Chan Alice
Montefiore Hospital and Medical Center, The University Hospital for Albert Einstein College of Medicine, Bronx, New York
J Dr Nurs Pract. 2018 Oct;11(2):95-99. doi: 10.1891/2380-9418.11.2.95.
Patients with congenital heart disease are surviving into adulthood because of new surgeries developed over the recent decades. One surgery is the Fontan procedure, which is used in patients with only one functioning ventricle. Although it has been saving lives, in the recent years multiple complications have been noted.
To discuss the Fontan procedure and inform nurse practitioners in the primary care setting the importance of early screening and referral because of increasing number of liver complications in these patients. This case study highlights the dilemmas a patient with the Fontan procedure faces as a young adult.
Evidence-based articles from the PubMed and Embase databases were used to support the case study.
Patients with the low-pressure Fontan circulation are under chronic passive congestion and have known liver complications such as liver fibrosis, cirrhosis, and protein-losing enteropathy. This can lead to a high-risk dual organ heart-liver transplant.
Early screening and referral to a hepatologist are critical in these patients.
Since patients with congenital heart disease often present to the primary care setting, nurse practitioners in this area should understand the Fontan procedure and its associated complications so they can effectively manage these patients.
由于近几十年来开发的新手术，先天性心脏病患者正存活至成年期。其中一种手术是Fontan手术，用于只有一个功能心室的患者。尽管它挽救了许多生命，但近年来已发现多种并发症。
讨论Fontan手术，并告知初级保健机构的执业护士，鉴于这些患者肝脏并发症数量不断增加，早期筛查和转诊的重要性。本案例研究突出了接受Fontan手术的患者在青年时期面临的困境。
使用来自PubMed和Embase数据库的循证文章来支持该案例研究。
接受低压Fontan循环的患者处于慢性被动充血状态，并且已知有肝脏并发症，如肝纤维化、肝硬化和蛋白丢失性肠病。这可能导致高风险的心脏-肝脏双器官移植。
对这些患者进行早期筛查并转诊至肝病专家处至关重要。
由于先天性心脏病患者经常前往初级保健机构，该领域的执业护士应了解Fontan手术及其相关并发症，以便他们能够有效地管理这些患者。
