Right Heart Catheterization-Related Complications

Abstract

Right heart catheterization (RHC) is considered to be the gold standard for the measurement of pulmonary artery pressure and has a class 1 indication to confirm the diagnosis of pulmonary arterial hypertension and to guide treatment decisions. Associated complications with RHC in contemporary practice are uncommon. In this review, we aim to summarize the complications that have been published in case reports or case series with updated management and techniques to prevent and mitigate complications. We searched the PubMed database for the following reports: “right heart catheterization,” “Swan-Ganz catheter,” “pulmonary artery catheter,” “balloon-tip catheter,” and “complication” or “adverse event.” Complications reported in 46 manuscripts were included in the final analysis. After evaluation of all reports, complications were grouped categorically. We found that the most commonly reported access site-related issues were either carotid artery injury or arteriovenous fistula formation, and injury to the tricuspid valve was the most commonly reported catheter-related complication. Our findings suggest that infrequent complications can occur with RHC and can be fatal. The optimal technique should be used to minimize complications. Operators should always be cautious during the procedure and monitor the patient closely.

Right Heart Catheterization in Pediatric Pulmonary Arterial Hypertension: Insights and Outcome from a Large Tertiary Center

“…RHC is considered to be the gold standard for the measurement of pulmonary artery pressure and an effective tool to evaluate the pulmonary vascular reversibility [3,22]. According to the latest European Cardiology Society guidelines [1], defect closure was recommended in patients with PVRI less than 4 WU•m 2 .…”

Venous excess ultrasonography (VExUS) captures dynamic changes in volume status surrounding hemodialysis: A multicenter prospective observational study

“…More importantly, such procedures cannot be performed serially at the bedside to inform clinical decisions such as the initiation or discontinuation of volume resuscitation, diuresis or renal replacement therapy. 6,7 Even indwelling pulmonary artery catheters, which can be utilized for serial monitoring over time, are associated with added cost and risk of complications. 8,9 As we move towards the personalization of care for critically ill patients with conditions such as septic shock and decompensated heart failure, it is increasingly pressing to develop a standardized point-of-care method for evaluating volume status that can inform clinical decision-making in real-time.…”

Effects of maternal pulmonary arterial hypertension on fetal hemodynamics and maternal‐fetal outcome in late pregnancy

“…Pregnant women with PAH are prone to develop hypoxemia in the late stages of pregnancy, resulting in reduced placental perfusion pressure and intrauterine fetal hypoxia. 3,4 As a result, the incidence of preterm birth, low birth weight and neonatal asphyxia is high. 1,5 In patients with PAH in late pregnancy, the timing of delivery has a significant impact on prognosis.…”

“…However, some women with PAH choose to become pregnant or continue their pregnancy. Pregnant women with PAH are prone to develop hypoxemia in the late stages of pregnancy, resulting in reduced placental perfusion pressure and intrauterine fetal hypoxia 3,4 . As a result, the incidence of preterm birth, low birth weight and neonatal asphyxia is high 1,5 .…”