An infant weighing 6.95 kg with severe suprasystemic pulmonary hypertension underwent creation of a reverse Potts shunt. The patient had previously undergone a modified two-patch repair of a complete atrioventricular septal defect.
Surgical Technique
Given the severity of the suprasystemic pulmonary hypertension, a reverse Potts shunt was created to decompress the right ventricle and offload the pulmonary circulation by allowing a right-to-left shunt at the level of the descending aorta. The procedure was performed through a repeat median sternotomy.
A cryopreserved 7 mm aortic homograft was used to construct the shunt. However, the effective shunt diameter was 5 mm because a branch of the aortic arch was used to create the distal anastomosis to avoid a larger communication that might otherwise compromise pulmonary blood flow.
Postoperative Course
Postoperatively, a differential oxygen saturation of 10–20 percent between the upper and lower extremities was observed, as expected, confirming patency of the shunt. The patient was discharged on pulmonary vasodilators and continued to do well on follow-up.
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