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Intraoperative Considerations in a Patient on Intravenous Epoprostenol Undergoing Minimally Invasive Cardiac Surgery

Published:April 22, 2022DOI:https://doi.org/10.1053/j.jvca.2022.04.021
      EPOPROSTENOL IS a prostaglandin effective in treating pulmonary hypertension, and its intravenous (IV) form has become a standard treatment for improving cardiopulmonary hemodynamics and exercise capacity across various patient populations with severe pulmonary hypertension.
      • Barst R
      • Rubin L
      • Long W
      • et al.
      A comparison of continuous intravenous epoprostenol (prostacyclin) with conventional therapy for primary pulmonary hypertension.
      ,
      • Sitbon O
      • Vonk Noordegraaf A.
      Epoprostenol and pulmonary arterial hypertension: 20 years of clinical experience.
      In cardiac surgeries, inhaled epoprostenol is more commonly used and has been shown to consistently reduce pulmonary artery pressures.
      • Buckley MS
      • Feldman JP.
      Inhaled epoprostenol for the treatment of pulmonary arterial hypertension in critically ill adults.
      ,
      • Haché M
      • Denault A
      • Bélisle S
      • et al.
      Inhaled epoprostenol (prostacyclin) and pulmonary hypertension before cardiac surgery.
      Although inhaled epoprostenol is frequently used in patients undergoing cardiac surgery in both the perioperative and intraoperative setting, patients presenting to surgery on the IV formulation are less common, and little literature currently exists on considerations for its management.

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