Diagnostic and Therapeutic Yield of Routine Esophagogastroduodenoscopy in Patients with Fontan Palliation.

Josue Diaz-Frias, Hari S Conjeevaram, Mark D Norris, Michael R Joynt, Sunkyung Yu, Ashley Duimstra, Timothy B Cotts

Abstract read

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Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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2 · The registry

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Josue Diaz-FriasDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.

Hari S ConjeevaramDivision of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.

Mark D NorrisDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.

Michael R JoyntDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA.

Sunkyung YuDivision of Pediatric Cardiology, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI, USA.

Ashley DuimstraDivision of Pediatric Cardiology, Department of Pediatrics, University of Michigan Health System, Ann Arbor, MI, USA.

Timothy B CottsDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA. cottstim@med.umich.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Fontan-associated liver disease (FALD) is an impactful complication for adults with Fontan circulation. The presence of esophageal varices is associated with increased morbidity and mortality in patients with underlying cirrhosis. The diagnostic yield of routine esophagogastroduodenoscopy (EGD) screening in Fontan patients with clinical or radiographic evidence of cirrhosis is not well known with wide practice variation across centers. We performed a retrospective chart review of all patients with Fontan circulation who underwent an EGD from 2020 to 2023 at our center. During the study period, a total of 66 patients (51.5% male) with Fontan circulation underwent a screening EGD at a median age 30.2 years (range 19.8-60.4 years). Esophageal varices were present in 41 (62.1%) patients, of which 35 (53.0%) had grade I esophageal varices, and 6 (9.1%) had grade II. The study showed a high incidence of esophageal varices in our patients with a Fontan circulation, suggesting a role for routine EGD as a screening tool in this population. This diagnostic procedure was well tolerated with no associated complications.

Indexed as

Endoscopy, Digestive SystemEsophageal and Gastric VaricesFontan ProcedureHeart Defects, CongenitalLiver CirrhosisPalliative CarePostoperative ComplicationsAdultFemaleHumansIncidenceMaleMiddle AgedRetrospective StudiesYoung AdultCongenital heart diseaseEsophageal varicesEsophagogastroduodenoscopyExtracardiac conduitFontan-associated liver diseaseFontan procedure

Identifiers

PMID40824488

DOI10.1007/s00246-025-03988-1

PMCPMC13144250

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