scholarly journals Bedside echocardiography for diagnosis of Intracardiac cement embolism after percutaneous vertebroplasty: A case report

2021 ◽  
Author(s):  
Panpan Yin ◽  
Junli Hu ◽  
Shaochun Wang ◽  
Guiling Sui ◽  
Guozhen Yuan ◽  
...  
Keyword(s):  
Bone Cement ◽  
Percutaneous Vertebroplasty ◽  
Pulmonary Arteries ◽  
High Density ◽  
History Of Surgery ◽  
Right Heart ◽  
Bedside Echocardiography ◽  
Cement Embolism ◽  
History Of ◽  
The Right

Abstract The purpose of this paper is to report a case diagnosed by bedside echocardiography in which bone cement infiltrated into the paravertebral vein system after percutaneous vertebroplasty (PVP) and caused intracardiac cement embolism (ICE). A 79-year-old female patient had suddenly become unconscious 14 hours after PVP. Emergency bedside echocardiogram showed that the patient had a strong echo in the right heart with a small amount of pericardial effusion, suspected of causing cardiogenic shock. Computed tomography (CT) showed high density in the distal branches of both pulmonary arteries and a high density in the right heart.Combined with the history of surgery, the clinician considers the foreign body as bone cement and the diagnosis was ICE. The bone cement in the heart was removed under emergency cardiopulmonary bypass. The patient recovered and was discharged smoothly.

scholarly journals A spear to the heart—the accidental discovery of a giant cement embolism in the right heart: a case report

2021 ◽  
Author(s):  
Moritz Lambers ◽  
Oliver Bruder ◽  
Heinrich Wieneke ◽  
Kai Nassenstein
Keyword(s):  
Case Report ◽  
Diagnostic Tests ◽  
Percutaneous Vertebroplasty ◽  
Pulmonary Arteries ◽  
Exertional Dyspnoea ◽  
Right Heart ◽  
Potential Harm ◽  
Case Summary ◽  
Cement Embolism ◽  
The Right

Abstract Background The incidence of recognized cardiopulmonary cement embolism in the context of percutaneous vertebroplasty varies between 0-23%. In most cases, only small fragments embolize in the pulmonary arteries or the right heart cavities. The latter can cause potential harm by right ventricular perforation. Case summary A 57-year-old patient was admitted to our department of cardiology due to exertional dyspnoea and chest pain. In the course of further diagnostic tests a huge cement embolus was accidentally discovered in the right ventricle. The unusual size and length and the threat of ventricular perforation make this case so unique. Discussion Large cement embolisms in kyphoplasty settings are possible and associated with the risk of fulminant complications.

scholarly journals P686 Right atrial, right ventricular and pulmonary cement embolism: a rare complication of percutaneous vertebroplasty

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
S Akhunova ◽  
R Khayrullin ◽  
N Stekolshchikova ◽  
M Samigullin ◽  
V Padiryakov
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Right Atrium ◽  
Percutaneous Vertebroplasty ◽  
Rare Complication ◽  
Clinical Manifestations ◽  
Stable Condition ◽  
Right Atrial ◽  
Cement Embolism ◽  
The Right

Abstract A 68-year-old man was admitted to the hospital with complaints of pain in the lumbar spine. He had L5 disc herniation, Spinal stenosis of the L5 root canal - S1 on the right in the past medical history. Percutaneous vertebroplasty at the level of L3 and Th8 vertebral bodies was performed six months ago due to painful vertebral hemangioma. The man is suffering from arterial hypertension, receives antihypertensive therapy. During routine transthoracic echocardiography, a hyperechoic structure with a size of 9.5 x 0.9 cm was found in the right atrium and right ventricle. Chest computed tomography with contrast enhancement revealed signs of bone cement in the right atrium and right ventricle, in the right upper lobe artery, in the branches of the upper lobe artery, in the paravertebral venous plexuses. Considering the duration of the disease, the stable condition, the absence of clinical manifestations and disorders of intracardiac hemodynamics, it was decided to refrain from surgical treatment. Antiplatelet therapy and dynamic observation were recommended. Conclusion Percutaneous vertebroplasty is a modern minimally invasive surgical procedure for the treatment of degenerative-dystrophic diseases of the spine. However, the cement can penetrate into the paravertebral veins and migrate to the right chambers of the heart and the pulmonary artery. This clinical case demonstrates asymptomatic cement embolism of the right chambers of the heart and pulmonary artery after percutaneous vertebroplasty, detected incidentally during routine echocardiography. Abstract P686 Figure.

Primary pulmonary angiosarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e244578
Author(s):  
Muhammad Kashif Rana ◽  
Owais Rahman ◽  
Aiden O’Brien
Keyword(s):  
Pulmonary Arteries ◽  
Rare Type ◽  
Pulmonary Artery Sarcoma ◽  
Pulmonary Angiogram ◽  
Primary Pulmonary Artery Sarcoma ◽  
History Of ◽  
Ct Pulmonary Angiogram ◽  
The Right ◽  
Specific Symptoms ◽  
Large Primary

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour with poor prognosis. Diagnosis is often late due to non-specific symptoms and low clinical suspicion for angiosarcoma. A 72-year-old man presented to hospital with a 6-month history of mild progressive dyspnoea, with associated cough, episodes of presyncope and weight loss. CT pulmonary angiogram (CTPA) was reported as a large saddle pulmonary embolism extending into both the right and left pulmonary arteries. Further Multidisciplinary team meeting (MDM) discussion, and review of CTPA and subsequent investigations revealed a large primary pulmonary artery sarcoma which was later confirmed histology. The patient was referred to the cardiothoracic surgeons and underwent left radical pneumonectomy.

Cardiac masses and potential sources of emboli

2016 ◽  
Author(s):  
Nadia Benyounes ◽  
Mauro Pepi ◽  
Roberta Esposito ◽  
Carmen Ginghina ◽  
Ariel Cohen
Keyword(s):  
Imaging Technique ◽  
Pulmonary Arteries ◽  
Clinical Manifestations ◽  
Transoesophageal Echocardiography ◽  
Right Heart ◽  
Postoperative Changes ◽  
The Right ◽  
Ultrasound Artefacts ◽  
Cardiac Masses

Cardiac masses are abnormal structures within or immediately adjacent to the heart. They have to be distinguished from variants of normal cardiac structures, postoperative changes, and ultrasound artefacts. These abnormal masses may be localized in the left or right heart cavities, with different clinical manifestations according to their localization. Among the abnormal cardiac masses (thrombus, vegetations, tumours), tumours are not discussed in this chapter. Echocardiography is the main but not the only imaging technique for the evaluation of cardiac masses, and is largely available. Hence, it is indicated in patients with a systemic embolic event, searching for a cardiac source embolism. When transthoracic echocardiography is negative, transoesophageal echocardiography is indicated, in cryptogenic ischaemic events (no cause found). Right heart masses are mainly responsible for pulmonary embolisms, but may be the cause of a systemic embolus, via the atrial septum. Right heart thrombi rarely form in situ, and are hence more often venous thrombi entrapped in the right heart on their way to the pulmonary arteries. Echocardiography is mandatory in the setting of pulmonary embolism.

scholarly journals Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure

2020 ◽  
Vol 13 (2) ◽  
pp. e232812
Author(s):  
Syed Tausif Ahmed ◽  
Matthew Barvo ◽  
Nayana Kamath ◽  
Richard Alweis
Keyword(s):  
Emergency Department ◽  
Asbestos Exposure ◽  
Anticoagulation Therapy ◽  
Abdominal Distension ◽  
High Density ◽  
Chemotherapy Treatment ◽  
Lower Limb Pain ◽  
History Of ◽  
The Right ◽  
Vague Abdominal Pain

A 75-year-old man presented to the emergency department with 1-day history of right lower limb pain and 3-month history of vague abdominal pain. In the emergency department a thrombus was discovered in the right popliteal artery. CT scan of the abdomen and pelvis revealed high-density material in the pelvis, multiple hypodensities on the liver, ascites with omental nodularity, and high-density material along the stomach wall. He underwent thrombectomy and was started on anticoagulation therapy. The core needle biopsy revealed primary omental mesothelioma. There was no history of any known asbestos exposure. He also had to undergo therapeutic paracentesis twice due to abdominal distension. Mesothelioma treatment of carboplatin and pemetrexed was started, and the patient is currently receiving this chemotherapy treatment regimen.

Orthostatic hypotension and right heart failure as the initial manifestation of intravenous leiomyomatosis

2015 ◽  
Vol 26 (3) ◽  
pp. 586-588 ◽  
Author(s):  
Ya-Qin Li ◽  
Xiao-Ping Yin ◽  
Zhan-Wen Xu
Keyword(s):  
Right Atrium ◽  
Right Heart Failure ◽  
Intravenous Leiomyomatosis ◽  
Right Heart ◽  
Caval Vein ◽  
Initial Manifestation ◽  
Inferior Caval Vein ◽  
Mobile Mass ◽  
History Of ◽  
The Right

AbstractA 36-year-old woman, who had a history of myomectomy, presented with lightheadedness after changing position from sitting to standing and effort-related shortness of breath. Echocardiography demonstrated a hyperechoic elongated mobile mass extending from the inferior caval vein to the right atrium. The mass was surgically removed, and histological examination established the diagnosis of intravenous leiomyomatosis. This case caught the attention of our cardiology group to consider the diagnosis when an inferior caval vein or right atrium mass is found in a patient with a history of uterine leiomyomatosis.

The life history of the rat lung-worm, Angiostrongylus cantonensis (Chen) (Nematoda: Metastrongylidae).

1955 ◽  
Vol 3 (1) ◽  
pp. 1 ◽  
Author(s):  
MJ Mackerras ◽  
DF Sandars
Keyword(s):  
Pulmonary Arteries ◽  
Blood Stream ◽  
The Body ◽  
Angiostrongylus Cantonensis ◽  
Intermediate Hosts ◽  
Anterior Portion ◽  
Third Stage ◽  
History Of ◽  
The Central Nervous System ◽  
The Right

Adult Angiostrongylus cantonensis live in the pulmonary arteries. Unsegmented ova are discharged into the blood stream, and lodge as emboli in the smaller vessels. First-stage larvae break through into the respiratory tract, migrate up the trachea, and eventually pass out of the body in the faeces. Slugs (Agriolimax laevis) act as intermediate hosts. Two moults occur in the slug, and third-stage larvae appear about the 17th day. The larvae remain within the two cast skins until freed in the stomach of the rat by digestion. They then pass quickly along the small intestine as far as the lower ileum, where they leave the gut and become blood-borne. They congregate in the central nervous system, and have been found there 17 hr after ingestion. The anterior portion of the cerebrum is the most favoured site, and here the third moult takes place on the sixth or seventh day and the final one between the 11th and 13th days. Young adults emerge on the surface of the brain from the 12th to 14th day, and spend the next 2 weeks in the subarachnoid space. From the 28th to 31st days they migrate to the lungs via the venous system, passing through the right side of the heart to their definitive site in the pulmonary arteries. The prepatent period in the rat usually lies between 42 and 45 days.

scholarly journals Acute Massive Pulmonary Embolism with Direct Visualization of a Free-floating Right Heart Thrombus Successfully Treated with Fibrinolysis: A Case Report

2020 ◽  
Vol 121 (1) ◽  
pp. 42-48
Author(s):  
Elisavet Kaitalidou ◽  
Dimitrios Karapiperis ◽  
Vasileios Makrakis ◽  
Maria Kipourou ◽  
Dimitrios Petroglou
Keyword(s):  
Pulmonary Embolism ◽  
Hemodynamic Instability ◽  
Massive Pulmonary Embolism ◽  
Right Atrial ◽  
Direct Visualization ◽  
Atrial Thrombus ◽  
Right Heart ◽  
Motor Weakness ◽  
History Of ◽  
The Right

A male patient with a history of immobilization due to motor weakness, was transferred to our emergency department after syncope during physiotherapy, with recorded hypotension. Transthoracic echocardiography showed severe dilatation of the right ventricle (RV), with apex hypercontractility and almost akinetic RV free wall. The above findings, in addition to the unexpected visualization of a large, free-floating, right atrial thrombus, a rare finding associated with high mortality, readily confirmed the clinical suspicion of acute pulmonary embolism (PE) causing circulatory collapse. Intravenous fibrinolysis and vasopressor therapy were successfully administered, and hemodynamic instability was soon alleviated.

scholarly journals Successful surgical treatment of intracardiac bone cement embolism after vertebroplasty of the L2 vertebral body

2020 ◽  
Vol 8 (4S) ◽  
pp. 130-134
Author(s):  
N. I. Zagorodnikov ◽  
I. K. Halivopulo ◽  
A. V. Sotnikov ◽  
E. I. Ardasheva
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Surgical Treatment ◽  
Bone Cement ◽  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Treatment Options ◽  
Cord Injury ◽  
Cement Embolism ◽  
Bone Cement Embolism

Percutaneous Vertebroplasty (PVP) is the minimally invasive radiological procedure consisting in the transdermal injection of bone cement into the damaged vertebral body. PVP performing has a high risk of complications including vascular embolism which has value from 3.5 to 30 %. There is an example of cardioembolism with bone cement as a result of PVP complication after surgical treatment of a patient with a spinal cord injury after ancar accident and the successful extraction of this embolus is given in this clinical case.The authors describe the approaches to this problem, including the diagnosis of the condition and treatment options.

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