Postoperative bone cement embolism in the right heart after percutaneous vertebroplasty: A case report

Postoperative bone cement embolism in the right heart after percutaneous vertebroplasty: A case reportTo the Editor, A 70-year-old woman presented to the emergency department with sudden-onset chest pain and dyspnea.Initial evaluation revealed no chest wall tenderness, no hypoxemia, and normal electrocardiographic findings and troponin levels.However, bedside transthoracic echocardiography demonstrated a linear echogenic structure within the right heart (Fig. 1A).Subsequent computed tomography more clearly showed a long foreign body in the right cardiac chamber, together with bilateral pleural effusions and pericardial effusion (Fig. 1B).Her medical history confirmed that she had undergone percutaneous vertebroplasty for an L2 vertebral fracture 6 months earlier, without subsequent follow-up.She was diagnosed with cement embolism, which carried a risk of further deterioration; therefore, emergency surgery was performed.Intraoperatively, cement was found retained in the right heart (Fig. 1C).Owing to the abnormal shape of the cement and the uncertain texture with a risk of fragmentation, the heart was carefully dissected, and the cement was removed under cardiopulmonary bypass (Fig. 1D), followed by repair of the right atrial wall.The patient was discharged 1 week after surgery and remained in good recovery at 3-month follow-up.