{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:25:41Z","timestamp":1787509541465,"version":"build-2736575974"},"reference-count":7,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fontan-associated liver disease (FALD) is an impactful complication for adults with Fontan circulation. The presence of esophageal varices is associated with increased morbidity and mortality in patients with underlying cirrhosis. The diagnostic yield of routine esophagogastroduodenoscopy (EGD) screening in Fontan patients with clinical or radiographic evidence of cirrhosis is not well known with wide practice variation across centers. We performed a retrospective chart review of all patients with Fontan circulation who underwent an EGD from 2020 to 2023 at our center. During the study period, a total of 66 patients (51.5% male) with Fontan circulation underwent a screening EGD at a median age 30.2\u00a0years (range 19.8\u201360.4\u00a0years). Esophageal varices were present in 41 (62.1%) patients, of which 35 (53.0%) had grade I esophageal varices, and 6 (9.1%) had grade II. The study showed a high incidence of esophageal varices in our patients with a Fontan circulation, suggesting a role for routine EGD as a screening tool in this population. This diagnostic procedure was well tolerated with no associated complications.<\/jats:p>","DOI":"10.1007\/s00246-025-03988-1","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T13:49:28Z","timestamp":1755524968000},"page":"2007-2017","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diagnostic and Therapeutic Yield of Routine Esophagogastroduodenoscopy in Patients with Fontan Palliation"],"prefix":"10.1007","volume":"47","author":[{"given":"Josue","family":"Diaz-Frias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hari S.","family":"Conjeevaram","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark D.","family":"Norris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Joynt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunkyung","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Duimstra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy B.","family":"Cotts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"issue":"6","key":"3988_CR1","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1161\/CIRCULATIONAHA.120.045597","volume":"142","author":"J Emamaullee","year":"2020","unstructured":"Emamaullee J, Zaidi AN, Schiano T et al (2020) Fontan-associated liver disease: screening, management, and transplant considerations. Circulation 142(6):591\u2013604","journal-title":"Circulation"},{"issue":"4","key":"3988_CR2","doi-asserted-by":"publisher","first-page":"3764","DOI":"10.1016\/j.ijcard.2013.06.008","volume":"168","author":"RW Elder","year":"2013","unstructured":"Elder RW, McCabe NM, Hebson C et al (2013) Features of portal hypertension are associated with major adverse events in Fontan patients: the VAST study. Int J Cardiol 168(4):3764\u20133769","journal-title":"Int J Cardiol"},{"issue":"2","key":"3988_CR3","doi-asserted-by":"publisher","first-page":"192","DOI":"10.5604\/01.3001.0010.8634","volume":"17","author":"L T\u00e9llez","year":"2018","unstructured":"T\u00e9llez L, Rodr\u00edguez-Santiago E, Albillos A (2018) Fontan-associated liver disease: a review. Ann Hepatol 17(2):192\u2013204","journal-title":"Ann Hepatol"},{"key":"3988_CR4","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1016\/j.ijcard.2016.02.041","volume":"209","author":"G Agnoletti","year":"2016","unstructured":"Agnoletti G, Ferraro G, Bordese R et al (2016) Fontan circulation causes early, severe liver damage. Should we offer patients a tailored strategy? Int J Cardiol 209:60\u201365","journal-title":"Int J Cardiol"},{"issue":"25","key":"3988_CR5","doi-asserted-by":"publisher","first-page":"3173","DOI":"10.1016\/j.jacc.2017.10.045","volume":"70","author":"CJ Daniels","year":"2017","unstructured":"Daniels CJ, Bradley EA, Landzberg MJ et al (2017) Fontan-Associated Liver Disease: Proceedings from the American College of Cardiology Stakeholders Meeting, October 1 to 2, 2015, Washington DC. J Am Coll Cardiol 70(25):3173\u20133194","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"3988_CR6","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1055\/s-0041-1732355","volume":"41","author":"L T\u00e9llez","year":"2021","unstructured":"T\u00e9llez L, Rodr\u00edguez de Santiago E, Albillos A (2021) Fontan-Associated Liver Disease: pathophysiology, staging, and management. Semin Liver Dis 41(4):538\u2013550","journal-title":"Semin Liver Dis"},{"issue":"3","key":"3988_CR7","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.cjcpc.2024.01.002","volume":"3","author":"MH Ahmed","year":"2024","unstructured":"Ahmed MH, Miranda WR, Kamath PS et al (2024) Outcomes of esophageal varices in adults with Fontan palliation and liver cirrhosis. CJC Pediatr Congenit Heart Dis 3(3):107\u2013114","journal-title":"CJC Pediatr Congenit Heart Dis"}],"container-title":["Pediatric Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-025-03988-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00246-025-03988-1","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00246-025-03988-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T15:17:17Z","timestamp":1777994237000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00246-025-03988-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,18]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["3988"],"URL":"https:\/\/doi.org\/10.1007\/s00246-025-03988-1","relation":{},"ISSN":["0172-0643","1432-1971"],"issn-type":[{"value":"0172-0643","type":"print"},{"value":"1432-1971","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,18]]},"assertion":[{"value":"17 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}