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Postoperative management of a case of SLE and mitral stenosis combined with severe pulmonary hypertension:Effect of prostaglandin E1 Naotaka Atsumi 1 , Akihiro Mizuhara 1 , Akira Sakai 2 , Tatsuo Tsutsui 2 , Kenji Okamura 2 , Hajime Maeta 2 , Hiroshi Ijima 2 , Toshio Mitsui 2 , Motokazu Hori 2 , Mikio Doi 3 , Takesaburo Ogata 3 1University of Tsukuba Hospital 2Dept. of Surgery, Institute of Clinical Medicine, University of Tsukuba 3Dept. of Pathology, Institute of Clinical Medicine, University of Tsukuba pp.1099-1103
Published Date 1987/10/15
DOI https://doi.org/10.11477/mf.1404205138
  • Abstract
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In some patients with severe pulmonary hyperten-sion secondary to mitral stenosis, we sometimes encounter much difficulty in postoperative care even after mitral valve surgery. We reported pulmonary hypertensive crisis in a patient with mitral stenosis, tricuspid regurgitation associated with pulmonary hypertension after mitral valve replacement and tricuspid annuloplasty. Low dose infusion of prosta-glandin E1 (0.1 ng/kg/min) reduced pulmonary arte-rial pressure and consequently resulted in improve-ment in postoperative hemodynamics. Histologic study of the pulmonary vasculature, in this case, reve-aled marked medial hypertrophy and concentric-laminar intimal fibrosis of the muscular arteries. This case was associated with systemic lupus erythemato-sus, but neither clinical data nor pathological find-ings could clarify the etiology of mitral lesion.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1200 印刷版ISSN 0452-3458 医学書院

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