Perioperative anesthetic challenges in pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension: A case series
Keywords:
Anesthetic management; Cardiopulmonary bypass; Endarterectomy; Pulmonary hypertension; Right ventricular dysfunctionAbstract
Pulmonary arterial hypertension as a result of the occlusion of the branches of the pulmonary vasculature is characterized by a rise in the mean pulmonary arterial pressure above 20 mmHg. Pulmonary endarterectomy is the preferred treatment modality for chronic thromboembolic pulmonary hypertension. Anesthetic challenges include management of right ventricular (RV) dysfunction, low baseline oxygen saturation, pre-operative deranged coagulation profile due to anticoagulant use, specific requirements for deep hypothermic circulatory arrest, and need for cerebral protection. Postoperatively, massive pulmonary hemorrhage, reperfusion pulmonary edema, residual pulmonary hypertension, and RV dysfunction may lead to prolonged intensive care unit stay and mechanical ventilation. We present a case series of the first seven endarterectomies in our institution, intending to highlight the perioperative anesthetic management of such patients.
Downloads
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Asian Journal of Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Authors who publish with this journal agree to the following terms:
- The journal holds copyright and publishes the work under a Creative Commons CC-BY-NC license that permits use, distribution and reprduction in any medium, provided the original work is properly cited and is not used for commercial purposes. The journal should be recognised as the original publisher of this work.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
