What is a Swan-Ganz Catheterization?
Sometimes referred to as the right heart catheter or pulmonary artery catheter (PAC), Swan-Ganz catheter is a diagnostic test. It is used to determine any abnormalities in the blood flow of the lungs and heart. For people who recently have problems with their heart, this method is very useful.
Pulmonary Artery Catheter (PAC)
The procedure needs the use of a diagnostic tool called PAC to monitor the function of both lung and heart. However, it is also used to determine a medication’s efficiency. It is a long, thin tube that has a balloon on the tip. The balloon is needed for the smooth trip of the catheter. Generally, medical practitioners inserted it into one of these 3 veins:
- Femoral Veins – veins that are located in the groin.
- Right Internal Jugular Vein (RIJ) – a vein that is located in the neck. It is considered the shortest and the most direct vein to the heart.
- Left Subclavian Vein – a vein that is located below the collarbone or clavicle.
Swan-Ganz Catheterization Procedure
The PAC will be inserted on one of the three access point mentioned above into the right side of your heart and into your arteries. Then the blood flow will be the one responsible to bring it to your lungs. Because of this method, a camera and monitor is not necessary for the procedure. The doctor will trust the blood flow to carry the catheter into the place it is needed.
The step-by-step procedure of the catheterization is as follows:
- You will be given with a tranquilizer to relax you, however, it will not put you to sleep.
- The doctor will shave and clean the area where the PAC will be inserted. Usually, it’s in the neck or groin. He or she will inject anesthesia on the said area so you won’t feel any pain.
- An incision will be made on the prepared area to let the PAC enter the vein.
- Before the PAC comes the hollow tube. This will be placed first so that the catheter will have an easier insertion.
- The catheter will be inserted through the veins and into the heart’s right side.
- As the catheter is successfully inserted, blood pressure will then be measured in the pulmonary artery.
- To check your blood oxygen levels, you will be taken with a blood sample. Similarly, to check your heart’s response, you will be administered with heart medications.
- Once all the tests are complete, the tools will be removed and the cut will be closed through stitches.
You’ll be awake throughout the procedure, but feeling some tinge of pain should not happen since you are injected with anesthesia. You may feel a bit of pressure where the catheter is inserted, though. Also, your heartbeat will be monitored during the procedure using an electrocardiogram (EKG) machine.
For how long the PAC will stay on the heart varies on a person’s condition. If a patient has an ill condition, the PAC has the possibility to stay for a few days.
What is the Use of Swan-Ganz Catheterization?
The reason why the procedure is sometimes called right heart catheterization is that as the blood flows from the right side of your heart, it allows measuring your blood pressure as well. Measuring the blood pressure can be done in the three different places of the body: pulmonary capillaries, pulmonary artery, and atrium. Measuring through these areas can help identify the amount of oxygen in the blood that is coming out of the right heart. Moreover, the method is useful in figuring out the overall amount of blood that flows out of your heart.
Furthermore, it can help evaluate the following:
- Valvular heart disease such as a leaky heart valves
- Pulmonary edema, or fluid in the lungs
- Heart failure
- Post-surgery monitoring of people who have had open-heart surgery
- Heart function following a heart attack
- Pulmonary arterial hypertension (PAH)
- Congenital heart disease
Sometimes, the catheterization is combined with an IV. We’ve mentioned earlier that this method also measures the effectivity of a medication. Heart medications are sometimes delivered through an IV, thus, checking its efficiency will be monitored through a Swan-Ganz Catherization.
But aside from an IV, sometimes it is partnered with endocardial biopsy, especially when a person needs a heart transplant. The combined method will serve as a preparation for the heart procedure. The heart muscle will be the focus of endocardial biopsy while the Swan-Ganz will be responsible to monitor if blood pressure needs medication to lower it.
Preparing for the Catheterization Procedure
Your doctor needs to know the following before the procedure. Tell him/her if you are:
- Pregnant or if you think that you are pregnant
- Taking blood thinners or have taken it in the past
- Having any form of allergy
- Taking any OTC medications
Prior to the procedure, jewelry should be removed. The preparation for the procedure may also require you for an 8-hour fast. In some cases, doctors ask their patient to stay in the hospital overnight before the test.
Lastly, a consent form regarding the risk of the procedure as well as other expectation will be asked for you to sign in.
What are the Risks of Swan-Ganz Catheterization?
The risk is divided into two: more and less common risk.
The more common risk includes excessive bleeding, vein tear, and bruising at the area where the PAC is inserted. Additionally, pneumothorax (lung collapse) is possible to happen because of lung puncture. The instance is more common when the catheter is inserted through the chest or neck veins.
The less common risk, on the other hand, involve irregular heartbeat, blood clots, cardiac tamponade, and low blood pressure. Cardiac tamponade occurs when either fluid or blood forms and compress the heart, resulting in insufficient ventricles filling.
But above all these risks, pulmonary artery rupture is the most dangerous one. According to a study, the risk has a 50% rate of fatality. The good thing, however, is the fact that it is a rare complication. It often affects women whose age are more than 60 years and have PAH. Another group of people who can be affected by it is those who receive anticoagulation—a therapy for blood thinning.