Potts Shunt for Refractory Pulmonary Hypertension: Historical and Future Perspectives
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摘要: 肺动脉高压是继发于先天性心脏病、肺血管病变、肺栓塞或因特发性疾病导致的以肺动脉压力升高为特点的疾病。充分靶向药物降压治疗下仍进展的顽固性肺动脉高压需手术干预,传统的肺移植或心肺联合移植手术面临供体有限、配型困难、免疫排斥等诸多问题。在此背景下,以建立心外体肺分流、缓解致命性右心衰竭为目的的Potts分流术逐渐复兴,但其用于治疗顽固性肺动脉高压的历史尚短,开展范围尚小,具体的适应证、禁忌证、手术策略及远期预后仍需更多循证医学证据支持。本文以Potts分流术的历史为线索,对该术式的优势、未来应用前景及尚未解决的关键问题进行论述。Abstract: Pulmonary artery hypertension (PAH) is a disease secondary to congenital heart diseases, pulmonary vascular disorders, embolism, or idiopathic reasons. Surgery is necessary for PAH refractory to modern combined medical therapy. Results of lung transplantation are limited by factors like donor shortage, matching difficulty, immune rejection, etc. In order to make an extracardiac shunt to release the deadly right ventricular failure, the old Potts shunt surgery has enjoyed a recent revival. Although some early and mid-term results are satisfactory, the history of Potts shunt surgery in the treatment of refractory PAH is short and the sample size is limited. More proofs of medical research are needed for its specific indications, details of surgical strategies, and long-term prognosis. Based on its origin and development in the treatment of PAH, this paper reviews the advantages, future directions and unsolved key problems of Potts shunt surgery.作者贡献: 作者贡献:刘鑫裴负责查阅文献、撰写论文; 苗齐负责选题设计、修订、审核论文; 刘剑州负责修订论文。利益冲突: 无
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