PMID- 19897552
OWN - NLM
STAT- MEDLINE
DCOM- 20100908
LR  - 20191210
IS  - 1399-3003 (Electronic)
IS  - 0903-1936 (Linking)
VI  - 35
IP  - 6
DP  - 2010 Jun
TI  - Noncardiothoracic nonobstetric surgery in mild-to-moderate pulmonary 
      hypertension.
PG  - 1294-302
LID - 10.1183/09031936.00113009 [doi]
AB  - The anaesthetic management and follow-up of well-characterised patients with 
      pulmonary arterial hypertension presenting for noncardiothoracic nonobstetric 
      surgery has rarely been described. The details of consecutive patients and 
      perioperative complications during the period January 2000 to December 2007 were 
      reviewed. Repeat procedures in duplicate patients were excluded. Longer term 
      outcomes included New York Heart Association (NYHA) functional class, 6-min 
      walking distance and invasive haemodynamics. A total of 28 patients were 
      identified as having undergone major (57%) or minor surgery under general (50%) 
      and regional anaesthesia. At the time of surgery, 75% of patients were in NYHA 
      functional class I-II. Perioperative deaths occurred in 7%. Perioperative 
      complications, all related to pulmonary hypertension, occurred in 29% of all 
      patients and in 17% of those with no deaths during scheduled procedures. Most (n 
      = 11, 92%) of the complications occurred in the first 48 h following surgery. In 
      emergencies (n = 4), perioperative complication and death rates were higher (100 
      and 50%, respectively; p<0.005). Risk factors for complications were greater for 
      emergency surgery (p<0.001), major surgery (p = 0.008) and a long operative time 
      (193 versus 112 min; p = 0.003). No significant clinical or haemodynamic 
      deterioration was seen in survivors at 3-6 or 12 months of post-operative 
      follow-up. Despite optimal management in this mostly nonsevere pulmonary 
      hypertension population, perioperative complications were common, although 
      survivors remained stable. Emergency procedures, major surgery and long 
      operations were associated with increased risk.
FAU - Price, L C
AU  - Price LC
AD  - Faculte de Medecine, University Paris-Sud, Kremlin-Bicetre, France.
FAU - Montani, D
AU  - Montani D
FAU - Jais, X
AU  - Jais X
FAU - Dick, J R
AU  - Dick JR
FAU - Simonneau, G
AU  - Simonneau G
FAU - Sitbon, O
AU  - Sitbon O
FAU - Mercier, F J
AU  - Mercier FJ
FAU - Humbert, M
AU  - Humbert M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20091106
PL  - England
TA  - Eur Respir J
JT  - The European respiratory journal
JID - 8803460
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anesthesia, General/*mortality
MH  - Emergency Medical Services/*statistics & numerical data
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/mortality
MH  - Hospital Mortality
MH  - Humans
MH  - Hypertension, Pulmonary/*mortality
MH  - Male
MH  - Middle Aged
MH  - Outcome Assessment, Health Care
MH  - Postoperative Complications/*mortality
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Surgery Department, Hospital/*statistics & numerical data
MH  - Time Factors
EDAT- 2009/11/10 06:00
MHDA- 2010/09/09 06:00
CRDT- 2009/11/10 06:00
PHST- 2009/11/10 06:00 [entrez]
PHST- 2009/11/10 06:00 [pubmed]
PHST- 2010/09/09 06:00 [medline]
AID - 09031936.00113009 [pii]
AID - 10.1183/09031936.00113009 [doi]
PST - ppublish
SO  - Eur Respir J. 2010 Jun;35(6):1294-302. doi: 10.1183/09031936.00113009. Epub 2009 
      Nov 6.