International journal of cardiology
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Review Case Reports
Three cases of hepatocellular carcinoma in Fontan patients: Review of the literature and suggestions for hepatic screening.
The Fontan procedure has been used since 1971 as a palliative treatment for various (functionally) univentricular hearts. The systemic venous blood flows passively to the pulmonary arteries, without passing through a functional ventricle. This results in chronic systemic venous congestion, which may lead to liver fibrosis, cirrhosis and hepatocellular carcinoma. ⋯ In case of liver fibrosis or cirrhosis, (reversible) causes should be ruled out (e.g. obstruction in the Fontan circuit). In case of severe fibrosis or cirrhosis, other complications of portal hypertension should be evaluated and screening for hepatocellular carcinoma is required on a regular (6-12 months) basis. As regards hepatocellular carcinoma, treatment should be discussed in a multidisciplinary team, before deciding a treatment modality.
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Cone reconstruction is a novel surgical procedure for tricuspid valve repair in Ebstein anomaly. This study examined the effect of cone reconstruction on right ventricle (RV) geometry, function, and synchronization. ⋯ Cone reconstruction yielded good short-term survival in Ebstein anomaly. It reduced functional RV volume, improved RV global synchronization, and restored RV geometry. As such, it may improve RV performance and long-term prognosis. In addition, our described TAMSI proved to be a useful adjunct to postoperative assessments.
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Letter Historical Article
Johannitius (809-873AD), a bridge between Greek and Persian knowledge of the pulse.