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  • Title: [Pulmonary artery rupture caused by a Swan-Ganz catheter during heart surgery. A successful therapeutic procedure].
    Author: Hess W, Marggraf G, Reidemeister C.
    Journal: Anaesthesist; 1988 Jul; 37(7):446-9. PubMed ID: 3414956.
    Abstract:
    A patient with mitral valve stenosis (NYHA IV) suffered a pulmonary artery rupture after valve replacement and weaning from bypass. This event coincided with the measurement of pulmonary capillary wedge pressure. Anticoagulation aggravated the endobronchial bleeding to a near fatal outcome. By intubating with a double-lumen endobronchial tube and clamping the right pulmonary artery, the pulmonary hemorrhage and its complications could be controlled. After antagonizing the heparin dose and supporting the right heart with epinephrine bleeding was reduced substantially, following which the right pulmonary artery was declamped. In older patients or patients with pulmonary hypertension the following procedures for preventing pulmonary artery rupture should be taken: before inflating the balloon the catheter should be withdrawn into a large vessel; after inflation the balloon the catheter can be advanced to the wedge position.
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