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Temple University Hospital's Pulmonary Thromboendarterectomy Program Celebrates Milestone

POSTED ON April 29, 2016

Paul Forfia, MDTo hear it described, pulmonary thromboendarterectomy (PTE) surgery may sound like something out of a science fiction novel. But, for patients it can be life altering and lifesaving. Temple University Hospital’s PTE Program recently completed its 50th PTE procedure, less than three years since its inception.

Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare and often fatal form of elevated blood pressure in the lungs resulting from a blood vessel that has been blocked by a clot for a long period of time.

"Those blood clots block blood flow through the lungs and can cause a variety of serious problems including right-sided heart failure and shortness of breath," says Paul Forfia, MD, Director of the Pulmonary Hypertension/Right Heart Failure and Pulmonary Thromboendarterectomy Program at Temple University Hospital. "CTEPH is a debilitating and potentially life threatening condition. In addition, true expertise in this condition is hard to come by, even at major medical centers throughout the country."

Sixty-four-year-old Kevin Dillon is a Marine Corps veteran from Willow Grove, PA, and was diagnosed with CTEPH decades after he had blood clots in his legs break off and travel to his lungs. "They were causing strain on my heart," says Dillon. "My pulmonologist said this is a problem and we’re going to have to do something about it. I was referred to Temple and Dr. Forfia, who assessed my condition and told me that I was going to need to have a surgery called PTE." Soon after, Dillon became one of Temple's first PTE patients.

During PTE, the patient's chest is opened-up to allow access to the heart and lungs – after which the surgeon makes a small incision in the patient’s pulmonary artery – the main blood vessel to the lung. "In order to enter the vessel safely to remove the clot, we need to first divert the blood flow by placing the patient on a heart-bypass machine and turning it off for short periods of time – putting them into circulatory arrest – while cooling their bodies to 60 degrees fahrenheit," says Yoshiya Toyoda, MD, PhD, Chief of Cardiovascular Surgery at Temple University Hospital. “During that time, the patient is in a state of hibernation and we use forceps and a suction dissector to gently peel the clots away from the blood vessels while the patient is in circulatory arrest."

Dr. Toyoda performed Kevin Dillon's surgery in June 2014 and Dillon saw results immediately.

"I had the surgery on a Monday and I went home on a Saturday," says Dillon. "I was told right away that my pulmonary hypertension was gone and that once they removed the obstructions in my pulmonary artery, my heart – which was enlarged and weakened on the ride side – returned to normal."

Dillon has been able to visit Walt Disney World with his family since undergoing surgery. He says he walks every day, has more stamina now and feels wonderful.

Temple is one of only a handful of centers in the U.S. that specializes in CTEPH and performs PTE surgery – more than two dozen in this fiscal year alone.

"The success of this program has not happened by accident," says Dr. Forfia. "You need a whole team – including specialists in pulmonary hypertension, thoracic imaging and cardiovascular surgery – to assess CTEPH patients properly and determine if the surgery, medicine or other procedures are appropriate for them. We are very fortunate to have a dedicated and highly specialized CTEPH team here at Temple, including Dr. Toyoda as our PTE surgeon."

"Temple's PTE program has grown rapidly since its inception,” adds Dr. Toyoda. “We are proud to be able to offer this surgical option to our patients."