Entrapment of Pulmonary Artery Catheters in Cardiac Surgery: A Structured Literature Review and Analysis of Published Case Reports

This systematic review aims to tabulate and analyze the published literature regarding pulmonary artery catheter (PAC) entrapment during cardiac surgery. Systematic review. Case reports and series. Adults undergoing cardiac surgery. None. 223 distinct incidents of PAC entrapment were published across 77 case reports and 3 retrospective studies. The reported incidence of an entrapped PAC was 137/200,831 (0.068%, 95% confidence interval: 0.067%, 0.069%). Reported PAC entrapment was most seen in the setting of mitral valve surgery and was not discovered until the postoperative period in 77% of cases. Inadvertent fixation to cardiac structures was the most common mechanism of PAC entrapment. A total of 75% of patients with an entrapped PAC required an immediate redo sternotomy for PAC retrieval. After PAC retrieval, these patients still had longer hospital length of stay compared with the Society of Thoracic Surgeons Adult Cardiac Surgery Database averages. Although PAC entrapment during cardiac surgery is rare, an entrapped PAC increases patient morbidity, delays recovery, and increases hospital length of stay. Surgeons and anesthesiologists are encouraged to be attentive to PAC entrapment before chest closure.