Key result
Major orthopedic surgery in severe pulmonary hypertension is linked to ~6% perioperative mortality.
Observational (n=16)
No
Major orthopedic surgery is feasible in patients with severe pulmonary hypertension when managed with an individualized, interdisciplinary perioperative approach, though complication rates remain notable.
Supports individualized perioperative care for major orthopedic surgery in severe pulmonary hypertension; leaves open need for larger prospective validation.
INTRODUCTION: It is known that pulmonary hypertension is associated with worse outcome in both cardiac and non-cardiac surgery. The aims of our retrospective analysis were to evaluate the outcomes of our patients with pulmonary hypertension undergoing major orthopedic surgery and to give experience-based recommendations for the perioperative management. MATERIAL AND METHODS: From 92 patients with pulmonary hypertension undergoing different kinds of surgical procedures from 2011-2014 in a tertiary academic hospital we evaluated 16 patients with major orthopedic surgery for perioperative morbidity and mortality. RESULTS: Regarding the in-hospital morbidity and mortality, one patient died postoperatively due to pulmonary infection and right heart failure (6.25%) and 6 patients suffered significant postoperative complications (37.5%; bleeding = 1, infection = 1, wound healing deficits = 3; dysrhythmia = 1). CONCLUSION: Our data show that major orthopedic surgery is feasible with satisfactory outcome even in cases of severe pulmonary hypertension by an individualized, disease-adapted interdisciplinary treatment concept.
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Seyfarth et al. (2015) conducted an observational in Severe pulmonary hypertension (n=16). Major orthopedic surgery with individualized perioperative management was evaluated on In-hospital mortality. Major orthopedic surgery in patients with severe pulmonary hypertension was associated with a 6.25% perioperative mortality rate and a 37.5% major complication rate.
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