What happens during a pulmonary thromboendarterectomy (PTE)?

You will be under anesthesia for the procedure, which generally starts early in the morning and lasts for around six hours. After you have the anesthesia:

  • An endotracheal tube and other tubes/lines will be placed.
  • The surgeon will make an incision in the sternum (breast bone) so that the team can reach your heart and lungs.
  • You will be put onto a heart-lung machine (called cardiopulmonary bypass), which will act as your heart and lungs.
  • The bypass machine will also be used to cool you to 65 degrees Fahrenheit (18 degrees Celsius), which is necessary because the machine must be shut off for a brief time during the procedure.
  • At this time, clots are removed with special tools from the arteries.
  • You will be re-warmed to your regular temperature and taken off the bypass machine.
  • Drains will stay in place in the chest to drain fluid, but the chest will be closed.
  • You will be taken from the operating room to the intensive care unit (ICU), where you will remain overnight. It is likely that you will be removed from the ventilator (breathing machine) in the morning after a test showing that you are able to breathe on your own.

What happens after the pulmonary thromboendarterectomy (PTE)?

People who have PTE usually are in the hospital for about 10 days. You will usually be up and walking in a few days. Drains and tubes are removed gradually. Before you are discharged, you will have a number of tests of your heart and lungs. A test will measure how much additional oxygen therapy you might need.

You will be able to resume your activities gradually. You will need to take blood-thinners. You will be asked not to drive, return to work, or lift anything heavier than 15-20 pounds for at least six weeks. Cardiopulmonary rehabilitation is often recommended.

By three months after the procedure, you will probably be able to resume all normal activities. The breathing and exercise capacity may continue to improve even 12 to 48 months after the surgery.

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