title: The Swan-Ganz catheter as a teaching tool for the anesthesiologist learning minimally invasive cardiac surgery.
abstract: OBJECTIVE
  To perform minimally invasive cardiac surgery through the smallest possible wound and with the least number of incisions in the heart or aorta, the necessary cannulations to undergo cardiopulmonary bypass must be done through peripheral vessels. A difficult skill to learn for the cardiac anesthesiologist is how to safely and efficiently position the coronary sinus catheter (Endoplege; Edwards Lifesciences LLC, Irvine, CA USA) required for retrograde cardioplegia administration.
  
  
  METHODS
  In patients in whom a Swan-Ganz catheter was inserted as part of the operative management strategy for non-minimally invasive heart surgery, we have been using it as a training tool to learn how to visualize and manipulate right-sided catheters under transesophageal echocardiography. We developed this teaching technique to help hone some of the necessary skills needed to place the Endoplege catheter for minimally invasive cardiac surgery. Manipulation was done with the goal of visualizing the catheter and guiding it into the coronary sinus. For a 4-month period, anesthesia records were retrospectively reviewed.
  
  
  RESULTS
  Fifteen patients, for a total of 19 catheter manipulations, were found in whom we had documented the use of the Swan-Ganz catheter and details about the insertion as a training tool. The coronary sinus and the catheter were visualized 100% of the time. The Swan-Ganz catheter was successfully inserted into the coronary sinus in 17 of 19 catheter manipulations.
  
  
  CONCLUSIONS
  The Swan-Ganz catheter can be used as a training tool to develop some of the necessary skills to place catheters into the coronary sinus with transesophageal echocardiography guidance.
authors.affiliation: Division of Cardiac Anesthesia, Department of Anesthesia and Division of Cardiothoracic Surgery, Department of Surgery, Robert Wood Johnson University Hospital University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08901, USA. pantin_enrique@hotmail.com
authors.forename: Enrique J
authors.initials: EJ
authors.lastname: Pantin
authors.forename: Jonathan L
authors.initials: JL
authors.lastname: Kraidin
authors.forename: Steven H
authors.initials: SH
authors.lastname: Ginsberg
authors.forename: John T
authors.initials: JT
authors.lastname: Denny
authors.forename: Mark B
authors.initials: MB
authors.lastname: Anderson
authors.forename: Alann R
authors.initials: AR
authors.lastname: Solina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000776:Anesthesiology / Q000193:education*; D006348:Cardiac Surgical Procedures / Q000193:education* / Q000379:methods; D002408:Catheters, Indwelling; D017548:Echocardiography, Transesophageal; D004502:Education, Medical, Continuing; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000193:education*; D012189:Retrospective Studies