Perioperative management with upfront combination therapy in a patient exhibiting idiopathic pulmonary hypertension with central pulmonary thrombosis.
A 47-year-old woman with idiopathic pulmonary arterial hypertension (IPAH) was referred to our hospital for treatment of an ovarian tumor. Although chest contrast-enhanced CT scans obtained on admission revealed pulmonary arterial thrombosis, she was diagnosed with IPAH with central pulmonary thrombosis based on a normal perfusion lung scan. We initiated upfront triple combination therapy with pulmonary vasodilators. After one month of the therapy, the patient's pulmonary hemodynamics improved. Gynecological surgery was performed under general anesthesia without any perioperative complications. Providing careful intensive management of patients with severe PAH can reduce the perioperative risks of non-cardiac and non-obstetric surgery.
Department of Respirology, Graduate School of Medicine, Chiba University, Japan.
Hiroki
H
Umezawa
Jiro
J
Terada
Nobuhiro
N
Tanabe
Toshihiko
T
Sugiura
Akira
A
Naito
Kyoko
K
Nishikimi
Seiichiro
S
Sakao
Yasunori
Y
Kasahara
Yasuhide
Y
Yoshida
Koichiro
K
Tatsumi
D000925:Anticoagulants / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D065627:Familial Primary Pulmonary Hypertension / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000601:surgery; D010052:Ovariectomy; D011300:Preoperative Care / Q000379:methods*; D011655:Pulmonary Embolism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D011669:Pulmonary Wedge Pressure; D014057:Tomography, X-Ray Computed; D014665:Vasodilator Agents / Q000627:therapeutic use*
D000925:Anticoagulants; D014665:Vasodilator Agents