Maryland Heart Center

Pulmonary Thromboendarterectomy (PTE)

What is PTE?

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Pulmonary thromboendarterectomy (PTE) is a delicate surgical procedure used to remove blood clots and restore blood flow to the lungs. Although many people have blood clots in their lungs,there are a small number of cases in which the clots do not dissolve on their own but instead stick to the vessel wall and obstruct the individual's blood flow. The result of this obstruction is chronic thromboemobolic disease, which causes a type of pulmonary hypertension known as secondary — or chronic — pulmonary hypertension.

People with secondary pulmonary hypertension caused by these blood clots often develop heart failure. PTE can can cure this type of pulmonary hypertension by restoring normal blood pressure in the pulmonary artery and reversing right-side heart failure.

What causes lung embolisms and what happens as a result?

Lung embolisms form from blood clots originating in the legs and pelvis. These blood clots can dislodge from the vein in the legs and pelvis and travel into the lungs, thus causing a pulmonary embolism.

If the clot is large enough, it can obstruct the blood flow to the arteries, or it can have a slightly more modest effect, where the person finds himself with a little shortness of breath and mild pain. However, there may also be no side effects at all.

If the individual has a few large clots, however, these clots break off and move to the lungs. A person can survive a fair amount of these clots, but ultimately, the body tries to digest them and in the process, it will cause scarring of the lung’s arteries. This scarring results in the disappearance of the branches of the lung's arteries, which causes patients to progressively lose the ability to pump blood through their lungs. The PTE operation is designed to cure this.

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