Right ventricular pseudoaneurysm formation due to pulmonary artery catheter insertion

Abstract

　An 88-year-old woman underwent emergency ascending aortic replacement for Stanford type A aortic dissection. Postoperative thoracic contrast computed tomography (CT) and right ventriculography revealed the formation of a pseudoaneurysm in the right ventricular apex, which was suspected to be caused by the insertion of a pulmonary artery catheter. The patient was treated conservatively, and six months after the surgery the pseudoaneurysm had disappeared on contrast CT. Right ventricular pseudoaneurysm formation is an extremely rare and potentially fatal complication of pulmonary artery catheter insertion. When inserting a pulmonary artery catheter, the possibility of myocardial injury, including right ventricular pseudoaneurysm formation, should be considered, and excessive repetition of intraventricular catheter manipulation should be avoided in high-risk patients. Catheter withdrawal should be considered if induction into the pulmonary artery is difficult. In addition, if habitual pulmonary artery catheterization is required, the indication should be reconsidered.