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Management of peri-operative pulmonary hypertension in a patient presenting for a portosystemic shunt

Published online by Cambridge University Press:  16 August 2006

B. Kinirons ,
L. Kuhlman ,
K. Mori  and
K. Samii
B. Kinirons
Affiliation:
Département d'Anesthésie-Réanimation, Centre Hospitalier, Universitaire de Bicêtre, 78, Le Kremlin Bicêtre Cedex, France
L. Kuhlman
Affiliation:
Département d'Anesthésie-Réanimation, Hoôpital Paul Brousse, Villejuif, France
K. Mori
Affiliation:
Département d'Anesthésie-Réanimation, Centre Hospitalier, Universitaire de Bicêtre, 78, Le Kremlin Bicêtre Cedex, France
K. Samii
Affiliation:
Département d'Anesthésie-Réanimation, Centre Hospitalier, Universitaire de Bicêtre, 78, Le Kremlin Bicêtre Cedex, France
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Abstract

We report the successful management of intra-operative pulmonary hypertension in a patient with mitral valve insufficiency and portal hypertension. A 48-year-old male with portal hypertension presented for a portosystemic shunt. Previously undiagnosed mitral valve insufficiency and pulmonary hypertension complicated his anaesthetic management. His intra-operative course was marked by systolic hypotension, pulmonary hypertension and a reduction in cardiac output. The use of nitric oxide in this patient reduced right ventricular afterload, increased cardiac output, without exacerbating pre-existing systolic hypotension.

Keywords

liver cirrhosismitral valveinsufficiencypulmonary hypertensionnitric oxide
Type
Case Report
Information
European Journal of Anaesthesiology , Volume 16 , Issue 10 , October 1999 , pp. 728 - 732
Copyright
1999 European Society of Anaesthesiology

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