Abstract
Pulmonary hypertension (PH) is a rapidly progressive disease with an unfavorable outcome, which is characterized by an increase in the mean pressure in the pulmonary artery (mPAP) by more than 20 mmHg at rest, according to catheterization of the right heart. To date, the treatment of PH remains a difficult task, despite the constant improvement of capabilities to combat this life-threatening condition. Without treatment, the average life expectancy of children after diagnosis of idiopathic PH is about 10 months, adults – 2.8 years. The survival rate of children with PH on the background of PAH therapy and surgical interventions is steadily improving, and currently more than 80% of children survive after 5 years from the moment of diagnosis. In addition to drug treatment, with the progressive course of PH, the palliative procedure Potts anastomosis is performed – this is an effective procedure that helps to improve the clinical and functional condition of patients suffering from suprasystemic PH. Direct non-restrictive Potts anastomosis can be performed in cases where the ratio of mean PAP to mean arterial pressure (mAP) and the ratio of indexed pulmonary vascular resistance (PVRI) to indexed peripheral vascular resistance (PerVRI) is less than 1.2. Thus, venous blood is discharged from the pulmonary artery system into the arterial system, with the lower half the body receives mixed blood, and the upper half receives arterial blood. In cases of more pronounced PH, when control of venoarterial discharge is required, the ratio of mPAP/AP and PVRI/PerVRI should be more than 1.2, and in such situations, it may be necessary to apply a vascular prosthesis. Potts anastomosis is also a promising and effective alternative method of surgical treatment of patients with severe suprasystemic hypertension.
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About the authors
- Fozilzhon K. Zokirov, Cardiovascular Surgeon; ORCID
- Igor E. Chernogrivov, Dr. Med. Sci., Head of Department of Surgical Treatment of Heart Diseases with Progressive Pulmonary Hypertension; ORCID
- Sergey V. Gorbachevsky, Dr. Med. Sci., Professor, Chief Researcher; ORCID
