Key messages

• Chronic pulmonary hypertension results in remodeling of pulmonary vessels.

• Surgical interventions should be considered at an early stage to avoid or reverse remodeling of pulmonary vessels.

• Both intravenously infused and inhaled vasodilator have been shown to lower pulmonary artery pressure.

• Inhaled nitric oxide and aerosolized epoprostenol (prostaglandin 12) may induce a selective vasodilation in ventilated lung regions.

• The inhalatory strategy may be advantageous in disease associated with increased pulmonary right-to-left shunting.

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