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| Vol. 22, No. 18 |
| October 1, 2000 |
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Surgery Removes Life-threatening Clots in Lungs An often undetected condition that leads to heart failure can be corrected with a specialized surgery to remove clots from the lungs. "Before this surgery, people with this condition died," says Dr. Rafael Espada, professor of surgery at Baylor College of Medicine. "This offers a life-saving cure." The procedure, called a pulmonary thrombo-endarterectomy, uses special instruments to clean out the interior of the pulmonary arteries. Dr. Espada says in most people, clots in the lungs do not present a problem, because the body dissolves them. Unfortunately, some people are missing the properties in blood that eliminate the clots. "Normally, a clot could form and go to your lungs, and you would never know it happened because your body will have destroyed it," says Dr. Espada. For others, however, the clots become rubbery masses and can obstruct the blood flow. Patients usually arrive at the hospital with an enlarged, failing heart and difficulty breathing. "Many times patients will come in with one diagnosis and we find, by doing an arteriogram, that there is an obstruction caused by these clots," says Dr. Espada. He said the condition often goes undetected because it is difficult to diagnose without the specialized test. A history of miscarriages, inflammation of veins in the leg and shortness of breath are possible indicators of the condition. During the surgery, the patient is placed on a heart-lung machine and the body temperature is dropped to stop circulation. The pulmonary artery is opened and cleaned out with special instruments that peel out the clots. After the surgery, patient recovery is usually quick. "Often you can see the difference in a couple of days. They breathe better and the heart goes back to normal size," says Dr. Espada. To keep the clots from returning, however, the patient must take a blood thinning medication for the rest of his or her life. "With the blood thinners, the chances of developing clots are very, very low," Dr. Espada says.
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