Chronic Thromboembolic Pulmonary
Hypertension (CTEPH) Treatments

For up to two-thirds of CTEPH patients, pulmonary thromboendarterectomy (PTE) surgery is the preferred CTEPH treatment. It’s the only procedure that may reverse CTEPH and right-sided heart failure with a single treatment.

During PTE surgery, the surgeon separates the breastbone to expose the heart and lungs. They then put the patient on a heart-lung machine. The machine takes over the work of these organs during the operation.

The surgeon opens the pulmonary arteries to remove clots and scar tissue. For brief periods, they stop the heart and lung machine to get a better view of the arteries. During the procedure, the surgical team lowers your body temperature to reduce the risk of organ damage while blood isn’t circulating.

If you are not a good candidate for surgery, you may qualify for pulmonary balloon angioplasty. This is a minimally invasive procedure performed by an interventional cardiologist.

BPA involves inserting a thin tube called a catheter through a blood vessel in the groin or neck. The doctor threads it to the narrowed area of the pulmonary artery. Then, they inflate a tiny balloon on the catheter’s tip.

The balloon widens the blood vessel, which makes it easier for blood to flow, so blood pressure lowers in the lungs. Typically, patients need multiple treatments spread over several days or weeks, but it can improve symptoms and quality of life.

If you’re unable to have surgery or angioplasty, doctors may recommend medication. Some medicines can improve symptoms and help dilate your pulmonary arteries, so your heart doesn’t have to work as hard. Doctors may also prescribe blood thinners to reduce the risk of new clots forming.

With expert care, most patients can undergo either PTE surgery or BPA. However, even if you have these procedures, medicine may be part of your treatment. In some cases, we use medication to improve heart failure symptoms so it’s safer to undergo surgery or BPA.

Surgery usually takes four to eight hours.

After your surgery, you typically spend two days in the Intensive Care Unit. Your overall hospital stay will likely be six to 10 days.

PTE is a major surgery, and recovery takes time. It may be several months before you return to all your normal activities. But you may notice improvement in your breathing and ability to be active much sooner.

Each BPA procedure typically takes two to four hours.

Expect to stay in the hospital at least one night after each procedure. Because angioplasty is less invasive than surgery, you will have less pain and a quicker recovery. Your doctor will explain when you can safely resume normal activities.

Like all medical procedures, PTE surgery and BPA come with certain risks. Among them are bleeding, infection and stroke. In very rare cases, death is also possible.

At Emory, we have a highly skilled team of physicians who carefully choose treatments for each patient. This significantly lowers risk. We take every precaution to make your procedure as safe and effective as possible.