Abstract Objective We investigated possible gender differences for hepatic fibrosis in extracardiac‐Fontan patients. Methods We identified extracardiac Fontan, performed between 2000 and 2016, who underwent cardiac catheterizations with transvenous hepatic biopsies between April 2012 and June 2022. We divided the patients by gender for analysis. Results We identified 116 patients who underwent 145 transvenous biopsies, with 29 patients undergoing 2 biopsies at an average interval of 5?±?1 years. We divided the 145 biopsies into two groups: 1) 98/145 (68) males and 2) 47/145 (32) females. For the 47 female liver biopsy specimens, the median total fibrosis score was 3 (0–8), and for the 98 male liver biopsy specimens, the median total fibrosis score was 2 (0–6), p?=?.007. The average age at surgery for females was 3?±?1 years and for males 3?±?1 years, p?=?.99. Average Fontan duration at biopsy for females was 11?±?5 years and for males, 10?±?4 years, p?=?.23. No other demographic, anatomic, echocardiographic, laboratory, or hemodynamic findings demonstrated statistically significant gender differences. Conclusions Females had statistically significantly higher median total fibrosis scores than males for the similar average age at extracardiac Fontan and average Fontan duration.
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