ISHLT consensus statement: Perioperative management of patients with pulmonary hypertension and right heart failure undergoing surgery

Dana P. McGlothlin, John Granton, Walter Klepetko, Maurice Beghetti, Erika B. Rosenzweig, Paul A. Corris, Evelyn Horn, Manreet K. Kanwar, Karen McRae, Antonio Roman, Ryan Tedford, Roberto Badagliacca, Sonja Bartolome, Raymond Benza, Marco Caccamo, Rebecca Cogswell, Celine Dewachter, Laura Donahoe, Elie Fadel, Harrison W. FarberJeffrey Feinstein, Veronica Franco, Robert Frantz, Michael Gatzoulis, Choon Hwa (Anne) Goh, Marco Guazzi, Georg Hansmann, Stuart Hastings, Paul M. Heerdt, Anna Hemnes, Antoine Herpain, Chih Hsin Hsu, Kim Kerr, Nicholas A. Kolaitis, Jasleen Kukreja, Michael Madani, Stuart McCluskey, Michael McCulloch, Bernhard Moser, Manchula Navaratnam, Göran Rådegran, Cara Reimer, Laurent Savale, Oksana A. Shlobin, Jana Svetlichnaya, Keith Swetz, Jessica Tashjian, Thenappan Thenappan, Carmine Dario Vizza, Shawn West, Warren Zuckerman, Andreas Zuckermann, Teresa De Marco

Research output: Contribution to journalEditorialpeer-review

Abstract

Pulmonary hypertension (PH) is a risk factor for morbidity and mortality in patients undergoing surgery and anesthesia. This document represents the first international consensus statement for the perioperative management of patients with pulmonary hypertension and right heart failure. It includes recommendations for managing patients with PH being considered for surgery, including preoperative risk assessment, planning, intra- and postoperative monitoring and management strategies that can improve outcomes in this vulnerable population. This is a comprehensive document that includes common perioperative patient populations and surgical procedures with unique considerations.

Original languageEnglish (US)
Pages (from-to)1135-1194
Number of pages60
JournalJournal of Heart and Lung Transplantation
Volume41
Issue number9
DOIs
StatePublished - Sep 2022

Bibliographical note

Funding Information:
No specific funding was available for this project. During this project, the following authors reported the listed financial activities, all outside the submitted work. Andreas Zuckerman received institutional research funding from Mallincrodt, Biotest, and Chiesi; and honoraria from Mallincrodt, Paragonix, and Kohler; and fees from Novartis and Biotest for DSMB work. Anna Hemnes received institutional research funding from CMREF and Imara, and consulting fees from Bayer, Janssen, GossamerBio, United Therapeutics, and Acceleron; and stock ownership in Tenax therapeutics. Bernhard Moser received writing fees from Up-to-Date. Celine Dewachter received advisory board fees from Novartis, Actelion-Janssen, MDS-Bayer. Chih-Hsin Hsu received speaking honoraria from Bayer, Johnson-Johnson, Pfizer, Novartis, Servier, and AstraZeneca. Elie Fadel received speaking honoraria from MSD. Erika B. Rosenzweig received institutional research funding from Janssen, Bayer, SonVie, and United Therapeutics. Evelyn Horn received consulting fees from Biotronik; DSMB fees from AADi Biosciences and SoniVie; and clinical events committee fees from V-wave Ltd. Georg Hansmann received consulting fees from Janssen and honoraria from Ferrer. Goran Radegran received institutional research funding from Janssen and Nordic Infucare; speaking honoraria from Janssen; and advisory board fees from Janssen and Acceleron paid to his company. Harrison Farber has received speaking honoraria from Bayer and SAB fees from Actelion, Acceleron, Altavant, Aerovate, and United Therapeutics. Jeffrey Feinstein has received institutional research funding from United Therapeutics. John Granton has received institutional foundation and fellowship support from Janssen Canada and Bayer Canada, and speaking honoraria from Janssen. Kim Kerr has received institutional research funding from Bayer and consulting fees from Actelion. Laurent Savale has received institutional research funding from Acceleron, Janssen, GSK, MSD; speaker honoraria from Actelion and MSD; and advisory board fees from Janssen. Manreet Kanwar has received advisory board fees from Abiomed, Bayer, and CareDx; and speaker honoraria from Abiomed. Marco Caccamo has received speaker honoraria from Bayer. Maurice Beghetti has received institutional research funding, speaker honoraria, travel support; consulting fees from Actelion-Janssen, Bayer, Orpha, Altavant, Gossamer, and Acceleron; DSMB fees from Actelion-Janssen, Altavant, Bayer, GSK, Merck, and Gossamer. Michael Gatzoulis has received institutional research funding and speaker honoraria from Janssen. Michael Madani has received royalties from Wexler Surgical; consulting fees from Actelion-Janssen and Merk; and travel expenses from Bayer. Nicholas Kolaitis has received consulting fees from United Therapeutics, Acceleron, and Janssen; and Advisory Board fees from Janssen and Bayer. Okasana Shlobin has received consulting fees from United Therapeutics, Bayer, Janssen, and Acceleron. Paul Heerdt has received institutional research funding from NTT Research and consulting fees from Cardiage LLC and Baxter; and he was co-founder of RVMetrics, LLC. Raymond Benza received consulting fees from Bayer, Janssen, United Therapeutics, Acceleron, CERENO, Abbott, and Gossamer; and advisory board fees from Acceleron. Robert Frantz received writing fees from Up-to-Date; personal consulting fees from Janssen, Liquidia, Shouti, Altavent, and Tenax; consulting fees to his institution from Gossamer and Bayer; speaking fees to his institution from United Therapeutics; personal speaking honoraria from France Foundation and Janssen; and DSMB fees from Janssen and Liquidia. Roberto Badagliacca received advisory board fees from MSD, Dompe, Janssen, United Therapeutics, and Ferrer; and speaker honoraria from Bayer, MSD, Ferrer, Dompe, Janssen, United Therapeutics, and AOP. Ryan Tedford received consulting fees from Merck, Actelion, Edwards, United Therapeutics, CareDx, Gradient, Abbott, Medtronic, Aria CV Inc, Itamar, Eidos, and Lexicon; travel support from Abiomed; DSMB fees from Edwards; and steering committee fees from Abbott, Acceleron, and Medtronic. Sonja Bartolome received consulting fees from Janssen and United Therapeutics, and travel support from Janssen. Teresa De Marco received institutional research funding from Acceleron and CareDx; consulting fees from Actelion-Janssen, Trio Health, Liquidia, Aerovate, Boston Scientific, NXT, Atara, and Acceleron; travel support from CareDx, and advisory board fees from BIAL and Acceleron. Thenappan Thenappan received institutional research funding from United Therapeutics, Aria CV, Acceleron, and Tenax; consulting and advisory board fees from Acceleron, Altavant, United Therapeutics, and Actelion-Janssen. Veronica Franco received institutional research funding from United Therapeutics, Acceleron, Aerovate, Aria CV, Cereno Scientific, Fluidda, and Gossamer.

Publisher Copyright:
© 2022 International Society for Heart and Lung Transplantation

Keywords

  • anesthesia
  • congenital heart disease
  • pediatric pulmonary hypertension
  • pulmonary arterial hypertension
  • pulmonary hypertension
  • surgery

PubMed: MeSH publication types

  • Editorial

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