This procedure is also called pulmonary endarterectomy (PEA). It is surgery to remove blood clots and scar tissue from the arteries in the lungs. The surgery can potentially cure a condition called chronic thromboembolic pulmonary hypertension (CTEPH).
With CTEPH, blood clots get trapped within the walls of the arteries and develop scar tissue over time. Pressure in the lungs is high and breathing can be difficult. The blockage leads to high pressures in the arteries eventually leading to right heart failure and damage to the lungs.
If you have CTEPH, your healthcare provider will examine you in order to assess your general level of health. They will also assess your breathing and the damage to your heart. The location of the blockages helps determine whether or not the surgery will be successful.
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:
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.
PTE is really the only way to cure chronic thromboembolic pulmonary hypertension (CTEPH). The surgery is successful in the majority of cases, either relieving breathing issues completely or improving them greatly.
There are risks with any procedure, but experienced teams have a mortality rate of less than 3% . Of course you will have pain to manage immediately after the surgery. A condition called pericardial effusion (fluid build-up around heart) does happen sometimes.
Recovery from PTE involves check-ups for lung testing, usually at about six weeks and at three to six months. Breathing and exercise capacity should continue to improve. Some people do have pulmonary hypertension (PH) that will not go away, or that returns. Your doctor might suggest a right heart catheterization if this occurs. You might then be treated with drugs specifically for PH.
You will need to contact 911 or go to the emergency room if any of the following things happen after you go home:
The first three might be symptoms of something called pericardial effusion, which means that fluid is building up around the heart. This does happen sometimes.
Other symptoms that mean you should call a doctor include:
You will need to contact your insurance provider for specific information.
© Copyright 1995-2020 The Cleveland Clinic Foundation. All rights reserved.
This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 10/17/2019