Enteric protein loss after the Fontan operation

Area of Science:

• Cardiology
• Gastroenterology
• Pediatric Surgery

Background:

• The Fontan operation is a palliative procedure for complex congenital heart disease.
• Enteric protein loss and protein-losing enteropathy are potential complications following cardiac surgery.
• Early assessment of these complications after the Fontan procedure is crucial for patient management.

Purpose of the Study:

• To determine the incidence of excessive enteric protein loss.
• To evaluate the frequency of protein-losing enteropathy.
• To assess these complications in the early post-Fontan operation period.

Main Methods:

• Twenty-six patients undergoing the Fontan procedure were studied.
• Alpha 1-antitrypsin clearance and fecal concentration were measured at two intervals within 4 months post-operation.
• Patients were evaluated between January and June 1990 at the Mayo Clinic.

Main Results:

• All patients had normal alpha 1-antitrypsin clearance in the first postoperative testing period (2-8 weeks).
• In the second testing period, all 17 evaluated patients showed normal clearances.
• One patient experienced transient protein-losing enteropathy with increased fecal alpha 1-antitrypsin concentration.

Conclusions:

• Excessive enteric protein loss is infrequent in the early phase after the Fontan operation.
• Protein-losing enteropathy is also relatively uncommon within the first 4 months post-procedure.
• These findings suggest a low risk of significant enteric protein loss early after Fontan palliation.