Complications with Flow-Directed Balloon-Tipped Catheters

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To the editor: The paper “Fatal Pulmonary Hemorrhage After Use of the Flow-Directed Balloon-Tipped Catheter” by Pape and associates in the March issue (1) serves to highlight the single most serious complication of the use of flow-directed catheters.

After publication of a case of fatal pulmonary hemorrhage in a patient with severe mitral-valve disease and pulmonary hypertension by Golden and colleagues (2), we expressed our serious concern that due to the relative simplicity of flow-directed catheterization, users tended to underestimate the potential for serious comlications that pertains to all invasive procedures. In that letter (3), we emphasized the need to

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