Knotting of a Pulmonary Artery Catheter in the Superior Vena Cava

Catheter knotting is a rare but severe complication of pulmonary artery catheterization. We present a case in which knotting of the pulmonary artery catheter occurred during tricuspid valve repair in a 29-year-old man. We attempted to uncoil the knot with a guidewire under fluoroscopy, but final successful removal of the knot in the pulmonary artery catheter required surgical intervention. Related instances in the literature are reviewed, and appropriate management and prevention strategies are discussed.