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.
The authors declare no conflicts of interest.
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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’firstname.lastname@example.org.