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Hereditary haemorrhagic telangiectasia and SMAD4 mutation in a patient with complex single ventricle heart disease.

Abstract
We report a case of hypoplastic left heart syndrome and with subsequent aortopathy and then found to have hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome due to a germline SMAD4 pathologic variant. The patient's staged palliation was complicated by the development of neoaortic aneurysms, arteriovenous malformations, and gastrointestinal bleeding thought to be secondary to Fontan circulation, but workup revealed a SMAD4 variant consistent with hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome. This case underscores the importance of genetic modifiers in CHD, especially those with Fontan physiology.
AuthorsMadison A Grasty, Constantine D Mavroudis, Aaron G DeWitt, Benjamin W Kozyak, Peter Mamula, Suzanne P MacFarland, Muhammad A K Nuri, Lindsay S Rogers, Jonathan J Rome, J William Gaynor, David J Goldberg
JournalCardiology in the young (Cardiol Young) Pg. 1-3 (Oct 09 2023) ISSN: 1467-1107 [Electronic] England
PMID37807723 (Publication Type: Journal Article)

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