Catheter-induced pulmonary artery perforation associated with an unusual wedge pressure tracing.

Pulmonary artery perforation is one of the most serious complications of pulmonary artery catheterization. We report a case of a pulmonary artery perforation which occurred during the placement of a Swan-Ganz catheter in a patient with mitral valve regurgitation. During the insertion of the catheter a deep negative pressure wave was seen in the pulmonary artery tracing, with concomitant haemoptysis. The postoperative chest radiograph revealed an infiltration distal to the tip of the pulmonary artery catheter. This type of unusual capillary wedge pressure tracing during pulmonary artery catheterization has not previously been reported.