UCSD developed a program to alleviate chronic, major vessel thromboembolic pulmonary hypertension by pulmonary thromboendarterectomy in 1970. Since that time, multiple evolutionary changes in the diagnostic evaluation, surgical approach and postoperative management have been implemented, and today the operation is considered curative and greatly superior to transplantation for this condition. Current techniques of operation have made the procedure relatively safe.
While medical therapy for pulmonary hypertension caused by pulmonary vascular occlusion is generally unsatisfactory and palliative only, surgical therapy—PTE—is curative. During the first 20 years of UCSD’s pulmonary endarterectomy program, only 188 patients underwent the procedure. With the increased recognition of the disease and the success of operative therapy, however, more than 1,500 operations have been done since 1990 at our center. We are unquestionably the world leader in performing this technically demanding yet highly successful treatment for pulmonary hypertension caused by chronic pulmonary thromboembolic disease. We currently believe that there is no degree of embolic occlusion within the pulmonary vascular tree that is inaccessible and no degree of right ventricular impairment or any level of pulmonary vascular resistance that is inoperable.
Although pulmonary transplantation is still used in some centers for patients with thromboembolic disease, we consider that treatment to be outdated. In good hands, the endarterectomy operation has a lower operative mortality rate than lung transplantation, it can be done electively without the wait for a donor, and the long-term problems associated with rejection and immunosuppressive drugs are eliminated. In addition, the mortality rate for transplantation (and especially double lung transplantation) as a therapeutic strategy should include patients on the waiting list and is therefore much higher than is generally reported.
As a patient of UCSD’s PTE program, you will work directly with the doctors, nurses and case managers involved in the multidisciplinary UCSD team. We pride ourselves on the personal attention given to each patient and his or her family members. Moreover, we will work closely with your personal physician so that when you return home your doctor will have a thorough understanding of the care you received at UCSD, as well as the follow up regimen required.
For more information on UCSD Healthcare or UCSD’s Pulmonary Thromboendarterectomy Program, we invite you to contact us: