Medical optimization improved clinical symptoms in a post-Fontan child with Down syndrome who presented with feeding refusal and ascites due to severe atrioventricular valve regurgitation.
Case Report (n=1)
Feeding refusal may represent an early clinical clue of Fontan failure in patients with Down syndrome and unbalanced atrioventricular septal defect.
Background: Feeding refusal is an uncommon and often overlooked manifestation of hemodynamic deterioration in patients with Fontan physiology. Case Presentation: We report a child with trisomy 21 and unbalanced atrioventricular septal defect who presented several years after Fontan completion with progressive feeding refusal and ascites. Comprehensive evaluation revealed severe atrioventricular valve regurgitation without Fontan pathway obstruction. Medical optimization resulted in clinical improvement, and surgical valve repair was planned. Conclusion: Feeding refusal may represent an early clinical clue of Fontan failure. Prompt recognition and multidisciplinary management are essential to optimize outcomes in this high-risk population.
Abdelaal et al. (2025) conducted a case report in Severe atrioventricular valve regurgitation post-Fontan (n=1). Medical optimization was evaluated. Medical optimization improved clinical symptoms in a post-Fontan child with Down syndrome who presented with feeding refusal and ascites due to severe atrioventricular valve regurgitation.