Severe-Pulmonary-Embolism-Chronic-Thromboembolic-Pulmonary-Hypertension

Clinical Case Report: Pulmonary Thromboendarterectomy-PTE (Pulmonary endarterectomy-PEA) and Pulmonary Embolectomy for Chronic Thromboembolic Pulmonary Hypertension [CTEPH] and Severe Pulmonary Embolism in a 59 Years Male Patient from Cameroon

Patient has been a case of Severe Pulmonary Embolism and Chronic Thromboembolic Pulmonary Hypertension, secondary to Pulmonary Embolism.

A pulmonary embolism (PE) is a potentially life-threatening blockage in a lung artery, most often caused by a blood clot that forms in the deep veins of the legs and travels to the lungs. 

Chronic Thromboembolic Pulmonary Hypertension, a condition where blood clots in the lungs become organized, leading to high blood pressure in the pulmonary arteries. It is a complication of acute pulmonary embolism, causing vascular obstruction and remodelling that results in pulmonary hypertension (PH) and can lead to right heart failure if untreated. 

Possible Line of Treatment – Post investigations we may have 3 possibilities in this case –

1. Medical Management with anticoagulants – These medications are the main treatment for pulmonary embolism (PE), slowing clot formation and preventing existing clots from growing. They can be given by injection. Long-term use is often necessary, typically for at least three to six months. (This looks less likely to be offered in this case).

• IVF Filter Placement – a filter can be placed in the inferior vena cava, the main vein that carries blood from the legs to the heart. This filter acts as a sieve to prevent blood clots from traveling to the lungs. 
• Surgery – Pulmonary Embolectomy or Pulmonary endarterectomy (PEA), or pulmonary thromboendarterectomy (PTE) – These are surgical procedures to remove obstructive blood clots and scar tissue from the pulmonary arteries, treating chronic thromboembolic pulmonary hypertension (CTEPH). (One of these are more likely to be offered.

The choice of procedures from one of the above will depend upon investigative outcome from following tests – CT Chest, Pulmonary Angiography, Bronchoscopy, Lung Function Tests, ECG, ECHO, and other routine tests.

We will recommend the following Cardiothoracic surgeons- 

1. Medanta’s Hospital-Gurgaon // Dr. Naresh Trehan 

 Kindly take a look at the hospital – https://pin.it/52SLu66Zq

2.Amrita Hospitals, Faridabad // Dr. Abhinav Sharma 

Kindly take a look at the hospital – https://pin.it/6VWWsyyzq

3. Artemis Hospital, Gurgaon // Dr. Surendra Nath Khanna

 Kindly take a look at the hospital – https://pin.it/1bs51UAGE

4. BLK-MAX Super Specialty Hospital // Dr. Ramji Malhotra 

Kindly take a look at the hospital – https://pin.it/1Ji84QapI

Estimated costs:

Estimated cost of Initial Evaluations will be approx. USD 500-600 on OPD basis-

Estimated cost of Angiography will be approx. USD 350-450

The Estimated Cost of Surgery- Pulmonary Embolectomy at various hospitals is as below: –
 

The Estimated Cost of Surgery- Pulmonary endarterectomy (PEA), or pulmonary thromboendarterectomy (PTE) at various hospitals is as below: –

Cost of IVC filter placement may come between $4000 and $5200 depending upon hospital chosen. This will be done if he is not found to be a candidate for Medical Management or Surgery.

Kindly Note: The above rates are on approximate basis; actual charges will depend upon the final plan confirmed on the basis of medical evaluation at the hospital.

Stay in India: Patient will require 3-5 days for initial evaluations on an OPD basis.

For Surgery- Patient will require 5-7 days of hospitalization for surgery. Post-Discharge he may require 10-15 days for follow up and recuperation.

Total Length Stay in India will be approx.-1 month.

 Inclusions in the Costs: 

1. The cost of all investigations related to the surgery

2. The cost of the treatment.

3. The doctor’s fee and surgery charges.

4. The stay of the patient and 1 attendant during hospital admission.

5. All meals for the patient and the attendant as per the available menu while in hospital.

6. Medical Consumables and Medicines while in hospital.

7. The fee for dietician and nursing while in hospital.

8. It also includes complimentary Airport Transfers, Forex Services, and assistance.

 Exclusions:

1. Any consultation other than in discussion.

2. Extended stay

3. Treatment for any other illness

4. If & when the patient is shifted to ICU (Intensive Care Unit) then attendant has to vacate the room and shift to a Guest House near the Hospital.

On Arrival: Patient and attendants will be received at the airport by our Representative. Apart from the medical and nursing team, one Case Manager will take care of all the needs. We shall also assist them with the reasonably charged accommodation near the hospital. You and attendant may arrange 35-50 USD per day toward accommodation and food at Guest House. 

Should you be having any queries or clarifications, we will be happy to answer & shall look forward to assisting you.

Regards,

Abhik.