Pulmonary Artery Embolectomy
What is Pulmonary Artery Embolectomy?
A pulmonary artery embolectomy is a critical surgical procedure to remove a blood clot (pulmonary embolism) or other blockage from the pulmonary arteries, which supply blood to the lungs. This emergency intervention is performed to restore blood flow, prevent right heart failure, and save lives in cases of massive or life-threatening pulmonary embolism (PE). In India, pulmonary artery embolectomy is conducted in specialized cardiac and thoracic surgery centers, offering advanced care at affordable costs. For patients and families in India, understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for informed decision-making and optimal outcomes.
Why do you need Pulmonary Artery Embolectomy?
A pulmonary embolism occurs when a blood clot, usually from the deep veins of the legs (deep vein thrombosis, DVT), travels to the pulmonary arteries, obstructing blood flow to the lungs. Pulmonary artery embolectomy is indicated for:
- Massive PE: Large clots causing severe symptoms like low blood pressure, shock, or cardiac arrest.
- Submassive PE with right heart strain: When clots cause significant heart stress despite stable blood pressure, and other treatments (e.g., thrombolytics) are contraindicated or ineffective.
- Contraindications to thrombolytic therapy: Patients with bleeding risks (e.g., recent surgery, stroke) who cannot receive clot-dissolving drugs.
- Rare cases: Tumor emboli or foreign bodies blocking the pulmonary arteries.
In India, hospitals like Apollo, Fortis, Medanta, Narayana Health, and AIIMS are equipped to perform this procedure, often as an emergency intervention by skilled cardiothoracic surgeons or interventional cardiologists.
Why Do Pulmonary Artery Embolectomy Costs Vary in India?
The cost of pulmonary artery embolectomy in India ranges from ₹1.5 lakh to ₹7 lakh, depending on:
- Procedure Type: Catheter-directed embolectomy (₹1.5–4 lakh) is cheaper than open surgical embolectomy (₹3–7 lakh); ECMO support adds ₹50,000–₹2 lakh/day.
- Hospital & Location: Top hospitals in metro cities (e.g., Apollo, Medanta) charge more; government hospitals (₹50,000–₹2 lakh) are cheaper but may have limited availability.
- Specialist Expertise: Experienced cardiothoracic surgeons or interventional cardiologists charge higher fees.
- Extra Costs: Diagnostics, ICU, medications, long-term anticoagulation, or vena cava filters increase expenses.
- Insurance & Aid: Most insurance plans cover emergency embolectomy; schemes like Ayushman Bharat offer free or subsidized treatment.
Pulmonary Artery Embolectomy Procedure
The procedure is tailored to the patient’s condition, urgency, and clot characteristics:
- Before Procedure Evaluation:
- Diagnosis is confirmed via imaging, primarily a CT pulmonary angiogram (CTPA), which visualizes the clot’s location and size.
- Echocardiogram assesses right heart strain or dysfunction, a key indicator of massive PE.
- Blood tests (e.g., D-dimer, troponin) and arterial blood gas analysis evaluate clot severity and oxygenation.
- Patients are stabilized with oxygen, IV fluids, or vasopressors if in shock; heparin (anticoagulant) may be started to prevent further clotting.
- Embolectomy Techniques:
- Open Surgical Embolectomy:
- Performed under general anesthesia in an operating room, lasting 2–4 hours.
- A median sternotomy (chest bone incision) provides access to the heart and pulmonary arteries.
- The patient is connected to a heart-lung bypass machine to maintain circulation while the surgeon opens the pulmonary arteries and removes the clot.
- Additional procedures (e.g., vena cava filter placement) may prevent future emboli.
- Reserved for massive PE with hemodynamic instability or cardiac arrest.
- Catheter-Directed Embolectomy:
- A minimally invasive approach performed in a catheterization lab under local anesthesia with sedation, lasting 1–2 hours.
- A catheter is inserted through the femoral or jugular vein, guided by fluoroscopy to the pulmonary arteries.
- Devices (e.g., aspiration catheters, mechanical thrombectomy systems like AngioJet or FlowTriever) suction or fragment the clot.
- Preferred for submassive PE or patients unfit for open surgery, offering faster recovery.
- Extracorporeal Membrane Oxygenation (ECMO) Support:
- In extreme cases (e.g., cardiac arrest), ECMO may be used pre- or post-embolectomy to stabilize oxygenation and circulation.
- Open Surgical Embolectomy:
- After Procedure:
- Patients are monitored in the ICU for 1–3 days to manage heart function, oxygenation, and anticoagulation.
- Hospital stay lasts 5–7 days for open surgery or 2–4 days for catheter-directed embolectomy.
- Anticoagulants (e.g., heparin, followed by warfarin or DOACs like apixaban) are continued for 3–6 months or lifelong to prevent recurrence.
- Follow-up imaging (CTPA or echocardiogram) confirms restored blood flow and heart recovery.
Recovery After Pulmonary Artery Embolectomy
Recovery depends on the procedure, patient’s health, and PE severity:
- Hospital Stay:
- Open surgical embolectomy requires 5–7 days, including 1–3 days in the ICU.
- Catheter-directed embolectomy involves 2–4 days, with 1–2 days in the ICU.
- Post-Procedure Care:
- Pain is managed with medications (e.g., paracetamol, opioids for open surgery).
- Anticoagulants are administered to prevent new clots, with regular INR monitoring for warfarin users.
- Oxygen therapy and breathing exercises (using a spirometer) support lung recovery.
- Patients are monitored for bleeding (due to anticoagulation) or recurrent PE.
- Activity and Diet:
- Light walking resumes within days to prevent DVT; strenuous activities are avoided for 4–6 weeks (open surgery) or 2–4 weeks (catheter-directed).
- A balanced diet supports recovery, with hydration emphasized to reduce clotting risk.
- Smoking cessation and weight management are critical to prevent recurrence.
- Follow-Up:
- Follow-up visits at 1, 3, and 6 months include echocardiograms, CTPA, or D-dimer tests to monitor heart/lung function and clot resolution.
- Long-term anticoagulation and DVT prevention (e.g., compression stockings) are tailored to the patient’s risk profile.
Most patients recover fully within 2–8 weeks, with 80–90% survival rates for massive PE treated promptly. Long-term outcomes depend on preventing recurrent clots and managing underlying risk factors (e.g., obesity, immobility).
Risks and Complications
Pulmonary artery embolectomy is a high-stakes procedure with significant risks:
- Surgical Risks:
- Open surgery: Bleeding, infection, or heart-lung bypass complications.
- Catheter-directed: Vascular injury at the catheter site or incomplete clot removal.
- Cardiac and Pulmonary Complications:
- Arrhythmias or right heart failure, especially in patients with pre-existing heart strain.
- Pulmonary edema or reperfusion injury after clot removal.
- Anticoagulation Risks:
- Bleeding (e.g., gastrointestinal, intracranial) due to heparin or warfarin, requiring careful monitoring.
- Recurrent PE if anticoagulation is inadequate.
- General Risks:
- Adverse reactions to anesthesia or contrast dye.
- Blood clots (DVT or new PE) despite treatment.
- Long-Term Issues:
- Chronic thromboembolic pulmonary hypertension (CTEPH) in 2–4% of patients, requiring specialized care.
- Reduced exercise capacity if right heart function remains impaired.
Prompt reporting of symptoms like chest pain, shortness of breath, or bleeding ensures timely management.
Frequently Asked Questions (FAQs)
What causes a pulmonary embolism?
Most PEs result from blood clots (DVT) in the legs, triggered by immobility, surgery, pregnancy, cancer, or clotting disorders.
Is embolectomy the only treatment for pulmonary embolism?
No, smaller PEs are treated with anticoagulants or thrombolytics. Embolectomy is reserved for massive/submassive PE or when other treatments fail/are contraindicated.
Is catheter-directed embolectomy better than open surgery?
Catheter-directed is less invasive, with faster recovery, but open surgery is necessary for massive PE or unstable patients.
How soon can I resume normal activities?
Catheter-directed patients resume normal activities in 2–4 weeks; open surgery patients take 4–6 weeks.
Is pulmonary artery embolectomy covered by insurance in India?
Most insurance plans cover emergency embolectomy for life-threatening PE. Confirm with your provider.
What are the signs of complications post-embolectomy?
Chest pain, shortness of breath, bleeding, or swelling require immediate medical attention.
Can elderly patients undergo embolectomy?
Yes, if their overall health permits, though catheter-directed approaches are preferred to reduce surgical risks.
How can I prevent another pulmonary embolism?
Take prescribed anticoagulants, stay active, use compression stockings, and manage risk factors like obesity or smoking.
Conclusion
Pulmonary artery embolectomy is a life-saving procedure for massive or submassive pulmonary embolism, restoring blood flow and preventing fatal complications. With advanced techniques like open surgery or catheter-directed embolectomy, India’s top hospitals (Apollo, Fortis, AIIMS) offer affordable, high-quality care. By understanding the procedure, cost variations, recovery, risks, and FAQs, patients and families can navigate this emergency with confidence. For urgent symptoms like sudden chest pain or breathing difficulty, seek immediate care at a cardiac center to ensure prompt treatment.
Looking for Best Hospitals for Pulmonary Artery Embolectomy
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we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
2,00,000 |
5,00,000 |
Ahmedabad |
2,50,000 |
5,50,000 |
Ajmer |
2,00,000 |
5,00,000 |
Aligarh |
2,00,000 |
5,00,000 |
Allahabad |
2,00,000 |
5,00,000 |
Amritsar |
2,25,000 |
5,25,000 |
Aurangabad |
2,25,000 |
5,25,000 |
Bangalore |
2,50,000 |
5,50,000 |
Bareilly |
2,00,000 |
5,00,000 |
Belgaum |
2,25,000 |
5,25,000 |
Bhopal |
2,25,000 |
5,25,000 |
Bhubaneswar |
2,25,000 |
5,25,000 |
Bikaner |
2,00,000 |
5,00,000 |
Chandigarh |
2,50,000 |
5,50,000 |
Chennai |
2,50,000 |
5,50,000 |
Coimbatore |
2,50,000 |
5,50,000 |
Dehradun |
2,25,000 |
5,25,000 |
Delhi |
2,50,000 |
5,50,000 |
Dhanbad |
2,00,000 |
5,00,000 |
Durgapur |
2,00,000 |
5,00,000 |
Faridabad |
2,50,000 |
5,50,000 |
Ghaziabad |
2,50,000 |
5,50,000 |
Gorakhpur |
2,00,000 |
5,00,000 |
Guntur |
2,25,000 |
5,25,000 |
Gurgaon |
2,50,000 |
5,50,000 |
Guwahati |
2,25,000 |
5,25,000 |
Gwalior |
2,00,000 |
5,00,000 |
Hyderabad |
2,50,000 |
5,50,000 |
Indore |
2,25,000 |
5,25,000 |
Jabalpur |
2,00,000 |
5,00,000 |
Jaipur |
2,50,000 |
5,50,000 |
Jalandhar |
2,25,000 |
5,25,000 |
Jamshedpur |
2,25,000 |
5,25,000 |
Jodhpur |
2,00,000 |
5,00,000 |
Kanpur |
2,00,000 |
5,00,000 |
Kochi |
2,50,000 |
5,50,000 |
Kolkata |
2,50,000 |
5,50,000 |
Kollam |
2,25,000 |
5,25,000 |
Lucknow |
2,25,000 |
5,25,000 |
Ludhiana |
2,50,000 |
5,50,000 |
Madurai |
2,25,000 |
5,25,000 |
Mangalore |
2,25,000 |
5,25,000 |
Meerut |
2,00,000 |
5,00,000 |
Moradabad |
2,00,000 |
5,00,000 |
Mumbai |
2,50,000 |
5,50,000 |
Mysore |
2,50,000 |
5,50,000 |
Nagpur |
2,25,000 |
5,25,000 |
Nashik |
2,25,000 |
5,25,000 |
Navi Mumbai |
2,50,000 |
5,50,000 |
Noida |
2,50,000 |
5,50,000 |
Patna |
2,00,000 |
5,00,000 |
Pune |
2,50,000 |
5,50,000 |
Raipur |
2,25,000 |
5,25,000 |
Rajkot |
2,25,000 |
5,25,000 |
Ranchi |
2,00,000 |
5,00,000 |
Surat |
2,50,000 |
5,50,000 |
Thane |
2,50,000 |
5,50,000 |
Vadodara |
2,25,000 |
5,25,000 |
Varanasi |
2,00,000 |
5,00,000 |
Visakhapatnam |
2,25,000 |
5,25,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.