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

Ann Thorac Surg. 2007 Dec;84(6):2110-2. doi: 10.1016/j.athoracsur.2007.06.064.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticoagulants / therapeutic use*
  • Female
  • Fontan Procedure / adverse effects*
  • Heparin, Low-Molecular-Weight / therapeutic use*
  • Humans
  • Palliative Care
  • Protein-Losing Enteropathies / drug therapy*


  • Anticoagulants
  • Heparin, Low-Molecular-Weight