Format

Send to

Choose Destination
Ann Thorac Surg. 2016 Apr;101(4):1539-43. doi: 10.1016/j.athoracsur.2015.08.068. Epub 2015 Oct 28.

Potts Shunt and Pediatric Pulmonary Hypertension: What We Have Learned.

Author information

1
Division of Cardiology, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri. Electronic address: grady@kids.wustl.edu.
2
Section of Pediatric Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

Abstract

BACKGROUND:

A Potts shunt has been proposed as effective palliative therapy in children with severe pulmonary hypertension (PH) who have suprasystemic right ventricular pressures.

METHODS:

A retrospective single-center study was performed to assess outcomes in 5 children who underwent a Potts shunt for severe PH.

RESULTS:

All 5 children were in World Health Organization functional class IV. Only 3 children were classified as having idiopathic pulmonary arterial PH. Preoperatively, 4 children were receiving intravenous prostacyclins, and 3 were placed on intravenous inotropes for acute right-side heart failure. Three children were potential lung transplant candidates. All but 1 child had evidence for suprasystemic right heart pressures immediately before their operation. All 5 children survived the procedure without significant complications. Four of the 5 children were successfully discharged from the hospital and have had sustained clinical improvement with follow-up ranging from approximately 5 to 16 months. The child who did not have suprasystemic right-side heart pressures before the operation did not benefit from the Potts shunt.

CONCLUSIONS:

The Potts shunt can be an effective palliation for children with severe PH. Our results further suggest that (1) a Potts shunt should be considered early in a child's clinical course, before right ventricular deterioration develops; (2) a Potts shunt should be considered in any child with severe, intractable PH regardless of etiology; (3) one might consider a Potts shunt in lieu of intravenous prostacyclins; and (4) a Potts shunt should be considered before lung transplantation and does not preclude future transplantation candidacy.

Comment in

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center