A 59-year-old obese female patient was diagnosed to be having severe pulmonary hypertension secondary to mixed connective tissue disease and pulmonary fibrosis. She presented for right hemi-colectomy for a large right-sided colonic polypoid mass and multiple polyps diagnosed by colonoscopy. Her surgery was postponed by 2 months by the anesthesiologist due to dyspnea at rest and high pulmonary artery pressure (70-80 mmHg) for further optimization of medical treatment. After 2 months, she was adequately fit enough to undergo surgery. High lumbar epidural anesthesia was adopted and weaned off. She was discharged after 5 days of surgery from the hospital without any sequel. This report presents the merits and recommendations for such patients.