Pulmonary Hypertension Perioperative Management
|
|
|
- Henry Bond
- 5 years ago
- Views:
Transcription
1 Pulmonary Hypertension Perioperative Management Bruce J Leone, MD Professor of Anesthesiology Chief, Neuroanesthesiology Vice Chair for Academic Affairs Mayo Clinic Jacksonville, Florida
2 Introduction Definition of Pulmonary Hypertension Increased Mean Pulmonary Arterial Pressure mpap > 25mmHg at Rest Normal: 14 (11-17) mmhg mpap > 30 mmhg Dropped from Definition Found in Many Normal Patients McLaughlin et al., Circulation 2009; 119:2250 Kovace et al., Eur Respir J 2009; 34:888
3 Introduction (cont.) Types of Pulmonary Hypertension Pulmonary Arterial Hypertension With Left-Sided Heart Disease With Lung Disease/Hypoxemia Due to Chronic Thrombosis/Emboli Miscellaneous Sarcoidosis, Histiocystosis X, Lymphangiomatosis, Compression of Pulmonary Vessels (Adenopathy, Tumor, Fibrosing Mediatinitis) Simonneau et al., J Am Coll Cardiol 2004; 43(12, suppl S):5S
4 Pulmonary Arterial Hypertension Etiology Idiopathic Familial Associated with Diseases/Conditions Collagen Vascular Disease, Congenital Shunts, Portal Hypertension, HIV, Drugs/Toxins, Miscellany Venous or Capillary Disease Persistent PAH of the Newborn Simonneau et al., J Am Coll Cardiol 2004; 43(12, suppl S):5S
5 Pulmonary Arterial Hypertension (cont.) Lung Diseases COPD Interstitial Lung Disease Sleep-Disordered Breathing/Obstructive Sleep Apnea Alveolar Hypoventilation Long-Term Exposure to High Altitude Developmental Abnormalities Simonneau et al., J Am Coll Cardiol 2004; 43(12, suppl S):5S
6 Natural History Median Life Expectancy 2.8 years Prevention Screening of High Risk Patients Family History Congenital Heart Disease Connective Tissue Disease Symptoms of PAH
7 Pulmonary Hypertension Therapeutic Options Reversal of Hypoxemia Management of Left Heart Failure Vasodilators Calcium Channel Blockers Prostacyclin Analogues Endothelin Receptor Antagonists PDE-V Inhibitors
8 Pulmonary Hypertension (cont.) Therapeutic Options Calcium Channel Blockers Nifedipine, Diltiazem, Amlodipine Minimally Effective in Treating PAH Prostacyclin Analogues Epoprostenol (Intravenous) Treprostinil (Oral and Intravenous) Iloprost (Inhaled) Endothelin Receptor Antagonists Bosentan (Oral) PDE-V Inhibitors Sildanefil
9 Perioperative Risk Marked Increase in Risk 29% Complication Rate 4/28 Mortality Mild to Moderate Pulmonary Hypertension Emergency Procedures, Major Surgery, Long Operative Times Increase Risk Price et al., Eur Respir J 2010;35:1294
10 PAH Perioperative Management Assessing Risk Contraindication to Liver Transplantation Thoracic Surgery Changes in Lung Volume, Intrathoracic Pressure, Oxgenation Acute Changes in PVR and RV Function Laparoscopy Decrease Preload, Increased Afterload Rapid Intraoperative Blood Loss Peripartum Therapy Decreases Mortality (38% to 25%) Ross Curr Opin Anesthesiol 2010; 23:25 Pedoto Curr Opin Anesthesiol 2010; 22:44 Bedard Eur Heart J 2009; 30:256
11 Pulmonary Hypertension (cont.) Effect on Outcomes 145 Patients Retrospective Analysis Non-Cardiac Surgery General Anesthetic 42% Short-Term Morbid Events Respiratory Failure (28%) Cardiac Dysrhythmia (12%) Congestive Heart Failure (11%) 7% (n=10) Death Within 30 d Respiratory Failure (60%), RV Failure (50%) Ramakrishna et al, J Am Coll Cardiol 2005;45:1691
12 Pulmonary Hypertension (cont.) Effect on Outcomes Thoracic Surgical Patients 61.5% Morbidity Orthopedic Surgical Patients 48% Morbidity Gynecologic/Urologic/Plastic/Breast Surgical Patients 16.7% Morbidity Ramakrishna et al, J Am Coll Cardiol 2005;45:1691
13 Pulmonary Hypertension (cont.) Effect on Outcomes 173 Patients; 96 PAH, 77 Control Non-Cardiac Surgery PAH Significant Risk for Congestive Heart Failure Sepsis Respiratory Failure Kaw et al., Respir Med 2011;105:619
14 Pulmonary Hypertension (cont.) Effect on Outcomes RVSP/SBP Ratio >0.66 Associated with Short-Term Morbidity CHF Most Frequent Post-Operative Event Patients More Likely to Require Post- Operative ICU Care Patients More Likely Readmitted to Hospital Within 30 d Kaw et al., Respir Med 2011;105:619
15 Pulmonary Hypertension (cont.) Preoperative Assessment Evaluation of Symptoms Functional Capacity ECG, Chest Radiograph, Echocardiogram Arterial Blood Gas
16 Pulmonary Hypertension (cont.) Preoperative Assessment Evaluation for RV Dysfunction Right Heart Catheterization Re-Evaluation of Surgery Aggressive Intervention COPD Patients Supplemental Oxygen Bronchodilators Antibiotics Steroids Cardiac (LV Dysfunction) Patients Inotropes Vasodilators
17 Perioperative Management Anesthetic Technique Maintain Preload and SVR Maximize Cardiac Function Maximize Right Heart Perfusion Systolic to RV Systolic Gradient Prevent Increases in PVR Hypoxia, Hypercarbia, Acidosis, Agitation, Pain, Hypothermia Aggressive Treatment of Hypotension Vasoconstrictors Inotropic Support Modulation of PVR in RV Failure Inhaled Prostaglandins (Iloprost)
18 Perioperative Management (cont.) Anesthetic Monitoring Intermediate to High Risk Procedures Thoracotomy/Thoracoscopy Prolonged Laparoscopy Open Intra-Abdominal Procedures Invasive Monitoring Pulmonary Artery Catheter Transesophageal Echocardiography Intensive Therapy Inhaled Iloprost Inhaled Nitric Oxide Intravenous Prostacyclin Inotropic Therapy to Maintain RV Perfusion/Cardiac Function
Nothing to Disclose. Severe Pulmonary Hypertension
Severe Ronald Pearl, MD, PhD Professor and Chair Department of Anesthesiology Stanford University Rpearl@stanford.edu Nothing to Disclose 65 year old female Elective knee surgery NYHA Class 3 Aortic stenosis
Pulmonary Hypertension in 2012
Pulmonary Hypertension in 2012 Evan Brittain, MD December 7, 2012 Kingston, Jamaica VanderbiltHeart.com Disclosures None VanderbiltHeart.com Outline Definition and Classification of PH Hemodynamics of
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE. Health Technology Appraisal. Drugs for the treatment of pulmonary arterial hypertension
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Health Technology Appraisal Drugs for the treatment of Draft remit / appraisal objective: Draft scope To appraise the clinical and cost effectiveness
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, and Pulmonary Thromboendarterectomy Program
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, and Pulmonary Thromboendarterectomy Program Advanced Heart Failure & Cardiac Transplant Temple University
Pulmonary Hypertension: Another Use for Viagra
Pulmonary Hypertension: Another Use for Viagra Kathleen Tong, MD Director, Heart Failure Program Assistant Clinical Professor University of California, Davis Disclosures I have no financial conflicts A
Teaching Round Claudio Sartori
Teaching Round 14.03.2017 Claudio Sartori Cas clinique Femme 47 ans, connue pour un BPCO, asthénie, douleurs thoraciques, dyspnée à l effort, œdèmes membres inférieurs, deux syncopes. Tabac, BMI 31 kg/m2
Pulmonary Hypertension. Pulmonary Arterial Hypertension Diagnosis, Impact and Outcomes
Pulmonary Hypertension Pulmonary Arterial Hypertension Diagnosis, Impact and Outcomes Pulmonary Arterial Hypertension Disease of small pulmonary arteries Characteristic changes Medial hypertrophy Intimal
Pharmacy Management Drug Policy
SUBJECT: Pulmonary Arterial Hypertension (PAH) POLICY NUMBER: Pharmacy-42 Clinical criteria used to make utilization review decisions are based on credible scientific evidence published in peer reviewed
Pulmonary Hypertension: Clinical Features & Recent Advances
Pulmonary Hypertension: Clinical Features & Recent Advances Lisa J. Rose-Jones, MD Assistant Professor of Medicine, Division of Cardiology Advanced Heart Failure/Cardiac Transplantation & Pulmonary Hypertension
Pulmonary Hypertension. Murali Chakinala, M.D. Washington University School of Medicine
Pulmonary Hypertension Murali Chakinala, M.D. Washington University School of Medicine Pulmonary Circulation Alveolar Capillary relationship Pulmonary Circulation High flow, low resistance PVR ~1/15 of
PVDOMICS. Study Introduction. Kristin Highland, MD Gerald Beck, PhD. NHLBI Pulmonary Vascular Disease Phenomics Program
PVDOMICS Study Introduction Kristin Highland, MD Gerald Beck, PhD NHLBI Pulmonary Vascular Disease Phenomics Program Funded by the National Heart, Lung, and Blood Institute of the National Institutes of
Pediatric Pulmonary Hypertension: Inside Out
Pediatric Pulmonary Hypertension: Inside Out Asma Razavi, MD Assistant Professor Pediatric Critical Care Medicine Loma Linda University Children s Hopsital Disclosures I have no conflicts of interest to
Pulmonary arterial hypertension. Pulmonary arterial hypertension: newer therapies. Definition of PH 12/18/16. WHO Group classification of PH
Pulmonary arterial hypertension Pulmonary arterial hypertension: newer therapies Ramona L. Doyle, MD Clinical Professor of Medicine, UCSF Attending Physician UCSF PH Clinic Definition and classification
PULMONARY HYPERTENSION
PULMONARY HYPERTENSION REVIEW & UPDATE Olga M. Fortenko, M.D. Pulmonary & Critical Care Medicine Pulmonary Vascular Diseases Sequoia Hospital 650-216-9000 Olga.Fortenko@dignityhealth.org Disclosures None
Dr. Md. Rajibul Alam Prof. of Medicine Dinajpur Medical college
Dr. Md. Rajibul Alam Prof. of Medicine Dinajpur Medical college PULMONARY HYPERTENSION Difficult to diagnose early Because Not detected during routine physical examination and Even in advanced cases symptoms
Update in Pulmonary Arterial Hypertension
Update in Pulmonary Arterial Hypertension Michael J Sanley, MD April 12, 2018 Disclosures I have nothing to disclose 2 1 Case Presentation 67 yo male with atrial fibrillation, CLL on IVIG, presents with
Acute Vasodilator Testing in Pulmonary Hypertension: What, When, and How?
Acute Vasodilator Testing in Pulmonary Hypertension: What, When, and How? Teresa De Marco, MD University of California, San Francisco Disclosures: Grants/Research: United Therapeutics, Lung Biotechnology,
22nd Annual Heart Failure 2018 an Update on Therapy. Pulmonary Arterial Hypertension: Contemporary Approach to Treatment
22nd Annual Heart Failure 2018 an Update on Therapy Pulmonary Arterial Hypertension: Contemporary Approach to Treatment Ronald J. Oudiz, MD, FACP, FACC, FCCP Professor of Medicine The David Geffen School
PVDOMICS. Study Introduction. Kristin Highland, MD Gerald Beck, PhD. NHLBI Pulmonary Vascular Disease Phenomics Program
PVDOMICS Study Introduction Kristin Highland, MD Gerald Beck, PhD NHLBI Pulmonary Vascular Disease Phenomics Program Funded by the National Heart, Lung, and Blood Institute of the National Institutes of
Recent Treatment of Pulmonary Artery Hypertension. Cardiology Division Yonsei University College of Medicine
Recent Treatment of Pulmonary Artery Hypertension Cardiology Division Yonsei University College of Medicine Definition Raised Pulmonary arterial pressure (PAP) WHO criteria : spap>40 mmhg NIH Criteria
SA XXXX Special Authority for Subsidy
SA XXXX Special Authority for Subsidy Special authority approved by the Pulmonary Arterial Hypertension (PAH) Panel. Application forms can be obtained from PHARMAC s website: www.pharmac.govt.nz or: PAH
Current and Emerging Drugs in Pulmonary Vascular Pharmacology Dr AS Paul DM Seminar 08 September 06
Current and Emerging Drugs in Pulmonary Vascular Pharmacology Dr AS Paul DM Seminar 08 September 06 Pulmonary Hypertension A mean pressure of greater than 25 mm Hg at rest (normal ~14 mm Hg) or greater
PREOPERATIVE CARDIOPULMONARY ASSESSMENT FOR LIVER TRANSPLANTATION James Y. Findlay Mayo Clinic College of Medicine, Rochester, MN, USA.
PREOPERATIVE CARDIOPULMONARY ASSESSMENT FOR LIVER TRANSPLANTATION James Y. Findlay Mayo Clinic College of Medicine, Rochester, MN, USA Introduction Liver transplantation (LT) has gone from being a high-risk
5/30/2014. Pulmonary Hypertension PULMONARY HYPERTENSION. mean PAP > 25 mmhg at rest. Disclosure: none
Disclosure: Pulmonary Hypertension none James Ramsay MD Medical Director, CV ICU, Moffitt Hospital, UCSF PULMONARY HYPERTENSION mean PAP > 25 mmhg at rest Pulmonary Hypertension and Right Ventricular Dysfunction:
ADVANCED THERAPIES FOR PHARMACOLOGICAL TREATMENT OF PULMONARY HYPERTENSION
Status Active Medical and Behavioral Health Policy Section: Medicine Policy Number: II-107 Effective Date: 04/21/2014 Blue Cross and Blue Shield of Minnesota medical policies do not imply that members
Neonatal and Pediatric Pulmonary Vascular Disease
Neonatal and Pediatric Pulmonary Vascular Disease Emma Olson, MS, ARNP Pediatric Cardiology Nurse Practitioner Canadian Respiratory Conference April 14, 2018 Financial Interest Disclosure (over the past
PULMONARY HYPERTENSION & THALASSAEMIA
3rd Pan-American Thalassaemia Conference Buenos Aires 2010 Dr Malcolm Walker Cardiologist University College & the Heart Hospital LONDON Clinical Director Hatter Cardiovascular Institute - UCLH PULMONARY
ELIGIBILITY CRITERIA FOR PULMONARY ARTERIAL HYPERTENSION THERAPY
ELIGIBILITY CRITERIA FOR PULMONARY ARTERIAL HYPERTENSION THERAPY Contents Eligibility criteria for Pulmonary Arterial Hypertension therapy...2-6 Initial Application for funding of Pulmonary Arterial Hypertension
The Hemodynamics of PH Interpreting the numbers
The Hemodynamics of PH Interpreting the numbers Todd M Bull MD Associate Professor of Medicine Division of Pulmonary Sciences and Critical Care Medicine Pulmonary Hypertension Center University of Colorado
COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) DRAFT
European Medicines Agency London, 18 December 2008 Doc. Ref. EMEA/CHMP/EWP/356954/2008 COMMITTEE FOR MEDICINAL PRODUCTS FOR HUMAN USE (CHMP) DRAFT CHMP GUIDELINE ON THE CLINICAL INVESTIGATIONS OF MEDICINAL
Advances in Pharmacotherapy of PAH
24 th Annual Advances in Heart Disease Advances in Pharmacotherapy of PAH Gabriel Gregoratos, MD 12/14/2007 UCSF Cardiology 1 Faculty Disclosure Statement for Gabriel Gregoratos, MD Nothing to disclose
Cardiac Catheterization is Unnecessary in the Evaluation of Patients with Pulmonary Hypertension: CON
Cardiac Catheterization is Unnecessary in the Evaluation of Patients with Pulmonary Hypertension: CON Dunbar Ivy, MD The Children s s Hospital Heart Institute 1 Diagnostic Evaluation: Right Heart Cardiac
National Horizon Scanning Centre. Tadalafil for pulmonary arterial hypertension. October 2007
Tadalafil for pulmonary arterial hypertension October 2007 This technology summary is based on information available at the time of research and a limited literature search. It is not intended to be a
The Case of Marco Nazzareno Galiè, M.D.
The Case of Marco Nazzareno Galiè, M.D. DIMES Disclosures Consulting fees and research support from Actelion Pharmaceuticals Ltd, Bayer HealthCare, Eli Lilly and Co, GlaxoSmithKline and Pfizer Ltd Clinical
Approach to Pulmonary Hypertension in the Hospital
Approach to Pulmonary Hypertension in the Hospital Todd M Bull MD Professor of Medicine Director Pulmonary Vascular Disease Center Director Center for Lungs and Breathing Division of Pulmonary Sciences
Pulmonary Hypertension Due to Left Heart Disease
ACC Middle East Conference 2018 Pulmonary Hypertension Due to Left Heart Disease Ammar Chaudhary, MBChB, FRCPC Advanced Heart Failure & Transplantation King Faisal Specialist Hospital and Research Center
Referral Forms for TYVASO and REMODULIN
Referral Forms for TYVASO and REMODULIN HOW TO GET STARTED Tyvaso and Remodulin are available only through select Specialty Pharmacy Services (SPS) providers. Follow these 5 simple steps to complete each
Recruitment and Consenting
1 Recruitment and Consenting MOP Chapter 4 NHLBI Pulmonary Vascular Disease Phenomics Program Funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health with support from
Pharmacy Management Drug Policy
SUBJECT: POLICY NUMBER: PHARMACY-42 EFFECTIVE DATE: 6/2005 LAST REVIEW DATE: 4/19/2018 If the member s subscriber contract excludes coverage for a specific service or prescription drug, it is not covered
Pulmonary Arterial Hypertension - Overview
Pulmonary Arterial Hypertension - Overview J. Shaun Smith, MD Co-Director, Pulmonary Vascular Disease Program Assistant Professor of Medicine Division of Pulmonary, Critical Care and Sleep Medicine The
Pulmonary Arterial Hypertension - Overview
Pulmonary Arterial Hypertension - Overview J. Shaun Smith, MD Co-Director, Pulmonary Vascular Disease Program Assistant Professor of Medicine Division of Pulmonary, Critical Care and Sleep Medicine The
Effective Strategies and Clinical Updates in Pulmonary Arterial Hypertension
Effective Strategies and Clinical Updates in Pulmonary Arterial Hypertension Hap Farber Director, Pulmonary Hypertension Center Boston University School of Medicine Disclosures 1) Honoria: Actelion, Gilead,
Pulmonary Vasodilator Treatments in the ICU Setting
Pulmonary Vasodilator Treatments in the ICU Setting Lara Shekerdemian Circulation 1979 Ann Thorac Surg 27 Anesth Analg 211 1 Factors in the ICU Management of Pulmonary Hypertension After Cardiopulmonary
ADCIRCA (tadalafil) The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
RATIONALE FOR INCLUSION IN PA PROGRAM Background Pulmonary arterial hypertension is a rare disorder of the pulmonary arteries in which the pulmonary arterial pressure rises above normal levels in the absence
Valutazione del neonato con sospetta ipertensione polmonare
Valutazione del neonato con sospetta ipertensione polmonare Cardiologia Pediatrica Seconda Università degli Studi di Napoli A.O. R.N. dei Colli-Monaldi Napoli Hypoxiemic infant Full or near-term neonate
REVATIO (sildenafil)
RATIONALE FOR INCLUSION IN PA PROGRAM Background Pulmonary arterial hypertension is a rare disorder of the pulmonary arteries in which the pulmonary arterial pressure rises above normal levels in the absence
Pulmonary Hypertension: When to Initiate Advanced Therapy. Jonathan D. Rich, MD Associate Professor of Medicine Northwestern University
Pulmonary Hypertension: When to Initiate Advanced Therapy Jonathan D. Rich, MD Associate Professor of Medicine Northwestern University Disclosures Medtronic, Abbott: Consultant Hemodynamic Definition of
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.10 Subject: Uptravi Page: 1 of 6 Last Review Date: September 15, 2017 Uptravi Description Uptravi
Case Presentation: Anesthetic Management For POEM Procedure in a Patient with Severe Pulmonary Hypertension CHUCK STRAUBHAAR BSN, SRNA
Case Presentation: Anesthetic Management For POEM Procedure in a Patient with Severe Pulmonary Hypertension CHUCK STRAUBHAAR BSN, SRNA OBJECTIVES Comprehend basic pathophysiology of pulmonary hypertension
Navigating the identification, diagnosis and management of pulmonary hypertension using the updated ESC/ERS guidelines
Navigating the identification, diagnosis and management of pulmonary hypertension using the updated ESC/ERS guidelines Host: Marc Humbert Speaker: Simon Gibbs Marc HUMBERT, MD, PhD Professor of Respiratory
Managing Multiple Oral Medications
Managing Multiple Oral Medications Chris Archer-Chicko, MSN, CRNP PENN Presbyterian Medical Center Arlene Schiro,, CRNP Massachusetts General Hospital Mary Bartlett, CRNP Winthrop University Hospital PH
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.23 Subject: Sildenafil Citrate Powder Page: 1 of 6 Last Review Date: September 15, 2017 Sildenafil
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.17 Subject: Remodulin Page: 1 of 5 Last Review Date: June 24, 2016 Remodulin Description Remodulin
Disclosures. ICU Management of Advanced Lung Disease 5/9/2015. No Disclosures. All pictures from commercial sources
Disclosures ICU Management of Advanced Lung Disease No Disclosures All pictures from commercial sources Lundy J. Campbell, MD UCSF Department of Anesthesia and Perioperative Care Division of Critical Care
Πνευμονική Υπέρταση Ι.Ε. ΚΑΝΟΝΙΔΗΣ
Πνευμονική Υπέρταση Ι.Ε. ΚΑΝΟΝΙΔΗΣ PH is defined as PAPm 25 mm Hg at rest The general definition of PH remains unchanged Most of the relevant epidemiological and therapeutic studies have used the 25 mm
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.21 Subject: Orenitram Page: 1 of 6 Last Review Date: June 24, 2016 Orenitram Description Orenitram
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (3)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.15 Subject: Flolan Veletri Page: 1 of 5 Last Review Date: September 15, 2017 Flolan Veletri Description
Disclosures. Objectives 6/16/2016. A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension
A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension Susan P. D Anna MSN, APN-BC, CHFN June 24, 2016 Disclosures Objectives Differentiate structure and function of RV and LV
National Horizon Scanning Centre. Oral and inhaled treprostinil for pulmonary arterial hypertension: NYHA class III. April 2008
Oral and inhaled treprostinil for pulmonary arterial hypertension: NYHA class April 2008 This technology summary is based on information available at the time of research and a limited literature search.
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.40.13 Section: Prescription Drugs Effective Date: July 1 2016 Subject: Tyvaso Page: 1 of 4 Last Review
Pulmonary Hypertension Drugs
Pulmonary Hypertension Drugs Policy Number: Original Effective Date: MM.04.028 10/01/2009 Line(s) of Business: Current Effective Date: HMO; PPO; QUEST Integration 05/22/2015 Section: Prescription Drugs
Paediatric PAH in the current era
Paediatric PAH in the current era Dunbar Ivy, MD The Children s Hospital Heart Institute University of Colorado School of Medicine Paediatric PAH in the current era & A Gap Analysis Dunbar Ivy, MD The
Pulmonary Hypertension: Definition and Unmet Needs
Heart Failure Center Hadassah University Hospital Pulmonary Hypertension: Definition and Unmet Needs Israel Gotsman The Heart Failure Center Hadassah University Hospital I DO NOT have a financial interest/
PDE5 INHIBITOR POWDERS Sildenafil powder, Tadalafil powder
RATIONALE FOR INCLUSION IN PA PROGRAM Background Sildenafil and Tadalafil are marketed as Revatio and Adcirca for pulmonary arterial hypertension. This is a rare disorder of the pulmonary arteries in which
Pulmonary Heart Disease: Evaluation and Management
Pulmonary Heart Disease: Evaluation and Management Robert C. Bourge, MD Professor of Medicine, Radiology, and Surgery Drummond Chair of Cardiovascular Medicine Vice Chair of Clinical Affairs, Department
Disclosures. Objectives. RV vs LV. Structure and Function 9/25/2016. A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension
Disclosures A Look at the Other Side: Focus on the Right Ventricle and Pulmonary Hypertension No financial relationships Susan P. D Anna MSN, APN BC, CHFN September 29, 2016 Objectives RV vs LV Differentiate
Pulmonary hypertension on. Simon MacDonald BSc(Hons) BMBCh DPhil FRCP Consultant Cardiologist in Adult Congenital Heart Disease
Pulmonary hypertension on echowhat next.? Simon MacDonald BSc(Hons) BMBCh DPhil FRCP Consultant Cardiologist in Adult Congenital Heart Disease Definition of PAH Mean PA pressure 25mmHg Precapillary if
1. Phosphodiesterase Type 5 Enzyme Inhibitors: Sildenafil (Revatio), Tadalafil (Adcirca)
This policy has been developed through review of medical literature, consideration of medical necessity, generally accepted medical practice standards, and approved by the IEHP Pharmacy and Therapeutic
ino in neonates with cardiac disorders
ino in neonates with cardiac disorders Duncan Macrae Paediatric Critical Care Terminology PAP Pulmonary artery pressure PVR Pulmonary vascular resistance PHT Pulmonary hypertension - PAP > 25, PVR >3,
Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease
Pulmonary Hypertension in Chronic Obstructive Pulmonary Disease Deedre Boekweg RN, BSN, CCRP Intermountain Medical Center Murray, UT Kerri Akaya Smith, MD University of Pennsylvania Philadelphia, PA PHPN
It has been more than a decade since
doi: 10.1111/j.1751-7133.2010.00192.x R EVIEW P APER Differentiating Pulmonary Arterial and Pulmonary Venous and the Implications for Therapy It has been more than a decade since the Second World Symposium
Pulmonary Arterial Hypertension (PAH) Treatments
Care1st Health Plan Arizona, Inc. Easy Choice Health Plan Harmony Health Plan of Illinois Missouri Care Ohana Health Plan, a plan offered by WellCare Health Insurance of Arizona OneCare (Care1st Health
Chronic Thromboembolic Pulmonary Hypertention CTEPH
Chronic Thromboembolic Pulmonary Hypertention CTEPH Medical Management Otto Schoch, Prof. Dr. Klinik für Pneumologie und Schlafmedizin Kantonsspital St.Gallen CTEPH: Medical Management Diagnostic aspects
Pulmonary vasodilator testing and use of calcium channel blockers in pulmonary arterial hypertension
Respiratory Medicine (2010) 104, 481e496 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/rmed REVIEW Pulmonary vasodilator testing and use of calcium channel blockers in pulmonary
PULMONARY ARTERIAL HYPERTENSION AGENTS
Approvable Criteria: PULMONARY ARTERIAL HYPERTENSION AGENTS Brand Name Generic Name Length of Authorization Adcirca tadalafil Calendar Year Adempas riociguat Calendar Year Flolan epoprostenol sodium Calendar
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, Pulmonary Thromboendarterectomy Program Advanced
Anjali Vaidya, MD, FACC, FASE, FACP Associate Director, Pulmonary Hypertension, Right Heart Failure, Pulmonary Thromboendarterectomy Program Advanced Heart Failure & Cardiac Transplant Temple University
THERAPEUTICS IN PULMONARY ARTERIAL HYPERTENSION Evidences & Guidelines
THERAPEUTICS IN PULMONARY ARTERIAL HYPERTENSION Evidences & Guidelines Vu Nang Phuc, MD Dinh Duc Huy, MD Pham Nguyen Vinh, MD, PhD, FACC Tam Duc Cardiology Hospital Faculty Disclosure No conflict of interest
The World Health Organization (WHO) has classified pulmonary hypertension into five different groups: (2)
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 Subject: Tracleer Page: 1 of 6 Last Review Date: September 15, 2017 Tracleer Description Tracleer (bosentan)
Sildenafil Citrate Powder. Sildenafil citrate powder. Description. Section: Prescription Drugs Effective Date: January 1, 2016
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.06.15 Subject: Sildenafil Citrate Powder Page: 1 of 6 Last Review Date: December 3, 2015 Sildenafil Citrate
Pulmonary hypertension and right ventricular failure
Pulmonary hypertension and right ventricular failure Sven-Erik Ricksten Dept. Anaesthesiology and Intensive Care, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg,
Index. Note: Page numbers of article titles are in boldface type
Index Note: Page numbers of article titles are in boldface type A Acute coronary syndrome, perioperative oxygen in, 599 600 Acute lung injury (ALI). See Lung injury and Acute respiratory distress syndrome.
Corporate Medical Policy
Corporate Medical Policy Pulmonary Hypertension, Drug Management File Name: Origination: Last CAP Review: Next CAP Review: Last Review: pulmonary_hypertension_drug_management 06/1998 3/2018 3/2019 3/2018
Review Article Diagnosis and Management of Pulmonary Arterial Hypertension
Pulmonary Medicine Volume 2011, Article ID 845864, 13 pages doi:10.1155/2011/845864 Review Article Diagnosis and Management of Pulmonary Arterial Hypertension Jeanne Houtchens, Douglas Martin, and James
Pulmonary Hypertension: Classification
Pulmonary Hypertension: Pathophysiology and Classification M. Maggiorini Medical Intensive Care Unit University Hospital Zürich Pulmonary hypertension is a disease of the pulmonary circulation with many
ACCP PAH Medical Therapy Guidelines: 2007 Update. David Badesch, MD University of Colorado School of Medicine Denver, CO
ACCP PAH Medical Therapy Guidelines: 2007 Update David Badesch, MD University of Colorado School of Medicine Denver, CO Disclosure of Commercial Interest Dr. Badesch has received grant/research support
DECLARATION OF CONFLICT OF INTEREST
DECLARATION OF CONFLICT OF INTEREST ESC Congress 2011 Pathophysiology of HFPEF Vascular Remodeling & Pulmonary Hypertension Carolyn S.P. Lam MBBS, MRCP, MS Case Presentation 81 yo woman with dyspnoea &
Ειδικές θεραπείες σε µη-αρτηριακή πνευµονική υπέρταση, πότε; - Στέλλα Μπρίλη Α Πανεπιστηµιακή Καρδιολογική Κλινική Ιπποκράτειο Νοσοκοµείο Αθηνών
Ειδικές θεραπείες σε µη-αρτηριακή πνευµονική υπέρταση, πότε; - Στέλλα Μπρίλη Α Πανεπιστηµιακή Καρδιολογική Κλινική Ιπποκράτειο Νοσοκοµείο Αθηνών . Updated Clinical Classification of Pulmonary Hypertension
A Best Practices Approach to Treating Pulmonary Hypertension for the ED and Acute Care Provider. Disclosures
A Best Practices Approach to Treating Pulmonary Hypertension for the ED and Acute Care Provider Sean M. Studer, MD, MSc Chief, Pulmonary & Critical Care Director, Pulmonary Hypertension & Lung Transplantation
4/14/2010. Pulmonary Hypertension: An Update. Tim Williamson, MD, FCCP. University of Kansas Hospital. Normal Physiology
Pulmonary Hypertension: An Update Tim Williamson, MD, FCCP Director, Pulmonary Vascular Program University of Kansas Hospital Normal Physiology 1 Pulmonary Perfusion 101 High Pressure Low Pressure Pulmonary
PULMONARY HYPERTENSION RESPIRATORY & CRITICAL CARE CONFERENCE APRIL 21, 2016 LAURA G. HOOPER
PULMONARY HYPERTENSION RESPIRATORY & CRITICAL CARE CONFERENCE APRIL 21, 2016 LAURA G. HOOPER OUTLINE Brief review of WHO Group Classification Scheme Subgroups we ll focus on: WHO Group I Pulmonary Arterial
Chronic Pulmonary Complications HEMO 2016 Florianopolis, November 12, 2016
Chronic Pulmonary Complications HEMO 2016 Florianopolis, November 12, 2016 Samir K. Ballas, MD, FACP, FASCP, DABPM, FAAPM Emeritus Professor of Medicine and Pediatrics Cardeza Foundation for Hematologic
2/4/2011. Nathan Kerner, M.D.
Nathan Kerner, M.D. Definition Elevated pressures - cut off usually >40 mmhg pulmonary artery systolic pressure (PASP) Usually associated with elevated pulmonary vascular resistance (PVR) measured in dynessec/cm
The Case of Lucia Nazzareno Galiè, M.D.
The Case of Lucia Nazzareno Galiè, M.D. DIMES Disclosures Consulting fees and research support from Actelion Pharmaceuticals Ltd, Bayer HealthCare, Eli Lilly and Co, GlaxoSmithKline and Pfizer Ltd Clinical
Pharmacy Management Drug Policy
SUBJECT: POLICY NUMBER: PHARMACY-42 EFFECTIVE DATE: 6/2005 LAST REVIEW DATE: 10/1/2018 If the member s subscriber contract excludes coverage for a specific service or prescription drug, it is not covered
PULMONARY HYPERTENSION
PULMONARY HYPERTENSION MARTIN T. MPE CARDIOLOGIST MEDICLINIC HEART HOSPITAL CASE REPORT A 35 year old female, general worker. Married with 2 children with the youngest aged 12 years. Presenting complaints
Clinical Policy: Treprostinil (Orenitram, Remodulin, Tyvaso) Reference Number: ERX.SPA.36 Effective Date:
Clinical Policy: (Orenitram, Remodulin, Tyvaso) Reference Number: ERX.SPA.36 Effective Date: 07.01.16 Last Review Date: 02.19 Revision Log See Important Reminder at the end of this policy for important
Untreated idiopathic pulmonary arterial hypertension
Congenital Heart Disease Outcomes in Children With Idiopathic Pulmonary Arterial Hypertension Delphine Yung, MD; Allison C. Widlitz, MS, PA; Erika Berman Rosenzweig, MD; Diane Kerstein, MD; Greg Maislin,
Pulmonary Hypertension: Evolution and
Management of Pulmonary Hypertension: Evolution and Controversies VERMONT CARDIAC NETWORK SPRING CONFERENCE MAY 10, 2018 MARYELLEN ANTKOWIAK, MD, PULMONARY & CRITICAL CARE MEDICINE, UVMMC WHO classification