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CARDIOVASCULAR ANESTHESIA

Damage to Pulmonary Artery Catheter During Transmyocardial Laser Revascularization

From the Departments of Anesthesiology and Surgery, State University of New York at Stony Brook, Stony Brook, New York

Address correspondence and reprint requests to Bharathi H. Scott MD, Department of Anesthesiology, SUNY at Stony Brook, Health Sciences Center, L4–060, Stony Brook, NY 11794–8480. Address email to bscott{at}anesthes.sunysb.edu

This case report describes damage to a pulmonary artery catheter (PAC) during transmyocardial laser revascularization. We observed persistent bleeding and a temperature reading of "too high" from the temperature connection port of PAC during cardiopulmonary bypass while the patient’s nasopharyngeal temperature read 34°C. This alerted us to the possibility of PAC damage during creation of laser channels in the right coronary artery territory on the inferior surface of the heart. This is a unique complication related to this coronary revascularization procedure.

IMPLICATIONS: We report an unusual case of pulmonary artery catheter (PAC) damage during transmyocardial laser revascularization (TMLR). This observation should alert the anesthesiologist to the fact that the PAC may be damaged when TMLR is performed on the right side of the heart. We recommend that the PAC be withdrawn during this procedure.