Anesthetic Management for Resection of Bilateral Pulmonary Artery Sarcoma.
We describe a patient who presented with a bilateral pulmonary artery sarcoma, initially treated as pulmonary embolism, that necessitated concomitant pulmonary endarterectomy and pneumonectomy. We reviewed the anesthetic management used for this procedure, which bears many similarities to the management of patients undergoing pulmonary thromboendarterectomy. Right ventricular failure, pulmonary hemorrhage, and cerebral ischemia due to circulatory arrest are life-threatening perioperative complications. The anesthesiologist can play a key role in the prevention (or timely recognition and treatment) of these perioperative complications by establishing adequate hemodynamic, echocardiographic, and neurologic monitoring and by optimizing cardiopulmonary function and coagulation.
From the Departments of *Anesthesiology, and †Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium; ‡Department of Cardiovascular Sciences, KU Leuven, Leuven, Belgium; and §Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium.
Danny
D
Hoogma
Bart
B
Meyns
Dirk
D
Van Raemdonck
Marc
M
Van de Velde
Carlo
C
Missant
Steffen
S
Rex
D000758:Anesthesia / Q000009:adverse effects / Q000379:methods*; D000776:Anesthesiology / Q000379:methods; D004691:Endarterectomy / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods; D011651:Pulmonary Artery / Q000473:pathology / Q000601:surgery*; D011655:Pulmonary Embolism / Q000175:diagnosis; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D019043:Vascular Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*