Anaesthetic management for oophorectomy in pulmonary lymphangiomyomatosis

Pulmonary lymphangiomyomatosis is an idiopathic disease, resulting in severe respiratory impairment. Bilateral oophorectomy has led to objective and subjective amelioration of the pulmonary pathology. In the anaesthetic management of such a patient, careful attention must be paid to pulmonary and systemic haemodynamics, and gas exchange. We describe the successful anaesthetic management of a 34-year-old female, using epidural anaesthesia, and pulmonary artery catheterization. Although the intraoperative and immediate postoperative courses were heralded by marked cardiorespiratory stability, refractory respiratory failure developed, and she died five months after surgery.