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Opacity over the left hemithorax after abdominal aortic aneurysm repair.

A 77-yr-old male was admitted for aortic aneurysm repair. His history recorded hypertension, left carotid artery desobstruction, stroke and an anterior invocardial infarction. Aspirin was discontinued 1 day before surgery. For periand postoperative haemodynamic surveillance, a Swan-Ganz catheter (7.5 Fr thermodilution catheter; Criticath; Ohmeda, Bilthoven, the Netherlands) was introduced through the venae cubiti of the right arm 1 day before surgery. Initially the catheter was in overwedged position. After withdrawal of the catheter a correct wedge curve was obtained. As a result of congestive heart failure, there were elevated pulmonary artery and wedge pressures. For this reason, the patient was treated with diuretics and nitroglycerin intravenously. The abdominal aortic repair was uncomplicated, with a blood loss of 1,900 mL. After surgery the chest radiograph showed a diffuse opacity over the left hemithorax (fig. 1).