Pulmonary valve injury: Swan-Ganz or surgery

Pulmonary artery catheter (PAC) is a commonly used monitor in cardiac surge ry. Pulmonary valve injury from the balloon of the pulmonary artery cathete r is exceedingly rare; its descrip tion by transesophageal echocardiography is nonexistent in the Literature. A patient is reported who developed a fl ail anterior pulmonary leaflet several clays after successful myectomy for hypertrophic cardiomyopathy. The temporal sequence of PAC use and four tran sesophageal echocardiography studies over 13 clays, with the first three sh owing normal pulmonary valves, suggested pulmonary valve trauma, most likel y: from a Swan-Ganz catheter, as the etiology. Partial damage to the pulmon ary valve from the original surgery may have predisposed the patient to fur ther damage when the PAC was reintroduced in the intensive care unit.