Liu Renlang, Wang Zhirong, Zhang Zhiwei, You Hong, Ai Qi, Jin Wancun, Wu Qin
Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Middle Renmin Road 139, Changsha, 410011, China.
J Cardiothorac Surg. 2025 Apr 2;20(1):174. doi: 10.1186/s13019-025-03403-z.
Percutaneous vertebroplasty is commonly used to treats vertebral fractures, tumors, and osteolytic vertebral metastases. However, cement leakage during the procedure can lead to severe complications, including cardiac perforation. This report presents a case of right atrial perforation and pulmonary embolism caused by cement leakage, emphasizing the clinical significance of these events and discussing the treatment strategy.
A 57-year-old female was admitted to the hospital with a slipped lumbar vertebra and back pain, for which she underwent percutaneous vertebroplasty. On the 10th postoperative day, the patient suddenly developed chest tightness and shortness of breath, accompanied by a gradual decline in hemoglobin levels. After several imaging studies, a diagnosis of right atrial perforation caused by bone cement was confirmed. The patient subsequently underwent open cardiac foreign body removal and made a full recovery, with no residual cardiac dysfunction.
This case highlights the rare but serious complication of right atrial perforation caused by bone cement leakage during percutaneous vertebroplasty. The report emphasizes the importance of early identification of bone cement-related complications. While conservative management may suffice for pulmonary embolism, urgent surgical treatment is required for cardiac cement embolism to prevent further complications.
经皮椎体成形术常用于治疗椎体骨折、肿瘤和溶骨性椎体转移瘤。然而，手术过程中骨水泥渗漏可导致严重并发症，包括心脏穿孔。本报告介绍了一例因骨水泥渗漏导致右心房穿孔和肺栓塞的病例，强调了这些事件的临床意义并讨论了治疗策略。
一名57岁女性因腰椎滑脱和背痛入院，接受了经皮椎体成形术。术后第10天，患者突然出现胸闷、气短，同时血红蛋白水平逐渐下降。经过多项影像学检查，确诊为骨水泥导致的右心房穿孔。患者随后接受了心脏异物取出术，完全康复，无残留心脏功能障碍。
本病例突出了经皮椎体成形术期间骨水泥渗漏导致右心房穿孔这一罕见但严重的并发症。该报告强调了早期识别骨水泥相关并发症的重要性。虽然肺栓塞的保守治疗可能足够，但心脏骨水泥栓塞需要紧急手术治疗以防止进一步并发症。
