[Pulmonary artery catheterization in 9071 cardiac surgery patients: a review of complications].

Background: The safety of pulmonary artery catheterization has been questioned. We report our experience on the incidence of complications in a large series of patients requiring cardiac operations by evaluating the learning curve of the operators.

Methods: Since 1988 at our Institution a pulmonary artery catheter (PAC) register records the following data from each patient: type of surgical procedure, insertion site of the venous introducer, type of PAC used, final position of the catheter, and complications associated with central venous access and those determined by PAC positioning and stay. During 16 years (from April 1988 to April 2004) 9071 PACs were registered.

Results: Complications associated with the access to the central venous pool consisted of carotid arterial puncture in 191 patients (2.1%) and pneumothorax in 4 patients (0.04%). Complications associated with PAC positioning consisted of runs of ventricular ectopic beats (> 6 s) in 62 patients (0.68%), atrial fibrillation in 2 patients (0.022%), complete atrioventricular block in 2 patients (0.022%), ventricular fibrillation in 1 patient (0.011%), nodal rhythm in 6 patients (0.066%), perforation of the right ventricular wall in 1 patient (0.011%), hematoma of the right ventricular wall in 2 patients (0.022%), anonymous vein lesion in 2 patients (0.022%), and pulmonary artery rupture in 2 patients (0.022%).

Conclusions: Pulmonary artery catheterization performed by experienced team appears to be a safe procedure in cardiac surgery patients.