Pulmonary artery rupture with pseudoaneurysm formation secondary to Swan–Ganz catheter balloon inflation

Atreya, Auras R.; Arora, Sonali; Valania, Gregory

doi:10.3109/17482941.2016.1174270

Cited by 4 publications

(3 citation statements)

References 4 publications

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“…Once positioning into the PA was determined during angiography, it was decided to remove the tube. As the PA is a low pressure system this should be safe based on most cases of incidental PA catheter perforation although hemoptysis and pseudoaneurysm formation requiring intervention have been described [ 12 ]. Due to the small diameter port a cath catheter, only a minor injury to the vessel occurred and on CT scan no active bleed but a hematoma was detected.…”

Section: Discussionmentioning

confidence: 99%

Accidental placement of an infusaport into the pulmonary artery: Case report and review of the literature

Bonatti

2019

Respiratory Medicine Case Reports

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BackgroundMisplacement of central venous catheters (CVC) may have devastating consequences.Patients and methodsPlacement of a CVC into the pulmonary artery (PA) and management of the complication is described. Literature search for accidental direct placement of CVCs into the PA was performed.ResultsA 46 year old morbidly obese female required an infusaport for chemotherapy. She was anaesthetized and placed in Trendelenburg. Three attempts to access the left subclavian vein (LSCV) using landmarks failed. In steeper Trendelenburg, a blood vessels was accessed. Non pulsatile dark blood was aspirated, a guidewire was easily advanced. Fluoroscopy projected the guidewire tip over the right atrium; infusaport placement was without difficulties. Postoperative chest x-ray showed the tube initially pointing caudally, then traversing the midline with the tip projecting over the right atrium. Emergent angiogram showed placement of the tube into the mainstem of the PA. The tube was removed; CT-angiogram showed no extravasation but a 3cm left mediastinal hematoma. Transfer to an ICU in a facility offering emergent cardiothoracic surgery was done. She remained stable, repeat CT-scan showed decreased hematoma size and she was retransferred. The infusaport was placed under ultrasound guidance into the left jugular vein. Six additional cases of direct puncture of the PA were reported; in all except one the LSCV had been targeted. No patient died directly from the complication, all catheters were removed, four patients required surgery or interventional procedures.ConclusionsAccidental placement of CVC s into the PA is a rare complication. The catheter should be removed. Patients should be urgently transferred to a center with access to interventional radiology and cardiothoracic surgery.

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Section: Discussionmentioning

confidence: 99%

Accidental placement of an infusaport into the pulmonary artery: Case report and review of the literature

Bonatti

2019

Respiratory Medicine Case Reports

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“…Post-traumatic PAPAs due to direct or indirect trauma and iatrogenic pseudoaneurysm formation due to Swan-Ganz catheter mispositioning or repetitive traumatic injury of permanent venous or arterial catheters can also occur [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The presentation of PAPAs may be asymptomatic or, often, characterized by massive hemoptysis, dyspnea, and coughing, which can quickly evolve into hypovolemic hemorrhagic shock if not treated promptly [32][33][34][35][36][37][38][39][40][41][42][43].…”

Section: Introductionmentioning

confidence: 99%

Pulmonary Artery Pseudoaneurysms Embolization: Bicentric Experience and Review of the Literature

Fontana

Piacentino

Curti

et al. 2023

JCM

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The purpose of this bicentric case series was to report the safety, efficacy, and clinical outcome of transcatheter embolization in pulmonary artery pseudoaneurysms (PAPAs). Between January 2016 and June 2021, eight patients with PAPA were subjected to transcatheter embolization. The total number of patients was eight, of which five were female, with a mean age of 62 ± 14 years (average ± standard deviation). Etiology was traumatic in 2/8 cases and iatrogenic in 6/8 cases (after positioning a Swan-Ganz catheter in 5/6 cases and a temporary pacemaker in the latter case). In a single case, the PAPA was incidentally discovered during a routine X-ray, in the remaining 7 cases, the procedure was performed in emergency settings. PAPA embolization was performed using detachable coils alone in 3 cases; coils and glue in 1 case; coils, glue, and vascular plug in 1 case; coils and non-adhesive liquid embolic agents (Onyx and Squid respectively) in 2 cases; and non-adhesive liquid embolic agent alone (Onyx) in 1 case. No peri-procedural or post-procedural complications were recorded. Both the technical and clinical success rates were 100.0%. In conclusion, endovascular embolization is a technically feasible and safe therapeutic option for patients with PAPAs.

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“…The gold standard of CO measurement during liver transplantation is the thermodilution technique using a pulmonary artery catheter (PAC) [ 2 ]. However, complications have been reported regarding the placement of the PAC, such as pneumothorax, air embolus, arrhythmia, right bundle branch block, catheter knotting, thrombosis [ 3 ], right ventricular rupture [ 4 ] or pulmonary artery rupture [ 5 ]. Whether there is an additional benefit to decision making provided by a PAC over standard care in elderly, high-risk surgical patients requiring intensive care [ 6 – 9 ] is questionable.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive cardiac output measurement with electrical velocimetry in patients undergoing liver transplantation: comparison of an invasive method with pulmonary thermodilution

et al. 2018

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BackgroundThe goal of this study was to evaluate the accuracy and interchangeability between continuous cardiac output (CO) measured by electrical velocimetry (COEv) and continuous cardiac output obtained using the pulmonary thermodilution method (COPAC) during living donor liver transplantation (LDLT).MethodTwenty-three patients were enrolled in this prospective observational study. CO was recorded by both two methods and compared at nine specific time points. The data were analyzed using correlation coefficients, Bland-Altman analysis for the percentage errors, and the concordance rate for trend analysis using a four-quadrant plot.ResultsIn total, 207 paired datasets were recorded during LDLT. CO data were in the range of 2.8–12.7 L/min measured by PAC and 3.4–14.9 L/min derived from the EV machine. The correction coefficient between COPAC and COEv was 0.415 with p < 0.01. The 95% limitation agreement was − 5.9 to 3.4 L/min and the percentage error was 60%. The concordance rate was 56.5%.ConclusionsThe Aesculon™ monitor is not yet interchangeable with continuous thermodilution CO monitoring during LDLT.Trial registrationThe study was approved by the Institutional Review Board of Chang Gung Medical Foundation in Taiwan (registration number: 201600264B0).

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Pulmonary artery rupture with pseudoaneurysm formation secondary to Swan–Ganz catheter balloon inflation

Cited by 4 publications

References 4 publications

Accidental placement of an infusaport into the pulmonary artery: Case report and review of the literature

Accidental placement of an infusaport into the pulmonary artery: Case report and review of the literature

Pulmonary Artery Pseudoaneurysms Embolization: Bicentric Experience and Review of the Literature

Non-invasive cardiac output measurement with electrical velocimetry in patients undergoing liver transplantation: comparison of an invasive method with pulmonary thermodilution

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