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Monday, December 9, 2013
Scar Tissue in Lungs
My 34 year old daughter got blood clots in her lungs two years ago and recently saw a Pulomalogist. She is using oxygen 24/7 and still is in tremedious pain. He had a sleep study and now is discussing surgery to remove the scare tissue. I can`t find anything on this, can you assist me? Please inform me all you know. She also has congested heart failure and RA. Thank you, Concerned Mother
Most patients who have pulmonary emboli (blood clots) have complete resolution of the clots fairly shortly after starting treatment. In a small percentage of patients, the blood clots do not dissolve and instead convert to scar inside of the blood vessels of the lung. This is a condition called "chronic thromboembolic disease".
Patients with this condition can develop pulmonary hypertension, right-sided heart failure (blood backing up behind the right ventricle of the heart), and a low blood oxygen level. The treatment for this ocndition is a surgery called "pulmonary thromboendarterectomy" when a surgeon opens the chest and removes the scar tissue from within the blood vessels of the lung.
This is a complex procedure that is most commonly done at larger hospitals with experienced teams of surgeons, anesthesiologists, and pulmonologists on hand to manage them. Successful surgery can result in a substantial improvement in the quality of life and many patients are able to come off of oxygen.
It is also important to look for reasons why young persons clot - many will have either inherited causes of clotting or will have a condition called "anti-phospholipid antibody syndrome", a condition that can occasionally occur with diseases such as rheumatoid arthritis.
From your question, I was not sure if this is the type of scar tissue that you were asking about.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University