Thoracic Duct Decompression for Protein-Losing Enteropathy in Failing Fontan Circulation

An infrequent but devastating late complication of Fontan circulation is protein-losing enteropathy (PLE), which results from unbalanced lymphatic homeostasis. Surgical decompression of the thoracic duct by redirecting its drainage to the pulmonary venous atrium has been introduced recently as a pos...

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Veröffentlicht in:	The Annals of thoracic surgery 2016-06, Vol.101 (6), p.2370-2373
Hauptverfasser:	António, Marta, MD, Gordo, Andreia, MD, Pereira, Conceição, MD, Pinto, Fátima, MD, Fragata, Isabel, MD, Fragata, José, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Adolescent Adrenal Cortex Hormones - therapeutic use Atrioventricular Block - etiology Atrioventricular Block - therapy Brachiocephalic Veins - diagnostic imaging Brachiocephalic Veins - surgery Cardiac Pacing, Artificial Cardiothoracic Surgery Combined Modality Therapy Decompression, Surgical - methods Female Fontan Procedure - adverse effects Heart Atria - diagnostic imaging Heart Atria - surgery Heart Defects, Congenital - surgery Humans Hypoplastic Left Heart Syndrome - surgery Lymphatic System - physiopathology Male Norwood Procedures Protein-Losing Enteropathies - etiology Protein-Losing Enteropathies - surgery Pulmonary Veins - surgery Surgery Thoracic Duct - surgery Tomography, X-Ray Computed Vasodilator Agents - therapeutic use Vena Cava, Superior - surgery
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Beschreibung
Zusammenfassung:	An infrequent but devastating late complication of Fontan circulation is protein-losing enteropathy (PLE), which results from unbalanced lymphatic homeostasis. Surgical decompression of the thoracic duct by redirecting its drainage to the pulmonary venous atrium has been introduced recently as a possible treatment. This report describes a single-institution experience with this innovative procedure in 2 patients with failing Fontan circulation with PLE refractory to optimized medical therapy.
ISSN:	0003-4975 1552-6259
DOI:	10.1016/j.athoracsur.2015.08.079