Perforation of the innominate vein: complication of a Swan-Ganz catheter.
A 71-year-old woman underwent placement of a Swan-Ganz pulmonary artery catheter after induction of general anesthesia for a triple-vessel coronary bypass procedure. The surgery was uneventful; however, the patient was in profound shock upon arrival in the cardiac intensive care unit. After a short delay, caused in part by the measurement of high "wedge" pressures, she was returned to the operating room where a laceration of the right innominate vein was repaired. Resuscitation was unsuccessful and death ensued in the operating room. Percutaneous pulmonary artery catheterization is very worthwhile in the management of patients with complicated problems; however, we should be more cautious in considering the risks involved when selecting patients for this procedure.
Walker
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Division of Thoracic and Cardiovascular Surgery, The University of Texas Medical School, Houston, Texas, USA.