Successful thrombolysis for massive pulmonary embolism after pulmonary resection

We report the successful use of thrombolysis for acute massive pulmonary em bolism 2 days after right lower lobectomy for bronchial adenocarcinoma. Pul monary angiography revealed extensive clot unsuitable for surgical embolect omy. A bolus infusion of recombinant tissue plasminogen activator produced an immediate improvement in the patient's hemodynamic state. There was subs tantial blood loss requiring the transfusion of 21 units of blood over the postoperative period. The patient made a successful recovery and remained w ell at 1 year. (C) 1999 by The Society of Thoracic Surgeons.