Fontan-Associated Liver Disease (FALD) is one of the complications for a patient who has undergone a Fontan procedure for congenital heart disease.
Physiologic changes in patients with a Fontan procedure:
(1) high systemic venous pressure
(2) low cardiac output
(3) low arterial oxygen saturation
Features of FALD:
(1) liver fibrosis, portal and centrilobular
(2) vascular congestion extending into the hepatic sinusoids
(3) no or low inflammatory activity
(4) portal hypertension
Possible mechanism: sinusoidal thrombosis associated with the release of fibronectin from the activated hepatic stellate cell
Complications may include:
(1) cirrhosis
(2) hepatocellular carcinoma
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Specialty: Gastroenterology
