Prevalence and Associated Factors of Protein-Losing Enteropathy After Fontan Surgery

Document Type : Original Article


1 Rajaie Cardiovascular, Medical, and Research Center, Iran University of Medical Sciences, Tehran, IR Iran.

2 Student Research Committee, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, IR Iran.

3 Student Research Committee, Epidemiology Department, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

4 Department of Epidemiology, School of Public Health and safety, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.

5 Department of Pediatric Cardiology, Isfahan University of Medical Sciences, Isfahan, IR Iran.

6 Pediatric Gastroenterology, Hepatology, and Nutrition Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.


Background: Nowadays, the attention is more set on the complications of the Fontan surgery such as protein-losing enteropathy (PLE). Determining the frequency rate and the contributing factors of the Fontan surgery complications like PLE would confer optimized preventive approaches, reduced rates of adverse effects, and improved prognosis and survival. 17 This cross-sectional study aimed to determine the prevalence and associated factors of PLE in a referral heart center.
Methods: The present cross-sectional analysis was performed on 73 patients using history taking, careful clinical examinations, laboratory tests (eg, fecal alpha-1-antitrypsin, complete cell blood count, chemistry, and venous blood gas), and echocardiographic and angiographic evaluations.
Results: In our study, the prevalence of PLE was 4 (5.47%) cases. The associated factors were edema, diarrhea, abdominal pain, ascites, and hypoalbuminemia. The echocardiographic and angiographic findings revealed that the left ventricular ejection fraction was significantly reduced in our patients with PLE.
Conclusions: In light of our results, we conclude that in any post-Fontan surgery patient exhibiting clinical manifestations such as edema, diarrhea, abdominal pain, or ascites, screening for fecal alpha-1-antitrypsin can be helpful for the early detection of PLE. (Iranian Heart Journal 2020; 21(2): 13-20)


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