Postoperative detection of pulmonary artery catheter entrapment during minimally invasive mitral valve repair: a case report.

IF 1.2 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-10-16 DOI:10.1186/s40981-025-00822-8

Ayaka Higashi, Sachiko Yamazaki, Atsushi Kainuma, Toshihito Mihara, Yuya Takahashi, Hiroki Matsuyama, Akiyuki Takahashi, Masahiro Sakaguchi

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Abstract

Background: Pulmonary artery catheter (PAC) entrapment is a rare but serious complication caused by inadvertent suturing to cardiac or vascular structures.

Case presentation: A 42-year-old man underwent minimally invasive mitral valve repair via right mini-thoracotomy. Thirty minutes after weaning from cardiopulmonary bypass (CPB), pulmonary artery pressure suddenly dropped, and the waveform became identical to that of central venous pressure. Two centimeters of PAC mobility, aspiration of blood from the balloon port, and blood accumulation in the monitor connector were noted. On postoperative day 1, resistance was encountered during catheter withdrawal at 7 cm, and chest radiography revealed abnormal catheter curvature. Reoperation under CPB confirmed PAC entrapment at the left atriotomy suture line, and the catheter was successfully removed.

Conclusions: In minimally invasive mitral valve repair, a left atriotomy approach might be associated with a risk of PAC entrapment, and the option of not inserting a PAC should always be considered.

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微创二尖瓣修复术中肺动脉导管夹持1例。

背景：肺动脉导管（PAC）夹持是一种罕见但严重的并发症，由不小心缝合到心脏或血管结构引起。病例介绍：一名42岁男性通过右小开胸行微创二尖瓣修复术。体外循环（CPB）脱机30分钟后，肺动脉压突然下降，波形与中心静脉压相同。观察到2厘米的PAC移动，从球囊口吸出血液，以及监测接头中的血液积聚。术后第1天，拔管7 cm处出现阻力，胸片显示导管曲度异常。在CPB下再次手术确认左心房切开缝合线处PAC夹持，并成功拔除导管。结论：在微创二尖瓣修复中，左心房切开入路可能存在PAC夹持的风险，不插入PAC的选择应始终考虑。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.