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[Inadvertant intracardiac entrapment of a Swan-Ganz catheter]
A Klockgether-Radke1, J Rathgeber, H Lange
1Zentrum Anaesthesiologie, Rettungs- und Intensivmedizin, Georg-August-Universität Göttingen.
Insights
A Swan-Ganz catheter became entrapped within the heart during cardiac surgery due to a misplaced suture. Surgical release of the suture allowed for safe catheter removal, highlighting a rare complication of cardiac procedures.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Device Complications
Background:
- A 58-year-old male patient presented with coronary artery disease and aortic valve insufficiency, necessitating cardiac surgery.
- The patient underwent single coronary bypass grafting and ascending aorta replacement using a composite graft.
Observation:
- A Swan-Ganz catheter was inserted via the right internal jugular vein for intraoperative monitoring.
- Post-operatively, the catheter could not be removed, prompting further investigation.
Findings:
- Fluoroscopy revealed intracardiac entrapment of the Swan-Ganz catheter.
- Rethoracotomy identified the catheter ensnared by a purse-string suture.
Implications:
- This case highlights a rare but serious complication of Swan-Ganz catheter use in cardiac surgery.
- Proper suture technique and vigilance are crucial to prevent catheter entrapment.
- Prompt diagnosis and surgical intervention are necessary for safe catheter retrieval.
Abstract:
A 58-year-old man, admitted with one-vessel coronary disease and aortic valve insufficiency, was scheduled for cardiac surgery. He underwent single coronary bypass grafting and aorta ascendens replacement by a composite graft. During surgery he was monitored by a Swan-Ganz catheter, which had been inserted uneventfully via the right internal jugular vein. Six hours after completion of surgery we were unable to remove this catheter. Fluoroscopy showed intracardiac entrapment of the catheter. Rethoractomy was performed, revealing entrapment by a suture. The purse-string suture was released, and the catheter was withdrawn without resistance.