Pulmonary Artery Catheter Passing between the Chordae Tendineae of the Tricuspid Valve

Flail Tricuspid Valve after Snare Retrieval of a Vascular Angioplasty Balloon

“…Damage to the tricuspid chordal apparatus by withdrawal of an inflated Swan-Ganz balloon catheter has been proposed as a mechanism of valve injury if the catheter should become entangled in the subvalvular apparatus. 7,8 In this case, if the retrieval snares had passed through the chordal structures and allowed subsequent passing of the balloon retrograde through these structures, significant damage to the tricuspid subvalvular structures may have occurred. One can also speculate that one of the many guide wire or snare catheters used in this case may have become entrapped within the tricuspid valve chordae.…”

“…This case is unique as the tricuspid valve was likely damaged by retrograde withdrawal of a vascular angioplasty balloon from the pulmonary artery to the SVC. Damage to the tricuspid chordal apparatus by withdrawal of an inflated Swan–Ganz balloon catheter has been proposed as a mechanism of valve injury if the catheter should become entangled in the subvalvular apparatus 7,8 . In this case, if the retrieval snares had passed through the chordal structures and allowed subsequent passing of the balloon retrograde through these structures, significant damage to the tricuspid subvalvular structures may have occurred.…”