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Anesthesiology pp 41–48Cite as

Anesthesia for Pulmonary Endarterectomy

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Abstract

Pulmonary endarterectomy (PEA) is the treatment of choice for chronic thromboembolic pulmonary hypertension (CTEPH), a disease that is increasingly being identified as a complication of acute pulmonary embolism. It is a complex surgical procedure involving the removal of obstructive material (including the intima and superficial media) from the pulmonary vasculature and requires cardiopulmonary bypass along with periods of deep hypothermic circulatory arrest. Complications include reperfusion pulmonary edema, pulmonary arterial steal, and persistent pulmonary hypertension, in addition to those common to other open-heart procedures. While PEA is still considered a high-risk surgery performed by only a small number of experienced medical centers, patient morbidity and mortality has significantly improved over the years. Surgical success is greatly dependent not only on surgical expertise, but also on the perioperative care delivered by an experienced cardiac anesthesiologist. This chapter reviews the pathophysiology of CTEPH as well as the pre-, intra-, and post-operative considerations for the anesthetic management of these patients.

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Emory University, Atlanta, GA, USA

    Cara Iorianni M.D.

  2. Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Emory University, Atlanta, GA, USA

    Ellen Richter M.D.

Authors
  1. Cara Iorianni M.D.
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  2. Ellen Richter M.D.
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Correspondence to Ellen Richter M.D. .

Editor information

Editors and Affiliations

  1. Hospital University Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA

    Basavana G. Goudra

  2. Department of Anesthesiology, Emory University, Atlanta, Georgia, USA

    Michael Duggan

  3. Department of Anesthesiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA

    Vidya Chidambaran

  4. University Hospitals Birmingham, Birmingham, United Kingdom

    Hari Prasad Krovvidi Venkata

  5. Emory University Hospital, Atlanta, Georgia, USA

    Elizabeth Duggan

  6. University of Alabama at Birmingham, Birmingham, Alabama, USA

    Mark Powell

  7. All India Institute of Medical Sciences (AIIMS), New Delhi, Delhi, India

    Preet Mohinder Singh

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Iorianni, C., Richter, E. (2018). Anesthesia for Pulmonary Endarterectomy. In: Goudra, B., et al. Anesthesiology. Springer, Cham. https://doi.org/10.1007/978-3-319-74766-8_5

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  • DOI: https://doi.org/10.1007/978-3-319-74766-8_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-74765-1

  • Online ISBN: 978-3-319-74766-8

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