Swan-Ganz Catheterization

What is a Swan-Ganz catheter?

A Swan-Ganz catheter is a medical device a healthcare provider uses to monitor your hemodynamics (how well your blood moves). Also known as a pulmonary artery catheter, it has four lumens (tubes) or ports that feed into one main tube.

Each of the Swan-Ganz catheter ports has a function:

• Putting fluid or medication into your heart.
• Checking blood pressure in various locations.
• Inflating a tiny balloon that helps with Swan-Ganz catheter placement in your pulmonary artery.
• Taking a blood sample from your pulmonary artery, which carries blood to your lungs.

What does a Swan-Ganz tell you?

A Swan-Ganz catheter can give your provider information about how well your heart is working. It can tell you:

• The filling pressures in the heart chambers (right atrium and right ventricle) on the right side of your heart.
• An estimate of the pressure in the chambers (left atrium and left ventricle) on the left side of your heart.
• The pressure in the vein the provider inserts the catheter through.
• The pressure in your pulmonary artery.
• Your cardiac output.
• How well your heart valves are doing.

Is a Swan-Ganz catheter still used?

Yes, healthcare providers still use Swan-Ganz catheters to gather information. Many consider it the “gold standard” for gathering accurate information about what’s going on inside your heart and pulmonary artery.

However, providers don’t use Swan-Ganz catheters as much now for people who are critically ill. Instead, they use echocardiography. This is a noninvasive tool that doesn’t have the risks of a Swan-Ganz catheter.

Who needs a Swan-Ganz catheter?

A healthcare provider may use a Swan-Ganz catheter if they suspect or know you have:

• Shortness of breath.
• Heart failure.
• Abnormal heart rhythms.
• Cardiogenic shock.
• Distributive shock.
• Constrictive pericarditis.
• Heart attack.
• Cardiac tamponade.
• Pulmonary hypertension.
• Pulmonary embolism.
• Adult congenital (since birth) heart disease.

They may also use a Swan-Ganz catheter to collect information before and after a heart transplant, placement of a left ventricular assist device or other surgery.

How does a Swan-Ganz catheter work?

A provider can use the various Swan-Ganz catheter ports to collect information from inside your body. A Swan-Ganz catheter measures pressure in the chambers on the right side of your heart. The catheter passes through these chambers on the way to your pulmonary artery. After Swan-Ganz catheter placement in your pulmonary artery, a provider can use a balloon at the end of the catheter to measure the pressure inside that artery.

What to expect before a Swan-Ganz catheterization

Before a Swan-Ganz catheterization, a healthcare provider will:

• Explain what they plan to do with a Swan-Ganz catheter.
• Tell you if you need to stop taking medication before your test.
• Tell you not to eat or drink for several hours before your catheterization.
• Ask for your permission to do the test.
• Ask you to lie on a table in a cardiac catheterization lab.
• Give you an IV with medicine to relax you.

What to expect during a Swan-Ganz catheterization

A healthcare provider will:

• Clean and then apply anesthesia to the spot on your skin where they’ll put in the catheter.
• Place a Swan-Ganz catheter into a major vein in your leg, neck or chest.
• Push the catheter through the heart chambers on the right side of your heart. Constant X-ray images that display on a monitor help them see where the catheter is going.
• Push the catheter into your pulmonary artery.
• Remove the catheter after they’ve gathered the information they need.

What to expect after a Swan-Ganz catheterization

After a healthcare provider removes the Swan-Ganz catheter, they’ll apply pressure to the area where they put in the catheter. They’ll apply a bandage to your skin and ask you to lie still for two to six hours if the catheter was in your leg.

It’s normal to have a bruise where the catheter went into your skin. It goes away in one to three weeks.

What are the risks of a Swan-Ganz catheterization?

Complications from a Swan-Ganz catheter are rare — less than 0.5%. Possible risks from a Swan-Ganz catheter include:

• Infection.
• Air bubble in your blood vessel.
• Collapsed lung if they use your subclavian vein.
• Abnormal heart rhythm.
• Damage to your heart wall, valve or pulmonary artery.

What does a healthcare provider do with the results of a Swan-Ganz catheterization?

A provider will use the information from your test to guide treatment. Test results can confirm that you have a certain condition. They can also tell your healthcare team about the severity of your issue. Depending on the condition, treatments may include:

• Medication. (You can receive medication through one of the Swan-Ganz catheter ports or through an IV in your arm.)
• Procedures.
• Surgery.

When should I call my doctor?

Contact your provider if:

• Your wound is swelling or has blood or fluid coming out of it.
• You have numbness or swelling in the leg that had the catheter.

A note from Cleveland Clinic

A Swan-Ganz catheter can help your provider collect the information they need to diagnose your heart or lung issue. Having this knowledge helps them give you the best treatment for your condition. A provider makes sure you’re comfortable during the test, which rarely has complications.