Liu XinPei, Chu PeiShan, Miao Qi
Department of Cardiac Surgery, Peking Union Medical College Hospital, Beijing, China.
Front Cardiovasc Med. 2023 Jul 18;10:1221525. doi: 10.3389/fcvm.2023.1221525. eCollection 2023.
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.
骨水泥栓塞是椎体后凸成形术已知的一种并发症。无心脏穿孔或低氧血症等即刻致命并发症的水泥栓塞在观察期间通常较为稳定。我们报告一例大量骨水泥栓塞累及右心室和肺动脉系统的病例。该患者在10年前接受经皮椎体后凸成形术（PKP）后出现轻度劳力性气短和胸痛。然而，她的轻微症状被归因于多发性骨髓瘤，直到6个月前新冠病毒感染后症状加重才进行胸部影像学检查。发现一个大的树枝状栓子，导致右肺动脉升支和中叶分支严重阻塞。肺灌注闪烁显像显示右上叶和中叶灌注受损。进行了心脏直视下栓子清除术，术后症状缓解。我们报告此病例以强调PKP术后常规胸部影像学检查的重要性，并表明心脏直视下清除慢性水泥肺栓塞在技术上是可行且安全的。
