Outcomes After Lymphatic Embolization for Protein-Losing Enteropathy in Congenital Heart Disease
Authors' conclusion
A combined IH + PD embolization strategy was associated with higher initial response rates and longer duration of remission compared with IH embolization alone.
Study context
- Population
- Patients with congenital heart disease (CHD) and medically refractory protein-losing enteropathy undergoing percutaneous lymphatic embolization
- Participants
- 71 patients
- Exposure
- Combined intrahepatic (IH) + PD vs isolated IH lymphatic embolization
- IHn = 17reference
- IH + PDn = 54
- Outcome
- Duration of remission (serum albumin ≥3.0 g/dL without IV albumin supplementation or repeat percutaneous protein-losing enteropathy (PLE) intervention)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Remission
Remission
PLE recurrence
P = 0.005
- IH + PD vs IH: P = 0.04 — sustained remission (albumin ≥3 g/dL for ≥1 year)
Observational data: associations, not effects.
Further findings
Initial response (albumin ≥3.0 g/dL within 30 days without IV albumin)
P < 0.0004
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Death or transplantation, per additional year of remission (initial responders) · exploratory secondary analysis | 0.45 (0.22–0.94) | P = 0.035 | |
| 0.20.5125Hazard ratio (log scale) |
Median serum albumin in IH + PD, pre- vs postprocedure
- Increased from 2.3 g/dL to 4.2 g/dL
- P < 0.0001
Thoracic duct obstruction
- Associated with shorter remission duration than no obstruction
- P = 0.0005
Safety
Serious and catastrophic adverse events
Level 3c/4/5
P > 0.99
Level 4/5
P = 0.57
Adverse events
- Transient pancreatitis
- 75%
- Hyperbilirubinemia
- 40%
- Most self-limited or managed conservatively
Original publication
Outcomes After Lymphatic Embolization for Protein-Losing Enteropathy in Congenital Heart Disease. J Am Coll Cardiol. Published 26 August 2026. doi:10.
Summarised from the published abstract; every number is checked against it