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

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.

Keywords: Pulmonary artery catheter; Pulmonary artery catheter entrapment; Minimally invasive cardiac surgery.