Morbidity and Mortality Associated With Accidentally Entrapped Pulmonary Artery Catheters During Cardiac Surgery: A Case Series

Abstract

ULMONARY ARTERY CATHETERS (PACs) are commonly used in patients undergoing cardiac surgery to guide hemodynamic management in the perioperative period. Although some early studies suggested that the PAC may provide valuable information that cannot be acquired in less invasive ways, 1,2 the routine use of the PAC for cardiac surgery remains controversial, especially in the light of 2 large studies with more than 1,300 randomized cardiac surgical patients that failed to show improvements in morbidity or mortality. 3,4 This lack of benefit is echoed in more recent studies pertaining to critically ill, noncardiac surgical patients, which imply that the use of the PAC may even increase morbidity and risk of hospital death. 5-7 Numerous complications associated with PACs have been described, 8,9 including entrapment. 10-21 The authors report a series of eight cases collected over a five-year period at a single institution in which the PAC was inadvertently sutured to cardiac structures during the course of the cardiac surgical procedure, leading to serious morbidity in seven patients and death in one patient.