Improvement in exercise capacity after a modified Potts shunt in an adult patient with pulmonary arterial hypertension

The Potts shunt has been proposed as a strategy to alleviate symptoms and to delay lung transplantation in paediatric patients with pulmonary arterial hypertension (PAH) [1]. In a similar way to patients with Eisenmenger physiology with a patent ductus arteriosus, the Potts shunt may confer protection to the pressure-overloaded right ventricle in patients with suprasystemic pulmonary pressures. The results, in selected paediatric patients, have been encouraging in terms of survival, World Health Organization (WHO) functional classification and need for transplantation [1–4]. Recently, modifications to the classic Potts shunt have been reported by creating a unidirectional central valved conduit to protect the pulmonary circulation from reverse shunting [5, 6]. We report a second adult patient who underwent placement of a central unidirectional (valved) Potts shunt for severe suprasystemic PAH. After 1 year of follow up, the patient demonstrated overall clinical improvement with a significant increase in exercise tolerance. For young adults with end-stage idiopathic pulmonary hypertension, a valved graft connecting the central pulmonary artery to the distal aortic arch can provide substantial palliation of symptoms and may defer lung transplantation https://bit.ly/2TvMFFC