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Beyond transplant: Roles of atrial septostomy and Potts shunt in pediatric pulmonary hypertension
  • Ronald Grady
Ronald Grady
Washington University in Saint Louis School of Medicine
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Abstract

Despite significant successes in treating children with pulmonary hypertension, many still die from their disease. Death most often results from right ventricular failure. Bilateral lung transplantation has historically been the ultimate palliation for children who develop heart failure despite maximal medical therapy. Creating an atrial level shunt has been advocated as a pre-transplant intervention to help reduce symptoms and perhaps serve as a bridge to transplant. More recently, the utilization of a pulmonary-to-systemic anastomosis, i.e., Potts shunt, has demonstrated efficacy in ameliorating symptoms in children with severe, progressive disease. This improvement is often coincident with a reduction in expensive and onerous pulmonary hypertension specific medications. Improvement has been sustained over years in some children, delaying the need for transplant consideration. Research is ongoing to determine more specific risk/benefits of using the Potts shunt in children with pulmonary hypertension both in the short term and long.

Peer review status:ACCEPTED

03 Jun 2020Submitted to Pediatric Pulmonology
04 Jun 2020Submission Checks Completed
04 Jun 2020Assigned to Editor
25 Jun 2020Reviewer(s) Assigned
06 Jul 2020Review(s) Completed, Editorial Evaluation Pending
10 Aug 20201st Revision Received
11 Aug 2020Submission Checks Completed
11 Aug 2020Assigned to Editor
11 Aug 2020Reviewer(s) Assigned
13 Aug 2020Review(s) Completed, Editorial Evaluation Pending
13 Aug 2020Editorial Decision: Accept