Seldinger Technique Based Pulmonary Artery Catheterization: A Procedure to Insert Pulmonary Artery Catheter Through the Jugular Vein in a Porcine Model

In pulmonary artery catheterization, a catheter is inserted into a large neck vein and is moved into the heart towards the pulmonary artery to determine cardiac and lung function. To begin, prep an anesthetized pig in the supine position.

Puncture the skin with an IV catheter and advance it gradually into the jugular vein. Now, replace the needle from the catheter with a guidewire. Subsequently, remove the catheter from the vein. Now, widen the skin incision near the guidewire to place a sheath over it. Remove the guidewire and advance the sheath into the vein to reach the right atrium.

To achieve right heart catheterization, insert through the sheath a Swan Ganz catheter – a thin tube with a balloon on its distal end. Observe the advancing catheter to ensure the distal part of the catheter is out of the sheath. Using a syringe at the proximal end, inflate the balloon and slowly move the catheter into the right ventricle and the pulmonary artery.

The inflation of the balloon temporarily blocks the pulmonary artery to enable measurement of blood pressure. Subsequently, deflate the balloon and ensure the catheter tip remains in the pulmonary artery to allow cardiopulmonary investigations.

After anesthetization, use a 17-gauge sterile venous catheter to puncture the skin. Guide the needle to intravascular positioning with the help of the ultrasound. Use the Seldinger technique to replace the needle with a guidewire. Remove the venous catheter, and leave only the guidewire in the intravascular lumen.

To ease the insertion of the sheath, make a small skin incision adherent to the guidewire. Then, place an appropriately sized sheath over the guidewire, and into the vessel of choice using the Seldinger technique.

Insert the Swan-Ganz catheter in the right jugular vein, through the 8-French sheath. Use fluoroscopy to observe when the distal part of the Swan-Ganz catheter is out of the sheath by resistance-free inflation of the balloon.

Slowly advance the Swan-Ganz catheter. Observe the changes in the pressure signal from the distal port as it enters the right ventricle and shortly after the distal port passes through the pulmonary artery.

Deflate the balloon and ensure that the distal pressure port is still in the main pulmonary artery using fluoroscopy and the pressure signal.