Chronic Thromboembolic Pulmonary Hypertension (CTEPH) Program

The Chronic Thromboembolic Pulmonary Hypertension (CTEPH) program is a collaboration between Houston Methodist DeBakey Heart & Vascular Center and Houston Methodist Lung Center. The program offers specialized care to CTEPH patients, and is one of few programs nationwide to perform CTEPH surgery — the only potentially curative option for CTEPH patients.


Not all CTEPH patients are suitable candidates for surgery, due to other medical issues or the location of blood clots in their lungs. For such patients, a new, catheter-based procedure called balloon pulmonary angioplasty (BPA) is available. This highly specialized procedure uses a small balloon to dilate the pulmonary artery, increasing blood flow. Houston Methodist is one of only a few hospitals in the country, and the only one in the region, with the expertise to treat CTEPH patients using BPA.

Our Approach to CTEPH Treatment


CTEPH leads to pulmonary hypertension, which is caused by blood clots in the lungs. It can be treated surgically and with medications.

Our team of cardiovascular and thoracic surgeons and cardiologists works with highly skilled pulmonologists who have vast expertise in identifying and treating CTEPH patients. CTEPH frequently is misdiagnosed as asthma, bronchitis, heart failure or being physically unfit.


Our experts perform a range of tests to properly assess and diagnose CTEPH, including a ventilation-perfusion scan (VQ scan), which is one of the most effective ways identify CTEPH. Diagnostic tests are also used to determine the best course of treatment.


Every patient is evaluated in a multidisciplinary team approach, to assess the risks and benefits of surgery, which can cure the condition. During this surgery, called pulmonary thromboendarterectomy (PTE), our surgeons remove blood clots from the pulmonary arteries, which can control pulmonary pressures and restore right-heart function.


We respond within two business days to patient and caregiver queries and website referrals.


What is CTEPH?

Chronic Thromboembolic Pulmonary Hypertension (CTEPH) is high blood pressure in the arteries of the lungs caused by clot-like masses.

What causes CTEPH?

Causes of CTEPH include:
  • Blood-clotting disorders
  • Deep venous thrombosis (DVT), or blood clots in leg or pelvis
  • Long periods of inactivity, such as extended travel or bed rest
  • Contraceptives and hormone replacements
  • Diseases, including cancerperipheral artery disease and heart disease
  • Some surgeries, such as hip or knee replacement
  • Bone fractures
  • Family or personal blood clot history
  • Spleen removal
  • Long-term use of intravenous catheters, including those for dialysis 

What are the symptoms of CTEPH?

Symptoms of CTEPH include:

  • Shortness of breath 
  • Chest pain
  • Fatigue
  • Palpitations
  • Edema, or fluid collection in the legs or abdomen
  • Fainting

How is CTEPH diagnosed?

CTEPH is diagnosed via the following diagnostic tests:

  • Right-heart catheterization
  • Echocardiogram
  • Ventilation-perfusion scan (VQ scan)
  • Pulmonary angiogram – shows blood flow through the lungs
  • Pulmonary function tests
  • Chest CT scan
  • Exercise testing – to determine how your body responds to increased oxygen demand during exercise

How is CTEPH treated?

CTEPH treatment options include:

  • Pulmonary thromboendarterectomy (PTE) surgery
  • Balloon pulmonary angioplasty (BPA)
  • Medications for patients unable to undergo surgery

How Patients Are Evaluated


A patient’s initial evaluation begins at the Houston Methodist Lung Center. Depending on the results of this evaluation, the patient will then see one of our cardiologists and a surgeon.


The CTEPH team discusses every new case in our monthly meeting and, during this time, our specialists work together to determine the best course of treatment for each patient.


Our CTEPH Program Team


Mahesh Ramchandani, MD, chief, section of cardiac surgery, surgical director, CTEPH program

Sandeep Sahay, MD, medical co-director, CTEPH program

Ashrith Guha, MD, medical co-director, CTEPH program

Zeenat Safdar, MD, interim director, Houston Methodist Lung Center and director of pulmonary hypertension program


CTEPH patients first are evaluated by our specialists at the Houston Methodist Lung Center. To request an appointment or make a physician referral call 713.441.7779 or click here.
Call 713.441.7779

Houston Methodist Hospital is among the country's top hospitals in 10 specialties by U.S. News & World Report, including pulmonology and cardiology.

CTEPH Program
Houston Methodist Lung Center
Houston Methodist Outpatient Center, 22nd Floor
6445 Main St.
Houston, TX 77030