Scenario: 67 yeear old male is now stable after his acute MI and cardiogenic shock. Patient is now 'delined' and 'detubed' and stable to transfer to floor. Whie reviewing morning CXR, you had following picture. Whats your diagnosis ?
Answer: Swan ganz catheter fragment which has broken loose and ended up in the right pulmonary artery.
Interventional Radiologist can remove the lost catheter via procedure call Snare Technique. This is done percutaneously, through a skin incision in the groin under local anesthesia. But Cardio-thoracic surgery should be taken on consult as backup, in case it requires open heart method.
Reference: click to get abstract
Embolization of the Tip of a Central Venous Catheter into the Pulmonary Artery - NEJM - Volume 352:e3 January 27, 2005 Number 4
