Managing Feeding Refusal as an Unusual Presentation of Severe Atrioventricular Valve Regurgitation in a PostFontan Patient with Down Syndrome

Key Result

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.

Key Points

• To highlight feeding refusal as a potential indicator of severe atrioventricular valve regurgitation in patients with Fontan physiology.
• Presented a case of a child with Down syndrome and atrioventricular septal defect after Fontan completion.
• Performed a comprehensive evaluation to diagnose the cause of feeding refusal and ascites.
• Administered medical optimization and planned surgical valve repair.
• Identified severe atrioventricular valve regurgitation without obstruction in the Fontan pathway.
• Noted clinical improvement post-medical optimization.
• Demonstrated feeding refusal as an early symptom indicating potential Fontan failure.