Pulmonary thrombo-endarterectomy: a study of 39 cases operated at our institution

Volume : VII, Issue : VII, July - 2018

Dr. Kamlesh Jain, Dr. Kalpesh Agrawal

Pulmonary thrombo–endarterectomy (PTE) is the treatment of choice to relieve pulmonary artery obstruction in patients with chronic thromboembolic

pulmonary hypertension (CTEPH). It is a complex surgical procedure with a simple principle: removal of obstructive thrombo–embolic

material from the pulmonary arteries in order to reduce pulmonary vascular resistance, relieve pulmonary hypertension (PH) and alleviate right

ventricular dysfunction. Operability assessment is not always easy, being largely subjective and based on experience. The most common reason for

inoperability is distal vasculopathy accounting for a high proportion of the vascular resistance. Surgery requires cardiopulmonary bypass with or

without arresting the heart. Complications include reperfusion lung injury and persistent PH. However, with careful patient selection, surgical

technique and post–operative management, PTE is a highly effective treatment with mortality rates <5% at experienced centres. Patients who are

unsuitable for surgery may be candidates for medical therapy.