Forman M B, Obel I W
S Afr Med J. 1980 Aug 23;58(8):329-31.
A case of haemoptysis following pulmonary artery rupture by a Swan-Ganz catheter is described. The most likely pathogenesis appears to be spontaneous migration of the catheter into a peripheral vessel due to a redundant loop in the right ventricle. This, in association with possible hyperreactivity of the vessel, caused a tight fit; on inflation of the balloon a shearing force ruptured the vessel, with subsequent haemoptysis. Severe pulmonary hypertension does not appear to be an absolute perequisite for the occurrence of this rare but potentially fatal complication. The most important preventive measures are the early removal of any redundant loop of the catheter in the right ventricle seen on the radiograph taken after insertion, and gradual inflation of the balloon.
本文描述了一例因 Swan-Ganz 导管导致肺动脉破裂后咯血的病例。最可能的发病机制似乎是由于右心室中导管形成多余的袢，导致导管自发迁移至外周血管。这与血管可能的高反应性相关，导致贴合紧密；球囊充气时产生的剪切力使血管破裂，随后出现咯血。严重肺动脉高压似乎并非发生这种罕见但可能致命并发症的绝对必要条件。最重要的预防措施是在插入后拍摄的 X 光片上看到右心室中导管有任何多余袢时尽早移除，以及球囊逐渐充气。
