Abstract
The perioperative management of pulmonary hypertension in a patient with Eisenmenger syndrome, the most advanced form of associated pulmonary artery hypertension (PAH), who required a sigmoidectomy is presented. The treatment for pulmonary hypertension was switched from oral sildenafil to intravenous epoprostenol to avoid the unexpected discontinuation of vasodilation during the perioperative period. The scheduled perioperative conversion should be considered for patients with severe PAH undergoing major abdominal surgery to ensure the stabilization of pulmonary and systemic hemodynamics.
Copyright © 2012 Elsevier Inc. All rights reserved.
MeSH terms
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Administration, Oral
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Antihypertensive Agents / administration & dosage
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Antihypertensive Agents / therapeutic use
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Colectomy / methods
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Eisenmenger Complex / complications
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Eisenmenger Complex / drug therapy*
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Eisenmenger Complex / physiopathology
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Epoprostenol / administration & dosage
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Epoprostenol / therapeutic use*
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Familial Primary Pulmonary Hypertension
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Humans
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Hypertension, Pulmonary / drug therapy
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Hypertension, Pulmonary / etiology
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Infusions, Intravenous
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Male
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Middle Aged
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Perioperative Care / methods
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Piperazines / administration & dosage
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Piperazines / therapeutic use*
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Purines / administration & dosage
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Purines / therapeutic use
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Sigmoid Neoplasms / surgery
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Sildenafil Citrate
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Sulfones / administration & dosage
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Sulfones / therapeutic use*
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Vasodilator Agents / administration & dosage
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Vasodilator Agents / therapeutic use
Substances
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Antihypertensive Agents
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Piperazines
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Purines
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Sulfones
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Vasodilator Agents
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Sildenafil Citrate
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Epoprostenol