Protein-losing enteropathy (PLE) due to leakage of lymph into the gut sometimes occurs in young patients after Fontan palliation but is very rarely reported with other aetiologies of chronic heart failure (HF). PLE leads to severe hypoalbuminemia and immunodeficiency and is associated with poor prognosis. The mechanisms and the predispositions to PLE are poorly understood. Here, we report an adult patient with advanced HF due to non-ischaemic non-dilated hypocontractile cardiomyopathy who developed severe PLE, probably owing to increased ventricular stiffness and constraint by atypically placed epicardial electrode encircling both ventricles. Importantly, both PLE and immunodeficiency completely resolved after heart transplantation.

Department of Cardiac Surgery Institute for Clinical and Experimental Medicine IKEM Vídeňská 1958 9 Prague 140 21 Czech Republic

Department of Cardiology Institute for Clinical and Experimental Medicine IKEM Vídeňská 1958 9 Prague 140 21 Czech Republic

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