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Laparoscopic Rectopexy in a Patient With Pulmonary Hypertension Associated With Scleroderma: A Case Report

Montandrau, Olivier MD*; Mascitti, Paola MD*; Boucau, Cécile MD*; Cosserat, Julie MD; Denet, Christine MD; Beaussier, Marc MD, PhD*; Philip, Ivan MD*

doi: 10.1213/XAA.0000000000000919
Case Reports
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We report the perioperative management of a patient with pulmonary hypertension under new-generation treatments who underwent laparoscopic surgery. Preoperatively, arterial catheter, central venous line, and transesophageal echocardiography probe were inserted in addition to standard monitoring. Intraoperatively, inhaled nitric oxide was used because of increasing pressure in the right heart chambers related to the Trendelenburg position and the pneumoperitoneum. The operation finally lasted <2 hours without complication. The prognosis of patients with pulmonary hypertension has evolved since the advent of new management strategies. Thorough preoperative assessment and multidisciplinary discussion in a referral center are essential for medical optimization.

From the Departments of *Anesthesia

Internal Medicine

Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.

Accepted for publication September 4, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Olivier Montandrau, MD, Department of Anesthesia, Institut Mutualiste Montsouris, 42 Boulevard Jourdan, 75014 Paris, France. Address e-mail to olivier.montandrau@imm.fr.

Copyright © 2018 International Anesthesia Research Society
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