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Mil Med. 1994 Apr;159(4):357-60.

Pulmonary artery laceration by a pulmonary artery catheter: a case report and review of the literature.

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  • 1Department of Cardiothoracic Surgery, Wilford Hall USAF Medical Center/PSST, 2200 Berquist Drive, Suite 1, Lackland Air Force Base, TX 78236-5300, USA.


A 74-year-old white man with unstable angina underwent an uneventful urgent four-vessel coronary bypass operation at which time a Tenkhoff catheter was placed because of renal insufficiency. Two hours following arrival in the intensive care unit, the patient demonstrated hemodynamic instability, progressive acidosis, and a fall in his hematocrit from 35% to 18%. In retrospect, this instability was initiated by wedging of the pulmonary artery catheter. Hemorrhagic complications involving the use of flow-directed, balloon-tipped catheters are rare following cardiopulmonary bypass operations. The estimated incidence is reported at 1 to 2 per 1,000, although many may go unreported. The mortality rate is in excess of 50%. We report a case of a successfully repaired laceration of the pulmonary artery caused by a pulmonary artery catheter following cardiac surgery, and provide a review of the literature. As illustrated by this case and emphasized in the literature, salvage of patients who suffer this complication requires a high index of suspicion in order to rapidly recognize the injury and intervene with the appropriate therapy.

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