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Pre-operative Evaluation of Patients with Pulmonary Hypertension

  • Preoperative Evaluation (BJ Sweitzer, Section Editor)
  • Published:
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Abstract

Purpose of Review

To highlight some clinical information and recent findings about pulmonary hypertension (PH) and use them as a resource to improve perioperative care in patients affected with this disease.

Recent Findings

The last PH Consensus was held in Nice (2013) and continues to classify PH in five major groups. Although transthoracic Doppler echocardiography is often used as a first screening tool, right heart catheterization is mandatory to accurately make the diagnosis. As the natural history of PH has been changed by modern drug therapies, with current median survival rate reaching up to 9 years in low-risk patients, it is likely that anesthesiologists will need to evaluate PH patients more often. Their perioperative management remains challenging, and patients should be preferentially cared for in specialized centers.

Summary

Although the perioperative mortality of PH patients has significantly decreased over the years, morbidity remains high. Thus, a careful pre-operative evaluation and risk stratification by a multidisciplinary team is strongly encouraged as it may improve outcomes after surgery.

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Authors and Affiliations

  1. Federal University of Rio de Janeiro (UFRJ)-Clementino Fraga Filho Hospital (HUCFF), Rio de Janeiro, Brazil

    Glauber Gouvêa, Camila Santos Spiller, Rodrigo Diaz & Daniel Waetge

  2. Fluminense Federal University, Rio de Janeiro, Brazil

    Glauber Gouvêa

  3. University of California San Francisco (UCSF), San Francisco, CA, USA

    Glauber Gouvêa

  4. Department of Anesthesia and Perioperative Medicine, UCSF, San Francisco, CA, USA

    Glauber Gouvêa

  5. Hôpital Saint Antoine, Paris, France

    Camila Santos Spiller

  6. Hôpital Paul Brusse, Villejuif, France

    Rodrigo Diaz

  7. Department of Brazilian Society of Pulmonology and Tisiology (SBPT), Rio de Janeiro, Brazil

    Daniel Waetge

  8. Basic Sciences Department, Valença Medicine School (FMV), Rio de Janeiro, Brazil

    Fabiano Gouvêa

  9. Samaritano Hospital, Rio de Janeiro, Brazil

    Fabiano Gouvêa

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  1. Glauber Gouvêa
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  2. Camila Santos Spiller
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  3. Rodrigo Diaz
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  5. Fabiano Gouvêa
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Correspondence to Glauber Gouvêa.

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Glauber Gouvêa, Camila Santos Spiller, Rodrigo Diaz, Daniel Waetge, and Fabiano Gouvêa declare they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Preoperative Evaluation

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Gouvêa, G., Spiller, C.S., Diaz, R. et al. Pre-operative Evaluation of Patients with Pulmonary Hypertension. Curr Anesthesiol Rep 8, 44–51 (2018). https://doi.org/10.1007/s40140-018-0251-z

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