Swan ganz

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INTRODUCTION: Heart failure (HF) is a complex clinical syndrome caused by a structural or functional heart disorder. One of the most important challenges for anesthesiologists is the management of anesthesia in patients with severe heart failure, which has been facilitated by advanced monitoring systems. CASE PRESENTATION: The patient was a 42-year-old man with a history of hypertension (HTN) and HF with involvement of the three coronary arteries (3VD) with ejection fraction (EF) 15%...

BACKGROUND: High-quality evidence for post-cardiotomy extracorporeal life support (PC-ECLS) management is lacking. This study investigated the real-world PC-ECLS clinical practices. METHODS: This cross-sectional, multi-institutional, international pilot survey explored center organization, anticoagulation management, left ventricular unloading, distal limb perfusion, PC-ECLS monitoring and transfusions practices. Twenty-nine questions were distributed among 34 hospitals participating in the Post-cardiotomy Extra-Corporeal Life Support Study...

The purpose of this bicentric case series was to report the safety, efficacy, and clinical outcome of transcatheter embolization in pulmonary artery pseudoaneurysms (PAPAs). Between January 2016 and June 2021, eight patients with PAPA were subjected to transcatheter embolization. The total number of patients was eight, of which five were female, with a mean age of 62 ± 14 years (average ± standard deviation). Etiology was traumatic in 2/8 cases and iatrogenic in 6/8 cases (after positioning a Swan-Ganz catheter in 5/6 cases and a temporary pacemaker in the latter case)...

BACKGROUND: Computed tomography pulmonary angiography (CTPA) is the primary modality for the detection and diagnosis of pulmonary embolism (PE) while the stratification of PE severity remains challenging using angiography. Hence, an automated minimum-cost path (MCP) technique was validated to quantify the subtended lung tissue distal to emboli using CTPA. METHODS: A Swan-Ganz catheter was placed in the pulmonary artery of seven swine (body weight: 42.6±9.6 kg) to produce different PE severities...

INTRODUCTION: Hemodynamic decompensation during catheter ablation occurs due to prolonged procedure time and irrigant delivery directly into the cardiac chambers. Real-time hemodynamic monitoring of patients undergoing catheter ablation procedures may identify patients at risk of decompensation; we set out to assess the feasibility of a novel, real-time, intracardiac pressure monitoring system using a standard irrigated ablation catheter. METHODS: We studied 13 consecutive who underwent pressure measurement of the left atrium (LA) and left ventricle (LV) via transeptal access with a Swan Ganz (SG) catheter followed by two commercially available irrigated ablation catheters...

BACKGROUND: Heart failure (HF) is a common condition with high morbidity and mortality  in  Obstructive Sleep Apnea (OSA), especially in obese patient. The causes of HF are often abnormal conduction pathways, pump filling and/or heart valves. Right heart catheterization using Swan-Ganz catheter remains the gold standard to determine pulmonary hemodynamics, but it is costly and invasive. Herein, we propose a new formula for non-invasive Pulmonary artery wedge pressure (PAWP) measurement using tissue Doppler echocardiography...

Acute pulmonary embolism [PE] in the setting of hemodynamic instability and right ventricular strain is a complex presentation and typically is associated with high mortality rates. Prompt recognition and early intervention are critical to the survival of these patient. In such cases, current guidelines recommend use of systemic thrombolytics, along with as needed cardiopulmonary support. If contraindications are present, mechanical thrombectomy is advised. However, guidelines poorly define the next steps in intervention if mechanical thrombectomy were to fail...

Hyperbilirubinemia is a common gastrointestinal complication seen post-cardiac surgery. Here, we describe a case of a 72-year-old male with a past medical history of chronic obstructive pulmonary disease, chronic kidney disease (CKD), pulmonary hypertension, and valvular heart disease with severe aortic stenosis, severe mitral and tricuspid regurgitations who underwent elective aortic valve replacement (AVR), mitral valve replacement (MVR), and tricuspid valve (TV) repair; in addition, he required left thoracotomy for the repair of pulmonary artery perforation from a Swan-Ganz catheter that resulted in a large left pleural bleed...

BACKGROUND: Heart transplantation in donation after circulatory death (DCD) relies on warm perfusion using either in situ normothermic regional perfusion (NRP) or ex situ normothermic machine perfusion. In this study, we explore an alternative: oxygenated hypothermic machine perfusion (HMP) using a novel clinically applicable perfusion system, which is compared to NRP with static cold storage (SCS). METHODS: In a porcine model, a DCD setting was simulated, followed by either (1) NRP and SCS (2) NRP and HMP with the XVIVO Heart preservation system or (3) direct procurement (DPP) and HMP...

The prevalence of patent foramen ovale (PFO) is 20-25% among adults. The role of right-to-left shunting through the PFO in systemic hypoxemia remains poorly understood. Right-to-left shunting through the PFO can occur either due to elevated right atrial pressure (pressure-driven) or directed venous flow toward the PFO (flow-driven). Herein, we report a rare case of flow-driven right-to-left shunting via the PFO in a patient with traumatic tricuspid regurgitation. A 45-year-old Chinese woman was admitted due to progressive dyspnea for 3 years, presenting with cyanosis and digital clubbing...

BACKGROUND: The entanglement of multiple central venous catheters is a rare and seriouscomplication. The Swan-Ganz catheter is a responsible for various cases. CASE: A 66-year-old male patient was under general anesthesia for a coronary artery bypassgraft surgery. As he had a pre-existing Perm catheter in the right subclavian vein, a SwanGanz catheter was inserted into the left internal jugular vein. Chest radiograph after catheterplacement revealed that the Perm catheter had migrated to the left brachiocephalic vein...

OBJECTIVES: Patients with hypertrophic cardiomyopathy often have concomitant pulmonary hypertension, which has a negative prognostic effect in patients undergoing myectomy. Our objective was to investigate the effect of myectomy on pulmonary artery pressure obtained via Swan-Ganz catheter and characterize how changes in pulmonary artery systolic pressure may indicate outcomes in these patients. METHODS: We performed a single-center retrospective analysis of 271 patients with recordings of intraoperative pulmonary artery pressures during surgical myectomy...

BACKGROUND: Atrial septal defect (ASD) closure can cause acute pulmonary edema. Before transcatheter closure is performed, temporary balloon occlusion test (BOT) is recommended in patients with left ventricular dysfunction to predict the risk of pulmonary edema. However, the accuracy of BOT has not been verified. This study aimed to compare hemodynamic differences between BOT and transcatheter closure. METHODS: A total of 42 patients with a single ASD over age 18 years who underwent BOT before transcatheter ASD closure between October 2010 and May 2020 were analyzed...

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...

INTRODUCTION: Shock is a generalized form of acute circulatory failure characterized by low tissue perfusion. If not recognized early, it highly increases patient morbidity and mortality. Central venous-arterial CO2 (Carbon dioxide) to arterial-central venous O2 (Oxygen) content ratio (Pcv-aCO2/Ca-cvO2) has been used for the early prediction of anaerobic metabolism in septic shock patients. However, knowledge about the usability of this ratio in cardiogenic shock is scarce. MATERIALS AND METHODS: We retrospectively collected the data of patients admitted to our 18-bed intensive care unit (Haga Hospital, Department of Intensive Care, The Hague, The Netherlands) with a diagnosis of septic shock or cardiogenic shock in 2018...

Severe pulmonary hypertension and severe tricuspid regurgitation are often considered strict contraindications for orthotopic liver transplantation. A combined approach of tricuspid repair and subsequent liver transplantation could provide a novel approach for patients with severe pulmonary hypertension and tricuspid regurgitation to undergo orthotopic liver transplantation. A 62-year-old male with a history of end-stage renal disease on hemodialysis, cirrhosis, and third-degree atrioventricular heart block status post single lead pacemaker insertion presented for an orthotopic liver transplant...

OBJECTIVE: To evaluate the effects of CO2 pneumoperitoneum on venous hemodynamics and cardiopulmonary function during transperitoneal or retroperitoneal laparoscopic surgery. METHODS: A single institution prospective study. 43 patients with renal cell carcinoma undergoing retroperitoneal (22) or transperitoneal (21) laparoscopic partial nephrectomy were enrolled. Hemodynamic functions were monitored by Swan-Ganz and radial artery catheters. Transesophageal echocardiography was used to measure the diameter and blood flow of the inferior vena cava (IVC)...

Right heart catheterization(RHC) is a technique of inserting a catheter into the right heart and pulmonary artery via a peripheral vein, to evaluate hemodynamics and oxygen dynamics. When Swan-Ganz catheter is used, it is called pulmonary artery catheterization (PAC). PAC plays an important role in the diagnosis and evaluation of pulmonary hypertension (PH), and hemodynamic assessment of critically ill patients. We developed this consensus to improve the overall quality of RHC operation, especially the PAC standardization in the diagnosis and evaluation of PH, thereby to promote the diagnosis and treatment of PH in China...

INTRODUCTION: Recent studies showed significant mortality benefit with right heart catheterization (RHC) use in cardiogenic (CS). The optimal timing of RHC in those patients is unknown owing to the lack of available data. METHODS: The Nationwide Readmission Database 2016-2018 was queried for hospitalizations with CS. We excluded patients presented with cardiac arrest or with a history of ventricular assist devices or heart transplantation. Complex samples multivariable logistic, cox, and linear regression models were used to determine the association between RHC timing in the index admission (<2 days [early RHC] vs ≥ 2 days [late RHC]) and in-hospital outcomes (mortality, acute kidney injury [AKI], mechanical circulatory device use [MCD], index length of stay [LOS], hospital charges), and all-cause 30-day readmissions...