Liver problems due to heart disease

My niece has a congenital heart defect. Her mother was afraid to have her operated because she's afraid of what might happen. Now, at 19 years old, my niece's cardiologist said that it would be impossible for her to be operated because her liver had already enlarged. What does this mean? Is there still a remedy? What can we do for her? I would really appreciate any reply that could enlighten us. Thank you very much.

[Jeffrey R Boris, M.D.]

Dear Lele,

Unfortunately, I have no idea what the heart defect is, so I cannot tell you if it is repairable, or not.  The liver enlargement actually does not help me in figuring out what it is.  My concern is that your niece had a congenital cardiac defect that may have caused her to have pulmonary hypertension, or high blood pressure across her lungs.  If she has this, it can be irreversible and can put her at risk for death if she were to become pregnant.  My recommendation at this point is that she should undergo a complete evaluation by an adult congenital heart disease specialist or by a pediatric cardiologist (if one will see her at this age).  I also recommend against her being seen by adult cardiologists for this evaluation, as they are not familiar with the risks, long term outcomes, and complications regarding most congenital cardiac defects.