Tricuspid valve Swan-Ganz catheter entrapment before cardiac surgery

S Colombier; V Rancati; C Marcucci; J Lavanchy; M Kirsch; L Niclauss

doi:10.1002/anr3.12085

Tricuspid valve Swan-Ganz catheter entrapment before cardiac surgery

Anaesth Rep. 2020 Nov 12;8(2):e12085. doi: 10.1002/anr3.12085. eCollection 2020 Jul-Dec.

Authors

S Colombier¹, V Rancati², C Marcucci², J Lavanchy², M Kirsch¹, L Niclauss¹

Affiliations

¹ Department of Cardiovascular Surgery Lausanne University Hospital Switzerland.
² Department of Anaesthesiology Lausanne University Hospital Switzerland.

Abstract

A Swan-Ganz catheter during cardiac surgery offers peri-operative haemodynamic monitoring, although insertion of these catheters is not without risk. We report a case of Swan-Ganz catheter entrapment within the tricuspid valve during elective off-pump coronary artery bypass surgery. The diagnosis was made immediately by transoesophageal echocardiography, thus preventing forced withdrawal of the catheter. Intra-operatively, the echocardiographically detected findings of complex entrapment was confirmed. The Swan-Ganz catheter was tightly wrapped around the subvalvular apparatus, requiring on-pump open surgical removal. This case illustrates the anatomical complexity of such a catheter entrapment around the tricuspid valve apparatus and the importance of rapid echocardiographic diagnosis to prevent iatrogenic damage.

Keywords: Cardiac anatomy; Cardiopulmonary bypass management; TEE; other abnormalities.