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Ann Thorac Surg 2010;89:281-283. doi:10.1016/j.athoracsur.2009.06.049
© 2010 The Society of Thoracic Surgeons
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Jared L. Antevil
Alexandros N. Karavas
John G. Byrne
Michael R. Petracek
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Case Reports

Pulmonary Artery Catheter Deviation on Chest Roentgenogram After Cardiac Operation: A Sign of Tamponade

Jared L. Antevil, MDa, Alexandros N. Karavas, MDa, John G. Byrne, MDa,*, Bernhard J. Riedel, MD, PhDb, Michael R. Petracek, MDa

a Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
b Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee

Accepted for publication June 9, 2009.

* Address correspondence to Dr Byrne, Vanderbilt University Medical Center, 1215 21st Ave, Medical Center East, Nashville, TN 37232-8802 (Email: john.byrne{at}vanderbilt.edu).

Tamponade after cardiac operations often does not manifest the classic clinical or even echocardiographic features of tamponade and may therefore be difficult to diagnose. We present 3 patients with cardiac tamponade in the early postoperative period in whom portable chest roentgenogram revealed marked leftward pulmonary artery catheter displacement at the level of the right atrium and superior vena cava due to adjacent hematoma. Awareness of this radiographic finding may allow immediate triage to a life-saving reoperation, obviating the need for further imaging or diagnostic delay.






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