Abstract
The perioperative management of patients with pulmonary hypertension (PH) undergoing heart and lung transplantation is challenging. As more patients with near-systemic pulmonary pressures receive donor lungs and pulmonary pressure cutoff values for heart transplant candidates become more fluid, perioperative physicians will be required to care for an increasing number of critically ill patients. Multidisciplinary care involving anesthesiologists, intensivists, PH experts, and cardiac surgeons is pivotal for a favorable outcome.
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References
Ramakrishna G, Sprung J, Ravi BS, et al. Impact of pulmonary hypertension on the outcomes of non cardiac surgery: predictors of perioperative morbidity and mortality. J Am Coll Cardiol. 2005;45:1691–9.
Subramaniam K, Yared JP. Management of pulmonary hypertension in the operation room. Semin Cardiothorac Vasc Anesth. 2007;11:119–36.
Hosseinian L. Pulmonary hypertension and noncardiac surgery: implications for the anesthesiologists. J Cardiothorac Vasc Anesth. 2014;28:1076–86.
Vakil K, Duval S, Sharma A, et al. Impact of pre-transplant pulmonary hypertension on survival after heart transplantation: a UNOS registry analysis. Int J Cardiol. 2014;176:595–9.
Galiè N, Hoeper MM, Humbert M, et al. ESC/ERS. Guidelines for the diagnosis and treatment of pulmonary hypertension. Eur Heart J. 2009;30:2493–537.
Champion HC, Michelakis ED, Hassoun PM. Comprehensive invasive and noninvasive approach to the right ventricle-pulmonary circulation unit. State of the art and clinical and research implications. Circulation. 2009;120:992–1007.
Bossone E, Duong-Wagner TH, Paciocco G, et al. Echocardiographic features of primary pulmonary hypertension. J Am Soc Echocardiogr. 1999;12:655–62.
Lang RM, Bierig M, Devereux RB, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of European Society of Cardiology. J Am Soc Echocardiogr. 2005;18:1440–63.
Giaid A, Saleh D. Reduced expression of endothelial nitric oxide synthase in the lungs of patients with pulmonary hypertension. N Engl J Med. 1995;333:214–21.
Tuder RM, Cool CD, Geraci MW, et al. Prostacyclin synthase expression is decreased in lungs from patients with severe pulmonary hypertension. Am J Respir Crit Care Med. 1999;159:1925–32.
Gaine S. Pulmonary hypertension. JAMA. 2000;284:3160–8.
Zamanian R, Haddad F, Doyle RL, et al. Management strategies for patients with pulmonary hypertension in the intensive care unit. Crit Care Med. 2007;35:2037–50.
Mac Knight B, Martinez EA, Simon BA. Anesthetic management of patients with pulmonary hypertension. Semin Cardiothorac Vasc Anesth. 2008;12:91–6.
Giaid A, Yanagisawa M, Langleben D, et al. Expression of endothelin-1 in the lungs of patients with pulmonary hypertension. N Engl J Med. 1993;328:1732–9.
Archer SL, Weir EK, Wilkins MR. Basic science of pulmonary arterial hypertension for clinicians: new concepts and experimental therapies. Circulation. 2010;121:2045–66.
Pietra GG, Capron F, Stewart S, et al. Pathologic assessment of vasculopathies in pulmonary hypertension. J Am Coll Cardiol. 2004;43:25S–32.
Shah SJ. Pulmonary hypertension. JAMA. 2012;308:1366–74.
Fischer LG, Aken HV, Bürkle H. Management of pulmonary hypertension: physiological and pharmacological considerations for anesthesiologists. Anesth Analg. 2003;96:1603–16.
Minai OA, Yared JP, Kaw R, et al. Perioperative risk and management in patients with pulmonary hypertension. Chest. 2013;144:329–40.
Lai HC, Wang KY, Lee WL, et al. Severe pulmonary hypertension complicates postoperative outcome of non-cardiac surgery. Br J Anaesth. 2007;99:184–90.
Price LC, Montani D, Jaïs X, et al. Noncardiothoracic non obstetric surgery in mild-to-moderate pulmonary hypertension. Eur Respir J. 2010;35:1294–302.
Kaw R, Pasupuleti V, Deshpande A, et al. Pulmonary hypertension: an important predictor of outcomes in patients undergoing non-cardiac surgery. Respir Med. 2011;105:619–24.
Minai OA, Venkateshiah SB, Arroliga AC. Surgical intervention in patients with moderate to severe pulmonary arterial hypertension. Conn Med. 2006;70:239–43.
Cesnjevar RA, Feyrer R, Walther F, et al. High-risk mitral valve replacement in severe pulmonary hypertension-30 years experience. Eur J Cardiothorac Surg. 1998;13:344–52.
Reich DL, Bodian CA, Krol M, et al. Intraoperative hemodynamic predictors of mortality, stroke, and myocardial infarction after coronary artery bypass surgery. Anesth Analg. 1999;89:814–22.
Melby SJ, Moon MR, Lindman BR, et al. Impact of pulmonary hypertension on outcomes after aortic valve replacement for aortic valve stenosis. J Thorac Cardiovasc Surg. 2011;141:1424–30.
Stobierska-Dzierzek B, Awad H, Michler RE. The evolving management of acute right-sided heart failure in cardiac transplant recipients. J Am Coll Cardiol. 2001;38:923–31.
Chang PP, Longenecker JC, Wang NY, et al. Mild vs severe pulmonary hypertension before heart transplantation: different effects on posttransplantation pulmonary hypertension and mortality. J Heart Lung Transplant. 2005;24:998–1007.
Sztrymf B, Souza R, Bertoletti L, et al. Prognostic factors of acute heart failure in patients with pulmonary arterial hypertension. Eur Respir J. 2010;35:1286–93.
Forfia PR, Mathai SC, Fisher MR, et al. Hyponatremia predicts right heart failure and poor survival in pulmonary arterial hypertension. Am J Respir Crit Care Med. 2008;177:1364–9.
Voelkel NF, Quaife RA, Leinwand LA. Right ventricular function and failure: report of a National Heart, Lung and Blood Institute working group on cellular and molecular mechanisms of right heart failure. Circulation. 2006;114:1883–91.
Bogaard HJ, Abe K, Vonk Noordegraaf A, et al. The right ventricle under pressure; cellular and molecular mechanisms of right-heart failure in pulmonary hypertension. Chest. 2009;135:794–804.
Meldrum DR. Tumor necrosis factor in the heart. Am J Physiol. 1998;274:R577–95.
Haddad F, Hunt SA, Rosenthal DN, et al. Right ventricular function in cardiovascular disease, Part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117:1436–48.
Haddad F, Doyle R, Murphy DJ, et al. Right ventricular function in cardiovascular disease, Part II: Pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008;117:717–1731.
Addonizio LJ, Gersony WM, Robbins RC, et al. Elevated pulmonary vascular resistance and cardiac transplantation. Circulation. 1987;76:V52–5.
Kirklin JK, Naftel DC, Kirklin JW, et al. Pulmonary vascular resistance and the risk of heart transplantation. J Heart Transplant. 1988;7:331–6.
Erickson KW, Costanzo-Nordin MR, O’Sullivan EJ, et al. Influence of preoperative transpulmonary gradient on late mortality after orthotopic heart transplantation. J Heart Lung Transplant. 1990;9:526–37.
Chen JM, Levin HR, Michler RE, et al. Reevaluating the significance of pulmonary hypertension before cardiac transplantation: determination of optimal thresholds and quantification of the effect of reversibility on perioperative mortality. J Thorac Cardiovasc Surg. 1997;114:627–34.
Tenderich G, Koerner MM, Stuettgen B, et al. Does preexisting elevated pulmonary vascular resistance (transpulmonary gradient >15 mmHg or >5 wood) predict early and long-term results after orthotopic heart transplantation? Transplant Proc. 1998;30:1130–1.
Espinoza NC, Manito N, Roca J, et al. Reversibility of pulmonary hypertension in patients evaluated for orthotopic heart transplantation: importance in the postoperative morbidity and mortality. Transplant Proc. 1999;31:2503–4.
Lindelow B, Andersson B, Waagstein F, et al. High and low pulmonary vascular resistance in heart transplant candidates. A 5-year follow-up after heart transplantation shows continuous reduction in resistance and no difference in complication rate. Eur Heart J. 1999;20:148–56.
Delgado JF, Gomez-Sanchez MA, Saenz C, et al. Impact of mild pulmonary hypertension on mortality and pulmonary artery pulse pressure profile after heart transplantation. J Heart Lung Transplant. 2001;20:942–8.
Cimato TR, Jessup M. Recipient selection in cardiac transplantation: contraindications and risk factors for mortality. J Heart Lung Transplant. 2002;21:1161–73.
Tsai FC, Marelli D, Bresson J, et al. Recent trends in early outcome of adult patients after heart transplantation: a single-institution review of 251 transplants using standard donor organs. Am J Transplant. 2002;2:539–45.
Goland S, Czer LS, Kass RM, et al. Pre-existing pulmonary hypertension in patients with end-stage heart failure: impact on clinical outcome and hemodynamic follow-up after orthotopic heart transplantation. J Heart Lung Transplant. 2007;26:312–8.
Tenderich G, Koerner MM, Stuettgen B, et al. Pre-existing elevated pulmonary vascular resistance: long-term hemodynamic follow-up and outcome of recipients after orthotopic heart transplantation. J Cardiovasc Surg. 2000;41:215–9.
Klotz S, Wenzelburger F, Stypmann J, et al. Reversible pulmonary hypertension in heart transplant candidates: to transplant or not transplant. Ann Thorac Surg. 2006;82:1770–3.
Mehra MR, Kobashigawa J, Starling R, et al. Listing criteria for heart transplantation: International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates—2006. J Heart Lung Transplant. 2006;25:1024–42.
Mancini D, Lietz K. Selection of cardiac trans-plantation candidates in 2010. Circulation. 2010;122(2):173–83.
Hosenpud JD, Bennett LE, Keck BM, et al. The Registry of the International Society for Heart and Lung Transplantion: seventeenth official report—2000. J Heart Lung Transplant. 2000;19:909–31.
Sitbon O, Humbert M, Jais X, et al. Long-term response to calcium channel blockers in idiopathic pulmonary arterial hypertension. Circulation. 2005;111:3105–11.
Balzer DT, Kort HW, Day RW, et al. Inhaled nitric oxide as a preoperative test (INOP test I): the INOP Test Study Group. Circulation. 2002;106(12 suppl 1):176–81.
Berger S, Konduri GG. Pulmonary hypertension in children: the twenty first-century. Pediatr Clin North Am. 2006;53:961–87.
Kettner J, Dorazilova Z, Netuka I, et al. Is severe pulmonary hypertension a contraindication for orthotopic heart transplantation? Not any more. Physiol Res. 2011;60:769–75.
Zimpfer D, Zrunek P, Sandner S, et al. Post-transplant survival after lowering fixed pulmonary hypertension using left ventricular assist devices. Eur J Cardiothorac Surg. 2007;31:698–702.
Etz C, Welp H, Tjan T, et al. Medically refractory pulmonary hypertension: treatment with non pulsatile left ventricular assist devices. Ann Thorac Surg. 2007;83:1697–706.
Punnoose L, Burkhoff D, Rich S, et al. Right ventricular assist device in end-stage pulmonary arterial hypertension: insights from a computational model of the cardiovascular system. Prog Cardiovasc Dis. 2012;55:234–43.
Trulock EP, Edwards LB, Taylor DO, et al. Registry of the International Society for Heart and Lung Transplantation: twenty-third official adult lung and heart-lung transplantation report—2006. J Heart Lung Transplant. 2006;25:880–92.
Girgis RE, Theodore J. Physiology and function of the transplant lung allograft. In: Baumgartner WA, Reitz BA, Kasper E, et al., editors. Heart and lung transplantation. Philadelphia, PA: WB Saunders; 2002. p. 467–88.
Conte JV, Borja MJ, Patel CB, et al. Lung transplantation for primary and secondary pulmonary hypertension. Ann Thorac Surg. 2001;72:1673–9.
Kasimir MT, Seebacher G, Jaksch P, et al. Reverse cardiac remodeling in patients with primary pulmonary hypertension after isolated lung transplantation. Eur J Cardiothorac Surg. 2004;26:776–81.
Waddell TK, Bennett L, Kennedy R, et al. Heart-lung or lung transplantation for Eisenmenger syndrome. J Heart Lung Transplant. 2002;21:731–7.
Santamore WP, Dell’Italia LJ. Ventricular interdependence: significant left ventricular contribution to right ventricular systolic function. Prog Cardiovasc Dis. 1998;40:289–308.
Lau CL, Patterson GA, Palmer SM. Critical care aspects of lung transplantation. J Intensive Care Med. 2004;19:83–104.
Blaise G, Langleben D, Hubert B. Pulmonary arterial hypertension: pathophysiology and anesthetic approach. Anesthesiology. 2003;99:1415–32.
Gayes JM, Giron L, Nissen MD, et al. Anesthetic considerations for patients undergoing double-lung transplantation. J Cardiothorac Anesth. 1990;4:486–98.
Hohn L, Schweizer A, Morel DR, et al. Circulatory failure after anesthesia induction in a patient with severe primary pulmonary hypertension. Anesthesiology. 1999;91:1943–5.
Piazza G, Goldhaber SZ. The acutely decompensated right ventricle: pathways for diagnosis and management. Chest. 2005;128:1836–52.
van Wolferen SA, Marcus JT, Westerhof N, et al. Right coronary artery flow impairment in patients with pulmonary hypertension. Eur Heart J. 2008;29:120–7.
de Boer W, Waterbolk TW, Brugemann J, et al. Extracorporeal membrane oxygenation before induction of anesthesia in critically ill thoracic transplant patients. Ann Thorac Surg. 2001;72:1407–8.
Cannesson M, Earing MG, Collange V, et al. Anesthesia for non cardiac surgery in adults with congenital heart disease. Anesthesiology. 2009;111:432–40.
Ebert TJ, Muzi M, Berens R, et al. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology. 1992;76:725–33.
Sarkar M, Laussen PC, Zurakowski D, et al. Hemodynamic responses to etomidate on induction of anesthesia in pediatric patients. Anesth Analg. 2005;101:645–50.
Todd MM, Drummond JC, U HS. The hemodynamic consequences of high-dose thiopental anesthesia. Anesth Analg. 1985;64:681–7.
Strumpher J, Jacobsohn E. Pulmonary hypertension and right ventricular dysfunction: physiology and perioperative management. J Cardiothorac Vasc Anesth. 2011;25:687–704.
Morray JP, Lynn AM, Stamm SJ, et al. Hemodynamic effects of ketamine in children with congenital heart disease. Anesth Analg. 1984;63:895–9.
Williams GD, Philip BM, Chu LF, et al. Ketamine does not increase pulmonary vascular resistance in children with pulmonary hypertension undergoing sevoflurane anesthesia and spontaneous ventilation. Anesth Analg. 2007;105:1578–84.
Kaye AD, Hoover JM, Kaye AJ, et al. Morphine, opioids, and the feline pulmonary vascular bed. Acta Anaesthesiol Scand. 2008;52:931–7.
Kerbaul F, Rondelet B, Motte S, et al. Isoflurane and desflurane impair right ventricular-pulmonary arterial coupling in dogs. Anesthesiology. 2004;101:1357–62.
Kerbaul F, Bellezza M, Mekkaoui C, et al. Sevoflurane alters right ventricular performance but not pulmonary vascular resistance in acutely instrumented anesthetized pigs. J Cardiothorac Vasc Anesth. 2006;20:209–16.
Keogh AM, Mayer E, Benza RL, et al. Interventional and surgical modalities of treatment in pulmonary hypertension. J Am Coll Cardiol. 2009;54:S67–77.
Nishikawa T, Dohi S. Errors in the measurement of cardiac output by thermodilution. Can J Anaesth. 1993;40:142–53.
Murphy GJ, Reeves BC, Rogers CA, et al. Increased mortality, postoperative morbidity, and cost after red blood cell transfusion in patients having cardiac surgery. Circulation. 2007;116:2544–52.
Groenveld HF, Januzzi JL, Damman K, et al. Anemia and mortality in heart failure patients a systematic review and meta-analysis. J Am Coll Cardiol. 2008;52:818–27.
Wheeler AP, Bernard GR, Thompson BT, et al. Pulmonary-artery versus central venous catheter to guide treatment of acute lung injury. N Engl J Med. 2006;354:2213–24.
Rudolph AM, Yuan S. Response of the pulmonary vasculature to hypoxia and H+ ion concentration changes. J Clin Invest. 1966;45:399–411.
McIntyre KM, Sasahara AA. Determinants of right ventricular function and hemodynamics after pulmonary embolism. Chest. 1974;65:534–43.
Goldstein JA, Barzilai B, Rosamond TL, et al. Determinants of hemodynamic compromise with severe right ventricular infarction. Circulation. 1990;82:359–68.
Meluzin J, Spiranova L, Bakala J. Pulsed Doppler. Tissue imaging of the velocity of tricuspid annular systolic motion; a new, rapid and non-invasive method of evaluating right ventricular systolic function. Eur Heart J. 2001;22:340–8.
Forfia PR, Fisher MR, Mathai SC, et al. Tricuspid annular displacement predicts survival in pulmonary hypertension. Am J Respir Crit Care Med. 2006;174:1034–41.
Fisher MR, Forfia PR, Chamera E, et al. Accuracy of Doppler echocardiography in hemodynamic assessment of pulmonary hypertension. Am J Respir Crit Care Med. 2009;179:615–21.
Hammarstrom E, Wranne B, Pinto FJ, et al. Tricuspid annular motion. J Am Soc Echocardiogr. 1991;4:131–9.
Jardin F, Vieillard-Baron A. Right ventricular function and positive pressure ventilation in clinical practice: from hemodynamic subsets to respirator settings. Intensive Care Med. 2003;29:1426–34.
Vieillard-Baron A, Jardin F. Why protect the right ventricle in patients with acute respiratory distress syndrome? Curr Opin Crit Care. 2003;9:15–21.
Pritts CD, Pearl RG. Anesthesia for patients with pulmonary hypertension. Curr Opin Anaesthesiol. 2010;23:411–6.
The Acute Respiratory Distress Syndrome Network. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342:1301–8.
Ko WJ, Chen YS, Lee YC. Replacing cardiopulmonary bypass with extracorporeal membrane oxygenation in lung transplantation operations. Artif Organs. 2001;25:607–12.
Raffin L, Michel-Cherqui M, Sperandio M, et al. Anesthesia for bilateral lung transplantation without cardiopulmonary bypass: initial experience and review of intraoperative problems. J Cardiothorac Vasc Anesth. 1992;6:409–17.
Aeba R, Griffith BP, Kormos RL, et al. Effect of cardiopulmonary bypass on early graft dysfunction in clinical lung transplantation. Ann Thorac Surg. 1994;57:715–22.
Barr ML, Kawut SM, Whelan TP, et al. Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part IV: Recipient-related risk factors and markers. J Heart Lung Transplant. 2005;24:1468–82.
Christie JD, Carby M, Bag R, et al. Report of the ISHLT Working Group on Primary Lung Graft Dysfunction: part II. Definition. A consensus statement of the International Society for Heart and Lung Transplantation. J Heart Lung Transplant. 2005;24:1454–9.
Whitson BA, Nath DS, Johnson AC, et al. Risk factors for primary graft dysfunction after lung transplantation. J Thorac Cardiovasc Surg. 2006;131:73–80.
de Perrot M, Bonser RS, Dark J, et al. Report of the ISHLT Working Group on Primary Lung Graft Dysfunction Part III: Donor-related risk factors and markers. J Heart Lung Transplant. 2005;24:1460–7.
Hartwig MG, Appel III JZ, Cantu III E, et al. Improved results treating lung allograft failure with venovenous extracorporeal membrane oxygenation. Ann Thorac Surg. 2005;80:1872–9.
Aigner C, Wisser W, Taghavi S, et al. Institutional experience with extracorporeal membrane oxygenation in lung transplantation. Eur J Cardiothorac Surg. 2007;31:468–73.
Missant C, Rex S, Claus P, et al. Thoracic epidural anesthesia disrupts the protective mechanism of homeometric autoregulation during right ventricular pressure overload by cardiac sympathetic blockade: a randomized controlled animal study. Eur J Anaesthesiol. 2011;28:535–43.
Nygård E, Kofoed KF, Freiberg J, et al. Effects of high thoracic epidural analgesia on myocardial blood flow in patients with ischemic heart disease. Circulation. 2005;111:2165–70.
Veering BT, Cousins MJ. Cardiovascular and pulmonary effects of epidural anaesthesia. Anaesth Intensive Care. 2000;28:620–35.
Von Dossow V, Welte M, Zaune U, et al. Thoracic epidural anesthesia combined with general anesthesia: the preferred anesthetic technique for thoracic surgery. Anesth Analg. 2001;92:848–54.
Pollard JB. Common mechanisms and strategies for prevention and treatment of cardiac arrest during epidural anesthesia. J Clin Anesth. 2002;14:52–6.
Mishra L, Pani N, Samantaray R, Nayak K. Eisenmenger’s syndrome in pregnancy: use of epidural anesthesia and analgesia for elective cesarean section. J Anaesthesiol Clin Pharmacol. 2014;30(3):425–6.
Hasegawa A, Azuma Y, Ohashi Y, Yamashina M, Moriyama K, Iijima T, Yorozu T. [Anesthetic management of a patient with pulmonary arterial hypertension undergoing caesarean section]. Masui. 2013;62(2):183–5.
Bonnin M, Mercier FJ, Sitbon O, Roger-Christoph S, Jaïs X, Humbert M, Audibert F, Frydman R, Simonneau G, Benhamou D. Severe pulmonary hypertension during pregnancy: mode of delivery and anesthetic management of 15 consecutive cases. Anesthesiology. 2005;102(6):1133–7. discussion 5A–6A.
Khan MJ, Bhatt SB, Kryc JJ. Anesthetic considerations for parturients with primary pulmonary hypertension: review of the literature and clinical presentation. Int J Obstet Anesth. 1996;5(1):36–42.
Atanassoff P, Alon E, Schmid ER, Pasch T. Epidural anesthesia for cesarean section in a patient with severe pulmonary hypertension. Acta Anaesthesiol Scand. 1990;34(1):75–7.
Davies MJ, Beavis RE. Epidural anaesthesia for vascular surgery in a patient with primary pulmonary hypertension. Anaesth Intensive Care. 1984;12(2):165–7.
Armstrong P. Thoracic epidural anaesthesia and primary pulmonary hypertension. Anaesthesia. 1992;47(6):496–9.
Chakravarthy M, Jawali V, Patil T, Krishnamoorthy J. Decrease in pulmonary artery pressure after administration of thoracic epidural anesthesia in a patient with Marfan syndrome awaiting aortic valve replacement procedure. J Clin Monit Comput. 2011;25(4):265–8.
Subash G, Mohammed S. Perioperative cardiac arrest after thoracic epidural analgesia in a patient with increased pulmonary artery pressure. Br J Anaesth. 2011;107(1):108–9.
Mallampati SR. Low thoracic epidural anaesthesia for elective cholecystectomy in a patient with congenital heart disease and pulmonary hypertension. Can Anaesth Soc J. 1983;30(1):72–6.
Burrows FA. Epidural anaesthesia and pulmonary hypertension. Can Anaesth Soc J. 1983;30(4):445–6.
Friesen RH, Williams GD. Anesthetic management of children with pulmonary arterial hypertension. Pediatr Anaesth. 2008;18:208–16.
Lang G, Klepetko W. Lung transplantation for end-stage primary pulmonary hypertension. Ann Transplant. 2004;9:25–32.
Kwak YL, Lee CS, Park YH, et al. The effect of phenylephrine and norepinephrine in patients with chronic pulmonary hypertension. Anaesthesia. 2002;57:9–14.
Leather HA, Segers P, Berends N, et al. Effects of vasopressin on right ventricular function in an experimental model of acute pulmonary hypertension. Crit Care Med. 2002;30:2548–52.
Price LC, Wort SJ, Finney SJ, et al. Pulmonary vascular and right ventricular dysfunction in adult critical care: current and emerging options for management: a systematic literature review. Crit Care. 2010;14:R169.
Chen EP, Bittner HB, Davis Jr RD, et al. Milrinone improves pulmonary hemodynamics and right ventricular function in chronic pulmonary hypertension. Ann Thorac Surg. 1997;63:814–21.
Wang H, Gong M, Zhou B, et al. Comparison of inhaled and intravenous milrinone in patients with pulmonary hypertension undergoing mitral valve surgery. Adv Ther. 2009;26:462–8.
Sablotzki A, Startzmann W, Scheubel R, et al. Selective pulmonary vasodilation with inhaled aerosolized milrinone in heart transplant candidates. Can J Anaesth. 2005;52:1076–82.
Lamarche Y, Perrault LP, Maltais S, et al. Preliminary experience with inhaled milrinone in cardiac surgery. Eur J Cardiothorac Surg. 2007;31:1081–7.
Lamarche Y, Malo M, Thorin E, et al. Inhaled but not intravenous milrinone prevents pulmonary endothelial dysfunction after cardiopulmonary bypass. J Thorac Cardiovasc Surg. 2005;130:83–92.
Laflamme M, Perrault LP, Carrier M, Elmi-Sarabi M, Fortier A, Denault AY. Preliminary experience with combined inhaled milrinone and prostacyclin in cardiac surgical patients with pulmonary hypertension. J Cardiothorac Vasc Anesth. 2015;29(1):38–45.
Kerbaul F, Rondelet B, Motte S. Effects of norepinephrine and Dobutamine on pressure-load induced right ventricular failure. Crit Care Med. 2004;32:1035–40.
Kota B, Prasad AS, Economides C, et al. Levosimendan and calcium sensitization of the contractile proteins in cardiac muscle: impact on heart failure. J Cardiovasc Pharmacol Ther. 2008;13:269–78.
Parissis JT, Karavidas A, Bistola V. Effects of levosimendan on flow-mediated vasodilation and soluble adhesion molecules in patients with advanced chronic heart failure. Atherosclerosis. 2008;197:278–82.
Kerbaul F, Rondelet B, Demester JP, et al. Effects of levosimendan versus dobutamine on pressure load-induced right ventricular failure. Crit Care Med. 2006;34:2814–9.
Morelli A, Teboul JL, Maggiore SM. Effects of levosimendan on right ventricular afterload in patients with acute respiratory distress syndrome: a pilot study. Crit Care Med. 2006;34:2287–93.
Kopustinskiene DM, Pollesello P, Saris NE. Levosimendan is a mitochondrial K(ATP) channel opener. Eur J Pharmacol. 2001;428:311–4.
Gruhn N, Nielsen-Kudsk JE, Theilgarrd S, et al. Coronary vasorelaxant effect of levosimendan, a new inodilator with calcium-sensitizing properties. J Cardiovasc Pharmacol. 1998;31:741–9.
Jeon Y, Ryu JH, Lim YJ, et al. Comparative hemodynamic effects of vasopressin and norepinephrine after milrinone-induced hypotension in off-pump coronary artery bypass surgical patients. Eur J Cardiothorac Surg. 2006;29:952–6.
Salzberg SP, Filsoufi F, Anyanwu A, et al. High-risk mitral valve surgery: perioperative hemodynamic optimization with nesiritide (BNP). Ann Thorac Surg. 2005;80:502–6.
Kelesidis I, Mazurek JA, Saeed W, et al. Effect of nesiritide in isolated right ventricular failure secondary to pulmonary hypertension. Congest Heart Fail. 2012;18:8–24.
Galiè N, Ghofrani HA, Torbicki A, et al. Slidenafil citrate therapy for pulmonary arterial hypertension. N Engl J Med. 2005;353:2148–57.
Galiè N, Brundage BH, Ghofrani HA, et al. Tadalafil therapy for pulmonary arterial hypertension. Circulation. 2009;119:2894–903.
Bigatello LM, Hess D, Dennehy KC, et al. Sildenafil can increase the response to nitric oxide. Anesthesiology. 2000;92:1827–9.
Steiner MK, Preston IR, Klinger JR, et al. Pulmonary hypertension: inhaled nitric oxide, Sildenafil and natriuretic peptides. Curr Opin Pharmacol. 2005;5:245–50.
Lepore JJ, Maroo A, Bigatello LM, et al. Hemodynamic effects of Sildenafil in patients with congestive heart failure and pulmonary hypertension: combined administration with inhaled nitric oxide. Chest. 2005;127:1647–53.
Vachiery JL, Huez S, Gillies H, et al. Safety, tolerability and pharmacokinetics of an intravenous bolus of slidenafil in patients with pulmonary arterial hypertension. Br J Clin Pharmacol. 2011;71:289–92.
Atz AM, Wessel DL. Sildenafil ameliorates effect of inhaled nitric oxide withdrawal. Anesthesiology. 1999;91:307–10.
Lee JE, Hillier SC, Knoderer CA. Use of sildenafil to facilitate weaning from inhaled nitric oxide in children with pulmonary hypertension following surgery for congenital heart disease. J Intensive Care Med. 2008;23:329–34.
De Santo LS, Mastroianni C, Romano G, et al. Role of sildenafil in acute posttransplant right ventricular dysfunction: successful experience in 13 consecutive patients. Transplant Proc. 2008;40:2015–8.
Lahm T, McCaslin CA, Wozniak TC, et al. Medical and surgical treatment of acute right ventricular failure. J Am Coll Cardiol. 2010;56:1435–46.
Inglessis I, Shin JT, Lepore JJ, et al. Hemodynamic effects of inhaled nitric oxide in right ventricular infarction and cardiogenic shock. J Am Coll Cardiol. 2004;44:793–8.
Fujita Y, Nishida O, Sobue K, et al. Nitric oxide inhalation is useful in the management of right ventricular failure caused by myocardial infarction. Crit Care Med. 2002;30:1379–81.
Oz MC, Ardehali A. Collective review: perioperative uses of inhaled nitric oxide in adults. Heart Surg Forum. 2004;7:E584–9.
Rimar S, Gillis CN. Selective pulmonary vasodilation by inhaled nitric oxide is due to hemoglobin inactivation. Circulation. 1993;88:2884–7.
Vizza CD, Rocca GD, Roma AD, et al. Acute hemodynamic effects of inhaled nitric oxide, dobutamine and a combination of the two in patients with mild to moderate secondary pulmonary hypertension. Crit Care. 2001;5:355–61.
Bradford KK, Deb B, Pearl RG. Combination therapy with inhaled nitric oxide and intravenous dobutamine during pulmonary hypertension in the rabbit. J Cardiovasc Pharmacol. 2000;36:146–51.
George I, Xydas S, Topkara VK, et al. Clinical indication for use and outcomes after inhaled nitric oxide therapy. Ann Thorac Surg. 2006;82:2161–9.
Bocchi EA, Bacal F, Costa Auler Junior JO, et al. Inhaled nitric oxide leading to pulmonary edema in stable severe heart failure. Am J Cardiol. 1994;74:70–2.
Semigran MJ, Cockrill BA, Kacmarek R, et al. Hemodynamic effects of inhaled nitric oxide in heart failure. J Am Coll Cardiol. 1994;24:982–8.
Christenson J, Lavoie A, O’Conner M, et al. The incidence and pathogenesis of cardiopulmonary deterioration after abrupt withdrawal of inhaled nitric oxide. Am J Respir Crit Care Med. 2000;161:1443–9.
Adhikari NK, Burns KE, Friedrich JO, et al. Effect of nitric oxide on oxygenation and mortality in acute lung injury: systematic review and meta-analysis. BMJ. 2007;334:779.
Barst RJ, Rubin LJ, Long WA, et al. A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension. The Primary Pulmonary Hypertension Study Group. N Engl J Med. 1996;334:296–302.
Olschewski H, Simonneau G, Galiè N, et al. Inhaled iloprost in severe pulmonary hypertension. N Engl J Med. 2002;347:322–9.
Haraldsson A, Kieler-Jensen N, Nathorst-Westfelt U, et al. Comparison of inhaled nitric oxide and inhaled aerosolized prostacyclin in the evaluation of heart transplant candidates with elevated pulmonary vascular resistance. Chest. 1998;114:780–6.
Khan TA, Schnickel G, Ross D, et al. A prospective, randomized, crossover pilot study of inhaled nitric oxide versus inhaled prostacyclin in heart transplant and lung transplant recipients. J Thorac Cardiovasc Surg. 2009;138:1417–24.
Voswinckle R, Enke B, Reichenberger F, et al. Favorable effects of inhaled treprostinil in severe pulmonary hypertension: results from randomized controlled pilot studies. J Am Coll Cardiol. 2006;48:1672–81.
Le Varge BL, Channick RN. Inhaled treprostinil for the treatment of pulmonary arterial hypertension. Expert Rev Respir Med. 2012;6:255–65.
Huang J, Bouvette MJ, Zhou J. Simultaneous delivery of inhaled prostacyclin and milrinone through a double nebulizer system. J Cardiothorac Vasc Anesth. 2011;25:590–1.
Galiè N, Olschewski H, Oudiz RJ, et al. Ambrisentan for the treatment of pulmonary arterial hypertension: results of the ambrisentan in pulmonary arterial hypertension, randomized, double blind, placebo controlled, multicenter, efficacy (ARIES) study 1 and 2. Circulation. 2008;117:3010–9.
Gille J, Seyfarth HJ, Gerlach S, Malcharek M, Czeslick E, Sablotzki A. Perioperative anesthesiological management of patients with pulmonary hypertension. Anesthesiol Res Pract. 2012;2012:356982.
Liu H, Kalarickal PL, Tong Y, et al. Perioperative considerations of patients with pulmonary hypertension. In: Elwing JM, Panos RJ, editors. Pulmonary hypertension [Internet]. Rijeka, Croatia: InTech; 2013 [cited 2015 Jul 22]. Available from: http://www.intechopen.com/books/pulmonary-hypertension/perioperative-considerations-of-patients-with-pulmonary-hypertension. doi:10.5772/56056
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Nazarnia, S. (2017). Perioperative Management of Pulmonary Hypertension. In: Subramaniam, K., Sakai, T. (eds) Anesthesia and Perioperative Care for Organ Transplantation. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6377-5_15
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