Bone cement embolism into the right heart.
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ABSTRACT:
SUBMITTER: Yang KJ
PROVIDER: S-EPMC9735423 | biostudies-literature | 2022 Dec
REPOSITORIES: biostudies-literature
Publications
Bone cement embolism into the right heart.
Yang Kelvin Jeason KJ Lee Yi-Ping YP Huang Chi-Hsiang CH Wang Chih-Hsien CH
JTCVS techniques 20221005
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Project description:BackgroundBone cement embolism is one of major complications of percutaneous kyphoplasty. Although rare, the intracardiac cement embolism is potentially life-threatening, with a documented incidence of 3.9%, and it is even more infrequent if symptomatic (0.3%).Case presentationHerein, we reported an extremely rare case of intracardiac bone cement embolism after percutaneous kyphoplasty causing right ventricle perforation. A 70-year-old woman, experiencing sudden left chest pain with radiation to the shoulder for 9 h, was transferred to our emergency department. Two hours before onset of her symptoms, she underwent percutaneous kyphoplasty at the local hospital. The computed tomography angiography revealed that an intracardiac foreign body penetrated her right ventricle. In light of her surgical history, bone cement embolism was suspected and thus, the patient was transferred to our center. Computed tomography and echocardiography confirmed the presence of intracardiac linear-shaped foreign body perforating the right ventricle. Therefore, the patient underwent open-heart surgery and the bone cement was removed successfully.ConclusionsSymptomatic intracardiac bone cement embolism is potentially fatal, so the rapid diagnosis and prompt treatment measures based on the cement emboli characteristics and the patient's condition are crucial.
| S-EPMC11829393 | biostudies-literature
Project description:Time and dose related expression profiles of rat right heart tissue in microsphere bead model for Pulmonary embolism Keywords: Time course and dose response in experimental PE
2008-07-01 | GSE6104 | GEO
Project description:BackgroundThe incidence of recognized cardiopulmonary cement embolism in the context of percutaneous vertebroplasty varies between 0% and 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 summaryA 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.DiscussionLarge cement embolisms in kyphoplasty settings are possible and associated with the risk of fulminant complications.
| S-EPMC8633739 | biostudies-literature
Project description:Time and dose related expression profiles of rat right heart tissue in microsphere bead model for Pulmonary embolism Experiment Overall Design: Rat right tissues of the Vehicle(no beads- control), low dose and high dose from rat bead model for Pulmonary Embolism were collected after 2, 6 and 18 hour time points. The extracted RNA was hybridized to Affymetrix Rat 230-2.0 microarrays to look for the dose and/or time related transcriptional changes associated with experimental Pulmonary Embolism.
2008-10-18 | E-GEOD-6104 | biostudies-arrayexpress
Project description:Bone cement embolism is a known complication after a kyphoplasty operation. Cement embolisms without immediate fatal complication such as cardiac perforation or hypoxemia were often stable during observation. We report a case of a large volume bone cement embolism involving the right ventricle and the pulmonary artery system. The patient developed mild exertional shortness of breath and chest pain after a percutaneous kyphoplasty (PKP) operation 10 years ago. However, her mild symptoms were attributed to multiple myeloma, and no chest imaging was taken until the symptoms exacerbated after a COVID-19 infection 6 months ago. A large, tree-branch-shaped embolus was found, causing severe obstruction of the ascending and middle-lobe branch of the right pulmonary artery. The pulmonary perfusion scintigraphy demonstrated an impaired perfusion of the right upper and middle lobe. An open-heart removal was performed, and the symptoms were relieved afterward. We report this case to highlight the importance of routine chest imaging after a PKP operation and to claim that open-heart removal for chronic cement pulmonary embolism is technically feasible and safe.
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Project description: Not available
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Project description:Percutaneous vertebroplasty procedure is of major importance, given the significantly increasing aging population and the higher number of orthopedic procedures related to vertebral compression fractures. Vertebroplasty is a complex technique involving the injection of polymethylmethacrylate (PMMA) into the compressed vertebral body for mechanical stabilization of the fracture. Our understanding and ability to modify these mechanisms through alterations in cement material is rapidly evolving. However, the rate of cardiac complications secondary to PMMA injection and subsequent cement leakage has increased with time. The following review considers the main effects of PMMA bone cement on the heart, and the extent of influence of the materials on cardiac embolism. Clinically, cement leakage results in life-threatening cardiac injury. The convolution of this outcome through an appropriate balance of complex material properties is highlighted via clinical case reports.
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Project description:Bone cement implantation syndrome (BCIS) is a known complication in patients undergoing cemented orthopedic surgeries; however, the etiology and pathophysiology of BCIS are not fully understood. We report the case of a patient who developed pulseless electrical activity (PEA) due to BCIS after cemented femoral head replacement. Transesophageal echocardiography (TEE) during PEA revealed a massive embolus extending from the main pulmonary artery to the inferior vena cava. Of note, this embolus disappeared completely and rapidly after return of spontaneous circulation. TEE proved to be useful in the diagnosis and management of this case of PEA.
| S-EPMC6967219 | biostudies-literature
Project description:We report a case of anterior loculated pericardial effusion misinterpreted on point-of-care ultrasound as a dilated right ventricle, and suggesting diagnosis of pulmonary embolism (PE), in a patient with renal failure. The compressed right ventricle from tamponade physiology appeared to be a thickened intraventricular septum. Heparin was given empirically for presumed PE. Later the same day, computed tomography of the chest showed the effusion, as did formal echocardiogram. The patient had drainage of 630 milliliters of fluid and recovered from tamponade. Loculated effusions comprise 15% of all pericardial effusions, and misdiagnosis of PE with heparin therapy could be fatal.
| S-EPMC6497205 | biostudies-literature
Project description:Right heart thrombus (RHT) is a rare but life-threatening condition in acute pulmonary embolism (APE) without clear management guidelines. This study aimed to address the clinical characteristics and outcomes of RHT-APE in Chinese patients. In this study, 17 RHT-APE and 329 non-RHT-APE patients, who were diagnosed between September 2015 and August 2019, were retrospectively recruited with the median follow-up was 360 days. The overall prevalence of RHT was 4.91% in APE. Its prevalence increased along the increase of APE risk stratifications. Comparisons showed that with higher proportion of male gender and younger age, RHT-APE patients also had worse hemodynamic instability and heart function, and higher risk stratification levels than non-RHT-APE patients. After adjusting by age and gender, multivariate logistic regression analysis found high/intermediate-high risk stratification, decreased right ventricular (RV) motion, NT-proBNP >600 pg/mL, and RV dysfunction were risk factors for RHT. Kaplan-Meier analysis showed non-RHT had better prognosis than RHT patients (30-day survival: log-rank: p < 0.001; 90-day survival: log-rank: p = 0.002). The multivariate logistic regression analysis showed RHT was an independent risk factor for 30-day mortality in APE. The subgroup analysis showed RHT would result in worse outcomes in patients who already had higher APE early mortality risk. RHT would increase the risk of 30- and 90-day mortality in APE. More attention should be paid to young male APE patients with decreased RV motion, NT-proBNP >600 pg/mL, RV dysfunction, or high level of risk stratification, to exclude the coexistence of RHT.
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