Early Impact of Fontan Operation on Enteric Protein Loss
Background Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance. Methods A prospe...
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Published in | The Annals of thoracic surgery Vol. 101; no. 3; pp. 1025 - 1030 |
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Language | English |
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01.03.2016
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Abstract | Background Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance. Methods A prospective cohort study was performed evaluating enteric protein loss in children undergoing Fontan operations. Stool alpha-1 antitrypsin (A1AT) concentration was measured in the preoperative, early postoperative, and intermediate postoperative (3–9 months) periods. The intestinal circulation was characterized by Doppler-derived resistance indices of the superior mesenteric artery (SMA), and serum albumin and protein levels were obtained. Results We enrolled 33 participants at a median age at operation of 3.0 years (interquartile range [IQR], 2.5–3.3 years). No clinical PLE was observed. Six of the 93 stool samples obtained had elevated A1AT levels (>54 mg/dL), with 2 abnormal samples at each of the 3 time points. Two of the 5 participants with elevated stool A1AT values had significant hemodynamic disturbances requiring intervention (junctional bradycardia or tricuspid stenosis). There was no difference in SMA resistance in the preoperative versus early postoperative periods ( p = 0.9). Serum albumin levels were lower in the early postoperative period compared with the preoperative period (3.2 mg/dL [{IQR}, 2.9–3.5] versus 4.1 mg/dL; IQR, 3.4–4.5; p = 0.01) but did not correlate with abnormal stool A1AT concentration or SMA resistance indices. Conclusions The Fontan operation does not commonly result in acute development of increased enteric protein loss. However, increased enteric protein loss may occur in children before or after a Fontan operation, particularly when hemodynamic disturbances are present. |
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AbstractList | Background Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance. Methods A prospective cohort study was performed evaluating enteric protein loss in children undergoing Fontan operations. Stool alpha-1 antitrypsin (A1AT) concentration was measured in the preoperative, early postoperative, and intermediate postoperative (3–9 months) periods. The intestinal circulation was characterized by Doppler-derived resistance indices of the superior mesenteric artery (SMA), and serum albumin and protein levels were obtained. Results We enrolled 33 participants at a median age at operation of 3.0 years (interquartile range [IQR], 2.5–3.3 years). No clinical PLE was observed. Six of the 93 stool samples obtained had elevated A1AT levels (>54 mg/dL), with 2 abnormal samples at each of the 3 time points. Two of the 5 participants with elevated stool A1AT values had significant hemodynamic disturbances requiring intervention (junctional bradycardia or tricuspid stenosis). There was no difference in SMA resistance in the preoperative versus early postoperative periods ( p = 0.9). Serum albumin levels were lower in the early postoperative period compared with the preoperative period (3.2 mg/dL [{IQR}, 2.9–3.5] versus 4.1 mg/dL; IQR, 3.4–4.5; p = 0.01) but did not correlate with abnormal stool A1AT concentration or SMA resistance indices. Conclusions The Fontan operation does not commonly result in acute development of increased enteric protein loss. However, increased enteric protein loss may occur in children before or after a Fontan operation, particularly when hemodynamic disturbances are present. BACKGROUNDProtein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance.METHODSA prospective cohort study was performed evaluating enteric protein loss in children undergoing Fontan operations. Stool alpha-1 antitrypsin (A1AT) concentration was measured in the preoperative, early postoperative, and intermediate postoperative (3-9 months) periods. The intestinal circulation was characterized by Doppler-derived resistance indices of the superior mesenteric artery (SMA), and serum albumin and protein levels were obtained.RESULTSWe enrolled 33 participants at a median age at operation of 3.0 years (interquartile range [IQR], 2.5-3.3 years). No clinical PLE was observed. Six of the 93 stool samples obtained had elevated A1AT levels (>54 mg/dL), with 2 abnormal samples at each of the 3 time points. Two of the 5 participants with elevated stool A1AT values had significant hemodynamic disturbances requiring intervention (junctional bradycardia or tricuspid stenosis). There was no difference in SMA resistance in the preoperative versus early postoperative periods (p = 0.9). Serum albumin levels were lower in the early postoperative period compared with the preoperative period (3.2 mg/dL [{IQR}, 2.9-3.5] versus 4.1 mg/dL; IQR, 3.4-4.5; p = 0.01) but did not correlate with abnormal stool A1AT concentration or SMA resistance indices.CONCLUSIONSThe Fontan operation does not commonly result in acute development of increased enteric protein loss. However, increased enteric protein loss may occur in children before or after a Fontan operation, particularly when hemodynamic disturbances are present. Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance. A prospective cohort study was performed evaluating enteric protein loss in children undergoing Fontan operations. Stool alpha-1 antitrypsin (A1AT) concentration was measured in the preoperative, early postoperative, and intermediate postoperative (3-9 months) periods. The intestinal circulation was characterized by Doppler-derived resistance indices of the superior mesenteric artery (SMA), and serum albumin and protein levels were obtained. We enrolled 33 participants at a median age at operation of 3.0 years (interquartile range [IQR], 2.5-3.3 years). No clinical PLE was observed. Six of the 93 stool samples obtained had elevated A1AT levels (>54 mg/dL), with 2 abnormal samples at each of the 3 time points. Two of the 5 participants with elevated stool A1AT values had significant hemodynamic disturbances requiring intervention (junctional bradycardia or tricuspid stenosis). There was no difference in SMA resistance in the preoperative versus early postoperative periods (p = 0.9). Serum albumin levels were lower in the early postoperative period compared with the preoperative period (3.2 mg/dL [{IQR}, 2.9-3.5] versus 4.1 mg/dL; IQR, 3.4-4.5; p = 0.01) but did not correlate with abnormal stool A1AT concentration or SMA resistance indices. The Fontan operation does not commonly result in acute development of increased enteric protein loss. However, increased enteric protein loss may occur in children before or after a Fontan operation, particularly when hemodynamic disturbances are present. Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE. We evaluated the acute effects of Fontan circulation on enteric protein loss and mesenteric vascular resistance. A prospective cohort study was performed evaluating enteric protein loss in children undergoing Fontan operations. Stool alpha-1 antitrypsin (A1AT) concentration was measured in the preoperative, early postoperative, and intermediate postoperative (3–9 months) periods. The intestinal circulation was characterized by Doppler-derived resistance indices of the superior mesenteric artery (SMA), and serum albumin and protein levels were obtained. We enrolled 33 participants at a median age at operation of 3.0 years (interquartile range [IQR], 2.5–3.3 years). No clinical PLE was observed. Six of the 93 stool samples obtained had elevated A1AT levels (>54 mg/dL), with 2 abnormal samples at each of the 3 time points. Two of the 5 participants with elevated stool A1AT values had significant hemodynamic disturbances requiring intervention (junctional bradycardia or tricuspid stenosis). There was no difference in SMA resistance in the preoperative versus early postoperative periods (p = 0.9). Serum albumin levels were lower in the early postoperative period compared with the preoperative period (3.2 mg/dL [{IQR}, 2.9–3.5] versus 4.1 mg/dL; IQR, 3.4–4.5; p = 0.01) but did not correlate with abnormal stool A1AT concentration or SMA resistance indices. The Fontan operation does not commonly result in acute development of increased enteric protein loss. However, increased enteric protein loss may occur in children before or after a Fontan operation, particularly when hemodynamic disturbances are present. |
Author | Mercer-Rosa, Laura, MD, MSCE Patel, Jyoti K., MD Goldberg, David J., MD Dodds, Kathryn, CRNP Rychik, Jack, MD Loomes, Kathleen M., MD |
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CitedBy_id | crossref_primary_10_1016_j_athoracsur_2019_05_039 crossref_primary_10_2174_1871529X19666190211165124 crossref_primary_10_1002_imt2_144 crossref_primary_10_31146_2949_4664_apps_2_1_163_169 crossref_primary_10_1007_s00246_017_1720_8 crossref_primary_10_1017_S1047951123003396 crossref_primary_10_1007_s00246_017_1632_7 |
Cites_doi | 10.1016/0016-5085(81)90506-0 10.1016/0016-5085(81)90140-2 10.1016/S0022-5223(98)70406-4 10.1016/S0022-3476(81)80332-0 10.1053/euhj.1997.0777 10.1016/S0140-6736(78)92650-8 10.1016/j.jtcvs.2008.09.031 10.1016/S0022-5223(96)70051-X 10.2214/AJR.13.11797 10.1111/j.1747-0803.2007.00116.x 10.1016/j.athoracsur.2006.02.048 10.1016/j.athoracsur.2006.08.043 10.1136/bmj.1.6058.428-a 10.1016/S0025-6196(12)61035-0 10.1097/00005176-200311000-00014 10.1016/S0002-9149(02)02584-5 10.1016/j.athoracsur.2005.06.038 |
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References | Hill, Hercz, Corey, Gilday, Hamilton (bib10) 1981; 99 Florent, L'Hirondel, Desmazures, Aymes, Bernier (bib9) 1981; 81 Thorne, Hooper, Kemp, Somerville (bib4) 1998; 19 Fujii, Shimizu, Takahashi (bib12) 2003; 37 Rychik (bib3) 2007; 2 Uzun, Wong, Bhole, Stumper (bib16) 2006; 82 Rychik, Gui-Yang (bib5) 2002; 90 Crossley, Elliott (bib7) 1977; 1 Ostrow, Freeze, Rychik (bib15) 2006; 82 Bernier, Florent, Desmazures, Aymes, L'Hirondel (bib8) 1978; 2 Feldt, Driscoll, Offord (bib2) 1996; 112 Thomas, Sinatra, Merritt (bib11) 1981; 80 Mertens, Hagler, Sauer, Somerville, Gewillig (bib1) 1998; 115 Dori, Keller, Fogel (bib13) 2014; 203 Odegard, Zurakowski, DiNardo (bib17) 2009; 137 Ascione, Talpahewa, Rajakaruna (bib6) 2006; 81 Davis, Driscoll, Perrault (bib14) 1994; 69 300037 - Br Med J. 1977 Feb 12;1(6058):428-9 6973500 - Gastroenterology. 1981 Oct;81(4):777-80 18377444 - Congenit Heart Dis. 2007 Sep-Oct;2(5):288-300 6970702 - Gastroenterology. 1981 Apr;80(4):776-82 16368344 - Ann Thorac Surg. 2006 Jan;81(1):97-103 16863787 - Ann Thorac Surg. 2006 Aug;82(2):695-700 80688 - Lancet. 1978 Oct 7;2(8093):763-4 17126088 - Ann Thorac Surg. 2006 Dec;82(6):e39-40 12231106 - Am J Cardiol. 2002 Sep 15;90(6):672-4 8800155 - J Thorac Cardiovasc Surg. 1996 Sep;112(3):672-80 9605076 - J Thorac Cardiovasc Surg. 1998 May;115(5):1063-73 19327521 - J Thorac Cardiovasc Surg. 2009 Apr;137(4):934-41 8309260 - Mayo Clin Proc. 1994 Feb;69(2):112-4 14581800 - J Pediatr Gastroenterol Nutr. 2003 Nov;37(5):577-80 9568457 - Eur Heart J. 1998 Mar;19(3):514-20 24848564 - AJR Am J Roentgenol. 2014 Aug;203(2):426-31 6973619 - J Pediatr. 1981 Sep;99(3):416-8 Florent (10.1016/j.athoracsur.2015.09.036_bib9) 1981; 81 Rychik (10.1016/j.athoracsur.2015.09.036_bib3) 2007; 2 Rychik (10.1016/j.athoracsur.2015.09.036_bib5) 2002; 90 Dori (10.1016/j.athoracsur.2015.09.036_bib13) 2014; 203 Feldt (10.1016/j.athoracsur.2015.09.036_bib2) 1996; 112 Odegard (10.1016/j.athoracsur.2015.09.036_bib17) 2009; 137 Thorne (10.1016/j.athoracsur.2015.09.036_bib4) 1998; 19 Mertens (10.1016/j.athoracsur.2015.09.036_bib1) 1998; 115 Fujii (10.1016/j.athoracsur.2015.09.036_bib12) 2003; 37 Bernier (10.1016/j.athoracsur.2015.09.036_bib8) 1978; 2 Ostrow (10.1016/j.athoracsur.2015.09.036_bib15) 2006; 82 Hill (10.1016/j.athoracsur.2015.09.036_bib10) 1981; 99 Ascione (10.1016/j.athoracsur.2015.09.036_bib6) 2006; 81 Uzun (10.1016/j.athoracsur.2015.09.036_bib16) 2006; 82 Crossley (10.1016/j.athoracsur.2015.09.036_bib7) 1977; 1 Davis (10.1016/j.athoracsur.2015.09.036_bib14) 1994; 69 Thomas (10.1016/j.athoracsur.2015.09.036_bib11) 1981; 80 |
References_xml | – volume: 115 start-page: 1063 year: 1998 end-page: 1073 ident: bib1 article-title: Protein-losing enteropathy after the fontan operation: An international multicenter study. PLE study group publication-title: J Thorac Cardiovasc Surg contributor: fullname: Gewillig – volume: 99 start-page: 416 year: 1981 end-page: 418 ident: bib10 article-title: Fecal clearance of alpha 1-antitrypsin: a reliable measure of enteric protein loss in children publication-title: J Pediatr contributor: fullname: Hamilton – volume: 2 start-page: 288 year: 2007 end-page: 300 ident: bib3 article-title: Protein-losing enteropathy after fontan operation publication-title: Congenit Heart Dis contributor: fullname: Rychik – volume: 137 start-page: 934 year: 2009 end-page: 941 ident: bib17 article-title: Prospective longitudinal study of coagulation profiles in children with hypoplastic left heart syndrome from stage I through Fontan completion publication-title: J Thorac Cardiovasc Surg contributor: fullname: DiNardo – volume: 19 start-page: 514 year: 1998 end-page: 520 ident: bib4 article-title: Gastro-intestinal protein loss in late survivors of Fontan surgery and other congenital heart disease publication-title: Eur Heart J contributor: fullname: Somerville – volume: 203 start-page: 426 year: 2014 end-page: 431 ident: bib13 article-title: Mri of lymphatic abnormalities after functional single-ventricle palliation surgery publication-title: am J Roentgenol contributor: fullname: Fogel – volume: 82 start-page: 695 year: 2006 end-page: 700 ident: bib15 article-title: Protein-losing enteropathy after fontan operation: investigations into possible pathophysiologic mechanisms publication-title: Ann Thorac Surg contributor: fullname: Rychik – volume: 82 start-page: e39 year: 2006 end-page: 40 ident: bib16 article-title: Resolution of protein-losing enteropathy and normalization of mesenteric Doppler flow with sildenafil after Fontan publication-title: Ann Thorac Surg contributor: fullname: Stumper – volume: 1 start-page: 428 year: 1977 end-page: 429 ident: bib7 article-title: Simple method for diagnosing protein-losing enteropathies publication-title: Br Med J contributor: fullname: Elliott – volume: 2 start-page: 763 year: 1978 end-page: 764 ident: bib8 article-title: Diagnosis of protein-losing enteropathy by gastrointestinal clearance of alpha1-antitrypsin publication-title: Lancet contributor: fullname: L'Hirondel – volume: 81 start-page: 777 year: 1981 end-page: 780 ident: bib9 article-title: Intestinal clearance of alpha 1-antitrypsin. A sensitive method for the detection of protein-losing enteropathy publication-title: Gastroenterology contributor: fullname: Bernier – volume: 69 start-page: 112 year: 1994 end-page: 114 ident: bib14 article-title: Enteric protein loss after the Fontan operation publication-title: Mayo Clin Proc contributor: fullname: Perrault – volume: 81 start-page: 97 year: 2006 end-page: 103 ident: bib6 article-title: Splanchnic organ injury during coronary surgery with or without cardiopulmonary bypass: a randomized, controlled trial publication-title: Ann Thorac Surg contributor: fullname: Rajakaruna – volume: 80 start-page: 776 year: 1981 end-page: 782 ident: bib11 article-title: Random fecal alpha-1-antitrypsin concentration in children with gastrointestinal disease publication-title: Gastroenterology contributor: fullname: Merritt – volume: 37 start-page: 577 year: 2003 end-page: 580 ident: bib12 article-title: Fecal alpha1-antitrypsin concentrations as a measure of enteric protein loss after modified fontan operations publication-title: J Pediatr Gastroenterol Nutr contributor: fullname: Takahashi – volume: 112 start-page: 672 year: 1996 end-page: 680 ident: bib2 article-title: Protein-losing enteropathy after the Fontan operation publication-title: J Thorac Cardiovasc Surg contributor: fullname: Offord – volume: 90 start-page: 672 year: 2002 end-page: 674 ident: bib5 article-title: Relation of mesenteric vascular resistance after Fontan operation and protein-losing enteropathy publication-title: Am J Cardiol contributor: fullname: Gui-Yang – volume: 81 start-page: 777 year: 1981 ident: 10.1016/j.athoracsur.2015.09.036_bib9 article-title: Intestinal clearance of alpha 1-antitrypsin. A sensitive method for the detection of protein-losing enteropathy publication-title: Gastroenterology doi: 10.1016/0016-5085(81)90506-0 contributor: fullname: Florent – volume: 80 start-page: 776 year: 1981 ident: 10.1016/j.athoracsur.2015.09.036_bib11 article-title: Random fecal alpha-1-antitrypsin concentration in children with gastrointestinal disease publication-title: Gastroenterology doi: 10.1016/0016-5085(81)90140-2 contributor: fullname: Thomas – volume: 115 start-page: 1063 year: 1998 ident: 10.1016/j.athoracsur.2015.09.036_bib1 article-title: Protein-losing enteropathy after the fontan operation: An international multicenter study. PLE study group publication-title: J Thorac Cardiovasc Surg doi: 10.1016/S0022-5223(98)70406-4 contributor: fullname: Mertens – volume: 99 start-page: 416 year: 1981 ident: 10.1016/j.athoracsur.2015.09.036_bib10 article-title: Fecal clearance of alpha 1-antitrypsin: a reliable measure of enteric protein loss in children publication-title: J Pediatr doi: 10.1016/S0022-3476(81)80332-0 contributor: fullname: Hill – volume: 19 start-page: 514 year: 1998 ident: 10.1016/j.athoracsur.2015.09.036_bib4 article-title: Gastro-intestinal protein loss in late survivors of Fontan surgery and other congenital heart disease publication-title: Eur Heart J doi: 10.1053/euhj.1997.0777 contributor: fullname: Thorne – volume: 2 start-page: 763 year: 1978 ident: 10.1016/j.athoracsur.2015.09.036_bib8 article-title: Diagnosis of protein-losing enteropathy by gastrointestinal clearance of alpha1-antitrypsin publication-title: Lancet doi: 10.1016/S0140-6736(78)92650-8 contributor: fullname: Bernier – volume: 137 start-page: 934 year: 2009 ident: 10.1016/j.athoracsur.2015.09.036_bib17 article-title: Prospective longitudinal study of coagulation profiles in children with hypoplastic left heart syndrome from stage I through Fontan completion publication-title: J Thorac Cardiovasc Surg doi: 10.1016/j.jtcvs.2008.09.031 contributor: fullname: Odegard – volume: 112 start-page: 672 year: 1996 ident: 10.1016/j.athoracsur.2015.09.036_bib2 article-title: Protein-losing enteropathy after the Fontan operation publication-title: J Thorac Cardiovasc Surg doi: 10.1016/S0022-5223(96)70051-X contributor: fullname: Feldt – volume: 203 start-page: 426 year: 2014 ident: 10.1016/j.athoracsur.2015.09.036_bib13 article-title: Mri of lymphatic abnormalities after functional single-ventricle palliation surgery publication-title: am J Roentgenol doi: 10.2214/AJR.13.11797 contributor: fullname: Dori – volume: 2 start-page: 288 year: 2007 ident: 10.1016/j.athoracsur.2015.09.036_bib3 article-title: Protein-losing enteropathy after fontan operation publication-title: Congenit Heart Dis doi: 10.1111/j.1747-0803.2007.00116.x contributor: fullname: Rychik – volume: 82 start-page: 695 year: 2006 ident: 10.1016/j.athoracsur.2015.09.036_bib15 article-title: Protein-losing enteropathy after fontan operation: investigations into possible pathophysiologic mechanisms publication-title: Ann Thorac Surg doi: 10.1016/j.athoracsur.2006.02.048 contributor: fullname: Ostrow – volume: 82 start-page: e39 year: 2006 ident: 10.1016/j.athoracsur.2015.09.036_bib16 article-title: Resolution of protein-losing enteropathy and normalization of mesenteric Doppler flow with sildenafil after Fontan publication-title: Ann Thorac Surg doi: 10.1016/j.athoracsur.2006.08.043 contributor: fullname: Uzun – volume: 1 start-page: 428 year: 1977 ident: 10.1016/j.athoracsur.2015.09.036_bib7 article-title: Simple method for diagnosing protein-losing enteropathies publication-title: Br Med J doi: 10.1136/bmj.1.6058.428-a contributor: fullname: Crossley – volume: 69 start-page: 112 year: 1994 ident: 10.1016/j.athoracsur.2015.09.036_bib14 article-title: Enteric protein loss after the Fontan operation publication-title: Mayo Clin Proc doi: 10.1016/S0025-6196(12)61035-0 contributor: fullname: Davis – volume: 37 start-page: 577 year: 2003 ident: 10.1016/j.athoracsur.2015.09.036_bib12 article-title: Fecal alpha1-antitrypsin concentrations as a measure of enteric protein loss after modified fontan operations publication-title: J Pediatr Gastroenterol Nutr doi: 10.1097/00005176-200311000-00014 contributor: fullname: Fujii – volume: 90 start-page: 672 year: 2002 ident: 10.1016/j.athoracsur.2015.09.036_bib5 article-title: Relation of mesenteric vascular resistance after Fontan operation and protein-losing enteropathy publication-title: Am J Cardiol doi: 10.1016/S0002-9149(02)02584-5 contributor: fullname: Rychik – volume: 81 start-page: 97 year: 2006 ident: 10.1016/j.athoracsur.2015.09.036_bib6 article-title: Splanchnic organ injury during coronary surgery with or without cardiopulmonary bypass: a randomized, controlled trial publication-title: Ann Thorac Surg doi: 10.1016/j.athoracsur.2005.06.038 contributor: fullname: Ascione |
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Snippet | Background Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of... Protein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of overt PLE.... BACKGROUNDProtein-losing enteropathy (PLE) is a challenging complication after a Fontan operation. Subclinical enteric protein loss may precede development of... |
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SubjectTerms | alpha 1-Antitrypsin - metabolism Cardiothoracic Surgery Child, Preschool Feces - chemistry Female Follow-Up Studies Fontan Procedure - adverse effects Heart Defects, Congenital - surgery Humans Male Mesenteric Artery, Superior - diagnostic imaging Mesenteric Artery, Superior - physiopathology Postoperative Complications Prognosis Prospective Studies Protein-Losing Enteropathies - diagnostic imaging Protein-Losing Enteropathies - etiology Protein-Losing Enteropathies - physiopathology Surgery Time Factors Ultrasonography, Doppler |
Title | Early Impact of Fontan Operation on Enteric Protein Loss |
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