Chronic Thromboembolic Pulmonary Hypertension Treatment

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Chronic thromboembolic pulmonary hypertension (CTEPH) turns your life upside down. You may have been a healthy, active person just months or years ago. But now, you have heart failure. Even small tasks might wear you out and make you short-of-breath. Doctors may not have known exactly what’s wrong and you’ve been looking for answers for a long time.

At UVA Health, we can help you get your life back. We’re one of the few centers in the U.S. with the knowledge and experience needed to help patients with CTEPH.

Getting the Right CTEPH Diagnosis

We’ll start by confirming your diagnosis. Diagnosing CTEPH is difficult, so it takes a specialized team. We’ll perform these tests:

  • Ventilation-perfusion scan (VQ scan) to measure airflow and blood flow in the lungs
  • Echocardiogram or ultrasound to see how well the heart is pumping
  • CT with contrast to see blockages in the lungs
  • Pulmonary angiogram to look at blood vessels in lungs
  • Heart catheterization to measure pulmonary system pressure and function of the heart

Pulmonary Thromboendarterectomy at UVA Health

CTEPH is the only type of pulmonary hypertension that can be fixed with surgery. The surgery, called pulmonary thromboendarterectomy, takes a skilled team of many different experts.

We start by splitting the breastbone to open the chest (median sternotomy). We’ll use a heart-lung machine to keep oxygen flowing to your body (cardiopulmonary bypass). Then we’ll open the pulmonary arteries to remove the blockages causing CTEPH.

This lowers blood pressure in your heart, so there’s less stress on your heart.

After Surgery & After CTEPH

You’ll spend 7-10 days in the hospital, starting in the intensive care unit (ICU) and moving to another unit as you’re doing better.

For many patients, their heart function goes back to normal. They’re able to have the same quality of life they had before CTEPH.

You’ll need to keep seeing a pulmonologist or cardiologist to watch for signs of heart failure. You’ll also need to take blood thinners to keep clots from forming in your lungs again.

When CTEPH Surgery Isn’t an Option

Sometimes patients are too weak for surgery. In these cases, we offer medicines that reduce symptoms and help you feel as comfortable as possible.