[Incidence and evolution of thrombotic images within the internal jugular vein following Swan-Ganz catheter insertion in cardiac surgery].
OBJECTIVE
Insertion of Swan-Ganz catheter for a few days may be necessary in cardiac surgery. This study was aimed at determining the incidence and the evolution of thrombotic images within the internal jugular vein as well as assessing their association with the presence of a prolonged fever at postoperative day 7 in the lack of any documented infection.


METHODS
All the patients undergoing cardiac surgery had a two-dimensional ultrasonography of internal jugular veins preoperatively, at discharge (day 7) and at postoperative day 90 if thrombotic images were seen at day 7.


RESULTS
Sleeve-like and compact thrombotic images have been observed in site of venipuncture in 52 patients (70.3%). None had any residual thrombotic image 90 days after the operation. No clinical thromboembolic migration has been observed. There was no statistical association between the presence of a thrombotic image at the ultrasonography and the duration of catheterization. Moreover, there was no association between the anticoagulation before, during and after the surgery and the presence of a thrombotic image. We found a non-significant association between fever at day 7 and the presence of a thrombotic image within the internal jugular vein.


CONCLUSIONS
Thrombotic images in the internal jugular vein after catheterization are frequent and disappear at day 90. The limited sample size of this study does not provide strong evidence of the role of jugular thrombi in the prolongation of fever after cardiac surgery.
Jeanneteau
J
J
Service de cardiologie, pôle cardiovasculaire, faculté de médecine d'Angers, CHU d'Angers, université d'Angers, 4, rue Larrey, 49933 Angers cedex, France.
Braud
O
O
Pinaud
F
F
Faraj
S
S
Gillet
S
S
Cottineau
C
C
de Brux
J-L
JL
Baufreton
C
C
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000295:instrumentation; D006348:Cardiac Surgical Procedures; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D018450:Disease Progression; D005112:Extracorporeal Circulation; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D015994:Incidence; D007239:Infections / Q000150:complications; D007601:Jugular Veins / Q000000981:diagnostic imaging* / Q000293:injuries; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation; D011183:Postoperative Complications; D011184:Postoperative Period; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D014463:Ultrasonography; D020246:Venous Thrombosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*
D000925:Anticoagulants