An Improved Technique for Pulmonary Endarterectomy

We report a modified technique for pulmonary endarterectomy (PEA) on a 67-year-old man with chronic thromboembolic pulmonary hypertension (CTEPH) who presented with dyspnea. He was referred to our medical center for coronary artery bypass grafting. CTEPH had not been detected in his first visit to another medical center, but upon re-evaluation, the diagnosis was confirmed. PEA was performed with a modified method, which seems to be safe and suitable for the removal of clot and fibrotic materials. Iatrogenic dissection was performed with normal saline injection in the pulmonary artery, and then, the clot was removed completely. Although the technique may not be applicable for all cases, it can be used as an alternative to using an aspirating dissector and a pair of forceps.