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CARDIOVASCULAR ANESTHESIOLOGY

Inadvertent Aortic Cannulation with a Pulmonary Artery Catheter Detected by Transesophageal Echocardiography

Claas Siegmueller, MD, FRCA^*, Alexander Bell, MBChB, Tarun Mittal, MD, FRCR, and Shane George, FRCA, FRCP^*

From the Departments of *Anesthesia and Intensive Care, Pathology, and Radiology, Harefield Hospital, Uxbridge, UK.

Address correspondence and reprint requests to Dr. Claas Siegmueller, Department of Anesthesia and Intensive Care, Harefield Hospital, Hill End Road, Uxbridge UB9 6JH, UK. Address e-mail to claassiegmueller{at}yahoo.com.

Abstract

Attempted pulmonary artery catheterization via the left internal jugular vein resulted in a misdiagnosis of pulmonary hypertension before transesophageal echocardiography revealed the catheter positioned in the ascending aorta. Inadvertent aortic cannulation through an unusual type of partial anomalous pulmonary venous connection was confirmed with transcatheter fluoroscopy and later at autopsy. Partial anomalous pulmonary venous connection describes one or more of the pulmonary veins draining into the right atrium or its tributaries instead of the left atrium.