PERIOPERATIVE MANAGEMENT OF PATENT DUCTUS ARTERIOSIS WITH EISENMENGERS SYNDROME WITH SEVERE PULMONARY HYPERTENSION POSTED FOR NONCARDIAC SURGERY.

Dr Sukela Venkata Padma Priya, Dr Mrunalini Parasa

Abstract


Victor Eisenmenger's initial definition of Eisenmengers syndrome was redefined by Wood as 'the presence of high
pulmonary vascular resistance associated with pulmonary artery hypertension at or close to systemic pressure
associated with a reversed or bi-directional shunt at the aortopulmonary, interatrial or interventricular level'. Survival
beyond 50 years is unusual, but patients may lead a relatively active and productive life in early adulthood and will
therefore present from time to time for noncardiac surgery. Though theoretical risks of anaesthesia are considerable
patients are known to do well with a variety of techniques, if pathophysiology of the disease is well understood. We
describe the anaesthetic management of the patient with Eisenmengers syndrome with abnormal uterine bleeding with
multiple fibroids. She underwent a total abdominal hysterectomy after pre-operative stabilization. Anaesthetizing such a
decompensated patient is an anaesthetic challenge.


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References


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Bedard E, Dimopoulos K, Gatzoulis MA. Has there been any progress made on pregnancy outcomes among females with pulmonary arterial hypertension? Eur Heart J 2009;30:256–265


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