Ruptured pulmonary artery

SEOBowhntr · Mar 25, 2006

Our Cath lab had one the other day (happened during the procedure). Can you tell me how it happened and what they do to save the patient. Can this be repaired in Cath lab? Or treated? The patient did go to ICU but I haven't had the chance to get all details yet.
Thanks.

Sharann,

It probably happened doing a Pulmonary Capillary Wedge Pressure. I've known of it to happen a couple of times, both times it was in a very elderly frail female. The doc was probably doing a Left and Right Heart Cath, and did a wedge and POP!!!! Both patients I know of died in short order.

sharann, BSN, RN · Mar 26, 2006

Yes, it was a right and left heart cath. The patient made it to ICU but thats all I know. I understand now, it was probably during them passing the Swan or getting the wedge as you said.Thanks. Scary too.

WOLFE, BSN, RN · Mar 31, 2006

Let's see if I can help you out...When an individual is in the cath lab, they have the catheter inserted through the groin (femoral artery) and threaded up to the heart vessles. The pulmonary artery is not a "true" artery, but a vein, therefore the vessel walls are not as sturdy as an arteries. So it could have been pierced through, or during the balloon inflation the artery wall ruptured.

JSRN81 · Mar 31, 2006

Our Chief of Cardio-Thoracic Surgery ruptured a PA about a year ago when he was attempting a PCWP. At our facility, we do not wedge following an open-heart, whether it be a valve or bypass unless we are specifically told to do so. Luckily for the nurses, it was the doc himself who wedged her. He could tell immediately what happened, so he opened her chest in the room and stabilized her before bringing her to the OR. Amazingly she survived it! She later died of sepsis, but not until almost 6 weeks later. Needless to say, now we REALLY don't wedge after surgery...nor will he.

JS