title: Surgical intervention in patients with moderate to severe pulmonary arterial hypertension.
abstract: BACKGROUND
  Patients with pulmonary arterial hypertension are believed to experience severe postoperative complications after major surgery.
  
  
  METHODS
  We retrospectively analyzed the data of 21 patients with pulmonary arterial hypertension who underwent 28 surgical procedures at our institution between 1996 and 2002.
  
  
  RESULTS
  The average mean pulmonary arterial pressure was 53 +/- 14.4 mm Hg. Twenty-two procedures were performed under general anesthesia. Extubation occurred within 24 hours of surgery in 72% and an intensive care unit stay was not required after 43% of the procedures. Perioperative morbidity and mortality were typically related to the surgical procedure or underlying disease.
  
  
  CONCLUSIONS
  In our study, patients with moderate to severe pulmonary arterial hypertension had an 18% per procedure mortality and a 19% rate of right heart failure after surgical intervention.
authors.affiliation: Department of Pulmonary anc Critical Care Medicine, Cleveland Clinic Foundation, OH 44195, USA. minaio@ccf.org
authors.forename: Omar A
authors.initials: OA
authors.lastname: Minai
authors.forename: Saiprakash B
authors.initials: SB
authors.lastname: Venkateshiah
authors.forename: Alejandro C
authors.initials: AC
authors.lastname: Arroliga
mesh_terms: D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009820:Ohio; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors