講演情報
[II-OR19-01]Transcatheter Potts Shunt Bridges Pharmacological Agents and Lung Transplantation
○Zhuoyuan Xu, Lijun Fu, Yanjun Sun, Xiafeng Yu, Zhuoming Xu, Hao Zhang (Shanghai Children's Medical Center, Shanghai Jiaotong University, Shanghai, China)
キーワード：
pulmonary arterial hypertension、transcatheter Potts shunt、pediatrics
We aimed to provide some evidience with transcatheter procedures to show the potential in improving patients' quality of life and functional status.We prospectively recruited 13 pediatrics patients with severely progressive PAH from February 2024 to February 2025. All the patients were under general anesthesia. The median age at the procedure was 15.0 years old. 85% patients were females. 10 patients were diagnosed with I/HPAH and 3 were with postoperative PAH. The median follow-up time was 3.7 months. The pulmonary artery pressures (PAP) are higher than the aortic pressures (AOP) at baseline. The mPAP was 86.5+-14.3mmHg while the mAOP was 81.6+-12.0mmHg, and the sPAP was 123.0+-18.8 mmHg while sAOP. 9+-4% differences in SpO2 were detected between upper and lower extremities at rest. The RVEF at baseline was 32.2+-12.0 % and the RVEDVI was 158.5+-43.5 ml/m2 by CMR. Pre- and post- operative comparisons were shown as follows: TAPSE 1.8 (1.5-2.1) vs. 1.7 (1.4-2.2) cm (p=0.318, % change: -5%), RV/LV basal (4CH) 1.5 (1.4-2.1) vs. 1.3 (1.2-1.6) (p=0.074, -13.3%), Tei index 0.9 (0.5-1.0) vs. 0.6 (0.5-0.8) (p=0.002, -33.3%). And significant decreases were found in NTpro-BNP and 6MWD as follows: 845 (188, 1131) vs. 189 (96, 581) pg/ml; 419+-107 vs. 446+-98 m (both p=0.01). 12 patients terminated the s.c. Treprostinil.In specialized PAH tertiary referral centers, transcatheter Potts shunts are safe and can improve activity tolerance in patients with severe progressive PAH. Short-term follow-up has shown improvement in cardiac function, which may delay the lung transplantation.