Coronary Artery Bypass Surgery in Left Main Disease with Idiopathic Artery Pulmonary Hypertension. Role of PGE Therapy

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.