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The Journal of Cardiovascular Surgery 2002 August;43(4):467-70

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Beware Swan-Ganz complications. Perioperative management

Asteri T. 1, Tsagaropoulou I. 1, Vasiliadis K. 2, Fessatidis I. 3, Papavasiliou E. 1, Spyrou P. 3

1 Cardiac Anesthesia Department 2 Cardiological Department 3 Cardiothoracic Surgery Department “G. Papanikolaou”, Hospital, Exohi, Thessaloniki, Greece


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Since ­the intro­duc­tion of ­the pul­mo­nary ­artery cath­e­ter (­PAC) in 1970 by Swan et al., var­i­ous com­pli­ca­tions ­are rec­og­nized ­with ­the inser­tion ­and ­the ­use of Swan-Ganz cath­e­ter. We ­present ­two dif­fer­ent cas­es ­with ­rare ­but ­life threat­en­ing com­pli­ca­tions ­which ­had ­been suc­cess­ful­ly man­aged. The ­first ­case is a carot­id can­nu­la­tion ­with an 8.5 Fr intro­duc­er ­sheath, in an ­attempt to ­insert a pul­mo­nary cath­e­ter ­via ­the ­right inter­nal jug­u­lar ­vein. Two ­weeks lat­er, ­the ­patient ­was re-ad­mit­ted to ­the hos­pi­tal ­and ­when an arter­i­ov­e­nous fis­tu­lae (carot­id ­artery-inter­nal jug­u­lar ­vein) ­was diag­nosed, he ­was treat­ed sur­gi­cal­ly. The sec­ond ­case ­presents ­the rup­ture of ­the ­right atri­um in ­the con­junc­tion ­with ­the super­i­or ­vena ­cava. This seri­ous car­diac com­pli­ca­tion ­was devel­oped dur­ing ­the floa­ta­tion of ­the ­PAC ­and ­the ­lesion ­was ­repaired ­while ­the ­mitral ­valve replace­ment ­was in ­progress.

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