The Swann

Dr. Ganz has died at 90.

William Ganz, Catheter Inventor, Dies at 90

Published: November 13, 2009

Dr. William Ganz, a cardiologist and medical inventor who helped develop a revolutionary catheter to measure blood flow and heart functions, died Tuesday in Los Angeles. He was 90. … 200911140159.jpg

The catheter, which is used more than one million times a year in the United States, is known as the Swan-Ganz because Dr. Ganz created it with Dr. Jeremy Swan at Cedars-Sinai Medical Center. It is inserted through a vein in the neck, shoulder or groin and fed into the right side of the heart. A balloon at the device’s tip allows it to be carried along by blood flow.

I was fortunate enough to get a chance to ‘float a Swan’ a few times as a resident, and never since. Are they still used?

I recall doing a lot of longhand math after a Swan, and a terrific amount of information could be discerned…and then it was kind of a big pain to decide when it was no longer needed.

Thanks, Dr. Ganz, and, are they still in frequent ICU use?


Comments

  1. Yep, still used frequently in surgical critical care, trauma critical care, and CV critical care…..a lot of it is regional but I’m seeing more of a move back to swan ganz cathethers vs. non-invasive methods in my area. All of that long hand math doesn’t have to be done anymore :) The monitoring box will do all of that garbage.

  2. TxTechMSIII says:

    After just getting off of my surgery clerkship, i was told by one of the trauma guys that he had them keep around a bunch of the Swan introducer kits, just because in an acute setting it served as a very efficient large-bore delivery system for all sorts of fluid/fluid type products. But the catheter itself, he said they really didnt use anymore.

  3. Eh. When they can’t figure out what else to do, they float a swan.

    Otherwise, it’s used for cardiac outputs/indexes/svr after open heart surgery.

    And that extra fluid port is very handy.

  4. TxTechMSIII: The 8.5F sheath/introducer that comes with the Swan is a great resuscitation tool. You can cram blood and fluids into somebody at an unbelievable rate with those things.

  5. doc Russia says:

    I distinctly recall a senior surgical resident expounding the utility of the swan. Floated one in a patient of mine in the SICU when I was rotating on her service. Patient also had pericardial tamponade. Urine output dropped off, and my inclination was to give more fluids. Still, the senior had ridden my ass about stuff, so I decided to call her and tell her my intended course so that she couldn’t come back after the fact and bitch about it after the fact. She asked for the swan numbers. I told them to her. She then started to go off on how *obviously* the patient had plenty of fluid on board, and needed lasix, not more fluids to increase their urine output.
    *blink*
    So I asked her how the pericardial tamponade affected the swan numbers. She said she would get back to me.
    I pushed fluids. Patient improved.

    I told you that story so I could tell you this:
    It is the swan song of the swan-ganz right now.
    If you want access, throw in a few EZ-IO lines, and back them up with a couple of cortices.
    I foresee even CVP measurement from the IJ or subclavian going away in the ED. We mostly use it for septic patients, and the few studies I have seen on comparative IJ vs. femoral CVPs have shown a relatively high degree of concurrence.

    At least in the ED, I do not see a future for the Swan-Ganz at all.