Nonsurgical removal of a knotted pulmonary artery catheter.

Though controversy exists regarding the utility of pulmonary artery catheters (PAC), their use persists in select patients. Knotting of these catheters upon insertion is a rare but serious complication. We present 2 cases of coagulopathic patients undergoing orthotopic liver transplantation complicated by PAC knotting on attempted line placement. Both knotted PAC were successfully removed nonsurgically in the operating room, allowing for timely continuation of the planned transplantations. It is essential for the clinician to recognize knotted PAC and understand strategies for safe removal.