title: Where does the pulmonary artery catheter float: transesophageal echocardiography evaluation.
abstract: BACKGROUND
  Pulmonary artery (PA) catheter provides a variety of cardiac and hemodynamic parameters. In majority of the patients, the catheter tends to float in the right pulmonary artery (RPA) than the left pulmonary artery (LPA). We evaluated the location of PA catheter with the help of transesophageal echocardiography (TEE) to know the incidence of its localization. Three views were utilized for this purpose; midesophageal ascending aorta (AA) short-axis view, modified mid esophageal aortic valve long-axis view, and modified bicaval view.
  
  
  METHODS
  We enrolled 135 patients undergoing elective cardiac surgery where both the PA catheter and TEE were to be used; for this prospective observational study. PA catheter was visualized by TEE in the above mentioned views and the degree of clarity of visualization by three views was also noted. Position of the PA catheter was further confirmed by a postoperative chest radiograph.
  
  
  RESULTS
  One patient was excluded from the data analysis. PA catheter was visualized in RPA in 129 patients (96%) and in LPA in 4 patients (3%). In 1 patient, the catheter was visualized in main PA in the chest radiograph. The midesophageal AA short-axis, modified aortic valve long-axis, and modified bicaval view provided good visualization in 51.45%, 57.4%, and 62.3% patients respectively. Taken together, PA catheter visualization was good in 128 (95.5%) patients.
  
  
  CONCLUSIONS
  We conclude that the PA catheter has a high probability of entering the RPA as compared to LPA (96% vs. 3%) and TEE provides good visualization of the catheter in RPA.
authors.affiliation: Department of Anesthesiology and Intensive Care, GB Pant Postgraduate Institute of Medical Education and Research, New Delhi, India.
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Tempe
authors.forename: Upma Bhatia
authors.initials: UB
authors.lastname: Batra
authors.forename: Vishnu
authors.initials: V
authors.lastname: Datt
authors.forename: Akhlesh Singh
authors.initials: AS
authors.lastname: Tomar
authors.forename: Sanjula
authors.initials: S
authors.lastname: Virmani
mesh_terms: D002407:Catheterization, Swan-Ganz; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011651:Pulmonary Artery / Q000000981:diagnostic imaging*