Enteric protein loss after the Fontan operation

Objective: The current study was undertaken to assess the frequency of excessive enteric protein loss and protein-losing enteropathy in the relatively early period after the Fontan operation. Design: Protein excretion was determined in 26 of 27 consecutive patients who underwent the Fontan procedure between January and June 1990 at the Mayo Clinic. Material and Methods: At two testing intervals during the first 4 months after the Fontan operation, α₁-antitrypsin clearance and fecal α₁-antitrypsin concentration studies were done. Results: All results were normal for the first postoperative test period (2 to 8 weeks). For the second study period, all 17 patients tested had normal α₁-antitrypsin clearances. One of the 17 patients had an appreciably increased fecal α₁-antitrypsin concentration and transient protein-losing enteropathy. Conclusion: Excessive enteric protein loss and protein-losing enteropathy are relatively uncommon during the first 4 months after the Fontan operation.