Unusual complication with a Swan-Ganz catheter

Abstract

The case is presented of a 44 year-old female patient with severe mitral regurgitation due to posterior leaflet prolapse at P2 level. Mitral repair was performed by quadrangular resection and implantation of a prosthetic ring through a left atriotomy in the interatrial groove. It was possible to extubate at 6 h, as the patient was haemodynamically stable without inotropic support. A transthoracic echocardiogram was performed at 24 h, confirming the good outcome and the absence of complications. An attempt was made to remove the Swan-Ganz catheter without success, so it was decided to re-intervene. In the operating room, direct extraction of the catheter was attempted, but it was firmly fixed. It was decided to connect to cardiopulmonary bypass and not clamp the aorta. A right atriotomy was performed, finding that the catheter was fixed by the left atriotomy suture. It was decided to try to remove it without removing the left atriotomy suture in order to avoid aortic cross clamping. The Swan-Ganz catheter was cut at the level of the suture and, with the help of a nerve hook, it was removed without damaging the atriotomy suture. The patient was extubated at 4 h and was discharged in 6 days. (c) 2017 Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Cirugia Toracica-Cardiovascular. This is an open access article under the CC BY-NC-ND license.