Intraperitoneal corticosteroids for recurrent ascites in patients with Fontan circulation: Initial clinical experience

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 a 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 the quality of life and describe our initial experience with intraperitoneal corticosteroids in this setting.

Automated summary

Patients with single-ventricle congenital heart disease who undergo Fontan circulation may develop recalcitrant ascites, with some cases exhibiting a low SAAG, suggesting an inflammatory process. Treating this condition may involve intraperitoneal corticosteroids to improve the quality of life.