Preoperative balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension led to successful anesthetic management for total hysterectomy under general anesthesia: a case report

JA Clinical Reports
Tomoko OtaHideki Fukuda

Abstract

Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease of obstructive pulmonary artery remodeling as a consequence of major vessel thromboembolism. Balloon pulmonary angioplasty (BPA) is an alternative treatment for patients with inoperable CTEPH. We report a case of CTEPH which improved following preoperative BPA intervention, allowing total hysterectomy to be performed. A 48-year-old woman was transferred to our hospital to undergo total hysterectomy for endometrial cancer. She developed pulmonary embolism 7 months ago at another hospital, and a diagnosis of CTEPH was made based on multiple pulmonary emboli and pulmonary hypertension at our institute. Two BPA sessions for seven branches of the bilateral pulmonary arteries were conducted, resulting in a decrease of mean pulmonary artery pressure from 54 to 33 mmHg. Total hysterectomy was successfully performed under general anesthesia without any complications. BPA could be effective for reducing PH in patients with CTEPH undergoing noncardiac surgery.

References

Jan 28, 2011·The New England Journal of Medicine·Gregory Piazza, Samuel Z Goldhaber
Nov 8, 2012·Circulation. Cardiovascular Interventions·Masaharu KataokaToru Satoh
Nov 30, 2012·Circulation. Cardiovascular Interventions·Hiroki MizoguchiHiromi Matsubara
Mar 31, 2017·European Respiratory Review : an Official Journal of the European Respiratory Society·Irene LangPhilippe Brenot
Nov 5, 2017·Circulation. Cardiovascular Quality and Outcomes·Aiko OgawaHiromi Matsubara
Apr 20, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Aiko Ogawa, Hiromi Matsubara
Jul 31, 2018·Cardiovascular Diagnosis and Therapy·Keshav MenonTakeshi Ogo

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