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心脏内水泥栓塞导致三尖瓣反流。

Intracardiac cement embolism resulting in tricuspid regurgitation.

机构信息

Department of Cardiothoracic Surgery, Radboud University Medical Center, Nijmegen, Netherlands.

出版信息

Eur J Cardiothorac Surg. 2019 Feb 1;55(2):366-368. doi: 10.1093/ejcts/ezy233.

Abstract

Bone cement leakage is a common complication after percutaneous kyphoplasty. In rare cases, leakage into the venous system occurs, which can be life-threatening, especially when it embolizes the heart. Here, we present a case of cement embolization of the right ventricle with tricuspid valve involvement. A 69-year-old woman with an asymptomatic severe tricuspid valve regurgitation was referred to our department. She had a history of balloon kyphoplasty because of osteoporotic collapsed vertebrae in 2010. Echocardiography showed a foreign body attached to the right ventricle, prolapsing into the right atrium and causing a severe tricuspid valve regurgitation. The foreign body was surgically removed, and the tricuspid valve was replaced with a biological valve. The foreign body was analysed by scanning electron microscopy and element analysis. Zirconium was identified within the foreign body, which is an additive in bone cement used in orthopaedic surgery. Intracardiac cement embolism following percutaneous kyphoplasty is a rare but life-threatening complication. Here, we present a case of tricuspid valve destruction caused by the long-term presence of an intracardiac foreign body, specifically a cement embolus.

摘要

骨水泥渗漏是经皮椎体后凸成形术后的一种常见并发症。在极少数情况下,会发生渗漏到静脉系统的情况,这可能是致命的,特别是当它栓塞心脏时。在这里,我们报告一例涉及三尖瓣的右心室水泥栓塞病例。一名 69 岁的女性因骨质疏松性塌陷椎体于 2010 年接受球囊后凸成形术,无明显症状的严重三尖瓣反流被转至我们科室。超声心动图显示附着在右心室的异物,突入右心房并导致严重的三尖瓣反流。异物通过手术取出,三尖瓣被生物瓣置换。通过扫描电子显微镜和元素分析对异物进行了分析。异物中鉴定出锆,这是骨科手术中使用的骨水泥的一种添加剂。经皮椎体后凸成形术后心脏内水泥栓塞是一种罕见但危及生命的并发症。在这里,我们报告一例由心脏内异物(具体为水泥栓子)长期存在引起的三尖瓣破坏病例。

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