Cardiopulmonary Exercise Testing With Forehead and Popliteal Oximetry in Evaluating Efficacy of Reverse Potts Shunt

Reverse Potts shunt (rPS) is a surgical procedure that creates an anastomosis between the left pulmonary artery and descending aorta to decompress the right ventricle in suprasystemic pulmonary arterial hypertension (PAH). In this paper, we introduce a unique procedure combining cardiopulmonary exercise testing with forehead and popliteal oximetry to evaluate the efficacy of the rPS. Our study involved tests on 4 patients with PAH who had the shunt in place. We found that the level of oxygen saturation in the popliteal artery decreased during exercise and correlated with the rPS efficacy and the overall clinical outcome. In conclusion, we demonstrate a simple, noninvasive technique for evaluating patency and function of rPS in patients with suprasystemic PAH.