I met with Dr. Eric Krieger from the University of Washington Adult Congenital Heart Disease group to talk about patients with the Fontan palliative shunt. This shunt is used to help infants born with single ventricle physiology survive into adulthood. We discuss the case of an infant born with tricuspid atresia, review the initial surgeries performed and then talk about complications that develop in adulthood.

For further reading, recommend reviewing the chapter titled “Late Complications Following the Fontan Operation” in Diagnosis and Management of Adult Congenital Heart Disease, Third Edition edited by Michael A. Gatzoulis MD, PhD.

I am joined by co-fellow Alex Taylor, MD and we visit with Alec Moorman, MD to discuss coronary artery disease in patients with chronic kidney disease. We talk about the recent ISCHEMIA-CKD trial, the nuances of treating patients with CKD and CAD and how to handle referrals for cardiac risk assessment prior to kidney transplant.

Links to trials referenced (links available on apcardiology.com)

AURORA

4D

ISCHEMIA-CKD

CARP