Hermes
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HERMES
Hermes Published online: 15 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
The rate of hepatic fibrosis progression in patients postFontan Evans WN, Acherman RJ, Mayman GA et al Pediatr Cardiol (2020) 41:905-909 The Fontan procedure is a life-saving definitive palliation for children born with severe congenital heart disease unsuitable for biventricular repair. However, one of the morbidities associated with the procedure is the effects of increased systemic venous pressure on the liver and development of hepatic fibrosis. The authors of this manuscript sought to determine the rate of biopsy-graded progression of hepatic fibrosis in 126 children who had undergone the Fontan procedure, of whom 27 (21%) had a lateral tunnel conduit and 99 (79%) had creation of an extracardiac Fontan. Age at the time of the procedure was 4±2 years for both groups. The average length of time post Fontan was 20±6 years for the patients with a lateral tunnel and 11±5 years for those with an extracardiac Fontan. Hepatic biopsies were performed via the transvenous route during cardiac catheterizations. The rate of change in hepatic fibrosis was calculated by dividing the total fibrosis score (TFS) by the number of years post Fontan for each child and averaging the results. The authors found that in 27 lateral tunnel Fontan patients, the average rate of progression of fibrosis was 0.16±0.10 TFS/year, while in the 99 extracardiac Fontan patients, the same value was 0.30±0.23 (P
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