CTEPH (Comprehensive Pulmonary Hypertension)
About Us
UPMC's Comprehensive Pulmonary Hypertension Program is one of only a few programs nationwide specializing in treatment of CTEPH. Because this disease is so rare and has similar symptoms to other cardiopulmonary conditions, diagnosing and treating this disease requires the kind of multi-disciplinary expertise that is the hallmark of our physicians.
The UPMC Treatment Approach
This disease is potentially curable, and UPMC's experts are well-skilled in providing treatment options that are best suited for each person, even at advanced stages of disease. When properly treated, the survival rates of people with CTEPH are comparable to those without any history of pulmonary hypertension.Treatment options include:
Pulmonary Thromboendarterectomy (PTE)
Also called Pulmonary endarterectomy (PEA).
In this highly-skilled surgical procedure, UPMC surgeons open the pulmonary arteries and remove the blood clot and restore proper blood flow to the lungs. PTE is a cardiothoracic surgical procedure, which lasts 4-6 hours, with the goal of improving blood flow from the right side of the heart through the pulmonary arteries, relieving stress on the right side of the heart (preventing heart failure), allowing you to breathe easier and improve your quality of life. The operation is done utilizing cardiopulmonary bypass. Patient’s body temperature is cooled and cessation (stoppage) of blood flow is sustained for a short period of time to allow for complete visualization and removal of the chronic pulmonary thromboemboli. Depending on how advanced the disease is, this surgery can cure up to 90% of all patients.There are a lot of factors which go into the decision of proper candidacy for PTE surgery. Our multidisciplinary team will determine if your patient will benefit from PTE surgery and if the benefits will outweigh the associated risks. Much has been learned over the past decade and has improved the safety of the operation. The success of the surgery is the combination of proper patient selection as well as surgical expertise and technique, and PTE is generally considered a safe surgery with an experienced team.
Medications
In the 10% of individuals who do not achieve a cure from PTE / PEA and in patients deemed not to be optimal medical candidates, medications can be used to provide treatment for pulmonary hypertension. However, neither surgical evaluation nor surgery itself should be delayed for a trial of medical therapy.
Lung transplantation
When surgery or medications fail to cure CTEPH, some people may become candidates for a lung transplant. Our physicians are leading experts in lung transplantation as part of the UPMC Thomas E. Starzl Transplantation Institute, a nationally regarded center of excellence in transplantation.
Clinical Research:
The CTEPH program is establishing a registry to track patients and outcomes post-pulmonary embolism as well as after CTEPH diagnosis and treatment.
Meet Our Team:
Belinda Rivera-Lebron, MD, MS
Assistant Professor of Medicine
Division of Pulmonary, Allergy & Critical Care Medicine
riveralebronbn@upmc.edu
Thomas G. Gleason, MD
Ronald V. Pellegrini Endowed Professor
Department of Cardiothoracic Surgery
gleasontg@upmc.edu
Other members of the multidisciplinary team include:
- Michael Risbano, MD
- Marc Simon, MD
- Mike Mathier, MD
