Hepatic Venous Flow for Assessing Liver Condition and Splanchnic Perfusion in Pediatric Congenital Heart Disease

Congenital heart disease (CHD) often requires intracardiac repair (ICR); however, its effects on splanchnic perfusion (SP) remain unclear. Currently, no available method can effectively assess liver status in children with CHD. In this study, the relationships among hepatic venous flow (HVF), SP, and liver status were examined in pediatric patients undergoing ICR. A total of 38 patients with CHD undergoing ICR were evaluated. HVF and stroke volume were measured using ultrasonography. HVF was divided into antegrade HVF (HVFant) and retrograde HVF (HVFret) components. Effective HVF (HVFeff) was defined as the absolute value of the net flow obtained by subtracting HVFret from HVFant. Serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were measured preoperatively and postoperatively. After ICR, HVFant did not change, whereas HVFret substantially decreased and HVFeff increased. In addition, the AST and ALT levels decreased postoperatively. Preoperative ALT levels were negatively correlated with HVFant and HVFeff. ICR increased HVFeff and decreased AST and ALT levels, which may reflect improved SP and liver function in patients with CHD. HVF measurement may serve as a noninvasive tool for monitoring liver function and evaluating the effects of ICR.