Related Experiment Video
Updated: Feb 27, 2026
Shunt Surgery, Right Heart Catheterization, and Vascular Morphometry in a Rat Model for Flow-induced Pulmonary Arterial Hypertension
Published on: February 11, 2017
Potts shunt in children with pulmonary arterial hypertension: institutional experience
Sergey V Gorbachevsky1, Anton A Shmalts1, Irina Y Barishnikova1
1Department of Pulmonary Hypertension, Bakoulev Center for Cardiovascular Surgery, Moscow, Russia.
Insights
The Potts shunt effectively lowers pulmonary hypertension in children, improving heart function and overall health. This procedure reduces right-sided heart failure symptoms and enhances patient quality of life.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
Background:
- Pulmonary arterial hypertension (PAH) in children presents significant challenges.
- The Potts shunt is an intervention used for PAH, but institutional experience varies.
Purpose of the Study:
- To evaluate the outcomes of the Potts shunt procedure in pediatric patients with severe pulmonary arterial hypertension.
- To assess the impact of the Potts shunt on hemodynamics and functional status.
Main Methods:
- Retrospective analysis of eight pediatric patients with suprasystemic PAH undergoing the Potts shunt.
- Follow-up included clinical assessment, echocardiography, and monitoring of oxygen saturation gradients.
Main Results:
- The Potts shunt decreased pulmonary artery-to-aorta pressure ratio and improved right ventricle-to-left ventricle diameter ratio.
- Patients experienced improved functional class, resolution of syncope, and reduced weight deficits.
- An arterial oxygen saturation gradient between upper and lower extremities was consistently observed post-procedure.
Conclusions:
- The Potts shunt is effective in reducing suprasystemic pulmonary hypertension and improving functional status in children.
- The procedure can limit right-sided heart failure manifestations.
- Careful patient selection is crucial, as high preoperative pressures were associated with early mortality.
Objectives:
Since 2004, different techniques for the Potts shunt have been used in patients with incurable pulmonary arterial hypertension. However, the experience with these interventions in a single institution is limited. We present our series of Potts shunts in children with pulmonary arterial hypertension.
Methods:
Eight patients with suprasystemic pulmonary arterial hypertension (pulmonary artery-to-aorta mean pressure ratio of 1.39 ± 0.30) had a Potts shunt at the median age of 13.5 months. Six patients were followed up for 2-32 (median 17) months after the operation.
Results:
In all cases, the Potts shunt caused a decrease in arterial blood oxygen saturation at the lower extremities and was the genesis of the arterial blood oxygen saturation gradient between the upper and lower extremities (10.5 ± 1.8% at discharge). Postoperative echocardiography revealed flattening of the ventricular septum as well as a decrease in the right ventricle-to-left ventricle end-diastolic diameter ratio from 1.36 ± 0.14 preoperatively to 0.99 ± 0.22 at discharge (P = 0.010). The 2 patients with the highest preoperative pulmonary artery-to-aorta mean pressure ratio (1.79-1.86) died during the early postoperative period from repeated pulmonary hypertension crises and uncontrolled hypoxaemia. There were no deaths during the follow-up period. The paediatric functional class of the patients improved from IIIb-IV to I-II, syncopal episodes no longer persisted and the weight deficit decreased from 21.8 ± 7.5% preoperatively to 11.5 ± 5.9% at the latest follow-up examination (P = 0.004). The arterial blood oxygen saturation gradient between the upper and lower extremities and the right ventricle-to-left ventricle end-diastolic diameter ratio were the same as they were while the patients were in the hospital.
Conclusions:
Our limited experience demonstrates that the Potts shunt lowers suprasystemic pulmonary hypertension to the systemic level, limits manifestations of right-sided heart failure and improves the overall functional status of the patients.
Related Concept Videos
01:16Treatment for Pulmonary Arterial Hypertension: Oxygen Therapy for Respiratory Failure
Oxygen therapy is vital in increasing and maintaining blood oxygen levels in PAH patients. As a result, it aids in reducing fatigue,...
01:30Pulmonary Hypertension: Classification and Pathogenesis
There are various classifications for PH, each relating to different underlying causes and also...