title: Successful thrombolysis after pulmonary endarterectomy.
abstract: We report the case of a 51-year-old woman who underwent pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension. On postoperative day 1 she developed bilateral pulmonary thrombosis due to preoperatively undiagnosed heparin-induced thrombocytopenia. Systemic thrombolytic therapy with alteplase on postoperative days 5 and 6 resulted in marked clinical improvement. To our knowledge this is the first report of successful thrombolysis of pulmonary thrombosis due to heparin-induced thrombocytopenia after pulmonary endarterectomy.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, University Hospital of Saarland, Homburg/Saar, Germany.
authors.forename: Kathrin I
authors.initials: KI
authors.lastname: Schmidt
authors.forename: Peter
authors.initials: P
authors.lastname: Fries
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Feldner
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Schäfers
mesh_terms: D002908:Chronic Disease; D004691:Endarterectomy / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D011669:Pulmonary Wedge Pressure; D015912:Thrombolytic Therapy / Q000379:methods*; D014655:Vascular Resistance
chemical_list: D005343:Fibrinolytic Agents