Accidental cannulation of the hepatic vein during pulmonary artery catheterisation--a case report.

ABSTRACT

A 22-year-old male was admitted to the adult ICU with a diagnosis of massive cardiomegaly and a large left ventricular thrombus, and needed Swan-Ganz catheterisation for proper haemodynamic monitoring. Insertion of the Swan-Ganz catheter resulted in hepatic vein cannulation. Pulmonary artery was successfully cannulated only when the patient was put in the head-up and right lateral position. It is suggested that to increase the success rate of patients with low cardiac output, cardiomegaly or pulmonary hypertension, they be placed in a head-up and right lateral position.