2010 Volume 17 Issue 4 Pages 525-530
We report on the perioperative management of a 38-year-old-female with severe pulmonary hypertension (PH) associated with systemic lupus erythematosus (SLE). The patient had been diagnosed with SLE 12 years ago and developed PH 9 years ago. She had a history of several hospitalizations for acute exacerbations of PH and was receiving home oxygen therapy. In April 2008, she underwent left total hip arthroplasty under general anesthesia for femoral head necrosis. Postoperatively she developed an acute exacerbation of PH and cor pulmonale, and she died of sudden circulatory collapse on postoperative day 2. Treatment with sildenafil during the postoperative period had transiently improved her right ventricular failure as a result of its selectively dilating effect on the pulmonary arteries, but it was suspected of causing the circulatory collapse because of interactions with concomitant drugs.
