CASE REPORT Short-term intravenous iloprost for treatment of reperfusion lung oedema after pulmonary thromboendarterectomy

C hronic thromboembolic pulmonary hypertension (CTEPH) is the result of chronic obstruction of the pulmonary arteries by thrombi which ultimately leads to right heart failure and death. Pulmonary thromboendarterectomy (PTE) has emerged as a standard therapeutic approach. Reperfusion lung oedema (RLE), which presents as acute deteriorating oxygenation and postoperative pulmonary hypertension, is the single most frequent complication of PTE. Mechanical ventilation and inhaled nitric oxide (NO) have been advocated to improve RLE, but this treatment does not work in all patients. We describe a case of RLE after PTE who responded poorly to mechanical ventilation and inhaled NO but was successfully treated with intravenous iloprost given for 7 days.