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Fontan Circulation - Protein-losing Enteropathy — EECC MCQ

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HardCongenital Heart Disease (Adult)Fontan Circulation - Protein-losing EnteropathyEECC

A 35-year-old woman with a total cavopulmonary connection for tricuspid atresia develops ascites and protein-losing enteropathy. Fontan pressure is 12 mmHg and angiography shows no pathway obstruction. Which mechanism best explains the enteric protein loss?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Mesenteric lymphatic hypertension from chronically raised systemic venous pressure

A Fontan circulation exposes the systemic venous and intestinal lymphatic beds to chronically supraphysiological pressure even when measured circuit pressure appears acceptable. Mesenteric venous congestion and lymphatic hypertension can then cause enteric protein loss without a discrete conduit obstruction.

Reference: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines