Improvement in exercise capacity after a modified Potts shunt in an adult patient with pulmonary arterial hypertension.

The Potts shunt has been proposed as a strategy to alleviate symptoms and to delay lung transplantation in pediatric patients with pulmonary arterial hypertension (PAH) [1]. In a way similar to patients with Eisenmenger physiology with a patent ductus arteriosus, the Potts shunt may confer protection to the pressure-overloaded right ventricle (RV) in patients with supra-systemic pulmonary pressures. The results, in selected pediatric patients, have been encouraging in terms of survival, WHO functional classification and need for transplantation [1–4]. Recently, modifications to the classic Potts shunt have been reported by creating a unidirectional central valved conduit to protect the pulmonary circulation from reverse shunting [5, 6]. We report on a second adult patient who underwent placement of a central unidirectional (valved) Potts shunt for severe suprasystemic PAH. After one-year follow-up, the patient demonstrated overall clinical improvement with a significant increase in exercise tolerance. Footnotes This manuscript has recently been accepted for publication in the ERJ Open Research . It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article. Conflict of interest: P. Symersky has nothing to disclose. Conflict of interest: S. M. A. Jansen has nothing to disclose. Conflict of interest: S. K. Kamminga has nothing to disclose. Conflict of interest: L. J. Meijboom has nothing to disclose. Conflict of interest: E. J. Lust has nothing to disclose. Conflict of interest: P. Eghtesady has nothing to disclose. Conflict of interest: R. M. Grady has nothing to disclose. Conflict of interest: H. J. Bogaard has nothing to disclose.