scholarly journals Thorned heart. Description of a near-fatal cardiac embolism after percutaneous Vertebroplasty

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Federica Pigna ◽  
Simone Calamai ◽  
Francesco Scioscioli ◽  
Lorenzo Buttarelli ◽  
Francesco Nicolini ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Rare Case ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Large Fragment ◽  
Common Complication ◽  
Fatal Complication ◽  
Cement Embolism ◽  
The Right ◽  
Cement Extravasation

Cement extravasation is a rather common complication of vertebroplasty, which can be observed in up to 30-40% of patients undergoing this procedure, further associated with venous leakage occurring in up to 24% of cases. Pulmonary embolism may eventually develop once the cement migrates within the pulmonary artery, and is the most common complication of cement extravasation (involving ~4.6% of patients). Intra-cardiac cement embolism is considerably less frequent, but is a potentially fatal complication, mostly managed with cardiac surgery. We describe here a rare case of near-fatal cardiac cement embolism, with a large fragment perforating the right ventricle and reaching the pericardium, who presented to the Emergency Department (ED) for syncope. The patient, who displayed this severe complication after a vertebroplasty procedure performed for osteoporotic compression fracture, needed cardiac surgery.

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.

scholarly journals Glue masquerading as a catheter: Retrieval of embolized vertebroplasty cement

2018 ◽  
Vol 5 (3) ◽  
pp. 14
Author(s):  
Meena Rohini Narayanan ◽  
Ray Matthews
Keyword(s):  
Foreign Body ◽  
Percutaneous Vertebroplasty ◽  
Cement Leakage ◽  
Optimal Management ◽  
Common Complication ◽  
Imaging Characteristics ◽  
Cement Embolism ◽  
Endovascular Approach

Identification of foreign body objects may be difficult based on imaging characteristics. History is essential to making a diagnosis. Cement leakage is a common complication of percutaneous vertebroplasty and the optimal management for cement embolism remains unknown. This report presents a case of a 72-year-old female with asymptomatic pulmonary cement embolism, which was partially retrieved via a percutaneous endovascular approach.

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 Paediatric Nonfunctioning Adrenocortical Carcinoma with Extension up to Right-Side Heart: Cardiac Surgery Approach

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Federica Iezzi ◽  
Andrea Quarti ◽  
Chiara Surace ◽  
Marco Pozzi
Keyword(s):  
Cardiac Surgery ◽  
Adrenal Gland ◽  
Adjuvant Treatment ◽  
Adrenocortical Carcinoma ◽  
Rare Case ◽  
Cardiac Involvement ◽  
Adrenal Carcinoma ◽  
Rare Malignancy ◽  
The Right ◽  
Treatment Prognosis

Adrenocortical carcinoma is a rare malignancy. Due to late diagnosis and no adequate effective adjuvant treatment, prognosis remains poor. Only approximately 30% of these malignancies are confined to the adrenal gland when they are diagnosed, as these tumors tend to be found years after their genesis. Cardiac involvement of adrenal carcinoma is very rare. We report a rare case of a 7-year-old female with right adrenal cortical carcinoma, involving the right-side heart.

scholarly journals Paraplegia complicating percutaneous vertebroplasty for osteoporotic vertebral fracture: case report

2004 ◽  
Vol 62 (3b) ◽  
pp. 879-881 ◽  
Author(s):  
Nilo M. Lopes ◽  
Vinicius K. Lopes
Keyword(s):  
Spinal Cord ◽  
High Speed ◽  
Surgical Intervention ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Cord Compression ◽  
Intercostal Nerve ◽  
Sudden Onset ◽  
Light Touch ◽  
The Right

We report a case of spinal cord and root compression during percutaneous transpedicular polymethylmethacrylate vertebroplasty (PTPV) for a compression fracture due to osteoporosis. Sudden onset of excruciating pain in the distribution of the right sixth intercostal nerve with hyperemia along its path, prompted the interruption of the procedure. Under narcotic sedation the patient was taken to the ICU and 10mg of dexamethasone was administered intravenously. Few hours later she developed paraplegia with preservation of light touch and a CT scan and MRI showed epidural extravasation of polymethylmethacrylate with spinal cord and root compression. Surgical decompression was followed by neurological recovery. The cement could be removed after been thinned out by high speed drill, with microsurgical technique, through a wide three level laminectomy of D5 to D7. Extravasation of cement is commonly encountered in PTPV and most of the time it is asymptomatic. Root compression may require surgical intervention if nonresponsive to steroid treatment. Cord compression is less often seen and requires emergency surgery. The cement does not adhere to the duramater and it can be removed easily.

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 Intracardiac and Pulmonary Cement Embolism after Percutaneous Vertebroplasty

Kardiologiia ◽  
2019 ◽  
Vol 59 (4) ◽  
pp. 92-96
Author(s):  
M. N. Alekhin ◽  
A. V. Ter-Akopian ◽  
A. S. Abramov ◽  
A. V. Skripnikova
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Percutaneous Vertebroplasty ◽  
Stable Condition ◽  
Left Pulmonary Artery ◽  
Blood Oxygen Saturation ◽  
Comprehensive Examination ◽  
Cement Embolism ◽  
The Right ◽  
Ray Methods

The article presents a clinical case of embolism with bone cement of the right ventricle of the heart and pulmonary artery after percutaneous vertebroplasty in a patient aged 63 years. According to the results of a comprehensive examination using ultrasound and x-ray methods, three foreign bodies were found: in the right ventricle cavity, in the trunk of the pulmonary artery, in the branches of the left pulmonary artery. Considering the stable condition, normal blood oxygen saturation, the lack of influence of formations on intracardiac hemodynamics, it was decided to refrain from surgery, since the risk of intervention exceeded the possible benefit. Conservative treatment tactics and dynamic observation were chosen. The literature data on the frequency of such events and tactics of management of these patients are presented.

Percutaneous Vertebroplasty in Osteoporotic Vertebral Body Compression Fracture

2001 ◽  
Vol 44 (2) ◽  
pp. 145 ◽  
Author(s):  
Hyuk Jung Kim ◽  
Seon Kyu Lee ◽  
Hee Young Hwang ◽  
Hyung Sik Kim ◽  
Joon Seok Ko ◽  
...  
Keyword(s):  
Vertebral Body ◽  
Percutaneous Vertebroplasty ◽  
Compression Fracture ◽  
Vertebral Body Compression Fracture

CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE

2019 ◽  
Vol 1 (4) ◽  
Author(s):  
Yustinus Robby Budiman Gondowardojo ◽  
Tjokorda Gde Bagus Mahadewa
Keyword(s):  
Spinal Cord ◽  
Left Lung ◽  
Lumbar Vertebrae ◽  
Compression Fracture ◽  
High Mobility ◽  
Early Mobilization ◽  
Cord Injury ◽  
Cardiothoracic Surgeon ◽  
The Right

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.

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