Lobar pulmonary hemorrhage. An unusual complication of Swan-Ganz catheterization.

Massive lobar pulmonary hemorrhage related to Swan-Ganz catheterization represents a catastrophic complication that, to our knowledge, has received little attention in the literature. Our experience with two recent cases emphasizes the life-threatening nature of such bleeding as well as the potential for patient salvage after urgent resectional therapy. A spectrum of pulmonary vascular injuries is incurred after the insertion of a balloon-tipped catheter, and there are therapeutic approaches for each. The anticoagulation associated with cardiac surgical procedures prompts us to suggest that the technique of insertion and the use of the Swan-Ganz catheter in these patients be modified to avoid this complication.