{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:09:13Z","timestamp":1792782553984,"version":"4.5.0"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Technische Universit\u00e4t M\u00fcnchen","id":[{"id":"https:\/\/ror.org\/02kkvpp62","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Cardiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Percutaneous creation of an aorto-pulmonary (AP) shunt has been explored in preclinical models for over 15 years, yet its clinical application remains limited. Surgical AP shunts are widely used to augment pulmonary blood flow in cyanotic congenital heart disease, but repeated thoracic operations and general anesthesia carry substantial risks in critically ill or surgically complex patients. A less invasive transcatheter alternative could therefore represent a transformative option. We report a case series of two pediatric patients in whom a percutaneous connection between the aorta and pulmonary artery was successfully established. Indications were severe cyanosis due to compromised pulmonary blood flow in one child and suprasystemic pulmonary arterial hypertension requiring decompression in the other. The procedures were technically feasible and resulted in the intended immediate hemodynamic effects, either by enhancing pulmonary perfusion or by enabling right-to-left shunting for right heart decompression. Conceptually, percutaneous AP shunt creation parallels the transcatheter Potts shunt, which is increasingly recognized as a therapeutic option in pulmonary arterial hypertension. Both approaches establish controlled communication between the aorta and pulmonary artery, adapted to distinct physiological settings. Our report represents, to our knowledge, the first description of percutaneous AP shunt creation to improve pulmonary blood flow and oxygenation in congenital heart disease, as well as the first percutaneous connection between the ascending aorta and the pulmonary artery. These cases illustrate the technical feasibility of catheter-based AP shunt creation in selected pediatric patients and support further evaluation of this approach.<\/jats:p>","DOI":"10.1007\/s00246-026-04504-9","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T13:25:48Z","timestamp":1792761948000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Aorto-Pulmonary Shunt Creation in Congenital Heart Disease: Different Indications, Various Modifications, but Common Technical Challenges"],"prefix":"10.1007","author":[{"given":"Matija","family":"Bako\u0161","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanimir","family":"Georgiev","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerstin","family":"Wustman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul Phillip","family":"Heinisch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Borgmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dunja","family":"Renner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Eicken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Lemmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ewert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarzyna","family":"Gendera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"issue":"4","key":"4504_CR1","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1002\/ccd.22150","volume":"75","author":"TM Sabi","year":"2010","unstructured":"Sabi TM, Schmitt B, Sigler M et al (2010) Transcatheter creation of an aortopulmonary shunt in an animal model. Catheter Cardiovasc Interv 75(4):563\u2013569. https:\/\/doi.org\/10.1002\/ccd.22150","journal-title":"Catheter Cardiovasc Interv"},{"issue":"3","key":"4504_CR2","doi-asserted-by":"publisher","first-page":"e105","DOI":"10.1093\/ejcts\/ezu445","volume":"47","author":"AE Baruteau","year":"2015","unstructured":"Baruteau AE, Belli E, Boudjemline Y et al (2015) Palliative Potts shunt for the treatment of children with drug-refractory pulmonary arterial hypertension: updated data from the first 24 patients. Eur J Cardiothorac Surg 47(3):e105\u2013e110. https:\/\/doi.org\/10.1093\/ejcts\/ezu445","journal-title":"Eur J Cardiothorac Surg"},{"issue":"9","key":"4504_CR3","doi-asserted-by":"publisher","first-page":"1188","DOI":"10.1016\/j.cjca.2017.06.004","volume":"33","author":"Y Boudjemline","year":"2017","unstructured":"Boudjemline Y, Sizarov A, Malekzadeh-Milani S et al (2017) Safety and feasibility of the transcatheter approach to create a reverse potts shunt in children with idiopathic pulmonary arterial hypertension. Can J Cardiol 33(9):1188\u20131196. https:\/\/doi.org\/10.1016\/j.cjca.2017.06.004","journal-title":"Can J Cardiol"},{"issue":"7","key":"4504_CR4","doi-asserted-by":"publisher","first-page":"2054","DOI":"10.1002\/ccd.30190","volume":"99","author":"P Ewert","year":"2022","unstructured":"Ewert P, Eicken A, Tanase D et al (2022) Transcatheter implantation of covered stents serving as extravascular conduits-proof of a CT-based approach in three cases. Catheter Cardiovasc Interv 99(7):2054\u20132063. https:\/\/doi.org\/10.1002\/ccd.30190","journal-title":"Catheter Cardiovasc Interv"},{"issue":"3","key":"4504_CR5","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1001\/jama.1945.02860280001001","volume":"128","author":"A Blalock","year":"1945","unstructured":"Blalock A, Taussig HB (1945) The surgical treatment of malformations of the heart in which there is pulmonary stenosis or pulmonary atresia. JAMA 128(3):189\u2013202. https:\/\/doi.org\/10.1001\/jama.1945.02860280001001","journal-title":"JAMA"},{"issue":"11","key":"4504_CR6","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1001\/jama.1946.02870460017005","volume":"132","author":"WJ Potts","year":"1946","unstructured":"Potts WJ, Smith S, Gibson S (1946) Anastomosis of the aorta to a pulmonary artery: certain types in congenital heart disease. JAMA 132(11):627\u2013631. https:\/\/doi.org\/10.1001\/jama.1946.02870460017005","journal-title":"JAMA"},{"key":"4504_CR7","first-page":"181","volume":"41","author":"DJ Waterston","year":"1962","unstructured":"Waterston DJ (1962) Treatment of Fallot\u2019s tetralogy in children under 1 year of age. Rozhl Chir 41:181\u2013183","journal-title":"Rozhl Chir"},{"key":"4504_CR8","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.121.011315","volume":"15","author":"JH Anderson","year":"2022","unstructured":"Anderson JH, Cabalka AK, Frantz RP, Cajigas HR, Taggart NW (2022) Transcatheter nonductal reverse Potts shunt creation in pulmonary arterial hypertension. Circ Cardiovasc Interv 15:e011315. https:\/\/doi.org\/10.1161\/CIRCINTERVENTIONS.121.011315","journal-title":"Circ Cardiovasc Interv"},{"key":"4504_CR9","doi-asserted-by":"publisher","DOI":"10.2174\/1573403X18666220509203335","author":"B Mendel","year":"2022","unstructured":"Mendel B, Christianto C, Angellia P, Holiyono I, Prakoso R, Siagian SN (2022) Reversed Potts shunt outcome in suprasystemic pulmonary arterial hypertension: a systematic review and meta-analysis. Curr Cardiol Rev. https:\/\/doi.org\/10.2174\/1573403X18666220509203335","journal-title":"Curr Cardiol Rev"},{"issue":"6","key":"4504_CR10","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1161\/CIRCULATIONAHA.117.028972","volume":"137","author":"JR Bentham","year":"2018","unstructured":"Bentham JR, Zava NK, Harrison WJ et al (2018) Duct stenting versus modified blalock-taussig shunt in neonates with duct-dependent pulmonary blood flow: associations with clinical outcomes in a multicenter national study. 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Written informed consent was obtained from all participants before inclusion, ensuring that they fully understood the purpose, procedures, potential risks, and benefits. Participant confidentiality was maintained throughout the study, with data anonymized and securely stored. The local institutional ethics committee of the Technical University of Munich approved the study protocol.","order":2,"name":"Ethics","label":"Ethical Approval","group":{"name":"EthicsHeading","label":"Declarations"}}]}}