Swan-Ganz Catheterization Health Article

Definition

Swan-Ganz catheterization, also known as pulmonary artery catheterization, is a diagnostic procedure in which a small catheter is threaded through a vein in the arm, thigh, chest, or neck until it passes through the right side of the heart into the pulmonary artery. The catheter is than able to measure the pressures in the right heart and pulmonary artery.

Purpose

Swan-Ganz catheterization is performed in order to:

• Evaluate heart failure.
• Determine whether pulmonary edema is caused by a weak heart (cardiogenic pulmonary edema) or leaky pulmonary capillaries (non-cardiogenic pulmonary edema or adult respiratory distress syndrome).
• Monitor therapy after a myocardial infarction (heart attack).
• Check the fluid balance of patients in shock as well as those recovering from heart surgery, serious burns, or kidney disease.
• • Monitor the effect of medications on the heart.

Precautions

Pulmonary artery catheterization is an invasive and potentially complicated procedure. The physician must decide if the value of the information obtained outweighs the risks of catheterization.

Description

Swan-Ganz catheterization is usually performed in the hospital intensive care unit. A catheter is threaded through a vein in the arm, thigh, chest, or neck until it passes through the right side of the heart into the pulmonary artery. The procedure takes about 30 minutes. Local anesthesia is administered at the catheter insertion site to reduce discomfort.

Once the catheter is in place, the physician briefly inflates a tiny balloon at its tip. This temporarily blocks the blood flow and allows the physician to make a pressure measurement in the pulmonary artery system. This pressure reading is called the pulmonary capillary wedge pressure. Pressure measurements are usually recorded for the next 48-72 hours in different parts of the heart. During this time, the patient must remain in bed so the catheter remains in position. Once the pressure measurements are no longer needed, the catheter is removed.

Preparation

Before and during the test, the patient will be connected to an electrocardiograph, which records the electrical stimuli that cause the heart to contract. The insertion site is sterilized and prepared prior to the test. The catheter is often sutured to the skin to prevent dislodgment.

Aftercare

The patient is observed for any sign of infections or complications from the procedure.