Surgical patients with pulmonary hypertension present a significant challenge to the anesthesiologist. Continuous perioperative monitoring of pulmonary artery (PA) pressure is recommended and most often accomplished with a PA catheter. Placement of a PA catheter may be difficult or contraindicated, and in these cases, transesophageal echocardiography is a useful alternative to monitor dynamic PA physiology. In this case, we used intraoperative transesophageal echocardiography to detect changes in peak PA pressure and guide clinical treatment in a patient with pulmonary hypertension and an extensive PA aneurysm undergoing partial nephrectomy.
From the Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina.
Accepted for publication March 30, 2016.
The authors declare no conflicts of interest.
This report was previously presented in part at the Society of Cardiovascular Anesthesiologists meeting in Washington, DC, on April 11, 2015.
Address correspondence to Michael J. Plakke, MD, Duke University Medical Center, DUMC 3094, Durham, NC 27710. Address e-mail to firstname.lastname@example.org.