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Congenital heart disease-associated liver disease: a narrative review

Authors
  • Reiter, Florian P.1
  • Hadjamu, Nino J.2
  • Nagdyman, Nicole3
  • Zachoval, Reinhart
  • Mayerle, Julia1
  • De Toni, Enrico N.1
  • Kaemmerer, Harald3
  • Denk, Gerald1,
  • 1 ; , (Germany)
  • 2 University Hospital Essen, Essen , (Germany)
  • 3 Technical University Munich, Munich , (Germany)
Type
Published Article
Journal
Cardiovascular Diagnosis and Therapy
Publisher
AME Publishing Company
Publication Date
Apr 01, 2021
Volume
11
Issue
2
Pages
577–590
Identifiers
DOI: 10.21037/cdt-20-595
PMID: 33968635
PMCID: PMC8102244
Source
PubMed Central
Keywords
Disciplines
  • Review Article on Current Management Aspects in Adult Congenital Heart Disease (ACHD): Part III
License
Unknown

Abstract

Congenital heart diseases (CHD) can be associated with liver dysfunction. The cause for liver impairment can result out of a wide spectrum of different causes, including liver congestion, hypoxemia or low cardiac output. Fortunately, most CHD show a good long-term outcome from a cardiac perspective, but great attention should be paid on non-cardiac health problems that develop frequently in patients suffering from CHD. The treatment of liver dysfunction in CHD requires a close multidisciplinary management in a vulnerable patient collective. Unfortunately, structured recommendations on the management of liver dysfunction in patients with CHD are scarce. The objective of this review is to provide insights on the pathophysiology and etiologies of liver dysfunction as one of the most relevant non-cardiac problems related to CHD. Furthermore, we advise here on the management of liver disease in CHD with special attention on assessment of liver dysfunction, management of portal hypertension as well as on surveillance and management of hepatocellular carcinoma (HCC). A multidisciplinary perspective may help to optimize morbidity and mortality in the long-term course in these patients. However, as evidence is low in many aspects, we encourage the scientific community to perform prospective studies to gain more insights in the treatment of liver dysfunction in patients with CHD.

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