Swan-Ganz / PA Catheter

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Swan-Ganz / PA Catheter

Developed and named by Doctors Jeremy Swan and William Ganz from the Cedars-Sinai Medical Center.

Often called a Pulmonary Artery (PA) Catheter as well, is inserted via the subclavian or jugular veins. It is advanced through the right atrium and right ventricle, and out of the right side of the heart to sit in the main pulmonary artery.

The catheter may have five or six lumens. <img align="right" alt="Swan-Ganz / PA Catheter - wikiRadiography" height="369" src="http://image.wikifoundry.com/wiki/wikiradiography/image/1ycoXemlsa2j9Ip$LBEPAHg==50171/GW350H369" title="Swan-Ganz / PA Catheter - wikiRadiography" width="350"/>

Its main function is to take various pressure measurements from around the heart. From its resting point in the pulmonary artery it can measure the

  • Pulmonary artery systolic pressure (PA systolic)
  • Pulmonary artery diastolic pressure (PA diastolic)

By advancing the catheter tip further into the pulmonary artery until it wedges in a distal branch, virtual or reflective left heart pressure may be measured. These measurements are called "WEDGE" pressures. This is possible since the catheter is wedged and there is no blood flow advancing around it from behind, it can only measure what is ahead, that being the pulmonary vein, left atrium and left ventricle. from this point it can measure the

  • LAFP (left atrial filling pressure)
  • LVDP (left ventricular diastolic pressure)

All these pressure measurements help provide an overall picture or how well the heart is functioning. If the pressure values fall outside the normal range, intervention may be required.

In addition the Swan-Ganz Catheter can measure the central venous pressure, temperature and be used for the administration of fluids, drugs and total parental nutrition (TPN).

Generall fluoroscopy is not required for insertion of a Swan-Ganz catheter for two reasons. Firstly, the catheter has a flow directed capability which is provided by the inflatable ballon located at the catheter tip. During insertion the inflated ballon follows the flow of venous blood through the right heart chambers into the pulmonary artery.

Secondly, each chamber of the heart and the associated great vessels generate pressure waveforms which are characteristic. When appropriate pressure waveform is visualized on a pressure monitor during insertion, catheter tip location within the right heart anatomy may be determined.


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