A novel unidirectional-valved shunt approach for end-stage pulmonary arterial hypertension: Early experience in adolescents and adults

ObjectivesDespite advances in treatment of idiopathic pulmonary arterial hypertension (IPAH), there remains no medical cure, and patients can experience disease progression leading to right heart failure, progressive exercise intolerance, death. The reversed Potts shunt (left artery descending aorta) was reintroduced for end-stage IPAH permit decompression the suprasystemic ventricle by left shunting, with preservation upper body oxygenation. has potential delay need lung transplantation offer a those who are transplant ineligible. To optimize design avoid complications bidirectional we developed novel approach using unidirectional-valved (UVS) pressure poor ventricular function.MethodsA single-center retrospective review performed UVS cases done at Columbia University Medical Center–New York Presbyterian between November 1, 2016, May 2019.ResultsFive (4 female; ages 12-22 years) underwent UVS. All had pressure, function, World Health Organization functional class IV symptoms baseline. alive transplant-free latest follow-up (range 3-33 months; median 6 ± 11 months).ConclusionsThe may an alternative solution adolescents young adults IPAH. Longer-term is needed determine ultimate impact unidirectional unloading these whether will enable broader