Protein losing enteropathy (PLE) is a severe consequence of Fontan physiology that sometimes requires heart transplantation for definitive treatment. We describe transplant refractory PLE in a patient with heterotaxia and complex systemic and hepatic venous connections, successfully treated by transcatheter relief of multiple venous obstructions.
MertensLHaglerDJSauerUSomervilleJGewilligM. Protein-losing enteropathy after the Fontan operation: an international multicenter study. J Thorac Cardiovasc Surg. 1998;115(5):1063–1073.
2.
JohnASJohnsonJAKhanMDriscollDJWarnesCACettaF. Clinical outcomes and improved survival in patients with protein-losing enteropathy after the Fontan operation. J Am Coll Cardiol. 2014;64(1):54–62.
3.
AggarwalSDeliusREWaltersHLL’EcuyerTJ. Recurrent protein-losing enteropathy and tricuspid valve insufficiency in a transplanted heart: a causal relationship?Congen Heart Dis. 2012;7(3):E10–E13.
4.
CarloWFPearceFBKirklinJK. Retransplantation as a successful therapy for post-transplant protein-losing enteropathy. J Heart Lung Transplant2013;32(4):472–473.
5.
GoldbergDJShaddyRERavishankarCRychikJ. The failing Fontan: etiology, diagnosis and management. Expert Rev Cardiovas Ther. 2011;9(6):785–793.
6.
HouriganSKAndersRAMitchellSESchwarzKBLauHKarnsakulW. Chronic diarrhea, ascites, and protein-losing enteropathy in an infant with hepatic venous outflow obstruction after liver transplantation. Pediatr Transplant. 2012;16(7):E328–E331.
7.
Rosario-QuinonesFMagidMSYauJPawaleANguyenK. Tissue reaction to porcine intestinal submucosa (CorMatrix) implants in pediatric cardiac patients: a single-center experience. Ann Thorac Surg. 2015;99(4):1373–1377.
8.
HibinoNMcConnellPShinokaTMalikMGalantowiczM. Preliminary experience in the use of an extracellular matrix (CorMatrix) as a tube graft: word of caution. Semin Thorac Cardiovasc Surg. 2015;27(3):288–295.