Entrapment of a Swan Ganz catheter in an IVC filter requiring caval exploration - A case report

The placement of Swan Ganz (SW) catheters and inferior vena cava (IVC) filt ers are common procedures performed in critically ill patients. Many report s describe the independent misplacement of SG catheters and IVC filters, an d others have reported migration of IVC filters and entanglement of various Intravascular devices in NC filter: Our patient is a 70-year-old Caucasian woman who underwent an aortic valve replacement and coronary artery bypass grafting. The patient developed a deep venous thrombosis and an infrarenal NC filter was placed. without incident. A Swan Ganz catheter was placed la ter in the postoperative period and became entangled in the NC filter. We a dvised operative removal after several unsuccessful percutaneous attempts t o retrieve the catheter. NC filters are indicated for prevention of fatal p ulmonary emboli In patients with a contraindication to anticoagulants or wi th recurrent embolism despite adequate anticoagulant therapy. Complications of NC filters include caval thrombosis, retroperitoneal hemorrhage and per foration of the NC, hepatic veins, duodenum and aorta. We describe our eval uation and operative approach and make recommendations for prevention of en tangling the SG into the IVC filter.