Swan-Ganz catheter entrapment in open heart surgery

Background and Aim: Swan-Ganz catheterization is an important technique for monitoring perioperative and postoperative cardiac pressures during open heart surgery. However, although a rare condition, resistance may be encountered while removing the catheter postoperatively and its removal must be accomplished through surgery. Methods: Between May 1988 and February 2000, we observed Swan-Ganz catheter entrapment complications in 10 cases subjected to open heart surgery. All the cases had valve replacement. Five cases were male, while five were female. The Swan-Ganz catheter was retained in the vena cava cannulation suture in four cases, in the right atriotomy in three cases, in a left atriotomy suture in one case, and looped around the right ventricular papillary muscle in one case. In the last case, it was looped around chordae tendinea between the tricuspid valve conal papillary muscle and septal leaflet. Although cardiopulmonary bypass equipment was prepared, it was not utilized in any of the cases. The catheter was released and removed by placing a pursestring suture on the vena cava cannulation site in four cases, by placing a matrix suture on the proximal and distal part of the left or right atria] suture line and a pursestring suture on the site of the entrapment in four cases, and by digital palpation from the right atria[ appendage in two cases. Results: All patients were taken to the intensive care unit postoperatively and to the wards the next day without complications. Conclusions: When performing open heart surgery, the surgeon should not leave the Swan-Ganz catheter in the suture while closing the right or left atriotomy or during venous cannulation. In addition, the catheter should be moved after suturing to ensure that there is no entrapment.