Massive bilateral pulmonary emboli complicating coronary artery bypass grafting: a case report

We report an unusual case of massive bilateral pulmonary emboli following single coronary artery bypass grafting on cardiopulmonary bypass. The patient was admitted electively, received deep vein thrombosis prophylaxis, and had no clinical evidence of deep vein thrombosis in the perioperative period. On the tenth postoperative day he developed sudden dyspnea and a diagnosis of pulmonary embolus was made with computed tomography. Despite full anticoagulation he continued to deteriorate, and despite attempts at pulmonary embolectomy he died of right-sided heart failure. Post-mortem confirmed the diagnosis, but there was no evidence of thrombi in the pelvic and leg veins.