Liver Hemodynamics in Fontan Patients

A novel analysis of liver hemodynamics, described by flow rates and pressures, and their associations with liver disease was carried out in Fontan patients. The flow analysis revealed that morphologic evidence of liver disease is associated with statistically significant reduction in flow rates in the superior mesenteric artery, portal vein, hepatic vein, and Fontan pathway. Simulations of liver hemodynamics using a patient-specific detailed lumped parameter model for Fontan patients showed excellent agreement to in vivo patient measurements. This model illustrated the fallacy of using the hepatic venous pressure gradient in estimating the liver pressure gradient associated with the degree of liver fibrosis. Additionally, the model provided estimates of liver pressures and compliances that were generally higher and lower, respectively, in Fontan patients with liver disease. Implementation of the mentioned hemodynamic parameters in clinical settings could enable better screening of Fontan liver disease and help in providing more personalized patient care.M.A.S