Knot in the Cava—An Unusual Complication of Swan–Ganz Catheters

Bagul, Nitin B; Menon, N.J.; Pathak, Rahul; Platts, Andrew; Hamilton, George

doi:10.1016/j.ejvs.2005.02.017

Cited by 24 publications

(18 citation statements)

References 25 publications

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“…Primary surgical removal performing a cutdown and venotomy at the initial insertion site has also been described [7][8][9]. For large and complex knots, surgical removal is often the only option and is performed via cutdown or open procedures, occasionally requiring cardiopulmonary bypass [6][7][8][9]11].…”

Section: Discussionmentioning

confidence: 99%

Nonsurgical Removal of Knotted Pulmonary Artery Catheter

Smith

2013

J Med Cases

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Though controversy exists regarding the utility of pulmonary artery catheters (PAC), their use persists in select patients. Knotting of these catheters upon insertion is a rare but serious complication. We present 2 cases of coagulopathic patients undergoing orthotopic liver transplantation complicated by PAC knotting on attempted line placement. Both knotted PAC were successfully removed nonsurgically in the operating room, allowing for timely continuation of the planned transplantations. It is essential for the clinician to recognize knotted PAC and understand strategies for safe removal.

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Section: Discussionmentioning

confidence: 99%

Nonsurgical Removal of Knotted Pulmonary Artery Catheter

Smith

2013

J Med Cases

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“…Described complications are arrhythmias, knotting of the catheter [20], perforations of superior vena cava, right atrium, RV [5,[11][12][13][14][15][16][17] and pulmonary artery [18,21,22]. They have a incidence of 0.03% to 1% of all cases [21].…”

Section: Discussionmentioning

confidence: 99%

Story of a Little Right Ventricular Pseudoaneurysm

Uluçam¹

2012

OJMI

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Cardiac trauma caused by Swann-Ganz catheter may very rarely cause cardiac perforation, tamponade and right ventricular pseudoaneurysm. In contrast to left ventricular equivalants, pseudoaneurysms of the RV have a weak tendency to rupture. Its impact on patient outcomes should be assesed very carefully depending on its size, filling rate/capacity. It is possible not to operate the patient and follow progression of RV pseudoaneurysm by clinical and echocardiographic findings. This case is a good sample for it and describes the lifespan of a small RV pseudoaneurysm. It is not only the unique right ventricle pseudoaneurysm due to cardiac trauma caused by Swann Ganz catheter, but medically treated case without surgery and recovered completely.

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“…5 Despite the absence of clear-cut evidence showing improved outcomes using the Swan-Ganz catheter, its use is still rampant today. 6 This comes, though, with considerable morbidity and mortality in an already physiologically compromised patient pool. Some of the complications associated with Swan-Ganz catheters are those related to catheter insertion such as pneumothorax/hemothorax, arterial injury, cardiac ar-rhythmias, valvular damage, creation of ventricular aneurysms, and pulmonary artery perforation and death; and those related to an indwelling foreign body such as infection, endocarditis, pulmonary artery thrombosis and infarction, and thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

A Knot in the Heart

Hesham

Kaufman

Zenilman

2008

The American Surgeon™

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Few diagnostic modalities in medicine have been the subject of greater debate for as long after their inception as the pulmonary artery catheter. Placement of a Swan-Ganz catheter is associated with various complications, one of which is knotting. Complications of usage of these catheters are numerous and can have devastating effects. Knotting of Swan-Ganz catheters is a rare complication that can often be managed successfully using interventional radiological techniques. The case reported is a rare case of Swan-Ganz catheter knotting resulting from inserting an excessive length of Swan-Ganz catheter into the heart. Knotting can be prevented by following the principle rule in floating Swan-Ganz catheters by correlating the inserted length of pulmonary artery catheter (PAC) with the expected change in waveform.

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Knot in the Cava—An Unusual Complication of Swan–Ganz Catheters

Cited by 24 publications

References 25 publications

Nonsurgical Removal of Knotted Pulmonary Artery Catheter

Nonsurgical Removal of Knotted Pulmonary Artery Catheter

Story of a Little Right Ventricular Pseudoaneurysm

A Knot in the Heart

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