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Low pulmonary vascular compliance predisposes post-Fontan patients to protein-losing enteropathy

Jeong Jin Yu1, Tae-Jin Yun, Sung-Cheol Yun

  • 1Division of Pediatric Cardiology, College of Medicine, University of Ulsan, Seoul, South Korea.

International Journal of Cardiology
|September 28, 2011
PubMed

Insights

Protein-losing enteropathy (PLE) after Fontan surgery is a serious complication. Low pulmonary vascular compliance before surgery is a key risk factor for developing PLE after the extracardiac conduit Fontan operation.

Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Surgery

Background:

  • Protein-losing enteropathy (PLE) is a severe complication following the Fontan operation.
  • The risk factors for developing PLE after the extracardiac conduit Fontan procedure remain poorly understood.
  • This study investigates pre-operative predictors of PLE in patients undergoing this specific surgical approach.

Purpose of the Study:

  • To identify pre-operative risk factors associated with protein-losing enteropathy (PLE).
  • To determine the relationship between pre-operative variables and the development of PLE post-extracardiac conduit Fontan operation.

Main Methods:

  • A cross-sectional retrospective study involving 235 patients who underwent an initial extracardiac conduit Fontan operation.
  • Pre-operative and peri-operative data were collected through medical record reviews.
  • Median age at operation was 3.5 years, with a median follow-up of 5 years.

Main Results:

  • 5.1% of patients (12/234) developed PLE at a median of 2.2 years post-operation.
  • Univariate analysis identified pulmonary vascular compliance (Cpv), central venous pressure, ICU stay, hospitalization duration, and chest tube indwelling as related factors.
  • Multivariate analysis confirmed that only low pulmonary vascular compliance (Cpv) remained a significant independent predictor of PLE (p=0.0367).

Conclusions:

  • Low pulmonary vascular compliance is significantly associated with the development of protein-losing enteropathy after the extracardiac conduit Fontan operation.
  • Identifying patients with low Cpv pre-operatively may aid in risk stratification and management strategies for preventing PLE.
Abstract

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