Volume 6: Issue 2

Pulmonary arterial hypertension (PAH) is a disease of the pulmonary vasculature that is characterized by a progressive increase in pulmonary vascular resistance (PVR) and pulmonary artery pressure (PAP) resulting in the development of right ventricular (RV) failure, inadequate oxygenation, and ultimately death. Anesthesia and surgery, both cardiac and noncardiac, are associated with significantly increased morbidity and mortality in patients with PAH due mainly to RV failure, arrhythmias, postoperative hypoxemia, and myocardial ischemia. Preoperative risk assessment and successful management of patients with PAH undergoing general surgery involves an understanding of the pathophysiology of the disease, analysis of preoperative and operative risk factors, intraoperative management, and early recognition and treatment of postoperative complications.

The past decade has witnessed enormous strides in the treatment of pulmonary arterial hypertension (PAH). Currently available pharmacologic agents are capable of inducing sustained clinical improvements and reducing mortality, particularly for idiopathic PAH (IPAH). However, response is variable, and morbidity and mortality remain unacceptably high in this relatively young population.1 2 Lung transplantation, therefore, remains an important option in the face of progressive disease.

Pulmonary hypertension as the result of chronic pulmonary thromboembolic disease is a serious condition with poor long-term prognosis. The condition is one of the more common cardiovascular diseases affecting Americans, yet it is severely underdiagnosed. Pulmonary thromboendarterectomy is the definitive treatment for chronic pulmonary hyper-tension as the result of thromboembolic disease; however. it is an uncommon procedure, primarily because of lack of recognition on the part of the clinicians. Patients affected by chronic thromboembolic pulmonary hypertension (CTEPH) may present with a variety of debilitating cardiopulmonary symptoms. However, once diagnosed, there is no curative role for medical management, and surgery remains the only option. Palliation therapy with medical management in order to delay surgery carries the risk of prolonging the disease and irreversibly damaging unaffected pulmonary vasculature.

The scientific program of the Pulmonary Hypertension Association is guided by the association’s Scientific Leadership Council. The Council includes the following health care professionals:

David B. Badesch, MD, SLC Chair University of Colorado, Health Sciences Center Denver, Colorado
Robyn J. Barst, MD, SLC Immediate Past Chair Columbia Presbyterian Medical, Center Babies Hospital New York, New York
Vallerie V. McLaughlin, MD, SLC Vice-Chair University of Michigan, Health System Ann Arbor, Michigan
Raymond L. Benza, MD, University of Alabama Birmingham, Alabama
Todd Bull, MD, University of Colorado, Health Sciences Center Denver, Colorado
Richard N. Channick, MD,

Jane Morse, MD—A Physician–Investigator Whose “New Career” Gave Immeasurably to the Pulmonary Hypertension Community

Preoperative Risk Assessment of Pulmonary Arterial Hypertension Patients Undergoing General Surgery

Lung Transplantation for Pulmonary Arterial Hypertension

Surgical Treatment of Chronic Thromboembolic Pulmonary Hypertension

Meeting the Challenge of Surgery and Pulmonary Hypertension: How to Manage the “Hemodynamic Environment” to Optimize Outcomes

Professionals in Pulmonary Hypertension

The Scientific Leadershp Council of the Pulmonary Hypertension Association

Conference Abstracts

Guest Editor’s Memo

A Roundtable Discussion Addressing Patient-Centered Care and Quality of Life in Patients With Pulmonary Arterial Hypertension

Editor’s Memo

Pulmonary Hypertension Associated With Parenchymal Lung Disease