Intraperitoneal corticosteroids for recurrent ascites in patients with
Fontan circulation: Initial clinical experience
Abstract
Individuals with single-ventricle congenital heart disease who are
palliated to a Fontan circulation are at risk for heart failure and
liver disease, with recurrent ascites being one potentially debilitating
cause of late morbidity. Although ascites associated with heart failure
or liver failure is usually characterized by a high serum-ascites
albumin gradient (SAAG), we have observed multiple instances of ascites
in Fontan patients with low SAAG, suggesting an inflammatory process. We
present three cases in which recalcitrant ascites severely and adversely
impacted quality of life, and describe our initial experience with
intraperitoneal corticosteroids in this setting.