Your PTE Surgery: What To Expect and FAQs

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Pulmonary Thromboendarterectomy, or PTE, is a complex surgical procedure that removes chronic blood clots from the pulmonary arteries in order to lower blood pressure and relieve strain on the right ventricle of the heart.

It is the only definitive and potentially curative therapy for chronic thromboembolic pulmonary hypertension (or CTEPH), a rare but dangerous condition.

Advantages of PTE surgery:

Improved blood flow
Easier breathing
Prevents heart failure and premature death

Before Your Surgery

During your visit, we’ll ask about your symptoms, medical history, and if you have a known genetic predisposition for clots.

Ahead of your procedure, you’ll need the following tests:

Echo: an ultrasound of the heart
Pulmonary Function Tests
Ventilation/Perfusion Scan and CTA to confirm the embolism burden
Pulmonary angiography to verify that the emboli is accessible by surgery
Right Heart Cath to assess the condition of the right side of the heart.

The Operation

Once surgery is scheduled, you will be instructed on when to hold your oral blood thinners and switch to low molecular weight heparin.

PTE surgery is performed under general anesthesia and a heart-lung machine, which keeps blood moving around your body while your heart is stopped.

Your surgeon will access your heart via a 6-inch cut through the breastbone.

At the end of the surgery, you will be taken to the ICU to begin your recovery.

After Your Surgery

After a day in the ICU, your breathing tube will be removed and you will be able to breath on your own. You’ll move to a regular hospital room 3-4 days after surgery. You will typically stay in the hospital for 7-10 days.

Our team will follow you closely the first few months after surgery to track your progress and check for improvements in your exercise capacity and pulmonary pressures.

Your symptoms may improve right away. Full recovery usually takes 3 months.

PTE Surgery FAQs

Q: What is PTE surgery?

Pulmonary Thromboendarterectomy (PTE) surgery is a procedure to remove chronic blood clots from the pulmonary arteries to improve blood flow and reduce symptoms of pulmonary hypertension.

Q: Are there any complications?

Immediately after surgery, fluid build up in the lungs and bleeding are the most important potential complications. Pulmonary pressures can remain high after surgery. In that case, you may require medications to dilate the small blood vessels causing that elevation.

Q: How long does the procedure take?

The procedure typically lasts 6 to 8 hours in the OR. During this time, your surgeon will be accessing your heart and carefully opening the pulmonary arteries, which carry blood from the heart to the lungs. From there, they will use special instruments to remove the clots inside.

Q: What does the surgical incision look like?

The PTE procedure requires the surgeons making an incision in the chest to gain access to the heart and lungs. This results in a thin six inch scar in the center of the chest.

Q: How long will I be in the hospital?

Typical length of stay in the hospital is 7-10 days. Once home, you will need to take blood-thinning medication regularly--this is important to help prevent new clots from forming. You may also continue physical therapy (which you’ll begin while recovering in the hospital) after you get home.

Q: Is PTE surgery covered by insurance?

Yes.

Need a PTE Surgeon?

At NewYork-Presbyterian/Columbia University Irving Medical Center, our cardiac surgeons are world-leaders in Pulmonary Thromboendarterectomy surgery.

If you or a loved one want our experts on your side, call (212) 305-2633 or use our appointment request form.

Resources

Heart Surgery Guides: What to Expect

Procedural Guides: What to Expect and FAQs

Your Transcatheter Aortic Valve Replacement (TAVR): What To Expect and FAQs

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