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心脏导管插入术期间经皮椎体成形术并发心内水泥栓塞的偶然发现:一例报告。

Incidental detection of an intracardiac cement embolism complicating percutaneous vertebroplasty during cardiac catheterization: A case report.

作者信息

Trongtorsak Angkawipa, Saad Eltaib, Mustafa Abdelrahman, Won Ki Seok, Haery Cameron, Hamblin Michael H, Akbar Muhammad S

机构信息

Department of Internal Medicine, AMITA Health Francis Hospital, Evanston, IL, USA.

Division of Cardiovascular Medicine, Department of Internal Medicine, AMITA Health Saint Francis Hospital, Evanston, IL, USA.

出版信息

J Cardiol Cases. 2022 May 1;26(2):151-153. doi: 10.1016/j.jccase.2022.04.003. eCollection 2022 Aug.

Abstract

UNLABELLED

Percutaneous vertebroplasty has emerged as an increasingly popular intervention for managing a variety of common spinal conditions. Nevertheless, kyphoplasty cement can accidentally leak into paravertebral venous plexus, then travel to the right heart chambers through the venous system. We report an exceedingly rare case of an intracardiac cement embolism, likely an inadvertent complication of a recent percutaneous lumbar vertebroplasty. A mobile mass was incidentally found during a cardiac catheterization procedure, most likely in right atrium. Subsequent computed tomography angio chest and cardiac imaging confirmed a floating foreign body in the right atrium, which was then retrieved successfully through an endovascular approach. Gross examination of the removed body confirmed a bone cement-like material. Intracardiac cement embolism warrants serious attention as it may result in catastrophic cardiac complications.

LEARNING OBJECTIVE

Intracardiac cement embolism is an extremely rare, but potentially life-threatening complication after percutaneous vertebroplasty. The bone cement fragments accidentally leak into paravertebral plexus and then via venous system into the right-sided cardiac chambers and pulmonary arteries.

摘要

未标注

经皮椎体成形术已成为治疗各种常见脊柱疾病越来越常用的一种干预手段。然而,椎体后凸成形术的骨水泥可能会意外漏入椎旁静脉丛,然后通过静脉系统进入右心腔。我们报告了一例极为罕见的心内骨水泥栓塞病例,这可能是近期经皮腰椎椎体成形术的意外并发症。在一次心导管插入术过程中偶然发现了一个活动的肿块,最有可能位于右心房。随后的胸部计算机断层血管造影和心脏成像证实右心房有一个漂浮的异物,随后通过血管内方法成功取出。对取出物体的大体检查证实为骨水泥样物质。心内骨水泥栓塞值得严重关注,因为它可能导致灾难性的心脏并发症。

学习目标

心内骨水泥栓塞是经皮椎体成形术后一种极其罕见但可能危及生命的并发症。骨水泥碎片意外漏入椎旁丛,然后通过静脉系统进入右侧心腔和肺动脉。

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本文引用的文献

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Snare or Scalpel: Challenges of Intracardiac Cement Embolism Retrieval.圈套器还是手术刀:心脏内水泥栓塞取出的挑战。
Ann Thorac Surg. 2022 Feb;113(2):e107-e110. doi: 10.1016/j.athoracsur.2021.04.037. Epub 2021 Apr 27.
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Intracardiac Cement Embolism: Images and Endovascular Treatment.心脏内水泥栓塞:影像学与血管内治疗
Circ Cardiovasc Imaging. 2021 Apr;14(4):e011849. doi: 10.1161/CIRCIMAGING.120.011849. Epub 2021 Apr 8.

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