Zhangwei Wang, Honghao Fu, Shoujun Li
Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases and Fuwai Hospital.
China
Cardiology in the Young
Cardiol Young 2025;
DOI: 10.1017/S1047951125101352
Abstract
Pulmonary artery hypertension in children is a progressive, fatal disease secondary to a variety of causes leading to right ventricular dysfunction. Traditional treatments include lung transplantation (LTx) and targeted therapy. However, due to the shortage of donor sources, heavy medical economic burden, immune rejection, and other problems, many patients are discouraged. In the past 20 years, the Potts palliative shunt, which was initially used for the treatment of cyanotic heart disease, has been gradually revived. Studies have shown that reverse Potts shunt can improve postoperative cardiac function, delay lung transplantation, and improve long-term quality of life in children with severe pulmonary arterial hypertension, which is a feasible and effective alternative to LTx. The surgical procedure is relatively less complex, so it is worth promoting in resource-poor countries, and limited medical expertise. In the future, with refinements of the reverse Potts shunt (unidirectional-valved shunt and transcatheter Potts shunt) and formulation of guidelines (shunt sizes, involvement of multidisciplinary team), there is expected to be further expansion of indications. This article reviews the physiological mechanisms, past and present status of reverse Potts shunt indications and contraindications, surgical procedures, benefits, future application prospects, and key unsolved problems of reverse Potts shunt in the treatment of severe pulmonary arterial hypertension in children.
Category
Surgical and Catheter-mediated Interventions for Pulmonary Vascular Disease
Review Articles Concerning Pulmonary Vascular Disease
Age Focus: Pediatric Pulmonary Vascular Disease
Fresh or Filed Publication: Fresh (PHresh). Less than 1-2 years since publication
Article Access
Free PDF File or Full Text Article Available Through PubMed or DOI: No