Author + information
- Kenneth Guo,
- Giuseppe Martucci,
- Richard Leask,
- Ariane Marelli,
- Avi Shimony,
- David Langleben,
- Jonathan Afilalo and
- Judith Therrien
Morbidity from pulmonary arterial hypertension (PAH) ensues when the pulmonary pressure reaches supra-systemic levels. A transcatheter alternative to the Pott's shunt would allow decompression of the right heart without the surgical risks. To aid development of a transcatheter aorto-pulmonary shunt (TAPS) device, we described the anatomic relationship between the left pulmonary artery (LPA) and the descending aorta (dAO) in adults with severe pulmonary hypertension.
Adults with severe PAH (types including idiopathic, drug-induced and associated PAH, with peak systolic pulmonary arterial pressure ≥ 80 mmHg) who had a computed tomography of the chest were enrolled. Measurements were taken on the axial plane at the level of the pulmonary artery bifurcation.
Forty patients (male: 9/40; median age of 59 ± 15 years; peak systolic pulmonary artery pressure of 93 ± 12 mmHg) were identified. The mean distance between the LPA and dAO was 2.3 ± 3.1 mm. The mean luminal dAO and LPA diameters were 23.4 ± 3.8 mm and 25.5 ± 5.1 mm respectively. The LPA and dAO approximated in 93% of patients with 38% having aortic calcification at the contact site. The mean contact width and height (defining an area with distance < 4mm between the outer borders) of the two arteries were 15.7 ± 3.4 mm and 20.6 ± 4.4 mm respectively at a mean distance of 28.0 ± 7.6 mm from the MPA bifurcation.
This study shows that a TAPS device would be anatomically feasible in the majority of patients with severe PAH.
Moderated Poster Contributions
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Pulmonary Hypertension: Physiology/Hemodynamics
Abstract Category: 27. Pulmonary Hypertension
Presentation Number: 1164M-155
- 2013 American College of Cardiology Foundation