Pulmonary Hypertension and Cognitive Decline for Colorectal Cancer Resection

You are the anaesthetist participating in a multidisciplinary team (MDT) meeting at the high-risk surgical clinic. The other members of the team are the colorectal surgeon, geriatrician, oncologist, stoma nurse and the social worker. You are meeting to discuss a 75-year-old woman who is being planned for a laparoscopic right ultralow anterior resection +/- open +/- colostomy for sigmoid colon adenocarcinoma. Medical History Cognitive decline Idiopathic pulmonary hypertension Tricuspid regurgitation - planned for percutaneous tricuspid valve repair Allergies Nil known Medications Donepezil 5mg once daily Enalapril 2.5mg bd Spironolactone 50mg once daily Physical Examination Weight 50 kg Height 166 cm BMI 18 kg/m2 Investigations Echocardiogram report attached Mild iron deficiency anaemia, stable Chronic kidney disease stage 2, stable Other investigations including ECG within normal limits