Visceral lesions in 49 infants with ductus dependent malformations of the heart were surveyed from postmortem material collected over a seven-year period. These lesions, all of which have previously been ascribed to ischemia, were found to be related to the duration of clinical illness dating from the occurrence of closure of the ductus arteriosus. The liver and adrenal glands were found to be the most consistently affected organs in peripheral circulatory collapse, whereas the kidneys and brain seem to be significantly spared. The frequent occurrence of hypoglycemia in infants with the hypoplastic left heart syndrome apparently has its origin in liver ischemia and its consequent glycogen depletion.
Coen R, McAdams AJ. Visceral Manifestation of Shock in Congenital Heart Disease. Am J Dis Child. 1970;119(5):383-389. doi:10.1001/archpedi.1970.02100050385001