Patient education: Pulmonary artery catheterization (The Basics)

What is a pulmonary artery catheter? — 

A pulmonary artery catheter ("PAC") is a long, thin tube that is placed in a large blood vessel and moved to the pulmonary artery (figure 1). One end is in the artery, and the other end stays outside of the body.

A PAC might also be called a "right heart catheter" or "Swan-Ganz catheter."

Doctors can use a PAC to learn how well the heart and lungs are working. They might do this to:

●Learn more about the blood flow and pressures in and around the heart

●Measure the pressures in the lungs

●Help monitor people who are critically ill, especially if they have heart failure or need more or less fluids

The procedure to place a PAC is called "pulmonary artery catheterization." Most PACs have 4 ends called "ports" or "lumens." These stay outside of the body and are connected to IV fluids or covered with a cap. The ports can be used to:

●Give IV fluids

●Measure pressure in different areas in and around the heart

●Fill a small balloon at the tip of the catheter to measure the pressure in the pulmonary artery

●Take blood samples

In some cases, a PAC is used to take measurements and then removed. In other cases, it is left in place for more monitoring.

What happens before pulmonary artery catheterization? — 

Before placing a PAC, your doctor will do an exam and review your health history. They might also order or review tests or X-rays. Sometimes, doctors need to place a PAC in an emergency.

If it is not an emergency, the doctors will talk with you about your options. They will discuss the risks and benefits of having a PAC and tell you if you need to do anything special to prepare. Ask the doctor or nurse if you have any questions or if there is anything you do not understand.

What happens during pulmonary artery catheterization? — 

Doctors can place a PAC in the intensive care unit ("ICU"), in a special heart catheterization lab, or during surgery. When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get anesthesia medicines to numb the area so you don't feel pain during the procedure. You might also get medicines to make you feel relaxed and sleepy.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●Your doctor will place a needle and catheter into a large blood vessel. They might make a very small cut in your skin over the blood vessel. They can use a blood vessel in the neck, upper chest, arm, or groin. They usually use ultrasound to help find the blood vessel.

●They will put the catheter into your blood vessel. Then, they will gently push the catheter through your blood vessels to your heart. You will not be able to feel this.

●While this is happening, the doctor might use ultrasound or special X-rays to help see the catheter as it moves through your blood vessels. Sometimes, an X-ray will be taken to make sure that it is in the right position. This helps your doctor know when the tube has reached the correct place in your heart.

●If the PAC will stay in place, the doctor will secure it to your skin with special tape or stitches so it can't move. They will cover the area where the catheter goes into your skin with clean bandages.

What happens after pulmonary artery catheterization? — 

The staff will watch you closely. They will do a chest X-ray to make sure that the PAC is in the correct place. If you have a PAC placed while you are very sick, you will be in the ICU until after it is removed.

A PAC can stay in place for several days. When it is no longer needed, the doctors will remove it.

What are the risks of pulmonary artery catheterization? — 

Your doctor will talk to you about all of the possible risks and answer your questions. The most common problems are:

●Bleeding

●Bruising

●Soreness in the area where the tube went in

These problems can last for a few days, especially if the tube was put in the leg.

Other problems can happen during or after a PAC is placed, but they are uncommon. They include:

●Arrhythmia (irregular heart rhythm)

●The PAC being in the wrong place

●Injury to the heart, valves, or blood vessels

●Limited blood flow to part of the lungs

●Coughing up blood

●Infection

●Blood clots

●Heart attack

●Stroke

More on this topic

Patient education: Pulmonary hypertension (The Basics)
Patient education: Cardiac catheterization (The Basics)
Patient education: Shock (The Basics)
Patient education: Heart failure (The Basics)
Patient education: Sepsis in adults (The Basics)

Patient education: Peripheral artery disease and claudication (Beyond the Basics)
Patient education: Heart failure (Beyond the Basics)