Background:

Swan-Ganz catheterization is an important technique for monitoring perioperative and postoperative cardiac pressures during open-heart surgery. However, although it’s a rare condition, resistance may be encountered while removing the catheter postoperatively and it could only be taken out surgically.

Methods:

Between May 1988 and February 2000 we observed Swan-Ganz catheter entrapment complication in 10 cases subjected to open-heart surgery. All the cases had valve replacement. Five cases were male, while five of them were female. During this period, we performed open-heart surgery on 15.244 patients with utilization of Swan-Ganz catheter. Thus, overall prevalence of catheter entrapment was 0.065%.

Results:

Swan-Ganz catheter was retained in vena cava cannulation suture in 4 cases, in right atriotomy in 3 cases, in left atriotomy suture in one case and it was looped around right ventricular papillary muscle in one case. In the last case it was looped around chordae tendinea between tricuspid valve conal papillary muscle and septal leaflet. Although cardiopulmonary bypass equipment was prepared, it was not utilized in any of the cases.

Catheter was released and removed by placing a purse-string suture on the vena cava cannulation site in 4 cases, by placing a matrix suture proximal and distal part of the left or right atrial suture line and a purse-string suture on the site of entrapment in 4 cases and by digital palpation from right atrial appendage in two cases. All patients were taken to the intensive care unit postoperatively and to the wards next day without any problem.

Conclusions:

In open-heart surgery one should be cautious about not the leave Swan-Ganz catheter in the suture while closing right or left atriotomy or during venous cannulation and he should ensure that there is not entrapment by moving the catheter after suturing.