Pulmonary Endarterectomy

Pulmonary Endarterectomy: общие сведения

Pulmonary endarterectomy (PEA) in India is a major cardiac operation used primarily to treat chronic thromboembolic pulmonary hypertension (CTEPH), a condition in which organised old blood clots obstruct the pulmonary arteries and raise pressure in the lung circulation. In suitable patients, surgery can markedly reduce pulmonary pressures and improve breathlessness, exercise capacity and right-heart function.

Assessment requires a specialist CTEPH evaluation, usually including echocardiography, right-heart catheterisation and detailed pulmonary vascular imaging such as CT pulmonary angiography and ventilation-perfusion scanning. Pulmonary angiography may also be used. The key decision is whether the obstructive disease is surgically accessible and whether the expected benefit outweighs operative risk. Patients who are not operable may instead be considered for medical therapy or balloon pulmonary angioplasty.

PEA is performed through open-heart surgery using cardiopulmonary bypass, often with periods of deep hypothermia and circulatory arrest so the surgeon can remove fibrotic clot material from the pulmonary arteries. It requires an experienced multidisciplinary team and specialised intensive-care support. Important risks include bleeding, reperfusion lung injury, persistent pulmonary hypertension, arrhythmia, neurological complications and prolonged respiratory support.

Cost in India varies with preoperative pulmonary-hypertension testing, surgical complexity, ICU duration, blood products and postoperative rehabilitation. Leading cardiac centres can provide pulmonary hypertension specialists, cardiothoracic surgeons, perfusion, advanced imaging and critical care. Medical Help India can connect international patients with an appropriate healthcare partner to review imaging and haemodynamic data, assess operability and obtain a detailed treatment estimate.

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