How would you do anesthesia on a full parturient.

Severe Pulmonary HTN,
Gets tired walking from parking lot to car
Severe RAE / dilation
Severe RVH / dilation
mPAP > 40
does not tolerate supine position very well
cardiomyopathy w/EF: less than 20%.
IV drug abuser,
poor venous access.

What is your plan? Explain it don't just say random stuff.