Pulmonary Endarterectomy (PEA) is a highly complex, specialized open-heart procedure. It is the gold-standard treatment for chronic thromboembolic pulmonary hypertension (CTEPH).
What is CTEPH?
CTEPH is a form of pulmonary hypertension that develops when old, organized blood clots block the arteries in the lungs. This obstruction increases blood flow resistance, leading to high blood pressure in the lungs (pulmonary hypertension) and putting severe strain on the right side of the heart, eventually causing right heart failure.
How Does PEA Surgery Help?
During a PEA operation, the surgeon opens the pulmonary arteries and carefully strips away the chronic, fibrous clot material lining the vessel walls. Unlike a standard clot removal (embolectomy), this requires removing the diseased inner lining (intima) of the arteries itself to restore proper blood flow.
Because this is a complex operation requiring the body's circulation to be cooled and temporarily paused, it is performed only in specialized centers. When successful, it can significantly lower pulmonary blood pressure, relieve shortness of breath, and improve heart function.