TY - JOUR
T1 - Protein-losing enteropathy after the fontan operation
AU - Feldt, R. H.
AU - Driscoll, D. J.
AU - Offord, K. P.
AU - Cha, R. H.
AU - Perrault, J.
AU - Schaff, H. V.
AU - Puga, F. J.
AU - Danielson, G. K.
PY - 1996
Y1 - 1996
N2 - Patients were observed after the Fortran operation to determine the frequency and severity of protein-losing enteropathy. A total of 427 patients who survived for 30 days after the Fontan operation, performed between 1973 and January 1987, were analyzed and, thus far, protein-losing enteropathy has developed in 47 of 427. The cumulative risk for the development of protein- losing enteropathy by 10 years was 13.4% among 30-day survivors, and 5-year survival after the diagnosis was 46%. Hemodynamic studies done coincident with the diagnosis of protein-losing enteropathy have shown increased systemic venous pressure, decreased cardiac index, increased pulmonary vascular resistance, and increased ventricular end-diastolic pressure. Medical management of protein-losing enteropathy was only partially successful. Statistical analysis has shown that factors related to protein- losing enteropathy were ventricular anatomy, increased preoperative ventricular end-diastolic pressure, longer operative bypass time, increased length of hospital stay, and postoperative renal failure. This study suggests that scrupulous selection of cases for the Fortran operation is mandatory and that certain perioperative factors may predispose to this serious complication of the Fontan procedure.
AB - Patients were observed after the Fortran operation to determine the frequency and severity of protein-losing enteropathy. A total of 427 patients who survived for 30 days after the Fontan operation, performed between 1973 and January 1987, were analyzed and, thus far, protein-losing enteropathy has developed in 47 of 427. The cumulative risk for the development of protein- losing enteropathy by 10 years was 13.4% among 30-day survivors, and 5-year survival after the diagnosis was 46%. Hemodynamic studies done coincident with the diagnosis of protein-losing enteropathy have shown increased systemic venous pressure, decreased cardiac index, increased pulmonary vascular resistance, and increased ventricular end-diastolic pressure. Medical management of protein-losing enteropathy was only partially successful. Statistical analysis has shown that factors related to protein- losing enteropathy were ventricular anatomy, increased preoperative ventricular end-diastolic pressure, longer operative bypass time, increased length of hospital stay, and postoperative renal failure. This study suggests that scrupulous selection of cases for the Fortran operation is mandatory and that certain perioperative factors may predispose to this serious complication of the Fontan procedure.
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U2 - 10.1016/S0022-5223(96)70051-X
DO - 10.1016/S0022-5223(96)70051-X
M3 - Article
C2 - 8800155
AN - SCOPUS:0029958170
SN - 0022-5223
VL - 112
SP - 672
EP - 680
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 3
ER -