{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T20:36:49Z","timestamp":1773693409396,"version":"3.50.1"},"reference-count":12,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100006942","name":"Medical University of South Carolina","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100006942","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Patients with Fontan circulation insidiously develop congestive hepatopathy related to chronically reduced cardiac output and central venous hypertension, also known as Fontan-associated liver disease (FALD). Fontan pathway obstruction is increasingly detected and may accelerate FALD. The impact of conduit stent angioplasty on FALD is unknown. Retrospective, single-center review of patients with Fontan circulation who underwent conduit stent angioplasty at cardiac catheterization over 5-year period. Demographics and cardiac histories were reviewed. Labs, liver ultrasound elastography, echocardiogram, hemodynamic and angiographic data at catheterization were recorded pre- and post-stent angioplasty. Primary outcome was change in hepatic function via MELD-XI scores and liver stiffness (kPa), with secondary outcomes of ventricular function, BNP, and repeat catheterization hemodynamics. 33 patients underwent Fontan conduit stent angioplasty, 19.3\u2009\u00b1\u20097.0\u00a0years from Fontan operation. Original conduit diameter was 19.1\u2009\u00b1\u20091.9\u00a0mm. Prior to angioplasty, conduit size was reduced to a cross-sectional area 132 (91, 173)\u00a0mm\n                    <jats:sup>2<\/jats:sup>\n                    and increased to 314 (255, 363)\u00a0mm\n                    <jats:sup>2<\/jats:sup>\n                    post-stent. Subjects\u2019 baseline median MELD-XI of 11 (9, 12) increased to 12 (9, 13) at 19\u2009\u00b1\u200915.5\u00a0months post-angioplasty (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200922,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.053). There was no significant change in liver stiffness at 12.1\u2009\u00b1\u20098.9\u00a0months post-angioplasty (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200915,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.13). Median total bilirubin significantly increased (1.4 [0.9, 1.8]), from baseline 1.1 [0.7, 1.5],\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04), as did median BNP (41 [0, 148] from baseline 34 [15, 79];\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). There were no significant changes in ventricular function or repeat invasive hemodynamics (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20098 subjects). Mid-term follow-up of Fontan subjects post-conduit stent angioplasty did not show improvements in non-invasive markers of FALD.\n                  <\/jats:p>","DOI":"10.1007\/s00246-024-03426-8","type":"journal-article","created":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T08:02:53Z","timestamp":1709280173000},"page":"372-378","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["\u201cFontan Conduit Stent-Angioplasty and Progression of Fontan-Associated Liver Disease\u201d"],"prefix":"10.1007","volume":"46","author":[{"given":"Umakanthan","family":"Kavin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aniqa","family":"Shahrier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varsha M.","family":"Bandisode","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahryar M.","family":"Chowdhury","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John F.","family":"Rhodes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8536-9899","authenticated-orcid":false,"given":"Stephanie S.","family":"Gaydos","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"issue":"6","key":"3426_CR1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1161\/CIRCULATIONAHA.120.045597","volume":"142","author":"J Emamaullee","year":"2020","unstructured":"Emamaullee J et al (2020) Fontan-associated liver disease: screening, management, and transplant considerations. Circulation 142(6):591\u2013604","journal-title":"Circulation"},{"issue":"2","key":"3426_CR2","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/j.healun.2013.10.033","volume":"33","author":"KE Simpson","year":"2014","unstructured":"Simpson KE et al (2014) Liver cirrhosis in Fontan patients does not affect 1-year post-heart transplant mortality or markers of liver function. J Heart Lung Transplant 33(2):170\u2013177","journal-title":"J Heart Lung Transplant"},{"issue":"1","key":"3426_CR3","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/j.jtcvs.2007.12.032","volume":"136","author":"SJ Kim","year":"2008","unstructured":"Kim SJ et al (2008) Outcome of 200 patients after an extracardiac Fontan procedure. J Thorac Cardiovasc Surg 136(1):108\u2013116","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"1","key":"3426_CR4","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1111\/j.1540-8183.2007.00323.x","volume":"21","author":"S Ovroutski","year":"2008","unstructured":"Ovroutski S et al (2008) Dilatation and stenting of the Fontan pathway: impact of the stenosis treatment on chronic ascites. J Interv Cardiol 21(1):38\u201343","journal-title":"J Interv Cardiol"},{"issue":"4","key":"3426_CR5","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1111\/chd.12757","volume":"14","author":"DJ Hagler","year":"2019","unstructured":"Hagler DJ et al (2019) Fate of the Fontan connection: mechanisms of stenosis and management. Congenit Heart Dis 14(4):571\u2013581","journal-title":"Congenit Heart Dis"},{"issue":"14","key":"3426_CR6","doi-asserted-by":"publisher","first-page":"1111","DOI":"10.1136\/heartjnl-2016-310511","volume":"103","author":"FEA Udink Ten Cate","year":"2017","unstructured":"Udink Ten Cate FEA et al (2017) Stenting the Fontan pathway in paediatric patients with obstructed extracardiac conduits. Heart 103(14):1111\u20131116","journal-title":"Heart"},{"issue":"10","key":"3426_CR7","doi-asserted-by":"publisher","first-page":"E254","DOI":"10.25270\/jic\/20.00131","volume":"32","author":"J Yell","year":"2020","unstructured":"Yell J et al (2020) Improvement in pulmonary vascular resistance after relief of Fontan circuit obstruction. J Invasive Cardiol 32(10):E254-e257","journal-title":"J Invasive Cardiol"},{"issue":"8","key":"3426_CR8","doi-asserted-by":"publisher","first-page":"1740","DOI":"10.1007\/s00246-021-02658-2","volume":"42","author":"E McGovern","year":"2021","unstructured":"McGovern E et al (2021) The Fontan pathway: change in dimension and catheter-based intervention over time. Pediatr Cardiol 42(8):1740\u20131748","journal-title":"Pediatr Cardiol"},{"key":"3426_CR9","doi-asserted-by":"crossref","unstructured":"Mets, J. M., et al. (2013). \"Outcomes of stent implantation for obstruction of intracardiac lateral tunnel fontan pathways.\" Circulation: Cardiovascular Interventions 6(1): 92\u2013100.","DOI":"10.1161\/CIRCINTERVENTIONS.112.000099"},{"issue":"6","key":"3426_CR10","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1111\/chd.12345","volume":"11","author":"M Mori","year":"2016","unstructured":"Mori M et al (2016) Catheter-measured hemodynamics of adult Fontan Circulation: associations with adverse event and end-organ dysfunctions. Congenit Heart Dis 11(6):589\u2013597","journal-title":"Congenit Heart Dis"},{"issue":"4","key":"3426_CR11","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1111\/chd.12770","volume":"14","author":"JA Silva-Sepulveda","year":"2019","unstructured":"Silva-Sepulveda JA et al (2019) Evaluation of Fontan liver disease: Correlation of transjugular liver biopsy with magnetic resonance and hemodynamics. Congenit Heart Dis 14(4):600\u2013608","journal-title":"Congenit Heart Dis"},{"issue":"1","key":"3426_CR12","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1002\/hep.26631","volume":"59","author":"SS Kutty","year":"2014","unstructured":"Kutty SS et al (2014) Increased hepatic stiffness as consequence of high hepatic afterload in the Fontan circulation: a vascular doppler and elastography study. Hepatology 59(1):251\u2013260","journal-title":"Hepatology"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03426-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-024-03426-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-024-03426-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T03:41:25Z","timestamp":1738381285000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-024-03426-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":12,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["3426"],"URL":"https:\/\/doi.org\/10.1007\/s00246-024-03426-8","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3478841\/v1","asserted-by":"object"}]},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,1]]},"assertion":[{"value":"22 October 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Authors are required to disclose financial or non-financial interests that are directly or indirectly related to the work submitted for publication. Please refer to \u201cCompeting Interests and Funding\u201d below for more information on how to complete this section.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}