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
‡Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.
Accepted for publication September 4, 2018.
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 firstname.lastname@example.org.