Pulmonary Artery Rupture Associated With the Swan-Ganz Catheter

Selective embolization of a pulmonary artery rupture caused by a Cournand catheter

“…However, all these figures arise from small studies and case reports. Kearney et al [2] published a large retrospective study of more than 32,000 patients studied with Swan-Ganz catheters and found an incidence of pulmonary artery rupture of 0.0031% with a high mortality of 70%.…”

“…Besides advanced age, pulmonary hypertension with sclerotic and fragile vessels and high pressure gradients across the pulmonary vascular bed have been identified as major risk factors [6]. Oral anticoagulation is probably not a risk factor for rupture of the vessel wall but rather one for continued bleeding after rupture [2]. An analysis of the FDA database revealed postmenopausal female as another significant risk factor for pulmonary rupture [7].…”

“…If hemothorax is present, the patient should undergo thoracotomy since nonsurgical treatment is associated with an excessive morality. In contrast, patients without hemothorax have a survival of up to 75% with both surgical and nonsurgical treatment strategies [2]. Among nonsurgical approaches, balloon tamponade of the ruptured artery [10], tamponade of the bleeding lung by bronchoscopy [5], and embolization of the ruptured branch [11][12][13][14][15][16][17][18] have been suggested.…”

“…Pulmonary artery rupture is a well-recognized complication of right heart catheterization with a high mortality rate [1,2]. Treatment strategies depend mainly on the patient's clinical status and the presence of additional risk factors such as pulmonary artery hypertension and/or oral anticoagulation or complications such as hemothorax.…”

Successful retrieval of a knotted Swan- -Ganz catheter using interventional approach in an adult: a case report

“…Well-documented complications include arrhythmias, infection, thrombophlebitis, thrombosis, cardiac perforation and pulmonary artery rupture [8]. The lattermost is the most severe complication due to catheterization, with an estimated incidence of 0.03−0.2%, mortality of 70% [9,10]. Catheter knotting is a rare but known complication [11,12], here we present a case involving a knotted an entrapped Swan-Ganz catheter that was successfully removed by a snare using interventional approaches.…”