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Adult Patients with Eisenmenger Syndrome Report Flying Safely on Commercial Airlines
  1. Craig S Broberg (brobergc{at}
  1. Oregon Heatlh and Sciences University, United States
    1. Anselm Uebing (uebing{at}
    1. Royal Brompton and Harefield NHS Trust, United Kingdom
      1. Linda Cuomo
      1. Royal Brompton and Harefield NHS Trust, United Kingdom
        1. Swee Lay Thein
        1. King's College Hospital, London, United Kingdom
          1. Michael G Papdopoulos
          1. Royal Brompton and Harefield NHS Trust, United Kingdom
            1. Michael A Gatzoulis (m.gatzoulis{at}
            1. Royal Brompton and Harefield NHS Trust, United Kingdom


              Background Despite fears of compromised oxygen delivery in patients with Eisenmenger syndrome during flight on commercial aircraft, a clinical study has shown no adverse effects, and many patients travel frequently.

              Methods We surveyed 53 patients with Eisenmenger syndrome and 48 acyanotic patients about their air travel history over the last decade. Patients were asked to list all flights and destinations, as well as any major adverse event or symptoms including specifically headache, palpitations, edema, or need for supplemental oxygen. In the Eisenmenger patients, full blood count, six-minute walk test, and p50 of the oxygen-hemoglobin dissociation curve were also obtained.

              Results 1157 flights were reported evenly between the two groups. Thirteen Eisenmenger patients reported no travel in the last 10 years (vs. 4 of 48 acyanotic patients, p=0.03), six of whom were told not to fly by health-care providers. Of those who flew, number and distance of flights was similar in both groups. No major adverse events were reported. One Eisenmenger patient had a possible transient ischemic attack and a second patient needed supplemental oxygen when exposed to ambient cigarette smoke in flight. Other symptoms such as headache, palpitations and lower extremity edema at the travel destination were reported with similar frequency in both groups. Eisenmenger patients had an elevated p50 of the oxygen hemoglobin dissociation curve (29.4,,b2.6 mmHg vs. 27 iÓ 3 mmHg in laboratory controls, p<0.01).

              Conclusions Eisenmenger patients report traveling frequently and safely on commercial airlines. Shifts in oxygen-hemoglobin dissociation curve are likely to attenuate the effects of low oxygen tension. Eisenmenger patients should, nevertheless, be advised to avoid inactivity and dehydration as usual, but there is no justification for limiting air travel.

              • Eisenmenger syndrome
              • air travel
              • cyanosis
              • hypoxia
              • pulmonary hypertension

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