Surgical-interventional hybrid orchestra consisting of Potts shunt, transcatheter tricuspid valve repair by Edwards-valve in a 26-year-old patient with pulmonary hypertension and right ventricular failure

Sabine Recla,Christian Apitz,Blanka Steinbrenner,Hakan Akintuerk,Jennifer Schreier,Juergen Bauer,Matthias Müller,Dietmar Schranz,Stephan Fichtlscherer,Dorle Schmidt

doi:10.4236/wjcd.2013.36a001

Abstract

Reported here is a 26-year-old patient with corrected congenital interrupted aortic arch admitted with massive hemoptysis and severe suprasystemic pul-monary hypertension provided him for heart-lung transplantation. Initial closure of a small aorto-pulmonary collateral remained ineffective. Persistent life-threatening hemoptysis led to the decision for a modified Potts shunt with the aim of decompressing the right ventricle and avoiding pulmonary-hypertensive crisis. The hemoptysis did not recur. However, the patient’s oxygen transport condition deteriorated and necessitated an orchestra of interventional-surgical approaches from re-coarctation stenting, Potts shunt flow reducing to surgical and transcatheter tricuspid valve repair with transient ECMO before the patient could be discharged home.

Highlights

Reported here is a 26-year-old patient with corrected congenital interrupted aortic arch admitted with massive hemoptysis and severe suprasystemic pulmonary hypertension provided him for heart-lung transplantation
Pulmonary hypertension (PH) with hemoptysis and suprasystemic pressures is associated with poor prognosis [1,2,3]
As a novel approach for palliating children with suprasystemic idiopathic pulmonary arterial hypertension (PAH), surgical Potts shunt has been reported as an alternative treatment to lung transplantation [5,6]

Summary

INTRODUCTION

Pulmonary hypertension (PH) with hemoptysis and suprasystemic pressures is associated with poor prognosis [1,2,3]. Decrease of cardiac output is related to impaired right ventricular (RV) function, and a consequence of impaired LV filling due to right-to-left ventricular interaction [4]. Ating children with suprasystemic idiopathic pulmonary arterial hypertension (PAH), surgical Potts shunt has been reported as an alternative treatment to lung transplantation [5,6]

CASE REPORT

COMMENT