Use of heparin in the treatment of protein-losing enteropathy after fontan operation for complex congenital heart disease

Protein-losing enteropathy (PLE) is a serious complication of the Fontan operation and is associated with pronounced mortality. Medical management of PLE has been only partially successful, A recent report noted dramatic improvement in patients with PLE within 3 weeks of subcutaneous administration of heparin, We report a case of reversal of PLE with resolution of clinical symptoms and normalization of serum albumin, total protein, and fetal alpha(1)-antitrypsin values after several months of heparin treatment, Our findings substantiate those recently reported but suggest that reversal of PLE may necessitate more than a few weeks of heparin therapy.