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Reversed Potts Shunt and Venopulmonary Extracorporeal Membrane Oxygenation Support in Sustained Pulmonary
Xiafeng Yu1, Yanjun Sun1, Lijun Fu2
1Department of Cardiothoracic Surgery, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Insights
Infantile idiopathic pulmonary arterial hypertension is a critical condition. Reversed Potts shunt (RPS) and venopulmonary extracorporeal membrane oxygenation (V-P ECMO) offer successful treatment for pulmonary hypertension crises.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Infantile idiopathic pulmonary arterial hypertension (IPAH) is a rare, life-threatening condition.
- Recurrent pulmonary hypertensive crises in infants with IPAH carry a high mortality rate.
- Medical therapy is often insufficient for managing severe pulmonary hypertensive crises.
Background:
Infantile idiopathic pulmonary arterial hypertension complicated by recurrent episodes of pulmonary hypertensive crisis is an extremely rare and critical condition with high mortality.
Case Summary:
We present the case of a 5-month-old infant with a pulmonary hypertension crisis refractory to medical therapy, who underwent successful treatment with an emergency reversed Potts shunt (RPS), along with postoperative venopulmonary extracorporeal membrane oxygenation (V-P ECMO) support.
Discussion:
From an imaging perspective, the mechanism by which RPS improves symptoms in patient with sustained pulmonary hypertension crises is explained. Additionally, this is the first reported case of successful postoperative use of V-P ECMO support after RPS.
Take-Home Messages:
It is important to recognize the importance of RPS and V-P ECMO in the treatment of pulmonary hypertension crises. By comparing pre- and postoperative imaging data, the mechanism by which RPS improves cardiac function is better understood.
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