Snaring of a Swan-Ganz catheter

Insertion of a Swan-Ganz catheter for measurement of pulmonary artery and pulmonary capillary wedge pressures is common for operative management of patients with borderline left ventricular function, particularly patients undergoing cardiac surgery. The transatrial course of the catheter may allow it to lie against the lateral and anterior walls of the right atrium, where it can be caught in a suture used to control bleeding. This report documents such a complication of cardiac surgery: A Swan-Ganz line was caught by a right atrial suture. The tip of the Swan-Ganz catheter was in the distal right pulmonary artery, so that the usual means of removal with a loop-snare catheter was impossible. Instead, a Teflon sleeve, inserted percutaneously was used to stabilize the right atrium while gentle traction was used to break the catheter at its point of entrapment. In this manner, the proximal portion of the catheter was removed. The distal segment of the catheter then was removed with a biopsy forceps inserted percutaneously through the femoral vein.