Year : 2022  |  Volume : 16  |  Issue : 4  |  Page : 478-480

Pulmonary artery catheter knot in a liver transplantation, a rare complication

Department of Anesthesiology, Hospital das Clínicas da Universidade Federal de Minas Gerais (Clinic's Hospital of the Federal University of Minas Gerais), Belo Horizonte, Minas Gerais, Brazil

Correspondence Address:
Felipe L Silva
Rua Varginha, 463, Bairro Colegio Batista, Belo Horizonte, Minas Gerais 31110-130
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.sja_711_21

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The pulmonary artery catheter (PAC) measures hemodynamic parameters in real time, providing valuable data for the management of the critical patient. Nevertheless, its use is associated with several complications. Knot formation is a rare complication related to PAC insertion. A 51-year-old patient with complicated ethanolic liver cirrhosis underwent orthotopic liver transplantation. Invasive hemodynamic monitoring was performed using a Swan–Ganz pulmonary artery catheter (PAC) inserted through the right internal jugular vein. Chest X-ray in the immediate postoperative period showed the presence of a possible knot adjacent to the tip of the sheath in the internal jugular vein. The patient was then referred to the hemodynamics room, where, through fluoroscopy, a true knot was successfully removed after femoral vein dissection. The medical team should weigh the risk and benefit of using the PAC, taking into account the patient's clinical conditions, the benefits, and possible complications of the procedure.

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