Pulmonary artery rupture with pseudoaneurysm formation secondary to Swan-Ganz catheter balloon inflation.
Pulmonary artery catheters have been extensively used for hemodynamic assessment over the past several decades. We present a case that highlights the management of a known, but rare and catastrophic complication of pulmonary artery catheter based therapy. An elderly lady with acute decompensated heart failure, severe pulmonary hypertension, and atrial fibrillation on anticoagulation had a pulmonary artery catheter inserted for hemodynamic monitoring. Subsequently, the patient developed acute hemoptysis and damped pulmonary artery pressure waveforms during inflation of the catheter tip balloon. The possibility of pulmonary artery rupture was immediately recognized and confirmed with CT angiogram of the chest. Emergent interventional radiology guided coil embolization of pulmonary artery rupture and pseudoaneurysm was successful.
a Division of Cardiology, Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.|b Department of Medicine , Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.
Auras R
AR
Atreya
a Division of Cardiology, Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.|b Department of Medicine , Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.
Sonali
S
Arora
a Division of Cardiology, Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.|b Department of Medicine , Baystate Medical Center/Tufts University School of Medicine , Springfield , MA , USA.
Gregory
G
Valania
D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects*; D000072226:Computed Tomography Angiography; D004621:Embolization, Therapeutic / Q000379:methods; D005260:Female; D005471:Fluoroscopy; D006333:Heart Failure / Q000628:therapy; D006801:Humans; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D012421:Rupture; D057772:Vascular System Injuries / Q000150:complications* / Q000175:diagnosis / Q000628:therapy
Swan-Ganz catheterization; iatrogenic complication; interventional coil embolization; pulmonary artery catheterization; pulmonary artery pseudoaneurysm; pulmonary artery rupture; right heart catheterization