Featured InnovationTranscatheter Potts shunt creation in patients with severe pulmonary arterial hypertension: Initial clinical experience
Section snippets
Methods
This study was conducted with institutional oversight provided through an “innovative therapy” framework. This approach ensures patient protection and arms-length review for therapies driven primarily by clinical need and considered too novel to yet conform to a research protocol.
Results
Of 7 patients considered for TPS creation, 4 were catheterized with the intent to perform TPS. TPS creation was performed successfully in 3 patients; in the fourth (our most recent patient), the case was complicated by intrathoracic bleeding, which was fatal. Demographic and procedural data are summarized in Table 1, with additional clinical observations outlined below.
Discussion
Idiopathic PAH has a bleak natural history, and medical intervention remains inadequate.12 Progressive RV failure and/or sudden death may be due to arrhythmia, RV ischemia, or acute RV decompensation with impairment of cardiac output.12, 13, 14 Measures of RV function carry important prognostic significance,12, 13, 14 and altering the RV loading conditions is the ultimate goal of all PAH treatment.
Strategies for management of severe PAH comprise drug therapy, transplantation, and anatomic
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the procedure described in the presented manuscript or other conflicts of interest to disclose.
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