Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Anesthesiology, RANDOMIZED CONTROLLED-TRIAL, CIRCULATORY ARREST, CARDIAC-SURGERY, ENDARTERECTOMY SURGERY, THROMBOENDARTERECTOMY, DEXAMETHASONE, COMPLICATIONS, HYPERTENSION, EXPERIENCE, OUTCOMES, Anesthesia, Endarterectomy, Humans, Male, Middle Aged, Pneumonectomy, Pulmonary Artery, Pulmonary Embolism, Sarcoma, Vascular Neoplasms, 1103 Clinical Sciences, 1109 Neurosciences, 3202 Clinical sciences

Abstract:

We describe a patient who presented with a bilateral pulmonary artery sarcoma, initially treated as pulmonary embolism, that necessitated concomitant pulmonary endarterectomy and pneumonectomy. We reviewed the anesthetic management used for this procedure, which bears many similarities to the management of patients undergoing pulmonary thromboendarterectomy. Right ventricular failure, pulmonary hemorrhage, and cerebral ischemia due to circulatory arrest are life-threatening perioperative complications. The anesthesiologist can play a key role in the prevention (or timely recognition and treatment) of these perioperative complications by establishing adequate hemodynamic, echocardiographic, and neurologic monitoring and by optimizing cardiopulmonary function and coagulation.