BACKGROUND: It is very challenging for anesthesiologists to manage patients with pulmonary hypertension undergoing general anesthesia for elective or emergent surgeries.

CASE REPORT: We present a patient with severe pulmonary hypertension going through a major robotic thoracic surgery.

CONCLUSIONS: A goal-directed anesthesia management algorithm based on serial stroke volume (SV) values obtained from FloTrac (Edwards Lifesciences, LLC.) minimally invasive arterial pressure sensor was utilized in an attempt to reduce the anesthetic and surgical risk associated with severe pulmonary hypertension.

Keywords: Hypertension, Pulmonary, one-lung ventilation, Stroke Volume, Thoracic Surgical Procedures, Anesthesia, General, Early Goal-Directed Therapy, Monitoring, Intraoperative