied widely with 70{\%} of patients undergoing serial studies. Cirrhosis with or without abnormal hepatic nodules was seen in 29 of 53 patients (55{\%}) at 18.4 ± 5.6 years after the Fontan procedure. Adverse hepatic-related outcome occurred in 22{\%} of the entire patient cohort and was unrelated to time from Fontan operation. In conclusion, there exists significant variability in the type and timing of testing for hepatic complications after the Fontan procedure. Structural hepatic alterations are common and can be associated with significant morbidity and mortality. Routine imaging, and serologic evaluation, is recommended in all Fontan survivors.",
author = "Ian Lindsay and Joy Johnson and Everitt, {Melanie D.} and James Hoffman and Yetman, {Angela T}",
year = "2015",
month = "1",
day = "15",
doi = "10.1016/j.amjcard.2014.10.032",
language = "English (US)",
volume = "115",
pages = "249--252",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Impact of liver disease after the fontan operation

AU - Lindsay, Ian

AU - Johnson, Joy

AU - Everitt, Melanie D.

AU - Hoffman, James

AU - Yetman, Angela T

PY - 2015/1/15

Y1 - 2015/1/15

N2 - Liver disease is being reported with increased frequency in survivors of the Fontan operation. The clinical impact of structural hepatic abnormalities in these patients remains largely unknown. We sought to assess if, and how, cardiologists are screening for hepatic disease in these patients to evaluate for clinical or laboratory correlates of structural hepatic disease and determine the prevalence and clinical impact of such disease. Retrospective data analysis from tertiary institutions was performed. Hepatic imaging studies and serology performed over the last decade were reviewed and clinical and laboratory correlates of structural hepatic alterations on liver imaging or biopsy were sought. Outcomes were determined. In this cohort study, 53 of 60 adult survivors (88%) underwent hepatic imaging with computed tomography, magnetic resonance imaging, or ultrasound with a median number of 2 (0 to 10) studies over the past decade. The frequency of hepatic imaging varied widely with 70% of patients undergoing serial studies. Cirrhosis with or without abnormal hepatic nodules was seen in 29 of 53 patients (55%) at 18.4 ± 5.6 years after the Fontan procedure. Adverse hepatic-related outcome occurred in 22% of the entire patient cohort and was unrelated to time from Fontan operation. In conclusion, there exists significant variability in the type and timing of testing for hepatic complications after the Fontan procedure. Structural hepatic alterations are common and can be associated with significant morbidity and mortality. Routine imaging, and serologic evaluation, is recommended in all Fontan survivors.

AB - Liver disease is being reported with increased frequency in survivors of the Fontan operation. The clinical impact of structural hepatic abnormalities in these patients remains largely unknown. We sought to assess if, and how, cardiologists are screening for hepatic disease in these patients to evaluate for clinical or laboratory correlates of structural hepatic disease and determine the prevalence and clinical impact of such disease. Retrospective data analysis from tertiary institutions was performed. Hepatic imaging studies and serology performed over the last decade were reviewed and clinical and laboratory correlates of structural hepatic alterations on liver imaging or biopsy were sought. Outcomes were determined. In this cohort study, 53 of 60 adult survivors (88%) underwent hepatic imaging with computed tomography, magnetic resonance imaging, or ultrasound with a median number of 2 (0 to 10) studies over the past decade. The frequency of hepatic imaging varied widely with 70% of patients undergoing serial studies. Cirrhosis with or without abnormal hepatic nodules was seen in 29 of 53 patients (55%) at 18.4 ± 5.6 years after the Fontan procedure. Adverse hepatic-related outcome occurred in 22% of the entire patient cohort and was unrelated to time from Fontan operation. In conclusion, there exists significant variability in the type and timing of testing for hepatic complications after the Fontan procedure. Structural hepatic alterations are common and can be associated with significant morbidity and mortality. Routine imaging, and serologic evaluation, is recommended in all Fontan survivors.

UR - http://www.scopus.com/inward/record.url?scp=84919665731&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84919665731&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2014.10.032

DO - 10.1016/j.amjcard.2014.10.032

M3 - Article

C2 - 25534765

AN - SCOPUS:84919665731

VL - 115

SP - 249

EP - 252

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 2

ER -