Received: 11 February
2014 / Accepted: 25 April 2014
© Springer Science+Business Media New York 2014
Transvenous Hepatic Biopsy in
Stable Fontan Patients Undergoing Cardiac Catheterization
Authors
William N Evans, MD, Brody J
Winn, MD, Noel S Yumiaco, MD, Alvaro Galindo, MD, Abraham
Rothman, MD, Ruben J Acherman, MD, Humberto Restrepo, MD, MPH
Source
ChildrenŐs Heart Center
Nevada, 3006 S Maryland Pkwy, Ste 690, Las Vegas, Nevada 89109, USA. Email: wnevans50@aol.com.
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.