Potts Shunt in Children With Idiopathic Pulmonary Arterial Hypertension: Long-Term Results Alban-Elouen Baruteau, MD, Alain Serraf, MD, PhD, Maryline.

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Potts Shunt in Children With Idiopathic Pulmonary Arterial Hypertension: Long-Term Results Alban-Elouen Baruteau, MD, Alain Serraf, MD, PhD, Maryline Lévy, MD, PhD, Jérôme Petit, MD, Damien Bonnet, MD, PhD, Xavier Jais, MD, Pascal Vouhé, MD, PhD, Gérald Simonneau, MD, Emre Belli, MD, Marc Humbert, MD, PhD The Annals of Thoracic Surgery Volume 94, Issue 3, Pages 817-824 (September 2012) DOI: 10.1016/j.athoracsur.2012.03.099 Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Transthoracic echocardiography during (A) preoperative assessment and at (B) last postoperative follow-up (left parasternal in short-axis view). In A, end-systolic inversion of the interventricular septum curvature indicates that right ventricular pressure is at a suprasystemic level. In B, flattening of the interventricular septal curvature indicates effective decompression of the right ventricular cavity. The Annals of Thoracic Surgery 2012 94, 817-824DOI: (10.1016/j.athoracsur.2012.03.099) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Drawing of the surgical technique for performing the Potts shunt. (A) The descending aorta below the isthmus and the enlarged left pulmonary artery were mobilized, then a side-biting clamp was applied on the descending aorta. (B) The size of the anastomosis was, according to the size of the lateral aortic clamp, as large as possible, aiming to be at least the same as the diameter of the descending aorta. (Ao = aorta; LPA = left pulmonary artery.) The Annals of Thoracic Surgery 2012 94, 817-824DOI: (10.1016/j.athoracsur.2012.03.099) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Multimodal evaluation of a patient who has a Potts shunt (white arrow): (A) two-dimensional computed tomographic scan; (B, C) three-dimensional reconstructions computed tomographic scan; and (D) color Doppler transthoracic echocardiography. The Annals of Thoracic Surgery 2012 94, 817-824DOI: (10.1016/j.athoracsur.2012.03.099) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Kaplan-Meier curve of lethal events during follow-up after Potts shunt (analysis on the 8 children operated on). The Annals of Thoracic Surgery 2012 94, 817-824DOI: (10.1016/j.athoracsur.2012.03.099) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Arterial oxygen saturation (Sao2) in upper (UL) and lower limbs (LL) at preoperative evaluation and during follow-up. Analysis was performed on the data from the 6 children who survived beyond the first postoperative month. Mean arterial oxygen saturation is symbolized for each scatter plot by a red bar. The Annals of Thoracic Surgery 2012 94, 817-824DOI: (10.1016/j.athoracsur.2012.03.099) Copyright © 2012 The Society of Thoracic Surgeons Terms and Conditions