Perioperative use of pulmonary artery catheter in a patient with severe chronic thromboembolic pulmonary hypertension undergoing major gynecological surgery : a case report

Kekec, Laura (avtor), Radisavljevič-Vitas, Sanja (avtor), Bervar, Mojca (avtor), Taleska Štupica, Gordana (avtor)

Pulmonary hypertension (PH) is associated with substantial perioperative risk in noncardiac surgery. In chronic thromboembolic pulmonary hypertension (CTEPH), persistent elevation of pulmonary vascular resistance (PVR) imposes considerable mechanical load on the right ventricle (RV), limiting its ability to tolerate acute physiologic changes. We report the successful management of a 52-year-old woman with severe CTEPH undergoing total hysterectomy and bilateral salpingo-oophorectomy. Comprehensive preoperative assessment, meticulous intraoperative management, and continuous hemodynamic monitoring with a pulmonary artery catheter (PAC) enabled tight control of pulmonary pressures without vasopressor support. Under low-dose glyceryl trinitrate infusion and PAC-guided titration of therapy, her mean pulmonary artery pressures (mPAP) remained stable throughout surgery and the early postoperative period. She experienced an uneventful recovery and was discharged home on postoperative day eight. This case underscores the critical role of meticulously tailored anesthetic management and advanced monitoring (PAC) in ensuring optimal outcomes for patients with severe PH undergoing noncardiac surgery.

• Jezik: Angleški jezik
• Ključne besede: anesthesia, chronic thromboembolic pulmonary hypertension, noncardiac surgery, pulmonary artery catheter, pulmonary hypertension
• Vrsta gradiva: Članek v reviji
• Tipologija: 1.03 - Drugi znanstveni članki
• Organizacija: MF - Medicinska fakulteta
• Status publikacije: Objavljeno
• Različica publikacije: Objavljena publikacija
• Leto izida: 2026
• Št. strani: 10 str.
• Številčenje: Vol. 18, no. 2, art. e103094
• PID: 20.500.12556/RUL-181245
• UDK: 616.1
• ISSN pri članku: 2168-8184
• DOI: 10.7759/cureus.103094
• COBISS.SI-ID: 270873603
• Datum objave v RUL: 03.04.2026

Gradivo je del revije

• Naslov: Cureus
• Skrajšan naslov: Cureus
• Založnik: Cureus
• ISSN: 2168-8184
• COBISS.SI-ID: 523497753

Licence

• Licenca: CC BY 4.0, Creative Commons Priznanje avtorstva 4.0 Mednarodna
• Povezava: http://creativecommons.org/licenses/by/4.0/deed.sl
• Opis: To je standardna licenca Creative Commons, ki daje uporabnikom največ možnosti za nadaljnjo uporabo dela, pri čemer morajo navesti avtorja.

Sekundarni jezik

• Jezik: Slovenski jezik
• Ključne besede: anestezija, kronična trombembolična pljučna hipertenzija, nekadialna operacija, pljučni arterijski kateter, pljučna hipertenzija