Perioperative Pharmacological Management of Pulmonary Hypertensive Crisis during Congenital Heart Surgery

PVRI Member Authors: Vinicio de Jesus Perez

Abstract

Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population.

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Topics

Congenital Heart Disease
Pulmonary Arterial Hypertension

Authors

Nathan Brunner, Vinicio A. de Jesus Perez, Alice Richter, François Haddad, André Denault, Vanessa Rojas, Ke Yuan, Mark Orcholski, Xiaobo Liao

Published in:

Pulmonary Circulation Vol 4: No 1 cover image

March 2014

Pulmonary Circulation Vol 4: No 1

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