Mamillo Keti, Frantz Robert P, Anderson Jason H, Allison Thomas G
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JACC Case Rep. 2025 Apr 2;30(7):103409. doi: 10.1016/j.jaccas.2025.103409.
Reverse Potts shunt (rPS) is a surgical procedure that creates an anastomosis between the left pulmonary artery and descending aorta to decompress the right ventricle in suprasystemic pulmonary arterial hypertension (PAH). In this paper, we introduce a unique procedure combining cardiopulmonary exercise testing with forehead and popliteal oximetry to evaluate the efficacy of the rPS. Our study involved tests on 4 patients with PAH who had the shunt in place. We found that the level of oxygen saturation in the popliteal artery decreased during exercise and correlated with the rPS efficacy and the overall clinical outcome. In conclusion, we demonstrate a simple, noninvasive technique for evaluating patency and function of rPS in patients with suprasystemic PAH.
反向波茨分流术(rPS)是一种外科手术,它在左肺动脉和降主动脉之间建立吻合,以减轻超系统性肺动脉高压(PAH)患者右心室的压力。在本文中,我们介绍了一种独特的方法,即将心肺运动试验与前额和腘动脉血氧测定相结合,以评估rPS的疗效。我们的研究涉及对4例已进行分流术的PAH患者进行测试。我们发现,运动期间腘动脉血氧饱和度水平下降,且与rPS疗效及整体临床结果相关。总之,我们展示了一种简单、无创的技术,用于评估超系统性PAH患者rPS的通畅性和功能。