title: Anesthesia for Potts Shunt in a Child with Severe Refractory Idiopathic Pulmonary Arterial Hypertension.
abstract: Childhood idiopathic pulmonary arterial hypertension is a progressive and fatal disease. When pulmonary artery pressures become suprasystemic and refractory to medical management, atrial septostomy can be recommended for bridging patients to lung transplantation. Recently, a surgical Potts shunt has been recommended as an alternative rescue therapy, and initial outcome data are promising. The placement of a Potts shunt converts the child to Eisenmenger physiology, which is anticipated to provide an improved quality and duration of life. We present the first description of anesthetic management of a child undergoing surgical Potts shunt for pulmonary arterial hypertension and summarize the multiple, unique intraoperative considerations.
authors.affiliation: From the Departments of *Anesthesiology and Pain Medicine, †Pediatric Cardiology, and ‡Pediatric Cardiovascular Surgery, Seattle Children's Hospital, University of Washington, Seattle, Washington.
authors.forename: Ashley
authors.initials: A
authors.lastname: Eggers
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Latham
authors.forename: Jeremy
authors.initials: J
authors.lastname: Geiduschek
authors.forename: Delphine
authors.initials: D
authors.lastname: Yung
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Chen
authors.forename: Denise C
authors.initials: DC
authors.lastname: Joffe
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000758:Anesthesia / Q000379:methods*; D002648:Child; D065627:Familial Primary Pulmonary Hypertension / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D006801:Humans; D007430:Intraoperative Care; D007530:Isoflurane / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007530:Isoflurane; D005283:Fentanyl