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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 1999 Dicembre;40(6):905-8

THORACIC PAPERS 

 CASE REPORTS

Entrapment of a Swan ­Ganz cath­e­ter in an IVC fil­ter requir­ing ­caval explo­ra­tion. A ­case ­report

Frezza E. E., Kagan S. A.

From the Department of Surgery Morristown Memorial Hospital, Morristown, New Jersey, USA

The place­ment of Swan Ganz (SW) cath­e­ters and infe­ri­or ­vena ­cava (IVC) fil­ters are com­mon pro­ce­dures per­formed in crit­i­cal­ly ill ­patients. Many ­reports ­describe the inde­pen­dent mis­place­ment of SG cath­e­ters and IVC fil­ters, and oth­ers ­have report­ed migra­tion of IVC fil­ters and entan­gle­ment of var­i­ous intra­vas­cu­lar devic­es in IVC fil­ter. Our ­patient is a 70-­year-old Caucasian wom­an who under­went an aor­tic ­valve replace­ment and cor­o­nary ­artery ­bypass graft­ing. The ­patient devel­oped a ­deep ­venous throm­bo­sis and an infra­ren­al IVC fil­ter was ­placed with­out inci­dent. A Swan Ganz cath­e­ter was ­placed lat­er in the post­op­er­a­tive peri­od and ­became entan­gled in the IVC fil­ter. We ­advised oper­a­tive remov­al ­after sev­er­al unsuc­cess­ful per­cut­aneous ­attempts to ­retrieve the cath­e­ter. IVC fil­ters are indi­cat­ed for pre­ven­tion of ­fatal pul­mo­nary embo­li in ­patients ­with a con­tra­in­di­ca­tion to anti­co­ag­u­lants or ­with recur­rent embo­lism ­despite ade­quate anti­co­ag­u­lant ther­a­py. Complica-tions of IVC fil­ters ­include ­caval throm­bo­sis, ret­ro­per­i­to­neal hem­or­rhage and per­fo­ra­tion of the IVC, hepat­ic ­veins, duod­e­num and aor­ta. We ­describe our eval­u­a­tion and oper­a­tive ­approach and ­make rec­om­men­da­tions for pre­ven­tion of entan­gling the SG ­into the IVC fil­ter.

lingua: Inglese


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