Do pulmonary artery catheters cause or increase tricuspid or pulmonic valvular regurgitation?

There are few quantitative data on the extent or mechanism of pulmonary art ery catheter (PAC)-induced valvular dysfunction. We hypothesized that PACs cause or worsen tricuspid and pulmonic valvular regurgitation, and tested t his hypothesis by using transesophageal echocardiography. In 54 anesthetize d adult patients, we measured color Doppler jet areas of tricuspid regurgit ation (TR) in two planes (midesophageal [ME] 4-chamber and right ventricula r inflow-outflow views) and pulmonic insufficiency (PI) in one plane (ME ao rtic valve long-axis view), both before and after we advanced a PAC into th e pulmonary artery. Regurgitant jet areas and hemodynamic measurements were compared by using paired t-test. There were no significant changes in bloo d pressure or heart rate after passage of the PAC. After PAC placement, the mean PI jet area was not significantly increased. The mean TR jet area inc reased significantly in the right ventricular inflow-outflow view (+0.37 +/ - 0.11 cm(2)) (P = 0.0014), but did not increase at the ME 4-chamber view. Seventeen percent of patients had an increase in TR jet area greater than o r equal to1 cm(2); 8% of patients had an increase in PI jet area greater th an or equal to1 cm(2).