Massive Pulmonary Embolism in the Early Postoperative Period Following Coronary Artery Bypass Surgery

Asymptomatic venous thromboembolism is surprisingly frequent following coronary artery bypass surgery. In most cases, this situation is not clinically important, however it may lead to clinical conditions such as deep venous thrombosis and pulmonary embolism which are life threatening with high morbidity and mortality. Pulmonary thromboembolism following coronary artery bypass surgery is a rare complication. Although there is not a standard therapy protocol, early diagnose and therapeutic approach are vitally important for a successful result. Sixty three year old male patient was operated coronary artery bypass grafting with cardiopulmonary bypass. Respiratory and cardiac arrest following sudden syncope occured during mobilization on the 3rd postoperative day in the inpatient clinic. The transthoracic echocardiographic imaging revealed thrombus in the apical segment of the right ventricle, and thrombus in bilateral pulmonary arteries were found in the spiral computerized tomography scan. Thrombolytic therapy was administered with the diagnosis of acute pulmonary embolism. The clinical and radiological findings were resolved on the 48th hour of therapy. In this paper, we aimed to present thrombolytic therapy and its efficiency in a case of massive (high risk) pulmonary embolism in the early postoperative period following coronary artery bypass surgery for which the ethiologic factor was thought to be the thrombus in the right ventricle.