Intrapulmonary activated factor seven for hemoptysis complicating pulmonary thromboendarterectomy.

Massive hemoptysis represents a life-threatening disorder due to different etiologies. Development of recombinant factor concentrates allows for novel treatments in this emergent setting. We present a patient with chronic thromboembolic pulmonary hypertension who underwent pulmonary thromboendarterectomy. Postoperative course was complicated by massive hemoptysis resulting in severe hypoxemia requiring extracorporeal membrane oxygenation and multiple daily blood transfusions. After failure of conservative and interventional approaches, recombinant factor seven was administered via bronchial isolation. Following treatment, her hemoptysis dramatically resolved with eventual discharge and excellent function at follow-up. This case presents the novel use of intrapulmonary activated factor seven to control massive hemoptysis.