Catastrophic Bone Cement Implantation Syndrome Treated with Venoarterial Extracorporeal Membrane Oxygenation: A Case Report

Figures

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  Figure 1. Plain radiography with anteroposterior pelvic projection showing a Garden IV left hip fracture with complete displacement (white arrow).

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  Figure 2. TEE midesophageal two-dimensional bicaval (111°) view immediately after cardiac resuscitation. Heterogeneous hyperechoic mobile content inside the right atrium is trapped within the Chiari network and measures 5.8 cm (white double arrow). IVC, Inferior vena cava; LA, left atrium; RA, right atrium; SVC, superior vena cava.

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  Figure 3. TEE midesophageal two-dimensional modified four-chamber (3°) view showing right atrial and ventricular dilatation after cardiac resuscitation. The hyperechoic mass is visible in the right atrium (white arrow). The interatrial septum is shifted toward left atrium due to increase right atrial pressure. LA, Left atrium; LV, left ventricle; RA, right atrium.

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  Figure 4. TEE midesophageal two-dimensional bicaval (102°) view after VA ECMO implantation. The hyperechoic mass (arrow) is trapped around the venous cannula of the VA ECMO (arrowheads). LA, Left atrium; IVC, inferior vena cava; RA, right atrium; SVC, superior vena cava.

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  Figure 5. TEE midesophageal two-dimensional bicaval (115°) view showing regression of the hyperechoic mass (white double arrow) after 5 days of therapeutic anticoagulation and before VA ECMO withdrawal. The mass is still trapped within the Chiari network albeit reduced in size and measuring 2.8 cm. LA, Left atrium; IVC, inferior vena cava; RA, right atrium; SVC, superior vena cava.