Carcinoma hepatocelular após cirugía de Fontan: relato de caso

BACKGROUND: Single ventricle includes various cardiac abnormalities in which either one ventricle is underdeveloped or a ventricular septal wall did not form, leading to the mixing of arterial and venous blood in the heart. The Fontan procedure separates the systemic and pulmonary circulations becau...

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Main Authors: Joana Ribeiro, Lara Adelino
Format: Article
Language:English
Published: Sociedade Galega de Medicina Interna 2025-04-01
Series:Galicia Clínica
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Online Access:https://ojs.galiciaclinica.info/gc/article/view/1431
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author Joana Ribeiro
Lara Adelino
author_facet Joana Ribeiro
Lara Adelino
author_sort Joana Ribeiro
collection DOAJ
description BACKGROUND: Single ventricle includes various cardiac abnormalities in which either one ventricle is underdeveloped or a ventricular septal wall did not form, leading to the mixing of arterial and venous blood in the heart. The Fontan procedure separates the systemic and pulmonary circulations because a surgical cavopulmonary connection is made. After this procedure, there is an increased systemic venous pressure, leading to low hepatic perfusion pressure and oxygenation, fibrosis, cirrhosis and ultimately hepatocellular carcinoma. PATIENT AND METHODS: This case report details a 40-year-old man who received the Fontan procedure, developing symptoms similar to cardiac failure 30 years later. After further evaluation, findings were consistent with hepatocellular carcinoma with lung metastasis, leading to death in less than one month. RESULTS AND CONCLUSION: Fontan patients must be screened for associated liver disease with cirrhosis and hepatocellular carcinoma to prevent disease progression and its detection in advanced stages. Despite the regular follow-up in a Cardiology consultation, we point out the importance of a multidisciplinary approach to screening for complications of the Fontan procedure.
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publishDate 2025-04-01
publisher Sociedade Galega de Medicina Interna
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spelling doaj-art-0750bcd32ccf45bfbc816b2bc3e254e72025-08-20T03:09:07ZengSociedade Galega de Medicina InternaGalicia Clínica0304-48661989-39222025-04-01854262810.22546/75/41711431Carcinoma hepatocelular após cirugía de Fontan: relato de casoJoana Ribeiro0https://orcid.org/0000-0003-1821-8334Lara Adelino1Centro Hospitalar do Médio TejoCentro Hospitalar do Médio TejoBACKGROUND: Single ventricle includes various cardiac abnormalities in which either one ventricle is underdeveloped or a ventricular septal wall did not form, leading to the mixing of arterial and venous blood in the heart. The Fontan procedure separates the systemic and pulmonary circulations because a surgical cavopulmonary connection is made. After this procedure, there is an increased systemic venous pressure, leading to low hepatic perfusion pressure and oxygenation, fibrosis, cirrhosis and ultimately hepatocellular carcinoma. PATIENT AND METHODS: This case report details a 40-year-old man who received the Fontan procedure, developing symptoms similar to cardiac failure 30 years later. After further evaluation, findings were consistent with hepatocellular carcinoma with lung metastasis, leading to death in less than one month. RESULTS AND CONCLUSION: Fontan patients must be screened for associated liver disease with cirrhosis and hepatocellular carcinoma to prevent disease progression and its detection in advanced stages. Despite the regular follow-up in a Cardiology consultation, we point out the importance of a multidisciplinary approach to screening for complications of the Fontan procedure.https://ojs.galiciaclinica.info/gc/article/view/1431carcinoma hepatocelularcirugía de fontancirrosiscuidados paliativos
spellingShingle Joana Ribeiro
Lara Adelino
Carcinoma hepatocelular após cirugía de Fontan: relato de caso
Galicia Clínica
carcinoma hepatocelular
cirugía de fontan
cirrosis
cuidados paliativos
title Carcinoma hepatocelular após cirugía de Fontan: relato de caso
title_full Carcinoma hepatocelular após cirugía de Fontan: relato de caso
title_fullStr Carcinoma hepatocelular após cirugía de Fontan: relato de caso
title_full_unstemmed Carcinoma hepatocelular após cirugía de Fontan: relato de caso
title_short Carcinoma hepatocelular após cirugía de Fontan: relato de caso
title_sort carcinoma hepatocelular apos cirugia de fontan relato de caso
topic carcinoma hepatocelular
cirugía de fontan
cirrosis
cuidados paliativos
url https://ojs.galiciaclinica.info/gc/article/view/1431
work_keys_str_mv AT joanaribeiro carcinomahepatocelularaposcirugiadefontanrelatodecaso
AT laraadelino carcinomahepatocelularaposcirugiadefontanrelatodecaso