Intravascular volume status can be particularly difficult to assess in patients with valvular heart disease, yet is of critical importance in patient management. Patients with stenotic lesions depend on adequate filling pressures for diastolic filling of the ventricle. Patients with the volume overload lesions of AI and MR can benefit from careful reductions in pulmonary pressure guided by real-time assessment of cardiac performance, for which a PA catheter is useful. Patients with current hemodynamic stability, and without severe respiratory distress, can be safely anesthetized before placement of the PA catheter. Overall, there is no evidence that use of the PA catheter improves cardiac surgical outcomes.

References

• American Society of Anesthesiologists and Society of Cardiovascular Anesthesiologists Task Force on Pulmonary Artery Catheterization. Practice guidelines for pulmonary artery catheterization: an updated report by the American Society of Anesthesiologists Task Force on Pulmonary Artery Catheterization. Anesthesiology. 2003;99:988-1014.
• Joseph C, Garrubba M, Smith JA, Melder A. Does the use of a pulmonary artery catheter make a difference during or after cardiac surgery? Heart Lung Circ. 2018;27:952-960.