[Anesthetic management of a patient with pulmonary hypertension due to a large anterior mediastinal tumor anticipated by preoperative computed tomography].

A 74-year-old man underwent an operation for an extremely large mediastinal tumor. Despite the lack of respiratory difficulty or distention of the jugular veins, preoperative computed tomography showed suppression of the left atrium by the huge tumor. We suspected pulmonary hypertension and monitored continuously with a pulmonary catheter. The Pp/Ps ratio decreased gradually from 0.8 to 0.7 by continuous administration of alprostadil or olprinone. After tumor resection, the Pp/Ps ratio was reduced and maintained at 0.2 even after alprostadil and olprinone administration was discontinued. The tumor was considered to have caused the severe pulmonary hypertension, as anticipated from the preoperative CT.