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Non-invasive assessment of liver alterations in Senning and Mustard patients

	author = {Nicole Nagdyman and Siegrun Mebus and Johanna Kügel and Reinhart Zachoval and Dirk-André Clevert and Siegmund Lorenz Braun and Guido Haverkämper and Bernd Opgen-Rhein and Felix Berger and Sophia Horster and Jörg Schoetzau and Claudia Pujol Salvador and Ulrike Bauer and John Hess and Peter Ewert and Harald Kaemmerer},
	title = {Non-invasive assessment of liver alterations in Senning and Mustard patients},
	journal = {Cardiovascular Diagnosis and Therapy},
	volume = {0},
	number = {0},
	year = {2019},
	keywords = {},
	abstract = {Background: Adults with congenital heart disease and ventricular dysfunction are prone to liver congestion, leading to fibrosis or cirrhosis but little is known about the prevalence of liver disease in atrial switch patients. Liver impairment may develop due to increased systemic venous pressures. This prospective study aimed to assess non-invasively hepatic abnormalities in adults who underwent Senning or Mustard procedures.
Methods: Hepatic involvement was assessed non-invasively clinically by laboratory analysis, hepatic fibrotic markers, sonography, and liver stiffness measurements [transient elastography (TE) and acoustic radiation force impulse imaging (ARFI)].
Results: Overall, 24 adults who had undergone atrial switch operation (13 Senning, 11 Mustard; four female; median age 27.8 years; range 24–45 years) were enrolled. In liver stiffness measurements, only three patients had values within the normal reference. All other patients showed mild, moderate or severe liver fibrosis or cirrhosis, respectively. Using imaging and laboratory analysis, 71% of the subjects had signs of liver fibrosis (46%) or cirrhosis (25%).
Conclusions: Non-invasive screening for liver congestion, fibrosis or cirrhosis could be meaningful in targeted screening for hepatic impairment in patients with TGA-ASO. As expert knowledge is essential, patients should be regularly controlled in highly specialised centres with cooperations between congenital cardiologists and hepatologists.},
	issn = {2223-3660},	url = {}