Individualized, multidisciplinary peri-operative management is crucial for minimizing risk in patients with PAH-CHD undergoing non-cardiac surgery.
Guidelines insufficient for PAH-CHD peri-operative risk assessment; leaves open validation of disease-specific tools in prospective studies.
Background Current guidelines for the peri-operative assessment and management are not sufficient to allow effective risk assessment and management of the patient with pulmonary arterial hypertension associated with congenital heart disease. Well-established risk stratification tools are not validated in this group. Additional, disease-specific risks require individualised, specialist, multidisciplinary management. Case presentation We present an illustrative clinical case of patients with pulmonary arterial hypertension associated with congenital heart disease undergoing non-cardiac surgery. The case follows a 66-year-old male with pulmonary hypertension associated with an atrial septal defect underwent an elective hernia repair. Conclusions We discuss useful management strategies for minimising risk during the peri- and post-operative periods in this population.
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Constantine et al. (2020) studied this question.
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