Pulmonary artery dissection induced by a Swan-Ganz catheter1

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A 70-year-old woman died after coronary artery bypass graft surgery. Autopsy revealed bilateral, massive, intrapulmonary hemorrhage secondary to pulmonary artery dissection induced by a Swan-Ganz catheter. Cystic medionecrosis of the pulmonary arteries was also identified. Catheter-induced pulmonary artery trauma is associated with a high mortality. Hemoptysis is the usual presenting sign. Great caution should be exercised when using Swan-Ganz catheters in elderly patients with known pulmonary hypertension, particularly in the setting of cardiac surgery or anticoagulation.



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