Semin Respir Crit Care Med 2023; 44(06): 797-809
DOI: 10.1055/s-0043-1772753
Review Article

Surgery and Anesthesia in Patients with Pulmonary Hypertension

Robin Condliffe*
1   Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom
2   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
,
Ruth Newton*
3   Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Kris Bauchmuller
4   Department of Critical Care, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Tessa Bonnett
5   Department of Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Robert Kerry
6   Department of Orthopaedics, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Alexa Mannings
3   Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Amanda Nair
3   Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Karen Selby
5   Department of Obstetrics and Gynaecology, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Paul P. Skinner
7   Department of Surgery, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
Victoria J. Wilson
3   Department of Anaesthesia, Sheffield Teaching Hospitals NHS Trust, Sheffield, United Kingdom
,
David G. Kiely
1   Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom
2   Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
› Author Affiliations
Funding D.G.K. receives funding from the National Institute for Health and Care Research (NIHR) Sheffield Biomedical Research Centre (BRC). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

Abstract

Pulmonary hypertension is characterized by right ventricular impairment and a reduced ability to compensate for hemodynamic insults. Consequently, surgery can be challenging but is increasingly considered in view of available specific therapies and improved longer term survival. Optimal management requires a multidisciplinary patient-centered approach involving surgeons, anesthetists, pulmonary hypertension clinicians, and intensivists. The optimal pathway involves risk:benefit assessment for the proposed operation, optimization of pulmonary hypertension and any comorbidities, the appropriate anesthetic approach for the specific procedure and patient, and careful monitoring and management in the postoperative period. Where patients are carefully selected and meticulously managed, good outcomes can be achieved.

* Equal contribution.




Publication History

Article published online:
20 September 2023

© 2023. Thieme. All rights reserved.

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