Arch vessel injury during pulmonary artery catheter placement

We have observed seven instances of unintentional cannulation of major arteries with 8F sheaths during preparation for open-heart operation. When the sheath was removed and the operation delayed, there were no complications; in the two instances in which the open-heart operation was performed immediately after arterial cannulation, there was 1 death due to hemorrhage and 1 false aneurysm of the carotid artery. Elective open-heart operations should be delayed if unintentional cannulation of a major artery occurs.