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Pulmonary Artery Catheter Knotted in the Tricuspid Valve Apparatus Requiring Surgery With Cardiopulmonary Bypass: A Case Report

Perez d’Empaire, Pablo MD, FRCPC, FCCM*; Derzi, Simone MD; Latter, David MD, FRCSC; Tousignant, Claude MD, FRCPC

doi: 10.1213/XAA.0000000000001028
Case Reports

Placement of a pulmonary artery catheter (PAC) is associated with complications such as entrapment or knotting. PAC entrapment in the heart, vena cava, or pulmonary artery is serious, potentially life-threatening, particularly if they are unrecognized. We present a patient with a PAC knot after aortic valve replacement. Interventional radiology (IR) determined that the catheter may have lodged in the tricuspid valve. Surgical exploration requiring cardiopulmonary bypass revealed that the PAC had passed through the tricuspid valve orifice and knotted itself around the anterior leaflet chordal structure. The catheter was unknotted, with the patient subsequently recovering without long-term sequelae.

From the *Department of Anesthesia, Sunnybrook Health Sciences Centre, Department of Anesthesia, University of Toronto, Canada

Department of Anesthesia, St Michael’s Hospital, Department of Anesthesia, University of Toronto, Toronto, Canada

Division of Cardiac Surgery, St Michael’s Hospital, Department of Surgery, University of Toronto, Toronto, Canada.

Accepted for publication March 18, 2019.

Funding: None.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the HTML and PDF versions of this article on the journal’s website.

Address correspondence to Pablo Perez d’Empaire, MD, FRCPC, FCCM, Department of Anesthesia, Sunnybrook Health Sciences Centre, 2075 Bayview Ave, Room M3-200, Toronto, ON M4N3M5, Canada. Address e-mail to pablo.perezd’

Copyright © 2019 International Anesthesia Research Society
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