{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:59:03Z","timestamp":1781182743429,"version":"3.54.1"},"reference-count":17,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T00:00:00Z","timestamp":1751500800000},"content-version":"unspecified","delay-in-days":32,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Fontan-associated liver disease is a condition characterised by structural, functional, and clinical alterations secondary to the haemodynamic changes of this circulation.<\/jats:p>\n                  <jats:sec id=\"S104795112510084X_as2\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To describe the experience of a series of paediatric patients with Fontan-associated liver dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510084X_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective study including 12 patients with Fontan-associated liver disease. Patients were selected from the single-ventricle program at a high-complexity centre in Colombia between 2001 and 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510084X_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>During the study period, 108 patients were in the Fontan stage. Among them, 12 met the criteria for Fontan-associated liver disease (11.1%). The median age at extracardiac Fontan completion was 3.9 years, while the median age at Fontan-associated liver disease diagnosis was 14.5 years. Concomitant protein-losing enteropathy and\/or plastic bronchitis were present in 33% of cases. Echocardiographic follow-up showed systolic dysfunction in 41% and diastolic dysfunction in 16% of patients. All patients exhibited some degree of valvular insufficiency, mild in 83.3% and moderate in 16%. Haemodynamic variables at the time of diagnosis did not show significant abnormalities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S104795112510084X_as5\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Liver disease is a persistent concern in paediatric patients with Fontan physiology, posing diagnostic and therapeutic challenges. Healthcare professionals managing these patients should be aware of its early identification and appropriate treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s104795112510084x","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:09:12Z","timestamp":1751515752000},"page":"1220-1224","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Fontan-associated liver disease: paediatric experience in a reference centre in Colombia"],"prefix":"10.1017","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0867-4793","authenticated-orcid":false,"given":"Andr\u00e9s David","family":"Aranzazu","sequence":"first","affiliation":[{"name":"Universidad Pontificia Bolivariana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4980-892X","authenticated-orcid":false,"given":"Isabel C.","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Cl\u00ednica CardioVID"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3404-6221","authenticated-orcid":false,"given":"Sydney","family":"Goldfeder","sequence":"additional","affiliation":[{"name":"Cl\u00ednica CardioVID"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1716-1999","authenticated-orcid":false,"given":"M\u00f3nica Isabel","family":"Guzm\u00e1n","sequence":"additional","affiliation":[{"name":"Cl\u00ednica CardioVID"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"S104795112510084X_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2016.05.016"},{"key":"S104795112510084X_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17952"},{"key":"S104795112510084X_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.09.005"},{"key":"S104795112510084X_ref13","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2023.1204545"},{"key":"S104795112510084X_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.01.074"},{"key":"S104795112510084X_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-024-02168-x"},{"key":"S104795112510084X_ref4","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.004809"},{"key":"S104795112510084X_ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.013"},{"key":"S104795112510084X_ref8","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000580"},{"key":"S104795112510084X_ref2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1354857"},{"key":"S104795112510084X_ref7","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-021-04163-3"},{"key":"S104795112510084X_ref6","first-page":"e234","volume-title":"Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association. Circulation","volume":"140","author":"Rychik","year":"2019"},{"key":"S104795112510084X_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2019.02.016"},{"key":"S104795112510084X_ref14","first-page":"1338","article-title":"Determinants of advanced liver fibrosis in adult patients after Fontan palliation: usefulness of ultrasound transient Elastography","volume":"39","author":"Butikofer","year":"2023","journal-title":"Can J Cardiol"},{"key":"S104795112510084X_ref16","first-page":"e1011","article-title":"Mechanics of the functionally univentricular heart\u2013how little do we understand and why does it matter?","volume":"32","author":"Grattan","year":"2016","journal-title":"Can J Cardiol"},{"key":"S104795112510084X_ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2015.11.014"},{"key":"S104795112510084X_ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2020.11.037"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S104795112510084X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T12:17:04Z","timestamp":1781180224000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S104795112510084X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["S104795112510084X"],"URL":"https:\/\/doi.org\/10.1017\/s104795112510084x","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. 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