Accidental entrapment of swan ganz in inferior vena caval cannulation site-A case report

Indian Journal of Thoracic and Cardiovascular Surgery 01/2007; 23(4):283-285. DOI: 10.1007/s12055-007-0062-1


Entrapment of a Swan-Ganz catheter to an intracardiac structure in open heart operation is a rare but serious complication.
In the intracardiac course, the catheter tends to rest against the anterior-lateral wall of the right atrium where the catheter
can be caught by a suture during cannulation for cardiopulmonary bypass1. A Swan-Ganz catheter entrapment by a suture in the inferior vena caval (IVC) cannulation site during mitral valve replacement
is presented. The diagnosis of the suture entrapment of the Swan-Ganz catheter was established by fluoroscopic observation
of the specific movement pattern of the cardiac structures when manual traction was applied from outside. In conclusion, awareness
of potential catheter entrapment by suture or other mechanisms should be the first step for management, when resistance is
met during catheter withdrawal. Smooth partial withdrawal of the catheter prior to initiation of cardiopulmonary bypass(CPB),
or at least before chest closure, to detect catheter mobility would provide an early clue for the diagnosis.

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