Successful retrieval of a knotted Swan-Ganz catheter using interventional approach in an adult: a case report.

Sir, Swan-Ganz catheterization, also known as the balloon tipped pulmonary artery catheterization, is widely used as a diagnostic and hemodynamic tool to monitor patients in the intensive care unit [1]. Knot formation is one of the rare complications with the incidence of 0.2−2.5%, which in general resulting in entrapping the catheter in the superior vena cava [2]. Surgical intervention is necessary. In recent years, due to the advances in radiology, interventional approaches are utilized to non-surgically extract the catheter [3]. We describe a case in which we succeeded removing the entrapped catheter using non-invasive procedure. A 58-year-old male was admitted to our center with a 36-month chest pain and 12-month exacerbation. Using ultrasonic cardiogram (UCG), he was diagnosed congenital septal defect, severe aortic regurgitation and cardiac function capacity II. The patient underwent aortic valve replacement and temporary pacemaker insertion. To monitor hemodynamic measurements, a Swan-Ganz catheter was passed into the pulmonary artery through the jugular vein on the following day in the intensive care unit. After obtaining hemodynamic indexes, attempts to withdraw the catheter were unsuccessful. A chest X-ray was performed to identify an obvious knotting at the rostral end (Fig. 1), which entrapped the catheter. X-ray also revealed the annuloplasty ring and the temporary pacemaker (Fig. 2). The diameter of