Cardiothoracic & vascular anesthesia
Distal Migration of the Pulmonary Artery Catheter During Cardiac Surgery With Cardiopulmonary Bypass Observed Using Transesophageal Echocardiography: A Prospective Observational Study
Authors' conclusion
TEE-enabled direct visualization showed that PAC tips commonly migrate approximately 3 cm during cardiac surgery with CPB, necessitating withdrawal to prevent distal complications. Patients with longer catheter insertions and higher pulmonary artery pressure and central venous pressure may require more extensive withdrawal.
Study context
- Population
- Adults undergoing elective cardiac surgery with cardiac arrest and cardiopulmonary bypass (CPB) who received pulmonary artery catheter (PAC) placement under transesophageal echocardiography (TEE) guidance
- Participants
- 146 adults
- Outcome
- Distance of PAC tip migration during surgery (pre to post CPB, by TEE)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
PAC tip migration distance · pre to post CPB
Pre to post CPB
3.0
median · IQR 3.0–4.0 · cm
Observational data: associations, not effects.
Further findings
Predictors of >3 cm withdrawal
- Cutoff for catheter length
- 46.5 cm
- Cutoff for mean pulmonary artery pressure
- 22.5 mmHg
- Cutoff for central venous pressure
- 9.5 mmHg
- Patients requiring >3 cm withdrawal had significantly longer catheter insertion lengths and higher mean pulmonary artery pressure and central venous pressure before CPB
Original publication
Distal Migration of the Pulmonary Artery Catheter During Cardiac Surgery With Cardiopulmonary Bypass Observed Using Transesophageal Echocardiography: A Prospective Observational Study. J Cardiothorac Vasc Anesth. Published 23 August 2025. doi:10.
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