Karna Rahul, Hussain Rahat, Jyothula Soma S K
Divisions of Pulmonary, Critical Care and Sleep Medicine, McGovern Medical School, Houston, TX, USA.
Center for Advanced Cardiopulmonary Therapies and Transplantation, McGovern Medical School, Houston, TX, USA.
Lung India. 2021 Nov-Dec;38(6):571-573. doi: 10.4103/lungindia.lungindia_76_21.
Severe pulmonary hypertension (PH) in obese patients pose a challenge to treat despite advances in medical therapeutics. Current treatment options are limited for patients who are not responding to maximal medical therapy. Here, we present a case of multifactorial PH, not responsive to ambrisentan, tadalafil, and treprostinil, even after optimization of cardiac and pulmonary function and had a poor prognosis. She demonstrated weight loss after bariatric surgery, improving her restrictive lung disease, obstructive sleep apnea and PH, and overall functionality. Bariatric surgery may offer a potential therapeutic option, in patients with morbid obesity and PH resistant to maximal medical therapy.
尽管医学治疗有所进展，但肥胖患者的重度肺动脉高压（PH）治疗仍面临挑战。对于对最大程度药物治疗无反应的患者，目前的治疗选择有限。在此，我们报告一例多因素PH病例，即使在优化心肺功能后，对安立生坦、他达拉非和曲前列尼尔均无反应，预后较差。她在接受减肥手术后体重减轻，限制性肺病、阻塞性睡眠呼吸暂停和PH均得到改善，整体功能也有所改善。对于患有病态肥胖且对最大程度药物治疗耐药的PH患者，减肥手术可能提供一种潜在的治疗选择。
