Pulmonary endarterectomy (PEA) is a complex but life-saving surgery for heart patients with chronic thromboembolic pulmonary hypertension (CTEPH).
Guth S, et al. Ann Cardiothorac Surg 2022:1 1:180-188.
Procedure of the Surgery
- During a PEA surgery, the chest is opened via a sternotomy, in which the breastbone is split lengthwise.
- The heart-lung machine temporarily takes over the function of the heart and lungs.
- The pulmonary artery is surgically opened, and the inner wall, including the scarred blood clots, is carefully removed. This process is called an endarterectomy.
- To perform this procedure, the patient’s body temperature is lowered to 18°C using the heart-lung machine. This allows both the heart and the heart-lung machine to be temporarily stopped, ensuring that the pulmonary arteries are completely free of blood.
- Afterward, the patient is gradually warmed up, the heart starts beating again, and the heart-lung machine is disconnected.
The surgery lasts an average of six hours and is performed under general anesthesia. Depending on the severity of the disease, the duration of the operation may vary.
A successful surgery results in a reduction or normalization of pulmonary pressure, leading to improved exercise capacity and life expectancy for the patient.