Successful thrombolysis after pulmonary endarterectomy.

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.