IJSR International Journal of Scientific Research 2277 - 8179 Indian Society for Health and Advanced Research ijsr-7-7-15889 Original Research Paper Pulmonary thrombo-endarterectomy: a study of 39 cases operated at our institution Kamlesh Jain Dr. July 2018 7 7 01 02 ABSTRACT

 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.