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Improvement of protein-losing enteropathy by coil embolization of the left azygos vein

Akira Ishii1, Shigeto Fuse, Noriaki Kubo

  • 1Department of Pediatrics, Sapporo Medical University School of Medicine, Sapporo, Japan. akila@kd5.so-net.ne.jp

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 25, 2003
PubMed

Insights

A protein-losing enteropathy in a teen with complex congenital heart disease resolved after a novel coil embolization procedure. This intervention successfully closed a vein-to-vein shunt, offering a new treatment avenue.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Vascular Surgery

Background:

  • Congenital heart defects, including double-outlet right ventricle, atrioventricular septal defect, and pulmonary stenosis, present complex challenges in pediatric patients.
  • Persistent left superior vena cava is a rare anomaly that can create unique hemodynamic situations.
  • Protein-losing enteropathy (PLE) is a serious complication associated with various cardiac conditions, leading to significant protein and albumin loss.

Observation:

  • A 17-year-old male with a history of complex congenital heart disease experienced the onset of protein-losing enteropathy.
  • The patient was found to have a persistent left superior vena cava, contributing to a vein-to-vein shunt via the azygos vein.
  • This shunt was suspected to be a contributing factor to the development of protein-losing enteropathy.

Findings:

  • Coil embolization of the left azygos vein was performed to interrupt the vein-to-vein shunt.
  • Following the embolization procedure, the protein-losing enteropathy in the patient showed complete resolution.
  • The successful closure of the shunt demonstrated its role in the patient's protein loss.

Implications:

  • This case highlights a potential therapeutic strategy for protein-losing enteropathy associated with venous anomalies and congenital heart disease.
  • Coil embolization of the azygos vein offers a minimally invasive option for managing specific types of vein-to-vein shunts.
  • Further research is warranted to explore the efficacy and broader applicability of this intervention in similar pediatric cases.

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