According to ACCF guidelines, what are the appropriate uses for pulmonary artery catheterization (PAC)?

Updated: Dec 22, 2017
  • Author: Bojan Paunovic, MD; Chief Editor: Karlheinz Peter, MD, PhD  more...
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Answer

In 2012, the American College of Cardiology Foundation (ACCF) published guidelines on the appropriate use of diagnostic pulmonary artery catheterization. [2]

Diagnostic

According to the ACCF guidelines, pulmonary artery catheterization is appropriate in the following diagnostic settings [2] :

  • Suspected acute coronary syndrome

  • Suspected coronary artery disease (CAD)

  • On stress testing with imaging, in high-risk findings in patients who are either symptomatic or asymptomatic, or in intermediate-risk findings, discordant findings, or equivocal/uninterpretable findings in patients who are symptomatic

  • On echocardiography, in findings of newly recognized, symptomatic, left ventricular (LV) dysfunction; in symptomatic, new regional wall-motion abnormality of unknown etiology; or in suspected significant ischemic complications related to CAD

  • On computed tomography (CT) angiography, for symptomatic lesions of 50% of greater, left main or non-left main; for symptomatic lesions of 50% or greater in more than one coronary territory; for symptomatic lesions of unclear severity, possibly obstructive (non-left main); and for symptomatic or asymptomatic, possibly obstructive non-left main lesions

Therapeutic

According to the ACCF guidelines, pulmonary artery catheterization is appropriate for aspiration of air emboli. [3]


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