Pulmonary artery rupture as a complication of Swan-Ganz catheter application. Diagnosis and endovascular treatment: a single centre's experience.
BACKGROUND
The placement of a Swan-Ganz catheter into the pulmonary artery may lead to a number of complications (2-17%). In less than 0.2% of cases Swan-Ganz catheterization results in serious vascular damage - pulmonary artery rupture (PAR). This paper presents two distinct forms of iatrogenic PAR treated endovascularly using different vascular devices.


OBJECTIVE
To evaluate the effectiveness of endovascular treatment and the application of different types of vascular devices in the management of pulmonary artery rupture caused by Swan-Ganz catheterization.


METHODS
In this retrospective study we evaluated 2 patients in whom Swan-Ganz catheter application was used for perioperative monitoring and resulted in pulmonary artery rupture. This complication was treated endovascularly by means of interventional cardiology.


RESULTS
We report the cases of 2 patients with a pulmonary artery pseudoaneurysm formed in the perioperative period. In case 1, a single, 4-loop, 3 mm diameter coil was implanted. In case 2, a 5 mm Amplatzer Vascular Plug IV was applied. In both cases, the endovascular approach resulted in total occlusion of the feeding artery and reduced further extravasation of the blood.


CONCLUSIONS
Despite its extremely low incidence, iatrogenic PAR is a serious, life-threatening complication of Swan-Ganz catheterization that requires urgent attention. Among available methods of treatment, percutaneous embolization is a relatively quick, safe, accurate and highly effective alternative to traumatizing surgery.
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Piotr N
PN
Rudziński
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Jan
J
Henzel
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Zofia
Z
Dzielińska
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Barbara M
BM
Lubiszewska
Department of Radiology, Institute of Cardiology, Warsaw, Poland.
Ilona
I
Michałowska
Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Piotr
P
Szymański
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Radosław
R
Pracoń
Department of Acquired Cardiac Defects, Institute of Cardiology, Warsaw, Poland.
Tomasz
T
Hryniewiecki
Department of Coronary and Structural Heart Diseases, Institute of Cardiology, Warsaw, Poland.
Marcin
M
Demkow
Swan-Ganz catheter; pulmonary arteriovenous malformation; pulmonary artery; pulmonary pseudoaneurysm; transcatheter embolization; vascular plugs