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BPA: An Alternative Procedure for Some CTEPH Cases
Balloon pulmonary angioplasty (BPA) is a minimally invasive procedure performed in our cardiac catheterization lab.
Pulmonary Thromboendarterectomy (PTE) Surgery
For patients who have chronic PE that has progressed to CTEPH, PTE surgery may be necessary.
If an acute (sudden) pulmonary embolism, a blood clot in the lung arteries develops into chronic thromboembolic pulmonary hypertension (CTEPH), this can be potentially life-threatening. While medication may be used initially to help control symptoms, people with CTEPH may require a procedure such as pulmonary thromboendarterectomy, or PTE surgery. During this open-heart procedure, the surgeon opens pulmonary arteries and removes the chronic blockages, such as old clots and scar tissue.
Pulmonary thromboendarterectomy (also known as pulmonary endarterectomy, or PEA) can significantly improve symptoms and quality of life for people who have chronic PE that has progressed to CTEPH, and it can also reduce the risk of right ventricular heart failure.
Why choose Henry Ford Health for pulmonary thromboendarterectomy?
- Multidisciplinary team: Given the complex nature of chronic PE and CTEPH, it requires several specialists who coordinate care throughout treatment. We have one of the most experienced and one of the very few specialized teams for CTEPH in the region and in the country, including cardiothoracic surgeons who are experienced in performing pulmonary thromboendarterectomy.
- Dedicated pulmonary and critical care team: We have a dedicated ICU for lung patients, and our critical care doctors specialize in pulmonary care, which gives them deep expertise in caring for patients who have had lung procedures such as PTE surgery.
- Comprehensive pulmonary rehabilitation program: This supervised exercise program can help you recover from a chronic pulmonary embolism, so you can breathe easier, regain strength and perform daily activities such as walking and climbing stairs. We also educate you about lung disease, including teaching you about medications and other therapies, breathing techniques and more.
- Research into new treatment options: As a leader in pulmonary research, we have studied new ways to diagnose and treat pulmonary embolism and related conditions most effectively. We continue to participate in multiple large clinical trials, which affords us access to currently approved therapies and emerging treatment options.
How does PTE surgery work?
- Like other open-heart procedures, the surgeon cuts through your breastbone (sternum). This is to access your lungs and the pulmonary arteries that contain the clots and scar tissue.
- Your body temperature is cooled, and you’ll be placed on a heart-lung bypass machine, a device that takes over your heart function during surgery.
- The blood is drained from your heart and lungs, and periodically the heart-lung machine is turned off.
- During these periods, your surgeon opens each blocked pulmonary artery one at a time to remove clots and scar tissue, until all affected arteries are cleared.
- Your body temperature is warmed back up, and you’re taken off the heart-lung machine.
- The surgeon closes your sternum using wires, and stitches up your skin.
- The pulmonary endarterectomy procedure typically takes about 6-8 hours, and you may be in the hospital up to 10 days after surgery.
- Following surgery, you’ll be in pulmonary rehabilitation for a few months.