Pulmonary artery thromboendarterectomy (PTE) has been regarded as a promising, potentially curative surgical procedure. However, PTE is associated with specific postoperative complications, such as reperfusion pulmonary edema and right heart failure leading to a considerable mortality of 7-24%. Despite its limitations PTE is a better surgical alternative to lung transplantation which carries high morbidity and mortality. The aim of the study is to analyze the efficacy, safety, morbidity and survival associated in the postoperative period and quality of life after six months of PTE in Indian patients.
Pulmonary endarterectomy is the operation of choice for thromboembolic pulmonary hypertension. As the largest referral center for thromboembolic pulmonary hypertension in the world, we are frequently asked whether patients with extreme pulmonary hypertension (pulmonary artery systolic pressure >100 mm Hg) can safely undergo this operation with therapeutic benefit.
Pulmonary endarterectomy is the best treatment for patients with chronic thromboembolic pulmonary hypertension. Traditionally pulmonary endarterectomy has been performed utilizing deep hypothermic circulatory arrest to provide a bloodless field, but some recent reports have challenged this concept. We reviewed our experience with selective antegrade cerebral perfusion as the initial strategy of controlling bronchial collateral flow to avoid complete circulatory arrest in patients undergoing pulmonary endarterectomy
The majority of patients (70-80%) referred to our service will benefit from surgery. Occasionally the type of disease may not be appropriate for surgery, or the patient may be too well or unwell to undergo the operation. In this circumstance you will be followed carefully and there may be some medical treatments available that can help improve the severity of pulmonary hypertension. At present, Papworth is working closely with other centres around the world to develop more effective treatments for this condition.
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