Perioperative Management of Pulmonary Hypertension in Pediatric Cardiac Surgery

Pediatric pulmonary hypertension (PH) is associated with many cardiovascular, and pulmonary diseases that result in a high risk of morbidity and mortality. The cause of PH in children is mainly due to congenital heart disease (CHD). The proper preoperative evaluation and the accurate anesthetic management are essential to obtain the best outcome. The perioperative anesthetic goal is directed to avoid pulmonary hypertensive crisis which is associated with poor outcome in children with PH secondary to CHD undergoing cardiopulmonary bypass. The purpose of this review is to discuss the pathophysiology of PH in children with CHD and to show how to avoid and manage the perioperative pulmonary hypertensive crisis.