Pulmonary Hypertension

  • Brian S. Porter


Overview: Pulmonary hypertension confers increased risk for perioperative morbidity and mortality in noncardiac surgery [1]. In the absence of evidence-based guidelines, perioperative management of patients with this condition demands thoughtful clinical reasoning.


Dioxide Ischemia Influenza Heparin Prostacyclin 


  1. 1.
    Kaw R, Sharma P, Minai OA. What risks does a history of pulmonary hypertension present for patients undergoing noncardiac surgery? Cleve Clin J Med. 2007;74 Suppl 1:S20–1.PubMedCrossRefGoogle Scholar
  2. 2.
    McLaughlin VV, Archer SL, Badesch DB, et al. ACCF/AHA 2009 expert consensus document on pulmonary hypertension. J Am Coll Cardiol. 2009;53:1573–619.PubMedCrossRefGoogle Scholar
  3. 3.
    Simonneau G, Galiè N, Rubin L, et al. Clinical classification of pulmonary hypertension. J Am Coll Cardiol. 2004;43:5–12.CrossRefGoogle Scholar
  4. 4.
    Poirier P, Alpert MA, Fleisher LA, et al. Cardiovascular evaluation and management of severely obese patients undergoing surgery: a science advisory from the American Heart Association. Circulation. 2009;120:86–95.PubMedCrossRefGoogle Scholar
  5. 5.
    McLaughlin VV, McGoon MD. Pulmonary arterial hypertension. Circulation. 2006;114(13):1417–31.PubMedCrossRefGoogle Scholar
  6. 6.
    Ramakrishna G, Sprung J, Ravi BS, et al. Impact of pulmonary hypertension on the outcomes of noncardiac surgery. J Am Coll Cardiol. 2005;45(10):1691–9.PubMedCrossRefGoogle Scholar
  7. 7.
    Rodriguez R, Pearl RG. Pulmonary hypertension and major surgery. Anesth Analg. 1998;87:812–5.PubMedGoogle Scholar
  8. 8.
    Jones AM, Howitt G. Eisenmenger syndrome in pregnancy. Br Med J. 1965;1(5451):1627–31.PubMedCrossRefGoogle Scholar
  9. 9.
    Collison EA, Nourmand H, Fraiman MH, et al. Retrospective analysis of the results of liver transplantation for adults with severe hepatopulmonary syndrome. Liver Transpl. 2002;8:925–31.CrossRefGoogle Scholar
  10. 10.
    Krowaka MJ, Plevak DJ, Findlay JY, et al. Pulmonary hemodynamics and ­perioperative cardiopulmonary-related mortality in patients with portopulmonary hypertension undergoing liver transplantation. Liver Transpl. 2000;6(4):443–50.CrossRefGoogle Scholar
  11. 11.
    Lai HC, Lai HC, Wang KY, et al. Severe pulmonary hypertension complicates postoperative outcome of non-cardiac surgery. Br J Anaesth. 2007;99(2):184–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Kaw R, Pasupuleti V, Deshpande A, et al. Pulmonary hypertension: an important predictor of outcomes in patients undergoing non-cardiac surgery. Respir Med. 2011;105:619–24.PubMedCrossRefGoogle Scholar
  13. 13.
    Memtsoudis SG, Ma T, Chiu YL, et al. Perioperative mortality in patients with pulmonary hypertension undergoing major joint replacement. Anesth Analg. 2010;111(5):1110–6.PubMedCrossRefGoogle Scholar
  14. 14.
    Fleisher LA, Beckman JA, Brown KA, et al. ACC/AHA 2007 guidelines on perioperative ­cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2007;116:e418–500.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Brian S. Porter
    • 1
  1. 1.Department of Medicine, Division of General Internal MedicineUniversity of Washington Medical CenterSeattleUSA

Personalised recommendations