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Ann Thorac Surg. 2007 Dec;84(6):2110-2.

Resolution of protein-losing enteropathy with low-molecular weight heparin in an adult patient with Fontan palliation.

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Section of Cardiology, Department of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.


Protein-losing enteropathy is a well-known complication after the Fontan procedure, and unfractionated heparin therapy has been tried with some success as a potential therapy. Low-molecular weight heparin is believed to be ineffective. We now describe a case in which an adult patient with protein-losing enteropathy after Fontan palliation was successfully treated with systemic doses of low-molecular weight heparin, with complete resolution in the 24-hour fecal alpha-1 anti-trypsin level and serum albumin. The patient continues to remain in remission with this therapy. In conclusion, these findings are novel and compel us to re-evaluate our pathophysiologic understanding of this difficult condition.

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