title: Perioperative pharmacological management of pulmonary hypertensive crisis during congenital heart surgery.
abstract: Pulmonary hypertensive crisis is an important cause of morbidity and mortality in patients with pulmonary arterial hypertension secondary to congenital heart disease (PAH-CHD) who require cardiac surgery. At present, prevention and management of perioperative pulmonary hypertensive crisis is aimed at optimizing cardiopulmonary interactions by targeting prostacyclin, endothelin, and nitric oxide signaling pathways within the pulmonary circulation with various pharmacological agents. This review is aimed at familiarizing the practitioner with the current pharmacological treatment for dealing with perioperative pulmonary hypertensive crisis in PAH-CHD patients. Given the life-threatening complications associated with pulmonary hypertensive crisis, proper perioperative planning can help anticipate cardiopulmonary complications and optimize surgical outcomes in this patient population.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Brunner
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Vinicio A
authors.initials: VA
authors.lastname: de Jesus Perez
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Richter
authors.affiliation: Division of Cardiology, Stanford School of Medicine, Stanford, California, USA.
authors.forename: François
authors.initials: F
authors.lastname: Haddad
authors.affiliation: Division of Anesthesiology, Montreal Heart Institute, Montreal, Quebec, Canada.
authors.forename: André
authors.initials: A
authors.lastname: Denault
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rojas
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Ke
authors.initials: K
authors.lastname: Yuan
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Orcholski
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Stanford School of Medicine, Stanford, California, USA ; Division of Cardiothoracic Surgery, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Liao
keywords: congenital heart diseases; perioperative pharmacological therapies; pulmonary arterial hypertension; pulmonary hypertensive crisis