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CARDIOVASCULAR ANESTHESIA

Sinus of Valsalva Aneurysm and Ventricular Tachycardia During Pulmonary Artery Catheterization

Department of Anesthesiology, University of Rochester, Rochester, New York

Address correspondence and reprint requests to Peter Bailey, MD, Department of Anesthesiology, Box 604, 601 Elmwood Ave., Rochester NY, 14642. Address e-mail to peter_bailey{at}urmc.rochester.edu.

Pulmonary artery catheterization is associated with numerous complications, including serious arrhythmias. We report a case where ventricular tachycardia occurred repeatedly during attempted pulmonary artery catheterization, precluding successful catheterization. Transesophageal echocardiography was used to image the tricuspid valve and right ventricle and revealed a Sinus of Valsalva aneurysm protruding significantly into the right ventricle and obstructing advancement of the pulmonary artery catheter. Our case reveals another identifiable cause of serious arrhythmia during pulmonary artery catheterization and highlights how transesophageal echocardiography can be useful in unanticipated ways during cardiac anesthesia and surgery.