Congenital heart diseaseCohort study

Outcomes After Lymphatic Embolization for Protein-Losing Enteropathy in Congenital Heart Disease

J Am Coll CardiolPublished

  • Retrospective cohort study
  • single-centre

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)

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

OutcomeHR (95% CI)P value
Death or transplantation, per additional year of remission (initial responders) · exploratory secondary analysis0.45 (0.22–0.94)P = 0.035

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:10.1016/j.jacc.2026.07.036

Summarised from the published abstract; every number is checked against it