Idiopathic pulmonary hypertension (PAH) is a rare disease of unknown etiology that leads to the development of severe precapillary pulmonary hypertension [1-3], characterized by impaired regulation of both pulmonary hemodynamics and vascular growth. The responsiveness to vasodilator therapy in patients with PAH varies considerably [4,5]. Coronary artery bypass grafting (CABG) with extracorporeal circulation has a deleterious effect on lung tissues.
Left coronary artery could be compressed by the enlargement of the main pulmonary artery. Postoperative pulmonary hypertension contributes to increased perioperative mortality and in patients undergoing CABG, was the only independent variable able to predict postoperative mortality. To date, right ventricular dysfunction, as surgical risk score, is not considered.
The main pathophysiologic mechanism of this dysfunction is the afterload mismatch.
The right ventricular (RV) contractility is increased, but not enough compared to the afterload.
Published on: Aug 6, 2016 Pages: 24-27