Haemodynamics, fluids & transfusion
Competing Hemodynamic Goals During Hepatectomy in Patients with Fontan Circulation: A Systematic Review of Case Reports
Authors' conclusion
Hepatectomy appears feasible in carefully selected patients with stable Fontan circulation.
Study context
- Population
- Patients with Fontan circulation undergoing open or laparoscopic hepatectomy, primarily for hepatocellular carcinoma in Fontan-associated liver disease
- Participants
- 31 patients · 28 studies
- Outcome
- Perioperative outcomes and hemodynamic management of hepatectomy after Fontan
Methodological detailsDatabases searched: PubMed, Scopus, Cochrane Library, Google Scholar, ICHUSHI, CiNii Research
- Databases searched: PubMed, Scopus, Cochrane Library, Google Scholar, ICHUSHI, CiNii Research
Pooled result
As reported in the abstract
Preoperative baseline central venous pressure (CVP)
10 to 15 mmHg
Median blood loss (range 10-4,130 mL)
1,106 mL
Safety
Intraoperative haemodynamic tolerance
- Pringle maneuver well tolerated; inferior vena cava clamping associated with significant hypotension
Postoperative complications
- Congestion-related complications (ascites, pleural effusion, HF, unspecified fluid retention) most commonly reported
Original publication
Competing Hemodynamic Goals During Hepatectomy in Patients with Fontan Circulation: A Systematic Review of Case Reports. J Cardiothorac Vasc Anesth. Published 25 September 2026. doi:10.
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