Temple University Hospital’s Pulmonary Hypertension, Right Heart Failure and Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program within the Temple Heart and Vascular Institute recently achieved two clinical milestones by performing its 200th pulmonary thromboendarterectomy (PTE) – a complex procedure offered at only a handful of hospitals in the U.S. – and earning accreditation as a Pulmonary Hypertension (PH) Comprehensive Care Center by the Pulmonary Hypertension Association.   

“We are extremely proud of these accomplishments,” said Paul Forfia, MD, Co-Director of the Pulmonary Hypertension, Right Heart Failure & CTEPH Program and Professor of Medicine at the Lewis Katz School of Medicine at Temple University. “Our CTEPH program has only been in existence since 2013, but has quickly grown to become the most active PTE program on the East Coast as evidenced by our 200th case.”

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. The clots block blood flow through the lungs and can cause a variety of serious problems, including debilitating shortness of breath and right-sided heart failure. PTE is a highly specialized surgery in which a surgeon removes the clots.

During PTE surgery, the patient’s chest is opened-up to allow access to the heart and lungs, and then the patient is placed on a heart-lung machine to keep blood circulating. Once this is done, the patient’s blood is cooled to 65 degrees Fahrenheit, which slows down the metabolism and allows the surgeons to periodically turn off the heart-lung machine.

“This permits the surgical team to open the affected arteries and completely clear the vessels by removing the blood clots and any scar tissue that has built up around them,” said Yoshiya Toyoda, MD, PhD, Professor of Surgery and the William Maul Measey Chair of Surgery & Chief of Cardiovascular Surgery. “Once the clots are removed and the patient’s blood has been warmed back up to a normal temperature, their heart and lungs are returned to normal function. This surgery is often curative for patients.”

In addition to having the most active PTE program on the East Coast, Temple published PTE data in a September 2017 issue of the Journal of Cardiovascular Surgery that showed its patients had a 96% survival rate,  70% decrease in pulmonary vascular resistance post-PTE and great improvements in heart function and quality of life.

“Careful preoperative assessment is critical to assure the best outcomes for our patients,” offers Daniel Edmundowicz, MD, FACC, Medical Director of the Temple Heart and Vascular Institute and Section Chief of Cardiology.  “In addition to PTE surgery, this collaborative effort also includes the expertise of our interventional cardiology team for balloon pulmonary angioplasty in those CETPH patients who are inoperable.”

Achieving accreditation as a PH Care Center by the Pulmonary Hypertension Association singles out Temple’s program as one with special expertise in pulmonary hypertension, particularly pulmonary arterial hypertension. The accreditation program is an initiative with the stated goal of raising the overall quality of care and outcomes in patients with pulmonary hypertension.

“The success of Temple’s program has always relied on our highly specialized CTEPH team, including the surgical expertise of Dr. Toyoda and medical specialists Drs. William Auger and Riyaz Bashir,” said Anjali Vaidya, MD, FACC, FASE, FACP, Co-Director of the Pulmonary Hypertension, Right Heart Failure & CTEPH Program, Associate Program Director of the Cardiology Fellowship and Associate Professor of Medicine. “For our patients, the improvements they experience after surgery are life-changing. We are pleased to be able to offer them the expertise of our dedicated team for optimal preoperative assessment, surgical care and postoperative patient management.”