Intervention of Potts shunt, from animal studies to human application

A 6-month-old girl infant with severe pulmonary hypertension in the setting of absence RPA was referred with cyanosis due to right to left shunt from ASD and attacks of increasing cyanosis down to 30% with irritability and hemodynamic compromise. Drug therapy with Sildenafil and Bosentan was ineffective. Several surgical and interventional procedures were discussed or attempted including PDA stenting, right or left surgical BT shunt, surgical Potts shunt, and right pneumectomy. However, all of them were either refused by surgeons or failed. We decided to create a transcatheter Potts shunt.By stiff end of a coronary guide wire, we passed from the Aorta to the pulmonary artery and a 6 Fr long sheath was crossed over it by the help of a 2 mm balloon catheter. Then a Be Graft stent size of 19mm on an Aviator balloon size of 5*20 was inflated in the path.The shunt made a 20% saturation difference between upper and lower extremities. The intensity and frequency of hypertensive crisis were reduced. After one week, the patient was discharged.In addition to the presentation of this case, my experiences in pigs of the same procedure in 2008 in Germany were also will be discussed.