Pulmonary artery rupture with pseudoaneurysm formation secondary to Swan–Ganz catheter balloon inflation

Abstract

Pulmonary artery catheters have been extensively used for hemodynamic assessment over the past several decades. We present a case that highlights the management of a known, but rare and catastrophic complication of pulmonary artery catheter based therapy. An elderly lady with acute decompensated heart failure, severe pulmonary hypertension, and atrial fibrillation on anticoagulation had a pulmonary artery catheter inserted for hemodynamic monitoring. Subsequently, the patient developed acute hemoptysis and damped pulmonary artery pressure waveforms during inflation of the catheter tip balloon. The possibility of pulmonary artery rupture was immediately recognized and confirmed with CT angiogram of the chest. Emergent interventional radiology guided coil embolization of pulmonary artery rupture and pseudoaneurysm was successful.

Keywords::

• Swan-Ganz catheterization
• pulmonary artery catheterization
• right heart catheterization
• pulmonary artery rupture
• pulmonary artery pseudoaneurysm
• iatrogenic complication
• interventional coil embolization

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.