Seminars in Cardiothoracic and Vascular Anesthesia

 

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Seminars in Cardiothoracic and Vascular Anesthesia, Vol. 12, No. 2, 91-96 (2008)
DOI: 10.1177/1089253208319872

Anesthetic Management of Patients With Pulmonary Hypertension

Brenda MacKnight

Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Elizabeth A. Martinez

Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, Departments of Anesthesiology and surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland

Brett A. Simon

Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, bsimon{at}jhmi.edu

Advances in the treatment of patients with chronic pulmonary hypertension have greatly improved their functional status and longevity, and increasing numbers of these complex patients are presenting for elective noncardiac surgery. In this communication we will briefly review the classification and pathophysiology of pulmonary hypertension, summarize outpatient pharmacotherapy approaches, and discuss the perioperative preparation and management of these complex patients. With an understanding of the underlying pathophysiology of the disease and pharmacology of these new therapies, combined with careful perioperative planning and care, these patients can safely undergo elective surgical procedures.

Key Words: pulmonary hypertension • pharmacotherapy • right ventricular function • anesthetic management


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