[Knotting Swan-Ganz catheter in right pulmonary artery]

Knotting Swan-Ganz catheter is a rare complication of hemodynamic monitoring. This is the second case reported in Mexico in over 20 years. Identified risk factors that increase likelihood of loop formation knotting of the catheter are blind introduction and small diameter of catheter, incomplete balloon inflation before advancing it, several tries to wedge it, bending of the catheter by heat, and enlarged right heart chambers. More frequent sites of knotting are right atrium and ventricle, subclavian vein, and pulmonary artery and its branches. Diagnostic confirmation is made by chest radiography, fluoroscopy, and echocardiography. Therapeutic approach depends on knot characteristics, either non-surgical or surgical.