VAST Score of Elder et al for Evaluating Portal Hypertension in a Patient with a History of the Fontan Procedure for Congenital Heart Disease

 

Paitent selection: Fontan surgery 11 to 23 years ago

 

Outcome: major adverse events involving death or cardiac transplant

 

Parameters:

(1) varices (V)

(2) ascites (A)

(3) splenomegaly (S)

(4) thrombocytopenia (T), with platelet count < 150,000 per µL

 

Parameter	Finding	Points
varices	absent	0
	present	1
ascites	absent	0
	present	1
splenomegaly	absent	0
	present	1
platelet count	>= 150,000 per µL	0
	< 150,000 per µL	1

 

• Ascites and varices were considered present if seen on imaging or identified clinically.

• Splenomegaly was defined as when any dimension of the spleen was > 13 cm.

 

total score =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• A score >=2 was assocated with portal hypertension and with major adverse events (odds ratio 9.8).