Swan-Ganz Catheter
Other Known Aliases – pulmonary artery catheter
Definition – intravenous catheter that is maneuvered through the right side of the heart into the pulmonary artery.
Clinical Significance – This catheter can directly measure several important hemodynamic variables in critical illness:
- right atrial pressures
- right ventricular pressures
- pulmonary artery pressures
- left atrial filling pressures (wedge pressure)
- cardiac output/cardiac index
- systemic vascular resistance
- pulmonary vascular resistance
It is “floated” through the right side of the heart using the flow of the blood to carry it into the pulmonary artery. This migration has a very characteristic pressure pattern to know where the catheter is in the vascular system.
History – Named after two physicians from Cedars-Sinai Medical Center, Jeremy Swan (1922-2005), an Irish American cardiologist, and William Ganz (1919-2009), a Slovak American cardiologist. Dr. Swan received his medical doctorate from Castleknock College and went on to become faculty at the Mayo Clinic before joining the faculty at Cedars-Sinai Hospital in Los Angeles. Dr. Ganz attended Charles University School of Medicine in Prague in 1938, but was closed in 1940 after the Nazi occupation of Czechoslovakia. Being jewish, he was then sent to a Hungarian Nazi labor camp and was actually scheduled to be sent to Auschwitz in 19944 before his escape. After hiding and waiting out the war, Dr. Ganz returned and graduated from Charles University in 1947 at the top of his class. He practiced in communist Czechslovakia until 1966 when he secretly defected to the US with his wife and sons. His first and only position as a physician in the US was at Cedars-Sinai Hospital, where he met Dr. Swan who got the idea of the catheter from watching the wind play with the sails of boats in the marina. Dr. Ganz had already published research on the use of thermodilution as a way to measure cardiac output and in 1970, they published their landmark article in the NEJM. It should be noted that German surgeon Werner Forssmann first demonstrated the safety of this type of catheter, by doing it on himself in 1929.
References
- Firkin BG and Whitwirth JA. Dictionary of Medical Eponyms. 2nd ed. New York, NY; Parthenon Publishing Group. 1996.
- Bartolucci S, Forbis P. Stedman’s Medical Eponyms. 2nd ed. Baltimore, MD; LWW. 2005.
- Yee AJ, Pfiffner P. (2012). Medical Eponyms (Version 1.4.2) [Mobile Application Software]. Retrieved http://itunes.apple.com.
- Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
- Up To Date. www.uptodate.com
- Swan HJ, Ganz W, Forrester J, Marcus H, Diamond G, Chonette D. Catheterization of the heart in man with use of a flow-directed balloon-tipped catheter. The New England journal of medicine. 1970; 283(9):447-51. [pubmed]
- FRONEK A, GANZ V. [Local thermodilution method of measuring minute volume and circulation rate in the peripheral vessels]. Ceskoslovenska fysiologie. 1959; 8(3):189. [pubmed]
- W. Forssmann. Die Sondierung des Rechten Herzens. Klinische Wochenschrift, Berlin, 1929, 8: 2085.
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