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Transvenous Hepatic Biopsy in Stable Fontan Patients Undergoing Cardiac Catheterization

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Abstract

Liver pathology complicates Fontan palliation. Previous reports established that both hepatic sinusoidal and portal fibrosis occur in patients after Fontan procedures. Past studies predominantly included symptomatic patient cohorts. Thus, the authors of this study aimed to characterize hepatic pathology via transvenous hepatic biopsies in 21 asymptomatic patients at the time of elective cardiac catheterization. Seven of these patients (33 %) were accompanied by an interventional procedure. Hepatic biopsies showed evidence of either sinusoidal or portal fibrosis or both in all but one patient. The findings showed a statistically significant (p = 0.005) moderately strong positive correlation between fibrosis scores and time since Fontan surgery. Additionally, no significant correlation was found between fibrosis scores and inferior vena cava pressure, pulmonary vascular resistance, platelet counts, or serum laboratory testing of hepatic function.

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Acknowledgments

We thank the interventional radiologists of Radiology Specialists at Sunrise Children’s Hospital and Medical Center who performed the transvenous hepatic biopsies including Drs. Demetrice Davis, Steven Davis, Kelly Gardner, Sunil Gujrathi, Aaron Peterson, and Matthew Rainey.

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Authors and Affiliations

  1. Children’s Heart Center–Nevada, 3006 S. Maryland Parkway Suite 690, Las Vegas, NV, 89109, USA

    William N. Evans, Alvaro Galindo, Abraham Rothman, Ruben J. Acherman & Humberto Restrepo

  2. Division of Pediatric Cardiology, Department of Pediatrics, University of Nevada School of Medicine, 2040 W. Charleston Blvd Ste. 402, Las Vegas, NV, 89109, USA

    William N. Evans, Alvaro Galindo, Abraham Rothman, Ruben J. Acherman & Humberto Restrepo

  3. Laboratory Medicine Consultants, 3059 S. Maryland Parkway, Suite 100, Las Vegas, NV, 89109, USA

    Brody J. Winn & Noel S. Yumiaco

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  1. William N. Evans
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  2. Brody J. Winn
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  3. Noel S. Yumiaco
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  4. Alvaro Galindo
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Correspondence to William N. Evans.

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Evans, W.N., Winn, B.J., Yumiaco, N.S. et al. Transvenous Hepatic Biopsy in Stable Fontan Patients Undergoing Cardiac Catheterization. Pediatr Cardiol 35, 1273–1278 (2014). https://doi.org/10.1007/s00246-014-0928-0

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  • DOI: https://doi.org/10.1007/s00246-014-0928-0

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