Indwelling cardiac catheters. An autopsy study of associated endocardial lesions.

An autopsy study was carried out to assess the relationship between indwelling intracardiac catheters and hemorrhagic, thrombotic, and infective lesions of the right heart endocardium and valve. Intracardiac catheters cause such lesions frequently, with a spectrum from uncomplicated valvular hemorrhage through nonbacterial thrombotic endocarditis to infective endocarditis. Pulmonary emboli were associated with the thrombotic, infective lesions. Endocardial lesions are more commonly seen with Swan-Ganz (SG) catheters; with these, lesions are more common and severe, with longer periods of catheterization. Pulmonic-valve lesions were only seen with SG catheters. However, not all hemorrhagic lesions in the right heart endocardium were associated with catheters, because a few inpatients without catheters had small subendocardial valvular hemorrhages; the cause of these hemorrhages is obscure because they were not seen in the hearts of patients who died outside the hospital.