{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T21:50:50Z","timestamp":1757627450179,"version":"3.44.0"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Justus-Liebig-Universit\u00e4t Gie\u00dfen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Anesthesiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The implantation of a Swan-Ganz catheter for invasive hemodynamic monitoring is an established measure after cardiac surgery. A rare but serious complication is the formation of a knot in the heart, which can be diagnostically challenging. We report on a patient who developed left heart failure postoperatively after quadruple bypass surgery combined with aortic valve replacement and in whom a knot formed inadvertently during monitoring using a Swan-Ganz catheter.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>An 82-year-old female underwent combined quadruple coronary artery bypass grafting and aortic valve replacement for severe coronary and valvular heart disease. Postoperatively, she experienced acute left ventricular dysfunction, necessitating mechanical circulatory support with an Impella device. A Swan-Ganz catheter was placed through the internal jugular vein for accurate hemodynamic monitoring. After placement, unexpected catheter immobility raised suspicion of an intracardiac knot. Initial transthoracic echocardiography did not clearly visualize the lesion; however, subsequent chest radiography and jugular vein ultrasound confirmed catheter-associated intracardiac knot formation. Considering the heightened risk for cardiac injury and thromboembolic events, interdisciplinary consensus recommended bedside surgical extraction. The catheter and associated knot were successfully removed via transcutaneous vascular incision without complications. Inspection revealed knot formation proximal to the catheter thermistor, while the balloon remained intact and functional.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Intracardiac knot formation associated with Swan-Ganz catheter placement is rare but presents significant risks. Timely interdisciplinary assessment, multimodal imaging, and surgical extraction under controlled conditions effectively mitigate potential complications, enabling safe catheter removal and favorable patient outcomes.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12871-025-03317-2","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T14:33:09Z","timestamp":1756737189000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cI had a knot in my heart\u201d: unusual complication after implantation of a Swan-Ganz catheter"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4139-3117","authenticated-orcid":false,"given":"Zulfugar. T.","family":"Taghiyev","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4404-510X","authenticated-orcid":false,"given":"Andreas","family":"B\u00f6ning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"3317_CR1","unstructured":"Keymel S, Steiner S.\u00a0Swan-Ganz Pulmonary Artery Catheterization-Safe But Not Harmless.\u00a0(2016)."},{"key":"3317_CR2","first-page":"677","volume":"62","author":"K Neya","year":"2009","unstructured":"Neya K. Swan-Ganz catheter (pulmonary artery catheter). Kyobu Geka. 2009;62:677\u201381.","journal-title":"Kyobu Geka"},{"issue":"4","key":"3317_CR3","doi-asserted-by":"crossref","first-page":"319","DOI":"10.7775\/rac.v87.i4.13409","volume":"87","author":"R Levin","year":"2019","unstructured":"Levin R, Vaca Valverde I, Porcile R. Resoluci\u00f3n percut\u00e1nea de Un Cat\u00e9ter de Swan-Ganz Anudado. Rev Argent Cardiol. 2019;87(4):319.","journal-title":"Rev Argent Cardiol"},{"key":"3317_CR4","unstructured":"Alconero Camarero AR, Guti\u00e9rrez Sandoval S, Garc\u00eda G\u00f3mez V.\u00a0Complicaciones del cat\u00e9ter swan-ganz en pacientes diagnosticados de procedimientos quir\u00fargicos cardiovasculares. Enfermeria en Cardiologia.\u00a02008;44\/2:29\u201332."},{"issue":"5","key":"3317_CR5","doi-asserted-by":"publisher","first-page":"367","DOI":"10.5603\/AIT.a2016.0048","volume":"48","author":"X Shang","year":"2016","unstructured":"Shang X, Yan Y, Wang B. Successful retrieval of a knotted Swan-Ganz catheter using interventional approach in an adult: a case report. Anaesthesiol Intensive Ther. 2016;48(5):367\u201370.","journal-title":"Anaesthesiol Intensive Ther"},{"issue":"3","key":"3317_CR6","first-page":"229","volume":"71","author":"R Carrillo-Esper","year":"2003","unstructured":"Carrillo-Esper R, Visoso-Palacios P, Su\u00e1rez-Mendoza C A. Anudamiento de Cat\u00e9ter de Swan-Ganz En La Rama derecha de La arteria pulmonar. Cir Cir. 2003;71(3):229\u201334.","journal-title":"Cir Cir"},{"issue":"6","key":"3317_CR7","doi-asserted-by":"publisher","first-page":"1274","DOI":"10.2214\/ajr.137.6.1274","volume":"137","author":"J Dach","year":"1981","unstructured":"Dach J, Galbut D. The knotted swan-ganz catheter: new solution to a vexing problem. Am J Roentgenol. 1981;137(6):1274\u20135.","journal-title":"Am J Roentgenol"},{"issue":"4","key":"3317_CR8","first-page":"1","volume":"3","author":"A Matta","year":"2019","unstructured":"Matta A, Boudou N, Ohayon P, Carri\u00e9 D. Angioplasty inflated balloon to unknot an entrapped Swan-Ganz catheter. Eur Heart J - Case Rep. 2019;3(4):1\u20132.","journal-title":"Eur Heart J - Case Rep"},{"key":"3317_CR9","doi-asserted-by":"crossref","unstructured":"Canitrot R, Lhermusier T, Servo C.\u00a0Complication of a Swan-Ganz catheter: an intravascular knot.\u00a02023.","DOI":"10.1093\/ehjcr\/ytad543"}],"container-title":["BMC Anesthesiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03317-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12871-025-03317-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12871-025-03317-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T02:19:42Z","timestamp":1757470782000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcanesthesiol.biomedcentral.com\/articles\/10.1186\/s12871-025-03317-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,1]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3317"],"URL":"https:\/\/doi.org\/10.1186\/s12871-025-03317-2","relation":{},"ISSN":["1471-2253"],"issn-type":[{"type":"electronic","value":"1471-2253"}],"subject":[],"published":{"date-parts":[[2025,9,1]]},"assertion":[{"value":"30 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"1 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images. Copy of the written consent forms are available for review.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"441"}}