Highlights the potentially fatal risk of pulmonary artery rupture from flow-directed catheters in patients receiving potent antithrombotic and thrombolytic therapies during acute coronary interventions.
Requires heightened vigilance for catheter-related complications in patients on multiple antithrombotic agents during rescue PTCA; leaves open identification of preventive strategies.
Since the introduction of pulmonary artery catheterization for hemodynamic monitoring, several complications associated with its use have been described. Pulmonary artery rupture is an infrequent complication of flow-directed pulmonary artery catheters. We report a case of pulmonary artery rupture complicating rescue PTCA in the presence of systemic platelet inhibition with abciximab (Reopro), anticoagulation, and thrombolytic therapy. With the increasing use of these medications in patients undergoing acute coronary interventions, particularly those patients requiring hemodynamic monitoring, this uncommon but potentially fatal complication may be seen more frequently.
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Chadow et al. (1999) studied this question.
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