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Related Experiment Videos

Protein-losing enteropathy after the Fontan operation

R H Feldt1, D J Driscoll, K P Offord

  • 1Section of Pediatric Cardiology, Mayo Clinic, Rochester, Minn 55905, USA.

The Journal of Thoracic and Cardiovascular Surgery
|September 1, 1996
PubMed
Summary
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Protein-losing enteropathy is a serious complication after the Fontan operation. Careful patient selection and management of perioperative factors are crucial to reduce its incidence and improve outcomes.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Gastroenterology

Background:

  • The Fontan operation is a palliative procedure for complex single-ventricle congenital heart defects.
  • Protein-losing enteropathy (PLE) is a known but serious complication following the Fontan procedure.
  • Understanding the incidence and risk factors for PLE is critical for patient management.

Purpose of the Study:

  • To determine the frequency and severity of protein-losing enteropathy (PLE) in patients after the Fontan operation.
  • To identify risk factors associated with the development of PLE.
  • To evaluate survival rates after PLE diagnosis.

Main Methods:

  • Retrospective analysis of 427 patients who survived at least 30 days post-Fontan operation (1973-1987).

Related Experiment Videos

  • Assessment of PLE development, cumulative risk, and survival post-diagnosis.
  • Correlation of hemodynamic parameters and perioperative factors with PLE incidence.

    • Main Results:

    • Protein-losing enteropathy developed in 47 of 427 patients (11%).
    • The 10-year cumulative risk of PLE was 13.4%; 5-year survival after diagnosis was 46%.
    • Associated factors included increased systemic venous pressure, decreased cardiac index, increased pulmonary vascular resistance, ventricular anatomy, preoperative ventricular end-diastolic pressure, longer bypass time, longer hospital stay, and postoperative renal failure.

    Conclusions:

    • Protein-losing enteropathy is a significant long-term complication of the Fontan procedure with poor survival.
    • Careful patient selection for the Fontan operation is essential.
    • Certain perioperative factors may predispose patients to developing PLE, necessitating vigilant management.