PTE is the surgical procedure to remove life-threatening blood clots—emboli—from pulmonary arteries to restore blood flow to the lungs. The surgery can provide a cure for pulmonary hypertension due to chronic pulmonary thromboembolic disease by restoring normal blood pressure in the pulmonary artery and removing the chance of right-heart failure.
PTE is an eight-hour procedure, performed under general anesthesia, in which the chest is opened and the patient is attached to a heart-lung bypass machine. The patient’s body is also cooled to about 68 degrees Fahrenheit, because this temperature reduces the body's need for oxygen by 95 percent.
Once the patient is attached to the heart-lung bypass pump and the body is cooled, the surgeons open the arteries obstructed by the clots. The doctors then turn off the heart-lung bypass pump to achieve a bloodless surgical field. While no blood is being pumped through the arteries, the doctors carefully extract the clots adhered to the arterial walls. The clots—often more than 10 inches long—are loosened and removed slowly, one by one. The on-off process of the heart-lung bypass pump is repeated until all of the clots are pulled out. Then, the arteries are sewn closed, blood is allowed to flow back through them, the chest is sewn closed, and the surgery is complete.
This is a simple description of the PTE procedure. For more in-depth information, please click here for an article written by two UCSD surgeons and pioneers of the procedure, or here for a pdf file of a 2003 article chronicling UCSD's experience over our last 1,500 cases.
Before PTE Surgery
Aside from the tests required to determine whether PTE is the right procedure for you, there are a number of things that need to be handled before your surgery:
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Complete the application and medical history information in the UCSD Pulmonary Thromboendarterectomy Program packet (which will be mailed to you) and send it to UCSD.
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Have your medical summary sent to the medical team at UCSD. This information will be reviewed by one of the PTE team members, who will contact you and your physician with information regarding the arrangements that need to be made.