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Case Reports
. 2025 Apr 2;30(7):103409.
doi: 10.1016/j.jaccas.2025.103409.

Cardiopulmonary Exercise Testing With Forehead and Popliteal Oximetry in Evaluating Efficacy of Reverse Potts Shunt

Keti Mamillo  1 , Robert P Frantz  2 , Jason H Anderson  3 , Thomas G Allison  4
Affiliations
Case Reports

Cardiopulmonary Exercise Testing With Forehead and Popliteal Oximetry in Evaluating Efficacy of Reverse Potts Shunt

Keti Mamillo et al. JACC Case Rep. .

Abstract

Reverse Potts shunt (rPS) is a surgical procedure that creates an anastomosis between the left pulmonary artery and descending aorta to decompress the right ventricle in suprasystemic pulmonary arterial hypertension (PAH). In this paper, we introduce a unique procedure combining cardiopulmonary exercise testing with forehead and popliteal oximetry to evaluate the efficacy of the rPS. Our study involved tests on 4 patients with PAH who had the shunt in place. We found that the level of oxygen saturation in the popliteal artery decreased during exercise and correlated with the rPS efficacy and the overall clinical outcome. In conclusion, we demonstrate a simple, noninvasive technique for evaluating patency and function of rPS in patients with suprasystemic PAH.

Keywords: CPET; NYHA; PAH; VO(2) max; forehead saturation; oxygen saturation; popliteal saturation; pulmonary hypertension; reverse Potts shunt; right to left shunt.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Echocardiography With Doppler Showing Reverse Potts Shunt Anatomy and physiology of the reverse Potts shunt at rest by echocardiography (patient 3 as an example).
Figure 2
Figure 2
Forehead and Popliteal O2 Saturation During Exercise in Reverse Potts Shunt Minute-by-minute O2 saturation measured by simultaneous forehead and popliteal oximetry (patient 1, first cardiopulmonary exercise test).
Figure 3
Figure 3
Forehead and Popliteal O2 Saturation During Exercise in Normal Subject Minute-by-minute O2 saturation measured by simultaneous forehead and popliteal oximetry for control patient without cardiovascular disease.
See this image and copyright information in PMC

References

    1. Kaminsky L.A., Arena R., Myers J., et al. Updated reference standards for cardiorespiratory fitness measured with cardiopulmonary exercise testing: data from the fitness registry and the Importance of Exercise National Database (FRIEND) Mayo Clin Proc. 2022;97(2):285–293. - PubMed
    1. Daida H., Allison T.G., Johnson B.D., Squires R.W., Gau G.T. Comparison of peak exercise oxygen uptake in men versus women in chronic heart failure secondary to ischemic or idiopathic dilated cardiomyopathy. Am J Cardiol. 1997;80(1):85–88. - PubMed
    1. Contreras A.M., Newman D.B., Cappelloni L., et al. Cardiopulmonary testing in long COVID-19 versus non-COVID-19 patients with undifferentiated dyspnea on exertion. Prog Cardiovasc Dis. 2024;83:71–76. doi: 10.1016/j.pcad.2023.05.005. - DOI - PMC - PubMed
    1. Stącel T., Latos M., Urlik M., et al. Interventional and surgical treatments for pulmonary arterial hypertension. J Clin Med. 2021;10(15):3326. doi: 10.3390/jcm10153326. - DOI - PMC - PubMed
    1. Kim S.H., Jang W.S., Lim H.G., Kim Y.J. Potts shunt in patients with primary pulmonary hypertension. Korean J Thorac Cardiovasc Surg. 2015;48(1):52–54. doi: 10.5090/kjtcs.2015.48.1.52. - DOI - PMC - PubMed

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