Friday, September 20, 2013

Road to recovery: Pedaling past PTE


Price and his wife Jean

Three years ago, John Price clutched the handlebars of his bike and attempted to slowly maneuver it up a short hill. His chest was tight, his heart racing and the near constant sense of being out of breath worsened with every step.

An avid runner and cyclist, the now 62-year-old Price had first noticed symptoms about four years earlier when his 7-minute miles began to steadily turn into 9- and 10-minute miles. “And then at one point I couldn’t even jog 50 yards without being out of breath,” he says. “It finally got to the point where it was so bad that I could barely breathe.”

Over the course of the next several months, a barrage of clinical tests to check for cardiac deficiencies all revealed that the Smith Point, New York, resident had a healthy heart. Yet his symptoms persisted – and soon worsened. Finally, Price says, a specialist diagnosed him with pulmonary hypertension, a lung disorder in which blood clots line the arteries in the lungs, restricting blood flow and causing blood pressure in the arteries to rise significantly.

Although overwhelming, the diagnosis was a relief, Price says. “It was actually a godsend because they found something wrong. They had been focusing on the heart and luckily they checked the lungs and found the clots,” he says.

Price was referred to the MGH where he learned he was a candidate for pulmonary thromboendarterectomy (PTE), a highly specialized operation to remove these chronic blood clots. Without surgery, patients who have this life-threatening disease will likely develop progressive shortness of breath so severe that it leads
to heart failure.

“It’s an amazing procedure,” says Richard Channick, MD, director of the MGH Pulmonary Hypertension and Thromboendarterectomy Program. “The patient is placed on a heart-lung machine and their body is cooled to less than 18 degrees Celsius. The surgeon then carefully peels the chronic blood clots away from the insides of the vessels. When done by experienced surgeons, the procedure can cure the problem.”

The PTE procedure was pioneered in the 1960s by physicians and surgeons at the University of California, San Diego. Three years ago Channick, who had been part of that program for more than 20 years, came to the MGH to become director of the MGH’s growing Pulmonary Hypertension and Thromboendarterectomy Program. Since Channick’s arrival the MGH program –
featuring a close collaboration with thoracic surgeon Cameron Wright, MD, and cardiac surgeons

Gus Vlahakes, MD, and Thoralf Sundt, MD – has established itself as a national referral center and is now the second largest program in the country. The MGH recently completed its 50th PTE and performs about
one of these specialized procedures every week. 

Despite the intensity of the surgery, the typical recovery is relatively brief. Most patients stay in the hospital for only five to seven days before returning home to their new and improved life. “The shortness of breath is relieved almost immediately,” Channick says. “And our patients say that they feel like a huge weight has been lifted off of their chest. It’s really, really satisfying to see the patients return home to a much better quality of life. Many of these patients would have died if we didn’t offer this resource.”

A year and a half after his surgery, Price is thankful to be feeling better and for the ability to be back to enjoying his active lifestyle. He recently took a four-day, 120-mile cycling trip through Glacier National Park in Montana. “I kind of jumped at the chance to do the surgery,” Price says. “It was something that I didn’t take lightly because the surgery itself is pretty serious – but I don’t know where I’d be today if I didn’t have the operation. The doctors were incredible – really miracle workers. I was going downhill pretty quickly. But now when I’m on my bike, I’m pedaling up those hills.

“Until the day I meet my maker, I will always thank them for giving me the quality of life that I wouldn’t have had,” Price adds. “I still have living left to do.” 

Read more articles from the 09/20/13 Hotline issue.

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