AB211. 180. Anaesthetic considerations for a patient with a history of pulmonary thromboendarterectomy during a laparoscopic cholecystectomy

Abstract: This case report describes how a patient with a complex medical history was managed during an elective surgery. The patient was a 68-year-old Caucasian female presenting for an elective laparoscopic cholecystectomy. The patient had a complicated background history including multiple pulmonary emboli, chronic thromboembolic pulmonary hypertension (CTPH) and breast cancer. Her CTPH was treated with a pulmonary thromboendarterectomy (PTE). PTE is a complex surgery carried out in a small number of centres around the world. PTE is the surgical management for CTPH. The laparoscopic cholecystectomy was carried out successfully and she was discharged home after 4 days. In this case report I describe how the case was managed differently to most elective surgeries and what other considerations came into play with respect to her anaesthetic and her post-operative care. This case report highlights the importance of thorough pre-operative planning and assessment of patients undergoing surgery.

Keywords: Chronic thromboembolic pulmonary hypertension (CTPH); elective surgery; pulmonary thromboendarterectomy (PTE)