Format

Send to

Choose Destination
Semin Cardiothorac Vasc Anesth. 2014 Dec;18(4):310-8. doi: 10.1177/1089253214534780. Epub 2014 May 13.

Perioperative management of the patient with pulmonary hypertension.

Author information

1
University of Colorado, Aurora, CO, USA Daniel.L.Fox@ucdenver.edu.
2
University of Colorado Health Sciences Center, Aurora, CO, USA.

Abstract

Patients with pulmonary hypertension are at increased risk for perioperative morbidity and mortality. Elective surgery is generally discouraged in this patient population; however, there are times when surgery is deemed necessary. Currently, there are no guidelines for the preoperative risk assessment or perioperative management of subjects with pulmonary hypertension. The majority of the literature evaluating perioperative risk factors and mortality rates is observational and includes subjects with multiple etiologies of pulmonary hypertension. Subjects with pulmonary arterial hypertension, also referred to as World Health Organization group I pulmonary hypertension, and particularly those receiving pulmonary arterial hypertension-specific therapy may be at increased risk. Perioperative management of these patients requires a solid understanding and careful consideration of the hemodynamic effects of anesthetic agents, positive pressure ventilation and volume shifts associated with surgery in order to prevent acute right ventricular failure. We reviewed the most recent data regarding perioperative morbidity and mortality for subjects with pulmonary hypertension in an effort to better guide preoperative risk assessment and perioperative management by a multidisciplinary team.

KEYWORDS:

PDE-5 inhibitors; cardiac anesthesia; cardiac surgery; cardiovascular risk; heart; outcome; perioperative mortality; pulmonary artery pressure; risk management

PMID:
24828282
DOI:
10.1177/1089253214534780
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center